DOMESTIC MEDICINE:
OR, A
TREATISE
ON THE
PREVENTION AND CURE
OF
DISEASES,
BY REGIMEN AND SIMPLE MEDICINES:
WITH
AN APPENDIX,
CONTAINING A DISPENSATORY FOR THE USE OF
PRIVATE PRACTITIONERS.
BY WILLIAM BUCHAN, M.D.
FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS,
EDINBURGH.
ADAPTED TO THE
Climate and Diseases of America,
BY ISAAC CATHRALL.
PHILADELPHIA:
PRINTED BY RICHARD FOLWELL,
FOR S. CAMPBELL, NEW-YORK.
1797.

COPY-RIGHT
SECURED ACCORDING TO LAW.

PREFACE
AMONG the motives which have induced me to re-
publish DR. BUCHAN'S book on DOMESTIC MEDICINE,
is that of rendering it more extensively useful to the
inhabitants of the United States of America, by accom-
modating it to their diseases. Although it contains a
comprehensive description of the diseases incident to
the nations of Europe, and is too well known by its
celebrity to the world, to require any encomium from
me, yet the variety to which diseases are subject from
climate, makes it somewhat deficient when applied to
those of America: To supply that defect is the object
of this publication. How far I have succeeded in the
accomplishment of my design, must be decided by the
candour of the public, to whose judgment it is now with
diffidence submitted, without any farther apology than
a consciousness of meaning well, and a desire or solici-
ting that portion of indulgence, which is due to every
attempt to promote the good of mankind.
Isaac Cathrall.
Philadelphia, August 20, 1797.

CONTENTS.
PART I.
Of the general Causes of
Diseases.
CHAPTER I.
OF Children PAGE 23
—Diseased Parents 26
-Clothing of Children 28
-Food of do. 32
—Exercise of do. 36
—Effects of unwholesome
Air upon do. 41
—Nurses 43
CHAPTER II.
Of the Laborious, &c. 45
—the Sedentary 51
—the Studious 55
CHAPTER III.
Of Aliment 60
CHAPTER IV.
Of Air 67
CHAPTER V.
Of Exercise 71
CHAPTER VI.
Of Sleep 75
—Clothing 76
CHAPTER VII.
Of Intemperance 79
CHAPTER VIII.
Of Cleanliness 82
CHAPTER IX.
Of Infection 86
CHAPTER X.
Of the Passions 89
—Anger ibid.
—Fear 90
—Grief 92
—Love 94
—Religious Melancholy 95
CHAPTER XI.
Of common Evacuations 95
—Stool ibid.
—Urine 97
—Perspiration 98
Are affected by Changes
in the Atmosphere  ibid.
—Wet Clothes 99
—Wet Feet ibid
—Night Air 100
—Damp Beds ibid
—Damp Houses 101
—Sudden Transitions
from Heat to Cold 102
PART II.
Of Diseases.
CHAPTER XII.
Of the Knowledge and
Cure of Diseases 105
CHAPTER XIII.
Of levers in General 108
CHAPTER XIV.
Of Intermitting Fevers
or Agues 112

CONTENTS. 5
CHAPTER XV.
Of an Acute continual
Fever 118
CHAPTER XVI.
Of the Pleurisy 122
—Bastard do. 125
—Paraphrenitis 126
CHAPTER XVII.
Of a Peripneumony, or
Inflammation of the
Lungs 126
CHAPTER XVIII.
Of Consumtions 128
CHAPTER XIX.
Of the Slow or Nervous
Fever 137
CHAPTER XX.
Of the Malignant, Putrid,
or Spotted Fever 141
CHAPTER XXI.
Of the Miliary Fever 147
CHAPTER XXII.
Of the Remitting Fever 150:
CHAPTER XXIII. 
Of the Yellow Fever 152
CHAPTER XXIV.
Of the SmaIl pox 167
—Inoculation 174
CHAPTER XXV.
Of the Chicken-Pox 182
CHAPTER XXVI.
Of the Measles 183
—Scarlet lever 186
-Bilious Fever 187
CHAPTER XXVII. 
Of the Erysipelas, or St.
Anthony's Fire 188
CHAPTER XXVIII.
Of the Phrenitis, of In-
Flammation of the
Brain 192
CHAP XXIX
Of the Opthalmia, or In-
flammation of the Eyes 194
CHAPTER XXX.
Of the Quinsey, or In-
flammation of the
Throat 198
 —Malignant do. 202
—Cynanche Parotidæa,
or Mump 205
CHAPTER  XXXI.
Of Colds and Coughs 205
—Common Cough 208
—Hooping-Cough 210
CHAPTER XXXII.
Inflammation of the Sto-
mach, & other Viscera 213
—Of the Intestines 215
Of the Cholic 217
Inflammation of the Kid-
nies 221
—Of the Bladder 223
—Of the Liver 224
CHAPTER XXXIII.
Of the Cholera Morbus,
and other excessive Dis-
charges from the Sto-
mach and Bowels 226
—a Diarrhœa, or Loose-
ness 228
-Vomiting 230
CHAPTER XXXIV.
Of the Diabetes, and other
Disorders of the Kid-
nies and Bladder 232
—Suppression of Urine 234
—the Gravel and Stone 236

6 CONTENTS.
CHAPTER XXXV.
Of Involuntary Dischar-
ges of Blood 238
—Bleeding at the Nose 240
—the Bleeding and Blind
Piles 242
Spitting of Blood 244
Vomiting of do. 246,
Bloody Urine 247
Dysentery, or Bloody-
Flux 248
Cœliac Passion 253
CHAPTER XXXVI.
Of the Head-Ach 253
—Tooth-Ach 256
—Ear-Ach 258
Pain of the Stomach, &c. 259
CHAPTER XXXVII.
Of Worms 261
CHAPTER XXXVIII.
Of the jaundice 264
CHAPTER XXXIX.
Of the Dropsy 266
CHAPTER XL.
Of the Gout 270
-—Rheumatism 275
CHAPTER XLI.
Of the Scurvy 278
—Schrophula, or King's
Evil 281
—Itch 283
CHAPTER XLII.
The Asthma 286
CHAPTER XLIII.
Of the Apoplexy 288
CHAPTER XLIV.
Of Costiveness, and other
Affections of the Sto-
mach and Bowels 291
—Want of Appetite 292
—Heart-Burn 293
CHAPTER XLV.
Nervous Diseases 294
Melancholy 298
The Palsy 301
Tetanus, or Locked Jaw 302
Of the Epilepsy, or Fal-
ling-Sickness 304
—Hiccup 306
—Cramp of the Stomach 307
—Night-Mare 308
—Swoonings 309
—Flatulencies, or Wind 311
—Low Spirits 313
Of Hysteric Affections ibid.
—Hypochondriac Affec-
tions 316
CHAPTER XLVI.
Disorders of the Senses 318
—of the Eye 319
A Gutta Serena 320
A Cataract ibid.
Short Sightedness ibid.
Seeing only at too great
a Distance ibid.
Squinting ibid.
Blood-shot Eye 321
Watery or weeping Eye ibid.
Or the Ear ibid.
—Taste and Smell 323
—Touch 324
CHAPTER XLVII.
Of a Schirrus and Cancer 325
CHAPTER XLVIII.
Of Poisons
—Mineral Poisons ibid.
—Vegetable do. 330
Bites of Poisonous Ani-
mals 331

CONTENTS. 7
—of the Mad Dog 313
—of the Viper 336
—of Poisonous Infects 337
CHAPTER XLIX.
Of the Venereal Disease 337
—Virulent Gonorrhœa 338
—Gleets 342
—Swelled Testicle 343
—Buboes 344
—Chancres 345
Confirmed Lues 348
General Observations 351
CHAPTER L.
Diseases of Women 355
Of the Menstrual Dis-
charge 356
Of Pregnancy 360
—Child Birth 362
—Barrenness 368
CHAPTER LI.
Diseases of Children 369
Of the Meconium 370
—the Apthæ or Thrush ibid.
—Acidities 371
—Galling and Excoria-
tion 372
—Stoppage at the Nose 373
-Vomiting ibid
—a Looseness 374
—the Vomiting and
Purging of Children 375
—Eruptions 377
—the Hives 378
—the Spasmodic do. 379
—Teething 380
—the Rickets 382
—Convulsions 384
—Water in the Head, or 
Dropsy of the Brain 385                  
CHAPTER LII.
Of Surgery 387
—Bleeding ibid
—Inflammations
Abscesses 389
—Wounds 391
-Burns 393
-Bruises 395
—Ulcers 396
CHAPTER LIII.
Of Dislocations 397
Dislocations of the Jaw 398
-of the Neck 399
--of the Ribs ibid
--of the Shoulder 400
--of the Elbow ibid.
--of the Wrist and
Fingers 401
--of the Thigh ibid
--of the Knees ibid
--of the Ancles ibid
—-of the Toes ibid
CHAPTER LIV.
Or Broken Bone. &c. 401
-Strains 404
-Ruptures ibid
CHAPTER LV.
Of Casualties 406
—Substances stopt be-
tween the Mouth and
Stomach 407
—Drowned Persons 411
—Noxious Vapours 413
Effects of extreme Cold 415
---Heat 416
--Drinking cold
Water in Warm Wea-
ther 417

8 CONTENTS.
CHAPTER LVI.
Of Fainting Fits, & other
Cases which require
immediate Assistance 418
—Intoxication 421
— Suffocation and
Strangling 422
—Persons falling into Con-
vulsion Fits 424
CHAPTER LVII.
Cautions concerning cold
Bathing and Drinking
the Mineral Waters, 426
CONTENTS OF THE APPENDIX.
Introduction 437
List of Simple 441
Medical Preparations.	
Balsams 443
Bolusses ibid.
Cataplasms & Sinapisms 444	
Clysters 445
Collyria, or Eye-Waters 446	
Confections 447
Conserves and Preserves ibid.	
Decoctions 448
Draughts 449
Electuaries 450
Emulsions 451
Extracts 452
Fomentations ibid.
Gargles 453
Infusions 454
Juleps 455
Mixtures 456
Ointments, Liniments,
Cerates 457
Pills, 459
Plaisters, 461
Powders 462
Syrups, 464
Tinctures, Elixirs, &c. 465
Vinegars 468
Waters by Infusion, &c. 469
Simple Distilled Waters ibid.
Spiritous distilled Waters 470
Wheys 471
Wines ibid.
A Glossary 473
Index 476

ADVERTISEMENT.
SIXTEEN years have elapsed, since the first edition of the
book appealed. During that period, the author has taken oc-
casion to improve-several articles, inserted in the more early im-
pressions. For this he has been censured; but it would be unpar-
donable in the writer, to suffer an error in a book, on which health
and life may depend, to stand uncorrected; or, to perceive an
omission, and leave it unsupplied. His improvements are not the
result of mercenary views. The same principle which prompted
him to write the book, will ever induce him to improve it, to the ut-
most of his power.
The author regrets, that the limits of one volume preclude many
interesting observations, and likewise deprive him of the pleasure
of inserting a number of very useful remarks, made by doctor
DUPLANIL, of Paris, who published an elegant translation of this
work, in five volumes octavo, with a commentary.
The improvements of the later editions are chiefly inserted in
the form of notes. These are intended either to illustrate the text,
or to put people on their guard in dangerous situations, and prevent
fatal mistakes in the practice of medicine.
Although the domestic medicine was never intended to su-
percede the use of a physician, but to supply his place in situations
where medical assistance could not easily be obtained; yet the au-
thor is sorry to observe, that the jealousies and fears of the faculty,
have prompted many of them to treat this work, in a manner un-
becoming the professors of liberal science: notwithstanding their
injurious treatment, he is determined to persist in his plan, being
fully convinced of its utility; nor shall interest, or prejudice, ever
deter him from exerting his best endeavours to render the medical
art more extensively beneficial to mankind.
But this treatment of the faculty, is not the only thing of which
the author has cause to complain. By some of them his book has
been served up mangled and mutilated, and its titles type, size,
&c. so closely imitated, that purchasers are missed, and frequently
buy these spurious productions instead of the real one. That a
needy author, incapable himself of producing an original work,
should prey upon another, is a thing not at all to be wondered at:
but that all this can be done with impunity, shews, that the laws
of this country, reflecting literary property, are still in a very im-
perfect state.
London,
Nov. 10, 1785.
B

PREFACE.
WHEN I first signified my intention of publishing the follow-
ing sheets, I was told by my friends, that it would draw
on me the resentment of the whole faculty. I resolved to make the
experiment; which came out as might have been expected. Many
whose learning and liberality of sentiments do honour to medicine,
received the book with indulgence, and the falsity of the opinion,
that every physician wishes to conceal his art; while the selfish and
narrow-minded,  persecute both the book and its author, shewed
the reception, however, which this work has met with from the
public, merits my most grateful acknowledgments. As the best way
of expressing these, I have endeavoured to render it more general-
ly useful, by enlarging that part which treats of preventing disea-
ses; and by adding many articles which had been entirely omitted
in the former impressions. It is needless to enumerate these addi-
tions: I hope that they will be found real improvements.
This was so apparent, as, with me, to amount to a proof of the
following melancholy fact: That almost one half of the human
species perish in infancy, by improper management or neglect. No
one, who has not had an opportunity of observing them, can ima-
gine what absurd and ridiculous practices still prevail in the nurs-
ing and management of infants, and what numbers of lives are by
that means loft to society. As these practices are chiefly owing to
ignorance, it is to be hoped that when nurses are better informed,
their conduct will be very different.
The observations relative to nursing and the management of
children, were chiefly suggested by an extensive practice among
infants, in a large branch of the Foundling Hospital, where I had
an opportunity not only of treating the diseases incident to child-
hood, but likewise of trying different plans of nursing, and of ob-
serving their effects. Whenever I had it in my power to place the
children under the care of proper nurses, to instruct these nurses in
their duty, and to be satisfied that they perform it, very few of them
died; but when, from distance of place, and other unavoidable
circumstances, the children were left to the sole care of mercenary
nurses, without any person to instruct or superintend them, scarce
any of them lived.
The application of medicine to the various occupations of life,
has been, in general, the result of observation. An extensive prac-
tice for several years, in one of the largest manufacturing towns
in England, afforded me sufficient opportunities of observing the
injuries which those useful people sustain from their particular
employments, and likewise of trying various methods of obviating 

PPREFACE. 11
such injuries. The success which attended these trials was suffici-
ent to encourage this attempt, which, I hope, will be of use to
those who are under the necessity of earning their bread by such
employments as are unfavourable to health.
I do not mean to intimidate men, far less to insinuate that even
those arts, the practice of which is attended with some degree of
danger, should not be carried on; but to guard the less cautious
and unwary against those dangers which they have it in their pow-
er to avoid, and which they often, through mere ignorance, in-
cur. As every occupation in life, disposes those who follow it, to
some particular diseases more than to others, it is of importance
to know these, that people may guard against them. It is better to
be warned of the approach of an enemy, than to be surprised by
him.
The observations concerning diet, air, exercise, &c. are of a
more general nature, and  have not escaped the attention of physi-
cians in any age. They are subjects of too great importance, how-
ever, to be passed over in an attempt of this kind, and can never
be sufficiently recommended. The man who pays a proper atten-
tion to these, will seldom need the physician; and he who does no,
will seldom enjoy health, let him employ as many physicians as
he pleases.
Though I have endeavoured to point out the causes of diseases,
and to put people upon their guard against them, yet they are of-
ten of such a nature, as to be removed only by the diligence and ac-
tivity of the public magistrate. I am sorry, indeed, to observe that
the power of the magistrate is seldom exerted in this country for
the preservation of health. The importance of a proper medical
police is either not understood, or little regarded. Many things
highly injurious to the public health are daily practised with impu-
nity, while others, absolutely necessary for its preservation, are
entirely neglected.
Some of the, public means of preserving health are mentioned
in the general prophylaxis, as the inspection of provisions, widen-
ing the streets of great towns, keeping them clean, supplying the
inhabitants with wholesome water, &c.; but they are passed over
in a very cursory manner. A proper attention to these, would have
swelled this volume to too large a size; I have therefore reserved
them for the subject of a future publication.
In the treatment of diseases, I have been peculiarly attentive to
regimen. The generality of people lay too much stress upon medi-
cine, and trust too little to their own endeavours. It is always in
the power of the patient, or of those about him, to do as much
towards his recovery as can be effected by the physician. By not
attending to this, the designs of medicine are often frustrated;
and the patient, by pursuing a wrong plan of regimen, not only
defeats the doctor's endeavours, but renders them dangerous. I
have often known patient killed by an error in regimen, when

12 PREFACE.
they were using very proper medicines. It will be said, the physi-
cian always orders the regimen when he prescribes a medicine. I
wish it were so, both for the honour of the faculty and the safety
of their patients: but physicians, as well as other people, are too
little attentive to this matter.
Though many reckon it doubtful whether medicines are more
beneficial or hurtful to mankind, yet all allow the necessity and
importance of a proper regimen in diseases. Indeed, the very appe-
tites of the sick prove its propriety. No man in his senses ever ima-
gined that a person in a fever, for example, could eat, drink, or
conduct himself in the same manner as one in perfect health. This
part of medicine, therefore, is evidently founded in nature, and
is confident with reason and common sense. Had men been more
attentive to it, and less solicitous in hunting after secret remedies,
medicine had never become an object of ridicule.
Indeed, this seems so have been the first idea of medicine. The
ancient physicians acted chiefly in the capacity of nurses. They
went very little beyond aliment in their prescriptions; and even
this they generally administered themselves, attending the sick, for
that purpose, through the whole course of the disease; which gave
them an opportunity not only of marking the changes of diseases
with great accuracy, but likewise of observing the effects of their
different applications, and adapting them to the symptoms.
Dr. Arbuthnot asserts, that by a proper attention to those things,
which are almost within the reach of every body, more good and
less mischief will be done in acute diseases, than by medicines im-
properly and unseasonably administered; and that great cures may
be effected in chronical distempers, by a proper regimen of the di-
et only. So entirely do the doctor's sentiments and mine agree,
that I would advise every person, ignorant of physic, to confine his
practice solely to diet, and the other parts of regimen; by which
means he may often do much good, and can seldom do any hurt.
This seems also to have been the opinion of Dr. Huxham, who
observes, that we often seek from art what all-bountiful nature
most readily, and as effectually, offers us, had we diligence and
sagacity enough to observe and make use of them; that the dietetic
part of medicine is not so much studied as it ought to be; and
that, though his pompous, yet it is the most natural method of
curing disease.
To render the book more generally useful, however, as well as
more acceptable to the intelligent part of mankind, I have, in most
diseases, besides regimen, recommended some of the most simple
and approved forms of medicine, and added such cautions and di-
rections as seemed necessary for their safe administration. It would
no doubt have been more acceptable to many, had it abounded
with pompous prescriptions, and promised great cures in conse-
quence of their use; but this was net my plan: I think the ad-
ministration of medicines always doubtful, and often dangerous,

PREFACE. 13
and would much rather teach men how to avoid the necessity of
using them, than how they should be used.
Several medicines, and those of considerable efficacy, may be
administered with great freedom and safety. Physicians general-
ly trifle a long time with medicines before they learn their proper
use. Many peasants at present know better how to use some of
the most important articles in the materia medica, than physicians
did a century ago; and doubtless the same observation will hold
with regard to others some time hence. Wherever I was convinced
that medicine might be used with safety, or where the cure de-
pended chiefly upon it, I have taken care to recommend it; but
where it was either highly dangerous, or not very necessary, it is
omitted.
I have not troubled the reader with an useless parade of quota-
tions from different authors; but have, in general, adopted their
observations where my own were either defective, or totally want-
ing. Those to whom I am most obliged are, Ramazini, Arbuth-
not, and Tissot; the last of which, in his Avis au Peuple, comes
the nearest to my views of any author which I have seen. Had
his plan been as complete as the execution is masterly, we
should have had no occasion for any new treatise of this kind soon;
but by confining himself to the acute diseases, he has, in my
opinion, omitted the most useful part of his subject. People in
acute diseases may sometimes be their own physicians; but in the
chronic, the cure must ever depend chiefly upon the patient's own
endeavours. The doctor has also passed over the Prophlyaxis, or
preventive part of medicine, very slightly, though it is certainly of
the greatest importance in such a work.
Several other foreign physicians of eminence, have written on
nearly the same plan with Tissot, as the baron Van Swieten, phy-
sician to their imperial magesties, M. Rosen, first physician of the,
kingdom of Sweden, &c.; but their productions have never come
to my hand. I wish that some of our distinguished countrymen
would follow their example. There still remains much to be done
on this subject, and no man could better employ his time or talents
than in eradicating hurtful prejudices, and diffusing useful know-
ledge among the people.
Some of the faculty disapprove every attempt of this nature, ima-
gining that it must destroy their influence. But this notion appears
to me to be as absurd as it is illiberal. People in distress will al-
ways apply for relief to men of superior abilities, when they have
it in their power; and they will do this with far greater confi-
dence and readiness, when they believe that medicine is a rational
science, than when they take it to be only a matter of more con-
jecture.
Though I have endeavoured to render this treatise plain and use-
ful, yet I found it impossible to avoid some terms of at; but those
are, in general, either explained, or are such as most people un- 

14 PREFACE.
derstand. In short, I have endeavoured to conform my stile to the
capacities of mankind in general; and, if my readers do not flatter
either themselves or me, with some degree of success. On a medical
subject, this is not so easy a matter as some may imagine. To make
a show of learning, is easier than to write plain sense, especially in a
science, which has been kept at such a distance from common ob-
servation. It would, however, be no difficult matter to prove, that
every thing valuable in the practical part of medicine, is within
the reach of common abilities.
It would be ungenerous not to express my warmest acknowledg-
ments to those gentlemen, who have endeavoured to extend the use-
fulness of this performance, by translating it into the language of
their respective countries. Most of them have not only given ele-
gant translations of the book, but have also enriched it with many
useful observations; by which it is rendered more complete, and
better adapted to the climate and the constitutions of their country-
men. To doctor Duplanil of Paris, physician to the count d'Artois,
I lie under particular obligations; as this gentleman has not only
considerably enlarged my treatise; but, by his very ingenious and
useful notes, has rendered it so popular on the continent, as to oc-
casion its being translated into all the languages of modern Europe.
The book has not more exceeded my expectations in its success
than in the effects it has produced. Some of the most pernicious
practices, with regard to the treatment of the sick, have already
given place to a more rational conduct; and many of the most
hurtful prejudices, which seemed to be quite insurmountable, have,
in a great measure, yielded to better information. Of this, a stron-
ger instance cannot be given, than the inoculation of the small-
pox. Few mothers, some years ago, would submit to have their
children inoculated, even by the hand of a physician; yet nothing
is more certain, than that of late, many of them have performed
this operation with their own hands; and as their success has been
equal to that of the most dignified inoculators, there is little rea-
son to doubt that the practice will become general. Whenever
this shall be the case, more lives will be saved by inoculation alone.
than are at present by all the endeavours of the faculty.

INTRODUCTION.
THE improvements in medicine, since the revival of learning,
have not kept pace with those of the other arts. The reason
is obvious. Medicine has been studied by few, except those who
intended to live by it as a trade. Such, either from a mistaken zeal
for the honor of medicine, or to raise their own importance, have
endeavoured to disguise and conceal the art. Medical authors have
generally written in a foreign language; and those who were une-
qual to this talk, have even valued themselves upon couching, at
least, their prescriptions, in terms and characters, unintelligible to
the rest of mankind.
The contentions of the clergy, which happened soon after the
restoration of learning, engaged the attention of mankind, and pav-
ed the way for that freedom of thought and enquiry, which has
since prevailed in most parts of Europe, as to religious matters.
Every man took a side in those bloody disputes; and every gentle-
man, that he might distinguish himself on one side or other, was in-
structed in divinity. This taught people to think and reason for
themselves in matters of religion, and at last destroyed that com-
plete and absolute dominion, which the clergy had obtained over
the minds of men.
The study of law has likewise, in the most civilized nations, been
justly deemed the necessary part of the education of a gentleman.
Every gentleman ought certainly to know at least the laws of his
own country: And, if he were also acquainted with those of others,
it might be more than barely an ornament to him.
The different branches of philosophy have also of late been uni-
versally studied by all who pretended to a liberal education. The
advantages of this are manifest. It frees the mind from prejudice
and superstition; fits it for the investigation of truth; induces ha-
bits of reasoning and judging properly; opens an inexhaustible
source of entertainment; paves the way to the improvement of arts
and agriculture; and qualifies men for acting with propriety in the
most important stations of life.
Natural History is likewise become an object of general atten-
tion. And it well deserves to be so. It leads to discoveries of the
greatest importance. Indeed, agriculture, the most useful of all arts,
is only a branch of natural history, and can never arrive at a high
degree of improvement, where the study of that science is ne-
glected.
Medicine, however, has not been reckoned a necessary part of the
education of a gentleman. No sufficient reason can be assigned for
this omssion. No science lays open a more extensive field of useful
C 

16 INTRODUCTION.
knowledge, or affords more ample entertainment to an inquisitive
mind. Anatomy, Botany, Chemistry, and the Materia Medica, are
all branches of natural history, and are fraught with such amuse-
ment and utility, that the man who entirely neglects them, has but
a sorry claim, either to taste or learning. If a gentleman has but
turn for observation, says an elegant and sensible writer*, surely
the natural history of his own species is a more interesting sub-
ject, and presents a more ample field for the exertion of genius,
than the natural history of spiders and cockle-shells.
We do not mean that every man should become a physician.
This would be an attempt as ridiculous as it is impossible. All we
plead for, is, that men of sense and learning, should be so far ac-
quainted with the general principles of medicine, as to be in a con-
dition to derive from it some of those advantages with which it is
fraught; and at the same time to guard themselves against the des-
tructive influences of Ignorance, Superstition, and Quackery.
As matters stand at present, it is easier to cheat a man out of
his life than of a shilling, and almost impossible either to detect or
punish the offender. Nothwithstanding this, people will shut their
eyes, and take every thing upon trust that is administered by any
pretender to medicine, without daring to ask him a reason for any
part of his conduct. Implicit faith, every where else the object of
ridicule, is still sacred here. Many of the faculty are, no doubt,
worthy of all the confidence that can be reposed in them; but as
this can never be the character of every individual in any profes-
sion, it would certainly be for the safety, as well as the honour of
mankind, to have some check upon the conduct of those to whom
they in trust so valuable a treasure as health.
The veil of mystery, which still hangs over medicine, renders
it not only a conjectural, but even a suspicious art. This has been
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 bet-
ter known, in order to secure the general esteem of mankind. Its
precepts are such, as every wife man would chuse to observe, and
it forbids nothing, but what is incompatible with true happiness.
Disguising medicine, not only retards its improvement as a sci-
ence, but exposes the profession to ridicule, and is injurious to the
true interests of society. An art founded on observation never can
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 towards the improvement of medicine, than those of the fa-
culty 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 name of the disease, it is
*Observations on the duties and offices of a physician.

