THE 
FAMILY PHYSICIAN; 
OR, THE 
REFORMED SYSTEM OF MEDICINE: 
ON VEGETABLE OR BOTANICAL PRINCIPLES 
BEING A COMPENDIUM OF THE "AMERICAN PRACTICE? 
DESIGNED FOR ALL CLASSES. 
IN NINE PARTS. 
PART I.-THE MEANS OF PREVENTING DISEASE, AND PROMOTING HEALTH. PART IL- 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE OF MEDICINE, AND INDICATIONS OF 
CURE. PART III. INTERNAL DISEASES. PART IV. SURGICAL DISEASES. PARTV.- 
MIDWIFERY. PART VI. VEGETABLE MATERIA MEDICA. PART VII. PHARMACY AND 
DISPENSATORY ; OR COxMPOUNDS. PART VIII. DIET FOR THE HEALTHY AND THE SICK. 
PART IX. OUTLINES OF ANATOMY AND PH VSIOLOGY, WITH ILLUSTRATIONS. APPENDIX. 
THIS WORK EMBRACES THE 
CHARACTER, CAUSES, SYMPTOMS, AND TREATMENT 
OF THE 
DISEASES OF MEN, WOMEN, AND CHILDREN 
OF ALL CLIMATES 
By W. BEACH, M.D., 
Member of the Medical Society of the city and county of New York ; Author of the " American Practice' 
of Medicine" in three volumes; Corresponding Member of the Royal College of Physicians and Surgeons 
ofBerlin, Prussia;ofthe Medical and Physiological Society of Wetterau,Germany; of Leipsic, Saxony 
the Medical Society of Bamberg, Bavaria; of the Natural Society of Friesburg, Dukedom of Baden, See. 
These doctrines have guided my practice many years, and experience has taught me not to distrust 
their truth, safety, and value. 
" Every one may now be his own doctor and surgeon at a cheap rate, and enjoy a sound mind in a sound 
tody." 
COMPLETE IN ONE VOLUME. 
ILLUSTRATED WITH NEARLY TWO HUNDRED.ENGRAVINGS. 
SIXTH EDITION. 
NEW YORK: 
PUBLISHED AND FOR SALE BY THE AUTHOR, 239 BOWERY, 
1 845. Snbncd, io , in -near 
WOOSTBK BBAOH, M.D., tn t/ie 
Qicoiuci tybezu- 
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competent jurisdiction thereof. 
STEREOTYPED BY VINCENT L. DILL, 
No. 128 Fulton Street, New-York. " GOLDEN OPINIONS." 
I was a dogmatic at twenty, an observer at thirty, an empiric at forty, and now, at fifty, I no longer have 
any system.-S. Bordeu. 
The art of medicine is founded on experience.-Edinburgh Medical and Surgical Journal. 
How egregiously do the greatest men err whenever they lose sight of facts, or substitute sallies of wit 
or specious arguments in physic, for observation and experience.-Buchan. 
If an opinion be erroneous, it requires discussion, that its errors may be exposed. If it be true, it will 
gain adherents in proportion as it is examined.-Dr. Cooper. 
Let truth and falsehood grapple. Who ever knew truth put to the worse in a free and open encoun- 
ter ?-Milton. 
If employment of the lancet were abolished altogether, it would, perhaps, save annually a greater num- 
ber of lives than in any one year the sword has ever destroyed.-Dr. Ring. 
The man who wantonly wields the bloody knife for the sake of experience or a vain display of his 
adroitness, is a human savage, in whose breast soft pity never dwelt.-Dr. Cumming. 
Abominable is the murdering quack, who, for ever impatient to unsheath his blood-thirsty lancet, 
draws from a fever patient the irreparable balsam of life.-Dr. Hunn. 
1 am neither for the ancients nor for the moderns, but shall be of every age and nation.-Baglivi. 
Let us study the character of diseases, and let us study the effects of the loss of blood.-Halt. 
It sometimes requires no little boldness to abstain from the loss of blood.-Ibid. 
We have not in any instance yielded our assent to authority, however high, when it has been contra- 
dicted by our own experience.-Dewees. 
It is owing to our ignorance that there is any necessity for instruments to cure disease.-Abernethy. 
If the Reformed System be a good one, let it flourish and progress. If it be a bad one, let it be frowned 
down by the just censure of an enlightened community.-Banner. 
Both surgery and medicine can and will, in the present astonis' ing strides of human intellect, be 
forced to pass a rigid scrutiny, and undergo a radical improvement.-Smead. 
" Minerals exert a pernicious and baneful influence on the system ; they seldom or never cure, but often 
destroy the patient. Their operation is altogether uncertain, depending entirely on the state of the 
stomach whether they act at all, or prove injurious." 
Among the numerous poisons which have been used for the cure or alleviation of diseases, there are 
few which possess more active, and, of course, more dangerous, powers than mercury.-Hamilton. 
" Mercury, the lancet, and the knife are now almost the only means made use of to cure disease, not- 
withstanding their deleterious effects are evidently fatal td multitudes." 
The popular belief, that every country produces simples suitable to cure all the prevailing local diseases, 
is not void of truth ; vegetable substances afford the mildest, most efficient, and most congenial remedies 
to the human frame. The numerous cures that are daily performed by the use of vegetable medicines, 
are sufficient evidence of their super-excellent virtues.-Prof. Rafinesque. 
The Flora of North America is astonishingly rich in remedies. There is no doubt in my mind that, in 
more diseases than is generally acknowledged, vegetable simples are the preferable remedies. Who 
knows but in time these native productions of the field and forest will so enlarge and confirm their 
dominion, as to supersede the employment of other medicines.-Prof. Waterhouse. 
To yield to any authority would here be criminal. Facts must and will stand.-Dr. Underwood. 
It would be highly advantageous to the public, and likewise to the best part of the medical profession, 
if the predispositions and occasions of disease were made a portion of the education of every gentleman.- 
Dr. Armstrong. 
Every physician must resfcn his own judgment, w'hich appeals for its rectitude to nature and experience 
alone.- Gregory. 9 
An obstinate adherence to an unsuccessful method of treating a disease is self-conceit; it generally 
proceeds from ignorance ; it is a species of pride to which the lives of thousands have been sacrificed.-Ibid. 
I am here insensibly led to make an apology for the instability of the theories and practice of physic. 
And those physicians generally become the most eminent who have the soonest emancipated themselves 
from the tyranny of the schools of physic.-Late Author. 
Our want of success is occasioned by the following causes : 1st, our ignorance of the disease ; 2d, our 
ignorance of a suitable remedy ; 3d, want of efficacy in the remedy.-Ibid. 
If truth does anywhere manifest itself, seek not to smother it with glossing delusion ; acknowledge the 
greatness thereof, and esteem it thy best victory when the same doth prevail over thee.-Hooker. 
The whole nation is groaning under the present practice of the medical profession, which fosters dis 
ease more than cures it, and debases or ruins our constitutions.-Morison. 
Physicians have been tinkering the constitution for about two thousand years, to cure diseases ; and the 
result of all their discoveries is, that brimstone and mercury are the only two specifics. Diseases remain 
what they ever were.-Lacon. 
All men ought to be acquainted with the medical art. I believe that knowledge of medicine is the sister 
and companion of wisdom.-Hippocrates. 
In early times skill in healing was esteemed a part of wisdom. I believe the practice of medicine should 
be agreeable to reason.- Celsus. 
As health is the most precious of all things, and is the foundation of all happiness, the science of pro 
tecting life and health is the noblest of all, and most worthy the attention of all mankind.-Hoffman. 
" Not only a reformation in medicine is necessary, but a revolution." 
" Oh, that men would stoop to learn, or at least cease to destroy."-Stokes's Practice. 
Dr. McNair, of Philadelphia, a physician of the old school, makes the following candid confession : " I 
have employed," says he, " the treatment recommended in the books, and used indiscriminately by medi 
cal men during the last forty years, and found them altogether useless, not only in my hands, but also in 
the hands of others, some of whom stand at the head of the science.-Medical Suggestions, p. 168. 
The whole art of healing may be comprised in three adverbs or words, viz.: what 1 how ? and whew 1 
In other language, what, agent to prescribe 1 how and when to administer it 1 INTRODUCTION. 
In laying this volume before the public, I deem it necessary to offer some prelimi- 
nary remarks. 
My large work, the American Practice of Medicine, being so nearly exhausted, 
I have found it necessary to issue another edition ; and, in order to place it within the 
reach of all classes, I have concluded to publish it in the form of a compendium, 
which, I trust, is better calculated to diffuse the principles of the practice. It contains 
all the practical part of the large work, besides various additions, and my latest im- 
provements and experience in the treatment of diseases; and I hope it will not disap- 
point the expectations of the friends of reform. 
It appears to me there never was a period in which a correct system of medical and 
surgical practice was more imperiously demanded, than the present; for the science of 
medicine is, at present, a perfect chaos. There are so many theories, so many modes 
of treating disease, such discordant sentiments entertained, both by physicians and the 
community at large, on the subject of medicine, that duty requires every exertion to be 
made to rescue the healing art from the intricacy and maze in which it has unfortu- 
nately become involved, and to exhibit it in its own native beauty and simplicity. 
The farther accomplishment of this object is the design of the present undertaking. 
My primary object, in my labours in the field of medical reform, is now, and has 
ever been, to clear away the rubbish of former, as well as of present, medical theories; 
and amid their wreck to collect whatever materials might be found, from all proper 
sources, for the construction of a new edifice, resting on a broader and more durable 
foundation. 
To insure success in this undertaking, the first step is, to enlighten the public mind 
on this interesting and important topic; for, as long as blindness, ignorance, and pre- 
judice exist, no reform can be effected: they are like the noxious exhalations of the 
deadly upas, infusing poison through the whole circle of their influence. 
The present period may be emphatically denominated an age of investigation and 
improvement; and, when truth is plainly presented to the honest mind, it seldom fails 
of receiving a cordial welcome. In the arts and sciences in general, greater researches 
and discoveries have been made than at any former period. In respect to steamboats, 
railroads, education, and various other matters, the human mind has achieved wonders, 
and given ample proof of its divine origin. Unfortunately, however, for suffering hu- 
manity, the healing art, among those who are regarded as the most learned and skill- 
ful, has, instead of advancing, greatly retrograded, and now constitutes a most lamen- 
table contrast to the progress made in other departments. But when we turn our eyes 
to the reformed medical school, we are greeted with the most cheering prospects. Mere, 
comparatively, in a short space of time, principles have been developed, and improve- 
ments made, which have kept pace with those in other branches of art and science. 
The old building, with its rubbish, has been torn down and cleared away, and an edifice 
erected, which, if not finished, is rapidly progressing, and requires but a few more 
efforts to complete it. We may, therefore, say with the great political reformer, Thomas 
Jefferson-" We are in the full tide of successful experiment." 
For the benefit of those who still remain ignorant of the present state of medicine 
and surgery, I will very briefly advert to its history from its commencement to the 
present day; and, 
First-THE ANCIENT PRACTICE OF MEDICINE. 
We may divide ancient practitioners into three principal classes: the empiric, 
the galenic or botanic, and the chemical. VI 
INTRODUCTION. 
First-THE EMPIRIC. 
By adverting to the history of the primitive ages of the world, we find that medicine 
and astronomy were the first sciences attempted to be cultivated by man. Medicine 
appears to have been at first "little else than a collection of absurd superstitions." 
" The human mind, influenced by superstition and untaught by experience," associated 
the idea of religion with medicine; and, consequently, resort was had " to charms 
and incantations," in full confidence of preventing and curing every malady. Hence, 
during the early part of the history of our species, " ignorant priests, magicians, and 
astrologers were their only physicians." Fatal experience, how'ever, soon taught the 
sufferers that " a cure of their maladies was to be effected by more potent remedies 
than those of sorcery and enchantment. In process of time, therefore, an expedient, 
suited to their circumstances, was put in practice for the attainment of medical know- 
ledge. The sick were directed to be exposed in public places to the view of travellers 
and strangers, who were required to examine and compare their cases with such as 
might antecedently have fallen under their observation, and to recommend such reme- 
dies as had been known to produce beneficial effects in similar complaints. And, when 
discoveries were thus made, the precious remedies were held in veneration, and the 
knowledge of them was conveyed by oral tradition, or recorded upon pillars in the 
most public places, or on the walls of the temples dedicated to the god of health ; and 
afterward registers of cures were kept in those consecrated places, for the general 
good of mankind," zEsculapius is the first person on record who collected together 
all the known remedies then in use: he founded a temple, in which they were sus- 
pended for the use of the diseased. It is said that he particularized the virtues of each 
plant, and placed a label under them for the use of such as sought relief at the temple, 
which was resorted to from great distances. This was the commencement of the 
healing art in a systematic form. 
Second-THE GALENIC. 
In the first year of the eighteenth Olympiad, Hippocrates was born, who effected a 
wonderful revolution in the practice of medicine, and reduced it to a science : his au- 
thority continued to be regarded more than two thousand years with implicit venera- 
tion. He was a man of pre-eminent genius, and the earliest medical theorist of any 
merit whose name has been transmitted to posterity. As a physician, he seems to have 
been more of a speculative observer, than strictly practical. A distinguished seat of 
medical learning, many years after the death of Hippocrates, was established at Alexan- 
dria, in which a schism arose, dividing the medical world into two rival sects, called 
dogmatists and empirics. The former advocated theory, the latter experience, in the 
treatment of diseases. 
In the year 131 of the Christian era, Galen, a remarkable genius, was born in Asia 
Minor. He was instructed in all the learning and philosophy of the age, and obtained 
a popularity which surpassed that of all others: he deviated from the beaten path, 
rejected the popular systems, and selected what he deemed best from other sects. So 
great was the persecution raised against him by the popular physicians, that he left 
Rome: he was, however, soon recalled by the emperor, who had so high an opinion 
of his medical skill, that he placed two of his sick sons under his charge, in whose 
cases Galen, contrary to the opinion of the other physicians, predicted a favourable 
result, which prediction was fulfilled. This rendered him so eminent, that opposition 
was thenceforward unavailing. For fourteen centuries his system remained in the 
ascendant. His practice was the vegetable, though he resorted to depletion or blood- 
letting. 
Third-THE CHEMICAL. 
In the year 1493, in Switzerland, arose Theophrastus Bombastus Paracelsus, the 
great prototype of all succeeding quacks. It was he who first introduced quicksilver 
or mercury as a medicine; and all who thus administered it were denominated 
" quacks," in allusion to the name quacksalver, given to this metal by the Germans. 
This individual succeeded in overthrowing the Galenic system, which had stood the 
test of fourteen hundred years; and in its place he introduced the mineral or chemical INTRODUCTION. 
VII 
system He burnt the works of Galen before the audience to whom he lectured. He 
at length became intolerably vain-glorious, boasting that there was more knowledge in 
his beard than in the whole of Galen. He was likewise shockingly impious, declaring 
that, if God would not impart to man the secrets of medicine, it was right to consult the 
devil. He professed to have discovered the elixir of life, which would prolong our 
mortal existence to any extent. He died a miserable vagabond, at the age of forty- 
eight. 
Such, then, was the personage to whom we are indebted for the introduction of the 
mineral practice, which has continued to the present day, entailing misery on the human 
family to an amount beyond all computation. 
The introduction of mineral agents into medical practice caused great excitement. 
The regular physicians of that day, the Galenic or Botanic, (now irregular,) contended 
with much zeal against minerals; while, on the other hand, the chemical practitioners, 
or quacks, inveighed against Botanies, as being weak and inefficient. The whole 
medical world was thus kept in commotion for 200 years. Both sides assailed each 
other with the most opprobrious epithets; and the contest has continued to the present 
day. 
" Since the days of Paracelsus the great mass of physicians have placed their chief 
reliance upon the lancet, the knife, and a few acrid and poisonous minerals, appearing, 
in the selection of their remedies, as if totally regardless of secondary consequences, 
and aiming only at present effects; thus seeming to leave entirely out of consideration 
the future health and condition of their patients. This circumstance has tended power- 
fully to retard the progress of medical science; and herein we believe that medical 
reform is particularly called for." 
We may sum up the whole history of medicine, from the earliest to the present 
period, in the language of that great and good man, John Wesley. 
Extract from the writings of John Wesley. 
The healing art was first brought into use in a very natural and simple manner. In 
the earliest age of the world mankind, by various experiments or accidents, discovered 
that certain plants, roots, and barks possessed medicinal properties. These -were found 
sufficient to remove their diseases. The application of these remedies was plain and 
easy; but in process of time many began to make a profession of medicine, and to 
strip it of its simplicity; they began to inquire into the operation of such remedies, why 
and how they performed such cures; they examined the human frame, and all its 
parts; the nature of the flesh, arteries, nerves; the structure of the brain, heart, lungs, 
stomach, bowels, &c., with the springs of the several animal functions. They explored 
the several kinds of animal and mineral, as well as vegetable, substances. And hence 
the whole order of physic was subverted, and founded upon hypothesis; they formed 
theories of diseases and their cures, and substituted these in place of experiments. 
As theories increased, simple medicines were more and more disregarded and disused; 
till in a course of years the greater part of them were forgotten, at least in the more 
polite nations. In the room of these, abundance of new ones were introduced, by 
reasoning, speculative men ; and those more and more difficult to be applied, as being 
more remote from common observation. Hence rules for the application of these, and 
medical books, were immensely multiplied; till at length physic became an abstruse 
science, quite out of the reach of ordinary men. Physicians now began to be held in 
admiration, as persons who were something more than human: and profit attended 
their employ, as well as honour; so that they had now two weighty reasons for 
keeping the bulk of mankind at a distance, that they might not pry into the mysteries 
of their profession. To this end they increased those difficulties by design, which were 
first, in a manner, by accident. They filled their writings with abundance of technical 
terms, utterly unintelligible to plain men. They affected to deliver their rules, and to 
reason upon them, m an abstruse and philosophical manner. They represented the 
critical knowledge of anatomy, natural philosophy, and what not, (some of them 
insisting on that of astronomy, and astrology too,) as necessary previous to the under- 
standing of the art of healing. Those who understood only how to restore the sick to 
health, they branded with the name of Empirics. They introduced into practice 
abundance of compound medicines, consisting of so many ingredients that it was scarce VIII 
INTRODUCTION. 
possible for common people to know which it was that wrought a cure : abundance 
of exotics, neither the nature nor names of which their own countrymen understood; 
of chemicals, such as they neither had skill, nor fortune, nor time to prepare ; yea, and 
of dangerous ones, such as they could not use without hazarding life, but by the advice 
of a physician. And thus both their honour and gain were secured, a vast majority 
of mankind being utterly cut off from helping either themselves or their neighbours, 
or once daring to attempt it. Yet there has not been wanting, from time to time, some 
lovers of mankind, who have endeavoured (even contrary to their own interest) to 
reduce physic to its ancient standard; who have laboured to explode out of it all 
hypothesis and fine-spun theories, and to make it a plain, intelligible thing, as it was 
in the beginning, having no more mystery in it than this-" such a medicine removes 
such a pain." These have demonstrably shown that neither the knowledge of astrology, 
astronomy, natural philosophy, nor even anatomy itself, is absolutely necessary to the 
quick and effectual cure of most diseases incident to the human body: nor yet any 
chemical, or exotic, or compound medicine; but a simple plant or root duly applied, so 
that every man of common sense (in ordinary cases) may prescribe for himself or his 
neighbour; and may be very secure from doing harm, even where he can do no good. 
Having given a short history of ancient medicine, I now come to treat of 
Second-THE MODERN PRACTICE. 
Under this head may be enumerated five classes: 1st, the common or Mineral Prac- 
titioners ; 2d, the Thomsonian ; 3d, the Homcepathic ; 4th, the Nostrum-monger, 
or Secret ; 5th, the Reformed or Botanic. 
1st. The Mineral and Depletive Class.-These constitute the " Faculty;" have 
chartered medical colleges; are deemed the most learned; and, in some respects, are 
the most popular. Their principal means for healing the sick are these deadly 
weapons-mercury, the lancet, and the knife. Their treatment, instead of assisting 
nature, only retards her efforts and aggravates disease. Happily for suffering huma- 
nity, their practice is so manifestly injurious, that it is now gradually on the wane, and 
must in a few years sink into oblivion. God, in his infinite goodness, has given to 
suffering man a practice far superior, and shown us that there is yet Balm in Gilead. 
Says the author of the " Key to Medical Science" We will yet add a few 
remarks in regard to mineral and vegetable agents in the treatment of disease. We 
are aware that those who use vegetable remedies alone, and contend earnestly for their 
exclusive use, are looked upon, by the great portion of the community, with an eye of 
indifference at least; but often are they singled out as men destitute of the knowledge 
of anatomy, possessed but of a small share of education, and but little knowledge of the 
science of medicine. This can only be attributed to a want of knowledge, or to a pre- 
judice, having its origin in the influence which interested individuals have been enabled 
to exert over their credulity. The only test must be a trial of their relative qualifi- 
cations. That point is now at issue, and is rapidly approaching its conclusion. 
How it must terminate, needs no particular foresight to perceive. The thousands and 
tens of thousands, in all sections of the United States, who have within a few years, 
and those who are now daily abandoning the use of mineral agents for the treatment 
of disease, speak a language which cannot be misunderstood. The ultimate issue is 
no longer involved in doubt; a change, a thorough change, will soon take place in 
medicine. Physicians will have to start their studies from a new point, practice upon 
different principles, and adopt very different remedies from what they are now using. 
A few years from this time, and the mineral and depletive practice will be held in con- 
tempt by every well-informed mind. The people themselves will take this great and 
important cause in hand : they begin to perceive that the health and well-being of both 
themselves and families demand it; posterity demands it; and they will not suffer the 
important obligation under which they feel themselves placed, to pass by unheeded. 
Already they have it in agitation to establish societies among themselves for the fur- 
therance and support of the Botanical cause, and for the suppression of the mineral 
practice. We bid them good speed, and shall not hesitate to throw all the force and 
energy of which we have control into the scale. It is a good work-a worthy un- 
dertaking, and one calculated to immortalize its projectors." 
2d The Thomsonian Class.-There are two parties belonging to this class; the INTRODUCTION. 
IX 
" pure " Thomsonians, and the " Independents," the latter calling themselves the Botanic. 
The pure Thomsonians are rigid followers of Samuel Thomson, an illiterate, conceited, 
arbitrary, and selfish individual, who obtained a patent for curing all diseases by the 
use of " some articles comprised in six numbers." The principal treatment consists 
in administering lobelia emetics, steaming, and injections; all good, if properly used. 
His theory is, that heat is life, and cold is death ; and hence the more heat, the more life; 
and also that this heat, instead of being formed in the lungs, is generated in the stomach. 
Both the theory and the practice are erroneous. Thomson says, in his book, " bile is 
discharged into the stomach to digest the food whereas it discharges into the intestines, 
several inches below the stomach, and is designed to quicken the action of the bowels, 
&c. Patients afflicted with diverse and opposite diseases; men, women, and children, 
in all stages of their complaints; are subjected to certain courses of medicine, vomiting, 
injections, steaming, and having cold water dashed upon them while in a slate of 
copious perspiration. Purgatives are rejected as pernicious, and pukes given for almost 
every complaint. 
Such a plan may cure one man, but may kill others; and such has actually been the 
fact. I ask any person of common sense, if such treatment is not empirical and pre- 
posterous : and yet it is cried up by blind devotees as the best system that ever was 
or ever will be. 
A young man by the name of Mattson, a "pure Thomsonian," appointed by 
Thomson himself to revise his work, and who has appropriated to himself the title of 
my large work, with an additional word, has the following remarks on purgatives'; 
" For my own part," says Mattson, " I consider blood-letting less pernicious, as a 
means of depletion, than cathartics." Again ; " With the exception of calomel and the 
lancet, there are no agents employed by medical men which do more injury to the 
human system than purgatives." A great contrast this between the doctrine of Thomson 
and Dr. Brandreth. The former rejects purgatives altogether, and pronounces them per- 
nicious, while the latter recommends them for every disease. This is a very bad feature 
in the practice. Nearly the whole length of the intestines, about thirty feet in length, 
are filled and obstructed with morbid accumulations, to the great hazard of the patient. 
A Thomsonian doctor in this city informed me the other day that he treated a case of 
bilious colic, in which he had given vomits and injections without relief; the patient, 
laying his hand below the stomach, often repeating, " you have not reached the disease 
yet." Finally he concluded to administer a purgative, when immediately the obstruc- 
tion was removed, and he was cured. Besides, in every disease Cayenne pepper is 
given, which is liable to. injure the patient by imparting too much heat or stimulus. 
Is this imitating nature, to vomit, steam, pepperize, and injeclionize for every dis- 
ease ? These men have yet to learn the difference between assisting and forcing nature, 
as well as other correct principles. With them it is lobelia, steam, and pepper, by the 
mouth and by the bowels. Our system has suffered much injury by being identified 
with the Thomsonian or Steam System.* 
Every article to which he lays claim was originally known and used a long time 
before by the Indians and others; lobelia, pepper, steaming, &c. As a specimen of 
Thomson's skill, I here give Mattson's statement of a case, who was, he states, 
" two years under the same roof, among the numerous patients." Mr. W. A. Parker, a 
highly respectable citizen, was afflicted with an ulcer on his breast, which had baffled the 
skill of the faculty. Dr. Thomson administered several courses of medicine ; and, pre- 
The editor, after having given the rise and progress of the Reformed System, similar to that of Dr. Por- 
ter, thus remarks : " There arc now, in different sections of the United States, about iwo hundred 
regularly educated scientific Medical Reformers, who have gone forth from the New York and Worth- 
I ington schools, besides a considerable number of old school physicians, who have come out and openlv 
declared themselves decidedly in favour of the improved or botanical system of medical and surgical 
practice, so far as they have been able to become acquainted with its principles. 
We have thought proper to give this brief sketch of the origin and progress of scientific Medical 
Reform, for the purpose of doing away certain erroneous impressions that exist in different parts of the 
country respecting our system, viz.: that it is identical, or intimately connected with, or fundamentally 
depending upon, the Thomsonian or Steam System. 
It will readily be inferred from the preceding statements, that our system originated even before 
Thomson was known ; and that, during its progress, it was gradually improved and developed, without 
the least reference to his system, and for the most part without even the knowledge that such a system 
as the Thomsonian, or such a being as Samuel Thomson, was in existence." 
* From the Western Medical Reformer of 1836. X 
INTRODUCTION. 
vious to each course, applied a poultice, two articles of which were lobelia and Cayenne 
pepper. This painful and highly injudicious application was intended, according to 
Dr. Thomson's own explanation, to drive the ulcer into the internal organs, so that, 
when vomiting ensued, it might be banished from the system ! Notwithstanding the 
Cayenne and lobelia poultices, however, the ulcer still continued, until he applied to an 
old woman, who used injections, &c., which soon effected a cure. 
Unfortunately for the healing art, men with little or no experience adopt a theory, 
and make everything bend to support it; whereas facts and experience alone should 
form the basis, and then the theory will of course be right. 
Independent Thomsonians.-The other party is Independent Thomsonians, 
though they should be designated by a more appropriate, respectable, and significant 
name. These had commenced with the Thoinsonian practice, and, after testing it, 
were obliged to adopt other principles and remedies; and have thus declared them- 
selves independent, which has created great commotion in their ranks. This class now 
constitute nearly the whole number of those called Thomsonians: scarcely one can 
be found who strictly adheres to Thomson's twenty dollar patent book; they having 
been compelled, by stern necessity, to abandon their sinking ship, and adopt a more 
rational and scientific practice. This reflects great credit on them, and may be considered 
an auspicious event in the history of medical reform : by keeping their minds open to 
conviction, and making farther improvements, they will become eminent, and more 
fully identified with the great body of scientific medical reformers : and these remarks 
are applicable to many other classes. When this takes place, and the various conflict- 
ing parties unite, they will march in a solid phalanx against the common enemy; and 
then will their banners of victory wave triumphant, and their shouts of exultation rend 
the skies. It cannot be expected that we shall all get right without stumbling more 
or less: but honesty will lead the mind to embrace the true and heavenly art of heal- 
ing the sick. Great forbearance and a free interchange of sentiments are, therefore, 
necessary to the prosperity of the cause. 
3d. Homcepathic Physicians.-The next class demanding our attention is, the 
Homcepathic, who, being unable to succeed writh the old mineral practice, have turned 
their attention to that novel method of treatment. The founder was by birth a Saxon 
or German. Their theory is, that whatever will create a disease in health, will cure it 
when it arises spontaneously : for instance, salt will cause fever, and, therefore, it will 
cure it. Their medicines are numerous; but one kind only is administered at a time. 
They use, among others, mercury, arsenic, antimony, fyc., but in very minute doses, as 
the millionth or billionth part of a grain, which, if they possess any curative properties, 
may prove deleterious, by penetrating into every part of the body, and there remaining. 
In a work by Samuel Hahneman, termed Organon, page 207, the following directions are 
given for administering the medicines: 
" The best mode of administering is, to make use of small globules of sugar the size 
of a mustard seed. One of these globules having imbibed the medicine, and being in- 
troduced into the vehicle, forms a dose containing about the three-hundredth part of a 
drop-for three hundred of such globules will imbibe one drop of alcohol; by placing 
one of these on the tongue, and not drinking anything after it, the dose is considerably 
diminished. But if the patient is very sensitive, and it is necessary to employ the 
smallest dose possible, and attain at the same time the most speedy results, it will be 
sufficient to let the patient smell one." 
From the good opinion expressed of the practice by my friend Dr. Ward, I was induced 
to purchase some of their medicine and books, to test the merits of the system, which I 
have done to a limited extent. From this, and observations of its effects on others under 
the treatment of several homcepathics, I have to state that I have very little confidence in 
its curative properties. It may answer as a kind of placebo to the mind where no medi- 
cine is required, or to amuse the patient while nature effects the cure; but in acute dis- 
eases valuable time would be lost under it, which ought to be employed in administering 
efficacious remedies. The reputed cures of homcepathy depend upon the conservative 
powers of the system; but still, it is better than the old practice, being necessarily harm- 
less : besides, the diet and regimen may prove very beneficial. A valuable lesson may 
also be learned by other practitioners, viz.: 1st, to give medicine as concentrated as pos- 
sible ; 2d, to give it as simple and seldom as possible; 3d, not to impair the integrity 
of the constitution by too much or too violent means; 4th, to rely much upon diet, INTRODUCTION. 
XI 
less on medicine, and more on the efforts of nature, in the treatment of disease. For 
these reasons the homeopathic physicians must be ranked among the number of ref or 
mers. 
Since writing the above, I have been called to a distinguished dentist of this city, Dr. 
Burdell, who was taken unwell, and called a homoepathic physician to attend him. 
He requested him to give him no mercury; but, contrary to his express desire,he gave 
both mercury and arsenic; and he now states that he has been injured, particularly by 
the latter. He thinks that the absorbents have taken up the poison, and that it has settled 
in all his joints. They are now swollen, stiff, and contracted; and he is unable to 
walk. So indignant does he feel against the practice, that he proposes to caricature it, 
by exhibiting two rats, one in a healthy state, and the other after having passed through 
the ordeal of taking ratsbane or arsenic, with the hair off! 
4th. Nostrum-mongers.-Another class of persons, who deal in and deal out medi- 
cine, and such as contrive, without skill or science, to make money by imposing upon the 
ignorant and credulous. These preparations''are ostensibly for the cure of all diseases 
" that flesh is heir to," and are puffed into notice by certificates, true or false. The 
public have been, and still are, greatly duped and imposed upon by these quacks 
and impostors. It would appear that the community love to be humbugged; and they 
are more to be blamed than the nostrum-mongers themselves: by advertising the most 
worthless compounds sufficiently, they can be brought into notice, and extensively sold. 
Well might a writer exclaim, in reference to the credulity of mankind, " The public is 
a goose, and he is a fool that will not pick her." It is often the case that persons will 
believe a lie much sooner than the truth ; hence the prevalence of error. 
From these conflicting opinions, an author uses the following language: "Facts evince 
the defects of physicians in the knowledge of the nature and cure of diseases, in all 
preceding ages, by the testimonies of their own writings; whereby the whole science has 
been overwhelmed with floods of errors and erroneous systems, from the time of Hip- 
pocrates down to the present age of learning and erudition; the whole art of medicine 
has been distracted by disputations and revolutions of its theories; and it continues 
still to fluctuate on the ocean of visions and uncertainties, and theoretical hypothesis, of 
its cultivators, who have either wished to exalt their names by the introduction of new 
systems and doctrines, or have laboured hard to acquire riches by some egregious imposi- 
tions on mankind; and very few have desired to advance the science and art of medicine, 
in order tp confer the most gratuitous and lasting benefits on their fellow-creatures." 
5th. Reformed or Botanic Physicians.-This class advocate scientific medical 
reform, and combine everything useful of eveiy other system. Their practice is tested 
by experience at the bed-side of the sick, and their theory is deduced from facts and 
correct principles of physiology. They recommend a general knowledge of anatomy 
and physiology; reject the use of mercury, the lancet, and almost exclusively the knife ; 
administer vegetable agents, and such as are in union with the laws of nature. They 
maintain that all the physician can do, is, to act as a servant or handmaid to nature, aiding 
her in overcoming obstructions in various parts of the animal economy. This system is 
denominated the Reformed or American Practice; it has taken deep root, and is 
extending its branches and bearing fruit, and its adherents may be found throughout the 
United States. It is continually increasing, and bids fair to triumph over every other 
erroneous treatment. I have advocated this practice from youth to the present period, and 
it is still farther illustrated in this work. 
That the reader, unacquainted with this system, may obtain farther information 
respecting it, I subjoin a short history of its rise and progress, as given by Dr. A. II. 
Porter, and published, withaseries of other communications on the same subject, in a con- 
troversy with a mineral physician, in the Lynn (Mass.) Freeman, and in Dr. Thomas 
Cooke's Philadelphia Botanical Medical Reformer. 
* I confess I have some hesitancy in giving it, in consequence of the language being too 
laudatory, which may expose me to the charge of egotism. But justice to the per- 
secuted cause in which I am engaged seems to demand it; and I hope this will be 
accepted as a sufficient apology for its insertion. 
THE REFORMED OR VEGETABLE SYSTEM OF MEDICAL PRACTICE. 
" In the western states the reformed practice has been thoroughly tested, and, if I may XII 
INTRODUCTION. 
credit the authority of a respectable individual who has resided in one of them for a 
number of years, is fast rising in public estimation, and will sooner or later eclipse the 
mineral system, and become the most popular and successful practice of the day. It is 
because the people see that vegetable medicines are safer than mineral, and equally or even 
more efficacious, that they prefer the former to the latter; and that has caused the system 
to spread with such unprecedented rapidity. In many places a mineral or old school 
physician can find no employment. Such is the hostility to bleeding and mercury, or, 
in other words, to the regular practice, that its advocates are sometimes obliged to abandon 
their system, or seek some other business to obtain a livelihood. 
" The Botanic practice, as I have already observed, is fast penetrating into our northern 
and eastern regions. The name .of its illustrious founder, Dr. Wooster Beach, will be 
held in everlasting remembrance for having been instrumental in bringing out of chaos, 
as it were, a system of medical practice founded on rational, philosophic principles. 
For, when we consider that no physician of the old stamp has dared publish to the 
world a scientific work on the reformed system of medicine, to Dr. Beach is certainly 
due unbounded praise for his independence and magnanimity in publishing one of this 
character, so able and useful as it is, when the whole medical faculty were arrayed 
against him. Possessing more than an ordinary share of native talent and intellectual 
acumen; with keen perceptive faculties, great discriminating powers, and a genius of 
the highest order, sanctified by the purest morality to the noblest ends, he was not con- 
tent with being confined within the narrow limits of a mere professional career; his 
philosophic mind was for more extensive investigation into medical science, and to ascer- 
tain, if possible, ' what is truth.' As he proceeded onward, step by step, in the path 
of inquiry, he became convinced, to use his own language, ' that the present practice 
of physic and surgery, so far from being founded on correct principles, both in theory 
and practice, was absolutely a curse to society.' 
"These sentiments grew with his growth, and strengthened with his strength, and 
constant observation confirmed him in the truth of them. Consequently he felt a deep 
solicitude to effect a reformation. At length he heard of a botanical physician of some 
eminence, Dr. Jacob Tidd, in the state of New Jersey, who obtained his medical 
knowledge of a German physician of high standing; and afterward obtained much valu- 
able information from a relative who had been taken prisoner among the Indians during 
the war. Forty years' experience, united to these advantages, had acquired him a repu- 
tation, as a successful practitioner, that had spread far beyond his immediate sphere. 
"Dr. Beach, determining to avail himself of all the means of obtaining the requisite 
knowledge, visited Dr. Tidd, studied medicine with him, and, after remaining with him 
until his death, succeeded him in his practice. Thus armed and equipped with that 
knowledge which was one day aided by experience to establish his fame as a scholar 
and a physician, he entered upon the practice of medicine with flattering prospects of suc- 
cess. He soon cured some cases that had been considered hopeless, an account of which 
reached the city of New York, and he was on that account sent for to attend some of 
those of a similar nature. His success was so signal and satisfactory, that the report 
of it was soon circulated to such an extent that he received numerous solicitations to 
remain in the city, to which he finally consented. 'He embraced the opportunity of 
attending the lectures in the city Medical College of Mineral Physicians in New York, 
where he graduated, and received a Diploma according to the laws of the state.' 
" His attention, however, was not all diverted from the Botanic Practice; if anything, 
his opinion of it became strengthened, being more than ever convinced of its superiority 
over that pursued by the mineral physicians. 
" ' In 1827 Dr. Beach erected an infirmary for the reception of patients. From 1st of 
June, 1827, to 1st of June, 1828, twenty-one hundred patients were attended at this 
institution under the superintendence of Dr. Beach, aided by others, who had formerly 
been his private pupils.' In the treatment of diseases he became so skilful and successful, 
that his fame spread far and wide, and he was sent for from various sections of the country 
to consult with distinguished surgeons and physicians in every variety of complaint. 
"He also attended many thousands of cases at the United States Infirmary, and pre- 
scribed for over one thousand cases of cholera, under the appointment of the New York 
Board of Health, in the short space of three months. In the year 1829, through his 
instrumentality, and that benevolent feeling and high regard for the prosperity of the 
cause of medical reform for which he was eminently distinguished, a college was erected INTRODUCTION. 
XIII 
and opened, denominated the ' Reformed Medical College of New York,' for the express 
purpose of teaching the various branches of medical science, and the principles of the 
botanic or reformed system of practice. The erection of this college led to the formation 
of a society called the Reformed Medical Society of the United States. And in 1830, 
in accordance with a resolution adopted by the aforesaid society, a school was established 
at Worthington, Ohio, as the medical department of the Worthington College." 
"If," says a respectable physician, "all the sick relieved and cured by the reformed 
or vegetable practice could be assembled together, a fair statement of their cases and 
continuance of their diseases made out, I am convinced the world would be amazed at 
the multitude and the results; and at the victory obtained over sickness and death, so 
signal and triumphant." 
And may I not with propriety add, could all those who have been made the dupes of 
the mercurial practice be assembled together, and a fair statement of their cases and the 
mode of treatment to which they were subjected made out, I am constrained to think 
that very few would present sound and healthy constitutions. The world would be 
astonished at the multitudes with exfoliated bones, ulcerated gums, carious teeth, swollen 
tongues, scrofulous nodes, fetid breath, mercurial eruptions, &c. And yet people, enlight- 
ened as they are, and eye-witnesses of the awful consequences of the use of mineral 
poisons, will persist in their use, and recommend them to their sick neighbours. Does 
any one doubt the efficacy of vegetable medicines in the cure of disease ? Let him go into 
the western states, and I'll be bound to say he'll come back an advocate of the reformed 
practice. He will there learn that bleeding, blistering, and mercury will not invariably 
conquer even the mildest cases, while vegetable remedies have done what mercury and 
its preparations could not do. 
To show still farther the estimation in which the reformed practice is held by those 
best acquainted with it, I add an extract of a letter from Dr. J. King, dated New Bedford, 
Mass., June 28th, 1842. 
" I am about preparing a new set of lectures on the glorious reformed practice, and, 
on delivering them, intend to challenge debate and investigation from all, or any, who 
think they can maintain the opposite side. 
" Although I am doing so well here, yet I must acknowledge that I prefer New 
York to any other place: the habits and customs here are not congenial to the spirit of 
a Yorker; everything is for money, and means money; and societies for mutual im- 
provement, or even one small society, cannot be raised; yet I shall stay here, and do 
my best to raise the standard of reform, not only in New Bedford, but, if I live, through- 
out the state and country, and hope to see it triumphant, respected, honoured, and 
admired by all. My whole internal man is bent to this purpose. Thomsonianism and 
regularism must fall before the superior worth of the American practice. And what 
reformer, who has witnessed the success of this system, and the failure of the others-nay, 
not even failure, but the miseries produced-and has a mind of any feeling whatever, 
of any love to his fellow-creatures, or who possesses the smallest spark of humanity 
in his breast, would not devote his whole time and • energy to the holy purpose of 
meliorating the condition of his afflicted fellow-beings, by placing before them, and 
forcing upon them, that system of practice which cures, and cures when all others fail ? 
" I have seen all this-I feel all this-and, with the help of Heaven, my voice shall yet 
be heard in tones of thunder against the Mercurialists, and all their train shall tremble 
and fall down with fear and a knowledge of the truth. The only thing I regret is, that 
the author and founder of this system cannot retrograde his years, so that we could 
start together upon this noble enterprise; for it seems to me that we could in a much 
shorter time accomplish our aim. But never mind-go on,doctor; the respect, the es- 
teem, the admiration, the love of mankind will always be with you; your system is 
destined to become the greatest and proudest ornament of the medical world. 
, " But I am getting too enthusiastical; yet I am almost always so on this subject, 
for I feel and know its importance to mankind: nevertheless, I feel that my enthu- 
siasm is truth itself." 
Thus God has, in his infinite goodness, brought into existence a more rational system 
of medicine, in the place of one productive of such pernicious consequences ; a system 
which heals disease with remedies more in conformity with the intentions of nature, 
and re-establishes health without destroying the source of life. 
The reader will at once perceive the propriety and necessity of a work calculated to XIV 
INTRODUCTION. 
effect a change, or introduce a reformation, in the noble science of medicine: to lay 
before the public or the world a system of practice that is both negatively and positively 
better than that now pursued. First, negatively, that shall abolish the present perni- 
cious treatment. Second, introduce a system that is infinitely superior; and the author 
professes to have accomplished these objects in the following pages. It is no vain ex- 
periment, hypothesis, theory, or conjecture, but founded upon the immutable and eternal 
principles of physiological truth, proved to be so by a series of experiments, illustra- 
tions, and facts deduced from extensive practice, which challenge the severest scrutiny, 
and court the minutest investigation from friends or enemies. We only ask a fair trial 
of the treatment recommended, (and this every honest man will acknowledge we are 
entitled to,) before they decide upon the merits or demerits of the practice. 
This work is the result of long experience and great research, and the materials have 
been collected from a great variety of sources. Ancient and modern authors have been 
referred to and analyzed, and everything valuable has been retained. I have availed 
myself of all the information worth preserving, contained in every botanical publication 
which has issued from the press of this country or Europe; but I must confess that I 
have derived very little practical information from any of them. 
I have spared neither pains nor expense to acquire a knowledge of the practice of the 
most noted botanical physicians, retaining from each everything which I have proved 
by experience to be useful. I have not thought it beneath me to converse with root 
and Indian doctors, and every one who has professed to possess any valuable remedy, 
or any improved method of treating any disease. The hints and suggestions of ex- 
perienced nurses and female practitioners have not escaped my notice. " For," says a 
former president of the New York College of Physicians and Surgeons, " there is not a 
maxim or remark of any experienced female or nurse which is not based upon sound 
pathological principles." They are generally diligent observers of nature, and often 
point out her indications in a correct and masterly manner, which often disappoints the 
physician and the friends of the patient. I have also availed myself of every advantage 
arising from a regular course of study in the university of the state of New York. Be- 
sides, an extensive practice for many years in the most populous city in the United 
States, (New York,) with repeated consultations with the most distinguished surgeons 
and physicians, has afforded me opportunities of ■witnessing and treating every variety 
of disease, and trying every variety of practice. 
I have also attended many thousand cases at the United States Infirmary, where 
constant application was made for medical aid, in physic, surgery, and midwifery. 
During the epidemic, (a period of three months,) under the appointment of the New 
York Board of Health, we prescribed for about one thousand cases of cholera, either in 
the premonitory or confirmed stages.* 
The information which I have received from others, the opportunities of clinical prac- 
tice, the improvements I have myself made, have brought me into the possession of a 
system of practice which I have found invaluable, and altogether superior to that pursued 
by physicians of the old school. Schools have been founded to disseminate this prac- 
tice, the graduates of which are giving us daily evidences of the unprecedented success 
of the system. One of our graduates writes as follows: " I have one objection to your 
practice-it destroys disease too soon. It gives me no opportunity to make a bill." 
In a word, then, this work is the result of my observations, reflections, inquiries, in- 
vestigations, researches, and experience from youth to the present period, most of which 
* By virtue of the power and authority in me vested as Aiderman and Warden of Health of the Tenth 
Ward, I do hereby nominate, constitute, and appoint Wooster Beach, M.D., to visit and take charge of, 
and to give such medical advice and assistance as may be required, to all poor persons, inhabitants of the 
ward, who may be affected with the prevailing epidemic ; and also to call to his aid such assistance from 
the medical faculty as he may require and deem necessary and expedient. 
July 17 th, 1832. JOHN PALMER, Jllderman Tenth Ward. 
After receiving the above appointment, the corporation immediately issued, and posted up in every part 
of the ward, the following bill: 
Tenth Ward Medical Station.-All persons affected with looseness, pain in the bowels, or cramp, are 
requested to apply immediately to Dr. W. Beach, No. 95 Eldridge-street, where they will receive advice 
and medicine free of charge. 
By order of the Board of Health. 
THOMAS T. WOODRUFF, 
HENRY P. ROBERTSON, 
WILLIAM MANDEVILLE. 
New York, July 18, 1882. 
Executive Committee. INTRODUCTION. 
XV 
time has been exclusively devoted to it, with an assiduity which has almost wholly sa- 
crificed my social enjoyments of life, and taxed my mind and body to a degree which ha» 
greatly impaired my health, and that, too, amid slander and persecution. I have suf- 
fered greatly in mind, body, and estate; yet I feel amply rewarded for all this in the con- 
sciousness, that my labours will result in alleviating the sufferings of my fellow-men. 
Having given a very brief history of medicine from its commencement to the present 
time, and explained the nature and kind of practice which I have proved to be the best, 
I now proceed to show the necessity and the best means of disseminating it generally; 
and also to point out some of the obstacles which retard its progress. 
My first attempt to introduce the reformed system was, to appeal more especially to 
the profession, and, by educating suitable persons in its theory and practice, to disseminate 
it through the community. This has been done to a considerable extent by means of 
medical schools, and of the press; and likewise by various publications, such as 
daily, weekly, and monthly papers, and various treatises, tracts, &c.; and, lastly, by the 
publication of the AMERICAN PRACTICE OF MEDICINE, in three large volumes. 
Notwithstanding all these exertions, I find that the work does not spread commensurate 
with the importance and exigencies of the cause. I have, thereiore, concluded, that 
the best method, in order to spread it more rapidly, and to bring it within the reach of 
all classes the most expeditiously, would be, to lay it directly before the people, and rely 
upon their good sense and intelligence for success, that they may avail themselves of its 
advantages, without receiving it through the tedious and expensive medium of interested 
professional men. This would not preclude the employment of such, if desired, but 
would qualify others to judge of their abilities. 
I am confident that the public are capable of appreciating it, and prescribing for them- 
selves and their neighbours. The system is simple, easily understood, and requires only 
common sense and judgment, with a little experience, to put it into practice. The only 
hope, then, of a reformation and revolution in medicine, under Divine Providence, 
is, the dissemination of our principles through the great mass of the community. 
" It is not less certain," says Professor Rafinesque, " but still more deplorable, that, 
beyond the immediate sphere of medical knowledge, the majority of the people are yet 
a prey to medical credulity, superstition, and delusion, in which they are confirmed by 
the repeated failures of theorists, and the occasional success of empirical rivals." 
All classes should possess a general knowledge of anatomy, physiology, and the 
practice of medicine, both as a matter of interesting information and practical utility. 
" The only way," says a writer, " to banish quackery in any art or science, is, to diffuse 
a knowledge of it among mankind." 
" As matters stand at present," says a writer, " it is easier to cheat a man out of his 
life than of a shilling, and almost impossible to detect or punish the offender. Notwith- 
standing this, people still shut their eyes, and take everything upon trust that is ad- 
ministered by any pretender to medicine, without daring to ask him a reason for any 
part of his conduct. Implicit faith, everywhere else the object of ridicule, is still sacred 
here. It would certainly be for our safety to have some check upon the conduct of 
those to whom we intrust so valuable a treasure as health." 
The veil of mystery which still hangs over medicine renders it not only a con- 
jectural, but even a suspicious art. This was long ago removed from the other 
sciences, which induces many to believe that medicine is a mere trick, and that it will 
not bear a fair and candid examination. Medicine, however, needs only to be better 
known, in order to secure the general esteem of mankind. Rs precepts are such as 
every wise man would choose to observe, and it forbids nothing but what is compatible 
with true happiness. 
Disguising medicine not only retards its improvement as a science, but exposes the 
profession to ridicule, and is injurious to the true interests of society. An art founded 
on observation can never arrive at any high degree of improvement while it is confined 
to a few who make a trade of it. The united observations of all the ingenious and 
sensible part of mankind would do more in a few years toward the improvement of 
medicine, than those of the faculty alone in a great many. Any man can tell when a 
medicine gives him ease, as well as a physician; and if he only knows the name and 
dose of the medicine, and the nature of the disease, it is sufficient to perpetuate the fact 
Yet the man who adds one single fact to the stock of medical observation, does more real 
service to the art, than he who writes a volume in support of some favourite hypothesis. v « Very few," says Buchan, " of the valuable discoveries in medicine have been made 
by physicians. They have, in general, either been the effect of chance or of necessity, 
and leave been usually opposed by the faculty till every one else was convinced of their 
importance. An implicit faith in the opinion of teachers, and attachment to systems 
and established forms, and the dread of reflections, will always operate upon those who 
follow medicine as a trade. Few improvements are to be expected from a man who 
might ruin his character and famil y by even the smallest deviation from an established 
rule." 
" If men of letters," says the author of the above-mentioned quotation, " were to claim 
their right of inquiry into a matter that so nearly concerns them, the good effects in 
medicine would soon appear. Such men would have no separate interest from that of 
the art. They would detect and expose assuming ignorance under the mask of gravity 
and importance, and would be the judges and patrons of modest merit. Not having 
their understandings perverted in their youth by false theories, unawed by authority, 
and unbiassed by interest, they would canvass with freedom the most universally re- 
ceived principles in medicine, and expose the uncertainty of many of those doctrines of 
which a physician dares not so much as seem to doubt." 
" No argument," continues he, " can be brought against laying open medicine, which 
does not apply with equal, if not greater, force to religion; yet experience has shown 
that, since the laity have asserted their right of inquiry into these subjects, theology has 
been improved, and the interests of real religion have been promoted." 
Had other medical writers been as honest as this gentleman, the art had been upon a 
very different footing this day. Most of them extol the merit of those men who brought 
philosophy out of the schools, and subjected it to the rules of common sense. But they 
never consider that medicine at present is in the same situation that philosophy was at 
that time, and that it might be as much improved by being treated in the same manner. 
Indeed, no science can either be rendered rational or useful, without being submitted to 
the common sense and reason of mankind. These alone stamp a value upon science; 
and what will not bear the test of these, ought to be rejected. 
I know it will be said, that diffusing medical knowledge among the people might 
induce them to tamper with medicine, and to trust to their own skill, instead of calling 
a physician. The reverse of this, however, is true. Persons who have most knowledge 
in these matters are commonly most ready both to ask and follow advice, when it is 
necessary. The ignorant are always most apt to tamper with medicine. Instances of 
this are daily to be met with among the ignorant. 
The following observations, by Dr. N. R. Smith, are applicable: " Medical men have 
first obscured their art, and deluded the community into the belief, that in medicine there 
is some charm, some conjuration, or some mighty magic. Persons are disappointed, 
therefore, when they learn somewhat of the limited resources of our art, and readily 
transfer their faith to those' who are ignorant, or dishonest enough to keep up the de- 
lusion. Men are indignant when we prescribe means as simple as the waters of Jor- 
dan, instead of smiting upon the part, and uttering some technical incantation. 
" To disenthral the public mind, medical men must cast off the whole garb of the 
charlatan, nor suffer anything to remain which shall confound medical philosophy with 
empiricism. The profession must seize every opportunity to educate the community 
in the first principles of medicine. 
" Undoubtedly the ingenuous part of our profession suffer most severely, not from the 
itinerant nostrum-monger, but from the scientific empiric-that ipember of the profes- 
sion who avails himself of that which science reveals, but, in practice, associates it 
with the artifice of the charlatan. Splendid instances of success achieved by such can 
always be pointed out, and against them the honest part of the profession can vindicate 
itself only by educating the community in the true character of the science of medicine. 
I consider that it is an urgent dictate of humanity to furnish the community with a cer- 
tain amount of knowledge, particularly in surgery; because at this time they are sin- 
gularly ignorant of its simplest principles; because infinite mischief and suffering are 
created by its abuses; and because the maladies which demand the surgeon are such 
as brook not a moment's delay. Accidents often occur which prove immediately fatal, 
when the knowledge of a single fact would enable any individual at least to arrest the 
hand of death till more efficient aid could be procured." 
" I believe," says Dr. A. H. McNair, author of " Medical Suggestions," " there might 
XVI 
INTRODUCTION. INTRODUCTION. 
XVII 
be a great amount of suffering prevented, if parents and others were to pay some atten- 
tion to the nature of disease and medicine." By reading half an hour every day, they 
would, in a short time, not only be able to detect the ignorant and malicious impostor, 
but toadminister medicine at the commencement of a disease with a success which would 
often prevent a protracted illness. For the purpose of enabling my readers to do so with 
success, I have, in connexion with the treatment of diseases, described the nature of the 
medicine recommended, together with the effects they are to produce; and, notwithstand- 
ing diseases may sometimes be complicated, the treatment will be extremely simple, as 
well as successful. How many strong reasons might be assigned why the community 
generally should understand medicine. The least is, the numerous kinds of theories and 
treatment adopted by different physicians, each claiming superiority, and on any of whom 
we may have occasion to call in sickness, without knowing their claims to merit. Now, 
if each individual was acquainted with medicine, he would be able to detect quackery 
in any shape among doctors or nostrum-mongers. Besides, a person, or some of his 
family, may be taken suddenly ill from home, among strangers, or far from any phy- 
sician. What a blessing to know the nature of the complaint, and the appropriate 
remedy: or, if he has this treatise, and a little medicine, he will be enabled in a few 
minutes to obtain the desired information and treatment. In a word, he has a physician 
and an apothecary ever in the house, ready to prescribe without fee or reward : in 
my estimation, therefore, the Family Physician is a treasure of inestimable value, in 
comparison with which, money dwindles into insignificance. 
Reflect for a moment upon the benefit of a judicious system of medicine, which may 
be resorted to in cases of sudden emergency or attack of disease. Even if the common 
practice were good, it is often a long time before a physician can be found; and, besides, 
there are some cases where immediate attention is required, as in croup, cholera morbus, 
colic, &c., and which demand prompt and vigorous treatment at the onset. These attacks 
are liable to occur in the night, or on the ocean, or at a great distance from medical aid 
of any kind, as stated before. 
To show the benefit resulting from the possession of this work while travelling, and 
where no medical advice can be procured, I subjoin the following extract of a letter, dated 
Westfield, Mass., October 4th, 1841, from an aged and highly respected and talented 
lady, Mrs. Ruth Stebbins, who has devoted a long life to the promotion of the cause of 
medical reform. She has not only used her influence, but her money, to disseminate 
it. Her labours have been more particularly directed to the unnatural and improper 
practice of employing men instead of females in midwifery. She writes: "Go on, my 
dear brother, in your work of reform, relying on the strength of Jacob's God: no weapon 
formed against thee shall prosper; and every tongue that shall rise against thee in judg- 
ment thou shalt condemn, because the truth is great, and must prevail. I do pray, 
that God would give you wisdom and strength equal to your day; and, for your en- 
couragement, I would say, that the sun is fast rising, and shining brighter and brighter 
on this cause of reform; and the more your books are read and understood, the more 
they are approved: and, in fact, the old school are working into the new, in adopting its 
principles as fast as they can, without confessing too much to suit their pride. But soon, 
I think, you will all lift up your voices together in defence of the vegetable art. Here 
I would mention, that a lady in Windsor, Conn., purchased a set of your books last fall, 
and presented them to her daughter, recently married, and bound to Canada The 
daughter, in her first letter to her mother, returned her grateful thanks for her invalua- 
ble present, saying she had been very sick on her journey, and believed the information 
she obtained from the work actually saved her from an untimely grave. Perhaps this 
incident will promote the sale of your work, and spread the Jjglft into some dark comer 
of the earth. May the Lord grant it. I have frequently said to my friends, (as I now 
believe,) if I had been blessed with your attendance in the days of youth, I should now 
enjoy a healthy old age, instead of this constant wretchedness, which renders life almost 
a burden; and knowing, as I do, the destruction of life and health from mineral poisons, 
I do feel compelled to use my influence in favour of your Reformed Practice." 
A person has just stepped into my office for medicine for his wife, who, he states, 
has been injured by bleeding; and, after subscribing for the Family Physician, stated 
that he knows a lady who has my Reformed Practice, and that it has saved her hundreds 
tf dollars. She has made it her study, prescribes when it is necessary, and thus has 
become the " family physician." XVIII 
INTRODUCTION. 
Another person, who has subscribed for the Family Physician, notwithstanding he 
nas my large work, states that two female members of his family are in the habit of 
prescribing, not only for themselves, but for their neighbours. Thus we see how much 
good may be done by a little correct information on this subject. 
Let us, then, strip the profession of everything that looks like mystery and imposture, 
and clothe medical knowledge in a more simple garb. Truth is simple upon all subjects; 
but, upon those which are essential to the general happiness of mankind, it is obvious to 
the meanest capacities. 
There is no man so simple that cannot be taught to cultivate grain, and no woman so 
devoid of understanding as to be incapable of learning the art of making that grain into 
bread; and shall the means of preserving our health by the culture and preparation of 
food be so intelligible, and yet the means of restoring it when lost be so abstruse, as to 
require so many complicated means for its application ? To suppose this, is to call in 
question the goodness of the Supreme Being, and to believe that he acts without unity 
and system in all his works. 
In no one of the acts of man do we behold more weakness and error than in our 
present modes of education. We teach our sons words at the expense of things. We 
teach them what was done two thousand years ago, and conceal from them what is 
doing every day. We instruct them in the heathen mythology, but neglect to teach them 
the principles of health. We teach them to predict eclipses and the return of comets, 
but we give them no instruction in the signs which precede general and individual dis- 
eases. How long shall the human mind bend beneath the usages of ancient and bar- 
barous times ? When shall we cease to be mere scholars, and become wise philosophers, 
well-informed citizens, and useful men ? 
From a review of what has been lately effected by our reformed system, I cannot 
help admitting with Dr. Hartley, that in that happy period predicted in the Old and 
New Testament, when religion shall combine its influence upon the passions and con- 
duct of men, there will be discoveries in medicine. Christian missionaries shall procure 
the same credit and kind reception among pagan and savage nations, by curing dis- 
eases by natural means, which the apostles obtained by curing them by supernatural 
power. Yes, the time I believe will come, and is near at hand, when, from the perfec- 
tion of our science, with uniformity of climate, men shall be so well acquainted with the 
method of destroying poisons, that they shall tread upon scorpions and serpents without 
being injured by them, and mothers, from their knowledge and use of the same antidotes, 
shall cease to restrain a sucking child from playing on the hole of the asp, and the 
weaned child from putting his hand on the cockatrice's den. Suspended animation, if it 
should occur in that enlightened state of the world, shall no more expose the, subjects of 
it to premature interment. Pestilential diseases shall then cease to spread terror and 
death over half the globe; for interest and prejudice shall no longer oppose the removal 
of the obvious and offensive causes which produce them. 
Lazarettos shall likewise cease to be the expensive and inhuman monuments of error 
and folly in medicine and in government. Hospitals shall be unknown, (the liquor and 
drug shopswill be destroyed,) the groans of pain, the ravings of madness, and the sighs 
of melancholy shall be heard no more. The cradle and the tomb shall no longer be 
related, for old age shall then be universal. 
Let all the remote causes of diseases, and, above all, let the resources of our profession 
in the materia medica, (which is nothing but a combination of error, got up by chance 
and conjecture, what Prof. Jcerg pleases to call a medical romance,) be subjected to fresh 
examinations. New remedies remain yet to be discovered; but most of the old ones 
demand new experiments and observations, to determine their doses and efficacy. It is 
impossible to say how much the certainty of medicine might be promoted and its use- 
fulness increased, by more extensive knowledge of its application. 
How interesting and useful for children and youth, as well as others, to acquire some 
knowledge of their own frame, the means of preserving their health, and the nature and 
treatment of diseases by the use of those ingredients which grow in their gardens, fields, 
or forests. It not only enlightens them in medical botany, but enables them to be their 
own physicians, and likewise the physicians of their poor neighbours. This must 
always prove a source of consolation; and how desirable to the benevolent mind, when 
it can be accomplished by agents which a bountiful Creator has scattered so richly around 
them, and placed within their reach. INTRODUCTION. 
XIX 
The collection and preservation of medical plants, roots, barks, fyc., will not only 
offer an innocent, but a useful and perhaps profitable employment. It will not only 
contribute to the relief of suffering humanity, but prevent a vast amount of expense, 
which may be saved to a family or an individual by avoiding apothecaries and 
bills, and, what is better, their poison. 
" The day has certainly arrived when medicine, like religion, should be placed before 
the face of the world stripped of all its mysteries, all its absurdities and professional 
intricacies, and appear in its genuine simplicity and rationality, open and undisguised 
before all who wish to examine and understand it." I have too exalted an opinion of 
Deity, to believe that he will permit mankind to be tortured much longer with a practice 
so clearly pernicious to the workmanship of his hands. The ice has been broken, or 
the way prepared; the flame is here and there bursting forth; and it appears to me that 
the cause of reform will hereafter spread more suddenly and rapidly than at any former 
period. 
In relation to botanic physicians in general, the following remarks of an author are 
very applicable: 
" The author has long seen, and with regret, the want of something like a general, 
systematic treatise upon the different branches appertaining to medicine, on a plan adapted 
to the peculiar profession of botanic physicians; and he has looked anxiously for some 
one more competent to the task to undertake it: but as yet no work of the nature of 
the one proposed, even professedly, has appeared, that I am aware of. Many books, 
indeed, have been written upon botany; but they have chiefly been either a scientific 
classification of plants, unconnected with their medical properties; or mere fugitive 
treatises upon the medical qualities and uses of particular plants, which, though very 
useful as far as they go, were not intended by their authors as a general guide for the 
practice of physic. Impelled, then, by the necessity of a work such as is proposed above, 
the author has attempted, in the following pages, to supply it: how far he has succeeded, 
others will determine. This, however, he can confidently assure the members of the 
botanic profession, that in his hands the treatment of diseases recommended has proved 
eminently successful; and it would be but a poor compliment to his Botanic brethren 
to suppose, that in their hands it would not be equally efficacious. 
" It will not be denied, that the depressed, and almost outlawed, condition under which 
botanic practitioners have laboured in modem times, is in a great measure owing to the 
deficiency of a substantial, comprehensive, and regular system of practice, which should 
render them independent of any other sect, elevate them to a standard of respectability, 
and remove all grounds for the imputations of ignorance and incompetency, which are 
now so lavishly heaped upon them by interested persons. Until such a standard is 
established, societies formed, and the botanic profession brought up to that standard, 
public confidence in them, as a body, cannot be expected. 
" And, I would ask, what should hinder the accomplishment of so desirable an object ? 
Are botanic medicines so intrinsically inefficient, or so deservedly unpopular, that 
they should for ever be condemned to insignificance ? None dare say it. Who has not, 
in the course of his life, seen astonishing cures performed by the simple virtues of vege- 
tables-even when administered by the humble man of ' roots and herbs,' when the 
whole force of minerals has failed ? Does any one say, that vegetable medicines are less 
safe than minerals ? Alas ! the miserable martyrs to the latter, who daily meet our eyes, 
forbid it. Why, then, do we grovel in the dust, when the Almighty has put in our pos- 
session such ample materials for relieving the sufferings of our fellow-beings ? And 
why are we permitted to render this service only with halters about our necks ? Why 
is it that the botanic profession is proscribed in most of the states by legislative restric- 
tions, which in many of them amount to absolute tyranny, as unconstitutional as unjust? 
If there is a shadow of a cause for such oppression, aside from the assiduous misre- 
presentations of interested persons, it is because botanic physicians are not just to them- 
selves. Let them unite, form societies, establish a respectable and intelligent standard of 
admission, and the favour of the public will soon break their fetters." 
" The time has arrived when those dark mists-the spell which has so long bound 
true science to the car of superstition-should be dissolved, the chain broken, the mist 
dispersed, and the standard of science erected upon that true and imperishable foundation 
-facts and experience ! It is time that the reign of medical tyranny should cease 
it has ruled the world with an iron erasp. Thousands have been the victims sacrificed XX 
INTRODUCTION. 
at its shrine. Let revolution-revolution be the cry through mountain and glen, valley 
and plain, until this hydra of medical aristocracy be shorn of its fangs -until the tears 
shed by suffering humanity shall cease to flow, and the sunshine of hope cast abroad its 
bright beams of joy upon a no longer oppressed and suffering human nature. Let those 
parents who have lost a beloved child by that violent and ignorant practice which cha- 
racterizes the medical profession, raise the cry of revolution ! Let her whose home is 
left lonesome and desolate, without friend or protection for her orphan children-who 
feel the untimely death of a father and friend--all, all raise the cry of revolution ! Let 
them at once refuse admission to their threshold the administratoi of poison, or his vio- 
lent depletive agents. Let all unite in this great work, and the ruddy countenance and 
vigour of mind and body will soon afford the most ample evidence that the work is done !" 
" The leaven of reform," says a writer, " is working well in our country, although 
there is only a beginning; it is perceptible in the community generally, so readily does 
truth commend itself to the human mind. Custom, interest, and ignorance growl brutally, 
or scoff foolishly; but growls and scoffs cannot subdue truth, nor drive it out of the field; 
it is destined to pursue the last of error's whelps to a deeper den than that to which 
Putnam drove the Pomfret wolf; and if it comes forth thence again to light, it must 
come as Putman brought forth his-dragged out dead, to feast the eyes of righteous 
execration." 
I have given a history of medicine, and shown the necessity and utility of dissemi- 
nating it among the community at large. I have now to point out some obstacles which 
stand in the way of its prosperity and progress: 
1st. Selfishness.-It is self-interest which retards the progress of the reformed system. 
Most physicians, and others, will follow that kind of practice which is the best establish- 
ed and the most profitable. Like the tories in the revolutionary war, they care more 
for their pockets than they do for the welfare of their fellow-men. 
2d. Want of Integrity.-A lamentable want of honesty is another cause. Many are 
fully convinced that the reformed system is the best; but, for some cause or other, they 
will not embrace it. 
3d. Prejudice.-Many look with an eye of prejudice on all innovation and reform; 
and where there is prejudice there is blindness, and, consequently, no reception of the 
truth. The effect of truth upon the minds of such may be compared to light upon the 
owl; it is sure to set them screeching. 
4th. Ignorance.-Many persons are totally ignorant of the principles of the reformed 
system, and, therefore, condemn it without knowing anything about its merits. They 
judge from reports, or the lies and slanders of its enemies. Not only so; often, when a 
skilful physician of the new school is called to prescribe, some one in the house, or a 
neighbour, perfectly ignorant of the disease, and also of his skill, will, from some impulse, 
condemn his prescriptions. I lately had a case of a very interesting child with putrid 
sore throat, the symptoms of which, under my treatment, were favourable; but the 
mother thought she knew best, and would employ a mineral doctor, although she had 
previously lost three or four children in a short period under the same treatment. 1 
left, with the emphatic remark, that the patient was then doing well, and that, if it died, 
I shordd be exonerated from all responsibility. 
The doctor, though apparently very friendly, exulted to obtain the patient, and con- 
sidered it, no doubt, quite a victory. But in a few days I was invited to the funeral of 
the child. I was once before dismissed from a case by a female Jezebel, which was 
also doing well, and which was subsequently attended by the same physician. But 
shortly I saw a coffin taken into the house for the little sufferer. I mention these cases 
by way of illustration. Ignorance, then, is another powerful obstacle in the way of 
reform; and, what is very lamentable, there is no cure for it. Well might Solomon 
say, " Though you bray a fool in a mortar with a pestle, yet will not his folly depart 
from him." Let it be remembered, that it takes a man of sense to judge a man of sense. 
5th. Popularity, Pride, Fashion, fyc.-Such is the power of custom, fashion, popu- 
larity, and pride, that many would rather die, than embrace anything contrary to esta- 
blished usages, lest they should be thought singular: they would rather perish under a 
fashionable doctor, than be cured by any one persecuted or unfashionable. 
6th. Midwifery.-Another great difficulty of introducing a better practice is, the un- 
natural and wrong custom of employing males, instead of females, to attend in parturi- 
tion. Women have been taught to believe a most notorious falsehood, viz., thad none INTRODUCTION. 
XXI 
but doctors are competent to attend at this period; and thus they become alarmed, and 
employ them instead of females. In this way the physician becomes identified with 
the family, and gains such an influence and ascendency over their minds, that they 
believe every assertion he makes. Thus physicians prejudice persons against all 
reformers, pronouncing every deviation from their pernicious treatment "quackery." 
Their slanders and falsehoods so operate upon the minds of people, that they reject the 
botanic treatment even against their better judgment, and are thus kept ignorant and 
deceived. But, when a few more of their relatives or friends have been injured or 
destroyed, perhaps their eyes may be opened to these impositions. 
I have sometimes almost despaired of ever extending the blessings of this system to 
adults, or at least to those over forty years of age. Their minds are too much warped 
or prejudiced. It is to the rising generation that we must look for the reception of new 
truths: and is it not a righteous judgment, that such are not permitted to participate in 
these blessings in consequence of their own wilful blindness or prepossessions ? 
There are few greater obstacles to the promotion of true medical improvement, than 
attachment to some favourite theory or practice, infused by noted teachers or authors, or by 
the popular schools of the day. They so pervert the mind or judgment, that it becomes 
incapable of receiving simple facts, although they may not be conscious of it in some 
measure at least. In this state of mind it is very difficult to be really impartial and 
honest. A very good and wise man has explained this matter by an illustration so true 
and striking, that I will here relate it :* 
" A watchmaker told me that a gentleman put an exquisite watch into his hands, 
that went irregularly. It was as perfect a piece of work as was ever made. He took 
it to pieces, and put it together again, twenty times. No manner of defect was to be 
discovered, and yet the watch went intolerably- At last it struck him that the balance- 
wheel might have been near a magnet: on applying a needle to it, he found his sus- 
picions true. Here was all the mischief: the steel work in the other parts of the 
watch had a perpetual influence on its motions; but the watch went as well as possible 
with a new wheel. If the soundest mind be magnetized by any predilection, it must 
act irregularly, and which accounts for the errors of common physicians." 
Men do not easily forsake old customs or forego their prejudices: hence the pro- 
gress of truth has been proverbially slow; but she has, nevertheless, been constantly ad- 
vancing. Nothing can arrest her march; her operations are sure; she will arrive at last 
at the true and highest attainable point through all the intermediate stages of opposition 
and difficulty. If selfish and personal interest were never brought into collision, there 
would be nothing to impede her progress; but this is perhaps inseparable from the na- 
ture of things; and those who labour for the reformation of abuses, must be content to 
endure much, and be inadequately rewarded. The consciousness of right is in many 
cases the sole recompense. It is not easy in any case to contend with the current; it 
is much easier to float with the stream. It is very certain that, if abuses in medicine, 
religion, politics, and everything else were never opposed, they would be perpetuated, 
and all the evils of ignorance and error would be for ever entailed upon the human race. 
What innovation, however important in itself, or beneficial in its consequences, ever 
claimed immediate and general approbation? No matter how good in itself-no matter 
what the amount of certain good it was calculated to accomplish-it has been denounced 
as contrary to ancient usages, and incompatible with custom. 
In concluding this preface, I will quote a few remarks from a late production, entitled 
" Manual of the Materia Medica." The editors observe : 
" We like and admire the ingenuous maxim promulgated by the celebrated Baglivi. 
' I am,' said he, ' neither for the ancients nor for the modems, but shall be of every age 
and nation.' This candid and philosophical declaration shall also be our motto. We 
have observed, in our addition to this work, as much as has laid in our power, the admira- 
ble rule-' Prove all things, hold fast that which is good.' For, as the same author 
remarks, ' to prejudge other men's notions before we have looked into them, is not to 
show their darkness, but to put out our own eyes.' We cannot see without regret, there- 
fore, the constant opposition which everything new encounters from some individuals 
who can read the past only, but will not admit, or cannot understand, the improvements 
of the present. The history of medicine offers us but too many examples of this system 
* Cecil's Remains, on Judging Justly. XXII 
INTRODUCTION. 
of opposition to everything that is not antique; and the difficulties which the justly 
celebrated Harvey, Jenner, Bichat, Gall, and Broussais experienced in promulgating their 
useful discoveries and doctrines, are remarkable instances of this spirit so hostile to every 
suggestion of improvement or innovation. 
" Locke, that great master of matter, mind, and human passions, has faithfully, 
although quaintly, recorded this feature of the character of man, too much to the purpose 
not to be cited in this place. 
" ' Truth,' says he, ' scarce ever yet carried it by vote anywhere at its first appearance. 
New opinions are always suspected, and usually opposed, without any other reason 
than because they are not common. But truth, like gold, is not the less so for being 
newly brought out of the mine. 'Tis trial and examination must give it price, and not 
any antique fashion; and though it be not current by public stamp, yet it may, for all 
that, be as old as nature, and certainly not less genuine.' 
" At the present epoch, when the collision of opposite and conflicting opinions is so 
great, it is very needful to refer from individual practice and experience to nature, un- 
biassed observation, general principles, and sound philosophical induction. 
" Although there has been no lack of endeavour to render the work as accurate, useful, 
and satisfactory as possible, yet still it may be found deficient in one or all of these par- 
ticulars : errors no doubt there are, sufficiently numerous to require the exercise of much 
charity, and an equal share of candour to excuse; neither of which, however, is solicited; 
for they are only desirable or estimable so far as they are the spontaneous effusion of 
generous and enlightened minds. 
"We expect that indulgence which the zeal for doing well, and the desire of aiding 
the advancement of medical science, even when not attained, always deserves. In con- 
clusion, we shall say of our labour (if small things may be compared to great) what the 
the celebrated Johnson said of his dictionary: ' In this work, when it shall be found that 
much is omitted, let it not be forgotten that much likewise is performed ; and though no 
hook was ever spared out of tenderness to the author, and the world is little solicitous to 
know whence proceeded the faults of that which it condemns; yet it may gratify curio- 
sity to inform it, that this work was written with little assistance of the learned, and 
without any patronage of the great; not in the soft obscurities of retirement, nor under 
the shelter of academic bowers, but amid inconvenience and distraction.' " 
Friends may flatter, and enemies may defame, but the public at large will do justice, 
because they are far removed from the sphere of personal feeling. It is to this tribunal I 
appeal for a decision of the merits or demerits of this work. 
I may add, that the style of the work, so far as practical, has been rendered simple, 
and the words and phrases selected with special reference to the ordinary language 
of persons not accustomed to medical terms. FOREIGN RECOMMENDATIONS. 
Copy of a letter from Professor Von Huff.land, First Physician to his majesty, King of 
Prussia, to Dr. Lobstein, of this city. 
SSertin, Sept. 10. 1S34. 
(* w. o b I g e b. 
foabe idj'bie @bre an$iqeiqen, bag id) 3br unb $errn T)r. ®cad)g 
SBrief nebft beffen intereffante S3ud), fo ivie and) ein @reinp(ar beflelben 
nebft Sdjreiben an S. 9)?ajeftdt ben jtonig, ridjtig erbalten babe, bag S- 
'■Dlajeftat bagelbe febr gudbig anfgenotninen, unb an £erru £r. S3ead) eine 
golbene $reig*sJ)?ebaiHe burd) ben (Sjefanbteu in 3Iniertfa 
gefenbet baben; bag id) fd)on in biefem eine Slntwort unb Daub 
fagungg SSrief an S i e nub £erru £r. S3 e a d) nebft ben Siplomen fur 
beibe'alg covrefponbirenbe sJ)litgIieber ber 9J?eb. (Shir. ($e# 
feUfd)aft SSeriin abgefenbet babe, unb bag id) boffe eg roerbeu nun 2IUe 
ricbtig in 3bre £dnbe gefommen fein. 
3d) bitte Sie'mir bauon gefalligd 9?adjrid)t ju geben, unb bin mitber 
voUfommeuften 
Sbr 
ergebenfter 
th $ufelaub. 
(translation.) 
Honourable sir-I have the honour to announce to you that I have received your letter 
and Dr. Beach's, with a copy of your interesting work accompanied by a letter to his 
majesty, the king. His majesty has politely accepted it, and has sent, through the Prussian 
minister in America, a GOLDEN PRIZE MEDAL to Dr. Beach. 
I sent this spring an answer and a letter of acknowledgment to you and Dr. Beach, 
with diplomas to you both, as corresponding members of the Medical and Surgical Society 
of Berlin ; and I hope that the same have all been safely received ; if so, have the kindness, 
I pray you, to inform me of it. 
I am, with the highest consideration, yours, 
Berlin, September 10th, 1834. VON HUFELAND. 
Extract of a letter from Dr. Von Ludwig, First Counsel and, First Physician to his majesty, 
King of Wurtemburg, to Dr. Lobstein, of New York. 
Das interessante Werk des Herrn Prof. Beach welches meinem gnadigen Monarchen 
zugeschickt wurde, habe ich durchgelesen und meinen giinstigen Rapport dariiber abgestattet, 
und es freut mich wenn bei Anerkennung welche Herrn Dr. Beach auf meinen Antrag zukam 
demselben Vergniigen gemacht hat. 
VON LUDWIG. 
(translation.) 
The interesting work of Prof. Beach, which he has sent to his gracious majesty, I have 
read and made a favourable report of; and I am glad if the acknowledgment which Dr. 
Beach has received by my report to his majesty will afford him satisfaction. 
April 19th, 1836. VON LUDWIG. XXIV 
RECOMMENDATIONS. 
Copy of a letter from Baron Von Lehr, Privy Counsellor to his majesty, the King of 
Wurtemburg, to Dr. W. Beach, of New York. 
Docteur et . Professeur 
Beach, 
a 
New York. 
Dapres les voeux enonces dans la Lettre que Mr. Le Docteur Lobstein m'a fait 1'honneur 
de m'ecrire sous le 31 Janvier, j'ai transmisa Sa Majeste Le Roi Vos deux Lettres du 10 
Janvier et 27 Avril, qui me sont parvenues ensemble, ainsi que L'exemplaire de Votre savant 
Ouvrage, The American Practice of Medicine, dont Vous m'avez charge pour Lui. Sa 
Majeste, tr&s sensible a 1'attention que Vous avez voulu Lui temoigner par cet envoy, m a 
charge de Vous en faire Ses grands remercimens, et de Vous prier, Monsieur, d'etre 
persuade de 1'accueil favorable, dont Elie a honore l'ouvrage, qui vient de sortir de Votre 
savante plume, et qui saus daute ne saura manquer d'emporter le suffrage de tous les con- 
noisseurs £claires. 
Je Vous prie en mdmetems, Monsieur, de vouloir bien 6tre assure de toute ma reconnois- 
sance pour la marque flatteuse d'attention et de Bienvieillance que Vous avez daignS me 
donner, en me rendant possesseur d'un Exemplaire de Votre precieux Ouvrage, et que je ne 
desire rien tant, que de trouver 1'occasion de Vous 6tre agitable en tout ce qui ddpendra de moi 
et pourra tourner a Votre satisfaction En attendant veuillez Monsieur 1'expression des 
sentimens d'estime et de consideration les plus disinguhs, avec lesquels j'ai 1'honneur d'etre. 
Monsieur. 
Votre tr£s humble el ties devoufe serviteur, 
Le Conseill6 intime de Legation, 
F. DE LEHR. 
Stutgard le 11 Octobre, 1833. 
(translation.) 
Sir-After the request contained in the letter that Mr. Lobstein did me the honour to 
write on the 31st of January, I transmitted to his majesty, the King of Wurtemburg, you: 
two letters, of the 10th of January and 27th of April, which were received together, as well 
as the copy of your learned work, "The American Practice of Medicine," which you sent 
to me for him. His majesty, very sensible of the attention that you have been pleased to 
manifest toward him by this present, has directed me to express to you his sincere thanks 
for it ; and that you, sir, may be persuaded of the favourable reception with which he has 
honoured the work that has just flowed from your learned pen ; and which, without doubt, 
will not fail to obtain the approbation of all enlightened persons. 
I pray you at the same time, sir, to be well assured of all my gratitude for the flattering 
mark of attention and kindness which you have deigned to give, in rendering me the pos- 
sessor of a copy of your precious work ; and that I desire nothing so much as to find an 
occasion of being serviceable to you in everything that may result to your satisfaction. 
In the meantime, be pleased, sir, to accept the expression of the most distinguished 
sentiments of esteem and consideration ; with which I have the honour to be, 
Sir, your very humble and very devoted servant, 
F. DE LEHR. 
N. B. This Gold Medal was sent to Dr. Lobstein, of this city, accompanied with a 
letter from Baron Lehr, requesting him in person to present it, in the name of his majesty, 
to Dr. Beach, which with great pleasure he performed. 
Stutgard, Oct. 11th, 1833. 
Copy of a letter from Baron Alibert, First Physician in the Hospital of St. Louts, Parts, 
to Dr, J. F. Daniel Lobstein, Professor of Midwifery, New York. 
Mon chfir, et trds Honore Colldgue, 
J'ai re<;u la lettre que vous avez eu 1'extrdme bonte de in'ecrire, L'ouvrage excellent de 
Mons, le Professeur Beach, m'est aussi parvenue; je vous suppli d'etre mon interprfite, 
aupres de cet homme, si recommandable, et de lui transmettre mes plus vives reconnoissances. 
J'ai en ce moment, chez-moi, deux paquets ; 1'un a votre addrese, 1'autre & 1'addrese de 
Mons, le Docteur Beach, les deux paquets contiennent, chacun, un exemplaire de ma Mo- 
nographie des Dermatoses, je vous les enverrai. Effigy cf tJu K/m/ . 
Zv /Z >' //z y/Z' /iZ;Z-Z7,f 
/{frf/Vf iSn/f ff' III/ .\fff/rtf . Effipv of the Pope. 
- r y '//< r r.-rtc'.anvidx/ 
/'// ///f ly 'rSi'/W<' . 
heverse side of the Medal. RECOMMENDATIONS. 
XXV 
Agreez, je vous prie, mon chilr Monsieur Lobstein, 1'assurance de rna haute et parfaite 
consideration. 
BARON ALIBERT. 
Paris, le 23 Aoflt. 1833. 
(translation.) 
My dear and much honoured Colleague-I have received the letter which vou had 
the extreme goodness to write me, and also Dr. Beach's excellent work. I beseech you 
to become my interpreter to this meritorious man, and to transmit to him my liveliest ac- 
knowledgments. 
I have this moment in my house two packages-one directed to you, and the other to 
Dr. Beach : each package contains a copy of my Monography of the Cutaneous Diseases. 
I will send them to you. 
Accept, I pray you, my dear Mr. Lobstein, the assurance of my high and perfect esteem. 
BARON ALIBERT. 
Paris, August 23d, 1833. 
Copy of a letter from Babon Von Lehr, Privy Counsellor of his majesty, King of Wur- 
temburg, to Dr. Lobstein, of New York. 
IB o big e b o b r e n er, 
£od)$nverebrenber $ e r r 
§uer 5Boblgeboren babe id) auf bbcbflen Slnftrag Seiner W?aje)ldt beg 
.ftbnigg aufbag Sdjreiben vom 12. 'Jtov.v. 3. ivelcbeg fte burcb meinc 38er# 
mittelung an 5?6d)ft biefelben eingefanbt, nebft be£ fritter an Seine $bnig* 
lid)C DJajefhit eiligefdjirften iffierfeg " The American Practice oj'Medicine" 
von 5?errn Dr. 5B. 53 e a d) in sJietv?7)orf, bie (5bre 511 erbflrnen, 
ba# beg Jtonigg IWajeildt biefeg intereffante sIBert in ®naben aiifjnnebmen 
entfprocben babon, unb (*uer erfitdjen laffen, bie beifolgenbe 
gotbene *preig#W?ebaille bem jperrn 53 e a d) alg einen 55eroeig 
ber bodglen Slnerfenntni# fein'er auggejeicbueten SSerbienfte um bie 5Biffen* 
fcbaft ber 50?ebicin im 9tamen bed jtbnigg jufiellen 511 roollen. 
3nbem eg mir ju einem befonberen 53ergniigeitgereid)t, mid) biefeg bbcb* 
(ten Sluftragg bie,nit Ju entlebigen, erfucbe id) @n>. IBoblgeboren mid) vom 
beg gegenivdrtigen jii benadjridjtigen, unb babe bie tyre mit ber 
auggejeicbnetflen $od)ad)tung ju fein 
@ro. WBobtgeboren, 
(Seborfatnfler Diener, 
©ebeimer gegationg 9tatb, 
von £ e b r • 
Stutgarb, b. 9. Sult, 1835. 
Honoured Professor-Having received the high order of his majesty to announce to 
you that his majesty has received your letter of Nov. 12th, which you forwarded to me, and 
Dr. Beach's work, "The American Practice or Medicine," which was delivered by me 
to his majesty ; the kino has been pleased to accept the same, and to request you to 
present to the doctor, in the name of his majesty, this letter, and the enclosed GOLD 
PRIZE MEDAL, as a testimony of his majesty's acknowledgment of the author's distin- 
guished merit and skill in Medical Science. 
With the greatest pleasure I obey his majesty's high commands; at the same time 
requesting you to inform me when the present shall have arrived. 
I have the honour to remain, with the highest consideration, your obedient servant, 
VON LEHR, Privy Counsellor. 
Stutgard, July 9th, 1835. 
(translation.) XXVI 
RECOMMENDATIONS. 
Copy of a letter from the Secretary of State of his holiness, Pope Gregory 16th. No. 56,623. 
Roma, 2 Marzo, 1837. 
Illmo Signore-Si c degnato il S. Padre di gradire la bella opera Medica in tre volumi, 
che il suo datto Antere il Signr. Professore Beach di New York, ha voluto tributargli ir 
omaggio di devozione versu la sua sacra persona. Il Santo Padre redendo onorataquest opera 
dul voto di tanti Sovrani di Europa c di tanti distinti Professori dei due Mondi, ha voluto aniot 
Egli ricamliare il deno con una Medaglia d'oro di Benemerenza, che io mi fo un devere di 
rimettere qui unita a U. S. affinchi Ena quinga a Signr. Dre. Beach pr to steno mezzo, onde 
1'opera lin i guinta a sua Santita accompagna da una letters motto onorifica 
del Signr. Professore D. Lobstein, il oni neme i chiaro egualmonte ir Europa, che ir America 
Mei e grato ir questo incentro il ripetere a U. S. le apicurazioni della mia distinta stima 
Per 1'Emo Segretarid, F. CAPACCINI, Sostituto, 
Signr. Geo. Butler Sartori, Console Gl. Pontificio Negli Stati Uniti di America. 
(translation.) 
Rome, March 2, 1837. 
Illustrious sir-It has been the pleasure of his holiness to accept the valuable work 
on medicine, in three volumes, that the author, Dr. Beach, of New York, has presented as 
a mark of respect and devotion toward his sacred person. 
The holy father, seeing this work honoured by so many sovereigns of Europe, and by so 
many distinguished professors in the two hemispheres, wishes also to interchange the gift 
with a medal of gold, and which I send to you to forward to Dr. Beach in the same mode in 
which the work was received by his holiness. 
The work was accompanied by a very gracious letter from Professor D. Lobstein, who is 
well known in Europe and America. Pleased with this occasion to renew the assurance of 
my high consideration, I remain, &c., &c., 
For his Excellency, the Secretary of State, 
F. F. CAPACCINI, Acting. 
To Jno. B. Sartori, Consul Gen. of Rome to the United States. 
Copy of a letter from Baron Alibert, Physician to Louis Phillippe, King of the French, 
to Dr. Beach, of New York. 
Docteur et Professeur 
Beach, 
tl 
New York. 
Mon trds illustre et triis Honorable Cologne, 
J'ai re<?u dans son temps le grand et admirable ouvrage que Vous avez eu I'extr&me 
bont6 de me faire parvenir. C'est un modele d'analyse, c'est un chef d'oetivre de methode 
et d'experience meidicinale. Je prends la Liberte de Vous envoyer en retour pour un aussi 
beau present, un exemplaire de ma Monographic des Dermatoses. Je Vous prie de vouloir 
bien agreer cette 16gere offrande, comme un foible t6moigna<>e de ma trds haute considera- 
tion pour vos talens distinguds. 
LE BARON ALIBERT, 
Professeur a la Faculty de M&decine de Paris, 
Madecin en Chef de L'Hopital, Saint-Louis. 
(translation.) 
Doctor and Professor Beach, N. Y.: 
My very illustrious and honourable Colleague-I have received your great and 
admirable work, which you had the extreme kindness to send me. It is a model of an- 
alysis, and a masterpiece of method and medical experience. 
I take the liberty to send you, in return for your excellent present, a copy of my work, 
entitled " Monography of Cutaneous Diseases." I hope you will receive it as a feeble 
testimony of my very high consideration for your distinguished talents. 
BARON AUBERT, 
Professor of the Medical Faculty of Paris, 
Chief Physician to the Hospital of St. Louis fiffiyy cf t/v A7ng. 
~~ ( /V ////• '■ '/wrris/st/ 
A' 7 'fj/ar/ /C/ //r 
/ffiTiw SkA cf th f Mf(/a/ 
TO VIHTITF. AND GENIUS 
Jo.' HarrbS. S 6 tAj Reverse Side cfMedal. 
EfTijfy of the Kt ny. 
r '^7rr //'ws/s //e Mt's/ 
'h -'{/'/■ 4 
VVlKTl'Min'R G. 
PHTTSSIAX. 
SAXON . EFFIGY OF THE KING 
-r Y'///, j^/'/ 
~ Z ZZ/ZZ'/ /■// //is r 
REVERSE SIDE OF MEDAL RECOMMENDATIONS. 
XXVII 
ry of a letter to Dr. W. Beach, President of the Reformed Medical Society, New York, 
rom Professor Hesselbach, Doctor of Physic, Professor of Philosophy and Surgery, 
First Physician and Surgeon in the Hospital at Bamberg, Corresponding Member of 
many distinguished medical societies and literary institutions of Europe, and Honorary 
Member of the Medical Society of New York. 
Wohlgeborener Herr President 
Hochgeschatzter Herr Collega. 
Mit dem innigsten Danke fur das unter Ihrem Presidium der reformirten medizinischen 
Gesellschaft der Vereinigten Staaten von America zu New York mir ertheilte hochst ehren- 
volle Diplom und der gutigen Zusendung Ihres vortrefflichen medizinischen Werkes, iiber- 
schicke ich Ihnen einige meiner litterarischen Arbeiten mit der Bitte, dieselben als einen 
Beweis meiner Hochachtung nicht zu verschmahen. Mogten meine Bemiihungen den 
Beifall eines so competenten Richters erhalten. 
Mit ausgezeichneter Verehrung und Hochachtung 
verbleibe ich 
Dero Ergebenster. 
ADAM KASPAR HESSELBACH, M.D., &c. 
Bamberg, am 12. April, 1834. 
(translation.) 
Mr. President : 
Honourable Colleague-I have the pleasure to acknowledge the reception of your 
valuable and excellent work, and the Diploma of the Reformed Medical Society of the 
United States. In return I send you copies of my various medical works, and I pray you 
to accept them, as a token of my highest consideration. It would be flattering to me if my 
labours could obtain the approbation of so competent a judge. 
With the highest respect, 
I remain yours, 
ADAM KASPAR HESSELBACH. 
Bamberg, April 12th, 1834. 
Copy of a letter from the Minister of the King of the Netherlands, to Dr. W. Beach. 
N. 95. 2d Division. 
La Hague, le 18 Aoiit. 1837. 
Monsieur-Le Roi, mon auguste Souverain, ayant pris connaissance de 1'ouvrage donl 
vous lui avez fait hommage sous le letre, The American Practice of Medicine, m'a chargS de 
vous offrir, en son nom, une medaille d'or, que j'ai 1'honneur de vous faire parvenir ci-jointe. 
En m'acquittant des ordres de sa Majestd, je vous prie monsieur, d'agrfcer les assurances 
de ma parfaite consideration. 
Le Ministre de 1'Intferieur. 
it De KORK. 
Monsieur le Professeur 
W. Beach, 
it New York. 
(TRANSLATION.) 
No. 95. 2d Division. 
The Hague, August 18, 1837. 
Sir-The king, my august sovereign, having appreciated the work which you have res- 
pectfully presented to him agreeably to your letter, " The American Practice of Medicine," 
he has directed me to present you, in his name, with a GOLD MEDAL, which I have now 
the honour to present. 
In acquitting myself of these orders of his majesty, I beg to apprise you of my great 
espect. 
Minister of the Interior. 
Ds KORK. 
To Mr. Professor W. Beach, 
New York XXVIII 
RECOMMENDATIONS. 
Washington, October 23, 1837. 
Sir-I have the honour to transmit to you a letter, received to day from the Minister of 
Foreign Affairs of my government, to your address, which contains a GOLD MEDAL, which 
his majesty, the King of the Netherlands, desires should be presented to you in considera- 
tion of a work written by yourself upon The American Practice of Medicine. 
It affords me great satisfaction to be the medium through which my sovereign's apprecia- 
tion of the merits of this work is communicated. 
I have the honour to be, with great regard, your obedient servant, 
ALEX. MARTINI, 
Charge d'Affairs of H. M., the King of the Netherlands, 
near the Government of the United States of America. 
To Professor W. Beach, 
New York. 
Copy of a letter from Professor Von Walther, Privy Counsel and Surgeon to his 
majesty, King of Bavaria, to Dr. Beach, of New York. 
Au 
Docteur et Professeur 
Beach, a New York. 
Monsieur, 
J'ai re?u 1'exemplair de votre savant ouvrage, que vous m'avez envoye. Cet ouvrage si 
interessant et si instructive, vous met au rang des plus cdldbres Auteurs dans notre art. 
J'ai 1'honneur d'etre, avec la plus haute consideration. 
Monsieur, Votre tr&s humble, et obeissant serviteur, 
DE WALTHER, 
Conseiller intime, &c. 
(TRANSLATION.) 
To Dr. and Professor Beach, N. Y.: 
Sir-I have received the copy of your learned work which you sent me. This work, so 
interesting and instructive, places you in the ranks of the most celebrated authors of our 
science. 
I have the honour to be, with the highest consideration, 
Sir, your very humble and 
Obedient servant, 
DE WALTHER, 
Privy Counsellor, &c. 
Munich, Oct. 17th, 1834. 
Extract of a letter from Edward Andrews, LL.D., and late Minister of the Gospel, 
London, one of the most learned and distinguished clergymen in England. 
* 14 West-street, Walworth, near London. 
Friday, October 15th, 1841. 
Mr dear Doctor-I do admire, beyond expression, your books. I keep them in my 
parlour, and they are constantly read. 
It is a mercy that God has given you health and ability to produce such a work; which 
is, indeed, the confluence of many rills of thought running into one mighty ocean of instructive 
wisdom. What a blessed thing it is to know the Lord, to do all in his fear, and to perceive 
that He is enabling us to prosper. Mrs. Andrews unites in expressions of high esteem with 
yours in the Lord. Adieu, my dear Doctor. 
EDWARD ANDREWS, LL.D., 
Minister of the Sutherland Chapel, Walworth, near London Eni4y of Um* Queen 
I'.Ji'n/f'f/ f 'fo/ 
. p/ -pre/LiSm 
Reverse side of Medal. Effigy of the Eng 
r frr ,7 '' //. '' ' • 
','. yy- r ///r' 
///Lt 
Reverse S ide of Medal RECOMMENDATIONS. 
XXIX 
Copy of a letter from his majesty, the King of Prussia, to Dr. Beach, of New York. 
st 
Monsieur Beach, 
MMe<;in, a New York. 
J'ai requ Monsieur, Votre Ouvrage que Vous m'avez presents, en date du 10 Janvier, et 
je vous engage d'accepter la medaille ci-jointe, comme une marque de ma reconnoissance 
Berlin, le 23 Octobre, 1833. 
FREDERIC GUILLAUME. 
(translation.) 
Sir-I have received your work which you presented to me under date of January 10th, 
and request you to accept the enclosed GOLD MEDAL as a token of my acknowledgment. 
Berlin, Oct. 23d, 1833. FREDERIC WILLIAM. 
Copy of a letter from the Minister of the King of Saxony, to W. Beach. 
Au Docteur et Professeur 
Beach, 
st 
New York. 
Monsieur, 
La Lettre du 10 Janvier de Fannie derniere par laquelle Vous faites hommage & Sa 
Majesty Le Roi de Saxe, mon Auguste Souverain, de Votre ouvrage sur la medecine pratique 
de 1'Amdrique, a ete recemment avec celui ci ii.sa haute addrese par Mr. Le Docteur 
Carus, lequel, en mdine temps, a su 1'accompagner d'un rapport infiniment avantageux et 
mettre au jour le m6rite distingue que Vous avez acquis par la publication de ce travail. 
Sa Majeste l'a done requ avec bien du plaisir, et a daigne me charger de V ous en exprimer 
Monsieur, toute Sa reconnoissance, ainsi que de Vous faire passer comme un 
ostensible du prix qu'Elle y attache, la medaille en or ci-jointe avec la legende " Virtuti 
et Ingenio." 
En m'acquittant de cette gracieuse commission, j'eprouve pour ma part une satisfaction 
4 pouvoir y ajouter i'expression de ma consideration distingue. 
Dresde, ce 2 Fevrier, 1835. 
Le Ministre D'Etat et des affaires de Sa MajestS Le Roi de Saxe. 
JDE MINCKWITZ. 
To Dr. W. Beach : 
Sir-The letter of the 10th January last, by which you presented to his majesty, my 
august sovereign, the King of Saxony, your work on the American Practice of Medicine, 
has been recently delivered to its high address, with the work, by Dr. Carus, who at the 
same time has been able to accompany it with a report, infinitely advantageous to it, and to 
display the distinguished merit which you have acquired by its publication. 
His majesty has received it with great pleasure, and has deigned to order me to express 
to you, sir, his acknowledgment for it; and to transmit to you, as a visible testimony of the 
value which he attaches to it, the enclosed GOLD MEDAL, bearing the motto, " Virtuti 
et Ingenio (To Virtue and Genius.) 
In discharging this grateful commission, I experience on my part a particular satisfaction 
in being able to add to it the expression of my distinguished consideration. 
Dresden, Feb. 3d, 1835. JO. MINKWITZ, 
The Minister of State and Foreign Affairs of his majesty, the King of Saxony. 
(translation.) 
Extract of a letter from the King of the French, Louis Phillippe, to the Author, through 
Mr. Robinson, at Havre. 
The king, being desirous to encourage everything which has in view the melioration of 
•offering humanity, requests me to forward you the accompanying plates. XXX 
RECOMMENDATIONS. 
Copy of a letter from the Hon. W. MacMichael, Librarian to his majesty, the King of 
England, to Dr. Beach, of New York. 
London, Feb. 10th, 1836. 
Sir-I am instructed to acknowledge the receipt of a copy of your work on " The Ame- 
rican Practice of Medicine," presented by you to his majesty, the King of England ; a 
present which the king duly appreciates ; and I am commanded to transmit to you, on the part 
of his majesty, the accompanying GOLD MEDAL. 
I have the honour to be, sir, your most obedient servant, 
W. MACMICHAEL. 
King's Librarian. 
From the Grand Duke of Tuscany, Italy. 
Monsieur-S. A. I. et R. Monseigneur, le Grand Due de Toscane, mon Auguste Maitre, 
me charge de vous accuser la reception, de 1'Ouvrage que vous avez bien voulu Lui adresser 
avec votre Lettre du 10 Avril, 1838, et il m'a invite de vous faire parvenir, avec ses, 
remerciements tres distingues, la Medaille que vous trouverez ci-jointe, pour vous temoigner 
d'avantage le Souverain agrement. 
Pour servir a ma tranquillite, je vous prie de me donner avis lorsque le Pacqnet vous 
sera remis, cependent je saisis avec plaisir cette occasion, pour vous assurer de ma con- 
sideration tres distingues avec laquelle je suis. 
Monsr. W. Beach, Votre tres humble servr., 
Docteur a Le Comte de la Sheroolepo, 
Neuve Yorch. Grand Maitre de la lourde dofeau. 
Florence, Le 31 Decemb, 1838. 
(translation.) 
Sir-His serene highness, my lord, the Grand Duke of Tuscany, my august master, 
has charged me to inform you of the reception of the work which you sent to his address, 
together with your letter of the 10th of April, 1838, and has instructed me to send you, 
with his best acknowledgments, the medal which you will receive with this letter, as a 
testimony to you of his sovereign pleasure. 
In order to afford me satisfaction, I pray you to accept this packet which I send you ; and 
be assured that it is with pleasure I avail myself of this occasion to assure you of the very 
high consideration with which I am your very humble servant, 
Doctor W. Beach, COUNT SHEROOLEPO, 
New York. Grand Master of the Palace. 
Florence, 31 si December, 1838. 
From the Courier and Enquirer of July 20th, 1839. 
Dr. Beach, of this city, author of the " American Practice of Medicine " on reformed 
principles, some period since prescribed with success for an Italian lady. Her husband 
advised him to send his work to the reigning sovereign of his native country, the Grand 
Duke of Tuscany. He did so one year ago, but heard no more of it till within a short time 
passed, when one of the counts of Italy wrote to a gentleman of this city, stating that a 
present had been sent in return to Dr. Beach, through the consul of the Netherlands, at 
Leghorn, by the ship Noble ; and which has now arrived, and proves to be a superb gold 
medal, from the Grand Duke of Tuscany, with his effigy on one side, around which is 
inscribed the following : Leopold II., D.G.P.I.A.P R.H E.T.B., A.A., M.D., E.T.R.V.R. 
The name of Dr. B. is engraved on the other side. The medal was also accompanied by 
a letter of thanks for the medical work, and which, no doubt, was reviewed by his physician 
before the royal favour was given it. 
In connexion with this it may also be mentioned, that one of the most distinguished 
medical societies of Europe has recently forwarded Dr. Beach a diploma, with the request 
that he will furnish the society any new remedies which he may have discovered, speaking at 
the same time in high commendation of his medical work, the Ameican Practice of Medicine THE mxcs 
K N H L I S II SEAL. 
LIBRARIAN ®EAL. 
Cfy-S/,///,' y fa,,' 
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•r frz- r ''zzz'/z z/ mz ' -tSz/. zt/i-a 
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H/verst Side ef Mt.da!. AMERICAN RECOMMENDATIONS. 
Extract of a letter from Mr. Jeremiah Parsell, dated Btnind-brook, New Jersey, 
Oct. 20th, 1835. 
J send, by Capt. Taylor, sloop Bayard, from this place, a ROCKING-CHAIR. I have 
made it purposely for you: please accept of it, together with my most grateful feelings 
toward you and your cause of Medical Reform ; and it is my humble wish that the GOD 
of Heaven, the Great. Rewarder, will reward and bless you. I can speak of the success of 
the practice, as laid down in your work, from my own experience, as well as of my neighbours. 
The Almighty has blessed the means, by following your plain directions. 
I have purchased two copies more of your work, for the purpose of lending out among 
my neighbours. 
PRESENTED TO DR. BEACH, A. D. 1835, BY JEREMIAH PARSELL, ESQ. , OF 
BOUND-BROOK, NEW JERSEY, FOR HAVING BEEN CURED OF A DISTRESSING 
DISEASE OF ELEVEN YEARS' STANDING. XXXII 
RECOMMENDATIONS. 
New York, Yay, 1836. 
Dr. W. Beach-I congratulate you, dear sir, that the favourable opinio; jch i have 
entertained of the merits of your work, and mentioned in your first edition, vz., dial '-our 
diligence, judgment, and erudition would be properly appreciated and rewarded, nas now 
been generally acknowledged in both hemispheres, and a second edition has been called for. 
Your work has not only been appreciated by, and received the highest approbation of, the 
most distinguished physicians in France and Germany, but of the first medical faculties, 
medical societies, and of many of the most scientific and literary institutions of Europe, of 
which you have been honoured with Diplomas as a Corresponding Member. Your work has 
also been honoured with the<»gA benevolence, approbation, and royal presents of their royal 
majesties, King of Prussia, King of England, King of Saxony, King of Wurtemburg, and 
King Phillippe, King of the French, whose great and distinguished personages are generally 
known as protectors of arts and. sciences, and whose royal generosity is extended to all dis- 
tinguished authors of any nation whatever. 
Has any physician of this country been favoured with the same honours I Can it be 
denied that your work has received the highest approbation which I have mentioned I Not- 
withstanding your insignificant opponents. 
What shall I presage now, my dear sir, to your second edition! It is the result of your 
skill, talents, and industry ; and, what is more, this is a production, like aromatic plants and 
flowers, from which the buzzing bee can take wax and honey, if they choose, without 
soiling or withering it. 
I have not any doubt that as your work is read, the merits of it will be more and more 
appreciated, many lives of our fellow-citizens will be saved, and a third edition will certainly 
be the result of it. 
Please to accept my best wishes for your health and prosperity, the assurance of the high 
regard and esteem in which I remain respectfully, my dear sir, your friend, 
J. F. DANIEL LOBSTEIN, M.D. 
Of the Medical Faculty of Paris ; Member of the Medical Society of the city and 
county of New York ; of many other Medical Societies, Academies, and Scienti- 
fic Institutions of Europe and America. Member of the Roval and Medical So- 
ciety of Arts and Sciences of Friesburg, Grand Dukedom of Baden, and Professor 
of the Theory and Practice of Pnysic, of Medical Jurisprudence, and of Midwifery 
in New York ; Author oj several works on Medical and Literary subjects. 
Extract from, the Speech of the Hon. Job Haskell in relation to the Practice of Physic and 
Surgery, before the Legislature of the state of New York during the Session of 1834. 
Among the most conspicuous of the botanic physicians stands Dr. Beach, of New York, 
a man of profound learning and research. He, sir, stands the great reformer and father of 
what is called the American Practice. Here, sir, are three volumes of his works, bearing 
a title on which every lover of his country can look, and his heart dilate with pleasure- 
The American Practice, (exhibiting them to the house ) This work has received the 
approbation of the most distinguished physicians of France ; and theauthorhas been honoured 
by his majesty, the King of Prussia, with a handsome GOLD PRIZE MEDAL for this 
valuable and interesting work, accompanied with a very flattering letter from his majesty. 
(Here being called upon, Mr. Haskell exhibited the medal to the house.) The author has 
also been honoured with a letter from the distinguished and celebrated Professor Von Hufe- 
land, first physician to his majesty, the King of Prussia, in which he has announced to him 
that his publication has received the highest approbation, and that the Royal Medical Col- 
lege of Berlin had received him unanimously as a member of their society. This work has 
also received the approbation of Louis Phillippe, King of the French, who awarded to the 
author a royal present. It has also received the patronage of several eminent professors in 
Germany. It has also been pronounced a work of great merit by Baron Alibert, one of the 
most distinguished authors in Europe, first physician of the hospital St. Louis, and first 
physician to Louis Phillippe, King of the French. I hope its exalted worth will be duly 
appreciated by this legislature, and the author receive from it the reward he justly merits. 
The botanic physicians have other highly meritorious and scientific works upon the dif- 
ferent practical branches of medicine ; they have a number of schools in different sections 
of our country, where principles of a reformed or improved system are taught by lectures, 
recitations, and examinations ; and where diplomas are granted to those who are competent 
to practise : the graduates of these schools are daily dispensing the o.-essmgs of medical 
reform to thousands of their fellow-citizens. Dr. Beach founded the Reformed Medical RECOMMENDATIONS. 
XXXIII 
College in the city of New York, and is the president: it has been established several years, 
and some two hundred graduates have received diplomas at this institution. There is a 
branch of the same in Worthington, Ohio. 
Medical Reformation. By Dr. Jesse .Torrey. 
We have examined, with peculiar gratification, a new medical work, recently published 
m the city of New York, entitled the " American Practice of Medicine, &c., on Botanical 
or Vegetable Principles," by W. Beach, M.D., President of the Reformed Medical 
Society, &c. 
Medical remedies, or medical instructions which enable us to prevent or relieve pain 
and disease, to preserve and prolong health and life, cannot be very precisely estimated in 
dollars and cents. Such is the value, in our estimation, of Dr. Beach's work. It is a de- 
sideratum which we have long been anxious to see, not only for our own accommodation, 
but for the general benefit of the human family. Dr. Beach not only informs us what to do 
to relieve diseases, but also what not to do, which last is equal, if not more important to 
know than the former. We are convinced that this work ought to be in every medical 
library and school. 
He recommends the total abolition of metallic remedies for internal use, and the rare use 
of blood-letting and surgical operations. The work is written entirely in the English lan- 
guage, and is designed for families and popular use in general, as well as for physicians ; 
and we sincerely advise every family to obtain it as soon as possible, without depriving 
themselves thereby of indispensable necessaries. 
We earnestly recommend every physician in America or elsewhere, acquainted with 
the English language, to procure the work as soon as possible, and study it carefully ; after 
which we do most ardently hope he will not hesitate to adopt Dr. Beach's system, so far 
at least as to renounce the use of mercurial, antimonial, and other metallic and vegetable 
poisons. , . 
The work commences with a set of valuable directions for the prevention of disease, and 
promoting health and longevity, and is replete throughout with so much of that kind of 
essential, necessary knowledge, which every human being ought to possess, that we should 
rejoice to see it translated into all the languages in use, and distributed among all nations 
as soon as possible. If we can obtain the consent of the author, we intend preparing an 
abstract of the work for the National Library.-From the National Library. 
Extract of a letter from Dr. W. Capen, Plymouth, (Mass.,) dated, Feb. 10, 1834 
Dear sir-I am now induced to write in consequence of lately perusing your medical 
work on " American Practice." 
I can assure you, without any flattery or pretence, that your work far surpasses any other 
I have ever seen : notwithstanding I have been educated, and always practised medicine 
and surgery, according to the " common " mode. In all my former reading, for tvoenty years, 
I have never been so fully satisfied with any theory or practice which has met my eye as 
with yours. I sincerely hope the time has come, or will soon arrive, when the philosophy of 
medicine in its various branches will undergo a thorough reform, and be regulated upon dif- 
ferent principles than it has ever been heretofore. I am very happy to see you, sir, 
so firmly on the ground of reform. There is evidently much need of a revolution in the 
medical sciences, as to learning more correctly the genuine principles of the operations of 
nature. False principles and vague theories are productive of much harm, and are well cal- 
culated to keep the mind always in doubt. 
It has always been my object to obtain true medical knowledge; and I have perused 
volume after volume, and have learned many valuable things therefrom; yet there always 
appeared to be a void, which was never filled up in any of my researches, in both ancient 
and modern writers, so well as when I perused your work. It appears to me that you have 
rightly opened the medical door, and I wish you every success. XXXIV 
RECOMMENDATIONS. 
Botetourt County, Virginia, January 2Gth, 1835. 
Dr. W. Beach : 
Sir-I take the liberty of addressing a few lines to you upon a subject in which I feel 
very deeply interested-I mean the reformation which your indefatigable industry and 
perseverance have brought about in the practice of medicine, for which every philanthropist 
and friend of humanity will for ever feel grateful to you. The miseries which the orthodox 
physicians (or mineral practitioners, as they are sometimes called) bring upon the human race 
by the indiscriminate use of mercury, the lancet, and the knife, are so great that our fellow- 
citizens begin to dread the orthodox remedies worse than the disease itself. 
And why should not sensible and feeling men dread the common practice, when they see 
their fellow-beings salivated until their bones are in a state of perfect rottenness and exfolia- 
tion-to see patients debilitated by blood-letting in fevers and other complaints ; and to see 
the amputating knife resorted to, to cure even simple fractures, bruises, &c. These abuses 
in the healing art call loudly to be put down: the poor cripple, hobbling on his wooden leg, 
cries, " put it downthe poor wretch who is racked with all the pains of a mercurial 
rheumatism, cries, " put it down." These abuses are awakening the great mass of the 
people, who begin to cry, with a voice which makes the old practitioners quake, " put it 
downand it will, it must sink into oblivion before the reformed practice as soon as the 
great superiority of it is known. 
The American Practice of Medicine, for which the world are so much indebted to you, 
by some means found its way among us : it was perused again and again; another copy was 
sent for by a friend, who favoured me with an opportunity of perusing it. I had not read 
long before I recollected what I had suffered from the common practice, (for you must 
know I was salivated for the cure of bilious remittent fever,) and immediately sent for a 
copy of the work myself. 
JACOB H. KERN, 
Near Fin Castle, Va. 
W. Beach, M.D., President of the Reformed Medical Society, Founder of the Reformed 
Medical System, &c. 
Extract of a letter from Dr. S. Wright, of Cleaveland, Ohio, a graduate of the New York 
Reformed Medical College. 
Dear sir-My success in practice, since I returned, has been even better than I anticipated. 
I have succeeded in a number of diseases which were considered hopeless. I have had a 
number of cases of chronic ophthalmia, one of which was truly interesting : it was of two 
years' standing ; six of the last months the patient was totally blind. All his acquaintances, 
even the physician, (one of the faculty,) doomed him to drag out a wretched existence in 
darkness and despair. In this hopeless and deplorable condition, the patient came to ine as 
his last resort. I commenced treating him on the reformed system, as laid down in the 
" American Practice of Medicine." He soon began to recover, and, to the astonishment of 
all, he now cannot only perform his daily avocation, but can see to read quite well. This, 
together with my general success, has enlisted many of the first of our citizens in favour of 
the reformed system. The more I reason and reflect upon this system of practice, comparing 
it with the old, witnessing its superior efficacy upon the human system, and hearing its 
applause from the mass of the community, the more I am encouraged, and the more I pride 
myself in being found among the happy number who advocate its cause and promulgate its 
practical utility to the world. It must and will prevail, in spite of all the puerile exertions 
of enemies. 
Rochester, N. H., Jan. IGth, 1836. 
To the President of the Reformed College of Medicine, New York city : 
Dear sir-Although personally unacquainted with you, yet your name and works are 
familiar to me. The American Practice I have studied, admired, and approved, and am fully 
of the opinion that your system of practice will eventually become universal. Permit me, sir, 
to introduce to your friendly notice the bearer of this note, Dr. J. M. Berry, of this village. 
It was chiefly through my advice that he was induced to quit a lucrative practice, and place 
himself for a season under your more immediate direction. He is a young man, of unexcep- 
tionable moral and religious character, of studious habits, and possessed of talents of a high RECOMMENDATIONS. 
XXXV 
order. He has been in practice in this village about one year, and, for a young physician 
has met with uncommon success. 
Yours affectionately, and with much respect, 
A. UPHAM, M.D. 
To the Author of the American Practice of Medicine : 
Sir-Some time has elapsed since I became acquainted with your Reformed System of 
Medical and Surgical Practice; and I now embrace the opportunity to state, that the theory 
or principles advanced in your work fully meet my approbation, and which have been amply 
illustrated and demonstrated by an extensive practice. 
I was educated in the old school of medicine, and have, therefore, tested both systems. 
But a sense of justice constrains me to state, that the reformed method of treating diseases 
entirely surpasses the other ; and I am fully of the opinion, if it is embraced by competent 
persons, that it will supersede the mineral and depletive course, and become the standard 
practice of the day. 
With my most cordial wishes for its dissemination and final success, I subscribe myself, 
Respectfully yours, 
ANDREW SHANKLIN, M.D. 
Middleton, Hyde Co., N. Carolina. 
From the New York Sun, May 28th, 1835. 
Royal presents.-Dr. W. Beach, the celebrated botanic physician, has received gold 
medals from the Kings of Prussia and Saxony, and a rich and splendid collection of plates, 
representing the battles of Napoleon, from Louis Phillippe, as testimonials of their respect 
to his talents as the author of "American Practice of Medicine on Vegetable or Botonic 
Principles." The following is a translation of the letter accompanying the medal received 
from the King of Saxony : 
To Dr. W. Beach : 
Sir-The letter of the 10th of January last, by which you presented to his majesty, my 
august sovereign, the King of Saxony, your work on the American Practice of Medicine, 
has been recently delivered to its high address, with the work, by Dr. Carus, who at the same 
time has been able to accompany it with a report infinitely advantageous to it, and to 
display the distinguished merit which you have acquired by its publication. 
His majesty has received it with great pleasure, and has deigned to order me to express to 
you, sir, his acknowledgment for it; and to transmit to you, as a visible testimony of the value 
which he attaches to it, the enclosed MEDAL, bearing the motto, " Virtuti et 
Ingenio:" To Virtue and Genius. 
In discharging this grateful commission, I experience on my part a particular satisfaction 
in being able to add to it the expression of my distinguished consideration. 
JOHN MINKWITZ, 
The Minister of Slate and Foreign Affairs of his Majesty, the King of Saxony. 
Dresden, Feb. 2d, 1835. 
From the New York Advertiser of June 4th, 1836. 
Dr. Beach's Book.-We some time since noticed the beautiful medals transmitted from 
the Kings of France, Prussia, Wurtemburg, and Saxony, to Dr. Beach, in return for his 
work sent to those distinguished personages. We yesterday saw the medal which the King 
of England has caused to be sent Dr. Beach ; and annexed is the correspondence : 
From the Hon. W. MacMichael, Librarian to his majesty, the King of England, to Dr. 
W. Beach, of New York. 
London, Feb. 10th, 1836. 
Sir-I am instructed to acknowledge the receipt of a copy of your work on " The Ameri- XXXVI 
RECOMMENDATIONS. 
can Practice of Medicine," presented by you to his majesty, the King of England; a 
present which the king duly appreciates ; and I am commanded to transmit to you, on the 
part of his majesty, the accompanying Gold Medal. I have the honour to be, sir, 
Your most obedient servant, 
W. MACMICHAEL. 
King's Librarian. 
This medal is of very fine gold, and exceedingly well executed ; it bears the effigy or 
inscription of " King William IV." on one side, and " Queen Adelaide " on the other. 
This is the fifth royal present with which Dr. Beach has been honoured, besides letters 
from the most distinguished physicians of Europe, announcing to him that his medical work 
has received their highest approbation. 
From the New York Daily Advertiser. 
Dr. Beach, of this city, has published a new medical work, entitled the " American Prac- 
tice of Medicine," in three volumes, being a treatise on the character, causes, symptoms, 
morbid appearances, and treatment of the diseases of men, women, and children of all cli- 
mates, on vegetable or botanical principles : which work has received the approbation of the 
most distinguished physicians of France. He has just been honoured by his majesty, King 
of Prussia, (through the minister in this country,) with a handsome GOLD PRIZE 
MEDAL for his interesting work, accompanied with a flattering letter from his majesty. 
He has also been honoured with a letter from the distinguished and celebrated Professor 
Von Hufeland, first physician to his majesty, King of Prussia, in which he has an- 
nounced to him that his publication has received the highest approbation, and that the Royal 
Medical College of Berlin has received him unanimously as a member of their society. 
From the New York Sun. 
Medical Reform.-Extract of a letter from Dr. J. Clarke, dated. Salem., Mass., Non. 
24/A, 1835. 
Dr. W. Beach : 
Dear sir-I promised, when about leaving New York last spring, to inform you of the 
state, condition, and prospects of medical refdltn in this part of the country ; and I now, 
after so long delaying, sit down to give you this information, which I do with much plea- 
sure, for I well know that the spirit of inquiry which is blazing up here will afford satis- 
faction to the frank and liberal mind which is characteristic of him whom I have the honour 
to address. 
I well know that the flame of benevolence, long ago enkindled in his bosom, which in- 
duced him to engage in the good work of effecting a medical reformation, will brighten on 
hearing that the noble cause is prospering here, amid the strong hold of monopolies. 
The excitement here on the subject is considerable ; so much so, that the faculty of this 
district, at one of their meetings, discussed the question, whether it would be proper for them 
to embrace the reformed system 1 It was decided in the negative, although a number of 
the young members voted in favour of it. You see, then, that confusion is already apparent 
in the ranks of our adversaries. The people are in our favour: thousands are ready to 
desert the poison-mongers. They are waking up in the adjoining towns around us, and we 
want them supplied with reformers. We want help here. We want combination. I repeat 
it-we want help all around us. " The harvest is great, but the labourers are few." 
We ought to have a reformed school to furnish this part of the country with physicians ; 
and we fully believe that such a school would flourish well at Boston. 
Our legislature, at their last session, struck out the aristocratical part of the medical law, 
which places us on a level with other physicians. The Thomsonians are divided against 
themselves. More than half of them have come out in opposition to the arbitrary conduct 
of Thompson ; and, had we a school somewhere in these parts, the greater number of them 
would join with us. RECOMMENDATIONS. 
We are doing all we can for the cause. We intend publishing, in the spring, a medical 
journal to enlighten the public, and hope to receive aid from your pen. 
XXXVII 
From the New York Commercial Advertiser of May T3d, 1835. 
Compliment to genius and learning.-We have examined this morning two splendid 
gold medals, recently transmitted by royal personages to an American citizen-Dr. W. 
Beach, of this city, author of " The American Practice of Medicine." Copies of the work 
were sent by the author to the Kings of Saxony and Prussia about six months ago; and 
the attention has been acknowledged by them in autograph letters, accompanied by the 
medals already referred to. Dr. Beach's work was specially recommended to the King of 
Saxony by Dr. Carus, and to his majesty of Prussia by Dr. Von Hufeland, who were in- 
structed by the monarchs to report on its merits. The medals, which are rich, heavy, and 
very handsome, bear the royal effigies, with appropriate inscriptions on the reverse. 
Extract from a letter from Dr. Wm. R. Haimer, Kindalville, Holmes Co., Mississippi, 1836. 
Dr. W. Beach : 
Dear sir-It affords me pleasurable emotions to learn that you have the wreaths of 
honour you so richly merit, as author of the American Practice of Medicine on Botanic 
Principles. May the Great Ruler of the universe grant that the guardians of health, who 
have espoused the doctrines of the Paracelsian school, have their judgments governed by 
stubborn facts, in preference to the principles and sophistries so eloquently harangued by 
the deluded votaries of inconclusive theories. 
Nineteen years' experience in the practice of medicine has convinced me of the unparal- 
leled superiority of vegetable over mineral practice. Where is the medical philosopher who 
can illustrate the modus operandi of mercury? True, a little, and but little, can be said on 
the subject; nothing but a hazardous uncertainty awaits the hand that regurgitates the 
human stomach with such a ponderous poison. Where is the learned anatomist who has a 
conscience that can reconcile it to his feelings to administer such messengers of death 1 
Some there are, but deluded they must be. 
I am desirous of a correspondence with you, when you can get a moment's leisure; and 
I want, and must have, your treatise. Several of my friends have desired me to request 
vou to send on one hundred copies ; if you are willing to do so, I am willing to become your 
agent. 
Extract from a letter dated Louisville, Oct. \§th, 1835. 
Sir-On my journey west I have had occasion to stop at different places, and have become 
acquainted with a large number of physicians, and, on speaking of your work, a majority have 
expressed a wish to obtain copies. My object in writing is, to inquire if it would not be 
advisable to appoint agents for the western states. 
I feel confident, from my knowledge of the work, and the faculty in this section of the 
country, that an agent would find no difficulty in disposing of any number of copies: and, 
as I feel an interest in the advancement of the principles laid down in your work, I shall take 
much pride in being selected as an organ for this object. 
LEWIS COLLINS. 
Extract from a letter from John H. Smith, dated Athens, 1835. 
Dr. W. Beach : 
Sir-I have received your work which I sent for, " The American Practice of Medicine," 
and never have I perused a medical work with so much pleasure and satisfaction : I con- 
sider it superior to any medical work that I have ever seen. There is no doubt but that 
there are herbs and plants of such variety and of such medical virtues, if rightly administered 
•r applied, as will cure every disease to which the human body is subject. XXXVIII 
RECOMMENDATIONS. 
Doctor Smith, of Boston, has given the following recommendation 
A concise description of Beach's Medical Work.-It exposes the worst of all the bad, 
(of the old or modern practice,) and contains the best of all the good, (of every other kind 
of practice.) 
From the New York Commercial Advertiser of June 14th, 1836. 
A Royal present.-Dr. Beach, of this city, author of " The American Practice of Me- 
dicine," has been singularly fortunate in winning golden opinions from the crowned heads. 
He has received no less than five gold medals from as many European kings, in testimony 
of the high estimate they entertain of his medical abilities, and of the excellence of his 
volume. The latest is from his most gracious majesty, William the IV. of England, to 
whom the doctor had transmitted a copy of his book ; by the diligent study of which, 
his majesty expects, no doubt, to attain a greater longevity than even his father. The 
medal is of fine gold, and bears on one side the name and title of King William, and of 
Queen Adelaide on the other. 
Extract from a letter from Dr. F. Hersey, {formerly Surgeon in the United States Army.) 
We congratulate the friends of botanical medicine, on the publication of a splendid edition 
of the botanical works of this distinguished writer. His talents, natural and acquired, 
have admirably qualified him for the arduous enterprise in which he is engaged : what he 
has already achieved by the prowess of his classical pen, and laborious efforts in the cause, 
have secured him an eminent niche in the temple of fame. Posterity shall tell the story 
of his worth when the ensigns of opposition shall be driven from the field, and the adminis- 
trators of quicksilver, calomel, and corrosive sublimate (as medicine) shall live only on the 
page of history, sad monuments of the folly of the day in which they used with impunity 
these instruments of death, under the ludicrous impression of saving the lives; such means 
are so notoriously calculated to destroy.-Independent Botanic Register. 
Extract from a letter from Dr. Gerrish, of Boston, to the Author 
I pursue your beautiful, and almost perfect, system of practice. 
From the Botanic Medical Reformer, conducted by Dr. Thomas Cooke. 
Our readers will find on the cover of our present number a Prospectus of a new and 
abridged edition of Dr. Beach's work: we hope it will be well patronized, as it is one of 
the best practical medical books ever published. In proof of its superiority, all the former 
opposers of it are now copying after it. 
Extract from a letter from Dr. G. Waterman, dated Cranston, R. I., Feb. 25th, 1842. 
I know not how to express my gratitude for the great benefit I have derived from your 
invaluable writings. The first 220 pages of the American Practice of Medicine, vol. i., 
are worth more than all the books on dietetics ever before published ; and, were it in my 
power, the head of every family should have free access to it. 
It seems to me sometimes that the greater the humbug the more eagerly the world will 
pursue it, while correct principles and true science are scarcely noticed. 
Certainly none but a truly benevolent mind could ever have placed a work so valuable 
as yours before the world. It has revealed the true art of healing, both to the common peo- 
ple as well as the profession. But you need no approbation or applause from me ; and I 
would to heaven that I could do more to promote your cause. I have introduced your 
work to several of my friends, who have placed it at the head of their libraries. 
Since the above was written I have received another communication from the same phy- RECOMMENDATIONS. 
sician. He remarks : " I rejoice greatly that an abridgment of your large work is forthcoming 
from your pen ; and I doubt not but that the demand for it will more than meet your ex- 
pectation. I see nothing but the people's ignorance of what your work really is, to prevent 
its introduction into every family. A gentleman to whom I recommended your work last 
spring, informed me, but a few days since, that it had saved him more than one hundred 
dollars since that time, a few months." 
XXXIX 
New York, Feb. 5th, 1842. 
It is now nearly twenty years since Dr. Beach first commenced his attendance in our 
family, during which time I have had ample opportunity of witnessing and testing his "Re- 
formed Practice of Medicineand I feel it a duty I owe society to state, that I have seen 
the salutary effects of his practice, not only in my own family, but also in a variety of cases 
among others ; some of which were obstinate and critical, and had baffled the skill of the 
most distinguished physicians of the " old school." I therefore have no hesitation in 
stating that I believe his system of medical and surgical treatment vastly superior to all 
others, and that it will eventually triumph, and become the prevailing practice. I therefore 
most cheerfully recommend it, and his medical work, to all classes of the community. 
LEMUEL RICHARDSON. 
I hereby acquiesce in the above declarations respecting Dr. Beach's Reformed Practice 
of Medicine, from actual experience in my family ; the doctor having frequently been 
called upon, and administered medicine with the best success, within the last twenty years 
in my family. 
DANIEL LA TOURRETTE, 
Formerly one of the Judges of the Court of Common Pleas, 
and Justice of the Peace for Somerset County, New Jersey. 
Copy of a letter from Elisha Morrill, Esq., late Judge of one of the Courts of Law in 
the city of New York. 
New York, February 11th, 1842. 
Doctor Wooster Beach : 
Dear sir-I have read, and heard with great interest, the reformation which your inde- 
fatigable industry and perseverance have brought about in the practice of medicine, by your 
medical work, entitled " The American Practice " on botanical principles. 
You had to meet the combined prejudices of the old system of medical and surgical practice, 
which must have been an Herculean task; but genius and a just cause will meet the plaudit of 
" well-done good and faithful servantgreat will be your reward, for your study has been to 
preserve the health and lives of the human family. I have known your practice many years ; 
and that you may receive the honour and pecuniary compensation commensurate with your 
expectation, is the sincere wish of vour friend and humble servant, 
ELISHA MORRILL. 
P. S. Please send me one of your books. 
Extract from a letter from. Dr. Thomas Richardson, dated Donegald, Westmoreland Co., Pa. 
January 10th, 1840. 
The opinion of your " American Practice " which distinguished foreigners, as well as 
Americans, have formed and publicly expressed, is truly gratifying to my feelings. 
When Baron Alibert says that your work is a " masterpiece of medical analysis and 
medical experience when Von Hufeland, the most celebrated physician in Europe, after 
examining your work, presents you with a diploma as "Corresponding Member of the 
Medical and Surgical Society of Berlin when Hasselbach acknowledges your work valu- 
able and excellent; and when Dr. Lobstien, whose Semiology of the eye I have read, says 
of your work, " It is the result of your skill, talents, and industry; and is a production, 
like aromatic plants and flowers, from which the buzzing bee can take wax and honey, if he 
choose, without soiling or withering it." I say, when such expressions are made relative 
to you and your work, you might well exclaim as you have done : " Thanks to the author XL 
RECOMMENDATIONS. 
of all good for the origin, success, and blessing of the important cause of medical reform." 
And I would say, in the words of the old Roman, " Magnum est veritas, et prevalebit." I 
humbly trust, sir, that you will reap the reward your distinguished talents, benevolence, and 
indefatigable industry so richly merit; for merit, sir, will be rewarded. 
Extract from a letter from Dr. George Shecut, dated Georgetown, S. C. 
July 10th, 1839. 
I had long indulged the hope that some master spirit would spring up from our botanic 
fraternity, one capable of collecting, arranging, and condensing the abundant materials which 
have been so long accumulating, and thus forming them into a system of medicine more 
simple and consistent than the world has yet seen, and supply a desiderata in medicine that 
has long been wanted. This Herculean task, I am happy to learn, you have undertaken; 
and, if I may judge from the specimen of your abilities as displayed in the first edition of 
your truly scientific work, I think I may say, without incurring the imputation of flattery, 
that you have fully demonstrated the practicability of this great work ; as I honestly believe 
you have done more toward the advancement of true medical knowledge than any one 
writer, ancient or modern, I have ever met with. 
Extract from a letter from that distinguished Author and Professor, C. C. Rafinesque, Author 
of the Medical Flora, and numerous other works, dated Philadelphia, Jan. 6th, 1840. 
I must now state again, that I think highly of your medical work : I belong, like yourself, to 
the Reformed School of Medicine, and agree with you much better than with the Thomsonian, 
Homoepathy, and Botanical Empirics. Your system is a good one, if not perfect : it is better, 
at any rate, than most of the fashionable systems, Galenian, Brunonian, or mineral. Your 
system of surgery appears benign and safe, and much better than the old butchering system. 
Extract from, a letter from Dr. A. Davis to the Author, dated Danville, Livingston Co., N. Y. 
July 20th, 1842. 
Sir-If you could send fifteen or twenty good practitioners of medicine on reformed 
principles, they could find location in this section of the country. 
New York, August, 1482. 
Since the reception of the preceding recommendations, to show still farther the esti- 
mation in which the practice is held in Europe, the author has to acknowledge the 
reception of diplomas entitling him to membership in three more medical societies. 
1st. A diploma from the Medical and Physiological Society of Wetterau, Germany. 
2d. A diploma from the Medical Society of Leipsic, Saxony. 
3d. Also one from the Medical Society of Bamberg, Bavaria. 
To show farther the estimation in which the practice is held by those acquainted with it, 
I subjoin an extract from the will of William Turpin, a distinguished and wealthy person, 
and a strong friend of a botanical system of practice. 
" I GIVE AND BEQUEATH TO DR. W. BEACH, THE MEDICAL REFORMER, HIS 
HEIRS AND ASSIGNS FOR EVER, FIVE HUNDRED DOLLARS." CONTENTS 
PART FIRST. 
MEANS OF PREVENTING DISEASE, AND PROMOTING HEALTH AND 
LONGEVITY 
Page 
Ch. i. Temperance, abstinence, diet, 
&c., 3 
11. Food and drink, 9 
Animal food, ----- ib. 
Vegetable food, - - - - 10 
Facts illustrating the difference 
between animal and vegeta- 
ble diet, - - - - - -11 
Simplicity in diet, - - - - 21 
Water, ------- ib. 
in. Fermented liquors, - - - - 22 
Ardent spirits, ib. 
Wine, - -- -- --24 
Beer, ------- 25 
Spruce beer, ----- ib. 
Medical or root beer, - - - ib. 
Cider, ------- ib. 
Mead, ------- ib. 
iv. Air, -------- 26 
Impure air, ib. 
Air of crowded assemblies, - 27 
Air of cities, ----- ib. 
Burying in meeting-houses, 
cities, &c., ----- 28 
Air in confined vessels, - - 29 
Change of air, ib. 
Trees and plants, - - - - ib. 
Burning charcoal, - - - - ib. 
Pure air in disease, - - - 30 
v. Exercise, ------- ib. 
vi. Clothing, ------- 36 
Climate, ------ ib. 
Age, 37 
Season, ------- ib. 
Fashion and figure, - - - ib. 
Bandaging, &c., - - - - ib. 
Quantity of clothing, - - - ib. 
Kind of dress, ----- 38 
vii Cleanliness, 40 
Disease occasioned by the want 
of cleanliness, - - - - ib. 
Filthy persons and apartments, ib. 
Fflthy cities and streets, - - ib. 
Personal cleanliness, - - - 41 
Page 
vni. Sleeping, early rising, &c., - - 43 
ix. Occupations, ------ 45 
x. Transitions from heat to cold, - 47 
Wet clothes, 48 
Wet feet, ------ 49 
Night air, ------ ib. 
Damp beds, ----- ib. 
Feather beds, 50 
Damp houses, ----- ib. 
xi. Evacuations or excretions, - - ib. 
<The bowels, ib. 
Remedy for habitual costive- 
ness, ------- 51 
The liver, ------ 52 
The kidneys, ib. 
The skin, 53 
xii. Baths, 54 
The cold bath, ----- ib. 
Topicalbathing, - - - - 55 
Warm or tepid bath, - - - 56 
Hot bath, 57 
Topical applications, - - - ib. 
The vapour bath, - - - - 58 
Sulphur bath, - - - - - 60 
Shower bath, ----- ib. 
xiii. Ablutions, or bathing the surface, 62 
xiv. Mineral or medicinal waters, - 63 
Properties and effects of the 
waters, - 64 
Farquier white sulphur springs, 
Virginia, ------ 65 
xv. Sea voyage, climate, and travel- 
ling, 66 
Dyspepsia, nervous diseases, 
&c., 67 
xvi. Tobacco, ib. 
xvii. Tight lacing, 72 
Remedy, ------ 74 
xviii. Sexual intercourse, onanism, ve- 
nery, &c., 76 
Masterbation, onanism, self- 
pollution, &c., - - - - ib 
xix. Marshes, 77 
Sea air, ------- 78 XLII 
Page 
xx. Hair, baldness, and fashion, - 78 
xxi. Bleeding, salts, and minerals, - 79 
xxn. Nostrums and patent medicines, 80 
xxni. Electricity,83 
xxiv. The passions,84 
Love, ------- ib. 
Grief,87 
Anger, ------- 88 
Fear, ------- 90 
Joy,92 
Envy, malice, and hatred, - 93 
Influence of the mind on the 
body, passions, &c., - - 94 
xxv. Rules for the prevention of infec- 
tious diseases and contagion, ib. 
CONTENTS. 
Pag« 
xxvi. Rules for the preservation of 
health and promoting lon- 
gevity, ------ 97 
xxvn. Bill of fare and rules for invalids 
and others, - - - - 9S 
xxviii. Remarkable instances of lon- 
gevity, - ----- 101 
Comparative statement of lon- 
gevity, ------ 103 
xxix. Testimonials in favour of the 
dietetic system, - - - 104 
Testimony of a wife and mo- 
ther, 106 
xxx. Anecdotes,107 
PART SECOND. 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE OF MEDICINE, 
AND INDICATIONS OF CURE. 
Page 
Ch. i. Mercury and other minerals, - 108 
Sec. i. Remarks,ib. 
ii. The pernicious effects of mer- 
cury in various diseases, - 114 
•in. Calomel or mercury, - - - 118 
iv. Dr. R. Reese's statement, - 120 
v. The effects of mercury illus- 
trated, ------ ib. 
vi. Minerals generally, - - - 123 
n. Blood-letting, - - - - - -125 
I. Remarks,ib. 
ii. Case of Dr. Vaughan, - - 129 
in. Bleeding in pleurisy, - - - 130 
iv. Remarks on bleeding, - - 134 
v. On the morbid effects of the 
loss of blood, - - - - 135 
vi. On the immediate effects of loss 
of blood, ----- 136 
vn. Effects of the loss of blood on 
the internal organs, - - 143 
vni. Morbid effects of bleeding in 
infancy, ------ 145 
ix. Bleeding in inflammation of 
the lungs, quinsy, St. An- 
thony's fire, &c., - - - 146 
x. Treatment of the effects of loss 
of blood,148 
xi. Concluding remarks, - - - 149 
ni. The knife, or abuses in surgery, 150 
I. Of surgical operations in gene- 
ral, ------- ib. 
ii. On operations in particular, - 157 
in. Concluding remarks, - - - 161 
Page 
iv. Midwifery,162 
I. Observations,ib. 
ii. Mrs. E. Arnold on midwifery, 163 
iii. Testimony of Dr. J. King, - 166 
iv. Statement of a London physi- 
cian, ------- ib 
v. Observations of different individuals 
on the present practice of 
medicine, - - - - -167 
i. Dr. John J. Steele, - - - ib 
ii. Dr. Anthony Hunn, of Ken- 
tucky, 170 
in. Thomas Jefferson, - - - 171 
iv. Dr. A. R. Porter,- - - - 172 
Letter from Dr. Greer, - - 177 
Comparison,178 
v. Remarks of eminent physi- 
cians and others, - ib. 
Concluding remarks, - - 181 
vi. Nature, causes, and treatment of 
diseases in general,- - - 182 
I. Pathology of diseases, - - ib. 
ii. Of the efforts of nature to re- 
move diseases, - - - - 185 
hi. General indications of cure, - 187 
iv. The physician the servant of 
nature,188 
vn. On the agency of heat and cold in 
the production and removal 
of diseases,190 
I. Remarks,- ib. 
ii. Diseases in which heat and 
cold are beneficial, - - - 192 CONTENTS. 
Page 
iv. The remediate influence of 
cold, - - 200 
v. Additional remarks, - - - 201 
XLIII 
Page 
in. Means of promoting warmth 
and perspiration, - - - 199 
PART THIRD. 
INTERNAL DISEASES. 
Page 
Ch. i. Nosology, or a systematic ar- 
rangement and classification 
of diseases, 202 
11. Preliminary remarks, - - - 206 
I. Definition of health and dis- 
eases, ib. 
hl Febrile diseases, - - - - - 208 
Class I. Fevers in general, - - 209 
ch. iv. Intermittent fever, fever and 
ague, or chills and fever, - 226 
v. Remittent fever, - - - - 230 
vi. Inflammatory fever, - - - 238 
vii. Simple continued fever, - - 243 
viii. Typhus or nervous fever, - - 246 
1. Slow, nervous, or typhus 
fever, ib. 
II. Putrid or malignant fever, - 253 
Plague, 256 
hl Yellow fever, 260 
iv. Spotted fever, - - - - - 270 
ix. Scarlet fever, 273 
1. Scarlatina anginosa, - - - 274 
11. Scarlatina maligna, - - - 275 
in. Malignant scarlet fever, - - 278 
Additional remarks, - - 279 
x. Miliary fever, ib. 
xi. Puerperal fever, - - - - 281 
xii. Hectic fever, 284 
xiii. Infantile remittent fever, - - 286 
Class II. Inflammatory Diseases, 288 
ch. i. Inflammation of the brain, - ib. 
11. Inflammation of the ear, - - 290 
in. Mumps, 291 
iv. Quinsy or inflammatory sore 
throat, 292 
v. Putrid sore throat, - - - - 295 
vi. Croup, - 296 
vii. Inflammation of the bronchial 
tubes, 298 
1. Chronic inflammation of the 
bronchia, 299 
viii. Hooping-cough, 300 
ix. Catarrh or influenza, - - - 302 
x. Coughs and colds, - - - - 303 
xi. Asthma, 305 
xii. Inflammation of the lungs, - 309 
Xin. Pneumonia typhoides, - - - 312 
Page 
xiv. Consumption, - - - - - 314 
xv. Pleurisy, 323 
xvi. Inflammation of the heart, - - 325 
Enlargement and chronic in- 
flammation of the heart, - 326 
xvn. Inflammation of the diaphragm, ib. 
xviii. Inflammation of the stomach, - 327 
xix. Inflammation of the liver, - - 328 
Chronic inflammation of the 
liver, - 330 
xx. Inflammation of the spleen, - ib. 
Chronic inflammation of the 
spleen, 331 
xxi. Inflammation of the intestines 
or bowels, ----- ib. 
Inflammation of the perito- 
naeum, ------ 332 
xxii. Inflammation of the kidneys, - 333 
xxiii. Inflammation of the womb, - 334 
xxiv. Inflammation of the bladder, - 335 
xxv. Inflammatory rheumatism, - 336 
Chronic rheumatism, - - 339 
Mercurial rheumatism, - - 341 
xxvi. Gout, 342 
Class III. Eruptive Diseases, - - 345 
ch. i. Small-pox, 346 
ii. Cow-pox, or vaccine disease, - 350 
in. Chicken and swine-pox, - - 351 
iv. Measles, 352 
Class IV. Dropsical Diseases, - - 355 
ch. i. Dropsy of the head or brain, - ib. 
Chronic form of the disease, 357 
ii. Dropsy of the abdomen or belly, 360 
hi. Dropsy of the chest, - - - - 364 
iv. Dropsy of the ovaria, - - - 367 
Dropsy of the womb, - - - 368 
v. Cellular dropsy, ib. 
vi. Dropsy of the scrotum, - - - 371 
Class V. Cerebral Diseases, - - 373 
ch. 1. Insanity or mental derangement, ib. 
11. Furor uterinus, 381 
in. Melancholy, 382 
iv. Epilepsy or falling sickness, - 383 
v. Apoplexy, 387 
vi. Catalepsy, 391 
vii. Lethargy, 392 
viii. Fainting or swooning, - - - 393 XLIV 
CONTENTS 
Page 
ix. Giddiness,394 
x. Delirium tremens, - - - - 395 
Class VI. Nervous Diseases, - - 396 
ch. 1. Hysterics, ------- ib. 
11. Hypochondria,399 
Hi. Palsy,405 
iv. St. Vitus's dance, - - - - 407 
Class VII. Gastric Diseases, - - 409 
ch. 1. Cholera morbus, ----- ib. 
Asiatic or Indian cholera, - 412 
Cholera of infants; or, summer 
or bowel complaints, - - ib. 
Sick stomach,414 
11. Water-brash, - - - - - -415 
in. Indigestion,416 
rv. Convulsions or fits, - - - - 422 
v. Cramp in the stomach, - - - 423 
vi. Heartburn,ib. 
vii. Canker, thrush, or sore mouth, 424 
vin. Milk sickness,426 
ix. Vomiting, ------- 427 
x. Hiccough, ------ 428 
xi. Sea sickness,ib. 
Class VIII. Intestinal or Bowel 
complaints,429 
ch. 1. Dysentery, ------ ib. 
Chronic dysentery, - - - 433 
11. Summer complaint or looseness, 434 
Chronic diarrhoea, - - - 435 
Hi. Colic, - -- -- -- - ib. 
Flatulent colic, - - - - 436 
Bilious colic,437 
Painters' colic, ... - 439 
iv. Costiveness, ------ 442 
Class IX. Profluent Diseases, - 443 
ch. 1. Vomiting of blood, - - - - ib. 
Page 
11. Spitting of blood, ... - 444 
in. Bleeding at the nose, - - - 445 
iv. Involuntary discharge of urine, 446 
v. Whites, or fluor albus, - - - 448 
vi. Immoderate flow of the menses, 450 
vii. Abortion,451 
vin. Cessation of the menses, - - 452 
ix. Incontinence of urine, - - - ib. 
x. Voiding of blood by urine, - - 453 
xi. Onanism, self-pollution, &c., - 454 
xii. Catarrh in the head, - - - - 455 
Class X. Refluent Diseases, - - ib. 
ch. 1. Retention of the menses, - - ib. 
11. Suppression of the menses, - 457 
hi. Painful and imperfect menstrua- 
tion, 460 
iv. Nightmare,462 
v. Enlargement and palpitation of 
the heart,463 
vi. Jaundice, ------- 464 
Class XI. Constitutional Diseases, 465 
ch. 1. Scurvy,466 
11. Heat of urine, ----- 468 
hi. General debility,ib. 
iv. Marasmus, emaciation, wasting 
of the body, &c., - - - - 469 
v. Mercurial diseases and saliva- 
tion, ------- ib. 
vi. Yaws,470 
Class XII. Local Diseases, - - - 471 
ch. 1. Lumbago, ------- ib. 
11. Worms, ------- 472 
hi. Ozsena, ------- 476 
iv. Headache,477 
v. Obesity or fat,478 
PART FOURTH. 
SURGICAL DISEASES. 
Page 
Ch. 1. Connexion between Physic and 
Surgery,479 
11. Inflammation, ----- ib. 
in. Mortification,481 
iv. Wounds,- ------ 482 
v. Fractures, ------ 490 
vi. Dislocations, - - - - - 501 
vii. Ulcers,510 
vin. Necrosis or decayed bone, - -511 
ix. Cancer and scirrhus, - - - 512 
x. Inflammation of the breast, ague 
in the breast, &c., - - - 517 
xi. St. Anthony's fire, - - - - 518 
Xii. Locked-jaw,520 
Page 
xin. Carbuncle, ------ 522 
xiv. Scrofula or king's evil, - - - 523 
xv. Fistula, -528 
xvi. Fissure of the anus, - - - 537 
xvii. Piles,538 
xviii. Strictures of the rectum, - - 541 
xix. Prolapsus ani, or falling down 
of the bowel,ib. 
xx. White-swelling-Hip disease, 542 
xxi. Venereal disease, - - - - 546 
xxn. Inflammation of the eye, - - 552 
xxiii. Aneurism,562 
xxiv. Rupture,566 
xxv. Strictures in the urethra, - 571 CONTENTS. 
XLV 
Page 
xxvi. Suppression and retention of 
urine, 572 
xxvii. Gravel and stone, - - - - 574 
xxviii. Dropsy of the scrotum, - - 579 
xxix. Felon or whitlow, - - - 582 
xxx. Polypus, 584 
xxxi. Salt rheum-Tetter, - - - 585 
xxxii. Chilblain, 587 
xxxiii. Tic douloureux, - - - - 588 
xxxiv. Tumours, &c., - - - - 589 
xxxv. Bronchocele, 591 
xxxvi. Common bile, ----- ib. 
xxxvii. Enlargement of the tonsils, - 592 
xxxviii. Ganglion, ib. 
xxxlx. Deafness, ------ 593 
xl. Ague, or pain in the face and 
jaw, ------- ib. 
xli. Inverted toe-nail, - - - - 594 
xlii. Corns and warts, - - - - 596 
Page 
xliii. Foreign substances in the oeso- 
phagus and trachea or wind- 
pipe, 596 
xliv. Rickets, 598 
xlv. Dow-worm or scald head, - ib. 
xlvi. Ringworm, 599 
xxvii. Itch, 600 
xlviii. Collections of matter in the 
antrum of Highmore, - - ib. 
xlix. Psoas and lumbar abscesses, 601 
l. Sprains, ------ 602 
li. Disease of the spine, - - ib. 
lii. Burns and scalds, - - - - ib. 
liii. Suspended animation, by hang- 
ing, drowning, suffocation, 
or exposure to intense cold, 603 
liv. Hydrophobia, or canine mad- 
ness, 604 
lv. Poisons-mineral and vege- 
table, ------ 605 
PART FIFTH. 
MIDWIFERY. 
CONCEPTION, PREGNANCY, AND DISEASES OF WOMEN AND CHILDREN. 
Page 
Introductory remarks, - - - - - 607 
Ch. i. Diseases of pregnancy, - - - 614 
ii. Labour, delivery, &c., - - - 617 
hi. Management of labour, - - - 618 
Page 
iv. Treatment after delivery, - - 625 
v. Diseases of children, - - - 628 
vi. Management of children, - - 630 
On rearing children, - - - 636 
A Course of Medicine for Diseases generally,- - - - 636 
PART SIXTH. 
VEGETABLE MATERIA MEDICA. 
Page 
Remarks, 639 
Terms of classification of medicines, 641 
Classification of articles, - - - 642 
Plants,* 642-690 
Page 
Botanical synopsis of plants occasion- 
ally used, and recommended for far- 
ther investigation, 681 
Minerals, mineral acids, salts, animal 
and earthy substances, &c., - - -691 
PART SEVENTH. 
PHARMACY AND DISPENSATORY; OR COMPOUNDS. 
Page 
Remarks,- 697 
Balsams, - - - 698 
Page 
Bitters, - -- -- -- -- 698 
Caustics or escharotics, ----- 699 
* See Index for general reference to the plants. XLVI 
CONTENTS. 
Page 
Drops,- --------- 699 
Decoctions, -------- 701 
Extracts, - -- -- -- -- ib. 
Eye-waters, -------- 702 
Fomentations,ib. 
Gargles, - -- -- -- -- 703 
Infusions, -------- 704 
Injections or clysters, ----- 705 
Liniments, -------- 706 
Liquids, --------- 707 
Mucilages, - -- -- -- - 708 
Oils,709 
Ointments, - -- -- -- - ib. 
Plasters, - -- -- -- --711 
Faga 
Poultices,712 
Pills,714 
Powders,717 
Salves, - -- -- -- -- 721 
Syrups,722 
Spirits,724 
Sinapisms or draughts,ib. 
Tinctures, -------- 725 
Essences, --------- 729 
Troches or suppositories, - - - - ib. 
Washes, --------- 730 
Mixtures, -------- - 731 
Electuaries,732 
PART EIGHTH. 
DIET FOR THE HEALTHY AND THE SICK. 
Page 
Remarks on excessive eating and im- 
proper diet, ------- 733 
Food, mode of preparing, - - - - 734 
Page 
Drinks, manner of forming, - 736 
Liquid for dyspepsia, 737 
Voltaire's dish for indigestion, - ib 
PART NINTH. 
OUTLINES OF ANATOMY AND PHYSIOLOGY; OR MECHANISM OF THE 
HUMAN BODY. 
Page 
Remarks,738 
The Bones,ib. 
Pelvis,741 
Muscles,ib. 
Membranes, ------ 742 
The Viscera or Internal Organs, ib. 
Brain,ib. 
Eye,745 
Lungs,746 
Heart,748 
Stomach, ------- 749 
Intestines, ------- 750 
Liver,753 
Kidneys, ------- ib. 
Lacteals, ------- 754 
Page 
Digestion,756 
Table showing the mean time of di- 
gestion of the different articles of 
diet,758 
Effects of spirits on the stomach, - - 761 
Inferences from Dr. Beaumont's expe- 
riments and observations, - - - 762 
The Arteries,- ------- 764 
Veins,765 
Blood, -ib. 
Nerves, -------- ib. 
Skin, - -- -- -- - ib. 
Temperaments,766 
Reflections, - -- -- -- - 767 
Conclusion, - -- -- -- - 768 
APPENDIX. 
THE TEETH. 
Page 
Effects of the teeth on personal appear- 
ance, --------- 769 
Page 
Directions for preventing decay and 
preserving the teeth,770 
Index, 773 LIST OF ILLUSTRATIONS. 
28. Jalap, Convolvulus Jalapa, . . 651 
31. Swamp Dogwood, Cornus Sericea, 653 
32. Senna, Cassia Senna, . . . . ib. 
33. Solomon's Seal, Convcdlaria Mul- 
tifiora,ib. 
34. Saffron, Crocus Sativus, . . . ib. 
35. Ladies' Slipper, Cypripedium Pu- 
bescens,654 
36. CamphorTree, Laurus Camphora, ib. 
37. Wild Carrot, Daucus Carota, . . ib. 
38. Fox-glove, Digitalis Purpurea, . ib. 
39. Stramonium,655 
40. Boneset,EupatoriumPerfoliatum, ib. 
41. Cloves, Eugenia Caryophyllata, . ib. 
44. Gentian, Gentiana Lutea, . 656 
45. Guaiacum, Guaiacum Officinale, . ib. 
47. Liquorice, Glycyrrhiza Glabra, . 657 
48. Black Hellebore, HelleborusNiger, ib. 
49. Golden Seal, Hydrastis Canadensis, ib. 
50. Hops, Humulus Lupulus, . . . 658 
51. Witch Hazel, Hamamelis Virgi- 
nica,ib. 
52. Liverwort, Hepatica Triloba, . . ib. 
54. Common Juniper, Juniperus Com- 
munis, 659 
55. Elecampane, Inula Helenium, . ib. 
57. Skunk Cabbage, Ictodes Fcetida, . ib. 
58. Water Hoarhound, Lycopus Vir- 
ginicus,660 
59. White Wood, Liriodendron Tu- 
lipifera,ib. 
60. Dandelion, Leontodon Taraxa- 
cum, ib. 
61. Lobelia, Lobelia Inflata, . . .661 
62. Sassafras, Laurus Sassafras, . . ib. 
64. Bayberry, Myrica Cerifera, . . 662 
66. Hoarhound, Marrubium Vul- 
gare,ib. 
67. Peppermint, Mentha Piperita, . 663 
68. Catnip, Nepeta Cataria, . . . ib. 
69. Spearmint, Mentha Viridis, . . ib. 
70. Olive Tree, Olea Europea, . . 664 
71- Black Alder, Prinos Verticillatus, ib. 
75. Pine, Pinus, . . 665 
78. Mandrake, Podophyllum Pelta- 
tum, ... .... 666 
79. Poppy, Papaver Somniferum, . 668 
80. Plantain, Plantago Major, . • ib. 
81. Poke, Phytolacca Decandria, ■ • 669 
82. Seneca Snake-root, Polygala Se- 
nega, . . . . . ih 
COPPER-PLATE MEDALS, ETC. 
1 Fac simile of the gold medal awarded 
to the Author by the King of Wur- 
TEMBURG,XXV 
2 Fac simile of the gold medal from 
Pope Gregory XVI. of Rome, xxvi 
3 Fac simile of the gold medal from the 
King of the Netherlands, . xxvn 
4 Fac simile of the gold medal from the 
King of Prussia, accompanied by the 
ROYAL SEALS,XXIX 
5. Fac simile of the gold medal from the 
King of Saxony, .... xxix 
6. A plate presented by Louis Phillippe, 
King of the French, representing the 
column of the grand army, erected in 
Vandome-square, Paris, . . xxix 
7. Fac simile of the gold medal from the 
King of England, with the seals ac- 
companying it, xxx 
8. Fac simile of the gold medal from the 
Grand Duke of Tuscany, . xxx 
9. Fac simile of the letter from Gen. 
Lafayette to the Author, with his 
seal (bearing the effigy of Wash- 
ington) attached, .... xxx 
FIGURES OF PLANTS. 
1. Pleurisy-root, Asclepius Tuberosa, 642 
2. Chamomile, Anthemis Nobilis, . ib. 
4. Aloe, yl/oe Spicata,643 
6. Cohosh, Actaa Racemosa, . . . 644 
7. Burdock, Arctium Lappa, . . ib. 
8. Asarabacca, Asarum Canadense, ib. 
10. Indian Turnip, Arum Triphyllum, 645 
12. Male Fem, Aspidium FilixMas.,. 646 
13. Marsh-mallows,AlthceaOfficinalis, ib. 
14. Almonds, Amygdcdus Communis, 647 
15. Spikenard, Aralia Racemosa,. . ib. 
17 Virginia snake-root, Aristolochia 
Serpentaria,648 
18. Barberry, Berberis Vulgaris, . . ib. 
20. Wild Indigo, Baptisia Tinctoria, . 649 
21. Copaiba, Copaifera Officinalis, . ib. 
22. Capsicum,ib. 
23. Cicuta, Conium Maculalum, . ■ 650 
25. Celandine, Chelidonium Maj us, . ib. 
27. Ipecacuanha, Callicocca Ipecacu- 
anm, 651 XLVIII 
LIST OF ILLUSTRATIONS. 
83. Oak, Querent Alba, .... 669 
85. Castor Bean, Ricinus Communis, 670 
86. Yellow Dock, Rumex Crispus,. ib. 
87. Rhubarb, Rheum Palmatum, . 671 
88. Sumach, Rhus Tiphinum, . . ib. 
89. Bitter-sweet, Solanum Dulca- 
mara, 672 
90. Blood-root, Sanguinaria Cana- 
densis, ib. 
91. Pink-root, Spigelia Marilandica, 673 
92. Comfrey, Symphytum Officinale, ib. 
93. Dwarf Elder, Sambucus Ebulus, ib. 
94. Mustard, Sinapis Alba, . . . 674 
95. Garden Nightshade, Solanum 
Nigrum, ib. 
96. Sarsaparilla, Smilax Sarsapa- 
rilla, ib. 
98. Balsam of Tolu, Toluifera Balsa- 
mum, ........ 675 
99. Tansy, Tanacetum Vulgare,. . ib. 
100. Euphorbia, ib. 
101. Slippery elm, Ulmus Fulva, . .676 
102. Devil's Bit, Liatris, ib. 
103. Blue Flag, Iris Versicolor, . . ib. 
104. Prickly-ash, Xanthoxylum Fraxi- 
neum, 677 
105. Pennyroyal, Hedeoma Pule- 
gioides, ib. 
106. Common Elder, Sambucus Nigra, ib. 
107. Rose, Rosa Gallica, . . . . ib. 
108. Henbane, Hyoscyamus Niger, . 678 
109. Flowering Ash, FrarmtisOrntis, ib. 
110. Polypody, Polypodium Vulgare, ib. 
111. Mullein, Verbascum Thapsus, . 679 
112. Skull-cap, Scutellaria Lateriflora, ib. 
113. Beth-root, Trillium Latifolium, ib. 
114. Wormwood, Artemisia Absin- 
thium, 680 
116. Striped Alder, 681 
Red Raspberry, 686 
Virginia Speedwell, 687 
Water Fennel, 690 
Ginger, . . ib. 
Nutmeg, ib. 
ENGRAVINGS. 
A Rocking-chair, presented by Jere- 
miah Parsell, xxxi 
Medicated Vapour Bath, .... 59 
Portable Shower Bath, 61 
Fig. 1. The form of a modem belle, . 75 
2. The natural form, . . . . ib. 
3. The skeleton as Art has de- 
formed it, ib. 
4. The skeleton as Nature form- 
ed it, ib. 
A Plate showing the effects of mer- 
cury, 121 
A case of amputation for white-swell- 
ing, representing a scene that took 
place in the dissecting-room, Stuy- 
vesant Institute, 154 
The Tape-worm, 475 
Fig. 1. The double inclined concave 
splint, (as applied for frac- 
tures of the thigh-bone,) . 497 
2. The same, (not applied,) . . 499 
3. The same, with a stiff joint, . ib. 
4. The concave angular splint, for 
fracture of the upper arm, . ib. 
5. The Sweet or lever principle 
of reducing dislocations, . 503 
6. Dislocation of the thigh-bone 
on the ilium, 506 
7. Reduction of the thigh-bone 
when dislocated and thrown 
on the ilium, 507 
8. A Plate representing Scrofula 
or King's Evil, .... 527 
9. An ordinary Fistula, . . . 530 
10. A bandage to be used in Fistula, 532 
11. White-swelling of the knee, . 544 
12. Aneurism 566 
13. A Truss for Rupture, . . . 567 
Nursing, 625 
Nipple shield, 627 
The nursing bottle a substitute for the 
breast, 631 
Fig. 1. A front view of the Male Ske- 
leton, 739 
2. A back view of the Male Ske- 
leton, 740 
3. The Pelvis, 741 
4. The base of the Brain,. . . 743 
5. The Brain seen at its base, and 
dissected so as to show the 
direction of its fibres, . .744 
6. The Eye, 745 
7. The right Lung, and Air-pas- 
sages of the left Lung, . . 747 
8. The Human Heart,.... 748 
9. The Human Stomach,. . . 749 
10. The Internal Parts, . . . . 750 
11. The (Esophagus, Stomach, and 
Intestines, 751 
12. The Intestinal Canal, . . . 752 
13. The Kidneys, 754 
14. The Lacteals, ib. 
15. Contents of the Abdomen after 
removal of the Intestines, . 755 
16. The Arteries, 764 
17. The Veins, ib 
18. The Lymphatic temperament, 766 
19. The Sanguine temperament, . ib 
20. The Bilious temperament, . 767 
21. The Nervous temperament, . ib. 
The Teeth 769 PART FIRST. 
MEANS OF PREVENTING DISEASE, AND PROMOTING 
HEALTH AND LONGEVITY 
" IT IS BETTER TO PREVENT THIN TO CURE." 
" Nor is it left arbitrary, at the will and pleasure of every man, to do as he list; after the dictates of a 
depraved humour and extravagant fancy, to live at what rate he pleaseth ; but every one is bound to 
observe the Injunctions and Law of Nature, upon the penalty of forfeiting their health, strength, and liberty 
-the true and long enjoyment of themselves." ' Mainwayrince. 
CHAPTER I. 
In the commencement of this work I am desirous of calling the attention 
of the reader, and particularly of the invalid, to the best means of preventing 
disease, as well as of recovering health when lost or impaired; and I wish 
to impress upon their minds that this consists, principally, in a well-regulated 
diet and regimen. It is very natural, and very customary, for us to indulge 
our propensities and appetites until some derangement of our digestive func- 
tions is the consequence ; and then, instead of avoiding the exciting cause of 
the evil, we resort to medicine for a remedy, which, at best, is a poor sub- 
stitute. I have heard of a person subject to dyspepsia, who was so fond of 
indulging his appetite, that he would have a good dinner ; and, after eating it, 
he was in the habit of running his finger down his throat and vomiting it up. 
This excess, in a greater or less degree, is indulged in by thousands; and 
they would rather suffer the penalty of gluttony, than to practice abstinence 
or temperance. They will eat and drink whatever their appetites crave; 
become diseased; then torture their stomachs with drugs or nostrums till 
their lives are rendered wretched indeed. 
I wish to see a reform in this respect, as well as in the habitual use of 
ardent spirits; as the one is almost as destructive to health as the other. 
Says Dr. Mott, in one of his lectures, " All who have abused their stomachs, 
will assuredly be brought to an account for it sooner or later. I am not 
sure," says he, " but more disease and suffering result from intemperance in 
eating, than intemperance in drinking. Hence there is as much need of a 
temperance eating, as a temperance drinking, society. From whatever cause 
the digestive organs become deranged, the system will exhibit disease in some 
form or another," although it may be years before the disease developes, or 
shows itself. 
" Happy would it often be," says a writer, " for suffering man, could he 
see beforehand the punishment which his repeated departure from the laws 
of physiology or nature is sure to bring on him. But, as in the great ma- 
1 2 
MEANS OF PREVENTING DISEASE, 
jority of instances, the breach of the law is limited in extent, and becomes 
serious by the frequency of its repetition, rather than by a single act; so is 
the punishment gradual in its infliction, and slow in manifesting its accumu- 
lated effect; and this very gradation, and the distance of time at which the 
full effect is produced, .are the reasons why man in his ignorance so often 
fails to trace the connexion between his conduct in life and bis broken health. 
" To the intemperate in eating and drinking the day of reckoning is merely 
delayed, and there is habitually present a state of repletion which clogs the 
bodily functions, and may lead to sudden death by some acute disease when 
the individual is apparently in the highest health." 
How many instances might be mentioned to prove this fact. A person 
who resides the next door to me, is now very low from the same causes. 
He had been a butcher by trade; bad lived very high, and taken very little 
exercise, which caused great plethora. He was suddenly attacked with a 
severe disease, and for some days his life was despaired of; I anticipated a 
similar result from his diet and mode of living. Another acquaintance of 
mine was lately brought to the same condition by indulgence in eating and 
drinking. One day he commenced working in his garden, and, on stooping, 
the blood rushed to the head, occasioning fatal apoplexy. How frequently 
do we hear of similar cases from similar causes. Another case occurs to me. 
A person asked my advice, some time ago, in relation to symptoms arising 
from improper regimen. I prescribed suitable diet, &c. Afterward he in- 
formed me that he began to follow my directions; but his wife dissuaded 
him from it. She prepared so many good things for him to eat that he could 
not abstain from them. He continued to violate the law's of nature till he 
was seized with a fit of palsy or apoplexy, which renders his recovery doubt- 
ful. Volumes might be filled with similar cases. 
Says a late writer, " Is it not better, by a rational exercise of judgment, to 
preserve health w hen we have it, than first to lose it, then pay tbe penalty in 
suffering and danger, as an indispensable preliminary to its subsequent restora- 
tion ?" It is knowrn, that as soon as a person applies to a judicious physician 
for advice he is put under a proper course of regimen to restore him to health. 
Now it must be evident, that the same course which is calculated to regain 
health is likewise calculated to prevent disease. To accomplish an object 
so desirable and important as to prevent disease and preserve health, I have 
laid down rules, in the following pages, founded upon the laws of physio- 
logy, and which, if strictly adhered to, will be the means, not only of the 
recovery, but likewise the preservation of health, and often without the use 
of medicine. 
" I have seen," says Graham, " hundreds of miserable dyspeptics, wrho 
had suffered almost everything for years; scores of those apparently con- 
sumptive ; many afflicted for years with fits and spasmodic affections, or 
asthma, or sick headache ; in short, I have seen nearly every form of chronic 
disease, after resisting almost every kind of medical treatment for months and 
years, yield, in a very short time, to a correct diet and a well-regulated 
general regimen." 
" It is not easily to be credited," says Cheyne, u what wonderful effects, 
even in the most desperate and universally-condemned-to-death diseases, I 
have seen produced by an exclusively milk and grain diet; and even these, 
the thinnest and least in quantity, the person could be tolerably easy under 
from the pain of hunger, and continued for one, two, or more years. Epilepsy 
totally cured; universal lepers made clean; stone and gravel laid quiet; 
cancers healed or palliated; ulcerated lungs made sound; and schirrous AND PROMOTING HEALTH AND LONGEVITY. 
3 
livers made pervious; and all accomplished by a total, obstinate, and con- 
tinued milk and grain or coarse flour diet. 1 firmly believe, and am as 
much convinced as I am of any natural effect, that water drinking only, 
with a diet of milk, grain, and fruit, duly continued and prudently managed, 
with proper evacuations, air, and exercise, are the most infallible antidotes 
for all obstinate diseases of body and mind. This regimen I have for the last 
twenty years pursued." 
At the close of these remarks on the subject of health, I intend to add, if 
space permit, by way of illustration, some cases which have been cured by 
diet, bathing, exercise, &c. This ought to be an encouragement to the sick 
and the invalid, as well as others, to follow the same course. I therefore 
beg the attention of the reader to this important subject, particularly to the 
article headed, Bill of fare for invalids and others ; and if they wish 
to have a sound mind in a sound body, not only to read, but likewise to prac- 
tise, the rules there laid down, as well as those in other parts of this treatise 
on the same subject. I also desire the reader to peruse the rules for the 
preservation of health, and the promotion of longevity, by Sir Richard Jebb. 
Says a late excellent writer, " Three-fourths of the vice that entails 
wretchedness on the human family, is physiological vice ; that is, that which 
consists in the depraved indulgence of the three appetites ; or in the moral 
feelings brought immediately into action by these means." 
I remark farther in detail, first on 
TEMPERANCE, ABSTINENCE, DIET, ETC. 
As perfect health is the greatest earthly blessing we can enjoy, without 
which all other blessings are of little consequence, I deem it of the first im- 
portance to point out the means of promoting it; by paying proper attention 
to which, persons who are born with, and enjoy a good constitution, will 
attain a healthful and long life, and even those who are delicate and tender 
will arrive at an advanced age. These means hold forth the doctrine, that 
regularity and temperance in all things are highly conducive to health and 
happiness; and, on the contrary, that irregularity and intemperance bring 
their votaries to an untimely grave. 
When the various functions of the body are performed with ease, and suffer 
no interruption, the body is said to be in health ; in a contrary case it is dis- 
used. Considering the many dangers to which man is exposed, it is sur- 
prising that he should remain in health so long; and our astonishment 
increases when we reflect how often he escapes the dangers prepared by his 
own hand. But parental nature frequently repairs the injury in a manner 
unknown to us. To set down supinely with a notion, that if the Majesty 
of Heaven wills us to die, we certainly shall, in the use of means to prolong 
life ; and if He wills the contrary, we shall live, in the neglect of those means, 
is a conduct unscriptural and absurd. Disease may be considered the con- 
sequence of the moral, or rather immoral, conduct of man, in deviating from 
a line prescribed by his Maker. 
The powers of life may be compared to the oil in a lamp: in time they 
will be exhausted; they may be supported or diminished; when exhausted, 
death invariably closes the drama. Death from mere old age may be com- 
pared to the extinction of the light when the oil is all consumed; and death 
from disease, to the blowing out of the light when the oil is not all consumed, 
and might have burned longer. There are laws in nature, by which man 
may arrive to maturity, to the summit of health and vigour; and there are 4 
MEANS OF PREVENTING DISEASE, 
laws, by which his powers of life are lessened and finally exhausted. These 
are the " bounds which he cannot pass." 
In order to extend the common term of life, mankind must be persuaded 
to return to that primeval state of nature, from which history furnishes us 
almost incredible instances of longevity. The antideluvians enjoyed an un- 
interrupted state of health; their manner of living and vegetable diet was 
simple and not injurious. They had little need to attend to their health, as 
the seeds of disease were little scattered in such a state. We have deserted 
from the simple mode of life which prevailed in the primitive ages. We 
have acquired our improved state of mental culture, by sacrificing to it much 
of our bodily welfare. We are less accustomed to consult what nature 
requires, with respect to diet, mode of life, clothing, &c., than to follow 
fashions, customs, and our own disordered inclinations. 
The desire of long life is inherent in all human nature; and the possibility 
of prolonging it was never doubted by the orientals. The most important 
circumstances which favour the attainment of long life are, 
Temperance, Abstinence, and Diet. 
" Temperance is a kind of regimen," says Dr. Thomas, " under which 
every man may put himself without interruption to business, expense of 
money, or loss of time ; and may be practised by all ranks and conditions, at 
any season, or in any place. If exercise assists in throwing off superfluities 
from the body, temperance prevents them; if exercise clears the vessels, 
temperance neither satiates nor overstrains them ; if exercise promotes a free 
circulation of the blood, temperance gives nature full play, and enables her 
to exert herself in all her force. Cheerfulness of temper and vigour of body 
are the usual results of temperance ; on the contrary, depression of spirits, a 
shattered constitution, disease, and often poverty, are the consequences of a 
continued course of intemperance. 
It is much easier to preserve health than to recover it when impaired, and 
to prevent diseases than to cure them. Toward the first, the means are 
generally in our own power, little else being required than strict temperance 
in all things ; but, toward the latter, the means are uncertain and perplexed, 
and for the knowledge of them the greatest portion of mankind must apply 
to others of whose skill and judgment they are in a great measure ignorant. 
The man who wishes to live long, and be healthy, must submit to live regu- 
larly and be temperate in his habits ; since he cannot otherwise expect to 
enjoy the fruits of such a life, nor be agreeable to himself or useful, in all 
probability, to his friends ; neither can he relish the bounties of Divine Pro- 
vidence, nor acquit himself of his duties to God. 
Some inconsiderate and sensual persons affirm, indeed, that a long life is no 
olessing, and that the state of a man who has passed his seventy-fifth year 
cannot really be called life, but death ; but we daily see, in our public papers, 
instances recorded of persons having attained the age of ninety or a hundred, 
enjoying most of their faculties; and whoever will read the tract of Sir 
Thomas Barnard on the comforts of old age, as also the life of Lewis Cor- 
naro, the Venetian, will perceive that this is a mistaken notion. At the age 
of one hundred years he was, by temperance in all his pursuits and in- 
dulgences, and particularly in his diet, capable of mounting his horse without 
any assistance, or advantage of situation, and could not only ascend a flight 
of stairs with ease, but climb up a hill on foot with the greatest ease; more- 
over, he was gay, pleasant, and good humoured; free from perturbation of AND PROMOTING HEALTH AND LONGEVITY. 
5 
mind and every disagreeable thought. He did not find life burdensome, but, 
on the contrary, spent every hour, we are informed by him, with the greatest 
delight and pleasure ; sometimes in conversing with men of his acquaintance, 
valuable for their good sense, manners, and letters ; sometimes in reading the 
works of favourite authors, and occasionally in writing. 
He was extraordinary sober, and dieted himself with so much wisdom and 
precaution, that, finding his natural heat decaying by degrees in his old age, 
he also diminished his diet by degrees, so far as to stint himself to a very 
trifling meal indeed. By this means he preserved his health, and was also 
vigorous to the age of a hundred years ; his mind did not decay; he never 
required the assistance of spectacles; neither did he lose his hearing; and 
that which is no less true than difficult to believe is, that he preserved his 
voice so clear and harmonious, that at the end of his life he sung with as 
much strength and delight as he did at the age of twenty-five years. 
" 0, Temperance," says Sir William Temple, " thou physician of the soul 
as well as the body, the best guardian of youth and support of old age, the 
tutelar goddess of health and universal medicine of life, that clears the head 
and cleanses the blood, that eases the stomach and purges the bowels, that 
strengthens the nerves, enlightens the eyes, and comforts the heart; in a 
word, that secures and perfects digestion, and thereby avoids the fumes and 
winds to which we owe the colic and spleen, those crudities and sharp 
humours that feed the scurvy and gout, and those slimy dregs and humours 
of which the gravel and stone are formed within us ; diseases to which man- 
kind are exposed rather by the viciousness than frailty of our nature, and by 
which we often condemn ourselves to greater torments and miseries of life 
than perhaps have yet been invented by anger and revenge, or afflicted by 
the greatest tyrants upon the worst of men. And yet so little notion have 
the generality of mankind of the virtue of temperance, that life with them is 
nearly one continued scene of intemperance. 
To what cause, so much as to intemperance, are owing faded youth and pre- 
mature old age, an enervated body, and an enfeebled mind, together with all 
that long train of diseases which the indulgence of appetite and sense have 
introduced into the world. Health, cheerfulness, and vigour are well known 
to be the offspring of temperance. The man of moderation culls the flowers 
of every allowable gratification without dwelling upon it until the flavour be 
lost: he tastes the sweets of every pleasure without pursuing it till the bitter 
dregs rise ; whereas the man of the opposite character dips so deep as to stir 
up an impure and noxious sediment, which lies at the bottom of the cup. 
How quickly does the immoderate pursuit of carnal pleasures or the abuse 
of intoxicating liquors ruin the best constitutions ! Indeed these vices gene- 
rally go hand in hand. Hence it is that we so often behold the votaries of 
Bacchus and Venus, even before they have arrived at the prime of life, worn 
out with diseases, and hastening with sw'ift pace to an untimely grave. Did 
men reflect on the painful diseases and premature deaths which are daily oc- 
casioned by intemperance, it would be sufficient to make them shrink back 
with horror from the indulgence even of their darling pleasures. 
The innocent too often feel the direful effects of it. How many wretched 
orphans are to be seen embracing dung-hills, whose parents, regardless of the 
future, spent in riot and debauch what might have served to bring up their 
offspring in a decent manner ! How often do we behold the miserable mother, 
with her helpless infants, pining in want, while the cruel father is indulging 
his insatiate appetites! 
It is too true, that the major part of mankind are intemperate and sensual 6 
MEANS OF PREVENTING DISEASE, 
and they love to gratify their appetites and commit excess; and seeing that 
they cannot avoid being greatly injured by their excesses, they, by way of 
apologizing for their conduct, say that it is better to live ten years less, and 
enjoy themselves, not properly considering of what importance are ten years 
more of life, especially a healthy life, and at a maturer age, when men be- 
come sensible of their progress in knowledge and virtue, which they cannot 
obtain to any degree of perfection before this period. 
A life of irregularity and intemperance has the certain effect to destroy 
persons of the best constitution, even in the prime of life ; while, on the other 
hand, one of regularity and temperance will frequently preserve men for a 
length of time, who are of a very delicate or bad constitution, and far gone in 
years. Whoever will read the life of Lewis Cornaro must be convinced of 
this. This Venetian had been addicted to a life of intemperance up to his 
fortieth year, the consequence of which was, that a heavy train of infirmities 
had invaded him, and made great inroads on his constitution; and after 
having to no purpose tried every means of relief that art and medicine ad- 
mitted of, he at last, by the advice of his physicians, entered on a life of the 
strictest temperance, by which he regained his health, and lived to a very 
advanced age. Daily observation has, indeed, fully convinced me that an 
elderly man, even of a delicate constitution, who leads a regular and sober 
life, has a better chance of a long one, than a young man of the best constitu- 
tion, who invariably leads a disorderly one. 
That irregularities of diet, repletion, and unwholesome food are the origin 
of many diseases, cannot admit of a doubt; and that the preservation of health 
much depends on a proper regimen, is equally obvious. 
When it is considered that many serious disorders are entirely occasioned 
by an improper diet, and that in almost every complaint the due direction of 
diet is perhaps of equal importance with the prescription of medicines, it is 
highly blameable to neglect this powerful resource. To delicate women and 
sickly persons, to pregnant women and those who are nurses, and to young 
children, restrictions on diet are indispensably necessary. 
It has wisely been observed by Hippocrates, (who has been called the 
father of medicine,) that, if a man eats sparingly and drinks little, he is nearly 
certain of bringing no disease upon himself, and that a moderate supply of 
food nourishes the body best. The quantity of food which nature really 
requires for her support is small, and he that lives temperately, and eats and 
drinks moderately at each meal, stands fair to enjoy sprightliness, vivacity, 
and freedom of spirits. Bodies that are governed by temperance and regu- 
larity are rarely hurt by melancholy, or any other affection of the mind. To 
have a clear head, we must have a clean stomach; for ..this is the grand re- 
servoir in which the food is first deposited, and thence its nutritive power 
is distributed throughout all parts of the body. 
An error into which many people fall is that of eating too much at once. 
If the stomach be filled with a greater quantity of food than it can easily bear, 
or what is proper, its coats are stretched beyond their natural tone, and ren- 
dered incapable of performing its digestive powers; the food being longer 
retained than by the laws of the circulation it ought to be, and undergoing a 
disorderly fermentation, gives rise to crudities, sour eructations, flatulence, 
listliness, headache, and stupour; for the stomach having an intimate connexion 
with the brain and nervous system by sympathy, whenever one of them is 
disordered, the other seldom fails of partaking in the calamity. 
Who never fasts, no banquet e'er enjoys ; 
Who never toils or watches, never sleeps. AND PROMOTING HEALTH AND LONGEVITY. 
7 
He that consults his health must check his appetite, and invariably rise 
from table with the ability and disposition to eat and drink still more than he 
has done. He should also diligently apply himself to discover what kinds 
of food are best suited to him; for the proverb, that whatever pleases the 
palate must agree with the stomach and nourish the body, or that which is 
palatable must be wholesome and nourishing, is founded in error. The best 
rule will be, not to take anything but in such quantity as the stomach can 
easily digest, and to of only those things which, from observation 
and experience, the person has found to agree with him. The quality as 
well as quantity is, therefore, to be taken into consideration. By repeated 
trials and experience any man may acquire a perfect knowledge of his con- 
stitution, and ascertain not only what food, but likewise the liquor, that 
agrees best with his stomach ; and, in regulating his diet, he may place a safer 
reliance on his own judgment than he can on the opinion of his medical atten- 
dant, be he ever so skilful. 
An attention to diet and temperance in all other respects is not only neces- 
sary for the preservation of health, but is likewise of great importance in the 
cure of diseases ; and many of them, indeed, may be cured by a suitable diet 
alone. Avoid, therefore, any excess at table, or the partaking of a great 
variety of dishes ; for intemperance not only renders the understanding cloudy 
and injures the constitution, but likewise degrades the soul. Do not. confine 
temperance, however, to merely eating and drinking, but let it be extended 
to the moderating every other appetite, inclination, or passion. 
Abstinence is the best cure for any excess which has been committed in 
eating or drinking. In paying a strict attention to temperance, we are to 
take care at the same time not to carry it so far as to border on abstinence of 
an excessive nature; for this is by no means conducive to health, but the 
direct contrary, because a copious supply of fresh and wholesome food is 
requisite for the support of the body, and is peculiarly necessary for those 
who labour hard. 
Dr. Cheyne imputes most of the chronical diseases, the infirmities of old 
age and short lives, to repletion or intemperance; and that they may be 
either prevented or cured by abstinence. 
But if abstinence is not sufficient for the cure of diseases, yet it greatly 
assists the operation of medicines, and is a preventive against a multitude of 
dangerous disorders. Several writers relate extraordinary cures performed by 
it, and many instances of its extending the term of human life. It is, indeed, 
surprising to, what a degree of age the primitive Christians of the East, who 
retired from persecution into the deserts of Arabia and Egypt, lived healthful, 
and cheerful, on a very little food. Cassian assures us, that the common 
allowance for twenty-four hours was only twelve ounces of bread and mere 
water; and adds, that on this spare diet Arsenius, tutor to the Emperor Arca- 
dius, lived a hundred and twenty years, and many others to nearly the same age. 
A man of the name of Laurence preserved his life to a hundred and forty 
years, by temperance and labour. And Spotswood mentions one man who 
attained the age of one hundred and seventy-five years, by means of 
abstinence. 
It appears from the registers of the society of Friends, that one-half of 
those born among them live to the age of forty-seven years ; whereas, says 
Dr. Price, that of the general population of London one-half live only two and 
three-quarter years. The number of Friends who live to the age of seventy, 
compared with the general population of London, is as four to one. This 
superior longevity is properly attributable to the temperate habits of the 8 
MEANS OF PREVENTING DISEASE, 
society generally; and it may be added that, from the same cause, they 
enjoy a greater portion of health, and exemption from the commonly allotted 
ills of life. A still greater benefit flowing from the habitual temperance 
of this society is, the almost total absence of pauperism among them. 
Although they relieve the public from all charge on account of their poor, 
it is believed that they are not subjected to any heavy burden thereby- 
their habits of temperance and economy operating to keep nearly all above 
want. w 
Food which is simple, provided it be easy of digestion, and affords a due 
quantity of nourishment, is far preferable to that which is compounded by 
the rules of art and cookery, and rendered more savoury by an addition of 
aromatic spices. Eating a variety of high-seasoned viands, and partaking of 
many dishes, is very unwholesome ; for the stomach thereby becomes over- 
loaded with an heterogeneous mass, exceedingly pernicious in its effects. 
Moreover, we are induced to exceed the bounds which nature has prescribed 
for us, and by such means the stomach labours under all the direful effects 
of repletion. To eat moderately of one dish is certainly most wholesome. 
Simplicity of food requires no physical alteratives, and due exercise, with 
temperance, proves the best cathartics. 
The new school of France seems to be well aware of this truth, and has 
retired back to the simplicity of nature, to those days of primitive manners, 
when the dietetic school spread its doctrines abroad fbi* the relief of man. If 
you ask the French professors what is the best mode of curing disease, they 
will answer you, like the Greek orator, when it was inquired, what was the 
first essential in eloquence? he answered, action; and what the second? 
action; and what the third? action. So would the physicians of Paris, if 
it were inquired wrhat was the first requisite in curing disease; they would 
answer, diet; and the second ? diet; and the third ? diet. 
Wonderful cures, says Dr. Mease, have been effected by simplicity of diet. 
The father of Professor Cooper, of South Carolina, was cured, in London, of 
an asthma, to which he had been long subject, by an exclusive diet of boiled 
carrots for two weeks, as recommended by John Wesley, in his " Primitive 
Physic." During this time he drank little water. He remained well for 
twelve years; but, having returned to his former generous living, he was 
again attacked. I have heard of another cure by the same diet. 
The disease called " broken wind," in horses, which is no more than the 
asthma in the human species, is cured in England by an exclusive diet of the 
same vegetable. 
A lady in Philadelphia was cured of a most severe rheumatism by a diet 
of milk solely; and Dr. Cheyne records, that Dr. Taylor, a contemporary 
with himself, was cured of epilepsy by the same diet.-English Malady, p. 
255. Our books of medicine record many other cures effected by rigorous 
simplicity of diet. 
In eating our food, due care should be taken to chew, or masticate, it suffi- 
ciently, previous to its being swallowed : this is a point deserving of a very 
strict attention, and may be deemed the first process of digestion ; for, with- 
out the solid parts of our food being well triturated in the mouth, and at the 
same time incorporated with a due proportion of the salivary secretion, it 
cannot be converted into good chyle or healthy nutriment. 
The simplicity of aliments and temperance arc, in fact, the abundant sources 
of health and life. It is sufficient, says Plutarch, to have the taste of true 
pleasure to be temperate. Regimen has the greatest influence, not only upon 
the physical, but also upon the mental part of man. AND PROMOTING HEALTH AND LONGEVITY. 
9 
The monks of La Trappe make it a part of their religion to eat only once 
a day, and nothing but vegetable food-unless when sick, in which case milk 
is allowed ; but it is long before they become reconciled to the restriction. 
CHAPTER II. 
FOOD AND DRINK. 
" Man should content himself with the produce of the fields, gardens, and dairy." 
ANIMAL FOOD. 
It appears very evident that man, in his primeval state of simplicity, never 
ate any animal food whatever. Previous to his transgression, he was not 
permitted to kill any animals nor partake of any meat, as appears by the com- 
mand of his Maker, recorded in the Bible. Vegetables alone seem to have 
been his only food. From this fact we may infer, that vegetable is more 
congenial to the system than animal food. We may infer this also from the 
effects which follow the long-continued use of meat. Sailors who use it on 
long voyages are subject to the scurvy, which often proves fatal, when a 
recurrence to vegetables immediately removes the disease. A vast number 
of other complaints are unquestionably produced by animal food. The evil 
consequences arising from it are in part owing to the quantities of oil or grease 
it contains ; by reason of which the digestion is disordered, the bile vitiated, 
the blood corrupted, and cutaneous and other diseases induced. 
Injurious effects are very frequently immediately felt after eating a meal 
of high-seasoned meats; such as oppression at the stomach, lethargy, and 
subsequently, if persisted in, dyspepsia, and other complaints. Animal food, 
then, may in general be considered hurtful, and requires a very strong and 
healthy stomach to digest it; and it ought, therefore, if used at all, to be taken 
very sparingly, and not more than once a day. Besides, it is better taken 
cold than warm. When animal food and wine have been received into the 
stomach, no sooner is the digestive process begun, even before any portion 
is introduced into the circulating fluid, than the action of the heart is in- 
creased and the pulse is quickened; but the same effect is not observed 
from vegetables. 
Animal food, says Dr. Parish, is too highly stimulant. The springs of 
life are urged on too fast, and disease necessarily follows, (such as a bilious, 
plethoric, and inflammatory state of the system.) The celebrated anato- 
mist, Alex Munroe, states that animal food produces the hot alkalescent 
scurvy, a fierce and savage temper, a peculiar feature, and leprosy, with a 
corruption of all the juices, which is only to be cured by a change of diet. 
In travelling, a few years ago, in the state of Ohio, I was forcibly struck 
with the dark and unnatural colour of the inhabitants. I observed it to a 
lady passenger, who stated that the peculiar colour of the skin was caused by 
eating so much meat, particularly pork. 
The blood of the person who eats animal food is richer, thicker, and more 
stimulating, and produces a much greater excitement of the different organs, 10 
MEANS OF PREVENTING DISEASE, 
than the blood of those fed on vegetables. Flesh diet, therefore, gives a 
greater tendency to inflammatory and other complaints than a vegetable diet. 
Among other ill effects of animal food is a temporary fever after eating it, 
called, by the old medical writers, " the fever of digestion." No such effects 
follow the use of vegetable food. 
Dr. Dick considers it incompatible with a state of innocence, to take the 
life of any sensitive being and feed on its flesh; and that, consequently, no 
such grant was given to Adam in Paradise, or to the antediluvians. He con- 
sidered it a grant only fitted to the degraded state of man after the flood. 
This accords with the opinion of another writer, I think Dr. Cheyne; I 
am almost convinced, says he, that animal food was never intended, but only 
permitted as a curse or punishment, and a cure for a malady, being adapted 
to the corrupt state of man. 1st, To let him feel and experience the natural 
and necessary effects of his own lusts by painful diseases. 2d, To shorten 
the duration of his natural life, that sin and misery might not increase 
infinitely. 
VEGETABLE FOOD. 
Vegetable food is much lighter, more easily digested, and much less in 
dined to putrify than animal food. Besides, from the natural stimulus which 
it possesses, the bile is rendered more healthy, by which the regular peris- 
taltic motion of the bowels is kept up, and costiveness, the source of so many 
evils, obviated. This is easily proved, for every one knows that the use of 
certain fruits, such as apples, raisins, tamarinds, peaches, prunes, pears, 
plumbs, whortleberries, &c., besides other articles which will be hereafter 
mentioned, keep the bowels in a constant soluble state. 
To show still farther the influence of vegetable food in promoting a healthy 
state of the system, we need only advert to the inhabitants of those countries 
who use it exclusively. For health and vigour of constitution, they are 
noted. Observe, for instance, the Irish, who live upon potatoes and butter- 
milk, how muscular and athletic they are, and how their countenances glow 
with genuine health. They can endure more hardships and more privations 
than any other people, and yet subsist upon this vegetable from infancy to 
old age. Our forefathers, the hardy sons of New England, enjoyed uninter- 
rupted health and lived to a good old age, by adhering to a simple diet, such 
as bean porridge and hasty (Indian meal) puddings. But how have their 
descendants degenerated in point of health, by a departure from these simple 
and wholesome rules. It must be acknowledged that, by their habits of 
luxury, they do not live half as long as their ancestors. 
That man is capable of sustaining the health, vigour, and strength of his 
system upon a diet purely vegetable, is established by so many proofs as to 
place the fact beyond the possibility of doubt. The Hindoo lives almost 
exclusively upon rice and water. A great proportion of the Irish peasantry 
subsist on potatoes, with the addition of oaten cake or bread and milk; and 
the labouring classes, in many districts of Scotland and the north of England, 
are nourished upon little else than oat meal and potatoes; while in various 
other countries of Europe the poor are restricted almost exclusively to a 
vegetable diet, even less nourishing than these. When the food just referred 
to is in sufficient quantity and of a good quality, more robust, active, and 
vigorous frames, and a greater amount of general health, can scarcely be met 
with in the inhabitants of any other country or among any other classes of 
tociety, whatever may be the nature of their diet. Vegetable food affords as AND PROMOTING HEALTH AND LONGEVITY. 
11 
much or more nutrition than animal, while the former produces much less 
excitement. 
We find, says Dr. Lawrence, that, whether we consider the teeth and jaws or 
the stomach, the human structure closely resembles that of the monkey race; all 
of which, in their natural state, are completely herbivorous, or vegetable eaters. 
FACTS ILLUSTRATING THE DIFFERENCE BETWEEN ANIMAL AND VEGETABLE 
DIET. 
" A mulatto girl," says George Paine, Esq., of Providence, R. I., " came 
to live in my family in her twelfth year; previous to this she had remained 
at home with her parents, who were very poor. She had always lived in 
the plainest, simplest, and coarsest manner. During her summers she had 
subsisted almost entirely upon fruit in its natural state, and through the 
whole year she ate very little, except the plainest vegetable food. On very 
rare occasions she ate a little flesh, but not enough to render it, in any pro- 
per sense, a part of her diet. She drank water exclusively, and slept on 
straw. When she first came to live with me her suppleness, activity, agility, 
and strength so far exceeded anything we had ever seen before in such a 
child, that she absolutely filled us with astonishment by her feats. Of her 
own accord she was up in the morning as soon as it was light, and wherever 
she went she always went with a run, and with the nimbleness and fleetness 
of a deer. In all her movements she exhibited uncommon natural ease and 
gracefulness ; and in her muscular efforts she evinced a surprising degree of 
strength. She would, for our amusement, often throw herself down at 
length in the grass and imitate the motions of the snake, so exceedingly like 
a snake that it sometimes gave one very unpleasant feelings to look at her; 
and in a great variety of ways she exhibited the most wonderful suppleness, 
nimbleness, and agility that I ever beheld in a human body. Her mind 
seemed to be active and vigorous as her body. Her power of mental appre- 
hension and retention, and facetiousness and wit, were a continual source 
of surprise and amusement to us. On coming into my family she began 
gradually to accustom herself to flesh-meat, and in the course of two or three 
months she became very fond of it, and ate it very freely; and, to our 
astonishment, for we could not then account for the change, in less than six 
months all her remarkable suppleness, activity, and strength were gone, and 
she had become exceedingly sluggish, heavy, and stupid. We could not get 
her up in the morning until breakfast-time without special and direct means; 
all her movements became slow, heavy, and sluggish, indicating great indo- 
lence ; and her mind became as stupid and inactive as her body-and such 
she has ever remained since, being now fifteen years old." 
« I took a boy from the alms-house, in the year 1827," says Mr. Thomas 
H. Burling, of Westchester County, New York. " He was then in his thir- 
teenth year, and had always before this subsisted entirely on vegetable food. 
When he first came to my house he was remarkably supple and nimble, 
and would throw a somerset backward two or three times in succession 
with great ease. I had a notion that he would be good for nothing to work 
unless he ate flesh, and so I encouraged and urged him to do so. He soon 
became fond of flesh and ate it freely, and in less than six weeks he becamo 
so clumsy that, whenever he attempted to throw a somerset, he fell like 
a log." 
The interesting young natives of Pitcairn's Island exhibited the same 
qualities in a very remarkable manner. " A young girl," says Captain Pipon, 12 
MEANS OF PREVENTING DISEASE, 
" accompanied us to the boat, carrying on her shoulders, as a present, a large 
basket of yams, over roads and down such precipices as were hardly passable 
by any creatures except goats, and over which we could scarcely scramble 
with the help of our hands ; yet, with this load on her shoulders, she skipped 
from rock to rock like a young roe." Captain Beechy testifies to the same 
suppleness and agility in all the youths of the island. 
The Greek peasantry and the lazzaroni of Naples, who subsist on the 
simplest and plainest vegetable diet, are distinguished for their suppleness, 
activity, and grace. 
" I returned from Greece with Captain Floyd, in the ship Factor," says 
the venerable Judge Woodruff, of Connecticut, who went out as the Agent 
of the New York Committee for the relief of the Greeks. " There came 
over with us to New York, as one of the ship's crew, a Greek youth-a na- 
tive of Thessaly-whom we called John. He was nineteen years old. He 
had, from his childhood, been driven about among the Turks almost in the 
condition of a dumb beast, and subsisted on the plainest, simplest, and 
coarsest vegetable food-mostly in a natural state, and chiefly fruit. His 
nimbleness and agility far exceeded anything that I ever before saw in human 
being. Without exaggeration I can truly say, that he would run up and 
down the shrouds, and out on the main-yards, and jump about on the rigging 
with all the nimbleness and rapidity of a squirrel; indeed his exploits of 
nimbleness upon the rigging often filled me with amazement, which was 
sometimes mingled with fear for his safety." 
The wild men found at different times in the forest in Europe, and who, 
in their rude state, subsisted entirely on fruits and vegetables, have all been 
remarkable for their natural suppleness and activity. The wild girl that was 
found in the forest, would run up trees, and leap from branch to branch and 
from tree to tree, with the nimbleness of a squirrel; but she lost all this re- 
markable suppleness and activity when she became accustomed to eat flesh. 
Benjamin Howland, Esq., of East Greenwich, R. I., was quite a feeble and 
infirm man at forty years of age. He abandoned the use of flesh-meat, and 
took to plain, simple, and unstimulating vegetable diet. He soon became a 
healthy and remarkably active man ; and now, at the age of eighty-two, he 
has more suppleness and agility than most men at fifty. " Few young men, 
indeed, walk with so quick and elastic a step as he does. When crossing 
the fields, if a fence comes in his way, instead of pulling it down or crawling 
clumsily over it, he places one hand on the top of it and springs over like an 
active youth." The same experiment has produced the same result in 
Thomas Shillitoe, of England, and a great number of others in that country 
and in America whom I might mention, but it is unnecessary. 
" With respect to the moorish porters in Spain," says Captain C. F. Chase, 
of Providence, R. I., "I have witnessed the exceedingly large loads they are 
in the habit of carrying, and have been struck with astonishment at their 
muscular power. Others of the labouring class, particularly those who are 
in the habit of working on board of ships, and called in that country steve- 
dores, are also very powerful men. I have seen two of these men stow off 
a full cargo of brandy and wine, in casks, (after it was hoisted on board and 
lowered into the hold,) apparently with as much ease as two American sailors 
would stow away a cargo of beef and pork. They brought their food on 
board with them, which consisted of coarse, brown wheat bread and grapes." 
" I have made several voyages to St. Petersburgh, in Russia," says Cap- 
tain Cornelius S. Howland, of New Bedford, Mass. " The people of Rus- 
sia generally subsist, for the most part, on coarse, black rye bread and garlicks. AND PROMOTING HEALTH AND LONGEVITY. 
13 
The bread is exceedingly coarse, sometimes containing almost whole grains, 
and it is very dry and hard. I have often hired men to labour for me in 
Russia, which they would do, from sixteen to eighteen hours and find them- 
selves, for eight cents per day, (the sun shining then sometimes twenty hours 
in the day.) They would come on board in the morning with a piece of 
thin black bread weighing about one pound, and a bunch of garlicks as big 
as one's fist. This was all their nourishment for the day of sixteen or eigh- 
teen hours' labour. They were astonishingly powerful and active, and en- 
dured severe and protracted labour far beyond any of my men. Some of 
these men were eighty, and even ninety, years old; and yet these old men 
would do more work than any of the middle aged men belonging to my ship. 
In handling and stowing away iron, and in stowing away hemp with the 
jack-screw, they exhibited most astonishing power. They were full of 
agility, vivacity, and even hilarity-singing as they laboured with all the 
buoyancy and blithesomeness of youth." 
u The Irish chairmen, porters, and coal heavers in London," says Adam 
Smith, in his Wealth of Nations, " who have been raised principally on the 
potato, and who continue to subsist on vegetable food, are perhaps the 
strongest men in the British Dominions." 
" I have frequently witnessed, both in England and in Spain, the amazing 
bodily strength of the salt and coal heavers, and their ability to perform an 
astonishing amount of labour in a day," says Captain Chase. " They perform 
so much, that they generally work by the ton, and not by the day; much, 
however, probably depends on their being accustomed to this particular 
species of employment. These men subsist on a simple; vegetable diet, except 
that in England some of them use milk or butter-milk, with oat meal bread, 
mush, potatoes, &c. I have visited many respectable families in Ireland, 
who never allow their children to partake of any other than this simple fare 
Moreover, I have been informed by many of the young Irishmen from six- 
teen to twenty-five years of age, that they had never eaten a pound of flesh 
in their lives, still they were remarkably vigorous, sprightly, and exceed- 
ingly well-formed : and the women are uncommonly handsome And of 
all classes with which I have ever been acquainted, in all countries and cli- 
mates, the Irish who have been thus reared, and who lead temperate lives, 
will endure more hardships, fatigue, and exposure than any other." " The 
finest specimens of human body I ever beheld I saw in Ireland, and they 
had never tasted animal food," says the Rev. Howard Malcolm, of Boston, 
who has travelled extensively in America, Europe, and Asia. 
" The salt and coal heavers in Liverpool and London are principally Irish," 
says Captain John Price, of New Bedford, Mass. " I have often employed 
these men in lading and unlading my ship, and have been surprised at their 
great strength and power of endurance, in connexion with their simple and 
scanty diet. Their food consists principally of oat meal and other coarse 
bread, and cheese-dining on about four ounces of coarse bread and two 
or three of cheese. On one occasion two of these men came alongside 
of my ship with a boat-load of salt for me ; and one of them actually threw 
the salt with a shovel up nine feet on to the deck of my ship, as fast as two 
of my men could throw it into the hole." 
" I once discharged a cargo of oil at the port of Lisbon, in Portugal," 
says Captain Cornelius S. Howland, " and casks of oil were carried from my 
ship to the store-house by porters. These porters were from the interior or 
the borders of Spain, and Portugal. They subsisted wholly on vegetable 
food, almost entirely on course rye bread, and were remarkably stout and 14 
MEANS OF PREVENTING DISEASE, 
healthy. I had a cask of oil of uncommon size on board, weighing upward 
of thirty-two hundred pounds, and four of these porters, yoked two by two, 
took it up by means of ropes going from these yokes under each end of the 
cask, and carried it about fifteen rods to the store-house." 
The celebrated Dr. Cheyne, of England, who flourished about a hundred 
years ago, says : " For those who are extremely broken with chronic dis- 
ease, I have found no other relief than total abstinence from all animal food, 
and from all sorts of strong fermented liquors. In about thirty years' prac- 
tice, in which I have, in some degree or other, advised this method in proper 
cases, I have had but two cases in whose total recovery I have been mis- 
taken ; and they were both too deeply diseased and too far gone for recovery 
before I undertook with them." Dr. Lambe, of England, now upward of 
seventy years old, after a very long, extensive, and successful practice, speaks 
most decidedly against the use of animal food of any kind in chronic disease. 
And, during the last seven years, my own opportunity to prove the virtues of 
different kind of diet in chronic disease has probably been more extensive 
than any other individual in any age ; and I have, as a general rule, always 
found the pure and well-regulated vegetable diet, under a correct general 
regimen, is decidedly better than that which contains any portion of animal 
food. I have, it is true, met with some invalids whose general physiological 
condition seemed to require that a portion of animal food should be retained 
in their diet for a few weeks, and perhaps a few months, till the general 
sluggishness and torpor of their systems could be overcome : but such cases 
are not common; while, on the other hand, as I have already stated, 1 have 
seen multitudes of chronic diseases of every name and type, which had long 
and incorrigibly withstood medical treatment of every kind, yield-in some 
instances immediately, and in others in a few weeks or months-to a pure 
vegetable diet and general regimen regulated by physiological principles. 1 
could fill a large volume with well-authenticated and most interesting de- 
tailed accounts of a very great variety of cases of chronic diseases cured in 
this manner. 
An intelligent farmer of Pennsylvania, whose health had for some time 
been declining, and who, at the age of sixty years, finding himself completely 
broken down and laid by with all the infirmities of a premature old age, was 
induced to adopt a simple diet of vegetable food and water, with the hope of 
mitigating, in some degree, the severity of his sufferings. Of the effects of 
this experiment he thus expresses himself: 
" In less than twelve months from the time I commenced living on my ab- 
stemious vegetable and water diet, I was perfectly restored to health, and 
seemed to have renewed my life ; I was entirely free from every pain and 
ailment, and was very active and vigorous, and more serenely and truly cheer- 
ful and happy than ever before since my childhood. My sight improved as- 
tonishingly, insomuch that-whereas, before my change of diet, I could, with 
difficulty, see to read with the best glasses I could procure-now I could 
easily read the finest print of my newspaper without glasses. But the most 
wonderful effect was produced on my mind, which became far more clear, 
active, and vigorous than it had ever been before ; indeed, no one who 
has not experienced the same, can have any adequate conception of the 
real intellectual luxury which I enjoyed. It seemed as if my soul was per- 
fectly free from all clogging embarrassments and influence of the body. I 
could command and apply my thoughts at pleasure, and was able to study 
and investigate the most obtuse subjects ; and to write with an ease, perspi- 
cuity, and satisfaction which I had never before known nor had any idea AND PROMOTING HEALTH AND LONGEVITY. 
15 
of." (For farther evidence of the same kind, see a treatise entitled " Science 
of Human Life."') 
As I wish to remove all doubts as to the injurious effects of animal food on 
the system generally, and thence to deduce conclusions more particularly, I 
subjoin the following testimony from writers on this subject, showing the 
happy effects produced by a mild vegetable diet on the passions and body, 
and, therefore, on the longevity of man. If we go back to the times of Kinj, 
Nebuchadnezzar, spoken of in Scripture, we shall find there a triumph ov 
the flesh-eating Babylonians, by the experiment made in the case of the four 
children of Judah, who refused the king's meat and drink, and confined them- 
selves simply to their pulse and water; and yet, for wisdom and fairness of 
face and proportion, none was found like them in all the king's realm. 
Before the discovery of the Ladrone Islands, by the Spaniards, about the 
year 1620, the inhabitants supposed themselves the only people in the world. 
(Something like the boy who went out some distance from his own resi- 
dence, and wondered how people could live so far from home.) They 
were destitute of almost everything that people in civic life think necessary 
to existence. There were no animals on the islands except birds, and these 
fliey did not eat. They had never seen fire, nor could they at first imagine 
the properties or the use of it. Their food was wholly vegetable ; consisting 
of fruits and roots in a natural state. They were well formed, vigorous, and 
active, and could carry with ease upon their shoulders a weight of five hun- 
dred pounds. Disease or sickness was scarcely known among them: and they 
generally attained to great age. It was no extraordinary thing for individuals 
among them to reach a hundred years without experiencing any sickness. 
Does any suppose they had pills to make them feel well, or doctors to 
salivate them, or dentists to take the tartar from their teeth ? 
Lycurgus, the distinguished lawgiver of Lacedemon, who was considered 
as a model by Diogenes, Plato, and Zeno, forbade his subjects the use of 
fatted animals, and even the assistance of either butchers or cooks ; and gave 
as his reason, that the use of fat animals not only tended to corrupt their 
natures, but likewise to disorder their bodies. 
The celebrated Porphyry of Tyre, the Platonist, who flourished about the 
middle of the third century, in his book concerning abstinence from animal 
food, addressed to Firmus Castricius, who had relinquished the Pythagorean 
system, tells him as follows : " You admitted, when you lived among us, 
that a vegetable diet was better than animal food, both for preserving health 
and for facilitating the study of Philosophy ; and now, since you have eaten 
flesh, your own experience must convince you that what you then confessed 
was true. It was not from among those who have lived on vegetables that 
robbers or murderers, sycophants or tyrants, proceeded ; but from flesh-eaters. 
The necessaries of life are few and easily acquired, without any violation of 
justice, liberty, health, or peace of mind : whereas luxury obliges those vul- 
gar souls who take delight in it, to covet riches, to give up their liberty, to 
sell justice, to misspend their time, to ruin their health, and to renounce the 
joy of an upright conscience." 
Porphyry says : 
1st. " That a conquest over the appetites and passions will greatly contri- 
bute to preserve health and to remove disease. 
2d. " That simple vegetable food, being easily procured and easily digested, 
assists very much in obtaining this conquest over ourselves. 
" Give me a man who considers seriously what he is, whence be came, 
and whither he must go, and from these considerations resolves not to be led 16 
MEANS OF PREVENTING DISEASE, 
astray nor governed by his passions, and let such a man tell me whether a 
rich animal diet is more easily procured, or incites less to irregular passions 
and appetites, than a light vegetable diet ! But if neither he, nor a physician, 
nor, indeed, any reasonable man whatsoever dares to affirm this, why do we 
oppress ourselves with animal food ? and why do we not, together with luxury 
and flesh-meat, throw off the encumbrances and snares which attend them ?" 
" You ask me," says Plutarch, " why Pythagoras abstained from eat- 
ing the flesh of brutes ? For my part, I am astonished to think, on the 
contrary, what appetite first induced man to taste of a dead carcass ; or what 
motive could suggest the notion of nourishing himself with the flesh of 
animals which he saw, the moment before, bleeting, bellowing, walking, and 
looking about them. How could he bear to see an impotent and defenceless 
creature slaughtered, skinned, and cut up for food ? We should, therefore, 
rather wonder at the conduct of those who first indulged themselves in this 
horrible repast, than at such as have humanely abstained from it." 
Cullen remarks, in his Lectures on the Materia Medica, that vegetable 
aliment, inasmuch as it never over-distends the vessels nor loads the system, 
never interrupts the stronger motions of the mind ; while the heat, fulness, 
and weight of animal food is an enemy to its vigorous efforts. Temperance, 
then, does not so much consist in the quantity, for that always will be regu- 
lated by our appetite, as in the quality. 
The celebrated Baron Cuvier says, that man resembles no carnivorous 
animal; and that the structure of the human frame is fitted and peculiarly 
adapted to a pure vegetable diet in every essential particular. It is true, 
that those who have long been accustomed to the stimulus of animal food, 
very reluctantly abandon its use, which is the case more particularly with 
those of a weak mind ; but this, however, is no argument in its favour. 
From examples and customs it may probably be concluded, that the 
common ingredients of health and long life are great temperance, open air, 
easy labour, little care, simplicity of diet, rather fruits and plants than flesh, 
which easier corrupts, and water, which preserves the radical moisture with- 
out too much increasing the radical heat. Whereas sickness, decay, and 
death proceed commonly from the one preying too fast upon the other, and 
at length wholly extinguish it. 
Doctor Abernethy says, " if you put improper food into the stomach, it 
becomes disordered, and the whole system is affected. Vegetable matter 
ferments and becomes gasseous, while animal substances are changed into a 
putrid, abominable, and acrid stimulus." The effects of animal food, and 
other improper stimulants upon the system, likewise induce preposterous 
noses, blotches on the face and other parts of the body, gout, apoplexy, in- 
flammation of the eyes, decay of the teeth, &c. 
Cheyne says, " it is surprising towhat a great age the Eastern Christians, 
who retired from the persecutions into the deserts of Egypt and Arabia, lived 
healthful on a very little food. We are informed by Cassian, that the com- 
mon measure for twenty-four hours was about twelve ounces, with only pure 
water for drink. St. Anthony lived to 105 years on mere bread and water, 
adding only a few herbs at last. On a similar diet James the hermit lived 
to 104. Arsenius, the tutor of the Emperor Arcadius, to 120; sixty-five 
years in society and fifty-five in the desert. St. Epiphanus to 115; St 
Jerome to about 100; Simeon Stylites to 109 ; and Romualdus to 120. 
A sheep that was fed on flesh for some time on board a vessel, where 
vegetable matter could not be obtained, at the end of the voyage refused its 
natural food. Instances of horses, oxen, and other herbivorous animals, after AND PROMOTING HEALTH AND LONGEVITY. 
17 
having been fed on flesh for some time, have actually loathed their natural 
food. 
Buchanan informs us of one Laurence who preserved himself to 140, by 
the mere force of temperance and labour. Spotswood mentions one Kentigern 
(afterward called St. Mongah, or Mungo, from whom the famous well in 
Wales is named) who lived to one hundred and eighty-five years ; and who, 
after he came to years of understanding, never tasted wine nor strong drink, 
and slept on the ground. My worthy friend, Mr. Webb, is still alive. He, 
by the quickness of the faculties of the mind and the activity of the organs 
of his body, shows the great benefit of a low diet; living altogether on ve- 
getable food and pure water. Henry Jenkins lived to one hundred and sixty- 
nine years on a low, coarse, and simple diet. Thomas Parr died at the 
age of one hundred and fifty-two years and nine months. His diet was 
course bread, milk, cheese, whey, and small beer; and his historian tells us 
that he might have lived a good while longer if he had not changed his diet 
and air ; coming out of a clear, thin air, into the thick air of London, and 
being taken into a splendid family, where he fed high and drank plentifully 
of the best wines, and, as a necessary consequence, died in a short time. 
" Ephraim Pratt, of Shutesbury," says the Library of Health, " who died 
in 1804, at the age of one hundred and sixteen years, took no animal food 
for forty years, and yet he could mow a ' good swarth ' almost to the hour 
of his death." 
" The Brazilians, when first discovered by the Europeans, lived the most 
natural original lives of mankind, so frequently described in ancient coun- 
tries, before laws or property or arts made entrance among them ; they 
lived without labour, farther than for their necessary food, by gathering 
fruits, herbs, and plants ; they knew no drink but water ; and were not 
tempted to eat or drink beyond their common thirst or appetite."-Sir John 
Sinclair's Code of Health, vol. iv., p. 333. 
" The chief food of the Japanese is rice, pulse, fruits, roots, and herbs ; 
but mostly rice, which they have in great plenty and perfection."-Mod. 
Univ. Hist, vol. ix., p. 62. 
" The philosophers of India eat nothing but rice, fruits, and herbs."-Bar- 
tolomeo's Voyage, by Johnson, p. 287. 
" The four most ancient orders of priests, the Rahans, the Bramins, the 
Magi, and the Druids, confined themselves to vegetable food, as did the 
Athenian Prince, Triptolemus, who established the Eleusinian mysteries, 
and prohibited, by law, all injury to animals."-Monthly Magazine, Feb., 
1812, p. 21. 
My friend, Dr. Parmly, says: " I have, myself, suffered much in former 
years from debility and other forms of indisposition, induced, I am per- 
suaded, by gross and improper diet. For the last year I have abstained 
from all exciting drinks, have utterly relinquished the use of tea and coffee, 
have abstained from animal food of every name and nature, and, by this 
course of conduct, have found my health so much benefited, that I feel it a 
duty, as well as a pleasure, to endeavour to impress upon the reader the 
necessity of living more frugally, if he wish to enjoy that health of body and 
tranquillity of mind which none can enjoy, for any length of time, but such 
as live in accordance with the rules prescribed by all sound philosophers, 
both of ancient and modern times." 
" The throat has destroyed more than the sword."-Martial. "The na- 
tions that subsist on vegetable diet are of all men the handsomest, the most 
robust, the least exposed to disease and violent passions, and they attain the 18 
MEANS OF PREVENTING DISEASE, 
greatest longevity. The Bramins of India, who frequently survive a century, 
eat nothing but vegetables. From the Pythagorean school (which was 
vegetable eating) issued forth Epaminondas, so renowned for his virtues, 
Archytas, so celebrated for his skill in mechanics, and Milo, of Crotona, for 
his strength. As vegetable diet has a necessary connexion with many vir- 
tues, and excludes none, it must be of importance to accustom young persons 
to it, seeing its influence so powerfully contributes to beauty of person and 
tranquillity of soul. The children of the Persians, in the time of Cyrus, and 
by his orders, were fed with bread, water, and cresses ; and Lycurgus intro- 
duced a considerable part of the physical and moral regimen of these children 
into the education of those of Lacedemon. Such diet prolongs infancy, and, 
of course, the duration of human life."-St. Pierre's Study of Nature, vol. 
iv., p. 357. 
" As, in every period of history, it has been known that fruit and vegeta- 
bles alone are sufficient for the support of life, and that the bulk of mankind 
live upon them at this hour, the adherence to the use of animal food is no 
more than a persistence in the gross customs of savage life-and evinces an 
insensibility to the progress of reason and to the operation of intellectual 
improvements."-Dr. Lambe on Regimen, p. 243. 
" It was well observed by the late Dr. Saunders, that we are made glut- 
tons from the cradle, by the officiousness of our nurses. A child's health is 
disordered by being over-fed ; it cries and complains from the effects ; and, 
with a view to silence it, more and more food is given ; so that the evil is 
increased instead of being remedied, and the capacity of the stomach gra- 
dually extended far beyond the salutary bounds of nature."-Dr. Hare on 
the Stomach, p. 134. 
" Dr. Alphonzo Lercy, of Paris, has published an essay on certain dis- 
eases of men, which he traces to the animals on which they are fed ; and he 
establishes the doctrine generally, that many diseases with which mankind 
are afflicted are communicated by eating the flesh of animals."-Monthly 
Magazine, June, 1815, p. 446. 
" The late Sir Edward Barry prevailed with a man to live on partridges 
without vegetables ; but, after eight days' trial, he was obliged to desist, in 
consequence of strong symptoms then appearing of an incipient putrefaction." 
-Sinclair's Code of Health, vol. i., p. 425. 
" The use of swine's flesh, in union with ardent spirits, is, in all likelihood, 
the grand cause of scurvy, which is so common in the British nation, and 
would probably assume the form and virulence of a leprosy, were our climate 
as hot as that of India."-Dr. Adam Clarke. 
" It is a remarkable fact, that at Heimaey, the only one of the Westmann 
Islands which is inhabited, scarcely a single instance has been known, during 
the last twenty years, of a child surviving the period of infancy. In conse- 
quence, the population, which does not exceed two hundred, is entirely kept 
up by emigration from the main land of Iceland. The food of this people 
consists principally of sea-birds, fulmars, and puffins. The fulmars they 
procure in vast abundance •, and they use the eggs and the flesh of the birds, 
and salt the latter for their winter food. There are a few cows and sheep 
on the island, but the inhabitants are said to have no vegetable food."-Dr. 
Lambe's Reports on Regimen, p. 197. 
" The man who forsakes not the law, and eats not flesh-meat like a blood- 
thirsty demon, shall attain good will in this world, and shall not be afflicted 
with maladies."-Laws of Menu, from Sir William Jones, vol. iii., p. 206. 
" Happy the man AND PROMOTING HEALTH AND LONGEVITY. 
19 
Who feeds on fruits which, of their own accord, 
The willing ground and laden trees afford." Dryden's Virgil. 
" The moral effect of aliment is clearly evinced in the different temper 
of carnivorous and frugivorous animals. The same effect of aliment is 
discernible among the different species of men; the peaceful temper of the 
frugivorous Asiatic is strongly contrasted with the ferocious disposition of 
the carnivorous European."-Rousseau. 
" The man who sheds the blood of an ox or sheep, will be habituated more 
easily than another to witness the effusion of that of his fellow-men."-En- 
cyclopedia, Methodique, tome vii-, part 1., liv. 65. 
" India, in fact, of all the regions of the earth, is the only public theatre 
of justice and tenderness to brutes and all living creatures; for there, not 
confining murder to the killing of man, they religiously abstain from taking 
the life of the meanest animal."-Ovington's Voyage to Surat, p. 286. 
" The Gentoos rear numerous herds of cattle ; but such is their venera- 
tion for these animals, on account of their useful and patient services to man, 
that to kill, or even maim one of them, is deemed a capital offence."-M. 
De Page's Travels, vol. ii., p. 27. 
" Among the Wallachians, though there is no positive institution to the 
contrary, yet the women never destroy the life of any living creature."-Dr. 
Alexander's History of Women., vol. i., p. 363. 
" The Indian Bramins never kill nor eat any sort of animal ; and it is certain 
they have not done it for more than 2000 years."-Dr. Clarke's Fleury, p. 87. 
" As a proof of the havoc committed by savage men on the creatures of 
his prey, it is said there are in Paris four thousand sellers of oysters ; and 
that fifteen hundred large oxen, and above 16,000 sheep, calves, or hogs, 
besides a prodigious quantity of poultry and wild fowls, are eaten daily."- 
Bayle's Dictionary, article Ovid. 
" I no longer eat flesh-meat nor drink fermented liquors. With regard 
to the flesh of animals, I am persuaded we have no other right than the right 
of the strongest, to sacrifice to our monstrous appetites the bodies of living 
things, of whose qualities and relations we are ignorant."-Life and Remains 
of J. Tweddell, p. 215. 
" Abstinence from animal food, says Shelley, subtilizes and clears the 
intellectual faculties."-Life of Shelley. 
" By salt and other high seasonings they stimulate the appetite, turn 
round the wheels of life too rapidly, and wear out the body or machine 
before its time."-Dr. Abernethy. 
u It is not, I think, going too far to say, that every fact connected with 
the human organization goes to prove that man was originally formed a 
frugivorous animal."-Bellon the Teeth, pp. 33-36. 
It has been ascertained, by the most careful experiments, that the various 
kinds of flesh-meats average about 35 per cent, of nutritious matter, while 
rice, wheat, and other kinds of grain afford from 80 to 95 per cent. 
Howard, the philanthropist, after testing the effect of a vegetable diet per- 
sonally, and while exposed to plague, pestilence, the foulest dungeons filled 
with malignant infections, remarks, " I am firmly persuaded, as to the health 
of our bodies, that herbs and fruits will sustain nature in every respect far 
beyond the best flesh." 
Animal food produces the following effects : 
1st. It is more stimulating than vegetable food. 
2d. It increases the action of the heart and arteries, and thus causes a 
quicker pulse and hotter skin. 20 
MEANS OF PREVENTING DISEASE, 
3d. The chyle and blood taken from a living vessel, formed by animal food, 
becomes sooner putrid than that formed from vegetable food. 
4th. The human body has more power to endure fatigue and resist disease 
when nourished by good vegetable food, than when nourished by flesh-meat. 
The following remarks are taken from Richerand's celebrated work on 
Physiology, a standard book in all medical schools : 
" A purely vegetable diet conveys into the blood," says Pythagoras, " mild 
and bland principles. This fluid excites the organs in a moderate degree, 
and this check over the physical excitement facilitates the observance of the 
laws of temperance, the original source of all virtues. The carnivorous, or 
flesh-eating species, are marked by their strength, their courage, and their 
ferocity. Savages who live by hunting, and who feed on raw, bloody, and 
palpitating flesh, (like the tiger,) are the most ferocious of men ; and in our 
own country, (France,) in the midst of those scenes of horror, called ' the 
reign of terror,' which we have witnessed and from which we have suffered, 
it was observed that butchers were foremost in the massacres and in all the 
acts of atrocity and barbarity. It would seem, 1st, that the habit of slaying 
animals had familiarized them to shed human blood ; 2d, that the daily use 
of animal food made them ferocious."- Physiology, p. 173. 
I shall make a few remarks upon the articles of diet most in use. 
Is/, Bread. Bread is said to be the staff of life, being used more than any 
other kind of diet. The articles, then, of which it is composed are of the 
greatest consequence. I am satisfied that bread, as now made and used, is 
one great cause of disease. The llour from which it is made is separated 
from the bran, the coarser part, designed by nature to keep up a continued 
action and stimulus to the bowels, for the purpose of preventing costiveness 
and a deranged state of the stomach and intestines. 
Another objection to bread made in our large cities is, the quantity of yeast 
added to the flour, which ferments it so much as to destroy the sweetness, 
and often forms acidity. 
Some, it is said, add alum, vitriol, and other deleterious substances, which 
render it very unwholesome. This is another source of indigestion and com- 
plaints of the liver. In grinding wheat, the coarser parts should never be 
separated from the fine ; but both should be ground coarse and mixed to- 
gether, then made into bread in the ordinary manner. A small quantity of 
indian may be added, and yeast to ferment it sufficiently. This kind of bread, 
although it is not so white as that made of superfine flour, is more palatable, 
much lighter, more easily digested, regulates the bowels, and I know not but 
I may with propriety add, that, with other precautions, it is a cure for the 
dyspepsia. 
2cZ, Tea and Coffee. Tea and Coffee are injurious, especially to invalids, 
dyspeptic and nervous people ; they produce debility, hysterics, and other 
evil consequences. Tea and Coffee, being both narcotic or poisonous, have 
many ill effects, by impairing the powers of the stomach, producing various 
nervous symptoms, palpitations of the heart, restlessness, headache, a pale 
and sallow hue of the skin, and all the usual train of morbid feelings which 
accompany dyspepsia. 
Sidney Bowne, of Westchester County, a man of great integrity, informs 
me that the use of coffee so debilitated his nervous system, that he could not 
write till nine o'clock in the morning. He, however, continued to use it very 
strong, till he became so nervous that he was obliged to abandon it, and drink 
nothing but water, which soon removed all his nervous symptoms. AND PROMOTING HEALTH AND LONGEVITY. 
21 
John Burdell, of this city, has discovered, by a course of experiments on 
animals, that tea is very poisonous. He made a decoction of the plant and 
gave it to a rabbit and a young cat, which killed them in a few minutes. 
How many of the nervous diseases, which are so common, proceed from the 
use of tea and coffee, is a question worthy of investigation. " During an 
extensive dental practice," says Burdell, " I have had an opportunity of ob- 
serving the condition of those of my patrons who were in the habit of drink- 
ing strong tea, and I have found that such persons have weak, irritable, and 
sensitive nerves." 
3d, Cookery. The arts of cookery render many things unwholesome 
which are not so in their own nature. By jumbling together a number of 
different ingredients, in order to make a poignant sauce or rich soup, the 
composition proves almost a poison. All high seasoning, pickles, &c., are 
only incentives to luxury, and never fail to injure the stomach; they disorder 
it and impair the health of the system generally, by rendering the food too 
heating and difficult of digestion, and by inducing us to partake of too 
much food, or to eat in the absence of the natural appetite. " It were 
well for mankind if cookery, as an art, were entirely prohibited. These 
alone are sufficient for people in health, and the sick have still less need 
of a cook." 
4f/i, Pastry. Pastry is generally unwholesome, and whatever is hard of 
digestion. In a word, plain and wholesome food, simply cooked, ought to be 
used. Ripe fruits of all kinds may be taken with safety ; but crude and un- 
ripe fruits are very dangerous : they bring on acidity and bowel-complaints. 
5M, Milk. Milk is the food destined by nature for the infant period, and 
seems admirably adapted for the use of young children, as well as adults 
whose powers of digestion are enfeebled either by dissipation or disease. In 
its pure state, however, it is apt to disagree with some persons ; in which 
case it will be advisable to dilute it with water. Those who labour under 
pulmonary consumption and hectic fever are frequently confined to a milk 
diet, and in such cases the milk of the goat has been much employed in pre- 
ference to that of the cow, being of a lighter nature. When that of the 
former is not to be obtained, that of the latter may be rendered more easily 
digestible, by allowing it to stand for some time, and then skimming off the 
cream from it. 
SIMPLICITY IN DIET. 
Nature delights in the most plain and simple food, and every animal, except 
man, follows her dictates. Man alone riots at large, and ransacks the whole 
creation in quest of luxuries, to his own destruction. An elegant writer of 
the last age speaks thus of intemperance in diet: "For my part, when I 
behold a fashionable table set out in all its magnificence, I fancy that I see 
gouts and dropsies, fevers and lethargies, with other innumerable distempers, 
lying in ambuscade among the dishes." 
WATER. 
Good water is of the greatest importance to the animal economy. It is 
the most simple of all liquids. 
" Nothing like simple element dilutes 
The food, and gives the chyle so soon to flow." 22 
MEANS OF PREVENTING DISEASE, 
Water should be free from any mineral or vegetable ingredient. It may 
be considered pure when it is perfectly clear, without any disagreeable smell 
or taste, soft, and easily unites with soap. The more pure the water, the 
more healthy. When it is impregnated with foreign substances, ill effects 
follow the use of it. The water of marshe sand stagnant ponds is not fit 
to drink, and the water of many cities, particularly the city of New York, 
is very injurious : it is highly impregnated with the carbonate of lime, as 
may be seen by the decomposition of calcareous matter which is copiously 
deposited on the bottom and sides of those vessels in which it has been 
boiled. By using such impure water constantly for drink and cooking, 
large quantities of earthy and deleterious substances are taken into the sys- 
tem, and occasion dyspepsia, gravel, and other complaints. Rain and snow- 
water, and that running over gravel beds, is considered purest; but good 
spring water is better than either. The noted " rain-water doctor " cured 
his patients by prescribing the free use of this " universal menstruum." It 
should never be drank too cold, especially when the body is heated or in a 
profused perspiration. The most dreadful consequences follow drinking cold 
water in hot weather, while the pores are open or when in a copious per- 
spiration. Spasms, convulsions, and death often follow quickly. If this 
should happen, perspiration should be restored as soon as possible. Bleeding 
should not be resorted to, as is now the custom, but give a large tea-spoonful 
or two of camphorated spirit in a little gin or brandy, every fifteen minutes 
until relief is afforded. The hands and face should be washed or bathed be- 
fore any cold water is drank, and then a small quantity only taken at a time. 
Let it also be held in the mouth a few minutes before it is drank. It is as 
equally dangerous to drink fresh buttermilk when a person is overheated. 
A person died in a few minutes aften drinking it freely. Many have lost 
their lives for want of these precautions. Another caution is necessary for 
farmers and other persons residing in the country. When stooping down to 
drink from brooks on woody mountains in this country, they will sometimes 
meet with small lizards and insects concealed among the leaves in the water, 
which are sometimes inadvertently swallowed, and prove dangerous. 
Simple water, in general, is sufficient for those who are in health, but it 
may be rendered more palatable by the addition of molasses. The addition 
of a table-spoonful of good lemon syrup to half a pint of fresh water makes a 
very pleasant and wholesome drink. Good syrup should be procured, as it 
is often adulterated by the juice of lemons that are decayed. Common lemon- 
ade, made by the fresh juice of lemons or limes, and sweetened with loaf 
sugar, makes a cooling and agreeable drink in hot weather. 
CHAPTER III. 
FERMENTED LIQUORS. 
ARDENT SPIRITS. 
Water, says Dr. Cheyne, is the only simple fluid fitted for diluting, mois- 
tening, and cooling-the only ends of drink appointed by nature ; and happy AND PROMOTING HEALTH AND LONGEVITY. 
23 
had it been for mankind if other mixed and artificial liquors had never oeen 
invented. Water alone is sufficient, and effectual for all the purposes of hu- 
man wants in drink. Strong liquors were never designed for common use : 
they were formerly kept as other medicines are, in apothecaries' shops, and 
prescribed by physicians to refresh the weary, strengthen the weak, and raise 
the low-spirited. As natural causes will always produce their effects, the 
effects of the common use of wine and spirituous liquors are, to inflame the 
blood into gout, stone, rheumatism, fevers, pleurisies, &c., and to dry up the 
juices, and scorch and shrivel the solids. Those whose appetite and diges- 
tion are .good and entire, never want strong liquors to supply them with 
spirits; such spirits are too volatile and fugitive for any solid or useful pur- 
poses of life. 
Spirituous liquors inflame the blood, corrode the coats of the stomach, im- 
pair digestion, destroy the appetite, and induce many diseases of the most 
dreadful kind, such as gout, scirrhus of the liver or spleen, dropsy, apoplexy, 
palsy, madness, and fevers of different kinds : they also impair the judgment, 
destroy the memory, and produce intoxication. 
all the ways in which spirituous liquors are used, that of drinking them 
in the form of drams is the most injurious ; and although, perhaps, it may be 
a slower way of destroying life than by taking a dose of any active poison, 
still in the end it will be attended with that direful effect. The habit steals 
on imperceptibly with many, and under any depression of spirits they have 
recourse to it ; but one dram begets a necessity for another, and at length the 
indulgence becomes unlimited and the vice uncontrollable. The constitution 
shows its effects ; the appetite is destroyed, digestion impaired, lowness and 
dejection of the mind, with tremours of the nerves, ensue, the face is blotched, 
the nose red and beset with bumps, and nausea, vomitings, frequent eructa- 
tions, flatulency, and great disorder in the biliary organs take place ; the liver 
becomes enlarged, indurated, and tubercular, and at last dropsy manifests it- 
self, if the patient is not previously cut off by apoplexy or palsy. 
It does not seem easy to determine which of the two, viz., opium or spiri- 
tuous liquors, by being improperly used, proves most detrimental to the hu- 
man constitution: unluckily, the victims who addict themselves to either 
are ensnared by a habit which they find it impossible to relinquish ; because 
the constitution, when habituated to a strong stimulus, becomes incapable of 
carrying on the functions of life without continual excitement, which of itself 
brings on debility and premature decay. 
The speedy effects which opium, or indeed any of its preparations, is ob- 
served to have on those persons who take it habitually, are an exhilaration 
of animal spirits ; and from a dozing and depressed state into which they 
sink after passing the usual time of taking the dose, they become alert and 
cheerful; but those who accustom themselves to this drug are of a yellow 
complexion, look much older than they really are, lose their appetite, and 
their bowels are invariably constipated. Those who indulge in a free use of 
strong and spirituous liquors, have but little desire for food after a time, the 
liver becomes diseased, (being either beset with tubercles, or indurated, 
scirrhous, or enlarged,) the countenance is tinged of a yellow hue, general 
debility ensues, and dropsy at last destroys life. Palsy is often also the con- 
sequence of a continued course of such intemperance. 
Habits of drunkenness often take their rise from a connexion with some 
company or companion already addicted to the practice ; which affords an 
almost irresistible invitation to take a share in the indulgences which those 
about us are enjoying with so much apparent relish and delight; or from 24 
MEANS OF PREVENTING DISEASE, 
want of regular employment, which is sure to occasion many superfluous 
and pernicious cravings, and frequently this among the rest; or it may have 
originated from grief or fatigue, either of which strongly solicit that relief 
which inebriating liquors administer for the present, and furnish a specious 
excuse for complying with the inclination. But the habit, when once 
adopted, is continued by different motives from those to which it owes its 
origin. Persons addicted to excessive drinking suffer, in the intervals of 
sobriety, and near the return of their accustomed indulgence, a faintness 
and oppression which exceed the common patience of human nature to en- 
dure. This is usually relieved, for a short time, by a repetition of the same 
excess: and to this relief, as to the removal of every long-continued pain, 
those who have once experienced it are urged almost beyond the power of 
resistance. The only remedy is total abstinence. 
A landlord, who gave to every customer an example of his moderate 
drinking, complained of the badness of his eyes, and asked a Quaker what 
he should do for them, removing his goggles and submitting his swollen, in- 
flamed eyes to the examination of his customer. " My advice, friend," re- 
plied the Quaker, " is, that thou should put thy brandy on thy eyes, and tie 
the goggles over thy mouth 1" 
WINE. 
Wine, unmixed with alcohol, used in moderation, may be considered a 
wholesome drink. In those countries where it is produced in abundance 
the people drink freely of it without injury, and are proverbially temperate. 
In France, where there are such immense quantities of wine, a drunkard is 
seldom or never to be found. It seems to destroy that hankering after ar- 
dent spirits, which is so peculiar to other countries where wine is not much 
made. The wine imported into this country contains such a large quantiiy 
of alcohol, that it becomes injurious. Hence the necessity and importance 
for Americans and others to plant vineyards. Some of our most sensible men 
give it as their opinion, that if wine was as freely used as in France, it 
would eradicate the universal vice of intemperance. This, however, is very 
doubtful. 
Says a noted writer upon this subject: " Wine, when used in moderation, 
proves generally grateful to the stomach ; it warms and stimulates it to 
greater exertion, promotes probably a more speedy discharge of its con- 
tents, and, from its immediate action, imparts a transient sensation of warmth 
and comfort; but when taken in an immoderate quantity, it produces intoxi- 
cation for the time, and, its exhilarating effects having subsided, it leaves 
the frame disordered, relaxed, and weak. Wine may be considered as the 
best of cordials, where its good qualities are not destroyed by too free and 
frequent a use. Most of the great drinkers of vinous and spirituous liquors 
die of relaxation, debility, loss of appetite, tubercles and scirrhosity of the 
liver, or dropsy." 
" The usages of wine are great, both as a beverage and a medicine. Seve- 
ral physicians recommend it as an excellent cordial, and particularly service- 
able in fevers. The moderate use of wine is of service to the aged, the weak, 
and the relaxed, and to those who are exposed to a warm and moist or 
corrupted air : wine deserves to be ranked first in the list of Antiscorbutic 
liquors. Considered as a medicine, it is a valuable cordial in languors and 
debilities ; grateful and reviving ; particularly useful, in the low stage of ma- 
lignant or other fevers, for raising the pulse and resisting putrefaction." AND PROMOTING HEALTH AND LONGEVITY. 
25 
BEER. 
Malt liquors waste the powers of life, keep up a constant fever, exhaust 
the spirits, inflame the blood, cause headache and premature old age, and, 
drank frequently and to excess, expose the body to numberless diseases. 
They particularly disagree with persons of a bilious temperament, and those 
subject to flatulency, coughs, and inflammatory affections. In cases, how- 
ever, of great debility, where a stimulus is required, they may be given with 
success, particularly in the form of Porter. This article is very strengthen- 
ing to females debilitated by nursing. 
SPRUCE BEER. 
This is a very cooling and pleasant beverage, which may be freely drank. 
It must be made, not of the syrup of spruce, w'hich is now customary, but 
with a decoction of the leaves, by which the flavour and qualities are 
rendered altogether different and much improved. 
MEDICAL OR ROOT BEER. 
The following Beer will not only be found a substitute for many common 
drinks, but a very pleasant and wholesome beverage. Besides, it possesses 
alterative properties, attenuates viscid humours, and purifies the blood. 
Take Sassafras root, (Rad. Sassafras) q. s. 
" Burdock root, (Arctium Lappa) q. s. 
" Wild Cherry tree bark, of the root, (Prinos Virginiana) q. s. 
" Root of Black Alder, (Prinos Verticillatus) q. s. 
" Spice Wood or Fever Bush, q. s. 
Make a strong decoction by boiling several hours, strain, sweeten well with 
molasses or honey, then add, when it is blood warm, sufficient yeast to ferment 
it. In a short time, or as soon as it commences fermentation, it is fit for use. 
This may be freely taken as a diet drink. It is very pleasant, and excellent 
to prevent disease and keep the system in a healthy state, and it is grateful 
and cooling in all kinds of fevers. A little ginger and hops make it better 
CIDER. 
Cider made from ripe apples, properly fermented, and racked or purified, 
is, of all fermented liquors, the most innocent and the best. But too little 
pains is taken with cider. It may be made, by care and proper management, 
as fine flavoured and as clear as wine. 
MEAD. 
Mead made by adding honey to water, and fermenting it, is very pleasant 
and wholesome. 26 
MEANS OF PREVENTING DISEASE, 
CHAPTER IV. 
AIR. 
Few are aware of the effect of air in producing disease or the promotion 
of health. It is the principal medium by which animal life is supported ; and 
so necessary is it for this purpose, that life cannot exist a moment without it, 
as will appear by placing an animal in the exhausted receiver of an air pump. 
IMPURE AIR. 
Impure air is a very common cause of disease. Where it is very impure 
it proves fatal suddenly ; and where it is mixed with that which is pure, the 
effect of it on the system soon becomes perceptible. Indeed it would appear 
that most disorders proceed from unwholesome air, or an atmosphere highly 
charged with deleterious gases. The Influenza, which often occurs as an 
epidemic, is caused by it, seizing thousands of persons and spreading over 
extensive districts. The Indian Cholera, so highly pestilential, is communi- 
cated by an impure atmosphere. Also the intermittent, remittent, and yellow 
fevers. Cities, towns, and villages have been almost depopulated, by reason of 
unwholesome air received into the circulation through the medium of thelungs. 
The deleterious nature of impure air is still more strikingly exemplified 
where carbonic acid gas, called " choke damp," or fixed air, has accumu- 
lated in large quantities, as in wells, mines, beer vats, and in such places as 
the Grotto Del Cani, in Italy, where animal life becomes immediately extinct. 
Dogs are thrown into the latter place, and are immediately killed by inhaling 
the gas with which it abounds ; and the great number of lives that are annu- 
ally lost in wells and mines is familiar to all; from which we learn the great 
influence which impure air has upon our health. Persons should never 
descend any of these places, until they have previously let down a light to 
ascertain if combustion can be supported. If the light is extinguished, I 
scarcely need add that no one can subsist in them a moment. By thus letting 
down a lighted candle into any place that has been long closed, many valu- 
able lives might annually be saved. I may here also observe, that, in case a 
person has been thus suffocated, another person may be let down with a rope 
fastened to a tub; or a noose may be made of the rope, by which he may be 
enabled to take hold of and rescue the patient, provided he holds his breath 
during the time he is in the lower part of the well, that he may not inhale 
the gas ; or a number of ordinary bags, or those made of muslin, may, in a 
few minutes, be made, and placed over the head and tied to the neck of the 
person ; these (bags) may be kept open by attendants above a sufficient 
time to admit the common atmospheric air, which will enable him to respire 
and continue any length of time where this gas exists. 
M. Schroeder, member of the New York Literary and Philosophical Socie- 
ty, has communicated an account of an ingenious contrivance, called a " safety 
pump," which extricates this kind of air from wells, vats, &c., in a very few 
minutes. It has been successfully tried several times in this city. A pump 
made of tin, in the ordinary manner, would no doubt answer the same purpose. 
When it has been discovered that this kind of air exists in any place, in 
order to remove it, slacked lime must be plentifully introduced. The cra- AND PROMOTING HEALTH AND LONGEVITY. 
27 
bonic acid gas unites with the lime, for which it has a great affinity, and a 
carbonate is formed, which renders the air pure. 
When we reflect upon the quantity of atmospheric air which a single per- 
son renders impure or unfit for inhalation, we shall readily see the danger 
arising from the air of crowded assemblies. It is computed that a man 
destroys the vital portion of a gallon of air per minute. To test this, let an 
animal be confined in a jar of common air, perfectly closed ; in a short time 
the inhalation of it absorbs the oxygen, and leaves only the nitrogen and a 
small proportion of carbonic acid gas, which, being incapable of supporting 
combustion, soon takes the life of the animal. In the same manner the health 
of people is impaired, by being confined in jails, prisons, or being in crowded 
assemblies, or sleeping in close rooms, and where there are a number of 
others. Many have been suffocated in this manner. A most melancholy 
circumstance occurred in the " black hole " of Calcutta. A vast number of 
prisoners were crowded so closely together, where there was little or no 
circulation of air, that most of them died in a short time. It is owing to this 
that close stoves prove so injurious. They destroy the vital portion of the 
air, so indispensable to health and life, while the remaining impure air is 
inhaled, and the consequence is headache, languor, and other ill effects. 
Those who are obliged to use small stoves should place a vessel of water 
upon them, which, in a great measure, affords a preventive. 
Persons should be careful also to promote a free circulation of air in 
their houses, by frequently opening their windows. I have been in the 
habit of doing it at night, without receiving the least injury ; but, on the 
contrary, I think, with much benefit. A noted physician was so impressed 
with the importance of this subject, that he slept with his windows open 
during the whole year. In the winter snow was often found upon his bed. 
He considered pure air of vital importance to health. 
" I would propose," says a writer, " that the casements of all public rooms, 
and, indeed, of private houses, shall be so constructed as that the upper 
division shall slide down, and that a certain portion of them, according as 
the room is more or less crowded, be always kept open. By thus promoting 
a free and constant circulation of air in every apartment, whether occupied 
or not, the internal or external air become nearly of an equal temperature; 
the foul air which is generated in close unoccupied chambers, and which ad- 
heres to the walls and furniture, will be carried off before it is accumulated, 
and the usual practice of airing rooms, by opening the windows, and warm- 
ing them with fires, will be less, if at all, necessary. 
" The most neat and delicate person, after having passed the night in his 
bed-chamber, does not, when he awakes, discover any offensive smell in his 
room ; but if he quits it for a few minutes, and returns to it after having 
been in the open air, and before fresh air has been admitted, he will quickly 
discover an essential difference." 
In crowded meetings or assemblies delicate persons often become sick 
and faint, and in every place where the air becomes injured by repeated 
breathing, or by fires, candles, &c. 
AIR OF CROWDED ASSEMBLIES. 
The air in cities is injured by being so often breathed and stagnated by 
AIR OF cities. 28 
MEANS OF PREVENTING DISEASE, 
narrow streets, numerous and compact houses and apartments, a dense 
population, exhalations arising from putrid substances, filth, smoke of fac- 
tories, dirty streets, &c. The streets of our cities are altogether too narrow, 
as well as too filthy. Those who come from the country to the city often 
become immediately affected by the polluted and contaminated air. 
Our cities should be built as Babylon and other ancient cities were. The 
streets were wide ; houses a distance apart; numerous gardens, trees, plants, 
&c. It is a disgrace to our municipal authorities, that no more attention is 
paid to the cleanliness of our streets and yards ; the exhalations arising from 
which is not only unpleasant, but very unwholesome. Yards, privies, and 
every house should be often thoroughly cleansed and white-washed. 
BURYING WITHIN MEETING-HOUSES, CITIES, ETC. 
Another detestable practice is, to bury within large cities, churches, &c. 
The air is rendered extremely fetid and unhealthy by the decay of animal 
matter, which often may be experienced on entering such places. This be- 
ing inhaled by the lungs, must prove injurious, especially to weak and deli- 
cate persons. This practice should be strictly forbidden. In most eastern 
countries it was customary to bury the dead at some distance from any town. 
As this practice obtained a reputation among the Jews, the Greeks, and also 
the Romans, it is strange that we should not have followed their example 
in a custom so truly laudable. 
The editor of the New York Lancet thus remarks : " The character of 
those whom we now address renders it unnecessary for us to make any re- 
marks on the disastrous influences which impure air exerts on the health. It 
is enough to say, that the very presence of the living multitudes that have 
their being in crowded cities, causes such a deterioration of the atmosphere, 
as renders the slightest additional cause a matter of the utmost importance. 
And surely the gaseous products of the charnel-house form an agency of 
death, sufficiently potent to awaken fear and induce avoidance. The expe- 
riments of Magendie on this subject will recur to the memories of most of 
our readers. He demonstrated, with sufficient clearness, that the decompo- 
sition of the dead produced a poison, which, even when diluted by the atmo- 
sphere and spread over a large extent of country, was the fruitful source 
of disease, decrepitude, and death. An infinitely small portion of the poison, 
injected into the jugular vein of a dog, produced death after the most intense 
symptoms of malignant fever. 
" Mr. Walker, a surgeon of London, has recently directed the attention 
of the British public to this important subject, in his ' Gatherings from Grave- 
yards,' to which we would beg to refer our readers, for a vast amount of 
curious information. Mr. Walker adduces a great number of cases, some 
of which ended fatally, in order to show the malignant influence of inhuma- 
tion in city burying-grounds, and vaults beneath churches, which is obviously 
still more destructive ; and he very earnestly, but not more earnestly than the 
occasion demands, presses on the municipal and civil authorities the imme- 
diate necessity of adopting measures for the prevention of this great evil. 
" Interment in crowded cities is as offensive to all those hallowed feelings 
which cling to the memories of the dead, as it is to health. We would not 
have our body laid in one of those receptacles, 
"1 To be thrown up again by some rude sexton, 
And yield its narrow house another tenant, 
Ere the moist flesh had mingled with the dust, AND PROMOTING HEALTH AND LONGEVITY. 
29 
Ere the tenacious hair had left the scalp- 
Exposed to insult, lewd, and wantonness.' " 
Nor are the lingering remembrances that connect us with the spot where 
kindred and friends are laid, relieved by the feeling that the repose of that 
sepulture is perpetually broken by the full tide and roar of life, that1 never 
stops to remember one inhabitant of all the tombs or that may one day be 
still more ruthlessly invaded, to make room for a new street or thoroughfare, 
over which the thronging crowds will hurry in their pursuit of business, or 
pleasure, or folly, or crime, soon to be numbered in their turn with those on 
whose utterly abandoned remains they tread." 
AIR IN CONFINED VESSELS. 
It becomes necessary to use great caution in rendering air pure in vessels, 
otherwise malignant diseases may prevail on board of them. Lime should 
be occasionally thrown into different parts of the hole, and the scuttle left 
open to permit the stagnant air to escape ; but what is still better, ventila- 
tion should be used in every vessel of any magnitude, which throws the pure 
air to the bottom and expels the foul. An account is given in a Scotch 
paper of two brothers, one of whom nearly suffocated, the other perished, 
by closing the companion so close that they had, during the night, exhausted 
the vital air necessary for respiration. 
CHANGE OF AIR. 
The effect of change of air on the health is almost incredible, especially 
by removing from the city to the country: the effect seems still greater on 
infhnts and children than adults, thousands of whom annually die from the 
effects of impure air. Many who have been labouring under the most serious 
and apparently incurable diseases, by removing from the city to the country, 
or from an inland residence to the sea-shore, have rapidly recovered. I 
might mention striking instances of this fact. It is often equally as salutary 
to remove from one climate to another of an opposite temperature : it fre- 
quently occurs that the whole system undergoes a complete change, without 
the use of medicine. Persons afflicted with pulmonary and nervous diseases, 
should be careful to avoid the air of great towns or cities. Those who are 
unable to leave the city for any length of time, should frequently take excur- 
sions in the country or on the water. 
TREES AND PLANTS. 
Trees and plants are great purifiers of the atmosphere, and are conducive 
to health. They emit oxygen gas (the only vital portion of the air) during 
the day, while at night they imbibe and decompose it, and retain the car- 
bonic acid gas or fixed air, the deleterious nature of which has been pointed 
out. By this we see how much they contribute to life and healths Let 
them, therefore, be nursed and cultivated, both for health and ornaments. 
BURNING CHARCOAL. 
The. practice of burning charcoal to cook or to heat rooms has become 
very common, and many have lost their lives by the gas produced by it. 
The newspapers have lately recorded many cases where jars or vessels of 30 
MEANS OF PREVENTING DISEASE, 
charcoal have been placed in cabins or rooms, and the persons sleeping in 
them have been killed. An account is given of two persons who lately lost 
their lives by burning charcoal in a vessel in this manner. It is not an un- 
common, but a very dangerous practice, and not to be repeated. 
Pure air is essential to the best possible health of the system, and that 
just in proportion as the air we breathe becomes impure does it become 
unhealthy. 
It is a universal law, and can never be violated with impunity. We see 
the effect of impure air in ill ventilated meeting-houses. It is not uncommon 
for persons to faint in consequence of inhaling this kind of air ; in others it 
produces different effects. The ball-room and crowded party give rise io 
headache, indigestion, fainting, eruptions of the skin, general debility, &c. 
Houses, factories, school-rooms, hospitals, and every place where many meet, 
should be well ventilated. Man subsists upon the air more than upon his 
food and drink. Hence the necessity of having it pure. 
A sensible writer on this subject thus observes : " If fresh air be necessary 
for those in health, it is still more so for the sick, who often lose their lives 
for want of it. The notion that sick people must be kept very hot is so 
common, that one can hardly enter the chamber where a patient lies, without 
being ready to faint, by reason of the hot suffocating smell. How this must 
effect the sick any one may judge. No medicine is so beneficial to the sick 
as fresh air. It is the most reviving of all cordials, if it be administered with 
prudence. We are not, however, to throw open doors and windows at ran- 
dom upon the sick. Fresh air is to be let into the chamber gradually, and, 
if possible, by opening the windows of some other apartment. 
" The air of a sick person's chamber may be greatly freshened and the 
patient much revived, by sprinkling the floor, bed, &c., frequently witli 
vinegar, juice of lemon, or any other strong vegetable acid. 
" In places where numbers of sick are crowded into the same house, or, 
which is often the case, into the same apartment, the frequent admission of 
fresh air becomes absolutely necessary. Infirmaries, hospitals, &c., are often 
rendered so noxious for want of proper ventilation, that the sick run more 
hazard from them than from the disease. This is particularly the case when 
putrid fevers, dysenteries, and other infectious diseases prevail." 
A number of persons lately lost their lives, by reason of the confined air on 
board of a ship, coming to this country from Europe. 
PURE AIR IN DISEASE. 
CHAPTER V. 
EXERCISE. 
We may be very temperate in eating and drinking, and observe the best 
rules for the prevention of disease; yet, without a strict attention to exercise, 
we cannot enjoy good health. 
In the curse pronounced upon our first Parents there is annexed a peculiar 
blessing; a circumstance so strikingly characteristic of Deity. It was pro- 
nounced upon Adam, " In the sweat of thy brow shalt thou earn thy bread.' AND PROMOTING HEALTH AND LONGEVITY. 
31 
In the very sweat produced by labour or exercise the blessing of health is 
found, which may be sought for in vain from any other source. 
Says Dr. Thomas on exercise : The labourer is apt to murmur that he is 
necessitated to earn his bread by the sweat of his brow ; and, looking round on 
his superiors, he repines at his condition and station, considering that as 
hard and afflicting which infinite wisdom has destined to be absolute, if not 
the only method by which he can be put in possession of the chief of all 
earthly blessings-a sound body and a quiet mind ; for those whom poverty 
obliges to labour for their daily bread are not only the most healthy, but, 
all things considered, generally the most happy of mankind. 
" Toil, and be strong. By toil the flaccid nerves 
Grow firm, and gain a more compacted tone ; 
The greener juices are by toil subdued. 
Mellow'd, and subtilized ; the vapid old 
Expell'd, and all the rancour of the blood." Armstrong. 
The industrious labourer, who is under the necessity of earning his daily 
sustenance by personal exertion, commonly enjoys good health ; he eats his 
scanty meal with a good appetite, unassisted by provocatives, which his ac- 
tive and athletic body, by proper exercise, is soon enabled to digest; and at 
the return of evening he retires to undisturbed repose, where sound and unin- 
terrupted sleep recompenses for his toil. Health makes his bed easy, and his 
wearied limbs, recruited by sound repose, fit him for the labour of the ensu- 
ing day. As his wants are few, he is nearly a stranger to care and solicitude ; 
and his progeny are partakers with him in the same inheritance. On the 
other hand, the sluggard is exposed to a variety of temptations ; and that 
indolence and inactivity are the source of much immorality, we may soon be 
convinced of by casting our eyes round the world. They also lay the foun- 
dation of many painful diseases, and at length the mind, as well as the body, 
dwindles into a state of torpor. 
Indolence impedes the organic functions, undermines the fountains of 
health, and gradually, but invariably, leads to disease. Accordingly, we find 
that those persons who are obliged to labour for their livelihood are generally 
strangers to the gout and some other disorders, which may be considered as 
the offspring of good living and indolence. 
There is no substitute which we can appropriate for the non-observance 
of this practice. Nothing so effectually prevents indigestion, and, conse- 
quently, strengthens the solids, as exercise ; but unless it be duly and properly 
persevered in, and our bodies daily habituated to it, we cannot experience all 
that benefit which accompanies its use. In the formation of our frames, and 
from the nature of our constitution, it evidently appears to have been the 
positive intention of Providence to create in us, for our well-being, an absolute 
necessity for exercise. Our love of motion is surely a strong proof of its 
utility, and nature implants no disposition in vain. It seems, moreover, to 
be a law throughout the whole animal creation that no creature, without 
exercise, should enjoy health or be able to find subsistence. 
Were men to live in an habitual course of exercise and temperance, there 
would be but little occasion for using medicines : accordingly, we find that 
those are the most healthy who subsist by the chase; and that men lived 
longest when their lives were employed in hunting, and had little food besides 
what they caught. It has been remarked that all those who have attained a 
very advanced age have undergone great labour and fatigue in their younger 
years; such was the case with Parr and Jenkins, the two oldest men on record. 
By an attention to exercise, the tone and vigour of the body are very much 32 
MEANS OF PREVENTING DISEASE, 
increased ; the nervous energy, and also circulation of the blood, are mate- 
rially accelerated ; and this increased impetus of the blood through the whole 
system produces an effectual determination to the surface of the skin, and a 
free perspiration is the consequence. By the same means the body is disposed 
to sleep, the appetite is increased, the tone of the stomach and other organs 
concerned in the process of digestion preserved, and the blood is determined 
from the interior parts ; thereby preventing as well as removing obstructions, 
and powerfully obviating any tendency to overfulness in the system. 
Moreover, by exercise, the spirits are enlivened, as well as the body re- 
freshed ; and it is an undeniable truth that, where it is neglected, the strength 
and energy of the whole machine gradually fall to decay, and a morbid irri- 
tability is induced, with a long train of those unpleasant symptoms which 
usually accompany chronic weakness. The natural powers of the stomach 
and intestines sustain particular injury, the appetite is vitiated, and the bile 
and other fluids employed by nature in the process of digestion, are very im- 
perfectly secreted, or, perhaps, considerably obstructed ; the muscular fibres 
of the body become relaxed and debilitated ; the whole animal economy is 
disordered; and a train of nervous and hypochondriacal symptoms, together 
with gout, apoplexy, palsy, glandular obstructions, and many other com- 
plaints incident to inactive, indolent, and sedentary persons, come on. 
Nothing but regular and sufficient exercise in the open air can brace and 
strengthen the muscles and nerves, or prevent the endless train of diseases 
which proceed from a relaxed state of these organs. The active and labo- 
rious are seldom the subjects of nervous disease : these are the portions of 
the sons of affluence and ease. Riches, indeed, supply many indulgences, 
but they are, at the same time, accompanied by many evils ; and thus are 
the good and bad things of this life pretty equally balanced. 
Those who wish to enjoy health should use exercise as regularly as they 
take their food : they should walk a certain distance in the open air every 
day, or ride on horseback ; and they will find it to their advantage to employ 
a portion of the day, besides, in gardening or some agricultural pursuit. 
The studious, and men of letters more particularly, are required to attend to 
these points; for, if study be united with a want of exercise, it infallibly 
proves injurious to health, and never fails to destroy the appetite and impair 
digestion ; then costiveness, flatulency, crudities, headache, apoplexy, and 
palsy are the certain consequences. Exertion of the mind and inaction of 
the body, when carried to excess, are destructive of the most robust health. 
An alternate mixture of daily and sufficient exercise, business, and reading 
enables us to allow rest by turns to the body and the mind, and keeps the 
faculties in due equilibrium and in a state of progressive improvement. 
To render exercise as beneficial as possible, it will be necessary that it be 
not too violent, and that moderation, both in eating and drinking, accompany 
it. 
Active exercise soon after eating a full meal is likely also to be injuri- 
ous : a state of quietude, therefore, for some time after dinner in particular, 
as being the principal meal with most persons, will be advisable ; but, never- 
theless, we should not indulge in sleep soon after eating. This custom some 
people practise, but it is an improper one. 
Exercise certainly gives strength and energy to the body, but it should 
not be carried too far or continued too long, as it may then be productive 
of mischief instead of benefit. It should be gentle and moderate, and, when 
practicable, be taken in the open air. Another rule necessary to be attended 
to for rendering exercise advantageous is, that due care be taken that the AND PROMOTING HEALTH AND LONGEVITY. 
33 
body, when heated, be not suddenly exposed to cold, either by subjecting it 
to currents of air or fresh breezes, or by drinking cold liquors of any kind. 
In warm climates exercise should always be taken in the cool of the day, 
particularly in the morning. 
We may consider exercise of the body as of three kinds. First, that of 
simple muscular motion, consisting in walking, or such employments as call 
forth the exertion of the limbs-as cutting, splitting, and sawing wood, gar- 
dening, digging, hunting, playing ball, and the like, commencing very mo- 
derately, and increasing it as the strength will permit: secondly, that which 
is obtained by riding on horseback or in any kind of carriage ; and, thirdly, 
that which may be given to the body by outward applications, such as fric- 
tions, either with the hand, a flesh-brush, or a piece of flannel. 
Exercises of the first kind are highly beneficial when the bodily powers 
will admit of them, as the mind being occupied therein adds very materially 
to the advantages resulting from them ; yet, on account of their being more 
fatiguing and laborious, there are many instances where they are scarcely 
admissible, in which case riding must be substituted in their stead. Of all 
the different species of exercise not taken on foot, that of riding on horseback 
is certainly entitled to the preference, if the person is capable of using it. 
In nervous affections of all kinds, but more particularly the hypochondriac, 
as well as obstructions in any of the internal organs, it is more likely to be 
beneficial than any other, from the parts being universally shook by it; and 
such persons ought to pass two or three hours every day on horseback, when 
the weather is not wet. 
This kind of exercise is extremely favourable to the proper and equal dis- 
tribution of the blood through the extreme vessels, and to the prevention 
of its undue accumulation in the central organs. From the tendency of 
riding to equalize the circulation, stimulate the skin, and promote the action 
of the bowels, it is well adapted as an exercise for the consumptive, dyspeptic, 
and nervous invalids. 
Riding on horseback, says Sydenham, will cure all diseases except con- 
firmed consumption. 
Dyspeptic and other chronic invalids, says Graham, ought never to hope 
for health by any means without exercise. 
Dancing does more harm than good ; the room is heated, air injured by 
being repeatedly inhaled, dusty rooms, unseasonable hours, the body in great 
perspiration, then in cold air and suddenly checked, with thin shoes and 
dresses, with other evils which often lay the foundation for consumption and 
other fatal diseases. 
Next to riding on horseback, a preference should be given to an open car- 
riage of some kind or other, as a person has the advantage of continually 
changing the air and breathing it pure, the importance of which must be ob- 
vious, as well as beholding the diversity of scenery and country. 
It now and then happens, however, that the motion of either a horse or a 
carriage, be the latter ever so expertly hung, is too much for the delicate 
frames of some invalids. In such cases easy exercise may be obtained by 
sailing in a small vessel or boat, at proper times of the day, when the weather 
is fine ; but when not so, swinging in a cot or hammock, or riding on a hobby- 
horse, maybe substituted. There is, perhaps, no better exercise for females 
within doors than the spinning-wheel. 
A person who is prevented from taking exercise in the open air, by incle- 
mency of the weather or other causes, should by no means remain in a 
continued state of inactivity ; he should engage in some employment or 34 
MEANS OF PREVENTING DISEASE, 
active amusement within doors. Where the taste and inclination extend to 
any mechanical pursuit, such as that of turning, &c., it ought to be indulged ; 
but where they do not, what are called dumb bells may be substituted for a 
considerable space of time each day ; or anything else, rather than take no 
exercise at all. 
In cities the exercises which are most suitable to the habits of the people 
and their opportunities, are, for men, the practice of walking, playing ball, 
and the gymnastics which have lately been introduced, and which were in 
the highest estimation among the Greeks in former days, and to which, in a 
great measure, is to be attributed their fine, healthy, and efficient forms which 
have come down to us in their statues. 
The third species of exercise which has been mentioned is that of frictions; 
and where the circulation is languid, and the motion of the other fluids slug- 
gish, or there is an inability of muscular motion from any paralytic affection, 
these may be employed with much advantage ; and, in the latter instance, 
still more so, if conjoined with electricity. Frictions may be made either 
with a piece of flannel, the flesh-brush, or simply with the hand ; and the 
best time for employing them seems to be in the morning, at the time of 
rising from bed ; for then the superfluous matter which is prepared for per- 
spiration, is more readily brought to the surface of the body. Kneading the 
bowels daily is excellent to prevent habitual costiveness. 
In every stage and state of life exercise is necessary for our welfare and 
health ; and it is equally as requisite for those of the female sex as for the 
male part of the creation. By food our bodies may be nourished ; but if not 
assisted by due exercise to carry on the digestion of it with advantage, and 
help in throwing off the superfluous humours by perspiration, we must una- 
voidably feel all the inconveniences of repletion and fulness in the blood- 
vessels, while at the same time the body will be afflicted with many painful 
diseases. 
Indolence, moreover, not only occasions diseases and renders men useless 
to society, but promotes all manner of vice. Indolence, when indulged, gains 
ground, and at length becomes agreeable ; hence many who were fond of 
exercise in the early part of life, become somewhat adverse to it when more 
advanced in years. This is the case with most gouty and hypochondriacal 
people, which, in a great measure, renders their diseases more untractable, 
if not incurable. Idleness may well be said to be the root of many evils ; 
and I think we may safely allege, that, on the contrary, a life of activity and 
industry is not only the greatest promoter as well as preservative of health 
at all periods of our mortal existence, but likewise one of the best guardians 
of virtue. 
No piece of indolence hurts the health more than the modern custom of 
lying abed too long in the morning. This is the general practice in great 
towns. The inhabitants of cities seldom rise before eight or nine o'clock : 
but the morning is undoubtedly the best time for exercise, while the stomach 
is empty and the body refreshed with sleep. Besides, the morning air 
braces and strengthens the nerves, and in some measure answers the purpose 
of a cold bath. Let any one who has been accustomed to lie abed till eight 
or nine o'clock, rise by five or six, spend a couple of hours in walking, riding, 
or any active diversion without doors, and he will find his spirits cheerful 
and serene through the day, his appetite keen, and his body braced and 
strengthened. Custom soon renders early rising agreeable, and nothing 
contributes more to the preservation of health. 
Every one knows that exercise favours, and indolence obstructs, the deve AND PROMOTING HEALTH AND LONGEVITY. 
35 
lopement of animal heat. Exercise produces its effect by the general stimulus 
which it gives directly to the respiratory and circulating systems, and 
indirectly to the nervous and digestive portions. 
In exercise let nature be consulted and facts attended to. It is notorious, 
says an English author, that a majority of those girls who, in opposition to 
the laws of nature, are encased in stays, and get insufficient exercise, become 
deformed and otherwise diseased ; an occurrence very rare in boys, who are 
permitted freely to follow nature in muscular action. In a seminary for 
young ladies, for example, containing forty pupils, on examination by Dr. 
Forbes, only two had straight spines; while out of an equal number of 
boys little or no deformity could be found. Yet such is the dominion of pre- 
judice and fashion, that these evils continue ; and on the same principle that 
Chinese parents compel the feet of their infants to be squeezed into a machine 
till they are most horribly deformed. When will mankind be governed by 
wisdom in all things ? Never, till Christianity becomes triumphant. 
Exercise should exert an influence on the whole body, upper as well as 
lower part; and such kinds should be taken as animate and exercise the 
mind, which, by increasing the nervous stimulus, makes exertion easy, 
pleasant, and invigorating. 
In a new work just published in Philadelphia, entitled " Health and Beauty," 
the following, among other instances, is given to illustrate the utility of exer- 
cise in developing strength and muscle: 
" When three years of age the subject of this brief history could scarcely 
stand ; at five he walked badly, and supported by leading strings ; and it was 
only after dentition, at seven years old, that he could walk without assis- 
tance : but even then he fell frequently, and could not rise again. Given up 
by the physicians, he continued in this state till the age of seventeen, when 
the loins and lower extremities could scarcely support the upper part of his 
body. The arms were extremely weak and contracted, the approximation 
of the shoulders diminished the capacity of the chest and impeded respira- 
tion, the moral faculties were quite torpid, and, " in short, nature was at a 
stand still." In the month of November, 1815, this unfortunate youth was 
presented to Mr. Clias, the celebrated superintendent of a gymnasium, then 
at Berne, in Switzerland, as he afterward was of others in Paris and in Lon- 
don. On being admitted his strength was tried, and his pressure on the 
dynamometer was only equal to that of children seven or eight years of 
age. In ability to pull, ascend the ladder, and jump, he was utterly deficient 
He ran over the space of a hundred feet, with great difficulty, in a minute 
and two seconds, and could not stand when he had finished. Carrying a 
weight of fifteen pounds made him totter, and a child of seven years old 
threw him with the greatest facility. 
" A person of the other sex, thus enfeebled, would be thought, by a commit 
tee of crones and mantua-makers, to whom probably she would be consigned, 
to require, of absolute necessity, the support and comfort of corsets and busks. 
Her physician would prescribe tonics and sea bathing, and a generous regi- 
men ; no bad things in their place, and with suitable hygienic aids ; but quite 
unfitted to prevent the increasing debility and superadded deformity from the 
use of exercise. But to return to the poor feeble youth. Was any effort 
made to strengthen his back by compression of its muscles, or to take off 
from the weight of his head and chest by various mechanical contrivances ? 
Captain Clias did not put faith in the doctrine, that, to give muscles strength, 
they must not be used at all; but he believed that the feeble imperfectly 36 
MEANS OF PREVENTING DISEASE, 
developed ones of this young invalid might be made to grow and acquire 
strength on the same principle as that by which the legs of a dancer and a 
porter,and the arms of bakers and boatmen become full, muscular, and strong. 
His scholar was subjected to the gymnastic regimen for five months ; after 
which period he could press fifty degrees on the dynamometer ; by the 
strength of his arms he raised himself three inches from the ground, and 
remained thus suspended for three seconds ; he leaped a distance of three 
feet, ran a hundred and sixty-three yards in a minute, and carried on his 
shoulders, in the same period of time, a weight of thirty-five pounds. Finally, 
in 1817, in the presence of several thousand spectators, he climbed to the 
top of a single rope, twenty-five feet high; he did the same exercise on the 
climbing pole ; jumped, with a run, six feet; and ran over five hundred feet 
in two minutes and a half. Subsequently, when he became a clergyman, in 
a village near Berne, he could walk twenty-four miles on foot without incom- 
moding himself; and the exercises, which he always continued, have given 
him, in place of his valetudinary state, a vigorous constitution." 
Females are so confined by domestic labour that they seldom have much 
exercise in the open air, which is calculated to make them sickly; besides, 
they are in general so over-burdened with work that their constitutions often 
become broken by over-exertion, and hence experience little besides care, 
vexation, and ill health-the accompaniments of such habits. They are made 
slaves either from necessity or choice; and mostly from the latter. Now, this 
is wrong, and was never intended by our Creator ; and, to obviate it, they 
should obey the command of the apostle, " be careful for nothing," and simply 
attend to those duties which are indispensably necessary, and, if too great, pro- 
cure assistance. As regards exercise, females should make it a part of their 
duty to labour as much as possible in the open air, and, instead of sitting so 
much, exercise the whole body in some manner ; if no other way, by walking 
or riding daily ; and in the summer season they should work at least two hours 
in the kitchen or the flower-garden every day. Even the practice of the 
Indian women excels us in this respect. How much has civilization done 
for us ? 
CHAPTER VI. 
clothing. 
Those who wish to pay a due regard to their health, must attend to 
their clothing. It should be adapted to the climate, the season of the year, 
age, &c. 
CLIMATE. 
The principal object of clothing is, to preserve a right temperature of the 
body. Hence persons in very cold climates require much more clothing than 
those in warm. Custom or habit, however, has a great influence. The 
natives of this country live throughout the most rigorous winters almost 
without any clothing, while we apparently experience more suffering with a 
very great quantity of clothing. AND PROMOTING HEALTH AND LONGEVITY. 
37 
AGE. 
Fouth, in consequence of the rapid circulation of the blood, requires less 
clothing than middle and old age. 
SEASON. 
The dress should be adapted to the season of the year, as every one knows 
that winter requires much more clothing than summer. But the greatest 
caution is necessary to make the change very gradually. Woollen garments 
should be put on early in the fall, and worn late in the spring. This is the 
more necessary, by reason of the sudden and great changes of our climate : 
one day the thermometer rises to a hundred, the next it sinks to forty; 
which racks the constitution, and proves very destructive to health. These 
vicissitudes must be guarded against by proper clothing, which should never 
be very thin, even in midsummer. 
FASHION AND FIGURE. 
More consequence is now attached to figure and form than to health and 
convenience. Persons must dress fashionable, no matter how ridiculous or 
dangerous it may prove. Hence fashion and shape are continually changing, 
without regard to health, climate, or comfort. In order to reduce the body 
to a fine shape, the stomach and bowels are squeezed into as narrow a com- 
pass as possible. By this reprehensible practice indigestion, fainting, coughs, 
consumption, and other complaints are produced. 
BANDAGING, ETC. 
Garters, when drawn too tight, not only prevent the free motion and use 
of the parts about which they are bound, but likewise obstruct the circula- 
tion of the blood, which prevents the equal nourishment and growth of these 
parts, and occasions various diseases. Tight bandages about the neck, as 
stocks, cravats, necklaces, &c., are extremely dangerous. They obstruct 
the blood in its course from the brain, by which means headaches, vertigoes, 
apoplexies, and other fatal diseases are often occasioned. 
QUANTITY OF CLOTHING. 
A judicious physician, in speaking upon this subject, has the following ex- 
cellent remarks: " Robust persons are able to endure cold better than the deli- 
cate, and, consequently, may clothe lighter; but the precise quantity of apparel 
which may be necessary for any person cannot be determined by reasoning. 
it must be entirely a matter of experience ; and every person is the best judge 
for him or herself, what quantity of clothes is necessary to keep him or hei 
sufficiently warm and comfortable. The state so nearly approaching to abso- 
lute nudity, in which fashionable females now make their appearance in 
public, is not only highly indecent, but must be very destructive of theii 
health and personal comfort. 
" While treating on clothing, I would recommend to every person to 
be careful in observing that their clothes are properly dried previous to being 
put on. This precaution will be particularly necessary in the winter months, 
as washer-women are then obliged to dry chiefly by the heat of a fire, and 38 
MEANS OF PREVENTING DISEASE, 
this is apt to be very imperfectly done. Many lives are annually sacrificed 
by persons putting on damp linen, as well as by sleeping in sheets not pro- 
perly dried. 
" Due care should be taken to change the stockings and other clothing as 
speedily as possible after their becoming wet by any exposure to inclement 
weather, rain, snow, &c. Many persons are so imprudent as to neglect this 
very necessary change, and to suffer their clothes, after such an exposure, 
to dry on them, assisted probably by going near a fire for some time; but 
such a practice is always attended with risk, and not unfrequently gives rise 
either to rheumatism, fever, pleurisy, cough, consumption, or some other 
disease of a dangerous or even fatal nature." 
KIND OF DRESS. 
I shall say but little upon the kind of clothing that ought to be worn, 
but leave this part of the subject to the good sense of the reader to deter- 
mine. I would merely add, that such articles must be used as will render 
the temperature of the body as uniform as possible, by keeping up a due 
degree of perspiration. Nothing contributes more to this than flannel. 
A very ingenious philosopher, (Sir Benjamin Thompson,) by a variety 
of experiments on the relative power of absorbing moisture from the atmo- 
sphere in different substances-as wool, fur, hair, silk, cotton wool, and linen- 
has found, contrary to what was supposed would be the result, that woollen 
cloth absorbed most of these substances, and linen the least; and hence this 
gentleman justly infers the vast advantage of a flannel waistcoat next the 
skin : and, from personal experience and accurate analogy, he concludes that 
it would prevent a multitude of diseases ; and as it promotes evaporation, 
instead of being too hot for summer, he found no inconvenience from it in 
the hottest weather, as it is well known that evaporation produces positive 
cold : hence probably it is that the East Indians find cotton shirts and shifts 
to be more comfortable than linen. 
Females of a delicate constitution really require some under clothing in 
addition to what is usually worn; and I would, therefore, recommend them 
drawers or sliders of flannel. Some persons, particularly invalids, may wear 
flannel throughout the year. 
Says a writer in Dr. Cooke's Medical Reformer : " The principal advan- 
tage in the use of flannel is its non-conducting property of sensible heat; 
it is, therefore, well calculated to protect the body against the too rapid escape 
of this important fluid. 
" Flannel should be used whenever it will be proper to accumulate heat, 
or to prevent its too rapid dissipation from the body; it should, therefore, be 
used precisely in the proportion which these ends may require. But it will 
be readily seen that no precise quantity can be directed, since the degree of 
necessity will be constantly varying as temperature may alter or as constitu- 
tion and period of life may change. 
" There is another operation of flannel that is highly valuable, especially 
in this variable climate ; and its agency in this respect may be considered as 
one of almost indispensable necessity-it is its protecting power against sud- 
den reductions of temperature. By virtue of its non-conducting power, the 
system is saved from a prodigious expense of caloric, or heat, at a time when 
its sudden escape might Le attended with effects of the most serious kind ; 
the advantages of flannel in this respect are familiar to everybody; for every- 
body adopts the practice, without exactly understanding the principle on AND PROMOTING HEALTH AND LONGEVITY. 
39 
which it is founded. It powerfully guards the body against the cooling 
effects of evaporation when in a state of perspiration ; and, by preventing a 
too sudden escape, it keeps a considerable portion of heat constantly applied 
to the surface of the skin, by means of this vapour, and thus hinders it from 
leaving the body too suddenly." For obvious reasons, it is very necessary 
that it should be washed often. 
I think it is much better to wear flannel over the shirt than next to the 
skin. It is certainly more pleasant, and, besides, it seems to maintain a more 
uniform and equal heat of the body. I have proved this by many years of 
experience; and I have just learned that the late Professor Smith, of New 
Haven, advanced the same opinion. A flannel waistcoat early in the fall, 
and, as the weather grows colder, flannel drawers, should be worn ; and they 
should be discontinued in the same order of time : by this course the tran- 
sition from one extreme to the other is not so great. It is better to wear 
cotton next to the skin than linen, as the latter, when moistened with per- 
spiration from great heat or exercise, gives a sense of chilliness as the body 
cools ; whereas cotton, by its absorbing properties, prevents any such effects. 
Flannel, by all means, should be taken off at night, otherwise the skin 
becomes too much accustomed to its stimulus, and its beneficial effects in 
some degree lost. If flannel is worn at night, the system becomes 
more susceptible of cold after rising from bed and being exposed to the 
atmosphere. Flannel should be worn during the day, to defend the system 
from a sudden contact of cold, which it does admirably, by absorbing perspi- 
rable matter, and thereby preventing too sudden evaporation ; and in this 
manner a uniform temperature is maintained. 
Imprudent persons have lost their lives by taking off" their flannel too early 
in the spring, merely because a day or two of warm weather commenced, 
which rendered it a little unpleasant. If it is not worn constantly, it should 
at least be continued till the beginning of summer, and again put on by the 
first of September-especially in this latitude. 
In the sultry days of summer every precaution should be taken that the 
body be not suddenly exposed to cold when overheated by exercise, by throw- 
ing off a portion of the clothing, as is customary with many. 
It is lamentable to see the great departure there is now from the former 
modes of dress, as well as in other respects. Our ancestors were in the 
practice of dressing very warm and comfortable-stout cloaks, thick shoes, 
&c.-and they, in consequence, were healthy. In these days it is the reverse. 
By the present mode or fashion in dress thousands of females are injured, if 
not killed. 
In concluding this chapter, I will quote the remarks of Buchan on this 
subject. " Nothing," says he, " can be more ridiculous than for any one 
to make himself a slave to fine clothes. Such a one, and many such there 
are, would rather remain as fixed as a statue from morning till night, than 
discompose a single hair or alter the position of a pin. Were we to recom- 
mend any particular pattern for dress, it would be that which is worn by the 
people called Quakers. They are always neat, clean, and often elegant, with- 
out anything superfluous. What others lay out upon tawdry laces, ruffles, 
and ribands, they bestow upon superior cleanliness. Finery is only the affec- 
tation of dress, and very often covers a great deal of dirt." 
The remarks of the celebrated Cobbett on dress occurs to me, and, although 
not immediately connected with the preservation of health, affords a useful 
lesson. " Let our dress be as cheap as may be without shabbiness ; attend 
more to the colour of your shirt than to the gloss or texture of your coat; 40 
MEANS OF PREVENTING DISEASE, 
be always clean as your situation will, without inconvenience, permit; but 
never, no, not for one moment, believe that any human being with sense in 
his skull, will love or respect you on account of your fine or costly clothes." 
CHAPTER VII. 
CLEANLINESS. 
Those who wish to preserve their health, must strictly attend to cleanli- 
ness : few things are of more importance to society, and should be attended 
to everywhere, among all classes. By reference to Deuteronomy, chapter 
22, 12th and 13th verses, it will be seen that the Jews, during their encamp- 
ments in the wilderness, received particular instructions with respect to it, 
and these instructions ought to be obeyed by every one. It appears that 
the whole system of laws delivered to that people had a tendency to promote 
cleanliness. 
In the most eastern countries cleanliness makes a great part of their reli- 
gion. Mahometan, as also as the Jewish, religion enjoins various bathings, 
washings, and purifications. 
Although these might be designed to represent inward purity, yet, at the 
same time, they are calculated for the preservation of health. It is rightly 
said, that the want of cleanliness is a fault which admits of no excuse ; for where 
water can be had for nothing, it is in the power of every one to be clean. 
The continual discharge from our bodies by perspiration renders frequent 
change of apparel necessary. Changing apparel greatly promotes the secre- 
tion from the skin, so necessary for health. When that matter which ought 
to be carried off by perspiration, is either retained in the body or reabsorbed 
from dirty clothes, it must occasion diseases. 
DISEASES OCCASIONED BY THE WANT OF CLEANLINESS. 
Many complaints are caused by want of cleanliness. Fevers, dysenteries, 
and diseases of the skin often arise from filth, and they may be mitigated or 
cured by a strict regard to cleanliness. 
FILTHY PERSONS AND APARTMENTS. 
It is well known that the itch and vermin attack those whose apartments 
and persons are filthy, by which they become a common nuisance. Some of 
the habitations of the lower classes of persons, particularly of our cities, are 
so dirty that the most disagreeable and feted effluvia is emitted from them. 
If such persons are too indolent to remove the filth about them, ought not 
magistrates to interfere, and cause it to be done ? 
FILTHY CITIES AND STREETS. 
Some cities are almost proverbial for their filthiness, and I know of none 
more so than the city of New York, notwithstanding the great sums that are 
paid for the purpose of keeping it clean. While the most popular streets are 
kept clean, there is such a stench arising from others, that a person, in passing AND PROMOTING HEALTH AND LONGEVITY. 
41 
them, is often obliged to suspend the functions of his lungs, or, in other words, 
obliged to " hold his breath." What effect such deleterious gases must 
have upon the health I leave the reader to judge. 
The same filthiness exists around our markets, docks, &c. If our corpo- 
ration have not ingenuity enough to keep our streets and docks clean, I will 
mention a method that is infallible, which is practised in some of the great 
cities of Europe ; a method which renders the streets so perfectly clean, that 
every traveller is forcibly impressed with it; and it is this : There are a 
sufficient number of scavengers, or men, to only a small portion of a street, 
and the overseer or superintendent sees that every particle of filth and 
dirt which is there accumulated is not only scraped and swept into a pile, 
but likewise removed ; and if every other day is not sufficient to keep it clean, 
it is done daily. By this means every street in the city is perfectly sweet 
and clean. It is true, the expense may be a trifle more, but what is this 
compared to the health of our citizens ! 
A writer has the following judicious remarks upon this subject: 
" In many great towns the streets are little better than dung-hills, being 
frequently covered with ashes, dung, and nastiness of every kind. Even 
slaughter-houses are often to be seen in the very centre of great cities. The 
putrid blood, excrements, &c., with which these places are generally cover- 
ed, cannot fail to taint the air and render it unwholesome. How easily 
might this be prevented by active magistrates, who have it always in their 
power to make proper laws relative to things of this nature, and to enforce 
the observance of them!" Most of the abominable and filthy slaughter- 
houses in New York are in the midst of a dense population. 
" Whatever pretensions people may make to learning, politeness, or civiliza- 
tion, we will venture to affirm, that, while they neglect cleanliness, they are 
in a state of barbarity. 
" In ancient Rome the greatest men did not think cleanliness an object un- 
worthy of their attention. Pliny says, the Cloaca, or common sewers for 
the conveyance of filth and nastiness from the city, were the greatest of all 
public works ; and bestows higher encomiums upon Tarquinius, Agrippa, 
and others who made and improved them, than those who achieved the 
greatest conquests. 
" How truly great does the Emperor Trajan appear when giving directions 
to Pliny, his proconsul, concerning the making of a common sewer for the 
health and convenience of a conquered city ! 
"As it is impossible to be thoroughly clean without a sufficient quantity of 
water, we would earnestly recommend it to the magistrates of great towns 
to be particularly attentive to this article. Most great towns and cities are 
so situated as to be easily supplied with water ; and those persons who will 
not make a proper use of it after it is brought to their hand, certainly deserve 
to be severely punished. The streets of great towns, where water can be 
had, ought to be washed every day. This is the only effectual method of 
keeping them thoroughly clean ; and, upon trial, we are persuaded it will 
be found the cheapest." 
Some of the most dreadful diseases incident to human nature might, in my 
opinion, be entirely eradicated by cleanliness. 
PERSONAL CLEANLINESS. 
" Personal cleanliness," says a writer, " is chiefly effected by a frequent 
change of dress, but is much increased by ablutions of different parts of the 42 
MEANS OF PREVENTING DISEASE, 
body daily with water. Of these the head, face, and mouth, as well as the hands 
and feet, claim our attention. From neglecting to keep the mouth, teeth, 
and breath properly cleaned, the breath is apt to acquire a disagreeable taint. 
The teeth ought, therefore, to be cleansed after every meal, as the refuse of 
the food naturally settles about them, and, in consequence of heat, rapidly 
becomes more putrid, and in this state proves injurious to them as well as 
the gums. Every morning the tongue should be cleansed, and the throat be 
well gargled and washed out with water. 
" The teeth are apt to become incrusted with tartar, which in time very 
much injures the enamel with which they are coated externally: it should not, 
therefore, be suffered to collect, but be removed from time to time. They 
should be washed every morning with a small piece of sponge, or very soft 
brush, dipped in cold water, joining occasionally the powder of fresh prepared 
charcoal. If any of the teeth have a tendency to caries or rottenness, or the 
gums are spongy and bleed, the mouth may be washed with the tincture 
of myrrh. 
" Attention to the feet is also very necessary, particularly in warm weather, 
and with those who, from a peculiarity of constitution, have them very moist. 
The perspiration proceeding from them in hot weather, and after much 
walking, emits a very disagreeable smell: they ought, therefore, to be fre- 
quently washed. Great cleanliness by daily ablutions of the feet, and the 
change of stockings, are not only the most convenient, but the most salutary 
means of preventing all unpleasant odours." 
The most rigid cleanliness must also be observed during sickness. The 
clothes of the person must be frequently changed, everything offensive 
removed, and the apartment must be kept perfectly clean. 
Mechanics, and those who are under the necessity of working where there 
is constant dirt and filth, ought to wash themselves and change their clothing 
as often as possible. They should frequently bathe, both in the summer and 
the winter season. 
I shall here quote the remarks of Mr. Jefferson, to show the great benefit 
derived from frequently bathing the feet, as well as to show the great advan- 
tage derived from an observance of the preceding rules and maxims on health. 
" I have lived temperately, eating little animal food, and that not as an 
aliment so much as a condiment for the vegetables, which constitute my 
principal diet. I double, however, the doctor's glass and a half of wine, and 
even treble it with a friend ; but halve its effects by drinking weak wines 
only. The ardent wines I cannot drink, nor do I use ardent spirits in any 
form. Malt liquors and cider are my table drinks, and my breakfast is of 
tea and coffee. I have been blest with organs of digestion which accept and 
concoct, without ever murmuring, whatever the palate chooses to consign to 
them ; and I have not yet lost a tooth by age. I was a hard student until I 
entered on the business of life, the duties of which leave no idle time to those 
disposed to fulfil them; and now, retired, and at the age of seventy-six, I 
am again a hard student. Indeed, my fondness for reading and study revolts 
me from the drudgery of letter writing ; and a stiff wrist, the consequence 
of an early dislocation, makes writing both slow and painful. I am not so 
regular in my sleep as the doctor says he was, devoting to it from five to 
eight hours, according as my company or the book I am reading interests 
me ; and I never go to bed without an hour or half an hour's previous reading 
of something moral, whereon to ruminate in the intervals of sleep. But 
whether I retire to bed early or late, I rise with the sun. I use spectacles 
at night, but not necessarily in the day, unless in reading small print. My AND PROMOTING HEALTH AND LONGEVITY. 
43 
nearing is distinct in particular conversation, but confused when several 
voices cross each other, which unfits me for the society of the table. I have 
been more fortunate than my friend in the article of health : so free from 
catarrhs, that I have not had one (in the breast I mean) on an average of 
eight or ten years through life. I ascribe this exception partly to the habit 
of bathing my feet in cold water every morning, for sixty years past. A 
fever of more than twenty-four hours I have not had above two or three 
times in my life. A periodical headache has afflicted me occasionally, once, 
perhaps, in six or eight hours, for two or three weeks at a time, which seems 
now to have left me: and, except on a late occasion of indisposition, I 
enjoyed good health ; too feeble, indeed, to walk much, but ride without 
fatigue six or eight miles a day, and sometimes thirty or forty." 
CHAPTER VIII. 
SLEEP, EARLY RISING, ETC. 
" For the purpose," says Dr. Thomas, " of recruiting the waste daily pro- 
duced in the human body, and enabling it to perform every function properly, 
nature has wisely and beneficially determined that an adequate renovation 
should succeed this exhaustion, by alternate periods of sleep and watching. 
" An insufficient quantity of sleep exhausts the spirits and produces head- 
ache, anxiety of mind, and moroseness of temper; moreover, it debilitates 
the nervous system. On the contrary, too great an indulgence in sleep is 
also injurious, as the muscular motions are thereby debilitated, the nerves 
and other fibres become relaxed or torpid, and a state of indolent stupidity 
supervenes, which is not thrown off the whole day; added to which, that 
sprightliness of life and vivacity are wanting which are usually the conse- 
quences of early rising. It is evident, therefore, that sleep requires some 
regulation as well as our diet. A habit of retiring soon to rest and of rising 
early appears to be very favourable to the developement of the powers and 
the preservation of health. Those who lie half of the day in bed become 
effeminate and enervated, and they soon lose that activity which, properly 
directed, can alone confer value on life. 
" It would appear that six hours' sleep every night is sufficient for any adult 
person during the summer, who is in health, and in winter about seven, or, 
at the most, eight. Those who indulge for nine or ten hours in bed are 
commonly wakeful or restless during the fore part of the night; and, when 
they ought to rise, sink to rest and slumber on till noon, by which impru- 
dent conduct even the strongest constitution will eventually be injured. 
" Nothing, however, more certainly destroys the constitution than that of 
sitting up a great part of the night and lying in bed the pleasantest and most 
healthy part of the day, as is too much the custom with those who lead a 
fashionable life, thereby converting night into day and day into night. This 
plan of proceeding is sure to injure the health of its votaries and to shorten 
the natural period of life, and it will undermine the strongest constitution, 
even if accompanied with habits of regularity in other respects ; but how 
much more destructive must its effects be when conjoined with intoxication, 
gambling, sensuality, and other midnight excesses ! Persons of athletic 
bodies may probably bear up for a time under late hours and intemperance; 44 
MEANS OF PREVENTING DISEASE, 
but the delicate and weak must unavoidably fall very soon martyrs to such 
indiscretions. 
" It is, indeed, melancholy to observe, among the votaries of fashion and 
dissipation, the ill effects produced on their constitutions by their midnight 
revels. Let any person view their pallid countenances, where colour is not 
resorted to, as well as their ghastly forms, and they will be well satisfied 
that inverting the established order of things, by turning night into day, soon 
robs the blooming cheek of its roses and lilies, brings on early decay in pro- 
cess of time, and destroys the most vigorous frame. 
"We should avoid sleeping in those apartments where we live during the 
day, and for a bed-chamber make choice of a spacious room exposed to the 
sun, and can have the windows opened in the day-time for the admission 
of pure air and the dispersion of vapours collected during the night. To 
secure ourselves from the effects of a vitiated atmosphere, we ought also to 
take care that the beds are well shaken up every morning ; and that these, 
as well as the bed-clothes, are freely exposed, for a due length of time, to 
the air. 
" Children may always be allowed to take as much sleep as they please, but 
it is a very different case with adults of a youthful age. Quietude and 
repose best, however, become the constitutions of those who are far advanced 
in years, since the springs of life in them are rather weakened than invigo- 
rated by excessive action and want of sufficient sleep. 
" The best way of making sleep refreshing is, to take proper exercise through 
the day ; to avoid strong infusions of tea or coffee in the evening ; to make 
a very light supper at least an hour or two before retiring to rest, where 
such a meal is indispensably necessary; to go early to bed ; to lie down 
with a mind as serene and cheerful as possible, placing the body in the posi- 
tion which is most congenial to the feelings and habits of the individual; and 
to rise betimes in the morning-for it has been observed that the most of 
those who have attained a great age, have generally been early risers. It 
must, however, be understood that, although early rising and activity are 
conducive to health, they should, nevertheless, be regulated by the state of 
bodily strength, the season of the year, and the habitual exertions of the 
mind. 