INTRODUCTION. 17
sufficient to perpetuate the fact. Yet the man who adds one single
fact to the stock of medical observations, does more real service to
the art, than he who writes a volume in support of some favourite
hypothesis.
Very few 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 have been usually opposed by the facul-
ty, till every one else was convinced of their importance. An im-
plicit faith in the opinions of teachers, an attachment to systems
and established forms, and the dread of reflexions, will always
operate upon those who follow medicine as a trade. Few improve-
ments are to be expected from a man who might ruin his character
and family by even the smallest deviation from an established rule.
If men of letters, says the author of the performance quoted
above, were to claim their right of enquiry into a matter that so
nearly concerns them, the good effects on 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 pa-
trons of modest merit. Not having their understandings perverted
in their youth by false theories, unawed by authority, and unbias-
sed by interest, they would canvass with freedom the most univer-
sally received 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 as-
serted their right of enquiry into these subjects, theology, consider-
ed as a science, has been improved, the interests of real religion have
been promoted, and the clergy have become a more learned, a
more useful, and a more respectable body of men, than they ever
were in the days of their greatest power and splendour.
Had other medical writers been as honest as this gentleman,
the art had been upon a very different footing at this day. Most
of them extol the merit of those men, who brought philosophy
out of the schools, and subjected it to the rools of  common sense.
But they never consider that medicine, at present, is in nearly the
same situation as philosophy was in at that time, and that it might
be as much improved by being treated in the same manner. In-
deed, 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.
It will be said, that diffusing medical knowledge among the peo-
ple, might induce them to tamper with medicine, and to trust to
their own skill instead of calling a physician. The reverse of this
is true. Persons who have most knowledge in these matters are
C

18 INTRODUCTION.
commonly most ready both to ask and to follow advice, when it is
necessary. The ignorant are always most apt to tamper with medi-
cine, and have the least confidence in physicians. Instances of this
are daily to be met with among the ignorant peasants, who, while
they absolutely refuse to take a medicine which has been prescri-
bed by a physician, will swallow, with greediness, any thing that
is recommended to them by their credulous neighbours. Where
men will act even with knowledge, it is certainly more rational
to afford them all the light we can, than to leave them entirely in
the dark.
It may also be alleged, that laying medicine more open to man-
kind would lessen their faith in it. This would indeed be the case
with regard to some; but it would have a quite contrary effect upon
others. Many people who have the utmost dread and horror of
every thing prescribed by a physician, will readily take a medicine
which they know, and whose qualities they are in some measure
acquainted with. Hence it is evident, that the dread arises from
the doctor, not from the drug. Nothing ever can or will inspire
mankind with an absolute confidence in physicians, but an open,
frank, and undisguised behaviour. While the least shadow of mys-
tery remains in the conduct of the faculty, doubts, jealousies, and
suspicions, will arise in the minds of men.
Cases will sometimes occur, where a prudent physician may find
it expedient to disguise a medicine. The whims and humours of
men must be regarded by those who mean to do them service; but
this can never affect the general argument in favour of candour and
openness. A man might as well allege, because there are knaves
and fools in the world, that he ought to take every one he meets
for such, and to treat him accordingly. A sensible physician will
always know where disguise is necessary; but it ought never to
appear on the face of his general conduct.
The appearance of mystery in the conduct of physicians not
only renders their art suspicious, but lays the foundations of quack-
ery. No two characters can be more different than that of the ho-
nest physician and the quack; yet they have been much confound-
ed. The line betwixt them is not sufficiently apparent; at least it
is too fine for the general eye. Few persons are able to distinguish
sufficiently between the conduct of that man who administers a
secret medicine, and him who writes a preseription in mystical cha-
racters and in an unknown tongue. Thus the conduct of the honest
physician, which needs no disguise, gives  a sanction to that of the
villain, whose whole consequence depends upon secrecy.
No laws will ever be able to prevent quackery, while people
believe that the quack is as honest a man, and as well qualified, as
the physician. A very small degree of medical knowledge, however,
would be sufficient to break this spell; and nothing else can effec-
tually undeceive them. It is the ignorance and credulity of the
multitude, with regard to medicine, which render them such an

INTRODUCTION. 19
easy prey to every one, who has the hardiness to attack them on
this quarter. Nor can the evil be remedied by any other means but
making them wiser.
The most effectual way to destroy quackery in any art or science,
is to diffuse the knowledge of it among mankind. Did physicians
write their prescriptions in the common language of the country,
and explain their intentions to the patient, as far as he could under-
stand them, it would enable him to know when the medicine had
the desired effect; would inspire him with confidence in the physi-
cian; and make him dread and detest every man who pretended to
cram a secret-medicine down his throat.
Men, in the different dates of society, have very different views
of the same object. Some time ago it was the practice of this coun-
try, for every person to say his prayers in Latin, whether he knew
any thing of that language or not. This conduct, though sacred in
the eyes of our ancestors, appears ridiculous enough to us; and
some parts of ours will seem as strange to posterity. Among these,
we may reckon the present mode of medical prescription, which
will some time hence appear to have been completely ridiculous,
and a very high burlesque upon the common sense of mankind.
But this practice is not only ridiculous; it is likewise dangerous.
However capable physicians may be of writing Latin, apothecaries
are not always in a condition to read it, and dangerous mistakes,
in consequence of this, often happen. But suppose the apothecary
ever so able to read the physician's prescription, he is generally
otherwise employed and the business 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 re-
ality trusts his life in the hands of an idle boy, who has not only
the chance of being very ignorant, but likewise giddy and careless.
Mistakes will sometimes happen in spite of the greatest care; but,
where human lives are concerned, all possible methods ought cer-
tainly to be taken to prevent them. For this reason, the prescrip-
tions of physicians, instead of being couched in mystical characters,
and a foreign language, ought, in my humble opinion, to be con-
ceived in the most plain and obvious terms imaginable.
Diffusing medical knowledge among the people, would not only
tend to improve the art, and to banish quackery, but likewise to
render medicine more universally useful. However long medicine
may have been known as a science, many of its most important
purposes to society have either been overlooked, or very little at-
tended to. The cure of diseases is a matter of great importance;
but the preservation of health is still greater. This is the concern
of every man, and surety what relates to it, ought to be rendered as
plain and obvious to all as possible. Men cannot be sufficiently on
their guard against diseases, who are totally ignorant of their causes.
Nor can the legislature, in whose power it is to do much more for
preserving the public health, than can ever be done by the faculty

20 INTRODUCTION.
exert that power with propriety, and to the greatest advantage,
without some degree of medical knowledge.
Indeed, men of every occupation and condition in life, might
avail themselves of a degree of medical knowledge; as it would
teach them to avoid the dangers peculiar to their respective sta-
tions; which is always easier than to remove their effects. Medical
knowledge, instead of being a check upon the enjoyments of life,
only teaches men how to make the most of them. It has indeed
been said, that to live medically, is to live miserably: But it might
with equal propriety be said, that to live rationally, is to live misera-
bly. If physicians obtrude their own ridiculous whims upon man-
kind, or lay down rules inconsistent with reason or common sense,
they will be despised. But this is not the fault of medicine. It pro-
poses no rules, but such as are perfectly consistent with the true
enjoyment of life, and conducive to the real happiness of mankind.
Medicine has hitherto hardly been considered as a popular sci-
ence, but as a branch of knowledge solely confined to a particular
set of men, while all the rest have been taught, not only to neglect,
but even to dread and despise it. But it will appear, upon a more
strict examination, that no science better deserves their attention,
or is more capable of being rendered generally useful.
People are told, that if they dip the least into medical know-
ledge, it will render them fanciful, and make them believe they
have got every disease of which they read. This, I am satisfied,
will seldom be the case with sensible people: and, suppose it were,
they must soon be undeceived. A short time will show their error,
and a little more reading will infallibly correct it. A single in-
stance will show the absurdity of this notion. A sensible lady,
rather than read a medical performance, which would instruct her
in the management of her children, must leave them entirely to
the care and conduct of the most ignorant, credulous, and stuper-
stitious part of the human species.
Indeed, no part of medicine is of more general importance
than that which relates to the nursing and management of chil-
dren. Yet few parents pay a proper attention to it. They leave
the sole care of their tender offspring, at the very time when care
and attention are most necessary, to hirelings, who are either too
careless to do their duty, or too ignorant to know it. More lives
are lost by the carelessness and inattention of parents and nurses,
than are saved by the faculty. The joint and well-conducted en-
deavours of private persons and the public, for the preservation
of infant lives, would be of more advantage to society, than the
whole art of medicine, upon its present footing. 
The benefits of medicine, as a trade, will ever be confined to
those who are able to pay for them; and of course, the far greater
part of mankind will be every where deprived of them. Physi-
cians, like other people, must live by their employment, and the
poor must either want advice altogether, or take up with that

INTRODUCTION. 21
which is worse than none. There are not, however, any where
wanting well-disposed people, of better sense, who are willing to
supply the defect of medical advice to the poor, did not their fear
of doing ill often suppress their inclination to do good. Such
people are often deterred from worthy actions, by the foolish
alarms founded in their ears by a set of men, who, to raise their
own importance, magnify the difficulties of doing good, find fault
with what is truly commendable, and fleer at every attempt to
relieve the sick, which is not conducted by the precise rules of medi-
cine. These gentlemen must, however, excuse me for saying, that
I have often known such well-disposed persons do much good; and
that their practice, which is generally the result of good sense and
observation, assisted by a little medical reading, is frequently more
rational, than that of the ignorant retainer to physic, who despises
both reason and observation, that he may go wrong by rule; and
who, while he is doling his patient with medicines, often neglects
other things of far greater importance.
Many things are necessary for the sick, besides medicine. Nor
is the person who takes care to procure those for them, of less im-
portance than a physician. The poor oftner perish in diseases, for
want of proper nursing, than of medicine. They are frequently in
want of even the necessaries of life, and still more so of what is pro-
per for a sick bed: No one can imagine, who has not been a witness
of these situations, how much good a well-disposed person may do,
by only taking care to have such wants supplied. There certainly
cannot be a more necessary, a more noble, or a more godlike ac-
tion, than to administer to the wants of our fellow-creatures in
distress.
Persons who do not chuse to administer medicine to the sick,
may nevertheless direct their regimen. An eminent medical au-
thor has said, that by diet alone all the intentions of medicine
may be answered. No doubt a great many of them may; but there
are other things beside diet, which ought by no means to be ne-
glected. Many hurtful and destructive prejudices, with regard to
the treatment of the sick, still prevail among the people, which
persons of better sense and learning alone can eradicate. To guard
the poor against the influence of these prejudices, and to instil in-
to their minds some just ideas of the importance of proper food,
fresh air, cleanliness, and other pieces of regimen necessary in dis-
eases, would be a work of great merit, and productive of many
happy consequences. A proper regimen, in most diseases, is at
least equal to medicine, and in many of them, it is greatly superior.
To assist the well-meant endeavours of the humane and benevo-
lent in relieving distress; to eradicate dangerous and hurtful pre-
judices; to guard the ignorant and credulous against the frauds
and impositions of quacks and impostors; and to show men what
is in their own power, both with regard to the prevention and cure
of diseases are certainly objects worthy of the physician's atten-            

22 INTRODUCTION.
tion. These were the leading views in composing and publishing
the following sheets. They were suggested by an attention to the
conduct of mankind, with regard to medicine, in the course of
a pretty long practice in different parts of this island, during which
the author has often had occasion to wish that his patients, or
those about them, had been possessed of some such plain directory
for regulating their conduct. How far he has succeeded in his
endeavours to supply this deficiency, must be left for others to
determine; but if they be found to contribute, in any measure,
towards alleviating the calamities of mankind, he will think his
labour very well bestowed.

PART I.
OF THE
General Causes of Diseases.
CHAPTER I.
OF CHILDREN.
THE better to trace diseases from their original causes, we shall
take a view of the common treatment of mankind, in the
state of infancy. In this period, the foundations of a good or bad
constitution are generally laid; it is therefore of importance, that
parents be acquainted with the various causes which may injure
the health of their offspring.
It appeals from the annual registers of the dead, that almost one
half of the children born in Britain, die under twelve years of age.
To many, indeed, this may appear a natural evil, but, on due ex-
amination, it will be found to be one of our own creating. Were
the death of infants a natural evil, other animals would be as liable
to die young, as man; but this we find is not the case.
It may seem strange, that man, notwithstanding his superior rea-
son, should fall so far short of other animals, in the management
of his young: But our surprise will soon cease, if we consider that
brutes, guided by instinct, never err in this respect; while man,
trusting solely to art, is seldom right. Were a catalogue of those
infants, who perish annually by art alone, exhibited to public view,
it would astonish most people.
If parents are above taking care of their children, others must be
employed for that purpose: These will endeavour to recommend
themselves by the appearance of extraordinary skill and address.
By this means such a number of unnecessary and destructive arti-
cles have been introduced into the diet, clothing, &c. of infants,
that it is no wonder so many perish.
Nothing can be more preposterous than a mother who thinks it
beneath her to take care of her own child, or who is so ignorant as
not to know what is proper to be done for it. If we search nature
throughout, we cannot find a parallel to this. Every other animal is
the nurse of its own offspring, and they thrive accordingly. Were

24 OF CHILDREN.
the brutes to bring up their young by proxy, they would share the
same fate with those of the human species.
We mean not, however, to impose it as a talk upon every mother
to suckle her own child. This is in some cases implacable, and
would inevitably prove destructive both to the mother and child.
Women of delicate constitutions, subject to hysteric fits, or other
nervous affections, make bad nurses: and these complaints are now
so common, that it is rare to find a woman of fashion free from
them; such women, therefore, supposing them willing, are often
unable to suckle their own children.
Almost every mother would be in a condition to give suck, did
mankind live agreeably to nature: but whoever considers how far
many mothers deviate from her dictates, will not be surprised to
find some of them unable to perform that necessary office. Mothers
who do not eat a sufficient quantity of solid food, nor enjoy the be-
nefit of free air and exercise, can neither have wholesome juices
themselves, nor afford proper nourishment to an infant: Hence
children, who are suckled by delicate women, either die young, or
are weak and sickly all their lives.
When we say that mothers are not always in a condition to suckle
their own children, we would not be understood as discouraging
that practice. Every mother who can, ought certainly to perform
so tender and agreeable an office*. But, suppose it to be out of
her power, she may, nevertheless, be of great service to her child.
The business of nursing, is by no means confined to giving suck.
To a woman who abounds with milk, this is the easiest part of it.
Numberless other offices are necessary for a child, which the mo-
ther ought at least to see done.
A mother who abandons the fruit of her womb, as soon as it is
born, to the sole care of an hireling, hardly deserves that name. A
child, by being brought up under the mother's eye, not only secures
her affection, but may reap all the advantages of a parent's care,
though it be suckled by another. How can a mother be better em-
ployed than in superintending the nursery? This is at once the most
delightful and important office; yet the most trivial business or in-
sipid amusements are often preferred to it! A strong proof both
of the bad taste and wrong education of modern females.
* Many advantages would arise to society, as well as to individuals,
from mothers suckling their own children. It would prevent the tempta-
tion which poor women are laid under, of abandoning their children, to
suckle those of the rich, for the sake of gain: By which means, society
loses many of its most useful members, and mothers become in some
sense the murderers of their own offering. I am sure speak within
the truth, when I say, that not one in twenty of those children live, who
are thus abandoned by their mothers. For this reason, no mother should
be allowed to suckle another's child, till her own is either dead, or fit to
be weaned. A regulation of this kind would save many lives among the
poorer sort, and could do no hurt to the rich, as most women who make
good nurses are able to suckle two children in succession upon the same
milk.

OF CHILDREN. 25
It is indeed to be regretted, that more care is not bestowed in
teaching the proper management of children to those whom nature
has designed for mothers. This, instead of being made the princi-
pal, is seldom considered as any part of female education. Is it any
wonder, when females so educated come to be mothers, that they
should be quite ignorant of the duties belonging to that character?
However strange it may appear, it is certainly true, that many mo-
thers, and those of fashion too, are as ignorant, when they have
brought a child into the world, of what is to be done for it, as the
infant itself. Indeed, the most ignorant of the sex are generally rec-
koned most knowing in the business of nursing. Hence, sensible
people become the dupes of ignorance and superstition; and the
nursing of children, instead of being conducted by reason, is the
result of whim and caprice*.
Were the time that is generally spent by females, in the acquisi-
tion of trifling accomplishments, employed in learning how to bring
up their children; how to dress them so, as not to hurt, cramp, or
confine their motions; how to feed them with wholesome and nou-
rishing food; how to exercise their tender bodies, so as best to pro-
mote their growth and strength: Were these made the objects of
female instruction, mankind would derive the greatest advantages
from it. But while the education of females, implies little more,
than what relates to dress and public show, we have nothing to ex-
pect from them, but ignorance, even in the most important concerns.
Did mothers reflect on their own importance, and lay it to heart,
they would embrace every opportunity of informing themselves of
the duties, which they owe to their infant offspring. It is their pro-
vince, not only to form the body, but also to give the mind its most
early bias. They have it very much in their power, to make men
healthy or valetudinary, useful in life, or the pests of society.
But the mother is not the only person concerned in the manage-
ment of children. The father has an equal interest in their welfare,
and ought to assist in every thing that respects either the improve-
ment of the body or mind.
It is a pity that the men should be so inattentive to this matter.
Their negligence is one reason why females know so little of it.
Women will ever be desirous to excel in such accomplishments as
recommend them to the other sex. But men generally keep at such
a distance from even the smallest acquaintance with the affairs, of
the nursery, that many would reckon it an affront, were they sup-
*Tacitus, the celebrated Roman historian, complains greatly of the
degeneracy of the Roman ladies in his time, with regard to the care of
their offspring. He says, that, in former times, the greatest women in
Rome used to account it their chief glory to keep the house and attend
their children; but that now the young infant was committed to the sole
care of some poor Grecian wench, or other menial servant. We are
afraid, wherever luxury and effeminacy prevail, there will be too much
ground for this complaint.
D

26 OF CHILDREN.
posed to know any thing of them. Not so, however, with the ken-
nel or the stables: A gentleman of the first rank is not ashamed to
give directions concerning the management of his dogs or horses,
yet would blush, were he surprised in performing the same office
for that being, who derived its existence from himself, who is the
heir of his fortunes, and the future hope of his country.
Nor have physicians themselves been sufficiently attentive to the
management of children: This has been generally considered as the
sole province of old women, while men of the first character in phy-
sic, have refused to visit infants, even when sick. Such conduct in
the faculty, has not only caused this branch of medicine to be ne-
glected, but has also encouraged the other sex to assume an absolute
title to prescribe for children, in the most dangerous diseases. The
consequence is, that a physician is seldom called, till the good wo-
men have exhausted all their skill; when his attendance can only
serve to divide the blame, and appease the  disconsolate parents.
Nurses should do all in their power to prevent diseases; but when
a child is taken ill, some person of skill ought immediately to be
consulted. The diseases of children are generally acute, and the
least delay is dangerous.
Were physicians more attentive to the diseases of infants, they
would not only be better qualified to treat them properly when sick,
but likewise to give useful directions for their management, when
well. The diseases of children are by no means so difficult to be un-
derstood as many imagine. It is true, children cannot tell their
complaints; but the causes of them may be pretty certainly disco-
vered, by observing the symptoms, and putting proper questions to
the nurses. Besides, the diseases of infants, being less complicated,
are easier cured than those of adults*.
Of Diseased Parents.
ONE great source of the disease of children is, the unhealthi-
ness of parents. It would be as reasonable to expect a rich crop,
from a barren soil, as that strong and healthy children should be
born of parents, whose constitutions have been worn out with in-
temperance or disease.
Rousseau observes, that on the constitution of mothers depends
originally that of their offspring. No one who believes this, will be
surprised, on a view of the female world, to find diseases and death
so frequent among children. A delicate female, brought up within
*The common opinion, that the diseases of infants are hard to disco-
ver, and difficult to cure, has deterred many physicians from paying that
attention to them which they deserve—I can, however, from experience,
declare, that this opinion is without foundation, and that they are nei-
ther so difficult to discover, nor so ill to cure, as those of adults.

OF CHILDREN. 27
doors, an utter stranger to exercise and open air, who lives on tea
and other slops, may bring a child into the world, but it will hardly
be fit to live. The first blast of disease will nip the tender plant in
the bud: Or, should it struggle through  a few years existence, its
feeble frame, shaken with convulsions from every trivial cause, will
be unable to perform the common functions of life, and prove a
burden to society.
If, to the delicacy of mothers, we add the irregular lives of fa-
thers, we shall see further cause to believe, that children are often
hurt by the constitution of their parents. A sickly frame may be
originally induced by hardships or intemperance, but chiefly by the
latter. It is impossible that a course of vice should not spoil the best
constitution: and, did the evil terminate here, it would be a just pu-
nishment for the folly of the sufferer; but when once a disease is
contracted and riveted in the habit, it is entailed on posterity.
What a dreadful inheritance is the gout, the scurvy, or the king's
evil, to transmit to our offspring! How happy had it been for the
heir of many a great estate, had he been born a beggar, rather
than to inherit his father's fortunes at the expense of inheriting
his diseases!
No person who labours under any incurable malady ought to
marry. He thereby not only shortens his own life, but transmits
misery to others: but when both parties are deeply tainted with
the scrophula, the scurvy, or the like, the effects must be still
worse. If such have any issue, they must be miserable indeed.
Want of attention to these things, in forming connexions for life,
has rooted out more families than plague, famine, or the sword;
and as long as these connexions are formed from mercenary views,
the evil will be continued*.
In our matrimonial contracts, it is amazing so little regard is
had to the health and form of the object. Our sportsmen know,
that the generous courser cannot be bred out of the foundered
jade, nor the sagacious spaniel out of the snarling cur. This is
settled upon immutable laws. The man who marries a woman of
a sickly constitution, and descended of unhealthy parents, what-
ever his views may be, cannot be said to act a prudent part. A
diseased woman may prove fertile; should this be the case, the
family must become an infirmary: what prospect of happiness
the father of such a family has, we shall leave any one to judge †.
*The Lacedemonians condemned their king Archidamus, for having
married a weak, puny woman; because, said they, instead of propa-
gating a race of heroes, you will fill the throne with a progeny of
changelings.
† The Jews, by their laws, were, in certain cases, forbid to have
any manner of commerce with the diseased; and indeed to this all
wise legislators ought to have a special regard. In some countries, dis-
eased persons have actually been forbid to marry. This is an evil, of a
complicated kind, a natural deformity, and political mischief; and
therefore requires a public consideration.

28 OF CHILDREN.
Such children as have the misfortune to be born of diseased
parents, require to be nursed with greater care than others. This
is the only way to make amends for the defects of constitution;
and it will often go a great length. A healthy nurse, wholesome
air, and sufficient exercise, will do wonders. But when these are
neglected, little is to be expected from any other quarter. The
defects of constitution cannot be supplied by medicine.
Those who inherit any family-disease ought to be very circum-
spect in their manner of living. They should consider well the
nature of such disease, and guard against it by a proper regimen.
It is certain, that family diseases, have often, by proper care, been
kept off for one generation; and there is reason to believe, that
by persisting in the same course, such diseases might at length be
wholly eradicated. This is a subject very little regarded, though
of the greatest importance. Family-constitutions are as capable
of improvement as family-estates; and the libertine, who im-
pares the one, does greater injury to his posterity, than the prodi-
gal, who squanders away the other.
Of the Clothing of Children.
THE clothing of an infant, is so simple a matter, that it is sur-
prising how any person should err in it; yet many children lose
their lives, and others are deformed, by inattention to this article.
Nature knows no use of clothes to an infant but to keep it warm.
All that is necessary for this purpose, is to wrap it in a soft loose
covering. Were a mother left to the dictates of nature alone, she
would certainly pursue this course. But the business of dressing an
infant has long been out of the hands of mothers, and has at last
become a secret, which none but adepts pretend to understand.
From the most early ages it has been thought necessary, that a
woman in labour, should have some person to attend her. This, in
time, became a business; and, as in all others, those who were em-
ployed in it, strove to out-do one-another in the different branches
of their profession. The dressing of a child came of course to be
considered as the midwife's province, who, no doubt imagined,
that the more dexterity she could show in this article, the more
her skill would be admired. Her attempts were seconded by the
vanity of parents, who, too often desirous of making a show of the
infant as soon as it was born, were ambitious to have as much finery
heaped upon it as possible. Thus, it came to be thought as necessary
for a midwife to excel in bracing and dressing an infant, as for a
surgeon to be expert in applying bandages to a broken limb; and the
poor child, as soon as it came into the world, had as many rollers
and wrappers applied to its body, as if every bone had been fractur- 

OF CHILDREN. 29
ed in the birth; while these were often so tight, as not only to
gall and wound its tender frame, but even to obstruct the motion
of the heart, lungs, and other organs necessary for life.
In most parts of Britain, the practice of rolling children, with so
many bandages, is now, in some measure, laid aside; but it would
still be a difficult talk to pursuade the generality of mankind, that
the shape of an infant does not entirely depend on the midwife.
So far, however, are all her endeavours to mend the shape,from
being successful, that they constantly operate the contrary way, and
mankind become deformed just in proportion to the means used
to prevent it. How little deformity of body is to be found among
uncivilized nations? So little indeed, that it is vulgarly believed,
they put all their deformed children to death. The truth is, they
hardly know such a thing as a deformed child. Neither should we,
if we followed their example. Savage nations never think of mana-
cling their children. They allow them the full use of every organ,
carry them abroad in the open air, wash their bodies daily in cold
water, &c. By this management, their children become so strong
and hardy, that, by the time our puny infants get out of the nurse's
arms, their's are able to shift for themselves*.
Among brute animals, no art is necessary to procure a fine shape.
Though many of them are extremely delicate when they come in-
to the world, yet we never find them grow crooked for want of
swaddling bands. Is nature less generous to the human kind?
No: but we take the business out of nature's hands.
Not only the analogy of other animals, but the very feelings of
infants tell us, they ought to be kept easy and free from all pres-
sure. They cannot indeed tell their complaints; but they can show
signs of pain; and this they never fail to do, by crying, when hurt
by their clothes. No sooner are they freed from their bracings, than
they seem pleased and happy; yet, strange infatuation! The moment
they hold their peace, they are again committed to their chains.
If we consider the body of an infant as a bundle of soft pipes,
replenished with fluids in continual motion, the danger of pressure
will appear in the strongest light. Nature, in order to make way
for the growth of children, has formed their bodies soft and flexi-
ble; and lest they should receive any injury from pressure in the
womb, has surrounded the fœtus every where with fluids. This
shows the care which nature takes, to prevent all unequal pressure
on the bodies of infants, and to defend them against every thing
that might in the least cramp or confine their motions.
Even the bones of an infant are so soft and cartilaginous, that
they readily yield to the slightest pressure, and easily assume a bad
*A friend of mine, who war, several years on the coast of Africa,
tells me, that the natives neither put any clothes upon their children,
nor apply to their bodies bandages of any kind, but lay them on a
pallet, and suffer them to tumble about at pleasure; yet they are all
strait, and seldom have any disease. 

30 OF CHILDREN.
shape, which can never after be remedied. Hence it is, that so
many people appear with high shoulders, crooked spines, and flat
breast, who were as well proportioned at their birth as others,
but had the misfortune to be squeezed out of shape by the appli-
cation of stays and bandages.
Pressure, by obstructing the circulation, likewise prevents the
equal distribution of nourishment to the different parts of the bo-
dy, by which means the growth becomes unequal. One part grows
too large, while another remains too small; and thus in time the
whole frame becomes disproportioned and misshapen. To this we
must, add, that when a child is cramped in its clothes, it naturally
shrinks from the part that is hurt; and, by putting its body into un-
natural postures, it becomes deformed by habit.
Deformity of body, may indeed proceed from weakness or dis-
ease; but in general, it is the effect of improper clothing. Nine
tenths, at least, of the deformity among mankind, must be imputed
to this cause. A deformed body is not only disagreeable to the eye,
but by a bad figure, both the animal and vital functions must be
impeded, and of course health impaired. Hence few people remark-
ably misshapen are strong or healthy.
The new motions which commence at the birth, as the circula-
tion of the whole mass of blood through the lungs, respiration, the
peristaltic: motion, &c. afford another strong argument for keeping
the body of an infant free from all pressure. These organs not hav-
ing been accustomed to move, are easily stopped; but when this
happens, death must ensue. Hardly any method could be deviled
more effectually to stop these motions, than bracing the body too
tight with rollers* and bandages. Were these to be applied in the
same manner to the body of an adult, for an equal length of time,
they could hardly fail to hurt the digestion, and make him sick.
How much more hurtful they must prove to the tender bodies of
infants, we shall leave any one to judge.
Whoever considers these things, will not be surprised, that so
many children die of convulsions soon after the  birth. These fits
are generally attributed to some inward cause; but in fact, they
opener proceed from our own imprudent conduct. I have known
a child seized with convulsion-fits soon after the midwife had
done swaddling it, who, upon taking off the rollers and bandages,
was immediately relieved, and never had the disease afterwards.
Numerous. examples of this might heaven, were they necessary,
would be safer to fix on the clothes of an infant with strings
than pins, as these often gall and irritate their tender skins, and
occasion about disorders. Pins have been found sticking above half an
inch into the body of a child, after it had died of convulsion fits,
which; in all probability, proceeded from that cause.
*This is by no means inveighing against a thing that does not hap-
pen in many parts of Britain, at this day, a roller, eight or ten feet
in length, is applied tightly round the child's body as soon as it is born. 

OF CHILDREN. 31
Children are not only hurt by the tightness of their clothes, but
also by the quantity. Every child has some degree of fever after
the birth; and if it be loaded with too many clothes, the fever
must be increased. But tills is not all; the child is generally laid in
bed with the mother, who is often likewise feverish; to which
we may add the heat of the bed-chamber, the wines, and other
heating things, too frequently given to children, immediately after
the birth. When all these are combined, which does not seldom
happen, they must increase the fever to such a degree, as will en-
danger the life of the infant.
The danger of keeping infants too hot will further appear, if we
consider, that after they have been for sometime in the situation
mentioned above, they are often sent into the country to be nursed
in a cold house. Is it any wonder, if a child, from such a transi-
tion, catches a mortal cold, or contracts some other fatal disease?
When an infant is kept too hot, its lungs, not being sufficiently
expanded, are apt to remain weak and flaccid for life; hence pro-
ceed coughs, consumptions, and other diseases of the breast.
It would answer little purpose, to specify the particular pieces
of dress, proper for an infant. These will always vary in different
countries, according to custom and the humour of parents. The
great rule to be observed is, that a child have no mote clothes than
are necessary to keep it warns, and that they be quite easy for its
body.
Stays are the very bane of infants. A volume would hot suffice
to point out all the bad effects of this ridiculous piece of dress,
both on children and adults. The madness in favour of stays,
seems however, to be somewhat abated; and it is to be hoped that
the world will, in time, become wise enough to know, that the
human shape does not solely depend upon whale-bone and bend-
leather*.
The clothes of children ought to be kept thoroughly clean,
Children perspire more than adults; and if their clothes be not
frequently changed, they become very hurtful. Dirty clothes not
only sret and gall the tender skins of infants, but likewise occasion
ill smells; and what is worse, tend to produce vermin and cuta-
neous diseases.
Cleanliness is not only agreeable to the eye, but tends greatly
to preserve the health of children. It promotes the perspiration,
and by that means, frees the body from superfluous humours,
* Stays made of bend-leather, are worn by all the women of lower
station, in many parts of England.
There are still mothers mad enough, to lace their daughters very
tight, in order to improve their shape. As reasoning would be totally
lost upon such people, I shall beg leave, just to ask them. Why there
are ten deformed women for one man? and likewise, to recommend to
their perusal, a short moral precept, which forbids us to deform the hu-
man body.