" Too much exercise will prevent sleep as well as too little. We very 
seldom hear, however, of the active and laborious complaining of restless 
nights : it is the indolent and slothful who are generally incommoded with 
these complaints. The labourer enjoys more real luxury in sound sleep and 
plain food than he who fares sumptuously and reposes on downy pillows, 
where due exercise is wanting. 
" Light suppers are also necessary to sound sleep; and many there are who 
experience uneasy and restless nights, if they commit the least excess at that 
meal; and when they do fall asleep, the load and oppression on their stomach 
occasion frightful dreams, the night-mare, broken and disturbed rest. 
" Those who follow intellectual pursuits with immoderate ardour, exhaust 
their powers, and speedily are visited by premature old age. Shun, there- 
fore, close meditation and intense study by nights. 
" Anxiety of mind and intense thinking are almost certain to prevent sound 
sleep ; and, therefore, we should endeavour to preserve tranquillity of mind, 
and banish anxious thoughts as much as possible, when we retire to rest, 
calling in the aid of philosophy to bear with due fortitude and resignation those 
ills which we cannot prevent. 
" He that goes to bed early at night will, in general, be desirous of rising AND PROMOTING HEALTH AND LONGEVITY. 
45 
betimes in the morning: moreover, he that accustoms himself to an early 
hour for retiring to rest, can rarely join in Bacchanalian revels or in the 
fashionable dissipations of high life : his sleep is not disturbed by the effects 
of unseasonable luxury ; his slumbers are sound and refreshing ; and he rises 
with cheerfulness and fresh acquired vigour to breathe the morning air and 
commence the duties of the day." 
CHAPTER IX. 
OCCUPATIONS. 
It is well known that certain kinds of business materially injure the health. 
Every kind which requires confinement and little motion, exerts a baneful 
influence on the system, such as shoe-makers, tailors, mantua-makers, &c. 
Many are injured by the air of some occupations being impregnated with 
certain deleterious matters-type-founders, printers, stone-cutters, millers, 
chemists, forgers, glass-blowers, miners, and other artists, painters, gilders, 
manufacturers of white and red lead, &c. The persons last-mentioned should 
frequently take a dose of olive oil or castor oil, to prevent the painter's 
cholic. 
Sedentary and studious persons are very liable to have their health impaired 
by continuing too long in one position, or for the want of proper exercise. 
Watch-makers, in consequence of their sedentary habits, are liable to a 
peculiar species of disease, to which many of them fall victims. Its com- 
mencement is indicated by deficient appetite and eructations of wind from 
the stomach : there is also sallowness of complexion and a muddy yellow 
appearance of the eyes. In the progress of the disease great quantities of 
black coagulated blood is discharged by stool, and occasionally by vomiting. 
On dissection, the whole intestinal canal is found replete with blood, either 
fluid or black and coagulated. The liver and spleen appear soft, and, as it 
were, rotten. In its more early stages this disease admits of being checked 
by active purgatives, exercise, and country air. 
Dr. Buchan gives the following judicious advice to persons of this descrip- 
tion, and those who lead a sedentary life: 
" Instead of multiplying rules for preserving the health of the sedentary, 
we shall recommend them to the following general plan, viz. : That every 
person who follows a sedentary employment should cultivate a piece of 
ground with his own hands. This he might dig, plant, sow, and weed at 
leisure hours, so as to make it both an exercise and an amusement, while it 
produces many of the necessaries of life. After working an hour in a garden, 
a man will return with more keenness to his employment within doors than 
if he had been all the while idle. 
Cultivating the ground is every way conducive to health. It not only 
gives exercise to every part of the body, but the very smell of the earth and 
fresh herbs revives and cheers the spirits, while the perpetual prospect of 
something coming to maturity delights and entertains the mind. We are so 
formed as to be always pleased with somewhat in perspective, however dis- 
tant or however trivial; hence the happiness that most men feel in planting, 
sowing, building, &c. These seem to have been the chief employments of 
the more early ages ; and, when kings and conquerors cultivated the ground, 46 
MEANS OF PREVENTING DISEASE, 
there is reason to believe that they knew as well wherein true happiness 
consisted as we do." 
It may seem romantic to recommend gardening to manufacturers in great 
towns ; but observation proves that the plan is very practicable. This 
practice has many salutary effects; it not only induces these people to take 
exercise without doors, but also to eat many greens, roots, &c., of their own 
growth, which they would never think of purchasing. 
Mechanics are too much inclined to crowd into great towns. The situation 
may have some advantages ; but it has likewise many disadvantages. All 
mechanics who live in the country have it in their power to cultivate a piece 
of ground; which, indeed, most of them do. This not only gives them 
exercise, but enables them to live more comfortably: so far at least as my 
observation extends, mechanics who live in the country are far more 
happy than those in great towns, enjoy better health, and live in greater 
affluence. 
In a word, exercise without doors, in one shape or another, is absolutely 
necessary to health. Those who neglect it, though they may for a while 
drag out life, can hardly be said to enjoy it. Weak and effeminate, they 
languish for a few years, and soon drop into an untimely grave. 
Intense study is so destructive to health, that few instances can be pro- 
duced of studious persons who are strong and healthy. Hard study always 
implies a sedentary life ; and when intense thinking is joined to the want of 
exercise, the consequences must be injurious. We have frequently known 
even a few months of close application to study ruin an excellent constitu- 
tion, by inducing a train of nervous complaints which could never be removed. 
Man is evidently not formed for continual thought more than for perpetual 
action, and would be as soon worn out by the one as by the other. 
So great is the power of the mind over the body, that, by its influence, the 
whole vital motions may be accelerated or retarded to almost any degree. 
Thus, cheerfulness and mirth quicken the circulation and promote all the 
secretions ; whereas sadness and profound thought never fail to retard them. 
Hence it would appear that even a degree of thoughtlessness is necessary 
to health : indeed the perpetual thinker seldom enjoys either health oi 
spirits ; while the person who can hardly be said to think at all, generally 
enjoys both. 
Perpetual thinkers, as they are called, seldom think long. In a few years 
they generally become quite stupid, and exhibit a melancholy proof how 
readily the greatest blessings may be abused. Thinking, like everything else, 
when carried to extreme, becomes a vice ; nor can anything afford a greater 
proof of wisdom than for a man frequently and seasonably to unbend his 
mind. This may generally be done by mixing in cheerful company, active 
diversions, and a change of scenery. 
I would recommend to merchants, clerks, and all classes of citizens who 
are very much confined, to rise very early, and as often as possible to walk 
or ride into the country. 
Were it early made a grave and important question, to what employment 
among the more useful employments of life is this girl or that boy best 
adapted by his native temperament and general constitution of mind and 
body-and were the advice which true medical wisdom, joined to parental 
intelligence and impartial investigation, would dictate, to be practically re- 
garded, we should not see so many of our females dying of consumption from 
breathing the bad air of factories, when they ought to have been bred to 
housework ; nor so many of our sons dying in shops, schools, and colleges. AND PROMOTING HEALTH AND LONGEVITY. 
47 
or under the weight of professional responsibilities too early assumed, when 
an education to agriculture or the mechanical arts would have saved them, 
and given to them, for the benefit of the world, a long life of usefulness. 
CHAPTER X. 
TRANSITIONS FROM HEAT TO COLD. 
Most of our diseases arise from a sudden transition from heat to cold. 
The sudden application of cold to the body in a state of perspiration cannot 
but be fraught with danger. The pores become closed, perspirable matter 
retained, which proves a source of irritation to the system, and soon termi- 
nates in a departure from health ; and this is generally brought about by a 
sudden transition from a high to a low degree of temperature. The system 
is capable of undergoing an intense degree of cold, when it is gradually 
brought under the influence of it; but when it is suddenly applied, such a 
shock is given to the body that it rarely escapes without receiving injury; 
from which we may infer the great necessity of care and caution against 
sudden transitions from heat to cold. A sensible writer thus remarks upon 
this subject: 
" By cold air the human body is considerably contracted and rendered 
more compact; which is very obvious, by observing that the same clothing 
which in summer sits tight, will, in the winter, be too large. In proportion, 
therefore, as the external heat is diminished, it would appear nature intended 
that the internal heat should be increased thereby. In winter the blood is 
much disposed to inflammation ; and, becoming in some measure obstructed 
in its passage through the lungs, produces coughs, pleurisy, inflammation of 
the organs of respiration, rheumatism, and inflammatory sore throat. By 
paying attention, however, to a proper degree of clothing, and taking particu- 
lar care that a due proportion of exercise be not neglected, cold may be ren- 
dered less hurtful to the body, and the risk of incurring these dangerous 
complaints in a great measure be obviated. 
The effects of extreme cold are, however, sometimes destructive to the 
human frame, as in northern countries persons have been known to drop 
down suddenly, and be deprived of life without any previous symptoms of 
disease. The loss of various parts of the body in persons of the most healthy 
constitution, by the effect of extreme cold, is well known. The toes, fingers, 
lips, and nose are frequently so far exposed to its effects as to induce a mor- 
tification In these parts. 
There is no change throughout nature more pernicious, either to animal or 
vegetable bodies, than from extreme heat to intense cold, or from freezing to 
sudden thawing, and the opposite of these. Hence it has been observed, 
that irritating coughs are never so prevalent as when there are sudden altera- 
tions of the weather, and when the air, after having been very cold, sud- 
denly becomes warm and damp, and after that assumes a considerable degree 
of coldness again. These transitions occasion a smaller quantity of matter 
to be thrown off by perspiration, and the lodgment of a greater proportion of 
fluids upon the internal parts, which become loaded and obstructed ; hence 
catarrhs, diarrhoea, and many other diseases. 
When an ordinary change of external temperature is made gradually, such 48 
MEANS OF PREVENTING DISEASE, 
is the constitution of the healthy human frame that it bears it -with impunity; 
but when it happens more rapidly, danger arises proportioned to the sudden- 
ness of the event. 
The most dangerous, however, of all, are those rapid and violent fluctua- 
tions which arise from the artificial modes of influencing temperature by the 
close rooms and fires of refined life, as also by the clothing. There are many 
thoughtless persons who will rush out into the freezing air from a room 
heated to the temperature of India, or, after having been warmly clad through- 
out the day, will go out into the cold damp air of night in the flimsy dress 
of a ball-room, with their bosoms uncovered and their necks and shoulders 
perfectly bare ; for such is the prevailing fashion among women nearly of 
all ages. They are never more dressed, according to their ideas, than when 
thus equipped for some place of amusement, although, in fact, they very 
nearly approach a state of nudity. It is by such imprudences, and the 
changes of temperature to which they become liable, that so many thousands 
are annually cut off by one disease or another, but particularly by pulmonary 
consumption. 
But we are now so accustomed to hear of colds, coughs, consumptions, 
rheumatism, and a long train of other diseases of a similar nature, that we 
have almost been brought to consider them as necessary attendants of our 
situations, the unavoidable scourges of our climate and land, the existence 
of which we may deplore, but against which it is almost useless to employ 
any precaution. It is a positive fact, however, that most of our winter mala- 
dies derive their origin from sudden and considerable vicissitudes of tempera- 
ture, and may, perhaps, be avoided by paying due attention to the following 
rule, viz. ■ To keep the temperature of the atmosphere which surrounds u> 
as uniform as possible, and when a change is unavoidable, to make it gradu- 
ally, and not suddenly. A due regard should, therefore, be paid to our 
clothing and management in other respects, on quitting our houses or 
coming out of any crowded place of public resort in cold weather. Persons 
of a delicate constitution will find it much to their advantage to pay atten- 
tion to the changing of their clothes, according to the vicissitudes of the sea- 
son, or even, indeed, to those of the same day, proportioning not only the 
quality, but the quantity thereto. 
As our bodies are readily acted upon by every sudden change of weather, 
as from heat to cold, and the reverse of this, every precaution should be 
taken, for the purpose of preventing any sudden check to perspiration ; and 
it should be a fixed rule to avoid all rapid transitions from one extreme to 
another, and never to remove from a room which is highly heated, to a cold 
air or fresh breeze, while the body remains warm, or till the necessary 
change by additional clothing has been previously made. If, at any time, 
the body should be greatly heated during the warm weather, it will be sure 
to suffer by going into a cellar, ice-house, or cold bath, or even by sitting on 
cold stones or ground that is damp. Severe colds, pulmonary consumption, 
rheumatism, and many other maladies of a severe nature, have been brought 
on by such imprudence, and even speedy death has been the consequence 
of such a transgression." Avoid a stream of wind or air, especially while 
in perspiration, as you would an arrow. 
WET CLOTHES. 
Another writer, treating on obstructed perspiration, has the following per- 
tinent remarks: Wet clothes not only by their coldness obstruct the per- AND PROMOTING HEALTH AND LONGEVITY. 
49 
spiration, but their moisture, by being absorbed or taken up into the body, 
greatly increases the danger. The most robust constitution is not proof 
against the danger arising from wet clothes ; they daily occasion fevers, 
rheumatisms, and other fatal disorders, even in the young and healthy. 
It is impossible for people who go frequently abroad, to avoid sometimes 
being wet: but the danger might generally be lessened, if not wholly pre- 
vented, by changing their clothes soon ; when this cannot be done, they 
should keep in motion till they are dry. So far are many from taking this 
precaution, that they often sit or lie down in the fields with their clothes 
wet, and sometimes sleep even whole nights in this condition. The numerous 
instances which we have of the fatal effects of this conduct ought certainly 
to deter all from being guilty of it. 
WET FEET. 
Wet feet often occasion fatal diseases. The colic, inflammations of the 
breast and of the bowels, cholera morbus, &c., are often the results of wet 
feet. Habit will, no doubt, render this less dangerous ; but it ought, as far 
as possible, to be avoided. The delicate, and those who are not accustomed 
to have their clothes or feet wet, should be extremely careful in this respect. 
NIGHT AIR. 
The perspiration is often obstructed by night air; even in summer this 
should be avoided. The dews which fall plentifully after the hottest day, 
make the night more dangerous than when the weather is cool. Hence, in 
warm countries, the evening dews are more hurtful than where the climate 
is more temperate. 
It is very agreeable after a warm day to be abroad in a cool evening ; but 
this is a pleasure to be avoided by all who value their health. The effects 
of evening dews are gradual, indeed, and almost imperceptible; but they are 
not the less to be dreaded : we would, therefore, advise travellers, labourers, 
and all who are much heated by day, carefully to avoid them. When the 
perspiration has been great, these become dangerous in proportion. By not 
attending to this, in flat marshy countries, where the exhalations and dews 
are copious, labourers are often seized with intermitting fevers, quinseys, 
and other dangerous diseases. 
DAMP BEDS. 
Beds become damp either from their not being used, standing in damp 
houses or in rooms without fire, or from the muslin not being dry when laid 
on the bed. Nothing is more to be dreaded by travellers than damp beds, 
which are very common in all places where fuel is scarce. When a travel- 
ler, cold and wet, arrives at an inn, he may, by means of a good fire, warm 
diluting liquor, and a dry bed, have the perspiration restored; but if he 
be put into a cold room and laid in a damp bed, the obstruction will be 
increased, and the worst consequences will ensue. Travellers should avoid 
inns which are noted for damp beds as they would a house infected with the 
plague. 
But inns are not the only places where damp beds are to be met with- 
Beds kept in private families for the reception of strangers are often equally 
dangerous. All kinds of linen and bedding, when not frequently used, be- 50 
MEANS OF PREVENTING DISEASE, 
come damp. How, then, is it possible that beds which are not slept in more 
than two or three times a year, should be safe ? Nothing is more common 
than to hear people complain of having caught cold by changing their bed. 
The reason is obvious : were they careful never to sleep in a bed that had 
not been recently used, they would seldom find any ill consequences from 
a change. 
No linen or muslin, especially if washed in winter, ought to be used 
till exposed for some time to the fire ; nor is this operation less neces- 
sary for sheets washed in summer, provided they have lain for any length 
of time. This caution is the more needful, as persons are often exceedingly 
attentive to what they eat or drink at an inn, yet pay no regard to a cir- 
cumstance of much more importance. Muslin sheets are much more healthy 
than linen ones. 
If a person suspects that his bed is damp, the simple precaution of taking 
off the sheets and lying in the blankets, with all, or most of his clothes on, 
will prevent the ill consequences that might otherwise ensue. I have prac- 
tised this for many years, and never have been hurt by damp beds, though no 
constitution, without care, is proof against their baneful influence. 
FEATHER BEDS. 
There is probably not a single disease that we are not more strongly pre- 
disposed to, and which, when actually existing, is not in some measure 
aggravated by the use of feather beds. 
Mattresses made of hair, straw, moss, manilla grass, husks, hay, or sweet 
balsam, are incomparably more favourable to health and comfort than feather 
beds. 
DAMP HOUSES. 
Damp houses are generally productive of ill results: for this reason, 
those who build should be careful to choose a dry situation. A house which 
stands on a damp marshy soil or deep clay, will never be thoroughly dry. 
All houses, unless where the ground is exceedingly dry, should have the 
first floor a little raised. Servants and others, who are obliged to live in 
cellars and sunk stories, seldom continue long in health. 
CHAPTER XI. 
EVACUATIONS OR EXCRETIONS. 
The state of our health is materially influenced by the excretions or eva- 
cuations of the body. Nature has provided certain outlets for the purpose 
of carrying off morbific and extraneous matter, which, if retained too long, 
injures the health. 
THE BOWELS. 
It is scarcely necessary to say that costiveness is the cause of many com- 
plaints. When the excrements are too long retained in the bowels, they AND PROMOTING HEALTH AND LONGEVITY. 
51 
contaminate the fluids, and seldom fail to prove injurious. The bowels, 
therefore, should be kept regular. We cannot precisely determine how often 
they should be moved in a given length of time, as this depends upon the 
constitution, habit, state of the health, and other causes. As a general rule, 
however, once in twenty-four hours is sufficient, and two days at farthest; 
but there are instances where persons are so imprudent as to suffer their 
bowels to become so constipated, that nothing is discharged in one or two 
weeks. This is a very dangerous practice. Some persons, from a torpid 
state of the stomach and intestines, want of exercise, &c., are habitually 
costive, causing flatulence, swelling of the abdomen, loss of appetite, head- 
ache, debility, nervous diseases, and sometimes convulsions. To those I 
would recommend such a course of treatment, diet, and exercise as will re- 
store a regular action of the bowels. Most persons continually take physic 
for this state of the system, which injures the tone of the stomach and intes- 
tines, and, after a while, rather aggravates than removes the cause. 
Young females, and all who lead a sendentary life, are liable to costiveness, 
which lays the foundation for many diseases. Mothers, and others who have 
the care of children, ought to pay great attention to this matter, for they 
may rest assured that it cannot be neglected without much hazzard to the 
health and life of the young. 
REMEDY FOR HABITUAL COSTIVENESS. 
A mild purgative may first be administered to remove the accumulation 
of feculent matter, and occasionally repeated, until costiveness can be re- 
moved by other means. 
After the operation of the physic, recourse must be had to proper diet. 
Nothing of a binding or heating nature must be taken ; but, on the contrary, 
that kind which possesses loosening properties, such as fruit of various kinds, 
raisins, prunes, figs, dried peaches, apples, whortleberries, &c., and particu- 
larly the coarse bread spoken of in a preceding chapter. 
Those who are habitually costive will derive great benefit from a tum- 
bler of cider before breakfast in the morning. I have seldom or never known 
it fail to act moderately upon the bowels and to obviate costiveness. But 
there is another method which I have practised with great success, which 
is, when the bowels become constipated or costive, to use friction with the 
hand over the stomach and whole belly. Let the parts be daily rubbed and 
kneaded for ten or fifteen minutes. This has had an admirable effect, and 
regulated the bowels when all other means have failed. 
Says Andrew Combe in his Treatise on Physiology: " Neither the sto- 
mach nor the bowels are adapted in structure for very concentrated food, as 
meat, jellies, &c. Such articles cannot be long used with advantage. Brown 
and rye bread and fruits are in repute for redeeming a costive habit of body, 
and their usefulness is explicable on the same principle. They leave a large 
residue to be thrown out of the system, and this residue forms the natural 
stimulus of the bowels, and, consequently, excites them to purer action." 
A dog fed on bread made of superfine flour will live but fifty days ; 
whereas a dog fed on unbolted wheat flour will continue in good health. 
Do we need any other proof than this of the injurious effects of common 
bread ? 
It is stated, upon good authority, that the following simple article is a 
remedy for costiveness: 
Begin with one new laid egg, raw, to which add three times its bulk of 52 
MEANS OF PREVENTING DISEASE, 
water, and beat it thirty minutes. Take it in the morning, and one or two 
more in the day. Increase to three at a time as the stomach will bear. It 
gradually removes the complaint. In cases where the bowels are very cos- 
tive, injections of warm water are excellent. 
I lately treated a very bad case of constipation, in which the excrements 
were so hard and impacted, that I was obliged to throw up the bowels large 
quantities of warm water, two or three times in the space of an hour, before 
complete evacuation and relief were afforded. 
THE LIVER. 
The state and quality of the bile must be attended to, in order to preserve 
health. The bile, in a vitiated state, or when not duly secreted, is some- 
times obstructed in the liver and gall-bladder, and becomes a source of 
dyspepsia, constipation, and nervous complaints, jaundice, &c. When this 
is the case, or when a person is possessed of a bilious habit, it should be 
corrected principally by diet. All high-seasoned food and meats must be 
avoided, and vegetables substituted. Exercise should by no means be ne- 
glected ; and one meal of victuals daily omitted. One or two anti-bilious 
pills may be daily taken, if a course of regimen should not prove effectual. 
KIDNEYS. 
The kidneys perform an important office, which, if suspended or imper- 
fectly performed, will affect the health, by inducing inflammation of the kid- 
neys, dropsies, &.c. When there is a disposition to pass the urine more 
frequently than usual, and when there is but a small quantity voided at a 
time, it is evident that there is some derangement in the animal economy. 
Persons in this case should immediately resort to the use of such me- 
dicines as stimulate the kidneys, and cause them to secrete a larger quan- 
tity of urine, or, in other words, to perform their office. An infusion of 
parsley, whortleberries, marsh mallows, and other diluent drinks, should 
be freely taken. Should there be, however, too great a quantity of urine 
emitted, it will constitute a disease termed Diabetes, which requires an op- 
posite course of treatment. If this be the case, as little drink as possible 
should be taken, and those of a tonic and astringent nature, such as a de- 
coction of the bark of the wild cherry tree and beth root. 
Some, who are styled urine doctors, pretend to know and cure diseases by 
the inspection of the urine alone. But this is impossible. So many things 
tend to change the quality and quantity of urine, as to render it altogether 
an uncertain criterion with respect to health or disease. 
A writer on this subject has the following excellent remarks : " It has 
long been an observation among physicians, that the appearances of the urine 
are very uncertain and very little to be depended on. No one will be sur- 
prised at this, who considers how many ways it may be affected, and, conse- 
quently, have its appearance altered. The passions, the state of the atmo- 
sphere, the quantity and quality of the food, the exercise, the clothing, the 
state of the other evacuations, and numberless other causes, are sufficient to 
induce a change either in the quantity or appearance of the urine. Any one 
who attends to this will be astonished at the impudence of those daring 
quacks, who pretend to find out diseases, and prescribe to patients, from the 
bare inspection of their urine. These impostors, however, are very common 
in some parts, and, by the amazing credulity of the populace, many of them AND PROMOTING HEALTH AND LONGEVITY. 
53 
amass considerable fortunes. Of all the medical prejudices which prevail in 
this country, that in favour of urine doctors is the strongest. The common 
people have still an unlimited faith in their skill, although it has been demon- 
strated that not one of them is able to distinguish the urine of a horse, or any 
other animal, from that of a man." 
THE SKIN. 
Perspiration constitutes the greatest of all the discharges from the body. 
Sanctorius, an Italian physician, was the first that directed the attention of 
the faculty to the cutaneous and pulmonary transpiration, which he proved 
to exceed the other secretions considerably in weight; and he maintained 
that this function must have a considerable influence on the system, and was 
deserving of great consideration in the treatment of diseases. From this we 
may learn what effects must follow its obstruction. No doubt more com- 
plaints arise from retained perspirable matter than from any other cause. It 
therefore becomes of vast importance to keep up a regular and constant 
perspiration; for want of a due attention to which, thousands of lives are 
annually sacrificed. 
u Whatever gives a sudden check to perspiration," says Thomas, " may be 
productive of very injurious consequences, and should, therefore, be carefully 
guarded against, as many persons annually fall a sacrifice to not paying proper 
attention to the various causes from which perspiration may become obstruct- 
ed ; one of the most common of which is, taking, or catching cold, as it is 
more usually called. 
By sudden transitions from heat to cold, either from changeableness of 
the weather, the state of the atmosphere, going immediately from a hot room 
into the cold air, or throwing off some part of the clothing when heated by 
exercise, the perspiration is very apt to be obstructed; and colds, coughs, 
and inflammation of the lungs are the usual effects of such conduct. Drink- 
ing freely of cold water, .or any other small liquor, when the body is heated, 
is not only injudicious, but fraught with many ill consequences. Damp 
houses and damp beds or linen ; exposure to night air, especially in hot 
countries ; not changing clothes quickly after their getting wet; and con- 
tinuing to wear stockings, shoes, or boots which are saturated with water, 
exposing the feet thereby to cold, are all likely to be attended with injurious 
consequences, by occasioning obstructed perspiration. The same will happen 
by throwing open a window when the room is hot, and sitting in or near it, 
so as to be exposed to a current of air. 
Some are so imprudent or fool-hardy as to bathe themselves in cold 
water when considerably heated by walking, dancing, or the like exercises ; 
and by such conduct have been soon attacked with some dreadful disease or 
other. In some instances death has been the result." 
I shall here give rules to pursue, when perspiration has been obstructed 
from any cause. If the clothes have been wet, they should be immediately 
taken off, and dry ones substituted. The feet must be immediately bathed 
in warm water, and a glass of gin sling or toddy taken as hot as possible. 
After which, an infusion of tea of some medical plant may be taken, such as 
sage, mint, catnip, pennyroyal, hyssop, &c. This course will restore perspi- 
ration, and prevent dangerous, if not fatal, diseases. This is much better than 
sending for a common physician, to be bled, blistered, and mercurialized ! 54 
MEANS OF PREVENTING DISEASE, 
CHAPTER XII. 
BATHS. 
Baths of various descriptions are now so generally resorted to for plea- 
sure or the cure of disease, that it becomes very important to consider their 
effect upon the human system in a medical point of view. They are attended 
either with considerable advantage or much injury to all who use them. Many 
have been cured, others have been injured, by them, and all which must be 
attributed to their indiscriminate use, the disease, or the circumstances under 
which they have been used. We shall now mention the different kinds, and 
different complaints in which they prove beneficial and which injurious. 
They are denominated the 
Cold 
Warm 
Hot 
Vapour 
Sulphur 
Shower 
Baths. 
THE COLD BATH. 
The cold bath consists of water, either fresh or salt, in its natural degree 
of heat, or it may be made colder by art. The temperature of it, in general, 
varies from thirty-two to sixty-five degrees of Fahrenheit's thermometer. 
Sea water and the water of ponds and rivers are very similar in their 
effects ; but sea water is preferable, from the stimulating effects of the salt 
with which it is impregnated. 
In treating of the cold bath, we wish it expressly understood, that the 
temperature of the water suitable for bathing in general must be similar to 
that of our bays and rivers in the summer months. A sensation of comfort 
and some degree of warmth must be experienced a few moments after 
immersion. A sensation of chillness, on the contrary, is an evidence that 
the temperature of the water is too cold. 
Cold bathing may be used in the following complaints : Fevers, chronic 
rheumatism, hysterics, hypochondriac, and paralytic affections, rickets, scro- 
fulous complaints, general debility, obstructed perspiration, languor and 
weakness of circulation, accompanied with profuse sweating and fatigue on 
very moderate exercise. It is useful in that slow, irregular fever to which 
many persons, particularly those who lead a sedentary life, are subject. Such 
persons have constantly a pulse rather quicker than natural, hot hands, 
restless nights, impaired appetite, dejection of spirits, &c. 
The cold bath is injurious in all cases where immediate reaction does not 
follow its use. If, instead of perspiration or warmth, it is attended with chills, 
great depression, languor, headache, &c., it is obvious that it should not have 
been used. It is productive of apoplexy in plethoric habits ; and is danger- 
ous in obstructed menses, in coughs, ruptures, or when any internal organ is 
diseased. If the temperature of the body is below the natural standard, or 
there is a profused perspiration, cold bathing should invariably be avoided. AND PROMOTING HEALTH AND LONGEVITY. 
55 
Those who are constitutionally weak, and who have but little energy of 
circulation, are injured rather than benefited by the cold bath. 
We believe that there are few, if any, cases in which the sudden applica- 
tion of cold water to the system (except in some particular diseases) proves 
beneficial. On the contrary, the sudden shock given to the system often 
brings on disease : therefore a very cold bath should be seldom used. The 
water for ordinary bathing, for persons in health as well as in disease, should 
be of such a temperature as to cause an agreeable sensation while bathing. 
When this agreeable sensation is not felt, but rather there is a sense of cold- 
ness, the person should leave the water immediately, wipe himself dry, then 
walk or exercise briskly until warmth of the system is restored. For the 
want of proper precautions in bathing, many have lost their lives. 
Bishop Heber, of Calcutta, on a mission from England to that country, 
died in the bath in consequence of not attending to the above precautions. 
It is said that Marcellus was so prostrated by the cold bath, that he died 
soon after. 
Five minutes is long enough to remain in the cold water ; and, on coming 
out, the whole body should be rubbed over briskly with a coarse towel. 
TOPICAL BATHING. 
The application of cold water in cases of local inflammation proves highly 
efficacious. It may be freely and safely used in inflammation of the brain, 
dropsy of the head, and in some grades of fever, particularly typhus. 
A variety of chronic catarrh, which displays itself in a troublesome flow of 
mucus from the nostrils,and often continues for months, is cured by immersion 
of the head in cold water, or by the application of this fluid to the part by 
means of a sponge or towel. The following case from an old writer little 
known, (Vander Heyden.,') will show the utility of this practice: 
" Bathing of the head in cold water cures inveterate pains of that part, 
and also the continual catarrhs and defluxions : for it is certain that, if 
the head be put in cold water as far as the middle bone of the hinder 
part of the head, and to the end of the nose before, so that there be left just 
so much of the nose out of the water as that the party may have freedom 
of breathing only, and that this be done so long as while a man may be 
saying the Lord's Prayer, the pain of the head, though it hath been of long 
continuance, will thereby be removed and the defluxions stopped, as hath 
often been proved by experience. And I have been much confirmed in this 
opinion of mine by an experiment of it made upon a certain English knight, 
named Sir Toby Mathews, a man no less eminent for wisdom than fit for 
public trust. This gentleman having been troubled twenty years together 
with an intolerable pain on one side of his head, and also with a continual 
and violent defluxion of the head, distilling through his palate and nose in 
so great a quantity, that he could never go without a wet handkerchief in his 
pocket; he was so happily cured of both these maladies in the sixtieth year 
of his age, by thus bathing his head in cold water, as that, till the seventieth 
year of the same, which he hath now passed, he hath never had the least 
touch of either during the said space of time ; and, being now better in health 
than ever he was in his life before, to prevent his falling into the like infir- 
mities again, he useth the said immersion of his head in cold water all the 
year long, and even in the depth of winter ; also, he saith that he received 
this profitable advice from a certain English nobleman, who, having himself 
been a long time much tormented with the same disease, had by this means 56 
MEANS OF PREVENTING DISEASE, 
cured both himself and very many others who were alike affected, and 
restored them to perfect health, to the great admiration of all men." 
It is stated that several wens have been cured by bathing them frequently 
in salt water. 
A very intelligent physician informs me that eyesights which are weak 
and dim from age or any other cause, are essentially benefited or cured 
by holding the face under clear water every day, and suffering it to come in 
contact with the eyes by winking a few times. It is reasonable to suppose 
that this practice is calculated to give them tone and energy. 
Dipping or bathing the crown of the head every morning in a basin of cold 
water is an excellent remedy for pains of the head, melancholy and nervous 
disorders. 
The temperature of the warm bath should be about ninety-five of Fahren- 
heit's thermometer. This kind of bath is much better calculated for bathing 
in general, in most seasons of the year, than either the cold or the hot bath- 
We cannot doubt of the tranquillizing and soothing effects of the sedative 
operation of warm bathing. There seems to be, however, this difference 
between the cold and the warm bath, that, while the former depresses at once, 
and powerfully, the circulating and nervous systems, benumbing and render- 
ing them torpid even unto death, or preparing for a violent and irregular re- 
action-tingling and glow-the latter is just in that relation with the nervous 
system to convey a sensation, soothing by its mildness and active by its 
diffusiveness, and with the capillary system to invite blood into the smaller 
vessels of the extremities, which were of a temperature less than the water, 
and thus produce an equal, yet moderate, fulness and action of these vessels ; 
an effect still farther ensured by the softened and diminished resistance of 
the skin. 
To those who arc past the meridian of life, says Darwin, and have dry 
skins and begin to be emaciated, the warm bath, for half an hour twice a 
week, I believe to be eminently serviceable in retarding the advances of age. 
Acting on this principle, this learned physician relates that, when Dr. Frank- 
lin was in England, he recommended the latter to use a warm bath twice a 
week, a practice which he afterward continued till near his death. 
" So early as the time of Homer an opinion seems to have prevailed of 
the utility of warm bathing in advanced life. When Ulysses, after his return 
to Ithaca, found his father Laertes reduced to great weakness, he advised 
him to use warm bathing, and, to encourage him, told him he had seen one 
whose case was exactly similar to his, worn down and emaciated with age, who, 
by the use of warm baths, very quickly recovered his appetite and rest. He 
likewise adds, that its efficacy in such cases was well known, and that it was 
a common custom among old men." Odyss. XXIV. 
It has been supposed till very lately that one constant effect of the warm 
bath is to relax and debilitate the body ; but numerous experiments seem to 
prove that this opinion was founded in error, and that, on the contrary, per- 
sons debilitated by disease have felt stronger on the days when they used 
the warm bath, and were soon restored to their former strength. If in 
any cases relaxation and debility follow the use of the warm bath, it is to be 
attributed to the heat of the bath having been too great for the constitution 
of the patient, or the immersion having been continued too long. The stimu- 
lant effects of the warm bath are very inconsiderable, and found useful 
WARM OR TEPID BATH. AND PROMOTING HEALTH AND LONGEVITY. 
57 
in allaying irritation, diminishing morbid frequency of the pulse, relaxing and 
purifying the skin, and in inducing sleep and repose. The warm bath will be 
attended with advantages in those cases of fever where the heat is preternatu- 
rally great, but where, from some affection of the lungs, consumption, or other 
unfavourable symptom, cold bathing is inadmissible ; in the paroxysms of 
hectic fever ; in several eruptive diseases attended with increased heat and 
dryness of the skin ; in gout and rheumatism, stiffness and swelling of the 
joints ; in obstruction of the menses ; in slight cases of palsy ; in scrofulous 
swellings; in some spasmodic and convulsive affections, where the cold 
bath might prove too violent; in all those affections of the bowels 
that seem to depend on an irregular or diminished action of any part of the 
alimentary canal; and in cases of debility attended with nervous irritation. 
In cases of predisposition to coughs it shares the frequency of the pulse, 
an 1 tends to retard at least, if it does not wholly prevent, the pulmonary 
affection. The time of continuing in the warm bath should be varied accord- 
ing to the temperature of the water and the feelings of the patient. In a 
bath of ninety-six a person may remain fifteen, twenty, or thirty minutes. 
Where the constitution is not sufficiently vigorous to secure reaction after 
the cold bath, as indicated by a warm glow over the surface, it certainly 
does an injury. 
For habitual use, bathing in water moderately warm is the safest and most 
valuable, especially for invalids, during the autumn, winter, and spring. 
In France the warm bath is held in such a high repute in some complaints, 
that it is used three or four times a day. It is highly recommended in cases 
of insanity. Says Dr. Combe : " When I visited the hospital for the insane 
M. Esquirol spoke to me in very strong terms of the benefits resulting from 
warm bathing, and declared that he had ever found it, when used with ordi- 
nary prudence, a safe and valuable remedy." 
HOT BATH. 
By the hot bath we understand a greater degree of heat than the warm bath. 
The water should be made as hot as the person can endure it. In this 
state it possesses the most powerful relaxing properties, and should only be 
used in cases of emergency, in very painful and dangerous diseases, where 
an immediate relaxation becomes necessary, such as fits, suppression of urine, 
gravel, strictures, complaints of the kidneys, cramp, hypochondria, bilious 
colic, &c. The most sudden and salutary effects are experienced from the 
hot bath in these and similar complaints. 
TOPICAL APPLICATIONS. 
Hot or warm water applied to any painful parts, is attended with the hap- 
piest effects. It removes the tension of the skin, diminishes irritability, and 
is often very useful. 
Neither the hot nor the warm bath should be used where there is a great 
determination of blood to the head, or where there is much plethora. 
Fourcroy relates the case of an individual who, being immersed in a bath 
of the immoderate heat of 66 degrees of Reaumur, (180 degrees of Fahren- 
heit,) fell down apoplectic an hour after. And a writer acquaints, us with 
the history of a patient who was seized with paralysis from having used a 
bath excessively hot. Peter Frank mentions the developement of an inflam- 
matory fever followed by the appearance of fourteen abscesses, after the 58 
MEANS OF PREVENTING DISEASE, 
application of such a bath. Venel saw, at Balaruc, a sick person sink into a 
state of fatal debility by remaining too long in a hot bath ; and the same author 
tell us that at Cauterets a Spaniard died of hemorrhage from the same cause. 
Similar inconveniences and alarming effects are also noticed by Currie. 
" By a hot bath," says Bell, " we are to understand that in which the water 
is of a heat exceeding 98 degrees of Fahrenheit. It is decidedly stimulating, 
and, in its often violent and marked effects on the human body, contrasts 
strongly with the more pleasurable impressions produced by the warm bath. 
This contrast must convince us of the impropriety of including the two under 
a common head, and of confounding their different powers. The hot bath, 
by imparting to the system an excessive dose of heat, strongly excites the 
circulation, and proves a nervous irritant." 
THE VAPOUR BATH. 
The vapour or steam bath is a contrivance by which steam, either simple 
or medicated, is brought by pipes from a vessel of boiling water, and admitted 
to the body placed in a small box or chamber. The room is heated to a 
temperature considerably above that of the atmosphere, and the naked body 
(sometimes including the head) is suffered to remain in this heated air until 
perspiration takes place. Aromatic herbs are thrown into the boiler, which 
render the bath more pleasant and more stimulating in its effects. It may 
be made by placing the person in a common chair, with the outside clothes 
removed, and a blanket thrown around the body to exclude the external air 
Under the chair a suitable tub or vessel must be placed, and a decoction of 
the herbs thrown into it. The vapour arising from this surrounds the body, 
and after fifteen or twenty minutes a free perspiration takes place. If the 
steam is insufficient to cause this perspiration, a brick or stone, previously 
heated, may be thrown into it: some substitute burning alcohol or spirits 
to produce the steam. A bath still more simple in its construction, and which 
answers well for all domestic purposes, may be made in the following manner: 
Let the herbs, say pennyroyal, spearmint, catnip, and tansy, a double handful 
of each, be all boiled in a pailful of water, and the whole thrown into a tub 
of a suitable size ; then place one or two narrow pieces of board across the 
tub, and partially covered w'ith a piece of flannel or cloth of any kind The 
person will sit over this in the manner above directed, until he per- 
spires freely. A heated brick or stone in readiness may also be necessary 
in this case, to add to the decoction. Care must be taken that there are 
sufficient openings by the sides of the strips of board, or the covering of them, 
to admit the steam to the body: bathing the feet at the same time, and drinking 
freely of an infusion or tea of catnip, will greatly aid the process of sweating. 
The steam or vapour bath, used in this manner, is very valuable in many 
diseases. It is useful in the commencement of all diseases where it is neces- 
sary to promote perspiration, and where the patient is not confined to his bed: 
in fevers, rheumatism, colds, inflammation of the lungs, and other painful 
affections. 
The vapour or steam bath may be applied with advantage in every case 
which is attended with a torpid state of the vessels of the surface and ex- 
tremities of the body. 
" Dr. D. T. Coxe, of this city," says Dr. Bell, " has published a short 
paper on the efficacy of the vapour bath, which he superintended at the 
time, in various diseases. In most of them the vapour was inhaled as well 
as applied to the surface of the body. The diseases enumerated as greatly AND PROMOTING HEALTH AND LONGEVITY. 
59 
relieved or entirely cured were, chronic diseases of the liver, rheumatism, 
ulceration of the fauces, pimples and other blemishes on the skin, enlarged 
spleen, with tendency to dropsy, dyspepsia, inflammation of the kidneys, 
hemicrania, influenza, and erysipelas. In reference to the dyspeptic patients 
who used the bath, he informs us that it removed the costiveness of the 
bowels, and generally improved their complexion; perspiration was with 
difficulty brought on. We are told that ' here the benefit terminated.' 
The erysipelas, says Dr. C., was one of the diseases which yielded readily 
and kindly to the influence of the vapour bath. 
It was remarked that the peculiar odour of some of the articles through 
which the steam was made to pass before its being applied to the body of 
the patient, w'as perceived in the urine. 
In one case, a person suffering under cutaneous eruption, accompanied with 
a torpor of the liver, it was at first about 104 degrees, in which the sweating 
was profuse. Each time the temperature was augmented, until it reached 
to between 115 and 120 degrees. This case serves to illustrate a fact men- 
tioned by all writers on this subject, viz., the impunity with which a person 
who has been exposed to the elevated temperature of a vapour bath can 
subsequently bear cold. The person in question ' was in the habit of taking 
several tumblersful of cold water while in the bath ; and neither in this 
case nor in any other in which this usage was followed, did any bad conse- 
quences result.' 
In the apparatus used by Dr. D. T. Coxe, after the plan obtained from Mr. 
Whitlaw, and the invention of which was claimed by the latter, ' the vapour, 
generated in a boiler, escaped through a bent tube, furnished with a stop 
cock, into a small basin or receiver in the lower part of a box. The top of 
this receiver, into which herbs or other articles were placed, as well as the 
upper covering of the box, was perforated, and allowed the free ascent of 
the medicated vapour into the upper or curtained part of the contrivance, 
where the bather sat, who either inhaled the vapour, or had it merely applied 
to the surface of the skin, according to the situation of his head, whether 
in the interior on the outside of the enclosure.' " 
The following figure represents a medicated vapour bath, made to steam 
two persons at one time. There is a furnace between the two baths, in 
which the water is put. The steam passes through tubes into the small 
receivers at the sides of the boiler, which contain the herbs, and thence into 
the baths, in which the patient is placed. One bath is sufficient for a family. 60 
MEANS OF PREVENTING DISEASE, 
Many a cold and many a rheumatism attack, arising from obstructed per- 
spiration, might be nipped in the bud by its timely use : in chronic affections 
of the skin ; in St. Anthony's Fire ; diseases of the lungs, throat, stomach, 
and intestines, with which the skin sympathizes so clearly, the judicious 
use of the vapour bath is very beneficial. It is also advantageous in mental 
and nervous diseases, in which langour and inaction of the skin are usually 
attendant symptoms. 
The prevalent fear of catching cold, which deters many from using the 
vapour bath, is founded on a false analogy between its effects and those of 
profuse perspiration from exercise or illness. The latter weakens the body, 
and, by diminishing the power of reaction, renders it susceptible of injury 
from sudden changes of the weather; but the effect of the vapour bath is 
very different. When not too warm or too long continued, it increases, 
instead of exhausting, the strength ; and, by exciting the vital action of the 
skin, gives rise to a power of reaction which enables it to resist cold better 
than before, as experience teaches : and the fact is exemplified in Russia, 
where in winter the natives sometimes rush out of the vapour bath and roll 
themselves in snow, the stimulus given to the skin by the bath preventing 
their taking cold. 
SULPHUR BATH. 
The sulphur and other medicated baths have been highly extolled for the 
cure of various complaints, but I have spent much time and money in testing 
their efficacy, and never could perceive that they possessed any advantages 
over the vapour bath. 
SHOWER BATH. 
This is a species of cold bath, an invention by which water falls from a 
height through numerous holes or apertures, on the head and body. It may 
be conveniently made by boring numerous small holes through a tub or half 
barrel, which must be fastened a few feet above the head of the person. Ano- 
ther tub of a sufficient size to contain two pails of water, must be suspended 
over the other, and made to turn upon an axis. A rope or cord must be 
fastened to this, so that it can be inverted or turned downward at pleasure. 
The person taking the shower bath must place himself beneath, uncovered ; 
and, having filled the tub with water, he will suddenly pull upon the cord, 
when almost instantaneously the contents of the upper tub or bath will fall 
into the lower one containing the holes, and the water will thus be conveyed 
in numerous and copious streams upon the head and body. 
The apparatus should be enclosed, as well as the body, in a box or frame 
a few feet square, or large enough to enable the person to stand or turn 
round with convenience. A few boards or plank enclosed in a small frame 
is sufficient for the purpose. Rub the body well with a dry towel after the 
bathing. 
This bath may be used in all diseases of the head, epilepsy, nervous com- 
plaints, headache, melancholy, hypochondriasis, obstruction of the menses, 
and such complaints as arise therefrom, delirium, general debility, &c. 
Dr. Sylvester Graham, who has become very celebrated on account of 
his lectures on temperance and diet, recommends, I am told, the shower 
bath for numerous complaints. 
A writer in Zion's Herald, over the appropriate signature " Comfort," has AND PROMOTING HEALTH AND LONGEVITY. 
61 
the following interesting remarks on the shower bath, and his own expe- 
rience in applying the same. We prefer it, whenever and wherever it can 
be used, to most other forms of cold bathing ; and hope that its inconvenience 
will be obviated-at least in part-by the simple method which is here 
proposed : 
" I had a shower bath made at the expense of ten dollars, and it makes a 
neat article of furniture in one corner of my chamber. On the top a box, 
that holds about a pail of water, swings on a pivot, and a string from it com- 
municates inside ; and underneath, to catch the water, is a snug-fitting drawer. 
Immediately on rising in the morning I shut myself in this enclosure, 
and receive the contents of the box at the top, let it drip off a moment, and 
then apply briskly a crash towel, and immediately a fine healthy glow is 
produced all over the body. The time occupied does not exceed five mi- 
nutes : I have often done it conveniently in three or four minutes, particularly 
when the wind has been in a cold corner, and all cheerless out of doors; but 
in these melting times it is too great a luxury to be hurried through with. 
I hope all will be induced to try this plan who can possibly raise ten dol- 
lars to pay for the bath. I can assure them they will never put this article 
aside as useless, or sell it for less than cost. I certainty would not part with 
mine for ten times its cost, if another could not be procured." 
The above figure represents an improved portable shower bath, which 
may be constructed at a small expense, and placed in a bed-room or other 
place. Both the bath and the water may be drawn to the desired height by 
means of the cord or rope running over the pulleys, and fastened to the ceil- 
ing. The person taking the shower bath is placed within, surrounded par- 
tially or wholly by the curtains, when he pulls a wire or cord which inverts 
the vessel overhead containing the water, and lets it fall in copious streams 
over the whole body. There is a receiver at the bottom in which the patient 
stands, and which prevents any escape of the water. 
" The warm, tepid, cold, or shower bath," says Combe, " as a means of 
preserving health, ought to be in as common use as a change of apparel, for 
it is equally a measure of necessary cleanliness." 
A bath on the above plan can be purchased for eight dollars. 62 
MEANS OF PREVENTING DISEASE, 
CHAPTER XIII. 
ABLUTIONS, OR BATHING THE SURFACE. 
When the perspiration is brought to the surface of the skin, and confined 
there either by injudicious clothing or by want of cleanliness, there is much 
reason to fear that its residual parts are again absorbed, and act on the system 
as a poison of greater or less power, according to its quantity and degree of 
concentration ; thereby producing fever, inflammation, and often death itself: 
for it is established, by observation, that concentrated animal effluvia form 
a very energetic poison. 
The substances emitted from the skin by perspiration are water, carbon, 
carbonic acid, phosphate of lime, and sometimes urea and animal oil, and 
perhaps phosphoric acid. Now it must be obvious, that an absorption of 
these agents is liable to cause disturbance and irritation, which proves the 
necessity of frequent attention to the skin, both in health and disease. 
When we consider that the whole surface of the body is continually dis- 
charging morbific matter or impurities from the body, and that it holds very 
near and powerful relations to the lungs, stomach, and other internal organs, 
we shall see the importance of keeping it in a healthy state; and, in order 
to do this, nothing is more necessary than frequent ablutions, bathing, or 
the shower bath. 
Bathing the surface, with friction, is excellent to prevent disease and restore 
health. It removes from the surface every species of impurity, promotes 
a free circulation of the blood in the minute vessels of the skin, and ena- 
bles this important organ to perform its office, without which some com- 
plaint ensues. It promotes the growth and developement of the muscles, 
invigorates the digestive organs, and imparts a pleasant glow and an increased 
energy to the whole system, by which it is rendered less liable to be disor- 
dered by cold or the changes of atmosphere. The ancients, it is said, had 
the art of rendering fat people lean, and those who were emaciated, fleshy, 
by exercise and frictions of the skin. Though useful to preserve health, 
bathing and rubbing the whole surface of the body are calculated to increase 
the health and vigour of persons labouring under debility, who lead a seden- 
tary life and are subject to indigestion, nervous diseases, rheumatism, coughs, 
fever, pains, and such as are subject to disease by the sudden changes of the 
weather. This practice destroys the susceptibility to cold, which is the 
existing cause of so many diseases. 
The whole body should be daily, or at farthest weekly, bathed entirely 
over with weak ley, or water, and immediately after brisk friction with a 
coarse or crash towel applied to the whole surface, till the skin begins to 
grow red and assumes an agreeable glow. 
This practice is highly useful in the case of delicate persons; and bathing 
children in this manner promotes their growth and activity, and prevents 
scrofula, rickets, cutaneous and other complaints. The best time for this 
operation is in the morning or evening. Those who are subject to wakeful- 
ness and disturbed sleep, and hysterical affections, will find, in addition to a 
properly regulated diet and active exercise in the open air, that sponging 
the body with cold or tepid water, followed by brisk frictions of the surface 
for a few minutes, will more effectually remove these symptoms than most AND PROMOTING HEALTH AND LONGEVITY. 
63 
other means : or the shower bath may be used. This process cleanses and 
invigorates the skin, is very refreshing, and contributes much to health ; it 
is pleasant even in cold weather. After this ablution, exercise of some kind 
should be taken. Should there be any sense of cold or chilliness, the opera- 
tion must be discontinued, or the water warmed. 
Those who practise this bathing of the surface will never suffer much, if 
any, from colds, (the forerunner of consumption,) sore throats, or similar 
complaints. " Man studies the nature of other animals, and adapts his con- 
duct to their constitution, but of himself he is ignorant, and him he neglects. 
If one-tenth of the persevering attention and labour," says Combe, " bestow- 
ed in rubbing and currying the skins of horses, were bestowed by the human 
race in keeping themselves in good condition, and a little attention were 
paid to diet and clothing, colds, nervous diseases, and stomach complaints 
would cease to form so large an item in the catalogue of human miseries." 
1 ordered a patient, now in the office, to bathe the surface as above directed, 
which he has done, and he states that he has not taken cold since, though 
he was formerly much subject to it. After bathing he experiences an un- 
usual warmth over the whole body. He stands in the fish-market, where 
he is liable to checks of perspiration from the sudden changes of the weather. 
If the whole body be, as it were, covered with varnish formed of perspi- 
rable matter, it is impossible that a person in such a state can possess 
sound blood, or enjoy good health. 
CHAPTER XIV. 
MINERAL OR MEDICINAL WATERS. 
Several springs have been found in the United States, holding in solution 
certain mineral, saline, or medicinal agents, which have obtained popularity 
from their real or supposed efficacy in curing diseases. The term mineral 
water seems not very appropriate, for such are found exceedingly dangerous 
to drink. Some are impregnated with copper and other deleterious sub- 
stances, and are dreaded by man and beast. But those which hold in solu- 
tion earthy substances principally, or even a small portion of iron, exert 
some sensible effect on the animal economy. Hence it is not irrelevant to 
notice them. Those most frequented by invalids throughout the United 
States are the following : 
Ballston, N. Y. 
Saratoga, N. Y. 
Bedford, Pa. 
Yellow, near Philadelphia. 
Do. Ohio. 
White Sulphur, Virginia. 
New Lebanon, N. Y. 
Schooley's Mountains, N. J. 
Orange, N.J. 
Stafford, Conn. 
Suffield, Conn. 
Pittsburgh, Pa. 
The effects of these waters vary according to their component parts. Their 
medicinal effects, if any they have, depend not upon the mineral agents, as 
many suppose, if we except the tonic properties of iron, to which metal we 
will not object; but to other ingredients, such as salt or muriate of soda, 
lime, magnesia, and sulphur, or the diluent properties of the water itself. 
These no doubt sometimes benefit, by their purgative or diuretic properties: 64 
MEANS OF PREVENTING DISEASE, 
but most of the benefits derived from these springs are owing to a change of 
air, diet, exercise, &c. 
Mineral waters are divided into different classes-those containing iron, 
salts, sulphur, and lime. The most popular are the 
BALLSTON AND SARATOGA SPRINGS. 
They are situated about twenty-eight miles from Albany, state of New 
Fork, in a healthy and pleasant part of the country. The water of these 
fountains is perfectly clear, and, as it rises up, sparkles briskly. Its taste is 
saltish, with a slight degree of bitterness, and its effects on the system pur- 
gative or aperient. 
Upon analysis, a bottle of 25 ounces of the Ballston water contains the 
following ingredients : 
1. Carbonic acid, three times its volume. 
2. Muriate of soda, 31 grains. 
3. Super saturated carbonate of lime, 22 grains. 
4. Muriate of magnesia, 12| grains. 
5. Muriate of lime, 5 grains. 
6. Carbonate of iron, 4 grains. 
A greater number visit these springs, either for health or pleasure, than 
any other in America. There are many other springs in the same section, 
but the general character of the waters are similar. 
PROPERTIES AND EFFECTS OF THE WATERS. 
Ballston waters contain a larger proportion of fixed air and a greater quan- 
tity of iron than any other mineral water which has ever been discovered 
It will be seen also that they contain a great portion of lime. Many who 
have drank of them state that they have received great benefit; others say 
they have been much injured. 
I shall first speak of cases in which they are not beneficial. First, in those 
complaints which are attended with an increased excitement of the whole 
system, or with local inflammation, they are manifestly prejudicial. We 
infer this from the qualities of the water alone. It is also confirmed by 
experience and observation. They are injurious in pregnancy. A woman 
some years ago lost her life by the imprudent use of them. They are inju- 
rious in diseases of the mesentery and of the lungs. A person afflicted by 
the consumption was evidently hastened to the grave by the frequent use 
of these waters. In cold, phlegmatic, bilious habits they must be hurtful: 
also in chronic diarrhoea and dysentery. 
Diseases in which they are beneficial. From the lime and salt, magnesia, 
&.C., which they contain, and their operation upon the urinary organs, they 
may be useful in the dropsy, gravel, and other affections of the kidneys and 
bladder. 
General Debility. Being strong chalybeates, they possess some tonic 
powers ; hence they are useful in dyspepsia, hypochondriasis, and hysteria. 
They may be serviceable in painful and suppressed menses ; likewise in that 
species of consumption arising therefrom; also the rickets and scrofulous 
affections, &c. 
Dr. J. H. Steel, who was for many years a resident at Saratoga Springs, 
speaks highly of the benefits derived from these waters, used internally and 
externally. He remarks, in a Treatise published on these waters, as follows: AND°PROMOTING HEALTH AND LONGEVITY. 
65 
They are of eminent service to an impaired or capricious appetite, and 
weakness of the assimilating organs ; in irregular digestion, flatulent disten- 
tion of the abdomen, anxiety about the pracordia, (chest,) difficult respira- 
tion from sympathy with the stomach, occasional vomiting of viscid mucus," 
&c. They are also excellent in bilious and dyspeptic complaints. 
In Dyspepsia it is usual to begin a course of the waters with the Congress. 
This should be taken in the morning, before breakfast; four or five tumblers- 
ful are commonly sufficient to produce a pretty copious discharge from the 
bowels ; and in weak, irritable habits half the quantity, or a single tumbler- 
ful in some cases, is amply sufficient to answer the purpose ; but in those 
cases where the bowels are attended with an habitual constipation, the 
quantity of water required to move them is apt to prove too cold to the 
stomach, and, by producing cold chills and nausea, frequently defeats the 
general intention of its application. This may be prevented by taking some 
suitable laxative over night, and a much less quantity of water in the morn- 
ing will answer the wishes of the patient, without subjecting him to any 
inconvenience. But the water of the Congress is not alone to be depended 
upon for the removal of this disease : when the stomach and bowels have 
been sufficiently cleansed by the pleasant and innocent purgative properties 
of this water, recourse must be had to the operation of the more powerful 
chalybeates. These are to be found in the waters of the Flat Rock, the 
Columbian, in EUis'> Spring, and at the Spa. 
The quantity of water, from either of these fountains, to be used daily, 
depends in a great measure on the state of the disease and the disposition of 
the stomach ; it is, therefore, necessary to commence their use in small quan- 
tities at a time, in distant and regular intervals, gradually increasing the 
quantity and frequency of the draught, as may be most agreeable to the sto- 
mach and least injurious to the feelings. In this way the quantity may be 
increased to from one to two quarts a day; and it is questionable whether a 
much larger quantity may be drank with any additional advantage. 
Conjoined with the internal use of the water, bathing should not be for- 
gotten ; its exhilarating effect upon the surface contributes much to the 
restoration of the vigour and health of the stomach. The cold shower bath 
should always be preferred where the energy of the system is sufficient to 
overcome the effects of the cold, and produce the sensation of warmth over 
the surface of the body immediately after its application. Where this sen- 
sation is not produced, the cold bath should be dispensed with, and the tepid 
or warm bath substituted in its stead, together with general friction, with a 
flesh-brush or coarse flannel, over the whole surface. 
The stimulating effects of these waters, arising from their saline and ga- 
seous properties, give them a decided preference over any other as a bath; 
and those who are labouring under a deficient or irregular action of the cuta- 
neous vessels, arising either from a sympathetic affection with a diseased 
stomach, or from an original affection of the vessels themselves, will find it 
to their advantage to persevere in its use under this form. They may be 
very beneficial in gout, ulcers, dropsy, cutaneous affection, rheumatism, scro- 
fula, and nervous diseases." 
FAUQUIER WHITE SULPHUR SPRINGS, VA. 
This spring is situated in the State of Virginia, Fauquier County. The 
water is impregnated with sulphate of magnesia, phosphate of soda, and 
sulphurated hydrogen. It has a strong sulphuric smell, and the taste is like 66 
MEANS OF PREVENTING DISEASE, 
the odour from the yolk of a hard-boiled egg. The water is highly recom- 
mended in dropsy, rheumatism, and bilious complaints. I knew a person who 
was afflicted with an enormous swelling of the abdomen, who was cured by 
warm bathing, causing perspiration, and drinking the water. This spring 
is now becoming a fashionable place of resort, there being about six hundred 
visiters at one time. 
Among the number of springs which have obtained notoriety in chronic 
diseases may be mentioned the Schooley's Mountains, New Jersey; Pittsburgh 
Chalybeate Mineral Spring ; Yellow Spring, Green County, Ohio, sixty-four 
miles from Cincinnati. New Mineral Spring, Albany ; Bedford Mineral 
Spring, Pennsylvania ; Saline Springs, Big Bone, State of Kentucky ; Leba- 
non Spring, twenty-six miles from Albany, New York. 
It is probable that most of the advantages derived from visiting these springs 
arise from the change of air, scenery, and exercise. Did the sick live accord- 
ing to the laws of physiology at these watering-places, health would soon be 
regained. But they eat and drink whatever their appetites crave, and that 
of the most unhealthy character, and thus counteract the benefit they 
otherwise would receive. Were invalids to live on a simple, plain diet, and 
take a sufficient quantity of exercise, they would recover their health even 
by drinking common spring or well water. 
CHAPTER XV. 
SEA VOYAGE, CLIMATE, AND TRAVELLING. 
A change of climate for the cure of disease is sometimes very salutary. 
A sea voyage often proves beneficial from the motion of the vessel causing 
nausea and vomiting, thus exciting a healthy action of the skin and the 
digestive and respiratory organs. Hence the influence of climate is some- 
times very great in changing the system from a morbid to a healthy state. 
A voyage to England or the continent of Europe is recommended for nervous 
and chronic diseases in general, which resist medical treatment; but for com- 
plaints of the breast or lungs, the climates of Brazil, the West Indies, and Flori- 
da are by far the best, and St. Croix is the best island for consumptive persons. 
A sensible writer, on the climate for invalids, thus remarks: " The 
best islands in the West Indies are those that are small and dry, having a 
constant sea-breeze and no change of temperature. At this place (St. Croix) 
I have seen the thermometer stand so long at eighty degrees, with a steady 
cool breeze, that I supposed it did not range ; but I found this no uncommon 
occurrence. Here, too, are by far more and better accommodations for inva- 
lids than in any other place in the West Indies, and the climate is more 
steady and less subject to rain than Cuba. As a proof of it, year after year 
the crop is not one-half, owing to the want of rain." 
I should not recommend a voyage to Europe for pulmonary complaints, 
although the south of France might prove beneficial. Long journeys by 
land, or on horseback, or by carriage are highly conducive to health, and have 
removed many obstinate complaints. A person in Newark, N. J., laboured 
under a very severe and fixed pain in his side, which only yielded to a long 
journey on horseback of three hundred miles. In the commencement it 
aggravated his symptoms. AND PROMOTING HEALTH AND LONGEVITY. 
67 
Sydenham states that riding on horseback will cure all disorders, except 
confirmed consumption. 
It would seem that a warm and dry atmosphere equalizes the circulation 
of the blood, which relieves the internal organs of the system from conges- 
tion and irritation. 
Again, when we reflect upon the extensive surface of the air cells of the 
lungs, being as great as the whole body, and which are continually exposed 
to the atmosphere, we may learn the influence of mild and bland air on 
these organs, and on pulmonary and other complaints. 
A change of scenery, the exercise of the journey or voyage, the hope of 
recovery, no doubt all contribute to the restoration to health. 
DYSPEPSIA, NERVOUS DISEASES, ETC. 
A lady of this city states that she was reduced to a most deplorable condi- 
tion of mind and body by the dyspepsia. She tried a great many medicines, 
all to no purpose ; finally she went to the Island of Cuba, where she resided 
for some time, and soon regained her health. She began to improve as soon 
as the vessel arrived in the gulf stream. 
Sir James Clark, present physician to the Queen of England, thus observes 
on this subject: " That in dyspepsia, and diseases of the digestive organs 
generally, and in the nervous affections and distressing mental feelings which 
so often accompany these, in asthma, chronical diseases, scrofula, and in 
rheumatism, the beneficial effects of climate are far more strongly evinced 
than they are in consumption." 
Dr. S. Forry, on the climate of Florida, says : " It is demonstrated 
that invalids, requiring a mild winter residence, have gone to foreign lands 
in search of what might have been found at home, namely, an evergreen 
land, in which wild flowers never cease to unfold their petals. " 
1 am inclined to believe that Kentucky, Tennessee, the Carolinas, Georgia, 
Florida, and New Orleans are as well, if not better, calculated for persons 
labouring under pulmonary diseases, as any other climate, except perhaps that of 
the Island of Cuba. A lady in Massachusetts had all the symptoms of con- 
sumption, and was considered incurable; she went to Kentucky and resided 
with her daughter, where she actually recovered. Another person, having a 
bad cough, removed to Savannah, and was cured. In cases of this kind the 
residence must be permanent. The Alleghany Mountains, together with a 
more southern latitude, seem to modify the temperature of the atmosphere, 
and render it more mild and salubrious. 
CHAPTER XVI. 
TOBACCO. 
The use of tobacco has become so prevalent in this country, that in some 
places a large majority of both sexes, above fifteen years of age, either snuff, 
smoke, or chew it. The same habits prevail to a great extent in almost 
every portion of the globe. 
When we take into consideration the disagreeable and repulsive character 
of this production to the unvitiated palate, it is truly surprising that it 68 
MEANS OF PREVENTING DISEASE, 
should ever have been thought of as an article for such use at all; and when 
to this consideration is added, the exceedingly important one, that it is highly 
injurious to the human system, the fact of its general use becomes still more 
astonishing. Many, however, are not aware of its pernicious effects ; and 
this will, in some degree, account for this extensive use. I propose, there- 
fore, to exhibit these effects in their true colours in this article, in the hope 
of inducing such to abandon those baneful habits. 
It should be understood, then, that tobacco is an actual and a virulent 
poison. Three drops of the distilled oil of tobacco, dropped upon the tongue 
of a full sized cat, usually causes death in from three to ten minutes : and even 
when used medicinally, it is so uncongenial to the system, and of so baneful 
a tendency, that physicians now seldom administer it, even in the most des- 
perate cases. In many instances, where it has been applied internally, oi 
even externally, it has caused death in a short period. A tobacco poultice 
applied to the pit of the stomach causes terrible vomitings in a very short 
time. Its application to the head produces similar effects. A girl about 
seven years of age, in good health, was seized with incessant vomiting, by 
merely having an ointment of butter and snuff applied to her head, which 
was affected with the scabies. Fontana ranks tobacco with the vegetable 
poisons ; and he gives the following account of his experiments : 
" I made," says he, " a small incision in a pigeon's leg, and applied to it 
the oil of tobacco ; in two minutes it lost the use of its foot. 1 repeated this 
experiment on another pigeon, and the event was exactly the same. I made 
a small wound in the pectoral muscles of a pigeon, and applied the oil to it; 
in three minutes the animal could no longer support itself on its left foot. 
This experiment repeated on an another pigeon, ended the same way. 1 
introduced into the pectoral muscles of a pigeon a small bit of wood covered 
with this oil; the pigeon in a few seconds fell insensible. Two other pigeons, 
to whose muscles I applied this oil, vomited several times all that they had 
eaten. Two others with empty stomachs, treated as above, made all possi- 
ble efforts to vomit. Vomiting was the most constant effect of this oil." 
To the foregoing it may be added, that an application of tobacco in almost 
any form will produce a similar effect: and chemists tell us that tobacco 
leaves, distilled in a retort, without addition, yield an acrid, empyreumatic, 
poisonous oil. Kempfer also classes it with the strong vegetable poisons ; a 
most appropriate classification indeed, seeing that a single drop of the chemical 
oil of tobacco, applied to the tongue of a cat, has produced violent convul- 
sions, and caused death in one minute ; and a thread dipped in the same oil, 
and drawn through a wound made by a needle in an animal, has killed it in 
seven minutes. Nay, what can be expected but that the strong caustic oil 
and acrid salt contained in it will produce incalculable evils. Some of those 
evils we will here bring into view. 
Dr. Maynwaring, in his treatise on the scurvy, asserts, that tobacco causes 
scorbutic complaints, and that the scurvy has abounded much more since 
the commencement of the use of tobacco than it ever did before. Old Mr- 
Salmon, a man most eminent in practical medicine in his day, says : " The 
ordinary and constant use of snush " (meaning snuff ) " is of very evil con- 
sequences, and induces apoplexies : and I am confident that more have 
died of apoplexy in one year since the use of this snush, than have died 
of that disease in a hundred before the use thereof: and most, if not all, 
of those I have observed to die of late of that disease, were such as were 
extreme and constant swash-takers." 
As to smoking, every medical man knows that the saliva, which is so AND PROMOTING HEALTH AND LONGEVITY. 
69 
copiously drained off by the pipe, is the first and greatest agent which nature 
employs in digesting food. Chewing likewise drains off this liquid, so neces- 
sary to digestion. Darwin, in his Zoonomia, says : " The unwise custom 
of chewing and smoking tobacco for many hours in the day not only injures 
the salivary glands, producing dryness in the mouth when this drug is not 
used, but I suspect that it also produces scirrhus of the pancreas. The use 
of tobacco in this immoderate degree injures the power of digestion, by 
occasioning the patient to spit out that saliva which he ought to swallow; 
and hence produces that flatulency which the vulgar unfortunately take it to 
prevent." " I saw what I conjectured to be a tumour of the pancreas, with 
indigestion, and which terminated in the death of the patient. He had been 
for many years a great consumer of tobacco, insomuch that he chewed that 
noxious drug all the morning and smoked it all the afternoon." 
But smoking and chewing not only carry off the necessary saliva from its 
proper place ; they likewise saturate the tongue and mouth with tobacco 
juice, thereby vitiating the saliva that remains, which in this pernicious and 
poisonous condition finds its way to the stomach. Who, in view of these 
considerations, can wonder that tobacco " fixes its deadly grasp upon the 
organs of vitality, gradually undermining the health, and sowing the seeds 
of disease, which are sure, sooner or later, to take root and spring up, 
carrying away its victim to a premature grave !" Who can wonder at the 
dizziness, the pain in the head, the faintness, the pain in the stomach, the 
weakness, the tremulousness, the huskiness of the voice, the disturbed sleep, 
the nightmare, the irascibility, the mental depression, the epilepsy, and 
even mental derangement, of the victim of tobacco ! " It seems," says 
Henry H. Brown, " to act directly upon the nervous system, enfeebling, 
exhausting, or destroying the powers of life. It is also especially liable to 
diminish the sensibility of the membrane lining the nose, mouth, and sto- 
mach ; enfeebling the nervous power of this latter organ, so that, instead of 
promoting digestion, as pretended by many, it has a direct tendency to pro- 
duce dyspepsia, with all its direful train of symptoms." One of the most 
eminent surgeons in this country states, that of the cases of cancer of the 
under lip which had come within his observation, all but three were those 
of individuals who had, <at some period of their lives, used tobacco in some 
one of its forms. With regard to snuff in particular, De Bomare says : 
" The least evil which you can expect it to produce is, to dry up the brain, 
emaciate the body, enfeeble the memory, and destroy, if not entirely, yet in 
a great measure, the delicate sense of smelling." " Common snuff, in habi- 
tual snuff-takers," says a sensible medical practitioner, " has been found to 
penetrate into the sinuses communicating with the nose, and into the antrum, 
where it has formed horrid abscesses : it is often carried down into the sto- 
mach ; and, by the use of it, the skin is tinged of a pale brown colour." The 
most delicate females have their complexion entirely ruined by it. Many 
cases have been observed where the appetite has been almost destroyed and 
consumption induced, by its excessive use. As to smoking, which some 
perhaps deem very harmless, J. Borrhi, in a letter to Bartholine, states, that 
the brain of an immoderate smoker, on dissection, was found dried and shri- 
velled up, by his excessive use of the pipe. 
Instead of preserving the teeth from decay, as many suppose, the chewing 
or smoking of tobacco wears down or absorbs the grinding surface of the 
teeth much faster than would otherwise be the case. So active a poison as 
the smoke or juice of tobacco, continually in contact with the surface of the 
teeth, must tend to destroy their vitality, and, consequently, to hasten, instead 
of retarding, their decay. 70 
MEANS OF PREVENTING DISEASE, 
In a German literary journal are mentioned several cases of vertigo, 
blindness, and paralysis, caused by the immoderate use of tobacco. Its use 
as an emetic is extremely dangerous, having occasioned intolerable cardi- 
algic anxieties, violent vomitings, and stupidity. Bomare informs us that 
it has been used as a remedy in lethargic swoonings; and the patient has 
been restored to sensibility, only to be racked by a more terrible disorder. 
Convulsions, accompanied by vomitings, cold sweats, and a feeble and inter- 
mitting pulse, with other dreadful symptoms, have been the consequence of 
its use in the above cases. 
" The use of tobacco," says Henry H. Brown, " also produces a dryness 
or huskiness of the mouth, thus creating a thirst, which in many cases is not 
satiated with anything short of alcoholic drinks. In this way the use of 
tobacco often lays the foundation of drunkenness." 
" To this dark catalogue of evils," continues he, " arising from the use of 
tobacco, may be added the turbid nostril, the besmeared lip, the spitting of 
saliva, imbued with this baneful narcotic, upon the floor, furniture, and even 
upon the clothes of those around them ; and last, though not least, the foul 
and offensive breath, which, to those whose olfactories have not been per- 
verted by the use of narcotics, is almost insupportable." 
The use of tobacco is a waste of money-nay, far worse than throwing it 
into the ocean, where it would at least do no harm. Some whole families 
make use of tobacco. Now, suppose a family to consist of six individuals, 
and their weekly expense for this article to be Is 6d ; this in fifty-four 
years, at compound interest, would amount to .£1000: and when to this are 
added the concomitants, such as strong drink, idleness, sickness, &c., the 
amount would probably be increased fourfold. A clergyman recently made 
a calculation, that a poor family among his parishioners expended nearly 
one-third of their earnings for snuff" and tobacco. 
The loss of time is likewise another serious evil connected with the use 
of tobacco. Some spend three, four, five, and even six hours in twenty-four, 
in smoking. 
In view of all the foregoing evils connected with the use of tobacco, it 
is not strange that a Turkish emperor, a Russian czar, or a Persian king 
should forbid its use on pain of death-mitigated, it is true, in the case of 
snuff-taking, by merely having the nose cut off. It is not strange that the 
Court of Clermont forbade the apothecaries to raise any tobacco, on pain of 
confiscation and a fine of 1000 livres. Nor is it strange that Pope Urban 
the VIII. made a bull, to excommunicate all who used tobacco in churches. 
Such penalties, however, would scarcely be necessary to deter some from 
its use, were they aware of the intolerable filthiness connected writh the 
tobacco concern. Simon Pauli, physician to the King of Denmark, in a 
treatise on tobacco, says, that the merchants frequently lay it in bog houses, 
to the end that, becoming impregnated with the volatile salt of the excre- 
ments, it may be rendered brisker, stronger, and more foetid. A dealer in 
this article acknowledges that he sprinkled his rolls and leaf frequently with 
stale urine, to keep them moist and to preserve the flavour. A person, 
whose curiosity led him to see tobacco spinning, observed that the boys who 
opened out the dry plants had a vessel of urine by them, writh which they 
moistened the leaves, to prepare them for the spinner. What a delicious 
morsel a quid of tobacco must be ! 
To the consumers of tobacco let me now say-desist ! First ; For the 
sake of your health, which must be materially injured, if not destroyed, by 
it. Secondly ; For the sake of your property, which, if you are a poor man, 
must be considerably impaired by it. But supposing you can afford this AND PROMOTING HEALTH AND LONGEVITY. 
71 
extra expense, consider how acceptable the pence (to go no farther) which 
you spend in this idle unnecessary employment, would be to those who are 
often destitute of bread ; and to whom one penny would sometimes be as an 
angel of God. Thirdly ; For the sake of your time, a large portion of which 
is irreparably lost, particularly in smoking. Have you any time to dispose 
of-to murder ? Is there no need of prayer-reading-study ? Fourthly ; 
For the sake of your friends, who cannot fail to be pained in your company. 
Fifthly ; For the sake of your voice, which a continuance in snuff-taking will 
infallibly ruin, as the nasal passages are almost entirely obliterated by it. 
Sixthly ; For the sake of your memory, that it may be vigorous and reten- 
tive ; and for the sake of your judgment, that it may be clear and correct to 
the end. Lastly ; For the sake of your soul-Do you not think that God 
will visit you for your loss of time, waste of money, and needless self-indul- 
gence ? Have you not seen that the use of tobacco leads to drunkenness 1 
Do you not know that habitual smokers have the drinking vessel often at 
hand, and frequently apply to it ? nor is it any wonder, for the great quan- 
tity of necessary moisture which is drawn off from the mouth, &c., by these 
means, must be supplied in some other way. You tremble at the thought; 
and well you may, for you are in great danger : may God look upon and 
save you before it be too late. 
It is with pain of heart that I am obliged to say, I have known several 
who, through their immoderate attachment to the pipe, have become mere 
sots. There are others who are walking unconcernedly in the same danger- 
ous road-I tremble for them. Should this fall into their hands, may they 
receive it as a warning from God ! 
" But I take (says one) only a little now and then in complaisance to 
others." Then you will soon be as great a slave to it as others are. When 
it is offered to you in this way, think of the conduct of Omiah, a native of 
Otaheite, who was brought to London by Captain Furneaux : when a certain 
lord presented him his golden snuff-box, and invited him to take some, the 
innocent savage, having gained little acquaintance with European refinement, 
bluntly replied : " I thank you, my lord, my nose is not hungry." 
You say, " I am so long accustomed to it, I cannot leave it off." Alas ! 
alas I your case is truly deplorable ; you are shorn of you strength, and power 
is now lacking to bring the expostulations of conscience to good effect. How- 
ever, try: see what God will do for you. 
Should all other arguments fail to produce a reformation in the conduct 
of tobacco consumers, there is one which is addressed to good breeding and 
benevolence, which, for the sake of politeness and humanity, should prevail. 
Consider how disagreeable your custom is to those who do not follow it. An 
atmosphere of tobacco effluvia surrounds you whithersoever you go : every 
article about you smells of it; your apartments, your clothes, and even your 
very breath. Nor is there a smell in nature more disagreeable than that of 
stale tobacco, arising in warm exhalations from the human body, rendered 
still more offensive by passing through the pores, and becoming strongly im- 
pregnated with that noxious matter which was before insensibly perspired. 
Consider what pain your friends may be put to in standing near you, in 
order to consult you on some important business, or to be improved by your 
conversation. 
King James finishes his piece on the subject of tobacco as follows : 11 A 
custom loathsome to the eye, hateful to the nose, harmful to the brain, dan- 
gerous to the lungs, and, in the black stinking fume thereof, nearest resem- 
bling the horrible stygian smoke of the pit that is bottomless." I consider 
no man who uses tobacco, either a gentleman or a Christian. 72 
MEANS OF PREVENTING DISEASE, 
CHAPTER XVII. 
TIGHT LACING. 
There are few customs, if any, which exert such a baneful influence on 
the system as that of tight lacing, and, therefoie, cannot be too generally cen- 
sured. It produces no benefit, real or imaginary, but positive injury ; and 
is the offspring of great weakness, folly, and sin. 
The structure of the chest is such that it forms a spacious arched chamber 
or cavity, in which the heart, lungs, and innumerable arteries, veins, valves, 
and muscles perform their important offices ; contracting, dilating ; inhaling 
fresh air with one set of cells, using part of it to purify the venous blood, 
and then exhaling the rest through another set; receiving from the veins 
blood which has gone its round-cleansing it with wonderful art in a few 
moments, and sending it on again by the arteries to meander through and 
renovate continually every part of the frame. At every breath the lungs 
dilate and contract-at every breath the heart receives a tide of blood into 
one of its divisions, and pours out an equal tide at another ; propelling it with 
a force equal to forty or fifty pounds weight. For all these delicate and 
and momentous operations, the chamber which nature has provided is exactly 
of the proper size; not a hair's breadth too small nor a hair's breadth too 
large. Nay, it is large enough, and the vital movements can be performed 
only by certain motions of the bones which compose it. The ribs hinge into 
the spine, and the gristles and collar-bones hinge into the sternum ; there 
are joints also where the ribs and gristles unite. By means of these hinges 
and joints the bones and gristles incessantly play in and out, or up and down, 
at each movement of the lungs; and to their healthful movement the free- 
dom of that play is indispensable. 
Now a corset, or tight lacing of any kind, fetters the freedom of those 
bones, destroys all the advantages of the joints and hinges which nature has 
provided, and thus lessens the room in which the lungs and heart move- 
besides depriving them of the aid, the impulse they derive from the motion 
of the bones and muscles. But all this is not half the mischief. The ribs, 
especially at the joints or hinges, being soft in young people, and the gristles 
much softer, are compressed by the lacing so as to approach nearer and 
nearer to the breast-bone in front; sometimes they lap over it and meet 
each other : nay, there are instances of tight lacing where the ribs have not 
only passed the sternum and met, but have overlapped each other 1 Far 
short of that extreme, however, fatal effects may be expected. Quite a 
moderate degree of lacing suffices to bring the points of the ribs several inches 
forward, and to press the sternum inward; narrowing just so much that 
chamber which was at first not a hair's breadth too large for the lungs and 
heart to work in-besides stopping the auxiliary motion of the bones them- 
selves. The consequences need not be detailed. That the lungs, thus 
cribbed and forced to beat in vain against the contracted walls of their pri- 
son, should be inflamed and diseased ; that the breathing should become short 
and difficult; that the heart should be subject to unnatural palpitations, and 
no longer drive the blood with regular and healthful vigour along the arte- 
ries ; that youth's joyous and active sports must be prematurely abandoned ; 
and that life itself, perhaps, after years of suffering, should retire from its 
besieged and oppressed citadel, can excite no wonder. PAGES 73-74 MISSING AND PROMOTING HEALTH AND LONGEVITY. 
75 
Fig. 1. UNNATURAL FORM. 
Fig. 2. natural form 
Fig. 3. COMPRESSED WAIST. 
Fig. 4. NATURAL WAIST. 76 
MEANS OF PREVENTING DISEASE, 
CHAPTER XVIII. 
SEXUAL INTERCOURSE, ONANISM, VENERY, ETC. 
This subject, from the nature of it, is not generally treated of by writers 
on health. But none is more important, as it involves consequences of the 
most serious kind. The semen is the most subtile, vital, and ethereal part of 
the body. It contributes to the support of the nerves, as well as the repro- 
duction of the human species ; and its evacuation is by no means necessary, 
and, when retained, adds greater strength to the system. The emission of 
the semen enfeebles the body more than the loss of twenty times the same 
quantity of blood, and more than violent cathartics, emetics, &c. Hence ex- 
cess of this nature produces a dibilitating effect on the whole nervous system, 
on both body and mind. 
It is founded on the observations of the ablest physiologists, that the 
greater part of this refined fluid is reabsorbed and mixed with the blood, of 
which it constitutes the most rarified and volatile part; and it imparts to the 
body peculiar sprightliness, vivacity, and vigour. These beneficial effects 
cannot be produced if the semen be wantonly and imprudently wasted. Be- 
sides, the emission of it is accompanied with lassitude and relaxation, and often 
with great nervous depression. It therefore should never be evacuated 
only in a state of superfluity, and even then never unnaturally. 
Perhaps the best criterion for married persons is this : Never indulge in 
the propensity while it can well be avoided, for the same reason, that we should 
never eat till very hungry ; any deviation from this rule will be attended di- 
rectly or indirectly with debilitating effects, especially with the weak and 
nervous. By this pernicious practice is meant the emission of semen arti- 
ficially, and which prevails among both sexes to a most fearful extent. 
MASTERBATION, ONANISM, SELF-POLLUTION, ETC. 
Persons should never practice it (onanism or masterbation) under any pre- 
tence, except they wish to expose or ruin their health and morals. Obey 
the injunction of the apostle, " Flee, youthful lusts." This doctrine is agreea- 
ble to the laws of physiology or nature, as well as the law of God. Emit- 
ting the semen artificially by the too common practice of onanism, lays the 
foundation for many incurable complaints, and causes more bad health than 
even physicians are aware of. It has been shown, by reports of Lunatic 
Asylums, that it often causes insanity in both sexes. 
" The fact, that the ceremony of marriage has been performed, will not 
save people from the consequence of venereal excesses. The laws of our 
nature remain the same ; and, if violated, we must suffer the consequences. 
Hundreds and thousands are hurried into a premature grave, or made wretch- 
ed while they live, by diseases induced by venereal excesses, with no know- 
ledge of their causes." The practice of self-pollution pervades all ranks, 
male and female. Professed Christians are often among its victims. Some 
time since, says Mary S. Gove, I became acquainted with a lovely and 
intellectual young man, who was a student in one of our theological semi- 
naries. His health became so poor that he was obliged to leave the seminary 
and return to his friends. I saw him lose his reason and become a maniac. AND PROMOTING HEALTH AND LONGEVITY. 
77 
I was satisfied, from all the symptoms in the case, that this sin was the cause 
of his wretched condition. He died without recovering his reason : and a 
friend of his, who was in the seminary with him, told me, after his decease, 
that he was indeed a victim of " solitary vice ; that it caused his death." 
A short time since I was conversing with a physician who seemed to feel 
deeply on this subject. " But," said he, " what can be done; I dare not offend 
parents by telling them the habits of their children. Only the other day," 
said he, " I was called to a youth who was destroying himself by this pac- 
tice, but I dared not mention it. The parents would have been very angry 
if I had." 
Dr. S. B. Woodward, superintendent of the hospital for the sane, has the 
following remarks on this practice : " For the last four years," says he, " it 
has fallen to my lot to witness, examine, and mark the progress of from ten 
to twenty-five cases daily, who have been the victims of this debasing habit, 
and I aver that no cause whatever, which operates on the human system, 
prostrates all its energies, mental, moral, and physical, to an equal extent. 
I have seen more cases of idiocy from this cause alone, than from all the other 
causes of insanity. If insanity and idiocy do not result, other diseases, 
irremediable and hopeless, follow in its train, or such a degree of imbecility 
marks its ravages upon body and mind as to destroy the happiness of life, 
and make existence itself wretched and miserable in the extreme." 
That the evil is wide spread and exceedingly injurious to the young, 
cannot be denied or doubted. Its effects upon physical strength and con- 
stitutional stamina are very prejudicial. 
Its influence in prostrating the mind is no less appalling. Consumptions, 
spinal distortions, weak and painful eyes, weak stomachs, nervous headaches, 
and a host of other diseases, mark its influence upon the one-loss of memory 
and the power of application, insanity and idiotism, show its devastating 
effects upon the other. 
It is equally opposed to moral purity and mental vigour. It keeps up the 
influence of unhallowed desires ; it gives the passions an ascendency in the 
character ; fills the mind with lewd and corrupt images, and transforms its 
victim to a filthy and disgusting reptile. 
The evil is common ; its danger little known. Let the young beware of 
it; and those who are in the way of danger, abandon it for ever ! 
Books have been written filled with the most startling facts on this subject. 
See Tissot Graham's advice to young men, and other works. Reader, be- 
ware how you thus hazard your health. 
The best preventative is abstinence, diet, and regimen. To avoid all animal 
food and stimulants, and to use vegetables and fruits only. High living excites 
venery, and leads directly to sensuality and licentiousness. 
CHAPTER XIX. 
MARSHES. 
The neighbourhood of marshes is peculiarly unwholesome, especially 
toward the decline of summer and during autumn, and more particularly after 
sunset. The air of marshy districts is loaded with an excess of dampness, 
and with the various gases given out during the putrefaction of the vegetable 78 
MEANS OF PREVENTING DISEASE, 
matters contained in the waters of the marsh. Persons exposed to this air 
are liable to various diseases, but especially ague, bilious fevers, diarrhoeas, 
and dysenteries. They who breathe it habitually exhibit a pallid counte- 
nance, a bloated appearance of the abdomen and limbs, and are affected with 
loss of appetite and indigestion. Health is best preserved in marshy districts 
by a regular and temperate life; exercise in the open air during the middle 
of the day, and by retiring, as soon as the sun sets, within the house, and 
closing all the doors and windows. The sleeping apartment should be in the 
upper story, and rendered perfectly dry by a fire lit a few hours before going 
to bed, and then extinguished. Exposure to the open air should, if possible, 
not take place in the morning before the sun has had time to dispel the fog, 
which, at its rising, covers the surface of the marsh. Persons who are in- 
temperate, or use ardent spirits habitually, are those most liable to suffer from 
the unwholesome air of marshes ; such generally perish from diseases of the 
liver and dropsy. 
SEA AIR. 
The air upon the sea and in its neighbourhood is generally distinguished 
by its greater coldness, purity, and sharpness ; and is, therefore, in many cases 
directed to patients whose complaints do not affect their respiration, and who 
have vigour of constitution enough to derive benefit from the stimulus which 
such air occasions. A residence by the sea-side is beneficial to persons of a 
scrofulous habit and debilitated constitution, provided they take care not to 
expose themselves to cold and damp ; and in the fine season, when there is 
no reason against it, they ought to bathe. In complaints of the chest the 
use of sea-bathing, and a residence near the sea, are more questionable ; and 
by such an inland rural situation, in a mild equable climate, is to be preferred. 
A sea voyage has long been famous for its good effects at the commencement 
of consumptive complaints ; and these good effects may be ascribed partly 
to the good air at sea, partly to the affection of the stomach and skin induced 
by sea sickness, and to the excitement of the mind, caused by change of scene 
and occupations. 
CHAPTER XX. 
The hair often falls off the head at an age which is quite unnatural, and 
which, therefore, constitutes disease. It is caused by excessive action of 
the brain, such as intense study, great anxiety of mind, afflictions, &c., all 
which cause unnatural heat or inflammation, and this causes the hair to drop 
off prematurely. I know of nothing better for this than bathing the head 
daily with cold water, and rubbing it well with a coarse towel. 
Mary S. Gove, a caustic but sensible writer, thus remarks in her excellent 
lectures on anatomy and physiology: " The hair needs much attention, to 
have it clean and soft. It is much influenced by the health of the body. 
You know that, after a severe fit of illness, fever, &c., the hair falls off. 
People are often led to try this thing and that thing, to prevent the hair from 
falling off. Doubtless there are many pounds of hog's fat sold every year 
HAIR, BALDNESS, AND FASHION. AND PROMOTING HEALTH AND LONGEVITY. 
79 
as Dear's grease, &c., to cause the hair to grow. Correct habits and dally 
washing the head with cold water, and combing it with a fine comb, are the 
best preservatives and restoratives of hair. 
If any one's hair should grow while putting on these quack ointments, 
which after all are only common oil and fat disguised, they may rest assured 
that it would have grown equally well without them. 
It is extremely desirable that the head should be as throughly washed as 
any part of the body, and that, too, every day. When the hair is very thick, 
the roots can be washed without wetting the entire length of the hair. The 
outside of the head has much to do with the inside, whether we know it or 
not; and serious mischief often results from suppressed perspiration in the 
head. Much evil results from loading the head with caps and hoods. We 
should dress the head as light and cool as we can, and be comfortable : 
it is of vast importance, and those who pursue a contrary course may have 
ague, tic doloreux, and even inflammation of the brain, as a reward for fol- 
lowing absurd fashions. But may we not hope yet to see fashions in accor- 
dance with the physiological laws of our nature ? A majority of the present 
fashions are an outrage on humanity, and many of them as repugnant to health 
as they could well be contrived, even had the contrivers sought after the 
most deleterious mode. 
Let us for a moment take a view of some of the " comforts " of a martyr 
to fashion. See her head loaded with hair, natural and artificial, and over 
this a cap heavy with ornaments, and under it exhalations and foreign 
mixtures, in the shape of hair oil, perfumes, &c. Over all is a large, heavy, 
hot bonnet; and drawn closely over the face is the veil, to keep out the 
vital air from the poor compressed lungs. 
CHAPTER XXI. 
BLEEDING, SALTS, AND MINERALS. 
Bleeding.-An opinion prevails that it is necessary to bleed occasionally 
to prevent disease or preserve health. This is a pernicious custom also, and 
ought be deprecated by all who place any value upon their lives. No per- 
son has a drop of blood to lose. This practice, which brings on many dis- 
eases, may afford present relief, but the consequences are very injurious. 
It occasions debility, dropsy, nervous diseases, &c. 
Salts.-Many suppose that it is necessary frequently to take salts, to pre- 
serve their health. This custom is also pernicious. A viscid, thin, or cold 
state of the blood follows the frequent use of the neutral salts. Nor are 
frequent purges of any kind conducive to health. The motto on a certain 
tomb-stone should be remembered by every person, particularly invalids. 
" I was well; I took physic, and died." 
Minerals.-Those who wish to preserve their health must avoid the use 
of all minerals internally. They never were designed by the Author of 
Nature for medicine. They injure the coats of the stomach and intestines, 
and, instead of removing, create diseases. Mercury, which is so universally 
in use, is the worst of all. Vegetables should be used in preference, being 
safer and more congenial to the system. 80 
MEANS OF PREVENTING DISEASE, 
CHAPTER XXII. 
NOSTRUMS AND PATENT MEDICINES. 
We deem it necessary to make a few remarks on the numerous nostrums 
and quack medicines offered for sale. The public are as much duped by 
taking these preparations, as from minerals or poisons administered undis- 
guisedly. It is astonishing to witness the facility with which many suffer 
themselves to be imposed upon by the pompous advertisements of some 
panacea, catholicon, pill, syrup, or universal remedy, which they purchase 
at a high rate from some pretender to a great secret or nostrum. The most 
foolish and palpable preparation is purchased and taken with avidity, pro- 
vided it is kept a secret and highly extolled or puffed. 
Our papers are filled with numerous nostrums, highly recommended for 
the cure of all diseases. " Whoever advertises any medicine," says Tissot, 
" as a universal remedy for all diseases, is an absolute impostor ; such a 
remedy being impossible, and contradictory in our present state, of knowledge. 
I freely appeal to every sensible man, who will reflect a little on the diffe- 
rent causes and symptoms of disease, whether this is not the case." 
Did people know the ingredients of the nostrums which they purchase, 
they would lose all confidence in them. Secrecy, in the minds of the igno- 
rant and vulgar, stamps a great value on every medical preparation. Cheats 
and impostors know this, and thus take the advantage of such persons to 
palm upon them their spurious trash. 
Some allowance, it is true, must be made, when we reflect upon the want 
of a correct system of medical practice. Many persons, finding no benefit 
from learned, fly to ignorant quacks for relief: but there certainly is no 
excuse for such wilful ignorance. When a man advertises that he can 
cure all diseases, or when he publishes a certain cure for all complaints, 
look out for an impostor ; no matter how many certificates are appended or 
exhibited. So, whenever we see a person professing to set or reduce bones, 
when there is neither dislocation nor fracture, then beware of a shameless 
interloper and an empyric. Look out also for those who arrogantly profess 
to have an infallible cure for cancer and some other complaints in all stages ; 
they will generally be found deceivers. The basis of their applications is 
usually arsenic, mercury, or some other poisonous article. 
Most of the lozenges and worm preparations contain mercury ; also many 
other remedies, highly extolled, contain the same deleterious article. 
Many of the syrups and panaceas, denominated vegetable, contain corrosive 
sublimate. 
Many of those persons who profess to cure diseases by vegetable remedies, 
make use of mercury almost exclusively, in some form or other. I here give 
the advertisement of a doctor who is repeatedly resorted to in the city of 
New York by a certain class of invalids, by way of specimen for puffing 
some of these nostrums : 
" Salas Populi Suprema Lex. Dr. H , having been legally bred to 
the medicial profession, confines his attention to a particular disease, which 
engages his most profound attention. His experience is very great; his 
success astonishing. Strangers may find some difficulty in making a choice. 
Dr. H looks down with conscious pride upon all competition ; his real AND PROMOTING HEALTH AND LONGEVITY. 
81 
respectability, skill, and integrity challenge the severest scrutiny. A 
pLurality of offices are provided," &c. 
This is given only as a specimen, but the newspapers are full of them. 
The following recipe is recommended by a doctor : 
" For gout, rheumatism, cramps, contractions of the sinews, &c.-Take a 
young fat dog, kill him, scald and strip off his hair. Then from a small 
incision take out the contents of his belly, and put in the cavity two handsful 
of nettles, two ounces of brimstone, a dozen of eggs, and four ounces of tur- 
pentine, well mixed together. Then sew up his belly, and roast him before 
a fire, and save the oil. This is to be applied to the parts affected, warm, 
and rubbed in by the fire. 
Or, the dog being prepared in the same manner, fill his belly with a pint 
of red pepper, a pint of fish-worms, the bark of sassafras roots, and three or 
four green frogs ; roast him in the same manner, and save the drippings. 
This is a valuable ointment for rheumatisms, contractions of the tendons, 
nervous affections, burns, &c. 
That these preparations, although singular, are valuable, no one need doubt." 
Some time since a German came to this city and proposed to cure all dis- 
eases by inspection of the urine. The old women and girls, as well as men, 
who imagined they were sick, sent a specimen of their urine for the wise 
doctor to learn their symptoms, and prescribe for their diseases. After 
pocketing a good fee, he ordered each one, no matter what was the disease, 
to be copiously and repeatedly bled. The consequence was, that their com- 
plaints were exasperated, and several destroyed. I might easily fill a volume 
on this subject; but a few hints to the wise are sufficient. 
Dr. Mallison has the following remarks on nostrums and patent medi- 
cines : " One of the greatest evils to which our country is exposed, and one 
also which has not been felt the least, is the use of nostrums and patent 
medicines ; the number of which that are offered for sale at the present day 
are almost innumerable; each of which is said to be a specific for nearly, or 
quite, all of the diseases to which a human being is subject. Now, it is high 
time the public should open their eyes and resist those gross impositions 
which have been the cause of many premature and untimely deaths. The 
honest and unsuspecting sufferers, who are labouring under afflicting dis- 
eases, feeling anxious for relief, and being induced by the high recommen- 
dations attached to these drugs, and likewise being ignorant of their compo- 
sition, vainly trust in them for relief, till many times their complaints advance 
beyond the reach of the most efficacious and judiciously applied remedy 
This has come under my immediate observation more than once. I am 
well aware, however, that certificates are sometimes obtained purporting cures 
to have taken place while the persons were using some of those nostrums 
but I am fully inclined to believe that most of such cures were accomplishea 
by the powers of nature overcoming the effects of the disease, and 1 think 
that it frequently had to overcome the effects of the remedy also. For it 
is an absolute fact, of which all persons may satisfy themselves, if they will 
only take the trouble to inquire of individuals who have been in the habit 
of using these articles, that nine times out of ten they have either been of 
no use or actually injurious. And if certificates should be obtained, accord- 
ing to the real effect they have produced, from all who have used these medi- 
cines, it is certain that not more than one out of ten would be in support of 
them. Did the public know the composition of these nostrums, which they 
certainly ought before hazarding the application of them, they would undoubt- 
edly detest the most of them as odious and baneful. The nostrum called 82 
MEANS OF PREVENTING DISEASE, 
' Panacea ' contains for its base corrosive sublimate, upon which all its virtues 
and activity depend. This is a fact which has been demonstrated by myself 
and others. Corrosive sublimate is a preparation of mercury, of which if a few 
grains should be taken into the stomach, it would undoubtedly produce death 
in a short time, if not immediately counteracted. I know of a case of scro- 
fula where the panacea has been given and relied on for a cure, until the 
young lady has become a spectacle to behold, and in all probability will remain 
a miserable and distressed object during the remainder of her life, in conse- 
quence of this deleterious mercurial effect, which is now one of the greatest 
scourges to our land. The Welch Medicamentum, of which it is said, " if 
a person uses he will never need nor require the healing art," is nothing more 
nor less than a compound tincture of aloes, diluted and mixed with a few 
aromatics, more to disguise it than to sooth its operation. The active articles 
in this preparation are fit for little else than medicine for horses, on which 
they operate, it is said, very well. A celebrated remedy, recommended and 
sold for a preventive and cure for fever and ague, contains a quantity of 
arsenic. The virtues of Anderson's Cough Drops depend on the opium 
which they contain. A preparation sold for the cure of dyspepsia, and 
which has gained considerable celebrity, is wholly dependant on prussic acid 
for its active agency. Now, prussic acid is a substance which, if one drop 
should be applied to the tongue in its concentrated state, would produce 
death as quick as an electric shock. I have known this article also to be 
taken until the society of the person, which was once pleasant and delightful, 
was rendered tedious and disagreeable even to his nearest friend, in conse- 
quence of the nervous and hypochondriacal affection it produced. What a 
curse is this ! How loaded with guilt must be the author of such a calamity ! 
It calls for a voice as loud as the thundering of the heavens to speak against 
it. I have been waiting for an elder practitioner of medicine to take up the 
pen against these life-destroying agents, until the scenes of human misery 
which were presented before my eyes, forbid my waiting any longer. Where 
is the man who knows these statements to be correct, and who has the least 
spark of a philanthropic spirit, that can sit and hold his peace, and see huma- 
nity and innocence thus tortured ! I write the above through a feeling sense 
of duty, knowing that the high recommendations which most of these nos- 
trums have received to be base fabrications ; and knowing the danger to 
which a person is exposed by using an article of medicine that he knows not 
the nature of, and having seen from time to time the injurious effects of these 
articles, I now candidly say to the public, ' Be particular, as you value your 
lives and health, to avoid all nostrums and patent medicines of which you 
know not the nature nor composition.' And the practising physician who 
uses or recommends to his patients these articles, only indirectly acknow- 
ledges that he has no confidence in his own preparations of medicine, and 
his ignorance of the healing art." 
A vile compound called " Dr. Taylor's Balsam of Liverwort," has obtained 
great notoriety by constant puffing, forged certificates, &c. To my certain 
knowledge two persons had their certificates forged and published. The 
preparation is worthless; the basis being fox glove and opium. Besides, 
there is no such person as Dr. Taylor : and the proprietor, Dr. Thayer, who 
amassed a fortune by the preparation, lately died of consumption, the very 
complaint for which it is so highly recommended. But it seems that the 
greater the humbug, the greater the patronage. 
Pease's Hoarhound Candy, as well as most of the compounds advertised, 
is a base imposition : and I would ask what kind of a conscience can these AND PROMOTING HEALTH AND LONGEVITY. 
83 
nostrum-mongers have, thus to cheat and gull the sick out of their hard 
earnings ? Why do not the editors of papers expose such villainy ? because 
no doubt their interest is at stake. 
" If any one wishes for a medicine that will infallibly cure every ill 
which flesh is heir to, he has only to take up the nearest paper, and he will 
assuredly find it advertised." Invalids often fancy that these nostrums benefit 
them : so did a woman who was in the habit of sending to a neighbouring 
doctor for pills, for a long period : she seemed to think that she could not 
live without them. One day she felt quite unwell, and, having no pills on 
hand, requested her husband to go for some. He started, and on his way 
he concluded to substitute sheep's dung, (which in appearance so nearly 
resembles pills,) and, instead of going to the doctor's office, he went to the 
cow-yard for them. He returned to the house, and his wife swallowed down 
the supposed pills, and she soon recovered : she was then told what she had 
taken. It is hardly necessary to add, that she had no more occasion for the 
same medicine. 
" A physician of my acquaintance," says M. S. Gove, " whose mother 
was obliged to take calomel pills, substituted bread pills, and his mother 
assured him they had a very powerful effect, and relieved her immediately." 
A person in Philadelphia, by the name of Swain, a bookbinder by trade, 
amassed a large fortune by a certain syrup called Panacea, the basis of which is 
sarsaparilla. It is now like Dr. Solomon's Balm of Gilead, who also amassed a 
princely fortune-fallen comparatively into disease. Time and space would 
fail to enumerate all the quack medicines with which our land abounds. 
The distinguished Hoffman lays down as one of his seven rules of general 
health, " avoid medicine and physicians, if you value your health and he 
might have added, the calamitous, pernicious, and wide spreading evil of the 
eternal and suicidal mania of pilling, pilling-drugging, drugging. The 
whole land is flooded, from Dan to Bursheba, with quack medicines ; and there 
is no knowing what amount of injury they inflict on a diseased community. 
The evil ought to be met, overcome, and destroyed. People must be con- 
vinced of the nature and effects of those compounds puffed into circulation 
for gain ; and besides, there must be placed before them a judicious practice 
of medicine. If after all this they will take these nostrums, there is no 
hope of their reformation: let them be humbugged. 
CHAPTER XXIII. 
ELECTRICITY. 
The application of electricity having been recommended for the cure of 
so many diseases, it becomes proper to make a few remarks upon its nature 
and effects. Ever since the discoveries made by Doctor Franklin, it has 
been resorted to by medical men and others, for the alleviation and cure of 
disease ; and in the present day many consider it as a specific for every com- 
plaint that " flesh is heir to." I know of no disease for which its advocates 
have not strongly recommended it; but I have very satisfactory evidence 
that most of the cures said to have been wrought by its agency must, like 
many other reputed remedies, be owing more to dame nature than any 
specific or medicinal effects which it possesses. 84 
MEANS OF PREVENTING DISEASE, 
I have had ample opportunities, since I commenced the practice of medi- 
cine, of testing its efficacy. I have kept a machine and superintended its 
administration, and, after abandoning it for want of success, I have recom- 
mended my patients to several persons in this city, two of whom are pro- 
fessed electricians : but I am now constrained to state, that I am very much 
disappointed in its operation and effects, having seen very few cures performed 
in the multiplicity of cases in which it has been applied; and some diseases 
have been aggravated by it. 
In palsy it is said to have been beneficial, and probably has in some cases 
relieved or cured it, particularly when it has been partial, or confined to a 
particular part of the system : but in other cases it has proved injurious. 
It may be serviceable in rheumatism and some other chronic complaints. It 
has been highly extolled in inflammatory diseases, but there is no evidence 
that it proves beneficial in any of them ; on the contrary, I think that, in ge- 
neral, it aggravates them. It has also been highly spoken of in cancers and 
scirrhous tumours of the female breast; but I have tried it in these com- 
plaints, and have never derived any advantage from it. Some good, no 
doubt, is sometimes derived from the effect it has upon the imagination. I 
wish, however, not to dissuade any one from trying it as an experiment in 
those diseases in which it is highly recommended, and particularly where 
other means are found unavailing. 
CHAPTER XXIV. 
THE PASSIONS. 
Such is the connexion between the body and the mind, that one cannot 
be affected without a correspondent or sympathetic affection of the other. 
But how this union of matter and mind exists, this material and immaterial 
connexion, is a subject of profound astonishment, which must ever remain a 
mystery to the greatest philosopher or metaphysician. The most we know 
is, that the nerves are the connecting medium between the soul and the body. 
Hence certain passions or mental affections have great influence over the 
system, and likewise whatever affects the body must, in like manner, affect 
the mind. It therefore becomes necessary to study the nature, causes, and 
symptoms of this reciprocal action ; but in this place the passions more 
especially form the subject of inquiry. Those passions which are the most 
subject to derangement, or to an unreasonable and morbid excess, are Zo»e, 
griefs fear, and anger. To these we might add, joy, envy, malice, and hatred. 
LOVE. 
This passion may, with propriety, be divided into two species or kinds : 
one is a supreme attachment to the Creator; the other, to the creature. 
1. Love to the Creator.-This constitutes the most noble, the most sublime, 
and the most heavenly of all the passions that actuate the human breast. 
That being whom the heaven of heavens cannot contain, is emphatically 
pronounced Love: from which we may infer that this is the most holy 
and blissful attribute of Deity, and the only true source of happiness to men 
and angels. AND PROMOTING HEALTH AND LONGEVITY. 
85 
The exercise of this passion constitutes a Heaven, while its opposite 
passion, anger, constitutes Hell and the sufferings of the damned. There 
is, therefore, no passion which exercises such a healthful and important an 
influence as pure, celestial love. It is a fact which has been confirmed by 
thousands, that the most inveterate and dangerous diseases, such as have 
baffled the skill of physicians, have been removed by the influence of that 
love which has followed the pardon of sin. While Anger, on the other hand, 
has brought on fatal and incurable diseases. There is, therefore, the highest 
incentive for us, both in a temporal and spiritual point of view, to be brought 
under the influence of this love. 
2. Love of the Creature, or Carnal Love.-The love of the Creator, just 
spoken of, begets a correspondent love to all mankind ; not a carnal or sel- 
fish love, but a pure, disinterested affection, emanating from a divine influ- 
ence, and, so far as it is exercised, is noble, praiseworthy, and highly benefi- 
cial to society. But there is another kind of love, which admits of two 
species, and both of which are very different in their effects. 
1. Selfish Love.-This consists in a supreme regard to ourselves, and 
those only through whom we derive some personal benefit. This originates 
from low and sordid principles, and is one great cause of the misery in the 
world. 
2. Carnal Love.-I now come to speak of that kind of love to which 
authors who write upon this passion invariably allude. They make no dis- 
tinction between the several kinds of this passion, but treat of it as emanating 
from one source. Whereas, it appears evident to me that the most clear 
distinction should be observed. There appears to be as much difference 
between disinterested and carnal love, as there is between any two diverse 
or opposite passions. A person becomes attached to a female, which he con- 
siders love, and, in the commencement, it may be disinterested love. But the 
next sensation is a carnal passion, which is associated with lust. When 
this is the case, it certainly, in my opinion, ceases to be genuine love; but 
how far this latter passion is consistent with the highest and best principle 
of love, or whether it is permitted in divine wisdom expressly to procreate 
the human species, I shall not attempt to decide. But I have seen so much 
misery result through mistaken notions of this passion, by reason of substi- 
tuting carnal for disinterested love, that I wish to draw a clear distinction 
between the two kinds. It is a question in the minds of many, how far the 
fall of man from his primeval state of simplicity has deranged this passion, 
and introduced selfish and carnal love. But it does appear that Deity, on 
account of the first trangression, permits the present state of things for wise 
purposes, however much it may differ from his original design. 
There is one thing, however, to which I wish to call the attention of the 
reader, and which points out, and seems to show, an irreconcilable difference 
between the two kinds of love, viz., disinterested and sensual. I allude to 
the testimony and experience of some of the best men, who have lived in 
any age of the world. They state that the two proceed from sources 
entirely opposite ; that, when spiritual and disinterested love pervades the 
soul, carnal love is entirely overpowered, suspended, and vice versa. 
It may not be improper here to state, while writing upon the passion of 
love, according to the common acceptation of the term, that its influence 
and effect upon the mind is, in every case, very insiduous and gradual; that 
the subject of it, from a state of indifference, slowly and imperceptibly is 
brought under its influence, until it becomes fairly seated in the mind ; when 
this is the case, it may be ranked among the strongest passions, and, when 86 
MEANS OF PREVENTING DISEASE, 
it is disappointed in its object, it becomes a disease and a subject of medical 
attendance. Every person should be well conversant with this fact, who is 
desirous of " avoiding entangling affections." The passion of love is pro- 
duced on the principle of association, which begets assimilation or attach- 
ment, from which every one may learn the prevention, if not the remedy 
There is one remarkable fact respecting this passion, which I shall here 
mention, and that is, that love creates the most irresistible and powerful im- 
pression between the ages of twelve and sixteen-a truth which shows the 
necessity of pointing out proper remedies. Again ; it is equally striking, and 
a fact of great practical importance, that frequently after disappointment in 
love, or even possession of the object, indifference or hatred succeeds, and 
the subject of it will soon be again under the influence of this passion to- 
ward another person. Perhaps, however, I should in some measure except 
the female sex. For the late Aaron Burr, after having taken leave of an 
elderly lady who was much attached to him when young, thus remarked : 
" That woman loves me yet, for a woman's love never dies." 
Symptoms.-The symptoms of love, when it creates disease, are well 
known: melancholy,loveofsolitude,sighing,wakefulness, &c. It sometimes 
has a great influence upon the system, such as dyspepsia, hysterica, hypo- 
chondriasis, fever, and mental derangement-the latter of which has some- 
times ended in suicide, while the others have occasionally terminated fatally. 
It is remarkable, that those who have been cured of any of the diseases 
from love, particularly by medicines, recover without possessing any affec- 
tions for the persons whom they formerly loved. It is stated that this was 
the case with one of the princes of Conde. He said that his physicians had, 
by their remedies, drawn off all his love for his mistress. 
Treatment. Avoid the company of the object.-When a cure is desired 
for love, an opposite course must be taken from that which caused it. As- 
sociation first begat assimilation, as stated above : it now becomes necessary, 
inorder to cure it, to pursue an opposite course, and keep from the company 
of the object beloved. By seeing the person often, it only adds fuel to the 
fire. A voyage or journey should be undertaken ; for absence has been 
justly styled " the tomb of love." 
Medicine.-If the passion has become so seated as to create any specific 
disease, appropriate remedies must be prescribed. These should be adapted 
to particular symptoms. The stomach must be cleansed, the bowels regu- 
lated, and a restorative course of treatment pursued. 
Divide the Affections.-Let the person labouring under this passion, and 
who wishes to be cured of it, mix in cheerful company, and let him or her 
select from the multitude another object, whose attractions shall engage the 
attention; by this means the affections become divided between the two 
objects, and the passions become weakened or entirely destroyed. Ovid 
speaks of this, and compares it to a river or stream which has dried up after 
it has become divided. 
Recreation and Rural Scenery.-.Recreation and rural scenery will con- 
tribute very much to the destruction of this passion. Let the person travel 
and behold the beauties of nature. Let the flower-garden be cultivated. 
Let cheerful and amusing books, of a moral tendency, be perused. 
Indignation.--I wish to suggest or recommend nothing inconsistent with 
morality or religion, nor anything calculated to excite any of the passions. 
But, in a medical point of view, I trust I shall be excused, if I recommend 
one passion less violent, more transient, and less injurious in its effects, for 
the purpose of removing another. I therefore would recommend the indul- AND PROMOTING HEALTH AND LONGEVITY. 
87 
gence of a suitable degree of spirit and indignation against the object loved, 
sufficient at least to remove the inordinate degree of love ; not, however, 
to the exclusion of friendship and benevolence. 
In accordance with this, I would advise the person labouring under this 
passion to indulge the opposite passion, viz., dislike or aversion. Let his 
or her ill treatment, deformities, and defects be constantly brought to mind, 
and in this way victory may be obtained. Many have been perfectly cured 
by this alone. 
Let the person under the influence of this passion exercise fortitude and 
resolution. Let him spurn the thought of being injured by becoming a dupe 
to this puerile, slavish, and transient passion, which subsides as soon as the 
object is possessed, and which is often followed by indifference, and even 
disgust, wrangling, quarrelling, care, burden, perplexity, to which " single 
blessedness " is a stranger, to say nothing of the grief and sorrow entailed 
by a numerous, and perhaps wicked, offspring. Think of the troubles from 
which you will be exempted, by living in a single state, and enjoying the 
company of your friends, without your affections being so divided as to render 
their company irksome. 
Morality and Religion.-Above all, let morality and religion be another 
incentive to you, to banish this passion for the creature, and to place your 
affections upon your Creator. Think how much better you can serve Him, 
divested of the cares of a family. Think of the fact that is so much com- 
plained of by Christians, that as soon as they get married their cares and 
affections are such, that they appear to lose all love for their Creator. 
Let Hope in the Lover be extinguished.-A celebrated writer has the 
following pertinent remarks upon this passion : " As hope and love are born 
together, so they can only die together." Uncommon pains, therefore, 
should be taken, in curing love, to extinguish every spark of hope in a lover. 
This advice is given with singular good sense and humanity by Dr. Gregory, 
in his legacy to his daughters, upon the subject of courtship and marriage. 
GRIEF. 
Few, if any, of the passions are more severe or more injurious than grief. 
Fear and anger, though more violent, are of shorter duration. Grief con- 
sumes slowly, and undermines the constitution, and is much more perma- 
nent in its effects than most any of the passions ; and, where it is very deeply 
seated, sometimes proves fatal. 
Symptoms.-The symptoms of grief are languid circulation ; contraction 
of the heart; slow, weak, and unequal pulse ; paleness, fretfulness, loss 
of sleep and appetite, flatulence, and dyspepsia. In females it is sometimes 
accompanied with suppressed menstruation ; indeed all the functions of the 
body become impaired by the indulgence of this passion ; and such is the 
effect on the mind, that the subject of it cannot enjoy health. 
A very sudden and powerful attack of grief causes hysteric and apoplectic 
fits, and sometimes it ends in loss of memory, marks of premature old age, 
melancholy, and insanity. 
Dissections of those who have died of grief discover congestion in, and 
inflammation of, the heart, with a rupture of its auricles and ventricles. 
Grief produces contraction of the womb, miscarriage, &c.; it destroys the 
circulation of the fcetus ; produces a relaxation of the muscles of the spincter 
and of the bladder. 
There is another peculiar symptom of grief not generally noticed, which 88 
MEANS OF PREVENTING DISEASE, 
is, that of profound sleep. A mothex' that has just lost a child often sleeps 
profoundly. The keeper of Newgate, in London, states, that criminals sleep 
soundly the night before their execution. The son of General Custine, in 
Paris, slept nine hours the night before he was led to the guillotine. The 
disciples of our Saviour slept during his agony in the garden, in consequence 
of a sorrow having filled their hearts." 
Treatment. Anodynes.-When grief seizes a person suddenly and power 
fully, very much shocking the system, an opium pill may be administered 
Should paroxysms or urgent symptoms occur, it may be repeated. 
Purgatives.-Should grief so prey upon the system as to create great ex- 
citement, a purgative may be administered : while it lessens the excitement, 
it will also obviate costiveness, a very attendant symptom upon this passion. 
Silence.-Conversing much with persons labouring under this passion 
often exasperates it. Silence is better than much conversation. 
There is science, says a writer, as well as sympathy in this silence ; for 
in this way grief most rapidly passes from the bosom of the sufferer into 
that of his friend. 
Solitude.--Grief is generally increased by solitude. When a person is 
afflicted with grief, he feels much more distressed when he is alone, no doubt 
by dwelling on the cause of it. Solitude should, therefore, by all means be 
avoided. 
Friends.-A person seized with grief almost invariably flies to his or ner 
nearest friend, to unbosom and unload the mind of its sorrows. Such a friend, 
if he is one indeed, receives a portion of the sufferings, which immediately 
lessens the affliction. Therefore the company of friends should be resorted to. 
Religion.-The greatest consolation is, no doubt, derived from religion. 
The sufferer should remember well that afflictions arise not from the dust ; 
that every event is permitted by Divine Providence, and under his superin- 
tendence, and that his afflictions or bereavements have been wisely dispensed, 
even for his or her individual benefit, however heart-rending the present 
trial may be. We should recollect that the Creator deals out afflictions and 
trials to the children of men with the same scrupulous exactness as the 
apothecary or physician deals out his medicines ; and that there is perhaps 
little, if any, difference in the aggregate between the various classes of 
society as regards their amount of suffering. The poor, who are so liable 
to complain of their condition in life, experience less afflictions than the 
rich, for various reasons which might be assigned. 
Change of scenery.-The mind in distress may be much relieved by a 
change of scenery. Let there be a constant succession of new ideas and 
new objects to divert the attention. Travelling, sailing, the study of any 
art or science, reading or writing on interesting subjects, &c., will sooner 
assuage grief than many other amusements. When the mind has nothing 
else to think about but its misfortunes and calamities, it is sure to indulge in 
grief. Some business, therefore, should be rigidly followed. 
Persons suffering under any misfortune should carefully abstain from the 
use of ardent liquors, as they are apt to fly to it for relief, and thus become 
intemperate. • 
In communicating sad tidings, it never should be done all at once, but 
gradually, that the mind may be prepared for it. 
ANGER. 
This passion exerts a most violent and powerful effect op the system AND PROMOTING HEALTH AND LONGEVITY. 
89 
When it ascends to rage and fury, or when it is protracted into malice and 
revenge, it becomes a sin, and proves very destructive to health. 
Symptoms.-A paroxysm of anger produces a determination of blood to 
the brain; fulness of the bloodvessels of the face; redness of the eyes; foaming 
at the mouth ; volubility or total suppression of speech ; agitation of the 
fists ; stamping of the feet; and uncommon bodily strength. It sometimes 
causes hysteria, haemorrhage, and mania. It affects the sanguiferous and 
nervous system, produces vomiting, and often breaks a bloodvessel, or brings 
on apoplexy. It causes a return of epilepsy; bleeding at the nose ; affects 
the secretions of the liver; induces colic, diarrhcea, faintings, and convulsions. 
Treatment.-When that portion of the brain which gives rise to a certain 
passion or emotion becomes unduly excited, the balance of cerebral power 
is lost, and there is an undue excitement, which is manifested in anger, des- 
pondency, or some other passion. 
I have witnessed persons under great passion or grief, who were frantic, 
and in a few moments, after conversing with them calmly, the mind was 
restored to its proper tone. Therefore the best remedy in all cases of pas- 
sion, as well as nervous diseases and insanity itself, is to apply to the brain a 
counterirritant, or to make an opposite impression ; and this may be denomi- 
nated the cordial of good or kindness, which overpowers the impression of evil 
or morbid excitement. 
The remedies for anger, when it becomes a disease, may be divided into 
two classes : First; Such as are proper during its paroxysms. Second; 
Such as are proper, during their intervals, to prevent a recurrence. 
1. During a paroxysm.-Let a person labouring under this passion drink 
a tumbler of cold water : it gives time for the rage to subside, and also 
gives time for reflection. Cold water thrown over the whole body has cured 
a paroxysm of anger. It never fails to part two contending fowls or dogs. 
Resolution.-Let the whole powers of the mind be concentrated instanta- 
neously to form a resolution not to indulge in the passion of anger. This is 
the most powerful of every other means to suppress it. 
Absence from the exciting cause.-As soon as a person is attacked with a 
paroxysm of anger, let him immediately absent himself from the exciting 
cause of it, except there is a strong probability of a reconciliation by seeing 
the person who has occasioned it. When this is the case, be resolved to 
meet the person with as much calmness as possible, and let the subject be 
conversed upon. In such cases the difficulty is often settled, and a greater 
friendship follows. 
2. Means of preventing a recurrence of Anger.-Those who are very pas- 
sionate should avoid all stimulating drinks and liquids, as nothing tends 
more to inflame the passion of anger than these. It is owing to this that 
even friends, when they assemble together and drink ardent spirits, often 
begin to wrangle, quarrel, or fight. Dr. Arbuthnot states that a milk and 
vegetable diet has cured a very angry disposition. 
Silence.-Whenever a person becomes very angry, let him be silent, and 
neither say nor do anything to fan the flame of anger. 
Science or education.-These have a great tendency to eradicate from the 
breast the baneful passion of anger. They teach the mind that there is true 
wisdom and philosophy in abstaining from the indulgence of such an unholy 
and pernicious passion. 
Opinion of others.-Those that are subject to fits of anger should recollect, 
in their calmer moments of reflection, that, when they exhibit a paroxysm of 
anger, they render themselves as ridiculous as a drunken man. 90 
MEANS OF PREVENTING DISEASE, 
" It will be useful for persons subject to the criminal degrees of this pas- 
sion," says Dr. Rush, " to reflect that it is not only contrary to religion and 
morals, but to good manners. The term gentleman implies a command of 
this passion above all others." 
Religion.-There is nothing so powerful to allay the tumults of this mighty 
passion as religion. It is this alone that seems fully capable of eradicating 
it from the human breast. It is remarkable that real Christians have been 
incapable of showing the least anger under the most aggravating circum- 
stances. Therefore, whoever labours under this besetting sin, should pray 
earnestly to God for its removal. 
Medicine.-When anger causes bilious and hepatic diseases, appropriate 
medicines must be administered, which will be hereafter mentioned. 
FEAR. 
Fear, which was no doubt implanted by the Creator for a wise purpose, 
exerts a great influence over the animal economy. Fear and anxiety, by 
depressing the spirits, not only dispose us to diseases, but have a tendency 
to aggravate them, or even render them fatal. 
Symptoms.-The effects of fear, when it acts suddenly upon the system, 
are tremours, quick pulse and respiration, globus hystericus, a discharge of 
urine, diarrhoea, and sometimes an involuntary discharge of the faeces, fever, 
convulsions, fainting, madness, and death. Dr. Brambilla relates the case 
of a soldier in whom fear produced not only a fever, but a mortification from 
a blister on the leg, which destroyed his life. Besides these general effects 
of fear, it acts in a peculiar manner upon the hair of the head. First; in 
causing it to stand perpendicular. This has been described by Virgil and 
Shakspeare. Secondly ; in converting it suddenly to a gray or white colour; 
and, thirdly, in causing it to come out by the roots and to fall off the head. 
Of this Dr. Huch states, that he knew an instance of a gentleman who was 
in Lisbon at the time of the great earthquake, in 1755. 
Other effects of fear have been lately noticed. The earthquake which 
took place on the shores of the Mississippi, in December, 1811, produced 
silence or great talkativeness, and moping stillness or constant motion, in dif- 
ferent people. 
Treatment.-Although fear appears to be in a considerable degree consti- 
tutional, yet it may be moderated or measurably overcome, by habit, the 
exercise of reason, philosophy, and religion. 
Those subject to this passion should endeavour to exercise fortitude of 
mind. They should reflect that they have no just grounds or reason to 
fear anything which can happen unto them, provided they are in the line of 
their duty, and act conscientiously ; that nothing will be permitted to over- 
take them but such as is for their benefit. In a word, they should endea- 
vour to exercise perfect resignation, ever bearing in mind the following lines 
of the poet: 
" Through all the downward tracts of time 
God's watchful eye surveys ; 
O, who so wise to choose our lot, 
Or regulate our ways. 
I cannot doubt, his bounteous love, 
Unmeasurably kind ; 
To his unerring, gracious will, 
Be every wish resigned. AND PROMOTING HEALTH AND LONGEVITY. 
91 
Good when he gives, supremely good. 
Nor less when he denies ; 
Even suff'rings from his sov'reign hand 
Are blessings in disguise. 
Here happiness cannot be found, 
The honey *s mixed with gall, 
'Midst changing scenes and dying friends, 
Be thou my all in all." 
Fear of Thunder and Lightning.-Dr. Rush has the following judicious 
remarks upon the prevention of fear in thunder storms : 
" The remedies for it are, 
1. Living in a house defended by a lightning rod. 
2. Sitting in the middle of a room, and remote from the doors and windows 
of a house not defended by a lightning rod. 
3. A citizen of Philadelphia, who was under the influence of this fear, 
obviated it in a degree by closing the doors and windows of a room, and 
sitting with a lighted candle in it. By this means he avoided the sight of 
the lightning and the anticipation of the noise of the thunder which usually 
follows it. 
4. A lady of respectable character, formerly of this city, usually fainted 
with terror during the time of a thunder-gust, and discovered, by a livid 
countenance and cold and clammy sweats, the signs of approaching death. 
She was apparently kept alive by pouring into her stomach three or four 
wine glasses of Jamaica spirits : it was remarkable she never was intoxicated 
by it, and that it was disagreeable to her at all other times. 
5. I crossed the Atlantic Ocean with a lady, in whom an acute headache 
was always induced by thunder. It left her as soon as the thunder ceased. 
Her only remedies for it were quietness and silence. It is probable a large 
dose of laudanum, taken upon the appearance of a thunder-gust, would have 
prevented this headache, as well as obviated the terror mentioned in the 
two preceding cases, more effectually than a close room artificially lighted, 
or a large quantity of ardent spirits. 
2. The fear which is excited by darkness may easily be overcome by a 
proper mode of education in early life. It consists in compelling children 
to go to bed without a candle, or without permitting company to remain 
with them until they fall asleep. 
3. The fear of ghosts should be prevented or subdued in early life, by 
teaching children the absurdity and falsehood of all the stories that are 
fabricated by nurses upon that subject. 
4. The fear from speaking in public was always obviated, by Dr. John 
Hunter, by taking a dose of laudanum before he met his class every day. 
5. The fear from sailing, riding, and from certain animals and insects, may 
all be cured by resolution. It should be counteracted in early life. The 
existence of it always shows a defective education. Peter the Great, of 
Moscovy, was born with a dread of water. He cured it by throwing himself 
headlong into a boat when obliged to cross a river. The horror he felt in 
doing this often induced syncope. He finally conquered his dread of water, 
so as to cross seas in pursuit of the great objects which characterized his 
life and reign. 
In cases of sudden fear from any cause, holding the breath, coughing, or 
hawking often give immediate relief; they impart tone to the brain, by pro- 
moting a determination of blood to it, and thus infuse vigour into the mind. 
To obviate fear from all its causes, great advantages will arise from creating 92 
MEANS OF PREVENTING DISEASE, 
counter motives in the mind. The fear of death in a battle is overcome by the 
powerful sense of glory or shame. The fear of the pain of an operation, such 
as drawing a tooth from a child, is overcome by the expectation of receiving 
afterward a piece of money, and the prospect of all the pleasures it will procure. 
Great advantages may likewise be derived for the cure of fear, by a proper 
application of the principle of association. A horse will seldom be moved 
by the firing of a gun or the beating of a drum, if he hears them for the first 
time while he is eating ; nor will he start or retire from a wheelbarrow, or 
a millstone, or any other object of that kind, after being once or twice fed 
upon them. The same law of association may be applied in a variety of 
instances to the human mind, as well to the prevention as cure of fear." 
OF JOY. 
" This emotion," says Dr. Rush, " is attended sometimes with pain in the 
region of the heart, a change in the voice, tears, syncope, and death. Mr. 
Bruce mentions another symptom of excessive joy, and that is thirst, which 
he felt in a high degree when he reached the long sought-for head of the 
Nile. He gratified it, he tells us, by drinking the health of his sovereign, 
George the Third, and of his mistress, by a draught from the fountain of that 
celebrated river. 
Joy is most intense when it has been preceded by fear. The Indian chief, 
Logan, has designated this form of joy in his eloquent speech, preserved by 
Mr. Jefferson in his notes upon Virginia, when he declares that " he knew 
not the joy of fear." 
There are many instances upon record of death being induced by a sudden 
paroxysm of joy. The son of the famous Leibnitz died from this cause, upon 
his opening an old chest, and unexpectedly finding in it a large quantity of 
gold. Joy from the successful issue of political schemes or wishes has often 
produced the same effect. Pope Leo the Tenth died of joy, in consequence 
of hearing of a great calamity that had befallen the French nation. Several 
persons died from the same cause, Mr. Hume tells us, upon witnessing the 
restoration of Charles the Second to the British throne : and it is well known 
the doorkeeper of Congress died of an apoplexy, from joy, upon hearing the 
news of the capture of Lord Cornwallis and his army, during the American 
revolutionary war. 
During a paroxysm of joy, if it be attended with danger to life, a new emo- 
tion or passion should be excited, particularly terror, anger, fear, or grief. 
Perhaps the effusion of cold water might have that effect. The stimulus of 
artificial pain should likewise be tried: it should be of a nature calculated 
to produce the most prompt effects. 
The morbid state of joy should be prevented by imparting the news which 
we expect will create it, in a gradual manner, and with the alloy of some 
unpleasant circumstances. 
Connected with joy, but produced by different causes, is laughter. It 
is a convulsive disease, and sometimes induces a rupture of a bloodvessel in 
the lungs, spleen, or brain. I have seen bleeding of the lungs induced by 
it, which had a fatal issue. Two sudden deaths are upon record from it- 
the one of Chrysippus, an ancient Greek philosopher ; the other of a pope. 
It was induced in the latter, while he was confined to his bed with a slight 
indisposition, by seeing a tame monkey put on a part of his pontifical robes. 
Excessive laughter, when not attended with these fatal effects, is often fol- 
lowed with a pain in the left side, hiccough, and low spirits. AND PROMOTING HEALTH AND LONGEVITY. 
93 
The remedies for a paroxysm of laughter should be fear, terror, or any 
other counter impression. Pinching the body, or the affusion of water over 
it, is calculated to produce the same good effects. Laudanum seldom fails 
to relieve the pain, hiccough, and low spirits which sometimes follow it." 
ENVY, MALICE, AND HATRED. 
The indulgence of these baneful dispositions is attended by injurious 
effects on the moral and physical part of man. They eat and corrode the 
mind like a canker. It has been said, by an inspired writer, to resemble 
" rottenness in the bones." It emits its poison not only against friends, but 
likewise those who have rendered the subject of it the greatest favours. 
Where such an unholy disposition dwells, the mind cannot enjoy peace. 
It is, therefore, best to use every exertion to overcome it, and, by repeated 
attempts, we may succeed. I know by experience that it is difficult not to 
cherish unfriendly feelings toward those whom you have benefited, and, 
instead of gratitude from them, receive ill treatment and injury. I have, 
with others, experienced a large share of such conduct, and know how 
very aggravating it is ; but still, it is a duty to submit as patiently as pos- 
sible, and endeavour to overcome evil with good, by forbearance and charity 
Let the revengeful man write down his feelings on the occasion, and after- 
ward peruse them. But the true antidote is to be found in religion, which 
enables us to love our enemies. 
There is now and then a torpor of the passions, the reverse of the diseases 
in those which have been described. Instead of being unduly excited, they 
are devoid of all sensibility and irritability. Those who are thus affected, 
love and fear nothing: they are strangers to grief and anger ; they envy 
and hate nobody ; and they are alike insensible to mental pleasure and pain. 
" I was once consulted by a citizen of Philadelphia," says Dr. Rush, " who 
was remarkable for his strong affection for his wife and children when his mind 
was in a sound state ; he was occasionally afflicted with this apathy, and, 
when under its influence, lost his affection for them all so entirely, that he 
said he could see them butchered before his eyes without feeling any dis- 
tress, or even an inclination to rise from his chair to protect them. 
This paralytic state of all the passions continues during life in some peo- 
ple. A physician of great eminence, who died some years ago in England, 
declared, upon his death-bed, that he had never known what it was to love 
man, woman, or child. But we sometimes meet with this disorder in a par- 
tial state. Thus, there are men who have never loved ; others who have 
never feared ; others who have never shed a tear ; and others in whom inju- 
ries have never excited an emotion of anger. In such persons the mind is 
in a mutilated state ; for man, without all his passions, is an imperfect being, 
both as to his duties and happiness. 
The remedies for this torpid state of the passions, whether general or 
partial, should be suited to the state of the system. ' Purgatives will be 
proper, if the bloodvessels are oppressed. In a contrary state of the system, 
powerful stimulants, particularly pain, labour, and the cold bath, are indi- 
cated." 
In conclusion I would observe, that the due regulation of the passions 
contributes much to health and longevity. The animating passions, such 
as joy, hope, love, &c., when kept within proper bounds, gently excite the 
nervous influence, promote an equable circulation, and are highly conducive 
to health ; while the depressing affections, such as fear, grief, and despair, 94 
MEANS OF PREVENTING DISEASE, 
produce the contrary effect, and lay the foundation of the most formidable 
diseases. 
INFLUENCE OF THE MIND ON THE BODY, PASSIONS, ETC. 
Bad news weakens the action of the heart, oppresses the lungs, destroys 
the appetite, stops digestion, and partially suspends all the functions of the 
system. An emotion of shame flushes the face, fear blanches, joy illumi- 
nates it, and an instant thrill electrifies a million of nerves. Surprise spurs 
the pulse to a gallop. Delirium infuses great energy. Volition commands, 
and hundreds of muscles spring to execute. Powerful emotion often kills the 
body at a stroke : Chilo, Dingoras, and Sophocles died of joy at the Grecian 
games. The news of a defeat killed Philip V. Muly Murdock was carried 
upon the field of battle in the last stages of incurable disease : upon seeing 
his army give way, he rallied his panic-stricken troops, rolled back the tide 
of battle, shouted victory, and died. The doorkeeper of Congress, as before 
stated, expired on hearing the surrender of Cornwallis. Eminent public 
speakers have often died in the midst of an impassioned burst of eloquence, 
or when the deep emotion that produced it had suddenly subsided. Lagrave, 
the young Parisian, died when he heard that the musical prize for which he 
had competed was adjudged to another. Hill, at New York, was appre- 
hended for theft, and taken before the police ; though in perfect health, men- 
tal agony forced the blood from the nostrils, and he was carried out, and died. 
Emmet, the noted lawyer, it is stated, fell and died suddenly, while plead- 
ing at the New York bar, under great excitement or emotion of eloquence. 
I recollect of having been called to two females in this city, both of whom 
took laudanum or opium, to destroy themselves. Anger was the exciting 
cause of it. One was in paroxysm of anger when I first saw her. I began 
to converse and reason with her on her conduct, when composure took pos- 
session of the mind. I administered large emetics, and soon after fish or lamp 
oil, with plenty of warm water, which caused vomiting, and thus prevented 
both of them from committing suicide. Let every one learn to govern the 
temper, lest it prove ruinous. I once saw a person who threw himself into 
the dock, and kept himself under the water till he was drowned, merely 
because his wife paid the carman his cartage, contrary to his wishes. The 
mind must be vigorously disciplined, in order to overcome anger, revenge, 
and other passions. For want of this, how many thousands have been mur- 
dered and otherwise injured or destroyed ! Self must be denied, or destruc- 
tion follows. What a man sows, that will he reap, both in a moral and 
physical point of view. 
CHAPTER XXV. 
RULES FOR THE PREVENTION OF INFECTIOUS DISEASES AND CONTAGION. 
It is no doubt the case that very many infectious or contagious diseases 
may be averted or completely destroyed, by adopting proper means for this 
purpose. 
Separation or removal.-When any person is attacked with a disease 
which is contagious or supposed to be contagious, he should be immediately AND PROMOTING HEALTH AND LONGEVITY. 
95 
removed to a place established expressly for that purpose; or, if convenient 
or desirable, let him be taken to a separate and remote part of the house, 
distant from the rest of the family, into a clear and well ventilated room. 
The upper portion of the house is preferable. First; because it is drier ; 
and, secondly, because it permits the contagious effluvia arising from the 
body of a patient more readily to pass off, as the current of air more ratified 
is naturally upward. 
Separate apartment for the Sick.-In all boarding-houses, and where a 
great number of persons are crowded together, there ought to be a separate 
room for those that are sick. Where there is not a suitable place, one should 
be provided in the vicinity or neighbourhood. 
Intercourse with the Sick.-There should be as little intercourse with the 
person affected with any contagious disease as possible. No one should be 
allowed to visit him, except the nurse or immediate relatives, and those 
should be careful to keep at a proper distance from the bed, that his breath 
and the vapour arising from his body may not be inhaled. A handkerchief, 
wet with vinegar, may be held occasionally to the nose while in the room. 
Those who are obliged to continue in the room should, as much as possible, 
avoid fatigue, be very temperate, and occasionally take a dose of physic. 
Let them eat plenty of raw onions : also apply onions to the feet and other 
parts of the body of the sick person. 
It is generally admitted that fear operates as a predisposing cause in the 
production of infectious diseases. It therefore becomes necessary to com- 
mand as much fortitude and resolution as possible, as well as to inspire 
confidence in the mind of the patient. 
Ventilation.-The greatest attention should be paid to a free and constant 
circulation of air in the apartment or apartments. The upper part of the 
window or the door should be left open ; but a current of air direct upon the 
person should oe avoided. If the weather should be very windy, let muslin 
or gauze be hung before the window. Nothing is more important than 
pure air. 
Cleanliness.-A due regard should also be paid to cleanliness. The 
clothes of the sick must be often changed, and the room kept perfectly clean. 
Haygarth lays down the following rules to prevent the spread of infectious 
diseases : 
1. " The chamber in which the patient lies must be kept clean and freely 
ventilated. No bed-curtains must be allowed to be drawn around the patient. 
2. " Dirty cloths, utensils, &c., should be often changed, and immediately 
immersed in cold water ; and washed clean when taken out. 
3. " The discharges from the patient must be instantly removed ; and the 
floor around the patient should be rubbed clean once a day with a wet cloth. 
4. " Avoid the current of the patient's breath, as well as the effluvia 
which ascends from his body and from the evacuations. 
5. u Visiters ought not to go into the patient's chamber with an empty 
stomach ; and in doubtful circumstances, on coming out, they should blow 
from the nose and spit from the mouth any contagious poison which may 
adhere to these passages." 
Fumigations.-In order to remove any offensive or disagreeable effluvia, 
and to destroy the power of contagion engendered, fumigations may be used. 
The following: Take a suitable quantity of common oil, put it into an 
earthen vessel of any kind, and add sufficient sulphuric acid or oil of vitriol 
to moisten it. A purifying gas will be disengaged and diffused through the 
room. This is sufficient for small apartments ; but for hospitals the vessel 96 
MEANS OF PREVENTING DISEASE, 
may be placed over a moderate degree of heat. Clothes may be submitted 
to this gas, and other places that are foul and suspected of contagion. 
Another excellent method to purify rooms where there is contagion is, to 
pour vinegar on a heated shovel or peal. This should be frequently done, 
and particularly when anything passes the bowels of the sick person. Green 
plants may be kept in the apartment; and the fumes of bitter herbs, bruised 
or boiled, are also excellent preventives. The hands, face, and body 
should be occasionally bathed with vinegar, and the temperature of the 
body should not be too great, as it tends to putrefaction. Whatever 
diet is given should be of an antiseptic nature, nutritious, and altogether 
vegetable. 
Sweet Oil a preventive.-For the prevention of the plague it has been 
recommended to bathe the body with sweet oil, as it has been ascertained 
that among a million of inhabitants carried off by the plague in Egypt, not a 
single oil-man, or those who worked in oil stores, were ever infected with 
the disease ; their clothes and bodies were besmeared with oil. I therefore 
recommend those exposed to any contagious disease to dip their flannels 
in sweet oil, wring them out, and constantly wear them in this state, thus 
saturated with the oil : also take an ounce of the oil once or twice a week, 
and observe universal temperance. 
Fever Institutions.-These are of great importance, and ought to be 
established near every large town and city, being the most likely to prevent 
the spreading of contagious diseases, under proper regulations, with proper 
medical attendance and nursing. 
Rigid Quarantine.-It becomes necessary for our municipal authorities to 
pay no regard to the disputed points of contagion and non-contagion ; but to 
maintain a rigid quarantine upon all vessels coming from those parts where, 
contagious diseases are from time to time prevalent. 
Secret of destroying Contagion.-The great secret of destroying contagion 
and preventing its increase unquestionably is, to dilute the infected air or 
atmosphere by ventilation, cleanliness, fumigation, separation of the sick, or 
those suspected. There is every reason to believe that this will not only 
prevent the spreading of contagion, but entirely destroy the powers of it. 
Chloride of Lime.-In conclusion I would state, that the chloride of lime 
possesses very antiseptic, disinfecting, and purifying properties, which render 
it highly important in the preservation of health and prevention of conta- 
gion, by decomposing putrid effluvia of every kind, and preventing the gene- 
ration of epidemic diseases, or arresting their progress when they already 
exist. It destroys the poisonous exhalations from privies, sewers, and docks 
or ponds left bare at low water; also of vaults, cellars, store-houses, hospitals, 
prisons, market-houses, gutters, &c. It is valuable for purifying the air of 
wells, mines, slaughter-houses, drains, stables, the holes of vessels, and the 
rooms of the sick. It prevents the fetid smell from dead bodies previous to 
burial, and such as are disinterred for judicial investigation ; also the fetid 
effluvia from dirty clothes. 
Chloride of lime immediately destroys the offensive smell from any 
source. 
Method of using it.-The method of using it is very simple. A little of 
it may be placed in a saucepan, and kept in any place where there is conta- 
gion, or any disagreeable effluvia whatever ; or the apartments may be 
sprinkled with the article. The fetid smell which arises from the excre- 
ments of the sick, or any other exhalation, is immediately destroyed by 
sprinkling a small quantity in the room. As a means of removing the AND promoting health and longevity. 
97 
sources of disease in cities and villages, chloride of lime demands the atten- 
tion of the guardians of the public health. 
CHAPTER XXVI. 
RULES FOR THE PRESERVATION OF HEALTH AND PROMOTING LONGEVITY. BY 
SIR RICHARD JEBB, LATE PHYSICIAN TO THE ROYAL FAMILY. 
1. The greatest preservatives of 
health are exercise and temperance; 
these may be practised by all ranks 
and at any season or place. Exercise 
throws off all superfluities, and tem- 
perance prevents them: exercise 
clears the vessels and promotes the 
circulation of the blood. 
2. A due degree of exercise is ab- 
solutely necessary to health. 
3. Walking is the best exercise for 
those who are able to bear it; riding 
for those who are not. 
4. The air we breathe is of the ut- 
most importance to our health. 
5. Every one that would preserve 
health should be as clean and sweet 
as possible in their houses. 
6. Nothing conduces more to 
health than abstinence and plain 
food. 
7. All malt liquors are hurtful; so 
are strong tea and coffee. 
8. Costiveness is very hurtful to 
health; therefore care should be taken 
to remove it at the beginning by cool, 
gentle purges. 
9. Obstructed perspiration (com- 
monly called catching cold) is the 
great source of all diseases. Let it, 
therefore, be removed immediately by 
gentle sweats. 
10. Physic, for the most part, is 
only a substitute for exercise and tem- 
perance. 
11. Blistering, cupping, bleeding, 
&c., are seldom requisite, except to the 
idle and intemperate; they are only 
expedients to make luxury consistent 
with health. 
12. The apothecary is chiefly em- 
ployed to counteract the cook and 
vintner. Nature delights in the most 
plain and simple diet. 
13. Most people are the best judges 
of their own constitution, and know 
what kind and what proportion of food 
agrees with them best. 
14. Artificial provocatives only 
create a false appetite. 
15. If you cannot do without wine, 
never drink more than a few glasses. 
16. A particular and very intelli- 
gent friend of mine (says Sir Richard) 
was extremely partial to what is 
called good living ; and, having a wife, 
of whom he was particularly fond, and 
a numerous offspring, he was desirous 
of living long enough to see them set- 
tled in the world. 
17. He was, however, of a very in- 
firm constitution, till he was about 
fifty years old, when, requesting my 
advice how to obtain that valuable 
end, I strongly recommended him to 
persist in an exact course of tempe- 
rance and exercise, by duly attending 
to which, he recovered a sound and 
perfect state of health. 
18. At the period I am speaking of 
a train of infirmities had made great 
inroads in his constitution, and he had 
fallen into different kinds of disorders, 
such as the colic, gout, spasms, &c., 
and continual slow fever ; so that the 
best delivery he had to hope for (ex- 
cept for the sake of his numerous 
family) was death to end his pains 
and misery. 
19. The result of my advice, which 
I here give in his own words, is as 
follows: When, says he to me, I re- 
solved firmly to live a temperate life, 
I soon found myself entirely freed from 98 
MEANS OF PREVENTING DISEASE, 
all my complaints, and have continued 
so even to this day, and I am now 
more than one hundred years old. 
20. I am now convinced that we 
should consider a regular life as a 
physician, and which is our natural 
and proper physic, since it preserves 
us in health, makes us live sound and 
hearty to great age, and prevents us 
dying of sickness through a corruption 
of humours. 
21. Whoever, trusting either to his 
youth or strength of constitution, 
slights my observations, must live 
in constant danger of disease and 
death. 
22. I am now fully convinced, from 
experience, that the man who leads a 
regular and sober life, is more likely 
to live long and healthy than a young 
man who leads an irregular and in- 
temperate life, however strong his 
constitution may be. 
23. I have heard some sensual, in- 
considerate persons affirm, that a long 
life is no blessing, and that, when a 
man has passed his seventieth year, 
he is better dead than alive. 
24. This, however, I know to be an 
error ; for I am now as well as ever I 
was in my life, (and perhaps better;) 
I even now relish every enjoyment of 
life better than when 1 was young. 
I sleep every night soundly and 
quietly, and all my dreams are plea- 
sant and agreeable. 
25. I am likewise now sure that 
even persons of a bad constitution 
may, by leading a sober and regular 
life, live to as great an age as 1 have 
done; for I solemnly declare that 
my brain is as much itself now as ever 
it was. 
26. Some perhaps will say that, 
without leading a regular life, there 
have been some that have lived to one 
hundred years or more, and therefore 
think that they may be equally for- 
tunate ; but I must tell such persons 
that not one in ten thousand ever at- 
tains that happiness ; and those who 
do, generally contract some disease 
which carries them off. 
27. Therefore the surest way is to 
embrace sobriety. 
28. What I call a regular and sober 
life is, not to eat and drink such things 
as disagree with the stomach, nor 
to eat or drink more than the stomach 
can easily digest. 
29. There are, I know, some old 
epicures who insist that it is requisite 
they should eat and drink a great deal, 
in order to keep up their natural heat 
and strength ; and that were they to 
lead a temperate life, it would be but 
a short one : but I know that large 
quantities of food cannot be digested, 
especially by old and feeble stomachs. 
30. Old people should eat often, 
and in small portions. 
31. Others will say that a sober life 
may indeed keep a man in health, but 
cannot prolong life. 
32. This I know likewise to be 
false, for I am myself a living instance 
of it; had I not followed the advice 
of my friend Dr. Jebb,but continued in 
my former way of living, I am sure I 
should have been in the grave years 
ago. 
33. Oh! what a difference have I 
found between a regular and an irre- 
gular life ; one gives health and lon- 
gevity, the other disease and untimely 
death. 
34. And it surely must be a great 
pleasure to a sober man to reflect, 
that the way he lives will keep him 
in good health, and be productive of 
no disease or impurity. 
35. It is impossible, in the common 
nature of things, that he who lives a 
regular and sober life should breed 
any sickness, or die an untimely death, 
before the time at which it is impos- 
sible he should live; but sooner he 
cannot die, as a sober life removes all 
the usual causes of sickness, and sick- 
ness cannot happen without a cause. 
36. Health and sickness, life and 
death, certainly depend on the bad 
qualities of the humours. Tempe- 
rance corrects and renders them per- 
fect, having the natural power of 
uniting and binding them together, so AND PROMOTING HEALTH AND LONGEVITY. 
99 
as to render them inseparable and in- 
capable of alteration or fermentation- 
circumstances which engender cruel 
fever, and end in death. 
37. For myself, I am even now, at 
the age of one hundred and seven, 
hearty and happy, eating with a good 
appetite and sleeping soundly. 
38. My senses are likewise as good 
as ever they were, my understanding 
as clear and bright as ever, my judg- 
ment is sound, my memory tenacious, 
my spirits good, and my voice (the 
first thing that generally fails us) 
strong and sonorous; and certainly 
these are true and sure signs that my 
humours are good, and cannot waste 
but with time. 
39. I likewise enjoy the satisfac- 
tion of conversing with men of bright 
parts and superior understanding, 
from whom, even at this advanced 
period, I learn something. 
40. What a pleasure and comfort 
it is that, at my time of life, I should 
be able, without the least fatigue, to 
study the most important subjects; 
nor is it possible that any one should 
grow tired of such delightful enjoy- 
ments, which every one else might 
enjoy by only leading the life I have 
led. 
41. So that, to finish my discourse, 
I say, since length of days abounds 
with so many blessings, and I happen 
to be one who has arrived at that state, 
it is, I conceive, my bounden duty to 
give testimony in favour of it, and 
solemnly assure all mankind that I 
really (even at this time of life) enjoy 
more happiness than I can describe ; 
and that what I have here stated is 
solely to demonstrate the great ad- 
vantages derived from longevity, that 
others may be induced to observe the 
delightful rules of temperance and 
sobriety. 
42. A sober man relishes every en- 
joyment of life ; drunkenness expels 
reason, drowns the memory, defaces 
beauty, diminishes strength, inflames 
the blood, causes internal, external, 
and incurable wounds, makes a strong 
man weak and a wise man a fool; 
he drinks to the health of others, and 
robs himself of his own. 
43. Now, taking my leave, I say, 
may others' years be as long and as 
happy as mine, and may they live in 
virtue and good-will toward all. 
CHAPTER XXVII. 
BILL OF FARE AND RULES FOR INVALIDS AND OTHERS. 
Articles Prohibited. 
coarse, and unbolted ; Indian, Rye, 
good Butter, Potatoes, Rice, and 
Stewed Fruit. 
Plain Puddings and Custard, Milk 
and Molasses, when they agree, Cocoa 
Shell made the same as Coffee, weak 
Black Tea, Oysters; fresh and salt wa- 
ter Fish, and salt Codfish ; Eggs cook- 
ed rare, Onions thoroughly boiled. 
Remarks. 
I have mentioned the kind'of diet 
which should be rejected, and which, 
as a general rule, should be taken ; 
Warm Meats of all kinds. 
Soup, Gravy, Spices. 
Coffee and Green Tea. 
Salt Fish, Lobsters, Crabs. 
Fresh Bread and Pastry. 
Mince Pie and Cake. 
Ardent Spirits and Malt Liqours. 
Unripe Fruits, Pickles, and Nuts. 
Tobacco in every form. 
All other indigestible kinds of food. 
Diet Recommended. 
Bread made of Wheat, ground MEANS OF PREVENTING DISEASE, 
100 
but there may be some exceptions, 
inasmuch as what may agree with 
one will not with another. In such 
cases it must be left to the choice of 
the patient, bearing in mind that what- 
ever digests well or rests easy on the 
stomach, may be safely taken ; but it 
should never be overloaded even with 
light food. No late suppers ; and early 
rising. 
As much depends upon the quantity 
as the quality of the food. " As 
great an amount of guilt is attached 
to the man who gluts or poisons him- 
self to death, as to one who cuts his 
throat or hangs himself." Rise with 
an appetite. 
" Let supper little be, and light, 
But none makes the best night." 
Again: 
After breakfast walk a while, 
After dinner sit a while, 
After supper walk a mile. 
Masticate or chew the food well. 
Eat slow. Drink no hot liquids. 
Meals should be taken at regular in- 
tervals, and as near as possible at six 
hours apart, and nothing between 
them, and none just before going to 
bed. 
Abstinence should be preferred to 
medicine. It is beneficial to omit a 
meal occasionally, particularly if a 
little unwell. No naps should be 
taken after dinner. Sleeping apart- 
ments should be well ventilated ; but 
no current of air should come directly 
upon the bed. All bed-clothes to be 
well aired. No corsets or tight clothes 
to be worn. Flannel should be taken 
off on going to bed, and it is best to 
wear it over the shirt. It is much 
better to wear muslin than linen ; it 
preserves a more uniform tempera- 
ture. Take a shower bath daily, or at 
farthest weekly ; after which rub the 
whole surface briskly with a coarse 
towel, and particularly any part which 
is weak. Bathe the throat, neck, head, 
and breast, for sore throat, earache, 
weak lungs, eyes, and nervous affec- 
tions. Ablution or bathing the body 
is a good substitute for the shower 
bath ; if the skin is very foul, add a 
little ley to the water. Exercise in 
the open air is very necessary. Walk- 
ing, riding, digging, ploughing, and 
the spinning-wheel are all very good. 
Feather beds are very injurious, es- 
pecially in the summer season ; straw 
or hair mattresses should be substi- 
tuted. Avoid over-exertion and fa- 
tigue as much as indolence. Avoid 
a stream of air, while in a state of 
perspiration, as you would an arrow. 
Avoid fretting and scolding and cor- 
roding care. Avoid the crowded par- 
ty, ball-room, and theatre. 
Says Hassar Imma, an Arabian: 
" Start from your couch betimes. 
The moments of the morning are sa- 
cred and salubrious : then the genii 
of health descend and communicate 
with those who visit the herbage of 
the field while rich with the dews of 
heaven. How pure and sweet the 
smell of the air in this unpolluted 
state, before it is contaminated by 
corporeal effluvia ! The fragrance 
of the groves will regale your senses, 
and the melody of birds allure your 
hearts to gratitude and praise. 
Your regimen ought to be simple 
and inartificial. Drink only the sim- 
ple water: it is the beverage of 
nature, and not by any means, nor in 
any way, to be improved by art. No 
spirits whatever are half so salutary. 
It is stronger than the strongest wine, 
purer than the virgin honey, and 
sweeter than the sweetest nectar. 
Cleanliness is one of our greatest 
concerns. All animals are subject to 
its laws. The means of it are always 
at hand: the limpid stream and the 
briny wave were for this purpose or- 
dained and given to the inhabitants 
of the earth. They purify the sur- 
face, and they brace and strengthen 
at the same time all the nerves and 
fibres of the human frame. In this 
manner have the destinies proscribed 
nastiness. It is the source of innu- 
merable diseases. It is loathsome and AND PROMOTING HEALTH AND LONGEVITY. 
101 
detestable; and the man or the woman 
who is averse to bathe or to wash, 
ought not to live. 
Forget not to mingle moderation 
and abstinence even with the holiest 
rites of wedlock. A proper and habi- 
tual restraint in conjugal pleasure is 
like incense to the flames of the altar. 
So far from quenching, it cherishes 
and improves the heavenly fire. 
Healthy, happy, vigorous, and beau- 
tiful are the offspring of chaste and 
rational love." 
Study to acquire a composure of 
mind and body. Avoid agitation or 
hurry of one or the other, especially 
just before and after meals, and while 
the process of digestion is going on. 
To this end, govern your temper- 
endeavour to look at the bright side 
of things-keep down as much as 
possible the unruly passions-discard 
envy, hatred, and malice, • and lay 
your head upon your pillow in charity 
with all mankind. Let not your 
wants outrun your means. What- 
ever difficulties you have to encoun- 
ter, be not perplexed, but only think 
what is right to do in the sight of Him 
who seeth all things, and bear the 
result without repining. 
" If I were asked," says a writer, 
" on what conditions more than others 
health and purity depend, I should 
reply, active exercise, attractive indus- 
try, and healthful employment for body 
and mind." 
In a word, there must be universal 
temperance, regularity, and exercise, 
in order to secure health and long life. 
In all cases of tolerable health, and in 
those cases of milder disease where 
exercise, drink, sleep, &c., can be so 
regulated as to bring about the resto- 
ration of health, medicine should be 
avoided. 
It is only by obedience to these 
constitutional laws, fixed and immu- 
table as the laws of the planetary 
world, which a wise and benevolent 
Creator has established in our nature, 
that life and health can be secured. 
CHAPTER XXVIII. 
REMARKABLE INSTANCES OF LONGEVITY. 
Isabel Walker, a Scotchwoman, died at one hundred and twelve, with- 
out much severity of regimen ; but she was distinguished by a placidity of 
temper, and possessed that happy medium state of habit, neither lean nor 
corpulent, favourable to long life. 
Peter Garden, a Scotchman, died at the age of one hundred and thirty-one: his 
stature was tall, and his employment agriculture, which he continued to his 
death, with a wonderful appearance of freshness and youth. 
John Taylor, a Scotch miner, lived to one hundred and thirly-two: his 
teeth continued sound to the last. 
Gylloul Macrain, a native of the Island of Toura, in the Hebrides, died 
after keeping one hundred Christmas masses. 
Catharine, Countess of Desmond, in Ireland, who died in the reign of 
James the First, was one hundred and forty ; and thrice in the course of her 
life she renewed her teeth. 
Brian Monagher, a native of Ireland, walked twenty miles to vote at a 
contested election in Queen's County, he being then one hundred and four- 
teen years old. The law required that forty-shilling freeholders should renew 
the registering of their qualification every seven years ; and so little idea had 
this farmer of death, that, in giving a plumper to Sir Henry Parnell, he 102 
MEANS OF PREVENTING DISEASE, 
intimated his intention of registering as a .£50 freeholder the next time, 
which answers for life. 
Thomas Parr, a native of Shropshire, was buried in the Abbey of West- 
minster at the age of one hundred and fifty-two. 
Lawrence, a native of the Shetland Islands, married at the age of one 
hundred, and died at one hundred and forty. 
Kentigern, or St. Mungo, Bishop of Glasgow, lived to the age of one 
hundred and eighty-five, as certified on his monument. 
Henry Jenkins, of Northallerton, Yorkshire, lived to the age of one hundred 
and sixty-nine, being first a labourer, and afterward a fisherman. 
Sarah Rouen, one hundred and sixty-four, and John Rouen, her husband, 
one h undred and seventy-two, were married one hundred and forty-seven years, 
both natives of the Directory of Carsoueber. 
Petratsch Zorten, a native of Hungary, and a cow-herd, lived to one 
hundred and eighty-five. 
The greater proportion of these persons were natives of Scotland ; though 
it is known that the most numerous instances of longevity are to be met with 
in Norway and Russia : out of 6229 persons in Norway, sixty-three had 
lived to a hundred ; and out of 726,273 in Russia, two hundred and sixteen 
attained one hundred years, two hundred and twenty above it, and four one 
hundred and thirty. In the list of longevity enumerated above all these 
persons were of a low situation of life, except the Countess of Desmond ; and 
the diet of all of them seems to have been moderate, and in some instances 
abstemious. Parr's maxims of health were, to keep your head cool by tem- 
perance, your feet warm by exercise ; to rise early and go soon to bed ; and 
if you are not inclined to get fat, to keep your eyes open and your mouth 
shut, or be moderate in your sleep and diet. 
The diet of Jenkins is said to have been coarse and sour ; and in the north 
of England, distinguished for long-lived people, it is much the same, consisting 
of salted meat and sour leavened bread. 
Zorten's diet consisted entirely of milk and cakes, with a glass of brandy ; 
and, being of the Greek church, he was to the last a strict observer of all 
their fasts. 
The following instance of longevity is mentioned in the St. Petersburgh 
Gazette : There is living near Polosk, on the frontiers of Lithuania, a man 
named Demetrius Crabowski, who is one hundred and sixty-eight years old. 
He has always led the humble but tranquil life of a shepherd, assisted by his 
two sons, the eldest of whom is one hundred and twenty, and the youngest 
ninety-seven years old. 
This man has lately died, aged 188. He had seen seven monarchs on the 
throne of Russia, and served Gustavus Adolphus as a soldier during the 30 
years war. At 93 he married his third wife, who lived 50 years with him 
and bore him several children. 
A person named Francisco died, at the head of Lake Champlain, aged 138. 
He was at the coronation of Queen Anne ; was in several battles under the 
Duke of Marlborough ; served in the British army during the French war in 
America ; served as a soldier in the American revolution; was desirous to 
serve in the last war, but was considered too old. His diet was very simple, 
seldom eat flesh, generally supped on milk. At the age of 90 he was active 
and cheerful, and able to perform light labour. 
Thomas Carn died at the age of 207 years ; of this individual the following 
account is given in Taylor's Annals of Health and Long Life: 
The most remarkable instance of longevity which we meet with in British aND PROMOTING HEALTH AND LONGEVITY. 
103 
nistory, is that of Thomas Carn, who, according to the parish register of St. 
Leonard Shoreditch, died on the 26th of January, 1588, at the astonishing 
age of 207 years. He was born in the reign of Richard the Second, anno. 
1381, and lived in the reigns of twelve kings and queens, namely, Richard 
IL, Henry IV., V.,and VI., Edward IV. and V., Richard HL, Henry VII. 
and VIII., Edward VI., Mary and Elizabeth. The veracity of this state- 
ment may be readily ascertained by any person who may choose to consult 
the above register. 
Jonathan Foster, at the close of the war, retired to Mason, N. H., where 
he lived in a shanty in the woods, far from trouble and care, and upon the 
plainest and simplest food, with water only for his drink. He died at the 
age of 103. 
Old Dr. Holyhoke died a few years since in one of the New England 
states, aged over 100. He lived very frugal and temperate. 
Sergeant Andrew Wallace, of Pennsylvania, died a few years since, aged 
105. He lived strictly temperate, drank almost exclusively water, food 
plain and simple. He had his sixth wife, and was the father of 34 children. 
While attending a cannon on the 4th of July, he was struck down by 
lightning, and lay in an insensible state for 17 without any signs of life, 
except a little warmth at the pit of the stomach. 
This should be a caution against premature interments. William Tennant, 
a Presbyterian minister, lay three days in a trance, and it was very difficult 
for his physician to prevent his friends from burying him. 
The following is an epitaph on Margaret Scott's tomb-stone, in Scotland : 
Stop, passenger, until my life you read, 
The living may get knowledge from the dead I 
Five times five years I lived a virgin's life ; 
Ten times five years I was a virtuous wife ; 
Ten times five years I lived a widow chaste: 
Now, wearied of this mortal life, I rest. 
Between my cradle and my grave have been 
Eight mighty kings of Scotland, and a queen. 
Four times five years the commonwealth I saw, 
Ten times the subjects rose against the law ; 
Twice did I see old Prelacy pulled down, 
And twice the cloak was humbled by the gown. 
An end of Stuart's race I saw-nay, more, 
My native country sold for English ore. 
Such desolations in my time have been, 
I have an end of all perfection seen. 
To these facts we may add, in comparing the different classes of society 
with respect to longevity, that the profession of the gardener is the most 
healthy : next to it husbandmen are also healthy ; but, from their great exer- 
tions and exposure to every weather, they are soon worn out, and generally 
old men before fifty. Manufacturers are neither healthy nor long-lived. 
Miners, who are much below ground, are generally healthy, and often long- 
lived. Soldiers, unless cut off by the casualties war, are long-lived, as well 
as sailors, who are generally healthy. Persons engaged in commerce, if not 
too speculative, and their minds racked with anxiety, are generally long-lived. 
The voluptuous, both in town and country, are commonly cut off in their 
prime, from their constant excesses. The learned professions, at the farthest, 
seldom exceed the age of eighty. In addition to these truths it may be ob- 
COMPARATIVE STATEMENT OF LONGEVITY. 104 
MEANS OF PREVENTING DISEASE, 
served, in respect to the sexes, that women are generally longer lived than 
men ; and mothers than single women. 
On this solid foundation, then, illustrated in the preceding columns, is the 
Code of Longevity built, which no speculative reasoning can overturn, and 
which every practical fact tends to confirm and enforce. The means of 
carrying it into effect are simple and clear, neither wrapped in mystery nor 
needing disguise to recommend them. 
CHAPTER XXIX. 
TESTIMONIALS IN FAVOUR OF THE DIETETIC SYSTEM. 
In concluding this treatise on hygiene, or the art of preserving health, I 
will add but a few cases of the beneficial effects resulting from obedience to 
her salutary laws ; hundreds of others might be added were it necessary 
The following were written for the Esculapian Tablets : 
Sir : Myself and wife nave been living pretty strictly on your system 
nearly a year. For some time previous to my adopting your plan of living, 
my health was a good deal impaired, and I was afflicted with many bodily 
pains ; and particularly troubled with impaired sight-so that I could not 
see to read at all by candlelight. A thick blur seemed to come before my 
eyes and obscure everything. Now all my bodily pains are gone and my 
sight is perfectly restored, so that I can read all the evening without the 
least inconvenience. 
My wife's health is also much improved by her new mode of living. 
Through the whole cholera season last summer our diet was almost exclu- 
sively Graham bread and water; and we enjoyed excellent health, and had 
not the slightest touch nor symptom of that terrible disease. 
Yours respectfully and with gratitude, 
Nicholas Van Heyniger. 
March 21, 1833. 
Sir : Myself, wife, and four children have lived strictly on your system 
more than a year, without eating any flesh at all. We have all enjoyed im- 
proved and uninterrupted health during the whole time. I am a carman, and 
do a great deal of hard work, and my general health and vigour and strength 
have decidedly improved since I have followed your system ; although I en- 
joyed ordinary health before, I can perform more hard labour now, and feel 
less fatigue at night than formerly. My children are all remarkably hearty 
and rugged and happy. Our fifth child has been born since we lived on 
your system. He is now about nine months old, and has not been unwell 
an hour since his birth, and has scarcely had one minute's restlessness. My 
wife enjoys the best of health and spirits. We were in the'very midst of 
the cholera last summer. Our neighbours died all around us, in front of us, 
in the rear of us, and on each side of us. I was much exposed by carrying 
the beds and furniture out of houses where people had died with cholera; 
yet neither myself nor one of my family had the least symptom of the 
disease. 
Yours very gratefully, John Torry. 
New York, June 16, 1833. AND PROMOTING HEALTH AND LONGEVITY. 
105 
Dear sir : For the last ten years I have been subject to a severe sick- 
ness every spring and fall. 
Twelve months ago I heard your lectures at Clinton Hall, and was in- 
duced to adopt your system of living; since which I have enjoyed perfect 
and uninterrupted health. I would not exchange my present mode of living 
upon any consideration. 
Yours respectfully, David Wood. 
New York, March 22, 1833. 
Sir : Myself and family, having heard your lectures and adopted your 
system of living, continued strictly on the system through the cholera season 
last summer; and during the whole season we were all entirely free from 
any symptom of that disease, and were without any indisposition whatever. 
Yours truly, with cordial respect and esteem, 
Wm. H. Pillow. 
Neu, York, March 18, 1833. 
Deas, sir : I have attended your lectures from the first in this city, and 
do not know how to express my' gratitude to you for the benefits I have 
received from your instructions. You have cured me of a very distressing 
sickness-that of nervous headache. I have left off coffee and tea, of which 
I used to drink great quantities, and live strictly on the diet system. You, 
sir, are an honour to your name and country. I am very desirous of making 
your acquaintance, and would be happy to call on you, or have you call 
on me. 
Respectfully yours, S. Wesere. 
New York, June 2, 1833. 
Sir : I enjoyed good health till I was married, which took place in my 
eighteenth year. Soon after this my health began to fail, and continued to 
decline for a considerable time. I became very weak, and subject to turns 
of fainting, and frequently fainted away while engaged in my domestic con- 
cerns, and sometimes two or three times a day. My bead ached incessantly, 
and often with great violence. I was also afflicted with what my physi- 
cians called the liver complaint, and was under treatment for it three several 
times, and each time salivated with mercury. I had a continual pain in my 
side, and extreme weakness and great susceptibility of the lungs. I laboured 
under a general debility, and at length became so feeble that I could hardly 
get about my house. 
I used to have a doctor as often, on an average, as once a fortnight or 
three weeks, and took a great deal of medicine, but without anything more 
than a momentary relief, while my complaints, on the whole, were no better. 
So I continued on for about eight years, suffering almost everything that 
could make life miserable in mind and body. Indeed my body seemed full 
of disease and pain, and I was sometimes brought very low-so that I did 
not expect to live much longer; while at the same time my mind was ex- 
cessively melancholy and full of despondency and wretchedness. 
I immediately abandoned my tea and coffee, the latter of which I had 
been very fond of, and gradually got into a course of diet system strictly. Some 
weeks elapsed before I could perceive that I was in any degree benefited. 
Aft: that I began to improve, and grew better very fast. My headache, 
pain in my side, and all other pains soon left me entirely, and in a short time 
I was restored to good health. Through the cholera season I ate fruit freely, 106 
MEANS OF PREVENTING DISEASE, 
but took care to get good fruit, and enjoyed excellent health during the sick- 
ness, without having a single premonitory symptom of cholera or an un- 
well hour ; nor have I had an hour's indisposition since : at present I enjoy 
the most perfect health. 
Before I adopted the system I was so feeble that I was unable to do any 
work at all; but now I can work about my house all day, and take a long 
walk in the evening for pleasure, without feeling fatigued. I have taken no 
medicine, and had no occasion for any since I fully adopted your system. My 
spirits are now uniformly cheerful and buoyant, and I am full of health and 
enjoyment. 
With sincere and lively sentiments of gratitude, I am very respectfully 
yours, in the very best of health, and wishing you always the same, 
New York, June 17,1833. Sarah Van Yorx. 
Sir : At about the age of twenty-one I became afflicted with the bleed- 
ing piles, for which I tried every remedy that I could hear or think of for 
such a complaint, but all without any lasting benefit. I became worse con- 
tinually, often bleeding excessively, and becoming much reduced; and 
sometimes I was so afflicted that I was confined to my room and unable to 
walk for the space of three months. I was obliged to take cathartic medi- 
cine once a week regularly, and in this suffering manner I lived on for six 
years ; the last two of which my complaint was extremely severe. 
In June, 1832, I adopted the vegetable system of living, and in a short 
time was entirely relieved by it from my complaint; since then I have 
not had to take a single dose of medicine, and have been perfectly free from 
all disease and illness, and have been blessed with excellent health and 
spirits, and am truly thankful that I can say that I am now every way per- 
fectly well. Yours with much gratitude and respect, 
New York, June 17, 1833. Cornelia Burr. 
TESTIMONY OF A WIFE AND MOTHER. 
" My health appeared to be as good in youth as that of most children, 
though medicine was frequently administered to me for indisposition. At 
about the age of thirteen my health become more delicate than ever before, 
and with declining health came an increase of " dosing and druggingand 
from that age to that of 41,1 think not one month has passed without taking 
some kind of medicine. During that period I was constantly feeble and 
sickly, and could seldom say I was free from pain. Different physicians 
prescribed various remedies, but, in spite of all this dosing and drugging, I 
was ever complaining. I was very nervous, troubled much by dyspepsy, 
and greatly distressed by the food I ate. Such was my situation when, two 
years ago last September, I abandoned the use of flesh meat, and butter, and 
tea and coffee, though very partial to the former, thinking my constitution 
required it, and, consequently, that I could not dispense with its use. Either 
tea or coffee was my usual drink at meals, of which I used great quantities, 
especially of tea, which was not unfrequently prepared three times a day. 
My food for the last two years has been of a plain, simple, and unstimula- 
ting kind, though I have not at all times and in all respects followed strictly 
such dietetic habits as I am convinced would be for my benefit. The effect 
of these changes upon my health and enjoyment are very striking. I now 
perform more labour, and that too with less fatigue, than I have been able 
to before; nor have I ever, within my remembrance, felt so well as I have AND PROMOTING HEALTH AND LONGEVITY. 
107 
during the last year. I indeed feel like a new individual, and never suffer 
from my old complaints of twenty years' standing, except when I transgress 
the rules of plain living, or labour uncommonly hard. At such times a pain 
in the side tells me of a violation of the laws of life, and warns me to shun 
them in future. My experience for the last two years in pursuing this 
manner of living, and my renewed health and strength, has firmly convinced 
me that the simpler, plainer, and more natural the food of man, the better it 
is adapted to his moral, mental, and physical constitution." 
I had selected a number of similar cases, but I am obliged to omit them, 
for want of room. Each one must practice the preceding rules, and then he 
can test their efficacy by personal experience, which is better than the tes- 
timony of others. 
CHAPTER XXX. 
I shall conclude the different chapters on Health and Longevity, by 
introducing a few anecdotes : 
A very aged man was called into court as an evidence. The judge, being 
struck with the advanced age of the witness, asked him how he had lived 
to be such an old man ; he replied in the following language : 
" Wine and women I always refused : 
Late hours I never used. 
I kept my head and feet from cold, 
And that is the reason I am so old." 
BOERHAAVE. 
This celebrated physician and scholar ordered in his will that all his books 
and manuscripts should be burnt, one large volume with silver clasps ex- 
cepted. The physical people flocked to Leyden, entreating his executors to 
destroy his will. The effects were sold. A German count, convinced that 
the great gilt book contained the whole arcanum of physic, bought it for ten 
thousand guilders. It was all blank but the first page, on which was writ- 
ten, " Keep the head cool, the feet warm, and the body open, and then 
bid defiance to the physician." 
THREE GREAT PHYSICIANS. 
The bed-side of the celebrated Desmoulins, a few hours before he breathed 
his last, was surrounded by the most eminent physicians of Paris, who 
affected to think that his death would be an irreparable loss to the profession. 
" Gentlemen," said Desmoulins, " you are in error ; I shall leave behind me 
three distinguished physicians." Being pressed to name them, as each ex- 
pected to be included in the trio, he answered, " Water, Exercise, and Diet." 
The secret let out.-A friend of mine, Wait Munson, during his residence 
in Ohio, asked the physician in his place what he done when he or his 
family became sick. He replied, " We abstain only." And why do you 
not recommend the same to your patients ? " O," said he, " in that case I 
should lose them all." PART SECOND. 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE OF 
MEDICINE, AND INDICATIONS OF CURE. 
There must be first principles in medicine as well as in philosophy, which, though simple, are inva 
riable and incontestible, and which, like the stars of the firmament in guiding the mariner, will conduct 
the physician with assured aim through the different stages of disease. 
CHAPTER I. 
MERCURY AND OTHER MINERALS. 
SECTION I. 
In treating on this subject, in order to add more weight to my own senti- 
ments, I have availed myself of the opinions and experience of the most 
celebrated physicians, particularly James Hamilton, M.D., Fellow of the 
Royal College of Physicians and Surgeons, and Professor of Midwifery in the 
University of Edinburgh; and the men referred to have ranked among the 
highest in the medical profession. 
" Among the numerous poisons," says Dr. James Hamilton, " which have 
been used for the cure or alleviation of diseases, there are few which possess 
more active and, of course, more dangerous powers than mercury. Even the 
simplest and mildest forms of that mineral exert a most extensive influence 
over the human frame, and many of its chemical preparations are so delete- 
rious, that in the smallest doses they speedily destroy life." 
Practitioners of the first respectability prescribe, on every trifling occasion, 
calomel or the blue pill. Thus, calomel is now almost the universal opening 
medicine recommended for infants and children, and a course of the blue pill 
(which is one of the mildest preparations of mercury) is advised, without 
any discrimination, for the cure of trifling irregularities of digestion in grown 
persons. 
Dr. Falconar, of Bath, has, in strong language, reprobated this practice, 
and has pointed out many of the dangerous effects of the indiscriminate use of 
mercury. His warning voice, however, has not been listened to ; for the 
employment of mercurial medicines has, for several years, become more and 
more extensive. 
When the effects of mercury upon the human body are accurately in- 
vestigated and duly considered, it cannot fail to appear, that infinite injury 
must accrue from its use. 
It is the object of the author to illustrate, in the following pages, those 
propositions ; and, in doing so, he readily avails himself of the recorded facts 
and observations of distinguished members of the profession. PRINCIPLES OF THE REFORMED PRACTICE OF MEDICINE. 
109 
In detailing the changes produced upon the system by preparations of mer- 
cury, it is necessary to premise the well-known fact, that there are some 
individuals on whom such medicines, though continued for a considerable 
length of time, have little or no perceptible influence, unless the activity of 
their form or the magnitude of their dose be calculated to excite immediate 
effects. For example, whatever the constitution of the person may be, a 
very few grains of the muriate of mercury, given in substance, prove rapidly 
fatal, and large doses of the submuriate are quickly followed by vomiting and 
purging. On the other hand, instances of constitutions which are unsus- 
ceptible of the influence of the ordinary doses and preparations of mercury, 
are very few in comparison with those which are affected by the smallest 
quantity of that mineral. 
Preparations of mercury, exhibited either internally or externally for any 
length of time, increase in general the action of the heart and arteries, and 
produce salivation, followed by emaciation and debility, with an extremely 
irritable state of the whole system. 
These effects of mercury are expressly mentioned, or virtually admitted, 
by every author, ancient and modern, who has directed its use ; and it must 
appear very extraordinary, that their full influence should have been misun- 
derstood, or at least not sufficiently regarded. 
Blood drawn from the arm of the most delicate and debilitated individual, 
subjected to a course of mercurial medicines, exhibits the same huffy crust 
with blood drawn from a person labouring under pleurisy, and the secretions 
from the skin or from the kidneys are greatly increased. From the time that the 
influence of mercury becomes evident, the general strength declines rapidly. 
It appears, therefore, that the increased action of the heart and arteries, 
excited by mercurial medicines, produces not only the same injurious 
changes upon the body with those arising from inflammation, but also certain 
effects peculiar to itself. This important fact has been incidentally noticed 
by numerous authors, although the natural inference to be deduced from it 
has been very much overlooked. Dr. Carmichael expressly says, " mercury 
induces a specific fever, different from all others, and attended with an in- 
crease of the various secretions." 
The health is rapidly undermined ; and if there be ulcerations in any part 
of the body, they must as certainly degenerate into malignant sores, as 
blistered surfaces or scarifications mortify in cases where the living powers 
are much exhausted. 
Experience has proved the reality of such conclusions, but prejudice and 
inaccurate observation led many practitioners of deserved reputation to attri- 
bute those effects of mercury to other causes, till Mr. Mathias published his 
valuable remarks on what he terms the mercurial disease. Thus, before 
Mr. Mathias's publication, the injurious effects of mercury in some syphilitic 
cases were attributed to the original virus operating on scrofulous, or can- 
cerous, or scorbutic constitutions, or to some complication or anomaly which 
was inexplicable. 
Mr. Mathias has unequivocally shown, that certain dangerous changes 
upon ulcerations originally syphilitic, and certain derangements of health, 
occur whenever mercury has been administered in too acrid a form or in too 
large a quantity; and his remarks are confirmed by the experience of ever} 
practitioner who has, with extensive opportunities of observation, been atten- 
tive to the phenomena. He imagines that the action of the mercury in such 
cases is of a specific or peculiar nature ; it more probably, however, is merely 
in an inordinate or excessive degree, and in no other respect different fror 110 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
what it is in every case. It is a well-known fact, that exposure to cold, 
bodily fatigue, and irregularities of diet, particularly indulgence in intoxi- 
cating liquors, have aggravated the severity and malignancy of syphilitic 
ulcerations, whether primary or secondary. But as all those different causes 
concur only in one respect, viz., in exciting inflammation, it is evident that 
mercury, when it affects the system, must be productive of equally injurious 
changes upon the ulcerations in question and upon the general health, be- 
cause it probably induces a more violent degree of inflammation than expo- 
sure to cold or irregularities of diet. 
Upon the same principle may be explained the fact noticed by all practical 
writers, that scrofulous sores, and scirrhous tumours, and cancerous affec- 
tions, in certain stages of their progress, are much aggravated by preparations 
of mercury. 
Dr. Blackall has shown that, from the same cause, thickening of various 
membranes, particularly the pericardium and pleura, has ensued; and it is 
more than probable that the aching pains which so often follow courses of 
mercury, are owing to partial adhesion, and thickening of the cellular mem- 
brane in contact with the fascia and extremities of the muscles. From Dr. 
Blackall's cases, too, there is reason to believe that the inflammatory dia- 
thesis induced by mercury may continue for a considerable time after the 
mercury has been laid aside, and without any manifest signs. When 
individuals in this state are subjected to accidental exposure to cold, or 
indulge in irregularity of living, a violent and anomalous indisposition takes 
place, which is apt to terminate fatally, or to occasion a broken state of 
health. 
Secondly ; Salivation, or an excessive and unusual flow of saliva, in general, 
follows the increased action of the heart and arteries, and is preceded by a 
certain metallic taste in the mouth, and is attended with a peculiar odour of 
the breath, different from what is ever perceived in any natural disease. 
When an increase of any of the ordinary secretions takes place during the 
course of inflammatory affections, the focal complaints may be relieved. But 
the excessive flow of saliva, in consequence of mercury, is accompanied with 
more or less local inflammation of all the parts within the mouth. In some 
cases, besides the ordinary ulceration of the gums and loosening and final 
separation of the teeth, the tongue, moveable palate, &.C., swell and ulcerate 
to a frightful degree. 
Thirdly; Emaciation so commonly follows a course of mercury, that 
several eminent physicians, about the beginning of last century, imagined 
that mercury had a natural tendency to destroy the fatty particles. The 
celebrated Van Swieten (§ 147) says, " All the pinguid humours are dis- 
solved by the action of mercury, all the viscid are attenuated and discharged 
out of the body through various outlets, together with the virus adhering to 
them ; therefore, when the patient's body is totally emaciated, &c." 
This emaciation has generally been supposed to proceed, partly from the 
diminished appetite for food, and chiefly from the increased secretions and 
excretions ; but as the observations of Dr. Blackall have proved that the 
serum of the blood passes off with the urine, it is more than probable that 
the excessive rapidity of the emaciation is occasioned by that circumstance. 
Fourthly ; Debility, with an irritable state of the whole system, accompanies 
the emaciation, and of course occurs in various degrees in different indivi- 
duals. The late Mr. Benjamin Bell, whose practical knowledge was so pre- 
eminent, comprehends in one short paragraph an emphatic list of those effects 
of mercury. He remarks that, besides the usual symptoms of fever, " mer- OF MEDICINE, AND INDICATIONS OF CURE. 
111 
cury is apt to excite restlessness, anxiety, general debility, and a very dis- 
tressful irritable state of the whole system. 
The consequences of this effect upon the nerves are different upon different 
subjects. In some, temporary delirium takes place ; in others, palsy or 
epilepsy supervene, and in many the memory and judgment are more or less 
permanently impaired. Instances, too, have occurred, where sudden death 
has supervened, apparently in consequence of a very trifling exertion or agita- 
tion. Mr. Pearson has well described such cases. He says, this state " is 
characterized by great depression of strength, a sense of anxiety about the 
precordia, irregular action of the heart, frequent sighing, trembling, partial or 
universal, a small, quick, and sometimes intermitting pulse, occasional vomit- 
ing, a pale contracted countenance, a sense of coldness; but the tongue is 
seldom furred, nor are the vital or natural functions much disordered." 
It may be alleged that these are extreme cases, and it must be admitted 
that, in many instances, those very violent effects do not follow. Delicate 
individuals, however, particularly those who have been accustomed to a 
sedentary life, and, therefore, in an especial degree, females, generally ex- 
perience, after a course of mercury, various modifications of disordered feel- 
ings, communicating the idea of imaginary diseases, which unfit them for the 
duties of life and render existence a burden. 
Among the anomalous complaints arising from this cause may be enu- 
merated impaired or capricious appetite for food, with all the ordinary 
symptoms of indigestion, particularly retchings in the morning, and flatulency; 
disturbed sleep, with frightful dreams; impaired or depraved vision ; fre- 
quent aches and pains in different parts of the body ; occasionally such sud- 
den failure of strength, as if just dying, and at other times violent palpitations 
at the heart, accompanied with difficulty of breathing. Along with all these 
complaints there is such a wretchedness of look, with such a propensity to 
brood over their miserable feelings, that it is extremely difficult to persuade 
the relations or the attendants of the patient that there is no serious indispo- 
sition. Indeed medical practitioners, who are not accustomed to weigh with 
mature deliberation all the complications of symptoms, are generally deceived 
in such cases. 
" I might cite all writers on the Materia Medica," says Dr. Falconar, in 
the paper alluded to, (page 110,) "for authorities that the long-continued 
and frequent use of mercury is not free from danger ; that, among other ill 
effects, it tends to produce tremours and paralysis, and not unfrequently in- 
curable mania. I have myself seen repeatedly, from this cause, a kind of 
approximation to these maladies, that imbittered life to such a degree, with 
a shocking depression of spirits, and other nervous agitations with which it 
was accompanied, as to make it more than commonly probable that many 
of the suicides which disgrace our country were occasioned by the intolerable 
feelings that result from such a state of the nervous system." To the truth 
of these remarks every unprejudiced physician who has been in extensive 
practice must bear testimony. 
Such are the ordinary atid well-known effects of mercury when given in 
sufficient quantity to act upon the human body; but in many cases other 
deviations from health ensue. 
Of these the most common are, excessive diarrhoea, accompanied often 
with discharges of blood from the bowels. This is so apt to occur in some 
individuals, even though the mercury be administered by being rubbed upon 
the surface, that every writer upon " Lues Venerea " has mentioned this 
effect as one of the great obstacles to the cure of the disease. 112 
The random experiments of speculative physicians upon patients labour- 
ing usder scrofulous affections have proved that, in some cases, ulcerations 
of the soft parts, and caries of the bones, originally arising from ill-conditioned 
states of the system, are much accelerated in their progress by mercurial 
medicine. Of this many melancholy examples might be cited. A boy about 
eleven years old had a sore on one cheek, with an affection of the jaw, 
which were attributed to the mismanagement of a dentist in extracting a 
carious tooth. A physician was consulted, (after the patient had suffered 
for some months,) who immediately prescribed a regular and full course of 
mercury. In a short time ulcerations in the throat appeared, the nose sunk, 
and one of the eyes was nearly destroyed, while the general health became 
so seriously injured, that death followed in a few months. Can it be for a 
moment doubted, that all those morbid changes proceeded from the inflam- 
matory action of the mercury ? 
Mental derangement, with eventual fatuity, has sometimes followed a 
course of mercury ; and the probable reason why it does not do so more fre- 
quently is, that the irritable state of mind, which usually precedes actual 
derangement, commonly alarms the attendants, and leads to active precau- 
tionary measures. 
Another consequence of the use of mercury is a very violent affection of 
the skin. This eruption is usually preceded by heat and itching of the skin, 
a frequent pulse, and a white tongue. Most commonly it begins on the in- 
side of the thighs, or about the flextures of the arms; and Mr. Pearson asserts, 
that it generally attacks the anterior parts of the body before the posterior. 
The parts affected are first of a faint red colour, and gradually the shade 
becomes deeper. The eruption proceeds by slow degrees over the whole 
surface, accompanied with an evident tumefaction of the skin, with great 
tenderness and heat, and most troublesome itchings. 
These minute vesicles contain at first a pellucid fluid, and are each sur- 
rounded by a circular redness. From the great itching they are soon and 
inevitably ruptured, and discharge a thin acrid fluid, which irritates and ex- 
coriates the surface, and aggravates greatly the patient's sufferings. In this 
way the disease proceeds from one part to another, till the whole person 
becomes affected. 
When the vesicles are first ruptured, the fluid which exudes, though thin, 
stiffens the linen ; but after a few days the discharge becomes thick, and emits 
a most offensive smell. As the different parts of the body are affected in 
succession, the exudation is thin in one part, and thick and adhesive in 
another. In a day or two the adhesive discharge ceases, the cuticle loosens, 
assuming first a pale brown colour, and then turning nearly black, when it 
separates in large flakes, leaving a faint redness on the exposed surface. 
Sometimes this disquamation is succeeded by a second or third, in the form 
of white scales, like farinaceous powder. In some cases the hair and even 
the nails have also separated along with the skin. 
The duration of the disease varies from a fortnight to eight or ten weeks, 
or even longer. Dr. Alley has described three varieties, viz., by hydrargyria 
mitis, simplex febrilis, and maligna ; and out of forty-three cases, which he 
witnessed within ten years, eight patients died. 
These morbid effects of mercury do not seem to depend entirely upon the 
quantity or mode of preparation of that medicine which may be administered 
to the individual; for while it is an established fact, that the mildest prepa- 
rations employed externally, if exhibited in too large doses, or continued for 
too great a length of time, are followed by some of the bad effects above 
PRINCIPLES OF THE REFORMED PRACTICE or' MEDICINE, AND INDICATIONS OF CURE. 
113 
enumerated, it is also notorious that very small quantities of mercury have 
suddenly proved equally injurious. Thus, in a lady, who had had such 
small doses of the blue pill, combined with opium, for three nights succes- 
sively, that the whole quantity amounted to no more than five grains of the 
mass, salivation began on the fifth day, and, notwithstanding every atten- 
tion, the tongue and gums became swelled to an enormous degree, bleeding 
ulcers of the mouth and fauces took place, and such excessive irritability 
and debility followed, that for nearly a whole month her life was in the 
utmost jeopardy. Every practitioner must have met with similar cases. 
Another common consequence of a very small dose of mercury is, an 
excessive bowel complaint. In many individuals a permanent irritability 
of the stomach and intestinal canal has followed the accidental exhibition 
of a few grains of calomel. 
Various other anomalous affections have been known to succeed the use 
of mercury. Thus, Dr. Falconar mentions, that he once saw a dropsy of 
the breast produced by the use of a mercurial remedy for a redness in the 
face, which it effectually removed, but instantly produced a dropsy of the 
chest, terminating in death. Dr. Blackall has recorded similar cases. 
Dr. Alley asserts that he had seen " that eruption appear over the entire 
body of a boy about seven years old, for whom but three grains of calomel 
had been prescribed ineffectually as a purgative." 
Many other instances of violent effects from a small dose of mercury 
might be cited. Besides, the following seems to prove that mercury may 
remain inert for a considerable time in the habit, and afterward, by some 
inexplicable circumstance, may become active : 
A lady, the mother of four children, in the twenty-eighth year of her age, 
had a bad miscarriage at the end of the fourth month. When the author 
was called, she was very much reduced from the loss of blood, and required 
the ordinary palliative remedies. Three days after the first visit she com- 
plained of a bad taste in her mouth, with soreness of her gums, and on the 
following day salivation took place. On inquiring into the circumstances of 
her previous history, it was learned that, four years before, she had had for 
a fortnight a course of the blue pill, which had only slightly touched the 
gums; and it was solemnly asserted, that she had never again taken any 
preparation of mercury, and had been, in general, in good health. 
The salivation was, therefore, at first attributed to some accidental cause , 
but when it was found to be proceeding with great violence, the medicines 
which the lady had been taking for the palliation of the complaints produced 
by the abortion, were carefully analyzed, from a suspicion that some mer- 
curial preparation might have been mixed with them ; but it turned out 
that they contained no mercury. The most anxious and unremitting atten- 
tion, and the careful exhibition of all the ordinary remedies which have been 
employed in similar cases, proved unavailing. The salivation, with the 
usual consequences of excessive emaciation, debility, and irritability, con- 
tinued for above twelve months. Occasionally for a day or two it was 
checked, but alarming vomiting, with threatening sinking of the living pow- 
ers, supervened. 
It is universally acknowledged that, although the morbid effects of mer- 
cury may be induced very suddenly, and by very small quantities of the 
medicine in certain constitutions, there are no marks by which such pecu- 
liarities of habit can be distinguished, and there is no method of arresting 
their progress. Hence the great danger of using this destructive mineral. 114 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
SECTION II. 
THE PERNICIOUS EFFECTS OF MERCURY IN VARIOUS DISEASES. 
In slight cases of indigestion popular prejudices may perhaps have led 
practitioners to attribute the most usual symptoms of indigestion to a reten- 
tion of bile, and to suppose that nothing else than calomel or the blue pill 
can afford them relief. 
Hazardous as it always must be for any individual to oppose popular pre- 
judice, it is incumbent on practitioners, in every instance of serious indis- 
position, to act according to their own deliberate judgment respecting the 
nature of the case, and not in compliance with the caprice of the patient. 
Physicians ought absolutely to refuse giving or sanctioning the use of mer- 
cury. 
Those who are subject to occasional fits of dyspepsia, particularly those 
who have resided in hot climates, are accustomed to appeal to their own 
personal experience, as directly evincing the great utility of calomel in such 
complaints. But if those persons could attend impartially to the effects of 
that medicine, they would find that its immediate operation is severe, and 
that it is followed for some time by uncomfortable feelings, and by an unusual 
susceptibility of derangement of the stomach and bowels. Perhaps, indeed, 
these very effects of calomel furnish in the majority of cases an antidote to 
the poison, for they compel the sufferers to adopt restrictions in diet, and 
other necessary precautions, which the immediate relief that would ensue 
from the operation of safer medicines might make them suppose to be useless 
Sometimes, it is true, a single dose of calomel seems to remove in a few 
hours the oppressive feelings produced by indigestion; and this happens 
from the sudden discharge of the acrid contents of the stomach and bowels. 
But a repetition of the same medicine, instead of being equally serviceable, 
generally aggravates the sufferings, inducing alarming fits of palpitation, or 
of faintings, or of such unaccountable feelings as lead to the dread of imme- 
diate death. 
The author can truly affirm that, in several cases to which he has been 
called, where patients had been under a course of mercury for stomach com- 
plaints, the irritable feelings described were in a much more violent degree 
than he ever witnessed from the same medicine given in other diseases. 
Nor is it wonderful that this should happen, since it is well known that one 
of the most common disorders occasioned by the use of mercury is indi- 
gestion. 
When symptoms resembling those of dyspepsia arise from organic disease 
of the stomach, or, through sympathy, from tubercles in the lungs, or altered 
texture of any other part than the liver, it may be questioned whether any 
beneficial effects were ever produced by mercury. In almost all the instances 
of this kind which have fallen under the author's notice, the original affec- 
tion was hurried on. 
The chemical preparations most generally in use as a purgative is calomel. 
w It has," as Mr. Carlisle has remarked, " a direct purgative power as a 
metalic salt; and it operates powerfully on the large intestines. It disor- 
ders the digestive powers of the stomach ; and, in debilitated persons, the 
frequent employment of it sinks the strength, and provokes haemorrhoids." 
It may be alleged that, in every complaint of infancy and childhood, calo- 
mel, within these few years, has been had recourse to, not only by practi- OF MEDICINE, AND INDICATIONS OF CURE. 
115 
tioners, but by parents and nurses; a practice which must have long ago 
been exploded if its bad effects had been known. 
Although a dose of calomel may seem merely to affect the stomach or 
bowels, it may, by its influence upon some latent disorder, such as tubercles 
in the lungs, or slight enlargements of the mesenteric or other internal glands, 
give activity to a disease, the source of which might otherwise have been 
removed by the natural powers of the constitution. The author has for 
several years been impressed with the conviction of this important truth. 
That there are many individuals who have often, with impunity, taken 
calomel as a purgative, is not to be denied; but it is equally true that 
extremely irritability of the stomach and bowels, ulcerations of the mouth 
with caries of the teeth, dropsy, epilepsy, and various other modifications of 
disease, have followed the use of that preparation. In several cases the 
author has decidedly ascertained that ulcerations of the villous coat of the 
intestines in infants and young children have been induced by the frequent 
repetition of doses of that medicine. 
Had these injurious effects of calomel upon delicate constitutions been hid 
from the rest of the profession, and known only to the author, some apology 
might be offered for the pertinacity with which that medicine is still pre- 
scribed ; but so far is this from being true, that it may be confidently asserted, 
that no medical man of competent knowledge and observation could administer 
colomel as a purgative, in a hundred instances, ivithout being convinced of its 
injurious tendency. Of this, innumerable proofs could be cited, but it is suf- 
ficient to appeal to the testimony of Professor Carlisle and of Dr. Blackall. 
Mr. Carlisle has expressed himself very strongly on this subject. " That 
grave men should violently persist in large doses of calomel, and order these 
doses to be daily reiterated in chronic and debilitated cases, is passing strange. 
Men starting into the exercise of the medical profession, from a cloistered 
study of books, and from abstract speculations ; men wholly unaware of the 
fallibility of medical evidence, and unversed in the doubtful effects of medi- 
cines, may be themselves deluded, and delude others for a time; but when 
experience has proved their errors, it would be magnanimous, and yet no 
more than just, to renounce both the opinion and the practice." 
Dr. Blackall's remarks, being very specific, afford a still more satisfactory 
proof of the validity of the author's opinions. " It appears to me," he says, 
" that no accidents proper to the disease can account for all those fatal con- 
versions to the head, which of late years have so frequently taken place in 
the fevers of children ; and I have on some occasions been disposed to attri- 
bute them to excessive and repeated doses of calomel, which, either not 
moving the bowels, as was expected, have given evidence of being absorbed ; 
or, on the other hand, have purged too violently, and been succeeded by 
diarrhcea without bile, and a prostration of strength, from which the little 
patient has never risen. Its less severe effects are sometimes of no slight 
importance; a slow and imperfect recovery, a languid feverish habit, and a 
disposition to scrofula. 
It need not surprise us that, in children, this disposition, particularly if so 
excited, should often be formed on the part most liable to every impression, 
and most actively developing itself-the brain ; since even in adults mercury 
is inimical to the nervous system. Parents have something to regret, who 
are so perpetually giving calomel to their children, without any distinction 
or care, as a common domestic remedy. And it is difficult to conceive on 
what view of the subject even practitioners proceed, who indulge in its use 
with less scruple than ever, with less caution as to management, while they 116 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
are observing and lamenting the daily increasing ravages of hereditary scro 
fulous disorders." 
Small doses of calomel may seem useful in bowel complaints, when, in 
reality, the amendment is to be attributed to the regulation of diet, and to the 
opiates which are commonly recommended at the same time. This is the 
case in all diseases. 
The author can confidently declare, that he has seen a number of infants 
and very young children destroyed, as he positively apprehends, by the indis- 
criminate use of calomel for complaints of the bowels. 
In dropsies there is either increased activity of the exhalents, or some 
altered condition of the circulating mass, which renders it acrimonious or 
stimulating when exhaled ; it is perfectly obvious that all medicines capable 
of aggravating such causes ought to be most carefully avoided : and since 
it is clearly established, that preparations of mercury have a direct tendency, 
both to increase the action of the arterial system and to alter the constituent 
parts of the blood, they must be regarded as most especially inadmissible. 
The author has never met, in consultation, with any practitioner of discern- 
ment and experience who has not admitted the fact, both that mercury and 
squills frequently fail to give relief in cases of general dropsy ; and also, that 
in many instances their exhibition has been succeeded by a rapid and mortal 
aggravation of the symptoms. If any reliance can be placed on the validity 
of the observations in the preceding pages, the reasons for these failures may 
be easily comprehended. 
Were any farther illustrations required, the author could state several 
distressing cases to which he has been called. The patients alluded to, while 
under a course of mercury and squills, had been unexpectedly seized with 
alarming breathlessness, or violent pain in the side, or sudden delirium, with 
a sharp pulse. But, although a rapid amendment had followed this change 
of treatment, the use of the mercury had been resumed whenever the alarm 
had fairly subsided and a hopeless recurrence of all the bad symptoms 
had ensued. 
Although the consideration may be humiliating, it is too instructive to be 
passed over, that the very reasons urged by practitioners of deserved eminence 
for the employment of mercury in dropsy of the head, are not unfrequently 
in direct contradiction to their own explanation of the nature of the disease. 
A late writer on this subject, of high reputation, for example, attributes it to 
increased action of the arteries, with, at the same time, venous congestations 
within the cranium, and recommends mercury for the purpose of substituting 
a new action. But the most ample proofs, it is presumed, have been brought 
forward in the preceding pages, to show that mercury increases the arterial 
action, that it alters the nature of the circulating mass, and that it impairs 
the energy of the nervous system, and, therefore, its operation must tend 
directly to aggravate those alleged causes. 
On this subject the author can express his sentiments with more than 
usual confidence, having, from his earliest years, had innumerable opportuni- 
ties of attending to the effects of mercury in this disease. In no instance 
under his observation has that medicine ever proved successful: and he fully 
agrees with Dr. Blackall in opinion, that on many occasions the injudicious 
use of that mineral has actually occasioned the disease. To his certain know- 
ledge, affections of the stomach and bowels have been converted into dropsy 
of the head, by the use of mercury prescribed on the presumption that the 
patient already laboured under that disease. 
Upon what principle mercury has been so universally employed in all cases OF MEDICINE, AND INDICATIONS OF CURE. 
117 
of enlarged ovarium, notwithstanding the variety of age, constitution, and 
state of general health of the individuals affected with it, no satisfactory 
explanation has hitherto been given. 
Far less can experience be pleaded in justification of this practice ; for the 
author speaks within bounds when he avers, that he has known mercury 
employed in some hundred cases of diseased ovarium, without its having- 
proved useful in a single instance. A few apparent exceptions have been 
reported to him by old pupils ; but, from the uniform result of all the cases 
which have been under his own notice, he is induced to believe that in those 
alleged exceptions the disease had not been the enlargement of the ovary. 
But while mercury can be of no utility whatever, it may, and certainly 
often has produced irreparable injury upon the general constitution. A most 
impartial attention to many of those cases has convinced the author that indu- 
rations, which might have remained for years without inconvenience to the 
patient, have been forced into morbid activity by a course of mercury. 
In some parts calomel has been employed for many years as the chief 
remedy in croup. But frequently two children in the same family, treated 
according to this plan, have died within a few days of each other. 
" About sixteen years ago," says a distinguished physician, " I was induced 
to give calomel a fair trial; and I can solemnly assert that, according to all that 
1 have seen, no relief whatever has been afforded by that medicine, unless 
copious dark green coloured stools, like boiled spinnage, have been discharged, 
and that it requires large and repeated doses of the medicine to produce even 
that effect. For example, to a child of seven years old one hundred and 
thirty-three grains were given within sixty hours." 
In reasoning upon this subject, it is extremely difficult to explain, in the 
first place, the safety with which a hundred and thirty-three grains of calomel 
could be given, within sixty hours, to a patient of seven years of age. 
It has been shown that the action of mercury tends, by exciting inflam- 
mation and effusion, to produce thickening of various membranes, particularly 
of the pleura; and several instances of that kind are recorded, where the 
fact was proved by the appearances on dissection. This effect of mercury 
has been long remarked by the author. 
Many practitioners imagine that mercury is a specific in the venereal disease. 
But this is not the case. Indeed it is very questionable whether it has any 
other than a deleterious effect in this disorder. 
This remark is exemplified in the experiments lately made in England by 
the head surgeon to the army. It is stated that about two thousand patients 
were cured without mercury, simply by abstinence and rest, or rather by the 
natural efforts of the constitution ; whereas no more were cured by mercury. 
Thus it is evident that that mineral exerts no influence in the removal of 
of syphilis, and that physicians impute to art, or rather to a dangerous medi- 
cine, what is due to nature. 
When we reflect that in fevers mercury is given with little scruple, we 
are led to remark, that " within the last thirty years either a sudden revolu- 
tion in the laws of the human machine had taken place, or that medical men 
had ceased to reason on the operations of medicine." 
Every practitioner who has paid the least attention to the effect of mercury 
in fevers, must be convinced of its immediate and subsequent injurious effects. 
No farther proof need be adduced than is found in the preceding pages : it 
is shown that it produces an augmentation of feverish and inflammatory 
symptoms ; that, from the time that the influence of mercury becomes evi- 
dent, the general strength declines rapidly, a dangerous emaciation, debility, 118 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
with an irritable state of the whole system ; also paralysis, epilepsy, loss of 
senses, and many other distressing and dangerous complaints. 
Who, then, in the possession of his reason, would think of exhibiting mercury 
in fevers. But, strange as it may appear, it is universally administered, and 
constitutes the chief medicine in the materia medica. We hope, however, 
that those who see its pernicious and fatal effects portrayed in this work, 
will in future flee from it as from the face of the most poisonous serpent. It 
would require years to give an account of the number of deaths it has occa- 
sioned. It has the power of decomposing the bones and to cause rottenness 
and exfoliation. 
Mercury appears to destroy the energy of the nervous system, producing 
weakness, tremours, palsies, fatuity, epilepsy, and mania, the most dreadful 
of all its bad consequences ; and indeed no part of the body is exempt from 
its deleterious effects. The patient becomes hectical, has a small quick pulse, 
and there is often a tendency to a colliquation on the skin and bowels, and a 
wasting atrophy of the flesh; his countenance is pale and wan, his nights 
bad, his appetite impaired, his strength much reduced, and he complains of 
general irritability, with headache and flying pains in his bones, especially 
on the approach of bad weather, of rain, of frost, or of north-easterly winds. 
Dr. Mathias states that the mercurial disease is rather greater than that 
awful scourge and curse, the venereal disease. I have seen, says he, the bones 
of the palate, the cartilages, and bones of the nose and palate all confounded 
in one diseased mass. I have also seen several cases of the mercurial dis- 
ease in which the complaint first commenced in the nose, and, after having 
produced considerable destruction there, the ulcerative process has crept up 
on each side of the jaw-bones, through the cheeks in an irregular direction, 
till at last the miserable patients have found the remedy for their sufferings 
only in their deaths. 
C. Bishop, of Massachusetts, both deaf and dumb, states that his deafness 
and that of his brother's was the effect of having calomel or mercury ad- 
ministered to them during their sickness with the typus fever. 
Mercury a cause of Onanism and other diseases.-We are inclined to 
imagine that intemperance and abuse of mercury predisposes to onanism, as 
to many other diseases, by impairing the general constitutional powers.- 
Porter on Onanism. 
SECTION III. 
CALOMEL OR MERCURY. BY DR. ANTHONY HUNN, OF KENTUCKY. 
This is the era of calomel. The present medical practice might well dis- 
pense with every other drug besides it. I own the calomel practice is both 
cheap and easy to the physician; for the whole extent of both theory and 
practice is, give calomel. If that will not help, give more calomel; and if that 
again proves abortive, double, treble the doses of calomel. If the patient 
recovers, " calomel has cured him if he dies, " nothing on earth could have 
saved him." The reader will conclude that medical schools and academies, 
with the headaching studies of anatomy, physiology, botany, pharmacology, 
chymistry, have been laid prostrate by this giant, calomel. Half a day's, nay, 
in a genius, half an hour's study will initiate any lady or gentleman into all the 
mysteries of the JEsculapian art, and the " aurea praxis " might swell the OF MEDICINE, AND INDICATIONS OF CURE. 
119 
account of a modern Galenus to one dollar at the expense of twelve and a 
half cents. This is certainly for the doctor a " consummation devoutly to 
be wished." But there is a heavy drawback on our joy, which the fable of 
the " boys and the frogs " so ingeniously portrays : " what is joy to you is 
death to us" said the expiring frogs. I expect to show to my impartial 
reader that the present calomel practice in fevers is a calamity in its ravages 
coextensive with the empire of civilization, and that war, with all its ghastly 
concomitants, must hail calomel its master. 
The proper effects of mercury on the human frame are, first, Fever, as I 
have before defined it. Second ; It is the cause of a peculiar action on the 
lymphatic vessels. Third ; It chymically decomposes the fluids, and pecu- 
liarly the lymph. This is, in my opinion, the true cause of the fetid breath 
in salivation. Fourth ; In constitutions prone to that effect, or under circum- 
stances favouring it, or when too long used, it produces mortifying ulcers of 
a specific kind, which hitherto have proved absolutely incurable. Its acci- 
dental effects are, first, salivation, which may also be produced by other 
drugs, and sometimes appear spontaneously, and which is not at all necessary 
to effect a cure. Second; In a state of great visceral irritability, or when 
given in large doses, it proves a sickening and powerful purgative, with a 
singular sympathetic affection of the liver, which viscus is thereby thrown 
into a morbid convulsive action, creating bile, exorbitant in quantity and 
poisonous in quality ; when, in a healthy state, the bilious secretion is mild, 
moderate in quantity, and salutary. 
Now, it appears to be a law in animaliation that two distinct fever causes 
cannot operate at the same time on the system. Thus, for instance, if the 
infection of the measles lodge in the body, when a patient is inoculated for 
the small pox, the latter will lay inactive till the first has run through its 
course. This law, I apprehend, has first introduced mercury into the fever 
practice; and it is a fact, if the proper mercurial action can be produced, the 
fever produced by a miasma will speedily cease. But my reader will please 
to observe, first, that in all fever cases it is extremely precarious and 
difficult to produce this proper mercurial action, and there are many cases 
in which it cannot be induced at all. Besides that, when induced, it is un- 
manageable. Second ; If the bowels are very irritable and weak, or in pecu- 
liar habits, it will operate as a purge and throw the liver into bile, creating 
convulsions, like a blister-plaster, on the very liver. It will attract more or 
less of the febrile impetus upon that vital organ, producing a dangerous in- 
equality, which is called " bilious fever." Third ; After a vast quantity of 
mercury has been introduced into the system, which, for want of sufficient 
excitability, has lain dormant; if now, by a sudden increase of that ex- 
citability, or from other unknown causes, it evinces its presence by salivation, 
this will be of course enormous and distressing. The teeth, valuable in- 
struments of our most substantial enjoyments, become loose and rot, perhaps 
fall out: or, worse still, the upper and lower jaw-bones exfoliate and rot out 
sometimes, as I have witnessed in the form of horse shoes; parts of the 
tongue and palate are frequently lost, and the poor object of commiseration 
lingers out a doleful existence during life. A tremendous description this, 
indeed; yet this happens when mercury performs a cure. In oui' summer 
and fall fever the pestilential bilious symptoms occasioned or aggravated by 
it, carry the patient speedily off in inexpressible torments, and spread the 
multiplied miasma among the mourning family, the unwary bystanders and 
mourners I 
Is there any of my readers who would not, by this time, pray " deliver us 120 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
from calomel ?" Yes, my fellow-citizens, you can be, the world will be 
delivered from it! Only drive away prejudice, that black thunder-cloud 
which ever hovers over truth ; think for yourselves, free as republicans ever 
should think; consult your precious healths and lives. Every free man 
should, at least to a certain degree, be his own lawyer, his own preacher, hit 
own physician. My method of cure in fever is entirely without mercurj 
and its doleful effects. Were I even not more successful than those gentle- 
men of the medical profession who trust so much to the virtues of calomel, 
still the gain would be immense; but, from facts enumerated fairly by my- 
self and others, I have nothing to fear from an impartial comparison. 
SECTION IV. 
THE STATEMENT OF DR. RICHARD REESE, OF LONDON, MEMBER OF THE ROYAL 
COLLEGE OF SURGEONS, AUTHOR OF THE " DICTIONARY OF POPULAR MEDI- 
CINE," " CHEMICAL GUIDE," CORRESPONDING MEMBER OF THE SOCIETY OF 
PRACTICAL MEDICINE OF PARIS, ETC. 
The charter of the " Royal College of Physicians " is found to contain a 
singular license, which is, a permission to any one and every one to practise 
the healing art by the use of herbs only. Now, we really do consider this as 
ample a permission as any man would require ; for poor must be the resources 
of that physician's mind, and very narrow his knowledge of medical botany, 
who could not, from the vegetable kingdom alone, cure most of the diseases 
of the human frame : even the specific of mercury, if we w'ere driven to the 
necessity of a substitute, might probably be rivalled in some of these produc- 
tions of nature. We know not whether we have most reason to hail the 
discovery of mercury as a blessing, or regard it as a curse, since the diseases 
it entails are as numerous as those which it cures. Our best informed 
dentists declare that they can clearly witness the progress of the use of 
mercury in the increasing diseases and decay of the teeth. There are 
serious objections also to other articles of the metallic world ; antimony, 
iron, and arsenic are dangerous remedies in the hands of the ignorant, and 
mankind, perhaps, in the aggregate, would be benefited by their expulsion 
from medical practice. 
SECTION V. 
PLATE SHOWING THE EFFECTS OF MERCURY OR CALOMEL UPON THE SYSTEM. 
The annexed figure represents the appearance and state of Mr. William 
W , of this city, in consequence of submitting to the treatment pursued 
and recommended by physicians and authors of the day. He had felt occa- 
sionally a little pain in his side, and requested a doctor to prescribe for it. 
He did so, and in a few days his tongue became enormously swelled and sore, 
and soon protruded out of his mouth, as appears in the figure. It separated 
and opened in four places, from which, as well as from his mouth, issued 
matter, blood, and water. The doctors, in consultation, concluded to operate 
upon his tongue, by making incisions in it. This, however, was objected OF MEDICINE, AND INDICATIONS OF CURE. 
121 
to : his jaws were also enormously swelled, and for ten days he ate nothing. 
One hundred and fifty-six leeches were applied to his tongue, and four 
quarts of blood were extracted from it. 
His tongue was thus protruded for the space of two weeks or more, during 
which time he was obliged to make his wishes known by writing ; and his 
recovery was considered very doubtful. He, however, employed another 
class of physicians, who, by pursuing an opposite mode of practice, (vegeta- 
ble instead of mineral,) soon counteracted the effects of the poison, by the 
application of poultices, &c.; and the man is now well, and ready to attest 
to the truth of this statement. This is by no means an uncommon case. It 
occurs often, and even worse consequences sooner or later follow the use of 
mercury and other poisonous metals, now so generally prescribed for every 
complaint. 
I am now attending a woman nearly destroyed by taking mercury for the 
prevailing influenza. Her whole system has been excessively diseased, 
almost unable to swallow ; her tongue, gums, throat, and jaws swollen and 
sore; her breath so fetid that it was almost impossible to stay in her room; 
flesh nearly wasted away ; countenance sunk, pale, and ghastly; excessive 
debility ; water running from the mouth ; appetite gone ; and, from the putrid 
staJ of the fluids, every appearance of mortification and death. • When the 
physician was first told of the mischief he had done, he made no apology for 
the treatment, but immediately began to converse upon another subject. 122 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
The son of this woman again called his attention to his mother, hut he was 
inexorable. Alas ! he had followed the books of the day, and this was suf- 
ficient to excuse his conscience ! This man was not one of the lowest grade 
of common physicians, by which some of the faculty might excuse the mat- 
ter, but a no less personage than one of the.physicians of the New York 
Hospital. 
Dr. Sweetser, in his work on consumption, states that calomel or mercury 
has been often ranked among the causes of consumption. That it may act 
as an exciting cause of the tubercles, hardly admits of a question. Mercury 
saps the constitution, creates the very diseases for which it is given to 
remove, and lays the foundation for infirmity, suffering, and premature decay. 
If mothers or doctors deal out calomel to children or others, we can only 
commend them to the mercy of heaven. 
In the year 1810 a large quantity of quicksilver, taken from the wreck of a 
Spanish vessel, was put on board the English ship Triumph, and the boxes 
stowed in the bread-room. Many of the bladders containing it soon rotted, 
which diffused it through the ship, mixing with the bread and other provi- 
sions. The consequence was, that very many of the officers and crew expe- 
rienced severe salivations and other deleterious effects from the mercury: 
two died from its influence ; and nearly all the live stock, as well as cats, 
mice, and a dog, and even a canary bird, died. Three persons, predisposed 
to pulmonary disease, died of consumption; and it caused consumptive 
symptoms in others. It is known that those who are doomed to work in 
the quicksilver mines soon lose their health, linger a short time, and are 
soon destroyed by its poisonous effects on the system. 
I was called, a few years ago, to visit a child in this city, to whom a phy- 
sician had administered mercury; and another such a melancholy and horrid 
spectacle I never witnessed. Nearly all of one side of the face, eye, and neck 
were mortified, black, and destroyed by this mineral ; and the wretched child 
was then dying from its effects. An attempt was afterward made by some 
to get the doctor indicted, but without effect, as the patient was killed 
according to law and rule. Suppose this mischief, or rather manslaughter, 
had been committed by a reformed practitioner, how soon would he have 
been arrested, tried, and punished. While ignorance continues, these evils 
will continue; but just as soon as the community are enlightened on the 
subject, down goes this poisonous system. What can change the tyrant of 
custom and fashion, or the religion of the Turks and Chinese? Nothing 
but intelligence and the light of Heaven. 
The disastrous effects of this " incendiary " practice have left fearfuk 
monuments of its destructive character in every city, town, village, and 
hamlet; in every civilized country, •where fashion and folly have been allowed 
to triumph over the dictates of common sense, and mercurial medicines per- 
mitted to assume the place of the more salutary productions of the life- 
preserving vegetable kingdom. So extensively, indeed, have mercurial 
medicines spread their ravages among mankind, that it has become an im- 
portant part of the physician's study to learn to designate and remove the 
maladies which are caused by them. 
Those who are engaged in working quicksilver mines, in New Spain, are 
almost always in a state of salivation ; and, when condemned as criminals to 
such labour for life, drag out a miserable existence in extreme debility, and 
wasting with stiff, bent limbs, total loss of teeth and appetite, till death in a 
few years puts an end to their existence. What a deadly poison ! 
The late Dr. Hunn remarks : " Has any physician yet discovered the OF MEDICINE, AND INDICATIONS OF CURE. 
123 
modus operandi of calomel ? No. Can anybody tell what calomel or mer- 
cury will do, when taken ? No. Calomel acts quite independently of the 
physicians wish or design. At one time three grains will purge the patient 
nearly to death ; at another time, in apparently the same situation, one hun- 
dred grains will produce no sensible effect." 
" The wife of a distinguished clergyman of Boston," says Mattson, " in- 
formed me that she had known, in her visits to the sick, at least one hundred 
cases in which salivation had been produced by small doses of mercury, 
contrary to the wishes or expectation of the attending physician." 
" A lady in Philadelphia was salivated by a small dose of colomel, and she 
suffered indescribable agonies ; her tongue swelled enormously, and protruded 
from her mouth, so that she could not speak nor scarcely swallow: her 
joints swelled and were exceedingly painful. She lingered in this situation 
for several weeks, when death put an end to her sufferings." 
Says Dr. McIntosh: " Some years ago Dr. Halliday, of the East India 
Company, was, by order of the Marquis of Hastings, put under arrest, and 
deprived of rank and pay, for showing, by most incontrovertible evidence, 
that in the general hospital of Calcutta the enormous quantity of twenty-six 
pounds of calomel was consumed by eight hundred and eighty-six patients ; 
and that, under the operation of this mineral, the proportion of deaths was 
one in about six and three-quarters of the whole list; while under a more 
rational treatment the mortality was reduced about one-half. The mortality 
bore almost an exact ratio with the quantity of calomel used." The same 
writer observes : " The deaths in the West Indies, under the mercurial plan, 
were never exceeded, amounting to nearly one-half of the whole number of 
the troops." 
Dr. Bigelow, of Boston, thus remarks: " I have known the tongue to be 
so much swelled, from the use of calomel, as to be pushed out of the mouth, 
and to remain out for three or four weeks before it could be restored. Infants 
terribly salivated by it, an extensive sloughing of the mouth and the gums 
takes place. A child will be affected by its mother's milk, if she is under 
the influence of mercury. 
Mercury enters into every part of the body-the blood, bones, milk, urine, 
bile, cutaneous discharges, serum, saliva, breasts, intestines, and there con- 
tinues ; and if the victim to such quackery lives, his system will be a living 
barometer, to denote the changes of the weather-great pain making the 
only difference. 
SECTION VI. 
MINERALS GENERALLY. 
In concluding this chapter, I will merely hint at the dangerous effects of 
most of the other minerals used for medicine, which I extract from an article 
I wrote some time ago, in reply to an attack made upon our practice by a 
physician of this city. 
Mercury.-The principal mineral now used internally to " heal all the ills 
to which our flesh is heir " is mercury. It is called the Samson of the 
materia medica, and so it appears to be ; for if Samson slayed his thousands, 
this mineral poison has slayed its tens of thousands. It is a matter of pro- 
found astonishment to me that any article, productive of such deleterious 124 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
effects, should be so highly extolled by the faculty, and be so universally 
used. It seems that modern not reformed physicians are the genuine 
descendants of that celebrated empiric, Paracelsus, who first discovered and 
made use of it. For many centuries previous Galen taught and practised 
the vegetable system of medicine for which we now contend. Many authors 
of distinguished reputation have raised their warning voice against the use 
and abuse of mercury, while others equally celebrated have proved, by expe- 
riments on thousands, that it is a very dangerous article; yet it is still 
administered for nearly every complaint. 
Muriate of Mercury.-Muriate of mercury, says a writer, is one of the 
most violent poisons with which we are acquainted. 
Zinc.-Zinc is the next mineral extolled by the writer as a suitable article 
for medicine. The following definition my be given of it: Zinc is a metal 
which exerts a powerful and very dangerous effect upon the system, espe- 
cially if an over dose is taken. 
Antimony.-It is known that antimony, given by physicians to puke, is 
often applied to the skin, mixed with lard, to produce pustules or eruptions ; 
and, after applying it a few days, they appear, and cause the most poisonous 
and painful ulcers. Now, it is obvious that the same mineral, when given 
internally, must act as a poison, by irritating the stomach and bowels: and 
is there not danger of its causing pustules in these organs, as well as on the 
surface ? Again; antimony, being very soluble in water, is liable to be 
absorbed into the circulation and exert its destructive, irritating, and poi- 
sonous effect on every organ, causing a metallic state of the mouth, nausea, 
vomiting, hiccough, burning heat and pain in the stomach, colic, copious 
evacuations from the bowels, fainting, increased action of the heart and 
arteries, cold skin, difficult respiration, loss of sense, convulsive movements, 
cramps, and death itself. And, notwithstanding all these baneful effects, 
physicians are in the daily habit of administering this dangerous metal. 
Antimony, says Hooper, is a medicine of the greatest power of any known 
substance ; a quantity too minute to be sensible in the most delicate balance, 
is capable of producing violent effects, if taken dissolved or in a soluble state. 
Arsenic or Ratsbane.-This is another mineral which physicians of the old 
school are in the habit of giving as a medicine, when it is knowm that a few 
grains are sufficient to destroy life. It is usually disguised and given in the 
form of Fowler's solution, which is very pleasant. It is also applied externally r 
in the form of powder or plaster, for the destruction of cancers ; and in this 
way is sometimes absorbed, and proves serious. Given internally, it causes 
nausea, sinking, burning pain and heat near the heart and over the whole 
body ; inflammation and eruptions on the face, lips, tongue, palate, and throat, 
vomiting black and fetid stools ; small pulse, palpitations, great thirst, faint- 
ing, coldness, cold sweats, difficult respiration, bloody urine, swelling and 
aching of the body, livid spots on the surface, great prostration, loss of sight, 
delirium, convulsions, and sometimes it proves fatal. It has been shown, by 
dissections, that the stomach and bowels have been inflamed and ulcerated, 
and partly destroyed. It is known that this mineral is given to destroy rats, 
and yet persons take it for medicine, because given by a physician. 
It is stated by Hooper that arsenic is one of the most sudden and violent 
poisons we are acquainted with. When the quantity is so small as not to 
prove fatal, tremours, paralysis, and lingering hectics succeed. We are, on 
the combined testimony of many medical practitioners, conspicuous for their 
professional zeal and integrity, irresistibly induced to declare our opinion, at 
least against the internal use of this active and dangerous medicine OF MEDICINE, AND INDICATIONS OF CURE. 
125 
Iodine.-It is stated in Hooper's Medical Lexicon that, whenever iodine 
is administered, an over dose must be avoided, as it acts with extreme and 
dangerous effects on the constitution. 
Metals generally.-The attention of the reader is particularly directed to 
the following testimony of the above-mentioned writer : 
" All the metallic preparations are uncertain, as it depends entirely on 
the state of the stomach whether they have no action at all, or operate 
with dangerous violence." 
" Minerals," says the learned Dr. Chyne, " are the most destructive to 
animal bodies that malice can invent, beyond gunpowder itself, and even 
spirituous liquors ; for not only nature has provided none such, but as poisons 
in venomous creatures, to kill their enemies. They become iron, bristles, 
nails, and lancets, darting perpendicularly into the solids of the body, so as 
quickly to tear, rend, and destroy ; and, therefore, can never be proper for 
food or physic. Whereas galenical, or vegetable, productions have none of 
these bad properties, and are, consequently, designed for both food and for 
the sick." 
CHAPTER II. 
BLOOD-LETTING. 
7/ the employment of the Lancet was abolished altogether, it would perhaps save annually a greater 
number of lives than in any one year the sword has ever destroyed. DR. REID. 
SECTION I. 
Among the various means made use of to restore the sick to health, there 
is none so irrational and absurd as blood-letting. It is, at present, consi- 
dered almost as a universal remedy, and resorted to for the cure of the 
slightest indisposition ; and, although daily slaying its thousands, it still 
continues to be the main pillar of the profession. Indeed, were bleeding 
and mercury to be altogether prohibited, many physicians would find them- 
selves in a sad dilemma; for their hands would be completely tied. 
We are unable to determine precisely the commencement of this pernicious 
custom, but we find it to be very ancient; having been, it appears, commen- 
surate with the declension of the healing art in the earliest ages of the world. 
It was not, however, carried to such an extent, till after the discovery of 
the circulation of the blood by Harvey. It was at this period that the whole 
faculty began their mad career, in committing the most wanton violation of 
the laws of nature. Those who were so unfortunate as to fall victims to 
disease, were doomed to suffer the most extravagant effusion of blood, and 
the poor sufferers were soon hurried to an untimely grave, secundum artem ; 
even the guillotine of France scarcely surpassed this systematic murdering. 
But in process of time practitioners began to witness the mischief they were 
committing, which in some measure damped their ardour in these bloody 
scenes. This check induced one physician to remark, that the proportionate 
disuse of the lancet was one of the greatest improvements in modern medicine. 
We find, however, that blood-letting has been practised for many centuries 126 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
almost with the same infatuation ; and, lamentable for mankind, in the 
present day it is regarded as the most powerful weapon to subdue disease. 
There are few maladies in which it is not recommended. In pleurisy and 
all inflammatory complaints an astonishing quantity of blood is drawn from 
the system. It is very common to take from five to seven pounds in twenty- 
four hours. One of the professors in the medical college of this city stated 
that he had frequently bled his patients to the amount of two hundred ounces 
in three days. Another professor declared that he had taken three hundred 
ounces in a short space of time, and, for proof of this fact, appealed to one of 
his students. The effect of this practice I shall leave for people of common 
sense to determine. How much is it to be regretted that such an awful 
scourge of humanity should exist! A little examination into the conse- 
quences of blood-letting will prove that, so far from its being beneficial, 
it is productive of the most serious and fatal effects. 
Nature has endowed the animal frame with the power of preparing, from 
proper aliment, a certain quantity of blood. This vital fluid, subservient to 
nutrition, is, by the amazing structure of the heart and bloodvessels, circulated 
through the different parts of the system. A certain natural balance between 
what is taken in and what passes off by the several outlets of the body is, 
in a state of health, regularly preserved. When this balance, so essential to 
life, is, contrary to the laws of the animal constitution, interrupted, either a 
deviation from a sound state is immediately perceived, or health from that 
moment is rendered precarious. Blood-letting tends artificially to destroy 
that natural balance in the constitution. Nature, deprived of a quantity of 
the circulating fluid, being fitted with means for repairing the loss she has 
sustained, begins immediately to repair it. The secretions and excretions 
in general are diminished ; the appetite is increased ; and, for a short time, 
the process of nutrition is unusually quick. 
Thus, by the wisdom of Providence, nature soon restores to the constitu- 
tion what art had taken from it.* The consequences, therefore, of having 
been once bled are rarely considerable. This single operation, however, is 
an imprudent violation of nature and of common sense. 
But too often the practice has not rested here : for various are the inci- 
dents which favour the repetition of blood-letting. The patient, if addicted 
to an easy, indolent, luxurious way of life, may find himself, after the evacua- 
tion, sensible of some present ease. The system, being before too full of 
blood, or rather the balance being lost, enjoys a short respite from its usual 
oppression. Or, after the bleeding, though it was improper, and tended 
rather to increase the disease, yet the hope of relief, or a change of weather, 
the benefit of exercise and country air, or some other alteration in an accus- 
tomed manner of living, may, by palliating or removing the complaint, pre- 
judice the patient in favour of the lancet. The disorder, it may be, was of 
such a kind as really to admit of alleviation from the use of bleeding ; but, 
nevertheless, the remedy unhappily proves of worse effect to the constitution 
than the disease itself would have done, though entirely left to nature. Great 
numbers of people who have been relieved by bleeding, are apt to be partial 
to the means of their own recovery, and to become strenuous advocates for 
its use, even in cases by no means similar to their own. 
These, and a variety of other accidental causes, often persuade to repeti- 
* It very frequently happens, however, that in many habits the loss of even small quanti- 
ties of blood induces such a debility as to prevent a reaction of the system, whereby the 
blood becomes thin and watery, dropsical and other diseases follow, and very commonly 
death itself. OF MEDICINE, AND INDICATIONS OF CURE. 
127 
tions of blood-letting. The consequences now become more serious. The 
constitution, though it did not suffer materially from one bleeding, yet, far 
from being able to undergo with impunity repeated operations of a similar 
kind, turns against itself those powers which were given for its preservation, 
and co-operates with the imprudent use of the lancet in promoting the ac- 
complishment of its own destruction. For now the constitution not only 
repairs the losses of blood it sustains, but, if the common intervals of time 
6e interposed, makes more blood than is naturally required for the purposes 
of health and life, that it may be able to bear such repeated evacuations. 
Thus the habit of blood-letting is established. But, in fact, habitual blood- 
letting augments the very evil it was intended to remove : for sanguine 
evacuations, necessitating the constitution to make more blood than is requi- 
site, produces too great fulness of the system. The balance between what 
is taken into the body and what passes off by its several outlets, is no longer 
maintained. As the disposition to plethora exists, plethora itself, if the 
person continue to live in his accustomed manner, will undoubtedly prevail, 
except at that time when the constitution has just received the unnatural 
assistance of the lancet. The habit of letting blood increases and becomes 
stronger by repetition. In this state the constitution, in spite of human art, 
will at times labour under various degrees of plethora, till the vessels arrive 
at that point of fulness which again creates the necessity of bleeding. 
Though some constitutions are so robust, or so peculiarly framed by nature, 
as to bear such treatment without any evident bad consequences, yet this is 
but the privilege of few. Many will severely suffer, though they themselves 
may often be the first to extol in the highest terms of praise that very re- 
medy which has proved so pernicious to their own constitutions. They 
have been bled till stated bleedings become necessary, not only for the sup- 
port of health, but even for the preservation of their lives. They have 
injudiciously created to themselves the necessity of bleeding, and are even 
happy to find that it relieves complaints, which it at first tended to conduce, 
and afterward to confirm. 
The effects of plethora are many and dangerous. A slight degree of it 
often produces strange commotions in weak and irritable habits. No person 
who depends for the preservation of his health on an artificial discharge of 
blood, can ever be pronounced out of danger. Before the usual means of 
relief be employed, the sanguine fulness at one time or another may have 
proceeded to a morbid, or even to a fatal length. The anticipation of the 
stated bleedings may, with the greatest inconvenience, lessen, but it can never 
remove, the danger. An increase of fatness, unnatural heat, torpor, inac- 
tivity, and a sense of lassitude are common effects of plethora. The whole 
vascular system is unnaturally put upon the stretch, and along with it the 
nervous and muscular fibres. Thus, by slow degrees, the tone of the body, 
in consequence of so considerable an over-distention, is in danger of being 
destroyed. The constitution itself, in proportion to its native vigour, is 
rendered liable, exclusive of every other cause of disease, to break many 
years sooner than it might otherwise have done in the common course of 
nature, if nature's laws had not been wantonly violated or presumptuously 
despised. Hence old age sets in at an earlier season, and becomes afflicted 
with heavier infirmities. Frequently the appetite fails, the powers of diges- 
tion and nutrition are impaired, the body shrinks, the mind becomes dejected, 
the stomach and bowels are disordered, sleep is interrupted and unrefreshing, 
and, in short, the whole constitution fundamentally shaken and debilitated. 
These are the slow, but frequent, consequences of bleeding. Others 128 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
in fact occur, which, though on the whole they are perhaps less destructive, 
are, however, more painful and better distinguished. 
Too great a fulness of blood predisposes the constitution to a world of dis- 
orders. Inflammatory fever and external inflammation, the phrensy, the 
pleurisy, and the quinsy, rheumatism, haemorrhage, &c., are frequently the 
disorders of a sanguine habit, depending greatly on the plethoric state. Phy- 
sicians likewise are perfectly agreed, that too great a quantity of blood, in- 
creasing irritability, has a strong tendency to excite, in habits where the 
predisposition to such disorders exists, convulsions, St. Vitus' dance, epilepsy, 
and hysteric fits; complaints which otherwise might never have made their 
appearance. We may farther add, pains of the head, vertigo, night-mare, 
often the forerunners of apoplexy and palsy, which are justly ranked among 
the unhappy effects of plethora. Habitual blood-letting tends, indeed, parti- 
cularly to bring on apoplectic and paralytic complaints. The morbid habit, 
acquiring strength by repetition, produces its fullest and most trying effects 
in advanced age, when venous plethora occurs, and when the veins of the 
head, in old people, are particularly subject to rupture and the consequent 
effusion of blood-far the most frequent and fatal cause of apoplexy. 
Thus much, by way of example, to show the injurious effects of bleeding. 
It has been proved that habitual artificial discharges of blood, instead of 
diminishing, tend to produce plethora ; the pernicious consequences of which, 
on the human constitution, have been briefly enumerated. 
Some may object to this reasoning, that in many instances of habitual 
blood-letting the effects here mentioned have not followed ; and that, where 
they have other causes more powerful, have principally produced them. We 
answer, that such argument is inconclusive in itself, and foreign to the pre- 
sent subject. Not uncommonly the slighter effects of blood-letting are in- 
accurately overlooked or ignorantly neglected. But where that is not the 
case, it may be observed that particular causes of disease, when not alone 
completely efficient, are often applied without inducing any morbid effect. 
Hard would be the fate of mankind were every species of contagion to infect 
every person to whom it might be applied. To argue, that habitual bleed- 
ings are no cause of apoplexy, because apoplexy is not constantly induced, is 
just as rational as to deny the very power of a pestilential contagion, because 
it has been applied to thousands without exciting the pestilential fever. To 
produce a disease, two particulars in general are requisite ; first, the predis- 
position of the body ; secondly, the application of the exciting cause. With- 
out the predisposition we are often exposed with impunity to otherwise very 
active causes of disease ; and, without the application of the cause, the pre- 
disposition may continue with us through life without inconvenience. With 
regard to the latter part of the objection, that other causes more powerful, act- 
ing in conjunction with habitual blood-letting, may probably have produced 
the effects which have been enumerated, it is evidently foreign to the pur- 
pose. We grant that full living and the neglect of exercise may very 
powerfully assist in exciting the consequences of plethora. It is believed, 
too, that there are men who would rather submit to be bled even once a 
month, with the privilege, in the meantime, of indulging their vitiated ap- 
petite at large, and of enjoying the pleasures of ease, than by living a tem- 
perate active life, possess the most perfect state of health, the free gift of 
heaven, independent of the assistance of art. Yet the argument just ad- 
vanced appears still decisive, that habitual blood-letting often produces a 
sanguine fulness of the vascular system, liable to be followed with pernicious 
effects, and is, therefore, absurd, and highly detrimental to health OF MEDICINE, AND INDICATIONS OF CURE. 
129 
The following are the (Observations of the surgeon of the western regiment 
of Kentish militia, England, on the effects of blood-letting. They plainly 
prove the inutility and absurdity of bleeding for the " cure of any disease 
with which we are acquainted." His language ought to be written in letters 
of gold. He remarks : 
" I have been upward of six years surgeon of the western regiment of 
Kentish militia, during which time our number of sick has never been incon- 
siderable ; whereby much opportunity of practice has been afforded me. I 
have been in the habit of keeping a journal of the different cases as they 
occurred, wherein I carefully noted every symptom of which the patient 
complained, the various remedies exhibited, the time when, and with what 
view given. I also marked every change that took place in the course of a 
disease, and the effect of the medicine made use of; and, lastly, my own 
opinion of the method of cure which I adopted. In the course of my prac- 
tice I have endeavoured, on every occasion, to determine the justness of 
preconceived theories by experience, and on every subject to think for my- 
self, uninfluenced the tenets of school or the opinions of others. The pre- 
valence of any mode of practice is certainly not a clear proof of its being 
useful, nor is it a sufficient recommendation that it may be practised with 
safety. If it is not evidently beneficial, it ought to be laid aside. In this 
light I consider that the custom of bleeding, as a means of cure in febrile and 
other diseases, which I have no hesitation in asserting, is not necessary in 
any complaint with which we are acquainted. If wre grant that any devia- 
tion from the healthy state denotes debility, either general or partial, surely 
whatever has a tendency to debilitate farther, it is reasonable to suppose, 
ought to be carefully avoided. It certainly cannot be denied that, in every 
disease wherein bleeding has been used, complete recovery has been pro- 
tracted, owing to the debility thereby occasioned. We are directed to use 
blood-letting to lessen irritability, to take off the phlogistic diathesis, to de- 
plenish the bloodvessels, and to prevent inflammation. I know' by experience 
that these indicationscan be fulfilled much better, with less danger,by other 
means. Though the ill effects of the loss of blood, unless excessive, are 
seldom perceivable in youth, yet they rarely fail of being felt before the 
age of forty-five. People who have been often bled when young, about this 
period of life begin to be afflicted with chronic pains : they recover very 
slowly from fits of illness, and are very liable to febrile paroxysms and 
a variety of other disorders. I have rarely been deceived in my conjec- 
tures respecting patients of this description, when I have met with them. 
The cases mentioned by Dr. Denman show that it does not prevent inflam- 
mation or abortion ; nor is it proved that, by taking away blood, we lessen the 
diameter of the bloodvessels, as we find that six ounces from a large orifice 
has a greater effect than twenty from a small one. 
SECTION II. 
dr. vaughan's case of death occasioned bv bleeding, from the 
LONDON MEDICAL AND PHYSICAL JOURNAL. 
Mr. Charles Green, saddler, in North Fleet-street, a man about thirty- 
five years old, athletic and convivial, was bled on Sunday in the arm. The 
wound in the vein was very large, and the discharge of blood from it was 130 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
profuse, quick, and difficult to be stopped. When stopped, however, the 
arm was kept quiet, and no pain was felt in it all the next day, nor indeed 
till Tuesday evening. At this time a pain was felt at the wound, particularly 
below, extending from it as high as the middle of the arm. The pain in- 
creasing, Mr. Green soon began to experience some pain in the head and 
some confusion of thought, which, together with extreme anxiety, restless- 
ness, shortness of breath, and frequent rigours, made him declare to his wife 
his apprehension that his having been bled would presently cost him his life. 
A surgeon was sent for on Wednesday. On Friday, by twelve o'clock, when 
I saw Mr. Green again, the tumour of his arm had totally subsided, and 
there were evident marks of inflammation from the bend of the arm to the 
axilla. But, alas ! though Mr. Jones had, in my absence, applied sinapisms 
to the feet with a view to relieve the head, yet the disease, which had a re- 
gular time of appearing and ending, went on with such celerity and increase, 
that Mr. Green died this very day, (Friday,) in less than three hours after I 
left him. 
Dr. John Pullffs Observations on the Effects of Bleeding,in relation to the 
above case.-There are evil symptoms following the use of the lancet not 
depending on the action of any morbid poison ; not resting on the unscientific 
conduct of the operation; but owing their appearance to a peculiarity (call 
it irritability, if you please) of constitution. Sometimes an abscess forms in 
a cellular membrane around the puncture from the lancet, which commonly 
approaches to the size of a walnut; and, if the habit be very bad, the inflam- 
mation will extend far around, and a considerable sloughing o.f the parts may 
be the consequence, insomuch as to render the removal of the limb a matter 
of necessity : and even after amputation the stump will, in all probability, 
assume the like disposition to slough. In either case the symptoms of irri- 
tation may be great enough to destroy life- When the vein is disposed to 
inflammation, much pain is felt after bleeding, and around the punctured 
part shortly appears aredness and swelling, which soon extends along the arm, 
both above and below the elbow. The arm feels knotty, and pain is given 
on the touch. The inflammation and swelling sometimes extend to the 
breast. The accompanying symptoms of irritation are always great; some- 
times producing delirium, and even the. death of the patient. It is said that 
horses, after bleeding, are not unfrequently attacked with this affection of the 
brain. On dissection, pus has been found in the vein, and even in the heart. 
It has been imagined that the inflammation has been induced by the external 
.orifice not being effectually closed : but this idea is by no means correct. 
SECTION in. 
BLEEDING IN PLEURISY. 
5 am perfectly satisfied that there is no necessity of bleeding scarcely in 
any case. A few days ago I was called to a patient labouring under a vio- 
lent attack of the pleurisy. Almost every practitioner, however averse to 
blood-letting in general, recommends it in this disease. As soon as I ex- 
amined the person, he requested me to bleed him, and give a dose of mer- 
cury and rhubarb, as a certain physician always was in the custom of doing 
in this complaint. I intimated to him that nothing was more common than 
for physicians to disagree, and hoped that he would abide by my directions OF MEDICINE, AND INDICATIONS OF CURE. 
131 
I, in the first place, ordered a decoction, which produced a most copious 
perspiration. This was about four o'clock, p. m. Early the next morning 
a vegetable purgative was administered. I called to see him on the same 
day about twelve o'clock, when I found the inflammation and cough had 
subsided; the pain in his side, which was very acute, entirely gone, and all 
the symptoms of the disorder, which were violent in the extreme, (inso- 
much that his friends dispaired of his life,) abated. I asked him how he 
felt ? He answered, I am well. In the morning he was not able to articu- 
late a single sentence. Had this person been treated according to the 
present system of depletion, and had his constitution been vigorous enough 
to have resisted the force of his disorder, together with the dangerous treat- 
ment, he must, in all probability, have been confined to his bed for the 
space of three months ; instead of which, in four days he was able to attend 
to his ordinary business. Did physicians know the number of people killed 
by bleeding, 1 am persuaded they would abolish such an irrational practice. 
It always endangers the life of a person, and never fails to aggravate his 
disorder; and, if so fortunate as to recover, he experiences a train of evil 
consequences through life. 
The, blood is properly called the vital fluid, and the life of a person is said 
to be in the blood. We know that, just in proportion to the loss of this 
substance, is our vigour and strength taken from us. When taken from the 
system, by accident or the lancet, it is succeeded by great prostration of 
strength, and a derangement of all the functions of the body. These effects 
are invariably, in a greater or less degree, consequent on bleeding. Is it not, 
then, reasonable to suppose, that what will debilitate the strongest constitu- 
tion in a state of health, will be attended with most serious evils when ap- 
plied to a person labouring under any malady ? Is it not like throwing 
spirits on a fire to extinguish it ? But, says one, we must deplete the sys- 
tem, empty the bloodvessels, and take away the strength to arrest the 
disorder. In other words, we must make the patient worse, before we can 
make him better. 
This argument shows how ignorant medical men are of the animal econo- 
my, and the indications and cure of diseases. No system could be invented 
better calculated to counteract the healthy efforts of nature. Bleeding is 
immediately resorted to in all inflammatory complaints ; but did practitioners 
know the nature and design of inflammation, their treatment would be 
different. In fever it is produced by an increased action of the heart and 
arteries to expel acrid and noxious humours, and should be promoted until 
the irritating matter is dislodged from the system. This should be effected 
in general by inducing perspiration ; to produce which, a preternatural de- 
gree of heat or inflammation must be excited by internal remedies. Fever 
is nothing more nor less than a wholesome and salutary effort of nature to 
throw off some morbific matter, and, therefore, every means to lessen this in- 
dication proves injurious. Bleeding, in consequence of the debility it pro- 
duces, prevents such indication from being fulfilled. 
I have now a London periodical publication before me, in which the editor 
laments that we have no better means to subdue inflammation than by 
bleeding. He remarks: 
" Our most valued remedies against inflammation are but ill adapted for 
curing that state of disease. They do not act directly on the diseased 
part; the action is only indirect; therefore it is imperfect. Bleeding, the 
best of any of these remedies, is in this predicament. The direct action 
of bleeding ia only to lessen the quantity of blood. Now, suppose, as often 132 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
happens, that a person is apparently well to-day, and he is taken ill with an 
inflammation of the lungs to-morrow ; in such a case it will, perhaps, be 
necessary to take away several pounds of blood from the patient, and yet 
the quantity of blood in his body must have been much the same just before 
the attack, when the person was in good health, as it was afterward when 
the disease had commenced. The bleeding, therefore, cannot be employed 
to lessen the quantity of blood. Some other reason must exist. 
The truth is, that lessening the quantity of blood is the best mode we 
know of to control that ebullition of the circulation which forms the impor- 
tant feature of the inflammatory state: but it is evident that this action of 
bleeding on the disease is only an indirect action ; and it is, moreover, true 
that it is positively injurious to the constitution to take away so large a 
quantity of the vital fluid, as the blood is very properly called." 
I was called a few days ago to see a lady who had been bled seventeen 
times within a few months, for some inconsiderable complaint. The last 
blood drawn was as transparent and limpid as water. She was so far 
exhausted as to be unable to walk; she was reduced to a state of misery : her 
pulse languid; her countenance ghastly ; her extremities swollen; and 
evident symptoms of approaching dissolution. I might cite scores of cases 
in which people have either lost their health or lives in the same manner. 
In pneumonia, or inflammation of the lungs, blood-letting is practised with- 
out reason or mercy. Again and again the patient is bled, till his strength 
is completely exhausted; when a free perspiration and other means would 
afford immediate relief, without destroying the constitutional stamina. 
Dr. Sandwich, an English surgeon, has written a treatise recommending 
in the highest terms the most copious depletions. He informs us, that in 
every species of inflammation it is necessary " to bleed in quick succession 
and that, unless we speedily repeat our bleedings, we often actually increase 
the violence of the disease, and convert what was mere congestion into 
positive inflammation. He, indeed, lays down the following position as a 
practical maxim: " Whenever an inflammation is not cured by the first 
bleeding, the operation should be repeated every two, four, or six hours, 
until it is." 
Dr. S. presents a case in point, viz., of pneumonia, in which thirty ounces 
of blood were first taken. This was at twelve o'clock, on the 28th of March. 
At eight o'clock thirty leeches were applied to the affected side. At six 
the next day, twenty ounces more of blood were taken; in the evening 
sixty small leeches were applied to the side. On the third day, at six, the 
pulse being 110, twenty ounces of blood were taken, and a physician was 
sent for. " The relief obtained by the bleeding was not at this time decisive. 
The blood still showed no size; nevertheless, I was certain," says Dr. S., 
" the disease was pneumonia," and anxiously pressed another bleeding, 
which was overruled. Another physician was accordingly sent for ; but, in 
consequence of a difference of opinion between the two, the patient was not 
again bled till the afternoon of the 2d of April, " when twenty-two ounces 
of blood were abstracted, with decided relief and syncope." After this there 
was a suspension of active measures, until the 6tb, -when inflammation, evi- 
dently to Dr. S. and one of the attending physicians, still existing in the 
pericardium, the patient was again "bled, usque ad (fifty ounces,) 
and was in a state verging on syncope for several horns." Early in the 
morning, on the 7th, twelve ounces more were abstracted; and during the 
following three days the system was in a state of torpor. On the 11th, in 
the evening, there was a relapse. In the morning (4 o'clock, a., m.) twelve OF MEDICINE, AND INDICATIONS OF CURE. 
133 
leeches were applied, and sixteen ounces of blood taken from the arm. Our 
author's next date is the 20th; but he speaks of this as of a day immediately 
succeeding the 11th; for he says, " a comfortable night was the result of 
these measures, (the measures of the 11th,) but the next morning we found 
it necessary to abstract sixteen ounces more of blood." On the 22d thirty 
ounces more were taken. On the 25th twenty-four good leeches were 
applied to the side. At eight o'clock on this day " the patient was almost 
exanimate, the face corpse-like, and the pulse vermicular and past numera- 
tion." The debility the whole of the next day was extreme. On the 
following morning the memory was gone and the mind imbecile.* 
Dr. Reid, in the Medical and Physical Journal, reports as follows: 
The reporter of Finsbury Dispensary has, this last month, been impressed 
more deeply than ever with the fatal folly of bleeding. A person who, at a 
very advanced period of life, was sinking under the combined operation of 
age and intemperance, was advised, on account of a difficulty of breathing, 
arising from general debility and a mutilation of the pulmonary organs, to 
experience frequent and extravagant evacuations from the arm; which, of 
course, in a very short time put a period to his terrestrial existence. 
If the employment of the lancet was abolished altogether, it would perhaps 
save annually a greater number of lives than in one year the sword has ever 
destroyed. Medical men are sometimes apt to consider themselves, and are 
generally regarded by others, as insignificant and inefficient, unless they are 
doing something ; that is, either performing some painful operation or admi- 
nistering some powerful remedy. Whereas the fact is, that in no inconsi- 
derable proportion of cases the best thing that can be done is, to let the patient 
alone. 
An inflammatory fever, or a habit indicating excess of general excitement, 
in this enervated age, very rarely occurs; and local inflammation, such as 
acute rheumatism, gout, or quinsy, will seldom, with impunity, admit the 
opening of a vein. In the last disease the writer has had more especial 
reason to entertain this opinion, in which he is confirmed by the authority of 
a man celebrated as a philosopher, although not a member of the medical 
profession. " Ah, these accursed physicians! they will certainly kill her 
with their blood-lettings. I have been myself extremely subject to the 
quinsy, and have invariably found that bleeding increased its violence; 
when, on the other hand, I contented myself with using a gargle, and putting 
my feet in warm water, I generally found myself well the following day." 
How absurd, to take away any part of that fluid which conduces most 
essentially and immediately to the vigour and support of the constitution. 
Dr. Whyth relates a case which proved fatal in consequence of bleeding. 
A delicate or nervous girl, having chilled herself at the return of a critical 
period, was next morning, at four o'clock, seized with stupour and difficulty 
of speaking or moving. She was soon after bled and blistered. At eight 
o'clock she could neither speak nor swallow, had a hiccough, and was pale 
and cold, though her pulse and breathing were natural. Besides taking 
medicines, she was now bled again, and a third time in the afternoon, and 
died at ten o'clock-eighteen hours after her seizure. No one can doubt 
for a moment but that this lady was killed by her physician. 
The reporter was called up last evening, suddenly, to a patient labouring 
under inflammation of the stomach. An evacuation of blood, which exag- 
gerates that complaint by inducing debility, was abandoned. I administered 
* Was ever a bullock more completely bled to death ! 134 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
a purgative, in the form of an emena, which afforded relief soon after it 
was given. Two persons were this day slain in this neighbourhood by the 
lancet, and it was expected that another would soon share the same fate. 
Well this philosopher exclaim, "Ah, these accursed physicians I" 
If one single man can do so much mischief with this instrument, the lancet, 
what mischief is done throughout the world by thousands of others ! 
Dr. James Mann, who was hospital surgeon to the army of the United 
States in the years 1812, 1813, and 1814, relates the following case : He 
says, " a man at Rochester was bled eight ounces, and within twenty-four 
hours took one hundred grains of mercury, one hundred grains of jalap, two 
ounces of castor oil, and four ounces of salts." He adds, "this man died, 
suffocated while walking his room." 
SECTION IV. 
REMARKS ON BLEEDING. BY DR. ROSS. 
Rush says, in his account of the yellow fever of 1793, page 275, " As 
a proof that I did not draw one ounce of blood too much, it will only be neces- 
sary to add, that haemorrhages frequently occurred after a third, a fourth, and, 
in one instance, after a sixth bleeding had been used." To this statement 
a Scotch physician, who was travelling through the United States, and who 
happened to be then at Philadelphia, made the following reply, by which 
the reader will be fully convinced that the spontaneous haemorrhage, in- 
stead of being prevented, is produced by copious bleeding, and that Rush's 
proof of the efficacy of his remedy is, on the contrary, a proof of its mortal 
effects. 
It is confidently asserted, that the spontaneous haemorrhages, which fre- 
quently occur in malignant fevers, are solely occasioned by the omission of 
copious blood-letting ; and as these excessive haemorrhages appear in many 
cases to be the immediate cause of the death of the patient, we are told this 
fatal termination would have been prevented, if blood had been freely drawn 
at any preceding period of the disease. 
This reasoning is so specious, that, in the minds of all those readers who 
are unacquainted with the anatomy and pathology of the human body, it 
must be decisive. 
We must cease to look for its explanation in the superabundance of blood, 
and fix our attention upon what appears to be its proximate cause, the 
extreme debility that prevails at the time of its occurrence. 
That excessive weakness alone is sufficient to account for spontaneous 
h<emorrhage,* will be completely proved by observing the frequency of its 
occurrence in a disease of pure debility, where there is no febrile action, and 
where, from the situation of those subject to the disorder, at and preceding 
the commencement of it, there can be no reason to suspect fulness of the 
vascular system.-I allude to the sea scurvy. This complaint afflicts not 
only seamen in long voyages, who are obliged to subsist on aliment, the 
nutritive quality of which has been diminished by time and the mode of 
preservation, but it also aggravates the miseries of winter to the poorer 
inhabitants of northern climates. 
* What folly, then, to induce a greater degree of debility in this and other disorders, by 
bleeding. OF MEDICINE, AND INDICATIONS OF CURE. 
135 
Among the symptoms of this shocking disease none are so formidable as 
spontaneous haemorrhages : they are apt to occur upon the slightest motion ; 
sometimes the bleeding is external, sometimes internal, and frequently fatal. 
So slowly does death advance from any other cause in this disease, that, 
should the wretched patient be so fortunate as to escape haemorrhage, he may 
linger out a miserable existence, till the conclusion of his voyage, or the 
approach of summer enables him to procure sustenance more nutritious ; and 
the danger of spontaneous haemorrhage is removed by his returning strength, 
though accompanied by increased fulness of the bloodvessels. 
The blood does not escape in these diseases in consequence of violent 
action in the moving powers, nor from any distention of the vascular system 
by the quantity contained, but from inability in the extreme vessels to resist 
the slightest impulse. 
From all this we learn that Rush's theory of bleeding, to prevent haemorr- 
hage, is very erroneous, inasmuch as it proceeds from relaxation and debility, 
and not from over-fulness or distention of the bloodvessels. It shows also 
how easily we may be led into a dangerous practice by false theory. 
SECTION V. 
ON THE MORBID EFFECTS OF THE LOSS OF BLOOD. 
Health cannot exist without a natural and uniform balance between the 
nervous, the circulating, and the organic systems, and which state of the 
system, undisturbed by art or other causes, is always present. Now, bleeding 
has the direct effect of destroying this relation, and, consequently, to bring on 
a long train of evils and diseases. In some cases of bleeding there is no 
reaction, in others it is excessive ; and this is owing to the age, climate, 
temperature, &c. Indeed, we may regard the practice of bleeding to cure 
disease much the same as we do gun-shot wounds, accidents, heemorrhage, 
&c. The effects of loss of blood then require to be traced in their relation 
to the nervous, vascular, or circulating and solid parts of the system, in order 
to ascertain the whole consequence of this common practice. They involve 
questions of the deepest interest in regard to physiology, health, and the 
treatment of diseases. 
Dr. Marshall Hall, an English physician, has written a treatise on the 
" morbid and curative effects of loss of blood," in which he demonstrates 
the pernicious effects of blood-letting in a variety of diseases. He states, in 
his introductory remarks, that the subject has been by no means understood 
until very recently. He has given many facts, " to afford, he states, not 
only an additional, but an unbiassed testimony to the truth of the general 
principles laid down." In farther discussing this subject, I shall refer to 
this work, and make such extracts from it as are calculated to corroborate 
my views. 
" The question of the morbid effects of loss of blood appears to me," says 
the author, " not to have sufficiently engaged the attention, either of the 
physiologist or of the practical physician ; yet to both they offer objects of 
inquiry of great interest and importance." 136 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
SECTION VI. 
ON THE IMMEDIATE EFFECTS OF LOSS OF BLOOD. 
1. Syncope or Fainting.-The most common effect of the loss of blood 
is syncope or fainting, which appears to arise from the usual stimulus of blood 
of the brain being withdrawn, or a deficiency of nervous fluid or excitement. 
This very fact is sufficient to show that abstracting any portion of the vital 
fluid from the system, instead of acting as a remedial agent, does violence to 
nature, by deranging the animal economy. Every physician who might be 
called to a person suffering under the ordinary effects of the loss of blood, 
would prescribe the same remedies as if it proceeded from disease. A small 
quantity of blood abstracted sometimes produces the most alarming and 
dangerous consequences ; but fainting is the most usual effect that follows 
the use of the lancet. In ordinary syncope, from bleeding, the patient first 
experiences dizziness ; then a loss of sensation; respiration is affected, being 
suspended until the painful sensation produced rouses the patient to draw 
deep and repeated sighs ; the heart and pulse beat slow and weak ; the face 
and general surface become pale, cool, and bedewed with perspiration ; 
nausea or sickness at the stomach, &c. On recovery, there is sometimes 
momentary delirium. 
In great haemorrhage, or excessive discharges of blood, these symptoms 
assume a more frightful aspect; the countenance becomes more and more 
pale and sunk; every symptom shows or denotes an impaired state of the 
energies of the brain ; the breathing becomes stentorious, and at length 
affected by terrible gasping ; pulse feeble or imperceptible ; heat of the body 
departs ; the extremities become colder and colder, notwithstanding the 
application of external warmth ; at length the strength fails, and the patient 
sinks, gasps, and expires. 
2. Convulsions.-The next most common effect of bleeding after fainting, 
is convulsion. It occurs particularly in children, and in cases of the slow 
and excessive loss of blood. In this case also the brain seems to be the 
primary seat of the injury, arising from exhaustion of its customary stimulus, 
the blood. It is a matter of surprise that physiologists have never noticed 
the connexion or correspondent relation between the nervous and the vas- 
cular system. Health cannot be preserved unless a regular and uniform 
balance is maintained. It is in consequence of this balance being lost that 
the abstraction of blood is attended with such pernicious effects. Dr. Hall 
relates the following two cases of convulsions : 
1. " A physician, aged thirty-four, became affected with inflammation of the 
larynx. He was bled freely on two successive mornings at his own instance. 
In the afternoon of the second day, the disease being unsubdued, he was 
bled a third time, placed in a rather inclined position upon a sofa. The blood 
was allowed to flow until thirty-four ounces were taken. He then suddenly 
fell upon the floor, violently convulsed ; and he remained for some time 
afterward in such a state of syncope as to render his recovery very doubtful • 
being carried to bed, however, and cordials being administered, he slowly 
recovered. 
2. A similar case is given by Mr. Travers. This gentleman observes, 
' Some patients cannot bear the loss of blood: it gives rise to prostration, 
attended with convulsions, in which the circulation fails so alarmingly as to 
require watching for several hours, and the repeated administration of stinau- OF MEDICINE, AND INDICATIONS OF CURE. 
137 
lants to restore it. A very intelligent surgeon, in the neighbourhood of Lon- 
don, in bleeding a clergyman to the extent of twenty ounces, was compelled 
to remain with him during the whole of that day ; and, notwithstanding fre- 
quent recourse to brandy, continued long apprehensive for the patient's life. 
He represented the convulsions, which returned in paroxysms, as resembling 
the puerperal in their severest form.' " 
A writer states, " that the loss of blood in operations, though insufficient 
to create alarm for the patient's safety on that score, obviously predisposes 
to the convulsions which sometimes prove fatal, especially to children. I 
have known an infant die of convulsions on the day after the removal of a 
small mark upon the head." 
Puerperal convulsions often arise from loss of blood. One of the common 
causes of fits in children also arises in consequence of the loss of blood. By 
the experiments of Dr. Kelly upon dogs and sheep, fits or convulsions were 
found to be a frequent consequence of exhaustion arising from the loss of 
blood. 
3. Delirium.-Delirium occurs as an immediate, and mania as a remote, 
effect of the loss of blood. 
The following case illustrates this fact: A young man, aged thirty, had 
lost much blood from the arm and by leeches ; and, under the operation of an 
active purgative, fell into complete syncope or fainting. He was found per- 
fectly colourless and senseless, and affected with rattling in breathing. He 
made a convulsive effort to expectorate, and the blood rushed into his cheeks. 
He then began to recover, opened his eyes, and complained of deafness ; 
chills followed; fever; constant delirium; numbness of the feet and legs, 
&c. He finally, however, recovered. 
A person fell and hurt his back. For four days in succession he was bled, 
followed by faintness, sickness, and retching, with much affection of the 
head ; paleness ; sighing; hurrying alarm of mind ; extraordinary noise and 
visions, with delirium, which finally destroyed the patient. 
Convulsion and Delirium combined.-Mrs. miscarried on the third 
month of pregnancy. There was much haemorrhage ; she turned pale, and 
nearly fainted; became affected with convulsion and delirium. 
Delirium sometimes occurs in certain habits from the loss of even a small 
quantity of blood. 
4. Coma or Lethargy.-A comatoze state is often followed by blood-letting, 
which is so nearly allied to apoplexy, that it is difficult to discriminate be- 
tween the two diseases. It very often appears in infants and children. 
Mr. C. Bell observes, " When a man who has cut his throat is brought 
into the hospital, he is in a state very much resembling that which some 
authors have described as accompanying severe wounds. Though sensible, 
he is cold, pale, taciturn, and very often, although such men are desirous 
of living, sink within twenty-four hours. This appears at first to proceed 
iom a strong impression on the mind; that is, I believe, the consequence 
of loss of blood, and the shock thus given to their powers of life." 
5. Of Sudden Death from the loss of Blood.-Sometimes the loss of blood 
suddenly proves fatal. One of our most distinguished citizens, it is stated, 
lost his life the other day by a single bleeding. 
A case of this kind is mentioned in the Lancet. A person received a slight 
injury, for which he was first bled eighteen ounces, and at noon twenty 
ounces more were taken. Next day the pulse was ninety, full, and rather 
jerking : eighteen ounces more were taken, and at night the same quantity. 
Next day he was ordered to be bled eighteen ounces more. In two hours 138 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
afterward another physician was called in consultation, when twenty ounces 
more of blood were drawn, making in all one hundred and twelve ounces in 
this short space of time. After the last bleeding the pulse became a mere 
flutter, and the man only survived a few hours. On a post mortem examina- 
tion, the vessels about the heart were quite empty ; the brain very pale ; 
almost colourless ; the liver was also of a very light colour. 
I shall here give, in illustration, the observations on the medical treatment 
of General Washington's last illness, by John Reid, M.D., physician to the 
Finsbury English Dispensary, and professor of the theory and practice of 
physic. 
In reading the official report of the death of General Washington, as stated 
in the newspapers, &c., I should imagine there were few medical persons 
who did not feel astonishment at the extraordinary manner in which that 
great man was treated by his physicians during his last and fatal indispo- 
sition. 
Some time in the night of the 13th of December, it is said, the general 
was seized by a disease called the cynanche trachealis, (croup.) 
During the same night he sent for a bleeder, who took from him twelve 
or fourteen ounces of blood. 
Next morning a physician was sent for, who arrived at Mount Vernon at 
eleven o'clock ; when, imagining danger in the case, he advised the calling 
of two consulting physicians. 
In the interval, however, he thought proper to employ, in spite of the 
twelve ounces that had already been expended, two copious bleedings. 
Now, when we consider that these are called copious, and the other is not 
noticed as such, and all indifference with which a future most copious 
bleeding is afterward mentioned, we may presume that each of these was 
twenty-five or twenty ounces at least. 
After this " two moderate doses of calomel were administered." I know 
not exactly what an American moderate dose of calomel may be, but if it is 
as fair to presume it be in proportion to the bleedings, we may conclude that 
it was at least very considerable. 
Upon the arrival of the first consulting physician it was agreed that, as 
there were no signs of accumulation in the bronchial vessels of the lungs, 
they should try another bleeding. 
Now, this appears to be perfectly inexplicable. As there were at pre- 
sent no signs of accumulation in the bronchial vessels of the lungs, they 
were driven to another bleeding. Hence it will be seen, that this last bleed- 
ing was to produce an accumulation in the bronchial vessels of the lungs. 
There was great difficulty of breathing, great inflammation ; but as there 
was as yet no accumulation in the lungs, they were determined to induce 
that also, and, as a likely means of inducing it, had recourse to the most ex- 
travagant effusion of blood. This it not an unfair interpretation of their 
words; but it could not have been their real meaning: their real meaning 
it is impossible to discover. In addition to all their previous venesections, 
thirty-two ounces are now drawn! The medical reader will not be sur- 
prised to find that this was unattended by any apparent alleviation of the 
disease. 
In the next place, vapours of vinegar and water are frequently inhaled. 
Two doses of calomel were already given ; but this not being deemed suffi- 
cient, ten grains of calomel are added-nor is even this sufficient. Repeated 
doses of emetic tartar, amounting in all to five or six grains, are now admi- 
nistered. It is said the powers of life now seemed to yield to the force of OF MEDICINE, AND INDICATIONS OF CURE. 
139 
the disorder. To many it may appear that the yielding of the vital prin- 
ciple, in these circumstances, was not altogether owing to the force of the 
disorder. 
The patient, lying in this feeble and nearly exhausted state, is to be still 
farther tormented. Blisters were next applied to his extremities, together 
with a cataplasm of bran and vinegar to his throat. 
It is observed that speaking, which was painful from the beginning, now 
became scarcely practicable. When we reflect upon the extreme weakness 
to which the patient must, by this time, have been reduced, and that he had 
both a blister and cataplasm of-bran and vinegar to his throat, can we wondex- 
that speaking would be scarcely practicable ! respiration grew more and more 
contracted and imperfect, until after eleven o'clock on Saturday night, when 
he expired without a struggle. 
Think of a man being, within the brief space of little more than twelve 
hours, deprived of eighty or ninety ounces of blood; afterward swallowing 
two moderate American doses of calomel, which were accompanied by an 
injection ; then five grains of calomel and five or six grains of emetic tartar; 
vapours of vinegar and water frequently inhaled; blisters applied to his ex- 
tremities ; a cataplasm of bran and vinegar applied to his throat, upon which 
a blister had already been fixed : is it surprising that, when thus treated, the 
afflicted general, after various ineffectual struggles for utterance, at length 
irticulated a desire that he might be allowed to die without interruption ? 
To have resisted the fatal operation of such herculean remedies, one would 
imagine that this venerable old man ought at least to have retained the 
vigour of his earliest youth. 
A friend of mine, a medical man, saw an individual who went to sleep 
while some leech-bites were bleeding ; and when he awoke in the morning 
he was so exhausted and so sunk, that he never rallied from the effects, and 
died.-Armstrong. 
Another medical friend of mine lost a brother in the same way, from the 
bleeding during the night, after the application of leeches.-lb. 
A friend of mine, a general practitioner, extirpated a small tumour from 
the breast of a female. After the operation, which was extremely well per- 
formed, the patient fainted, and a surgeon and physician who were present 
became alarmed ; and, without affording any assistance, kept her erect. My 
friend immediately laid her in a horizontal position, but it was too late, for in 
that short interval she had died.-lb. 
A patient was bled in the arm ; a large lump of round linen was applied, 
and covered by a twisted tape. Inflammation occurred at the orifice, spread 
to the adjacent cellular membrane, and erysipelas was the consequence. 
Fever occurred, with violent inflammation of the brain, and the patient sunk 
and died.-lb. 
I once saw a patient bled for a supposed inflammation of the lungs, by two 
professors of medicine, till 160 ounces had been lost, though she had but a 
slight degree of fever. The consequence was, that the pulse was not at all 
reduced, but she died of the blood-letting.-lb. 
I witnessed a case in which two physicians bled a patient till upward of 
160 ounces of blood had been drawn, for a supposed affection of the lungs. 
The patient then became dropsical; but still the hard round pulse remained 
till she died; and, upon examination of the body, not a trace of disorder or 
disease was found about the lungs, but the heart was exceedingly thickened. 
If this patient had been treated mildly, the probability is, that she might have 
lived on comfortably for years.-lb. 140 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
6. Of Exhaustion with Excessive Reaction.-Exhaustion from blood-let- 
ting may assume several different characters : it may be attended with ex- 
cessive or defective reaction, or with actual sinking of the vital powers, 
causing delirium or lethargy. When there has been great loss of blood, or 
repeated blood-lettings, the pulse, instead of being slow and feeble, acquires 
a morbid frequency, a throbbing beat, and in some cases there is excessive 
reaction. 
It is from this kind of pulse that physicians are so frequently deceived. 
They bleed and bleed,because the pulse is tense and full, when, in reality, this 
very fulness is occasioned by the bleeding: thousands are bled to death in 
consequence of these erroneous views. 
The reaction that follows bleeding is sometimes followed by symptoms 
still more severe. The brain becomes very much affected ; great intolerance 
of light and sound; pain in the head and delirium; the action of the heart 
and arteries are morbidly increased; great palpitation ; throbbings of the 
carotid arteries ; the patient is greatly alarmed, and impressed with the feeling 
of approaching dissolution ; fainting; the pulse will sometimes rise from 100 
to 130, with a bounding of the artery; respiration is frequent and hurried, 
attended with panting and sighing, restlessness, and heat of the skin ; sudden 
dissolution has sometimes occurred upon the slightest exertion. 
" I was about," says a physician, " to bleed in such a case ; but, fortunate- 
ly," observes he, " for my patient and for myself, the repugnance of the 
patient to general bleeding prevented me from using the lancet, and so saved 
her life." 
Dr. Cooke relates a case which corroborates the doctrine here maintained. 
He says; " After uterine haemorrhage, and also after copious depletion on 
account of pulmonary and other inflammations, I have frequently observed 
the symptoms of brain congestion; and which has generally appeared to 
arise from the excitement occasioned by some mental effort, though occa- 
sionally it has arisen without an evident cause. While the other parts of 
the body appear comparatively bloodless, the vessels of the head throb vio- 
lently ; there is severe pain ; confusion of intellect, sometimes to such a de- 
gree as to threaten delirium; the pulse at the wrist is usually small and 
vibrating, and the countenance distressed. When I first observed these 
symptoms I was led to abstract blood, from an apprehension of inflamma- 
tion ; but I did harm; for if the urgency of symptoms was diminished, the 
susceptibility to a recurrence was increased and restoration to health was 
protracted. 
This susceptibility to local congestion, after excessive loss of blood, de- 
pends upon the want of that due balance which, in a state of health, subsists 
between the nervous and vascular or circulating systems. 
A lady aged twenty-five had been frequently bled, on account of symptoms 
in the head, which had followed an injury. Considerable relief had followed 
each bleeding, but the symptoms had soon returned, so as to lead to a repeti- 
tion of the bleeding at short intervals, and this had been going on for several 
months. When I saw her she was stretched upon a couch, her face of the 
most death-like paleness, or rather of the paleness of a stucco figure, her 
pulse very rapid and as small as a thread, her general weakness extreme. 
The mass of blood appeared to be reduced to the lowest point that was com- 
patible with life, but she still complained of frequent headache, violent 
throbbing in the head, confusion, and giddiness. It was evident that evacua- 
tion could be carried no farther ; and, in consultation with a very intelligent 
medical man who had the charge of her, it was agreed, as a last experiment, OF MEDICINE, AND INDICATIONS OF CURE. 
141 
to make a trial of the opposite system-nourishing diet and tonics. In a 
fortnight she was restored to very tolerable health. 
Where bleeding has been carried to a great extent, symptoms frequently 
occur, which, in reality, arise from the loss of blood, but which a superficial 
observer will be led to attribute to the injury itself; and concerning which, 
indeed, it is sometimes difficult even for the most experienced surgeon to 
pronounce, in the first instance, to which of these two causes they are to be 
referred. Repeated copious blood-letting is of itself adequate to produce a 
hardness of the pulse, which we shall in vain endeavour to subdue by perse- 
vering in the same system of treatment. In many individuals it will produce 
headache and confusion of mind, not very different from what the injury it- 
self had previously occasioned. These things maybe observed, especially in 
young females who are disposed to hysterics, and whom I have often known 
to suffer from a continued aggravation of such symptoms as I have described, 
while the system of depletion has been continued-recovering immediately 
on the use of the lancet being laid aside, and on their being allowed to take 
solid nourishment, with occasional doses of carbonate of ammonia. 
7. Of Sinking, or more Sudden Dissolution.-If the loss of blood be re- 
peated still farther, not only syncope, but a state of sinking is induced; the 
effects of reaction are of course in this case permanently relieved, while a 
different series of phenomena, already fully described, is established. This 
transition of reaction into sinking may either be spontaneous, or it may be 
the effect of a last blood-letting-the state of syncope scarcely ceasing, no 
reaction following, but the total though gradual failure of the vital powers. 
When the last bleeding has been considerable, it has, in some cases, been 
followed by the most dreadful gaspings and other convulsive motions, and 
death. It should be observed that, between the most gradual sinking and 
the most sudden dissolution, as the effects of blood-letting, there is every 
intermediate shade, with the phenomena of which it is of the utmost im- 
portance to be acquainted. These varied phenomena may, I think, be col- 
lected from the observations which have been made in this and the preceding 
sections. They are farther illustrated by the following cases, which exem- 
plify the fatal effects of loss of blood, as supervening more and less gradually 
upon the use of the lancet: 
Mrs. , aged thirty, had been affected with what appeared to be a 
slight attack of influenza; she was seized with chills, and soon afterward 
the pains of labour came on, and issued in delivery in about fifteen hours : at 
9 o'clock, a. m., this was followed by much fever, the countenance being 
flushed, the pulse frequent, and the breathing difficult, with incessant cough ; 
these symptoms increased toward evening and in the night, and about forty 
ounces of blood were drawn from the arm at two blood-lettings, and the next 
morning twelve leeches were applied to the chest, with great relief. In 
evening a blister was applied. The night was passed more comfortably ; 
she dozed a little and was cheerful, and continued relieved in the morning. 
As a preventive against a relapse, however, three tea-cupsful of blood were 
taken. The patient became faint during the flow of the blood, sank from 
that time, and never again rallied; she became extremely feeble, and could 
scarcely articulate; and , from being cheerful the day before, was now impressed 
with the conviction of approaching dissolution, and expressed herself as una- 
ble to recover from the last blood-letting. During this day, Saturday, and 
during the succeeding two days, there was a state of extreme exhaustion, 
and still a sense of load at the chest and pain of the side. 
On the succeeding Tuesday the countenance was observed sometimes to 142 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
flush to a deep scarlet, and then to become quite pallid, and a profuse per- 
spiration frequently ran down the face; the pulse was extremely frequent, 
and the pain severe on coughing: there was no delirium, though she awoke 
hurriedly from sleeps which she described as " just like death." During the 
following four days there was little obvious change; distressing faintings 
usually came on about two or three o'clock, p. m. On the Sunday she 
became drowsy and evidently more sinking; this state continued to increase, 
and she died in the evening of the following day. 
Mrs. -- was of a pale and sallow complexion and weak constitution. 
She was taken with severe pain in her head, which appeared to be relieved 
by bleeding or purgatives. Subsequently she became indisposed: she 
dreaded being bled, from the faintness she had before experienced from it, and 
said it would certainly kill her. Notwithstanding which she was bled to the 
amount of sixteen ounces. 
On the morning of the Sth Mrs. -- appeared to be relieved in every 
respect; the heat of the surface and the pain of the head were diminished : 
the blood presented the buffy coat. It was thought proper, however, to 
abstract more blood. Four tea-cupsful were taken ; the most dreadful faint- 
ing followed, with gasping, open mouth, a convulsive action of the diaphragm, 
and in an hour or two death closed the scene. 
The following case, forwarded to me by a medical friend, is not, I think, 
unworthy of an insertion : 
" A gentleman nearly seventy years of age, the subject of frequent gouty 
paroxysms, whose constitution was broken down, and who was of a pallid 
complexion, was suddenly seized with severe pain in the side, hot skin, quick 
full pulse, and difficulty in breathing. A physician was consulted, who re- 
commended the abstraction of six ounces of blood. The arm was tied up 
accordingly, the patient being in bed; before two ounces were taken away 
his pulse sunk, and heavy perspiration came on, with faintness. The patient 
was placed horizontally in bed; and it was some length of time before his 
medical attendant deemed it prudent to leave the house. 
The blood taken away manifested the usual character of inflammation, 
but the pain in the side was not removed. On the following morning he 
was again visited by his physician, who, finding that the pain and other symp- 
toms detailed were not relieved, directed the bleeding to be repeated to six 
ounces : this was again attempted, but before one ounce escaped he became 
so alarmingly faint, that he fell back in the bed-the circulation being sus- 
pended for a length of time, and his dissolution expected to take place. 
Stimuli of every description which could «at the moment be brought forward, 
were resorted to ; after a considerable lapse of time the heart's action was 
feebly renewed, but its power was never again restored, and the pain in his 
was not relieved. From this time he progressively sank, and in a short 
time expired." 
Dr. Rush, who was such a strenuous advocate for blood-letting, never 
discovered his error, it appears, until his last disease. He requested his at- 
tending physician to bleed him repeatedly ; and, when he refused, it is stated 
that he introduced the lancet into his own arm, and extracted so much of the 
vital fluid that he sunk under it. It appears that now, for the first time, he 
saw the delusion in which he had been shrouded all his life. 
Dr. Dewees mentions the case of a person who was so repeatedly bled in 
a fever, inducing such a state of debility and sinking, that every stimulant ad- 
ministered availed nothing. He sunk and expired, like thousands of others- 
a victim to the lancet! OF MEDICINE, AND INDICATIONS OF CURE. 
143 
A middle aged man, who for several years had been an asthmatic, applied 
to a medical man for advice. Symptoms-hoarseness and difficulty of breath- 
ing, with frequent bounding pulse. The physician prescribed venesection, 
to which the patient readily consented, and accordingly about twenty ounces 
of blood were taken from his arm in a sitting posture, the pulse continuing 
full and strong, when suddenly he said, " I feel very faint; do lay me down." 
He was now laid upon the floor in a horizontal position; cold water was 
sprinkled on his face and volatiles applied to his nostrils, when reaction took 
place; but, complaining of considerable debility, he was advised to lay an 
hour or two to recruit; after which he felt relieved, and walked a short 
distance to his lodgings, but within ten days he expired. 
I once bled a young lady in the arm for a suppression of the menses. I 
had not taken more than half an ounce of blood before she fainted, and con- 
tinued so long in a state of frightful syncope, that I was really apprehensive 
that reaction would never take place. However, by sprinkling a few drops 
of cold water on her face, by the application of volatiles to the nostrils, 
and the administration of hot brandy sling internally, she recovered. 
Another young lady, in New Haven, fainted immediately on the introduc- 
tion of the lancet into her arm. 
A lady in this city was bled for a sick or periodical headache. It pro- 
duced such a sinking and prostration, that it proved fatal in three hours. 
Each successive blood-letting is of course attended with increased risk. 
There is considerable danger where the reaction is strong ; still greater 
when it is feeble. A large blood-letting, in such cases, may be followed by 
sudden death. There is greater danger when fainting has been several 
times induced, and when there is the least tendency to " want air." 
SECTION VII. 
EFFECTS OF THE LOSS OF BLOOD ON THE INTERNAL ORGANS. 
It appears evident that debility, arising from loss of blood, may lead to 
effusion in the ventricles of the brain, and that such a state of exhaustion is 
no security against an attack of the apoplexy. Dr. Denman relates a case 
which shows conclusively that this is the fact. A patient of his had suffer- 
ed several years by haemorrhage from the uterus. After passing a day 
without any unusual complaint, she went to bed in good spirits, but was 
found next morning in a state of insensibility, &c. She remained in this 
state about twenty-four hours, and died. Leave was also given to inspect 
the body, which she often expressed a wish might be done. About four 
ounces of blood were found in the ventricles of the brain, containing serum 
or water. This extravasation was clearly the immediate cause of her death, 
little as it might have been expected, on account of the daily profuse dis- 
charge to which she had for so many years been subject. 
Dr. Hey, in treating of child-bed fever, relates a case which shows that a 
loss of blood causes congestion of the brain. She had been bled several 
times, which did not reduce the pulse. After a few days she died in a state 
of great anxiety and restlessness. The seat of the disease appeared to be 
in the head, evidently showing that there was congestion and extravasation 
of the brain. 
Dr. Sweedy relates another case, which corroborates this fact. A lady 144 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
had lost much blood during the first months of pregnancy, which caused 
palsy and delirium. 
Dr. Hammond recites a case in point. A lady in confinement lost about 
three pints of blood, which produced faintness, headache, &c. She was 
bled to twenty-four ounces, which also produced syncope, but the head was 
not relieved. The bleeding was repeated, and carried even to fainting. 
She lost twenty ounces, which produced convulsions. She was much ex- 
hausted : the countenance was blenched to an ivory whiteness. She re- 
vived and became more comfortable for a few days. She was then attacked 
with extreme depression ; the right arm and leg paralyzed, speech muii 
altered, and swallowing difficult; countenance deathly, and the pulse feeble 
and scarcely perceptible; all which show the injury done to the brain by 
the loss of its customary stimulus, by which we see that the blood is the 
mobile or main-spring, both to the corporeal and mental organization ; 
or, in other words, is the support of body and mind. 
Dr. Travers mentions a case of inflammation of the lungs, in which a 
stroke of palsy, which destroyed the patient, took place in the very act of 
bleeding. Permanent blindness also sometimes immediately occurs from 
bleeding. Thousands of cases might be mentioned of a similar nature. 
The Lungs.-Physicians are not aware of the effect of the loss of blood 
upon the lungs. It has the effect of substracting the nervous energy almost 
the same as if the eighth pair of nerves were divided. 
Let a person apply his ear to a patient who has been freely bled for in- 
flammation of the lungs: he will find that their office and powers become 
so far weakened and diminished as to labour at every inspiration. A pecu- 
liar rattle can be heard with or without the immediate application of the ear 
The bronchial vessels first become clogged or loaded with mucus; the 
lungs become oedematous, and are no longer capable of decomposing the air, 
and receiving the oxygen or vital portion of it, so essential to life. Ever 
since I commenced my practice I have witnessed this fact, the knowledge 
of which has induced me to withhold the lancet in every case of this kind, 
no matter how severe the attack; and I know not that I have ever lost a 
single case in all my practice, where I have been called within a reasonable 
time. Notwithstanding this, some of my opponents have pronounced me 
presumptuous for not bleeding. 
No one, however, can form an idea of the superiority of our practice over 
that usually pursued by physicians, unless tested by actual experience: the 
patient recovers in half the time, without that constitutional injury which 
invariably arises from repeated blood-lettings. 
It has been found that the lungs of those who have died of haemorrhage 
have been affected by swelling, effusions of lymph, adhesions, &c. 
I have not room to enter fully into the effect of the loss of blood upon 
different parts of the system. Every one knows the tendency to effusion 
into the cellular membrane. One half of the cases of dropsy arise, in my 
opinion, from the use of the lancet. 
Typhus Fever.--A judicious practitioner informs me that, after bleeding 
in most diseases for a number of years, he abandoned it altogether, in conse- 
quence of the injury that resulted from it. It often induced typhoid symptoms. 
Contusions, Injuries, fyc.-Many surgeons state that, popular as bleed- 
ing is, it destroys the restorative principle, or so far prevents the healing 
process that the patient cannot recover. One of the surgeons in the New 
York hospital now declaims much against the lancet in injuries. " Some- 
times," hs says, " you cannot obtain a particle of blood after a fall, and it is OF MEDICINE, AND INDICATIONS OF CURE. 
145 
a fortunate circumstance that you cannot, as life is saved by omitting it." 
For hundreds of years it has been customary to bleed freely after every acci- 
dent ; but now a new fashion is in vogue, viz., to wait an hour or two before 
you bleed, or until reaction takes place. What the next fashion in relation 
to this practice may be, time alone must decide ; but I sincerely hope that 
my maxim will be adopted, which is, after testing its effects thoroughly 
upon the human system-seldom or never bleed. 
I shall only give a few more hints on the effects of the loss of blood. Dr. 
Hall states, that there is a remarkable similarity between the effects of the 
loss of blood and the state of bloodlessness in chlorosis or obstruction of the 
menses. Both have a tendency to induce dropsy, extravasation, and, lastly, 
of ending in a state of great prostration, or even of sudden death : from 
which it is evident that the capillary and the general circulation is similar in 
both complaints. The blood appears almost entirely to desert the surface 
and to terminate in serum or water. 
SECTION VIII. 
MORBID EFFECTS OF BLEEDING IN INFANCY. 
If physicians were aware of the morbid effects of bleeding in infancy, 
they would have recourse to it less frequently. The bare idea of tying up 
the arms of infants, and abstracting a portion of the vital fluid, has ever 
seemed to me not only unnatural, but appalling. Besides the immediate in- 
jurious effect which arises from loss of blood in infancy, there are the best 
reasons to believe that very many complaints are occasioned by it. 
Dr. Hall, to whom we are indebted for much very interesting information 
on this subject, states that, of the whole number of fatal cases of disease in 
infancy, a great proportion occur from this inappropriate or undue applica- 
tion of exhausting remedies. 
" This observation," says he, " may have a salutary effect in checking 
the ardour of many young practitioners, who are apt to think that, if they 
have only bled, and purged, and given calomel enough, they have done their 
duty ; when, in fact, in subduing a former, they have excited a new disease, 
which they have not understood, and which has led to the fatal result. 
This question, and that of the effects of exhaustion in infants and children, 
open a new field for investigation. Almost all our works on infantile dis- 
eases are silent on the subject; and yet, without an accurate knowledge of 
it, I regard it as totally impossible that we should be prepared to watch and 
treat the morbid affections of this young and tender age. The subject must 
be taken up and investigated anew. All the affections which may arise 
from exhaustion must be accurately observed, distinguished from similar 
affections arising from other causes, and traced back to their origin, and 
forward in relation to their remedies. In this manner some complaints of 
the head, convulsive, and even croupy affections will be viewed in a new 
aspect; and we shall be preserved from some painful dilemmas, into which 
we should assuredly fall without this knowledge of the effects of exhaustion." 
Bleeding, in dropsy of the head and other complaints of children, infalli- 
bly plunges the little patient into imminent, if not irretrievable, danger. 
There is a complaint peculiar to infants which very nearly resembles the 
dropsy of the head, and for which it is customary to bleed ; but which 146 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
like the latter disease, instead of being benefited by any kind of depletion, is 
only aggravated. An opposite course of treatment is required, viz., stimulants. 
Dr. Tweedy, Hall, Hemery, Gooch, and Abercrombie have all hinted at 
this disease. 
The following case is given by Dr. Hall: 
I was called a short time ago to see a little girl, aged two years and three- 
quarters, who had laboured under an attack of influenza. The affection of the 
chest had been severe and protracted, and sixteen leeches had been applied, 
besides the administration of other depletory measures, before it had subsided. 
The symptoms of the affection of the chest were, however, subdued at 
last; but the little patient was left extremely exhausted, and in this state a 
new train of symptoms supervened, not less alarming, and more puzzling 
than the first. The child fell into a dozing state, and lay with its eyelids 
but half closed; it moaned when any attempt was made to rouse it; the 
eyes were unfixed on any external object; the pupils were dilated, yet par- 
tially contractile on the influx of light; the pulse was 140. 
On withdrawing into an adjoining room, the medical gentleman whom I 
had the pleasure of meeting, observed, " dropsy in the head has now super- 
vened, and we must administer calomel." I replied, that I took a different 
view of the case ; that it resembled dropsy of the head, indeed, but arose 
from exhaustion ; and that brandy, not calomel, could alone save the patient's 
life. I referred to the history of the case for sufficient sources of exhaus- 
tion, and to facts for the actual occurrence of such cases in practice. 
We administered brandy, directing thirty drops to be given every two 
hours, with barley water in the intervals, and a quarter of a pint of milk 
twice in the twenty-four hours. The bowels were relieved by magnesia 
and the warm water injection. This plan of treatment lowered the number 
of the pulse, and gradually diminished the severity of the other symptoms, 
and the patient eventually recovered. 
Another case is related, where a few leeches were applied for inflamma- 
tion of the head, and which, instead of affording relief, brought on congestion, 
lethargy, &c., and proved fatal. 
A physician was sent for to visit a child with croup, who prescribed 
bleeding and blistering, if not calomel : the father asked him if he could 
prescribe nothing better; he said he could not. " Then I must," said the 
father, " apply to a physician who can." He sent for Dr. G. Downing, the 
first graduate of our Reformed School of Medicine, who treated the child on 
the principle laid down in this work, and it soon recovered. 
" A little patient," says a writer, " was reduced to copious and repeated 
bleeding for croup. There supervened a state of irritability of temper, so 
that, when greatly exhausted, it made great efforts to scratch, bite, and beat 
its attendants. This state of agitation continued until the powers of life 
were gradually exhausted." 
SECTION IX. 
BLEEDING IN INFLAMMATION OF THE LUNGS, QUINSY, ST. ANTHONY'S FIRE, ETC 
A work has been published on the effects of blood-letting in inflammatory 
diseases, by Louis, of Paris, one of the most distinguished physicians in 
France, in which he proves, by notes taken during a number of years' prac- OF MEDICINE, AND INDICATIONS OF CURE. 
147 
tice in hospitals at the bed-side of the patient, that blood-letting has an 
effect on the system entirely different to that generally maintained by medical 
men. He says : " I have observed, at the hospital of La Pitie, a great 
number of cases of inflammation of the lungs, St. Anthony's fire, and quinsy; 
and although I have employed blood-letting to the extent of twenty or twenty- 
one ounces, and, moreover, to fainting, yet I have never seen these inflamma- 
tions arrested in a single case. Some of the symptoms are even augmented 
in intensity and extent after the first blood-letting." 
A noted surgeon, Granville Sharp Pattison, of this city, professor of ana- 
tomy, was lately called to a Mr. Little, labouring under inflammation of the 
lungs, and bled him to that degree that he fainted. He then gave antimony 
internally, and applied it in the form of ointment externally. This treatment 
increased all his symptoms, and his recovery was considered very doubtful, 
till he discharged the doctor and employed a botanic physician, when he 
began to improve, and has measurably recovered. With what propriety 
or truth can such men state that anatomy is the foundation of the healing 
art ? so far from it, that it seems that the bad practice of a physician is just 
in proportion to his anatomical knowledge, (not necessarily so, however.) 
Mr. Carr informs me that he was bled for some trifling disease, and which 
produced epileptic fits, from which he has never recovered. How evident, 
therefore, that bleeding is a disease creating practice ! 
Lord Byron left England to serve in the cause of Grecian liberty. He 
was taken sick in Greece, and his physicians, against his will, persisted in 
bleeding him. Day and night they beset him to be bled, until exhausted, when 
the bard, in an angry tone, exclaimed : " You are, I see, a D. D. set of butch- 
ers ; take away as much blood as you like, but have done with it." We 
seized the opportunity, says Dr. Milligan, and drew twenty ounces ; yet the 
relief did not correspond to the hopes we had formed. The restlessness 
and agitation increased, and the patient spoke incoherently. On the 17th 
the bleeding was twice repeated, says Moore, and appearance of inflam- 
mation on the brain was hourly increasing; and on the 19th he expired-and 
shall I not add, a victim, like General Washington, to learned and scientific 
quackery. 
A short time since a child was taken sick in this city, and one of our 
most popular doctors was sent for, who first bled it, then ordered leeches to 
be applied, and to be kept bleeding till the lips turned blue. The effect was, 
that, instead of curing the child, the treatment either aggravated the com- 
plaint or killed it: and so ignorant are the dupes of such imposition and mal- 
practice, that the same tragedy would no doubt be again repeated in the 
very next case of sickness in that family ! Let a physician only keep their 
confidence, and he may kill them all, and still be reputed " skilful." 
Patients who recover after general and copious bleedings have been 
employed, may attribute their recovery to a mere accidental cause, or to the 
strength of their constitutions. 
Bleeding appears to be the order of the day. The inveterate theoretical 
bleeder will bleed in the most opposite states of the system : he will bleed to 
check the circulation ; if depressed, he will bleed to restore it, and to increase 
the heat of the body when it is below a healthy standard ; he draws blood to 
subdue reaction, and to excite it; he calls bleeding a sedative, and again he 
says it is a stimulant. With such a man bleeding is a sine qua non; it is 
almost food and drink; it is refrigerant in summer and calefacient in winter 
-a hobby which he rides either rough or smooth shod. 
Whm the question was put to an ancient orator as to what was most 148 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
necessary to constitute a good speaker, he replied action; when he was 
asked what was next most important, again he replied action ; and when the 
question was reiterated the third time, the third time he replied action 
Were a modern Sanyrado asked what was most necessary in the treatment of 
disease, doubtless he would reply, bleeding ; should the question be repeated, 
undoubtedly he would repeat the same answer ; and should it be reiterated 
the third, or to the thirtieth time, the same answer would be as often re- 
turned, unless, perchance, it should be varied to Calomel, purgatives. 
Our modern pathologists, surgeons, and others, think bleeding the 
fac totum in all maladies; it is the non plus-ultra, when drawn in quantities 
of forty or fifty ounces. Blood-letting, says this author, is not only the most 
powerful and important, but the most generally used, of all our remedies 
Scarcely a case of acute, or, indeed, of chronic, disease occurs in which it 
does not become necessary to consider the propriety of having recourse to 
the lancet (?!). To what extent blood-letting is carried in our modern age, 
may be learned from the most standard work on the blood. 
I might go on and speak of the effects of the loss of blood in inflammation 
and every other disease; but the limits of this work will not permit, and I 
must leave it for others hereafter farther to enlarge upon and to illustrate. 
SECTION X. 
TREATMENT OF THE EFFECTS OF LOSS OF BLOOD. 
It is not my design, in this place, to treat much upon the curative effects 
of the loss of blood. This part of the subject is reserved for another section 
of this work. I will, however, speak of the curative effects in general. 
1. Posture.-When fainting occurs, which is so common in bleeding, the 
patient should be laid upon the floor, bed, or in a recumbent position, which 
more readily admits a return of blood to the head and brain. 
2. Stimulants.-Administer spirits or brandy, or, which is better, ten drops 
of the spirits of hartshorn in a little spirits of lavender. 
3. Application of Water.-A small quantity of water may be dashed in 
the face. 
4. Volatiles.-Camphorated spirits or hartshorn may be applied to the 
nostrils and face. If reaction does not take place soon, the feet and surface 
may be bathed in warm water. 
5. All tight bandages should be removed. 
6. Air.-Few persons should be permitted where the patient lies. 1 ne 
doors or windows should be opened, that there may be a free current of air. 
7. When the patient is recovered from fainting, a restorative course of 
treatment must be instituted. Wine or wine bitters may be given, and a 
very nutritious diet recommended. 
8. Anodynes.-Where there is great irritability of the nervous system, 
exhaustion, delirium, &c., anodynes may be prescribed. The tincture of 
hyoscyannes has an excellent effect. 
9. Sinapisms.-Mustard plasters may be applied to the feet and to the 
nape of the neck. 
10. Laxatives.-The bowels must be kept regular by aperient or laxative 
medicines. 
11. Quiet or Repose.-In most diseases arising from loss of blood, the OF MEDICINE, AND INDICATIONS OF CURE. 
149 
person is very susceptible of noise or disturbance of any kind. Quietude 
and rest, therefore, should be strictly enjoined. 
SECTION XI. 
CONCLUDING REMARKS 
In concluding this chapter on the morbid and dangerous effects of blood- 
letting, I anticipate the remarks of an objector or inquirer, " Do you, then, 
reject bleeding in every disease ?" In answer to which I have to observe, 
that ever since I commenced the practice of medicine I have witnessed the 
effects of bleeding in different diseases. The practice has been so popular, 
and recommended by such high authority, and been adhered to by physicians 
for such a great length of time, that I concluded to follow it until I satisfac- 
torily ascertained the effect of it upon the system. At one time I even 
took a bleeder with me in my visits to my patients, and in some degree 
followed the footsteps of Dr. Sangrado, and bled almost every one of them. 
I soon found that I injured, instead of benefited them ; and although I 
discontinued the practice of bleeding so constantly and so indiscriminately, 
yet I have for years occasionally resorted to it, till more recently I have laid 
aside my lancet, and it is now rusting in its scabbard. It is true my students 
sometimes bleed patients who insist upon its being done, but this is not in 
conformity with my practice. I can fulfil every indication for which bleeding 
is practised, by the substitution of other means more rational, natural, and 
congenial with the system ; and, therefore, after a most extensive observation 
and practice at the bed-side of the patient, I must, as an honest man, what- 
ever may be the opinion or practice of others, adopt the following maxim- 
" SELDOM OR NEVER BLEED." 
Since writing the above I have had a number of years' experience in the 
practice of medicine, and all which confirms me in the belief of the principles 
here laid down on blood-letting. It is now about ten years since I have bled 
a patient, except a few times locally; and even those cases, I am now con- 
vinced, might have been successfully treated without any abstraction of 
blood. 
Dr. S. states that a surgeon of this city amputated the leg of a coloured 
man without any kind of necessity, merely to show Dr. W. how to operate. 
The Hon. Mark Harris, of Portland, Me., ex-member of congress from one 
of the eastern states, recently, on a visit to this city, became indisposed in 
consequence of a rupture. Dr. Gunn was called to him, and Dr. A. Post, 
who almost immediately commenced a surgical operation ; and they had no 
sooner completed it than the man died. He had been in excellent health 
previously. 
Dr. Valentine Mott recently performed a horrid operation on an elderly 
lady from New Jersey, for a polypus or tumour on the face or of the nose. 
After dissecting the skin from one side of the face, he sawed off the upper 
cheek-bone, &c. As a matter of course, she is now dead, or nearly so. 
Is it not as dangerous to employ one of our regular mineral and butchering 
doctors as it is to jump into the dock, take poison, or to hazard life in any 
other way ? And may we not regard such practice among the same calami- 
ties as pestilence, earthquake, or famine ? 150 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
CHAPTER III. 
THE KNIFE, OR ABUSES IN SURGERY. 
" What a sarcastic, what a damning catalogue of great operations, performed within these last feu 
years, might a diligent cynic compile for the gratification of the world." Johnson. 
SECTION I. 
OF SURGICAL OPERATIONS IN GENERAL. 
The limits of this work will not permit a full investigation of this part of 
the subject, or that which relates to abuses in surgery. I shall, however, 
give an abstract or outline. 
Within some years past it has become very fashionable to attempt to cure 
a great variety of diseases by the knife, or by manual operations ; but with 
what propriety or rationality, I have never yet been able to determine. I 
cannot reconcile the propriety of it with any indications of nature, physio- 
logy, anatomy, observation, or experience. It is true, perhaps, although I 
have seldom or never seen an instance, that some diseases may be removed 
by a surgical operation. But this affords no reason why they should be so 
generally resorted to, for it is well known that diseases for which such opera- 
tions are performed are otherwise removed, either by nature or by other 
means. 
When we reflect for a moment upon the structure and organs of the dif- 
ferent parts of the system, we shall see why so little benefit and so much 
injury results from operative surgery. Wherever any disease is seated, for 
which cutting is recommended, we shall see that there is, in general, such 
an intimate connexion between it and the surrounding healthy parts, that 
the knife cannot separate between them. It is owing to this that those 
diseases for which an operation has been performed, so frequently reappear 
after they have been apparently extirpated. 
The morbid and healthy vessels and fluids are so interwoven and connected 
together, and so freely inosculate with each other, that operations oftener 
exasperate than cure. This is exemplified in tumours of various kinds, the 
scrofula, white-swelling, cancer, fistula, &c. 
Operations are acknowledged by all to be the opprobrium of surgery, and 
rather a disgrace than credit to the operator. It ought to be the primary 
object of every practitioner to prevent the use of the knife. But in this day 
it is certainly not the case. Some of our noted surgeons express the most 
joyful sensations whenever they can obtain a subject for carving. It appears 
to be their delight to dissect and cut human flesh, devoid of all sympathy; 
and there might be. some excuse for it, were such operations indispensably 
necessary; but when it is a fact, (which has been demonstrated in scores 
and hundreds of cases,) that there is seldom, if ever, any necessity for them, 
we confess that we feel horror-struck and indignant, that mankind must con- 
tinue to be tortured, mangled, and quartered for those very diseases which 
have been so frequently cured by the most safe and mild means. 
Dr. Johnson, editor of the Medico-Chirurgical Review, and physician ex- OF MEDICINE, AND INDICATIONS OF CURE. 
151 
traordinary to the King of Great Britain, has the following pithy remarks on 
this subject: " If operations-bloody, cruel operations-are looked on with 
admiration, it can only be by those who regard plague, pestilence, and famine 
as beneficial also. No! operations are our opprobrium, our disgrace-not 
our proper and legitimate boast: the mere operator is little better than a 
human butcher by rule. There is too great a taste for the knife at present; 
shame to those who encourage it; wo to those who practise it! unnecessary 
operations bring discredit on surgery; unsuccessful ones, even when per- 
fectly justifiable, inspire doubt and repugnance to it in the public mind. 
Patients who see or hear of their relatives or friends submitting to barbarous 
and frightful maimings, only that they might live for a month or a week, 
feel no great relish for the knife when its use might bring safety and a cure. 
What a sarcastic, what a damning catalogue of great operations, performed 
within these last few years, might a diligent cynic compile for the gratifica- 
tion of the world ! But we have done, and we trust that these observations 
may not be without their effect." 
In Dr. Gibson on bony tumours, pages 136-7, is the following to the same 
import: 
" Whoever attends an European Infirmary, will be struck with the diversity 
and multiplicity of operations performed upon the most trivial occasions. 
Will it be credited, when I say that the illustrious founder of American sur- 
gery, during a practice, both hospital and private, of thirty years, and more 
extended than that of any other individual of our country, has hardly ever 
had occasion to resort to amputation ? It may be asked, what became of his 
patients ? I answer, they have been cured by general and local means. 
Doctor, said a surgeon of Pennsylvania hospital, to a distinguished practi- 
tioner of a neighbouring city, what would be done in your town with such 
a leg ? We should cut it off, was his reply. We can cure it here without, 
rejoined the other. " In a certain London hospital," says Dr. Gregory, " a 
patient was under the care of the physicians on account of a very bad leg, 
which baffled their skill, and appeared to them almost hopeless ; they there- 
fore requested a consultation of the surgeons, to examine the leg and to decide 
what should be done with it. The surgeons accordingly met, examined it, 
consulted about it, and resolved, nemine contradicente, that the leg could not 
be saved, and ought to be cut off. They cut it off* without delay. But, 
strange to tell, the physicians, at their next visit, on examining the patient, 
found, to their great astonishment, the supposed hopeless leg as fast to his 
body as ever it had been. 
The puzzle was soon explained. It happened that the man had two legs, 
both of them very bad ; one the physicians thought they could save, the 
other they despaired of. There being but right and wrong, it was not very 
marvellous that the consultation took the wrong. Both physicians and sur- 
geons, I believe, were a little disconcerted at that (jwid pro quo ; and as it 
was thought rather a strong measure to cut off both of the man's legs, they 
exerted themselves to the utmost and saved the leg which should have been 
cut off: so that, after all, the poor man was but one leg out of pocket. 
As I was not an eye-witness of this edifying transaction, it is proper to give 
some notion of the genealogy of the story, which is very short and simple. 
I have it from a reverend clergyman, who had it from one of the physicians 
concerned, and who is now one of the most eminent of his profession in Lon- 
don. I know both the clergyman and the physician intimately; I know 
them both to be men of veracity and men of sense ; and I have no doubt that 
the facts were just as I have stated them. 152 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
These remarks may appear, perhaps, irrelative, but I am satisfied of their 
importance, and shall be gratified if they tend to check the disposition so 
prevalent among surgeons to use the knife, or contribute, in a single in- 
stance, to alleviate pain or remove diseases by milder or more appropriate 
means." 
The following cases are related by a physician of this city. They show still 
farther the fondness of surgeons to perform even unnecessary operations : 
" Yesterday, in passing down Delancy-street, my attention was arrested 
by a number of persons collected together in consequence of an accident 
which had just occurred to a lad by the name of William Thompson, about 
twelve years of age. After he had been conveyed to the residence of his 
mother, No. 91 Delancy-street, I took the liberty of calling and making some 
inquiry respecting the nature of the accident. I there found Drs. D. L. 
Rodgers, Bowron Vache, and some half dozen other physicians or medical stu- 
dents, who in a very superficial manner were examining the wound of the boy. 
It was pronounced a compound fracture of the lower, and a simple fracture of 
the upper arm. The ends of both bones were seen protruding through a 
large wound, although the blood circulated freely below it, and the motion 
of the hand was not lost. The injury had been done, I was informed, by 
the machinery in a manufactory for cutting glass. All the physicians or 
students present immediately decided, with the exception of one, the oldest 
and most experienced, that the arm must be amputated. This physician 
stated that the wound, though extensive, might be cured. At any rate, he 
thought an attempt ought to be made to effect it; that there would be no 
more danger in making a trial than would result from amputation ; he 
quoted for authority Sir Astley Cooper, and spoke of the danger of an opera- 
tion so soon after the injury. He concluded by asserting that he had cured 
a wound equally as serious and unfavourable. Although the opinion of this 
physician was respectfully solicited by the principal surgeon, yet the enmity of 
the others was so much excited at the opposition he made to the proceedings, 
that they tried every means, in the most clandestine and disgraceful manner, 
to rid themselves of his presence. The proposition to heal the wound was 
not listened to. The physicians began to make preparation to remove the 
arm, by displaying before the eyes of the unfortunate lad numerous surgical 
instruments ! The scene resembled a number of butchers eager, to shed the 
blood of a poor animal. 
The boy strenuously and perseveringly objected to the operation, and 
called some around him to prevent it being done. His cries, entreaties, and 
agonies were truly heart-rending, and convulsed his whole frame. He was 
firmly held by them, however, till the arm was cut off-not below the 
elbow, where it ought to have been, as I was forcibly impressed, if at all, 
but above. • ♦ 
My object in this communication is, to express my conviction (and I judge 
from common sense and common observation) that this arm could have been 
saved, as intimated by the physician above alluded to. I have seen a wound 
apparently as bad, if not wrnrse, cured by him, after it had been decided that 
amputation must be immediately performed. I have no doubt that many 
limbs are taken off, which, if left to nature and judicious treatment, might be 
preserved. 
A few years ago a person was expelled from the New York alms-house, 
because he would not consent to have his leg amputated. He succeeded, 
after three days of great toil and distress, in reaching the city, a distance of 
only three miles. He then began to prescribe for himself, and in a few OF MEDICINE, AND INDICATIONS OF CURE. 
153 
months recovered the use of his legs, and can now walk perfectly well. 
Ought not these " stubborn facts " outweigh any and every theory leading 
to an opposite practice, however plausible, or founded on authority however 
high ? If there is an improved system of practice, and I have the fullest 
evidence of the fact, by which we may be cured of our diseases without the 
loss of our limbs, or without being " quartered and mangled," ought it not 
to be investigated and patronized by every humane and philanthropic person, 
however opposed they may be by the illiberal, the interested, the envious, or 
the prejudiced 3 
These cases are too painful to be contemplated with ordinary patience by 
any humane reader. The anxiety which we have ourselves witnessed in 
some jujune practitioners of surgery, to flourish the scalpel about the limbs 
of a maimed patient, for the sole sake of showing off their professional adroit- 
ness, has on more than one occasion induced feelings of exquisite and un- 
mentionable anguish. 
There are thousands of juvenile slaughterers, secundum artem, who are 
always longing for chances to display their callous philosophy and cunning 
agility, in slashing off a bruised armor sawing away a shattered leg, without 
condescending to wait for any of the efforts of nature. 
An instance is within our own recollection somewhat analogous. The 
circumstances occurred in Massachusetts, four or five years since, and can 
be proved by the testimony of hundreds. A little girl, about four years of 
age, while riding in a gig with her parents, fell out of the vehicle, and the 
wheel immediately passed over one leg and one arm of the child, crushing 
horribly the bone of the thigh and that of the upper arm. A council of sur- 
geons resolved that the wound was past all remedy, other than immediate 
amputation; and while preparing for the operation, a noted bone-setter, named 
Sweet, illiterate, coarse, better acquainted with nature than art, saw the 
patient and remonstrated, with effect, against the proposed mutilation. The 
surgeons of course abandoned the sufferer to her fate and retired, pronouncing, 
however, sentence of death upon her. The bone-smith, who pretended to 
be nothing more than one of nature's journeymen, bandaged the crushed 
limbs, without even using the wooden splints or frames, considered so essen- 
tial by all scientific chirurgeons. Thus nature was left to work itself out of 
its own predicament; and, by dint of careful, simple, and gentle treatment 
on the part of her attendants, the little patient in a few weeks was restored 
to her overjoyed parents, whole and sound, and is at this day one of the most 
sprightly children of her age, enjoying the free use and original shape of all 
her limbs. We are by no means inclined to disparage the noble science of 
surgery; we view it as even the most honourable of professions ; but we would 
deprecate that precipitate zeal in imprudent practitioners which, in its ear- 
nestness to make exhibitions of skill, loses sight of the grand truth-that art 
is but nature's auxiliary. In young persons especially, the utmost caution 
and hesitancy ought to be observed. Such is the practice w'ith all experienced 
surgeons, before applying the cruel instruments, whereby misery and de- 
formity are for ever entailed upon the unfortunate sufferer. 
The details of an operation, as related in the Morning Herald of 21st July, 
1841, are sufficient to sicken the soul at such rash and merciless treatment. 
" The next case (represented in the annexed engraving) was an interesting 
one of white swelling, for which the thigh was to be amputated. The 
patient was a youth about 15, pale, thin, but calm and firm. One professor 
From the New York Herald. 154 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
AMPUTATION OF THE THIGH FOR WHITE SWELLING; AT THE DISSECTING-ROOM, STU YVES A NT INSTITUTE. OF MEDICINE, AND INDICATIONS OF CURE. 
155 
felt for the femoral artery, had the leg held up for a few moments to ensure 
the saving of blood, the compress part of the tourniquet was placed upon the 
artery, and the leg held by an assistant: the white swelling was frightful. 
A little wine was given to the lad ; he was pale, but resolute ; his father sup- 
ported his head and left hand: a second professor took the long, glittering 
knife, felt for the bone, thrust in the knife carefully, but rapidly ; the boy 
screamed terribly, the tears ran down the father's cheeks. The first cut from 
the inside was completed, and the bloody blade of the knife issued from the 
quivering wound ; the blood gushed by the pint; the sight was sickening, 
the screams were terrific, the operator calm. Again the knife was thrust in 
under the bone ; the terrific screaming was renewed; one or two picked up 
their hats to leave ; scream on scream-and again the bloody blade of the 
knife issued from the wound, and was laid aside. The flesh quivered, and 
the boy cried agonizedly, ' Oh father ! father ! father ! Oh mercy ! mercy !' 
The flesh was thrust back with a small piece of wet linen, the divided ends 
of the quivering muscles were stopped from blood with a sponge, the saw 
glistened in the hands of the operator, the father turned as pale as death, the 
boy's eyes fastened on the instrument with glazed agony: grate-crush-once 
-twice-and the useless limb, from the toes to the centre of the thigh, was 
quickly dropped into the tub under the table. At this moment the father's 
eyes closed, his child's hand dropped from his grasp, he reeled from the table, 
and fell senseless on the floor. 
The arteries were taken up, cold compresses only were applied ; one or 
two stitches in the flesh, one or two more screams, and the boy was taken 
into an adjoining room and laid on a bed. The whole took less time to per- 
form than the details have occupied in writing. 
With what eagerness and curiosity these ' cut and slash ' proceedings are 
viewed by the assembled students: but are not scenes like these calculated 
to give an impetus to the deadly use of the knife ? Have they not a tendency 
to destroy that patient investigation and research into the nature of diseases, 
requisite to a thorough knowledge of their treatment ? Alas ! these public 
displays of surgery are fraught with the most alarming evils. A perseverance 
in simple remedies is liable to be discarded by the medical student; and when 
disease has arrived at its most dangerous state, the only remedy deemed to be 
potent will, perhaps, be to lop off the morbid part-to add another maimed 
member to the list of cripples created by maltreatment and the dernier resort 
of desperate tyros. When those ' distinguished lights,' Hunter and Aberne- 
thy, have designated these operations as ' imperfections ' of the medical art, 
surely their solemn assertions are worthy of serious regard. Surely the 
' little stars ' of the New York University may hide their ' diminished heads,' 
devote their precious hours in studying the preservative means of a milder 
system, and avoid those ' imperfections,' so sincerely deplored by the deepest 
philosophers and brightest scholars the science of medicine ever called into 
action." The above operation was performed at the Stuyvesant Institute. 
'Tis the sad spot where Mis'ry sheds her tear, 
And scenes of blood the human feelings sear. 
I will here give the authority of one of the most distinguished surgeons 
and authors in London, Sir Benjamin Brodie, as related by Wm. Gibson, 
M.D., Professor of the University of Pennsylvania, in his late work entitled 
" Rambles in Europe." He says, in walking the rounds of St. George's 
Hospital, containing upw'ard of four hundred beds, I saw many diseased joints, 
and could not avoid asking Sir Benjamin if he performed as many amputa- 156 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
tions for the relief of such diseases as formerly; to which he replied, " Oh, 
no-not the twentieth part." " How, then, do you manage ?" " By rest, 
position, splints, and diet!" was the answer. 
The following letter of Dr. Brodie to Professor Gibson gives additional 
testimony against operations: 
14 Saville Row, May 22d, 1839. 
" My dear Sir, 
" I beg your acceptance of a copy of the last edition of my Treatise on 
the Diseases of the Joints. I also send you some pamphlets, which you 
may, perhaps, find leisure to peruse on your voyage. I hope that my work 
on the joints has, at all events, contributed to diminish the number of ampu- 
tations performed in this country, on account of this class of diseases. Cer- 
tain it is, that many diseased joints were amputated in the earlier part of 
my professional life, which the London surgeons would not even dream of 
amputating at the present time ; and that in several of the cases recorded in 
my treatise as having been the subject of amputation formerly, (and to which, 
by the way, I am indebted for many of my pathological observations,) a cure 
would now have been obtained by easier means, and without the mutilation 
of the patients. 
" Altogether the proportion of severe operations has of late years become 
very much diminished in the hospitals of our metropolis, and I attribute this 
mainly to the improvements that have taken place in our art. Without 
underrating the importance and value of operative surgery on many occa- 
sions, I must say, I could never bring myself to regard it as constituting the 
glory and pride of our profession. The mutilation of the human body is, at 
best, but a sorry expedient; severe operations are always attended with more 
or less of hazard ; and I conceive that it is a much greater triumph for 
science when she teaches us to cure a disease by other means, than when 
she leads us to the same result by the most skilful and masterly operation. 
" I am, dear sir, with great respect, your faithful friend and servant, 
B. C. Brodie." 
The Count La Sallee, in one of his papers addressed to the academy des 
arts, at Paris, thus expresses himself in relation to the practice of surgery 
among the Indians. The paper is dated August 10, 1565. 
" In my travels through the wilds of America I visited most of the Indian 
tribes which populate the regions of the west. I commenced my pilgri- 
mage at the mouth of the St. Lawrence, and ended it at the passes of the 
Mississippi. A nobler race of beings I never witnessed; and I was surprised 
when I found that, though unacquainted with any of the sciences, they were 
masters of the art of surgery. During my travels I found a number of the 
aborigines who had been wounded and mangled in the wars, but I never 
found one who was in the least deformed by the fracture of bones and the 
numerous accidents to which Indian warfare is liable-not a single amputation 
I had noticed, in most of the hospitals of Europe, that but few of the inmates 
who had been confined came out without being lame and deformed ; and 
when I recollected this, I expressed my astonishment to the chiefs of the 
tribes that the invalids perfectly recovered the use of their limbs, and did 
not bear any of the marks of previous disaster. To my observations one of 
the chiefs replied, " you have men to mend limbs, who are taught by men 
to do so; we obtain our knowledge from the Great Spirit. We are perfect, 
for our knowledge comes from the clouds ; yours comes from man only." I OF MEDICINE, AND INDICATIONS OF CURE. 
157 
confess that I was thunder-struck with the reply ; but I could not but admit 
the justice, accuracy, and pungency of the remark. 
The celebrated missionary, John Zimmerman, as early as the year 1620, 
made a voyage to Patagonia, under the auspices of the Moravian church, 
and in one of his letters to the Synod, took an elaborate view of that peo- 
ple, and' from the which we make the following extract: 
" I was not more surprised than delighted to find among this people men 
who were practically and theoretically acquainted with surgery, though they 
were unacquainted with the terms and phrases which are employed by civi- 
lized nations. I inquired of them how they became acquainted with the art; 
their reply was, our ' God forms not his mortals without intelligence, and he 
has wisely ordained that we should all possess the capacity of supplying our 
wants. He that formed us endowed us with the necessary knowledge to 
enable us to heal our wounds and restore our fractured bones.' " 
Were I disposed I could proceed and relate hundreds, if not thousands, of 
the most inhuman, barbarous, bloody, and fatal operations, both in Europe 
and America ; and that, too, for those very diseases which nature often cures 
without any assistance from art. It may be that occasionally an operation 
removes a disease. But if so, this is blazoned to the world, and brings great 
fame to the operator, when perhaps the scores of cases which he has butchered 
out of the world are kept silent. Indeed I have sometimes thought the more 
patients a surgeon kills by formidable operations, the more popular he becomes. 
I never would object to any operation, were I convinced that there was no 
other alternative; but when I see persons operated upon and destroyed for 
complaints which I have so frequently cured, if I did not raise my warning 
voice against such practice, and express my indignation, I should be destitute 
of the least spark of humanity. 
SECTION II. 
OF OPERATIONS IN PARTICULAR. 
1. Amputation.-It is customary to amputate a limb when mortification 
takes place, but it is directed not to remove it until a line of demarcation is 
formed between the mortified or dead, and the living or sound flesh ; assign- 
ing as a reason, that if it is done the stump will slough or that the disease 
will return. 
Now, I ask, in the name of reason, common sense, and philosophy, where 
is the propriety or necessity for amputating a limb for mortification, or any 
other disease, when it has been stopped or arrested. In this case, according 
to the very directions given or principles laid down, the limb will, if left to 
nature alone, be saved. 
The extract already quoted from Gibson proves that a surgeon who under- 
stands the healing art, may practise perhaps all his life-time without cutting 
off a single limb. How, then, can surgeons in this day reconcile their cutting 
and carving system with their consciences, or with correct principles of the 
science of medicine. 
It is a very common circumstance for persons to apply to us for the treat- 
ment of some disease for which amputation or an operation has been proposed; 
and I now do not recollect a solitary case in which we have not been success- 
ful, where our prescriptions have been followed: and a great share of the 158 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
abuse and calumny which has been heaped upon the author of this work, 
has arisen in consequence of having cured those very diseases for which 
operations have been proposed and recommended as absolutely necessary. I 
must, however, here state, that it is alleged that some improvements have 
taken place within a few years past in operative surgery. A medical gentle- 
man informs me that not one half the limbs are now amputated that were 
some years ago. 
2. Compound Fractures and Dislocations.-It has been very customary 
to amputate for compound fractures and dislocations ; but this is seldom, if 
ever, necessary. The worst cases of which I have' any account may be cured ; 
and, indeed, amputations now are not so frequently performed for these acci- 
dents as they were some years ago. 
Sir Astley Cooper proves conclusively that these accidents can be cured 
without amputation. Why, then, do other surgeons in this day amputate 
for them ? 
But I humbly trust that a new era in medical science will soon dawn upon 
the world. 
3. White Swelling.-It is customary to amputate for white swellings. This 
is truly a cruel, unnecessary, and shocking practice. How must the hearts 
of parents bleed to see the limb or limbs of their beloved children amputated 
or cut off for a disease that can be infallibly cured, as I have demon- 
strated in a number of cases ! 
4. Operations for Cancer.-It is recommended by authors and lecturers, 
both in Europe and America, to use the knife for cancers in the female breast 
and other parts of the body. But how this practice has so long prevailed, 
in face of all the facts on record, I cannot divine. I cannot account for it 
in any other way, except on the same principle that error always prevails. 
I know, by a life's time experience, that the method of extirpating cancers 
with the knife is not attended with success ; but, on the contrary, I have 
found that it aggravates the complaint. I have been often called to treat 
the disease in all stages, both before and after excision, and, therefore, I 
consider myself a competent judge ; and now have to state that this operation 
is uncertain, ineffectual, and generally renders the complaint worse, and, 
therefore, ought to be abandoned, and other means substituted. 
Among all the operations performed for cancer of the female breast, I have 
never known a solitary cure performed. Dr. Alexander Munro, of Edinburgh, 
states that he has been present at the extirpation of sixty-two cancers of 
the female breast, and not two of the individuals remained free of the disease 
two years afterward. Is there, then, any encouragement or any authority for 
continuing this barbarous practice ? 
The method that we pursue in the treatment of this disease is altogether 
better. 
Attempts to cut a cancer may be compared to the act of cutting down a 
tree and leaving the roots to sprout. It grows with renewed vigour. 
5. Fistula.-A horrid operation is now recommended and performed by 
surgeons for the cure of this most obstinate and unpleasant disease ; but the 
success of it is very little better than that for cancer. It seldom or never 
effects a cure. I have had persons apply to me after they had been operated 
upon a number of times, the disease exasperated, and have entirely cured 
it without any surgical operation. 
The operation consists in passing a bistoury or knife up the sinus or open- 
ing, and then cutting it entirely open ; after which lint is applied, without 
any other applications. Now, it requires but a small share of common sense OF MEDICINE, AND INDICATIONS OF CURE. 
159 
to perceive that the act of making one common opening with the rectum is 
not sufficient to cure the disease: it does not eradicate the callus, which 
constitutes the very essence of it. The method we adopt is, to excite a 
preternatural discharge, and thus remove the complaint. 
I have not yet seen a single case, no matter of how long standing, or how 
inveterate or deep-seated, provided the general health has not been too much 
impaired, but I have been enabled to cure; and that, too, where our most 
popular surgeons have failed. In proof of this, I can refer any person to 
numerous cases in every part of the city ; and to facts of this kind we depend 
for the success and merit of our work and system of practice. 
6. Hernia or Rupture.-When a hernia or rupture becomes apparently 
irreducible or strangulated, after a few attempts to reduce it, and without 
waiting long enough to know if it can be reduced, an incision is made down 
to, and through, the stricture, and the contents of the sac returned. It is 
possible that there are cases in which this operation may be necessary, 
but I have never yet found any such. I have reduced the worst case I have 
ever seen : and when we reflect that this operation often proves fatal, ought 
we not to substitute a course of treatment which will obviate the necessity 
of it ? 
M. Malgaigne, of Paris, has presented to the Royal Academy a very 
interesting paper on hernia. 
The writer first attacks earnestly the imposition laid down by Pott, " that 
the operation for hernia is not dangerous in itselfand which has exercised 
such a pernicious influence. He says, In order to establish the true chances 
of the operation, I have selected all the operations of hernia which have been 
performed in Paris by myself and colleagues during a space of five years 
and over, from '36 to '41. I have found that in 183 operations there were 
114 deaths; as to age, I have found that from 50 to 80 years there were 
70 deaths in 97 operations ; that is, about three-fourths. I have, adds he, like 
all other surgeons, paid a fatal tribute to this fatal doctrine. You will find 
mistakes committed by Percival, Pott, Dupetran, and Astley Cooper. Now 
the question naturally arises, how many of these patients fatally operated 
upon, would have recovered without medical treatment ? and again, how 
many would have been saved by judicious treatment ? How shall this be 
settled ? 
Some years ago I saw an amiable lady of this city, Mrs. Valentine, appa- 
rently destroyed by an operation performed by a popular surgeon, Alexander 
H. Stevens ; under proper treatment, she might have recovered. 
7. Aneurism.-There are few diseases more painful or dangerous than an 
aneurism, or a partially ruptured bloodvessel, producing a pulsating tumour ; 
and there are few, if any, in which the knife proves more dangerous or fatal 
Tying the artery above the tumour may, when it is on the extremities, effect 
a cure ; but when some great artery is the seat of the disease, an operation 
almost invariably proves fatal. I have successfully treated an aneurism of 
the femoral artery after the patient was told that, without an operation, she 
must inevitably die; and I am confident that if such an operation had been 
performed, the patient could not have survived it. This operation proves 
fatal from various causes ; first, from irritation ; secondly, from inflamma- 
tion ; thirdly, from mortification, and, consequently, haemorrhage. Out of 
very numerous operations which I have seen detailed by authors, or which 
have come under my own observation, (and which I might here insert if I 
had room,) nearly all proved fatal or exceedingly injurious. 
I am of the opinion, from my experience in the treatment of this complaint, 160 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
that many more would recover if left entirely to nature, than by a surgical 
operation. 
8. Trephining.-There has been much dispute and controversy among 
surgeons respecting the propriety of trephining for injuries of the head. Some 
highly extol, while others deprecate it. The surgeon of the hotel Dieu, of 
Paris, has stated that almost every one who was admitted into the hospital 
for injuries of the head, and who was trephined, died in consequence, no 
doubt, in a great measure, of the operation. Even the late Sir Astley Cooper, 
the oldest and most popular surgeon of London, and who cannot be accused 
of departing much from common established surgical practice, recommends 
the operation of trephining to be very rarely performed. He uses, in cases 
of depression with fracture, simply an elevator to raise the bones. He 
relates a case in his lectures where some surgeons expressed astonishment 
that he refused to trephine, and yet the patient did well. 
A surgeon told me the other day that he insisted upon trephining a child 
who had received an injury of the head; but as the mother refused, it was 
omitted, and the child rapidly recovered. An operation very probably would 
have killed it. Mr. Abernethy mentions many such cases. 
The act of boring one hole in the head to cure another seems to be very 
irrational and absurd. I have had patients who have received almost every 
kind of injury of the head, and I have found no difficulty in curing them 
without the operation of trephining; a single case excepted, and which was 
hopeless from the commencement. I had one case of fracture with depres- 
sion of such a character, that I even doubted whether he would recover with 
or without an operation ; he was thrown into convulsions, lethargy, &c., 
from a wound made in the right parietal bone by a stone. Means were 
taken to reduce the inflammation, the irritation was allayed by anodynes, 
and the man recovered without bleeding or trephining. A depression still 
remains in the skull an eighth of an inch deep. Cases are on record almost 
without number, where recovery has taken place in a similar manner. 
9. Lithotomy or Operation for the Stone.-When we reflect upon the 
number that die from this operation, being about one in five, and the liability 
to a relapse, even if there was no other means of removing it, it would remain 
a question, whether a person suffering with the complaint had better submit 
to the danger and excruciating pain of the knife, or take palliatives and 
trust the disease to nature. 
But it is sometimes cured by medicine ; and when it cannot be, it may be 
cured by the new process adopted in Europe, of perforating and destroying 
the stone in the bladder, without any cutting whatever. 
It would be interesting to relate the vast number of fatal cases which have 
resulted from the operation of lithotomy. An acquaintance of mine was 
operated upon for the stone, but when an incision was made into the bladder, 
none was found. A surgeon a short time ago stated that a child was afflicted 
with a stone in the bladder, and he proposed to cut for it. Some diuretic 
medicine was given by the father secretly, and the child soon recovered. 
10. Operation for the Cataract.--I have never yet seen a single case of 
cataract cured by an operation, but I have seen many eyes injured, if not 
ruined, by it. Some state that soon after the operation they received some 
benefit, but the disease soon returned, and was even worse than ever. One 
writer states that he ruined a hatful of eyes before he could operate with 
any kind of success. He ought to have said that he had ruined a hatful 
of eyes, and after all could not cure a single case by the operation. 
A person informed me the other day that he had submitted to an operation OF MEDICINE, AND INDICATIONS OF CURE. 
161 
for a cataract, and it not only made the eye worse, but caused inflammation 
in the eye that was sound, and which endangered the sight of it. 
SECTION III. 
CONCLUDING REMARKS. 
I cannot here farther enlarge upon the use and abuse of the knife, but 
will close the chapter with the remarks of the late Professor Godman on this 
subject, with some that I made a few years since in reply to an attack made 
upon our practice by a physician in this city, in the American Lancet. 
Are there not gross abuses of the knife in the practice of surgery, and is 
it not productive of more injury than good ? 
It is now generally admitted by the most judicious physicians and surgeons, 
that too many operations are performed-that many have recovered of mala- 
dies for which the knife was said to be the only remedy. Again, it is univer- 
sally known and admitted that many die of capital operations, or are mutilated 
or crippled for life, who, if left entirely to nature, might have lived comfortably 
for years. This has occurred in amputations, lithotomy, aneurisms, cancers, 
tumours, fistulas, injuries of the head, white swellings, hernia, cataract, and 
other diseases. Numerous facts can be adduced to substantiate this assertion. 
I do not say there are no cases in which an operation is necessary; but in a 
vast majority I know, by observation and experience, they can be dispensed 
with. That celebrated surgeon, Mr. Abernethy, of London, positively 
declares, every time he commences his lectures, that " it is owing to our 
ignorance that instruments or operations are necessary in any case." 
In discussing the propriety of performing surgical operations, we must 
take into the account the great uncertainty and hazard there is always 
attending them. In most cases it is impossible to predict, with any degree 
of certainty, what will be the issue ; whereas nature oftentimes, when left 
entirely to its own resources, removes diseases apparently beyond the reach 
of art; and if blind reason and art were permitted to interrupt her salutary 
efforts, the patient would be destroyed. 
Remarks of the late Professor Godman on the Knife.-The following judi- 
cious discrimination is from the pen of the late Professor Godman, and does 
honour to his head and heart: 
" The difference between a surgeon and a mere operator maybe estimated 
by contrasting them. The surgeon inquires into the causes, and removes 
the consequences of constitutional and local disease ; the operator inquires 
into the willingness of his patient to submit, and resorts to the knife. The 
surgeon relies on the restoration of the healthy actions by regimen and 
medicine ; the operator relies on himself, and cuts off the diseased part. 
The surgeon, reflecting on the comfort and feelings of his patient, uniformly 
endeavours to save him from pain and deformity; the operator considers 
his own immediate advantage, and the notoriety he may acquire, regardless 
of other considerations. The surgeon reluctantly decides on the employment 
of instruments; the operator delays no longer than to give the knife a keen 
edge. The surgeon is governed by the principles of the science ; the operator 
most generally by the principle of interest: one is distinguished by the 
number he has saved from mutilation and restored to usefulness ; the other 
by the number of cripples he has successfully made." 162 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
" The surgeon is an honour to his profession and a benefactor of mankind ; 
the mere operator renders the profession odious, and is one of the greatest 
curses to which mankind among their manifold miseries are exposed." 
CONCLUDING REMARKS. 
I anticipate the same objection here, in relation to the knife, that I did in 
the preceding chapter on the use and abuse of the lancet. " Do you, then, 
reject all operations ?" In reply to which I would state, that I have seen 
the effects of various operations performed in the New York hospital, as well 
as in private practice. I have carefully noticed the result under different 
circumstances and for different diseases, and, after the most mature reflection 
and deliberation upon the subject, as an honest physician, I am under the 
necessity of adopting the following maxim-" seldom or never operate.7' 
CHAPTER IV. 
MIDWIFERY. 
SECTION I. 
The abuses and impositions resulting from the present practice of mid- 
wifery by physicians, are as serious and reprehensible, and call as loudly for 
a reformation, as those pointed out under the head of Physic and Surgery: 
and, notwithstanding the severe animadversions on the subject by many 
persons for a length of time, the custom still continues. 
Females have been made to believe that physicians only are competent to 
assist them in the hour of child-birth, and that midwives are incompetent; 
by which this branch of medicine has been very unjustly and improperly 
wrested from them, and monopolized by the faculty. Did females know the 
ignorance, the untimely and rash interference with the unwieldy hands of 
doctors, the exposure, the rash attempts to accomplish delivery, the injury 
done by bleeding, minerals, ergot, and instruments-I state, did they know 
all this, the serpentine charm which now unfortunately deludes them would 
be broken, and they would shrink with disgust and horror at the very 
thought of employing males in parturition, or child-birth. Nothing but the 
grossest ignorance leads them to embrace a practice so unnatural and revolt- 
ing. In nearly every case nature is quite sufficient to expel the child ; and 
where aid is required, females are in every respect calculated to render all the 
assistance required, except, perhaps, in some rare or extraordinary cases. A 
very little instruction and experience will enable any sensible female to 
become proficient in this branch of medicine; and I venture to affirm that 
her success will be far greater than that of male practitioners: in proof, I 
refer to the practice of Mrs. Ruth Stebbins, of Westfield, Mass., Mrs. Halsey, 
of New York, and hundreds of others, whose great success is ample evidence 
of their skill and competency. Also, Madame Boivin, and Lachapelle, of OF MEDICINE. AND INDICATIONS OF CURE. 
163 
trance, who have been present at the delivery of more than forty thousand 
cases, nearly all of which terminated favourably, even without aid: and 
observe, also, the great success of other midwives in Germany, Denmark, 
and other parts of the world. So stupidly or wilfully blind are many 
females, that they are ignorant that nature accomplishes the delivery, and 
that the doctors get the credit and the fee, while the worthy and skilful 
midwife is pronounced ignorant or incompetent. I cannot see why such a 
custom, so recent, unnatural, and novel in its character, should have pre- 
vailed, and gained such an ascendency, except in the same manner that 
every other foolish and absurd fashion prevails. 
I have practised this branch of medicine ever since I began my profession; 
but so fully convinced have I been that it is wrong, and belongs to the 
other sex, that I have abandoned it to its rightful owners, female midwives : 
and I am, therefore, as anxious to bring about a reformation in this depart- 
ment as in other branches of medicine. I trust that I shall have at least 
the enlightened portion of the community to sustain me in a cause of such 
vital importance, both to the moral and physical well-being of the female sex. 
In the next section I will give a communication on this subject from a 
worthy and respectable lady, Mrs. E. Arnold, of Westfield, Mass. 
SECTION II. 
From the Botanic Medical Reformer. 
MIDWIFERY. BY MRS. ELIJAH ARNOLD. 
I receive regularly the " Home Physician," and I hail it as a welcome 
visiter, for I feel more than ever interested in the subject of " Medical Re- 
form." While the subjects of abolition, temperance, and moral reform 
have been much agitated, and become quite popular in the community, the 
subject of medical reform has been much neglected, especially by women; 
for many, no doubt, think it far above their comprehension, and suitable 
only for the medical faculty, but I do not so regard it. I believe women 
are created with minds capable of improvement; they have intellect and 
reasoning faculties ; they, too, unlike Mahomet's doctrine, have souls 
capable of existing through a never-ending eternity, and of course will be 
required to render an account of their stewardship on earth; they, too, are 
commanded, equally with their brethren, to improve their talents, to the 
honour and glory of God ; and if their pilgrimage on earth is passed in vain 
and trifling amusements, or in heaping up gilded treasures-if they have dis- 
regarded the bodies and souls of their fellow-men-how will they answer to 
an offended God ? I believe it is the duty of a Christian woman to do good, 
and not only do it, but qualify herself for more extensive usefulness. 
By this, I do not mean to be foremost in the popular reforms of the age, 
but take up some branch of duty that has been neglected or passed over 
with indifference; and what more claims the attention of women at the 
present day than the subject of medical reform, and a knowledge of the 
human system generally. We are, indeed, " fearfully and wonderfully 
made and can we think ourselves so much above it as to refuse to study 
into the workmanship of God ? And why should not women be qualified 
to act as physicians for their own sex ? have they not minds capable of im- 164 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
provement, hearts to sympathize with the afflicted, and hands to administer 
to the comforts of the sick ? I do not ask that women alone should have 
this place ; I do not desire that they should become fashionable physicians, to 
deal out mineral poisons-but that they should become qualified to be useful 
members of society, and ready, in any emergency, to administer to their 
own sex when required. 
Another branch of medical reform, and one to which I would more par- 
ticularly call the attention of women, is and upon this subject 
1 can hardly speak without manifesting my indignant feelings that a physi- 
cian should ever occupy this place. It is contrary to every principle of de- 
licacy and refinement, and disgusting to every feeling of our nature. It is 
an unheard-of practice in most countries, except in some parts of Europe 
and enlightened America. It is degrading to our natures, and a reproach to 
any people who submit to the practice, and is universally reprobated by 
moral writers. Says the celebrated Dr. Beach, of New York, " the prac- 
tice is unnecessary, unnatural, and wrong." Many others, justly celebrated 
writers, might be named, of the same sentiment, but we need not appeal to 
physicians or moral writers ; our own sense of propriety teaches us that we 
must sacrifice all principle of right, before we submit to the practice. Now, 
upon this point we shall probably agree that a reform is necessary, and a 
change must be effected in order to have our practice to correspond with 
our moral feelings, with reason, and with the revealed will of God. It re- 
mains now to inquire in what way this can best be done. So long as women 
are so ignorant upon this subject, and public sentiment is so much against it, 
and designing physicians are endeavouring to keep it in their own hands, 
through self-interest, very little, comparatively, can be accomplished ; but 
let an interest be awakened in the community, light disseminated, and 
knowledge increased, then we shall clearly perceive that a change is neces- 
sary. Let two or three, or more women in every town or village, of piety, 
talents, learning, and respectability, make a sacrifice, and step forward to 
become properly qualified to act as midwives, and then let them be suitably 
instructed, and let those physicians who have honesty and candour enough 
about them to give up this practice from principle, patronise them, and pub- 
lic sentiment would soon turn in their favour. Let the most respectable 
women of every town be guarded about whom they employ ; let them give 
no countenance to a physician, but patronise the women thus qualified, and 
this would soon be instrumental in turning the tide of public sentiment. 
Let our brethren, Botanic physicians, and editors of Botanic journals 
throughout the length and breadth of our land, continue to pour a flood of 
light upon the community, and no doubt but this practice, by the blessings 
of God, will soon be restored to its original place, where our Creator design- 
ed it should be. I appeal to Botanic editors, because apparently they 
alone dare come out in opposition to public sentiment, to advocate this 
cause. 
This subject must come before the public through the mediurr of your 
periodical, and others of a similar kind, because Christian newspapers, and 
some edited by our own sex, too, have refused to publish well-written com- 
munications upon this subject; and even some, who profess to have for their 
object the advancement of moral reform principles, refuse to take up this 
branch of the subject, which every investigating mind must know is a 
branch of moral reform; and how can they expect to exterminate the sin 
of licentiousness, if they refuse to lay the axe to the root of the tree ? 
The celebrated Dr. Ewell, in speaking of man midwifery, after thirty years' OF MEDICINE, AND INDICATIONS OF CURE. 
165 
practice, says, " it is the secret history of adultery." I appeal to my 
brethren and sisters, is not this a fact ? If so, let us arise in the power of 
our might, and exert our influence in this cause of truth. I bless God that 
our world is being enlightened upon this subject; and though some of our 
sisters are too delicate to favour this cause, or refuse through seif-interest, 
yet God is raising up brethren and physicians to enlighten the world on this 
subject, and may they do it in the fear of God. I regret that the Church 
and the Watchmen are so silent; ought they not to investigate the subject 
in the fear of God, and exert their influence in its promotion ? When will 
the time arrive when virtue, and purity, and peace shall prevail on earth.' 
-O Lord, hasten the day. 
TFes(/zeZ<Z, Mass., June, 1841. 
" I have seldom," says Dr. Ewell, in treating upon this same subject, 
" felt a more ardent desire to succeed in any undertaking, because I view 
the present increasing practice, of calling upon men in ordinary births, as a 
source of serious evils of child-bearing-as an imposition upon the credulity 
of women, and upon the fears of their husbands-as a means of sacrificing:; 
delicacy, and consequently virtue-as a robbery of many of the good common 
women (midwives) of their employment and support. Truly, it shows as 
extraordinary a revolution in practice as any afforded by a survey of all the 
arts." " Should the strangers to the practice inquire if our men have large 
unwieldy hands-great curiosity about women; should they ask if our wo- 
men have the requisites for useful services-small hands, good sense of touch, 
and patience in attendance-they will absolutely deny this monstrous per- 
version of the course of nature." 
But so it is; the practice of midwifery, in all our towns and villages, and 
to a great extent in the country, is now almost exclusively confined to the 
hands of the physicians, who, by their marvellous tales of the hair-breadth 
escapes of numerous women to whom they have been called just in time to 
save life, strike a terror in the mind of the suffering woman, which confirms 
her in the determination, no matter how repulsive to her delicacy, to employ 
none but doctors. These tales are told, of course, in presence of the atten- 
dants of the woman in labour; and most commonly perhaps the individual 
whom the doctor has so fortunately rescued from such great peril, was at the 
same time in the hands of a female midwife, who, however skilful, was un- 
able to render the needful assistance. The frequent repetition of these 
stories in the presence of the same women, with the affected mystery in 
which the transaction is enveloped, make a serious impression on their minds, 
and fill them with the most awful apprehensions ; and they, in turn, employ 
the same individual, feeling themselves safe in the hands of no one else, un- 
less it be some other physician who can tell equally marvellous tales. 
" A thousand times," says Dr. Ewell, " you dwell upon the miseries of 
one sufferer, without thinking upon the millions who happily and healthily 
pass the period of parturition. Away with your forebodings ! Believe the 
truth, when pregnant, that, in all human probability, you will do perfectly 
well; that the most ordinary women can render you every needful assistance, 
without the interference of men midwives. Their harry, their spirit for 
acting, have done the sex more harm than all the injudicious management of 
midwives, of which they are so fond of talking. This Dr. Denman, Dr. Buchan, 
and many other really great physicians, have long since remarked." 166 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
SECTION III. 
TESTIMONY OF DR. J. KING. 
Dr. John King, of New Bedford, Mass., writes as follows on the subject 
of midwifery : " I agree with you, and I insist upon it wherever I go, that 
this is not the part of a physician's labour. It is not a sickness in reality- 
but a natural effect, intended by our Creator, and should be solely in the 
hands of women; yet, owing to prejudice and the custom of society, how- 
ever much they concur with me in this fact, when the hour arrives, the 
man is called, and she, whose modesty would at any other time mantle her 
cheeks with crimson, willingly submits to the laws of custom. 
About four-fifths of the female patients whom I attend for falling of the 
womb and other diseases, have satisfied me beyond a doubt, that the sole 
cause of their afflictions was the improper interference of their man midwife ; 
and you would not only laugh at the ignorance and stupidity of some of our 
most celebrated physicians, but would be surprised and disgusted, were I to 
inform you of the manual operations for dilating the vagina, &c., that the 
woman might get through labour sooner and with less pain. 
I shall continue to decry this unnatural and immodest practice as long as 
life remains." 
I conversed with a person a few days ago, who stated that his wife had 
been afflicted nearly twenty years with falling of the womb, produced, while 
living in England, by her doctor during parturition. He was in a great 
hurry to get through, and took such means to facilitate delivery as thus to 
injure her. 
Females, dare you any longer hazard your health and lives by employing 
men to attend you instead of females, whose province alone it is to officiate 
in this branch ? Remember, if you do, it is at your peril, and I fear a curse 
instead of a blessing will attend you. Let the public be aroused to a proper 
sense of the evils and abuses connected with this subject, and let them adopt 
proper means for instructing suitable persons in midwifery. Let selfishness 
and ignorance be sacrificed on the altar of benevolence. 
SECTION IV. 
STATEMENT OF A LONDON PHYSICIAN. 
To show how grossly and wickedly women are sometimes deceived and 
imposed upon by medical men, I give the following paragraph from the 
London Practice of Midwifery : 
" A patient, after the waters are discharged," says the author, " requires a 
little management; it is not just to stay with her at the time ; and yet it is 
necessary, if we leave her, to leave her in confidence; therefore we may 
give her the idea of making provision for whatever may happen in our ab- 
sence : we may pass our finger up the vagina or opening to the womb, and 
make a moderate degree of pressure for a few seconds on any part of it, so 
that she may just feel it, after which we may say to her, ' There, ma'am, I 
have done something that will be of great use to your labour.' This she OF MEDICINE, AND INDICATIONS OF CURE. 
167 
trusts to; and if, when she sends for us, we get there in time, it is well; if 
later than we should be, we easily satisfy her. (For the doctor knows.) 
' Yes, you know I told you I did something which would be of great service 
to you in your labour.' If the placenta is not yet come away-' oh, I am 
quite in time for the after-birth, and that you know is of the greatest 
consequence in labourand if the whole has come away-' we are 
glad the after-birth is all come away in consequence of what we did be- 
fore we last left the patient, and the labour terminated just as we intended it 
should!'" 
This farce and deception probably costs the husband five or ten guineas. 
Do you think, reader, that one of our North American Indian women could 
be thus cheated and humbugged ? 
CHAPTER V. 
OBSERVATIONS OF DIFFERENT INDIVIDUALS ON THE PRESENT PRACTICE OF 
MEDICINE. 
SECTION I. 
1. REMARKS OF DR. JOHN J. STEELE ON MERCURY, THE LANCET, AND THE 
KNIFE BEING A PART OF AN ADDRESS DELIVERED AT THE NEW YORK RE- 
FORMED MEDICAL COLLEGE. 
"Though there be some who shut their eyes against light and debar 
truth from their reception, yet, thanks be to Heaven, the mass of the good 
and the truly wise have ever been ready to receive both, when fairly and 
honestly presented. 
In the following lecture truth, honesty, and benevolence shall influence 
the speaker. He shall only exhibit his own views, founded upon experi- 
ence, matters of fact, and common observation. He, too, let it be recollect- 
ed, was early disciplined into the old school of medicine, and for many years 
used calomel, the lancet, and the knife without compunction or reserve. 
Every man who thinks or reflects for a moment upon the frail nature of 
man, the diseases which afflict him, and the system of practice pursued by 
modern physicians, must come to the conclusion, that the inordinate use 
of mercury and other mineral poisons, the abuse of the lancet, and the irra- 
tional use of instruments in surgery and midwifery, are fruitful sources of 
disease and death to thousands. This is an evident fact at first sight. But 
follow up the subject-call to mind the numerous instances that have oc- 
curred in your neighbourhood, of persons who have been poisoned by mer- 
cury, killed by bleeding, or butchered into eternity by the knife in surgery, 
and the forceps in midwifery, and then say honestly what you think of the 
present system of practice. 
An inquisitive people must discover that the old system is both defective 
and dangerous. What disease can its disciples cure ? Examine critically 
what they prescribe, and you will find their remedies consist of mercury, 
antimony, lead, bleeding, &c., all of which are disease-creating remedies, 168 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
and all of which act in direct opposition to the laws of our animal nature 
Is, then, such a course of conduct, in relation to one of the most important 
objects of human life, to be sanctioned by popular opinion ? The people 
certainly are awaking out of sleep on this all-important subject. The light 
of reform is spreading far and wide, and a still small voice begins to be heard 
from one end of our country to the other: Physicians, you are. in error ; your 
indiscriminate use of mercury, the lancet, and the knife are adding to, rather 
than alleviating, the sum of human misery ! Reform! Reform the abuses of 
the healing art, and endeavour to become a blessing to the human family. This 
voice of enlightened public opinion begins to wax louder and louder, and if 
unheeded by medical men, sentence will soon be passed upon them from the 
bar of public opinion. 
Every one who has given the subject of medicine the least attention has 
discovered that, first, the common mode of practice is unequal in contending 
against disease ; secondly, that it is the most easy and profitable to the physi- 
cian who pursues it; and, thirdly, that it is dangerous to the sick. It is 
unequal, because, upon a close examination, you find that it rarely, if ever, 
cures a deep-seated or malignant disease, and that most of those who do re- 
cover, recover from constitutional vigour. It is profitable, because a lancet 
and a pound of calomel will not cost two dollars, and the neat profits, inde- 
pendent of visits, will exceed one hundred ; and, moreover, how easy for a 
medical dandy to carry his lance in one vest pocket and his calomel in the 
other. But it is dangerous. Every man, upon a moment's reflection, must 
admit the high importance of the blood in the animal economy; and the 
reasonableness of the supposition, that no more blood is formed in our system 
than is necessary, and that upon the proper quantity of blood depends the 
measure of health we enjoy. Now, if it were possible for man to generate 
too much blood, or that in certain states of diseased excitement the removal 
of disease depended upon a diminution of the volume of blood, would not 
the God of nature have provided such an outlet ? none, however, exists 
from the blood, for all natural disease-removing processes are carried on 
through the medium of the stomach, the bowels, the kidneys, and the skin. 
Besides, bleeding in every case, both of health and disease, in proportion to 
the amount taken, destroys the balance of circulation, and robs the system 
of its most valuable treasure and support; this balance must be restored and 
this treasure replaced, before a healthful action can be complete in the 
system. 
Again, the old practice is dangerous, because its remedial agents are un- 
natural mineral poisons. The bad effect of calomel or mercury upon the 
system is not sufficiently known or admitted. It exerts a most powerful 
influence upon the liver and other glands; it is one of the most fruitful 
causes of liver complaints, consumptions, kings-evil, dropsies, dyspepsias, 
&c., that exist in the present day. Its use is now general as a worm medi- 
cine, and it is the champion of modern physicians in the cure of every dis- 
ease. To prove this, we need only quote the words of a learned professor 
in one of the old schools, when lecturing to a class of upward of one hundred 
students: <c Give me," says he, " calomel in the one hand and the lancet in 
the other, and I am prepared to cope with disease in every shape that it may 
attack the human family." What a world of ignorance is contained in such 
a declaration ! And, oh ! what an amount of moral turpitude and crime is 
contained in such a precept, when delivered and enforced under such cir- 
cumstances ! 
I know full well the effects of mercury upon the human system, for I OF MEDICINE, AND INDICATIONS OF CURE. 
169 
have tried it in every shape, and for almost every disease, and have uni- 
formly found it attended with risk ; and, if pushed to a salivation, absolute 
consequences of a dangerous character, either open or hidden, were produced. 
This fact is no secret to the physicians who administer it, for they admit, 
among themselves and in their writings, that mercury does produce disease 
of the most disagreeable and dangerous character. Why, then, persist in the 
use of it ? But if they will persist, in the face of all the evidence they have, 
and in defiance of all moral obligations imposed by the sixth commandment, 
surely the people cannot be so infatuated as deliberately to swallow down 
the seeds of certain disease and death. Nay, the mass of them will halt and 
consider. 
The knife is another source of immense mischief to the human family. 
Every day brings us tidings of some unfortunate man or woman being usher- 
ed into eternity through the means of a surgical operation. I could name 
twenty cases which have occurred within a year, when the persons were in 
a common degree of health at the time the operations for different purposes 
were commenced, and all of whom died in less than a week after undergoing 
such operations. How melancholy would the reflection be, if, from an ab- 
solute necessity, physicians were compelled to operate in this manner, and 
when the fact was known that such operations were generally followed by 
death. But what different feelings inspire us, when we reflect that most of 
those operations are undertaken and performed without any necessity, and 
only to exhibit to the world the manual surgical tact of a vapouring, iron- 
hearted M.D. That in nine cases out of ten, when operations are performed 
and death ensues, the patient might have been cured or sensibly benefited, 
we have not the shadow of a doubt. For, as Professor Abernethy says, " It 
is owing to our ignorance that the knife is used in any case." 
Is it asked what will we substitute for mercury and the knife ? we an- 
swer that, for mineral poisons, we substitute the vegetables that grow in 
Nature's garden : we have tried them, and we find them abundantly suc- 
cessful. Moreover, we find them of such variety in strength and medicinal 
qualities, as to answer every indication disease presents, and to accomplish 
all, and much more than the conjoined use of calomel and the lancet. Dis- 
eases which have been given up my mineral practitioners, have been cured 
by vegetable prescriptions, both here and elsewhere. A vast number of 
cases denominated surgical, in which deadly operations have been recom- 
mended, have been completely cured by the Reformed Practice. Indeed, in 
no department of God's vast scheme of goodness to man is that goodness so 
strikingiy exhibited as in the arrangements of medicinal plants to restore 
health and remove obstinate diseases. All that is required of us is, to know 
the medicinal quantity of each plant and the disease it is designed to cure; 
then, when we are sick, we may put forth our hand and take it as the boon 
of Heaven. 
It becomes our duty to investigate the quality of each plant, from the 
forest tree down to the humble ivy : and, in the performance of this duty, I 
trust that we have the prayers of the philanthropist and the patronage of 
every good man. It is a work of vast importance to the human family: 
and if we have found substitutes for minerals, the lancet, and the knife, 
surely the world will not withhold from us that respect or patronage which 
so great a discovery demands. Some physicians of the old school will jeer, 
and mock, and lie, and slander, but their efforts to put down our system will 
be i i vain, g The mass of the people are on our side; they are our defence, 
our judges, and rewarders. Besides, the object of our pursuit is, above all 170 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
others, calculated to cheer us in our researches and comfort us in our priva- 
tions ; having no less object in view than the redemption of the rising gene- 
ration from the evils of mineral poison and blood-letting, and our army, navy, 
and other unfortunate fellow-beings from the horrors of the scalpel and 
amputating knife. Let us go on, then, and do our duty, fearless of all that 
the enemy can do. 
SECTION II. 
REMARKS OF DR. ANTHONY HUNN, OF KENTUCKY, ON THE SUBJECT OF REFORM 
IN MEDICINE. 
" 1 have laid before the public only a few of the many existing facts which 
press themselves upon the mind of an observing thinker, and must inevitably 
lead him to the conclusion, that the present medical practice is so far from 
being beneficial, as even to create a serious doubt whether it be not, in the 
whole, detrimental and injurious to mankind. This is owing to the want of 
truth in all oui' system of medical science. A system should consist of just, 
logical deductions drawn from familiar, known, indubitable, and undoubted 
facts. Instead of this, all our systems are either false conclusions from mere 
imaginary whims, begged principles, or mere suppositions; or even false 
conclusions from erroneous principles. All systemisers pretend to build 
upon facts ; but their facts are pressed and whipped into their service. The 
doctor first spins his system out of the cobweb of his fancy, and afterward 
squeezes some facts into forms resembling proofs of it, and very honestly 
shuts his eyes against all such facts as are at variance with his beloved air 
castle. He creates distinctions, when in nature all is whole, and forges 
classifications, when in nature all swims together. Thus Boerhaave, Cullen, 
Brown, Darwin, Staehl, are all blind leaders of the blind; and the young 
physician, who thinks he has in his notes and books a remedy for every dis- 
ease, when he comes to the sick-bed, finds all a chaos; no rule will apply: 
he looks in vain for the vaunted effects of his cure-all nostrums ; either for- 
sakes in disgust a practice which may lead him to manslaughter, or from 
experience chalks himself out some dictionary: This is good for that; or 
that is good for this; and becomes a quack: for practice without system 
is the very definition of quackery. Another, and not less efficient cause of 
the falsity of our medical systems is, the prejudiced respect for ancient and 
modern celebrated names. The most important data presented to us by 
modern improvements in physiology and anatomy (the marrow of the medi- 
cal science) are bartered away for the dicta of Hippocrates, Galen, Boerhaave, 
Cullen, and Rush; and thus the lancet, or calomel, or cold bath, or opium, 
or salt of tartar, all in their turn, become panaceas (cure-alls) with the 
accession of every new popular profession ; and 
' For the king's offence the people die.' 
I offer to the public a new system of medical science, which I have formed 
conscientiously clear of all those impediments, and which is confirmed in its 
salutary effects by the experience of a life-time's practice. 
But I anticipate a question which has been put to Moses, to Socrates, to 
Galileo, to Columbus, to every man that has presented the face of a reformer, 
and which green-eyed envy never yet has failed to accompany with the sneer OF MEDICINE, AND INDICATIONS OF CURE. 
171 
of detraction : ' Who are you, that you dare to presume to know more than we V 
Free from that cowardly, bastard modesty, which trembles to own its com- 
petency before the scorn of malevolence, I frankly answer, as a freeman, that 
from my sixth year I was dedicated to the sciences by a father rich enough 
to give three sons besides me a full chance of the highest scientific education 
that Europe affords. At a riper age I studied for five years, (not for half a 
year, 4 off and on,') in the celebrated academy of Jena, in Saxony, succes- 
sively, theology, law, and medicine. The last, as my predilection, I chose for 
the employment of my life. I graduated as doctor of medicine and surgery 
(as my diplomas show) in two universities on the continent, Jena axA Erfurt, 
profited afterward by visiting the universities of Erlang, Gottingen, Keel, 
enjoyed the lectures of Reich, Stark, and of the most eminent physician of 
the present age, Hufeland. Then I embraced the opportunity of the assis- 
tance of my mother's relations in France, to attend the surgical operations in 
the hotel de Dieu, in Paris, practiced afterward three years in Amsterdam, and 
embarked for America, where I have had for thirty years the amplest of 
opportunity to effect a reformation in the science of medicine, and of study- 
ing the power of nature on the sick-bed. Being acquainted with ancient and 
modern languages, I have read till twelve every night, every author of note, 
and made extracts ; and now I am nearly sixty years of age, and am the very 
man who offers his services to the sovereign people of America." 
SECTION HI. 
OPINION OF THOMAS JEFFERSON ON THE STATE OF MEDICINE. 
I have given the views of some physicians on the present practice of 
medicine. I will now subjoin those of Mr. Jefferson, who did not belong to 
the profession, but who, by the by, possessed an extraordinary mind, and who 
was fully competent to judge correctly upon this subject. 
"We know, from what we see and feel, that the animal body is in its organs 
and functions subject to derangement, inducing pain and tending to its destruc- 
tion. In this disordered state we observe nature providing for the re-esta- 
blishment of order, by exciting some salutary evacuation of the morbific 
matter, or by some other operation which escapes our imperfect senses and 
researches. She brings on a crisis by stools, vomiting, sweat, urine, expec- 
toration, &c., which for the most part ends in the restoration of healthy action. 
Experience has taught us also that there are certain substances by which, 
applied to the living body, internally or externally, we can at will produce 
the same evacuations, and thus do in a short time what nature would do but 
slowly, and do effectually what perhaps she would not have strength to ac- 
complish. Where, then, we have seen a disease characterized by specific 
signs or phenomena, and relieved by a certain natural evacuation or process, 
whenever that disease occurs under the same appearances, we may reason- 
ably count on producing a solution of it, by the use of such substances as we 
have found, by experience, produce the same evacuation or movenent. Thus, 
fulness of the stomach we can relieve by emetics ; diseases of the bowels by 
purgatives, &c., &c. Here, then, the judicious, the moral, the humane physi- 
sian should stop ***** But the adventurous physician goes on, and 
substitutes presumption for knowledge. From the scanty field of what is 
known, he launches into the boundless regions of what is unknown. He 172 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
establishes for his guide some fanciful theory of corpuscular attraction of 
chemical agency, of mechanical powers, of stimuli, of irritability accumulated 
or exhausted, of depletion by the lancet, and repletion by mercury or some 
other ingenious dream which lets him into all nature's secrets at short hand. 
On the principle which he thus assumes he forms his table of nosology, arrays 
his diseases into families, and extends his curative treatment, (says he,) by 
analogy, to all he has thus arbitrarily marshalled together. 
I have lived myself to see the disciples of Hoffman, Boerhaave, Staehl, 
Cullen, and Brown succeed one another like the shifting figures of the magic 
lantern, and their fancies, like the dresses of the annual doll-babies from 
Paris, becoming, from their novelty, the vogue of the day, and yielding 
to the next novelty their ephemeral favours. The patient, treated on the 
fashionable theory, sometimes gets well in spite of the medicine. The. 
medicine, therefore, restored him, and the young doctor receives new 
courage to proceed in his bold experiments on the lives of his fellow- 
creatures. 
I believe we may safely affirm that the inexperienced and presumptuous 
band of medical tyros let loose upon the world, destroys more human life in 
one year, than all the Robbinhoods, Cartouches, and Macheaths do in a 
century. 
It is in this part of medicine I wish to see a reform; an abandonment of 
hypothesis for sober facts ; the first degree of value set on clinical observa- 
tion and the lowest on visionary theories. I would wish the young practi- 
tioner especially, to have deeply impressed on his mind the real limits of 
his art. ***** 
The only sure foundations of medicine are an intimate knowledge of the 
human body, and observation of the effects of medicinal substances on that. 
The anatomical and clinical schools, therefore, are those in which the young 
physician should be formed. If he enters, with innocence, that of the theory 
of medicine, it is scarcely possible that he should come out untainted with 
error. His mind must be strong, indeed, if, rising above juvenile credulity, 
he can maintain a wise infidelity against the authority of his instructors and 
the bewitching delusion of their theories. ********* I hope and 
believe that it is from this side of the Atlantic that Europe, which has 
taught us so many other things, will be led into sound principles in this 
branch of science, the most important of all others, being that to which we 
commit the care of health and life."-Letter to Dr.Wister, vol. iv., p. 91. 
SECTION IV. 
From the Botanic Medical Reformer. 
MEDICAL REFORMER, NO. I. BY DR. A. R. PORTER 
The present age is truly denominated an age of reform. The people are 
an investigating people. Everything that appears contrary to Scripture, 
reason, and true philosophy, is brought up before the ordeal of public exami- 
nation, to be censured or approved. 
Questions important and unimportant, interesting and uninteresting, are 
continually coming up in the minds of the people. Conventions are as- 
sembled ; discussions are going on; men collect themselves together in OF MEDICINE, AND INDICATIONS OF CURE. 
173 
groups at the corners of our streets ; they meet promiscuously in the news- 
rooms, in the stores, in private domicils, in public halls, in highways, in by- 
ways, to discuss the prominent topics of the day, and consult upon the most 
efficient means to promote the happiness and prosperity of mankind. In this 
way do a portion of the human race occupy a part of their vacant time. 
And when industriously pursuing their mechanical or professional occupa- 
tion, each one is thinking for himself, originating new ideas, concocting plans, 
devising schemes, and arranging and maturing his thoughts, to communicate 
to his confidential friend, or to develope them in some more extensive cir- 
cle, to be subjected to a more rigid and scrutinizing examination. 
While inquiry is thus going on, and society undergoing a severe investi- 
gation, a mass of wickedness is laid open to the view. Humbug and 
quackery, ignorance, superstition, ecclesiastical domination, church tyranny, 
professional insolence and empiricism, unbridled libertinism, and innumerable 
other evils exist to an alarming degree. 
No wonder, indeed, when people see the disclosures of iniquity that are 
daily taking place, no wonder, that they cry out, Reform ! Reform ! For 
one, I say, let it come: never was it more imperatively needed than at the 
present time. 
The world needs to go through a process of purification, in order to make 
it what it ought to be, and I shall always feel proud to lend a helping hand 
to carry on the noble enterprise. But as it is impossible to do everything 
at once, those which stand out most prominently deserve our immediate at- 
tention ; and upon such should be unhesitatingly directed the weapons of 
reform. 
Among these conspicuous evils there is one on which I have bestowed no 
little consideration. It is the present practice of medicine. Medical Re- 
form-that is the question. It is in the common, or regular system of prac- 
tice, so called, that I desire to see a thorough, radical reform If I could be 
fully persuaded in my own mind that the use of poisonous mineral ingre- 
dients, such as mercury, antimony, arsenic, and the like, are safe, sure, and 
efficacious remedies, and did not produce effects deleterious to the human 
constitution; if I were assured that there were no substitutes to be found 
in nature's extensive vegetable dispensary more admirably adapted to the 
nature of disease, and which could not cure without making the last state 
worse than the first, I certainly would abandon my idea of a reform, and 
cheerfully submit to the present system, and risk my life and health alto- 
gether upon its own merits. 
But while I am fully convinced, from observation and experience, that the 
regular practice of medicine is absolutely imperfect and highly dangerous, 
and while I am satisfied that the vegetable system of practice, which is now 
extending itself rapidly over the western portion of our country, is eminently 
superior to every other with which our land is superabundantly stocked, I 
cannot too anxiously desire a reform. It is on this subject that I wish the 
people to be aroused to proper and honourable action. 
It is time that this apathy and indifference, which has existed in the minds 
of the mass of the people on the subject of medicine, and which is totally at 
variance with its great importance, should be totally removed; for there 
is surely no art or science of so much consequence to their well-being as 
that which has for its object the preservation of health and the cure of 
disease. 
As there are but few tried, faithful, sterling advocates (comparatively 
speaking) of the vegetable system of practice in this country, it may seem 174 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
presumptuous to undertake so great an enterprise, while a powerful mono- 
poly, propped up by public opinion, hemmed in by constitutional barriers, 
combining genius and wit, learning and talent, are bending all their mighty 
energies against us. But I hope that an intelligent people will not be daunted 
by this; for the more the reformed practice becomes known, the more the 
people will appreciate and support it. 
The practice of medicine should be divested of all those technicalities 
which the most limited intellect cannot clearly understand. It should be 
based upon true, scientific, philosophical principles, employing such remedies 
as will act in perfect harmony with the laws of nature and animal life. 
The grand mystery to be understood in the practice of medicine is, not to 
create disease, but to remove it; and as disease is obstruction, such medi- 
cines as wifi assist nature in removing obstruction are the only remedial 
agents that can be safely and successfully employed. 
Where, then, the question is asked, are these remedial agents to be ob- 
tained ? Not in the submarine depths of the Alantic or the Pacific, nor in the 
impenetrable regions of the terraqueous globe ; but in the vegetable kingdom, 
in the little plant that shoots heavenward its spiral boughs, and spreads out 
its tinsel leaves to receive the drops of the silver dew or the warm beams 
of the noon-day sun. 
In the vegetable kingdom there may be found the elixir of health; there 
may be found the healing balm. Would to Heaven that the study of this 
extensive division of natural objects was more generally pursued than ap- 
preciated. Because, if it were, and the medicinal properties of plants better 
understood, disease might be more easily and successfully treated. 
In the vegetable kingdom an all-wise Being has deposited such plants 
and herbs as are congenial to our constitutions, and adapted to the cure of 
all curable diseases to which human nature is incident. We have no need, 
then, to resort to the application of poisonous mineral ingredients (such as 
mercury and the like) in the cure of disease, because they do not answer 
the purpose of their application: they clog up the system and poison the 
fountains of life, and make the patient a sickly, wretched being through the 
remainder of his days. I appeal to the lame, the sick, and the blind, to the 
toothless and deformed, to the dyspeptic, the hypochondriac, to the indi- 
vidual of scrofulous habits and ulcerated gums, to the rheumatic invalid and 
broken down constitution, who are the unhappy victims of mercurial em- 
piricism. It is a lamentable fact, that the most active and potent articles 
used by the faculty as medicines, and upon which they place their principal 
reliance, are destructive to life and injurious to health, the latter of which 
they are intended to promote. 
But many there are, I know, who will not believe it. Intelligent and 
well-meaning as they may be, their prejudices have become so deep-rooted 
in favour of the mineral practice, that it is almost impossible to turn their 
attention to the work of reform. 
There are many, too, who are capable of discriminating between a true 
and false system of medicine, who are almost prepared to go for a thorough 
reform, but cannot abandon altogether the use of minerals, because they think 
that calomel, blue pill, or some other preparation of mercury is indispensably 
necessary to the cure of diseased liver. But however strongly inclined they 
may be to this opinion, it is, nevertheless, erroneous. Calomel may exert a 
potent, powerful action on the liver, and give it mere temporary relief. By 
its acrid and irritating nature, it arouses it to action, the secretion of bile is 
increased, the bowels are moved, and the patient feels relieved; but this OF MEDICINE, AND INDICATIONS OF CURE. 
175 
relief is of short duration ; in a few weeks he finds his liver has become 
torpid, and even more inactive than before, and he again has recourse to 
another dose, with the same results as before : and thus he continues to take 
dose after dose, until the healthy tone of his stomach and bowels is irre- 
coverably gone, and by and by falls a victim to the combined agency of his 
original disease and the deadly remedy which he took for the purpose of 
removing it. In confirmation of what I have said, I will give the opinion 
of Dr. Barnwell: he says-"Mercury will produce the liver complaint." 
Dr. Hamilton and Dr. Fies state, " that it will, in some constitutions, lie inert 
for years, and then burst forth with tremendous violence; and that it de- 
stroys the digestive organs." Dr. Hamilton also declares, " that every phy- 
sician of competent knowledge does know these deadly effects of mercury 
on the constitution." 
I am acquainted with an individual, who has been afflicted with liver 
complaint for a number of years, who has been in the habit of taking a dose 
of calomel every time he felt the alarming symptoms, but without any posi- 
tive cure. And I know another individual, who has had the same disease 
a much longer time than the former, and equally as formidable, who has en- 
tirely cured himself by the use of vegetable medicines. 
Of the superiority of vegetable over mineral medicines, I can fully testify 
from my own individual experience and observation, having witnessed 
some of the most astonishing cures performed by their application. Of the 
effects of the latter I speak with pain, living to see a near friend dragging 
out a miserable life, produced by the administration of poisonous mineral 
drugs. 
In view of the evils of the present system of medicine, a reformation is 
loudly called for; something more safe and effectual must be had; and I 
trust that it will go on, until the glaring inconsistencies in the healing art are 
ferreted out and held up to the indignation of an injured community, and 
the vegetable system of practice substituted to meet the emergencies of the 
people. 
MEDICAL REFORM, NO. II. 
Danvers, Mass., May 17, 1841. 
To the Editor :-Dear Sir: I am personally unacquainted with you. I 
know you only by name, as editor of a publication advocating the botanic 
system of medical practice. 
The great interest I feel in this system is a sufficient apology, if any is 
needed, for addressing you in this manner. I am a poor, humble, unlettered 
mechanic ; by honest, industrious labour I derive a comfortable subsistence, 
which is all I ask, and all I expect while I am an inhabitant of this earth. 
Yet I have thoughts, and feelings, and sympathies as well as others of my 
own species; and why may not I (humble and illiterate as I am) give vent 
to these thoughts as well as the man of letters, even though they be not con- 
veyed in such classical and euphonious language ? 
Young as I am, I have seen something of the world, and learned by ex- 
perience and observation the frailty and imperfection of human nature. 
I have seen that selfishness is the governing principle of human nature ; 
and that the generality of mankind are more desirous for their own personal 
aggrandizement, than for the happiness of those around them. In a word, a 
monopolizing, aristocratic, selfish spirit pervades the mass of the people. 
There is a lack of congeniality of good feeling toward each other; a manifest 176 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
disposition to lampoon and oppose everything that may not suit the taste or 
please the fancy. 
This is peculiarly true in reference to the reform which is now going on 
in the practice of medicine. The botanic or vegetable system of medical 
practice, being an improvement on the old or calomel system as I call it, has 
aroused the opposition of the faculty and the advocates of their system, and 
caused many falsehoods and bitter observations to be uttered against it. 
Such conduct is disingenuous ; it ought not to be. If the system is founded 
on error, if it is impracticable, let its opponents show up its errors by fair 
and manly argument-by clear and logical reasoning-by an appeal to facts ; 
then will the people have tangible evidence of its truth or falsity. To im- 
press upon it the indentations of infamy, humbug, and empiricism is not 
argument; the very attempt demonstrates to the intelligent mind the utter 
incapability of overthrowing the object of their malediction. Such a course 
only strengthens the system, and makes it the more impregnable. Every 
slanderous blow which they strike rebounds to the destruction of their own 
darling system. I think my alloeopathic friends are aware of this, for they 
show less of that disposition to slander and brow-beat, and their attacks are 
less invidious than formerly. 
I think they must see that the botanic practice, as conducted by reformers, 
is placed upon the immutable basis of truth, and cannot be overthrown by 
base assertions or fierce denunciations originating from a spirit of enmity. 
So far as I have investigated the subject, it meets my approval; and 1 
hesitate not to say it is the only system of practice that is calculated to meet 
the wants of the great family of man. It is philosophic, it is rational; and, 
when practically exemplified, is safe, sure, and efficacious. 
It is now two years since I have been impressed with the truth of this 
remark ; and I feel more than ever attached to the botanic or vegetable sys- 
tem, since, within the space of time above-mentioned, I have known cures 
performed under this practice that completely nonplussed the skill of the 
alloeopathic practitioner. 
By the vegetable system I mean that which is practised by the reformed 
medical society of the United States. I have nothing to do with the Thom- 
sonian steam system. It has done good and it has done evil, but it is too 
much on the steam power for my liking. The foundation is botanic; it has 
some valuable remedies, and, for aught I know, they are all innocent; but the 
system is limited ; there is a manifest want of judgment, skill, and experience 
in a majority of those who are its practitioners. 
This was a great oversight in the founder of the system, and one promi- 
nent reason why it has fallen into such general disrepute. Doubtless you 
see this as well as myself. How near your views coincide with mine in 
reference to the two systems I cannot say, never having seen the prospectus 
of your medical journal; nor have I read but one or two numbers of it since 
its first appearance, and those were loaned me by my friend Dr. Quimby, 
who goes altogether on the vegetable or reformed system. In those numbers, 
which I examined very closely, I was at a loss to know whether you advo- 
cate the Thomsonian in its length and breath, vomiting and steaming fcr 
anything and everything, kill or cure; or whether you go for the more 
rational and scientific doctrines taught in Beach's reformed practice. 
However, advocate which you may, they contained some excellent arti- 
cles, from which I received much valuable information. I should really like 
to subscribe for your publication if 1 could be assured it advocates the doc- 
trines of the before-mentioned school; and if so, I think, by a little exertion, OF MEDICINE. AND INDICATIONS OF CURE. 
177 
a number of subscribers might be obtained in this vicinity, as there is great 
need of such a work here. 
I am, very respectfully, your obedient servant, 
Alfred R. Porter 
LETTER FROM DR. GREER, OF GLASGOW, TO THE PUBLIC 
In entering upon the important task of criticising the works of the medical 
profession, my motive is threefold : First, so many of the inhabitants of the 
world as are unacquainted with me, either personally or by character, will 
expect this duty at my hand. Second, my conscience, which I cannot with 
any degree of propriety resist, is night and day exciting me forward, by 
every allurement of happiness, to accompany the embarking in this glorious 
cause, and by every degree of unhappiness, if I faintheartedly shrink back 
into apathy, after being so long as seventeen years using every means in my 
power, both in and out of the profession, to stir up some more able hand to 
undertake this of all reforms the most necessary ; and, Third, my God, whom 
I incline to serve with all my heart, soul, strength, and mind, says, (Exodus 
xx.,) " Thou shalt not kill." Hence, if I suffer any false system to oppress 
the human family, and countenance the same, and do not lift up my voice 
against it, He will rank me as a murderer, and punish me accordingly. See 
the 27th and 28th chapters of Deuteronomy: read also the 25th chapter of 
Matthew, where every one of us are called upon not to hide our talents, be 
they ever so few or weak; and hence I contend that, if I possess only one 
talent as a qualification to eradicate only one error of medical practice, or 
establish only one truth of medical theory, and not make a proper use of that 
talent, I am as culpable as if I had five talents rolled in a napkin. Many 
are the arguments in favour of my attempting to reform the medical profes- 
sion ; one of which is, that no professional man, so far as I am acquainted, is 
engaged in this cause. It is true there is scarcely a popular character be- 
longing to the profession but can tell us he is anxious to see his profession 
reformed; and I must admit that a great many well-meaning zealots are re- 
forming it in their own way, with all the talents they possess ; but this reform 
is analogous to that of plastering and repairing an old zigzag reclining edifice 
-every cast and sketch of the trowel and brush to beautify, and every prop 
to uphold it, only tends to aggravate the danger of the fabric. Review, my 
rational readers, the medical journals, and contrast them with your own com- 
mon sense, and you will perceive not one sentence of radical reform in any 
of them, otherwise than that of their technical garnish and literature ; and 
in this itself they are, even in this advanced stage of intellect's march, 
lamentably deficient. Were the errors of the profession confined to its letter, 
although the letter itself killeth some, yet I would not urge so incessantly 
for its radical reform. But when its principles are wrong; when we per- 
ceive it is built on the sand, it is high time for us to fly from the danger. 
Some systematic short-sighted creatures may ask, how do I know that the 
medical profession is built on the sand ? Willing to become all things to all 
inquirers after truth, I will digress a little from the intended propositions, 
and inform the inquirer thus : Men, women, and children are prematurely 
launched into eternity, in ratio as the medical profession is cultivated in any 
land 178 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
COMPARISON. 
In a letter from A. C. Becker, dated Hamburgh, Germany, 1841, to Dr 
Vanderburgh, of this city, it is stated that Dr. Muhlenbein, in Brunswick, last 
year celebrated the fiftieth anniversary of his medical practice. For thirty- 
three years he practised upon the old mineral and bleeding system, and be- 
came very distinguished in his profession, acquiring not only a very hand- 
some fortune, but honours too, and was raised by his sovereign to the dignity 
of body physician, was knighted, and appointed medical counsellor. In 1822, 
having attained this eminence, and, to use his own words, having convinced 
himself of the fallacy and insufficiency of the old system, soon discovered, 
upon diligent study and experiments upon his patients, the superiority of the 
new system. Since then he has practised for seventeen years with brilliant 
success. According to his own statement, among his patients under the old 
practice the mortality was six per cent., and under the improved treatment 
only one per cent. 
SECTION V. 
REMARKS OF EMINENT PHYSICIANS AND OTHERS, ON THE PRACTICE 
OF MEDICINE. 
What names, we would ask, continue to survive the oblivious tendency 
of time ? The detailers and chroniclers of facts, not opinions ; the latter 
have sunk into the abyss of forgetfulness, and truth alone swims over the 
extant of ages.-Cowan. 
An undue attachment to great names : Hippocrates, Galen, Araeteus among 
the ancients, Boerhaave, Cullen, Brown, Broussais among the moderns, 
have all in their turns established a despotism in medicine, by the popularity 
of their names, which has imposed a restraint upon free inquiry, and thereby 
checked the progress of medicine, particularly in the ages and countries in 
which they have lived. Also an undue attachment to unsuccessful but 
fashionable modes of practice.-Rush. 
Conferring exclusive privileges upon bodies of physicians, and forbidding 
men of equal talents and knowledge, under severe penalties, from practising 
medicine within certain districts of cities and countries. Such institutions, 
however, sanctioned by ancient charters and names, are the bastiles of our 
science.-ib. 
Also the refusal in universities to tolerate any opinions in the private or 
public exercise of candidates for degrees in medicine which are not taught 
aor believed by their professors, thus restraining a spirit of inquiry in that 
period of life which is most distinguished for ardour and invention in 
our science. It was from a view of the prevalence of this conduct that 
Dr. Adam Smith has called universities the dull repositories of exploded 
opinions.-ib. 
Boerhaave calls the physician a fortunate man, if positively he does not 
injure his patient. 
Reil, in speaking of modern practice, says: " I have long enough been tossed 
on the sea of unfounded hypothesis, to feel convinced that absolute darkness 
prevails in the medical practice, which cannot be dispelled by assertions, 
but only by experiments and experience." OF MEDICINE, AND INDICATIONS OF CURE. 
179 
There is among medical men, even as to the treatment of the simplest 
malady, a constant controversy of opinion, which has no other tendency but 
to confuse the mind. 
The ingenious Professor Hartmann, from Vienna, says, on the theory of 
diseases or general pathology : 
" Through all these gradations of developement, the theory of diseases and 
medicines is now arrived at its present position, whence, from the highest 
point of theoretical speculation, physicians are now falling into the deepest 
abyss of- empiricy, although men are not wanting who, without regard to 
their private interest, generously publish their observations and the result of 
their experience for the benefit of pathology, seeking not only to give form, 
but also substance and organic connexion to the treatment by the bed of the 
sick. But taking the general run of practitioners, we can convince ourselves 
that the most of them exercise nothing but the rudest empiricy under the 
cloak of science." 
" When it is farther considered," says Sir Gilbert Blane, " what a mass of 
credulity and error has actually accumulated in medicine, from the presump- 
tuous attempt to grasp at such objects, and to make hasty and dangerous 
application of them to practice-when we cast our eyes upon our shelves, 
loaded with volumes, few of them containing any genuine profitable knowledge, 
the greater part of them composed chiefly either nugatory, erroneous, inap- 
plicable, or mischievous, in which the dear bought grain is to be sought in 
the bushel of chaff-may it not be questioned whether such researches have 
not tended more to retard and corrupt, than to advance and improve practi- 
cal medicine ?" 
" Girtanner," says our materia medica, " is a mere collection of fallacious 
observations; there are in it some correct ones, founded upon experience ; but 
who would waste time in seeking for a few particles of gold in that immense 
rubbish, collected so many centuries since ?" 
Hoffman's Opinion.-Few are the remedies whose virtues and opera- 
tions are certain ; many are those which are doubtful, suspicious, fallacious, 
false. 
" In mixing together," says Dr. Luther, " so many different kinds of drugs, 
physicians consider the stomach a general post-office, w'here all the drugs 
arrive at once, and are thence despatched each to its proper destination-one 
to the nerves, another to the circulation, another to the lungs, another to 
the brain, &c." 
"Medical prescriptions," says Dr. Buchan, "are written in Latin; this 
practice is not only ridiculous, but is likewise dangerous. However capable 
physicians may be of writing Latin, I am certain apothecaries are not in 
condition to read it, and that dangerous mistakes in consequence of this may 
often happen. But suppose the apothecary ever so capable of reading the 
physician's prescriptions, he is generally otherwise employed, and the busi- 
ness of making up prescriptions is left entirely to the apprentice. By this 
means the greatest man in the kingdom, even when he employs a first-rate 
physician, in reality trusts his life into the hands of an idle boy, who has not 
only the chance of being very ignorant, but likewise giddy and careless. 
Sir Gilbert Blanc.-In many cases patients get well in spite of the means 
employed; and sometimes, when the practitioner fancies he has made a great 
cure, we may fairly assume the patient to have had a happy escape. 
" I know very well," says an old practitioner, " that perhaps more than 
seven-tenths of mankind die, not from disease, but from the unsuitableness 
and excess of medicine." 180 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
Several circumstances, indeed, connected with the science of medicine 
have retarded its improvement, and given a plausibility to this charge of 
uncertainty; and none more than the different theories which have been 
advanced in explanation of the phenomena of the animal system in health 
and disease. 
Scraps from Krueger Hansen, a Physician of the Old School.-When the 
regular functions of the intestinal canal are disturbed by physicians with their 
use of the lancet, leeches, calomel, salts, &c., these gentlemen assume the 
character of masters in the art of healing. They are not unlike the monarch 
who, while he silences the plaintive voices of his subjects with grape shot, 
is, in fact, the destroying angel of mankind. In consequence of this antiphlo- 
gistic treatment, the activity in the secretory and assimilative functions is 
suddenly checked, which either causes prolongation of the disease, a pro- 
tracted convalescence, or the conversion of the inflammatory into a nervous 
fever- Instead of a resolution of the inflammation in the affected organ, a 
suppuration, or even mortification, is produced. If the fever is accompanied 
by eruptions of the skin, a repulsion is to be feared, attended by other and 
more dangerous disorders. It is the victims of such treatment which crowd 
our mineral springs or watering-places. Hence, too, the lamentations about 
the increasing decrepitude of the human race in highly civilized life. If these 
consequences do not follow in every instance from such a despotical antiphlo- 
gistic treatment, it is no argument against my assertion. Many individuals 
are blessed from their birth with such a powerful constitution, that they are 
able to resist the worst kind of medical treatment. But let us remember, 
that it is not every soldier who is struck in battle by a bullet that is killed. 
The following apologue, says D'Alembert, made by a physician, a man 
of wit and of philosophy, represents very well the state of that science : 
" Nature," says he, " is fighting with disease. A blind man armed with a 
club, that is, the physician, comes to settle the difference. He first tries to 
make peace. When he cannot accomplish this, he lifts his club and strikes 
at random. If he strikes the disease, he kills it-if he strikes nature, he slays 
her." An eminent physician, continues the same writer, renouncing a prac- 
tice which he had exercised for thirty years, said, " I am wearied of guessing. " 
Dr. L. M. Whiting, of Massachusetts, declares that " Cullen knew nothing, 
or next to nothing, about the organs in their physiological condition; much 
less did he know of their condition in a pathological state. From him, there- 
fore, we get no more light on the grand question, what constitutes disease ? 
than we do from old Hippocrates, Galen, Boerhaave, Brown, Darwin, and all, 
indeed, who either preceded or followed him, until within the last half cen- 
tury, and that amounts to just nothing at all that is satisfactory to the inquir- 
ing mind." He farther affirms both the materia medica and therapeutics to 
be a perfect chaos. 
Thatcher declares, " Far, indeed, beneath the standard of perfection, it 
(medical science) is fraught with deficiencies, and altogether inadequate to 
our desires." 
Macintosh says, in reference to inflammation, " It must be confessed that 
there is much undiscovered. Physiologists have to settle several disputed 
points in the doctrine of physiology, and anatomists have to discover a great 
deal regarding the anatomy and physiology of the nervous system, before 
pathology can be expected to advance in any remarkable degree." 
He also sarcastically inquires, u Who knows anything of the cause of 
disease ?" 
" The science of medicine," observes Dr. Good, " has been cultivated for OF MEDICINE, AND INDICATIONS OF CURE. 
181 
more than two thousand years. The most devoted industry and the greatest 
talents have been exercised upon this subject; yet upon no subject has the 
wild spirit of imagination been more widely displayed than in the history of 
medicine." He adds, " We know nothing of the cause of disease." 
" To harmonize the contrarieties of medical doctrines," exclaims Profes- 
sor Chapman, " is indeed a task as impracticable as to arrange the fleeting 
vapours around us, or to reconcile the fixed and repulsive antipathies of 
nature." 
" The whole art of medicine," says Sir Anthony Carlisle, " was founded 
in conjecture and improved by murder." 
" It is so impossible," observes Dr. Leutaud, " to separate the useful from 
the trivial, that it were better to reject it all." 
" I am sick," exclaims Professor Waterhouse, " of learned quackery." 
" There must," declares Professor Jackson, of Philadelphia, " be a medical 
reform." 
There is doubtless great and important truths yet to be discovered as it 
regards the nature and cause of human suffering; and when the facts are fully 
developed, the world will be astonished at the simplicity of the truth, and 
great men will wonder why such discoveries were not sooner made. 
Remark of Napoleon to his physician when pressed to take more mercury : 
" Your disgusting preparations are good for nothing. Medicine is a collec- 
tion of blind prescriptions, which destroy the poor, sometimes succeed with the 
rich, but whose whole results are more injurious than useful to humanity." 
I met one of our old school physicians to-day, Dr. J. Rodgers, and in the 
course of our conversation he remarked that he had practised sixteen years, 
but did not now give half as much medicine as formerly, and he had changed 
his treatment. Now, for inflammation of the lungs, &c., he resorted to 
simples. He administered the syrup of Ipecacuanha, and bathed the chest 
with hartshorn, which proved very successful. He farther added, that he 
was for reform. 
A few minutes previous to this I met another physician of the old school, 
Dr. Robson, a man of good judgment and much experience, and quite popular. 
He informed me that he disapproved of active medicines. He farther stated 
that he was called a few days since to a considerable distance in the country 
to see a patient, and her physicians were dosing her with various kinds of 
drugs, such as arsenic, quinine, and other deleterious agents. He ordered 
the whole to be discontinued. Another distinguished physician, a friend of 
his, he stated, was of the same opinion about severe treatment. 
Some time ago, in an interview with another practising physician in this 
city, Dr. Nichols, he remarked to me thus : " Your work has led me to 
change my practiceor similar language; " I do not," said he, " bleed 
half so much as I did, nor give half so much mercury." Thus, happily for 
the community, many physicians are adopting an improved system of medi- 
cine. They begin to believe with Dr. Jackson, of Philadelphia, who once 
stated, " except we adopt the reformed system, we shall lose our practice." 
CONCLUDING REMARKS. 
After preparing the preceding chapters on the principles laid down in this 
work, I observed to a physician, who, by the by, is a graduate of the old 182 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
school, and whose medical sentiments are in union with mine, that the prin- 
ciples here maintained are so plain and clear, and yet so simple, that every 
person must see their consistency and the truth of them. Does it not, I 
added, appear exceedingly plain and clear to you ? He replied in the affir- 
mative, as he had many times before, in expressing his opinions of them, 
often asserting that they would stand the minutest investigation ; that it was 
impossible to overthrow or subvert them ; yet at the same time there would 
be some physicians, who, in face of all the light and truth exhibited, would 
cavil, reject, and oppose. If they admit that these principles are correct, 
added he, they will bleed to equalize the circulation, and give mercury as in- 
dications of cure. In reply to this I observed, that for such there was no 
remedy. If there is not a principle of honesty, uprightness, and integrity in 
them, sufficient to receive the truth, it would be as useless to attempt to convince 
them as to cause vegetation to grow upon a rock, or to give medicine to a dead 
man to raise him to life. 
CHAPTER VI. 
" PRINCIPLES, NOT RECIPES." 
NATURE, CAUSES, AND TREATMENT OF DISEASES IN GENERAL. 
SECTION I. 
The pathology or doctrine of diseases in general has been a subject of 
controversy in all ages of the world. A thousand different causes have been 
assigned for disease, and as many different modes of cure. Nor is the ques- 
tion at this day settled, or any better understood. We shall not here take 
up time, nor discuss this subject to refute either the ancient or modern doc- 
trines maintained, any farther than we conceive they interfere with correct 
medical practice. 
Theory and speculation are harmless, while they do not lead to any perni- 
cious course of treatment. But when they lead to erroneous practice, it 
becomes necessary to refute them. 
We shall now inquire into the pathology or nature of disease, and lay down 
such principles as will lead to a judicious mode of treatment. In prosecuting 
this inquiry, no elaborate researches are deemed necessary. We have only 
to follow the simple path of truth, or reason and nature. 
The Excretions the only outlets of Disease.-The author of our existence 
has wisely established certain laws in the animal economy, to guard and 
protect it against the inroads of disease, and, when formed, to remove it. 
By these laws we understand an inherent power of the system to throw 
off any and every thing which is foreign or injurious, or such a process as 
brings about a healthy action on a diseased system. Let us now inquire in 
what manner this is performed. A little attention to the system shows us 
that there are certain outlets or excretions of the system, designed especially OF MEDICINE, AND INDICATIONS OF CURE. 
183 
to carry off everything retained which is incompatible with health. When 
these excretions perform their offices, a person may be said to be well; but 
when they cease to act, or act imperfectly, morbific matter is retained, and 
derangement follows, which causes irritation, and, if not removed by the se- 
cretions, inflammation and suppuration ensue. 
I shall here briefly treat upon these several excretions, show their offices, 
and the consequences arising from their obstruction. 
1. The skin.-The whole body is covered and lined with this membrane, 
through which there are innumerable pores or openings destined to carry off 
everything which is not salutary or compatible with a healthy state of the 
system. The fluid which thus passes off is distinguished into sensible and 
insensible perspiration. By looking at any part of the body in the summer 
season with a microscope, vapour or steam may be seen to rise like a foun- 
tain, which, coming in contact with the atmosphere, becomes condensed, 
and falls down in the form of drops, which we term sweat or perspiration. 
When this is kept up, and continued, the blood is pure, being separated in 
this manner from every impurity. But when this perspiration becomes 
checked by cold, the humours engendered in the system are retained, carried 
into the circulation, settle upon some organ that is most predisposed to 
disease, and become a source of irritation. Every day's observation con- 
vinces us that the moment the pores become in any degree closed, a uni- 
versal derangement succeeds : a sensation is felt in that part where such 
retained perspirable matter is thrown, as if a needle or some foreign sub- 
stance was piercing it. This may be said to be the proximate cause of irri- 
tation. 
It may be translated to the lungs, brain, kidneys, and other organs, causing 
inflammation and pain ; or it may remain in the blood, and cause fever. 
This fact is demonstrated by the phenomena of eruptive disease, small-pox, 
measles, &c. The infection or contagion is taken into the blood through 
the medium of the lungs, and as soon as it becomes sufficiently impregnated 
with the specific humour or virus, nature is aroused, and makes a powerful 
effort or struggle to expel it from the system. As soon as she accomplishes 
this object, the poison in these eruptive complaints is thrown copiously to 
the surface, and appears in the form of vesicles or eruptions ; and when they 
are thus expelled the fever immediately subsides, but will reappear, if, from 
debility or other causes, the poison or humours are absorbed. It is the case 
also in hectic fever, as almost every one knows. Matter from the lungs, 
or an ulcer, is taken into the circulation, and causes irritation and febrile 
excitement, and it is also proved from the termination of fever by sweat or 
perspiration, and also by fever sores. Those facts reduce it to a mathemati- 
cal precision, and render the subject so simple and plain, that it is really a 
matter of profound astonishment that any one the least acquainted with 
fever should be ignorant of its nature, cause, and cure, as well as that of 
other diseases. 
No doubt a preternatural accumulation of blood to such parts may serve 
as an auxiliary source of irritation; but, from various experiments, it may 
be shown that an accumulation of blood alone to any particular organ is 
not sufficient to account for all the phenomena of disease: but this subject 
will be farther illustrated in the next chapter. It is also well known that 
fevers, inflammation, and a variety of other complaints immediately follow a 
check of perspiration. 
Sanctorius proved that two-thirds of the fluids taken into the system are 
discharged by the skin, which shows the danger that must arise when such 184 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
fluids are retained. The whole external skin of the human body is in some 
measure a breathing organ, and is continually exhaling a vapour loaded with 
various excrementitfous matter, and held in an aeriform state by the heat 
which passes with it from the body. This evacuation, if checked, so over- 
taxes other excretory organs as to produce disease ; and, if retained on the 
surface and returned through the absorbents into the circulation, acts as a 
poison in the system. Frequent, if not daily, ablution or washing is neces- 
sary to preserve, in a healthy state, an organ of such great importance to 
the animal economy. 
The perspirable matter thus thrown to the surface contains carbonic acid 
gas, and may be the exciting cause of irritation, fever, or other diseases. 
Every person the least acquainted with physiology, must perceive that a 
departure from health must follow their obstruction. t 
2. The Bowels or Intestines--The bowels or intestines are also designed 
by nature to carry off much that is noxious or injurious to the system, and 
which does not serve the purposes of health or nutrition. Hence the dis- 
eases that arise from their long constipation. It cannot otherwise be but 
that such a great quantity of extraneous and feculent matter lodged in the 
body, and perhaps absorbed, must disorder it. The effluvia arising from the 
operation of physic is an evidence of the deleterious nature of retained 
alvine discharges. 
Nature, therefore, expels disease very frequently by the intestines. 
3. The Kidneys.-From the blood is secreted the urine through the me- 
dium of the kidneys, and which is another excretion designed to rid the 
system of something extraneous, foreign, or morbific. When this excretion 
is checked, or if it does not duly perform its office, certain noxious matters 
are retained and mixed with the circulating fluid, and prove another 
source of morbid derangement, such as dropsy, inflammation of the kidneys, 
and how many other complaints it is difficult to decide. That diseases are 
carried off by a copious discharge of urine, every physician knows. The 
effects which arise from the suppression of urine point out the purpose for 
which it is designed. 
4. The Stomach.-The stomach is another organ by which nature expels 
morbific agents. When violence has been done by overloading it, or when 
anything poisonous or dangerous has been received, or when any contami- 
nated fluid is poured into it, or when it becomes unhealthy, or diseased from 
any cause whatever, the peristaltic or regular motion of it is inverted, vomit- 
ing commences, and its contents are discharged, its tone restored, and health 
follows. Thus we see that this organ is designed to eliminate deleterious 
agents, and constitutes, therefore, an important excretion. 
5. The Lungs.-The lungs are another organ which serves the purpose of 
secreting from the blood offensive agents. They not only throw off carbonic 
acid gas, but likewise mucus; and when they become diseased, more espe- 
cially, they cast off pus, which, if retained, would cause suffocation. Hence 
we see in pulmonary diseases an effort of nature to effect a cure through the 
medium of this organ. 
Inasmuch, then, as health depends upon each and all of these performing 
their respective offices, it follows, that when any one becomes torpid, or 
ceases to perform its duties, that morbid excitement is the consequence : 
and this shows, in a most striking light, the proximate cause of most dis- 
eases at least; being nothing more or less than the retention in the system 
of morbific perspirable matter, producing irritation, morbid action, and a de- 
viation from health. These humours are no doubt taken into the system OF MEDICINE, AND INDICATIONS OF CURE. 
185 
through the medium of the air, food, or drink. The air breathed is returned 
loaded with watery vapour, which is calculated to amount to nearly twenty 
ounces a day, from which we learn the injurious effects arising from its 
obstruction. » 
Although the symptoms of complaints in general are very different, yet 
this is not owing to the exciting cause, (this being similar,) but to the pecu- 
liar structure, or the tissue of the organ which is the seat of the disease. 
I have just seen a French work which corroborates these views: the 
author says, " If this fluid (meaning perspirable matter) should be stopped 
or considerably lessened, and thereby be transferred to any inward part, it 
must occasion some dangerous complaint. In fact, this is one of the most 
frequent causes of disease." 
SECTION IL 
OF THE EFFORTS OF NATURE TO REMOVE DISEASES. 
Many authors, particularly the ancients, wrote much on the powers of 
nature to remove diseases. It was usually called vis mediatrix naturce, or a 
certain principle inherent in the system, to expel from it everything injuri- 
ous, foreign, or extraneous. Some have denied that such an effort exists, 
while others admit it, and term it reaction, which may be considered an ap- 
propriate term. That it does exist must be evident to every person the 
least acquainted with the animal economy. A writer in England, by the 
name of Townsend, in his Guide to Health, has the following remarks on 
this subject: 
" The efforts of nature to relieve herself have, in all ages, exercised the 
attention of speculative minds. It is not my intention here to introduce the 
Archceus of Van Helmont to the student; but I shall state some facts, which 
will give him an idea of those efforts which nature can exert for warding off 
approaching evil, for removing whatever disturbs her economy or functions, 
and for repairing any injury the system has received. 
When cantharides, spread on a plaster, are applied to the surface of the 
body, they first excite a genial warmth, with inflammation of the skin. A 
sense of burning follows, and nature, distressed, goes instantly to work, se- 
parates the cuticle to form a bag, interposes serum between the nerves and 
the offensive matter, then prepares another cuticle, that, when the former, 
with the adhering substance, shall fall off, the nervous papillse may be again 
provided with a covering. 
If a grain of sand falls into the eye, tears flow in great abundance to float 
it off, that it may not mechanically injure that delicate and most irritable organ. 
The same reasoning will apply to the operation of emetics and cathartics ; 
for not only is the peristaltic motion either greatly quickened or inverted, 
according to the urgency of the distress, but both the mucous glands and 
the exhalent arteries pour forth their fluids in abundance, to wash away the 
matter that chemically, or even mechanically, offends. 
When a thorn is lodged in some irritable part, the first suggestion of the 
mind is by the fingers, or by the assistance of the nails, to extract that thorn. 
But it is perhaps beyond our reach. 
The design of nature, in the consequent inflammation, is to produce sup- 
puration, and thereby to remove the thorn. 186 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
Should this effort be effectual, she next proceeds to the granulation of new 
flesh. The arteries and the veins, the lymphatics and the nerves, extend 
themselves, unite, and renew their communication, and, without the assis- 
tance of a surgeon, nature effects a cure. 
Supposing her efforts to float off the offending matter, whatever it may be, 
should be insufficient after the suppuration is complete, she th'en proceeds 
to surround it with a wall; a hard and insensible callus is produced ; or, in 
the language of surgery, a fistula is formed, and here, as 1 apprehend, her 
efforts cease. 
In case of pleuritic inflammation, nature pours forth coagulating lymph, 
and, without the physician's aid, forms a new membrane, supplied, like the 
renovating flesh already mentioned, with arteries, veins, lymphatics, nerves, 
and thereby preserves the substance of the lungs from injury. 
Van Swieten makes mention of cases in which calculi in the gall-bladder, 
being too large for the common duct, had, after producing inflammation, ad- 
hesion, and suppuration, found their way by fistulous ulcers to the external 
surface of the body, and thus effected their escape. Comment. § 950. 
Among the most astonishing efforts of nature to relieve herself are those 
exerted in some cases of extra uterine conception. For when a child has been 
lodged within the cavity of the abdomen, from which it cannot be extracted 
in the usual way, nature, by inflammation, usually forms adhesion, and in 
process of time an abscess, so as to eject the foetus either through the tegu- 
ments of the abdomen or by the rectum; and this frequently without con- 
siderable injury to the mother's health. 
Yet more astonishing are her resources in cases of necrosis. For sup- 
posing some portion of a bone (for example, of the tibia) to be deprived of 
animation ; this she envelopes with new bone, united at each extremity with 
the fibres of the living bone. Here it proves a stimulus, and calls forth 
renewed efforts of the vital principle. Inflammation is produced ; suppuration 
follows ; fistulous openings are formed in the new bones, and the dead portions, 
if not extracted by the surgeon, are dissolved by the pus and floated off. 
Thus nature in almost innumerable cases, even without assistance, is able 
to effect a cure. 
I have already mentioned, in cases of inflammation, the efforts to relieve 
herself by resolution and by suppuration ; but when the vital energy in a 
part has been totally exhausted, and sphacelus ensues, she has still one ex- 
pedient left, and this frequently effects a cure. Fresh inflammation is excited, 
and makes a separation between the living and the dead. The part deprived 
of animation is cast off by sloughing; a kindly suppuration follows; and 
granulation with a new cuticle completes the cure." 
We see from these remarks, as well as by what passes in the system daily, 
that the author of nature has wisely provided a principle which is calculated 
to remove disease. It is very observable in fevers. No sooner is noxious 
or morbid matter retained in the system, than there is an increased action of 
the heart and arteries to eliminate the exciting cause by the skin, or it may 
pass off by other outlets established for that purpose. With what propriety, 
then, can this provision of nature be denied, as it is bysome. A noted pro- 
fessor in Philadelphia or Baltimore, ridicules this power in the constitution ; 
he says to his class, "kick nature out of the doors." It was this man, or a 
brother professor, who exclaimed to his class, " give me mercury in one 
hand and the lancet in the other, and I am prepared to cope with disease in 
every shape and form." I have not time to stop here, and comment upon 
such palpable and dangerous doctrine. I have only to say, let the medical OF MEDICINE, AND INDICATIONS OF CURE. 
187 
historian record this sentiment maintained in the highest medical universities 
in America in the nineteenth century. I am pleased, however, to observe 
that all physicians do not coincide with such views. 
Disease, then, according to what has been stated, may be considered rather 
a healthy effort of nature than otherwise, or a restorative process to bring 
about a healthy action. 
Many physicians adopt an absurd and dangerous practice in the treatment 
of disease, such as mercury, bleeding, &c.; and sometimes, notwithstanding, 
Divine Providence will assist nature, and curt; in spite of their fool-hardiness 
and misapplied drugs. They then put on their peacock feathers and ascribe 
to themselves the success which results from her strong constitution. 
Jaun says, " As an idiot at the clock turns on and only ends in stopping 
the machine, so rude practitioners continue working at the machinery of 
the Creator, until, through their ignorance of the laws of nature, all farther 
operation is suddenly suspended. 
SECTION III. 
GENERAL INDICATIONS OF CURE. 
If, then, the cause of disease consists in the retention of morbific agents, 
and a recession of blood from the surface ; if it be caused by morbid excite- 
ment, as we have already shown ; if a deviation from a healthy standard is 
owing to the inactive state of the excretions, does not the plainest dictates 
of reason, common sense, and experience show the necessity of restoring 
those secretions ? Is there, or can there be, any other indication of cure, if 
they are the only channels which nature makes use of to restore the system 
to health ? and we confess we know no other. There is an effort of nature 
to restore these suppressed evacuations. The whole art of physic, then, 
consists in aiding her salutary efforts. Then what else is there to accomplish 
but to give such medicines as remove the obstruction and restore the secre- 
tions ? This is shown by the crisis or termination of diseases in general. 
They subside when perspiration takes place upon the skin, by diarrhoea, by 
vomiting or urine, or expectoration by the lungs. With what propriety, then, 
we ask, do physicians of the old school give mercury or bleed ? Do they 
fulfil any indications of nature ? Nature cures no disease by salivation, nor 
does she seldom or ever cure any by bleeding. Hence we may safely say 
that they are injurious. They produce disease, sui generis, of a specific 
character. Bleeding lessens or destroys the healthy effort established by 
nature, and thereby counteracts her intentions and exasperates the complaint. 
An objector to this doctrine may say that nature relieves herself occasionally 
by bleeding at the nose, hemorrhoidal vessels, &c., which must be admitted ; 
yet it is very rarely the case. But can it be proved that it is a healthy action, 
established for the same purpose as the common excretions ? We think it. 
is very evident that this is not the case. It appears rather to be the effect 
of disease, unequal circulation in the system ; and, therefore, instead of pro- 
Note.-I am aware that it has been alleged of late, by the author of a treatise entitled 
" Key to Medical Science," that there is no such principle as an effort of nature, or vital 
principle ; but I cannot find a particle of evidence in his work to support this opinion : indeed 
I consider it as absurd to deny it as it would be to deny the existence of any material sub- 
stance. It is self evident. It would be only a waste of time to attempt to refute a statement 
go directly at variance with the well-known laws of physiology, and even common sense. 188 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
moting this, as we should do if it was a natural excretion, we find it good 
practice to check it by promoting perspiration, and thereby equalizing the 
circulation. But to be a little more particular: is any disease terminated, 
or scarcely any, by a discharge of blood from the system ? Do they not 
almost invariably subside by vomiting, purging, sweating, and urine 3 and 
do not physicians form a favourable or unfavourable opinion of a disease by 
these symptoms ? Then if health is restored in this manner, is it philosophy, 
is it reason, is it common sense, is it acting in the capacity of a servant of 
nature, to institute a mode of treatment which she seldom or never takes to 
accomplish this object ? Besides, admitting that bleeding occasionally does 
occur and relieve, it will not prove the propriety of general blood-letting, as 
this cannot remove the cause, even if it should have the least beneficial effect. 
That haemorrhage sometimes occurs and affords relief, only shows the 
wise provision of nature in cases of ignorance on the part of the physician. 
When he is unable to administer such medicines as will remove a malady 
by the proper and ordinary passages of the system, certain bloodvessels 
become preternaturally full, and are either distended or ruptured, by which 
bleeding follows, succeeded sometimes by relief. Had proper means been 
used, no such effect would have taken place. This provision of nature is 
like that established to return the blood after amputation : certain lateral 
bloodvessels, called anastomosing branches, become distended, which returns 
the blood, and which never conveyed it thus before. A remarkable fact 
established especially for accident and ignorance. 
Bleeding sometimes takes place from the gums, nose, &c., in scurvy and 
in yellow fever; but shall we infer, then, that this is a healthy effort of 
nature ? It is well known to be the reverse. It is in the last stages that 
these characteristic symptoms prevail. Dr. Rush, I know, endeavoured to 
maintain that nature, in such cases, struggled to cast off the fever in this 
manner; and he, therefore, supposing it to be in accordance to her dictates, 
bled his patients nearly to death. Doctor Ross, a physician from the West 
Indies, extensively acquainted with the yellow fever, proved conclusively 
that haemorrhage or bleedings of this kind proceeded from debility and relaxa- 
tion of the bloodvessels : that it was no law of nature to cure the fever, but 
the effect of the disease. Then we ask, where is the authority, in imitation 
of nature, to cure diseases by blood-letting or salivation ? 
SECTION IV. 
THE PHYSICIAN CAN ONLY BE THE SERVANT OR HANDMAID OF NATURE IN 
THE CURE OF DISEASE. 
In reality we can cure nothing. We can only remove the offending cause, 
while nature performs a cure ; and, therefore, lay it down as a fundamental 
maxim in medicine, that all the physician can do is, to act as a servant or 
handmaid to nature. 
The author of the Medical Sketches thus remarks in relation to this sub- 
ject : " The ancients," says he, " not only observed the effects of that 
instinct by which brutes are directed to certain plants for relief when they 
are unwell, and then applied them to the complaints of men, but they also 
attended with diligence to the manner in which nature, when left entirely to 
herself, relieved or threw off diseases. They perceived that certain disor- OF MEDICINE, AND INDICATIONS OF CURE. 
189 
ders were carried off by spontaneous vomitings, others by looseness, and 
others by augmented perspiration; and having thus learned how diseases 
were cured by nature, whenever her powers seemed too weak and tardy, 
then, and then only, they ventured to assist her by art. 
Here it is worthy of observation, that although that sensation or instinct 
by which some animals are prompted to select particular vegetables for the 
removal of disorders, is not given in so strong or particular a degree to man ; 
yet nature often directs him also, though in a more general way, to the best 
method of relieving his complaints. In fevers the patient generally has a 
desire for cooling, light, acescent drinks, and dislikes those which are of a 
heavier and more heating nature: he covets juicy ripe fruits of various kinds, 
and nauseates animal food ; a free stream of air and a spacious cool bed- 
chamber are equally salutary and agreeable to him ; while confined air and 
a small heated room are pernicious and oppressive. In those instances, 
what the sick person shows an aversion to has a tendency to promote the 
disease ; and what he relishes has an effect in abating its violence. Other 
instances of the same kind might be enumerated : I will confine myself to 
one which I have frequently had occasion to observe. 
Toward the end of very bad putrid fevers, when the patient, exhausted 
by the violence and length of the disease, lay constantly on his back, had 
continual startings in the tendons of the wrists; his lips and teeth being 
covered with a black crust; his tongue trembling, and with difficulty held 
out; the pulse weak and quick ; in this deplorable condition, when the 
patient seemed insensible to everything else, he rejected, with every mark of 
aversion that was in his power, medicines of every kind; but upon his lips 
and tongue being moistened with wine, he sucked it in greedily, and was 
soon cured." 
This doctrine is farther exemplified by the writings of Dr. Hillary, who 
states in his secret of curing diseases, by adopting a better system, " that, by 
accurately observing all the motions, endeavours, and indications of nature 
to carry off and cure diseases-and by observing by what critical evacuations 
she does at last cast off the morbid matter which caused them, and so restores 
health-we may, by the same method of reasoning, know both the methods 
and the means we should use to assist nature in producing those salutary 
effects; if we avoid all hypothetical reasoning, and by thus observing, fol- 
lowing, and assisting nature, agreeably to her indications, our practice will 
always be more satisfactory and successful. 
The human body is so wisely and wonderfully formed, that whenever 
any noxious matter is got into it that would be injurious or destructive, we 
may observe that it always so irritates, stimulates, and offends nature, that 
she always exerts her power, or the vis vita:, to throw it off. And she acts 
with great regularity, order, and uniformity in her endeavours to expel the 
offending matter out of the body ; and, by carrying off the disease, restore 
health and preserve life. 
And thus, by observing, investigating, and truly knowing the diseases and 
their causes, and justly reasoning therefrom, we shall know when to assist 
nature according to her indications ; and in this is contained the chief part of 
medical knowledge, and the true scientific principles of the medical art. And 
when we shall thus have learned of nature, by observing her laws and indica- 
tions, we may reasonably hope to render the theory and practice of physic bene- 
ficial to mankind." 190 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
CHAPTER VII. 
ON THE AGENCY OF HEAT AND COLD IN THE PRODUCTION AND REMOVAL 
OF DISEASE. 
SECTION I. 
The influence that cold possesses in the production of disease must be 
evident to every person of the least discernment. Medical writers have im- 
puted the causes of diseases in general to the vicissitudes of the atmosphere ; 
but the immediate effect of cold upon the system seems to have been but 
little understood, or very imperfect views of it entertained. Nor has the 
agency of heat in the cure of disease been well understood or duly appre- 
ciated. It is somewhat remarkable that both heat and cold are the cause 
of most diseases, while they at the same time are (the former more particu- 
larly) so eminently subservient to their removal. It would appear that a 
certain temperature of the body is necessary to maintain a healthy state of 
the system. Persons, however, will bear a great degree of heat or cold, if 
applied to the system gradually; but, on the contrary, if suddenly applied, 
the most serious effects follow. Great heat, however, can be much better 
borne than a great degree of cold, and it is on this account that cold plays 
such an important part in the production of morbid excitement. Some parts 
of the system are much more susceptible of cold than others. The minute 
bloodvessels of the surface, coming in contact with the atmosphere, are more 
susceptible of its impression than the internal organs. Cold, long and sud- 
denly applied, brings on a torpid or inactive state of the capillary vessels, by 
which the pores are closed, morbific matter retained, and a deviation from 
health follows. The blood becomes obstructed in these vessels of the skin, 
consequently it is withdrawn from the general circulation, and the balance 
of it is lost, impaired, or rendered unequal. The consequence of all this is, 
that the blood recedes, or is driven back from the surface to some of the 
internal organs of the system ; the heart and arteries become distended with 
an unusual quantity ; increased action or more powerful contractions follow, 
to return the blood back to the surface, and to overcome the constriction of 
the capillary vessels, which greatly increases the circulation. 
When we reflect upon the vast quantity of blood contained in the small 
vessels of the skin, we must be sensible of the effect it must produce upon 
the system when so much is stagnated or obstructed, or is driven back and 
forced upon the vital organs. The great bloodvessels become preternatu- 
rally full, the various functions impaired, and inflammation and congestion 
follow. Whatever organ or part of the system is the most predisposed to 
disease, will feel the effect of this change. It may be translated to the brain, 
and create inflammation of the lungs ; or it may affect the liver, stomach, 
or bowels. The irritation occasioned thereby proceeds from two causes. 
First; an effusion of blood to the part. Second ; morbific matter retained 
in the circulation. 
The intimate connexion between the skin, the stomach, the heart and 
arteries, intestines, and other organs, readily accounts for the effect of cold OF MEDICINE, AND INDICATIONS OF CURE. 
191 
suddenly or long applied to the surface. Sometimes even very slight impres- 
sions, thus applied, cause the great quantities of blood in the minute vessels 
of the skin to recede, and to be thrown internally upon some portion of the 
organ: reaction then takes place. The heart propels the blood with redoubled 
energy back again to the extremities or the surface, by which the organ 
affected is relieved of its oppression. It appears, therefore, evident that 
there is a flux and reflux of blood constantly passing from the heart or centre 
to the surface of the body. Thus there is a regular balance or equilibrium 
maintained in the circulation, which constitutes, as it were, a standard of 
health. 
When this balance of circulation is lost in the system ; when the blood 
becomes unequal, or is driven from one part of the body to another, from the 
influence of cold or any other cause, morbid excitement or a deviation from 
healthy action is the consequence. I have observed this fact for many years 
in the course of my practice. It has been almost invariably the case, if one 
part of the system has suffered from disease, particularly inflammation, the 
opposite part of the system has been unusually cold. 
" Many youths," says Emet, " particularly females and those whose occu- 
pations are sedentary, pass days, and weeks, and months, without even 
experiencing the pleasing glow and warmth of a healthy skin, and are habitu- 
ally complaining of chillness of the surface, cold feet, and other symptoms 
of deficient cutaneous circulation. Their suffering unfortunately does not 
stop here, for the unequal distribution of blood oppresses the internal organs, 
and too often, by insensible degrees, lays the foundation of tubercles in 
the lungs, and other maladies, which showr themselves only when arrived 
at an incurable stage." 
When there is inflammation or pain of the head or upper portion of the 
body, there is a coldness of the extremities. I therefore always first, in the 
treatment of such complaints, direct my attention to the part thus primarily 
affected. My great object is to recall or restore the circulation as soon as 
possible, by bathing the feet and giving such medicines as promote a 
determination to the surface ; and this practice is always attended with the 
happiest effect. As soon as the cutaneous circulation takes place the disease 
is relieved. It is very clear that the blood thus recedes from the surface in 
fevers, and in a great variety of other complaints. After the body has been 
exposed to cold suddenly or long applied, we see that the circulation ceases 
or is lessened in the capillary vessels, by the chills, sense of coldness, pale- 
ness of the skin, with a husky or dry state of it; and the great heat and 
commotion that rages throughout the system arises, no doubt, from an 
engorgement in the heart and arteries, with the irritation from the morbific 
matter retained in the circulation. It requires, therefore, but a small share 
of common sense or discernment to learn the indications of cure ; which are, 
not to abstract any portion of blood from the system, which decreases the 
power of overcoming the disease in proportion to the quantity taken by in- 
ducing debility, but to recall the blood to the surface by the application of heat 
or sudorific medicines, or, in other words, to equalize the circulation. 
Cold, it will be seen, therefore, causes a torpor and inactivity of the exha- 
lents, and the system generally ; while heat has an effect diametrically 
opposite, by stimulating these vessels to perform their proper functions ; the 
effect of which is the restoration of warmth, vitality, and circulation. These 
phenomena are exemplified in the repulsion of eruptive diseases; upon the 
application of cold the eruptions disappear, and are translated to some other 
organ. In gout it will attack the brain, stomach, or intestines The ery- 192 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
sipelas or St. Anthony's fire is sometimes characterized by the same symp- 
toms ; also the measles, small-pox, &c. The remedy, therefore, must be 
obvious. Bleeding, which is resorted to by many, will take or endanger the 
life of the patient, by averting the power of reaction which is so essential 
to recovery, while the application of heat to equalize the circulation will 
prove a sovereign remedy. Bathing the feet and surface with warm appli- 
cations and medicines to promote perspiration, will return the eruptions to the 
surface, or will carry them off through their proper channels or emunctories. 
By this means the morbid excitement preying upon the vascular system 
or internal organs will be relieved. 
We may, therefore, see, from the effect of heat and cold upon the system, 
how greatly they are concerned in the production of disease and the resto- 
ration of health. A due regulation of both is of vital importance to the 
animal economy. If either is suffered to prevail to too great a degree, life 
becomes extinct. 
It has been shown that heat and cold, especially the latter, is a fruitful 
source of disease ; that they are (the latter more especially) the most common 
cause of all complaints ; and admitting these premises, the importance of 
heat for their removal must be duly appreciated in a medical point of view, 
as well as the importance of cold where heat predominates. 
Heat, properly applied to the system, will bring about symptoms the reverse 
of that occasioned by the exciting cause of the complaint. When the blood 
recedes from the surface it settles upon some organ ; and, by its accumulation, 
together with the irritation arising from retained perspirable matter, the 
substitution and application of heat and other stimulating medicines will 
cause a revulsion, whereby the congestion, irritation, &c., will be removed 
by unloading these internal organs, and causing the blood to recirculate 
in the vessels of the surface. 
When disease proceeds from too much heat of the body, or when fever 
arises to expel from the system morbific matter, and to equalize the circula- 
tion, it often becomes necessary to moderate it by lessening arterial excite- 
ment. In such cases tepid or cold water will have a salutary effect, by 
abstracting a portion of heat from the body by the evaporation that follows, 
together with the stimulus given to the exhalent vessels of the surface. 
SECTION II. 
DISEASES IN WHICH HEAT AND COLD ARE BENEFICIAL. 
It may not be improper to mention some forms of disease in which heat 
and cold will prove eminently beneficial. 
1. Febrile Diseases--Fevers, as we have shown elsewhere, proceed from 
a check of perspiration, cold commonly proving the exciting cause. It must 
be evident, therefore, that the first duty of the practitioner is to remove the 
injury which it has caused to the system. The skin has become torpid, its 
pores closed, by which the vascular system particularly is disordered as a 
consequence. Heat must, therefore, be applied both internally and exter- 
nally, to remove this morbid state of the skin, by restoring perspiration. 
The blood is sometimes driven so suddenly and so forcibly from the sur- 
face and extremities to the internal organs, that the powers of nature arc 
suspended, (occasionally cut off,) and a state of asphyxia or swooning fol- OF MEDICINE, AND INDICATIONS OF CURE. 
lows It is on this account that not even a particle of blood can be drawn 
in such cases. The office of the heart and arteries, which is to send or pro- 
pel the blood to every part of the body, partially or wholly ceases, on account 
of the prostrating and overwhelming influence of intense cold giving them 
such a shock that reaction cannot take place, or takes place very feebly. 
This was remarkably exemplified in the cold plague which raged in the 
southern and western states some years ago. Persons W'ere seized with it 
in the manner just mentioned ; and Dr. Anthony Hunn, of Kentucky, states 
that every other means proved useless but the hot bath, which recalled the 
blood from the centre to the surface. As soon as the heart and arteries be- 
came unloaded, they immediately began to play and perform their offices, 
when reaction and heat, consequently relief, immediately took place. 
The following case, related by Dr. Hunn, is very applicable : " Mr. N. 
Rochester, Esq., came from what is termed the wilderness, for medicines 
for his father-in-law, Mr. Johnston, who was dangerously ill with the ' cold 
plague.' He had ridden day and night, and swam several streams in rainy 
and cold weather. When he was getting the medicines I predicted that he 
would undoubtedly also be taken with it, if he returned: I advised him to 
get a negro from his brother, in Danville, and send him on full speed to his 
father-in-law, while he remained for a day or two to recruit and refresh him- 
self. He pleaded the absolute necessity of speedily returning personally 
He started, but on the short road from town to his brother's mansion he 
was suddenly taken with a terrible shaking and inexpressible torments, 
which drew him from his horse. He was carried to his brother's mansion, 
and I was immediately sent for. In a state of suffocation, with a clay cold 
feel of hands and face, and red suffused eyes, he exclaimed, that ' his insides 
were tearing to pieces,' with a constant raging desire to urinate, but he could 
not void a drop. The hot bath was quickly prepared, and the patient put 
into it. In less than half a minute he said : ' I feel easier, and can void urine. ' 
The blood in his face, and warmth, and the pulse, (which was before hardly 
io be felt,) gradually returned, and a warm sweat dropped from his forehead. 
When he was taken out of the bath he was completely relieved: for the 
recovery was, in such cases, as sudden as the symptoms were dangerous and 
alarming. A gentle warm sweat was kept up for twenty-four hours, when 
he again started for the wilderness. On his road to his father-in-law's he 
was again taken, but immediately using the hot both, was enabled to reach 
the place of his destination, and remained well. Mr. Johnston, though des- 
paired of, also quickly recovered by the same means. 
In its highest grade this sickness wanted nothing to cure it speedily but 
the hot bath, with such medicine as kept the patient in a constant warm 
perspiration, not amounting to an actual profuse sweat: for this might cause 
indirect debility." 
It is stated that a disease raged several years ago in the New England 
states called typhoid pneumonia, attended with similar symptoms. The skin 
and extremities were remarkably cold and torpid, with chills, &c.: nervous 
energy evidently much diminished. Nothing was found of so much utility 
in this complaint as heat or perspiration. The common people, I infer from 
the statement, treated it the most successfully, by using the vapour bath. 
It is said that its application arrested it at once. How different is the effect 
of heat and perspiration in these and similar diseases, from the practice of 
abstracting blood, which debilitates the system, protracts the complaint, and 
endangers the life of the patient, or, at best, if he recovers, injures his health; 
while the course here recommended returns the vital fluid to its proper 
193 194 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
channel, thereby removing congestions and inflammations, restoring strength 
and warmth, equalizing the vascular and nervous influence, and removing 
the shock and mischief occasioned by the cold. 
Dr. Gallup, who wrote on the disease above-mentioned, thus remarks 
" As the causes of the disease act upon the nerves, and show their morbid 
influence on the surface of the body by coldness in the first stage, want of 
perspiration, &c., the natural indication is, to restore warmth and activity to 
the surface as quickly as possible. I have succeeded in this oftentimes by 
the use of the warm bath. It is one of the most powerful agents we can 
employ, while at the same time it is safe and agreeable. Nothing is more 
common than for patients to express it as a great luxury. If it does not im- 
mediately bring on sweating ; it invites the circulation to the surface, relieves 
external chills and internal pain, and prepares the system for the remedies 
which are soon to follow. Were the bath cannot be obtained for immersion, 
rolling the patient several thicknesses in blankets, dipped in warm water, 
serves as a substitute. 
Perhaps no remedy is better agreed on as being generally useful in this 
disease than sweating, or, in other words, the application of external heat. 
If it is not always useful, it is in some solitary cases where there is an 
abundant heat from reaction having taken place in vigorous habits. At the 
onset of the disease, however, this remedy may be said to be always useful. 
External warmth is of vast importance in keeping up the centri-fugal action 
of the system. If the action is allowed to recede to the centre, by neglect of 
external warmth, after sweating has been used with advantage, the patient 
is apt to be exercised with sinking distress, and will be in danger, if heat be 
not immediately applied." 
Dr. Armstrong, speaking of typhus, observes : " The warm bath is a safe 
and efficacious remedy, and, with the means above-mentioned, has con- 
siderable effect in equalizing the circulation." Again, in speaking of pros- 
tration, he remarks: " This depression of the animal heat, however, occa- 
sionally comes on in the collapse of typhus, without any apparent cause ; an 
instance of which I have witnessed in a medical gentleman, who I believe 
would have died if external and internal warmth had not been promptly and 
perseveringly employed. When the pulse still remains oppressed, and the 
tide of the circulation does not return to the surface, some wine with.warm 
water should be occasionally exhibited, and the patient speedily immersed 
in a bath, strongly impregnated with salt, and at least about the tempera- 
ture of 100 degrees. He should remain in the bath till his skin becomes 
warm; and, on being removed, it should be well rubbed all over with hot 
flannel; he ought then to be laid in an aired bed, with bottles of warm 
water at his feet. This plan, together with tepid wine and water occa- 
sionally, will often promote a flow of blood toward the skin, and considerably 
relieve the viscera from congestion." 
The following remarks on cholera, from a late number of the Medical and 
Chirurgical Journal, farther corroborate these principles : 
" In the history of disease in this country we recollect but one that ap- 
pears to bear any analogy, either in its general mode of attack, its great 
fatality, or the means most clearly indicated in its treatment, to the present 
cholera of Europe. The disease to which we refer is the spotted fever, which 
prevailed in the state of Maine in the year 1814. Its symptoms were more 
various than those of the cholera, and its fatal issue was not quite so speedy. 
But the attack consisted in the main, in the sudden departure of blood from 
the surface, and an appalling prostration of the powers of life. Having been OF MEDICINE, AND INDICATIONS OF CURE. 
195 
an eye-witness to this epidemic, it has been recalled to our mind by every 
history we have read of the symptoms of cholera. We have seen persons 
in the fulness of health suddenly fall under its blow, apparently lifeless ; and 
the sudden and obstinate coldness of the surface, in all cases, gained for the 
disease the popular name of the cold plague. In no disease have we seen so 
marked effects from different modes of treatment. Purgatives and venesec- 
tion were generally followed by fatal results ; where calomel was given, the 
unhappy sufferer often died while under its operation; and in spite of most 
forms of treatment, from the first, most heating and stimulating remedies 
internally and externally, with an unsparing hand, exerted an entire control 
over the disease. This practice was pursued with marked and almost uni- 
form success by Dr. Page, of Hallowell, by that man of Ross, whose benevo- 
lence will never be forgotten by the hundreds of his townsmen to whom it 
has ever been liberally extended. In the small town of Wiscasset, contain- 
ing about two thousand inhabitants, two or three (equal to sixty a day in 
Boston) were dying daily of this epidemic, until Dr. Page was persuaded to 
visit the place; and after the day he entered the town and introduced the 
mode of treatment that had been so successful at home, not an individual 
died of this disease.'1'1 
I have extracted the following remarks from a communication by Dr. 
North, upon a malignant fever, lately prevalent in New London, Connecti- 
cut, and which still farther corroborate the doctrine of disease here advocated: 
" As counter illustration in regard to malignant asthenia, the reader is in- 
formed that the first thirteen patients at Winchester, Litchfield county, were 
treated about twenty years ago upon the then fashionable, cooling, depleting 
plan of treating fevers; and I have the very best authority for saying that 
ail of these patients died: and their constitutional organization was good, 
for they were young persons. Then the sweating and stimulating plan was 
introduced by the memorable Dr. Samuel Woodward, in imitation of Mrs. 
Hurlburt's process. After this the success was as great there as here, (having 
reference to the north part of Litchfield county, and some other places.) 
There was much oral testimony against depletion, and in favour of sweating, 
long before anything was printed on the subject. This accidental discovery, 
or revival of an ancient practice, in regard to malignant fevers or malignant 
asthenia, I regard as being now fully established by our experience in New- 
London, if it was not a long time ago. 
Non-professional readers may imagine that information in regard to deple- 
tion and sweating is annually taught in our medical schools. Such is not the 
fact. 
If the plan in use among a few medical men in this country was adopted, 
mortality would probably be lessened in the eastern world. The plan is, to 
teach the ignorant to take a sweat in a warm bed the instant they begin to 
feel unwell, and not wait for the tardy arrival of a physician. 
I hope the promulgation of the above facts may do more good among the 
sick than many medical speculations. These last may, however, give noto- 
riety to authors, and manifest the greatest ingenuity of human brains. 
Broussa-ism, Homoopathic-ism, and slight monomania of many kinds may 
be useful, by amusing a grave profession, yet not very much benefit the sick." 
2. Rheumatism.-In rheumatism also similar effects take place. It is in 
general caused by the sudden transition from heat to cold, bringing about the 
symptoms before-mentioned, and the same treatment is here called for. 
Sometimes the force of the disease is concentrated upon some particular 
part of the body, the head, lungs, liver, or the joints : when this happens, 196 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
the act of producing warmth of the surface, and restoring perspiration, 
affords immediate relief, and often cures the disease in its incipient or form- 
ing stage. It is exceedingly important in fulfilling the indications here laid 
down, (in inflammatory rheumatism particularly, as well as febrile diseases) 
that, while we administer stimulating sudorifics or sweating medicines inter- 
nally, we apply heat externally to the whole surface of the body, in order 
to remove the stricture or tension of the cutaneous vessels. If this pre- 
caution is not attended to, stimulating medicines will often increase or exas- 
perate the disease. The reciprocal influence between the stomach and 
surface is such, that attention must be directed to both at the same moment 
or time, if we wish to equalize the excitement. Such is the sympathy or 
intimate connexion between the stomach and the skin, that it seems impos- 
sible for one to suffer, or be affected, without the other likewise suffers. 
3. The Lungs.-The lungs are very liable to receive morbid impressions 
from the influence of cold suddenly applied to the body. After a person Jias 
been very much heated, apd immediately after exposed to a current of air, 
or if he has been long exposed to the sedative and debilitating influence of 
cold, the pores become closed, recrementitious or morbific matter is retained 
in the system, and the blood in an accumulated quantity is thrown upon the 
mucous membrane or the parenchyma of the lungs. Irritation and inflam- 
mation take place, which, if not arrested, are followed by suppuration. Now, 
under these circumstances, perspiration must be immediately resorted to, to 
counteract the deleterious effect of this morbific agent, viz., cold. The blood 
also in this case, as in the other, recedes from the surface and is thrown upon 
the lungs, causing engorgement and irritation ; therefore, it must be imme- 
diately recalled by these means. It is here that we have it in our power to 
arrest that terrific monster (phthisis pulmonalis, or consumption) which 
daily slays its thousands, by instituting this course of treatment, which will 
terminate the disease by resolution or without suppuration. Bleeding, so 
far from accomplishing this desirable end, will inevitably bring on danger- 
ous or fatal prostration, and in all probability carry the patient to an untimely 
grave.* 
4. Dysentery.-The. dysentery is a disease in which the application of 
warmth to the surface and diaphoretic medicines are very serviceable. It 
has been thought by some, particularly the ancient physicians, to be a fever 
translated to the intestines; but, from the effect of perspiration in the com- 
plaint, we are led to believe that it arises from a retention of humours or 
acrid and morbific matter, which is translated to these parts. As soon as the 
patient begins to perspire freely, he experiences relief. The same good 
* A person, speaking of the diseases of poultry, makes the following remarks, which show 
that the agency of heat and cold upon animals is similar to its effects upon the human system : 
1. In these animals cold exercises a constant and determinate action on the lungs. 
2. The effect of this action is the more rapid and more severe, the younger the animal is 
3. When cold does not cause acute and speedily fatal termination of the lungs, it produces 
a chronic inflammation, which is pulmonary consumption itself. 
4. Heat always prevents the attack of pulmonary consumption ; when the latter has taken 
place, heat suspends its progress, and even sometimes arrests it entirely, and effects a com- 
plete cure. 
5. Pulmonary consumption is never, in any stage, contagious : fowls affected with that 
disease were not only all day long with the healthy, but at night roosted in the same places, 
without communicating their disease to them. 
6. The action of too long confined air exposes these animals to abscesses of the cornea 
■and inflammation of the ball of the eye. These abscesses and inflammations arc also caused 
in a still more cruel manner by cold, especially when accompanied with moisture. This 
fact explains the manner in which diseases are generated in men as well as animals. OF MEDICINE, AND INDICATIONS OF CURE. 
197 
effects arise in bowel complaints generally. Spotted fever, cholera morbus, 
colic, diarrhoea, &.c. Dr. Mosely, in his work on diseases of warm climates, 
strenuously insists upon the propriety of sudorifics in bowel complaints. 
External heat, in the form of fomentations, is invariably attended with an 
admirable effect in bowel complaints of every description. They divert the 
fluids from the intestines to the skin, and, by their stimulating and relaxing 
properties, prove very serviceable. The surface and extremities in these 
diseases are pale and cold, from which we see that the balance of the circu- 
lation in the system is lost. The recession of blood, in connexion with those 
foreign agents which are not eliminated by the skin, operates as an undue 
and as a disease-creating stimulus in the intestines. 
5. Pleurisy.-In pleurisy I have been called when the patient appeared 
to be dying from the cause last-mentioned. The irritation upon the pleura 
was so great, that a sensation was created as if needles were piercing it, the 
breath nearly gone. In this case, when the disease threatened immediate 
destruction of life, and when scarcely a physician could be found, either in 
Europe or America, who would not have copiously drawn the vital fluid, and 
that repeatedly for days no doubt, I have pursued the course above recom- 
mended, viz., recalled the vitiated blood to the surface by producing free 
perspiration, and I have had the pleasure of witnessing sudden abatement 
of the pain, succeeded by a recovery of the patients in a few days. 
6. Apoplexy.-In apoplexy this course is attended with much better 
effects than general blood-letting. I cannot think in this disease there is 
too great a quantity of blood which calls for an abstraction of it, but the 
disorder arises from unequal circulation. The blood recedes from the sur- 
face and extremities, and is accumulated or effused upon the brain. The 
remedy then is, to equalize the circulation. I have never failed to arrest the 
disease by such treatment, particularly in the commencement. 
7. Fits.-In fits this practice is equally efficacious. I never knew it fail 
of affording relief. I was called some time ago to a man who had been sub- 
ject to convulsions for years, and he had sometimes several in the course of 
the day. One of our most popular physicians in this city repeatedly bled 
him, without affording any, except momentary, relief. The treatment was 
now reversed, bleeding was entirely dispensed with, and means made use 
of to divert the fluid from the brain to the surface and extremities. Nothing 
at all was done for him, except on every accession of the fit to immerse his 
feet in warm water, to which ley had been added sufficient to render it 
somewhat sharp or biting to the tongue. This treatment alone in a short 
period effected a cure. I think I gave him little or no medicine. 
8. Syncope or Fainting.-In asphyxia and fainting of every kind the 
immersion of the feet in warm water will restore the patient. 
9. Hysterics, {Hysteria.')-In hysteria (hysterics) the same benefit will 
be experienced. The extremities here are cold, the surface pale, attended 
usually with chills, all which is accounted for on the same principles. Phy- 
sicians generally are in the habit of bleeding in this complaint, notwithstand- 
ing it is a disease of debility; but this practice renders the disease worse. 
The treatment should be the same as before recommended. The feet and 
surface must be bathed with warm water and weak ley, and other means 
recommended to cause perspiration. If fits come on, the feet should be im- 
mersed in warm ley water. 
10. Intermittent Fever.-In the intermittent fever, or fever and ague in the 
cold stage, stimulating medicines given internally, and heat applied externally, 
will be found highly beneficial. The application of sudorific or sweating medi- 198 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
cines, just before a paroxysm or fit comes on, will often cure or diminish the 
violence and continuance of it. The duration of the hot stage is always in 
proportion to the cold ; hence those medicines which lessen or moderate the 
cold, necessarily shorten or lessen the hot stage. The patient should, there- 
fore, be well covered in bed, hot bricks or bottles of water may be applied 
to the sides and feet, warm drinks freely taken until perspiration succeeds. 
In some cases of intermittent so powerful is the influence of cold upon the 
system, that little or no reaction takes place. Nothing but heat in this case 
will save the life of the patient. 
11. Headache, (Cephalalgia.)-In headache the same course will be 
found useful, by diverting the fluids from the head and extremities ; the pain 
arising from different causes will cease. That headache arising from difficult 
or suppressed menstruation, by bathing the feet in warm water and using a 
hip or warm bath, will often be removed without any other medicine. 
12. Dropsy of the Head.-The dropsy of the head is also very much 
relieved by this process, by bathing the feet and surface, and cold or tepid 
applications to the head. It powerfully assists in allaying the inflammatory 
action. 
13. Inflammation.-In phlegmonous and erysipelatous inflammation per- 
spiration, aided by warm and relaxing poultices, are attended with excellent 
effects. 
14. White Swellings and other painful diseases.-In white swellings and 
other painful diseases the application of heat in the form of steaming is 
attended with the happiest effects, and, indeed, is often a complete and sove- 
reign remedy. Cases have been relieved and cured by it, which had baffled 
the skill of our most noted physicians. This principle, properly applied, will 
mitigate the acute symptoms of white swellings and similar complaints in 
fifteen or twenty minutes, and, by its repeated application, will wholly remove 
the horrid sufferings of the patient. 
15. Opthalmia, or Inflammation of the Eyes.-It is difficult to make a 
practitioner, unacquainted with the fact, believe what salutary effects follow 
the means here recommended in cases of opthalmia, or inflammation of the 
eyes. I have cured blindness of one or two years' standing, when the dis- 
ease has depended on sub-acute inflammation. I have merely ordered the 
feet to be bathed every night, or every other night, for a great length of 
time, and this treatment has recalled the blood from the head to the feet and 
surface, which, of course, lessens the pain and inflammation of the head. 
A lady, whose child I had formerly cured of sore eyes, has just stepped 
into my office in company with a neighbour, whose daughter is now afflicted 
with the same complaint. In prescribing for it, she soon asked, " shall not 
her feet be bathed ?" " This," added she, " contributed as much toward 
curing my child as the medicine did." When her head was in pain and her 
eyes much inflamed, bathing her feet gave immediate relief. This will not 
appear strange to the physiologist or the physician who understands the 
pathology of diseases in general. He will at once see the cause and the 
indications of cure. 
We might here go on and enumerate a great variety of other complaints 
in which the same treatment will be found exceedingly beneficial: but suf- 
ficient has been written to show its importance and utility, as well as to give 
an idea of all other cases in which it may be advantageously applied. 
This principle or method of treatment is very extensive. We know not 
how many diseases may be treated in the same manner. By substituting 
agents diametrically opposite to those which cause the disease, the cure is OF MEDICINE, AND INDICATIONS OF CURE. 
199 
effected : for example, a complaint caused by acidity in the stomach is 
cured by an alkali. In inflammation, or heat of any part, cold or refrigerant 
applications afford relief, and vice versa. Scurvy, which is caused by a long 
course of animal food, is cured by substituting vegetable food. Persons who 
are brought near the grave by this complaint, are immediately restored to 
health by pursuing this treatment; all which demonstrate the truth of the 
latin maxim : 
" Contraria contrariis medentur." 
The translation of which may be thus rendered: Diseases are cured by means 
or agents diametrically opposite to the causes which produced them. 
The great object should be, in every complaint, first to ascertain if the 
circulation is uniformly and equally carried on through the system; and if 
this is not the case, as will be found in most diseases, the means recommended 
with others that will be hereafter mentioned must be resorted to, and per- 
sisted in until warmth and perspiration are restored. Copious and long-con- 
tinued perspiration, except in the most urgent cases, should be avoided as 
injurious and dangerous. Many have been literally sweat to death by too 
great and too long-continued heat; more particularly by the steaming pro- 
cess now so much in fashion by those called " Patent Doctors." 
Dr. Thompson, who has procured a patent to treat diseases principally by 
steaming and puking, states, in his theory of medicine, that heat is /i/e, and 
cold is death ; and under this impression, that this vital principle (heat) cures 
almost every disease, steaming or sweating is carried to such a degree that 
many have lost their lives by it. The abuses of it must be carefully guarded 
against. 
It must be continually kept in mind that, in advanced stages of some dis- 
eases, (for instance, typhus fever,) when there is great prostration of strength, 
the heart and arteries having become exhausted by their ineffectual struggle 
to return the blood and morbific humours to the surface, to overcome the 
constriction of the skin, very stimulating sudorific medicines internally should 
not be given. In this case the most heating or stimulating agents, designed 
to promote perspiration, will only increase the disease. When called under 
such circumstances, the blood must be invited from the centre to the surface 
by repeatedly bathing the whole surface with tepid or cold applications, 
according to the temperature of the body. 
SECTION III. 
MEANS OF PROMOTING WARMTH AND PERSPIRATION. 
I have already hinted at some of the means to promote warmth and per- 
spiration ; but it may be proper to dwell somewhat more upon them in this 
place. In general, perspiration may be promoted by taking warm diluent 
drinks, and nothing is better than a strong infusion of catnip, freely drank ; 
also bathing the feet in warm water or weak ley. The surface in most cases 
may also be bathed with the same, as warm as possible, while the patient is 
in bed. The clothes may be raised with one hand, and a piece of flannel 
dipped in warm ley applied with the other hand to the surface. When one 
side of the body has been thoroughly bathed from the neck to the feet, then 
the sick person must be turned on the other side and bathed in the same 
manner. The liquid should be kept hot or warm by the bed-side ; addi- 200 
GENERAL PRINCIPLES OF THE REFORMED PRACTICE 
tional clothing sometimes becomes necessary to aid the process. Bottles of 
hot water may likewise be placed to the sides and feet. These means will 
answer in many cases, but it often becomes necessary to apply more power- 
ful means to accomplish this object. The pores of the skin are frequently 
so closed or constricted, that a greater degree of heat is necessary to open 
them. For this purpose there is nothing more simple and effectual than the 
Vapour Bathy mentioned under the head of baths, page 58. Certain other 
medicines to answer these indications will be mentioned while treating of 
different diseases. 
SECTION IV. 
THE REMEDIATE INFLUENCE OF COLD. 
I will now speak of cold applications. This is a class of very great im- 
portance, one which has been too long in disrepute, and too little used in 
our attempts to alleviate human sufferings. Cold applications are required 
in high feverish heat, in all bruises, sprains, and inflammations, in violent head- 
aches, sore eyes, wasp stings, &£. 
Now let us look at the reason for applying cold. It is in all cases to pre- 
vent too much inflammation. It is one law of our nature, as before shown, 
that an unusual quantity of blood immediately rushes to any part inflamed. 
As proof, think how quick the eyelids will swell when struck, or the arm 
swell when stung by a wasp. Now, this swelling is in part owing to the 
flesh being crowded too full with blood. Again ; it is another law of our 
nature that less blood goes to any part that is cold, and more to any part that 
is warm. As proof, in winter we come into the house with hands, face, 
ears, &c., white with cold ; but we find the good woman sitting by the fire 
red with heat. 
By this course of reasoning, then, we see why cold is applied, and may 
also learn all the cases in which it is required, viz., in all cases where we 
wish to prevent inflammation and swelling, or where swelling has taken 
place and we wish to remove it: and may learn likewise how effectually 
this may be done, by remembering that if we remain out in a cold evening 
long enough, that is, apply cold enough to the ear to freeze it, we have driven 
every particle of blood from it, and it is as white as a lily. In all common 
cases much less cold than that will answer our purposes. The effect will 
always be the same, differing only in degree. Cold will always keep the 
blood from rushing to the part; that is, will prevent inflammation and swell- 
ing, and that is what we are called upon to do. Having proved, then, that 
cold applications are necessary and useful, the next question will be, how 
will this application be made ? What article shall be used ? 
I will say that there are many articles and many ways of accomplishing 
this object; but the cheapest, the most convenient, the neatest, and altogether 
the best mode of applying cold is, by means of cold water. Cold is applied 
then in cases of inflammation of various kinds. Of the brain, the applica- 
tion of cold water is attended with benefit. In certain cases of typhus fever 
ablution and the effusion of it has often been attended with benefit. Also 
in other febrile diseases, where the heat is above the natural temperature of 
the body, except in eruptive diseases, in which it should not be used. In 
hemorrhages cold water is sometimes used with advantage. In weak and OF MEDICINE, AND INDICATIONS OF CURE. 
201 
inflamed eyes it imparts tone and a healthy action to them. In contusions, 
sprains, and burns the application of cold water is sometimes useful, and oc- 
casionally it has been found of benefit in the form of the cold and shower 
bath ; but heat or warmth in most diseases is far preferable. 
Cold seems almost invariably, when long and suddenly applied, to be re- 
pulsive to nature. After its application, particularly where the system is 
feeble, it is necessary that reaction or an effort of the system be instituted 
to counteract its effects. Therefore, when applied as above or last-mentioned, 
it must be considered as an enemy. Throughout the whole course of my 
practice I have found that heat exerts a much more salutary influence both 
in health and disease, and is, therefore, the most congenial to the system. 
SECTION V. 
ADDITIONAL REMARKS. 
Although I have laid great emphasis upon the necessity and importance 
of promoting warmth and perspiration in diseases, I wish it not to be under- 
stood that it is insisted upon or recommended to the exclusion of other appro- 
priate means, or that other remedies be in anywise neglected. I have dwelt 
more largely upon this subject, because physicians generally have not paid 
that attention to it which it deserves, and because they, like Dr. Sangrado, have 
substituted bleeding for perspiration, believing, no doubt, that no other means 
are sufficient to reduce it. Again, I have not in this treatise insisted so strenu- 
ously upon attention to the other excretions, because there is not so great a 
disparity in our views as there is on the subject of the capillary system. 
We all agree upon the propriety of fulfilling most of the indications for the 
cure of disease ; but the wide, the radical, the irreconcilable difference consists 
in the various means made use of to fulfil those indications of cure. 
It appears, from the strictures on the treatment of the late W. H. Harrison, 
President of the United States, by Dr. S. A. Gallup, of Woodstock, Vt., 
that the treatment by his physicians might have been the cause of his dis- 
traction. He shows that it was wronp. He states that he was induced to 
publish his strictures to get rid of a burden which has for some time op- 
pressed him. The disease was inflammation of the lungs, and the usual 
remedies were administered, viz., bleeding, mercury, and opium. Dr. Gallup, 
an old school physician, thus exclaims: " What shall we say of the medical 
treatment in this case ?" PART THIRD. 
INTERNAL DISEASES. 
CHAPTER I. 
NOSOLOGY, OR A SYSTEMATIC ARRANGEMENT AND CLASSIFICATION OF 
DISEASES. 
There have been several systems or treatises on nosology or the classi- 
fication of diseases; one by Dr. Cullen, and which has been perhaps the 
most popular of any, and next to it that of Sauvages; one also by Hosack, 
Good, and other writers ; but all have been found so prolix, arbitrarily 
arranged, and exceptionable, that many have rejected them almost with 
disgust, and pay no regard to any order or arrangement whatever. It does 
certainly forcibly strike the mind of an observer, that arranging diseases into 
classes, orders, genera, and species, as we do plants, is unnatural and inju- 
dicious, and I view every system of nosology that I have hitherto seen very 
much in the same light. I have not, however, been willing on this account 
to discard a systematic arrangement of diseases in every respect in conse- 
quence of the defects of writers upon this subject; but I have given such an 
arrangement or classification of diseases as does, in my humble opinion, 
supersede that of all others, by reason of its simplicity, and the easy, natural, 
and systematic classification laid down. 
By this nosology it will be seen that any person of ordinary capacity, who 
has perused it once, will be able in a moment to refer any disease to its 
proper class, order, and species. No part of it is unnatural, arbitrary, or 
forced ; but diseases are classed as they naturally occur, and the mind is 
left free to rest upon some one specific disease, in reference to the organ or 
part affected. 
CLASS I. FEBRILE DISEASES. 
Order 1. Intermittent Fever, Fever and Ague, Febris Intermittens. 
2 Remittent do. 2 Species, Febris Remittens. 
1. Simple, Simplex. 
2. Bilious, Biliosa. 
3. Inflammatory, Febris Ardens 
4. Simple Continued or Long Fever, Synochus. 
5. Typhus, 4 Species, Typhus. 
1. Mild, Mitior. 
2. Putrid or Malignant, Gravior. 
3. Yellow, Icterodes. CLASSIFICATION OF DISEASES. 
203 
4. Spotted, Petechialis. 
Order 6. Scarlet, 3 Species, Scarlatina. 
1. Mild, Mitis. 
2. Affecting the Throat, Anginosa. 
3. Malignant, Maligna. 
7. Puerperal or Child-bed, Febris Puerperalis 
8. Hectic, Febris Hectica. 
CLASS II. INFLAMMATORY DISEASES. 
Order 1. Inflammation of the Brain, Phrenitis. 
2. Do. of the Ear, Otitis. 
3. Mumps, Cynanche Pa.rotidea 
4. Quinsy or Inflammatory Sore Throat, Cynanche Tonsillaris. 
5. Putrid or Malignant do Cynanche Maligna. 
6. Croup, Hives, or Rattles, Cynanche Trachealis. 
7. Inflammation of the Pharynx, Cynanche Pharyngea 
8. Do. of the Larynx, Cynanche Laryngea. 
9. Do. of the Bronchia, Bronchitis. 
10. Hooping-cough, Pertussis. 
11. Influenza, Tussis Epidemicus. 
12. Cold or Cough, Tussis. 
13. Asthma, Asthma. 
14. Inflammation of the Lungs, Pneumonia. 
15. Consumption, Phthisis Pulmonalis. 
16. Pleurisy, Pleuritis. 
17. Inflammation of the Pericardium, Pericarditis 
18. Do. of the Diaphragm, Paraphrenesis 
19. Do. of the Stomach, Gastritis. 
20. Do. of the Liver, Hepatitis. 
21. Do. of the Spleen, Splenitis. 
22. Do. of the Intestines or Bowels, Enteritis. 
23. Do. of the Kidneys, Nephritis. 
24 Do. of the Uterus or Womb, Hysteritis. 
25 Rheumatism, Rheumatismus. 
26. Gout, Podagra, or Arthritis 
CLASS III. ERUPTIVE DISEASES. 
Order 1. Small Pox, 2 Species, Variola. 
1. Distinct, Interpuncta. 
2. Confluent, Confluens. 
2. Cow Pox, Vaccina. 
3. Chicken Pox, Varicella. 
4. Measles, Rubeola. 
5. Nettle or Scarlet Rash, Urticaria 
6. Itch, Psora. 
CLASS IV. DROPSICAL DISEASES. 
Order I. Dropsy of the Head, 2 Species, Hydrocephalus. 
1. Internal, Internus. 
2. External, Ext emus 204 
THE REFORMED PRACTICE OF MEDICINE. 
Order 2. Dropsy of the Abdomen or Belly, Ascites. 
3. Do. of the Chest, Hydrothorax. 
4. Do. of the Ovaria, Ascites Ovarii. 
5. Do. of the Cellular Membrane, Anasarca. 
6. Do. of the Scrotum, Hydrocele. 
CLASS V. CEREBRAL DISEASES. 
Order 1. Insanity or Mental Derangement, Mania. 
2 Species, 1. Idiopathic, Idiopathica. 
2. Symptomatic, Symptomatica. 
2. Nymphomania, or Furor Uterinus. 
3. Melancholy, Melancholia. 
4. Epilepsy or Falling Sickness, Epilepsia. 
5. Apoplexy, 2 Species, Apoplexia 
1. Sanguineous, Sanguinea. 
2. Serous, Serosa. 
6. Catalepsy, Catalepsia. 
1. Lethargy, Coma. 
8. Fainting or Swooning, Syncope. 
9. Giddiness, Vertigo. 
CLASS VI. NERVOUS DISEASES. 
Order 1. Hysterics, Hysteria. 
2. Hypochondria, Hypochondriasis. 
3. Palsy, Paralysis. 
4. St. Vitus' Dance, Chorea Sancti Viti. 
CLASS VII. GASTRIC DISEASES 
Order 1. Cholera Morbus, 2 Species, Cholera Morbus. 
1. Bilious, Biliosa. 
2. Spasmodic, or 
Malignant, 
sive 
Maligna. 
2. Water Brash, Py rosis. 
3. Indigestion, Dyspepsia 
4. Convulsions, Spasmi. 
5. Cramp, Tetanus. 
6. Heartburn, Cardialgia 
1. Canker, Apthae. 
8. Vomiting, Emesis. 
9. Hiccough, Singultus. 
CLASS VIII. INTESTINAL OR BOWEL DISEASES. 
Order 1. Dysentery, 2 Species, Dysenteria 
1. Acute, Acuta. 
2. Chronic, Chronica. 
2. Bowel, Summer Complaint, or Relax, Diarrhoea. 
3. Colic, 4 Species, Colica. 
1. Flatulent, Flatulenta. 
2. Bilious, Biliosa. CLASSIFICATION OF DISEASES. 
205 
3. Painter's, Pictonum. 
4. Hysteric, Hysterica. 
Order 4. Costiveness or Constipation, Constipatio. 
CLASS IX. PROFLUENT DISEASES. 
Order 1. Vomiting of Blood, Hematamesis. 
2. Spitting of Blood, Hemoptysis. 
3. Bleeding from the Nose, Epistaxis. 
4. Involuntary Discharge of Urine, Diabetes. 
5. Whites or Fluor Al bus, Leucorrhea. 
6. Immoderate Flow of Blood from the 
Womb, 
Menorrhagia. 
7. Abortion, Abortio. 
8. Cessation of the Menses. 
9. Incontinence of Urine, Eneuresis. 
10. Catarrh. 
11. Bloody Urine, Hematuria. 
12. Onanism, or Artificial Discharge of 
Semen. 
CLASS X. REFLUENT DISEASES. 
Order 1. Menses, Retention of, Chlorosis. 
2. Do. Suppression of, Amenorrhcea- 
3. Do. Painful Affections of Dysmenorrhoea. 
4. Do. Angina Pectoris. 
5. Night-mare, Incubus. 
6. Palpitation of the Heart, Palpitatio 
7. Urine, Suppression of, Ischuria. 
8. Jaundice, Icterus. 
CLASS XI. CONSTITUTIONAL DISEASES. 
Order 1. Scurvy, Scorbutus 
2. Urine, Heat of, Ardor Urina. 
3. Emaciation, Marasmus. 
4. General Debility. 
5. Mercurial Disease and Salivation. 
6. Enlargement of the Heart, Hypertrophy. 
7. Yaws, Frambazsia. 
8. Rickets, Rachitis. 
CLASS XII. LOCAL DISEASES. 
Order 1. Lumbago. 
2. Worms, 4 Species, Vermes. 
1. Pin, Ascarides. 
2. Long Round, Lumbricoides. 
3. Hair, Trichuris. 
4. Tape, Tania. 
3. Teething, or Dentition, Dentitio. 
4. Poisons. 206 
THE REFORMED PRACTICE OF MEDICINE. 
Order 5 Headache, 2 Species, Cephalalgia. 
1. Idiophatic, Idiophatica. 
2. Symptomatic, Symptomatica. 
CHAPTER II. 
PRELIMINARY REMARKS. 
SECTION I. 
DEFINITION OF HEALTH AND DISEASE. 
Health.-When all the functions of the system are duly performed, a per- 
son may be said to be in health. 
Disease.-Any alteration from this state, or when any part ceases to per- 
form its office or function, disease is the consequence. It is a salutary effort 
of Nature to repair an injury to the system or re-establish health. 
What is termed disease appears, in reality, to be nothing more than an in- 
herent principle in the system to restore healthy action, or to resist offending 
causes. Pain or disease is not the result of any new or independent action 
in the system, but arises from an excess of excitement in the healthy func- 
tion of the body ; or, in other words, is, like fever, a healthy or conservative 
power of nature to expel noxious agents, or restore health. 
Disease a Unit.-Is it irrational or unphilosophical to consider disease a 
unit? all its innumerable forms or symptoms being derived from one cause 
acting upon different organs or tissues of the body. 
Disease, Primary or Symptomatic.-Disease is either primary (idiopathic') 
or symptomatic. Primary, when it does not depend upon any other. Symp- 
tomatic, when it does depend on some other complaint; for instance, when 
the head aches by reason of a disordered state of the stomach. 
Disease is Acute or Chronic.-Acute, when the attack is very severe, at- 
tended with violent symptoms, terminates in a few days, and is dangerous. 
Chronic, when it is slow in its progress, little or no inflammation, and is not 
attended with immediate danger. 
Peculiarity of Constitution, (Idiosyncrasy.)-A peculiarity of constitution, 
in which a person is affected by certain agents, which, if applied to a hun- 
dred other persons, would produce no effect: thus some people cannot see a 
finger bleed without fainting; and thus violent inflammation is induced on 
the skin of some persons by substances that are perfectly innocent to 
others. 
State of the Mind.-Fear, anxiety, and a fretful temper occasion and ag- 
gravate diseases. In vain do we apply medicines to the body for diseases 
which proceed from the mind. When that is affected, the best is 
to sooth the passions, to divert the mind from anxious thought, and to keep 
the patient as easy and cheerful as possible. This constitutes a considerable 
part of the duty of those who prescribe medicine to the sick. 
Aye.-Here it must be observed, that the doses of medicine mentioned in 
this work (with some exceptions, pointed out in their place) are those 
adapted for an adult; but as in the two extremes of life, childhood and old PRELIMINARY REMARKS. 
207 
age, the body is weaker, and in early youth more susceptible of all the im- 
pressions, these quantities cannot be administered with safety in every case; 
and hence the judgment of the prescriber must be exercised. 
Sex.-Although some women possess as much bodily strength and vigour 
of constitution as the majority of men, yet the greater delicacy and sensibility 
of the female frame, at every period of life, requires not only caution in appor- 
tioning the doses of active medicine, which should be less than those ordered 
for men of the same age, but the medicines themselves should be such as 
are likely to fulfil the indications without much violence. The state of the 
uterine system likewise must not be overlooked in prescribing for a female. 
Thus the employment of aloetic and drastic purgatives should be suspended 
during the period of pregnancy. 
Temperaments.-It is undoubtedly true that persons of different tempera- 
ments or original confirmations of body are differently affected by the opera- 
tions of medicines. Stimulants more readily affect those of a sanguine than 
those of a phlegmatic temperament, and, therefore, smaller doses are required. 
In the phlegmatic also the bowels are generally torpid, and require both a 
description of purgatives and such doses as would endanger an irritable and 
delicate constitution. 
Habit.-Habits have considerable influence in modifying the operation of 
medicines. Persons addicted to the use of spirits, narcotics, and other stimu- 
lants, are less easily excited, both by medicinal stimulants and narcotics. 
Persons in the daily habit of taking purgatives must take a different article 
to produce much effect upon the bowels. In the employment of medicines, 
which require to be long-continued, the beneficial effect is soon lost if the 
doses be not increased. 
Of the Form and Composition of Prescriptions.-In every prescription sim- 
plicity should be kept in view; and when such medicine will answer the inten- 
tion of the prescriber, it ought to be preferred. The nauseous taste, however, 
and other qualities of some medicines, require the addition of others to modify 
their taste or action: but, although medicines are more generally prescribed 
in a compound form, yet the practice of accumulating a great variety of in- 
gredients in one prescription should be avoided. 
Medicines exhibited in a fluid form operate sooner and with more cer- 
tainty than in the solid state; but in choosing the vehicle or solvent, the 
taste of the patient ought not to be overlooked. Syrups do this tolerably 
well. Medicines which, when given alone, produce griping, require the 
addition of aromatics to correct that quality; and when they operate with 
violence, mucilages or opiates are necessary to moderate their action. . In 
prescribing purgatives it is also necessary to consider the particular part of 
the alimentary canal on which they immediately act. Thus, rhubarb acts 
chiefly on the upper part of the bowels, aloes on the lower, and jalap and 
senna on the whole intestines. 
Another reason for ordering medicines in a compound form is, the necessity 
of producing two or more effects at one time. Thus, the same dose may be 
jequired in a case of colic, for example, to allay pain and to open the bowels, 
or in fever to determine to the skin, to allay irritation, and to produce sleep. 
But, in combining medicines, care must be taken not to bring together incom- 
patibles, or substances that decompose each other, or chemically combine, 
and, consequently, alter the nature of the mixture, or render it inert, unless 
the resulting compound be the remedy on which the prescriber relies. Thus, 
acids and alkalies are incompatible, unless the neutral salt be the remedy 
required. 208 
Doses.-It should be remembered that when we speak of a tea-spoonful 
being a dose, one of an ordinary size is meant, which is a fluid drachm. 
When a table-spoonful is mentioned, one also of an ordinary size is meant, 
and which is half an ounce. 
Pills.-When the weight of pills is not mentioned, those of an ordinary 
size are meant; they contain usually three or four grains. 
I prefer this method, because it is much more convenient than to weigh 
every time it is necessary to administer it, and it is sufficiently accurate for 
all ordinary medicines. When greater accuracy is required, the weight and 
measure will be mentioned. 
Prescriptions.-Every prescription or direction for the administration of 
medicine, except the prescriber gives it himself, should be in writing, and 
that very plain and explicit. The quantity to be given, and the time when 
it should be given, ought to be particularly mentioned, and these directions 
ought to be left with the nurse only. Many valuable lives have been lost 
for the want of these precautions. 
Cardinal rules in the practice of medicine, to be committed to memory : 
1st. As far as practicable to ascertain the disease. 
2d. What indication or intention to fulfil in treating it. 
3d. The best agents or means to accomplish this object. 
4th. To administer the medicine at the right time, or when it is obvi- 
ously required. 
5th. Give as little medicine as possible to answer the purpose. 
6th. Give the most simple kinds or compounds. 
7th. To know when to omit the administration of medicine, and to rely 
on the resources of nature, with diet, bathing, regimen, and nursing. 
In these rules consist the principal art of healing the sick. 
The physician who assists our nature to throw off disease and recover 
health with the least use of medicine, is the best friend to our constitution, 
and evinces the most true science and skill, and deserves our highest respect 
and warmest gratitude. 
The greater the ability, age, and experience of physicians, the less medi- 
cine they give : the longer they practise, the more they depend on the 
restorative efforts of nature, and the less confidence they have in the specifics 
of art. Therefore do not think less favourably of your physician, if you 
employ one, because he prescribes little. Thousands are sent to their graves 
by the very medicine which is intended to cure them. 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER III. 
CI-ASS I. 
FEBRILE DISEASES. 
Character.-This class of diseases is characterized by an increase of heat* 
an accelerated pulse, a foul tongue, and an impaired state of several functions 
of the body. FEVERS IN GENERAL. 
209 
SECTION I. 
FEVERS IN GENERAL. 
Fever constitutes perhaps the largest proportion or class of diseases 
which assail the human family; and, notwithstanding the numerous inquiries, 
experiments, and theories on the subject by medical men, from time imme- 
morial the nature, cause, and treatment remain the same; and there is, at 
this day, no uniformity either in opinion or practice ; they all go blindly to 
work to cure it, like the physician mentioned by D'Alembert. He com- 
pares him to a blind man armed with a club, who comes to interfere between 
nature and disease: if he strikes the disease, he kills the disease ; if he strikes 
nature, he kills nature or the patient. 
Says a writer, " This is the disease which, to break, to baffle, to conquer, 
or subdue, the learned colleges of physicians have tried all their efforts, and 
spent their skill in vain. It must run its course, is the common sentiment; 
if one mode of treatment fails, we must try another, and another, and another, 
till the exhausted imagination, the worn out sources of the meteria medica, 
and the dying patient arrest the hand of the experimenter, (and I might 
have said tormentor,) or nature triumphs equally over medicine and disease. 
The practice of medicine is, perhaps, the only instance in which a man 
can profit by his blunders and mistakes. The very medicines which aggra- 
vate and protract the malady, bind a laurel on the professor's brow; when 
at last the sick is saved by the living powers of nature struggling against 
death and the physician: he receives all the credit of a miraculous cure; 
he is lauded to the skies for delivering the sick from a detail of the most 
deadly symptoms of misery, into which he himself had plunged them; and 
out of which they never would have arisen but by the restorative efforts 
of that living power which at once triumphed over poison, disease, and 
death. 
The causes which have conspired to cover with uncertainty the treatment 
of fever, and to arm the members of the faculty often against each other, 
are numerous and important. A brief detail would unfold the many causes 
of error, and the fatal consequences which often result from the established 
practice." 
Doctor Eberle, who has lately written a treatise on the Theory and Prac- 
tice of Medicine, thus remarks: " When, indeed, it is considered that the 
destroying angel has made his most desolating visitations under the form of 
febrile epidemics ; and that in the long list of human maladies fever occurs 
in perhaps nine cases out of ten, the paramount importance of this subject 
is strongly forced upon our convictions." 
" If we except," says Van Swieten, " those who perish by a violent death, 
and such as are extinguished by mere old age, (and which are, indeed, few,) 
almost all the rest die either of fever, or of diseases accompanied with fever. 
We read in Pliny with what fear and trembling the Romans endeavoured to 
have this universal disease, fever, appeased, by their supplications in the 
temple of Fanum. And hence, perhaps, it is that fevers are called diseases 
by Hesiod, and that Horace calls all diseases simply fevers when they rushed 
out of the'box of Pandora." 
Dr. Donaldson, who published a new Theory and Practice of Fevers, re- 
marks as follows: 
" From a retrospective glance at the history of our science, we are forced 210 
THE REFORMED PRACTICE OF MEDICINE. 
to acknowledge that there is perhaps no subject which is more eminently 
calculated to humble the pride of human reason than this one. For, in re- 
lation to this subject especially, pathology has been in a continued state of 
revolution and instability. The human mind has been engaged with this 
subject for near three thousand years. Theories have risen and sunk again 
in a continued and rapid series of succession ; each has had its hour' ' to strut 
upon the stage,' and its votaries to yield it faith ; but the stream of time has 
hitherto overturned all these unsubstantial, though often highly wrought, 
fabrics. 
In fact, no physician whose works I have read, no professor of medicine 
whom I have heard speak on the nature of diseases, has ever discovered, or 
even hinted at, the nature and cure of fevers; all have delivered theories 
which amount to open acknowledgments of their ignorance of it; or have 
candidly professed the universal ignorance of all physicians in the world, of 
the former and present times, respecting the nature of these diseases. 
I observed the plan of cure followed by the East-Indians in fevers. I 
saw the practitioners cure the most vehement cases of intermittent fevers in 
the space of a single day, with such a mathematical precision and certainty 
as I never beheld in any region of the earth-by purging, vomiting, sweat- 
ing, <SfC." 
DESCRIPTION, OR DEFINITION OF FEVER. 
Fever is an increased action of the heart and arteries, to expel from the 
system irritating or morbific matter, or to bring about a healthy action. It 
is salutary in its nature, being the means used to throw off something that 
offends or oppresses her. It is often fatal ; but this is rather to be attributed 
to the fault of the constitution than the disease itself, or rather to the want 
of proper remedies. 
When a person is attacked by shiverings or rigours, followed by a hot 
skin, a quick pulse, and a feeling of languor and lassitude, he is said to have 
an attack of fever. With such symptoms are usually present also a loss of 
appetite, thirst, restlessness, and diminished secretion. These constitute 
the leading symptoms of fever, the characteristic features by which its pre- 
sence may always be detected. Every function of the body, indeed, is more 
or less disturbed. 
CAUSES. 
As much controversy and speculation as there is respecting the pathology 
or nature of fever, we think there is no complaint that is more simple or 
easily understood, as regards causes, symptoms, and treatment. 
It would be too tedious farther to enumerate the various theories that have 
been maintained respecting the origin and nature of this class of diseases. 
We shall, therefore, omit this, and enter into a practical disquisition of the 
subject. 
I shall now speak of the remote, intermediate, and proximate cause of fever. 
We may consider fever a unit ; that the various phenomena of the com- 
plaint depend not so much upon any specific difference in the many types of 
fever, but consist rather in the various exciting causes, habit, temperament, &c. 
Remote Causes.-In general, every cause capable of producing a departure 
from a healthy standard predisposes the system to fever. 
1st. High atmospheric temperature may be mentioned as a cause. 
2d. Cold.-As a cause of fever, cold plays a very important part. It FEVERS IN GENERAL. 
211 
diminishes the action of the capillary vessels, giving a pale, shrunken, and 
dry state of the skin. It also diminishes the sensibility of the system. 
The most prolific and fruitful source of disease is cold united with moisture. 
When the atmosphere is cold and dry, it seldom causes any complaint; but 
in damp, wet, and very cold weather the system becomes more susceptible 
of morbid impressions. Much, however, depends upon the state of the body 
when exposed to cold. If it be very gradually applied, it can be borne with 
impunity : but if it be applied suddenly, and especially when there is great 
perspiration, fever or inflammation succeeds. 
. All sudden transitions from heat to cold, or cold to heat, are sources of 
fever. The capillary system ceases to perform its office, or performs it im- 
perfectly, the consequence of which is, that vitiated blood recedes from the 
surface, and is accumulated in too great a quantity upon the heart and large 
arteries, which causes in them an unnatural or preternatural effort to return 
it to its original channels, or into the vessels of the skin, to relax or over- 
come its constriction, and thereby expel the irritating, morbific, or perspi- 
rable matter. 
3d. Heat.-Heat may also be reckoned as a remote or predisposing cause 
to fever. Dr. James Johnson, in speaking of the effect of heat upon the 
system, thus remarks : " Solar heat produces only the predisposition, while 
terrestrial exhalations and cold call into action the principal diseases of hot 
climates." 
The mode in which solar heat contributes to the production of disease 
appears to be either by augmenting the general irritability of the system, or 
more generally by exciting inordinate functional action of the skin and the 
liver, and thereby rendering them more susceptible of the paralyzing impres- 
sion of cold. 
Between the skin and the liver there exists a close and powerful sympathy, 
in consequence of which whatever excites the functions of the former 
produces perhaps an equal increase of the function of the latter organ. 
Heat also operates as a cause of fever, by extricating or evolving certain 
deleterious gases or agents. 
Infection.-Deleterious Effluvia.-By this term we understand a class of 
febrile agents floating in the air, and which is taken into the circulation 
through the medium of the lungs. It may be-divided into three kinds : 
1. Effluvia arising from the decomposition of vegetable agents. 
2. An effluvia produced by a person in a state of disease. 
3. Effluvia from putrid animal substances. 
1. Marsh or Vegetable Effluvia.-The effluvia arising from the decompo- 
sition of vegetable matter, aided by a suitable degree of heat, and perhaps 
moisture, mixes with the atmosphere and contaminates it. This is taken 
into the system, and, if not thrown off' by some of the excretory ducts, proves 
an exciting cause of fever. 
It is an established fact, that marsh and other effluvia, passing over bays 
or rivers of water, are absorbed and annihilated. 
Daily experience still confirms that it is in the neighbourhood of marshes, 
and all such places where vegetable and animal putrefaction takes place to 
any extent, that pestilential and other diseases of various grades and violence 
prevail. Epidemics, attended with carbuncles and buboes, which are de- 
nominated, in conjunction with ordinary symptoms of what is called jail 
and hospital fever, the characteristics of the plague, down to the mildest 
intermittents, have appeared and raged with extraordinary violence, occa- 
sioned by the exhalations from putrifying animal and vegetable substances. 212 
THE REFORMED PRACTICE OF MEDICINE. 
There can be no doubt but stagnated water is a very common cause of 
fever under any circumstances. It is related, in Goldsmith's Animated 
Nature, that a vessel became becalmed in the ocean, near the Cape of Good 
Hope. When the water had been perfectly still for some time, its surface 
was covered with a green slime, and numerous snakes and other animals 
were seen in different directions. The consequence of this corrupted state 
of the water was, that a number of the crew became sick of a fever and soon 
died. As soon as they were favoured with a breeze, no more were attacked, 
and recovery of the sick succeeded. This fact shows that a deleterious 
gas or effluvia proceeded from the water and generated the disease. 
2. Human Effluvia.-By this term we understand such a secretion from 
the body of a person labouring under disease as is capable of producing 
another of a similar nature, aided also by filth, heat, and other causes. It 
occurs in crowded apartments, jails, hospitals, ships, &c., and other places 
not duly ventilated. Dr. Smith, of New York, observes, that this effluvia is 
especially generated in the apartments of the sick, particularly of those who 
are labouring under a typhus state of fever. Dr. Eberle, of Philadelphia, 
says : " I would restrict this term to those morbific effluvia which are 
generated by decomposition of the animal secretions, whether formed in a 
state of health or disease, and to the ordinary exhalations from the body, 
when accumulated in such a manner as to deteriorate the atmosphere of con- 
fined rooms, if these be really capable in themselves, and without decompo- 
sition, of exciting fevers." This effluvia is the source of typhus and some 
other continued fevers. 
Under this head may be enumerated the effluvia or contagion arising 
from persons labouring under small-pox, measles, scarlet fever, &c. 
There is an instance recorded in the New England Medical Journal, from 
Dr. J. A. Allen, in the state of Vermont, of three persons having died in one 
house of typhus gravior or malignant typhus. The weather being unusually 
warm, the corpses of the last two suddenly run into the putrefactive process, 
and not being deposited in coffins sufficiently close, the effluvia evolved was 
very offensive to the people who attended the funeral ceremonies. Nearly 
all who were exposed to those septic gases had an attack of the disease ; 
and from the sick it was communicated to their attendants through the season, 
and thus it became epidemical. The interim of time from exposure to an 
attack was from ten to twenty-one days. The spasmodic cholera may be 
communicated in the same manner. 
3. Animal Effluvia.-Putrid animal matter is another cause of fever. Ma- 
gendie found that, on exposing different animals to the exhalations arising from 
putrid animal matter, diseases were produced in them similar to those produced 
by pestilential effluvia. It is, therefore, very probable that such putrid agents 
floating in the atmosphere constitute the deleterious principle of putrid 
animal effluvia, and that the different kinds or modifications of disease pro- 
duced by it depend upon the state of the system, peculiarity of constitution, 
the quality of noxious effluvia, and the substances from which it is derived. 
It has been from this source that many pestilential fevers have originated 
in different parts of Europe, particularly after battles. The gas or effluvia 
arising from the decomposition of dead bodies after a battle, when they have 
been suffered to lay above ground, has caused fevers of the most fatal character. 
It appears very evident that contagious diseases, fevers particularly, are 
communicated to the system through the medium of the lungs, and not the 
stomach, as some suppose. The small-pox cannot be communicated by 
conveying the poison or virus into the stomach, as has been proved ; but, on FEVERS IN GENERAL. 
213 
exposing animals to the effluvia arising from putrid substances, they became 
diseased and died. After this poison has been taken into the circulation, it 
acts as a foreign or extraneous agent to the internal surface of the heart and 
arteries, and there is immediately commotion or effort to dislodge it by the 
skin or the other excretions ; and if they perform their offices well, if the 
perspiration be not obstructed, or if it be free, such agents or poisonous effluvia 
will be carried off without much shock or injury to the system. But, on the 
contrary, if it be predisposed to the disease by any means whatever, fever 
becomes established, to effect what the powers of nature are unable to accom- 
plish. It is under such circumstances that her salutary efforts must be aided. 
The reason why the stomach is generally so much affected in febrile dis- 
eases is, in consequence of the lungs and their appendages being lined with 
a continuation of the mucus tissue of the primes, vice, or first passages, and, 
therefore, being more accessible to the deleterious air or effluvia inhaled or 
inspired. 
Intermediate Causes.-Among the various intermediate causes of fever 
may be ranked a morbid state of the stomach, arising either from vitiated bile, 
worms, or other sources of irritation. This morbid condition of the stomach, 
however, sometimes arises from the deleterious state of the atmosphere. A 
late French author, Broussais, maintains that the source of all diseases 
originates in the stomach and first passages, or the mucous membrane of the 
alimentary canal. This he terms gastro enteritis. In accordance with this 
theory, he gives few or no purgatives, but prescribes the mildest and simplest 
medicines, leeches over the region of the stomach, glysters, &c. 
But the principal and almost only intermediate cause of fever is, obstruc- 
tion in the capillary vessels ; cold, suddenly applied or long-continued, acts 
as a sedative, closes the pores, and thus becomes a powerful intermediate 
cause of fever. A viscid state of the blood or other fluids may in part 
cause this obstruction. 
Nature, in such circumstances, appears to be retreating before some 
powerful invader; but when the sedative powers are violent and suddenly 
applied, she makes strong efforts to relieve herself, and the gates of this 
tumultuous city are barred, while she is assembling all her forces to expel 
the enemy ; for during the paroxysm of fever the pores are strongly closed, 
while the vital energy is evidently concentrated and collected in the heart, 
which propels the blood with renewed vigour through the arterial system 
in its whole extent. 
It is not found easy to explain how debility produces this spasmodic con- 
traction, but it is imputed to the vis medicatrix natures, or the law in the 
animal economy above-mentioned, by which motions are excited to obviate 
the effects of anything noxious to the constitution ; and that the spasm exists 
appears from the suppression of all excretions, and the shrinking of the 
external parts during the cold stage. This proves an indirect stimulus to 
the sanguiferous system, by throwing the blood, mixed with acrid perspirable 
matter, back with violence upon the heart and large arteries, and exciting 
them to stronger and more frequent contractions ; which increased action of 
the heart and arteries continues till it restores the diminished energy of the 
brain, extends this energy to the extreme vessels, overcomes the spasm, 
restores their action, on which sweat breaks forth, the other excretories 
are also relaxed, and the fever abates. 
Proximate or Immediate Cause.-The proximate or immediate cause of 
fever is a retention of acrid, stimulating, or morbific matter or humours, 
which, instead of being carried off by the outlets or excretions of the system 214 
THE REFORMED PRACTICE OF MEDICINE. 
enter the circulation, and stimulate the heart and arteries to an undue and 
increased action, to overcome the obstruction of the capillary vessels and to 
expel such morbific matter.* The seat of fever, then, is in the bloodvessels or 
the vascular system. It is well known that most fevers follow a sudden check 
of perspiration. Hence it is evident that the exciting cause must be in the 
blood, and arises from an excess of stimulus, or a morbid excitement applied 
to the heart and arteries, or the sanguiferous system. This fact is demon- 
strated by the phenomena of eruptive disease, small-pox, measles, &c. This 
infection or contagion is taken into the blood through the medium of the 
lungs, and as soon as it becomes sufficiently impregnated with the specific 
humour or virus, a preternatural action of the bloodvessels immediately 
takes place. Nature is aroused, and makes a powerful effort or struggle 
to expel the poison from the system. As soon as she accomplishes this 
object, the exciting cause or agent in these eruptive complaints is thrown 
copiously to the surface, and appears in the form of vesicles or eruptions ; and 
when they are thus expelled, the fever immediately subsides, but will 
reappear if, from debility or other causes, the poison or humour is absorbed. 
It is the case also in hectic fever, as almost every one knows ; matter from 
the lungs or an ulcer is taken into the circulation, and causes fever. It is also 
proved from the termination of fever by sweat, and also by fever sores. 
These facts reduce it to a mathematical demonstration, and render the 
subject so simple and plain, that it is really a matter of profound astonish- 
ment that any one, the least acquainted with fever, should be ignorant of 
their nature, cause, and cure. 
" The venous system," says Bichat, " may be regarded as a general re- 
servoir, into which are poured all the materials which are to be thrown out 
of the body, and all those which are to enter it. In this last respect this 
system of vessels performs an essential part in the production and support of 
diseases. The deleterious substances may be introduced into the blood- 
vessels with the chyle, and produce ravages in the system in circulating with 
the fluids. There can be no doubt, moreover, that, besides the principles 
which convert the venous into arterial blood, there often passes through the 
lungs into the circulation deleterious miasmata, which produce diseases, as 
my experiments on fainting have proved. The intestines, the lungs, and the 
skin are the three avenues through which the morbific agents may gain ad- 
mission into the circulation." 
With all the evidence which we possess, therefore, that the blood fre- 
quently becomes charged with substances of an irritating or deleterious cha- 
racter, there can surely exist no reasonable doubt that fever must sometimes 
be the result of a direct and primary irritation of the heart and arteries ; for 
it will, most assuredly, not be denied that agents which are capable of causing 
morbid impressions on the nerves of the skin, the alimentary canal, or of any 
other organ, will be equally capable of producing irritation in the heart and 
arteries, when they are brought in immediate contact with their internal 
surface. 
These morbific agents may likewise act upon some organ, cause inflamma- 
tion, and thereby produce symptomatic fever. 
The acid sweats (says a writer) thrown out from the poisoned mass of 
blood by means of the small exhalent arteries, in malignant and pestilential 
diseases forming the matter of infection, and adhering to the bed-clothes and 
linen, which, by its corrosive qualities, it destroys and rots-and, if exerted 
* Dr. Mitchill supposed this agent to be carbonic acid gas, mixed with oxygen. FEVERS IN GENERAL. 
215 
in any considerable quantity, so commonly relieve the patient, (inasmuch as 
the volume of poison contained in the arterial system is thereby lessened,) 
-show that the blood, in certain diseases, contains something of a noxious 
nature. The appearances also which blood, drawn in pestilential fevers, 
puts on corresponds with that in which septic gas had been artificially in- 
jected. Blood, thus infected with this poison, taken up by the absorbent 
vessels, will continue to stimulate the heart and arteries, wearing out their 
excitability, and, consequently, bring on death, if the constitution be inca- 
pable of becoming habituated to its stimulus, or a part or whole of the 
stimulus be not subducted. If it be present in any great quantity, it may 
cause a sudden extinction of the vital principle, as is observed sometimes to 
happen in highly pestilential diseases. 
In a word, we may sum up the causes of fever as follows : 
1. Remote Causes. 
1. Cold. 
2. Heat. 
3. Marsh or vegetable effluvia. 
4. Human effluvia. 
5. Animal effluvia, to which may be added great exertion and fatigue, the 
passions, injuries, &c. But cold, or a check of perspiration, no doubt pro- 
duces three-fourths of febrile diseases. 
2. Intermediate Causes. 
1 Morbid state of the stomach from worms, bile, &c 
2. Obstruction in the capillary vessels. 
3. Proximate Causes.-Extraneous morbific or deleterious agents, gene- 
rated in or out of the body, mixed with the blood, and acting as incitants or 
stimulants upon the internal surface of the heart and arteries, propelling the 
blood with increased force or velocity, in order to expel these morbific agents 
by the skin or other outlets or excretions of the system; and, therefore, 
fever may be considered a friendly effort of nature to restore the system to 
health. It is evident that the deleterious agent is first mixed with the blood 
and occasions the fever; and, consequently, if not arrested, it fastens itself on 
some of the organs or solids, and causes irritation and inflammation. 
SYMPTOMS. 
1. Chills and Heat.-'The first characteristic symptom of fever is chills, 
succeeded by a preternatural degree of heat. Sometimes the chill is very 
severe, at other times very light; but fever is almost invariably ushered in 
by this symptom. The patient complains of great coldness ; he shakes and 
trembles ; the skin becomes pale, rough, and shrunken, and sometimes there 
is a sensation as if cold water was running down the back. After a while 
the chillness subsides, and flushings and heat prevail, with a return of the 
colour of the skin. The eyes and face become red, and the patient now com- 
plains of heat. This may be said to constitute the " hot stage " of fever. 
The continuance of the cold stage is very uncertain : sometimes it lasts an 
hour ; at other times it continues several days, with alternate flushings of 
heat. 
I have never seen any satisfactory or reasonable cause assigned for the 216 
THE REFORMED PRACTICE OF MEDICINE. 
chill or cold stage of fever: but it appears to me very obvious and self- 
evident. When the blood, by cold or anything else, is obstructed in the 
bloodvessels of the surface, it must recede, be thrown back, and accumulate 
upon the heart and great bloodvessels. Cold, then, as a matter of course, 
must predominate. The blood or circulation, the cause and seat of animal 
heat, being cut off, or carried on very partially in the vessels of the skin, 
there is then experienced a cold sensation, which we call chills or rigours. 
As soon as an unnatural or a preternatural stimulus of the blood is felt by 
the heart and arteries on account of such obstruction, a powerful reaction 
takes place to overcome it, the heart beats more violent, the pulse is ac- 
celerated, and the blood is thrown back into the capillary system so forcibly 
as to cause an unnatural or too great a degree of heat, which we term fever. 
Thus we see that a battle, as it were, occurs between these two contending 
parties or agents, cold on the one hand, termed chills, and heat on the other, 
termed fever. If the former (cold) prevails, the disease proves fatal; if the 
latter, (heat,) recovery or health is the result; that is, if it so far prevails 
as to overcome the obstruction or remove the cause of the disease. In other 
language, there is a struggle between the vital powers and the febrific agent. 
2. Increase of the Pulse.-Another invariable symptom is an increase in 
the frequency of the pulse. It usually becomes more frequent, fuller, and 
harder ; showing clearly the increased action of the heart and arteries, which, 
however, is modified or altered by various incidental circumstances; by 
some of the passions ; by diet, air, medicine, &c. 
3. Debility.-Another invariable symptom attendant on fevers is debility. 
There is a sense of languor, lassitude, and fatigue, which is generally in- 
creased by any exertion. 
4. Pain.-There is pain experienced in different parts of the body ; in the 
head, neck, and along the course of the spine and in the extremities ; in the 
muscles and joints ; a sense of soreness of the flesh or bones, and great de- 
pression and heaviness is complained of; a general trembling ; want of sleep, 
or it is disturbed and unrefreshing; there is a peevish or fretful temper, and 
difficult respiration. 
5. The Secretions.-All the secretions and excretions of the body are 
deranged on or before the accession of fevers. By looking at the tongue, the 
back part of it in particular, a very unhealthy and morbid appearance will 
be discovered : it appears coated with a foul substance, and this serves as 
an index to point out the accumulation of bilious matter, or a disordered state 
of the stomach. There is usually thirst, loss of appetite, nausea, and vomit- 
ing. The mouth is dry and clammy; the skin is dry and parched from 
diminished perspiration; the urine is scanty and high coloured, and there is 
generally constipation of the bowels, and the evacuations from them are 
generally dark and fetid. In a word, all the functions of the body are 
impaired. 
6. These are the leading characteristic symptoms of fever; from various 
causes and circumstances, there is an infinite number of variations and modi- 
fications ; but such are the most prominent features of this class of diseases. 
7. Fever is Primary or Symptomatic.-There should be a distinction made 
and kept in view between primary and symptomatic fever. First; Primary, 
when it does not arise from any other complaint. Second; When it does 
arise from some complaint, as injuries, -wounds, &c. 
8. Restoration of the Secretions.-It is exceedingly important, in a prac- 
tical point of view, ever to bear in mind the method invariably adopted by 
nature to cure a fever, which is the restoration of the secretions, and in most FEVERS IN GENERAL. 
217 
cases it is by sweat or perspiration. Without this knowledge, there will 
be error in practice. But when a practitioner is well apprised of this fact, 
he will at once know what indications to fulfil; in other words, what course 
of treatment to pursue. 
COMMON TREATMENT. 
The principal and almost only remedies (if such they may be called) re- 
sorted to by physicians in this day, are mercury, salts, bleeding, and blistering 
I shall not consume time here to descant on the impropriety and injurious 
t fleets of such practice: this has been farther exemplified in other parts of 
this work. It is sufficient here to observe that, instead of such treatment 
proving beneficial, by aiding nature to overcome the disease, it counteracts 
her salutary efforts, and either destroys the patient, endangers his life, or 
protracts his complaint; and should his constitution be sufficiently vigorous 
to withstand the combined influence of these " Herculean remedies," or, in 
other words, should the patient recover in spite of them and the violence of 
the disease, the subsequent effects injure or ruin his health. 
The practice is certainly absurd and irrational; and I ask, is it not prepos- 
terous in the extreme, and can it be supported by arguments, reason, ex- 
perience, or facts ? 
When a person is attacked with a fever, the whole sanguiferous system is 
stimulated or aroused to throw off or cast out the enemy, and she invariably 
points, as we before stated, to certain doors, outlets, or excretions of the sys- 
tem as the only natural and proper passages through which such enemy 
must be driven from the system ; and it is the province of the physician to 
aid her in this wise and well-established effort and intention; but when such 
means are made use of, instead of rendering her the necessary assistance, her 
powers and energies are entirely crushed, weakened, or diminished : first, 
by bleeding ; second, by administering a poisonous mineral, mercury, and 
thereby corrupting the fluids and inducing another dangerous disease, per- 
haps worse than the first. 
I am satisfied that mercury and bleeding in febrile, as well as other diseases, 
bring on a contaminated state of the blood, and dangerous, if not fatal, 
debility. 
REFORMED PRACTICE. 
General Indications of Cure.-Restore the suppressed evacuations, or the 
secretions and excretions. This will remove the offending or irritating 
cause; and when this is removed, the effect, or, in other words, the fever, must 
necessarily cease. In fulfilling this one indication consists the whole secret 
of curing febrile diseases. 
Particular Indications of Cure. 
1. Moderate the violence of arterial excitement. 
2. Obviate local inflammation and congestion. 
3. Support the powers of the system. 
4. Relieve urgent symptoms. 
The necessity of fulfilling all these indications must be borne in mind by 
the practitioner : in every modification of fever it becomes his duty to 
render himself an assistant of nature. * 218 
THE REFORMED PRACTICE OF MEDICINE. 
What she endeavours in the commencement of the disease to accomplish, 
is, to evacuate the deleterious agents by the proper passages. The whole 
business of art, therefore, is to assist her in these two efforts of secretion and 
excretion of the morbific matter. The manner of effecting this, in every 
particular species of fever, is given under their respective heads : but as we 
are treating of fever in general, it may be proper to give the general princi- 
ples of treating them, without entering into the various subdivisions or modi- 
fications. The treatment, however, here laid down is proper for all kinds 
of fever. 
The remedies which are to be given to assist the secretion and prepara- 
tion of the morbid and diseased matter, are, sudorific, diluting drinks and 
medicines, such as produce a determination to the surface, evacuate and give 
a healthy tone to the stomach and bowels, kidneys, &c. 
Secretions and Excretions.-I have already stated that the great secret of 
curing fever is the restoration of the secretions and excretions : the violence 
of the disease is just in proportion to their torpor or obstruction; and as soon 
as they are restored and perform their offices, the whole catalogue of symp- 
toms attendant on fever at once vanish, like fire before the watery element. 
When they are restored to their healthy action, how quick does con- 
valescence take place. The gastric, the alvine, the urinary, and perspiratory 
discharges and functions become natural; the heat of the system equalized ; 
the pulse falls to its natural standard, and with this decline of the febrile 
commotion there is a correspondent healthy action in every organ ; the 
appetite is improved, and strength and health is re-established. 
The Stomach.-When we reflect upon the extensive influence of the 
stomach over the system, and particularly the skin, we shall be able more 
readily to appreciate the utility of emetics in febrile diseases. It is by reason 
of this intimate relation and connexion between the stomach and every part 
of the system that the administration of an emetic proves so very effectual : 
it not only cleanses the stomach of any bilious, feculent, irritating, or 
morbific matter, but it proves eminently beneficial by the general relaxation 
which follows it, approaching sometimes almost to fainting, and which ex- 
tends to the skin, and produces perspiration. They may, as a general rule, 
be given where there is much nausea, and where there is no peculiarity of 
constitution to forbid. They are very serviceable in bilious, intermitting, 
and remitting fevers. 
An emetic, given in the commencement of a fever, will sometimes remove 
it at once. Even when the stomach has been thoroughly cleansed, the ex- 
hibition of an emetic may be advantageously given, in consequence of the 
shock and stimulating effect given to the stomach, liver, and neighbouring 
organs. Intermittent fever has sometimes been cured by a single emetic. 
In some diseases there appears to be such a morbid accumulation, that 
other medicines will not act upon the living fibre, and, therefore, this class 
of medicines becomes important as a preparatory step in the treatment. In 
typhus, and other modifications of fever, emetics may be beneficially admi- 
nistered. 
" In the typhoid and typhus pneumonica," says Potter, u that occasioned 
such lamentable mortality, of late years, throughout the United States, eme- 
tics, judiciously employed, were more beneficial than any other remedy. It 
was indeed a novel spectacle to those who were accustomed to unsheath the 
lancet in almost every thoracic affection, to behold a pneumonic fever, per- 
haps an heemoptoe, removed by the incantation of a single emetic." 
• " Emetics," says Dr. Chapman, " exhibited early in fevers, (bilious par- FEVERS IN GENERAL. 
219 
ticularly,) operating well, will frequently check an attack; and in the more 
advanced stages, judiciously repeated, we shall find by it the pulse reduced, 
pain in the head relieved, sickness of the stomach appeased, temperature of 
the surface lowered, with perspiration, which restores quietness and hastens 
a critical solution. 
This precept is strongly applicable to the bilious fevers of our own climate, 
and especially as they occur in the southern states, where they prove exceed- 
ingly intractable under any other mode of treatment." 
Sydenham has the following judicious remarks on the efficacy of emetics: 
" When I have happened," says he, " sometimes carefully to examine the 
matter thrown up by vomit, and found it neither considerable in bulk nor 
of any remarkable bad quality, I have been surprised how it should happen 
that the patient should be so much relieved thereby ; for as soon as the 
operation is over the several symptoms, viz., the nausea, anxiety, restless- 
ness, deep sighing, blackness of the tongue, &c., usually abated and went 
off, so as to leave the remainder of the disease tolerable." Wallace, com- 
menting on this passage, thus observes: " Sydenham was not aware 
of the sympathetic affections which take place in the constitution, nor 
knew that an extremely small portion of morbid matter could produce .effects 
so sudden and surprising from a local action, so as to derange the whole 
system." 
The Bowels.-The intimate relation which exists between the whole of 
the alimentary tube or canal, the skin, and other parts of the animal econo- 
my, points out the necessity of promoting in them a healthy action. 
Purgatives, therefore, have a decided good effect in fever. The preter- 
natural excitement of the bloodvessels is sensibly diminished by the exhibi- 
tion of purgatives. This effect takes place by removing the feculent matter 
which they contain, and by stimulating the exhalent vessels of the mucus 
membrane of the intestines, causing them to pour out copious effusions from 
the blood or circulating mass. Their importance must be seen in a striking 
view, when the length of the intestines is considered, which is about thirty 
feet, and also their office. There is an immense number of vessels opening 
into them through their whole extent, and from which there is poured out 
a vast quantity of feculent matter ; and when there is a preternatural stimu- 
lus given to the intestines by purgatives, there is a sympathetic affection of 
the whole system ; the circulation becomes more equal, the pulse is lowered, 
pain in the head and other parts diminished or removed, and there is a sen- 
sible improvement. Dr. Dewies has the following excellent remarks on the 
utility of purgatives in febrile diseases : 
u In fevers of almost every description purging is not only useful, but in 
many is indispensable. There exists constantly a want of equilibrium in 
the circulatory system whenever the body is attacked with fever, and the 
determination, for the most part, is to the brain, the liver, the spleen, or to 
the lungs; and few remedies are found so effectual in restoring this want of 
balance as well-chosen and properly adapted aperients. Besides the deter- 
minations just mentioned, fecal matter in the bowels is constantly accumu- 
lating, which it is of much consequence to remove. Occasionally there will 
be a redundancy of bile, at other times a deficiency; and we are obliged 
sometimes to remove the one, or to solicit the other ; and both of these ends 
are answered by the proper choice and exhibition of cathartics." 
What an absurd and dangerous treatment must that of Thompson be, and 
his followers, who reject purgatives, not only in this, but every disease. 
See Thompson's Guide to Health, Howard and Mattson's works; all of 220 
THE REFORMED PRACTICE OF MEDICINE. 
which inveigh much against this class of medicines, but highly extol emetics 
and steaming ! ! 
Repetition of Purgatives.-Purgatives may be repeated daily, and in the 
morning before any nourishment is taken, in those fevers which ordinarily 
run their course in a short time; such as inflammatory and yellow fever. 
In those of longer duration, such as typhus and other continued fevers, they 
may be given every other morning, or once in three days may be sufficient, 
(according to the state of the disease, and other circumstances,) provided 
no particular symptoms or state of the system contra-indicate. Moderate 
doses of physic in general are sufficient, except in the onset or commence- 
ment of a fever, when a brisk purgative may be administered. 
The Pores of the Skin, or Capillary System.-It appears that febrile dis- 
eases, in their very nature and essence, consist in a derangement of the skin 
or capillary system, and that no means will subdue a fever, until these func- 
tions are restored. We must be convinced of the necessity of this, from the 
extensive surface of the skin; its connexion with the stomach and sangui- 
ferous system, and its important office in casting off superfluous and noxious 
matter. It is calculated that two-thirds of what is taken into the system is 
evaporated by sensible or insensible perspiration. Hence it will be seen 
what mischief will arise from a retention of this perspirable matter, and what 
benefit will also follow by restoring this secretion. Another great benefit to 
be derived from perspiration is the evaporation that constantly takes place 
on the surface, which keeps the skin cool and soft. 
Diaphoretic or sudorific medicine, then, reduces general excitement, and 
is one excellent method of depleting the system. Evacuations from the 
skin invariably lessen the force of the heart and arteries, by taking from the 
circulation every agent which is useless or injurious; and,by relaxing the 
constriction of the surface, they remove congestions by a determination of 
blood to the extreme vessels ; and, in a word, lay the axe, as it were, at the 
root of the disease. 
No sooner does perspiration break out in a febrile patient, than there is a 
mitigation of all the symptoms; the dry, pale, and husky state of the skin 
is removed; the balance in the circulation is restored, and very often a vio- 
lent attack of fever is cut short as soon as free sweating takes place. The 
object then should be immediately to restore perspiration, and continue it 
throughout the course of the fever ; not violent sweating, but moderate per- 
spiration, or a gentle moisture of the skin. It is by this moisture, or the 
dry and parched state of the skin, that we form a favourable or unfavourable 
opinion of the fever. If natural perspiration cannot be promoted, we predict 
danger. On the contrary, if it can be promoted and kept up, we predict a 
favourable issue. Indeed, on this depends the basis of our prognosis. One 
reason why ablution or bathing the surface lessens the heat or fever of the 
system is, that the air which comes in contact with the skin conducts off the 
caloric or heat of the body, and gives us a sensation of cold. Dry atmo- 
sphere, with a dry state of the skin, is a bad or ?ion-conduction of heat, and, 
therefore, conducts off little ; but a moist atmosphere or skin is a good or 
quick conductor, and carries off the animal heat from the body very rapidly. 
This is one reason why bathing the surface has such an astonishingly bene- 
ficial effect in fever. 
Sudorific or sweating medicine must, therefore, be given, but not too freely, 
especially after a few first days from the accession or the attack. If those 
medicines, which are very stimulating, will not fulfil this indication, or will 
not answer the purpose, then others must be given, such as will bave the FEVERS IN GENERAL. 
221 
desired effect without increasing the heat of the body, as lobelia, Virginia 
snake-root, sage, lemon balm, catnip, amaranthus, &c. 
The following refrigerant or cooling drink I have administered with excel- 
lent effect: Take the juice of a lemon ; cream of tartar, supertartrate of 
potash, one tea-spoonful ; add a pint of water, and then sweeten with loaf 
sugar. Whenever the patient is thirsty, let it be freely drank. 
I recently cured a violent continued fever by giving this drink alone, and 
bathing the surface with weak ley water about three times a day. The 
effect wras almost immediate, and the fever removed in a very short time. 
The nature of the preparation, although simple, will convince the reader 
that it possesses very cooling or anti-febrile properties. It promotes the 
discharge of urine, is laxative, antiseptic, and refrigerant. 
Of late I have prescribed ipecac as a febrifuge, instead of the diaphore- 
tic poicders, as I think it best to give as few anodynes as possible. This 
article seems to act on the skin without increasing the fever, while it imparts 
a more healthy tone to the digestive organs-indications very important to 
fulfil in the treatment of every grade of fever. 
From three to five grains may be given three or four times during the 
day in the form of pill powder or wine tincture : a cup of catnip or other 
herb tea to be taken immediately after each dose. From the experience I 
have had of this root, I entertain a high opinion of its efficacy. 
The Kidneys.-When the kidneys cease to perform their offices, or do it 
imperfectly, the urine is scanty, or much diminished. This fluid is re- 
tained, carried into the circulation, and must prove a source of irritation ; and 
hence the necessity of restoring the secretion of them. 
Diuretic medicines, therefore, or such as promote a discharge of urine, 
must be administered; and it will be found that, as the urine begins to flow 
freely, there is diminished arterial excitement. It is the case, that fevers and 
other inflammatory diseases are brought to a favourable termination by a 
spontaneous discharge of this fluid. 
An infusion of spearmint possesses a remarkable diuretic property, and it 
may be drank freely. It not only acts upon the kidneys, but likewise upon 
the skin, and often allays nausea and irritability of the stomach. 
The Lungs.-The lungs is an organ to which strict attention must be paid. 
It is the prirnum mobile, or main-spring of the system; its office being to 
supply it with the vital principle. If this is withheld, or if they absorb im- 
pure air, the fever is exasperated. It is, therefore, necessary to place the 
patient in a large well-ventilated room. - 
The method of suppressing fevers by this means was practised by the 
ancients : they exposed their patients to cold air, and gave them cold water 
to drink. Fresh air is very salutary to a person in a fever ; it removes his 
anxiety, cools the blood, revives the spirits, and is in every view beneficial. 
There ought, therefore, to be a constant stream of fresh air in his chamber, 
so as to keep it moderately cool. Air that has been repeatedly breathed, 
when the blood is inflamed or the humours are in a putrid state, becomes 
unfit for respiration, and acquires a noxious quality. 
The lungs also become affected by sympathy; and where this is the case, 
irritation and cough succeed. Under such circumstances, expectorants must 
be given. 
Local Treatment.-Attention must be paid to particular symptoms, such 
as soreness of the throat, pain in the head or other parts, from congestion, or 
an unusual quantity of blood thrown upon some other organ; for sickness at 
the stomach, &c. 222 
THE REFORMED PRACTICE OF MEDICINE. 
The Surface.-A tenacious, viscid, perspirable matter is deposited upon 
the surface of the body in febrile diseases, which dries upon it, and becomes 
an additional means of keeping the pores closed or obstructed. The usual 
moisture being gone, as before-mentioned, a preternatural degree of heat is 
generated, which creates great distress and protracts the fever. This state 
of the system obviously points out the propriety and necessity of bathing the 
surface very frequently: it removes everything which obstructs perspira- 
tion externally, by relaxing the cutaneous vessels, and, by the evaporation 
which follows, diminishes the temperature of the body surprisingly. Nothing 
is better for this purpose than warm water with ley added. 
According to Sir John Chardin, the celebrated traveller, the Persian 
physicians (devoted followers of the Galenical school) had frequent recourse 
to bathing in febrile diseases. His own case is a remarkable example of their 
practice in particular. He had with him a French surgeon, who gave him 
every assistance in his power during the violent remittent fever with which 
Sir John was attacked ; but, on arriving at Laar, they concluded to send for 
the governor's physician. The latter, on his arrival, stated the nature of 
the disease, (the fever of Bender, or bilious remittent,) and, contrary to the 
gloomy prognostics of Sir John and his professional friend, promised a speedy 
cure. Chardin called out, " I am dying of heat." " I know it," said he, 
" but you shall soon be cooled." Chardin says : 
" The apothecary, who paid me the most constant attention, then procured 
two buckets of cold water, and having placed me on a chair, on which I 
was supported by two men, poured the water over my body little by little, 
from the haunches downward, and then, taking a large bottle of rose water, 
bathed, in the same manner, my head, face, arms, and breast. I blessed, in 
my heart, the Persian practice of medicine, which treated sick persons so 
voluptuously ! But our French surgeon, who was always by me, could not 
contain his indignation. ' The man is killing you, sir,' said he to me, in a 
compassionate tone. ' What! bathe you with cold water in the heat of a 
malignant fever, with a pint of emulsion, two pints of decoction, and a pound 
of confection in your belly, with I do not know how many draughts of snow 
water. Depend upon it,' added he, ' that, instead of being very soon without 
fever, as he has promised you, your death will be the end of the business.' 
' I do not know what will happen,' answered I, 1 but at any rate I do not 
feel as if I were about to die, as you suppose.' Indeed, at that moment I 
felt the heat within me diminish, and my senses return; upon which, my 
apothecary, having felt my pulse,.said, ' your fever is abating.' It went off 
from that time so quickly, that by one o'clock in the afternoon I was quite 
free from it, even in the opinion of the French surgeon. He was quite 
astonished, and I was transported with joy. Purgatives were also adminis- 
tered." 
I recollect attending a girl many years ago for typhus fever, where I 
ordered the nurse, in connexion with other means, to bathe the surface at 
night thoroughly with rain water mixed with ley.* I called in the morning, 
* It is very necessary that Icy should be added ; first, because the nature of the perspi- 
rable matter is such, being very greasy or oily, and being so tenacious and viscid, that it 
appears almost to cement or dose the pores ; or, at any rate, it adheres so closely to the 
surface that simple water will not effectually remove it. Ley, by its cleansing and purify- 
ing properties, completely removes it. Secondly ; it not only cleanses, but appears to soften 
the skin, and invites perspiration by its stimulating or relaxing nature. I have applied 
various liquids, such as spirits, vinegar, &c., but the skin is not left in the same state. 
Even pearl-ash water will not leave the skin so soft and moist. Besides, it seems more 
caustic and heating in its effects. Ley should be used which has been well leached, as it FEVERS IN GENERAL. 
223 
and found that the skin was very dry, parched, and shrunken, and heat 
great. I expressed my disappointment, and asked her if she had followed 
my directions ; she replied that she had : (a falsehood, by the by:) I could 
not, however, account for the symptoms, for I had never, in all my practice, 
been deceived in regard to the happy effect of this process. I, however, 
directed the same medicine to be given through the day, and the surface to 
be bathed at night, as before directed. In the morning I again called, and 
found my patient just as I anticipated the day previous, in a fine perspiration ; 
skin cool; arterial excitement, and, of course, the heat diminished, and all 
the symptoms manifestly better. 
The woman or nurse then had the candour to acknowledge the deception 
she had used. She said that she had not, as she before stated to me, bathed 
the surface the first night, as I directed it, from a supposition that it was too 
simple to do any good ; but that the preceding night she had strictly followed 
my directions, and had applied the liquid freely over the whole surface of 
the body; and the consequence was, as before intimated, a remarkable 
change for the better. Thus we see, from this circumstance, first, the folly 
and criminality of refusing to administer medicine because it is apparently 
simple ; and, secondly, the reprehensible conduct of those nurses who pretend 
to be wiser than the physician.* 
The Feet.-Every one knows that fevers are often occasioned by the ap- 
plication of cold to the feet, which drives the blood from the extremities 
and throws it upon some organ, or retains such agents as ought to be elimi- 
nated, in consequence of which fever takes place. Now, it must be evident 
that there is no better method of preventing the consequences than by re- 
calling the blood to the feet and surface, thereby preventing and removing 
fever, by bathing the feet in warm water, to which a small quantity of ley 
has been added. 
I am persuaded that bathing the feet immediately after exposure to wet 
or cold, in nine cases out of ten, will prevent an attack of fever, aided by 
drinking freely of warm catnip or other tea, and then covering warm in bed. 
Medicine.-All violent medicines are to be avoided in fevers, such as an- 
timony, mercury, or any other mineral whatever; also blood-letting. Na- 
ture attempts to do her office placidly and quietly in these cases, and such 
medicines violently disturb her motions, and often bring on mischief which 
she, if left entirely to herself, would wholly avoid. 
Rest and Quietude.-Lassitude or heaviness is generally the consequence 
of a recent fever; and this symptom evinces the propriety of keeping the 
appears to acquire new or different properties by the oxygen which it imbibes from the 
atmosphere. 
Not only so; I am inclined to think that the momentum of blood is diminished by the 
sympathetic effect produced by stimulating the cuticular vessels of the surface. It cer- 
tainly must effect the internal organs of the system directly or indirectly, from the fact that, 
if one function is deranged or healthy, there is a correspondent effect in others. 
* The following circumstance, in relation to this subject, will show how easily any im- 
provement can be introduced when it is sanctioned, or supposed to be sanctioned, by high 
authority. One of the graduates of our school, on his way home to West New Jersey, was 
taken ill of a fever in Philadelphia. He gave directions that the whole surface should be 
repeatedly bathed, which was attended with the most salutary effect. Those who attended 
him, however, were not aware that he was a student of our school; and the treatment, 
therefore, was taken up by a physician near the city, who, by some means, had heard of the 
effects of it; and, supposing that it was sanctioned by the medical faculty of Philadelphia, 
commenced the same process of bathing the surface, with decided benefit, in every case of 
fever under his care. Now, had he known the source from which it originated, he proba- 
bly would have rejected it, because not sanctioned by different, or orthodox authority. 224 
THE REFORMED PRACTICE OF MEDICINE. 
patient easy, and, if possible, in bed : lying in bed relaxes the spasms, abates 
the violence of the circulation, and gives nature an opportunity of exerting 
her whole force to overcome the disease. The bed alone would often 
remove a fever in its early stage. 
" The patient," says Dr. Fordyce, " is to be confined to his bed, where unne- 
cessary exertion is avoided, and the heat is equable over the whole body. 
The bed-chamber is to be large, and heated, when necessary, by fuel burn- 
ing in an open fire-place; or cooled by sprinkling the floor with infusions, 
vinegar, or distilled waters of some of the aromatic herbs." 
It is of the utmost importance that the patient lay upon a straw bed or 
mattress, as a feather bed increases the fever. 
The Mind.-If the patient's spirits, in a fever, are low and depressed, he 
should not only be supported, but every method should be taken to cheer 
and comfort his mind, by conversing on subjects that are pleasant and agree- 
able, and cautiously avoiding every syllable that may create uneasiness. 
Everything, indeed, that disturbs the imagination promotes the disease. In 
fevers every patient ought to be kept perfectly quiet, and not be permitted 
to hear or see anything which might discompose the mind. 
Drinks.-We have already hinted at the propriety of taking freely of 
diluent drinks, and this should by no means be neglected. Such kinds may 
be given as are pleasant and agreeable to the person, and such as are calcu- 
lated to keep up a moisture of the surface. Many of those kinds already 
used in domestic practice are very good, both in this and other countries. 
Cold or cool water may be taken at proper intervals and in proper quanti- 
ties when the heat of the body is uniformly above the natural standard, or 
when there is no chill or sensation of coldness. There has ever been a very 
popular prejudice against the use of cold water in fevers, and which ought 
to be put down. There are few articles in the whole materia medica which 
exert such an immediate and salutary effect in fevers as cold water ; but too 
great a quantity should not be taken into the stomach at a time, as it some- 
times overloads it and causes mischief. There are thousands of instances 
on record where nature has pointed out the cure by creating in the mind of 
the febrile patient an irresistible desire for draughts of cold water, and, when 
drank, it has been followed by the happiest effects ; by a remission of all the 
symptoms. Celsus directs large draughts of the coldest water in ardent fevers, 
and dwells with emphasis on the highly beneficial consequences of it. " The 
patient," says he, " falls into a sound sleep, the heat remits, and a free per- 
spiration ensues, though he had previously suffered much from thirst, heat, 
and restlessness." 
Vegetable acids are discarded by some as injurious, but without founda- 
tion. They moderate thirst, allay heat, and are very grateful and pleasant 
to the patient. Nothing of the kind is better than lemonade, which may be 
freely taken after the skin has become properly relaxed or perspiration takes 
place. Buttermilk mixed with water is a very nourishing and cooling drink. 
General St. Clair, who was once a physician, was wont to cure the scarlet 
fever by causing the patient to drink several times each day of buttermilk, 
moderately acid, and as much of buttermilk whey as the patient could take. 
This rarely, if ever, failed of a cure. 
Regimen.-The dictates of nature must be followed as regards food or 
regimen in fevers ; though the patient has the greatest inclination for drink, 
yet he seldom has any appetite for solid food ; hence the absurdity of urging 
him to take victuals: much solid food in fever is very injurious; it op- 
presses the stomach, and, instead of nourishing the patient, serves only to FEVERS IN GENERAL. 
225 
increase the disease. The food that is taken must be vegetable, very light, 
and easy of digestion. It should consist chiefly of panado, thin gruel, roasted 
apples, &c. 
Ripe fruit of every kind is excellent, such as apples, oranges, grapes, &c 
Cravings.-Particular attention should be paid to the cravings of a patient. 
They are often the calls of nature, and point out the remedy. 
They are not to be indulged in everything that their capricious appetites 
may desire ; but when any particular article is eagerly desired, it may be given, 
although it may seem not altogether proper. 
Convalescence.-Few are aware of the danger of a relapse in fevers. The 
lives of thousands have been lost for the want of proper care on recovering 
from a fever. The stomach and body is extremely weak, and hence will 
not bear much food or exercise, and in which convalescent persons are very 
liable to indulge. 
Nursing.-In vain will the best medicine be given without a proper nurse 
or person to administer it, and to attend faithfully to every duty of her office 
or business. It is very seldom that we find a good nurse as profitable and 
as important as the profession is. Some are ignorant, some careless and in- 
attentive. 
I know not but that I may say, that more depends upon a good nurse than 
upon the physician. It is the duty of the nurse to punctually administer the 
medicine prescribed, according to the directions given, (except they know it 
is poison,) and not to cheat the practitioner by throwing it into the fire, and 
then give their own nostrums or some others, and, when interrogated respect- 
ing it, dissemble and lie by affirming that it has been given. The practice is 
very reprehensible, no matter what kind of practitioner attends the patient. 
Let the physician be discharged, or follow his prescriptions. 
It is the duty of the nurse to pay strict attention also to the wants of the 
sick, to the medicines, drink, diet, &c.,that they be given in right quantities 
and at a right time; that the clothes of the patient and his bed be often 
changed and kept clean: also, that everything offensive be immediately re- 
moved. Let the room be kept well ventilated, clean, and quiet. 
It is not her duty to dictate and pretend to know more than the person who 
prescribes, nor to suffer a dozen gossips, or women, to associate together, and 
recommend new doctors, patent medicines, nostrums, &c., or to made use of 
any language calculated to excite distrust, unnecessary alarm or fear of the 
patient or friends. Great mischief is often done by such a course of conduct, 
and all classes of physicians suffer much by it. Nurses who are guilty of 
such deportment ought to be admonished.* 
* Would it not be a good plan for a number of respectable middle-aged females to associ- 
ate themselves together, and receive lectures or instructions from an experienced physician 
or nurse, and, after having become well qualified by theory and practice, to receive a certifi- 
cate or recommendation from the society 1 
This would inspire confidence in the public, or in the minds of the sick, and such nurses 
would command much more respect and better wages. 226 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER IV. 
INTERMITTENT FEVER, FEVER AND AGUE, OR CHILLS AND FEVER. 
(Febris Intermittens.') 
DESCRIPTION. 
The title of Intermittent, or chill and fever, is applied to that kind of fever 
which consists of a succession of paroxysms or periods of fever, between 
each of which there is a distinct and perfect intermission from febrile 
symptoms. 
Different names have been applied to this fever, according to the distance 
of time observed between the periods of its return; as first, second, third, 
and fourth, day ague. 
In intermittent fever it is obvious that the balance of circulation is lost in 
the system, the blood recedes from the surface of the body, and is thrown 
in an undue quantity, or accumulates, upon the deep-seated organs ; and some- 
times, when the disease has not been properly treated or cured, irritation or 
congestion may be the consequence, and so react on the system as to aggra- 
vate or continue it. v The most superficial observer must be struck with the 
remarkable retreat of the blood from the skin, and its accumulation upon the 
internal parts: there is great coldness, showing the absence of the blood, 
consequently the heat; the skin is pale and constricted, while the heart and 
arteries and internal organs are thrown into great commotion, and cause a 
powerful reaction to expel the offending cause; and our duty is clearly evinced, 
which is, to assist nature in her salutary efforts to restore the circulation, and, 
by tonics or strengthening medicine, to prevent a return of the paroxysms. 
Intermittents often prove obstinate, and are of long duration in warm 
climates; and they not unfrequently resist the common mode of treatment, 
so as to become very distressing to the patient, .and often give rise to other 
chronic complaints, but more particularly dropsical swellingsand an enlarge- 
ment of the liver or spleen. 
CAUSES. 
Marsh miasma, or the effluvia arising from stagnated water or marshy 
ground, when acted upon by heat, are the most frequent exciting causes of 
this fever. In marshes the putrefaction of vegetable and animal matter is 
always going forward; and hence it has been generally conjectured, that 
vegetable or animal putrefaction imparted a peculiar quality to the watery 
particles of the effluvia arising thence. It has been ascertained that marsh 
maisma, when much diluted with aqueous exhalation, as in summers where 
an unusual quantity of rain has fallen, are nearly inert; but when arising 
from stagnant waters of a concentrated foulness, in consequence of great 
drought and heat in the latter end of.summer and the early part of autumn, 
they act with great violence and malignity. 
It is found that persons residing constantly in the most healthy part of 
cities, and far from marshes, are sometimes attacked by them. 
Febrile miasma or effluvia may be wafted by currents of air to a distance 
far exceeding what has been supposed or admitted upon this subject. INTERMITTENT FEVER. 
227 
This disease may also be occasioned by debility, however induced, by a 
poor watery diet, damp houses, evening dews, lying upon the damp ground, 
watching, fatigue, depressing passions of the mind, &c. 
When the inhabitants of a high country remove to a low one, they are 
generally seized with intermittent fevers, and to such the disease is most apt 
to prove fatal. In a word, whatever relaxes the solids, diminishes the per- 
spiration, or obstructs the circulation in the capillary or small vessels, disposes 
the body to agues. 
One peculiarity of this fever is, its great susceptibility of a renewal from 
very slight causes, as from the prevalence of an easterly wind, or from the 
repetition of the original exciting cause. It would appear likewise that a 
predisposition is left in the habit, which favours the recurrence of the com- 
plaint. In this circumstance intermittents differ from most other fevers, as 
it is well known that after a continued fever has once occurred, and been 
completely removed, the person so affected is by no means so liable to a fresh 
attack of the disorder, as one in whom it had never taken place. Some- 
times intermittents degenerate into continued fevers, or affect other organs, 
as the liver, spleen, &c. 
SYMPTOMS. 
This disease may be divided into three stages, viz.: 1. The cold stage 
2. The hot stage. 3. The sweating stage. 
Cold Stage.-An intermitting fever generally begins with pain of the head 
and loins, weariness of the limbs, coldness of the extremities, stretching, 
yawning, with sometimes great sickness and vomiting; to which succeed 
shivering and violent shaking : respiration is short, frequent, and anxious. 
Hot Stage.-After a longer or shorter continuance of shivering the heat 
of the body gradually returns ; irregularly at first, and by transient flushes"; 
soun, however, succeeded by a steady, dry, and burning heat, considerably 
augmenting above the natural standard. The skin, which before was pale 
and constricted, becomes now swollen, tense, and red, and is remarkably 
sensible to the touch. The sensibility, diminished in the cold stages, is now 
preternaturally acute; pains attack the head, and flying pains are felt over 
various parts of the body. The pulse is quick, strong, and hard ; the tongue 
white, the thirst is great, and the urine is high coloured. 
Sweating Stage.-A moisture is at length observed to break out upon the 
face and neck, which soon becomes universal and uniform. The heat falls 
to its ordinary standard ; the pulse diminishes in frequency, and becomes 
full and free ; the urine deposites a sediment; the bowels are no longer con- 
fined ; respiration is free and full ; all the functions are restored to their 
natural order; when, after a specific interval, the paroxysm returns, and 
performs the same successional evolutions, generally once in twenty-four 
hours. Sometimes in this fever there is more or less delirium. 
TREATMENT. 
Indications of Cure.-The indications of cure in the treatment of inter- 
mittents are, first, to put as speedy a stop as possible to the fit when it has 
taken place ; and, secondly, during the intermission to prevent its return at 
the usual or any after period, both by exciting a new or healthy action in 
the system, by administering certain remedies at the commencement or 
immediately before the accession of the cold fit, thereby destroying the mor - 
bid action induced by the disease. 228 
THE REFORMED PRACTICE OF MEDICINE. 
In the proper treatment of this complaint two classes of medicines are 
indispensably necessary; and to the omission of these the failure of a cure 
must be imputed : first, a tonic ; second, a stimulant; and often an emetic. 
A combination of these breaks up the disease, and renders the cure speedy 
and permanent. 
It is seldom we see a radical cure in fever and ague under the common 
treatment, or by any of the numerous and costly nostrums so highly extolled. 
But I am confident that the course here laid down will be found infallible, 
except the disease is complicated with some other affection. 
It will be necessary, in treating intermittent fever, first to cleanse the 
stomach and bowels. A purgative often will be sufficient; but the soonest 
and the most effectual method of curing the complaint is, to administer first 
an emetic. The liver and stomach are in a very morbid condition, viscid 
phlegm and bile being discharged by vomiting. For this purpose give the 
following: Take common emetic, two parts ; capsicum, {cayennepepper,} one 
part; of this give half a tea-spoonful, mixed in plenty of water or herb tea, 
every twenty minutes, till nausea or vomiting takes place. A little boneset, 
pennyroyal, chamomile, or other herb tea may be given to aid the operation. 
This is to be given before the cold stage, and it may break up the disease at 
once. In cases where the capsicum cannot be taken, the emetic may be 
given without it, or half the quantity may be given, sufficient only to cause 
a little nausea or sickness.* 
Emetics not only cleanse the stomach, but increase perspiration, and all 
the other secretions, which render them of such importance that they often 
cure without any other medicine. 
Should any peculiar temperament, debility or state of the system, render 
it injudicious to administer an emetic, it must be dispensed with, and a 
moderate purgative given. Take mandrake, or May-apple root, {podophyl- 
lum peltatum,} pulverized ; cream of tartar, {super, tart, potassce,} equal 
parts. 
Of this powder give an ordinary sized tea-spoonful. Let this be put into 
a tea-cup or tumbler, and a small lump of loaf sugar added. Add a gill of 
boiling water, or it may be given in any syrup. Let the whole be taken at 
a dose. This will cleanse the stomach and bowels, and prepare the system 
for tonics. Those who prefer, may take the anti-bilious physic. 
Cold Stage.-Should it be necessary to prescribe at, or just before, the 
accession of the cold stage, it will be desirable to diminish its force and to 
lessen its duration; for on this circumstance will depend the continuance 
or duration of the other stages of the complaint. If suitable means are used 
to cut it short, the hot and sweating stages will be proportionably short, and 
often the disease entirely cured. To this end, in addition to the emetic or 
purgative, let stimulating and warm teas be freely taken, such as catnip, 
Virginia snake-root, infusion or tea of boneset and peppermint, all of which 
are calculated to answer this purpose. The person may be covered with 
warm clothing, heated bricks may be placed to the feet, and every means used 
to promote perspiration. 
Hot Stage.-As soon as the cold stage is terminated this treatment must 
be reversed : the bed-clothes must be removed, and, instead of giving warm 
infusions, cold drinks may be given. Lemonade is very grateful, and par- 
* Every formula or prescription, the component parts of which are not mentioned, will be 
found under the head of Pharmacy or Compounds. INTERMITTENT FEVER. 
229 
ticularly cold water, both of which may be freely taken. This course will 
allay the febrile excitement. 
Sweating Stage.-During this stage warm and cold drinks must be with- 
held, and those that are tepid given. 
Intermission.-During the intermission of the fever such medicines must 
be taken as will prevent a recurrence of the paroxysm. 
Many practitioners rely almost wholly on the salts of bark, (sulphate of 
quinine,) but there are objections to the general use of this article. Some 
has been found to contain arsenic, and the use of it has been followed by 
swelling of the face, spleen, liver, &c. There is another objection. The 
disease is very liable to recur, upon slight exposure or fatigue: besides, 
quinine is sometimes adulterated. When all other means have failed, I have 
found the tonic ivine tincture almost, if not quite, infallible. 
The patient will take of this tincture from half a wine glass to a wine 
glass full every two or three hours during the intermission. This treatment 
cures in a very short time, usually in one or two days. 
Vomiting.-Sometimes in intermittent fever there is great irritability of 
the stomach ; vomiting ensues, and prevents the operation of those medicines 
that are necessary to effect a cure or to remove it. When this is the case, 
dissolve one drachm of sal teratus (bicarbonas potassse) in eight ounces of 
peppermint water, or, as a substitute, in the same quantity of a tea or infu- 
sion of peppermint. Of this give an ordinary sized table-spoonful, sweetened 
with loaf sugar, every half hour, or as often as vomiting occurs. Should 
this preparation fail to check the vomiting, (which is seldom the case,) then 
add to every table-spoonful of it five drops of laudanum, tincture of opium. 
Should the above medicines, from debility or any other cause, be rejected, 
the following may be taken : Take pure salts of bark, or quinine, {sulphate 
quinina,') one scruple ; capsicum, one scruple ; mix : divide into ten powders. 
Let one be taken in currant jelly or sweetened water, or any other vehicle, 
every two hours while the person is free from fever. It is scarcely neces- 
sary to state, that these bracing or tonic preparations are to be discontinued 
upon an accession of the chill. 
This course of treatment must be repeated until the complaint is removed. 
The intermittent fever sometimes attacks infants and children. When this 
is the case, the quinine can be administered more easily than any other pre- 
paration, particularly in the following liquid form, which deprives it of its 
hitter taste : Take sulphate of quinine, sixteen grains ; loaf sugar, a suitable 
quantity ; water, two ounces ; mix. The dose is a tea-spoonful every two 
hours for a child between two and five years of age. 
It is sometimes the case that the chill is almost wholly or entirely removed, 
but some fever and much debility remain. When such symptoms occur, an 
emetic must be given every two or three days. This will give tone and 
energy to the stomach, and restore the patient to health. When the chills 
and fever subside, give a purgative. 
Various other medicines have been highly extolled for the cure of inter- 
mittent fever, but we have tried most of them with little or no success- 
such as cobweb, coffee, opium, spiders, spirits, the juice of gourds, &c. 
These nostrums should be carefully guarded against. 
A lady in South Carolina was recommended to take the latter article 
namely, the juice of the gourd, which soon proved fatal. 230 
THE REFORMED PRACTICE OF MEDICINE. 
REGIMEN. 
In the intermission, or between the paroxysms, the patient must be sup- 
ported by nutritious diet, such as is easy of digestion. Vegetable food is 
preferable. He may take infusions of bitter herbs, such as 'boneset, snake- 
root, chamomile, or wormwood. The patient may also take exercise as much 
as his strength will permit: nothing tends more to protract the intermit- 
tent fever than indulgence in idleness. Small quantities of mustard and 
cayenne pepper may be taken as condiments with food. 
Hundreds of cases might be mentioned of the efficacy of the foregoing 
treatment, many of which had been treated by various physicians without 
any benefit. 
I recently cured a person who had laboured under this disease for two 
years, and who had been attended for a length of time by a Homoepathic 
doctor, by the following treatment: I first cleansed the stomach and bowels, 
and then prescribed the following: Spirituous extract of best red or yellow 
Peruvian bark, one part; capsicum or cayenne pepper, one part; incorpo- 
rate or mix well together : a few drops of the oil of cloves may be added. 
Then form into pills size of a common pea, (which is four grains.) Dose, 
two or three, morning, noon, evening, and bed-time, in the absence of fever. 
In order to prevent a relapse, the same medicine that removes it should be 
continued for some time, but half the quantity will be sufficient. Night 
air, fatigue, and a hot sun must be avoided, and proper diet should be taken. 
There are few diseases more fully under the control of remedies than 
this ; and yet it is very often badly treated by ignorant and injudicious prac- 
titioners, until some of the vital organs become dangerously diseased. Pro- 
per care and diet, with a little of the wine bitters twice or three times a 
day, will prevent an attack of the disease. 
It is very necessary, in order to effect a cure, that the medicines be ge- 
nuine. For want of this, the best treatment will fail. What is sold for 
Peruvian bark is often so very much adulterated that it can be had for ten 
cents per pound, pulverized; while the best quality, (the red,) course, is 
worth two dollars. The quinine is also adulterated ; some has been found 
to contain only one-sixth of the genuine article. It is best to purchase the 
bark in its crude state, and pulverize it; and when quinine is bought, pro- 
cure it of a person who may be relied upon. When the Peruvian bark is 
purchased in powder, the yellow is preferable, as it is unlikely to be adul- 
terated, on account of its being cheaper. 
CHAPTER V. 
REMITTENT FEVER. (Febris Remittens.') 
DESCRIPTION. 
By a remittent fever is to be understood that modification of fever which 
abates, but does not go entirely off'before a fresh attack ensues ; or, in other 
words, where one paroxysm succeeds another so quickly, that the patient 
is never without some degree of fever. REMITTENT FEVER. 
231 
CAUSES. 
Remittent fever is principally induced, as well as the intermittent, by 
exhalations from marshy ground or from stagnant water, impregnated 
with the decaying remains of animal and vegetable substances, and is 
most apt to arise when calm, close, and sultry weather quickly succeed 
heavy rains or great inundations. It is very prevalent on the borders 
of our great lakes, and on the rivers in the western and south-western sec 
tions of our country. In warm climates, where great heat and moisture 
rapidly succeed each other, the remittent is a very prevalent type of fever, 
and often appears under a highly aggravated and violent form, prevailing 
epidemically. It is likewise often met with in low marshy situations, 
abounding with vegetation and water, from which miasma or effluvia are 
consequently evolved ; and it most generally attacks those of a relaxed habit, 
those who undergo great fatigue, and those who breathe an impure air, and 
make use of a poor and unwholesome diet. Although this fever is produced 
originally by marsh miasma, and in its simple state is, consequently, not of 
an infectious nature, still, under bad management, such as crowding too 
many sick together, and neglecting proper cleanliness and a free ventilation, 
there cannot be a doubt that it may, in its course, engender a matter capable 
of occasioning a highly contagious fever. 
The remittent fever is the same disease everywhere in the neighbour- 
hood of low, swampy, or marshy grounds, which are subject to be over- 
flowed by the freshets after great rains, or to be covered occasionally by in- 
undation from the sea, which cannot be drained by any other means than 
evaporation by the heat of the sun. Dead fish, left upon the overflowed land, 
become putrid, and animal and vegetable life destroyed by the salt water in 
the various insects, reptiles, and the smaller order of animals, and the different 
vegetable productions which happen to be covered by it, and the noxious 
effluvia which must arise from such accumulation of putrefaction, produce 
the worst kind of remittent fevers. It has been shown by travellers that 
certain marshes on the borders of the Mediterranean receive, and are mixed 
with, the salt water. The mixture of salt and fresh water thus formed, and 
which in summer was rarely changed, became corrupt, and spread infection 
of the most destructive kind over the neighbourhood; and in this way the 
disease was produced annually, with all its peculiar horrors. One single 
night in August or September proved fatal to the incautious traveller. This 
continued till the sea was excluded by gates, which has put a stop to the 
scourge ever since, and these part are now healthy. 
In a narrative of an expedition into the interior of Africa by the River 
Niger, one of the company thus remarks: " The principal predisposing causes 
of the awful mortality were the sudden change from the open sea to a nar- 
row and winding river, the want of a sea-breeze, and the prevalence of the 
deadly miasma, to which we were nightly exposed, from the surrounding 
country. The horrid, sickening stench of this miasma must be experienced 
to be conceived. No description of it can convey to the mind the wretched 
sensation that is felt before and after daybreak. In these accursed swamps 
one is oppressed bodily and mentally with an indescribable feeling of heavi- 
ness, languor, nausea, and disgust." It is owing to the swamps and rivers 
in the south and west, charged with vegetable decomposition and putrefac- 
tion, that there is so much fever. I saw a letter from Illinois, which stated 
that nearly all the population on one of the rivers had been swept away by 232 
THE REFORMED PRACTICE OF MEDICINE. 
SYMPTOMS. 
An attack of a common remittent fever is very similar to that of an inter- 
mittent. Preceding the attack the person usually feels heavy and languid, 
anxiety, sighing, yawning, and alternate fits of heat and cold. In the com- 
mencement he experiences pain in the head and back, heat of the whole 
system, thirst, difficulty of breathing, and great dejection of spirits. The 
pain of the back and legs is very similar to the inflammatory rheumatism. 
The eyes and skin assume a yellow tinge, pain and a sense of fulness about 
the region of the stomach, nausea, and sometimes vomiting of mucous or 
bilious matter. The urine is scanty and of a yellowish colour, and the skin 
usually very dry and hot; after these symptoms continue for a short time, 
a gentle perspiration takes place, and the fever abates, or goes off imperfectly, 
but not so as to leave the patient free from some fever. This remission con- 
tinues perhaps not more than an hour or two. The fever then commences 
again as severe as before, and perhaps worse; and, after a short period, again 
abates and gives place to another remission. In this manner, with accessions 
and remissions, it proceeds at last to a crisis, or is changed into a fever of a 
different type. In warm climates the remissions often occur so early as the 
second day; but in cold ones it frequently does not take place until from the 
fourth, the sixth, or eighth day. 
Sometimes the attack of fever is much more violent in all its symptoms ; 
severe delirium arises, and soon carries off the patient, or the remission is 
scarcely observable, and is succeeded by another paroxysm, on which all the 
symptoms are much aggravated. The heat of the system is much increased, 
countenance flush, thirst very great, tongue coated with a dark brown fur, 
breathing laborious, and the pulse quick, throbbing, and tremulous. Some 
time after, another short but imperfect remission occurs, but the fever returns 
with greater violence, and finally destroys the patient. 
That the reader may have an opportunity of witnessing the symptoms of 
the remittent fever as it occurs in various sections of the United States, and 
under different circumstances, we subjoin a letter from Dr. Norcum, Edenton, 
(N. C.) 
" The annual remitting fever of Edenton, and the country in its vicinity, 
usually begins with the month of August, and I have remarked that the most 
malignant cases always occur in this month, or during the hot weather of 
September. As the autumn advances and the heat decreases, fevers of 
every grade seem disposed to assume more and more the character of inter- 
mittents, which generally conclude the sickness of the season. The remit- 
ting fever with us, as far as I have been able to ascertain, is most fatal in 
seasons tending to dryness and accompanied with unusual heat. In its 
character and symptoms it is as various as the circumstances of the climate 
and season under w'hich it exists. Sometimes persons are seized violently, 
without any previous indisposition, with a chill, or mixed sensations of heat 
and chilliness, that last for an hour or two, and are succeeded by a severe 
fever, with pains in the head and back, a full, hard, quick, and bounding 
pulse, great thirst, a hot and dry skin, hurried respiration, with redness or a 
muddy suffusion of the eyes, and a disposition to delirium. The stomach, 
in this form of the fever, does not seem to be affected with much sickness 
or nausea; yet vomiting is a frequent occurrence, and it is with difficulty 
that a patient can retain the least particle of food whatever. A sense of heat 
or burning is generally complained of, which is very distressing, and occa- 
sions everything to be thrown up that is swallowed, if it contains stimulus, REMITTENT FEVER. 
233 
or be in any way substantial. The exacerbations of the fever are oftenest 
quotidian, returning generally in the afternoon, and the intervals short, with 
an imperfect remission, without sweating, or any considerable abatement of 
pain. 
Bilious Remittent Fever.-Another form of remitting fever, which is the 
true bilious remittent of our climate, (continues Dr. Norcum,) comes on with 
a distinct chilly fit, of greater or less duration, and is succeeded by the ordi- 
nary symptoms of fever, with a frequent, full, and soft pulse, such as may 
almost always be felt in the paroxysm of an intermittent. It is not accom- 
panied with much acute pain, but great aching and restlessness, nausea, or 
vomiting, with ejections of bile, or matter exhibiting a bilious appearance. 
The type of this fever is generally that of a double tertain, having an exacer- 
bation one day in the afternoon, the next in the evening. Its remissions 
are more distinct than those of the inflammatory remittent. It is rarely fatal, 
and when it is, seldom terminates in less than from ten to sixteen or seven- 
teen days. Toward its close it sometimes puts on the garb of typhus, and 
does not end in death, or a recovery, in less than from twenty to thirty days. 
The fever last described is that which we usually meet with, which affects 
the greatest number of persons at a time, and is the least mortal of any of 
our continued fevers. Neither the inflammatory nor the bilious remittent 
is very fatal; the former, however, is much the more so, in the proportion 
I should suppose of at least three to one. It either ends fatally in from four 
to eight or nine days, or favourably somewhere between the eighth and thir- 
teenth, but is not unfrequently protracted to a later period: the fatal issue 
generally occurs early in the disease. 
The tongue in the bilious remittent is commonly furred and yellow; the 
skin likewise exhibits a yellow hue, which increases as the fever progresses : 
whereas, in the inflammatory remittent, the tongue exhibits the common 
febrile fur in most cases without yellowness, and the skin is hardly ever dis- 
coloured until about the close of the complaint. In two or three instances 
1 have known the surface of the body to turn yellow soon after death from 
the inflammatory remittent, when not the smallest discolouration had been 
observed before. The vomiting in one of these fevers, or forms of fever, 
(which you please,) is different from that which attends the other: in the 
first it occurs with little nausea or sickness ; is seldom attended with bilious 
discharges; affords scarce any relief, and is always increased by bark and 
stimulants. In the last it is preceded by great nausea, attended with large 
discharges of bile, which gives the patient relief." 
Discharges of blood rarely occur in either of these fevers; in one or two 
cases I have seen blood discharged from the gums. 
u I am not quite certain that I have ever seen the black vomit in any of 
our endemic fevers ; but a vomiting of black matter of various descriptions 
is no unfrequent occurrence. In 1799, when we had a true yellow fever in 
Edenton, I saw the genuine black vomit in several cases; but I do not be- 
lieve I have ever seen exactly the same thing since, though I confess I have 
seen perhaps half a dozen cases in wrhich my suspicions have been strongly 
excited. Haemorrhages from the nose and gums are occasionally met with 
in protracted cases ending fatally; and I remember one case of a malignant 
nature, in which a bleeding from the mouth took place, that ended in death 
in three or four days. Glandular swellings, so far as my observation has 
extended, have not been among the characteristics of any of our fevers. In 
most of the fatal cases of inflammatory remitting fever which have fallen 
under my notice, the heat of the skin has continued intense until a short time 234 
THE REFORMED PRACTICE OF MEDICINE. 
before dissolution, and the patient has expired in a paroxysm or exacerba- 
tion of fever. The bilious remittent, when about to prove mortal in a ma- 
jority of instances, puts on the garb of typhus, and terminates with the 
symptoms common in the last stage of that disease." 
Congestive Fever.-Says Dr. J. R. Canon: " In the first stage or commence- 
ment there are no other symptoms, unless a rare case, than those common 
to the most of our bilious fevers. There is, as is usual before the rising of 
the fever, a chill or coolness of the extremities, pulse becomes quick, though 
generally small. This coolness in the extremities continues, and advances 
as the pulse recedes. In a short time the pulse is gone ; cold, clammy sweat 
covers all but the chest. In most cases great thirst, stomach irritable, re- 
jecting everything, delirium, restless beyond measure, frequently sighing, 
hurried respiration, feeling no pain, say nothing's the matter, the arterial ac- 
tion very great, the cold pallid countenance, the great dew drops of death, 
admonish loudly that dissolution is near, and in a few hours the scene is 
over. So insidious is its approach, that neither the patient nor his friends 
become at all alarmed until the pulse is nearly extinct, and the patient cold 
and awfully restless. 
The doctor reaches, the patient is insensible to his situation-he has to 
work almost on a lifeless system. Thus I have found numbers, with all 
these aggravated symptoms, despaired of by all their friends, and some of 
them given up and left by the nurse. 
For four years your writer has been familiar with this form of disease, 
and has treated numerous cases, from mild to the most desperate; and he 
states, most unhesitatingly, that he has not lost one patient where he was 
the only physician; and more, he has practised eight or nine years, and has 
had all kinds of fever to which the lower part of Georgia and Florida was 
incident, without losing, one excepted only; and not more than five or six 
have died under his care in that time, where he only was administering. 
During the sickly season he did all that his strength would permit, and for 
two years past might have had more than two efficient men could have done. 
One has not been lost out of each hundred. 
Some will say, 'boasting-exaggeration.' If stating the simple fact be 
called boasting, let it be so. 
I defy the reverse to be proved-yea, I challenge an investigation. The 
destroying angel has passed over our country : doctor and patient have 
died ; but I am proud to state, among the numerous deaths I have heard of 
but one death under botanic treatment." 
TREATMENT. 
INDICATIONS OF CURE. 
1. Moderate the violence of arterial action, if too great. 
2. Remove the tension and obstruction in the capillary vessels of the skin. 
3. Cleanse the stomach and first passages, and restore a healthy action 
of the same. 
4. Restore the secretions and excretions. 
5. Support the strength of the system. 
In order to cure this fever, we must endeavour to bring it to a regu- 
lar intermission. To effect which, give, when indicated, emetics.- 
Vegetable emetics, in the first stages of the fever particularly, prove 
very serviceable. They not unfrequently disarm fever of the greatest part REMITTENT FEVER. 
235 
of its violence and malignity, and reduce it comparatively to a simple type, 
requiring afterward very mild means to effect a cure. Numerous cases 
might be cited to prove that suitable emetics have arrested the disease ; and 
not only in its forming stage, but after it has become fairly established. The 
common emetic may be given as directed, and occasionally repeated, according 
to the violence or duration of the disease. 
Purgatives.-It will be necessary, after the operation of the emetic, and 
when the sickness at the stomach has fully subsided, to administer the anti- 
bilious or mandrake physic. In cases where the tongue is very much 
furred or coated, and which is not removed by the use of the common anti- 
bilious physic, I have found mandrake very effectual, and the very best 
purgative. It has a specific action on the stomach, liver, and first passages ; 
removes the congested and morbid conditions of these organs more readily 
than any other agents with which I am acquainted. It seems to fulfil the 
very indication for which mercury is given. I have sometimes given equal 
parts of mandrake and the anti-bilious physic ; the dose of which is a com- 
mon tea-spoonful of the mixture. If the bowels are very costive, it may be 
given very soon after the operation ; otherwise a period of six hours may 
previously intervene. 
This purgative may be repeated every other day, or every third day, 
without reference to the state of the bowels, according to symptoms and 
circumstances. The benefit is derived, not so much from evacuating the con- 
tents of the stomach and bowels, as by expelling the morbid agents from the 
system, and by exciting a healthy action of the liver, stomach, and intestines. 
Sudorifics.-It is exceedingly important in this, as well as all other fevers, 
to attend particularly to the skin. This circumstance is lamentably neglected 
by physicians. Some pay little or no attention to it, but, like Dr. Sangrado, 
substitute bleeding. It is impossible to treat fever successfully, or to act 
as a servant of nature, without restoring the obstruction which invariably 
exists in the capillary vessels. It appears to be the first great effort of the 
system to fulfil this indication. Such medicines, then, must be given as will 
have the effect of producing perspiration. The feet must be frequently 
bathed in warm rain water, to which a suitable quantity of ley should be 
added : the patient may then take the sudorific drops, or diaphoretic powders, 
to be repeated every two hours until perspiration takes place. The infusion 
of catnip must be taken frequently and freely, to aid the operation of the 
medicine ; or a tea made of the holy or blessed thistle. These agents 
may be occasionally repeated, to continue perspiration: one or two doses 
generally is sufficient to cause sweating ; and when it has taken place, they 
must be omitted, and given occasionally to continue a moisture of the skin. 
They possess anodyne as well as diaphoretic properties. Hence they are 
useful in allaying the nervous irritation attendant on this type of fever. They 
may be repeated daily, in the same manner, if the fever does not subside, or 
the skin is very dry and parched, particularly in the first stages. It is some- 
times the case that in the middle and last stages of the fever the drops 
prove too stimulating ; the patient cannot bear them or anything of a similar 
nature. It then becomes necessary to substitute in their place such medi- 
cines as keep up a determination to the surface, without increasing the heat 
of the body. Under such circumstances ipecac, pulverized, may be given, 
about three grains in the form of pill, powder, or wine tincture, three or four 
times a day. I generally give a pill or two made up with a little mucilage 
of gum arabic or molasses, the size of a common pea; it should occasion 
no nausea: it is tonic and febrifuge. It is calculated to excite a healthy 236 
THE REFORMED PRACTICE OF MEDICINE. 
action of the stomach and first passages, which are always in a morbid 
condition, and is often a substitute for the diaphoretic powders. Some 
have objections to these as a constant medicine, on account of the opium 
they contain. Catnip or other herb tea, warm, may be drank after each 
dose ; it keeps the skin moist, without proving too stimulating. Give 
also an infusion of boneset (cold) through the day, and warm at night. 
Bathing the Surface.-Those who are unacquainted with the effects of 
bathing the surface, cannot appreciate its value, and it therefore must by 
no means be neglected. 
Rain or spring water may be used for this purpose, to which sufficient ley 
has been added as to render it mucilaginous or slightly caustic to the tongue. 
When the heat is very great, this may be applied over the whole surface. 
In general, it is best to apply it tepid or moderately warm, but in some cases 
it proves more serviceable to apply it quite cold. The manner of using it 
should be as follows: Place the vessel containing the liquid by the side of 
the patient's bed, then let an assistant or the nurse raise the clothes from 
the body with one hand, and with a piece of flannel or sponge, dipped in the 
liquid, thoroughly rub first one side of the surface, from the neck to the feet, 
with the other. The patient must then be turned upon the opposite side, 
and bathed in the same manner- This process is invariably attended with 
a salutary effect. It may be repeated as often as the heat of the system 
becomes very considerable, until a remission or partial remission takes place. 
This process removes the slimy, viscid, and perspirable matter which is 
thrown upon the surface, and which assists in obstructing the pores of the 
skin. It removes the tension and spasm of the capillaries by its relaxing 
properties. It likewise diminishes the preternatural heat by the evaporation 
which takes place. 
This effusion has been found productive of the most decided good effects 
in remittent fevers. This should be employed at the height of the paroxysm, 
when the sensations of heat are violent, the headache severe, and the skin 
dry. The effects to be observed from the effusion are, an alleviation of the 
violent symptoms, a tendency to quiet sleep is soon induced, the skin becomes 
moist, and a distinct remission follows. 
Diluents.-Various drinks may be given possessing diluent and diaphoretic 
properties, such as infusions of balm, slippery elm bark, mint, and catnip ; 
but few articles in the whole materia medica are of more essential benefit 
than cold water. The parched lips, dry mouth, intolerable thirst, and the 
great heat of the system, all call loudly for the use of this universal diluent 
liquid. It may be taken freely at all times, except when chills are present. 
Should it, however, produce any uneasiness or fulness of the stomach, it 
must be taken in smaller quantities, and repeated oftener. There are an 
infinite number of cases on record where the free use of w'ater internally and 
externally have cured fevers in their forming, and even advanced stages. 
Dr. A. Atkinson states that a physician, who had practised physic in 
Louisiana for forty years, informed him that he had found the mucilage or 
tea of slippery elm bark a very superior remedy for the fevers peculiar to 
that country, (such as bilious and other ;) that he had used little or nothing 
else for many years ; and they generally recovered. He thought no person 
would die of fever who could procure slippery elm. When w~e reflect that 
these diseases irritate, and often ulcerate, the mucous coat of the intestines, 
we must see the utility of administering this cooling and soothing drink. 
Nothing so soon reduces inflammation externally, and why not internally ? 
Lemonade may also be freely drank as a change, except when stimulating REMITTENT FEVER. 
237 
medicines are given to produce perspiration. In such cases it ought not to 
be taken, except when very warm. 
Anodynes.-When the patient is very restless and unable to sleep, ten 
grains, or a small tea-spoonful, of the diaphoretic powders to be taken in 
currant jelly or any other suitable vehicle. They are less stimulating than 
the drops before-mentioned, and, to fulfil this indication, answer sometimes 
a better purpose. They should generally be given at night. These powders 
not only have the effect of producing sleep, but likewise cause a moisture 
of the surface. 
Tonics.-I have often given tonics in fevers when there was some little 
remission, but have seen little or no benefit from them. There is one article, 
however, that may be given with benefit, which combines tonic and diapho- 
retic properties: Take Virginia snake-root, and add boiling water ; to be given 
occasionally through the day : an infusion of boneset may also be given. 
Having spoken of the general treatment of remittent fever, I shall now 
speak of particular symptoms. 
Headache.-There is usually great pain in the head, to relieve which the 
feet must be frequently bathed in warm water, and the following plaster or 
sinapism applied to them: Take Indian meal and mustard, equal parts ; add 
vinegar sufficient to form a plaster or paste. 
If the pain and heat of the head be great, apply the following lotion : Take 
spirits, vinegar, and rain water, equal parts; to a pint of which add a tea- 
spoonful of salt. Let this be repeatedly applied to the head, nearly cold. It 
is necessary to apply a cap or handkerchief over the head, to prevent a too 
speedy evaporation. 
Sickness at the Stomach.-This symptom is very common, and extremely 
distressing; to allay which give an infusion of spearmint, (mentha sativa.j 
Sometimes the peppermint given in the same manner proves even more 
serviceable. The same articles bruised and mixed with a small quantity 
of vinegar, and applied over the pit or region of the stomach, have proved 
very effectual. 
Should not this allay the vomiting, give the neutralizing mixture; ora 
little sal seratus may be dissolved in cold water, and given. 
The common soda powders, taken according to the directions printed upon 
them, will answer very well, if the above articles cannot be procured. 
Local Pains and Congestions.-When any particular part or organ is 
very much affected, apply a fomentation of bitter herbs. Should these not 
remove the irritation, a mustard plaster may be applied ; a little Indian meal 
to be added, to prevent the flesh from becoming excoriated. 
Canker.-If there are aphthous spots in the mouth, or if the throat is sore, 
let it be gargled with a decoction made of sage and hyssop, sweetened with 
honey, to which add a little powdered borax. 
Debility or Prostration.-Should there be great prostration of strength, 
the pulse low, wine whey may be given, pure wine, or wine sling, or yeast. 
Cough.-Should there be a cough, demulcent and mucilaginous medicines 
must be given, a decoction of hoarhound sweetened with honey, and such as 
are mentioned under this head. 
Mustard Plasters.-Many apply blisters in this and almost every kind of 
fever, but I think that they should be seldom applied. They are very tor- 
menting, often produce great excitement, and sometimes mortify. 1 have 
occasionally applied them when pain in the head, or any particular part, has 
been very great; but more recently I have used the mustard plaster in pre- 
ference ; I think it much better in every respect. 238 
THE REFORMED PRACTICE OF MEDICINE. 
The late Dr. Anthony Hunn, of Kentucky, a very aged and learned phy 
sician, has written a treatise against the common method of treatment in 
febrile diseases. He proscribes almost all medicine in a fever, and uses only 
a blister on the right side, over the region of the liver. The benefit, he 
says, depends upon the stimulus it gives to this organ. He deprecates the 
use of the lancet and mercury, after having practised about half a century 
upon the common or ordinary plan. In very severe cases of fever I have 
applied them just below the shoulder. 
Relapses.-It is of the utmost importance that the patient, as soon as a 
state of convalescence takes place, should use every precaution to prevent a 
relapse. His diet should be very spare and principally vegetable, and he 
should use moderate exercise. 
REGIMEN. 
The regimen must be adapted to the prevailing symptoms. When there 
are any signs of inflammation, the diet must be slender and the drink weak 
and diluting: but when nervous or putrid symptoms prevail, it will be 
necessary to support the patient with food and liquors of a more generous 
nature. 
The patient ought to be kept cool, quiet, and clean. His apartment, if 
possible, should be large, and frequently ventilated by letting in fresh air at 
the doors and windows; it ought likewise to be sprinkled with vinegar, 
juice of lemon, or the like. His shirt, bed-clothes, &c., should be frequently 
changed, and all his excrements immediately removed. 
When the above treatment has been strictly followed, I have never known 
it fail of curing this type of fever. I have been called to treat it in its vari- 
ous stages, and have uniformly found the same result from the practice. 
I have never found it necessary in any case to give a particle of mercury, 
or any other mineral, nor to bleed a single patient. 
The last two patients I attended for this fever were in a very critical and 
dangerous situation, but under the treatment here given they both recovered. 
They were very freely purged, and the surface most effectually sponged 
with ley water. In one case a coloured man, the nurse, employed as 
much force as in currying a horse ; the amendment was speedy, without 
prostration. 
CHAPTER VI 
INFLAMMATORY FEVER. (Synocha.) 
DESCRIPTION. 
This type of fever is characterized by great inflammation, intense heat, 
frequent, strong, and hard pulse, flushed countenance, redness of the face, &c. 
It may be readily distinguished from typhus, by its being attended with 
symptoms much more inflammatory. It makes its attacks at all seasons of 
the year, but is most prevalent in the spring. Persons of all ages and habits 
are subject to it, but more especially those in the vigour of life, with strong 
elastic fibres and plethoric constitutions. It is a species of fever almost 
peculiar to cold and temperate climates, being rarely met with in warm ones INFLAMMATORY FEVER. 
239 
CAUSES. 
Remote Cause.-This fever may be produced by a variety of causes, but 
cold is the most common ; and it is sometimes likewise occasioned by heat: 
also by intemperance in eating and drinking stimulating kinds of food and 
liquid, and whatever else causes plethora. Sudden transition from heat 
to cold is the most frequent cause of inflammatory fever : exposing the 
body in a state of perspiration to cold will bring it on; also lying on damp 
ground, drinking cold liquor when a person is very hot, repelled eruptions, 
suppressed evacuations, &c. 
Proximate Cause.-The proximate cause of this disease is seated in the 
sanguiferous or vascular system, in the heart, arteries, and capillary vessels. 
Cold checks perspiration, by which irritating perspirable matter is taken 
into the circulation, and stimulates the bloodvessels to an undue and in- 
creased action. 
• By reference to Eberle's practice, I perceive that he maintains a similar 
opinion of the proximate cause of inflammatory fever. He thus observes: 
" A large proportion of the recrementitious elements of perspirable matter 
must remain mingled with the blood, (unless speedily removed by the vica- 
rious action of some other emunctory,) and necessarily impart to this fluid 
qualities which are not natural to it. Most assuredly the retention of ma- 
terials which have become useless to the system, and for whose constant 
elimination nature has provided so extensive a series of emunctories as the 
cutaneous exhalents, cannot be long tolerated by the animal economy with 
entire impunity. The blood is the natural stimulant of the sanguiferous 
vessels, and we must believe that its stimulating qualities are naturally in 
due and harmonious relation with the sensibility and irritability of its appro- 
priate vessels. When, therefore, in consequence of suppressed perspiration, 
this fluid becomes surcharged with the elements of recrementitious perspira- 
ble matter, its natural relations with the heart, arteries, and capillaries will 
be destroyed, and irritation more or less intense must almost necessarily 
ensue." 
SYMPTOMS. 
The attack of inflammatory fever is generally very sudden, commencing 
with distinct rigours or chills ; the patient complains of debility, which is 
succeeded by dizziness and pain in the head, back, and more or less over 
the whole body. These symptoms are soon succeeded by redness or flush- 
ing of the face ; the eyes assume a red and unnatural appearance, and are 
intolerant to light. There is great throbbing of the carotid and temporal 
arteries, great restlessness, heat which is intense and biting, thirst, difficult 
respiration, and sickness at the stomach. The pulse is very full, hard, and 
quick, compressed with difficulty. If the attack is very severe, or if the 
fever'is not arrested in the beginning, stupour and delirium will intervene, 
particularly in the latter stages. The mouth, throat, tongue, and lips are 
very dry, and gradually become dark, the tongue of a scarlet colour at the 
sides, and furred with white in the centre. Occasionally there is a hzemorr- 
hage or bleeding from the nose ; there is sometimes yellowness of the skin, 
and it is very dry and parched ; swelling of the abdomen ; the urine is scanty, 
red, or high coloured; and there is usually constipation of the bowels. These 
symptoms undergo slight remissions and exacerbations-the first occur in 
the morning, the latter in the evening. 240 
THE REFORMED PRACTICE OF MEDICINE. 
This fever generally goes through its course in one or two weeks, and 
often terminates critically, by perspiration, diarrhoea, occasionally a slight 
haemorrhage from the nose, or a deposition of much sediment in the urine. 
The crisis is generally preceded by some change in the pulse. Sometimes 
it runs into typhus, particularly after mal-practice or bad management, such 
as copious blood-letting, mercury, &c. 
TREATMENT. 
Indications of Cure.-From the character of inflammatory fever, it is obvi- 
ous that our first attempt should be to diminish inflammation, and thereby 
prevent the mischief that may arise from it. 
Remedies.-To fulfil this indication, it is necessary to deplete the system, 
not by blood-letting, which will often bring on typhus and other serious 
consequences, but by promoting all the secretions and excretions of the sys- 
tem. This is the only proper method to reduce inflammation of any kind. 
The course pursued by physicians of the day protracts the complaint, injures 
the constitution, or endangers the life. 
Bleeding, so strenuously insisted upon, suddenly or subsequently " pros- 
trates the system into a state of collapse or debility, out of which the most 
potent stimulants will be hardly sufficient to raise the patient." 
Lieutaud, physician to Louis XV., in his synopsis of medicine, thus re- 
marks on blood-letting in inflammatory fever : 
" Repeated bleedings," as the illustrious Van Sweiten remarks, " are apt to 
bring on more vehement symptoms, or convulsions themselves, as has hap- 
pened in my own observation, even before the flow of blood was stopped. 
It is best, therefore, to avoid them, notwithstanding what some practitioners 
adduce to the contrary, who are used to accommodate themselves to the whims 
of the bystanders, and are never deterred by the unhappy event of things, 
so long as they can keep the confidence of the sick. Here, by the by, we 
may note that they shamefully mistake who persuade themselves that, by 
blood-letting, they answer the end of spontaneous and critical flows of blood, 
because it has been observed a hundred times that in every disease a certain 
critical haemorrhage is of more service than frequent blood-letting: besides 
that, a haemorrhage in this species of fever is for the most part dangerous." 
" I remember," says Eberle, (a strenuous advocate for blood-letting,) 
" with pain, the unfortunate lot of an amiable and intelligent friend. He 
was a man of a healthy constitution, and fond of indulging in the pleasures 
of the table. He was seized with simple synochal fever from cold. His 
physician bled moderately ; the fever went on unchecked ; he bled again 
and again daily: after the seventh bleeding there was still too much quick- 
ness and tension in the pulse; the lancet was inserted the eighth time, and 
the patient almost immediately sunk into a state of collapse. Stimulants, 
both external and internal, the most diffusive and potent were now diligently 
applied, but all in vain ; he lived but a few hours longer." 
" In Italy," says the same writer, " the most violent inflammatory fevers 
are treated, and, according to the published reports, with success, by large 
and frequent doses of antimony, without any direct depletion whatever. " By 
this statement alone it is evident that this fever can be treated successfully 
without any bleeding, and even by a very inferior remedy. 
I shall now lay down the course of treatment to be pursued in this variety 
of fever ; and the first medicine to be given, whether there be costiveness or 
not, is our common purgative. INFLAMMATORY FEVER. 
241 
Of this powder give a common tea-spoonful (about one drachm) in molasses, 
currant jelly, tea, or any other convenient vehicle, every two hours, until free 
purging is produced. Any warm tea will aid the operation of it. This will 
lessen the heat, lower the pulse, remove the pain of the head and other 
parts. After the effect of this has fully subsided, let sudorifics be admi- 
nistered. The sudorific or sweating drops may be given every two hours in 
a tumbler of catnip tea, until the patient perspires freely. 
In the next place let the whole surface be well bathed with tepid alkaline 
wash, (weak ley,) and let it be repeated three or four times ■within twenty- 
four hours, or as often as the skin becomes dry and parched. The very first 
bathing generally removes that biting heat usually attendant on this fever. It 
diminishes pain and arterial excitement, and, by its stimulating effect on the 
capillary vessels, promotes perspiration, and, in short, has a salutary effect on 
the whole system. 
Farther, to equalize the circulation, let the feet be well bathed in the above 
mixture of ley and water; after which let a sinapism or a poultice be ap- 
plied to the soles of them, made of Indian meal and mustard, mixed with 
vinegar. Should there be great pain in the head, let it be bathed with equal 
parts of spirits, rain water, and vinegar, to which must be added a small 
quantity of salt. It will be necessary also to give diluent drinks or infusions. 
An infusion of catnip is excellent; also an infusion of elder flowers: cream 
of tartar water may be occasionally drank ; it is refrigerant or cooling, laxa- 
tive, and acts upon the urinary organs. A writer on this fever has the fol- 
lowing remarks: 
" Almost every person in a fever complains of great thirst, and calls out 
for drink, especially of a cooling nature. This at once points out the use of 
water and other cooling liquors. What is so likely to abate the heat, attenu- 
ate the humours, remove spasms and obstructions, promote perspiration, in- 
crease the quantity of urine, and, in short, produce every salutary effect in 
an ardent or inflammatory fever, as drinking plentifully of water, thin gruel, 
or any other weak liquor of which water is the basis ? The necessity of 
diluting liquors is pointed out by the dry tongue, the parched skin, and the 
burning heat, as well as the unquenchable thirst of the patient. 
In inflammatory fevers, where the thirst is great, the following forms a 
grateful and cooling beverage: Take cream of tartar, (supertart, pot.,') half 
an ounce ; white sugar, q. s. ; hot water, three pints. Half a pint or more 
may be drank as occasion requires. 
There is usually great restlessness and wakefulness, and it is, therefore, 
necessary to give an anodyne, combined with a diaphoretic medicine. To 
fulfil this indication, nothing is better than the diaphoretic powders; they 
procure refreshing sleep, and at the same time promote perspiration. Ten 
grains may be given every night in any suitable vehicle. These medicines 
must be repeated until the fever terminates or subsides; or the ipecac pills 
or powders may be given three or four times a day. 
If it is very violent, a purgative may be administered every day, and at 
farthest every other day. Sufficient of the diaphoretic powders must also 
be administered, to keep up a gentle perspiration. 
After this course has been pursued two or three days from the accession 
of the fever, should the pulse continue tense and full, give the tinct. of fox 
glove, (digitalis.) Fifteen drops may be taken three times a day, in a tum- 
bler of an infusion or tea made of balm or catnip. An infusion or tea of the 
holy or blessed thistle may be freely drank. This herb is in great repute as 
a febrifuge. Fox glove, given in the form of infusion, possesses the power 242 
THE REFORMED PRACTICE OF MEDICINE. 
of reducing vascular action and lessening general excitement. It diminishes 
the irritability of the system, increases the action of the absorbents, and also 
the discharge of urine. 
Ferrier considers digitalis a substitute for the lancet in all diseases. " It 
is well known," says he, " that bleeding is very inadequate to the purpose 
of lessening the velocity of the circulation, unless it be carried to a danger- 
ous excess. The fox glove furnishes us with the means of regulating the 
pulse to our wish, and of supporting a given state of velocity as long as we 
judge it proper." 
REGIMEN. 
The patient's diet must be very little and very light. Nutritious liquids 
should be given, such as Indian meal gruel, panado, toasted bread water. 
Ripe fruits, roasted apples, currant jelly, &c., may be given ; but nothing of 
a heating or stimulating nature should be allowed, except there be great 
prostration in the latter stages of the complaint; wine sling and wine whey 
may then be given. Fresh air must always be admitted to the patient, using 
due precaution that a current of air be not permitted to reach the patient; it 
must be broken by curtains or window-blinds. 
The patient must not be loaded with bed-clothes, under pretence of sweat- 
ing him or preventing him from taking cold ; such a practice increases the 
fever, debilitates the patient, and retards, instead of promoting, perspiration. 
The patient may be allowed, if the strength will permit, to sit up in bed ; or, 
if not able, let his head and shoulders be elevated by means of a chair. 
Cleanliness must be regarded. The chamber may be sprinkled with vine- 
gar. The patient's mouth should be often washed with a little wine and 
water, or equal parts of vinegar and water, sweetened with honey. The 
forehead, temples, and hands may be frequently bathed in vinegar ; this is 
very refreshing and grateful to the patient. 
All noise and disturbance should be avoided, and the patient kept as quiet 
and still as possible. Persons should not be suffered to be in the chamber 
talking and whispering ; it disturbs the mind by creating fears and suspicions. 
Let there be few attendants in the room. Should there be a great desire for 
any particular kind of drink or food, it may be given. 
Convalescence.-There is great danger of relapse when the patient becomes 
convalescent; the appetite becomes keen, and the patient is very apt to in- 
dulge it, by overloading the stomach; the digestive organs being weak, a 
relapse is brought on, which very often proves fatal: little should be ate at a 
time, and that ought to be very light and nutritious. If the appetite should 
not return, an infusion or tea of chamomile or Virginia snake-root may be 
drank occasionally through the day. 
Fresh air, gentle exercise, and the moderate use of good wine will greatly 
contribute to the recovery of convalescents. 
The depletion or evacuation induced by this treatment will be found quite 
sufficient: it will generally cure the fever in a few days, without any of those 
injurious effects consequent on the common practice. SIMPLE CONTINUED FEVER. 
243 
CHAPTER VII. 
SIMPLE CONTINUED FEVER. (Synochus.) 
DESCRIPTION. 
This fever was formerly known and distinguished by the name of " Long 
Fever." A combination of inflammatory or synochal, and typhoid or putrid 
symptoms, constitutes simple continued fever. An inflammatory type prepon- 
derates in the commencement, and nervous or typhoid in the latter stages. 
CAUSES. 
Cold is the most frequent cause of this as well as other types of fever. It 
may also be occasioned by a morbid condition of the biliary organs, stomach, 
and alimentary canal. 
Whatever has a tendency to debilitate the system, may act as a predis- 
posing cause of continued fever. Hence we find it arises from great ex- 
ercise or fatigue, violent exertions, intemperance, and certain kinds of 
diet, as well as too great indulgence in sensual pleasures. It may like- 
wise be produced by the suppression of some customary evacuation, certain 
passions, &c. 
The most prolific cause is the application of cold to the system, pro- 
ducing a check of perspiration. It would appear that much depends upon 
the peculiar nature or circumstances of the cold itself, as well as the person 
to whom it is applied, the degree or intensity of cold, the continuance of it, 
manner of its application, its being accompanied with moisture, also a sudden 
transition from heat to cold. It may be occasioned likewise by breathing 
vitiated or contaminated effluvia, directly or indirectly from the body of a 
person labouring under the disease. 
The peculiar gas or excretions proceeding from a diseased person floats 
in the air, and, being inspired or inhaled, is capable of generating this kind 
of fever. It is well known that human effluvia, or the effluvia arising from 
the human body, if concentrated, and is not permitted to mix with the air, 
and thus become diluted from want of cleanliness and free ventilation, is 
sufficient to create a fever of great malignity, and, when taken into the sys- 
tem, actually creates a specific disease. This is unquestionably the case in 
typhus. Emanations from animal and vegetable substances, in a state of 
decomposition or putrefaction, may also cause this fever. Marshy, or that 
kind of soil the bottom of which is clayey, and which retains for a great 
length of time an unusual quantity of water, being acted upon by heat, 
emits or sends forth noxious effluvia, which proves a prolific source of fever 
of various types and grades. 
SYMPTOMS. 
The first symptom of this fever is a considerable degree of debility, inac- 
tivity, heaviness, yawning, and stretching ; a sensation of cold is now felt in 
the back and over the whole system, which increases till a regular chill over 
the whole body succeeds. There is nausea or vomiting, little or no taste 244 
THE REFORMED PRACTICE OF MEDICINE. 
in the mouth, oppressed and frequent respiration, pulse increased, and there 
is some confusion of intellect. After a short time the cold stage, which is 
characterized by these symptoms, decreases or becomes less violent, and is 
alternated with flushings, and finally subsides, and is succeeded by a preter- 
natural degree of heat diffused over the whole system; there is redness of 
the face ; also a dull, heavy, or throbbing pain in the head ; oppression at 
the chest, and sickness at the stomach ; the skin is dry, hot, and parched, 
with some degree of colour or redness; the pulse is full and frequent, 
beating perhaps a hundred strokes in a minute ; the patient complains of 
great restlessness; is fretful, and manifests some confusion of mind. The 
tongue, which is at first white, gradually loses this colour, and as the disease 
advances it becomes dry and dark. The urine is usually scanty and high 
coloured, sometimes pale ; there is likewise great thirst and costiveness. 
If the attack is very severe, there is a great determination of blood to the 
head, which causes delirium. In this and other kinds of continued fevers 
there is usually an increase of all the symptoms toward evening. 
These symptoms generally go on about a week without any particular 
change, except very slight remissions and exacerbations, which take place 
in the morning and at night. As the disease advances, however, it becomes 
more seated, unfavourable and dangerous in its character. The inflammatory 
symptoms in a considerable degree subside, and typhoid symptoms manifest 
themselves, or great prostration, attended with delirium, lethargy, furred 
dark tongue, fetid breath, sordes about the teeth, hurried respiration, starting 
of the tendons, picking at the bed-clothes, &c. The pulse grows weaker 
and smaller, and the fever proves fatal in two or three weeks. 
The typhoid stage often commences as early as the fourth or fifth day, 
and sometimes sooner. 
This is the ordinary course of the disease, except when it declines under 
a favourable crisis, which is usually in about a week. 
There is a modification of all these symptoms ; sometimes the attack is 
light, and the fever soon subsides ; at other times it is very severe. 
The simple continued fever terminates invariably by a regular crisis, by 
vomiting, purging, or sweating, or by the morbific or febrile matter falling 
on some organs, which excites inflammation and abscess, or proves fatal. 
TREATMENT. 
INDICATIONS OF CURE. 
1. Lessen arterial excitement. 
2. Restore the secretions and excretions. 
3. Equalize the circulation. 
4. Remove local congestions. 
5. Expel from the system the sources of irritation. 
All these indications will be best fulfilled by the means recommended under 
the head of remittent and inflammatory fevers, particularly the former. In 
the commencement and first stage, particularly if there be nausea, administer 
an emetic. It exerts not only a powerful and salutary influence upon the 
stomach and neighbouring organs, but likewise upon the whole system, the 
skin and other excretory organs, and sometimes brings about a revulsion. 
After the operation of the emetic, give the common purgative. 
These two classes of medicine are indicated from the morbid condition of 
the stomach and alimentary canal. The purgative must be occasionally SIMPLE CONTINUED FEVER. 
245 
repeated through the course of the disease, either daily, every other day, or 
once in three days at farthest. The surface and feet must be frequently 
bathed with tepid ley water. The repeated ablution of this liquid is admira- 
bly calculated, as before stated, to arrest the febrile course, to moderate exces- 
sive heat, and to restore a healthy action of the skin. As often as the skin 
becomes dry and parched, the surface must be well bathed. It is necessary 
also to give diaphoretic medicines, in order to keep up a moisture or a con- 
stant determination to the surface. For this purpose give the diaphoretic 
powders, particularly at night. They will lessen pain and restlessness, pro- 
cure sleep, and diminish arterial excitement; ten grains may be given at 
night in syrup or currant jelly, to be accompanied with the free use of an 
infusion of catnip. The ipecac pills or powders may likewise be given. 
It will be necessary, as in other types of fever, to administer diluent drinks, 
such as infusions or teas of balm, spearmint, blessed thistle, and Virginia snake- 
root. If the patient is not in great perspiration, cold water, cream of tartar 
water, and lemonade may be freely drank. 
Acidulated drinks are very refrigerant and refreshing. 
Tamarind water may be taken, as also the juice of oranges and ripe fruits. 
Attention must be paid to local congestion, or pains in any particular parts 
of the system ; for such symptoms let fomentations be applied. 
Haps, tanzy, and wormwood may be simmered in equal parts of water and 
vinegar, enclosed in flannel, and applied to the abdomen, or any other part 
where there is pain or congestion. Let them be applied warm, and often 
changed: for the pain in the head, apply a mustard poultice to the nape 
of the neck and to the soles of the feet. 
The only method to obviate the subsequent stage of prostration and 
typhus is, to subdue the inflammatory symptoms in the commencement, 
which is most easily effected by the treatment here laid down. 
The practice pursued, of bleeding or reducing the system, to accomplish 
this, is exceedingly dangerous. It has a manifest tendency so far to weaken 
the tone of the system, that there is not sufficient strength left to combat the 
succeeding stage, which is invariably one of great debility. Thousands are 
annually swept off for want of this precaution. 
It is of the greatest importance in the latter stages of this complaint, when 
the system becomes exhausted, to keep up the strength of it, by nourishing 
liquids and diet. Wine may be given pure or mixed with water, if the 
stomach will bear it. If it is attended with any putrid symptoms, a wine 
glass of good yeast may be given four or five times through the day, in any 
manner that can be most conveniently taken. 
Should the stomach become irritable and reject purgatives, injections or 
glysters may be given, composed of a decoction of catnip or mint, one pint; 
milk, half a pint; molasses, one gill; sweet oil, half a wine glass : mix. 
Should a cough be present, such medicine must be given as is calculated 
to allay it; for example, an infusion of hoarhound (marrubium vulgare} and 
hyssop. 
REGIMEN. 
Nothing heating or stimulating should be taken in the first stages of this 
complaint. The diet should consist of panado, Indian meal gruel, barley 
and toast water, rice water, stewed fruit, and, in the latter stages, light boiled 
rice, raw egg and wine where there is great debility, oysters or oyster soup. 246 
THE REFORMED PRACTICE OF MEDICINE 
CHAPTER VIII. 
TYPHUS OR NERVOUS FEVER 
CHARACTER. 
The word typhus is derived from a Greek word, which signifies stupour, 
this being the characteristic symptom of the disease. It is also called ner- 
vous fever, in consequence of the nervous system being very much affected. 
There are three species of this fever: One is called typhus mitior, being the 
mildest, and the attack more gradual. The second species is named typhus 
gravior, in consequence of its being more violent in its attack, more malig- 
nant, and discovering in its character more putrescency. It is also called 
putrid fever. The third, typhus icterodes, or yellow, in consequence of bile 
and yellowishness. 
SECTION I. 
SLOW, NERVOUS, OR TYPHUS FEVER. (Typhus Mitior.) 
DESCRIPTION. 
1'he slow or nervous fever is distinguished from other kinds of fever by 
its effects on the nervous system. It is a peculiar form of fever, which may 
be spread by contagion, characterized by a torpid state of the brain or great 
lethargy, with great prostration of muscular power, and more or less delirium. 
It principally attacks those of a weakly constitution, and is generated in 
jails, hospitals, prison ships, and ill-ventilated apartments of the poor, and 
in damp, dirty cellars, cities, and large towns. In a number of persons 
exposed to the contagion of typhus, some, although rarely, are attacked on 
the third or fourth day ; others on the thirteenth, and some not under three 
months: but the most common period of an attack after an exposure, is, 
from the end of the first week to the middle of the third. 
CAUSES. 
Typhus fever may be produced by whatever depresses the spirits or im- 
poverishes the blood, by certain passions, watching, intense study, the use 
of poor diet, or unripe fruits of any description. It may likewise be pro- 
duced by bleeding, mercury, and other minerals ; by moist, close, or impure 
air. Hence it is more prevalent in wet weather, and proves most fatal to 
those who live in small filthy houses, narrow and dirty streets, hospitals, 
jails, and manufacturing or large towns. It generally attacks those wrho 
Rave been frequently bled and have taken mercury, and those who lead an 
irregular and licentious life, or whose constitutions have been broken from 
any cause whatever. It is occasioned from sudden transition from heat to 
cold, getting the feet or clothes wet, lying upon the damp ground, great 
fatigue, or bodily exercise. These are all predisposing causes ; but the most 
frequent of all is infection or contagion communicated through the medium TYPHUS OR NERVOUS FEVER. 
247 
of an impure or heated air, by concentrated noxious effluvia arising from the 
body of a person labouring under the disease ;* and although it may not be 
contagious in the commencement, or under proper regulations, yet it may 
become so from the want of ventilation, treatment, &c. Other fevers, as 
before intimated, sometimes degenerate into typhus. This fever occurs 
sometimes in warm climates, but more generally in those that are cold and 
temperate, often in cold, wet autumns. 
SYMPTOMS. 
Typhus fever usually commences with a great degree of mildness in all its 
symptoms. It is generally preceded by slight indisposition for several days, 
succeeded by rigours or chills, debility, sighing, and oppression in breathing, 
with nausea and loss of appetite; with a certain unpleasant, uneasy sensa- 
tion in the pit of the stomach. The countenance is pale and dejected, the 
eyes are dull and heavy, and there is often tremour of the extremities, sense 
of weariness both mental and corporeal. Toward evening there is some in- 
crease of these symptoms. In the course of a few days, as the disease pro- 
gresses, there is oppression in the chest, pain in the head, giddiness, confusion 
of intellect, and great depression of nervous energy. There is sometimes a 
sinking or fainting, particularly when the patient attempts to sit up; the 
tongue is dry, at first white, and afterward coated with a dark brown fur; 
also the teeth are incrusted with the same, yet the patient seldom complains 
of thirst. There is a small, low, frequent, and irregular pulse ; a cold, unna- 
tural, and clammy perspiration breaks out upon the backs of the hands, while 
the inside of them is hot; the skin is dry and constricted, and all the excre- 
tions diminishes ; the bowels are usually costive; intellects grow more con- 
fused ; the patient becomes fretful, restless, and watchful ; the countenance 
more anxious and dejected; urine scanty and high coloured, or is pale and 
watery; sometimes there are catarrhal symptoms, with a short, dry cough ; 
there is pain in the back, loins, and extremities, with a sense of soreness 
over the whole body ; sleep disturbed and unrefreshing ; the functions of 
the brain become more and more disordered ; there is more or less deafness ; 
delirium increases ; indeed body and mind seem, as it were, almost paralyzed. 
The patient has a great aversion to exercise, as well as to conversation 
This stage of excitement generally continues about a week, when it termi- 
nates in a stage of prostration or great debility. The inflammatory symp- 
toms subside, and a great weakness and sinking ensues. The body emaciates 
rapidly, and if the disease is suffered to progress, it daily assumes more 
formidable and unfavourable symptoms ; there is fluttering ; a very weak 
and intermitting pulse, with startings of the tendons, hiccoughs, &c. There 
is also, in violent cases, some eruptions on the surface, a peculiar hollow 
* Dr. Haggarth, who devoted considerable attention to the consideration of the conta- 
gious nature of typhus fever, and the manner in which it is propagated, has deduced there- 
from a variety of important facts, of very great importance for the prevention of misery and 
the preservation of human life ; whence he concludes that it may be easily and certainly 
prevented by ventilation, (in large, airy, and clean rooms,) or by separation, (into our hos- 
pitals, or into an adjoining room of the same house, where practicable,) or especially by 
cleanliness, which entirely destroys the poison, wherever it can be completely accomplished. 
Wedekind states that, during the campaign of the French against Russia, the typhoid 
contagion, which was generated in the hospitals and houses crowded with prisoners, and 
which was communicated to the inhabitants along the road by which the soldiers returned, 
afterward spread gradually from the road-side to the adjacent districts, until the disease 
became widely prevalent. 248 
THE REFORMED PRACTICE OF MEDICINE. 
sound of the voice, and a swelling and tenderness of the abdomen or bowels. 
The later stages of fever are also attended with diarrhoea, the discharges being 
very fetid, watery, and acrid. There is also generally so much lethargy 
that it is with difficulty the patient can be aroused. 
There is sometimes one very prominent symptom in this complaint, at 
which I believe I have not hinted, which is a very unequal circulation. It 
is common for the temperature of one part of the body to be about natural, 
while another part is unnatural. Again, it is very remarkable that in the 
middle and latter stages of the complaint the whole force of the disease is 
apparently withdrawn from every other part, except the nervous system. 
This fever frequently continues for some weeks, and terminates in such a 
state of prostration as to prove fatal, or it degenerates into a malignant type ; 
but when it terminates favourably, it generally subsides about the fourteenth 
or fifteenth day, by diarrhoea, or by perspiration diffused over the whole body. 
It often, however, continues thirty or forty days, and finally subsides without 
any evident crisis. 
The symptoms of typhus fever may be summed up in a few paragraphs : 
1st. Great prostration of strength. 
2d. Great alteration in the blood and other fluids of the system. 
3d. A very morbid state of the digestive organs, occurring as secondary, 
not primary, symptoms. 
4th. Agitation, anxiety, and loss of sleep, and delirium ; spasms in various 
parts of the body; respiration hurried, sometimes with cough and bloody 
expectorations; lips dry and parched ; gums red, dry, and covered with 
mucus ; teeth crusted ; tongue generally swelled and stiff; skin dry ; great 
lethargy; quick, small, and irregular pulse ; thirst, nausea, and vomiting. In 
some cases the fluid discharged from the stomach is of a bilious character; 
in others it is dark, or like coffee grounds. Passages from the bowels very 
unhealthy and fetid ; flatulence ; sometimes swelling of the abdomen. Thus 
the circulating respiratory and digestive organs are all disordered. 
TREATMENT. 
INDICATIONS OF CURE. 
1. Diminish arterial excitement by stimulating the excretory organs to a 
healthy action. 
2. Equalize the circulation. 
3. Remove local congestions. 
4. Support the strength of the patient, or the powers of the system. 
Emetics.-If called in the incipient stage of this fever, or a few days after 
the attack, a gentle emetic may be given, particularly if there is nausea, 
oppression, and sickness. 
Should not the complaint yield to this, and such other medicine as will 
be mentioned, this emetic may be repeated once in three days, any time 
before the stage of prostration commences. One or two doses in the com- 
mencement is sufficient; and where there is any peculiar temperament to 
contra-indicate the use of emetics, and in the middle and latter stages of the 
fever, they may be entirely dispensed with. The early exhibition of an 
emetic is generally attended with a very salutary effect, often arresting the 
fever in its commencement; but when the fever has existed for some time, 
they should not be given, particularly when the system is much debilitated. 
Emetics, judiciously given, not only cleanse the stomach of its acrid and TYPHUS OR NERVOUS FEVER. 
249 
morbid contents, but the impression which they give to the skin, the other 
excretions, and the whole system, is attended with a very excellent effect. 
They promote perspiration, and thereby prevent congestion, expel irritating 
agents from the circulating mass, give tone and energy to the stomach, liver, 
and the connecting organs, and in many cases their early use breaks up the 
disease before it becomes fairly seated or established ; or at any rate mitigates 
the symptoms. 
As valuable, however, as they are, it is not always necessary to administer 
them in order to remove the disease. 
Purgatives.-Gentle cathartics are exceedingly valuable throughout the 
whole course of typhus fever. 
* The full operation of aperients," says Armstrong, " sometimes reduces 
the morbid heat of the skin, and the morbid force of the pulse in the stage, 
almost as effectually as the effusion of cold water, &c." 
In typhus the brain, and the system generally, is thrown into a very morbid 
condition, by an accumulation of acrid and vitiated bile, and matter collected 
in the stomach and first passages, in consequence of an inactive or torpid 
state of the liver. 
Delirium, great heat, and prostration of strength take place from this 
cause. The sympathy that exists between these organs is truly surprising : 
if one is healthy, so is the other; if one is in a morbid condition, those that 
sympathize with it are diseased also. Hence the very great importance 
of exciting a healthy state of the stomach, liver, and whole alimentary 
canal. 
Purgatives are admirably calculated to fulfil this indication. They cleanse 
and stimulate at the same time ; and, although a patient is very weak, he will 
gain strength under the administration of repeated purgatives. They may 
be given in moderate doses every other day in protracted cases. 
Persons in a very low or distressed state of typhus fever will soon assume 
a more healthy appearance after the administration of purgatives. The man- 
drake physic is very good : in some conditions of the stomach it operates 
both as an emetic and purgative, evacuating large quantities of offensive 
matter, which almost invariably improves the condition of the patient. 
Says Hamilton, " My experience in the treatment of typhus enables me 
to draw the following conclusions : 
1st. Purgative medicines are given with safety in typhus, to evacuate the 
contents of the bowels. 
2d. Under this limitation, they may and ought to be exhibited at any 
period, from the commencement to the termination of the fever. 
3d. The early exhibition of purgatives relieves the first symptoms, pre- 
vents the accession of more formidable ones, and thus cuts short the disease. 
4th. In the advanced period of typhus gravior, symptoms that indicated 
the greatest danger were relieved by the evacuation of the bowels, and the 
patients in this instance recovered. 
5th. Reconvalescence from typhus is greatly promoted and confirmed by 
a preservation of a regular state of the body. The same means secure against 
the danger of a relapse." 
Diaphoretics.-Among all the class of medicines prescribed for this dis- 
ease, none stand higher than sudorifics, or medicines which produce per- 
spiration. They are calculated to relieve the stupor and pain, they expel 
the morbific matter from the system, allay heat, and procure rest. The 
diaphoretic powders may be given as directed under the head of bilious re- 
mittent ; these may be given, particularly in the first stage of the disease, in 250 
THE REFORMED PRACTICE OF MEDICINE. 
doses of a tea-spoonful in a small quantity of catnip tea, sufficient to produce 
a moderate degree of perspiration. Too much sweating must not be pro- 
moted or encouraged, as debility is apt to follow. A moisture of the skin 
must be produced, at least, throughout the whole course of the disease, until 
a crisis takes place ; and to effect this, three grains of ipecac in any form may 
be given three or four times a day, with an infusion of balm and catnip, or tea 
of the amaranthus or crawley root. 
Refrigerants ar cooling Medicines.-After the disease has become fairly 
established, and assumes an obstinate character, I have known every pre- 
scription of a heating or stimulating nature to aggravate the complaint. In 
this case it becomes necessary to reverse the treatment. Refrigerant and 
cooling remedies must be used. The anti-bilious and mandrake physic may 
be given alternately in moderate doses. Gentle purgatives may be given, as 
a general rule, every other day. Frequent and excessive purging is injurious. 
Diluents.-Cold water may be drank from time to time, if the patient 
complains of great thirst: also lemonade, toast water, cream of tartar, whey, 
and soda powders. Likewise beer made of various roots may be freely 
drank; such as spice-wood, sassafras, burdock, and black alder. Let them 
all be boiled down strong, sweetened with honey or molasses, and, when 
blood warm, a sufficient quantity of yeast added. This will prove a grateful 
and cooling beverage, and it may be drank freely. 