32 OF CHILDREN.
which, if retained, could not fail to occasion diseases. No mother
or nurse can have any excuse for allowing a child to be dirty. Po-
verty may oblige her to give it coarse clothes; but if she does not
keep them clean, it must be her own fault.
Of the Food of Children.
NATURE not only points out, the proper food for an infant,
but actually prepares it. This does not prevent some, who think
themselves wiser than nature, from attempting to bring up their
children, without her provision. Nothing can show the disposition
which mankind have to depart from nature, more, than their en-
deavouring to bring up children without the breast. The mother's
milk, or that of a healthy nurse, is unquestionably the best food
for an infant. Neither art nor nature can afford a proper substi-
tute for it. Children may seem to thrive for a few months with-
out the breast; but when teething, the small-pox, and other diseases,
incident to childhood, come on, they generally perish.
A child, soon after birth, shows an inclination to suck; and it
should be gratified. The mother's milk does not always come im-
mediately after the birth; but this is the way to bring it: Besides,
the first milk that the child can squeeze out of the breast, answers
the purpose of cleansing, better than all the drugs in the apotheca-
ry's shop, and at the same time prevents inflammations of the breast,
fevers, and other diseases incident to mothers.
It is strange how people came to think, that the first thing given
to a child, should be drugs. This is beginning with medicine by
times, and no wonder, if they generally end with it. It sometimes
happens, indeed, that the child does not discharge the meconium
so soon as could be wished; this has induced physicians, in such
cases, to give something of an opening nature, to cleanse the first
passages. Midwives have improved upon this hint, and never fail
to give syrups, oils, &c. whether they be necessary or not. Cram-
ming an infant with such indigestible stuff, as soon as it is born,
can hardly fail to make it sick, and is more likely to occasion dis-
eases, than to prevent them. Children are seldom long after the
birth without having passage both by stool and urine; though
these evacuations may be wanting for some time, without danger.
But if children must have something before they be allowed the
breast, let it be a little thin water-pap, to which may be added an
equal quantity of new milk; or rather water alone, with the addi-
tion of a little raw sugar. If this be given without any wines or
spiceries, it will neither heat the blood, load the stomach, nor oc-
casion gripes.
Upon the first sight of an infant, almost every person is struck
with the idea of its being weak, feeble, and wanting support. This

OF CHILDREN. 33
suggests the need of cordials. Accordingly, wines are universally
mixed with the first food of children. Nothing can be more falla-
cious than this way of reasoning, or more hurtful to infants than
the conduct founded upon it. Children require very little food for
some time after the birth; and what they receive should be thin,
weak, light, and of a cooling quality. A very small quantity of
wine is sufficient to heat and inflame the blood of an infant; but
every person conversant in these matters, must know, that most of
the diseases of infants proceed from the heat of their humours.
If the mother or nurse has enough of milk, the child will need
little or no other food, before the third or fourth month. It will
then be proper to give it, once or twice a day, a little of some food,
that is easy of digestion, as water-pap, milk-pottage, weak broth,
with bread in it, and such like. 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 sud-
den 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 a long time after.
Next to milk, we would recommend good light bread. Bread
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 plain bread, 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. Chil-
dren discover an early inclination to chew whatever is put into
their hands. Parents observe the inclination, but generally mistake
the object. Instead of giving the child something, which may at
once exercise its gums and afford it nourishment, they commonly
put into its hands apiece of hard metal, or impenetrable coral. A
crust of bread is the best gum-stick. It answers the purpose better
than any thing else, and has the additional properties of nourishing
the child, and carrying the saliva down to the stomach, which is
too valuable a liquor to be lost.
Bread, besides being used dry, may be many ways prepared in-
to food for children. One of the best methods is to boil it in water,
afterwards pouring the water off, and mixing with the bread, a
proper quantity of new milk unboiled. Milk is both more whole-
some and nourishing this way than boiled, and is less apt to occa-
sion costiveness. For a child farther advanced, bread may be mixed
in veal or chicken broth, made into puddings, or the like. Bread is
a proper food for children at all times, provided it be plain, made
*A mixture of one-fourth milk, and three-fourths barley-water,
with the addition of some loaf-sugar, is a good substitute for the milk of
the mother. (I. C.)
E

34 OF CHILDREN.
of wholesome grain, and well fermented; but when enriched with
fruits, sugars, or such things, it becomes very unwholesome.
It is soon enough to allow children animal food, when they have
got teeth to eat it. They should never taste it till after they are
weaned, and even then they ought to use it sparingly. Indeed,
when children live wholly on vegetable food, it is apt to four their
stomachs; but on the other hand, too much flesh, heats the body,
and occasions fevers and other inflammatory diseases. This plainly
points out a due mixture of animal and vegetable food, as the most
proper for children.
Few things prove more hurtful to infants, than the common me-
thod of sweetening their food. It entices them to take move than
they ought to, which makes them grow fat and bloated. It is pret-
ty certain, if the food of children were quite plain, that they would
never take more than enough. Their excesses are entirely owing
to nurses. If a child be gorged with food at all hours, and enticed
to take it, by making it sweet and agreeable to the palate, is it any.
wonder, that such a child should in time be induced to crave more
food than it ought to have?
Children may be hurt by too little as well as too much food*.
After a child is weaned, it ought to be fed four or five times a day;
but should never be accustomed to eat in the night; neither should
it have too much at a time. Children thrive best with small quanti-
ties of food frequently given. This neither overloads the stomach,
nor hurts the digestion, and is certainly most agreeable to nature.
Writers on nursing have inveighed with such vehemence against
giving children too much food, that many parents, by endeavour-
ing to shun that error, have run into the opposite extreme, and ru-
ined the constitutions of their children. But the error of pinching
children in their food is more hurtful than the other extreme. Na-
ture has many ways of relieving herself when overcharged, but
a child, who is pinched with hunger, will never become a strong
or healthy man. That errors are frequently committed on both
sides, we are ready to acknowledge; but where one child is hurt
by the quantity of its food, ten suffer from the quality. This is the
principal evil, and claims our strictest attention.
Many people imagine that the food they themselves love, can-
not be bad for their children: but this notion is very absurd. In
the more advanced periods of life, we often acquire an inclination
for food, which, when children, we could not endure. Besides, ma-
ny things may by habit, agree very well with the stomach of a
grown person, which would be hurtful to a child; as high-season-
ed, salted, and smoke-dried provisions, &c. It would also be im-
proper to feed children with fat meat, strong broaths, rich soups,
or the like.
*They should be indulged in eating, as long as they eat with avidity,
but as soon as that has subsided, the food should be withdrawn, or they
will be apt to overload their stomachs. (I. C.)

OF CHILDREN. 35
All strong liquors are hurtful to children. Some parents teach
their children to guzzle ale, and other fermented liquors, at every
meal. Such a practice cannot fail to do mischief. These children
seldom escape the violence of the small-pox, measles, hooping-
cough, or some inflammatory disorder. Milk, water, butter-milk,
or whey, are the most proper for children to drink. If they have
anything stronger, it may be fine small beer, or a little wine mix-
ed with water. The stomachs of children can digest well enough,
without the assistance of warm stimulants: Besides, being naturally
hot, they are easily hurt by every thing of a heating quality.
Few things are more hurtful to children than unripe fruits.
They weaken the powers of digestion, and four and relax the sto-
mach, by which means it becomes a proper nest for insects. Chil-
dren show a great inclination for fruit, and I believe, that if good
ripe fruit were allowed them in proper quantity, it would have no
bad effects. We never find a natural inclination wrong, if proper-
ly regulated. Fruits are generally of a cooling nature, and correct
the heat and acrimony of the humours. This is what most children
require; only care should be taken left they exceed. The best way
to prevent children from going to excess in the use of fruit, or eat-
ing that which is bad, is to allow, them a proper quantity of what is
good*.
Roots which contain a crude viscid juice should be sparingly
given to children. They fill the body with gross humours, and
tend to produce eruptive diseases. This caution is peculiarly ne-
cessary for the poor; glad to obtain at a small price, what will fill
the bellies of their children, they stuff them two or three times a
day, with greasy potatoes, or other crude vegetables. Children had
better eat a smaller quantity of food, which yields a wholesome nou-
rishment, than be crammed with what their digestive powers are
unable properly to assimilate.
Butter ought likewise to be sparingly given to children. It both
relaxes the stomach, and produces gross humours. Most things
that are fat or oily, have this effect. Butter, when salted, becomes
still more hurtful. Instead of butter, so liberally given to children
in most parts of Britain, we would recommend honey. Honey is
not only wholesome, but cooling, cleansing, and tends to sweeten
the humours. Children who eat honey, are seldom troubled with
worms: They are also less subject to cutaneous diseases, as itch,
scabbed-head, &c.
Many people err, in thinking that the diet of children ought to
be altogether moist. When children live entirely upon slops, it re-
*Children are always sickly in the fruit-season, which may be thus
accounted for: Two-thirds of the fruit which comes to market in this
country, is really unripe; and children not being in a condition to judge
for themselves, eat whatever they lay their hands upon, which often
proves little better than a poison for their tender bowels. Servants and
others who have the care of children, should be strictly forbid to give
them any fruit without the knowledge of their parents.

36 OF CHILDREN.
laxes their solids, renders them weak, and disposes them to the
rickets, the scrophula, and other glandular disorders. Relaxation
is one of the most general causes of the diseases of children. Every
thing therefore which tends to unbrace their solids, ought to be
carefully avoided.
We would not be understood by these observations, as confining
children to any particular kind of food. Their diet may be fre-
quently varied, provided always, that sufficient regard be had to
simplicity.
Of the Exercise of Children.
OF all the causes which conspire to render the life of man short
and miserable, none has greater influence than the want of proper
exercise; healthy parents, wholesome food, and proper clothing,
will avail little, where exercise is neglected. Sufficient exercise
will make up for several defects in nursing; but nothing can sup-
ply the want of it. It is absolutely necessary to the health, the
growth, and the strength of children.
The desire of exercise is coeval with life itself. Were this prin-
ciple attended to, many diseases might be prevented. But, while
indolence and sedentary employments prevent two-thirds of man-
kind from either taking sufficient exercise themselves, or giving it
to their children, what have we to expect, but diseases and de-
formity among their offspring? The rickets, so destructive to
children, never appeared in Britain, till manufactures began to
flourish, and people, attracted by the love of gain, left the country
to follow sedentary employments in great towns. It is amongst
these people that this disease chiefly prevails, and not only deforms,
but kills many of their offspring.
The conduct of other young animals, shows the propriety of
giving exercise to children. Every other animal makes use of its
organs of motion as soon as it can, and many of them, even when
under no necessity of moving in quest of food, cannot be restrain-
ed without force. This is evidently the case with the calf, the lamb,
and most other young animals. If these creatures were not per-
mitted to frisk about and take exercise, they would soon die or be-
come diseased. The same inclination appears very early in the hu-
man species; but as they are not able  to take exercise themselves,
it is the business of their parents and nurses to help them.
Children may be exercised various ways. The best method while
they are light, is to carry them about in the nurse's arms*. This
gives the nurse an opportunity of talking to the child, and of
* The nurse ought to be careful to keep the child in a proper position;
as deformity is often the consequence of inattention to this circumstance.

OF CHILDREN. 37
pointing out every thing, that may please and delight its fancy.
Besides, it is much safer than swinging an infant in a machine, or
leaving it to the care of such as are not fit to take care of them-
selves. Nothing can be more absurd than to set one child to keep
another: This conduct has proved fatal to many infants, and has
rendered others miserable for life.
When children begin to walk, the safest and best method of
leading them about, is by the hands. The common way, of swing-
ing them in leading-strings fixed to their backs, has several bad 
consequences. It makes them throw their bodies forward, and
press with their whole weight upon the stomach and breast; by
this means, the breathing is obstructed, the breast flattened, and
the bowels compressed; which must hurt the digestion, and occa-
sion consumptions of the lungs and other diseases.
It is a common notion, that if children be set upon their feet
too soon, their legs will become crooked. There is reason to be-
lieve, that the very reverse of this is true. Every member acquires
strength, in proportion as it is exercised. The limbs of children
are weak indeed, but their bodies are proportionally light; and
had they skill to direct themselves, they would soon be able to sup-
port their own weight. Whoever heard of any other animal that
became crocked by using its legs too soon? Indeed, if a child be
not permitted to make any use of its legs till a considerable time
after the birth, and be then set upon them with its whole weight
at once, there may be some danger; but this proceeds entirely from
the child's not having been accustomed to use its legs from the
beginning.
Mothers of the poorer sort think that they are great gainers by
making their children lie or sit while they themselves work. In
this they are greatly mistaken. By neglecting to give their chil-
dren exercise, they are obliged to keep them a long-time before
they can do any thing for themselves, and to spend more on medi-
cine than would have paid for proper care.
To take care of their children, is the most useful business in
which even the poor can be employed: But, alas! it is not always
in their power. Poverty often obliges them to neglect their off-
spring, in order to procure the necessaries of life. When this is
the case, it becomes the interest as well as the duty of the public
to assist them. Ten thousand times more benefit would accrue to
the state, by enabling the poor to bring up their own children,
than from all the hospitals* that can be erected for that purpose.
*If it were made the interest of the poor to keep their children alive,
we should loose very few of them. A small premium given annually to
each poor family, for every child they have alive at the years end,
would save more infant lives, than if the whole revenue of the crown
were expended in hospitals for this purpose. This would make the poor
esteem fertility a blessing; whereas many of them think it the greatest
curse that can befal them; and in place of wishing their children to live
so far does poverty get the better of natural affection, that they are often
very happy when they die.

38 OF CHILDREN.
Whoever considers the structure of the human body, will soon
be convinced of the necessity of exercise for the health of children.
The body is composed of an infinite number of tubes, whose fluids
cannot be pushed on without the action and pressure of the mus-
cles. But if the fluids remain inactive, obstructions must happen,
which cannot fail to occasion diseases. Nature has furnished both
the vessels which carry the blood and lymph with numerous valves,
in order that the action of every muscle might push forward their
contents; but without action, this admirable contrivance can have
no effect. This part of the animal œconomy proves to a demon-
stration the necessity of exercise for the preservation of health.
Arguments to show the importance of exercise, might be drawn
from every part of the animal œconomy: Without exercise, the
circulation of the blood cannot be properly carried on, nor the dif-
ferent secretions duly performed; without exercise, the fluids can-
not be properly prepared, nor the solids rendered strong or firm.
The action of the heart, the motion of the lungs, and all the vital
functions, are greatly assisted by exercise. But to point out the
manner in which these effects are produced, would lead us farther
into the œconomy of the human body, than most of those for whom
this treatise is intended would be able to follow. We shall there-
fore only add, that, where exercise is neglected, none of the ani-
mal functions can be duly performed; and when that is the case,
the whole constitution must go to wreck.
A good constitution ought certainly to be our first object in the
management of children. It lays a foundation for their being use-
ful and happy in life; and whoever neglects it, not only fails in
his duty to  his offspring, but to society.
One very common error of parents, by which they hurt the con-
stitutions of their children, is the sending them too young to school.
This is often done solely to prevent trouble. When the child is at
school, he needs no keeper. Thus, the school-master is made the
nurse; and the poor child is fixed to a seat seven or eight hours a
day, which time ought to be spent in exercise and diversions. Sit-
ting so long cannot fail to produce the worst effects upon the body;
nor is the mind less injured. Early application weakens the facul-
ties, and often fixes in the mind an aversion to books, which con-
tinues for life*.
But, suppose this were the way to make children scholars, it cer-
tainly ought not to be done at the expense of their constitutions.
Our ancestors, who seldom went to school very young, were not
less learned than we. But we imagine the boy's education will be
* It is undoubtedly the duty of parents to instruct their children, at
least till they are of an age proper to take care of themselves. This
would tend  much to confirm the ties of parental tenderness and filial af-
fection, of the want of which, there are at present so many deplorable
instances. Though few fathers have time to instruct their children, yet
most mothers have; and surely, they cannot be better employed.

OF CHILDREN. 39
quite marred, unless he be carried to school in the nurse's arms. No
wonder if such hot-bed plants seldom become either scholars or men.
Not only the confinement of children in-public schools, but their
number, often proves hurtful. Children are much injured by be-
ing kept in crowds within doors; their breathing not only renders
the place unwholesome, but if any one of them happens to be dis-
eased, the rest catch the infection. A single child has been often
known to communicate the bloody-flux, the hooping-cough, the
itch, or other diseases, to almost every individual in a numerous
school.
But, if infants are to be sent to school, teachers, as they value
the interests of society, ought not to confine them too long at a
time, but allow them to run about and play at such active diver-
sions as may promote their growth, and strengthen their consti-
tutions. Were boys, instead of being whipped for stealing an hour,
to run, ride, swim, or the like, encouraged to employ a proper
part of their time in these manly and useful exercises, it would
have many excellent effects.
An effeminate education will infallibly spoil the best natural
constitution; and if boys are brought up in a more delicate man-
ner than even girls ought to be, they never will be men.
Nor is the common education of girls less hurtful to the con-
stitution than that of boys. Miss is set down to her frame before
she can put on her clothes; and is taught to believe, that to ex-
cel at the needle is the only thing that can entitle her to general
esteem. It is unnecessary here to insist upon the dangerous con-
sequences of obliging girls to sit too much. They are pretty well
known, and are too often felt at a certain time of life. But sup-
pose this critical period be got over, greater dangers still await them
when they come to be mothers. Women who have been early ac-
customed to a sedentary life, generally run great hazard in child-
bed; while those who have been used to romp about, and take suf-
ficient exercise, are seldom in any danger.
One hardly meets with a girl who can at the same time boast
of early performances by the needle, and a good constitution. Close
and early confinement generally occasions indigestions, head-achs,
pale-complexions, pain of the stomach, loss of appetite, coughs,
consumptions of the lungs, and deformity of the body. The last of
these indeed is not to be wondered at, considering the awkward pos-
tures in which girls sit at many kinds of needle-work, and the de-
licate flexible state of their bodies in the early periods of life.
Would mothers, instead of having their daughters instructed in
many trifling accomplishments, employ them in plain work and
housewifery, and allow them sufficient exercise in the open air,
they would both make them more healthy mothers, and more use-
ful members of society. I am no enemy to genteel accomplish-
ments, but would have them only considered as secondary, and al-
ways disregarded, when they impair health.

40 OF CHILDREN.
Many people imagine it a great advantage for children to be
early taught to earn their bread. This opinion is certainly right,
provided they were so employed as not to hurt their health or
growth; but, when these suffer, society, instead of being benefitted,
is a real loser by their labour. There are few employments, except
sedentary ones, by which children can earn a livelihood; and if
they be set to these too soon, it ruins their constitutions. Thus, by
gaining a few years from childhood, we generally lose twice as
many in the latter period of life, and even render the person less
useful while he does live.
In order to be satisfied of the truth of this observation, we need
only look into the great manufacturing towns, where we shall find
a puny degenerate race of people, weak and sickly all their lives,
seldom exceeding the middle period of life; or if they do, being
unfit for business, they become a burden to society. Thus, arts and
manufactures, though they may increase the riches of a country,
are by no means favourable to the health of its inhabitants. Good
policy would therefore require, that such people as labour during
life, would not be set too early to work. Every person conversant
in the breed of horses, or other, working animals, knows, that if
they be set to hard labour too soon, they will never turn out to ad-
vantage. This is equally true, with respect to the human species.
There are nevertheless, various ways of employing young people
without hurting their health. The easier parts of gardening, hus-
bandry, or any business carried on without doors, are most proper.
These are employments which most young people are fond of, and
some parts of them may always be adapted to their age, taste, and
strength*.
Such, parents as are under the necessity of employing their chil-
dren within doors, ought to allow them sufficient time for active di-
versions without. This would both encourage them to do more
work, and prevent their constitutions from being hurt.
Some imagine, that exercise within doors is sufficient; but they
are greatly mistaken. One hour spent in running, or any other
exercise without doors, is worth ten within. When children can-
not go abroad, they may indeed be exercised at home. The best
method of doing this, is to make them run about in a long room,
or dance. This last kind of exercise, if not carried to excels, is of
excellent service to young people. It cheers the spirits, promotes
perspiration, strengthens the limbs, &c. I knew an eminent physi-
cian, who used to say, that he made his children dance, instead of
giving them physic. It were well if more people followed his ex-
ample.
The cold-bath may be considered as an aid to exercise. By it
the body is braced and strengthened, the circulation and secretions
*I have been told that in China, where the police is the best in the
world, all the children are employed in the easier part of gardening and
husbandry; is weeding, gathering stones off the land, and such life. 

FOR CHILDREN. 41
promoted, and, were it conducted with prudence, many diseases,
as the rickets, scrophula, &c. might thereby be prevented. The
ancients, who took every method to render children hardy and ro-
bust, were no strangers to the use of the cold bath; and, if we may
credit report, the practice of immersing children daily in cold wa-
ter must have been very common among our ancestors.
The greatest objection to the use of the cold bath arises from the
superstitious prejudices of nurses. These are often so strong, that
it is impossible to bring them to make a proper use of it. I have
known some of them who would not dry a child's skin after bathing
it, lest it should destroy the effect of the water. Others will even
put cloths dipt in the water upon the child, and either put it to bed,
or suffer it to go about in that condition.
Every child when in health, should at least have its extremi-
ties daily washed in cold water. This is a partial use of the cold-
bath, and is better than none. In winter this may suffice; but in
the warm season, if a child be relaxed, or seem to have a tendency
to the rickets or schrophula, its whole body ought to be frequently
immersed in cold water. Care however must be taken not to do
this when the body is hot, or the stomach full. The child should
be dipped only once at a time, should be taken out immediately,
and have its skin well rubbed with a dry cloth.
The Effects of unwholesome Air upon Children,
FEW things prove more destructive to children, than confined
or unwholesome air. This is one reason why so few of those infants,
who are put into hospitals, or parish work-houses, live. These places
are generally crowded with old, sickly and infirm people; by which
means the air is rendered so extremely pernicious, that it becomes
a poison to infants.
Want of wholesome air is likewise destructive to many of the
children born in great towns. There the poorer sort of inhabitants
live in low, dirty, confined houses, to which the fresh air has hardly
any access. Though grown people, who are hardy and robust, may
live in such situations, yet they generally prove fatal to their off-
spring, few  of whom arrive at maturity, and those who do, are
weak and deformed. As such people are not in a condition to carry
their children abroad in the open air, we must lay our account with
losing the greater part of them. But the rich have not this excuse.
It is their business to see that their children be daily carried abroad,
and that they be kept in the open air for a sufficient time. This
will always succeed better if the mother goes along with them.
Servants are often negligent in these matters, and allow a child to
sit or lie on the damp ground, instead of leading or carrying it
about. The mother surely needs air as well as her children; and
how can she be better employed than in attending them?
F

42 OF CHILDREN.
A very bad custom prevails, of making children sleep in small
apartments, or crowding two or three beds into one chamber. In-
stead of this, the nursery ought always to be the largest and best
aired room in the house. 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 up 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. Cradles indeed are on many accounts hurtful to
children, and it would be better if the use of them were totally laid
aside†.
A child is generally laid to sleep with all its clothes on; and if a
number of others are heaped above them, it must be overheated;
by which means it cannot fail to catch cold on being taken out of
the cradle, and exposed to the open air, with only its usual clothing,
which is too frequently the case.
Children who are kept within doors all day, and sleep all night
in warm close apartments, may, with great propriety, be compar-
ed to plants, nursed in a hot-house, instead of the open air. Though
such plants may, by this means, be kept alive for some time, they
will never arrive at that degree of strength, vigour and magnitude,
which they would have acquired in the open air, nor would they
be able to bear it afterwards, should they be exposed to it.
Children, brought up in the country, who have been accustomed
to open air, should not be too early sent to great towns, where it is,
confined and unwholesome. This is frequently done with a view
to forward their education, but proves very hurtful to their health.
All schools and seminaries of learning ought, if possible, to be so
situated as to have fresh, dry, wholesome air, arid should never be
too much crowded.
Without entering into a detail of the particular advantages of
wholesome air to children, or of the bad consequences which pro-
ceed from the want of it, I shall only observe, that, of several thou-
sands of children that have been under my care, I do not remem-
ber one instance of a single child, who continued healthy in a close
confined situation; but have often known the most obstinate diseases
cured by removing them from such a situation to an open free air.
† It is amazing how children escape suffocation, considering the man-
ner in which they are often rolled up in flannels, &c. I lately attended
an infant, whom I found muffled up over head and ears in many folds of
flannel, though it was in the middle of June. I begged for a little free
air to the poor babe; but though this indulgence was granted during my
stay. I found it always on my return in the same situation. Death soon
freed the infant from all its miseries; but it was not in my power to free
the minds of its parents from those prejudices which proved fatal to their
child. 

OF CHILDREN. 43
Of Nurses.
IT is not here intended to lay down rules for the choice of nurses.
This would be wasting time. Common sense will direct everyone
to choose a woman who is healthy, and has plenty of milk*. If she
be at the same time cleanly, careful, and good-natured, she can
hardly fail to make a proper nurses. After all, however, the only
certain proof of a good nurse, is a healthy child upon her breast.
But, as the misconduct of nurses often proves fatal to children, it
will be of importance to point out a few of their most baneful er-
rors, in order to rouse the attention of parents, and to make them
look more strictly into the conduct of those to whom they commit
the care of their infant offspring.
Though it admits of some exceptions, yet, we may lay it down
as a general rule, that every woman who nurses for hire ought to
be carefully looked after, otherwise she will not do her duty. For
this reason, parents ought always to have their children nursed un-
der their own eye, if possible; and where this cannot be done, they
should be extremely circumspect in the choice of those persons to
whom they intrust them. It is folly to imagine that any woman,
who abandons her own child to suckle another for the sake of gain,
should feel all the affections of a parent towards her nursling; yet
so necessary are these affections in  a nurse, that, but for them, the
human race would be extinct.
One of the most common faults of those who nurse for hire, is
to dose children with stupefactives, or such things as lull them
asleep. An indolent nurse, who does not give a child sufficient ex-
ercise in the open air to make it sleep, and does not choose to be
disturbed by it in the night, will seldom fail to procure for it a dose
of laudanum, diacodium, saffron, or, what answers the same pur-
pose, a dram of spirits, or other strong liquors. These, though they
be certain poison to infants, are every day administered by many
who bear the character of very good nurses‡.
A nurse who has not milk enough, is apt to imagine that this de-
fect may be supplied by giving the child wines, cordial-waters, or
other strong liquors. This is an egregious mistake. The only thing
that has any chance to supply the place of the nurse's milk, must
be somewhat nearly of the same quality, as cow's milk, ass's milk,
*I have often known people so imposed upon, as to give an infant to
a nurse to be suckled who had not one drop of milk in her breast.
† In addition to these qualifications, she would be clear of any defor-
mity about her eyes, such as squinting, &c. as children are very liable to
contract unpleasant habits from their nurses. (I. C.)
‡ If a mother on visiting her child at nurse finds it always asleep, I
would advise her to remove it immediately; otherwise, it will soon sleep
its last.

44 OF CHILDREN.
or the like, with good bread. It never can be done by the help of
strong liquors. These, instead of nourishing an infant, never fail to
produce the contrary effect.
Children are often hurt by nurses suffering them to cry long and
vehemently. This strains their tender bodies, and frequently oc-
casions ruptures, inflammations of the throat, lungs, &c. A child
never continues to cry long without some cause, which might al-
ways be discovered by proper attention; and the nurse who can
bear an infant cry till it has almost spent itself, without endeavor-
ing to please it, must be cruel indeed, and is unworthy to be in-
trusted with the care of an human creature.
Nurses who deal much in medicine are always to be suspected.
They trust to it, and neglect their duty. I never knew a good nurse
who had her Godfrey's cordials, Daffy's elixirs, &c. at hand. Such
generally imagine, that a dose of medicine will make up for all de-
fects in food, air, exercise and cleanliness.
Allowing children to continue long wet, is another very perni-
cious custom of indolent nurses. This is not only disagreeable, but
it galls, and frets the infant, and by relaxing the solids, occasions
schrophulas, rickets, and other diseases.  A dirty nurse is always to
be suspected.
Nature often attempts to free the bodies of children from bad
humours, by throwing them Upon the skin: By this means fevers
and other diseases are prevented. Nurses are apt to mistake such
critical eruptions for an itch, or some  other infectious disorder.
Accordingly, they take every method to drive them in. In this way
many children lose their lives; as nature is  opposed in the very
method that she takes to relieve them. A nurse should never stop
any eruption without proper advice, or being well assured that it
as not of a critical nature. At any rate, it is never to be done with-
out previous evacuations.
Loose stools are another method by which nature often prevents
or carries off the diseases of infants. If these proceed too far, they
ought to be checked; but never without great caution. Nurses,
upon the first appearance of loose stools, frequently fly to the use of
astringents, or such things as bind the body. Hence inflammatory
fevers, and other fatal diseases, are occasioned. A dose of rhubarb,
a gentle vomit, or some other evacuation, should always precede the
life of astringent medicines*.
One great fault of nurses is, concealing the diseases of children
from their parents. This they are extremely ready to do, especially
when the disease is the effect of their own negligence. Many in-
* Some nurses are so extremely nice, that rather than take the trou-
ble of cleansing a child frequently, they will attempt to stop up the pas-
sage: Squeamish maids have actually used corks for this purpose. What
have not mothers to fear, who intrust their children to the care of such
worthless drabs?