Anodynes.-If the patient is unable to sleep, complains of pain or distress, 
a portion of the diaphoretic powders maybe given at bed-time in any suitable 
vehicle. This produces sleep, moisture of the skin without causing any 
excitement, and is a most invaluable medicine in typhus. These powders 
may be repeated daily. 
Ablution.-Among the various means made use of to arrest the progress 
of this disease, few are more valuable than the cold affusion. Such con- 
fidence had Dr. Currie, of Liverpool, in this application in fevers, " that," 
he says, " for the cure of our most common febrile diseases it is no longer 
necessary to ransack the elaboratory of the chemist, nor to traverse the moun- 
tains of Peru ; that the cold affusion, used in the first three days of fever, 
very .generally stops the disease. The same happy effects sometimes follow 
its use on the fourth, or even fifth day, but seldom later. Even in the sub- 
sequent stages, where the heat continues preternaturally great, and the skin 
dry, it is of great and manifest advantage, almost immediately relieving the 
most distressing symptoms, particularly restlessness and delirium, and con- 
ducting the disease to a safe and speedier issue. " 
If the heat is not much above the natural temperature, as is sometimes 
the case in typhus, tepid or moderately warm applications may be applied 
to the body; the whole surface should be bathed with it three or four times a 
day, or as often as the fever increases; this answers all the purposes in ge- 
neral of dashing buckets of water upon the patient. Should the heat be be- 
low the natural standard, let the parts occasionally be bathed with cayenne 
pepper and spirits. It is of the utmost importance to bathe the feet in warm 
rain water or ley once a day. Great attention must be paid to cleanliness ; 
the patient's hands, face, and breast should often be washed with warm 
water, his hair should be combed, and his bed and body linen frequently 
shifted, his mouth washed and gargled ; lemonade, tea, or toast and water 
should be given very frequently ; all excrementitious matters should be im- 
mediately removed, and the apartment should be well ventilated. 
Sinking stages of Typhus.-We have hitherto been speaking of the first 
stage of typhus, before collapse, or great prostration, or sinking takes place. It is well known that debility is a characteristic symptom of this 
fever, and hence it is necessary to use the utmost precaution to support the 
strength of the system. To effect which, we must first give tonics or stimu- 
lants. Even though the pulse be somewhat irregular, weak, or quick, it will 
not contra-indicate or deter us from the use of corroborating or strengthen- 
ing medicines, especially where prostration of strength is very great, and the 
person sinking. If the skin be dry, and there is great debility, the best 
Madeira wine may be used, diluted with twice its quantity of water, 
sweetened, and given warm. This acts not only as a tonic, but likewise as 
a diaphoretic, promoting perspiration. A wine glassful may be occasionally 
taken through the day. Good porter and yeast may also be given. 
Dr. McNair has the following remarks on tonics in typhus : " The tonic 
which I should advise to be used, and the one which I have found most 
effectual, is the muriatic acid, (spirit of salt.) It allays the heat and tran- 
quillizes the restlessness at the same time that it supports the strength of 
the patient, and, therefore, may be always given at an early period of the 
disease without danger, and at a time when it would be extremely danger- 
ous to employ either wine or bark. Besides, this acid is a remedy peculiarly 
well adapted to domestic practice in this disease, it being more manageable 
than most other diseases, and may be used by unprofessional persons with 
more prospect of advantage and less risk of injury than they can expect to 
obtain by giving bark or wine. Ten drops of muriatic acid may be taken in 
a wine glass of cold chamomile tea, and repeated every six hours." 
Mustard Plasters.-I have very little confidence in blisters, although some 
highly extol them. Applied in the first stages of the disease, they have a 
tendency to increase it, and there is also danger from mortification. A 
mustard plaster is not attended with these unpleasant effects. 
If there is a great determination of blood to the head, one may be applied 
to the nape of the neck, and kept on long enough to excite redness of the 
skin. It may then be removed, and placed on the right side, over the region 
of the liver, and continued until the same effect is produced. 
If the head is in great pain, cold water, spirits, and vinegar, to which has been 
added a little common salt, may be applied to it; or a strong decoction of hops. 
When we reflect upon this stage of prostration, is it not a matter of pro- 
found astonishment that many of the physicians of this day should practice 
blood-letting, even when the patient is on the borders of the grave from 
debility ? I ask the candid, sensible reader whether there is any sense, 
judgment, or philosophy in such treatment ? 
As before-mentioned, it is very common in typhus for the temperature of 
one part of the body to be natural, while in another there is an unnatural 
degree of heat. This arises from a recession of blood from the surface to 
the internal organs, or to an unequal circulation of the blood. To obviate 
this, fomentations and frictions must be used. Hops foiled in vinegar may 
be applied ; also the following : Cayenne pepper, {capsicum annuum,') a tea- 
spoonful ; spirits of any kind, half a pint; simmer a few minutes, and apply 
to the parts with a piece of flannel. 
These applications have a tendency to recall the blood from the internal 
parts to the surface, and to equalize the circulation. 
If great weakness continues, and the system cannot be aroused by the 
stimulants already mentioned, the following powder may be given : Cayenne 
pepper, {capsicum annuum,') ten grains, or half a tea-spoonful; mint water 
or tea, one gill; sweeten with sugar or lemon syrup : give the whole at a 
dose, and repeat three times a day. 
TYPHUS OR NERVOUS FEVER. 
251 252 
THE REFORMED PRACTICE OF MEDICINE. 
This is one of the most permanent and pure stimulants that can be admi- 
nistered, and has this peculiar effect upon the system, that, while it stimu- 
lates, it does not increase the fever. Should a diarrhcea come on, and the 
general symptoms indicate a favourable crisis, it must not be checked; but, 
on the contrary, should the patient continue to grow worse under it, it must 
be checked or moderated ; for this purpose give the neutralizing mixture. 
Tonics.-Many are in the habit of giving Peruvian bark in typhus fever, 
but I have no evidence of its ever proving beneficial. While the exciting 
cause of the disease remains, it seems to possess no power of removing, but 
rather increases it. Should, however, a complete remission take place, cen- 
taury, boneset, or chamomile tea may be drank. 
Should any symptoms of putrescency appear, the following mixture may 
be given : Good yeast, a wine glass ; milk, the same quantity ; sweeten with 
molasses : the whole be taken at a dose, and repeated two or three times a day. 
Fresh Air.-In this, as well as every other type of fever, fresh air must be 
admitted into the apartment of the patient, and the most rigid attention to 
cleanliness must be observed. As soon as anything passes the bowels, it 
must be immediately removed, and the casements of the windows or the 
doors left so far open as to admit of a current of air. 
It has been proved by dissections that in typhus, and no doubt in other 
fevers, the stomach and intestines are considerably diseased. There is often 
inflammation and ulceration of the mucous coats and the glands, which show' 
the propriety of administering cooling and mucilaginous drinks and soothing 
medicines, as well as diet. For this purpose yeast, mucilage of slippery elm, 
charcoal, fyc., may be alternately given. Where disease exists in the in- 
testines, there is usually a relax, tenderness, and severe swelling of the bow- 
els. In such cases particular attention must be paid to external applications, 
as mustard plasters, fomentation of hops and bitter herbs, and frequent injec 
tions, to which yeast may be added. When it is deemed advisable to give 
physic with these symptoms, rhubarb is very good, as it has a very tranquil- 
lizing effect upon the mucous membrane of the intestines. In consultation 
with a distinguished physician of this city, in a case of typhus he recom- 
mended a dose of this root, a tea-spoonful daily, under which the patient 
improved and recovered. 
" We should ever bear in mind, in the treatment of this and other types of 
fever, the conservative powers of the system, and w'hich was illustrated in 
a contagious fever in Italy, in 1817, as well as in numerous other cases," 
says Dr. Valentini, an Italian physician. "To prove how much nature is 
capable of performing, and to what extent we should rely on her exertions, 
in a great number of cases of this fever nothing was administered but. 
copious drinks, either of pure water, lemonade, or emulsion of nitre." He 
cites, as a proof of the efficacy of this plan, the case of a soldier in the ponti- 
fical service, thirty-three years of age, and of a robust habit, who was seized 
with a gastric nervous fever. This man obstinately refused all medicines, ex- 
cept an emetic which had been given at the commencement of the disease ; 
yet, by his drinking simple lemonade and abundance of the purest water, 
after having suffered the attack of mortal symptoms on the seventeenth day 
of the disease, he fell into a copious sweat, and recovered. " I was per- 
suaded," continues Dr. Valentini, "of the inefficacy of medicine in the 
greater number of cases, and willingly followed the wishes of the patient." 
He supports his opinion by referring to Hippocrates, and others of the ancient 
as well as modern writers, and concludes by a quotation from Celsus, in 
which this author says: " Multi magni merbi curanter abstinentia et quiete TYPHUS OR NERVOUS FEVER. 
253 
which may be translated thus : " Many of the most serious diseases are 
cured by abstinence and quietude " 
REGIMEN. 
The patient must be kept cool and quiet in body and mind, and as much 
encouragement held out as the nature of the fever will admit. After the 
stage of excitement is over, a nourishing and generous diet may be allowed, 
such as panado and gruel mixed with wine. Chicken soup may be given, 
particularly in the middle and latter stages of typhus, but it must be freed 
from oil. Wine whey may also be used as a common drink; and, as before 
intimated, occasionally a glass of good Maderia wine may be given, and, if 
there is no fever, with great weakness, wine bitters or the sulphate of 
quinine. 
Prevention of Typhus Fever.-11 It cannot be too widely known," says an 
English writer, " that nitrous acid gas possesses the property of destroying 
the contagion of the typhus fever, and certainly of preventing its spread. 
By the following simple method the gas may be produced at a very trifling- 
expense : Place a little powdered saltpetre in a saucer, and pour on it as 
much oil of vitrol as will cover it; a copious discharge of acid gas will in- 
stantly take place, the quantity of which may be regulated by lessening or 
increasing the quantity of materials." 
SECTION II. 
PUTRID OR MALIGNANT FEVER. {Typhus Gravior.) 
DESCRIPTION. 
Malignant or putrid fever takes its name from the putrescent and malig- 
nant character with which it is attended, especially in the latter stages of it. 
It is by some called the pestilential fever of Europe, and seems nearly allied 
to the plague. It may be distinguished from the mild species of typhus by 
the great violence of the attack, and from the inflammatory fever by the 
smallness of the pulse, the sudden and great debility in its commencement, 
the brown or black tongue, the foul matter about the teeth, the intense 
heat of the skin, and, in the advanced stages, purple spots which appear in 
various parts of the body; fetid stools, &c. 
CAUSES. 
The malignant fever is occasioned by impure air, from many persons being 
crowded together into small, dirty, and unventilated apartments or houses; 
from putrid animal and vegetable effluvia, &c. 
Like common typhus, it is prevalent in jails, camps, and hospitals, parti- 
cularly where they are much crowded, filthy, and the air confined. Long 
periods of rainy or wet weather, it is thought, likewise occasion putrid fever. 
It often succeeds great inundations in low and marshy countries, particularly 
where these are preceded and followed by a hot and sultry season. It may 
likewise arise from eating too much animal food without the use of vegetable, 
or eating meat that is on the verge of putrefaction. Hence those from the 
calamities of war; those who are confined on ship-board, and are obliged to 254 
THE REFORMED PRACTICE OF MEDICINE. 
live upon unwholesome, tainted animal food, are very liable to an attack of 
putrid fever. A vessel lately arrived at our quarantine, having on board 
many suffering with this fever. 
It may also arise from stagnant water ; also the effluvia arising from the 
decomposition of animal matter, dead bodies, &c. Hence it has often pre- 
vailed where persons have been suffered to remain above ground, unburied. 
Want of cleanliness is a common cause of malignant fever, and it prevails 
where the inhabitants are crowded together, the apartments filthy, and a 
very little circulation of air. This fever is unquestionably contagious. 
SYMPTOMS. 
An attack of this disease is characterized by debility, great depression of 
spirits, and of muscular power. There is sense of soreness, pain in the head, 
back, and extremities, attended with chills; the eyes appear full, heavy, 
yellowish, and somewhat inflamed ; there is a great beating of the temporal 
arteries, the tongue is dry and parched, breathing laborious and interrupted 
with deep sighs, the breath is hot and offensive, urine pale, an intense, heat 
of the skin, which is dry and constricted, great constipation of the bowels, 
the pulse is quick, small, and hard, fluttering and irregular; there is often 
great heat, oppression, and pain at the pit of the stomach ; and as the disease 
advances the pulse increases in frequency, (beating often from 100 to 130 
in a minute:), there is apparently vast debility ; great heat and dryness of 
the skin ; oppression at the breast, with anxiety, sighing, and moaning ; the 
thirst is greatly increased ; the tongue, mouth, lips, and teeth are covered 
over with a brown or black tenacious fui'; the speech is inarticulate and 
scarcely intelligible; the patient mutters much, and dilirium arises. The 
fever continuing to increase still more in violence, symptoms of putrefaction 
show themselves ; the breath becomes highly offensive ; the urine deposites 
a black and fetid sediment; the stools are dark, disagreeable, and pass off 
insensibly; haemorrhages issue from the gums, nostrils, mouth, and other 
parts of the body ; livid spots, or petechise, appear on its surface ; the pulse 
intermits and sinks ; the extremities grow cold ; hiccoughs ensue ; and death 
at last closes the tragic scene. 
When this fever does not terminate fatally, it generally begins, in cold 
climates, to diminish about the commencement of the third week, and goes 
off gradually toward the end of the fourth, without any very evident crisis ; 
but in warm climates it seldom continues above a week or ten days, if so long. 
The great indication of cure in putrid fever is, to arrest it as speedily as 
possible, in order to prevent the fluids from running into a state of putrefaction. 
An emetic may be administered, as directed in the preceding type of fever; 
and, if it proves beneficial, it may be repeated in a day or two afterward. 
Give the anti-bilious physic : a tea-spoonful may be taken in syrup, mo- 
lasses, or any convenient vehicle; to be repeated daily, or every other day, 
according to circumstances. 
Give a tea-spoonful of the diaphoretic powders, to be repeated every two 
hours until perspiration takes place. These powders must be used often 
enough to keep the skin moist, and two or three times a day is sufficient for 
this purpose. Let an infusion or tea of catnip or other herbs be freely taken 
at the same time. No means that can be made use of will cut short the 
fever so quick as free perspiration 
TREATMENT. TYPHUS OR NERVOUS FEVER. 
255 
Let acidulated drinks also be given. Lemonade is a valuable medicine in 
putrid fever ; it is antisceptic, or has a great tendency to prevent putrefaction. 
Dr. Thomas, who had much experience in this kind of fever, has the fol- 
lowing remarks on the use of acids : 
" Whatever is given to the patient for drink ought to be cold and gently 
acidulated with the juice of oranges or lemons. The mineral acids likewise 
are, beyond all doubt, better remedies in this and other malignant diseases 
than we have been accustomed to regard them ; and, from having employed 
them, but more particularly the muriatic, for several years with very great 
success in typhus gravior, I can vouch for their efficacy. My usual plan of 
proceeding is as follows: Having relieved the stomach by a gentle emetic 
where nausea prevails, cleared the bowels of their feculent contents, and 
subjected the patient to cold affusion, wThen the circumstances already noticed 
have admitted of it, I prescribe for adults ten or twelve drops of the muriatic 
acid, guarded with five drops of laudanum ; and as a vehicle I employ about 
an ounce and a half of an infusion of chamomile or columbo. This draught 
J direct to be repeated every four hours, gradually increasing the quantity of 
the acid in each to eighteen or twenty drops, or more. 
The Surface.-In order to aid the process of sweating, and, consequently, 
to abate the febrile symptoms, let the whole surface be thoroughly and re- 
peatedly bathed with tepid ley water. The happy and permanent effects of 
this practice, the astonishing power that it possesses to arrest and destroy 
fevers of every grade, can only be known by those who have experienced it. 
It seems almost capable at once of snatching the victim from the grave. It 
lowers the pulse; diminishes arterial excitement; removes pain, tension, 
and congestion; equalizes the circulation; quenches thirst; procures rest 
and sleep, and, in short, is one of the greatest anti-febrile remedies which we 
possess. 
The feet also must be bathed once or twice a day, and mustard poultices 
applied, and to the nape of the neck if there be great pain in the head. By 
reference to Thomas, I see that he highly extols, with others, cold affusions 
in putrid and malignant fever. At the same time, as far as my experience 
goes, I have found that tepid applications are preferable to cold in all febrile 
diseases. 
Antiseptics.-When symptoms of putrescency occur, let good yeast be 
given freely. Brewers'yeast is preferable, if it can be procured. A wine 
glass may be given every three hours through the day. Besides the laxative 
effects of the yeast, it possesses great antiseptic properties. A clergyman 
and practitioner, in England, records the good effects as follows. It would 
appear to possess almost specific properties. 
Whatever may be the mode of action of yeast in typhus, the fact appears 
to be indisputable, that fixed air takes off that extreme debility of the stomach 
so conspicuously marked in disorders of this nature ; and in proportion as 
that subsides the pulse rises, becomes slower and fuller, the burning heat on 
the skin disappears, and a truce is gained for the reception of nutritive supplies. 
" Seventeen years past, I went," says a benevolent individual, " to reside 
at Brampton, near Chesterfield. I had not been there many months before 
a putrid fever broke out among us : finding a great number of the people too 
poor to afford relief to themselves, I undertook, by the help of such books 
as were in my possession, to prescribe for them. I early attended a boy 
fourteen years of age, attacked with the fever, the symptoms unequivocally 
putrid ; I gave bark, wine, and such other remedies as my books directed, 
but found them of no avail; his disorder grew every day worse, and I was 256 
THE REFORMED PRACTICE OF MEDICINE. 
hourly in expectation of his dissolution. Being under the necessity of taking 
a journey, before I set off I visited him, and 1 thought for the last time, and 
prepared his parents for the event of his death. While conversing on this 
distressing subject I observed in the corner of the room a tub of wort 
working ; the sight brought to my recollection an experiment I had some- 
where met with, of a piece of putrid meat being made sw'eet by being sus- 
pended over a tub of wort in the act of fermentation. The idea rushed 
into my mind that the yeast might correct the putrid nature of this disease, 
and I instantly gave him two large spoonsful, and told the mother, if she found 
her son better, to repeat the dose every three hours. On my return, after 
a few days, I anxiously inquired after the boy, and was informed he was 
recovered. I went immediately to the house, when the boy opened the door, 
and looked surprisingly well." 
He proceeds to relate a number of very bad cases, all of which recovered 
by the use of yeast. 
Examinations of those who have died of fever, particularly of malignant 
typhus, in different parts of the world, show that the gall-bladder, and some- 
times the first passages, are in a very congestive or morbid condition, and 
sometimes the spleen. A black and fetid fluid, resembling tar or coffee 
grounds, is found secreted by the liver, which proves the necessity of resort- 
ing to prompt means in order to excite a healthy action of the secretions 
or emunctories ; otherwise the system is in'danger of sinking under the pros- 
trating power of febrile poison ; and it is no doubt owing to this poison that 
the intestines and contiguous organs are so frequently found inflamed and 
ulcerated. This state points out the advantage of giving freely of yeast 
and slippery elm bark, especially in advanced stages of the disease ; as well 
as the treatment already recommended in the first stages. 
Mustard Plasters.-Blisters must be carefully avoided in putrid fevers. 
There is such a tendency to putrescency in the fluids, that mortification is 
very likely to follow their application. If the pain of the head be great, 
and delirium present, a mustard plaster, as before intimated, may be applied 
for a short time to the nape of the neck. 
Bathing the Head and Feet.-Great attention must be paid to the act of 
bathing the feet and head. Nothing has a greater tendency to mitigate pain 
than this practice. Cold water, vinegar, and salt may be applied to the head ; 
it abstracts the heat from it, and equalizes the circulation. 
Remission.-When there is evident remission, the wine tincture may be 
given. 
Gargles.-The mouth must be frequently cleansed with vinegar and water, 
or wine and water sweetened with honey : also yeast and milk. 
Pain and Restlessness.-If there is much pain, distress, restlessness, and 
want of sleep, give ten grains of diaphoretic powders, particularly at night. 
They are anodyne, diaphoretic, refrigerant, antiseptic, and diuretic. Their 
operation must always he aided by an infusion or tea of balm, catnip, or other 
herbs. 
PLAGUE. (Pestis.) 
DESCRIPTION. 
The plague is a very malignant fever, of a putrid and contagious nature, 
characterized by extreme debility, buboes, carbuncles, red or purple spots TYPHUS OR NERVOUS FEVER. 
257 
upon the skin, hremorrhages, diarrhoea, &c. The infection of this disease is 
of a specific nature, producing febrile symptoms, and affecting the nervous 
and glandular system. 
The plague is, in strict nosological language, a continued fever closely allied 
to typhus, and, therefore, demands notice more particularly in this place. 
In its symptoms and progress we shall trace an obvious resemblance to those 
of typhus. 
The disease attacks persons of all ages and both sexes indiscriminately: 
but women, young people, and infants at the breast have been observed, in 
'•eneral, to resist infection more than robust men. Those who were exposed 
-o vicissitudes of heat and cold, such as bakers, cooks, and smiths, were 
noticed, during the campaign in Egypt, to be more particularly attacked 
with it. 
In all epidemic plagues terror and anxiety, filth and defective nutriment, 
fatigue and hurry, anger and intemperance of every description, have acted 
as predisposing and accelerating causes of the distemper. 
• Its laws have been investigated with some accuracy, and the following 
seem to be the most important of those which have hitherto been ascertained. 
1. The latent period of the contagion of plague, or that between commu- 
nication with an affected individual and the appearance of symptoms, varies 
in different cases. It is scarcely ever less than three days, and it seldom 
exceeds six. Instances, indeed, are recorded of the disease not appearing 
until the tenth day, but these cases are rare. 
2. The contagion spreads to only a very small distance from the body of 
the patient The consequence of which is, that the disease is seldom, if ever, 
communicated, except by actual contact. 
3. The dead body does not communicate the disease so readily as the 
living. This appears to be well understood in Turkey ; but that the conta- 
gion is sometimes received from the dead body, cannot, I apprehend, be 
doubted. 
4. The contagion of plague is readily imparted to /omi/es, in which it may 
lurk for a very long time, more particularly if secluded from the air. 
5. Reinfection is occasionally observed, but, upon the whole, is not com- 
mon. The individuals throughout Turkey, who are employed about the 
persons of plague patients, have, with very few exceptions, undergone the 
disease. Sufficient instances, however, are met with of persons taking the 
disease a second time, and even dying of the second attack, to make all who 
have previously had it cautious in their intercourse with the affected. 
6. Plague, like the small-pox, may be taken by inoculation. The experi- 
ment has been tried in several instances, but in none has it succeeded in 
mitigating the disorder. Dr. Whyte, in 1801, and Mr. Van Rosenfeldt, in 
1817, paid with their lives the forfeit of their temerity. The former died 
on the fourth, the latter on the second day of the disease. 
Plague I have stated to be epidemic in Egypt; and both at Cairo and 
Constantinople cases of the disease are almost always to be met with. 
SYMPTOMS. 
A feeling of great langour and lassitude ushers in the attack of plague, 
which for the most part happens toward evening. There is always a cold 
stage, though it is seldom of long duration. Heat of skin, headache, and 
giddiness succeed; the pain of the head is referred to the temples and 
eyebrows; the eyes appear heavy, dull, and muddy ; the expression of 258 
THE REFORMED PRACTICE OF MEDICINE. 
countenance changes in a remarkable manner. Sometimes there is a wild 
and furious look ; sometimes a look claiming commiseration, with a sunken 
eye and contracted feature. The most striking of all the early symptoms 
of plague is the staggering and the sudden extreme prostration of strength. 
A strong tendency to void the urine is generally noticed; the stomach is 
very irritable, and rejects almost everything presented to it ; the tongue is 
white and moist; the bowels are sometimes torpid, and at other times 
loose, the evacuations being always highly offensive ; the speech falters ; 
the pulse is at first small, hard, and quick; but after the appearance of 
buboes it often becomes fuller and softer. It is sometimes intermittent. In 
point of frequency, its average may be stated at 100 ; the heat of the skin 
is seldom very intense ; the head is occasionally perfectly clear and col- 
lected ; at other times stupor occurs immediately after the formation of 
the hot fit. Some cases of the disease are ushered in by a violent fit of 
mania. The greatest indifference with regard to recovery prevails, which 
is always reckoned a most unfavourable symptom. 
After one, two, or at farthest three days, pains in the groins and arm-pit 
announce the formation of buboes. These pains are often highly acute, and, 
unless speedily followed by the swelling of the gland, the patient dies deli- 
rious. In women the arm-pit, in men the groins are chiefly affected. Car- 
buncles appear at the same time, but indifferently, on all parts of the body. 
Eruptions are much more frequent than carbuncles, which it appears do not 
occur above once in twenty cases. The fatal termination is sometimes pre- 
ceded by violent haemorrhages from the mouth, nose, or intestines. 
The duration of the disease is very various. A few cases are on record 
where the patient died within a few hours from the invasion. To many it 
proves fatal during the first paroxysm or period, which includes the time 
from the evening of the attack to the close of the following night. The 
third and fifth days are, however, upon the whole, those of the greatest 
danger. The former is the usual period of the appearance of bubo ; the lat- 
ter of the abatement of the febrile symptoms. If the patient survives the 
fifth day, and the bubo is fully formed, he may be considered as nearly out 
of danger. The convalescence, indeed, is always very tedious, from the 
extreme debility which the disease leaves ; and the patient's life is not unfre- 
quently again put into imminent hazard, from the occurrence of gangrene in 
the extremities. 
Such is the train of symptoms which characterize this disease. Some idea 
of the extent of the mortality which it occasions may be formed from the 
fact, that out of 700 persons attacked by it in the district of Leftimo, in Corfu, 
1815, seventy only were saved, and 630 died. It is curious, however, to 
observe, that occasionally this very formidable disease assumes a totally dif- 
ferent character. The miZd form of plague is not peculiar to any families, or 
classes of persons, or districts, or periods of the epidemic. It is more com- 
monly met with toward its decline, but it is observed occasionally even from 
the very first. Buboes form in this variety of the disease about the usual 
period, generally with a good deal of inflammation, and go on to suppuration. 
Carbuncles and eruptions, however, are never observed to attend it. It is 
marked by the same set of febrile symptoms as characterize the malignant 
form of the disease, but they are all milder in degree. It terminates occa- 
sionally by a critical discharge, but does not appear to require, or to be 
at all affected by, common medical treatment. A few cases have been re- 
corded of plague appearing in the form of buboes, without any constitutional 
affection. TYPHUS OR NERVOUS FEVER. 
259 
TREATMENT. 
From the nature, history, and symptoms of this disease, the indications 
to fulfil will appear very obvious. The impropriety of bleeding, where there 
is such excessive debility, must be apparent. It is stated that " Dr. Whyte, 
one of the physicians to the forces in Egypt, used the lancet very freely, but 
that every one of his patients died." 
The treatment evidently called for in the plague is nearly pointed out 
under the preceding type of fever, {typhus gravior,) which it very closely 
resembles. 
Purgatives have been almost proscribed by some practitioners. But, from 
the large quantities of fetid, bilious matter secreted by the liver, and thrown 
into the stomach and first passages, it appears clear that vegetable purgatives 
are indispensably necessary. So far from inducing, they must remove de- 
bility, by evacuating the morbid and feculent matter attendant on the com- 
plaint. 
Emetics have been found by those most experienced in the plague to be 
very valuable. They therefore should be given as early as possible, and 
occasionally repeated, according to the severity and symptoms of the disease. 
I am confident that no emetic, from its extensively stimulating effects, will 
answer a better purpose than the lobelia ivjlata anAipecac. 
Sudorifics are the principal class of medicines to be relied upon, to expel 
from the system the peculiar virus or poison, which is the immediate cause 
of the disorder. The patient, therefore, should be put into a state of per- 
spiration as speedily as possible, by the usual means, to be continued till a 
crisis or remission succeeds. A writer states, " It has been observed that a 
gentle diaphoresis or sweating sometimes proves critical and carries off the 
disease." 
Antiseptics must be administered, if symptoms of putrescency appear: 
the same as recommended under the head of malignant fever. If there be 
great prostration, yeast and good wine may be drank. Infusions of medicinal 
plants, such as balm, catnip, snake-root, mint may be freely taken ; also 
lemonade, cream of tartar, whey, and other diluent, acidulated drinks. 
Ablutions, or bathing the whole body very often with the alkaline wash, 
(ley water,) will be found one of the most powerful and salutary remedies. 
It usually requires not more than fifteen minutes measurably to remove the 
most violent heat of the skin and lower the pulse to its natural standard. 
The feet must also be immersed morning and night in the same liquid. 
Savary, in his Letters on Egypt, mentions an anecdote, which is considered 
by Dr. Falconer as much to his purpose. The captain of a ship, whose 
sailors had contracted the plague at Constantinople, caught it himself by at- 
tending on them: he felt, as he expressed himself, excessive heat, which 
made his blood boil; the disease seized his head, and he perceived (as he 
thought) that he had only a few moments to live. The little remaining 
reason he had taught him to attempt an experiment: he laid himself down 
quite naked on the deck; the heavy dews that fell penetrated, according to 
his sensations, to his very bones. In a few hours he could breathe better, 
his agitated blood became calm, and, bathing the morning after in the sea, he 
was perfectly cured. 
This case brings to my recollection another, of a French soldier, and re- 
ported by Dr. Desgenettes, who, being afflicted with the plague, threw him- 
self into the Nile under a high degree of delirium, and, on being taken out 
of the water after a short lapse of time, soon recovered from the disease, 260 
THE REFORMED PRACTICE OF MEDICINE. 
seemingly in consequence of his immersion. A similar case is brought for- 
ward of the good effects derivable from the sudden application of cold water, 
by Sir Brooke Faulkner, in his Observations on the Plague. 
Water applied to the surface too cold, when the excitement of the blood- 
vessels runs high, or when it is reduced very low, increases reaction in the 
first stage, and prevents it in the latter. In the intermediate stages of the 
disease it is useful. Water which has stood awhile in the air allays thirst 
much more than when it is very cold. This has been confirmed by the ex- 
perience of persons who work in the open air in hot weather, as well as by 
patients in fever. 
Mustard Plasters may be applied to the nape of the neck and to the bot- 
tom of the feet, for pain in the head or delirium. 
For sickness at the stomach, local pains, and congestion, make use of the 
same treatment as recommended under the head of other types of fever. 
Anodynes., combined with diaphoretics, may be given to procure sleep and 
produce perspiration. Nothing will equal the diaphoretic powders, which 
may be given two or three times a day. 
SECTION III. 
YELLOW FEVER. {Typhus Ider odes.) 
DESCRIPTION. 
The yellow fever is a disease which very much resembles in its character 
the highest grades of the bilious remittent fever. It is more violent in its 
attack, and all the symptoms are more aggravated, and there is a greater 
tendency to putrescency, together with some other distinguishing charac- 
teristics. 
CAUSES. 
Predisposing Causes.-There are many predisposing causes of this com- 
plaint, among which may be reckoned intemperance of every kind. Almost 
all the first victims of yellow fever are addicted to the use of ardent spirits, 
and such are the most liable to fall victims to it. The constitutions of such 
are more susceptible of the disease, more violent, and more malignant. 
Another predisposing cause is great fatigue, exposure to damp, wet weather, 
getting the feet and clothes wet, a check of perspiration, overloading the 
stomach, and everything which causes a deviation from health. 
Immediate or Intermediate Causes.-A contagious and poisonous gas or 
gases must be considered the immediate cause of this kind of fever. 
" Pestilence or contagion has always been the peculiar curse of populous 
cities. Of about two hundred general plagues recorded in history," says 
Webster, " a few only have been so violent as to spread over countries into 
villages and farm-houses; almost all have been limited to large towns, evi- 
dently demonstrating that they would never have affected mankind without 
the influence of impure air generated in those places. This is a truth as 
unquestionable as it is important; and on a conviction of this hangs the 
safety of men from that dreadful calamity." 
A writer states that yellow fever, instead of being caused by contagion, is TYPHUS OR NERVOUS FEVER. 
261 
produced, like all other fevers, by debility, and that this debility is caused, at 
least among the patients of New Orleans, by great changes of temperature 
and careless habits ; and that the greatest sufferers are strangers from northern 
climates, whose system have been debilitated by cold winters. This causes 
a balance between internal or vital heat and external heat, which prevents 
that determination to the surface which is essential to health. Another 
cause is the great difference in temperature between day and night, which 
is so great as to produce debility, and thus predispose the system to the 
disease. 
Origin.-There has been great dispute among physicians respecting the 
origin of yellow fever. Some contend that it may be generated in this 
country; others that it is imported. Some, again, contend that it is com- 
municated from one subject to another ; others believe the contrary. Hence 
it has been the theme of fruitful discussion and controversy. From all the 
facts that we can gather, we are led to believe, 
1. That it may be imported from the West Indies and other warm climates, 
into the United States. 
2. That it may arise spontaneously among us from local causes, filth, &c. 
Is Yellow Fever Contagious ?-It is equally evident that the yellow fever 
is not contagious, except under peculiar circumstances. It is highly infec- 
tious within a certain distance of an infected ship or place. In other words, 
as far as the atmosphere is sufficiently contaminated with the deleterious 
effluvia, it may be communicated to those who inhale it. This was clearly 
proved when it last occurred in this city, in 1822. A certain part was en- 
closed, called the " infected district." Those who went within it caught 
the fever, while those who remained outside were free from it. But it is 
equally as clear, and as well established, that the fever was seldom, if ever, 
communicated to those who visited or nursed such as were sick with it. 
As soon as they were removed into the country, or even a short distance 
from the infected part, they never communicated it to a single individual. 
Those who are the strongest advocates for contagion seem to admit that it 
cannot be communicated from one person to another, except the air becomes 
very much vitiated or impure where the patient lays. Hence it is a great 
consolation to know under what circumstances the yellow fever is generated 
and produced. While on the one hand we entertain no groundless fear of 
taking the complaint, on the other, it becomes our city authorities to main- 
tain a rigid quarantine. 
It appears that yellow fever is infectious, not contagious-that is, it is not 
communicated from one person to another, but is communicated by visiting 
the place infected with the malaria or poison. The ship Ten B;others, which 
arrived at Boston in 1819, affords an illustrative example, both of the produc- 
tion of malaria or infection on board ship, and its non-contagious nature. 
This vessel having arrived at Boston on the first of August, a number of 
persons went on board while she was discharging her cargo, and of these 
twelve individuals, living in various parts of the city, were seized with 
malignant fever, nearly all of whom died. The disease was not, however, 
communicated to a single one of those who visited the sick. 
Mortality of the Disease.-Yellow fever has hitherto been very prevalent 
in many of our Atlantic cities, in the West Indies, and some other parts. It 
nas ever been very formidable and very fatal, and which may be imputed in 
a great measure to the want of proper medical treatment. New York, 
Philadelphia, Baltimore, Charleston, Savannah, and New Orleans have 
offered terribly by this horrid malady, and it has been still more destructive 262 
THE REFORMED PRACTICE OF MEDICINE. 
in some of the West India islands. In Havana it is stated that in the montt 
of June (1816, I think) it swept off, in the course of three weeks, thirteen 
hundred persons. 
Proximate Cause.-It is self-evident that the proximate cause of this type 
of fever is a specific poison received from the atmosphere through the medium 
of the lungs, and which enters the circulation, is thrown upon the liver, and 
in an attempt or effort to expel it from the system through the medium of 
this organ and the stomach, vomiting and gastric irritation ensue. The 
poison also being mixed with the blood, is carried to the heart and becomes 
a foreign irritating and morbific agent, which stimulates it and the blood- 
vessels to a most powerful action, to throw it off by the skin and the other 
excretions. 
SYMPTOMS. 
The yellow fever usually attacks with lassitude and weariness, chilly fits, 
listlessness of everything around, faintness, giddiness, flushing of the face, 
redness of the eyes, pains in the eyeballs and lower part of the forehead, 
as likewise in the back; debility and sighing; thirst, and a tendency to le- 
thargy ; the urine is high coloured, small in quantity, and turbid ; the perspi- 
ration is irregular, interrupted, and greatly diminished ; the saliva is viscid ; 
the tongue is covered over with a dark fur ; the bile, which is scalding ana 
acrid, is secreted in unusual quantities, and is thrown into the stomach, from 
which it is again speedily ejected, and the skin is intensely hot, dry, and hard. 
The disease continuing to advance, the eyes become of a deep yellow ; the 
face and breast are tinged with the same hue ; an incessant retching and 
vomiting of frothy bile ensues ; great costiveness prevails, which is attended 
with a permanent dilatation of the pupils of the eyes. 
There is hardly ever an evident remission until the fever has entirely gone 
through its first stage, which is generally in thirty-six or forty-eight hours, 
W'hen there is often such an abatement of the symptoms as to induce the 
patient to think himself tolerably well ; but an early recurrence of the symp- 
toms in an aggravated form, accompanied with extreme debility, soon con- 
vinces him of the contrary. In the last stage of the disease the greatest 
debility prevails, and symptoms of universal putrefaction arise ; large patches 
of livid spots are to be observed on different parts ; the tongue becomes dry 
and black ; the teeth are incrusted with a dark fur ; the breath is highly 
offensive ; the whole body exhibits a livid yellow in many cases, but not in 
all ; haemorrhages break forth from the mouth, ears, and nostrils ; dark and 
fetid stools are discharged; hiccoughs; the pulse sinks, and death follows 
very quickly. These are the usual symptoms, but there is considerable 
variation. 
TREATMENT. 
Indications of Cure.-The great object to be accomplished in the treatment 
of this kind of fever is, to use the most prompt and energetic means to expel 
the poison from the system. 
1. The arterial excitement must be moderated, if excessive. 
2. Excite a healthy action of the stomach and liver, which is always in 
a very morbid condition. 
3. Remove local congestions. 
4 Correct the putrescent state of the fluids. TYPHUS OR NERVOUS FEVER. 
263 
5. Support the strength of the patient; to accomplish which, attend to 
the following : 
The only safe treatment is stimulation. In all cases where debility is 
great, obstruction exists in some part of the system, but especially in the skin. 
Hence the insensible perspiration, by which several pounds are daily dis- 
charged from a healthy subject, is checked, and the matter thus accumulated 
is retained in the system, or carried off'by other channels, producing diseased 
action. The skin is especially inactive in yellow fever, and so is the liver. 
H?nce the bile, a fluid necessary to digestion, instead of being discharged into 
t ie stomach, is distributed through the system, and reaches the skin to be 
thrown off by perspiration ; but as the skin also is inactive, and perspiration 
consequently checked, this bile is retained at the surface. Hence the dryness 
an 1 yellowness of the skin. The stomach and bowels also are paralyzed; 
hence the loss of appetite and inability to digest. Under this theory of causes 
and symptoms, the indication of cure, to use technical language, is to excite 
action where it is* most deficient, in the stomach, bowels, liver, and skin ; and 
this can be done only by stimulants. The first step is to clear the stomach and 
bowels by an emetic ; the second by a brisk purgative: a diaphoretic should 
be swallowed, and the patient placed in a water or vapour bath at a moderate 
temperature at first, which is to be augmented according to the patient's 
strength, not exceeding 120Q of Fahrenheit, till perspiration appears; and, 
while in the bath, the patient should occasionally drink of catnip or other 
herb tea. On leaving the bath the patient should be placed in a warm bed, 
well covered with blankets, to promote perspiration. After perspiration has 
ceased, the bed clothing should be gradually removed, till only enough remains 
for comfort and the prevention of cold. 
We venture to say that this practice will cure most cases of yellow fever, 
and are told that it is almost uniformly successful among the French and 
Spanish physicians at Havana, while the Americans and English are slaughter- 
ing with calomel and the lancet. All physicians who have attended yellow 
fever, will admit that perspiration will save the patient ; a proof of our 
theory about obstruction of the skin. They also know that when perspira- 
tion first appears its odour is offensive, and that it dyes linen of a yellow 
or brown colour; additional proofs of our theory about obstruction in the 
liver, and of the diversion of the bile from the stomach to the surface. The 
hinge of our practice is a determination of the vital energies from the centre 
to the surface, and the excitement of the skin ; these are to be obtained only 
by clearing the stomach and bowels of unnatural loads, and exciting perspi- 
ration, and sponging the surface often with ley water. 
Such is the treatment in general; but, to be more particular, I will treat 
first of the stomach. 
The Stomach.-The stomach in this complaint is in a very irritable and 
morbid state, in consequence of a secretion of acrid, vitiated bile from the 
liver. Probably an acid of a peculiar nature is generated. It therefore 
becomes necessary to use the most prompt and energetic means to bring about 
a healthy state of these organs. Emetics have been proscribed by almost all 
practitioners, by reason of the extreme irritability which exists ; and that, 
too, very justly, except an opportunity offers to prescribe before this state of 
the stomach appears, previous to which a vegetable emetic may be given 
with safety and advantage. It will have a tendency to mitigate the violence 
of the disease, and act favourably upon the liver. 
The Bowels.-It is indispensably necessary, in any stage of this fever, to 
administer brisk purgatives. The same kind may be given as directed in 264 
THE REFORMED PRACTICE OF MEDICINE. 
the preceding disease, viz., the common or anti-bilious physic. When the 
stomach is overloaded with bilious matter, it often acts as a mild emetic, then 
as a cathartic, evacuating the stomach and first passages thoroughly, and 
exerting a healthy action upon the liver and the whole alimentary canal. 
These purgatives relieve the head, lessen the fever, and in every respect 
improve the condition of the patient. 
Where the stomach is very irritable and excessive vomiting prevails, such 
medicine must be given as is calculated to allay it. The neutralizing mixture 
for this purpose is excellent. 
One table-spoonful of the above may be taken at a dose, and repeated 
every half hour until it ceases. This will be found an admirable remedy 
for removing nausea and vomiting, which prevail in this fever. 
One writer states that in some instances the vomiting has been known 
to cease upon the application of a large poultice of mustard flour to the 
stomach and feet, which ought not to occasion inflammation of the skin. 
A mustard plaster will be found far preferable to blisters. It will be 
necessary to give a purgative every day, and, if the attack is very violent, 
twice a day, particularly in the first stage of the disease. 1 have been called 
where delirium was present from an accumulation of bilious matter in the 
system inducing fever, in which the administration of a brisk cathartic has 
restored the patient to a sane state of mind, diminished the fever, and appa- 
rently cut short the disease at once, or within twenty-four or forty-eight 
hours. The quantities of offensive or bilious matter discharged have been 
truly surprising. In one instance the health officer had previously been 
giving only an infusion or the tincture of snake-root as a tonic. 
The Skin.-It is inconceivably important to attend to the skin. The dry, 
hot, and parched state of the skin points out the necessity of promoting per- 
spiration. An infusion of boneset., drank very freely, has an admirable effect, 
by promoting sweating ; a quart may be drank in the shortest space of time. 
This infusion appears to act upon all the excretions ; and we have some well- 
authenticated cases of its having performed a perfect cure in yellow fever, 
without any other medicine, except the addition of a little brandy. Should 
this alone fail of producing perspiration, a tea-spoonful of the sudorific or 
sweating drops may be taken, till free perspiration is produced. 
When the stomach becomes no longer able to bear it, or should they cause 
too much sickness, cold water, except when there is great perspiration, and 
cream of tartar water may be taken ; also, lemonade, infusions of mint, catnip, 
balm, fye* 
The Surface.-The whole surface of the body, as early as possible, must 
be thoroughly bathed with weak ley every two hours through the day and 
night if the patient does nortsleep, or as often as the fever increases. This 
will have a remarkable effect in allaying the febrile excitement. The transi- 
tion from pain to relief, by this application, is truly surprising, not only in 
this, but in all febrile diseases. 
The Feet.-It is equally important to bathe the feet morning and night. 
* Yellow and other Fevers.-It is stated that, in the year 1793, when the yellow fever raged 
in Philadelphia, a person was seized with it, and deserted bv every one. He dreamed that 
could he procure the '■'beloved or holy blessed thistle," (Cardus Benedictns.) he would soon 
be cured, having, been accustomed to use it while in Europe. Through the Health Com- 
mittee he obtained it, made a tea, drank freely of it, and he soon recovered. 
Henry states in his Herbal on this plant as follows : As a sweating medicine, a wine glass- 
ful every two hours of the strong decoction in bed. He says it is good in fevers, and 
makes an excellent bitter, as follows: Prepare four ounces of the dry herb in two quarts 
of cold spring water: take half a tumbler three or four times a day. TYPHUS OR NERVOUS FEVER. 
265 
This equalizes the circulation, and thereby prevents local congestions and a 
determination of blood to the head. If the patient cannot rise from his bed, 
it may be done in a recumbent position. 
77/e Abdomen.-Oftentimes the abdomen is tender, and becomes swollen 
from the irritation of the intestines. When this is the case, apply warm 
fomentations to it. Hops and wormwood, boiled in vinegar and enclosed in 
a flannel bag, must be applied to it. 
The Head.-If there is great determination to the head, delirium, &c., a 
towel may be dipped in a mixture of spirits, vinegar, and water, to which 
has been added a little salt. 
Anodynes.-Anodynes may be given if the patient is very restless and 
unable to sleep. Fifteen grains or a tea-spoonful of the diaphoretic powders 
must be given night and morning, and repeated every two hours if the pain 
is not removed or sleep procured. The ordinary effects of opium is prevented 
by this peculiar compound. It induces sleep without increasing the fever ; 
but its diaphoretic properties lessen it. 
Antiseptics.-In a great tendency to putrescency yeast may be freely 
given, as much as the stomach will bear. It may be mixed with a little 
milk and molasses. If there is great prostration and sinking, wine may be 
drank, mixed with water and given warm. 
Cold Affusion.-Should the fever prove refractory under this treatment, 
or should it not readily yield, the cold affusion must be used. The whole 
body must be repeatedly and thoroughly bathed with cold water, until the 
fever abates. 
Give internally, if there remains any irritability of the stomach and great 
thirst, the following liquid : Take sal seratus, (bi-carbonas potasses,') a tea- 
spoonful, (1 drachm ;) mint water or tea, 8 oz.; mix : give a table-spoon- 
ful every three hours through the day. 
This alkaline liquid will allay the irritability of the stomach, correct the 
putrid state of the fluids, and act favourably on the skin, and is admirably 
calculated to neutralize the acidity and poison in the stomach and intestines. 
Cream of tartar whey is a very valuable drink, and which may be occa- 
sionally taken. 
Boneset is also a very valuable remedy in yellow fever. A Mr. Gilbert 
Fowler, of this city, was attacked with this fever in the year 1805, and the 
only medicine that he took was the following : A strong decoction of boneset, 
two quarts ; French brandy, half a pint. The whole to be taken as soon as 
possible, and as warm. This, from its action upon all the excretions, stomach, 
skin, &.c., soon arrested the disease, and he recovered. 
Mr. David Whitehead, of this city, in the year 1794, wdiile the yellow 
fever raged here, was attacked with the disease, and having been told of the 
salutary effects of the boneset, he commenced taking a strong decoction of it, 
with the addition of Virginia snake-root. In fifteen or twenty minutes he 
drank two quarts of the tea, and such was the effect upon the system that 
it cut short the fever at once. 
Thus it seems that simple plants are very effectual in removing even the 
most formidable diseases; but in these days of popularity, error, and preju- 
dice they are despised, rejected, and trampled underfoot. This very plant 
just mentioned was likewise found of singular efficacy in a remittent or in- 
termittent fever which prevailed during the American war among the soldiers. 
The physician of the regiment, or the nurse, I know not which, went into 
the meadow and collected a large quantity of the thoroughwort or boneset, 
and put it into a large iron kettle, boiled it until it became a strong decoction, 266 
THE REFORMED PRACTICE OF MEDICINE. 
and then administered it to all that were sick with the fever. The conse- 
quence was, that the whole of the sick recovered rapidly and in the most 
surprising manner. It also had an astonishing effect in the remittent fever, 
which prevailed in another section of the country. 
There are numerous other authorities to prove the superiority of the vege- 
table over the mineral practice. 
Dr. Hosack states in a letter to the mayor of New York, on the yellow 
fever, that, however humbling it is to the pride of medical science, a certain 
quaker of this city cured more patients by giving catnip tea and castor oil, 
than the rest of the faculty !* 
Cold Water.-The patient may also in this disease take cold water. It 
is not only very refreshing, but diminishes the fever, and is a valuable aux- 
iliary in curing the disease. I know a man in this city who was in the most 
hopeless condition with yellow fever, and who was forbid by his physician 
to taste any cold water ; he procured it in a clandestine manner and drank it 
very freely, which caused perspiration and removed the fever in a very short 
space of time, without any other medicine. Nature in such cases seems to 
point out the cure. 
In concluding this section on the treatment of yellow fever, I will partly 
recapitulate. 
First. Negatively.-Be careful not to administer a particle of mercury ; it 
is almost as dangerous as the disease itself. Abstain from bleeding ; it w'ill 
hasten the disease by the debility wrhich it induces. 
Second. Positively.-The treatment in this disease must be very prompt 
and energetic. The whole secret of curing it depends upon the means made 
use of to open all the excretions, and that as soon as possible before the 
stage of collapse or prostration ensues; and all this is effected in a similar 
manner as it is in other types of fever, with this difference, that the treat- 
ment must be more active. 
There are three principal things to be relied upon in arresting this disease. 
1. Cathartics.-I find none so good in this as well as in most febrile dis- 
eases, as that which I have before recommended. 
2. Sudorific or Sweating Medicine.-The sudorific or sweating drops must 
be administered, a large tea-spoonful at a dose, every hour, till free and 
copious perspiration ensues ; to be given in half a pint of catnip tea, and to 
be kept up during the fever. After which let an infusion of boneset be drank, 
warm. Should these drops at anytime prove too stimulating, substitute the 
diaphoretic powders. The medicated vapour bath may be advantageously 
used in this and other types of fever in their commencement. 
A very skilful French physician, who practised many years ago in Phila- 
delphia, was in the habit of saying, that as soon as he got his patients (afflicted 
with this fever) into a free perspiration he pronounced them out of danger. 
Since writing the preceding I have been favoured with a small treatise 
upon the nature and cause of yellow fever, in which my views are farther 
confirmed. The writer thus remarks : 
* Allow me to add this truth, however humiliating it may be to the pride of science, and 
I mention it in confirmation of the good effects of this comparatively mild treatment, that, 
in the yellow fever of 1798, under the direction of Richardson Underhill, a member of the 
Society of Friends, who, like another Howard, volunteered his services to the poor, on that 
memorable occasion a greater proportion of persons ill of that disease were cured by means 
of castor oil and catnip, than by those more active prescriptions employed by many of the 
physicians of our city. With the hope that these suggestions may be useful, 
I am, dear sir, &c., DAVID HOSACK. 
THE HON. CADWALLADER D. COLOEN. TYPHUS OR NERVOUS FEVER. 
267 
" On the subject of a remedy permit me to state, from undoubted informa- 
tion, that in most parts of the West Indies there are now regular-bred 
nurses, who take with them their large bathing tubs, and first immerge their 
patients in a warm bath; rubbing them with cloths, squeezing over them 
warmed lime and lemon juice, and causing them to drink plentifully of lemon- 
ade and other diluting drinks. If a perspiration succeed, they clap their 
hands in signs of safety. They also administer emetics and gentle purges, 
if necessary. This ' sudorific ' practice seldom fails of cure, if the golden 
moment be not lost, and if applied immediately on the first attack of cold 
chills, and before the mucus begins to form in the stomach and external 
fever sets in, which is about the second on third day. As this said mucus 
or phlegm accumulates, through the body into the stomach, after a check of 
the perspiration, the fever, as a counteracting effect, increases in its struggle 
to relieve the patient. 
These West Indians have no terrors of contagion; they neither speak of 
nor heed its importation or exportation ; they know its true cause, and call 
yellow fever the highest grade of indigenous bilious fevers among them. 
They have already, in most of the islands, rendered its effect mild and 
manageable to a great extent among themselves, and may, by this simple 
practice, ' within reach of everybody,"1 ultimately neutralize its consequences, 
perhaps to its final melioration. 
That I may be fully understood, I beg leave to explain my own simple 
view of this said check of the perspiration, now so little regarded. 
Our bodies are externally covered with a kind of net-work, called skin, 
consisting of innumerable pores, which expand with heat and contract with 
cold. In perfect health these pores emit a constant insensible fluid or 
steam, and, when the body is agitated, appears in a visible sweat. Through 
these pores by far the greater portion of our food is discharged. When 
sudden cold seizes on a healthy body, these pores experience shivering and 
chills, which draw them shut, and the fluids cease to be discharged through 
them externally. This I apprehend to be a check of the perspiration, and 
may be more or less general over the whole body. Its effect also is the 
precise manner in which yellow' fever begins, viz., with chills. It is then 
fczW nature instantly commences the w'ork of relief through a reaction of in- 
ternal heat or fever. To effect this, the blood is set in rapid motion through 
the body, and the pulse, from its natural beat of about seventy-five, is made 
to strike more than one hundred times in a minute. This heat or fever, in 
the order of nature, reacts with all its power on the external cold ' infec- 
tion,' and a perspiration is thereby frequently forced on bodies in previous 
good health by the mere rapid motion of the blood, without any other aid 
than this increase of nature's fever heat. If the warm drinks and bathing 
practice, as above stated, be instantly applied on the first attack of cold, 
nature receives a powerful auxiliary (in her own way, through an external 
and internal heat) toward an increased motion of the blood ; and if a pro- 
fuse sweat be the consequence, nine times out of ten the pores open and 
assume their functions, and the patient is relieved in a few days. If an 
attack of cold in this season of the year be a relapse on bodies previously 
unwell, and the efforts to produce perspiration fail, the heat or fever puts 
on an alarming external appearance on or about the second or third day, 
and continues to act with a proportionate, though natural and necessary, 
vigour toward a restoration. In these extremities we are most inclined to 
tamper with the patient, who ought not to be otherwise acted upon until the 268 
THE REFORMED PRACTICE OF MEDICINE. 
paroxysm of fever shall abate. To practice on this fever as a cause, in my 
view of it, is death ; to treat it as a friend, is life I 
A fever pervades animated nature, and almost instantly follows diseases 
of every kind. It is then an effect, not a cause ; a remedy, not a disease, 
and ought to be promoted as a. friend to destroy an enemy, when itself will 
disappear ! It is nature's restorative. The medical practitioner is rarely 
called until the second stage of diseases ; he finds the patient in high fever ; 
4 pestilential yellow fever ' is declared! In 1793-95, and '98, (and as the 
young practitioner had been taught to practice,) in went the lancet, down 
went the calomel and jalap, all to kill the fever, treating it as a cause. The 
fever is lessened, and the patient lapses in a stupor. Again, the fever 
(deemed to be the dire enemy) rouses the patient for life into action ; other 
' copious bleedings were then had, and purges repeated ' to the entire empti- 
ness of the body of its blood and the bowels of their sustenance ! The fever 
is broken. The patient becomes cool and easy, is not emaciated, conceits 
himself well, walks erect at flighty intervals, though in a general stupor 
through want of fever, and dies apparently cool and without fever ! 
The great danger in all diseases is the application of too much art inter- 
rupting the efforts of nature.* 
If the 'sudorific' practice shall prevail, it is confidently believed that 
our fall fevers will be rendered mild, as they are daily becoming in the West 
Indies, from a true knowledge of their causes and management. Nature 
will then be studied by the common people, in her health and her diseases, 
on the broad basis of her elements, in every climate, and especially in our 
own. Disputations about non-entities will then be heard of no more, at least 
among the real students of nature, and particularly those of the reformed 
faculty." 
3. The Surface.-The whole surface from the neck to the feet must be 
drenched, and effectually rubbed and bathed with strong leached ley water, 
used sometimes tepid and sometimes cold, as it may most diminish febrile 
excitement. 
These, and the auxiliary means recommended in the preceding chapter, 
will be found a very superior and sovereign remedy for the yellow fever, 
called in any reasonable time. 
REGIMEN. 
Diet in this fever is almost out of the question, as patients seldom can eat 
anything; but should the patient desire it, he may take a little panado, 
Indian meal gruel, or barley water. A very grateful and nourishing drink 
is made by toasting bread very brown and soaking it in water, and then 
drinking the water. It is good for the nausea; is cooling and nourishing. 
For a change, lemonade, currant jelly, tamarind, and apple water may be drank. 
Buttermilk, moderately acid, and mixed with water, is very refrigerant. 
Vegetable acids of all kinds are very agreeable to the patient, and very 
antiseptic. 
Cool Air.-Cool air is as necessary to the patient as medicine. The room 
* This is declared of George Washington, the Father of his Country, who is believed 
to have sunk into premature death by this practice of bleeding, so repeatedly performed on 
him. It is believed that thousands have since fallen by like practice ; and millions may yet 
fall from a misapplication and disregard of the only true means of relief, through a multi 
plicily of frivolous and false hypothesis. TYPHUS OR NERVOUS FEVER. 
269 
must be kept clean and well ventilated, by opening the windows, removing 
the bed-curtains, and placing the bed, when practicable, in the middle of the 
room. Vinegar and water applied to the head, on a cloth or napkin, lessens 
the pain and heat of it, and thus affords great relief by rendering the intel- 
lects clearer and lessening delirium. Washing the face, hands, and feet 
often with the same liquid will prove equally serviceable and refreshing. 
Quietude.-Company, noise, and conversation must be avoided. As much 
encouragement must be held out to the patient as the symptoms will warrant; 
but never, no, never deceive or flatter him by creating false hopes of recovery. 
Anv physician who is guilty of this, is answerable to his conscience and to 
the Bar of God. 
A young man, whose veracity can be relied upon, states that, during his 
residence in New Orleans, he, with two others, was seized with the yellow 
fever, and his case was pronounced hopeless. He had an irresistible desire 
for cold water, which was denied him; one night, in the absence of his 
nurse, he reached a basin of soap-suds, and such was his intolerable thirst, 
that he greedily drank it. The consequence was, a free perspiration, a re- 
mission of the symptoms, convalescence, and recovery ; while the other two, 
affected with the same fever, died. May we not draw a practical inference 
from this fact: 
1. That nature often in this.manner points out the cure, and we ought, 
therefore, to be always careful to watch and follow her dictates. 
2. We may also learn from this fact, as well as numerous others, the anti- 
febrile properties of water. 
3. We may also infer that the soap which was mixed with the water might 
have contributed to the cure, and, therefore, may contain great medicinal 
properties. 
" To prevent the yellow fever," says Elisha Morrel, Esq., " A Catholic 
bishop in the West Indies, aged about eighty, informed a physician of this 
city, who was there as surgeon on board one of our naval ships, that he had 
been much exposed to the yellow fever, in the worst cases, and he never 
had any attack of it in his life. His preventive was, taking charcoal daily. 
The physician farther states, that he gave the same to the men on board of 
the vessel, and not one man took the disease." 
Moral reflections.-" What striking instances of the transitory nature 
of life does such a disease afford ! We see men, exulting in the bloom of 
youth and prime of health and strength, in three or four days numbered with 
the dead. Our gayest companions, our most amiable friends, in less than a 
week are laid in the dust. When we have been daily witnessing these 
scenes around us, who can avoid reflecting that his turn may be next 3 yet 
the mind, when habituated to the most afflictive and extraordinary events, 
becomes hardened and views them with indifference- Disease and death, 
the most dreadful accidents which can affect the human frame, when made 
familiar to the sight, cease to inspire dread, and are ranked with the most 
common occurrences." 
A merited tribute.-The New Orleans crescent city awards high praise to 
Mrs. Shall, the proprietress of the City Hotel, for her attention and kindness 
to the sick of that city during the prevalence of the epidemic, not only in 
1841, but past seasons. It is stated that in 1830 Mad. Shall had in her house 
upward of sixty yellow fever cases, only one of which proved fatal. This 
year she had eighteen cases, with only one death. And all this principally 270 
THE REFORMED PRACTICE OF MEDICINE. 
attributable, under Providence, to her skilful and kind nursing. Besides this, 
she has visited neighbourhoods and sufferers, carrying the balm of health in 
her hands. This is indeed the reality of the poet's vision, who wrote of 
woman: 
" When pain and anguish wring the brow, 
A ministering angel thou." 
SECTION IV. 
SPOTTED FEVER. (Typhus Petechialis.) 
DESCRIPTION. 
" Perhaps there is no disease," says Hand, " which so soon makes the 
tongue to falter, the knees to totter, locks up the senses, alienates the mind, 
and with unconquerable weakness saps the very basis of our life, as spotted 
fever. It is not confined to any season, and it has not been observed to choose 
any peculiar aspect or atmosphere, but visiting in turn the bleak ridge and 
the banks of the clear stream." 
This very formidable disease made its first appearance in our country in 
the town of Medfield, Massachusetts, in the year 1806. Subsequently to 
that period it has occasionally been recognised as an epidemic in various 
parts of the New England states, in the state of New York, and on the 
borders of Canada. In 1810 it prevailed with mortal rage in Worcester, 
Massachusetts, and in the autumn of 1812 and winter of 1813 the same or 
distinct epidemic visited the army of the United States, stationed at Green- 
bush, and at various other situations, where its destroying power has scarce- 
ly been exceeded by military slaughter. It was prevalent also in Connecticut 
and Vermont, and a considerable number of fatal cases occurred likewise in 
Boston, both among the inhabitants and the soldiers quartered in that metro- 
polis. It has usually occurred during the cold weather of wunter and spring, 
and its continuance has been protracted in some seasons to May and June, 
chiefly in the interior of the country. 
CAUSES 
We have never heard any cause assigned for this fever ; but it would ap- 
pear that it arises from a peculiar morbid state of the atmosphere, engender- 
ing some specific virus, or poison different from any other. The paleness of 
the surface which sometimes attends the disease, and the partial or total want 
of reaction, show that the blood is forcibly and powerfully driven from the 
surface to the internal organs. The congestion or accumulation of blood is 
sometimes so great, that the heart and arteries are incapable of exerting the 
least power to counteract the cause of the disease : hence they sink immedi- 
ately under its withering influence. Dissections demonstrate a morbid state 
of the heart and lungs with their contiguous membranes. 
o o 
SYMPTOMS. 
Though the leading features of this enemy are always the same, yet his 
dress is endlessly varied. 
To enumerate symptoms • Some patients are seized with violent pains in TYPHUS OR NERVOUS FEVER. 
271 
the stomach, head, joints, and limbs ; and frequently the pain is confined to a 
single point; often to a single toe or finger. Some have a violent ague and 
shaking, and yet are not sensible of cold; and some have no heat. Some 
were taken suddenly, totally blind, or impenetrably deaf; others were not 
affected at all in those organs. A palsy of a member was not unfrequent, 
and a strange numbness was felt in the nose and face of some, which led 
them to be rubbing their face, and that for hours. Some had raving or 
furious delirium, others a playful or hysteric alienation of mind, while others 
were more shrewd than before. Some were conscious of their sinking, yet 
seemed not to mind it. Some fell into a snoring lethargic sleep, from which 
nothing would rouse them. Some were so painfully sensible as to complain 
of the slightest touch or motion, while others felt not the pricks of needles, 
nor even the contact of living coals. 
Dr. Miner, of Middletown, (Conn.,) said in some cases the stomach was 
perfectly torpid, like a leather bag; the most powerful stimulants conveyed 
into it did no good; while in others there was dreadful gastric (stomach) 
irritability, immediately ejecting everything swallowed. The pulse was 
commonly feeble, frequent, irregular, and often interrupted. In some cases 
it seemed inflated, yet would disappear upon the slightest pressure. Some- 
times, when the pulse was gone in the wrist, the arteries of the neck would 
be seen beating with seemingly impatient and fretful motion. 
Bleedings were frequent from different parts of the body, and often fatal. 
Purple spots appeared in some, from oozing of blood from the relaxed vessels 
of the true skin, yet without sufficient force to penetrate or elevate the scarf 
skin, and spreading to various sizes, from a point to that of a shilling; and 
assuming different hues, from scarlet to black. In this disease, however, there 
are often no spots nor fever at all, and the patient is in many cases dead 
before fever could form. 
From the onset a clay-like coldness came over the whole system, and all 
efforts to restore genial warmth were frequently unavailing. The tongue 
was in some cases clear and moist, in others dry, in others bloodless; in the 
progress of the disease it commonly turns brown or black. The swallowing 
was often difficult, from canker in the throat or from palsy of the parts. 
Nausea and vomiting commonly harassed the patient from first to last; yet 
the contents of the stomach were not at all vitiated. The bowels seldom suf- 
fered at all. A horrid sensation of cold was felt in the stomach, as if ice was 
melting there ; this symptom, as well as that of puking, was greatly aggra- 
vated by drinking cold water or any weak beverage. Patients who inquired 
for water could not distinguish it from brandy. 
Dr. Wolcott states the case of a medical gentleman, a relative of his, who 
was suddenly seized with strong, fixed pain in his shoulder. The patient 
undertook to open a vain in his arm, but the blood was so stagnated that it 
would not flow. The patient and his friends became alarmed, and sent for 
a council of physicians, who arrived in time to investigate his case. The 
pain in the shoulder, still increasing, became terribly severe, and he screamed 
aloud. " Gentlemen," said the patient to the physicians, " what do you think 
of mv case ? I request you to speak without reserve, and name, if you can, 
my disorder. Do not hesitate to tell me whether you think I can or cannot 
survive. 1 beseech you do not deceive me. I wish to know the worst." 
" Doctor," said the physicians, " we would not give you unseasonable alarm, 
but as vou have, requested us to express our opinon, we, as in duty bound, 
must tell you that we think your disease very nearly resembles (if it is not 
identified with) the spotted fever, and that your case is desperate." 272 
THE REFORMED PRACTICE OF MEDICINE. 
" Give me opium," said the patient, " the pain is intolerable, I cannot bear 
it." Opium, in substance, was accordingly immediately administered, of 
which he took in a short time a piece as large as a butternut, but without 
any alleviation of the pain. At length he swooned away, and sunk into the 
arms of death, in sixteen hours from the first attack. During the whole of 
the tragic scene the pain was constantly fixed in the shoulder. His body 
was not opened, but the shoulder, after death, exhibited a gangrenous (black 
and blue) appearance. 
The invasion of the disease is generally sudden and violent. The patient 
is seized in the midst of his usual labour, and oftentimes is struck down sud- 
denly almost as by a stroke of lightning. 
TREATMENT. 
Indications of Cure.-The indications of cure in this disease are, first, to 
recall the blood from the internal parts to the surface of the body, by pro- 
moting perspiration. Second, to remove urgent symptoms. Third, to sustain 
the sinking powers of life. 
The whole history and symptoms of spotted fever show the absolute neces- 
sity of administering such medicines as will cause a copious perspiration. 
The means recommended under the other types of fever may be used in 
this, but given oftener and in greater doses; in conjunction with which the 
vapour or hot bath may be used. Dr. Miner, who had considerable experi- 
ence in this disease, says, that not only a warm, but a hot bath should be 
used. An infusion of the bonesei or thoroughwort is highly recommended. 
A small quantity of brandy may be added, and taken as warm and as often 
as possible. 
Purgatives should be daily given ; and when the patient is in great distress, 
twenty grains of the diaphoretic powders may be repeated every two hours. 
In clay-like coldness of the surface let it be thoroughly bathed with capsicum 
(cayenne pepper') and brandy in suitable proportions, simmered and applied 
as warm as the patient can bear it. A tea-spoonful of the pepper may be 
given internally in a tumbler of mint tea every hour or two, until warmth 
of the system is restored or reaction takes place. The medicated vapour 
bath may also be used to produce perspiration. The feet must be frequently 
bathed in warm or hot water. When the head is much affected, tepid water 
may be applied to the temples and forehead. Sinapisms can also be applied 
to the feet. If there is pain and oppression at the chest, warm applications 
should be applied to it. Infusions of snake-root, chamomile, catnip, balm, 
&c., may likewise be given. Should the violence of the disease be directed 
to the bowels, apply fomentations of hops and vinegar. Give also injec- 
tions. If there is much retching and vomiting, give small quantities of brandy 
and essence of peppermint, mixed, or the neutralizing mixture. If this 
should not stop the retching, let the mixture be given as recommended for 
vomiting under yellow fever. 
If great sinking comes on in the course of the disease, give a wine glass 
of yeast every two hours ; also wine or porter. 
Dr. Hand says : Under this view of the subject, we sec what must decide 
when doctors disagree, the cases giving laws to the prescriber, and the symp- 
toms pointing, with iron index, to the only means which can save the patient 
from sinking, viz., cordial, stimulating medicine, and nourishing diet. The 
pressure of the disease and the remaining strength must determine the kind 
and quantity of means ; and the range is between going into a warm bed. SCARLET FEVER. 
273 
with drinking pennyroyal, horsemint, spearmint, or peppermint tea, and hot or 
vapour bath, with brandy, laudanum, ether, &c. 
Begin the treatment by putting the patient into a warm bath, apply flannels 
wrung out of hot water, or bladders of hot water, to the sides and feet of the 
patient. If the disease be more than slight, give as a drink hot wine whey, 
milk punch, or warm wine and w'ater. If obstinate nausea or puking attend, 
give hot brandy, a spoonful at a time, with only water enough to keep it from 
strangling ; put a capsicum and a mustard plaster over the stomach. If 
lethargic symptoms come on, apply the same on the nape of the neck, and 
increase all the stimulants. • 
If the warmth and moisture return, and the pulse is raised, there is hope ; 
yet the patient must be kept up, and the disease kept at bay by anodynes, in 
full portions every two or three hours, essence of peppermint, spearmint, &c. 
The late Dr. Anthony Hunn, of Kentucky, who had considerable experi- 
ence in this complaint, cured every case by plunging his patients immedi- 
ately into a hot bath. 
The whole indication of cure in this disease is to bring on reaction, to recall 
the poison which is mixed with the blood and thrown to the centre, which 
can only be done by inducing a copious perspiration in the most prompt and 
energetic manner. 
If I mistake not, where sweating was produced in this complaint, recovery 
invariably followed, while bleeding, mercury, &c., only aggravated it. 
The sweating or sudorific drops, then, given freely, and bathing the surface 
repeatedly with capsicum or cayenne pepper, with spirits or brandy simmered 
a few minutes together, and applied over the whole surface as hot and as 
often as possible, together with bathing the feet, the hot bath, and an infusion 
of peppermint given as warm as can be drank, constitute the principal remedies 
in this type of fever. 
CHAPTER IX. 
SCARLET FEVER. (Scarlatina.) 
DESCRIPTION. 
The scarlet fever is so denominated from the scarlet colour and eruptions 
which appear on the body. It occurs at all seasons of the year, but generally 
in the fall or beginning of winter. It often seizes whole families, but children 
and young persons are more subject to it. It is divided into three principal 
kinds : Simple scarlatina, when the throat is not affected ; scarlatina angi- 
nosa, when the throat is affected ; when accompanied with symptoms of 
putrescency and malignancy, it is called scarlatina maligna. The latter two 
kinds are generally blended together. There has been a dispute whether 
the scarlet fever and malignant sore throat are the same diseases, or only a 
variety of the same. " It is now pretty generally admitted," says a writer, 
" that the scarlet fever in all its forms, as well as putrid sore throat, (cynanche 
maligna,} is produced by the same specific contagion." 
CAUSES. 
Scarlet fever arises from a specific contagious effluvia. 274 
THE REFORMED PRACTICE OF MEDICINE. 
SYMPTOMS. 
The scarlet fever commences with a chill and shivering, like other kinds 
of fever, with nausea and often vomiting, great sickness succeeded by heat, 
thirst, and headache ; sometimes in a very mild degree, at others more violent. 
The pulse is accelerated, the breathing is frequent or interrupted, the eyes 
red, and eyelids swollen. In two or three days the flesh begins to swell, 
a pricking sensation is experienced, and an eruption appears on the body in 
the form of a red stain or blotch, or rather of a fiery redness. It usually 
appears first upon the face, breast, and arms, then over the whole body, of 
a uniform red colour. In about three days a gentle perspiration takes place ; 
the effervescence or eruptions disappear ; the cuticle peels off, and there 
remains a kind of branny scales dispersed over the whole body, which some- 
times reappears two or three times. 
The scarlet fever may be distinguished from the measles, by the eruptions 
of the former {scarlatina) being more of a fiery redness, and diffused over 
the whole body, and not as in measles, in distinct spots; nor is it accompanied 
with any cough or a weeping or watering of the eyes ; and the efflorescence 
of the measles does not appear till about two days later than scarlet fever. 
Where the disease appears in the simplest form, there is little required from 
art; a simple course of treatment soon removes it. 
SECTION I. 
SCARLATINA ANGINOSA. {Affecting the Throat.) 
Scarlatina anginosa, in several instances, approaches very near to the 
malignant form. The patient is seized not only with a coldness and shivering, 
but likewise with great languor, debility, and sickness, succeeded by heat, 
nausea, vomiting of bilious matter, soreness of the throat, inflammation, and 
ulceration in the tonsils, &c., a frequent and laborious breathing, and a quick 
and small depressed pulse. When the efflorescence appears, which is usually 
on the third day, it brings no relief; on the contrary, the symptoms are 
much aggravated, and fresh ones arise. 
In the progress of the disease one universal redness, unattended, however, 
by any pustular eruption, pervades the face, body, and limbs, which parts 
appear somewhat swollen. The eyes and nostrils partake likewise more or 
less of the redness, and in proportion as the former have an inflamed appea- 
rance, so does the tendency to delirium prevail. 
On the first attack the throat and mouth are often much inflamed ; but this 
is usually soon succeeded by grayish sloughs, which give the parts a speckled 
appearance, and render the breath more or less fetid. The patient is often 
cut off in a few days : and even if he recovered, it will be by slow degrees ; 
dropsical swellings, or tumours of the parotid and other glands, slowly 
suppurating, being very apt to follow. 
" The patient," says an author, " complains of a stiffness in the neck, with 
acute pain in the back of the head. The throat is sore and inflamed, exhi- 
biting a shining redness of a deeper colour than in common inflammatory sore 
throat, and interspersed with pale or ash-coloured spots. In many cases the 
affection of the throat is among the first symptoms, a dark red line extending 
along the curtain and lower part of the uvula. The breath is highly offen- 
sive, the tongue is covered with a yellow mucus or thick brown fur, and the 
inside of the lips is beset with vesicles containing an acid matter, which SCARLET FEVER. 
275 
excoriates the corners of the mouth and other parts. In the progress of 
the disease the inside of the nose becomes red and inflamed, and a thin 
acrid matter issues from the nostrils, which corrodes the skin wherever 
applied." 
SECTION IL 
SCARLATINA MALIGNA. (Malignant Species.) 
" This," says Dr. Thatcher, " is the cynanche maligna of Cullen, the 
ulcerated or putrid sore throat of Huxham and other authors. This form of 
the disease has several symptoms in common with scarlatina anginosa. It 
comes on with rigours, dejection of spirits, pain in the head and back, giddi- 
ness, vomiting, and much general oppression. The eruption comes out in 
blotches, or small points scattered over the body and extremities, of a dark 
purplish or livid hue. The fever is intense and progresses with rapidity, but 
manifesting an augmentation in the evening and slight remission in the 
morning. The pulse is small, indistinct, and irregular. There is a very great 
determination of blood to the brain, producing redness of the eyes, intolerance 
of light, throbbing, pain of the head, and delirium or lethargy. The whole 
neck sometimes swells and assumes a dark red colour. It sometimes happens 
that the malignant kind appears without any affection or efflorescence of the 
skin, as scarlet fever in some cases presents itself without any ulceration of 
the throat. As the sloughs about the mouth spread they generally become 
of a darker colour, the whole internal mouth and throat are at length covered 
with thick sloughs, which, when they fall off, discover ulcers very deeply 
seated, and the parts appear quite black, and the sloughs often extend 
throughout the whole of the intestines. The eruption sometimes suddenly 
recedes, an alarming train of symptoms ensues, as also when the eruption 
suddenly assumes a very pale and livid appearance. The symptoms called 
putrid and malignant are now conspicuous, a dissolved state of the blood is 
indicated by inky vessels, oozings of black gore from the nostrils, gangrenous 
appearances of the throat, spots upon the skin, and haemorrhages from various 
parts of the body. This kind generally arrives at its height about the fifth 
or sixth day, but in some fatal cases the scene closes as early as on the third 
day. The inflammation on some occasions effects the eustachian tube, 
producing ulceration in the internal ear, and often extending to the glands 
of the mouth, which become swelled and painful. The malignant or putrid 
sore throat may be distinguished from the inflammatory by the looseness 
and vomiting, the puffy and dark-coloured redness attending the swelling, 
and by the fetid ulcers of the throat, covered with white or ash-coloured 
sloughs. It may also be distinguished by the slight delirium appearing 
early in the disease, and by the sudden weakness with which the patient 
was seized. 
TREATMENT. 
Indications of Cure.-From the appearance of the eruptions on the skin 
soon after the commencement of the disease, it is very evident that this fever 
is produced by some morbific matter taken into the circulation through the 
medium of the lungs, and that the increased action in the system is a healthy 
effort of nature to throw off such humours or morbific matter; it is, there- 
fore, our duty to aid nature in her salutary efforts. If unable to expel to the 
surface the irritating cause from the system, she must be assisted by sudori- 276 
THE REFORMED PRACTICE OF MEDICINE. 
fas, or sweating medicine. If her struggles are too great, by which too 
much inflammation is produced, she must then be restrained or moderated. 
Emetics.-Emetics will be found very useful in the commencement of the 
fever ; none will have a better effect than pulverized ipecac and lobelia, 
given in suitable doses, according to the age of the patient. It is not always 
necessary, however, to give them ; but if there is soreness of the throat, and 
an accumulation of mucus impeding respiration, a mild emetic will have a 
beneficial effect. When given in the forming stage of the disease, or at a 
very early period, they abate the febrile symptoms, and render the subse- 
quent effects of the fever less violent, and in some cases cure the disease, or 
render it extremely light: Withering recommends them throughout the 
whole course of the fever ; but the best effects arise from their use in the 
early stages of it. One great effect derived from emetics in febrile diseases 
is, the sympathetic action they exert upon the capillary system. The con- 
nexion which exists between the stomach and skin is so great, that if a 
healthy action is exerted upon one, the other experiences a correspondent 
good effect; they appear to overcome that tension and stricture which exist 
in the pores of the skin, by their stimulating effects. 
Purgatives.-Purgatives, in this fever as well as others, are highly useful. 
Hamilton, on purgative medicines, speaks of their utility in scarlet fever in 
the highest terms; they moderate arterial action, relieve the pain in the 
head, prevent delirium, and remove the morbid state of the liver, stomach, 
and whole alimentary canal. It must be borne in mind, however, that there 
is a great difference in purgatives; some pass through the stomach and 
bowels without carrying away or removing any feculent matter, or altering 
the condition of the mucous membrane. In general, castor oil and salts may 
be mentioned among this class of purgatives ; no kind will be found so 
useful as the common purgative, or mandrake ; a tea-spoonful of this powder 
to be put in a tea-cup or tumbler, with a lump of sugar sufficient to sweeten, 
then add a gill of boiling water or mint tea : an adult will take the whole of 
it when cool; but it must be recollected that children, among whom scarla- 
tina more generally prevails, must take a dose proportioned to their age. 
This thoroughly cleanses the stomach and bowels, and invariably benefits 
the patient; it may be repeated every other morning, or at farthest every 
third morning. 
Sudorifas.-Since the mischief exists in the capillary vessels or the skin, 
the exhalents not performing their offices, such medicines must be given as 
will open the pores and cause perspiration ; in this state of the system there 
are two difficulties: First, obstructed perspiration, by which the poison is 
retained in the system; and, second, the want of perspirable matter, by 
which the process of evaporation is carried on, keeping the skin moist and 
cool. Hence it is necessary to give sudorifas to promote the excretions of 
the skin. 
In the first stages of scarlet fever the feet must be bathed, and an infusion 
or tea of saffron freely given; also a tea-spoonful of the diaphoretic powders, 
with a tumbler of catnip tea, to be repeated occasionally until moderate per- 
spiration follows. The same dose may afterward be given to keep up a 
determination to the surface, except the temperature of the body is too great 
to admit of this stimulating diaphoretic medicine, which is very seldom the 
case, especially if every other excretion of the body has been duly attended 
to. Should this be the case, however, we must rely on those medicines 
which produce perspiration without increasing the heat of the body, such as 
the ipecac pills or tincture, with an infusion of catnip, amaranthus, &c., which SCARLET FEVER. 
277 
may be drank warm, and drank freely through the day. An infusion or tea 
made of lemon balm or sage may likewise be given as a change ; in general 
it is sufficient to keep the skin moist. 
Bathing the Surface.-Cold affusions have been highly extolled by some 
authors, as well as cold drinks. I grant that cold water may often be applied 
to the surface with impunity, and often with benefit, even in the different 
forms of scarlet fever; but injury may arise from its indiscriminate use. 
The subsequent effects arising from the repeated and sudden applications of 
cold to the body, under a great state of excitement, especially in an eruptive 
disease like scarlatina, may prevent the appearance of the eruption, and cause 
a recession of them after they have appeared, and thus prove fatal. Bathing 
the surface with warm rain water, to which has been added a little ley, is 
far preferable. No dangerous reaction takes place from the use of tepid, as 
from cold water ; nor will any danger result from it whatever, as it is a most 
valuable auxiliary, and the use of it cannot be too strongly recommended. 
We may say with Bateman, when speaking of the application of cold water : 
" We are possessed of no physical agent, as far as my experience has taught 
me, by which the functions of the animal economy are controlled with so 
much certainty, safety, and promptitude, as by the application of cold water 
to the skin, under the augmented heat of scarlatina and of some other fevers. 
This expedient combines in itself all the medicinal properties which are in- 
dicated in this state of disease, and which we should scarcely expect it to 
possess, for it is not only the most effectual febrifuge., the ' febrifugum mag- 
num,' as a reverend author (Dr. Hancock) long ago called it, but it is, in 
fact, the only sudorific or anodyne which will not disappoint the expectation 
of the practitioner under these circumstances. I have had the satisfaction, 
in numerous instances, of witnessing the immediate improvement of the 
symptoms and the rapid change in the countenance of the patient, produced 
by washing the skin. Invariably in the course of a few minutes the pulse 
has been diminished in frequency, the thirst abated, the tongue has become 
moist, a general free perspiration has broken forth, the skin has become soft 
and cool, and the eyes have brightened ; and these indications of relief have 
been speedily followed by a calm and refreshing sleep." 
It may be applied as often as the fever increases ; but should be omitted 
if there is any chill, or if the skin is not above the natural temperature. It 
may then, however, be applied very warm. 
When the throat is sore and the swallowing difficult, which often occurs 
in the scarlet fever, it must be bathed with the rheumatic liquid-soap lini- 
ment is very good-apply warm ; after which bind flannel around the neck. 
The throat may be gargled, if it can be conveniently done, with the follow- 
ing : Take sage, hyssop, or sumach berries, equal parts : make a strong tea 
or decoction, sweeten with honey, add a small piece of borax, and gargle 
often. 
Mustard Plasters, made weak, may be applied to the feet. 
Anodynes.-I have always seen the happiest effects from anodynes, com- 
bined with diaphoretics. 
Diaphoretic Powders.-Our diaphoretic powders are attended with very 
excellent effects. They tranquillize the system, mitigate pain, procure 
sleep, lessen the fever by causing perspiration, and will have the desired 
effect in any and every state or stage of the complaint, particularly after the 
evacuants recommended have been made. They may be given at night to 
procure sleep if the patient is very restless. 
Whenever there are symptoms of inflammation of the brain present, 278 
THE REFORMED PRACTICE OF MEDICINE. 
apply tepid or lukewarm water, or cooling lotions to the head, such as a 
mixture of water, vinegar, and brandy, with frequently bathing the feet and 
applying sinapisms, will do more to allay it than drawing any quantity of 
blood from the system. If no other means would subdue it, leeches or 
cupping might be resorted to; but I have never found either necessary in 
all my practice. 
SECTION III. 
MALIGNANT SCARLET FEVER. 
I have hitherto dwelt on the severe and ordinary form or type of scarlet 
fever, and the treatment given is, in general, sufficient for the other species ; 
but when it assumes a more formidable and malignant character, some vari- 
ation is called for. 
Should the attack of scarlatina be very violent, it is liable to run into a 
malignant type. It is, therefore, necessary to use the most energetic means 
to arrest the fever in its incipient stage. For in proportion as the disease is 
controlled and checked in its commencement, will its subsequent course 
become more manageable, and be attended with less violence and danger. 
When it is judiciously treated in the beginning, the patient is safely and 
speedily conveyed through it, without that exhaustion and prostration which 
results from the lamentable and dangerous prostrating practice of orthodox 
physicians, or physicians of the old school. Should, however, the patient 
become very feeble and debilitated, a restorative or stimulating course of 
treatment must be pursued. Wine whey may be given ; also yeast: infu- 
sions of Virginia snake-root and chamomile flowers ; they may be repeated two 
or three times a day. An infusion of boneset may likewise be given. 
Expectorants or Emetics.-When the throat becomes very much affected, 
emetics are very valuable. 
" Emetics," says Armstrong, " are the best gargles, where the throat is 
much obstructed from an accumulation of tenacious mucus; their operation 
effectually dislodges that morbid secretion for a time ; often greatly relieves 
the respiration ; improves the appearance of the ulcers; and they may be 
repeated at any time during the continuance of the fever, whenever the res- 
piration or swallowing becomes much impeded by an accumulation of 
phlegm." Expectorants are in general to be preferred. 
Dr. Thomas, in treating of this species of scarlet fever, thus remarks: 
" At the commencement of cynanche maligna it has been found of service to 
give a gentle emetic : wherefore a few grains of ipecacuanha may be taken. 
It will not fail to bring off a considerable quantity of acrid matter, which, by 
getting into the bowels, might induce a diarrhoea-an affection to be avoided 
by every possible means, as always adding to debility and endangering the 
life of the patient. During the first four-and-twenty hours an emetic will, 
in some cases, cut short the progress of the disease, and in all it will be 
likely to break the force of it. 
The grand objects to be kept in view in this malignant disease should be, 
to check or counteract the septic tendency which prevails, to wash off from 
time to time the acrid matter from the fauces, and to obviate debility. 
Should any particular symptoms arise during its progress which may tend 
to aggravate the disease, such as diarrhoea, haemorrhage, &c., they ought to 
be immediately attended to." 
" In the year 1785, at which period I was in the West Indies, this disease MILIARY FEVER. 
279 
prevailed in the Island of Saint Christopher's as a universal epidemic among 
children, and a vast number of them fell martyrs to it in spite of the utmost 
endeavours of the profession to save them; when at last the most happy 
effects were derived from the use of the remedy, the basis of which was 
cayenne pepper : Take two table-spoonsful of red or cayenne pepper ; a tea- 
spoonful of salt; add half a pint of boiling water; in fifteen minutes after 
add half a pint of vinegar ; let it stand an hour, then strain through a fine 
cloth ; give two table-spoonsful every half hour. 
The speedy and good effect produced by the use of this medicine in every 
case in which it was tried, evidently points out the utility of giving warm 
aromatics, which will bring on a timely separation of the sloughs, as well 
as other antiseptics, to correct the tendency in the parts to gangrene. 
Since the period above-mentioned, many practitioners in the United King- 
dom have become vouchers for the very beneficial effects which were derived 
in various instances of cynanche maligna from this medicine. My own 
experience induces me to speak well of it also." 
Yeast may be freely given if the putrid symptoms continue, and the throat 
may likewise be occasionally gargled with it. It must be mixed with milk, 
and a little honey added. If suppression of urine occurs, give a strong tea 
or infusion of spearmint, with a little spirits of nitre, and apply hops and vine- 
gar, simmered together, over the region of the bladder. 
Mortification.-The face and inside of the mouth often mortify in scarlet 
fever, particularly after the use of mercury. When this is the case, apply 
a yeast poultice over the part, and let the mouth be gargled with it: or apply 
it to the parts in the best manner possible. 
Dropsy.-The dropsy sometimes follows the scarlet fever; generally in 
consequence of mal-practice. It occurs after bleeding or mercury. When 
this is the case, treat it the same as common dropsy. 
Since scarlet fever in some of its forms is so extensively prevalent, and 
often so very fatal, a judicious course of treatment is imperiously called for, 
and I know that such treatment is recommended above. It has been so 
repeatedly tested, that it no longer remains a subject of doubt; but is esta- 
blished on sure, safe, and unerring principles, and to be known needs but to 
be tried. The practice of bleeding and giving mercury, in this and other 
diseases, will no longer exist when people learn the difference between the 
two kinds of treatment. 
A few drops of the tincture of belladonna is said to be a preventive for this 
fever; and, to relieve the symptoms of the disease, ten drops may be taken 
three times a day, in a little water, both as a cure and antidote. 
ADDITIONAL REMARKS. 
CHAPTER X. 
MILIARY FEVER. {Febris Miliaris.) 
In this fever nature seems to be endeavouring to drive out the morbific 
matter to the surface of the body, by increasing her secretory and excretory 
motions. 
DESCRIPTION. 280 
THE REFORMED PRACTICE OF MEDICINE. 
It derives its name from the small pustules or bladders which appear on 
the skin, resembling in shape and size the seeds of millet. These pustules 
or pimples are either red or white, and sometimes both are mixed together ; 
sometimes they are distinct, and sometimes in clusters. 
Sometimes this is a primary disease, but more frequently symptomatic of 
some other malady ; as the small-pox, measles, inflammation, putrid or ner- 
vous fever, &c. In all which cases it is generally the effect of too stimu- 
lating a regimen. 
CAUSES. 
This fever is sometimes occasioned by violent passions and emotions of 
the mind ; by great evacuations, a weak, watery diet, rainy seasons ; by the 
immoderate use of cold, crude, and unripe fruits, impure water, and unwhole- 
some provisions. It may also be occasioned by the suppression of any 
customary evacuations, as issues, setons, ulcers, the bleeding piles, or the 
menstrual flux. 
It attacks both sexes, all ages, and constitutions, but more frequently 
people of weakly and delicate constitutions. This disease in child-bed women 
is often occasioned by great costiveness during pregnancy, and very fre- 
quently by their excessive use of green trash and other improper things, in 
which pregnant women are too apt to indulge ; but indolence and inactivity 
are the most general causes. 
SYMPTOMS. 
This fever, when it is a primary disease, generally commences with a 
violent cold stage, succeeded by great heat, anxiety, and sighing; the heat 
soon increases, and produces a profuse sweat, preceded by a sense of prick- 
ing in the skin ; and it has a peculiar, strong, disagreeable smell. The period 
of eruption is indeterminate ; it seldom attacks the face, but appears first on 
the neck and breast, and thence spreads all over the body. The patient is 
restless, and sometimes delirious; the tongue appears white, and the hands 
shake, with often a burning heat in the palms ; and in child-bed women the 
milk generally ceases, and also the other discharges. After the patient has 
experienced an itching or pricking pain under the skin, innumerable small 
pustules, of a red or white colour, begin to appear. These symptoms then 
generally abate, the pulse becomes fuller and softer, the skin moist, and the 
sweat, as the disease advances, has a more fetid smell: the oppression on the 
breast and spirits usually subsides, and the customary evacuations regularly 
return. Though the eruption appears at no fixed period, nor is of any regu- 
lar certain duration, the pustules generally begin to dry and fall off about the 
sixth or seventh day from the eruption, occasioning a very troublesome itch- 
ing in the skin. 
The pustules usually come out on the third or fourth day when the erup- 
tion is critical; but when symptomatical, they may appear at any time of the 
disease. When the pustules appear and disappear by turns, there is always 
danger; but when they disappear suddenly and do not appear again, the 
danger is very great. 
In child-bed women the pustules are commonly at first filled with clear 
water, afterward they become yellowish. Sometimes those of a red colour 
are interspersed. When these only appear, the disease is named a 
rash. PUERPERAL FEVER. 
281 
If the stomach is oppressed, and there be nausea, &c., give a mild 
emetic, and then treat it on the same principle as other fever, particularly 
scarlatina. We must not increase the sweat too much, for fear of debility. 
Moderate doses of physic must be occasionally given, and such liquids 
and infusions drank as cause a moisture of the skin. For this purpose give 
saffron and snake-root tea. The feet must be daily immersed in ley water, 
and the body frequently bathed with the same, and applied warm. There 
is very often danger in this, as well as in many other diseases, of doing 
too much. A particular attention only is required to all the secretions and 
excretions. Here, as we have before stated, consists the " grand secret " of 
curing febrile, as well as most other complaints. 
TREATMENT. 
REGIMEN. 
In all eruptive fevers, of whatever kind, the chief point is to prevent tne 
sudden disappearing of the pustules, and to promote their maturation and 
expulsion. For this purpose the patient must be kept in such a tempera- 
ture as neither to expel the eruption too fast nor to cause it to retreat pre- 
maturely. The diet and drink ought, therefore, to be in a moderate degree 
nourishing and cordial, but neither strong nor heating. The patient's cham- 
ber ought neither to be kept too hot nor cold, and he should not be too much 
covered with clothes. Above all, the mind is to be kept easy and qjieerful; 
nothing so certainly causes an eruption to recede as fear, or the apprehen- 
sion of danger. 
The food must be weak chicken broth, with bread, panado, Indian meal 
gruel, &.C., to a gill of which may be added a spoonful or two of wine, as 
the patient's strength requires, with a few grains of salt and a little sugar. 
Good apples, roasted or boiled, with other ripe fruits of an opening, cooling 
nature, may be eaten. 
The drink may be suited to the state of the patient's strength and spirits. 
If these be pretty good, the drink ought to be weak; as catnip and balm tea. 
When the patient's spirits are low, and the eruption does not rise suffi- 
ciently, his drink must be a little more generous ; as wine whey, sharpened 
with the juice of orange or lemon, and made stronger or weaker, as circum- 
stances may require. 
Sometimes the miliary fever approaches toward a putrid nature, in which 
case the patient's strength must be supported with generous cordials, joined 
with acids ; and if the degree of putrescence be great, the Peruvian bark and 
yeast must be administered. If the head be much affected, the body must 
be kept open by injections or clysters. 
CHAPTER XI. 
PUERPERAL FEVER. (Febris Puerperalis.) 
DESCRIPTION. 
This is a disease peculiar to women after delivery, particularly in lying- 
in hospitals, and is supposed to occasion the death of nearly one-half who 282 
THE REFORMED PRACTICE OF MEDICINE. 
die in child-bed. Three-fourths of those who have been attacked have fallen 
victims to it. It commences, in general, three or four days, sometimes a 
week, after delivery; and it appears to occur oftentimes as an epidemic. 
CAUSES. 
Various reasons have been assigned as the cause of puerperal fever; but 
none very satisfactory seems as yet to have been given. A check of per- 
spiration from cold, combined with a moist and unhealthy state of the at- 
mosphere, probably gives rise to it. Morbific matter is retained, enters the 
circulation, and is thrown upon some of the viscera of the abdomen, exciting 
inflammation and other symptoms of the complaint; or it may cause the 
complaint, by mixing with the circulating mass. 
The late Dr. Young, professor of midwifery at Edinburgh, was of opinion 
that the puerperal fever, strictly so called, is in every instance the conse- 
quence of contagion; but he contends that the contagious matter of this 
disease is capable only of producing its effects, in consequence of a peculiar 
predisposition given by delivery and its consequences. In support of this 
doctrine he remarks, in a paper read in the Philosophical Society of that 
city, that for many years the disease was altogether unknown in the lying-in 
ward of the Royal Infirmary, at Edinburgh ; but that after it was once intro- 
duced into the hospital almost every woman was, in a short time after de 
livery, attacked with it; although prior to delivery she may have lain even 
for weeks together, not only in the same ward with the infected, but even 
in the very next bed. He farther remarks, that it was only eradicated from 
the hospital in consequence of the wards being entirely emptied, thoroughly 
ventilated, and newly painted. After these processes puerperal females in the 
hospitals remained as free from the disease as formerly. 
With respect to the infectious nature of this fever, a great contrariety of 
sentiment has indeed existed: the probability is in favour of its being so ; 
but it is nearly impossible to form a decided opinion on the subject. Doubt- 
less it will be the safest practice to consider it as infectious, and to cut off 
all intercourse of pregnant and parturient women with those who labour 
under it. 
It is certain that puerperal fever has a strong tendency to the typhoid type 
in an advanced stage, although at its commencement, or during the first 
twenty-four or thirty-six hours, it is usually attended with inflammatory 
symptoms, and even with topical inflammation in the abdominal organs, but 
more particularly the peritonaeum, or membrane which envelopes them. 
SYMPTOMS. 
Puerperal fever commences with rigour or chills, which is succeeded by 
great heat, and frequently ends in perspiration; but its characteristic symp- 
tom, by which it is always accompanied, is pain in the region of the womb, 
which, although generally attended with remarkable aggravations, resembling 
after pains, has no complete intermission as they always have. It is in- 
creased by motion, attended by extreme soreness and tenderness to the touch, 
and accompanied by a pulse so rapid as to rise to 140 to 160 in a few hours 
after the attack. 
The pulse, especially during epidemic constitutions, although full and strong, 
and but moderately quick, at the very commencement of the disease, in a 
few hours becomes very rapid, running up to 160 strokes in a minute, and is PUERPERAL FEVER. 
283 
then proportionably small; at same time the patient's strength rapidly fails, 
her countenance expresses great pain and anxiety, and her head is frequently 
affected with pain, giddiness, and with a ringing in her ears. The secretion 
of milk is generally suppressed, the breast becomes suddenly flaccid ; the 
bowels in the commencement are generally costive, but a diarrhoea is soon 
apt to come on. The belly swells to a great extent, and the tenderness is 
spread over the whole abdomen, compelling the patient to lie immoveable in 
one posture, with her extremities drawn up, and generally on her back; 
and such is the extreme tenderness, that she cannot bear the weight of 
the bed-clothes. The tongue soon becomes foul, the stomach is oppressed 
with nausea, and the teeth collect a brown sordes, the breath offensive, pur- 
ple or red spots appear, and extreme debility comes on sooner in this than 
in any fever which begins with such decided symptoms of inflammation, and 
makes a sudden and total change of its nature into that of a putrid and ma- 
lignant fever. 
This complaint frequently attacks within forty-eight hours, generally 
within five days after delivery, and, in general, the earlier the attack the 
more violent are its symptoms. It runs through its course in a very short 
period of time, ending in death in a few days : indeed a great and sud- 
den mortality, particularly in some epidemic constitutions, has proved the 
most distinguishing, as well as the most terrible, characteristic of the disease. 
In some epidemics very few indeed, in others none, it is said, have re- 
covered ; some patients have died within eighteen hours, and most of the 
fatal cases have ended within three or four days ; but when it has ended in 
recovery, the symptoms have often been protracted to six or eight days, with 
occasional but irregular intermissions and exacerbations; and it has been 
remarked that, after very considerable remissions, indeed after such complete 
intermissions as to afford the most sanguine hopes of recovery, the attack has 
been renewed with increased danger. 
Such in general is the course of the puerperal fever; the symptoms of 
which, however, may be often varied, according to the constitution of the 
patient, the degree of the disease, and its earlier or later invasion after 
delivery. 
TREATMENT. 
It requires no discernment to see the pernicious effect of the common prac- 
tice. Some bleed five or six times in succession, which soon sinks the pa- 
tient into the arms of death. Mercury is also given at the same time, which 
hastens dissolution. 
Indications of Cure.-The principal indication in the cure of this disease 
is, to subdue the inflammatory symptoms; to effect which, sweating and 
purging are the two Herculean remedies to be relied on. 
The sweating drops or diaphoretic powders maybe given every two hours 
until free perspiration is produced. Physicians in general place their greatest 
reliance on copious bleeding. We place our greatest reliance on perspira- 
tion. It must be continued until the inflammatory symptoms subside. 
Bathing the surface and feet greatly promotes it. 
Purgatives are exceedingly important in reducing this fever. The same 
may be given as recommended in the preceding fevers, and repeated at least 
once a day. If vomiting supervenes, give the neutralizing mixture. 
To alleviate the soreness and distension of the abdomen, we may recom- 
mend the application of fomentations, both inwardly and externally; in- 284 
THE REFORMED PRACTICE OF MEDICINE. 
wardly, by injecting every four or six hours, and administering emollient 
clysters from time to time ; and externally, by applying flannel cloths, wrung 
out in a warm decoction of bitter herbs or hops, over the whole region of the 
abdomen; and these ought to be renewed as often as they become cold, 
taking due care that they are not so wet as to run about the bed and incom- 
mode the patient. 
After suitable evacuations diaphoretic powders may be given, particularly 
at bed-time. The dose must depend on the severity of the pain, and the 
age and constitution of the patient. It may be repeated every two hours, 
until there is a mitigation of the symptoms and a moisture of the skin. 
Should putrid or malignant symptoms commence, yeast must be given, as 
much as the stomach will bear. Wine and porter may likewise occasionally 
be given. An infusion of chamomile flowers, cold, may be taken to keep up the 
strength of the patient, as also nourishing diet, &c. Dr. Guinot recommends 
ten or twelve grains of the carbonate of potash to be given in any proper 
vehicle three times a day, not only in puerperal fever, but in all diseases 
connected with the secretion of milk. This treatment he recommends under 
the idea that the disease is occasioned by a predominance of acid. Other 
practitioners likewise speak of its good effects. Ten drops of muriatic acid 
in a gill of water may be given three times a day. 
It is stated that a Dr. Cochroft, of this city, an old school doctor, lost 
eleven out of twelve cases, or nineteen out of twenty cases of child-bed fever 
the present season. Some time ago it was also stated that the same physician 
lost three cases of scarlet fever in one family. So much for the practice of 
blood-letting and mercury ! Such men pass current for skilful physicians I 
A very light, cooling diet should be used in the commencement of the 
disease, and in the latter stages of it a more nutritious diet recommended; 
Indian meal gruel, panado, toast, and bread water, barley water, rice 
water, &c. 
REGIMEN. 
PRECAUTION. 
When the disease prevails as an epidemic among puerperal women, or 
occurs in a lying-in hospital, all communication ought immediately to be 
cut off between those who are affected, and such as have been confined, or 
expect shortly to be so; and, inorder to root out the disease and stifle con- 
tagion, we should have recourse to fumigations, as advised under the head 
of malignant fever, and afterward to painting, white-washing, and a free 
ventilation. 
CHAPTER XII.. 
HECTIC FEVER. (Febris Hectica.) 
DESCRIPTION. 
Hectic fever is generally characterized by a frequent, weak pulse ; flush- 
ing in the face, the hands, or the feet; night sweats or diarrhoea. A wound HECTIC FEVER. 
285 
or local injury upon a healthy person produces a fever that may properly be 
termed symptomatic or sympathetic. 
CAUSES. 
The cause of hectic fever is almost always some local disease. This 
form of fever appears to be a feeble and hopeless struggle of the system about 
to be overpowered, without any apparent tendency to remove the disease. 
It arises from long-continued irritation of any severe local disease upon the 
constitution, whether accompanied with suppuration or not. It arises from 
the absorption of pus or matter from tubercles on the lungs, diseased hip- 
joints, white-swelling, curvature of the spine, scrofula, abscesses, ulcers, &c. 
SYMPTOMS. 
Hectic fever arises at different periods after the commencement of any 
serious local disease. This may be owing to some peculiarity of constitu- 
tion, or the particular structure or functions of the part diseased. The more 
weak and feeble the patient naturally is, and the more severe and incurable 
the local disease, the. sooner do the hectic symptoms generally begin, and 
the more rapid is their progress. 
Sometimes the first accessions of this fever are almost imperceptible ; a 
very slight degree of emaciation ; a pulse a little quicker than ordinary, with 
a trivial increase of heat, particularly after meals, being the only early symp- 
toms. As the fever becomes more established, the symptoms generally run 
as follows: A frequent small pulse, quickens toward evening, but is always 
ten or twenty strokes in a minute faster than in health; moist skin, pale, 
copious urine, with sediment; a good deal of debility; the tongue seldom 
so much furred as in most other fevers, its edges being of a bright red colour, 
and the papillee swollen and prominent; a florid, circumscribed suffusion of 
the cheeks; loss of appetite; sometimes an ejection of all food from the 
stomach ; a great readiness to be thrown into sweats ; profuse nocturnal per- 
spirations ; frequently a constitutional purging ; repeated chills and flushes 
of heat; derangement of the nervous system ; loss of sleep ; indigestion ; 
heartburn ; flatulence. When, however, the biliary system is undisturbed, 
the digestive powers are little impaired, and the appetite remains good to 
the last. In an advanced stage the hair falls off and the nails become bent. 
Hectic fever is more or less remittent, but never wholly intermittent. It 
is observed that the frequency of the pulse is generally from 100 to 140 in 
a minute, seldom falling below 100 even in the time of a remission, and in 
some cases never being under 120; while in other constitutions the pulse 
of health may be so low that 90 strokes in a minute would be enough to 
indicate an exacerbation. 
TREATMENT. 
In the cure of hectic fever attention must first be directed to the exciting 
cause of the disease, before it can be removed. If it arises from the absorp- 
tion of matter in consequence of an ulcer, how can it be cured while the 
primary affection exists ? As soon as the disease is relieved or cured, which 
produces the febrile disturbance, the fever will cease. But when the local 
disease cannot be cured, which causes it, it must of course be mitigated, 
which in almost every instance can be effected. Under such circumstances 286 
THE REFORMED PRACTICE OF MEDICINE. 
the hectic fever must be treated on general principles. The bowels must 
be regulated by laxative medicines ; equal parts of charcoal and magnesia 
are excellent, given daily; and upon every accession of the fever the surface 
must be bathed with tepid ley water. 
Attention must be paid to the debility, which almost invariably exists. 
And it must be borne in mind that this debility arises in consequence of ths 
night sweats which attend this form of fever, caused by a relaxation of the 
capillary vessels. They maybe checked in almost every instance by admi- 
nistering fifteen or twenty drops of elixir of vitriol, in a gill of water or tea of 
any kind, once or twice a day. At night is the most suitable time to give 
them. During the day give an infusion or tea of the crawley or blessed this- 
tle, to be taken cool. This drink may be changed, and an infusion of the 
Virginia snake-root may be taken. It acts both as a diaphoretic and tonic. 
Everything of a stimulating nature should be avoided, but a nutritious diet 
may be taken. Equal parts of cloves, nutmeg, cinnamon, pulverized and 
mixed, and put in wine ; one ounce to one quart; dose, half a wine glass two 
or three times a day. 
CHAPTER XIII. 
INFANTILE REMITTENT FEVER. 
DESCRIPTION. 
Tins fever is peculiar to children from the age of one to five or six. It 
comes on very gradually, manifesting itself by irregularity, wrhich is sometimes 
by costiveness, and at other times by relaxations of the bowels. 
This fever is evidently symptomatic of disordered digestion. It depends 
perhaps partly upon absorption of the putrid contents of the intestines. 
CAUSES. 
SYMPTOMS. 
On its coming on, the child becomes fretful, his lips are dry, his hands hot, 
his breath short, the head painful, and his pulse quick, being often 120 in a 
minute; he is unwilling to stir or speak, the sleep is disturbed by startings, 
and the food rejected; sometimes very little is discharged from the intestines, 
and at others too much, the stools being often mucous or slimy; some chil- 
dren are delirious, or lost and stupid ; many for a time are speechless. In 
the course of the day there are several slight accessions of fever, during 
which the child is usually drowsy; in the intervals of these paroxysms he 
appears tolerably well, though at times more peevish than usual. 
These symptoms probably manifest themselves more or less for eight or 
ten days, when all at once a more violent paroxysm of fever will arise, pre- 
ceded by a shivering fit and by vomiting. The pulse rises to 140 in a 
minute; the cheeks are flushed, the drowsiness is much increased, and the 
child keeps picking almost incessantly at the skin of the lips and nose, and 
of the angles of the eyes. INFANTILE REMITTENT FEVER. 
287 
This species of fever is mild at its commencement, slow in its progress, 
and very uncertain in its event. In some respects it resembles dropsy in the 
head, and, I apprehend, is sometimes mistaken for it; but in the latter there 
are occasional screamings, with much tossing of the hands above the head, 
intolerance of light, with more or less of squinting; whereas in the remit- 
tent fever of infants none of these appearances are to be met with. In this 
fever the desire for food is destroyed, and the little patient will take neither 
aliment nor medicine. In dropsy of the brain, on the contrary, he will 
usually take whatever is offered to him, without reluctance. The faeces are 
remarkably changed from their natural appearances in the remittent fever, 
being sometimes black, and smelling like putrid mud ; and at others they 
are curdled, with shreds of coagulable lymph floating in a dark greenish- 
coloured fluid. 
TREATMENT. 
The indications of cure in this disease are, to clear the stomach by a gentle 
emetic and the bowels by purgatives, to moderate or remove the febrile 
symptoms, and then, if necessary, to restore the lost energy by tonics. 
A dose of senna and manna may be administered to the child twice or 
thrice a week. The surface may be bathed with tepid water occasionally; 
also the feet. If there is pain, apply linen cloths, wetted in vinegar and 
water, on the head. Keep up a determination to the surface, by giving dia- 
phoretic medicines. The diaphoretic powders, a tea made of elderflowers, 
balm, &.C., may be occasionally drank throughout the day. When the fever 
is nearly subsided, and there is great debility, give tonics, such as an infusion 
of equal parts of columbo, gentian, and chamomile: give a little occasionally. 
If there is acidity in the stomach, give the neutralizing mixture. A milk and 
vegetable diet must be observed. 
PREVENTION OF FEVERS. 
In concluding this class of diseases I shall give the recipe for preparing 
the disinfecting gas, as follows : Take nitre, pulverized, six drachms ; oil of 
vitriol, six drachms : mix them in a tea-cup by adding to the nitre one 
drachm at a time of the oil; the cup to be placed, during the operation, on 
a hot or heated brick, shovel, hearth, or any other heated substance. The 
mixture to be stirred with a tobacco pipe or piece of iron. 
In the treatment of the foregoing class of diseases I have recommended 
several kinds of herbs or plants to promote perspiration ; but there are 
others equally as good, and some perhaps better, which may be substituted 
when it is necessary. Every climate abounds with medicinal plants, the 
virtues of which, if known, are sufficient to remove all curable diseases ; 
those, therefore, in Europe and other parts of the world who wish to pre- 
scribe for the sick according to the principles of this work, will find no diffi- 
culty in selecting suitable kinds of herbs to serve as auxiliaries in the 
treatment of febrile and other diseases. In England Culpepper, John Ge- 
rard, and other herbalists describe many very good, and others are already 
known in domestic practice. 
In France there is a botanical work in several volumes, with figures, 
entitled Introduction a la Flore des Environs de Paris, by Bulliard; from 
these and similar works many valuable medical agents can be chosen. 
Dr. Shecut, a botanic physician, who has practised in fevers in South 288 
THE REFORMED PRACTICE OF MEDICINE. 
Carolina, states that the following treatment will cure ninety-nine cases in 
every hundred of intermittent and remittent fevers. " First, when in inter- 
mittent fever there is the least fever or remission, give an emetic, afterward 
a purgative. The next morning give the tonic, which is prepared as follows : 
Take charcoal, freshly pulverized, two ounces ; black or white oak bark, 
pulverized, (or bayberry will answer,) two ounces ; sassafras bark off the 
root, one ounce ; aloes, one drachm ; cloves, half an ounce ; capsicum, half 
an ounce : pulverize all, and add to one quart of Madeira wine. Then add 
two drachms of laudanum. Those who prefer, may put the powder in one pint 
of boiling water ; then add one pint of spirits or brandy, and four ounces of 
sugar; or even a tea will answer. Dose, a table-spoonful every second or third 
hour until the chill approaches; then perspiration must be excited; the tonic to 
be continued till cured ; and afterward for some time, to prevent a relapse." 
Should this prove a remedy, it will be found very convenient when bark or 
quinine are very costly and difficult to procure. Dr. Shecut states that he 
gives the same mixture in remittent fever with success, as soon as there is 
a little remission ; but it appears that it must, from its stimulating proper- 
ties, increase the fever before there is a perfect intermission. 
INFLAMMATORY DISEASES. 
CHARACTER. 
CLJ1SS II. 
This class of diseases is characterized by heat, pain, redness, and swelling. 
Inflammation is either general or local; general, when the system is exten- 
sively affected; local, when confined to some particular part or organ. It is 
also acute or chronic ; acute, when the attack is severe and the symptoms 
violent; chronic, when the inflammatory action has in a considerable degree 
subsided, and the disease becomes less painful and less violent in its charac- 
ter, and protracted. There are several varieties of inflstnmation, occasioned 
by difference of cause, function, or texture of the part affected. 
All the viscera are subject to inflammation. The various phenomena or 
symptoms exhibited in this class of diseases are owing more to the peculiar 
structure of the part inflamed than to the exciting cause. 
CHAPTER I. 
INFLAMMATION OF THE BRAIN. (Phrenitis.) 
Phrenitis is an inflammation of the membranes, or brain itself. When it 
occurs independent of any other disease it is termed primary. It is called symp- 
tomatic when it is produced by some other disease, as fevers, eruptions, &c. 
DESCRIPTION. 
Proximate Cause.-Whatever causes a determination of blood to the head 
CAUSES. INFLAMMATION OF THE BRAIN. 
289 
produces an inflammation of the brain or membranes. Hence we find that 
in this complaint the blood recedes from the extremities, thereby producing 
coldness, and flows in an unusual quantity to the head, in consequence of 
which there is heat, inflammation, &c. 
Remote Causes.-The remote causes are, fits of passion, intense applica- 
tion of the mind, great exercise, external violence of any kind, fractures 
or injuries of the head, intemperance, exposure to great heat of the sun, and 
suppressed evacuations: animal food, ardent spirits, &c., are exciting causes 
of this disease. Symptomatic phrenitis is produced by the repulsion of febrile 
and cutaneous diseases. 
SYMPTOMS. 
Inflammation of the brain exhibits the following symptoms: It usually 
commences with inflammatory fever, flushed countenance, redness of the 
eyes, intolerance of light and sound, headache, watchfulness, and delirium. 
The patient experiences a fulness of the head, which is usually attended 
with a throbbing of the temporal arteries. The patient becomes restless, 
his sleep is disturbed, or wholly forsakes him. There is a peculiar disposi- 
tion in the patient to injure or destroy himself, which he often accomplishes 
if he obtains a proper instrument. It is often preceded by great pain in the 
stomach, which, no doubt, is produced by sympathy of the brain. Some- 
times fierce delirium does not commence within several days after the attack. 
The pain is sometimes in other parts of the head. The hearing is acute, 
sometimes the reverse. There is usually preternatural heat, while the ex- 
tremities, particularly the feet, are cold, showing evidently a determination 
of blood to the head. The patient talks incoherently, and delirium gradually 
increases, till he arrives at a state of complete phrensy. The complaint some- 
times, though rarely, intermits. Respiration is generally deep and slow, 
and now and then difficult; seldom hurried or frequent. The patient imagines 
that some persons or evil spirits are constantly pursuing him to take his life, 
from whom he starts with horror, and no argument or assertion can induce 
him to believe the contrary. Sometimes there is a discharge of mucus from 
the nose; occasionally blood. It is usually attended with a tremour of the 
joints, grinding of the teeth, twitching of the muscles of the face, which is 
often florid, then suddenly turning pale, with a general derangement of the 
internal functions and whole system. The length or duration of this disease 
is very uncertain, as it may prove fatal in a week, at other times it conti- 
nues for months. 
TREATMENT. 
Indications of Cure.-The indication of cure is, to divert the blood from 
the brain by restoring the circulation in the extremities; in other words, by 
equalizing the circulation. 
Treatment.-Bathe the feet in warm water, to which has been added a 
little pearlash or ley. Let this be repeated at least twice in twenty-four hours. 
Purgatives.-Administer a purgative every morning, or every other 
morning; that kind which acts with peculiar force upon the stomach and 
first passages. Nothing will be found better than our common physic, to 
be given as before directed. If the inflammation is very great, apply 
mustard to the nape of the neck. It will be necessary also to keep up a 
determination to the surface, by giving a dose of our fever or sweating drops 290 
THE REFORMED PRACTICE OF MEDICINE. 
Rubefacients.-Should not this treatment mitigate the symptoms after a 
few days, apply a blister plaster between the shoulders. Mustard maybe 
applied to the feet at night. When there is great pain of the head, or 
delirium, make use of a fomentation of hops simmered in vinegar, enclosed in 
flannel or muslin ; to be occasionally repeated. 
Anodynes.-Should there be great pain, restlessness, or want of sleep, give 
a small tea-spoonful of the diaphoretic powders in an infusion or tea of catnip, 
to be repeated every night. 
A continuance of this course will generally subdue the inflammation in a 
short time. Cupping or leeching wilLbe found altogether superior to ge- 
neral blood-letting. It removes the turgid vessels of the brain, and, by its 
counter-irritating effects, produces immediate relief; but even this operation 
is seldom, if ever, necessary. Lemonade, cream of tartar, spirits of nitre, 
and cold water may be taken. 
REGIMEN. 
The patient must be kept from all noise, and a strict adherence to alight, 
cooling diet. Nothing of a stimulating nature must be given, either in food 
or drink. 
CHAPTER II. 
INFLAMMATION OF THE EAR. {Otitis.} 
DESCRIPTION. 
This is an inflammation of the membranes well furnished with nerves, 
which are spread upon the internal surface of the ear. 
CAUSES. 
An inflammation of the ear is usually brought on by exposing the ear to a 
partial current of air. It may arise from cutting the hair of the head very 
short, particularly in the winter; or any exposure. 
SYMPTOMS. 
When the ear is inflamed the pain is very acute, attended with more or 
less fever, and sometimes delirium. Swelling and redness is often perceived 
externally, attended with throbbing; suppuration occasionally takes place, 
when a copious discharge of matter follows. This discharge will sometimes 
continue for years ; in which case inject, with a syringe, soap suds, a decoc- 
tion of white oak, and introduce the brown ointment. 
If the pain be very severe, take hops, {humulus a suitable 
quantity; vinegar and water, equal parts: simmer till the strength is extract- 
ed; enclose the hops in linen or flannel, and apply them over the ear. 
TREATMENT. INFLAMMATION OF THE EAR-MUMPS. 
291 
Repeat the same until the pain subsides. Let the feet be bathed in warm 
water. 
Should these means not remove the pain, take oil of sassafras, {oleum lauri 
sassafras,) half an ounce ; olive or sweet oil, {oleum olivarum,) one ounce; 
camphor, {gummi camphora,) one drachm: mix. 
Warm this liniment, and pour a small quantity on a pledget of cotton, 
and bind over the ear. Provided the pain still continues, drop it in the ear. 
Also laudanum, juice of roasted onions, equal parts. 
If the above fails, give an anodyne. Perspiration may be promoted and 
a purgative given. 
The sap of walnut or hickory wood is said to be an infallible remedy for 
pain in the ear, and is highly recommended for deafness. Take a small 
stick, put it over the fire or stove, and place a vessel under each end to 
receive the sap ; put it into the ear on cotton, and repeat occasionally. An 
elderly person states that he obtained it among the Indians, and has known 
it succeed in numerous cases. 
This treatment w'ill almost invariably remove the pain and inflammation 
of the ear. The complaint more generally attacks children, but adults are 
subject to it. It sometimes becomes somewhat chronic in its character, and 
is very protracted. When this is the case, if the means prescribed above 
should not be sufficient to remove it, apply a mustard plaster behind the ear, 
and also to the bottom of the feet, particularly at night. 
PREVENTION. 
Great care is necessary in screening the head from any cold or current of 
air. The head should be covered, particularly at night, and a pledget of 
cotton or wool applied in the ear. 
CHAPTER III. 
MUMPS. (Cynanche Parotidea.) 
DESCRIPTION. 
Mumps is a swelling of the glands about the throat, and often occurs as an 
epidemic. Children of both sexes are more liable to it than adults. It more 
generally occurs in the spring than at other periods. Causes, Contagion. 
SYMPTOMS. 
One or both of the parotid glands of the neck become large, hard, and 
often painful, and sometimes become so large as to impede respiration, and 
cause a difficulty of swallowing. The swelling is often translated to the 
testicle and becomes dangerous, increasing for three or four days, then sub- 
sides, and wholly disappears. There is usually some fever attending the 
complaint; other parts are sometimes affected from sympathy. Suppuration 
sometimes, but rarely, takes place. The contents of the tumour being 
discharged into the larynx, produce suffocation; but this is rarely the 
case, as the disease usually puts on a mild aspect. The great danger arises 
from the patient's taking cold. 292 
THE REFORMED PRACTICE OF MEDICINE. 
TREATMENT. 
The patient should be directed to keep warm in bed, and perspiration pro- 
moted, by drinking freely of diluting liquors, such as an infusion of balm tea. 
If there is costiveness, give a gentle purgative and bathe the feet. Cover the 
swelling with a pledget of cotton; and should it be very painful or trouble- 
some, it may be bathed with the following liniment: Castile soap, scraped, 
one drachm; sassafras oil, (oZ. sassafras,) half an ounce; sweet oil, (oZ. 
oliv.,) one ounce ; camphor, (gum camph.,) three drachms : mix, and apply 
it three times a day, warm. 
In case of a recession (by which this complaint is thrown to the testicle 
or other parts) an emetic may be taken, and free perspiration must be pro- 
moted, by giving one tea-spoonful of the red or sweating drops every hour, 
diluted with tea and sweetened. Should suppuration take place, a poultice 
must be applied, made by adding Indian meal to beer until it is formed into 
the consistence of a poultice. The above treatment has invariably been 
found successful. 
CHAPTER IV. 
QUINSY OR INFLAMMATORY SORE THROAT. (Cynanche Tonsillaris.) 
DESCRIPTION. 
When the tonsils, commonly called the almonds of the ear, or the mucus 
membrane lining the throat, become inflamed, it is termed quinsy or inflam- 
matory sore throat. It generally affects the young and sanguine, and it 
occurs more especially in the spring and autumn 
CAUSES. 
The most common causes of this disease are, a sudden check of perspira 
tion, wet clothes, wet feet, damp beds, moist air, drunkenness, acrid or irri- 
tating food, &c. 
An inflammation of the throat is often occasioned by omitting some part 
of the covering usually worn about the neck. Singing or speaking loud and 
long, or whatever strains the throat, may also cause an inflammation of that 
organ. It may also proceed from pins, bones, or other sharp substances 
sticking in the throat; by sitting near an open window, or in a room newly 
plastered or white-washed. This disease is sometime epidemic and infectious. 
When there is chronic inflammation of the throat it ought to be sponged 
every morning, or oftener, with cold salt water. I have found decided 
benefit myself from this practice. Lord Byron was cured of the same 
complaint by constantly bathing his throat with cold water. 
SYMPTOMS. 
An inflammatory sore throat discovers itself by a difficulty of swallowing 
and breathing, accompanied by a redness and tumour in one or both tonsils; 
dryness of the throat; foulness of the tongue ; shooting pains in the parts 
affected; hoarseness of the voice ; a frequent but difficult excretion of mucus, QUINSY OR INFLAMMATORY SORE THROAT. 
293 
and some small degree of fever. As the disease advances the difficulty of 
swallowing and breathing becomes greater; the speech is very indistinct; 
the dryness of the throat and the thirst increase; the tongue swells and is 
incrusted with a dark fur, and the pulse is full, hard, and frequent, beating 
from 100 to 140 in a minute. In a few cases small white sloughy spots are 
to be observed on the tonsils, and in very violent ones there is complete deaf- 
ness. When the symptoms are considerable, the whole face partakes of it, 
the eyes are inflamed, and the cheeks florid and swelled; respiration is per- 
formed with difficulty, and the patient is obliged to be supported in nearly an 
erect posture, to prevent suffocation. Even delirium and lethargy sometimes 
supervene and stop respiration. Sometimes both tonsils are very much 
inflamed and swelled, so that it becomes exceedingly difficult to give any 
kind of nourishment. It may terminate in suppuration, and in some cases 
subsides without it; terminating by what is called resolution. When suppu- 
ration takes place, the parts affected become more pale and less painful; a 
sense of pulsation is felt, and very slight chills. The matter is often dis- 
charged into the throat, and passes into the stomach, when immediate 
relief follows. 
TREATMENT. 
Indications of Cure.-The first object in the treatment of this disease is, 
to remove urgent symptoms; the next, to subdue or moderate the inflamma- 
tion. It is truly astonishing that any person, professing a knowledge of the 
science of medicine, should make use of the common practice to cure this 
compl&int, especially when it is well known that this very treatment occa- 
sioned the death of General Washington, as well as thousands of others. 
In the incipient stage of quinsy it is necessary to administer an emetic. 
None answers better than that which we use in complaints generally. This 
often affords immediate relief. Should the attack, however, be very severe, 
and the disease continue, the patient will steam the throat with the following 
preparation: Take wormwood, (absyntheum vulgare,} hops, (humulus lupulus,} 
catnip, equal parts. Make a strong decoction by boiling one or two hours 
in equal parts of rain water and vinegar. Put these into a large pitcher, or 
any convenient vessel, over which place a funnel; then let the patient inhale 
the steam arising from this for fifteen or twenty minutes each time, to be 
repeated every two hours until the urgent symptoms are removed. The 
herbs to be bound on the neck. This generally affords immediate relief, by 
relaxing the tension of the parts inflamed. The breathing soon becomes 
easy, and the pain and difficulty of swallowing much less. The above articles 
may be put into a common tea-pot, and the steam inhaled from the spout. 
The following liniment or oil must now be applied to the throat: Take 
sassafras oil, (oleum lauri sassafras,} olive oil, (oleum olivarum,} spirits of 
hartshorn, (aqua ammonce,} of each half an ounce ; add two drachms of gum 
camphor, (gummi camphora:} mix. Warm this preparation and bathe the 
throat as long as the patient can bear ; after which put a piece of flannel 
around it. This must be repeated occasionally through the day. 
It will be necessary also to gargle the throat with the following prepara- 
tions : A handful of sage ; two bunches or heads of sumach berries ; add two 
quarts of boiling water : simmer a short time ; then add a tea-spoonful of 
pulverized alum, and as much saltpetre ; when blood-warm add a tea-cupful 
of good yeast, sweetened with molasses or honey: gargle often. 
When the acute inflammatory symptoms have subsided, a gargle more 294 
THE REFORMED PRACTICE OF MEDICINE. 
stimulating may be prescribed. The gargles mentioned on page 296 may be 
used frequently through the day. 
A gargle made of weak ley has been found remarkably efficacious where 
other means have proved useless, particularly where persons have been 
subject to the quinsy, and when it assumes a chronic character. 
Purgatives must be given repeatedly, as they have a great tendency to 
allay the febrile excitement: the feet must be bathed in warm rain water, 
to which has been added ashes or a quantity of ley, and perspiration pro- 
moted by the vapour bath, or warm drinks, &c. If there is great swelling 
of the throat, apply a poultice made of slippery elm bark and ley. 
Should the disease increase, and exhibit symptoms of suppuration, so as 
to threaten suffocation, the tongue must be pressed down with the finger or 
handle of a spoon, and the swelling punctured with a gum lancet. 
M. Velpeu, of Paris, highly extols the use of alum for a gargle in quinsy 
and all kinds of sore throat: Take alum, one ounce; barley water four 
ounces ; apply a little of the alum, fine, on the parts inflamed, with a little 
stick or brush, or the finger. Many cases are said to have been success- 
fully cured by this simple treatment. 
A respectable and aged person states that he has seen the most signal 
benefit derived from the application of mullein and milk boiled together, and 
bound on the neck, in the quinsy. 
The last case of quinsy I attended was very much aggravated ; the inflam- 
mation and swelling was so great that it was deemed best to apply two or 
three leeches. After which I applied henbane, (hyoscyamus,') simmered with 
spirits. This treatment appeared to arrest the complaint almost imme- 
diately. » 
REGIMEN. 
All food and drinks of a stimulating nature must be avoided. Warm 
diluent drinks. Nothing cold must be given. 
PREVENTION. 
Great care must be taken to prevent a check of perspiration. The throat 
should never be uncovered or exposed to the cold air. A piece of flannel 
should be worn about the neck. The practice of bathing the feet in weak 
ley water should by no means be neglected. If persons would sponge their 
throat and neck daily with cold water, and be careful to keep themselves 
warm, wear flannel, especially about the throat, use a spare diet, the disease 
would seldom become very aggravated. It is particularly necessary to guard 
against drinking cold water when the body has been heated. 
The late celebrated Col. Aaron Burr, of this city, a great enemy to the 
common practice, had been subject to frequent attacks of the quinsy for 
most of his life, from the age of sixteen years and upward. He had twice 
tried the orthodox physician without benefit. He submitted to a similar 
course of treatment, and it effected a cure. 
A cold moist air continuing for some time, or suddenly succeeding a dry 
and warm state, is extremely prejudicial to health, which causes the fluids 
to circulate with less velocity, noxious humours are retained, and if not 
discharged by some excretions, pleurisy, quinsy, coughs, fevers, &c., are 
produced. The spring of 1842 has been remarkable for this kind of weather, 
and also the complaints above-mentioned. PUTRID SORE THROAT. 
295 
CHAPTER V. 
PUTRID SORE THROAT. (Cynanche Maligna.) 
DESCRIPTION. 
This disease generally affects the glands of the throat, while the common 
quinsy affects the mucous membrane. In the putrid sore throat there are 
also cankers, sores, and ulcers in the fauces, together with great debility of 
the system. In the inflammatory sore throat there is always great difficulty 
of swallowing, whereas in the other these symptoms are not present. 
CAUSES. 
The cause of this disease is specific contagion ; it is often communicated 
by infection; when it is not, it most generally arises from cold, in habits 
predisposed to the disease. Whatever tends to produce putrid or malignant 
fevers may occasion the putrid ulcerous sore throat; as neglect of cleanli- 
ness, unwholesome air, damaged provisions, &c. 
SYMPTOMS. 
Some consider this disease the same as scarlatina maligna; but, although 
very similar, there appears in some respect a marked difference. The symp- 
toms of this complaint are chills, fever, stiffness of the neck, soreness and 
inflammation of the throat. Ash-coloured spots appearupon the inflamed parts, 
which produce deep ulcerations. The breathing and speaking are attended 
with a peculiar noise and hoarseness. It is ushered in with sickness, vomit- 
ing, looseness, and great anxiety. The pulse in general small, quick, and- 
fluttering. The countenance is often full and bloated, sometimes pale and 
sunk, and the breath is intolerably offensive. The ulcers become livid or 
black, and sometimes gangrene to a considerable degree takes place. Putrid 
symptoms now appear, under which the patient sometimes sinks in a few 
days. At the close of the disease haemorrhages from the mouth, nose, and 
other parts take place. 
TREATMENT. 
Indication of Cure.-The indication of cure will be, to counteract a putrid 
tendency and to keep up the strength of the patient. Bleeding and mercury, 
now generally prescribed, are extremely injurious. 
In the first stage of the disease a mild emetic may be administered, after 
which mild cathartics may occasionally be given. If there is great soreness 
and inflammation of the throat, let the patient inhale the steam of the decoc- 
tion mentioned in the treatment of the common quinsy. The liniment there 
mentioned may also be applied to the throat. 
When putrid ulcers appear in the throat, let it be gargled with a mixture 
of yeast and milk. It will be necessary also to administer antiseptic medi- 
cines ; a wine glass of good yeast may be taken every two hours during 
the day. If the pulse is very weak, and the patient sinks, the system must 296 
THE REFORMED PRACTICE OF MEDICINE. 
oe supported by stimulating medicines and liquids. Porter and wine may 
occasionally be given. 
Dr. Thomas speaks in the highest terms of the efficacy of the following 
formula, which, from experience, I have found very valuable. Two table- 
spoonsful of cayenne pepper; salt, a tea-spoonful in half a pint of boiling 
water, and add the same quantity of warm vinegar. Let it stand for about 
an hour, and strain the liquor through a fine cloth. Dose, two table- 
spoonsful every half hour. A plaster may be applied to the throat, made 
by melting equal parts of common brown soap and rosin, to be spread on 
thin leather or linen. 
In the revolutionary war, when the putrid sore throat prevailed in the army 
and proved very fatal, all means to avoid it proved unavailing, till a French 
or German physician came and prescribed, when every case recovered. The 
treatment consisted in a gargle made as follows : Take the bark or berries of 
sumach, white oak bark, white or common elm bark, the common high black- 
berry root, of each two parts, or a handful of each ; add black snake-root, half 
a handful. Make a strong decoction by boiling well; then strain and sweeten 
with honey ; add a lump of alum, and frequently apply to the parts affected. 
Also gargle with the same. This soon removed the mass of corruption from 
the mouth and throat. 
CHAPTER VI. 
CROUP. (Cynanche Trachealis.) 
DESCRIPTION. 
This is an acute inflammation of the mucous membrane of the trachea 
or wind-pipe, characterized by fever, cough, and hoarseness, difficulty of 
breathing, with a considerable degree of spasmodic affection. 
CAUSES. 
The usual causes of croup are, cold, exposure to a damp atmosphere, and 
whatever checks perspiration. It prevails chiefly in winter and spring. 
SYMPTOMS. 
The symptoms of this complaint are, difficulty of breathing, and a peculiar 
whistling noise. It is attended with a cough, which generally increases 
until it becomes very troublesome. It occurs in paroxysms, which agitate 
the whole frame; great thirst, restlessness, and expectoration of mucus, which 
is raised with a great deal of difficulty. The head is thrown back in great 
agony, as if attempting to escape suffocation. The cough is generally dry; 
but if anything is spit up, it has either a purulent appearance, or seems to 
consist of films resembling portions of a membrane. Where great nausea 
and frequent retchings prevail, coagulated matter of the same nature is brought 
up. There is an uneasy sense of heat over the whole body, a continual 
inclination to change from place to place, and frequency of the pulse. Very 
often the symptoms suffer considerable, and sudden remissions and exacerba- 
tions take place. CROUP. 
297 
In an advanced stage of the disease respiration becomes more difficult, 
and is performed with still greater difficulty and some degree of spasmodic 
affection, being repeated at longer periods and with greater exertions, until 
at last it ceases entirely. 
The disease has, in a few instances, terminated fatally within twenty-four 
hours ; but more generally, when it proves fatal, it runs on to the fourth or 
fifth day. In this disease great quantities of lymph are poured out into the 
trachea or wind-pipe, and bronchial tubes, larynx, &c., which produce the 
suffocation and many other symptoms attending it. 
TREATMENT. 
Indications of Cure.-Prompt means should be taken to lessen increased 
action of the mucous membrane of the wind-pipe, larynx, and bronchial 
tubes. To accomplish these means, it will be necessary to bathe the feet in 
weak ley. Give the expectorant tincture or the emetic powder. To a child of 
one year old give a common tea-spoonful every twenty minutes until gentle 
vomiting takes place. This acts with peculiar force upon the trachea, sepa- 
rating or removing the effusion of lymph collected there, by which the breath- 
ing becomes easy and all the symptoms more favourable. This must be 
repeated occasionally, or as often as there are any returns of the severe 
symptoms or paroxysms. Of the powder give quarter of a tea-spoonful. 
A Purgative may be given a short time after the operation of the emetic, 
which may be repeated every day until the symptoms abate. 
Expectorants.-Should there be great difficulty of expectoration, the fol- 
lowing syrup may be given : Take seneca root {polygela seneka) and squills, 
of each half a pound ; water, eight pounds ; boil it slowly till the water is 
half consumed ; strain off the liquor, and add strained honey, four pounds; 
then boil to six pounds, or the consistence of a syrup; to every pound of 
this syrup add one quarter of a pound of tincture of lobelia. An ordinary 
sized tea-spoonful may be given to a child one year old, as often as a parox- 
ysm of coughing occurs, particularly if the mucus is discharged with diffi- 
culty. This acts as an expectorant, diaphoretic, and laxative. Bathe the 
chest and throat with the rheumatic liquid. 
If the cough proves very troublesome, give occasionally a tea-spoonful of 
the syrup of garlic. Should not this preparation diminish it in a reasonable 
time, administer the pulmonic syrup according to the directions given. If 
there is much febrile excitement, let the surface be occasionally bathed, and 
mustard plasters applied to the feet and between the shoulders, and to the 
chest alternately. Steep hops and vinegar, inhale the steam, and apply to 
the throat. It is stated that it has cured when all other remedies have 
failed. 
Mrs. Martin, of this city, states that her child is subject to the croup. 
He is taken suddenly and much distressed. She bathes his throat and chest 
with a stimulating liniment, and gives a purgative, which invariably relieves 
him in about half an hour. This treatment has proved very successful in 
cases of croup where a prospect of recovery has been very small. 
Says Dr. McNair, " I have had the misfortune to lose a brother and two 
sisters by croup. They were attended by one of the best physicians in the 
state of Maryland, and were all bled from the arm as long as blood could be 
obtained from that part. After which the largest vein in the neck was 
opened, all without the least benefit. I mention this to show what quackery 
is practised under the garb of science." 298 
THE REFORMED PRACTICE OF MEDICINE. 
The inflammation of the pharynx and larynx are of the same nature, pro- 
duced by the same causes, and require a similar treatment. 
CHAPTER VII. 
INFLAMMATION OF THE BRONCHIAL TUBES. {Bronchitis.) 
DESCRIPTION. 
This is an inflammation of the mucous membrane of the bronchial tubes, 
which convey the air into the lungs. It is either chronic or acute. The 
acute stage very much resembles inflammation of the lungs. The causes 
are the same as inflammation of the lungs. 
SYMPTOMS. 
It is frequent in cold and variable climates. In its simplest forms it con- 
stitutes those protracted catarrhal affections which are so common during 
winter in old persons, especially in those who are predisposed to cold and 
coughs. The acute bronchitis generally commences, like a common cold or 
catarrh, with lassitude, chillings, slight cough, oppression, and tightness of 
the chest, with some fever. As the disease increases these symptoms in- 
crease, great anxiety of the countenance, respiration more laborious, attended 
with a wheezing or rattling sound, as if the air were forced through a narrow 
aperture clogged with a viscid fluid. It is generally attended with hoarse- 
ness ; respiration is more difficult in the recumbent than in the erect position. 
At first the cough is dry, but afterward a copious secretion of viscid trans- 
parent mucus, resembling the white of eggs, soon occurs, and with it con- 
siderable abatement of the violence of the cough ensues. But when the 
inflammation is about terminating without suppuration, the matter expec- 
torated loses its transparency, and becomes mixed with yellowish, white, or 
greenish masses, which are scanty at first, but continue to increase more and 
more, until at last they compose the whole of the expectoration. A severe 
pain in the forehead, which is aggravated by coughing. When the secretion 
of mucus into the bronchia is very copious, and respiration is much obstructed, 
considerable drowsiness occurs. The tongue is white, and covered with 
transparent mucus; the skin is dry, and its temperature generally but very 
little above the natural standard. 
TREATMENT. 
In the acute bronchitis emetics and sudorifics are the only anchors of hope. 
The following mixture may be given: Tincture of emetic plant, (lobelia, 
inflata f) tincture of blood-root, (sanguinaria canadensis equal parts : mix 
Dose, a table-spoonful: for an infant, or a child of one year old, a tea- 
spoonful every half hour till vomiting is produced. This may be repeated 
as often as there is an accumulation of mucus in the bronchial vessels, with 
difficulty of expectoration, respiration, &c. Twenty-five drops of the sweat- 
ing or sudorific drops may afterward be given in tea of any kind every hour 
until a moisture or perspiration is produced; or the diaphoretic powders. The INFLAMMATION OF THE BRONCHIAL TUBES. 
299 
surface must be frequently bathed with warm water, to which ley must be 
added. The feet should also be frequently bathed and mustard applied. 
Purgatives to be administered, to keep the bowels gently open. To re- 
lieve the cough, give pulmonic syrup or balsam, syrup of poppies, fyc. For 
adults the same treatment, but doses of medicine in proportion to age. 
SECTION I. 
CHRONIC INFLAMMATION OF THE BRONCHIA. 
This is often the result of acute bronchitis. It is characterized by a 
troublesome cough, attended with a copious expectoration of viscid, purulent, 
or a whitish frothy matter; uneasy and somewhat oppressed respiration, 
accompanied at times with wheezing ; more or less weight and uneasiness 
at the pit of the stomach ; loss of appetite ; a slightly furred tongue ; irre- 
gular action of the bowels; a quick and irritated pulse, particularly toward 
evening ; and deep red and scanty urine. The coughing usually occurs in 
fits of considerable violence, being almost always most severe in the morn- 
ing on rising from bed, or on passing from warm to a cold air. Sudden at- 
mospheric vicissitudes also seldom fail to increase the violence and frequency 
of the spells of coughing; and the same effect is usually produced by the 
inhalation of various vapours, fine dust, and occasionally by the act of swal- 
lowing food. Sometimes slight transient pains are felt in the chest; but 
more frequently no painful sensations whatever are experienced, except im- 
mediately after a fit of coughing, when a general aching pain is left for a few 
moments in the breast. 
CAUSES. 
Chronic inflammation of the mucous membrane of the bronchia may occur 
as the sequel of acute bronchitis. It most commonly, however, arises from 
neglected catarrh. It is the consequence sometimes of measles, of hepatic 
diseases, and of protracted disorders primarily located in the digestive organs. 
It may proceed directly from the vicissitudes of heat and cold, and from the 
inhalation of irritating vapours or particles of matter floating in the atmo- 
sphere. It occasionally occurs in consequence of hooping-cough, particularly 
from taking cold while under the influence of this affection. 
o 
TREATMENT. 
In the chronic form of this complaint emetics may likewise be given, as 
directed in the acute species, but repeated only at longer intervals. They 
unload the viscid secretions with which the bronchial cells become gorged. 
The same syrup may likewise be given as recommended under that head. 
From the sympathetic relation which exists between the skin and lining 
membrane of the bronchial tubes, it is necessary to keep up a regular action 
of the cutaneous vessels, for in the proportion as we increase the activity of 
these emunctories, so we lessen the influx of fluids to the lungs. Flannel 
and proper clothing should be worn to prevent the effects of cold and sudden 
atmospheric changes. When the cough is very troublesome, two tea-spoons- 
ful of the syrup of white poppy may be given to allay irritation. Great atten- 
tion must be paid to the extremities, that an equal circulation may be produced, 300 
THE REFORMED PRACTICE OF MEDICINE. 
by which the disease will be mitigated. A stimulating or strengthening 
plaster may be worn upon the chest. Spunging the throat, neck, and chest 
with cold water daily is an excellent preventive. 
CHAPTER VIII. 
HOOPING-COUGH. {Pertussis.} 
DESCRIPTION. 
This is a disease known by a convulsive, strangulating cough, with hoop- 
ing, returning by fits that are usually terminated by vomiting. Children 
are most commonly the subjects of this disease, and it seems to depend on a 
specific contagion, which affects them but once in their life. The disease 
being once produced, the fits of coughing are often repeated without any 
evident causes ; the frequency of the fits may depend upon various exciting 
causes, such as violent exercise, a full meal, the having taken food of diffi- 
cult digestion, and irritation of the lungs by dust, smoke, or disagreeable 
odours. Emotions of the mind may likewise prove an exciting cause. 
It is evidently produced by contagion. Its proximate or immediate cause 
seems to be a viscid matter or phlegm lodged about the bronchia, trachea, 
and fauces, which sticks so close as to be expectorated with the greatest 
difficulty. 
CAUSES. 
SYMPTOMS. 
The hooping-cough usually comes on with a difficulty of breathing, some 
degree of thirst, a quick pulse, and other slight febrile symptoms, which are 
succeeded by a hoarseness, cough, and difficulty of expectoration. These 
symptoms continue perhaps for a fortnight or more, at the end of which time 
the disease puts on its peculiar and characteristic form, and is now evident, 
as the cough becomes convulsive, and is attended with a sound which has 
been called a hoop. 
When the sonorous inspiration has happened, the coughing is again renew- 
ed, and continues in the same manner as before, till either a quantity of mucus 
is thrown up from the lungs, or the contents of the stomach are evacuated 
by vomiting. The fit is then terminated, and the patient remains free from 
any other for some time, and shortly afterward returns to the amusements 
he was employed in before the fit, expresses a desire for food, and when it is 
given to him takes it greedily. In those cases, however, where the attack 
has been severe, he often seems much fatigued, makes quick inspirations, 
and faints. 
At the commencement of the disease there is little or no expectoration; 
or, if any, it consists only of thin mucus ; and as long as this is the case, the 
fits of coughing are frequent and of considerable duration; but on the ex- 
pectoration becoming free and copious, the fits of coughing are less frequent, 
as well as of shorter duration. 
By the violence of coughing, the free transmission of blood through the 
lungs is somewhat interrupted, as likewise the free return of blood from HOOPING-COUGH. 
301 
the head, which produces that turgescence and suffusion of the face which 
commonly attend the attack, and in some instances bring on a hsemorrhage 
either from the nose or ears. 
The disease having arrived at its height, usually continues for some weeks 
longer, and at length goes off gradually. In some cases it is, however, pro- 
tracted for several months, or even a year, and sometimes terminates in other 
complaints. 
TREATMENT. 
The symptoms of this disease can only be mitigated, not suddenly arrest- 
ed ; but it will run its course. 
Emetics.-It is generally reckoned a favourable symptom when a fit of 
coughing makes the patient vomit. This cleanses the stomach and greatly 
relieves the cough. It will, therefore, be proper to promote this discharge, 
by giving an emetic or the expectorant tincture. 
Emetics not only cleanse the stomach, which in this disease is generally 
loaded with viscid phlegm, but they likewise promote perspiration and the 
other secretions, and ought therefore to be repeated according to the obstinacy 
of the disease. They should not, however, be strong ; gentle vomits frequent- 
ly repeated are both less dangerous and more beneficial than strong ones. 
For this purpose a tea-spoonful of the expectorant tincture or emetic poicder 
may be given to a child a year old, in any kind of tea sweetened, every half 
hour till it operates as a gentle emetic. It may be repeated whenever a fit 
of coughing occurs and there is a sense of suffocation ; or if there is great 
debility, or the attack is not very severe, a sufficient quantity may be given to 
loosen the mucus or phlegm, and to cause the child to breath freely. Give 
also the pulmonic syrup. 
Opiates are sometimes necessary to allay the violence of the cough. For 
this purpose a little of the syrup of poppy, according to the age of the 
patient, may be taken in a cup of hyssop or pennyroyal tea, and repeated 
occasionally. 
Laxatives.-The bowels must be kept freely open by gentle laxatives. A 
good medicine for this purpose is the cold-pressed castor oil, mixed with a 
little milk, sweetened. A tea-spoonful or two may be given to a child one 
year old two or three times a day, as there is occasion. For those that are 
older the dose must be increased and repeated till it has the desired effect. 
Those who cannot be in this manner induced to take the castor oil, may have 
it mixed with a little syrup or currant jelly, to disguise the taste, or the com- 
mon bilious physic may be given. 
The feet must be bathed in warm ley water every night, and draughts 
applied to the feet and chest. 
My friend, Dr. Thomas Cooke, editor of the Philadelphia Botanic Medical 
Reformer, a talented practitioner, thus remarks on the virtues and use of the 
black cohosh or squaw-root in hooping-cough: 
" This article is the best, the most efficacious of all others in hooping- 
cough. We have used it in a great many cases and in all stages of the dis- 
ease, and rarely has it failed to produce decidedly beneficial effects, render- 
ing the cough less violent, the expectoration freer, and, in many instances, 
apparently bringing the disease to an abrupt, yet happy, termination. 
The saturated tincture we have found the most convenient form of ad- 
ministering it. For a child of one year old the dose is from fifteen to twenty 
drops, four or five times a day. For one that is three or four years old, from 302 
THE REFORMED PRACTICE OF MEDICINE. 
half to a tea-spoonful, in a little sweetened water. We prepare the tincture 
by adding a pint of spirits to two ounces of the pulverized root. It may also 
be used in decoction." 
REGIMEN. 
Whatever injures the digestion, obstructs the perspiration, or relaxes the 
solids, disposes to this disease ; consequently its cure must depend upon cleans- 
ing and strengthening the stomach, bracing the solids, and at the same time 
promoting perspiration and the different secretions. 
The diet must be light and of easy digestion ; for children milk, good bread 
made into pap or pudding, chicken broth, with other light diet, are proper. 
One of the most effectual remedies in the hooping-cough is change of air- 
This often removes the malady even when the change seems to be from a 
purer to a less wholesome air. The feet should be frequently bathed in 
lukewarm water, and a sweating or strengthening plaster kept constantly 
between the shoulders. 
CHAPTER IX. 
CATARRH OR INFLUENZA. {Tussis Epidemicus.) 
DESCRIPTION. 
This is an epidemical disease which occasionally prevails, and sometimes 
affects nine-tenths of the inhabitants of Europe and America. It is an in- 
creased secretion of mucus from the membranes of the nose, mouth, and 
bronchia, with fever, and attended with sneezing, cough, thirst, lassitude, and 
want of appetite. 
CAUSES. 
A species of catarrh, to which the name of influenza has been applied, 
sometimes makes its appearance ; and considering the manner in which the 
epidemic infection of this disease occasionally spreads, even over whole 
countries, in the space of a very short time, it is evident that it is conveyed 
by a current of the atmosphere, and derives its origin from some casual source 
capable of impregnating the air which we breathe with the specific poison 
of the malady. 
Catarrh and influenza are not accompanied with danger when appearing 
under a mild form and properly attended to at an early period ; but when 
connected with highly inflammatory symptoms, and these are not counter- 
acted at the commencement by appropriate means, or there is a predisposition 
in the constitution to consumption, or a tendency to asthma, unfavourable 
consequences may result therefrom. 
SYMPTOMS. 
It commences by sneezing, coughing, hawking, chills succeeded by heat, 
hoarseness, soreness and rawness of the throat, lungs, and stomach. There 
is an expectoration of mucus, pain of the head, chest, back, shoulders, and CATARRH OR INFLUENZA-COLDS AND COUGHS. 
303 
forehead. The eyes are red, and there is great weakness and debility. The 
cough is often attended with great difficulty of expectoration. 
As before intimated, it seldom proves fatal, but in some epidemics the attack 
has been so universal as to occasion great mortality. Toward the close of 
the year 1831, and commencement of 1832, it prevailed throughout the 
United States, and proved very mortal upon those principally who were 
aged or were subject to some other complaint. It swept off' many of our 
most distinguished inhabitants. 
TREATMENT. 
In general the vapour bath alone will soon remove it. It may be repeated 
every other day; at the same time the feet must be bathed, and warm teas 
drank, made of boneset., hoarhound, or other herbs, until perspiration is 
promoted. 
A tea-spoonful of the tincture of lobelia or syrup of ipecac may be taken 
every morning; and if the cough proves troublesome, a tea-spoonful of the 
syrup of white, poppy may be given. A purgative likewise may be occasion- 
ally taken ; also bathe the feet. 
Influenza and Cough.-Equal parts of good vinegar and water; to a tea- 
spoonful of this mixture add as much capsicum; sweeten with honey or sugar. 
A tea-spoonful will allay the cough instantly; a dose taken at bed-time will 
generally enable the patient to rest well all night. It may be taken when- 
ever the cough is troublesome.-John Shaw. 
REGIMEN. 
The diet should be light, and taken in moderate quantities; liquids are 
preferable. This treatment will be found very effectual in the catarrh and 
influenza. 
CHAPTER X 
COLDS AND COUGHS. (2Ws.) 
DESCRIPTION. 
The inhabitants of every climate are liable to take cold when the seasons 
are variable, and there are sudden and considerable changes in the surround- 
ing atmosphere. Those are chiefly the subjects of it who are of a delicate 
constitution, whose employments expose them to quick transitions from 
great heat to a very reduced temperature, and who have a morbid suscepti- 
bility to the impression of cold, and are disposed to coughs. 
Most persons affect to despise colds ; and as long as they can walk about, 
scorn to be confined by what they call a common cold. Hence it is that colds 
destroy such numbers of mankind. Like an enemy despised, they gather 
strength from delay, till at length they become incurable. 
CAUSES. 
The application of cold to the body giving a check to perspiration, is the 
general cause of these complaints. 304 
THE REFORMED PRACTICE OF MEDICINE. 
SYMPTOMS. 
A cold is usually accompanied with a weight and pain in the head, oppres- 
sion at the chest, and some difficulty of breathing; a sense of fulness and 
stopping of the nose, watery inflamed eyes, soreness of the throat, cough, 
pains about the chest, cold shiverings, succeeded by transient flushes of heat, 
pains in the neck and other parts of the body, an increased secretion of mu- 
cus from the nose, throat, and lungs, in consequence of a slight inflamma- 
tion of the mucous membrane of these parts, and in many instances with 
some degree of fever. 
Common Cough.-A cough is generally the effect of a cold which has 
been improperly treated or entirely neglected. When it proves obstinate, 
there is always reason to fear the consequences, as this shows a weak state 
of the lungs, and is often the forerunner of consumption. 
TREATMENT. 
1. Bathe the feet in blood-warm ley water. 
2. If very severe, use the vapour bath as directed under that head. 
3. Take an infusion or tea of common hoarhound and boneset, sweetened 
with honey. 
4. Give a dose of physic. 
5. If the cough is troublesome, particularly at night, give syrup of poppies. 
Should the cough return after using the above means, an emetic may be 
taken, and afterward the cough drops : thirty drops three or four times a 
day to be given on loaf sugar or in sweetened water. This treatment will 
be found very effectual for colds or coughs, and which, if properly applied, 
will prevent the consumption. Also a mixture of honey, vi egar, and but- 
ter melted, and a tea-spoonful taken often. The pulmonic syrup or balsam 
maybe taken, if it be obstinate. Take half a wine glass morning, noon, and 
particularly at night on retiring to rest. This has cured many apparently 
in the consumption. Slippery elm bark, flax-seed, bran, all make a good 
mucilaginous tea, separately or together, and promote expectoration. A 
little lemon juice may be added, and sweetened with loaf or other sugar 
REGIMEN. 
When a person finds himself much indisposed from any exposure to cold, 
he ought immediately to put himself on a light, spare diet, abstaining from 
the usual quantity of food, and from all fermented and spirituous liquors, 
together with everything that is likely to heat and inflame the body. The 
best food for him will be gruel, weak broths, bread puddings, roasted apples, 
barley water, &c. The patient in particular should avoid eating any supper, 
except gruel, with a little bread. It will likewise be advisable that he be 
confined to the house, and not expose himself to the external atmosphere ; 
he should also be warmly clothed. 
Previous to his going to bed he had better put his feet into warm water 
and ley for ten or twelve minutes; and, after having them well wiped, he 
should take freely of hoarhound, and, as a change, honeset tea, very warm at 
bed-time, and cold through the day ; and covering himself in bed with suf- 
ficient clothes, so as to excite a proper perspiration throughout the night. 
The next morning he ought to continue in bed longer than usual. ASTHMA. 
305 
PREVENTION. 
Persons liable to coughs from any little exposure to cold, should wear 
flannel next to the skin, but particularly over the chest; they should adapt 
their clothing to the vicissitudes of the weather, and be cautious how they 
expose themselves too quickly to the external air when heated by exercise 
or crowded rooms. Bathing the surface with cold water or taking the 
shower bath daily are excellent preventives. 
CHAPTER XI. 
ASTHMA. {Asthma.) 
DESCRIPTION. 
Asthma is an affection of the lungs or the bronchial vessels, generally of 
a spasmodic nature, that occurs in paroxysms which take place usually at 
night. It is characterized by frequent, difficult, and short respiration, 
wheezing, stricture of the chest, and a cough; all which symptoms are 
aggravated when in a recumbent position. It more generally attacks those 
of a full or plethoric habit. 
When there is a great discharge of mucus from the lungs it is termed 
humid ; but when it is attended by little or no expectoration, it is termed the 
dry or spasmodic asthma. It more generally attacks men than women. 
CAUSES. 
Asthma, but more particularly the spasmodic, is brought on by almost 
everything which increases the action of the heart, and which stimulates 
and fills the vessels of the mucous membrane. Thus it is produced by 
intense heat, lightness of air, severe exercise, strong mental emotions, full 
meals, stimulating drinks, exposure to cold and atmospherical influence, and 
by certain effluvia, as those of hay, whether new or old, of sealing-wax, and 
other burning substances. 
Congestions of blood, or of serous humours in the lungs, noxious vapours 
arising from a decomposition of lead or arsenic, impure and smoky air, cold 
and foggy atmosphere, sudden changes of temperature, scrofulous, rheumatic, 
gouty, and scorbutic taints; dyspepsia, or irritation in some of the organs, 
suppression of long-accustomed evacuations, frequent catarrhal attacks, gout, 
general debility, water in the chest, aneurisms, polypi, or concretions of 
grumous blood in the large vessels, are the causes from which this formida- 
ble disease may arise in different individuals. In some instances it proceeds 
from an hereditary predisposition, and in others from mal-conformation of 
the chest. 
Asthma having once taken place, its fits are apt to return periodically, 
and more especially when excited by certain causes, such as a sudden 
change from cold to warm weather, or from a heavier to a lighter atmo- 
sphere ; severe exercise of any kind which quickens the circulation of the 
blood ; an increased bulk of the stomach, either from too full a meal or from a 
collection of air in it; exposure to cold, obstructing the perspiration, and 
thereby favouring an accumulation of blood in the lungs; violent passions 306 
THE REFORMED PRACTICE OF MEDICINE. 
of the mind; disagreeable odours ; and by irritations of smoke, dust, and 
other subtle particles floating in the air. 
The bronchial vessels seem very much concerned in the production of this 
disease. It is the large quantity of mucus secreted and collected in them 
which appears to be the proximate cause of the suffocation and difficulty of 
breathing which attends the complaint, by preventing the free admission of 
air into the lungs. 
SYMPTOMS. 
There is often some degree of warning given of the approach of an asth- 
matic paroxysm, not by pulmonary symptoms, but by those of indigestion, 
heartburn, wind, itching of the skin, pain over the eyes, and sleepiness. The 
attack most commonly occurs at night, and the patient is perhaps awakened 
out of his sleep by it. To those who experience or witness a paroxysm of 
asthma for the first time, it appears one of the most formidable diseases to 
which man is liable. The patient is oppressed by a tightness across the 
breast, which so impedes respiration as to threaten the immediate extinction 
of life. He starts up into an erect posture, and flies to the window for air. 
For a considerable time his breathing is performed by gasps, slowly and 
with a wheezing noise ; speaking is difficult, and even painful to him ; there 
is often present also a propensity to coughing. 
In this state of urgent distress the patient continues till the approach of 
morning, when a remission commonly takes place. However suddenly the 
fit began, it always goes off slowly. By degrees the breathing becomes less 
laborious, and coughing and speaking are performed with greater ease. In 
the generality of cases a copious expectoration of mucus at length takes place, 
and with it the paroxysm ceases, and the patient falls asleep. During the 
fit the pulse usually continues of the natural standard, the surface of the body 
is pale, the muscles appear shrunk, and there is a considerable flow of limpid 
urine. In a few cases expectoration is very scanty. 
During the next day the asthmatic experiences some remaining sense of 
stricture across the breast, and any exertion of the body increases his uneasi- 
ness. At night the urgent difficulty of breathing returns, and in this manner 
he is harassed for three or four successive days ; after which, the symptoms 
gradually yielding, he enjoys his usual rest without farther disturbance. 
This terminates the paroxysm of asthma. 
When it has once taken place, the disease is apt to recur periodically ; and 
when the asthmatic disposition is very strong, to be brought on at all times 
by some of the circumstances enumerated. A degree of difficulty of breath- 
ing, particularly on ascending a hill or flight of steps, is never wanting during 
the intervals, and respiration is always attended more or less with wheezing ; 
that is, with a morbid accumulation of mucus in the bronchial tubes. Per- 
sons subject to asthma acquire a peculiar expression of countenance, easily 
recognised when once observed. 
TREATMENT. 
During a paroxysm or fit of the asthma the patient must be placed in an 
erect position, and his feet immediately immersed in warm ley water, and 
sinapisms applied, with a view to equalize the circulation, or to divert the 
blood or humours from the lungs and bronchial vessels. An infusion of 
catnip or pennyroyal may be given at the same time, to excite gentle perspira- ASTHMA. 
307 
tion, which course will soon afford relief. Should the paroxysm, however, 
be very severe, attended with a sense of suffocation, &c., administer imme- 
diately, in a cup of warm tea, an ordinary sized table-spoonful of the tincture of 
lobelia, to be repeated every half hour if the first portion does not afford relief. 
This medicine exerts the most astonishing effects in this complaint. It is 
no sooner introduced into the stomach than the tension and spasm is removed, 
by dislodging collections of mucus in the bronchial vessels, and thereby 
giving free admissions of air into the lungs; and it is invariably attended 
with a salutary effect. I have been called when patients have been pro- 
nounced past recovery, when they have been apparently dying, and upon 
the exhibition of this plant an immediate amendment has taken place. I 
recollect one case where a young woman appeared to be nearly gone with 
the disease, after having been attended by another physician, who had 
administered antimony without any benefit. 1 gave only an infusion of the 
plant as it was gathered, not having been pulverized. I commenced with 
table-spoonful doses ; the first afforded relief, and, after repeating it a few 
times, the paroxysm subsided and she soon recovered. The other physician 
afterward called in, and, upon being shown the simple article I made use of, 
he cried out, with indignation, " O ! it is nothing but the Indian tobacco," a 
name given it by some. 
Another case now occurs to me, where two or three physicians had been 
attending a boy who was nearly suffocated with the asthma, croup, or a similar 
disease, and he was pronounced hopeless. They called frequently, and asked 
J£ if he was not yet dead." In this condition 1 was called to visit him ; but 
so near his end did he appear to be, that I thought it entirely useless to 
prescribe for him ; but, as an experiment, 1 directed some of the tincture of 
lobelia to be given, which was done after my departure ; having no hopes 
of his recovery, I did not again call to see him, supposing that he could not 
survive but a few hours. Six months after this a person who was acquaint- 
ed with the family, asked me if I had ever heard of the fate of the boy for 
whom I had prescribed. I told him I had not, but I supposed that he was 
dead. He informed me that he was alive and well ; that the medicine I 
left was given, and that it almost immediately caused him to breathe easier, 
mitigated the symptoms, and in a short time cured him. 
Hundreds of cases might be mentioned of a similar nature. 
The virtues of lobelia are extraordinary in asthma, croup, &c.; much 
discretion and judgment, however, is necessary in the administration of it. 
Having suspended the paroxysm, the next step will be to effect a radical 
cure ; and this is seldom done, for the reason that asthmatic patients gene- 
rally discontinue the medicines when they become comfortable. But when 
the patient wishes a cure effected, he must persevere in the use of proper 
means. It will be necessary for him to repeat the dose of the tincture or 
powder of lobelia once or twice a week, in doses sufficient to excite general 
vomiting. He must also occasionally take a purgative. 
During the intermissions, and when the patient is afflicted only with cough, 
difficulty of breathing, &c., the following medicine may be taken: Take 
liverwort, (fiepatica triloba,') a quarter of a pound ; Solomon's seal, (con». 
multiflora,) a quarter of a pound ; skunk cabbage, (icterodes foetida,) a quarter 
of a pound ; water hoarhound, (Jycopus virginiana,) a quarter of a pound ; 
blood-root, (sanguinaria canadensis,) two ounces : bruise, and add a suffi- 
cient quantity of water. Boil until the strength is extracted, strain, and 
continue to boil until there is four quarts of the liquid ; then add five 
rounds of honey and half a pint of brandy ; let it settle, and it is fit for use 308 
THE REFORMED PRACTICE OF MEDICINE. 
Of this let a wine glass be taken three or four times a day. During the 
time that this is taken, give an infusion of hoarhound, warm at night and cold 
through the day. It will be necessary to keep a determination to the surface, 
by giving diaphoretic medicines. A strengthening plaster may be worn upon 
the breast and between the shoulders, to divert the humours from the lungs. 
When there is difficulty of breathing from an accumulation of mucus, give 
the expectorant tincture. 
A lady of this city, who has been for many years afflicted with the asthma, 
(apparently spasmodic,) and had tried almost every kind of medicine, could 
find no relief from any except the following : Take aether, tincture of castor, 
tincture of opium, (laudanum,) equal parts : mix. A tea-spoonful to be 
taken whenever the symptoms are urgent. A plaster may be applied to the 
chest and between the shoulders. 
The following may be taken: Vinegar, one pint; beat well three eggs, 
including the shells, and add ; let all stand till dissolved : then add one 
pound of loaf sugar, or one pint of molasses. Give half a wine glass occa- 
sionally. Also seneka snake-root, one ounce ; water, two pints ; boil to one 
pint, strain; add a quarter of an ounce of spirits of hartshorn; vinegar of squills, 
three drachms : mix. Dose, three or four table-spoonsful three times a day 
in herb tea. Dr. Bree extols the latter in habitual asthma. If the parox- 
ysms or cough are severe after the preceding treatment, the cough powders 
may be taken in a little honey or molasses. 
A person afflicted with this complaint, states that one of our stimulating 
or strengthening plasters between the shoulders, and our rheumatic liquid on 
the chest, removed the spasms connected with the asthma, and afforded him 
great benefit. I also prescribed the expectorant tincture. Smoking the 
stramonium or stink-weed leaves twice a day is very beneficial. 
A friend of mine, Mr. Millett, has been severely afflicted with this com- 
plaint for many years. About a year ago he was attacked with it so severely, 
that he was a number of times nearly suffocated. His sufferings were awful. 
Several physicians considered his case hopeless. I gave my opinion, how- 
ever, that he would recover, which has proved to be the case. 
Asthmatic Tincture.-Lobelia, one handful; skunk cabbage root, double 
handful; bark of root of bittersweet, double handful; stramonium leaves, 
about one ounce by weight ; slippery elm bark, a handful; Solomon's seal, 
and Comfrey, of each about one ounce ; the whole covered with spirits, and 
digested four days. Dose, from a tea-spoonful to a table-spoonful, three times 
a day. An infusion of the above may be made, should the spirits prove too 
stimulating.-Dr. Vere. 
REGIMEN. 
The patient by all means should breathe a pure air. He must avoid 
smoke, dust, &c. He ought to lay upon a straw mattress, with his head 
elevated. A spare diet to be used; vegetables, milk, &c. INFLAMMATION OF THE LUNGS. 
309 
CHAPTER XII. 
INFLAMMATION OF THE LUNGS. (Pneumonia.) 
DESCRIPTION. 
When the mucous membrane lining the lungs, or the substance of the 
lungs, are inflamed, it is termed pneumonia or an inflammation of the lungs. 
When any part of the contents of the thorax is inflamed, it is termed by some 
pneumonia ; by some peripneumony. This disease attacks all classes, and 
is extremely prevalent. 
CAUSES. 
The most general cause of this disease is the application of cold to the 
body, which gives a check to the perspiration, and determines a great flow 
of blood to the lungs. It attacks principally those of a robust constitution 
and plethoric habit, and occurs most frequently in the winter season and 
spring of the year; but it may arise in either of the other seasons, when 
there are sudden vicissitudes from heat to cold. 
Other causes, such as violent exertions in singing, speaking, or playing on 
wind instruments, by producing an increased action of the lungs, have been 
known to occasion inflammation of this organ. Those who have laboured 
under a former attack of this complaint are much predisposed to returns of it. 
SYMPTOMS. 
Inflammation of the lungs comes on with an obtuse pain in the chest or 
side, great difficulty of breathing, (particularly in a recumbent position, or 
when lying on the side affected,) together with a cough, dryness of the skin, 
heat, anxiety, and thirst. At the first commencement of the disease the pulse, 
is usually full, strong, hard, and frequent; but in a more advanced stage it is 
commonly weak, soft, and often irregular. In the beginning the cough is 
frequently dry and without expectoration ; but in some cases it is moist even 
from the first, and the matter spit up is various both in colour and in con- 
sistence, and is often streaked with blood. 
If relief is not afforded in time, and the inflammation proceeds with such 
violence as to endanger suffocation, the vessels of the neck will become turgid 
and swelled ; the face will alter to a purple colour ; an effusion of blood will 
take place into the cellular substance of the lungs, so as to impede the circu- 
lation through that organ, and the patient will soon be deprived of life. 
If these violent symptoms do not arise, and the proper means of subduing 
the inflammation have either been neglected or have proved ineffectual, 
although adopted at an early period of the disease, a suppuration may ensue, 
which event is to be known by frequent slight shiverings, and an abatement 
of the pain and sense of fulness in the part, and by the patient being able to 
lie on the side which was affected, without experiencing great uneasiness. 
When pneumonia proves fatal, it is generally by an effusion of blood taking 
place in the cellular texture of the lungs, so as to occasion suffocation, which 
usually happens between the third and seventh days ; but it may likewise 
prove fatal, by terminating either in suppuration or gangrene. 310 
THE REFORMED PRACTICE OF MEDICINE. 
When it goes off by resolution, some very evident evacuation always 
attends it; such as a great flow of urine, with a copious sediment, diarrhoea, 
a sweat diffused over the whole body, or a haemorrhage from the nose ; but 
the evacuation which most frequently terminates the complaint, and which 
does it with the greatest effect, is a free and copious expectoration of thick 
white or yellow matter, slightly streaked with blood ; and by this the disease 
is carried off generally in the course of ten or twelve days. 
TREATMENT. 
Indications of Cure.-The most prompt means should be used to reduce 
the inflammation and remove the disease, by resolution or by preventing 
suppuration. 
In consequence of the vicissitudes of our atmosphere, this disease (inflam- 
mation of the lungs) is the greatest scourge of this country. It proves more 
fatal than the yellow fever, or any other epidemic-if not immediately, by its 
subsequent effects upon the system. 
It is the practice universally among physicians to bleed in this as well as 
other inflammatory diseases ; but I have invariably succeeded in treating the 
worst species of the complaint without ever having drawn one drop of the 
vital fluid ; notwithstanding it is asserted by authors that the most dangerous 
consequences result from the neglect of bleeding. I know by experience 
that the disease is cured much sooner, and without endangering the life or 
health of the patient. The lives of thousands have been destroyed by the 
use of the lancet in this and other diseases. 
Lieutaud, a celebrated doctor and physician to Louis XV., deprecates the 
practice of free bleeding in this disease. He says, " that bleeding must be 
confined within certain limits, lest the strength necessary to promote expec- 
toration or any other effort of nature, should fail from too great depletion of 
the vessels. Every one knows that bleeding, even the smallest, is fatal in 
some epidemic constitutions. To this we may add, that, by common con- 
sent, bleeding hinders suppuration, which nature usually points to about the 
third or fourth day of the disease. 
It is not to be denied that many, not of inferior note, have followed a con- 
trary method ; who have, for instance, in every obvious inflammation of the 
breast, ordered bleeding ten or fifteen times, or even more. The young and 
athletic may bear this astonishing loss of blood with success; but I have 
seen many afterward relapse into phthisis or dropsy, after overcoming the 
inflammatory disease; to say nothing of many whose strength had been 
prostrated by this immoderated depletion of the vessels, whereby they be- 
came unequal to the promoting of expectoration, and were carried off by 
suffocation or gangrene." 
In this, as well as other diseases, it will be necessary, in the incipient or 
first stage of inflammation of the lungs, to produce free and copious perspira- 
tion, by administering sudorific medicines; and a very excellent method to 
answer this purpose is, to steam the patient over bitter herbs, as mentioned 
in other parts of this work, or by making use of the vapour bath. This may 
be resorted to if the strength of the patient will enable him to sit up ; other- 
wise the sudorific or sweating drops may be given in the usual manner, until 
the patient perspires freely for several hours, and this must be continued 
moderately until the inflammation has subsided. This single operation will 
divert the blood from the lungs and prevent congestion, lessen the febrile 
excitement by equalizing the circulation, remove the pain, and favour ex- INFLAMMATION OF THE LUNGS. 
311 
pectoration. When the patient has recovered from the operation of free 
perspiration, a purgative may be given, and occasionally repeated during the 
disease. When the arterial action has diminished, mild emetics may be ad- 
ministered ; they generally produce immediate relief from the oppression 
of the chest, cause a determination to the skin as well as a free expectora- 
tion. They expel the viscid mucus which fills the air cells of the lungs, 
restore respiration, and thereby increase the strength of the system. These 
may be repeated as often as the circumstances of the case justify. The 
emetic powder is the best medicine that can be administered. 
It will be found very serviceable to inhale the steam of bitter herbs : the 
tension of the lungs is thus removed, and mucus expectorated with more 
freedom ; and these may be repeated frequently through the day. When the 
arterial excitement has diminished, should the cough prove troublesome, one 
or two tea-spoonsful of the syrup of poppy or paregoric may be given. If 
these should not allay the cough sufficiently, give ten grains of diaphoretic 
powders at bed-time, until rest or sleep is procured; to be repeated every 
night, if necessary. 
Expectorants.-If there is much accumulation of mucus, oppression at the 
chest, cough, &c., difficulty of breathing and expectoration, give the expec- 
torant tincture, or syrup of ipecac. 
These preparations have the effect of lessening all the symptoms of the 
complaint. They are expectorant, diaphoretic, &c. 
Mustard Plasters.-When the inflammation is very acute and the symp- 
toms violent, a mustard plaster may be applied on the chest, till the skin be- 
comes reddened; and when the inflammation has in some degree subsided, 
should the cough continue, use the cough powders. An infusion of hoarhound 
and boneset may be used through the day, sweetened with honey. 
I once attended a case of inflammation of the lungs, in which the paroxysms 
of coughing were so severe and protracted that I was baffled with all my usual 
means. The cough powders gave immediate relief and, with other appro- 
priate treatment, the patient recovered. I have ever since used the same 
invariably with success. A distinguished physician of this city, having heard 
of its effect, applied to me for the preparation. 
The patient may drink an infusion of fiax-seed, bran, and slippery elm. 
These, by their demulcent properties, will be found singularly beneficial.1 
Lemon juice may be added, and it may be sweetened. 
It will be particularly necessary, in the acute stage of this disease, to avoid 
the use of pectorals, syrup, and such medicines as possess bracing or tonic 
properties, except in conjunction with depletive means. 
The inflammation must be in some degree first subsided, before these can 
be administered with a good effect. f 
The feet must be daily immersed in warm ley water, fifteen or twenty minutes 
at a time ; and, when removed, wiped dry, and sinapisms applied at night. 
Should the pulse continue full, tense, and hard after the patient has sub- 
mitted to this treatment, or should not the inflammation gradually subside, 
then give the tincture of fox glove, {digitalis f) fifteen or twenty drops may 
be given morning, noon, evening, and at bed-time, in any kind of tea. 
This plant increases the discharge of urine, and thereby lessens inflamma- 
tion. It lessens the circulation through the lungs, by diminishing the action 
of the heart and arteries, and is thus attended with a very favourable effect. 
" I am of opinion," says a practical physician, " that the digitalis may in 
all cases of active inflammation be most advantageously employed, and that 
much of the pabulum vit® can by its aid be preserved. I have had lately 312 
THE REFORMED PRACTICE OF MEDICINE. 
under my care a man who, from a violent cold, was seized with pneumonia; 
he was old, greatly enervated, and had typhoid symptoms combined with it; 
he took, without any inconvenience, in twenty-four hours, six grains of this 
powerful sedative on the third day, which reduced his pulse to seventy-five, 
and cured the inflammation." 
A purgative must be administered every day or two, according to the ob- 
stinacy or violence of the disease. It has a tendency to lessen inflammation. 
Pectorals.-Should the cough continue obstinate, or should it remain 
troublesome after the other symptoms have subsided, give the pulmonary 
syrup or balsam. In very severe cases I have applied a blister to the chest. 
Inflammation of the Lungs.-Dr. J. Rodgers, who has practised sixteen 
years in this city, informs me that he formerly, when called to a patient 
labouring under inflammation of the lungs, immediately bled him and gave 
mercury freely. " But now," said he, " I only give syrup of ipecac and bathe 
the chest externally, and the patient soon recovers." 
He states that he orders molasses to be boiled half away, and to a table- 
spoonful of this add a table-spoonful of the above syrup. Of this mixture a 
tea-spoonful is to be taken often or occasionally. The patient soon recovers 
under this treatment. 
I have recently been attending a patient with inflammation of the lungs so 
severe that I was fearful he would not recover. I gave occasionally an emetic 
and a mandrake purgative, with our pulmonic syrup, under which he gradually 
grew better, until he entirely recovered. 
The syrup of blood-root is also a very good medicine in this and all other 
bronchial affections : and likewise the balm of Gilead. 
REGIMEN. 
The diet should be diluting, light, cooling, and nutritious. No kind is 
more cooling, while at the same time it is nourishing, than Indian meal gruel. 
It is food, drink, and medicine in this disease, and in almost every other. 
This course of treatment has proved an effectual and sovereign remedy in 
the worst form and stage of pneumonia or inflammation of the lungs, when 
the course now pursued by physicians sends the patient into the grave in a 
few days, or throws him into the consumption. None can realize the differ- 
ence in the two kinds of practice, except they witness it. 
CHAPTER XIII. 
PNEUMONIA TYPHOIDES. 
DESCRIPTION. 
This disease is termed by some peripneumonia notha, pneumonia ty- 
phoides, bilious pneumonia, and malignant pleurisy. In the southern states 
it is vulgarly called " cold plague or cold skin fever," in consequence of the 
remarkable coldness of the surface and extremities, and its great mortality 
in some places and seasons. It is termed bilious inflammation of the lungs, 
in consequence of the liver being affected in the disease. In the eastern 
states it is called "pneumonia typhoides," in consequence of its being a mixed PNEUMONIA TYPHOIDES. 
313 
disease; in other words, the true peripneumony, or inflammation of the 
lungs, degenerating into typhus. 
The disease has, in general, commenced with acute pain in the side or 
breast, stricture across the thorax, and difficulty of breathing; short, dis- 
tressing cough, sometimes attended with a mucous expectoration, tinged with 
blood; numbness in the muscles, excruciating pains in the limbs and about 
the region of the heart, chills, and great prostration of strength, together with 
palpitation, irregularity, depression, and annihilation of the pulse, syncope, 
and cold sweats ; but in a few cases the pulse was very rapid, and not de- 
pressed. In some instances the patient was seized with a violent pain in 
the head, soon became delirious, and died in a few hours.-(See Spotted or 
Petechial Fever.) 
CAUSES. 
Supposed to be epidemic, or produced by the various vicissitudes of climate. 
It prevails in the cold weather of winter and spring. Resembles very much 
in its character the spotted fever, by the violence and suddenness of its at- 
tack, the variety of its forms, sudden and great prostration of strength, its 
rapid progress, and fatal termination. The peripneumony notha was de- 
scribed by Sydenham, in 1680, under the name of bastard peripneumony, 
which, he says, arises every year toward the beginning, but more frequently 
toward the close, of winter. It chiefly attacks such as are of a gross habit 
of body and middle-aged persons, but oftener those who are more advanced 
in years and " too much addicted to spirituous liquors, especially brandy." 
TREATMENT. 
In the first or inflammatory stage of the disease the means made use of 
should be to subdue the inflammation, the same as in inflammation of the 
lungs ; and the treatment in the latter stages similar to that for typhus fever. 
A physician states that the following formula has proved efficacious as a 
mild diaphoretic in this disease: Take salt of hartshorn, (carbonas ammo- 
niac.,') camphor, (gum camphora,') equal parts ; divide into doses of eight 
grains each: give one every two, three, or four hours, according to symp- 
toms. If there is great pain, restlessness, or delirium, combine ten drops of 
laudanum with each powder, until quietude is procured. 
In one case of this disease the above prescription had a very salutary 
effect, and the patient soon recovered. 
It should be borne in mind that the loss of even a few ounces of blood in 
this disease is attended with fatal consequences.* If the pulse continues 
too frequent, give fifteen drops of the tincture of digitalis three times a day. 
The feet should be daily bathed in tepid ley water, and mustard sinapisms 
applied. If this disease, in its incipient or acute stage, was judiciously 
treated, in all probability it would seldom or never run into the typhoid state. 
It is the mal-practice of physicians which causes the true pneumonia to de- 
generate into the real typhoid state. 
REGIMEN.-I am confident that bathing the surface with cold water 
daily, or the shower bath, with friction and temperance, would be a com- 
plete antidote against all pulmonary diseases. 
* Dr. Drake, of Peekskill, N Y., informs me that this disease was very prevalent in that 
section of the country a few years since, and proved very mortal. Bleeding was found ex- 
ceedingly injurious. He states that a Dr. White bled twelve persons labouring under this 
complaint, and eleven of them died. 314 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER XIV. 
CONSUMPTION. (Phthisis Pulmonalis.) 
DESCRIPTION. 
Pulmonary consumption {phthisis pulmonalis') is characterized by ema- 
ciation, debility, cough, hectic fever, and purulent expectoration. Some 
authors enumerate thirty different species of this complaint, but this distinc- 
tion seems unnecessary for practical purposes. 
CAUSES. 
The causes which produce this afflicting and extensive malady, which 
may emphatically be called consumption, are very numerous. The follow- 
ing are the most general: 
Hereditary disposition, particular formation of the body, obvious by a long 
neck, prominent shoulders, and narrow chest; scrofula, or state of the sys- 
tem indicated by a fine clear skin, fair hair, delicate rosy complexion, large 
veins, thick upper lip, a weak voice, and great sensibility ; certain diseases, 
such as venereal, scrofula, the small-pox, and measles ; particular employ- 
ments, exposing artificers to dust, such as needle-pointers, stone-cutters, 
millers, &c., or to the fumes of metals or minerals under a confined and 
unwholesome air; violent passions, exertions, or affections of the mind, as 
grief, disappointment, anxiety, or close application to study, without using 
proper exercise ; frequent and excessive debaucheries, late watching, and 
drinking freely of strong liquors; great evacuations, as diarrhoea, diabetes, 
excessive venery, fluor albus, immoderate discharge of the menstrual flux, 
and the continuing to suckle too long under a debilitated state; and, lastly, 
the application of cold, either by too sudden a change of apparel, keeping on 
wet clothes, lying in damp beds, or exposing the body too suddenly to cool 
air when heated by exercise ; in short, by anything that gives a considerable 
check to the perspiration. The more immediate or occasional causes are, 
bleeding of the lungs, pneumonic inflammation proceeding to suppuration, 
catarrh, asthma, and tubercles, the last of which is by far the most general. 
Intemperance in living and folly of dress contribute to cause this disease. 
Thin dress, tight lacing till a female can hardly stoop or breathe : one minute 
in a heated be'l-room or crowd, in perspiration-the next in extreme cold 
air: a cough follows, and next the hasty consumption. 
Another cause of this malady is, the confined and sedentary habits of 
males and females in cellars, factories, &c. The air inhaled is impure, and 
the chest contracted by the employment of corsets ; the stomach, lungs, or 
liver soon become disordered. Another cause of consumption is, the 
manner in which persons are treated by physicians; if they are attacked 
with cold or cough, a pain in the chest or side, the doctor comes and bleeds 
freely, then gives mercury and salts, till they are salivated or injured. 
Says Dr. E. Smith; " I do not believe there is a well man on earth who 
could go through all this treatment without being confined to his bed." 
History and Prevalence of the Disease.-This disease has prevailed exten- 
sively from the earliest period of history to the present time, and has swept 
more from the earth than the sword or famine. In all northern climates it CONSUMPTION. 
315 
commits the most terrible ravages. A writer some years since computed 
that, out of a population of eleven millions in the Island of Great Britain, 
fifty-five thousand annually died of consumption, and the same fatality at- 
tends the disease in this climate. I presume one-third of those who die in 
this country are taken off by pneumonic diseases or affections of the lungs ; 
all which show not only the prevalence and fatality of the complaint, but 
likewise the inefficacy of the various methods of treatment, including the 
vast number of the boasted nostrums of the day with which the community 
are now so shamefully deceived and imposed upon. That the reader may have 
an opportunity of seeing the mortality of consumption in this city, he need 
only refer to the report of the city inspector. 
Curability of the Disease.-It is supposed by most people that consumption 
is incurable, and nothing is more common than, when an individual is attacked 
with this disease, to consign him to the grave. But we should not be too 
hasty in arriving at such a conclusion. VVe have many well-authenticated 
instances on record where consumption has been cured, either spontaneously 
or by proper remedial agents. An author in Europe enumerates thirty or 
forty cases restored to health. I have myself attended a considerable num- 
ber of persons who, having every symptom of the disease in its confirmed 
stages, were cured, are now well, and enjoying good health. I recollect one 
person reduced so low that I refused to prescribe for him, under the supposi- 
tion that medicine would avail nothing ; some months after the same man 
accosted me in the street, and stated that after I saw him he took a syrup 
made of the very ingredients which enter into the preparation which 1 am 
now in the habit of prescribing, under the use of which he completely 
recovered. Indeed it is beyond dispute, that the lungs recover from disease 
the same as any other organ, though less frequently, provided the powers of 
nature are sufficient to bring about a healthy action ; all which show the 
propriety of pursuing a rational and judicious course of treatment; besides, it 
is our duty to alleviate disease when we cannot cure, and which can always 
be done, even in the worst stages of this formidable malady. The fact, that 
cicatrices or scars have been discovered in the lungs of persons on post 
mortem examination, who had been cured of consumption, and who subse- 
quently died of some other complaint, proves beyond dispute that the disease 
is curable. 
SYMPTOMS. 
This disease may arise from inflammation of the mucous or lining mem- 
brane, or external parts of the lungs ; and also from tubercles. 
The incipient symptoms usually vary with the cause of the disease ; but 
when it arises from tubercles,* it is usually thus marked : It begins with a 
short dry cough that at length becomes habitual, but from which nothing 
* Tubercles are small, hard, round knots or tumours situated in different parts of the lungs, 
(generally at the upper part,) and their number varies much. In their incipient stage they 
are no larger than a fine shot, but finally increase and become as large as a nut. They 
often exist in clusters, and, if numerous, run into each other, and form hard yellow masses 
like cartilage. At length, from cold or other causes, they soften, and are changed into a 
cream colour, inflame, break, and open into the bronchial tubes, and are discharged by expecto- 
ration. They form open ulcers, from which great quantities of matter issue, and sometimes 
blood ; they depend upon a strumous or scrofulous state of the system. Tubercles will 
sometimes exist for many years, even to old age, without very serious inconvenience. By 
regularity, temperance, diet, &c., they may be prevented from doing much injury ; otherwise 
they soon cause consumption. 316 
THE REFORMED PRACTICE OF MEDICINE. 
is spit up for some time, except a frothy mucus. The breathing is at the 
same time somewhat impeded, and upon the least bodily motion is much 
hurried ; a sense of straitness, with oppression at the chest, is experienced ; 
the body becomes gradually leaner, and great languor, with indolence, de- 
jection of spirits, and loss of appetite prevail. In this state the patient fre- 
quently continues a considerable length of time, during which he is, however, 
more readily affected than usual by slight colds; and upon one or other of 
these occasions the cough becomes more troublesome and severe, particularly 
by night, and it is at length attended with an expectoration, which toward 
morning is more free and copious. By degrees the matter which is expec- 
torated becomes more viscid and opaque, and now assumes a greenish colour 
and purulent appearance, being on many occasions streaked with blood. In 
some cases a more severe degree of bleeding at the lungs attends, and the 
patient spits up a considerable quantity of florid, frothy blood. The breath- 
ing at length becomes more difficult, and the emaciation and weakness in- 
creased. With these the person begins to be sensible of pain in some part 
of the chest, which, however, is usually felt at first under the sternum, 
particularly on coughing. At a more advanced period of the disease a pain 
is sometimes felt on one side, and at times prevails in so high a degree as to 
prevent the person from lying easily on that side ; but it more frequently 
happens that it is felt only on making a full inspiration or coughing. Even 
where no pain is felt, it often happens that those who labour under consump- 
tion cannot lie easily on one or other of their sides, without a fit of coughing 
being excited or the difficulty of breathing being much increased. 
At the first commencement of the disease the pulse is often natural, or 
perhaps is soft, small, and a little quicker than usual; but when the symp- 
toms which have been enumerated have subsisted for any length of time, it 
then becomes full, hard, and frequent. At the same time the face flushes, 
particularly after eating; the palms of the hands and soles of the feet are 
affected with burning heat; the respiration is difficult and laborious; at 
evening there is an increase of symptoms, and by degrees the fever assumes 
the hectic form. This species of fever is evidently of the remittent kind, 
and is increased twice every day. The first augmentation occurs usually 
about noon, and a slight remission ensues about five in the afternoon. This 
last is, however, soon succeeded by another accession, which increases 
gradually until after midnight; but about two o'clock in the morning a re- 
mission takes place, and this becomes more apparent as the morning advances. 
During the exacerbations the patient is very sensible to any coolness of the 
air, and often complains of a sense of cold, when his skin is, at the same time, 
preternaturally warm. Of these exacerbations, that of the evening is by far 
the most considerable. From the first appearance of the hectic symptoms 
the urine is high coloured, and deposites a copious branny red sediment. 
The appetite, however, is not greatly impaired, the tongue appears clean, 
the mouth is usually moist, and the thirst is inconsiderable. As the disease 
advances, the mouth and fauces put on rather an inflamed appearance, and 
are beset with apthje or canker, and there is a blue or pearly whiteness of 
the eye. During the exacerbations a florid circumscribed redness appears 
on each cheek; but at other times the face is pale and the countenance 
somewhat dejected. At the commencement of hectic fever the belly is 
usually costive ; but in the more advanced stages of it a diarrhoea often comes 
on, and this continues to recur frequently during the remainder of the dis- 
ease; colliquative sweats likewise break out, and these alternate with each 
other, and induce great debility. In the last stage of the disease the emaciation CONSUMPTION. 
317 
is so great that the patient has the appearance of a walking skeleton; his 
countenance is altered, his cheeks are prominent, his eyes look hollow and 
languid, his hair falls off, his nails are of a livid colour and much incurvated, 
and his feet are affected with cedematous or dropsical swellings. To the 
end of the disease the senses remain entire, and the mind is confident and 
full of hope. It is, indeed a peculiar symptom attendant on consumption, 
that those who labour under it are seldom apprehensive or aware of danger ; 
and it is no uncommon occurrence to meet with persons, labouring under its 
most advanced stage, flattering themselves with a speedy recovery, and 
forming distant projects under that vain hope. Some days before death the 
extremities become cold. In some cases a delirium precedes that event, and 
continues until life is extinguished. The throat is generally sore. There 
is usually looseness and irritation of the bowels, and more or less pain in the 
chest and side. 
" Coughs, purulent expectoration, hectic fever, and wasting do not neces- 
sarily constitute true consumption of the lungs. On the contrary, there is 
every reason that all these symptoms may proceed from various other morbid 
affections; some of them as untractable as the true consumption, but others 
affording a much more favourable opinion ; and that all of them may be fatal 
with the usual symptoms of consumption, and yet the substance of the lungs 
be found entirely free from disease." 
TREATMENT. 
Indications of Cure.-The indications are, 
1. To moderate inflammatory action. 
2. To support the strength and promote the healing of ulcers in the lungs. 
3. To palliate urgent symptoms. 
Debility being one great cause of consumption, those medicines which 
remove it aid in curing the disease. The lungs, being weak, are unable to 
resist the invasion of disease ; but as soon as their office or functions are 
restored, they are enabled to overcome the irritation, which is the proxi- 
mate cause of morbid action. This fact I have ascertained by experience. 
What consummate folly or ignorance, then, to induce greater debility by 
bleeding, &c. The process of nature, in removing ulceration or tubercles, 
appears to be, first, by absorption ; second, by expectoration ; third, by the 
excretory vessels of the skin. It is well known that medicine cannot be intro- 
duced into the lungs, except by inhalation; it acts through the medium of 
the blood, and also by sympathy; the sympathetic effect of medicine is 
strikingly shown by emetics and expectorants. 
It is undoubtedly the case that thousands die of this disease in conse- 
quence of the mal-practice of physicians. It has become proverbial, that as 
soon as patients are placed under their charge they begin rapidly to decline. 
Indeed, this cannot otherwise be, as the medicine they give produces the 
most debilitating effects, and undermines the constitution much faster than 
the disease itself. From the structure of the lungs, it is unquestionably a 
difficult disease to cure ; the constant motion of them prevents the healing 
or restorative process ; notwithstanding which, pulmonary consumption may 
be cured as well as other diseases, by judicious or skilful treatment, espe- 
cially in the first stages of the disease. 
Almost numberless medicines are recommended in this complaint, few of 
which have much claim upon our attention. The following treatment we 
have found very generally successful, especially in the incipient stages of the 
disease; and, when it has failed to cure, has uniformly mitigated the complaint 318 
THE REFORMED PRACTICE OF MEDICINE. 
and rendered the patient more comfortable, and thus prolonged his life, which 
is one great object of medicine. 
Vegetable Emetics.-There is no class of medicines so highly beneficial in 
this disease as certain kinds of emetics. Mineral agents, such as antimony 
and vitriol, are dangerous to administer ; but vegetable operate very different. 
In consequence of their action upon the thoracic organs of the chest by sym- 
pathy, they are very valuable in consumption, acting with peculiar force and 
effect upon the lungs, removing the tough viscid mucus from the air cells, 
and, producing absorption by their tonic and corroborant effects, bring about 
a healthy state of these organs. No preparation will be found to answer a 
better purpose than the emetic powders. 
This preparation seems to exert a specific effect upon the stomach, lungs, 
and all the surrounding viscera. 
Emetics should be repeated according to the strength of the patient and 
continuance of the symptoms, particularly in the commencement of the dis- 
ease. No fear need be apprehended from the shortness of breath and ap- 
parent debility that follow their use. 
Principal Remedy.-The medicine on which I place the most reliance, and 
which we prescribe in every stage of the disease, is the pulmonic syrup or 
balsam. It is expectorant, tonic or restorative, alterative, stimulant, pec- 
toral, demulcent, 6fc. Hence it aids expectoration, removes congestion, and 
strengthens or restores the tone of the whole system, and is calculated to 
remove the consumptive taint from the fluids, and, by its stimulating proper- 
ties, removes tubercles from the lungs, by promoting absorption. In ad- 
ministering a medicine combining all these properties, it will be seen that 
the treatment of consumption is reduced to great simplicity, and from among 
the numerous medicines which we have tried from time to time, we have 
found this superior to all others. 
This syrup will be found to possess great virtues in pulmonary consump- 
tion. It lessens the cough, removes the pain of the breast, and gives strength 
and energy to the system generally, and has cured many persons who have 
had every symptom of genuine consumption. 
Should this fail of removing the complaint, let the following syrup be given : 
Take liverwort, (hepatica triloba,') one ounce ; Solomon's seal, (convalaria 
poly gonat urn,)t\vo ounces; skunk cabbage, {symplocarpus faitida,) twoounces; 
blood-root, (sanguin. canad.) half an ounce ; bugle weed, or water hoarhound, 
two ounces: add a suitable quantity of rain or soft water, and extract the 
strength by boiling. Let it be reduced to two quarts, then add two pounds 
of sugar. Dose, a wine glass three or four times a dry, fasting. This will 
be found very serviceable, particularly when there is bleeding at the lungs. 
One female, labouring under the symptoms of pulmonary consumption, re- 
covered under the use of the following medicine. 1 collected all the ingre- 
dients on a farm near this city, and gave them green at the time. Lobelia, 
hyssop, spikenard, water hoarhound, called bugle weed, elecampane, golden 
rod ; a suitable quantity of water added, and a strong syrup made. Dose, as 
much as the stomach could bear during the day. 
A friend of mine, labouring under all the symptoms of tubercular consump- 
tion, was cured by the following treatment: She first took the pulmonic 
syrup; then she drank freely of the following decoction, cold, viz., worm- 
wood, tansy, and hoarhound, half an ounce of each to one quart of boiling 
water. Steep a short time, and sweeten. Drink as much as the stomach 
will bear during the day. Exercise was daily taken in the open air, which 
promoted expectoration and effected a cure. She also took the following: CONSUMPTION. 
319 
wood ashes, a table-spoonful; boiling water, one pint. Drank a wine glass 
occasionally through the day. 
Anodynes.-Should the cough be very troublesome and the patient's 
rest very much disturbed in consequence of it, he may take the cough 
powders. 
For night sweats give ten or fifteen drops of elixir vitriol, in sweetened 
water, twice a day. 
Diluent and Tonic Drinks.-An infusion of hoarhound and boneset combined, 
and sweetened with honey, may be drank through the day, and especially 
while taking the syrups. 
Dr. McNair gives two grains of ipecac three times in every twenty-four 
hours; it reduces the pulse. To prevent irritation, two grains of extract 
of henbane (hyoscyamus} may be taken. 
For night sweats, sulphuric acid, nitric acid, of each one drachm; water, 
two ounces ; mix. One tea-spoonful to be taken in one pint of cold sage 
tea, and drank during the day, soon cures the sweats. Should there be pain 
in the bowels or a relax, give the neutralizing mixture. If this fails, give 
charcoal, pulverized, two parts ; magnesia, one part; mix, and give a small 
table-spoonful daily. It is an excellent remedy. . If there is pain in the 
chest or side, bathe with the rheumatic liquid. Apply also the strengthening 
plaster. 
A change of Climate or Air.-This has sometimes performed wonders. 
Persons have gone from a northern to a southern climate, where bilious 
diseases prevail, and have been perfectly cured when they have been even 
in the last stages of the consumption. East Florida, New Orleans, the 
West Indies, the south of France, and Italy possess such peculiar tempera- 
ture as to suspend or cure the disease : the soothing effect of the air has the 
power of healing the lungs in a most remarkable manner ; and I have the 
fullest evidence of the benefit arising from this change of climate. 
One man, nearly gone with the disease, was recommended to go to a place 
where he would be likely to take the bilious fever. He did so, and became 
much reduced with it, and the consequence was, that he was soon cured of 
the consumption. 
A patient of mine, who had been reduced very low with this disease, 
embarked on board of a ship bound to Brazil, took up her residence there, 
and in a few weeks after her arrival (she afterward informed me) was free 
from her cough, and apparently well. It appears that heat or bile is an anti- 
dote to pulmonary diseases, from its opposite properties or effects. 
I have sometimes thought that the vicissitudes of our northern climate 
produced or generated an acid of a very irritating nature, which is accom- 
panied by a check of perspiration, and which is counteracted or neutralized 
by the influence of a southern climate acting specifically upon the liver, 
causing it to pour out an unusual quantity of bile, which, by its sympathetic 
action upon the lungs, removes the disease ; for we are aware that one organ 
cannot be sensibly diseased without the other participates with it; or the 
benefit may be entirely owing to the genial warmth, heat, and uniform tem- 
perature of the climate. 
Many have been cured by remaining a long time at sea, and constantly 
breathing a pure air. Would not a three years' voyage to the South Seas 
or Pacific Ocean remove this complaint ? 
A respectable person informs me that a lady in Massachusetts, apparently 
in a hopeless state of consumption, went to Kentucky to spend her few 
remaining days with her daughter, without any expectation of recovery. 320 
THE REFORMED PRACTICE OF MEDICINE. 
But her symptoms soon began to subside, and she entirely recovered her 
health. A change from the city to the country is often attended with great 
benefit; and going from an inland residence to the sea-shore is also very 
efficacious. 
Exercise on horseback is proverbially serviceable in all pulmonary af- 
fections. 
Sea Voyage and Travelling.-" The two remedies," says Combe, " which 
have the oldest and the most general reputation in the successful treatment 
of pulmonary and consumptive disease have this quality in common, that 
both owe much of their influence to their exciting the cutaneous functions 
and equalizing the circulation. I allude to sailing, and riding on horseback." 
Sydenham considered the latter almost a specific. Dr. Rush extols it with 
nearly equal force. Dr. Combe states that he was seized with a pulmonary 
disease, and went by sea to London, and afterward he sailed up the Medi 
terranean. During the voyages he was almost constantly sea-sick, which 
kept up a moisture of the skin. In one month he found a decided improve- 
ment in his health. After ten months' illness he nearly recovered. On his 
return he began to ride on horseback, which kept the skin bedewed with 
moisture, in proportion to which he gained. He continued this practice, 
which, with sponging the body, friction, and other means, enabled him to 
resume his professional duties, and for nine years afterward his health con- 
tinued good. After that period it gave way, and pulmonary symptoms 
commenced. The same system was pursued, and the same results again 
followed ; the functions of the skin restored with general health by a sea 
voyage, horseback exercise, and the regular use of the bath. These, as 
formerly, have proved beneficial in proportion to their influence in keeping 
up the warmth and moisture of the surface and extremities. 
Says Graham ; " The beneficial effects of horseback riding to those la- 
bouring under pulmonary consumption, are often truly astonishing. I have 
known invalids, affected -with this disease, when they were too feeble to 
mount the horse without help, by riding a short distance the first time, and 
gradually increasing the length of the ride daily, become able, in the course 
of two weeks, to ride twenty miles without stopping by the way, and far 
more vigorous at the end of the journey than at the beginning ; and I have 
known instances in which such individuals have made journeys of several 
hundred miles on horseback, and returned home to their friends almost per- 
fectly restored to health. Indeed I am entirely confident that if strict simplicity 
and propriety of diet, and riding on horseback to the full extent of the patient's 
ability, will not cure pulmonary consumption, no earthly means can cure it." 
Inhalation.-I have thrown several powders into the lungs by means of 
an inhaler; but no satisfactory result has yet been obtained. The vapour 
or gas of iodine has been introduced by inhalation, and, it is stated, success- 
fully. An ounce of the iodine, pulverized, may be put into an open-mouthed 
bottle and placed in warm water, with the head over it, and thus inhaled 
for a short time, or as long as the patient can bear it, and repeated occasion- 
ally through the day. 
Ramages' Tube has been highly recommended by my friend Mr. Howe, 
of this city, who thinks he has been cured by it. I have seen it tried in 
other cases without benefit. It deserves a farther trial. 
I subjoin the following circumstance, which I recollect many years since 
to have read, and which may prove interesting and useful: 
A lady retired to the country to die, being in the last stage of consumption. 
One morning while sitting at her chamber-window she observed a dog, almost CONSUMPTION. 
321 
wasted to a skeleton, enter the garden very early, went into a bed of chamomile, 
and licked the dew from the flower of the plant. After a number of days 
she noticed an improvement in the appearance of the consumptive animal. 
This induced her, as the last alternative, to imitate his example, and every 
morning in the same manner to sip the dew from the same bed. The effect 
of which was, an abatement of all her symptoms, followed by a perfect cure 
of her complaint. 
This story may at least inspire confidence enough to induce us to drink 
freely of this excellent plant, if not literally to imitate the consumptive 
d°g- 
Dr. Hopkins informs me that, during his residence in South or North 
Carolina, a lady was nearly reduced to a skeleton by the consumption. She 
was abandoned by the physician as incurable, and found no remedy from any 
source whatever. 
In this situation some person advised her to take the following prepara- 
tion : Take common polypody ; liverwort, (hepatica triloba fl) a decoction 
to be taken freely through the day. 
She took this medicine, and immediately began to grow better; and, after 
continuing it some time, it effected a radical cure, and she is now well. 
A physician informs me that a person in the state of Connecticut was cured 
of a deep-seated cough, attended with hgemoptysis, or bleeding at the lungs, 
by taking a syrup of the polypody and black cohosh. 
The following recipe has been sent to me by Dr. T. Seely for insertion 
in this work. He states that he has been remarkably successful in treating 
consumption by the use of it: Take water, six ounces; olive oil, two 
ounces; paregoric, two drachms; spirits of ammonia, (hartshorn,) one 
drachm; sugar, two ounces: mix. Take a table-spoonful every two 
hours. 
« This medicine," says Dr. Seely, " after proper evacuations and the fluids 
corrected, will generally produce a vomica or abscess on the lungs, which 
will discharge the most fetid matter that can be conceived ; at which time 
a gargle of yeast and water must be used to cleanse the mouth and throat." 
The following recipe is taken from a small medical treatise entitled " Dr. 
John William's Last Legacy to the World," and which may be taken with 
safety and advantage : Take a table-spoonful of common tar, three spoons- 
ful of honey, three yolks of hens' eggs, half a pint of wine : mix together 
in a dish with a knife or spoon, then bottle for use. 
Dose, a tea-spoonful morning, noon, and night, before eating. Drink barley 
tea for constant use. 
Mr. Crittenden informs me that he was cured of a disease supposed to 
have been consumption, by an Indian doctor, in the following manner : A 
strengthening plaster was put on the breast; a tea was also made of equal 
parts of rock polypody and spice or fever bush, drank freely through the day. 
Pulverized blue flag was given, about ten grains, every other day; and, to 
relieve his cough, the following mixture : 
Beat up one egg to the consistence of froth ; then take of honey one table- 
spoonful ; tar, one tea-spoonful; add the egg, combine the articles, and take 
the whole for a dose, and repeat two or three times a day. 
It would appear that the atmosphere on the sea board is so modified by 
the ocean, that it maintains a greater uniformity than the interior of the 
country ; and, therefore, a residence near the salt water may be the best for 
consumptive invalids. But any change is often very beneficial. 322 
THE REFORMED PRACTICE OF MEDICINE 
DIET AND REGIMEN. 
The diet must be light and nutritious; animal food should be avoided, 
and whatever is heating and indigestible : oysters are good. The following 
makes a very excellent kind of diet: Boil buttermilk, thicken with rye flour 
and Indian meal equal parts. When taken from the fire break in an egg, 
previously beaten, and eat with molasses or sugar. Milk fresh from the 
cow is excellent. As a general rule, whatever digests well may be used. 
The Irish moss makes a pleasant and useful mucilage ; boil a little in water 
and sweeten ; drink freely. 
Under the preceding treatment many have recovered who had all the symp- 
toms of consumption. I impute, however, more virtue to nature than art. 
Sponging the whole body with cold water daily, or the shower bath, then 
rubbing well with a coarse towel, is exceedingly valuable in removing that 
predisposition to a check of perspiration arising from atmospheric changes. 
I advised it some time ago to a patient who was subject to cold from ex- 
posure, and in a short time after he informed me that he had not taken cold 
since he commenced the practice. In the commencement the water may 
be tepid ; bathing in salt water, warm, may be tried. 
A current of air, particularly in a state of perspiration, should be avoided. 
We daily hear people dating their first attack of pulmonary complaints from 
sitting in a cool place after having been over-heated, from being thoroughly 
soaked with rain, or from cold bathing in an improper state of the system. 
Flannel should be worn, and over the shirt. Avoid as much as possible the 
city ; the air, habits, dust, &c., are all unfavourable to health. The country 
atmosphere, exercise, and pursuits are better calculated to preserve and 
recover health. 
Such efforts of the voice as are required in singing or playing on any 
wind instrument of music, frequently produce discharges of blood from the 
lungs; but the practice of reading or reciting for some time together, in a 
moderate tone of voice, tends to strengthen these organs, and to diminish 
the danger of pulmonary haemorrhage from any sudden exertion. 
If the presence of the symptoms characterizing this disease renders its 
existence no longer equivocal, the person so affected ought without delay to 
migrate toward a warmer climate. Should circumstances render this ex- 
pedient impracticable, the next best plan a consumptive person can adopt is, 
to remove into a low and rather damp situation, where bilious diseases prevail. 
The fatal event of pulmonary consumption is uniformly accelerated by re- 
siding in an elevated region. There are even instances on record of phthisis 
making its appearance in families, previously unaffected by it, on changing 
their places of residence from a level to a hilly country. While, on the con- 
trary, the inhabitants of extensive districts in low places enjoy a complete 
immunity from this disease. In Holland pulmonary consumption is a dis- 
ease of comparatively rare occurrence. The same situations that predispose 
to ague are unfavourable to the attack of phthisis, as if these two states of 
consumption were incompatible with each other. The physicians of ancient 
Rome were accustomed to send their consumptive patients to the low and marshy 
land of Egypt. Cicero, the celebrated orator, who in his youth was threat- 
ened with consumption, as the hollow temples and sharp features of his re- 
maining busts abundantly testify, travelled into Egypt for the recovery of 
his health. In this country the choice of situation is not sufficiently at- 
tended to. 
N. B. As a farther preventive to consumption see regimen, page 313. PLEURISY. 
323 
The Stethoscope.-Many physicians profess to know all about the diseases 
of the lungs by this instrument, but I consider it very fallacious ; besides, 
that person has very little judgment or experience who cannot form a correct 
opinion of consumption by the symptoms : all persons unacquainted with 
medicine seldom fail to do this. A minister of this city, at my request, gave 
me the following statement: 
Dr. Beach-Mrs. M. being sick with consumption, (of which disease she 
finally died,) I took her to Boston to consult the physicians there. Dr. J. 
pronounced the right lobes diseased and the left sound. I then took her to 
another eminent physician, Dr. F., who also examined the lungs, and pro- 
nounced the left lobes diseased and the others nearly sound, exactly an opposite 
opinion. They both used the stethescope. Yours, &c., J. H. M. 
CHAPTER XV. 
PLEURISY. (Pleurztis.) 
DESCRIPTION. 
Pleurisy is an inflammation of the pleura, which lines the internal coat 
of the thorax and covers its viscera. When it is seated in this membrane, 
which lines the inside of the breast, it is called a true or internal pleurisy; 
but when it chiefly occupies the external parts, and principally affects the 
muscles within the ribs, it is called the spurious or bastard pleurisy. The 
pleurisy is most predominant in the spring season, and prevails among labour- 
ing people, especially such as are much exposed, and are of a sanguine con- 
stitution. 
CAUSES. 
Its causes are cold applied to the skin ; sudden and great distention of the 
pleura in drawing breath • drinking cold liquors after being heated by violent 
exercise; cold, northerly winds; sleeping without doors, on the damp ground; 
wet clothes ; plunging the body into cold water, or exposing it to the coldair, in 
a state of perspiration. Generally speaking, whatever obstructs perspiration 
may occasion the pleurisy. It may also be produced by drinking strong liquors; 
stopping issues, ulcers, sweating of the feet or hands, or other usual evacua- 
tions ; the sudden striking in of the small-pox, measles, or any eruption. It 
may also be brought on by violent exercise, as running, leaping, wrestling, 
lifting heavy burthens, blows on the breast, &c. 
SYMPTOMS. 
This, like most other forms of fever, begins with chilliness and shivering, 
which are followed by heat, thirst, inquietude, and the other common symp- 
toms of fever. After a few hours the patient is seized with a violent prick- 
ing pain in one of his sides, commonly about the short ribs, which sometimes 
extends itself toward the back-bone, sometimes toward the shoulder-bone, 
and toward the fore part of the breast; and this is attended with frequent 
coughing. 
The matter which the patient spits up is at first small in quantity, thin, 324 
THE REFORMED PRACTICE OF MEDICINE. 
and mixed with particles of blood ; but as the disease advances, it is more 
plentiful and more purulent, but seldom without a mixture of blood. The 
pulse is remarkably strong, and seems to vibrate like the tense string of a 
musical instrument; and the blood drawn from a vein, as soon as it is cold, 
looks like melted suet. Sometimes there is little or no expectoration, 
and hence pleurisies are distinguished into moist and dry. 
TREATMENT. 
I formerly bled in the commencement of this disease, but more recently I 
have entirely dispensed with it, and substituted treatment which I have 
found far less injurious and much more effectual. 
As soon as I am called to a patient labouring under an acute attack of the 
pleurisy, I administer two tea-spoonsful of the sudorific drops in half a pint 
of the infusion of and repeat the same in half an hour, if the first dose 
does not relieve the severe pain in the side. The feet are to be bathed in 
tepid water and ley. In conjunction with these means, it will be necessary 
to apply the following fomentation to the side : Cayenne or red pepper, 
{capsicum annuum,) alcohol or best brandy, one pint: simmer a few minutes 
together, then dip flannels in the same, and apply to the side. When cool, 
repeat the same. Should this not relieve the pain in one or two hours, 
apply the following fomentation : Take tanzy, {tanacetum vulgare,} worm 
wood, {absynthium hoarhound, (MiarnzWw/n catnip, {ne- 
peta cat ana vulgare.} Boil all down together in a suitable quantity of water, 
and enclose the same in flannel, and apply to the side as warm as can be borne. 
This application mitigates the pain, relaxes the vessels, and prevents conges- 
tion. If there is much cough and difficulty of expectoration, give the 
following infusion : Pleurisy root, {asclepias tuberosa,') half an ounce ; bruise, 
and add one pint of boiling water. Let this be drank freely through the day. 
This infusion acts as an expectorant and diaphoretic, and will be found 
altogether better than antimony. The drops recommended with the other 
auxiliaries produce in a short space of time a copious perspiration, and 
often cut short the disease in a few hours, or at most in a few days, and 
without debilitating or injuring the system, or protracting the disease, as 
bleeding invariably does. Should the pain in the side after the above treat- 
ment continue, which very seldom is the case, apply a mustard plaster over 
the seat of it, and sprinkle the anodyne poicders or pulverized opium over it. 
After submitting to this course of treatment, should not the inflammation 
be subdued, or nearly so, fifteen or twenty drops of the tincture of digitalis 
may be given every three or four hours in a tumbler of pleurisy root tea. 
If the patient is not free of pain at night, or should be very restless, give ten 
grains of the diaphoretic powders. Purgatives must also be given every 
day or two. In very severe cases I have applied a blister. 
A person informs me that he had a severe attack of pleurisy, and his 
case was pronounced hopeless. An English physician prescribed as much 
capsicum as could lay on the handle of a tea-spoon, given in spirits, and the 
side bathed with the tincture of the same; it afforded relief, and he soon 
recovered. 
REGIMEN. 
The diet ought to be cool, slender, and diluting. The patient must avoid 
all food that is hard of digestion, and everything of a heating or stimulating 
nature. His drink may be panado, gruel, &c. INFLAMMATION OF THE HEART. 
325 
Case 1.-Mr. A , residing in Christie-street of this city, was supposed 
to be dying with pleurisy ; catching for breath, and unable to articulate, so 
severe was the complaint. Cough excessive, and no expectoration. The 
sudorific drops were administered in a strong infusion of catnip, fomentations 
to his side, feet bathed, &c. The effect was, in a very short time to produce 
a copious perspiration, which removed the acute symptoms almost immedi- 
ately. In a few days he was well and attending to his business. 
Case 2.-A lady in Essex-street was taken in a similar manner. The 
pain was so acute in the side that it was with the utmost difficulty that she 
could breathe ; constant inclination to cough ; great fever ; pulse tense, quick, 
and hard ; her distress was so very great that I thought it best to bleed her, 
as it appeared that she could not live but a few minutes. I asked Dr. 
Downing, the physician who accompanied me, (a real Brunonian,) for his 
lancet. He objected to the bleeding, and immediately replied, " administer 
the sweating drops." I hesitated, fearing that I should jeopardise the life 
of the patient, but finally concluded to try the powers of vegetable medicine 
alone. I accordingly administered it, together with a large quantity of an 
infusion of catnip, with the other medicines recommended, and relief was 
afforded in a few minutes. She rapidly recovered, and in a few days was 
about her business as strong as ever. Had this patient been bled, as is now 
practised by physicians, in all probability it would have killed her, or she 
would have suffered under the influence of debility for a long time. A small 
volume might be filled with similar cases. 
We now ask, if the worst cases of pleurisy can be cured without bleeding, 
cannot every disease incident to the human body ?* 
CHAPTER XVI. 
INFLAMMATION OF THE HEART. {Pericarditis.) 
DESCRIPTION. 
This is an inflammation of that membranous bag which surrounds the 
heart, the use of which is to secrete and contain the vapour of the pericar- 
dium, which lubricates the heart, and thus preserves it from concreting with 
the pericardium. 
SYMPTOMS. 
Pain in the region of the heart, suffocating weight, violent palpitation, 
motion of the heart, breathing by starts, dyspnea, or difficulty of breathing, 
increased by motion or exercise. Pressure also aggravates the symptoms. 
Pulse frequent and bounding ; the countenance has a peculiar pale and 
haggard appearance. 
The treatment of this complaint is very similar to other inflammatory 
diseases. The sudorific drops may be given until perspiration is produced, 
and repeated occasionally, to keep up a determination to the surface. 
TREATMENT. 
* In the above case I applied a blister to the side. 326 
THE REFORMED PRACTICE OF MEDICINE. 
If the pain and symptoms are very acute, apply a mustard plaster over the 
region of the heart. The following pill may be given every four hours 
through the day : Fox glove, (digitalis purpurea,') pulverize, and form into a 
pill of two grains ; or the tincture may be given. 
Should there be much distress, want of sleep, &c., give the diaphoretic 
powders; and give also freely an infusion of catnip, and let the feet be 
frequently bathed. 
SECTION I. 
ENLARGEMENT AND CHRONIC INFLAMMATION OF THE HEART. 
(Hypertkophy.) 
DESCRIPTION. 
The same symptoms as in the acute, but with less violence, and more 
protracted. It may arise from enlargement of the heart, or sub-acute 
inflammation of that organ. 
TREATMENT. 
Give the digitalis tea five or six times during the day. A strengthening- 
plaster may be laid over the region of the heart, and the bowels be purged 
by the compound powder of jalap. 
REGIMEN. 
Great care is necessary in these complaints. No stimulating food or 
liquor should be taken. Avoid violent exercise of every kind, great 
fatigue, and whatever has a tendency to debilitate the system. The food 
should be light, and in no respect stimulating. 
CHAPTER XVII. 
INFLAMMATION OF THE DIAPHRAGM. (Paraphrenitis.) 
DESCRIPTION. 
This disease is produced by an inflammation of the diaphragm that divides 
the thorax from the abdomen, usually called the midriff. Causes, the same 
as pleurisy. 
SYMPTOMS. 
There is very violent pain, which is deep-seated under the short ribs, striking 
through to the back ; breathing quick, small, and difficult; frequent sickness 
and hiccough ; the pulse is small, hard, frequent, and irregular. It is nearly 
connected with pleurisy. Treatment, the same as pleurisy. INFLAMMATION OF THE STOMACH. 
327 
CHAPTER XVIII. 
INFLAMMATION OF THE STOMACH. (Garfnhs.) 
DESCRIPTION. 
This is an inflammation of the coat or coats of the stomach, characterized 
by fever, great anxiety, heat, pain over the region of the organ, increased 
when anything is taken into the stomach ; hiccough ; pulse small and hard ; 
and great debility. 
CAUSES. 
Inflammation of the stomach is produced by acrid substances taken into 
the stomach, such as arsenic, antimony, mercury, &c. Likewise by food or 
drink of an improper kind ; drinking cold liquor when the body is heated. It 
may be brought on by inflammation of some of the neighbouring parts at- 
tacking the stomach, or a sudden check of perspiration from any cause. 
SYMPTOMS. 
Burning heat, pain, and swelling, particularly after any liquor has been 
swallowed ; hiccough ; cold extremities; hard, quick, and tense pulse; pain 
which is produced by pressure. There is also great thirst; when anything 
is ate or drank, it produces great difficulty of breathing and swallowing ; 
sometimes syncope and fits will ensue. There is restlessness, with continual 
tossing of the body, and great prostration of strength. 
TREATMENT. 
The Indications of Cure will be, to allay the irritability of the stomach, by 
lessening the inflammation. 
In this disease it will be necessary to give cooling and mucilaginous drinks; 
and none will be found better than the mucilage of slippery elm bark. Apply 
fomentations to the stomach. An ounce of sweet oil may be given every 
day ; and if the vomiting is very troublesome, a soda powder may be taken 
as often as it occurs. Should this not mitigate the symptoms, the anodyne 
powders may be given, a few grains at a dose, as often as the pain becomes 
violent. The feet must be often bathed ; and should the disease continue 
obstinate, apply a mustard plaster over the region of the stomach, and after- 
ward between the shoulders. Give also the neutralizing mixture. 
Vomiting.-Should vomiting continue, give the following : Bicarbonate of 
potash, one drachm, or a tea-spoonful; mint water, or tea, half a pint: mix. 
Give a tea-spoonful or two occasionally, or as often as the vomiting occurs. 
All acrimonious, heating, and irritating food and drink are carefully to be 
avoided. The weakness of the patient may deceive the bystanders, and in- 
duce them to give him wines, spirits, or other cordials ; but these never fail 
to increase the disease, and may occasion sudden death. The inclination to 
vomit, too, may often impose on the attendants, and make them think a puke 
necessary; but that, too, is not good practice. The food must be light, 
thin, cool, and easy of digestion; it must be given in small quantities, and 328 
THE REFORMED PRACTICE OF MEDICINE. 
should neither be quite cold nor too hot. Thin Indian meal gruel has a 
charming effect in this complaint; light toasted bread dissolved in cold 
water, or very weak chicken broth, are proper. The drink should be 
clear whey, barley water, in which toasted bread has been boiled, or decoc- 
tions of mucilaginous vegetables, as marsh mallows, bene plant, and slippery elm. 
The last case I had was so severe, I ordered a few leeches over the stomach. 
CHAPTER XIX. 
INFLAMMATION OF THE LIVER. {Hepatitis.) 
DESCRIPTION. 
By this disease we understand an inflammation either in the membranes 
or substance of the liver, characterized by febrile excitement, with tension 
and pain of the right side often pungent, like that of pleurisy, but more fre- 
quently dull; a pain at the top of the shoulder-blade ; difficulty of breathing, 
dry cough, vomiting, and hiccough. Yellowness of the eyes sometimes 
appears. This disease is either chronic or acute. 
CAUSES. 
The causes are all those producing inflammation; scirrhous tumours in 
the liver; injuries from external violence; mercury; hot climate; ob- 
structing the hepatic ducts; anything that suddenly cools the liver after it 
has been much heated; drinking largely of wines and spirituous 
eating hot, spicy aliment; violent exercise; exposure of the heated body td 
the cold air, &c. 
Those who have exposed themselves to the destructive habit of drinking 
to excess are particularly liable to diseases of the liver. Tubercles, scir- 
rhous hardness, and chronic inflammations are the change which in general 
are produced in this organ by this pernicious practice. 
SYMPTOMS. 
The acute species of this complaint comes on with a pain in the right side, 
extending up to the shoulder, which is much increased by pressing upon the 
part, and is accompanied with a dry, short, and frequent cough, oppression 
of breathing, and difficulty of lying on the left side; together with nausea 
and sickness, and often with a vomiting of bilious matter ; tongue coated. 
The urine is of a deep saffron colour, and small in quantity; there is loss 
of appetite, great thirst, and costiveness, with a strong, hard, and frequent 
pulse ; and when the disease has continued for some days, the skin and eyes 
become tinged of a deep yellow. 
The chronic species is usually accompanied with a morbid complexion, 
loss of appetite and flesh, costiveness, indigestion, flatulency, pains in the 
stomach, a yellow tinge of the skin and eyes, clay-coloured stools, high 
coloured urine, depositing a red sediment and ropy mucus; an obtuse pain 
in the region of the liver, extending to the shoulder, and not unfrequently 
with a considerable degree of asthma. INFLAMMATION OF THE LIVER. 
329 
The symptoms are, however, often so mild and insignificant as to pass 
almost unnoticed; as large abscesses have been found in the liver upon dis- 
section, which in the person's life-time had created little or no inconvenience, 
and which may have been occasioned by some previous inflammation. 
Hepatitis, like other inflammations, may end in resolution, suppuration, 
gangrene, or scirrhus ; but its termination in gangrene is a rare occurrence. 
Sometimes suppuration takes place, and the matter is discharged by vomiting 
or purging. 
TREATMENT. 
Indications of Cure.-As in all other inflammatory diseases, the first ob- 
ject will be to lessen the determination of blood to the part inflamed, by 
equalizing the circulation; to effect which, it will be necessary to produce 
a free perspiration. The feet must be bathed in wrarm water and ley, and a 
tea-spoonful of the sudorific drops, in half a pint of an infusion of catnip, must 
be given every hour or two until the pain ceases, or perspiration is produced 
or promoted. The patient must drink freely of balm or pennyroyal tea. Let 
fomentations be applied warm to the side or over the region of the liver. 
Should they not take off the tension and afford relief, apply cayenne pepper 
and brandy simmered a few minutes together. These may be applied often, 
and as warm as the person can bear. A purgative may be given daily while 
the acute symptoms continue. In this disease vomiting is a very attendant 
symptom ; to allay which, give a little supercarbonate of potash, or sal jeratus, 
in peppermint water or tea, as often as the vomiting returns. This will 
allay the irritability of the stomach. Should not these applications mitigate 
the symptoms, apply the following plaster to the side : Take mustard, red 
cayenne pepper, equal parts ; Indian meal, a table-spoonful; vinegar suffi- 
cient to form a plaster or poultice of suitable consistence. Apply warm to 
the side, and continue it as long as the patient can bear. I have occasionally 
applied a blister in this disease, but I find that mustard plasters do much bet- 
ter. Blisters should be dispensed with, their effect always proving very 
troublesome and not unfrequently serious. If the pain continues severe and 
prevents sleep, ten grains of the diaphoretic powders may be given in currant 
jelly, roasted apple, or any other convenient vehicle, every two hours until 
relief is afforded. Or, if there is much nausea, give the anodyne powders. 
If the stomach continues to exhibit a morbid state, which is sometimes the 
case from sympathy, great relief will be found by giving a mild emetic every 
other morning or evening; this will stimulate the liver to healthy action 
when other means fail. And should the disease be so obstinate as to resist 
the above treatment, which with me has been invariably successful, a few 
leeches may be applied ; one application of which is far better than many 
bleedings from the arm. The neutralizing mixture may likewise be given. 
REGIMEN-. 
The same regimen is to be observed in this as in other inflammatory dis- 
orders. All heating articles are to be totally avoided, and cool diluting 
liquors, as whey, barley water, &c., drank freely. The food must be light 
and thin, and the body, as well as the mind, kept easy and quiet. 330 
THE REFORMED PRACTICE OF MEDICINE. 
SECTION I. 
CHRONIC INFLAMMATION OF THE LIVER. {Liver Complaint.) 
DESCRIPTION. 
Sometimes inflammation of the liver becomes chronic in its character, as 
before-mentioned, arising from long-continued intermittents and other causes. 
The symptoms are, a dull pain in the right side and top of the shoulder, the 
stomach sometimes disordered, yellow tinge of the skin, and often a swelling 
over the region of the liver. 
There is usually in this complaint dyspepsia, cough with slight expec- 
toration, headache, lowness of spirits or despondency, debility or weakness, 
flatulence, morbid sensibility, great irritability, jaundice, gall stones, emacia- 
tions, stools clay coloured, tongue coated, costiveness and indigestion, urine 
pink coloured, countenance sallow. 
TREATMENT. 
An emetic may be given occasionally, and our common purgatives admi- 
nistered. Deobstruent medicines must likewise be given, and none is better 
than the hepatic pills. These soon remove the pain and obstruction, and 
will be found exceedingly valuable in liver complaint. Give two or three 
at a dose twice a day. Apply the common strengthening plaster to the side, 
and let it remain for several weeks. If the disease proves obstinate, give a 
portion of mandrake twice a week. The cure of this complaint is generally 
slow, requiring sometimes six months or more. 
Diet, the same as in dyspepsia. 
CHAPTER XX. 
INFLAMMATION OF THE SPLEEN. (Sptemtis.) 
DESCRIPTION. 
This disease very much resembles inflammation of the liver, but the pain 
is in the left side. 
SYMPTOMS. 
It is characterized by fever, tension, heat, tumour, and pain in the left 
side, increased by pressure. This disease comes on with a remarkable 
shivering, succeeded by a most intense heat and very great thirst; a pain 
and tumour are perceived in the left side, and the paroxysms for the most 
part assume a quartan form ; when the patients expose themselves for alittle 
to the free air, their extremities immediately grow very cold. If a hsemorr- 
hage happens, the blood flows out of the left nostril. The other symptoms 
are the same as those of inflammation of the liver. Like the liver, the 
spleen is also subject to a chronic inflammation, which often happens after 
agues, and is called the " ague cake," though that name is also frequently 
given to a scirrhous tumour of the liver succeeding intermittents. INFLAMMATION OF THE INTESTINES OR BOWELS. 
331 
CAUSES. 
The causes of this disease are the same as those of other inflammatory 
disorders ; but those which determine the inflammation to that particular part 
more than another are very much unknown more than cold. It attacks 
persons of a very plethoric and sanguine habit of body rather than others. 
TREATMENT. 
During the acute stage of this disease prescribe remedies to subdue the 
inflammation. 
1. Give a purgative every other day, according to the strength of the 
system and severity of the disease. 
2. Give sudorific medicines to produce perspiration. 
3. Apply cayenne pepper, (capsicum annuum,') mixed and simmered with 
spirits, to the part. 
4. Should this not relieve the pain and mitigate the symptoms, a mustard 
plaster may be applied to the side or over the region of the spleen. 
SECTION. I. 
CHRONIC INFLAMMATION OF THE SPLEEN. 
The spleen sometimes becomes enlarged, and suppurates. This may be 
known by the soft or scirrhous feeling. In either case it is seldom attended 
with danger. Should symptoms of suppuration appear, a poultice may be 
applied to the part, and thus be promoted. Should the spleen become soft 
and pulpy, and partly destroyed, as is sometimes the case, a plaster may be 
applied to the side, and purgatives and emetics occasionally used, together 
with the hepatic pills. 
CHAPTER XXL 
INFLAMMATION OF THE INTESTINES OR BOWELS. (Enteritis.) 
DESCRIPTION. 
An inflammation of the mucous membrane lining the intestines. This 
disease is characterized by fever, fixed pains in the abdomen, costiveness, 
and vomiting. 
CAUSES. 
An inflammation of the intestines is occasioned by long-continued costive- 
ness or hardened feculent matter lodged in some part of the tube ; by the 
strangulation of a protruded portion of the gut in a rupture ; by preceding 
colic ; eating unripe fruits or great quantity of nuts, and by scirrhous tumours 
of the intestines, or strictures ; but the most frequent cause is exposure to 
cold, particularly when applied to the lower extremities or bowels, and occa- 
sionally by cold drink swallowed when the body is much heated by exercise. 
This dangerous and painful disease is characterized by acute pain in the 
SYMPTOMS. 332 
THE REFORMED PRACTICE OF MEDICINE. 
bowels, which is much increased upon pressure, and shoots round the navel 
in a twisting manner ; there is obstinate costiveness, tension of the belly, and 
the vomiting generally bilious, or dark and fetid; the urine is high coloured, 
the pulse quick, hard, and contracted, with some degree of febrile heat, 
thirst, and great depression or loss of strength. The patient is constantly 
belching up wind, and in protracted cases he even discharges excrement 
by the mouth, the motion of the intestines becoming inverted from their 
being no passage downward. 
TREATMENT. 
Stimulating purgatives should be avoided in this disease, as they are calcu- 
lated to exasperate it. The most cooling treatment and regimen must be 
followed. The feet should be frequently bathed in strong ley water, and 
warm fomentations applied to the abdomen. An ounce or table-spoonful of 
cold-pressed castor oil may be given every two hours until it acts upon 
the bowels, and afterward administered as occasion requires. 
Should not this operate as a laxative or purgative, administer our common 
injection, to which add a tea-spoonful of laudanum. 
Administer this injection blood-warm with a French syringe, to be repeated 
according to the urgency of the symptoms. If the pain is severe, it may be 
given every two hours. 
To allay the irritation of the stomach and vomiting, which not unfre- 
quently attend this disease, as well as to mitigate urgent symptoms, ten 
grains of the anodyne or diaphoretic powders may be given every two hours 
till relief is afforded, and a dose also given every night. 
Bleeding and blistering are much resorted to in inflammation of the intes- 
tines ; yet I have never known any benefit derived from them ; but, on the 
contrary, much injury. 
Should not this treatment arrest the complaint in a short time, the follow- 
ing fomentation may be applied: Take tanzy, wormwood, hoarhound, and 
hops. Boil all in vinegar and water, then enclose them in flannel or muslin ; 
apply to the abdomen, and change them often. 
Should vomiting be a predominant symptom, the following preparation 
maybe given : Infusion of spearmint, half a pint; sal leratus, a tea-spoonful. 
Give a table-spoonful every hour. 
The inflammation sometimes is so great that the passage of the bowels 
seems closed, so that nothing will pass them. Should this be the case, and 
should not the means already prescribed prove effectual, the patient may be 
put into a warm bath, and occasionally repeated. Should the swelling, 
inflammation, or pain continue after the above treatment, let a mustard 
plaster be applied to the bowels, and kept on till the skin is reddened, and 
the anodyne powders given every two hours. 
Give also senna and manna, to which may be added a tea-spoonful of 
epsom salts. In very urgent cases a few leeches may be applied to the bowels. 
REGIMEN. 
The regimen in this disease should by no means be stimulating, but the 
reverse ; the most cooling, demulcent, and diluting, such as slippery elm. 
INFLAMMATION OF THE PERITONAEUM. 
This membrane envelopes and surrounds all the different organs which are INFLAMMATION OF THE KIDNEYS. 
333 
contained in the abdomen or cavity of the belly ; it defends them from injury by 
any motion or concussion, and their whole mass is prevented through its means 
from being misplaced by their own weight. 
The disease is accompanied by symptoms pretty similar to the same 
affection of the intestines, just pointed out; it arises from the same causes, 
and must be treated in a similar manner. 
CHAPTER XXII. 
INFLAMMATION OF THE KIDNEYS. {Nephritis) 
DESCRIPTION. 
Inflammation of the kidneys is known by fever, pain in the region of 
the kidneys, and shooting along the course of the ureter; drawing up of the 
testicles, numbness of the thigh, vomiting, urine high coloured and fre- 
quently discharged, costiveness, and colic pains. It is symptomatic of calcu- 
lus, gout, &c. 
CAUSES. 
The causes which produce this complaint- are external contusions, strains 
of the back, acrids conveyed to the kidneys in the course of the circula- 
tion, violent and severe exercise either in riding or walking, calculous 
concretions lodged in the kidneys or ureters, and exposure to cold. Jn some 
habits there is an evident predisposition to this complaint, particularly the 
gouty, and in these there are often translations of the matter to the kidneys. 
SYMPTOMS. 
This disorder is characterized by an acute, pungent, or more frequently 
an obtuse or dull pain in the region of the kidneys, shooting along the course 
of the ureters, or ducts which convey the urine from them into the bladder; 
pain also in the small of the back, together with a fever, and frequent dis- 
charge of urine, which is small in quantity, red, and high coloured, yet, in 
the highest degree of the disease, watery and limped; the thigh feels be- 
numbed, and there is a pain in the groin and testicle of the same side, toge- 
ther with a retraction. There are, moreover, continual eructations, with 
bilious vomitings, debility, &c. 
This disease sometimes assumes a chronic form, known by heat, pain, &c., 
over the loins. 
TREATMENT. 
The first object to accomplish is, to relax the system by producing perspi- 
ration. If the pain be violent, apply over the seat of the disease the follow- 
ing fomentation of bitter herbs: Take hops and wormwood, equal parts; 
simmer in vinegar and water ; apply warm, and renew often. 
The diuretic drops may be given to diminish the inflammation of the kid- 
neys, to promote the urinary discharge, &c.; give a tea-spoonful three or 
four times through the day, in one or two tea-spoonsful of the mucilage of 334 
THE REFORMED PRACTICE OF MEDICINE. 
gum Arabic. At the same time give through the day a decoction of marsh- 
mallows, parsley, mint, or slippery elm tea; make a strong decoction, drink 
freely and warm. This promotes the discharge of urine and allays irritation. 
It will be necessary, if the patient be of a costive habit, to give a purga- 
tive every day or two, according to the violence of the disease. Sometimes 
spasms arise from irritation of gravel passing the ureters ; when this is the 
case an opium pill or powders, containing two or three grains, may be admi- 
nistered every two hours until relief is afforded, and the patient may be put 
into a warm bath; this usually affords great and sudden relief; a tea- 
spoonful or two of spirits of nitre in a gill of mint tea is very beneficial. Equal 
parts of spirits of mint and spirits of nitre, mixed, and given often in half 
table-spoonful doses, are an excellent remedy. 
When the disease is chronic, and there is pain in the small of the back, 
&c., let the part affected be bathed with the following : 
Red pepper or cayenne, (capsicum,) one ounce ; alcohol, one pint; bathe 
the parts two or three times a day, and use the drops mentioned above. In 
the course of a few days, or when the inflammation has measurably subsided, 
apply a strengthening plaster to the back. 
Vomiting.-Should the disease be attended with vomiting, which is often 
the case, give sal ceratus : one tea-spoonful may be dissolved in half a pint 
of cold water ; a table-spoonful given as often as vomiting takes place. At 
the same time give an infusion or tea of peppermint. 
I attended one person with this disease, in which the symptoms were so 
violent that her life was in imminent danger; the hot bath soon cured. 
REGIMEN. 
Everything of a heating or stimulating nature is to be avoided. The food 
must be thin and light; as panado, Indian gruel, with mild vegetables, mint 
tea drank freely. Emollient and thin liquors must be plentifully drank ; as 
pennyroyal tea, sweetened with honey, decoctions of marsh-mallow roots, 
and other diuretic plants, with barley, &c. Let the feet be often bathed. 
CHAPTER XXIII. 
INFLAMMATION OF THE WOMB, (fiystentw.) 
This disease is characterized by fever, heat, tension, tumour, pain in the 
region of the womb, and vomiting. 
DESCRIPTION. 
CAUSES. 
Besides the common causes productive of inflammation, this disease some- 
times take place after delivery, particularly where the labour has been long 
protracted, instruments have been used, or the lochial discharge, which ought 
to have taken place, has been suddenly stopped by an exposure to cold. 
It is accompanied by pains in the lower region of the belly, w'hich are 
SYMPTOMS. INFLAMMATION OF THE WOMB-BLADDER. 
335 
greatly aggravated upon pressure with the hand, as also by tension or tight- 
ness of the surrounding parts, considerable depression of strength, a change 
of countenance, increased heat of the whole body, great thirst, nausea, and 
vomiting. The pulse is weak, but hard and frequent; the bowels confined, 
the urine high coloured and scanty, the secretion of milk somewhat inter- 
rupted, and the lochial discharge much diminished, if not wholly sup- 
pressed. 
TREATMENT. 
Perspiration ought to be promoted as soon as possible. An infusion of 
catnip should be drank freely, with a tea-spoonful of the diaphoretic powders 
or sudorific drops. The abdomen should be freely fomented, as in other 
inflammatory diseases ; and, if necessary, apply mustard. 
When there is great irritation, an anodyne may be administered; ten grains 
of the diaphoretic powders. 
A cathartic may be occasionally given. 
For inflammation of the womb 1 have used the following with excellent 
effect: 
Take the spirits of spearmint, made by bruising the green mint and adding 
best of Holland gin: add as much spirits of nitre ; give freely. This has cured 
several cases. 
The dry mint may be added to the gin, and a tincture thus made. 
CHAPTER XXIV. 
INFLAMMATION OF THE BLADDER. (Cistttw.) 
DESCRIPTION. 
This disease is characterized by pain in the region of the bladder, attended 
with fever and hard pulse, frequent painful discharges of urine, with sup- 
pression and general tenesmus. 
CAUSES. 
It is occasioned by an improper use of acid medicines, (such as cantharides,) 
inflammation extending along the urinary channel, permanent or spasmodic 
stricture, local irritation from the lodgment of a stone, hardened fceces, or a 
diseased state of the prostrate gland, and mechanical injury, as well as by 
all the usual causes of inflammation. 
SYMPTOMS. 
Where this disease exists, an acute burning pain and some degree of 
tension at the bottom of the belly, with a constant desire to make water, a 
difficulty in voiding it, or total stoppage, a frequent inclination to go to stool, 
much uneasiness and heat, a general febrile disposition, a frequent and hard 
pulse, sickness and vomiting, not unfrequently attend. 
It sometimes becomes chronic, and is very afflicting. There is a frequent 
desire to urinate, and a discharge of mucus or blood. 336 
THE REFORMED PRACTICE OF MEDICINE. 
TREATMENT. 
We must employ similar means in this disease as in the inflammation of 
the kidneys. The hip or warm bath may be employed morning and evening. 
The diuretic drops must be given ; also mint and barley tea. 
Spirits of mint and spirits of nitre, equal parts, may be given every two 
hours, in half a tumbler of herb tea or water, as in inflammation of the kidneys. 
Fomentations of bitter herbs must also be applied over the region of the 
bladder. 
The patient should abstain from everything that is of a hot, acrid, and 
stimulating quality ; and should live on gruels and mild vegetables. 
Purgatives must also be administered. 
In the chronic form I have seen great benefit derived from repeated purga- 
tives, and a blister occasionally applied on the pubis or lower part of the 
bladder: take also the teas of burdock,wild carrot, wild parsley seed, dandelion, 
cleavers, and pennyroyal. Diet, the same as above. 
CHAPTER XXV. 
INFLAMMATORY RHEUMATISM. (Rheumatismus.) 
The rheumatism is a very painful disease, which affects the muscles and 
joints in different parts of the body, and in many cases so nearly resembles 
the gout as to be distinguished from it with difficulty. It makes its attacks 
in all seasons of the year when the atmosphere is moist and variable, but is 
more frequently met with in the autumn and spring. It is sometimes accom- 
panied with fever, and sometimes there is none. In the former instance it 
is known under the name of acute rheumatism; in the latter it is called 
chronic rheumatism. 
DESCRIPTION. 
CAUSES. 
Obstructed perspiration, occasioned either by laying in damp linen or damp 
unventilated rooms, wearing wet clothes, or being exposed to cold air, after 
having been much heated by exercise or other ways, may be considered the 
chief and most frequent causes of the rheumatism. 
The gout is the disorder which most nearly resembles the rheumatism, but 
in the latter it is principally the large joints which are affected ; moreover, 
the pain frequently shifts its seat, and follows the course of the muscles in 
its transition to other parts. Besides, it is in general preceded by flatulency 
and indigestion, as is the case in gout; and it occurs at any period of life, 
whereas gout is usually confined to adults. 
SYMPTOMS. 
The acute rheumatism generally commences with weariness and shiver- 
ing, succeeded by heat, thirst, restlessness, anxiety, a hard, full, and quick 
pulse, and all the usual symptoms of inflammatory fever. After a short lapse 
of time acute pain is felt by the patient in one or more of the large joints INFLAMMATORY RHEUMATISM. 
337 
of the body, and these are followed by a tension and swelling of the parts so 
affected. The pain is transitory, and generally shifts from one joint to ano- 
ther, leaving the part it occupied red, swollen, and very tender to the touch. 
The tongue is white, the bowels are obstinately costive in general, the urine 
is high coloured, the pulse full and hard; the blood, when drawn from a 
vein, exhibits a thick, buffy-coloured coat on its surface, as in pleurisy; and 
sometimes there is a profuse sweating, unattended, however, by any relief. 
When the patient is in bed the pains are usually much increased, and he 
cannot bear the least motion without their being highly aggravated. 
The chronic form of rheumatism may either be a consequence of the ter- 
mination of the acute, or it may be independent of it. In the first cases the 
parts which are affected with inflammation are left rigid, weak, and in some 
instances puffed up ; and the pain, not being moveable, is now confined to 
particular parts; sometimes, however, it shifts from one joint to another, 
but without being accompanied by any inflammation or fever. In the latter 
cases, where it has risen from an exposure to cold and sudden vicissitudes 
of the weather, pain seizes the head, shoulders, knees, loins, wrists, and 
other parts ; and these often continue for a considerable length of time, and 
then go off, leaving the seat they occupied in a state of debility. 
Very alarming and fatal symptoms sometimes follow the recession of 
rheumatism. It passes to the heart, diaphragm, stomach, bowels, and every 
part of the body. When it is translated to the heart the patient is seized 
with acute pain and great anxiety over that region, palpitation, partial faint- 
ing, pale, distressed countenance. When it is translated to the brain it is 
attended with heaviness, with acute pain in the head, intolerance of light 
and sight, wild and anxious expression of countenance, occasional delirium, 
&.c. ; when the stomach is affected by a recession of this disease, pain, nau- 
sea, and vomiting. Sometimes the bladder is affected with rheumatism, 
producing a retention of urine and pain over the seat of that organ. Some- 
times it is translated to the lungs and pleura, which become affected, pro- 
ducing an inflammation of those parts. Sometimes it passes to the uterus, 
or womb, &c. 
Dr. Cox, of England, states that the numerous cases of organic disease of 
the heart and pericardium which he met with at Guy's Hospital were refera- 
ble to, or connected with, rheumatism. All of which symptoms unquestion- 
ably arise from a retention of morbid humours in the system. 
TREATMENT. 
Indications of Cure.-The first and great object in acute rheumatism is, to 
lessen the inflammatory action and lower the fever. 
A late author, Dr. Eberle, writes: The very profuse sanguineous evacua- 
tions so frequently resorted to in this complaint, so far from proving beneficial, 
lead often to very disastrous consequences; for experience has fully esta- 
blished the fact, that metastasis of the local affection to an internal organ is 
particularly favoured by thus draining the system of its blood, and impairing 
the vital energies. 
Is it not remarkable that such a great change should take place in the 
minds of physicians as regards the treatment of this disease ? They have 
ever considered it of the greatest importance to bleed copiously and repeat- 
edly, and this is agreeably to their pathological views of acute rheumatism 
being characterized by so much inflammation. Are they not as liable to be 
mistaken in their views and treatment of other diseases ? 338 
THE REFORMED PRACTICE OF MEDICINE. 
Purgatives.-In this complaint it will be necessary, 
1st. To give purgatives. Two or three operations are far more beneficial 
than several bleedings. The common vegetable purgative may be given, and 
repeated occasionally. 
2d. Sudorijics.-It will be of the highest importance to administer sudo- 
rifics, and to promote free perspiration. For this purpose the vapour bath 
may be used, if the patient be able to sit up; otherwise a tea-spoonful of 
the sudorific drops may be given every two hours till perspiration takes place, 
and afterward to be given occasionally to keep up a moisture of the skin, to 
be aided by drinking freely of an infusion of catnip. Gentle and uniform 
perspiration is always serviceable. 
Emetics.-Some persons speak highly of emetics ; I cannot speak of their 
effects from experience, never having used them in this complaint. 
Anodynes.-If the pain prevents sleep, ten grains of diaphoretic powders 
may be given at bed-time in syrup or molasses. 
Oils or Liniments.-The following liniment is very valuable: Take tinc- 
ture of opium, one ounce ; gum camphor, one quarter ; oil of hemlock, one 
half; alcohol, one pint; mix. Let this be occasionally applied blood-warm 
to the parts most painful and swelled. 
If the inflammation be very acute, and the heat and swelling considerable, 
bathe the parts with the following wash : Take spirits, half a pint; vinegar, 
half a pint; rain water, half a pint; salt, half an ounce ; mix. Let it be 
applied tepid, with a piece of flannel, three or four times in the course of 
the day. This wash often affords great relief, by lessening the heat, pain, 
and swelling. 
Let the following liquid be taken: Hydriodate of potash, one ounce ; 
water, one quart; mix : take from half to a wine glass three or four times 
a day. 
The patient may drink through the day the following : Take hemlock tree 
leaves, one ounce ; boiling water, one quart. A wine glass to be taken at 
a dose, and as often as the stomach can bear. 
When there is great tension, swelling, and pain of the joints, the following 
poultice will be found excellent: 
Simmer together for a short time bran and vinegar, until a poultice of 
proper consistence is formed, and apply tepid. I have known this simple 
mixture afford relief when all other applications have proved useless. 
This treatment will be found very effectual in curing inflammatory rheu- 
matism ; although the disease under the best treatment will be sometimes 
protracted, at other times it is cured very soon. By the common treatment 
it often degenerates into the chronic rheumatism, or is attended with other 
very serious consequences. 
The last case of inflammatory rheumatism I attended recovered rapidly 
under the following treatment. Bowels regulated by purgatives: Take 
hydriodate of potash, one ounce ; add one quart of water. Dose, half a wine 
glass three times a day. Occasionally a dose of the diaphoretic powders were 
given, followed by a tea of the leaves of the hemlock tree, and also drank 
freely through the day. 
He bathed with the following liniment: Oil of hemlock, one ounce; qum 
camphor, half an ounce; tincture of opium, one ounce; alcohol, one pint: 
mix, and bathe three or four times a day. A mustard plaster is sometimes 
very beneficial. 
Rheumatism in the Head.-In a very obstinate and painful case of this 
description I prescribed stramonium, simmered in spirits, and applied externally INFLAMMATORY RHEUMATISM. 
339 
to the parts affected, and it afforded relief. It has relieved also in other 
cases. 
REGIMEN. 
Cool and (ffluting diet, consisting chiefly of vegetable substances, milk, 
&.C., will be the most proper. Nothing heating should be prescribed in food 
or drink. Buttermilk may be drank freely ; also barley water and gruel. 
SECTION I. 
CHRONIC RHEUMATISM. 
DESCRIPTION. 
The chronic rheumatism differs from the acute in its not being attended 
with fever or much inflammation, and the pain being usually confined to some 
particular part of the body, as the shoulders, arms, or loins ; but it generally 
occupies those joints which are surrounded by many muscles, and particularly 
such muscles as are employed in the most constant and vigorous exertions. 
When it affects those of the loins it is called lumbago ; when seated in the 
hip joint it is known by the name of sciatica. 
CAUSES. 
The causes of rheumatism are frequently the same as those of an inflam- 
matory fever, viz., an obstructed perspiration, the immoderate use of strong 
liquors, and sudden changes of the weather; all quick transitions from heat 
to cold are liable to occasion the rheumatism. " The most extraordinary 
case of rheumatism that I ever saw," says a writer, " where almost every joint 
of the body was distorted, was a man who used to work one part of the 
day by the fire and the other part of it in the water." Very obstinate rheu- 
matisms have likewise been brought on by persons not accustomed to it 
allowing their feet to continue long wet. The same effects are often pro- 
duced by wet clothes, damp beds, sitting or lying on the damp ground, tra- 
velling in the night, &c. 
The rheumatism may likewise be occasioned by excessive evacuations or 
the stoppage of customary discharges. It is often the effects of chronic dis- 
eases, which vitiate the humours. 
The rheumatism prevails in cold, damp, marshy countries. It is the most 
common among those who are ill-clothed, live in low damp houses, and eat 
coarse and unwholesome food, which contains but little nourishment and Is 
not easily digested. 
SYMPTOMS. 
Chronic is often the consequence of acute rheumatism ; but it occurs also, 
frequently, as a direct consequence of exposure to cold and damp air, more 
especially when the system is under the influence of mercury. The affected 
parts are commonly neither swollen nor red ; nor is there often any manifest 
fever connected with the chronic variety of the disease, although quickness, 
tension, and contraction of the pulse are in some instances present in the 
evening and during the night. The pain often wanders from one part to 340 
THE REFORMED PRACTICE OF MEDICINE. 
another, fixing itself by turns in the head, shoulders, knees, wrists, fingers, 
hips, loins, &c., more especially in those cases which approach the sub-acute 
character. Some individuals are hardly ever entirely free from pain ; others 
are affected with it only occasionally, on the occurrence of damp and cold 
weather. In some instances the pain is seated in the joint^; in others, in 
the muscles and parts situated between the joints. After remaining at rest 
for a while the patient feels stiffness and pain on attempting to move the 
affected limb ; but, on using exercise until the body becomes warm, both the 
pain and stiffness usually disappear. Those who are subject to this form 
of the disease generally feel a dull aching pain in one or more joints on the 
approach of stormy and rainy weather. Severe and inveterate cases of 
chronic rheumatism are apt to give rise to organic disease of the tendons, 
wasting and hardening of the muscular structure about the affected parts. 
The joints stiff. A jelly-like effusion into the cavity of the affected joints 
occurs occasionally. 
TREATMENT. 
Indications of Cure.-The object in this disease will be, 
1st. To stimulate the cutaneous vessels to a healthy action, and thus 
restore perspiration. 
2d. To attenuate the thick viscid or sizy state of the blood which invaria- 
bly attends this complaint. 
Internal Remedies.-The alterative syrup may be given. 
The following infusion may likewise be taken in conjunction with the 
above syrup: Take white pine bark, {cort pinus sylvestris,') burdock seeds, 
{sem. arct. lappa,') prickly-ash bark, {xanthoxylumfraxineum,') Virginia snake- 
root, {serpentaria Virginiana,') equal parts: make a strong infusion, and 
drink freely through the day. 
After using the above prescription, should the complaint still prove obsti- 
nate, the following liquid may be administered : Take extract of poke-berry, 
{phytolacca decandria,') half an ounce; white pine turpentine, {terebinth,') 
half an ounce ; add one quart of Malaga wine. Half a wine glass may be 
given three times a day, and the dose gradually increased to a wine glass. 
External Remedies.-Bathe the parts with the following tincture : Take 
cayenne pepper, {capsicum annuum,) one ounce; alcohol, one quart: mix. 
To be applied warm with a piece of flannel. The parts may also be bathed 
with the rheumatic liquid two or three times a day, warm ; and the rheumatic 
pills may likewise be taken. 
The common strengthening plaster may be applied to the parts most affected 
after the use of the above articles, or when the disease has partially subsided. 
The vapour bath may be occasionally used in this complaint. In conse- 
quence of the free perspiration it produces, it will be found very serviceable. 
If the disease proves very obstinate, give the hydriodate of potash, as in 
inflammatory rheumatism. 
Lusk's Rheumatic Drops.-Mandrake roots half an ounce ; black cohosh, 
half an ounce ; prince's pine or pipsiseway, two drachms ; prickly-ash bark, 
two drachms: bruise all, and mix; add to one quart of wine. Dose, a table- 
spoonful three times a day. 
REGIMEN. 
A heating or stimulating diet may be used in this disease INFLAMMATORY RHEUMATISM. 
341 
Cayenne pepper and mustard may be taken with food ; also articles con- 
taining ginger. 
o o o e 
Flannel should be worn during the day, and taken off at night. The 
greatest precaution should be observed to prevent a check of perspiration, 
from the vicissitudes of the weather or other causes. 
SECTION II. 
MERCURIAL RHEUMATISM. 
This disease is somewhat similar to the chronic, but more painful and 
more difficult to remove. It proceeds from the use of the universal panacea 
now given called mercury. At every change of the weather the person feels 
most intolerable pains; indeed his system is a complete thermometer, by 
which he is enabled always to designate the variations of the weather. The 
treatment in this disease is similar to the chronic rheumatism. Sulphur and 
cream of tartar may be given internally, and a plaster composed of sulphur 
and Venice turpentine applied to the joints, and renewed often. The syrup 
mentioned in the preceding disease may likewise be freely taken, to eradicate 
the mercury from the system. The vapour bath will also be found useful. 
The following is from " Dr. John Williams's Last Legacy to the World," 
and recommended in this disease : Take prince's pine-tops, horse-radish roots, 
elecampane roots, prickly-ash bark, bitter-sweet bark off of the root, wild 
cherry bark, mustard seed, a small handful of each; make a decoction and drink. 
One gill of tar water into one pint of brandy, or the same proportion. 
Drink a small glass, before eating, three times a day. 
The following remedy has been forwarded by a very respectable and 
judicious physician for insertion in this work. 
For Sciatic or Sciatica Arterice.-Make a beer of the following articles: 
Spruce, sage, sarsaparilla, hackmetac, or, by another name, tamarac, 
garden rhubarb, elder roots, the bark of burdock roots, Even roots, or by 
some called Even's root, rheumety or Wintergreen, (such as bears the red 
aromatic berries, grows low, and keeps green throughout the winter,) and 
water-cresses. 
Syrup.-Spikenard, comfrey, white Solomon's seal, Johnswort, sweet agri- 
mony, prince's feather, or what is called " love lies a bleeding," (grows 
in the garden,) swamp brake roots, (a plenty,) one pound of raisins, two 
ounces of saffron. Put all into an earthen pot, adding a course of sugar 
between each course of roots and herbs; cover the pot or jar with a rye 
dough or paste, put it in a hot oven, and, when it is sufficiently digested, 
wring out the liquor; add one-third rum or brandy. The beer is for common 
drink. The syrup is to be taken a wine glassful two or three times a day. 
A young lady, who had been a long time afflicted and a cripple with this 
complaint, was cured by the above. 
" In all instances of sciatica, during my practice," says Dr. Seely, " I 
found this medicine a sovereign specific ; and I well know that the generality 
of mankind afflicted with sciatica call it the rheumatism, and that the quack, 
unacquainted with the system, is ignorant of the case, sports with his un- 
wary patient, gulls from him his money, and, lastly, what is worse, robs him 
of his life." 342 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER XXVI. 
GOUT. {Arthritis.) 
DESCRIPTION. 
This disease is usually divided into the regular and irregular. When the 
inflammation occupies the joints to a great degree, and after a certain dura- 
tion gradually disappears, leaving the health unimpaired, it is termed regular 
gout. Of the irregular gout there are three species, viz. : 
1st. The Atonic. When there is not sufficient energy in the system to 
produce a proper degree of inflammation in the extremities, in consequence 
of which the general health is considerably affected, the stomach performs 
the office of digestion imperfectly, and the patient is troubled with flatulency, 
loss of appetite, eructations, violent pains of a spasmodic nature, and fre- 
quently with nausea, accompanied not unusually with dejection of spirits and 
other hypochondriacal symptoms. 
2. The Retrocedent. In this the inflammation, having occupied a joint, 
ceases suddenly, and is translated to some internal part, such as the head, 
lungs, heart, or stomach. 
3. The Misplaced, or where gout, instead of producing the inflammatory 
affection of the joint at all, seizes some internal parts, producing inflamma- 
tion there, and giving rise to some symptoms which attend inflammations of 
those parts from other causes. 
CAUSES. 
The attacks of gout are generally in the winter or spring, and are rarely 
met with before the adult age, or middle period of life. Persons of a full 
and robust habit are most subject to this disease, particularly those who live 
luxuriously and lead an indolent inactive life; whereas those who are em- 
ployed in constant bodily labour, and who live upon a vegetable diet princi- 
pally, are seldom afflicted with it. Women are much less the subjects of it 
than men : no sex, age, or even youth, are, however, exempt from it; but 
in the latter cases it can only be ascribed to that predisposition or constitu- 
tional bias which is entailed by the parents of the child. An hereditary pre- 
disposition, therefore, as also too free an indulgence in the use of animal 
food, fermented liquors, venery, anxiety of mind, excessive evacuations, 
fatigue, the application of cold to the extremities, sprains, and intemperance, 
are to be considered as the chief causes which produce gout. 
The disease may, in general, be readily distinguished from rheumatism, 
by the pains attacking the smaller joints instead of the large ones, as in the 
latter; by its not being accompanied, nor even preceded, at its commencement, 
with symptoms of inflammatory fever ; and by the previous affection of the 
stomach with flatulency, eructations, and pain. 
SYMPTOMS. 
An attack of regular gout sometimes comes on suddenly, and without any 
previous warning; but most usually it is preceded by a belching of wind, 
flatulency in the stomach and bowels, nausea, weariness, dejection of spirits, GOUT. 
343 
pains in the limbs, with a sensation as if cold water or wind were passing 
down the thigh; great lassitude and fatigue are felt after the slightest exer- 
cise, the bowels are costive, and the urine is of a pale colour. 
The paroxysm most frequently comes on about two o'clock in the morn- 
ing, with excruciating pain either in the joint of the great toe, the heel, calf 
of the leg, or perhaps the whole of the foot; and this, becoming more violent 
by degrees, is accompanied with shiverings, succeeded by heat, swelling, 
and redness, and other febrile symptoms. The pain, having attained its 
height toward the following evening, ceases gradually, a gentle moisture 
breaks out upon the skin, and the patient, being greatly relieved from his pain, 
falls asleep; but upon awakening he finds the parts before painful now 
much inflamed and swollen. During several succeeding evenings there is 
a return of both pain and fever, and these continue with more or less vio- 
lence during the night, and toward morning they cease. 
A fit of the gout consists of several such paroxysms as have been de- 
scribed ; and although there may be some little alleviation in the symptoms 
after a day or two, still the pain and fever return every night, going off again 
the following morning. According to the disposition of the body to the 
disease, the strength of the patient, and season of the year will be the dura- 
tion of a fit of the gout; but it usually continues at first for two or three 
weeks, and then goes off either by perspiration, an increased flow of urine, 
or some other evacuation; the scarf-skin of the parts 'which have been 
affected peeling off in branny scales, and some slight lameness and tender- 
ness remaining for a considerable time. 
In the atonic gout, if the head be affected, there is great pain there, with 
perhaps giddiness; and not unfrequently apoplectic and paralytic affections 
are the consequence. If the lungs, it produces an affection similar to asthma. 
If the heart, faintings, palpitations, and an intermittent pulse. If it is seated 
in the stomach, there is great pain, nausea, vomiting flatulency, and eructa- 
tions, dejection of mind, languor, want of energy, and apprehension of dan- 
ger ; and these are frequently accompanied with cramps in several parts of 
the trunk of the body and upper extremities. Sometimes there is obstinate 
costiveness ; sometimes a purging. 
In the retrocedent gout, if the disease is translated to the stomach, there 
is great anxiety, violent pain, and vomiting, with a peculiar sense of cold 
over the region of this organ. If to the heart, there are faintings and pal- 
pitations. If to the lungs, asthma. If to the head, apoplexy and palsy. 
In misplaced gout, instead of there being an inflammatory affection of the 
joints, the disease attacks some internal part, produces inflammation there, 
and then we meet with the symptoms specified. 
Attacks of gout usually become more severe during each returning fit, 
both as to the degree of pain as well as the number of parts which are 
affected. Probably it only seizes one foot at first, but afterward both feet 
are affected by every paroxysm, the one after the other; and as the disease 
advances it not only affects both feet at once, but, after having ceased in the 
foot which was secondly attacked, again returns to the first, and perhaps a 
second time into the other. Sometimes it shifts its seat from the feet into 
the other joints of the upper and lower extremities; and in severe cases 
there is scarcely a joint of the body that does not in its turn feel its effects. 
Although two joints may be affected at the same time, yet it generally hap- 
pens that the attack is only severe in one, passing successively from one to 
another, so that the sufferings of the patient are frequently prolonged to a 
considerable length of time. 344 
THE REFORMED PRACTICE OF MEDICINE. 
At first a gouty attack occurs probably only once in two or three years; 
it then comes on every year, till at length it becomes very frequent, and is 
not only of longer duration, but much severer each succeeding fit. After 
repeated attacks the joints lose their flexibility and strength, and become so 
stiff as essentially to interfere with their performing their accustomed mo- 
tions. On the joints of the fingers little hard swellings or small nodes arise, 
chalky concretions and sores are formed, and both the kidneys and bladder 
occasionally become affected with small stones of a similar nature. Gout 
usually attacks the small joints, and rheumatism the large ones. 
TREATMENT. 
Cold Water.-Cold water has been highly recommended in gout. Hip- 
pocrates says that cold water, freely poured upon gouty swellings of the 
joints, allays the pain, by producing a moderate degree of numbness. 
In one particular, says an author, Dr. Good is rather singular in his 
practice; it is in the use of cold water externally applied. He speaks from 
atrial of several years upon his own person, and is anxious that others should 
participate in what has proved so decisive a comfort to himself. In the 
height of a paroxysm of pain he stripped off the flannel and boldly plunged 
his foot into cold water for four or five times in succession. The appli- 
cation was peculiarly refreshing ; the fiery heat and pain, and all the inflam- 
matory symptoms, diminished instantly; he repeated the cold bathing two 
hours afterward, and continued to do so through the whole of the day ; the 
complaint gradually diminishing upon every repetition, and in twenty-four 
hours the fit completely disappeared, and he was capable of resuming his 
accustomed exercise of walking. For five or six years afterward, in his 
annual attacks he always had immediate recourse to cold immersion or 
affusion. A handful of salt may be added to the water. 
The vapour bath may likewise be used. 
In case the toe, foot, hand, or any other part is much swelled or painful, 
apply a poultice made by simmering bran and vinegar together till a poultice 
of suitable consistence is formed : apply tepid. 
Should this fail to give relief, take equal parts of sicuta, stramonium leaves, 
or leaves of henbane, simmer in good vinegar until soft, then add a sufficient 
quantity of slippery elm bark, pulverized, to form a poultice : apply blood- 
warm ; renew before it becomes dry. 
This will be found an excellent application when other appropriate means 
have been used. One or more of the plants may be used. 
The following means have been advised in the forming stage of the dis- 
ease, in order to moderate or prevent the paroxysm. Emetics, (Chalmers ;) 
active cathartics, (Musgrave;) vegetable bitters, iron, (Grant;) Dover's 
powder, opium, (Fothergill;) large doses of musk or castor, (Williams ;) 
gratiola, (Wolff;) bleeding from the foot, (Gilbert;) the application of 
very cold water to the feet, (Giannini;) the internal use of iced water, 
(Barthez;) &c. 
The following liniment may be applied to the swelling : Take oil of hem- 
lock and spirits of turpentine, one ounce ; gum camphor, one ounce ; alcohol, 
one quart; mix : apply warm. 
Should the pain, swelling, and heat be great, the foot or part affected may 
be steamed over bitter herbs. This generally affords the most sudden and 
permanent relief. The diaphoretic powders may be taken. 
If the foregoing treatment does not cure the complaint, the Botanical drops ERUPTIVE DISEASES. 
345 
may be given, two tea-spoonsful four times a day in a tumbler of prickly-ash 
tea, made either of the bark or berries. 
Poultices.-If the parts are very painful, let a poultice be applied made by 
simmering together elm bark and vinegar. 
A portion of physic should be occasionally taken, and a course of alterative 
medicine, as directed under the head of rheumatism. 
Says the experienced Dr. Heberden : " The most perfect cures of which 
I have been a witness have been effected by a total abstinence from spirits, 
wine, and fiesh, which hath restored the helpless and miserable patients from 
a state worse than death, to active and comfortable life. The great Dr. 
Harvey, as I have been told by some of his relations, upon the first approach 
of gout in his foot, would instantly put it off by plunging the leg into a 
pail of cold water." Sea bathing is excellent, and exercise important. If 
it strikes to the stomach, give the anodyne powders, and excite perspira- 
tion. The wine tincture of colchicum has been highly recommended. 
REGIMEN. 
In the fit, if the patient be young and strong, his diet ought to be thin and 
cooling and his drink of a diluting nature; but where the constitution is 
weak, and the patient has been accustomed to live high, this is not a proper 
time to retrench. In this case he must keep nearly to his usual diet. Wine 
whey is a very proper drink in this case, as it promotes the perspiration with- 
out greatly heating the patient. It is well known that the whole habit may 
be so altered by a proper regimen as quite to eradicate this disease; and 
those only who have sufficient resolution to persist in such a course have 
reason to expect a cure. 
The course which we would recommend for preventing the gout is as 
follows: In the first place, universal temperance. In the next place, suffi- 
cient exercise-labour, sweat, and toil. These only can expel the morbid 
humours. Going early to bed and rising early are also of great importance. 
It is likewise proper to avoid night studies and intense thinking. The sup- 
per should be light and taken early. The use of milk, gradually increased 
till it becomes the principal part of diet, is particularly recommended. 
All strong and fermented liquors, especially wines and punch, are to be 
avoided. 
ERUPTIVE DISEASES. 
CLASS III. 
CHARACTER. 
Most of this class of diseases are characterized by fever, nausea, or vomit- 
ing, and at a particular time numerous and small eruptions appear on the 
skin or surface of the body. Also, most of the diseases of this class are con- 
tagious, and attack a person only once in life. 
All the symptoms exhibited show conclusively that the pathology of fever, 
as advocated in this work, is strictly correct. While the contagious matter 
is in the circulation all the phenomena of fever are observed; but as soon as 
the eruptions, the excitive cause, are thrown to the surface, the fever subsides 346 
THE REFORMED PRACTICE OF MEDICINE. 
and reappears when such humours or eruptions are absorbed, showing in 
the plainest possible manner the nature and cause of fever. 
CHAPTER I. 
SMALL-POX. (Variola.) 
Small-pox is a disease of a very contagious nature, marked by a fever 
which is usually inflammatory, but now and then is of a typhoid nature, 
attended with vomiting, and, upon pressure of the stomach, with pain; 
succeeded after a few days by an eruption of red pimples on different parts 
of the body, which in the course of time suppurate and scab, and at length 
fall off, leaving frequently behind them little pits in the skin, and, in severe 
cases, scars. 
It has been estimated that, before the introduction of vaccination, 450,000 
individuals died annually of small-pox in Europe. 
DESCRIPTION. 
CAUSES. 
Both the distinct and confluent small-pox are produced either by breathing 
air impregnated with the effluvia arising from the bodies of those who labour 
under the disease, or by the introduction of a small quantity of variolous 
matter into the habit by inoculation; and it is probable that the variety of 
the small-pox is not owing to any difference in the contagion, but depends 
on the state of the person to whom it is applied, or on certain circumstances 
concurring with the application of it. On or after the sixth day the infec- 
tion is communicated to another. The period during which infection remains 
latent in the body is from the fifth day to the sixteenth, seventeenth, and 
even the twenty-third. The disease may be communicated from the mother 
to the child. In some cases the body of the child at its birth has been covered 
with pustules, and the nature of the disease has been most satisfactorily 
ascertained by inoculating with matter taken from these pustules. In other 
cases there has been no appearance of the disease at the time of the birth. 
SYMPTOMS. 
Of this disease there are two species, the distinct and confluent. In the 
distinct small-pox the disease begins with an inflammatory fever. It gene- 
rally comes on with some symptoms of a cold stage, and commonly with a 
considerable langour and drowsiness. A hot stage is soon formed, and 
becomes more considerable on the second and third days. During this course 
children are liable to frequent startings from their slumbers ; and adults, if 
they are kept in bed, are disposed to much sweating. On the third day 
children are sometimes affected with one or two epileptic fits. Toward the 
end of the third day the eruption commonly appears, and gradually increases 
during the fourth; appearing first on the face, and successively on the infe- 
rior parts, so as to be completed over the whole body on the fifth day. 
From the third day the fever abates, and by the fifth it entirely ceases. 
The eruption appears at first in small red spots, hardly prominent, but by 
degrees rising into pimples. There are generally but few on the face ; but SMALL-POX. 
347 
even when more numerous they are separate and distinct from one another. 
On the fifth or sixth day a small vesicle or bladder, containing an almost 
colourless fluid, appears on the top of each pimple : for two days these vesicles 
increase in breadth only, and there is a small pit in their middle, so that they 
are not raised to globular pustules or eruptions till the eighth day. These 
pustules, from their first formation, continue to be surrounded with a circu- 
lar inflamed margin, which, when they are numerous, diffuses some inflam- 
mation over the neighbouring skin, so as to give somewhat of a damask-rose 
colour to the spaces between the pustules. 
As the pustules increase in size the face swells considerably, if they are 
numerous on it; and the eyelids particularly are so much swelled that the 
eyes are entirely shut. As the disease proceeds the matter in the pustules 
becomes by degrees, first more opaque or cloudy, then white, and at length 
assumes a yellowish colour. On the eleventh day the swelling of the face 
is abated, and the pustules seem quite full. On the top of each a darker 
spot appears ; and at this place the pustule on the eleventh day, or soon after, 
is spontaneously broken, and a portion of the matter oozes out, in conse- 
quence of which the pustule is shrivelled and subsides ; while the matter 
oozing out dries and forms a crust upon its surface. Sometimes only a little 
of the matter issues out, and what remains in the pustules becomes thick 
and even hard. After some days both the crusts and the hardened pustules 
fall off, leaving the skin which they covered of a brownish red colour; nor 
does it resume its natural colour till many days after. In some cases, where 
the matter of the pustules has been more liquid, the crusts formed by it are 
later in falling off. x 
On the legs and hands the matter is frequently absorbed; so that at the 
height of the disease these pustules appear empty. On the tenth and 
eleventh days, as the swelling of the face subsides, a swelling arises in the 
hands and feet; but which again subsides as the pustules come to maturity. 
When the pustules are numerous on the face upon the sixth or seventh day, 
some uneasiness in the throat, with a hoarseness in the voice, comes on, and 
a thin liquid is poured out from the mouth. These symptoms increase with 
the swelling of the face ; and the liquids of the mouth and throat, becoming 
thicker, are with difficulty thrown out; and there is at the same time some 
difficulty in swallowing, so that liquids taken into the mouth are frequently 
rejected or thrown out by the nose. But all these affections are abated as 
the swelling of the face subsides. 
The more exactly the disease retains the form of the distinct kind, it is 
the safer; and the more completely the disease takes the form of the con- 
fluent kind, it is the more dangerous. It is only when the distinct kind 
shows a great number of pustules on the face, or otherwise, by fever or 
putrescency, approaching to the circumstances of the confluent, that the dis- 
tinct kind is attended with any danger. 
There is not much danger in the mild distinct small-pox, except when the 
patient is extremely loaded, especially about the head and throat. This dis- 
ease sometimes lays the foundation of consumption and obstinate inflamma- 
tion of the eyes, and frequently, by removing complaints that existed before, 
it improves the health and constitution. 
Confluent Species.-In the confluent small-pox all the symptoms above- 
mentioned are much more severe. The eruptive fever particularly is more 
violent, the pulse is more frequent and more contracted. The drowsiness 
is more considerable, and there is frequently a delirium. Vomiting also 
generally attends, especially at the beginning of the disease. In very young 348 
THE REFORMED PRACTICE OF MEDICINE. 
infants epileptic fits are sometimes frequent on the first days of the disease, 
and sometimes prove fatal before any eruption appears; or they usher in a 
very confluent and putrid small-pox. The eruption appears more clearly on 
the third day, and sometimes in clusters like the measles. 
In the confluent species of small-pox the vesicles or eruptions all flow or 
run together, and the whole face and other parts assume a black or crusty 
appearance. The effluvia is very offensive ; and I have seen worms or mag- 
gots crawling in the flesh, and yet the patient has recovered. This disease 
generally terminates favourably under proper treatment, except where the 
subject of it is intemperate, in which case it proves very dangerous or fatal. 
In this kind of small-pox there is often a very considerable putrescency 
of the fluids, as appears from petechia, serous, or watery vesicles, under 
which the skin shows a disposition to gangrene or mortification, and form 
bloody urine or other haemorrhages ; all which symptoms frequently attend 
this disease. In the confluent small-pox also the fever, which had only 
suffered a remission from the eruption to the maturation, at or immediately 
after this period, is frequently renewed again with considerable violence. 
This is wffiat has been called the secondary fever, and is of various duration 
and event. 
In the confluent kind the danger is always very considerable; and the 
more violent and permanent the fever is, the greater the danger; and espe- 
cially in proportion to the increase of the symptoms of putrescency. When 
the putrid disposition is very great, the disease sometimes proves fatal before 
the eighth day ; but in most cases death happens on the eleventh, and some- 
times not till the fourteenth or seventeenth day. Though the small-pox may 
not prove immediately fatal, the more violent kinds are often followed by a 
morbid state of the body, sometimes of very dangerous event. 
TREATMENT. 
Indications of Care.-The object of the physician in this disease, as ought 
to be in every other, should be, to aid the salutary efforts of nature in 
eliminating or expelling the morbific or variolous poison. 
1. If the powers of nature are insufficient to expel it, such medicine must 
be given as will produce this effect. 
2. If, on the other hand, there is too great an excitement in the system, 
or too much fever, it must be moderated. 
3. Counteract a tendency to putrescency. 
When called in the commencement of small-pox, it will be found neces- 
sary to treat it in a considerable degree on general principles, having in view 
at the same time particular symptoms, such as vomiting. For such is the 
similarity between eruptive and febrile diseases, that it is sometimes difficult 
to discriminate between them ; and if the symptoms are ever so well marked, 
a very similar course of treatment is called for in both complaints. Should 
vomiting be predominant, such medicine must be given as will allay the 
irritability of the stomach ; and the best for this will be the bicarbonate of 
potash, or sal ceratus, given as has previously been directed, to be accompa- 
nied with an infusion or tea of spearmint. When this is allayed, administer 
a purgative. After the stomach and bowels have been cleansed, attention 
must be directed to the skin ; such medicine must be given as will produce 
gentle, not profuse, perspiration. This must be kept up moderately through- 
out the whole course of the disease. 
The following infusion may be given : Take of saffron and catnip, equal SMALL-POX. 
349 
parts : make a tea and give it warm. This will soon produce a moisture 
of the skin, and assist nature to expel the eruptions. 
It will be indispensably necessary to immerse the feet in warm ley water, 
to be repeated once or twice daily. 
The surface must be entirely bathed with the same liquid, and repeated 
as often. 
Should the reaction or febrile excitement be too great, it must be mode- 
rated by attention to all the secretions and excretions. Purgatives and 
sudorifics are the principal class of medicines to fulfil this indication. Should 
the heat be great, let the body be bathed with warm water, notwithstanding 
the eruptions. Attention must be paid to particular symptoms, such as 
pains in the head, delirium, sore throat, &c. For pain in the head, in addition 
to bathing the feet, which alone is often sufficient to remove it, let a mustard 
poultice or plaster be applied to the bottom of the feet. The head may 
likewise be bathed with equal parts of rain water, spirits, and vinegar, and 
applied tepid. 
For soreness of the throat, and accumulation of mucus and phlegm in the 
bronchial vessels, give one or two tea-spoonsful of the expectorant tincture, to 
be repeated occasionally. The throat may also be gargled with a decoction of 
equal parts of sage and hyssop, sweetened with honey, and a little borax added. 
When there is a great tendency to putrescency in the fluids, give a wine 
glass of yeast three or four times a day. 
Sometimes there is a sinking or great prostration of strength ; when 
this is the case, wine whey may be given, and buttermilk, moderately acid; 
also quinine or Peruvian bark. 
During the complaint there is great restlessness or pain, want of sleep, &c. 
For such symptoms, as well as to keep up a determination to the surface, 
without increasing the heat of the body, give ten grains of the diaphoretic 
powders, and particularly at bed-time ; at the same time a weak infusion of 
the Virginia snake-root may be given. 
In consequence of debility, it is sometimes the case that the vesicles or 
eruptions are flabby or not well filled, showing evidently that the variolous 
matter is retained in the system. Under such circumstances a more stimu- 
lating course of treatment must be pursued. 
A tea-spoonful of the sweating drops must be given in half a pint of catnip 
tea ; and after giving this, should not the pox become fuller and more healthy, 
give milk punch, to be continued until an improvement is perceptible. 
When the eruptions suddenly subside, or, as it is familiarly expressed, 
strike in-or, in other words, when there is a recession of them before they 
have arrived at maturity-the danger is very great. Should such symptoms 
occur, the same treatment as last mentioned must be promptly and rigidly 
pursued ; in addition to which a tea made of equal parts of saffron and 
snake-root may be freely given. 
The most dangerous period of the small-pox is when a secondary fever 
appears, which generally commences when the disease begins to blacken or 
turn. Most of those who fall victims to the small-pox are carried off by 
this fever, and often, it appears to me, for the want of proper treatment. 
Nature often attempts at the turn of the small-pox to relieve the patient by 
diarrhoea ; and did physicians take this hint, they would know what to pre- 
scribe. We learn from this fact that the secondary fever arises from the 
absorption of the variolous matter, and that there would be little or none 
were nature properly aided in her attempts to carry off the complaint. 
Therefore her kind endeavours must be promoted. When the eruptions are 350 
THE REFORMED PRACTICE OF MEDICINE. 
thrown to the surface and the disease begins to turn, the patient must be 
freely purged; whereas, previous to this period, a cathartic occasionally 
administered is sufficient 
Our common physic is the best preparation that can be given in both species. 
Sometimes infants are affected with convulsions before the eruptions appear. 
There is no occasion for alarm in this case. All that is necessary to be 
done is, to bathe the feet in warm water, and give warm diluent drinks, such 
as balm, mint, or catnip tea, &c. 
This treatment is designed for both the distinct and confluent species. 
The only difference in the treatment is, that in the latter a more active 
course of treatment is called for. 
REGIMEN. 
During the eruptive fever the patient must be kept cool and easy, and 
weak diluting infusions given, such as mint, balm, and catnip tea ; and if the 
patient is very thirsty and the eruption well out, give also lemonade, currant 
jelly, and toast water. 
His nourishment should be barley water, Indian meal gruel, buttermilk and 
water, roasted apples, ripe fruit, and particularly mush or hasty pudding. 
There should be a current of air in the room, but must not be suffered to 
come in direct contact with the patient. The temperature of the room 
should be uniform, neither too hot nor too cold. Great attention ought to be 
paid to cleanliness. As soon as anything passes the bowels it should be 
immediately removed, and vinegar thrown upon a heated brick or other 
substances. The linen and clothes should be often changed, and all noise 
and confusion, as far as possible, prevented. 
Various means have been recommended to prevent the pitting which 
attends the small-pox; such as opening the pustules, and the application of 
lunar caustic ; but it is very questionable whether any benefit arises from 
this practice, or any other of a similar nature. 
Nothing is better to diminish the inflammation and pitting of the face, as 
well as to mitigate the inflammation of the eyes, than a poultice made of the 
superfine flour of the slippery elm. The eruptions, if very large and full of 
matter, attended with great irritation, may be punctured, the fluid let out, 
and sprinkled with the dry flour of slippery elm. 
The above treatment I have found invariably successful in small-pox, 
never having lost a single case where I have been called in any reasonable 
time. It carries the patient safely and shortly through the worst species of 
the disease, while the course pursued by physicians generally, such as 
bleeding, mercury, and cold applications, is attended with the most distress- 
ing or fatal effects. 
CHAPTER II. 
COW-POX, OR VACCINE DISEASE. (Vaccina.) 
It has been demonstrated that the cow-pox or vaccination is in most 
cases an antidote against the small-pox. It either prevents it entirely, or 
modifies the violence of it. When this does not prove to be the case, it is COW-POX-CHICKEN AND SWINE-POX. 
351 
to be presumed the vaccine matter has not been genuine, or has not been 
taken at a proper period ; in all cases where a scar or mark remains after 
vaccination, it may be considered a proof that the matter has made the 
desired impression on the system. It is prudent, however, to vaccinate 
again with cow or small-pox ; and it will generally be found, if the first has 
been genuine, that the pustule forms imperfectly or is spurious. Some have 
supposed that after a term of years cow-pox loses its efficacy, and the system 
again becomes liable to the small-pox ; but there is no satisfactory evi- 
dence of this. 
The following circumstances are deserving of attention in inoculating for 
the cow-pox, and substituting this mild and safe disease for that dangerous 
and pestilential one, the small-pox. 
1. That the matter with which we inoculate be not taken later in the 
disease than the ninth day, and from a healthy person. 
2. That the fluid be perfectly transparent, as it is not to be depended upon 
when it has in any degree become opaque. 
3. That the matter taken should be allowed to dry gradually and thoroughly 
before it is laid by for use, when not employed immediately or in its fluid state. 
4. That the punctures with the besmeared lancet or powdered scab, 
which lasts any length of time, be done as superficially as possible, and only 
one be made in the same arm. 
Here it may not be improper to remark, that the inoculation for this disease 
will not be likely to succeed well if there be any herpetic eruption on the skin. 
If the inflammation of the arm be very great, apply a slippery elm poultice. 
In many instances, as has been already stated, vaccination protects the 
system completely against infection from small-pox contagion. In other cases 
the system is only partially freed from liability to variolous infection. 
CHAPTER III. 
CHICKEN AND SWINE-POX. 
DESCRIPTION. 
These diseases are the same, and differ only in name. 
SYMPTOMS. 
The eruptions make their appearance, in many instances, without any 
previous illness ; in others they are preceded by a slight degree of chilliness, 
lassitude, cough, interrupted sleep, wandering pains, loss of appetite, and a 
febrile disposition for three or four days. Most of the eruptions are of the 
common size of those of the small-pox, but they are not numerous nor con- 
fluent. On the first day they are red, and much resemble in their appearance 
the small-pox. On the second day the red pimples have become small 
vesicles, containing a colourless fluid, but sometimes a yellowish liquor. On 
the third the pustules arrive at full maturity, and in some instances so much 
resemble the small-pox as to be distinguished with difficulty. When the 
little bladder is broken by accident or rubbing, as sometimes happens on the 
first or second day, there forms a thin scab, and the swelling of the other 
part abates without its ever being converted into proper matter, as it is in 
the small-pox. The few which escape being burst have the little drop of 352 
THE REFORMED PRACTICE OF MEDICINE. 
fluid contained in the vesicle at the top of them, turn yellow and thick, and 
it dries into a scab. On the fifth day of the eruption the pustules are 
almost dried and covered with a slight crust, but no mark is left behind 
when this falls off. 
The complaint is usually of so trivial a nature as seldom to require the 
aid of medicine ; but should the febrile symptoms run high previous to the 
appearance of the eruption, or after it has shown itself, it may be advisable 
to give the patient some cooling medicine from time to time ; drinking plen- 
tifully of herb teas, and keeping the bowels open, if necessary, by some 
gentle aperient medicine. 
After the disappearance of the eruption, one or two doses of any mild 
purgative may be administered, with an interval of three or four days 
between each. 
TREATMENT AND REGIMEN. 
CHAPTER IV. 
MEASLES. (Rubeola.) 
DESCRIPTION. 
The measles are known by the appearance of small eruptions, somewhat 
resembling flea-bites, over the face and body, but particularly about the neck 
and breast, not tending to suppuration. Many of these spots soon run into 
each other, and form red streaks or suffusions, larger or smaller, which give 
the skin an inflammatory appearance, and produce a perceptible swelling of 
the face; each spot is raised a little above the surface, especially on the 
face, where they are manifest to the touch ; on the limbs and trunk they form 
only a roughness. 
The disease is highly infectious; often prevails epidemically, however; 
and the constitution that has been once under its influence is seldom liable 
to a second attack. It only happens when the person has at first had a very 
mild or spurious species of measles. It appears ten or fourteen days after 
the infection. 
CAUSES. 
Specific infection or contagious matter received into the constitution. 
Children are more liable to the measles than grown people, and the winter 
is the season of the year when the disease prevails. 
SYMPTOMS. 
The eruption in grown persons is usually preceded by a general uneasi- 
ness, chilliness, shivering, and pain in the head ; but in children a heaviness 
and soreness of the throat, sickness, and vomiting, as in most fevers ; but the 
principal symptoms are, a heaviness about the eyes, with swelling, inflam- 
mation, and a secretion of sharp tears, and great acuteness of sensation, so MEASLES. 
353 
that they cannot bear the light without pain, together with a discharge of 
such serous humour from the nostrils which produces sneezing. The heat 
and other febrile symptoms increase very rapidly; to which succeed a fre- 
quent and dry cough, a stuffing, great oppression, and oftentimes retching to 
vomit, with violent pains in the loins, and sometimes a looseness; at other 
times there is great sweating, the tongue foul and white, the thirst very 
great, and, in general, the fever runs much higher than in the milder sort of 
the regular small-pox. The eruptions appear about the fourth or fifth day, 
and sometimes at the end of the third. On the third or fourth day from 
their first appearance the redness diminishes, the spots dry up, the skin 
peels off, and is replaced by a new one. The symptoms do not disappear on 
the eruption, as in small-pox, except the vomiting; the cough and head- 
ache continue, with the weakness and defluxion of the eyes, and a conside- 
rable degree of fever. On the ninth or eleventh day no trace of redness is 
to be found, but the skin assumes its natural appearance ; yet, without there 
have been some considerable evacuations, either by the skin or by vomiting, 
the patient will hardly recover strength; but the cough will continue, the 
fever return with renewed vigour, and bring on great distress and danger. 
In the more alarming cases spasms of the limbs, lethargy, delirium, or, 
what more frequently happens, twitching of the tendons, supervene. 
In measles, as in other febrile diseases, the symptoms generally suffer some 
remission toward the morning, returning, however, toward the evening with 
increased severity. 
The measles, when violent, are not usually attended with a putrid ten- 
dency ; but it sometimes occurs that such a disposition prevails both in the 
course of the disease and at its termination ; in such cases livid or black 
spots are to be observed interspersed among the eruptions, and these last 
become livid, or assume almost a black colour. Haemorrhages break out 
from different parts of the body, the pulse becomes frequent, feeble, and 
perhaps irregular, universal debility ensues, and the patient is destroyed. 
TREATMENT. 
Indications of Cure.-1. It is our duty in this disease, as well as in small- 
pox, to assist nature in expelling the eruption, if her efforts be too feeble; 
and when they are too violent, they must be moderated by suitable eva- 
cuations. 
2. The attention must be directed to urgent and particular symptoms, 
such as cough, restlessness, difficulty of breathing, &c. 
The greatest danger in the treatment of measles, as well as in most other 
diseases, consists in doing too much by improper and untimely interference, 
and thus taking the business out of the hands of nature, and trusting it to the 
danger and uncertainty of art. The measles being usually attended with 
great inflammation, it is often the first business of the physician to moderate 
it; to effect which, the same means must be pursued as recommended under 
the head of small-pox. The first step to be taken will be, to immerse the 
feet in warm ley water, and bathe the surface with the same once or twice 
a day, according to the urgency of the symptoms, until the eruptions appear : 
this will relieve the head and facilitate the appearance of the eruptions. 
The following infusion should be given as early as possible: Take saffron, 
two parts ; Virginia snake-root, one part; make a tea, sweeten, and give 
warm; to be repeated, and as much drank as the stomach will bear. 
This infusion, with the means recommended above will lessen the distress- 354 
THE REFORMED PRACTICE OF MEDICINE. 
ing and urgent symptoms attendant on the forming stage, by diminishing 
excessive inflammation, as well as aiding the expulsion of the eruptions. 
If, from debility, cold, or any other cause, the eruptions should only par- 
tially appear-or, after their appearance, should there be a recession of 
them-in addition to these means give sudorific drops or diaphoretic powders, 
warm milk punch, &c. ; and should not this be sufficient, use the warm bath. 
When they have made their appearance on the surface, and assume a 
healthy appearance, very little medicine is necessary. In this complaint the 
eyes are generally very much affected ; when this is the case they may be 
washed with the mucilage of slippery elm bark and borax water. 
There are also pulmonary symptoms in measles, which prove very dis- 
tressing to the patient. When there is difficulty of respiration, from the 
accumulation of mucus, give a dose of the expectorant tincture, sufficient to 
dislodge it, to be repeated on the return of the symptoms ; in addition to 
which a tea of catnip and hoarhound may be given. 
Should the pain of the head be very great, with delirium or convulsions, 
continue to bathe the feet often, and apply the mustard paste to them. 
There is usually considerable febrile excitement, restlessness, and pain. 
For these symptoms, as well as to keep up a continual moisture of the skin, 
give a dose (according to the age of the person) of the diaphoretic powders 
every night at bed-time. 
Should nausea or vomiting prevail, let mint tea and bicarbonate of potash 
be given. 
It is of the greatest importance in measles to attend to the bowels. In 
the first stages of this disease a purgative should be given, and repeated ac- 
cording to the violence of the disease and inflammation. If the excitement 
is very great, a moderate dose of physic may be given every day-but in 
general every two or three days will be sufficient-till the eruptions have 
fully appeared, when it may be necessary to repeat them oftener, in order to 
prevent any morbific matter which may have been retained in the system 
from being thrown upon some organ, and thus causing subsequent diseases, 
such as inflammation of the eyes, dropsy, consumption, &c. The following 
purgative, under these circumstances, may be given: Take best senna and 
manna, a large tea-spoonful of each ; add half a pint of boiling water ; 
when cool strain it, and add a tea-spoonful of cream of tartar; sweeten. For 
a child two years old give a large table-spoonful every two hours until it acts 
upon the bowels : this purgative may be occasionally repeated. 
Should any disease remain after the measles have disappeared, let it be 
treated the same as if arising from other causes. If great debility of the system 
should take place, denoting a tendency to putrescency, give yeast, mixed with 
a little milk and molasses, three or four times a day ; give also wine sling or 
sangoree, warm, with plenty of nutmeg grated into it. 
Should there be looseness, treat it as laid down under the head of that 
complaint. 
REGIMEN. 
Panado, gruel, ripe fruits, currant jelly, &c., may be taken. The patient 
may drink barley, toast water, buttermilk whey, &c. The room should 
be well ventilated, clean, and of a moderate temperature, and the clothes 
often changed. Patients'recovering from the measles should be careful 
about their diet; their food for some time ought to be light, and in small 
quantities. DROPSY OF THE HEAD OR BRAIN. 
355 
This treatment will carry the patient safely through the disease ; while the 
opposite course, bleeding, mercury, &c., will cause such debility or putres- 
cency in the fluids as to protract the complaint, harass and distress the 
patient, if not prove fatal. 
DROPSICAL DISEASES. 
CLASS IV. 
CHARACTER. 
In this class of diseases there is a preternatural or morbid collection, con- 
sisting of a serous fluid in the cellular membrane in the organs, and the 
circumscribed cavities of the body, impeding or preventing the functions of 
life. This accumulation receives different names, according to the particular 
parts in which it is lodged. When it is deposited in the cranium or brain, it 
is called hydrocephalus ; when it is deposited in the chest, it is called hydro- 
thorax ; when in the cavity or the abdomen, it is denominated ascites; 
when in the scrotum, hydrocele ; when in the ovarium, ascites ovarii; when 
in the uterus, hydromet ra ; when it is diffused through the cellular membrane, 
it is called anasarca. 