OF CHILDREN. 45
stances might be given of persons who have been rendered lame
for life by a fall from their nurse's arms, which she through fear,
concealed till the misfortune was past cure. Every parent who in-
trusts a nurse with the care of a child, ought to give her the strictest
charge not to conceal the most trifling disorder or misfortune that
may befal it.
We can see no reason, why a nurse, who conceals any mis-
fortune which happens to a child under her care, till it loses its life
or limbs, would not be punished. A few examples of this kind would
save the lives of many infants; but as there is little reason to ex-
pect that it will ever be the case, we would earnestly recommend,
it to all parents to look carefully after their children, and not to
trust so valuable a treasure entirely in the hands of an hireling.
No person ought to imagine these things unworthy of his atten-
tion. On the proper management of children depend not only their
health and usefulness in life, but likewise the safety and prosperity
of the state to which they belong. Effeminacy ever will prove the
ruin of any state where it prevails; and, when its foundations are
laid in infancy, it can never arterwards be wholly eradicated. Pa-
rents who love their offspring, and wish well to their country, will,
in the management of their children, avoid every thing that tends
to make them weak or effeminate, and take every method in their
power to render their constitutions strong and hardy.
— By arts like these
Laconia nurs'd of old her hardy sons;
And Rome's unconquer'd legions urg'd their way,
Unhurt, thro' every toil in every clime.           
Armstrong.
CHAPTER II.
Of the Laborious, the Sedentary, and the Studious.
MEN are exposed to particular diseases from the occupations
which they follow; but to remedy this evil is difficult. Most
people are under the necessity of following those employments to
which they have been bred, whether they be favourable to health
or not. Instead of inveighing, as some authors have done, against
those occupations which are hurtful to health, we shall endeavour
to point out the circumstances in each of them from which the
danger chiefly arises, and to propose the most rational methods
of preventing it.
Chemists, founders, forgers, glass-makers, and several other ar-
tists, are hurt by the unwholesome air which they are obliged to
breathe. This air is not only loaded with the noxious exhalations

46 OF THE LABORIOUS, THE SEDENTARY,
arising from metals and minerals, but is so charged with phlogiston
as to be rendered unfit for expanding the lungs sufficiently, and
answering the other important purposes of respiration. Hence pro-
ceed asthmas, coughs, and consumptions of the lungs, so incident
to persons who follow these employments.
To prevent such consequences, as far as possible, the places where
these occupations are carried on, ought to be constructed in such
a manner as to discharge the smoke and other exhalations, and
admit a free current of fresh air. Such artists ought never to con-
tinue too long at work; and when they give over, they should
suffer themselves to cool gradually, and put on their clothes before
they go into the open air. They ought never to drink large quanti-
ties of cold, weak, or watery liquors, while their bodies are hot,
nor to indulge in raw fruits, sallads, or any thing that is cold on
the stomach.
Miners, and all who work under ground, are likewise hurt by
unwholesome air. The air, by its stagnation in deep mines, not
only loses its proper spring and other qualities necessary for respi-
ration, but is often loaded with such noxious exhalations as to be-
come a most deadly poison.
The two kinds of air which prove most destructive to miners,
are what they call the fire damp, and the choke damp. In both
cases the air becomes a poison, by its being loaded with phlogiston.
The danger from the former may be obviated by making it ex-
plode before it accumulates in too great quantities; and the latter
may be generally carried off by promoting a free circulation of air
in the mine.
Miners are not only hurt by unwholesome air, but likewise by
the particles of metal which adhere to their skin, clothes, &c. These
are absorbed, or taken up into the body, and occasion palsies, ver-
tigoes, and other nervous affections, which often prove fatal. Fal-
lopius observes, that those who work in mines of mercury, seldom
live above three or four years. Lead, and several other metals, are
likewise very pernicious to the health.
Miners ought never to go to work fasting, nor to continue too
long at work. Their food ought to be nourishing, and their liquor
generous: Nothing more certainly hurts them than living too low:
They should by all means avoid costiveness. This may either be
done by chewing a little rhubarb, or taking a sufficient quantity of
sallad oil. Oil not only opens the body, but sheaths and defends
the intestines from the ill effects of the metals. All who work in
mines or metals ought to wash carefully, and to change their clothes
as soon as they give over working. Nothing would tend more to
preserve the health of such people than a strict regard to cleanliness.
Plumbers, painters, gilders, smelters, makers of white-lead, and
many others who work in metals, are liable to the same diseases as
miners, and ought to observe the same directions for avoiding them.
Tallow-chandlers, boilers of oil, and all who work in putrid ani- 

AND THE STUDIOUS. 47
mal substances, are likewise liable to suffer from the unwholesome
smells or effluvia of these bodies. They ought to pay the same re-
gard to cleanliness as miners; and when they are affected with
nausea, sickness, or indigestion, we would advise them to take a
vomit or a gentle purge. Such substances ought always to be ma-
nufactured as soon as possible. When long kept, they not only be-
come unwholesome to those who manufacture them, but likewise
to people who live in the neighbourhood.
It would greatly exceed the limits of this part of our subject, to
specify the diseases peculiar to persons of every occupation; we
shall therefore consider mankind under the general classes of Labo-
rious, Sedentary, and Studious.
The Laborious.
THOUGH those who follow laborious employments are in ge-
neral the most healthy of mankind, yet the nature of their occupa-
tions, and the places where they are carried on, expose them more
particularly to some diseases. Husbandmen, for example, are ex-
posed to all the vicissitudes of the weather, which in America, are
often very great and sudden, and occasion colds, coughs, quinsies,
rheumatisms, fevers, and other acute disorders. They work hard,
and often carry burden above their strength, which, by overstrain-
ing the vessels, occasion asthmas, ruptures, pleurisies, &c.
Those who labour without doors are often afflicted with inter-
mitting fevers or agues, occasioned by the frequent vicissitudes of
heat and cold, poor living, bad water, sitting or lying on the damp
ground, evening dews, night air, &c. to which they are frequently
exposed.
Such as bear heavy burdens, as porters, labourers, &c. are obli-
ged to draw in the air with much greater force, and also to keep
their lungs distended with more violence than is necessary for com-
mon respiration: By this means the tender vessels of the lungs are
over-stretched, and often burst, insomuch that a spitting of blood
or fever ensues. Hippocrates mentions an instance of a man, who,
upon a wager, carried an ass; but was soon after seized with a
fever, a vomiting of blood, and a rupture.
Carrying heavy burdens is generally the effect of mere laziness,
which prompts people to do at once what should be done at twice.
Sometimes it proceeds from vanity or emulation. Hence it is, that
the strongest men are most commonly hurt by heavy burdens, hard
labour, or seats of activity. It is rare to find one who boasts of his
strength, without a rupture, a spitting of blood, or some other dis-
ease, which he reaps as the fruit of his folly. One would imagine
the daily instances we have of the fatal effects of carrying great

48 OF THE LABORIOUS, THE SEDENTARY,
weights, running, wrestling, and the like, would be sufficient to
prevent such practices.
There are indeed some employments which necessarily require a
great exertion of strength, as porters, blacksmiths, carpenters, &c.
None ought to follow these but men of strong body; and they
should never exert their strength to the utmost, nor work too long.
When the muscles are violently strained, frequent rest is necessa-
ry, in order that they may recover their tone; without this, the
strength and constitution will soon be worn out, and a premature
old age be induced.
The erisipelas, or St. Anthony's fire, is a disease very incident
to the laborious. It is occasioned by whatever gives a sudden
check to the perspiration, as drinking cold water when the body
is warm, wet feet, keeping on wet clothes, sitting or lying on the
damp ground, &c. It is impossible for those who labour without
doors always to guard against these inconveniencies; but it is
known from experience, that heir ill consequences might often
be prevented by proper care.
The iliac passion, the cholic, and other complaints of the bowels,
are often occasioned by the same causes as the erisipelas; but they
may likewise proceed from flatulent end indigestible food. La-
bourers generally eat unfermented bread, and great quantities of
unripe fruits, baked, stewed, or raw, with various kinds of roots
and herbs, upon which they often drink four milk, stale small
beer, or the like. Such a mixture cannot fail to fill the bowels
with wind, and occasion diseases of those parts.
Inflammations, whitloes, and other diseases of the extremities, are
likewise common among those who labour without doors. These
diseases are often attributed to venom, or some kind of poison;
but they generally proceed either from sudden heat after cold, or
the contrary. When labourers, milk-maids, &c. come from the
field, cold or wet, they run to the fire, arid often plunge their hands
in warm water, by which means the blood and other humours in
those parts, are suddenly expanded, and, the vessels not yielding
so quickly, a strangulation happens, and an inflammation or morti-
fication ensues.
When such persons come home cold, they ought to keep at a
distance from the fire for some time, to wash their hands in cold
water, and to rub them well with a dry cloth. It sometimes hap-
pens, that people are so benumbed with cold, as to be quite de-
prived of the use of their limbs. In this case, the only remedy is
to rub the parts affected with show, or, where it cannot be had,
with cold water. If they be held near the fire, or plunged into
warm water, a mortification will generally ensue.
Labourers in the hot season are apt to lie down and sleep in the
sun. This practice is so dangerous, that they often wake in a burn-
ing fever. These ardent fevers, which prove so fatal about the end
of summer and beginning of autumn, are frequently occasiond by

AND THE STUDIOUS. 49
this means. When labourers leave off work, which they ought al-
ways to do during the heat of the day, they should go home, or, at
least, get under some cover, where they may repose themselves in
safety.
Many people follow their employments in the fields from morn-
ing till night, without eating any thing. This cannot fail to hurt
their health. However homely their fare be, they ought to have
it at regular times; and the harder they work, the more frequently
they should eat. If the humours be not frequently replenished
with fresh nourishment, they soon become putrid, and produce fe-
vers of the very worst kind.
Many peasants are extremely careless with respect to what they
eat or drink, and often, through mere indolence, use unwholesome
food, when they might for the same expense have that which is
wholesome. In some parts of Britain, the peasants are too careless
even to take the trouble of dressing their own victuals. Such peo-
ple would live upon one meal a-day in indolence, rather than la-
bour, though it were to procure them the greatest affluence.
Fevers of a very bad kind are often occasioned among labourers
by poor living. When the body is not sufficiently nourished, the
solids become weak; from whence the most fatal consequences
ensue. Poor living is likewise productive of many of those cuta-
neous diseases so frequent among the lower class of people. It is
remarkable that cattle, when pinched in their food, are generally
affected with diseases of the skin, which seldom fail to disappear,
when they are put upon a good pasture. This shows how much a
good state of the humours depends upon a sufficient quantity of pro-
per nourishment.
Poverty not only occasions, but aggravates, many of the diseases
of the laborious. Few of them have much foresight; and, if they
had, it is seldom in their power to save any thing. They are glad to
make a shift to live from day to day; and, when any disease over-
takes them, they are miserable indeed. Here, the godlike virtue of
charity ought always to exert itself. To relieve the industrious
poor in distress, is surely the most exalted act of religion and hu-
manity. They alone, who are witnesses of those scenes of calamity,
can form an opinion of what numbers perish in diseases, for want
of proper assistance, and even for want of the necessaries of life.
Labourers are often hurt by an emulation, which prompts them
to vie with one another, till they overheat themselves to such a de-
gree as to occasion a fever, or even to drop down dead. Such as
wantonly throw away their lives in this manner, deserve to be
looked upon as self-murderers.
Soldiers suffer many hardships from the inclemency of seasons,
long marches, bad provisions, hunger, watching, unwholesome cli-
mates, bad water, &c. These occasion fevers, fluxes, rheumatisms,
and other fatal diseases, which generally do greater execution than
the sword, especially when campaigns are continued too late in. 
G

50 OF THE LABORIOUS, THE SEDENTARY,
the season. A few weeks of cold rainy weather will often prove
more fatal than an engagement.
Those who have the command of armies should take care that
their soldiers be well clothed and well fed. They ought also to fi-
nish their campaigns in due season, and to provide their men with
dry and well-aired winter quarters. These rules, taking care, at the
same time, to keep the sick at a proper distance from those in health,
would tend greatly to preserve the lives of the soldiery.
Sailors may be numbered among the laborious. They undergo
great hardships from change of climate, the violence of weather,
hard labour, bad provisions, &c. Sailors are of so great impor-
tance to the trade of a nation, that too much pains can never be
bestowed in pointing out the means of preserving their lives.
One great source of the diseases of sea-faring people is excess.
When they get on shore, after having been long at sea, without re-
gard to the climate, or their own constitutions, they plunge head-
long into all manner of riot, and often persist till a fever puts an
end to their lives. Thus, intemperance, and not the climate, is often
the cause why so many of our sailors die on foreign coasts. Such
people ought hot to live too low; but they will find moderation the
best defence against fevers, and many other maladies.
Sailors, when on duty, cannot avoid sometimes getting wet.
When this happens, they should change their clothes as soon as
they are relieved, and take every method to restore the perspira-
tion. They should not in this case, make too free with spirits or
other strong liquors, but should rather drink them diluted with
warm water, and go immediately to bed, where a sound sleep and
a gentle sweat would set all to rights.
But the health of sailors suffers most from unwholesome food.
The constant use of salted provisions, with a scant allowance of
bad, water debilitate their constitutions, occasions the scurvy, and
other obstinate maladies. It is no easy matter to prevent this dis-
ease in long voyages; yet much might be done towards effecting
so desirable an end, were due pains bellowed for that purpose. For
example, various roots, greens, and fruits, might be kept a long
time at sea, as onions, potatoes, cabbages, lemons, oranges, tama-
rinds, apples, &c. When fruits cannot be kept, the juice of them,
either fresh or fermented, may. With these, all the drink, and
even the food of the ship's company, ought to be acidulated in
long voyages.
Stale bread and beer likewise contribute to vitiate the humours.
Flour will keep for a long time on board, of which fresh bread
might frequently be made. Malt, too, might be kept, and infused
with boiling water at any time. This liquor, when drank even in
form of wort, is very wholesome, and is found to be an antidote
against the scurvy. Small wines and cyder might likewise be plen-
tifully laid in; and should they turn sour, they would still be use-
ful as vinegar. Vinegar is a great antidote against diseases, and

AND THE STUDIOUS. 51
should be used by all travellers, especially at sea. It may either
be mixed with the water they drink, or taken in their food.
Such animals as can be kept alive, ought to be carried on board,
as hens, ducks, pigs, &c. Fresh broths made of portable soup, and
puddings made of peas, or other vegetables, ought to be used plen-
tifully. Many other things will readily occur to people conversant
in these matters, which would tend to preserve the health of that
brave and useful set of men*.
We have reason to believe, if due attention were paid to the
diet, air, clothing, and above all things, to the cleanliness of sea-
faring people, they would be the most healthy set of men in the
world; but when these are neglected, the very reverse will happen.
The best medical antidote that we can recommend to sailors or
soldiers on foreign coasts, especially where dampness prevails, is
the Peruvian bark. This will often prevent fevers and other fatal
diseases. About a drachm of it may be chewed every day, or if this
should prove disagreeable, an ounce of bark, with half an ounce of
orange-peel, and two drachms of snake-root coarsely powdered,
may be infused two or three days in an English quart of brandy,
and half a wine-glass of it taken twice or thrice a day, when the
stomach is empty. This has been found to be an excellent antidote
against fluxes, intermitting, and other fevers, in unhealthy climates.
It is not material in what form this medicine is taken. It may ei-
ther be infused in water, wine, or spirits, as recommended above,
or made into an electuary with syrup of lemons, orange, or the like.
The Sedentary.
THOUGH nothing can be more contrary to the nature of man
than a sedentary life, yet this class comprehends by far the greater
part of the species. Almost the whole female world, and in manu-
facturing countries, the major part of the males, may be reckoned
sedentary†.
* Captain Cook has shown how far, by proper care and attention, the
diseases formerly so fatal to seamen, may be prevented. In a voyage, or
three years and eighteen days, during which he was exposed to every
climate, from the 52° north to the 71° of south latitude, of one hundred
and eighteen men, composing the ship's company, he lost only, one, who
died or a phthisis pulmonalis. The principal means he used were, to
preserve a strict attention to cleanliness, to procure abundance of vege-
tables and fresh provisions, especially good water, and to allow his peo-
ple sufficient time for rest.
† The appellation of sedentary has generally been given only to the
studious; we can see no reason, however, for restricting it to them alone.
Many artificers may, with as much propriety, be denominated sedentary
as the studious, with this particular disadvantage, that they are often
obliged to sit in very awkward postures, which the studious need not un-
less they please. 

52 OF THE LABORIOUS, THE SEDENTARY,
Agriculture, the first and most healthful of all employments, is
now followed by few who are able to carry on any other business.
But those who imagine that the culture of the earth is not suffici-
ent to employ all its inhabitants, are greatly mistaken. An ancient
Roman, we are told, could maintain his family from the produce
of one acre of ground. So might a modern Briton, if he would be
contented to live like a Roman. This shows what an immense in-
crease of inhabitants Britain might admit of, and all of them live
by the culture of the ground.
Agriculture is the great source of domestic riches. Where it is
neglected, whatever wealth may be imported from abroad, pover-
ty and misery will abound at home. Such is, and ever will be, the
fluctuating state of trade and manufactures, that thousands of peo-
ple may be in full employment to-day, and in beggary to-morrow.
This can never happen to those who cultivate the ground. They
can eat the fruit of their labour, and can always by industry ob-
tain, at least, the necessaries of life.
Though sedentary employments are necessary, yet there seems
to be no reason why any person should be confined for life to these
alone. Were such employments intermixed with the more ac-
tive and laborious, they would never do hurt. It is constant con-
finement that ruins the health. A man will not be hurt by sitting
five or six hours a-day; but if he is obliged to sit ten or twelve, he
will soon become diseased.
But it is not want of exercise alone which hurts sedentary peo-
ple; they likewise suffer from the confined air which they breathe.
It is very common to see ten or a dozen taylors*, or staymakers,
for example, crowded into  one small apartment, where there is
hardly room for one person to breathe freely. In this situation
they generally continue for many hours at a time, often with the
addition of sundry candles, which tend likewise to waste the air,
and render it less fit for respiration. Air that is breathed repeated-
ly becomes unfit for expanding the lungs. This is one cause of
the phthisical coughs, and other complaints of the breast, so inci-
dent to sedentary artificers.
Even the perspiration from a great number of persons pent up
together, renders the air unwholesome. The danger from this quar-
ter will be greatly increased, if any one of them happens to have
bad lungs, or to be otherwise diseased. Those who sit near him, be-
ing forced to breathe the same air, can hardly fail to be infected.
It would be a rare thing to find a dozen sedentary people all in
*A person of observation in that line of life told me, that most tay-
lors die of consumptions; which he attributed chiefly to the unfavoura-
ble postures in which they sit, and the unwholesomeness of those places
where their business is carried on. If more attention was not paid to
profit than to the preservation of human lives, this evil might be easily
remedied; but while masters only mind their own interest, nothing
will be done for the safety of their servants.

AND THE STUDIOUS. 53
good health. The danger of crouding them together must there-
fore be, evident to every one.
Many of those who follow sedentary employments are constantly
in a bending posture, as shoe-makers, taylors, cutlers, &c. Such a
situation is extremely hurtful. A bending posture obstructs all the
vital motions, and of course must destroy the health. Accordingly,
we find such artificers generally complaining of indigestions, flatu-
lences, head-achs, pains of the breast, &c.
The aliment in sedentary people, instead of being pushed for-
wards by an erect posture, and the action of the muscles, is in a
manner confined in the bowels. Hence, indigestions, costiveness,
wind, & other hypocondriachal affections, are the companions of the
sedentary. No excretion can be duly performed where exercise is
wanting; and when the matter which ought to be discharged in
this way, is retained too long in the body, it must have bad effects,
as it is again taken up into the mass of humours.
A bending posture is hurtful to the lungs. When this organ is
compressed, the air cannot have free access into all its parts, so as
to expand them properly. Hence tubercles, adhesions, &c. are
formed, which often end in consumptions. Besides, the proper ac-
tion of the lungs being absolutely necessary for making good bloody
when that organ fails, the humours soon become universally de-
praved, and the whole constitution goes to wreck.
Sedentary artificers are not only hurt by pressure on the bowel,
but also on the inferior extremities, which obstructs the circula-
tion in those parts, and renders them weak and feeble. Thus, tay-
lors, shoe-makers, &c. frequently lose the use of their legs altoge-
ther; besides, the blood and humours are, by stagnation, vitiated,
and the perspiration is obstructed: From whence proceed the scab,
ulcerous sores, foul blotches, and other cutaneous diseases, so com-
mon among sedentary artificers.
A bad figure of body is a very common consequence of close ap-
plication to sedentary employments. The spine, for example, by
being continually bent, puts on a crooked shape, and generally re-
mains so ever after. But a bad figure of body has already been ob-
served to be hurtful to health, as the vital functions are thereby
impeded.
A sedentary life seldom fails to occasion an universal relaxation
of the solids. This is the great source from whence most of the
diseases of sedentary people flow. The schrophula, consumption,
hysterics, and nervous diseases, now so common, were very little
known in this country before sedentary artificers became so nume-
rous: And they are very little known still among such of our peo-
ple as follow active employments without doors, though in great
towns, at least two thirds of the inhabitants are afflicted with them.
It is very difficult to remedy those evils, because many who have
been accustomed to a sedentary life, like ricketty children, lose all
inclination for exercise; we shall throw out a few hints with respect 

54 OF THE LABORIOUS, THE SEDENTARY,
to the most likely means for preserving-the health of this useful set
of people.
Sedentary  artificers are often hurt by their bending posture.
They ought to stand or sit as erect as the nature of their employ-
ments will permit. They should change their posture frequently,
and never sit too long at a time, but leave off work, and walk, ride,
run, or do any thing that will promote the vital functions.
Sedentary artificers are generally allowed too little time for ex-
ercise; yet, short as it is, they seldom employ it properly. A jour-
neyman taylor or weaver, for example, instead of walking abroad
for exercise and fresh air, at his hours of leisure, chooses often to
spend them in a public-house, or in playing at some sedentary
game, by which he generally loses both his time and his money.
The awkward postures in which many sedentary artificers work,
seem rather to be the effect of custom than necessity. For example,
a table might surely be contrived for ten or a dozen taylors to sit
round, with liberty for their legs either to hang down, or rest upon
a foot-board, as they should choose. A place might be cut out for
each person, in such a manner that he might sit as conveniently for
working as in the present mode of sitting cross-legged.
All sedentary artificers ought to pay the most religious regard to
cleanliness. Both their situation and occupation render this highly
necessary. Nothing would contribute more to preserve their health,
than a strict attention to it; and such of them as neglect it, not only
run the hazard of losing health, but of becoming a nuisance to their
neighbours.
Sedentary people ought to avoid food that is windy, or hard of
digestion, and pay the strictest regard to sobriety. A person who
works hard without doors will soon throw off a debauch; but one
who sits has by no means an equal chance. Hence sedentary peo-
ple are often seized with fevers after hard drinking. When such per-
sons feel their spirits low, instead of running to the tavern for re-
lief, they should ride, or walk in the fields. This would remove the
complaint more effectually than strong liquor, and would never
hurt the constitution.
We shall recommend the following general plan, viz. That eve-
ry 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 amusement, while it produced 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.
Labouring 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, whilst the
perpetual prospect of something coming to maturity, delights and
entertains the mind. We are always pleased with somewhat in pros- 

AND THE STUDIOUS. 55
pect, however distant or 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, there is reason to be-
lieve, they knew as well wherein true happiness consisted as we do.
It may seem romantic to recommend gardening to manufacturers
in great towns; the plan is very practicable. In Sheffield, where
the great iron manufacture is carried on, there is hardly a journey-
man cutler who does not possess a piece of ground, which he cul-
tivates as a garden. 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. There can be no reason why ma-
nufacturers in any other towns of Britain should not follow the
same plan. In London, a plan of this kind is not practicable; yet
even there, sedentary artificers may find opportunities of taking air
and exercise, if they choose to embrace them.
Mechanics are too much inclined to crowd into great towns.
The situation may have some advantages; but it has many disad-
vantages. 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, me-
chanics who live in the country are far more happy than those in
great towns. They enjoy better health, live in greater affluence,
and seldom fail to rear a healthy and numerous offspring.
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 languid for a few years, and soon drop into
an untimely grave.
The Studious.
INTENSE thinking is so destructive to health, that few instan-
ces can be produced of studious persons who are strong and heal-
thy. Hard study always implies a sedentary life; and when intense
thinking is joined to the want of exercise, the consequence must
be bad. We have frequently known even a few months of close ap-
plication to study, ruin an excellent constitution, by inducing a
train of nervous complaints which could never be removed. Man
is evidently not formed for continual thought more than for per-
petual 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 in-
fluence the whole vital motions may be accelerated or retarded, 

56 OF THE LABORIOUS, THE SEDENTARY,
To almost any degree. Thus cheerfulness and mirth quicken the cir-
culation, and promote all the secretions; sadness and profound
thought retard them. Hence, even a degree of thoughtlessness is
necessary to health. The perpetual thinker seldom enjoys either
health or 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 melan-
choly proof how readily the greatest blessings may be abused. Think-
ing, like every thing else, when carried to an extreme, becomes a
vice: nor can any thing 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,
or the like.
Instead of attempting to investigate the nature of that connexion
which subsists between the mind and body, or to enquire into the
manner in which they mutually affect each other, we shall only
mention those diseases to which the learned are more peculiarly
liable, and endeavour to point out the means of avoiding them.
Studious persons are very subject to the gout. This painful dis-
ease in a great measure proceeds from indigestion, and an obstruc-
ted perspiration. It is impossible that the man who sits from morn-
ing till night should either digest his food, or have any of the se-
cretions in due quantity. But when that matter, which should be
thrown off by the skin, is retained in the body, and the humours
are not duly prepared, diseases must ensue.
The studious are likewise very liable to the stone and gravel. Ex-
ercise greatly promotes both the secretion and discharge of urine;
a sedentary life must have the contrary effect. Any one may be
satisfied of this by observing, that he passes much more urine by day
than in the night, and also when he walks or rides, than when he
sits.
The circulation in the liver being slow, obstructions in that or-
gan can hardly fail to be the consequence of inactivity. Hence, se-
dentary people are frequently afflicted with schirrous livers. But the
proper secretion and discharge of the bile is so necessary a part of
the animal economy, that where these are not duly performed, the
health must soon be impaired. Jaundice, indigestion, loss of appe-
tite, and a wasting of the whole body, seldom fail to be the conse-
quences of a vitiated state of the liver, or obstructions of the bile.
Few diseases prove more fatal to the studious than consumptions
of the lungs. This organ cannot be duly expanded in those who
do not take proper exercise; and where that is the case, obstructions
and adhesions will ensue. Not only want of exercise, but the pos-
ture in which studious persons generally fit, is very hurtful to the
lungs. Those who read or write much are ready to contract a ha-
bit of bending forwards, and often press with their breast upon a
table or bench. This posture hurts the lungs. 

AND THE STUDIOUS. 57
The functions of the heart may likewise by this means be in-
jured. I remember to have seen a man opened, whose pericardium
adhered to the breast-bone, in such a manner, as to obstruct the mo-
tion of the heart, and occasion his death. The only probable cause
that could be assigned for this singular symptom was, that the man,
whose business was writing, used constantly to sit in a bending
posture, with his breast pressing upon the edge of a flat table.
No person can enjoy health who does not properly digest his
food. But intense thinking and inactivity never fail to weaken the
powers of digestion. Hence the solids become weak and relaxed,
and the whole constitution goes to ruin.
Long and intense thinking often occasions grievous head-achs,
which bring on vertigoes, apoplexies, palsies, and other fatal dis-
orders. The best way to prevent these is, never to study too long
at one time, and to keep the body regular, either by proper food,
or taking frequently a little of some opening medicine.
Those who read or write much are often afflicted with sore eyes.
Studying by candle-light is peculiarly hurtful to the sight. This
ought to be practised as seldom as possible. When it is unavoid-
able, the eyes should be shaded, and the head should not be held
too low. When the eyes are weak or painful, they should be
bathed every night and morning in cold water, to which a little
brandy may be added.
The excretions are very defective in the studious. The dropsy
is often occeasioned by the retention of those humours which ought
to be carried off in this way. Any person may observe, that sit-
ting makes his legs swell, and that this goes off by exercise; which
clearly points out the method of prevention.
Fevers, especially of the nervous kind, are often the effect of
study. Nothing affects the nerves so much as intense thought. It
in a manner unhinges the whole human frame, and not only hurts
the vital motions, but disorders the mind itself. Hence a delirium,
melancholy, and even  madness, are often the effect of close appli-
cation to study. There is no disease which can proceed from a
defect of the usual secretions, or a debility of the nervous system
which may not be induced by intense thinking.
But the most afflicting of all the diseases which attack the stu-
dious is the hypochondriac. This disease seldom fails to be the
companion of deep thought. It may rather be called a complica-
tion of maladies than a single one. To what a wretched condition
are the best of men often reduced by it! Their strength and appe-
tite fail; a perpetual gloom hangs over their minds; they live in
the constant dread of death, and are continually in search of re-
lief from medicine, where it is not to be found. Those who la-
bour under this disorder, though they are often made the subject
of ridicule, justly claim our highest sympathy.
Hardly any thing can be more preposterous than for a person
to make study his sole business.  A mere student is seldom an use-
H

58 OF THE LABORIOUS, THE SEDENTARY,
ful member of society. He often neglects the most important du-
ties of life, in order to pursue studies of a very trifling nature. It
rarely happens, that any useful invention is the effect of mere stu-
dy. The farther men dive into profound researches, they generally
deviate the more from common sense, and too often lose sight of
it altogether. Profound speculations, instead of making men, wiser
or better, generally render them absolute sceptics, and overwhelm
them with doubt and uncertainty. All that is necessary for man
to know, in order to be happy, is easily obtained; and the rest, like
the forbidden fruit, serves only to increase his misery.
Studious persons, in order to relieve their minds, must not only
discontinue to read and write, but engage in some employment or
diversion, that will so far occupy the thought as to make them for-
get the business of the closet. A solitary ride or walk are so far from
relaxing the mini, that they rather encourage thought. Nothing
can divert the mind, when it gets into a train of serious thinking,
but attention to subjects of a more trivial nature. These prove a
kind of play to the mind, and consequently relieve it.
Learned men often contract a contempt for what they call tri-
fling company. They are ashamed to be seen with any but philoso-
phers. This is no proof of their being so. No man deserves that
name who is ashamed to unbend his mind, by associating with the
cheerful and gay. Even the society of children will relieve the
mind, and expel the gloom which application to study is too apt
to occasion.
As studious people are necessarily much within doors, they should
make choice of a large and well-aired place for study. This would
not only prevent the bad effects which attend confined air, but
would cheer the spirits, and have a most happy influence both on
the body and mind. It is said of Euripides, that he used to retire
to a dark cave to compose his tragedies, and of Demosthenes, that
he chose a place for study where nothing could be either heard or,
seen. With all deference to such venerable names, we cannot help
condemning their taste. A man may surely think to as good pur-
pose in an elegant apartment as in a cave; and may have as happy
conceptions where the all-cheering rays of the sun render the air
wholesome, as in places where they never enter.
Those who read or write much should be very attentive to their
posture. They ought to sit and stand by turns, always keeping as
nearly in an erect posture as possible. Those who dictate may do
it walking. It has an excellent effect frequently to read or speak
aloud. This not only exercises the lungs, but almost the whole bo-
dy. Hence studious people are greatly benefited by delivering dis-
courses in public. Public speakers, indeed, sometimes hurt them-
selves by overacting their part; but this is their own fault. The
martyr to mere vociferation merits no sympathy.
The morning has been  reckoned the best time for study. It is
so. But it is also the most proper season for exercise, while the sto- 

AND THE STUDIOUS. 59
mach is empty, and the spirits refreshed with sleep. Studious peo-
ple should sometimes spend the morning in walking, riding, or
some manly diversions without doors. This would make them re-
turn to study with greater alacrity, and would be of more service
than twice the time after their spirits are worn out with fatigue.
It is not sufficient to take diversion only when we can think no
longer. Every studious person should make it a part of his business,
and should let nothing interrupt his hours of recreation more than
those of study.
Music has a very happy effect in relieving the mind when fa-
tigued with study. It would be well if every studious person were
so far acquainted with that science as to amuse himself after severe
thought, by playing such airs as have a tendency to raise the spi-
rits, and inspire cheerfulness and good humour.
It is a reproach to learning, that any of her votaries, to relieve
the mind after study, should betake themselves to the use of strong
liquors. This indeed is a remedy; but it is a desperate one, and al-
ways proves destructive. Would such persons, when their spirits
are low, get on horseback, and ride ten or a dozen miles, they
would find it a more effectual remedy, than any cordial medicine,
or strong liquors.
The following is my plan, and I cannot recommend a better to
others. When my mind is fatigued with study, or other serious bu-
siness, I mount my horse, and ride ten or twelve miles into the
country, where I spend a day, and sometimes two, with a cheerful
friend; after which I never fail to return to town with new vigour,
and to pursue my studies or business with fresh alacrity.
It is to be regretted, that learned men, while in health, pay so
little regard to these things! There is not any thing more com-
mon than to see a miserable object over-run with nervous, diseases,
bathing, walking, riding, and doing everything for health after it
is gone; yet, if any one had recommended these things to him by
way of prevention, the advice would, in all probability, have been
treated with contempt, or at least, with neglect. Such is the weak-
ness and folly of mankind, and such the want of foresight, even in
those who ought to be wiser than others.
With regard to the diet of the studious, we see no reason why
they should abstain from any kind of food that is wholesome, pro-
vided they use it in moderation. They ought, however, to be spa-
ring in the use of every thing that is sour, windy, rancid, or hard
of digestion. Their suppers should always be light, or taken soon
in the evening. Their drink may be water, fine malt-liquor, not too
strong, good cyder, wine and water, or, if troubled with acidities,
water mixed with a little brandy, rum, or any other genuine spirit.
With regard to those kinds of exercise which are most proper
for the studious, they should not be too violent, nor carried to ex-
cessive fatigue. They ought to be frequently varied so as to give
action to all the different parts of the body; and should, as often as 