Diminished absorption and increased effusion, or both united, may be 
considered as the proximate cause of the different species of dropsy. 
CHAPTER I. 
DROPSY OF THE HEAD OR BRAIN. (Hydrocephalus.) 
DESCRIPTION. 
By dropsy of the head we understand a collection of water either between 
the membranes of the brain or in the ventricles. It is divided into two 
species, internal and external. Internal, when the fluid is collected within 
the ventricles of the brain ; external, when it is collected between the mem- 
branes of the brain. In this latter case it is usually of a chronic nature, 
and water has been known to increase to an enormous quantity, swelling the 
head to a prodigious size ; widely separating the bones of the head, and 
sometimes causing an absorption of the brain. 
Pain in the head, particularly across the brow, stupor, dilatation of the 
pupils, nausea, vomiting, preternatural slowness of the pulse, and convul- 
sions are the symptoms of this disease. 
Dropsy of the head is almost peculiar to children, being rarely known to 
extend beyond the age of twelve or fourteen; and it seems more frequently 
to arise in those of a scrofulous habit than in others. It is a complaint which 
has been observed to pervade families, affecting all, or the greater part, of 
the children at a certain period of their life ; which seems to show that in 
many cases it depends more on the general habit than on any local affection 
or accidental cause. 356 
THE REFORMED PRACTICE OF MEDICINE 
CAUSES. 
The immediate cause of every kind of dropsy is such a state of the parts 
as makes the exhalent arteries throw out a greater quantity of fluids than 
the absorbents can take up, which causes an overflow or collection of 
serum or water in the cavities of the body: this state consists in debility. 
The dropsy of the head is, in some instances, the consequence of conges- 
tion or slight inflammation of the brain, or general debility. 
A morbid state of the stomach and bowels has been supposed by some to 
be a predisposing cause; but of all the causes which contribute to the pro- 
duction of this disease, cold plays the most conspicuous part. 
SYMPTOMS. 
The symptoms are those which more unequivocally direct attention to the 
head as the seat of disease. They are, headache, sometimes diffused, some- 
times referred to a particular spot; impatience of light and noise, a flushed 
countenance, preternatural redness of the eyes, contracted pupil, tossing the 
arms to the head, and occasionally screaming or shrieking without any obvious 
cause. With these are joined the common symptoms of infantile fever, and 
they denote acute inflammatory action of the vessels of the brain. 
As the disease progresses, the pulse, before quick, becomes slow, inter- 
mitting, or irregular ; the pupils are permanently dilated, and cease to con- 
tract on the approach of light. There is squinting. Instead of being rest- 
less, and tossing about his arms, the child falls into a state of stupor, and is 
insensible to things and persons around him. The screaming fits occur more 
frequently, and there is an almost constant moaning. The child will often 
vomit on being brought into an erect posture. Any sudden exertion brings 
on a fit of convulsion, in which the child dies. 
If the child survives this stage, it is occasionally found that after a time 
the pulse again rises, so as to beat 150 or more in a minute, and is withal 
small and feeble. The child lies perfectly insensible, and takes nourishment 
from actual inability to swallow. The stools and urine pass involuntarily ; 
the face is pale ; the tongue dry and brown; convulsions or partial paralysis 
occur ; occasionally one side becomes perfectly paralytic. Severe inflamma- 
tion of the eyes is sometimes witnessed. The immediate approach of death 
is often preceded by gangrenous spots, appearing particularly about the neck, 
hips, or tips of the ears. 
The first stage is sometimes wanting, the attack being sudden, and perhaps 
the first evidence of the disease a strong convulsive fit. In many instances 
the pulse never becomes slow. Occasionally there is neither permanent 
contraction nor dilatation of the pupil. The pupil of the eye dilates on the 
approach of the candle, and contracts as it recedes. In a few cases children 
continue sensible to the last moment. Aberration of intellect can scarcely 
be said to occur in this, nor indeed in any of the diseases of early life. 
The duration of the complaint is liable to almost as much variation as the 
symptoms which characterize it. It has been known to prove fatal in a 
week ;' some cases run on even as long as two months, but these are com- 
paratively rare. The average duration of the complaint may be stated to 
be three weeks. 
The extremities are cold, showing a determination to the head, or an un- 
equal circulation; and in some cases there is costiveness in the commence- 
ment of the complaint. There is in others, particularly when the attack is DROPSY OF THE HEAD OR BRAIN. 
357 
very violent, free purging. There is also generally great heat or inflamma- 
tion of the head, and this may be the principal cause of the disease. 
The commencement of the disease is often very mild ; but the symptoms 
which strongly characterize a collection of water in or on the brain, and 
distinguish it from other diseases, are, the heat and excruciating pain in the 
head, an intolerance of light, followed by squinting, throwing the head back 
and the arms to the head, dilated pupils, and profound stupor and vomiting. 
At first the pulse is very quick, afterward slow and irregular ; fever and urine 
scanty; sometimes the first symptom of illness is sudden puking and 
purging, in which case it generally proves fatal suddenly. 
SECTION I. 
CHRONIC FORM OF THE DISEASE. 
Sometimes this disease is congenital, but more usually it begins during the 
first month. In consequence of the bones of the cranium giving way, the 
usual symptoms of compression do not come on. The size which the head 
attains in this disease is often enormous. In the progress of the disease the 
functions of the body generally are very little, often not at all, impaired till 
a short time before death. It is almost incredible how little the powers of 
the mind are affected by this disorder. Dr. Monro states, that in no instance 
seen by him could it be said that the intellect was deranged. In one re- 
markable case, of twenty-six years' duration, in which the head measured 
forty-four inches in circumference, the patient displayed a very affectionate 
disposition toward his parents, entered into the amusements of his brothers 
and sisters, and enjoyed a tolerably retentive memory. Attempts have been 
made to afford relief to this apparently hopeless state of disease by tapping: 
more recent observations have shown that the risk from this operation is 
great, and that it is not generally to be recommended. Very little can be 
done in this form of the disease. 
TREATMENT. 
Indications of Cure.-1. The indication of cure in this disease is, to 
lessen the inflammatory action, by equalizing the circulation, and thus pre- 
venting a serous effusion. 
2. When water has been collected, to evacuate it through the medium of 
the absorbents, by stimulating them to a healthy action. 
From the nature of this complaint it is evident that it becomes more diffi- 
cult to remove than most of others. By prompt and suitable measures it 
may often be successfully treated. 
When the disease is marked by inflammation, the first steps to be taken 
are, to use such means as are calculated to subdue it. General bleeding is 
resorted to by physicians usually ; but with what propriety I am unable to 
determine. It may exasperate or irritate the disease, but can never effect 
a cure. 
The usual effect of blood-letting, viz., that of debility or prostration, is 
sensibly experienced in hydrocephalus, and that, too, without at all lessening 
arterial action. 
To reduce the inflammation, our reliance must be placed upon more appro- 358 
THE REFORMED PRACTICE OF MEDICINE 
priate means; and such, in general, must be resorted to as have been laid 
down under the head of other inflammatory complaints, in order to divert 
the blood from the head, and recall it to the extremities and the surface. Let 
the feet and legs be immersed in warm ley water, and rubbed with flannel or 
muslin. Bathe the surface with the same ; both of which processes must 
be often repeated, or according to the urgency of the symptoms. 
Great reliance in the treatment of this disease must be placed upon pur- 
gatives ; and such as act equally through the whole alimentary canal. Our 
common purgative, combined with cream of tartar, answers well for this pur- 
pose. About equal parts of the two articles may be combined, and given in 
any suitable vehicle. 
It is difficult to lay down any precise rule for the repetition of purgatives, 
as this depends upon the violence of the disease, constitution, &c-; but, as a 
general rule in severe attacks, they may be given daily, and in protracted 
cases every two or three days. In most cases immediate amendment 
follows their administration, either when there is inflammation ox serous 
effusion. 
It is indispensably necessary in this, as in most other diseases, to pay strict 
attention to the capillary system. Such medicines must be given, and such 
means taken, as are calculated to promote perspiration. In addition to bathing 
the feet and surface, mentioned above, sudorific medicines may be given. 
For this purpose give the sudorific or sweating drops in doses according to 
the age of the child, to be accompanied with free use of the infusion of 
spearmint, (mentha saliva ;) the same tea or infusion to be given when the 
child is thirsty. This plant has a threefold effect upon the system; First, 
it allays the irritability of the stomach ; Second, it promotes gentle perspira- 
tion ; Third, it promotes a preternatural discharge of urine. 
Should the sweating drops prove too stimulating, and thus increase the febrile 
excitement, substitute the diaphoretic powders ; and give particularly at night, 
to allay irritation, procure rest, promote perspiration, &c. 
Should all these means fail of producing perspiration, which, from the 
dry and constricted state of the skin, may occasionally be the case, let the 
child be held in the arms of its mother or nurse, and a blanket thrown around 
it, and let both be placed over a tub containing a strong decoction of bitter 
herbs. The steam must be permitted gradually to come in contact with the 
body of the child; after which let it be "wrapped in a blanket and placed 
in a bed or cradle. If benefit is experienced from this process, let it be 
repeated. 
In almost every case of hydrocephalus there is great heat or inflammation 
of the head; and, therefore, it is necessary to apply refrigerant or cooling 
lotions or applications to it. Equal parts of spirits, rain water, and vinegar, 
to which a little salt has been added, may be often applied to the head, tepid. 
I have applied it cold and sometimes warm ; and when I have ascertained 
which has afforded the most relief, I have continued it of the same tem- 
perature. 
Should this only partially relieve, or should it lose its efficacy after fre- 
quent application, let it be omitted, and apply hops, simmered with vinegar, 
to the whole head. Great benefit is invariably experienced by these ap- 
plications. The child, after great restlessness and pain, will generally fall 
asleep immediately on applying them. Camphorated spirits will also very 
good to apply. 
In some cases, where the disease has been of an unusual obstinate cha- 
racter, resisting the ordinary remedies of this nature, I have applied, with DROPSY OF THE HEAD OR BRAIN. 
359 
decided benefit, a poultice of slippery elm bark over the whole head, to be 
removed before it becomes dry. 
Care must be taken, in making these applications, that there be not too 
speedy an evaporation. The head must be covered with a cap or handker- 
chief. 
I have administered, and, as far as I have able to ascertain, with great 
advantage, the plant of fox glove or digitalis. To one-half a tea-spoonful of 
the dry herb add one gill of boiling water; let it stand till cold. To a child 
one or two years of age give an ordinary tea-spoonful every two hours during 
the day, in a table-spoonful of parsley tea ; it promotes a discharge of urine, 
and also allays irritation. Purgatives may be given in the morning, if neces- 
sary ; and, if much pain, the diaphoretic powders at night. 
Mustard plasters sufficiently strong to excite a little redness, must be kept 
to the feet; after which let them be applied between the shoulders, and 
thus changed alternately. 
The great object in this complaint is, to subdue inflammation and promote 
absorption of the serum or water; to accomplish which, purgatives and 
diuretics are principally to be relied upon. Emetics, in some stages of the 
disease, might be given beneficially. Cases which appeared almost hopeless, 
have recovered under the treatment here laid down. 
Cupping has been highly spoken of by some in this disease. A physi- 
cian of this city became very celebrated, some years ago, for the cure of 
dropsy of the head, and his principal reliance was upon this operation. 1 
have occasionally tried it in the worst or most desperate cases, but 1 am not 
clearly convinced how far it is beneficial. In one case which was given up 
as incurable, and one of the worst I ever saw, as a last alternative, 1 ordered 
the child to be cupped. It appeared to mitigate all the pain, the child fell 
asleep, and soon recovered. It might be resorted to, should all other means 
fail. The cups should be placed upon the temples and nape of the neck. 
Dr. Vere, of this city, a skilful physician of the reformed school of medi- 
cine, states that he cured a case of dropsy of the head by giving a tea of the 
(apocynum cannabinum', bitter root or milk weed every two hours during the 
day, as much as the stomach would bear. It acted as a diuretic and laxative, 
and caused nausea. 
The head was fomented with the following until the pain abated: Take 
of wormwood, two ounces ; mullein and hops, two ounces each ; stramonium, 
one ounce ; mix, and add water and vinegar; after which the saline wash, 
with the addition of tincture of stramonium, was freely used four or five times 
a day. 
At first one dose of anti-bilious physic was given; after which, to change the 
secretions, the neutralizing physic was administered. 
Whenever fever was present the child was bathed with the ley water, 
and sinapisms of garlic applied to the feet; the latter always when there 
was pain in the head. 
There were some pneumonic symptoms present, for which equal parts of 
the wine tincture of lobelia and ipecacuanha were given. When fever was 
present, a tea made of amaranthus or crawley, eight parts, sweet spirits of 
nitre, one part, was administered. As a common drink throughout the dis- 
ease, amaranthus, four ounces, and infused in boiling water, to which cream 
of tartar, half a drachm, was added. 
The child was about four years of age, and by this treatment recovered in 
about three weeks. 360 
THE REFORMED PRACTICE OF MEDICINE. 
REGIMEN. 
It is very necessary that tjie room should be kept quiet and somewhat 
darkened. For nourishment give arrow-root tea, milk, panado, &c. 
When nourishment cannot be taken by the mouth, it may be given by the 
way of injection. By this treatment we have cured many cases of this dis- 
ease which appeared beyond the control of medicine. 
CHAPTER II. 
DROPSY OF THE ABDOMEN OR BELLY. {Ascites.) 
DESCRIPTION. 
By this species of dropsy we understand a collection of water in the cavity 
of the abdomen. The water is generally collected in the sac of the peri- 
tonaeum or general cavity of the abdomen. Sometimes it is found without 
the peritonaeum, and between this and the abdominal viscera. Sometimes 
the water is contained in sacs, and connected writh some of the viscera. It 
is then called encysted dropsy. 
CAUSES. 
A preternatural collection of serous fluid, whether in the cellular mem- 
brane or in the cavities of the body, is caused by absorption falling short of 
exhalation in these cells and cavities ; and this effect may be produced either 
by increased effusion from the exhalant arteries, or from diminished action 
of the absorbents. Absorption is increased, although not in proportion to 
the exhalation ; and, therefore, the cause of dropsy is in the exhalant 
vessels, which pour out more serum or water than the absorbents take up, 
and thus collects and forms dropsy. 
Increased effusion from the exhalants may arise, 
1. From their relaxation, which may be occasioned by fevers, con- 
tinued grief, excessive evacuations of any kind, the several species of in- 
temperance, indolence and inactivity, or by drinking only stagnant or cold 
water when heated. 
2. From superabundance of serum in the blood, which may be occasioned 
by the above-mentioned causes ; by a penurious diet, profuse haemorrhage 
and repeated bleeding, weakened powers of digestion, interruption of the 
watery excretions, jaundice, &c. 
SYMPTOMS. 
This variety of dropsy is often preceded by loss of appetite, sluggishness, 
dryness of the skin, oppression at the chest, cough, diminution of the natural 
discharge of urine, and costiveness. Shortly after the appearance of these 
symptoms an enlargement in the abdomen is perceived, which extends gra- 
dually, and keeps on increasing until the whole belly becomes at length uniform- 
ly swelled and tense. The distension varies according to the posture of the 
body, the weight being felt the most on that side on which the patient lies ; 
while at the same time the distention becomes somewhat less on the opposite DROPSY OF THE ABDOMEN OR BELLY. 
361 
side. In general the practitioner may be sensible of the fluctuation of the 
water, by applying his left hand on one side of the abdomen, and then passing 
on the other side with his right: in some cases it will be obvious to the ear. 
As the collection of water increases, the difficulty of breathing is much in- 
creased ; the countenance exhibits a pale and bloated appearance ; im- 
moderate thirst; the skin is dry and parched ; and the urine is very scanty, 
thick, high coloured, and deposites a sediment. With respect to the pulse, 
it is variable, being sometimes considerably quickened, and at other times 
slower than natural. The principal difficulty which prevails in ascites is, 
the being able to distinguish with certainty when the water is in the cavity 
of the abdomen, or when it is in the different states of encysted dropsy, or 
when the water is contained in small bags or cysts. When the water is in 
separate cysts, the bowels feel heavier, and it is very difficult to carry it off 
by promoting a discharge of urine. 
The encysted form of the disease is more difficult to cure, though its pro- 
gress to a fatal termination is generally very slow ; and the peritoneal dropsy 
is mostly very obstinate, depending usually on organic disease in the liver or 
other abdominal organs. If the swelling from the beginning is equally dif- 
fused over the whole belly, the probability is strong in favour of the water 
being contained in the cavity of the abdomen. But if at its commencement 
the tumour and tension appear in one part of the belly more than another, 
we have much reason to suspect an encysted dropsy. 
It is often extremely difficult to distinguish between a dropsy of the belly 
and a state of pregnancy. When deception is intended, the most skilful phy- 
sician, with all his care and attention, is liable to suffer imposition, and on 
certain occasions the character both of the physician and his patient may es- 
sentially depend on a correct decision. " Dreadful to relate !" says Dr. Parr, 
" the trocar has more than once within our own observation, happily not by 
our direction, been plunged into a pregnant uterus." Dr. Good relates the 
following singular incident: " If dropsy occurs at a period of life when the ca- 
tamenia are on the point of naturally taking their leave, and where the patient 
has been married for many years without ever having been impregnated, it is 
not always easy, from the collateral signs, to distinguish between the two. A 
lady under these circumstances was a few years ago attended for several 
months by three or four of the most celebrated physicians of this metropolis, 
one of whom was a practitioner in midwifery, and concurred with the rest in 
affirming that her disease was an encysted tumour of the abdomen. She was 
in consequence put under a very active series of different evacuants ; afresh 
plan being had recourse to as soon as a preceding had failed. She was suc- 
cessively purged, blistered, salivated, treated with powerful diuretics, and 
the warm bath, but equally to no purpose ; for the swelling still increased 
and became firmer ; the face and general form were emaciated, the breathing 
was laborious, the discharge of urine small, and the appetite intractable ; till 
at length these threatening symptoms were followed by a succession of sud- 
den and excruciating pains, that by the domestics, who were not prepared for 
their appearance, were supposed to be the forerunners of a speedy dissolu- 
tion, but which fortunately terminated, before the arrival of a single medical 
attendant, in giving birth to an infant, that, like its mother, had wonderfully 
withstood the whole of the preceding medical warfare without injury. 
TREATMENT. 
Indications of Cure.-1. Evacuate the water. 362 
THE REFORMED PRACTICE OF MEDICINE. 
2. Prevent the reaccumulation, by restoring the tone of the system. 
To answer the first indication, give the 
Compound Powder of Jalap. 
This purgative evacuates the water very copiously, lessening the tension 
and swelling of the abdomen. Let it be repeated two or three times a week. 
It generally has the most signal and immediate good effect. 
The next preparation to be given will be the following: Take queen of 
the meadow, (spirea ulmaria,} one ounce; milk weed, (asclepias syriaca,} 
two ounces; juniper berries, (bace.jump.,} two ounces ; horse-radish root, 
(raph. rusticanus,} one ounce; white mustard seed, (sinapis alba.,} half an 
ounce; prickly-ash bark, (zanthox. fraxin.,} two ounces. Bruise all these 
articles separately, then mix. To the powder add one gallon of sound cider ; 
give a wine glass four or five times a day, or as much and as often as the 
stomach will bear. This will stimulate the kidneys and promote a free dis- 
charge of urine, and thus aid in evacuating the watery fluid. This medicine 
should be continued daily, if it agrees with the patient. 
After the continuance of this treatment, should it only partially remove 
the complaint, give the hydragogue tincture, made as follows: Take elder 
bark, (cortex sambucus,} one pound, if green ; if dry, half a pound ; add one 
gallon of white or Lisbon wine ; simmer an hour ; strain and bottle; dose, 
a wine glass three times a day. This is a very valuable diuretic, and I have 
found it very successful in the treatment of this disease. It has cured many 
Cases without the aid of any other medicine. While the patient is taking 
this tincture, let him drink freely of a decoction made of the roots of the 
vaccinium, commonly called whortleberry. Let the root be dry and properly 
cleaned, cut fine, and bruised. Then add sufficient boiling water to make a 
strong decoction. This may be taken freely through the day, or the berries 
in Holland gin will answer. 
Should the disease, from any cause whatever, still remain intractable 
after the above treatment, then administer in a little syrup, or tea sweetened, 
the euphorbia ipecacuanha fifteen or twenty grains or a small tea-spoonful 
at a dose; it sometimes vomits, and almost invariably purges, producing 
copious watery passages; it acts in a peculiarly favourable manner in all 
dropsical diseases. This alone has removed the dropsy; but a medicine 
which cures one person will not always produce the same effect on another : 
it therefore becomes necessary to resort to various agents. If the preceding 
treatment fails, the patient may take an emetic once or twice a week, and be 
steamed over bitter herbs, or take the vapour bath. The following may be 
taken at the same time : Take Indian turnip or bitter root, one ounce ; add 
one quart of boiling water ; evaporate to one pint; take a table-spoonful 
three or four times a day. This tea alone evacuated several gallons of water 
from Aiderman Scot in two or three days, and he has been comfortable for 
several years since ; occasionally from cold there is a little affection of water, 
but the same infusion removes it. A similar course to that just named cured a 
patient of mine who had used many other means without effect. Perspiration 
often aids much in the cure. The patient may be placed over a tub of bitter 
herbs, as directed under the head of vapour bath, and continued fifteen or 
twenty minutes, or until perspiration is produced. Let him be removed to 
the bed ; and, if sweating takes place only partially, let a tea-spoonful of the 
sudorific or sweating drops be given in a tumbler of catnip tea; and some- 
times it becomes necessary to apply two or three heated bricks to the sides DROPSY OF THE ABDOMEN OR BELLY. 
363 
and legs; they should be covered with muslin that has been wet in vine- 
gar, to increase the heat or vapour. 
This process or operation must be repeated twice a week, being as often 
as the euphorbia is administered; or once a week will answer in protracted 
cases. The abdomen should be supported by proper bandages. 
When the water is partially evacuated, or nearly so, a reaccumulation of 
it must be prevented, by giving two or three capsicum pills morning, noon, 
and night. 
The restorative wine bitters should also be given as a tonic, to keep up the 
strength of the patient, create an appetite, &c. 
The spirits of spearmint and a decoction of the queen of the meadow, 
aided by whortleberries and gin, cured Mrs. of a dropsy. 
It is the practice to tap the patient, and draw off the water when the 
accumulation has become very great; but the operation is attended with 
only temporary benefit, and indeed the fluid appears to collect much faster 
after it has been drawn off than before, which precludes all hope of recovery. 
In one case, where I was called too late to cure the disease, the person 
having an organic complaint of the uterus, and had the water often drawn 
off, I repeated the operation and took from her five gallons of serous fluid. 
A strong decoction of male fern root and blue flag root, equal parts, taken 
freely, cured a very bad case, for which fifty dollars was paid. A little wine 
was taken during the treatment, as a tonic. 
Dr. Heberden, an ancient but a very experienced author, gives his treat- 
ment for dropsy as follows : " I begin with one, two, or three grains of elate- 
rium in one spoonful of brandy. If the first dose does not evacuate much 
of the water without too much disturbance, it may be repeated twice a week 
till the water is discharged. In the intermediate days give some cordial 
bitters. These active purges cannot always be borne, when milder ones 
should be used. Give pulverized squills, from one grain upward, one drachm 
of sal diureticus ; wintergreen, parsley, and other herbs possessed of diuretic 
properties, may be taken." 
Saratoga waters have proved beneficial in some cases of dropsy. Man- 
drake physic may occasionally be given. I cured a very obstinate and dis- 
tressing case of the whole system on a child, effects of scarlet fever, by this 
purgative. 
Dr. Henry states, in his Medical Herbal, that he was instrumental in curing 
a woman in two weeks, who had been troubled with the dropsy for twelve 
years, by the following decoction: Boil one ounce of the seneka or rattle-snake 
root in a quart of water till the latter is reduced to half a pint. " I first ordered 
a puke, and the next day a table-spoonful of the decoction every hour till she 
had taken the whole, which operated both by stool and urine. I then ordered 
tonic medicines, and in two weeks her husband called on me with the infor- 
mation of his wife's perfect recovery, which was dropsy of the abdomen." 
Henry farther remarks, " I have also cured the croup or hives with this 
decoction, first giving an emetic, and then ordering a tea-cupful of the tea of 
the root every two hours, which raised a powerful perspiration. I can 
recommend it in all fevers." 
The following formula has been given to me as a remedy for the dropsy, 
but I am not prepared to speak of its effect, never having tried it; but, from 
the component parts or ingredients of which it is composed, I think that it 
it may prove very beneficial : 
Take mustard, half an ounce ; juniper berries, one ounce ; milk weed root, 
one ounce ; horse-radish root, one ounce; black alder bark, one ounce; 364 
THE REFORMED PRACTICE OF MEDICINE. 
mandrake root, one ounce ; dwarf elder root or bark, one ounce ; bitter sweet 
bark, from the root, one ounce : pound or bruise all, and add one gallon of 
hard cider. One wine glass to be taken three or four times a day on an 
empty stomach. 
" The best two medicines," says Sydenham, " for such as are hard to 
purge are, elaterium or wild cucumber, and the infusion of crocus metallorum, 
red sulphuret of antimony. They operate powerfully in a small quantity, and 
carry off abundance of foul and watery humours; dose of the infusion from 
one and a half to two ounces, and repeated daily, as the strength will bear : it 
usually vomits and purges. Of the elaterium two grains are a dose. In one 
case the first medicine evacuated a gallon of water every day, and soon re- 
duced the swelling one yard by measurement." He adds, " there is another 
pretty common and simple medicine, which cures the dropsy in the same 
manner as the emetic. It is made by boiling three handsful of the inner bark 
of elder in a quart of milk and water, to one pint: half of which is to be taken 
morning and night, every day till cured." In weak constitutions give 
diuretics : Take one pound of the ashes of brooms, infuse in two quarts of 
Rhenist wine, with a handful of wormwood; give four ounces of the bittered 
liquor morning, noon, and night. 
REGIMEN. 
Stimulating diet is required in every species of dropsy. Mustard, horse- 
radish, red pepper, &c., may be freely taken with food. It usually requires 
only a part of the remedies here recommended. But should the treatment 
fail, it will probably depend upon an organic affection of some of the organs 
implicated in the complaint. 
CHAPTER III. 
DROPSY OF THE CHEST. (Hydrothorax.) 
DESCRIPTION. 
By this disease we understand a collection of water in the pericardium, a 
membrane which surrounds the heart, or in the cavities of the thorax. Some- 
times it is diffused in the cellular texture of the lungs without being deposited 
in the cavity of the thorax. Occasionally the water is enveloped in small 
cysts of a membranous nature, known by the name of hydatids, which 
apparently float in the cavity, but generally are connected with, and at- 
tached to, particular parts of the internal surface of the pleura, a membrane 
lining the chest. 
CAUSES. 
The causes which give rise to the disease are much the same as those 
which produce other species of dropsy. In some cases it exists without 
any other kind of dropsical affection ; but it very often prevails as a part of 
more universal dropsy. 
Bleeding and mercury may be reckoned among the most common causes 
of this complaint, by the debility and effusion they occasion. Also inflamma- DROPSY OF THE CHEST. 
365 
tion of the lungs, liver, or any other neighbouring organ. Malt liquors, 
ardent spirits, and whatever tends to produce debility or serous effusion, may 
cause it. 
SYMPTOMS. 
Hydrothorax or dropsy of the chest often comes on with a sense of un- 
easiness at the lower end of the sternum or breast-bone, accompanied by a 
difficulty of breathing, which is much increased by any exertion or motion, 
and is always most considerable during night, when the body is in a 
horizontal posture. With these symptoms there is a cough that is at first 
dry, but which after a time is attended with an expectoration of thin mucus. 
There is likewise a paleness of the complexion, and an anasarcous swelling 
of the feet and legs, together with a considerable degree of thirst and a di- 
minished flow of urine; occasionally the face swells and pits upon pressure, 
especially in the morning ; anddhese signs of the disease are accompanied by 
debility and loss of flesh. Under these appearances we have just ground to 
suspect that there is a collection of water in the chest. The symptoms 
which have been described gradually increase, but their progress is slow, and 
a considerable time elapses before the disorder is fully formed. 
The difficulty of breathing at length becomes excessive : the patient can 
seldom remain in a recumbent posture for any length of time, and the head and 
upper part of the trunk must be supported almost erect. The sleep is fre- 
quently interrupted on a sudden by alarming dreams, out of which the patient 
quickly starts up in bed, with a sense of impending suffocation. Convulsive 
efforts of the muscles subservient to respiration, resembling an attack of spas- 
modic asthma, with violent palpitations of the heart, generally accompany the 
paroxysms, which are also frequently excited by the most trifling voluntary 
motion, or by a fit of coughing. 
When afflicted with these distressing symptoms, the patient is under the 
necessity of continuing erect, with his mouth open, and he betrays the utmost 
anxiety for fresh air. His face and extremities are cold ; the pulse, with 
little exception, is feeble, irregular, and intermits in a degree seldom expe- 
rienced in other disorders ; and a pain or sensation of numbness frequently 
extends itself from the heart toward the insertion of the deltoid muscle of 
one or both arms. Excepting a livid hue of the lips and cheeks, the coun- 
tenance is pale, and indicates a peculiar anxiety and ghastliness of appearance, 
and, together with the upper parts of the body, is usually covered with a 
profuse clammy sweat. Drowsiness, coma, or delirium, occasioned by the 
difficult transmission of the blood through the lungs and want of sleep, 
frequently attend the latter periods of hydrothorax, and from the same cause 
the expectoration is sometimes bloody. Nowand then a sensation of water 
floating about can be distinctly perceived by the patient on any sudden 
change of posture. The urine is generally scanty and very high coloured, 
like brandy or beer- There is a sense of tightness or stricture across the 
chest. 
Palpitation of the heart, irregularity and intermission of the pulse, maybe 
regarded as among the. most frequent attendants on hydrothorax. But these 
symptoms are much varied in different cases ; and we know that in some 
instances they are not present. 
The patient sometimes observes that he has a sensation as if water were 
contained in the chest, passing from one side to the other in turning, or as 
if the heart were moving in a fluid. 366 
THE REFORMED PRACTICE OF MEDICINE. 
The natural functions are variously disordered in the progress of hydro- 
thorax ; the appetite and digestion are sometimes impaired ; the tongue foul 
and furred ; and the bowels are various, but generally bound. The pressure 
of the water on the oesophagus has sometimes occasioned a distressing 
difficulty of swallowing. 
TREATMENT. 
Indications of Cure.-1. Evacuate the water. 
2. Prevent its return, by exciting a healthy action of the absorbents. 
It will be proper to commence the treatment of the hydrothorax by admi- 
nistering the following cathartic : Take the mandrake or May apple, {pod. 
peltatumf) cream of tartar, {sup. tart, potass,} peppermint plant, {menth. pip.,} 
of each equal parts ; or the compound powder of jalap. 
Of this powder give a large tea-spoonful; it may be given by pouring a 
little boiling water upon the powder, and sweetening it with loaf sugar, or it 
may be taken in molasses or common syrup ; and mint tea may be freely 
drank after taking it. This purgative is remarkably well calculated to 
evacuate the water in this and other species of dropsy. It acts as a diuretic 
and as a hydragogue, and immediately improves the condition of the patient, 
by the copious evacuations of water which follow its exhibition. 
I have sometimes substituted the jalap root for the mandrake, which answers 
the purpose ; and, from the remarkable success I have more recently derived 
from the use of the former, I am inclined to give it the preference. One of 
these cathartics is by no means sufficient; they must be continued until the 
disease is removed, and given according to the strength, constitution, &c. 
As a general rule, two or three in the course of a week are sufficient. After the 
operation of this medicine, and the stomach has become quieted, administer 
the following: Take fox glove, {digitalis purpurea,} pulverized, one scruple, 
or a tea-spoonful; add half a pint of boiling water, and cover it with a 
plate. Of this infusion, when cool, give a table-spoonful every two hours. 
Should it produce any nausea, or giddiness of the head, half the quantity 
only should be taken. This infusion has a very powerful and sovereign effect 
in hydrothorax or dropsy of the chest. A very short space of time only 
elapses before there is a sensible improvement. It promotes reabsorption of 
the serous fluid, and causes a free discharge of urine. It is powerfully aided 
by the free use of the following tea, all of which articles are strongly diu- 
retic : Take spearmint, parsley, elder flowers, dandelion roots and tops, a 
handful of each. Put them into a tea-pot, and add boiling water sufficient 
to make a strong infusion; this to be freely taken during the day: other 
diuretic herbs may be taken. The patient may be rubbed or anointed upon 
the chest and abdomen, morning and evening, with warm sw'eet oil, to which 
a few grains of capsicum or cayenne pepper has been added, sufficient to heat 
or stimulate the skin. When the water has been evacuated, which will be 
known by a subsidence of the symptoms, give three of the stimulating or 
capsicum pills morning, noon, and night; they act as a tonic, and in some 
degree as a diuretic. If the water should diminish very slowly, their use 
may be commenced earlier, as they will aid this evacuation. 
Without great care, using preventives, &c., the disease is liable to return 
after convalescence. It will therefore be necessary to continue the use 
of the medicine some time after the patient is apparently well. Give also 
as a tonic, and to prevent a reaccumulation of water, the wine bitters. Half 
a wine glass may be taken three or four times a day on an empty stomach. DROPSY OF THE OVARIA. 
367 
I have found this treatment exceedingly valuable. I recently treated some 
very inveterate cases of dropsy, particularly of the chest, and succeeded 
in nearly all. Two or three of these were apparently beyond recovery. In 
one case the patient, Mrs. Freeman, of Newark, N. J., evidently could not 
survive the night; her distress was very great, and she had been afflicted 
with the disease for a length of time. The fluctuation of water around the 
heart could be heard as distinctly as water shaken in a bottle partly full. 
When the hand was laid over the heart it was thrown back with considera- 
ble force; great sickness at the stomach, and debility ; diminution of urine ; 
face began to grow cold with symptoms of dissolution. In this critical and 
almost hopeless state I ventured to give an emetic, which acted favourably, 
and, with other means, she recovered. 
The treatment here laid down has, in my hands, restored to health nearly 
every person labouring under this disease ; and a report of many of the cases 
would be very interesting. 
Should not this treatment cure, (and I know not that I now remember a 
single failure,) emetics must be given every third day, to be accompanied 
with the use of the vapour bath, compound powder of jalap, and the decoction 
of Indian hemp, as mentioned in dropsy of the abdomen. 
REGIMEN. 
The diet should be light and nutritious. Pepper sauce may be freely taken 
with food ; also mustard, horse-radish, and cayenne pepper, all of which possess 
medicinal properties in this disease. 
CHAPTER IV. 
DROPSY OF THE OVARIA. (Ascites Ovarii.) 
DESCRIPTION. 
This species of dropsy begins without much pain or constitutional dis- 
turbance. It is not usually discovered until it is much enlarged, and then 
appears on one side. It is known by its being moveable when the patient 
is in a recumbent position; and, by passing the finger up the vagina, the tumour 
may be felt, which distinguishes it from dropsy of the abdomen ; but it seldom 
is the case that the tumour rises above the pelvis until anasarca appears, 
and prevents the tumour from being discovered. The fluctuation is not very 
perceptible, the disease being generally occasioned by the fluid which is in 
small white bladders of various sizes, called hydatids. 
Until the tumour has acquired a considerable size, the patient's health suf- 
fers no very visible diminution; it then induces pain and numbness in the 
thigh Corresponding with the side in which the swelling is situated, and by 
degrees the body becomes wasted, the appetite bad, and the strength impaired. 
The progress of the disease varies in different cases. In some, dangerous 
symptoms have ensued soon after the disorder became apparent, while others 
have laboured under it for a year or two previous to its destroying the patient. 
Nothing can be more uncertain than the progress and termination of the com- 
plaint ; for experience has proved that under the most apparently desperate 
circumstances the health has been in some measure restored, or life protracted 368 
THE REFORMED PRACTICE OF MEDICINE. 
for a considerable time ; while, on the other hand, where no urgent symptoms 
have been manifest, a sudden aggravation of the disease has occurred, and a 
rapid advance to a fatal termination has taken place. 
Nothing satisfactorily can be offered respecting the causes of a dropsy of 
the ovarium, as women of every condition and age are found to be afflicted 
with it. 
Dropsy of the ovarium is to be distinguished from ascites by attending to 
the symptoms which have been already enumerated. Great caution will be 
requisite in not mistaking pregnancy for this complaint, as fatal consequences 
might ensue therefrom. Fortunately the two may readily be distinguished 
from each other. 
The quantity of water in ovarial dropsy is commonly from thirty to thirty- 
five pints, and some cases have occurred where it has been nearly a hundred 
TREATMENT. 
Some are in the habit of tapping or drawing off' the water in this disease ; 
but this is attended with little or no benefit, and cannot be considered good 
practice. The only reliance must be upon the treatment laid down in other 
species of dropsy, particularly ascites. 
SECTION I. 
DROPSY OF THE WOMB. (Hydrops Uteri.) 
It is sometimes the case that there is a collection of water or hydatids in 
the womb. A tumour appears over the region, which gradually increases, 
and somewhat resembles the figure of it. It yields upon pressure, and there 
is a sense of fluctuation. There is not much, if any, diminution of urine. 
It is distinguished from the dropsy of the abdomen by its being confined to 
the region of the uterus. 
This disease is soon followed by general dropsy, a slow fever, and emacia- 
tion. Treatment, the same as ascites. 
CHAPTER V. 
CELLULAR DROPSY. (Anasarca.) 
DESCRIPTION. 
By anasarca is to be understood a collection of water in the cellular 
membrane, which is extensively diffused throughout the body, and which is 
moistened by a fluid thrown out by the arterial exhalents. In various ways 
the quantity of this fluid may be increased, constituting the disease called 
anasarca or cellular dropsy. 
SYMPTOMS. 
Anasarca, or dropsy of the cellular membrane, usually commences in the CELLULAR DROPSY. 
369 
lower extremities, and first shows itself with a swelling of the feet and ankles 
toward evening, which by degrees ascends, and successively occupies the 
thighs and trunk of the body. The swelling is soft and inelastic, retaining 
for a time the pressure of the finger; the colour of the skin is paler than 
usual, and, in the more advanced stages of the disorder, now and then exhibits 
more or less of a livid hue. When the effusion has become very general, 
the cellular membrane of the lungs partakes of the affection, the breathing 
becomes difficult, and is accompanied by frequent coughing and the expecto- 
ration of a watery fluid. The urine is scanty in quantity, very high coloured, 
and generally deposites a reddish or pink-like sediment, although in a few 
instances it is of a pale whey colour. These symptoms are accompanied by 
insatiable thirst, dryness of the skin, and costiveness; the countenance be- 
comes sallow ; and there is sluggishness and inactivity, together with a slow 
fever. When the cellular membrane of the legs and ankles is greatly dis- 
tended, the water is apt to ooze through the pores of the skin, or raise it up 
in small blisters. The pnlse is usually small and feeble. 
CAUSES. 
General dropsy arises from a variety of causes, which concur in producing 
a debilitated state of the whole body. Anasarca succeeds severe heemorr- 
hages, (natural or artificial,) fevers, and fluxes; and it frequently occurs in 
the latter stages of diabetes, pulmonary consumption, or obstructed menses. 
Under such circumstances the dropsical symptoms commence slowly and, as 
it were, imperceptibly. 
Exposure to cold and damp has frequently been followed by dropsical 
swellings. 
General anasarca arises, in the next place, from excess in the use of 
spirituous liquors. 
Another cause of anasarca is disturbance in the uterine functions. 
The only other circumstance requiring attention in anasarca is, its con- 
nexion with some of the febrile eruptions. It has long been known that 
dropsy, particularly in the form of anasarca, occasionally follows scarlet fever. 
The same phenomenon is sometimes observed as a sequel of measles, small- 
pox, and erysipelas. 
Anasarca is closely connected with that of hydrothorax. In many cases 
these forms of dropsical effusion coexist, and the remedies are the same for 
both. 
Is it not probable that the first cause of every species of dropsy exists in 
the kidneys, in consequence of their ceasing to perform their office or fail- 
ing to secrete the urine ? 
When this is the case it is retained or reabsorbed, and taken into the cir- 
culating mass. The exhalents then pour it out in greater quantities than 
the absorbents can take up; consequently serous or watery effusion and a 
collection follow, which we term dropsy. 
All know that a diminution of urine is the characteristic symptom of 
dropsy, and that diuretics or medicines which stimulate the kidneys to a 
healthy action, or cause them to secrete or separate the urine from the blood, 
immediately relieve or cure the disease. Does not this phenomena, then, 
explain the cause or nature of this complaint ? 370 
THE REFORMED PRACTICE OF MEDICINE. 
TREATMENT. 
The first object will be, as in every other kind of dropsy, to evacuate ths 
water, and afterward to prevent a reaccumulation of it. 
To effect which, a very similar course must be pursued as recommended 
under the head of ascites or dropsy of the abdomen. 
If the swelling is confined to the legs, let them be steamed every night 
over a large tub containing a strong and hot decoction of bitter herbs, com- 
prised of tanzy, wormwood, hoarhound, hops, and catnip. The legs should be 
held over this fomentation hot, or warm as possible ; and if they do not per- 
spire, let a heated brick or stone be put into the decoction. A blanket should 
be thrown over the legs to prevent the escape of the steam. If the swelling 
extends to the abdomen, the patient may sit over the vapour or steam, with 
a blanket around him, that a general perspiration may be excited. This 
process is to be repeated two or three times a week, or according to circum- 
stances. It is always necessary to aid the process, by giving some diaphore- 
tic infusions or tea, as sage, hyssop, mint, or catnip. 
The following cathartic may be given about twice a week: Take jalap 
root, pulverized ; cream of tartar; spearmint, pulverized, equal parts by 
weight: mix. Of this compound give a tea-spoonful every three hours until 
it acts freely upon the bowels. After this let the hydragogue tincture be 
given, to be accompanied with the use of the following infusion or tea: Take 
Indian hemp, milk weed, dandelion roots, equal parts. Make an infusion, 
and drink through the day. 
When every other means have failed in curing the dropsy, 1 have suc- 
ceeded by giving repeated emetics. They appear to give a new impulse 
or tone to the whole system, by the shock they occasion or by the sympa- 
thetic effect they exert, particularly on the skin and absorbent system. I 
have found the common emetic powders to be an excellent preparation, and 
may be given two or three times a week. I recently cured a very difficult 
and complicated case of dropsy, resulting from the use of mercury, (given to 
cure the intermittent fever,) by administering an emetic twice a week, and 
sweating the patient as often by the vapour bath, as before mentioned. 
When there is great swelling in any part, fomentations of bitter herbs 
afford great relief. Should the disease prove obstinate, give fifteen or twenty- 
drops of the tincture offox glove four times a day, in a tumbler of spearmint tea. 
The following preparation may be taken the same as the tincture, and at 
the same time : Take common whortleberries, dried and bruised, four ounces. 
Add sufficient boiling water to cover them. Let the whole stand two hours, 
then add a quart of fourth-proof Holland gin. Of this give from half to a wine 
glass morning, noon, and evening. I have seldom known this preparation, 
though simple, fail of evacuating large quantities of water, and producing a 
very salutary and permanent benefit in this and other kinds of dropsy. 
Give also a small tea-spoonful of the pulverized root of the euphorbia ip- 
pecacuanha. In all other respects the anasarca must be treated the same as 
laid down under the head of ascites. 
In all dropsical diseases, to prevent a relapse, it will be best to continue 
the raedicine for some time after a cure has been effected. DROPSY OF THE SCROTUM. 
371 
CHAPTER VI. 
DROPSY OF THE SCROTUM. (Hydrocele.) 
I shall here only writer few words upon this disease. I would merely 
state that it consists in an effusion of serum or water in the coats of the tes- 
ticle. There is a tumour formed, which slowly increases and appears trans- 
parent, or light and elastic. Sometimes a fluctuation of water can be dis- 
covered. Great care is necessary to discriminate between this and hernia 
or rupture. In the last complaint the tumour recedes in a recumbent posi- 
tion, but not so in the former. 
TREATMENT. 
Tapping the tumour and drawing off the water is the usual course pre- 
scribed ; but this is not calculated to effect a radical cure : not only so, it 
is desirable to cure the complaint without an operation, especially in infants 
and children; and this may be done by using the same remedies recommended 
in other kinds of dropsy, particularly anasarca. 
It will be necessary also to use fomentations of bitter herbs to the scrotum, 
and to administer, two or three times a week, purgatives and diuretics. I 
have succeeded admirably in every case, by pursuing this method. 
TYMPANITES 
The symptoms are, elastic distension of the abdomen, not readily yielding 
to pressure, and sounding like a drum, with costiveness and emaciation, but 
no fluctuation. 
In the beginning we observe flatulence or difficulty of breathing, that is, 
hollow rumbling of the bowels. Thirst and loss of appetite, pain in the loins, 
and difficulty of breathing, with frequency of pulse, succeed, and wasting 
follows. 
The persons most liable to this disease are chiefly those of a relaxed and 
irritable habit, such as have been debilitated by profuse evacuations, inter- 
mittents, or typhus fever; patients who have recently suffered by spasmodic 
and inflammatory affections of the bowels, and particularly women after 
child-birth. 
It is sometimes occasioned by ascites and morbid affections of the liver ; 
at other times by biliary or renal calculi; frequently by worms ; and in one 
most curious case, reported by Van Swieten, it arose from haemorrhagic effort 
after suppression of the catamenia and of the haemorrhoidal flux. 
It may likewise be induced by poisons, when they occasion flatulence and 
spasmodic constriction in the bowels. 
There is evidently a preternatural distension of the intestines by air, pro- 
ducing loss of tone in the muscular fibres of the part distended; and, from 
what has been suggested on the process of digestion, it must appear that the 
extrication of this air or gas in the stomach or the bowels is to be attributed 
to some defect either in quantity or quality of the several fluids, the saliva, 
pancreatic juice, and bile, which are mixed with the jiment to assist in the 372 
THE REFORMED PRACTICE OF MEDICINE. 
reduction of it into chyle, and to restrain the progress of fermentation in the 
faeces while they are passing the intestines. But this alone cannot be the 
proximate cause of tympanites ; for with this must be united spasmodic 
stricture in some part of the intestines, which prevents the escape of wind, 
and this spasmodic stricture must be occasioned by some irritation in the 
system. 
TREATMENT. 
In accordance with this idea of the proximate cause, the indications of cure 
must be, 
1. To relieve the spasm. 
2. To restore the tone of the intestines. 
3. To evacuate the water when it exists. 
It will be necessary, in treating this disease, occasionally to administer the 
compound powder of jalap ; and we must depend for a cure upon repeated 
stimulating injections. The following I have found very excellent: A strong 
decoction of the seeds of Angelica, one pint; milk, half a pint; molasses, one 
gill; olive oil, one gill; salt, one tea-spoonful. Introduce as much of the 
liquid each time as possible, to be repeated daily, or twice a day, according 
to the symptoms. This discharges large quantities of wind, and soon relieves 
the patient. 
In this complaint I have found the hydragogue tincture to contribute essen- 
tially to the cure ; also the whortleberries and gin, as mentioned under some 
of the preceding species of dropsy. 
It appears that flatulence alone is not the sole cause of tympanites. It 
often depends on watery effusions or collections; and when they are of the 
encysted kind, the disease is very difficult to cure. 
I lately .attended a lady in this city whose case appeared to be almost 
hopeless, having, from long standing, reduced her exceedingly. But I cured 
her by the above treatment. 
Great care is necessary to distinguish between tympanites and other forms 
of dropsy, particularly by those physicians who perform the unnecessary 
and useless operation of tapping. 
When I first commenced the practice of medicine in this city I was called, 
with three other physicians, to visit a female having symptoms of dropsy. 
After each one had examined the patient, I was requested to give my opinion, 
which I did very reluctantly, as I was a mere tyro; and besides, I had to 
give it in direct opposition to that expressed by the three elderly and ex- 
perienced physicians. They concurred in the statement of the principal 
one, that the disease was ascites or dropsy of the abdomen, and that the water 
must be immediately drawn off. I expressed my conviction that it was only 
a case of tympanites, (principally wind.) No attention, however, was paid 
to my youthful judgment, and the patient was tapped, but it proved to be a 
dry tapping, in which case little or no water could be obtained. One of the 
doctors acknowledged the fact to me afterward. This circumstance shows 
that neither age nor experience walk hand in hand with true science or 
knowledge, and also that there is not always safety in the multitude of council. INSANITY OR MENTAL DERANGEMENT. 
373 
CEREBRAL DISEASES. 
CLASS V. 
CHARACTER. 
We understand by this class, cerebral diseases, those which proceed from a 
deranged or impaired state of the functions of the brain and nervous system. 
CHAPTER I. 
INSANITY OR MENTAL DERANGEMENT. {Mania.) 
DESCRIPTION. 
Insanity or mania may be termed a false perception of things, displayed 
most generally in the opinion formed by the patient of his nearest friends, or 
things in general; in a want of due connexion of the train of thoughts marked 
by an incoherence or raving; and in a resistance of the passions to the com- 
mand of the will, accompanied, for the most part, with a violence of action 
and furious resentment at restraint. Every species of madness, whether it 
has originated in the mind or the body, becomes the same by continuance. 
In madness both the mind and the body must ultimately be diseased ; for a 
disease of the mind soon produces one of the body. 
CAUSES. 
Proximate Cause.-Dr. Rush states that the cause of madness is seated 
primarily in the bloodvessels of the brain ; but such is the connexion be- 
tween body and mind, and such are the operations of moral and physical 
causes upon it, that the proximate or immediate cause of insanity is very 
difficult to explain. All we know is, that certain impressions, made upon the 
mind or sensorium, are sufficient to destroy or suspend that principle or 
faculty which enables a person to perceive and judge, and act rationally and 
consistently. 
It seems to take place somewhat similar to the manner in which a musical 
instrument is thrown out of tune. Sufficient force exerted upon it is enough 
to effect this purpose, and thus with the mind. Certain agents or impres- 
sions seem capable of unhinging the sentient faculty, or throwing it into such 
disorder that it becomes incapable of directing the judgment or performing 
its functions. 
Remote and Exciting Causes.-Among the various causes of mental 
derangement we may enumerate certain local diseases, such as enlargement 
of the bones, tumours, and dropsy of the brain. Certain diseases of the brain 
also, such as palsy, epilepsy, apoplexy, headache, &c., gout, dropsy, con- 
sumption, pregnancy, and febrile diseases, profuse evacuations from bleeding, 
mercury, or other causes. Perhaps the most fertile of all causes of insanity 
is the use of ardent spirits. Another cause of insanity is, inordinate sexual 
desires. Dyspepsia is probably one of the most frequent causes of insanity 374 
THE REFORMED PRACTICE OF MEDICINE. 
A very common practice among young men and women, called onanism, is 
another cause of the disease. Also great pain, great labour or exercise, very 
hot or cold weather, and narcotic substances taken into the stomach, may pro- 
duce it. Worms, foreign matters retained in irritable parts of the body, trans- 
lations of morbid humours to the brain, hysterics, cutaneous eruptions, 
measles, inordinate ambition, intense study, and the passions, such as joy, 
terror, love, fear, grief, shame, may likewise be enumerated among the various 
causes of insanity. It frequently arises from defamation, calumny, ridicule, 
loss of property and beauty, and domestic quarrels. 
It is said that the extravagant joy experienced by many of the successful 
speculators in the South Sea expedition, in England, was productive of insanity. 
Charles the VI. became deranged from a paroxysm of anger. Religious 
enthusiasm, or mistaken notions of religion, is another cause. But perhaps 
one of the most common causes of insanity is, the struggle between conscience, 
or a sense of duty on the one hand and natural propensities on the other. 
I entertain no doubt in my mind, if people would adhere strictly to the prin- 
ciples of true religion, they would never be afflicted with insanity. 
According to a tabular statement given by Dr.'Casper, it appears that, in 
the different hospitals at Paris, the proportion of cases depending on an 
hereditary predisposition is to the whole number as is one to four and a 
half. Esquirol states that he has met with an instance of seven sisters and 
and brothers in one family who were affected with insanity. Haslam 
mentions ten families, in each of which several cases of mental derangement 
occurred. 
In the report of the governors of the New York Bloomingdale Asylum 
we find a table giving the causes of the insanity of all the patients, 233 in 
number, treated in the institution during the year 1841. They were as 
follows : Hereditary, thirty-five ; puerperal, ten; uterine disorders, nine ; 
succeeding fever and other diseases, thirteen; congenital, two ; insolation, 
one ; masturbation, twelve ; constitutional, twelve ; intemperance, twenty- 
six ; injury, three; cerebral disease, twelve; fatigue and exposure, one; 
domestic troubles, six ; pecuniary embarrassment, thirteen ; religious excite- 
ment, sixteen ; disappointed affection, fifteen ; over-exertion of mind, three ; 
mortified pride, seven ; apprehension of want, two ; fright, one ; remorse, 
two ; litigation, two ; loss of friends, four ; political excitement, two ; home- 
sickness, one ; jealousy, one ; unknown, twenty-two. 
The exciting causes of mental derangement are usually divided into the 
moral and physical; or into those which affect the animal organization through 
the medium of the mind, and those which act directly upon the body. Grief, 
distress, want, and disappointed love are decidedly the most common ex- 
citing causes of insanity. 
A derangement of the liver and stomach are the most fruitful sources of 
insanity. From obstruction or disorder in this organ, a morbid action of the 
great sympathetic and other nerves follows, and the functions of the brain 
are impaired and deranged ; and, as the nerves are the connecting medium 
between mind and matter, it follows, from the reciprocal action, that both 
must be more or less implicated and deranged, simultaneously. 
Dr. Burrows, a physician of high standing, states, in his work on insanity, 
" I have assisted at several accurate anatomical investigations, conducted 
by eminent demonstrators of the brain, of insane patients who have been 
under my care, and who had exhibited, for many months previous to their 
demise, the most furious symptoms of mania, and yet not a vestige of disease 
could be traced." INSANITY OR MENTAL DERANGEMENT. 
375 
SYMPTOMS. 
The most common form of insanity is the intermitting, or that in which 
the paroxysms of the disease are divided by lucid intervals. The accession 
of the paroxysms is far from being regular, but generally continues with more 
or less violence during the summer, and terminates toward the decline of 
autumn. Mania comes on at different periods of life; but in the greater 
number of cases it makes its first attack between the ages of thirty and forty. 
Sometimes insanity, instead of being temporary, or occurring in paroxysms, 
which go off and return again at certain periods, continues during the whole 
of the person's life without any intermission, and the patient sinks at last 
under the violence of the conflict, without any abatement of the symptoms ; 
or a state of perfect idiotism ensues. 
Although insanity usually breaks out suddenly, the manners of the patient 
becoming preternaturally impetuous, his conversation hurried, his mind full 
of projects, which he pursues with restless activity, yet there are instances 
where insanity makes its approach gradually : a certain whimsicality of 
disposition, and waywardness or singularity of character, are observed for 
some time, perhaps for years, before the individual is set down by his friends 
as a maniac; and this is particularly the case in hereditary derangement. 
In no two patients is the disease ushered in, or continued, with precisely 
the same appearances ; for the different propensities and habits of different 
patients lead of necessity to a difference of idea and of expression in each. 
The precursory symptoms are, however, very frequently, as follows : The 
patient complains of a sense of tightness at the region of the stomach, want 
of appetite, costiveness, and a sensation of heat in the bowels. He is subject 
to a kind of uneasiness, which he cannot describe or account for ; experiences 
a degree of fear that sometimes amounts to terror, and feels either little 
disposition or absolute incapacity to sleep. Soon after these appearances 
incoherence and incongruity of idea are betrayed in his outward conduct, by 
unusual gestures, and by extraordinary changes in the expressions and 
movements of his countenance. He generally holds his head erect, and fixes 
his eyes and attention upon the heavens. He speaks with a deep, hollow 
voice ; walks with a quick and precipitate step ; then stops suddenly, as if 
arrested by the most interesting and profound contemplations. Some maniacs 
are remarkable for good humour and mirth, which they express by fits of 
loud and immoderate laughter. There are others, again, whose taciturnity is 
perpetual ; who express their afflictions by tears, or who sink without a tear 
under the distressing influence of solitary anxiety. The latter happens in 
melancholy, to which are usually added fondness for solitude, timidity, 
fickleness of temper, great watchfulness, flatulence in the stomach and bowels, 
costiveness, and a small weak pulse. Furious madness is marked by severe 
pains in the head, redness of the face, noise in the ears, wildness of the coun- 
tenance, rolling and glistening of the eyes, grinding of the teeth, loud roarings, 
violent exertions of strength, absurd incoherent discourse, unaccountable 
malice to certain persons, particularly to the nearest relatives and friends, a 
dislike to such places and scenes as formerly afforded particular pleasure, a 
diminution of the irritability of the body with respect to the morbid effects 
of cold, hunger, and watching, together with a full quick pulse. The insane 
person often acts like a drunken man highly excited or greatly depressed. 
He sings, whistles, halloos, walks to and fro with rapidity, or stands still, 
with his arms folded and his eyes fixed upon one object; frequently he does 
not sleep for weeks. 376 
THE REFORMED PRACTICE OF MEDICINE. 
The variety of mental disorder, partial insanity, (dementia," consists, 
not in false perception, like the worst grades of madness, but of an associa- 
tion of unrelated perceptions or ideas, from the inability of the mind to per- 
form the operations of judgment and reason. The judgments are generally 
excited by sensible objects; but ideas collected together without order, 
frequently constitute a paroxysm of the disease. It is always accompanied 
with great volubility of speech, or with bodily gestures, performed with a 
kind of convulsive rapidity. We rarely meet with this disease in hospitals ; 
but there is scarcely a city, a village, or a country place that does not 
furnish one or more instances of it. Persons who are afflicted with it are 
good tempered and quarrelsome, malicious and kind, generous and miserly, 
all in the course of the same day." 
There is a species of insanity, called monomania, in which the patient is 
rational on all subjects, with the exception of a single one ; as, for instance, 
religion. 
Says Dr. Me Nair: " The treatment which has been used during the last 
forty years in our public institutions by those physicians who believe that 
the cause of mental derangement is confined to the head alone, has been of 
such a nature as would have caused the most sane among them to become 
mad. It may all be embraced in the following words, namely, bleeding, 
cupping, blistering, and applying ice to the head; and, by those who believe 
that religion has been the cause, attempts were made to demoralize the 
patients, by associating them with the wicked and licentious." 
Dr. Burrows, a distinguished physician, says: " Following example rather 
than experience, I tried blood-letting for several years, but discovered my 
error ; I became more cautious, and believe that I have scarcely ordered it 
in six cases of simple mania or melancholy in as many years. Since I 
changed my practice more have recovered." 
Indications of Cure.-1. The cure of mental as well as bodily diseases is 
to be effected, first, by reducing the system by suitable evacuations. 
2. To create revulsive actions, and finally remove subsequent debility or 
feeble morbid actions, by tonics and stimulating remedies. 
3. By the influence of proper moral treatment. 
Moral and General Treatment.-Little does he know, and poorly appreciates 
the science of medicine, who confines it to the preparation and application 
of remedies to the body. The physician that is true to the high claims of 
his office must profoundly study the nature, the sensibilities, and powers 
of the human mind, the diversities of disposition, and the varieties of tem- 
perament. He must be able to trace the workings of the heart under all the 
influences of love, ambition, and the impulses of every passion, that thereby 
he may better know when to draw from the materia medica, and when he 
should minister to a mind diseased. 
And then, how to adapt his treatment to the mental affliction, such, and so 
masterly, should be his intellectual and moral attainments, that he may 
approach and detect a secret sorrow, and sometimes claim the sacred privi- 
lege of so kindly and delicately leading the stricken and afflicted patient, as 
to rescue him from himself, light up hope on the pale and fallen countenance, 
and disappoint the decisions of despair. 
It will be necessary, in the first place, when the disease is seated, to remove 
the patient to a place where he will be prevented from injuring himself or 
TREATMENT. INSANITY OR MENTAL DERANGEMENT. 
377 
others. If he is taken to an insane hospital, it must be one that is properly- 
conducted ; not one that is calculated to exasperate the complaint by the 
treatment and regulations established there. 
Much depends upon the conduct of the physician. The practice of some 
is harsh, censorious, and tyrannical toward lunatics. This conduct is very 
reprehensible, as it prevents the recovery of the patient. His language should 
be that of kindness and respect; however absurd the remarks of the patient 
may be, never contradict them ; suppress everything that may tend to wound 
the feelings. In a word, the law of kindness should be upon his tongue. 
Acts of justice and a strict regard to truth are calculated to secure the respect 
and obedience of deranged patients. Everything necessary for their comfort 
ought to be provided for them, and every promise made should be strictly and 
punctually performed. 
" As an inducement," says Dr. Rush, " to treat mad people in the manner 
that has been recommended, I shall only add, that, in those cases in which 
the memory has been greatly impaired, they seldom forget three things 
after their recovery, viz., acts of cruelty, acts of indignity, and acts of 
kindness. 
I have known instances in which the former two have been recollected 
by them with painful, and the last with pleasant, associations for many 
years. In gratitude for kindness and favours shown to them they exceed all 
other classes of patients after their recovery. A physician once asked a 
young woman of the society of Friends, whom he had assisted in curing in 
the Pennsylvania hospital, if she had forgiven him for compelling her to 
submit to the remedies that had been employed for that purpose: ' Forgive 
thee !' said she ; ' I love the very ground thou walkest on.' " 
Should not persuasion and kindness be sufficient to produce obedience, it 
will be necessary to use coercion ; but it must be consistent with the great- 
est kindness. No harsh or severe measures must be taken. Moderation 
and decision of character should be observed. 
The means generally made use of to confine those lunatics who are un- 
manageable, are the straight-jacket; but this has been condemned, particu- 
larly by Haslam, who employs, instead of it, a belt from eight to ten inches 
wide. This is passed round the lower part of the body, and fastened on the 
back by strong buckles. On each side leather bags are fastened, into wrhich 
the hands of the patient are thrust, and secured by proper bandages. By 
this the pressure usually occasioned by the straight-jacket is avoided, and it 
is preferred or borne with less restraint. It is said that in Dubuison's 
private institution, an arm-chair is used as a mode of coercion. It consists of 
a chair with a high back and foot-board; the arms, legs, feet, and body are 
fastened to it by means of strong and broad straps furnished with buckles. 
This is an excellent contrivance to secure deranged patients in paroxysms 
of the complaint. Some have recommended total darkness in such cases ; 
but the expediency of this measure is very doubtful. 
" In the furious state," says Dr. Rush, " insane patients should never be 
contradicted, however absurd their opinions and assertions may be, nor 
should we deny their requests by our answers when it is improper to grant 
them. In the second grade of the disease we should divert them from the 
subjects upon which they are deranged, and introduce, as it were, acciden- 
tally, subjects of another and more agreeable nature. When they are 
recovering we may oppose their opinions and incoherent tales by reasoning, 
contradiction, and even ridicule." 
Sometimes threatening the patient with some kinds of punishment will 378 
THE REFORMED PRACTICE OF MEDICINE. 
tend to tranquillize them; but kindness and soothing treatment will be 
found the most sovereign remedy. 
Amusements.-Various kinds of amusements have a tendency to benefit 
insane persons : such as are pleasing must be recommended. Reading 
interesting books, writing, copying, &c., will often afford much relief. 
" Committing entertaining passages of prose and verse to memory," says 
Dr. Rush, " and copying manuscripts, have been found useful in relieving 
hypochondriaism ; they divert and translate attention and action from the 
understanding to a sound part of the mind. Reading aloud has nearly the 
same effect." 
Dr. Burton recommends, in the highest terms, the reading of the bible to 
hypochondriac patients. He compares it to an apothecary's shop, in which is 
contained remedies for every disease of the body. I have frequently ob- 
served the languor and depression of mind which occur in the evening of 
life, to be much relieved by the variety of incidents and the sublime and 
comfortable passages that are contained in that only true history of the origin, 
nature, duties, and future destiny of man. A Captain Woodward, of 
Boston, who lately suffered all the hardships of shipwreck on an inhospita- 
ble island in the East Indies, found great comfort in revolving the history 
of Joseph and his brethren in his mind. A Captain Inglefield, while in a 
similar situation, revived the spirits of himself and crew, by relating pleasant 
stories. 
Music has a tendency to tranquillize the mind, and may be practised. 
M. Luther has left the following testimony in its favour: "Next to theo- 
logy, I give the highest place to music, for thereby all anger is forgotten ; 
the devil, melancholy, and many tribulations and evil thoughts are driven 
away." For the same reason that tragedies afford more relief than comedies, 
plaintive tunes are more useful than such as are of a sprightly nature. " 1 
attended a citizen of Philadelphia," says Rush, " in paroxysms of this disease, 
who informed me that he was cured of one of them by hearing the old hun- 
dred psalm tune sung in a country church. His disease, he said, instantly 
went off in a stream of tears." Dr. Cardan always felt a suspension of the 
anguish of his mind from the same cause. And Cowper tells his friend, Mr. 
Hayley, in one of his letters, that he was " relieved as soon as his troubles 
gushed from his eyes." The tears in these cases acted by indirectly depleting 
the brain. 
Interesting Scenery.-Perhaps nothing contributes more to the recovery 
of insane patients than interesting scenery. Therefore an institution for 
this unfortunate class of our fellow-beings should be located in the most de- 
lightful, pleasant, and romantic section of the country, and especially by the 
side of the ocean, a lake, or a large and beautiful river or sheet of water. 
In a word, he should be placed in the midst of all the beauties of landscape 
combined ; pleasant grounds and walks, groves and flower-gardens. A house 
should be placed in the midst of this scenery, having all the appearance of 
a private residence, and without anything to create an idea in the mind 
respecting a hospital or public institution, and- the internal affairs of which 
should correspond with the external. The rooms should be large and con- 
venient, with suitable furniture, and should be superintended by the most 
humane, kind, discreet, and judicious persons, and every means made use 
of to impress upon the minds of the deranged inmates that they were in the 
midst of a domestic circle in a private dwelling, among those who take the 
greatest interest in their welfare and health, or those who are their best 
friends. How different such a situation from some of the hospitals where INSANITY OR MENTAL DERANGEMENT. 
379 
the insane are now obliged to resort; they are better calculated to render 
people " crazy," than to cure them of insanity. 
It has been the practice to force them into narrow, cold, and dismal cells, 
put on the straight-jacket, or confine them to the floor by large iron chains; 
in addition to which, they have been obliged to submit to corporeal punish- 
ment, abuses, &c., and treated more like brutes than human beings. 
Nothing will supply the place of scenery and kind treatment. An oppo- 
site course will produce gloominess and despondency, and is calculated to 
aggravate, rather than cure, insanity. How enlivening, how well adapted 
to cheer the desponding spirit, would be a situation with such advantages, 
especially when connected with proper nursing, diet, exercise, amusements, 
kind treatment, cheerful friends, with the administration of suitable medicine. 
A water prospect is inconceivably important, and should by no means be 
omitted in a site or situation of this kind. It has the most salutary, cheering, 
and permanent good effects. Sailing and fishing are also good employment. 
Those who are insane should be kept apart as much as possible, lest one 
contract an additional degree of insanity from another. 
Employment.-Every insane person should be employed at something 
that is calculated to concentrate the mind upon one object, and dispel gloomy 
sensations. Females may be engaged in various kinds of domestic concerns, 
while males should attend to gardening, farming, or mechanical occupations. 
Exercise.-This in part will be sufficient for exercise, where patients can 
be prevailed upon to practise it; but where they are unable to follow any 
kind of employment, they must often be compelled to walk or ride out. 
This, by restoring the secretions and giving tone to the system, strengthens 
the nerves, diverts the mind, and thus has a tendency to remove the com- 
plaint. 
Travelling.-Travelling is often attended with a happy effect. A change 
of air benefits the patient, as well as the constant change of scenery. Many 
persons have been entirely cured J>y it. 
Medicine.-It is not necessary in general to give much medicine in mania ; 
but that which is suitable may be given with advantage. Even supposing 
that the first cause of the disease exists in the mind, such is its influence 
upon the body, that it is thrown into disorder or derangement. There is 
usually a morbid condition of the stomach, liver, and alimentary canal. 
Hence emetics and purgatives should be occasionally administered. Dr. 
Munro, speaking of emetics, remarks : " Evacuants are the best cure, and 
vomiting preferable to all others ; and, if not carried beyond the patient's 
strength, nor crowded too fast upon him, his health of body will visibly im- 
prove." Where there is habitual costiveness the anti-dyspeptic, the tonic, and 
the hepatic pills may be given alternately, or at the discretion of the practi- 
tioner. They are all calculated to excite a healthy action of the stomach, liver, 
and bowels. The body should be frequently bathed with ley water, to divert 
the blood from the centre to the surface, and thus equalize the circulation ; 
the feet also must be repeatedly bathed with the same, and sinapisms applied 
to them. When there is considerable febrile excitement, or a determination 
of blood to the brain, a mustard plaster may be placed between the shoulders, 
and the diaphoretic powders given at bed-time. 
In a paroxysm, and when there is wakefulness, and the patient is unable to 
sleep, administer an opium pill, or the anodyne powders ; or extract of henbane 
may be given, and repeated every two or three hours, or until the patient 
becomes quiet; these will exert a very tranquillizing effect. The saturated 
tincture of hops is also an excellent medicine to allay irritation and procure 380 
THE REFORMED PRACTICE OF MEDICINE 
sleep. When the nerves are very irritable, and there is great debility, with 
little or no fever, tonics may be given ; and none will be found better than the 
restorative cordial or wine bitters. 
Bathing.-The patient must use the tepid bath occasionally, and particu- 
larly the shower bath. They divert the blood from the head, and give tone 
and energy to the brain. A physician, who has charge of an hospital for 
the insane, in France, highly extols the warm bath in insanity. In conclu- 
sion, I will add a short account of a private institution established in England 
some years ago, by Dr. Willis. It is worthy of imitation : 
" Dr. Willis lived at Greatford, in Linconshire, where he had one of 
the largest private establishments in the kingdom for the reception of luna- 
tics. His house was pleasantly situated, with grounds and plantations neatly 
laid out around it, where his patients could enjoy salutary exercise, and have 
interesting natural objects continually before their eyes. Some of those 
intrusted to his care were distributed in the neighbouring villages, with 
proper attendants to wait upon them and overlook their conduct. An asy- 
lum in the country is better adapted ' to heal the wounded spirit ' and correct 
the morbid trains of thought, than a crowded hospital in the midst of a large 
town. The calm retreat, the multitude of agreeable objects, the kind and 
benign aspect of the physician, his constant superintendance, the select 
society of strangers in similar circumstances, the fear of being put to shame, 
must all have a favourable effect in promoting the cure. 
" From what can be gathered from the few sources of information to which 
we have access, the patients at Greatford were treated like human beings ; 
they were managed like children, and not shut up, or chained down like wild 
beasts. Moral means were principally trusted to, yet physical ones were 
never neglected. The patients were taught to fear and to love their physi- 
cian ; they were permitted to breakfast and dine with him, and to remain in the 
company of others as long as they behaved well, and could restrain their feel- 
ings ; whenever any transgressed the rules of good behaviour, the straight- 
waistcoat was employed as the badge of disgrace. No chains or bandages 
were ever made use of, and the straight-waistcoat only in cases of necessity." 
Speaking of the numerous modifications of insanity, Dr. Abercrombie says : 
" A most interesting affection of this class often comes under the observation 
of the physician, consisting of deep, but erroneous, views of religion, generally 
accompanied with disturbed sleep and considerable derangement of the system, 
and producing a state of mind closely bordering on insanity. It occurs most 
commonly in young persons of acute and susceptible feelings, and requires 
the most delicate and cautious management. With such individuals a 
regular course of history appears to succeed best, and fixing the attention by 
writing out the date and leading events in the form of a table. When the 
mind has been thus gradually exercised for some time in a connected train 
of thought, it is often astonishing to observe how it will return to the sub- 
ject which had entirely overpowered it, with a complete dissipation of former 
erroneous impressions. A frequent complaint at the commencement of such 
an exercise is, that the person finds it impossible to fix the attention, or to 
recollect the subject of even a few sentences : this is part of the disease, 
and, by perseverance, gradually disappears. This experiment I have had 
occasion to make many times, and it has always appeared one of extreme 
interest. I do not say that it has uniformly succeeded, for the affection fre- 
quently passes into confirmed insanity ; but it has succeeded in a sufficient 
number of instances to give every encouragement for a careful repetition of 
it. The plan is, of course, to be assisted by regular exercise, and attention FUROR UTERINUS AND PRIAPISM. 
381 
to the general health, which is usually much impaired. The affections are 
particularly connected, in a very intimate manner, with a disordered state of the 
stomach and bowels, and with derangements in the female constitution ; means 
adapted to these become, therefore, an essential part of the management." 
The above remarks of Abercrombie, and the following from Young, were 
handed me by Elizabeth White, a very pious member of the society of 
Friends, and who was subject to great despondency, and sometimes partial 
insanity: 
" Art thou dejected ? Is thy mind o'ercast 1 
Go, chase thy gloom-go, fix some weighty truth ; 
Chain down some passion ; befriend thy greatest foe ; 
Or, with warm heart and confidence divine, 
Spring up, and lay strong hold on Him who made thee : 
Thy gloom is scattered, sprightly spirits flow."-Yowng. 
" Do thy best, 
And leave the rest." 
Dr. McNair recommends the following plaster to be placed along every 
part of the spine, and particularly on the back of the neck: " Take venus tur- 
pentine, nine parts; Spanish flies, pulverized, six parts; white wax, two 
parts; mustard seed, powdered, red pepper, each one part; melt the pitch 
and wax, then add the turpentine, and to these, while hot, add the other in- 
gredients : mix well together, and form into thin plasters. This," he adds, " I 
consider one of the best applications for diseases of the spine, accompanied 
with want of vigour in the constitution, which is generally the case in ner- 
vous affections. Spread the salve on a strip of adhesive plaster about three 
and a half inches long and one and a half inches broad, leaving one quarter 
of an inch of margin; apply to the back part of the neck, and let it remain 
twelve or eighteen hours ; it will produce a discharge for three or four days, 
when another may be applied below; and thus let them be changed, and a 
little discharge kept up." [See Irritating Plaster, p. 712.] 
REGIMEN. 
A light and nutritious diet should be given. Such medicines as create 
wind must be avoided. The room is to be kept quiet, and no instruments left 
through which suicide can be committed. 
CHAPTER II. 
FUROR UTERINUS AND PRIAPISM. 
DESCRIPTION. 
By this disease we understand an inordinate priapism and excessive desire 
for coition, sometimes amounting even to insanity or mania. 
TREATMENT. 
1. Let purgatives be administered, to reduce the system. 
2. Let refrigerant applications be applied to the organs of generation and 
over the pubis. 382 
THE REFORMED PRACTICE OF MEDICINE. 
3. Occasionally let anodynes be given. 
4. Let the patient be restricted to a low diet. 
5. Let the patient avoid company. 
CHAPTER III. 
MELANCHOLY. (Melancholia.) 
DESCRIPTION. 
Melancholy is a low kind of delirium, with a fever; usually attended 
with fear, heaviness, and sorrow, without any apparent occasion. Or, as 
some define it, a disease which consists in the perturbation or injury of the 
imagination, which prevents it from forming a regular and determinate idea 
of things, as at other times ; so that its due operations are interrupted, and 
often second ideas, having no connexion with the first, crowd in, and are 
succeeded by actions nowise analogous or similar to the first idea, and, there- 
fore, appearing irrational. 
CAUSES. 
It may proceed from an hereditary disposition, melancholic temperament, 
depressing passions or affections of the mind, great and affecting disappoint- 
ments, dyspepsia, suppressed evacuations, intemperance, and injuries of the 
cranium. Sometimes it is occasioned by a sedentary life and solitude, and 
by acute fevers or other diseases. It is sometimes the effect of excessive 
venery; and is frequently produced by gloomy and fanatical notions of religion. 
SYMPTOMS. 
" In this disease," says Dr. Temple, " the patient shuns society and courts 
solitude, is fearful and low spirited, and these symptoms are frequently ob- 
served for some time before an actual derangement is perceived. He indulges 
a certain train of thoughts upon one subject, and generally fixes upon that 
which was the cause of his misfortune, if it has been brought on by any 
sudden and violent affection of the mind. The face is generally pale ; the 
urine small in quantity, and watery ; the patient is commonly costive, and 
the stomach affected with wind; and in some cases so miserable are the 
feelings, that the unfortunate wretch seeks every opportunity of putting an 
end to them, by terminating his existence." 
To these symptoms the following may be added: The patient is fretful, 
capricious, and inquisitive ; solicitous about trifles, and alternately niggardly 
and prodigal ; he has a distaste and dislike to everything, even before it 
comes in sight, and frequently weeps for imaginary causes, or for no cause 
at all. Many people in this case seem always to want room; they are for 
opening all the windows they can, and for running out into the streets or 
fields, thinking themselves everywhere imprisoned ; others leave their houses, 
and dread being taken up for capital offences, though never guilty of any ; 
and in others these symptoms of the mind are evidently joined with those of 
the body, such as palpitations of the heart, deep sighs, and painful breathing. 
This disease is varied in an infinite number of ways, according to the tempe- EPILEPSY OR FALLING SICKNESS. 
383 
rament and ideas of the person affected with it. It is a species of madness, 
and only differs from a dowmright mania in degree. 
There is a lower species of melancholy, called low spirits, to which per- 
sons of weak nerves are more or less subject. Generous diet, the cold bath, 
exercise, and amusements are the most likely means to remove this com- 
plaint. It is much increased by solitude and the indulgence of gloomy 
ideas, but may often be relieved by cheerful company and proper regimen. 
TREATMENT. 
In the treatment of melancholy, attention must be directed to the mind as 
well as the body. The patient should be amused with a variety of scenery ; 
and take freely of exercise in the open air, such as riding, walking, garden- 
ing, farming, &c. He should peruse interesting books, and converse with 
cheerful friends ; and, above all, be located amid pleasant scenery, where he 
can enjoy a water prospect, a country air, and country diet. The shower 
bath must often be used, after which rub the whole body well with coarse 
flannel. A mild emetic, gentle laxatives, and restorative bitters can occasion- 
ally be taken. 
The diet should be principally vegetable, but not of those vegetables which 
produce flatulence. He may use milk, if it agrees with him, and eat fruit, 
particularly after it has been cooked. 
CHAPTER IV. 
EPILEPSY OR FALLING SICKNESS. {Epilepsia.) 
DESCRIPTION. 
Epilepsy, called also falling sickness, is a sudden privation of sense, ac- 
companied with unusual motions and violent convulsions of the whole system. 
It occurs in paroxysms, which, after a period, leave the patient nearly in his 
former state ; but they are generally succeeded by languor, debility, stupor, 
and drowsiness. It takes place more frequently among young children than 
grown persons. It occurs also periodically, and oftener in the night than in 
the day-time. It is frequently an hereditary disease, attacking several in the 
same family. 
CAUSES. 
Blows, wounds, fractures, and other injuries done to the head by external 
violence, together with plethora of the vessels of the head, of water in the 
brain, tumours, concretions, polypus, and a deformity in the shape of the 
bones in any interior part of the skull, give rise to this disease. Epilepsy 
has also been known to arise from an affection of the spinal marrow; and it 
is to inflammation in that part, of a more chronic form, that those shaking 
palsies, which are attended with pain, have been imputed. Violent affections 
of the nervous system, sudden frights, fits of passion, great emotions of the 
mind, frequent intoxications, acute pains in any part, worms in the stomach 
or intestines, teething, the suppression of some long-accustomed evacuation, 
too great emptiness or repletion, and poisons received into the body, are pro- 384 
THE REFORMED PRACTICE OF MEDICINE. 
ductive of epilepsy. Sometimes it is hereditary, and at others it depends on 
a predisposition arising from a disease of the sensorium, which is occasioned 
either by plethora or a state of debility. Derangement of the stomach and 
bowels is a very frequent cause of this complaint. 
SYMPTOMS. 
The epileptic fit, for the most part, occurs suddenly; the patient falls to 
the ground, and hence the disease has received the appropriate name of the 
falling sickness. When the complaint is fully established, it is usual for the 
patient to experience certain warnings of the approach of a fit, which, though 
lasting only a few seconds, enable him to make some preparations for it. 
The most frequent of these warning symptoms are, headache, giddiness, dim- 
ness of sight, or flashes of light passing before the eyes, ringing in the ears, 
and coldness of the extremities. Some persons are apprised of the approach 
of the fit by the appearance of particular spectres ; but the most common of 
all epileptic warnings is that singular sensation of tremour, or coldness, or 
numbness, which has been called the aura epileptica. It begins at the ex- 
tremity of a limb and gradually ascends to the head, when the paroxysm of 
lethargy and convulsion ensues. 
During the fit the convulsive agitations of the body are violent. The eyes 
are fixed and reverted, and the pupils permanently contracted; the teeth 
gnash against each other; the tongue is thrust forward, and often severely 
bitten, and there is foaming at the mouth; the breathing is irregular and 
laborious ; and the pulse, for the most part, small and contracted. Complete 
insensibility prevails. The fit varies in duration, from a few minutes to a 
quarter, or even half an hour ; in some cases it has lasted even longer. On 
its cessation the patient remains for some time motionless, insensible, and 
apparently in a profound sleep. From this he recovers by degrees, but with- 
out any recollection of the circumstances of the fit. It leaves him weak and 
exhausted, and for the rest of the day he generally complains of a degree of 
stupor and sense of oppression in the head. In many cases this has amounted 
to actual mania, continuing for two or three days. 
The periods of recurrence of the fits are too various to admit of being 
stated with any degree of accuracy. When the disease first developes itself, 
the intervals are long, perhaps two or or three months. As it becomes more 
firmly rooted in the system, the fits recur with a corresponding frequency, 
until at length the patient hardly passes a day without one. It is important, 
however, to bear in mind, that genuine epilepsy seldom occurs oftener than 
this; and, therefore, when a person has more than one fit in the day, we 
may reasonably conclude that the disease is of an hysterical nature. 
Epileptic fits occur at all hours; but much more commonly during the 
night than in the day; sometimes on first going to sleep. 
TREATMENT. 
During the epileptic paroxysm in general, little or nothing is to be done, 
except using precautions that the patient may not injure himself; and it 
will be prudent to remove anything which may compress the veins of the 
neck, to obviate congestion in the head. 
Indications of Cure.-1. To remove all sources of irritation. 
2. To return the blood to the brain. 
3. To alter that morbid condition of the nervous system on which con- 
vulsion depends; and to strengthen the body. EPILEPSY OR FALLING SICKNESS. 
385 
To one or other of these principles may be traced the good effects of all 
the medicines and plans of treatment which prove efficacious in the cure of 
epilepsy. 
In the epilepsies of infants and children, scarification of the gums may 
sometimes prove beneficial ; also the administration of an emetic, occasional 
doses of purgative medicines, the more liberal use of mild aperients and 
tonics, and strict attention to diet and regimen. Where the symptoms indicate 
the presence of worms, medicines to remove them must be immediately ex- 
hibited. 
When the irritation is seated in the uterine system, (scanty and laborious 
menstruation, and the peculiar periods at which the fits recur,) our measures 
must be directed to the restoration of the natural determination to the uterus. 
Recourse may be had to the warm hip bath, stimulating injections, relaxing 
medicines, diaphoretics, and the different kinds of emmenagogues. 
The second principle in the treatment of epilepsy is, the obviating general 
plethora, and the taking off that peculiar determination of blood to the ves- 
sels of the head, which is one of the most important features in the pathology 
of the disease. Such a principle is equally applicable to the sympathetic 
as to the primary varieties of epilepsy. Where the disease is still recent; 
where it occurs to adults and young persons of robust habit; and, more es- 
pecially, where, in the intervals of the fits, the patient complains of headache, 
giddiness, stupor, or any other mark of permanent fulness in the bloodvessels 
of the brain, purgatives and sudorifics must be given. It may even be ne- 
cessary to repeat them,before the tendency to accumulation of blood about the 
head can be thoroughly subdued. 
Keeping the same important object in view, the practitioner will aid the 
effects of medicine by directing a mild and unirritating diet, early hours of 
rising and going to bed, regular exercise, abstinence from all fermented 
liquors, washing the head and neck with cold water, and bathing the feet. 
Under particular circumstances he may, if other means fail, substitute cupping 
between the shoulders, mustard plasters to the nape of the neck, and the 
steady use of purgative medicines. 
The physician will attempt to alter that peculiar condition of the brain 
and nervous system with which the state of convulsion is associated. Ex- 
perience has shown that medicines of the narcotic kind possess a considerable 
power over it. Many of them have accordingly been employed in epilepsy, 
and with advantage ; more particularly camphor, opium, hyoscyamus, and 
stramonium. Farther ; there are the strongest grounds for believing that 
the morbid irritability of the brain and nerves, on which spasm depends, 
is often connected with general constitutional weakness. Hence it is that 
many of the most powerful of the anti-spasmodic medicines are, in fact, tonic. 
Medicine.-Having detailed the general indications and principles of cure, 
I shall now speak of the administration of particular kinds of medicine. 
1. Emetics.-The stomach being either primarily or secondarily affected 
in this disease, it will be necessary to administer our common emetic 
once or twice a week, according to circumstances : from the extensive 
influence of emetics on the system, they are adapted to diseases of this kind; 
they stimulate the stomach, liver, pancreas, brain, and whole nervous system, 
and usually bring on more or less perspiration. 
2. Moderate purgatives should also be occasionally given, to cleanse the 
first passages and intestines : afterward laxatives or aperient medicines 
may be taken, sufficient to keep the bowels regular. 
3. Anti-spasmodics must be given. The following I have found preferable 386 
THE REFORMED PRACTICE OF MEDICINE. 
to any other: Take seeds or herb of stramonium, (datura stramonium,) pul- 
verized, one drachm; henbane, a tea-spoonful ; spirits, half a pint: digest 
until the strength is extracted. Of this tincture let from twenty to fifty drops 
be taken three times a day in a little tea, or any suitable vehicle. The dose 
may be increased until there is a slight degree of dizziness, when the dose 
should be continued the same. 
Tonics.-I have found, by experience, that epilepsy is a disease of general 
debility or weakness; indeed it seems to be the proximate cause of the 
complaint: I have, therefore, always derived the greatest benefit from such 
medicines as have given the most tone and energy to the system. 
The following formula combines anti-spasmodic and tonic properties : 
Take garden pteony, ( paonia officinalis,) one ounce ; Peruvian bark, (cinchon 
officinal,) one ounce ; Virginia snake-root, (serpent. Virginian,) half an ounce; 
wild valerian, or ladies' slipper,one ounce: extract all the strength from these, 
by repeated boilings, then strain, and simmer to one quart, and add a pound 
of loaf sugar and half a pint of Madeira wine. Of this the patient may take 
from half a wine glass to a wine glassful three or four times a day, fasting. 
I have found that fine salt has a very salutary effect in epilepsy. As soon 
as there are any premonitory symptoms, give a tea-spoonful in a little water, 
and, if practicable, repeat in fifteen or twenty minutes : it prevents or 
shortens the fit, and may be taken two or three times a day. 
Capsicum is also very good in this complaint, and may be given in the 
form of powder, half tea-spoonful doses, in syrup or water, just before an 
accession of a fit, or when there are any unpleasant symptoms. It may like- 
wise be given combined with other articles, as follows : Take tincture of 
lobelia seeds, one pint; tincture of capsicum, one pint; tincture of valerian, 
three gills, or in this proportion; mix : dose, from a small tea-spoonful to a 
small table-spoonful, occasionally, or according to circumstances, in water. 
Take dragon's claw, (called also crawley amaranthus,) fever root, &c., two 
ounces, bruised; wild valerian; ladies' slipper or nervine, bruised, one 
ounce ; put the ingredients into a two quart pitcher, and pour boiling water 
upon them. Dose, half a pint twice a day, milk warm. The warm bath 
three times a week, and a cold salt water bath, may be used after the fits have 
been suspended. The shower bath will probably be better than the cold 
bath. 
The above will be found well calculated to remove the disease ; but should 
these means fail, others may be tried. 
The following is used by a celebrated French physician, in Paris, for epi- 
lepsy : Nitrate of silver, six grains ; extract opium, one drachm ; musk, two 
scruples; camphor, four scruples: mix, and divide into ninety-six pills. 
The dose is one pill, night and morning, gradually augmented, according to 
the patient's ability to support it. These pills are employed in the treatment 
of chronic nervous affections, more especially of epilepsy. 
Old Dr. Henry states, in his Herbal, that several miserable patients have 
been radically cured of epileptic fits or convulsions, (under the Divine bless- 
ing,) by the following prescription, in three or four weeks : Take one pound 
of fresh green leaves of stramonium or stink-weed, pound them, press out the 
juice, put it in a pewter plate, and place in the sun to evaporate; stir fre- 
quently, until the extract is fit for pills. First give the patient an emetic ; 
the next day give a small sized pill of the extract (two grains) night and 
morning. The dose may be increased to three grains morning, noon, and 
night. 
I was recently in a Methodist meeting, where a person was taken with a APOPLEXY. 
387 
fit during the sermon. He was immediately taken out, and I examined 
him. One asserted that it was no fit, and supposed that he fell under a re- 
ligious excitement. I expressed an opposite opinion, and stated that he was 
subject to fits : on the removal of a cravat from his neck, which was drawn so 
tight as to prevent a free circulation of the blood, he immediately recovered, 
and said that it relieved him ; he then informed us that he was subject to the 
disease. Two inferences may be drawn from this circumstance: first, avoid 
fanaticism, and never impute to supernatural that which arises from natural 
causes ; second, upon an attack of the kind, remove all tight bandages from 
the neck or waist, and give plenty of air. 
Shower Bath,.-The patient may use the shower bath three or four times 
a week, after which the body should be thoroughly rubbed with flannel. 
If the above means fail to cure the disease, the restorative and the wine bitters 
may be alternately used. 
REGIMEN. 
It is necessary to diet in epilepsy ; and it should be light and nutritious. 
Ardent spirits must be avoided; also all fatigue, and everything calculated 
to excite the passions. 
Dr. ******* *, of Connecticut, was cured of this disease by pursuing 
a rigid course of diet. He avoided all fat and greasy substances, and observed 
Franklin's rules, to rise from table with a desire for more food. 
Epileptic patients ought to breathe a free and pure air. Exercise is like- 
wise of great service, but the patient must be careful to avoid all extremes of 
heat and cold ; also all dangerous situations, such as standing or working upon 
houses, precipices, or near deep waters, rivers, &c., lest a fit should happen 
to come on at the time, and they be precipitated to the ground. 
CHAPTER V. 
APOPLEXY. (Apoplexia.) 
DESCRIPTION. 
Apoplexy is a sudden privation, in some degree, of all the senses and mo- 
tions of the body, except those of the heart and lungs. The disease is usually 
divided into two species, the sanguineus and serous. The first is caused by 
the blood distending the vessels, and thereby confessing the brain, or by 
an extravasation of blood in consequence of the rupture of a vessel: the 
second arises from a collection or effusion of s serous fluid in the cavities of 
the brain. 
Apoplexy makes its attacks chiefly at an advanced period of life, and 
usually on those who are of a corpulent habit, with a short neck and large 
head, and who lead an inactive life, make use of flesh, full diet, &c. 
There appears to be a predisposition to apoplexy, either hereditary or from 
a peculiar formation of body, as a full plethoric habit, a short thick neck, a 
florid complexion, broad shoulders, short statue, corpulency, &c. The dis- 
CAUSES. 388 
THE REFORMED PRACTICE OF MEDICINE. 
ease, however, sometimes occurs in persons who are spare and delicate. 
Persons advanced in life are more subject to it than younger persons. 
The immediate cause arises from an effusion of blood, in consequence of the 
arteries throwing more into the veins of the head than the veins can retain, 
by which congestion and rupture take place ; or rather their inability to 
return the blood. 
A predisposition to apoplexy is farther given by such habits of life as tend 
to produce plethora generally, to drive the blood in more than ordinary 
quantity upon the vessels of the brain, or to prevent its free return to the 
heart. Hence it is that full living, habitual intoxication, sedentary pursuits, 
too great indulgence in sleep, intense and long-continued thought, have 
always been accused of leading to apoplexy. 
The principal exciting causes of apoplexy are, the distention of the stomach 
by a full meal, the immoderate use of wine or spirits, straining to evacuate 
a costive stool, violent exercise, very long or loud speaking, severe fits of 
coughing, tumours on the neck, stooping, the recumbent posture, and, lastly, 
violent passions of the mind. It is a singular circumstance, that both heat 
and cold, when in an extreme degree, may occasion apoplexy. The coup 
de soleil of hot climates has been considered, on good authority, to be of the 
nature of apoplexy. The improper use of the warm bath has brought on 
complete and fatal apoplexy. Bleeding and mercury are two great causes 
SYMPTOMS. 
Generally there are premonitory symptoms of apoplexy, which may be 
termed incipient; and it is in this stage of the disease that the most benefit of 
proper treatment is derived. In the first state of the disease there is gene- 
rally a dull pain in the head, weakness, giddiness, particularly on stooping- 
down, dimness of sight, drowsiness, loss of memory, faultering of the tongue, 
bleeding from the nose, flushed face, heat of the head, and vomiting. But 
its attack is often sudden, when the person falls to the ground without 
warning, and lies as in a deep sleep, from which he cannot be roused : or 
he may be convulsed, foam at the mouth, and the saliva or spittle be blown 
away from the mouth with considerable violence. The teeth are clenched, 
the face is red and puffed up, the veins of the neck and head full, bleeding 
from the nose, eyes fixed, breathing difficult and hard, swallowing impossible 
or difficult, pulse strong at first, then weak ; it sometimes causes palsy of one 
side. The fit may last but a short time, or it may be protracted for twenty- 
four hours, and sometimes several days. Sometimes the first attack proves 
fatal; if not, each succeeding one is more aggravated; but the third one 
generally carries off the subject of it. 
In serous apoplexy the attack is more gradual in general, the face pale 
and humid, the veins depre&sed, the pulse small, weak, irregular, and 
intermitting; respiration is impeded and stertorous, and the extremities are 
cold and flaccid. Sometimes these appearances are preceded by vertigo, 
torpor, and an impediment in the speech, together with a failure of memory - 
Although the whole body is affected with the loss of sense and motion in 
apoplexy, it takes place, nevertheless, very often more on one side than the 
other, which is called a hemiplegia; in this case the side least affected 
with palsy is somewhat convulsed. In some few instances of apoplexy the 
patient lies for several days insensible and motionless, and yet gradually 
recovers the use of his understanding and muscular strength ; but for the 
most part he is permanently deprived of the command of one side of his body, APOPLEXY. 
389 
or he regains it imperfectly after a time ; his mind sustains a shock, from 
which it never recovers; his sensations and perceptions become less accurate; 
and his memory and powers of combining, or at least his faculty of expres- 
sion, are much weakened ; for, even while his memory and imagination are 
unimpaired, he is not always able to find appropriate words to express the 
notion which is excited in his mind. 
TREATMENT. 
Indications of Cure.-The object to be accomplished in this complaint will 
be, during the paroxysm, first, to suspend it, by recalling the blood from the 
brain to the surface and extremities ; second, to prevent a determination of 
blood to that organ. 
When called to a person labouring under a fit of apoplexy, prompt and 
energetic measures must be put in execution. The patient should be imme- 
diately removed to a pleasant, airy, and cool place, and placed in a recum- 
bent position, to favour a return of blood from the brain. All compression 
should be removed from the neck, and all tight bandages or ligatures. The 
feet and legs must be immediately immersed in very warm ley water. This 
simple process is attended with the most extraordinary effects in all cerebral 
affections, as well as numerous other diseases ; the reasons of which will 
appear obvious to all who have perused the principles of this practice, detailed 
in the second part of this work. I have never known it fail to exert a salutary 
and decided good effect. The feet and legs should remain in the water fifteen 
or twenty minutes, and friction then applied to them. The whole surface 
must also be bathed with a mild tincture of capsicum, and applied very 
warm. If the patient is unable to take medicine, a large injection or clyster 
should be immediately administered, made as follows: Take infusion of 
lobelia and capsicum, one pint; milk, one pint; sweet or olive oil, one gill ; 
molasses, one gill; fine salt, a tea-spoonful; mix, and introduce the whole 
with a French syringe. This will serve nearly all the purposes of a purga- 
tive, with the additional advantage of a quicker operation. From the large 
quantities of feculent matter which it discharges from the bowels, and from 
its action upon the brain through the medium of the stomach, it is productive 
of great benefit. The patient should be covered warm, in order to excite 
perspiration. Hot bricks, covered with cloths wet with vinegar, may be 
applied to the extremities, to assist in recalling the blood back to its original 
channels. 
In all the cases that I have ever attended of apoplexy I have invariably 
found that the cause of the disease consisted in an unequal circulation of the 
blood. It recedes from the extremities, and is effused upon the brain. 
Hence, when you ask a patient who has the premonitory or incipient symp- 
toms of apoplexy, if the feet are not cold and head hot, he will answer in 
the affirmative ; from which circumstance the indication of cure may be 
clearly inferred. 
A mustard plaster should also be immediately applied between the 
shoulders. 
As soon as the patient can swallow, let a brisk purgative be administered. 
This class of medicines is very important in apoplexy. 
It is sometimes occasioned by an over-distention of the stomach, and a mor- 
bid state of the alimentary canal; and evacuations of this kind are necessary, 
not only to unload the stomach and bowels, but likewise to remove the 
turgescence or congestion of the brain, by the sympathetic action exerted on 390 
THE REFORMED PRACTICE OF MEDICINE. 
this organ through the medium of the stomach. These are the means to be 
pursued during an attack of the complaint, and they will be found altogether 
more effectual than the sanguinary practice now pursued, viz., " to abstract 
a vast quantity of blood, from six to eight pounds," to use the language of a 
standard author. It seems astonishing that physicians persist in pursuing a 
practice which has been conclusively shown, by writers, to bring on apoplexy, 
or congestions of the brain. Occasionally an author may be found who has 
experienced the mischievous effects of bleeding, and among the number, I 
think, is Professor Recamier, who has several times observed, " loss of blood 
in such cases aggravates the cerebral congestion." I have not the least 
evidence that blood-letting has the smallest power to diminish the violence 
or duration of an apoplectic paroxysm; but, on the contrary, I have every 
reason to believe that it so far weakens the powers of reaction as greatly to 
retard the cure, or prove fatal to the patient. 
My friend Mr. Richardson, whose recommendation of this work is herein 
given, had symptoms of incipient apoplexy. I ordered him to apply cold 
water to his head and hot water to his feet, by immersion, which forced 
back the blood from the upper to the lower extremities with such velocity 
through the heart, that he was afraid that it would kill him : however, it 
removed the disease. This shows what simple treatment will accomplish- 
even the use of water 
Since preparing the above for the press, 1 have seen a patient of mine, Mr. 
Stammers, of Haerlem, who had been labouring under the premonitory symp- 
toms of apoplexy for a length of time, and had been repeatedly bled for it, 
with injury only ; after this I prescribed for him, when in the most imminent 
danger. He was distressed with pain and heat in the head, flushed coun- 
tenance, beating and fulness of the bloodvessels of the head, &c. I gave brisk 
purgatives, at first twice a week, then once a week ; I then ordered his feet 
to be often bathed, cold applications to the head, and light vegetable diet- 
This course has entirely removed the complaint. The whole secret or art of 
treatment consists in equalizing the circulation. 
I attended an elderly person who was subject to apoplexy, and who, 
upon an attack, or the approach of symptoms, sent for his physician, who bled 
him ; after a while it appeared almost necessary that he should be bled 
to save his life. I remonstrated with the man, and told him the consequence 
of such a procedure. He, however, paid no attention to my remarks, but 
continued to submit to the treatment of his family physician ; after a short 
time the complaint proved fatal, as I predicted. 
I attended a patient, about the same age, with the same complaint, pursued 
the treatment recommended above, and he recovered, and now enjoys good 
health. When the patient has recovered from an attack of apoplexy, (and 
sometimes it continues a week or two in a greater or less degree,) the next 
object will be to prevent a return of it; to effect which, it will be necessary 
to continue the use of purgatives about once a week. Emetics may be given 
where there is nothing to contra-indicate their use ; they likewise should 
be repeated as often as the purgatives : they have a very beneficial effect, 
by diverting the blood from the head, and throwing it into the capillary 
system ; and they have also a tendency to keep up perspiration. Moderate 
sweating should be now and then encouraged by the use of the vapour bath, 
which likewise has a tendency to prevent a return of the complaint, by expel- 
ling such humours or extraneous agents as corrupt, or as cause a thick and 
sizy state of it; in other words, it has a tendency, with the other means 
recommended, to purify the blood. For the same purpose the patient may CATALEPSY. 
391 
take alterative syrup, and infusions. It will be necessary to continue the 
practice of bathing the feet at least three or four times a week. The head 
may likewise be bathed with a weak tincture of capsicum, particularly when 
there is any pain. These measures must be continued until there are no 
symptoms of the disease remaining. I have been in the habit of occasionally 
applying cups to the temples and the nape of the neck, when the patient 
has complained of a fulness and dizziness of the head, and have found 
that benefit was derived from it; but I have never resorted to cupping, even 
during an attack of the complaint, (except once, and then it was of no service ; 
neither bleeding ;) and very seldom in any stage of it, having invariably suc- 
ceeded by the other means already mentioned. In a very severe paroxysm 
it may be justifiable to resort to it. In the treatment of apoplexy I now dis- 
pense with emetics and the vapour bath. 
REGIMEN. 
Much depends upon diet in this complaint. It is often brought on by high 
living, inducing plethora, and, therefore, may be prevented or cured by an 
opposite course of living. No high-seasoned victuals, meat, &c., must be 
used ; neither wine, fermented liquors, nor ardent spirits; the patient should be 
confined to a cooling, spare, vegetable diet, with regular exercise in the open 
air; the use of the tepid bath likewise: great fatigue or exertion are to be 
avoided ; also intense application to study. He must be careful not to stoop, 
or continue in a bended posture : avoid sudden transitions from heat to cold, 
and in all things observe universal temperance. By this course I have often 
been instrumental in removing the first symptoms of this disease. 
CHAPTER VI. 
CAT ALEPSY. (Catalepsia.) 
DESCRIPTION. 
Catalepsy consists in the temporary suspension of voluntary motion, and 
consciousness and volition; the exact position of the body remaining the 
same as it was when the attack came on. It generally lasts a short time, 
when it subsides, leaving the person in the same condition as formerly, with-: 
out any disease, or recollection of anything that has passed. 
CAUSES. 
Catalepsy may arise from various causes; from passions, intense applica- 
tion of mind to any study or pursuit, suppressed customary evacuations, 
worms, morbid state of the stomach and alimentary canal, plethora, &c. A 
person died of the catalepsy in this city, and was examined by Dr. Kissam, 
who stated that one of the valves of the heart had become callous or un- 
durated. 
SYMPTOMS. 
The disease generally commences suddenly, without any premonitory 
symptoms; but more generally the attack is sudden, and commences without 392 
THE REFORMED PRACTICE OF MEDICINE. 
any warning; but when there is any warning given of its approach, it is 
known by swimming in the head, or headache, lassitude, pain in the breast, 
sense of heaviness, tremour of the hands and legs, flatulence, yawning, &c. 
When an attack commences, it is very sudden, and the patient remains in 
the same position, like a statue, without being able to move a single finger. 
The eyes remain immoveably fixed, either open or closed. If a limb is 
changed, it still remains fixed in the same position, until the paroxysm sub- 
sides. All the senses are entirely suspended, and the patient remembers 
nothing that has occurred: and it is stated that, if the paroxysm comes on while 
he is conversing, or in the performance of any other continuous act, he will 
resume the thread of the conversation, or even finish the half-pronounced 
word, or continue his acts, as soon as the paroxysm is over, as if no interrup- 
tion had taken place. It is stated that cases have occurred where patients, 
during a paroxysm, have continued their employment, such as walking, with- 
out any consciousness of it. A case is mentioned by Galen, in which the 
patient (one of his fellow-students) lay motionless, like a dog, with his eyes 
open, but he heard and remembered what occurred during the paroxysm. 
Sometimes respiration is feeble and the surface cold. 
The continuance of a fit of catalepsy varies from a few minutes to several 
days. The patient, when it leaves him, sighs deeply. Sometimes the 
paroxysm comes on three or four times a day, and only lasts a few minutes. 
Hoffman mentions the case of a woman, in which upward of one hundred 
paroxysms occurred during a period of forty days. 
Catalepsy is sometimes complicated with other diseases, such as epilepsy, 
hysteria, &c. 
This disease seems to be similar, or nearly allied, to what is called a trance, 
and ecstasy. It will either go off* spontaneously, or may be removed by 
medicines and proper diet. 
TREATMENT. 
During a paroxysm of the catalepsy friction should be applied to the sur- 
face and extremities, and particularly around the region of the heart. After- 
ward the disease must be treated on general principles ; all the secretions and 
excretions regulated. The stomach, bowels, and skin should be kept in a 
healthful tone. Administer anti-spasmodics and restoratives, with suitable 
diet and exercise. 
CHAPTER VII. 
LETHARGY. (Coma.) 
DESCRIPTION. 
Lethargy is generally a symptomatic disease, arising from apoplectic 
symptoms or a morbid state of the stomach, or some other complaint. It 
may also arise from the use of opium, or other narcotic substances. 
TREATMENT. 
Sometimes drowsiness or lethargy proves exceedingly troublesome, as the FAINTING OR SWOONING. 
393 
person affected with this complaint frequently falls asleep, contrary to his wish. 
When this is the case, the best remedy, and one that is very effectual, is 
the administration of an emetic, to be repeated occasionally; and also im- 
mersing the feet in warm water. 
The bowels must be kept regular A light vegetable diet should also be 
used. 
CHAPTER VIII. 
FAINTING OR SWOONING. (Syncope.) 
DESCRIPTION. 
Fainting consists in a decreased action, and sometimes total cessation, of 
the pulse and respiration. It is sometimes preceded by anxiety about the 
heart; a sense of fulness ascending from the stomach toward the head ; 
vertigo, or confusion of ideas ; dimness of sight; and coldness of the extre- 
mities. Attacks of syncope or fainting are frequently attended with, or end 
in, vomiting, and often in convulsions or an epileptic fit. 
CAUSES. 
Fainting is most generally occasioned by profuse evacuations, especially 
of blood; but it may happen also from violent passions of the mind, 
surfeits, excessive pain, violent exercise, disgusting sights, drinking freely 
of warm or strong liquors, exposure to great heat, intense application to 
study, certain odours or smells, &c. 
People of delicate constitutions are subject to it from slight causes ; and 
sometimes it will arise from affections of the heart and large vessels, not 
easy to be understood. Fainting is also a symptom of many disorders, 
(especially of that fatal one called a polypus of the heart,) such as the plague, 
profuse bleeding or flooding, and other diseases. 
A disposition to this disease may take place wherever debility exists ; but 
when it frequently recurs without any obvious cause, a morbid state of the 
heart or brain themselves is to be suspected. 
SYMPTOMS. 
A syncope begins with a remarkable anxiety about the heart; after which 
follows a sudden extinction, as it were, not only of the animal powers and 
actions, but also of the vital powers, so that the patients are deprived of 
pulse, sense, and motion all at once. 
In these cases the patient does not entirely lose his senses, but turns cold 
and pale, and the pulse continues to beat, though weakly ; the heart also 
seems to tremble rather than beat, and the respiration or breathing is just 
perceptible. But in the true syncope not the smallest sign of life can be 
perceived ; the face has a death-like paleness, the extremities are cold, the 
eyes shut, or at least troubled ; the mouth sometimes shut, and sometimes 
gaping wide open; the limbs flaccid or relaxed; and the strength quite gone; 
as soon as the patient begins to recover he fetches deep and heavy sighs. 394 
THE REFORMED PRACTICE OF MEDICINE. 
TREATMENT. 
In order to revive the patient, he ought to be laid in a horizontal pos- 
ture, in any airy place; the legs, thighs, and arms are to be rubbed with 
hot flannel; very strong vinegar, or salt of hartshorn, may be held to the 
nostrils, and the following mixture given : Take spirits of hartshorn, (aq. 
ammonia,') ten drops ; compound spirits of lavendar, (spts. lavend.,') one tea- 
spoonful : mix. Dilute with water, and give the whole. If circumstances 
permit, let the feet be immersed in warm water, and the breast and pit of 
the stomach rubbed with the tincture of capsicum. 
If the patient does not soon revive, let a little hot spirits or brandy sling 
be administered. Persons subject to fainting should avoid all crowded 
assemblies, or places where the air is confined. They are to avoid every- 
thing calculated to excite the mind or the passions, as well as too much 
labour or fatigue. All tight bandages, neck-cloths, corsets, &c., must be 
immediately removed. 
CHAPTER IX. 
GIDDINESS; {Vertigo.') 
DESCRIPTION. 
Vertigo or dizziness is generally symptomatic of some other complaint, 
such as dyspepsia, and hypochondria ; or it may be a premonitory symptom 
of apoplexy, or over-determination of blood to the head. 
SYMPTOMS. 
The patient is suddenly seized with a sense of swimming in the head; 
everything appears to him to turn round : he staggers, and is in danger of 
falling down. This complaint is attended with very little danger where it 
arises from hysterics, or any nervous disorder: but when it arises from plethora, 
or an unnatural quantity of blood in the head, there is danger of apoplexy. 
This complaint often proceeds from difficult or obstructed menstruation. 
TREATMENT. 
It will be necessary, first, to ascertain the cause of the complaint. If it 
is symptomatic of some other disorder, that must first be removed, in order 
to cure it; but if it be a primary affection, or be apparently seated in the 
head or stomach, a purgative should be occasionally used, and the feet bathed. 
If this does not remove it, administer an emetic. DELIRIUM TREMENS. 
395 
CHAPTER X. 
DELIRIUM TREMENS. {Mania Potu.) 
DESCRIPTION. 
This is a disease which, in this day, very often occurs among those who 
are addicted to an excessive use of ardent spirits, and such as indulge in the 
use of opium and other narcotic substances. It is characterized by most of 
the ordinary signs of insanity. This disease is called, by some, the brain 
fever of drunkards. 
CAUSES. 
It is difficult to state, with certainty, what the proximate cause of this 
complaint may be. Dr. Coates, who wrote a treatise on it, says that " the 
disease is the result, not of the application, but of the sudden intermission of 
the use of these articles." But it appears to arise from excessive stimulus 
of the stomach and brain, in which organs the complaint is seated. 
SYMPTOMS. 
It commences with nausea, vomiting, or belching of wind, and sometimes 
after a sudden disuse, it is said, of stimuli, and in subjects addicted to the use 
of spirits to excess, without becoming habitually drunk. The complaint 
seems to come on gradually, and it is several days before it arrives to its 
greatest degree of violence. There is great wakefulness, walking to and fro, 
or raving, and the patient seems to be in the greatest agitation and distress 
of mind. He is very apt to imagine that there is evil spirits continually 
before him, or haunting him. I was called to one case of this kind, where 
the person insisted that there were devils before him, which he could see upon 
the carpet. " This disease," says Thatcher, " is always attended by febrile 
symptoms; and it is one of its peculiarities that the mind is continually 
haunted with the idea that they are infested by snakes and insects. I have 
frequently seen patients," says he, " weary in attempting to catch snakes, 
which they imagined were curling about them under their clothes." The 
countenance assumes a peculiar appearance, expressive of anxiety, alarm, and 
suspicion. The patient becomes irritable, talkative, and often cries out for 
assistance. He becomes boisterous and raving, being continually tormented 
with the idea that some one is about to rob or destroy him. The system is 
usually more or less disordered during the complaint. There is costiveness, 
loathing of food, &c. Delirium tremens usually runs its course in four or 
five days, and often terminates in a fit of epilepsy; at other times, where it 
is properly treated, the patient recovers. 
TREATMENT. 
The first object of the practitioner in this complaint will be, to allay the 
paroxysm, and to calm and support the nervous system, and afterward, by a 
orooer course of treatment, to prevent a return of the complaint. For this 396 
THE REFORMED PRACTICE OF MEDICINE. 
purpose brandy or spirits may be given, which usually affords immediate 
relief. Should there be a determination of blood to the head, which may be 
known by a redness of the countenance, a fulness and beating of the carotid 
arteries, heart, &c., the first object will be, to equalize the circulation, by 
recalling the blood to the surface and extremities. This may be effected by 
bathing the feet and legs in a tub of warm ley water, and applying mustard 
plasters to the feet and nape of the neck. At the same time a cathartic may 
be administered: after its operation, should the symptoms continue, give a 
pill made of the solid opium, about the size of a small pea, which contains 
three grains, to be repeated every three hours until rest is procured. This 
will break the paroxysm and procure sleep. Afterward the patient must be 
treated according to the symptoms exhibited. Emetics will be found very 
useful, and may be given in the same kind of spirits that the patient has 
been in the habit of taking. 
NERVOUS DISEASES. 
VI. 
CHARACTER. 
This class of disease is confined, or apparently confined, to the nervous 
system. Irregular or preternatural motions of the muscles or muscular fibres 
are characteristic of it. 
CHAPTER I. 
HYSTERICS. (Hysteria.) 
DESCRIPTION. 
Hysteria or hysterics is characterized by a grumbling noise in the bowels, 
followed by a ball ascending to the throat, attended with a sense of suffoca- 
tion, stupor, insensibility, convulsions, laughing and crying without visible 
cause, sleep interrupted by sighing and groaning, attended with flatulence. 
CAUSES. 
This disorder may be produced by various causes. It usually arises from 
certain passions operating upon a feeble constitution. The persons most 
liable to this disease are females, from the time of puberty to the age of thirty- 
five, unmarried women, and young widows, chiefly those of the sanguine 
temperament, relaxed habit, great sensibility, and of an irritable fibre ; 
more especially after profuse evacuations ; the indolent, and those who are 
exhausted by either long-protracted fevers or habits of intemperance; and 
such also in whom the uterine haemorrhage is unseasonably stopped, or 
habitually obstructed. Can we, therefore, hesitate to assign debility, with 
morbid irritability, as the predisposing cause ? HYSTERICS 
397 
SYMPTOMS 
This disease attacks in paroxysms or fits. These are sometimes preceded 
by dejection of spirits, anxiety of mind, effusion of tears, difficulty of breath- 
ing, sickness at the stomach, and palpitations at the heart; but more usually 
a pain is felt on the left side, with a sense of distention, advancing upward till 
it reaches the stomach, and thence into the throat; it occasions, by its pres- 
sure, a sensation as if a ball was lodged there. The disease having arrived 
at this height, the patient appears to be threatened with suffocation, becomes 
faint, and is affected with stupor and insensibility; while at the same time 
the trunk of the body is turned to and fro, the limbs are variously agitated, 
wild and irregular actions take place in the alternate fits of laughter, crying, 
and screaming ; incoherent expressions are uttered, a temporary delirium 
prevails, and a frothy saliva is discharged from the mouth. The spasms at 
length abating, a quantity of wind is evacuated upward, with frequent sigh- 
ing and sobbing, and the woman recovers the exercise of sense and motion 
without any recollection of what has taken place during the fit; feeling, 
however, a severe pain in the head, and a soreness over the whole body. 
In some cases there is little or no convulsive movement, and the person lies 
for some time seemingly in a state of profound sleep, without either sense 
or motion. 
However dreadful and alarming an hysteric fit may appear, still it is sel- 
dom accompanied with danger ; and the disease never terminates fatally, 
unless it changes into epilepsy or mania, or the patient is in a very weak 
and reduced state. 
TREATMENT 
In the cure of hysteria two indications are to be attended to: 
The first is, to allay the spasmodic symptoms, which constitute the fit. 
The second, to lessen the excitability of the nervous system, and strengthen 
the whole frame during the intermission of the paroxysms. 
During a fit the patient's dress should be loosened, so that the circulation 
and respiration may be embarrassed as little as possible ; cold water should 
be sprinkled, or rather dashed, over the face, the body laid in a recumbent 
position, with the head a current of air admitted into the apart- 
ment. The attendants may be employed in rubbing the temples, abdomen, 
and extremities. It is usual for five or six persons to clinch the patient 
during an hysteric fit, and confine her to the bed, or in a certain position ; 
but this practice should be avoided. It is best to use only force sufficient 
to keep the patient from injuring herself or her attendants. When she sud- 
denly rises and springs from the bed, allow as much latitude, liberty, and 
motion to the body and limbs as possible. If the patient shows a disposition 
to roll upon the floor, to use the language of the late Professor Smith, of 
New Haven, "let her roll." 
When called to treat the disease during the paroxysm, the first object will 
be to suspend or shorten it. To this end, such measures must be adopted 
as have a tendency to divert the blood from the centre of the circulating 
system toward the extremities; in other words, to equalize the circulation 
and nervous excitement. It will, therefore, be of the first and greatest conse- 
quence to immerse the feet and legs in very warm water. If the patient can 
swallow, give an emetic : in the next place administer the expectorant tincture, 
which removes the rising in the throat, sense of suffocation, and the phlegm or 398 
THE REFORMED PRACTICE OF MEDICINE. 
mucus collected upon the stomach, while at the same time it throws the 
blood to the surface and extremities, and makes such an impression upon the 
brain and nervous system, that the paroxysm is often cut short by a single dose, 
even under the influence of spasms. Where the teeth are tightly clinched, a 
small quantity of the expectorant tincture may be introduced into the mouth 
between the teeth, which will relax the muscles, cause the patient to open her 
mouth, and enable her to swallow. Should it, from any cause, be impracticable 
to administer medicine, the following injection may be given : Take a strong 
infusion of catnip or other herb tea, one pint; milk, half a pint; sweet or 
olive oil, one gill; molasses, one gill ; laudanum, a small tea-spoonful; fine 
salt, a small tea-spoonful: mix. Let the whole be, if possible, introduced 
at a time, blood-warm, with a French syringe. This alone rarely fails to 
moderate the symptoms very speedily, and induce a complete intermission 
of the spasmodic action. It will also be necessary to apply to the abdomen 
fomentations of hops, wormwood, and tanzy, equal parts, boiled in vinegar 
and water, to be renewed as often as the fomentation becomes cold. This 
course will soon bring about an intermission of the hysteric fit. 
Should the above, however, fail, give the anodynepowders. This is infalli- 
ble under all circumstances and in all cases. I have prescribed it where a 
number have attended the person, under the influence of hysteric fits, for a 
whole day, and in an hour or two the patient was free from pain and con- 
valescence. I have now spoken of the treatment of hysteria during a 
paroxysm ; and, having suspended it, our next object will be to prevent a re- 
currence, to which the patient is very liable ; and this must be effected by 
restoring the tone of the system. We may commence by giving a moderate 
cathartic, as this will cleanse the stomach and bowels, and prepare the way 
for other medicines. After the operation of it, an aperient pill must be taken, 
to regulate the bowels, which, in this complaint, are habitually constipated ; 
for this purpose I give the anti-dyspeptic pill. Two or three should be 
taken at bed-time, in a little currant jelly or roasted apple, to be continued 
until the bowels become regular. This is very necessary, as the complaint is 
often induced by an inactive or torpid state of them, causing fetid gases and 
feculent matter to accumulate in the intestines. During the day the patient 
should take from half a wine glass to a wine glassful of the restorative cordial 
or bitters. This preparation invariably improves the condition of the patient; 
it creates an appetite, gives tone and energy to the nervous system, and pre- 
vents a recurrence of the hysteric paroxysm. 
Where we wish to effect a radical cure, a mild emetic may be given once 
a week. It is only necessary to excite gentle vomiting, which contributes 
much toward the cure, by imparting tone and energy to the stomach and 
nerves. 
With me the above treatment has uniformly and invariably been successful. 
I have been called to the patient when she has been nearly destroyed by the 
lancet-a succession of paroxysms immediately attending its use-irritable, 
delirious, and extremely feeble ; the countenance almost as white as marble ; 
and, by discontinuing such practice, and substituting the course here recom- 
mended, a remission of all the hysteric and nervous symptoms have follow- 
ed, with convalescence and recovery. 
REGIMEN. 
There is no disorder that, requires more care and attention, as regards diet, 
soothing or kind? treatment, &c. Nothing harsh or censorious must be said HYPOCHONDRIA. 
399 
to the patient, or anything calculated to arouse the passions or emotions of 
the mind. She should be kept as quiet and composed as possible : no sad 
intelligence suddenly imparted, if at all; the mind kept as free as possible 
from every kind of anxiety; must avoid great fatigue or labour, nursing of 
infants who are too old, and, in short, every cause of debility. She must 
exercise often in the open air ; and never overload the stomach, but use a 
nutritious diet, and such as easily digests. 
Some years ago I was called to a young lady of this city, recently from 
England, or Canada, labouring under this complaint, which had been brought 
on by adversity; she had become reduced from a degree of affluence to 
great poverty, and, being ashamed to make known her situation, submit- 
ted to great privation. She was finally assisted by a religious society; but 
a sense of her former and present situation produced great nervous debility, 
hysterics, with more or less delirium. A physician of this city had greatly 
aggravated her symptoms by his treatment, having bled her until her 
countenance became like marble, her strength gone, confined to the bed with 
great irritability of the nervous system, &c. Besides, the family with whom 
she resided did not treat her kindly: all these circumstances rendered her 
truly miserable. I now reversed the treatment, and received her into my 
family, endeavour to treat her with kindness, in addition to proper medical 
treatment. The change was surprising; all her unfavourable symptoms 
vanished ; her appetite returned ; also her flesh strength, reason, and spirits ; 
in short, she entirely recovered, and has remained well ever since. 
CHAPTER II. 
HYPOCHONDRIA. (Hypochondriasis.') 
DESCRIPTION. 
By the term hypochondria is to be understood a disordered or diseased 
state of the mind, arising generally from debility of the nervous system, con- 
nected usually with dyspeptic symptoms. It is denominated, by some, spleen, 
vapours, low spirits, &c. In this complaint the patient's mind is harassed 
with great anxiety, principally from the anticipation of imaginary evils, or 
from the slightest grounds ; and, however erroneous such imaginary troubles 
may be, there is always the most obstinate belief and persuasion of them. 
It is the lowest grade of mental derangement. 
CAUSES. 
This disease seems to depend upon a loss of tone or energy in the nervous 
system, induced by various causes, such as close and intense study, long and 
serious attention to abstruse subjects, the constant remembrance of some 
material loss or disappointment which has occurred, great anxiety of mind, 
leading an inactive, indolent, or sedentary life, immoderate venery, or a use 
of crude, flatulent, or unwholesome food, being guilty of great irregularity 
and intemperance, and by long-continued evacuations. 
Hypochondriasis and other nervous complaints are, through the medium 
of sympathy, scarcely less infectious (it is probable) than febrile diseases; 400 
THE REFORMED PRACTICE OF MEDICINE. 
and even persons naturally of a cheerful temper, by being long domesticated 
with those of a melancholy, desponding cast, have been known to become 
decidedly, and often deplorably, dejected. 
SYMPTOMS. 
This disease is attended with inactivity, a want of resolution with respect 
to all undertakings, lowness and dejection of spirits, great despondency, 
apprehension of evil upon the slightest grounds, and a dread of danger from 
any unusual feeling, even of a trifling kind, together with flatulency in the 
stomach and bowels, acid eructations, costiveness, a copious discharge of pah- 
urine, spasmodic pains in the head and other parts of the body, giddiness, 
dimness of sight, and palpitations ; in short, it is attended with such a long 
train of symptoms, that it would fill many pages to enumerate them all, as 
there is no function or part of the body that does not suffer in its turn by its 
tyranny ; the miserable patient indulges wild imaginations, and fancies that 
he labours under almost every disease ; and, with respect to these feelings 
and apprehensions, he entertains the most obstinate belief, being highly dis- 
pleased if any attempt is made to reason with him on the absurdity of his 
persuasions. 
The symptoms of this form of derangement, as they appear in the body, are, 
dyspepsia, costiveness or diarrhoea, with slimy stools, and flatulency of urine. 
One of the most prominent symptoms of hypochondriacal disorders is, a most 
distressing dread and fearful apprehensions, and a despair of recovery. The 
judgment is impaired, so that almost everything is viewed in a wrong light . 
This disease is frequently attended with fear and dread of death. It is 
peculiar to the sedentary and studious, and such as are possessed of genius 
and great sensibility, and hence has been pronounced the " disease of the 
learned the dull, stupid, and corpulent are seldom or never subject to it. 
Another symptom is, a disposition to apply to various physicians, or to take 
a variety of medicines. 
The person who labours under this disorder often imagines that he is 
afflicted with various diseases, and sometimes that he has live animals inside 
of him. Every little pain or unpleasant symptom is magnified, and he is 
harassed with horrid forebodings of evil; fear that he will come to want; fear- 
ful apprehensions; and constant fear of dying : very fickle and peevish ; liable 
to quarrel with friends and relatives; is irritable and capricious ; great de- 
pression and despondency of mind, often on the subject of religion ; some- 
times in despair. I know a person who was a year in this state, and she suffered 
awfully, being in despair, and all apparently from a congested state of the 
liver : free purging cured her. I have known others who have committed 
spicide under the influence of this disease. Cowper, the poet, was subject 
to it. It renders the subject of it the most unhappy being ; and, notwith- 
standing, his friends generally, instead of manifesting sympathy, treat his case 
lightly, or rather with ridicule. 
TREATMENT. 
Indications of Cure.-1. Restore the nervous energy. 
2. Mitigate or remove the exciting causes of the complaint. 
3 Give tone to the stomach and alimentary canal, and promote the secre- 
tions. 
The complaints of hypochondriacs should be treated as of real existence ; HYPOCHONDRIA. 
401 
and, from whatever cause they may arise, it is our duty to employ art to 
remove it. Nor should we ruffle an irritable mind by levity, or expose a 
morbid sensibility to insult and reproach. 
Compassion, and not raillery, is to be bestowed on the hypochondriac, as 
the firm persuasion which he entertains will not allow his feelings to be 
treated as imaginary, nor his apprehension of danger to be considered as 
groundless, however the physician may be of opinion that it is the case in 
both respects. To gain his confidence, it will be necessary to attend to his 
complaints as if they were real. 
In general it is physical diseases which lead people to commit suicide. 
The disposition is produced by derangement of the brain or nervous system, 
and hence our attention should be directed to the fact: we should treat all 
affections of the mind as serious maladies. Persons who have attempted 
suicide, and have been rescued from it, subsequently, upon their recovery, 
express an abhorrence at the deed. The general health must be improved. 
The" remedies for this form of derangement divide themselves into two 
classes: 
1. Such as are intended to act directly upon the body; and, 
2. Such as are intended to act indirectly upon the body, through the 
medium of the mind. 
Gentle purgatives and injections, with anodynes, may occasionally be given. 
Before we proceed to administer the remedies that are indicated under our 
first head, it will be proper to review carefully the history of all the remote 
and exciting causes of this disease, and, when possible, to remove them. 
As regards medicine, we may commence by administering to the patient 
a mild emetic, which may be repeated, if the disease is obstinate, every week. 
The day after the exhibition of the emetic, a portion of our common physic 
may be given. These medicines will cleanse the stomach and bowels, and 
impart new action and tone to them, which is indispensably necessary in the 
cure of this complaint. 
It will be proper, in treating this disease, afterward to give mild laxatives 
to regulate the bowels ; and for this purpose there is nothing better than 
the anti-dyspeptic pill, to be occasionally given at bed-time. It corrects a 
morbid state of the stomach and intestines, and very gently excites a natural 
or peristalic action or motion, and thus gives tone and energy to the nervbus 
system. 
The next class of medicines to be given will be corroborants or tonics, 
such as the restorative cordial, or wine bitters* The patient may take from 
a table-spoonful to half a wine glass morning, noon, and night, to be ac- 
companied with an infusion of the common valerian. The body should be fre- 
quently bathed, as well as the feet; and, for pain in the head or other parts, 
fomentations and plaster should be applied to the seat of irritation, 
except it be in the head, when the rubefacient should be applied between the 
shoulders. When the patient is troubled with flatulence or any spasmodic 
affections of the head or stomach arising from it, or when there is great de- 
pression of mind, the following mixture may be given : Take spirits of cam- 
phor, ten or fifteen drops ; spirits of hartshorn, five or ten drops ; compound 
spirits of lavender, a tea-spoonful: mix. Let the whole of this be taken in 
half a tumbler of fennel-seed tea. This mixture will remove flatulence, 
nervous irritation, and exhilarate the spirits. It may be repeated when there 
is an occurrence of similar symptoms. 
* Half an ounce of red oxide or carbonate of iron may be added to every quart of the 
restorative wine bitters: it is also a good addition for hysterical and all nervous diseases. 402 
THE REFORMED PRACTICE OF MEDICINE. 
Ipecac may be given in this complaint. Take ipecac, pulverized, twenty 
grains ; castile soap, one drachm ; extract of chamomile, one drachm: mix. 
Divide into forty pills; take two twice or three times a day, or the ipecac 
pills may be given. Ipecac strengthens the stomach, causes a moisture of 
the skin, and favours the natural action of the bowels. In addition to what 
has been stated, it may be remarked, that, in regard to the moral management, 
great kindness, and encouraging and consoling conversation, are attended with 
good effects. The patient should not be opposed, except when he entertains 
false impressions about his disease or prospects-symptoms so prominent in 
this complaint; he should never be treated with ridicule. A strong attempt 
must be made to remove his groundless fears ; for the greatest part of his 
affliction consists in a deranged state of his perceptive faculties, received 
through the medium of the great sympathetic nerve, which leads from the 
brain to a disordered stomach. 
I have been called to patients almost frantic with hysterical or hypochon- 
drical paroxysms ; and, by sitting down with them, conversing calmly, and 
reasoning with them, and showing how groundless were their fears, they 
have recovered in a few minutes ; so great is the tranquillizing effect of 
soothing language, and imparting an opposite impression to the brain oi 
nervous system. It is the duty of the physician to administer to the diseased 
mind as well as the body. 
Says a writer, " in connexion with his experience he could say, that he 
believed if Payson, and Brainard, and Martin had understood the laws of 
the physiological constitution, they would not have suffered, as they did, such 
a remarkable degree of despondency ; and w'hat they considered the vileness 
of their own hearts was often only the corruption of their bodies. He knew 
that persons, afflicted, as he had been, with a nervous affection, could not but 
be in a gloomy state, if they did not understand the laws of the physiological 
constitution. Many there probably could bear testimony to the truth-he 
spoke to those that loved God-how often the heavens seemed to gather 
blackness ; their hearts appeared hard, and as though God had forsaken them • 
and this condition perhaps continued for days and weeks and months, and 
perhaps for years. But by and by perhaps they were a little better ; health 
and hope sprang up anew, and they saw once more the light of the sun of 
righteousness, and felt its cheering rays in their hearts. This he believed 
was often attributable to the state of their bodies." 
Dr. Gilman, of the state of Maine, when called to females labouring 
under a nervous or melancholic state of mind, prescribes the use of the 
which invariably restores them to health. In conversation 
with an aged minister, Mr. Smith, of Haverhill, Mass., and who has preached 
half a century, he remarked, in relation to the religious experience of ner- 
vous persons, as follows : " Weak nerves are the Devil's fiddle-strings, and 
he plays away well upon them." 
Says Hebberden, an old and experienced physician ; " The nerves of the 
stomach and bowels have so great a dominion and control over the whole 
nervous system, and these parts are so generally disordered in hypochondriac 
and hysteric patients, that, in my judgment, the best medicines will be such 
as correct their acidities, and are known by experience to be efficacious in 
restoring them to their proper strength and functions." 
" I would by no means be understood, by anything which I have said, to 
represent the sufferings of hypochondriac and hysteric patients as imaginary; 
for I doubt not their arising from as real a cause, as any other distemper. 
However, their force will be very different, according to the patient's choos- HYPOCHONDRIA. 
403 
mg to indulge in, and give way to, them, or to struggle against and resist them, 
which is much more in his power than he is aware of, or can easily be brought 
to believe: and it is surely a cause worthy of any one's utmost endeavours 
and exertions; for his striving to shake off this distemper is not contending 
about a frivolous concern, but whether he shall be happy or miserable ; since 
it is of the essence of this malady to view everything in the worst light: 
and human happiness, in many instances, depends not so much upon a man's 
situation and circumstances, as upon the point of view in which he contem- 
plates them." 
Bathing.-Two persons, Mrs. Moulson, of Philadelphia, and Mrs. Ludlum, 
of this city, inform me that they both experienced great benefit from salt 
water, in the summer season, in nervous debility. 
" Exercise," says Boerhaave, " by dissolving the viscid humours and pro- 
moting the circulation of the blood, increases perspiration, and by this means 
expels morbid humours and removes obstructions. These effects render it 
more important than all other remedies in insanity and nervous diseases." 
When the disease proves very obstinate, not readily yielding to this course, 
the anodyne powder will be found a valuable remedy; it will sometimes 
act like a charm when all other means fail. Cowper, who was subject to 
this complaint, states that a preparation of it saved him from being de- 
voured by melancholy. It calms the irritability of the nervous system, by 
raising the tossed or depressed powers of the brain. Should costiveness arise 
from its use, aperient pills must be taken to obviate it. 
A remarkable cure was effected by the use of opium in the case of Mr. 
Hezekiah Reynolds, of Wallingford, Connecticut. He had been a miserable 
hypochondriac for three years, and had applied to a number of physicians 
without aper having received any benefit. In this condition opium was 
prescribeu, of which he was directed to take from half a grain to a grain 
daily, which was gradually increased. This medicine had the desired effect, 
and restored him to health. Speaking of the cure, he exclaimed, u this is 
the medicine (opium) which has reached my disease." 
Opium, however, for obvious reasons, should be the last remedy resorted to. 
When the mind is so diseased that the patient imagines he has a living 
animal in his body, or something of the kind, he must be indulged in this 
belief, and apparent or deceptive means taken to destroy it, or to remove 
whatever cause of this nature may exist. Great attention must be given to 
the mind. The person afflicted with this disease should be recommended 
to read the Bible, particularly the New Testament, and to seek relief in 
obedience to the precepts of religion ; or, if he has no relish for this, recom- 
mend the perusal of interesting histories and narratives. Travelling has a 
powerful influence upon the mind of hypochondriacs ; the change of scenery, 
constant succession of new objects, together with the restoration of the ex- 
cretions, the natural circulation of the blood, all tend to remove the morbid 
or diseased state of the imagination. 
Gardening and agriculture have a great tendency to remove this complaint; 
while it engages the mind, and calls it from objects of gloom, it invigorates 
and strengthens the bodily powers. It seldom fails to create a keen appetite, 
which indicates a healthful state of the stomach, and, consequently, the tone 
of the nervous system is improved. If possible, the patient should reside 
where the scenery is pleasant and cheering, and near the water is always 
preferable, as it affords enlivening sensations to the mind, while it affords 
opportunities for agreeable amusements, pleasant walks, sailing, fishing, &c. 
A writer on this subject has the following remarks: " The patient's atten- 404 
THE REFORMED PRACTICE OF MEDICINE. 
tion is to be engaged in, and diverted to, other subjects than his own feelings , 
he is to be directed to vary the scene frequently, by going from one place to 
another ; associate as much as possible with agreeable, cheerful company; 
engage in such pursuits as will afford him moderate exercise in the open 
air, which gardening and riding on horseback are admirably calculated 
to do; and by all means to avoid absolute idleness ; but, in doing this, all 
applications to former studies, especially professional ones, are to be forbid: 
entertaining books will, however, be serviceable in assisting to divert the 
mind from itself. Gardening is a pursuit highly proper for hypochondriacs, 
as it will keep the mind alert and the body in exercise ; such as live in the 
country should, therefore, engage in it. In cities or large towns, where this 
healthy recreation cannot be enjoyed, no better substitute can be employed 
than that of fitting up an apartment as a work-shop. Working in a cool and 
free atmosphere would prove a deliverance from that chilliness which, for 
above half of our year, so miserably persecutes the tender (and it might act 
equally as a charm on the ruffled) spirits. When the hypochondriasis pro- 
ceeds from the influence of any one passion, exciting an opposite one will 
sometimes remove it; or, when it proceeds from attachment to an object, 
changing it to some other will remove it, as in disappointed love." 
A striking case occurred in Connecticut, where the affections of a young 
man were placed upon a coquette, who deceived him. He became affected 
with the hypochondriac disease, which rendered him very unhappy and 
miserable. He opened his mind to a friend, who advised him to place his 
affections upon some other female, which he did. He travelled south, was 
taken ill, and became attached to the person who nursed him during his sick- 
ness, and afterward married her, the effect of which was an entire change in 
his mind. His complaint left him, and he has remained perfectly well ever 
since. 
From sacrifices and long-protracted mental sufferings, (in establishing this 
system of Practice,) and other causes, about two years since the author of this 
work was reduced very low with a complaint of the liver and stomach. The 
force of the disease was exerted principally upon the nervous system, and 
for nearly a year induced such indescribable depression, despondency, and 
mental anguish, as bordered at times on insanity. Fearful and destructive 
apprehensions were constantly present, and every little pain or symptom was 
magnified, and caused dangerous or serious anticipations; nearly all the 
unavoidable distress consisted in this state of the mind, and w hich wras occa- 
sioned by irritation on the nerves of the stomach sympathizing with those 
of the brain, and next the mind : this should be well understood by hypo- 
chondriac and nervous patients. " Those who recover from this complaint," 
says Dr. Cheyne, " I have observed, live to a green old age." 
Although somewhat humiliating, I publish this for the benefit of those 
who may unfortunately be afflicted with the same horrid disease. 
REGIMEN. 
The regimen in the hypochondriac disease should be such as is easily 
digested. Those vegetables must be avoided which create flatulence ; meals 
are to be taken regularly and at stated times; fatigue and excessive labour 
avoided, and everything calculated to excite the passions or depress the mind. 
Red pepper or capsicum, mustard, and salt may be freely used ; they act as 
stimulants and tonics. Strong coffee and tea must be avoided, as well as 
ardent spirits. See Melancholy and Insanity. PALSY. 
405 
Nothing can surpass, nor even equal, the efficiency of exercise in nervous 
diseases; and I have long been persuaded that it is the principal remedy 
which can afford much permanent benefit in a majority of cases of this most 
distressing class of diseases. Abernethy is in the habit of saying, that he 
knows of no medicine but air and exercise for nervous complaints. 
CHAPTER III. 
PALSY. {Paralysis.) 
DESCRIPTION. 
Palsy is a disease principally affecting the nervous system, characterized 
by a loss or diminution of motion or feeling, or of both, in one or more parts 
of the body. When one entire side of the body, from the head downward, 
is affected,it is distinguished among professional men by the name of hemi- 
plegia. If one half of the body, taken transversely, by the seat of the disease, 
it is named paraplegia; and, when confined to a particular limb or set of 
muscles, it is called a paralysis. 
CAUSES. 
It may arise in consequence of an attack of apoplexy. It may likewise 
be occasioned by anything that prevents the flow of the nervous power from 
the brain into the organs of motion ; hence tumours, over-distention, and 
effusion often give rise to it. It may also be occasioned by translations 
of morbid matter to the head, a suppression of usual evacuations, and the 
pressure made on the nerves by luxations, fractures, wounds, or other external 
injuries. The long-continued application of sedatives will generally produce 
palsy, as we find those whose occupations subject them to the constant 
handling of white lead, and those who are much exposed to the poisonous 
fumes of metals or minerals, are liable to be attacked with it. Whatever 
tends to relax and enervate the system, may likewise prove an occasional 
cause of this disease. 
Palsy usually comes on with a sudden and immediate loss of the motion 
and sensibility of the parts ; but in a few instances it is preceded by a 
numbness, coldness, and paleness, and sometimes by slight convulsive 
twitches. When the head is much affected, the eye and mouth are drawn 
on one side, the memory and judgment much impaired, and the speech 
is indistinct and incoherent. If the disease affects the extremities, and has 
been of long duration, it not only produces a loss of motion and sensibility, 
but likewise a considerable flaccidity and wasting away in the muscles of the 
parts affected. 
The most perfect form of cerebral palsy is hemiplegia, in which the 
affection extends over the whole of one side of the body, from the head to 
the foot. Sometimes it takes the form of paraplegia, or palsy of the lower 
extremities ; and in some rarer instances the affection is confined to the loss 
of function in a particular nerve. 
SYMPTOMS. 406 
THE REFORMED PRACTICE OF MEDICINE. 
Hemiplegia, to which form of the disease the term palsy is in common 
language appropriated, has generally been considered as a minor degree of 
apoplexy. The attack of it is sometimes unexpected, but more commonly 
it is preceded for several days, or even weeks, by one or more of those symp- 
toms formerly described as the forerunnecs of apoplexy; such as giddiness, 
drowsiness, numbness, dimness of sight, failure of the powers of mind, forget- 
fulness, transient delirium, or indistinctness of articulation. For the most 
part, the paralytic seizure is sudden ; but occasionally*the approaches of the 
disease are made more slowly ; a finger, a hand, or an arm, the muscles of 
the tongue, of the mouth, or of the eyelids, being first affected, and the 
paralytic state gradually extending to distant parts. 
TREATMENT. 
In case the disease should attack the patient suddenly and violently, the 
same course must be pursued as in apoplexy. 
Spasmodic symptoms are very common in this complaint. The person is 
seized with a violent twitching of the muscles of the face, generally those 
on one side of it, which occasions very great distress. For this symptom, 
and to allay the spasm and pain, give the following mixture: Take ether, 
(cether sulphuricus,') one part; laudanum, (tinct. opii.,') one part; spirits of 
camphor, (tinct. camphorce,') one part: mix; of this mixture give a tea- 
spoonful in a tumbler of hop tea, or any other kind as a substitute, every 
half hour until the spasms subside. During the intermission the patient 
must take such medicines as are calculated to promote and equalize the cir 
culation, and purify the blood ; for this purpose the stimulating drops may 
be taken, a small tea-spoonful in a tumbler of any kind of tea, two or three 
times a day. The parts affected must be as often bathed with flannel. Let 
poultices, or plasters composed of equal parts of pepper, mustard, and Indian 
meal, moistened with vinegar, be applied to the feet, between the shoulders, 
and on the parts affected. 
Purgatives in palsy will be found very useful. One may be given two or 
three times a week, or as occasion requires. They rarely fail of proving 
beneficial to the patient. 
It is sometimes the case, however, that the lower portion of the system is 
in such a torpid or paralytic state, that no purgatives will act upon the 
bowels. When this symptom is present, stimulating injections or clysters 
must be administered. 
The following is excellent: Take red or cayenne pepper, one tea-spoonful; 
lobelia, two tea-spoonsful ; add a pint of boiling water. After standing a 
sufficient length of time to extract the strength, sweeten with molasses, add 
half a pint of milk and a gill of sweet oil. Let it be given warm, and as 
much of it as the patient can bear. This will excite action in the bowels 
and promote evacuations. Salt and water make a very good injection. I 
have seen patients in whom the fseces have been so hardened that instruments 
were required to remove them ; in such cases nothing is more valuable than 
injections of this kind. It is very necessary in this complaint to use frictions ; 
the parts must be rubbed for twenty or thirty minutes, two or three times 
a day. Where the feet or any other part swell, let them be frequently 
steamed over bitter herbs ; this I have found very useful. When the dis- 
ease is seated in one particular part more than another, I find stimula- 
ting plasters very useful. None is better than our common strengthening 
plaster, more particularly in consequence of the capsicum and camphor it ST. VITUS' DANCE. 
407 
contains. If the patient does not grow better under the above treatment, 
give the alterative syrup ; this medicine acts as an alterative, and seems to 
improve that morbid or viscid state of the blood, which is probably one of 
the exciting causes of the complaint. During the use of it let the part be 
bathed with the rheumatic liquid. 
For wakefulness, pain, inquietude, &c., an anodyne may be given at bed- 
time. The saturated tincture of hops may likewise be given, particularly 
when preparations of opium disagree with the person. The tincture or ex- 
tract of hyoscyamus is also very good. 
Electricity has been highly extolled for the cure of palsy; in some cases 
it appears to have been successful, in others injurious. I have known 
both effects arise from its application. The most benefit which I have seen 
from it has been where the disease was confined to particular parts. Re- 
course may be had to it, if other means fail ; or it may be tried in conjunc- 
tion with other means. Few, or no shocks, however, should be given ; and, 
should it prove the least injurious, it ought to be immediately discontinued. 
Nervines may be given, and also the restorative wine bitters. 
My prescription for a person, just called to visit, with a paralytical affec- 
tion of the arm and leg, is as follows : Cowage sprinkled on flannel, and bound 
on the parts ; vegetable counter-irritating plaster to the spine ; stimulating 
injections ; restorative wine bitters, with the addition of a little capsicum and 
alterative syrup. To which may be added friction and electricity. 
REGIMEN. 
In the palsy which arises in persons of a full habit, the diet should be light 
and spare ; but when the disease proceeds from relaxation or debility, which 
is generally the case, or makes its attack at an advanced period of life, it 
ought to be invigorating and warm, being seasoned with spicy and aromatic 
vegetables, as mustard, horse-radish, &c. Exercise is of great importance 
in palsy ; if the patient is capable of walking, he should take his exercise 
daily ; but if deprived of the use of his legs, he ought then to be carried 
abroad in a carriage of some kind, and none more appropriate than chairs 
upon wheels, on account of the facility of placing the patient in them, and 
their being drawn about by an attendant. Flannel should always be worn 
next the skin, and cold, moist, or damp air be avoided. Friction may like- 
wise be used. 
CHAPTER IV. 
ST. VITUS' DANCE. (Choera Sancti Viti.) 
DESCRIPTION. 
This singular disease is characterized by a twitching and convulsive action 
of certain muscles, usually confined to one side of the system ; and it affects 
principally the arm and leg. It is chiefly incident to young persons of both 
sexes, but particularly those of a weak constitution, or whose health and 
vigour have been impaired by confinement, or by the use of scanty and im- 
proper nourishment; and makes it attacks between the ages of ten and fifteen, 
occurring but seldom after that of puberty. By some physicians it has been 408 
THE REFORMED PRACTICE OF MEDICINE. 
considered rather as a paralytic affection than as a convulsive disorder, and 
has been thought to arise from a relaxation of the muscles, which, being 
unable to perform their functions in moving the limbs, shake them irregu- 
larly by jerks. 
CAUSES. 
This disease may arise from various causes ; from morbid condition of the 
stomach, as teething, worms, acidity in the bowels, offensive smells, violent 
affections of the mind, as anger, fear, &c. It may arise also from debility, 
and from extreme irritability of the nervous system. 
SYMPTOMS. 
" It is," says Sydenham, " a kind of convulsion which principally attacks 
children of both sexes, from ten to fourteen years of age. It first shows it- 
self by a lameness, or rather unsteadiness, of one of the legs, which the patient 
draws after him like an idiot; and afterward affects the hand on the same 
side, which, being brought to the breast or any other part, can by no means 
be held in the same posture for a moment, but is distorted or snatched away 
by a kind of convulsion into a different posture or place, notwithstanding all 
possible efforts to the contrary. If a glass of liquor be placed in the hand 
to drink, before the patient can get it to his mouth he uses a thousand odd 
gestures, not being able to carry it in a straight line thereto, because his 
hand is drawn different ways by the convulsions ; as soon as it has reached 
his lips, he throws it suddenly into his mouth and drinks it very hastily, as 
if he only meant to divert the spectators." 
With these evidences of disturbance of the brain are usually united very 
unequivocal marks of a deranged condition of the stomach and bowels. A 
variable, and often ravenous, appetite, a swelling and hardness, or sometimes 
flabbiness, of the abdomen, with constipation, accompany, in a large propor- 
tion of cases, the onset of the disease. In its advanced periods we may ob- 
serve impaired digestion, a very offensive state of the al vine evacuations, and 
flaccidity and wasting of the muscles throughout the body. 
TREATMENT. 
The indications in this complaint are : 
1. To remove the exciting causes. 
2. To remove the constipated state of the bowels, and regulate their 
functions. 
3. To strengthen the general system. 
First; If, upon inquiry, the stomach is found deranged, administer an emetic ; 
this will evacuate the stomach, and impart new tone to it, as well as to the 
nervous system. The day after this emetic has been exhibited, a moderate 
purgative may be given, to be repeated weekly; from the sympathetic effect 
of this class of medicines, they are very valuable in this complaint. 
After having thus cleared the stomach and bowels, and created in them a 
more healthy action, give the restorative wine bitters, to which add half 
an ounce of the red oxide of iron. Anti-dijspeptic pills to be taken at night, 
and in sufficient number to regulate the bowels ; two or three every day or 
two are usually sufficient. They impart tone and energy to the system, 
while they carry off all feculent matter from the intestines. The feet should 
be occasionally bathed, as also the surface of the body, if the skin is usually CHOLERA MORBUS. 
409 
dry. The following infusion, used with the other means recommended, (and 
probably used alone,) is a specific in this disease ; I know not of a single 
case in, which it has failed to effect a cure: Take scullcap, (scutellaria 
one ounce; boiling water, one quart; strain, and sweeten with 
loaf sugar. Let the patient drink of this freely through the day, and con- 
stantly to be drank alternately with the tea of valerian before-mentioned. 
1 have found this treatment invariably successful. One case occurred in a 
woman fifty years of age, who had had the complaint a length of time, had 
been treated by seven or eight physicians without benefit, and, after submit- 
ting to the use of the above remedies, (emetics excepted,) she recovered. 
The scullcap appears to have specific effects in this and most other nervous 
complaints. 
Dr. Ellitson states, in the London Lancet, that he has cured several cases 
of cholera by giving two diachms of carbonate of iron every six hours. The 
dose was increased to half an ounce every six hours, given in molasses 
REGIMEN. 
A diet that is nutritious and easy of digestion must be used, and every- 
thing calculated to excite mental affections avoided. 
GASTRIC DISEASES. 
VII. 
CHARACTER. 
Gastric diseases include such as are more especially or apparently located 
in the stomach, or have their origin in that organ. 
CHAPTER. I. 
CHOLERA MORBUS. (Cholera Morbus.) 
DESCRIPTION. 
Cholera morbus is a disease of the stomach and alimentary canal, cha- 
racterized by vomiting and purging, with severe griping, pain, cramps in the 
stomach, abdomen, and extremities. It is very prevalent in this climate, 
particularly during hot weather, and much more so in the East and West 
Indies. 
CAUSES. 
The immediate exciting cause of the cholera morbus is, the action and 
stimulus of an acid secreted in the liver, or formed in the stomach and 
alimentary canal, and which produces an irritation of the mucous membrane 
of these parts, the same as many kinds of poison, and which cause the phe- 
nomena of the complaint; and this probably is the nitric or septic acid. Dr. 
Vought and (I believe) Dr. Mitchill entertained similar views. I have 410 
THE REFORMED PRACTICE OF MEDICINE. 
read an author who speaks of the same effects following the use of certain 
kinds of fish, said to feed on copper banks, and which cause vomiting, 
purging, cramps, &c.; all which show conclusively that the cholera morbus 
is occasioned by some kind of poison. It is well known that corrosive sub- 
limate, and other agents, have very similar effects on the system as are 
exhibited in this complaint. This poison is no doubt received into the 
circulation through the medium of the atmosphere ; and, not being eliminated 
by the ordinary excretory organs, especially the skin, is thrown back from 
the surface to the liver, which becomes deranged and engorged with an 
accumulated quantity of blood, combined with a morbid fluid or acid, which 
proves the exciting cause of the complaint. There are very many predis- 
posing causes, such as indigestible and irritating kinds of food and drink, 
crude or unripe fruit, and all articles that contain much acid, or such liquids 
as soon run into a state of fermentation ; but causes of this kind rarely pro- 
duce the disease, unless the system is predisposed to it by a debilitated state 
of the digestive organs, or by a general relaxation and exhaustion from the 
influence of great heat. Fermentation, which generates an acid, may be the 
immediate cause of this disease. 
SYMPTOMS. 
The cholera morbus generally comes on very suddenly. It usually com- 
mences with nausea and pain in the stomach, followed by severe griping and 
distress in the abdomen. These symptoms are immediately succeeded by 
vomiting and purging, which generally continue in paroxysms until great 
prostration follows. In the intervals between the periods of vomiting there 
is great sickness and distress at the stomach. The stools are at first thin and 
watery, and generally tinged with bile. After the disease has continued for 
a short time, the evacuations are very bilious. As the disease advances, the 
vomiting, retching, purging, and pain are severe and incessant. The peculiar 
feature of the complaint is a spasmodic affection of the abdominal muscles 
and extremities. The person is drawn up on every attack or in every 
paroxysm, often causing him to scream aloud with dreadful agony. The 
thirst is usually very great, but almost every liquid taken into the stomach 
is immediately ejected. As the disease progresses the pulse becomes small, 
feeble, and intermitting ; there is coldness of the extremities, countenance 
pallid and expressive of great distress, a cold sweat breaks out, and great 
prostration follows. 
Cholera morbus is a very common and dangerous disease, often proving 
fatal in twenty-four hours, and the malignant type of it in a few hours. 
TREATMENT. 
The principal indication of cure in this complaint is, to neutralize or de- 
stroy the acid, vitiated, or acrid bile ; in other words, the exciting cause of 
the complaint. Some have recommended and prescribed emetics, and some 
purgatives; but I have no evidence of the utility of either, and I consider 
them very injurious. They both seem calculated to aggravate the disease, 
by continuing or increasing the vomiting and purging ; although it is possible 
that a new action might be excited by the use of one or both, and in this 
way prove beneficial. The following treatment, I think I may say with pro- 
priety, I have found an infallible remedy for the cholera morbus, even in 
the last stages of it. When first called to a patient labouring under the 
complaint, my first object is, to allay the irritability of the stomach ; not by CHOLERA MORBUS. 
411 
giving any medicine calculated to retain the morbid secretions, or to lock 
them up in the system, but by neutralizing, or rendering inert and harmless, the 
deleterious agent or agents, which is the immediate cause of it; and the neu- 
tral mixture fulfils this indication admirably : put the powder into a tea-cup ; 
add sufficient loaf sugar to sweeten, then add half a pint of boiling water, 
and, when nearly cold, two table-spoonsful of best brandy ; of this give two 
table-spoonsful every half hour, or as often as the paroxysms or periods of 
vomiting and purging take place. In very severe cases I have occasionally 
added to every dose fifteen or twenty drops of laudanum. This must be 
repeated until the urgent symptoms are diminished. The effect of this 
medicine is truly surprising. So sudden and powerful is it, that I have often 
been delighted with its salutary effects. It is seldom that the patient will vomit 
up more than one dose of the medicine ; it rests upon the stomach, calms 
the irritation, checks the nausea and vomiting, passes gently through the 
alimentary canal, changing their contents or fieces from the most morbid and 
fetid, to the most healthy state. While mercury, which is now given in 
such cases, only aggravates, this preparation acts divinely, and, I was 
about to say, might be compared to the act of extinguishing fire by pouring 
water upon it. Besides, the administration of this mixture, in case the dis- 
ease is so severe as to render it imprudent to wait the short time that is 
necessary for the operation of it, an opium pill may be given. I have sel- 
dom, however, found this necessary. External applications must be used, 
and also the following: Take red or cayenne pepper, one table-spoonful; 
spirits, one pint; simmer a few minutes, then dip flannel in, and let it be 
applied warm to the stomach and abdomen, and also to the extremities, par- 
ticularly if there are cramps. As a change, I have also applied fomentations 
of bitter herbs over the parts with decided benefit. Hops, simmered in vine- 
gar, are excellent. These applications remove the tension and spasms so 
peculiar to this complaint. 
Sometimes a greater portion of the disease seems concentrated in the in- 
testines, or the umbilical region, occasioning very great distress, when it be- 
comes necessary to administer injections. Should this be the case, or should 
there be such an assemblage of symptoms as require the application of seve- 
ral remedial agents to subdue them, the following injection must be given: 
Take mucilage of slippery elm bark, one pint; sweet milk, half a pint; mo- 
lasses, half a pint; olive oil, one gill; bicarbonate of potash, a tea-spoonful; 
laudanum, a tea-spoonful; mix: introduce as much as possible ; it has a 
very soothing effect upon the bowels, and generally in ten or fifteen minutes 
relieves the pain. Hot bricks may be applied to the feet, and they should 
be bathed in warm ley water. The patient should take freely of mint tea, 
slippery elm, and other mucilaginous drinks. Cold water poured upon 
bread toasted very brown or black, makes a very grateful and medicinal 
drink. Indian or oat meal gruel also has a very excellent effect upon the 
bowels in this disease; it acts as a soothing or emollient poultice to the 
stomach and intestines, while at the same time it affords nourishment. 
I repeat, that the above practice is uniformly successful in cholera morbus ; 
where it has been promptly tried, it has never, to my knowledge, failed in a 
single instance. I have been called upon when life was nearly extinct, 
and the patient has been drawn nearly double with the pain or spasms, 
and when the ordinary course of treatment, such as mercury, salts, senna and 
manna, &c., had only rendered the complaint worse ; and, by pursuing the 
treatment here laid down, they have been immediately relieved, and in a few 
hours cured. I have just prescribed for a case of the cholera morbus, where 412 
THE REFORMED PRACTICE OF MEDICINE. 
the person had been vomiting and purging three days, and had been attended by 
a physician without benefit. He had become almost senseless, with excessive 
prostration, and the evacuations passed off involuntarily. I administered 
the mixture first-mentioned, combined with a small quantity of cinnamon and 
cloves ; in a few hours the disease was arrested, and he soon recovered. It 
is impossible for my pen to describe the great contrast between the common 
and the reformed practice, in this as well as other diseases; and, to be known, 
needs but to be tried. The treatment is founded upon a belief that the cause 
of the disease is an acid, and that the remedy is an alkali, and hence the bi- 
carbonate of potash is given, and may be considered the antidote. 
SECTION I. 
ASIATIC OR INDIAN CHOLERA. 
The great Asiatic or Indian Cholera, which swept off so many thousands, 
and which often proves fatal in a few hours, appears to be only an aggrava- 
tion of the common cholera, or a more malignant type of it. Treatment,the 
same, only more active ; the warm bath and friction are excellent. 
SECTION II. 
CHOLERA OF INFANTS; OR, SUMMER OR BOWEL COMPLAINTS. 
{Cholera Infantum.) 
DESCRIPTION. 
This disease is the cholera of infants, which in some respects resembles 
that of adults ; but differs from it in many respects. It is usually known 
by the name of the summer or bowel complaint, and is very prevalent among 
children during the summer season; it very often proves fatal. 
CAUSES. 
There appears to be three principal causes which produce this complaint: 
1. A great degree of heat. 
2. The impure air of crowded cities. 
3. Dentition, or teething. 
But the most common cause in children is, unripe fruit. 
This disease is very seldom met with in the country, where the air is 
salubrious ; but in cities it produces annually a most frightful mortality. It 
may be caused by a check of perspiration, causing the blood to retreat from 
the surface to the internal parts, and deranging the liver and mucous mem- 
brane of the intestines. 
SYMPTOMS. 
This complaint is usually characterized by fever, and commences in a 
gradual manner, with more or less diarrhoea; and, after a short time, it is at- 
tended with nausea, retching, and vomiting. The evacuations are very offen- CHOLERA 
413 
sive, apparently not very bilious, and consisting of a slimy, whitish, frothy, 
or nearly of a colourless, watery fluid. If the disease progresses for a short 
time, the child begins rapidly to waste. There is a coldness in the extremities, 
the skin is shrivelled and dry, and there is a preternatural degree of heat in 
the head and bowels. The face is very pale, the eyes dull and sunk, the 
pulse weak, irregular, and frequent. There is lethargy or drowsiness, and 
the child sleeps with his eyes partly open. There is considerable tossing or 
motion of the head when awake; and, if no remedy is administered, the child 
rapidly sinks into a state of great prostration and insensibility, and which 
proves fatal. 
This complaint is liable to assume a chronic form, and become very much 
protracted ; when this is the case, an almost incredible degree of emaciation 
follows : the child becomes a living skeleton; canker appears on the tongue 
and cheeks; the face and other parts bloat; and the discharges are ex- 
tremely acrid, excoriating, and fetid. 
The continuance of this disease is very various, depending upon many 
causes, such as air, diet, nursing, medical treatment, &c. It may prove fatal 
in a few hours, or it may last many months. 
Where the disease has continued for a length of time, there is ulceration 
of the lining menbrane of the stomach and bowels, showing conclusively 
that the disease is caused by the action of an acid or poisonous fluid acting 
upon these parts. 
TREATMENT. 
If called to prescribe for this- complaint when there is vomiting, the first 
object is, to allay it; and this may be done by the exhibition of the neutrali- 
zing mixture, as in cholera morbus. It must be given according to the age 
of the child and the urgency of the symptoms; one or two tea-spoonsful 
to a child one year old, and repeated every half hour. This preparation is 
not only necessary in the stage of nausea and vomiting, but in any and 
every stage of the complaint; it acts mildly upon the stomach and whole 
alimentary canal, neutralizing acidity, while it evacuates the fetid and morbid 
accumulation, and brings on a healthy action, and thus improves the con- 
dition of the patient speedily and in an eminent manner. After repeated 
trials of all other kinds of medicine, I find this altogether superior to every 
other : it has a threefold effect; it corrects acidity, cleanses the stomach 
and bowels, while it restores the tone of them by its astringent qualities. It 
should be continued until the passages become healthy, which is usually the 
case as soon as it acts moderately upon the bowels, or as a laxative. In 
protracted cases of the disease it may be given four or five times through 
the course of the day. In this complaint injections or clysters are exceed- 
ingly valuable ; they have a soothing and emollient effect upon the intes- 
tines ; allaying pain and inflammation in a very remarkable manner. One 
may be administered whenever the child is very fretful and distressed. The 
following: Take an infusion or mucilage of slippery elm, half a pint; milk, 
half a pint; molasses, one gill; sweet, or olive oil, a wine glassful; common 
salt, half a tea-spoonful : mix, and introduce with a suitable sized syringe. 
There is usually, as before observed, considerable heat and swelling of th© 
abdomen: for this symptom let a fomentation of hops be applied. 
Particular attention must be paid to the state of the skin. If the disease 
is caused by morbid humours retained in the system and thrown upon the 
intestines, how necessary is it that they should be thrown off through the 414 
THE REFORMED PRACTICE OF MEDICINE. 
proper excretory ducts. Therefore such means and medicines must be used 
as will divert the vitiated fluids from the centre to the surface. The feet 
and body must be often effectually bathed and rubbed with weak ley water, 
applied tepid; this will prove very cooling and refreshing, and lessen the 
violence of the disease. In order to promote gentle perspiration, as well as 
to allay irritation or pain, medicine should be given that has this twofold 
effect, which is the diaphoretic powders ; and they are particularly serviceable 
when the child is wakeful, restless, and in pain; for a child a year old 
give a few grains in a little tea; if the desired effect is not produced in three 
hours, repeat the dose. Mucilaginous and cooling drinks are very useful 
in this complaint. The benne plant makes an excellant mucilaginous drink ; 
a few leaves, dipped in a tumbler of cold water, immediately form a clear, 
tasteless, cooling, and soothing mucilage, which, it is stated, has cured hun- 
dreds of cases without any other preparation. The benne plant is annual, and 
very easily raised, by sowing a few seeds in the garden, in the spring, and 
should be kept in every family. When the disease assumes a chronic form, 
and proves very obstinate, additional means may be necessary to remove it. 
In such a stage of the complaint, after proper evacuations, give the black- 
berry syrup, and occasionally an injection. 
This treatment has, in my hands, invariably cured the worst stages of this 
disease. My practice has been very extensive in it, and I can scarcely 
recollect a single instance of failure. 
REGIMEN. 
Arrow-root tea or jelly may be given, and mucilaginous drinks and liquid ; 
panado, gruel, &c. The best diet for children afflicted with bowel com- 
plaints is, milk thickened with wheat, or, which is better, rice flour, to which 
a little cinnamon may be added. The child must be kept clean, clothes 
often changed, and, if possible, removed to a pure atmosphere. 
SECTION III. 
SICK STOMACH. {Cholera Americana.) 
DESCRIPTION. 
This is rather a novel disease, and seems peculiar to Ohio and other 
western states. It appears to be a complaint in which morbid bile or poison 
preponderates, characterized by heat, burning and sickness at the stomach, 
with retching and vomiting. 
CAUSES. 
It is difficult to say precisely what the cause of this disease is; some of 
the inhabitants of those places where it prevails suppose that it arises from 
an unknown vegetable poison, eaten by cows, and poisoning their milk, 
butter, and cheese, and all those who eat of them. 
The symptoms of this novel complaint are, disagreeable and sickening sensa- 
SYMPTOMS. WATER BRASH. 
415 
tions at the stomach, general debility and lassitude, succeeded by extreme 
loathing, nausea, and vomiting, or distressed retching to vomit; the vomit- 
ing returns every hour; the patient complains of great distress, and a burning 
sensation at the stomach. Hiccough and hot belchings are often troublesome. 
The tongue is slightly furred; the breath is very offensive, and has a 
peculiar and disagreeable smell. In more malignant cases the patient 
falls into a stupor, the eyes are protruded, and pupils dilated, with othei' 
symptoms of inflammation of the brain ; with an occasional vomiting of 
black matter, which generally destroys the patient in a few days. The mate- 
rials usually thrown out of the stomach consist of liquids that have been 
swallowed, which are hot, acrid, or sour when ejected ; the patient is dizzy, 
trembles, and staggers; as also the animals seized with it. 
TREATMENT. 
To allay the irritability of the stomach, give the following: Bicarbonate 
of potash, one drachm ; mint water, eight ounces: mix. A table-spoonful 
every hour may be taken. When the stomach is calmed or quieted, the 
neutralizing mixture may be given until it acts as a gentle purgative ; 
after which let it be administered two or three times through the course of 
the day. Should this fail to correct the morbid state of the stomach, let the 
common purgative be administered, and occasionally repeated : smart weed tea 
is said to be a very valuable remedy in this complaint. If the disease does 
not yield to this treatment, it will be necessary to exhibit emetics occasionally, 
until a healthy state of the stomach is produced : the common emetic pow- 
ders may be given; and, where circumstances justify, or there is nothing to 
contra-indicate it, the treatment may be first commenced by a gentle emetic. 
CHAPTER IL 
WATER BRASH. (Pyrans. 
DESCRIPTION. 
This disease is known by a burning pain in the stomach, attended with 
copious eructations, generally of a watery and insipid fluid. 
CAUSES. 
Whatever deranges the functions of the stomach or the surrounding vis- 
cera, may give rise to the water brash ; as indigestion, acidity, &c. 
SYMPTOMS. 
The fits of pyrosis usually come on in the morning and forenoon, when 
the stomach is empty ; and the first symptom which the patient perceives is 
a pain at the pit of the stomach, with a sense of constriction, as if it was 
drawn toward the back ; and this is usually much increased by an erect pos- 
ture. The pain, after proving severe, and continuing for some time, is fol- 
lowed by eructations and the discharge of a considerable quantity of thin 
watery fluid, sometimes of an acid taste, but often quite insipid ; in some 416 
THE REFORMED PRACTICE OF MEDICINE. 
instances, however, it is very ropy, and of an appearance somewhat similar 
to the white of an egg. On a frequent repetition of the eructations and dis- 
charge, the fit at length goes off. This disease rarely proves fatal, but is 
often tedious and troublesome to remove, being apt to recur occasionally a 
long time after it has once taken place. 
TREATMENT. 
The patient will commence with the following liquid: Take elixir salutis, 
or compound tincture of senna, eight ounces ; tincture of the balsam of tolu, 
half an ounce : mix. Of this the patient will take a table-spoonful every 
morning, fasting; it creates a healthy action of the stomach, and thus soon 
mitigates the symptoms of the complaint. It is carminative, stimulating, 
laxative, and tonic in its effects, and, therefore, well calculated for the re- 
moval of this disease. 
I recollect an instance where the person had applied to various physicians 
for a most obstinate case of water brash, and could find no remedy till he 
took the above preparation, which operated like a charm, soon effecting a 
cure. If this fails, take the anti-dyspeptic pills. 
REGIMEN. 
Great attention must be paid to regimen ; nothing greasy or acid should 
be taken; only use such articles as are easy of digestion. Red pepper, 
mustard, and salt may be taken with food. 
CHAPTER III. 
INDIGESTION. (Dyspepsia.) 
DESCRIPTION. 
Dyspepsia, is a derangement of the digestive functions, occasioning an in- 
terruption in the organs concerned in the process of digestion ; the immediate 
cause of which appears to be a diminished or increased quantity, or vitiated 
quality, of the gastric juice, or the secretion of bile. 
CAUSES. 
Whatever causes a derangement in the digestive organs may produce dys- 
pepsia ; the most frequent are, intemperance in eating and drinking, and the 
want of exercise in the open air; intense anxiety of mind, depressing pas- 
sions, cold, the use of animal food, hot bread, pastry, tobacco, tea and 
coffee, superfluous evacuations, excessive venery, mercury, bleeding, ob- 
struction in the liver and spleen : swallowing the food without chewing is 
a common cause- " Many in America," says an English traveller, Tyrone 
Power, " swallow their food with the rapidity of a wolf." Debility is a fre- 
quent cause of this complaint; also eating crude and indigestible substances. 
Says a very eminent European surgeon, when speaking of the cause of 
this affection; " The foundation of this complaint is often laid in infancy and 
youth by the excessive employment of mercury, a preparation which is totally INDIGESTION. 
417 
uncalled for, but which has become very much in fashion of late years; and 
when the patient has fortunately escaped its use in early life, it has often 
proved a direct cause of indisposition at a later period. Mercury is a strong 
and peculiar stimulant (or poison) to the digestive organs, and, when re- 
peatedly administered, impairs their natural energies, and exerts a very de- 
pressing and distressing effect upon the whole nervous system." 
All these causes so weaken the coats of the stomach, that the latter becomes 
incapable of performing its office. It may occasion a morbid, deficient, or in- 
creased secretion of the gastric juice, or may produce inflammation of the 
mucous membrane which lines the stomach. 
SYMPTOMS. 
The symptoms of indigestion differ considerably, according to the stage 
of the complaint, or the degree and extent of the irritation. In the com- 
mencement the appetite b variable, generally weak, and often entirely de- 
stroyed ; the patient is troubled with flatulency, distention, acid eructations, 
and colic pains; the mind is, at times, depressed and languid ; the tongue 
covered with a white fur ; the bowels usually constipated ; the whole sys- 
tem languid, particularly during the process of digestion ; and there is almost 
a constant uneasy feeling in the stomach. Sometimes the appetite is mor- 
bidly craving; but, if the patient indulges freely in taking food, he becomes 
much oppressed, and generally suffers severe pains some hours after eating. 
After the disease has continued for some time, or is aggravated by some 
unusual irritating cause applied to the stomach, the pulse becomes tense 
and quick ; the epigastrium tender to the touch ; the mind irritable, discon- 
tented, and gloomy. The colic pains are more frequent and severe some 
time after taking food; the bowels irregular, being sometimes constipated ; 
at others affected with diarrhcea, during which portions of food are occa- 
sionally passed off in an imperfectly digested state ; the stools vary in colour, 
consistence, and character. The body now begins to waste ; the strength 
fails; the epigastric distress severe and constant; the countenance assumes a 
haggard and sallow aspect; the patient complains of more or less difficulty 
of lying on the left side ; the skin becomes dry and shrivelled ; and there is 
usually a morbid sensibility to low temperature. 
From the extensive sympathies which subsist between the stomach and 
every other part of the living body, dyspeptics are frequently much harassed 
by painful and other distressing affections in parts situated remotely from 
the stomach. Among these sympathetic affections of indigestion, headache 
is the most common and annoying. 
We may sum up the symptoms of dyspepsia as follows: Nervous debility, 
depression of the mind, oppression after eating, acid eructations, sick head- 
ache, costiveness, scanty and painful evacuations, jaundice, piles, female ob- 
structions, heartburn, furred tongue, flatulency, distention of stomach and 
bowels, dizziness, sickness at the stomach, water brash, loss of appetite, 
pain in the side, and torpor of the liver and bowels. 
The objects to be kept in view in the treatment of dyspepsia are, 
1. To obviate the several exciting causes of it. 
2. To expel from the stomach the several offending agents. 
3. To obviate costiveness. 
4. To improve the tone or energy of the stomach; and, 
TREATMENT. 418 
THE REFORMED PRACTICE OF MEDICINE. 
Lastly, to remove urgent or distressing symptoms. 
The patient must abstain from every exciting cause which he is conscious 
has given rise to the disease, whether in eating or drinking, or any other 
irregularity. 
The most important course to pursue in this disease, in order to remove 
the exciting cause and effect a cure, is, a rigid course of diet and regimen. 
Irregularity in these respects have formed it, and it follows that an opposite 
course of treatment is required, and indispensably necessary. It is useless 
to prescribe medicine without a strict adherence to such measures. A strict 
and undeviating course must be paid to diet, both in quantity and quality. 
Meals should be taken at regular hours, eat sparingly, and drink very little. 
Excess and dissipation must be avoided; also late hours, indolence, wine, 
and ardent spirits, animal food, hot bread, pastry, &c. Exercise in the open 
air should be taken, and, if practicable, in the country. Early rising, and 
conversation only with virtuous persons. All sedentary habits to be avoided; 
likewise intense study and excessive venery. Avoid also one great propensity 
in dyspeptic persons, which is, to resort every day to different doctors or to 
take nostrums ; this keeps the stomach all the time in motion, without 
giving an opportunity of testing any treatment or medicine. It is only by a 
very slow process the stomach resumes its lost functions ; and the making 
a drug-shop of it must disturb its efforts to bring about a healthy action. 
Bathing in salt or other water daily, of a moderate temperature, is very use- 
ful ; also the shower bath, and the surface well rubbed with a coarse towel. 
For removing from the stomach all offensive or morbid agents, an emetic may 
be given. The day after the emetic has been given, our common purgative 
may be administered ; but in obstinate cases the compound powder oj man- 
drake is far preferable ; a moderate dose of either will be sufficient. It 
will be necessary to repeat each of these classes of medicines once a week, 
especially where the disease has been of long standing and inveterate. 
There is, in this complaint, such a tenacious viscid fluid, or state of the 
stomach, that every means to remove the complaint is apt to prove ineffectual, 
Until there is a new or healthy action excited. No medicine appears to act 
upon the living fibre of the stomach, until its actions have been very much 
stimulated or inverted. 
Emetics particularly prove beneficial in dyspepsia, first, by evacuating 
morbid or offending materials; and, second, by imparting new tone or energy 
to it; third, by their action upon the skin, by eliminating morbid or vitiated 
humours ; and, fourth, by the healthy shock they give to the neighbouring 
organs and the whole system. Even where dyspepsia is complicated with 
organic or chronic affections of the liver, which is very often the case, and 
where mercury is supposed to be necessary to remove them, this kind of 
emetic, particularly when accompanied by mandrake, affords a substitute 
for this mineral. Where the liver has been much affected, I have found 
their exhibition very successful. In this case the hepatic pill may likewise 
be given. 
The next great indication to fulfil in the treatment of dyspepsia is, to re- 
gulate the bowels. It appears that the liver in this disease,, from debility, 
obstruction, or torpor from some cause, ceases to perform its office, or per- 
forms it very imperfectly; in consequence of which there is not a sufficient 
quantity, or a proper quality, of bile secreted to keep up a regular or peristaltic 
motion of the intestines ; the effect of which is, an inactive or costive state 
of them ; and, therefore, such medicines as stimulate the liver to perform its 
office are obviously indicated. INDIGESTION. 
419 
In addition to the emetics recommended, the patient must endeavour to 
regulate the bowels, if possible, by a course of diet; and there is no article so 
effectual as the coarse or brown bread, which is now in many places very 
much used. The bran, in which consists the physical properties of the 
wheat, is retained in making this bread, and which affords a more natural 
stimulus to the liver and alimentary canal than any medicine that can be 
given. The wheat should be ground coarse, but not bolted, and in all other 
respects made as ordinary bread. Some prefer biscuit made of the same. 
1 do not now remember a single case, however costive the bowels may have 
been, where this bread has failed to regulate them, as well as to improve 
the state of the stomach. 
The next indication is, to improve the tone of the stomach. 
The means already recommended are calculated to fulfil this object, but 
other medicines may be necessary ; and I have found that the anti-dyspeptic 
pills are well calculated for this purpose; they first gently stimulate the 
stomach, while at the same time they cleanse and impart tone and energy to 
it, without causing that debility -which so often follows the use of other pre- 
parations : they also serve to obviate costiveness; and have cured many 
cases of dyspepsia without the aid of any other medicines. Another most 
valuable tonic for indigestion, and which is likewise calculated to fulfil 
several of the above indications, is, the restorative wine bitters. 
When the stomach has been cleansed the following pills may be given: Take 
pulverized ipecac, one scruple, or a tea-spoonful; add three times the quantity 
of castile soap, scraped fine: mix well together; and, if necessary, a little 
molasses or mucilage may be added j form into pills the size of a small pea, 
and take one or two three or four times a day: they ought not to produce 
nausea. Those who prefer may take the powder of ipecac, one or two 
grains, as often during the day ; this strengthens the digestive organs and 
excites a gentle action on the bowels and skin. During the use of these 
pills the patient may take the following tea : Take boneset, tansy, wormwood, 
hoarhound, equal parts, make a tea, and drink a wine glassful, cold, three or 
four times during the day. I am now prescribing the above for a patient 
who has been a miserable dyspeptic for years, without any other medicine, 
with rio-id diet, and who is constantly growing better. 
Paw in the Side and Breast.-For these symptoms bathe the parts with 
the rheumatic liquid; also the spine, and particularly between the shoulders. 
A strengthening plaster may subsequently be applied. In some severe cases 
I have ordered repeated blisters on the side, and with much benefit: they 
should, however, if possible, be dispensed with. Vegetable counter-irritant, 
to the same parts, would probably do as well, or better, and give very little 
inconvenience. There is often great pain in the stomach from two causes, 
viz., indigestion and flatulence ; to relieve which give the compound spirits 
of lavender : this usually affords immediate relief. 
Acid in the Stomach.-Give our neutralizing mixture. An acquaintance 
of mine says he derived great benefit from taking the super carbonate of soda, 
a tea-spoonful in a little water, several times a day. Where many kinds of 
medicines have been tried without any advantage, it may be best to take none 
at all, and rely on diet, exercise, and the resources of nature. 
With us this treatment has been very successful. A thousand other ar- 
ticles have been recommended, and many have I tried, but found little or 
no benefit resulting from them. 
A Mr. Halsted, of this city, a short time ago became very popular for 
treating the dyspepsia ; but his practice has now fallen into disrepute. It 420 
THE REFORMED PRACTICE OF MEDICINE. 
consisted principally in suddenly thumping or striking upon the abdomen, 
and kneading it with the hand, with a view to remove the torpid state. 
Several have informed me that they received great benefit from this pro- 
cess ; that it almost always had the effect of regulating the bowels : being 
very simple and easily put in practice, it may be tried with safety, and with a 
prospect of some advantage. 
Mr. McChesney states that he cured himself by taking yellow dock tea, 
as follows : Yellow dock, one ounce ; boiling water, one quart; boil one 
quarter away; then take one gill morning and night: it purges gently, or 
regulates the bowels, and is alterative. It has cured others. 
Dyspeptic Ley-Take of hickory ashes, one quart; common soot from 
the chimney, six ounces ; boiling water, one gallon : mix, and let them stand 
twenty-tour hours, frequently stirring the ingredients ; a tea-cupful of this 
liquor decanted, to be given three times a day : it must be decanted at the 
end of twenty-four hours ; by standing longer it becomes too caustic for use. 
This liquid was employed by Dr. Physick in his own case, and was of de- 
cided advantage when the common alkaline preparations were of no use. 
Indian Remedy for Dyspepsia-Take an emetic of lobelia, thirty grains, or 
am. ipecac ; after its operation take a mild purgative of the culver's phy- 
sic, about thirty grains ; or of pulverized mandrake, about twenty grains ; 
then of the powder of the inner skin of a wild pigeon's gizzard ; take a tea- 
spoonful three times a day, in molasses, syrup, or cold water. Drink freely 
of a tea made of pipsissiway, (pyrolla umbellata.') 
REGIMEN. 
There is no disease in which a rigid attention to diet is of more absolute 
importance than in dyspepsia : indeed the disease may be entirely cured by 
a proper course of regimen. The patient must eat no food that will not di- 
gest easily, which he must ascertain by his own experience: he should always 
get up from the table with an appetite somewhat sharp; whatever he finds 
will create flatulence, or give an uneasiness, must be carefully laid aside • 
and no animal food used. Coffee, tea, and chocolate should not be drank: 
cocoa shells, made the same as coffee, are very good. 
Counter-irritating Plaster for the Spine.-" I have met with some hundreds 
of cases," says Dr. McNair, " where the disease had resisted all common 
remedies, of fifteen or twenty years standing, which were readily removed 
by directing the remedies to the diseased nerves or the spine. His plaster 
which causes a little discharge,may be applied to the spine." 
" Of the necessity of regular exercise to the due performance of the func- 
tions of the stomach, every one must be fully sensible : walking is, of all ex- 
ercises, the best; it is that which nature intends for us, and can never be 
compensated by what are called the passive exercises of the luxurious. 
Pure air is eminently conducive to healthy digestion." 
In dyspepsia a change of air, a voyage to sea, or a residence near the 
salt water, has been of great service. I know a man who was so far re- 
duced with dyspepsia that he was carried on his bed from this city to the 
town of Westchester, about fourteen miles distant, on the banks of the 
East River ; and, after remaining there a while, entirely recovered his health. 
No less important to the restoration of the dyspeptic patient is exercise on 
horseback, and change of place and amusing scenes, remembering that riding 
should be performed with an empty stomach, and the most proper hour is in 
the morning, before breakfast. INDIGESTION. 
421 
Dr. Abercrombie mentions an interesting case, showing the effect of vege- 
table diet in dyspepsia : " A gentleman had been for many years a martyr to 
stomach complaints, seldom a day passing in which he did not suffer greatly 
from pain in his stomach, with flatulence, acidity, and the usual train of 
dyspeptic symptoms ; his mode of living had rendered it impossible for him 
to partake of vegetables without suffering severely : he had gone on in this 
manner for years, when he was seized with a complaint in his head, threaten- 
ing apoplexy, which, after being relieved, showed such a constant tendency to 
return, that it has been necessary ever since to restrict him to a diet almost 
entirely of vegetables, and in very moderate quantities : under this regimen, 
so different from his previous manner of living, he has continued free from 
any recurrence of the complaint in his head, and has never been known to 
complain of his stomach."-Abercrombie on diseases of the stomach. The 
very moderate quantity of vegetables, no doubt, contributed to the cure. 
It is a fact, that the great mass of the commonwealth not only use a diet 
too rich and stimulating in quality, but by far too much in quantity: and 
but a glance at the community will show that their penalties are meted out 
in the form of dyspepsia, liver diseases, dropsy, gout, and premature death. 
The tender mother wonders that her sinless offspring should suffer so much 
pain, and then be snatched from her embrace by a u mysterious providence 
when, in fact, the child only suffers the penalty of just and immutable laws, 
which her own pampering and indulgence have broken. 
The stomach, like every other organ, requires rest after the performance 
of its labour ; and yet how every mother'will tell her dyspeptic son to "eat 
little and oftenoh! ruinous practice ! " eat little and often!" the echo 
of these words has been the death dirge of thousands : ah ! how does it ring 
upon the ear of the poor dyspeptic, and how does it hasten his progress to 
that grave which he so much dreads ! 
" Nowhere," says Dr. Andrew Combe, " does man hurry off to business 
so immediately as in the United States, and nowhere does he bolt his food so 
much as if running a race against time. The consequence is, that nowhere 
do intemperate eating and dyspepsia prevail to the same enormous extent. 
Rapid eating almost invariably leads to overloading the stomach ; and when to 
this is added a total disregard of the quietude necessary for digestion, what can 
be expected to follow but inveterate dyspepsia ?" In this case the stomach 
must perform the office of the teeth, which is well calculated to derange it. 
Bilious Affectum?.-Many persons, particularly in the southern states 
and West Indies, are great sufferers from a redundancy of bile destroying 
the digestive organs. Such persons should depend upon prevention more 
than cure, and make use of that diet which will prevent the accumulation 
of bile ; for example, pepper sauce, mustard, stewed fruits of various kinds, and 
sound or hard cider. Much exercise should be taken, to excite a healthy 
action of the digestive organs. It will be absolutely necessary to abstain 
from all kinds of greasy meat, sweet articles, pastry, and rancid butter; 
likewise coffee and chocolate, both of which increase these affections. Cos- 
tiveness must invariably be prevented. When a person is labouring under a 
bilious complaint, he may take a gentle emetic, or, as a substitute, a portion 
of mandrake; after which one or two of the bilious pills occasionally ; also 
the wine bitters, and a tea made of the bark or berries of the black alder 
For diet, see bill offare for invalids. 422 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER IV. 
CONVULSIONS OR FITS. (Spasrrii.) 
DESCRIPTION. 
The term convulsion is usually applied to all kinds of spasmodic affections, 
such as hysteria, epilepsy, &c. In treating of the complaint, I have in view 
fits or convulsions which often occur in children, and sometimes in adults, 
and which assume no specific character; frequently they proceed from the 
eruption in small-pox being retained or suddenly receding, or from teething, 
pregnancy, &c. 
CAUSES. 
Fits in children and others usually proceed from some acrid matter in the 
stomach and intestines, such as various kinds of poison, or from flatulence, 
teething, worms, recession of some kinds of rash, or the retreating of an erup- 
tive disease, such as scarlatina, small-pox; sudden emotions of the mind, as 
fear, anger, &c. 
SYMPTOMS. 
Previous to an attack of convulsions in men or children, there is often 
great debility, with an unnatural appearance of the eyes and countenance. 
At other times there is a hasty accession of the complaint; the patient 
is suddenly seized with a spasmodic affection of the face, body, and whole 
extremities ; trembles and shakes violently, and unexpectedly falls down, and 
remains senseless for a longer or shorter period; with involuntary twitchings 
of the muscles or tendons; the teeth clenched ; and a discharge of saliva from 
the mouth ; pupils of the eyes contracted, &c. 
TREATMENT. 
Where the attack is sudden and violent, put the patient in a warm bath ; 
but as considerable time elapses before this can be prepared, the feet must 
be immersed in warm water, and the region of the stomach bathed with 
capsicum and spirits, simmered a few minutes together. If there is time, an 
injection or clyster may be given. It is difficult to introduce any medicine 
during the paroxysm; but, after it is over, means must be used to prevent a 
recurrence of them. If the disease appears to exist from acrid or foul matter 
in the stomach, give an emetic, and afterward a dose of senna and manna. A 
decoction of common mullein is said to be an excellent remedy for convulsions in 
children. If they appear to proceed from worms, give medicines to expel them. 
Should fits arise from a recession of rash, or from the invasion of some 
eruptive disease, excite perspiration to aid their reappearance. A little salt 
and water will afford immediate relief, and shorten the fit. 
When they arise without any apparent cause, and occur at different inter- 
vals, they must be treated by giving emetics and tonics ; in other respects 
treated the same as epilepsy. When other means fail, give the tincture of 
stramonium and hyoscyamus. In one very severe case, where the infant had 
several hundred fits, the tincture of opium cured it; the dose was gradually 
increased. CRAMP IN THE STOMACH-HEARTBURN. 
423 
CHAPTER V. 
CRAMP IN THE STOMACH. 
DESCRIPTION. 
This is a violent and painful disease, generally attacking persons very sud- 
denly, and is extremely dangerous. Weakly and nervous constitutions are 
the most liable to it. It may arise from acrid matter, or from a check of 
perspiration. 
Friction should be immediately employed over the region of the stomach, 
and continued until a preternatural degree of heat is produced and the pain 
subsides. I am, from experience in my own person, enabled to vouch for its 
utility. I was once suddenly seized in the night while in the country, where 
little aid or medicine could be procured. It occurred to me that friction 
would afford relief, and I therefore requested a person, sleeping in the adjoin- 
ing room, to rub my stomach and breast as hard as possible, which he did ; 
as soon as the friction occasioned heat, the pain began immediately to 
subside.-{See principles of our Practice.) Should this, however, prove 
ineffectual, half a tea-spoonful of red pepper may be given in half a tumbler 
of water or tea ; at the same time let mint or peppermint tea be given, or, 
as a substitute, any common herb tea. The feet must also be bathed in warm 
water, and red pepper and spirits be applied, hot, over the region of the breast. 
Should this fail to afford relief, apply a heated brick, covered with muslin, 
and steeped in vinegar, to the breast, as hot as can be borne. This also has 
removed a severe cramp or pain in the breast, when other means have failed. 
The person attacked may also take a tea-spoonful of equal parts of laudanum, 
essence of peppermint, and spirits of camphor. An excellent remedy for 
cramp in the breast is, to take ten drops of the essential oil of hemlock in a 
little tea, sweetened; at the same time apply hops, simmered in vinegar, to 
the stomach or chest. Give the stimulating drops, or a tea made of 
capsicum. The above medicines to be given and varied as occasion requires. 
TREATMENT. 
CHAPTER VI. 
HEARTBURN. (CardiaZgia.) 
DESCRIPTION. 
This disease is an uneasy sensation about the part called the pit of the 
stomach; it is attended with great anxiety, difficulty of breathing, want of 
strength, inquietude, vomiting, coldness and trembling of the extremities. 
Those whose stomachs abound with acid, or with bilious disorders, are 
the most subject to this complaint. 
The causes are various, as wind, acid, and other acrimonious humours in 
CAUSES. 424 
THE REFORMED PRACTICE OF MEDICINE. 
the stomach; it may arise from debility of that organ, or a loss of its 
mucus; worms; and frequently spicy and pungent food; or a transi- 
tion of rheumatism or gouty humours to the stomach, or an ulcer in any 
part of it. It may be occasioned by fat meats, especially if cold liquors are 
drank too soon after. If it proceeds from bilious matter, it is attended 
with bitter and nauseous eructations or belching, as well as by a yellow or 
greenish discharge by vomiting ; collections of blood about the region of 
the stomach ; plethora, or spasms. 
TREATMENT. 
Where the complaint appears to proceed from acidity or sourness of the 
stomach, with belching, heat, pain, &c.,the carbonate of magnesia is a good 
medicine ; from a tea-spoonful to a table-spoonful may be occasionally taken 
in a tumbler of mint tea. Should this fail to remove the disease, a mild 
emetic may be given, succeeded by a purgative. If it proceeds from wind, 
give a tea-spoonful of the compound spirits of lavender. The neutralizing 
mixture is also very good. 
The food should be such as is very easy of digestion. 
CHAPTER VII. 
CANKER, THRUSH, OR SORE MOUTH. {Aphtha.) 
DESCRIPTION. 
Tins is a disease to which children more particularly are subject. 
It appears in small white ulcers upon the tongue, gums, and around the 
mouth and palate, resembling small particles of curdled milk. When the 
disease is mild, it is confined to these parts ; but when violent, and of 
long standing, it may extend through the whole course of the alimentary 
canal, from the mouth down to the anus, and excite severe purgings, 
flatulencies, and other disagreeable symptoms. The disease, when recent 
and confined to the mouth, may, in general,be easily removed ; but when of 
long standing, and extending down to the stomach and intestines, with impro- 
per treatment, it very often proves fatal. 
The thrush sometimes occurs as a chronic disease. 
CAUSES. 
Retention of acrid humours, turned inward upon the mouth, stomach, and 
intestines. 
SYMPTOMS. 
It shows itself at first by an uneasy sensation, or burning beat in the sto- 
mach, which comes on by slow degrees, and increases gradually in violence. 
After some time small pimples show themselves on the tip and edges of the 
tongue, which at length spread over the whole inside of the mouth, and 
occasion such a tenderness and rawness that the patient cannot take any 
food of a solid nature; neither can he receive any vinous or spirituous 
liquor into his mouth without pain: it is accompanied with a dry skin, CANKER, THRUSH, OR SORE MOUTH. 
425 
pale countenance, small pulse, and cold extremities. These symptoms will 
probably continue for some weeks, the general health being sometimes better 
and sometimes worse ; and then the patient will be attacked with acrid eruc- 
tations or severe purgings, which greatly exhaust his strength, and produce 
considerable emaciation of the whole body. After some time these symptoms 
cease, and he again enjoys better health ; but sooner or later the acrid matter 
shows itself once more in the mouth, with greater violence than before, and 
makes frequent translations to the stomach and intestines, and so from these 
to the mouth again, until at last the patient is reduced to a perfect skeleton. 
Elderly people, and persons with a shattered constitution, are most liable to 
its attacks. Infants are subject to an inflammatory affection of the mucous 
membrane of the alimentary canal, generally classed as a species of diarrhoea, 
but known also by the name of aphtha or the thrush, from a symptom which 
attends it in one of its stages. It chiefly occurs between the fourth and 
eighth months, and among such as are fed wholly or partially upon spoon- 
meat. There is reason to believe that it is always connected with an impro- 
per diet. It is characterized by vomiting, fetid eructations, pain, diarr- 
hoea, and some degree of tenderness of the belly on pressure. The stools 
are green and slimy, or tinged with blood ; frequently they are ejected with 
great force. As soon as any food is taken into the stomach the child has a 
motion, giving an appearance as if it passed immediately through the bowels. 
As the disease advances the tongue becomes red, the mouth is covered 
with aphthae, and the verge of the anus appears inflamed ; the brain also 
becomes affected. The child is frequently drowsy before the aphthae appear ; 
this symptom is vulgarly called " sleeping of the thrush." Drowsiness is 
occasionally observed to come on toward the termination of the complaint. 
The infant rapidly emaciates. 
There is a peculiar and painful sore mouth or canker incident to nursing 
women, and which extends throughout the whole intestines; it assumes a 
very obstinate character. This and the other kinds proceed from acrid se- 
cretions, which cause an inflammation of the lining membrane of the stomach 
and bowels. 
TREATMENT. 
When the disease is seated it may sometimes be necessary to give a 
gentle emetic, but, in general, purgatives are sufficient: the neutralizing 
mixture or cordial may be taken until it acts upon the bowels, to be occa- 
sionally repeated ; and let the mouth be washed with the following gargle : 
Take sage, hyssop, sumach berries, equal parts : make a strong decoction, 
sweeten with honey, and to half a pint of it add half a tea-spoonful of 
pulverized borax : let the mouth be often washed with this. The child should 
take for nourishment Indian meal gruel, milk, &c. A tea made of the red 
raspberry leaves is also good for this complaint. 
1 lately prescribed ipecac pills to an adult for a case of canker, which soon 
effected a cure without any wash ; one pill containing two or three grains 
was given three times a day. For the sores in the mouth apply pulverized 
burnt allum. 
During the revolutionary war the following gargle cured all cases of 
canker and putrid sore mouth, which was then very prevalent, and previously 
carried off many persons : Take white oak bark, ivhite elm bark, (not slippery 
elm,) high blackberry root bark, bark of the root of sumach, nanny berry 
bark, black snake-root, (it is a small, black, bitter root:) bruise and boil all 426 
THE REFORMED PRACTICE OF MEDICINE. 
together, and make a strong decoction; then add a piece of allum, sweeten with 
molasses, and bottle for use : gargle the throat and wash the mouth. The 
complaint may first grow a little worse. This, it is stated, cured all. It must 
be excellent for all kind of ulcers. 
The following preparation cured a very severe case of canker: Gold thread, 
one quarter of a pound ; add one quart of water, boil out the strength, strain ; 
add one quarter of a pound of sugar, (loaf,) simmer to three gills; add French 
brandy to preserve it: dose, half a wine glassful two or three times a day ; 
keep the mouth and stomach moist with it: in some cases it might be best 
to omit the brandy. In very obstinate cases, where other means fail, use 
the following liquid: Muriatic acid, ten drops ; rose water, twenty drops: 
mix ; apply a drop to each ulcer once or twice a day. 
CHAPTER VIII. 
MILK SICKNESS. 
This complaint is supposed to arise from some poison eaten by cows, 
which is communicated to the milk and butter. When this is taken into the 
stomach the annexed symptoms follow: Sometimes languor and lassitude 
are felt for some days previous to the attack of this disease, with putrid 
tongue and very offensive breath ; at other times it comes on suddenly, with 
severe vomiting, thirst, and burning at the pit of the stomach, and obstinate 
costiveness, &c. The cattle that eat it quiver, stagger, and die within a few 
hours. It often proves fatal to man and beast. When dogs, crows, cats, 
fowl, &c., eat the animals that die of it, it kills them. Dr. Graffs, of Illi- 
nois, states that hundreds of persons perish annually in the west and south- 
west. The butter and cheese manufactured from infected cows are sup- 
posed to possess the most concentrated part of this poison, yet they appear 
precisely the same as healthy articles. 
TREATMENT. 
First give an emetic, after which the neutralizing mixture, and treat it 
in other respects as the cholera morbus. A mustard plaster may be ap- 
plied to the stomach, injections given, and perspiration promoted. Should 
vomiting continue, a tea-spoonful of salt can be given every two hours in 
equal parts of hot water and vinegar : toasted bread water and mint tea are 
good. Dr. Jones highly recommends smart weed tea. 
" The greatest difficulty," says Dr. Levi Houston, of Columbus, Ohio, 
" seems to be to relieve the spasmodic affection of the stomach, so that 
medicine can be retained upon it. My course has always been, to give weak 
lobelia tea to take off the tension of the stomach, and injections to relieve 
the bowels; then apply the steam to relax the surface ; and, when this is 
properly done, give lobelia, so as to produce thorough vomiting, that the sto- 
mach may be relieved of all irritating matter in it; and, as soon as the 
stomach is settled, give physic enough to operate freely on the bowels ; 
the operation will be quicker and more effectual if the patient be kept in a 
gentle perspiration. After the physic has operated, if the stomach does 
not feel clear of weight and soreness, give another emetic, with steaming VOMITING. 
427 
and toning the surface, as one course will do more good after physic has 
operated well, than two courses would before. Generally, when lobelia 
operates thoroughly, there is a dark substance thrown from the stomach like 
coffee-grounds, which gives immediate relief; and, by giving laxative bitters 
sufficient to keep the bowels open, the patient is soon well." 
This complaint has been briefly treated upon in a preceding chapter ; but, 
being very important, and having obtained some additional information respect- 
ing it, I have deemed it advisable to add the above remarks. 
CHAPTER. IX. 
VOMITING. {Emesis.) 
It is sometimes the case that persons are taken with vomiting without 
any apparent cause, and when it does not proceed from other complaints, or, 
in other words, is not a symptomatic disease. The stomach, from various 
causes, becomes irritable, and everything taken into it is ejected : when this 
is the case, and it does not apparently proceed from some particular disease, 
our attention must be directed exclusively to the symptom of vomiting. A 
solution of sal seratus should be frequently given; a drachm may be added 
to eight ounces of mint water, and a table-spoonful given as often as retching, 
nausea, or vomiting occurs; or the neutralizing mixture. Should not this 
check it, give equal parts of essence of peppermint, laudanum, and spirits of 
camphor, twenty drops of each, in spearmint tea. An infusion of peppermint 
may be occasionally drank. The common soda powders are often sufficient 
to put a stop to ordinary vomiting. If the complaint is very violent, apply 
mustard paste over the region of the stomach. The following plaster has 
also been found very effectual in allaying the irritability of the stomach: 
Take equal parts of cloves, nutmegs, alspice, and ginger ; pulverize, and add 
sufficient Indian meal and vinegar to form a.plaster, to be applied to the pit of 
the stomach: bathing the feet has also an excellent effect. When all other 
means fail, the exhibition of an opium pill has stopped the vomiting. I have 
also succeeded by withholding all kinds of liquids and drinks, and by giving 
injections, to which half an ounce of laudanum has been added : cases, how- 
ever, seldom occur in which these last remedies are called for. 
A physician related to me the following case: He had administered anti- 
mony, which had a very unfavourable effect; it operated with great violence, 
and very much prostrated the patient: the retching or vomiting continued 
incessantly, till the patient appeared to be in a very dangerous situation, 
being almost speechless and pulseless. He first administered sling, (brandy, 
water, and sugar,) to check the vomiting, but it was immediately rejected ; 
he then gave equal parts of peppermint and laudanum, which was retained 
upon the stomach, and checked the vomiting. He afterward administered 
spirits, which raised the pulse, and the woman soon recovered. 
The physician who communicated the above account, states, that such was 
the operation of the medicine (antimony) that he has never given another 
dose of it since. 428 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER X. 
HICCOUGH. {Singultus.) 
The hiccough is a spasmodic or convulsive affection of the stomach and 
midriff, arising from any cause that irritates their nervous fibres. It may pro- 
ceed from excess in eating or drinking, or eating too fast; an injury of the sto- 
mach; poisons, wind, &c.; inflammations of the stomach, intestines, bladder, 
midriff, and the rest of the viscera. When the hiccough proceeds from the use 
of aliment that is flatulent or hard of digestion, spirituous liquors will generally 
remove it. If poison be the cause, plenty of oil and milk must be drank. 
Should the hiccough not cease, give ten or fifteen drops of laudanum, to be 
occasionally repeated. It sometimes proceeds from flatulence or wind ; 
when this is the case give fennel-seed tea, lavender compound, and carmina- 
tive drops. 
CHAPTER XL 
SEA SICKNESS. 
Sea sickness is a nausea or tendency to vomit, which varies, in respect of 
duration, in different persons upon a sea voyage; with some it continues 
only for a day or two, while with others it remains throughout the voyage. 
Sea sickness appears to depend on the peculiar excitement of the brain, 
occasioned by the swinging or rocking motion of a vessel at sea. 
The symptoms of sea sickness are so familiar, that they require no descrip- 
tion. It is a very distressing complaint, and in some habits peculiarly so, 
sometimes even proving fatal; invariably attended with a dizzipess of the 
head, great distress in the stomach, nausea, with vomiting and purging of 
bilious matter, resembling very much in its character cholera morbus. Like- 
wise accompanied with great prostration. It, however, is generally very 
beneficial. 
As soon as a person begins to feel sick at sea, let him place himself in the 
open air on the deck, and in a recumbent position ; this contributes much 
to allay the symptoms : but if it cannot be practised by reason of the weather 
or other causes, let him lay in a birth, in the middle of the vessel, with his 
head toward the prow or forepart, being less motion there. I have practised 
this myself with very great benefit. Should the sickness continue severe, 
take a solution of sal aratus or bicarbonate of potash, in proportion of a tea- 
spoonful to half a pint of water ; a small table-spoonful can be taken when- 
ever there is retching or vomiting, or the neutralizing mixture may be used. 
Should this fail to allay it, take essence of peppermint, twenty drops; lau- 
danum, twenty drops : mix ; the whole at a dose, to be occasionally repeated. 
When the vomiting first commences, a weak infusion of chamomile tea may 
be taken. A sea captain recommends old Jamaica spirits, with little or no 
water. Best French brandy is also very good, and a little physic may be useful. 
TREATMENT. DYSENTERY. 
429 
I prescribed for a lady about to depart for France, and who was in the habit 
of being so sick that she vomited blood. I received a letter from her on her 
arrival, stating that she had received great benefit from my prescription. 
INTESTINAL OR BOWEL DISEASES. 
CLJ1SS VIU. 
CHARACTER. 
This class of disease is characterized by more or less pain in the abdomen, 
nausea, vomiting, prostration of strength, and fever, with either costiveness 
or copious evacuations. 
CHAPTER I. 
DYSENTERY. (Dysenteria.) 
DESCRIPTION. 
This is an affection or inflammation of the alimentary canal, characterized 
usually by nausea, pain, fever, tenesmus, with fetid or bloody evacuations. 
It is attended with more or less fever, and is sometimes contagious 
CAUSES. 
Whatever has a tendency to obstruct perspiration may give rise to this 
complaint. Morbid humours are retained in the circulation, mixed with 
the blood, and thrown upon the intestines, causing irritation, inflammation, 
and all the phenomena of the disease. Unwholesome diet, night air, damp 
beds, wet clothes, &c. It sometimes appears to be caused by contagion, 
becoming epidemic in jails, camps, hospitals, ships, &c. Sudden change of 
weather, with humid or moist air, may •act as a predisposing cause of the 
disease. 
Proximate Cause.-It would appear that the immediate exciting cause of 
the dysentery is, a peculiar acid, the same as in the cholera morbus, which 
is secreted by the liver, and which corrodes and irritates the mucous mem- 
brane of the intestines ; as nitric or other acids. 
SYMPTOMS. 
An attack of dysentery is sometimes preceded by loss of appetite, costive- 
ness, flatulence, sickness at the stomach, and a slight vomiting, and comes 
on with chills, succeeded by heat in the skin, and frequency of the pulse. 
These symptoms are, in general, the forerunners of the griping and increased 
evacuations which afterward occur. When the inflammation begins to oc- 
cupy the lower part of the intestinal tube, the stoois become more frequent 
and less abundant; and, in passing through the inflamed parts, they occa- 
sion great pain, so that every evacuation is preceded by a severe griping, as 430 
THE REFORMED PRACTICE OF MEDICINE. 
also a rumbling noise. The evacuations vary both in colour and consistence, 
being sometimes composed of frothy mucus, streaked with blood, and at other 
times of an acrid watery humour, like the washings of meat, and with a very 
fetid smell. Sometimes pure blood is voided ; now and then lumps of coagu- 
lated mucus, resembling bits of cheese, are to be observed in the evacuations, 
and in some instances a quantity of purulent matter is passed. Frequently 
the discharges consist merely of mucus, without any appearance of blood. 
While the stools consist of these various matters, and are voided frequently, 
it is seldom that we can perceive any natural faeces among them ; and, when 
we do, they appear in small hard balls, which being passed, the patient ex- 
periences some temporary relief from the griping and tenesmus. From the 
violent efforts which are made to discharge the irritating matters, a portion 
of the gut is sometimes forced beyond the rectum, which, in the progress of 
the disease, proves a troublesome and distressing symptom; as does likewise 
the tenesmus, there being a constant inclination to go to stool, without the 
ability of voiding anything, except perhaps a little mucus. More or less fever 
usually attends it, with the symptoms which have been described, through- 
out the whole of the disease, where it is inclined to terminate fatally ; and 
is either of an inflammatory or putrid tendency. In other cases the febrile 
state wholly disappears after a time, while the proper dysenteric symptoms 
probably will be of long continuance; hence the distinction of acute and 
chronic dysentery. 
TREATMENT. 
Indications of Cure.-1. Correct the acrimonious state of the fluids, (the 
exciting causes of the complaint,) and cleanse the alimentary canal. 
2. Remove urgent symptoms, by allaying the irritation and spasms. 
3. Sheath the irritated portions of the intestines by mucilaginous substances, 
injections, &c. 
In the cure of the ordinary forms of dysentery, such medicines must first 
be given as will cleanse the stomach and bowels, astringe and restore the 
tone of them; but active cathartics should never be employed. To fulfil 
these indications, there is no compound so valuable as the neutralizing mix- 
ture ; compared to this, all other medicines sink into insignificance ; it has 
a specific effect which no other known agent possesses, and it seems as 
though the Author of Nature had designed it especially for this and similar 
diseases. 
It is really a subject of astonishment to me that physicians, with this 
medicine, or the basis of it, before them, should neglect to use it, and sub- 
stitute poisonous minerals in its place. The following is the preparation, 
which I first administer in every stage of dysentery : Take best Turkey 
j-hubarb root, bruised ; sal seratus, or bicarbonate of potash, pulverized ; pep- 
permint plant, pulverized ; cinnamon, pulverized; of each two scruples, or 
a small tea-spoonful: mix ; rub in a mortar ; then add half a pint of boiling 
water; strain, and add sufficient loaf sugar to sweeten; and, when cool, if 
there is no fever, add two table-spoonsful of best French brandy. Of this 
preparation give a table-spoonful'every hour, until the passages are changed 
in their appearance and consistence. 
The alkali neutralizes the acidity of the stomach, while the rhubarb, by 
quickening the peristaltic motion of the intestines, carries it to the seat of the 
disease, and removes the morbid collections in them, and restores their tone. 
The peppermint also lessens the irritation, while the loaf sugar and brandv DYSENTERY. 
431 
are valuable Auxiliaries. It should be repeated according to the urgency of 
symptoms, duration of the disease, and other circumstances ; but generally, 
after it has once acted upon the bowels, a table-spoonful given three or four 
times a day is sufficient, or it may be given at intervals, as required. This 
medicine in a short time entirely changes the complexion of the disease: it 
relieves the spasms and tenesmus; corrects and lessens the fetid discharges; 
and, in short, brings about a healthy action throughout the whole extent of 
the intestines. Other means, however, are sometimes necessary to remove 
the disease. After this preparation has acted upon the bowels, there may 
still be inflammation and irritation in the colon, which require other means 
to subdue them, and the most powerful are injections or clysters. Give the 
following : Take mucilage of slippery elm bark, one pint ; milk, one pint; 
olive oil, a wine glassful; molasses, half a pint; common salt, fine, one tea- 
spoonful : mix ; and let it be introduced warm, with a large French syringe, 
to be repeated as often as the patient complains of much pain. If the spasms, 
or pressing down, or pain be very great, a tea-spoonful of laudanum may be 
added to the injection. Usually, in ten or fifteen minutes after one of these 
injections are given, there is a mitigation of the urgent symptoms; it 
sheathes the irritated portion of the intestines, and thereby lessens the in- 
flammation. It very speedily relieves griping and tenesmus. I have some- 
times known the disease so centred upon the lower portion of the bowels, 
that I have had to depend almost exclusively upon injections for a cure. 
I now recollect one case where all medicine proved useless; but, upon the 
use of the above injection, the patient immediately recovered. 
It is necessary also, in almost every stage of the complaint, to keep up a 
gentle perspiration or moisture of the skin. As the disease is sometimes 
occasioned by translations of morbific matter to the intestines, means must 
be used to throw them off by the excretion of the skin : for this purpose 
diluent and sudorific drinks may be given ; and, when the bowels have been 
well cleansed, eight or ten grains, or half a tea-spoonful, of the diaphoretic 
powders can be given, particularly at bed-time; while they serve to pro- 
duce perspiration, they relieve pain and procure sleep. If there is much 
febrile excitement; if the skin be dry and husky, attended with thirst, the 
surface must be often bathed with tepid ley water, and also the feet. As 
soon as the cutaneous vessels have become thus stimulated, a portion of the 
morbific agents are translated from the mucous membrane of the intestines, 
and expelled through this medium. Copious perspiration, however, is not 
called for in the complaint; a general and uniform moisture of the skin is 
all that is required. When the pain is located more especially in one par- 
ticular part, or where there is very great distress accompanying the disease, 
fomentations will be found a valuable auxiliary. 
The following may be applied: Take hops, tansy, hoarhound, and catnip, a 
handful of each ; boil in vinegar, enclose in a flannel bag, and apply to the 
abdomen or belly ; to be often renewed : they divert the humours from the 
intestines to the surface, and assist to remove pain, spasm, tension, &c. 
Mucilaginous drinks are beneficial in dysentery, such as an infusion of slip- 
pery elm bark, benne plant, fyc. ; they may be given alternately, as the stomach 
of the patient will bear. The slippery elm is decidedly the best article, 
as it possesses very soothing and cooling properties: a tea-spoonful of the 
superfine flour of the bark may be stirred into a tumbler of cold water, and 
the whole or part given, as the patient is able to take it; three or four tea- 
spoonsful may be given through the course of the day. Should the putrid 
symptoms appear, a wine glassful of yeast, mixed with a little milk and loaf 432 
THE REFORMED PRACTICE OF MEDICINE. 
sugar, may be given occasionally through the day, and about a gill of it added 
to every injection. 
With me this treatment has been attended with unprecedented success, 
never having lost a case of dysentery in all my practice. The remedies are 
prompt, energetic, and sovereign. 
In protracted and unusually obstinate cases, a syrup made of the black- 
berry root may be used. It has effected a cure when all other means have 
proved unavailing. 
Dr. Perkins' last remedy (so called) for dysentery is, good vinegar, and 
as much salt as it will dissolve; add one table-spoonful of it to four of 
hot water, and let it be taken by spoonsful, as fast and as hot as it can be 
swallowed. This dose is to be continued once in two hours till it operates 
as physic. It is said to be a sovereign remedy in dysentery. 
REGIMEN. 
Good nursing in this, as well as in other diseases, is very important. The 
excrements should be immediately removed, and buried under ground. 
Change the clothes often, and admit fresh air into the room. Great attention 
to diet. The following is good : Take a table-spoonful of wheat flour, and 
add cold water sufficient to moisten it; then add one pint of milk, boil for 
fifteen or twenty minutes, remove from the fire, sprinkle in a small quantity 
of cinnamon, and sweeten with loaf sugar; let it be taken in moderate quan- 
tities through the day. 
Cold water, with wheat bread well toasted put into it, makes a very good 
drink. The best diet in dysentery and bowel complaints is rice, the flour of it, 
if it can be procured, to be scalded in water, and then boiled in milk. The 
editor of the New York Farmer informs me that this proved more service- 
able to him than all the medicines which he had taken. 
A short time since I was called to prescribe for two of the worst cases J 
ever treated. One was that of Mr. Tucker, of Williamsburg, L. 1. He had 
been suffering under this disease for some time, and reduced so low that his 
life was dispaired of. Blood, mucus, and matter almost constantly passed his 
bowels; with fever and great prostration; his stools so fetid that it was difficult 
to remain at his bed-side; and he was so far gone that he paid no attention to 
me. He had two physicians, Cooke, of that place, and Dr. McClay, of New 
York, both of whom pronounced him incurable. One said " that he could 
not live twenty-four hours the other, that "neither man nor medicine 
could save him." Cooke, the family physician, (should I not rather say 
quack ?) had bled him, given him mercury, and, as it did not salivate him, 
was about to rub the body with mercurial ointment. As an experiment, at 
the request of his friends, and in this almost hopeless state, I prescribed for 
him as above ; an immediate amendment took place, and, to the astonishment 
of all, he has recovered. The ignorant and unprincipled person (I will not 
say physician, for he does not deserve the name) who treated him, had the 
effrontery, not only to slander me for curing Mr. Tucker, but likewise to 
allege that his mercury had begun to take effect; thus imputing the cure 
to the poison and treatment which had injured, if not nearly killed him. 
Another very interesting case occurred a few days since. Mr. Martyn, a 
minister of this city, called upon me about one o'clock at night, and stated 
that his daughter was very bad with the dysentery, and requested me to visit 
her. I went, and found her in a critical and dangerous situation. Every DYSENTERY. 
433 
few minutes blood and matter passed the bowels, attended with such pain 
that her cries could be heard from the back-room to the street. She had 
been attended by five physicians, two homoeopathies and three alloeopathics. 
During eleven days neither class had prescribed anything to correct or eva- 
cuate the morbid secretions ; and I never saw a greater want of skill and 
science than was exhibited in this and the preceding case. Under the 
treatment already detailed the patient recovered rapidly, and is now well. 
In these cases there were symptoms of mortification, and I gave aquantity 
of yeast, mixed with milk and loaf sugar. Mr. Martyn, who was greatly dis- 
tressed about his daughter, stated to me that " he had prayed to the Lord 
or direction," and that he was led to the reformed practice of medicine 
vVill mankind ever get their eyes opened on the subject of medicine, or will 
they always continue to be humbugged ? 
SECTION I. 
CHRONIC DYSENTERY. 
It is sometimes the case that the acute runs into a chronic form, arising from 
ineffectual struggles in the system to excite a healthy action ; or it may take 
place from errors in diet, check of perspiration, &c. The pulse in this form 
of dysentery is generally somewhat accelerated ; the patient very feeble ; 
the appetite impaired ; the bowels deranged ; unnatural evacuations, with 
tenesmus or " pressing down the countenance pale, or assumes a yel- 
lowish tinge; the skin dry and husky, and the face sometimes bloats ; the 
patient becomes emaciated, and the discharges are very frequent and fetid, 
and sometimes general dropsy intervenes. Dissections show that the mucous 
membrane is the seat of the disease : it becomes thickened, rough, ulcerated, 
and covered with pustules, and sometimes it is gangrenous. 
TREATMENT. 
The treatment in this disease is somewhat similar to that recommended 
under the acute form of dysentery. The preparation of rhubarb and potash, 
first-mentioned, may be given daily ; a table-spoonful three or four times in 
the course of twenty-four hours. At the same time the following might be 
given: Bayberry bark, wild cherry, cinnamon, nutmeg, alspice, cloves, and 
capsicum ; pulverize all, and mix : put a tea-spoonful into a tea-cup, add a 
little loaf sugar, and fill nearly full with hot water. Drink the whole ; repeat 
two or three times a day. 
The above may be taken during the day, morning and evening; and at 
bed-time equal parts of fine charcoal and magnesia, a table-spoonful in milk 
or syrup. 
Should the above treatment not prove effectual, the blackberry syrup must 
be taken, and occasionally an emetic administered. Injections to be given 
often. 
The diet should consist principally of thickened milk and rice. 434 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER II. 
SUMMER COMPLAINT OR LOOSENESS. (Diarrhea.) 
DESCRIPTION. 
This disease is characterized by frequent discharges from the bowels, with 
a pressing down, or disposition to evacuate their contents. It is attended 
with more or less griping, but generally without much fever. 
CAUSES. 
Whatever increases the action of the intestines may produce the disease; 
such as improper food, or irritating substances ; or it may be occasioned by 
bile of an acrid or vitiated quality. 
It may also be occasioned by a suppression of perspiration, worms, crude 
and unripe fruits, acids, &c. In some habits there is a variety of agents 
which will bring on this complaint; but probably the most common of all is 
unripe fruits, and too great quantities of any kind ; also retained perspira- 
tion and vitiated agents or humours, which, not being expelled by the skin, 
are thrown upon the liver and the mucous membrane, causing a vitiated or 
unhealthy secretion of bile and mucus. 
SYMPTOMS. 
In diarrhoea each discharge is usually preceded by a murmuring noise and 
flatulence in the intestines, together with a sense of weight and uneasiness 
in the lower part of the bowels. The appearance of the stools are various ; 
sometimes they are thinner than natural, from the admixture of a larger 
quantity of fluid poured out by the exhalents of the intestines than common ; 
sometimes and green when first discharged, and are of a dark brown 
colour, and very fetid. As the disease advances the stomach becomes affected, 
and sickness, nausea, and vomiting occasionally prevail; the countenance 
turns pale, and the skin is dry and rigid. If it continues for any length of 
time, universal emaciation, dropsy of the lower extremities, and relaxation 
of every part ensue, together with a great loss of strength. 
In the treatment it will be necessary to attend to the following indications: 
First; To obviate or remove the morbid cause. 
Secondly ; To restore the impaired tone of the parts. 
When diarrhoea has arisen from excess or repletion, or from crude and 
acrid matter in the stomach, the first indication may be answered by giving 
a gentle emetic in the evening, and an aperient the succeeding morning. If 
it has proceeded from obstructed perspiration, in consequence of exposure 
to cold, we must then endeavour to restore this by diaphoretic medicine. 
It is very seldom necessary to resort to an emetic to cure any species of 
diarrhoea, except it has assumed a chronic form, and becomes extremely ob- 
stinate. The neutralizing mixture usually puts a stop to the complaint in a 
short time, and may be given every hour until the passages are changed in 
TREATMENT, SUMMER COMPLAINT OR LOOSENESS-COLIC. 
435 
their appearance ; afterward given at longer intervals. In ninety-nine cases 
in a hundred this preparation almost immediately cures ordinary forms of 
diarrhoea. When an exception, however, occurs, give our common injection, 
and apply fomentations to the bowels. Powdered charcoal and magnesia aro 
excellent: for a child one year old give a tea-spoonful three times a day, in 
sweetened water or milk. The diet of the patient must consist of boiled 
milk, mixed with a little wheat or rice flour. 
SECTION I. 
CHRONIC DIARRHCEA. 
Simple diarrhoea sometimes becomes chronic in its character, often con- 
tinuing for a length of time very obstinate. There is a preternatural dis- 
charge from the bowels, which is kept up at intervals for a great length of 
time, and which proves very obstinate. When this is the case, and when 
the common diarrhoea does not yield to the usual course of treatment, but 
assumes this protracted type, it must be treated the same as chronic dysen- 
tery : recourse must be had to mild emetics and laxatives; and our 
common purgative, in such cases, is very serviceable. Afterward the neu- 
tralizing mixture may be given in doses of a table-spoonful three or four 
times a day. At the same time the syrup of blackberry root can be given. 
The diet must be composed principally of thickened milk, to which a 
little powdered cinnamon may been added. 
It arises from a morbid state of the liver or stomach, which secretes an acrid 
or poisonous fluid that seriously affects the mucous membrane of the intestines, 
causing inflammation, ulcerations, or contractions. The object should be, first, 
to subdue the local inflammation ; second, to change the nature of the secre- 
tions of the stomach and bowels, and allay the irritation of the intestines; third, 
to diminish the frequency of the discharges, with aperients combined with as- 
tringents ; fourth, to restore lost strength. Injections are excellent; likewise 
pulverized charcoal and magnesia. In treating the complaint, regard must 
always be paid to the skin, as well as any other secretion and excretion. 
The following syrup or cordial is excellent for bowel complaints, particu- 
larly chronic, of children and adults: Take two quarts of ripe blackberries, 
add one pound of loaf sugar, half an ounce of nutmeg, half an ounce of 
cinnamon, one quarter of an ounce of cloves, and one quarter of an ounce of 
alspice; boil all together for a short time, and, when cold, add one pint of 
imported (not spurious American) French brandy. After standing for a few 
days in a close vessel or bottle, it may be strained. This makes a very rich, 
pleasant, and efficacious syrup, and may be given after the bowels have been 
well cleansed. Dose, from a tea-spoonful to a wine glassful, according to 
age, three or four times a day. How much better this than mercury ! 
CHAPTER III. 
COLIC. (Colica.) 
DESCRIPTION. 
Colic is characterized by great pain in the bowels, seated principally in 
the umbilical region, and extending to the stomach, accompanied with nau- 436 
THE REFORMED PRACTICE OF MEDICINE. 
sea, retching or vomiting, and often a spasmodic contraction of the muscles of 
the abdomen. Several species are enumerated: 
1. Flatulent Colic, when there is costiveness, griping in the bowels, a 
rumbling noise, distention of the stomach, pain severe, with an inclination 
to vomit, &c. 
2. Hysteric Colic, when there is nausea and sickness at the stomach, severe 
spasms, costiveness, and dejection of spirits, &c. 
3. Bilious Colic, when there is a bitter taste in the mouth, thirst, febrile 
heat, a vomiting of bilious matter, and costiveness. 
4. Painter's Colic, occasioned by the absorption of lead. 
This disease is called colic, from its being more directly seated in the in- 
testines called the colon, than any other. 
CAUSES. 
The disease is produced by various causes, such as crude and acessant 
food, wind, a redundance of acrid bile, long-continued costiveness, hardened 
faeces, certain metallic poisons, derangement of the stomach, recession of 
gout or rheumatism, hysteria, the application of cold and moisture, worms 
in the intestines, and from swallowing poisonous substances, as lead. 
In all cases there is evidently an irritating substance in the alimentary 
canal, which produces a spasmodic contraction of the intestines and abdominal 
muscles, and sometimes violent inflammation, coldness of the extremities, 
distention of the stomach by a collection of wind, vomiting, obstinate costive- 
ness, and sometimes an evacuation of feces by the mouth, (a very disagree- 
able and distressing symptom,) called the iliac passion. The pain changes 
its situation, and is not confined particularly to one spot. 
SECTION I. 
FLATULENT COLIC. 
This disease is termed flatulent colic in consequence of indigestion and 
flatulence being the most predominant symptoms. A weak or debilitated 
state of the digestive organs induces this species of colic. In persons of this 
description certain articles of food will produce the disease, such as unripe 
fruit, crude vegetables, &c. 
Flatulent colic generally commences by a sense of fulness and uneasiness 
at the pit of the stomach, attended usually with pain, nausea, retching or 
vomiting, which continues to increase until the patient becomes very dis- 
tressed. After a while these symptoms subside, or partially subside, and there 
are short intervals, the pain occurring in paroxysms, upon an accession of 
which the patient is extremely uneasy, and can scarcely lay a moment in 
one position. He rolls upon the bed, and, if his strength permits, gets upon 
the floor, where he still continues to change his posture, moving to and fro, 
with his body bent forward and his hands pressing upon the abdomen. 
The pain flies from one part of the bowels to another, and is much lessened 
when there is a discharge of wind either upward or downward. There is 
costiveness, with considerable febrile excitement, pain, soreness, griping 
of the bowels, a rumbling noise, extension of the stomach, an inclination to 
throw up, and coldness of the extremities. The presence of wind enables 
the physician to distinguish this form of colic from the others. COLIC. 
437 
TREATMENT. 
Flatulent colic is cured with very little difficulty. The principal object 
is, to expel the wind, and to remove the constipation of the bowels ; to 
effect which, I usually administer a purgative combined with aromatics ; our 
common purgative is very good. The following likewise generally affords 
immediate relief: Take capsicum, cinnamon, cloves, nutmegs, ginger,- gum 
aloes, of each equal parts: pulverized. Add a large table-spoonful of this 
compound to half a pint of Holland gin ; after it has stood a short time 
give a table-spoonful, in sweetened water or herb tea, until it acts upon the 
bowels, or relief is procured. At the same time the patient must take freely 
of spearmint or peppermint tea every hour. Brisk friction should be made 
upon the stomach and bowels, which frequently occasions a free discharge 
of wind. The bowels may also be bathed with capsicum and spirits. If the 
colic has proceeded from overloading the stomach, an emetic might be given, 
and the operation of it aided by drinking a weak infusion of chamomile. 
When called to prescribe for a patient who is labouring under spasms, or 
who is in acute distress, it is desirable to afford immediate relief, or before 
the above medicine has time to mitigate the symptoms. When this is the 
case, give an emetic, the anodyne powder, or an opium pill half the size of a 
pea, which contains two or three grains, to be repeated in an hour or two, 
if the pain does not subside. As soon as the patient becomes relieved, give 
an ounce of cold-pressed castor oil; if it does not act as a purgative in the 
course of an hour or two, let its operation be aided by an injection. This 
treatment soon removes the complaint. 
Some time ago, during a visit to a patient in the country, I was taken with 
the flatulent colic, caused by error in diet ; I took half a tea-spoonful of 
capsicum, (African cayenne,') put it into a tea-cup, added a tea-spoonful of 
sugar, and then poured it nearly full of hot water. After standing till it 
was a little cool, I sipped it all, and in one hour my pain was gone. Had 
I sent for a common physician, he probably would have administered a 
portion of poison, (calomel.} Capsicum may thus be given on the attack, 
followed by our common purgative ; or a table-spoonful of cold-pressed castor 
oil may be taken, and a fomentation of hops applied to the bowels. 
SECTION IL 
BILIOUS COLIC. 
DESCRIPTION. 
This species of colic seems to depend upon a super-abundant or morbid 
secretion of bile, and remotely upon noxious or deleterious effluvia of the 
atmosphere. It occurs more generally in the fall, after sultry and hot weather. 
CAUSES. 
It would appear that bilious colic is occasioned oftener by a deficiency of 
biliary secretion, than a redundancy of it. This may be inferred from the 
want of the customary stimulus of bile imparted to the intestines giving rise 
to the most obstinate costiveness ; and there is no doubt but that the quantity 
of the bile also is very acrid or vitiated, and which causes such a morbid and 
irritable state of the stomach. 438 
THE REFORMED PRACTICE OF MEDICINE. 
The intermediate cause of the complaint seems to be a derangement in the 
capillary vessels, which do not eliminate the ordinary morbific agents, and 
which mix with the blood, are carried to the inward parts, and there is an 
effort of the system to expel them through the medium of the liver, stomach, 
and intestines. Acrid bile pent up in the intestines becomes literally a poison 
to the system, and is the occasion of many very anomalous symptoms. 
The bilious colic generally seizes the patient with a vomiting of a yellow 
greenish cast; a bitter taste in the mouth, with great heat; circumscribed 
pain about the region of the navel; sometimes with most excruciating pain 
all over the abdomen ; then shifting from place to place ; little or no discharge 
of urine ; a pulsation in the abdomen, with a sense of coldness about it; 
frequently it is attended with a hoarseness, which continues during the whole 
stage of the disease, with thirst, fever, and costiveness ; and sometimes 
terminates in the iliac passion. 
" In this state of the disease, if a discharge of feculent bilious matter can 
be obtained, the symptoms generally yield ; but it is sometimes difficult to 
procure evacuations of this character, on account of the irritability of the 
stomach. Where bilious stools are not brought away, it is common to find 
chocolate-coloured motions passed, often in vast quantity, reducing the patient 
to a state of great weakness. If, by the fortunate combination of medicines, 
or by the efforts of nature, the irritating cause is removed, the tongue becomes 
clean, appetite returns, and the patient recovers strength." 
SYMPTOMS. 
TREATMENT. 
Indications of Cure.-The indications of cure in this disease are, 
1. To allay the irritability of the stomach. 
2. To evacuate the bowels of their acrid contents. 
3. To remove spasms, irritation, or urgent symptoms. 
4. To excite a healthy secretion of the liver. 
The most distressing symptoms of the complaint are, nausea, retching or 
vomiting ; and, therefore, the first attention of the practitioner seems naturally 
directed to the stomach : indeed, very little can be done by medicines until 
this irritable state of the stomach is allayed ; something, therefore, must be 
prescribed calculated to accomplish this object. Let the following be admi- 
nistered : Take sal leratus, a tea-spoonful; mint tea, half a pint; laudanum, a 
tea-spoonful: mix ;-or our neutralizing mixture may be given. Of this give 
a small table-spoonful every half hour, or as often as vomiting occurs ; and, 
when it is allayed, let it be followed up by the administration of a double 
portion of our common purgative or anti-bilious physic. The liver and 
stomach are sometimes in such a very torpid state, that even these active 
cathartics are insufficient to evacuate the contents of the intestines. When 
this happens, clysters or injections become the anchor of hope, or the only 
alternative. Those which are properly prepared, and of the right materials, 
exert a most powerful, sovereign, and salutary effect in this disease ; they 
remove the spasms and griping pains, stimulate the intestines, by which 
their contents are discharged, as well as allay the nausea and vomiting. 
The injection may be given, as mentioned under the head of dysentery. This, 
in general, is sufficient; but sometimes those more stimulating are necessary. 
Introduce as much of the injection as the patient can bear, to be repeated 
every hour or two, until evacuations are procured or relief obtained. A tea- 
spoonful of laudanum may be added to our common injection, where there COLIC. 
439 
is great pain. The next step in order will be the use of fomentations to the* 
stomach and bowels. Hops may be boiled with vinegar and water, en- 
closed in flannel or muslin, and applied over the whole abdomen as warm 
as the patient can bear, to be often renewed. When the patient has sub- 
mitted to this treatment, should the disease still continue unsubdued, or 
should there be much pain, administer the anodyne powders. If the first 
uose does not have the desired effect in two hours, repeat it. It is sometimes 
the case that the disease assumes such a very violent character, that it 
becomes necessary, at the very onset, to give an anodyne, and which will gene- 
rally be attended with an excellent effect; it will put a stop to the vomiting, 
allay the irritation of the intestines by its anti-spasmodic and relaxing pro- 
perties, and prepare the way for purgatives. 
Again; I have seen the system in such a state, under the influence of 
bilious colic, that nothing could be made to pass the bowels until perspi- 
ration was promoted. It will, therefore, be necessary to give sudorific medi- 
cines. Catnip and peppermint tea should be freely drank, the feet bathed in 
warm ley water, and heated bricks, covered with cloths wet in vinegar, 
applied to the legs and sides of the body. Where the disease is very violent 
and severe in its character, in conjunction with the means recommended, it 
may be necessary to use the warm bath. Should all other means fail, take 
one pint of new milk, heat it, pour into it molasses until it turns to whey; 
the adult may take half a pint at a time, every half hour until it operates. 
After the bowels have been freed and the symptoms mitigated, occasional 
purgatives or injections may be required, to prevent a relapse. Occasion- 
ally a case has occurred where the following preparation has apparently 
answered better than any other : Take Epsom salts, eight ounces ; muriatic 
acid one quarter of an ounce; boiling water, one pint; mix: dose, a 
table-spoonful every hour in half a tumbler of water, till it acts as a laxative. 
This mixture usually allays the vomiting very soon. 
SECTION III. 
PAINTERS' COLIC. (Pictonum.) 
DESCRIPTION. 
This species of colic differs from the other in some respects, more par- 
ticularly as regards its severity or violence, and the paralytic symptoms 
attending it. It is characterized by very obstinate costiveness, with a 
vomiting of acrid bile, severe pains about the region of the navel, and shoot- 
ing thence to each side with great violence ; strong spasms in the intestines 
and muscles of the abdomen. 
CAUSES. 
It is occasioned by long-continued costiveness; an accumulation of acrid 
bile; cold applied either to the extremities or to the belly itself; a free 
use of unripe fruits; great irregularity in the mode of living; acrid food 
or drink, such as sour wines or cider; and the inhalation of vapours arising 
from a decomposition of lead, or frequently handling some of its chemi- 
cal preparations; hence painters and glaziers are very often attacked by 
it. From the disease occurring frequently in Devonshire, (England,) and 440 
THE REFORMED PRACTICE OF MEDICINE. 
other cider counties, it has generally been supposed to arise from an impreg- 
nation of lead received into the stomach; and it seems now to be perfectly 
understood that the malic acid of the apple takes up in solution a portion of 
the lead of the vats employed in manufacturing the cider, which soon acts 
upon the stomach of those who drink this liquor abundantly, and produces the 
disease in question. 
SYMPTOMS. 
The painters' colic comes on gradually, with a pain at the pit of the stomach, 
extending downward to the intestines, particularly round the navel, accom- 
panied by eructations, slight sickness at the stomach, thirst, anxiety, obsti- 
nate costiveness, a frequent, but ineffectual, desire to evacuate the contents 
of the bowels, and a quick contracted pulse. After a short time the pains 
increase considerably in violence, the whole region of the belly is highly 
painful to the touch, the muscles of the abdomen are contracted into hard 
irregular knots or lumps; the intestines themselves exhibit symptoms of 
violent spasm, insomuch that a clyster can hardly be injected from the pow- 
erful contraction of the sphincter ani; and there is constant restlessness, with 
a frequent vomiting of an acrid matter, but more particularly after taking 
either food or medicine. 
Upon a farther increase of the symptoms, or their not being quickly alle- 
viated, the spasms become more frequent as well as violent, the costiveness 
proves invincible, and an inflammation of the intestines ensues, which soon 
destroys the patient, by terminating in gangrene. In an advanced state of the 
disease it is no uncommon occurrence for suppression of urine to take place. 
TREATMENT. 
The indications to be fulfilled are, to stimulate the inactive or paralyzed 
intestines into action, to expel their irritating contents, and at the same time 
allay the irritation or pain. These intentions are fulfilled by purgatives, 
injections, narcotics, and fomentations. Extract of hyoscyamus is very good, 
as it deadens the sensibility without increasing the constipation, which 
opiates do. Croton oil, one or two drops given in a little milk, is very effec- 
tual, and will cure when all other means fail ; or, if the pain is very great, 
give the following : Extract of henbane, nine grains ; croton oil, three drops ; 
incorporate well together, and make three pills; give one every two hours 
till relief is afforded. A little croton oil may be rubbed upon the bowels, and 
a few drops put into the injections. 
The treatment in this species of colic, in other respects, is nearly the same 
as in the bilious. The means in general, however, require, if practicable, to 
be more prompt and energetic. I usually commence the treatment of the 
painters' colic, 
1. By giving medicine to allay the vomiting, the same as in bilious colic. 
2. By administering cathartics, and dislodging the irritating and acrid 
agents from the intestines ; and, 
3. By removing the spasms, irritation, &c., by the administration of injec- 
tions, anodynes, and sudorijics. 
After the vomiting has in some degree ceased, or before, if the alkaline 
medicine does not allay it, give the anodyne powders, or an opium pill the size 
of a small pea, and repeat every two hours till the pain subsides ; then give 
a double portion of the anti-bilious physic every two hours until the bowels 
are evacuated, to be aided by injections and fomentations, as in bilious colic. COLIC. 
441 
I have found the warm bath of very great service in the painters' colic; it 
should be made hot, and the patient kept in as long as possible. I remem- 
ber one case where the patient was, for a length of time, senseless, from 
the violence of the pain, and where the hot bath, with other means, soon 
restored him to health. Indeed the treatment laid down is invariably suc- 
cessful in every species of colic, never yet having lost a single case ; while 
those who, labouring under this disease, have submitted to the common prac- 
tice have been bled, mercurialized, blistered, and destroyed. 
Dr. Luckey, formerly of Elizabethtown, has jfhblished the result of a very 
large experience with opium and castor oil in the present disease. Foiled 
by the ordinary modes of practice, he resorted to the use of powerful doses 
of opium, followed by castor oil, and always with the happiest effects. " I 
began," says he, " by administering large doses of opium, and generally gave 
ten grains at a dose every hour until two scruples were taken. I was 
exceedingly rejoiced to find that the symptoms now began to yield, and a 
few common doses of oleum ricini, or the infusion of senna, would produce 
the desired effect. Of forty cases which occurred in my practice, none, 
except one, proved fatal after the adoption of this practice." 
The prevalence of this disease arose from the country people, in the vici- 
nity of Elizabethtown, putting up their apple during the fall of 1814, 
in earthen vessels badly glazed, obtained from a neighbouring pottery. The 
acid of the apple butter acting upon, and dissolving, the glazure of the crocks, 
(composed of red-lead,) converted into acetate of lead, which, being received 
into the system with the apple butter, gave rise to this disease. 
A person had been several days in great pain with this disease, constipa- 
tion, &c. Four physicians were in attendance, but all their endeavours to 
alleviate the pain were of no avail; another physician was sent for, who im- 
mediately ordered tobacco injections, which afforded relief and shortly cured 
him. Take tobacco, a tea-spoonful; boiling wrater, one pint; inject. 
Dr. Dudley Atkins, in a work entitled " Medical and Surgical cases," gives 
the following case and treatment: 
Ileus cured by Croton Oil.-" Mr. P., a labourer, aged about fifty, of intem- 
perate habits, was suddenly seized with vomiting and purging after drinking 
very freely of small beer while much heated. I did not see him until the 
subsequent day. The discharges from the bowels had then stopped ; he had 
great pain in the bowels, and constant vomiting. 
" All the common means were resorted to for the purpose of quieting the 
the stomach, both external and internal, without the slighest relief. The 
bowels were obstinately closed, and medicine in every form was instantly 
rejected. He continued in this state for several days, and on the third 
day the fluid discharged by vomiting became decidedly bad, as tested both 
by the smell and taste. Finding all the usual means wholly to fail, I deter- 
mined to make trial of the croton oil. This was administered in doses at 
first of one, and afterward of two drops, until he had taken ten drops. After 
a few hours the vomiting ceased, and small discharges took place from the 
bowels of bright yellow matter, like the stools of an infant, which continued 
for a couple of days, becoming at last very copious. The pain then subsided,' 
and a rapid convalescence succeeded. It was remarkable that the operation 
of the oil caused very little griping or pain. 
" Bleeding, blisters, sinapisms, injections, calomel, and opium were tried in 
every form without the least effect. If I remember aright, the vomiting of 
foecal matter continued at least one day ; I think during a portion of the 
second. It was about five days from the attack before he got entire relief. 442 
THE REFORMED PRACTICE OF MEDICINE. 
" I embrace this opportunity to recommend an application which I have 
always found in the highest degree serviceable and convenient in all painful 
complaints of the bowels, when not attended by inflammation. It is the 
frequently repeated application of dry hot salt, which is folded up in a towel 
or napkin. This is always to be had, it is soon heated, and has this great 
advantage over hot fomentations, that it does not leave the patient wet and 
cold after his pain is relieved. By keeping two napkins in use, the salt for 
the one may be heated while the other is applied, and thus a constant suc- 
cession kept up. In all calbs of colic the heat gives relief almost from the 
first application, and is by far preferable to any mode of applying heat, whe- 
ther dry or wet, that I have ever made use of." 
CHAPTER IV. 
COSTIVENESS. {Constipation 
A certain state of the bowels may be either constitutional or symptoma- 
tic ; generally the latter. There is a retention of the excrements, attended 
with hardness and dryness of the evacuations, which are often difficult, and 
sometimes painful. Sedentary persons are peculiarly liable to this com- 
plaint, especially those of a sanguineous or choleric temperament; or who 
are subject to hypochondriac affections, the gout, acute fevers, or a diseased 
state of the liver and spleen. Costiveness is frequently occasioned by ne- 
glecting the usual times of going to stool, and checking the natural tendency 
to those salutary excretions ; an extraordinary heat of the body and co- 
pious sweats; receiving into the stomach animal food, or a larger propor- 
tion of solid food than is proper for the quantity of fluids swallowed ; a 
free use of opium, and by taking food that is dry, heating, and difficult of 
digestion. Drinking freely and frequently of port wine may likewise occa- 
sion costiveness. With the defect of stools there sometimes exist nausea, 
want of appetite, flatulency, pains in the head, and a degree of febrile heat. 
This disease is to be obviated by an attention to diet; by observing certain 
regular periods for soliciting motions ; and, where these fail, by having 
recourse to laxatives, injections, and aperients. The diet of those who are 
of costive habits should consist chiefly of vegetables and ripe fruits ; and their 
drink, of molasses, water, buttermilk, &c. The second object to be attended 
to is, a habit of regularity, by going at a certain hour or hours each day, and 
making proper efforts at each period for promoting an evacuation. If a 
natural inclination arises at any time, this ought likewise to be encouraged. 
The laxatives most proper for obviating costiveness are those which afford 
the least irritation, but which will at the same time procure one motion daily. 
The anti-dyspeptic pills should be given daily in the commencement, and 
afterward occasionally ; but it is necessary to obtain a regular state of the 
bowels, by exercise, food, &c. The use of every purgative medicine creates 
a necessity for its repetition, and by this repetition the bowels lose their 
energy, and their delicate nerves become torpid. A natural discharge of the 
contents of the bowels ought, therefore, to be solicited by those of costive 
TREATMENT. VOMITING OF BLOOD. 
443 
habits, in preference to the habitual use of any kind of purgative whatever. 
The brown bread is exceedingly valuable in this complaint; stewed apples, 
peaches, and all kinds of ripe fruits are excellent. I find that most cases 
of costiveness arise from want of exercise, and nothing will supply the place 
of it; it should be punctually practised, and brisk frictions made upon the 
abdomen, with daily " kneading." Wheat bread must be avoided ; also 
all astringent articles, spices, &c. Ipecac pills may be taken ; they are 
tonic and aperient. A raw egg or two may be beaten up and taken two or 
three times a day. 
PROFLUENT DISEASES. 
CLASS IX 
CHARACTER. 
By this class of diseases is to be understood such as are characterized by 
a preternatural discharge of blood, or some fluid from the system produced 
in most cases, by muscular debility, or relaxation of the muscular fibre. 
CHAPTER I. 
VOMITING OF BLOOD. (Hamatemesis.-) 
DESCRIPTION. 
By this disease we understand a discharge of blood by the mouth, generally 
in a considerable quantity, attended with retching or vomiting, and without 
its being characterized by those symptoms attendant on bleeding at the 
lungs. 
CAUSES. 
This disease may arise from wounds, blows, bruises, or anything which 
causes too great a flow of blood to this organ; from a suppression of the 
menses, or the bleeding piles; or it may be symptomatic of some other dis- 
eases. It more generally, however, arises from debility, a relaxation of 
certain bloodvessels, &c. 
SYMPTOMS. 
A vomiting of blood is readily to be distinguished from a discharge from the 
lungs, by its being usually preceded with a sense of weight, pain, or anxiety 
in the region of the stomach.; unaccompanied with coughing ; the blood being 
discharged in a very considerable quantity, and of a dark colour ; and, lastly, 
by its being mixed with the other contents of the stomach. 
TREATMENT. 
If the disease arises from a suppression of the menses, let means be taken 444 
THE REFORMED PRACTICE OF MEDICINE. 
to restore them, by appropriate remedies ; in all cases it will be necessary to 
divert the blood from the seat of the complaint to its original channels. The 
feet must be bathed, and perspiration promoted or restored. I have found 
purgatives very useful, which may be given about once a week, or according 
to the urgency of the symptoms ; they will remove the oppression and load at 
the stomach, and the sense of fulness which accompanies this complaint, and, 
by their revulsive effects, will heal the diseased bloodvessels. If called to 
suppress a copious bleeding from the mouth, it will be necessary to administer 
astringents. A little common salt will often suppress the discharge, to be 
taken every two hours in water ; alum water is also good. If these fail, give 
a decoction of beth root. After the haemorrhage is stopped, strengthening 
medicine must be given, for which the restorative and wine bitters are very 
valuable. The anti-dyspeptic pill should be given, to keep the bowels in 
a soluble state ; and even though they be soluble, a purgative must occasion- 
ally be administered. The patient should exercise moderately, and never 
fatigue or strain himself in any way; likewise avoid sudden transitions 
from heat to cold : he will find it serviceable to wear a strengthening plaster 
on the pit of the stomach. His diet should be light, but nutritious. A 
cold decoction of the bugle weed or water hoarhound (lycopus Virginicus) 
may be used for constant drink, and also the flea bane ; they are tonic and 
astringent. 
CHAPTER II. 
SPITTING OF BLOOD. {Haemoptysis.') 
DESCRIPTION. 
This disease is characterized by coughing up florid or frothy blood, pre- 
ceded usually by heat or pain in the chest, irritation in the windpipe, and a 
saltish taste in the mouth. It is readily to be distinguished from vomiting 
of blood, as in this last the blood is usually thrown out in considerable 
quantities ; and is, moreover, of a darker colour, more gumous, and mixed 
with the other contents of the stomach ; whereas blood proceeding from the 
lungs is usually in small quantity, of a florid colour, and mixed with a little 
frothy mucus only. 
CAUSES. 
A spitting of blood arises most usually between the ages of sixteen and 
twenty-five, and may be occasioned by any violent exertion, either in run- 
ning, jumping, wrestling, singing loud, or blowing on wind instruments; 
likewise by wounds, plethora, weak vessels, hectic fever, coughs, irregular 
living, excessive drinking, or a suppression of some accustomed discharge, 
such as the menstrual. Persons in whom there is a faulty proportion, either 
in the vessels of the lungs or in the capacity of the chest, being distinguished 
by a narrow thorax and prominent shoulders, or who are delicately formed 
and of a sanguine temperament, seem much predisposed to this htemorrhage ; 
but in these the complaint is often brought on by the concurrence of various 
occasional and exciting causes before-mentioned. A spitting of blood is not, 
however, always to be considered as a primary disease; it is frequently only a BLEEDING AT THE NOSE. 
445 
symptom ; in some disorders, such as pleurisies, peripneumonies, and many 
fevers, it often arises, and is the presage of a favourable termination. 
SYMPTOMS. 
Sometimes it is preceded by bleeding at the lungs, a dry tickling cough, 
and some slight difficulty of breathing; at other times it is ushered in with 
shiverings, coldness at the extremities, pains in the back and loins, flatulence, 
costiveness, and lassitude. The blood that is spit up is generally thin and 
of a florid red colour ; but sometimes it is thick, and of a dark or blackish cast; 
nothing, however, can be inferred from this circumstance, except that the 
blood has lain a longer or shorter time in the breast before it was discharged. 
It is not attended with danger where no symptoms of consumption have 
preceded or accompanied the hemorrhage, or where it leaves behind no 
cough, dyspnoea, or other affection of the lungs; nor is it so dangerous in a 
strong healthy person, of a sound constitution ; but when it attacks persons 
of a weak, lax fibre, and delicate habit, it may be difficult to remove it. 
TREATMENT. 
For the bleeding pursue the same treatment as pointed out for the 
preceding disease : in addition to which, a strong decoction of the bugle weed, 
cold, may be freely taken as soon as the haemorrhage has subsided, in 
order to prevent a recurrence of it; the vegetable syrup should be taken, and 
the ordinary course pursued, to equalize the circulation. A decoction of flea 
bane is also very good to arrest the bleeding; where the bleeding is very bad, 
give the anodyne powders. 
I lately attended a case of this kind, where the patient bled two gallons 
in a short time, and yet he recovered. 
CHAPTER III. 
BLEEDING AT THE NOSE. {Epistaxis.} 
DESCRIPTION. 
In the nose there is a considerable network of bloodvessels expanded on 
the internal surface of the nostrils, and covered only with a thin tegument; 
hence, upon any determination of a greater quantity of blood than ordinary to 
the vessels of the head, those of the nose are easily ruptured. In general, 
the blood flows only from one nostril; but in some cases it is discharged 
from both, then showing a more considerable disease. Persons of sanguine 
and plethoric habits, and not yet advanced to manhood, are very liable to be 
attacked with this complaint. Females are much less subject to it than 
males, particularly after menstruation has commenced. Peculiar weakness 
in the vessels of the part, and the decline of life, may also be considered as 
predisposing causes. Great heat, violent exertion, external violence, parti- 
cular postures of the body, and everything that determines the blood to the 
head, are exciting causes. 
Bleeding at the nose comes on at times without any previous warning; 
but at others it is preceded by a pain and heaviness of the head, vertigo, 446 
THE REFORMED PRACTICE OF MEDICINE. 
flushing in the face, heat and itching in the nostrils, a throbbing of the 
temporal arteries, and a quickness of the pulse. In some instances a cold- 
ness of the feet, and shivering of the whole body, together with costiveness, 
are observed to precede an attack of this haemorrhage. 
TREATMENT. 
In general bleeding at the nose soon ceases ; but this is not always the 
case, as it sometimes proves very serious. When a person has bled from the 
nose some length of time, it is necessary to take proper means to check it; 
and in most cases it may easily be done by diverting the blood from the 
head, and throwing it back to the extremities and surface, which must be 
effected by the usual means to equalize the circulation ; the feet must be 
immediately immersed in a tub of warm ley water, and hys'sop or penny- 
royal tea taken to produce perspiration; this will generally stop it in 
every case : if these fail, let a little cold water be applied to the nape of the 
neck, the head, and the face. Again ; take a piece of smoked beef that is 
very dry and hard-the more flesh that has been cut off the better-and grate 
it; this forms a fine brown powder ; push this up the nostril as far as possible, 
and continue to do it till it is closed, or the bleeding ceases : I have never 
known this fail. This information cost Mr. Hays, the high constable of this 
city, he states, five hundred dollars ; the curative property, I suppose, de- 
pends upon the sa/L 
CHAPTER IV. 
INVOLUNTARY DISCHARGE OF URINE. (Diabetes.) 
DESCRIPTION. 
This disease is characterized by large quantities of urine, and often an in- 
voluntary discharge of it. It is accompanied with great debility, costiveness, 
fever, voracious appetite, emaciation, a large proportion of saccharine and 
other matter, which is generally voided in a quantity far exceeding that of 
the aliment or fluid taken into the system. 
CAUSES. 
Sometimes it arises from the use of spiritous liquors, debility, cold, diuretic 
medicines, poor diet, depressing passions, an impoverished state of the 
blood, &c. ; it is thought to be occasioned by a perverted or diseased action 
of the kidneys. 
Diabetes makes its approaches very insidiously; the first symptoms 
usually complained of are, lassitude, weakness, a disposition to sweating on 
slight exertions, and headache. Sometimes a diseased state of the urine ad- 
vances to a considerable extent, and exists for some time without being 
accompanied by any strongly-marked constitutional disturbance, and occa- 
sionally even without attracting the notice of the patient. The most striking 
symptom of the disease is, an increase in the quantity of the urine. This 
varies very much in different cases, and is, for the most part, a good index of 
the violence of the disease. The largest quantity recorded as having been DIABETES. 
447 
passed in twenty-four hours is, thirty-six pints ; and it is not uncommon to 
find from twenty to thirty pints discharged daily for weeks, or even months 
together. The average quantity may, perhaps, be stated at twelve or fifteen 
pints ; and it is a remarkable fact, that in many instances it exceeds the 
whole amount of solid and fluid. The secretion of so much urine is almost 
necessarily attended with a frequent desire to pass it; the patient is gene- 
rally compelled to rise three or four times in the night for this purpose. 
The appetite is usually much greater than in health; though digestion is 
seldom, if ever, perfect. There is uneasiness in the stomach after meals, with 
flatulence, acid eructations, and irregular bowels. Thirst is a never-failing 
source of complaint, and often attracts the notice of the patient before he is 
sensible of the true nature of his case ; the skin is dry, and has a peculiarly 
rough and parched feeling, from the total want of perspiration ; the gums are 
often swelled, tender, and red ; sometimes ulcerated ; the breath has a sub- 
acid odour ; the tongue white and foul in the centre, writh bright red 
edges ; the mouth dry and parched, and the taste depraved. The patient 
will generally be found to complain of some pain or sense of weakness in the 
loins. Phymosis and excoriations on the penis are frequently noticed. Be- 
sides these, in almost all cases there occur symptoms indicating general 
weakness or exhaustion, such as swelled legs, emaciation, coldness of the feet, 
difficulty of breathing on the slightest exertion,a sense of weight at the pit 
of the stomach, with tendency to syncope, general languor, lassitude, and 
depression of spirits. Early in the disease the pulse is seldom affected ; but 
in its progress hectic fever supervenes, and the pulse becomes frequent, feeble, 
and irritable. 
The duration of diabetes is very variable. An instance is recorded where 
it ran its course, and proved fatal, in five weeks ; on the other hand, it has 
been known to last for several years, and ultimately to wear out the constitu- 
tion. 
TREATMENT. 
The common treatment in this disorder is so various and opposite, that it 
is impossible to state in what it consists, except it be said, in a word, that it 
is strictly empyrical. The indication of cure will be, to adopt such a course 
of treatment as will restore the tone of the system, which must be effected 
by restorative medicines. If there is nothing to contra-indicate, give a mild 
emetic; after this has operated, let attention be paid to every secretion 
and excretion of the system. The bowels should be kept regular, the skin 
moist, and the feet warm. Let the patient take the following decoction : 
Take beth root, black cohush, crane's bill, wild cherry and hemlock bark, 
equal parts ; pulverize : to a table-spoonful of the powder add a pint of boil- 
ing water, and let it be drank cool or cold through the day. A mild laxative 
pill should be taken, to keep the bowels regular; and, for the febrile symp- 
toms and irritation, let the diaphoretic poivdcrs be taken at bed-time ; at 
the same time let the surface be bathed with tepid ley water. If, after 
using the above means, the disease is not removed, or the patient does not 
grow better, give three capsicum pills in the morning and three at night, to 
be accompanied with the use of the restorative bitters. A strengthening 
plaster may be applied to the small part of the back: should the disease still 
prove obstinate, the bitters may be taken, the emetic occasionally repeated, 
and perspiration promoted, with the use, occasionally, of a purgative con- 
sisting of the pulverized mandrake and cream of tartar. The tepid bath, 448 
THE REFORMED PRACTICE OF MEDICINE. 
during the treatment, should be used every other day. All these means are 
calculated to excite a healthy action of the system and remove the disease, 
by imparting tone and energy. The balm of Gilead may be taken. 
REGIMEN. 
Diet sometimes has great influence in curing this disease. Doctor Wil- 
loughby L. Lay, of Branford, Connecticut, cured a very difficult case of 
diabetes, which had resisted every other mode of treatment, by means of diet, 
which consisted simply of boiled beef-steak, well cooked, and thoroughly 
chewed or masticated, without bread or vegetables of any kind ; this was 
taken three times a day in small quantities, with very little drink. One or 
more physicians had previously tried, in vain, to cure the disease. 
CHAPTER V. 
WHITES, OR FLUOR ALBUS. (Leucorrhaa.) 
DESCRIPTION. 
We understand by this disease an increased secretion or discharge of 
mucus from the vagina, which consists of a thin white or yellow matter, 
and is attended with some degree of fcetor, smarting in making water, accom- 
panied with pains in the back and loins, with considerable debility. It 
is stated that in some cases the discharge is so acrid as to produce symptoms 
on those who are connected with the woman, somewhat similar to the 
venereal disease, causing excoriations about the penis, and a discharge from 
the urethra. There is usually pain and weakness in the back and loins, 
appetite poor, and the feet swell. 
CAUSES. 
Debility is one great cause of this complaint, and this may be occasioned by 
immoderate coition, injury done to the parts by difficult and tedious labours, 
frequent miscarriages, immoderate flowings of the menses, excessive evacua- 
tions, and a sedentary life. Delicate women are very subject to this disease. 
The disease shows itself by an irregular discharge of a fluid from the 
uterus and vagina which, in different women, varies much in colour, being of 
a white, green, yellow, or brown hue. In the beginning it is, however, 
most usually white and pellucid, and in the progress of the complaint 
acquires the various discolorations, and different degrees of acrimony ; 
whence proceeds a slight smarting in making water. Besides the discharge, 
the patient is frequently afflicted with severe and constant pains in the back 
and loins, loss of strength, failure of appetite, pain in the stomach, dejection 
of spirits, paleness of the countenance, chilliness, and languor. The sleep is 
disturbed by fearful dreams, and affords but little refreshment. The woman 
becomes pale and emaciated, her eyes are dull, and a flushing of the face is 
alternated by a ghastly paleness. In process of time the feet and ankles 
SYMPTOMS. WHITES, OR FLUOR ALBUS. 
449 
swell, palpitations and a difficulty of respiration are experienced; the mind 
is dejected, apprehensive, and occasionally affected with melancholy. Very 
frequently the functions of generation are greatly injured, and barrenness is 
often the consequence. Hysterics also, in a greater or less degree, are gene- 
rally attendant on this complaint; the urine is turbid, and the menstrual dis- 
charge sometimes scanty, and even suppressed; at other times it is too 
copious, irregular, or attended with much pain. 
TREATMENT. 
The chief object of the physician should be, in treating this disease, to im- 
part tone and energy to the system. This course will, in most cases, be 
attended with success. If the stomach is in a disordered state, a mild emetic 
may be given; but, in general, it is sufficient to commence with the exhibi- 
tion of a moderate purgative; after which give the diuretic drops: of this 
let the patient take half a tea-spoonful in a wine glass of milk or any kind 
of tea, three times a day, before eating, to be taken on an empty stomach. 
While the patient is using this, give the restorative wine bitters; from 
half a wine glass to a wine glassful may be taken three or four times a 
day. This preparation gives strength to the system, and generally soon di- 
minishes the complaint. While the patient is taking these preparations, an 
adhesive or strengthening plaster should be put upon the back. The patient 
may also make a tea of the hollyhoke and rose leaves, equal parts, and drink 
through the day. A tea of beth root is also excellent. Should the disease 
continue after the exhibition of these medicines, let the following decoction 
be injected up the vagina: Take white oak bark, sumach berries or bark, 
bark of witch hazel, hemlock bark ; bruise or pulverize, and make a strong 
concentrated decoction ; to every pint add a tea-spoonful of pulverized alum : 
let it be injected morning and night, with a female syringe. If this in- 
jection, with the preceding remedies, does not effect a cure, the patient may 
take the following: Beth root, sweet fem, lady's slipper, of each one ounce ; 
steep in three pints of water and four gills of milk: dose, a pint during the day. 
Inject, with witch hazel or crane's bill, twice a day. 
A lady of this city, subject to this complaint, and unable to obtain a re- 
medy in this country, went to Paris, in France, and applied to a physician 
there- He prescribed the following, (in Latin,) and it has cured her. It has 
likewise restored others to health : 
1. Tincture of aloes, one ounce ; muriated tincture of iron, two drachms : 
mix : dose, forty drops three times a day, in a little water. 
2. Inject up the womb, with a female syringe, the following wash twice 
a day: Sugar of lead, one drachm ; white vitriol, one drachm ; add one pint 
of rain water : mix. 
I have cured this disease, when other means have failed, by giving only 
the alterative syrup, which may be used, should the complaint remain very 
obstinate. Strong tea and coffee must not be used. The patient should 
take sufficient exercise to promote a healthy action of the bowels and keep 
them regular. 450 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER VI. 
IMMODERATE FLOW OF THE MENSES. (Menorrhagia.) 
There is sometimes an immoderate flow of blood from the womb. When 
the menses return more frequently than is natural, when they continue longer, 
or are more abundant, it is termed menorrhagia. The disease is accompanied 
with bearing or pressing down, and pains in the back and abdomen. 
DESCRIPTION. 
CAUSES. 
Whatever produces too great a determination of blood to the womb, may 
cause this disease ; as too much exercise, strains, injuries, violent passions of 
the mind, check of perspiration, abortion, difficult or tedious labours, and 
debility arising from any cause, such as drinking freely of warm, enervating 
drinks, tea and coffee, w ant of exercise, &c. 
SYMPTOMS. 
An immoderate flow of the menses arising from plethora is often preceded 
by headache, giddiness, shortness of breath, and is afterward attended with 
pains in the back and loins, some degree of thirst, universal heat, and a fre- 
quent, strong, hard pulse; but where it arises in consequence of a laxity of 
the organ, or of general debility, and such attacks are frequently repeated, 
the symptoms which attend are, paleness of visage, chilliness, laxity, un- 
usual fatigue in exercise, a hurried respiration on the slightest effort, pains 
in the back on remaining any length of time in an erect"posture, and cold- 
ness of the extremities, together with loss of appetite, indigestion, and a 
long train of nervous complaints. If the disease has induced much debility 
and severe attacks, it is no uncommon occurrence for the feet to be affected 
with dropsical swellings, particularly toward evening. 
When there is excessive discharge from the womb, active means must be 
taken to suppress it. The feet must be immediately immersed in warm 
water, and, if there is great pain in the abdomen, a fomentation of hops 
and wormwood applied, and the following powder given internally: Take 
diaphoretic powders, ten grains; capsicum, or cayenne pepper, ten grains, 
or half a tea-spoonful of each: mix. If the pain and haemorrhage is con- 
siderable, give the whole; otherwise give one half, and in an hour give 
the other. At the same time give a strong decoction of flea bane or beth 
root. Apply cloths, wet with vinegar, spirits, and rain water, to the abdo- 
men and over the vagina. If this does not check the discharge in a short 
time, let the patient take alum whey. 
When the urgent symptoms have been removed, means must be taken to 
prevent a recurrence of the haemorrhage; to effect which give a course of 
tonics: a decoction of beth root to be taken through the day, and the 
restorative wine bitters morning, noon, evening, and at bed-time. 
Where there is a considerable discharge from the vagina, appearing sud- 
TREATMENT. ABORTION. 
451 
denly or at various periods, and which resists, in any degree, these remedies, 
the patient may inject once or twice a day the decoction mentioned under 
the head of fluor albus or whites. It is necessary to distinguish between 
an approaching miscarriage and a common flooding, which may readily be 
done. Cold application must not be continued too long, lest injurious effects 
follow their application. 
I lately cured a case of this kind, which baffled all former attempts to re- 
move it, by the treatment here laid down. The patient had become exceed- 
ingly reduced by the loss of several gallons of blood in the course of a few' 
months. There was geat debiity, paleness, emaciation, &c. The medicine 
restored her to perfect health in a short space of time. 
Indian Remedy for the Immoderate Flow of the Menses.-Red alder bark, 
yarrow, mullein, crowfoot,ecpwA. parts; beth root, half as much; make a tea, and 
drink, when cold, a tea-cupful every two, three, or four hours, as the case 
may require ; or equal parts of finely pulverized beth root and crowfoot, one 
tea-spoonful in a cup of yarrow tea, every hour. Apply flannel cloths, 
dipped in vinegar, on the lower part of the bowels. 
The last case of flooding I attended was very severe and dangerous. I 
ordered cold applications over the abdomen, a tea of bane taken inter- 
nally, and the anodyne powders. The patient lost an immense, quantity of 
blood, but she rapidly recovered. When faint, I prescribed a little lavender 
compound. Cold water may be drank, and, if very faint, ten drops of harts- 
horn may be taken occasionally in a little water, or in the lavender. 
CHAPTER VII. 
ABORTION. (Abortio.) 
DESCRIPTION. 
Miscarriage, or the expulsion of the foetus from the uterus, before the 
seventh month, is called abortion ; after which, premature labour. It most 
commonly occurs between the eighth and eleventh weeks of pregnancy, but 
may happen at a later period. In early pregnancy the ovum sometimes 
comes off entire ; sometimes the foetus is first expelled, and the placenta after- 
ward. It is preceded by floodings, pains in the back, loins, and lower part 
of the abdomen, evacuation of the water, shiverings, palpitation of the heart, 
nausea, anxiety, fainting, subsiding of the breasts and belly, pain in the in- 
side of the thighs, opening and moisture of the womb. The principal causes 
of miscarriage are blows or falls ; great exertion or fatigue ; sudden frights 
and other violent emotions of the mind ; a diet too sparing or too nutritious ; 
the abuse of spirituous liquors; other diseases, particularly fevers and 
haemorrhages ; likewise excessive bleeding, profuse diarrhoea or colic, parti- 
cularly from accumulated faeces ; immoderate venery, &c. 
TREATMENT. 
A very similar course of treatment must be pursued in abortion as that re- 
commended in the preceding disease, menorrhagia. Cleanse the bowels by 
the use of cathartics, directing the patient to remain quiet in a recumbent 
position, kept as cool as possible, with a low diet, and the cooling regimen in 452 
THE REFORMED PRACTICE OF MEDICINE. 
other respects. Should there be much flooding, cloths wetted with cold 
water ought to be applied to the region of the uterus, or even introduced into 
the vagina, to obstruct the escape of the blood mechanically. Where vio- 
lent forcing pains attend, an anodyne may be given by the mouth, or in the 
form of glyster, after proper evacuations. Should these means not avail to 
check the discharge of the forcing pains, and particularly if the water be 
evacuated, there can be no expectation of preventing the miscarriage ; and 
where there is reason for believing the foetus dead, from the breasts having 
previously subsided, the morning sickness gone off, the motion stopped, &c., 
it will be proper rather to encourage it by manual assistance. If, on the 
other hand, females of a delicate and irritable habit, rather deficient in blood, 
be subject to abortion, or where this accident is threatened by profuse eva- 
cuations and other debilitating causes, it may be more probably prevented 
by a diet nutritious, yet easy of digestion, with tonic medicines, and the use 
of the tepid bath, attending at the same time to the state of the bowels, 
giving anodynes if pain atend, and carefully avoiding the several exciting 
causes. When a female has suffered several abortions, it becomes almost 
impossible to prevent a repetition at the same period of gestation in a subse- 
quent pregnancy. Nothing, however, will be so successful in preventing a 
recurrence of a similar misfortune, as in allowing the uterine vessels to re- 
cover their tone ; for which purpose tonics must be given. Attend to par- 
ticular symptoms as they occur; with proper diet and exercise. Sea bathing 
and the shower bath are both excellent. 
CHAPTER VIII. 
CESSATION OF THE MENSES. (Commonly called the " Turn of Life.") 
DESCRIPTION. 
That period of life at which the menses cease to flow is likewise very 
critical to the sex. The stoppage of any customary evacuation, however 
small, is sufficient to disorder the whole frame, and often to destroy life itself. 
Hence it is that so many women either fall into chronic disorders, or die 
about this time. Such of them, however, as survive it without contracting 
any chronic disease, often become more healthy than they were before, and 
enjoy strength and vigour to a very great age. 
If the menses cease suddenly, which is seldom the case in women of a full 
habit, they ought to eat less food, especially of the more nourishing kind. 
They should likewise take sufficient exercise, and keep the body open. 
CHAPTER IX. 
INCONTINENCE OF URINE. (Eneuresis.) 
DESCRIPTION. 
It is generally known that some children, and occasionally adults, are 
subject to an involuntary discharge of urine, particularly at night. It arises VOIDING BLOOD BY URINE. 
453 
from a debility of the urinary organs, occasioned by drinking great quantities 
of tea, coffee, or ardent spirits, or by strains, or whatever relaxes the parts 
It may likewise be occasioned by irritating substances contained in the bladder 
TREATMENT. 
The treatment of this disease will consist in restoring the tone of the parts 
by the exhibition of tonics and astringents. The patient should be directed 
to drink a decoction made of the following articles : Take wild cherry tree 
bark, hemlock bark, bayberry bark : bruise or pulverize, and add a sufficient 
quantity of water to make a strong tea or decoction. While the patient is 
taking this decoction, let him take the diuretic drops in a tumbler of beth 
root tea or water three times a day : the diet should consist of boiled milk 
and wheat flour, with a little nutmeg and cinnamon sprinkled in it. He 
must abstain from the use of tea and coffee, and take as little as possible of 
liquids of any kind. This complaint in children is often the result of habit 
or carelessness, in not being made to void the urine immediately before 
going to bed. As this disease is often occasioned by a check of perspiration, 
this secretion should always be restored. Tepid bathing, or applying cold 
water to the loins and lower part of the bowels, is beneficial as well as 
laxatives. An adhesive or strengthening plaster should also be applied to 
the small part of the back and sacrum. Some are in the habit of giving tinc- 
ture of cantharides in this complaint; formerly I administered it in a few 
cases, and in one it effected a cure. 
CHAPTER X. 
VOIDING BLOOD BY URINE. (Hematuria \ 
DESCRIPTION. 
This is rarely, if ever, a primary disease, but is commonly a symptomatic 
complaint, arising from some external injury by blows, bruises, or a fall; 
by some violent exertion, as lifting a heavy weight, jumping, or hard riding ; 
or from a small stone lodged either in the kidney or the duct for conveying 
the urine thence to the bladder, and which, by its irregularity or size, 
wounds or lacerates the surface of the part in which it is lodged or through 
which it has passed. If the blood proceeds immediately from the bladder 
in consequence of a stone contained in it, it is generally accompanied by a 
sense of heat and pain at the bottom of the bowels, and occasionally much 
difficulty in making water. When a discharge of blood proceeds from the 
kidney or urinary ducts, and is occasioned by a rough stone descending 
thence to the bladder, it is accompanied by an acute pain and sense of weight 
in the back, and a difficulty in emitting urine. The depositing of clotted blood 
at the bottom of the chamber in this complaint, and its staining linen of a 
red colour, will enable us to distinguish it from the high-coloured urine 
attendant on many diseases. The voiding of bloody urine denotes danger, 
but it is particularly so when mixed with purulent matter, as it then points 
out that there is ulceration in some part of the urinary passages. Nor is the 
danger less when it has been produced by wounds or bruises of the kidneys. 454 
THE REFORMED PRACTICE OF MEDICINE. 
TREATMENT. 
The treatment of this complaint likewise consists in giving stimulating 
diuretics and astringents. The urinary decoction may be taken, according to 
directions given under the head of that preparation ; likewise the diuretic 
drops, as directed in the preceding disease ; give a decoction of the gravel 
plant, (epigea repens.') I lately attended one case of this kind, which I 
cured by a strong decoction of peach tree leaves. 
CHAPTER XL 
ONANISM, SELF-POLLUTION, &c. 
DESCRIPTION. 
By this disease is to be understood an excessive discharge of the seminal 
fluid, either naturally or artificially. It is a very common practice among 
men and women, more particularly youth. It gives rise to a variety of symp- 
toms, which are often unsuspected or overlooked by the physician, and by 
the friends of the patient. The semen being the most vital fluid of the 
system, it is easily seen what the consequence must be when it is thrown 
off in an undue or excessive degree; and it is somewhat doubtful whether 
a discharge of it in any manner does not more or less injure the health or 
lessen the growth of persons. 
SYMPTOMS. 
This disease produces febrile complaints, mania or mental derangement, 
dyspepsia or indigestion, hectic fever, and general debility. The more one 
indulges the practice, the greater the propensity for it. It causes a long train 
of complaints, tremours of the limbs, headache, restless nights, gleets or dis- 
charges from the urethra, pains of the system in different parts ; the memory, 
judgment, and reason become impaired ; discharge of semen, particularly at 
the thought or sight of women; pain in the breast and loins, cough and 
consumption, weakness in the back and genitels, sometimes fits of apoplexy, 
hypochondria, and hysteria, and great despondency of mind. 
TREATMENT. 
1. The patient must abandon the practice immediately. 
2. Neither see nor think of women more than is possible. 
3. If there is nocturnal emissions of semen, let the patient take a few grains 
of the diaphoretic powders at bed-time. 
4. Give the diuretic drops through the day. 
5. Apply the tincture of capsicum to the back and loins. 
6. Let the wine bitters be taken. 
7. Tepid bathing in salt water. 
8. A cooling, but nutritious, diet, milk, &c. 
9. Reside in the country. 
For farther particulars on this important disease, consult a work by Tissot, 
translated from the French CATARRH-RETENTION OF THE MENSES. 
455 
CHAPTER XII. 
CATARRH IN THE HEAD. 
The glands and membranes of the head secrete a fluid to keep the mouth, 
nose, and eyes moist; from cold, debility, and other causes, it is liable to 
become obstructed, in which case this liquid is secreted too copiously, when 
it is called a catarrh. The liquid that flows from the nostrils makes the 
eyes tender, irritates the nose, and occasions sneezing, or falls into the 
throat and windpipe, and causes coughing, and, if long continued, the con- 
sumption. It irritates the mouth and other parts over which it passes, 
and sometimes collects in the throat, and almost chokes the person. It 
may last for years, and cause pain in the eyes, cough, drowsiness, and 
emaciation. 
TREATMENT. 
Bathe the head and shoulders with cold water, and use the cephalic snuff. 
If these do not cure, use the following, which I have found a very valuable 
remedy : Take common sage, a table-spoonful; black pepper, a tea-spoonful: 
pulverize : smoke two or three pipes during the day, and force the smoke 
through the nose ; this has proved a superior remedy. This treatment 
would probably be very useful in all chronic complaints of the head. 
Dr. Leavit, a botanic physician of this city, states that he has found the 
following snuff very efficacious in catarrh : Blood-root, gum Arabic, gum 
myrrh, pulverized, equal parts. He also asserts that he would not take 
five thousand dollars for an ounce of this snuff, in case he could not procure 
any more. He was reduced very low with the catarrh, and it cured him. 
REFLUENT DISEASES. 
CLJ1SS X. 
CHARACTER. 
This class of diseases is directly the reverse of the preceding, viz., pro- 
fluent diseases. When any fluid is obstructed, or is returned back into the 
circulation, it constitutes a disease which comes under this head. 
CHAPTER I. 
RETENTION OF THE MENSES. (Chlorosis.) 
DESCRIPTION. 
It is well known that females, from the age of twelve to sixteen, (or ac- 
cording to the climate,) begin to menstruate, and which constitutes a critical 456 
THE REFORMED PRACTICE OF MEDICINE. 
period in their lives, as health depends very much upon this discharge. It 
is liable, from various causes, to become obstructed at the period when it ought 
to appear; when this takes place it is attended with very painful or serious 
effects ; and, if nature is not assisted, the health is impaired or the constitution 
undermined, inducing consumption or some other complaint. 
CAUSES. 
The remote cause of this complaint is most frequently suppressed perspi- 
ration ; and it may arise, in part, from an inactive and sedentary life, and such 
habits as are peculiar to the higher classes of society, particularly in cities 
and towns. The proximate cause of it seems to be a want of power in the 
system, arising from inability to propel the blood into the uterine vessels 
with sufficient force to open their extremities and allow a discharge of blood 
from them. 
SYMPTOMS. 
Heaviness, listlessness to motion, fatigue on the least exercise, palpitations 
at the heart, pains in the back, loins, and hips, flatulence, acidities in the 
stomach and bowels, costiveness, a preternatural appetite for chalk, lime, and 
various other absorbents, together with many dyspeptic symptoms. As it 
advances in its progress the face becomes pale, and afterward assumes a 
yellowish hue, even verging upon green, whence it has been called green 
sickness; the lips lose their rosy colour; the eyes are encircled with a 
livid areola; the whole body has an unhealthy appearance, with every 
indication of a want of power and energy in the constitution ; the feet are 
affected with swellings ; the breathing is much hurried by any great exertion 
of the body ; the pulse is quick, but small; and the person is liable to a 
cough, and to many of the symptoms of hysteria. Sometimes a great 
quantity of pale urine is discharged in the morning, and not unfrequently 
hectic fever attends. In cases of a more chronic character " there is a 
continued, though variable, state of sallowness, yellowness, darkness, or a wan, 
squalid, or sordid paleness of complexion, or a ring of darkness surround- 
ing the eyes, and extending perhaps a little toward the temples and cheeks 
TREATMENT. 
As this disease proceeds from debility, it is evident that the great object 
to be fulfilled will be, to give tone and energy to the system; and if this 
debility has arisen from a sedentary life, the patient must begin immediately 
to exercise in the open air, and, if practicable, to change her residence. I 
once had a case so very violent and protracted, that the patient often had fits 
resembling the apoplexy. I gave her medicine, and during the time she 
was taking it she went to the sea-shore, bathed, took herb tea, and after a few 
weeks or months was entirely restored to health. The change of air, bath- 
ing, &c., appeared to contribute as much to the cure as the other means made 
use of. The tepid or warm bath should be used in preference to the cold. 
The first medicine given may be the pulverized mandrake root, combined 
with a little cream of tartar; and, when the stomach is very irritable, our 
common purgative will be found excellent. This, as well as other medicines, 
should be taken upon an empty stomach : after it has been given, mother- 
wort ,pennyroyal., and other herb teas may be freely drank. After the exhibi- 
tion of the purgative, which may be occasionally repeated, gum aloes may SUPPRESSION OF THE MENSES. 
457 
be taken, combined in such a manner as to prevent the piles. This medi- 
cine, from its action upon the uterus through the medium of the rectum, is 
very useful in retention of the menses ; and its benefit is much increased by 
combining it with other articles ; hence we have used it in the form of the 
anti-dyspeptic pill, which answers the purpose very well; it is mild, gently 
laxative, and tonic : two or three of these may be taken at bed-time, or as 
many as are sufficient to keep the bowels regular. During the use of these 
pills let the patient take the restorative wine bitters, as directed under that 
head. Emenagogues, or " forcing medicines," should not be used to bring 
on the menses, except there be a struggle or effort of nature to effect it, which 
may be known by the periodical pains and pressing down about the hips 
and loins. When this occurs let the feet be bathed, and perspiration pro- 
moted, by drinking freely of diluent teas, such as pennyroyal, motherwort, 
and garden thyme. Should considerable pains attend the complaint, eight 
or ten grains of the diaphoretic powders may be given, and fomentations of 
bitter herbs applied over the region of the womb. The black or emenagogue 
powders are very good ; the female pills may also be taken, if the disease 
proves obstinate. 
A physician of this city states that he has cured several cases by the use of 
hydriodate of potash in solution. Bathe the feet daily. 
Dr. Dewees states that he has never known the following to fail during 
thirty years' practice : Take pulverized gum guaiacum, four ounces ; carbo- 
nate of soda or potash, half a drachm ; pulverized alspice, one ounce ; diluted 
alcohol, one pint: digest a few days ; one or two drachms of hartshorn to 
every four ounces of the tincture: dose, a tea-spoonful morning, noon, and 
night, in sweetened milk or wine; gradually increase the dose. 
The patient should be very careful not to expose herself to the vicissitudes 
of the weather, and not suffer the feet or clothes to become wet; warm 
clothing must be worn, and particularly flannel. Chalybeate waters, such 
as Ballston and Saratoga, have been taken with success in this complaint. 
A table-spoonful of the red oxide of iron may be added to every quart of 
the bitters. For pain apply a heated brick, covered, to the bowels. 
The diet should be light, nutritious, and easy of digestion. 
CHAPTER II. 
SUPPRESSION OF THE MENSES. (Amenorrhea.) 
DESCRIPTION. 
In this disease there is a partial or total obstruction of the menses in women 
from other causes than pregnancy and old age. The menses should be regular 
as to the quantity and quality; that this discharge should observe the monthly 
period, is essential to health. When it is obstructed, nature makes her efforts 
to obtain for it some other outlet; if these efforts of nature fail, the conse- 
quence may be, fever, pulmonic diseases, spasmodic affections, hysteria, epi- 
lepsy, mania, apoplexy, green sickness, according to the general habit and 
disposition of the patient. Any interruption occurring after the menses have 
once been established in their regular course, except when occasioned by 
conception, is always to be considered as a case of suppression. A constric- 458 
THE REFORMED PRACTICE OF MEDICINE. 
tion of the extreme vessels, arising from accidental events, such as cold, 
anxiety of mind, fear, inactivity of body, the frequent use of acids and other 
sedatives, &c., is the cause which evidently produces a suppression of the 
menses. In some few cases it appears as a symptom of other diseases, and 
particularly of general debility in the system, showing a want of due action 
of the vessels. When the menses have been suppressed for any considerable 
length of time, it not unfrequently happens that the blood which should have 
passed off by the uterus, being determined more copiously and forcibly to 
other parts, gives rise to hjemorrhages; hence it is frequently poured out 
from the nose, stomach, lungs, and other parts, in such cases. At first, 
however, febrile or inflammatory symptoms appear, the pulse is hard and 
frequent, the skin hot, and there is a severe pain in the head, back, and loins. 
Besides, the patient is likewise much troubled with costiveness, colic pains, 
and dyspeptic and hysteric symptoms. 
TREATMENT. 
It will be necessary, in the treatment of this disease, to remove urgent 
symptoms if they are present. If the patient is in severe pain, give the 
diaphoretic powders, and at the same time let a strong infusion of garden 
thyme and pennyroyal be freely given. Immerse the feet in warm ley 
water, and rub well with coarse flannel. If relief is not obtained in the 
course of an hour, or in a very short time, a strong decoction of bitter herbs 
should be thrown into a proper vessel, and the patient steamed fifteen or 
twenty minutes, as long as she is able to bear, or until perspiration is pro- 
duced ; immediately after which let her be put in bed, covered warm, and 
the herbs be enclosed in flannel or muslin, and applied to the lower part 
of the abdomen or belly. This process will almost immediately relieve 
the urgent symptoms. After this our next object w'ill be, to regulate the 
menstrual discharge, by a proper course of strengthening medicine ; that 
recommended under the head of chlorosis, or a retention of the menses, may 
be taken with advantage. Inasmuch as this complaint, like the preceding, 
proceeds from debility, it is evident that it must be removed, in order to effect 
a cure ; and, therefore, that medicine and treatment whicb strengthens and 
invigorates tbe system, will invariably benefit the patient. The skin, stomach, 
and intestines, all seem concerned in the production of this disease, and hence 
our attention should be directed to a restoration of their proper offices : the 
stomach and bowels should be cleansed and stimulated to a healthy action ; 
perspiration must be promoted, and, in short, every secretion and excretion 
of the system. If the stomach is in a morbid condition, let an emetic be 
occasionally given, and afterward a dose of mandrake ; both of which may 
be repeated as occasion requires. The patient may then take the following 
tonic bitters : Take prickly ash bark, two ounces; wild cherry tree bark, 
two ounces ; Seneca snake-root, one ounce ; tanzy, one ounce ; gum soctorine 
aloes, half an ounce; devil's bit, two ounces: pulverize ; to every two 
ounces of the powder add half a pint of boiling water and one quart of 
Holland gin, and half a wine glassful taken three or four times a day. 
This may be continued while it agrees with the patient, or as long as benefit 
is derived. About once a month there will generally be felt more or less 
symptoms preceding a catamenial discharge; considerable pain will be felt 
through the lower part of the abdomen, hips, and loins, showing that there 
is a strong effort or struggle of nature to return the menses. Our principal 
object, when this occurs, should be, to aid her salutary efforts, as directed SUPPRESSION OF THE MENSES. 
459 
in the preceding complaint; the patient should sit over the steam of bitter 
herbs for ten or fifteen minutes, retaining the steam by means of a blanket, to 
concentrate it upon the lower part of the body ; at the same time the feet 
may be bathed, and tanzy tea freely drank. The abdomen should also be 
fomented, as before directed. It will not be necessary, however, to use these 
means, except there is an obvious indication to return the menses. 
It must be recollected, that when the patient labours under some other dis- 
ease, there is such debility that there is not superfluous blood sufficient to 
keep up the menstrual discharge ; and in this case our attention must be 
directed to the primary affection, without any regard to such symptoms; 
it is also very necessary to bear in mind the fact, that the menses are often 
suppressed from pregnancy, and the physician will be applied to return them, 
with a view to procure abortion. No man, possessed of any principle, will 
ever be guilty of prescribing medicine in such a case, with a view to return 
them; such conduct would be very criminal, and an indictable offence. 
Great rewards or remuneration are held out in such cases to the practitioner ; 
but, as he values his reputation, character, and conscience, let him never 
yield to the temptation. By a proper attention, he can always discriminate 
between a suppression of the menses and pregnancy ; and the principal diag- 
nostic symptom is, that in the former complaint there is a pain or an affection 
of the head, attended with dizziness. 
I lately attended a case of amenorrhoea which had existed for two years, 
and the abdomen had gradually acquired an enormous magnitude, much 
larger than a female in the last month of pregnancy; after having tried 
all my ordinary remedies to return the menses, I succeeded with the follow- 
ing treatment: I first gave a tea or infusion of the digitalis or fox-glove, as 
directed under the head of hydrothorax. In the next place a purgative was 
ordered once or twice a week. During the same time the patient was 
directed to drink freely of parsley tea, and rub the whole abdomen twice 
a day with sweet oil, and as often with white precipitate ointment. From 
the time that the patient commenced this treatment the belly began to sub- 
side, and shortly the courses returned, she soon entirely recovered her health, 
and has been well for many years. Having exhausted my skill in trying all 
ordinary remedies, I resorted to this last treatment, as an experiment, or as 
the last alternative, and never was a medicine more strikingly successful. 
The cure was a matter of astonishment to all who witnessed it. The abdo- 
men was perfectly tense and hard, and appeared almost rn a state of scirrhus. 
Of the modus operandi of the medicine, I must leave the reader to judge. 
A person informed me, some years ago, that a physician on Long Island 
cured his wife of obstructed menses, which had placed her life in the greatest 
jeopardy, and which other physicians could not remove. The following 
formula was used : Take tincture of gum myrrh ; tincture of castor, equal 
parts: give a tea-spoonful three or four times a day. 
Since writing the preceding remarks upon this complaint, I administered 
a dose of mandrake for a bilious complaint to young woman who had been 
afflicted with partial or deficient menses for many years, and which not only 
removed the symptoms for which it was given, but likewise returned the 
menses. 
Again; a gentleman has come a distance of forty miles to obtain relief 
for his daughter, who has been labouring under a spasmodic affection from 
suppressed or obstructed menses. Two physicians have attended her, and 
pursued the usual course of bleeding, &c., the effect of which has been (as 
I predicted) an aggravation of the complaint. The bleeding soon induced 460 
THE REFORMED PRACTICE OF MEDICINE. 
greater spasms, and, finally, convulsions. I explained to him the nature of 
the disease, gave him my opinion, that it proceeded not from repletion or 
excess of blood, as his physician stated, but from an unequal circulation or an 
undue quantity thrown upon the brain. He then stated that her feet and 
legs were as cold as a dead person's, evidently showing a recession of blood 
from these parts to the head. After stating my views and treatment of the 
disease, he appeared forcibly struck with the difference, and exclaimed, " How 
you doctors differI" 
Dr. Tidd, with whom I first studied, was in the habit of giving a prepara- 
tion which has been attended with success, and which I have formerly been 
in the practice of giving. He procured it from some person in the section 
of the country where he resided, who obtained great celebrity for removing 
this disease. It is made as follows : Take gum myrrh, four ounces ; flowers 
of sulphur, four ounces ; steel filings, four ounces ; loaf sugar, four ounces , 
pulverize, and simmer all in a quart of wine, until the mass becomes nearly 
dry; after which remove from the fire, and, when dry, pulverize: of this 
let the patient take half a tea-spoonful two or three times a day. Some 
prefer taking the same quantity in the form of pills. 
I cured a patient labouring under this complaint, by giving the white gum 
turpentine in wine ; mustard plasters applied to the breasts. A great change 
followed, and she soon recovered. One ounce of the gum to one pint of 
Malaga wine : dose, half a wine glassful three of four times a day. 
Or the following : Take gum turpentine, half an ounce ; red oxide or car- 
bine of iron, half an ounce ; capsicum, one drachm; Malaga wine, one quart: 
mix: dose, a table-spoonful four times a day. 
Under the treatment here laid down I do not now recollect a single in- 
stance of failure. 
The following case occurred within my knowledge: A young lady had 
laboured under almost a total suppression of the menses all her life, or for 
many years. She had tried almost every kind of medicine without receiving 
the least benefit, and her case appeared utterly hopeless. Having been advised 
to apply to a woman who was very noted for curing this disease only, she 
called upon her, stated her symptoms, received a box of pills, and took them 
according to her directions ; the effect of which was, the natural return of 
the catamenial discharge and perfect restoration to health. The father pre- 
sented me with a few of the pills, which I found to be composed of about 
four parts of white turpentine gum, and one part of sulphate of iron, (green 
vitriol,) formerly called sal rnartis. Two or three pills of the same to be 
taken at a dose, three or four times a day. 
CHAPTER III. 
PAINFUL AND IMPERFECT MENSTRUATION. {Dysmenorrhea.) 
DESCRIPTION. 
Besides the two deviations from the usual course of nature already men- 
tioned, there sometimes occurs a third, viz., where menstruation, although not 
wholly suppressed, is, nevertheless, somewhat difficult, and accompanied with 
severe pains in the back, loins, and bottom of the belly. This disease is PAINFUL AND IMPERFECT MENSTRUATION. 
461 
owing to a weak action of the vessels of the uterus, or spasm of its extreme 
vessels, and is to be obviated by tonics, warm bathing, both local and general, 
together with the use of anodynes, which should be employed as soon as the 
symptoms that denote its approach are apparent. This complaint is a com- 
mon, and generally an extremely harassing, affection. It may occur at every 
period during the menstruation stage of life ; but it appears to be most com- 
mon between the twentieth and thirtieth years of age, and in subjects of an 
irritable and sanguineous temperament. In many instances severe pains are 
experienced in the back, loins, and lower part of the abdomen for five or 
six hours previous to the appearance of the menses. This, however, soon 
ceases, and an immediate aggravation of the torturing pain follows. Some- 
times the catamenia begin to flow moderately, with little or no previous 
pains ; but in an hour or two they become suddenly arrested, at the same 
time that violent pains come on in the hips, side, loins, back, and thighs, with 
a distressing sensation of forcing or bearing down. Occasionally a very 
slight menstrual discharge continues uninterruptedly for three or four days, 
accompanied throughout with extremely severe pains in the abdomen; and 
in some rare instances the catamenial evacuation, although attended with 
great suffering, is sufficiently copious and prolonged in its course, and may 
even exceed the regular duration and quantity of an ordinary healthy men- 
struation. 
TREATMENT. 
Since it is well known that a derangement in the uterine functions must 
generally proceed from a check of perspiration, astringing the minute ends 
of the uterine vessels, or in some manner deranging their functions, causing 
debility, &c., it will appear clear that our first attention must be directed to 
the skin. Cold appears to be the cause of the disease, and heat seems to 
remove it; therefore, when these periods of distress occur, let the patient 
sit over a strong decoction of bitter herbs, such as tansy, hoarhound, worm- 
wood, catnip, and hops, while a blanket is thrown round the waist of the 
patient to confine the steam to the lower parts. After the diseased person 
has been thus steamed and the feet bathed, let her be put into a bed, warmly 
covered, and diluent drinks given, such qs tansy, thyme, pennyroyal, &c. 
At the same time let fomentations of the same herbs, enclosed in a flannel 
bag, be applied to the abdomen, as before directed. This will produce per- 
spiration and afford immediate relief; and when these distressing symptoms 
are removed, and the patient becomes comfortable, a course of treatment 
must be adopted to prevent a recurrence of these symptoms, or to produce a 
natural flow of the catamenial discharge; and similar to that recommended 
under the preceding complaints. Herb tea may be freely drank. 
A writer on this subject thus remarks. " This case of painful menstruation 
deserves particular attention, because it impairs the health of patients by its 
present effects, and seems to render them less prolific in future. Dr. Fothar- 
gill has afforded relief to several by the following process : Let the patient have 
near her a few pills, consisting of opium, gr. i. each, made soft with a little of 
any kind of conserve. She is to take one of these pills the moment the 
pain attending this discharge comes on. A pill may be taken every hour 
till the pain ceases; more than two will seldom be required; yet they 
must be taken in quantities sufficient to mitigate the pain. Let the 
patient keep either in or upon the bed, or at least in a recumbent posture, 
drink moderately of any diluting liquor, as herb teas, weak whey, or 462 
THE REFORMED PRACTICE OF MEDICINE. 
thin broth. When the time is past, a course of chalybeate bitters, in small 
doses, may be continued, till within a few days of the return ; and the belly 
should be kept open with some proper laxative. This excruciating pain 
seems to be spasmodic, and to proceed from the extreme irritability of the 
uterine system." The diaphoretic powders will be found very useful. Diet 
and exercise are important. A hot brick or salt, enclosed in flannel wet with 
vinegar, and applied to the bowels, soon relieves the pain. 
CHAPTER. IV. 
NIGHTMARE. (Incubus.) 
SYMPTOMS. 
The nightmare attacks the person during sleep, and the first approach of 
the fiend is usually in the shape of a disagreeable and frightful dream. He 
perhaps supposes himself in great danger, or pursued by an enemy whom he 
finds it impossible to avoid. He frequently feels as if his limbs were confined 
and deprived of motion. After a time the uneasiness of the patient rapidly 
increases, he feels oppressed with a sense of weight on the chest, impressing 
him with the idea that some living being is seated thereon, inspiring terror, 
impeding respiration, and paralyzing all the voluntary muscles. The sensa- 
tion is highly distressing and painful; he becomes every instant more awake 
and conscious of his situation ; makes violent efforts to move his arms, with 
the view of throwing off the weight, but all to no purpose ; he moans sadly, 
his heart is sometimes affected with palpitations, but generally moves with 
additional velocity; the difficulty of breathing goes on increasing, the eyes 
are half open, and the countenance puts on a ghastly appearance. He gene- 
rally lies in this state for two or three minutes, when all at once he recovers 
the powers of volition, upon which he either changes his position instantly, 
so as to awake himself thoroughly, or he jumps out of bed in a violent fright. 
When this is not done, the paroxysm or fit is very liable to return imme- 
diately, or very soon, as there is an irresistible propensity to sleep, which, if 
yielded to, is most likely to be productive of another attack. 
CAUSES. 
The disease is most frequent among persons of a nervous temperament, 
and those who are studious or lead an inactive life. It seems principally to 
arise from indigestion, being usually accompanied with flatulence, acid eruc- 
tations, and costiveness. Nothing is more likely to produce an attack of the 
nightmare than going to bed soon after having eaten a hearty supper, and 
particularly of food of an indigestible or flatulent nature. It only takes 
place when the person is lying on his back. Great anxiety, abstruse think- 
ing, or anything that oppresses the mind, may be considered also as exciting 
causes of this disease. 
The nightmare has generally been looked upon as a trifling complaint; 
but it is by no means improbable that some of those persons who have been 
found dead in their beds were destroyed by it. Those who are subject 
to attacks of this disease should, therefore, have some person to sleep near 
them, that they may be immediately awoke on their moaning or making a 
noise during the fit, as the uneasiness goes off as soon as the patient is roused. ENLARGEMENT AND PALPITATION OF THE HEART. 
463 
TREATMENT. 
Persons subject to the nightmare must abstain from all kinds of food 
that is either difficult of digestion or flatulent, particularly for supper, 
they should take regular and sufficient exercise throughout the day, court 
cheerful society, and avoid gloomy contemplations and intense study, with 
late hours. On recovering from an attack of the nightmare, or being 
roused, it may be advisable, if the patient seems distressed by flatulency or 
uneasiness at the stomach, to give lavender compound. If these medicines 
are not at hand, a table-spoonful of brandy, or salt and water, may be taken. 
Persons who are young and full of blood, if troubled with the nightmare, 
ought frequently to take a purge, use a spare diet, and exercise in the open 
air. 
CHAPTER V. 
ENLARGEMENT AND PALPITATION OF THE HEART. (Hypertrophy.) 
This complaint is also called angina pectoris. Sometimes the heart is 
diseased primarily, and sometimes symptomatically. It is primary when there 
is an organic affection of the heart, such as enlargement or alteration of struc- 
ture by ossification of its arteries. When it is affected by contiguous organs, 
as the stomach in dyspepsia, or by a collection of serum or water in its in- 
vesting membrane, it is then symptomatic. The walls of the heart become 
thickened or dilated: sometimes the coronary arteries become ossified or 
hardened. A physician in the navy has an enormous enlargement of the 
heart, which has lasted twenty years. 
SYMPTOMS. 
When there are chronic enlargements, or some real disease of the heart, 
the following symptoms are present: Palpitation is generally a very promi- 
nent symptom ; but this may proceed from dyspepsia or debility ; there is 
shortness of breath, particularly from exertion ; pain, and a sensation of tight- 
ness or stricture of the chest, and pain over the region of the heart; diffi- 
culty of laying in a recumbent position, and sudden startings up ; a little 
fatigue, as walking fast, or going up stairs, will occasion distress ; the feet 
begin to swell, the strength fails, the pulse sometimes intermits, the counte- 
nance, particularly around the mouth, assumes a pale, haggard appearance, 
and there is sometimes paroxysms of pain, which are very distressing; 
in one of these the subject of the disease is liable to be suddenly snatched 
away. By placing the hand over the region of the heart a great beating of 
that organ may usually be felt. Most of these are peculiar, however, to 
water around the heart, and some of them consequent on dyspepsia. The 
symptoms occur periodically. 
CAUSES. 
Whatever weakens the heart may have a tendency to bring on these symp- 
toms ; also great excitement of the mind, intemperance in eating and drink- 
ing, venereal excess, &c. 464 
THE REFORMED PRACTICE OF MEDICINE. 
TREATMENT. 
If the disease is symptomatic of some other, as dropsy of the chest or 
indigestion, then give medicines accordingly. If it be a primary affection, 
direct the treatment to the organs affected. Abstain from every exciting 
cause, as anger, over-exertion, everything of a heating nature, &c. A rigid 
course of diet is necessary. Upon an attack of the disease take half a tea- 
spoonful of capsicum in a little sweetened water ; this will probably afford 
immediate relief. JElher, laudanum, and tincture of castor, a mixture of equal 
parts, and a tea-spoonful taken in a little water, as also lavender compound. 
After the paroxysms have subsided, use preventions; take the compound 
powder of jalap twice a week, apply a counter-irritant plaster over the heart 
and on the spine, and use the restorative wine bitters. It is very seldom that 
a real primary disease of the heart can be cured ; but relief is very desirable. 
Two or four grains of extract of henbane may be given, to relieve the pa- 
roxysms, and also a tea-spoonful of salt and water. With a view of pre- 
venting the recurrence of the disorder, the patient should carefully guard 
against passion, or other emotions of the mind; use a light diet, avoiding 
everything of a heating nature; and take care never to overload the 
stomach, nor use any kind of exercise immediately after eating. Besides 
these precautions, he should endeavour to counteract obesity, which has 
been considered as a predisposing cause ; and this is to be effected most 
safely by a vegetable diet, moderate exercise at proper times, early rising, 
and keeping the body perfectly open. Angina pectoris is a disease always 
attended with considerable danger, and in most instances has proved fatal 
under every mode of treatment. It is stated that several cases of it have 
been treated with great success, and the disease radically removed, by in- 
serting a large issue on each thigh. Purgatives and emetics may be given, 
and perspiration promoted. 
CHAPTER VI. 
JAUNDICE. {Icterus.) 
DESCRIPTION. 
Jaundice is derived from the French jaunisse, yellowness, ofjaune, yel- 
low ; in medicine a disease consisting in a suffusion of the bile to the surface 
of the body, whereby the whole exterior habit is discoloured. There is also 
a species of this disease called the black jaundice. 
CAUSES. 
The immediate cause of the jaundice is an obstruction of the bile in its 
passage into the duodenum. 
SYMPTOMS. 
The jaundice first shows itself by a listlessness and want of appetite ; tne 
patient becomes dull, oppressed, and generally costive. These symptoms 
have continued but a very short time, when a yellow colour begins to diffuse JAUNDICE. 
465 
itself over the white of the eyes and nails of the fingers ; the urine becomes 
high coloured with the yellowish sediment; the stools are whitish or gray ; 
the patient's skin is dry, and he generally feels a kind of itching or pricking 
pain over the whole body. Sometimes the patient has a continual propen- 
sity to sleep, but in others there is too great watchfulness; and sometimes 
the pain is so great that the patient cannot sleep. The pain comes by fits. 
As the disease advances the yellow colour becomes more and more deep ; 
and even the internal membranes, the bones, and the brain itself, become 
tinged. All the secretions are affected with the yellow colour of the bile, 
which in this case is diffused throughout the whole mass of fluids; the 
saliva or spittle becomes yellow and bitter ; the urine excessively high co- 
loured, in such a manner as to appear almost black ; the blood itself is said 
sometimes to appear of a yellow colour when drawn from a vein. In process 
of time the blood begins to acquire a tendency to dissolution and putrefac- 
tion, which is known by the patient's colour changing from a deep yellow to 
a black or dark yellow. Haemorrhages ensue from various parts of the body, 
and the patient frequently dies of an apoplexy ; though in some the disease 
degenerates into an incurable dropsy. 
TREATMENT. 
If the stomach is much disordered, which is usually the case, we may 
commence the treatment of this disease by giving a mild portion of the emetic 
■powders ; after the operation, and the stomach has become settled, give 
a portion of the pulverized mandrake root, combined with a little of the cream 
of tartar and cloves, to prevent griping ; and the repetition of these must de- 
pend upon the obstinacy of the complaint. After these have been given the 
patient should commence the use of the following preparation : Take yellow 
root or golden seal, one drachm ; bitter root, two drachms ; white poplar 
bark, two drachms ; capsicum, one drachm : cover with boiling water; then 
add a pint of Holland gin : of this let the patient take from half a wine glass 
to a wine glassful, morning, noon, and night. During the same time the fol- 
lowing decoction may be taken : Take the root of dandelion, and bark of bar- 
berry root; pound or bruise, make a decoction, and drink freely. Take two 
or three of the hepatic pills three times a day. The diet should be vegetable, 
light, and nutritious. A raw egg maybe taken every morning. Soot tea is 
likewise very good. 
Dr. A. Sherman states that tincture of blood-root is a remedy for the 
preceding complaint; from ten to fifty drops three or four times a day, in 
water or herb tea. 
CONSTITUTIONAL DISEASES. 
CLASS XI. 
CHARACTER. 
By this class we understand those diseases which are not confined to any 
particular organ, but more or less affect the whole system. 466 
THE REFORMED PRACTICE OF MEDICINE. 
CHAPTER I. 
SCURVY. (Scorbutus.) 
DESCRIPTION. 
This disease prevails chiefly in cold, northern countries, especially in low, 
damp situations, near large marshes or great quantities of stagnating water 
Sedentary people, of a dull, melancholy disposition, are most subject to it- 
It often proves fatal to sailors on long voyages, particularly in ships that 
are not properly ventilated, have many people on board, or where cleanli- 
ness is neglected. 
It is not necessary to mention the different species into which this disease 
has been divided, as they differ from one another chiefly in degree. What 
is called the land scurvy, however, is seldom attended with those highly 
putrid symptoms which appear in patients "who have been long at sea, and 
which are rather owing to confined air, want of exercise, and the unwhole- 
some salt animal food eaten by sailors on long voyages, than to any specific 
difference in the disease. 
CAUSES. 
The scurvy is occasioned by cold, moist air ; by the constant use of salted 
or smoke-dried provisions, or any kind of food that is hard of digestion and 
affords little nourishment: it may also proceed from the suppression of cus- 
tomary evacuations, as the menses, bleeding piles, fyc. It is sometimes owing 
to an hereditary taint; grief, fear, and other depressing passions, have a great 
tendency both to excite and aggravate this disease: neglect of cleanliness, 
bad clothing, want of proper exercise, confined air, unwholesome food, or any 
disease that greatly weakens the body or vitiates the humours, may cause it 
SYMPTOMS. 
Unusual weariness, heaviness, and difficulty of breathing, especially after 
motion ; ulcers of the gums, which bleed; a disagreeable breath, frequent 
bleeding at the nose, crackling of the joints, and difficulty of walking ; some- 
times a swelling, and sometimes a falling away of the legs, on which there 
are livid, yellow, or violet-coloured spots; the face is generally of a pale or 
leaden colour : as the disease advances other symptoms come on, as decay 
of the teeth, hgemorrhages, or discharges of blood from different parts of the 
body; obstinate ulcers ; pains in various parts, especially about the breast, 
dry, scaly eruptions all over the body, &c. At last a wasting or hectic fever 
comes on, and the miserable patient is often carried off by dysentery, 
diarrhoea, dropsy, the palsy, fainting fits, or a mortification of some of the 
bowels. 
TREATMENT. 
We know no way of curing this disease but by pursuing a plan directly 
opposite to that which brings it on. It proceeds from a vitiated state of the 
humours, occasioned by errors in diet, air, or exercise; and this cannot be SCURVY. 
467 
removed, except by a proper attention to these important articles. If the 
patient has been obliged to breathe a cold, damp, or confined air, he should be 
removed as soon as possible to a dry, open, and moderately warm one. If 
there is reason to believe that the disease proceeds from a sedentary life, or 
depressing passions, as grief, fear, &c., the patient must daily take as much 
exercise in the open air as he can bear; and his mind should be diverted. 
When the scurvy has been brought on by a long use of salted provisions, the 
proper medicine is a diet consisting chiefly of fresh vegetables of all kinds : 
the use of these, with milk, herbs, fresh bread, and fresh beer or cider, will 
seldom fail to remove the scurvy of this kind, if taken before it is too far 
advanced ; but, to have this effect, they must be persisted in for a considera- 
ble time. When fresh vegetables cannot be obtained, pickled or preserved 
ones may be used ; and where these are wanting, recourse must be had to 
vegetable acids. All the patient's food and drink should, in this case, be 
sharpened with cream of tartar, vinegar, or the muriatic acid. These things, 
however, will more certainly prevent than cure the scurvy, for which rea- 
son sea-faring people, especially on long voyages, ought to lay in plenty of 
them. Cabbages, onions, and many other vegetables may be kept a long 
time by preserving, fyc.; and when these fail, the acids recom- 
mended above, which will keep for any length of time, may be used. We 
have reason to believe, if ships were well ventilated, and stored with fruit, 
vegetables, cider, &c., and proper regard paid to cleanliness and warmth, 
that sailors would be the most healthy people in the world, and would seldom 
suffer either from the scurvy or putrid fevers, which are so fatal to that use- 
ful class of men : but is too much the disposition of such people to despise 
all precaution ; they will not think of any calamity till it overtakes them, 
when it is too late to ward off the blow. 
In the course of the disease particular symptoms may arise, requiring a 
separate consideration. Pains of the bowels are to be relieved by emollients 
and opiates; oppression at the chest and impeded respiration, by mustard 
plasters ; contractions of the hams and calves of the legs, by fomenting the 
parts, and by the application of emollient poultices and frictions ; ulcers of the 
gums and looseness of the teeth, by washing the mouth frequently with 
anti-septic and astringent gargles : ulcers are to be cleansed and healed by 
washing them with soap and water, or the tincture of myrrh, and then 
dressed with some ointment, salve, or poultice. In bad cases of ulceration 
the yeast poultice will be serviceable. 
"I have often seen," says a writer, " very extraordinary effects, in the 
land scurvy, from a milk diet. This preparation of nature is a mixture of 
animal and vegetable properties, which, of all others, is the most fit for 
restoring a decayed constitution, and removing that particular acrimony of 
the humours which seems to constitute the very essence of the scurvy and 
many other diseases." The most proper drink in the scurvy is whey or but- 
termilk ; w'hen these cannot be had, sound cider or spruce beer may be used. 
A decoction of the tops of the spruce fir is likewise proper; it may be drank 
in the quantity of a pint twice a day: tar water may be used for the same 
purpose, or decoctions of any of the mild mucilaginous vegetables, as sarsa- 
parilla, marsh mallow roots, &c. Infusions of the bitter plants, as tanzy, 
centaury, S>'c., are likewise beneficial. All kinds of salad are good in the 
scurvy, and ought to be eaten very plentifully ; as spinage, lettuce, parsley, 
celery, radish, dandelion, &c. It is amazing to see how soon fresh vegetables, 
in the spring, cure the brute animals of any scabs or ulcers that are upon 
their skins. It is reasonable to suppose that their effects would be as great 468 
THE REFORMED PRACTICE OF MEDICINE. 
upon the human species, were they used in proper quantity for a sufficient 
length of time. " I have sometimes seen," says a writer, " good effects, in 
scorbutic complaints of very long standing, from the use of a decoction of the 
roots of dock. It is usually made by boiling a pound of the fresh root in six 
pints of water, till about one-third of it be consumed. The dose is from half 
a pint to a pint of the decoction every day; but in all the cases where 1 
have seen it prove beneficial, it was made much stronger, and drank in larger 
quantities." 
CHAPTER II. 
HEAT OF URINE. {Ardor Urina.) 
DESCRIPTION. 
From various causes persons are afflicted with heat and scalding of the 
urine. It often proceeds from venereal, but may arise from various other 
causes ; from inflammation of the kidneys, uterus, gravel, &c. 
TREATMENT. 
Cooling and mucilaginous drinks must be taken for this complaint. Half 
a tea-spoonful of the diuretic drops may be administered in half a pint of spear- 
mint tea ; the mucilage of slippery elm bark is excellent. A cooling and 
spare diet should be used, and all heating kinds of food or liquids avoided. 
Buttermilk is an excellent article of diet. This course will soon remove the 
complaint. 
CHAPTER III. 
GENERAL DEBILITY. 
DESCRIPTION. 
Persons are many times afflicted with universal languor, debility, or great 
weakness, without being able to trace it to any particular cause. They com- 
plain of a sense of sinking, particularly after a little exercise or fatigue. The 
appetite is generally good, and there is seldom any pain; nor is any particular 
organ seemingly deranged. 
The stomach and bowels must be cleansed, the skin kept moist, and any 
particular symptoms attended to. I have found the use of the restorative 
wine bitters invariably to benefit or cure this anomalous complaint. From 
half a wine glass to a wine glassful may be taken three or four times a day. 
The bowels must be kept regular by the anti-dyspeptic pills. 
TREATMENT. EMACIATION-MERCURIAL DISEASE AND SALIVATION. 
469 
CHAPTER IV. 
MARASMUS, EMACIATION, WASTING OF THE BODY, &c. 
Marasmus is a disease which affects the young of both sexes. A slug- 
gishness, lassitude on slight exertion, depravity and loss of appetite, wasting 
of the flesh, fulness of the features and paleness of the countenance, 
swelling of the abdomen, an irregular and generally a costive state of the 
bowels, a change in the colour and odour of the feces, fetid breath, swelling 
of the upper lip, and itching of the nose, mark the beginning of the disease. 
When these symptoms have continued for some time, they are followed by 
alternate paleness and flushings of the countenance, heat and dryness of the 
skin, feeble and quick pulse, thirst, fretfulness, increasing debility and dis- 
turbed sleep, during which the patients grind or gnash their teeth, and are 
subject to involuntary starting, and twitching of different muscles. Every 
case of marasmus does not necessarily include all the symptoms enumerated. 
Different combinations of them give a variety of the disease, which is, how- 
ever, in general, readily known and distinguished. Marasmus appears most 
commonly among weak and infirm children, whether they are so from deli- 
cacy of constitution or from incidental causes. It is particularly prevalent 
in large and populous cities, where children are deprived of ready access to 
exercise in pure air, and sicken and pine; or when they are confined in 
crowded and airless school-rooms. Children who are employed m manu- 
factories, where their occupation and confinement are such as to weaken and 
enervate them, are also liable to be attacked with this disease. Irregularity 
in diet and improper food likewise give rise to marasmus. It prevails most 
commonly in autumn, the season which affords opportunity for eating unripe 
fruit and vegetable articles. 
TREATMENT. 
Examine all the organs, and, if any are found diseased, direct the treatment 
to them ; otherwise treat it on general principles. Give mandrake or anti- 
bilious physic twice a week. During the time restorative wine bitters may 
be given, except the fever be too great; and let the child use nothing but a 
milk and vegetable diet. Use the tepid salt water bath every day or two. 
If not inconvenient, bathe the whole surface with salt and water. If the 
symptoms arise from worms, give medicines to expel them. 
CHAPTER V. 
MERCURIAL DISEASE AND SALIVATION. 
DESCRIPTION. 
The symptoms of this disease are too well known to need description; 
they are detailed in the first part of this work, under the head of the injurious 
effects of mercury. I may remark, however, that there is soreness of the 470 
THE REFORMED PRACTICE OF MEDICINE. 
gums and mouth, looseness of the teeth ; swelling, and sometimes protrusion 
and inflammation, of the tongue ; constant and profuse discharge of saliva or 
spittle, wasting, &c. If those who give this poison to cure disease are not 
woful quacks, then 1 do not understand the meaning of the term " quackery." 
TREATMENT. 
I was about to recommend the same treatment in this as in ordinary poisons, 
but that would not do, as it is much worse than most kinds ; other poisons 
can be immediately dislodged from the stomach by an emetic ; but this subtle 
poison insinuates itself into every part of the system, and diseases the fluids 
so extensively that its effects cannot always be easily removed. 
When the practitioner is called to the patient, if he is still using mer- 
cury in any form, he must order it to be immediately discontinued. A 
cooling gargle is to be prescribed for the mouth, and, as soon as the patient 
can swallow, let him take cream of tartar and flowers of sulphur once or twice 
a day ; this will check the salivation and counteract the effects of the poison. 
The greatest suffering is experienced in consequence of taking cold after the 
use of it: when this happens, let perspiration be promoted. When the 
mercurial rheumatism is produced, and the joints are stiff, let the alterative 
syrup be freely taken; an infusion of burdock seed is also very good. A 
little sulphur may be mixed with Venice turpentine, spread upon linen, and 
laid upon the parts affected ; after which let a strengthening plaster be 
applied : but it is exceedingly difficult to remove the consequences attending 
such lamentable mal-practice- 
CHAPTER VI. 
YAWS. (Frambasia.) 
DESCRIPTION. 
1 aws is a disease peculiar to the negroes in the West India Islands, said 
to be imported from Africa. It is propagated by contagion. It occasionally 
attacks white people, but they are not so liable to it as the blacks. Like the 
small-pox, it only affects the person once during life. 
SYMPTOMS. 
Pain in the limbs, back, and joints, with debility, chills, fever, headache, 
and loss of appetite. After a few days there is an eruption of pustules ; 
when these fall off, more appear, attended with fever. They are at first 
very small, but increase to the size of a six cent piece, and frequently arise 
excrescences, and discharge a glutinous fluid, which forms a disagreeable 
scab. The complaint continues several weeks. 
u Having clearly ascertained the disorder to be the yaws," says an expe- 
rienced physician, " the negro ought to be sent immediately to some very 
private part, where he can have no possible communication with such as 
TREATMENT. LUMBAGO. 
471 
never had it. This precaution is by no means sufficiently attended to, as 
those who labour under the disease are too frequently suffered to associate 
and mix in friendly intercourse with other negroes, by which means it is 
propagated from one to another, instead of being eradicated. During the 
eruptive stage of the disease we are to assist the efforts of nature in deter- 
mining the noxious matter to the surface of the body, by giving some mild 
diaphoretic, which may be washed down with about half a pint of the decoc- 
tion of herb tea. With these remedies the patient should make use of a warm 
bath about twice a week, confining himself at the same time to a vegetable 
diet. He ought to be comfortably and warmly lodged, and his system be 
invigorated by taking daily exercise proportioned to his strength. In the 
second stage of the disease, where the eruptions begin to dry off, it will be 
advisable to employ purgatives, so as to produce an alterative effect. The 
alterative syrup may be used at the same time. Both are to be continued 
until the scabs become perfectly dry and fall off; at which period they are 
to be omitted, and then a gentle purgative should be given. It has already 
been observed, that there usually remains one large eruption after all the 
rest have died away ; and this, by degenerating into a foul ulcer, discharges 
an ichorous matter. The best application for its cure is the brown ointment, 
and a suitable wash. From the thickness of the cuticle in the feet, when 
the yaws appear there, the discharge is apt to be confined. When they 
break they are difficult to heal, often ulcerating the whole sole, and thereby 
rendering the person incapable of walking. A poultice of the elm bark, and 
black salve, are the best applications in such cases. Hard swellings of a very 
painful nature, which do not suppurate, sometimes appear likewise in the 
soles of the feet as a consequence of the yaws, and occasion lameness: to 
remove them the patient should bathe his feet in warm water until the swell- 
ings become somewhat soft; they then should be touched by the caustic 
potash, which produces an eschar and sore, that are readily healed by dress- 
ing with a yeast poultice. 
LOCAL DISEASES. 
CLASS XII. 
CHARACTER. 
By this class we understand such diseases as are located more especially 
in some particular part of the body, but not affecting apparently any parti- 
cular organ. 
CHAPTER I. 
LUMBAGO. 
The disease is a species of rheumatism that is more particularly concen- 
trated in the small part of the back or the lower part of the spine. It causes 
great weakness or pain, with difficulty of stooping, and often of wralking. 
The treatment of Lumbago is the same as that recommended for common 472 
THE REFORMED PRACTICE OF MEDICINE. 
rheumatism. The part may be bathed with the tincture of capsicum or 
Cayenne pepper, and, if this does not relieve, the rheumatic liquid; after which 
let a strengthening plaster be applied. 
CHAPTER IL 
WORMS. (Vermes.) 
DESCRIPTION. 
These are chiefly of three kinds, viz., the tomia, or tape worm ; the teres, 
or round and long worm ; and the ascarides, or round and short worm. 
There are many other kinds of worms found in the human body ; but as they 
proceed, in a great measure,! from similar causes, have nearly the same 
Symptoms, and require almost the same method of treatment as these already 
mentioned, we shall not spend time in enumerating them. 
The tape worm is white, very long, and full of joints. It is generally bred 
either in the stomach or small intestines. The round and long worm is like- 
wise bred in the small guts, and sometimes in the stomach. The round and 
short worms commonly lodge in the rectum, and occasion a disagreeable itch- 
ing about the seat. The long round worms occasion squeamishness, vomiting, 
a disagreeable breath, gripes, looseness, swelling of the belly, swooning, 
loathing of food, and at other times a voracious appetite, a dry cough, con- 
vulsions, epileptic fits, and sometimes a privation of speech. These worms 
have been known to perforate the intestines, and get into the cavity of the 
belly. The effects of the tape worm are nearly the same with those of the 
long and round, but rather more violent. 
Andry says, " The following symptoms particularly attend the solium, which 
is a species of tape worm, viz.: swoonings, privation of speech, and a vora- 
cious appetite. The round worms, called ascarides, besides an itching of the 
anus, cause swoonings and tenesmus, or an inclination to go to stool." 
CAUSES. 
Worms may proceed from various causes ; but they are seldom found, ex- 
cept in weak and relaxed stomachs, where the digestion is bad. Sedentary 
persons are more liable to them than the active and laborious. Those who 
eat great quantities of unripe fruit, or live much on raw herbs and roots, 
are generally subject to worms. There seems to be an hereditary disposi- 
tion in some persons to this disease. 
SYMPTOMS. 
The common symptoms of worms are, paleness of the countenance, and 
at other times a universal flushing of the face ; itching of the nose, (this, 
however, is doubtful, as children pick their noses in all diseases;) starting, 
and grinding of the teeth in sleep ; swelling of the upper lip ; the appetite 
sometimes bad, at other times quite voracious ; looseness; a sour breath; 
hard swelled bowels ; great thirst; the urine frothy, and sometimes of a 
whitish colour; griping, or colic pains ; an involuntary discharge of saliva, 
especially when asleep; frequent pains of the side, with a dry cough, and WORMS. 
473 
unequal pulse, palpitations of the heart, swoonings, drowsiness, cold sweats, 
palsy, epileptic fits, with many other unaccountable nervous symptoms. 
Small bodies in the excrements, resembling melon or cucumber seeds, are 
symptoms of the tape worm. 
Says Buchan, " I lately saw some very surprising effects of worms in a girl 
about five years of age, who used to lie for whole hours as if dead. She at 
last expired, and, upon opening her body, a number of the teres, or long round 
worms, were found in her intestines, which were considerably inflamed; 
and what anatomists call an intus-susceptio, or the involving of one part of 
the gut within another, had taken place in no less than four different parts 
of the intestinal canal." 
TREATMENT. 
Calomel is now principally used for the removal of worms; but this medi- 
cine, as has been frequently shown, is very dangerous to administer. Calo- 
mel or mercury is the basis or principal ingredient of most of the highly 
reputed nostrums for worms, such as worm lozenges, vermifuges, &c. 
The principal indication in the removal of worms is, to excite a healthy ac- 
tion of the digestive organs. It is owing to a derangement of these that they 
exist; hence there is mucus and disease always present. The following 
preparation will be found very effectual in expelling different kinds of worms 
from the system: Take Carolina pink-root, (spigelia marilandica;) Alex- 
andria senna, (cassia senna ;) manna, (fraxinus omits,) of each half an ounce; 
bruise all, and add to the powder one pint of boiling water. Let it stand a 
short time, in order to extract the strength of the articles; sweeten with 
molasses, and add a small quantity of milk. For a child five years old give 
a gill three or four times a day, on an empty stomach ; if this does not purge, 
increase the dose until the effect is produced. 
The cowhage is a good vermifuge, given in molasses or arrow-root jelly. 
My worthy friend, Dr. W. A. Prince, a Moravian missionary in the Island 
of Jamaica, informs me that he has found the cowhage remarkably efficacious 
in the removal of worms. He gives a little of the cowhage mixed with arrow- 
root jelly; say, to a child from one to two years old, one-fourth of a tea- 
spoonful twice a day : every third day he gives a tea of equal parts of com- 
mon salt and senna, sufficient to purge. Dr. Prince thinks that many diseases 
proceed from worms. He meets with great success in the treatment of dis- 
eases on the reformed system, which shows demonstratively that our practice 
is as successful in the West Indies as in other parts. He gave one of our 
anti-bilious purgatives to a coloured women; after its operation she ex- 
claimed, " O, massa, me never took such medicine before ; it brings away so 
much cold and slime." One of his neighbouring physicians says he does 
not fear him ; as he gives no mercury, he cannot injure his practice. 
Says an ancient author, Dr. Brooks, " To adults I give two ounces of the 
powder of pure tin, sifted through the finest hair sieve, mixed with eight 
ounces of treacle, after the patient has been purged with an infusion of senna 
and manna the Thursday preceding. On Saturday morning I give half an 
ounce of the tin in two ounces of treacle, and as much on Sunday morning. 
On Monday I give a dose of the same infusion. Though probably there is 
nothing in the day, I thought proper to follow the directions of the recipe; 
and as I found the medicine succeed beyond expectation, I never altered it. 
I gave this mixture to a woman for the tape worm, who had been long 
troubled with this disease ; she had taken many medicines for it, and among 474 
THE REFORMED PRACTICE OF MEDICINE. 
the rest small quantities of this powder. Small fragments had been often 
brought away, and she was far gone in a hectic consumption. This powder 
brought away the rest of the tanta, as I believe, for she was troubled no 
more with it. This powder immediately cures the pain in the stomach oc- 
casioned by worms, but it does not bring them away till some days after." 
Worms sometimes ascend into the throats of children and choke them. 
This symptom may readily be removed by giving a little salt and water, and 
repeating it occasionally will often expel them, and always is a preventive. 
This will be found a very valuable remedy for different kinds of worms ; and, 
even should none exist, it will cleanse the stomach and bowels, and prove 
very beneficial. When small worms infect the rectum, a weak infusion of 
tobacco, used as an injection, will dislodge them; and the above medicine 
should likewise be given. Salt and water may be injected also. 
Says Dr. J. King, " For worms in children, and for pale, sickly children, 
the following is a good vermifuge, and also tonic : One pint of black alder 
berries, one pound of cedar or juniper apples : digest for fourteen days in one 
quart of alcohol, strain, and add one pint of molasses: dose, for a child one 
or two years of age, one tea-spoonful three times a day. It is rather a 
pleasant vermifuge, and tonic. Children love it." 
A young woman at Peekskill, NewYork, was attended for dyspepsia. 
After her decease, worms were discharged from her mouth. 
Tape Worm.-The symptoms of a tape worm, as related to me by Miss 
Dumouline, who had been suffering by it for twenty-five years, are as follows, 
communicated to the author for this treatise : 
It commenced at the age of ten, and afflicted her to the age of thirty-five. 
The worm often made her distressingly sick at the stomach, and she would 
sometimes vomit blood, and was suddenly taken ill, and occasionally when 
walking. It caused symptoms of many other diseases, great wasting of the 
flesh, &c. Her appetite was very capricious, at times very good, and again 
poor for months, during which time her symptoms were aggravated : sickness, 
vomiting, great pain in the chest, stomach, side, and bowels, dizziness, heavi- 
ness of the eyes, motion in the stomach and bowels, beating or throbbing in 
the bowels, and so miserable that she feared it would destroy her; a sense 
of fulness or swelling of the stomach and bowels ; and, when she wore any- 
thing tight, or laced, it caused great distress. The worm appeared to rise up 
into her throat and sicken her ; and her general health was very bad. 
At intervals pieces of the worm would pass from the bowels, often as many 
as forty during the day, all alive, and would swim in water. This gene- 
rally occurred some time after taking medicine. 
TREATMENT. 
This patient states that she had employed twenty physicians, at different 
periods, and taken a hundred kinds of medicine, but without expelling the 
worm; under these circumstances I commenced my treatment. She had 
taken spirits of turpentine, which she could not retain upon her stomach. 
After, having administered various preparations, I prescribed the following, 
so highly extolled for common worms by my friend Prince, a Moravian 
missionary in the Island of Jamaica, with whom I have been in the habit of 
corresponding for years, and who is a devoted friend to the reformed system ; 
it occurred to me that it might be useful for the tape worm as well as for 
others: Cowhage, stripped from the pod, a small tea-spoonful given three times WORMS 
475 
a day, fasting, in a little arrow-root jelly ; then occasionally a purgative of 
mandrake. In connexion with this I directed her to eat freely of garlic and 
common fine salt. I gave these under the belief that each possessed vermi- 
fuge properties, without ever having administered them for the tape worm. 
After having taken them for some time, all her unfavourable symptoms 
ceased, and subsequently the remaining portion of the worm passed from 
her, lifeless ; a circumstance wrhich never occurred before. 
She has since, and immediately, regained her health, and there is no 
evidence that there is any remaining. This patient states that the worm 
which passed from her during the time she has been afflicted with it would 
fill a peck measure, and reach one mile in length. Her feeling and gratitude 
may be better expressed than described. A portion of this worm I now 
have in my possession. Annexed is a plate of it. 
When once the tape worm begins to pass the bowels, care must be taken 
not to break it off, otherwise it will grow again, as it has this peculiar pro- 
perty. It should be wound around a stick or something else, and very 
moderate extension made upon it whenever there is a motion of the bowels. 
The ethereal oil of male fern is highly extolled for the removal of tape 
worm : dose, one drachm twice a day ; the second day a powerful physic. 
The lowest diet to be taken.- Weisman. 
A merchant in Providence had voided portions of a tape worm for twenty 
years. He had tried various medicines to no purpose, till he took a strong 
decoction of sweet fern, (complonea asplenifolia,) taking large quantities daily 
for several days ; then taking a brisk purgative, {mandrake is good.) Would 
not the same plant be good for all kinds of worms ? 
The tape worm is sometimes found in animals. Mr. Holdridge informs 
me that he once killed a sheep, and, upon opening the intestines, found a tape 476 
THE REFORMED PRACTICE OF MEDICINE. 
worm throughout the whole extent. The sheep was well fed, but could not 
be fatted. 
Doctor Lobstein's Remedy for Tape Worm. 
1. 
Rp: Calomel gr. xii. 
conch® s. igne ppt. 9j. 
m. f. pulv. 
d. s. No. 1. 
2. 
Rp: 01. anrydal. dulc. ?j. 
S. No. 2. 
3. 
Rp : Gum. gutt. gr. X X X vj. 
Pulv. card. Bened. 3j- 
- rad-angelic® 
- marchionis epilept au gr. viij. 
m. divid. in iij. part. acq. 
4. 
Rp: herb. card. Benedict. Pugill iij. S. No. 4. 
After a little supper the patient will take the powder No. 1, in the eve- 
ning, with cold water ; half an hour after take No. 2 ; the following morning 
take of the powder No. 3, which commonly excites a little vomiting and 
purging; between this time drink a cup of the tea No. 4 ; two hours after, 
when the worm is not expelled, take the 2d pow'der, and two hours after the 
3d powder. 
Should any one be disposed to use the above preparation of the late Dr. 
Lobstein for tape worm, it will be necessary to procure it of a German 
apothecary, one or two ingredients not being in common use. 
This treatment expelled a tape worm from a person in this city, eighteen 
feet long, which I have seen, and is now in the possession of Dr. James Vere. 
The spirits of turpentine has also removed it. It may be taken daily in 
table-spoonful doses, mixed with milk, and sweetened. 
Two pills of common brown soap, size of a pea, taken twice a day, cured 
a person in England of the tape worm when all other means failed. 
CHAPTER III. 
0Z2ENA. 
The ozcena is an ulcer affecting the nostrils, and from which there is an 
acrid or corrosive discharge, very fetid, and often mixed with a bloody mucus. 
TREATMENT. 
Use the cephalic snuff, and apply up the nose the brown ointment; at 
the same time smoke the following : Black pepper, one tea-spoonful; sage, 
fine, a table-spoonful: mix. Smoke two pipesful a day, and force the 
smoke through the nostrils, the same as for catarrh in the head. 
Herpes's ozcena : taint from vaccination, fyc. I have just seen a patient 
for whom I prescribed, about a week since, for an affection of the nose, HEADACHE. 
477 
which has apparently arisen from impure vaccination. The discharge has 
been so corrosive, that it has excoriated the parts with which it has come 
in contact, and there was a herpetic eruption of the same nature on the face. 
1 prescribed the celandine wash, brown ointment, capsicum and sage to 
smoke, and force the smoke through the nostrils. It has nearly removed 
all the complaint in so short a time. 
CHAPTER IV. 
HEADACHE. (Cephalalgia.) 
DESCRIPTION. 
Headache is of two kinds, primary or symptomatic. It often arises from 
a morbid state of the stomach, in consequence of an effusion of bilious matter ; 
when this happens, it is termed sick headache. It frequently proceeds from 
a determination of blood to the head, as well as from many other causes. 
TREATMENT. 
In treating the headache we must first ascertain the cause of it: if i* 
proceeds from the stomach, our attention must be directed to that organ, and 
it must be cleansed by a gentle emetic, or, as a substitute, a purgative, and 
which must be occasionally repeated. 
The feet must be often bathed in warm water, to equalize the circulation, 
particularly when it arises from a determination of blood to the head, as in 
incipient apoplexy. 
When it proceeds from irritability of the nervous system, take nervines, 
such as the valerian, diaphoretic powders, &c. Equal parts of blood-root 
and bayberry, pulverized, may be used as a snuff. Smoke capsicum and 
sage, and force the smoke through the nostrils, as in catarrh. 
A case of many years' standing of sick headache, which had resisted all 
remedies, and about every three months occasioned retching or vomiting 
of three days'continuance, has been nearly cured by taking a table-spoonful 
daily of our compound tincture of senna, (elixir salutis.) 
The late Dr. Valangin used frequently to cure headaches by desiring the 
patient to snuff up a mixture of the yellow oxide of mercury, (formerly 
called Turbeth mineral,) with a little sugar. It often produces a prodigious 
discharge of serous fluid from the nose, without sneezing. Dr. Buchan 
has also often cured obstinate complaints in the head by the same means. 
Turbeth mineral is of a very bright yellow colour, and it is possible that a 
solution of it may be the celebrated East Indian remedy for headache. 
If the pain at any time be very severe, let mustard plasters be applied 
between the shoulders and the bottom of the feet. Diet is very necessary 
in this disorder. It should be vegetable, cooling, and light, and such as easily 
digests. Stewed fruit is very useful, as it tends to regulate the bowels, which 
is very necessary. 
Bathing the crown of the head every morning in cold water has proved a 
sovereign remedy for headache. Captain Snow informs me that he laboured 
under this complaint for a length of time, and several physicians prescribed 
bleeding for it. During his residence in the West Indies he applied to an 478 
THE REFORMED PRACTICE OF MEDICINE. 
elderly Scotch physician, who objected to bleeding, and pronounced it igno- 
rance, and recommended him to bathe his head every morning in cold water, 
which he did, and has continued for many years, and it has effected a perfect 
cure ; and that, no doubt, by equalizing the circulation, and the sympathetic 
and healthy effect produced upon the stomach, upon which he states it 
always has a sensible effect. 
JEther applied to the head as a wash cured a person suffering under a 
very acute attack of nervous headache. 
CHAPTER V. 
OBESITY OR FAT. 
John Mason Good, the justly celebrated author of " The Study of Medi- 
cine," " Book of Nature," &c., says, with regard to the cure of obesity or 
fat, " that, as a life of indolence and indulgence in eating and drinking is 
highly contributary to obesity, the remedial treatment should consist in the 
use of severe, regular, and habitual exercise, a hard bed, little sleep, and dry 
and scanty food, derived from vegetables alone. " 
" Generally speaking," says the same noted author, " the diet and regimen 
just recommended, with a spare allowance of water, will be sufficient to bring 
down the highest degree of adipous corpulency. Of this we have a striking 
example in the case of Wood, of Billerica, in Essex. Born of intemperate 
parents, he was accustomed to indulge in excessive eating, drinking, and 
indolence, till, in the forty-fourth year of his age, he became unwieldy 
from his bulk, -was almost suffocated, laboured under very ill health from 
indigestion, and -was subject to fits of gout and epilepsy. One would think 
all these enough for one person to bear. Fortunately a friend pointed out 
to him the life of Cornaro ; he instantly resolved to take Cornaro for his 
model, and, if necessary, to surpass his abridgments. With great prudence, 
he made his change from a highly superfluous to a very spare diet, gradu- 
ally-first diminishing his ale to a pint a day, and using much less animal 
food, till at length, finding the plan wrork wonders in his renewed vigour of 
mind as of body, he limited himself to a simple pudding made of sea biscuit, 
flour, and skimmed milk, of which he allowed himself one and a half 
pounds, about four or five o'clock, for his breakfast, and the same quantity 
for his dinner. Besides this, he took nothing either solid or fluid, for he had 
at length brought himself to abstain even from water, and he felt much 
easier without it. He went to bed about eight or nine o'clock, rarely slept 
for more than five or six hours, and hence usually rose at two o'clock in the 
morning, and employed himself in laborious exercise of some kind or other 
till his breakfast-time. By this regimen he reduced himself to a middle- 
sized man, of firm flesh, well-coloured complexion, and sound health." 
NETTLE RASH, BLIGHTS, HIVES.-This is an eruptive or cutaneous disease, 
which makes its appearance on the skin suddenly, in large, red, diffusive patches, 
white in the centre, with intense itching and burning, resembling the sting of the nettle. 
It appears in different parts of the body, for an hour or two at a time; then suddenly 
disappearing, and altogether-usually in one or two days. 
Treatment.-Bathe the parts with spirits; and a little gum camphor may be added, 
or celandine. Drink saffron tea, and take a portion of physic. PART FOURTH. 
SURGICAL DISEASES. 
CHAPTER I. 
Connexion between Physic and Surgery.-It has been, and still is, custo- 
mary to make a distinction between physic and surgery, committing the two 
branches to different sets of men. But this distinction is not well founded, 
since it is impossible to decide where either branch begins or ends. Internal 
diseases have been assigned to the physician-external to the surgeon. 
Unfortunately for this notion, nature has connected the outside and inside 
so closely, that we can hardly say where one ends and the other begins 
Internal causes produce external diseases, as we see in erysipelas, carbuncle, 
&c.; while external agencies affect internal parts, as in rheumatic affections 
and wounds; and injuries produce fever: by keeping these branches sepa- 
rate, two persons would be required to treat one patient of the same disease 
or accident. 
Sympathy.-The doctrine of sympathy should be well understood, other- 
wise a wrong opinion may be formed of diseases. Such is the intimate 
connexion between distant parts, that if one organ is affected, another, con- 
tiguous or remote from it, may also be disordered ; for instance, if the stomach 
is deranged, it may cause a sick headache ; if the liver is disordered, the 
stomach, bowels, head, and shoulders, by sympathy, feel the effects. The 
irritation of the womb, in pregnancy, causes vomiting, as also will an injury 
of the head. In the white swelling of the knee the pain may be felt in the 
hip. In treatment the attention must be directed to the primary, and not to 
the symptomatic, disease. 
CHAPTER II. 
INFLAMMATION. 
Character.-Increased heat, redness, swelling, pain, and tension. 
Causes.-Cold, wounds, or anything which irritates the part. 
Symptoms.-There is redness, swelling, pain, heat, shooting, and throb- 
bing. The skin is dry and hot; fever; tongue coated; and the secretions 
diminished. 
Termination.-It terminates with or without suppuration, adhesion, and 
rarely by mortification. 
Treatment.-First remove all exciting causes, as splinters, and all 
extraneous substances. To reduce inflammation, let all the secretions and 480 
THE REFORMED PRACTICE OF SURGERY. 
excretions be restored ; for this purpose give occasionally a purgative. Sen- 
na and manna, and cream of tartar, are very good. Perspiration must be 
promoted. Where there is local inflammation, apply a decoction of bitter 
herbs. Apply poultices also to the inflamed part; and none equals the slip- 
pery elm bark for all kinds of inflammation: there has been nothing disco- 
vered that will bear any comparison, in point of utility, with it. The 
powdered bark may be mixed with rain water, milk, and sometimes with 
weak ley, to the consistence of a poultice, and applied either cold, tepid, or 
warm, as upon trial may afford the most relief; tepid in general is preferable. 
For white swellings, felons, and inflammation of the breast, the bark mixed 
with ley is the best. I sometimes mix it with beer or ale, and occasionally with 
a decoction of catnip, wild indigo root, sassafras, and such other agents as the 
peculiar character or stage of the inflammation may require. The powder 
of linseed or flaxseed, pulverized, forms a very good poultice in many cases. 
Indeed, in inflammation attending carbuncle, I have found this poultice, 
combined with an equal part of slippery elm, preferable to any other ; it has 
the property of very much facilitating suppuration. As much hot water is 
to be put into a basin as the size of the poultice requires, and then the linseed 
powder and elm bark are to be gradually mixed with it till the mass is of the 
proper consistence. A small quantity of sweet oil may be added, to keep 
it longer soft and moist. Fomentations are only to be considered as tem- 
porary applications, while poultices are permanent ones. As regards the 
temperature of poultices in their application to inflamed parts, no definite 
direction can be laid down. As a general rule, however, I have always 
found that they answer best when applied warm or tepid : when applied 
cold a more immediate or temporary benefit may sometimes follow, but the 
sedative effect of the cold after a time seems to prove injurious; the only 
sure criterion is, the feeling and comfort of the patient. Poultices should 
never be suffered to get dry and hard, but often be renewed or changed; 
they will keep moist much longer, if the muslin or linen on which they are 
laid be first moistened. I have tried various other kinds, such as bread and 
milk, linseed, &c., and find, compared to the elm, that they dwindle into 
insignificance; it is the most soothing, softening, relaxing, and refrigerant, 
and acts the most speedily, of any other production ; and it is the most uni- 
versal in its application, being suitable for every species of inflammation. It 
usually changes the appearance of the inflamed part from a high degree of 
redness to perfect whiteness; at the same time it diminishes the swelling, 
and lessens irritation and inflammation ; and it is the only article that will 
seldom or never disappoint the practitioner in its effects. Even where other 
kinds of poultices are indicated, this, in combination, forms a most valuable 
auxiliary. 
Dr. Shanklin informs me that it is a popular remedy in North Carolina ; 
a decoction is used mixed with bread or Indian meal, and applied ; not know- 
ing, or being able to procure, the pulverized bark. He says he is seldom 
called upon to treat any kind of inflammation, the inhabitants curing it sim- 
ply by the use of the elm bark. Where there is great pain it may be neces- 
sary to give anodynes. Rest must be enforced, and a very light vegetable 
diet; Indian meal gruel is good. 
Suppuration.-When suppuration or matter has evidently formed, which 
may be known by the softness of the parts and fluctuation, it may sometimes 
be necessary to puncture the abscess; after which still apply the poultice 
as long as there is any inflammation ; then apply the black salve. For Ery- 
sipelas and Inflammation, see St. Anthony's Fire. MORTIFICATION. 
481 
CHAPTER. III. 
MORTIFICATION. 
Symptoms.-If it supervene on inflammation, an excessive, acute, and 
constant pain, great anxiety, often delirium, followed by a sudden cessation 
of all inflammatory symptoms. The part before tense now becomes flaccid, 
>f a livid colour, losing its heat and sensibility. Blisters are formed, under 
which appear brown spots. The parts soon become black, and acquire a 
fetid smell. If the event proves favourable, the mortified portion is com- 
pletely surrounded by a white line, about which pus (matter) is formed. 
The dead part now loosens and sloughs out, leaving a suppurating ulcer. If, 
on the contrary, the termination be fatal, the mortification rapidly extends ; 
great constitutional irritation arises; the pulse becomes small, rapid, and 
irregular, there is a fixed flush on the countenance, with great anxiety and 
prostration of strength ; and death soon ensues. 
Mortification is sometimes produced without previous inflammation, by 
bloodvessels choked by pressure, long-continued cold, long-continued pres- 
sure, violent bruises, debility, &c. 
Treatment.-When inflammation has been properly treated, it will sel- 
dom or never terminate in mortification. But, when called to treat it, our 
object should be to arrest and prevent any farther extension of it by means 
both local and constitutional. If it be connected with, or dependant on, 
inflammation, means must be taken to subdue that inflammation. If debility 
of the system has been a predisposing cause, it must be remedied by a more 
wholesome regimen, and the strength of the patient be supported by stimu- 
lants, such as wine and a nutritious diet. Tonics also should be administered ; 
the wine bitters may be taken, and a glass of yeast three or four times during 
the day. 
Local Applications.-When blisters or vesicles appear upon the part show- 
ing a disposition to gangrene, or when sloughing actually takes place, the 
following poultice will separate the living from the dead parts, and put a 
speedy check to it: Take yeast, a sufficient quantity ; stir in slippery elm 
bark, to form a poultice of the proper consistence : apply tepid, and often 
renew. This will correct the fetor of the parts, and assist the powers of 
nature to separate the mortified from the living flesh. I have not kftown 
this application to fail in a single instance, except in one case of dry mortifi- 
cation, from which a person seldom recovers. 
It is now customary to amputate a limb in cases of mortification, but with 
what propriety I am unable to decide, as it is easily arrested by very simple 
means; and where it cannot be, I have no evidence that the knife would 
save the life of the patient. If a proper course of treatment will not cure, 
there will be such a faulty state of the constitution, or in the ulcer or wound 
itself, that, should amputation be performed, the stump will slough, or the 
patient will sink from irritation or the, direct consequence of the operation. 
It does appear to me passing strange that surgeons should direct us to wait 
till mortification has stopped before we amputate. We are directed to remove 
a limb for mortification, and at the same time are directed not to do it 
until this very mortification is arrested, or until a line of demarcation is 
formed, or a separation takes place between the dead and living parts! 482 
THE REFORMED PRACTICE OF SURGERY. 
Now, I ask, how can this doctrine be reconciled with reason, common 
sense, philosophy, or correct principles of surgery ? It does appear most 
absurd to me, however it may appear to others ; and this absurdity and in- 
consistency is more strikingly exemplified in practice, or at the bed-side of 
the patient. 
The mortified limb must be bathed three times a day in warm weak ley, 
one hour each time. The application of a ley poultice has proved a sovereign 
remedy in mortification, as well as in lock-jaw. It is not only well calculated 
to prevent, but to cure it when it has taken place. After having been ap- 
plied a short time, it has often separated and detached large portions of mor- 
tified flesh, and brought about a healthy action. The elm bark should be 
mixed in leeched rearm ley, and applied tepid. 
A case now occurs to me where this poultice arrested the disease, seated 
on or near the breast of a female, and detached such a portion of dead flesh, 
that the opening left was as large as a common sized tea-cup. 
Another case occurs to me where a young man was to have had his leg 
amputated, but before his surgeon or the physician came the above poultice 
was applied, which arrested it, and he recovered. 
Dr. Ferris, who was noted for a successful method of treating mortifica- 
tion, made use of the following poultice : Scraped carrots and spikenard 
root, bruised; boil till soft; stir in a small quantity of Indian or oat meal, 
and apply warm. I have used this poultice but little, and, therefore, cannot 
speak with much certainty of its effects; but in one very difficult and criti- 
cal case of inflammation, bordering on gangrene, it changed the character 
of it, and was attended with a good effect. 
CHAPTER IV. 
WOUNDS. 
A wound is a division of the soft parts of the body by different instru- 
ments or agents. They are divided into incised, or those done with a sharp 
instrument; lacerated and contused, when done by a rough instrument, as a 
saw or stone ; punctured, when done by a pointed instrument; and poi- 
soned or gun-shot wounds. 
Treatment.-Indications of Cure.-1. To put a stop to the bleeding. 
2. To remove any extraneous bodies that may be present. 
3. To effect a union by the first intention ; or, if that be impracticable, 
to promote suppuration. 
1st. The Bleeding.-In the worst species of wounds to which I have been 
called I have found the following treatment sufficient to stop the bleeding : 
I first ascertain the situation of the vessel whence the blood issues : then 
I take a pledget of lint, roll it up into a little ball, and press it directly upon 
the mouth of the artery, (I mean where there is profuse haemorrhage ;) 
afterward apply lint and small compresses, to secure permanent pressure 
upon the artery, after which the dressings are to be applied. In general a 
piece of linen folded thick, of a suitable size, and laid directly over the 
wound, and a bandage applied, is quite sufficient to stop the haemorrhage. 
Occasionally I have applied styptic powders to contract the end of the vessel, 
produce coagulum, and thus arrest it; for this purpose the red or styptic WOUNDS. 
483 
powders are employed, a preparation which is extremely astringent. Salt 
water, by its astringent and refrigerant effect, is useful ; the lint and com- 
presses maybe wet with it. When an artery is cut, the blood is of a bright 
scarlet colour, and gushes from the bleeding vessel in jet, with great force. 
When a vein is cut, the blood runs in an even, unbroken stream, of a dark 
purple red colour. The bleeding having been suppressed, the next object 
is, to remove any extraneous matter, such as dirt, bits of glass, clots of blood, 
&.C., which may remain in the wound. 
As soon as attention has been paid to the foregoing indications, the practi- 
tioner must put the lips of the wound in contact, and take measures for 
keeping them in this state until they have grown firmly together. The sides 
of incised wounds are kept in a state of apposition by means of an adhesive 
plaster, a proper position, the pressure of a bandage, and, in a few particular 
instances, by the employment of sutures or stickes. 
With respect to sutures, as they create pain, irritation, and some degree 
of suppuration, they ought never to be employed when the parts can be 
kept in contact without them. 
It is wonderful with what celerity union by the first intention takes place 
under favourable circumstances. In the course of three days a large wound 
is frequently healed. 
After having removed every extraneous substance, and arrested the bleed- 
ing, (if there is any,) clean the wound with a soft sponge or cloth and warm 
water, dry the skin, and bring the sides neatly and closely together with 
straps of adhesive plaster ; the straps should be an inch wide, and extend 
across the wound far enough to secure it from gaping. The number of straps 
must be in proportion to the extent of the wound, and a little space between 
them, to allow the escape of any fluid which may run from the wound. 
Over the straps should be placed a cushion of soft lint, and over the whole 
a bandage drawn agreeably tight, and making equal pressure. 
Under this dressing a clean cut wound may be expected to heal without 
the formation of matter, i. e., without suppuraton ; and this is what surgeons 
call union by the first intention. A cooling diet and regimen should be 
observed, and every kind of motion and disturbance of the part avoided. 
The rest is the work of nature. This dressing should not be removed within 
two or three days, or longer ; frequently wet the dressing with spirits and 
water, or, which is better, the tincture of balm of Gilead buds. 
It is sometimes the case that, from some cause or other, more or less 
suppuration will follow, which will very much retard the healing process ; 
when this is the case, and when inflammation takes place, the salve or 
external plaster must be removed, and a poultice of the slippery elm bark 
applied ; after the inflammation has subsided, again apply the salve or plaster. 
Should fungus., or what is termed " proud flesh," arise and prevent the wound 
from healing, it may be sprinkled with a little pulverized blood-root. If this 
is insufficient to remove it, a few grains of the vegetable caustic musp)e 
daily applied. Incised wounds heal very readily. 
Contused or Lacerated Wounds.-In many wounds union by the first 
intention should not be attempted, but allowed to suppurate, in order that 
the extraneous matter may be expelled. Wounds which are attended with 
laceration, although free from contusion, cannot always be united by the first 
intention ; because it must frequently be impossible to bring the external 
parts or skin so much in contact as to prevent that inflammation which is 
naturally produced by exposure. But even in cases of simple laceration, 484 
THE REFORMED PRACTICE OF SURGERY. 
where the external influence is but slight, or can be prevented, we find that 
union by the first intention often takes place. 
Many of the remarks on the treatment of simple and incised are applicable 
to lacerated wounds. There is not, however, much difficulty about bleeding 
or haemorrhage, very seldom being much present; but the same attention 
must be paid to the removal of extraneous substances from the wound, after 
which the parts must be brought in contact, or as closely together as possible, 
by narrow strips of adhesive plaster ; afterward a pledget of lint, wet in 
spirits, or the balm of Gilead, may be applied ; if there is little or no inflam- 
mation present, the black plaster or healing salve should be spread thin upon 
a piece of linen, and applied, not only over the wound, but to some distance 
on the adjacent parts. Should swelling or inflammation take place, this 
plaster must be immediately removed, and a poultice of the slippery elm bark 
applied until they subside, when the salve or plaster may be again used. 
Attention should be paid to the constitution, and such medicine and diet 
prescribed as will serve to allay irritation. The bowels must be kept open, 
perspiration promoted, and a cooling regimen recommended. 
Contused Wounds or Bruises.-They are made by the stroke of a, blunt 
instrument against any part of the body, the skin remaining unbroken ; and black 
and blue spots appear on the bruised part. 
Treatment.-Slight bruises require only to be covered with linen wetwitn 
vinegar and wormwood, boiled together, and applied tepid or cold. In very bad 
cases a few leeches will expediate the cure. This treatment soon cures. 
Punctured Wounds, made by a sharp-pointed instrument, as by a dagger, 
bayonet scissors, fyc- Punctured wounds are not only dangerous on account 
of their depth, injury of bloodvessels, nerves, or vital parts, but they also 
frequently give rise to extensive inflammation. Immense agitation of the 
nervous system, even to lock-jaw, follows. 
Treatment.-Punctured wounds are not apt to heal, but form deep-seated 
ulcers. But as no man can tell whether such wounds will heal or not, and 
as no harm can result from the attempt to unite them by the first intention, 
the orifice should be closed with straps of adhesive plaster, and gentle com- 
pression applied along the whole course of the wound. Perfect quietude is 
to be observed. When the pain is severe, an opium pill may be administered, 
and fomentations and poultices applied. Sometimes under this treatment 
the wound speedily unites by the first intention. More frequently, however, 
in cases of deep stabs, the pain is intolerable, and the inflammation runs so 
high as to leave no hope of avoiding suppuration. In this condition a poultice 
is the best application. When matter is formed, the treatment must be the 
same as for suppuration. 
I was recently called to a person who attempted to kill himself by running 
a butcher's knife into the lower part of the stomach. The wound was deep, 
and the bleeding profuse ; it soaked his clothes, and ran down upon the sofa 
and carpet. I removed his clothes, washed off* the blood, brought the edges 
of the wound together, and secured them by placing adhesive straps longi- 
tudinally, and then in the form of a cross, passed a roller around his body, 
put him to bed, ordered spirits to be applied to the wound, and gave a tea- 
spoonful of laudanum. He was soon after removed to the lunatic asylum. 
But, as far as I know, the wound done well. The wound, bleeding, mob, 
and consternation rendered it truly a tragic and bloody spectacle- 
A poultice may be applied to the wound in some cases. WOUNDS. 
485 
Gun-shot Wounds.-When the ball, or any other foreign matter introduced 
into the wound, is not carried through, but remains, it ought to be removed, 
if this can be done without any serious cutting or searching; for such ex- 
traneous substances often acquire a fibrous cyst, and cause no disagreeable 
symptoms. The finger is the best probe for detecting the ball or other foreign 
body; and when farther search is requisite to find it, the nature of the tis- 
sues concerned ought to be carefully considered, since the direction of its 
course is much affected by those of dense and unyielding structure, as the 
bones, muscles, and even the skin. The velocity of the ball, and the posi- 
tion of the body when it entered, ought also to be taken into account. The 
forceps is the best instrument to extract it, when this step is practicable. 
It is recommended to dilate all gun-shot wounds; but this practice is 
attended with very little benefit; on the contrary, with much mischief, except 
the ball is within reach, and it becomes necessary to remove it. 
If there is much pain, swelling, or inflammation, apply a ley poultice. 
Poisoned Wounds.-Of the bite of the rattle-snake.-Nausea ; a full, 
strong, agitated pulse ; swelling of the whole body ; the eyes much diffused 
with blood ; sometimes copious bloody sweats ; fainting ; and often haemorr- 
hages from the eyes, nose, and ears. The teeth chatter, and the pains and 
groans of the sufferer indicate his approaching dissolution. 
Treatment.-Indications of Cure.-1. To prevent the absorption of the 
poison. 
2. To counteract its destructive effects when already introduced into the 
system. 
1st. When a person has been bitten by any kind of a snake that is poison- 
ous, as a rattle-snake or adder, a cup should be applied to the part as soon 
as possible; after it has drawn awhile, use the scarificators, apply the cups 
again, and thus extract as much fluid as the circumstance will admit. 
The efficacy of cupping in poisoned wounds has been well tested in ex- 
periments made upon animals which had been bitten; it has been proved 
that those to which the cups were applied experienced no bad effects of the 
poison, while the others soon died. This operation prevents the absorption 
of the poison. 
2d. As soon as the wound has been cupped, apply the vegetable caustic, 
to be repeated twice a day. 
3d. Make a strong decoction of the common plantain, and wash the wound 
with it; keep it wet also with salt and water; after which mix it with the 
slippery elm bark, add freely of sweet oil, and apply it constantly, or as long 
as there is any swelling or inflammation. This has proved very effectual in 
poisoned wounds. The plantain has been found a certain antidote against 
the bites of different animals. Salt is also very good. 
I have read an account of a battle fought between a toad and a snake, in 
which the former, whenever he was bitten, repaired immediately to a little 
distance and ate the leaves of the plantain, after which he returned and 
renewed the conflict. The person who witnessed the scene, after a short 
time, plucked up the root, and when the animal was deprived of it he im- 
mediately died, thus demonstrating the power of the plant. This production 
forms the basis of a recipe for the cure of poisoned wounds, which was 
long and successfully used by a negro named Ckesar, residing in one of the 
southern states ; his master gave him his liberty, on conditions that he would 
publish the recipe. It may be drank internally, and applied externally. 
4th. An ounce of olive oil must be taken by the patient every day, and 486 
THE REFORMED PRACTICE OF SURGERY. 
the cupping repeated. It is now customary to cut out the part wounded; 
but this is cruel and unnecessary. 
A singular case of poisoned wound, from the bite of a rattle-snake, occurred 
some years since, under the observation of Dr. S. T. Barstow, of Wikes- 
barre, Pennsylvania, and in some respects is perfectly anomalous. 
A lady, in the fourth or fifth month of her pregnancy, was bitten by a 
rattle-snake ; under proper treatment she at length recovered from the symp- 
toms usually consequent upon such wounds. At the full period of gestation 
she was safely delivered of a fine, healthy-looking child ; but immediately 
on its being applied to the breast, and allowing it to suck, the child assumed 
the peculiar hues of the rattle-snake, swelled exceedingly, and soon died. 
She then procured a puppy to relieve her breast, which died in two days of 
the same symptoms. A lamb was then tried ; and, in succession, one puppy 
and three lambs shared the same fate. Another puppy was then procured, 
which escaped with its life, but exhibited some of the symptoms which had 
proved fatal to its predecessors. The lady remained all this time without 
any symptom of the disease, and had as rapid a convalescence from partu- 
rition as is usually observed. 
The poison seems to have been excreted by the process of lactation; for 
the second year afterward she had another child, and though she applied 
it to her breasts, not without fearful forebodings, yet no evil consequences 
resulted. 
Wounds of the Joints.-In all wounds of the joints it is proper to place the 
limb in such a posture as to favour the approximation of the sides of the 
wound ; and absolute rest must be enjoined. In every other respect they 
must be treated as other wounds. When there is a discharge of synovia, or 
joint water, it may sometimes be necessary to sprinkle styptic powders upon 
the wound, to prevent its escape ; but as the wound heals the discharge 
usually lessens. 
I attended one case where the knee was wounded with a scythe, and there 
was a discharge both of pus and of the synovial fluid. The application of 
the elm poultice and black plaster reduced the swelling and inflammation, the 
wound rapidly healed, and he soon recovered. 
Wounds of the Tendons.-It requires sometimes nice discrimination to 
detect wounds of the tendons, as they are usually complicated with ulcers. 
There is a discharge of matter or pus from the sore, and also of a clear fluid 
resembling joint water ; in such cases, instead of exciting a preternatural 
discharge, as we do in common ulcers, we must reverse the treatment, and 
make use of such applications as will check this discharge. 
I attended a young man, between twenty and thirty years ago, who received 
a wound of the leg by a cart-wheel passing over it, and which was attended by 
a physician or surgeon of New Brunswick, who stated that it would be a year 
or two before he could recover, and that a portion of bone must first be sawed 
off. He was brought to me, a distance of thirty miles, exhibiting, when he 
arrived, very unfavourable symptoms. He had become very pale and much 
reduced, and, upon an examination, his disease, which was upon the leg, 
assumed the appearance or character of a common ulcer, and for such I pre- 
scribed. I applied medicine to make it discharge more freely, with a view 
Io bring about a healthy action ; but this discharge was attended with a very 
serious effect, as it reduced him in twelve hours surprisingly, and I could not 
account for it; but, upon a more minute examination, I discovered two WOUNDS. 
487 
kinds of matter or fluids issuing from the ulcer; one kind was pus, the other 
such as issues from a common ganglion, from which 1 perceived that my 
treatment was diametrically the reverse from what it ought to have been. 
I therefore reversed it, and injected, with a small syringe, an astringent pre- 
paration, made by adding a few grains of the styptic powder to a strong 
decoction of the persimmon bark, which immediately checked the discharge, 
and so changed the character of the ulcer that the patient was soon able to 
walk, and he entirely recovered, to the great disappointment and mortifica- 
tion of his former physician. When he first came he was unable to walk, 
I think, even with crutches. 
Such is the proper treatment of various kinds of wounds ; and no matter 
in what part of the body they are received, the practitioner, in treating them, 
is to be governed by the same principles, with such variations as particular 
and peculiar cases may require. 
Wounds of the Head.-Wounds on the head are more dangerous than 
on other parts, on account of injuring the brain. 
In treating wounds of the integuments of the head, the hair must be care- 
fully shaved off', extraneous substances removed, the divided parts placed in 
contact, and secured by narrow strips of the improved adhesive or slick- 
ing plaster. No matter how extensive the wound is, the separate scalp 
or integuments must be replaced. In cases where nearly half the scalp 
has been torn off', and covered with dirt and splinters of wood, the parts 
have been cleansed and replaced, and the wound has healed. If the bone 
is depressed, if practicable, raise it. 
Concussion of the Brain.-Sometimes a person will receive a blow on 
the head, which produces concussion or a stunning of the brain, without any 
wound or manifest injury ; yet it may prove very serious or fatal. In such 
cases there is great stupor, vomiting, and sometimes total loss of mental 
power, and bleeding at the nose. 
Treatment.-Purgatives and injections, cooling fomentations to the head, 
bathing the feet, afterward mustard applied to them, and between the shoul- 
ders. Rest, quietude, and low diet. 
Dr. Valentine Mott, generally a great advocate for bleeding, says, in his 
Lectures on Injuries of the Brain ; " But one thing, gentleman, let me tell 
you ; never be moved by the hue and cry of the bystanders of ' bleed the 
patient! bleed the patient!' If the experience of forty years is worth 
anything at all, let it warn you against so dangerous and foolish a practice. 
If you do,you will rob the brain of that fluid which is to restore it." Will 
net this remark apply to diseases generally ? Does not the abstraction of 
the vital fluid rob the system of the principal means designed to restore it 
to health ? 
Fractures of the Skull.-If there is one or more pieces of bone, with 
a suitable instrument raise them up; if any are loose, remove them ; shave 
the hair off* for some distance around the wound, and then proceed to dress it 
in the same manner as an ordinary wound. Spirits and water, with other 
means before-mentioned, may be applied, to keep down the inflammation. 
The treatment in other respects the same as in concussion. 
Some surgeons in such cases bleed freely and apply the trephine. 
I have little or no confidence in general blood-letting. It produces injury, 
by the debility which it occasions ; and, besides, it prevents the restorative 488 
THE REFORMED PRACTICE OF SURGERY. 
process. Other means are much better to mitigate the violence of arterial 
action or excessive inflammation. 
As regards the trephine, I have still less confidence in it. From all the 
information I can obtain respecting its effects, I think it has killed ten where 
it has cured one ; and I am not at all surprised that Desault, in the last years 
of his practice, should abandon the use of this instrument altogether, in con- 
sequence of the fatal effects which followed its use. Formerly it was very 
fashionable to trephine for even trivial injuries of the head ; but for some 
years past surgeons have become less partial to the operation, from the noto- 
rious bad effects which have followed the operation ; but it is still, I regret 
to say, too much practised. We are directed to trephine, to remove depressed 
pieces of bone, in order to relieve compression of the brain ; but in doing 
this we make a compound fracture, and which is more mischievous in it* 
effects than the wound for which the operation is performed. 
It is very evident to all who are in the least acquainted with injuries of 
the head, that patients do well in very bad cases of compression without 
elevating the bone ; that they recover and do well, when this very operation, 
under similar circumstances, proves fatal; and it can readily be accounted 
for: two severe wounds of the head are much more likely to kill a person 
than one. It is hardly possible to bore a hole in a person's skull down to 
the dura mater, or its vicinity, and not produce a dangerous wound. But 
when this is done in addition to a previous serious injury, what besides can 
we expect but fatal consequences. It is hardly possible that irritation, 
inflammation, or suppuration will not supervene. 
In compression from a depressed bone we may apply the old maxim : " of 
the two evils, choose the least." If the pressure on the brain be an evil, 
and if the operation is still greater, would not common sense dictate to us the 
propriety of pursuing that course of treatment which wre know, by experi- 
ence, is attended with the least danger ? Another objection to the use of the 
trephine is, that it is often extremely difficult to discriminate between con- 
cussion and compression of the brain. Hence there is no sure criterion for 
performing the operation. 
" I once saw a woman," says Dorsey, " who had been assaulted by a 
lunatic, and struck forcibly with an iron bar: I found her skull fractured 
near the junction of the parietal bones, a depression existed, which in one 
part was full half an inch below the natural level, and yet none of the usual 
symptoms of compressed brain occurred, and the fracture healed up without 
any dressings, except a superficial pledget." Similar cases are recorded. 
" If the inflammation comes on," says Sir Astley Cooper, " the patient will 
generally die, whether you trephine or not;" and it is added, that the opera- 
tion will even be likely to increase the inflammation which has been excited 
by a depressed portion of the skull. " The rule," says Sir Astley, " wrhich I 
always follow is this : when I am called to a compound fracture with depres- 
sion, which is exposed to view, whether symptoms of injured brain exist or 
not, I generally use an elevator, and very rarely the trephine. I put the 
elevator under the bone, raise it, and, if it has been comminuted, remove the 
small portions of bone."-{Lectures, 5fc., vol. i., pp. 304, 308.) Of the 
propriety of using the elevator in such cases, and also of taking away loose 
fragments, there cannot be a doubt. 
Forty years ago trephining was the plan generally adopted with the patients 
admitted into tbe London hospitals ; many were submitted to the operation ; 
inflammation of the membranes of the brajn supervened, and nearly all died; 
recovery being very rare. WOUNDS. 
489 
u I have," says Cooper, " several times seen these appearances ; but the 
first case which I recollect of in my own practice was that of a child brought 
into Guy's, who had received a severe blow on the head from a brickbat. 
A.U present were prepared for the operation, fully expecting that I should 
apply the trephine, for they felt convinced that there was considerable 
depression of bone ; when 1 stated that I should notoperate, they exclaimed, 
4 Good God ! I wonder what can be his reason !' This child, after having 
been freely bled and purged, in two or three days recovered, and the appear- 
ance of depression vanished. 
44 I have been often sent for by my dressers to these cases, and have been 
requested to bring my instruments with me ; but, upon examination, have 
found that there was no depression of bone, and that the uneven appearance 
of the scalp was produced by the cause before-mentioned." 
44 One general principle," says a writer, 44 I would inculcate, which is, 
4 that injuries of the head, apparently trifling, should never be neglected ; and, 
on the other hand, those which appear most dangerous and alarming should 
never be despaired of.'" 
I have not myself been fully acquainted with the great resources of nature 
in curing serious injuries till within a few years past. I have treated some 
injuries successfully, which seemed impossible to heal, without amputation. 
One was discharged well a few weeks ago, whose limb was mashed, muscles, 
tendon, and bone, and all separated, except a small place of the skin, which 
seemed insufficient for the circulation ; by bringing the parts in contact, and 
securing them by splints, with the use of refrigerant liquids and poultices, 
recovery followed. This affords a caution how we operate for wounds. 
I might detail numerous cases to illustrate these sentiments; there are 
enough on record, of the same nature, to prove that there is no necessity foi 
trephining, even in compression of the brain. 
A case occurs to me, which I attended some time ago, in which a large 
portion of the os frontis was driven in upon the brain by a stone, causing 
loss of sense, dilatation of the pupil of the eye, convulsions, &c., and having 
all the symptoms for which trephining is recommended ; and yet the patient 
recovered by the treatment here laid down. The bone still remains depressed, 
but without injury. 
Some time ago a woman was struck, by her husband, with an iron instru- 
ment, which produced an extensive fissure in the skull, with great depression 
of the bones; notwithstanding, she recovered, by the employment of proper 
means. 
Another case occurs to me, in which a person fell upon a stone from a 
considerable height, and wounded the head in a most dangerous manner. 
The wound bled for several hours, and delirium and inflammation succeeded ; 
but, by pursuing the treatment which I recommended, he recovered. 
A grocer of this city, a short time since, was thrown from his cart, and 
so exceedingly injured, that it seemed impossible for him to live even for a 
short time. Though there were several wounds of the scalp, contusion, 
concussion, extravasation, if not compression, yet this man has so nearly 
recovered, that he feels only some chronic affection of the brain. 
A man was thrown from a building, and injured his head in such a manner 
that his life for some time was despaired of. The contusion, concussion, and 
inflammation were excessive, and which resulted, no doubt, from extravasa- 
tion of blood or pus ; yet the man, under the same treatment, recovered. 
A vast number of cases might be mentioned, and given in detail, if the 
limits of this work would permit. 490 
THE REFORMED PRACTICE OF SURGERY. 
Mr. Abernethy, who was the most skilful surgeon in London, relates 
several very bad cases of fracture and depression of the skull, and all 
recovered without the use of the trephine, by very simple treatment. 
With all our skill, we have at last to depend almost wholly upon the 
restorative power of the system for a cure. 
Says Dr. Valentine Mott, " You are justified, by the advice of the most 
judicious surgeons of the age, such men as Abernethy, Sir Astley Cooper, 
including myself, in leaving cases of simple fracture of the skull with depression 
of the bone, without compression of the brain, without an operation by the 
trephine," (or boring a hole in the head.) 
Jewet, who sailed to Nootka Sound, on the north-west coast of America, 
informed me that, on their arrival, an altercation arose with the natives, and 
all the crew was massacred, except himself. He was struck down with 
a tomahawk, his skull fractured in the forehead, and nearly killed. He was 
taken home by the Indians, and tobacco wet in spirits, applied to the 
wound, under which it healed. I afterward saw him in Philadelphia selling 
his narrative, when he exhibited to me the scar in his forehead ; and, judging 
from which, the injury must have been very serious. 
CHAPTER V. 
FRACTURES. 
Fracture is a division of bone into two or more fragments, generally- 
occasioned by external violence. 
Species.-1. Simple: where the bone has been divided and the integu- 
ments remain unimpaired. 
2. Compound : where there is a corresponding wound in the soft parts, by 
which the fractured extiemity of the bone becomes exposed. 
Causes.-Predisposing.-Certain diseases of the bone ; as abscess, fria- 
bility or white swelling, &c. 
Exciting.-External violence. 
Symptoms.-Some of the symptoms of fractures are equivocal. The pain 
and inability to move the limb, commonly enumerated, may arise from a mere 
bruise, a dislocation, or other cause. The grating ; the separation and in- 
equalities of the ends of the fracture, when the bone is superficial; the change 
in the form of the limb, and the shortening of it, are circumstances com- 
municating the most certain information. The signs of fractures, however, 
are so exceedingly various, according to the bones which are the subject of 
injury, that it cannot be said that there is any one which is invariably pre- 
sent and characteristically confined to them. Loss of motion in the injured 
limb, deformity, swelling, tension, pain, &c., are usually noticed as forming 
the general knowledge of fractures. The crepitus, or the grating sensation, 
or noise occasioned hy the ends of a fracture, when they are moved and rub- 
bed against each other, is one of the most positive symptoms of the existence 
of such an accident. 
Treatment of Fractures in general.-In the treatment of fractures in 
general there are three indications to be fulfilled : 
First, to replace or reduce the fractured or broken bones into their original 
or natural situation. FRACTURES. 
491 
Second, to secure and keep them in this situation. 
Third, to prevent excessive inflammation and pain. 
1st. Examination of Fractures.-When called to an accident of this kind 
it will first be necessary carefully to examine, and ascertain whether the bone 
or limb is fractured ; by passing the finger or thumb along the course of the 
bones, the fracture can generally be felt: there is an unevenness or rough- 
ness communicated; a depression ; and, upon rotating or turning the frac- 
tured limb, a grating noise is heard or a jar felt. Besides, there is an in- 
ability to raise or move the limb, and it is usually shorter than the opposite 
one. Having ascertained the nature of the accident, the next step will be 
to remove the patient to his residence, or the place where he is permanently 
to remain ; if he is to be removed to any distance, the bones may be tem- 
porarily secured by splints. Having arrived, or been carried, to the destined 
place, preparations must next be made for reducing and dressing. If splints 
have not already been provided, they should now be made, of a proper width 
and length, according to the part which requires their application ; and they 
must be properly covered. Next, bandages must be prepared ; muslin will 
answer, but those made of linen are preferable. They should be made three 
or four inches wide, and several yards in length, and rolled up for use. 
Having made the necessary preparations, the patient must be placed on a 
bed or mattress, and gradual extension and counter-extension made, pro- 
vided one bone rides another, or is not already in coaptation. It is quite 
erroneous to suppose that force or much extension is necessary in reducing 
all fractures. In most of those that I have attended the ends of the bones 
have been in contact with each other, or nearly so, so that very little force 
has been necessary to be employed. The physician or bone-setter should 
take hold of the lower limb, if the fracture be upon a limb, while an assistant 
grasps or holds the upper portion of it; and, upon slight extension, examina- 
tion should be made to ascertain whether the fractured bones are in a straight 
or direct line with each other; and also whether the ends of the bones are 
even, or in no respect depressed one below the other, as these are the dis- 
tinguishing marks, or the criterion which will enable us to judge whether 
they are brought properly together, or in coaptation. 
" It is true that, when swelling has come on, it is impossible always to 
decide, by the touch, in what degree we have accomplished our object; we 
are obliged to judge by the relative position of the joints above and below 
the fracture, and the general aspect of the limb. I have often desisted from 
my unavailing efforts to reduce a fractured limb to a right position, the spasms 
that were excited being so violent as to threaten a protrusion of the bones 
through the skin ; and yet have afterward found no difficulty in bringing the 
bones into a very satisfactory position. In many cases it has appeared to me 
that the coaptation has been effected by the action of the muscles themselves ; 
for when, on the subsequent day, I had removed the splints, I have felt so 
well satisfied with the general position, that I have done nothing more, and 
each succeeding day found less cause for interference. In these cases, upon 
the subsidence of the swelling, scarcely any irregularity could be perceived 
in the outline of the bone." 
The bones being properly adjusted, the bandage will be put round the 
limb, commencing below and rising upward, or from the inferior extremity 
and continuing it to the top, a suitable distance above and below the place 
of fracture. After covering the limb, let the bandage be still held, and splints, 
as many as are necessary, be placed round it, to give security ; and let these 
be held by an assistant. The roller must then be continued over the splints, 492 
THE REFORMED PRACTICE OF SURGERY. 
until they are sufficiently compressed to keep the bones in their proper places, 
or in coaptation. I sometimes fold a piece of linen the width of the splints 
a number of times, to place them upon, in order to prevent undue pressure. 
When this has been accomplished, tape or narrow strips of linen may be tied 
round in two or three places, to render the dressings and the fractured bones 
still more secure. 
The bandages must not be put on too tight, as the swelling that always 
follows will excite too much pain, by impeding the circulation. The limb 
may now be placed upon a pillow, a little flexed or bent, and kept in an easy 
and quiet position. 
A decoction, made by boiling wormwood and hops in vinegar, may be ap- 
plied, to prevent and diminish excessive inflammation ; and after this applica- 
tion has been continued awhile, it may be discontinued, and equal parts of 
rain water, spirits, and vinegar be substituted. After the parts have been 
wet with the liquid, a cloth should be laid, over, to prevent too much 
evaporation. 
All that art can do toward the reunion of a fractured bone is, to lay it 
perfectly straight in its original situation, secure it in that position, keep it 
easy, and moderate excessive inflammation. All tight bandages are in- 
jurious. Il, is in this way that excess of art does mischief. Indeed, frac- 
tures may be successfully treated without either the use of splints or ban- 
dages. It is not necessary often to remove the dressings to examine the 
fracture, provided we have no just grounds to suppose there is any displace 
ment. It is sufficient to remove them occasionally, or as often as the ban- 
dages become loose, from a subsidence of the swelling or other causes. As 
a general rule, once a wreek is sufficient, except we have some doubt on our 
minds respecting the bones being in contact or in their proper places. The 
patient should lay in a horizontal position as much as possible ; and should 
twitchings of the tendons occur, or much pain, an anodyne may be given, 
particularly at bed-time. When the inflammation and swelling have subsided, 
the parts may be bathed with capsicum and spirits, and afterward a strengthen- 
ing plaster applied. 
Treatment of Compound Fractures.-In the treatment of compound 
fractures we are governed by the same principles as in simple fractures. The 
wound is to be cleared of all extraneous substances, such as splinters of bone, 
dirt, &c., which should be removed with all possible gentleness, without 
pain, violence, or laceration; for if the parts surrounding the fracture be 
farther injured, inflammation will be the consequence, and prove very in- 
jurious. There is no necessity for exciting any additional pain by probing, 
or any harsh means whatever. 
Reduction of, or setting, a compound fracture is the same as in the sim- 
ple ; that is, the intention in both is the same, viz., by means of a proper 
degree of extension to obtain as apt a position of the ends of the fracture, 
with regard to each other, as the nature of the case will admit, and thereby 
produce as perfect and speedy a union as possible. The wound being cleared 
from any loose pieces of bone or other substances, the next thing to be done 
is, to apply the dressing. The wound must be treated the same as any other ; 
the edges gently brought in contact as nearly as possible, and then two or 
three strips of adhesive plaster applied to secure them, thus affording an oppor- 
tunity to heal without suppuration. Lint should be placed over this, and 
then the black or healing salve. 
Shortly after a bone is broken osseous matter is deposited by the vessels, FRACTURES. 
493 
which forms a callus and unites it. This shows a wonderful provision of 
nature to cure such accidents ; and so powerful is this principle, that it proves 
effectual under the most disadvantageous circumstances. A bone will unite 
even without bandages, splints, or any other application, either internal or 
external, and that, too, when it is subject to a considerable degree of motion. 
I lately had an opportunity of seeing this exemplified in the case of a dog 
that broke its leg. I daily saw it opposite my oilice, and had thought of apply- 
ing splints and bandages, but neglected it. The poor animal kept constantly 
in motion, and the limb also, with more or less pressure upon the ground. 
After a short time the bone united, and the dog walked as well as ever; 
leaving, however, the limb a little crooked or deformed. 
A cow also broke its leg; as an experiment, it was set, and bark taken 
from a tree and applied to the fractured limb, and firmly bound on. It 
united very handsomely, and the cow was as useful as formerly. A fact of 
practical importance should be drawn from this; instead of killing valuable 
animals when a bone is broken, they may, in this manner, be saved, and ren- 
dered as serviceable as ever. 
When the requisite time for a broken bone to become firmly united has 
elapsed, it is proper to examine carefully and cautiously the place of the 
fracture, in order to learn whether the callus has acquired a suitable degree 
of strength. If the bone should be found to bend in the least at the injured 
part, the callus is not sufficiently strong, and the limb must be immediately 
put up in the apparatus again, with a view of preventing a new fracture, or, 
at all events, deformity. 
For the same reason, the patient should not be allowed to make use of his 
limb as soon as the fracture has united. In fractures of the lower extremity 
he ought to use crutches, and only let the weight of the trunk bear by de- 
grees upon the injured limb. From neglect of this precaution the callus has 
been known to be absorbed, the limb to be shortened, and the patient become 
a cripple. An accidental slip may also produce the fracture again ; for the 
callus, so far from being firmer than the rest of the bone, is at first much 
weaker. 
I have often been astonished to see the treatment practised by different 
persons in cases of fracture. There is no uniformity among them, and the 
majority appear to be governed by no principles whatever. One practitioner 
extends and binds down a limb in the most absurd manner, and thus tortures 
his patient; while another uses Desault''s long splint, which is another spe- 
cies of torture. Another confines the limb in a box, with little or no other 
treatment. A physician in New Jersey practised this method till the wound 
suppurated, and became filled with worms ; and it is proverbial, that in some 
hospitals in Europe patients with fractures are sure to come out cripples. 
A case of this kind of treatment occurred in this city a few years ago, the 
circumstances of which I will briefly relate. A physician of this city was 
upset with his gig, and his leg became so entangled as to fracture the tibia 
and fibula just above the ancle. It was a compound fracture. Two or three 
physicians were called, who examined it; one of them, a noted hospital sur- 
geon, (Dr. Cheesman,) proceeded, after the patient was taken home, to treat 
it; I cannot say to reduce or dress it, for this he did not attempt to do. He 
left him in the same situation in which he was placed in the house where he 
was first taken after the accident. A wide splint each side of his leg had 
been temporarily applied, and these continued without any attempt to reduce 
the fracture; nor did this surgeon scarcely attempt to give it a superficial 
examination It appears that he adopted a new fashion, which has latolv 494 
THE REFORMED PRACTICE OF SURGERY. 
been introduced into some parts of this country for the treatment of fractures, 
viz., to do nothing, at least under ten days, and then put on an apparatus to 
make gradual and permanent extension. This patient not being mine, nor 
having been called to him in the capacity of a physician, I had no right to 
interfere ; besides, the attending surgeon manifested much jealousy and hos- 
tility at my presence. I, however, took the liberty, in the presence of the 
bystanders and two or three of the physicians, to show the true nature of the 
accident, and thus expose the man's ignorance. I placed one finger upon 
the upper portion of the fractured bone and one upon the lower, and then 
pointed out the wide separation existing between them, or the great dis- 
tance they were apart; and, strange as it may appear, this man was left in 
this condition for a length of time ; and it was by mere accident that he disco- 
vered that the fracture had never been reduced. This the patient subse- 
quently communicated to me himself; and stated that he had afterward found 
it necessary to make an incision in the wound, to let out the pus or matter 
that had collected. 
Now, is it not passing strange, that some of our most noted surgeons are 
guilty of such mal-practice ? From the many accounts that 1 have heard 
of a similar kind, 1 am confident that there is no branch of surgery so badly 
managed as fractures. 
I witnessed a case in New Jersey many years ago, where a person received 
a compound fracture of the femur or thigh-bone, which proved fatal from 
the want of proper treatment. The surgeon had received the first medical 
education in Philadelphia, and he seemed to possess sufficient knowledge to 
reduce the fracture; but, being unable to subdue the inflammation, the per- 
son died. 
There is no branch of surgery that is more simple or more easy to treat 
than fractures or dislocations. 1 have had my share of practice in them, and 
should really feel mortified and ashamed if a single case that I ever treated 
could be exhibited in which there was any deformity or bad management. 
I have never yet attended one, no matter what bone of the system has 
been fractured, but that has been properly set, secured, and successfully 
treated ; no lameness, deformity, or inequality in the bones remaining, nor 
the least mark or symptom that could lead a person to suspect there had 
ever been a fracture ; and this has been accomplished by the simple treat- 
ment here laid down, and which every person, possessed of common sense, 
can easily put in practice. 
Particular Fractures.-I have thus given the general rules by which we 
are to be governed in the treatment of fractures in general; which, if kept in 
view, are sufficient to enable us scientifically and successfully to treat par- 
ticular fractures, or every species or variety of them. 1 shall, however, 
briefly notice fractures occurring in various parts of the body, in order, if 
possible, to throw more light upon the subject, or still farther to illustrate 
the subject. 
Fracture of the Nose or Ossa Nasi.-These bones, from their situation, 
are much exposed to fractures. The fragments are sometimes not deranged, 
but most frequently depressed. In order to replace them, the surgeon must 
pass a female catheter, a ring-handled forceps, or any such instrument, into 
the nostrils, and, using it as a lever, push the fragments outward ; while with 
the index finger of the left hand he prevents them from being pushed out 
too far. FRACTURES. 
495 
Fractures of the Lower Jaw.-This bone is sometimes fractured near 
the chin, but seldom so as to produce a division of the symphisis. In other 
instances the fracture occurs near the angles of the jaw. The soft parts are 
generally contused and wounded. 
Treatment.-The fracture or broken bone should be raised, and its end 
brought in contact with the other; after which a compress is to be laid over 
it, and on this a piece of pasteboard, previously wet, the better to adapt it 
to the shape of the jaw; when this has been applied, the whole is to be 
secured by a proper bandage. The patient must be directed to keep still, 
and to talk none. The nourishment must be liquids. 
I attended, some time ago, a very bad fracture of the jaw, which occurred 
in a female, in consequence of a blow from a ruffian, and which did remar- 
kably well by this treatment. 
Fracture of the Clavicle or Collar-bone.-The clavicle is perhaps 
as often broken as any bone of the body. Its exposed situation at the upper 
part of the trunk, its long slender shape, and its being covered only by the 
common integuments, render it liable to frequent accidents. The fracture 
commonly occurs near the middle of the bone, as it is here most prominent. 
The arm of the affected side falls upon the breast, and the patient is unable 
to rotate the humerus, so that it is impossible for him to raise his hand upon 
his head. He leans to the fractured side. Crepitation, or a grating sensa- 
tion, may easily be produced by moving the arm ; and the finger passed 
over the clavicle readily detects the place of fracture. This accident in itself 
is not dangerous, but becomes so when accompanied with great contusion or 
laceration of the neighbouring soft parts. 
The treatment of this fracture has been the source of much difficulty 
among surgeons ; a vast variety of machinery has been contrived for keeping 
the fragments together; and a surgeon of great celebrity, Mr. Pelletan, 
surgeon-in-chief to the hotel dieu, has renounced all applications, and trusts 
to rest in a horizontal posture as the only remedy. 
Treatment.-The object to accomplish in this accident is, to raise the de- 
pressed bone and keep it even with the other; to effect which apply a large 
cushion underneath the arm-pit, and secure it by a bandage carried over the 
opposite shoulder; then place the arm into a sling, and put a strengthening plas- 
ter over the fracture. The patient should keep very quiet. This course of 
treatment will be found invariably successful, without that inconvenience 
and torture which accompanies the common practice. 
Fractures of the Sternum or Breast-bone.-Fractures of the sternum 
require common treatment, viz., a piece of strengthening plaster over the 
situation of the injury ; a roller round the chest; quietude, and a low regimen, 
with a view of preventing what may be considered the most dangerous 
consequence-inflammation of the parts within the chest. 
Fractures of the Ribs.-Simple fractures of the ribs require very simple 
treatment. The grand object is, to keep the broken bones as motionless as 
possible ; for this purpose a strengthening plaster should be applied to the 
side, and over it proper compresses ; a broad bandage is to be firmly put 
round the chest. 
Fractures of the Thigh.-A fracture of the thigh-bone, or os femoris, 496 
THE REFORMED PRACTICE OF SURGERY. 
is liable to take place at every point; but it is at the middle third of this 
extent that fractures mostly occur. 
A fractured thigh is attended with the following symptoms : A local acute 
pain at the instant of the accident; a sudden inability to move the limb ; a 
preternatural mobility of one portion of the bone ; sometimes a very distinct 
crepitus, when the two ends of the fracture are pressed against each other; 
deformity in regard to the length, thickness, and direction of the limb. 
As now treated, almost all fractures of the thigh are attended with deformity; 
but, when treated according to the principles or directions we lay down, no 
such deformity will exist. 
Various have been the contrivances, such as very long splints, to secure, 
in its original situation, the thigh-bone in cases of fracture ; but I have never 
seen any that has been, in all respects, well adapted to the nature and state 
of this accident. Some are useless, others injurious, and the best, which is 
probably Amesbury's, is so expensive that it is in the reach of but few; 
besides, it is too complicated : none will answer for general use, except such 
as are cheap, simple, and of easy application; and such an apparatus, com- 
bining all these advantages, 1 now have the pleasure to describe. After 
studying a length of time to invent something to answer the purpose, I 
finally succeeded in making one, which I have found, by experience, to be 
superior to any other ; the figure of which is>given on page 499. And, when 
we reflect upon the peculiar or critical nature of this accident, the acknow- 
ledged deformity which attends the ordinary treatment, I think I may pro- 
nounce the invention (simple as it is) very valuable. The representation 
given of it will enable any person to form a pretty correct idea of its mecha- 
nism, and also the mode of applying it. It may be made by hollowing out 
two pieces of pine or white wood, of suitable width and length, sufficiently 
to receive the thigh and the lower extremity, or a suitable portion of it. 
The upper part, as a matter of course, should be made wider and deeper 
than the lower, to suit the shape of the limb ; and it must be made smooth, 
thin, and rounded externally, to correspond with the shape of the limb. It 
is to be fastened in the middle by a hinge, or it may be stiff: it may either 
be lined or not; or, what will answer the purpose as well, and which I have 
almost always used, is one made in the same manner, except there is a stiff 
joint, or a joint that admits of no motion. After the twro pieces are exca- 
vated or hollowed out, and made very light, they may be both nailed and 
glued together. Such an angle, however, must be formed as will keep the 
limb, when placed in it, considerably flexed or bent; this may be made, in 
cases of emergency, in half an hour; but it it always best to keep one or 
more on hand ready made. A crooked limb of a tree is an excellent article 
for making this apparatus in the most simple, cheap, and secure manner ; or 
one may be made of tin, or binder's pasteboard. While the principle of the 
appartus is kept in view, it is of little consequence of what material it is 
made, or what the peculiar construction may be, provided the right indica- 
tion be fulfilled. 
Mode of Application.-Having ascertained that the thigh-bone is fractured 
in any part of it, no matter whether transversely or obliquely, it must be re- 
duced the same as a simple fracture, by a little extension and counter-exten- 
sion ; and sometimes none at all is necessary. Let a bandage or roller be 
passed round, beginning just above the knee, and continuing it upward to 
the groin. Let a splint, properly covered with linen or muslin, be placed on 
the anterior part of the thigh, the length of the bandage ; and one also 
little below, on each side of it, leaving sufficient room for the apparatus. FRACTURES 
497 
Representation of the double inclined concave Plane or Splint for Fractures of the Femur or Thigh-bone 
Fig. 1. 498 
THE REFORMED PRACTICE OF SURGERY. 
then let the roller oe continued over the splints, the same as in other frac- 
tures; afterward let the whole leg be carefully placed in this apparatus. 
Narrow strips are next to be tied round the whole, above and below the 
knee, in order properly to secure it. An easy bed is now formed for the 
limb; and such is the convenience and adaptation of the contrivance to the 
leg, that the patient almost forgets that he has met with the accident. He 
can change his position, and the position of the leg, without the least danger 
of displacing the broken bones ; he can be moved to any place, if necessary, 
without injury or inconvenience ; and can sit up in the bed or on a chair, 
take medicine, or safely submit to considerable motion. The limb reposes 
in its concavity with perfect ease and support; and I have found this frac- 
ture apparatus to be remarkably successful in every instance : the bones 
speedily unite ; there is no deformity attending the accident; and I am per- 
suaded that no one, who has ever applied it once, can fail of recommending 
it, or entertaining a high opinion of its utility. Refrigerant or cooling applica- 
tions can be applied, the same as in other fractures. It may also be success- 
fully applied in compound fractures, due care being taken to leave an opening 
over the wound. 
After the apparatus has been applied the knee must be turned a little 
outward, and should rest upon a pillow ; which posture, I find, is the most 
easy and natural. I could here relate cases of its successful application in 
this species of fracture, but the limits of this work will not permit: I must, 
therefore, leave it for those who are disposed to make trial of it, which is 
the best method of testing its merits. 
Fracture of the Humerus or Upper Arm.-This bone is frequently 
fractured near its middle; occasionally in other parts. When the fracture 
is transverse, and about the middle of the bone, no great derangement takes 
place ; the limb preserves its length, and, unless moved, its form. In oblique 
fracture the limb is shortened by the action of the muscles, and considerable 
alteration in its shape is perceived. 
Treatment.-The patient being seated in a convenient place, (in a chair 
or on a bed,) the arm must be a little separated from the body, and carried 
somewhat forward ; then, by an assistant, let gradual extension and counter- 
extension be made until the arm is straight, and until it can be perceived by 
the pressure of the finger that the ends of the bones are in contact; then 
let a roller be put round it, and two narrow and covered splints on the out- 
side, and at a short distance from each other; these must also be secured by 
the bandage. After this has been accomplished, let the aparatus, or the 
angular and concave splint, be applied inside of the arm, as represented in 
the figure or plate (p. 497) in which is exhibited the apparatus for a fracture 
of the thigh. This splint must be made similar to that given as fig. 4, on 
page 499, and may be manufactured of pine, or any other light wood. It 
should be convex externally, and concave internally, with a stiff'joint, form- 
ing an angle of ninety degrees or more, or such obliquity as will enable the 
patient to place his hand in a sling and keep it directly across the abdomen. 
After it has been applied, it must be secured by a narrow bandage or strips 
of linen. This simple apparatus (which I have likewise contrived) as effec- 
tually secures the bones in their natural situations as the other apparatus 
secures the femur or thigh-bone. 
One may also be made of binder's pasteboard, by cutting it of a proper 
width and length, slitting the edges, in order to fit it to the arm; then wet FRACTURES. 
499 
and apply it; when dry, it forms a perfect and secure bed for a fractured or 
dislocated limb. 
Since writing the above I have been called to a fracture of the humerus 
or upper arm of a child about eighteen months old, produced by a fall from 
a chair. The bone was broken immediately above the elbow or the con- 
dyles, the fractured bone nearly driven through the integuments, and was 
attended with a considerable contusion ; the fore-arm was twisted, and the 
bones were so widely separated that the elbow-joint had every appearance 
of a dislocation, and the swelling soon became considerable. 1 took a piece 
of pine board, and split it into two small narrow pieces, about an inch wide 
and half an inch thick. After cutting them even and smooth, 1 placed the 
ends of each together, so as to form a right angle, nearly as represented in 
the plate annexed, (fig. 4,) and then fastened them together with two 
Fig. 2. 
Fig. 3. 
Fig. 4. 
Figure 2 represents the double inclined concave plane or splint. 
Figure 3 represents the same, with a stiff joint. 
Figure 4 represents the concave angular splint, for a fracture of the humerus 
or upper arm THE REFORMED PRACTICE OF SURGERY. 
500 
small nails. After placing them upon the opposite arm for the purpose 
of ascertaining the proper length, the ends were cut off, and the whole 
then covered with muslin. This, and one or two splints, and a very narrow 
roller or bandage, being prepared, the child was placed in the lap of a female, 
when 1 took hold of the fore-arm and directed a student to grasp the upper 
portion of the humerus. I now held it a few minutes, and made very slight 
extension ; the bones and parts gradually became approximated, which was 
known by examination, comparison, &c. With the left hand I held the limb, 
directly over the fracture, and with the right I applied sufficient of the ban- 
dage to cover a considerable portion of the upper and lower arm, passing it 
over the elbow. I then applied a common splint on the posterior part of the 
upper arm, extending it down to the elbow, and at the same time placed on 
a suitable sized compress, the angular concave splint on the inner side, each 
wing or end extending about two-thirds the length of the upper and lower 
bones, and then continued to pass the bandage the whole length of it. The 
arm was then placed in a sling, across the abdomen or belly. I directed the 
arm to be kept wet with a decoction of wormwood and hops boiled in vinegar, 
and at the same time ordered it to be covered after the application, to pre- 
vent too much evaporation of the liquid: during which an anodyne was 
administered. 
The fracture being very bad, contrary to my usual practice, the next day 
I removed the dressings and examined it, and found the parts natural, the 
limb straight, bones in coaptation, swelling much diminished, and the dark 
colour of the flesh measurably gone, and every symptom favourable. 
This morning I have visited the child, and so well is it doing, that, without 
examination, no one would suspect the child had met with the accident; and 
I am confident that not the least deformity will ever succeed the fracture. 
I have been thus particular in detailing this case, that the practitioner may 
understand the particulars of the mode of treatment. 
Fracture of the Fore-arm and of the Leg.-These bones are very 
liable to be fractured, either one bone or both; and they are detected the 
same as other fractures, by a grating noise upon rotating the limb, depres- 
sion or inequalities in the bones, with difficulty or inability of rotation or 
movement. 
The directions laid down under the treatment of fractures in general are 
sufficient to enable any one to treat these fractures. Moderate extension 
and counter-extension must be made, until the bones are brought in a straight 
line and in contact. The bandage must then be placed round the limb, and 
narrow compresses, upon which the splints must be placed ; after which let 
the whole be secured by a roller or bandage. If it be a fracture of the fore- 
arm, let it be placed in a sling; if the leg, then placed upon a pillow. 
Fractures of the wrist, hand, and feet are to be treated on the same general 
principles. DISLOCATIONS. 
501 
CHAPTER VI. 
DISLOCATIONS. 
Description.-When the bones are thrown from their natural cavities or 
articular surfaces, the accident is termed a dislocation or luxation. 
It may be partial or complete, simple or compound. Any person of common 
sense and resolution can reduce a dislocation, as well as treat a fracture; 
and it can be done much better on the spot, than to wait till a doctor is sent 
for, by which time it may swell and be very difficult to reduce. Besides, 
there is often much ignorance and mal-practice betrayed in the reduction and 
treatment of dislocations. 
Causes.-In general, external violence, sometimes disease, or the white 
swelling or hip disease. 
Symptoms.-The ends of the bone are not in contact, change in the length 
of the limb, and little or no motion of it. There is usually a prominence 
or depression. 
Treatment.-In general, extension and counter-extension ; but it would 
appear that this is not always necessary. 
A method of reducing dislocation has been practised by many, particularly 
the family of Sweets, in one of the New England states, for half a century 
or more, to reduce it without any extension whatever ; and it is done in such 
a simple and easy manner, that no assistants are required. These men have 
obtained or possessed this art, it appears, without anatomical knowledge, or 
even much education. They have acquired it by a natural genius or turn 
of mind, aided by extensive practice in the most difficult and complicated 
cases ; and have succeeded when the most celebrated surgeons have 
abandoned cases as hopeless; and so often, and under such a variety of cir- 
cumstances, that their superior skill in reducing luxations is placed beyond 
all doubt, and generally admitted. One of the Sweets was called to a case 
in this city, many years ago, in which other physicians or surgeons had failed, 
and succeeded in treating it successfully. 
He succeeded likewise in another case, of a dislocation of the hip, and after 
a professor of surgery and others had exerted great force in vain, and aban- 
doned it as irreducible. 
In the case of a Captain Russel, where his shoulder was dislocated, and 
where the man was dreadfully tortured by the violence exerted by two phy- 
sicians, who in vain attempted to reduce it, Sweet came, and without any 
assistance, by a certain motion, (hereafter to be explained,) returned the 
bone to its original situation in a few seconds. 
Having heard so much of the skill of Sweet in dislocations, I was ever 
anxious to come in possession of it, although some of the faculty affected to 
despise the man, merely through envy, jealousy, prejudice, or for departing 
from what they call " a scientific " or orthodox course of practice. An op- 
portunity presented itself, some time ago, to obtain this knowledge. A son- 
in-law of Dr. Sweet came to this city, who imparted to the students of our 
school his peculiar method of treating luxations ; and, subsequently to this, 
one of the Dr. Sweets came to this city to practise, and I accompanied him, 
upon his invitation, to witness his treatment. The method pursued by both 
of these men I found accorded with each other. 502 
THE REFORMED PRACTICE OF SURGERY 
I shall now disclose, or give, the Sweet principle of " bone-setting," and 
afterward state how far it may be successfully applied or practised. 1st. 
The operation is performed, according to this plan, by the practitioner him- 
self, although in some cases an assistant is required. In order to illustrate 
the principle, I will give the method of reducing a dislocation of the hip. 
Instead of it being performed by extension and counter-extension, it is done by 
a compound movement. The patient must be placed upon a table, a floor, or a 
bed, with his face upward ; then the practitioner seizes the dislocated leg, and 
flexes or bends it a little, taking hold principally of the knee with one hand 
and the ankle with the other. After having very much flexed the leg 
upon the thigh, for the purpose of converting it into a lever, he carries it 
a little outward ; in the next place the thigh is to be gradually abducted ; 
and, lastly, the operator freely pushes the leg upward upon the pelvis, by 
the knee, toward the face, inclining the leg a little to the opposite side, as 
represented in the annexed plate, (p. 503.) I noticed that Dr. Sweet, after 
freely flexing the leg upon the pelvis, rotated it in different directions, to 
give an opportunity for the head of the bone to pass into the socket. 
This is the principle or method to be employed in every species of dis- 
location ; and in this manner he often attempted to reduce dislocations which 
had been displaced for eight or ten years, and even where the joint was in a 
state of anchylosis, or stiff; but I never could learn with any degree of suc- 
cess. The elder Sweet, 1 presume, never attempted anything of this kind ; 
some of his followers being probably more sanguine than their predecessor. 
1 have it from good authority, that some of those who have attempted this 
practice have caused much serious injury. 
After learning and witnessing this practice, I began closely to examine its 
merits and defects. I have found that the principle is good, but that it has 
been abused, and often wrongly applied. 
It certainly does appear, by numerous cases, that the greatest force that 
can be applied, even by the pulleys, is not sufficient to reduce some kinds of 
dislocations, unless the limb be rotated in such a manner as favours the 
action of the muscles, and thus throw the head of the bone toward its socket. 
" After attempting," says Smith, u the ordinary methods by extension, in 
vain, to reduce a dislocation, he, Sweet, bent the leg upon the knee, seized 
the leg, and using it as a lever, rotated the thigh a little outward ; then he 
gently abducted the thigh ; and, lastly, flexed it freely on the pelvis, by carry- 
ing the knee toward the face of the patient." These movements " instantly 
succeeded, and with little effort of strength." But, to return to the merits 
of the operation or practice, having availed myself of the benefit arising 
from a knowledge of the principle, I find that, although it possesses great 
merit, often of much practical importance, yet it does not, as far as my 
experience goes, entirely supersede the ordinary method of extension and 
counter-extension. I therefore have, upon the comparative merits of both 
methods, adopted neither exclusively, but have combined the distinguishing 
principles of both. 
1st. Let very moderate extension and counter-extension be made; then 
let the Sweet principle, or the compound movement before-mentioned, with 
abduction, flexion, and rotation, be practised in connexion with such exten- 
sion, by which the improvements or advantages are combined, and put in 
execution at the same time. 
The first thing, then, to be attended to, in reducing dislocations, is, the 
position of the patient. He must be placed, as before intimated, in such a 
manner that the body will not be subjected to change or alteration ; in other DISLOCATIONS. 
503 
Fio. 5. Representation of the Sweet or lever principle of reducing Dislocations 504 
THE REFORMED PRACTICE OF SURGERY. 
words, his posture or position must be firm and secure. After the patient 
has been properly placed, the joint or socket whence the bone has been 
thrown must be firmly and securely fastened by the use of a towel, sheet, 
or suitable bandage; this should be fastened or firmly held by assistants. 
The practitioner will now take hold of the dislocated limb, near the seat of 
it; and he, with other assistants, will make extension, while those who 
have hold of the sheet, or bandage which secures the socket or joint, will 
make counter-extension ; and it is very important that this extension and 
counter-extension should be made extremely slow and gradual. 
Says a writer, " With respect to the means to be employed for reducing 
dislocations, it is now generally agreed, among the most eminent surgeons, 
that force should be only gradually applied. Violence is as likely to tear 
sound parts as to reduce those which are luxated ; it calls up all the powers 
of resistance to oppose the efforts making by the surgeon. But it is his duty 
to produce gradually that state of fatigue and relaxation which is sure to 
follow continued extension, and not attempt at once to overpower the action 
of the muscles." 
The extension should always be first made in the same direction in which 
the dislocated bone is thrown ; but, in proportion as the muscles yield, the 
bone is to be gradually brought back into its natural position. Thus, the 
head of the bone becomes disengaged from the parts among which it has 
been placed, and is brought back to the articular cavity again, by being made 
to follow the same course which it took in escaping from it. 
Extension wull prove quite unavailing, unless the bone, with which the 
dislocated head is naturally articulated, be kept motionless by counter-exten- 
sion, or a force at least equal to the other, but made in a contrary direction. 
The dislocated limb must often be compared with the sound one, to ascer- 
tain whether the head of the bone has been brought to a level with the 
socket; and when this is the case, or nearly so, the assistants may slightly 
relax their extension, while the practitioner will freely flex or bend the limb, 
in the manner as before directed ; and the muscles will now replace the bone. 
The limb may be occasionally rotated while the assistants are making the 
necessary extension, as a very little change in the position of the bone wili 
often return it to its place. Sometimes it is necessary to elevate it, that it 
may pass over the brim of the socket. 
The reduction of a dislocation is known by the limb recovering its natural 
length, shape, and direction, and being able to perform certain motions, not 
possible while the bone was out of its place. The patient experiences a 
great and sudden diminution of pain, and very often the head of the bone 
makes a noise or snap at the moment when it turns into the cavity of the joint. 
When the bone has been reduced the patient should be placed in bed, if 
he has not been before ; and, after a bandage has been applied, refrigerant 
and astringent lotions or washes may be applied, such as equal parts of 
spirits, rain water, and vinegar, to which a little fine salt must be added. 
In cases where, before the accident or after, there is great pain, swelling, 
or inflammation, fomentations must be applied ; equal parts of wormwood 
and hops, simmered in vinegar, and enclosed in a muslin or linen bag, and 
placed on the parts. I have applied this with decided benefit and success. 
In one case it so far reduced the swelling and pain, that- the patient could 
scarcely be persuaded that his thigh was dislocated. 
Much mischief has been done by attempting to reduce old dislocations ; 
the integuments often become lacerated or torn, and the patient is rendered 
much worse. No definite time can be given, as this depends upon the history DISLOCATIONS. 
505 
of the disease, state of the joint, &c. It is not proper to attempt to reduce 
some dislocations after a month ; but some, again, have been reduced even 
after three months. This point must be determined by the judgment and 
experience of the practitioner. 
One of the family of Sweets attempted to reduce three cases of old dislo- 
cations of the hip, which had proceeded from the white-swelling. One a 
female,about fifteen years of age, whom I had attended and cured ; but a new 
socket had formed for the joint, which enabled her to walk about as well as 
ever, although there was some prominence of the hip, with a little lameness. 
The second case was a young woman who had received an injury of the 
hip during the act of moving from a fire. She had been confined to her bed 
for a length of time, with excessive swelling and inflammation, which re- 
sulted in extensive suppuration. The whole hip, in every direction from 
the joint, was covered with sinous ulcers, which also affected the bones. 
After some length of time I succeeded in curing the disease ; but an artificial 
joint had previously formed, with partial anchylosis or stiffness. 
The third case was that of a boy who had, for two or three years, a white- 
swelling of the hip, which had likewise thrown the head of the femur or 
thigh-bone from its cavity. I succeeded in curing the disease, but not in 
reducing the dislocation, as I never entertained an idea of this nature. But 
all these patients, or their parents, having heard of the great skill of Dr. 
Sweet, sent for him, who attempted to reduce them, but without success, 
as every person the least acquainted with surgery must know. I assisted 
him to go through the operation with one of the worst of the cases; and 
such violence did he use, that I was really afraid we should so far injure the 
female that an indictment would be brought against us for mal-practice, if 
not for manslaughter. J know not, however, that Dr. Sweet held out much 
encouragement to any of these patients ; but it appeared to me that the very 
act of attempting to reduce a dislocation of this nature carried the marks of 
empiricism upon the face of it. I must add at the same time, as before stated, 
that the principle in itself, properly applied, is good. 1 cannot think that 
the elder Sweet ever attempted to reduce old dislocations of this kind. I he 
best principle is liable to abuse. 
PARTICULAR DISLOCATIONS. 
Dislocation of the Lower Jaw.-Put two corks between the back 
teeth ; then raise the chin, which immediately reduces it. 
Dislocation of the Hip.-The bone of the thigh may be dislocated four dif- 
ferent ways: 1. Downward. In this case the leg is lengthened an inch and a 
half, the knees forcibly separated from each other, and the foot turned outward. 
Mode of Reduction-The patient is to be laid upon his opposite side, the knee 
bent so as to form a right angle w ith the body. T. he right hand of the operator 
should be placed on the outside of the knee, his left hand on the inside of 
the thigh, as high as possible. The thigh should be made a lever, the 
right hand a power, the left a bait or opposing power. The left hand should 
raise the head of the bene from its new bed, and the right carry it opposite 
to its socket. Should there be any difficulty of reducing this dislocation in 
this manner let it be done by extension and counter-extension. A sheet, folded 
longitudinally, is first to be placed over the groin or under the perinseum ; one 
end^must be carried behind the patient, the other before, and then either held 
by assistants, or fastened to one of the legs or posts of the bed. Thus the 506 
THE REFORMED PRACTICE OF SURGERY. 
Fig. 6. 
Dislocation of the Femur or Thigh-bone on the Ilium . 
Diagnosis or Symptoms. 
1st The limb is one, two, or two and a half inches shorter than the 
other. 
2d. The toe rests upon the tarsus of the other foot, the knee and foot 
being turned inward. 
3d. The dislocated leg is nearly locked, admittiuj of but very little motion, 
but may be flexed or bent, and brought across the other. 
4th. The head of the thigh-bone may be felt when motion of the limb 
is made, or when rotated, inward, except the swelling be too great. Again ; 
it is less prominent than the other. DISLOCATIONS. 
507 
Fig. 7. 
Reduction of the Thigh-bone when dislocated and thrown on the Ilium. 508 
THE REFORMED PRACTICE OF SURGERY. 
pelvis or the joint will be secured, so as to allow the necessary extension 
to be made. Great care must be taken, during the extension, to keep the 
scrotum and testicles in men, or the pudenda in women, from being hurt by 
the sheet: to prevent this, a little cotton may be placed under. A bandage 
made of American muslin must now be firmly bound, immediately above the 
knee or ankle, round the limb, from which two or three bandages must be 
fastened, in order to make the necessary extension. The practitioner will 
now take hold of the dislocated leg, while his assistants make slow and 
gradual extension in the line made by the limb, when it is brought across 
the other thigh a little above the knee. As soon as the head of the bone has 
been brought on a level with the socket by the assistants who are making 
the extension, the practitioner is to carry the leg first a little outward ; he 
will then flex or bend it, and carry it upward on the abdomen, or toward 
the face; at the same time a person must press hard upon the hip. This 
will throw the head of the bone into its natural cavity or socket, which is 
generally accompanied with a snap or jar. The extension should always 
be made in a gradual and unremitting manner ; at first gently, but afterward 
more strongly ; never violently. 
The disappearance of all the symptoms, and the noise made by the head 
of the bone when it slips into the acetabulum, denote that the reduction is 
effected. This noise, however, is not always made "when pulleys are used. 
The bone is afterward to be kept from slipping out again, by tying the 
patient's thighs together, with a bandage placed a little above the knees. 
The patient should be kept in bed at least three weeks, live low, and rub the 
joint with the green oil or liniment. A strengthening plaster should also be 
applied over the hip. Due time must be given for the lacerated ligaments 
to unite and the sprained parts to recover. Premature exercise may bring 
on irremediable disease in the joint. 
In general, sufficient force can be made without applying any bandages 
upon the dislocated limb, either above the knee or the ankle. One or two 
persons, by taking hold of the inferior extremity of the limb, can make force 
or extension quite sufficient. 
I would not be understood to suppose that force alone is sufficient for the 
reduction of dislocations: skill and address will often succeed better than 
force. A dislocation of the thigh has been set by one man, after all the 
force that could be exerted by six had proved ineffectual. 
The parts injured by dislocations require rest; afterward easy motion, to 
enable them to regain their wonted vigour. 
The other three kinds of dislocations distinguished by surgeons require 
the same treatment; with little variation, a description would onlv tend to 
confuse the common reader. 
Dislocation of the Shoulder.-A dislocation of the upper bone of the 
arm, more frequently downward, into the axilla or arm-pit; sometimes 
upward. From the nature of the articulation, as well as from its exposed 
position upon the body, this bone is more subject to dislocation than any bone 
in the body. A dislocation of this bone may be known by a depression or 
cavity on the top of the shoulder, and an inability to move the arm ; when 
the dislocation is downward or forward the arm is elongated, and a ball or 
lump is perceived under the arm-pit; but when it is backward there appears 
a protuberance behind the shoulder, and the arm is thrown forward toward 
the breast. 
The usual method of reducing dislocations of the shoulder is, to seat the DISLOCATIONS 
509 
patient on a low stool, and cause an assistant to hold his body so that it may 
not give way to the extension, while another lays hold of the arm a little 
above the elbow, and gradually extends it. The operator then puts a napkin 
under the patient's arm, and causes it to be tied round his own neck ; by this, 
during the extension, he lifts up the bone into its place ; or a towel, doubled 
or folded several times, should be placed under the arm-pit on a thick linen 
or muslin compress, the two ends of which ascend obliquely before and 
behind the chest, and meet each other at the sound or opposite shoulder, 
and are held there by an assistant, in order to secure the trunk or shoulder, 
and make the necessary counter-extension. The practitioner will now take 
hold of the arm, and gradually extend it in the direction in which it has been 
dislocated : with the right hand seize the elbow of the dislocated arm, keep 
it bent, and gently move it from the body ; with the left hand crowd a large 
ball of yarn as far under the arm-pit as possible ; then use the arm as a lever, 
the ball acting as a fulcrum, over which the head of the bone is guided into 
its socket. 
A farmer set the dislocated bones of his neighbours in a country village 
much more ingeniously than most surgeons. He employed precisely the 
same process as that just mentioned ; all which he did without assistance, 
and gratuitously. This dislocation is very easily reduced. 
Dislocation of the Elbow.-A dislocation of this joint may take place 
in any direction. A protuberance may be felt on that side of the arm toward 
which the bone is pushed, from which, and the patient's inability to move 
the joint, a dislocation is easily known. 
Treatment.-Extension is to be made upward and downward by two 
assistants, while the operator guides the protruded bone into its cavity. All 
this time the arm should be half bent, that the joint may be as much 
relaxed as possible. 
Dislocation of the Wrist and Fingers.-Dislocations of the wrist and 
fingers are to be reduced by simple extension, and guiding the bones to 
their proper places. 
It is only necessary to look at injured parts, to learn the method of relief 
required ; yet, strange as it may seem, bystanders will remain idle spectators, 
when a little resolution exerted on their part would instantly put all things 
right. 
Dislocation of the Knees, Ankles, and Toes.-Dislocations of these 
joints are relieved much the same way as the joints of the arm, viz., by exten- 
sion in opposite directions, while the operator replaces the bones. In many 
cases extension alone is sufficient, and the limb will slip into its place merely 
by exerting sufficient force. 
Dislocation of the Knee-pan or Patella.-The patella may be lux- 
ated outward, or even inward, when violently pushed in this direction. It is 
also liable to a displacement upward. 
Reduction.-Let the inferior extremity of the leg on which the knee-pan 
is dislocated, rest on the practitioner's lap, in order to flex the extensors of 
the leg ; when the patella or knee-pan must be pushed upward, or to its 
original situation. When reduced, let a bandage be placed round it. I 
lately reduced a very bad case of this kind in the above manner, when other 
means were found unavailing. 510 
THE REFORMED PRACTICE OF SURGERY. 
In concluding this chapter on dislocations I have to remark, that the 
practice recommended of bleeding, with the use of antimony, &c., is very 
objectionable ; there is no necessity in any case whatever for either, where 
the operation is properly conducted. Any dislocation can be reduced with- 
out resorting to them, or to inconvenient and complex pulleys. Without 
keeping in mind the nice distinction made in the different species or variety, 
any person can, with a little experience and judgment, effect a reduction 
without the least difficulty. The practical rules are the same in every acci- 
dent. The practitioner has only to keep in mind the general principles of 
reducing dislocations, viz., by moderate extension and counter-extension, 
with flexion, rotation, and abduction, and he will invariably succeed, where 
no insuperable obstacles present. 
lam satisfied that our method of treating dislocations, as well as fractures, 
is better than the old, for the cases we have had have recovered soon, with- 
out any deformity. The whole secret consists in placing and securing the 
bones in contact, and moderating excessive inflammation. 
Dr. Chevers and Hibbard, of our Reformed School of Medicine, have re- 
duced a case of dislocation of the thigh by extension and counter-extension. 
Dr. Shanklin informs me that he has very easily reduced a case of disloca- 
tion of the femur upon the u Sweet principle," as laid down in this work. 
(See fig. 5, p. 503.) He says it was done by himself with great facility. 
CHAPTER VII. 
ULCERS. 
An ulcer is an injury done to the flesh from various causes, and from which 
issues matter, with more or less pain and inflammation. It may arise from 
any source that occasions inflammation or corrupts the fluids; as fever, 
scrofula, the venereal disease, retention of acrid humours, cold, injuries, 
&c. It is divided into many different kinds ; but this is unnecessary for 
practical purposes. 
Treatment.-When there is inflammation, pursue the same course to 
reduce it as laid down under that head : afterward wash it well with 
castile soap and rain water, to which a little spirits may be added ; then 
apply a little lint, wet occasionally with salt and water, and over it the 
black salve, alternately with the yellow salve ; over this a bandage may be 
applied. The dressing, as a general rule, may be repeated twice a day. If 
it does not heal readily, or if there is unhealthy flesh, sprinkle the ulcer with 
pulverized blood-root; mandrake may be combined with it. If this is not 
sufficient to remove the fungous flesh, apply a little of the vegetable caustic 
or red precipitate. If there are any orifices or openings, dissolve a tea- 
spoonful of the vegetable caustic in a gill of rain water, and inject it into them 
every time the ulcer is dressed. The strength may be increased as the person 
can bear it, and tents made of twine and passed through beeswax, to stiffen 
them, may be introduced to keep the orifices open. Poultices, injections, 
and decoctions of the black or pussy willow, oak bark, sumach bark, are 
all very good, and may be used alternately; in case the ulcer proves unusually 
obstinate, likewise the cancer plaster, with very little, if any, of the white 
vitriol mixed with it ULCERS-NECROSIS OR DECAYED BONE. 
511 
Internal treatment.-A portion of physic may be occasionally taken ; 
also the alterative and scrofulous syrups, and other vegetables calculated 
to purify the blood. I have lately used the following with good effect: 
Take hydriodate of potash, one ounce ; add it to one quart of rain water : 
take half a wine glassful three times a day. Diet to be milk and vegetable. 
A tea of the American or foreign sarsaparilla may also be used. (Scrofu- 
lous, venereal, and cancerous ulcers will be treated under their respective 
heads.) Several cases of obstinate sores have been cured by salt and best 
French brandy applied on linen folded several times, and the ulcers kept 
constantly wet with it. This may be tried when other means fail. I have 
occasionally applied cups round the sore and on the leg. 
In some ulcers, which have baffled the skill of all physicians, I have found 
the application of an ointment made of the following plant prove a sovereign 
remedy: Take sweet clover tops and stalks, burdock leaves, and parsley, a 
handful of each ; boll in water till you get the strength ; strain, and add one 
pound of rosin and a quarter of a pound of fresh butter ; simmer until of a 
proper consistence. This recipe cost fifty dollars. 
Sidney Bowne states that he has had great success in treating ulcers in the 
following manner: Bathe the parts or limb in ley water daily, half an hour 
each time ; then apply a bandage, and keep it wet with cold water. He 
says that it cures all cases. 
Fungous flesh, Cancer, &c.-The pulverized blood-root is a good es- 
charotic. I lately removed a fleshy excrescence of the eye by applying a little 
to it daily, by means of soft muslin moistened with water. Dr. Stewart 
uses it as follows: Extract the clear juice of blood-root by pounding and 
pressing ; then reduce it to the consistence of salve, either in the sun or by 
the heat of embers. Says he, " This simple salve will kill the fungous part 
of a sore cancer faster than any medicine I am master of; and the patient 
may sleep the meanwhile." He also combines it with the red precipitate. 
CHAPTER VIII. 
NECROSIS OR DECAYED BONE. 
The bone sometimes becomes rotten from inflammation or other causes, 
mercury, &c. When the bone is diseased the ulcer over it shoots out fleshy 
excrescences, and the edges are either everted or turned out. 
Treatment.-This disease is usually quite protracted. The treatment 
must be the same as for ulcers, and attempts made as soon as practicable, or 
any bone appears, to use means to aid its exfoliation or expulsion, which 
may be done by a pair of forceps. I have removed a greater part of the 
tibia or shin-bone, and the lower jaw, in this manner. Some cut down to 
the bone, and extract the diseased portions; but I consider this generally 
bad practice. Aiding nature, with patience, is preferable. 
By the above treatment I have cured many with the worst kind of ulcers, 
after many years' standing. Mr. Van Name, of Staten Island, had an ulcer 
in the leg, with necrosis of the bone so bad that he had been attended by 
seven or eight physicians. By degrees I removed a considerable portion of 
the tibia, and he recovered. Mr. Milwood, of Brooklyn, had a shocking 
ulcerated leg; it had thirty-eight ulcers on it. He was attended in this 512 
THE REFORMED PRACTICE OF SURGERY. 
country, Ireland, and in London, without benefit. Under the preceding 
treatment he recovered, and has been well for many years since. On his 
arrival at London he went to one of the members of the colleges of physi- 
cians and surgeons, showed his leg, and obtained his certificate of the cure, in 
which he states that the treatment reflected great credit on the surgeon who 
performed the cure. 
CHAPTER IX. 
CANCER AND SCIRRHUS. {Carcinoma.} 
Character.-A hard tumour or scirrhus is considered as the occult or 
primary stage of cancer, and is not an unfrequent consequence of inflamma- 
tion, when it has attacked or occupied glands. The part becomes of in- 
creased size, is knotty, hard, and irregular to the touch-being, however, 
unattended with any discolouration of the skin-and acute pains are every 
now and then felt darting through the tumour. At length a tendency to 
cancerous ulceration becomes obvious. 
A cancer is an ulcer of the very worst kind, with an uneven surface, and 
ragged and painful edges, which spreads in a very rapid manner, discharges 
a thin, acrimonious matter, that excoriates the neighbouring integuments, 
and usually has a very fetid smell, and which is generally preceded by a 
hard or scirrhous swelling of the part, if glandular. The disease is most 
commonly confined to glands, and particularly the breasts, now and then to 
be met with in the uterus, the face, and other parts, such as the lower lip, 
the angles of the eyes, the organs of vision, the tongue, &c. 
Cancer is most generally met with in persons advanced in life, and parti- 
cularly in women about the period when the menses cease. 
The cancerous sore is extremely irregular ; on its surface are seen various 
prominences and excavations, from one or more of which a haemorrhage is 
frequently observed to proceed. It is attended with a peculiarly burning 
and lancinating pain, which is generally intermittent. The edges are thick, 
indurated, and often exquisitely painful; they are sometimes retorted, most 
generally inverted. The odour of the discharge is frequently so intolerably 
offensive that it is difficult to inhale it long, and of a very excoriating or 
scalding nature. 
There is a species of cancer called no li me tang ere which means, touch me 
not. It appears on the surface, generally the face, and is very small and 
slow in its progress; and rough, scaly, and itchy. It will continue for a 
great many years without much injury, or perhaps danger. Cancers of the 
female breast proceed to a more speedy termination, particularly when they 
have submitted to empirical treatment by the knife : there are few ex- 
ceptions. 
Dr. Allen, of Middlebury, Vt., states that alady, about one hundred years 
of age, died from another cause, who had an open cancer of the breast for 
more than thirty years. Several other cases of a similar character, though 
less protracted, have occurred. 
Cancer is one of the most distressing diseases to which poor mortals are sub- 
jected. The unhappy sufferer is literally destroyed by a slow, but virulent, 
poison, with which the fluids are contaminated, and which is the immediate 
cause of cancer; while the remote causes may be blows, cold, &c. CANCER AND SCIRRHUS. 
513 
Treatment.-Various applications are recommended and used for cancer; 
although the knife is generally employed as a remedy, yet I have never seen a 
solitary instance cured by it; the very nature of the disease, its extensive 
ramifications, the structure of the parts diseased, show conclusively that the 
act of cutting out a portion of the diseased mass is of no service ; but, on the 
contrary, in almost every case exasperates it. I have seen a cancer grow 
more in one motith after an operation, than it did in three previously ; and it 
appears to arise partly from the nature of an incised wound, that soon heals and 
retains the cancerous matter, which proves an additional source of irritation, 
and partly from irritation, inflammation, and other causes ; or the injury done 
to the absorbents. 
I have had a great share of practice in this disease, both before and after 
an operation has been performed, and, therefore, have had an opportunity 
of knowing the effects of the common practice, particularly of the knife; 
and I must give my testimony against the use of it in any case whatever, 
for I am satisfied that it only aggravates the disease. I am astonished that 
surgeons will continue to operate for cancers, when they must positively know, 
by their oion experience, that, instead of removing, it exasperates the disease 
and accelerates its growth. 
I have been called in every direction to see persons labouring under cancer, 
for which excision has been made; and I have invariably found that every 
one of the patients has deprecated and given their testimony against it. 
Could the knife penetrate as far as the cancerous poison extends into the 
glandular system, and could the subject of it bear the operation of having 
the whole extirpated, there might be some probability of effecting a cure. 
But how can this be ? Is not the blood, or the mass of lluids, in a greater 
or less degree contaminated ? and, if so, does it not betray consummate igno- 
rance, to say the least of it, to use the knife with a view to remove, the dis- 
ease ? We have evidence that the constitution is more or less affected ; and, 
if so, with what propriety or prospect of success can such cruel and unna- 
tural means be relied upon or resorted to ? 
Sir Astley Cooper, and.many other experienced men, both of the past and 
present time, consider cancer as decidedly a complaint connected with a 
peculiar state of the constitution. When an operation is performed, little 
cancerous bands, resembling ligaments, shoot into the surrounding adipous 
substance, and even the fibres of the muscles beneath the cancerous disease 
are frequently affected. 
I know that many tumours have been extirpated which have borne the 
name of cancer, but I am well satisfied that they were fleshy or sarcomatous. 
As Mr. B. Bell remarks, the great authority of Dr. Alexander Monro 
must have no inconsiderable influence, even with practitioners, in making 
them much more backward in undertaking the extirpation of cancers than 
they otherwise would have been. " Of near sixty cancers," says he, " which 
I have been present at the extirpation of, only four patients remained free of 
the disease at the end of two years ; three of these lucky people had occult 
cancers in the breast, and the fourth had an ulcerated cancer of the lip." 
(Edin. Med. Essays, vol. v.) Dr. Monro also observes that, in those in 
whom he saw the disease relapse, it was always more violent, and made a 
quicker progress, than it commonly did in others on whom no operation had 
been performed. 
Treatment of Cancer in a state of Scirrhus, or before it ulce- 
rates.-When any gland has become enlarged, indurated, and shows a 
tendency to be scirrhous, we should, from the earliest period, use our utmost 514 
THE REFORMED PRACTICE OF SURGERY. 
exertions to discuss, or at least to prevent, its farther increase. Applications 
of a discutient and sedative nature should be had recourse to without delay; 
pressure of any kind should be guarded against, particularly from lacing ; the 
bowels must be kept free and open by purgatives administered from time to 
time, and a cooling regimen be enjoined, cautioning the patient to abstain 
from all spirituous liquors, and from other stimulants of every kind. 
When the disease is in a state of tumour or scirrhus, let the following 
discutient ointment be applied: Take of bark of the root of bitter-sweet, 
(solanum dulcamara,) stramonium leaves, {daturastramonium,) cicuta leaves, 
(conium maculatum,) deadly night-shade, {atropa belladonna,) yellow dock- 
root, (rumex crispus,) pokeberry or root, equal parts : bruise the articles, 
cover with spirits, and simmer a few hours; then add fresh butter sufficient, 
when melted, to cover the whole; simmer moderately over embers until the 
strength is extracted ; then strain and cover in an earthen jar. Let the 
tumour be well bathed with this ointment three or four times a day before the 
fire, or any heated substance may be held a little distance from the part during 
the act of bathing. After the tumour has been anointed, let a plaster be applied. 
Inspirated juice of pokeberry is good; also cicuta and extract of henbane. 
Every other night, on going to bed, if there is any pain in the tumour, 
steam with the following decoction: Take boneset, wormwood, hoarhound, 
and hops ; boil two or three hours in equal parts of vinegar and water ; throw 
the decoction and the herbs into a suitable vessel, to which add a small 
quantity of soft soap ; place the vessel underneath the tumour or parts 
affected, and let the steam be confined by a blanket. Continue the applica- 
tion for fifteen or twenty minutes each time, and, if it produces no perspira- 
tion, throw in a heated iron or brick. If the tumour be in the breast, the articles 
may be put into a large bowl, and placed directly under it. When the 
axilla and arm are swelled, let the steam be extended to these parts also. 
If the patient should be in the most excruciating pain, this treatment will 
mitigate it, by eliminating the cancerous humours, removing the tension, 
swelling, and inflammation connected with it, and rendering the parts more 
soft and natural. During the use of these medicines the patient may take the 
scrofulous syrup. Also give, in connexion with this syrup, a pill made of the 
extract of cicuta, containing a grain or two, twice a day ; and, if no nausea 
follows its use, to be gradually increased. The following may be tried : 
Take yellow dock-root, one ounce ; common salt, one ounce ; add one pint 
of best French brandy ; keep the parts wet with it, instead of the plaster. 
This is very discutient. A purgative should be given once or twice a week; 
the powdered root of mandrake is preferable. 
1 wish to impress on the mind of the person afflicted with a cancer of the 
breast, the importance and necessity of avoiding the use of the knife and any 
corrosive plaster, especially before it ulcerates, as both are sure to exasperate 
the complaint, which otherwise, if treated mildly, or even left to nature, 
might progress very slowly: the knife and the plaster I have found, by 
extensive experience and observation, to exasperate the disease, and hasten 
it on to a speedy and fatal termination, to say nothing of the sufferings which 
they must occasion. If you do it,remember, it is at your peril: the opinion 
of quacks to the contrary, notwithstanding. 
1 have thus given the treatment for cancer in its scirrhous state, and it has 
removed some very obstinate cases; but it sometimes, in spite of the best- 
known treatment, puts on a very malignant character, and inflammation 
will take place : when this occurs the same remedies may be applied, except 
the plaster ; instead of which the following poultice must be substituted, with CANCER AND SCIRRHUS. 
515 
a view to moderate inflammation and favour suppuration : Take eicwZa leaves, 
and simmer them in rain water until they are soft; then stir in slippery eLn 
bark to form a poultice, to be applied, tepid, morning and night, as long as 
there is inflammation or ulceration ; and even after an abscess is formed, or 
the tumour discharges, the poultice may be continued, at least a part of the 
time, in order to reduce the swelling and promote a discharge. 
After this has taken place, when the inflammatory symptoms have been 
measurably subdued, and the disease assumes a chronic character, a course 
somewhat different must be pursued. It will be necessary to use the poul- 
tice occasionally, to lessen heat and irritation, as in almost all cases of cancer 
there are more or less of these symptoms present; but in general we must 
rely more upon stimulating applications, with a view to aid the powers of 
nature to throw off the disease: to effect this she establishes a discharge, 
and it is our business to promote it, if the strength of the system will admit. 
Many are in the habit of accomplishing this by applying various kinds of 
cancer plasters, such as arsenic, fyc. ; and almost always under pretence that 
they are vegetable. There was an agent in this city, of Dr. Davidson, who 
became very popular for the cure of cancers, and, as he says, by simple 
and vegetable means ; but it is, I believe, a well-established fact, that the 
basis of his plaster is arsenic; and if it has cured some, it has killed others. 
I have, however, more confidence in almost any of the preparations used for 
extracting cancers, than I have in any operation by the knife. The latter is 
exceedingly painful, uncertain, and dangerous ; while the former, even 
though it be very severe, will sometimes, by its corrosive or escharotic 
effects, cure the disease : but much depends upon the nature of the applica- 
tion or plaster made use of, as there is a very great difference in the effect of 
different agents employed. I have tried, and seen tried, almost everything 
that has been highly extolled, or that has gained much celebrity for the cure 
of cancer ; and I feel, therefore, prepared to make such a discrimination, 
and to give such directions, as may be relied on and entitled to confidence. 
Any preparation of arsenic, blue vitriol, &c., I consider to be injurious. 
The attention of practitioners has long been directed to the vegetable 
kingdom for an antidote to this formidable disease ; but, unhappily, none has, 
as yet, been discovered, the properties of which are sufficiently active inva- 
riably, or even generally, to cure it, especially when it has become con- 
firmed, or in the latter stages ; nor have our researches into the mineral 
kingdom been successful. It is true, cancers may be cured in their incipient 
or forming stages, and oftentimes when they are considerably advanced or 
progressed. I have successfully eradicated them in numerous cases, where 
the disease had not proceeded too far. 
Of the different vegetable productions, I have found the vegetable caustic, 
ley, made by leaching hickory ashes, and boiling to an extract or plaster, the 
most active and salutary where cancer is in a state of ulceration: Take any 
quantity of hickory ashes and leach them ; boil the ley until it is of the consis- 
tence of molasses or honey ; spread a small quantity upon a piece of leather, 
and apply to the part affected. Let it remain until the pain produced by it 
subsides, or as long as the strength of the patient will admit; after which 
apply a poultice daily. The plaster or extract must be kept from the air, or 
its virtues or active properties will be destroyed. The effect of this prepa- 
ration is, to excite a preternatural discharge, or cause a sloughing of the 
ulcer, and thus remove or diminish it: it has a peculiar operation, different 
from any known substance ; that while it proves very active, and somewhat 
corrosive, instead of creating inflammation, like other kinds of caustic, it 516 
THE REFORMED PRACTICE OF SURGERY. 
absolutely diminishes it. Hence it becomes a valuable agent in this as well 
as in many other complaints. In general a poultice may be applied at night, 
and our black salve or plaster during the day, using, after every dressing, 
lint on which is spread a little emollient ointment, such as the celandine 
or discutient. This treatment has removed many cancerous ulcers which 
were supposed to be incurable. 
Should the disease, however, resist these applications and remain stationary, 
or continue to progress, let a plaster be applied, made as follows: Take 
white oak bark, clear of the exterior portion, half a bushel, and bruise; 
cover the same with soft water, or, which is much better, urine; let it 
stand in a warm place two or three days, to digest properly; then boil, pour 
off' the liquid, add more of the urine, and boil again, and thus repeat till 
all the strength is extracted; slowly simmer down till it becomes of the 
consistence of molasses; then take white turpentine, the gum, four ounces, 
and inspissated juice of pokeberry, four ounces ; melt and strain it, and add to 
the extract, and also half a pint of strained honey; boil a few minutes, to 
incorporate, and remove it from the fire : to every ounce of this extract 
add from half a drachm to a drachm of pulverized white vitriol; let it be 
spread on a soft piece of leather, and applied to the cancer. It may be 
renewed every day or two, according to circumstances. This forms about 
the best cancer plaster, taking all circumstances into consideration, of any 
article with which I am acquainted. The tumour almost invariably becomes 
diminished and soft under it; the indurated or hardended edges gradually 
diminish ; the size of the sore lessens ; and, in very many instances, used 
with the other means recommended, will effect a radical cure ; and even 
where it does not, it never fails to arrest the progress of the disease, to lessen 
the pain, swelling, and inflammation, and in every respect to improve the 
condition of the patient. It changes both the quality and quantity of the 
discharge, and renders the patient comfortable. 
If the patient complains of great pain under the influence of this or any 
other application, a narcotic may be administered. I have used a plaster 
made of the cicuta leaves with advantage ; and it may be tried when others 
fail. 
When a cancer is very fetid, a yeast poultice may be applied ; also a solu- 
tion of chloride of lime. In cancers of the womb this may be injected. Hy- 
driodate of potash is highly recommended ; it may be taken internally, and 
applied externally in the form of ointment. 
Cornelius C. Cuyler, pastor of the Reformed Dutch church, in Pough- 
keepsie, has communicated the following preparation for the cure of cancer ; 
he details several cases which have been removed by it: Take the nar- 
row-leaved dock-root, boil it in soft water, wash the ulcer with a strong 
decoction of it, warm as it can be borne ; fill the cavity with the liquor for two 
minutes ; then scrape the hulk of the root, bruise it fine, put it on gauze, 
and lay it over every part of the ulcer; dip a linen cloth in the decoction, 
and put that over the gauze; repeat this three times in twenty-four hours ; 
and at each time let the patient take a wine glassful of the tea made of 
the root, with one-third of a glass of port wine, sweetened with honey. 
A person states that the juice of poke leaves cured a very inveterate cancer, 
which was applied merely to prevent the annoyance of flies. INFLAMMATION OF THE BREAST, &c. 
517 
CHAPTER X. 
INFLAMMATION IN THE BREAST, AGUE IN THE BREAST, MAMMARY 
ABSCESS, &c. (Mast Gdynia.) 
The breasts of women are occasionally the seat of very painful and dis- 
tressing swellings and abscesses. 
The inflammation commences in the usual manner, and the pain, hardness, 
and swelling are, in general, very considerable. 
The progress of this complaint varies; sometimes it is rapid, and causes 
great distress. It arises from cold or other causes, which obstruct the flow 
of milk. 
Treatment.-The treatment is similar to other kinds of inflammation and 
abscess. When there is simply an ague or swelling in the breast, the object 
should be to discuss it, which may be done by applying the bitter-sweet oint- 
ment, and the adhesive and strengthening plaster or the common strengthening 
plaster, and remove the chill by perspiration. The breast may be bathed 
with soap liniment. Also take one tea-spoonful of Jamaica rum, ground 
pepper and ginger, one tea-spoonful of each: boil about five minutes, and 
thicken with rye flour, (elm bark, I suppose, would be better ;) put a little 
oil on the breast, then apply the poultice, and repeat three times; it gene- 
rally cures. It has cured a number of persons ; one Hannah Burling three 
times. 
This course wdl, in general, remove the swelling and hardness ; but when 
this cannot be accomplished, poultices must be applied, the same as in other 
inflammations. The ley thickened with the elm bark is very valuable. When 
matter has evidently formed, and there is a disposition to discharge it, and 
the pain is very great, it may be punctured with a lancet, or, which is better, 
if the patient can wait, let it break spontaneously, as recovery is more 
speedy and the cure permanent. I have sometimes aided the exit of the 
matter by slowly and carefully working a probe down, with a spiral motion, 
on the most prominent and soft part, where generally a small tumour is 
formed ; to be repeated several times. A little caustic may be applied. 
When open, still continue the poultice till all the inflammation has subsided; 
then apply the black salve. I treated one case of long standing, in which 
the v-hole breast was indurated, and in a state of abscess, with numerous 
openings, through which milk and matter issued. One surgeon recom- 
mended amputation of the breast. It healed, and has remained well for about 
twenty 'years. 
By this method I have cured the most desperate and loathsome diseases 
of this kind wrhich are on record, when the whole breast has been, as it were, 
a mass of corruption, numerous sinuses pouring out matter and milk, the 
glands so indurated that they have been apparently in a state of scirrhus or 
cancer, and when other physicians have treated them without the least benefit. 
Nor has the practice failed in a single instance : it is attended uniformly 
and invariably with the same success. 
Sometimes the pain is so great that it is necessary to give anodynes. 
Attention must be paid to the general health. 518 
THE REFORMED PRACTICE OF SURGERY. 
CHAPTER XL 
ST. ANTHONY'S FIRE. {Erysipelas.-) 
In this disease there is generally constitutional disturbance, more or less 
fever, and the secretions disordered. There is a shining redness and swell- 
ing of the parts affected, accompanied with very distressing irritation ; the 
inflamed parts being hot and painful, stinging, itching, smarting, and burn- 
ing sensation, with acute pain or pressure. Frequently serous or watery 
effusion takes place from the inflamed surface, elevating the skin into small- 
er or larger vesicles, like those produced by blisters ; or raising it by a soft, 
yellow, jelly-like deposite, which remains slightly adherent to both the cutis 
and cuticle. The contents of the vesicles are transparent, sometimes nearly 
colourless, but more commonly yellowish ; sometimes they consist of a thin 
pus or matter, or they may exhibit a bloody or livid discolouration. The fluid 
loses its clearness, becoming thicker, opaque, and whitish or yellowish. The 
cuticle gives way; the fluid escapes, and incrustations form, which soon fall 
off, leaving the skin sound ; or they may lead to superficial ulcerations. 
Erysipelas sometimes produces gangrene, but this is of comparatively rare 
occurrence. Ulceration sometimes follows, and becomes very tedious 
and distressing; red, deep-seated ulcers being formed, particularly on the 
legs. It appears in various parts of the body, more especially the ears, eyes, 
face, and extremities, and attacks persons of gross habits. It proceeds from 
morbid or acrid secretions retained in the system. 
I attended one lady who had the complaint in her eyes, which made her 
blind, and the lids ulcerated ; but she entirely recovered. 
The following singular occurrence shows that erysipelas proceeds from a 
specific poison : " At Worcester, Massachusetts, on the twenty-eighth ulti- 
mo, (May, 1842,) Mr. Samuel Harrington, aged fifty years, an undertaker, 
and his wife Nancy, both died of erysipelas, contracted by Mr. H. from a 
corpse which he assisted in laying out on the twenty-third of April. A 
daughter very narrowly escaped death from the same cause. While adjust- 
ing the head of the corpse in the coffin he got erysipelas matter from the 
deceased person into a slight cut in the ball of one of his thumbs, made with 
a glass a few days previous. Shortly after he experienced a sensation of 
heat and smarting in the thumb, and very soon erysipelas distinctly mani- 
fested itself about the cut, and, extending through his entire arm, proved fatal. 
His wife and daughter both contracted the disease while attending him." 
Treatment.-From the derangement of the digestive organs, it is obvious 
that purgatives should be given. Senna, manna, and cream of tartar, with 
a little fennel seed, to prevent griping, answer a good purpose. A dose of 
this should be given every other day, or twice a week, according to circum- 
stances. During the day the patient may take a strong decoction of elder 
flowers ; they are laxative, cooling, and alterative. These medicines, by 
their depletive and refrigerant operation, diminish the inflammatory symptoms. 
I have found that the vapour bath is attended with a very excellent effect 
in this complaint. One single bath will sometimes remove all the heat, 
swelling, itching, &c. I think it is better when so contrived that the head, 
as well as other parts of the body, be exposed to the heat or steam of the 
herbs. The good effects, I suppose, depend simply upon the discharge from ST. ANTHONY'S FIRE. 
519 
the skin, or the perspiration produced. The acrid humours, which appear 
to he the exciting cause of the complaint, are expelled from the system by 
restoring this secretion. If it be inconvenient to use that kind of vapour 
bath which admits the application of steam to the head, the common domes- 
tic vapour bath may be substituted. Sudorific medicines, then, are indis- 
pensably necessary in the treatment of St. Anthony's fire, or erysipelas: 
external or local applications are also very valuable in every species or stag© 
of this disease. The inflamed parts may be often anointed with the brown 
ointment. Some have an idea that any preparations of oil are injurious ; but 
this idea is not correct, as I have proved by ample experience. The opinion 
has been formed, no doubt, in consequence of uniting with greasy or oily 
substances acrid or stimulating agents. The parts should be frequently 
washed with the following liquid or tincture: Take of the leaves of garden 
celandine, one ounce; Irish whiskey, or, as a substitute, common whiskey or 
spirits, one pint; add the leaves, and after it has stood a few hours it is fit 
for use. Let this be applied three or four times in the course of the day, or 
when there is much itching. When the extremities are the seat of erysipe- 
las, and when the swelling and inflammation are very great, the following 
will be found a good application : Take borax, one drachm ; sugar or acetate 
of lead, half a drachm ; rain or soft water, one porter bottleful; pulverize the 
articles, and add them to the water. Let linen cloths be dipped in this mixture, 
and kept upon the parts affected. But of all the articles or preparations 
which I have ever used for erysipelas, in any stage of it, I have found a 
poultice made of the slippery elm bark to he the most decidedly beneficial. 
Indeed, in this, as well as in every other inflammatory affection, it proves a 
sovereign remedy. If the patient is in even the greatest distress, he expe- 
riences relief as soon as it is applied. The superfine flour of the bark should 
be mixed with pure milk ; and, what is sometimes preferable, buttermilk or 
fresh cream, when it can be procured. 
If this disease terminates in ulceration, or gangrenous blisters appear, a 
little of good brewer's yeast must be added to the same poultice. Where 
there is an ichorous discharge, apply a little of the elm bark, powdered, to 
absorb it. Some are in the habit of using burnt rye meal in this disease, 
which, no doubt, is in some degree serviceable. A continuance in these 
means will, in a short time, arrest the disease, and soon remove it. Nothing 
stimulating or heating must be given to the patient. A cooling diet should 
be recommended, consisting principally of milk, vegetables, and ripe fruit. 
I have applied best Irish whiskey, or, as a substitute, best Jamaica spirits, 
to the parts with the most signal benefit; it affords immediate relief,and 
may be used whenever there is much heat and irritation. I recollect one 
case on the face, which it apparently cured when all other means failed. 
Free purging and a low vegetable diet are very important. In some cases 
I have found the black or pussy willow bark, pulverized, and mixed with 
cream or milk, superior to the elm bark: the last case I attended improved 
rapidly under it. The root beer recommended in this work is also very good, 
and aided much in curing one bad case. 
Henry states, in his Herbal, that beech drops are very beneficial in St. 
Anthony's fire and canker in the throat. In four quarts of water put eight 
ounces of beech drops ; boil it down to two quarts ; strain the decoction, and 
sweeten with loaf sugar. After proper evacuations the patient may take a 
tea-cupful four times a day, and keep linen rags, wet with the decoction 
before it is sweetened, over the inflamed parts until it is well. 520 
THE REFORMED PRACTICE OF SURGERY. 
A physician states that he cured a case of St. Anthony's fire by the 
application of elder ointment. 
I lately successfully treated an extraordinary, painful, and obstinate case 
of erysipelatous inflammation in one of the lower extremities, in which 
the patient's life was considered almost hopeless ; great swelling and pain, 
which occurred in paroxysms, brought on by a slight change of position ; 
he was obliged to sit in a chair for five or six months, day and night ; and had 
received the advice and consultation of Stevens, Rogers, and Bowron, of this 
City, without the least benefit. Steaming, fomenting, poulticing, and all our 
common remedies, for about two months, made but very little improvement; 
every watery application aggravated it: I then commenced the use of the 
pulverized black willow bark, commonly called pussy willow ; it was mixed 
with cream, and applied three times a day, under which it grew better; it 
sloughed in several places nearly to the bone; after most of the pain had 
subsided, 1 applied the slippery elm bark and milk, and subsequently the 
black salve, which effected a cure in about five months, to the disappoint- 
ment and gratification of the patient and all his friends. The name of the 
patient was Mr. Timothy Youle, of the Mechanics and Traders' Bank of 
this city. 
I have attended another case, of a girl, attacked with inflammation in the 
hips and whole system; her pulse was 130 in a minute ; the pain very 
great; the muscles so contracted that she was distorted in a most horri- 
ble manner, and rendered perfectly helpless ; and it was thought that 
she could not survive from one day to the other. It had arisen, it was sup- 
posed, in consequence of having taken mercury ; sloughing took place on 
each hip, from the bone. Under our common treatment she slowly recovered, 
and in four or five months was able to sit up ; she is now well, and can 
walk with a cane, although the pelvis is thrown in a very unnatural position, 
and must ever remain so. Her general health, however, is excellent, and I 
think she will yet be able to walk without crutches, although so much 
deformed. 
Since writing the above I have seen the patient, and she is able to walk 
without crutches ; and will be less deformed than I anticipated. 
CHAPTER. XII. 
LOCKED-JAW. 
Sometimes this disease arises without any previous injury, more especially 
in warm climates, and near the sea. Robust, vigorous, middle-aged men are 
more liable than others. 
In the majority of cases locked-jaw comes in consequence of stabs and 
punctures in tendinous parts, and about the fingers and toes; and this fre- 
quently when the wound heals kindly. 
Symptoms.-The muscles of the lower jaw become contracted and hard ; 
at length the patient cannot open the mouth at all. A difficulty of swallow- 
ing succeeds, resembling hydrophobia. The muscles of the neck and back, 
and, indeed, of the whole body, become successively affected with violent 
spasms. The symptoms are sometimes rapid, at others slow in their progress LOCKED-JAW. 
521 
If the patient survives the fourth day, there is a chance of his recovery. The 
symptoms never recede but by slow degrees. 
Treatment.-There is no disease which is treated with such a variety 
of medicines as the locked-jaw. There are as many different applications 
as there are physicians, none of which seem to have much effect. 
When the tetanus proceeds from a wound, as is frequently the case, the 
attention should be chiefly directed to such wound. It will be usually 
found that an unhealthy or ill-conditioned state of it is the exciting cause 
of the disease. There is either no discharge, or it consists in an unhealthy 
or a sanious matter : hence the importance of applying such agents as will 
bring about a healthy state of it. If the situation will admit, the'parts should 
be fomented or steamed over bitter herbs, after which they must be bathed or 
held in hot ley three times a day, one hour each time. A captain of a vessel, 
in one of the eastern states, was cured of a severe attack of the locked-jaw 
by bathing the part in ley as hot as could be borne. 
When it has been thus bathed let a poultice be applied, made of slippery 
elm bark stirred in the ley, and applied warm ; and let it be often thus steamed 
and poulticed. To the wound itself let the vegetable caustic be applied 
whenever it is dressed ; as a substitute, the carbonate of potash may be 
used ; it is not, however, so powerful. 
When the muscles become stiff', rigid, and contracted, let the patient be 
thoroughly sweated by means of the vapour bath, made by putting a strong 
decoction of bitter herbs into a small tub, and placing the patient over, with 
a blanket around him to retain the steam. At the same time let him drink 
a tea or infusion of catnip. After this he should be put to bed, and covered 
warm, in order to keep up a perspiration. If the symptoms of the com- 
plaint continue, and if there be spasms, rigidity, affection of the throat and 
jaws, give the patient a table-spoonful of the tincture of lobelia, diluted 
with any kind of tea, every twenty minutes until it operates as an emetic. 
When the jaws have been so closed that no medicine could be introduced, 
I have known this to cause an immediate relaxation of the muscles, and open 
them. If the symptoms are very severe, a tea-spoonful of the tincture of 
capsicum may be added to the tincture of lobelia. If these medicines do not 
control the disease, or if the patient does not receive essential benefit from 
their exhibition, administer the black drop. When the case is very urgent, 
a tea-spoonful may be given ; but the physician should be governed by the 
violence of the symptoms ; or a pill of opium the size of a pea every four 
hours till relief is experienced. If called to a case where there is any diffi- 
culty of administering any kind of medicine, injections or clysters should be 
administered, made with a strong decoction of lobelia, mixed with half its 
quantity of milk, and sweetened with molasses, to which a little sweet oil 
must be added. To each injection from half an ounce to an ounce of lau- 
danum may be added. It will not be requisite to use this, unless the other 
means fail. 522 
THE REFORMED PRACTICE OF SURGERY. 
CHAPTER XIII. 
CARBUNCLE. {Anthrax.) 
Description.-A deeply-seated, hard, immoveable, and distinctly circum- 
scribed tumour, generally appearing in the posterior parts of the body, and 
most frequently attacking people above the middle age, and luxurious livers. 
About its centre it is of a dusky red, purple, or livid colour; but is much 
paler, and often variegated, toward its circumference. There is often an ex- 
tensive areola of a brownish hue. It is accompanied with an intensely pain- 
ful sense of burning ; small purulent matter or pustules appear, which, when 
ruptured, evacuate a dark-coloured matter. 
It usually commences with a small pimple, which runs deeper and deeper 
until the base becomes extremely broad. In the beginning it is sometimes 
accompanied with symptoms of general inflammation, but more commonly 
with chills, sickness, faintings, succeeded by great prostration of strength, 
languid pulse, and symptoms of typhus. It not unfrequently degenerates 
into a sloughing ulcer. 
Sometimes a little slough, of a black colour, appears in the middle of the 
tumour. The progress of carbuncles to the gangrenous state is generally 
quick. Their size is various; they have been known to be as large as a 
plate. Considerable local pain and induration always attend the disease. 
The skin, indeed, has a peculiar feeling, like that of bran. As the com- 
plaint advances several apertures generally form in the tumour. Through 
these openings there is discharged a greenish, bloody, fetid, irritating matter. 
The internal sloughing is often very extensive, even when no signs of mortifi- 
cation can be outwardly discovered. 
Treatment.-The treatment of carbuncle may be commenced by foment- 
ing or steaming the part with bitter herbs, as directed for some other inflam- 
matory complaints. This should be repeated whenever the pain is severe. 
After this let the following poultice be applied : Take equal parts of pul- 
verized linseed and slippery elm bark ; add a sufficient quantity of rain water, 
and simmer until the linseed becomes mucilaginous and a poultice of a proper 
consistence is formed. When it is cool, or about blood-warm, to every half 
a pint of the mass add a wine glassful of good yeast, and let it be well mixed ; 
apply to the carbuncle tepid, and renew it before it becomes dry: this 
will be found to have a very salutary effect upon the disease, and will lessen 
the pain, swelling, and inflammation, while at the same time it has a tendency 
to promote suppuration. After some length of time little orifices will be 
seen in different parts of the carbuncle, through which a peculiar matter, 
sometimes resembling water mixed with flour, discharges, and it will often, 
after a while, be converted into a pulpy or soft substance, which will slough 
off, and leave a deep opening; the symptoms of it very much resembling 
mortification. After the inflammatory symptoms have in a considerable 
degree subsided, although erysipelatous inflammation is the characteristic 
symptom of this complaint, stimulating applications may be used, such as 
pulverized blood-root. A small quantity of the vegetable caustic may be daily 
sprinkled upon the ulcer, and the poultice continued. But if the disease 
has subdued in a considerable degree, the black plaster may be applied to it, 
particularly during the day. Every time it is dressed it should be cleansed SCROFULA OR KING'S EVIL. 
523 
with soap, water, and brandy ; after which pledgets of lint may be laid in the 
opening. Carbuncle is attended with much pain, itching, and burning; 
it will, therefore, be found beneficial to wash it often with cooling lotions and 
ointments. If the poultice mentioned should in any respect disagree with the 
patient, which it may possibly do in the first stages of the complaint, it may 
be omitted, and one made by boiling the bark from the root of sassafras, and 
mixing the elm bark with the decoction, substituted ; this makes an excel- 
lent poultice for this and other kinds of inflammation. The patient must take 
such medicines and diet as are calculated to impart tone and energy to the 
system, as carbuncle appears to be a disease arising from debility : a purga- 
tive to be occasionally administered, and the patient may take yeast; and, 
if he is very weak, porter and Madeira wine, and through the day an infusion 
of Virginia snake-root, might be used. Should there be any febrile symptoms 
present, perspiration must be promoted. This course will be found very 
effectual. 
CHAPTER XIV. 
SCROFULA OR KING'S EVIL. 
Description.-The scrofula was so called, as is supposed, in consequence 
of swine being subject to this disease ; and it is vulgarly called the " King's 
Evil," from the custom of submitting patients to the royal touch. 
The disorder consists in hard, indolent tumours of the glands in various 
parts of the body, particularly in the neck, behind the ears, and under the 
chin, which, after a time, suppurate and degenerate into ulcers, from which, 
instead of pus, a white curdled matter, somewhat resembling the coagulum 
of milk, is generally discharged. 
The first appearance of the disease is most usually between the third and 
seventh years of the child's age ; but it may arise at any period between these 
and the age of puberty, after which it seldom makes its first attack. It most 
commonly affects children of a lax habit, with a smooth, soft, and fine skin, 
fair hair, rosy cheeks, and a delicate complexion ; but it is occasionally met 
with in those of a dark one. 
The glandular system appears to be almost entirely, if not exclusively, 
the seat of the disease ; and in almost every instance it is located in the con- 
globate glands of the neck. It was denominated the king's evil in the time 
of Edward the Confessor, the first who attempted to cure it by the royal 
touch. From a register kept in the royal chapel, we find that Charles II. 
touched 92,107 persons in a certain number of years. 
Writers, from their representation, make out almost every morbid taint 
of the system to consist of the scrofula. The hip disease, white swelling, 
chronic ophthalmia, and every morbid affection of the system, by them is 
pronounced " scrofulous." The term is entirely too extensive, at any rate, 
for practical purposes. 
A physician of this city was called to a boy who had a white swelling in 
the knee, and, upon being asked what it was, he said it was a scrofulous 
affection ; on which the. mother asked him if he meant the king's evil, when 
he replied in the affirmative I 
It has been supposed by many that the scrofula is hereditary ; but we have 
no evidence of this, as it often appears in families whose predecessors, as 524 
THE REFORMED PRACTICE OF SURGERY. 
far as they can be traced, have never had a vestige of it. Children born of 
scrofulous parents are not invariably affected with scrofulous diseases ; and 
sometimes one child has some strumous affection, while the parents and the 
rest of the family have no appearance of scrofula. 
Symptoms.-Among the earliest, the most frequent, and most characte- 
ristic symptoms of the disease, are swellings of the absorbent glands, particu- 
larly those of the neck. Such tumours sometimes continue for a long time, 
neither advancing nor receding, unattended by pain or any constitutional dis- 
turbance. Sometimes they subside spontaneously, but more frequently sup- 
puration of an imperfect kind gradually takes place in them, followed by 
open ulceration. The ulcers heal slowly, leaving ragged and purple scars, 
and are succeeded by other tumours, which run a similar course. In this 
manner the disease is often kept up for a series of years, until at length the 
constitution either throws it off, or it appears under some of its more severe 
and dangerous forms. 
The whole gland and cellular substance often becomes extremely ulcerated, 
and frequently numerous openings, through which matter is discharged. 
Scrofulous inflammation, as Burns observes, is marked by a soft swelling 
of the affected part, which very frequently is one of the lymphatic glands. 
The covering or coat of the gland becomes slightly thickened, and its sub- 
stance more porous and doughy. The swelling increases, and the doughy 
feeling changes by degrees into that of elasticity or fluctuation, and a firm, cir- 
cumscribed, hardened margin can be felt around the base of the tumour : the 
skin is slightly red. If at this time an incision or puncture be made, either 
no matter or very little is evacuated; the lips of the wound inflame and 
open, displaying a sloughy-looking substance within ; and between this and 
the skin a probe can often be introduced for some distance all around. 
Treatment.-There is nothing very definite in the treatment of this dis- 
ease laid down by physicians. It is considered by them incurable, and very 
little is done for it. Mercury is given by some, but with a decided injurious 
effect. 
" For the cure of scrofula," says Cullen, " we have not yet learned any 
practice that is certainly, or even generally, successful." 
There are four particular states of this disease, which must be kept in view 
in treating it: 
1st. A state of inflammation. 
2d. A state of abscess or ulcer. 
3d. A state of tumour or scirrhus. 
4th. A state of constitutional affection. 
1st. A State of Inflammation.-When the disease attacks a person with 
pain, swelling, and inflammation, the ley poultice, and others recommended 
under the head of inflammation, may be applied. Let them be continued 
until the swelling subsides, either by or without suppuration ; but it is very 
difficult, if not impossible, to disperse scrofulous swellings, attended with much 
pain and inflammation. You may apply a poultice made of the yellow or 
narrow-leaved dock, by bruising or pulverizing the root, simmering it in milk, 
and then adding a sufficiency of the elm bark to form a poultice, to be applied 
the same as the one preceding. 
2d. State of Abscess or Ulcer.-When the swelling or the abscess breaks, 
or suppuration takes place, our next object will be to bring the ulcer into a 
healthy state and heal it. As before stated, these ulcers assume a very in- 
dolent and inveterate character, and, therefore, require altogether a different 
treatment from that usually pursued to cure them. We must be governed SCROFULA OR KING'S EVIL. 
525 
in our applications, in some degree, by the state of the ulcer. If it be well 
opened, and no orifice is connected with it, let the following dressings be 
applied: 
1st. Thoroughly cleanse the ulcer with soap, water, and spirits ; after 
which apply to the ulcer a little lint, and over this the following salve or 
plaster : Take bayberry tallow, one part; white turpentine, two parts : mix, 
and melt over a slow fire ; then strain, spread upon a piece of linen, and 
apply to the ulcer. In some seasons and latitudes a little sweet oil is ne- 
cesary, to make the plaster of the right consistence. Let this dressing be 
continued through the day. Apply also the black salve. 
During the night use the following poultice : Take the bark of the root of 
bayberry, (myrica cerifera,) a sufficient quantity: bruise or pulverize ; then 
add rain or soft water, and simmer until it is soft ; after which stir in suffi- 
cient Indial meal to form a poultice, and continue during the night; it 
may be used during the day, provided there is any pain or inflammatory 
symptoms present. The original poultice was directed to be made in this 
manner; but I find that it is a considerable improvement to substitute the 
elm bark instead of the Indian meal, as it makes a better poultice. 
I have found, by experience, the bayberry to be one of the most extraor- 
dinary remedies in scrofula, particularly in a state of ulcer, of any other 
article, either in the animal, vegetable, or mineral kingdoms ; and if there 
is a specific in this complaint, I think it is this very plant or shrub. I have 
never yet known it to fail in a single instance, in all my practice, in the most 
advanced and worst stages of the complaint, and when they have been 
treated without any benefit by our most popular physicians and surgeons. 
I have hitherto spoken of scrofula in a state of ulcer. I shall now give 
directions for the treatment of it in a state of ulcer connected with a sinus 
or orifice. 
By a close examination often a small opening will be seen, penetrating 
deeply into the integuments or cellular substance, even to the bone, denuding 
the periosteum, and from this issues either a thin or thick matter. When 
such an opening is found or discovered, it should be kept open and freely 
discharging, by the use of tents made of twine drawn through beeswax or 
adhesive plaster, and then rolled in the vegetable caustic, and introduced as 
far into the sinus as possible. 
In addition to this the sinus must be injected, by a proper sized syringe, 
morning and night, with a strong concentrated decoction of the bayberry bark, 
alternately with a solution of the vegetable caustic ; a tea-spoonful to half a 
pint of water. Other astringent decoctions may be injected, as oak bark 
and balm of Gilead; and disentients applied. 
The black salve may occasionally be substituted for the plaster first men- 
tioned. 
When the bone is diseased, which may be ascertained by the grating sen- 
sation which is communicated when probed, a few grains of the vegetable, 
caustic must be introduced to the bottom of the sinus, and a solution of the 
same daily injected. 
3d. State of Tumour or Scirrhus.-This variety or species of scrofula is 
very frequent. Hard, indolent, inert, and indurated tumours appear in the 
glands of the neck, which often continue a long time very stationary ; at 
other times they slowly increase. Sometimes they are very painful, at other 
times they give none at all ; but sooner or later, if they are not dispersed, 
they degenerate into malignant and scrofulous ulcers. 
In the treatment of these tumours our first attempt should be to disperse 526 
THE REFORMED PRACTICE OF SURGERY. 
or discuss them, to effect which apply the discutient ointment. Rub the 
tumour well with the ointment three or four times a day : a poultice made 
of the poke root, simmered in rain water till soft, and then mashed, may be 
applied. It will be found very beneficial to bathe the tumours with salt and 
water, or best French brandy saturated with it. The ulcer may like- 
wise be bathed with it. 
Miss Hunt, of East Chester, N. Y., whom I recently cured of a cutaneous 
disease of long standing, and very inveterate, disfiguring the whole face with 
callous pustules, &c., informs me that she derived great benefit from the 
following ointment. It diminished or removed the hard tumour under the 
skin very effectually : Hydriodate of potash, one ounce ; lard or fresh but- 
ter, four ounces : rub well together, and apply to the parts affected morning 
and evening. 
A young lady of this city informs me that she found great benefit from 
the use of the following ointment, in a large scrofulous tumour, seated on 
the parotid gland of the neck : Take common sponge, Q. S., burn to ashes, 
which mix with lard a sufficient quantity, and apply to the tumour two or 
three times a day. One drachm of the ashes of the sponge to one ounce of 
lard, well mixed. These applications will sometimes discuss these tumours 
even when very large, if aided by proper internal medicine. 
I recollect, however, having one case, on the neck of a young lady of this 
city, of very long standing, so large and so indolent as not only to baffle the 
skill of several physicians, but likewise my own. In this case I applied a 
cancer plaster, which removed it. 
I am not very partial to this method, as it excites considerable pain, 
and requires skilful management. But it is seldom, if ever, required, 
if the means I have recommended be properly applied, and persevered in a 
suitable length of time. ■' 
When all means fail to discuss the tumour, mild dressings must be applied, 
until there are symptoms of inflammation or suppuration, and then it must 
be poulticed, as before directed. I removed a tumour with the brown 
ointment. 
Constitutional Affection.-It appears that there is generally a scrofu- 
lous diathesis, or state of the system which may be known by a peculiar 
haggard and pale countenance, flabby muscles, and small tumours appearing 
in the glands in different parts of the body, attended with a considerable 
degree of debility, with more or less derangement of the digestive organs. 
When such symptoms present, give the following decoction : Take yellow 
and bark of the bitter-sweet, of each a pound, bruise : add a sufficient 
quantity of water, and boil till all the strength is extracted, and reduced to two 
quarts ; strain, and add four pounds of sugar ; then boil a few minutes, to 
form a syrup: of this give to a child five or six years old from half a wine 
glass to a wine glassful three or four times a day. As a change, give the 
alterative syrup, to every quart of which add one ounce of the hydriodate of 
potash. Both are exceedingly well calculated to eradicate a scrofulous or 
other taint of the system. In addition to this the patient should take a 
purgative at least once a week. If small tumours are perceived in any 
part of the body, let the discutient ointment be applied to them three oi 
four times a day, and also bathed with salt and water. 
By pursuing this treatment I have succeeded in curing the most formi 
dable cases of scrofula on record, one of which I here represent by the 
annexed figure. SCROFULA OR KING'S EVIb. 
527 
Fig. 8. 
The subject of the disease was a coloured man, then residing in Trenton, 
N. J. The swelling and inflammation were prodigious, and several physi- 
cians, who were first called, appeared to consider the case entirely hopeless. 
One of them observed that whoever cured the disease should be pronounced 
" King of Doctors." It was first poulticed with the green root of Indian 
turnip, (arum triphyllum,) until suppuration followed, with fifteen different 
apertures or orifices, through which the pus or matter discharged. I now 
injected the alkaline liquid, and it issued through every one of them. Tents 
were used, to prevent the ulcers from healing; a plaster kept upon the 
swelling, and in other respects treated in the usuflft manner. It improved 
daily, till it healed perfectly sound, leaving but very small scars immediately 
over the sinuses or apertures. 
May not the bayberry (the principal article used in the cure of this com- 
plaint) derive some of its medicinal effects from the muriate of soda which 
it imbibes from the salt water, near which it grows; or upon some peculiar 
organization arising from it ? 
It is somewhat remarkable that the bayberry should only grow near the 
sea-coast or salt water; which is known often to exert 4ome beneficial effect 
on the patient by bathing with it. 
Regimen.-The patient must be confined to a nutritious diet, principally 
milk. He should bathe once a week in salt water, and, if convenient, should 
live near it, in the country. 
Salt water bathing used daily is exceedingly efficacious in removing a 
scrofulous taint of the system, rickets, white swelling, debility, and parti- 
cularly those tumours and indulated glands so common to children. The 
last case I treated was seated and very severe, swelling immense, and no 
relief. He recovered very fast by giving the alterative powders, with the 
hydriodate of potash, bayberry, and elm bark, mixed with salt water for a 
poultice. Salt water bath daily, and a milk and vegetable diet. 
A short time ago Mrs. Bonsai, from Lebanon, Ohio, consulted me for a 528 
THE REFORMED PRACTICE OF SURGERY. 
very severe, protracted, and almost hopeless case of scrofula. It had con- 
taminated her whole system: debility, serious cough,ulceration,and tumours 
of the neck extending under the arm. I gave once or twice a week man- 
drake physic, alterative powders, our cough medicines, and applied discutient 
ointment to the parts,pulverized blood-root to the ulcers, and injected a decoc- 
tion of the same into the openings. Under this treatment she recovered 
very fast, and, I believe, is now well. 
In another very serious case I pursued the same treatment, with the 
addition of hydriodate of potash to the syrup, and applied to the parts an 
ointment made by simmering the tincture of stramonium, hyoscyamus, and 
bark of the bitter-sweet, equal parts, in fresh butter or lard till the tincture 
evaporated. It cured in a few weeks. As a substitute for the salt water 
bathing, add plenty of salt to common soft water : the water may be first 
tepid, then gradually colder, but no chill must be produced. 
CHAPTER XV. 
FISTULA. 
The term fistula is generally applied to those kinds of ulcers which are 
very obstinate in their character, and which are attended with hardness, and 
sinous openings or orifices with callous edges ; there are three species enu- 
merated : 
1. Fistula in ano, when situated in or near the rectum or anus. 
2. Fistula in perinao, when situated in the perinaeum, and communicating 
with the urethra. 
3. Fistula lachrymalis, a sinous ulcer, situated in the inner canthus or 
corner of the eye, obstructing the lachrymal duct. 
Fistula in Ano.-Description.-By fistula in ano we understand a 
most serious, loathsome, and troublesome disease, which is located in the 
vicinity of the anus and rectum, and appears in the form of abscess and sinous 
ulcers, emitting a fetid discharge, with callous edges. 
" It is a disease," says Sir A. Cooper, in which you w'ill be called upon 
to operate more frequently, perhaps, than any other. I do not consider it a 
disease which is very easy to treat: it very often baffles the skill of the best 
surgeons." Dorsey says it is very difficult to be healed ; and this statement 
is confirmed by the many cases which remain uncured, as well as the fatality 
which attends it. Henry VIII., King of England, it is stated, died of this 
disease. 
Causes.-The causes of fistula are numerous; such as costiveness and 
relaxation of the bowels, derangement of the liver and alimentary canal, 
sedentary habits, high living, plethora, bruises, piles, &c. It is often con- 
nected with, and probably produces, a pulmonary disease. 
Symptoms.-The fistula in ano usually commences with swelling near the 
rectum, attended with great pain, hardness, and acute inflammation ; the 
tumour advances slowly to suppuration, and matter is formed. 
In some cases, however, the disease proceeds till a sinus is formed, with 
Very little pain-so much so, that the patient is ignorant of the time when 
't formed; but more generally the pain is very severe, swelling great, and FISTULA. 
529 
suppuration very extensive; and, in consequence of the pressure upon the 
neck of the bladder, or urethra, there is a suppression of urine. 
Fistula in ano is more painful than a common abscess. The patient is in 
most excruciating pain when the faeces are voided ; great pressing down, and 
very often retention of urine. There is considerable variety in the size and 
complication of fistula. Sometimes the sinus is confined to one side of 
the intestine; in other cases it nearly surrounds it Sometimes the fistu- 
lous sinus is very short, penetrating the anus a little above the ring or open- 
ing ; at other times it is several inches deep, and extends near the os coccygis, 
or end of the spine ; at other times it burrows to a great distance behind the 
gluteal muscles. I have seen cases where it appeared to extend underneath 
and above the spinal bone. I have seen cases, also, where the whole sur- 
rounding integuments and cellular substance were in a state of sinous suppu- 
ration or fistulous abscess; and the flaps or edges of the ulces projected an 
inch, and from which issued the most fetid and sanious matter : this happens 
more generally where there is a faulty state of the constitution. 
Sometimes there is a communication between the bladder, vagina, os sa- 
crum, and other contiguous parts ; and when so, matter issues through every 
opening, and the very fieces or contents of the intestine (when the bowels 
are very soluble) are also discharged ; thus constituting an artificial anus. 
In the commencement of the disease the adjacent parts are generally sound ; 
but whenever the ulcer has been of long duration, not only the parts about 
the anus, but even the perinaeum and buttocks frequently become diseased. 
This may depend on different causes ; but it appears most frequently to pro- 
ceed from the matter of the abscess or sinus not finding a free outlet, and 
thereby spreading along the contiguous cellular substance, with numerous 
sinuses running in different parts ; and the matter from them is usually sharp 
and acrid. 
The most common form of the fistula in ano, after suppuration has taken 
place, is an opening or orifice extending from the verge of the anus, and 
running obliquely, and penetrating it or the rectum at a greater or less 
distance from its termination. This sinus has very hard, callous edges 
throughout its course ; and the longer it has existed, the greater is the cal- 
lous or hardness. It sometimes communicates with an internal cavity near 
the intestine ; and, although it may not penetrate it immediately, which is 
somewhat doubtful, it does eventually, as far as my experience goes, in every 
instance. If a probe be passed up the orifice and a finger up the anus, this 
communication can be easily detected. 
Sometimes there are two sinuses in the same neighbourhood, or very near 
each other, and communicate together ; at other times one is directly oppo- 
site the other, or a considerable distance from it. From this opening issues 
a thin or thick matter or pus, and it is often very copious ; but occasionally 
there is very little, or none, for a certain period : sometimes it will heal up 
for several days, then give considerable pain, break out again, and freely 
discharge. 
These symptoms depend very much upon the general health and habits 
of the patient; but, be they ever so good, such is the inveteracy of & fistula 
in ano, that a spontaneous cure is seldom or never known. It generally 
continues to increase and grow worse, until there is an absorption of the 
fistulous virus or matter, which is translated to the lungs, and ends in con- 
sumption. 530 
THE REFORMED PRACTICE OF SURGERY. 
The following figure (fig. 9) represents an ordinary fistula. Number 1 
shows the anus; number 2, the sinus; and number 3 the nates or verqe 
of the anus. 
Fig. 9. 
Treatment.-The common method of treating a fistula in ano is, by a 
surgical operation, which consists, 1st, in making a common opening of the 
fistula with the rectum or the anus. A knife or bistoury is forced up the 
opening or orifice until it communicates with the bowel or intestine; the 
finger is passed up the rectum until it meets it, when both are drawn down 
together, which makes one common opening. It is afterward dressed simply 
■with lint, and attempts made to heal it. 2d. Some recommend this operation 
alone, while others attempt to cut out the whole diseased flesh or fistula 
This course has been pursued by surgeons for a great length of time, both 
in Europe and America, but the practice is neither rational, philosophical, nor 
effectual. It is inconsistent with correct principles of the healing art; and, 
although, like many other operations, is sanctioned by the highest authority, 
it ought to be abandoned. My objections to the operation are, 1st, it is 
exceedingly painful; 2d, it is dangerous, sometimes proving fatal by irritation, 
inflammation, and mortification that follows ; 3d, it is very uncertain in its 
effects, seldom or never effecting a cure, even after several operations have 
been formed ; 4th, because I have a safer, milder, more effectual, and a radi- 
cal cure for the disease, without the use of the knife. 
Ever since I commenced the practice of physic I have been endeavouring 
to ascertain the merits of the ordinary treatment for this complaint. I have 
seen many on whom the operation has been performed, and some repeatedly, 
and I have found only one person during all that time who was really cured, 
and he suspected that he was not sound ; besides, he came near losing his 
life by the extensive cutting, or incisions which were made. He informed 
me that such was the fetor occasioned by the wound made by the operation, 
that it was almost impossible to stay in his room. Another man informs me 
that he had been operated upon five times for the fistula in ano, and still 
he was not cured. Among the number of patients afflicted with this com- 
plaint who have applied to me, a considerable proportion of them had under 
gone a formidable operation for it; and, instead of having received any benefit, were only injured; and this effect must be obvious to every rational person 
who reflects upon the pathology or the nature of the disease. I would ask 
how the act of merely dividing a diseased or indurated mass of flesh can 
remove it ? especially when we take into consideration the morbid connexion 
that always exists between contiguous parts. It is well known that a simple 
incised wound readily heals; and if inflammation be the object of perform- 
ing the operation, as some assert, it is quite insufficient to accomplish the 
purpose. Not only so : as soon as there is a common opening made between 
the fistula and the anus, it is very difficult to apply such dressings to the 
ulcers as are calculated to remove it. They cannot be applied directly to 
the diseased parts ; and if they were, when the fieces pass the bowels they 
would probably be removed. 
It is true, I have heard of some cures performed by the knife; but, upon 
strict inquiry, and upon the minutest examination, 1 know not that I have 
ever witnessed a solitary case in which a permanent cure had been effected, 
although occasionally, I think, the suppuration that follows it has proved 
effectual. 
Again ; how is it possible that a cure can be effected when the sinus is 
highly situated, very extensive, and beyond the reach of the finger ? In such 
a case there is no chance or opportunity of curing it. 
The after dressings, it is stated by every patient who submits to the opera- 
tion, are as painful as the operation itself; and this he must daily submit to, 
besides the necessity of being confined to his room or bed for a great length 
of time. Not only so: the consequence which follows such treatment is 
sometimes deplorable. The sphincter ani is often cut, and the patient is 
unable to retain his stools, and they pass off involuntarily, with other per- 
nicious effects which might be mentioned, such as haemorrhage or bleeding, 
in consequence of cutting an artery. 
What man, then, in his sober senses, will suffer a knife to be thrust up his 
bowels, and the parts ripped open and mutilated, without any prospect of acure, 
when it can be removed by an easy, safe, and scientific course of treatment ? 
The practice, then, is cruel, unnecessary, and wrong. 1 know, by long and 
repeated experience, that the fistula is curable by means which are more 
expeditious, more easy, and neither hazardous in the use nor productive of 
evil in the event. It is true, the method which I pursue will dispense with 
the knife, such a favourite with many, wholly and entirely ; but it will be 
attended with success, and produce that which every patient has a right to 
expect from his physician or surgeon--a speedy and permanent cure, without 
confinement to his room or house, and with ability to attend daily to his 
ordinary business. 
I shall now give an improved method of treating this disease, which I have 
found altogether superior to that now pursued, and which has invariably and 
infallibly, in my hands, succeeded in every stage of the complaint; and that, 
too, when our most popular surgeons have been unable to cure it by repeated 
operations. 
The treatment of fistula depends upon the stage in which we are called 
to prescribe. A very different course is required in a state of inflammation 
from that of suppuration or abscess. I shall first treat of the means to be 
employed in its incipient, forming, or inflammatory stage. First, moderate 
excessive inflammation ; second, diminish painful or urgent symptoms ; third, 
promote suppuration, if the swelling cannot be discussed; to accomplish 
which the discutient ointment may be first applied to the swelling ; imme- 
diately after which let it be steamed or fomented with bitter herbs, tanzy, 
FISTULA. 
531 532 
THE REFORMED PRACTICE OF SURGERY. 
wormwood, hoarhound, catnip, and hops, a handful of each: add water, and 
boil until the strength is extracted. Put the whole into a small or suitable 
sized vessel, and add about half a pint of soft soap. Place a narrow piece 
of board over the vessel or tub, and let the patient sit over it fifteen or 
twenty minutes, with a blanket thrown around him to retain the steam. A 
chamber or bed-pan is well calculated for this purpose. The process or 
steaming must be repeated morning and night, or as often as the pain be- 
comes severe. 
This operation, in almost every case, immediately relieves the patient; 
even when the parts are so tender that they cannot bear the weight of the 
bed-clothes, it so much diminishes the irritability and soreness, that the 
patient can afterward bear considerable pressure upon the swelling. In a 
word, it usually affords relief in the most painful stage of the disease; it 
not only allays the pain, but promotes either resolution or suppuration. 
As soon as the patient has been thus steamed, apply a poultice made of 
equal parts of powdered linseed and elm bark, mixed to form a proper con- 
sistence ; let this be applied tepid: about a table-spoonful of sweet oil may 
be added, which is cooling, emollient, and prevents it from adhering to the 
skin. It will be necessary to renew this poultice morning and night. 1 
have, in many cases, found a ley poultice excellent, where the other did not 
agree with the patient. Every time either poultice is applied, let the discu- 
tient ointment be rubbed on the swelling. 
It will be necessary, for the sake of convenience, as well as to secure the 
dressings, to use a bandage made by passing a piece of linen, of a suitable 
width, just above the hips, and fastened on the right or left side of the abdo- 
men with tapes or buttons; a piece fastened to this behind, and brought 
between the legs, and secured to the bandage around the body; likewise in 
front, or before, in the same manner. This will effectually secure the poul- 
tice and the other dressings. 
The following figure represents this bandage, and will enable any person 
to prepare it in a few minutes : 
Fig. 10. FISTULA. 
533 
When the pain prevents sleep, and should not the means recommended 
sufficiently mitigate it, a portion of the diaphoretic powders may be given at 
bed-time, or an opium pill. Perspiration should likewise be promoted, the 
feet daily bathed, warm tea drank, and the skin thus kept moist. 
It will be very necessary also to attend to the bowels : an emollient pur- 
gative should be given every day or two ; the cold-pressed castor oil is very 
good, the dose of which is an ounce. 
Sometimes the parts become so swelled that any kind of physic causes 
much pain. Under such circumstances injections must be relied upon. 
With this treatment the inflammation will gradually subside, and matter 
or an abscess will form, which is usually very large and extensive. This 
may be known by a subsidence of the pain, redness, and the tumour becoming 
softer, yielding readily upon pressure. Sometimes the pus or matter con- 
centrates, more especially to a certain part of the swelling, which projects a 
little, assuming a white appearance. When these symptoms appear an in- 
cision may be made to let out the matter, which I have occasionally done; 
but I prefer, where the patient is willing to wrait, to let the abscess burst 
spontaneously, or by the aid of the poultice, in which case there appears to 
be less callus or hardness remaining, and the sinus is not so liable to close. 
There seems to be a necessary digestive process for the fluids to pass through 
before matter is formed, or is in a proper state to be expelled. 
It is surprising to see what a vast quantity of matter these abscesses con- 
tain, and how fetid the discharge is. I once opened one in a female, who 
had been previously cut for the complaint, which poured out a stream of the 
most offensive fluid, and rendered it almost impossible to continue in the room. 
It soon discharged a quart. 
It is equally astonishing how extensive oftentimes are the ravages of this 
disease. I have seen the inner portion of the rectum completely denuded 
as far up as could be seen. I have seen it destroy the parts from the anus 
to the testicle, as well as for a great distance around it; also to extend into 
the vagina of women, and destroy the adjacent integuments to a considera- 
ble extent, in which case a portion of the matter is discharged by the vagina. 
When the disease becomes so seated or extensive, there is apt to be an ab- 
sorption of the fistulous virus or matter into the system, causing great con- 
stitutional debility and disturbance. Sometimes it is translated to the lungs, 
and terminates in the consumption. Indeed, this is the most usual method 
of its proving fatal. Having, then, arrived at a stage of the disease in which 
suppuration has taken place, there must be a variation in the treatment. 1 
mean after the matter has been well evacuated from the abscess, and the 
pain, swelling, and inflammatory symptoms have subsided ; for, until this 
has taken place, the same treatment must be continued, especially the poultice. 
It sometimes happens that even a real fistulous abscess will heal up after 
a short time, but generally there remains an indurated tumour, in the centre 
of which there is a small hole, orifice, or sinus, from which the matter dis- 
charges, and which extends a greater or less distance from the verge of the 
anus, running obliquely to the intestinum rectum, communicates with it lower 
or higher up, or at a greater or less distance from the end of the bowel or 
anus. The peculiarity and difficulty of curing this disease is the hardness 
or callus which lines the sinus. It is sometimes almost as hard as ligament, 
or as tough as a piece of whitleather ; and a person familiar with the disease 
can trace the course of it from one end to the other with his finger, without 
ever seeing it. It is owing to this characteristic symptom that opening it 
with the knife or bistoury with the rectum is so ineffectual. 534 
THE REFORMED PRACTICE OF SURGERY. 
Our next object, then, will be to remove this hardness, and place the ulcer 
in a condition to heal; to effect which we have only to act in the capacity 
of a servant to nature. We must watch with an eagle's eye her attempts to 
remove the complaint, and all we have to do is, to aid her in her efforts 
when she is inadequate to the task ; and in a fistula her attempts to restore 
health appear, in almost every case on record, to be too feeble, and it there- 
fore becomes our duty to render assistance. We see plainly what she en- 
deavours to accomplish, which is, such a state of inflammation and discharge 
as will remove the callous edges of the orifice, and, by adhesive inflammation, 
agglutinate or unite the separated parts together. Then, in obedience to 
the dictates of this great teacher of the healing art, we must first prevent 
the sinus from closing ; second, establish a greater or preternatural discharge 
from it. It is not sufficient to create inflammation alone, for this is insufficient 
to heal the sore. The diseased part must be first removed, before it can 
be placed in a state for healing ; in other words, we must remove the offend- 
ing cause before a cure can be effected. The first of these objects (the act 
of keeping open the fistula) may be accomplished by introducing a suitable 
sized tent, made of the ravellings of linen or thread ; or a piece of twine will 
answer. It should be made small or pointed at one end, similar to a probe, 
and drawn through beeswax, or some plaster of a proper consistence, in 
order to stiffen it; and then it is to be introduced as far up the sinus as 
possible, and a very small portion left out ; after which a little lint should 
be placed on the end of it, and a plaster of the black salve applied. On this 
a compress should be placed, and secured by the bandage, as before-mentioned. 
The tents should be gradually enlarged, to fill the opening. Generally, 
when first introduced, they are required to be exceedingly small, and can 
be introduced only a very short distance; but the orifice becomes more 
open, and in a short time larger ones can be used, and they will penetrate 
to the whole depth of the ulcer: nor will they excite any pain, as many 
might suppose; for the matter soon renders them soft after their introduc- 
tion. It is not sufficient to introduce these tents without any application upon 
them. It is necessary to make use of some stimulating agents ; and for this 
purpose I employ, with decided benefit, an or preparation of potash. 
Let Zey, made of hickory ashes, be boiled down until it is perfectly dry; 
then to be removed from the vessel, pulverized, and kept from the air. 
A few grains of this must be put upon the tent every time it is introduced, 
which should be morning and night. It soon alters the nature of the dis- 
charge, rendering it more healthy, the fistula less irritable, and the inflam- 
matory state of the system is subdued. It excites sharp pain for a few 
minutes; but, instead of operating like common causing greater 
inflammation, it removes it. The carbonate of potash will answer the pur- 
pose, but I think does not act so kindly as the preparation just mentioned. 
In the next place the syringe must be resorted to, to aid in curing the com- 
plaint ; and we may commence by injecting into the sinus a solution of the 
article just named. About one drachm of the alkali may be dissolved in 
eight ounces of rain water, and injected once a day, the strength of it gra- 
dually increased, as the patient can bear it. Weak ley answers very well, 
the strength of which may be gradually increased, as required: there is 
no danger in using it very concentrated, for the cure is expedited in propor- 
tion to its strength ; but we must be governed by the feelings of the patient, 
which will not permit its being used too strong, as it might cause too much 
pain. This liquid should be injected once or twice a day. Soon after a 
fistulous abscess breaks, the parts are too irritable to bear the use of the FISTULA. 
535 
syringe : a little time should be allowed for the soreness to subside; and 1 
often commence with the use of injections consisting of castile soap and water. 
The fistula may be washed twice a day with salt and water. This course 
must be pursued as long as the fistula continues to grow better ; although 
such is the insidious nature of the complaint, that, after the painful symp- 
toms have subsided, the patient is unable to decide whether he is improving 
or not, although the callous or hardened edges of the fistula are daily di- 
minishing. 
The best, and only sure, criterion to ascertain whether the morbid or dis- 
eased organization has been removed, is, the quantity of matter discharged 
when no dressings are applied ; and, therefore, when the fistula becomes 
pitted.) or depressed around the edges, and the hardness in a measure gone, a 
trial may be made to heal it, by omitting the use of the tents and the syringe. 
The plaster or salve should only be applied, which will enable the practitioner 
to decide whether the discharge arises from the fistula itself, or whether it 
arises from the stimulating properties of the agents or medicine made use of; 
for I mag say, in a word, that the principle of cure depends upon the act of 
making and keeping up a permanent issue or drain upon the fistula, until the 
morbid nature of it is so destroyed that the edges of the sinus may agglutinate 
and heal. In general, however, after these applications have been used a suffi- 
cient length of time, the discharge of matter will gradually diminish, and the 
fistula will close in spite of the stimulus arising from the dressings. 
It is always best to wait, before dressing the fistula, till there has been an 
evacuation from the bowels, provided this generally takes place daily, and in 
the morning, as the applications are sometimes disturbed by the passages. 
The parts should first always be well washed and cleansed with soap and 
water, to which a little spirits should be added. 
It is better for the practitioner to attend personally to the dressings, if 
practicable, as this will facilitate the cure. But in more than half the cases 
which have been attended I have been unable, from a multiplicity of business, 
to do it, and have, therefore, committed it to the wife, husband, or a friend ; 
and, although a cure is invariably made, yet it is often much more protracted. 
A person well experienced in the treatment can cure it in half the time 
that will be required for any one who must first be instructed, and then 
act only under the supervision of the physician. 
In making objections to my practice, some have asked, how can my appli- 
cation be made to a fistula when it runs very crooked or obliquely, or perhaps 
passes off laterally into the ilesh ? In answer to which I have to observe, 
that I know not that any such case occurs. At any rate, I have never yet 
seen a fistula in which I could not introduce the medicine to the very extent 
or bottom of it, either by the use of the syringe, or by some of the other 
means recommended. But should this not be the case, if the applications 
do not penetrate to the bottom, provided a cure is performed, the modus 
operandi of the agents employed is of little moment. It is sufficient for us 
to know that they have the desired effect. 
It is necessary to administer internal as well as external applications. A 
purgative should be given once a week, and, in addition, an alterative course 
pursued, to remove any morbid taint that may exist or give rise to the com- 
plaint ; for this purpose nothing is better than the alterative syrup, which 
the patient may take three or four times a day, as directed under that head. 
A fistula in ano is certainly one of the most obstinate, the most loathsome, 
and the most serious diseases that afflicts the human body ; and, in conse- 
quence of its inveterate nature, it requires considerable time to effect a 536 
THE REFORMED PRACTICE OF SURGERY. 
permanent cure, especially when the disease has become deeply seated. 
No definite time can be given in which it may be cured : in some cases it 
may be effected in a few weeks ; others will require a number of months. 
But, where the treatment here laid down is strictly pursued, it will infallibly 
cure the disease. 
I have thus given the description, causes, symptoms, with the common 
and reformed treatment, of fistula in ano ; and I must now submit it (as I do 
the treatment of other complaints) to those who have honesty and candour 
sufficient to appreciate or test the practice which I have recommended ; and 
I hope they will ascertain, by experience, the comparative merits of both 
the old and reformed or improved method, hoping that prejudice will not 
so far blind the eyes of the practitioner as to prevent him from giving the 
treatment of this or any other disease a fair and impartial trial. We have 
experience and facts for our superstructure ; and, therefore, we solicit any 
pne to overthrow it, if possible, by fair and honest means. My mode of 
treating the fistula in ano, in particular, has excited much attention, and has 
induced some physicians, who have had the most indubitable evidence of its 
efficacy and superiority, to request me to publish it to the world. I have 
done so, not only as regards this, but other diseases ; and I, for the merits 
of the same, must appeal for a decision to an enlightened, a candid, and 
impartial public. 
Considerable pains were taken and exertions made, some years ago, by 
one of our most distinguished merchants, to extend the benefits of our improved 
method of treating fistula to other parts; but he was defeated in his philan- 
thropic designs by the envy and jealousy manifested by the most egregious 
misrepresentations, falsehood, and calumny. I subjoin brief statement of 
the facts, by way of illustration. 
Between twenty and thirty years ago I was sent for, about sixty miles, to 
attend an influential person in this city, labouring under a fistula. I came, 
and succeeded in effecting a cure ; he not only compensated well for it, but 
used his exertions to introduce me into practice in New York ; and such was 
his success that I was induced to locate here. 
Subsequently Mr. A. G. Thompson, one of the most wealthy and respec- 
table merchants or auctioneers of this city, having ascertained the merits of 
the reformed system in this and some other complaints, expressed an anxiety 
that its benefits should be extended to others, and that I should meet with 
a suitable remuneration for the discoveries and improvements made in the 
healing art. As he had very little hope that our government, or any body 
of men, would bestow their patronage for any improvement of the kind ; and, 
entertaining an exalted opinion of the character of Alexander, the late Em- 
peror of Russia, in patronizing everything useful, or calculated to benefit 
mankind, he wrote a letter to him, with certificates of cure, under the seal of 
the Russian Consul. In due time Mr. Politica, the Russian Minister, 
at Washington, received instructions from the Russian government to 
inform the author that, if he would repair to Russia, he should be 
rewarded according to deserved merits. In the meantime the opinion 
of a popular physician in this city was solicited respecting the merits 
of the treatment or remedy ; and such was his malicious reply, that the 
undertaking was frustrated. This shows what envy, ignorance, prejudice, 
and self-interest will effect. 
Those who have any doubts of the curability of fistula without cutting, may 
make inquiry of those who have been treated, both in the city and county. 
The following persons I recollect of having cured, besides others : Mr. Henry FISSURE OF THE ANUS. 
537 
Chrocheron, first operated upon by Dr. Ferris ; C. Lyon, master of the ship 
Ohio ; ditto, steamboat Columbia ; his brother, ditto ; Moses Odell; William 
Gaulidet, first cut by Dr. Smith ; Mr. Post; Mr. Oliver; Mr. Jacob 
Anthony, formerly teller in the United States Bank; Capt. Gregory ; Mr. 
Meyers ; Capt. Knap ; Mahlon Day, bookseller, Pearl-street, first operated 
upon by Dr. Kissam ; Mr. Mather, ink-maker; Mr. Clark, wholesale grocer; 
Mr. George Peterson, then leather inspector; Mr. Emmons; Mr. Allen, a 
merchant from Columbia county ; Peter Graham ; Mrs. Tanner ; Mrs. Le- 
count; Mrs. Grinnel, and numerous others. 
Females should learn to treat and cure their own sex in this and other 
diseases generally. 
Fistula in the Perinjeum-Description.-By this disease we under- 
stand an abscess which terminates in a fistulous sinus into the perinseum, and 
penetrates the urethra, which carries the water off from the bladder. The 
treatment of this species of fistula is the same as the fistula in ano. 
Fistula Lachrymalis.-A swelling and inflammation in the inner cor- 
ner of the eye, occasioned by an obstruction in the duct which conveys the 
tears. The object in the treatment should be, to remove the obstruction. 
Occulists inject water into the puncta of the lids, by means of a small sy- 
ringe, which may relieve it: if there is swelling and inflammation, use eye 
water and the brown ointment; smoke capsicum and sage, as in catarrh, and 
force the smoke through the nose: use also the cephalic snuff. Some bore 
a hole through the bone, and introduce a metalic tube; this is very painful, 
and only affords partial relief. 
CHAPTER XVI. 
FISSURE OF THE ANUS. 
There is a crack or fissure in the anus or rectum which is exceedingly sore 
and troublesome ; it proves very obstinate and painful. Surgeons cut down 
directly upon, and through, it; but I consider this bad practice. 
Treatment.-Apply a little of the vegetable caustic, in powder or solu- 
tion, daily ; also the celandine and bitter-sweet ointment. 
11 A distinguished judicial officer of the United States," says Dr. A. H. 
Stevens, " who refused to submit to an operation for fissure of the rectum, 
thus describes the mode in which he treated himself: ' I betook myself to bed 
and maintained the horizontal position; I kept myself on a very spare diet, 
living on arrow-root and gruel: after a day or two thus spent, I requested 
my surgeon to apply caustic ; this he did twice, by passing the pencil slowly 
over the anus, which was done by the aid of long forceps: the applica- 
tion of the caustic produced acute suffering at the time. I used flaxseed 
enemas every day, and warm hops, both every other night, and regularly 
used the belladonna ointment: under this treatment I got well in nine or ten 
days.' I have little doubt," he concludes, "that this mode of treatment 
would succeed in a great many cases of fissure of the anus."-New York 
Lancet, No. 8. 538 
THE REFORMED PRACTICE OF SURGERY. 
CHAPTER XVII. 
PILES. (Hemorrhoids.) 
Description.-The piles appear in two states: 1st, a varicose, or preter- 
naturally distended state of the veins, in the vicinity of the anus; 2d, in a 
state of tumour or excrescence, which apparently consists of a solid, fleshy 
mass. 
The first is internal; the second, external. 
Causes.-The piles are often occasioned by aloetic purgatives. When 
I first commenced the practice of medicine, not knowing this fact, I took a 
large dose of aloes, which produced the piles, attended with gieat severity 
and obstinacy. Sedentary habits, corpulence or a plethoric habit, a morbid 
condition of the liver, pregnancy, costiveness, and drastic purgatives of any 
kind will occasion them. 
Symptoms. - A patient afflicted with the bleeding piles is subject to 
greater or less discharges of blood, from a rupture or distention of the veins 
while evacuating his bowels, and sometimes a fatal haemorrhage succeeds. 
The founder of the Arian system of religion, and the philosopher Copernicus, 
are said to have perished in this manner. I was acquainted with a Metho- 
dist minister who had bled, at different times, several gallons from the 
haemorrhoidal vessels, by which he became exceedingly reduced and ema- 
ciated. This symptom continues a longer or a shorter time, according to 
circumstances. 
There are sometimes tumours internally, but more generally they are most 
numerous externally. 
They usually commence with dyspeptic symptoms, nausea, &c. There 
appears to be a morbid or acrid secretion from the liver, which either causes 
costiveness, or such a state of the bowels as brings on the complaint. The 
patient first experiences an uneasy sensation about the rectum, especially 
when he is costive, and anything passes the bowels. He first perceives a 
small tumour at the end of the anus, or a little distance up, which an eva- 
cuation forces down. As the disease increases the inconveniences attending 
the complaint are very great. There is extreme pain in going to stool, fol- 
lowed by a great tenesmus or pressing down, with a heaviness, and an itching, 
disagreeable sensation through the hips, attended with bleeding, and some- 
times by a prolapsus ani, or falling down of the bowel; oftentimes a descent 
of a large mass of tumours ; and these, if the disease is not cured, or is pro- 
tracted, remain large, hard, and round, and difficult, if not impossible, to re- 
duce. When the bowels are relaxed or constipated, they are much worse. 
Sometimes inflammation supervenes, followed by suppuration, giving rise to 
abscess and fistula. The pain attending this complaint is often very dis- 
tressing. 
Treatment.-In the treatment of either species of piles, whether bleeding 
or blind, (as they are vulgarly called,) or in a state of tumour, the first 
object will be to obviate costiveness, and to regulate the bowels by laxative 
medicines and a due course of regimen ; but aloes, particularly uncombined 
with other substances, must never be given. Medicine that acts moderately 
upon the bowels is calculated to remove that morbid state of the liver and 
stomach which not unfrequently gives rise to the complaint. When the PILES. 
539 
faeces are so impacted or hardened that neither laxatives nor purgatives would 
be proper to administer, an emollient injection or clyster may be given. The 
bowels having been properly evacuated and regulated, our next object will 
be to employ such local applications as are calculated to relieve or remove 
the disease ; and they will depend upon the kind of piles for which they are 
prescribed. 
1st. Bleeding Piles.-If bleeding is present, or if we are called to prescribe 
for what is termed the " bleeding piles," in which haemorrhage is the most 
predominant symptom, the following ointment will be found very effectual 
in arresting it: Take the red or styptic powders, pulverized, one part; Venice 
turpentine, two parts ; lard, eight parts : add the whole together, and simmer 
over a gentle fire till the lard is melted. Remove from it, and continue to 
stir until it is cold, in order to mix or incorporate the articles. Let a small 
portion of this be introduced as far up the bowels as possible with the finger, 
or on a piece of lint, or in any manner that can be most conveniently done. 
The first application of this ointment usually stops the bleeding. 
2d. Blind Piles, or in a state of Tumour.-If this variety of piles is in a 
state of chronic inflammation, with swelling, &c., astringent and refrigerant 
or cooling washes should be applied. The following is good : Take acetate 
or sugar of lead, one drachm ; borax two drachms ; soft or rain water, one 
pint: dip a piece of linen or muslin in this liquid, and wet the parts occa- 
sionally with it; after which apply the tincture of garden celandine. This 
wash is cooling and discutient. During the time that these local applications 
are made, administer internally the pile electuary. This medicine is given 
internally, to correct a faulty state of the liver and stomach, which causes 
costiveness, and, subsequently, the piles. In almost every case of piles this 
electuary either proves a sovereign remedy or gives immediate relief, and 1 
have found it superior to all other preparations ; it has a very favourable 
effect upon the parts diseased, by its laxative, cooling, and astringent effects. 
When the tumours become very painful, and are attended with considerable 
inflammation, a poultice made of slippery elm bark and milk will be found a 
valuable application; it usually soon gives relief, and may be continued, 
with the stramonium ointment, until the swelling and inflammation subside, 
or until there is suppuration, which sometimes supervenes. It is desirable 
always to reduce the tumours after they are forced down, and this may be 
done by applying a little ointment to the finger, and pressing upon the most 
prominent tumour until it returns. A leech or two, applied to the tumours 
when they are very much inflamed and painful, often give great relief. The 
spirits or tincture of spearmint, applied to the parts on cotton, is very good. 
There are few complaints in which diet has a more beneficial effect than 
in the piles. They are brought on by high living, and may be removed 
by an opposite course, or by spare diet. Rye bread should be preferred ; and 
Indian in any form, eaten with molasses, stewed fruit, &c. No wines or 
ardent spirits must be used. 
From time to time an attempt may be made to return the bowel, by gently 
pressing on it with the finger which has been immersed in a little ointment. 
It is sometimes necessary to use a bandage to support the parts. 
Some profess to have experienced great benefit in the piles by steaming 
them over oakum or tarred ropes ; but steaming them with bitter herbs will, 
probably, do better. 
Radical Cure for the Piles.-The above treatment will not only relieve, 
but often cure, the piles ; but sometimes, when they have been neglected 540 
THE REFORMED PRACTICE OF SURGERY. 
or improperly treated, they become so seated and enlarged that it is necessary 
to remove the tumours. Should this happen, or should not the above means 
be sufficient to remove the complaint, a piece of silk or thread may be passed 
round the largest tumour, (after having been drawn down,) and tied as tight 
as the patient can bear ; and the knot may be occasionally drawn a little 
closer. This will stop the circulation in the tumour or tumours, and in 
about a week they will be separated, and a radical cure effected. 
I have removed pile tumours by ligature, the knife, and caustic, and have 
found the following treatment superior to all other methods : Take a piece or 
roll of caustic potash and cover it with paper or muslin, except the end, and 
carefully touch the tumour every day with it; keep the liquid, as it dissolves, 
from running down on the surrounding parts ; after which apply an elm poul- 
tice, with yeast. It usually bleeds some and leaves it black, and soon sloughs 
off. I have cured some very obstinate cases in this manner. I discovered 
this from analogy, or its effects on other flesh. 
A person applied to me for the removal of a pile tumour with which he 
was afflicted, and which was so troublesome that he was rendered miserable 
by it. He had been to Europe for his health, and, on his arrival in this 
country, had applied to Dr. Jackson, of the hospital of Boston, who pro- 
posed an operation by the knife. I removed it by the caustic potash, as above. 
In very obstinate cases, where other means have failed, any of the fol- 
lowing may be tried: Wash the parts four times a day with a very strong 
solution of alum and water ; before they become dry, dust on powdered alum. 
E. Underhill found this to cure in several cases. Also, take a sufficient 
quantity of garden parsley and boil in sweet milk until reduced to a pulpy 
consistence ; then strain, add hogs lard, and boil to an ointment, which may 
be rubbed on the part affected. This has been known to have cured many. 
The following is a good medicine for the piles : Equal parts of sulphur, 
cream of tartar, and magnesia, given as a laxative, in tea-spoonful doses 
Take a small paper,of cut tobacco and put it in a frying-pan; place the pan 
over the fire and burn the tobacco to ashes, (but not suffer it to blaze,) and 
then mix it with lard, and anoint the piles four times a day. It cured T. 
Baxter entirely, after being troubled with the piles a number of years. Many 
others have been effectually cured by the same. 
Dr. Thomas Cooke, of Philadelphia, states that golden seal, in half tea- 
spoonful doses, will cure the piles : the dose to be increased. 
A gentleman came to me from the country, who had been many years 
afflicted with the piles in the worst possible stage: he was disabled from 
work ; matter discharging from the rectum ; enormously swelled ; tumours 
so large that the passage was literally closed ; and sometimes he was in 
fits when there was an evacuation from the bowels. He could obtain no 
relief from the physicians in the country nor in this city ; so obstinate was 
the disease, that I despaired myself of being able to effect a cure. I how- 
ever concluded to try a new method, by way of experiment: there wrere three 
large prominent tumours, which closed the passage ; the inner one being the 
most irritable, to it I applied the smallest quantity of the caustic potash, 
which occasioned less pain than I anticipated; it turned it browrn, and 
soon began to slough off, or discharge, by a poultice made of slippery elm 
mixed with yeast. I renewed the application of the potash every day, or 
every other day, until the inner tumour disappeared, which afforded a pretty 
easy passage to the fieces. I then applied it to those tumours on the sides 
until they disappeared. He has now recovered, and gone to his usual avo- STRICTURES OF THE RECTUM-PROLAPSUS ANI. 
541 
cation. I confess I was surprised at the successful result of this case; it 
appeared impossible that the patient could ever be cured. The piles were so 
bad that a surgeon here was afraid to operate on them. 
A botanist from Connecticut informs me that a plant called " sweet gale " 
is an infallible cure for this disease. An infusion to be made of it, and 
drank freely. 
CHAPTER XVIII. 
STRICTURES OF THE RECTUM. 
Description.-It is sometimes the case that the rectum, from various 
causes, becomes partially or nearly closed by the formation of tumours or 
scirrhus, which almost renders it impossible for the feces to be voided, ex- 
cept they are in a very liquid state. It is complicated not unfrequently with 
ulcer, from which there is a discharge of pus or matter. 
Causes.-It may proceed from costiveness or hardened feces, piles, drastic 
purgatives, and other sources of irritation. 
Treatment.-We may commence the treatment of stricture of the rectum 
first by ordering such medicine and such a course of regimen or diet as 
are calculated to keep the bowels in a soluble state. In the commencement 
a portion of our common purgative may be given ; afterward a laxative 
pill, sufficient to obviate costiveness, or to act moderately upon the bowels. 
One or two of the troches, mentioned under the head of pharmacy, may 
be introduced up the rectum daily, to be accompanied with the use of the 
discutient ointment. 
It sometimes becomes necessary to dilate the stricture, which may be 
done in the following manner : Take equal parts of the bayberry and com- 
mon tallow; then make candles of different sizes, in the ordinary manner; 
they should be about six inches long, and a little smaller at one end than the 
other. Immerse in sweet oil the end of one of the smallest of these, which 
should be of such a size as can be introduced without much pain, and let it 
be gently put up the rectum, and continued half an hour each time, or as 
long as the patient can bear. The same should be repeated for three or four 
days, and then one larger used the same length of time; and thus the size 
should be increased as the stricture becomes dilated. The patient himself 
can generally introduce them without any difficulty. This will be found a 
very excellent method of treating strictures of the rectum. 
CHAPTER XIX. 
PROLAPSUS ANI, OR FALLING DOWN OF THE BOWEL 
In this disease the rectum protrudes in a greater or less degree at the anus, 
either from mere relaxation of the internal membrane of the bowel, or from 
a real displacement and inversion of its upper portion, which presents itself 
as an external tumour. The tumour sometimes admits of reduction with 
ease ; sometimes it cannot be returned without difficulty. The disease 542 
THE REFORMED PRACTICE OF SURGERY. 
occurs in persons of all ages; but it is most common in infants and elderly 
subjects. Such examples as are combined with thickening and relaxation 
of the inner coat of the rectum, piles, or other tumours, are sometimes at- 
tended with a copious discharge from the anus, and from the prolapsed 
bowel, of a serous and mucous fluid, mixed with blood. 
Causes.-The disease may originate from circumstances tending to relax 
and weaken the parts which retain the rectum, or its inner membrane, in its 
situation, and from various other causes. The habitual prolapsus, which has 
existed for years, and comes on whenever the patient goes to stool, is the 
case which is most difficult of relief. 
Treatment.-The treatment of prolapsus ani embraces three principal 
indications: 
1. The speedy reduction of the prolapsed part. 
2. The retention of the reduced bowel. 
3. The removal and avoidance of the causes by which the disease is 
induced. 
In general, when the case is recent, and the tumour not of immoderate 
size, the reduction may be accomplished with tolerable ease, by putting the 
patient in a suitable posture, with the buttocks raised and the thorax depressed, 
and by making gentle and skilful pressure either with the palm of the hand 
or the fingers ; but, from the inflammation and swelling, this cannot always be 
done, and it will not do to press too hard or exert too much force, for fear 
of irritation. No farther attempts must be made at reduction, until means 
have been made use of to reduce the inflammation. Astringent washes may 
first be tried, if the pain and swelling be not too great. Take white oak bark, 
bruise, and make a strong decoction, and to every pint add a tea-spoonful 
of pulverized alum ; let the parts be frequently washed with this : soon after 
apply the brown ointment, as directed under the head of " piles." 
After these have been applied, should it still continue irreducible, apply the 
slippery elm bark poultice, to be secured by the T bandage, as recommended 
under the head of " fistula." This will soon lessen the inflammation, so 
that the intestine can be reduced. 
If it proceeds from a relaxed state of the bowels, medicines must be given 
for that complaint. The diet shonld be such as to keep the bowels in a 
soluble state, as rye or brown bread, " mush or hasty pudding and molasses." 
After the protruded intestine has been replaced, let the ftroww ointment be 
continued for some time, until the tone of the parts is restored. 
I have attended some deplorable cases of this complaint, particularly in 
infants, where the anus had been protruded for many weeks, and which had 
extended several inches, with great swelling, inflammation, and ulceration; 
and yet recovery followed by pursuing these means. In one case it was 
necessary to poultice a month before the swelling was sufficiently reduced 
to return the intestine. 
CHAPTER XX. 
WHITE-SWELLING-HIP DISEASE. (Hydarthrus.) 
Description.-This is a very inveterate and painful disease, and is 
usually seated on some of the joints of the body ; principally the hip, knee, 
ancle, and elbow. As the name implies, the skin remains white, even in WHITE-SWELLING-HIP DISEASE. 
543 
great inflammation. Sometimes it is rather mild in its character, at other 
times exceedingly painful; and the seat of the pain is in the periosteum or 
covering of the bone, which in most cases becomes diseased, and exfolia- 
tion takes place. It is peculiar to children, and those of scrofulous habits. 
Causes.-A taint of the blood, cold, injuries, &c. 
Symptoms.-In the commencement there is a very severe pain felt deep 
in the joint, and, when the child or person moves, the pain becomes intole- 
rable. As it progresses there is swelling, but no redness ; a shining white- 
ness, with hardness or callus. It slowly increases, till the swelling is very 
considerable and the distress great, and suppuration ensues. There is a dis- 
charge of matter from a number of openings. The limb wastes, becomes 
bent, and, when in the hip, osseous matter fills up the joint, and slowly 
dislocates the head of the bone, either causing permanent dislocation or 
stiffness: fleshy excrescences shoot out from the ulcers, showing that the 
bone is affected, and in process of time there is generally small pieces of 
bone detached. The patient is very thin and pale, with much constitutional 
disturbance, hectic fever, &c. 
Common Treatment.-The common treatment for white-swelling, like 
other complaints, is very bad. After tormenting the patient awhile with 
blistering, setons, mercury, &c., amputation is resorted to. 
That the reader may have an opportunity of knowing the inefficacy of the 
present practice, I here subjoin the report of B. C. Brodie, from a work called 
"• Morisonia," page 310. 
Of Tumours, White-swellings, and Diseases of the Joints.-11 I have now 
before me the work of B. C. Brodie, F. R. S., Professor of Anatomy and 
and Surgery to the Royal College of Surgeons, and Surgeon to St. George's 
Hospital, on diseases of the joints ; and, from the cases stated, a more unsuc- 
cessful practitioner never presented himself before the public. One would 
think this learned and dexterous surgeon considered it only the patient's wish 
to have his limbs torn off, or to die a wretched, lingering death. What have 
his researches benefited the world, by his cutting up, dissecting joints, or 
giving plates of diseased, carious bones ? When once you have imbibed a 
true knowledge of disease and of the human body, don't you see the futility 
of this practice ? and has not experience proved to you the quackery and 
perniciousness of such medical practice ? Without entering into this author's 
mode of treatment, I shall merely lay before the reader the cases stated, and 
allow him to form his own opinion from them." 
" In all, this volume contains sixty-five cases, all terminating in the same 
unsatisfactory way ; and it is certain that, even in the most favourable cases, 
not one of them approaches to a radical, perfect cure ; and that, if the patients 
who did not die could be called together and examined, they would declare 
that their pain and infirmities are far from gone. It is perfectly unnecessary 
to go through the various treatments, conjectures, and false doctrines set forth 
in the work ; leeching, bleeding, blisters on the part, incisions, cutting out, 
embrocations, and a variety of fatiguing nostrums without meaning, and at 
last amputation ; such are the means of cure recommended. Deluded peo- 
ple ! your lives and comfort are sacrificed by this barbarous science, surgery." 
Treatment.-When the disease first begins steam the parts over bitter 
herbs, such as the following : Tansy, hops, wormwood, catnip, and pennyroyal; 
make a strong decoction, and add half a pint of soft soap : boil again a few 
minutes, then put all into a suitable vessel, and place the limb over the steam, 
with a blanket around to prevent any escape of it; and thus steam for fifteen 
minutes. If there is not sufficient heat to make it perspire, throw in a hot 544 
THE REFORMED PRACTICE OF SURGERY. 
brick or pieces of iron ; if there is too much heat, raise the blanket and 
let it escape ; then wipe dry,and apply the following liquid: Take oil of 
hemlock, half an ounce ; oil of sassafras, half an ounce ; gum camphor, half 
an ounce ; tincture of opium, half an ounce ; add to one pint of alcohol: mix ; 
bathe, and repeat as often as it is dressed, or two or three times a day: after this 
apply a ley poultice. This course, particularly the fomentation or steaming, 
affords immediate relief, while the poultice lessens the inflammation and 
favours suppuration, when there is any disposition for matter to form. As 
a general rule, the fomentation may be repeated every night, or whenever 
the pain is very great. After suppuration has taken place the ulcers must 
be treated the same as laid down under that head. 
Contraction of the Sinews or Tendons.-In addition to steaming the parts 
when the limb is contracted, bathe with the following oil: Take oil of sas- 
safras, wormwood, turpentine, neats-foot oil, gum camphor, equal parts : mix ; 
rub or bathe the sinews with this oil or mixture thoroughly twice a day, 
near the fire. Skunks' grease, or oil simmered in angle worms, may be 
applied, if other means fail. 
Callus.-In almost all cases of white-swelling there is an enlargement or 
callus about the joints ; and this often remains after the ulcers have healed, 
and throws the leg into a state of semiflexion, or such contraction that the 
patient cannot touch it to the floor or ground, as represented in the annexed 
engraving, (fig. 11.) To obviate this, in addition to -what has been recom- 
mended, the above oil should be applied, and friction or rubbing the part three 
or four times a day, for half an hour each time; after which let a strength- 
ening plaster be applied to the parts. 
Fig. 11. White-swelling of the Knee. 
Internal Treatment.-The general health must be attended to. The 
pale and unhealthy appearance of the countenance of children afflicted with 
white-swelling shows that there is a scrofulous or morbid taint of the system ; 
and, therefore, it is of primary importance, while we apply proper local applica- 
tions, that we improve the condition of the general health. To this end, let a 
purgative be given once or twice a week; likewise the alterative syrup be daily 
exhibited, according to the age and strength of the patient; to every bottle WHITE-SWELLING-HIP DISEASE. 
545 
of which add half an ounce of the hydriodate of potash. Dose, for a child 
ten years of age, a table-spoonful three times a day. Bathing in salt water 
is often very beneficial. The scrofulous syrup is also excellent, and may 
be used part of the time. When the pain is very severe, and prevents sleep, 
let an ajiodyne be given. 
This treatment I have found invariably successful where the disease has 
not proceeded too far, or where the constitution has not been too much 
undermined. 
I have successfully treated patients labouring under white-swelling, nearly 
in every stage of the complaint, when all other means have been tried in 
vain ; and, wherever the above treatment has been pursued, it has been 
attended with the same salutary effects. I therefore consider it one of the 
most valuable improvements in medicine or surgery. 
When the patient is labouring under the most excruciating pain, one single 
process of steaming or fomenting, in the manner described, usually operates 
as a charm in allaying pain and imflammation. 
Mrs. Moore, of New Jersey, became very celebrated for the cure of white- 
swelling, by using a remedy obtained of an Indian chief, who had cured a 
very distressing case. As Mrs. Moore was about to leave for the state of 
Ohio, some of her neighbours, who valued the remedy very highly, purchased 
it for me for the sum of twenty-five dollars. I consider this an improvement 
on my former treatment, although it had ever been very successful. I sub- 
join the remedy as I received it; the principal addition to mine consists in 
the application of medicated vapour or steam to the parts. 
1st. Steaming or Fomentation.-Take for the sweat catnip, hearts of mullein, 
double tansy, wormwood, and may-weed, two double handsful of each ; boil 
them in six quarts of water, together with a pint of soft soap, a sufficient 
time to get the strength from the herbs. Put the affected part over the 
steam, and cover the same closely with a blanket, for fifteen or twenty 
minutes. Immediately after steaming take a liquid and bathe the part 
affected, made of half a gill of spirits, half an ounce of camphor, a large table- 
spoonful of laudanum, the marrow of three hogs' jaws, simmered together on 
embers ; apply the liquid, and rub the swelling downward. Then apply a 
poultice made of one handful of dandelion roots, one handful of the hearts of 
mullein, and the same quantity of catnip : boil them in sweet milk, and thicken 
with wheat flour. Steam in the evening, and poultice every morning and 
evening until the swelling breaks. After the swelling breaks, apply a salve 
made of one handful of English clover, a lump of rosin as large as a walnut, 
half a pound of sheep's tallow, one handful of bitter-sweet berries ; stew slow 
on embers. Apply the salve twice a day. Take an equal quantity of red 
precipitate and loaf sugar, with a small lump of charcoal, and powder them, 
to cleanse the sore of proud flesh. If the sinews should be contracted, take a 
pint bottle, fill it half full of sweet oil, then fill it with chamomile flowers: let 
it hang in the sun for three days, taking it in every evening. Rub the sinews 
hard with this twice every day, and heat it in with a hot iron. 
It is impossible for a practitioner truly to appreciate the immediate and 
sovereign effect of the fomentation made use of, or rather the effect of the 
steam or heat arising from the combination, except they make a trial of it. 
I have seen the languishing sufferer, nearly worn out with excruciating pain, 
so suddenly relieved, the transition of change so great, that the patient 
suspected that a dangerous or fatal dose of opium had been administered- 
(t not only has an astonishing effect upon the parts immediately diseased, 
but a correspondent or sympathetic one upon the whole system ; and I have 546 
THE REFORMED PRACTICE OF SURGERY. 
found it equally applicable and beneficial in case of felons, inflammations, and 
other painful diseases. 
CHAPTER XXL 
VENEREAL DISEASE. (Lues Venerea-Syphilis.') 
Description.-This is a most loathsome affection, which extends to every 
part of the system, and is occasioned by a specific poison, conveyed by con- 
tagion or actual contact. 
Causes.-The venereal disease is supposed to arise from a specific morbid 
poison, which, when applied to the human body, has the power of propa- 
gating or multiplying itself, and is capable of acting both locally and consti- 
tutionally. 
Dr. Steward supposes that this disease originated in the camp of Israel, 
as may be inferred by reading the fifth chapter of Numbers. No doubt it 
was first inflicted upon mankind as a curse, in consequence of departing 
from moral rectitude, or the law of God. 
Gonorrhcea.-Symptoms.-Gonorrhoea is a discharge, resembling pus or 
matter, from the urethra, with heat of urine, &c., after impure coition, to 
which often succeeds a discharge of mucus from the urethra called a gleet, 
and which commences a few days after exposure. It begins with an unea- 
siness about the parts of generation, such as an itching in the glans penis, 
and a soreness and tingling sensation along the whole course of the urethra ; 
soon after which the person perceives an appearance of whitish matter at 
its orifice, and also some degree of pungency upon making water. 
In the course of a few days the discharge of matter will increase consi- 
derably ; will assume, most probably, a greenish or yellowish hue, and will 
become thinner, and lose its adhesiveness; the parts will also be occupied 
with some degree of redness and inflammation ; the stream of urine will be 
smaller than usual, owing to the canal being made narrower by the inflamed 
state of the internal membrane, and a considerable degree of pain and scald- 
ing heat will be experienced on every attempt to make water. 
Where the inflammation prevails in a very high degree, it prevents the 
extension of the urethra, on the taking place of any erection, so that the 
penis is, at that time, curved downward, with great pain, which is much 
increased ifattempted to be raised ; (this is called a chordee ;) and the stimulus 
occasions it often to be erected, particularly when the patient is warm in 
bed, and so deprives him of sleep, producing, in some cases, an involuntary 
emission of semen. 
Chancre.-From absorption of the venereal poison, little eruptions, scabs, 
and ulcers arise on different parts of the head of the penis. It usually begins 
with an itching in the part. A small pimple, full of matter, generally arises, 
without much hardness, or apparent inflammation or swelling. The itching 
is gradually changed into pain, and is converted into an ulcer. Its base is 
hard, and the edges a little prominent. When it begins on the frtenum, or 
near it, that part is very commonly destroyed, or a hole is made in it by 
ulceration. When the disease is more advanced, inflammation is liable io 
take place. VENEREAL DISEASE. 
547 
Bubo.-When the venereal poison takes its natural course, it becomes 
absorbed, and usually affects the glands of the groin. This complaint comes 
on with a pain in the groin, accompanied with some degree of hardness and 
swelling, and is at first about the size of a kidney bean ; but, continuing to 
increase, it at length becomes as large as an egg, occasions the person to 
experience some difficulty in walking, and is attended with a pulsation and 
throbbing in the tumour, and a great redness of the skin. In some cases the 
suppuration is quickly completed ; in others it goes on very slow ; and in 
others, again, the inflammatory appearances go off without any formation 
of pus. 
Secondary Symptoms.-Sometimes, from improper treatment or other 
causes, the venereal poison is taken up into the circulation, and the whole 
system becomes diseased. The skin, mouth, throat, tongue, nose, tonsils, 
palate, eyes, and head become very much diseased. Ulcers are formed, 
which discharge acrid, fetid matter, which is peculiarly loathsome. The 
matter sometimes falls on deep-seated parts, such as the tendons, ligaments, 
and periosteum, and occasions hard, painful swellings to arise, known by the 
name of nodes. 
When the disease is suffered to proceed, and is not counteracted by pro- 
per remedies, the patient will, in course of time, be afflicted with severe pains, 
but more particularly in the night-time ; his countenance will become sal- 
low ; his hair fall off; lose his appetite, strength, and flesh ; rest much dis- 
turbed by night, and a small fever of a hectic kind will arise. The ulcers 
in the mouth and throat being likewise suffered to spread, and to occasion 
a caries of the bones of the palate, an opening will be made from the mouth 
to the nose; and the cartilages and bones of the nose being at length cor- 
roded away, this will sink to a level with the face; all which render the 
wretched patient an object of disgust and severe suffering, and which not 
unfrequently proves fatal. 
Females who labour under this disease during pregnancy, communicate 
the poison to the child in the womb, which sometimes destroys it before it 
is born ; at other times its effects are seen afterward, and the poor, innocent 
offspring must suffer for the crimes of its parent. What a curse is annexed 
to a promiscuous intercourse of the sexes ; and yet there are some who ad- 
vocate the practice, under the sanction of religion-yea, the highest holiness. 
Treatment.-Mercury is now almost exclusively relied upon in some 
form for the cure of this disease, and yet I have to learn that it possesses 
any specific virtue in removing it. In the reliance of physicians upon this 
poison they betray their prejudice, error, and ignorance, as long experience 
and facts demonstrate. 
Setting aside the unpleasant and injurious effects to which mercury sub- 
jects the venereal patient, there are other considerations of paramount 
importance for entirely dispensing with it; which is principally the fact, that' 
to preparation of mercury whatever, according to the experience and obser- 
vation that I have had, (and it has not been very limited,) has any power, 
directly or indirectly, of curing the disease in any stage of it; but, on the 
contrary, often exasperates, protracts the cure, and brings on the mercurial 
disease, which is much worse than any form of syphilis. It is frequently 
itself a source of cutaneous diseases, sore throats, and symptoms, which, 
without its baneful influence, would never have occurred. 
Is it not a startling fact, that this has never been discovered, with all the 
boasted learning and improvement of physicians ? All their talents have 548 
THE REFORMED PRACTICE OF SURGERY. 
been engaged to ascertain whether the venereal disease can be cured without 
mercury ; whereas they have never yet learned, it appears, that it never was 
cured with it. 
When Dr. Alexander H. Stevens first commenced his surgical course in 
the university of the state of New York, 1 attended his lectures ; and I 
recollect that he remarked, when speaking on the treatment of venereal 
disease, as follows : said he, " Gentlemen, I know not what to say to you on 
the use of mercury in the venereal disease; the whole medical world has 
been upset within a few years." He then went on to state the experiments 
which had been tried in Europe, in the military hospitals, which went to esta- 
blish the fact, that, in an equal number of venereal patients treated with and 
without mercury, those recovered the most speedily who did not submit to a 
course of mercury, and were treated merely by cleanliness, rest, and absti- 
nence, with the most simple and mild dressings. 
" When I was an articled student at- St. Bartholomew's hospital," says 
Dr. Cooper, " most of the venereal patients in that establishment were seen 
with their ulcerated tongues hanging out of their mouths, their faces prodi- 
giously swelled, and their saliva flowing out in streams. The wards were 
not sufficiently ventilated, and the stench was so great that the places well 
deserved the appellation of foul. Yet, notwithstanding mercury was thus 
pushed, (as the favourite expression was,) it was then common to see many 
patients suffer the most dreadful mutilations, in consequence of sloughing 
ulcers of the penis ; many unfortunate individuals, whose noses and palates 
were lost; and others who wrere afflicted with nodes and dreadful phage- 
denic sores." 
Says Dr. S. D. Broughton, in the London Medical Gazette, " Usually a 
mine of prejudice has been ready to explode when any anti-mercurial doc- 
trines have been broached ; and, in attempting to disturb theories sanctioned 
by age. and rendered orthodox from ancestorial experience, the curse of 
modern heresy often attaches itself to the avower of that which many regard 
rather in the light of rash innovation than improvement. 
I aver that mercurial saturation tends to the destruction of mucous mem- 
branes, the removal, by morbid absorption, of soft parts, and the disorganiza- 
tion of the osseous substance. The mind itself has suffered, the constitution 
received a baneful impression, and pulmonary consumption has not unfre- 
quently terminated the patient's earthly career, when the system has 
undergone mercurial saturation ; while the wretched victim of imbecility or 
imprudent rashness has been reported to have died of another disease. 
This propensity of giving mercury I remember once to have heard very 
satisfactorily accounted for in a medical debating society, by a candid avowal 
that, if the anti-mercurial mania continued to spread, ' it would be ruin to the 
apothecaries and general practitioners. Therefore the inference drawn from 
this liberal sentiment was, that it is better to be on the safe side, and not to 
hazard the adoption of modern heretical opinions against the ' wisdom and 
experience of our ancestors.' 
The extent and injury to the soft and bony parts of the system, arising 
from the action of mercury, is far more dreadful than any primary or secon- 
dary effects of venereal poison. 
That mercury never was a specific against the venereal poison ; for relapses 
were constantly occurring during its fullest operation; nor possessed any 
virtue in the cure of the disease ; and that the creed so long believed in, (to 
the ruin of the health of multitudes, through mercurial salivation,) of its 
indispensability toward the cure, and the destruction of the patient if omitted, is utterly false and groundless; are facts which can admit of immediate, every- 
day demonstration, in the many thousands of the healthiest British soldiers, 
who have been easily, effectually, and permanently cured of every stage of the 
venereal disease, without ever having taken one particle of mercury. 
The bigoted adherence to a belief so false and so universal, in which the 
wisest and most philosophic of our profession blindly participate, will be 
quoted in after ages as a national reproach ;* and, as it has indeed already 
done, will, it is to be feared, go far in destroying our confidence in all medi- 
cal dogmata, or any doctrines whatever." 
VENEREAL DISEASE. 
549 
Treatment of Gonorrhcea.-Having shown the inutility, and, in some 
degree, the injury, of mercury, or the common practice, in the venereal 
disease, I shall now lay down such a course of treatment as I have found 
speedily to remove the disease ; and, in justice to the efforts of nature, I must 
add, that gonorrhoea, as well as other venereal affections, are sometimes spon- 
taneously cured, and very generally by a simple and mild treatment, such 
as cleanliness, simple dressings, diet, and regulation of the secretions. At 
the same time, by the use of more active means, the disorder may be sooner 
eradicated. 
The first medicine to be administered in this state of the disease is, the diure- 
tic drops ; this soon allays the irritation, scalding of the urine, &c. After the 
inflammatory symptoms have subsided, should there remain any gleet, some 
stimulating injection may be used ; for example, take ten grains of white 
vitriol, pulverized ; twenty grains of borax, pulverized ; a tea-spoonful of elm 
bark, pulverized: add half a pint of warm water, and inject two or three 
times a day. If this does not remove it, take cubebs, pulverized, one ounce ; 
best Holland gin, one pint; spearmint, one ounce : mix, and let it stand to 
digest: then take balsam of copaiva, two ounces ; oil of Wintergreen, one 
drachm : mix each of the above preparations, and give two tea-spoonsful, 
clear, three times a day, at bed-time in particular. Also inject a weak solu- 
tion of sal soda two or three times a day. Dr. Snow, of Boston, who has 
had much experience in this complaint, makes use of the latter preparations. 
As a general rule, give the compound powder of mandrake twice a week: 
avoid all stimulants in eating and drinking. Should the skin of the prepuce 
retract, and become inflamed and swelled, an blm poultice may be applied, 
and also the brown ointment. Local and general bathing is very useful. If 
ehordee attend the complaint, take an anodyne at bed-time. After this, if 
there still be a gleet, inject twice a day with the following : Nitrate of silver, 
eight grains ; water, two ounces : mix. Gradually increase the strength. 
Treatment of Chancre.-The treatment of chancre must be very 
similar to that of an ordinary ulcer. The inflammation must first be 
reduced, by applying the elm bark poultice ; also the brown ointment on a 
pledget of lint. When the inflammation has subsided, apply the Wad: salve ; 
if the ulcer does not heal under this dressing, let it be sprinkled with the 
powdered blood-root, daily; and subsequently, if it does not heal, with 
calomel. No irritation is excited by these powders ; but they change the cha- 
racter of the sore usually in twenty-four hours, causing it rapidly to heal 
Every time the sore is dressed it should be well cleansed with a mixture 
of Castile soap, soft water, and spirits ; any collection of matter in the con- 
tiguous parts must be removed with the same. 
* This time has already arrived ; and this bigoted adherence to a belief so false in the use 
of mercury 1 now quote, and pronounce, with thousands of others, " a national reproach." 550 
THE REFORMED PRACTICE OF SURGERY. 
I have been in the habit of using a wash made by adding about ten grains 
of the corrosive sublimate to ten ounces of borax water ; this makes a very 
cooling and astringent wash for venereal ulcers, without any danger of its 
being absorbed, and it disposes the ulcer to heal rapidly. I attended a female 
nearly destroyed with a venereal ulcer : this, on lint, cured it in three weeks. 
Chancres are often attended with that stage of the disease called phymosis, 
or paraphymosis, which renders it difficult to make any applications to the 
ulcers. When this occurs, poultices, cooling lotions, and other means must 
be applied to remove the inflammation, before anything can be done to the 
chancres. Sometimes it is necessary to apply them a number of days before 
the swelling subsides ; but there is no necessity of dividing the prepuce, as 
surgeons recommend, as it only requires a little time to accomplish that for 
which the operation is recommended. In addition to these local applica- 
tions, it will be necessary to attend to the constitution. The mandrake must 
be given as a purgative; and the alterative syrup may be freely taken, with 
the addition of hydriodate of potash, in the proportion of half an ounce to a 
porter bottleful of the syrup. 
Treatment of Bubo.-When the poison becomes absorbed, and affects the 
inguinal glands, particularly as before stated, it is termed a bubo, and our 
first object should be to discuss or disperse it; to effect which apply the 
discutient ointment three or four times a day, rubbing it in well before the 
fire ; after which a poultice may be made, by simmering the cicuta leaves in 
water, and, when soft, the slippery elm bark to be stirred in, to form a 
poultice ; it may be used constantly, but night is the most convenient 
time. The patient should be pretty freely purged. Should this attempt to 
discuss the venereal tumour or bubo fail, and should the swelling and inflam- 
mation increase, suppuration will probably succeed, which must be promoted, 
by applying the following poultice : Take the root of wild carrot, (daucus 
sylvestris,) bruise,and simmer in milk; then stir in the elm bark: or our com- 
mon poultice may be applied to the part, to be secured by proper bandages. 
When symptoms of suppuration appear, which will be known by the sub- 
sidence of pain and inflammation, with softness and fluctuation of the bubo, 
a small opening may be made to let out the matter ; or it may be left a short 
time, to open spontaneously. 'After it has discharged freely, the poultice may 
be laid aside, and the black plaster or salve substituted. It should be washed 
with a little soap water and spirits, and, if it does not heal kindly, treated 
as any other ulcer. 
Constitutional Affection-Lues Venerea.-If, from neglect, impro- 
per treatment, peculiar temperament, or any other cause, the venereal poison 
is suffered to be absorbed and taken into the circulating mass, and thus con- 
taminate and affect the whole system, our treatment must be varied, and 
adapted to this melancholy stage of the complaint. 
Mercury is given in this as well as other stages of the disease, but it does 
not cure it. The investigations made in the military hospitals of Europe, 
and in the hospital at Hamburgh, by Dr. Trecke, show conclusively that 
secondary symptoms can be cured without mercury much better than with 
it: the experiments were made on five thousand cases, and those who took 
no mercury done the best. In the treatment of this form of the disease the 
object should be to eradicate the poison from the system, which must be by 
the excretions of the system. The patient may take the mandrake physic 
one or twice a week ; and the alterative syrup, with the potash, as in bubo. VENEREAL DISEASE. 
551 
I have tried every preparation used by modern physicians, with most of 
the nostrums now so highly extolled, such as Swaim's panacea, and other 
preparations ; and, after repeated and comparative trials for years, 1 find 
that the above syrup by far exceeds the whole of them. If there is any 
chance of recovery for the patient, or the disease is within the control of 
medicines, with proper agents accompanying it, this syrup will prove effec- 
tual. It requires to be given a length of time, in certain cases, before it has 
the desired effect. I know not the modus operandi, or how it acts on the 
system, nor is this of »much consequence ; the effect of it is enough for us 
to know; but it appears pretty evident that it must change the secretions, 
or eliminate the morbific matter by the skin, kidneys, bowels, or intestines, 
although it has very little sensible effect upon any of these organs. 
In very obstinate cases fifteen or twenty bottles of syrup should be taken. 
Should the ulcers be very intractable and unyielding, they must be occa- 
sionally touched with the yellow wash or some caustic, the same as in other 
ulcers. A decoction of the stillingia sylvatica, called yaw weed, may be 
freely taken during the day, or sufficient to purge. 
This course, with me, has been invariably successful, even in those despe- 
rate cases where they have been abandoned, or given up as incurable, by 
hospital surgeons and others ; but much time and patience is often required 
to effect a cure in the wost variety of the complaint. 
This treatment is also very beneficial in mercurial affections, which are 
usually connected with the venereal disease. 
In concluding this chapter on the venereal disease I have to remark, that 
there is one diagnostic symptom, which will enable the practitioner always 
to detect the real character of the venereal ulcer: it is the peculiar fetid 
effluvia or stench which arises from it; it is different from that arising from 
any and every other complaint. 
Treatment of Stricture.-When there is an obstruction in the urine, or 
it is discharged in a small stream, it shows that a stricture must exist in the 
urinary canal; to cure this, inject a solution of sal soda two or three times a 
day, and introduce a bougie, moistened with the brown and discutient ointments, 
daily : commence with a small one, and gradually increase the size; continue 
it for fifteen minutes each time. 
Nodes.-Mrs. B. was relieved of a severe pain of the head, (arising, I 
suppose, from venereal nodes,) after many applications had been tried, such 
as blisters, capsicum, fomentations, and other heating applications, by apply- 
ing acetate or sugar of lead, and vinegar, cold. 
Another person was cured of an inflammation of the brain by the same 
application. Would not this be good for all inflammatory affections of the 
head ? I have found that cold applications will often remove pain in the 
head, while hot or stimulating applications are of no avail. 552 
THE REFORMED PRACTICE OF SURGERY. 
CHAPTER XXII. 
INFLAMMATION OF THE EYE. {Ophthalmia.) 
Symptoms.-Sharp pain confined to a point, as if occasioned by the pre- 
sence of extraneous matter ; great heat and redness; the parts swell, and 
the vessels of the eye not only increase in size and become turgid, but appear 
more numerous than in the natural state : great pain upon the least motion 
of the eyeball; morbid sensibility to light; effusion of tears of an excori- 
ating quality. If the inflammation run high, a febrile disposition attends. 
After a longer or shorter continuance, these appearances gradually abate, 
or entirely cease ; but in some cases, although the patient is left free from 
pain, tumour, and symptomatic fever, yet the suffused redness of the eye and 
the external marks of inflammation still remain, and long continue to exist 
after every other symptom has subsided. 
During the continuance of the inflammation small ulcers are often formed 
upon the cornea, and little collections of matter are sometimes deposited, 
which frequently harden into white, opaque specks, and either partially or 
totally obstruct the entrance of light. 
The ophthalmia tarsi consists in a chronic inflammation (frequently with 
ulceration) of the sebaceous glands, which are situated in the tarsus or edges 
of the eyelids. It is often productive of much irritation, and, when severe, 
occasions the destruction of the eyelashes. It is a scrofulous affection. 
Causes-External injuries; as blows, contusions, wounds of the eyes ; 
extraneous bodies, of an irritating nature, introduced under the eyelids ; 
exposure to bleak winds and cold, too free a use of vinous and spirituous 
liquors, suppression of accustomed discharges, long exposure to strong 
light, a fixed attention to some minute object, and inversion of the eyelids. 
It is symptomatic of certain other diseases, as measles, small-pox, scurvy, 
scrofula, and syphilis. Contagion. 
Treatment.-The first indication to be fulfilled in the treatment of oph- 
thalmia is, to remove all extraneous substances from the eye, or whatever 
may prove a source of irritation. 
Second. To reduce the inflammation as speedily as possible. 
The first indication, viz., that of removing foreign bodies from the eye, is 
very important; for, so long as they continue, the inflammation will be kept 
up. Sometimes it continues for months, when something has been found 
in the eye which has been the source of all the mischief. A magnet is very 
good. A physician in England removed a piece of iron from the eye with 
a magnet, which was the means of introducing him into practice. 
The smallest particle, lodging in the eye, from its irritable and delicate 
structure, produces great pain, swelling, inflamfnation, and inability to move 
the lids. There is a preternatural secretion of tears, which often removes 
the exciting cause ; but should not this be the case, the lids must be open- 
ed with the fingers, and the patient rotate the eye in different directions, 
especially to the opposite side to that wherein the extraneous body appears to 
lie ; and, when the substance is brought in view, it may readily be removed 
by the end of a probe or bodkin covered with a silk handkerchief of a close 
texture, or a small roll of fine linen will answer the purpose. Should one of the 
lashes fall into the eye, it may be removed in the same way. If the foreign INFLAMMATION OF THE EYE. 
bodies be very small, either dust or sand, the mucilage of slippery elm bark 
should be introduced, by directing the person to throw his head as far back 
as possible, and then pour, or inject with a syringe, a quantity of the clear 
mucilage into the inner corner or canthus of the eye at the same time that 
he is directed to wink or move it in different directions. The dust or sand 
will, in this manner, adhere to the mucilage, and will be washed out; the 
mucilage will also diminish the inflammation, by its soothing and cooling 
properties. 
It is sometimes the case that extraneous particles are insinuated under the 
lids and adhere to them : in these cases the lid should be everted, or turned 
inside out, the particle brought in sight, and removed, as before directed. 
Sometimes particles of metal, or insects, get imbedded into the coat of the 
eye. A silver wire, beat thin and fixed into a handle, will be convenient 
to remove them. A hog's bristle, bent semicircular, is very good. 
When dust or any small particles that cannot be extracted get into the eye, 
put an eye-stone in it, which causes no pain, comes out easily, and often 
removes the offending matter. A poultice of elm bark may be put over the 
eye. A young man was lately very essentially benefited by this means. 
Sometimes foreign substances penetrate the conjunctiva, and project a 
little, causing much pain. They may be removed by a small pair of tweezers. 
It is very common in cities, and in factories where much iron is used, for 
scales, or small pieces of it, or steel, to penetrate into the cornea, and become 
so imbedded that they cannot be dislodged without touching them with a 
sharp instrument. 
We very often have persons apply to us in this situation; and it requires 
some skill to take them out. The method which I adopt, and which is very 
effectual, is as follows: I seat myself directly before the patient, and direct 
an assistant to hold his head as steadily as possible. I then press the left 
fore-finger on the upper lid of the eye, and the left thumb upon the lower lid, 
and extend them sufficiently open to discover the object; and, by the by, 
the scale is often scarcely perceptible. On one or two occasions the patient 
had applied to a physician, who said there was no substance in the eye. But 
in every case, by looking very closely, a minute dark speck could be seen on 
the cornea. When the practitioner discovers this, and everything has been 
adjusted, he will direct the person to look steadily at some object in that 
direction which brings the substance fairly into view. At the same time 
he will press with his fingers sufficiently to keep the ball of the eye from 
turning ; while at the same moment he will, with a common thumb or ab- 
scess lancet, carry the point directly to the particle or body, and carry it 
outward. In this manner it can be easily taken out. Sometimes it will 
adhere to the point of the lancet; at other times it will fall upon the eye, 
and is washed out by the tears; and occasionally it is removed without dis- 
covering it. After the removal of the body a minute speck will be seen 
where it has been imbedded, which is liable to deceive the physician. The 
only sure criterion to ascertain whether or not it has been removed, is, the 
subsidence of the pricking sensation, or the removal of the source of irrita- 
tion ; and this will sometimes take place immediately, at other times not till 
several hours afterward. 
When pieces of lime get into the eye, as many as possible must be re- 
moved in the same manner as has been directed for the removal of other 
foreign agents; and such as cannot be thus removed must be washed out 
by the mucilage of slippery elm bark. In this manner we have succeeded 
in every case of the kind, and they have been numerous. 
553 554 
THE REFORMED PRACTICE OF SURGERY. 
After the first indication has been fulfilled, viz., to remove all extraneous 
bodies from the eye, our next one will be to subdue the inflammation; and 
the first application to be made may be locally. 
1st. Fomentations.-If the pain be very severe, let the eye be fomented 
with a decoction of stramonium leaves, simmered in spirits. The eye or 
eyes may be washed with it, and the leaves then bound on, and often renewed. 
I have known this to give relief when all other means failed. With the ad- 
dition of a little laudanum and water applied to the eyes as a wash, it soon 
relieved and cured one case, where there was excessive pain and inflam- 
mation, after having used all my usual prescriptions. 
2d. Cooling Washes.-After this fomentation has been used a wffiile, the 
cooling or refrigerant wash may be applied, which consists of one drachm 
of pulverized borax, to which may be added eight ounces of boiling rain 
or spring water, and afterward strained or filtered. After the eyes have been 
washed with this, if the inflammation is slight, the use of a more stimulating 
eye-water may be sufficient to remove it; and, when first used, to be a little 
diluted. Should it, however, continue, after the use of this a short time 
apply the following wash, called laurus eye-water : make a strong mucilage, 
by immersing the pith of sassafras in rose water ; after which let the eyes 
be washed with this frequently. 
A patient applied to me with excessive irritation of the eyes, occasioned 
by the use of brandy and opium, taken habitually for a length of time. All 
our ordinary means proved unavailing, in consequence of the continued use 
of the above stimulants. I then gave the dried stramonium leaves, and 
directed him to simmer them in equal parts of water and spirits, and apply it 
to the eyes in the form of a poultice. Secondly, I directed him to wash his 
eyes occasionally with equal parts of the tincture of opium and water. This 
treatment produced an immediate amendment, and cured the patient in a 
very short period. The irritation was so great that it was difficult to con- 
vince the patient that he had no foreign substance in his eye. 
Henbane plant, (hyoscyamus,) applied to the eye in the form of a poultice, 
is an excellent remedy for inflammation. 
3d. Poultices.-Of all the applications which can be employed to reduce 
inflammation, there is none so powerful, so strikingly effectual and sovereign, 
as a poultice made of the slippery elm bark. The superfine flour of it should 
be mixed with equal parts of milk and water, and applied tepid, and next to 
the skin. It should not be placed between linen, if it can be kept on without: 
in infants and children, however, it is sometimes necessary to enclose it, in 
order to keep it upon the eyes ; when this is necessary, it should be made 
very thin. If the inflammation is very acute, it may be kept on during the 
day and night, otherwise the wrashes may be applied during the day and the 
poultice at night. This does more to remove the pain and inflammation than 
any other means besides. There is not the least danger arising from its use, 
as some, entirely ignorant of its effects, have intimated might be the case ; 
or rather this has been their charge against poultices in general ; and was 
this, that is here recommended, no better than those usually employed, such 
charge would be very valid or properly made ; but the bark, applied as here 
directed, is exceedingly valuable, surpassing every other application ; and no 
injurious effects arise from it in any case. 
4th. Stimulating Eye-water or Wash.-When the inflammation has par- 
tially subsided, an eye-water or wash that is a little stimulating to the 
absorbents may be applied to the eye : for this purpose let the stimulating 
eye-water be applied two or three times a day, to be diluted with a little rain INFLAMMATION OF THE EYE. 
555 
water, and the strength of it gradually increased, as the eyes will bear. 
If it increases the inflammation, let it be omitted. A wash made of salt 
and white vitriol, a few grains of each to a little rain water, is very good, 
and may frequently be applied to the eye through the day. If it smarts, 
dilute it. 
5th. Equalize the Circulation.-When the pathology of this disease is 
well understood, (which I am persuaded is not the case in this day,) the 
method of treating it will be found simple, easy, and very effectual: people 
■will not then have their eyes so often destroyed, as at the present time, by 
improper treatment. When the cause is well understood, the treatment 
will be necessarily right; and I have found that, in nine cases out of ten, 
ophthalmia of all kinds arises from an unequal circulation of blood. It 
recedes in consequence of cold from the surface and extremities, and is 
thrown in an undue quantity upon the eyes, which, with the morbific agents 
contained in the circulation, is the great cause of inflammation of these organs. 
Ask the patient if his feet have not been, and are not, habitually cold, while 
his head and eyes are hot: he will answer in the affirmative. Or place 
one hand upon the feet, the other upon the forehead, and you will dis- 
cover that, while the former (the feet) are cold, the forehead is hot, i. e., the 
temperature, instead of being regular and uniform, is unequal and diametri- 
cally opposite. Hence the indication of cure must be obvious to the 
meanest capacity, which consists in recalling, not abstracting, the blood from 
the eyes and head back again to its original channels, which is no sooner 
done than inflammatory symptoms subside ; and this is effected by means 
so simple, that, except a practitioner possesses a good share of candour and 
honesty, combined with discernment and some physiological knowledge, he 
will reject it, from errors previously imbibed. 
One great and principal means by which to equalize the circulation is, the 
application of heat to the surface and extremities. Diaphoretics may be 
given to excite perspiration or a determination to the skin, and the feet should 
be repeatedly bathed in warm ley water, to return the blood, or to promote 
a natural warmth and circulation ; and it is usually the case that in the very 
act of this process the patient experiences great relief; the temporal arte- 
ries cease to beat so violently, the pain in the head subsides, and the irritation 
of the eyes are lessened. After the feet are bathed, mustard plasters may be 
applied, and kept on, particularly at night. The vapour bath may be used, 
to promote gentle perspiration, in cases where internal medicines prove 
insufficient, or where it is excited by any difficulty ; and perspiration should 
be aided also by warm diluent drinks. The skin must be kept moist 
while any inflammation remains. 
6th. Rest and Quietude.-The patient should keep in his room as much 
as possible, as exercise and exposure to the air or cold are apt to increase the 
inflammation. The room should be a little darkened, and but little, as the 
act of keeping the eyes entirely from the light will prove injurious, particu- 
larly when they first begin to be exposed to it; and they ought gradually to 
be accustomed to a moderate degree of it. 
7th. Anodynes.-Where the patient is very restless and wakeful, a portion 
of the diaphoretic powders may be given at bed-time. 
Sth. Purgatives.-Physic should be given to the patient two or three times 
a week, as it contributes very much to lessen the inflammation, by lessening 
the quantity of the circulating mass and equalizing the circulation. Our 
common purgative may be given, and senna, manna, and cream of tartar 
occasionally substituted. When the eyes adhere much together, from a 556 
THE REFORMED PRACTICE OF SURGERY. 
secretion of matter which takes place most commonly in the morning, they 
should be washed with a little Castile soap and water; when they are 
very irritable, a little milk and water may be sufficient; but the soap should 
be used in this case in preference, if the patient can bear it: I have found the 
daily use of it, particularly in purulent ophthalmia, exceedingly beneficial. 
It not only cleanses the eyes of all viscid secretions, but gives tone and 
energy to them, by stimulating the absorbents to a healthy action. 
Eye-water.-Take garden celandine, green, bruise it, and rose water ; to 
one ounce add half a pint of rose water; if too strong, dilute. 
Film.-An ointment of celandine, for the cure of sore eyes, soon cured a 
very bad case. 
Fleshy Excrescence of the Eyes.-Pulverized blood-root, fine, applied daily 
with a wet rag, cured a case. 
Specks on the Cornea. (M. Dupuytren.)-The insufflation of the subjoin- 
ed powder on the eye, repeated morning and evening, by means of a quill, 
while the eyelids are kept separated : " Oxidi zinci imp. prsep.; sacchari 
candi albi; submuriate mercury, aa, equal parts. 
" The eyes should neither be washed nor rubbed after the insufflation. 
When there does not exist any disease of the eyelids nor inflammation of 
the conjunctiva, the insufflation of the powder generally suffices to resolve 
the specks. Those which are recent and slight are completely dissipated 
in a few weeks by the insufflations. The specks that have existed longer, 
that are thicker and broader, usually give way in a month or six weeks ; and 
specks that occupied almost the whole cornea, covering the pupil, and entirely 
intercepting the passage of light into the eye, have been frequently seen to 
disappear completely in the course of a few months." 
Weak Eyes.-Of all the remedies for weak eyes, bathing them in pure 
cold water is the best. Bathe or sponge the brows, temples, head, ears, 
neck, and upper lip, these being closely connected with the optic nerve. The 
sponge should be dipped frequently into cold water and applied ; after which 
rub all the parts briskly with a dry towel: repeat this two or three or 
more times a day ; this practice strengthens the eyes. One drop of sweet 
oil, put into the eye, is also recommended. 
Chronic Ophthalmia, and Ophthalmic Tarsi.-When acute ophthalmia 
or inflammation of the eyes has been properly treated, there is very little 
danger of its running into a chronic form. But when a patient has been 
freely bled, blistered, mercurialized, and reduced, as they now are, chronic 
inflammation will supervene, or ulceration will follow, which will destroy all 
vision or disorganize the eyes, as may be seen daily where such practice has 
been followed. When we are called to treat chronic ophthalmia, although 
we cannot prevent the mischief which has been done, we may remedy it in 
part, and perhaps wholly : first, we must make use of the same means to 
subdue it as are recommended for the acute stage of the disorder; if they 
proved ineffectual, which will seldom be the case, some variation in practice 
will be called for. Additional, or somewhat different, means must be taken 
to divert the blood from the head, to equalize the circulation, and to excite 
a healthy action in the eyes. 
First, Emetics.-Emetics sometimes have an excellent effect where the 
disease has become stationary, or where chronic inflammation exists : about 
two a week should be given, and a purgative administered as often. The fact, 
that ophthalmia depends upon gastric irritation, is often overlooked by the prac- 
titioner ; even though it does not depend upon a morbid state of the stomach, INFLAMMATION OF THE EYE. 
557 
yet the shock given by the emetic to the head and capillary system exerts 
a salutary influence on the eyes, by lessening subacute inflammation, and 
giving tone to them. 
Says Abernethy, " Most of even our local diseases originate in a bad state 
of the stomach, a truth which cannot be too often impressed upon those who 
speak of the treatment of purulent ophthalmia." He traces nearly all the 
maladies which affect the eye to this fertile cause of human suffering, and 
tells the following amusing story, in illustration of the vulgar errors on the 
subject: we quote from the report of his lectures in the Lancet: 11 A lady 
and gentleman brought their child to me with inflamed eyes; the pupils 
could hardly be distinguished ; there were ulcers on the cornea, and it 
was very much clouded. They said,1 Sir, we are going out of town, and 
thought we would ask your opinion of our child's eyes ; he has been under 
the care of several of the most eminent surgeons, and is getting rather worse 
than better.' I said, ' Do you expect that I will prescribe an eye-water, 
or an eye-salve, and so on ? I tell you that I am persuaded that the cause 
of irritable eyes is a disordered state of the stomach and bowels.' I desired 
the lad to put out his tongue, and it was very furred and dirty indeed. 1 
told them that they must pay great attention to the child's diet, to the regu- 
lation of his bowels, to take exercise in the open air, and so on. ' Oh !' they 
said, ' if that is all the advice you can give, we must wish you good 
morning ;' so they paid me a guinea, and off they went. They were going 
into Devonshire ; when they were about seventy miles from the town the 
child was seized with a diarrhoea, which caused them to stop on the road, 
and in a day or two the child's eyes became much better. They now 
began to think that there was some truth in what had been told about a dis- 
ordered state of the stomach and bowels, and away they came again toward 
town, after having travelled above seventy miles, to hear something more 
about this matter, which, if they had had a little patience, they would have 
heard at first in a few minutes." 
I have found that in the chronic, and particularly in the purulent, ophthal- 
mia the inflammation depends in some degree upon a morbid or vitiated 
state of the blood; and I have, therefore, administered alteratives, particu- 
larly in the purulent and scrofulous, and for this purpose the alterative syrup 
should be freely given. The eye balsam or brown ointment is exceedingly 
efficacious in chronic affections of the eye, particularly the lids ; a little to 
be rubbed on night and morning. 
If the patient complains of any pain or heat about the eyes and forehead, 
and W'hich is not easily removed, let him be directed to immerse the crown 
of his head once or twice successively in spring or rain water that has just 
been drawn : this will have a tendency to abstract the remaining heat from 
the parts, by the evaporation which follows; while at the same time it diverts 
the blood from the head to the other parts, and gives tone and energy to the 
absorbents. Should the patient feel any worse after this operation, or after the 
use of any other medicine, let it be discontinued ; for it is well known that a 
medicine that will cure nineteen persons, may disagree with the twentieth. 
Much benefit is derived, in chronic and purulent ophthalmia, from exercise 
in the open air, a change of diet, and from travelling. 
The purulent ophthalmia, it must be remembered, is contagious ; and, 
where a member of a family is afflicted with it, great care must be taken 
that it is not communicated to others by washing in the same basin, wiping 
on the same towel, or letting the matter from the eyes be conveyed in any 
way to those with whom he associates. 558 
THE REFORMED PRACTICE OF SURGERY. 
Ophthalmia Tarsi is a troublesome species of ophthalmia, which affects 
the lids of the eye, and appears to be occasioned by a scrofulous state of 
the system. It is situated in the sebaceous glands, and is often produc- 
tive of much inflammation, is very inveterate, and sometimes destroys the 
eyelashes. Apply the brown ointment. 
Mrs. Boyd states that burnt alum and cream, applied to the eyes, cured 
her of a scrofulous ophthalmia. 
A person lately applied to me, who came a distance of nearly two hundred 
miles, to be attended for this complaint. The lids of the eye were four times 
the thickness that they were in their natural state, and there was a constant 
corrosive discharge from the eyes, which extensively excoriated the cheeks. 
She had laboured under the complaint for eight years, and was rendered 
completely miserable by it. The whole routine of our common treatment 
only afforded partial relief. The flowers of sulphur, enclosed in a bag, and 
placed over the eyes at night, she thought, rendered her the greatest service. 
After trying every medicine that afforded any prospect of a cure, I was 
about to abandon the case as incurable. But it occurred to me, on my last 
visit, that one of the preparations (tincture of capsicum annum) which 1 
had before directed her to use, and which she said had aggravated her eyes, 
might still be beneficial, if used in a weak or diluted state. I accordingly 
took about a drachm of this stimulating liquid, added to it an ounce of rain 
water, and directed her to apply it to the eyes two or three times a day. 
The next time that I saw her I found a remarkable change for the better. 
This diluted tincture of capsicum or Cayenne pepper checked the discharge, 
reduced the swelling, inflammation, and pain, and, in a word, operated like 
a charm, and the old lady soon returned home nearly well. Of the modus 
operandi, or the manner in which this article acts, affording relief in such 
cases, is not easy to determine. The benefit is probably derived from the 
new action excited, or from the stimulus given to the absorbents, which 
causes them to perform their office, and thus removes the complaint. 
The patient must be directed to take purgatives occasionally, and such 
medicines as have a tendency to eradicate any taint of the system; and, 
above all, he should enjoy the benefit of pure air, and every morning the 
eyes should be well cleansed and washed with good Castile soap and water. 
We have had, at our institution, a very extensive practice in various 
diseases of the eye ; and, for the success of the treatment here laid down, we 
can appeal to the numerous patients we have attended. We have had cases 
so severe that they have been abandoned by other physicians, after having 
been exceedingly injured by mercury, bleeding, blistering, scarifications, &c- 
They have been led to our institution blind, and we have, after a length of 
time, (for under the best treatment such cases are very tedious,) succeeded 
in restoring them to sight. Those who persevere in this plan of treat- 
ment may safely hold out a prospect of cure to the patient, if vision has not 
been completely lost or the eye disorganized by inflammation. 
I might here give a vast number of cases in illustration of this practice, 
but neither time nor space will permit. One case, however, occurs to me, 
which I will briefly give, more particularly to demonstrate the effects of the 
present practice of medicine. 
A Captain Allen, from Lockport, N. Y., residing a distance of 400 miles 
from this city, applied to me to be treated for the Egyptian or purulent 
ophthalmia, which has been endemical in the western states. 
The account and treatment which he gave of his disease were most afflict- 
ing and appalling ; and illustrates, more strikingly than words or assertions, INFLAMMATION OF THE EYE. 
559 
the lamentable practice of medicine in this day, and as clearly illustrates the 
superiority of the reformed over the mineral practice. He informed me that, 
when he was first attacked with the disease, his general health was excel- 
lent, he was strong and athletic, and enjoying a good constitution. He was 
seized with the usual symptoms of acute ophthalmia, with severe pain, 
swelling, and inflammation in the eyes, with a great discharge from them. 
He immediately placed himself under the care of a person who was a pro- 
fessed oculist, and who had taken extraordinary pains to acquire all the 
medical knowledge possible, particularly as relates to the eye.* 
This physician began in the usual method, to bleed him most copiously, 
and repeated this operation till he was so far reduced that he was con- 
fined to his bed. Pint after pint, and quart after quart was taken from his 
arm and head, by cupping and leeching. 
He was bled twenty or thirty times in the course of two or three months ; 
during this time he was purged as freely, by taking several pounds of 
salts. In addition to this he was tortured by the repeated and continued 
application of blisters. Not only so: his whole system was completely 
contaminated and poisoned by large portions of mercury : the water or saliva 
flowed copiously from his mouth, teeth loose, gums swelled, breath horrid, 
debility excessive, and rapidly sinking. This was not all ; as the course 
did not have the desired effect, he must follow the rule of Dr. Sangrado,and 
stick to the principles of the book. He now applied the most irritating 
applications to the eye, everted the lids, made incisions in them with his 
lancet, and abstracted more blood from a part already irritated and inflamed 
Again ; blue vitriol was next applied, and he was farther tormented by cor- 
rosive applications. He was suffered to eat little or nothing during the whole 
time, which produced nearly a state of starvation; and his room was rendered a 
complete dungeon, by excluding all light. As he grew worse under this, 
two or three other physicians were called in consultation ; but, as a matter 
of course, no change, not a single new idea on the nature or treatment of his 
complaint. The principles of the book must be adhered to, and a similar 
course of treatment was directed to be continued. The man was now in a 
most deplorable state ; pus or matter streaming from his eyes, totally blind, 
and an abscess formed on one eye, so extensive as to let out the humours 
and completely disorganize it; and in the other but a little vision left. 
While thus distracted with pain, with the most horrid sufferings, and with a 
constitution broken, ruined, and sinking very rapidly, a thought struck him, 
for the first time, that the treatment of his physicians was murdering him. 
He therefore discharged them, and from that very time he began to grow a 
little better. He gradually let light into the room, and he soon rode out in 
a carriage, from which he derived great benefit. After a while the acute 
inflammation ceased, and he was left with a shattered constitution and with 
blindness. 
It was in this state that he was led to our institution ; and it would be 
interesting could I give a representation of this man's eyes. I can only com- 
* He had attended lectures, or received instruction from the Eye Infirmary in this city, 
which claims uncommon skill in treating diseases of the eye, and which has acquired con- 
siderable notoriety, but with what propriety I shall leave the public to decide. A sense of 
duty constrains me to state, that I have heard of, and seen, numerous cases which have 
been exceedingly injured, but I know not of any cures performed or any benefit derived. 
A person who has attended at the place, or infirmary alluded to, informs me that scores 
of sore eyes have remained under their treatment for a year or two, without receiving 
any benefit. 560 
THE REFORMED PRACTICE OF SURGERY. 
pare them to two bad ulcers, from which matter is constantly issuing, 
attended with pain, swelling, inflammation, and disorganization. Like other 
cases of ophthalmia, the extremities were cold, and had been so during the 
whole course of the complaint, while the head was very hot and painful. 
The digestive functions were exceedingly impaired, great debility, and mind 
very much depressed. It was in this state that we commenced treating his 
complaint. He had already asked the opinion of a noted surgeon of this city, 
who gave him no encouragement: it appeared to me that little or no benefit 
could be afforded, farther than to give temporary relief; but, by pursuing the 
course already laid down, an improvement was soon manifest. The appli- 
cations checked the discharge of pus from his eyes in a very short time ; the 
inflammation and pain began to subside ; the constant heat which he had for 
such a length of time was removed; the warmth returned in the extremi- 
ties ; the ulcerated state of his eyes was removed, and they assumed their 
former globular and healthy appearance. The fungous flesh that lined 
the eyelids, and which proved a constant source of irritation, was likewise 
removed, and in a short time every symptom grew more and more favour- 
able ; and in the course of three months, although it appeared that all vision 
was destroyed, he was able to walk the streets alone, and could distinguish 
the different signs upon the stores ; a circumstance which was almost incre- 
dible to all those acquainted with his situation. His general health became 
good; he recovered his former plethoric and robust state of the system, and 
he has ever since transacted business. 
For several years, and ever since, he has almost made it a business to give 
a history of his disease, and the treatment; and to recommend to us every 
person labouring under a similar complaint, for which we feel under particu- 
lar obligations. 
Mr. Coleman, late editor of the Evening Post, stated, that for three months 
he suffered most excruciatingly from the treatment of his physicians for an 
inflammation of his eyes. He was bled, blistered, cupped, reduced, &c., 
till he was under the necessity of discontinuing their applications ; when, by 
the advice of a friend, he washed his eyes with the water in which potatoes 
were boiled, and he immediately began to recover, and in a short time was 
well! A large library of books could be made of such cases. 
Diet.-Avoid everything heating. 
Cataract.-The cataract is an opaque state of the crystalline humour, 
or of its capsule, by which the rays of light are obstructed in their passage 
to the retina, and blindness is the consequence. By looking through the 
pupil deep, a cloudy or coloured coat is seen. 
Treatment.-This disease is rarely cured. Stimulating applications 
may be applied externally, and emetics, cathartics, and alteratives inter- 
nally. Cases have been cured, it is stated, by keeping up a discharge back 
of the neck, by an issue, or by irritating applications. Salt water bath, with 
friction, is very good. Purge once a week, or oftener ; and abstain from all 
stimulating food and drink. Apply tincture of garden celandine to the eye. 
An operation is most generally performed for the disease ; but in almost 
every case it only affords temporary relief, and scarcely even this. Not 
only so: in most cases it is apt to bring on inflammation, suppuration, and 
disorganization, both to the eye operated upon, and the remaining sound one. 
The act of running an instrument into the eye, and wounding it, to cure a 
disease, seems neither reasonable nor philosophical. I will not, however, 
take it upon myself to say, that the experiment should never be tried ; but I deem it very questionable whether it is ever justifiable; at any rate, the 
patient should be apprized of the danger and uncertainty of the operation ; 
he should be told that, if the vision of one eye remains, he will be in danger 
of losing it by the operation, as well as in danger of losing the natural 
appearance of the eye or eyeball on which such operation is performed. 
He should be told the remarks of a celebrated operator, that he had spoiled 
a hatful of eyes before he had operated with the least degree of success. He 
ought, I think, rather to have said that, even after he had ruined a hatful of 
eyes, he was still unable to cure the disease. 
Since writing the above a lady of this city, Mrs. Avery, informs me that 
she submitted to two operations for the cataract (the first depression, the 
second couching} without deriving the least benefit; but, on the contrary, it 
nearly destroyed her life : and they were performed, too, by the physicians 
of the New York Eye Infirmary, who are considered the best acquainted with 
diseases of the eye. In this case they had an excellent opportunity of testing 
the merit of this operation. After depressing it, she states that she was con- 
fined to a dark room for the space of thirty-one days ; was fed on mercury 
(to use her own expression) and salts every day; was bled, cupped, and 
leeched, until she was exceedingly reduced. This not proving effectual, in 
one month after she submitted to the operation of extraction, and underwent 
the same subsequent treatment; which, with the low diet, nearly destroyed 
her. Her eye collapsed, the pain horrid, teeth loose and rotten, strength and 
flesh gone, general health about ruined, and, finally, such debility followed 
that she was thrown into convulsions. 
Now, I will not comment upon this tragedy or treatment, but merely ask 
the reader, if a " botanical physician or medical reformer " should be guilty 
of such mal-practice, whether he would not be indicted and tried as a crimi- 
nal ? Yet all this passes current, and as scientific and learned, because it is 
popular, and sanctioned by custom and great names ! 
Mr. T. Williams, of this city, underwent the most dreadful sufferings, in 
consequence of an operation performed of the same kind. So excruciating 
was the pain during the operation, that his shirt was drenched with perspi- 
ration ; and, after all, he was still left blind. 
Since writing the preceding a gentleman informs me that a physician in 
Cincinnati ruined the eyes of his brother by the same operation. 
Hundreds of other cases of the same nature might be mentioned. 
INFLAMMATION OF THE EYE. 
561 
Amaurosis.-Amaurosis is a partial or total loss of vision, arising from 
paralysis of the optic nerve or retina; and this is produced by a congestion 
of the vessels of the part, or minute alteration of its structure. The eyes look 
almost natural; the pupil is generally dilated and motionless. There is fre- 
quently the sensation as if a cloud was before the eye- 
Treatment.-This disease, like cataract, is also extremely difficult to 
cure. Electricity may be tried, and means made use of to excite a healthy 
action of the system. Stimulants may be applied to the eyes, and there is 
nothing better than the diluted tincture of capsicum. The head should be 
dipped every morning in cold water ; benefit may be derived from bathing 
the feet, and making an issue behind the ears, keeping up a constant dis- 
charge. In a word, it should be treated on general principles. Emetics, 
purgatives, sudorifics, tonics, nervines, and alteratives are classes of medicines 
which should be tried. The following may be used : Take equal parts of 
extract of henbane and belladonna; mix them well together with a little 
water, and rub the eyebrows once or twice dtily, and the nape of the neck. 562 
THE REFORMED PRACTICE OF SURGERY. 
Opacity of the Cornea.-From inflammation there are produced specks, 
felons, or opacities of the eye ; to remove these apply a little stimulating eye- 
water, and also a drop of molasses. If these do not remove them, apply a 
little of the pulverized blood-root once a day with a piece of wet muslin. 
I recently removed a fleshy excrescence by this last application alone. 
Pure white ashes, obtained by burning any hard wood, may be applied to 
the specks or opacity once or twice a day, and a little molasses inserted into 
the eye as often, both of which are sufficiently stimulating. If inflammation 
follows, apply a poultice. 
CHAPTER XXIII. 
ANEURISM. (Anewrisma.) 
Description.-By the term aneurism we understand a pulsating tumour, 
situated over some artery, containing blood, and formed by the dilatation or 
rupture of the proper coats of the artery, internal and muscular. 
Aneurisms are situated either externally or internally ; that is, they are 
either so situated on the limbs that access may be had to them, and the 
nature of the disease clearly ascertained, or they are so placed in cavities of 
the body, such as the abdomen or chest, as to render the nature of the disease 
very often extremely doubtful. z 
They are divided by writers into true and false. One kind is made out 
to be that which depends on an extension or dilatation of the coats of an 
artery, and is denominated the true aneurism ; that which proceeds from 
an effusion of arterial blood into the surrounding parts is called false. The 
parts where it is most frequently met with are, the ham, thigh, neck, under 
the shoulder-blade, arm, and groins, and sometimes the aorta. 
Symptoms.-The popliteal aneurism in the ham, being that which occurs 
most frequently, may be taken as an example. A small tumour is first per- 
ceived, firm, and little affected by the pulsation of the artery ; it is attended 
with little or no pain, and is disregarded by the patient. It increases in size, 
becomes softer to the feeling, and has now a very strong pulsatory motion; 
upon pressure it entirely disappears, but returns again as soon as the cause of 
compression is removed. Lancinating pains arise, and there is an unaccoun- 
table sensation of heaviness, pain, and numbness through all the limb, often 
accompanied with severe cramps. As the swelling enlarges it acquires 
great hardness, and the throbbing, before violent and alarming, is now dimi- 
nished ; neither is the blood capable of being removed, by pressure, from its 
situation. The leg swells, is heavy, cold, and pulseless. At length the 
integuments, in some cases, acquire a livid hue, the skin becomes thinner 
from day to day, it cracks and scabs, and blood issues through the crevices ; 
but the first hiemorrhage seldom proves fatal: the patient immediately faints, 
and a coagulum is formed and closes the orifice ; ulceration, however, soon 
extends, and the patient at last expires after a large effusion, though often 
not until the lapse of many months, or even years, from the first accession 
of the disease ; or he may recover. 
Causes.-Predisposing.-A constitutional predisposition; appearing most- 
ly about the middle period of life. 
Exciting.-Debility, however induced; accidental injury, of whatever ANEURISM. 
563 
kind; the removal or destruction of neighbouring parts, by which the artery 
is deprived of its usual support. 
Discrimination.-Aneurismal tumours may be known by the pulsation 
being perceptible over every part; whereas, in tumours which derive their 
pulsation from being situated over an artery, it is only to be felt in the direc- 
tion of the vessel. 
Treatment.-The method now adopted in the treatment of aneurismsis, 
to make an incision down to the artery, passing a ligature around, tying it, 
and then closing the lips of the wound : this is done to prevent the entrance 
of blood into the aneurismal sac; but, from the effect of this operation, and 
from the various reports which have been detailed by those who have per- 
formed it, (I mean honest reports, for many I have found have been false,) 
I am led to doubt the propriety or the utility of the operation. I find, by 
strict inquiry, that more cases even on record have been cured without an 
operation, or cured spontaneously by the natural efforts of the system, with- 
out the least medicine whatever, than have been cured by a surgical opera- 
tion, or tying the artery. A large proportion of the cases in which an 
operation has been performed have proved fatal : occasionally one has been 
reported which has proved successful; but even such, I find, has often been 
followed by the most serious, injurious, or fatal effects, such as mortification 
of the leg, scirrhous enlargement, stiffness, and permanent lameness. 
Were I to give an account of the number of cases that have proved fatal 
by a surgical operation, the catalogue would indeed be frightful. My ob- 
jections to the operation are the following: 
1st. The consequences arising from irritation or pain. 
In some habits, and in some aneurisms, such a degree of pain or irritation 
is produced, that the patient is carried off at the time, or shortly afterward. 
In this city, some time ago, a woman died in about twenty-four hours after 
an operation for a femoral aneurism; and numerous others might be men- 
tioned. 
2d. The second objection is, the danger arising from hremorrhage- The 
impetus of blood is so great after an artery has been tied, that sometimes* 
haemorrhage or bleeding takes place, and proves fatal. 
3d. Mortification of the Limb.-If haemorrhage does not immediately arise 
from the act of tying the artery, as soon as the ligature or ligatures cut 
through it mortification often takes place, and carries off the. patient. 
4th. After the operation of tying the artery has been performed, even if 
no such effects follow as above-mentioned, in consequence of the anasto- 
mosing branches not being sufficient to supply the limb with blood below the 
aneurismal tumour, or in consequence of the want of a due circulation, the 
temperature of the limb is diminished or reduced, mortification and sloughing 
take place, and the limb or life of the patient is endangered or lost: this 
happened in this city in the case of a Mr. Parcells, who wras operated upon 
for femoral aneurism by Dr. M-. 
5th. Callus and stiffness of the limb. 
Where an aneurism is situated upon any of the extremities, if the circula- 
tion is cut off by tying the artery for an aneurismal tumour, the whole limb 
frequently becomes not only cedematous and exceedingly swelled, but it like- 
wise becomes stiff, indurated, and so permanently enlarged, that the use of 
it is entirely lost, and amputation is proposed as the only remedy. This 
occurred in the case of Richard White, of Brooklyn, who was operated upon 
for a popliteal aneurism ; and such deplorable consequences resulted from it, 
that amputation was proposed as the only alternative. I objected to this 564 
THE REFORMED PRACTICE OF SURGERY. 
operation, (for which I received a liberal share of abuse,) and, after about 
nine months, succeeded so far in reducing the enlargement and removing 
the stiffness of the limb, that he was enabled to walk without crutches, and 
now attends to his ordinary business. 
6th. I object to the operation, because it does not in all cases even pre- 
vent the blood from passing into the aneurismal sac, by which the pulsations 
and the tumour still continue in a greater or less degree. 
7th. I object to the operation again, because nature alone effects more cures 
than are effected or performed by the operation. 
Sth. I object to it, because I have succeeded in curing where an opera- 
tion has been proposed as the only alternative to save life, and where a fatal 
event was predicted, without such operation being performed, by a most dis- 
tinguished operator of this city, (Dr. Valentine Mott.) 
9th. I object to it, because the operation is not only uncertain in the 
event, but because it is excruciatingly painful, particularly under certain cir- 
cumstances. 
10th, and lastly. Because the operation maybe resorted to as an experi- 
ment, when all other means fail, or as the last alternative. 
Did time and space permit, I could here insert numerous cases in which 
operations have been performed, but proved fatal. See American Practice 
of Medicine, vol. ii., page 341, in which twenty-one fatal cases are de- 
tailed : numerous cases are also there given, in which a spontaneous cure 
had been effected with little or no medicine. 
In the treatment of aneurism I recommend almost the non-medical course : 
the patient must avoid all irritating kinds of drink and food, and all exertion ; 
a mild, vegetable, low diet. The tumour may be kept constantly wet with 
narcotic plants, as stramonium, henbane, and wormwood simmered in vinegar ; 
a little salt may be added. A purgative to be given about twice a week; 
and, when the pain is very severe, narcotics to be administered, as the extract 
of hyoscyamus, anodyne powders, fyc. When the pulsation and pain are great, 
rub on the parts a strong solution of veratria digested in alcohol, until the pain 
ceases. Compresses in some cases may prove beneficial. As a spontane- 
ous cure is effected by a rupture of the external coat of the artery, thus 
diffusing the blood into the cellular substance, would it not be advisable, 
under some circumstances, when other means fail, to puncture the coat of the 
sac or tumour with a needle, and thus, in imitation of nature, let out the 
blood when the pulsations and pain cease ? When the coat bursts it is 
accompanied by a loud report. The blood is diffused into the cellular sub- 
stance, and a callus or hardness closes the artery. The blood circulates by 
the anastamosing or tatteral branches, as in amputation. 
After the preceding treatment has been continued for some time, there will 
often be an audible snap or report, sometimes almost as loud as a pistol, (to 
use the expression of the patient,) when instantaneously the beating and 
pain will cease, the swelling and inflammation subside, and gradually dimi- 
nish, until there is nothing left except a cartilaginous tumour directly over 
the artery, which becomes, no doubt, obliterated. 
Should this theory be correct, then, as stated above, we might expedite the 
cure by rupturing the artery with a probe, or passing a seton through it, on 
the same principle that a ganglion is destroyed by bursting its sac. How- 
ever, I leave this for the reflection of others. I conceive that there is less 
danger in pursuing it, and a greater probability of effecting a cure, than by a 
surgical operation, or tying the artery. 
In concluding this chapter I will relate an interesting case of femoral ANEURISM. 
565 
aneurism, which will serve to illustrate the principle of treatment here laid 
down. 
Mrs. Grant, aged about forty, then residing in Reed-street, in this city, 
was attacked with a throbbing and beating sensation in the thigh, just below 
the groin, and over the femoral artery. It gradually increased for several 
weeks, until the tumour became very large, and the whole leg exceedingly 
swollen and enlarged. The pulsations were very great, and the tumour 
almost lost in the surrounding parts; extremely hard, and excruciatingly 
painful. The whole thigh, from the groin to the knee, and particularly the 
upper portion of it, assumed a very morbid and diseased state. The circula- 
tion was carried on feebly below the tumour, which rendered it exceedingly 
cold. She was now confined to the bed ; and such was the pain attending 
it, that she took an ounce of laudanum during each night to procure relief. 
I was called to attend her soon after its commencement; and so formidable 
was it, that there appeared to be very little chance or prospect of recovery. 
It appeared, too, that, if an operation was performed and the artery tied, it 
must inevitably prove fatal, and I had not much confidence that anything 
which I could prescribe would prove effectual; I was, therefore, at a loss to 
know what course to pursue. I took a physician, or surgeon, to examine 
the limb, who immediately proposed an amputation, to save the patient's life. 
About this time one of the neighbours requested Dr. Mott, of this city, to 
examine the disease, who, upon finding it an aneurism, immediately proposed 
an operation, without which, he said, she could not live. To this the woman 
objected, and said, " the knife should never enter her flesh," let the con- 
sequences be what they might. 
Taking everything into consideration, the objections of the patient and the 
danger and uncertainty of the operation, I concluded that it would be more 
prudent and safe to rely upon nature, aided by suitable means, than to rely 
upon an operation ; it appeared to me that the chance of her recovery 
would be greater, and, therefore, concluded to abandon it, and wait the result. 
When Dr. Mott found that both myself and the patient were not disposed 
to take his advice, so anxious was he to try the experiment of tying the 
artery, that he employed another surgeon, and one or two private citizens, 
one of whom was a minister of the gospel, to wait upon the patient, and 
inform her that, except she submitted to the operation, it would certainly kill 
her. She replied that she was getting better under the prescriptions of her 
present physician, and, therefore, should not discharge him. Accordingly, 
after this I was permitted to treat the case without farther interference or 
molestation. 
My applications were the same as before-mentioned, with the addition 
that, during part of the time, I applied stramonium leaves the whole length 
of the leg, to assist in reducing the swelling and inflammation. I also applied 
a tourniquet above the tumour, over the femoral artery, with directions that 
it must be tightened in case the tumour should burst, as I feared it would, 
from the great swelling and enlargement, together with the excessive pain 
and inflammation. 
The tumour continued slightly to improve for some time, when one night 
she felt and heard a sudden snap or report in the leg, from which time all 
the symptoms subsided, and she continued to improve, till, two or three 
weeks afterward, there was nothing left of the aneurismal tumour but a little 
hardness, or apparently a cartilaginous tumour, immediately over the femoral 
artery, and which appeared to be the centre of the swelling. Her leg for 
some time was weak, but the strength gradually returned, and she was soon 566 
THE REFORMED PRACTICE OF SURGERY. 
able to walk as well as ever. She has been 
perfectly sound for more than twenty years; 
and I have several times exhibited the patient 
to our school, when lecturing upon this subject. 
I herewith annex a plate (fig. 12) representing 
the appearance of the aneurism when I first com- 
menced the treatment of it. About two years 
after the patient recovered, two surgeons called 
upon her to know whether she continued well, 
and what means I employed to effect the cure. 
Dr. Porter states two bad cases of aneurism, 
cured by applying a bandage the whole length 
of the limb. It first caused great pain, but 
afterward entirely subsided. It deserves farther 
trial. 
Dr- Mott operated upon a person, on the 
11th of June, 1818, in the New York hospital, 
for subclavian aneurism. On the twenty-third 
day haemorrhage came on from the wound : it 
was stopped by the introduction of lint and the 
employment of pressure. About twenty-four 
ounces of blood were lost, whereby the patient 
was so depressed that the pulse w'as no longer 
distinguishable. On the twenty-fourth day, in 
the evening, he lost four ounces more of blood ; 
on account of his restlessness and the painful 
state of his arm, two grains of opium were ad- 
ministered to him. After one or more returns 
of bleeding, he died on the twenty-sixth day. 
Fig. 12. 
CHAPTER XXIV. 
RUPTURE. {Hernia.) 
Description.-Hernia or rupture is the protrusion of any viscus or part 
from its proper cavity. It has obtained various names from its situation, as 
the inguinal, when it occurs in the groin; the scrotal, when it occurs in the 
scrotum ; the femoral, when it is situated above the groin ; umbilical, when it 
occurs in the abdomen or umbilical region; ventral, when it is situated in 
some other part of the abdomen. 
There is no rupture, as the term implies, but a relaxation of the parts, 
which permits some portion of the abdomen to protrude and form a tumour. 
Sometimes the intestine descends ; sometimes the omentum or cawl which 
covers them, and occasionally both come down. Hernia is divided into reduci- 
ble and irreducible ; the former, where the contents can be replaced; the latter, 
where they cannot be, or except with great difficulty. Also strangulated. 
Treatment.-1st. In Reducible Hernia.-First return the protruded parts 
into their original cavity, by making gentle pressure upon the hernial tumour, 
and this, in general, is most easily effected in a recumbent position. There is 
very little inconvenience attending this complaint while the protruded parts RUPTURE. 
567 
can be easily returned. It may be troublesome, both from the bulk of the swell- 
ing and from the intestinal derangements which take place ; but, independent 
of these circumstances, it may exist throughout life without causing more than 
slight inconvenience. But this state cannot be depended upon, as, from various 
causes, such as straining, lifting, coughing, &c., the parts may be displaced 
from their natural situation, and become exceedingly difficult to reduce, and 
be attended with very serious, if not fatal, consequences. The patient, there- 
fore, should immediately return the parts, and then take proper means to 
secure them, to prevent them from being displaced. There have been se- 
veral contrivances to effect this, such as various kinds of bandages and trusses. 
A truss, in general, of proper mechanism, is best adapted to the purpose: 
by its permanent pressure upon the opening the parts are prevented from 
descending, and a permanent cure is often effected. There are a great 
variety of trusses for the relief and cure of hernia or rupture, and some are 
very good. A proper truss should have a spring neither too strong nor too 
weak; the pad should be neither too convex nor too concave, and so con- 
structed that it may be graduated at pleasure, and should prevent the descent 
of the intestines or omentum : the best manner to apply it is in a recumbent 
position. By the use of such a truss, bathing the parts with the oil of eggs, 
and, subsequently, wearing a plaster of the extract of oak bark, a permanent 
cure may be expected. The following figure (fig. 13) represents a truss 
properly adjusted. 
The parts may be bathed twice a day with 
salt and water, and, when well dried, bathe them 
with the oil of eggs as often ; the truss to be 
afterward applied : if these do not cure in a rea- 
sonable length of time, apply the extract of 
white oak bark, spread on thin leather; place this 
first over the rupture, and then the truss : this 
has cured the disease of many years' standing. 
2d. Irreducible Ruptures.-When a rupture, 
from any cause, cannot be reduced, it must be 
supported, in the best possible manner, by a 
suspensory bag. The bowels must be kept 
regular, and a vegetable diet taken. 
3d. Strangulated Hernia or Rupture.-When 
any of the contents of the bowels protrude, and 
cannot be returned, they are said to be strangu- 
lated, usually caused by a strain. There is pain 
in and about the parts, sickness and vomiting, 
fever, tension and swelling of the parts, and costiveness. There is always 
more or less danger attendant on these symptoms; although patients under 
my treatment have, in almost every case, recovered. The first object is, to 
reduce it as soon as possible; to effect which the body must be bent, and 
the tumour pressed upon until it is reduced. The endeavours of the patient 
to reduce it will be attended with more success than those of another person. 
The method of reduction practised by M. Gimbernat, of Madrid, is so 
ingenious, and at the same time so successful, that I shall give it in detail. He 
places the patient on his side opposite the hernia, with his body a little bent, 
and lower than the pelvis, in order to relax the muscles of the abdomen: 
with the same intention the head is brought forward toward the chest. 
In the femoral hernia he elevates the thigh on which the hernia is, yet so 
ns not in the least to obstruct the operation. Sitting then by the 
Fig. 13. 568 
THE REFORMED PRACTICE OF SURGERY. 
with his hand which is nearest to the patient he grasps the tumour at its 
base, which is the upper part, and with his first three fingers he compresses 
it all around, to diminish its diameter ; at the same time with the fingers of 
the other hand he pushes the apex, which is the lower end of the tumour, 
upward and inward, to direct it toward the crural arch, because it cannot be 
reduced in any other direction. He has sometimes found that more than one 
hour was required for this operation. When the patient is fatigued, he ceases 
both to press and push, yet never quits his hold ; when he renews these 
efforts he graduallly increases their force. Of numerous hernize treated by 
him in this way, and many of them desperate, those which have not been 
reduced have been very few. It may be needless to add, that this method is 
improper, if the tumour is inflamed and very painful, of the part which causes 
the strangulation. This operation is safe, easy, and generally successful. 
It is now the practice with most surgeons to wait but a very few hours 
before an operation is performed in strangulated hernia. After following those 
means which I have found are not calculated to reduce it, recourse is had 
to the knife. Some surgeons commence an operation almost immediately, 
alleging that it is extremely dangerous to delay even a few hours. Others, 
again, wait a greater length of time. The operation consists in dividing the 
integuments, dissecting down to the hernial sac and opening it, removing the 
stricture, and replacing the protruded viscera. 
I will not take it upon me to assert that this operation is never necessary, 
but I am confident that it is very seldom requisite. I have the best 
authority for stating, that most of the cases of strangulated hernia for which 
an operation is performed, would be spontaneously cured, or might be by 
proper treatment. In very many cases where an operation has been pro- 
posed the patient has recovered by very simple means, or none at all. I 
have been called to some where, at first view, it has seemed impossible to 
return the protruded viscera without cutting down and dividing the stricture ; 
and yet, by prompt and energetic means, I have succeeded in reducing it, 
and by the following course : 
1st. Purgatives.-The treatment may be commenced by administering a 
dose of croton oil, two drops in milk ; no other physic (olive or castor oil 
excepted) but this will answer in the complaint. Those of a very stimu- 
lating nature are apt to aggravate the symptoms : but oleaginous purgatives 
are beneficial, by the relaxation which follows their exhibition. 