60 OF ALIMENT.
possible, be taken in the open air. In general, riding on horseback,
walking, working in a garden, or playing at some active diversions,
are the best.
We recommend the use of the cold-bath to the studious. It will,
in some measure, supply the place of exercise, and should not be
neglected by persons of a relaxed habit, especially in a warm season.
No person ought either to take violent exercise, or to study im-
mediately after a full meal.
CHAPTER III.
Of Aliment.
UNWHOLESOME food, and irregularities in diet, occasion
many diseases. There is no doubt but the whole constitu-
tion of body may be changed by diet alone. The solids may be
braced or relaxed, have their sensibility, motion, &c. greatly in-
creased or diminished, by different kinds of aliment. A very small
attention to these things will be sufficient to show, how much the
preservation of health depends upon a proper regimen of the diet.
Nor is an attention to diet necessary for the preservation of health
only: it is likewise of importance in the cure of diseases. Every
intention in the cure of many diseases, may be answered by diet
alone. Its effects, indeed, are not always so quick as those of me-
dicine, but they are generally more lasting: besides, it is neither
so disagreeable to the patient, nor so dangerous as medicine, and
is always more easily obtained.
Our intention is not to inquire minutely into the nature and
properties of the various kinds of aliment in use among mankind;
nor to show their effects upon the different constitutions of the hu-
man body; but to mark some of the most pernicious errors which
people are apt to fall into, with respect both to the quantity and
qualities of their food, and to point out their influence upon health.
It is not easy to ascertain the exact quantity of food proper for
every age, sex, and constitution: but a scrupulous nicety here is
not necessary. The best rule is to avoid all extremes. Mankind
were never intended to weigh and measure their food. Nature
teaches every creature when it has enough; and the calls of thirst
and hunger are sufficient to inform them when more is necessary.
Though moderation is the chief rule with regard to the quantity,
yet the quality of food merits a farther consideration. There are
many ways by which provisions may be rendered unwholesome.
Bad seasons may either prevent the ripening of grain, or damage
it afterwards. These, indeed, are acts of Providence, and we must
submit to them; but no punishment can be too severe for those

OF ALIMENT. 61
who suffer provisions to spoil by hoarding them, on purpose to
raise the price, or who promote their own interest by adulterating
the necessaries of life*.
Animal, as well as vegetable food, may be rendered unwhole-
some, by being kept too long. All animal substances have a con-
stant tendency to putrefaction; and, when that has proceeded too
far, they not only become offensive to the senses, but hurtful to
health. Diseased animals, and such as die of themselves, ought ne-
ver to be eaten. It is a common practice in some grazing countries,
for servants and poor people to eat such animals as die of disease,
or are killed by accident. Poverty may oblige people to do this;
but they had better eat a smaller quantity of what is sound and
wholesome: it would both afford a better nourishment, and be at-
tended with less danger.
The injunctions given to the Jews, not to eat any creature which
died of itself, seem to have a strict regard to health; and ought
to be observed by Christians as well as Jews. Animals never die
of themselves without some previous disease; but how a diseased
animal should be wholesome food, is inconceivable: even those
which die by accident must be hurtful, as their blood is mixed
with the flesh, and soon turns putrid.
Animals which feed grossly, as tame ducks, hogs, &c. are nei-
ther so easily digested, nor afford such wholesome nourishment as
others. No animal can be wholesome which does not take sufficient
exercise. Most of our stalled cattle are crammed with gross food,
but not allowed exercise nor free air; by which means they indeed
grow fat, but their juices, not being properly prepared or assimi-
lated, remain crude, and occasion indigestion, gross humours and
oppression of the spirits, in those who feed upon them.
Animals are often rendered unwholesome by being over-heated.
Excessive heat causes a fever. For this reason, butchers should be
severely reprimanded who over-drive their cattle. No person would
choose to eat the flesh of an animal which had died in a high fever;
yet that is the case with all over-drove cattle; and the fever is of-
ten raised even to the degree of madness.
But this is not the only way by which butchers render meat un-
wholesome. The abominable custom of filling the cellular mem-
brane of animals with air, in order to make them appear fat, is every
day practised. This not only spoils the meat, and renders it unfit
for keeping, but is such a dirty trick, that the very idea of it is
sufficient to disgust a person of any delicacy at every thing which
* The poor are generally the first who suffer by unsound provisions;
but the lives of the labouring poor are of great importance to the state;
besides, diseases occasioned by unwholesome food often prove infectious,
by which means they reach people in every station. It is therefore the
interest of all to take care that no spoilt provisions of any kind be ex-
posed to sale.

62 OF ALIMENT.
comes from the shambles. Who can bear the thought of eating
meat which has been blown up with air from the lungs of a dirty
fellow, perhaps labouring under the very worst of diseases?
Butchers have likewise a method of filling the cellular mem-
branes of animals with blood. This makes the meat seem fatter,
and likewise weigh more, but it is a very pernicious custom, as it
both renders the meat unwholesome and unfit for keeping. I sel-
dom see a piece of meat from the shambles, where the blood is not
diffused through the cellular texture. I shall not say that this is al-
ways the effect of design; but I am certain it is not the case with
animals that are killed for domestic use, and properly blooded.
Veal seems to be most frequently spoilt in this way. Perhaps that
may in some measure be owing to the practice of carrying calves
from a great distance to market, by which means their tender flesh
is bruised, and many of their vessels burst.
No people in the world eat such quantities of animal food as the
English, which is one reason why they are so generally tainted with
the scurvy and its numerous train of consequences, indigestion, low
spirits, hypochondriacism, &c. Animal food was surely designed
for man, and with a proper mixture of, vegetables, it will be found
the most wholesome; but to gorge beef, mutton, pork, fish, and
fowl, twice or thrice a day, is certainly too much. All who value
health ought to be contented with making one meal of flesh in
twenty-four hours, and this ought to consist of one kind only.
The most obstinate scurvy has often been cured by a vegetable
diet; nay, milk alone will frequently do more in that disease than
any medicine. If vegetables and milk were more used in diet, we
should have less scurvy, and likewise fewer putrid and inflammato-
ry fevers. Fresh vegetables, indeed, come to be daily more used in
diet: This laudable practice we hope will continue to gain ground.
Our aliment ought neither to be too moist nor too dry. Moist
aliment relaxes the solids, and renders the body feeble. Thus, fe-
males, who live much on tea, and other watery diet, generally be-
come weak, and unable to digest solid food: Hence proceed hyste-
rics, and all their consequences. On the other hand, food that is
too dry, renders the solids in a manner rigid, and the humours vis-
cid, which disposes the body to inflammatory fevers, scurvies, and
the like.
Much has been said on the ill effects of tea in diet. They are, no
doubt, numerous; but they proceed rather from the imprudent use
of it, than from any bad qualities in the tea itself. Most delicate
persons, who are the greatest tea-drinkers, cannot eat any thing in
the morning. If such persons, after fasting ten or twelve hours,
drink four or five cups of tea, without eating almost any bread, it
must hurt them. Good tea, taken in moderate quantity, not too
strong, nor too hot, nor drank upon an empty stomach, will seldom
do harm; but if it be bad, or substituted in the room of solid food,
it must have many ill effects. 

OF ALIMENT. 63.
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 hurt the stomach. Is
were well, if cookery as an art were prohibited. Plain roasting or
boiling is all that the stomach requires. These alone are sufficient
for people in health, and the sick have still less need of a cook.
The liquid part of our aliment likewise claims our attention
Water is not only the basis of most liquors, but also composes a
great part of our solid food. Good water must therefore be of the
greatest importance in diet. The best water is that which is most
pure, and free from any mixture of foreign bodies. Water takes
up parts of most bodies with which it comes into contact; by this
means, it is often impregnated with metals or minerals of a hurtful
or poisonous nature. Hence the inhabitants of some hilly countries
have peculiar diseases, which in all probability proceed from the
water. Thus the people who live near the Alps in Switzerland,
and the inhabitants of the Peak of Derby, in England, have large
tumours or wens in their necks. This disease is generally imputed
to the snow-water; but it is rather owing to the minerals in the
mountains through which the waters pass.
When water is impregnated with foreign bodies, it generally
appears by its weight, colour, taste, smell, heat, or some other
sensible quality. Our business is to choose such water, for common
use, as is lightest, and without any particular colour, taste, or smell.
In most places of Britain the inhabitants have their choice of wa-
ter; and few things would contribute more to health than a due
attention to this article. Indolence often induces people to make
use of the water that is nearest, without considering its qualities.
Before water be brought into great towns, the strictest attention
ought to be paid to its qualities, as many diseases may be occa-
sioned or aggravated by bad water; and when once procured at
a great expense, people are unwilling to give it up.
The common methods of rendering water clear by filtration, or
soft, by exposing it to the sun and air, &c. are generally known.
We shall only advise all to avoid waters which stagnate long in small
lakes, ponds, or the like; as such waters often become putrid, by the
corruption of animal and vegetable bodies with which they abound.
Even cattle frequently suffer by drinking, in dry seasons, water
which has flood long in small reservoirs, without being supplied
by springs or freshened with showers. All wells ought to be kept
clean, and to have a free communication with the air.
Fermented liquors, though exclaimed against by many writers,
continue to be the common drink of almost every person who can
afford them: We shall rather endeavour to assist people in the
choice of those liquors, than pretend to condemn what custom has
so firmly established. It is not the moderate use of sound fermented

64 OF ALIMENT.
liquors which hurts mankind: It is excess, and using such as are
ill prepared or vitiated. 
Fermented liquors, which are too strong, hurt digestion; and
the body is so far from being strengthened by them, that it is weak-
ened and relaxed. Many imagine that hard labour could not be
supported without drinking strong liquors: This is a very errone-
ous notion. Men who never taste strong liquors are not only able
to endure more fatigue, but also live much longer, than those who
use them daily. But, suppose strong liquors did enable a man to do
more work, they must nevertheless waste the powers of life, and
occasion premature old age. They keep up a constant fever, which
exhausts the system, and disposes the body to numberless diseases.
But fermented liquors may be too weak as well as too strong:
when that is the case, they must be either drank new, or they be-
come sour and dead; when such liquors are drank new, the fer-
mentation not being over, they generate air in the bowels, and oc-
casion flatulencies; and, when kept till stale, they four on the sto-
mach, and hurt digestion. For this reason, all malt-liquors, cider,
&c. ought to be of such strength, as to keep till they are ripe, and
then they should be used. When such liquors are kept too long,
though they should not become sour, yet they generally contract a
hardness, which renders them unwholesome.
All families, who can, ought to prepare their own liquors. Since
preparing and vending of liquors became one of the most general
branches of business, every method has been tried to adulterate
them. The great object both to the makers and venders of liquor
is, to render it  intoxicating. But it is well known that this may
be done by other ingredients than those which ought to be used
for making it strong. It would be imprudent even to name those
things which are daily made use of to render liquors heady. Suf-
fice it to say, that the practice is very common, and that all the
ingredients used for this purpose are of a narcotic or stupefactive
quality. But as all opiates are poisonous, it is easy to see what
must be the consequence of their general use. Though they do
not kill suddenly, yet they hurt the nerves, relax and weaken the
stomach, and spoil the digestion.
Were fermented liquors faithfully prepared, kept to a proper
age, and used in moderation, they would prove real blessings to
mankind. But, while they are ill prepared, various ways adulte-
rated, and taken to excess, they must have many pernicious effects.
We recommend it to families, not only to prepare their own
liquors, but their bread. Bread is so necessary a part of diet, that
too much care cannot be bestowed in order to have it sound and
wholesome. For this purpose, it is not only necessary that it be
made of good grain, but likewise properly prepared, and kept free
from all unwholesome ingredients. This is not always the case
with bread prepared by those who make a trade of vending it.
Their object is rather to please the eye, than to consult the heath. 

OF ALIMENT. 65
The best bread is that which is neither too coarse nor too fine,
well fermented, and made of wheat flour, or rather of wheat and
rye mixed together.
To specify the different kinds of aliment, to explain their nature
and properties, and to point out their effects in different constitu-
tions would far exceed our design. We shall only mention the fol-
lowing easy rules with respect to the choice of aliment.
Persons, whose solids are weak and relaxed, ought to avoid all vis-
cid food, or such things as are hard of digestion. Their diet ought
to be nourishing, and they should take sufficient exercise in the
open air.
Such as abound with blood should be sparing in every thing that
is highly nourishing, as fat meat, rich wines, strong ale, and such
like. Their food should consist mostly of bread and other vegetable
substances; and their drink ought to be water, whey, or small-beer.
Fat people should not eat freely of oily nourishing diet. They
ought frequently to use radish, garlic, spices, or such things as are
heating and promote perspiration and urine. Their drink should
be water, coffee, tea, or the like; they ought to take much exer-
cise, and little sleep. Those who are too lean must follow an op-
posite course.
Such as are troubled with acidities, or whose food is apt to sour
on the stomach, should live much on animal food; and those afflict-
ed with hot alkaline eructations, ought to use a diet consisting
chiefly of acid vegetables.
People affected with the gout, low spirits, hypochondriac or
hysteric disorders, ought to avoid all flatulent food, every thing that
is viscid, or hard of digestion, all salted or smoke-dried provisions,
and whatever is austere, acid, or apt to four on the stomach. Their
food should be light, spare, cool, and of an opening nature.
The diet ought to be suited to the age, constitution, and manner
of life: A sedentary or studious person should live more sparingly
than one who labours hard without doors. Many kinds of food will
nourish a peasant very well, which would be almost indigestible to
a citizen; and the latter will live upon a diet on which the former
would starve.
Diet ought not to be too uniform. The constant use of one kind
of food might have some bad effects. Nature teaches us this, by
the great variety of aliment which she has provided for man, and
likewise by giving him an appetite for different kinds of food.
Those who labour under any particular disease, ought to avoid
such aliments as have a tendency to increase it: For example, a
gouty person should not indulge in rich wines, strong soups or gra-
vies, and should avoid all acids. One who is troubled with the
gravel ought to shun all austere and astringent aliments; and those
who are scorbutic should be sparing in the use of salted provisions.
In the first period of life, our food ought to be light, nourishing,
and frequently taken.  Food that is solid, with a sufficient degree
I

66 OF ALIMENT.
of tenacity, is most proper for the state of manhood. The diet
suited to the last period of life, when nature is upon the decline,
approaches nearly to that of the first. It should be lighter and more
succulent than that of vigorous age, and likewise more frequently
taken.
It is not only necessary for health that our diet be wholesome,
but also that it be taken at regular periods. Some imagine long fast-
ing will atone for excess; but this, instead of mending the matter,
generally makes it worse. When the stomach and intestines are
over-distended with food, they lose their proper tone, and, by long
fasting, they become weak, and inflated with wind, thus, either
gluttony of fasting destroys the powers of digestion.
The frequent repetition of aliment is not only necessary for re-
pairing the continual waste of our bodies, but likewise to keep the
fluids found and sweet. Our humours, even in the most healthy
state, have a constant tendency to putrefaction, which can only be
prevented by frequent supplies of fresh nourishment: when that is
wanting too long, the putrefaction often proceeds so far as to occa-
sion very dangerous fevers. From hence we may learn the necessi-
ty of regular meals. No person can enjoy a good state of health,
whose vessels are either frequently overcharged, or the humours
long deprived of fresh supplies of chyle.
Long fasting is extremely hurtful to young people; it not only
vitiates their humours, but prevents their growth. Nor is it less in-
jurious to the aged. Most persons, in the decline of life, are afflict-
ed with wind: This complaint is not only increased, but rendered
dangerous, and often fatal, by long fasting. Old people, when their
stomachs are empty, are frequently seized with giddiness, head-
achs, and faintness. These complaints may generally be removed
by a piece of bread and a glass of wine, or taking any other solid
food; which plainly points out the method of preventing them.
Many of the sudden deaths, which happen in the advanced pe-
riods of life, are occasioned by fasting too long, as it exhausts the
spirits, and fills the bowels with wind; we would therefore advise
people in the decline of life, never to allow their stomachs to be too
long empty. Many people take nothing but few cups of tea and
a little bread, from nine o'clock at night till two or three next after-
noon. Such may be said to fast almost three-fourths of their time.
This can hardly fail to ruin the appetite, and fill the bowels with
wind; all which might be prevented by a solid breakfast.
It is very common to eat a light breakfast and a heavy supper.
This custom ought to be reversed. When people sup late, their
supper should be very light; but the breakfast ought always to be
solid. If any one eats alight supper, goes soon to bed, and rises be-
times in the morning, he will be sure to find an appetite for his
breakfast, and he may freely indulge it.
The strong and healthy do not suffer so much from fasting as the
weak and delicate; but they run great hazard from its opposite, 

OF AIR. 67
viz. repletion. Many diseases, especially fevers, are the effect of a
plethora, or too great fulness of the vessels. Strong people, in high
health, have generally a great quantity of blood and other humours.
When these are suddenly increased, by an overcharge of rich and
nourishing diet, the vessels become too much distended, and ob-
structions and inflammations ensue. Hence so many people are seiz-
ed with inflammatory and eruptive fevers after a feast or debauch.
All great and sudden changes in diet are dangerous. What the
stomach has been long accustomed to digest, though less whole-
some, will agree better with it than food of a more salutary nature
which it has not been used to. When a change becomes necessary,
it ought to be made gradually; a sudden transition from a poor
and low, to a rich and luxurious diet, or the contrary, might so
disturb the functions of the body, as to endanger health, or even to
occasion death itself.
When we recommend regularity in diet, we condemn not every
small deviation. It is next to impossible for people at all times to
avoid some degree of excess, and living too much by rule might
make even the smallest deviation dangerous. It may be prudent
to vary a little, sometimes-taking more, sometimes less, than the
usual quantity of meat and drink, if due regard be had to modera-
tion.
CHAPTER IV.
Of Air.
UNWHOLESOME air is a very common cause of diseases.
Few are aware of the danger arising from it. People gene-
rally pay some attention to what they eat and drink, but seldom
regard what goes into the lungs, though the latter often proves
more suddenly fatal than the former.
Air, as well as water, takes up parts of most bodies with which
it comes into contact, and is often so replenished with those of a,
noxious quality, as to occasion immediate death. But such violent
effects seldom happen, as people are generally on their guard against
them. The less perceptible influences of bad air, prove more ge-
nerally hurtful to mankind; we shall point out some of these, and
show from whence the danger chiefly arises.
Air may become noxious many ways. Whatever greatly alters
its degree of heat, cold, moisture, &c. renders it unwholesome. Ve-
ry cold air obstructs the perspiration, constringes the solids, and
occasions rheumatisms, coughs, and catarrhs, with other diseases
of the throat and breast. Air that is too moist destroys the elasti- 

68 OF AIR.
city or spring of the solids, induces phlegmatic or lax constitutions,
and disposes the body to agues; or intermitting fevers, dropsies, &c
Wherever great numbers of people are crowded into one place,
If the air has hot a free circulation, it soon becomes unwholesome.
Hence it is that delicate persons are so apt to turn sick or faint in
crowded churches, assemblies, or any place where the air is in-
jured by breathing, fires, candles, or the like.
In great cities, so many things tend to contaminate the air, that
it is no wonder it proves so fatal to the inhabitants. The air in
cities is not only breathed repeatedly over, but is likewise loaded
with sulphur, smoke, and other exhalations, besides the vapours
continually arising from innumerable putrid substances, as dung-
hills, slaughter-houses, &c. All possible care should be taken to
keep the streets of large towns open and wide, that the air may
have a free current through them. They ought likewise to be kept
very clean. Nothing tends more to pollute the air of a city than
dirty streets.
It is very common in this country to have church-yards in the
middle of populous cities. Whether this be the effect of ancient
superstition, or owing to the increase of such towns, is a matter of
no consequence. Whatever gave rise to the custom, it is a bad one.
Habit alone reconciles us to these things; by means of which the
most ridiculous, nay, pernicious customs, often become sacred. Thou-
sands of putrid carcasses, so near the surface of the earth, in a place
where the air is confined, cannot fail to taint it; and such air, when
breathed into the lungs, must occasion diseases*.
Burying within churches is a practice still more detestable. The
air in churches is seldom good, and the effluvia from putrid car-
casses must render it still worse. Churches are commonly old build-
ings with arched roofs. They are seldom opened above once a
week, are never ventilated by fires nor open windows, and rarely
kept clean. This occasions that damp, musty, unwholesome smell
which one feels upon entering a church, and renders it a very un-
safe place for the weak and valetudinary. These inconveniences
might, in a great measure, be obviated, by prohibiting all person
from burying within churches, by keeping them clean, and permit-
ting a stream of fresh air to pass frequently through them, by open-
ing opposite doors and windows.
Wherever air stagnates long, it becomes unwholesome. Hence
persons confined in jails not only contract malignant fevers them-
selves, but often communicate them to others. Nor are many of
the holes, for we cannot call them houses, possessed by the poor
in great towns, much better than jails. These low dirty habitations
*In most eastern countries, it was customary to bury the dead at some.
distance from any town. As this practice obtained among the Jews, the
Greeks, and also the Romans, it is strange that the western parts of Eu-
rope should not have followed their example in a custom so truly laudable. 

OF AIR. 69
are the very lurking-places of bad air and contagious diseases. Such
as live in them seldom enjoy good health; and their children com-
monly die young. In the choice of a house, those who have it in
their power ought to pay the greatest attention to open free air.
The various methods which luxury has invented to make houses
close and warm, contribute to render them unwholesome. No house
can be wholesome unless the air has a free passage through it. For
which reason, houses ought daily to be ventilated, by opening op-
posite windows, and admitting a current of fresh air into every
room. Beds, instead of being made up as soon as people rise out
of them, ought to be turned down, and exposed to the fresh air
from the open windows through the day. This would expel any
noxious vapour, and promote the health of the inhabitants.
In hospitals, jails, ships, &c. where that cannot be conveniently
done, ventilators should be used. The method of expelling foul,
and introducing fresh air, by means of ventilators, is a most salu-
tary invention, and the most useful of all modern medical improve-
ments. It is capable of universal application, and is fraught with
numerous advantages, both to those in health and sickness. In all
places where numbers of people are crowded together, ventilation
becomes absolutely necessary.
Air which stagnates in mines, wells, cellars, &c. is extremely
noxious, and ought to be avoided as the most deadly poison. It of-
ten kills almost as quickly as lightning. For this reason, people
should be very cautious in opening cellars that have been long shut,
or going down into deep wells or pits, especially if they have been
kept close covered*.
Many people who have splendid houses, choose to sleep in small
apartments. This is very imprudent. A bed-chamber ought always
to be well aired; as it is generally occupied in the night only, when
all doors and windows are shut. If a fire be kept in it, the danger
from a small room becomes still greater. Numbers have been stifled
when asleep by a fire in a small apartment, which is always hurtful.
Those who are obliged, on account of business, to spend the day
in close towns, ought, if possible, to sleep in the country. Breath-
ing free air in the night will, in some measure, make up for the
want of it through the day. This practice would have a greater
effect in preserving the health of citizens than is commonly ima-
gined.
Delicate persons ought, as much as possible, to avoid the air of
great towns. It is peculiarly hurtful to the astmatic and consump-
tive. Such persons should avoid cities as they would the plague.
* We have frequent accounts of persons who lose their lives by going
down into deep wells and other places where the air stagnates; all these
accidents might be prevented by only letting down a lighted candle be-
fore them, and stopping when they perceive it go out; yet this simple
precaution is seldom used. 

70 OF AIR.
The hypochondriac are likewise much hurt by it. Persons, so much
afflicted with this malady while in town, that it seemed impossible
for them to live, have, upon removing to the country, been imme-
diately relieved. The same observation holds as to nervous and hy-
steric women. Many people have it not in their power to change
their situation in quest of better air. All we can say to such persons
is, that they should go as often abroad into the open air as they
can, that they should admit fresh air frequently into their houses,
and take care to keep them very clean.
It was necessary in former times, for safety, to surround cities,
colleges, and even single houses, with high walls. These, by ob-
structing the free current of air, render such places damp and un-
wholesome. Proper attention to air and cleanliness would tend
more to preserve the health of mankind, than all the endeavours
of the faculty.
Surrounding houses too closely with planting, or thick woods,
likewise tends to render the air unwholesome. Wood not only ob-
structs the free current of air; but fends forth great quantities of
moist exhalations, which render it constantly damp. Wood is ve-
ry agreeable at a proper distance from a house, but should never
be planted too near it, especially in a flat country. Many gentle-
men's seats in England are very unwholesome from the great quan-
tity of wood which surrounds them.
Houses situated in low marshy countries, or near large lakes of
stagnating water, are likewise unwholesome. Waters which stag-
nate not only render the air damp, but load it with putrid exhala-
tions, which produce the most dangerous and fatal diseases. Those
obliged to inhabit marshy countries, ought to make choice of the
driest situation they can find, to live generously, and to pay the
strictest regard to cleanliness.
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 hard-
ly enter the chamber where a patient lies, without being ready to
faint, from the hot suffocating smell. How this must affect 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 administered
with prudence. We are not to throw open doors and windows
at random 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 with vinegar, juice of lemon, or any other strong ve-
getable acid.
Where numbers of sick are crowded into the same house, or,
into the same apartment, the frequent admission of fresh air be-
comes absolutely necessary. Infirmaries, hospitals, &c. are often 

OF EXERCISE. 71
rendered so obnoxious, 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.
Physicians, surgeons, and others who attend hospitals, ought,
for their own safety, to take care that they be properly ventilated.
Such persons as are obliged to spend most of their time amongst
the sick, run great hazard of being themselves infected when the
air is tad. All hospitals, and places of reception for the sick,
ought to have an open situation, at some distance from any great
town, and patients under an infectious disease ought never to
come near the rest.
CHAPTER V.
Of Exercise.
MANY people look upon the necessity man is under of earn-
ing his bread by labour, as a curse. But it is evident from
the structure of the body, that exercise is not less necessary than
food for the preservation of health: those whom poverty obliges
to labour for daily bread, are not only the most, healthy, but gene-
rally the most happy part of mankind. Industry seldom fails so
place such above want, and activity serves them instead of physic.
This is peculiarly the case with those who live by the culture of
the ground. The great increase of inhabitants in infant colonies,
and the longevity of such as follow agriculture every where, prove
it to be the most healthful as well as the most useful employment.
The love of activity shows itself very early in man. So strong
is this principle, that a healthy youth cannot be restrained from
exercise, even by the fear of punishment. Our love of motion is
a strong  proof of its utility. Nature implants no disposition in
vain. It seems to be a law throughout the animal creation, that
no creature, without exercise, should enjoy health, or be able to
find subsistence. Every creature, except man, takes what is ne-
cessary. He alone, and such animals as are under his direction,
deviate from this original law, and they suffer accordingly.
Inactivity never fails to induce an universal relaxation of the
solids, which disposes the body to innumerable diseases. When
the solids are relaxed, neither the digestion, nor any of the secre-
tions, can be duly performed. In this case, the worst consequen-
ces must ensue. How can persons who loll all the day in easy
chair, and sleep all night on beds of down, fail to be relaxed? 

78 OF EXERCISE.
Nor do such greatly mend the matter, who never stir abroad but
in a coach, sedan, or such like. These elegant pieces of luxury are
become so common, that the inhabitants of great towns seem to be
in some danger of losing the use of their limbs altogether. It is
now below any one to walk, who can afford to be carried. How
ridiculous would it seem, to a person unacquainted with modern
luxury, to behold the young and healthy swinging along on the
shoulders of their fellow-creatures! or to see a fat carcase, over-
run with diseases occasioned by inactivity, dragged through the
streets by half a dozen horses*!
Glandular obstructions, now so common, generally proceed
from inactivity. These are the most obstinate of maladies. So long
as the liver, kidnies, and other glands, duly perform their func-
tions, health is seldom impaired; but when they fail, nothing can
restore it. Exercise is almost the only cure we know for glandular
obstructions; indeed, it does not always succeed as a remedy; but
there is reason to believe that it would seldom fail to prevent these
complaints, were it used in due time. One thing is certain, that,
amongst those who take sufficient exercise, glandular diseases are
very little known; whereas the indolent and inactive are seldom
free from them.
Weak nerves are the constant companions of inactivity. Nothing
but exercise and open air can brace and strengthen the nerves, or
prevent the endless train of diseases which proceed from a relaxed
state of these organs. We seldom hear the active or laborious com-
plain of nervous diseases; these are reserved for the sons of ease and
affluence. Many have been completely cured of these disorders by
being reduced from a state of opulence, to labour for their daily
bread. This plainly points out the sources from whence nervous
diseases flow, and the means by which they may be prevented.
It is absolutely impossible to enjoy health, where the perspira-
tion is not duly carried on; but that can never be the case where
exercise is neglected. When the matter which ought to be thrown
off by perspiration is retained in the body, it occasions fevers, rheu-
matism, &c. Exercise alone would prevent many of those diseases
which cannot be cured, and would remove others where medicine
proves ineffectual.
Doctor Cheyne says, that the weak and valetudinary ought to
make exercise a part of their religion. We recommend this not
only to the weak and valetudinary, but to all those whose business
does not oblige them to take sufficient exercise, as sedentary artifi-
*It is not necessity, but fashion, which makes the use of carriages
so common. Many people have not exercise enough to keep their
humours from stagnation, who yet dare not venture to make a visit to
their next neighbours, but in a coach or sedan, left they should be look-
ed down upon. Strange, that men should be such fools as to be laughed
out of the use of their limbs, or to throw away their health, in order
to gratify a piece of vanity, or to comply with a ridiculous fashion!

OF EXERCISE. 73
cers*, shop-keepers, studious persons, &c. Such ought to use ex-
ercise as regularly as they take food. This might generally be done
without any interruption to business or real loss of time.
No piece of indolence hurts the health more than the modem
custom of lying a-bed too long in the morning. This is the general
practice in great towns. The inhabitants of cities seldom rise be-
fore 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 strength-
ens the nerves, and, in some measure, answers the purpose of a cold-
bath. Let anyone who has been accustomed to lie a-bed till eight
or nine o'clock, rise by six or seven, 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 appe-
tite keen, and his body braced and strengthened. Custom soon
renders early-rising agreeable, and nothing contributes more to the
preservation of health.
The inactive are continually complaining of pains of the sto-
mach, flatulencies, indigestions, &c. These complaints,  which
pave the way to many others, are not to be removed  by medi-
cines. They can only be cured by a vigorous course of exercise,
to which indeed they seldom fail to yield.
Exercise, if possible, ought always to be taken in the open air.
When that cannot be done, various methods may be contrived for
exercising the body within doors, as the dumb-bell, dancing, swing-
ing, &c. It is not necessary to adhere strictly to any particular
kind of exercise. The best way is to take them by turns, and to
use that longest which is most suitable to the strength and consti-
tution. Those kinds of exercise which give action to most of the
bodily organs, are always to be preferred, as walking, running,
riding, fencing, digging, swimming, and such like.
It is much to be regretted, that active and manly diversions are
how so little practised. Diversions make people take more ex-
ercise than they otherwise would do, and are of the greatest ser-
vice to such as are not under the necessity of labouring for their
* Sedentary occupations ought chiefly to be followed by women.
They bear confinement much better than men, and are fitter for every
kind of business which does not require much strength. It is ridiculous
enough to see a lusty fellow making pins, needles, or watch wheels,
while many of the laborious parts of husbandry are carried on by the
other sex. We want men for laborious employments, while one half of
the other sex are rendered useless for want of occupations suited to their
strength, &c. Were girls bred to mechanical employments, we would
not see such numbers prostitute themselves for bread, nor find such a
want of men for the important purposes of navigation, agriculture, &c.
An eminent silk manufacturer told me, that he found women answer
better for that business than men; and that he had lately  taken a great
many girls apprentices as silk-weavers. I hope this example will be fol
lowed by many others.
K 

74 OF EXERCISE.
bread. As active diversions lose ground, those of a sedentary kind
seem to prevail. Sedentary diversions are of no other use but to
consume time. Instead of relieving the mind, they often require
more thought than either study or business. Every thing that
induces people to sit still, unless it be some necessary employment,
ought to be avoided.
The diversions which afford the best exercise are, hunting,
shooting, playing at cricket, hand-ball, &c. These exercise the
limbs, promote perforation, and the other secretions. They like-
wise strengthen the lungs; and give firmness and agility to the
whole body.
Such as can, ought to spend two or three hours a-day on horse-
back; those who cannot ride, should employ the same time in
walking. Exercise should never be continued too long. Over-
fatigue prevents the benefit of exercise, and instead of strengthen-
ing the body, tends to weaken it.
Every man should say himself under some sort of necessity to take
exercise. Indolence, like other vices when indulged, gains ground,
and at length becomes agreeable. Hence, many who were fond of
exercise in the early part of life, become quite averse from it af-
terwards. This is the case of most hypochondriac and gouty peo-
ple, which renders their diseases in a great measure incurable.
In some countries, laws have been made, obliging every man, of
whatever rank, to learn some mechanical employment. Whether
such laws were designed for the preservation of health, or the en-
couragement of manufactures, is of no importance. If gentlemen
were frequently to amuse and exercise themselves in this way, it
might have many good effects. They would at least derive as
much honour from a few masterly specimens of their own work-
manship, as from the character of having ruined most of their
companions by gaming or drinking. Besides, men of leisure, by
applying themselves to the mechanical arts, might improve them,
to the great benefit of society.
Indolence not only occasions diseases, and renders men useless
to society, but promotes all manner of vice. To say a man is idle,
is little better than calling him vicious. The mind, it not engaged
in some useful pursuit, is constantly in quest of idle pleasures, or
impressed with the apprehension of some imaginary evil. From
these sources proceed most of the miseries of mankind. Certainly
man was never intended to be idle. Inactivity frustrates the very
design of his creation; whereas an active life is the best guardian
of virtue, and the greatest preservative of health. 

[75]
CHAPTER VI.
Of Sleep and Clothing.
SLEEP, as well as diet, ought to be duly regulated. Too little
sleep weakens the nerves, exhausts the spirits, and occasions
diseases; and too much renders the mind dull, the body gross,
and disposes to apoplexies, lethargies, and other complaints of a
similar nature. A medium ought to be observed; but this is not
easy to fix. Children require more sleep than grown persons, the
laborious than the idle, and such as eat and drink freely, than those
who live abstemiously. Besides, the real quantity of sleep cannot
be measured by time; as one person will be more refreshed by five
or six hours of sleep, than another by eight or ten.
Children may always be allowed to take, as much sleep as they
please; but, for adults, six or seven hours is certainly sufficient,
and no one ought to exceed eight. Those who lie a-bed more
than eight hours may slumber, but they can hardly be said to sleep;
such generally toss and dream away the fore-part of the night,
sink to rest towards morning, and doze till noon. The best way
to make sleep sound and refreshing is to rise betimes. The custom
of lying a-bed for nine or ten hours, not only makes die sleep less
refreshing, but relaxes the solids, and greatly weakens the consti-
tution.
Nature points out night as the proper season for sleep. Nothing
more certainly destroys the constitution than night-watching. It
is great pity that a practice so destructive to health should be so
much in fashion. How quickly the want of rest in due season will
blast the most blooming complexion, or ruin the belt constitution,
is evident from the ghastly countenances of those, who, as the
phrase is, turn day into night, and night into day.
To make sleep refreshing, the following things are requisite:
First, to take sufficient exercise in the open air; to avoid strong
tea or coffee; next, to eat a light supper; and lastly, to lie down
with a mind as cheerful and serene as possible.
It is certain that too much exercise will prevent sleep, as well as
Too little. We seldom however hear the active and laborious
complain of restless nights. It is the indolent and slothful who
generally have these complaints. Is it any wonder that a bed of
down should not be refreshing to a person who sits all day in an
easy chair? A great part of the pleasure of life consists in alternate
rest and motion; but they who neglect the latter can never relish
the former. The labourer enjoys more true luxury in plain food
and sound sleep, than is to be found in sumptuous tables and
downy pillows, where exercise is wanting.
That light suppers cause sound sleep, is true even to a proverb.
Many periods, if they exceed the least at that meal, are sure to
have uneasy nights; and, if they-fall asleep, the load and oppression 

76 OF SLEEP AND CLOTHING.
on their stomach and spirits occasion frightful dreams, broken and
disturbed repose, the night-mare, &c. Were the same persons to
go to bed with a light supper, or sit up till that meal was pretty
well digested, they would enjoy sound sleep, and rise refreshed and
cheerful. There are indeed some people who cannot sleep unless
they have ate some solid food at night, but this does not imply the
necessity of a heavy supper; besides, these are generally persons
who have accustomed themselves to this method, and who do not
take a sufficient quantity of solid food and exercise.
Nothing more certainly disturbs our repose than anxiety. When
the mind is not at ease, one seldom enjoys sound sleep. That
Greatest of human blessings flies the wretched, and visits the hap-
py, the cheerful, and the gay. This is a sufficient reason why
every man should endeavour to be as easy in his mind as possible
when he goes to rest. Many, by indulging grief and anxious
thought, have banished sound sleep so long, that they could never
afterwards enjoy it.
Sleep, when taken in the fore-part of the night, is generally
reckoned most refreshing. Whether this be the effect of habit or
not, is hard to say; but as most people are accustomed to go early
to bed when young, it may be presumed that sleep, at this season,
will prove most refreshing to them ever after. Whether the fore-
part of the night be best for sleep or not, surely the fore-part of the
day is fittest both for business and amusement. I hardly ever knew
an early riser who did not enjoy a good state of health*.
Of Clothing.
THE clothing ought to be suited to the climate. Custom has
very great influence in this artilcle; but no custom can ever
change the nature of things so far, as to render the same clothing
fit for an inhabitant of Nova Zembla and Jamaica. It is not ne-
cessary to observe an exact proportion betwixt the quantity of
clothes we wear, and the degree of latitude which we inhabit;
but, at the same time, proper attention ought to be paid it, as
well as to the openness of the country, the frequency and vio-
lence of storms, &c.
In youth, while the perspiration is free, it is less necessary to
cover the body with a great quantity of clothes; but, in the de-
cline of life, when the skin becomes rigid, the clothing should be
increased. Many diseases in the latter period of life proceed from
a defect of perspiration: these may, in some measure, be prevent-
*Men of every occupation, and in every situation of life, have lived
to a good old age; nay, some have enjoyed this blessing whose plan of
living was by no means regular: but it consists with observation, that
all very old men have been early risers. This is the only circumstance
attending longevity, to which I never knew an exception.

OF SLEEP AND CLOTHING. 77
ed by a suitable addition so the clothing, or by wearing such as
are better calculated for promoting the discharge from the skin,
as clothes made of cotton, flannel, &c.
The clothing ought to be suited to the season of the year. Clo-
thing may be warm enough for summer, which is not sufficient
for winter. The greatest caution is necessary in making these
changes. We ought neither to put off our winter clothes too
soon, nor to wear our summer ones too  long. In this, country,
the winter often sets in very early with great rigour, and we have
frequently cool weather even after the commencement of the
summer months. It would likewise be prudent not to make the
change all at once, but to do it gradually; and indeed the changes
of apparel in this climate ought to be very inconsiderable, especi-
ally among those who have passed the meridian of life*.
Clothes often become hurtful by their being made subservient
to the purposes of pride or vanity. Mankind in all ages have con-
sidered clothes in this view; their fashion and figure have been
continually varying, with very little regard either to health, cli-
mate, or conveniency.
Even the human shape is often attempted to be mended by
dress, and those who know no better believe that mankind would
be monsters without its assistance. All attempts of this nature
are highly pernicious. The most destructive of them in this coun-
try is that of squeezing the stomach and bowels into as narrow a
compass as possible, to procure, what is falsely called a fine shape.
By this practice the action of the stomach and bowels, the motion
of the heart and lungs, and almost all the vital functions, are ob-
structed. Hence proceed indigestions, syncopes, or fainting fits,
coughs, consumptions of the lungs, and  other complaints so com-
mon among females.
The feet likewise often suffer by pressure. How a small foot
came to be reckoned genteel, I will not pretend to say; but this
notion has made many persons lame. Almost nine-tenths of man-
kind are troubled with corns: a disease that is seldom or never
occasioned but by strait shoes. Corns are not only very trouble-
some, but, by rendering people unable to walk, they may likewise
be considered as the remote cause of other diseases†.
* That colds kill more than plagues, is an old observation; and,
with regard to this country, it holds strictly true. Every person of
discernment, will perceive, that most of the colds which prove so des-
tructive to the inhabitants, are owing to their imprudence in changing
clothes. A few warm days in March or April induce them to throw off
their winter garments, without considering that our most penetrating
colds generally happen in May.
† We often see persons quite lame by the nails  of their toes having
grown into the flesh, and frequently hear of mortifications proceeding
from this cause. All these, and many other inconveniencies attending the
feet, must be imputed solely to the use of short and strait shoes. 

78 OF SLEEP AND CLOTHING.
The size and figure of the shoe ought certainly to be adapted to,
the foot. In children the feet are as well shaped as the hands,
and the motion of the toes as free and easy as that of the fingers;
yet few persons in the advanced periods of life are able to make
any use of their toes. They are generally, by narrow shoes, squeezed
all-of-a-heap, and often laid over one-another in such a manner as
to be rendered altogether incapable of motion. Nor is the high
heel less hurtful than the narrow toe. A lady may seem taller for
walking on her tiptoes, but she will never walk well in this man-
ner. It strains her joints, distorts her limbs, makes her stoop,
and utterly destroys all her ease and gracefulness of motion: It is
entirely owing to shoes with high heels and narrow toes, that not
one female in ten can be said to walk well.
In fixing on the clothes, due care should be taken to avoid all
tight bandages. Garters, buckles, &c. when drawn too tight, not
only prevent the free motion and use of the parts about which they
are bound, but likewise obstruct the circulation of the blood, which,
prevents the equal nourishment and growth of these parts, and oc-
casions 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 head-achs, ver-
tigos, apoplexies, and other fatal diseases are often occasioned.
The perfection of dress is to be easy and clean. Nothing can be
more ridiculous, than for any one to make himself a slave to fine
clothes. Such an one, and many such there are, would rather re-
main as fixt as a statue from morning till night, than discompose a
single hair or alter the position of a pin. Were we to recommend
any particular pattern for dress, it would be that which is worn by
the society of Friends, commonly called Quakers. They are always
neat, clean, and often elegant, without any thing superfluous.
What others lay out upon tawdry laces, ruffles and ribbands, they
Bestow upon superior cleanliness. Finery is only the affectation of
dress and very often covers a great deal of dirt.
Clothing ought not only to be suited to the climate, the season
of the year, and the period of life; but likewise to the temperature
and constitution. Robust persons are able to endure either cold or
heat better than the delicate; consequently, may be less attentive
to their clothing. But the precise quantity of clothes necessary for
any person cannot be determined by reasoning. It is entirely a mat-
ter of experience, and every man is the best judge for himself,
what quantity of clothes is necessary to keep him warm*.
* Boerhaave used to say, that no-body suffered by cold, save fools
end beggars; the latter not being able to procure clothes, and the for-
mer not having sense to wear them. In many cases where the powers of
medicine had been tried in vain, I have cured the patient by recom-
mending thick shoes, a flannel waistcoat and drawers, a pair of under
stockings, or a flannel petticoat, to be worn during the cold season at least.

[79]
CHAPTER VII.
Of Intemperance.
ROUSSEAU, observes, that temperance and exercise are the
two best physicians. He might have added, that if these were
duly regarded, there would be little occasion for any other. Tem-
perance may justly be called the parent of health; yet numbers of
mankind act as if they thought diseases and death too flow in their
progress, and by intemperance and debauch seem to solicit their
approach.
The danger of intemperance appears from the very construction
of the human body. Health depends on that state of the solids and
fluids which fits them for the due performance of the vital func-
tions; and while these go regularly on, we are sound and well;
but whatever disturbs them, necessarily impairs health. Intempe-
rance never fails to disorder the whole animal economy. It hurts
the digestion, relaxes the nerves, renders the different secretions
irregular, and occasions numberless diseases.
The analogy between the nourishment of plants and animals af-
fords a striking proof of the danger of intemperance. Moisture and
manure greatly promote vegetation; yet an over-quantity of either
will entirely destroy it. The best things become hurtful, nay, de-
structive, when carried to excess. Hence we learn that the highest
degree of human wisdom consists in regulating our appetites and
passions so as to avoid all extremes. It is that chiefly which entitles
us to the character of rational beings. The slave of appetite is the
disgrace of human nature.
The Author of Nature hath endued us with various passions,
for the propagation of the species, the preservation of the indi-
vidual, &c. Intemperance is the abuse of these passions; and
moderation consists in the proper regulation of them. Men, not
contented with satisfying the simple calls of Nature, create arti-
ficial wants, and are perpetually in search of something that may
gratify them; but imaginary wants never can be gratified. Nature
is content with little; but luxury knows no bounds. Hence the
epicure, the drunkard, and the debauchee, seldom stop in their ca-
reer, till their money or their constitution fails: Then indeed they
see their error when too late.
It is impossible to lay down fixt rules with regard to diet, on ac-
count of the different constitutions of mankind. The most ignorant
person, however, certainly knows what is meant by excess; and
every man, if he chooses, can avoid it.
The great rule of diet is to study simplicity. Nature delights in
the most 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. "For my part," says Ad- 

80 OF INTEMPERANCE
dison, "when I behold a fashionable table set out in all its magnifi-
cence, I faney that I see gouts and dropsies, fevers and lethargies,
With other innumerable distempers, lying in ambuscade among the
dimes." 
Nor is intemperance in other things less destructive than in diet.
How quickly does the immoderate pursuit of carnal pleasures, or the
abuse of intoxicating liquors, ruin the best constitution! These vices
generally go hand in hand. Hence 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 hasting with swift pace to an
untimely grave. Did men reflect on the painful diseases, and prema-
ture deaths, which are daily occasioned by intemperance, they
would shrink back with horror from the indulgence of their darling
pleasures.
Intemperance does not hurt its votaries alone: The innocent too
Often feel the effects of it. How many wretched orphans are to be
seen embracing dunghills, 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
mother, with her infants, pining in want, while the cruel father is
indulging his insatiate appetites?
Families are not only reduced to misery, but even extirpated by
intemperance. Nothing tends so much to prevent propagation, and
to shorten the lives of children, as the intemperance of parents.
The poor man who labours all day, and at night lies down conten-
ted with his humble fare, can boast a numerous offspring, while
his pampered lord, sunk in ease and luxury, often languishes with-
out an heir to his ample fortunes. Even states and empires feel the
influence of intemperance, and rise or fall as it prevails.
Instead of mentioning the different kinds of intemperance, and
pointing out their influence upon health, we shall only, by way of
example, make a few observations on one particular species of that
vice, viz. the abuse of intoxicating liquors.
Every act of intoxication puts Nature to the expense of a fever,
in order to discharge the poisonous draught. When this is repeat-
ed almost every day, it is easy to foresee the consequences. That
constitution must be strong indeed, which is able long to hold
out under a daily fever! but fevers occasioned by drinking do not
always go off in a day: They frequently end in an inflammation of
the breast, liver, or brain, and produce fatal effects.
Though the drunkard should not fall by an acute disease, he
seldom escapes those of a chronic kind. Intoxicating liquors, when
used to excess, weaken the bowels and spoil the digestion; they
destroy the power of the nerves, and occasion paralytic and cort-
vulsive disorders. Hence obstructions, atrophies, dropsies, and con-
sumptions of the lungs. These are the common ways in which
drunkards make their exit. Diseases of this kind, when brought
on by hard drinking, seldom admit of a cure. 

OF INTEMPERANCE. 81
Many people injure their health by drinking, who seldom get
drunk. The habit of soaking, though its effects be not so violent,
is not less pernicious. When the vessels are kept constantly full and
upon the stretch, the different digestions can neither be duly per-
formed, nor the humours properly prepared. Hence, most people
of this character are afflicted with the gout, the gravel, ulcerous sores
in the legs, &c. If these disorders do not appear, they are seized with
low spirits, hypochondriacal affections, and other symptoms of in-
digestion.
Consumptions are now so common, that it is thought one-tenth
of the inhabitants of great towns die of that disease. Hard drinking
is no doubt one of the causes to which we must impute the increase
of consumptions. The great quantities of viscid malt liquor drank
by the common people of England, cannot fail to render the blood
sizy and unfit for circulation; from whence proceed obstructions,
and inflammations of the lungs. There are few great ale-drinkers
who are not phthisical: nor is that to be wondered at, considering
the glutinous and almost indigestible nature of strong ale.
Those who drink ardent spirits or strong wines run still greater
hazard; these liquors heat and inflame the blood, and tear the
tender vessels of the lungs to pieces; yet so great is the consump-
tion of them in this country, that one would almost be induced to
think the inhabitants lived upon them*.
The habit of drinking proceeds frequently from misfortunes in
life. The miserable fly to it for relief. It affords them indeed a
temporary ease. But, this solace is short-lived; and when it is over,
the spirits fink as much below their usual tone as they had before
been raised above it. Hence, a repetition of the dose becomes ne-
cessary, and every fresh dose makes way for another, till the un-
happy wretch becomes a slave to the bottle, and at length falls a
sacrifice to what at first perhaps was taken only as a medicine. No
man is so dejected as the drunkard when his debauch is gone off.
Those who have the greatest flow of spirits while the glass circu-
lates freely, are of all others the most melancholy when sober, and
often put an end to their existence in a fit of spleen or ill humour.
Drunkenness not only proves destructive to health, but likewise
to the faculties of the mind. It is strange that creatures who value
themselves on a superior degree of reason to that of brutes, should
take pleasure in finking so far below them. Were such as volun-
tarily deprive themselves of the use of reason, to continue ever
* We may form some notion of the immense quantity of ardent spi-
rits confirmed in Britain from this circumstance, that in the city of Edin-
burgh and its environs, besides the great quantity of foreign spirits duly
entered, and the still greater quantity which is supposed to be smuggled,
it is computed that above two thousand private stills are constantly em-
ployed in preparing a poisonous liquor called molasses. The common
people have got so universally into the habit of drinking this base spirit,
that when a porter or labourer is seen reeling along the streets, they say,
he has got molassed.
L 

82 OF CLEANLINESS.
After in that condition, it would seem but a just punishment.
Though this be not the consequence of one act of intoxication, it
seldom fails to succeed a course of it. By a habit of drinking, the
greatest genius is often reduced to a mere idiot*.
Intoxication, is peculiarly hurtful to young persons. It heats
their blood, impairs their strength, and obstructs their growth;
besides, the frequent use of strong liquors in the early part of life
destroys any benefit that might ante from them afterwards. These
who make a practice of drinking generous liquors when young,
cannot expect to reap any benefit from them as a cordial in the
decline of life.
Drunkenness is not only in itself a most abominable vice, but is
an inducement to many others. There is hardly any crime so horrid
that the drunkard will not perpetrate for the love of liquor. We
have known mothers fell their children's clothes, the food that
they should have ate, and afterwards even the infants themselves,
in order to purchase the draught.
CHAPTER VIII.
Of Cleanliness.
THE want of cleanliness admits of no excuse. Where water
can be had for nothing, every person can be clean. The
continual discharge from our bodies by perspiration, renders fre-
quent change of apparel necessary. Changing apparel greatly pro-
motes the secretion 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 resorbed from dirty clothes, it must occa-
sion diseases.
Diseases of the skin are chiefly owing to want of cleanliness †.
They may indeed be caught by infection, or brought on by poor
*It is amazing that improvements in arts, learning, and politeness,
have-not put the barbarous custom of drinking to excess out of fashion
it is indeed lets common in South Britain than it was formerly; but it
still prevails, very much in the North, where this relic of barbarity is
mistaken for hospitality. There no man is supposed to entertain his
guests well, who does not make them drunk. Forcing people to drink,
is certainly the greatest piece of rudeness that any man can be guilty of.
Manliness, complaisance, or mere good-nature may induce, a man to
take his glass, if urged to it, at a time when he might as well take poison.
The custom of drinking to excess has long been out of fashion in France;
and, as it begins to lose ground among the politer part of the English,
we hope it will soon be banished from every part of this island.
† Mr. Pot, in his surgical observations, mentions a disease which he
calls the chimney-sweepers, cancer, as it is almost peculiar to that un-
happy set of people. This he attributes to neglect of cleanliness, and
with great justice. I am convinced, if that part of the body which is the
seat of this cruel disease was kept clean by frequent washing, it would
never happen.

OF CLEANLINESS. 83
living, unwholesome food, &c. but they will seldom continue long
where cleanliness prevails. To the same cause must we impute the
various kinds of vermin which infest the human body, houses, &c.
These may, always be banished by cleanliness alone, and wherever
they abound, we have reason to believe it is neglected.
One common cause of putrid and malignant fevers is the want
of cleanliness. These fevers commonly begin among the inhabi-
tants of close dirty houses, who breathe unwholesome air, take lit-
tle exercise, and wear dirty clothes. There the infection is gene-
rally hatched, which often spreads far and wide, to the destruction
of many. Hence cleanliness may be considered as an object of pub-
lic attention. It is not sufficient that I be clean myself, while the
want of it in my neighbour affects my health as well as his own.
If dirty people cannot be removed as a common nuisance, they
ought at least to be avoided as infectious. All who regard their
health should keep at a distance even from their habitations.
In places where great numbers of people are collected, cleanli-
ness becomes of the greatest importance. It is well known that in-
factious diseases are communicated by tainted air. Every thing,
therefore, which tends to pollute the air, or spread the infection,
ought with the utmost care to be guarded against. For this reason,
in great towns, no fifth of any kind, should be permitted to lie up-
on the streets. Nothing, is more apt to convey infection than the
excrements of the diseased.
In many great towns the streets are little better than dunghills,
being frequently covered with ashes, dung, and nastiness of every
kind. Even slaughter-houses, or killing-shambles are often to be
seen in the very centre of great towns. The putrid blood, excre-
ments, &c. with which these places are generally covered, 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!
We are sorry, that the importance of general cleanliness, does
not seem to be sufficiently understood by the magistrates of most
great towns in Britain; though health, pleasure, and delicacy, all
conspire to recommend an attention to it. Nothing can be more
agreeable to the senses, more to the honour of the inhabitants, or
more conducive to their health, than a clean town; nor can any
thing impress a stranger with a more disrespectful idea of any peo-
ple, than its opposite. Whatever pretensions people may make to
learning, politeness, or civilization, while they neglect cleanliness,
they are in a state of barbarity*.
* In ancient Rome the  greatest men did not think cleanliness an
object unworthy of their attention. Pliny fays, the Cloacæ, or com-
mon sewers, for the conveyance of filth and nastiness from the city, were
the greatest of all the public works; and bestows higher encomiums up-
on Tarquinius, Agrippa, and others who made and improved them,
than on those who atchieved the greatest conquests.

84 OF CLEANLINESS.
The peasants in most countries hold cleanliness in contempt.
Were it not for the open situation of their houses, they would
often feel the bad effects of this disposition. One seldom sees a
farm-house without a dunghill before the door, and frequently the
cattle and their matters lodge under the same roof. Peasants are
likewise extremely careless with respect to change of apparel, keep-
ing their houses, &c. clean. This is merely the effect of indolence
quid a dirty disposition. Habit may indeed render it less disagreea-
ble to them, but no habit can ever make it salutary to wear dirty
clothes or breathe unwholesome air.
In camps, the strictest regard should be paid to cleanliness. By
negligence in this matter, infectious diseases are often spread
amongst a whole army; and frequently more die of these, than by
the sword. The Jews during their encampments in the wilder-
ness, received particular instructions with respect to cleanliness*.
The rules enjoined them ought to be observed by all in the like
situation. Indeed, the whole system of laws delivered to that peo-
ple, has a manifest tendency to promote cleanliness. Whoever
considers the nature of their climate, the diseases to which they
were liable, and their dirty disposition, will see the propriety of
such laws.
In most eastern countries, cleanliness makes a great part of their
religion. The Mahometan, as well as the Jewish religion, enjoins
various bathings, washings, and purifications. These might be de-
signed to represent inward purity; but they were at the same time
calculated for the preservation of health. However whimsical these
washings may appear to some, few things would tend more to pre-
vent diseases than a proper attention to many of them. Were eve-
ry person, for example, after visiting the sick, handling a dead bo-
dy, or touching any thing that might convey infection, to wash
before he went into company, or fat down to meat, he would run
less hazard either of catching the infection himself, or of commu-
nicating it to others.
Frequent washing not only removes the filth and sordes which
adhere to the skin, but likewise promotes the perspiration, braces
the body, and enlivens the spirits. How refreshed, how cheerful,
and agreeable does one feel on being shaved, washed, and shifted;
especially when these offices have been neglected longer than usual!
The eastern custom of washing the feet, though less necessary in
this country, is a very agreeable piece of cleanliness, and contri-
butes greatly to the preservation of health. The sweat and dirt
with which these parts are frequently covered, cannot fail to ob-
struct the perspiration. This piece of cleanliness would often pre-
* "Thou shalt have a place also without the camp, whither thou shalt
go forth abroad; and thou shalt have a paddle upon thy weapon: and
it shall be when thou shalt ease thyself abroad, thou shalt dig therewith,
and shalt turn back, and cover that which cometh from thee, &c." Dent.
chap, xxiii. ver. 12, 13. 

OF CLEANLINESS. 85
vent colds and fevers. Were people careful to bathe their feet and
legs in lukewarm water at night, after being exposed to cold or
wet through the day, they would seldom experience the ill effects
which often proceed from these causes.
A proper attention to cleanliness is no where move necessary
than on shipboard. If epidemical distempers break out there, no
one can be safe. The best way to prevent them, is to take care
that the whole company be cleanly in their clothes, bedding, &c.
When infectious diseases do break out, cleanliness is the most like-
ly means to prevent their spreading and to prevent their returning
afterwards, or being conveyed to other places. For this purpose, the
clothes, bedding, &c. of the sick ought to be carefully washed, and
fumigated with brimstone. Infection will lodge a long time in
dirty clothes, and afterwards break out in the most terrible man-
ner.
In places where great numbers of sick people are collected to-
gether, cleanliness ought to be most religiously observed. The
very smell in such places is often sufficient to make one sick. It is
easy to imagine what effect that is likely to have upon the diseas-
ed. In an hospital or infirmary, where cleanliness is neglected, a
person in perfect health has a greater chance to become sick, than
a sick person has to get well.
Few things are more unaccountable than that neglect, or rather
dread of cleanliness, which appears among those who have the
care of the sick; they think it almost criminal to suffer any thing
that is clean to come near a person in a fever, for example, and
would rather allow him to wallow in all manner of filth, than
change the least bit of his linen. If cleanliness be necessary for
persons in health, it is certainly more so for the sick. Many dis-
eases may be cured by cleanliness alone: most of them might be
mitigated by it; and, where it is neglected, the slightest disorders
are often changed into the most malignant. The same mistaken
care which prompted people to prevent the least admission of fresh
air to the sick, seems to have induced them to keep them dirty.
Both these destructive prejudices will, we hope, be soon entirely
eradicated.
Cleanliness is agreeable to our nature. We cannot help approv-
ing it in others, even though we practise it not ourselves. It sooner
attracts our regard than even finery itself, and often gains esteem
where that fails. It is an ornament to the highest as well as the
lowest station, and cannot be dispensed with in either. Few vir-
tues are of more importance to society than general cleanliness.
It ought to be carefully cultivated every where; but in populous
cities, it should be almost revered*.
*As it is impossible to be throughly clean without a sufficient quan-
tity of water, the magistrates of great towns should be particularly at-
tentive to this article. Most great towns in Britain are so situated as
to be easily supplied with water; and those persons who will not make 

[86]
CHAPTER IX.
Of Infection.
MANY diseases are infectious. Every person ought, therefore,
as far as he can, to avoid all communication with the diseas-
ed. The common practice of visiting the sick, though often well
meant, has many ill consequences. We cannot help blaming such
as endanger their own or their neighbours lives by a mistaken
friendship or an impertinent curiosity.
The houses of the sick, especially in the country, are generally
crowded from morning till night with idle visitors. It is customa-
ry, in such places, for servants and young people to wait upon the
sick by turns, and even to sit up with them all night. It would be
a miracle indeed should such always escape. Experience teaches
us the danger of this conduct. People often catch fevers in this
way, and communicate them to others, till at length they become
epidemic.
It would be thought highly improper, for one who had not had
the small-pox, to wait upon a patient in that disease; yet many
other fevers are almost as infectious as the small-pox, and not less
fatal. Some imagine that fevers prove more fatal in villages than
in great towns, for want of proper medical assistance. This may
sometimes be the case; but we think it oftener proceeds from
the cause above-mentioned.
Were a plan to be laid down for communicating infection, it
could not be done more effectually than by the common method
of visiting the sick. Such visitors not only endanger themselves
and their connections, but likewise hurt the sick. By crowding
the house, they render the air unwholesome, and by their private
whispers and dismal countenances disturb the imagination of the
patient, and depress his spirits. Persons who are ill, especially in
fevers, ought to be kept as quiet as possible. The sight of strange
faces, and every thing that disturbs the mind, hurts them.
The common practice in country places of inviting great num-
bers of people to funerals, and crowding them into the same apart-
ment where the corpse lies, is another way of spreading in-
fection. The infection does not always die with the patient. Eve-
ry thing that comes into contact with his body while alive, receives
the contagion, and some of them, as clothes, blankets, &c. will re-
tain it for a long time. Persons who die of infectious disorders,
a proper use of it, after it is brought to their hand, deserve to be punch-
ed. The streets of great towns, where water can be had, ought to be
washed every day. This is the only effectual method for keeping them
thoroughly clean; and upon trial, we are persuaded it will be found
the cheapest.