2d. Injections.-It sometimes occurs that neither this nor any other kind 
of medicine will be retained upon the stomach. When this takes place, our 
dependence must be placed upon injections or clysters. The following may 
be given: Take of lobelia inflata and stramonium, q. s. : make a strong 
infusion ; to half a pint of which add milk and molasses, the same quantity 
of each, and a gill of olive or sweet oil; five drops of croton oil may be 
added: mix, and administer with a suitable sized syringe, to be repeated 
every hour. Not only the feecal contents of the intestine are evacuated by 
this injection, but it has a great tendency to remove the stricture by its 
emollient and relaxing properties. 
3d. Opiates.-Opium, in strangulated hernia, is often exceedingly valuable. 
It checks the vomiting attendant on the stricture ; allays pain and irritability 
of the system ; removes the tension of the parts, and will often effect a 
speedy reduction. About three grains should be given every two hours, 
until the desired effect is produced. 
External Applications.-1st. Steaming or Fomentations.-A strong decoc- 
tion of bitter herbs, tansy, wormwood, hoarhound, catnip, and hops may be RUPTURE. 
569 
thrown into a suitable sized tub or vessel; a narrow piece of board placed 
over it, on which the patient must be placed, and a blanket thrown round to 
retain the steam. This will produce perspiration, and contribute very much 
to lessen the inflammation. 
2d. Discutients.-Let the hernial tumour, including the neck of it, be 
bathed with the bitter-sweet or disculient ointment for half an hour at a time, 
and, when applied, let some heated article be held a little distance from the 
parts ; the green oil may also be used : let them be alternately applied every 
hour or two. They also prove serviceable by their emollient and relaxing 
properties. Bathe likewise with the croton oil. 
3d. The Hot or Warm Bath.-Should the hernia still remain unreduced 
or strangulated after these means, let the patient be immersed in a warm bath, 
and continued in until he begins to feel faint. 
4th. Poultices.-After any of the foregoing applications have been used, 
let an alkaline poultice be applied over the parts and over the seat of the 
stricture. Let the slippery elm bark be mixed with weak ley, until a poultice 
of a proper consistence is formed, to be applied tepid, and often renewed. I 
have found the best effects from this application in strangulated hernia. In 
one case I applied it when I left the patient at night, and in the morning 
the viscera returned without the taxis or any manual operation. It removed 
the pain, swelling, and inflammation, and the parts in the morning appeared 
very wrinkled or shrivelled. 
5th. Cupping.-In very critical cases, where reduction is found difficult, 
four or five cups or leeches may be applied around the neck of the tumour. 
Cupping has a much better effect than general blood-letting, although I have 
seldom found this operation necessary in the worst cases. 
6th. Cold or Refrigerant Applications.-Some physicians or surgeons 
highly extol cold applications, such as cold water, ice, &c. ; but in most 
cases, as far as I have ascertained, they are attended with a decided injuri- 
ous effect. They seem to make the stricture worse instead of better; and 
this, no doubt, arises from the sedative effects of the cold. There is one 
application, however, that appears to have been attended with some success, 
which is the sulphuric tether. Wet the hernial tumour with the liquid, and 
then, in order to produce speedy evaporation, blow upon it with a pair of 
bellows. A physician states that he has reduced a number of strangulated 
hernias by this method alone, when they had been doomed to undergo an 
operation. 
7th. Manual Aid or Assistance.-It becomes necessary, during the time 
the patient is making use of these various means, from time to time to make 
attempts to return the protruded viscera by manual assistance, or what is 
usually termed the taxis. In accomplishing this considerable judgment is 
necessary. The position of the patient should be particularly attended to: 
his legs and buttocks should be elevated as high as convenient, forming an 
angle, if possible, of forty-five degrees. This can be very easily accomplished, 
by placing the back part of a chair underneath him. His thighs and body 
must be a little flexed, in order to relax the muscle. The tumour may then 
be seized, and moderate pressure made, in order to return the parts, as has 
been previously directed. 
I have usually found that the patient himself could succeed best in 
performing this part of the business. In most instances it is the case, that 
the viscera have been down often, and he has been in the habit of returning 
them himself, by which means he acquires a tact in doing it, with which 
the most skilful surgeon is not conversant. 570 
THE REFORMED PRACTICE OF SURGERY. 
The above method, in case of strangulated hernia, I have practised inva- 
riably with success ; nor have I found that danger arising from delay of 
which writers speak. In difficult cases it sometimes has required several 
days to reduce the hernia ; in other cases a few hours only. It is stated by 
many that even a few hours' delay are fatal; and this is probably the case 
under bad treatment or bad management: but I have never witnessed any 
such result. An opponent to this treatment, or to any longer delay than 
usual, before an operation was performed, might say that mortification would 
take place, and in this way prove fatal; and, had such operation been per- 
formed, the life of the patient might have been preserved. But this is by no 
means a conclusive or valid argument, because it is impossible to say what 
might be the case under different management, or the common course of 
treatment. It is more probable that the life of the patient would be lost or 
endangered by the use of the knife or the dividing the stricture ; an inference 
which is very fairly drawn from the many fatal cases resulting from such 
practice. Suppose that a patient should be lost under the treatment that 
I lay down, would it prove that it was any the less efficacious than a surgical 
operation ? I conceive not. I think it would be much more reasonable, 
judging of the comparative effects of the two modes of practice, to infer that 
this treatment would save the lives of those patients which are lost in con- 
sequence of an operation ; and, therefore, from the uniform success which I 
have had by pursuing this method, I can confidently recommend it in prefer- 
ence to the one adopted, viz., of operating for a strangulated hernia almost 
immediately. I am persuaded that more cases would be lost by the knife 
than by the treatment I adopt ; and even should it fail, (which I have never 
known,) it does not preclude the act of dividing the stricture: more time 
only is allowed to try the resources of nature and the powers of art, in whose 
favour, if we err at all, I have found it the most safe to err. 
A tumour appeared in the groin of Mrs. Valentine, of this city ; it was 
thought that the omentum or intestine had descended, and a stricture pro- 
duced ; although the pain and tension of the tumour had subsided, yet vomit- 
ing continued. Before proper means had been taken to reduce the hernia, 
Dr. Alexander H. Stevens, of this city, laid open the tumour, and found that 
the intestine had protruded and assumed rather a dark colour; also the 
omentum ; all of which he was unable to return, and cut off. He then sewed 
up the wound. The symptoms for a while were mitigated, but those more 
dangerous commenced, the parts mortified, which soon destroyed the patient. 
A judicious treatment would probably have saved the woman.* 
* " We copy the following editorial remarks from the Philadelphia Gazette, the oldest and 
most respectable daily newspaper in this city. We are pleased that others than ourselves 
have penetrated through the dark veil that has heretofore mystified the humbug which has 
so long been the support of the self-constituted faculty ! We recollect, while attending 
some few years ago a course of ' Lectures on Practical Surgery,' the professor had a case 
of hernia; we believe the intestine protruded through the abdominal ring, and produced 
somewhat of a ' lump.' Our professor thought it best to cut off that portion of the gut 
which fell out of its place, as he thought it was sphacelus, (mortified.) He stated to the 
class that he would report progress of the case ; he did so for a few evenings ; but suddenly 
the reporter ceased reporting. In the course of the season we took occasion to inquire 
after the 'case of hernia,' when we were informed that the 'poor man died.' From 
what we could glean from the subject, there was not the slightest possible necessity for the 
operation. Had there been, first, a relaxative from lobelia ; second, proper degree of 
taxis employed, there is no doubt in our mind that this ' poor man ' would not have died. 
"The love of 'operating,' cutting and slashing of 'poor men's' limbs, has been a 
dreadful curse to our land. It shows a great want of theraputical knowledge in thus 
butchering people to such a degree : had these ' men of steel ' more information in regard STRICTURES IN THE URETHRA. 
571 
It would be very pleasing to me, had I room, to detail a number of cases 
which I have successfully treated, by pursuing this treatment. In one which 
occurred some time ago in a very aged man, the practitioner who attended 
with me decided that the hernia could not be reduced without an operation ; 
and, from its great magnitude, pain, &c., it appeared so ; but, by persevering 
a few hours, I effected a reduction. 
I attended a young man, Mr. Neale, with strangulated rupture, who 
appeared in a most dangerous condition : so completely strangulated were the 
parts, and so enormous the swelling, and so unyielding the tumour, that I 
was fearful he could survive but a short time. Every surgeon in New 
York, I suppose, would have operated immediately : I, however, chose 
(with great fears, I confess) to pursue the treatment here laid down, and he 
soon recovered. 
In concluding this chapter I will relate a case recorded in the Boston 
Medical Journal, which shows what course nature alone, sooner or later, 
takes to cure hernia or rupture. Some practical inferences may, perhaps, 
be drawn from it. 
" Remarkable case.-A married woman, of middle age, on one of the 
islands below the harbour of this city, (Boston,) a short time since, had a 
strangulated hernia. An opening formed from the tumour, and a considerable 
portion of the intestine sloughed off. From the peculiar location of the 
woman, it became exceedingly difficult to obtain a physician; and her hus- 
band, therefore, as the only alternative, as he supposed, gave her enormous 
quantities of physic before the sloughing took place. 
There was a complete relief from pain after the faeces began to discharge 
at the artificial opening, where they continued to pass off* about ten days, 
when the orifice again closed, the discharges readily took a natural course, 
and the patient now remains in perfect health. We have understood she 
was not visited by any physician or surgeon till after the cure was perfectly 
completed." 
CHAPTER XXV. 
STRICTURES IN THE URETHRA. 
From various causes the urethra, or canal that leads the water from the 
bladder, becomes thickened, smaller, and inflamed, which partially or wholly 
obstructs the flow of the water. The water may likewise be obstructed by 
a spasmodic action of the canal. It is generally caused by the venereal 
disease, and cold. 
Treatment.-First, when the urine is obstructed, give the diuretic drops. 
If these do not afford relief in a reasonable time, the spirits or mint may be 
given, and repeated as occasion requires. Apply fomentations of hops over 
the bladder. If this course fails, a warm bath may be used : should neither 
to botanic remedies, they would seldom have occasion to use the knife. We admit that 
there is occasionally a necessity for amputation, &c., but as Dr. Rush once remarked to his 
students. 1 Gentlemen, one surgeon is sufficient for all Philadelphia.' The doctor knew 
what ought to be, and he was honest enough to admit it. Oh, that some of the faculty of 
the present day would act as Dr. Rush thought."-From Dr. Cooke's Botanic Medical 
Rejormer. 572 
THE REFORMED PRACTICE OF SURGERY. 
have the desired effect, introduce the catheter, which is very simple, and may 
be done by the patient himself. When the stricture is permanent, a bougie, 
anointed with the brown ointment, and sometimes with the celendine or the 
bitter-sweet ointment, should be introduced every day or two, as the person 
can bear it, and remain twenty or thirty minutes. An injection twice a 
day may likewise be used, of a solution of sal soda, a tea-spoonful to half a 
pint of water. Give the alterative syrup, with the hydriodate of potash, in- 
ternally, as mentioned under the head of venereal disease. Nothing heating 
in drink or food to be taken. 
CHAPTER XXVI. 
SUPPRESSION AND RETENTION OF URINE. 
From different causes the urine is liable to be suppressed, either partially 
or wholly, causing great distress. It may proceed from gravel, inflamma- 
tion of the bladder, prostate gland, urethra, cold, &c. There is swelling, 
pain, and inflammation of the bladder, with great difficulty of voiding urine, 
or a complete suppression. 
Treatment.-1 have found it exceedingly useful to steam the patient over 
a strong decoction of bitter herbs or hops, as recommended in several other 
complaints. Both the decoction and the herbs should be thrown into a sui- 
table sized vessel, and a blanket put around the waist of the patient, that the 
steam may be applied more immediately to the seat of the disease. At the 
same time let his feet be immersed in warm ley water, and let him drink freely 
of parsley tea. After he has been steamed fifteen or twenty minutes, let the 
herbs be enclosed in flannel and applied over the region of the bladder, to 
be often renewed, and applied as hot as can be borne. This will usually 
produce such a relaxation of the parts as to cause a free discharge of urine. 
The patient may also take the following : Take a wine glassful of the best 
Holland gin ; add to it a tumbler of spearmint tea and two tea-spoonsful of 
spirits of nitre ; sweeten with honey, and drink the whole. The same por- 
tion should be taken every hour until relief is afforded. Where the pain is 
very exquisite, forty drops of laudanum may be added to each dose. In 
half an hour, or an hour, this treatment, in almost every case of retention of 
urine, will afford relief. The spirits of mint is also very efficacious ; it usually 
gives immediate relief. 
If the suppression of urine does not give way to the means advised, the 
patient should be put into a warm bath ; and, having kept him in for about 
ten or fifteen minutes, he is then to be taken out: if the urine does not flow, 
introduce a silver catheter, or one of flexible gum. 
In all cases it will be necessary to introduce the catheter with gentleness; 
even a moderate force, improperly directed, is capable of injuring the urethra 
in such a manner as to render the operation almost impracticable; and it 
must be obvious to every physician, that long-continued and violent attempts 
have a tendency to increase the inflamed state of the urethra; but, besides 
this, a laceration of its membranous parts might arise, and make an artificial 
passage by the catheter. 
Mr. Miller, of Hamilton, Ohio, who came to this city to consult me for a 
fistula, and who has been subject to inflammation of the bladder, causing a SUPPRESSION AND RETENTION OF URINE. 
573 
suppression of water, states that a strong tea made of pennyroyal always 
afforded great relief. 
A physician called a few days ago and requested me to visit a patient of 
his, labouring under suppression of urine from a stricture. On examination, 
I found that there was great swelling and inflammation of the bladder, sup- 
pression of urine, and so bad that I was doubtful of his recovery. I had 
thought of using the catheter to draw off the water, but concluded first to 
make trial of other means for a short time. I prescribed the spirits of mint, 
with a quantity of spirits of nitre and a little gum camphor, to be given in 
table-spoonful doses every half hour, with parsley tea ; and fomentation of 
hops to the bowels. This soon produced a free discharge of urine, and relieved 
him almost immediately, and in a short time he recovered. A purgative 
was soon after given. I have found this course invariably successful. 
In every instance of suppressed urine, whether arising from stricture, 
gravel, inflammation, an enlarged state of the prostrate gland, or spasm, 
opiates will prove highly serviceable, and ought, therefore, to be administer- 
ed, not only by the mouth along with diuretics of a mild or bland nature 
every four hours, but likewise in clysters, repeated frequently. The liquor 
potassse, in doses of from twenty to thirty drops, joined with tincture of 
opium, the patient drinking freely of mucilaginous liquors, such as linseed 
tea, parsley, elm bark, or barley water, in which a little gum Arabic has 
been dissolved, is a very useful remedy in all cases of irritation at the neck 
of the bladder. 
Injecting sweet oil, or even "warm milk and water, frequently up the 
urethra, will often afford relief, especially if the suppression has been occa- 
sioned by a small piece of gravel which has stuck in the canal. Injecting 
tepid water into the bladder itself, in similar cases, by a syringe, will also 
afford great relief. 
Where the patient is frequently troubled with strangury, he should take 
the urinary decoction, diuretic drops, and infusions of spearmint; also the 
queen of the meadow, cleavers, pumpkin seeds, &c. 
I have been called to patients when nearly deprived of their senses 
from the excruciating pain arising from a retention of urine; and, after putting 
this practice in execution, they have experienced almost instantaneous relief. 
The transition from acute suffering to relief has been truly surprising to all 
who have witnessed it; and the feelings of the patient can be more easily 
conceived than described. 
One one occasion a person, with spasmodic stricture, had retained his 
urine so long that the flesh above the pubis had turned black. Several at- 
tempts had been made to introduce the catheter, but all were unsuccessful. 
Medicine was given, warm bath and injections used, when the catheter very 
readily entered the bladder, and evacuated its contents. 
I have been called when the patient has been groaning and screaming from 
the severe agony and distress under which he laboured, and in a short time 
have removed the sufferings, even without the introduction of the catheter : 
as for puncturing the bladder above the pubis, or by the rectum, I consider 
it cruel and unnecessary. 
The following case is translated from a late work published in Canada, and 
may be of practical importance : 
A case of Retention of Urine from Stricture of the Urethra, related by M. 
Amussat.-{Quebec Medical Journal, 1827 : No. V.,p. 60.)-" A man aged 
seventy years, of a plethoric constitution, thirty years previous had had 
three attacks of gonorrhoea, and ever since has had considerable diffi 574 
THE REFORMED PRACTICE OF SURGERY. 
culty in discharging his urine, not being able to eject more than one 
or two ounces at a time. At eight o'clock, p.m., he made an effort to void 
his urine, without success, which caused him most excruciating pain. His 
pulses were agitated, face flushed, his abdomen distended, the lower part 
much tumefied, the subcutaneous abdominal veins distended, and a partial 
priapism. His efforts to void his urine were extremely painful and fruitless. 
The following day, at ten o'clock, a. m., M. Amussat introduced a bougie, 
which was arrested by the bulb of the urethra, and brought a trifling quantity 
of blood. The urine had now been retained fourteen hours, though he 
was accustomed to pass it as often as twelve or sixteen times every night. 
The obstruction was such, that there seemed to remain no other alternative 
than either to introduce the catheter by force, or to puncture the bladder. 
M. Amussat finally had recourse to a method which completely succeeded, 
without putting his patient to the pain of either of the other operations. He 
injected gradually, but with force, warm water into the urethra, which, in 
dilating the orifice of the stricture, freed the urethra from the thickened 
mucus, which was an additional obstruction. As soon as the injected liquid 
had reached the urine the patient cried out he was cured, and the flow of 
urine returned, as heretofore. At two efforts he voided about two pints of 
muddy urine ; he has had no retention since, and continues in good health." 
If this method is confirmed by experience, of which I have no doubt, it 
will be of great value in the treatment of strictures.* 
CHAPTER XXVII. 
GRAVEL AND STONE. 
Gravel.-Description.-By the term gravel we understand a collec 
tion of sand or small particles of stone collected in some part of the body, 
in the kidneys, ureters, or the bladder. 
Causes.-There is no doubt contained in our food and drink the agents 
which form the gravel and stone. There is a sufficient quantity of sand, 
either in a native state, or combined with other substances, to produce or 
form calculous affections. When the system is healthy these ingredients 
are carried off by the proper secretions of the system: but, when there is 
debility of any organ, especially the kidneys, they become incapable of ex- 
pelling such sandy concretions, and, consequently, they lodge in the kidneys, 
ureters, or bladder. In general, these minute portions of gravel pass off 
without occasioning much disturbance or disease : but, if there be an excess 
of uric or any other acid, a chemical union takes place, and these particles 
* Dr. Hubbell, of Owensville, Bath County, Kentucky, who has adopted our system of 
practice, was called, after other physicians, in great haste to a very distressing and dan- 
gerous case of gravel; he ordered the patient to be immersed in a hogshead of warm water, 
then to be covered warm in bed, and perspiration promoted: he also gave a strong tea of 
the queen of the meadow. This treatment expelled several pieces of gravel, and in the 
morning all his symptoms were removed. The former attending physicians desired Dr. 
Hubbell to communicate his remedies; he replied, " Read the American Practice, and then 
you will know." This physician has met with extraordinary success in the treatment of 
diseases. He has successfully treated several hundred cases of scarlet fever ; and such has 
been the demand for his services, that for five days ho has been unable to remove his clothes 
for sleep. His practice entirely supersedes the old he has now eleven student? under his 
tuition GRAVEL AND STONE. 
575 
of stone are united or combined together, and there is a constant apposition, 
until they become considerably enlarged, or a stone is formed. This stone (or 
stones) may be deposited in the kidneys or ureters, and give rise to inflamma- 
tion of these organs ; or it may pass down into the bladder, and, if not dis- 
charged, constitute all the symptoms of stone. 
Symptoms.-There is usually a frequent and almost irresistible desire of 
voiding the urine. There is often a sense of weight or dull pain in the back, 
and an occasional irritation about the neck of the bladder, which now and 
then extends along the urethra. 
A fit of the gravel is attended with a fixed pain in the loins, numbness of 
the thigh on the side affected, nausea and vomiting, and not unfrequently 
with a slight suppression of urine. As the irritating matter removes from 
the kidney down into the ureter, it sometimes produces such acute pain as 
to occasion faintings and convulsive fits. The symptoms often resemble 
those of inflammation of the kidneys ; but the deposition of reddish brown 
sand, or very fine powder of the same colour, in the urine, on becoming cold, 
will demonstrate the difference. 
When gravel has once formed in the pelvis of the kidney or elsewhere, 
it continues to increase, by receiving on its surface new layers of uric acid 
successively precipitated ; of which we may be convinced by cutting the 
concretions transversely, which enables us to perceive that they are almost 
entirely composed of concentric layers. 
Treatment.-In treating this disease, our object must be to expel the 
gravel from the system, which must be accomplished, first, by relaxing the 
parts which are the seat of the affection, and, second, by administering stimu- 
lating diuretics. If we are called to treat a fit of the gravel, the most speedy 
way of giving relief will be to administer an opiate, the black drop, or an 
opium pill-the doses to be in proportion to the urgency of the symptoms. 
This medicine will so far diminish the sensibility of the parts, and at the 
same time take off the tension or relax them, that the spasms or fit will be 
allayed. There is usually very severe pain across the kidneys, proceeding 
from the irritation of the calculus. When this symptom occurs, fomentations 
will be found very useful: hops, simmered in vinegar, must be repeatedly 
applied. It will be found of great service to throw the patient into a free 
perspiration; to effect which let the feet be bathed, and a strong infusion 
of spearmint tea be given; this plant has a tendency to allay the vomiting, 
to produce perspiration, and at the same time promotes a discharge of urine ; 
and, should it be necessary, the vapour bath may be used. If there is a 
strangury, or difficulty of passing the water, the spirits of mint may be freely 
given, combined with the spirits of nitre. The spirits of mint is made by 
pounding or bruising the green plant (spearmint) to a pulp or soft mass, then 
adding sufficient of the first runnings from the still of Holland gin to make 
a saturated tincture ; add an equal part of spirits of nitre, the strongest kind. 
The watery portion will so far dilute the gin, that it may be taken without 
the addition of any menstruum. This is to be given as often, and as much, 
as the patient can bear. No fear need be apprehended of inflammation arising 
from the stimulating properties of this medicine. There is no other prepa- 
ration, with which I am acquainted, so exceedingly efficacious as the above 
in producing the discharge of urine in retention from any cause. I was 
lately called to a case where two physicians exerted their skill in vain, in 
a retention of urine from gravel and calculi; and, after giving this prepa- 
ration, or a similar one, all the symptoms of the complaint subsided in a 
very short space of time. Having none of the medicine then prepared, 576 
THE REFORMED PRACTICE OF SURGERY. 
went into the garden and broke off a quantity of the tops of the plant, bruised 
them, put them into a quart bottle, and then filled it up with best Holland gin. 
Of this I directed the woman to take about a wine glassful (whether with 
the addition of the spirits of nitre, or otherwise, I cannot now say) as often 
as the stomach would bear. The effect of the medicine was almost imme- 
diate. Although she was exceedingly reduced from pain, arising from a long 
retention of urine, but a very short time elapsed before she was better. Nor 
was she, like too many in this day, ungrateful for the benefit received. In 
addition to the commendation bestowed when I presented my bill, she most 
promptly produced a bag of silver, and evinced, by her manner and feelings, 
a disposition to pay double the amount. But, alas ! where we find one pa- 
tient of this description, we find five, even after we have cured them of some 
desperate disease, who, instead of manifesting gratitude for the favour con- 
ferred, refuse to pay, and probably will even censure. 
Where the case is desperate, it may be necessary to use the warm bath, 
to produce sufficient relaxation to afford relief. The patient should take 
mucilaginous and diluent drinks ; such as slippery elm, parsley, fyc. Physic 
should also be given ; and in some cases emollient injections will be required. 
After the urgent symptoms have been removed, and the ordinary symptoms 
of gravel exist, a tea-spoonful of the diuretic drops should be given two or 
three times a day, in a tumbler of wild carrot tea; and at the same time 
let the person drink the following decoction: Take marshmallows, three 
ounces; queen of the meadow, (spiraa ulmaria,') three ounces; add four 
quarts of water; boil to one; then add two ounces of gum Arabic and half 
an ounce of nitre, (nitras potassa.} The dose is a tea-cupful four or five 
times a day: it may be sweetened with honey. If nausea and vomiting 
attend the complaint, give the solution of the bicarbonate of potash or sal 
ar at us: this has a tendency, not only to allay the vomiting, but also to 
remove the calculous affection. Many persons have derived great benefit from 
the use of Harlem oil- 
For gravel and urinary obstructions the following is excellent: Acetate 
of potash, two drachms ; honey, half an ounce ; spirits of turpentine, half a 
drachm; carbonate of soda, half a drachm; mint water or tea, eight ounces : 
mix; dose, two table-spoonsful three times a day. 
Let the patient drink a gill of red onion juice and a pint of horse-mint tea 
morning and evening, but not together : three days will cause a change. It 
is stated that it will dissolve the stone. 
The above was communicated, by a slave, to a Baptist Minister of Virgi- 
nia, who was cured by it; he afterward bought the slave, and gave him his 
liberty. 
Says a person: " A strong infusion of Pipsissiway, drank freely, has proved 
a valuable remedy." 
Mr. Blanchard states that he was cured of the gravel, when a boy, by 
eating freely of fresh whortleberries. They discharged large quantities of 
foreign matter. 
Stone.-Symptoms.-The symptoms of a stone in the bladder are, a sort 
of itching along the penis, particularly at the extremity of the glans; and 
hence the patient often acquires the habit of pulling the prepuce, which be- 
comes very much elongated; frequent propensities to make water and go to 
stool; great pain in voiding the urine, and difficulty of retaining it, and often 
of keeping the feces from being discharged at the same time: the stream of 
urine is liable to stop suddenly while flowing in a full current, although the GRAVEL AND STONE. 
577 
bladder is not empty, so that the fluid is expelled, as it were, by fits ; the pain 
is greatest toward the end of, and just after, the evacuation; there is a dull 
pain about the neck of the bladder, together with a sense of weight or pres- 
sure at the lower part of the pelvis; and a large quantity of mucus is mixed 
with the urine; sometimes the latter is tinged with blood, especially after 
exercise. 
Treatment.-A strong tea of pennyroyal may be drank freely ; also the 
following: Take burdock, dandelion, and wild carrot, equal parts ; make a 
strong tea, and drink freely through the day. The gravel plant {epigea 
repens') is highly extolled ; make a tea, and drink freely. The button snake- 
root (liatris spicatd) is a powerful diuretic, well adapted to cases of stran- 
guary in case of partial paralysis of the secreting vessels : dose, one gill 
of the decoction, made by boiling one ounce of the bruised root in one pint 
of water fifteen minutes. Saturated tincture, dose half an ounce. 
I lately prescribed the following, which benefited in two cases : one was 
exceedingly bad, and this was the only medicine that afforded any relief; 
Castile soap one ounce ; oil of juniper, twenty drops : mix, and form into 
pills size of a pea, and take two or three morning, noon, and night; increase 
the dose as the strength will bear. Dandelion tea was freely drank with 
them. 
Henry states, in his Herbal, that he has cured a number of cases of gravel 
by a tea of the life root, to be drank freely. One person was cured of gra- 
vel and obstructions of urine by it, who had tried many medicines without 
the least effect. He took four quarts of a strong decoction of the leaves 
and roots. 
Mr. Smith states that he took a solution of sal seretus for gravel, which 
expelled two pieces of calculi, and cured him. 
The most reasonable theory given of the formation and cure of the gravel 
and stone, where it is effected, is given by Dr. Perry. He states that all 
that internal medicine can do is, to prevent any future apposition of the stony 
concretions, by exciting a healthy action of the urinary organs, and then 
depending entirely upon the power of the urine alone to dissolve the stone ; 
and, in all probability, it is in this way that medicine, when taken internally, 
proves efficacious in the disease. In this manner, unquestionably, many 
persons have been cured of stone in a very aggravated form, and the medicine 
given has acquired the character of a solvent. 
Some years ago I was called forty or fifty miles from this city, to see a 
lady labouring under a fistula. On my passage there, a gentleman stated to 
me that he had been for a length of time afflicted with a stone in the bladder, 
and that he had been entirely cured of it by taking a tea of a simple plant, 
which was the wild carrot, (Jancus sylvestris.) He voided forty-seven large 
pieces of stone, part of which he exhibited to me, and the other pieces, he 
said, were in the hands of a physician in the city of New York. He made 
a strong decoction of the top or seeds of the plant, and drank it freely and 
very warm, and continued the use of it for a length of time- He also stated 
that, when the stone produced a retention of the urine, he avoided the diffi- 
culty by laying upon his back or in a recumbent position, by which the stone 
was thrown to the posterior part of the body, and he was enabled to make 
water by turning on one or the other side. 
The course which has been recommended in the preceding complaint, the 
gravel, should be first thoroughly tried in this disease ; if it does not 
prove effectual, I would recommend the patient to submit to the use of the 
instrument called the lithontriptor, employed for crushing the stone in the 578 
THE REFORMED PRACTICE OF SURGERY-. 
bladder, oy which the horrible and dangerous operation of lithotomy, or cut- 
ting open the bladder, is rendered unnecessary. 
From the success which has attended this ingenious invention, by those 
who well understand it, I confidently hope that this dreadful operation will 
hereafter be dispensed with. 
I speak with confidence on this subject, because I have had an opportunity 
of witnessing and learning the treatment and operation, as practised by an 
ingenious French surgeon. 
Of thirty patients operated upon by M. Civiale since the month of April 
of the year 1824, twenty-five have been cured, and the remainder were still 
under treatment when the memoir was published. Among the former was 
a lad seven years of age, in whom the operation was attended with great 
difficulty, by reason of the imperfect developement of the parts and the irri- 
tability of the patient; every obstacle, however, was surmounted; the stone, 
of the size of an almond, and composed of oxalate of lime, was perforated, 
and extracted in three sittings of ten minutes each. 
Should this instrument, and the means recommended, fail of performing a 
cure, I cannot conscientiously recommend the operation of lithotomy, as 
practised in this day. There is one, however, that might, under some cir- 
cumstances, be justifiable, and which I consider to be altogether preferable 
to that now adopted. It is the ancient method practised by Celsus, being 
safe, more simple, altogether less painful, and more certain, and may even be 
performed on children without causing great irritation or much hazard: and 
we have the best authority for stating, that nothing but the simplicity and 
the success attending it in the hands of every one who thought proper to 
make use of the method, induced surgeons to abandon it, and to substitute in 
its place the common operation of lithotomy. Interest, and new and com- 
plicated inventions, then, were the cause of its falling into disuse. 
I will now describe this method, as practised by the ancients : 
Apparatus Minor Cutting on the Gripe, or Celsus1 Method.-The most 
ancient kind of lithotomy was that practised upward of two thousand years 
ago, by Ammonius, at Alexandria, in the time of Herophilus and Erasistratus, 
and by Meges, at Rome, during the reign of Augustus ; and, being described 
by Celsus, is named Lithotomia Celsiani. As the stone, fixed by the pres- 
sure of the fingers in the anus, was cut directly upon, it has been called 
cutting on the gripe, a knife and a hook being the only instruments used. 
The appellation of the less apparatus was given to it by Marianus, in order 
to distinguish it from a method which he described, called the apparatus 
major, from the many instruments employed. 
The operation was done in the following way: The rectum was emptied 
by a clyster a few hours previously ; and, immediately before cutting, the 
patient was desired to walk about his chamber, to bring the stone down to 
the neck of the bladder; he was then placed in the lap of an assistant, or 
secured in the manner now practised in the lateral operation. The surgeon 
then introduced the fore and middle fingers of his left hand, well oiled, into 
the anus, while he pressed with the palm of his right hand on the lower 
part of the abdomen, above the pubes, in order to promote the descent of the 
stone. With the fingers the calculus was next griped, pushed forward 
toward the neck of the bladder, and made to protrude and form a tumour on 
the left side of the perinteum. The operator then took a scalpel and made 
a lunated incision through the skin and cellular substance, directly on the 
stone near the anus, down to the neck of the bladder, with the horns toward 
the hip. Then, in the deeper and narrower part of the wound, a second DROPSY OF THE SCROTUM. 
579 
transverse incision was made on the stone into the neck of the bladder itself, 
till the flowing out of the urine showed that the incision exceeded in some 
degree the size of the stone. The calculus, being strongly pressed upon with 
the fingers, next started out of itself, or was extracted with a hook for the 
purpose.-(CeZsus, lib. 7, cap. 26. J. Bell's Principles, vol. ii., p. 42. Al- 
lan on Lithotomy, p. 10.) 
Enlargement of the Prostate Gland.-Symptoms.-Sense of weight 
and bearing down in the perinseum ; frequent inclination to make water, with 
difficulty and pain in voiding it; great costiveness ; the evacuation of faeces 
is attended with much pain, and is, in general, accompanied with a discharge 
of urine ; micturition and dysuria increase, and at length a total suppression 
takes place. 
Diagnosis.-The urine and faeces discharged at the same time; the patient, 
in making water, is observed to kneel and separate his legs from each other, 
in order to effect a relaxation of the muscles ; an examination per rectum, 
when a large irregular tumour will be discovered in the situation of the 
prostate gland. 
Treatment.-Recourse should be had to all those means which allay 
irritation in the urinary organs. The internal use of opium, cicuta; the 
occasional or constant use of a catheter.-(See Gravel and Slone.) 
CHAPTER XXVIII. 
DROPSY OF THE SCROTUM. {Hydrocele.) 
Symptoms.-An accumulation of a fluid is perceived to commence at the 
bottom of the scrotum, which gradually increasing, the latter becomes 
enlarged and distended ; a distinct fluctuation is generally to be distinguished ; 
the tumour acquires a pyramidal shape ; there is no pain nor discolouration 
of the integuments ; and, upon viewing the parts near to a strong light, a 
transparency is observable. 
Treatment.-At the commencement of the disease, and when a small 
quantity of fluid only is collected, attempts may be made to disperse it by 
internal and external applications. When it occurs in children, which is 
often the case, it may readily be cured by proper treatment, without ever 
evacuating the water by the trocar or lancet. It is usually connected with 
anasarca, or a general dropsical affection ; and we must begin the treatment 
in the same manner as we do for general dropsy, by administering hydra- 
g agues and diuretics. 
Let the parts be fomented or steamed, by placing the patient over a suitable 
sized vessel, in which is put a strong decoction of bitter herbs ; the heat or 
steam to be retained in the usual manner, by means of a blanket. Immedi- 
ately after let the herbs be enclosed in muslin or linen, and applied warm to 
the scrotum, to be repeated two or three times a day. This treatment should 
be applied not only to children, but to adults, as in some cases it may remove 
the disease without farther applications. When it has become large, it 
usually requires a different course to effect a radical cure. 
The water may first be drawn off in the following manner: Let the patient 
be seated in a chair, when the practitioner will grasp a portion of the tumour, 580 
THE REFORMED PRACTICE OF SURGERY. 
at its anterior and inferior parts, between his thumb and finger ; then, w ith a 
lancet, make a small puncture or incision, by which the contents of the scro- 
tum will be discharged. Some use a trocar, but there is no necessity for it; 
a simple puncture is sufficient. As soon as the water has been discharged, 
a tent must be introduced into the orifice sufficiently stiff; (and to the largest 
end there should be a piece of silk thread tied, to keep it from entirely enter- 
ing the sac ;) and another should be introduced in the course of twelve hours, 
in order to keep the wound from healing, as a radical cure depends, in a 
considerable degree, upon this circumstance. 
Should there be any difficulty attending it in consequence of the wound 
healing too fast, a mild escharotic must be applied to each tent before it is 
introduced, to enlarge it or keep it open. As soon as the water has been 
evacuated, every day afterward Castile soap and water, to which a small 
quantity of the tincture of gum myrrh has been added, must be injected into 
the scrotum by a syringe with a long pipe : it should be strong enough to 
excite a little pain. After this a plaster of the black salve is to be applied, 
and the dressing secured by a suspensory bandage ; and, should any inflam- 
mation follow, let a poultice be applied. 
The hydrocele may also be cured by introducing a seton into the scrotum, 
and turning or drawing it a little every day, and using injections, as above- 
mentioned. 
This complaint, in all stages, is the most easily managed of any in surgery; 
at least I have found it so, having always cured it without any difficulty. 
Sometimes the hydrocele is connected with an indurated state of the 
testicle, and which Pott called the hydro-sarcocele. After the water has 
been evacuated, by examining the testicle with a probe, it will be found hard 
and insensible. The cure consists in keeping the orifice open, and injecting 
occasionally stimulating liquids, sufficiently strong to excite a slight degree 
of inflammation. 
Some time ago I attended a gentleman in this city, who was first attacked 
with a collection of water in the scrotum, which continued to increase until 
the swelling or tumour became enormous. I think it had continued for one 
or two years. It was not transparent, but still its appearance indicated the 
existence of more or less water. He had applied to several practitioners; 
but so formidable had it become, that all, except one, w ere afraid to undertake 
it. This surgeon proposed such a severe operation, that the patient wras 
deterred from having it performed. When I commenced the treatment I 
was doubtful what the event might be, but I concluded to undertake it, and 
hazard the result. I first punctured the tumour in the lower portion of it, 
about half an inch from the septum or middle portion. After making a 
puncture with a lancet, I attempted to introduce a trocar, but the water 
flowed so freely that I found it quite unnecessary. After having evacuated 
thirty or forty ounces of serous fluid, I injected, with a small syringe, a weak 
solution of corrosive sublimate, which caused some inflammation, but it sub- 
sided in a few days. I then introduced a long tent, over which I placed a 
piece of lint, then a plaster of the black salve. The whole dressings were 
then secured by a suspensory bandage. In this manner it was dressed once 
or twice a day, (the injection excepted.) The patient was now very feeble, 
and confined to his bed; and, although there wTas a great diminution of the 
tumour, yet, from the solution made use of, or injected into the scrotum, 
there was considerable pain and inflammation. I next applied a poultice, 
which soon reduced the inflammation, but still the patient did not recover ; 
and, as the disease had become stationary, and assumed a very obstinate and DROPSY OF THE SCROTUM. 
581 
dangerous character, I requested a surgeon to examine the disease with me. 
He did so, and, after introducing his probe, and finding a scirrhous state of 
the testicle, gave it as his opinion that castration was necessary to effect a 
cure. I could not, however, agree with him, but communicated his opinion 
to the patient, who was totally unwilling to submit to the operation. I there- 
fore continued my treatment, with very little variation. I applied poultices 
and discutient ointments until pus or matter collected, when, after being 
discharged, the hardness, swelling, and inflammation soon subsided, and the 
man grew better very fast, and in a few weeks entirely recovered. 
Scirrhus of the Testicle.-Symptoms.-An enlargement is first ob- 
served in the body of the testicle, which becomes preternaturally hard, and 
gradually increases in size. An acute, intermitting, lancinating pain ensues ; 
the colour of the integuments become livid ; the surface assumes an irregular, 
knotty appearance ; and often adhesions of the skin take place: ulceration 
supervenes; the edges of the ulcer become livid, sore, hard, and retorted ; 
fungous excrescences sprout forth; and, if timely means are not employed 
to prevent the extension of the disease, the spermatic cord partakes of the 
affection, becoming hard and knotty. Emaciation and hectic fever ensue. 
Treatment.-It is recommended to remove the testicle; but this opera- 
tion, I believe, is never attended with any success. Sir Astley Cooper, when 
speaking of this disease, thus remarked : " The operation of castration for this 
disease is, however, extremely unsuccessful, for it rarely happens that the 
complaint does not return after the removal of the scirrhous testicle." The 
same course must be pursued for scirrhus of the testicle as for scirrhus of 
any other part. 
Inflammation of the Testicle.-Symptoms.-Pain and enlargement 
of the affected testicle; shooting pains along the course of the spermatic 
cord. The body of the testicle next becomes affected; it swells, appears 
hard and painful; the scrotum becomes much enlarged and inflamed ; there 
is a distressing pain in the loins ; the system at length becomes affected with 
fever, quick, hard pulse, nausea, and vomiting. 
Causes.-Inflammation of the testicle may be induced by any of the com- 
mon causes of inflammation, but is most frequently produced by irritation 
of the urethra, the matter of gonorrhoea, the improper use of injections, or 
incautious introduction of a bougie. It often follows a suppression of the 
gonorrhoeal discharge from cold ; sitting on wet grass is a frequent cause. 
Treatment.-The patient should be put upon a spare regimen, remain 
in a recumbent posture, with the part suspended by means of the bag- 
truss employed for irreducible hernia. If the inflammatory symptoms run 
high, subdue them by the ordinary means; by fomentations, refrigerant washes, 
poultices, fyc. 
The treatment laid down for inflammation in general, must be applied in 
this disease. Suppuration must be prevented, if possible, by the use of dis- 
cutient applications. 
The testicle must be bathed two or three times a day with the stramonium 
ointment; and, after a short time, let it be changed for the discutient and bitter- 
sweet ointments. It should also be fomented or steamed over bitter herbs 
once a day, and continued as long as there is any pain, swelling, or inflam- 
mation. A plaster may also be applied. 
Should the disease still progress, and threaten to suppurate, apply a 
stramonium poultice. Simmer the plant in water till it is soft, then stir in 582 
THE REFORMED PRACTICE OF SURGERY. 
a little of the slippery elm bark, sufficient to make it of a proper consistence. 
This should be applied to the testicle, and kept on by a proper bandage. 
After suppuration has taken place, or an abscess formed and the matter 
evacuated, the orifice or orifices must be kept open by means of tents. Injec- 
tions must also be used, the same as for any sinous ulcer. In general, I use 
the alkaline liquid, made strong enough to excite a considerable pain for a few 
minutes ; the black plaster or salve to be applied as usual. A purgative 
should be given once or twice a week, and the general health renovated by 
the exhibition of alterative medicines. 
In this manner I have cured some of the worst diseases of inflamed and 
diseased testicles, where other surgeons have been unable to succeed, and 
where castration has been proposed as the only alternative. 
CHAPTER. XXIX. 
FELON OR WHITLOW. {Paronychia.) 
A whitlow is an inflammation of the fingers, thumb, or hand, exceedingly 
painful, and very much disposed to suppurate. The toes are also sometimes 
the seat of the disease. 
The pain commences deep, with pricking, throbbing, swelling, and inflam- 
mation. It proceeds very slowly to suppuration, and often affects the bone 
and sinews. 
Treatment.-It is customary, in treating felons, to make a deep incision, 
even down to the bone ; but I have found this practice in most cases to make 
the complaint worse, as much pain and inflammation follow. Some apply 
blisters, which also prove injurious, while others recommend a bread and milk 
poultice, most of which treatment I have found to be useless and injurious. 
In treating this complaint successfully, our object should be, if possible, 
to remove it by resolution, or without the formation of pus or matter ; and, 
if we are not able to accomplish this, to make use of such applications as 
will favour suppuration. 
The patient should be directed to immerse the finger in strong ley, as hot 
and as long as he can bear it, three times a day; after which mix the elm 
bark with the liquid, and apply it. If this fails to afford relief, the whole 
hand must be effectually steamed over a decoction of herbs, consisting of 
catnip, wormwood, hoarhound, tansy, and hops. A handful of each should be 
boiled down until the strength is extracted, then a small quantity of soft 
soap must be added, and the whole thrown into a small vessel, the hand 
placed over it, and the steam retained by means of a blanket or piece of flannel, 
as directed for several other diseases. The steaming should be continued 
fifteen or twenty minutes, or as long as the patient can bear ; and, if there is 
not sufficient heat to produce perspiration, let a hot brick or stone be thrown 
into the decoction. This process should be repeated every time it becomes 
painful. The same herbs and decoction may be preserved, as they answer 
the purpose as well as those that are fresh. In almost every case, no matter 
how severe the sufferings of the patient are from the complaint, this opera- 
tion alone will mitigate them, and afford the most sudden relief. 
I have ordered this when the patient has been in acute distress : when he 
has delayed putting it into practice, under a supposition that it would afford FELON OR WHITLOW. 
583 
no benefit, a continuance of the sufferings has forced him to employ it, and 
the process has been followed by the happiest effects. 
Where the disease was deep-seated and protracted I have sometimes found 
it necessary to apply two or three different kinds of poultices. 
I have occasionally used equal parts of linseed and slippery elm, simmered 
awhile in milk, and applied. 
After it has been treated in this manner for a time, a small white spot will 
appear in the centre of the swelling, indicating the formation of matter. 
When this symptom appears, the exit of the matter may be favoured by 
slowly and cautiously introducing a large needle or probe directly through 
this point or place, from which the matter appears about to issue. By roll- 
ing the probe backward and forward, or by giving it a drill-like motion, and 
making a little pressure, and continuing it for some time, it can be introduced 
even down to the periosteum without exciting much pain ; but, if matter or 
pus has sufficiently formed, it is unnecessary to introduce it so far. If it can- 
not be accomplished at one operation, it must be repeated. Where there 
has been any difficulty in making the opening, I have occasionally touched 
the end of the needle or probe with the mineral or vegetable caustic ; but 
this is very seldom necessary. Even after there is a considerable discharge 
of matter, it may be proper to introduce the probe, to prevent the orifice from 
closing. Fungous flesh will often shoot from the opening: this must be 
removed and kept down by a little of the vegetable caustic or potash. A 
little of the vegetable caustic must also be put into the opening daily. 
Some species of felons are exceedingly painful and protracted, producing 
a necrosis or destruction of the bone. I have, been called to cases where 
the whole thumb or finger has been in a state of ulceration, and the bone, 
partially or wholly destroyed, and where the flesh of the patient has wasted 
away one hundred pounds in a short space of time, from excessive irritation. 
When such a form of the complaint presents, in addition to the means already 
prescribed, the vegetable caustic must be applied, and the ulcer enlarged as 
much as possible, to obtain access to the diseased bone ; and when the bone 
is sufficiently loose, it must be removed by a pair of forceps : after this has 
been removed, or when the inflammatory symptoms subside, simple dressings 
are sufficient to complete the cure. The ulcer may be dressed with a little 
lint, and the black or healing salve applied. 
When there is any constitutional disturbance, suitable medicine should be 
given. If the patient is unable to sleep at night, let him take an anodyne. 
After the felon has healed up, sometimes the sinews are contracted, im- 
peding the motion of the joint. For this let the part be daily rubbed with 
a relaxing ointment or oil. In this manner I have invariably succeeded in 
curing the worst and every species of felons, and in all stages of them, and 
often when the complaint has been exceedingly aggravated by the common 
practice, particularly in laying it open. 
A patient has just called, who has been in great distress with a whitlow 
or felon, and who had tried a number of applications without much benefit, 
a day or two ago I recommended to him the process of steaming, but he 
neglected it, apparently from the supposition that it was too simple to afford 
any relief; but, after repeating to him the necessity of resorting to it, he 
steamed his hand thoroughly, by throwing the decoction, with the herbs, 
into a small vessel, placing his hand over it, and retaining the steam by 
a blanket. He states that it gave immediate relief, deadening or remomny 
the pain, and producing a free discharge of matter, and also lessening the 
swelling or inflammation. 584 
THE REFORMED PRACTICE OF SURGERY. 
The following was communicated to me by Sidney Bowne, who has had 
considerable experience in the treatment of felons: " Soak the part half an 
hour in weak ley, as hot as can be comfortably borne; if the skin on the 
part is thick, shave it down, but not to bleed; then take clay, dry it, pul- 
verize, and sift it; add spirits of camphor, made very strong with alcohol 
and camphor, until it is about the consistency of common mortar; apply to 
the part affected, about half an inch thick; in a short time the clay will be- 
come dry, then pour on spirits of camphor until it will not absorb any more. 
Continue to moisten the clay in this manner as often as it becomes dry, which 
it will generally do in fifteen minutes. By proceeding in this manner for 
two or three days, without removing the bandage or changing the clay, I 
consider the above almost an infallible cure, as I have used it on my own 
person five times ; and perhaps, in thirty cases where I have prescribed, not 
one has failed, when properly attended to. I have known them to be cured 
without any opening, after a speck of matter was discernible under the skin 
CHAPTER XXX. 
POLYPUS. 
A polypus is a fleshy excrescence, of various density and colour, origi- 
nating from the lining membrane of a canal or cavity, as the nose, vagina, 
rectum, &c. 
The common polypus is pendulous, and hangs by a small pedicle; it is 
moveable within the nose ; its size is influenced by the state of the weather, 
the protrusion being greatest when hazy and damp ; it is of the natural colour 
of the skin, or of a faint red, in some degree transparent and free from pain ; 
it sometimes projects from the anterior, at other times from the posterior, 
aperture into the nose. Frequently it ulcerates and discharges matter, and 
affects the bone. The nostrils become full, the voice altered, and the eyes 
suffused with tears ; headache, &c. 
Several species of nasal polypi are described by authors, one of which is 
said to be of a malignant nature, disposed to end in cancer. This, however, 
I believe is extremely rare ; the most common are a fleshy, red, vascular poly- 
pus, and a pale, tough, firm polypus, neither of which is of a cancerous 
nature. 
Treatment.-I have succeeded in curing this disease, when it has not 
become too large, by directing the patient to use the following snuff: Take 
bayberry bark and blood-root, pulverize, and mix. This must be snuffed 
up the nose frequently through the day. If the polypus is too large to 
admit it, it may be introduced by tying a strip of linen to a probe, wetting it, 
then dipping in the powder, and touching the tumour with it; to be often 
repeated. Where the tumour is quite large, and this method does not prove 
effectual, it may be necessary to introduce a pair of forceps, seize the tumour 
as far up as possible, and compress so hard as to disorganize it; or by turn- 
ing the forceps to twist it off, and afterward apply the powder to prevent 
a regrowth. I have never had occasion to do this, except in one instance, 
and this was in the last stage of the complaint. Many practitioners 
are in the habit of introducing a ligature round the polypus, by means of a 
double canula. But, whether taken out in this manner or by the forceps, it is very apt to appear again, except some escharotic be applied to the source 
or origin of it. The above powder generally turns the polypus black, when 
it will either disappear by a discharge, or drop off. The powder must be 
continued for some time after it is apparently well. The blood-root alone, 
snuffed up the nose, has cured the polypus. 
The last case I attended was that of a farmer, who came from the state 
of Pennsylvania to ask advice of me. His nostril was filled with the 
polypus. I was obliged to extract a portion of it with the forceps before I 
could introduce the medicine. 1 gave him pulverized poke-root to put up 
his nose, which, I was informed, subsequently continued to slough it off till, 
in all probability, it was entirely destroyed. 
When he was about to leave he wished to know what my demand was, 
and requested me to " charge him -well," adding, " I am afraid that you will 
not ask enough." I replied, " Suppose that I should charge twenty dollars ?" 
(twice the sum I had thought of.) In the most prompt manner, he unfolded 
a large roll of bills and handed me that amount, and added, " Now, I will 
give more, if you desire it." 
I mention this to exhibit a very rare trait in the human character, and as 
an example worthy of imitation. 
SALT RHEUM-TETTER. 
585 
CHAPTER XXXI. 
SALT RHEUM-TETTER. {Herpes-Psoriasis.) 
This is a troublesome, inveterate eruption, appearing on different parts of 
the body, usually the hands. Very small eruptions or vesicles appear, which 
break and discharge a thin, ichorous, or corrosive fluid, that causes a very 
great degree of irritation or itching: afterward scabs often form upon the 
part affected, which, though they be rubbed off or dry away, will reappear 
after awhile. 
It is attended with more or less inflammation and swelling ; and such is 
the degree of itching sometimes attending it, that the patient is obliged to 
scratch continually, to obtain the least relief. The whole hands or parts 
occasionally become excoriated, stiff', and almost immoveable. It seems to 
be located principally underneath the skin ; although, from its disappearing 
in one part, and then appearing in another, it is evident that the disease is 
located in the vascular system or the blood. It appears to be occasioned 
by a retention of morbid humours, which are thrown to the surface, and 
which the system seems unable entirely to expel. 
The disease appears to be very similar to the different species of herpes, 
as described by some authors. Four kinds are enumerated: 
1. Herpes Farinosus, or what may be termed the dry tetter, is the most 
simple of all the species. 
2. Herpes Pustulosus. This species appears in the form of pustules, which 
originally are separate and distinct, but which afterward run together in 
clusters. 
3. Herpes Miliaris-the miliary tetter. This breaks out indiscriminately 
over the whole body ; but more frequently about the loins, breast, perinseum, 
scrotum, and groin, than in other parts. It generally appears in clusters, 
though sometimes in distinct rings or circles, of very minute pimples, the 586 
THE REFORMED PRACTICE OF SURGERY. 
resemblance of which to the millet seed has given rise to the denomination 
of the species. 
4. Herpes Exedens, the eating and corroding tetter, (so called from its de- 
stroying or corroding the parts which it attacks,) appears commonly, at first, 
in the form of several small painful ulcerations, all collected into larger spots, 
of different sizes and of various figures, with always more or less of an ery- 
sipelatous inflammation. These ulcers discharge large quantities of a thin, 
sharp, serous matter, which sometimes form into small crusts, that in a short 
time fall off. 
Treatment.-The treatment may be commenced by applying the follow- 
ing wash : Take of celandine, (chelidonium major,') a table-spoonful; Irish 
whiskey, or good spirits, one pint: add the celandine to the spirits, and digest 
a few days, to extract the strength : wash often with this tincture; after 
which apply the brown ointment. 
An ointment of the garden celandine is also very good; it may be applied 
whenever the itching is troublesome. 
If the complaint is attended with any inflammation, it must be first 
subdued by a poultice made of slippery elm bark and fresh milk, which will 
soon allay it, as well as the itching. 
The patient should take internally such medicines as are calculated to 
purify the blood; as the alterative syrup, and an infusion of black alder bark 
and yellow dock. 
An excellent beer or diet drink, possessing alterative properties, is made 
by boiling, in a suitable quantity of water, the following articles: Take the 
root of sassafras, (founts sassafras,) burdock, (arctium lappa,) black alder, 
(prinos verticillatus,) wild cherry tree, (primus Virginiana ;) of this let a 
strong decoction be made, then sweeten with molasses or honey, and, when 
about blood-warm, add a sufficient quantity of yeast to ferment it: the 
patient should take freely of this beer. 
The alterative syrup should be taken internally, and the hydriodate oj 
potash added, half an ounce to every bottle : it should be used until well 
Roots and herbs possessing alterative properties may be used. The vapom 
bath is likewise a great auxiliary in the treatment of this complaint. It often 
proceeds from the use of animal food, and, therefore, a milk and vegetable 
diet must be strictly observed. 
Take yellow dock, pound fine, add one quart of cold vinegar, (perhaps 
spirits would be better,) and let it stand twenty-four hours ; wash every two 
hours : said to cure all cases. 
In some eruptions, assuming an anomalous character, and particularly 
those appearing on the face, body, and extremities of infants and children, as 
well as adults, I have found the application of the brown ointment a very 
valuable remedy. 
In some species of this disorder, where other means fail, the yellow dock, 
stramonium, and the discutient ointments may be used alternately ; for such 
a protean type does the salt rheum or herpes sometimes assume, that a variety 
of medicines become necessary to eradicate every species of it. 
Barbers' or Jackson's Itch.-This is an herpetic affection, which much 
resembles the salt rheum. It is contagious, being communicated from one 
person to another, generally by a razor in shaving ; and is attended with 
heat, itching, swelling, and the formation of eruptions and scabs : it spreads 
to a considerable extent, which renders it very difficult to have the beard 
taken off. CHILBLAIN. 
587 
Treatment.-Apply the celandine tincture and the brown ointment alter- 
nately. Should this fail, apply a little of the white precipitate, dry ; wet 
the finger with spittle, and touch the parts whenever they itch : this removed 
one severe case, which several physicians tried in vain to cure. Yellow dock, 
pulverized, and added to vinegar, and the parts wet with it, is said to be a 
remedy. 
Chafing and Excoriations.-Salt and brandy, a saturated solution 
applied to the parts daily, is an excellent application for chafing and exco- 
riations. The celandine ointment is also very efficacious. If these fail, 
apply the herpetic or brown ointment. 
Stiff Joints, Callus, Contraction of Tendons, etc.-Apply the 
rheumatic liquid, bitter-sweet and discutient ointments. Also the following : 
Take fish oil, beef brine or salt and water, beef's gall, one gill each; four yolks 
of eggs, (beat up:) mix, and shake well together ; apply three times a day. 
CHAPTER XXXII. 
CHILBLAIN. (Pernio.) 
Chilblains are painful, inflammatory swellings, of a deep purple or leaden 
colour, to which the fingers, toes, heels, and other extreme parts of the body 
are subject on being exposed to a severe degree of cold. The pain is not 
constant, but rather pungent and shooting at particular times, and an insup- 
portable itching attends. In some instances the skin remains entire, but in 
others it breaks and discharges a thin fluid. When the degree of cold has 
been very great, or the application long continued, the parts affected are apt 
to mortify or slough off, leaving a foul, ill-conditioned ulcer behind. 
Children and old people are more liable to be troubled with chilblains 
than those of a middle age ; and such as are of a scrofulous habit are 
remarked to suffer severely from them. 
The best mode of preventing these affections is, to avoid, with much care, 
any exposure to wet or cold ; therefore those who are subject to them 
should be cautious, on the approach of winter, to keep warmly clothed. 
Treatment.-If the parts have been recently frozen or frost-bitten, the 
fire must not be approached, but the cold gradually abstracted. The affected 
parts may first be immersed in snow or cold water, which will remove the 
frost; after which let brisk friction be used, and a little camphorated spirits 
be applied. If there is much pain or inflammation, apply an elm bark 
poultice ; after which a cooling and soothing ointment, and, lastly, the 
black or healinq salve. The brown and celandine ointments are good. 
A person informs me that pure linen stockings are a sure remedy for 
chilblains, to be worn from fall to spring. Immersing the parts often in 
salt and water, cold, invariably benefits this affection. , 588 
THE REFORMED PRACTICE OF SURGERY. 
CHAPTER XXXIII. 
TIC DOULOUREUX. {Neuralgia.) 
This term is used to signify a disorder, the most prominent character of 
which consists in severe attacks of pain, affecting the nerves of the face. It 
commences with acute pains shooting from certain parts about the forehead, 
eyebrows, inner corner of the eye, ear, cheek, nose, palate, and teeth, attended 
with more or less twitching of the muscles. It attacks suddenly, and is very 
peculiar. The pain darts along the course of the affected nerves, and occurs 
in paroxysms of the most excruciating agony, succeeded by intervals or 
intermissions. The pain may be compared to a sharp instrument piercing 
the flesh, and generally draws the tears copiously from the eyes. It is 
usually quite protracted, and wastes the patient, and. sometimes proves fatal. 
Generally there is no swelling nor inflammation of the parts. It proceeds 
from debility of the whole nervous system. 
Treatment.-The treatment consists, 1st, in cleansing the stomach and 
bowels ; 2d, in giving tone to the system, by the exhibition of strengthening 
medicines; 3d, in administering anodynes. If the pain is very severe, 
administer the anodyne powders in large doses, or the extract of henbane. 
Bathe the parts affected with the tincture of the same, and also with the 
rheumatic liquid, to be repeated every hour or two until relief is obtained; 
after which let the restorative bitters be taken internally, with the addition of 
red oxide of iron, half an ounce to a quart of the bitters : occasionally an emetic, 
and the anti-dyspeptic pills every night, or every other night. I treated the 
last case, which was very distressing, in this manner, and soon effected a 
cure. The extract of belladonna and hyoscyamus, equal parts, rubbed together, 
with a little spirits, and applied to the parts affected, is calculated to remove 
the urgent symptoms ; or an ointment made of the tincture of henbane, by 
simmering with lard or fresh butter, and rubbed on the parts affected, is a 
good auxiliary. 
I attended an old lady who had been suffering under nervous irritation in 
various parts of the body, from some cause, for more than twenty years, and 
could obtain no relief. I gave her alterative syrup, with the addition of 
hydriodate of potash, which was the only treatment that afforded any relief. 
I relieved or cured three very bad cases by giving our restorative wine 
bitters, with the addition of an ounce of the red oxide of iron to one quart; 
the dyspeptic pills, occasionally a dose of mandrake physic, and an emetic ; 
also extract of henbane, one common size pill twice a day. When the dis- 
tress is very great, anodyne powders are excellent. 
Dr. King states that his brother-in-law, Professor T. Woodward, uses the 
extract of conium maculatum for the cure of tic douloureux. The extract is 
prepared by grinding the plant, pressing out the juice, and then suffering it to 
evaporate in the sun to a proper consistence. He makes extract of poke, 
stramonium, &c., in the same manner. 
Smoke equal parts of black pepper sage and stramonium, mixed and pul- 
verized, and force the smoke through the nose; repeat often. Rub the parts 
with an alcoholic solution of veratria, to deaden the sensibility of the nerve. TUMOURS, ETC. 
589 
CHAPTER XXXIV 
TUMOURS, &c. 
Tumours are of various kinds and sizes, as sarcomatous or fleshy stea- 
tomatous, called wens; encysted, when there is matter contained within a 
cyst. The contents of some are soft and pulpy, like honey ; others similar to 
common flesh; in general they are free from pain, but are more or less 
troublesome, and grow to a great size. 
Treatment.-Tumours may be removed, particularly when they are 
pendulous, by passing a silk or linen thread around the base, and then fasten- 
ing it to a short piece of metal or wood, and daily drawing it tight enough to 
stop the circulation. Tumours of great magnitude may be taken off in this 
manner; and there is an advantage in removing them in this way, in conse- 
quence of no hcemorrhage attending the operation. Besides, the patient has 
less dread of it than excision by the knife. 
I removed a very large sarcomatous or fleshy tumour, of fourteen years' 
standing, in this manner, from the shoulder of a lady in this city, which 
was preserved in a jar of turpentine, and exhibited a length of time in 
Scudder's museum as a curiosity. I have found very little difficulty in 
removing every kind of tumour, without resorting to the knife. 
Another method I have successfully practised, which consists in applying 
the caustic potash over a small portion of the most prominent part of the 
tumour, until a deep eschar is formed, and afterward applying slippery elm 
bark and yeasty to promote suppuration. After a few days sloughing will 
commence, and the contents of the tumour will be discharged. 1 once 
removed a tumour from the face of aperson, which was so large that the boys 
were in the habit of running after him, to examine it as a matter of curiosity. 
The following is the method of applying the caustic : Take a stick or roll 
of the caustic potash, and enclose it in a piece of paper, all except the end, 
to prevent injury to the fingers; then, after having wet the most prominent 
part of the tumour, gently touch or rub it in a circular form, about the size 
of a twenty-five cent piece, or according to the size of the tumour, to be con- 
tinued until the skin turns brown or dark, which is usually in about five or 
ten minutes. As the caustic dissolves it runs down and excoriates the parts : 
this should be absorbed by cotton or linen. The pain is severe for a short 
time only, and no more is experienced until the eschar separates. A poul- 
tice of the elm bark and yeast must now be kept on, to favour the process of 
sloughing, or a detachment of the disorganized parts; which, when done, 
gives vent to the internal portion or substance of the tumour. 
I think it is much better to remove tumours in this manner, than by the 
knife; because, 1st, in using the knife, it is necessary to dissect the whole 
tumour, which is very painful ; 2d, there is sometimes danger of hsemorr- 
hage ; 3d, the tumour is more apt to recur after excision, than when it is 
taken out by this method, particularly where the contiguous parts are 
diseased. 
I saw an account, in a Baltimore paper, of one or two large tumours being 
removed merely by puncturing them in several places, and then exciting a 
discharge by injecting a stimulating liquid. 
In passing through the street some time ago, my curiosity was attracted 590 
THE REFORMED PRACTICE OF SURGERY. 
by a tumour of considerable magnitude, which was situated on the cheek of 
a negro. I examined it, and made some inquiries respecting it. I found 
that about one-half of the tumour had been removed, which, he informed 
me, had been effected by rubbing upon it, two or three times a day, the juice 
of milk-weed, or the milky fluid which issues from the plant; and, from the 
change that had been produced, I have a favourable opinion of this juice in 
some kinds of tumours. 
There is a species of tumour w'hich, it appears, the knife, caustic, ligature, 
or anything else, has not been sufficient always to remove : I mean the bony, 
callous, or osteo-sarcomatous tumour. Amputation has been performed for 
this, and various other means tried, but without effect; although I cured 
one which appeared upon the side of a gentleman, who, in consequence of 
its inveterate character, came to me a distance of sixty miles to have it 
treated. I applied sassafras oil and camphor, and cupped it often ; then a 
discutient or sweating plaster, which, after about six months, entirely dis- 
persed it. I have repeatedly seen the patient since, who is perfectly well. 
A gentleman from the eastward informs me that a bony tumour appeared 
upon some part of an ox belonging to his father, and which he entirely re- 
moved by applying the phytolacca decandria, or the common poke or scoke 
root. From analogy, we may infer that this plant, which possesses great 
discutient properties, would cure tumours of a similar nature appearing on 
the human body. 
A gentleman called at the office the other day, who had had a wen upon his 
cheek for eighteen or twenty years, and which one of my students removed 
by the preceding treatment: and another student has removed one since, 
which had been upon the face for many years, by one application of the 
caustic potash, which enveloped the whole in an eschar, and removed it in 
a solid mass. 
From the success we have invariably had in removing different kinds of 
tumours in the manner here laid down, I am induced to believe that the 
knife is very seldom required. 
Wash the tumour three or four times a day with salt and water. A large 
sarcomatous or fleshy tumour was benefited, growth arrested, and pain 
removed, by applying yellow ointment, {bitter-sweet,') and poke-root, roasted 
and mashed. The patient called to see me a few days ago, and stated that 
he should not now be living, but for the benefit he had received from the 
reformed practice. 
Mother's Mark.-{Navus Maternus.')-A small prominence or excre- 
scence in infants, rising generally a little above the skin. They are fleshy and 
very vascular, (bloody,) consisting of a number of bloodvessels. The infant 
is born with this mark: sometimes they disappear spontaneously; at other 
times they become malignant, and prove serious. 
Treatment.-The treatment has formerly been to cut them out; now the 
practice is, to run a number of red-hot needles into the tumour, and thus 
destroy it. Both of these methods are cruel and unnecessary. Apply, three 
or four times a day, the juice of milk-weed, (asclepias syriaca;) if this does 
not remove it, rub it well, and often, with the juice of celandine. Should it 
still remain, touch it daily very slightly with the caustic potash, as little as 
can be applied at a time. BRONCHOCELE-COMMON BILE. 
591 
CHAPTER XXXV. 
BRONCHOCELE. 
A tumour on the forepart of the neck, formed by an enlargement of the 
thyroid gland. The progress of the swelling is extremely gradual, and, in 
general, the skin long retains its natural appearance. It is at first soft; but 
as it advances in size it acquires a great degree of hardness ; the skin becomes 
of a brownish or copper colour, and the veins of the integuments are varicose. 
The face is subject to frequent flushing ; the patient complains of frequent 
headaches, and likewise of pains shooting through the body of the tumour. 
It is often accompanied with hysteric affections. 
Causes.-The inhabitants of Derbyshire, and other mountainous parts of 
Europe, and those of the Alps and adjacent mountains on the continent, are 
peculiarly subject to this disorder. Arnone the latter it is known by the 
name of goitre, and its origin is ascribed to the use of snow water. It is 
considered a scrofulous affection of the gland. 
Treatment.-An ointment made of the roots of poke may first be applied ; 
and, if this does not discuss it, apply the discutienl ointment: if this fails, 
make an issue upon the tumour with the caustic potash, and then poultice 
it with yeast and elm bark, to promote a discharge. The juice of milk-weed, 
from its specific effects in removing wens, might also remove this kind of 
tumour: in other respects, let it be treated the same as scrofulous tumours, 
both internal and external. 
Dr. S. Bell, a graduate of our school, has recently cured a difficult case of 
bronchocele by pursuing this kind of treatment. The discutient ointment, 
united with an ointment made of the poke-root, contributed much toward 
the cure. Also apply poke-root, roasted. 
An ointment made by mixing the ashes of burnt sponge with lard, equal 
parts, is recommended ; it should be rubbed on three or four times during 
a day: it will subside very slowly. 
CHAPTER XXXVI. 
COMMON BILE. (Furunculus.') 
This disease is so well known that it needs not much description ; and, 
although very common, is extremely tedious and painful. A hard, circum- 
scribed, exquisitely painful phlegmonous tumour, generally appearing under 
the figure of a cone, the base of which is considerably below the surface of 
the surrounding skin. Upon the most prominent part of the bile there is 
commonly a whitish or livid pustule, exquisitely sensible to the touch, and 
immediately beneath this is the seat of the abscess. The matter is generally 
slow in forming, and seldom found to exist in considerable quantity. 
Treatment.-When in a state of inflammation let it be poulticed with a 
mixture of equal parts of linseed and slippery elm bark, boiled for a short 
time in rain water or milk. If the pain is very great, steam the part over bitter 592 
THE REFORMED PRACTICE OF SURGERY. 
herbs. After it suppurates and breaks, and when the inflammation has 
subsided, apply the black or healing salve, or the yellow salve. 
CHAPTER XXXVII. 
ENLARGEMENTS OF THE TONSILS. 
Enlargements of the tonsils may be of two kinds : 
1. The common abscess, occurring in cynanche tonsillaris or inflammatory 
sore throat. 
2. A chronic swelling, generally the consequence of previous inflamma- 
tion of the gland in a scrofulous habit. They often become so large as to 
impede both respiration and swallowing. 
Treatment.-Occasionally give a purgative, and also an emetic; after 
which excite ordinary means recommended. If the 
child is of a suitable age, let it frequently inhale the steam of bitter herbs. 
When the swelling is very great, bathe it with equal parts of sassafras and 
olive oils, to which add a little gum camphor : afterward apply over the 
tonsils equal parts of hops and wormwood, simmered in vinegar. When the 
inflammation has in a measure subsided, apply the discutient ointment on a 
batt of cotton, to be kept constantly bound on the throat, over the seat of 
the swelling. The tonsils, if practicable, should be frequently touched with 
common ley, by means of a piece of sponge or muslin fastened to a probe or 
piece of stick. The feet must be frequently bathed, and exposure to wet 
and cold avoided. 
It is customary to remove the tonsils, when they become enlarged, with 
the knife or ligature; but this is very painful, and not devoid of danger, and, 
if possible, should never be resorted to: if these means be persevered in, 
they will effect a cure without either of these operations. 
In case the almonds of the ear are so large that the difficulty of breathing 
is very great, they may be touched daily with a little caustic potash until 
dispersed. 
CHAPTER XXXVIII. 
GANGLION. 
A hard tumour, moveable on the tendons, called " weeping sinew. " 
These tumours, although indolent, being yet very troublesome by pressing 
on the tendons, it may be necessary to remove them. This can in common 
be effected by exciting the absorbents-the best way of doing which is, by 
pressure ; for this, when applied to a degree just beyond the point of ease, 
calls forth their activity to remove, when it is removable, the pressing sub- 
stance, and that substance is the ganglion. I need scarcely add, that the 
pressure must be uniform and long continued. 
Another method of cure is, to give hard and repeated blows with a 
book ; for this, by bruising, disturbs the organic structure of the part, and DEAFNESS-AGUE. 
593 
thereby, according to a beautiful law of the animal economy, excites the 
absorbents into action for the purpose of conveying it away. 
When the ganglion, by neglect, has been suffered to enlarge itself, it may 
be vain to attempt its resolution in these ways. Nothing then remains but 
to remove it. 
Treatment.-I have removed this complaint in the following manner : 
Make a small puncture into the tumour with a lancet, which will evacuate 
a fluid of a transparent appearance ; then, with a suitable syringe, inject a 
stimulating liquid ; after which introduce a tent, and apply a plaster. Let it 
be kept open as long as possible. 
It may also be removed in the same manner that is recommended for the 
removal of other tumours. Let it be touched with the caustic potash until an 
eschar is formed, and then employ the yeast and elm poultice to separate it. 
CHAPTER XXXIX. 
DEAFNESS. 
This is most commonly owing to a relaxation of the tympanum, accumula- 
tion of wax, or paralysis of the auditory nerves. 
Treatment.-Hot, stimulating oils applied by means of wool; drop into 
the ear the balsam of copaiva, then inject soap-suds daily. If this fails, try 
electricity, and keep up a discharge behind the ear by means of an issue- 
Introduce into the ear the sap of hickory, procured by placing a stick over 
the stove or fire, and preserving the sap as it is forced out; watchmakers'1 
oil, and the same quantity of spirits of turpentine, may also be tried in the 
same manner. Frequently stand by the side of a cannon when fired. 
Dr. C. Brady, a botanic physician, recommends the following: Take 
sassafras oil, five drops ; sweet oil, half an ounce : mix, and drop into the ear 
once or twice a day. He says that this seldom or never fails. 
Extraneous Bodies in the Ear.-These may often be extracted by 
means of a small forceps, or by syringing the ear with tepid water. Should 
these means be unsuccessful, they may be suffered to remain with impunity, 
if they do not produce pain, as in a short time they will be forced out with 
the accumulating wax. 
Insects may be killed by filling the ear with spirits, or any other fluid, 
and afterward removed by injections of warm water. 
CHAPTER XL. 
AGUE, OR PAIN IN THE FACE AND JAW. 
The jaws, teeth, and face frequently become swollen and painful, pro- 
ceeding from cold, which is termed, by some,ague in the face. It is a very 
distressing complaint. 
Treatment.-1st. Steam the jaws or face over bitter herbs 594 
THE REFORMED PRACTICE OF SURGERY. 
2d. If the swelling be very great, apply a ley poultice. 
3d. Bathe the parts with the rheumatic liquid. 
4th. Dip a piece of cotton or lint in the tincture of red pepper, (capsicum,) 
made warm, and place it between the cheek and the teeth. A free discharge 
of saliva follows, which usually affords immediate relief. 
Toothache.-Pursue the same course. If it fails to cure, dip a piece of 
lint in the oil of cloves, and press it into the tooth affected. If this fails, apply 
the oil of capsicum in the same manner. And if all these means fail, the 
nerve may be destroyed by putting into the decayed tooth a few drops of 
nitric acid. Great care must be observed to keep it from touching or getting 
into the mouth. 
If the patient is unwilling to have the tooth drawn, and the pain is very 
great, an anodyne may be taken. 
By cleaning the teeth two or three times a week, or even once a week, 
with a powder composed of equal parts of levigated charcoal and prepared 
chalk, it will both preserve and prevent them from aching: or salt and water. 
Dr. Harris states that the oil of summer savory instantly and permanently 
cures the toothache ; to be introduced on cotton or wool. 
CHAPTER XLI. 
INVERTED TOE-NAIL. 
A disease frequently occurs in the toe, productive of much inconvenience 
and distress-an inversion of the nail, generally of the great toe, which grows 
in upon the flesh, usually in consequence of wearing a tight shoe. 
This complaint is attended with severe pain and inflammation, sometimes 
with ulceration. A fungus arises in many cases, which is extremely sensi- 
ble, and gives great pain when touched, so that the patient is completely 
incapacitated from walking. The nail, in many cases, becomes entirely 
imbedded in the flesh, and in others a thick skin forms over the greater part 
of it. Distressing spasms occasionally result. 
Treatment.-The foot must be well bathed in very warm ley water at 
least once a day, and the slippery elm bark poultice applied immediately 
after: this will diminish excessive inflammation, and render the patient 
more comfortable. But, in order to effect a radical cure, it will be necessary, 
immediately after the foot has been immersed in the ley water for twenty oi 
thirty minutes, to press down as far as possible, without exciting too much 
pain, pledgets of lint between the nail and the flesh, until the nail is brought 
upon a level with the contiguous parts; and after this has been done, if the 
inflammation has measurably subsided, let a plaster of the black salve lie 
applied directly over, and a narrow bandage again bound over this, in ordei 
to secure the dressings. 
I find it best to apply sufficient lint to elevate it above the nail and flesh, 
that the plaster and bandage may continually produce such a degree of pres- 
sure as to separate the flesh from the nail. Where there is great soreness, 
the lint may be dipped in a little celandine or bitter-sweet ointment ; and if 
there is much fungus or proud-flesh shooting up from the ulcer, apply s. few 
grains of the vegetable caustic INVERTED TOE-NAIL. 
595 
After continuing this treatment a few days, an opening will be made down 
to the bottom of the projecting nail, except it be unusually deep; and the 
act of bathing the part will so soften the nail, that the portion which is the 
source of irritation can easily be removed, which may be done in different 
ways. 
I have been in the habit of raising the nail with a small pair of tweezers, 
and then cutting it off with a penknife. Previous to this, however, it is 
desirable, not only to open the parts well, but actually to introduce the lint 
underneath the point of the nail which penetrates the flesh ; and, when this 
is done, the patient feels comparatively well, as the pain and inflammation 
suddenly subside. This not only affords great relief, but enables a person 
to cut off the nail without creating much pain. Sometimes I cut off a little 
at every dressing; at other times nearly the whole. 
The nail must be removed upon a line level with the nttil of the opposite 
foot on the same side, and afterward the lint and plaster must be kept on 
until the ulcer has healed. In following this method I have never yet failed, 
in a single intance, of effecting a cure ; nor have I ever known a case, after 
it has been thus cured, to return again. 
One lady, I now recollect, applied to me, a distance of forty or fifty 
miles from this city, who was suffering under a very severe case of inverted 
toe-nail. It was very painful, and she was unable to walk; but, after pur- 
suing the foregoing treatment a few weeks, she was cured, and has remained 
well ever since. 
Another case occurs to me, which strikingly exemplifies the difference 
between this practice and that usually pursued. A woman of this city had 
been for many years labouring under this disease in a most aggravated form. 
She was in the hospital some length of time, but the surgeons there were 
unable to cure it. She suffered so much that she requested them, and sub- 
sequently myself and another surgeon, to amputate the leg. 
It is impossible for me to describe the deplorable state into which this 
woman was thrown by the complaint. The seat of the disease was in the 
great toe of each foot ; and so deep had the nails penetrated into the flesh, 
that the pain, swelling, inflammation, and ulceration were excessive, extend- 
ing to the feet and legs, and which affected the constitution, and rendered 
her not only a cripple, but completely miserable. 
I was called to attend her in connexion with a noted surgeon of this city. 
He commenced the treatment of one toe, and I commenced the treatment of 
the other; and while I pursued the plan already laid down, he passed a pair 
of forceps underneath one corner of the nail, and suddenly tore the whole 
of it off, in the act of which the woman fainted, and was thrown into con- 
vulsions. 
Although the nail was thus entirely removed, so far from curing her, it 
only aggravated the complaint: whereas, the toe which I treated, and on 
which no such operation was performed, became perfectly well, and has 
remained so for years ; and it is now my impression that it was, in the com- 
mencement, much worse than the other; thus clearly evincing the difference 
between the two modes of treatment. 596 
THE REFORMED PRACTICE OF SURGERY. 
CHAPTER XLII. 
CORNS AND WARTS. 
Corns are too well known to need any description ; and, although attended 
with no danger, they are exceedingly troublesome and painful. They are 
usually occasioned by wearing shoes that are too tight or small. 
Treatment.-As prevention is better than cure, persons should be careful 
to wear such shoes as sit easy, and produce no pressure or irritation. But 
when this precaution has not been attended to, and he becomes afflicted with 
them, the following treatment will be found very effectual: Bathe the feet 
or foot in warm ley water every day; after which apply the black salve or 
plaster. I know not that I have ever recommended this without its having 
had the desired effect. 
Dr. Seely informs me that he has always cured corns by bathing the part 
in warm water, and paring or shaving the corn with a razor, and then cover- 
ing it with an alkaline powder called kali preparation. This, he says, entirely 
destroys them. I presume that the vegetable caustic would be still better, 
as it is more active. 
Corn Plaster.-Purified ammonia and yellow wax, each two ounces; acetate 
of copper or verdigris, six drachms : melt the first two ingredients together, 
and, after removing from the fire, add the verdigris just before they get cold : 
then spread on soft leather or linen, pare the corn with a knife, and apply the 
plaster: remove in two weeks. " This is infallible," says Samuel Cooper. 
Warts.-A very popular remedy for warts, in the country, is, the juice of 
milk-weed and the juice of celandine. If neither of these should remove 
them, they may be touched with some kind of caustic. 
CHAPTER XLIII. 
FOREIGN SUBSTANCES IN THE (ESOPHAGUS AND TRACHEA OR 
WINDPIPE. 
Substances sometimes become lodged in some portion of the oesophagus 
or throat, and, by pressing upon the trachea or windpipe, impede respiration ; 
such as fish-bones, copper coins, &c. 
When I attended the lectures of Dr. Stevens on surgery, I recollect he 
exhibited a preparation, in w'hich a pair of clasps had destroyed the child by 
one entering the trachea and the other the oesophagus, " and which might 
easily have been removed," said the professor, " had the situation of them been 
known at the time." From this circumstance, we may infer what ought to 
be done when first called to an accident of this nature. The tongue should 
be pressed down, and the finger introduced as far as possible, which will often 
enable a person to extract the article, even though it may not be seen. I 
removed a fish-bone from the throat of a person the other day, in this manner, 
in a few moments. 
If a fish-bone, or pin, or needle can be seen in the posterior part of the FOREIGN SUBSTANCES IN THE (ESOPHAGUS, ETC. 
597 
throat, it may be seized by a pair of tweezers and extracted. An emetic, 
by the spasmodic affection which it produces, often dislodges any substances 
of this kind. 
If these means should fail, a small piece of sponge may be fastened to a 
piece of whalebone or wire, and, after having immersed it in water, slowly 
and cautiously introduced into the throat in a spiral-like manner. Dr. Per- 
kins, one of the graduates of our school, informed me, a few months since, 
that, by this simple instrument, he removed a fish-bone from the oesophagus 
of a patient. 
Some use a probang, and force down the substance ; but there is danger 
of driving some agents, such as needles, into the integuments, and thus causing 
serious, if not fatal, consequences. A lady in this city lost her life by this 
means a few years ago. 
A physician in Canada obtained great celebrity, a few years ago, by a 
simple, but ingenious, contrivance, with which he extracted a substance from 
the oesophagus of a person. It consisted simply in tying a small piece of 
sponge to a piece of silk, and causing the person to swallow it; after which to 
drink warm tea ; and, after waiting a short time for the sponge to expand by 
the absorption of the liquid, the end of the string was seized and cautiously 
drawn until the sponge came up, and with it the substance. This may be 
practised in some cases. 
The late Dr. Nathan Smith, of New Haven, professor of surgery in the 
medical institution of Yale College, invented a very excellent instrument to 
extract coins from the oesophagus. 
" I have twice been called upon," says he, " to remove coins from the 
throats of children. In both instances they had descended to near the 
inferior extremity of the oesophagus, where the passage is a little narrowed, 
just before entering the stomach. Of course, they were entirely beyond the 
reach of forceps, or any instrument which might be employed to grasp and 
thus withdraw them. 
" The instrument which the exigencies of the case suggested, and with 
which I succeeded, was unlike anything that I have known to be employed 
for a similar purpose. A very few words will be sufficient to give an idea 
of it. 
" The shaft of the instrument is a rod of whalebone, twenty inches in 
length, and of the size of a small quill. Half an inch from one extremity 
there are attached, at acute angles, like the barbs of an arrow, two wrings of 
silver, an inch and a quarter in length, a quarter of an inch w'ide, and so thin 
as to be very elastic and flexible. The extremity, which stands off from the 
instrument, is convoluted, so as to render it blunt, and is a little curved 
inward toward the shaft of the instrument. The two wings are pinned to 
the shaft of the instrument, and may be continued over its extremity, which 
should terminate with a bead or obtuse point. 
11 From the position of the oesophagus between the trachea and spine, the 
faces of the coin present forward and back. When the instrument is thrust 
down the oesophagus, avoiding the glottis, as may be done without difficulty, 
and presenting the barbs one forward and the other back, it will pass either 
behind or before the coin, and the barb wdll spring beyond it, and catch it 
between itself and the shaft, when it may be very easily withdrawn. The 
manner in which the shaft is embraced by the oesophagus above, prevents its 
slipping off laterally. In both the cases alluded to I accomplished the ex- 
traction of the coin without any difficulty, and at the first trial. In the second 
case, after I had once raised the coin into the mouth, the child instantly swal 598 
THE REFORMED PRACTICE OF SURGERY. 
lowed it again, though I had almost seized it with my fingers. It returned 
to the same place, and I again withdrew it at the first trial. 
" The barbs are made so thin that, should they catch in any of the follicles 
of the oesophagus, they would be everted sooner than rupture the membrane." 
Sometimes substances get into the trachea or windpipe, and prove serious 
or fatal. When this happens, an emetic may first be given ; and if this fails, 
and the substance still continues, it may be necessary to make an opening 
into the trachea; this has sometimes succeeded when other means have 
failed. A longitudinal or horizontal incision is made just below the thyroid 
cartilage, which constitutes the prominence in the throat. 
I extracted a splinter from the throat of an infant, which was very deep, 
penetrated perpendicularly, and caused great distress. I could see the sub- 
stance only when the infant cried, during which time I introduced a pair of 
scissors, closed them upon it, drew it out, when blood followed. How im- 
portant is such information, though simple, to every person. 
CHAPTER XLIV. 
RICKETS. (Rachitis.) 
This is a disease common to children, and caused by debility. It first 
shows itself in the glands; the bowels are enlarged; the face swells and 
becomes altered; the spine is bent in the form of the letter S ; the flesh is 
flabby ; the body wastes ; the forehead is unusually prominent, and the neck 
small; the teeth are liable to drop out; the ribs become flattened ; the breast- 
bone rises ; joint-bones enlarged; and the bones so weak and soft that they 
are unable to support the body ; stools unnatural. Sometimes deformity of 
the female pelvis, and other parts, follow. 
Treatment.-With respect to the treatment of these cases, you will 
observe the same general principles which I have laid down for scrofula. 
The joints, or parts affected, may be bathed with salt and water and the 
rheumatic liquid ; afterward a strengthening plaster applied. The alterative 
syrup should be freely given, and continued a length of time. The bowels 
must be kept regular. Bathing in a tepid salt water bath will also aid in the 
cure. I have found that a syrup made of comfrey and Solomon's seal is very 
serviceable in this complaint. 
Some time ago I cured two very bad cases of rickets by pursuing this 
method. Friction on the parts is also useful. Take exercise, pure air, and 
nutritious diet. 
CHAPTER XLV. 
DOW-WORM OR SCALD HEAD. (Tinea Capitis.) 
This disease consists in a chronic inflammation of the skin of the head, 
productive of a secretion of matter peculiar in its nature, and capable of 
propagating the complaint, if applied to the head of a healthy subject. At 
first the eruption is confined to only a small portion of the* head ; but by RINGWORM. 
599 
degrees its acrimony is extended to the neighbouring parts, and at length the 
whole of the scalp is eroded and beset with a scabby eruption. 
Children principally are affected with it. It may arise from uncleanliness, 
the want of a due proportion of wholesome nutritive food, and possibly from 
bad nursing : at any rate, these will very much aggravate the disease. In 
many instances it is propagated by contagion, either by using a comb imbued 
with the matter from the head of a person labouring under it, or by putting 
on his hat or cap. 
Treatment.-The head, or the part affected, should be first well washed 
with soap and water, and then the brown ointment applied : let this be rub- 
bed upon the affected parts once a day. Give the child cream of tartar and 
sulphur, mixed in molasses, sufficient to act lightly upon the bowels; or 
other physic, as mandrake. This course soon cures it. 
Professor Spielman, late Professor of Medicine in the University of Stras- 
burgh, France, uses the following ointment, in this disease, with success : 
Take of rose ointment, one ounce; white precipitate, one drachm; mix 
well. Wash with soap and water. 
Dr. King highly recommends the following: Chamber ley, (urine,) two 
quarts ; lard, half a pound ; tar, one ounce ; boil all together for two hours ; 
when blood-warm strain ; add slowly two ounces of flour of sulphur ; let it 
cool; then strain. Wash the parts affected with the liquid ; and, when eva- 
porated, wash with the ointment. Good for scald head and other eruptions. 
Also, simmer a decoction of elder with a little cream till an ointment is 
formed, and apply daily: Take sulphur internally. This is said to cure always. 
CHAPTER XLVI. 
RINGWORM. 
I his is a cutaneous disease : it shows itself in small red pimples, which 
break out in a circular form, and contain a thin acrid fluid. When the body 
is heated by exercise these itch intolerably, and, upon being scratched, dis- 
charge their contents, which, by falling on the neighbouring parts, spread 
the disease to a considerable degree. The original size of the circle formed 
by the pimples is usually about that of a sixpenny piece ; but in process of 
time it will become, by neglect, as large as the palm of the hand. 
In some cases the disease is so universal that the habit becomes tainted, 
the skin puts on a leprous appearance, is much disfigured with blotches, and 
the unhappy patient enjoys not a moment's ease, from the intolerable itching 
and painful excoriations. 
Treatment.-Wash with the tincture of celandine twice a day, and then 
apply an ointment of the same. If these fail, use the brown or herpetic oint- 
ment. An ointment of the yellow dock is also good. 
The following is highly recommended, by Dr. Sidney Bowne, for ring- 
worm, dow-wcnm, and barbers'1 itch : Take one ounce of Barbadoes tar, mutton 
tallow size of a common nutmeg, one-half of an even tea-spoonful of fine 
ground pepper; simmer together a few minutes, let it stand till nearly cold, 
and then stir in sulphur sufficient to form a soft ointment. It has cured in 
a number of instances, and no failure known where it has been tried. Wash 
the parts three times a day with Castile soap-suds, and wear a cap on the head. 600 
THE REFORMED PRACTICE OF SURGERY. 
CHAPTER XLVII. 
ITCH. (Psora.) 
The itch is evidently confined to the skin, and rarely affects the general 
system, however great its irritation. It arises most usually from infection, 
communicated by coming into immediate contact with the body of a person 
already affected, or by wearing the same clothes, or lying in the same bed 
that he has; but it is sometimes produced by unwholesome food, bad air, 
and a neglect of cleanliness. 
The itch shows itself in small pimples about the fingers, wrists, hams, and 
waist, which, after a short time, become so many pustules, and are attended 
with such an itching as to occasion a constant desire to scratch. When they 
break, the acrid fluid which they contained falls on the neighbouring parts, 
and thereby spreads the disease over almost the whole body, if proper reme- 
dies are not used to check its progress. Where the pustules are very large, 
and attended with much inflammation, they are apt to run into biles. The 
animalcule which are seen in the pustules are the effect, not the cause, of 
them; as all other stagnating fluids abound with microscopic animals. 
Treatment.-Give internally the following : Take flour of sulphur, two 
parts ; cream of tartar, one part: mix ; of this powder, to an adult, give a 
tea-spoonful in molasses morning and night. Apply the brown or herpetic 
ointment whenever there is itching; also the yellow dock ointment. Should 
these fail, apply the following : Take sulphur vivum, {native sulphur,') pul- 
verized, half an ounce; lard, two ounces; melt the lard, and stir in this 
powder until it is cold : let the parts be bathed two or three times a day 
with this ointment. This treatment will cure this loathsome disease in a 
few days, without the necessity of even changing the clothes, or producing 
any offensive effluvia. 
CHAPTER XLVIII. 
COLLECTIONS OF MATTER IN THE ANTRUM OF HIGHMORE. 
Symptoms.-Pain extending upward to the eyes, nose, and ears ; swelling 
and redness of the integuments over the part; frequently, on a sudden, and 
especially upon rising from bed, a discharge of matter issues from the nose, 
which affords a relief to the symptoms until the cavity becomes again dis- 
tended. 
Treatment.-Evacuating the matter by means of a puncture made 
through the alveolus with a probe or sharp-pointed instrument, and, after 
the contents of the cavity have been thus emptied, preventing the sides of 
the opening from closing, by means of a tent; and occasionally injecting 
tincture of myrrh, or some astringent fluid. 
Generally, after matter has formed, it will find an exit, or may be eva- 
cuated by a probe, without extracting the molar tooth, as some recommend PSOAS AND LUMBAR ABSCESSES, 
601 
CHAPTER. XLIX. 
PSOAS AND LUMBAR ABSCESSES. 
By these terms are understood chronic collections of matter, which form 
in the cellular substance of the loins. 
If the disease forms on the side of the spine instead of the forepart, it is 
termed a lumbar abscess, instead of psoas. The origin of psoas abscess is 
not, in general, attended with any symptoms of acute pain and inflammation, 
nor with any febrile disturbance of the constitution. Previous to the ap- 
pearance of any other symptom, the patient long feels an unaccountable sense 
of weakness across the loins, accompanied by an obtuse, yet distressing, pain ; 
but this, so far from leading to a suspicion of the nature of the disease, is 
usually regarded as rheumatic. The matter is formed slowly and imper- 
ceptibly, and occasions at first no manifest swelling nor fluctuation. When 
the matter has collected it spreads until it reaches the origin of the psoas 
muscle, which passes into ulceration, and forms a bag, surrounded by a 
complete ring. 
The swelling, when in the groin, sometimes insinuates itself beneath the 
femoral fascia; in other instances it descends as far as the knee, where it 
forms a prominent swelling : sometimes it makes its way downward into the 
pelvis, and occasions a swelling in the neighbourhood of the anus ; at other 
times it tends toward the loins and sacrum, giving rise to a swelling exactly 
in the place where abscesses often make their appearance in the disease of 
the hip-joint. In a few instances the matter causes a swelling in the vicinity 
of the spine ; and, less frequently still, it makes its way through the abdo- 
minal muscles, and produces a tumour at some part of the abdomen. 
Causes.-The causes of a psoas abscess are frequently involved in great 
obscurity. It is supposed sometimes to arise from injury done to the back 
and loins, by severe twists, blows, &c.; at other times to proceed from sud- 
den exposure to cold after severe exercise, particularly in scrofulous habits 
Treatment.-If there is inflammation and pain, steam the part, and after- 
ward apply the slippery elm poultice. Continue this treatment until the 
abscess breaks; and, after the matter is evacuated, let it be kept open and 
the discharge of matter facilitated. After a few days inject in Castile soap 
and water, and, subsequently, liquids more stimulating, such as weak ley, 
tincture of gum myrrh, &c. ; they promote the adhesive process in the 
interior of the abscess, glue its sides together, promote a healthy secretion 
and the healing process. The black salve may be applied to the ulcer. 
There being usually much constitutional disturbance, particularly after it 
suppurates, such as debility, loss of appetite, &c., it will be necessary to give 
such medicines as will counteract these symptoms. 602 
THE REFORMED PRACTICE OF SURGERY. 
CHAPTER L. 
SPRAINS. 
Bruises.-By this term we understand an injury or contusion of some 
part of the body, without laceration or breaking the skin. A bruise is often 
very painful, much swelled, and turns the skin black or purple. 
Treatment.-The best application is wormwood leaves, simmered in vine- 
gar to extract the strength, with a little salt added, to be applied cold 
or warm, as agrees best; nothing so soon reduces the swelling. The 
rheumatic liquid is also a good application. After the above has been used, 
apply a strengthening plaster. Salt and tallow, mixed, will prevent the skin 
from turning black. 
CHAPTER LI. 
DISEASE OF THE SPINE. (Spinal Irritation.) 
Some diseases originate in the spinal column, and affect it primarily ; and, 
as the nerves lead from it to every organ and part of the system, it follows 
that in almost every complaint it is more or less diseased symptomatically : 
when this is the case, by pressing the thumb hard on the sides of, and be- 
tween, the prominences of the spine, a tenderness or pain will be felt; when 
this is the case, and any complaint appears to depend upon spinal irritation, let 
the whole length of it be bathed often with the rheumatic liquid. After a 
few days apply the following plaster, which will cause more or less irrita- 
tion, and probably a discharge; and if too much, lay it aside for a short 
time, or apply it to a contiguous part. Direct the attention also to the liver, 
stomach, and bowels. This course will be found very efficacious. 
Irritating Plaster.-Take of May-apple, or mandrake-root, blood-root,poke- 
root, Indian or wild turnip, equal parts ; pulverize fine, and mix the powders 
with tar, the latter to be boiled half an hour before adding the powders ; incor- 
porate and work well together, and form a plaster ; to be spread on soft leather. 
The whole surface may be bathed daily with salt and water ; and, indeed, 
in all other cases where the bones are affected. 
CHAPTER LIL 
BURNS AND SCALDS. 
Apply a poultice of the elm bark and milk: when it has been spread 
upon linen or muslin, let it be covered with olive or sweet oil. The poul- 
tice should not be suffered to get dry, but must be changed often. After 
the pain and inflammation have been removed, apply the black plaster or 
salve; sometimes it is necessary to apply a little lint previously. When SUSPENDED ANIMATION. 
603 
the burn degenerates into an ulcer, and becomes difficult to heal in conse- 
quence of fungous flesh, it must be touched with mild escharotics, the same 
as any common sore. 
Sometimes hot water or liquids are taken into the mouth or swallowed: 
when this happens, let it be gargled with borax water, and a mucilage 
of slippery elm be freely drank ; give the patient occasionally a portion of 
olive oil. , 
For very slight burns the black salve alone is sufficient to remove the 
pain and inflammation. 
This simple treatment I have found strikingly successful in all kinds of 
burns and scalds, and in the worst stages of them. The elm poultice, in the 
course of a few hours, completely changes the appearance of the burn; it 
removes the inflammation, and, from a state of extreme redness or high 
colour, changes the parts to perfect whiteness. At the same time the pain 
and swelling speedily subside. 
All other applications will bear no comparison with this mode of treat- 
ment. On one occasion a child fell backward into a large kettle of boiling 
water, and not only burnt itself severely, but actually roasted or disorga- 
nized the parts from the back nearly to the feet. A poultice of slippery elm 
bark and olive oil alone, in a short space of time, removed the inflammation 
and acute sufferings of the patient, and the child recovered, which, to all 
acquainted with the accident, seemed almost incredible. The deep and 
extensive scars left are frightful. The practice is equally successful in all 
cases of the kind. 
Attend to any particular symptoms that may arise, as fever, costiveness, 
&c. When it is inconvenient to obtain the elm bark, potatoes, scraped fine, 
make a good application. Cold water is also excellent to apply, is always at 
hand, and can be used before any other means can be procured; linen or 
muslin cloths may be wet with it, applied, and often renewed. The relief 
is immediate and effectual, and the part is kept from blistering. It is not 
advisable to apply water too cold to the body, but may be applied cold to 
the extremities. The feelings of the patient, however, must be consulted. 
Stramonium ointment is also good to apply. 
CHAPTER LIII. 
SUSPENDED ANIMATION, BY HANGING, DROWNING, SUFFOCATION, 
OR EXPOSURE TO INTENSE COLD. 
Suspended Animation from Freezing.-A person was senseless and 
almost lifeless from cold ; he was immediately plunged into a barrel of cold 
water, up to the neck, then taken out, dried well, and rubbed with flannels ; 
and, although cold (to use the expression of a bystander) as ice, warmth 
gradually returned; ice formed on the body in scales, as it was drawn from 
the surface by the cold water. As soon as anything could be introduced 
internally, Cayenne pepper and brandy were given in large quantities. When 
reaction took place there was great soreness of the flesh, with excessive 
pain, fever, &c. It was nearly two hours before he recovered. 
Drowning.-When animation has been suspended by drowning or immer- 604 
THE REFORMED PRACTICE OF SURGERY. 
sion under water, many of the same means recommended are here proper 
The person must be taken to a suitable place, the wet clothes taken off, and 
the body immediately rubbed dry with warm flannels. The face is to be turned 
somewhat downward, to give exit to any water that may have been intro- 
duced into the lungs ; but it should not be rolled over a barrel, or roughly 
handled, as is sometimes practised. An injection may be given, the feet 
bathed in warm water, and constant friction kept up for a long time. Bricks 
and stones may be heated, and covered with cloths wet with vinegar, and 
applied to the feet, legs, and sides ; the windows should be opened, to admit 
fresh air. The lungs may also be inflated, by blowing into them with the 
mouth, or by means of a pair of bellows, while an assistant gently presses 
the breast up and down in imitation of natural breathing or respiration. 
When signs of life appear, and the person can swallow, a little lavender 
compound and spirits of hartshorn may be given. 
The means to be used for the recovery of persons suddenly apparently 
deprived of life, are nearly the same in all cases ; such as lightning, poi- 
sonous gases, &c.: dash a pail of water on the person, then rub dry with 
flannel, and use friction. 
CHAPTER LIV. 
HYDROPHOBIA, OR CANINE MADNESS. 
Cause.-In the human species it is always the result of a specific virus 
or contagion, derived from the bite of an animal labouring under the disease. 
The poison appears to be exclusively attached to the saliva, by the fact of 
the disease being produced by wounds inflicted with the teeth of a rabid 
animal. It may be communicated by bringing the contagious virus in contact 
with a wounded surface. The bite of a rabid animal is not always followed 
by hydrophobia: when the person is bitten through clothes, particularly 
woollen, the virus is frequently wiped from the teeth before they enter the 
skin; from this cause we sometimes find only one or two out of a number 
bitten by the same animal become rabid. 
Symptoms.-At some uncertain period after the bite a painful tension, 
redness, and heat attack the part bitten, and at the same time darting pains 
and spasms arise in it; the patient is seized with languor, lassitude, anxiety, 
frequent sighing, and love of solitude ; twitching of the tendons, and horrible 
dreams torment him. These symptoms continue for some time, and then 
become worse ; a great aversion to, and dread of, any kind of liquid super- 
venes, inasmuch as the sight of it causes spasms in the throat; a frothy 
saliva is frequently ejected, and during the paroxysms a desire for biting 
attends ; respiration hurried, gasping convulsions, and death. 
Treatment.-The wound or bite should be cupped as soon as possible ; 
after which apply the caustic potash until an eschar is formed; then apply 
a yeast poultice, and keep up a discharge as long as possible. The patient 
should now take a strong infusion or decoction of scullcap through the day ; 
mandrake physic once a week. If this does not prevent the disease, and 
should symptoms of hydrophobia appear, lobelia emetics must be given every 
other day. Perspiration must be promoted by the steam or vapour bath. POISONS. 
605 
CHAPTER. LV. 
POISONS-MINERAL AND VEGETABLE. 
Since so many cases of poisoning occur, how important that every one 
should have some information respecting antidotes to them, as the only 
prospect of affording benefit is by administering antidotes immediately after 
poisons has been swallowed. 
1st. Laudanum or Opium, and all other Narcotics.-I have been called 
to four persons, within a few years, who took laudanum to destroy them- 
selves ; I gave in each case a double portion of our common emetic, with 
plenty of herb tea, and a short time after, say fifteen minutes, a wine glassful 
of lamp oil. If this does not operate, repeat in twenty or thirty minutes ; 
the person to be kept walking. Copious vomiting soon took place, and re- 
stored every one. This course may be pursued where any kind of poison 
has been taken into the stomach. As a substitute for the above emetic, give 
a large tea-spoonful of pulverized black mustard, mixed with water; it 
operates promptly, and is perfectly safe. 
When there is suspicion, or symptoms of any kind, of poison having been 
taken by accident or design, administer immediately large quantities of milk, 
then give an emetic, and repeat till free vomiting ensues; also lamp oil, as 
above. 
Treatment.-For acids, give vinegar and water; for alkalies, give vine- 
gar and lemon juice, to be accompanied with the free use of the mucilage of 
slippery elm bark ; after vomiting has been excited a wine glassful of sweet 
oil may be administered : it will be necessary at the same time to adminis- 
ter injections or clysters also, composed of equal parts of the mucilage of 
elm bark and milk, sweetened with molasses, and a gill of olive oil added ; 
a quart of this must be introduced every half hour. Where these means 
fail, let a stomach pump be procured and used. I consider lobelia, in the 
form of tincture or powder, to be a good antidote to all kinds of vegetable 
poisons : I prescribed it to one woman, who had taken three large opium 
pills, (by mistake;) when this article was administered, it soon removed 
all unfavourable symptoms. Vinegar has been often recommended for lau- 
danum, but I know not that it is of much use. The person must be aroused, 
and kept awake and in motion as much as possible, by shaking and moving 
him about. But the greatest reliance must be placed upon the speedy eva- 
cuation of the stomach by emetics. 
A late writer states that severe whipping has had the desired effect, by 
the irritation produced. Rather a severe remedy ! In cases of poison by 
fungi and other narcotic plants, a similar course of treatment is required. 
Where vomiting and other symptoms continue, an ounce of the bicarbo- 
nate of potash may be dissolved in two quarts of water, and a tea-cupful 
drank frequently ; fomentations to the stomach and bowels will also prove 
beneficial. Lime water is highly recommended by Orfila as an antidote to 
arsenic. 
The same writer states that, of all antidotes to the poison of the corrosive 
sublimate, he has found the white of an egg, dissolved in water, to be the 
most powerful and efficacious ; it must be diluted with water before it is 
given. In cases where persons have been poisoned by taking verdigris, 606 
THE REFORMED PRACTICE OF SURGERY. 
emetics must first be given, and afterward a solution of sal seratus (bicar- 
bonate of potash) should be freely taken, as directed above. 
For any of the salts of copper, the same remedy as the last. 
Sugar is said to be an excellent antidote to verdigris. The effects of lead 
must be remedied by the use of castor oil and injections. 
Salt and water counteract the corrosive effects of the nitrate of silver and 
lunar caustic, and make the best antidote. A person suffering under the de- 
leterious effects of this, should drink several glasses of it, in the proportion 
of a table-spoonful of the salt to two pints of water. Vomiting will ensue 
and the symptoms diminish. 
Milk is the best antidote of muriate of tin, by which it is completely 
coagulated. The coagulum contains muriatic acid and oxyde of tin, which 
are not deleterious. 
An over-dose of tartarized antimony sometimes produces severe conse- 
quences. In such cases our chief dependence is to be placed upon mucila- 
ginous and diluent drinks to speedily remove the medicine from the stomach ; 
and, when this is done, opium, and perhaps mustard plasters, may be of some 
service. 
In cases where nothing can be administered by the mouth, lobelia injec- 
tion may be given. ■ 
For oil of vitriol, the best antidote is large doses of magnesia and water; 
or, what is still better, equal parts of soft soap and water. For aquafortis, 
same remedy as last. For oxalic acid, (this resembles Epsom salts, and is 
often used for bedbug poisons,) chalk and water renders it perfectly inert, 
forming an insoluble salt of lime : magnesia is also a good antidote. For 
tarter emetic in poisonous doses, Peruvian bark and water, it is stated, render 
it perfectly harmless ; if the bark cannot be procured, use a strong decoction of 
tea until it can. For saltpetre, (which also is sometimes taken for salts,) a 
prompt emetic of mustard and water; afterward mucilages and small doses 
of laudanum. For lunar caustic, (the principal ingredient is indelible ink,) 
common salt forms an invaluable substance, which is harmless. 
For corrosive sublimate, metallic substances, mercury, verdigris, tin, lead, 
sulphuric acid, and arsenic, white of egg may be given, and then lime water 
or an emetic, with plenty of water. In all alarming cases, as before directed, 
give immediately a double portion of the emetic powders, with the addition 
of a little linseed or sweet oil; in place of this give flour of mustard. For 
arsenic, three or four cases are reported as having been cured by doses of 
magnesia. 
Poison Vine.-Both men and animals are severely poisoned by a vege- 
table called the poison vine, or mercury, which runs upon trees, fences, &c. 
It causes great heat, itching pain, swelling, pain, and inflammation, and gives 
rise to unpleasant and serious symptoms. 
I have found the following an excellent remedy for this kind of poison, 
both for man and beast: 
1st. Apply a wash to the parts, made by simmering the bark of elder in 
buttermilk, every two hours ; after which apply a little sweet oil, and then, 
if practicable, a poultice made of the slippery elm bark : give occasionally a 
dose of sweet oil. 
A horse of mine, a short time since, became so poisoned by this vine 
that his eyes were entirely closed; this remedy removed the complaint in 
about twenty-four hours. Elder, brown, and celandine ointments may be 
applied ; also a weak solution of salt and water. PART FIFTH. 
MIDWIFERY. 
CONCEPTION, PREGNANCY, AND DISEASES OF WOMEN AND CHILDREN 
INTRODUCTORY REMARKS. 
Says the author of a Treatise entitled the " Mother's Book," " Every 
intelligent observer must have remarked the slavery in which custom and 
fashion bind the human race, and the mass of restrictions which surround 
those in advanced stations in civilized life. We hear of one class spoken of 
as the necessitous class; but there is no class more necessitous than the 
highest; no people on the face of the earth so much under the dominion of 
the word ' must ' as the fashionable world. They must regulate every move- 
ment by what the professional men choose to fix as law, or they may and 
will be pointed at as singular characters. In matters of the greatest impor- 
tance how is this exemplified, and particularly in the practice of midwifery. 
" I am fully aware of the difficulty of finding language sufficiently explicit 
to convey the necessary information to enable a person to attempt this prac- 
tice, without some previous personal experience. To unlearn more than to 
learn is, however, one of the requisites to become a useful assistant to a 
female at this important period. Midwifery appears at this time to be alto- 
gether a matter of speculation with the medical faculty, as if their assistance 
was absolutely necessary ; and that it is a matter of profit to them is evi- 
denced by their exorbitant charges for attendance. This tax falls extremely 
heavy on the industrious classes, and it often is not the greatest grievance 
they have to bear ; they are often, alas ! deprived of their wives and offspring, 
by the ignorant and unnatural, falsely called scientific, practices resorted to 
by male practitioners. 
" Formerly the practice of midwifery was in the hands of experienced 
females, who, by attending to the personal wants of their patients, and leav- 
ing nature to perform her own work, considered they did all really required. 
Scarcely was an instance known in those days of a woman dying in child-bed, 
and the loss of a child was a rare circumstance ; but in the present time it 
is no unusual occurrence. There must be some cause for this difference, 
and I cannot account for it in any other way than the unskilful treatment 
females experience from the doctors, who have monopolized the practice. 
In many sections of this country, until this few years, families were brought 
into the world without the consultation of the doctor. A midwife was all 
that was thought necessary, and the instances were very rare where they 
were not successful. They used but little art, and afforded only such assis- 
tance as nature required; gave herb tea to excite perspiration and to allay 
nervous irritation ; and were content with a moderate compensation for their 
services. I trust these remarks may be the means of awakening reflection 608 
THE REFORMED PRACTICE OF MIDWIFERY. 
in the minds of the fair sex, on this to them the most important circumstance 
in life, their management in pregnancy and child-bearing. It is preposterous 
that females, in that most delicate and critical period, cannot rely on the 
assistance of their own sex. A woman, on the ground of experience in such 
matters, must be far superior, as she must have personal experience, such 
as a man never can or will acquire. It is a practice of late invention for 
men to assist nature in parturition ; and the plea used for their employment 
was, that in difficult and monstrous births they had greater nerve, that is, 
less feeling for the sufferings of those in travail, than women, and that, con- 
sequently, they were more useful where manual assistance wras required. 
This was the plausible reason assigned for their first employment; but it is 
contrary to common observation, and an erroneous opinion, that females are 
ineligible. Medical men tell you in their works, and it is well known, that 
it is a difficult task for a man to assist at a labour with decency ; and if that 
is the case, it is obvious a female must be the proper assistant at this period. 
No one can read the awfully numerous cases of deliveries by instruments 
used by the man-midwife, without feeling a wish at least to correct the bar- 
barous practice of such mock-professional science, and substituting in lieu a 
rational practice. 
" I have witnessed numerous instances, and many others upon record have 
satisfied me, that the vegetable medicines are all the medicines required during 
pregnancy, whether a fulness or determination of blood in the early stages, 
accompanied with nausea, or costiveness, or, as is sometimes the case, relax- 
edness in the later stages. Experience teaches that proper regimen and gentle 
cleansing medicines are the natural and reasonable method to keep the blood 
in healthy action, and the mind temperate and calm. A contented mind is 
a prelude to a safe delivery." 
" Formerly it would have been considered a violation of decency for a man 
to be consulted on the occasion. The company of an experienced matron 
was all that was required to assist a female at this period, as nature, never 
deficient, or rarely so, has made ample provision for the birth of the child. 
Dr. Buchan, a member of the Royal College of Physicians in Edinburgh, 
and who, in fifty years' practice, endeavoured to extirpate some of the craft 
and mystery from medical subjects, especially in midwifery, makes this 
assertion : ' Nature, if left to herself, will seldom fail to expel the foetus 
so that, according to the doctor, it is to not leaving nature to herself she fails 
to expel the child from the womb. 
" The attendance of one female on another is all that is required in many 
nations at the present day ; and even in one of the most difficult of cases, 
one that has been shown about as a wonder, I mean the Siamese twins, the 
phenomena -were brought into the world by female aid only, without instru- 
ments. Ancient historians only mention the assistance of females ; and I will 
just call to remembrance the Old Testament account, that, when Pharoah 
ordered the nurses to destroy the Israelitish infants, it was to female kind- 
ness they owed their lives, and it was female ingenuity prompted them to 
excuse themselves from the anger of the king, by referring to the. well known 
quick and easy delivery the Hebrew females were favoured with. So that a 
saving of life and an easy delivery were the accompaniments of employing 
females. The custom of employing females was not confined to Egypt or 
Palestine ; there is not on record in history any account of males 
being employed as midwives. The consequence of their employment has 
been a number of deformed beings, who are disfigured by the indecent and 
unnatural means used to bring them into the world ; and the mother, if she INTRODUCTORY REMARKS. 
609 
escapes with life, suffers a long and protracted weakness by their improper 
treatment. 
" It is very important to keep up the strength of the female as she advances 
in pregnancy, so that at the time of labour she may be in possession of all 
her powers. To effect this, she should use proper diet and exercise, and 
medicines from time to time, as they will carry off the humours which 
weaken the system ; they will also open the pores and keep the body in a 
good state of perspiration during labour, and prevent severe after-pains. The 
doctors give opium to stupify, and by bleeding weaken the frame ami deaden 
the feelings, instead of such medicines as invigorate the faculties of body and 
mind, to increase the efforts nature is called upon to perform. I will relate 
a case to show this point: ' A woman was taken in travail, and a doctor was 
sent for : when he came the prospect was, she would be delivered in two 
hours ; he gave her some medicine, which caused vomiting and turned the 
pains to the stomach ; she continued in this situation for twelve hours. When 
her strength was nearly gone, he then bled her, and gave her so much opium 
as to cause such a stupor, that it required all the exertions of the women to 
keep the breath of life in her throughout the night; in the morning she 
remained weak, and so continued till the afternoon, when she was delivered 
with instruments. The child was dead, and the woman continued weak for 
six months.' Many instances might be given of the bad success of the 
bleeding and opium treatment, instead of strengthening the system by 
suitable medicines. If married men were to persuade their wives to pursue 
the course laid down in this work, they would find it more proper and safe 
than to trust them in the hands of the doctors. Often they are young and 
inexperienced, and their cruel and harsh treatment would induce the husband 
to forcibly expel them, were they permitted to be present; but this is not 
allowed for that reason. 
" So long as there is no obstruction or hindrance to the operations of nature, 
she performs her work with unerring precision. In case of any obstruction, 
a female may require assistance, but never more than females can give. 
Obstructions will be very rare where the practice now recommended is 
pursued. Sufficient can be shown to satisfy the most skeptical that men are 
inefficient as midwives. It is not by a familiarity with rules alone that a 
knowledge of the practice of midwifery is to be obtained. It is not sufficient 
to have a knowledge of, and exact acquaintance with, the structure, situation, 
and functions of the different organs which constitute the living body. It 
is not sufficient to have surmounted the disgust, difficulty, and fatigue which 
must necessarily be endured by such as investigate the cold remains of 
mortality, and with a view to learn from the dead body the structure of the 
living. It is not this that makes a successful assistant in labour, or in the 
practice of medicine. This study on the dead has often led to scientific 
operations on the living, to the prejudice of both mother and child. This 
scientific parade and useless number of attendants have been more injurious 
than no attention at all. This was the case of the Princess Charlotte, of 
England, wife of Prince Leopold, now king of the Belgians. It was in a 
measure the indecent presence of the ministers of state, who, with the royal 
physicians, are obliged by law to be present at the accouchement of a royal 
princess, that brought on that anxiety of mind and excessive fatigue, followed 
by haemorrhage and convulsions, and which terminated in a fatal syncope, 
which all their united skill, it appears, could neither prevent nor cure. I 
quote this case, because the rank of the sufferer made it a matter of public 
notoriety, although far from a solitary instance of females who have died from 610 
THE REFORMED PRACTICE OF MIDWIFERY. 
the excitement and distress occasioned by the unseemly presence of too many 
attendants. 
" The employment of men as midwives, in addition to the reasons previously 
stated, is tolerated on the ground that it is difficult to find females who have 
studied the subject sufficiently to acquit themselves with propriety. This 
may be an evil, but it is not without a remedy. When females have a suffi- 
cient inducement in the shape of remuneration, it will cause many intelligent 
females better qualified to follow midwifery as a profession, who are now 
deterred by the fact, that the male practitioner receives the greater part of 
the emolument, while indifferent wages and the drudgery part only are the 
lot of the female. 
" The essential requisites in a female practitioner are, patience, cleanliness, 
attention, and watchfulness, accompanied with experience and that presence 
of mind which are peculiar to a well-regulated female. The work must be 
left to nature. Labour is a natural act. It does not require the interference 
of art for its promotion or accomplishment. We have been told of the im- 
provements made in this branch of medical science ; but it is notorious that, 
as the science of anatomy advanced to what is called its present splendid 
developement, labours were taught by the professors to be more difficult, and 
needed mechanical assistance to perfect. But this is easily refuted by fact, 
by referring the reader to the quick and very easy deliveries which the 
Indians in this country are well known to have ; and that, when the pangs 
of parturition come on them, they fly to solitude and retirement, and refuse 
the assistance of either male or female; and a speedy labour and a quick 
return to convalescence are the result of leaving nature to her own un- 
assisted operation. This is also the course pursued by the females at the 
south, and, indeed, in every part of the globe where what the doctors call 
great ignorance prevails. But they are also in happy ignorance of the separa- 
tion of the bones of the pelvis, the inversion of the uterus, and the numerous 
excruciating tortures and fatal results which have followed the unnecessary 
deliveries by instruments and the hasty efforts of male practitioners. The 
C<esarian operation is unknown to them, and those useless and cruel experi- 
ments which have been brought into practice ; because the powers of nature 
were not understood, and the powers of art too much relied upon. 
" One of the great difficulties in labour appears to be a contracted or deformed 
pelvis; but this rarely occurs in this country ; and I will quote a highly 
respectable authority on the subject, I mean W. P. Dewces, M.D. In his 
'System of Midwifery' he says, page 31, 'I believe that the united 
experience of all the American practitioners would not have led to a correct 
conclusion on the subject; as the occurrence of deformity of the pelvis in 
this country is so very rare, as never to have been encountered by some 
practitioners of pretty extensive experience. As far as regards my own, I 
must declare I have not met with extreme deformity in American women 
three times in my life.' So that this is a case of so rare occurrence as 
seldom to have come under the notice of men of extensive practice. Had 
this doctrine been understood by practitioners, we should not have heard of 
the numerous instances of instruments being applied to separate the bones 
of the pelvis, which is followed by a melancholy train of evils. 
" And now, reader, if I have succeeded in awakening your attention and 
enlisting your feelings on a subject important to you, to me, to all our fellow- 
creatures. Reader ! if you be a woman, forget that I am a man ; if a man, 
listen to me as you would to a brother. Let us converse, not as men, not as 
women, but as human beings, with common interests, instincts, wants, weak- INTRODUCTORY REMARKS. 
611 
nesses. Let us converse without prejudice and without passion; let the 
poet's exhortation be applied to the investigation : 
" 'Retire ! the world shut out; thy thoughts call home : 
Imagination's airy wing repress. 
Lock up thy senses; let no passion stir; 
Wake all to reason: let her reign alone.' 
" I may invoke your aid in carrying out the great principles I advocate, 
namely, of ensuring your greater safety at the hour of trial, and the future 
health and happiness of yourselves and little ones ; and the banishment from 
your bed-sides of that anomaly so offensive to the refined delicacy of your 
natures, the man-midwife, and the substitution of a qualified female in his 
place. Well assured am I, from along intercourse with my fellow-men, that 
if you will but allow your own feelings of self-respect to exercise their due 
influence, and induce you to proclaim your reluctance (rather your abhor- 
rence) to have the privacy of such sacred moments invaded by the disgusting 
presence of a strange man, (except on extraordinary occasions,) your hus- 
bands will be foremost to second you in your resolutions and in securing 
your welfare, and will not fail to appreciate, by their increased regard for you, 
the aspirations of such true delicacy. 
Dr. A. McNair has the following excellent remarks on the subject of mid- 
wifery : He says ; " All that is proper to be done in a case of natural labour, 
from its commencement to its termination, will suggest itself to any person 
of common understanding; and I have long laboured under the conviction 
that the office of attending women in their confinement should be intrusted 
to prudent females. There is not, according to my experience, and the 
reports of many of the most eminent surgeons, more than one case in three 
thousand that requires the least assistance. I am aware, however, that 
there are a few crafty physicians who attempt, and often succeed, in causing 
the distressed and alarmed female to believe that it would be altogether im- 
possible for her to get over her troubles without their assistance; and, for 
the purpose of making it appear that their services are absolutely necessary, 
they will be continually interfering with their instrument when there is not 
the Jeast occasion for it. How blind, deluded, females are duped and imposed 
upon by interested and unprincipled doctors. There is no excuse for such 
ignorance, and no wonder such a curse attends it. 
" Physicians do not give nature an opportunity to perform her work. They 
are averse to set ten or twelve hours, or more, as is often nepessary. This 
would be consuming too much time ; and, therefore, when called to a female, 
delivery must be accomplished as soon a? possible. There is no doubt in 
my mind (says Dr. McNair) but that one-half of the women attended by 
these men are delivered before the proper period ; and that this is the reason 
why we see so many deformed children, and meet with so many females 
who have incurable complaints. Jf the business was intrusted to well-in- 
structed and experienced females or midwives, they would give more time, 
and nature would have an opportunity to do its own work ; we should not 
hear of so many lives being Dst, both of parent and child, nor of so many 
diseases entailed by bad management. If there should happen to be a 
difficult case, an experienced doctor could be called, who would be much 
more likely to succeed than in the case of the female having been injured 
by the untimely or instrumental interference of some male practitioner." 
I was lately called to meet in consultation with a physician in the coun- 
try, in a case of parturition; and in my absence he bored a hole in the 612 
THE REFORMED PRACTICE OF MIDWIFERY. 
child's head, let out the brains, and with a hook drew out the child and all, 
when the pains and presentation were natural, and strength excellent. A 
little more time and patience were only wanted to accomplish delivery. 
The following is an extract of a letter from Mrs. Ruth Stebbins, a highly 
respectable, aged, pious, and talented midwife, of Westfield, Mass. She has 
devoted most of her life in endeavouring to wrest midwifery from men, and 
to introduce it among females. Mrs. Stebbins has made a donation to the 
author of this work, to promote the cause ; at one time twenty dollars, and 
at another one hundred; and has also stated to him that she should leave 
a legacy, still farther to disseminate this branch of reform. Who is suffi- 
ciently disinterested and benevolent as to go and do likewise 1 
" I rejoice that you have commenced the publication of the abridgment 
of your reformed practice, and wish I was able to assist you much in the 
sale of the work; but my advanced age and ill health, with the care of a sick 
husband, forbid my doing much ; however, I will take one copy for myself, 
and would do so if it contained nothing of interest to me, except on the few 
pages which you have kindly sent me; they are now going the rounds. 
Perhaps by and by, when the earth is warmed by the returning sun, I may 
again visit among my friends; and, if I am thus favoured, all my influence 
will be most cheerfully devoted to the sale of your abridgment: I desire 
that the public may rightly estimate its real worth, and that every family 
may avail themselves of a copy, and thus, for a few dollars, become their 
own physician, and likewise enjoy the benefit of your reformed practice. 
I do ardently wish that this opportunity for increasing in knowledge may 
not indifferently pass by, and the people left to choose darkness rather than 
light. Is it not surprising that an intelligent people should so long hold on 
to the old system, which has slain its thousands ? It is but three years since 
it became my painful duty to close the eyes of a beautiful young lady, six- 
teen years of age-one, too, whom I loved as my own soul, and had carried 
in my bosom from her cradle to her untimely grave-a victim to that deadly 
poison, calomel: there can be no mistake about it, for she was only a little 
drooping when the doctor commenced his course with her ; she had a good 
appetite, was about the house, and walked out as far as the garden, when 
the docter dealt out his poison : the mother of the patient, who is my adopt- 
ed daughter, and had embraced my sentiments in these points, raised her 
warning voice against the doctor's course, saying, ' I must part with my 
daughter as sure as she follows your directions:' the father was in favour 
of the doctor, and in little more than one week she took her flight from earth. 
Calomel brought on a discharge which could not be checked ; she frequently 
called for toast and tea, but was forbid the favour of any kind of nourishment 
upon the pain of death. I did not see her until the day before she expired ; 
she had no cough, nor any other consumptive symptom. In the course of 
the same week several other young people in the neighbourhood died in 
the same manner; what killed them? it was not vegetable remedies. 1 re- 
gret that there are so many among my female friends who will cast a mantle 
of charity over the most daring and cruel mid-practice of their family physi- 
cians, and at the same time expose to censure, and condemn without mercy, 
the most trifling misfortunes attending female piactice. Now, can the ladies 
shut their eyes to the following fact, and refuse to hear its. warning voice, 
even were there no other case of the kind known on earth ? In Massachusetts, 
some twenty miles from this place, and perhaps four years since, a lady was 
taken in travail with her first child; she called the physician of her choice, 
and one who was educated according to the rules of the old school; he soon INTRODUCTORY REMARKS. 
613 
informed her that nature was in course, and circumstances appeared favour- 
able : however, within two hours he apprehended great danger, and warned 
the friends that neither mother nor child could be saved without the aid of 
instruments ; of course he was permitted to apply them, and thus relieve 
nature from any part of the burden ; she was not sutfered to wait for one 
natural pain from the time instruments were applied until the mangled and 
slaughtered babe was dragged into the world with more force than the 
strength of one man, as the doctor prayed, for God's sake, that one of the 
women present would assist him, which was granted; and with such vio- 
lence did they exert their strength, that the child was hurled into the middle 
of the room. The grandmother, on beholding its lacerated, bleeding scalp, 
exclaimed, ' O, dreadful sight!' The woman was much injured, as the 
instruments slipped off three times ; and she informed me that she positively 
knew the doctor thrust them into a portion of the flesh, which was afterward 
proved. Five weeks she lay with but little hope of life ; then she recovered. 
When again she became pregnant, she began to read and reason on the 
subject, until she became so much enlightened and convinced of her error, 
as to renounce her prepossessions in favour of men operators ; and there being 
in town a good midwife, she made up her mind to employ her in the hour 
of parturition, and leave the event with Him who hath promised salvation 
to all those who continue in faith, charity, holiness, and sobriety; and bless- 
ed be the God of all grace, when the hour arrived the promise was verified ; 
she brought forth a living child without any professional aid, and with 
comparatively little anxiety, as there was no time for frightful foreboding, 
or the retarding influence of interfering practitioners ; and in this instance 
she recovered her health in a few days, though she must always suffer from 
the bad effects of the doctor's shameful mal-practice. I will only add, that 
all this work of torture and death was accomplished within eight hours after 
the doctor arrived: and thus I leave this woman, and would just hint that, 
soon after her first case, a neighbour others, in the like situation, employed 
the same doctor, and met the same fate. On a second occasion of this kind 
this lady, not ' having learned righteousness by the things which she had 
suffered,' employed again her beloved physician; again instruments were 
applied, and, after a most distressing scene, another slaughtered child was pre- 
sented to the disappointed and grieved parents. Some time after this I saw 
this lady, who was again numbering her weeks; I endeavoured to impart 
unto her needful instruction, which inspired her with more courage, and, 
when the hour came, she confided in nature, and, while she was entirely 
alone, brought forth a healthy babe, to the joy and astonishment of all. 
About this time, and in the same town, two brothers were taken with a 
common influenza, and the doctor above alluded to destroyed them both in 
five days, with calomel and bleeding. Just before the last expired the mo- 
ther was taken with the same disorder, and the dying son cautioned her 
against the doctor, saying ' he has killed my brother, and now I must die 
also ;' the mother obeyed his injunction, and soon recovered. Being acquainted 
with all these families, I have stated the above as solemn facts, which is 
only a part of the black deeds of the kind that I might relate, and from my 
own observation too." 614 
THE REFORMED PRACTICE OF MIDWIFERY. 
CHAPTER I. 
DISEASES OF PREGNANCY. 
Conception.-In order to procreate the human species, there is a periodi- 
cal discharge of blood from the vagina of every female, termed the catamenia 
or menses. The secretion of this fluid commences at that period of life 
termed puberty, which occurs at different ages, according to the climate. In 
some latitudes it commences as early as eight or ten, and in others not until 
fifteen. As soon as conception or pregnancy commences this discharge 
ceases, and goes to support the foetus or the child. 
4 The manner in which conception takes place has ever been a fruitful sub- 
ject of inquiry, but we are unable to account for this change precisely. It 
is, however, pretty evident that the semen of the male is introduced into 
the uterus, while the semen of the female is discharged from the ovaria by 
means of the Fallopian tubes, the fimbricated extremity of which closely 
embraces that organ. 
These tubes, by a kind of peristalic motion similar to the intestines, convey 
the semen of the female into the uterus, where it unites with the semen 
of the male ; and it is these united fluids which constitute the rudiment of 
the foetus, and which often give to the child the appearance and dispositions 
of their parents. Sometimes one trait is inherited, sometimes another ; at 
other times a new compound or character is formed, (like a chemical union,) 
which does not partake of the nature of either of the former. 
Pregnancy.-As soon as the female becomes pregnant many new symp- 
toms follow, such as suspension of the menses, sickness at the stomach, 
heartburn, peculiar longings, indigestion, headache, giddiness, &c. The 
breasts become enlarged, shooting pains extend through them, and the 
circle around the nipple alters to a dark brown colour. There often occurs 
likewise a feverish disposition, with debility, emaciation, irritability, and 
peevishness of temper, and a total alteration of the countenance, every fea- 
ture of which becomes much sharpened. Some women breed so easily as 
to experience scarcely any kind of inconvenience whatever ; while others, 
again, are perfectly incapable of retaining the least thing on their stomach, 
and are thereby reduced to a state of extreme weakness. 
With some women the vomiting will continue during the whole, or greater 
part, of the second stage of pregnancy, as well as the first; but this does 
not usually happen. Partial suppressions of urine, with a frequent inclina- 
tion to void it; itching about the external parts of generation, costiveness, 
tenesmus, and the piles, are the complaints they are chiefly incommoded by 
during this period. Most women quicken about the sixteenth week after 
conception, at which time the mother becomes sensible of the slightest 
efforts of the child ; and, besides the complaints just enumerated, she will then 
be liable to sudden faintings and slight hysteric affections. 
According to the common received opinion, quickening, so termed, generally 
has been understood to commence at the time when particular sensa- 
tions are perceived by the mother, supposed to be occasioned by the first 
motion of the child. The most usual time of feeling any such symptoms 
is about the latter end of the fourth, or beginning of the fifth, month of preg- 
nancy ; at this period the uterus, filling up the pelvis, slips out and rises above DISEASES OF PREGNANCY. 
615 
the rim ; and, from that sudden transition, women of a delicate constitution 
and irritable fibre are apt to faint, more particularly so if in an erect position. 
During the last three months, or third stage of pregnancy, general uneasi- 
ness, restlessness, (particularly by night,) costiveness, cedematous swellings 
of the feet, ankles, and private parts, cramps in the legs and thighs, difficulty 
of retaining the urine for any length of time, varicose swellings of the veins 
of the belly and lower extremities, and the piles, are the afiections which 
usually prove most troublesome. In weak, delicate women, of an irritable 
habit, convulsive fits sometimes arise, which are ever to be regarded in a 
dangerous light. 
There is great danger of being deceived respecting pregnancy ; it is some- 
time difficult to discriminate between it and common obstruction of the 
menses. On one occasion my opinion was asked about two females, sisters, 
supposed to have monthly obstructions ; I decided that they were both preg- 
nant, which was positively denied ; but, subsequently, I attended'both in their 
confinement. 
Professer Channing, of Harvard University, made the following statement 
in one of his lectures : " A few years ago," said he, " there was a young 
woman, at the Massachusetts General Hospital, with all the symptoms of 
dropsy ; she bore a good character, and was of a religious turn of mind. She 
was treated with foxglove, bleeding, and all the remedies for dropsy, and 
at length discharged as incurable. In a short time after this, however, I 
heard that she had been put to bed with twins. I do not know," he added," 
how I could have been so deceived ; but such are the errors which are some- 
times committed in the medical profession." 
Particular Symptoms of Pregnancy.-Were females to use proper diet 
and exercise, they would suffer very little from pregnancy. Civilization 
and fashion have brought on a train of diseases. 
Sickness of the Stomach.-Some women are incessantly harassed by 
nausea, or sickness of the stomach, and that during the whole period of 
gestation or pregnancy. For this symptom the patient should take the fol- 
lowing preparation : Take sal aeratus, {bicarbonate of potash,,} one tea-spoon- 
ful ; peppermint or spearmint tea, half a pint: mix; of this let a table- 
spoonful be taken occasionally, to be accompanied with the use of spearmint 
tea. Soda powders have also been found very serviceable to allay the irri- 
tability of the stomach in such cases; but the best preparation that I have 
ever found to relieve the sickness of the stomach attendant on pregnancy 
is, an infusion or tea made of the rose willow bark, {cornus sericea.} This 
has proved, in my hands, exceedingly valuable. The bowels must be regu- 
lated by gentle laxatives. 
A lady has just gone from my office, who stated to me that she derived 
great benefit from the neutralizing mixture. Saratoga water benefited one 
person more than all other means. A dry cracker should be eaten on first 
rising from bed. 
Heartburn.-For the heartburn which sometimes takes place in preg- 
nancy, let the mixture be given mentioned under the head of sickness of the 
stomach ; if that fails, let large tea-spoonsful of carbonate of magnesia be 
taken morning and evening, in a little milk or syrup. 
Lethargy, Headache, etc.-When there is a sense of fulness in the 
head, with giddiness and plethora, a dose of our common physic should 
be given, the feet immersed in warm ley water, and mustard plasters 
applied to them ; bathe the head with salt and water. A vegetable and spare 
diet should be strictly adhered to : this will prevent the necessity of bleeding. 616 
THE REFORMED PRACTICE OF MIDWIFERY. 
Costiveness.-If costiveness supervenes, laxative medicine must be taken; 
but it is always better to regulate the bowels by stewed fruits, such as apples, 
peaches, prunes, fyc. Take the anti-dyspeptic pills ; injections are sometimes 
necessary. 
Piles.-For the piles apply the mullein or celandine ointments, and obviate 
costiveness by the use of cream of tartar, flour of sulphur, &c. Of all the 
preparations for the piles I have found none so effectual as the pile electuary. 
The first or second dose usually affords relief: it should be taken sufficient to 
act merely as an aperient or laxative. It may be dissolved in warm or cold 
water, or taken in the form of pills, four morning, noon, and night. 
Toothache.-To relieve the toothache, a few drops of the oil of cloves, 
red pepper, or any other essential oil applied to the affected tooth, will 
often remove it for the time. 
Longings.-It is always desirable to gratify the peculiar longings of preg- 
nant women, otherwise they are apt to miscarry, from the anxiety these 
occasion when not indulged in them. But that the child in the womb can 
be marked by any depraved appetite of the mother, or be mutilated by any 
disagreeable sight that may be present to her, is doubtful. 
Hysterics and Fainting.-Should sudden fainting or any other hyste- 
rical affection arise, little more will be necessary than to expose the patient 
to a free open air, to place her in a horizontal position, and to give her a 
glass of cold water, with a few drops of hartshorn ; or a little wine, suffi- 
ciently diluted, may also be taken, or compound spirits of lavender. 
Swelling and Pain in the Breasts.-Sometimes the breasts become 
swollen and very painful ; to obviate this symptom, great care must be 
taken that no part of the dress be tight over the breasts ; and they should 
be rubbed with equal parts of sassafras, sweet oil, and camphorated spirits, 
morning and night. 
Palpitation of the Heart.-When this affection occurs during preg- 
nancy, it is usually from a disordered state of the stomach, and must, 
therefore, be cleansed by moderate doses of physic ; fifteen or twenty drops 
of the tincture of digitalis, to be taken three or four times a day in a little 
tea, or a little compound lavender. 
Swellings.-There are often puffy swellings in advanced stages of preg- 
nancy, particularly toward evening; for this symptom bathe the feet often, 
and apply fomentations of bitter herbs. 
Cramps.-For cramps of the legs and thighs, which often occur, let the 
parts be rubbed with tincture of capsicum. The feet must be bathed often 
in warm water, and the legs should be well covered with flannel. 
Wakefulness, etc.-For wakefulness, want of sleep, &c.,give the tinc- 
ture or extract of hops at bed-time, and let exercise be taken through the day. 
False Pains.-False pains, resembling those attendant on actual labour, 
are apt to come on at a late period of pregnancy, often occasioning unneces- 
sary alarm. Confinement in a horizontal position; laxative medicines, if 
costive, and giving small and frequent doses of anodyne until the patient 
finds relief, may in such cases be necessary. * 
Suppression of Urine.-Take equal parts of the spirits of mint and sweet 
spirits of nitre, and add a little gum camphor ; of this take one or two tea- 
spoonsful every hour or two. Drink parsley tea, and foment the bowels ; 
should the above fail after a reasonable length of time, use the female 
catheter ; the female herself, the midwife, or husband can introduce it 
very easily. A small goose-quill will answer well ; cut a hole near the 
end, and another at the top of the hollow part or barrel, without otherwise LABOUR, DELIVERY, ETC. 
617 
cutting the quill, lubricate it with sweet oil, and gently introduce it upward 
and backward. 
Fits or Convulsions.-Sometimes, in advanced stages of pregnancy, 
hysteric or other fits occur, as well as during labour. They may arise from 
various causes, such as exhaustion, fatigue, bleeding, &c. The face is pale, 
the eyes sunk, and the extremities cold : the fits usually succeed each other 
rapidly, and terminate in fainting. It was this kind of fits, a writer states, 
that destroyed the Princess Charlotte, of Wales. 
Treatment.-For these convulsions, whatever may occasion them, an 
opium pill, containing about three grains, should be given. The feet must 
be immediately immersed in water, as warm as can be borne, and a large 
injection or clyster administered; and if these means do not soon afford 
relief, a mustard plaster should be applied between the shoulders and to the 
feet, and evaporating lotions, such as spirits, rain water, and vinegar, applied 
to the head. 
The warm bath is strongly recommended, by Dr. Denman, among the 
means for preventing convulsions in women previous to, or during, their con- 
finement. He states that from its occasional use women will often find 
much benefit; and that it is one of the principal means for preventing puer- 
peral convulsions, and for insuring an undisturbed labour. He also recom- 
mends a warm bath in labours rendered complex by convulsions ; and this 
upon a long and extensive experience. 
Abortion.-Abortion frequently takes place during pregnancy. When 
this occurs, let it be treated the same as laid down under that head. 
CHAPTER II. 
After seven months of pregnancy the foetus has all the conditions for 
breathing and exercising its digestion. It may then be separated from its 
mother, and change its mode of existence. Child-birth rarely, however, 
happens at this period: most frequently the foetus remains two months 
longer in the uterus, and it does not pass out of this organ till after the 
revolution of nine months. 
Examples are related of children being born after ten full months of ges- 
tation ; but these cases are very doubtful, for it is extremely difficult to know 
the exact period of The legislation in France, however, has 
fixed the principle, that child-birth may take place the two hundred and 
ninety-ninth day of pregnancy. 
Nothing is more curious than the mechanism by wffiich the foetus is ex- 
pelled ; everything happens with wonderful precision; all seems to have 
been foreseen, and calculated to favour its passage through the pelvis and the 
genital parts. 
The physical causes that determine the exit of the foetus are the contrac- 
tion of the uterus and that of the abdominal muscles ; by their force the 
liquor amnii flows out, the head of the foetus is engaged in the pelvis, it 
goes through it, and soon passes out by the valve, the folds of which disap- 
pear ; these different phenomena take place in succession, and continue a 
certain time ; they are accompanied with pains more or less severe, with 
swelling and softening of the soft parts of the pelvis and external genital 
parts, and with an abundant mucous secretion in the cavity of the vagina. 
LABOUR, DELIVERY, ETC. THE REFORMED PRACTICE OF MIDWIFERY. 
618 
All these circumstances, each in its own way, favour the passage of the foetus. 
To facilitate the study of this action, it may be divided into several pe- 
riods ; but without practical use. 
The first period, of child-birth.-It is constituted by the precursory signs. 
Two or three days before child-birth a flow of mucus takes place from the 
vagina, the external genital parts swell and become softer; it is the same 
with the ligaments that unite the bones of the pelvis ; the mouth of the 
womb flattens, its opening is enlarged, its edges become thinner ; slight pains, 
known under the name of flying pains, are felt in the loins and abdomen. 
Second period.-Pains of a peculiar kind come on ; they begin in the lum- 
bar region, and seem to be propagated toward the womb or the rectum ; and 
are renewed only after intervals of a quarter or half an hour each. Each 
of them is accompanied with an evident contraction of the body of the uterus, 
with tension of its neck and dilatation of the opening; the finger directed 
into the vagina discovers that the envelopes of the foetus are pushed out- 
ward, and that there is a considerable tumour, which is called the waters ; 
the pains very soon become stronger, and the contraction of the uterus more 
powerful; the membranes break, and a part of the liquid escapes ; the uterus 
contracts on itself, and is applied to the surface of the foetus. 
Third period.-The pains and contractions of the uterus Increase conside- 
rably ; they are instinctively accompanied by the contraction of the abdomi- 
nal muscles. The woman who is aware of their effect is inclined to favour 
them, by making all the muscular efforts of which she is capable : her pulse 
then becomes stronger and more frequent; her face is animated, her eyes 
shine, her whole body is in extreme agitation, and perspiration flows in 
abundance. The head descends into the lower strait of the pelvis. 
Fourth period.-After some moments of repose the pains and expulsive 
contractions resume all their activity; the head presents itself at the vulva, 
makes an effort to pass, and succeeds when there happens to be a contrac- 
tion sufficiently strong to produce this effect. The head being once disen- 
gaged, the remaining parts of the body easily follow, on account of their 
smaller volume. The section of the umbilical cord is then made, and a liga- 
ture is put around it at a short distance from the umbilicus or navel. 
Fifth period.-If the midwife has not proceeded immediately to the extrac- 
tion of the placenta after the birth of the child, slight pains are felt in a short 
time, the uterus contracts freely, but with force enough to throw off'the pla- 
centa and the membranes of the ovum ; this expulsion bears the name of 
delivery. During the twelve or fifteen days that follow child-birth the 
uterus contracts by degrees upon itself, the woman suffers abundant perspi- 
rations, her breasts are extended by the mitk that they secrete ; a flow of 
matter, which takes place from the vagina, called lochia, first sanguiferous, 
then whitish, indicates that the organs of the woman resume, by degrees, the 
disposition they had before conception. 
CHAPTER III. 
MANAGEMENT OF LABOUR. 
Women in general are ignorant of parturition or delivery. Almost all 
of them are under the impression that labour is completed more by art than 
nature ; hence the most noted accoucheurs are employed to attend during this 
interesting period; and professional men, in general, have no wish to unde- MANAGEMENT OF LABOUR. 
619 
ceive them on this subject, as their interest is too much concerned. I have 
been often astonished to see the credulity and ignorance manifested on these 
occasions. Thanks and blessings have been poured upon me, under the idea 
that I had saved their lives in labour, when I had merely looked on and 
admired the perfectly adequate powers of nature, and superintended the 
efforts of her work; and it is nature that accomplishes all, while the 
accoucheur gets the credit of it. There is not one case in a thousand in 
which you can do more than remain a silent spectator, except to calm the fears 
of the ignorant and timid attendants. The mischief and injury that is done 
by the untimely interference of art is incalculable. 
In pregnancy women are bled till they have not strength enough to 
accomplish delivery; and, when it takes place, the forceps or other instru- 
ments are used, which often prove fatal to the mother or child, or both. 
Were all women properly instructed in this branch, many lives would be 
saved ; and it is in this branch that I wish to see a reform, as well as other 
branches of medicine ; but the want of room prevents me from here enlarg- 
ing upon this subject. 
All women ought to be instructed in midwifery, and those who are of a 
proper turn of mind should..be well qualified to act in the capacity of mid- 
wives : no man should ever be permitted to enter.the apartment of a woman 
in labour, excepting in consultations or on extraordinary occasions. The 
practice is unnecessary, unnatural, and wrong. 
There are various particulars to be avoided, and several things to be done, 
in the management of women during labour. I have room here to state only 
a few, and shall begin by pointing out the course to be pursued in 
Natural Labour.-When called to a woman supposed to be in labour, we 
must first ascertain whether her pains are true or false, and which may be 
easily known by a little inquiry. If the female complains of flying or un- 
settled pains about the system, occurring mostly toward evening or during 
the night, and being slight or irregular, it may be taken for granted that they 
are spurious or false. If these symptoms prove troublesome, an infusion or 
tea of hops may be taken ; or, if this is not sufficient to relieve them, or pro- 
cure sleep, an anodyne may be taken; and it may be necessary also to give 
laxative medicines or an injection, with a little laudanum. 
True pains may be known by the pain being more concentrated in the 
lower part of the belly, through the loins and hips. 
The pains now increase in regularity and force, returning every ten or 
fifteen minutes, and leaving the woman comparatively easy in the intervals. 
When the pains become regular and severe, there is a discharge of 
slimy matter, tinged with blood, known by the name of shows. At this 
period of labour it will be proper for the person who attends the labour to 
examine, in order to ascertain what part of the child presents, which may be 
done by requesting the female to sit in a chair or on the side of the bed, and to 
extend the legs, when the longest finger, dipped in sweet oil, may be passed 
up the vagina to the part which presents, and the sense communicated will 
determine the nature of the presentation. In nineteen cases out of twenty, 
or in almost every case, the head will be felt. Frequent examinations should 
be avoided. 
Dr. Bard, speaking of examinations, remarks : " What terms shall I use 
to condemn, as it deserves, the abominable practice of boring, scooping, and 
stretching the soft parts of the mother, under the preposterous idea of making 
room for the child to pass. It is impossible to censure this dangerous prac- 
tice too severely ; it is always wrong; nor can there be any one period in 620 
THE REFORMED PRACTICE OF MIDWIFERY. 
labour, the most easy and natural, the most tedious and difficult, the most 
regular or preternatural, in which it can be of the least use ; in which it will 
not unavoidably do great mischief: it will render an easy labour painful; 
one which would be short, tedious ; and one which, if left to nature, would, 
terminate happily, highly dangerous." 
" All that is proper to be done in a case of natural labour, from its com- 
mencement to its termination," says Dr. McNair, " will suggest itself to any 
person of common understanding; and I have long laboured under the con- 
viction, that the office of attending women in their confinement should be 
intrusted to prudent females. There is not, according to my experience, 
and the reports of the most eminent surgeons, more than one case in three 
thousand that requires the least assistance. I am aware, however, that 
there are crafty physicians who attempt, and often succeed, in causing the 
distressed and alarmed female to believe that it would be altogether impos- 
sible for her to get over her troubles without their assistance; and, for the 
purpose of making it appear that their services are absolutely necessary, 
they will be continually interfering, sometimes with their instruments, when 
there is not the least occasion for it. It is my confirmed opinion (after 
forty years' practice) that there would be much less danger in case of con- 
finement, if they were intrusted altogether to females. There is no doubt in 
my mind but that one-half of the women attended by these men are delivered 
before their proper period; and this is the reason wrhy we see so many de- 
formed children, and meet with so many females who have incurable com- 
plaints. If the business was trusted to aged midwives, they would give more 
time, and nature would have an opportunity to do its work ; and, if necessary, 
advice might be had with more safety." 
It is a very common circumstance for an inexperienced (or he may be an 
experienced, but ignorant) practitioner to attempt a rupture of the membranes, 
and, in doing so, rupture the bladder, -which would render the woman mise- 
rable during life. I am acquainted with twenty-five or thirty females who 
have met with this sad misfortune, and many of them have been attended 
by those who are termed our most successful, or old experienced, physicians. 
Dr. Rush, speaking of child-bearing among the Indians, says, " that nature 
is their only midwife ; their labours are short, and accompanied with little 
pain ; each woman is delivered in a private cabin, without so much as one 
of her own sex to attend her: after washing herself in cold water, she re- 
turns in a few days to her usual employment; so that she knows nothing of 
those accidents which proceed from the carelessness or ill management of 
midwives or doctors, or the weakness which arises from a month's confine- 
ment in a warm room." 
Dr. Whitney remarks; " I have had many cases where I found the atten- 
dants alarmed, and some in tears, from supposing they should have had help 
sooner, fearing the worst consequences from delay; but, admitting that the 
' doctor knew best,' they would wait calmly for hours, when in nature's time 
all ended well. I pledge myself as a physician, that all honest doctors will 
tell you that labour is the work of nature, and she generally does it best when 
left io herself." 
" Among the Araucanian Indians," says Stevenson in his Twenty Years' 
Residence in South America, " a mother, immediately on her delivery, takes 
her child, and, going down to the nearest stream, washes herself and it, and 
returns to the usual labour of her station." 
" The wonderful facility with which the Indian women bring forth their 
children," say Lewis and Clark in their well known journal, " seems rather MANAGEMENT OF LABOUR. 
621 
some benevolent gift of nature, in exempting them from pains which their 
savage state would render doubly grievous, than any result of habit. One 
of the woman who had been leading two of our pack horses, halted at a 
rivulet about a mile behind, and sent on the two horses by a female friend. 
On inquiring of one of the Indian men the cause of her detention, he an- 
swered, with great appearance of unconcern, that she had just stopped to lie 
in, and would soon overtake us. In fact, we were astonished to see her in 
about an hour's time come on with her new-born infant, and pass us on her 
way to the camp, apparently in perfect health." 
Washington Irving, in his work entitled Astoria, relates a similar incident 
in the following language : " The squaw of Pierre Dorion (who, with her 
husband, was attached to a party travelling over the Rocky Mountains in 
winter-time, the ground being covered with several feet of snow) was sud- 
denly taken in labour, and enriched her husband with another child. As 
the fortitude and good conduct of the woman had gained for her the good 
will of the party, her situation caused concern and perplexity. Pierre, how- 
ever, treated the matter as an occurrence that could soon be arranged, and 
need cause no delay. He remained by his wife in the camp, with his other 
children and his horse, and promised soon to rejoin the main body on their 
march. In the course of the following morning the Dorion family made 
its appearance. Pierre came trudging in advance, followed by his valued, 
though skeleton, steed, on which was mounted his squaw with the new-born 
infant in her arms, and her boy of two years old wrapped in a blanket, and 
slung on her side. The mother looked as unconcerned as if nothing had hap- 
pened to her; so easy is nature in her operations in the wilderness, when 
free from the enfeebling refinements of luxury and the tampering appliances 
of art." 
Having thus shown who are the proper persons to assist in parturition, 
and the necessity of dependin* on the great resources of nature to accom- 
plish delivery, I proceed to treat of labour, delivery, &c. 
When it has been ascertained that the labour is natural, or that there are 
no impediments or obstacles, there will be very little more to do than super- 
intend the person. It will be necessary to give instructions to the attendants 
to make suitable preparation, or have everything required in readiness. 
The woman may be delivered upon a bed or a cot, as is most convenient; 
if a bed be used, all but the mattress should be turned back toward the head, 
and it should be so prepared that the moisture from the uterus and other 
discharges may not add to the discomfort of the woman. A dressed skin, 
oil-clotb, or folded blanket may be placed on that part of the mattress on 
which the body of the woman is to rest; a coarse blanket, folded within a 
sheet, ought to be laid immediately beneath the patient, to absorb the 
moisture, which must be removed after delivery ; the rest of the bed- 
clothes are to be put on in the ordinary way. The woman, when she is no 
longer able to remain up, may lie down, with her head elevated in any 
position which is most desirable; and in nearly every case that I have ever 
attended the back has been preferred, although most all writers recommend 
that the woman be placed upon her side : the latter practice is unnatural and 
wrong, for obvious reasons ; it retards the labour pains, and prevents the 
midwife from superintending the progress of the labour; the pillow that is 
directed to be placed between the knees, to keep them widely separated, soon 
gets displaced by the motion or change of the female ; and the legs, instead 
of being kept apart, again come in contact, and thus tbe passage of the child 
is obstructed: but when the female is placed upon her back this difficulty 622 
THE REFORMED PRACTICE OF MIDWIFERY. 
is obviated, a free passage is permitted, the pains are more effectual, the 
spine is better supported, and better access can be had to the parts during 
labour and after the delivery of the child ; in short, there is a decided ad- 
vantage in this position in every respect. 
The dress of women in labour should be light and simple, both to keep 
themselves from being overheated, and to prevent anything from being in the 
way of what assistance is necessary. In addition to the means recommended, 
I direct a sheet to be placed around the waist of the woman, to prevent the 
blood, excrements, or waters from coming in contact with the linen or clothes, 
and, as much as possible, the bed; her linen may be tucked or pushed up so 
far that there will be no necessity of a removal after delivery. 
Everything being thus adjusted, very little more will be necessary but to 
wait patiently the efforts and operations of nature. There should be but few 
attendants in the room, and these are not to whisper to each other, or ex- 
press any fears or doubts. 
" A humane midwife will use every ingenious effort in her power to quiet 
the useless fears, and support and comfort the patient. A crowd of frightened, 
hysterical women, assailing the ears of the woman with tales of wo and sad 
disasters that have happened, should be admonished. Half a dozen mid- 
wives, each making pretensions to great skill, ambition, and competition for ob- 
stetric fame, assembled around a feeble woman when labour is of a lingering 
character, is always an unfortunate circumstance, and it would be much 
better if nearly every one were afar off." 
When the pains become very severe, quickly succeeding each other, the 
mid wife, or the person who officiates, may sit by the side of the woman, and, 
upon every severe pain, may keep her hand upon the parts, even though no 
manner of assistance can be afforded ; and occasionally, when the head of 
the child presses hard, it may be gently touched or pressed with the longest 
finger, in order to ascertain the parts that present the progress of labour, 
as well as to be able to give from time to time suitable encouragement: not 
only so; in the last stage of labour the hand may be kept near the parts, to 
know the moment when the head of the child presents, as some little 
assistance at this time is called for ; not by supporting the perinamm, as some 
advise, but, 
First. To remove any obstruction which often arises from the clothes. 
Second. To support the child in its passage, and in the interval of pains; 
and to keep the head from pitching downward, and thus obstructing the labour. 
Third. To detach the umbilical cord or navel-string from the neck when 
it encircles it, as is often the case, and which endangers the life of the child. 
Fourth. To deliver the woman in case of hcemorrhage or great flooding; 
but at the same time there must be no farther interference of art; little or 
nothing can be done toward facilitating the delivery of the child, except when 
a large bag or collection of water presents and opposes, when it may be rup- 
tured with the longest finger, which often affords much aid ; although such 
is the ignorance and credulity of some women, that they suppose almost 
everything to be accomplished by art. Physicians or midwives who watch 
only the process of labour, and do little or nothing, are pronounced inhuman 
and cruel, and perhaps ignorant, because they are honest in not interfering with 
the simple and beautiful process of labour, or, in other words, for relying upon 
the great resources of nature ; but such is the fashion and credulity of man- 
kind, or rather womankind, that physicians are obliged to take the advantage 
of such ignorance and credulity, and regulate their proceedings accordingly. 
I have often been obliged to stand for hours over a woman, und*r pretenca MANAGEMENT OF LABOUR. 
623 
of aiding delivery, when, in reality, I done nothing at all. The labour would 
have progressed just as well had I been out of the room ; but this deception 
I have been obliged to practice, in order to satisfy ignorant, gossiping, or crying 
attendants. When the woman is disposed to make much noise, she should 
be directed to hold her breath during the pains, and aid or assist them by 
pressing downward as much as possible. The feet may press against the 
bed-post, and the woman take hold of a handkerchief and pull when a 
pain occurs ; or she may grasp the hand of an assistant for that purpose. 
Sometimes, from various causes, labour is very much retarded, from rigidity 
of the parts, the situation of the child, debility, &c.: when this occurs, and 
labour is tedious and protracted, our reliance must still be upon the powers 
of nature. We may, however, aid her efforts, by warm fomentations of bitter 
herbs, often applied to the lower part of the belly, which will prove relaxing, 
and will facilitate the labour : warm diluent drinks may also be given, such 
as tansy, pennyroyal, <SfC. 
If the labour still continues stationary, we have nothing to fear, provided 
there is a right presentation ; but should the pains become feeble or lessened 
from flooding, debility, or any cause, or should they prove unavailable after 
a reasonable length of time, a drachm of spurred rye or ergot may be put into 
a tea-cup, and a gill of boiling water poured upon it, and, when cool, a table- 
spoonful given every fifteen minutes. This will increase the pains, and 
speedily accomplish a delivery ; but it should be very seldom, or never, 
used, except when there is a right presentation, and under the most urgent 
circumstances. 
It is prudent, by judicious precaution and care, to remove obstructions, 
prevent accidents by holding or supporting the child in a proper position, 
and giving such aid as reason and judgment will dictate. Receiving the 
child, preventing its fall, securing the navel cord, assisting in the removal 
and disposal of the after-birth, are objects which are to be accomplished, 
and all in the most calm and simple manner ; no hurry or excitement is 
necessary, but, on the contrary, they embarrass. Yet how common is it 
that females in general, married and unmarried, are so stupid and ignorant, 
that, instead of attending to those duties, if necessary, or in cases of imer- 
gency, they are thrown into the greatest consternation, and perhaps run 
out of the room and let the child suffocate by the bed-clothes, or by the 
navel cord twisted about the neck, and die merely for want of a little 
common sense and knowledge, which might be acquired in an hour. Is it not 
highly disgraceful, if not criminal, that farmers can, and do, attend to these 
duties toward their stock, and yet remain entirely ignorant of them toward 
their nearest relations ? Young women and men are taught music, dancing, 
drawing, needle-work, and many ornamental branches considered so essen- 
tial to a polite education ; yet they are suffered to remain entirely ignorant 
on a subject of so much vital importance. Is there any hope or prospect 
of enlightening this generation, or must it be delayed till the next, and 
have them look back with amazement at our ignorance ? I hope there is 
something yet redeeming in a large proportion of the community; that the 
people will yet awake to their own interests. 
When the head is delivered, all that is necessary to do is, to support it, 
and wait for the pains to expel the child ; except it seems livid and in danger 
of injury, or when the cord is twisted around the neck, when assistance must 
be rendered, to accomplish the delivery. The face of the child must now be 
turned upward, and the cord freed from the neck or body ; the person who 
assists will pass a narrow piece of tape around the cord or navel-string, about 624 
THE REFORMED PRACTICE OF MIDWIFERY. 
an'inch from the body, and tie as tight as it can be drawn, otherwise haemorr- 
hage or bleeding will take place; and another must be tied at a little 
distance from it, above, and be separated between them with a pair of scis- 
sors. The child is then to be given to the nurse, to be washed, dried, and 
dressed. The woman must now be covered, and directed to lay quiet. 
The after-birth.-The after-birth or placenta must be detached or 
removed, if nature does not accomplish it in a short time. Generally, after 
about twenty or thirty minutes, a pain is felt, which may be sufficient to 
expel it; if it should not, and should there be no pain, gentle manual 
attempts may be made to remove it. 
The head and breast may be elevated, and the cord taken hold of by the left 
hand: the two first fingers may be carefully introduced into the vagina, and 
the anterior or forepart of the placenta or after-birth held in this situation 
for some minutes, in order to excite a contraction of the uterus. The woman 
may now be directed to hold her breath and press down, which forces it 
forward ; and at the same time a little extension may be made upon the cord 
with the left hand, while extension is made upon the after-birth with the 
right: this will almost invariably extract it in a few minutes. If from any 
cause it should not, no farther attempts must be made for the present, but 
left for a few hours, when, if the natural contractions of the uterus do not 
remove it, it must be done in the manner recommended, with this difference, 
that a little more force be used. In the interval, however, everything wet 
must be taken away. 
Subsequent Treatment.-After the labour has been thus completed, if the 
woman is not too weak, assistants may raise her up, and seat her upon the side 
of the bed or cot, while another removes all the wet clothing from the patient 
and her bed, and with a little warm spirits washes off the blood, water, &c., 
that remains on her person. This is particularly necessary, as the omission 
of it may give rise to puerperal fever. I know not that any other has prac- 
tised this method ; but I have found it conducive to the comfort as well as 
the health of the patient. Some practitioners will not suffer the woman to 
be removed from the situation in which she has been delivered under twelve 
or twenty-four hours, for fear of haemorrhage or flooding ; but this is a great 
and dangerous error. It is impossible to tell what mischief may arise in 
consequence of suffering her to remain drenched in water and blood for this 
length of time. 
After these precautions have been observed, and the bed properly prepared, 
on which has been placed folded blankets, skin, or oil-cloth, covered with a 
warm sheet, she may be laid down, and a diaper or suitable piece of muslin 
laid to the parts to absorb the lochial discharges. A bandage may be also 
placed around the abdomen or belly, and made moderately tight, but not 
so as to render her uncomfortable. A large tub, previously well dried, 
may be placed by the side of the bed, and the woman directed to place her 
feet in it, and, when she is lifted up, everything that is around her wet to be 
passed into it. It prevents the necessity of afterward washing the floor and 
carpet, which might prove injurious by causing a check to perspiration. 
Preternatural labour, or cross births, are those in which some other part 
than the head presents. We cannot in general assign any reason for such 
occurrences, nor can the woman, by any sensation of her own, be assured that 
the presentation is unusual. Apprehensions of this kind should not be in- 
dulged in. If the feet or breech present, the delivery is to be accomplished 
by properly accommodating the position of the child to the capacity of the 
pelvis, but no force should be employed ; and though there is always some TREATMENT AFTER DELIVERY. 
risk to the life of the infant, yet there is none to the mother. If the arm, shoul- 
der, or sides of the child present, the delivery is not impossible, but difficult, 
until the infant be turned and the feet brought down into the passage. This 
is an operation which may be done with comparative ease and safety, if the 
wrong position of the infant be discovered before the waters are discharged ; 
but otherwise both mother and child are in considerable danger, though 
there is often a spontaneous evolution, and delivery is effected. The womb 
closely contracting around the body of 
the infant when the water is drained 
away, and being soft and spongy in its 
texture, it is liable to be torn if much force 
be employed, and then either the child 
may escape into the cavity of the belly, 
or, if it be extracted by the feet, blood 
may be effused from the womb into that 
cavity, and such injury be done as to 
prove fatal. Women too frequently add 
to the danger of the operation of turning, 
by their restlessness and impatience ; they 
should remember how much is at stake, 
and exert all their fortitude, so as not to 
embarrass the practitioner. 
The labour having been thus accom- 
plished, it will be necessary to guard 
against any subsequent symptoms which 
may occur or take place. 
In tedious and very difficult labours, and where common physicians use 
the lancet, the hot bath will be found of extraordinary benefit in facilitating 
labour, by its relaxing the system without debility ; altogether better than 
bleeding. First apply spirits, water, and salt to the head ; then let the 
woman continue in the bath about fifteen minutes. 
625 
CHAPTER IV. 
TREATMENT AFTER DELIVERY 
After-pains.-Soon after delivery these usually come on, and with some 
women prove remarkably severe. The quicker the labour has been, the 
slighter will they prove in general. Women with their first child are seldom 
much troubled with after-pains ; but as the uterus is thought to contract less 
readily after each future labour, so they are more liable to suffer from them 
in any succeeding delivery than in the first. 
When after-pains prove so troublesome, as to deprive the patient of her 
rest, it will be necessary to have recourse to fomentations or anodynes ; red 
pepper and spirits, simmered together a few minutes, and flannels dipped in 
it and applyed to the belly, will generally relieve them ; if it fails, apply a 
fomentation of bitter herbs, and give two tea-spoonsful of the tincture of 
hops in milk or tea. If these fail, which I never knew, give half a tea-spoon- 
ful of capsicum in milk. These remedies are to be assisted by keeping up a 
sufficient pressure on the belly at the same time by means of a broad bandage. 626 
THE REFORMED PRACTICE OF MIDWIFERY. 
Puerperal Fever.-I have already treated of this disease under the head 
of fever. Dr. McNair thinks it not an inflammatory type of fever, but con- 
gestion. He gives, 1st, an emetic ; 2d, antimony, to cause perspiration ; 3d, 
mustard to the bowels. Dr. Boer, of Vienna, highly recommends antimony. 
Among the European writers on this fever are, Drs. Butler and Clark, 
who have given the results of their practice. The former depended upon 
purgatives and cordials, and was successful with all his cases ; the other 
used bleeding in all cases, and lost more than two-thirds of his patients. 
{See Puerperal Fever, under the head of Fevers.') 
Costiveness.-Costiveness is apt to prevail after delivery, and should 
always be removed by a laxative clyster or some gentle purgative, such as 
senna and manna, or about an ounce of castor oil. The anti-dyspeptic pills 
are also excellent. 
Flooding or Lochia.-After delivery there is a flow of blood from the 
womb, and sometimes it is excessive. When this is the case apply vinegar, 
spirits, and water to the lower part of the bowels, and give some astringent, 
as a cold tea of fleabane, beth-root, fyc. A little salt and ivater is also very 
good. 
Milk Fever.-From cold or other causes the milk becomes obstructed, 
and the breasts are hard, swelled, and painful, attended with fever, nausea, 
pain in the head and back, with thirst. 
Treatment.-Apply tbe child to the breast as early as possible, and, if 
necessary from any cause, let the milk be drawn two or three times a day 
by some person. If there is too much milk, use a spare diet: no animal food. 
The breasts may be bathed with the bitter-sweet ointment or with soap lini- 
ment. Keep the bowels regular. A little physic may be required. Should 
there be inflammation and tumours in the breast, treat them as laid down under 
that head. 
Milk or Swelled Leg.-{Phlegmasia Dolevs.}-A short time after de- 
livery this disease sometimes appears. It usually attacks one leg, and may 
extend to the other, and the whole system may become affected. The limb 
appears firm, glossy, elastic, swelled, and painful. The attack is generally 
preceded by a chill, succeeded by fever. The limb is stiff, heavy, and is in- 
creased by motion ; is tender; the skin is not discoloured, but has an increase 
of heat. After a period of about two weeks these symptoms subside, leaving 
the limb stiff, benumbed, heavy, and weak, apd is very liable to remain more 
or less so for a great length of time. It may arise from a suppression of the 
lochial discharge or the milk, or from cold. 
Treatment.-Give occasionally a cathartic, and promote moisture of the 
skin. Foment the limb with cloths immersed in a strong decoction of hops, 
and repeat two or three times a day. It may likewise be steamed over bit- 
ter herbs, or a bandage applied and kept wet with the decoction. If hot appli- 
cations aggravate it, keep the limb wet with stramonium leaves, simmered 
in spirits, and applied cool. If it proves obstinate, ley water may be used in 
the same manner ; likewise salt and water; and the whole limb may be 
anointed with bitter-sweet or mullein ointments. 
Dr. Leavitt, a botanic physician of this city, informs me that he cured a 
case of milk leg by cold applications. 
Falling or Projection of the Womb.-This happens to lying-in women 
and others, either partially or wholly. The womb descends into the vagina, 
and sometimes protrudes entirely out, which causes much distress ; pains in 
the back, groin, bearing down, with great weakness, and nervous symptoms. 
It arises from various causes, as over-exertion, straining, lifting, or any vio- TREATMENT AFTER DELIVERY. 
627 
lent exercise. The ligaments that secure the womb to the body become 
relaxed, which permits it to fall down. 
Treatment.-A broad bandage should be worn over the lower part of 
the bowels and drawn moderately tight, a strengthening plaster applied to 
the back, the restorative wine bitters used, the bowels kept regular, and the 
surrounding parts bathed twice a day with salt and water. A decoction of 
oak bark, to which add a little alum, may be injected into the womb or 
vagina once or twice a day. 
There are several kinds of abdominal supporters invented to take off the 
weight and tension from the womb, which may prove very serviceable. 
These can easily be made, or one may be purchased already made. 
Where the womb protrudes, it ought to be replaced by laying the woman 
in a recumbent position, applying the fingers and thumb to the lower part 
of the tumour, and then, by a gradual and gentle pressure, carried upward 
into its centre, and continued until the parts are returned to their natural 
place. This being effected, a proper sized sponge is to be introduced, and 
the woman kept in a recumbent posture for several hours. A sponge ought 
to be introduced as high up the vagina as can easily be borne,'and it must 
occasionally be removed and well cleansed. As the parts recover their 
proper strength and tone, one somewhat of a smaller size should be substi- 
tuted. The same bandage may be worn as recommended under the head 
of fistula. 
Inflammation of the Womb.-This disease sometimes takes place. For 
symptoms and treatment I refer the reader to it under inflammatory complaints. 
Sore and excoriated Nipples.-This complaint often happens, and it 
is very distressing. Wash the parts with a little borax water; also with a 
tincture of the balm of Gilead buds. The celandine and mullein ointments 
are very good ; after applying one or more of them, cover the parts with 
slippery elm bark, mixed with cream or milk. This course will, in general, 
cure. Should it fail, anoint the nipples and excoriated parts with the oil of 
eggs. This cured one very bad case, when some of the above applications 
failed. The oil is procured by boiling the egg hard, and pressing it out 
between two pewter plates. 
Dr. C. Pratt has invented an artificial nipple, which is very ingenious and 
simple ; the object of which is, to relieve and cure sore nipples. It con- 
sists of a small metallic shield, over which is placed a soft substance, (pre- 
pared cows' teat,) from which the child nurses with the greatest ease, and 
without giving any pain to the mother. The child extracts the milk from 
the breast with the greatest facility where the nipple is wanting entirely, 
excoriated, the skin abraded, and where the nipple is inverted ; also when 
the mouth of the child is so sore that it cannot nurse. The construc- 
tion of the old nipple shield is such as to prevent a flow of milk. This is 
made somewhat in the shape of the nipple, with a narrow 
rim, which comes in contact with the breast. It is so sim- 
ple that it can easily be made of glass, ivory, silver, or 
other metal, and may be covered with India rubber, or be 
used without any covering. I give a drawing of one which I 
think will answer : A represents the breast; B the nipple shield. 
Nursing.-A child must not be put to the breast, if the mother's health 
is very poor, or if she has any venereal, scrofulous, consumptive taint, or 
herpetic disease, St. Anthony's fire, &c. I have conversed with a female 
to-day who is subject to the last complaint, and she has communicated 
it to three of her children, which destroyed them all. The poison is 628 
THE REFORMED PRACTICE OF MIDWIFERY. 
transmitted from the mother to the child. In any of these cases the infant 
must be reared on the nursing bottle. Jemima Bowne, a very sensible 
woman, states that in all cases it is best to use cream instead of milk; the 
child thrives well upon it, less quantity answers, and it does not curdle, 
like milk, upon the stomach. She has always reared her own children 
upon cream. 
Atrophy from Suckling.-Some women of a delicate constitution cannot 
suckle long without an evident appearance of declining health ; and, if per- 
sisted in, it might terminate in a general wasting of the body and loss of 
strength, or some morbid affection of the lungs. When, therefore, a woman 
finds her health declining, and that she gets weaker every day with loss of 
appetite and languor, she ought immediately to leave off suckling ; she should 
use a generous diet, with a moderate quantity of wine bitters daily, and, 
if convenient, change the air, particularly if an inhabitant of a large and po- 
pulous city or town. If the change is not found sufficiently efficacious of 
itself, when conjoined with a restorative diet, a course of tonics should be 
given. Gentle exercise on horseback or in a carriage will greatly assist 
the effect of these remedies. 
Other diseases of women, as well as children, not noticed here, are treated 
under their proper heads. 
CHAPTER V. 
DISEASES OF CHILDREN. 
Still-born Infants.-This occurs from difficult labours, or the cord 
encircling the neck ; or a membrane may cover the head or body. I once 
attended a woman who was delivered of a child that had a singular appear- 
ance when it wras born, and was at a loss for a few seconds to account for 
it. I discovered that a thin membrane covered nearly the whole body, and 
prevented the child from breathing. I immediately removed it, brought it 
home, and laid it aside to keep. But, from a superstitious notion that the 
child would possess a " second sight," or see into futurity, some females I 
believe, knowing the circumstance, destroyed it. When anything of the kind 
occurs, the membrane should be immediately removed. If no signs of life 
appear, the infant may be put into the warm bath, and the mouth and body 
wiped dry. A little cold water may be dashed into the face, the lungs 
inflated by some person, and a slight motion made upon the chest in imita- 
tion of breathing. The navel-string may be permitted to bleed a little. I 
attended a woman, whose child was still-born in consequence of having been 
in labour for a long time, locked in the passage, with the face upward. The 
pains were terrible. The head and face were bruised and swelled, and I sup- 
posed it was dead ; but after a time it gasped, and finally recovered. 
Retention of the Meconium.-The bowels of all infants, at the time of 
their birth, are filled with a blackish coloured and viscid matter, of the con- 
sistence of syrup, known by the name of meconium. The efforts of nature 
are in general sufficient to dislodge and carry it off, if assisted by the mother's 
milk, which is always at first of a laxative quality ; therefore infants 
should be applied to the breast as soon as they show an inclination to suck. 
Should it be retained, or not sufficiently carried off, a small tea-spoonful of DISEASES OF CHILDREN. 
629 
castor oil, or a little senna tea, may be given, particularly if the secretion of 
milk in the mother's breasts is rather tardy. 
Acidity, Flatulency, and Gripes.-From various causes the infant is 
sometimes afflicted with these complaints. They arise generally from impure 
milk from the mother: when this is the case the mother should take the 
neutralizing mixture ; and, if it does remove them, give some to the infant. 
The bowels may likewise be bathed with warm spirits or brandy, to which 
a little salt must be added. The mother should be careful about her diet, 
and avoid taking cold, both of which affect the child. Catnip and soot teas 
are very good; also the carminative drops. 
Looseness or Purging.-This is soon removed, by giving both the child 
and the mother a little of the neutralizing mixture. 
Teething or Dentition.-A great many children are taken off from 
teething. It causes heat and pain in the head, restlessness, and fever, and 
the gums are swelled and painful; it often occasions fits. 
Treatment.-In extremely bad cases the gums may be scarified. A little 
physic may be administered every other day ; the feet often bathed; also 
the head, with spirits ; the warm bath is excellent. If the child cannot 
sleep, give a few of the diaphoretic powders. u A crust of bread," says a 
writer, " is the best gum-stick." A strengthening plaster may be put be- 
tween the shoulders. 
Galling and Excoriation.-Young children are very apt to become 
excoriated in particular parts of the body, especially about the groins, 
wrinkles of the neck,,behind the ears, and under the arms, such places being 
kept much moistened by urine or sweat. 
These complaints prove very troublesome to children, and are, in some 
measure, owing to a want of due cleanliness in the mother or nurse. To 
prevent, and likewise to remove, them when they do occur, it will be neces- 
sary to wash the parts well with cold water once or twice a day, to change 
the clothes often, and keep the child perfectly clean. After the child is 
washed and dried, the parts affected may be sprinkled with a little fine elm 
bark. Where the excoriation or galling is considerable, the parts, after 
having been washed with cold water, may be anointed with celandine, elder, 
or mullein ointment. . 
Aphth.e, Thrush, or Canker.-Infants and children are often affected 
with little sore spots or eruptions about the mouth ; the disease usually extends 
from the stomach to the end of the bowels, giving rise to many painful and 
unpleasant symptoms. 
This complaint arises from a morbid state of the stomach, and must be 
treated by giving a gentle neutralizing physic, such as the medicine mentioned 
above. The mouth may be washed often with a decoction of sage, gold 
thread, and hyssop, sweetened with honey; a little fine borax may be 
added. 
Says a physician, u Among the vegetable productions of our country per- 
haps none excel the wake robin, or wild turnip, finely pulverized, and rubbed 
into a paste with a little honey, which should be placed in small quantities 
on the infant's tongue, and often repeated, to have it spread through the 
mouth." 
Convulsions.-When fits or convulsions arise from teething or any other 
cause, the feet must be immediately bathed in warm ley water, and an ano- 
dyn * be administered, such as the syrup of poppy or paregoric. 
Garlic should be bruised and applied to the stomach ; and, if there is heat 
of the head, spirits, rain water, and vinegar may be applied. These means 630 
THE REFORMED PRACTICE OF MIDWIFERY. 
must be repeated as often as fits occur: in obstinate cases it may be neces- 
sary to use a warm bath. 
Soreness or excoriation of the Navel-string or Umbilical Cord.- 
About the time the umbilical cord separates there is sometimes soreness and 
inflammation ; for such symptoms sprinkle with a powder of slippery elm 
bark, and apply the black salve; also the brown ointment. 
Rupture.-{Hernia.)-Sometimes, from crying or other causes, infants 
are afflicted with ruptures; when this happens the earliest attention is 
required. The infant or child should be placed in a recumbent position, or on 
its back; then press the tumour or protruded part back, make a compress of 
linen, which has been previously wet in a decoction of oak bark, apply it 
over the rupture, and secure it by a bandage. If this fails to keep it in its 
proper situation, apply a truss. 
Tongue-tied, or division of the Frjenum Linguae.-Sometimes the 
fraenum of the tongue is so contracted that the child cannot nurse or suck. 
When this occurs, and only then, there must be a very slight incision made 
with a pair of scissors or lancet. 
The cut must be very small and superficial, lest a bloodvessel be wounded. 
If the child can nurse, this practice must never be resorted to. In almost 
every case this is an imaginary complaint; and when a parent (or parents) 
insists upon its being done, from a mistaken notion, the back of the lancet 
may be used, and this will satisfy them. 
Imperforated Vagina.-Sometimes a thin membrane forms across the 
mouth of the vagina, which partially or wholly closes it. This is very 
easily divided by a lancet or pair of scissors. I have had but one case of 
this kind. 
Club, Crooked, or Deformed Feet.-When children are born with this 
deformity, an intelligent person informs me that a certain practitioner is 
always in the habit of immediately turning them at birth into a right posi- 
tion, and securing them with proper splints and bandages. " This," he says, 
" always obviates deformity." 
Choking.-Infants often become choked by getting various substances 
into their mouth and throat. When this accident occurs, let the child be 
placed upon the lap of the mother or nurse, and its head turned downward, 
while it is gently struck a few times on the back between the shoulders ; if 
this does not immediately remove it, let the fore-finger be introduced and 
extract it: should this fail, give a mild emetic. 
CHAPTER VI. 
MANAGEMENT OF CHILDREN. 
It is during infancy that the foundation of a good constitution is generally 
laid, and it is, therefore, important that parents be taught the best method of 
managing their offspring, in order to preserve their health. Great ignorance 
is manifested on this subject; it is owing to this that so many children 
sicken and die; and, farthermore, it is in consequence of this ignorance in 
our forefathers that the present generation have become so weak, sickly, and 
effeminate ; and most of these evils may be imputed to errors in diet, regi- 
men, mineral and depletive agents, &c. We have departed from the simpli- 
city of nature, and we must, of course, suffer the penalty. MANAGEMENT OF CHILDREN. 
1st. On Diet.-If the mother or nurse has enough of milk, the child will 
need little or no food for the third or fourth month. It will then be proper 
to give it a little of some food that is easy of digestion once or twice a day 
this will ease the mother, will accustom the child by degrees to take food, 
and will render the weaning both less difficult and less dangerous. All great 
and sudden transitions are to be avoided in nursing; for this purpose the 
food of children ought not only to be simple, but to resemble as nearly as 
possible the properties of milk ; indeed, milk itself should make a principal 
part of their food, not only before they are weaned, but for some time after. 
Next to milk we would recommend good bread, which may be given to 
a child as soon as it shows an inclination to chew ; and it may at all times 
be allowed as much as it will eat. The very chewing of bread will promote 
the cutting of the teeth and the discharge of saliva, while, by mixing with 
the nurse's milk in the stomach, it will afford an excellent nourishment. 
Many are in the habit of pouring down various liquids and mixtures made 
of rich substances, and so much sweetened that the tender organs of digestion 
are impaired, and acidity and bowel diseases follow ; articles of this nature 
should be avoided : no food, except the milk of the mother, should be given, 
unless absolutely necessary ; nature has designed this liquid exclusively for 
the nourishment of the infant, and, indeed, we may say for children. 
There is another precaution to be observed, which is, " never to put an 
infant to a wet-nurse if it can possibly be avoided such persons are gene- 
rally strangers, and they often communicate the most loathsome and fatal 
diseases; besides, their milk is often rendered unwholesome by age or 
other causes: this is a very unnatural practice. 
The milk of the mother, then, should constitute the only food of the infant, 
except in cases of disease, when it becomes necessary to obtain a wet-nurse, 
or bring up the children on the bottle, which can be done very easily. 
I attended a,lady of this city who was almost covered with a herpetic com- 
plaint , or the salt rheum, and that, too, when her child was born. I treated and 
cured her of the complaint. The infant was fed on milk, by introducing a 
silver tube into a bottle containing it, a figure of which is annexed. 
I never knew a child so 
quiet and free from pain ; as 
much so as any offspring of 
the brute creation, which are 
free from it merely by follow- 
ing nature or instinct, which 
never errs. The milk was 
supplied from Governeur 
Morris's dairy, near this 
city, where cows are fed on 
pasture instead of slops, and, 
therefore, give pure milk. 
Now, it appears to me that 
if females imitated these ani- 
mals, were to live'on vegeta- 
ble instead of animal food, 
and drink nothing but water, 
they would not only bring 
forth as easy as the Indians 
or these animals, but their 
offspring would be free from 
631 632 
THE REFORMED PRACTICE OF MIDWIFERY. 
pain, and perhaps be as exempt from sickness. Would not this course pro- 
duce a revolution in our habits, health, and in the practice of medicine ? In 
the present diseased state of society it might require a long time to bring 
about a change in the system ; but an immediate benefit would follow by 
adopting these physiological principles. Do not these facts open a new field 
of investigation and improvement ? 
Is it not notorious that some infants are crying a great proportion of their 
time in consequence of pain ? and is it natural, or can there be any other cause, 
except the poison communicated to it, through the medium of the blood, 
before and after it is born; or the disease may proceed from the impurity 
of the mother's milk occasioned by errors in diet ? It is self-evident that it 
is so, from the fact that animals are free from these symptoms. Then let me. 
enjoin upon all who do not wish to torment and destroy their children, the re- 
formed system of dietetics, as well as medicine ; they must all go hand in hand. 
Can there be any other cause why so many children are in distress from 
birth, and generally die young, or continue weak and sickly all their lives ? 
There must be a reformation in the habits, taste, and education of modern 
females. Many mothers are as ignorant, when they have brought a child 
into the world, of what is to be done for it as the infant itself. 
Says Combe ; " The leading error in the rearing of the young, J must 
again repeat, is over-feeding, an error serious in itself, but which may easily 
be avoided by the parent yielding only to the indications of appetite, and 
administering food slowly and in small quantities at a time. By no other 
means can the colics, and bowel-complaints, and irritability of the nervous 
system, so common in infancy, be effectually prevented, and strength and 
healthy nutrition be secured. Nature never meant the infant stomach to be 
converted into a receptacle for laxatives, carminatives, antacids, spicy stimu- 
lants, and astringents; and when these become necessary, wre may rest as- 
sured that there is something faulty in our management, however perfect it 
may seem to ourselves. The only exception is where the child is defectively 
constituted, and then, of course, it may fail to thrive under the best measures 
which can be devised for its relief. 
" Another cause of infantile indigestion, and which is too much overlooked 
through ignorance of its importance, is vitiation of the quality of the milk, 
caused by imprudence, neglect, or anxiety on the part of the mother. The 
extent to which this cause operates in inducing irritation and suffering in the 
child, is not generally understood ; and, accordingly, it is not unusual for 
mothers to display as much indifference to health, regimen, and tranquillity 
of mind during nursing, as if the milky secretion, and all other bodily func- 
tions, were independent of every external and corporeal influence. Healthy, 
nourishing, and digestible milk can proceed only from a healthy and well- 
constituted parent; and it is against nature to expect that, if the mother 
impairs her health and digestion by improper diet, neglect of exercise, impure 
air, or unruly passions, she can, nevertheless, provide a wholesome and un- 
contaminated fluid, as if she were exemplary in her observance of all the 
laws of health. 
" It is no new or uncertain doctrine, that the quality of the mother's milk 
is affected by her own health and conduct, and that in its turn it directly 
affects the health of the nursling. Even medicines given to the parent act 
upon the child through the medium of the milk; and a sudden fit of anger, 
or other violent mental emotion, has not unfrequently been observed to 
change the quality of the fluid so much as to produce purging and gripes 
in the child. Care and anxiety, in like manner, exert a most pernicious MANAGEMENT OF CHILDREN. 
633 
influence, and not only diminish the quantity, but vitiate the quality of 
the milk." 
" It is a common mistake to suppose that, because a woman is nursing, 
she ought, therefore, to live very fully, and to add an allowance of wine, 
porter, or other fermented liquor, to her usual diet. The only result of this 
plan is to cause an unnatural degree of fulness in the system, which places 
the nurse on the brink of disease, and which of itself frequently puts a stop 
to, instead of increasing, the secretion of the milk. The health and useful- 
ness of country nurses are often utterly ruined by their transplantation into 
the families of rich and luxurious employers. Accustomed at home to con- 
stant bodily exertion, exposure to the air, and a moderate supply of the 
plainest food, they live in the enjoyment of the best health, and constitute 
excellent nurses. But the moment they are translated from their proper 
sphere, their habits and mode of life undergo an unfavourable change. Ha- 
ving no longer any laborious duties to perform or any daily exposure to 
encounter, they become plethoric and indolent; and as they are at the same 
time too well fed, the digestive functions become impaired, the system speedily 
participates in the disorder, and the milk, which was at first bland, nourish- 
ing, and plentiful, now becomes heating and insufficient, and sometimes even 
stops altogether." 
Cocoa shells, made precisely like coffee, make a very pleasant and nutritious 
drink for nursing females. 
Weaning.-•" Diet for infants after weaning may be pure milk, two parts ; 
water, one part; slightly sweetened. This," says Combe, " makes the nearest 
approach to the nature of the mother's milk, and, therefore, is more suitable 
than any preparation of milk and flour, or any other that can be given." A 
child, as a general rule, one year old, ought to be gradually weaned, and the 
appearance of the teeth shows the propriety of giving food a little more sub- 
stantial than milk. Bread a day old, mixed with milk and sweetened, may be 
given in connexion with nursing. Gruel, arrow-root, plain bread, Indian and 
rice puddings as they grow older, and subsequently bread and butter, thicken- 
ed milk, hasty pudding or Indian, potatoes, and vegetables. Not a particle 
of flesh should ever be given. By the use of meat the system becomes ex- 
cited, and diseases of irritation are apt to be produced, which impede nutri- 
tion, and lead ultimately to the production of scrofula and other organic 
changes in the glands and bowels, and not unfrequently also in the brain and 
lungs. In these instances the child generally eats heartily, but, neverthe- 
less, continues thin, and is subject to frequent flushing and irregularity of the 
bowels, headache, and restlessness. His mind partakes of the general irri- 
tability of the system, and peevish impatience takes the place of the placid 
good-humour natural to healthy childhood. In this state the ordinary dis- 
eases of infancy-measles, scarlet fever, and hooping-cough-are often at- 
tended with an unusual and dangerous degree of constitutional disturbance; 
and when inflammation takes place it is borne with difficulty, and the system 
does not easily rally; or the digestive organs become irritated, and the various 
secretions immediately connected with digestion are diminished, especially 
the biliary secretion. Constipation of the bowels soon follows ; congestion 
of the hepatic and abdominal veins succeeds, and is followed by the train of 
consequences which have already been detailed. In reality the wonder 
comes to be, not that so many children die, but that so many survive their 
early mismanagement. A morbid condition of the system arises, extremely 
favourable to the production of scrofulous, consumptive, dyspeptic, and other 
diseases, under which, perhaps, the infant sinks; and yet, strange to state. 634 
THE REFORMED PRACTICE OF MIDWIFERY. 
parents will stuff their children with flesh and grease two or three times a 
day. 
Says Combe, " One of the most pernicious habits in which children can 
be indulged is that of almost incessant eating. Many mothers encourage it 
from the facility with which, for a time, the offer of ' something nice ' pro- 
cures peace. Even from infancy the child ought to be gradually accustomed 
to eat only when hungry, and when food is really required. After two 
years of age an interval of four hours between meals will rarely be more 
than enough ; and to give biscuit, fruit, or bread in the meantime, is just 
subtracting from the digestive power of the stomach. Like almost every 
organ of the body, the stomach requires a period of repose after the labour 
of digestion; and, accordingly, in the healthy state, the sensation of appetite 
never returns till it has been for some time empty. To give food sooner, 
therefore, is analogous to making a weary traveller walk on without the re- 
freshment of a halt." 
" When we reflect that the object of digestion is, to furnish materials for 
the growth of the body, and to supply the waste which the system is con- 
stantly undergoing, it must appear self-evident that, if the digestive powers 
be impaired by disease, by improper quantity or quality of food, or by any 
other cause, the result must necessarily be the formation of an imperfect 
chyle, and, consequently, of imperfect blood. The elements of the blood are 
derived from the chyle, and if it be vitiated, the blood also must suffer : if 
the blood be diseased, so must necessarily be all the organs which it supplies ; 
and if the body be thus debilitated, can any wonder be felt that it should no 
longer be able to resist the action of offending causes which full health alone 
can withstand ?" 
Clothing.-Infants and children are often injured by improper clothing 
It is customary for some nurses to wrap them in such a quantity as to injure 
their health ; moderation in this respect should be observed, due regard 
being paid to that which is sufficient to render them comfortable. Infants, 
when first born, have clothing enough almost to smother them. 
Medicine.-Another very reprehensible custom is, to pour down some 
nauseous drug, such as paregoric, Godfrey's cordial, or some other articles, 
every time the child begins to cry or is fretful, by which it becomes 
habituated to the use of opium, and makes it necessary to increase the dose 
in order to produce the same effect. 
Another injurious practice is, to give frequently worm lozenges (the basis 
of which is calomel or mercury) upon any attack of illness, under the im- 
pression that the disorder is occasioned by worms. By this imprudent course 
both the health and life of the child is endangered. Therefore those who 
wish to bring up their children in a healthy condition must avoid these evils, 
and be content to follow the simple path of nature and common sense. 
Few things tend more to the destruction of children than drenching them 
with drugs. Medicine may be sometimes necessary for children ; but that it 
injures them ten times for once it does them good, I will venture to assert. 
A nurse or mother, the moment her child seems to ail anything, runs imme- 
diately to the doctor or the apothecary, who throws in his powders, pills, 
and potions, till the poor infant is poisoned; when the child might have been 
restored to perfect health by a change of diet, air, exercise, clothing, er 
some very easy and simple means. 
Care must be taken to keep the bowels regular, which may be effected in 
most cases by the milk of the mother alone. Most of the complaints in 
children arise from flatulence or wind ; to remove which give common cat- MANAGEMENT OF CHILDREN. 
635 
nip or fennel seed tea, let them drink it freely, and let the mother regulate 
her diet. 
When children complain of pain in the stomach and bowels, it may be 
necessary sometimes to give a moderate dose of vegetable physic ; senna and 
manna is very good; after the operation of physic let the diet be attend- 
ed to. Green fruit must be avoided, and whatever is hard of digestion. The 
feet should be often bathed in warm water, the bowels must be fomented 
with bitter herbs, and it is also necessary to give the child sufficient exer- 
cise in the open air. 
Bathing should never be neglected, as it contributes much to health. 
Many complaints of the skin and the system are caused by the neglect 
of this practice. Filth collects on the surface, obstructs perspiration, which 
retains morbid humours, and which are thrown upon some of the internal 
organs and create irritation. Is it not owing to this that infants fret and cry 
so much ? Daily bathe with tepid water; this is also good for galling, 
chafing, excoriations, &c. 
Pure Air and Exercise.-This is very necessary ; impure and confined 
air, with the want of exercise, causes disease ; and hence children in 
cities are more pale, feeble, and sickly than those who live in the country 
and breathe pure air and play in the dirt. Confining children at home, in 
low, confined, dirty houses, cellars, and in school-rooms, is pernicious ; also 
crowding too many in sleeping-rooms. When children are confined in small 
apartments, the air not only becomes unwholesome, but the heat relaxes 
their solids, renders them delicate, and disposes them to colds and many 
other disorders. Nor is the custom of wrapping them too close in cradles 
less pernicious. One would think that nurses were afraid lest children should 
suffer by breathing free air, as many of them actually cover the child's face 
while asleep, and others wrap a covering over the whole cradle, by which 
means the child is forced to breathe the same air over and over all the time 
it sleeps. Children, therefore, must have as much exercise and air as 
possible, and should be employed in something useful and interesting. 
Again; " The premature exertion of intellect to which the mind is stimulated 
at our schools, by the constant excitement of emulation and vanity, far from 
strengthening, tends to impair the health and tone of the brain, and of all 
the organs depending on it; and hence we rarely perceive the genius of the 
school manifesting in future years any of the superiority which attracted 
attention in early life." 
Another bad custom deserves attention, which is the barbarous and cruel 
treatment of parents and school-teachers toward their children in beating 
and whipping them. This course has not only a strong tendency to harden 
them in vice, but likewise to injure both mind and body. Generally these 
persons act under the influence of passion, and then vent it upon those under 
their charge ; which, instead of reforming them, infuses the same infernal 
spirit into the children : have not many an awful account to give for such 
conduct! What cruelty and suffering children undergo by this reprehensible 
custom ! love begets love, and wrath begets wrath. 
I was about to state, that if anything in the city ought to be indicted by the 
grand jury as a nuisance, " as sores on the body politic." it should be our common 
schools, as regards injury to health, morals, and education. Several hundred 
children are crammed into small, ill-ventilated rooms, and are under such 
discipline, that injurious effects must, in the very nature of things, result to 
body and mind. What a pity to pervert the best of institutions. The best 
child, placed in these schools, by association soon becomes as bad as the others. 636 
A COURSE OF MEDICINE 
ON REARING INFANTS. 
The following communication is from a worthy member of the Society 
of Friends, a woman of excellent judgment and experience, and who has 
reared several children : 
" Westchester, Gino. 23d, 1842. 
" Esteemed Friend : Agreeable to thy request, I send thee information 
respecting the treatment of rearing infants, the use of cream, &c. I begin with 
them from the time they are twenty-four hours old, and give pure cream, 
and without any sugar, unless they please ; I never used any myself. Thou 
asks how often I give it; I never had any particular period for giving it, 
but should judge as often as five or six times a day. Thou also wishes to 
know what I give in case of pain, gripes, crying much, &c. ; I very often 
give the articles catnip, lavois seed, oil of annis, <Sfc., but have often found 
great benefit from soot tea ; take it from the chimney where wood fire alone 
has been used. In answer to thy next, on bathing, I wash the infant entirely 
over with cold water ; but, when quite young, put a little brandy in the water ; 
and lastly, as regards food while weaning, 1 frequently give arrorv-root, with 
a little manna, as there is often need of a little gentle medicine. 
" I would also inform thee that, after taking the cream for a week or two, 
there has, on all my children, appeared an eruption on the skin, which may 
perhaps cause the nurse to he alarmed, but it will wear off in a few days. 
I was always particular to give them the cream from one cow's milk. 
" I believe I have now answered all thy questions ; and if they will be of 
any use, 1 shall be paid for mv trouble. 
" W. B. Thy Friend, S. H. B. 
" P. S. In cold weather warm the cream, but be careful not to let it boil." 
All diseases of women and children not noticed in the preceding chapters, 
will be found under the appropriate heads; such as rickets, worms, dropsy 
in the head, croup, &c. 
A COURSE OF MEDICINE 
FOR DISEASES GENERALLY. 
It is common for physicians of the old school, and some others, to " put 
or carry " persons through a course of medicine. One class a mineral or 
mercurial course; another, steaming, puking, &c. I also wili give mine, 
which, in many diseases, may be pursued with success. This plan, how- 
ever, has a tendency to lead a person too much to generalize or adopt a 
routine of practice for complaints, instead of prescribing according to particu- 
lar symptoms. 
1st. THE COURSE IN CHRONIC DISEASES. 
In diseases of long standing, or such as have assumed a chronic character, 
and such as are termed " anomalous." or those which do not assume a spe FOR DISEASES GENERALLY. 
637 
cific character and are difficult to detect, which is often the case even by the 
most experienced and learned physicians, the following course may be pur- 
sued. 
In cases where the tongue is very much furred or the stomach disordered, 
give the 
Emetic, 
according to the directions under that head. The day after the emetic give 
the 
Mandrake Physic ; 
at bed-time it is rather preferable to take it. After this has operated admi- 
nister the 
Restorative Wine Bitters, 
and occasionally the tonic tincture. When there is any pain internally, chills 
or coldness of the system, showing a want of a proper circulation of the 
blood, add a tea-spoonful of the capsicum to the bitters, and give them as 
laid down under that head ; where wine disagrees, an infusion or tea may 
be made of them, and drank as the stomach will bear. 
The next step in order is, to bathe the whole surface of the body, feet, and 
extremities with 
Ley Water, or a weak solution of Sal Soda. 
Sponge or flannel is very suitable for this purpose; when the patient is 
unable to sit up, it may be done in bed ; raise the clothes with one hand and 
bathe with the other ; at the same time let the patient drink freely of catnip 
tea. This opens the pores of the skin and frees the surface of viscid per- 
spirable matter, which obstructs perspiration. The feet may be immersed 
in warm ley water before the body is bathed, particularly when they are 
habitually cold. This course may be repeated according to its effects. If 
the first course benefits, but does not remove the complaint, repeat, as a general 
rule, once or twice a week. In a majority of cases, however, the emetic 
may be dispensed with, or given occasionally ; but the mandrake physic may 
be continued. Where the stomach is very weak, and it causes much nausea 
or sickness, the anti-bilious or mandrake pills, or Culver's physic, may be sub- 
stituted, and given every other night. 
2d. PAINFUL AND INFLAMMATORY DISEASES. 
In fever, inflammatory rheumatism, colds, inflammation of the lungs, St. 
Anthony's fire, and other painful diseases, if the stomach is very much 
disordered, an emetic may be given ; otherwise dispensed with. Next, in 
order to equalize the circulation, the patient may take the 
Medicated Vapour Bath 
as follows : Take a suitable quantity of herbs, such as catnip, pennyroyal, 
spearmint, and tansy, a double handful of each, and add a gallon or two of 
water: boil a short time, then put the whole into a suitable vessel, and 
place a narrow piece of board over it, on which let the patient sit, with his 
clothes off, and a blanket around him to retain the vapour; or the decoction 
may be placed under a cane or chair, on which the patient may 638 
A COURSE OF MEDICINE. 
sit with a coverlid over or around him, to prevent the escape of the vapour. 
Let the feet at the same time be immersed in warm ley water. Should 
there not be heat sufficient to produce perspiration, a hot stone, brick, or 
piece of iron, which should be in readiness, may be thrown into the decoction 
of herbs ; and should there, be too much heat, an opening may be made for 
its escape. At the same time give freely of warm 
Catnip Tea. 
In general a free perspiration will take place in fifteen or twenty minutes; 
after which rub the surface dry, and let the patient be put to bed and covered 
with a proper quantity of clothing. Should there be any faintness while 
using the vapour bath, a little cold water may be given ; and, if it continues, 
he may be put to bed : in case there is not much perspiration, hot bricks, 
properly covered with cloth, and wet with vinegar, may be placed to the 
feet. When the sick person is unable to sit up long enough to be thus 
treated, perspiration must be excited in bed, which, in general, maybe done 
by giving a portion of the diaphoretic powders, followed by warm catnip or 
other herb tea, and hot stones or bricks laid at the feet and sides. After the 
perspiration is over a portion of the 
Anti-bilious Physic 
may be given ; mandrake physic is also very good. A complete course of 
this kind will, in general, be sufficient to remove a recent disease. 
The bilious physic may be given in fever and urgent cases daily, and 
followed with means to promote perspiration, such as bathing the surface 
daily, herb tea, &c., sufficient to keep up a gentle moisture of the skin. 
Should the tongue continue very much coated or furred, give occasionally 
an emetic, and subsequently the mandrake physic or pills. In a majority of 
diseases the emetic or vapour bath may be dispensed with, the other means 
being sufficient. It is very important in all cases of fever, in a hot and dry 
state of the skin, to bathe the whole body once or twice a day with a weak 
solution of sal soda or ley water, and rub the surface with a coarse towel. 
The watchword must in all cases be moderation ; avoid violence and excess. 
In some cases, where medicine, after a fair trial, does not benefit, it may 
be best to discontinue it, or take very little, and rely upon nature, with 
diet, exercise, bathing, &c.-See 11 bill of fare for invalids. " 
When any part of the spine is tender, or any other part is painful, apply 
the irritating or common strengthening plaster, and, in acute cases, a mustard 
plaster. When there is habitual coldness, pain in the stomach or bowels, 
when the pulse is weak, veins small, and system languid, take stimulants : a 
little capsicum may be taken daily, or as occasion requires ; from one-fourth 
to a tea-spoonful, in syrup, molasses, or sweetened water. 
Illustrations.-In my large work I have given several hundred cases 
successfully treated according to the principles here laid down ; but want of 
room prevents me from inserting them in this treatise. Those who desire 
more evidence to inspire confidence, must follow the practice which I have 
recommended, and then they will have ocular demonstration of its efficacy, 
which seldom fails to convince. PART SIXTH. 
VEGETABLE MATERIA MEDICA. 
By matena medica is to be understood the nature, properties, and em- 
ployment of those agents or articles used in the treatment of disease; and 
they, it will be seen, are principally derived from the vegetable kingdom, 
which abounds in medicinal productions of the choicest kind, and shows 
how ample is our vegetable materia medica, and how adequate to all needful 
purposes. How much more natural is it to look to the field and the forest 
for plants and roots to cure our complaints, than to dig in the bowels of the 
earth and procure certain metals, which prove poisonous and destructive 
even in obtaining them, and much more so after having been subjected to 
a chemical process. Both the untutored savage and the beast are taught, by 
reason and instinct, to use those vegetables which are scattered so richly 
around them, to relieve their diseases. Those who have travelled among 
the natives of all countries testify to these facts. The Indians of North 
America know how to treat their complaints, both in physic, surgery, and 
midwifery, related by Count La Sallee, Washington Irving, Catling, Lewis 
and Clark, and numerous others. It is the same in the East Indies, South 
Sea Islands, Patagonia, Africa, &c. 
Bosman, in his Description of the Coast of Guinea, speaking of the different 
herbs employed by the natives, says ; " I have seen several of my country- 
men cured by these medicines, when our own physicians were at a loss what 
to do.'1'' Again he says ; " I have several times observed the negroes cure 
such extensive and dangerous wounds with these herbs, that I have looked 
on with amazement." 
Le Vaillant also, in his Travels into the Interior Parts of Africa, gives an 
interesting account of the use of vegetable remedies by the savages of that 
country. Upon one occasion they cured him of a violent attack of quinsy, 
after he had given up his case as hopeless. His tongue and throat wrere so 
swelled that he could only speak by signs ; and his breathing became so 
much impeded that he expected to be suffocated. In the meantime he was 
visited by a party of savages, who, feeling an interest in his situation, pledged 
themselves to cure him. He had at this time despaired of his life for nearly 
a week. The remedy was a hot local application of a certain herb. It was 
also to be used as a gargle. The poultice was renewed several times in the 
night, and the gargle still more frequently repeated. When day appeared 
he was greatly eased : he could breathe more freely, and the swelling and 
inflammation of the throat were abated. By the third day he found himself 
cured. He then went out to examine the plant by which he had been re- 
stored to health. " Nothing in the country," says he, " was more common,; 
it grew all around the camp, and was to be met with in every direction." He VEGETABLE MATERIA MEDICA. 
640 
describes it as a species of sage, about two feet high, with a pleasant smell 
and balsamic taste. 
Le Vaillant, abounding in gratitude, no doubt, for his unexpected cure, 
and regretting that so few of the plants which cover the surface of the globe 
should be unknown, says ; " If there be any of real importance to us, we 
have been almost always indebted to savages, or even to beasts, for their 
discovery." 
" The art of healing among the Sumatrans," says Marsden in his history 
of that country, " consists almost entirely in the application of simples, in 
the virtues of which they are surprisingly skilled. All the old men and 
women in the country are physicians, and their rewards depend upon their 
success." Marsden also says ; " The Sumatrans have a degree of botanical 
knowledge that surprises a European. They are in general, and at a very 
early age, acquainted not only with the names, but the qualities and proper- 
ties of every shrub and herb among that exuberant variety with which their 
country abounds." 
Order or Arrangement.-It is generally customary, in treating on this 
branch of medicine, to divide the various remedies or agents into classes: 
but as every plant possesses several or many properties, and cannot be 
classed into any definite medical order, but belong to several at the same 
time, a different arrangement is adopted in preference. 
The following is the order which is adhered to in this work. 1st. Arti- 
cles are treated of which are purely vegetable, such as medicinal plants, 
roots, bark, &c. 2d. Minerals, certain salts, &c. 
Season of collecting Vegetable Medicines.-1st. Roots.-Roots must be 
collected in the spring, before the sap begins to rise, or in the fall after the 
top is dead. 
2d. Barks.-Barks may be stripped from the tree or shrub any time when 
the sap prevents it from adhering to the wood. The exterior portion must 
be shaved off; the bark then cut thin, and dried in the shade. 
3d. Medicinal Plants.-Medicinal plants should be collected while in 
blossom, and also dried in the shade ; their virtues, however, are not essen- 
tially diminished any time before frost appears. 
4th. Flowers and Seeds.-Flowers and seeds should be collected when 
they are fully ripe, and likewise dried in the shade. All vegetables, after 
having been dried, should be kept from the air, and preserved air-tight, or in 
a dry place. In this way they may be preserved for many years, without 
losing any of their medicinal properties. 
Preparations.-1st. Extracts.-The best method to obtain all the strength 
and virtues of a plant or vegetable is, to mash them, to which add a little 
alcohol if necessary, press out the juice, and evaporate in the sun to the con- 
sistence of honey ; then put it in jars, and cover tight with bladder or skin. 
This is the inspissated juice, and is much superior to extracts made by 
boiling. 
Infusions or Teas.-Put a handful of the herb into a tea-pot, add one pint 
of boiling water, and let it stand fifteen or twenty minutes: dose, a full draught 
three or four times a day, unless differently prescribed. To promote per- 
spiration, take it warm. 
Decoctions.-Make the same as infusion; but continue the boiling till all the 
strength is extracted. 
Component parts of Vegetables.-Plants arechymical compounds, prepared 
by the hand of nature ; and, although despised by the foolish as simple, they 
are more ingenious than can made by the greatest chymist in the world. VEGETABLE MATERIA MEDIC A. 
641 
Nor will his productions bear any comparison with them as regards beauty 
or medical properties ; and the reason is, because one is made by man, there- 
fore imperfect; the other by the Creator, and, therefore, absolutely perfect. 
Vegetables in general contain gum, fecula, gluten, sugar, oil, rosin, balsam, 
tannin, acid, wax, camphor, and albumen. 
TERMS OF CLASSIFICATION OF MEDICINES. 
Narcotics are substances which diminish the actions and powers of the 
system, without occasioning any sensible evacuation. They have the effect 
of producing sleep. 
Anti-spasmodics are medicines which have the power of allaying irritation 
and spasms. 
Tonics are those articles which increase the tone of the animal fibre, by 
which strength is given to the system. 
Astringents are articles which have the power of binding or contracting 
the fibres of the body. 
Emetics are medicines which excite vomiting, independent of any effect 
arising from the mere quantity of matter introduced into the stomach. 
Purgatives or Cathartics are medicines which increase the peristaltic motion 
of the intestines, and thereby produce a preternatural discharge. 
Emmenagogues are those medicines which are capable of promoting the 
menstrual discharge. 
Diuretics are those medicines which increase the urinary discharge. 
Diaphoretics are those medicines which increase the natural exhalation 
by the skin, or promote moderate perspiration. 
Sudorifics are those medicines which produce copious exhalations or 
sweating. 
Expectorants are those medicines which increase the discharge of mucus 
from the lungs. 
Sialagogues are those medicines which excite a preternatural flow of 
saliva. 
Errhines are those medicines which increase the secretion from the nose 
and head, and excite sneezing. 
Epispastics or Blisters are those substances which, when applied to the 
surface of the body, produce a serous or puriform discharge, by exciting a 
previous state of inflammation. 
Rubefacients are substances which, when applied to the skin, stimulate, 
redden, or inflame it. 
Refrigerants, medicines which allay the heat of the body or of the blood. 
Antacids, remedies which obviate acidity in the stomach. 
Lithontryptics, medicines which are supposed to have the power of dis- 
solving urinary concretions in the bladder. 
Escharotics or Caustics, substances which corrode or dissolve the animal 
solids. 
Anthelmintics, medicines which have the effect of expelling worms from 
the intestines. 
Demulcents, medicines which obviate and prevent the action of stimulating 
and acrid substances, by involving them in a mild and viscid matter, which 
prevents their action on the body. 
Diluents, those medicines which increase the fluidity of the blood. 
Emollients, substances which sooth and relax the living fibre. 642 
VEGETABLE MATERIA MEDICA. 
Alteratives. This term is applied to substances which are found to promote 
a change in the system favourable to recovery from disease, but not with 
certainty referable to any other class. 
Counter-irritants, agents applied to the surface, which excite an eruption 
or an inflammation, and thus divert the humours from internal to external 
parts. 
CLASSIFICATION OF ARTICLES. 
The various articles composing the materia medica may be classed or 
divided as follows: 
1st. Medicinal Plants. 6th. Medicinal Barks. 
2d. " Roots. 7th. " Gums. 
3d. " Flowers. Sth. " Oils and Balsams. 
4th. " Seeds. 9th. " Salts. 
5th. " Extracts. 10th. " Minerals. 
11th. Medicinal Earthy Substances. 
No. 1. Pleurisy-root. [Asclepias Tuberosa.) The Root 
Common Names.-Orange Swallow-wort, Pleurisy-root, Butterfly-weed, 
Flux-root, Wind-root, White-root, Silk-weed, Canada-root, &c. 
History.-This plant is easily known by its bright orange-coloured flow- 
ers, blossoming in July and August: it is a very ornamental plant. All the 
Asclepias are milky, but this is less so than the others. 
Locality.--It is found throughout the United States, but grows more 
abundantly in the southern states ; it prefers open situations, poor and 
gravelly soils, along gravelly streams, and on hills. 
Properties.-Diaphoretic, expectorant, diuretic or astringent, carminative, 
anti-spasmodic, fyc. 
Employment.-This root is a popular remedy for pleurisy, and is used in 
the form of tea to promote perspiration; it is also recommended for colic, 
flatulence, and lung complaints. I sometimes add it to our pulmonic syrup., 
and give a strong tea in pleurisy. 
No. 2. Chamomile. [Anthemis Nobilis.) The Flowers. 
Common Name.-Chamomile. 
Locality.-Chamomile is a perennial plant, indigenous in the south of 
England, but cultivated in our gardens for medical purposes. 
Properties.-Chamomile flowers are anti-spasmodic, carminative, tonic, Sfc. 
They enter into one of our pectoral preparations; also into our restorative 
cordial. Chamomile flowers, boiled down with milk, and applied to Mrs. H.'s 
neck, cured her of a painful glandular swelling, proceeding from cold. 
Employment.-These flowers may be given in infusion or tea, which 
may be drank warm, to promote the action of emetics. It may be taken in 
wine in cases of debility, and in the form of tea in pulmonary complaints ; 
and, boiled in vinegar, may be used as a fomentation in painful glandular 
swellings. They give out their virtues both to water and spirits. 1. Pleurisy Root. (Asclepias Tuberosa.) 
2. Chamomile. (Anthemis*Nobilis.) 
4. Aloe. (Aloe Spicata ) H Asarabacca. (Asarum Canadeuse.) 
7. Burdock. (Arctium Lappa.) 
6. Cohosh. (Acttea Raaemosa.) VEGETABLE MATERIA MEDICA. 
643 
No. 3. Wild Chamomile. (Anthemis Cotula.) 
Common Names. Wild Chamomile, May-weed, Dogs' fennel, Dilly, Dilweed, 
Field-weed, &c. 
History.-It blossoms from June to November, affording a profusion of 
flowers in succession, of the size of chamomile, but never double. The 
whole plant has a strong smell, but not foetid. 
Locality.-Our plant is indigenous, and not naturalized, as mentioned by 
some botanists. It is spread all over the United States, from Maine to Loui- 
siana, but confined almost everywhere to open fields. It is never found in 
woods, but delights in the sun, road-sides, stony places, old fields, &c. 
Properties.-The properties of this article are similar to the common 
chamomile, but weaker, and less pleasant to the taste. It may be substituted 
for it with safety. It is sudorific, stimulant, anodyne, emetic, fyc. The ex- 
ternal use in fomentations is proper in white swellings, rheumatism, hysteric 
fits, suffocations, piles, pains, and contusions. It acts always as a sudorific, 
promoting copious sweating, and is very beneficial to assist the action of 
emetics. In large doses it is emetic, but in small ones it is diaphoretic, and 
gently tonic. It is highly prized by country people, to promote perspiration 
in many incipient complaints. 
Employment.-A tumblerful of the infusion may be given three or four 
times a day ; and, to promote perspiration, it may be freely drank, and warm. 
No. 4. Aloe. (Aloe Spicata.) Juice of the Leaves. 
Common Name.-Aloe. 
Locality. -The aloes is a perennial plant, of which there are many 
varieties, which grow in the south of Europe, Asia, Africa, and America. 
Properties.-There are three kinds of aloes in commerce, viz., the so- 
cotorine, the hepatic, and the horse aloes; this last is used only for horses. 
The first is the kind generally made use of by physicians. It is a warm, 
stimulating purgative, operating with peculiar force upon the large intestines, 
and particularly upon the rectum; and, by emptying the uterus, often pro- 
ducing piles, if given alone. It is good in habitual costiveness and in ob- 
struction of the menses. It warms the habit and quickens the circulation. 
It enters into our formula for dyspepsia, " the anti-dyspeptic and anti- 
bilious pills." It is the basis of many noted nostrums. 
No. 5. Archangel. (Angelica, Archangelica.) The Root, Stem, and Seed. 
Common Name.-Garden Archangel. 
History.-This plant flowers in June and July, and the seeds are ripe in 
August. 
Locality.-This is a biennial plant, and indigenous to the southern parts 
of France, but is cultivated in our gardens. 
Properties.-It is administered with advantage in disorders arising from 
flatulence, and debility of the stomach and digestive organs. It is recom- 
mended in nervous headache pains. We use it in the form of infusion oi 
tea for flatulence or wind. It may be given also for pain in the breast. 644 
VEGETABLE MATERIA MEDICA. 
No. 6. Black Snake-root. {Actaa Racemosa.) 
Common Names.-Black Snake-root, Squaw-root, Rich-weed, Rattle-weed, 
Rattle Snake-root, Black Cohosh. 
Description.-The black cohosh rises from four to six feet high, with 
white flowers, succeeded by shells, which contain the seed. The root is 
black externally, irregularly sloped, with many prongs and fibres. 
History. -The American species has an extensive range, and was used 
by all the Indians. It blossoms in June and July; its seeds are ripe in 
August. The whole plant, and even the flowers, are possessed of medicinal 
properties. 
Locality.-Found all over the United States, from Maine to Florida, 
Louisiana, and Missouri, Canada, and Texas ; common in open woods, rich 
grounds, and on the sides of hills; not so common on rocky mountains and 
in sunny glades ; very scarce in moist and swampy soils. 
Properties.-It makes a good poultice for every kind of inflammation. 
A decoction may be made, and thickened with slippery elm bark. A syrup 
made of it is good for coughs ; and a tincture, made by adding an ounce of 
the pulverized to one pint of spirits, may be given for chronic rheumatism, 
from a tea-spoonful to a table-spoonful three times a day. 
Dr. Thomas Cooke, of the Reformed Medical School, Philadelphia, highly 
extols a saturated tincture of the cohosh in hooping-cough ; dose for a child 
a year old a tea-spoonful four or five times during the day, in water. 
Dose.-Tincture, from twenty to thirty drops several times a day. As 
an astringent, give a strong tea or infusion. As a gargle, any quantity 
No. 7. Burdock. {Arctium Lappa.) The Root and Seed. 
History.-This plant flowers in July and August, and is well known by 
the burs or heads, which stick to the clothes ; the seeds ripen in September. 
Locality.-This plant is indigenous to Europe, and naturalized in 
America. It grows abundantly in damp places, and along the sides of 
roads and around old buildings. 
Properties.-It is used as an alterative. The seeds or the root enter 
into the alterative syrup. It is administered, in the form of decoction, in 
salt rheum, herpes, ulcers, and rheumatism, and in all diseases of the skin. 
Thornton recommends the use of this article in dropsy where more active 
articles cannot be used, " having known it to succeed in two dropsical cases 
where other powerful medicines had been ineffectually used." 
The leaves, applied to the feet and forehead, are useful in febrile diseases. 
Employment.-The root or seeds may be given in the form of a decoc- 
tion or infusion, which is made by boiling two ounces of the fresh root in 
three pints of water to two ; which, when intended as a diuretic, should be 
drank in the course of two days. The root enters into a medical beer, 
which is good to purify the blood; also the alterative syrup. 
Common Name.-Burdock. 
No. 8. Asarabacca. (Asarum Canadense.) 
Common Names.-Broadleaf Asarabacca, Wild Ginger, Indian Ginger, Canada 
Snake-root, Heart Snake-root, Colts' foot. 
History.-This is an humble, stemless plant; the flowers are nearly 10. Indian Turnip. (Arum Triphylltim) 
14. Altnonds. (Amygdalus Communis.) 12. Male Fern. (Aspidimn Filix Mas.) 13. Marsh Mallows. (Althaea Officinalis.) 17. Virginia Snake-root. (Arietolochia Serpentaria.) 
15. Spikenard. (Aralia Racemoea.) VEGETABLE MATERIA MEDICA. 
645 
concealed in the ground. There are many varieties of this plant, with large 
and small leaves, rounded, spotted, and unspotted ; the flowers vary also in 
colour, from greenish purple to dark purple. They blossom in May and June. 
Locality.-This plant is indigenous to Europe ; but is found from Canada 
to Carolina, and Missouri, in shady woods and in clay soils ; more abundant 
on hills, in valleys, and moist soils. 
Properties.-Aromatic, stimulant, diaphoretic, and pectoral. It has been 
used with success in intermittent fevers. The pulverized leaves make an 
excellent errhine, and enter into Henry's celebrated cephalic snuff. It is 
excellent for colds, coughs, and pulmonary diseases generally. 
Employment.-The dose of this must be small, as it is apt to excite 
vomiting. It may be given, in the form of syrup or infusion, in all deep- 
seated coughs. 
No. 9. Deadly Nightshade. {Atropa Belladonna.} The whole Plant. 
Common Name.-Deadly Nightshade. 
History.-This is a perennial plant, and flowers from June to August. 
Its fruit is ripe in September, when it is black. 
Locality.-It is found growing in stony and shady places, along old walls 
and fences, and among old ruins. 
Properties.-It produces heaviness of the head, vertigo, dilatation of the 
pupils of the eyes, &c. This plant, notwithstanding its poisonous quality, 
is used with great benefit, externally, in the cure of cancers, and in discuss- 
ing indolent tumours in the breast of females. It enters into the discutient 
ointment. 
Employment.-The leaves and roots, either green or dry, may be sim- 
mered in soft water until the strength is extracted; then the slippery elm 
bark may be stirred in till a poultice is formed. It may be applied to biles, 
and all hard, painful glandular swellings. 
No. 10. Indian Turnip. {Arum Triphyllum.} The Root. 
Common Names.-Three-leaved Arum, Indian Turnip, Dragon-root, Dragon 
Turnip, Pepper Turnip. 
Description.-This plant rises from one to two feet in height; roots 
perennial, round, flattened, tuberous, with many white fibres around the 
base ; skin dark, wrinkled, and loose ; leaves oval, three on each plant, pale 
beneath, with regular parallel nerves. The germs, when ripe, become 
berries of a very bright scarlet colour. 
History.-This plant blossoms with us from May to July, and in the 
summer bears its bright scarlet berries. 
Locality.-It grows all over North America, in woods and low moist 
soils. All soils and regions appear suited to this plant; but rich and shady 
grounds appear to suit it best. 
Qualities.-The whole plant, and the root in particular, is possessed of a 
violent acrid, pungent, and even caustic taste. 
Properties.-Indian turnip, when fresh, makes a powerful, strong, stimu- 
lating, acrid remedy. It makes an excellent poultice in scrofulous swellings ; 
when dried and pulverized, it is a good remedy in coughs, canker, pains in 
the breast; and, given in tea-spoonful doses, it is a valuable remedy in colic. 
It is said to be very efficacious in cases of low typhus fever. u An ointment 646 
VEGETABLE MATERIA MEDICA. 
made of the fresh root and lard is useful," says a writer, " in tinea capitis," 
(scald head.) It enters into the irritating plaster. 
No. 11. Indian Hemp. {Apocynum Cannabinum.) The Root. 
Common Names.-American Ipecacuanha, Indian Hemp, Indian Physic. 
Description.-Stems of this plant, from one to several, about two feet in 
height, branched above, round, and of a reddish colour ; leaves numerous and 
ovate, hanging on footstalks ; flowers terminal, forming a loose panicle, 
whitish, similar to buckwheat, which terminate in seed pods resembling 
cucumbers, containing seeds ; root composed of numerous long, brown, and 
slender branches, radiating from a thick tuber. 
Locality.-This is a perennial plant, indigenous to the United States ; 
grows in meadows and in low, moist woods. 
Properties.-The root has been used with success in dropsy. Add one 
quart of water to one ounce of the root, and boil to one pint. Dose, a table- 
spoonful three or four times a day ; measure the dose as the stomach will 
bear. This preparation cured Aiderman Scott, of this city, of dropsy, and 
several others. It is somewhat laxative, and is used for indigestion, in the 
form of bitters. 
No. 12. Male Fern. (Aspidium Filix Mas.) The Root 
Common Name.-Male Shield Fern. 
Description.-Root horizontal: has a great many appendages placed 
close to each other in a vertical direction, while a number of small fibres 
strike downward ; leaves large, oval, pinnate ; pinnulie close to each other, 
very long, and pinnatifid ; petioles short, of a deep brown colour, and fur- 
nished with scales ; fruit kidney form and rounded. 
Locality.-This plant is perennial, and grows in great abundance in every 
part of Great Britian where the ground is not cultivated. It is found also 
growing on the mountains and among rocks, in New Jersey. 
Properties.-Appears to be highly deleterious to intestinal worms, and 
particularly to the tape-worm. This article constitutes the basis of the cele- 
brated specific of Madam Nomer for the tape-worm. There is much evi- 
dence that it has expelled the tape-worm: it is much given in Europe for 
this purpose. A table-spoonful of the powdered root may be given three or 
four times a day. Three days afterward give a strong purgative, or a tea may 
be freely drank. The oil of the same is highly recommended for the tape- 
worm. 
No. 13. Marsh-mallows. (Althaa Officinalis.) Root,Leaves, and Flowers. 
Common Name.-Marsh-mallow. 
History.-This is a perennial plant, flowering in June and July. 
Locality.-Marsh-mallow is a plant indigenous to Europe, and grows 
plentifully throughout the United States ; growing along the banks of rivers 
and marshy places. 
Properties.-Emollient and demulcent: good in diseases attended with 
irritation and pain, especially of the urinary organs. They relax the 
passages in nephritic complaints, in which last case a decoction is the best 
preparation Two or three ounces of the fresh roots may be boiled in a 18. Barberry. (Berberis Vulgaris) 
20 Wild Indigo. (Baptisia Tinctoria.) 
21. Copaiba. (Copaifera Officinalis.) 23. Cicuta. (Conium Maculatum.) 
22. Capsicum sufficient quantity of water to a quart, to which one ounce of gum Arabic 
may be added. 
VEGETABLE MATERIA MEDICA. 
647 
No. 14. Almond. (Amygdalus Communis.) 
Common Name.-Common Almond. 
History.-This tree flowers early in the spring, before the leaves have 
put forth ; and it nearly resembles the peach tree. 
Locality.-This tree originally came from Syria and Barbary, but is now 
much cultivated in the south of Europe. 
Properties.-The oil of almond is serviceable in tickling coughs, hoarse- 
ness, &c. It acts likewise upon the urinary organs. In the scalding of urine 
and in the diseases of the kidneys, especially when combined with other 
remedies, it is peculiarly serviceable. 
Employment.-It enters into one of our preparations for pulmonary dis- 
eases, denominated " cough drops," and which we find very useful: also into 
one called " diuretic drops," for diseases of the kidneys, urinary organs, &c. 
No. 15.. Spikenard. (Aralia Racemosa.) 
Common Name.-Common Spikenard. 
Description.-This plant rises four or five feet in height; leaves are many, 
small, and ovate, on long footstalks ; main stalk of the size of the thumb, 
jointed, and purplish ; flowers inconspicuous, very small, of a bluish colour, 
producing berries very much resembling those of elder, of a sweet, pleasant, 
aromatic taste. 
History.-It blossoms in July and August; its berries are ripe in Sep- 
tember and October. 
Locality.-Spikenard is found from New England to Carolina and 
Indiana, but is more common in the north than in the south; grows in 
deep woods and good soils. It is generally cultivated in gardens. 
Qualities.-The root of this plant has a balsamic, fragrant, and warm 
aromatic, sweetish taste. 
Properties.-The root of this plant is healing, pectoral, stimulant, cordial, 
and diaphoretic. 
This plant is much used by the Indians. The roots, bruised, chewed, or 
pulverized, were used by them in all kinds of sores and ulcers. In colds and 
coughs the roots and berries may be used in syrups, cordials, and decoctions. 
Henry speaks very highly of the superiority of this medicine in gout of the 
stomach. The manner in which he prescribes this article is, by pouring a 
pint of brandy on a pint of the fresh berries, and let the whole stand by the 
fire for a week ; then pour on a pint of rain water. Dose, a wine glassful 
three times a day. This article enters the " restorative cordial;" also the 
pulmonary balsam. 
Employment.-It may be given in infusion, decoction, or syrup. 
No. 16. Silk or Milk-weed. (Asclepias Syriaca.) The Root 
Common Names.-Common Silk-weed, Milk-weed. 
Description.-This plant has a square stalk, rising three feet high; leaves 
oval, smooth, and milky; flowers yellow, which terminate in pods resem- 
bling cucumbers, filled with a silky down ; seeds somewhat resembling the 648 
VEGETABLE MATERIA MEDICA. 
seeds of parsnip. The root is white, and of the size of the finger, about a 
foot in length. 
Locality.-It grows plentifully throughout the United States, along the 
sides of roads and in sandy grounds. 
Properties.-The root of this plant is a powerful diuretic. Boil eight 
ounces of the root in six quarts of rain water to three; strain it for use. 
For the dropsy take a gill of this decoction four times a day, increasing the 
dose according to the effect. Those who are troubled with a suppression of 
urine may take a tea-cupful of this decoction four times a day, sweetened 
with honey. This plant, it is stated, cured several convicts, in the state 
prison, labouring under dropsy. 
No. 17. Virginia Snake-root. (Aristolochia Serpent aria-') 
Common Names.-Snake-root, Birthwort, Virginia Snake-root, Snake-weed, 
Sangree. 
Locality.-Found in shady woods, from New England to Florida and 
Missouri. 
Qualities.-The root has an agreeable, penetrating, aromatic smell, some- 
what similar to valerian ; and a warm, bitterish, pungent taste. 
Properties.-Tonic and diaphoretic, and, therefore, good to promote per- 
spiration and strengthen the stomach. It enters into the sudorific tincture 
or sweating drops. A tea may be given freely; warm, to sweat; cold, to 
strengthen. 
No. 18. Barberry. (Berberis Vulgaris.) Bush 
Common Name.-Barberry. 
History.-This shrub blossoms in April and May ; the berries ripen in 
June, but they are sometimes abortive. The stamina of the flowers are 
irritable, and bend with elasticity toward the pistil when touched. 
Locality.-It is found from Canada to Virginia, on mountains,hills, among 
rocks, &c. ; common in New England, in rocky fields; rare in the west and 
in rich soils. 
Qualities.-The whole shrub, even the root, is acid. In the berries 
this acid becomes very pleasant, and is probably the tartaric acid, but mixed 
with some astringency. The bark is yellow and bitter. 
Properties.-Antiseptic, acid, subastringent, refrigerant, 8fc. Added to 
good hard cider, it is good in jaundice. The berries contain a very acid and 
red juice, which forms a pleasant and useful drink in fluxes and malignant 
fevers, for abating heat, quenching thirst, raising the strength, and preventing 
putrefaction. Prosper Alpinus says that, being attacked with a putrid fever, 
accompanied with a bilious diarrhoea, he attributes his recovery entirely to 
eating the fruit of the barberry. Simon Pauli gives a similar account of the 
use of the berries. J. Bauhin recommends the same remedy in dysentery. 
Employment.-Made into syrup, infusion, or decoction. We add to it 
hard cider, and give it in jaundice. 
No. 19. Black Snake-root. (Radix Anapodaphyllon Nigrus.) 
Description.-This plant rises three feet in height; leaves similar to the 
leaves of crow-foot, blossoms small and blue. 
History.-This aromatic plant grows in meadows and low woods, among VEGETABLE MATERIA MEDICA. 
649 
rocks ; the root is about the size of a small quill; fibrous ; of a black or pur- 
ple colour, smell strong, and very aromatic. 
Medical Virtues.-It is an excellent sudorific, aromatic, and emmena- 
gogue. 
Employment.-In all fevers, colds, obstructed menses, pleurisy, &c.; 
make a tea, and give freely; at the same time bathe the feet, to produce 
perspiration. 
No. 20. Wild Indigo. (Baptisia Tinctoria.) 
Common Names.-Indigo Broom, Wild Indigo, Indigo-weed, Horseflee-weed, 
Yellow Broom, Clover, Broom, Rattle Bush, Yellow Indigo. 
History.-This plant has the appearance of a small shrub or broom. It 
blossoms in July and August. The whole plant (even the flowers) often 
becomes black in the fall, or in a herbarium. It dies a kind of blue-like in- 
digo, but it is inferior. The young shoots of this plant are eaten in New 
England, like those of poke ; and, like this latter article, they are of a drastic 
nature. 
Locality.-Found all over the United States, from Maine to Louisiana 
and Illinois, in woods and on hills. It prefers dry and poor soils. 
Properties.-Astringent, antiseptic,purgative, emetic,and stimulant. This 
plant, in the form of poultice, is very efficacious in inflammatory affections, 
bordering upon gangrene. The corticle part of the bark is that which we 
use. It is good in syphilitic ulcers ; also for almost every sore, such as 
malignant ulcerous sore mouth and throat, mercurial sore mouth, sore nip- 
ples, chronic sore eyes, &c. It may be used externally, in strong decoction, 
as a wash, fomentation, poultice, or ointment, with lard or cream. It forms 
the basis of our yellow salve, which is very useful in various kinds of ulcers 
Employment.-For a poultice make a strong decoction, and thicken with 
slippery elm bark. 
No. 21. Copaiba. (Copaifera Officinalis.) 
Locality.-This tree is a native of the Spanish West Indies and of some 
parts of South America. It grows to a large size ; and the resinous juice is 
obtained by making incisions in the trunk of the tree. 
Qualities.-The balsam is a liquid of an oily consistence, transparent, 
of a yellowish white colour, of a strong and disagreeable smell, and of an 
acrid and bitter taste. 
Properties.-The balsam has been much used as a cooling diuretic and 
astringent; but the manner in which it has been used renders it less effica- 
cious than it might be. It enters into one of our preparations, the diuretic 
drops ; and we have used it in this manner with particular benefit. 
Common Name.-Officinal Copaiba. 
No. 22. Cayenne Pepper. (Capsicum Annuum.) 
Common Names.-Jamaica Pepper, Red Pepper. 
History.-This plant is a native of South America, and is raised in the 
West Indies. It will likewise ripen its fruit in the United States. 
Properties.-Capsicum is one of the purest and strongest stimulants with 
which we are acquainted ; also carminative, tonic, and diuretic. It is good 650 
VEGETABLE MATERIA MEDICA. 
to remedy flatulency arising from eating vegetable food, and likewise to warm 
the stomach. It is used in rheumatism and coldness of the system. In 
malignant sore throat capsicum is much used, both as a gargle and as an 
internal remedy. Two table-spoonsful of the small red pepper, or three of 
the common Cayenne pepper, and two tea-spoonsful of fine salt, to be beat 
into paste, on which half a pint of boiling water is to be poured, and strained 
off when cold ; an equal quantity of very sharp vinegar being added to this 
infusion. A table-spoonful every hour is a proper dose for an adult. Mr. 
Stephens gave it to four hundred patients labouring under this disease ; " and 
it seemed," says he, " to save some whose state had been thought desperate." 
Employment.-It may be employed in the form of powder, in half tea- 
spoonful doses, given in molasses. Of the tincture give a tea-spoonful in 
plenty of water. Of the tea a table-spoonful occasionally, or according to 
the symptoms. For pains externally, bathe the parts freely with the tinc- 
ture. It is useful in coldness of the system, fever and ague, colic, wind, &c. 
The West India or African capsicum is the best. 
No. 23. Cicuta. {Conium Maculatum.) 
Locality.-This plant is indigenous to Europe, but now naturalized in 
New England, New York, Pennsylvania, Virginia, Ohio, &c. Mostly found 
in old fields, near roads and fences, on the banks of rivers, &c. 
Properties.-This is a powerful acrid narcotic and resolvent. It is not 
dangerous in very small doses, often repeated and gradually increased. It 
is also anodyne, sedative, and anti-spasmodic; useful to allay pain in acute 
diseases. In scrofulous tumours it is a useful article. We, however, seldom 
use it as an internal remedy. It enters into our discutient ointment. 
Employment.-In the form of extract, and made into pills half the size 
of a small pea, given twice a day, is good to discuss scrofulous and cancer- 
ous tumours of the breast, and also applied externally in the form of a poul- 
tice. The plaster is also good for tumours and swellings. For scirrhous 
tumours take inspissated juice of hemlock, or the extract, wax, and rosin, 
of each two parts; olive oil, one part; melt, and spread on leather 
Common Name.-Hemlock. 
No. 24. Colocynth. (Cucumis Colocynthis.') 
Common Name.-Bitter Cucumber. 
Locality.-An annual plant, native of the Levant, and cultivated in 
gardens. 
Properties.-Colocynth is one of the most powerful and active cathar- 
tics. When given alone, it is apt to occasion severe griping. It enters into 
the " anti-dyspeptic pills.r> 
No. 25. Celandine. (Chetidonium Majus.') 
Common Name.-Great Celandine. 
Description.-This plant rises two or three feet in height, has many- 
tender, round, green, watery stalks, with large joints, very brittle and trans- 
parent ; leaves large, serrated, and very tender ; and the flowers, consisting 
of four leaves, yellow; after which come long pods, which, when pressed 
by the fingers, fly into pieces instantly. 25. Celandine. (Chelidoniiun Majlis.) 
27. Ipecacuanha. (Callicocca Ipecacuanha.) 31. Swamp Dogwood. (Cornus Sericea.) 
28. Jalap. (Convolvulus Jalapa.) VEGETABLE MATERIA MEDICA. 
651 
Locality.-This plant grows in meadows, by the sides of running brooks, 
and in low, marshy places; found throughout the United States. 
Properties.-The properties of this plant are acrid, stimulant, anti-her- 
petic, detergent, diuretic, and discutient. The juice, rubbed on warts, removes 
them ; cures ringworms and cleanses old ulcers. We make use of it only 
for the piles, salt rheum, or tetter, in the form of tincture and ointment. 
Employment.-An ointment of the roots is made by boiling them in hogs' 
lard, and is useful in the piles. The tincture may be made by digesting one 
ounce of the plant in one pint of spirits. 
No. 26. Golden Thread. (Coptis Trifolia.} 
Common Names.-Common Gold Thread, Mouth-root. 
History.-This plant flowers early in the spring of the cold regions, or 
in May; they are of a fine golden colour, whence they derive their name. 
They ought to be collected in the summer, and are easily dried, but not easily 
pulverized. 
Locality.-Found from Canada to Greenland and Iceland on the east, 
and to Siberia on the west. The most southern limits are New England, 
New York, and the shores of Lake Erie. It is commonly found in mossy 
swamps and bogs of evergreen woods; but likewise on the rocks of the 
White Mountains, Labradore, and Newfoundland. 
Properties.-Tonic and stomachic, promoting digestion and strengthen- 
ing the viscera ; useful in dyspepsia, debility, and convalescence from fevers. 
It is much used as a gargle in ulceration of the mouth. 
ntmenti 
No. 27. Ipecacuanha. (Callicocca Ipecacuanha.) The Root. 
Common Name.-Ipecacuanha. 
Locality.-Ipecacuanha is indigenous to South America. 
Employment.-In large doses, thirty grains, is an easy and good emetic, 
without causing debility. In small doses, two or three grains, it acts as a 
tonic, strengthening the digestive organs, and is useful in indigestion, bilious 
and liver complaints. It is good also in fevers, by keeping up a determina- 
tion to the surface. It may be given in powder, or formed into pills, with 
soap, molasses, or mucilage of gum Arabic. We give it, in general, combined 
with lobelia. A wine tincture makes a good expectorant, particularly for 
children. Add of the root, bruised, one ounce to one part of Malaga wine : 
dose for a child a year old one or two tea-spoonsful. A syrup made of it 
is also very good. It enters into the emetic and diaphoretic powders ; also 
the sudorific drops. 
No. 28. Jalap. (Convolvulus Jalapa.} The Root. 
Common Name.-American Jalap. 
Locality.-Jalap is a plant indigenous to Mexico and Vera Cruz, and 
brought to us thence. I have had this plant growing in my garden, but 
our climate is rather too cold to cultivate it. 
Properties.-The root of this plant is a brisk cathartic, acting in a re- 
markably efficacious manner, without griping upon the whole alimentary 
canal. It enters into the anti-bilious physic ; also the compound tincture of 652 
VEGETABLE MATERIA MEDICA. 
senna. It possesses great anti-bilious and detergent properties. Twenty- 
five grains of jalap, united with from forty to sixty grains ofcream of tartar, 
form a powerful cathartic and hydragogue, and are more effectual in eva- 
cuating water than any preparation I am acquainted with. 
Employment.-The pulverized root, in the dose of thirty grains, acts as 
a safe and efficacious cathartic. This is one of the most valuable roots pro- 
duced in America. 
No. 29. Peruvian Bark. (Cinchona Officinalis.) 
Common Name.-Peruvian Bark. 
Description.-The tree which produces the bark varies in size. Wood- 
ville describes it as being a very lofty tree, and sending off large branches ; 
its leaves are oblong, three inches in length, and about an inch and a half in 
breadth. 
History.-There are commonly enumerated three varieties of Peruvian 
bark, viz. : 1. The common, the yellow of some authors. 2. The yellow, 
the orange of some authors. 3. The red. 
The use of this bark was first learned from the following circumstance : 
Some cinchona trees being thrown by the winds into a pool of water, lay 
there till the water become so bitter that everybody refused to drink it. 
However, one of the neighbouring inhabitants, being seized with a violent 
paroxysm of fever, and finding no other water to quench his thirst, was forced 
to drink of this, by which he. was perfectly cured. He afterward related 
the circumstance to others, and prevailed upon some of his friends who were 
ill of fevers, to make use of the same remedy, with whom it proved equally 
successful. After this it was taken to Europe by the Jesuits, and hence 
called " Jesuit's bark." The use of Peruvian bark was first discovered, like 
most other remedies, by accident, or rather Providence. 
Locality.-Grows in South America. 
Employment.-The red and yellow kinds are the best, but it is often 
adulterated. It may be used in form of powder or wine tincture, combined 
with stimulants, or the quinine, a production of it. It is not, however, so 
certain in its effects. Properly administered, it is a sure remedy for chills and 
fever. We give it in the form of the wine tincture, which always cures, if 
the bark is genuine. 
No. 30. Dogwood. (Cornus Florida.') The Bark. 
Common Names.-Large-flowered Cornel, Virginia Dogwood. 
History.-This tree is one of the chief ornaments of our forests. It is 
rather below the middle stature, not usually reaching the height of more than 
twenty or thirty feet. It is, however, among the most conspicuous trees in 
our forests. In the months of April, May, or June, according to its lati- 
tude, it is covered with a profusion of its large and elegant flowers. 
Locality.-This tree is found throughout the United States, but more 
plentifully in the middle states. 
Properties.--It is tonic, and may be used as a substitute for the Peru- 
vian bark. Give a strong tea of the flowers or bark. 32. Senna (Cassia Senna.) 
33. Solomon's Seal. (Convallaria Multiflora.) 35. Ladies' Slipper. (Cypripediiim Pubeseens.) 
34. Saffron. (Crocus Sativns.) 36. Camphor Tree. (Laurus Camphors ) 
37. Wild Carrot. (Daucus Carota ) 40. Boneset. (Eupatorium Perfoliatum.) 
39. Stramonium. 
.38, Foxglove. (Digitalis Purpurea.) No. 31. Rose Willow. (Cornus Seneca.) The Bark. 
VEGETABLE MATERIA MEDICA. 
653 
Common Names. Dogwood, Green Osier, Red Rod, Red Wil- 
low, Swamp Dogwood. 
Locality.-It grows near brooks, along the banks of rivers, and on up- 
land meadows; it is known throughout the United States by the name of 
red rose willow, or swamp dogwood. 
Properties.- Tonic and astringent. In vomiting this is an excellent 
remedy, given in form of an infusion, particularly in the vomiting arising from 
pregnancy and diseased uterus. This is a valuable article. 
No. 32. Senna. (Cassia Senna.) The Leaves. 
Common Name.-Alexandria Senna. 
Description.-The stalk rises from two to four feet high, resembling a 
shrub, and sending out hollow woody stems ; flowers yellow ; leaves small 
and running to a point, of a pale green. The East India senna is the kind 
generally used, but is entirely a different article, and not to be compared with 
the Alexandria. I procure the best quality, and have it ground, which 
makes a handsome green powder, which is valuable. It also enters into the 
electuary of senna, and is used in the form of tea, combined with manna. 
Locality.-Grows in the Levant, Egypt, North of Africa, and up the 
Mediterranean. 
Properties.-This is a very useful cathartic, operating effectually and 
mildly. It is necessary to combine this article with other ingredients, to 
prevent its griping effects. It enters the anti-bilious physic, and the worm 
or vermifuge powders. 
No. 33. Solomon's Seal. (Convallaria Multiflora.') The Root. 
Description.-This plant rises six or seven inches high ; leaves lanceo- 
late, and of a dark green colour ; flowers in umbels, and hang on the sides 
of the stalks, producing red berries. 
Locality.-It grows on the sides of meadows, high banks, and mountains, 
in every part of the United States. 
PROPERTiEs.-<-The roots are astringent., incrassant, and corroborant. The 
mucilage of the roots is good when applied to inflammations and piles. |he 
roots are useful in all cases of fluor albtis, (whites,') and in immoderate flow- 
ing of the menses, arising from female weakness. It enters into the resto- 
rative cordial. 
Employment.-Externally, as a poultice ; internally, as above directed. 
Common Name.-Solomon's Seal. 
No. 34. Saffron. {Crocus Satinas.) 
Common Name.-Garden Saffron; 
Locality.-This plant is a native of the Levant, and cultivated in Europe 
and in this country. 
Properties.-In small doses, saffron is employed as a diaphoretic, causing 
perspiration. It enters into the sudorific drops. 
Employment.-In the form of tea, very valuable in all eruptive diseases, 
measles, small-pox, &c. 654 
VEGETABLE MATERIA MEDICA. 
No. 35. Ladies'Slipper. {Cypripedium, Pubescens.') 
Common Names.-Yellow Ladies' Slipper, Moccasin Flower, Yellow Umbel, 
Nerve-root, &c. 
Locality.-It is common on the hills and in the swamps of New York, 
and is found throughout the United States. 
Properties.-Ladies' slipper root is a sedative, nervine, and anti-spasmo- 
dic, and may be used as a substitute for valerian. Dose, a tea-spoonful of 
the powder occasionally in tea, or a table-spoonful of the tincture in water. 
I think that the foreign valerian is better ; as a nervine I seldom or never 
use American. 
No. 36. Camphor. {Laurus Camphoia.} The Gum. 
Common Name.-Camphor Tree. 
Description.-A large tree, native of the forests on the north-western 
coast of Sumatra ; and from the laurus camphora, Lin, a tree growing in 
China and Japan. 
Locality.-Native of the north-west coast of Sumatra, and of China and 
Japan. 
Properties.-Camphor is stimulant, sudorific, and anti-spasmodic. Use- 
ful internally and externally. 
Employment.-Given in the form of powder, emulsion, or tincture. By 
titurating it with a few drops of alcohol, it is easily pulverized. 
The dose of camphor is, from two grains to one scruple; of the tincture, 
from ten to twenty drops, in water. 
Gum camphor is very valuable. It enters into the sweating drops, the 
diaphoretic powders, the rheumatic liniment, black salve, fyc. 
No. 37. Wild Carrot. {Daucus Carota.) The Seeds and Roots. 
Common Name.-Wild Carrot. 
History.-This plant is indigenous, and flowers in July and August; 
seeds ripe in September. 
Locality.-This plant (the wild) grows in many parts of the United 
States, and is found by the sides of old fields and uncultivated grounds. 
Properties.-This plant is diuretic, acting particularly upon the urinary 
organs. Given in strong decoction, it is very useful in gravelly complaints, 
and in the passage of the stone from the kidneys and bladder. 
Employment.-For gravel take a strong tea, warm, through the day. It 
removed an enormous quantity of gravel in one case, and cured the person. 
No. 38. Fox-glove. {Digitalis Purpurea.} The Leaves. 
Common Name.-Fox-glove. 
History.-This plant seldom flowers before July, and the seeds are ripe 
in August. 
Locality.-This plant grows on dry sandy ground for the most part, on 
the high as well as the low places. This is a biennial plant, indigenous to 
Europe, but flourishes well in America. 
Properties.-Sedative and diuretic, diminishing the activity of the pulse 
and the general irritability of the system, and increasing the action of the 4'. Cloves. (Eugenia Caryophyllata.) 
44. Gentian. (Gentiana Lutea.) 47. Liquorice. (Giycyrrhiza Glabra.) 
45. Gnaiacum. (Guaiacum Officinale.) absorbents and the discharge of urine. In hydrothorax or dropsy in the chest 
this medicine is very useful. 
Employment.-Add half a pint of boiling water to a tea-spoonful of the 
leaves. For dropsy give a table-spoonful every two hours. It never fails 
to increase the discharge of urine and afford relief. 
VEGETABLE MATERIA MEDICA. 
655 
No. 39. Thorn Apple. {Datura Stramonium.) The Leaves and Seeds. 
Common Names.-Common Thorn Apple, Jamestown-weed, Jimson, Stink- 
weed, &c. 
History.-This plant blossoms from May to September in the southern 
states, and from July to October in the northern, bearing blossoms when the 
seeds of the first flowers are ripe. It is killed by the frost with us ; but in 
warmer climates it becomes a semi-biennial plant. 
Locality.-This is one of the wandering plants, common to all parts of the 
world, and spreading with the utmost facility. Probably of Persia and India. 
Employment.-Stramonium, green or dry, simmered in water and thick- 
ened with elm bark, makes an excellent poultice for inflammatory and pain- 
ful swellings of the glands, eyes, breasts, groin, &c. The ointment is good 
for piles, burns, &c. Inspissated juice, in doses of two grains, twice a day, 
is good for epilepsy and other fits. 
No. 40. Boneset. {Eupatorium Perfoliatum.) The Leaves and Flowers. 
Common Names.-Boneset, Thoroughwort, Jiepye, Teazel, Feverwort, Sweat- 
ing Plant, Thorough-stem, Crosswort, Indian Sage. Ague-weed, Thorough- 
wax, Vegetable Antimony. 
History.-A very striking plant, easily recognised among all others, even 
when not in bloom, by its connate leaves perforated by the stem. This 
plant blossoms from August to October. 
Locality.-Common in meadows and swamps, near streams. Found 
growing throughout the United States, from Maine to Florida, from Ohio to 
Louisiana. 
Properties.-Emetic, cathartic, sudorific, tonic, SfC. This plant possesses 
very active remedial properties, according to the dose in which it is admi- 
nistered. It has been given in intermittent fever with complete success, either 
in infusion, decoction, or powder. Dr. Anderson states that this article was 
used in nearly every case of intermittents that occurred in the alms-house in 
1812, instead of the Peruvian bark, and it proved uniformly successful. Drs. 
Bard and Hosack speak very highly of this plant as a diaphoretic, in the cure 
of yellow fever; is a very good tonic in dyspepsia and colds. A warm infu- 
sion of this plant, drank previous to taking an emetic, assists its operation, 
and causes the patient to vomit with more ease. For dyspepsia use the tea, 
cold, through the day. 
No. 41. Cloves. {Eugenia Caryophyllata.) 
Common Name.-Cloves. 
History.-This is a beautiful tall tree, a native of the Molucca Islands. 
Cloves are the flower-buds, which are gathered in October and November, 
before they are open, and dried in the sun. 
Properties.-Cloves are among the most stimulating of the aromatics. 656 
VEGETABLE MATERIA MEDICA. 
They are employed principally as adjuvants to other medicines, particularly 
in combination with bitters or with the vegetable cathartics. The essential 
oil is used with the same intention, and as a local application to severe tooth- 
ache. We make use of the pulverized cloves as an aromatic in our " anti- 
bilious physic," and the essential oil enters into our " anti-dyspeptic pill." 
Cloves also enter into some others of our preparations, particularly for some 
forms of bowel complaints. 
No. 42. Asafcetida. Asafoetida.) The Gum. 
Common Names.-Asafcetida. 
Locality.-A perennial plant, indigenous to Persia. It has been raised 
in the botanical garden in Edinburgh. 
Properties.-The gum of this plant is very useful in hysterics and other 
nervous disorders. It is efficacious in spasmodic asthma. 
Dr. Wolcott states that he cured a case of spasmodic asthma of nine 
years' standing, which had resisted the treatment prescribed by other practi- 
tioners, by administering the asafoetida in the form of a pill or bolus, ten 
grains three times a day ; also the following expectorant : Squills in powder, 
thirty grains ; gum ammoniac, one and a half drachms ; extract of hemlock, 
(cicuta,) thirty grains ; made into thirty pills, of which the patient took one 
or two every six hours, until a slight giddiness was felt. He also smoked 
stramonium leaves and tobacco. 
No. 43. Gamboge {Garcinia Gambogia.) The Gum. 
Common Name.-Gamboge. 
Locality.-The tree that furnishes the gamboge is of middling size, and 
grows wild in the kingdom of Siam and in Ceylon, and on the peninsula of 
Cambodia. The gum is obtained by making incisions in the bark of the 
tree, from which the juice exudes and concretes. 
Properties.-Gamboge evacuates powerfully both upward and downward. 
In small doses it acts as a mild laxative. Gamboge enters as one of the arti- 
cles in the anti-dyspeptic pill. 
No. 44. Gentian. (Gentiana Lutea.) The Root. 
Locality.-Gentian is a perennial plant, indigenous to Europe, growing 
upon the Alps, Appenines, Pyrenees, and other mountains in the temperate 
parts of Europe. It blossoms in May. 
Properties.-Gentian is a very useful tonic. In dyspepsia this article has 
obtained much celebrity, and not without foundation. It is given in con- 
junction with other tonics and astringents, which appear to increase its value. 
The extract of gentian enters the anti-dyspeptic pills, and is one ingredient 
in the restorative bitters. 
No. 45. Guaiacum. {Guaiacum Officinale.) The Gum and Raspings. 
Common Warne.-Guaiacum. 
Locality.-This tree is a native of the West Indies. 
Properties.-Both the wood and resin of guaiacum possess diaphoretic 
and alterative properties. It is employed in gout, chronic rheumatism, and VEGETABLE MATERIA MEDICA. 
657 
affections of the skin in old and very obstinate venereal ulcers, scrofulous affec- 
tions, &c.; in rheumatism, particularly that arising from the use of mercury; 
in gout, &c. Dr. Chapman, of Philadelphia, in his Therapeutics, speaks 
very favourably of this article in diseases of the eyes. The raspings of 
guaiacum enter into the alterative syrup. It is well calculated to remove 
the mercurial disease. 
No. 46. Crane's bill. [Geranium Maculatum.) The Root. 
Common Names.-Spotted Crane's bill, Crowfoot, Alum-root, Tormentil, 
Storkbill. 
History.-This is a very pretty plant, blossoming in the spring, from 
May to July. The best time for collecting this plant is in the fall. 
Employment.-It is a good astringent; useful in bleeding, internally or 
externally ; also from the lungs, womb, &c. A decoction of beth-root and 
crane's bill is excellent for flooding, whites, &c. A tea of crane's bill, sweet- 
ened with honey, is said to be a superior remedy for hooping-cough. 
No. 47. Liquorice., (Glycyrrhiza Glabra.) The Root. 
Common Name.-Sweet Liquorice. 
Locality.-Liquorice is a perennial plant, and indigenous to the south ot 
Europe. It is likewise cultivated in England for medical use. 
Properties.-The root of this plant is at present used principally to alle- 
viate coughs and inflammation of the lungs. 
Employment.-Dr. Sawyer, of Cleveland, Ohio, a graduate of our school, 
states that the following preparation cured him of a very deep-seated cough, 
bordering on -consumption: Take liquorice-root, lungwort, Iceland moss, 
equal parts. Make a strong decoction, sweeten with rock candy, and take 
as much as the stomach will bear. 
No. 48. Hellebore. [Helleborus Niger.) The Root. 
Common Name.-Black Hellebore. 
History.-About Christmas, if the weather be temperate, this plant 
flowers. The flowers appear upon footstalks; flowers consisting of five 
large round white petals, each of which are purple, sometimes on the edges. 
Locality.-This is a perennial plant, growing in the mountains ofVasges, 
Dauphine, and Provence. 
Employment.-Dose of the powdered root from ten grains to a scruple ; 
of the infusion, two drachms to one pound of boiling water, one ounce of 
which is given every four hours. 
For obstructed menses take equal parts of the tincture of hellebore and 
tincture of logwood, of which let one or two tea-spoonsful be taken three 
or four times a day. 
No. 49. Golden Seal. [Hydrastis Canadensis.) The Root 
Common Names.-Yellow Pucoon, Yellow-root, Ground Raspberry, Yellow 
Paint, Golden Seal, Orange-root, Indian Plant, &c. 
Locality.-From Canada and Maine to Carolina and Tennessee, in rich 
shady woods, on the banks of rivers, sides of hills, and deep valleys. 658 
VEGETABLE MATERIA MEDICA. 
Properties.-It is tonic, and at the same time laxative, which makes it 
very appropriate in dyspeptic disorders. 
Employment.-It enters into the " wine bitters " and " tonic tincture." 
No. 50. Hops. (Humulus Lupulus.) The Fruit. 
Common Name.-Garden Hops. 
Employment.-The saturated tincture of hops relieves pain, in tea-spoon- 
ful doses. It is very good for " after-pains," and in cases where opium 
cannot be taken. Boiled in vinegar and water, makes an excellent fomenta- 
tion to relieve pain of the bowels, head, and other parts. The extract or 
pollen of hops may be given as an anodyne. 
No. 51. Witch Hazel. (Hamamelis Virginica.} The Bark. 
Common Names.-Winter Witch Hazel, Witch Hazel, Snapping Hazelnut, 
Winter-bloom, Pistachce-nut, &c. 
History.-This shrub blossoms in winter, when no other tree is in bloom 
The blossoms remain from October till February. The fruit remains on 
throughout the whole year till the next fall, and then explodes with a noise, 
scattering the seeds around. 
Locality.-Found from New England to Carolina and Ohio, commonly on 
hills and mountains, near stony banks of streams ; rare in plains, &c. 
Employment.-This article may be applied externally as a poultice in 
ulcers, &c. ; and in the form of a strong decoction as an injection into the 
vagina for prolapsus or falling down of the womb ; and as a wash for falling 
of the intestine. 
No. 52. Liverwort. (Hepatica Triloba.} The Plant and Root. 
Common Names.-Common Liverwort, Liver-weed, Trefoil, Noble Liverwort. 
History.-This is a vernal plant: the leaves stand the winter, and early 
in the spring the flowers come out, sometimes while the snow is yet falling. 
They last from March till May. 
Locality.-This plant is a native of the northern parts of Europe, Asia, 
and America ; growing on this last continent from Labradore to Virginia and 
the Pacific Ocean; found in woods, on hills, and mountains throughout the 
United States. 
Properties.-Subtonic, sub astringent, deobstruent, pectoral, and demulcent. 
It may be used in fevers, liver complaints, indigestion, hypochondria, &c. 
It is useful for hemoptysis (bleeding at the lungs) and coughs. 
Employment.-It may be given in the form of infusion, either warm or 
cold. It enters into the vegetable syrup. 
No. 53. Butternut. (Jug Ians Cinerea.) The Bark and unripe Fruit. 
Common Names.-White Walnut and Butternut. 
Locality.-These trees are very common in the United States. Found 
growing in valleys and on mountains. 
Properties.-During the American revolution, when medicines were 
scarce, this article was brought into use by the physicians of the hospitals, 
and was esteemed by them an excellent substitute for the ordinary cathartics 48. Black Hellebore. (Helleborns Niger.) 
49. Golden Seal. (Hydrastis Canadensis.) 51. Witch Hazel. (Hamatnelis Virginica.) 
50. Hops. (Humulus Lupulus.) VEGETABLE MATERIA MEDICA. 
659 
The extract made from the inner bark of these trees is alone employed 
When given alone, in doses of from fifteen to thirty grains, it operates as an 
active cathartic, without " occasioning heat and irritation." It is thought to 
be very applicable in indigestion, and as an aperient in habitual costiveness, 
as it does not leave the bowels in a costive state, as many other cathartics do. 
The extract should be made from the bark in the months of May or June. 
Employment.-It is given in the form of an extract, made into pills ; dose, 
four or five size of a pea. 
No. 54. Juniper. {Juniperus Communis.) The Fruit. 
Common Name.-Common Juniper 
History.-The berries of this shrub, the only part used, are ripe in 
August. It flowers in June. 
Locality.-This shrub is indigenous to Europe, but naturalized in this 
country, and grows in abundance in the state of New York, on the banks 
of rivers, &c. 
Properties.-The berries and essential oil are possessed of a powerful 
diuretic quality, exercising a very decided stimulating action on the general 
economy, but more especially upon the kidneys, increasing the secretion of 
those organs. They are principally exhibited in dropsy. The oil is carmi- 
native, and may be given in flatulencies, gravel, &c. 
Employment.-The berries maybe given in the form of infusion, and the 
oil may likewise be given. From three to five drops are a dose. 
No. 55. Elecampane. {Inula Helenium.) The Root 
Common Name.-Elecampane. 
Locality.-This is a perennial plant, indigenous to Europe, but is very 
common in this country, growing in low meadows, by the road-side, and in 
stony pastures. It flowers in July or August. 
Properties.-This plant is possessed of pretty energetic tonic properties. 
It is an excellent article, in combination with others, in colds and coughs, 
pulmonary irritation, and consumption. It enters into the pulmonary balsam. 
No. 56. Cedar. (Juniperus Virginiana.) The Leaves and Berries. 
Common Name.-Red Cedar. 
Locality.-This tree is indigenous to America, growing in great abun- 
dance in the southern states, but found all over the United States. 
Qualities. The leaves of this tree have a strong, unpleasant smell, and 
acrid, hot, bitterish taste. Distilled with water, they give out an essential oil. 
Properties.-The oil which is procured from the cedar by distillation, is 
very useful in inflammatory rheumatism. 
No. 57. Skunk Cabbage. (Ictodes Foetida.) The Balls and Roots. 
Common Name.-Swamp Cabbage. 
History.-Its flowers are among the first that appear in the spring, after 
the rigours of winter have passed, appearing from February to April, accord- 
ing to its latitude. 660 
VEGETABLE MATERIA MEDICA. 
Locality.-This is a perennial native plant, growing in boggy woods and 
swamps, and other moist places, throughout the United States. 
Properties.-The root of this plant is possessed of anti-spasmodic pro- 
perties, similar to asafcetida and other fetid gums. It is very useful in spas- 
modic asthma. 
Employment.-It constitutes one of the ingredients of our vegetable syrup, 
used for bleeding at the lungs, coughs, asthma, &c. Henry, in his Herbal, 
states, that this root is good for obstructed menses, for worms, asthma, and 
rheumatism. Gather the balls in September, cut and dry them, then pul- 
verize and sift them ; dose of the powder from half to a tea-spoonful night 
and morning in molasses, for three mornings in succession, before the full 
and change of the moon. On the fourth morning give a purge. For the 
asthma, and to promote the menses, make a syrup, and give as much as the 
stomach will bear. 
No. 58. Bugle. (Lycopus Virginicus.) The Plant. 
Common Names.-Sweet Bugle, Bugle-weed, Water Bugle, Buglewort, 
Water Hoarhound, &c. 
History.-This plant blossoms in the summer, in July and August; seeds 
ripen in September. 
Locality.-This plant grows near water, ditches, creeks, swamps, &c. 
Properties.-" Sedative, subtonic, subastringent." It is very useful in 
coughs and bleeding of the lungs. It enters into the vegetable syrup 
Employment.-It may be given in infusion or decoction, cold. 
No. 59. Poplar. (Liriodendron Tulipifera.) Bark of Trunk and Roots. 
Common Names.-White Poplar, White Wood, Wild Poplar, &c. 
History.-This tree flowers about the middle of May. 
Locality.-This is a tree indigenous to America, and is found growing 
throughout the United States, on mountains and in low forests. 
Properties.-The bark of the tree and root is possessed of valuable tonic 
properties, and by some is considered equal to Peruvian bark. Dr. J. T. 
Young, in a letter to Gov. Clayton, of Delaware, says : " I have prescribed 
the poplar bark in a variety of cases of intermittent fever, and can declare, from 
experience, that it is equally efficacious with the Peruvian bark, if properly 
administered." The same gentleman says he has used it in hysteria with 
the greatest benefit. " There is not," says he, " in all the materia medica, 
a more certain, speedy, and effectual remedy in hysteria than the poplar 
bark, combined with a small quantity of laudanum." In dyspeptic states 
of the stomach and bowels this is a valuable remedy, owing to its ionic and 
stimulant powers. 
Employment.-The dose of this bark is from half to two drachms, in pow- 
der ; the infusion from half to one ounce, in a pint of boiling water. It 
enters into the wine bitters. 
No. 60. Dandelion. (Leontodon Taraxacum.) The Leaves and Roots. 
Common Name.-Common Dandelion. 
History.--This is a well-known plant, common to Europe, Asia, and 
America. It blossoms from April to October. 52. Liverwort. (Hepatica Triloba.) 
54. Common Juniper. (Junipene Communis.) 
55. Elecampane. (Inula Helenium.) 58. Water Hoarhound. (Lycopus VirginicusJ 
57. Skunk Caonage. (Ictodes Fcetida.) 59. White Wood. (Liriodendron Tulipifera.) 
GO. Dandelion. (Leontodon Taraxacum.) 63. Sassafras (Murns Sassafras.) 
61. Lobelia. (Lobelia Inflate.) VEGETABLE MATERIA MEDICA. 
661 
Locality.-It is found in pastures, fields, and along road-sides. 
Properties.-" Deobstruent, diuretic, herpetic, subtonic, aperient." It 
is much used in liver complaints, dropsy, jaundice, hypochondria, and ob- 
structions. 
Employment.-I consider this plant one of the most valuable in the 
materia medica. It exerts a sure and efficacious effect upon the liver, re- 
moving obstructions. It enters into the hepatic pills. It is also excellent 
for the gravel and kidney complaints, and may be taken in the form of tea 
freely. The inspissated juice of the plant is the best form to give it. 
No. 61. Lobelia. (Lobelia Inflata.) The Seeds, Leaves, and Capsules 
Common Names.-Common Lobelia, Indian Tobacco, Emetic-weed, Wild 
Tobacco, Puke-weed, Asthma-weed, &c. 
Description.-A biennial plant, one or two feet high, pale blue flower, 
capsule contains numerous small seeds. The taste of the leaves is nauseous, 
and excites vomiting, something like common tobacco. It was discovered 
by Lobel, a noted botanist, and named after him. Used by the Indians of 
this country as an emetic. Samuel Thomson and his followers employ it for 
almost every disease as a puke ; but this indiscriminate use of it is wrong. 
Like other plants, it is good, judiciously used. 
History.-This plant blossoms from June to November. The flowers 
are very small, but singular; when broken, a milky, acrid juice is emitted. 
It is beinnial, throwing out the first year only a few radical roundish leaves. 
Localitf.-This plant is indigenous to America, and found growing all 
over the United States, in fields, woods, &c. 
Properties.-In tea-spoonful doses, repeated every twenty minutes, it 
pukes freely, but is very prostrating to the system, and, when given alone, 
sometimes causes alarming appearances, although the patient soon recovers 
from its effects. It is best combined with those articles which modify its 
action, in which manner I administer it. I combine it with ipecac and blood- 
root, equal parts, which make an excellent emetic in all cases where its use 
is required. Very useful in asthma, &c. It enters into the emetic powders. 
No. 62. Sassafras. (Laurus Sassafras.) Roots, Twigs, and Bark. 
Common Name.-Common Sassafras. 
Locality.-This tree is a native of North America, and found growing 
plentifully throughout the United States, in forests and along the borders of 
swamps. 
Properties.-This article is stimulating and alterative, and very good 
in rheumatic complaints and eruptive diseases. The bark of the young 
branches and the pith contain a considerable quantity of mucilage. If the 
pith be infused in rose water, a considerable quantity of mucilage is extracted, 
which renders this infusion very useful in acute inflammation of the eyes, in 
catarrhs, and dysentery. Dr. Eberle says, " I have known the long-continued 
use of an infusion of this article effectually cure a case of inveterate rheuma- 
tism." It enters into the alterative syrup. The pith of sassafras, put into 
rose water, makes the laurus eye-water, which is very valuable for ophthal- 
mia or inflammation of the eyes. 662 
VEGETABLE MATERIA MEDICA. 
No. 63. Lavender. (Lavendula Spica.) The Leaves and Stems. 
Common Name.-Broad-leaved Lavender. 
Locality.-A perennial plant, native of the south of France, and culti- 
vated in our gardens; flowering from May to September. 
Properties.-Although lavender possesses very energetic stimulant pro- 
perties, it is, nevertheless, very little used now, except as a perfume. It 
is, however, administered with advantage in flatulence, fainting, and nervous 
affections. It is carminative, pectoral, nervine, and anti-spasmodic. 
Employment.-It constitutes the principal ingredient in the compound 
spirits of lavender. The oil is generally used for this purpose, but it makes 
the composition too heating. We use the flowers. 
No. 64. Bayberry. (Myrica Cerifera.) The Bark of the Root. 
Common Name.-Wax Myrtle. 
Locality.-A native shrub of the United States, found particularly in the 
states of Connecticut, New Jersey, Pennsylvania, Delaware, Virginia, the 
Carolinas, and Louisiana. 
Properties.-This article is narcotic, astringent, emetic, fyc. The bark 
of the root is found to be a sovereign remedy in scrofula in a state of ulcer, 
applied in the form of poultice, by bruising the bark and simmering it in rain 
water ; then applying the poultice to the ulcers, and injecting a strong decoc- 
tion into the sinuses. It is likewise very good in jaundice, especially that 
called black jaundice. 
I consider this shrub to be one of the most valuable productions of this 
or any other country. We use it principally in the form of poultice, as a 
remedy in the scrofula or king's evil; and also, combined with blood-root, 
as a snuff, for the polypus. 
Employment.-It may be given in powder, infusion, or decoction. The 
poultice for scrofulous ulcers is made by simmering the bark of the root, 
bruised or pulverized, in rain or spring water, until soft; and then stirring 
in Indian meal, or, which is better, slippery elm bark, until a poultice of a 
proper consistence is formed. Bayberry tallow or wax is the basis of one 
of our plasters for scrofulous ulcers. 
No. 65. Colombo. (Menispermum Palmatum.) The Root. 
Common Name.-Colombo. 
Localitv.-This is a native growth of Africa, Madagascar, and the East 
Indies. 
Properties.-It acts as a Zonic, giving strength to the stomach and intes- 
tinal canal, without stimulating. In dyspeptic complaints it exerts its 
greatest benefits, and is one of the best tonics that we can employ in those 
cases. Dr. Eberle administered this article, in union with ipecacuanha, with 
" marked advantage " in dyspepsia. He gives ten or twelve grains of Colom- 
bo with two of ipecacuanha. Colombo enters into the restorative cordial- 
No. 66. Hoarhound. (Marrubium Vulgare.) The Leaves and,. Stems 
Common Name.-Common Hoarhound. 
Description.-This plant is perennial, arising about a foot in height, 64. Bayberry. (Myrica Cerifera.) 
66. Hoarhound (Marrubium Vulgar*!..: 69. Spearmint. (Mentha Viridis.) 
68. Catnip. (Nepeta Cataria.) 
67. Peppermint. (Mentha Piperita.) VEGETABLE MATERIA MEDICA. 
663 
leaves deeply serrated, veined, wrinkled, and hoary, in pairs, standing upon 
long, thick foot and broad footstalks; flowers white; calyx cut into ten 
segments. 
Locality.-This is a native plant of Europe, but flourishes well with us, 
and is found growing along fences and road-sides. 
Properties.-It is pectoral and tonic, and is a very excellent remedy in 
colds, coughs, and all pulmonary affections. It is very good in consumption 
and pneumonia. It enters into the pulmonary balsam, which constitutes an 
exceedingly valuable preparation in all pulmonary diseases. 
Employment.-It is most generally given in the form of syrup and infu- 
sion or tea. It is used also in the form of syrup, for colds and coughs. 
No. 67. Peppermint. (Mentha Pipent a.) The Leaves and Stems. 
Common Name.-Peppermint. 
Locality.-This plant is indigenous to Europe, but is cultivated in our 
gardens for medical use. 
Properties.-This plant possesses decided stimulant, sudorific, anti-spas- 
modic, pungent, and anti-emetic properties. It may be administered with 
advantage in nervous affections of the stomach ; such as flatulence, colics, 
dyspepsia, spasmodic vomiting, <SfC. It is also very useful as an adjunct to 
other medicines, particularly cathartics, to facilitate their action, and to con- 
ceal their odour or unpleasant taste. It enters into the neutralizing and 
anti-bilious physic. It is excellent to allay vomiting, and very useful in 
bowel complaints, cholera morbus, &c. 
Employment.-It may be given in powder, infusion, or the essential oil. 
Essence, one tea-spoonful may be given at a dose. Infusion, a handful to a 
quart of boiling water; and should be taken freely. 
No. 68. Catnip. (Nepeta Calaria.) The Leaves and Flowers. 
Common Names.-.Common Catnip, Catnip, Catmint, &c. 
Locality.-This is a perennial plant, indigenous to this country, and is 
found growing throughout the United States, along the sides of roads and 
old buildings. 
Properties.-It is diaphoretic, carminative, diluent, refrigerant. It is use- 
ful in all kinds of fevers, producing perspiration without increasing the heat 
of the body. Although this plant is very simple, and is by some despised, 
yet it is a very valuable article. In colds, a tea made of it is much used in 
domestic practice, and not without effect, as it most generally induces a pro- 
fuse perspiration, which throws off the cold, and restores the patient to his 
ordinary health. Very efficacious in all kinds of fevers. 
Employment.-It is given in infusion, by infusing a small quantity in a 
quart of boiling water. Externally, as a poultice in painful swellings. Ex- 
cellent also in fomentations. 
No. 69. Spearmint. (Mentha Viridis.) The Leaves, Branches, $c. 
Common Name.-Spearmint. 
Description.-This plant rises two or three feet in height; stem qua- 
drangular, straight, with small branches, leaves opposite, on short peduncles, 
oval, serrated; flowers on a short terminal spike. 664 
VEGETABLE MATERIA MEDICA. 
Locality.-It is a perennial plant, found growing along brooks and rivulets. 
Properties.-Febrifuge, diuretic, anti-spasmodic, and anti-emetic. This 
plant is excellent to allay nausea and sickness at the stomach. It is also an 
excellent remedy in gravel, suppression of urine, &c. The oil is valuable in 
pains and rheumatic affections. 
Employment.-Infusion, made by bruising a handful in a quart of boiling 
water. It constitutes the principal article in the spirits of mint, which is 
made by bruising the green plant, and adding sufficient fourth-proof Holland 
gin to make a saturated tincture, which makes a preparation remarkablv 
efficacious in suppression of urine, gravelly affections, &c. I discovered this 
many years ago, more by accident than design. The dose of this prepara- 
tion is a wine glassful, drank as often as the stomach will bear. Cotton, wet 
with the above liquid or tincture, and applied to the piles, affords immediate 
relief. It makes the spirits of mint. 
No. 70. Olive. {Olea Europea.) The Oil. 
Common Name.-Olive Tree 
Description.-This is an evergreen, with oblong, narrow, willow-like 
leaves, and monopetalus, whitish flowers, cut into four sections or segments, 
followed by a cluster of oval black fruit, containing, under a fleshy pulp, a 
hard, rough stone. 
Locality.-This tree is a native of the south of Europe and north of 
Africa. It is cultivated in France, Spain, and Italy for the sake of its fruit 
and oil. 
Employment.-Emollient, purgative, antiseptic, vulnery, refrigerant, 6fc. 
This oil, taken internally, operates as a gentle laxative, and is useful in in- 
flammation of the bowels and stomach ; also in dysentery. It is often used 
to mitigate the action of acrid substances taken in the stomach. It is used 
externally, in clysters; but its principal employment is in the composition 
of ointments and plasters. It has been thought to be a specific for the bite 
of poisonous serpents. 
In the Philosophical Transactions (vol. xxxiv., p. 310) are related the 
experiments of one William Oliver, who suffered his arm to be bitten by a 
viper, and waited until the most violent symptoms ensued, which were soon 
removed by applying the warm oil of olives to the affected parts. 
The dose of the oil, as a cathartic, is one ounce. Externally, it is rub- 
bed on the parts, or formed into plasters or ointments. 
No. 71. Alder. (Prinos Verticillatus.) The Bark and Leaves. 
Common Name.-Black Alder. 
Properties.-Alterative, anti-herpetic, <SfC. A tea or decoction of the 
bark, sweetened, has been highly extolled for the removal of worms in the 
stomach of children. The bark or the root of black alder is found excel- 
lent to purify the blood ; to be combined with other articles, and made into 
beer or diet drink. 
Matthew Noyes, a clergyman in Northford, Connecticut, it is said, was 
cured of an affection of the lungs, which had rendered him unable to preach. 
He took a wine glassful of the above preparation three or four times a day. VEGETABLE MATERIA MEDICA. 
665 
No. 72. Anise seed. (Pimpinella Anisum.) The Seed. 
Common Name.-Garden Anise seed. 
Locality.-An annual plant, native of the Levant; cultivated both in 
Europe and America. 
Properties.-The properties of this plant are somewhat similar to those 
of fennel. The seeds are carminative and pectoral. They are useful in dys- 
pepsia, and flatulent affections incident to children. The oil of anise seed 
enters into the cough drops. 
Employment.-The seeds may be given, but the oil dropped on sugar is 
preferable. For flatulence an infusion of the seeds may be given. 
No. 73. Canada Balsam. (Pinus Balsamea.) The Resinous Juice. 
Common Name.-Canada Fir Balsam. 
Locality.-This tree is found growing plentifully in Canada and in some 
parts of the United States. 
Properties.-When given internally, this balsam is stimulating, gently 
laxative ; applied internally, it is emollient and cooling. It is efficacious 
when applied to sore nipples, and is esteemed very much by some in cuts, 
wounds, &c. Dr. Budd prescribes this in leucorrhoea or fluor albus. It 
enters into the cough drops. Equal or superior to copaiva. 
No. 74. Dragon's Claw. (Pterospora Andromeda.) The Root. 
Common Names.-Dragon's Claw, Fever-root, &c. • 
Description.-This plant rises six or seven inches in height; the leaves 
grow in a cluster from the top of the root; blossoms yellow ; small black 
root, about the size of cloves, very tender, resembling the claws of a hen. 
Locality.-It is found in the Genesee country and in the mountains 
around Albany. 
Properties.-This plant is useful in different kinds of fevers, particularly 
typhus. It keeps up a moisture of the skin, and produces no excitement. 
Employment.-To a tea-spoonful of the root add about half a pint of 
boiling water. It may be drank freely. 
No. 75. White and Yellow or Pitch Pine. (Pinus, Strobus, and 
Palustus.) 
Common Names.-White Pine ; also, Pitch and Yellow or Southern Pine. 
Locality.-Found principally in the northern and southern states. 
Properties.-Both the white and the yellow pitch or southern pine are 
stimulant., laxative) diuretic, pectoral) vermifuge) discutient) anli-herpetiC) 
detergent) balsamic) vulnerary) &;c. This, together with the white pine, is 
one of the most valuable productions to be found. The bark and gum are 
very useful in rheumatism anil consumption. They likewise act as emmena- 
gogue, increasing the flow of the menses. They are also beneficial in diseases 
of the kidneys. Externally, they are much used in the form of plasters, for 
ulcers, &c. In short, they appear to act upon all the secretions and excretions 
of the body. 
Employment.-Internally, infusion of the pitch, white, and other pines, 666 
VEGETABLE MATERIA MEDICA. 
drank, or pills made of the gum; externally, plasters, spread on cloth or 
leather, for lumbago, rheumatism, and local pains. The gum itself, spread 
on leather, makes an excellent strengthening plaster. Digested in wine, it 
is a valuable remedy in rheumatic affections and obstructed menses. The 
oil of tar is excellent in pain in the breast. Ten drops, three or four times 
a day, are a dose; to be given in milk. Tar enters into the irritating 
plaster. 
No. 76. Wild Cherry. (Prunus Virginiana.) The Bark. 
Common Name.-Wild Cherry tree. 
Locality.-This tree is indigenous to the United States, in many parts 
of which it is found in abundance. Found growing in our forests. 
Properties.-It enters into the wine fitters, given in intermittent fever. 
It is excellent in many forms of dysentery, and, combined with other articles, 
makes a good beer for the blood. 
Employment.-In the form of infusion ; as a tonic, should be given cold, 
and is excellent in involuntary discharges of urine. 
No. 77. Hemlock. {Pinus Canadensis.) The Bark, Leaves, and Oil. 
Common Name.-Common Hemlock. 
Description.-This is a large tree, growing throughout the northern 
states, and is so well known as to need no description. The bark is used 
for tanning leather. 
Properties.-A decoction of the bark makes an excellent astringent wash 
for falling of the bowel and womb. A tea or infusion made of the leaves 
is excellent to produce perspiration in rheumatism. Externally, the oil is 
very valuable in painful rheumatic affections ; internally, is very good in 
pain of the breast; also for quinsy, bathed on the throat. The gum makes 
an excellent plaster for lumbago, sciatica, and rheumatism. A valuable 
plaster is made of the gum, by melting, straining, and adding to it one-fourth 
gum turpentine, melted ; it is beneficial wherever a plaster is required. 
No. 78. Mandrake. {Podophyllum Peltatum.) The Root. 
Common Names.-May Apple, Indian Apple, Mandrake, &c. 
Description.-The mandrake grows about two feet high, with two or 
three large leaves, broad at the base, terminating in a sharp point The 
stem is smooth, round, and divided at the top into two leaf stalks, each of 
which supports a leaf at its extremity. It bears one white flower, which 
appears in May, and is succeeded by fruit of a yellow colour, like a lime, of 
an acid, delicious taste. It has a jointed, creeping root, about the size of a 
pipe-stem w'hen dry. Brown externally, white when broken, and, when 
pulverized, makes a beautiful powder. 
Locality.-Grows in woods and meadows, and in patches, throughout 
the United States. 
Properties.-Purgative, deobstruent, anti-bilious, anthelmintic, hydro- 
gogue, anti-dyspeptic. A complete substitute for mercury. The properties 
of this article are that of a sure and active cathartic, equal, if not superior, 
in some diseases, to that of jalap. 
We have found this root very valuable in many inveterate chronic dis- 70. Olive 'free. (Olea Europe*.) 
71. Black Alder. (Prinou Verticillutus.) VdVxt\\u\A 
T>. VEGETABLE MATERIA MEDICA. 
667 
eases, such as venereal, scrofulous, bilious, dyspeptic, or chronic affections 
of the liver, dropsy, &c. The following is an excellent form to administer it: 
Compound Powder of Mandrake.-Pulverized mandrake root, pulverized 
spearmint, cream of tartar, equal parts ; mix : dose, a tea-spoonful in mo- 
lasses or tea. 
The mandrake is often considerably nauseating, and sometimes vomits, 
and, upon the whole, is not so pleasant as some other purgatives ; but it has 
a peculiar effect upon all the secretions and excretions, stimulating them to 
a healthy action, and often answers the purpose both of an emetic and ca- 
thartic. It is excellent in chronic affections of the liver, indigestion, &c. I 
have invariably given this preparation with success in a variety of complaints. 
" The root of this plant," says Miles, " is peculiarly calculated for a 
cathartic, extending its influence through every part of the system ; touch- 
ing every gland, when given in small doses, and repeated every two or three 
hours. It is particularly serviceable in all dropsical cases and intermittents, 
or any other disease where a general action is wanting. It is often success- 
fully employed as a vermifuge, in tea-spoonful doses, and repeated." " I 
will remark," says he, " in regard to this medicine, also, that small doses 
excite a general action, and stimulate the glands to a discharge of their res- 
pective offices ; while large doses evacuate and exhaust the system." 
Employment.-Internally, the pulverized root maybe given in the dose of a 
small tea-spoonful, or from twenty to thirty grains, combined with aromatics. 
Mandrake Pills, fyc.-Dr. Waterman, of Providence, R. I., states that he 
cured a person considered hopeless, after the common physicians had put 
him through a course of their medicine, by giving four pills made of extract 
of mandrake and capsicum, three grains each. It evacuated three quarts of 
clear water by the bowels. " I find it," says he, " to work admirably in 
stubborn cases of dropsy, obstructed menses, and diseases of the liver and 
kidneys. It seems to act upon all the secretions, and increase the strength 
of the system." In the above case he says this preparation, the extract 
and capsicum, equal parts, operated with astonishing effects. 
Almost every botanical writer extols mandrake. Judge Murphy, of 
Brooklyn, who was formerly a strong Thomsonian, states that if he were to 
give up either of the two plants, it would be lobelia. He administers man- 
drake in half tea-spoonful doses every two hours. It prevents the sickness 
arising from a full portion for most complaints. 
Dr. S. Annibil, it is said, calls mandrake " king of roots." I have used 
it in the form of powder, tincture, and extract. 
Says Dr. Thomas Cooke, " My own experience goes to confirm the valua- 
ble properties of this article ; I have been in the habit of using it in my 
practice extensively for the last ten years in the various forms of disease, 
and can say that I know of no single article in the whole materia medica 
that acts so generally on the secretions and excretions, removing obstructions, 
and exerting a healthy action throughout the system, without any bad effects 
whatever. I am confident that if the faculty would for once divest them- 
selves of their blind prejudices in favour of the mineral, and consent, at least, 
to make a trial of this vegetable substitute, it would be a happy event for 
mankind. I consider it a complete substitute for mercury in all the dis- 
eases in which, in the common practice, it is supposed that mineral is indi- 
cated. I consider it far preferable, because, after having its operation and 
effect, it passes off and leaves the system free ; whereas mercury fastens 
upon the bones and solids, and remains like a corroding and eating canker, 
rendering vast numbers feeble and debilitated for life. Their humanity 668 
VEGETABLE MATERIA MEDICA. 
should be a sufficient inducement for this. The plea, that the vegetable king- 
dom contains no equivalent to mercury, is no longer tenable ; then why 
should not physicians discard the use of it at once, when it is universally 
acknowledged, and felt, that in the aggregate it has proved a curse, a de- 
stroyer to the human race ? The disuse of it, it is true, would lessen the 
employment of the medical profession; but the satisfaction they must feel 
at the proportionate decrease of suffering among their fellow-beings would 
no doubt, richly compensate them for the pecuniary sacrifice." 
No. 79- Poppy. (Pap aver Somniferum.) Capsules, Flowers, and Gum. 
Locality.-This plant is indigenous to Asia, and is cultivated now both 
in Europe and America. 
Properties.-The action of opium appears to be directly or indirectly 
upon the nervous system. When administered in small doses, it diminishes 
sensibility, and causes a tranquillity in the system, which is followed by sleep. 
It should be seldom used, except as an anodyne; but when combined with 
other ingredients, with a view to act upon the secretions, it may be given in 
very many diseases with signal benefit. 
Employment.-Opium may be given in doses from one to three grains. 
Laudanum, from thirty to one hundred drops. A medium dose for an adult 
is forty or fifty drops. A syrup made of the capsules is excellent for children, 
as the water takes up less of the narcotic principle than spirits. About a 
tea-spoonful of it is a dose for a child of two years old. The product of this 
plant enters into the sudorific drops, diaphoretic powders, fyc. In cases where 
other means fail to allay pain, it is good practice to give opium in the form 
of pills or powder ; but should be dispensed with in every case where it is 
possible. 
Common Name.-Garden Poppy. 
No. 80. Plantain. {Plantago Major.} Root and Leaves. 
Common Name.-Large Plantain. 
Locality.-This plant is indigenous to this country, and is found grow- 
ing plentifully in meadows, pastures, by road-sides, and in gardens. 
Properties.-It is possessed of " refrigerant, vulnerary, antiseptic, deter- 
gent, and subastringent " properties. It is held in high repute, by some, in 
the cure of bites from poisonous serpents and insects. 
It was recorded in a Virginia paper that a gentleman was bitten above 
the knee by a spider. A few minutes after he perceived a pain shooting 
upward from the spot, which soon reached his heart. A quantity of plan- 
tain was immediately gathered and bruised, and the juice squeezed out and 
swallowed, which stopped the progress of the poison, so that a cure of the 
bite was obtained immediately. 
The leaves, simmered in spirits or fresh butter, make an excellent oint- 
ment for erysipelas, tetter, or salt rheum. It is also remarkably efficacious 
in poisons of all kinds. 
A negro at the south obtained his freedom, by disclosing a nostrum for the 
bites of snakes, the basis of which was the plantain. It consisted in giving 
the expressed juice of plantain and hoarhound, equal parts : a table-spoon- 
ful, to be repeated as often as the stomach would bear ; and the same to be 
applied to the wound. 79. Poppy. (Papaver Somniferuiu.) 
80. Plantain. (Plantago Major ) #i2. Seneca Snake root. ( Senega.} 
81- Pok.0. (Phytolacca Decaudria.} 83. Oak. (Qnercus Alba.) 
86. Castor Bean. (Ricinus Communis.) 
S6. Yellow Dock. (Rumex Crisnus. 80. Bitter-sweet. (Solatium Dulcamara. 
88. Sumach. (Rhus Tiphinum.) 
87. Rhubarb. (Rheutn Palmatum.) VEGETABLE MATERIA MEDICA. 
669 
A writer states that a toad, in fighting with a spider, as often as it was 
bitten retired a few steps, ate of the plantain, and then renewed the attack. 
The person deprived him of the plant, and it soon died. 
No. 81. Poke. {Phytolacca Decandria.) Root, Leaves, and Berries. 
Common Names.-Poke, Skoke, Garget, Coakum. 
Locality.-This is a plant indigenous to America, but is now naturalized 
in Europe. It is found growing in all parts of the United States, along the 
way-sides, in woods, fields, &c. 
Properties.-The inspissated juice of the berries is of great service in 
rheumatism, and, externally, in ulcers. We occasionally employ it in the 
cure of fistula; also as a discutient in hard, glandular tumours, and it fre- 
quently proves very efficacious. 
A graduate of our school has used the ointment successfully in bronchocele. 
The juice has removed a bony tumour from an animal, by rubbing with it. 
Employment.-We use it in the form of extract and the inspissated juice 
of the berries; also as an ointment and poultice for hard, indolent tumours. 
I apply it in the form of poultice, made by roasting or boiling the root, to 
hard, indolent tumours with excellent effect. I have found it more service- 
able than any other application. 
No. 82. Seneca Snake-root. {Polygala Senega.) The Root. 
Common Names.-Seneca Snake-root, Rattlesnake-root. 
Description.-It is a perennial plant, grows wild in Pennsylvania, New 
Jersey, and Virginia. Root about the thickness of the little finger, contorted, 
variously bent, with joints resembling the tail of a rattlesnake, whence its name. 
Locality.-This is a perennial plant, indigenous to America. It is found 
growing in nearly all the states in the Union. 
Properties.-Stimulant, expectorant, and diuretic. Henry states, in his 
Herbal, that he cured a case of twelve years' standing by a decoction of this 
plant; one ounce of the root to one quart of water, boiled to half a pint. Give 
a puke. Next day give a table-spoonful of the decoction every hour till all 
is taken, which operates both by stool and urine. 
For the hives and croup, first give a puke, then give a decoction every 
two hours, as much as can be drank. The same is good for all fevers. It 
enters into " Coxes' hive syrup." 
Employment.-Dose of the pulverized root, from ten grains to half a 
drachm. Decoction ; take one ounce of the root, bruised, and simmer it in 
a close vessel, with a pint of boiling water, until the quantity is reduced to 
one-third. 
No. 83. White Oak. {Quercus Alba.) The Bark. 
Common Name.-White Oak. 
Locality.-Found growing in the forests throughout the United States 
abundantly. 
Properties.-Oak bark has been given in some instances as a substitute 
for bark, to which, however, it is greatly inferior. Its chief an 
external astringent and antiseptic. A strong decoction is employed with 670 
VEGETABLE MATERIA MEDICA. 
advantage, as a gargle, in sore throat, and as a lotion in gangrenous ulcers 
and offensive discharges of different kinds. 
The powder of this bark has, it is said, by inhaling, cured consumption. 
Il is used by us in falling down of the uterus, prolapsus ani, leucorrhoea, 
and all other diseases in which astringents are required. It enters into 
the "astringent decoction." The extract is used for hernia, rupture, and 
ulcers. It forms an excellent wash or injection. 
Employment.-It is the basis of the astringent decoction. It enters into 
Ferris's cancer plaster, for cancers and inveterate ulcers; also the tonic tincture. 
No. 84. Blackberry. (Rubus Villosus.) The Root and Berries. 
Common Name.-Common Blackberry. 
Locality.-This plant is found growing abundantly throughout the United 
States, and is indigenous to this country. Found growing along swamps 
and fences. 
Properties.-The bark of the root or the berries, formed into a syrup, is 
exceedingly valuable in chronic diarrhoea, and dysentery, cholera infantum, 
or summer complaint. It often proves a sovereign remedy when all other 
remedies fail. It is a medicine much used by the Indians in dysentery ; and 
it is said that, in the Oneida tribe, five hundred were attacked with this 
disease in one season, and, by the use of the blackberry root, all recovered, 
while their neighbours, the whites, fell before the disease ; no doubt in conse- 
quence of taking mercury, or some of the common agents made use of. 
Employment.-The root may be given in powder, infusion, decoction, or 
syrup : decoction, one ounce of the bruised root to a pint of water. I pre- 
scribe it in the form of syrup. The fruit makes an excellent syrup. Gather 
it when ripe, add a little cinnamon, bruise, simmer, and strain ; add loaf 
sugar, and boil a few minutes; when cool add a little French brandy. 
Dose, according to age, four or five times a day, for bowel complaints. 
No. 85. Castor Bean. (Ricinus Communis.') The Oil 
Common Name.-Castor Bean. 
Locality.-This plant is a native of the East Indies and Africa. In those 
countries it is said to be perennial; but in our country and in Europe, 
where it flourishes well, it is an annual plant. 
Properties.-The castor oil is a very mild cathartic, unloading the bowels 
of their contents, without occasioning any intestinal irritation, which renders 
it very useful in bowel complaints, by its oleaginous particles lubricating the 
inflamed mucous surface of the intestines. It is also serviceable in colics 
and in strangulated hernia. It is excellent in inflammation of the stomach 
and bowels, and in all diseases where an unirritating, emollient purgative is 
required. 