OF INFECTION. 87
ought not to lie long unburied; and people should keep as much
as possible at a distance from them.
It would tend greatly to prevent the spreading of infectious dis-
eases, if those in health were kept at a proper distance from the
sick. The Jewish legislator, among many other wife institution
for preserving health, has been peculiarly attentive to the means
of preventing infection, or defilement as it is called, either from a
diseased person or a dead body. In many cases the diseased were
to be separated from those in health; and it was deemed a crime
even to approach their habitations. If a person only touched a
diseased or dead body, he was appointed to wash himself in water,
and to keep for some time at a distance from society.
Infectious diseases are often communicated by clothes. It is ex-
tremely dangerous to wear apparel which has been worn by the
deceased, unless it has been well washed and fumigated, as infec-
tion may lodge a long time in it, and afterwards produce very tra-
gical effects. This shows the danger of buying at random the
clothes which have been worn by other people.
Infectious disorders are frequently imported. Commerce, toge-
ther with the riches of foreign climes, brings their diseases. These
do often more than counter balance all the advantages of that trade
by means of which they are introduced. It is to be regretted, that
so little care is commonly bestowed, either to prevent the intro-
duction or spreading of infectious maladies. Some attention in-
deed is generally paid to the plague; but other diseases pass un-
regarded.
Infection is often spread through cities, by jails, hospitals, &c.
These are frequently situated in the very middle of populous towns;
and when infectious diseases break out ill them, it is impossible for
the inhabitants to escape. Did magistrates pay any regard to the
health of the people, this evil might be easily remedied.
Many are the causes which tend to diffuse infection through
populous cities. The whole atmosphere of a large town is one con-
taminated mass, abounding with various kinds of infection, and
must be pernicious to health. Such as are obliged to live in large
cities, ought to choose an open situation; to avoid narrow, dirty,
*Were the tenth part of the care taken to prevent the importation
of diseases, that there is to prevent smuggling, it would be attended with
many happy consequences. This might easily be done by appointing a
physician at every considerable sea-port, to inspect the ship's company,
passengers, &c. before they came ashore, and, if any fever or other in-
fectious disorder prevailed, to order the ship to perform a short quaran-
tine, and to send the sick to some hospital or proper place to be cured.
He might likewise order all the clothes, bedding, &c. which had been
used by the sick during the voyage, to be either destroyed, or thoroughly
cleansed by fumigation, &c. before any of it were sent ashore. A scheme
of this kind, if properly conducted, would prevent many fevers, and
other infectious diseases, from being brought by sailors into sea-port
towns, and by this means diffused alt over the country.

88 OF INFECTION.
crowded streets; to keep their own houses and offices clean; and
to be as much abroad in the open air as their time will permit.
It would tend greatly to prevent the spreading of infectious dis-
eases, were proper nurses every-where employed to take care of the
sick. This might often save a family, or even a whole town, from
being infected by one person. Not that people should abandon
their friends or relations in distress, but only be on their guard
against being too much in company with those who are afflicted
with diseases of an infectious nature.
Such as wait upon the sick in infectious diseases run very great
hazard. They should stuff their noses with tobacco, or some other
strong smelling herb, as rue, tansy, or the like. They ought like-
wise to keep the patient very clean, to sprinkle the room where
he lies with vinegar, or other strong acids, frequently to admit a
stream of fresh air into it, and to avoid the smell of his breath as
much as they can. They ought never to go into company without
having changed their clothes and washed their hands; otherwise,
if the disease be infectious, they will in all probability carry the
contagion along with them*.
A due attention to those things which tend to diffuse infection
would be of great importance in preventing diseases. As most dis-
eases are in some degree infectious, no one should continue long
with the sick, except the necessary attendants. I mean not howe-
ver, by this caution, to deter those whose duty or office leads them
to wait upon the sick, from such a laudable and necessary employ-
ment.
Many things are in the power of the magistrate which would
tend to prevent the spreading of infection; as the promoting of
public cleanliness; removing jails, hospitals, burying grounds, and
other places where infection may be generated, at a proper dis-
tance from great towns†; widening the streets; pulling down
useless walls, and taking all methods to promote a free circulation
of air through every part of the town, &c. Public hospitals, or
proper places of reception for the sick, provided they were kept
clean, well ventilated, and placed in an open situation, would like-
wise tend to prevent the spreading of infection. Such places of
* There is reason to believe that infection is often conveyed from
one place to another by the carelessness of the faculty themselves. Many
physicians affect a familiar way of sitting upon the patient’s bedside, and
holding his arm for a considerable time, if the patient has the small-pox,
or any other infectious disease, there is no doubt but the doctor's hands,
clothes, &c. will carry away some of the infection; and, if he goes di-
rectly to visit another patient without washing his hands, changing his
clothes, or being exposed to the open air, which is not seldom the case,
is it any wonder that he should carry the disease along with him? Phy-
sicians not only endanger others, but also themselves, by this practice.
And indeed they sometimes suffer for their want of care.
† The ancients would not suffer even the temples of their gods where
the sick resorted, to be built within the wall of a city.

OF THE PASSIONS. 89
reception would prevent the poor, when sick, from being visited
by their idle or officious neighbours. They would likewise render
it unnecessary for sick servants to be kept in their masters houses.
Masters had better pay for having their servants taken care of in an
hospital, than run the hazard of having an infectious disease diffu-
sed among a numerous family. Sick servants and poor people,
when placed in hospitals, are not only less apt to diffuse infec-
tion among their neighbours, but have likewise the advantage of
being well attended.
We are not, however, to learn that hospitals, instead of pre-
venting infection, may become the means of diffusing it. When
they are placed in the middle of great towns; when numbers of
patients are crowded together into small apartments; when there
is a constant communication kept up between the citizens and the
patients; and when cleanliness and ventilation are neglected, they
become nests for hatching diseases, and every one who goes into
them, not only runs a risk of receiving infection himself, but like-
wise of communicating it to others. This is not the fault of hos-
pitals, but of those who have the management of them. It were
to be wished, that they were both more numerous, and upon a
more respectable footing, as that would induce people to go into
them with less reluctance. This is the more to be desired, because
most of the putrid fevers and other infectious disorders break out
among the poor, and are by them communicated to the better
sort. Were proper attention paid to the first appearances of such
disorders, and the patients early conveyed to an hospital, we should
seldom see a putrid fever, which is almost as infectious as the
plague, become epidemic.
CHAPTER X.
Of the Passions.
THE passions have great influence both in the cause and cure
of diseases. How the mind affects the body, will, in all proba-
bility ever remain a secret. It is sufficient for us to know, that there
is established reciprocal influence between the mental and corpo-
real parts, and that whatever injures the one, disorders the other.
Of Anger.
THE passion of anger ruffles the mind, distorts the countenance,
hurries on the circulation of the blood, and disorders the whole
vital and animal functions. It often occasions fevers, and other
acute diseases; and sometimes even sudden death. This passion
M

90 OF THE PASSIONS.
Is peculiarly hurtful to the delicate, and those of weak nerves.
Such persons frequently lose their lives by a violent fit of anger,
and I would advise them to guard against the excess of this passion
with the utmost care.
It is not indeed always in our power to prevent being angry;
but we may surely avoid harbouring resentment in our breast. Re-
sentment, preys upon the mind, and occasions the most obstinate
chronical disorders which gradually waste the constitution. Nothing
shows true greatness of mind more than to forgive injuries; it
promotes the peace of society, and greatly conduces to our own
case, health, and felicity.
Such as value health should avoid violent gusts of anger, as they
would the most deadly poison. Neither ought they to indulge re-
sentment, but to endeavour at all times to keep their minds calm
and serene. Nothing tends so much to the health of the body as a
constant tranquillity of mind.
Of Fear.
THE influence of fear, both in occasioning and aggravating
diseases, is very great. No man ought to be blamed for a decent
concern about life; but too great a desire to preserve it is often
the cause of losing it. Fear and anxiety, by depressing the spirits,
not only dispose us to diseases, but often render those diseases fatal
which an undaunted mind would overcome.
Sudden fear has generally violent effects. Epileptic fits, and
other convulsive disorders, are often occasioned by it. Hence the
danger of that practice, so common among young people, of
frightening one another. Many have lost their lives, and others
have been rendered miserable, by frolics of this kind. It is dange-
rous to tamper with the human passions. The mind may easily be
thrown into such disorder as never again to act with regularity.
But the gradual effects of fear prove more hurtful. The con-
stant dread of some future evil, by dwelling upon the mind, often
occasions the very evil itself. Hence it comes to pass, that so many
die of those very diseases of which they long had a dread, or which
had been impressed on their minds by some accident, or foolish
prediction. This, for example, is often the case with women in
child-bed. Many of those who die in that situation are impressed
with the notion of their death a long time before it happens; and
there is reason to believe that this impression is often the cause
of it.
The methods taken to impress the minds of women with ap-
prehensions of the great pain and peril of child-birth, are very
hurtful. Few women die in labour, though many lose their lives
after it; which may be thus accounted for. A woman after deli- 

OF THE PASSIONS. 91
very, finding herself weak and exhausted, immediately apprehends
she is in danger; but this fear seldom fails to obstruct the necessa-
ry evacuations, upon which her recovery depends. Thus, the sex
often, fall a sacrifice to their own imaginations, when there would
be no danger, did they apprehend none.
It seldom happens that two or three women in a great town die
in child-bed, but their death is followed by many others. Every
woman of their acquaintance who is with child dreads the same
fate, and the disease becomes epidemical by the mere force of ima-
gination. This should induce pregnant women to despise fear, and
by all means to avoid those tattling gossips who are continually
buzzing in their ears the misfortunes of others. Every thing that
may in the least alarm a pregnant of child-bed woman, ought with
the greatest care to be guarded against.
Many women have lost their lives in child-bed by the old su-
perstitious custom, still kept up in most parts of Britain, of tolling
the parish bell for every person who dies. People who think them-
selves in danger ate very inquisitive; and if they come to know
that the bell tolls for one who died in the same situation with
themselves, what must be the consequence? At any rate they are
apt to suppose that this is the case, and it will often be found a dif-
ficult matter to persuade them of the contrary.
But this custom is not pernicious to child-bed women only. It
is hurtful in many other cases. When low fevers, in which it is
difficult to support the patient's spirits, prevail, what must be the
effect of a funeral peal sounding five or six times a day in his ears?
No doubt his imagination will suggest that others died of the dis-
ease under which he labours. This apprehension will have a great-
er tendency to depress his spirits, than all the cordial pf medicine
will have to raise them.
If we have not sense enough to abolish this useless piece of cere-
mony, we ought to keep the sick as much from hearing it as possible,
and from every other thing that may tend to alarm them. So far
however is this from being generally attended to, that many make
it, their business to visit the sick, on purpose to whisper dismal sto-
ries in their ears. Such may pass for sympathizing friends, but they
are their enemies. All who wish well to the sick ought to keep
such persons at the greatest distance from them.
A custom has long prevailed among physicians, of prognosti-
cating, or foretelling the issue of the disease. Vanity introduced
this practice, and still supports it, in spite of common sense and
the safety of mankind. I have known a physician barbarous enough
to boast, that he pronounced more sentences than all his Majesty's
judges. Would to God that such sentences were not often equal-
ly fatal! It may indeed be alleged, that the doctor does not de-
clare his opinion before the patient. So much the worse. A sensi-
ble patient had better hear what the doctor says, than learn it from
the disconsolate looks, the watery eyes, and the broken whispers 

92 OF THE PASSIONS.
of those about him. It seldom happens, when the doctor gives an
unfavourable opinion, that it can be concealed from the patient.
The very embarrassment which the friends and attendants show in
disguising what he has said, is generally sufficient to discover the
truth.
Heaven has concealed from mortals their fate; and we do not
see what right any man has to announce the death of another, es-
pecially if such a declaration has a chance to kill him. Mankind
are indeed very fond of prying into future events, and seldom fail
to solicit the physician for his opinion. A doubtful answer, or one
that may tend rather to encourage the hopes of the sick, is surely
the most safe. This conduct could neither hurt the patient nor the
physician. Nothing tends more to destroy the credit of physic than
those bold prognosticators, who by the bye, are generally the most
ignorant of the faculty. The mistakes which daily happen in this
way are so many standing proofs of human vanity, and the weak-
ness of science.
There are cases where the physician ought to give intimation of
the patient's danger to some of his near connections; though even
this ought always to be done with the greatest caution: but it ne-
ver can be necessary in any case that the whole town and country
should know, immediately after the doctor has made his first visit,
that he has no hopes of his patient's recovery. Persons whose im-
pertinent curiosity leads them to question the physician with regard
to the fate of his patient, deserve no answer.
The vanity of foretelling the fate of the sick is not peculiar to
the faculty. Others follow their example, and those who think
themselves wiser than their neighbours often do much hurt in this
way. Humanity surely calls upon every one to comfort the sick,
and not to add to their affliction by alarming their fears. A friend,
or even a physician, may often do more good by a mild and sym-
pathizing behaviour than by medicine, and should never neglect
to administer that greatest of all cordials, Hope.
Of Grief.
GRIEF is the most destructive of all the passions. Its effects are
permanent, and when it finks deep into the mind, it generally
proves fatal. Anger and fear, being of a more violent nature, sel-
dom last long; but grief often changes into a fixed melancholy,
which preys upon the spirits, and wastes the constitution. This
passion ought not to be indulged. It may generally be conquered
at the beginning; but when it has gained strength, all attempts to
remove it are vain.
No person can prevent misfortunes in life; but it shows true
greatness of mind to bear them with serenity. Many persons make 

OF THE PASSIONS. 93
a merit of indulging grief, and when misfortunes happen, they
obstinately refuse all consolation, till the mind, overwhelmed with
melancholy, sinks under the load. Such conduct is not only de-
structive to health, but inconsistent with reason, religion, and com-
mon sense.
Change of ideas is as necessary for health as change of posture.
When the mind dwells long upon one subject, especially of a dis-
agreeable nature, it hurts the whole functions of me body. Grief
indulged spoils the digestion and destroys the appetite; hence the
spirits are depressed, the nerves relaxed, the bowels inflated with
wind, and the humours, for want of fresh supplies of chyle, vitia-
ted. Many an excellent constitution has been ruined by a family-
misfortune, or any thing that occasions excessive grief.
It is utterly impossible, that any person of a dejected mind
should enjoy health. Life may indeed be dragged out for a few
years: but whoever would live to a good old age, must be good-
humoured and cheerful. This indeed is not altogether in our
own power; yet our temper of mind, as well as our actions, de-
pends greatly upon ourselves. We can either associate with cheer-
ful or melancholy companions, mingle in the amusements and
offices of life, or sit still and brood over our calamities as we choose.
These, and many such things, are certainly in our power, and from
these the mind generally takes its cast.
The variety of scenes which present themselves to the senses,
were certainly designed to prevent our attention from being too
long fixed upon any one object. Nature abounds with variety,
and the mind, unless fixed down by habit, delights in contempla-
ting new objects. This at once points out the method of reliev-
ing the mind in distress. Turn die attention frequently to new
objects. Examine them for some time. When the mind begins
to recoil, shift the scene. By this means, a constant succession of
new ideas may be kept up, till the disagreeable ones entirely disap-
pear. Thus travelling, the study of any art or science, reading
or writing on such subjects as deeply engage the attention, will
sooner expel grief than the most sprightly amusements.
As the body cannot be healthly unless it be exercised; neither
can the mind. Indolence nourishes grief. When the mind has no-
thing else to think of but calamities, no wonder that it dwells there.
Few people who pursue business with attention are hurt by grief.
Instead therefore of abstracting ourselves from the world or busi-
ness, when misfortunes happen, we ought to engage in it with
more than usual attention, to discharge with double diligence the
functions of our station, and to mix with friends of a cheerful
and social temper.
Innocent amusements are not to be neglected. These, by lead-
ing the mind insensibly to the contemplation of agreeable objects,
help to dispel the gloom which misfortunes cast over it. They
make time seem less tedious, and have many other happy effects. 

94 OF THE PASSIONS.
Some persons, when overwhelmed with grief, betake themselves
to drinking. This is making the cure worse than the disease. It
seldom fails to end in the ruin of fortune, character, and consti-
tution.
Of Love.
LOVE is perhaps the strongest of all the passions; at least, when
it becomes violent, it is less subject to the controul either of the
understanding or will, than any of the rest. Fear, anger, and seve-
ral other passions are necessary for the preservation of the indivi-
dual, but love is necessary for the continuation of the species itself:
It was therefore proper that this passion should be deeply rooted in
the human breast.
Though love be a strong passion, it is seldom so rapid in its pro-
gress as several of the others. Few persons fall desperately in love
all-at-once. We would therefore advise every one, before he tam-
pers with this passion, to consider well the probability of his being
able to obtain the object of his love. When that is not likely, he
should avoid every occasion of increasing it. He ought immediate-
ly to fly the company of the beloved object; to apply his mind
attentively to business or study; to take every kind of amusement;
and above all, to endeavour, if possible, to find another object which
may engage his affections, and which it may be in his power to
obtain.
There is no passion with which people is so ready to tamper as love,
although none is more dangerous. Some men make love for amuse-
ment, others from mere vanity, or on purpose to show their conse-
quence with the fair. This is perhaps the greatest piece of cruel-
ty, which any one can be guilty of. What we eagerly with for we
easily credit. Hence, the too credulous fair are often betrayed into
a situation wich is truly deplorable, before they are able to discover
that the pretended lover was only in jest. But there is no jesting
with this passion. When love has got to a certain height, it admits
of no other cure but the possession of its object, which in this case
ought always if possible to be obtained*.
* The conduct of parents with regard to the disposal of their chil-
dren in marriage is often very blameable. An advantageous match is the
constant aim of parents; while their children often suffer a real mar-
tyrdom betwixt their inclinations and duty. The first thing which pa-
rents ought to consult in disposing of their children in marriage, is cer-
tainly their inclinations. Were due regard always paid to these, there
would be fewer unhappy couples, and parents would not have so often
cause to repent the severity of their conduct, after a ruined constitution,
a lost character, or a distracted mind, has shown them their mistake.

[95]
Of Religious Melancholy.
MANY persons of a religious turn of mind behave as if they
thought it a crime to be cheerful. They imagine the whole of re-
ligion consists in certain mortifications, or denying themselves the
smallest indulgence, even of the most innocent amusements. A
perpetual gloom hangs over their countenances, while the deepest
melancholy preys upon their minds. At length the fairest prospects
vanish, every thing puts on a dismal appearance, and those very
objects which ought to give delight, afford nothing but disgust.
Life itself becomes a burden, and the unhappy wretch, persuaded
that no evil can equal what he feels, often puts an end to his own
existence.
Persons whose business it is to recommend religion to others,
should beware of dwelling too much on gloomy subjects. That
peace and tranquillity of mind, which true religion is calculated to
inspire, is a more powerful argument in its favour, than all the ter-
rors that can be uttered. Terror may indeed deter men from out-
ward acts of wickedness, but can never inspire them with that love
of God, and real goodness of heart, in which alone true religion
consists.
The best way to counteract the violence of any passion, is to
keep the mind closely engaged in some useful pursuit.
CHAPTER XI.
Of the Common Evacuations.
THE principal evacuations from the human body are those, by
stool, urine and insensible perspiration. None of these can
be long obstructed without impairing health. When that which
ought, to be thrown out of the body is too long retained, it occa-
sions a plethora, or too great fulness of the vessels.
Of the Evacuation by Stool.
FEW things conduce more to health than keeping the body re-
gular. When the fœces lie too long in the bowels, they vitiate the
humours; and when they are too soon discharged, the body is not
sufficiently nourished. A medium is to be desired, which can only
be obtained by regularity in diet, sleep and exercise. Whenever the
body is not regular, there is reason to suspect a fault in one or other
of these.
Persons who eat and drink at irregular hours, and who eat vari-

96 OF THE COMMON EVACUATIONS.
ous kinds of food, and drink of several different liquors at every
meal, have no reason to expect either that their digestion will be
good or their discharges regular. Irregularity in eating and drink-
ing, disturbs every part of the animal œconomy, and never fails
to occasion diseases. Either too much or too little food will have
this effect. The former indeed generally occasions looseness, and
the latter costiveness; but both have a tendency to hurt the health.
It would be difficult to ascertain the exact number of stools which
may be consistent with health, as these differ in the different pe-
riods of life, in different constitutions, and even in the same con-
stitution under a different regimen of diet, exercise, &c. It is how-
ever generally allowed, that one stool a-day is sufficient for an
adult, and that less is hurtful. But this, like most general rules
admits of many exceptions. I have known persons in perfect health
who did not go to stool above once a-week. Such a degree of cos-
tiveness is not safe; though the person who labours under it may
for some time enjoy tolerable health, yet at length it may occasion
diseases.
One method of procuring a stool every day is to rise betimes, and
go abroad in the open air. Not only the posture in bed is unfavour-
able to regular stools, but also the warmth. This, by promoting
the perspiration, lessens all the other discharges.
The method recommended for this purpose by Mr. Locke, is
likewise very proper, viz. to solicit Nature, by going regularly to
stool, every morning whether one has a call or not. Habits of this
kind may be acquired, which will in time become natural.
Persons who have frequent recourse to medicines for preventing
costiveness, seldom fail to ruin their constitutions. Purging medi-
cines frequently repeated, weaken the bowels, hurt the digestion,
and every dose makes way for another, till at length they become
as necessary as daily bread. Those who are troubled with costive-
ness, ought rather, if possible, to remove it by diet than drugs.
They should go thinly clothed, and avoid every thing of an astrin-
gent or heating nature. The diet and other regimen necessary
in this case, will be found under the article Costiveness, where this
state of the bowels is treated as a disease.
Such persons as are troubled with a habitual looseness ought
likewise to suit their diet to the nature of their complaint. They
should use food which braces and strengthens the bowels, and
which is rather of an astringent quality, as wheat-bread made of
the finest flour, cheese, eggs, rice boiled in milk, &c. Their
drink should be red-port, claret, brandy and water, in which
toasted bread has been boiled, and such like.
As an habitual looseness is often owing to an obstructed perspi-
ration, persons affected with it ought to keep their feet warm, to
wear flannel next their skin, and take every other method to pro-
mote the perspiration. Further directions, with regard to the
treatment of this complaint, will be found under the article Looseness.

[97]
Of Urine.
SO many things tend to change both the quantity and appear-
ances of the urine, that it is very difficult to lay down any deter-
mined rules for judging of either*. Dr. Cheyne says, the urine
ought to be equal to three-fourths of the liquid part of our aliment.
But suppose anyone were to take the trouble of measuring both,
he would find, that every thing which altered the degree of per-
spiration, would alter this proportion, and likewise, that different
kinds of aliment would afford very different quantities of urine.
For these, and other reasons, no rule can be given for judging of
the precise quantity of urine which ought to be discharged, yet a
person of common sense will seldom be at a loss to know when it
is in either extreme.
As a free discharge of urine not only prevents, but actually cures, 
many diseases, it ought, by all means, to  be promoted; and every
thing that may obstruct it should be carefully avoided. Both the
secretion and discharge of urine are lessened by a sedentary life,
sleeping on beds that are too soft and warm, food of a dry and
heating quality, liquors which are astringent and heating, as red-
port, claret, and such like. Those who suspect that their urine
is in too small quantity, or who have any symptoms of the gravel,
ought to avoid these things, and whatever else has a tendency to
lessen the quantity of their urine.
When the urine is too long retained, it is not only re-absorbed
or taken up again into the mass of fluids, but, by stagnating in
the bladder, it becomes thicker, the more watry parts flying off
first, and the more gross and earthy remaining behind. By the
constant tendency which these have to concrete, the formation of
stones and gravel in the bladder is promoted. Hence, indolent
and sedentary people are much more liable to these diseases, than
persons of a more active life.
* It has long been an observation among physicians, that the ap-
pearances of the urine are very uncertain, and very little tube depen-
ded on. No one will be surprised at this, who considers how many ways
it may be affected, and consequently have its appearance altered. The
passions, the state of the atmosphere, the quantity and quality of the
food, the exercise, the clothing, the date 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 all over Britain,
and by the amazing credulity of the populace, many of them amass con-
siderable 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
demonstrated that no one of them is able to distinguish the urine of a
horse, or any other animal, from that of a man.
N

98 OF THE COMMON EVACUATIONS.
Many persons have lost their lives, and others have brought oil
very tedious, and even incurable disorders, by retaining their urine
too long, from a false delicacy. When the bladder has been over-
distended, it often looses its power of action altogether, or be-
comes paralytic, and is rendered unable either to retain the urine,
or expel it properly. The calls of nature ought never to be post-
poned. Delicacy is a virtue; but that can never be reckoned
true delicacy, which induces any one to risk his health or hazard
his life.
Urine may be in too great as well as too small a quantity, by
drinking large quantities of weak watery liquors, by the excessive
use of alkaline falls, or any thing that stimulates the kidnies, di-
lutes the blood, &c. This disorder very soon weakens the body,
and induces a consumption. It is difficult to cure, but may be
mitigated by strenghtening diet and astringent medicines, such are
recommended under the article Diabetes.
Of the Perspiration.
INSENSIBLE perspiration is generally reckoned the greatest of
all the discharges from the human body. It is of so great impor-
tance to health, that few diseases attack us while it goes properly
on; but when it is obstructed, the whole frame is soon disordered.
This discharge, however, being less perceptible than any of the
rest, is consequently less attended to. Hence, acute fevers, rheu-
matisms, agues, &c. often proceed from obstructed perspiration
before we are aware of its having taken place.
On examining patients, we find most of them impute their
diseases either to violent colds which they had caught, or to slight
ones which had been neglected. For this reason, instead of a
critical inquiry into the nature of the perspiration, its difference
in different seasons, climates, constitutions, &c. we shall endea-
vour to point out the causes which most commonly obstruct it,
and to show how far they may be either avoided, or have their
influence counteracted by timely care. The want of a due at-
tention to these, costs Britain annually some thousands of useful
lives.
Changes in the Atmosphere.
ONE of the most common causes of obstructed perforation, or
catching cold, in this country, is the changeableness of the wea-
ther, or state of the atmosphere. There is no place where such
changes happen more frequently than in Britain. With us, the
degrees of heat and cold are not only very different in the differ-

OF THE COMMON EVACUATIONS. 99
ent seasons of the year, but often change almost from one extreme
to another in a few days, and sometimes even in the course of one
day. That such changes must affect the state of the perspiration
is obvious to every one.
The best method of fortifying the body against the changes of
the weather, is to be abroad every day. Those who keep most
within doors are most liable to catch cold. Such persons generally
render themselves so delicate as to feel even the slightest changes
in the atmosphere, and by their pains, coughs, and oppressions of
the breast, &c. they become a kind of living barometers.
Wet Clothes.
WET clothes not only by their coldness obstruct the perspiration,
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 oc-
casion fevers, rheumatisms, and other fatal disorders, even in the
young and healty.
It is impossible for people who go frequently abroad, to avoid
sometimes being wet. But the danger might generally be lessened,
if not wholly prevented, by changing their clothes soon; when
this cannot be done, they should keep in motion till they be dry.
So far are many from taking this precaution, that they often sit
or lie down in the fields with their clothes wet, and frequently
sleep even whole nights in this condition. The frequent instances
which we have of the fatal effects of this conduct, ought to deter
Others from being guilty of it.
Wet Feet.
EVEN wet feet often occasion fatal diseases. The cholic, inflam-
mations of the breast and of the bowels, the iliac passion, cholera
morbus, &c. are often occasioned by wet feet. Habit will 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 peculiarly careful in this respect.
*I never knew a more remarkable instance of the uncertainty of
the weather in this country, than happened while I was writing these
notes. This morning, August 14, 1783, the thermometer in the
shade was down at fifty-three degrees, and a very few days ago it
stood above eighty. No one who reflects on such great and sudden
changes in the atmosphere, will be surprised, to find colds, coughs,
rheums, with other affections of the breast and bowels, so common
in this country.