Employment.-The dose of this oil is from half an ounce to one ounce, or 
a table-spoonful poured on peppermint water or in boiled milk, which, in 
a measure, disguises it. 
No. 86. Yellow Dock. (Rumex Crispus.) The Root. 
Common Names.-Yellow Dock, Garden Patience. 
Locality.-Plant perennial, indigenous to Europe, and naturalized in 90. Blood root. (Sanguitiaria Canadenaii.) 
91. Pink-root. (Spigelia Marilandica.) 
-92. Comfrey. (Symphytum OtlicinaJr. 94. Mustard. (Sinapis Alba.) 
SB. Dwarf Elder. (Sambucus F.bulus. >■ VEGETABLE MATERIA MEDICA. 
671 
America. Grows abundantly in damp places, gardens, &c.; flowering in 
the summer. 
Properties.-This plant is slightly tonic, narcotic, and detergent. The 
decoction of this root, drank, is considered very useful in the cure of cancers. 
A poultice of these roots, applied to indolent swellings, is very useful to 
discuss them. An ointment is also good to discuss indolent, glandular 
tumours. Thatcher says it will effectually cure the itch. A syrup made 
of the root is excellent to eradicate scrofulous and other taints of the system. 
Employment.-A decoction of the roots made and drank; also a syrup. 
No. 87. Rhubarb. {Rheum Palmatum.) The Root. 
Common Name.-Rhubarb. 
Locality.-A perennial plant, native of China and Tartary ; cultivated 
in various parts of Europe, especially in France ; and it is likewise produced 
in America. 
Properties.-The root of this plant is a valuable and singular cathartic, 
differing from all others of the materia medica. It operates, first, by eva- 
cuating the intestinal canal, and then gently astringing or restoring the tone 
of it. Upon these singular properties combined (purgative and astringent) 
depend its utility in dysentery and diarrhoea. Its medicinal properties are 
heightened by the addition of an alkali. And in other diseases depending 
upon a lax state of the muscular fibres of the intestines, together with the 
existence of an acrid state of the fluids, this preparation is exceedingly use- 
ful. Its operation in those disordered states of the bowels is by neutralizing 
the acid, by evacuating the contents of the bowels, and then by gently as- 
tringing the relaxed fibres. I have often been astonished that this valuable 
plant should be neglected by physicians, particularly in bowel complaints, 
and mercury substituted, when this mineral invariably injures, while the 
rhubarb proves a sovereign remedy. 
Employment.-The dose of the pulverized root is about a tea-spoonful, 
as a cathartic ; or it may be given in the form of syrup or cordial, which 
renders it a very pleasant medicine. It forms the base of our neutralizing 
cordial or mixture. 
No. 88. Sumach. {Rhus Tiphinum.') Bark of the Roots and the Berries. 
Common Name.-Common Sumach. 
Description.-There are two kinds of the common upland sumach, one 
known as the narrow-leaved sumach, the other as the Pennsylvania sumach. 
The latter is smooth, and rises to the height of ten or fifteen feet; the leaves 
are feathered, sawed, lanced, naked on both sides, and change to a beautiful 
red in autumn ; the seeds are in large bunches, arranged like the flowers, are 
red, and covered with a white powder of an agreeable acid taste. 
Locality.-It grows throughout the United States, in barren fields, by 
the sides of fences, generally in gravelly soils. 
Properties.-The two species above-mentioned are astringent. An in- 
fusion of the berries, sweetened with honey, is sometimes used as a gargle 
in sore throats, and for cleansing the mouth in putrid fevers. The bark of 
the root is considered a very great antiseptic ; in form of poultices for old 
ulcers, it is hardly equalled by any. 
Employment.-Sumach bark is used in the form of decoction, for prolapsus 672 
VEGETABLE MATERIA MEDICA. 
ani, falling of the bowels, and of the womb. A decoction of the berries 
makes an excellent gargle for the quinsy and putrid sore throat. 
No. 89. Bitter-sweet. (Solanum Dulcamara.') The Bar4 of the Root. 
Common Name.-Bitter-sweet. 
Locality.-This is an under shrub, indigenous to Europe, and is now 
naturalized in this country. It flowers in June and July. 
Properties.-It is beneficial, when administered internally, in combina- 
tion with yellow dock, in scrofulous and scirrhous diseases. It is also bene- 
ficial in liver complaints, and in all cutaneous diseases, and in ill-conditioned 
ulcers. 
Employment.-Used externally, an ointment must be made of the bark; 
and internally in the form of the scrofulous syrup. An ointment made of the 
bark is good to discuss swelled breasts. 
No. 90. Blood-root. {Sanguinaria Canadensis.') The Root. 
Common Name.-Blood-root. 
Description.-Root perennial, horizontal, fleshy, and throwing out a few 
fibres; reddish outside, and emitting, when fresh and broken, a bright red juice; 
leaves large, and few roundish or heart-shaped ; upper side a little ground, 
under side almost white, and only one on a stalk; flowers white, supported on 
several stalks, putting forth very early in the spring, before the leaves are 
near grown. 
Locality.-This is an indigenous plant of this country, found growing in 
low grounds, among rocks, in meadows, or in woods near meadows. 
Properties.-This root is emetic, sudorific, emmenagogue, detergent, ex 
pectorant, &c. 
This root is efficacious in bleeding of the lungs, croup, scarlet fever, jaun- 
dice, &c. We also use it in the form of snuff, for the cure of polypus, and 
likewise, in combination with other articles, in pulmonary diseases. Also in 
the form of extract, and the powdered root as an escharotic, in foul ulcers. 
Dr. Woodruff, a botanical physician of Orange county, in this state, informs 
me that he has recently had considerable practice in the malignant scarlatina, 
which has prevailed as an epidemic in that section of the country, and that 
he has treated the disease with remarkable success by the administration of 
mild vegetable emetics, purgatives, and sudorifics. But the most signal 
benefit, he states, was derived from the blood-root, used in the following 
manner : 
For Malignant Scarlet Fever--Blood-root, (sanguinaria canadensis,) pul- 
verized, from twenty to thirty grains or a tea-spoonful, in half a pint of boil- 
ing water. Strain off the infusion, and sweeten with honey : dose, a 
tea-spoonful for a child of from two to four years of age. Repeat every 
hour through the day, if the child can bear it. If the surface gets broken 
and becomes ulcerated, wash the parts with the same infusion. 
Dr. W. states that the virtue of this root is too little understood. He 
uses it in bilious, hepatic, and pulmonary affections, as an expectorant, 
deobstruent, tonic, and antiseptic, creating a healthy action in the biliary 
organs and stomach. 
Dr. Wolcott states that " the sanguinaria, two drachms of the root put 
to half a pint of boiling water, is highly beneficial in pneumonia, attended VEGETABLE MATERIA MEDICA. 
673 
with expectoration of mucus, streaked with blood. It should be given after 
the action of a gentle emetic and mild laxative. 
" Dose of the above infusion a tea-spoonful every two hours throughout 
the day." 
Employment.-Dose of the powrdered root, as an emetic, from ten to 
fifteen grains, &c. Given also in the form of syrup, infusion, tincture, and 
extract. It enters into the pulmonic balsam. 
Dr. A. Sherman informs me that the saturated tincture of blood-root is 
an excellent medicine for suppression of the menses ; dose, ten drops three 
or four times a day, in tea or water, increasing the dose daily. It is also 
very valuable for jaundice and liver complaint, taken in the same manner. 
No. 91. Pink. (Spigelia Marilandica.) The Leaves, Stems, and Roots. 
Common Name.-Carolina Pink. 
Locality.-This is a perennial herbaceous plant, indigenous to this coun- 
try. Found growing in the southern states, from Maryland to Florida. 
Properties.-This article is well known to possess vermifuge properties, 
which act particularly upon the kind of worm called lumbrici, by destroying 
them. In this country this medicine has superseded the use of almost all 
other worm medicines. Whenever this article is given as a vermifuge, some 
brisk cathartic should be added, as senna, &c.; in doing so, we increase the 
powers of the remedy, and prevent any unpleasant nervous symptoms. 
Employment.-The following form is remarkably efficacious. Take equal 
parts of pink-root and leaves, senna and manna; make a strong tea or infu- 
sion ; sweeten. To a child four or five years old give a gill three or four 
times a day until it acts upon the bowels. 
No. 92. Comfrey. {Symphytum Officinale.) The Root. 
Common Name.-Comfrey. 
Description.-Stem herbaceous ; leaves oval, lanceolate, acute ; flowers 
white, or of a rose colour, in spikes at the extremity of the branches ; corolla 
tubular, furnished with five lanceolate and acute processes. 
Locality.-This plant is indigenous to Europe, but naturalized in this 
country, growing in gardens and meadows. Flowers in May and June. 
Properties.-The roots of this plant are demulcent, pectoral, and astrin- 
gent; good demulcent in pulmonary irritations, arising from colds, coughs, 
&c. In consumption it is a valuable remedy. 
Employment.-We make extensive use of it, in combination with other 
ingredients, and principally in the form of syrup. It enters into the pul- 
monary balsam and restorative cordial, and is very useful in leucorrhcea, 
(whites,) debility, &c. 
No. 93. Dwarf Elder. (Sambucus Ebulus.) The Flowers, Berries, 
and inner Bark. 
Common Name.-Dwarf Elder. 
Locality.-This is a perennial plant, growing abundantly throughout the 
United States. Found along fences and road-sides. Flowers in July and 
August, and its berries are ripened in September. 
Properties.-A decoction of this bark has been found beneficial in 674 
VEGETABLE MATERIA MED1CA. 
dropsy. The extract of the inner bark of elder is very good in piles and 
dropsy. The juice of the inner bark, taken in the dose of a gill, vomits and 
purges powerfully. 
No. 94. Mustard. {Sinapis Alba.) The Seeds. 
Common Name.-White Mustard. 
Properties.-Mustard seeds are stimulant and rubefacient. Bruised and 
mixed with Indian meal and vinegar, to form a paste or plaster, and spread 
on cloth, are excellent to relieve inflammation, both superficial and deep-seated; 
and I have found this much preferable to the cantharides or Spanish flies. 
The mustard cataplasm or poultice is also used to arouse the system in 
apoplectic and comatose affections, and in the last stages of low typhus fever. 
As a preventive to the return of convulsions in children and adults, this 
cataplasm should never be omitted. It is a remedy which may be used to 
attract and fix gout on the extremities, and likewise in bringing out eruptive 
diseases that have left the surface: in those cases it should be applied 
to the extremities. In the treatment of cholera, both spasmodic and com- 
mon, large mustard poultices, applied to the abdomen, very much assist in 
overcoming those diseases. In dyspepsia, and in obstinate costiveness, they 
are useful, by stimulating the intestines. Indeed, mustard is an excellent 
auxiliary in producing revulsion, or in equalizing the circulation. 
In case of accidents by poisons, a tea-spoonful of mustard flour, promptly 
administered, is a very valuable remedy, expelling it from the stomach before 
a practitioner can be called. 
Employment.-Dose of the seeds, in dyspepsia and costiveness, a tea- 
spoonful three or four times a day; cataplasm as above. It is an excellent 
condiment with food in dyspeptic cases. The black mustard is equally as 
beneficial as the white. 
No. 95. Garden Nightshade. (Solanum Nigrum.) The whole Plant. 
Common Name.-Garden Nightshade. 
Locality.-An annual plant, native of Europe, and naturalized in this 
country; found growing along old walls, fences, and in gardens. 
Properties.-Narcotic and discutient. We use it only in the discutient 
ointment. 
No. 96. Sarsaparilla. (Smilax Sarsaparilla.) The Root. 
Common Name.-Sarsaparilla. 
Locality.-This plant is indigenous to South America, growing spon- 
taneously in Peru, Mexico, and all over South America, and in the Spanish 
West Indies. 
Properties.-We make much use of this article in our practice, as an 
alterative, fyc. It enters into the alterative syrup, which is very beneficial in 
many complaints. The American sarsaparilla is equally as efficacious, if not 
superior. 
Employment -Decoction, from half to four ounces to a quart of water. 95. Garden Nightshade. (Solatium Nigrum.) 
96. Sarsaparilla. (Srnilax Sarsaparilla.) 1(JU. Euphorbia. 
99. /Tanzy. (Tanaoelum Vuigare.) 
98. Balsam of Tolu. (Toluifera Balsamuin.) VEGETABLE MATERIA MEDICA. 
675 
No. 97. Sage. {Salvia Officinalis.) 
Common Name.-Garden Sage. 
Properties.-One author has such a high opinion of this plant, that he 
thus observes : " Why dies the man whose garden sage affords ?" It is a 
sudorific, producing perspiration ; and is a popular remedy for colds, coughs, 
fevers, &c. We use it principally as a gargle, in apthse and quinsy. 
No. 98. Balsam of Tolu. {Toluifera Balsamum.) The Balsam. 
Common Name.-Balsam of Tolu. 
Description.-This tree grows to a great height: the leaves are oval or 
ovate, and stand upon short footstalks ; the fruit is a round berry. 
Locality.-This tree grows in Spanish America. The balsam flows 
from incisions made in the bark during the hot seasons. 
Properties.-This is the mildest of all balsams. It is useful in coughs, 
as an expectorant; and in pyrosis it is likewise beneficial. It enters into the 
composition of the cough drops of our pharmacopoeia. 
No. 99. Tansy. {Tanacetum Vulgare.) The Leaves. 
Locality.-Native of Europe, growing in moist pastures and on borders 
of corn-fields ; flowers in July and August. 
Properties.-When fresh, sudorific, emmenagogue, vermifuge, carminative, 
deobstruent, tonic, and stomachic. Very useful as a tea in fevers, agues, 
cachexy, hysterics, dropsy, and to regulate labour-pains. 
Employment.-Given in the form of tea. 
Common Name.-Tansy. 
No. 100. Euphorbia Ipecacuanha. (Euphorbia Ipecacuanha.) 
Common Names.-American Ipecacuanha, American Ipecac, Purge, &c 
Locality.-This plant is a native of America, growing in shady woods, 
bogs, and sandy soils, in the middle and southern states. 
Properties.-Emetic, cathartic, and tonic. Euphorbia possesses very 
powerful properties. It is an excellent hydragogue, evacuating the water 
when all other agents prove abortive or useless. A physician lately con- 
sulted me in a case of obstinate dropsy, which had resisted every means 
made use of to remove it. I advised him to give fifteen grains of the euphor- 
bia ipecacuanha, which he did two or three times throughout the week; 
and the effect of it was a complete evacuation of all the water, followed by 
a permanent cure. It also has a tendency to promote the menstrual evacua- 
tion. A person informed me that it is an infallible cure for the bilious colic. 
It first produces nausea or vomiting, then purges freely.. Dr. Bone, of New 
Jersey, a celebrated botanic physician, prescribes this medicine with great 
success in a variety of diseases. 
Employment.-The powdered root may be given in doses of from twelve 
to fifteen grains, in molasses or tea ; or from a half to a tea-spoonful. 676 
VEGETABLE MATERIA MEDICA. 
No. 101. Slippery Elm. (UlmusFulva.) The Bark 
Common Name.-Slippery Elm. 
Description.-Seldom grows above thirty feethigh; trunk slender, dividing 
in numerous branches, furnished with a rough and light-coloured bark ; 
leaves oval-oblong accuminate, serrate, pubescent on both sides, almost 
equal at the base; buds tomentose, of a tawny colour ; flowers red, sessile, 
succeeded by membranous seed-vessels of a compressed and oval shape, 
containing one oval seed. 
Locality.-A native tree of North America. 
Properties.-Demulcent, diuretic, pectoral, deobstruent, emollient, and 
refrigerant. Useful in all urinary and bowel complaints, stranguary, sore 
throat, catarrh, pneumonia, pleurisy, or inflammation of the lungs, stomach, and 
bowels, scurvy, scorbutic affections, herpes, inveterate eruptions, &c. As 
an external application, in the form of poultice, it is an admirable remedy, 
far exceeding any other known production in the world, for ulcers, tumours, 
swellings, gun-shot wounds,chilblains, burns, cutaneous diseases, erysipelas, 
felons, old, obstinate ulcers, and scabs ; for sore mouth, used as a wash. 
It quickly and powerfully allays inflammation, promotes resolution, also 
suppuration, and heals speedily. The tea is much used by the Indian women 
to procure easy labour, and is drank for two or three months previous to their 
being confined in child-bed. We make extensive use of the flour of the bark, in 
the form of poultice, for every variety of inflammation, wounds, ulcers, &c. 
In point of utility, it is of far more value than its weight of gold ; and, 
therefore, whoever has a tree on his farm should never permit it to be cut. 
No. 102. Devil's Bit. (Liatris.) 
Description.-Root tuberous, acrid, and bitterish, pungent, spicy, smell- 
ing like turpentine or juniper, holding a peculiar balsamic resin, but no oil: 
properties partly soluble in a watery decoction, wholly in alcohol. A 
powerful diuretic, acting mildly; may be used freely ; also discutient, 
tonic, diaphoretic, and deobstruent. Useful in dropsy, sore throat, scrofula, 
gravel, pains in the breast, after-pains in women, and bites of snakes. 
Employment.-It is used both externally and internally. It may be 
administered in the form of powder, tea, or syrup. 
No. 103. Blue Flag. (Iris Versicolor.) The Root. 
Common Name.-Blue Flag. 
Locality.-Found throughout the United States, on the borders of 
swamps and in wet meadows ; flowering in June. 
Qualities.-The root has a nauseous taste, and, when held in the mouth, 
imparts a powerful sense of heat and acrimony to the fauces. " The most 
active constituent," says Bigelow, " appears to be a resin, which precipitates 
in the form of a white powder, when water is added to the alcoholic solution." 
Properties.-Dr. Woodruff informs me that this root is very valuable 
in several diseases. Given in doses of six or eight grains, night and morning, 
it proves gently laxative, and eradicates the most inveterate taint of the 
system. It is excellent in venereal and hepatic affections, fluor albus, &c. 
It forms the basis of Smith's anti-mercurial syrup, which is given and 
recommended for syphilitic and many other complaints. It is highly 101. Slippery Elin. (Ulmus Fulva.) 
103. Blue Flag. (Iria Versicolor.) 
102. Devil's Bit. (Liatris.) 105. Pennyroyal. (Hedeotna Pulegioides. 
106. Common Elder. (Sambucus Nigra.) 
1H4. Prickiy Ash. (Xanthoxy lum Fraxineum.) J07. Rose. (Rosa Gallica.) 
JOS. Henbane. (Hyoscyamus Niger.) 109. Flowering Ash. (Fraxinua Orens.) 
111. Mullein- < v'erbascutn Thapsus.) 
11U. Polypody. <Polypodium Vulgare.) VEGETABLE MATERIA MEDICA. 
677 
recommended for dropsy, combined with the root of male fern; make a 
tea and drink freely. 
No. 104. Prickly-Ash. (Xanthoxylum Fraxineum.) Bark and Berries. 
Common Names.-Prickly-ash, Toothache bark, Toothache tree. 
Locality.-This is a tall shrub, indigenous to the southern states ; and 
found plentifully in the middle states, in meadows and low, moist ground. 
Properties.-This bark possesses very energetic, stimulant, and dia- 
phoretic properties, analogous to those of mezereon bark. It is a popular 
medicine, often exhibited in practice as a remedy in chronic rheumatism. 
It is said that, by an internal and protracted use, it has, in several instances, 
produced salivation. We also make use of the bark or berries in chronic 
rheumatism. 
No. 105. Pennyroyal. (Hedeoma P ulegioides.) The Plant. 
Common Names.-American Pennyroyal, Thick-weed, Stinking Balm, Squaw 
Mint. 
Locality.-Found all over the United States and in Canada, in dry 
woods, plains, &c. 
Properties.-Carminative, stimulant, diaphoretic, emmenagogue, fyc. It 
is a popular remedy in the country for suppressed menses; an infusion or 
tea, given freely, assists nature to restore this evacuation, particularly where 
t has arisen from a sudden check of perspiration. 
Employment.-A strong tea made of the plant should be taken warm, 
freely, and frequently, for gravel, suppression of urine, &c. 
No. 106. Elder. (Sambucus Nigra.) The Flowers, Leaves, Bark, fyc 
Common Name.-Common Elder. 
Locality.-This shrub is found growing all over the United States, in 
hedges, &c. Flowers in June ; fruit ripens in September. 
Properties.-Every part of this plant possesses considerable medicinal 
properties. It is " laxative, diuretic, alterative, anti-herpetic, refrigerant, 
vulnerary, deobstruent, &c. The bark is useful in dropsy : the flowers are 
excellent to purify the blood : from the leaves is made an excellent ointment, 
very useful in eruptions of the skin ; and they also form an excellent poultice 
for inflammations. A tea made of the flowers is very good to remove the 
hepatic affections of children, and to obviate costiveness. 
Employment.-The flowers enter into the alterative syrup ; and the bark, 
simmered with wine, forms the hydragogue tincture, which is given in drop- 
sical complaints. 
No. 107. Rose. (Rosa Gallica.) The Flowers. 
Common Name.-Red Rose. 
Locality.-Native of the south of Europe, but now very common in our 
gardens. Flowers in June and July. 
Properties.-Astringent, tonic, <Sfc. Exhibited with advantage in passive 
haemorrhage, mucous discharges, colliquative diarrhoea, and other similar 678 
VEGETABLE MATERIA MEDICA. 
affections We use occasionally this article externally, in theform of an eye- 
water, by adding rose water to the pith of sassafras, which constitutes a mu- 
cilaginous liquid, and is very serviceable in ophthalmia or inflammation of 
the eyes. 
Employment.-Infusion, by adding two pinches of the petals to a pint of 
boiling water. Syrup of roses is made by adding one part of roses to nine 
of boiling water and ten of sugar. 
No. 108. Henbane. (Hyoscyamus Niger.') The whole Plant. 
Common Name.-Black Henbane. 
Locality.-This is an annual plant, native of Europe, but grows plenti- 
fully with us, along road-sides and among rubbish. Flowers in July. 
Properties.-This plant is a powerful narcotic, and in general better for 
external than internal use. Applied externally, in the form of poultice and 
fomentation, it is useful in all cases of painful and obstinate inflammations, 
such as fistulas, biles, and swellings of the breast. 
Given in the form of tincture, it will sometimes allay irritation where 
opium cannot be administered. 
It may be given in tic douloureux, tetanus, and other painful nervous af- 
fections ; also in epilepsy, &c. 
Employment.-In very severe pains a small tea-spoonful of the tincture 
may be given. Externally, a poultice may be made of the leaves by simmer- 
ing them in water, and then adding the slippery elm bark. The extract in 
doses of from one to four grains, gradually increasing; the dose of the leaves 
the same as the extract. 
No. 109. Flowering Ash. (Fraxinus Ornus.) The Concrete Juice of the 
Tree-{Manna.) 
Common Name.-Flowering Ash. 
Locality.-Native of the south of Europe, particularly of Sicily and 
Calabria. 
Properties.-Manna is a very mild purgative : it appears even that, 
when it is recently collected, it has no action on the intestinal canal ; since, 
in the country where it is gathered, it is employed for the same purposes as 
sugar. By the alterations produced by age, it acquires its laxative proper- 
ties. Indeed, the older it is, the more powerful are its effects. 
Employment.-Dose, one drachm to three ounces in milk. This enters 
in the composition of our worm powders. 
No. 110. Polypody. {Polypodium Vulgare.) The Root and Tops. 
Common Names.-Common Polypody, Rock Polypod, Fern-root, Rock-brake, 
Brake-root, Female Fern, &c. 
Locality.-Found on mountains and rocks throughout the United States, 
from Canada to Carolina. 
Properties.-This plant is pectoral, demulcent, purgative, and vermifuge. 
A syrup made of this plant is very good in pulmonary diseases; and, being 
united with liverwort, is said to have permanently cured a lady in South 
Carolina of the consumption in its last stage. A strong decoction of this 
plant, when given to children, will purge, and also expel worms. This root J12. Skullcap. (Scutellaria Lateriflora.) 
113 Beth Root. (Trillium Latifolinm.) 
114. Wormwood ( ArtPinigia A koir»tki»i\ 
■- -- Red Raspberry. 
116. Striped Alder. VEGETABLE MATERIA MEDICA. 
679 
has also been used, in combination with purgatives, to expel the trenia or 
tape-worm, and, it is said, with success. 
Employment.-Given in the form of syrup or decoction. 
No. 111. Mullein. {Verbascum Thapsus.) The Leaves and Blossoms. 
Common Name.-Common Mullein. 
Locality.-This plant is a native of Great Britain, and grows plentifully 
with us, along the road-sides and in old fields. 
Properties.-The blossoms of this plant are anodyne, anti-spasmodic, 
pectoral, $c. They make a very pleasant tea, which is useful in coughs, 
huemoptysis, hiemorrhage, &c. The leaves are very useful in dysentery 
and in piles. A decoction of the leaves may be drank in dysentery ; and in 
piles they make a valuable fomentation to discuss the tumours. In the form of 
a poultice, the leaves and pith of the stalk are useful in white swellings. 
Employment.-As above directed. 
No. 112. Skull-cap. {Scutellaria Lateriflora.') 
Common Names.-Officinal Skull-cap, Mad-weed, Hoodwort, Blue Pimpornell. 
Locality.-This plant is found all over the United States, in meadows, 
woods, near water, &c.; blossoming in the summer. 
Properties.-Tonic, nervine, and anti-spasmodic. It is remarkably effica 
cious in chorea, or St. Vitus's dance : with the infusion I have cured a great 
number of cases of this disease. It has of late become quite famous as a cure 
for the bites of mad dogs. Its property as a medicine in this case was first 
discovered by Dr. Vanderesveer, toward 1772. He used it with the utmost 
success ; and is said to have, till 1815, at which period he died, preserved 
four thousand persons and one thousand cattle from becoming affected with 
the disease, after they were bitten by rabid animals. It is likewise stated 
that his son prevented, relieved, or cured forty persons in three years, in 
the states of New York and New Jersey, by the use of this article. It is 
also very useful in convulsions, tetanus, and tremours. 
Employment.-Given in the form of infusion, to be drank freely through 
the day. It is an excellent nervine, with free use. 
No. 113. Beth-root. {Trillium Latifolium.) The whole Plant. 
Common Names.-Broad-leaf Beth-root, Beth-root, Rattlesnake-root, Wake 
Robin, Cough-root, Indian Balm, Ground Lily, &c. 
Description.-Root perennial; stem terete, smooth, erect, with three 
verticillate leaves and one terminal flower. 
Locality.-This plant is a native of North America. 
Properties.-The root of this plant is astringent, pectoral, tonic, antisep- 
tic, alterative, <8fc. The root is employed, internally, in haematuria, or bleed- 
ing from the kidneys, bladder, or urethra ; in uterine haemorrhage, immode- 
rate menstrual evacuations, spitting of blood, hectic fever, asthma, cough, 
&c., in doses of a tea-spoonful of the powdered root, or in infusion. In fluor 
albus of females I have employed an infusion of this root with much suc- 
cess. Says Rafinesque ; " Externally, this root is very useful, in the form 
of a poultice, in tumours, indolent and putrid ulcers, carbuncles, and mortifi- 
cations, by itself; or, what is still better, in combination with blood-root." 680 
VEGETABLE MATERIA MEDICA. 
As a tonic, this article, in combination with blood-root, is said to be, by the 
same writer, u a certain cure for inflamed carbuncles and ulcers, after a purge 
has been administered." , It is also said that this root restrains gangrene. 
In female complaints this is a good astringent, given in menorrhagia, leu- 
corrhcea, and, after parturition, to astringe the uterine organs. 
Employment.-The powdered root may given in tea-spoonful doses. 
Externally, in the form of poultice. The infusion is made by adding a pint 
of boiling water to a table-spoonful of the powder; drink freely. 
No. 114. Wormwood. {Artemisia Absinthium.) The whole Plant. 
Locality.-This is a perennial plant, native of Europe, but raised in our 
gardens ; it is found growing in stony and uncultivated places in Europe and 
America : flowers in July and August. 
Properties.-Wormwood is possessed of very valuable stimulant and 
tonic properties. When given in moderate doses it promotes the appetite and 
digestion, quickens the circulation, and imparts to the whole system a 
strengthening influence. It is given in all cases requiring the administration 
of tonics; in dyspepsia, and other atonic states of the intestinal canal, in 
certain cases of amenorrhoea, chronic leucorrhcea, and in obstinate diarrhoea, 
depending upon debility of the membranes of the intestines. It is often 
administered in intermittent fevers with complete success. It is likewise 
given as an anthelmintic. The herb is very useful in fomentations foi 
bruises, and inflammations in general. 
Employment.-Dose of the powder from one scruple to one drachm 
infusion, from half to one ounce, in a pint of cold water. Externally, as t 
fomentation. 
Common Name.-Common Wormwood. 
No. 115. Eryngo. (Eryngium Charittium.) 
Common Name.-Sea-holly. 
Description.-This shrub rises from one to two feet in height, leave? 
circular, plaited form, shiny, like those of common holly, of a pale blue colour, 
and marked with white reticuled veins ; flowers blue, and terminate the 
branches in round heads. The calyx consists of five erect, sharp-pointed 
leaves; the corolla is composed of five petals, which turn inward: the 
germin is beset with short hairs. 
Locality.-It grows along the sea-coast, and flowers from August to 
September. 
Properties.-Aromatic, expectorant, tonic, and stimulant, and has been 
found useful in pulmonary diseases. It strengthens the system, and, it is 
said, excites to venery. 
Mr. Bowen, a Presbyterian minister, communicated the following to me 
He states that a physician, in Virginia, I think, became very celebrated for 
treating consumptive diseases, and this preparation was his principal remedy 
I see that Henry has nearly the same receipt: Take eryngo-root or sea- 
holly, (not common holly,) half an ounce ; pearl barley, half an ounce • 
liquorice-root, three ounces : boil in one quart of water very gently to one 
pint; strain, and mix an equal quantity of cow's new milk; or mix a 
wine glassful of the decoction with new milk when used, which should 
be always fasting, that is, before breakfast, before dinner, and after supper. VEGETABLE MATERIA MEDICA. 
681 
No. 116. Striper Alder. 
Says Dr. G. Westervelt: " Among all the valuable discoveries which I 
have made during five years' successful practice, and experience, is the shrub 
called tobacco wood, striped alder, &c.: the enclosed drawing is as correct as 
I could imitate. This plant grows as high as twenty feet, with the branches 
confined mostly to the top, where the leaves put out in pairs from the 
branches, and are not very numerous. They are as long (some of them) as the 
two hands of a man, of a pale green colour, very soft and smooth, and a 
strong, agreeable smell; but, when dry, have an odour like hyson tea, or 
young hyson : they are very mucilaginous, and, mixed up in hot water, form a 
poultice very similar to slippery elm bark flour. The bark of the shrub is of a 
greenish cast, and striped ; the fruit is from two to three inches in diameter, 
tough, and yielding. It grows on sides of hills, and in thick, shaded woods, 
where there is running water below. Leaves from one to eight inches wide. 
Properties.-The leaves astringent, demulcent,pectoral, antiseptic,altera- 
tive, refrigerant, and a powerful febrifuge and counter-irritant. 
Employment.-A tea of the leaves allays and relieves vomiting, under all 
circumstances, sooner than any other article known : half an ounce makes 
a quart, steeped five or ten minutes; dose, a wine glassful once in twenty 
minutes: the same in any internal inflammation ; four times a day in pulmo- 
nary affections or internal ulcers. Externally, it is a powerful refrigerant 
&c., as above, in all cases of swelling and inflammation, from the head to 
the feet, of every name and denomination. Caked breasts of women are 
relieved and cured sometimes in twenty-four hours, by anointing them with 
an ointment made of the leaves, two ounces; bitter-sweet root, one ounce ; 
spirits, one gill; lard, four ounces : boil ; then soak a necessary quantity of 
the leaves in hot water sufficient to soften them, and apply to the breast; 
a little elm flour may be added, to form a poultice. In general, the leaves 
should be kept whole, and three or four soaked in hot water and vinegar, 
equal parts, just enough to soften them. In all cases of inflammation of the 
stomach, lungs, spleen, liver, intestines, bladder, kidneys, pleura, and uterus 
they are indispensable: but first apply a mustard poultice, until the skin is 
red, then the leaves, and change them every three or six hours, according 
to the violence of the case; and between each application bathe the part 
over the seat of the disease with an anodyne wash, and take the tea internally, 
as above directed, with the other appropriate remedies for inflammatory 
complaints." 
BOTANICAL SYNOPSIS 
OF PLANTS OCCASIONALLY USED, AND RECOMMENDED FOR FARTHER 
. INVESTIGATION. 
American Columbo-(Trasera Verticellata.)-Root bitter and nauseous; 
vomits and purges ; tonic ; given in weakness of the stomach attended with 
costiveness. 
Motherwort-(Leonurus Cardiaca.}-Is nervine, anti-spasmodic, and 
emmenagogue; useful in hysteria, and to promote the menses. Given in 
the form of tea, it is anodyne: relieves pains peculiar to females. 682 
VEGETABLE MATERIA MEDICA. 
Laurel-{Kalmia Latifolia.)-The powdered leaves are employed suc- 
cessfully in tinea capitis and in certain forms of fever. 
Lungwort.-Found growing on maple trees ; is good in coughs and de- 
fluxions of the lungs. 
Maiden Hair.-This plant is mucilaginous and subastringent; good in 
coughs, asthma, pleurisy, jaundice, fevers, &c. 
Watermelon.-The fruit is a good diuretic, and very cooling in hot, 
bilious constitutions. The seeds, used in Holland gin, make an excellent 
medicine in dropsy and suppression of urine. 
Jerusalem Oak-(Chenopodium Anthelmintic um.)-It is emmenagogue, 
deobstruent, and anthelmintic ; the oil is much used as a vermifuge. 
Wild Marjoram-(Origanum Vulgare.}-Fragrant, pungent, acrid, bit- 
terish, stomachic, corroborant, detergent, stimulant, menagogue, and diapho- 
retic ; useful in tea, for cough, asthma, chlorosis, oedema. The distilled oil 
has all the properties ; it is acrid and caustic, burns the skin, relieves tooth- 
ache, &c. 
Broomrape-(Orobanche Americana.)-Astringent, antiseptic, and anti- 
syphilitic ; considered in the west as a specific for gonorrhoea and syphilis ; 
useful in obstinate ulcers, apthse, and herpetic sores, diarrhoea, and dysentery. 
Partridge Berry-(Gaultheria Procumbens.)-Mild diuretic and emme- 
nagogue ; used in New England to cure dropsy ; given in tea. Berries mild 
astringent. A popular remedy in the north for diarrhoea, and for disury in 
Carolina. Said to facilitate parturition. 
Red Mulberry-{Morus Rubra.)-Fruit refrigerant and corroborant; 
useful in sore throat, angina, and putrid fevers: syrup chiefly used. 
Beech Drops-(Sept omnium Virginianum.)-Called also cancer root. 
Root and stem astringent, bitterish, and nauseous ; useful in cancers : grow 
under beech trees. They are the basis of Martin's powder, (with white 
arsenic, sulphur, and ranunculus;) a painful remedy for curing cancers by 
application, but injurious in scrofula and scrofulous cancers. 
Henry recommends a decoction for St. Anthony's fire, to be drank freely, 
and the parts affected kept moist with linen rags wet with the liquid. 
St. John's-wort-{Hypericum Perforatum.)-Is vulnerary, pectoral, pel- 
lant, nervine ; blossoms chiefly used ; although yellow, they dye oils red: 
infused in bear's oil, sweet oil, &c., they make a fine balsamic ointment for 
wounds, sores, swellings, ulcers, tumours, rough skin, &c. A tea of the 
leaves gives relief in diseases of the breast and lungs. Used by empirics in 
diarrhoea, menorrhoea, hysterics, hypochondria, mania, low spirits. A syrup 
made with sage is a specific for coughs. Dose, a table-spoonful for a child 
twelve months old ; half, if six months old. 
Corsican Worm-weed-{Fucus Helminthocorton.)-This plant grows 
on the coast of the Mediterranean, and especially on the Island of Corsica. 
This plant (the whole of which may be used) is possessed of very powerful 
vermifuge properties, which act very powerfully upon the intestinal worms. 
It is principally administered to children, for the expulsion of the lumbricoid 
worms. The dose of the powder is from ten grains to two drachms, mixed 
with honey, &c. 
Cowhagf.-{Dolichos Pmriens.)-The operation of this article seems to 
be merely mechanical. It has been found particularly useful in expelling 
the round worm, lumbricus teres ; the spiculae irritating and aiding its ex- 
pulsion, by wounding it without affecting the intestines. It is prepared by 
dipping the pods in syrup or molasses, and then with a knife scraping off 
the hairs along with the syrup, until they form a mixture of the thickness of VEGETABLE MATERIA MEDICA. 
683 
honey, to be given in doses of from a tea-spoonful to a table-spoonful, in the 
morning, and followed by a brisk cathartic. 
Water Hemlock-(Cicuta Maculata.)-This plant acts in the same 
manner as the narcotic poisons. It has been used of late, by several prac- 
titioners, as a substitute for the conium maculatum. Its effects were very 
analogous to those of the true hemlock, but rather more powerful. A pri- 
mary symptom which attended a large dose, was nausea and vomiting. 
Strong-scented Lettuce-(Lactuca Virosa.)-This plantacts upon the 
nervous system in a manner similar to the hyoscyamus : this is the reason why 
it may be substituted in many cases for opium. In sufficiently large doses, 
it produces nausea, alvine evacuations, and often, especially in cases of dropsy, 
a remarkable increase in the secretion of urine. It has been exhibited with 
success in ascites, engorgements of the abdominal viscera, jaundice, &c., 
and as a substitute for opium in nervous cases. Extract, the dose from two 
grains to one scruple. 
Vervain-( Verbena Hastata.)-The roots of this plant, when boiled 
down to a strong decoction, and that decoction drank, are very beneficial as 
a tonic in intermittents and scrofula; they open obstructions of the viscera, 
promote the menses, and are good in gravelly complaints, coughs, wheezing, 
and to expel worms. They should be prepared in strong decoction, and drank 
freely. 
Yarrow-(Millefolium.}-This plant possesses considerable medicinal 
property as a detergent, purifies the blood, opens the pores, removes obstruc- 
tions, &c. It stops the spitting of blood, and cures the bleeding piles ; and 
is also very beneficial in dysentery. It may be given the form of decoction, 
sweetened with honey. 
Wintergreen-(Gaullheria Repens.}-Wintergreen is stimulant, ano- 
dyne, astringent, emmenagogue, anti-spasmodic, diaphoretic, milky, and cor- 
dial ; and a popular remedy in many parts of the country. It is gene ally 
used as a tea ; but the essence and oil possess eminently all the properties, 
and are kept in the shops. The oil is used as a disguise to many of the 
popular panaceas. 
Iceland Moss-(Lichen Icelandic, us.)-The Iceland moss is given in colds 
and coughs. It is soothing and nutritious. Cover a handful with sal aeratus 
water, let it stand an hour, strain, and add a quart of boiling water : this 
may be sweetened, and a little lemon juice added ; to be drank freely. 
Ice Plant-(Crystallinum.}-The root of this plant has, by some, been 
thought almost an infallible remedy for fits in children. The juice, diluted 
in cold water, is useful in sore eyes. The roots should be pulverized, and 
kept in bottles. Children troubled with fits may take from half to one tea- 
spoonful of the powder, in a cup of peony-root tea, &c. 
Ground Ivy-(Glecoma Iledcracea.}-The leaves of this plant, made 
in a decoction, are a good purifier of the blood, a pectoral, &c. This decoc- 
tion is good in consumption, obstructions, laxity, and debility of the viscera ; 
for cleansing and healing ulcers in the lungs, kidneys, and other internal 
parts ; and is likewise a good remedy in jaundice and asthmatic coughs. 
Golden Rod-{Solidago Virga Aureal-The flowers are aperient and 
corroborant, and the leaves gently astringent. The flowers have been found 
beneficial in removing obstructions of the urinary organs, in gravelly com- 
plaints, and ulcerations of the bladder; are good in vitiation of the humours 
and in the first stages of dropsy. The leaves are good in debility and laxity 
of the viscera or bowels, and all disorders proceeding from that cause. They 
may be taken in infusion or decoction. 684 
VEGETABLE MATERIA MEDICA. 
Five-Finger-{Potentilla Reptans.}-The root is a gentle astringent, and 
has been found by experience to be very beneficial in fevers, and particularly 
when there is great debility, lassitude, and night sweats, which last it seldom 
fails to check ; it also helps the appetite. It is taken in decoction, or may 
be boiled in milk. It is serviceable in allaying fluxes, immoderate flow of 
the menses, &c. 
Fever-few-{Matricaria Vulgaris.}-Leavesand flowers.-Both the wild 
and garden fever-few have the same virtues. They are warm, aperient, car- 
minative, bitter, and strengthen the stomach, expel wind, promote the menses, 
destroy worms, and are beneficial in hysterical complaints and lowness of 
spirits. For a decoction, pour two quarts of boiling water on two handsful 
of the leaves, of which a tea-cupful may be taken three or four times a day, 
in order to promote the menses : the same may be taken in colds and fevers. 
In hysterical complaints a tea-spoonful of the compound spirits of lavender 
may be added to the above decoction. 
Cleavers-(Galium Aparine.)-We copy the following from Dr. Smith's 
Botanic Physician : 
" Cleavers is one of the most valuable diuretics that our country produces. 
I have found it an excellent and speedy medicine in all suppressions of the 
urine and gravelly complaints, and is a powerful discutient. 
" It has also been found beneficial in the cure of scurvy and spitting of 
blood. The expressed juice of this plant, mixed with oat meal to the con- 
sistence of a poultice, and applied cold, over an indolent tumour, three times 
a day, keeping the bowels open in the meantime by castor oil, and taking a 
table-spoonful of the juice every morning, will often disperse it in a few days. 
Infusion of this herb should always be made in cold water, heat destroying 
its virtues : three or four ounces of the dried herb to a quart of water are 
sufficient; this should be drank for a common daily drink. It is an admirable 
remedy in gravelly disorders, often curing them entirely, alone. It seems 
to possess a solvent power over the stone or gravel, crumbling it into a sandy 
substance, so that it is discharged without difficulty. When urinary ob- 
structions proceed from a collection of cold, slimy, or muddy substance in the 
kidneys or bladder, this effectually clears it out in all cases. In inflamma- 
tory affections of the kidneys or bladder the cleavers infusion is peculiarly 
applicable, from its cooling as well as diuretic quality. It gives great relief 
in the scalding of the clap." 
Centaury-(Ccntaurium Minor.)-Leaves and flowers.-Centaury is just- 
ly esteemed one of the most efficacious bitters indigenous to the United 
States, and is a good substitute for the English gentian, which it resembles 
in taste. It is a good stomachic, emmenagogue, febrifuge, and vermifuge. 
Two ounces of the leaves and flowers of centaury and one ounce of orange 
peel may be infused in two quarts of brandy for two weeks. One table- 
spoonful of this tincture, taken before breakfast and dinner, will create an ap- 
petite ; and children having worms may take two tea-spoonsful or more 
every morning, which will effectually destroy the worms. 
Caraway-(Carum Carui.)-The seeds.-This plant is cultivated in our 
gardens, both for medicinal and culinary purposes. On account of their aro- 
matic smell, and warm, pungent taste, the seeds of caraway may be classed 
among the finest stomachics and carminatives of our climate. To persons 
afflicted with flatulency, and liable to colics, if administered in proper quan- 
tities, they generally afford considerable relief. 
Striped Bloodwort-{Laphathum Sanguineum Rubrum.)-The proper- 
ties of this plant are, antiseptic, voluntary, astringent, and pectoral. A de VEGETABLE MATERIA MEDICA. 
685 
coction of it, drank, will immediately stop immoderate flowing of the menses, 
and other hcemorrhages. The powder of bloodwort, mixed with an equal 
quantity of blood-root and a little alum, and used as a snuff for polypus in the 
nose, frequently destroys it in the course of a week. The decoction of this 
root, made into a syrup, has been found very beneficial in consumptions ac- 
companied with spitting of blood. The juice of the green leaves of blood- 
wort, boneset, and rattlesnake plantain, equal parts, and a gill drank at a 
dose, is said to be an infallible cure for the bite of a rattlesnake or any other 
poisonous reptile. The bruised leaves should also be applied to the wound, 
and changed often. 
Whortleberry-(Vaccinium.)-This plant is vulgarly called "huckle- 
berry," and is familiar to most persons. The fruit is much used and esteemed. 
The berries contain very considerable medicinal properties. They are, with 
the root, strongly diuretic, and seldom fail of relieving or curing gravelly 
and dropsical affections. They may be bruised, put in gin, and drank as the 
stomach will bear. 
Horsemint-{Monardus Punctata.)-A powerful diuretic. A strong tea, 
drank, affords immediate relief in gravel and suppression of urine. It restored 
one person, aided by the warm bath, when other means had failed, and when 
he had nearly lost his senses from pain. The oil is very useful. 
Hemlock Tree.-The bark, gum, and leaves are all useful. The leaves 
are good in inflammatory rheumatism, to purify the blood and to produce 
perspiration; the tea given freely. The gum, four parts ; white turpentine, 
one part, melted together, and spread on leather for a plaster, are very effica- 
cious to remove pain. 
Spruce.-The leaves and branches make a pleasant and healthy beer, 
good for scurvy and to purify the blood. 
Hollyhoke-{Athece Rosea.)-The flowers are astringent; a tea of them 
and rose leaves is useful in flour albus ; may be drank freely. 
Culver's Physic-{Septandria Virginica.)-Called black root, brinton 
root, bowman root, &c. A good purgative ; it operates with mildness and 
certainty, without debility. In typhus and bilious fever it is said to remove 
black, tarry, and morbid matter from the intestines. Dose, a large tea- 
spoonful in half a gill of boiling water, sweetened. If it does not operate, 
repeat in three hours. 
Balm of Gilead-{Populus Balsamifera.)-The buds from the tree are 
filled with a rich balsamic gum, which is good in coughs and debility : to 
one ounce of the buds, bruised, add one pint of fourth-proof spirits; dose, 
from a tea to a table-spoonful, three or four times a day, in sweetened water. 
Excellent also for cuts and wounds. 
Sweet Clover.-A very handsome, fragrant plant, cultivated in gardens. 
The bruised plant, simmered with fresh butter or lard, and a little resin added, 
makes a valuable salve for all kinds of ulcers. 
Sweet Fern-{Comptonia Asplenifolia.)--Alterative, astringent, and 
tonic. When the bloody flux prevailed in Rhinebeck, in 1781, and swept 
off the inhabitants daily, an infusion of this herb cured all who drank it. A 
strong tea expelled a tape-worm from a person in Rhode Island. The tea 
is good to check night sweats ; it also makes a pleasant beer. 
Adder's Tongue-{Erythronium Americanum.)-Dog-tooth violet, snake- 
leaf, rattlesnake violet, yellow snow-drop, &c. It is stated that this plant 
is a remedy for the scrofula ; the fresh leaves and root are stewed in milk, 
and applied to the scrofulous sores as a poultice, which heals them speedily 
a tea of the same is to be drank at the same time. 686 
VEGETABLE MATERIA MEDICA. 
Prickly-Ash-(Xanthoxylum.)-Both the bark and berries are used. 
They are good, in the form of tea, to purify the blood ; useful in chronic 
rheumatism, pain in the breast, and debility. 
Nanny Berry or Bush ; Black Thorn.-Good for sore mouth and sore 
throat. 
American Sarsaparilla-{Arabia Nudicaulis.}-Alterative ; equally as 
good to purify the blood as foreign sarsaparilla. Old Dr. Bubb considers it 
superior to the latter. 
Smart-weed-{Arse-smart.}-A tea of this is good to stop vomiting. A 
decoction is exceedingly good to reduce swellings, by applying it as a fomen- 
tation, simmered in vinegar. It soon removes the black and blue spots in 
bruises, and is valuable in sprains. 
Marsh-rosemary.-Grows only in salt marshes. A powerful astringent: 
useful in bowel complaints, flour albus, &c.; make a tea, and drink. Good 
also for a gargle in sore mouth. 
Yaw-root-Jfarcory, Cock-up Hat, Queen's Delight-{Stillingia Sylva- 
tica.}-Large root; purgative, alterative, anti-venereal. Valuable in yaws, 
ulcers, venereal, and leprosy. Said to be one ingredient in Swaim's panacea. 
Make a syrup or decoction, and take sufficient to act as a laxative. 
Mountain-mint-{Melissa Grandiflora.}-Stimulant and sudorific. The 
tea of it is useful in colds, and is said to relieve the gravel when other means 
fail. A hot tea also returns the menses, with bathing the feet. 
Devil's Bit-(Veratrum Lutium.}-This plant rises two or three feet high, 
with round, green, smooth stalk, with many long, smooth, green leaves, 
nipped at the edges ; at the end of each branch stands a round head of nu- 
merous small blue flowers. Grows in meadows and moist places. Numerous 
fibres shoot out from the root, which are small and indented. This root is 
useful in pains of the breast, colic, and wind. Half a tea-spoonful of the 
powder may be taken in molasses or in a tea, or bitter. This root no doubt 
possesses great medicinal properties. 
Blessed Thistle, Holy Thistle-{Cardus Benedictus.}-An annual plant, 
cultivated in gardens for beauty, both in England and America; leaves with 
sharp-barbed points or prickles ; yellow flowers. Makes a good bitter to 
strengthen the strength, and excellent to excite perspiration in fevers, in the 
form of tea. It cured a case of yellow fever given up as hopeless. 
Nettle-{Urtica Deocca.}-The juice is astringent, and good in gravel, 
bleeding of every kind, and, when snuffed up the nose, checks bleeding. A 
tea is good for those who pass bloody uiine, and for incipient consumption. 
White Hellebore-{Veratrum Album.}-Grows by the sides of brooks, 
and is among the first plants seen in the spring, with large green leaves. A 
few grains of the powder causes a continual sneezing. An ointment cures 
the itch, scald head, and other eruptions. A substance, called is 
made from it, which is powerful to deaden pain. See Neuralgia. 
Butternut-{Juglans Cinerea.}-An extract of the bark, formed into 
pills size of a pea, with a little essential oil, makes a very good purgative. 
About four are a dose. 
Cubebs, pulverized, are useful in discharges from the urethra, gleet, &c. 
Dose, a tea-spoonful three times a day, in molasses or sweetened water. 
Sweet Gale-{Myrica Gale.}-A tea is said to be a cure for the piles. 
White Bryonv-{Bryonia Alba.)-A drastic purgative. Sydenham used 
it in dropsy. An extract may be made into pills, and give sufficient to 
purge freely, for dropsy and suppression of urine. 
Common Raspberry.-A tea made of the leaves is used for canker. Ginger 
Nutmeg Virginia Speedwell. 
Water Fennel. VEGETABLE MATERIA MEDICA. 
687 
Virginia Speedwell.-Highly recommended for dropsy. Make a tea 
and drink freely. 
Wild Parsley-[Petroselinum.)-A warm and powerful diuretic. Very 
effcacious in chronic inflammation of the bladder and prostrate gland, sup- 
pression of urine, gravel, &c. Add one ounce of the seeds to one pint of best 
Holland gin, and take half a wine glassful four or five times a day; or a de- 
coction may be taken. 
Uva Uitsi.-Good in the same complaints as«the above, and in ulcera- 
tions of the kidneys and bladder. A tea to be freely drank. 
Fellow Parilla-(Menispermum.)-Grows plentifully in the western 
states, and is highly recommended for purifying the blood. Make a tea and 
drink freely. 
Fever-bush, Wild Alspice, Spice Wood.-A tea of it is recommended 
in fevers, particularly in the inflammatory type. 
Fleabane, Cult's tail-(Erigeron Canadensis.)-A strong styptic. Ex- 
cellent to stop bleeding from wounds, in form of powder: a tea is good to 
check any kind of internal bleeding, especially of the lungs ; drink it cold. 
Croton Oil.-Procured from a tree in the East Indies. Very efficacious 
in severe constipation, where other means fail .of procuring a passage, as in 
colic. From one to three drops are a dose, on sugar or in milk, every two 
hours. 
Bind-weed, Man in the ground.-One foot high, creeping, large root, 
deep in the earth ; flowers bell-shaped, white, with a purple tinge. Some- 
times grows as large as a person's leg. A purgative and diuretic. Has been 
found useful in cough, asthma, debility, and dropsy. A syrup of this root 
and of balm of Gilead buds is very beneficial in weakly, consumptive diseases. 
Calamus, Sweet Flag.-A tea of this is excellent in flatulence, colic, 
and wind. 
Agrimony.-A tea of it is highly recommended for asthma, scrofula, 
gravel, and eruptions of the skin. 
Blue Cardinal Flower-[Lobelia Syphilitica.)-A milky plant, and 
grows plentifully in the western states : said to be diuretic, cathartic, sudo- 
rific, purgative, and anti-venereal, and good in bowel complaints ; from half 
to a table-spoonful of the pulverized root, taken in water, and repeated, if 
necessary. 
Pimpernel.-Foreign and American plant; a decoction is recommended 
for cleansing ulcers. 
Cinquefoil, Five-finger-[Potentilla Reptans.)-A tea has been found 
useful in fevers, and to check bowel complaints. 
Crosswort-(Cruccata.)-A tea is said to be useful in coughs, by pro- 
moting expectoration. 
Feather-few.-A common garden plant; a tea of it, freely drank, expels 
wind, promotes the menses, and relieves hysterics and low spirits. 
Frostwort-(Cistus Canadensis.)-Said to be a remedy for the king's 
evil; make a poultice and apply : also make a tea and drink freely ; this is 
said to have cured a number. 
Fumitory-(Fiimaria Officinalis.)-A tonic, bitter, anti-scorbutic ; and 
good for cutaneous eruptions. Make a tea and drink freely, and wash the 
parts with the same. 
Horseweed, Stonf.-root, Ox balm, Hardback.-A decoction is recom- 
mended for the gravel. 
Wild and Garden Lettuce.-The extract, without causing costiveness, 
is an anodyne, and allays coughs: take two or three pills occasionally. 688 
VEGETABLE MATERIA MEDICA. 
Life-root.-Says Henry, " I have found it a sure cure for all complaints 
of the gravel and pains in the breast." Is a febrifuge and a powerful diuretic. 
take a tea-cupful of the tea three times a day. He has cured numerous cases 
of gravel by it. 
Masterwort.-Expectorant and laxative. " Good," says Henry, " in 
colic, indigestion, asthma, cold, catarrh, and ague :" take a tea-cupful of the 
tea three times a day. 
Mugwort.-A woman, who was affected with hysteric fits for several 
years, was perfectly cured, by taking a tea-spoonful of the powdered leaves 
four times a day, after she had tried various other medicines. It is recom- 
mended for worms, and to promote the menses and urine. 
Common Sorrel.-An inspissated juice makes a plaster which destroys 
tumours and incipient cancers ; to be applied on leather: it is very painful to 
bear. 
Scabious.-Excellent to purify the blood in all skin diseases. A syrup 
of it promotes expectoration in dry coughs : it is diuretic and emmenagogue. 
Snake-weed-(Polygonum Bistorta.)-This root makes a good gargle in 
sore mouth, and is a powerful astringent; stops all discharges by the womb 
or bowels: to be given in powder or tea. 
Soapwort-(Saponaria Officinalis.')-A strong decoction, given freely, 
cures the jaundice and obstruction of the liver, and purifies the blood. 
Stinking Goosefoot-(Chenopodium Foetidum.)-Anti-spasmodic; better 
in hysterics than asafcetida. 
Sweet Sicily.-Valuable in syrup for pain in the breast, coughs, and 
consumption. A tea-spoonful or two of the powder is recommended for 
worms, to be given in molasses night and morning. 
Spleenwort.-A tea is said to cure the gravel, and pain in the urinary 
organs and kidneys. 
Succory.-Laxative ; good in juandice, hectic fever, nervous debility, and 
weakness of the bowels : make a tea.and drink freely. 
Striped Bloodwort.-Astringent, pectoral; a syrup is good in consump- 
tive diseases. 
Avens-root- (Geum Virginianum.)-Called chocolate-root, throat-root, 
cure all; a powerful astringent and a good tonic. A strong decoction, 
sweetened, is useful in all cases of debility, dyspepsia, bleeding at the 
lungs, relax, colic, and sore throat. Dr. Pardon Lapham, of this city, 
informs me that this is the best article he uses for uterine haemorrhage 
or flooding, and always gives it with success. Make a strong tea, and 
give freely and often. 
Betony-(Betonica Officinalis.')-Emetic and cathartic ; recommended 
for gout and rheumatism : take a cup of the tea three or four times a day. 
Snakehead-(Chelone Glabra.)-Is good to expel worms: make a 
tea and drink ; after a few days give a purge. 
Snake-root, Rattlesnake-root, Corn Snake-root-(Eryngium Aqua- 
ticum-)-A powerful diuretic and expectorant; good in dropsy and gravel ; 
make a tea and drink freely. The root, bruised or chewed, and laid on the 
wound, cures the bite of a snake. 
Cow Parsnip-(Heracleum Sphondylium.)-Recommended in epilepsy and 
flatulence. Give freely a strong decoction. 
Thimble-weed-(Rudbeckia Laccinata.)-Diuretic and balsamic; recom- 
mended in wasting diseases of the kidneys : given freely, in decoction. 
Lavender.-A common garden plant; aromatic, carminative, pectoral, 
and nervine. The flowers enter into the " lavender compound." VEGETABLE MATERIA MEDICA 
689 
Mountain Dittany, horsemint, stonemint, wild basil, sweet horsemint.- 
Stimulant, nervine, sudorific, cephalic, and aromatic. This plant is popular for 
colds, headache, and in all cases where it is necessary to excite perspiration. 
Good for nervous headache, hysterics, and suppressed menses and urine. 
Mouse-ear-[Hieracium Pilosella.)-The decoction, drank freely, is good 
in jaundice, relieves the stone and griping in the bowels, and makes a good 
gargle for sore throat. 
Persimmon Bark.-A decoction is good to inject in wounds, where there 
is a discharge of sinew water. Very astringent. 
Prince's Pine-[Pipsissiway.)-A tea is used to purify the blood. 
Wintergreen.-Diuretic ; good to promote a discharge of urine. 
Rue, Garden.-A tonic bitter. 
Twin-leaf.-(Jeffersonia Diphylla.)-Grows in the west, and is highly 
recommended in the rheumatism. Add two ounces of the dried root to one 
quart of spirits; dose, a table-spoonful three times a day. 
White or Yellow Pond Lily.-A decoction, mixed with elm bark, makes 
a very good poultice for white swellings, king's evil, and other swellings. 
False Cromwell, Wild Job's Tears,Gravel weed-(Onos modium His- 
pidum.)-Dr. A. Robinson, of Indianna, says that this plant is a solvent for 
the stone. Steep the roots and seeds in water, and drink freely. 
Gensing.-A pleasant tonic for weakness of the stomach. 
Nephritic Plant, Cutting Almond-[Parlhenium Integrifolium.)-A 
tea is recommended for the stoppage of urine in gravel and stone. 
Water Plantain-[Planlago Cordata.)-Boil the roots till soft, mash 
them, and apply for a poultice. " Removes inflammation, reduces swelling, 
and cleanses and heals the most foul and inveterate ulcers." 
Greek Valerian, Abscess root, Blue Bells, Sweat root-(Polemonium 
Reptans.)-Howard, in his medical work, attaches extraordinary virtues to 
this plant; says the Indians make a tea of the root and drink freely in fevers, 
pleurisy, and where they wish to produce copious perspiration : it cleanses 
the blood of humours. A person alleges that we will find this plant excel- 
lent for consumptions, and all affections of the lungs and liver. It is stated 
that many cases of consumption have been cured by it: deserves farther trial. 
Figwort, Square Stalk, Carpenter's Square, Heal all-(Scrophii- 
laria Marylandica.)-" A tea, drank freely," says Smith, " restores the lochial 
discharges, and relieves the pains of difficult menstruation. 
American Gentian.-A good tonic. 
Wolf's-bane, Leopard's-bane-[Aconite.)-Narcotic; the extract is 
used to relieve pain : dose, three or four grains. 
Blue Violet-(Fi la Corulata.)-Demulcent, tonic, and laxative; re- 
commended, in tea-spoonful doses, for the piles. 
Lily of the Valley-[Convallaria Majalis.)-The root and flowers, in 
extract, purge like aloes. 
Black Ash Bark.-With the extract of the bark I once cured one of the 
most inveterate cases of salt rheum, when all other means failed. Spread 
and apply as a plaster. 
Benne Plant.-An annual plant. A few leaves, dipped in cold water, 
make a clear mucilage, which has been highly extolled for bowel com- 
plaints of children : to be given as a common drink. 
Cramp Bark, High Cranberry-[Virburnum Oxyconus.)-Anti-spas- 
modic. " A strong tea, drank freely, is very effectual," says Smith, " in 
relaxing cramps, and spasms of all kinds." 690 
VEGETABLE MATERIA MEDICA. 
Water Rushes.-A popular medicine for gravel, dropsy, and suppression 
of urine: make a tea and drink freely. 
Tag, or Spotted Alder.-Alterative. Make a tea and drink often ; for 
the blood. 
Water Fennel.-In doses of five grains, pulverized, given three times a 
day, is recommended for consumption. 
Labrador Tea-{Ledum Latifolium.)-Diuretic, balsamic. 
Sweet Balsam, Life Everlasting.-A tea is good for pain in the breast, 
■weakness of the lungs, and in consumption, stranguary gravel, and fluor 
albus. Excellent to excite perspiration. 
Horseradish.-Grated root, in cider, good in chronic rheumatism, palsy, 
dropsy, and debility. Leaves, applied to the bowels and feet, relieve colic 
and swellings. 
Flower de Luce, Blue Flag-[Iris Versicolor.')-The root, in decoction, 
promotes discharge by urine, and relieves dropsy. 
Cat-tail Flag root.-Simmer till soft, and apply as a poultice for inflam- 
mation. 
Balm.-A pleasant and cooling tea in fevers. 
Crowfoot Buttercups-{Ranunculus Acris.)-The bruised root, applied 
to the skin, produces a blister. Good where a blister is required, in diseases 
of the joints, and old deep-seated pains. When eruptions strike in, it may 
be applied, to redden the skin without blistering. 
Prickly-pear.-Scrape the inner part and apply to ulcers twice a day 
till cured. For corns, bathe the foot in ley water, pear off the corn, and 
apply, on linen, till cured. 
Fennel Seed.-A tea is useful to expel wind in adults or infants. 
Garlic.-A syrup is good for coughs and inflammation of the lungs, par 
ticularly in infants; also to apply to the feet in inflammation. 
Ginger.-A warm, aromatic root. In syrup or tea, is good to relieve 
pain arising from wind. 
Parsley.-Excellent to promote a discharge in suppression of urine from 
any cause. 
Orange.-The juice is good to swallow in fever. The external part 
makes a useful tonic bitter to promote an appetite. 
Lemon.-The juice, mixed with water and sweetened with loaf sugar, is 
very7 cooling in fever. 
Cinnamon.-Useful in flatulence and bowel complaints. Enters into the 
lavender compound. 
Hyssop.-A tea is used for colds. 
Gum Arabic makes a fine mucilage for stranguary and scalding of urine. 
Tobacco.-A tea is used for injection in severe constipation of the bowels 
and worms of the rectum. 
Nutmeg.-Similar to cinnamon. MINERALS, ACIDS, SALTS, ETC. 
691 
MINERALS, MINERAL ACIDS, SALTS, ANIMAL AND 
EARTHY SUBSTANCES, &c. 
Oil of Vitriol, Sulphuric Acid-(Acidum Sulphuricum.) 
• Description and History.-It may be prepared by burning, in a leaden 
chamber, a mixture of eight parts of sulphur with one of nitre. The floor, 
being covered with water, absorbs the gas, and diluted sulphuric acid is the 
result. 
General Properties and Employment.-It is extremely caustic, destroying 
the clothes as well as the texture of the body wherever it is applied. It is 
the principal article in the elixir of vitriol, and much in use as a remedy in 
night sweats in consumption. It is used by some as an astringent, to check 
the flow of blood in haemoptysis and other kinds of bleeding. It is never 
administered in a concentrated state. 
Sulphuric JEther-(JElher Sulphuricus.) 
Description.-Sulphuiic aether is colourless, limpid liquid, extremely vola 
tile, of a strong, peculiar smell. It is formed from sulphuric acid and alcohol. 
Properties and Employment.-It is a good anti-spasmodic and stimulant. 
Its dose is from twenty to thirty drops, given in some kind of tea. It is ex- 
hibited with advantage in most of the nervous affections, such as spasmodic 
vomiting, nervous colics, hysteria, and asthma. It is also useful in typhoid 
fevers, in calming the convulsive motions, hiccough, &c. Externally, it is 
used as a refrigerant. 
Lime-(Calx.) 
Properties and Employment.-Lime water is prepared by pouring hot watei 
upon unslacked lime ; is anti-acid and antiseptic. By adding a small portion 
of the muriate of mercury, it forms the yellow wash, which is applied to 
venereal ulcers, and soon heals them. 
Copperas, Green Vitriol, Sulphate of Iron-(Sulphas Ferri.) 
Description and History.-Copperas is a salt composed of iron and sul- 
phuric acid. It is found native, and also combined with other substances. 
Properties.-We use it only as an external application. By submitting 
copperas to the action of a red heat, a red powder is formed, which acts as 
a very powerful astringent. It is applied in cases of haemorrhage, piles, &c. 
It is also serviceable, combined with lard, in cutaneous eruptions. 
Sal Ammoniac, Muriate of Ammonia-(Marias Ammoniac.) 
Description and History.-This article is found in nature, principally in 
the vicinity of volcanoes. Mount JEtna furnishes it in considerable quanti- 
ties. It comes to us in masses, concave on one side and convex on the 
other, or in conical pieces, crystalline, white, inodorous, of a bitter and acrid 
taste. It is compressible, and difficult to pulverize. 
Properties.-This is a cooling application for inflammation, and especially 
for erysipelas and inflammatory rheumatism. 692 
MATERIA MEDICA. 
Muriate of ammonia, in combination with a decoction of wormwood, makes 
an excellent application for inflammations, the result of sprains or contusions. 
In inflammation of the brain a wash, made of sal ammoniac, vinegar, and 
water, is very useful in relieving the heat of the head. 
Muriate of Mercury, Corrosive Sublimate-(Murias Hydrargyri, 
Hydrargyri Oxymurias.) 
Description and History.-This compound is found in the shops in the 
form of circular pieces, white, semi-transparent on the edges; convex, smooth, 
and shining on one side ; extremely acrid, caustic, and metallic taste. It is 
prepared by mixing, in a close vessel, four parts of common salt, one part of 
peroxide of manganese, and five parts of sulphate of mercury. This mix- 
ture is submitted to heat, and the muriate of mercury volatilizes and con- 
denses on the superior sides of the vase. 
Properties.-We have occasionally used it, only as a caustic and as an 
external application. With borax or lime water it also forms the yellow 
wash. 
Spanish Flies, Cantharides-{Meloe Vesicatoria.') 
These insects are found in Spain, Italy, and France, on trees. They are 
brought here pulverized, and a plaster made of them, which produces a blister 
In certain cases they may prove beneficial; but we rarely use them, as they 
seem rather an unnatural remedy. 
Description and History.-This salt is found in large quantities in nature, 
principally in the East Indies, Spain, the kingdom of Naples, and in old 
walls, on the surface of which it effloresces. It is also extracted, by chemi- 
cal process, from the earth ; found under old houses, barns, &c. It is white, 
transparent, unalterable in the air, inodorous, of a cool and sharp taste, fol- 
lowed by a slightly bitter after-taste. 
Properties.-This article is refrigerant and diuretic : it enters into the 
urinary decoction and pile electuary. 
Saltpetre, Nitrate of Potash-(Nitras Pot ass a.'] 
Red Oxide of Lead, Red Lead-(Plumbi Oxidum Rubrum.) 
Description and History.-Red lead is found in the form of powder, of a 
very bright orange red colour. It is composed of lead and oxygen ; formed 
by submitting common lead to a great degree of heat in a large oven pre- 
pared for that purpose, which produces a scum upon the surface. This 
forms an oxide of lead. The white lead is prepared by submitting common 
lead to the action of acetic acid. 
Properties.-The properties of red and white lead depend not upon the 
lead itself, but upon the oxygen with which they are combined. These pre- 
parations form the basis of some plasters, which, by reason of the large quan- 
tity of oxygen they contain, are very serviceable. 
Sugar of Lead, Saccharum Saturni, Superacetate of Lead-(Plnmbi 
Super acet as.) 
Properties.-As an external application, sugar of lead is often employed MINERALS, ACIDS, SALTS, ETC. 
693 
to obtain its astringent effect. A weak solution is a common application in 
inflammation. 
Caustic Potassje-(Potassa Fusa, Lapis Causticus.) 
Description and History.-This article is found in a state of round sticks, 
like the nitrate of silver, of a grayish white, sometimes reddish, with a smell 
like slaking lime, and a corrosive action on the mouth : exposed to the air, it 
attacks quickly the carbonic acid and moisture of the atmosphere, and is 
thus dissolved. 
Properties.-Caustic potash is a powerful escharotic. It quickly decom- 
poses the parts with which it is put in contact. It is principally used to re- 
move tumours and to form issues; which are most conveniently made by 
placing on the skin a piece of linen spread with adhesive plaster, and per- 
forated with a hole of the size of the proposed issue. The caustic, being held 
in a paper, is then applied to all the skin which is left bare by the perfora- 
tion. This skin immediately becomes moist, and turns a dark colour, -a 
burning sensation taking place in the part. If the caustic be good, the 
vitality of the skin will be destroyed in ten or fifteen minutes. It may then 
be washed with vinegar, to neutralize what caustic remains. The yeast 
poultice must now be used. The dead skin commonly sloughs off in about 
a week or two. Caustic potash differs from all other caustics, in exciting 
no pain or inflammation, except when first applied, and then only for a few 
moments. 
Cream of Tartar, Crystals of Tartar, Supertartrate of Potash- 
{Potassce Supertartras.) 
Description and History.-The casks in which some kinds of wine are kept 
become gradually incrusted with a hard, saline substance, tinged with a 
colouring matter of the wine, which has long been known by the former 
name of tartar. When this saline substance is purified by solution, filtration, 
and crystallization, it constitutes the common cream of tartar. 
Properties.-Cream of tartar is refrigerant, laxative, and diuretic. Small 
doses, in solution, form a cooling drink in febrile diseases, and excite the 
urinary secretion ; large doses, in substance, occasion copious watery dis- 
charges from the bowels ; hence it is very useful in dropsical cases, whether 
it operates by the kidneys or alimentary canal. When added to the resinous 
purgatives, it renders them better suited to inflammatory cases, as in the 
compound powder of jalap and mandrake. Combined with sulphur, it is a 
popular internal remedy in various diseases of the skin ; also in piles. 
Sal JEratus-(JPotassa Bicarbonas-Bicarbonate of Potash.) 
Description and History.-This is a white alkaline salt, prepared by ex- 
posing pearl-ash in wooden boxes, perforated with holes, to the carbonic 
acid of a distiller's or brewer's fermented vat for several months, until the 
alkali is nearly or quite neutralized. 
Properties.-Sal reratus is a very valuable remedy. Its comparatively 
agreeable taste renders it one of the most pleasant and efficacious alkaline 
remedies, both as an anti-acid, diuretic, and for gravel. It enters into our 
neutralizing cordial or mixture, which we find so remarkably successful in 
every species of bowel complaints. 694 
MATERIA MEDICA. 
Castile Soap-{Sapo Venetiensis.} 
Description and History.-Castile soap is made from olive oil and soda ; 
its marble appearance being given by the sulphate and red oxide of iron, 
which are mixed in at different stages of the process by which it is made. 
Good soap should have little odour, and a disagreeable alkaline taste. With 
water it forms an opaque milky solution ; with alcohol, a nearly transpa 
rent one. 
Properties.-Applied externally, it is detergent and cleansing. In phar- 
macy it is used for' the formation of pills. It enters into our anti-dyspeptic, 
pills. Excellent for the gravel and diseases of the urinary organs; dose, a 
table-spoonful of the thin scrapings three times a day in milk ; should 
be made without the iron. 
Borax, Sub-borate of Soda-{Soda. Sub-boras.) 
Description and History.-It is found in large quantities in several lakes 
of Thibet and China, and in some of the mines of Peru. It is purified by 
melting it over the fire, then dissolving it while in powder, and permitting 
it to crystallize. It is white, semi-transparent, and of a styptic, urinous taste- 
Properties.-It is used only externally, as an astringent and gargle in apthae, 
excessive salivation, attended with ulcerations of the tongue and of the 
internal surface of the cheeks. It is remarkably cooling in its nature, and 
very readily allays heat and irritation. A solution of it forms the cooling 
wash, which is useful in opthalmia and other inflammations. 
Description and History.-This is a neutral saline substance, resulting 
from the action of sulphuric acid upon quinia. It is found in commerce in 
very minute needles, or of a pearly white flexible, resembling fibrous and 
silky asbestos, united in radiated flakes, and of an excessively bitter taste. 
It is obtained by repeatedly boiling the yellow Peruvian bark in water, 
acidulated with sulphuric acid. 
Properties.-The sulphate of quinine possesses the tonic, and principally 
the febrifuge, properties of the bark from which it is obtained, and is exhibited 
in the same cases. Where, from irritability of the stomach, the bark cannot 
be retained, the sulphate of quinine may be usefully employed. Much of 
this article is adulterated ; some of it mixed with arsenic, and serious effects 
have followed its use. 
Sulphate of Quinine-{Sulphas Quininee.) 
Flowers of Sulphur, Sublimed Sulphur-{Sulphur Sublimatuin.) 
Description and History.-This is a preparation of sulphur, obtained by 
subliming common brimstone in a large cast-iron vessel communicating with 
a chamber, which is used as a receiver. For medicinal use, it is then washed, 
in order to remove a small quantity of sulphuric acid, which is formed during 
the operation. It combines with almost all the simple metallic substances, 
and others, and forms, with them, sulphurets. 
Properties.-Administered internally, in large doses, sulphur acts as a 
purgative ; but taken in less quantity it increases animal heat and accele- 
ration of the pulse ; it promotes the secretion of the skin and kidneys. Its 
exhibition for a length of time is capable of producing very serious conse- 
quences ; such as haemorrhage, agitation, fever, &c. It is administered MINERALS, ACIDS, SALTS, ETC. 
695 
internally, and applied externally in the treatment of piles, itch, and some 
other cutaneous diseases. It enters into our preparation for the intermittent 
fever. Cream of sulphur is similar. 
Salts of Hartshorn, Sal Cornu Cervi, Subcarbonate of Ammonia- 
{Ammonite Carbonas.) 
Properties.-It is nervine and stimulating; of importance as a general 
stimulus in the advanced stages of typhus fever. The stimulus raised by 
carbonate of ammonia more resembles healthy action than any other article 
generally made use of. The following is an excellent prescription: Take 
carbonate of ammonia, three scruples; gum Arabic and loaf sugar, two 
drachms ; mint water, distilled, or tea, half a pint; mix : take a table-spoon- 
ful or two every hour, according to circumstances. 
" Dr. Fitch, of North Guilford, Connecticut, prescribes the carbonate as 
follows : Carbonate of ammonia, finely pulverized, fifty grains ; pure honey, 
four table-spoonsful; mix: thoroughly beat up together, until some effer- 
vescence takes place. Dose, a tea-spoonful once in three or four hours, or 
oftener, according to circumstances. This prescription I have proved to be 
very superior in low excitement."-Walcot. 
" Not long before his death, the late Dr. Khun," says a writer, " who 
was one of the most sagacious and discriminating practitioners of this coun- 
try, told me, with some emphasis, that, after an experience of nearly half a 
century, if he was called upon to say with what remedy he had done the 
most good, he should, without hesitation, name the carbonate of ammonia, 
aided by wine whey. 
White Vitriol-{Sulphate of Zinc.) 
White vitriol is found in water, but in an impure state and in small quan- 
tities. It is made by the application of diluted sulphuric acid upon zinc; 
then suffering the solution to crystallize. 
Properties.-It is used as an escharotic, in the form of powder, or corp,, 
bined with other articles. Added to water, it makes a cooling wash, and is 
employed in inflammation of the eyes, and occasionally in the form of injection. 
Native Sulphur-{Sulphur Vivum.) 
This article is common sulphur, as found in its native state. It is a dark brown 
powder, without much resembling sulphur, as regards appearance or smell. 
Properties.-I have found sulphur vivum to be a specific for the itch. It 
soon cures it, without producing any disagreeable symptoms or smell, or 
without the necessity of even changing the clothes. It should be pulverized, 
and mixed with fresh butter or hog's lard, and the part affected bathed or 
rubbed with it as often as there is any itching. This powder appears to be the 
basis of some of those itch ointments which are said to cure the disease in a 
few hours. This ointment is also useful in salt rheum, herpetic affections, &c. 
Veratria.-A salt procured from white hellebore; powerfully narcotic- 
Dissolved in alcohol, or made into an ointment with lard, and rubbed on the 
parts affected, relieves acute pain very speedily; as neuralgia, &c. 
Sal Soda.-Superior to ley for bathing the surface, more cleansing, and 
does not excoriate the skin ; can be carried in a vial, and given out as wanted 696 
MATERIA MEDICA. 
Charcoal, (made of hickory or maple wood.) This is highly recom- 
mended, by Mr. Jonathan Chase, for bilious complaints, dyspepsia, acid 
stomach, foul stomach, piles, &c.; it is very purifying: dose, three tea- 
spoonsful three times a day, before each meal, till cured ; to be taken in 
milk or any other vehicle. It purges. This is a very safe, cheap, and use- 
ful medicine. As an evidence of its purifying properties, it will restore tainted 
meat in a short time. Mr. Chase states that he has found more benefit 
from charcoal than all other medicines. 
Water is one of the most valuable articles in the materia medica. In- 
ternally, it is diluent, sweating, cooling, and, if necessary, may be given warm 
to puke. It keeps the blood and other fluids in a right state to circulate. 
Externally, is very valuable to cleanse, cool,or strengthen the system, in 
the form of bathing; and, given in the form of an injection, will purge. It 
has sometimes appeared to me that I could fulfil almost every indication 
by the use of water : vomit, purge, sweat, strengthen, and thus cure all 
fevers, &c. But we must not simplify too much, lest we destroy our own 
business too soon. 
Yeast makes a very valuable poultice for inflammation and mortification 
to be mixed with a little elm bark and tepid water. It is very good foi 
dysentery, and fevers attended with putrid symptoms : dose, a wine glassful, 
mixed with milk and loaf sugar. 
Gall, from the gall-bladder of an animal, is highly extolled for some com 
plaints. Dr. Prince, of Lebtz, Island of Jamaica, informs me that he uses 
it in most complaints with signal benefit; in stomach, liver diseases, &c. 
He mixes it with mandrake, forms it into pills, and gives three or four once 
or twice a day. He says it acts upon the human system as oil does upon 
a watch, which makes it run easy. 
Red Oxide and Carbonate of Iron are mild preparations of iron, simi- 
lar to the rust. They possess tonic properties, and are useful in nervous 
diseases. Dose, from half to a tea-spoonful three or four times a day, in 
molasses. 
Common Salt-{Muriate of Soda.}-This salt possesses great medicinal 
as well as antiseptic properties. Dissolved in best brandy, it is excellent for 
sore throat and all kinds of ulcers; also to disperse scrofulous and other 
swellings, fistula, tumours, wens, &c. A tea-spoonful taken frequently, is 
excellent to stop bleeding of any kind ; and, applied externally, to stop it from 
wounds. Good also for fevers, dyspepsia, &c. 
Dr. G. W. Bond, a botanic physician of this city, prescribed salt, mixed 
with vinegar and hot water, with great success in the cholera, and recom- 
mends it for all diseases, particularly of the stomach ; as follows : Common 
fine salt, a tea-spoonful ; two table-spoonsful of pure cider vinegar ; boiling 
water, half a pint: give the whole as soon and as hot as possible. In half 
an hour give an injection of the same, about a pint, sweetened with molasses. 
Repeat as occasion requires. For children, sweeten with loaf sugar, and give 
often, according to their age, from a tea-spoonful to a table-spoonful. 
Scrofulous Tumours, Wens, and Fistula.-Take the yolks of eggs, 
beat up, and add as much pure salt as will dissolve; apply every twelve hours. PART SEVENTH. 
PHARMACY AND DISPENSATORY; OR COMPOUNDS. 
Pharmacy may be defined that branch of medical science which teaches 
the art of preparing and combining remedies for the treatment of diseases. 
It is the object and province of materia medica to provide or furnish 
articles or ingredients for the prevention and cure of diseases, and to treat 
of their properties and virtues. But it is the province of pharmacy to show 
how these articles are prepared and compounded for administration. It is 
the design of therapeutics to show the effects on the human body, and their 
application to the cure of diseases. 
We wish every one to be deeply impressed with this sacred maxim in 
physic, that the virtue of a medicine consists wholly in the skill of its ap- 
plication ; and that the best and most salutary medicine, if injudiciously 
administered, may prove injurious. 
Table of Doses.-As a general rule, the following table of doses will be 
quite sufficient; but much must always be left to the judgment of the pre- 
scriber, who alone can judge of the constitution and state of the case: 
A person from fourteen to twenty years of age may take two-thirds of a 
dose intended for an adult; from nine to fourteen, one-half; from six to nine, 
one-third ; from four to six, one-fourth ; from two to four, one-sixth ; from 
one to two, one-tenth; below' one year, a twelfth. A woman generally 
should take a little less than a man. 
Apothecaries' Weight.-A pound contains twelve ounces ; an ounce, eight 
drachms ; a drachm, three scruples ; a scruple, tw'enty grains. 
Measure for Liquids.-A pint contains sixteen ounces ; an ounce, eight 
drachms ; a table-spoonful is about half an ounce ; a tea-spoonful is one- 
fourth of a table-spoonful; sixty drops make one tea-spoonful. 
Some substances are administered in their natural state ; others previously 
undergo various preparations. Every article used in medicine should be 
collected in the right season, and be free as possible from impurities. 
The articles of the materia medica, in their natural state, are generally unfit 
for medicinal use; and their remedial powers are often increased by combining 
two or more together; hence the necessity of preparation and composition. 
Our different medicinal preparations are arranged under the following heads: 
1. Balsams. 
2. Bitters. 
3. Caustics. 
4. Drops. 
5. Decoctions. 
6. Extracts. 
7. Eye-waters. 
8. Fomentations. 
9. Gargles. 
10. Infusions. 
11. Injections. 
12. Liniments. 
13. Liquids. 
14. Mucilages. 
15. Oils. 
16. Ointments. 
17. Plasters. 
18. Poultices. 
19. Pills 
20. Powders. 
21. Salves. 
22. Syrups. 
23. Spirits. 
24. Sinapisms. 
25. Tinctures. 
26. Essences. 
27. Troches or Suppositories 
28. Washes. 
29. Mixtures. 
30. Electuaries. 698 
PHARMACY AND DISPENSATORY. 
BALSAMS. 
By balsams is generally understood the concrete or inspissated juice of 
vegetables ; such as balsam of fir, copai va, &c. But we make use of the term 
here to designate certain artificial preparations, which, as regards qualities 
or consistence, resemble balsams. 
Pulmonic or Pulmonary Balsam. 
Take of Spikenard root, 1 ounce. 
Hoarhound tops, do. 
Elecampane root, - - do. 
Comfrey root, do. 
Blood-root do. 
Add a suitable quantity of water ; boil, and pour off the infusion repeatedly, 
until the strength is all extracted ; then strain : add to the same one gill 
of spirits, press and strain, reduce the whole of the liquid down to about 
one quart bottle full; then add two pounds of white sugar, and boil a 
few minutes, to form a syrup. Let the whole stand twenty-four hours, in 
order that it may settle ; then bottle for use. 
Dose.-A wine glassful three or four times a day. 
Use.-This preparation is highly useful in the treatment of pulmonary 
affections and coughs of long standing. It is admirably calculated to relieve 
that constricted state of the lungs which is often met with in consumption, 
and to assist expectoration. It does not increase the circulation, and is, 
therefore, a safe remedy in any stage of consumption. 
BITTERS. 
By this class of medicines is understood certain liquids, as wine or spirits, 
impregnated with those vegetables which contain the greatest quantity of 
the bitter principle ; such as gentian, centaury, &c. They are used to im- 
part tone to the stomach. 
Wine Bitters. 
Take of Golden seal 1 drachm. 
White wood bark, 1 do. 
Indian hemp, 1 do. 
Cayenne pepper, i do. 
Bruise all, and add one quart of wine. 
Dose.-From a table-spoonful to a wine glassful three times a day. 
Use.-This forms a useful tonic and pleasant bitter. It is administered 
in dyspepsia and other complaints, where tonics are indicated. 
Take of Tamarach bark, 6 pounds 
Prickly-ash bark, 4 do. 
Wild cherry bark, 3 do. 
Seneca snake-root, 3 do. 
Tansy, 1 do. 
Socotorine aloes, i do. 
Let these articles be pulverized and mixed; then take of mixture one 
quarter of a pound, add three pints of boiling water, two quarts of Holland 
gin, and one pint of molasses : let it stand a week. 
Dose.-Haifa wine glassful morning, noon, and evening. 
Use.-This forms an excellent tonic for dyspepsia, obstruction of the 
menses, and other diseases, where tonics are required. It constitutes old 
Dr. Bones' bitters. 
Compound Bitters. COMPOUNDS. 
699 
Take of Comfrey root, 1 ounce. 
Solomon's seal, . 1 do. 
Spikenard root, 1 do. 
Colombo root | do. 
Gentian root, J- do. 
Chamomile flowers, j. do. 
Bruise all together, cover with boiling water, and then add four quarts of 
wine or metheglin. 
Dose.-Half a wine glassful three or four times a day. 
Use.-This is a very useful tonic in all cases of debility, particularly that 
peculiar to females. It is pectoral and corroborant. It is valuable in fluor 
albus and incipient consumption. Seldom or never given without benefit. 
Restorative Wine Bitters. 
CAUSTICS OR ESCHAROTICS. 
Caustics and escharotics are those substances which, when applied to 
fungous flesh or the skin, disorganize the same. Their operation, however, 
differs very much, according to the agents employed ; some acting very mildly, 
others very severely. They are derived both from the mineral and vege- 
table kingdom. The latter are always to be preferred, when they answer 
the indication required. 
Vegetable Caustic. 
Make a strong ley of hickory or oak ashes, put it into an iron kettle, and 
evaporate till dry; pulverize, and preserve it in closed vessels. 
Use.-This caustic is highly useful in the treatment of fistulas; also in 
indolent ulcers of every character. It removes fungous flesh without ex- 
citing any inflammation, and acts but little, except on spongy or soft flesh. 
It is useful in cancers, and in every case where a caustic is required. 
This article, applied, on lint, to some species of ulcers, proves very bene- 
ficial. 
Extract of Blood-root. 
White vitriol, pulverized, makes an excellent caustic, particularly to re- 
move fungous or "proud flesh." A few grains to be occasionally applied. 
While Vitriol, Mineral Caustic. 
DROPS. 
Drops include medicines which, from their strength or active properties, 
require to be given in very minute doses ; the dose being usually graduated 
by the number to be administered. 
Great care or caution is necessary in giving this class of medicine, as mis- 
takes are more liable to be made in this than in some other forms. 
Vials containing drops should always be kept corked, that the strength 
may not be increased by evaporation, or the virtues of them lost. 
Diuretic Drops. 
Take of Sweet spirits of nitre, 2 ounces. 
Balsam of copaiva, ......... 1 do. 
Oil of almonds, 2 do. 
Spirits of turpentine, 1 do. 
Mix these together, and add one scruple of camphor. 700 
PHARMACY AND DISPENSATORY. 
Dose.-A small tea-spoonful, given in mucilage of gum Arabic or herb 
tea, three or four times a day. 
Use.-The drops are successfully administered in cases of scalding of urine, 
whether arising from syphilitic or other complaints. In inflammation of the 
kidneys they give prompt relief. 
Black Drop. 
The black drop was originally prepared, upward of one hundred years ago, 
by Edward Toustall, a practitioner, of the Society of Friends, in England ; 
the recipe passed into the hands of a relative, and was finally published. 
Take of Opium, J pound. 
Vinegar, 3 pints. 
Nutmeg, 1| ounces. 
Saffron, £ do. 
Boil a while, and then add a quarter of a pound of loaf sugar and two 
table-spoonsful of yeast; set the whole in a warm place for four or five 
weeks ; decant, and bottle for use. 
Dose.-From fifteen to fifty drops. 
Use.-This, perhaps, is the best form in which opium can be administered 
as an anodyne. It is given in all cases when an anodyne is indicated. 
Take Oil of anise, % drachm. 
Oil of almonds,| do. 
Balsam of fir, i do. 
Tincture of balsam tolu, I do. 
Wine, i do 
Mix. 
Dose.-Thirty drops three or four times a day. 
Use.-These drops should be given in a little mucilage or tea. They 
assist expectoration in tickling coughs, and afford great relief. 
Cough Drops. 
Anti-emetic Drops. 
Take Salt, 2 ounces. 
Capsicum, I do. 
Vinegar, 1 quart. 
Mix. 
Dose.-A table-spoonful whenever there is great nausea or vomiting. 
A writer says that this compound is the best remedy to stop vomiting 
that we have ever used. 
Take Angelica, 4 ounces. 
Wild valerian, 2 do. 
Calamus, - - | do. 
Anise, dill, and fennel seeds, (each) I do. 
Catnip blows or leaves, and motherwort, each a large handful; 
Pleurisy root, 4 do. 
Infuse the whole in two quarts of brandy or good common spirits, and 
digest in a moderate heat for twenty-four hours ; then press out and strain the 
liquid, and add to it half a pound of loaf sugar. When settled, bottle it for use. 
Dose.-For children, from ten to sixty drops, according to the age ; for 
adults, from one to four tea-spoonsful in a cup of warm tea. It may be 
repeated once in four or six hours. 
Use.-Jt eases pain, creates a moderate perspiration, and produces refresh- 
Carminative Drops. COMPOUNDS. 
701 
ing sleep; is good for restless children, removes flatulency and wind colic, 
and is useful in hysteric and nervous affections, female debility, &c. 
Toothache Drops. 
Take of Oil of sassafras, ounce. 
Oil of cloves, % do. 
Mix : dip a piece of lint or cotton in the drops, and put it in the tooth. 
DECOCTIONS. 
Decoctions are certain preparations of medicines and drinks, made by 
boiling substances in water for a considerable time. Where we wish to 
administer the virtues of any plant in a small volume in the form of drink, 
decoctions are very useful. Some ingredients, however, loose a part of 
their efficacy by long boiling, and are given best in some other form. 
Vegetables designed for decoction should be cut into slicesxor bruised 
into a coarse powder, that their strength may be more easily extracted. 
Diuretic Decoction. 
Take of Queen of the meadow, 2 ounces. 
Milk-weed, 2 do. 
Juniper berries, 2 do. 
Dwarf elder, 2 do. 
Spearmint, ... 2 do. 
Wild carrot seeds, 2 do. 
Put all into a mortar, and bruise : make a strong decoction. 
Dose.-Half a pint, to be taken often through the day. 
Use.-This decoction is very useful in gravel, dropsy, fyc. It is strongly 
diuretic. 
Rheumatic Decoction. 
Take of Virginia snake-root, 1 drachm. 
White pine bark, 2 do. 
Burdock seeds, 2 do. 
Prickly-ash bark, 2 do. 
Pulverize all together, and add half a gallon of water ; boil to three pints. 
Dose.-Half a pint two or three times a day. 
Use.-This forms an excellent decoction in chronic rheumatism. 
Take of Marsh-mallows, 3 ounces. 
Queen of the meadow, 3 d0. 
Add four quarts of water, and boil to one ; then add two ounces of gum 
Arabic and half an ounce of pulverized nitre. 
Dose.-A tea-cupful four or five times a day. 
Use.-This is an excellent remedy in nephritis or inflammation of the 
kidney. It is also useful in the treatment of inflammation of the bladder, 
in hrematuria or bloody urine, and other urinary diseases. It is a demulcent 
diuretic 
Urinary Decoction. 
For the Gravel. 
Take of the root of Jacob s ladder, 2 ounces 
Make into a decoction ; to be taken as a common drink. Said to be 
infallible for the gravel. 
EXTRACTS. 
Extracts are the products of vegetables, produced by boiling or evapo- 702 
PHARMACY AND DISPENSATORY. 
rating to a proper consistence. There are two kinds: spirituous and watery - 
In the former spirits are used to extract the strength of the article of which 
the extract is made; in the latter water is made use of. In preparing 
them it is necessary often to add fresh water, if water he used, until all the 
strength is extracted; then strain and slowly evaporate until the liquid is 
brought to the consistence of thick molasses ; after which let it be placed in 
earthen jars, and tightly covered with a bladder or skin, to prevent moulding. 
This is an excellent form to administer many kinds of medicinal plants, 
as the quantity to be given is very small. 
The inspissated juice of vegetables is the best method to obtain their 
virtues in a concentrated form. 
The extract of jalap, dandelion, blood-root, henbane, gentian, stramonium, 
butternut, &c.,are all obtained in a similar manner : the roots or plants may 
be bruised, and spirits added ; then pressed out, and placed in the sun till 
evaporated. 
EYE-WATERS. 
Eye-waters or collyriums are prepared either from mineral or vegetable 
substances, and which are usually added to spirits or waler, and applied to 
the eyes in the form of wash. They should first be applied very weak, and 
the strength gradually increased. 
Spirituous Eye-water. 
Take of Fourth-proof brandy, J pint. 
Rainwater, -J do. 
Camphor, & drachm. 
Mix. 
Use.-This eye-water is used in chronic ophthalmia, or inflammation of 
the eyes. 
Take of pith of sassafras, 1 drachm. 
Add it to a suitable quantity of rose water, which makes an excellent muci- 
laginous and cooling wash. 
Use.-It will be found beneficial in the treatment of ophthalmia, or in- 
flammation of the eyes, during the acute stages. 
Mucilaginous or Lauras Eye-water. 
Take of White vitriol, 1 drachm. 
Common table salt, fine, - 3 do. 
Common water, 1 pint. 
Boil the water for a quarter of an hour; then put the two salts in a new 
earthen pot, and pour the boding water over it; Jet it simmer for fifteen 
minutes; when cold, strain it through filtering paper 
Use.-For inflammations of the eye. 
Dr. Lobstein's Eye-water. 
FOMENTATIONS. 
Fomentations are usually composed of several kinds of bitter herbs, and 
are very useful to relieve pain and inflammation, by taking off tension and 
spasm ; or to brace and restore the tone and vigour of those parts to which 
they are applied. 
The first of these intentions may generally be answered by warm fomen- 
tations ; and the second, by those that are cold. They should often be 
renewed. This class of medicine is very valuable in a great many complaints COMPOUNDS. 
703 
Take two handsful of hops and one pint of vinegar; heat the latter, and 
pour it on the hops : boil till the strength is extracted. 
In cases of sore throat, hoarseness, or soreness of the breast, severe pain 
in the abdomen, colic, dysentery, &c., this fomentation will give ease and 
allay irritation. It may be applied at bed-time, and kept on all night; or any 
time in the day, if necessary. It is usually best to apply warm, and often 
renew. 
Hop Fomentation. 
Common Fomentation. 
Take Hops, 3 ounces 
Tansy, 3 do. 
Wormwood, 3 do. 
Hoarhound, 3 do. 
Catnip, . 3 do 
Or a handful of each. Make of these articles a strong decoction, by boiling 
in equal parts of vinegar and water. 
Use.-This will be found very efficacious in relieving pain and reducing 
inflammation, resulting from contusions, sprains, dislocations, and other 
causes. 
It may also be usefully employed in inflammation of the bowels and of the 
stomach; in short, in almost every species of inflammation it will be found 
very useful. 
Stimulating Fomentation. 
Take Red pepper 2 ounces. 
Bruised mustard seeds, 2 do. 
Alcohol or spirits, 2 quarts. 
Simmer a few minutes. 
Use.-This is used as an external application in paralysis or palsy. 
Poppy Fomentation. 
Take of white poppy heads or the flowers a suitable quantity; add equal 
quantities of vinegar and water, and simmer a few minutes. 
Use.-This is an excellent anodyne fomentation, used in painful affections. 
Ophthalmic Fomentation- 
Take of stramonium leaves, and simmer them in water. 
Use.-In severe or acute ophthalmia, or inflammation of the eyes, this 
fomentation is sometimes used with good effect. 
Mini Fomentation. 
Take of fresh spearmint a proper quantity; let it be bruised, add spirits, 
and simmer. 
Use.-In cases of great irritability of the stomach, attended with frequent 
vomiting, this fomentation, applied to the pit of it, will often relieve when 
other means fail. 
GARGLES. 
Gargles, in many complaints, are very useful, particularly in the apthae, 
quinsy, fevers, &c. By this class of medicines we understand certain infu- 704 
"PHARMACY AND DISPENSATORY. 
sions, decoctions, or liquids, suitable or designed for washing the mouth 
and throat, which, by their stimulating or detergent properties, become 
efficacious. 
Adults can generally gargle their mouth or throat with little difficulty ; 
but infants and children require an assistant to apply them, which is done 
best by tying a little piece of linen to a probe or stick, dipping it in the liquid, 
and often applying it. They should never be made very stimulating, except 
m severe cases. 
Stimulating Gargle. 
Take of sumach berries and golden seal a sufficient quantity; make a 
strong decoction, strain, and add one drachm of pulverized alum to every 
pint of the decoction. 
Use.-This gargle is used frequently in ulcerated sore throat of long 
standing. 
Take of cohosh a proper quantity, and make a strong decoction. 
Use.-This gargle is used in quinsy. 
Astringent Gargle. 
Take of Sage, _ 1 ounce 
Hyssop, 1 do. 
Pour on one quart of boiling water, and let it stand half an hour ; then strain, 
and add one drachm of fine borax. 
Use.-This gargle is usefully employed in apthre, and in quinsy or sore 
throat, particularly where there is acute inflammation. 
Antiphlogistic Gargle. 
Take yeast, a wine glassful; milk, a gill; sweeten with molasses. Ex 
cellent for sore throat. 
Yeast Gargle. 
Gargle for Putrid Sore Throat. 
Take of the Bark of upland sumach, 
High blackberry, 
Common white elm bark, 
White oak bark, 
Small blacksnake-root, 
Nanny berry bark, 
Of each a handful, except the snake-root, which must be half the quantity : 
make a strong decoction, add a piece of alum, and sweeten well with honey ; 
then bottle for use. Apply often to the sores with a rag. It may at first 
irritate a little, butthen cures. Cured all in the revolutionary war, when all 
other means were of no avail, and many cases had previously proved fatal 
Infusions, or, as they are usually called, teas, are a very common and good 
method of administering the virtues of various medicinal agents. It probably 
is the most natural, if not ancient, method of preparing medicine. A two- 
fold benefit is derived from infusions : 1st, the medicinal properties of the 
article made use of; 2dly, the heat and diluent properties of the water. 
An excellent method to make teas or infusions is, to put the plant or root 
into a tea-pot, pour on boiling water, and let it stand a short time by the side 
of the fire. In this way the infusion is readily made very clear. 
INFUSIONS. COMPOUNDS. 
705 
For infusions generally, put a handful of the herb into a tea-pot, and add a 
quart of boiling water ; when cool, drink freely. All kinds are prepared in 
this manner, except otherwise directed ; such as hops, elecampane, elder, 
fennel seed, flag-root or calamus, boneset, linseed, slippery elm, balm, catnip, 
hyssop, spearmint, peppermint, tansy, pennyroyal, dandelion, sassafras, 
snake-root, &c. 
Take of Snake-root, one handful. 
Gold thread, do. 
Centaury do. 
Wormwood, do. 
Tansy, do. 
Boneset. do. 
Hoarhound, do. 
Mix all well together. 
Dose.-To a large table-spoonful pour one pint of boiling water ; when 
cold, drink a wine glassful four times a day. 
Use.-For weak lungs, coughs, pain in the breast, loss of appetite, dys- 
pepsia, &c. 
Composition or Bitter Tea. 
Take of Carolina pink, | ounce; 
Senna, | do. 
Manna, | do. 
Add to these one quart of boiling water, and let it stand six hours; strain, and 
sweeten with loaf sugar or honey, and add a little milk. 
Dose.-Half a tea-cupful three or four times a day for a child six years 
old ; or sufficient to purge. 
Use.-It is an excellent medicine to expel worms. 
Anthelmintic Infusion or Worm Powder. 
Take of Senna, | ounce. 
Manna, | do. 
Cream of Tartar, | do. 
Fennel seed, bruised, 1 tea-spoonful. 
Add one pint of boiling water to the senna and manna, strain, add the cream 
of tartar, and sweqten. 
Dose.-A wine glassful every hour till it purges. 
Use.-A cleansing and cooling purgative ; useful in fevers and inflam- 
matory diseases. 
Compound Infusion of Senna. 
Injections or clysters are certain liquids thrown into the rectum by me- 
chanical means. Their operation or effect depends upon the ingredients used : 
some are emollient; others are stimulant,anodyne,purgative, anti-spasmodic, 
&c. Those generally used by practitioners are composed of starch ; and so 
inefficiently are they used, or directed to be used, that little or no benefit is 
derived from them. 
A bladder and pipe is generally employed to administer injections ; but 
the liquid cannot be effectually introduced by this instrument. A large 
syringe should always be used for adults, and a small one for infants and 
children. This enables the practitioner or nurse, one of whom should al- 
ways perform this simple, but valuable, operation, to throw up the injection 
to such an extent or distance as will be exceedingly efficacious. To proyo 
INJECTIONS OR CLYSTERS. 706 
PHARMACY AND DISPENSATORY. 
effectual, a large quantity should always be given. Few are aware of the 
great benefit and efficacy of injections or clysters. They often prove a 
sovereign remedy for diseases which nothing else will relieve ; hence every 
family should possess a syringe, and a knowledge of its use. 
Sometimes the stomach is in such a state that medicine cannot be given 
to act upon the bowels: in this case the syringe is very useful; also in 
strangulated or incarcerated hernia or rupture, bilious colic, dysentery, 
cholera morbus, and bowel complaints generally. 
Take of Sweet milk, 1 pint. 
Mucilage of slippery elm, 1 do. 
Olive oil, 1 gill. 
Molasses, | pint. 
Sal aeratus, 1 tea-spoonful. 
Mix. 
Use.-This forms an injection of much value, and may be used in almost 
every case where one is indicated. It is often used with admirable effects 
in dysentery and diarrhoea. Sometimes, when there is great pain in the 
lower intestines, it will do better if a drachm of laudanum is added to each 
injection; and it will not fail of relieving the griping pain occasioned by 
the disease. It should be used with a large sized French syringe. 
Common Injection. 
Soap-suds Injection. 
Take of soap-suds, strong, a sufficient quantity ; inject it about blood- 
warm. 
Use.-This is an injection which may always be conveniently procured. 
It is mild, and may be administered when a more stimulating injection would 
be hurtful. It is very useful in habitual costiveness, when purgatives are 
ineffectual. 
Take of Lobelia, 1 drachm. 
Inner bark of large hemlock, j ounce. 
Red pepper, . 1 drachm. 
Make a tea or infusion, sweeten, and introduce from half a pint to a pint. 
Use.-This injection is occasionally used in very obstinate cases of cos- 
tiveness, bilious and painters' cholic, and strangulated or incarcerated hernia. 
Stimulating Injection. 
Take of Tobacco, 1 drachm. 
Tepid water, 1 pint. 
Infuse for twenty or thirty minutes. 
Use.-This injection is sometimes used in the treatment of incarcerated 
hernia, with a view to its relaxing properties. It should be employed with 
caution, as it has sometimes produced alarming symptoms. It is also used 
to destroy worms from the rectum. Salt and water injection is also very 
good. 
Tobacco Injection. 
LINIMENTS. 
Liniments are preparations employed in frictions or embrocations on the 
skin. They are usually composed of oily, spirituous, and gummy or sapo- 
naceous substances; as some of the essential oils, alcohol, soap camphor, &c. COMPOUNDS. 
707 
They are used externally, for rheumatism, quinsy, and other painful affections. 
The benefit is derived from their counter-irritant effects. 
Soap or Common Liniment. 
Take of Castile soap, 1 ounce. 
Oil of sassafras, 1 do. 
Camphor, . - 1 do. 
Spirits of hartshorn, 1 do. 
Alcohol, 1 do. 
Mix. 
Use.-This forms an excellent liniment in diseases of the throat and tonsils. 
Take of Oil of hemlock, I ounce. 
Gum camphor, | do. 
Gum opium, i do. 
Add one quart of alcohol: mix. 
Use--This forms an extraordinary combination for all cases of pain, par- 
ticularly of an inflammatory character, where heating liniments prove too 
stimulating. I have scarcely ever found it fail of affording immediate relief 
in inflammatory rheumatism, quinsy, white swelling, inflamed breasts, &c. 
Bathe frequently. 
Hemlock Liniment. 
LIQUIDS. 
Liquids include such medicines as are made from various menstruums or 
solvents, such as spirits, wine, water, &c. They are usually compound 
preparations. 
Rheumatic Wine Tincture. 
Take of White turpentine, 4 ounces. 
Inspissated juice of poke berries, 4 do. 
Malaga wine, or metheglin, 3 gallons. 
Let these articles be mixed, and stand one week ; then filter, and bottle. 
Dose.-Half a wine glassful two or three times a day. 
Use.-This is an excellent preparation for chronic rheumatism. 
Anti-pyrosis Liquid. 
Take of Elixir salutis, . 1 pound. 
Tincture of balsam tolu, .... 1 ounce. 
Mix. 
Dose.-A table-spoonful every morning or evening. 
Use.-This liquid will be found efficacious in removing the troublesome 
symptoms of water-brash or pyrosis. It may be taken, mixed in water, 
every night, at the time of going to bed. 
Mint, or Spirits of Mint, Liquid. 
Take of spearmint, green, bruise, and add a sufficient quantity to saturate a 
quart of Holland gin. 
Use.-This preparation of mint will be found exceedingly useful in the 
treatment of strangury and retention of urine., arising from stricture in th6 
urethra, and diseases of the prostrate gland. It has proved successful when 
other means have failed. 
Dose.-The dose must be regulated according to the patient's habits. 
Some will require half, others a gill, at a time, and repeated every thirty 708 
PHARMACY AND DISPENSATORY. 
minutes. The patient should take it till it produces relief. This liquid has 
also been used with the best effects in the treatment of haemorrhoids, par- 
ticularly in a state of inflammation ; to be applied on a little cotton. In cases 
where the green mint cannot be procured, the dried may be used, although 
it may not be so good. This liquid may also be used, both externally and 
internally, in cases of severe vomiting. 
Rheumatic Liquid. 
Take of Sassafras oil, 2 ounces. 
Hemlock oil 1 ounce. 
Red cedar oil, 1 do. 
Oil of turpentine, 1 do. 
Gum camphor, 1 do. 
Capsicum, 1 do. 
Mix : add two quarts of alcohol. 
Use.-This is a very valuable compound for rheumatism, and every kind 
of pain, ague in the face and jaws, neuralgia, spinal irritation, &c. Bathe 
the parts affected for a few minutes with the hand or flannel; repeat when 
painful: if too strong, dilute with a little water. The addition of an ounce 
or two of opium would no doubt make it still better. 
Stimulating Liquid or Drops. 
Take of Red pepper, 2 ounces. 
Common spirits or brandy, 2 quarts. 
' Let it stand a few days ; or, if wanted immediately, simmer a few minutes. 
' Use.-This liquid is used externally, in rheumatism, paralysis, " soreness 
of the flesh," ague in the face and breast, pain of the breast, and, indeed, 
of any and every other organ. It is exceedingly valuable, seldom or never 
disappointing the practitioner in relieving pain. Good internally, to relieve 
pain, in half tea-spoonful doses. 
Tincture of Ipecacuanha, or Wine of Ipecacuanha. 
Take of the Root of Ipecacuanha, in powder, 1 ounce. 
Malaga wine, 16 do. 
Macerate for seven days, and filtrate. 
Use.-This makes a valuable emetic for children. 
Dose.-The dose is one ounce for adults; children two years of age, one 
tea-spoonful every ten or fifteen minutes till it pukes them. 
Mucilages are soft, bland substances, made by dissolving different kinds 
of gum, or the roots, leaves, or other parts which abound with mucilage. 
Mucilaginous drinks are useful in diseases of the bowels, urinary organs, &c. 
Also to cover any acrid matter, so as to prevent its irritating the parts over 
which it passes. 
MUCILAGES. 
Mucilage of Gum Arabic. 
Take of Gum Arabic, 4 ounces. 
Boiling water, 8 do. 
Rub the gum with the water gradually, until it forms a mucilage; then strain. 
Use.-Mucilage of gum Arabic is used in pharmacy, to suspend in water 
substances insoluble in that liquid, to diffuse oils in water, and for similar 
purposes. It is sometimes employed in the formation of pills. It is very 
useful in heat and scalding of the water. 
Dose.-Half a wine glassful three or four times a day. COMPOUNDS. 
709 
Take of Slippery ehn bark, 1 table-spoonful. 
Boiling water 1 quart. 
Let it stand an hour. It is employed in inflammation of the stomach and 
other diseases. It is useful in bowel complaints generally. 
Mucilage of Slippery Elm. 
OILS. 
Oils are of various kinds, and used either singly or combined. They are used 
generally, when applied externally, for rheumatism and other painful affections. 
Anthelmintic or Worm Oil- 
Take of Castor oil, 1 ounce. 
Worm-seed oil, 1 drachm. 
Anise oil, 1 do. 
Tincture of inyrrh 1 do. 
Mix, and warm to the temperature of milk. 
Dose.-For an adult, a large tea-spoonful three or four times a day for 
three days. For children, give in proportion to their age ; on the third day 
give a portion of mandrake physic. This preparation is highly recommended 
by a person of competent knowledge and skill. 
Since writing the above, another physician, Dr. Davis, states that a 
similar preparation is very excellent. 
Oil of Red Pepper. 
This oil may be obtained by adding the pepper, pulverized, to aether, and 
letting it evaporate. The oil only remains. 
Use.-This oil is very efficacious in white swellings, lumbago, sciatica, 
rickets, ague in the face and breast, quinsy, pain in the side and breast, 
pleurisy, and for painful affections generally. It is powerful, and should be 
applied very sparingly. The essence of it is excellent for pain and cramp 
in the breast and stomach. 
Ointments are a class of medicines which contain the properties of certain 
vegetables designed for external use. Their consistence is softer than that 
of salves or plasters, but the heat of the body is sufficient to melt them. 
Lard and butter, or oil and wax, are principally used to make them. 
According to the direction given in common dispensatories, the properties 
of vegetables are not communicated to either of these substances through 
the medium of water alone, particularly if they are dry ; but, by simmering 
them in spirits, the desired union is obtained. 
OINTMENTS. 
Stramonium Ointment. 
Take of stramonium leaves a proper quantity, while green ; bruise them 
to a pulp, and put them into an earthen vessel; then cover with spirits and 
lard, and simmer the leaves until they become crisped ; strain, and add of 
Venice turpentine half a pound to every ten pounds of the ointment. 
Use.-This forms an excellent application for scalds, burns, and cutaneous 
eruptions, attended with inflammation. It may be applied occasionally, with 
the finger or with a piece of linen 710 
PHARMACY AND DISPENSATORY. 
Take of Tansy, 
Wormwood, 
Hoarhound, » 
Catnip, 
Hops, 
Of each an equal quantity. Bruise them, put the whole into a kettle, cover 
over with spirits and lard, and let it stand two weeks ; then simmer awhile, 
and strain. Add one pound of common turpentine to every ten pounds of 
the ointment. 
Use.-This ointment is very cooling, resolvent, relaxing, and emollient. 
It is very useful in sprains, contusions, swellings, dislocations, contracted 
sinews, &c. 
Green Ointment. 
Dis cut lent Ointment. 
Take of Cicuta leaves, | pound. 
Yellow dock, 1 do. 
Poke-root, 1 do. 
Stramonium, 1 do. 
Deadly nightshade, 1 do. 
Bitter-sweet, bark of root, £ do. 
Bruise all except the stalks, which ought to be left out; cover with cider, 
brandy, or any kind of spirits, and let it stand for twenty-four hours ; then 
add sufficient lard, when melted, to cover the whole, and simmer slowly, 
till all the virtue of the articles has been communicated to the lard Then 
strain and press. After which add half a pound of Venice turpentine. 
Use.-This ointment is exceedingly valuable in discussing scrofulous, 
indolent, and glandular tumours and swellings. 
It should be rubbed on the parts about thirty minutes each time that it is 
applied ; after which let a piece of cotton be applied and secured by a 
proper bandage. 
Itch Ointment. 
Take of Sulphur vivum, fine, . 1 ounce 
Venice turpentine, 1 do. 
Lard, J pound. 
Melt the lard and turpentine ; then add the sulphur, and stir till it is cold : 
let it be applied two or three times a day. 
Use.-It soon cures the complaint, without the necessity of changing the 
clothes. 
Celandine Ointment. 
Take the herb or plant, bruise, cover with any kind of spirits, and simmer 
awhile ; then add fresh butter, and let the whole remain over the fire until 
the leaves are crisped: strain. 
Use.-This ointment is useful in the piles and in cutaneous eruptions. 
Brown Ointment, Ophthalmic Ointment, Eye-salve, or Eye-balsam. 
Take of Fresh butter, 3 ounces 
White wax, 1 do. 
Red precipitate, drachms. 
Prepared tutty 1 do. 
Camphor, dissolved in olive oil, _ . 1 do. 
Melt the first two articles, and, when nearly cold, stir in the others, finely 
pulverized. This ointment, for eruptions generally, sore eyes, &c., is 
superior to all others. It almost invariably benefits in every case. COMPOUNDS. 
711 
For the Salt Rheum. 
Take of narrow dock-roots, scabious, and swamp sassafras, equal parts ; 
boil down strong, and add one pound of lard ; simmer down to an ointment. 
Rub the parts affected three or four times a day. 
Marsh-mallow Ointment. 
Take marsh-mallow tops and roots, add spirits, bruise, and simmer ; then 
cover the plant with fresh butter; simmer till the strength is extracted. 
Use.-This forms a very cooling ointment, and is efficacious in all kinds 
of eruptions attended with inflammation, such as erysipelas, (St. Anthony's 
fire,') sore nipples, cutaneous affections, particularly in children, in the face 
and around the ears. 
PLASTERS. 
Plasters, like ointments, have generally for their base an oily or fatly sub 
stance; but they are more solid and tough, and adhere to the parts with- 
out melting. 
Some are composed of wax, resin, and oils ; others are the product of a 
chemical combination between oleaginous substances and the metallic ox- 
ides, with which they are combined. Some are spread upon leather, others 
upon linen. 
Ferris'1 s Black Plaster. 
Take of white oak bark a proper quantity, bruise, add urine sufficient to 
cover it, let it stand two or three days, and then boil it till it becomes of 
the consistence of honey; add to every five pounds one pound of honey 
and one pound of strained turpentine gutn : add two drachms of white 
vitriol, pulverized, to every ounce, when it is intended to act as an escharotic. 
Use.-This forms a very valuable plaster for cancers, ulcers, or white swell- 
ing in a state of ulceration, and for the removal of spongy or fungous flesh. 
It excites but little pain or inflammation. It should be spread on linen or a 
soft piece of leather. 
Strengthening Plaster. 
Take of hemlock gum, add one-fourth the quantity of white turpentine, 
dissolve, and strain it. 
Use.-This forms an excellent strengthening and stimulating plaster. It 
is employed in chronic rheumatism, weakness in the back, &c. 
Blistering Plaster. 
Take of Mutton suet 
Beeswax, 
White resin. 
Of each an equal part. Melt these articles together, and add one proportion 
of Spanish flies, pulverized. 
Astringent Plaster. 
Take of white oak bark a sufficient quantity; macerate it in cold water 
one day ; then put it into a boiler, and evaporate till an extract is obtained. 
Use.-It is useful in hernia or rupture To be spread on a soft piece of 
leather, and applied over the rupture ; after which a truss must be worn. 712 
PHARMACY AND DISPENSATORY. 
Take of White resin, 3 pounds 
Beeswax, 4 ounces. 
Burgundy pitch, 4 do. 
Mutton tallow, _ 4 do. 
Melt these together, and then add 
Sweet oil, j ounce. 
Camphor, | do. 
West India rum, I gill. 
Sassafras oil, • | ounce. 
When the latter articles have been incorporated with the former, let the 
whole be poured into a vessel of water, and work it in the hands till cold. 
In some seasons and climates a little more resin, or a little more sweet oil, 
is required to make it of the right consistence. 
Use.-This is used as a sticking plaster, in rheumatism It is likewise 
useful in cuts, ulcers, &c. This makes an elegant plaster. 
Adhesive and Strengthening Plaster. 
Irritating Plaster. 
Substitute for McNair's ; and far superior. The following plaster is 
an admirable preparation for chronic and painful complaints, for the liver, 
spine, and other diseases. I find that it is a substitute for McNair's counter- 
irritating plaster, and altogether better. Mr. Drury B. Boyd, from Kentucky, 
informs me that he has worn it on his side, for a complaint of his liver, with 
excellent effect. It produces some irritation, and a slight discharge. 
Take Mandrake, Blood-root, Indian turnep, and Poke-root, finely pulver- 
ized, of each half a pound ; cover with alcohol, and let it stand until nearly 
dry. Melt four pounds of pure or strained Burgundy pitch, and add half a 
pound of pure Venice turpentine. Then stir in the powdered roots, and in- 
corporate the whole well together. Simmer three or four hours, or until it 
forms a very soft Plaster. 
Directions.-Spread on a piece of soft leather and place over the part 
affected. Keep it on as long as can be borne, then remove, and put it on 
again in a day or two. 
If the itching proves too troublesome, occasionally remove and wash the 
parts with water or Spirits. 
This plaster brings out pustules or eruptions like the small-pox, and causes 
a discharge of matter. It appears superior to all other plasters. I should 
recommend those who have obstinate ulcers to apply the irritating plaster. 
Common Strengthening Plaster, called " Sear Cloth Plaster." 
Take of Resin, (usually termed rosin,) 1 pound. 
Beeswax, . 4 ounces. 
Capsicum, 4 do. 
Spirits, 1 quart. 
Simmer the pepper (enclosed in a linen bag) in the spirits, and strain. Melt 
the other articles together, and add the tincture; simmer till the spirits is 
nearly all evaporated. Take it from the fire, and, when nearly cold, add 
two ounces of fine camphor and three drachms of oil of sassafras. 
Use.-This is used whenever a strengthening plaster is wanted. It sel- 
dom or never fails to afford relief. 
Poultices or cataplasms are external applications, of a soft or pulpy con 
POULTICES. COMPOUNDS 
713 
sistence. and somewhat tenacious. They are of various kinds : some are 
designed for discutients, others to produce suppuration ; some are refrigerant 
or cooling, while others are stimulating; others, again, are emollient. In 
general, poultices are best applied warm or tepid ; and they should not be 
suffered to get dry before renewed. 
Take of Linseed, powdered, 4 ounces. 
Hot water, } pint. 
Gradually sprinkle the powder into the water, and stir well together with 
a spoon. 
Use.-This is a good and convenient emollient poultice for many cases. 
It is preferable to the bread and milk poultice, so much in use, as it is not so 
liable to become brittle and hard when dry. It is very useful in carbuncle, 
obstinate inflammation, &c. 
Linseed Poultice. 
Take of Boiled carrots, bruised, 1 pound. 
Flour, 1 ounce. 
Butter, | do. 
Mix them with a sufficient quantity of hot water to form a pulp. 
Use.-This will be found a valuable application to ulcerated sores and 
swellings, scrofulous sores of an irritable kind, and many other inveterate 
ulcers. 
Carrot Poultice. 
Take of Mustard, in powder, 4 ounces. 
Soft bread, or Indian meal, 6 do. 
Vinegar, of the best quality, as much as is sufficient to mix, and make into 
a cataplasm. 
Use.-This is found to be a good application to the soles of the feet in 
cases of rheumatism, gout, inflammatory diseases, fevers, &c. 
Mustard Cataplasm. 
Common Poultice. 
Take of slippery elm bark a sufficient quantity, pulverized; stir it in hot 
or warm milk and water, to the consistence of a poultice. 
Use.-This poultice exceeds every other in point of efficacy. It is of 
almost universal application, and removes inflammation sooner than any 
other. Compared to this, every other poultice dwindles into insignificance. 
Alkaline Poultice. 
Take of ley, rather weak, warm it, and stir in of slippery elm bark suffi- 
cient to form a poultice. 
Use.-This poultice is useful in inflammation of the breast and other 
parts, in felons, white swellings, lock-jaw, wounds, fistulas, &c. 
Yeast Poultice. 
Take of Milk, blood-warm, 1 pint. 
Yeast 1 gill. 
Stir in fine slippery elm bark, to form a poultice. 
Use.-This is a good antiseptic and refrigerant poultice. Applied to gan- 
grenous ulcers, it is more efficacious than any other; it sooner arrests mor- 
tification, used with proper auxiliaries. It is also very serviceable in other 
species of inflammation. 714 
PHARMACY AND DISPENSATORY. 
Indian Turnip Poultice. 
Take of the tops and roots of Indian turnip, if green; if dry, the roots 
only ; simmer in water, and add slippery elm bark sufficient to form into a 
poultice. 
Use.-This poultice is used in the treatment of king's evil or scrofula 
with the best effect. I think it altogether superior to every other poultice 
in scrofula in a state of swelling and inflammation. 
Potatoe Poultice. 
Boil the common potatoe, mash or bruise soft, and then stir in the slip- 
pery elm bark. 
Use.-This poultice has been used with success in ophthalmia of an acute 
character, when other means have failed. 
Cicuta Poultice. 
Take the plant, green or dry, and boil in milk and water until it is very 
soft; add a very small quantity of the slippery elm bark, sufficient to make 
it adhere ; apply it blood-warm. 
Use.-It is excellent to produce suppuration, especially in those swellings 
where the glands are indurated, inflamed breasts, testicles, cancers, &c. 
Scrape the common carrot, add to it a decoction of spikenard root, and stir 
in Indian meal. 
Use.-The late Dr. Ferris was in the habit of using this poultice in cases 
of inflammation bordering on gangrene or mortification. 
Ferris'>s Poultice. 
Black Willow Poultice. 
Take the root of black willow bark, (called pussy willow,) pulverized, a 
sufficient quantity ; form it into a poultice by the addition of cream. 
Use.-This is the common poultice of the celebrated Dr. Bone, of New 
Jersey, who has acquired great celebrity for the successful treatment of in- 
flammation and ulcers. 
PILLS. 
Pills are certain small, round substances, composed of vegetables, and are 
designed to operate in a small dose : the disagreeable taste or smell of them 
renders it necessary that they should be concealed from the palate. 
In general, they do not operate as soon as medicine in other forms. Pills 
are a good form to administer some kinds of medicine, as some can take it 
made in this manner better than any other. 
take of Socotorine aloes, 4 ounces. 
Castile soap, _ 2 do. 
Colocynth, . _ 2 do. 
Gamboge, 2 do. 
Extract of gentian, 4 do. 
Oil of cloves, 2 drachms. 
Mix, and form into pills of the size of a pea. 
Dose.-One or two morning and evening, according as they operate. 
Anti-dyspeptic Pills. COMPOUNDS. 
715 
Use.-This is a very valuable pill; while it cleanses the stomach it restores 
the tone, without creating debility. 
Nervous or Hysteric Pill. 
Take of Asafcetida, - - 1 ounce. 
Opium, 1 do. 
Carbonate of ammonia, 1 do. 
Dissolve the same over a fire, mix, and form into pills of the size of a pea. 
Dose.-One or two. 
Use.-It is useful in hysterics, and all nervous cases. 
Opium Pill. 
Take of Turkey opium, cut out the soft part, and form it into pills of the 
size of a pea, (three grains,) and rub them in a little flour. 
Dose.-One every hour; or two, if necessary. 
Use.-This is the best form to give opium in very urgent and acute cases. 
Tn vomiting from any cause, attended with spasm, it affords prompt relief. 
It is useful in colic, &c. 
Hepatic Pill. 
Take extract of dandelion ; mandrake, pulverized ; blood-root, pulverized ; 
of each equal parts, or sufficient to make a pill mass ; add a few drops of 
essential oil, peppermint, or spearmint, and form into common sized pillc. 
Take three night and morning. 
This is an extraordinary remedy for the liver complaint. It generally soon 
removes the pain in the side, shoulder, &c., and is excellent in jaundice and 
affections of the kidneys. The irritating plaster should be worn over the 
seat of the disease. An amendment is sure to follow their use in a few days. 
Croton Pill. 
Take of Croton oil, 2 drops. 
Extract of rhubarb or mandrake, 1 drachm. 
Form into twelve pills, and take two or three every night: they will keep 
the bowels regular, without debility. 
Ipecac Pill. 
Add molasses or mucilage of gum Arabic, and form into pills size of a 
pea. Dose, one or two three times a day. Good for fever, dyspepsia, &c. 
Rheumatic Pill. 
Inspissated juice of poke; gum turpentine ; gum guaiacum, pulverized ; 
mix all, melt, and strain. When sufficiently cool, form into pills common 
size. Dose, three morning, noon, and night. Excellent for rheumatism. 
Female Pill. 
Crocus martis or red oxide of iron ; white turpentine ; aloes, pulverized : 
slowly melt the turpentine, and strain ; then add the aloes and iron, and form 
into pills. Dose, three or four two or three times a day ; to be taken with 
motherwort tea, for obstructed menses. 716 
PHARMACY AND DISPENSATORY. 
Take of Extract of mandrake, 2 parts. 
Capsicum, 1 do. 
Mix : form into pills common size. Dose, three or four every night, or 
sufficient to regulate the bowels. Excellent for liver, bilious, dropsical, 
dyspeptic, and nervous complaints. 
Mandrake Pill. 
Pill for Chronic Bronchitis and Asthma. 
" The following preparation," says Dr. J. King, " may almost be called a 
specific for the cure of chronic bronchitis." " I have used it," says he, " in 
several cases, and performed cures in each: Make a pill of tar, loaf sugar, and 
pulverized skunk cabbage-root: take one every one, two, or three hours, as 
they agree with the stomach, and continue daily till cured ; which, in my 
cases, was from four to six weeks." 
Cicuta Pill. 
Take of Cicuta leaves, add sufficient turpentine to form into pills. 
Dose.-One or two may be given for a dose. 
Use.-This pill aids in discussing hard, glandular tumours. 
Take of Jalap, 1 scruple. 
Scarnmony, 1 do. 
Gamboge, 1 do. 
Add mucilage of gum Arabic,enough to form into pills. Make sixteen pills. 
Dose.-One every hour. 
Use.-This pill has cured the dropsy of the chest, and may be given 
when other means fail. 
Hydragogue Pill. 
Red or Stimulating Pill. 
Take of Cayenne pepper, add sufficient of molossesand flour to form into pills. 
Use.-Useful in dropsy of the chest, asthma, flatulence, indigestion, 
pain, &c. 
Dose.-Give three pills three times a day; or take them occasionally. 
These pills cured a person labouring under dyspepsia, when other means 
had failed. It also cured a case of pain in the breast. 
Nervous Pill. 
Take of Extract of foreign valerian, 
Extract of chamomile, 
equal parts. 
Mix, and form into three grain pills, and take three or four a day. Useful 
in Chorea and nervous cases. 
Take best Aloes, pulverized, 4 ounces. 
Dry Castile soap, fine, | do. 
Gamboge, fine, 1 do. 
Colocynth, 1 do. 
Extract of gentian, 1 do. 
Mandrake, 1 do. 
Capsicum, 2 do. 
Oil of peppermint, ..................................... | drachm. 
Incorporate well together, and form into pills. 
Dose.-From three to five. This makes one of the best pills for all ordi- 
nary complaints, and purges without griping or causing debility, or leaving 
the bowels costive. 
Anti-bilious Pill. COMPOUNDS. 
717 
Take of Musk, 24 grains. 
Extract of opium, 12 do. 
Extract of valerian, 24 do. 
Make sixteen pills. 
Dose.-Give one or two occasionally. 
JJnti-hysteric Pill. 
POWDERS. 
Powders are the most simple and natural form in which medicine can be 
given, as their virtues are not impaired by passing through any particular 
process; but when it is necessary to administer a large quantity of any article, 
they cannot be conveniently taken in this form. They are either simple or 
compound. All powders should be kept in a glass vessel, closely stopped, 
and from the light, otherwise their virtues may be impaired. 
Powders may be administered in molasses, honey, syrup, tea, or any 
other suitable vehicle. 
Snuff Powder. 
Take of High laurel, 1 ounce. 
Sassafras, 1 do. 
Blood-root, 1 do. 
Pulverized ; mix well. 
Use.-Good for catarrh, obstructions of the head, &c. 
Anti-bilious or Cathartic Powder, Common Purgative or Physic. 
Take of Jalap-root, 1 pound. 
Alexandria senna, 2 do. 
Cloves, 2 ounces 
Let these articles be separately pulverized ; then mix them together, ano 
pass through a fine sieve. 
Dose.-A tea-spoonful, (about a drachm.) It should be put into a tea- 
cup, with a lump of loaf sugar, and a gill of boiling water added ; given to 
the patient when cool, fasting, or on an empty stomach. 
Use.-This forms the best general purgative that is now known. It 
combines power with mildness of action, and acts throughout the whole ali- 
mentary canal, cleansing it, and producing a healthy action. It may be 
given to every age and sex; it removes offensive accumulations in the 
bowels without bringing on subsequent constipation ; and it stimulates 
every contiguous organ to a healthy state. It is useful in all diseases where 
physic is required. It is very valuable in bilious and febrile diseases. The 
articles must be genuine. I have seen it made so bad that I could not 
recognise it. Gruel alone to be drank during the day the above is taken. 
Fever and Ague Powder. 
Take of Sulphate of quinine, 1 scruple. 
Capsicum, 2 do. 
Mix, and rub well in a mortar ; divide into ten powders, and give one 
every two hours, in syrup, after having cleansed the stomach and bowels. 
A sure remedy for chills and fever ; and excellent where the wine tincture 
cannot be taken. 
Take best Turkey opium, and suspend it in a bag in the chimney till hard 
or dry : pulverize, and sift. 
Take of this opium, | ounce. 
Capsicum, 1 do. 
Mix, and rub well in a mortar. 
Anodyne Powder. 718 
PHARMACY AND DISPENSATORY. 
Dose.-From two to four grains, in syrup, every two or four hours till 
relief is obtained. This is a powerful anodyne, and is sure to relieve pain 
when all other means fail; but should only be given in urgent cases, and 
when no relief can be obtained by other means. Exceedingly valuable in 
fits, lock-jaw, colic, and severe pain. 
Common Emetic Powder 
Take of Ipecacuanha, 4 ounces. 
Lobelia, 4 do. 
Blood-root, - - 2 do. 
Pulverize separately. 
Dose.-A tea-spoonful, given every thirty minutes till it operates. It 
should generally be given in warm boneset or chamomile flower tea. If 
the first or second portions are rejected, continue to give it till vomiting 
takes place. 
Use.-This emetic, perhaps, is unsurpassed by any other for efficacy of 
action. It is administered in all those cases where an emetic is indicated ; 
and, from its extensive effects upon the system, is very efficacious in breaking 
up morbid associations, or exciting a healthy action of the system. It is 
useful in febrile and other diseases, &c. Excellent in the chronic affections 
of the liver, stomach, and intestines : drink freely of herb tea. 
King's Emetic. 
Says Dr. King, 111 use the following powder for an emetic. The skunk 
cabbage seems to prevent any unpleasant spasm : 
Take of Lobelia, 12 ounces 
Blood-root 6 do. 
Skunk Cabbage, . _ 6 do. 
Ipecac, 8 do 
Capsicum, 2 do. 
Mix. 
Dose.-Half a tea-spoonful, in boneset tea, every fifteen minutes till it 
operates. If the first or second doses are rejected, repeat. Boneset facilitates 
and renders the operation less severe." 
Bone's Emetic and Cathartic Powder. 
Take of Euphorbia ipecacuanha, (half a tea-spoonful,) 12 grams. 
To be given in molasses. 
Use.-This is excellent in dropsy, obstruction of the menses, jaundice, and 
liver complaint. This medicine is much given by Dr. Bone. 
Take of Flour of sulphur, 4 ounces. 
Gum myrrh, 4 do. 
Steel filings, fine, 4 do. 
Loaf sugar, 4 do. 
Add to these articles a quart of wine, and simmer till nearly dry ; remove 
from the fire, and, when cold, pulverize, and bottle for use. 
Dose.-Half a tea-spoonful three times a day, to be taken in molasses ; 
or the same quantity may be taken in the form of pills. 
Use.-This forms an excellent preparation for the treatment of amenorr- 
hcea or obstructed menses, when that complaint is an idiopathic or primary 
disease. 
Emmenagogue, Black, or Tonic Powder. COMPOUNDS. 
719 
Take of Gum opium, | drachm. 
Camphor 2 do. 
Pulverized ipecacuanha, - 1 do. 
Cream of tartar, or super-carbonate of soda, 1 ounce. 
Pulverize all separately, then mix. It is best to use pulverized opium. 
Dose.-Ten grains, or half a tea-spoonful, as often as may be necessary. 
Use.-This forms a valuable anodyne, diaphoretic, and sudorific. It is 
beneficially administered in fever, St. Anthony's fire, diarrhoea, dysentery, 
and cholera morbus, and in all cases where an anodyne, combined with a 
sudorific, is required. In these diseases it should be administered in small 
doses. It is also applicable to many other diseases, such as rheumatism, 
gout, &c. It promotes perspiration without increasing the heat of the body. 
It produces a constant moisture of the skin for a great length of time, while 
it allays irritation. 
Dr. F. H. Judd, of Greenville, Pa., Mercer county, substitutes the 
super-carbonate of soda in place of cream of tartar. He considers it a great 
improvement. He follows the reformed practice with extraordinary success. 
Diaphoretic Powder. 
Take of boneset, and pulverize it very fine. 
Dose.-From a tea-spoonful to a table-spoonful three or four times a day, to 
be taken fasting ; mixed in half a pint of hoarhound tea, and sweetened. 
Use.-These powders have been used with considerable success in the 
treatment of dyspepsia, intermittent fever, and pulmonary diseases. 
Eupatorium Powder. 
Smith's Cough Powder. 
Take of Elecampane-root, 2 ounces 
Liquorice-root, 2 do. 
Blood-root, _ . 2 do. 
Crane's bill, -. 2 do. 
Indian turnip, - 2 do. 
Pulverize fine. 
Dose.-Half a tea-spoonful three times a day. 
Use.-Good expectorant, pectoral, and tonic. 
Smith's Colic Powder. 
Take of Pleurisy root, 1 ounce. 
Cayenne pepper, ........ 1 drachm 
Pulverize, and mix in half a pint of water. 
Dose.-One table-spoonful every twenty minutes till it operates or relieves. 
Fever Powder. 
Take of dragon's claw, pulverized. 
Dose.-A tea-spoonful, infused in a proper quantity of water, morning and 
evening. 
Use.-These powders have been much celebrated in the treatment of 
fevers, and particularly of that species called hectic fever. They act as a 
mild, but efficient, sudorific, without increasing the force of the circulation. 
They may be safely administered in almost every stage of fever. 
Take of Blood-root, 1 ounce. 
Bark of the root of bayberry, 1 do. 
Common snuff, 1 do 
Mix. 
Cephalic Powder. 720 
PHARMACY AND DISPENSATORY. 
Use.-Useful in catarrh, headache, polypus, &c. 
Red or Styptic Powder. 
Take of copperas ; submit it to a red heat, in a flame of fire ; a decompo- 
sition is effected, and a red substance is formed. This, pulverized, forms a 
powder containing highly styptic and astringent properties. 
Use.-It is used in the treatment of bleeding, (piles,) and in stopping 
haemorrhage or bleeding. It may be mixed with a little melted tallow, and 
introduced up the rectum, for the bleeding piles. It is very good, in salt 
rheum, mixed with fresh butter. 
Take of Socotorine aloes, 8 ounces 
Gum myrrh, 1 do. 
Cinnamon, 1 do. 
Cloves, 1 do. 
Ginger, 1 do. 
Saffron, ... 1 do. 
Garden sunflower, 4 do 
Pulverize fine, and mix. 
Dose.-A tea-spoonful every hour till it operates. 
Use.-This preparation has been celebrated as a remedy in the treatment 
of bilious colic. 
Hull's Bilious Physic. 
Henry'1 s Cephalic Snuff. 
Take the roots of daisies, yarrow, and white hellebore, colt's foot leaves, 
and bayberry bark, of each one ounce, finely pulverized, and sift through 
gauze ; mix the powders well together in a mortar, and drop in it one drachm 
of the essence of bergamot; after which put it in a bottle, closely corked, 
for use. 
Dose.-A small pinch of this snuff may be taken at bed-time, as a cure 
for vertigo, " megrims," obstructions from catarrh, &c.; and I have found 
it effectual in relieving the headache. 
Cephalic Powder. 
Take black pepper, pulverized, two tea-spoonsful; stramonium, a table- 
spoonful ; sage, a table-spoonful: mix well together, smoke in a new pipe, 
and force the smoke through the nose. Excellent for catarrh and pain in 
the head. 
Compound Powder of Mandrake 
Take of Pulverized mandrake, .... 
Pulverized spearmint, - 
Cream of tartar, 
equal parts. 
Mix. 
Dose.-A tea-spoonful, in tea or syrup. 
Use-Useful in diseases of the liver, dyspepsia, obstructed menses, dropsy, 
in venereal diseases, and in every taint of the system. 
I have this moment been to visit a young lady, whose menses had been 
obstructed for many months, attended with dizziness and pain in the head, 
enormous swelling of the abdomen, &c.; and where the exhibition of the 
above medicine, mandrake alone, every other morning, with two or three 
pills of gum turpentine, restored them, and removed the symptoms. COMPOUNDS. 
721 
Taka of Capsicum, 2 parts. 
Ipecac, 2 do. 
Pulverized opium, 1 do. 
Mix, and incorporate well together. 
Dose.-One-half as much as will lay upon a six-cent piece (five grains) 
every four hours, mixed with honey. 
Use--The above will allay irritation of the lungs when all other means 
prove unavailing. I give it in severe inflammation of the lungs and obstinate 
coughs, where other means afford no relief. 
Cough Powder. 
SALVES. 
Salves are medicines of proper consistence, for spreading on linen or 
muslin, designed for external use, for burns, ulcers, &c. They are formed 
by uniting wax, resin, or oil with some remedial agent, either vegetable or 
some of the metallic oxydes, such as red lead. They require to be made 
of a little harder consistence for summer than winter, and which may be 
done by adding or diminishing the quantity of oil. 
Salves designed for ulcers should be renewed about twice a day. 
Take of Olive oil, 3 quarts. 
Common resin, 3 ounces. 
Beeswax, 3 do. 
Melt these articles together, and raise the oil almost to boiling heat; then 
gradually add of pulverized red lead two and a quarter pounds, if it be in 
the winter ; if in the summer, two and a half pounds. In a short time after 
the lead is taken up by the oil, and the mixture becomes brown or a shining 
black, remove from the fire; and, when nearly cold, add of pulverized cam- 
phor half an ounce. 
It should remain on the fire until it forms a proper consistence for spread- 
ing, and which may be known by dipping a spatula or knife into it from time 
to time, and suffering it to cool. 
Use.-We have found this salve superior to every other, where applica- 
tions of this kind are required. It has an excellent effect in burns, in 
venereal, scrofulous, fistulous, and all other ulcers. 
It should be spread thin, on a piece of linen, and renewed once or twice 
a day. 
Black Plaster or Healing Salve. 
Green Salve. 
Take of Turpentine, . | pound. 
Bayberry tallow, j do. 
Dissolve together, and form into a salve ; add sweet oil, if necessary 
Use.-This salve is designed for scrofulous ulcers. 
Yellow Salve. 
Take one bushel of the roots of the baptisia tinctoria, or wild indigo weed, 
and boil till the strength is out; then strain, boil, and skim; add ten pounds of 
fresh butter, three pounds of beeswax, and one and a half pounds of mutton 
tallow ; then boil the water out, and strain till clear. 
Use.-This salve is used by Dr. Bone for all kinds of ulcers. It is cleans- 
ing, detergent, discutient, &c. It makes a very handsome and efficacious 
salve wherever one is required. 722 
PHARMACY AND DISPENSATORY. 
SYRUPS. 
Syrups are liquids containing the properties of certain vegetables in a very 
concentrated state : they are prepared by boiling the ingredients until their 
strength is extracted and much of the watery portion evaporated ; then 
adding a sufficient quantity of clarified sugar to prevent fermentation. 
Syrup is an excellent form to administer many kinds of medicines. They 
should always be kept in a cool place. 
In consequence of the oleaginous and other peculiar properties of most, 
or all, vegetables, water is not sufficient to extract their virtues ; it will be 
necessary to use spirits. The two menstruums combined answer this purpose 
admirably: after the alcohol has extracted the component parts of the plants 
or roots, it is evaporated by boiling, when no danger need be apprehended 
from its stimulating effects. 
Alterative Syrup. 
Take of American or foreign Sarsaparilla, 6 pounds 
Guaiacum shavings, 3 do. 
Sassafras-root bark, 2 do. 
Elder flowers, 2 do. 
Burdock-root, . 2 do. 
Add one gallon of cheap spirits and one gallon of water ; boil, and pour off 
the liquid ; then add water repeatedly, and boil till the strength is obtained, 
strain, and reduce to sixteen porter bottlesful; then add twenty-five pounds of 
sugar. Let it stand twenty-four hours to settle ; pour off, and bottle 
for use. 
The sugar may be clarified by adding to it half its weight of water, then 
a few eggs, and boiling till no more scum rises. 
Dose.-A wine glassful three or four times a day. 
Use.-This syrup, the alterative, we use in a great variety of cases. In 
syphilitic or venereal diseases, rheumatism, and chronic inflammation of the 
liver we could not dispense with it: we also use it in the treatment of 
scrofula, which presents itself in so many shapes. In some of the cutaneous 
diseases we find it very effectual: in every species of ulcer it is also valu- 
able ; white swelling, necrosis, rickets, salt rheum, or herpes ; and, in short, 
we have found it very useful in every taint of the system, from whatever 
cause it may arise. I have used Swaim's, and many other boasted nostrums, 
but I find this preferable to all of them. It appears to act upon all the secre- 
tions and excretions. A tea of yellow dock may be taken with it: half an 
ounce of the hydriodate of potash to every bottleful is a valuable addition. 
Take of Liverwort, 1 pound. 
Solomon's seal, 1 do. 
Skunk cabbage, 1 do. 
Blood-root, i i do. 
Water hoarhound, 1 do. 
Add a sufficient quantity of water ; boil, and pour off the water till the 
strength is obtained; strain, and boil to twenty porter bottlesful, and add 
twenty pounds of strained honey ; remove from the fire, and add one pint of 
brandy; let it settle, and bottle for use. 
Dose.-A wine glassful three or four times a day. 
Use.-This preparation is used in every variety of pulmonary disease, and 
particularly, however, in haemoptysis (bleeding at the lungs) and asthmatic 
affections. 
Vegetable Syrup. COMPOUNDS. 
723 
Take of Yellow dock-root, 2 pounds. 
Bark of bitter-sweet root, 2 do. 
Bruise, and boil till the strength is obtained ; then strain, and boil to twelve 
porter bottlesful ; add sugar sufficient to prevent fermentation. 
Dose.-A wine glassful three times a day. 
Use.-This syrup is useful in scrofula and herpetic affections. 
Scrofulous Syrup. 
White Poppy Syrup. 
Take of the capsules of white poppy, infuse them in warm water for 
twelve hours ; then boil and strain, and add sufficient sugar to preserve it. 
This forms a good anodyne, particularly for infants and children. 
Prepared in this manner, there appears to be less of the narcotic property 
of the herb, than when prepared with spirits. 
Dose.-The same dose is, therefore, required. 
Use.-It relieves coughs and pains similar to paregoric, and possesses 
about the same strength. 
Blackberry Syrup. 
Take two pounds of the bark of the root, well cleansed or washed, and add 
a suitable quantity of water; then boil two hours. Pour off the liquid ; then 
add more water ; and thus continue to boil and pour off'until all the strength 
is extracted ; then strain, and add all the boilings together. Simmer to two 
quarts ; strain ; then add four pounds of loaf sugar, and, when cool, add half 
a pint of best French brandy. 
Dose.-A table-spoonful three times a day, fasting. If it does not arrest 
the disease after taking it a few days, gradually increase the dose, as the 
stomach can bear it. 
Use.-This is a very valuable syrup in bowel complaints, particularly the 
chronic form. It will effect a cure when every other means fail. It appears 
to possess specific virtues, different from all other vegetables. 
A rob or jelly is made of the fruit by bruising it, pressing out the juice, 
straining, and adding sugar, which is useful to mix with water, and to drink. 
Hoarhound Syrup. 
Take of the leaves of hoarhound, dried, two ounces ; infuse them for 
twenty-four hours in half a pint of boiling water and as much spirits ; 
strain, and add quarter of a pound of honey and one tea-spoonful of the essence 
of lemon. 
Dose.-For an adult, one or two table-spoonsful every two hours. 
Use.-This is recommended for hoarseness, asthma, complaints of the 
breast, lungs, &c. It promotes the fluid secretions in general, and, if used 
very freely, will loosen the mucus. 
Syrup for the Dysentery. 
(Which, it is said, has never failed in thirty years.) 
Rhubarb and wild cherry bark, a handful; four table-spoonsful of sugar; 
simmer awhile. 
Dose--Give a table-spoonful every fifteen minutes until the pain ceases. 
Make it fresh every day, and add a little brandy. 
Use.-The above is taken from a work called the " Indian Physician,'1 
and is pronounced infallible in dysentery. 724 
PHARMACY AND DISPENSATORY. 
Expectorant Syrup. 
(From the same.) 
A handful of St. John's-wort; one of sage. Make a syrup. 
Dose.-For a child six months old, a tea-spoonful; for one of six years 
old, give a table-spoonful every fifteen minutes. 
Cough Syrup. 
Take of Iceland moss, ..................... 2 ounces 
Four poppy heads, 
One table-spoonful of barley, (whole.) 
Put in three pints of water, and boil down to two; strain. Then dissolve 
one pound brown rock candy. 
Dose.-A table-spoonful whenever the cough is troublesome. 
Use.-Useful in tickling cough. 
SPIRITS. 
Spirits are similar to tinctures ; they are usually compounded of several in- 
gredients. The principal menstruum is alcohol, either pure or diluted: 
sometimes spirits or vinegar alone are used to prepare this class of medicines. 
Compound Spirits of Lavender, (called Lavender Compound.) 
Take of Flowers of lavender, 2 drachma. 
Nutmeg, 2 do. 
Mace, 2 do. 
Cloves, 2 do. 
Cinnamon, 2 do. 
Pulverize, and add a quart of spirits. 
Dose.-One or two tea-spoonsful may be taken often, in a little water or 
tea. 
Use.-This pleasant, aromatic preparation is useful in debility, fainting, 
hysterics, and all nervous affections, pain in the breast, flatulence, &c. 
Take of Gum camphor, 1 ounce. 
Alcohol, 1 pint. 
Mix. 
Dose.-Half a tea-spoonful may be taken in a little water, sweetened. 
Use.-This preparation contains all the virtues of camphor : it is useful 
in flatulence, pain or sickness of the stomach, colic, cramp, &c. Combined 
with equal parts of spirits of lavender and essence of peppermint, it becomes 
more efficacious. I found much benefit from it myself during the cholera. 
Spirits of Camphor. 
SINAPISMS OR DRAUGHTS. 
Sinapisms and other stimulating draughts are employed with the same 
intention as the common blister, to produce counter-irritation; and they 
often give relief very speedily in internal pains and inflammation. Mustard 
poultices or plasters act much more quickly than blisters, and are free from 
that inconvenience and distress which arise from the latter. They should 
be applied sufficiently strong to produce a little pain, or to redden the skin ; 
after which they may be removed, and applied near the same place. They 
are excellent to relieve pain and inflammation of the head in febrile and COMPOUNDS. 
725 
other diseases; are very useful to equalize the circulation in very many com- 
plaints. Recently I have substituted mustard plasters for blisters. 
Mustard Sinapism. 
Take of Mustard, 
Rye, Indian, or oat meal, 
> equal parts. 
Form it into a proper consistence by the addition of vinegar. 
Use.-This plaster answers all the purposes of a blister, without its being 
attended with any of the distressing effects which generally result from its 
application. They should be made sufficiently strong to redden, but not to 
break, the skin. They may be very often changed from place to place with 
a good effect. They are very valuable, applied to the feet, to cause revul- 
sion or equalize the circulation ; hence they are useful in fevers, inflam- 
mation, &c- 
Garlic and Onion Sinapism. 
Bruise garlic or raw onions, and apply. 
Use.-Useful in the same diseases as the preceding, in pneumonia or in- 
flammation of the lungs, &c. 
TINCTURES. 
Tinctures are certain active ingredients, principally vegetable substances, 
which are imparted to alcohol, spirits, or wine. Tinctures are excellent for 
administering a great variety of medicinal agents ; but in some cases there 
may be an objection to them, in consequence of the spirits which they con- 
tain. Substances yield their virtues more readily to spirits by the addition 
of heat. 
Hydragogue Tincture. 
Take of Bark of sweet elder, 1 pound. 
Good wine, 1 gallon. 
Let it simmer an hour; strain, and bottle. 
Dose.-A wine glassful three or four times a day. 
Use.-This tincture is usefully administered in dropsical affections, par- 
ticularly in abdominal dropsy. It has cured many without any other in- 
gredient. ' • - .. 
Botanical Tincture. 
Take of Gum guaiacum, 1 ounce. 
Nitre, 1 do. 
Camphor, - 2 drachms. 
Balsam tolu, 2 do. 
Spirits, 2 quarts. 
Mix. 
Dose.-Two tea-spoonsful three or four times a day, to be taken in a 
tumbler of prickly-ash tea. 
Use.-This formula I obtained from Dr. Budd, a celebrated physician in 
New Jersey. He procured it from another physician in Charleston, S. C. 
It is highly extolled in rheumatism and many external painful chronic affec- 
tions. I have used it but little; but the doctor informs me he is so partial 
to it that he usually prepares five gallons at a time. 
Take of Pulverized lobelia, seeds or pods, 2 ounces. 
Spirits, 2 quarts. 
Let it stand two or three days, or longer, and filter. 
Tincture of Lobelia. 726 
PHARMACY AND DISPENSATORY. 
Dose.-From a tea-spoonful to a table-spoonful, as often as necessary. 
Use.-This tincture is an excellent remedy in the treatment of asthma, 
croup, and pulmonary affections. It is also given in tetanus and poisons. 
Tincture of Hops. 
Saturate alcohol with the pollen of hops. 
Dose.-From one to two tea-spoonsful, in milk. 
Use.-Useful in after-pains, and in cases where opium cannot be taken. 
Take of Balsam tolu, • 1 ounce. 
Alcohol, 1 pint. 
Let it stand one week, and filter. 
Use.-This is combined with the compound tincture of senna, for the 
water-brash. 
Tincture of Balsam Tolu. 
Take of Castor, 2 ounces. 
Spirits, 1 quart. 
Let it digest one week. 
Use.-Useful in nervous diseases and suppressed menses. 
Tincture of Castor. 
Anti-spasmodic Tincture. 
Take of Tincture of lobelia, 1 pint. 
Tincture of Capsicum, 1 do. 
Compound tincture of valerian or nervine, 3 gills. 
Mix, and bottle for use. 
Dose.-From a tea-spoonful to a table-spoonful, jn a gill of water or herb tea; 
to be given every twenty minutes. 
Use.-Dr. Booth, of Alabama, states that he has found it an infallible 
remedy for fever and ague. He gives a tea-spoonful just before the cold 
stage of the disease; to be repeated every twenty minutes until nausea 
or vomiting takes place. 
This tincture is also recommended for fits, spasms, and all violent attacks 
of disease ; suspended animation from drowning, hanging, lightning, or any 
other cause. Also good in cases where poisonous substances have been taken- 
Compound Tincture of Valerian or Nervine. 
Take of Skull-cap, 4 ounces 
American valerian, or ladies' slipper, 4 do. 
Best French brandy, 1 quart. 
Bruise the plants, and add to the brandy. 
Dose.-From a tea-spoonful to a table-spoonful occasionally, in sweet- 
ened water. 
Use.-This tincture is useful in all nervous diseases 
Balm of Gilead. 
Take of Balm of Gilead buds, bruised - 2 ounces 
The strongest Jamaica spirits, 1 quart. 
Digest a few days. 
Dose.-From a tea-spoonful to a table-spoonful, mixed with sweetened 
water. This has benefited many. 
Use.-Excellent for colds, coughs, and pain in the breast. COMPOUNDS. 
727 
Take of Good sour or hard cider, 4 gallons. 
White oak bark, - 10 ounces. 
Horseradish root, 1 pound. 
Seneca snake-root, . 6 ounces. 
Carbonate of iron, 6 do. 
Golden seal root, 4 do. 
Capsicum, 2 do. 
Bruise all fine and put in the cider; let it be shaken up every day for 
eight or ten days. 
Use.-A sure remedy for intermittent fever, debility, and impoverished 
state of the blood. It is excellent in obstructed menses, and the dropsy, 
worms, &c. 
Dose.-For an adult, half or two-thirds of a wine glassful three times a 
day ; for children, according to their age. 
The above was communicated by Isaac S. Smith, M.D., of this city, a 
very judicious physician of the Reformed School of Medicine. 
Tonic Tincture. {For four gallons.) 
Stimulating Drops, Hot Drops, Tincture of Capsicum. 
Take of African capsicum or Cayenne pepper, 1 ounce. 
Best French brandy, 1 pint. 
Mix. 
Dose.-From half to a tea-spoonful, in plenty of sweetened water. 
Use.-Good internally and externally; for pain in the stomach and bowels, 
cold and languid circulation, &c. Repeat, if necessary. 
A patient has just stepped into the office to whom I gave most of our 
ordinary remedies without any benefit; finally, I administered the tincture 
of capsicum, which immediately removed the pain. 
Take of Alexandria senna, 2 ounces. 
Jalap, 1 do. 
Fennel seeds, J do. 
Spirits or best brandy, 1 quart. 
Let it stand one week, and then strain. 
Dose.-A tea-spoonful or two to a child one year old, mixed with a little 
sweetened water. 
Use.-A mild, but effectual, purgative. This forms an excellent purgative, 
particularly for children. It acts mildly, but effectually, cleansing well the 
stomach and bowels ; besides, it is very pleasant. 
Physical Tincture, Elixir Salutis, or Compound Tincture of Senna. 
Take of Turkey opium, 2 ounces. 
Proof spirits, 1 quart. 
Let it stand a week. 
Dose.-From thirty to one hundred drops. 
Use.-Given as an anodyne. 
Laudanum, or Tincture of Opium. 
Compound Tincture of Camphor, or Paregoric. 
Take of Opium, 1 drachm. 
Flowers of benzoin, 1 do. 
Camphor, 2 scruples. 
Anise, . . I drachm. 
Proof spirits, ........ 1 quart. 
Dose.-A tea-spoonful for a child a year old. 728 
PHARMACY AND DISPENSATORY. 
Use.-Given to allay irritation or pain, for flatulence or wind, in coughs, 
&c. This preparation should be sparingly used. 
Tincture of Stramonium. 
Take of Pulverized seeds of stramonium, - 2 ounces. 
Proof spirits, - 1 quart. 
Let it stand one week. 
Dose.-Twenty-five drops twice a day. In cases of fits it may be increased 
until the pupil of the eye becomes somewhat dilated, or until it causes a 
little pain or dizziness in the head. 
Use.-It is useful in epilepsy, neuralgia, palpitation of the heart, &c. 
Take of Capsicum, . | ounce. 
Blood-root, 1 do. 
Lobelia seeds, 1 do. 
Ipecac, 2 do. 
Wine, spirits, or metheglin, 3 pints. 
Let it stand one week. When taken, mix with water. 
Dose.-A table-spoonful twice a day, or as often as may be necessary. 
Use.-It is useful in inflammation of the lungs, pleurisy, hooping-cough, 
consumption, fits, &c., and when there is any difficulty of expectoration. 
Expectorant and Anti-spasmodic Tincture. 
Tincture of Cohosh. 
Take of Black cohosh, the root, 3 ounces. 
Proof spirits or wine, 1 quart. 
Let it stand a few days. 
Dose.-Half a table-spoonful three or four times a day. 
Use.-Useful in obstinate coughs, rheumatism, and impurity of the blood. 
It is highly recommended by Dr. Cooke, for hooping-cough. 
Tincture of Fox-glove. 
Take of Fox-glove, 1 ounce. 
Proof spirits, 1 pint. 
Digest one week, and strain. 
Dose.-From fifteen to twenty drops, to be given three or four times a 
day, in parsley tea. 
Use.-Used for inflammatory diseases. It lessens the pulse, by diminish- 
ing arterial excitement, and thereby prevents the necessity of blood-letting. 
It is recommended in inflammation of the lungs. It is also very valuable in 
dropsy of the chest. 
Take of Ipecac, 2 ounces. 
Saffron, . 2 do. 
Camphor, 2 do. 
Virginia snake-root, 2 do. 
Opium, 2 do. 
Holland gin, or Jamaica spirits, 3 quarts. 
Let it stand two weeks, and filter. 
Dose.-One tea-spoonful, given in a tumblerful of catnip tea, every hour 
or two till it produces perspiration. 
Use.-This medicine is probably unsurpassed in fulfilling the indications 
for which it is given, which is generally to produce free perspiration. One 
or two doses, aided by warm infusions, and bathing the feet, cause a copious 
perspiration. Hence it is useful in a variety of diseases : in fever, inflam- 
Sudorific Tincture or Sweating Drops. COMPOUNDS, 
729 
mation, &c., I know of no medicine so certain in its operation. I should be 
much gratified to find the same effect from some native plant. Perhaps the 
sweat root (polemonium reptans') of Ohio will fulfill the same indications: 
it is called Greek valerian, abscess root, &c. I hope it will be more fully 
tested. 
Take of Peruvian bark 2 ounces. 
Wild cherry tree bark, 1 do. 
Cinnamon, . . 1 drachm. 
Cloves, 1 do. 
Nutmegs, 1 do. 
Capsicum, 1 tea-spoonful. 
Sulphur, 1 ounce. 
Wine, 2 quarts. 
Let it stand awhile. All the articles to be pulverized. 
Dose.-A wine glassful every two or three hours. 
Use.-This mixture we have found an infallible cure for intermittent fever, 
or fever and ague. It removes it when all other means fail. 
Tonic Wine Tincture. 
ESSENCES. 
Essences are made by adding alcohol to the essential oils, in proportion of 
one ounce of oil to sixteen ounces of alcohol. They are useful externally, 
to relieve pain, and used with advantage internally, for many complaints. 
Essence of Peppermint. 
Take of Oil of Peppermint, 1 ounce. 
Alcohol, 1 pint. 
Mix. 
Dose.-A tea-spoonful. 
Use.-Useful in pain of the breast, cramp, sickness of the stomach, &c. 
Essence of Hemlock. 
Made in the same manner. 
Dose.-Twenty-five or thirty drops, on sugar or in tea. 
Use.-Useful in rheumatism and pain in the breast; also for sprains, &c 
Essence of Sassafras. 
Made in the same manner. 9 
Use.-It is useful in gout and rheumatism, pain in the breast, lumbago, 
sciatica, contusions, &c. 
The other essences are made in the same manner, and their virtues are 
the same as the oils from which they are made. 
TROCHES OR SUPPOSITORIES. 
These are solid remedies, of the conical form, intended to be introduced 
into the rectum, and to remain there for a certain length of time, to act as 
stimulants and discutients. 730 
PHARMACY AND DISPENSATORY. 
Take of Aloes, pulverized, - | ounce 
Gum myrrh, pulverized, -| do. 
Castile soap, shavings,J- do. 
Sugar lead, J- do. 
Oxide of copper,| do. 
Vegetable caustic, j do. 
Pulverize?, and add two quarts molasses ; put the whole in an iron vessel, and 
simmer until, upon trial, the mass becomes sufficiently hard to form into 
small troches, about the size convenient for introduction per anus. 
One or two, introduced up the rectum daily, are excellent for the piles and 
strictures of the bowel. 
Troches. 
Washes or lotions are certain liquids, in which are suspended medicinal 
agents, and designed principally for external use. 
WASHES. 
Take Bayberry, 
Lobelia, . 
Yellow dock, 
Herpetic Wash 
equal parts. 
Bruise, and add a table-spoonful to one pint of vinegar or spirits 
Use.-Bathe often for eruptions of the skin. 
Alkaline JFasA. 
Ley made of hickory ashes, weak; or, which may be better for some 
reasons, a solution of sal soda. 
Use.-These are remarkably efficacious for fevers, by bathing the surface 
often. Extraordinary benefit attends this practice; equal, if not superior, 
to internal medicine. 
Ophthalmic or Cooling Wash. 
Take of Borax, pulverized, 1 ounce. 
Rain or spring water, ........ 1 quart 
Let it stand twelve hours. 
Use.-This forms a very cooling and useful wash for all kinds of inflam- 
mation, particularly the eyes ; also sore and inflamed nipples, canker, and 
sore mouth and throat. It may be applied freely and often. 
Refrigerant or Cooling Lotion or IFos/i. 
Take of Sugar of lead, . 1 drachm. 
Rain water, . - | pint. 
Mix. 
Use.-This wash is cooling or refrigerant, and serviceable in inflammation, 
particularly erysipelatous. 
Take of Borax water . 1 pint. 
Muriate of mercury, 1 drachm. 
Mix. 
Use.-This wash has been used occasionally as a mild and cleansing 
caustic, in the treatment of venereal and indolent ulcers. Seldom used. 
Yellow Wash. COMPOUNDS. 
731 
Take of Fine salt, - 1 ounce 
Spirits, - i pint. 
Vinegar, -- i do. 
Rain water, i do. 
Or equal parts. Mix. 
Use.-This makes a good refrigerant or cooling wash for many kinds of 
inflammations. We are in the habit of prescribing it, particularly in inflam- 
mation of the brain, dropsy of the head, &c. Sometimes it is applied tepid, 
at other times cool; but seldom cold, except in very urgent cases. 
Saline Wash. 
Astringent Wash. 
Take of Dried bark of large hemlock, ' 
Upland sumach-root bark, 
Witch-hazel bark, 
White oak bark 
■equal parts. 
Make a strong decoction. 
Use.-This is useful to inject in fluor albus, to wash the parts in pro- 
lapsus ani, and utero or falling of the bowel and womb. An excellent 
method is, to wet a sponge, tie a piece of tape to it, and keep it up the uterus 
till the complaint is cured. A decoction of oak and alum will answer. 
MIXTURES. 
Mixtures are a combination of medicines in a liquid form, or when sub- 
stances are diffused through liquids by means of mucilage or syrup. 
Take of Epsom salts, i pound. 
Rochelle salts, i do. 
Sulphate of potash, (vitriolated tartar,)i do. 
Common salt,i do. 
Mix, and add one gallon of boiling water; when cool, add one ounce of 
muriatic acid and one ounce of nitric acid. 
Dose.-From one to two table-spoonsful every two hours till it purges, in 
cold water. 
Use.-A cooling purgative ; good to allay sickness at the stomach, vomit- 
ing, for colic, bilious and bowel complaints, &c. A tumblerful of warm herb 
tea to be taken after each dose. 
Saline Physic, White Liquid Physic. 
Anti-choleric and Anti-spasmodic Mixture. 
Take of Camphor mixture, 4 ounces. 
Essence of peppermint . .... 4 do. 
Tincture of capsicum, 1 drachm 
Syrup of ginger, - } ounce. 
Mix. 
Dose.-One table-spoonful every quarter, half, or one and two hours, ac- 
cording to the urgency of the symptoms. 
Use.-This mixture is useful in the malignant or spasmodic cholera, 
cramp of the stomach, fits, &c. 
Nervous Mixture. 
Take of Mixture or liquid carbonate of ammonia, J drachm. 
Mint water, distilled, ... --- 14 ounces* 
Compound tincture cardamon, . i do. 
Mix. 732 
PHARMACY AND DISPENSATORY. 
Dose--Two table-spoonsful three times a day. 
Use.-Useful in fainting, hysterics, debility, and all nervous cases. 
Neutralizing Mixture, Neutralizing Cordial or Physic. 
Take of Rhubarb, pulverized, 
Sal aeratus, pulverized, 
Peppermint plant, pulverized, 
equal parts. 
To a large tea-spoonful add half a pint of boiling water ; when cool, strain, 
sweeten with loaf sugar, and add a table-spoonful of brandy. 
Dose.-One or two table-spoonsful every quarter, half, or one or two 
hours, according to symptoms. 
Use.-This is one of the most valuable preparations known for cholera 
morbus, cholera infantum, or summer complaint of children, diarrhoea, dysen- 
tery, &c. Its operation and action appear to be a specific, if not infallible. 
It is excellent for pregnant women, to allay sickness and regulate the bowels. 
Pile Electuary. 
ELECTUARIES. 
Take of Cream of tartar, 1 ounce. 
Jalap, pulverized, 1 do. 
Electuary of senna, 2 do. 
Cream or flowers of sulphur, J do. 
Nitrate of potash, | do. 
Add molasses sufficient to make a pill or thick mass : roll into small cakes, 
quarter of an inch square; dissolve one in water and take every night; or it 
may be formed into pills common size, and four taken night and morning. 
This makes a very superior remedy for the blind and bleeding piles. It 
usually excels all others : it corrects a faulty state of the biliary organs, 
which produces costiveness, and, subsequently, the piles. 
Electuary of Senna, Lenitive Electuary. 
Take of Alexandria senna leaves, 8 ounces. 
Figs, 1 pound. 
Tamarind pulp, obtained by macerating in water 
Pulp of prunes, obtained in the same manner, 
Coriander seeds, 4 ounces. 
Refined sugar, . 2| pounds. 
Powder the senna leaves with the coriander seeds, and separate by sifting 
ten ounces of the mixed powder : boil the remainder with the figs, in four 
pints, until it is reduced to half; then press out and strain the liquor : evapo- 
rate the liquor to half a pint, and add the sugar to make a syrup ; lastly, 
mix the pulp gradually with the syrup, and, having added the sifted powder, 
mix the whole together. 
This is used for costiveness: a piece the size of a hickorynut to be eaten. 
It enters into the pile electuary. It is generally best to purchase it already 
prepared. The English is very superior. 
I have given numerous compounds for diseases; but a few, well selected, 
are in general sufficient. It is desirable, however, to have them in possession, 
that they may be used if necessary; for it is known that a medicine which will 
benefit one person, will sometimes have little or no effect on another. PART EIGHTH. 
DIET FOR THE HEALTHY AND THE 8ICK. 
Excess in eating and improper diet, as has been fully shown in Part 1. 
of this work, is a prevailing error, and causes more diseases than anything 
else, and aggravates those already formed. Dr. Caldwell has some excellent 
remarks on this subject: says he, " One American can consume as much food 
as two Highlanders or two Swiss, although the latter are among the stout- 
est of the race. Intemperate eating is, perhaps, the most universal fault we 
commit. We are all guilty of it, not occasionally, but habitually, and almost 
uniformly, from the cradle to the grave. ' It is the bane alike of our infancy 
and youth, our maturity and age. It is infinitely more common than intem- 
perance in drinking; and the aggregate of the mischief it does is greater. 
For every reeling drunkard that disgraces our country, it contains one hundred 
gluttons-persons, I mean, who eat to excess and suffer by the practice." 
" How, indeed," he afterward exclaims, " can the case be otherwise, while 
children and youth are regularly taught, hired, bribed, or tempted to over-eat 
themselves from their birth! Do you ask me for evidence in proof of this 
charge ? Go to our dining-rooms, nurseries, fruit-shops, confectionaries, and 
pleasure-gardens-go even to sick-rooms-and you will find it in abundance. 
You will witness there innumerable scenes of gormandizing, not only pro- 
ductive of disease in those concerned in them, but in many instances offen- 
sive to beholders. The frightful mess often consists of all sorts of eatable 
materials that can be collected and crowded together; and its only measure 
is the endurance of appetite and the capacity of the stomach. Like the ox 
in rich pasture-ground, or the swine at his swill-trough, men stow away their 
viands until they have neither desire nor room for any more." 
Even in sickness, when nature obviously enjoins abstinence, by depriving 
the sick of an appetite, the nurse will often tease the patient to eat some 
nicely-prepared food ; urging, as a reason, that he can't get well, or will 
become worse, without it. Beware of the bait! Abstinence is often much 
better than medicine; when food is necessary nature will soon call for it. 
Galen, who flourished sixteen hundred years ago, maintained excellent 
views on diet, worthy of imitation. He remarks; " 1 beseech all persons 
who shall read this work, not to degrade themselves to a level with the 
brutes or the rabble, by eating and drinking promiscuously whatever pleases 
their palates, or by indulging their appetites of every kind. But, whether 
they understand physic or not, let them consult their reason, and observe 
what agrees and what does not agree with them; that, like wise men, they 
may adhere to the use of such things as conduce to their health, and forbear 
from everything which they find, by their own experience, to do them harm ; 
and let them be assured that, by a diligent observation and practice of this 
rule, they may enjoy a good share of health, and seldom stand in need of 
physic or physicians." 734 
DIET FOR THE HEALTHY AND THE SICK. 
I will now give directions for some dishes which are suitable both for the 
healthy and the sick. 
In all preparations of food simplicity should be observed ; the fewer ingre- 
dients in a dish, the better. 
Wheat Bread.-Bread should be made of unbolted wheat flour, or only 
the very coarsest part separated, ground coarse, and made in the usual manner. 
This keeps the bowels regular, while that made of superfine flour causes 
costiveness and dyspepsia, by a deficient stimulus imparted to the intestines. 
" The ancients," says Dr. Scott, " considered that bread most wholesome 
and nourishing which was made of flour retaining the whole of the bran 
that is contained in the wheat. Hence the Greek wrestlers used no other 
bread than that made, of coarse, unsifted flour ; and this they considered so 
strengthening and nourishing, that they called a brown loaf which 
imparts strength of limb. It would be well, then, if those who suffered from 
irregularity of bowels made use of this kind of bread only, as well as others. 
The'heat and friction of the mill-stone serve, in some measure, to render the 
superfine flour insipid and lifeless. 
Recipe for Bread.-Pour warm water, with the yeast, into the flour, and 
make a thick batter; let it rise ; then stir in more meal, knead it, and put it 
into pans ; let it rise again, and then bake it. A little Indian meal or mashed 
boiled potatoes are a good addition. It may be mixed with milk or butter- 
milk. 
Bread and Milk are an excellent dish. 
Wheat Pudding.-Mix coarse wheat flour with milk, (water will answer,) 
put into a bag, and boil well: to be eaten with butter and molasses or sauce. 
Minute Pudding.-Boil milk, sweet or sour, and thicken with flour : to be 
eaten as above. An excellent dish. 
Bread Pudding.-Soak bread or crusts in cold water till soft, and squeeze 
dry ; to one pint of which add one quart of milk, three or four eggs, and a 
tea-cupful of sugar. It may be baked or boiled. 
Cakes.-Ferment coarse flour, and bake it on a griddle, the same as 
buckwheat cakes : to be eaten with butter or molasses. 
Toast.-Toast bread slowly till very brown, pour on it a little milk or 
water, and add butter : generally rests well on the stomach. 
Rye.-Rye breaxl is a wholesome article of diet, much more so than 
common wheat bread. 
Rye Pudding.-Milk, thickened with rye flour, and eaten with butter and 
molasses, is very good. 
Indian Corn.-Indian corn is probably the most healthy and nutritious 
food in the world. See Joel Barlow's poem on " Hasty Pudding." It may 
be used in various ways ; in the form of bread, pudding, cakes, &c. 
Best Indian Bread--Take one quart of sour milk, (or sour buttermilk,) 
add to it two tea-spoonsful of sal seratus, four eggs, and Indian meal sufficient 
to make it of the consistence of mush or pudding; bake in a tin-pan for an 
hour with a moderate heat. The best Indian bread ever used. 
Indian Bread.--Mix Indian meal with a little salt, wet with cold water, and 
make a thick batter; put into tin-pans, and bake well; to be eaten with butter. 
This is preferred to wheat bread at the south and west, and was the only 
bread used by General Washington. 
Indian Pudding.-This is used daily in most of the eastern states. Indian 
is mixed with milk or water, and kneaded well till a batter is formed, then 
put into a bag, and boiled for six hours ; then cut in slices, and eaten with 
butter and molasses or sauce. A superior and wholesome dish. DIET FOR THE HEALTHY AND THE SICK. 
735 
Hasty Pudding.-Made by boiling salted water, and thickening it slowly, 
as it boils, with Indian meal till stiff: makes a very valuable and pleasant 
article of diet, both for the healthy and the invalid; to be eaten with milk, 
butter, molasses, or sugar. 
Samp. Hommony.-Favourite and wholesome dishes : made by hulling 
corn, grinding it very coarse, and boiling it till soft. The corn should be 
soaked over night; eat it with milk or otherwise. 
Baked Indian Pudding.-Prepared by mixing milk and Indian meal 
together, and adding eggs and sugar ; to be well baked, and eaten with 
butter or sauce : very palatable and healthy. 
Light Corn Bread.-Stir four pints of Indian meal into three pints of 
warm water, add a tea-spoonful of salt, and let it rise five or six hours ; 
knead well, and bake thoroughly. 
Indian Meal Gruel.-Boil a pint of water, add a little salt, and stir in a 
table-spoonful of Indian meal, previously wet with cold water ; boil fifteen 
minutes, and sweeten with sugar. Rests well on the most delicate stomach, 
and is very soothing and nutritious ; very good when medicine is taken. 
Unbolted Wheat Meal Gruel.-May be made in the same manner. 
Oat and Rye Meal Gruel.-Likewise made in the same manner. 
Rice.-This is a very valuable grain, and supports millions in the east. 
It digests well, and is very nutritious. 
Boiled Rice.-The most simple and best method is, to boil rice, well 
washed in pure water, with a little salt till very soft. It may be eaten with 
milk, or with butter and molasses. 
Baked Rice Pudding.-This makes a very fine dish : take a tea-cupful 
of rice, and as much sugar, two quarts of milk, and a tea-spoonful of salt; 
bake with a moderate heat for two hours. A very wholesome and rich dish. 
Rice Flour may be used in various ways. A gruel made of it is excellent 
in all kinds of bowel complaints, with the addition of a little nutmeg and 
cinnamon. 
Eggs.-Eggs, beat well, and milk and sugar added, are very nutritious. 
Custard.-One quart of milk, five eggs, a small tea-cupful of sugar, a little 
salt and nutmeg ; bake it at a moderate rate three-quarters of an hour. 
Pastry.-Crust to be made of unbolted wheat flour, mixed with cream 
or with a little sal seratus, and shortened with a little butter. Lard, or any 
other grease, should never be used in cookery. All kinds of pies should be 
made with this pastry. 
Cake.-Good cake may be made by taking one pint of light dough made of 
unbolted flour, adding half a tea-cupful of butter, a tea-cupful of sugar, three 
eggs, a tea-spoonful of sal seratus, and one pound of raisins. Bake one hour. 
Wheat Cake.-Take three pints of wheat meal, one pint and a half of 
buttermilk, and a tea-spoonful of sal seratus : roll and cut into round cakes, 
and bake by a quick fire. 
Plain Cake.-One cupful of molasses, one cupful of good cream or milk, 
half a tea-spoonful of pearlash, and coarse wheaten meal to make a soft paste. 
Cup Cake.-Two cupsful of milk or cream, two of sugar, two of unbolted 
wheat meal, one of rice flour, and a tea-spoonful of salt: beat the articles 
well, put into cups, and bake half an hour. 
Potatoes generally digest well. The mealy kinds should be used, (as the 
Mercer.) To boiling water add the potatoes, with a little salt,boil till a fork 
passes easily through them, pour off the water, and let the vessel stand by 
the fire till they are perfectly dry. Potatoes baked in a stove or oven are still 
better. 736 
DIET FOR THE HEALTHY AND THE SICK. 
Codfish Cakes.-Soak codfish over night, separate the bones, and scald 
it; add to it twice its quantity of boiled potatoes, knead all well together, 
make them up into small cakes, and fry in butter. This is an excellent 
diet for the healthy and the invalid. 
Buttermilk Pop.-Buttermilk, four parts ; water, one part; mix : boil and 
thicken with Indian meal. May be made thin, and drank ; or thick, and 
eaten with butter, sugar, or molasses. Pleasant and nourishing. 
Milk Porridge.-Mix two table-spoonsful of sifted flour in three or four 
of water, pour it into a gill or more of boiling water, and stir often, while 
it cooks eight or ten minutes ; then add a pint of new milk, and let it boil 
again. 
Arrow-root JeZZy.-Stir a table-spoonful of arrow-root powder into half 
a cupful of cold water, pour in a pint of boiling water, let it stand five or ten 
minutes, and sweeten it. This is very good for infants, children, and 
others. 
Panado.-Put a little water on the fire, with a glass of wine, some sugar, 
and a little grated nutmeg ; boil all together a second, and add some crumbs 
of bread or pounded cracker, and again boil all together a few minutes. 
All these dishes, with every kind of good vegetables, good butter, milk, and 
all kinds of fruit, rice, fresh fish, and oysters, are sufficient in all conscience 
to satisfy every reasonable person, even, I should think, a gormandizer, 
without including any kind of flesh and grease in the catalogue, which cer- 
tainly cause disease. Hot rolls, hot biscuits, short cakes, rich puddings, flit- 
ters, doughnuts, mince pies, sausages, &c., ought never to be eaten, either by 
the sick or the healthy ; and the stomach should never be overloaded even 
with the lightest kinds of diet. 
DRINKS 
Having treated of different kinds of food, I now treat of drinks. At the 
head of the list stands water as being best for general use. 
Cocoa.-Tea and coffee are narcotic, and it would be best to dispense 
with them. Cocoa is a good substitute, very pleasant, nutritious, and 
divested of any pernicious properties, and better than chocolate or prepared 
cocoa. Take cocoa-shells, a tea-cupful, add two quarts of boiling water, and 
boil for half an hour; then add one quart of milk, and boil a few minutes, 
when it is fit for use ; sweeten with sugar. 
Milk and Buttermilk are both good drinks where they agree. A little water 
and sugar or molasses may be added. 
Toast Water.-Toast slowly a thin piece of bread till extremely brown 
and hard, but not black ; then plunge it in a pitcher of cold water, and cover 
it an hour before used. This is very beneficial in fever, sickness of the 
stomach, vomiting, bowel complaints, &c. 
Wine Whey.-Put half a pint of new milk on the fire ; the moment it boils 
pour in as much good wine as will curdle and clarify it. Boil and set it 
aside till the curd subsides, but not stir it: pour the whey off, and add to it 
one pint of boiling water, and sufficient loaf sugar to sweeten it. Thus you 
will have a clear, rich, pleasant, and medicinal liquid, which may be drank 
in typhus and other fevers, debility, &c. 
One physician, after he had practised most of his life, states, " If I am in- 
debted to one thing more than another in the treatment of diseases, it is car- 
bonate of ammonia (hartshorn) and wine whey. 
Barley Water.-Take a table-spoonful of ground barley, mix it with a lit- DIET FOR THE HEALTHY AND THE SICK. 
737 
tie cold water, add one pint of boiling water, boil a few minutes, and sweeten. 
Very soothing and strengthening. 
Lemonade.-Squeeze the juice out of a fresh lemon, add a large table- 
spoonful of loaf sugar, mix well, and add one pint of cool water. This 
liquid is not only very grateful and cooling in fevers, but likewise in health. 
Root Beer.-Make a strong decoction of green spruce boughs and leaves, 
strain, and sweeten with molasses ; when cool, add yeast sufficient to ferment. 
The second day bottle for use. Medicinal and pleasant. See Medical Beer. 
Both food and drink should be taken rather cool, otherwise they relax 
and weaken the stomach. 
Liquid for Dyspepsia. 
Take fresh lean beef, cut thin, one pound, put it in a large-mouthed botte 
or jar, add a little salt, place the vessel in a kettle of boiling water, and let 
it remain for one hour ; then strain through a woollen cloth. There will be 
about one gill of a clear, nutritious liquid. Begin by taking one tea-spoonful, 
and increase the quantity as the stomach will bear. This has been retained 
on the stomach when nothing else could. It cured Capt. Sands when nearly 
gone with dyspepsia. 
Excellent Diet for Dyspeptics and others. 
Take a piece of stale wheat bread and a little white sugar, and cover with 
boiling water ; then cover with a plate for a short time. Add cream or good 
milk. This dish rests easv on the stomach, and is very pleasant. 
Voltaire's Dish for Indigestion. 
in the memoirs of Count de Segur (vol. i., p. 168) there is the following 
anecdote: " My mother (the Countess de Segur) being asked by Voltaire 
respecting her health, told him that the most painful feeling she had arose 
from the decay of her stomach, and the difficulty of finding any kind of 
aliment that it could bear. Voltaire, by way of conversation, assured her that 
he was once nearly for a year in the same state, and believed to be incurable ; 
but that, nevertheless, a very simple remedy had restored him. It consisted 
in taking no other nourishment than yolks of eggs, beaten up with flour of 
potatoes and water." Though this circumstance took place as far back as 
about fifteen years ago, and respected so extraordinary a personage as 
Voltaire, it is astonishing how little it is known, and how rarely the remedy 
has been practised. Its efficacy, however, in cases of debility, cannot be 
questioned ; and the following is the mode of preparing the valuable article 
of food, as recommended by Sir John Sinclair: Recipe-Beat up an egg in 
a bowl, and then add six table-spoonsful of cold water, mixing the whole 
well together ; then add two table-spoonsful of the farina, (or mashed 
potatoes,) mixing it -with the liquor in the bowl : then pour in as much 
boiling water as will convert the whole into jelly, and mix it well. It may 
be taken either alone or with the addition of a little milk, and moist or best 
sugar, not only for breakfast, but, in cases of great stomachic debility or in 
consumptive disorders, at the other meals. This dish is light, easily digested, 
extremely wholesome, and nourishing. Bread or biscuit should be taken 
with it, as the stomach gets stronger. PART NINTH. 
OUTLINES OF ANATOMY AND PHYSIOLOGY OR 
MECHANISM OF THE HUMAN BODY. 
Anatomy explains the nature, office, and mechanism of the human body, 
while physiology explains the actions and uses of the different functions. 
A knowledge of the system is interesting, as a branch of natural philosophy, 
and in some measure is useful in the practice of medicine; but too much 
dependance is laid upon it: many assert that it is the foundation of the heal- 
ing art, which is an egregious error, since its greatest use consists in teach- 
ing us how to live in such a manner as to avoid the use of medicine. When 
disease becomes seated, the most minute knowledge of the system will do but 
very little in enabling us to remove it: all our skill, then, resolves itself into 
this maxim-such a medicine removes such a pain. I treated complaints quite 
as successfully before I studied anatomy as afterward ; indeed it is almost pro- 
verbial, that a great anatomist is a poor practitioner, being very liable to be 
misled by it. A good general knowledge of the human system is desirable ; 
and this can be acquired without those disgusting and revolting scenes which 
are exhibited in the lecture and dissecting rooms of our medical colleges 
Plates, wax preparations, &c., are sufficient. 
The " illustrious Chesselden," a great anatomist, remarks ; " For all prac- 
tical purposes, anatomy needs not many lectures, descriptions, nor minute 
dissections; what is most worth knowing is soonest learned, and least the 
subject of dispute; while dividing and describing the parts more than the 
knowledge of their uses require, perplexes the learned, and makes the science 
dry and difficult." 
Let us have a reformation on this subject, as well as in the practice of 
medicine. 
In treating on anatomy and physiology, I am under the necessity of being 
very brief, having already exceeded the contemplated limits of this work. 
THE BONES. 
The skeleton is the frame-work of the body, or that part which supports 
the rest and gives it firmness. It may be compared to the frame of a ship; 
the spine or back-bone represents the keel; and the ribs, the beams of the 
ship, which support the other parts. The skeleton is divided into three 
parts ; head, trunk, and extremities. The number of bones are 241, which 
make the body so flexible ; they are of all shapes and sizes, and are com- 
posed of earth and lime, and held together by means of gelatine, a kind of 
glue. The hollow construction of the bones renders them less liable to be 
broken: they are covered by a dense membrane, called periosteum. 
The bones of an infant before birth are cartilaginous; in children, soft and 
yielding, which prevents their injury. The manner in which bones are THE BONES. 
739 
formed is very curious. The blood and milk contain the materials for the 
formation of bone : the first mark of bony structure is an artery or blood- 
vessel running into the centre of the jelly in which the bone is to be formed. 
This artery deposites particles of bony matter, and a speck is first formed, 
and by a slow accession of new matter the bone is made, while another set 
of vessels carries away the jelly. Bones are liable to be diseased, as in 
rickets, white-swelling, &c. To prevent friction, the ends of the bones are 
Fig. 1. A Front View of the Male Skeleton. 
HEAD AND NECK. 
a, The frontal bone 
ft, The parietal bone. 
c, The temporal bone. 
d, A portion of the sphenoid 
bone. 
e, The nasal bone. 
/, The malar, or cheek-bones 
g, The superior maxillary, 
or upper jaw. 
A, The lower jaw. 
t, The bones of the neck. 
TRUNK. 
а, The twelve bones of the 
back. 
б, The five bones of the loins. 
e, d, The breast-bone. 
e,f, The seven true ribs. 
g, g. The five false ribs. 
A, The rump-bone or sacrum. 
i The hip-bones. 
UPPER EXTREMITY. 
o, The collar-bone. 
A, The shoulder-blade. 
c, The upper arm-bone. 
d, The radius. 
e, The ulna. 
f, The carpus, or wrist. 
g, The bones of the hand. 
A, 1st row of finger-bones. 
», 2d row of finger-bones. 
k, 3d row of finger-bones. 
l, The bones of the thumb. 
LOWER EXTREMITY. 
a, The thigh-bone. 
4, The knee-pan. 
c, The tibia, or large bone 
of the leg. 
d, The fibula, or small bone 
of the leg. 
e, The heel-bone. 
f, The bones of the instep. 
g, The bones of the foot. 
A, 1st row of toe-bones. 
i, 2d row of toe-bones. 
k, 3d row of toe-bones. 740 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
supplied with cartilage, something like India rubber, from which issues a 
substance called sinovial fluid, and which keeps the parts soft and causes 
them to move easily. 
Ligaments are tough substances, which enclose and keep the joints together. 
Bones are supplied with arteries, veins, absorbent vessels, and nerves. 
There are twenty-four ribs, twelve on each side. 
Tendons are short, strong cords, fastened to the ends of muscles, and then 
to the ends of the bones. Bones do not become perfectly hard before puberty 
Fig. 2. A Back View of the Male Skeleton. 
THE HEAD. 
a, The parietal bone. 
b, The occipital bone. 
c, The temporal bone. 
d, The cheek-bone. 
e, The lower jaw-bone. 
RECK AND TRUNK. 
а, The bones of the neck 
б, The bones of the back 
c, The bones of the loin* 
d, The hip-bone 
e, The sacrum. 
UPPER EXTREMITY. 
a, The collar-bone 
b, The blade-bone. 
c, The upper bone of the arm 
d, The radius. 
e, The ulna. 
f, The bones of the wrist. 
g, The bones of the hand. 
h, 1st row of finger-bones. 
i, 2d row of finger-bones. 
Jr, 3d row of finger-bones. 
I, The bones of the thumb. 
LOWER EXTREMITY. 
a, The thigh-bone. 
b, The large bone of the leg 
c, The small bone of the leg 
d, The heel-bone. 
e, The bones of the instep. 
f, The bones of the toes THE MUSCLES. 
741 
Fig. 3. The Pelvis. 
a a, Innominate, u u, Foramen ovale. G G, Femur, or thigh-bone. 
The Pelvis.-The office of the pelvis is, to give a steady bearing to the 
trunk, and to connect it with the lower extremities, by a sure and firm join- 
ing, to form the centre of all the great motions of the body, to contain the 
internal organs of generation, the urinary bladder, the rectum, and occasion- 
ally part of the small intestines, and to give support to the gravid uterus. 
THE MUSCLES. 
The muscles are that part called flesh, and such as is used for food. There 
are over five hundred belonging to the system, most of which are in pairs. 
They co«sist of minute threads or fibres, and are covered with sheaths to sepa- 
rate one from another. They are fastened to the ends of the bones by tendons, 
and are designed to move them in obedience to the will ; also to move the 
fluids through the intestines and bloodvessels, sustain the body and ofgans, 
to lengthen and shorten or compress parts, as the eye, tongue, arms, legs, 
&c. How many hundred different positions can the body be suddenly thrown 
into by means of these muscles or levers, merely by willing it; for example, 
throw your head back, forward, to the right or left; or your fingers, arm, leg, 
&c. How amazing the contemplation ! Other muscles are involuntary, 
which perform their offices independent of the will; as those of respiration, the 
heart, &c. Muscles are supplied with veins, arteries, lymphatics, and nerves. 
How exceedingly complicated is the mechanism of our bodies ! what a 
multitude of tubes, valves, cords, threads, and bones; all harmonizing, per- 
fect in their action, and answering a determinate end I How calculated to 
excite our astonishment, and lead us to fall down in profound adoration before 
the great, mighty, and glorious architect, and to cry with the apostle, " great 
and marvellous are thy works, Lord God Almighty !" There are over two 
hundred bones, most admirably articulated one with another; and, to move 
them, there are attached more than four hundred muscles or cords, so sys- 742 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
tematically, carefully, and beautifully arranged and applied to the levers, 
that the object is perfectly accomplished without the least derangement, and 
at the same time symmetry of form is secured. 
These are delicate webs, that line the cavities of the bodies and enclose 
all the organs. 
Serous Membrane.-This membrane covers and protects the various 
organs, as the chest, bowels, lungs, stomach, &c. It is constantly supplied 
with serum or water. 
Mucous Membrane.-This membrane lines all the organs and internal parts, 
the nose, mouth, throat, windpipe, lungs, bladder, stomach, intestines, &c. 
It has a pale purple colour in health, but red when inflamed, as may be seen 
by looking into the throat when it is inflamed. It is this which secretes 
mucus or slime in coughs and bowel complaints. 
Cellular Membrane.-This is made up of numerous little cells, which are 
everywhere interposed between the skin and the muscles. These are sup- 
plied with a watery vapour, and, when obstructed, constitute dropsy. 
MEMBRANES. 
THE VISCERA OR INTERNAL ORGANS. 
The brain is divided into two principal parts, one called cerebrum, the 
other cerebellum, or, in other words, the great and little brains. Above the 
level of the ears all the upper portion of the skull is occupied by the cere- 
brum, the seat of intellect; below that level, in the lower and back part of the 
head, is the cerebellum or little brain, separated by a membrane. The brain 
is also divided into lobes, and entirely covered, externally, with a membrane, 
called dura mater, to protect it; next is the pia mater, which is an immense, 
broad, thin net of bloodvessels, which ramify through the brain to supply it 
with blood. The brain is so soft that, without it were secured by a mem- 
brane, it would fall to pieces of its own weight. The brain is the seat of 
perception or knowledge, while the heart is the seat of the a ffections. A cer- 
tain portion of the brain may be referred to the intellectual faculties ; another 
to the moral sentiments ; and a third to the animal propensities. a 
The brain in its natural state completely fills the cavity of the skull. The 
form which it presents is that of a spheroid elongated at the upper part, nar- 
rower at the front than behind. In the brain we observe a superior and 
anterior mass, called the hemispheres, (Fig. 4, A C, A C,) and an inferior 
and posterior portion, not so large, called the cerebellum, (FF.) 
The two hemispheres, the one on the right side and the other on the left, 
are separated longitudinally and deeply by the falx of the dura mater. 
Each hemisphere is divided into three portions, which are named lobes 
The anterior lobe (Fig. 4, A A) rests on the vault of the orbits, and is 
separated from the middle lobe by a deep furrow, (ee.) The middle lobe 
(B B) is scarcely separated from the posterior, (C C.) This last is situated 
partly in the internal temporal foss<e of the skull, and partly on the tentorium 
of the cerebellum. 
On all the. surfaces of the hemispheres we perceive convolutions, larger or 
smaller, and more or less projecting. They are separated from each other 
by winding furrows called anfractuosities, into which the pia mater descends, 
while the other two membranes, the arachnoid coat and the dura mater, pass 
directly over the convolutions, and envelope the whole brain. 
I.-THE BRAIN. THE BRAIN. 
743 
Fig. 4. The Base of the Brain. 
Description of Figure 4.-AC AC, Are the right and left hemispheres of tne 
brain. FF, The cerebellum. A A, The anterior lobe, e e, The line which denotes the 
separation between the anterior lobe and the middle lobe. BB, The middle lobe. CC, 
The posterior lobe. GG, The Pons Varolii, which brings the two sides of the cerebellum 
into communication. HH, The medulla oblongata, rr, The 
ss, The corpora olivaria. tt, The corpora restijormia. , 
1. The Olfactory nerves or first pah'. Their origin is not yet demonstrated. They 
go through the holes in the cribriform plate of the ethmoid bone, and are distributed on 
the membrane which lines the nostrils. 
2. The optic nerves. They pass along the side of the thalami nervorum opticorum, 
and can be traced to the nates of the corpora quadrigemina, which bear a proportion 
to them. This is the second pair of the anatomist. They pass through the optic holes 
of the sphenoid bone to the orbits. 
3. Third pair or motores oculi. They originate from the crura of the cerebrum a 
little before the tuber annulare. They go through the fissure between the sphenoid 
bone and orbitar plate of the frontal bone to the muscles of the eyeball. 
4. Fourth pair or pathetic nerves. They originate near the corpora quadrigemina, 
and pass between the middle lobes of the brain and the adjacent part of the tuber annu- 
lare. They go through the same fissure as the above to the obliquus-superwr muscle 
of the eyeball. 
5. Fifth pair of nerves, trigeminus or trifacial nerves. They-wiay be traced to above 
the corpora olivaria and go to the orbits, great part of the face, and superior and 
inferior maxilice. 
6. Abductor nerve or sixth pair. They originate from a furrow between the posterior 
edge of the tuber annulare and the corpora pyramidalia. 'They go through the 
cavernous sinus and sphenoido-orbitar fissure to the abductor muscle of the eyeball. 744 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
7. Facial nerve or portio dura, or sympatheticus minor, is the second branch of the 
seventh pair. They pass through the aqueduct of Fallopius, to the external ear, neck, 
and face, and originate at the angle formed between the Pons Varolii and the corpus 
restiforme. 
8. Auditory nerve, or portio mollis, first branch of the seventh pair. They go through 
a number of small holes within the auditory passage to all the internal parts of the ear. 
They come from medullary streaks on the surface of the fourth ventricle. 
9. Glossopharyngeal nerve, principal branch of the eighth pair. They go to the 
styloid the tongue, and the pharynx. 
10. Vocal nervqs, or eighth pair. They originate from the base of the corpora 
olivaria. They go to the tongue, the pharynx, larynx, and lungs, and part to the 
stomach. 
11. Spinal accessory nerves, or spinal nerves. They originate from the beginning 
of the spinal marrow. They go through the condyloid hole of the occipital bone to the 
sterno-mastoid and trapezius muscles. 
Fig. 5. The Brain &een at its Base, and dissected so as to show ths? 
DIRECTION OF ITS FlBRES. 
The letters refer to the same parts as in the description of Fig. 4, adding the following 
a, The corpus dentatum, or ganglion of the cerebellum. 
h, The corpus striatum. THE EYE. 
745 
II-THE EYE. 
Several thin pieces of bone form the cavity or socket of the eye, which 
is shaped much like a pear, with its large end turned outward. The eye is 
a ball or bag, which contains a clear, thick liquid, something similar to the 
white of an egg. The coats of the eye answer to the brass tubes in a spy- 
glass ; one is fitted within the other like a nest of boxes. There are three 
principal ones. The external coat is called conjunctiva. The outside of the 
eye is called the sclerotic coat, which is a .membrane; it is 
strong, firm, and dense as leather: we call it thg-" tyhite of the eye." 
There is an opening in the centre, where the cornea is set: it is placed here 
much like the crystal of a watch, and is clear or transparent. The cornea 
is very hard and firm. Beneath the cornea is the choroid coat, which is the 
medium for the bloodvessels. Beneath this is the pigmentum nigrum, called 
black paint, which it resembles, and ' can be easily washed off. Next is 
the iris, being the coloured circle which surrounds the pupil of the eye, and 
hung before the crystalline lens. The iris divides the liquids or humours 
into two parts : the one before the iris is called aqueous or watery humour, 
and the part back of the iris is the vitreous or glassy humour. The crystal- 
line lens is a small body, convex on both sides, transparent, but more dense, and 
lies directly back of the iris, and swims, as it were, in the liquid or humour. 
The following figure represents the eyeball, with its muscles, (designated 
by the various letters,) lens, retina, optic nerve, with the formation of an ob- 
ject on the retina. 
Fig. 6. The Eye. 
a, represents the eyeball. C, crystalline lens, where the rays of light, 111, from A, the 
arrow, meet like a sun-glass and diverge, or are refracted and thrown on the retina B, 
which represents the object absolutely perfect, though extremely small, e, the optic 
nerve, conveys it to the brain and gives a knowledge of the above object. How minute 
must the image of a man be on the retina of a humming-bird, or an insect which cannot 
be seen by the naked eye. Ill, rays of light from an arrow, which pass through C, 
the crystalline lens, by which they are concentrated the same as in a sun-glass, in front, 
and refracted by the concavity of it on the back, and thrown on the retina B, which 
ought to be a little farther back. Here the object is formed. The other letters re- 
present the different muscles of tb' ■ ,e. 746 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
Lastly, the optic nerve is expanded on the back part of the eye, and this 
expansion forms a membrane called the retina. On this all objects or images 
are formed, a perception of which is transmitted to the brain and mind. 
The rays of light pass through the cornea, aqueous humour, crystalline 
lens, and vitreous humour, and then fall on the retina. 
The eye may be compared to a camera obscura, which means a dark 
chamber with one small hole to let in the rays of light, concentrated by a glass 
cut like the crystal of a watch, and thus gives a perfect picture of objects, 
with the exact colour. Thus the light enters the little clear window in 
front, called the " sight " of the eye. The " w'hite " around it does not per- 
mit the light to enter anywhere else, and of course the inside of the eye is a 
dark chamber, except as it receives that little light which passes to the back- 
side of the hollow ball, and there forms a perfect little picture of everything 
toward which the eye is turned. It is smaller than you can well imagine, 
when you consider how perfectly every object must be represented there. 
Look at the page of a newspaper, and consider that every letter and point is 
distinctly drawn upon a surface not so large as a sixpence. Look at the 
carpet, or walk forth and gaze at nature's verdant carpet in the fields, and 
remember that every figure, and every blade of grass, and every flower, are 
all drawn on that same little spot, and you will admire the wisdom of Him 
who has so wonderfully furnished this beautiful little instrument. The 
back part of the eye is filled with glassy and watery substances, as already 
mentioned, which are so contrived as to reduce the images of objects to the 
necessary smallness, while the shape and colour are perfectly preserved. 
Our sight is the most perfect and most delightful of all our senses. It fills 
the mind with the largest variety of ideas, converses with objects at the 
greatest distance, and continues the longest in action without being tired or 
satiated with its proper enjoyments. The sense of feeling can, indeed, give 
us a notion of extension, shape, and all other ideas that enter at the eye, ex- 
cept colours ; but, at the same time, it is very much straitened and confined 
in its operations to the number, bulk, and distance of its particular objects. 
Our sight seems designed to supply all these defects, and may be considered 
as a most delicate and diffusive kind of touch, that spreads itself over an in- 
finite multitude of bodies, comprehends the largest figures, and brings into 
our reach some of the most remote parts of the universe. It is this sense 
which furnishes the imagination with its ideas ; so that, by the pleasures of 
the imagination or fancy, (which I shall use promiscuously,) I mean such as 
arise from visible objects, either when we have them actually in our view, or 
when we call up their ideas into our minds by paintings, statues, or descrip- 
tions. What would all the world be to us without the eye ? Be grateful, 
then, to the giver, and show mercy to the blind. 
III.-THE LUNGS. 
The lungs are a delicate, sponge-like substance, composed of innumerable 
air-cells. The membrane which composes these cells is much more deli- 
cate than gauze: they are situated in the chest, by means of which we 
breathe. The lung in the right cavity of the chest is divided into three 
lobes, that in the left into two. They hang in the chest, attached at their 
superior part by means of the trachea or windpipe; and are also attached 
to the heart by means of the pulmonary vessels. The substance of the lungs 
is of four kinds, viz.: vesicular, vascular, bronchial, and parenchymatous. 
The vesicular substance is composed of the air-cells. The vascular invests THE LUNGS. 
747 
those cells like a net-work. The bronchial is formed by the ramifications 
of the bronchia throughout the lungs, having the air-cells at their extremi- 
ties ; and the spongy substance that connects these parts is termed the 
parenchyma. The lungs are covered with a fine membrane, a reflection of 
the pleura, called pleura pulmonalis. The windpipe a, divides into two 
lateral branches 6, and forms the bronchial tubes. 
The internal surface of the air-cells is covered with a very fine, delicate, 
and sensible membrane, which is continued from the larynx through the 
trachea and bronchial tubes. The arteries of the lungs carry blood to the 
lungs for their nourishment; and the pulmonary circulates the blood through 
the air-cells to undergo a certain change. The pulmonary veins return the 
blood that has undergone this change, into the heart. The lungs, then, may 
be compared to a bellows, which expands by every inspiration, by inhaling 
the air, and collapses by every exhalation, by forcing the air from it. It is 
owing, then, to the constant motion of this organ that they become more 
difficult to heal than other organs. 
The air breathed undergoes a great change in the lungs : they throw off 
carbonic acid gas, which is very deleterious, and absorb oxygen or the vital 
part, which changes the venous or black into arterial or florid blood, and at 
the same time receive vital heat or electricity. 
The surface of the air-cells is said to equal the whole surface of the body, 
which shows what a volume of air is inhaled at every breath, and the effect 
of good or bad air on the health. It is computed that the lungs destroy a 
gallon of air per minute. The air breathed is returned loaded with watery 
vapour, which is calculated to amount to nearly twenty ounces in a day. 
Fig. 7. The Right Lung, and Air-passages of the Left Lung 
a, The trachea or windpipe, b, Bronchial tubes, ccc, Three lobes of the right lung. 
d, The inferior or concave surface of the right lung, eee, Air-passages of the left lung, or 
division and subdivision of the bronchial tubes. 748 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
The heart is an organ situated in the left cavity of the chest, resting on 
the diaphragm or midriff, left of the sternum or breast-bone, between the fifth 
and sixth ribs. It is contained in a strong membranous sac, termed the 
pericardium, which secures it in its proper situation : it is divided into four 
cavities, termed the auricles and ventricles. It continually contracts and 
dilates, and at each pulsation throws the blood to every part of the body 
with amazing velocity. The number of its contractions in a single day is 
computed to be one hundred thousand- 
Plato, in speaking of the heart, remarks: It is the centre or pivot of the 
bloodvessels ; the spring or fountain of the blood which is carried impetu- 
ously around. The blood is the pabulum or food of the flesh; and, for the 
purpose of nourishment, the body is laid out in canals like those which are 
drawn through gardens, that the blood may be conveyed, as from a fountain, 
to every part of the body. The heart contracts, and throws the blood into 
the lungs to be vitalized: from the lungs it is carried back into the left 
side of the heart; the heart contracts, and throws this renovated blood into 
the arteries ; by these it is carried all over the body to nourish it. After it 
has thus circulated all over the body, it is returned by the veins to the right 
side of the heart, when it is poured into the heart mixed with the chyle, 
again sent to the lungs, and prepared to go the rounds. All the blood in the 
body, which amounts to several gallons, passes through the heart, on its 
way to and from the lungs, every four minutes. 
IV-THE HEART. 
EXPLANATION. 
q, The descending vena cava, 
returning black blood from the 
head and upper extremities. 
o, The ascending vena cava, 
returning the same kind of blood 
from the lower parts of the body. 
n, The right auricle of the 
heart, where both veins meet. 
p, and x, veins from the liver, 
spleen, and bowels, uniting with 
the inferior cava. 
The auricle being filled, con- 
tracts and forces the blood into b, 
the ventricle: next the ventricle 
contracts and sends it to k, the 
pulmonary artery, which branch- 
es into ll, to supply the lungs on 
both sides of the chest. From 
the lungs, where a scarlet colour 
has been given it, four veins of 
the lungs gather it together, and 
deposite it in the left auricle, r ; 
that contracts and the blood is 
driven into the left ventricle, a; 
lastly, the ventricle contracts and 
throws it into c, the aorta, which 
conducts it over and through 
every bone, muscle, and organ. 
Fig. 8. The Human Heart. 
Who but a fool or a lunatic, after examining the structure of the heart 
alone, and the circulation of the blood through it, can doubt the existence 
of its maker. THE STOMACH. 
749 
V.-THE STOMACH. 
The stomach is a membranous muscular sac, a greater portion of which is 
situated in the left side of the abdomen, mostly under the diaphragm under 
the ribs. It reaches toward the |jght side, a little beyond the " pit of the 
stomach," as it is termed. It resembles in shape the Scotch bagpipe. The 
place where the food enters is called the cardiac orifice, and the outlet is 
called the pyloric, which closes and prevents the entrance of improper articles 
into the intestines. It is supplied with numerous glands, bloodvessels, and 
nerves. It has three coats : the external is the peritoneal, the second is the 
muscular, and the third and inner coat is the mucous or villous, which contains 
numerous absorbing and exhaling vessels, which secrete the fluids in digestion. 
The sympathy of the stomach with other organs renders it one of the most 
important parts of the body ; it is the great centre of sympathy. The 
great sympathetic nerve leads from the brain to the stomach, which affects 
so many contiguous portions of the system when it is disordered. The 
stomach and liver are the two great sources or inlets of disease; as fever, 
indigestion, bowel complaints, &c. It is owing to this connexion with 
neighbouring parts that the majority of medicines are first applied to the 
stomach, and which benefit by their sympathetic action. 
Fig. 9. The Human Stomach. 
C, Cardiac orifice or entrance. P, The pyloric orifice, or opening into the intestines. 
SS, Smaller arch or curvature. GG G, The great arch or curvature. 
Gastric Juice.-When food is taken into the stomach the exhalent 
arteries secrete a fluid called gastric juice, which acts upon the food and 
reduces it to a pulpy mass. Of its nature and qualities we know but little. 
Professor Silliman, in a lecture, stated that the gastric juice, which is the 
great agent of digestion, would pour into the stomach when any food or 
other substance was placed there. This juice, he said, was easily taken 
from the stomach ; he had a bottle of it. The liquid was, at that time, 
apparently as pure as it was ten years ago ; it had the peculiar property 
of self-preservation, or of resisting putrefaction. It would, if warmed to 
blood-heat, dissolve meat in a wine glass. He said he had never come to 
any satisfactory conclusions, as to its character, from his attempts in ana- 
lyzing it; and he had sent a portion of it to one of the most learned and 750 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
skilful chemists of Europe, but he was able to throw but very little light on 
the subject. But this Professor S. said he did know, that it had no affinity 
with alcohol, and that they were, in their nature and attributes, totally 
diverse, and possessed counteracting qualities. 
Fig. 10 The Internal Parts. 
H, The heart. RL, Right lung. LL, Left lung. D D, Diaphragm, which separates 
the chest from the bowels. Livr. Liver. Stm. Stomach. G, Gall-bladder. Ill, Intestines 
VI.-THE INTESTINES. 
By the intestines is meant the whole of the alimentary canal below the 
stomach. They are divided into small and large. The small are subdivided 
into the duodenum, the jejunum, and the ileum ; the large into the caecum, 
the colon, and the rectum. They are coiled up, or lay in folds in the abdo- 
men, and extend about thirty feet in length. How can all this extent be 
cleansed of morbid matter by " pukes " and " injections ?" The coats of 
them are similar to those of the stomach. 
The muscular coats contain longitudinal and circular fibres, which, by their 
contraction and relaxation, produce the vermicular or peristaltic motion, com- 
pared to the creeping of a worm. These serve to propel the contents of the 
intestines out of the body. The small intestines assist in the preparation of 
the chyle, and propel their contents toward the great intestines. 
The proper uses of the intestines are to serve, Isf, for the performance 
of chylification; 2dly, for the absorption of the nutritive chyle ; and, 3dly, 
as a resevoir for the indigestible residue of the food, and an outlet for both 
it and the effete matter which requires to be thrown out of the general 
system THE INTESTINES. 
751 
Fig- 11. The (Esophagus, Stomach, and Intestines 
f, (Esophagus or gullet i, The stomach. A, The pyloric orifice, where the food 
enters the intestines. 3 3, External rim of the liver, k, The hepatic duct, m, 
Cystic duct, n, Common duct, formed by the union of the two. j, Gall-bladder. The 
arrows represent the intestines, with the course of the food. 752 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
The intestine or intestinal canal, as represented in the subjoined figure, 
begins at the pyloric orifice of the stomach P, and, after many windings and 
turnings, called convolutions, (from the Latin word convolutus, rolled or folded 
together,) terminates in the rectum or straight gut Y, at the external orifice, 
called the anus. Although throughout its whole extent, the 
intestinal tube is, nevertheless, divided b'jf anatomists into six portions, to each 
of which a different name is assigned : tne distinction between some of these 
is more nominal than real, but it still continues to be made on account of its 
convenience 
Fig. 12. The Intestinal Canal. 
The first grand division is into the small and great intestines ; the former 
beginning at the stomach, including all the convolutions marked RSSSS- 
and the latter beginning at T, where the small intestine terminates, and 
including the large gut UUUUXYY, which surrounds, and is partly hidden 
by, the other bowels. THE LIVER-THE KIDNEYS. 
753 
VIL-THE LIVER. 
The liver is an organ of a deep red colour, and is the largest in the body. 
It is situated in the right side, under the ribs ; the left lobe extends con- 
siderably toward the left side over the stomach, which produces pain in this 
part when the liver is diseased. The upper surface of the liver is convex 
and smooth; the lower, concave and uneven. It is divided into two principal 
lobes. The liver is thick and massy on one side, and thin on the other. It 
s supplied with bloodvessels, nerves, and absorbents. Its office is to prepare 
md secrete the bile; it serves also as a filter to the blood, to separate all 
mpurities from it, or to refine it. We learn, then, how indispensably neces- 
sary to the health is the proper performance of this function; if diseased, it 
cannot purify the blood, which, if sent to the lungs, brain, and other parts 
in a morbid condition, may cause jaundice, consumption, insanity, &c.; and, 
by withholding the natural stimulus to the intestines, cause dyspepsia, piles, 
and other complaints. 
Gall-bladder.-This is attached to the under side of the liver. It is shaped 
like a shot-pouch, and contains between one and two ounces of gall, which 
is deposited by the liver. 
A long, slender pipe extends from it to the first intestine, into which it 
pours the bile a few inches below the pyloric orifice ; the use of which is, 
to stimulate the intestines, and separate the chyle from the excrements. 
Biliary Ducts.-The bile is secreted by the liver, and carried by a great 
number of small pipes to the hepatic duct, which unites with the cystic and 
forms the common duct, and conveys the bile into the intestine. One comes 
from the liver, the other from the gall-bladder. 
Bile.-This fluid is secreted by the liver, and is commonly called the 
" gall." It is of a yellowish green colour, of a soapy compound or nature, very 
bitter, and of a peculiar smell. It is composed of water, albumen,soda,phosphate 
of lime, common salt, phosphate of soda, lime, and another peculiar substance. 
It seems to separate the nutritious part of the food from the coarser and 
useless, and at the same time keeps up an action of the bowels. 
Spleen.-The colour is red, something like the liver, broad as the palm of 
the hand, and one or two inches thick. It is in contact with the stomach 
on the left side. The use of it is not well understood. 
Pancreas, called " sweetbread," is a glandular body, of a pale red colour, 
like the tongue of a dog, eight or ten inches long. It lies behind the 
stomach, directly across the spine. It secretes a fluid that is carried into 
the intestine, and aids digestion. 
The pancreatic duct enters the duodenum along with the biliary duct, so 
that the two fluids meet at their entrance, which takes place at the first 
curvature of the intestine, at the distance of about one-third of its whole 
length from the stomach. 
The bile and pancreatic juice, thus poured out together, are both requisite 
for the formation of chyle, and apparently modify the action of each other. 
The bile being somewhat of an unctuous nature, and the pancreatic juice 
somewhat alkaline, their union forms a kind of saponaceous compound, 
which is less irritating, and more easily incorporated with the chyme, than 
pure bile. 
VIII.-THE KIDNEYS. 
One of these glands is placed on each side, in the loins, near the spine, a little 754 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
above the hips. Their office is to secrete the urine from the blood, which is 
effected by innumerable little tubes, 
and is then conveyed down to the 
bladder by two tubes called the 
ureters, which pierce it obliquely, and 
thus prevent its return when full or 
distended. Now, when this organ 
is weak and unable to perform its 
office, the gravel or stone is formed. 
This organ is composed of three 
substances ; a cortical, which is ex- 
ternal, and very vascular; a tubulous, 
which consists of small tubes ; and a 
papillous substance, which is the 
innermost. The kidneys are gene- 
rally surrounded with more or less 
adipose membrane; and they have 
also a proper membrane, which is closely accreted to tne cortical substance. 
Bladder.-This is a membranous bag, situated in the lower part of the abdo- 
men, anteriorly, and is a receptacle of the urine, which passes off by the urethra. 
Uterus or Womb.-An organ about the size and shape of a pear, and 
is situated between the bladder and the rectum ; as one writer says, it 
ought to make man very humble, that he has his origin in a place so loath- 
some, viz., between urine and excrement. It lays rather loose, and is kept in 
its situation by means of ligaments. 
In this organ the foetus or infant is formed: first so small that it cannot 
be seen by the naked eye ; and it slowly grows, being nourished by the 
blood derived from the mother through the umbilical cord or navel-string, 
till in nine months the womb contracts and expels it. 
Fig. 13. The Kidney. 
IX.-THE LACTEALS. 
These are clear, delicate vessels, which arise from the mucous coat of the 
small intestines, passing in their course 
through small glands, and terminate in 
the thoracic dad. Their office is to ab- 
sorb the milky fluid or chyle from the 
food, and to convey it from the intestines 
to the blood. 
Lymphatics take up fluids from diffe- 
rent cavities and parts of the body, and 
convey them into the circulation. 
LL, milk vessels or lacteals. T D, 
commencement of the thoracic duct. 
MG, mesenteric gland, through which 
the chyle passes. S, a portion of the 
spine. 
The lacteal vessels are most easily 
seen an hour or two after a meal; because 
they are then fully distended with chyle, 
even in their smaller branches. The 
latter, indeed, may then be distinctly 
traced proceeding from the different por- 
Fig. 14. The Lacteals. DIGESTION. 
755 
rions of intestine, and gradually coalescing into larger trunks, as seen at 
LL in fig. 14. 
Fig. 15. Contents of the Abdomen after removal of the Intestines 
The letters LLLL point out the inferior surface of the liver, a little raised from its 
natural position, to stow the gall-bladder G, and the pancreas PP, round the right end 
of which the duodenum is curved. S indicates the spleen, with a vacant space over it, 
in which the etomach lies The kidneys K K lie one on each side of the spine ; and 
the two pipes U U are the ureters, which convey the urine into the bladder. V V, vena 
cava. R, rectum. B, bladder. P P, pancreas or sweetbread. 756 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
DIGESTION. 
" When the food is received into the stomach, it is there subject- 
ed to the action of a solvent fluid, called the gastric or stomach juice, 
by which it is gradually converted into a soft, grayish, and pultaceous 
mass, called chyme; whence the process is called chy unification, or chyme- 
making. The chyme, as fast as it is formed, is expelled by the contractile 
power of the stomach into the duodenum, (from duodenus, consisting of twelve, 
because it is supposed to be about twelve inches long,) or first portion of the 
intestines. It there meets with the bile from the liver, and with the pan- 
creatic juice, which very much resembles the saliva, from the pancreas or 
sweetbread. By the action of these two fluids the chyme is converted into 
two distinct portions-a milky white fluid named chyle, and a thick yellow 
residue. This process is called chylification, or chyle-making. The chyle is 
then sucked in by absorbent vessels, extensively ramified on the inner mem- 
brane or lining of the bowels, and sometimes named, from the white colour 
of their contents, lacteals, or milk-bearers, (from lac, milk.) These lacteals 
ultimately converge into one trunk, named the thoracic duct or chestpipe, 
(from its ccurse lying through the thorax or chest,) and which terminates in 
the great vein under the clavicle or collar-bone, hence called subclavian 
vein, just before the latter reaches the right side of the heart; and there the 
chyle is poured into the general current of the venous blood. 
" But, although thus mingled with the blood, the chyle is not yet suffi- 
ciently capacitated for its duties in the system. To complete its preparation, 
it still requires to be exposed to the action of the air during respiration. 
This is accordingly done by its passing through the lungs along with the 
dark or venous blood, which stands in need of the same change. In the 
course of this process both the chyle and the venous blood are converted 
into red, arterial, or nutritive blood, which is afterward distributed by the 
heart through the arteries, to supply nourishment and support to every part 
of the body. Hence the change which takes place in the lungs is properly 
enough named sanguification, or blood-making. 
" The thickish yellow residue left in the duodenum after the separation of 
the chyle from the chyme, is that portion of the food which affords no nour- 
ishment, and which, after traversing the whole length of the intestinal canal, 
and undergoing still farther change, is thrown out of the body in the shape 
of fceces or excrement. But in this course its bulk is increased and its 
appearance changed, by the addition of much waste matter, which, having 
already served its purposes in the system, is at last thrown out by the 
same channel." 
A series of experiments has been instituted by Dr. Beaumont, of the 
American army, on the person of Alexis St. Martin, a young Canadian, 
eighteen years of age, which shows the nature of digestion more clearly than 
has ever before been. He was accidently wounded by a gun on 6th June, 
1822. " The charge," says Dr. Beaumont, " consisting of pow'der and 
duck-shot, was received in the left side, and blew off the integuments to 
the size of a man's hand, breaking some of the ribs, lacerating the lower 
portion of the left lung, and penetrating the stomach. On the fifth day 
sloughing took place; portions of the lung bones and stomach separated, 
leaving an opening in the latter large enough to admit the whole length of 
the finger into its cavity ; and also a passage into the chest half as large as 
his fist. After one year the wound closed, leaving the orifice into the 
stomach, which remained open two and a half inches in circumference. For DIGESTION. 
757 
some months after the food could be retained, by wearing a compress ; but 
finally a small fold of the villous coat of the stomach began to appear, which 
gradually increased till it filled the aperture and acted as a va/ce, so as com- 
pletely to prevent any efflux from within, but to admit of being easily pushed 
back by the finger from without." 
Here, then, was a good opportunity for making experiments on digestion, 
which was improved by the ingenious Dr. Beaumont with zeal and per- 
severance, and by which he has thrown much light on this interesting 
subject. 
The first disputed point which is conclusively settled by Dr. Beaumont 
is, that the gastric juice does not continue to be secreted between the intervals 
of digestion, and does not accumulate to be ready for acting upon the next 
meal. Dr. Beaumont could easily observe what changes occurred, both 
when food was swallowed in the usual way, and when it was introduced at 
the opening left by the wound. Accordingly, on examining the surface of 
the villous coat with a magnifying-glass, he perceived an immediate change 
of appearance ensue whenever any food was brought into contact with it. The 
coat of the stomach changed from a pale pink to deeper red, the worm-like 
motions of the stomach became excited, and from innumerable little lucid 
points could be seen distilling a pure, colourless, and slightly viscid fluid, 
called the gastric juice, which mixed with the food. In the course of his 
attendance on St. Martin he found that, whenever a feverish state ensued, 
whether from obstructed perspiration, from undue excitement by stimulating 
liquors, from overloading the stomach, or from fear, anger, or other mental 
emotion depressing or disturbing the nervous system, the villous coat of the 
stomach became sometimes red and dry, and at other times pale and moist, 
and lost altogether its smooth and healthy appearance. As a necessary con- 
sequence, the usual secretions became vitiated, impaired, or entirely sup- 
pressed. When these diseased appearances were considerable, the system 
sympathized, and dryness of the mouth, thirst, fever, and other symptoms 
showed themselves ; and no gastric juice could be procured or extracted 
even on the application of the usual stimulus of food. This experiment 
shows why the stomach, in fever and other complaints, instinctively refuses 
much of any food. To test the solvent powers of the gastric juice, Dr. 
Beaumont withdrew from St. Martin's stomach about one ounce of it, ob- 
tained after fasting seventeen hours, by introducing first a thermometer to 
induce the secretion, and then a tube to carry it off. Into this quantity, 
placed in a vial, he introduced a piece of boiled salted beef, weighing three 
drachms. He then corked the vial tightly, and immersed it in water raised to 
the temperature of 100°, which he had previously ascertained to be the heat 
of the stomach. In forty minutes digestion had commenced on the surface 
of the beef. In fifty minutes the fluid became quite opaque and cloudy, and 
the texture of the beef began to loosen and separate. In sixty minutes chyme 
began to be formed. In one hour and a half the muscular fibres hung loose 
and unconnected, and floated about in shreds. In three hours they had 
diminished about one-half. In five hours only a few remained undissolved. 
In seven hours the muscular texture was no longer apparent; and in nine 
hours the solution was completed. 
To compare the progress of digestion in the natural way with these re- 
sults, Dr. Beaumont, at the time of commencing the above experiment, sus- 
pended a piece of the same beef, of equal weight and size, within the stomach 
by means of a string. At the end of the first half hour it presented the 
same appearances as the piece in the vial; but when Dr. Beaumont drew 758 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
out the string at the end of an hour and a half, the beef had been completely 
digested and disappeared, making a difference of result in point of time of 
nearly seven hours. 
Having thus obtained a brief view of the agent employed in digestion, 
and of the changes produced by it on different kinds of food, we proceed to 
mention the comparative digestibility of different kinds of food. These ex- 
periments were performed somewhat in a vague manner, some things having 
been omitted which are known to exert a powerful influence on digestion. 
The following table exhibits the general results of all the experiments 
made upon St. Martin posterior to 1825; and the average is deduced from 
those which were performed when the stomach was considered by Dr. 
Beaumont to be in its natural state, and St. Martin himself subjected to or- 
dinary exercise. 
TABLE showing the Mean Time of Digestion of the different Articles of Diet. 
Articles of Diet. 
Mode 
of 
Preparation. 
Time 
required for 
Digestion. 
H. M. 
Rice _____ 
Boiled 
1 
Pig's feet, soused - - - 
Boiled 
1 
Tripe, soused _ - - - 
Boiled 
1 
Eggs, whipped - - _ 
Raw 
1 30 
Trout, Salmon, fresh 
Boiled 
1 30 
Trout, Salmon, fresh 
Fried 
1 30 
Soup, barley - - - - 
Boiled 
1 30 
Apples, sweet and mellow 
Raw 
1 30 
Venison steak - - - - 
Broiled 
1 35 
Brains - - - 
Boiled 
1 45 
Sago _____ 
Boiled 
1 45 
Tapioca - - - - 
Boiled 
2 
Barley ----- 
Boiled 
2 
Milk ----- 
Boiled 
2 
Liver, beef's, fresh - - - 
Broiled 
2 
Eggs, fresh - - - - 
Raw 
2 
Codfish, cured, dry - - - 
Boiled 
2 
Apples, sour and mellow 
Raw 
2 
Cabbage, with vinegar 
Raw 
2 
Milk ----- 
Raw 
2 15 
Eggs, fresh - - - - 
Roasted 
2 15 
Turkey, wild _ _ _ 
Roasted 
2 18 
Turkey, domestic - - - 
Boiled 
2 25 1 
Gelatine - - - - 
Boiled 
2 30 
Turkey, domestic - - - 
Roasted 
2 30 
Goose _ _ - - 
Roasted 
2 30 
Pig, sucking - - - - 
Roasted 
2 30 
Lamb, fresh _ _ _ 
Broiled 
2 30 
Hash, meat and vegetables 
Warmed 
2 30 
Beans, pod - - - - 
Boiled 
2 30 
Cake, sponge - - - - 
Baked 
2 30 
Parsnips - - - _ 
Boiled 
2 30 DIGESTION. 
759 
TABLE showing Mean Time of Digestion-continued. 
Articles of Diet. 
Mode 
of 
Preparation. 
Time 
required for 
Digestion. 
H. 
M. 
Potatoes, Irish 
- 
Roasted 
2 
30 
Potatoes, Irish 
Baked 
2 
30 
Cabbage, head 
- 
Raw 
2 
30 
Spinal marrow 
Boiled 
2 
40 
Chicken, full grown - 
- 
Fricassee 
2 
45 
Custard - 
Baked 
2 
45 
Beef, with salt only - 
- 
Boiled 
2 
45 
Apples, sour and hard - 
Raw 
2 
50 
Oysters, fresh - 
- 
Raw 
2 
55 
Eggs, fresh, 
Soft boiled 
3 
Bass, striped, fresh - 
- 
Broiled 
3 
Beef, fresh, lean, rare - 
Roasted 
3 
Beef steak 
Broiled 
3 
Pork, recently salted 
Raw 
3 
Pork, recently salted 
- 
Stewed 
3 
Mutton, fresh 
Broiled 
3 
Mutton, fresh - 
- 
Boiled 
3 
Soup, beans 
Boiled 
3 
Chicken soup 
- 
Boiled 
3 
Aponeurosis 
Boiled 
3 
Cake, corn 
- 
Baked 
3 
Dumpling, apple - 
Boiled 
3 
Oysters, fresh 
- 
Roasted 
3 
15 
Pork steak - - - 
Broiled 
3 
15 
Pork, recently salted 
- 
Broiled 
3 
15 
Mutton, fresh 
Roasted 
3 
15 
Bread, corn 
- 
Baked 
3 
15 
Carrot, orange 
Boiled 
3 
15 
Sausage, fresh - 
• 
Broiled 
3 
20 
Flounder, fresh 
Fried 
3 
30 
Catfish, fresh - 
- 
Fried 
3 
30 
Oysters, fresh 
Stewed 
3 
30 
Beef, fresh, dry 
- 
Roasted 
3 
30 
Beef, with mustard, &c. 
Boiled 
3 
30 
Butter _ - - 
- 
Melted 
3 
30 
Cheese, old, strong 
Raw 
3 
30 
Soup, mutton 
- 
Boiled 
3 
30 
Oyster soup 
Boiled 
3 
30 
Bread, wheaten, fresh 
- 
Baked 
3 
30 
Turnips, flat 
Boiled 
3 
30 
Potatoes, Irish 
- 
Boiled 
3 
30 
Eggs, fresh - - - 
Hard boiled 
3 
30 
Eggs, fresh 
- 
Fried 
3 
30 
Green corn and beans 
Boiled 
3 
45 
Beet _ - - 
- 
Boiled 
3 
45 
Salmon, salted 
- 
Boiled 
4 760 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
TABLE showing Mean Time of Digestion-continued 
Articles of Diet. 
Mode 
of 
Preparation. 
Time 
required for 
Digestion. 
Beef, fresh, lean 
* 
Fried 
H. 
4 
M. 
Veal, fresh - - - 
- 
Broiled 
4 
Fowls, domestic 
- 
Boiled 
4 
Fowls, domestic - 
- 
Roasted 
4 
Ducks, domestic 
• 
Roasted 
4 
Soup, beef, vegetables, and bread 
Boiled 
4 
Heart, animal - 
Fried 
4 
Beef, old, hard, salted - 
Pork, recently salted 
- 
Boiled 
4 
15 
- 
Fried 
4 
15 
Soup, marrow bones 
* 
Boiled 
4 
15 
Cartilage 
- 
Boiled 
4 
15 
Pork, recently salted 
- 
Boiled 
4> 
30 
Veal, fresh 
• 
Fried 
4 
30 
Ducks, wild 
- 
Roasted 
4 
30 
Suet, mutton - 
- 
Boiled 
4 
30 
Cabbage, with vinegar - 
«• 
Boiled 
4 
30 
Suet, beef, fresh 
- - 
Boiled 
5 
3 
Pork, fat and lean 
- 
Roasted 
5 
15 
Tendon - - - 
- 
Boiled 
5 
30 
This table is very interesting, but the results must not be too much relied 
upon, or regarded as representing the uniform rate of digestibility. We have 
already seen that chymification is greatly influenced by the interval which 
has elapsed since the preceding meal, the amount of exercise taken, the 
keenness of the appetite, the state of the health and mind, the completeness 
of the mastication, the state of rest or exercise after eating, and various other 
circumstances ; and, above all, the quantity swallowed in proportion to the 
gastric juice secreted. And, consequently, if an experiment be made without 
regard to these conditions, and without anything being recorded except the 
time occupied in digestion in the individual case, the conclusions deduced 
from it may be most fallacious. The very aliment which, taken in full 
quantity, remains on the stomach for hours, may, in a smaller quantity, be 
entirely digested in one-third of the time. Thus, in the foregoing table, 
two and a half hours are set down as the average time required for the 
chymification of jelly ; and yet, in one of his experiments, we find that eight 
ounces of that substance were entirely digested in one hour. So that, if all 
the other conditions are not carefully kept in view at each trial, the results 
cannot possibly be held as conclusive. 
As a general rule, animal food is more easily and speedily digested, and 
contains a greater quantity of nutriment in a given bulk, than either herba- 
ceous or farinaceous food ; but, apparently from the same cause, it is also 
more heating and stimulating. Minuteness of division and tenderness of 
firbre are shown by Dr. Beaumont's experiments to be two great essentials 
for the easy digestion of butcher-meat; and the different kinds of fish, flesh, 
fowl, and game are found to vary in digestibility chiefly in proportion as 
they approach or depart from these two standard qualities. DIGESTION. 
761 
Farinaceous food, such as rice, sago, arrow-root, and gruel, are also rapidly 
assimilated, and prove less stimulating to the system than concentrated ani- 
mal food. Milk seems to rank in the same class, when the stomach is in a 
healthy state. 
Says Combe; " Many persons imagine that spirits, taken in moderate quan- 
tity, and improper quality and quantity of food, cannot be injurious, because 
they feel no immediate bad effects from their use. If the fundamental princi- 
ple which I have advanced is sound, and if all the functions of the system 
are already vigorously executed without the aid of spirits, their use can be 
followed by only one effect-morbid excitement; and it is in vain to contend 
against this obvious truth. The evil attending their use may not be felt at 
the moment, but, nevertheless, it is there ; and, for demonstrative proof of the 
fact, we are again indebted to Dr. Beaumont. On examining St. Martin's 
stomach after he had been indulging freely in ardent spirits for several days, 
Dr. Beaumont found its mucous membrane covered with inflammatory and 
aphthous (ulcerous) patches, the secretions vitiated, and the gastric juice 
diminished in quantity, viscid and unhealthy ; although St. Martin still com- 
plained of nothing, not even of impaired appetite. Two days later, when 
the state of matters was aggravated, ' the inner membrane of the stomach was 
unusually morbid, the inflammatory appearance more extensive, the spots more 
livid than usual; from the surface of some of them exuded small drops of 
grumous blood; the aphthous patches were larger and more numerous, the 
mucous covering thicker than common, and the gastric secretions much more 
vitiated. The gastric fluids extracted were mixed with a large proportion of 
thick, ropy mucus, and a considerable muco-purulent discharge slightly tinged 
with blood, resembling the discharge from the bowels in some cases of dysentery. 
Notwithstanding this diseased appearance of the stomach, no very essential 
aberration of its functions was manifested. St. Martin complained of no 
symptoms indicating any general derangement of the system, except an uneasy 
sensation and a tenderness at the pit of the stomach, and some vertigo, with 
dimness and yellowness of vision, on stooping down and rising again; had a thin 
yellowish-brown coat on his tongue, and his countenance was rather sallow ; 
pulse uniform and regular, appetite good ; rests quietly, and sleeps as usual.' 
" I have marked part of this quotation in italics, because it cannot be too 
attentively considered by those who contend that the stimulus of spirits is 
not injurious to the stomach or general health, unless where the mischief 
shows itself by palpable external signs. Here we have incontestible proof, 
that disease of the stomach was induced, and going on from bad to worse, 
in consequence of indulgence in ardent spirits, although no prominent symp- 
tom made its appearance, and St. Martin was in his general habits a healthy 
and sober man. And if such be the results of a few days of intemperance 
in a person of a sound constitution, it is impossible to deny that continued 
indulgence must be followed by more serious evils, whether these show them- 
selves from the first by marked external signs or not. 
" After a few days of low diet and the use of mild diluents, the coats of 
St. Martin's stomach were seen to resume their healthy appearance ; the 
secretions became natural, the gastric juice clear and abundant, and the 
appetite voracious. Dr. Beaumont adds, that, in the course of his experi- 
ments, diseased appearances of a similar kind were frequently observed- 
generally, but not always, after some appreciable cause ' Improper indulgence 
in eating and drinking has been the most common precursor of these diseased 
conditions of the coats of the stomach. The free use of ardent spirits, wine, 
beer, or any intoxicating liquor, when continued for some days, has invariably 
96 762 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
produced these morbid changes. Eating voraciously or too excess, swallowing 
food coarsely masticated or too fast,"*1 almost invariably produce similar effects, 
if repeated a number of times in close succession.' These observations 
require no comment; their practical bearing must be obvious to all who are 
willing to perceive it. 
" Dr. Beaumont had also frequent occasion to remark, that, when stomachic 
disorder, attended with febrile symptoms, was present, the mucous coat of 
the stomach presented distinct appearances of disease. It was red, irritable, 
and dry. Anger and violent emotions of the mind often produce these ap- 
pearances. 
" The condition of the stomach above described, and the consequent fail- 
ure and vitiation of the gastric secretion, induced by drinking ardent spirits, 
and by general intemperance, explain at once the miserable digestion and 
impaired appetite of the habitual drunkard ; and it would be well for those 
who are in danger of becoming the victims of the habit, were they early 
impressed with some of these striking and important truths. 
" If it be asked whether I go the length of proscribing all fermented liquors, 
from table beer upward, I answer that I do not; I merely mean that, where 
the general health is perfect without them, they ought not to be taken, be- 
cause then their only effect is to produce unnatural excitement. But where- 
ever the constitution or health is so deficient, or the exertions required by 
the mode of life are so great, that the system cannot be sustained in proper 
vigour without some additional stimulus, I would not only sanction, but re- 
commend the use of either wine or such other fermented liquor as should 
be found by experience to support the strength, without quickening the circu- 
lation, exciting the mind, or disordering the digestive functions. If, however, 
any of these effects be produced, I would consider its occurrence as a proof 
that the stimulus is inappropriate, and cannot be too soon discontinued, or at 
least diminished to such a quantity as shall be consistent with the ordinary 
action of the animal functions. 
It may be alleged that a glass of brandy after a heavy dinner facilitates 
digestion, and, therefore, cannot do harm. I admit at once, that, when we eat 
too much, or fill the stomach with indigestible food, a dram of brandy, from 
its temporary stimulus, enables us to get rid of the load sooner than we could 
do without it. But it seems to me that a far wiser plan would be, to abstain 
from eating what we know to be oppressive to the stomach ; and that by 
this means we shall attain our end infinitely better than by first eating a 
heavy meal, and then taking a stimulus, the efficacy of which is diminished 
by every repetition of its use. If we w'ere compelled to exceed the bounds 
of moderation in eating, there would be some apology for our conduct. 
INFERENCES FROM DR. BEAUMONT'S EXPERIMENTS AND OBSERVATIONS. 
1. That hunger is the effect of distention of the vessels that secrete the 
gastric juice. 
2. That the process of mastication, insalivation, and deglutition, in an 
abstract point of view, do not in any way affect the digestion of the food ; 
or, in other words, when food is introduced directly into the stomach in a 
finely divided state, without these previous steps, it is as readily and as 
perfectly digested as when they have been taken. 
3. That saliva does not possess the properties of an alimentary solvent. 
4. That the agent of chymification is the gastric juice. 
5. That the pure gastric juice is fluid, clear and transparent; without 
odour ; a little salt; and perceptibly acid. DIGESTION. 
763 
6. That it contains free muriatic acid, and some other active chemical 
principles. 
7. That it is never found free in the gastric cavity ; but is always excited 
to discharge itself by the introduction otfood or other irritants. 
8. That it is secreted from vessels distinct from the mucous follicles. 
9. That it is seldom obtained pure, but is generally mixed with mucus, 
and sometimes saliva. When pure it is capable of being kept for months, 
and perhaps for years. 
10 That it coagulates albumen, and afterward dissolves the coagxike. 
11. That it checks the progress of putrefaction. 
12. That it acts as a solvent of food, and alters its properties. 
13. That, like other chemical agents, it commences its action on food as 
soon as it comes in contact with it. 
14. That it is capable of combining with a certain and fixed quantity of 
food, and when more aliment is presented for its action than it will dissolve, 
disturbance of the stomach, or " indigestion," will ensue. 
15. That its action is facilitated by the warmth and motions of the stomach. 
16. That it becomes intimately mixed and blended with the ingestae in the 
stomach by the motions of that organ. 
17. That it is invariably the same substance, modified only by admixture 
with other fluids. 
18. That the motions of the stomach produce a constant churning of its 
contents, and admixture of food and gastric juice. 
19. That these motions are in two directions, transversely and longitudinally. 
20. That no other fluid produces the same effect on food that gastric juice 
does ; and that it is the only solvent of aliment. 
21. That the action of the stomach and its fluids is the same on all kinds 
of diet. 
22. That solid food, of a certain texture, is easier of digestion than fluid. 
23. That animal and farinaceous aliments are more easy of digestion than 
vegetable. (Butflesh is more stimulating, and, consequently, less healthy.) 
24. That the susceptibility of digestion does not, however, depend 
altogether upon natural or chemical distinctions. 
25. That digestion is facilitated by minuteness of division and tenderness 
of fibre ; and retarded by opposite qualities. 
26. That the ultimate principles of aliment are always the same, from 
whatever food they may be obtained. 
27. That chyme is homogeneous, but variable in its colour and consistence. 
28. That, toward the latter stages of chymification, it becomes more acid 
and stimulating, and passes more rapidly from the stomach. 
29. That the wmer coat of the stomach is of a palepinA: colour, varying in 
its hues according to its full or empty state. 
30. That, in health, it is sheathed with mucus. 
31. That the appearance of the interior of the stomach in is essen- 
tially different from that of its healthy state. 
32. That stimulating condiments are injurious to the healthy s-tomach. 
33. That the use of ardent spirits always produces disease of the stomach 
if persevered in. 
34. That tvater, ardent spirits, and most other fluids, are not affected by 
the gastric juice, but pass from the stomach soon after they have been received. 
35. That the quantity of food generally taken is more than the wants of 
the system require ; and that such excess, if persevered in, generally pro- 
duces, not only functional aberration, but disease of the coats of the stomach 764 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
36. That bulk as well as nutriment is necessary to the articles of diet 
37. That bile is not ordinarily found in the stomach, and is not commonly 
necessary for the digestion of the food ; but, 
38. That, when oily food has been used, it assists its digestion. 
39. That oily food is difficult of digestion, though it contains a large 
proportion of the nutrient principles. 
40. That the digestibility of aliment does not depend upon the quantity of 
nutrient principles that it contains. 
41. That the natural temperature of the stomach is about 100° Fahrenheit. 
42. That the temperature is not elevated by the ingestion of food. 
43. That exercise elevates the temperature ; and that sleep or rest, in a 
recumbent position, depresses it. 
44. That gentle exercise facilitates the digestion of food. 
45. That the time required for that purpose is various, depending upon 
the quantity and quality of the food, state of the stomach, &c. ; but that the 
time ordinarily required for the disposal of a moderate meal of the fibrous 
parts of meat, with bread, &c., is from three to three and a half hours. 
THE ARTERIES. 
Arteries are strong, elastic, membranous tubes, which arise from the heart 
Fig. 16. Arteries. 
Fig. 17. Veins. VEINS-BLOOD-NERVES-SKIN. 
765 
by two trunks, and convey the blood, by their innumerable branches, to every 
part of the body. They have three coats. 
THE VEINS. 
After the blood has thus been carried to every part of the system by the 
arteries, the latter terminate in small vessels- because they 
resemble hairs, being sc «ztxeirje.y mil; it neslity, they are smaller than 
hairs. These fern. ir termediate link between the arteries and the veins. 
The veins take their rise from these, and return the blood to the heart. 
THE BLOOD. 
A red fluid, of a saltish taste and urinous smell, which circulates in the 
heart, arteries, and veins. It is the most important fluid in the body. It 
is the source of heat, and furnishes materials from which all the parts of the 
body are supplied. Strength, health, and life depend upon, and the loss of a 
small quantity often deranges, the system. It stimulates the heart to con- 
traction. In the arteries it is of a crimson colour ; in the veins of a dark 
colour, and is changed in its passage through the lungs. 
THE NERVES. 
These are contractile bundles of white cords, the ends connected to the 
brain or spinal marrow, and thence expanded over the whole body, to receive 
mpressions from external objects, or to convey muscular motion. There 
are two pair issuing out of each side of the spine, and thence to every part 
of the body, so that you cannot touch any part of the skin with the point of a 
pin without coming in contact with a nerve and a bloodvessel. The great 
sympathetic nerve is the most important of all. The main trunk of it com- 
municates with all of the spinal nerves, and several of those of the brain. 
It presides over all the organs which are affected independent of the will. 
THE SKIN. 
The skin is a smooth, delicate, external membrane, which lines the whole 
oody, and forms the most beautiful covering. It is the last stroke of the 
great artist, which gives the finishing touch and makes the form divine. It is 
very superficial; and without it, or if removed, the most disgusting or revolt- 
ing spectacle would be presented : hence it is said that " beauty is only 
skin deep." First is the scarf skin, being the exterior part; insensible and 
rough. It is this which is raised in blisters : it is constantly wearing off, 
and as often renewed. Next to this is a very thin layer of paste, called 
rete mucosunij and on this depends the colour. In the African this mem- 
nrane or paste is jet black ; in the Indian, copper coloured; in the Spanish, 
yellow ; and in our race, white, which is ridiculed in Africa as being pale and 
homely, they considering their colour the standard of beauty. What will 
not education do ! Then, as this coat makes the difference of colour in the 
human family, it should not form the criterion of moral character or worth; 
but it should be merit or demerit, or, in other words, virtue. The third and 
last coat is the true skin, which is thicker than the others, and lays next to 
the muscles. It is freely supplied with bloodvessels and nerves. The 
colour of this membrane, the true skin, is nearly the same in all races of 
men, being as white in the negro as in the European. 766 
OUTLINES OF ANATOMY AND PHYSIOLOGY. 
The skin is a most important function in the animal economy. Two- 
thirds of the fluids taken into the system pass off by the skin. It has an 
infinite number of pores, which are designed to carry off extraneous and hurt- 
ful fluids from the blood; and hence, when they are obstructed, so many 
diseases follow ; by a knowledge of which we learn the true remedy, viz., 
to restore its secretion, and eliminate the poison. It is owing to this phy- 
siological view of it that we are led to bathe thoroughly the whole surface 
with stimulating or cleansing liquids in fever and other diseases, and which 
is followed by the most signal benefit. I am now attending a very obstinate 
case of remittent fever, fast recovering by bathing the body with an alkaline 
wash, and giving a warm tea of catnip immediately after. The most happy 
effects follow; a moisture usually breaks out, with a mitigation of all the 
symptoms. The stomach, liver, and bowels being disordered, 1 have given 
every other morning a small tea-spoonful of rhubarb. It has removed the 
weakness of the bowels, and a congested state of the liver, and at the same 
time operated as a tonic. In such cases rhubarb is the best purgative. 
THE TEMPERAMENTS. 
There are four of these : 1st, The lymphatic, in which there is easily seen 
a full, soft, and rounded form, and languid action. 
2d, The sanguine, in which there is a florid complexion, expanded chest, 
and general vivacity of disposition, showing the preponderance of the vascu- 
lar system, known generally by the term of plethoric or full habit, the cir- 
culation of the blood being very full and strong. 
3(Z, The bilious, in which the muscular system predominates. The body 
is remarkable for a compactness of fibre, indicative of strength and acti- 
vity. 
4th, The nervous, in which there is a thin, sharp outline, irregular and 
vivacious activity, and great susceptibility of impressions, and which 
betoken the predominance of the nervous over all the other functions. 
The following figures represent the different temperaments: 
Fig. 18. Lymphatic. 
Fig. 19. Sanguine. REFLECTIONS. 
767 
Fig. 20. Bilious. 
Fig. 21. Nervous. 
The temperament of the author is decidedly the latter, viz., nervous; and, while it 
has enabled him, under Devine Providence, to push his favourite pursuit, Medical 
Reform, it has been necessarily attended with great mental suffering. 
REFLECTIONS. 
Look at the mechanism of the system, the brain, eye, lungs, heart, liver, 
and other organs, the circulation of the blood, the arteries, veins, nerves, and 
absorbents; in short, any part of the body: see how wonderful, yea, how 
marvellous. If it has been said that " an undevout astronomer is mad," should 
we not rather say, or with equal propriety, that an undevout anatomist is mad ? 
Contrasting the system above us with the- anatomy of the human frame, 
we grant to this lofty canopy a grander aspect ; its amplitude, its sublimity. 
But, in delicate symmetry, in exquisite adaptedness of the minutest parts, 
what are stars and planets compared with this human form, so fearfully and 
wonderfully made ! 
And what is that splendid frame-work, studded, indeed, with glorious con- 
stellations, to the human eye that surveys it; that, through a pin's head 
opening, can let into the mind this whole hemisphere, with its thousand 
worlds! And even the marvellous powers of the eye in vision can hardly 
compare with the machinery of the human voice, that can make audible 
report to God of the adoration, awe, and gratitude that his works inspire ; 
and that can discourse of the feelings of the soul in the sacredness of its 
affections and the fulness of its joys. 
The divine wisdom and skill displayed in the construction of the body, 
and the arrangement of its parts, their wonderful adaptation and exact con- 
formity to a clear and settled purpose, open to us the richest stores of instruc- 
tion. There is in this study the profound philosophy whiih, while it often 
amazes, always elevates and expands the mind : the wisdom shown in the 
adjustment of every muscle and nerve, and in the articulation of every joint, 
overwhelms the conception of a finite intellect; and such results are by no 
means injurious ; they serve to reduce the loftiness of human pride; they 
constrain the soul to bow in submission, and, with the modesty of true science, 
confess its feebleness in the presence of such ineffable glory and power. 768 
CONCLUSION. 
CONCLUSION. 
Now, in conclusion, I have to request that a few minutes be daily directed 
by every member of the family, male and female, to the study of anatomy 
and physiology, as well as to the other branches of medicine laid down in 
this work. The information received will soon enable them to be their own 
physicians, and give such a knowledge of the human system as will lead 
them to promote their health, and prevent the necessity of using much medi- 
cine. It will enlighten their minds in one of the most interesting branches of 
science, and thus banish that hydra monster, quackery, which now stalks 
abroad in and out of the profession, and endangers our health and life. In this 
manner, and this only, can we ever expect to have a reform in medicine : while 
so much ignorance prevails it is out of the question to expect a better state 
of things. I am confident that an emancipation from the deadly effects of 
mercury the lancet, and the knife would be a greater blessing than was 
the emancipation of this country from foreign oppression and tyranny. 
I have exhibited the truth or this subject to others, but I cannot believe for 
them, nor compel them to receive it: according to the proverb, we may lead 
a horse to the water, but we cannot compel him to drink 
" Truth would you teach to save a sinking land, 
A_ Sk'.un, none aid you, and few understand." APPENDIX. 
THE TEETH. 
I Represents the incisor or cutting teeth, being the eight broad and flat 
teeth, with a sharp cutting edge, one-half seen in front of the upper and 
lower jaws. C, cuspidati, canine, or dog teeth, being sharp-pointed, resem- 
bling those in dogs, and used by them to tear their food. B G represents the 
molares or grinders, twenty in number, situated at the back part of the jaw, 
and so called because they are used to grind or bruise the food. 
Effect of the Teeth on Personal Appearance.-" The expression and 
general appearance of the face depend much upon the condition of the teeth. 
If they are perfect, regular, pure, and clean, they contribute more to beauty 
than any of the other features ; but if neglected, diseased, or incrusted with 
an offensive accumulation, they excite in the beholder both pity and disgust. 
" To illustrate this fact, the following picture is drawn by Mr. Pleasants, 
in a work written by him : 
" ' If the sculptor, the painter, or the poet,' says Mr. Pleasants, £ would 
invest the production of his genius with those forms of horror at which 
humanity shudders and recoils, he perfectly comprehends the art of giving 
to his allegorical personages an array of teeth, black with tartar, mutilated 
with gangrene, broken by violence, or wrested by distortion. Should Envy 
present herself in the group, her parted lips would disclose but a single fang. 
Should Malice approach to persecute his victim, his teeth would be turned 
away as if by the violence of his passion. Thus the wrinkled witch, the 
smoky gipsy, the fortune-telling hag, and the freebooter of the seas would 
lose the proper expression of their distinctive characters if supplied with 
perfect, regular, and beautiful sets of teeth. 
" ' On the other hand, the skilful artist, who would exhibit the amiable 
and worthy passions in all their loveliness and attraction, bestows untiring 770 
APPENDIX. 
labour in the exhibition of perfect arches of teeth, white as monumental 
alabaster, and regular as the crystal columns in the palace of Odin, inhabited 
bj' the virgins of the Valhallah. If he exhibit beauty in her smiles, a colon- 
nade of pearls contribute to the enchantment; if he show us Love, with 
music on her lips, the emblematic purity of her teeth must lend its tributary 
charm. Thus the ideal Venus of the polished Greeks, as well as the living 
Beauty in the hamlet of Circassia, would cease to please on the discovery 
of sensible defect in these important organs.' 
" A scientific medical writer of Paris thus concludes, in describing the in- 
fluence of the teeth over the other attractions of the face : ' The influence 
which the teeth exercise over beauty justifies the pre-eminence which 1 
attribute to them over all the other attractions of the countenance. This 
ornament is equally attractive in both sexes : it distinguishes the elegant 
from the slovenly gentleman, and diffuses amiability over the countenance, 
by softening the features. But it is more especially to woman that fine 
teeth are necessary, since it is her destiny first to gratify the eyes before she 
touches the soul, and captivates and enslaves the heart.' 
" J assent most cordially to the preceding remarks. The dark black eye 
may be ever so piercing, the soft blue eye may melt with tenderness, the 
rose may blossom brightly upon a downy cheek, and the graceful form, even 
of the Venus de Medicis, may be found among the softer sex ; yet all charms 
lose their power if the teeth are defective. 
" Let all fair readers remember Moore's lines: 
" ' What pity, blooming girl, 
That lips so ready for a lover 
Should not beneath their ruby casket cover 
One tooth of pearl ! 
But, like a rose beside the church yard stone, 
Be doomed to blush o'er many a mouldering bone !' " 
Says Combe ; " The great source of injury to the teeth in childhood and 
age, is disordered digestion." 
Directionsfor Preventing Decay and Preserving the Teeth.-The teeth of most 
persons in the present day, in consequence of submitting to the treatment of 
mineral quack doctors, and taking their poison, (mercury,) have become so 
decayed that very little can be done for them. Not so with the African, the 
Indian, and other nations who are blessed with an exemption from this class 
of men. Their teeth are whole and sound. Pardon me, dentists, for this 
blow against your profession. Pope says, " partial evil, but universal good." 
Tartar.-If the teeth are incrusted with much tartar, let it be removed 
by a dentist; after which brush them daily inside and out with charcoal 
and water, and occasionally with salt and water. 
Scurvy in the Gums.-Let all the tartar around the teeth be removed, then 
brush the teeth night and morning, as directed above. This complaint pro- 
ceeds from foreign matter incrusting the teeth, and formed, says a French 
writer, by an insect. Liquids should never be taken too hot nor too cold. 
Improper food also injures the teeth. Nuts or hard substances should never 
be mashed with the teeth; and, if you wish to save all your teeth, as well as 
health and life, never submit to the treatment of our popular mineral doctors. 
Decayed Teeth.-If the tooth is habitually painful, clean it and drop in 
some oil of cloves or powdered opium. If these fail, dip a splinter of any 
kind into nitric acid, and insert it at the bottom of the tooth ; this is to destroy 
the nerve: if necessary, repeat, and cover with cotton. Great care must be THE TEETH. 
771 
taken not to suffer the acid to get on the gums. The tincture of capsicum is 
also excellent for pain in and about the teeth ; apply it in the tooth, between 
the lip and gums, and outside of the cheek : very effectual for ague in 
the face. If these means fail, cut the gum around the tooth, then apply 
the forceps, (not a turnkey,) and work it backward and forward till a 
little loose; after which draw directly out in a line with the tooth. In this 
way it is drawn with one-half the pain produced by the old method. Where 
the subject of the complaint has not fortitude to have it extracted, an opium 
pill may be taken. Most of the pain, however, is in anticipation. 
I once had a patient dreadfully tortured with toothache, who strove several 
days to obtain courage sufficient to have it taken out; at last she seated 
herself before me to have it extracted, when the fear of it caused the most 
exquisite suffering. She began to pray, when in a second 1 took it out, 
without pain, being loose and having no prong. 
M. Cadet de Gassicourt recommends the following compound as a safe 
and excellent dentrifice, viz.: of white sugar and powdered charcoal each 
one ounce, of Peruvian bark half an ounce, of cream of tartar one drachm 
and a half, and of canella twenty-four grains, well rubbed together into an 
impalpable powder. He describes it as strengthening to the gums and 
cleansing to the teeth, and as destroying the disagreeable odour in the breath 
which so often arises from decaying teeth ; and, as a preventive oi toothache, 
1 have heard washing the mouth and teeth twice a day with salt and water 
strongly recommended by a gentleman who had both experienced and 
observed much benefit from it. 
Sidney Bowne states that, at nineteen years of age, four of his upper teeth 
were much decayed ; he filed them apart, brushed them once or twice a day 
with a hard brush (with cold water and soot from wood ashes) lengthwise 
of tbe teeth ; the brush to be dipped four or five times in the soot every time 
they are cleaned. In this manner his teeth have been remarkably preserved. 
Says Dr. J. King; " Where the gums are spongy, the teeth loose, and 
accompanied with haemorrhage upon brushing, the following forms one of 
the best tooth-washes ever used. The teeth and gums may be brushed 
every day for a few days, then every other day, till finally once a week 
will be sufficient; brushing in the intermediate time with clear water. B. 
prepared chalk, Peruvian bark, of each equal parts; combine with them a suffi- 
cient quantity of tincture of rhatany root to form a thin paste ; it is excellent. 
The teeth must be brushed both front and back; and a brush should be 
lightly applied to them, with a little water, after each meal regularly." 
The mouth should be well washed out with cold w * «• after each meal. 
THE END INDEX. 
Page 
Abdomen, the, ....... 265 
Dropsy of, 360 
Abercrombie quoted on Insanity, • • 380 
Abernethy on Inflammation of the Eye, 557 
Abortion, 541, 617 
Abscess-root, 689 
Abstinence, 3 
Acidity, 629 
Adder's Tongue, 685 
After-birth, 622 
After-pains, 625 
Age, 37,206 
Agrimony, 687 
Ague, Fever and, 226 
in the Breast, 517 
or pain*in the Face and Jaw, 593 
Air, . . . .26, 49, 78, 252, 268, 635 
Change of, 29 
in confined vessels, 29 
-- of cities, 27 
-- oi crowded assemblies, ... 27 
Pure, in disease, 30 
Alder, 664 
Almonds, 647 
Aloe 643 
Amaurosis, 561 
American Gentian, 689 
Amputation, 157 
Anatomy and Physiology, outlines of, 738 
Aneurism, . 159, 562 
Anger, 88 
Anginosa, Scarlatina, 274 
Animal Effluvia, 212 
Food, 9 
Substances, 691 
Anise seed, 665 
Ankles, dislocation of, 509 
Antrum of Highmore, collections of 
matter in, 600 
Anus, Fissure of, 537 
Apoplexy, 197,387 
Aphthae, 629 
Archangel, 643 
Ardent Spirits, 22 
Arm, fracture of 500 
Arnold, Mrs. Elijah, on Midwifery, . 163 
Arteries, 764 
Asafoetida, 656 
Asarabacca, 644 
Asiatic Cholera, 412 
Asthma, 305 
Page 
Atkins, Dudley, quoted on Colic,. . 441 
Atrophy from suckling, 628 
Avens-root, 688 
Baldness, 78 
Balm, 690 
of Gilead, 685, 726 
Balsam of Tolu, 675 
Balsams, 698 
Pulmonic and Pulmonary, . 698 
Bandaging, &c., . 37 
Barberry, 648 
Barber's Itch, 586 
Bath, 54 
Cold, 54 
Hot, 57 
Shower, 60 
Sulphur, 60 
Warm or Tepid, . 56 
Bathing, Topical, 55 
Bayberry, 662 
Beaumont, Dr., his experiments on 
Alexis St. Martin, 757 
Summary of inferences 
drawn from his experiments, . .762 
Beds, 49, 50 
Beech Drops, 682 
Beer, 25 
Medical or Root, 25 
Spruce, 25 
Benne Plant, 689 
Beth-root, 679 
Betony, 688 
Bile, 753 
Common, . 591 
Biliary Duct, 753 
Bilious Affections, .... . 421 
Colic, 437 
Remittent Fever, .... 233 
Temperament, 766 
Bind-weed, 687 
Bitters, 698 
Compound, 698 
Restorative Wine, .... 699 
Wine, . 698 
Bitter-sweet, . 672 
Black Ash Bark, . 689 
Blackberry, \ . 670 
Black Snake-root, .... 644., 748 
Thorn 686 
Bladder, the, 754 774 
INDEX. 
Page 
Bladder, Inflammation of, ... . 335 
Bleeding, 79, 129, 149 
at the Nose, 445 
Piles, 539 
Blessed Thistle, 686 
Blind Piles, 539 
Blood, the, 765 
Blood-letting, 125 
Blood-root, 672 
Blood, Spitting of, 444 
Vomiting of, 443 
Blue Bell, 689 
Cardinal Flower, 687 
Flag, 676, 690 
Violet, 689 
Body, wasting of, 469 
Boerhaave, 107 
Bones, the, 738 
Boneset, 655 
Borax, 694 
Botanical Synopsis, 681 
Bowels, the, ... 50, 184, 219, 263 
Bowel Diseases, ....... 429 
Bowels, falling down of, . . . .541 
Inflammation of, ... . 331 
Bowne, Sidney, quoted on Felons, . 584 
Brain, the, 742 
• Concussion of, 487 
Dropsy of, 355 
Inflammation of, 288 
Bread, 20 
Breast-bone, fractures of, ... . 495 
Breast, Ague in, 517 
Inflammation of, 517 
Breasts, swelling and pain in, . . .616 
Bronchial Tubes, Chronic Inflamma- 
tion of, 299 
Inflammation of, . 298 
Bronchocele, 591 
Broomrape, 682 
Bruises, 484 
Bubo, 547 
Bugle, 660 
Burdock, 644 
Burns, 602 
Burying in meeting-houses, cities, &c., 28 
Butternut, ....... 658,686 
Blights, 478 
Calamus 687 
Caldwell, Dr., on excessive eating, . 733 
Callus, 544,587 
Camphor, 654 
Canada Balsam, 665 
Cancer, 158, 512 
Canine Madness, 604 
Canker, 237, 424, 629 
Cantharides, 692 
Caraway, 684 
Carbonate of Iron, 696 
Page 
Carbuncle, . . 522 
Carrot, Wild, ....... 654 
Castile Soap, . . 694 
Castor Bean, ........ 670 
Catalepsy, 391 
Cataplasm, Mustard, 713 
Cataract, 160,5b0 
Catarrh, 302, 455 
Catnip, 663 
Cat-tail Flag-root, 690 
Caustic Potassse, 693 
Vegetable, 699 
White Vitriol, Mineral, . . 699 
Cayenne Pepper, 649 
Cedar, 659 
Celandine, 650 
Cellular Dropsy, 368 
Centaury, 684 
Cerebral Diseases, 373 
Cessation of the Menses, .... 452 
Chafing, 587 
Chamomile, 642 
Wild, 643 
Chancre, 546 
Charcoal, 29, 696 
Chest, Dropsy of, 364 
Chicken-pox, 351 
Chilblain, 587 
Children, Diseases of, 628 
Management of, • . . . 630 
Chills, 215,226 
Chloride of Lime, 96 
Choking, 630 
Cholera Morbus, 409 
Chronic Diarrhoea, 435 
Dysentery, 433 
Inflammation of the Bronchial 
Tubes, 299 
Heart, . 326 
- Liver, . 330 
Spleen, . 331 
Ophthalmia, 556 
Rheumatism, 339 
Cicuta, 650 
Cider, 25 
Cinnamon, 690 
Cinquefoil, 684, 687 
Cleanliness, 40 
Cleavers, 684 
Climate, 36, 66 
Clothing, 36, 48, 634 
quantity of 37 
Cloves, 655 
Club or crooked feet, 630 
Clysters, 705 
Coffee, . 20 
Cold, influence of, 200 
Colds, 210,303 
Colic, 435 INDEX. 
775 
Page 
Colic, Bilious, 437 
Flatulent, 436 
Painters' 439 
Collar-bone, fracture of, 495 
Colombo, 662,681 
Colt's-tail, 687 
Colocynth, 650 
Combe on Consumption, .... 320 
Digestion, ... . . 756 
effects of Spirits on the Sto- 
mach, 761 
excessive eating, . . .634 
rearing Children, . . . 632 
Weaning, 633 
Comfrey, 673 
Common Raspberry, 686 
Sorrel, 688 
Compound Fractures, treatment of, . 492 
Concussion of the Brain, .... 487 
Congestive Fever, 234 
Constitutional Affection, . . 526,550 
Consumption, 314 
Curability of, . . . .315 
History and prevalence of, 314 
Contused Wounds, 483 
Convalescence, 225,242 
Convulsions, 402,617,629 
Cookery, *21 
Cooper, Sir Astley, quoted, .... 488 
Copaiba, 649 
Copperas, 691 
Cornea, opacity of, 562 
specks on, 556 
Corns, 596 
Corn Snake-root, 688 
Corrosive Sublimate, 692 
Corsican Worm-weed, 682 
Costiveness, . . . 51, 442, 616, 626 
Coughs, 237, 303 
Cowhage, 682 
Cow Parsnip, 688 
Cow-pox, 350 
Cramp Bark, 689 
Cramps, 423,616 
Crane's bill, 657 
Cravings, 225 
Cream of Tartar 693 
Crosswort, 687 
Croton Oil, 687 
Croup, 296 
Crowfoot Buttercups, 690 
Crystals of Tartar, 693 
Cubebs, 686 
Culver's Physic, 685 
Cutting Almond 689 
Dandelion, 660 
Deadly Nightshade, 645 
Deafness, 593 
Pag* 
Debility, 216, 237, 468 
Decayed Bone, 511 
Decoction, Diuretic, 701 
for the Gravel, . . . .701 
Rheumatic, 701 
Urinary, 701 
Delirium Tremens, 395 
Delivery, 617 
treatment after, . . . 625 
Derangement, Mental, 373 
Desmoulins, 107 
Devil's Bit, 676, 686 
Diaphragm, Inflammation of, . . . 326 
Diarrhcea, Chronic, 435 
Diet, 3, 21, 631 
for the Healthy and the Sick, . 733 
Dietetic System, 104 
Digestion, 756 
time required for, of diffe- 
rent articles of diet, 758 
Diseases in general, nature, causes, 
and treatment of, 182 
efforts of Nature to remove, . 185 
Dislocations, 158, 501 
cases of, 505 
Dislocation of the Elbow, . . . 509 
Hip, .... 505 
Knees, Ankles, and 
Toes, 509 
Knee-pan, . . . 509 
Shoulder, . . . 508 
Wrist and Fingers, 509 
Dogwood, 652 
Dow-worm, 598 
Dragon's Claw, 665 
Draughts, 724 
Drinks, 9, 224, 736 
Drops, Anti-emetic, 700 
Beech 682 
Black, 700 
Carminative, 700 
Cough, 700 
Diuretic, 699 
Hot, 727 
Stimulating, .... 708, 727 
Sweating, 728 
Toothache, 701 
Dropsical Diseases 355 
Dropsy, Cellular, 368 
of the Abdomen or Belly, . 360 
Chest, 364 
Head or Brain, . 198, 355 
Chronic 
form of, 357 
Ovaria, 367 
Scrotum,. . . 371,579 
- Womb, . . . 368 
Dwarf Elder, .... 673 
Dysentery, ... 196,429 776 
INDEX. 
Page 
Dysentery, Chronic, 433 
Dyspepsia 67 
Liquid for, 736 
Ear, Inflammation of 290 
Early rising 43 
Earthy Substances, 691 
Effluvia, Animal, 212 
Human, 212 
Vegetable, 211 
Elder, 677 
Elecampane, 659 
Electricity, 83 
Electuary Lenitive, 732 
of Senna, 732 
Pile, 732 
Emaciation, 469 
Enlargement of the Heart, . . 326, 463 
Tonsils, . . .392 
Envy, 93 
Epilepsy or falling sickness, . . .383 
Eruptive Diseases, 345 
Eryngo, 680 
Escharotics, 699 
Essence of Hemlock, 729 
Peppermint, 729 
Euphorbia Ipecacuanha, .... 675 
Evacuations, 50 
Excess in eating, 733 
Excoriated Nipples, 627 
Excoriations, 587,629 
Excretions, 50,182,218 
Exercise, 30, 635 
Extract of Blood-root, ..... 699 
Extracts, 701 
Extraneous bodies in the Ear, . . . 593 
Eye, the, 745 
Inflammation of, 552 
Eye-balsam, 711 
Eye-salve, 710 
Eye-water, Dr. Lobstein's, .... 702 
Laurus, 702 
Mucilaginous, . . . .702 
Spirituous, ,702 
Face and Jaw, ague and pain in,. . 593 
Fainting, 197,393,616 
Falling of the Womb, 626 
False Cromwell, 689 
Fashion, 37, 78 
Fat, 478 
Fear, 90 
Feather-few, 687 
Febrile Diseases, .... 192, 208 
Feet, the, .... 49, 223, 255, 264 
Felon, . . 582 
Fennel seed, 690 
Fever, 216,226 
and Ague 226 
Page 
Fever, Bilious Remittent, . . . 233 
Congestive, 234 
Hectic, 284 
Infantile Remittent, .... 286 
Inflammatory, 238 
Intermittent, .... 197,226 
• Malignant Scarlet, .... 278 
Miliary, 279 
Milk, 626 
Puerperal, 281,626 
Putrid or Malignant, . . . 253 
Remittent, 230 
Scarlet, 273 
Simple Continued, .... 243 
Spotted, 270 
Typhus or Nervous, . . . 246 
Yellow, 260 
Fevers in general, 209 
Fever-bush, 687 
Fever-few, 684 
Figure, 37 
Figwort, 689 
Filth, 40 
Fingers, dislocation of, 509 
Fissure of the Anus, 537 
Fistula, 158, 528, 696 
in Ano, 528 
Persons cured of,. . . . 536 
in the Perinaeum, . . . .537 
Lachrymalis, 537 
Fits, 197,422,617 
Five-finger, 684, 687 
Flatulence, . . 629 
Flatulent Colic 436 
Fleabane, . . . 684 
Flooding, 626 
Flower de Luce, 690 
Flowering Ash, 678 
Flowers of Sulphur,. . ... 694 
Fluor Albus, 448 
Fomentations 702 
Fomentation, Common, 703 
Hop, 703 
Mint, 703 
Ophthalmic, .... 703 
Poppy, 703 
Stimulating, . . . .703 
Food, 9,11 
difference between Animal and 
Vegetable, 11 
mode of preparing, .... 734 
Foxglove, 654 
Fractures, 158,490 
of the Breast-bone, . . . 495 
Collar-bone, . . . 495 
Fore-arm and Leg, . 500 
Lower Jaw, 495 
Nose, .... 494 
Ribs, .... 495 INDEX. 
777 
Page 
Fractures of the Skull, . • . • 487 
Thigh, 495 
Upper Arm, . . . 498 
Fumigations, 95 
Fumitory, 687 
Furor Uterinus and Priapism, . . . 381 
Galen on Diet, 733 
Gall, 696 
Gall-bladder, 753 
Galling, 629 
Gamboge, 656 
Ganglion, 592 
Garden Lettuce, 687 
Nightshade, 674 
Rue, 689 
Gargles, 256, 703 
Gargle, Antiphlogistic, 704 
Astringent, 704 
- for Putrid Sore Throat, . .704 
Stimulating, 704 
Yeast, 704 
Garlic, 690 
Gastric Diseases, 409 
Juice, 749 
General Debility, 468 
Gensing, . 689 
Gentian, 656 
Giddiness, 394 
Ginger, 690 
Godman quoted on the Knife, . . .161 
Golden Rod, 683 
Seal, 657 
Thread, 651 
Gonorrhoea, 546 
Gout, 342 
Graham quoted on Consumption,. . 320 
Gravel, 574,701 
Weed, 689 
Green Ivy, 683 
Valerian, 689 
Vitriol, 691 
Grief, 87 
Guaiacum, 656 
Gum Arabic, 690 
Habit, 207 
Hatred, 93 
Headache, . . . 198, 237, 477, 615 
Head, the, 265 
Catarrh in, 455 
Dropsy of, 198, 355 
■ Wounds of, 487 
Health and Disease, definition of,. . 206 
Heartbum, 423,615 
Heart, the, 748 
• Chronic Inflammation of, . . 326 
■ Enlargement of, . . . 326,463 
Inflammation of 326 
Pag# 
Heart, Palpitation of, . . . . 463,616 
Heat, 211,215 
of Urine, 468 
to Cold, transition from, . . 47 
Hectic Fever, 284 
Hellebore, 657 
Hemlock, 666,685 
Henbane, . 678 
Hernia, . . 159,566 
Hiccough, . 428 
Hip Disease, 542 
dislocation of, 505 
Hoarhound, 662 
Hollyhoke, 685 
Hooping-cough, 30C 
Hops, 658 
Horsemint, 685 
Horseradish, . . 690 
Human Effluvia, 212 
Hunn, Dr. Anthony, 170 
Hydrophobia, 604 
Hypochondria, 399 
Hyssop, 690 
Hysterics, 197, 396, 616 
Hives, 478 
Iceland Moss, 683 
Ice Plant, 683 
Immoderate flow of the Menses, . . 450 
Imperfect Menstruation, .... 460 
Incontinence of Urine, 452 
Indian Cholera, 412 
Hemp, 646 
Turnip, 645 
Indigestion, 416 
Voltaire's dish for, . .737 
Indigo, 649 
Infantile Remittent Fever, .... 286 
Infants, on rearing of, 636 
Inflammation, 198,479 
of the Bladder, . .. . 335 
Brain,.... 288 
Breast, . . .517 
Bronchial Tubes, 298 
Diaphragm, . . 326 
Ear, .... 290 
Eye, .... 552 
Heart,.... 325 
Intestines, . . 331 
Kidneys, . . . 333 
Liver, .... 328 
Lungs, . 309,312 
Peritoneum, . 332 
Spleen, . . . 330 
Stomach, . . . 327 
- Womb, . 334, 627 
Inflammatory Diseases, 288 
Fever, 238 
Rheumatism, . . . 336 
Sore Throat 292 778 
INDEX 
Page 
Influenza, 302 
Infusion, Anthelmintic, 705 
Compound of Senna,. . .705 
Injections, ... 706 
Insanity, . . 373 
Intermittent Fever, . . . 197,226 
Internal Organs 742 
Intestinal Canal, 752 
Diseases, 429 
Intestines, 750 
Invalids, Rules for 99 
Inverted Toe-nail, 594 
Involuntary discharge of Urine, . . 446 
Ipecacuanha, 651 
Irritating Plaster, 712 
Irving, Washington, on Labour, . .621 
Itch, 586,600 
Jackson's Itch 586 
Jalap, 651 
Jaundice, 464 
Jebb, Sir Richard, his Rules for pre- 
serving Health 97 
Jerusalem Oak, 682 
Joints, Diseases of, 543 
- Wounds of, 486 
Joy, 92 
Juniper, 659 
Kidneys, the, ... 52, 184, 221, 753 
Inflammation of, .... 333 
King's Evil, 525 
Knee-pan, dislocation of, ... . 509 
Knees, dislocation of, 509 
Labour in child-birth, 617 
- Management of, . . . .618 
Natural, 619 
Labrador Tea, 690 
Lacerated Wounds, 483 
Lachrymalis, Fistula 537 
Lacteals, the, 754 
Ladies' Slipper, 654 
Lavender, ...... 662,688 
Laurel, 682 
Leg, fractures of, 500 
Lemon, 690 
Leopard's-bane, 689 
Lethargy, 392,615 
Lieutaud quoted on Bleeding, . . .310 
Life everlasting, 690 
Life-root, 688 
Ligaments, 740 
Lily of the Valley, . . . . . .689 
Lime, 691 
Liniments, 707 
Liquid, Anti-pyrosis,.' . . . . . 707 
Mint, 707 
Rheumatic, 708 
Page 
Liquid, Spirits of Mint, 707 
Stimulating .708 
Liquorice, . 657 
Liquors, Fermented, 22 
Lithotomy, . 160 
Liver, the, 52, 753 
•- Inflammation of, 328 
Chronic Inflammation of, . . 330 
Liverwort, 688 
Lobelia, 661 
Lobstein's Remedy for Tape-worm, . 476 
Lochia, 626 
Locked-jaw, 520 
Longevity 101 
Longings, 616 
Looseness 434, 629 
Love, 84 
Lower Jaw, fractures of, ... . 495 
Lumbago, 471 
Lumbar Abscesses, 601 
Lungs, the,. . . . 184,196, 221, 746 
Inflammation of,. . . 309,312 
Lungwort, 682 
Lymphatic Temperament, .... 766 
Maidenhair, 682 
Male Fern, 646 
Malice, 93 
Malignant Fever, 253 
Scarlet Fever, .... 278 
Maligna, Scarlatina, 275 
Mammary Abscess, 517 
Mandrake, 666 
Marasmus, 469 
Marsh-mallow, 646 
Marsh-rosemary 686 
Masterbation, 76 
Masterwort, , 688 
McNair quoted on Labour,.... 620 
-Midwifery, . .611 
Mead, 25 
Measles, 352 
Meconium, retention of, 628 
Medical Beer, 25 
Medicine, 634 
a Course of, for diseases 
generally, 636 
Medicines, Patent, 80,178 
Melancholy, 382 
Membranes, 742 
Menses, cessation of, 452 
Immoderate flow of, . . . 450 
Retention of, 455 
Suppression of, 457 
Menstruation, painful and imperfect,. 460 
Mental Derangement, 373 
Mercurial Diseases, 469 
Rheumatism, 341 
Mercury, 108,114,118 INDEX. 
779 
Page 
Midwifery, 162,607 
Miliary Fever, 279 
Milk, 21 
Fever, 626 
Sickness, 426 
or Swelled Leg, 626 
Milk-weed, 647 
Mind, state of, 206, 224 
Mineral Acids 691 
Poisons, 605 
Minerals, .... 79, 108, 123, 691 
Mixture, Anti-choleric and Anti-spas- 
modic, 731 
Nervous, 731 
Neutralizing, 732 
Saline Physic, . . . .731 
Mortification, 481 
Mother's Mark, 590 
Motherwort, 681 
Mountain-mint, 686 
Mouse-ear, 689 
Mucilage of Gum Arabic, .... 708 
Slippery Elm,.... 709 
Mugwort, 688 
Mullein, 679 
Mumps,. ... ... 291 
Muriate of Ammonia, . ... 691 
Mercury, 692 
Muscles, 741 
Mustard, 674 
Cataplasm 713 
Sinapism, 725 
Nannyberry, 686 
Navel-string, excoriation of, . . . 630 
Necrosis, 511 
Nephritic Plant, 689 
Nerves, the, 765 
Nervous Fever, 246 
Diseases, 67, 396 
Temperament, 766 
Nettle, 686 
Nightmare, 462 
Nitrate of Potash, 692 
Nodes, 551 
Nose or Ossa Nasi, fracture of, . .494 
Nosology 202 
Nostrums, 80 
Nursing, 225, 627 
Nutmeg, 690 
Nettle Rash, 478 
Obesity, 478 
(Esophagus, .751 
- Foreign substances in, . 596 
Oil, Anthelmintic or Worm, . . . 709 
of Red Pepper, 709 
Vitriol, 691 
Ointment, Brown, 710 
Celandine, . . . .710 
Page 
Ointment, Discutient 710 
for Salt Rheum, . . . .711 
Green, 710 
Itch, 710 
Marsh-mallow, . . . .711 
Ophthalmic, 710 
Stramonium, 709 
Olive, 661 
Onanism, 76,454 
Ophthalmia, 198 
Ophthalmic Tarsi, 556 
Orange, 690 
Ovaria, Dropsy of, 367 
Ozsena, 476 
Painful Menstruation, 460 
Painters' Colic, 439 
Palpitation of the Heart, . . 463, 616 
Palsy, 405 
Pancreas, 753 
Parsley, 690 
Partridgeberry, 682 
Passions, the, 84 
Pelvis, the, 741 
Pennyroyal, 677 
Peppermint, 663 
Perinaeum, Fistula in, 517 
Peritoneum, Inflammation of, . . . 332 
Persimmon Bark, . 689 
Peruvian Bark, 652 
Physic and Surgery, connexion between ,479 
Hull's Bilious, .... 720 
Piles, 538, 616 
Pill, Anti-bilious, 716 
Anti-dyspeptic, 714 
Anti-hysteric, 717 
Cicuta, 716 
Croton, 715 
Female, 715 
for Chronic Bronchitis and Asthma, 716 
Hepatic, 715 
Hydragogue, 716 
Ipecac 715 
Mandrake, 716 
Nervous, 716 
or Hysteric, . . . .715 
Opium, 715 
Red or Stimulating 716 
-- Rheumatic, 715 
Pimpernel, 687 
Pink, 673 
Pitch Pine, 665 
Plague, 256 
Plantain, 668 
Plaster, Adhesive or Strengthening, . 712 
Astringent, 711 
Blistering, 711 
Common Strengthening, . .712 
Ferris's Black, 711 780 
INDEX. 
Page 
Plaster, Irritating, 712 
Strengthening, . . . 711,712 
Pleurisy, 197, 323 
Pleurisy-root, 642 
Pneumonia Typhoides, 312 
Poisoned Wounds, 485 
Poisons, 605 
Poke, 669 
Polypody, 678 
Polypus, 584 
Poplar, 660 
Poppy, 668 
Powder, Anodyne, 717 
Anti-bilious or Cathartic, . 717 
Bone's Emetic and Cathartic, 718 
Cephalic, .... 719,720 
- Common Emetic, . . . .718 
Cough, 721 
Diaphoretic, 719 
Emmenagogue or Tonic, . 718 
Eupatorium, 719 
Fever, 719 
and Ague, . . .717 
King's Emetic, . . . .718 
Mandrake, 720 
• - Red or Styptic, . . . .720 
Smith's Colic, 719 
Cough, .... 719 
Snuff, 717 
Worm, 705 
Poultice, Alkaline, 713 
Black Willow, 714 
Carrot, 713 
Cicuta, ....... 714 
Common, 713 
Ferris's, 714 
Indian Turnip, . . . .714 
Linseed, 713 
Potatoe, 714 
Yeast, 713 
Pregnancy, Diseases of, 614 
Preternatural Labour, '624 
Priapism, ......... 381 
Prickly-ash, 677, 686 
Prickly-pear, 690 
Prince's Pine, 689 
Profluent Diseases, 443 
Projection of the Womb, .... 626 
Prolapsus Ani, 541 
Prostrate Gland, Enlargement of, . . 579 
Psoas, .... 601 
Punctured Wounds, 484 
Puerperal Fever, 281,626 
Putrid Fever, 253 
Sore Throat, 295 
Quinsy, 292 
Rattlesnake-root, 688 
Pag« 
Rectum, Strictures of, 541 
Red Lead, 692 
Mulberry, 682 
Oxide of Iron, 696 
Lead, 692 
Refluent Diseases, 455 
Remittent Fever, 230 
Infantile,.... 286 
Retention of the Meconium, . . .628 
Menses, .... 455 
Urine, 572 
Rheumatism, ........ 195 
Chronic, . . • . . 339 
Inflammatory, . . .336 
in the Head, .... 338 
Mercurial, . . . .341 
Rhubarb, 671 
Ribs, fractures of, 495 
Rickets 598 
Ringworm, 599 
Root Beer, 25 
Rose, 677 
Willow, 653 
Rupture, 159, 566, 630 
Saffron, 653 
Sage, 675 
Sal JEratus, 693 
- Ammonia, 691 
Saline Physic, 731 
Salivation, 110,469 
Sal Soda, 695 
Saltpetre, 692 
Salt Rheum, 585 
Salts, 79, 691 
of Hartshorn, 695 
Salves, 721 
Sanguine Temperament, . . 766 
Sarsaparilla, 674,686 
Sassafras, 661 
Scabious, 688 
Scald Head, 598 
Scalds, 602 
Scarlatina Anginosa, 274 
Maligna, 275 
Scarlet Fever, 273 
Malignant, .... 278 
Scirrhus, . 512 
of the Testicle, . . . .581 
Scrofula, 525 
Scrotum, Dropsy of 371, 579 
Scurvy, 466 
Secretions, 216,218 
Self-pollution, 76,454 
Seneca Snake-root, 669 
Senna, 653 
Sexual Intercourse, 76 
Shoulder, dislocation of, 508 
Silk-weed, 647 INDEX. 
781 
Page 
Simple Continued Fever, .... 243 
Sinapisms, 725 
Sinews, contraction of, . . . 544,587 
Skin, the, . . .53, 183, 220, 264, 765 
Skull-cap, 679 
Skull, fractures of, 487 
Skunk Cabbage, 659 
Small-pox, 346 
Smart-weed, 686 
Smith, Dr. Nathan, his instrument, . 597 
Snake-head, 688 
Snake-root, 688 
Snake-weed, 688 
Snuff, Henry's Cephalic, .... 720 
Soapwort, 688 
Solomon's Seal, 653 
Sore Mouth, ........ 424 
Nipples, 627 
Throat, Inflammatory,.... 292 
-Putrid, 295 
Sorrel, 688 
Spanish Flies, 692 
Spearmint, 663 
Spice Wood, 687 
Spikenard, 647 
Spine, Diseases of, 602 
Spirits, Ardent, 22 
Effects of, on the Stomach, . 761 
of Camphor, 724 
Lavender, 724 
Spitting of Blood, 444 
Spleen, 750 
Inflammation of, . . . .330 
Spleenwort, 688 
Spotted Fever, 270 
Sprains, 602 
Springs, Farquier White Sulphur,. . 65 
Spruce, 685 
Beer, 25 
St. Anthony's Fire 518 
St. John's-wort, 682 
St. Martin's case, 756 
St. Vitus's Dance, 407 
Stebbins, Mrs. Ruth, on Midwifery, . 612 
Still-bom Infants, 628 
Stinking Goosefoot, 688 
Stomach, the, . 134,218,237,263,749 
Inflammation of, • . . . 327 
Stone and Gravel 576 
Stramonium, 655 
Stricture in the Urethra, 571 
Strictures of the Rectum, . . . .541 
Treatment of, 551 
Striped Alder, 681 
Bloodwort, .... 684, 688 
Strong-scented Lettuce 683 
Sub-borate of Soda, 694 
Sublimed Sulphur, 694 
Succory, 688 
Page 
Sugar of Lead, . . .... 692 
Sulphate of Iron, 691 
- Quinine, 694 
Sulphuric Acid, 691 
jEther, 691 
Sulphur, Native, 695 
Sumach, . . 671 
Summer Complaint, 434 
Suppositories, 729 
Suppression of the Menses, .... 457 
-Urine, . . . 572,616 
Suppuration, 480 
Surgical Diseases, 479 
Operations, 150 
Suspended Animation, 603 
Sweat-root, 689 
Sweet Balsam, 690 
Clover, 685 
Fem, 685 
Flag, 637 
Gale, 686 
Sicily, 688 
Sweet, his principle of Bone-setting, 502 
Swelled Leg, 626 
Swine-pox, 351 
Syrup, Alterative, 722 
Blackberry, 723 
Cough, 724 
Expectorant, 724 
for the Dysentery, .... 723 
Hoarhound, 723 
Scrofulous 723 
Vegetable, 722 
White Poppy, . . . . , 723 
Tag, or Spotted Alder, 690 
Tansy, 675 
Tape-worm, 474 
Tea, Composition or Bitter, .... 705 
Teeth, directions for preserving, . . 770 
Effects of, on personal appear- 
ance, 769 
Temperaments 207, 766 
Tendons, 740 
Contraction of,. . . 544, 587 
Wounds of, 486 
Tetter, 585 
Thigh, fractures of, 495 
Thimble-weed, 688 
Thom Apple, 655 
Thrush, 424, 629 
Tic Douloureux, 588 
Tight Lacing, 72 
Tincture, Anti-spasmodic, . . . .726 
Balsam of Tolu, .... 726 
Botanical, 725 
Camphor, 727 
Castor, 726 
- Expectorant, 728 782 
INDEX. 
Page 
Tincture, Foxglove, 728 
Hops, 726 
Hydragogue, 725 
of Capsicum, 727 
Cohosh, 728 
Ipecacuanha, .... 708 
Lobelia, 725 
Opium, 727 
Senna, 727 
Physical, 727 
Rheumatic Wine,.... 707 
Stramonium, 728 
Sudorific, 728 
Tonic, 727 
Wine, 729 
- - Valerian or Nervine,. . . 726 
Tobacco, 67, 690 
Toe-nail, Inverted, 594 
Toes, dislocation of 509 
Tongue-tied, 630 
Tonsils, Enlargement of, . . 592 
Toothache, 594,616 
Trachea, foreign substances in, . . 596 
Troches, 729,730 
Tumours, 543,589, 696 
Twin-leaf, 689 
Typhoides, Pneumonia, 312 
Typhus Fever, 246 
Ulcers, . .... . . 510 
Umbilical Cord, excoriation of, . . 630 
Upper Arm, fracture of, 498 
Urethra, strictures in, 571 
Urine, Heat of, 468 
Incontinence of, 452 
• Involuntary discharge of, . . 446 
Suppression and retention 
of, 572,616 
Voiding of Blood by, . . . 453 
Uterus, 754 
Uva Ursi, 687 
Vaccine Disease, 350 
Vagina, Imperforated, 630 
Vegetable Effluvia, 211 
Food, ....... 11 
• Materia Medica,. . . . 639 
• Poisons, 765 
Veins, 605 
Venereal Disease, 546 
Venery, 76 
Veratria, 695 
Vervain, 683 
Virginia Snake-root, 648 
Speedwell, 687 
Viscera, 742 
Voiding of Blood by Urine, . . . . 453 
Vomiting, 229,427 
• of Blood, 443 
Page 
Wakefulness, 616 
Warts, 596 
Washes, 730 
Wash, Astringent, 731 
Saline, 731 
Wasting of the Body, 469 
Water-brash, 415 
Fennel, 690 
Hemlock, 683 
Watermelon, 682 
Water, 21, 266, 696 
Plantain 689 
- Rushes, 690 
Waters, Mineral or Medicinal, . . 63 
Weaning, 633 
Wens, 696 
White Bryony, 686 
Hellebore, 686 
Oak, 669 
Pine, .... . . 665 
Pond Lily . 689 
Whites, or Fluor Albus, .... 448 
White-swelling, . . 153,158,198,542 
White Vitriol, 695 
Whitlow, 582 
Whortleberry, 685 
Wild Alspice, 687 
Carrot, 654 
Chamomile 643 
Cheny, 666 
Indigo, 649 
Job's Tears, 689 
Lettuce, 687 
Marjorum, 682 
Parsley, 687 
Windpipe, foreign substances in, . . 596 
Wine of Ipecacuanha, 708 
Wintergreen, 683,689 
Witch Hazel, 658 
Wolf's-bane, 689 
Womb, 754 
Dropsy of, ... . . 368 
Inflammation of, 334, 627 
Worms,... .... 472 
Wormwood, 680 
Wounds, 482 
of the Head, 487 
Joints, 486 
Tendons, .... 486 
Wrist, dislocation of, 509 
Yarrow, 683 
Yaw-root, 686 
Yaws, 470 
Yellow Dock, 670 
Fever, 260 
Parilla 687 
Pine, 665 
Pond Lily, 689 ADVERTISEMENT. 
THE FAMILY fflWIAN: OR, g 
THE REFORMED SYSTEM OF MEDICINE. 
At the time the Prospectus of this work was issued it was the intention of the Author not to 
exceed 600 pages, and to charge five dollars per copy ; but he has been obliged to increase 
it to 800 pages, in consequence of which he finds it necessary, in justice to himself, to fix 
the price at six dollars. 
The work will be promptly sent to any part of the world, if ordered, and the money 
forwarded in advance. A few copies will be reserved in sheets, which can be sent by mail 
-the purchasers to have them bound. The work may also be forwarded ready bound to any 
part of the United States by other conveyance, particularly by Hamden's express, established 
for forwarding small packages, at a reasonable price. 
The Author of the above-named work would call the attention of his readers 
to the following propositions : 
1.-THE AMERICAN PRACTICE OF MEDICINE. 
I propose, if suitable encouragement be given, to publish another edition of my large 
work, The American Practice of Medicine, in two large volumes, with numerous coloured 
figures of plants, and other plates, &c. Five dollars a volume, to be sold separately or 
together. 
2-A TREATISE ON ANATOMY AND PHYSIOLOGY. 
I propose also to issue a popular Treatise on Anatomy and Physiology, illustrated with 
plates. Price not to exceed Two Dollars. 
3-A TREATISE ON MIDWIFERY. 
I intend also, as soon as circumstances permit, to publish a Treatise on Midwifery, with 
plates, at $1,50 per copy. 
4.-A MEDICAL DICTIONARY, 
For popular use. From one to two dollars per copy. 
5.-A HISTORY OF THE REFORMED PRACTICE. 
Probably by Dr. Cooke. 
6-THE MEDICAL REFORMER. 
I propose also to republish a work called The Medical Reformer. Nearly twenty years 
ago I issued 1500 copies : it has been out of print for many years. It is designed to 
enlighten the community on the subject of the present practice of medicine, and to lead 
them to embrace the reformed system. Price, fifty cents per copy. Reformed physicians 
should purchase by the hundred, to circulate. 
Should there not be schools to teach the Reformed Practice? I shall be pleased to confer 
with any on this subject. I hope that donations and legacies will be given for the promotion 
of this object. Can money be appropriated for a better purpose I 
A Medical Almanac.-I shall most probably issue an Almanac of this kind for the ensuing 
year, (1843.) 
Improvements.-I shall be highly gratified to receive any new remedies or improved me- 
thods of treating diseases ; likewise figures and descriptions of plants, roots, 
Medals.-In conclusion, I propose to award Medals to those who have honestly and 
faithfully advanced the interests of the reformed practice of medicine. 2 
It is to be hoped that those who are convinced of the superiority of the reformed over the 
mineral and depletive treatment, will take measures to establish hospitals and dispensaries 
on improved principles. 
HOSPITALS AND DISPENSARIES. 
Maison De Sant.e.-Tn France there are many places established for the invalid and tho 
sick, called Maison de Sante, or house of health, with all the advantages of a private resi- 
dence. These should be founded in different sections of our country. The design and 
location of an institution for this purpose might be similar to that represented in the above 
plate. They may be substituted for hospitals, which, as now conducted, like dispensaries, 
are a curse, instead of a blessing, to the community ; they are managed wrong in every 
respect. 
MEDICINES. 
I intend to keep on hand a good supply of genuine medicine, both in a raw and prepared 
tate, which will be sent to any part of the world. Great discount made to those who 
purchase by the quantity. Two kinds of articles are kept by druggists; it is impossible to 
obtain the desired result of any medicine if it be spurious. I have also contemplated sending 
out small boxes of medicine for vessels, family use, &c. The price of some to be as low 
as five dollars. 
Orders for books, medicines, medicine chests, &c., to be directed to Dr. W. Beach, New 
York city. 
New York, September, 1842.