[100]
Night Air.
THE perspiration is often obstructed by night-air; even in sum-
mer, this ought to be avoided. The dews which fall plentifully af-
ter 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 the 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 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 at-
tending to this, in flat marshy countries, where the exhalations and
dews are copious, labourers are often seized with intermitting fe-
vers, 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. Nothing is snore to be
dreaded by travellers than damp beds, which are very common ill
all places where fuel is scarce. When a traveller, 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 on a damn bed, it will be more ob-
structed, and the worst consequences will ensue. Travellers should
avoid inn, which are noted for damp beds, as they would a house
infected with the plague, as no man, however robust, is proof
against the danger arising from them.
But inns are, net 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, become damp. How then is it possible that
beds, which are not slept in above 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 obvi-
ous: Were they careful never to sleep in a bed but what was fre-
quently used, they would seldom find any ill consequences from a
change.
Nothing is more to be dreaded by a delicate person, when on a
visit, than being laid in a bed which is kept on purpose for strangers.
That ill-judged piece of complaisance becomes a real injury. All 

101 OF THE COMMON EVACUATIONS. 
the bad consequences from this quarter might easily be prevented
in private families, by causing their servants to sleep in the spare—
beds, and resign them to strangers when they come. In inns, where
the beds are used almost every night, nothing else is necessary than
to keep the rooms well seasoned by frequent fires, and the linen dry.
That baneful custom, said to be practised in many inns, of
damping sheets, and pressing them, in order to save washing, and
afterwards laying them on the beds, ought, when discovered, to
he punished with severity. It is really a species of murder, and
will often prove as fatal as poison or gun—shot. Indeed, no linen,
especially if it has been washed in winter, ought to be used until
it has been exposed for some—time to the fire; nor is this opera—
tion less necessary for linen washed in summer, if it has lain by
for any length of time. This caution is the more needful, as gen—
tlemen are often exceedingly attentive to what they eat or drink at
an inn, yet pay little regard to a circumstance of more importance*.
Damp Houses
FREQUENTLY produce the like ill—consequences; 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 ne—
ver be thoroughly dry. All houses, unless where the ground is ex—
ceeding dry, should have the first floor a little raised. Servants
and others, who are obliged to live in cellars and sunk stories, sel—
dom continue long in health: Matters ought surely to pay some
regard to the health of their servants, as well as to their own.
Nothing is more common than for people, merely to avoid some
trifling inconveniency, to hazard their lives, by inhabiting a house
almost as soon as the masons, plasterers, &c. have done with it:
Such houses are not only dangerous from their dampness, but like—
wise from the smell of lime, paint, &c. The asthmas, consump—
tions, and other diseases of the lungs, so incident to people who
work in these articles, are sufficient proofs of their being unwhole—
some.
Rooms are often rendered damp by an unseasonable piece of
cleanliness; I mean the pernicious custom of washing them imme—
diately before company is put into them. Most people catch cold,
if they fit but a very short time in a room that has been lately wash—
* 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 all danger. I have practised this for many
years, and never have been hurt by damp beds; though no constitution,
without care, is proof against; their baneful influence.

102 OF THE COMMON EVACTUATIONS.
ed; the delicate ought carefully to avoid such a situation, and even
the robust are not always proof against its influence*.
Sudden Transitions from Heat to Cold.
PERSPIRATION is frequently obstructed by sudden transi—
tions from heat to cold. Colds are seldom caught, unless when peo—
ple have been too much heated. Heat rarifies the blood, quickens
the circulation, and increases the perspiration; but when these are
suddenly checked, the consequences must be bad. It is impossible
for labourers not to be too hot upon some occasions; but it is ge—
nerally in their power to let themselves cool gradually, to put on
their clothes when they leave off work, to make choice of a dry
place to rest themselves in, and to avoid sleeping in the open fields.
These easy rules, if observed, would often prevent fevers and other
fatal disorders.
It is very common for people, when hot, to drink freely of cold
water, or small liquors. This conduct is extremely dangerous.
Thirst indeed is hard to bear, frequently gets the better of reason,
and makes us do what our judgment disapproves. Every peasant,
however, knows, if his horse be permitted to drink his belly—full of 
cold water after violent exercise, and be immediately put into the
stable, or suffered to remain at rest, that it will kill him. This they
take the utmost care to prevent. It were well if they were equally
attentive to their own safety.
Thirst may be quenched many ways without swallowing large
quantities of cold liquor. The fields afford a variety of acid fruits
and plants, the very chewing of which would abate thirst. Water
kept in the mouth for some time, and spit out again, if frequently
repeated, will have the same effect. If a bit of bread be eaten along
with a few mouthfuls of water, it will both quench thirst more
effectually, and make the danger less. When a person is extreme—
ly hot, a mouthful of brandy, or other spirits, if it can be obtained,
ought to be preferred to any thing else. But if any one has been so
foolish, when hot, as to drink freely of cold liquor, he ought to
continue his exercise at least, till what he drank be thoroughly
warmed upon his stomach.
It would be tedious to enumerate all the bad effects which flow
from drinking cold liquors when the body is hot. Sometimes this
has occasioned immediate death. Hoarseness, quinseys, and fevers
of various kinds, are its common consequences. Neither is it safe
* People imagine, if a good fire is made in a room, after it has been
washed, that there is no danger from sitting in it; but this increases the
danger. The evaporation excited by the fire generates cold, and ren—
ders the damp more active. 

103 OF THE COMMON EVACUATIONS. 
when warm, to eat freely of raw fruits, sallads, or the like.
These, indeed, have not so sudden an effect on the body as cold
liquors, but they are notwithstanding dangerous, and ought to be
avoided.
Sitting in a warm room, and drinking hot liquors till the pores
are quite open, and immediately going into the cold air, is ex—
tremely dangerous. Colds, coughs and inflammations of the breast,
are the usual effects of this conduct: Yet nothing is more com—
mon than for people, after they have drank warm liquors for seve—
ral hours, to walk or ride a number of miles in the coldest night,
or to ramble about in the streets*.
People are very apt, when a room is hot, to throw open a win—
dow, and to sit near it. This is a most dangerous practice. A per—
son had better fit without—doors than in such a situation, as the
current of air is directed against one particular part of the body.
Inflammatory fevers and consumptions have often been occasioned
by sitting or standing thinly clothed near an open window. Nor
is sleeping with open windows less to be dreaded. That ought ne—
ver to be done, even in the hottest season, unless the window is at
a distance. Mechanics frequently contract fatal diseases, by work—
ing stript at an open window, and I would advise all of them to
beware of such a practice.
Few things expose people more to catch cold, than keeping their
own houses too warm; such persons may be said to live in a sort
of hot—houses; they can hardly stir abroad to visit a neighbour,
but at the hazard of their lives. Were, there no other reason for
keeping houses moderately cool, that alone is sufficient: But no
house that is too hot can be wholesome; heat destroys the spring
and elasticity of the air, and renders it less fit for expanding the
lungs, and the other purposes of respiration. Hence consumptions
and other diseases of the lungs prove so fatal to people who work
in forges, glass—houses, and the like.
Some are even so fool—hardy, as to plunge themselves when hot
in cold water. Not only fevers, but madness itself, has frequently
been the effect of this conduct. Indeed, it looks too like the action
of a madman to deserve a serious consideration.
The result of all these observations is, that every one ought to
avoid, with the utmost attention, all sudden transitions from heat
to cold, and to keep the body in as uniform a temperature as pos—
sible; or, where that cannot be done, to take care to let it cool
gradually.
People may imagine that too strict an attention to these things
* The tap—rooms in London and other great towns, where such num—
bers, of people spend their evenings, are highly pernicious. The breath
of a number of people, crowded into a low apartment, with the addition
of fires, candles, the smoke of tobacco, and the fumes of hot liquor,
&c. must not only render it hurtful to continue in such places, but dan—
gerous to go out of them into a cold and chilly atmosphere. 

104 OF THE COMMON EVACUATIONS.
would tend to render them delicate. So far is this from being my
design, that the very first rule proposed for preventing colds, is to
harden the body, by enuring it daily to the open air.
I shall put an end to this part of my subject, by giving an ab—
stract of the advice of Celsus, with respect to the preservation of
health. "A man," says he, "who is blessed with good health, should
"confine himself to no particular rules, either with respect to re—
"gimen or medicine. He ought frequently to diversify his man—
"ner of living; to be sometimes in town, sometimes in the coun—
"try to hunt, fail, indulge himself in rest, but more frequently to
"use exercise. He ought to refuse no kind of food that is com—
"monly used, but sometimes to eat more and sometimes less;
"sometimes to make one at an entertainment, and sometimes to
"forbear it; to make rather two meals a—day than one, and al—
"ways to eat heartily, provided he can digest it. He ought neither
"too eagerly to pursue, nor too scrupulously to avoid, intercourse
"with the fair sex: Pleasures of this kind, rarely indulged,ren—
"der the body alert and active; but, when too frequently repea—
"ted, weak and languid. He should be careful in time of health
"not to destroy, by excesses of any kind, that vigour of constitu—
"tion which should support him under sickness.”

PART II.
OF DISEASES.
CHAPTER XII.
Of the Knowledge and Cure of Diseases.
THE knowledge of diseases does not depend so much upon
scientific principles as many imagine. It is chiefly the re—
sult of experience and observation. By attending the sick, and care—
fully observing the various occurrences in diseases, a great degree
of accuracy may be acquired, both in distinguishing their symp—
toms, and in the application of medicines. Hence, sensible nurses,
and other persons who wait upon the sick, often discover a dis—
ease sooner than those who have been bred to physic. We do not
insinuate that a medical education is of no use: it is doubtless of
the greatest importance; but it never can supply the place of ob—
servation and experience.
Every disease may be considered as an assemblage of symptoms,
and must be distinguished by those which are most obvious and,
permanent. Instead, therefore, of giving a classical arrangement of
diseases, according to the systematic method, it will be more suit—
able, in a performance of this nature, to give a full and accurate
description of each particular disease as it occurs; and, where any
of the symptoms of one, disease have a near resemblance to those
of another, to take notice of that circumstance, and at the same
time to point out the peculiar or characteristic symptoms by
which it may be distinguished. By a due attention to these, the
investigation of diseases will be found less difficult than most peo—
ple would imagine.
A proper attention to the patient's age, sex, temper of mind, con—
stitution, and manner of life, will greatly assist, both in the investi—
gation and treatment of diseases.
In childhood, the fibres are lax and soft, the nerves extremely
irritable, and the fluids thin: whereas, in old age, the fibres are rigid,
the nerves become almost insensible, and many of the vessels im—
perviable. These, and other peculiarities, render the diseases of the
young and aged very different, and of course, they must require a
different method of treatment.
O 

106 OF THE KNOWLEDGE
Females are liable to many diseases which do not afflict the other
sex: besides the nervous system being more irritable in them than
in men, their diseases require to be treated with greater caution.
They are less able to bear large evacuations; and all stimulating
medicines ought to be administered to them with a sparing hand.
Particular constitutions not only dispose persons to peculiar dis—
eases, but likewise render it necessary to treat these diseases in a
peculiar manner. A delicate person, for example, with weak nerves,
who lives mostly within doors, must not be treated, under any dis—
ease, precisely in the same manner as one who is hardy and robust,
and who is much exposed to the open air.
The temper of mind ought to be carefully attended to. Fear,
anxiety, and a fretful temper, both occasion and aggravate diseases.
In vain do we apply medicines to the body to remove maladies
which proceed from the mind. When it is affected, the best me—
dicine is to sooth the passions, to divert the mind from anxious
thought, and to keep the patient as easy and cheerful as possible.
Attention ought likewise to be paid to the climate, or place
where the patient lives, the air he breathes, his diet, &c. Such as
live in low marshy situations are subject to many diseases which
are unknown to the inhabitants of high countries. Those who
breathe the impure air of cities, have many maladies to which the
more happy rustics are entire strangers. Persons who feed grossly,
and indulge in strong liquors, are liable to diseases which do not
affect the temperate and abstemious, &c.
It has already been observed, that the different occupations and
situations in life dispose men to peculiar diseases. It is therefore
necessary to enquire into the patient's occupation, manner of life,
&c. This will not only assist us in finding out the disease, but will
likewise direct us in the treatment of it. It would be very impru—
dent to treat the laborious and the sedentary precisely in the same
manner, even supposing them to labour under the same disease.
It will be proper to enquire, whether the disease be constitution—
al or accidental; whether it has been of long or short duration ;
whether it proceeds from any great and sudden alteration in the
diet, manner of life, &c. The state of the patient's body, and of
the other evacuations, ought also to be enquired into; and whether
he can with ease perform all the vital and animal functions, as
breathing, digestion, &c.
Lastly, it will be proper to enquire what diseases the patient has
formerly been liable to, and what medicines were most beneficial
to him; if he has a strong aversion to any particular drug, &c.
As many of the indications of cure may be answered by diet
alone, it is always the first thing to be attended to in the treatment
of diseases. Those who know no better, imagine that every thing
which goes by the name of a medicine possesses some wonderful
power or secret charm, and think, if the patient swallows enough
of drugs, that, he must do well. This mistake has many ill conse— 

107 AND CURE OF DISEASES. 
quences; it makes people trust to drugs, and neglect their own en—
deavours; besides, it discourages all attempts to relieve the sick
where medicines cannot be obtained.
Medicines are no doubt useful in their place, and, when admi—
ristered with prudence, they may do much good; but when they
are put in place of every thing else, or administered at random,
which is not seldom the case, they must do mischief. We therefore
wish to call the attention of mankind from the pursuit of secret
medicines, to such things as they are acquainted with. The proper
regulation of these may often do much good, and there is little
danger of their ever doing hurt.
Every disease weakens the digestive powers. The diet ought,
therefore, in all diseases, to be light and of easy digestion. It would
be as prudent for a person with a broken leg to attempt to walk,
as for one in a fever to eat the same kind of food, and in the same
quantity, as when he was in perfect health. Even abstinence alone
will often cure a fever, especially when it has been occasioned by
excess in eating or drinking.
In all fevers attended with inflammation, as pleurisies; peripneu—
monics, &c. thin gruels, wheys, watery infusions of mucilaginous
plants, roots, &c. are not only proper for the patient's food, but
they are likewise the best medicines which can be administered.
In fevers of a slow, nervous, or putrid kind, where there are no
symptoms of inflammation, and where the patient must be sup—
ported with cordials, that intention can always be more effectually
answered by nourishing diet and generous wines, than by any me—
dicines yet known.
Nor is a proper attention to diet of less importance in chronic
than in acute diseases. Persons afflicted with low spirits, wind,
weak nerves, and other hypochondriacal affections, generally find
more benefit from the use of solid food and generous liquors, than
from all the cordial and carminative medicines which can be ad—
mistered to them. The scurvy will sooner yield to a proper vege—
table diet, than to all the antiscorbutic remedies of the shops.
In consumptions, when the stomach is so much weakened as to
be unable to digest, the solid fibres of animals, or even to assimilate
the juices of vegetables, a diet consisting chiefly of milk will not only
support the patient; but will often cure the disease after every other
medicine has failed. 
Nor is an attention to other things of less importance than to
diet. The strange infatuation which has long induced people to
shut up the sick from all communication with the external air, has
done great mischief. Not only in fevers but in many other diseases,
the patient will receive more benefit from having the fresh air,
prudently admitted into his chamber, than from all the medicines
which can be given him. 
Exercise may likewise in many cases be considered as a medicine.
Sailing, or riding on horseback, for example, will be of more ser— 

108 OF FEVERS IN GENERAL.
vice in the cure of consumptions, glandular obstructions, &c. than
any medicine yet known. In diseases which proceed from a relaxed
state of the solids, the cold bath, and other parts of the gymnastic
regimen, will be found equally beneficial.
Few things are of greater importance in the cure of diseases
than cleanliness. When a patient is suffered to lie in dirty clothes,
whatever perspires from his body is again resorbed, or taken up
into it, which serves to nourish the disease and increase the danger.
Many diseases may be cured by cleanliness alone; most of them
may be mitigated by it, and in all of them it is highly necessary
both for the patient and those who attend him.
Many other observations, were it necessary, might be adduced
to prove the importance of a proper regimen in diseases. Regimen
will often cure diseases without medicine, but medicine will seldom
succeed where a proper regimen is neglected. For this reason, in the
treatment of diseases, we have always given the first place to regi—
men. Those who are ignorant of medicine may confine themselves
to it only. For others, who have more knowledge, we have recom—
mended some of the most simple but approved forms of medicine
in every disease. These, however, are never to be administered but
by people of better understanding; nor even by them without the
greatest precaution.
CHAPTER XIII.
Of Fevers in General.
MORE than one half of mankind are said to perish by fevers.
Their most general causes are infection, errors in diet, un—
wholesome air, violent emotions of the mind, excess or suppression of usual
evacuations, external or internal injuries, and extreme degrees of heat or
cold. As most of these have already been treated of at considerable
length, and their effects shown, we shall not now resume the con—
sideration of them, but only recommend it to all, as they would
wish to avoid fevers and other fatal diseases, to pay the most punc—
tual attention to these articles.
Fevers are not only the most frequent of all diseases, but they are
likewise the most complex. In the most simple species of fever
there is always a combination of several different symptoms. The
distinguishing symptoms of fevers are, increased heat, frequency of
pulse, loss of appetite, general debility, pain in the head, and a difficulty
in performing some of the vital or animal functions. The other symp—
toms, usually attendant on fevers are, nausea, thirst, anxiety, de—
lirium, weariness, wasting of the flesh, want of sleep, or the sleep
disturbed and not refreshing.
When the fever comes on gradually, the patient generally com— 

109 OF FEVERS IN GENERAL.
plains first of langour or listlessness, soreness of the flesh or the bones,
heaviness of the head, loss of appetite, sickness, with clamminess
of the mouth; after some time come on excessive heat, violent
thirst, restlessness, &c.
When the fever attacks suddenly, it always begins with an un—
easy sensation of excessive cold, accompanied with debility and
loss of appetite; frequently the cold is attended with shivering,
oppression about the heart, and sickness at stomach, or vomiting.
Fevers are divided into continual, remitting, intermitting, and
such as are attended with cutaneous eruption or topical inflam—
mation, as the small—pox, erysipelas, &c. By a continual fever is
meant that which never leaves the patient during the whole course
of the disease, or which shows no remarkable increase or abate—
ment of the symptoms. This kind of fever is likewise divided into
acute, slow, and malignant. The fever is called acute when its pro—
gress is quick, and the symptoms violent; but when these are
more gentle, it is generally denominated slow. When with livid
or petechial spots, the fever is called malignant, putrid, or petechial.
A remitting fever differs from a continual only in degree. It
has frequent increases and decreases, or exacerbations and remis—
sions, but never wholly leaves the patient during the course of the
disease. Intermitting fevers or agues are those, which, during the
time that the patient may be said to be ill, have evident intervals
or remissions of the symptoms.
As a fever is only an effort of Nature to free herself from an
offending cause, it is the business of those who have the care of
the sick, to observe with diligence which way Nature points, and
to endeavour to assist her operations. Our bodies are so framed,
as to have a constant tendency to expel or throw off whatever is
injurious to health. This is generally done by urine, sweat, stool,
expectoration, vomit, or some other evacuation.
There is reason to believe, that if the efforts of Nature, at the
beginning of a fever, were duly attended to and promoted, it would
seldom continue long; but when her attempts are either neglect—
ed or counteracted, it is no wonder if the disease proves fatal.
There are daily instances of persons, who after catching cold, have
all the symptoms of a beginning fever; but by keeping warm,
drinking diluting liquors, bathing their feet in warm water, &c.
the symptoms in a few hours disappear, and the danger is prevent—
ed. When fevers of a putrid kind threaten, the best method of ob—
viating their effects is by repeated vomits.
Our design is to mark the most obvious symptoms in fevers, and
to point out the proper treatment of the patient with respect to his
diet, drink, air, &c. in the different stages of the disease. In these
articles, the inclinations of the patient will, in a great measure,
direct our conduct.
Almost every person in a fever complains of great thirst, and
calls out for drink, especially of a cooling nature. This at once

110 OF FEVERS IN GENERAL.
points out the use of water, and other cooling liquors. What is
so likely to abate the heat, remove spasms and obstructions pro—
mote perspiration, increase 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 li—
quors is pointed out by the dry tongue, the parched skin, and the
burning heat, as well as by the unquenchable thirst of the patient.
Many cooling liquors, which are extremely grateful to patients
in a fever, may be prepared from fruits; as decoctions of tama—
rinds, apple—tea, orange—whey, and the like Mucilaginous liquors
might also be prepared from marshmallow—roots, linseed, lime—
tree buds, and other mild vegetables. These liquors, especially
when acidulated, are highly agreeable to the patient, and should
never be denied him.
At the beginning of a fever, the patient generally complains of
great lassitude or weariness, and has no inclination to move. This
evidently shows the propriety of keeping him 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 all
her force to overcome the disease. The bed alone would often
remove a fever at the beginning; but when the patient struggles
with the disease, instead of driving it off, he only fixes it the dee—
per, and renders it more dangerous. This observation is too often
verified in travellers, who happen, when on a journey, to be seized
with a fever. Their anxiety to get home induces them to travel
with the fever upon them, which conduct seldom fails to render it
fatal.
In fevers, the mind as well as the body should be kept easy.
Company is seldom agreeable to the sick. Every thing that disturbs
the imagination increases the disease; for which reason, every per—
son in a fever ought to be kept perfectly quiet, and neither allow—
ed to see nor hear any thing that may in the least affect or discom—
pose his mind.
Though the patient in a fever has the greatest inclination for
drink, yet he seldom has any appetite for solid food; hence, the
impropriety of urging him to take victuals, is evident. Much solid
food in a fever is every way hurtful: It oppresses Nature, and in—
stead of nourishing the patient, serves only to feed the disease.
What food the patient takes should be in small quantity, light, and
of easy digestion. It ought to be chiefly of the vegetable kind, as
panada, roasted apples, gruels, and such like.
Poor people, when any of their family are taken ill, run directly
to their rich neighbours for cordials, and pour wine, spirits, &c.
into the patient, who, perhaps, never had been accustomed to taste 
such liquors when in health. If there be any degree of fever,
this conduct must increase it, and if there be none, this is the rea—
dy way to raise one. Stuffing the patient with sweet—meats and 

111 OF FEVERS IN GENERAL.
other delicacies, is likewise very pernicious. These are always
harder to digest than common food, and hurt the stomach.
Nothing is more desired by a patient in a fever,than fresh air.
It not only removes his anxiety, but cools the blood, revives the
spirits, and proves every way beneficial. Many patients are in a
manner stifled to death in fevers for want of fresh air; yet such
is the unaccountable infatuation of most people, that the moment
they think a person in a fever, they imagine he should be kept in a
close chamber, into which not one particle of fresh air must be ad—
mitted. Instead of this, there ought to be a constant stream of fresh
air into a sick person's chamber, so as to keep it moderately cool.
Indeed, its degree of warmth ought never to be greater than is
agreeable to one in perfect health.
Nothing spoils the air of a sick person's chamber, or hurts the pa—
tient more, than a number of people breathing in it. When the
blood is inflamed, air that has been breathed repeatedly will great—
ly increase the disease. Such air not only loses its spring, and be—
comes unfit for the purpose of respiration, but acquires a noxious
quality, which renders it in a manner poisonous to the sick.
In fevers, when the patient's spirits are low and depressed, he is
not only to be supported with cordials, but every method should
be taken to cheer and comfort his mind. Many, from a mistaken
zeal, when they think a person in danger, instead of solacing his
mind with the hopes and consolations of religion, fright him with
the views of hell and damnation. It would be unsuitable here to
dwell upon the impropriety and dangerous consequences of this
conduct.
Among common people, the very name of a fever generally sug—
gests the necessity of bleeding. This notion seems to have taken its
rise from most fevers in this country having been formerly of an
inflammatory nature; but true inflammatory fevers are now seldom
to be met with. Sedentary occupations, and a different manner of
living, have so changed the state of diseases in Britain, that there is
now hardly one fever in ten where the lancet is necessary. In low,
nervous fevers, which are now so common, bleeding is really hurt—
ful, as it weakens the patient, sinks his spirits, &c. We would re—
commend this general rule, never to bleed at the beginning of a
fever, unless there be evident signs of inflammation. Bleeding is
an excellent medicine when necessary, but should never be wan—
tonly performed.
It is likewise a common notion, that sweating is always necessary
in the beginning of a fever. When the fever proceeds from an ob—
structed perspiration, this notion is not ill—founded. If the patient
only lies in bed, bathes his feet and legs in warm water, and drinks
freely of water—gruel, or any other weak diluting liquor, he will
seldom fail to perspire freely. The warmth of the bed, and the
diluting drink, will relax the universal spasm, which generally af—
fects the skin at the beginning of a fever; it will open the pores, 

112 OF INTERMITTING FEVERS,
and promote the perspiration, by means of which the fever may
often be carried off. But instead of this, the common practice is
to heap clothes upon the patient, and to give him things of a hot
nature, as spirits, spiceries, &c. which increase the spasms, and
render the disease more dangerous.
In all fevers, a proper attention should be paid to the patient's
longings. These are the calls of Nature, and often point out what
may be of real use. Patients are not indeed to be indulged in every
thing that the sickly appetite may crave; but it is generally right
to let them have a little of what they eagerly desire, though it may
not seem altogether proper. What the patient longs for, his sto—
mach will generally digest; and such things have sometimes a very
happy effect.
When a patient is recovering from a fever, great care is neces—
sary to prevent a relapse. Many persons, by too soon imagining
themselves well, have lost their lives, or contracted other disease
of an obstinate nature. As the body after a fever is weak and de—
licate, it is necessary to guard against catching cold. Moderate
exercise in the open air will be of use, but great fatigue is by all
means to be avoided; agreeable company will also have a good
effect. The diet must be light, but nourishing. It should be taken
frequently, but in small quantities. It is dangerous at such a time
to eat as much as the stomach may crave.
CHAPTER XIV.
Of Intermitting Fevers, or Agues.
INTERMITTING fevers afford the best opportunity both of
observing the nature of a fever, and also the effects of medicine.
No person can be at a loss to distinguish an intermitting fever
from any other, and the proper medicine for it is now almost uni—
versally known.
The several kinds of intermitting fevers take their names from
the period in which the fit returns, as quotidian, tertian, quar—
tan, &c.
CAUSES.—Agues are occasioned by effluvia from putrid
stagnating water. This is evident from their abounding in rainy
seasons, and being most frequent in countries where the soil is
marshy. This disease may also be occasioned by eating too much
stone fruit, by a poor watery diet, damp houses, evening dews, ly—
ing upon the damp ground, watching, fatigue, depressing passions,
and the like. When the inhabitants of a high country remove to
a low one, they are generally seized with intermitting fevers, and
to such the disease is most apt to prove fatal. In a word, whatever
relaxes the solids, diminishes the perspiration, or obstructs the 

113 OF INTERMITTING FEVERS. 
circulation in the capillary or small vessels, disposes the body to
agues.
SYMPTOMS.—An intermitting fever generally begins with
a 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.
Afterwards the skin becomes moist, and a profuse sweat breaks
out which generally terminates the fit or paroxysm. Sometimes
the disease comes on suddenly, when the person thinks himself in
perfect health; but it is more commonly preceded by listlessness,
loss of appetite, and the symptoms mentioned above.
REGIMEN.—While the fit continues, the patient ought to
drink freely of water—gruel, orange—whey, weak camomile tea; or,
if his spirits be low, small wine—whey, sharpened with the juice of
lemon. All his drink should be warm, as that will assist in bringing
on the sweat, and consequently shorten the paroxysm*.
Between the paroxysms the patient must be supported with food
that is nourishing, but light and easy of digestion, as veal or chick—
en broths, sago, gruel with a little wine, light puddings, and such—
like. His drink may be small negus, acidulated with the juice of
lemons or oranges, and sometimes a little weak punch. He may
likewise drink infusions of bitter herbs, as camomile, wormwood,
or water—trefoil, and may now—and—then take a glass of small wine,
in which gentian root, centaury, or some other bitter, has been in—
fused.
As the chief intentions of cure in an ague are to brace the solids,
and promote perspiration, the patient ought to take as much exer—
cise between the fits as he can bear. If he is able to go abroad, rid—
ing on horseback, or in a carriage, will be of great service. But if
he cannot bear that kind of exercise, he ought to take such as his
strength will permit. Nothing tends more to prolong an intermit—
ting fever, than indulging a lazy, indolent disposition.
Intermitting fevers, under a proper regimen, will often go off
without medicine; and when the disease is mild, in an open dry
country, there is seldom any danger from allowing it to take its
course; but when the patient's strength seems to decline, or the
paroxysms are so violent that his life is in danger, medicine ought
immediately to be administered. This, however, should never be
done till the disease be properly formed, that is to say, till the pa—
tient has had several fits of shaking and sweating.
MEDICINE—The first thing to be done in the cure of an
intermitting fever, is to cleanse the stomach and bowels. This ren—
ders the application of other medicines more safe and efficacious.
*Dr. Lind says, that twenty or twenty—five drops of laudanum put
into a cup of the patient's drink, and given about half an hour after the
commencement of the hot fit, promotes the sweat. shortens the fit, re—
lieves the head, and tends greatly to remove the disease.
P

114 OF INTERMITTING FEVERS.
In this disease, the stomach is generally loaded with cold viscid
phlegm, and frequently great quantities of bile are discharged by
vomit; which points out the necessity of such evacuations. Vomits
are therefore to be administered before the patient takes any other
medicine. A dose of ipecacuanha will generally answer this pur—
pose very well. A scruple or half a dram of the powder will be
sufficient from an adult, and for a younger person the dose must be
less in proportion. After the vomit begins to operate, the patient
ought to drink plentifully of weak camomile—tea. The vomit should
be taken two or three hours before the return of the fit, and may
be repeated at the distance of two or three days. Vomits not only
cleanse the stomach, but increase the perspiration and all the other
secretions, which render them of such importance, that they of—
ten cure intermitting fevers without the assistance of any other me—
dicine.
Purging medicines are useful and often necessary in intermitting
fevers. A smart purge has cured an obstinate ague, after the bark and
other medicines had been used in vain. Vomits are more suitable
in this disease, and render purging less necessary; but if the pa—
tient be afraid to take a vomit, he ought to cleanse the bowels by
a dose or two of Glauber's salt or jalap.
Bleeding may sometimes be proper at the beginning of an inter—
mitting fever, when excessive heat, a delirium, &c. give reason to
suspect an inflammation; but as the blood is seldom in an inflam—
matory state in intermitting fevers, this operation is rarely necessary.
When frequently repeated, it tends to prolong the disease.
After proper evacuations, the patient may safely use the Peruvian
bark, which may be taken in any way that is most agreeable to
him. No preparation of the bark seems to answer better than the
most simple form in which it can be given, viz. in powder.
Two ounces of the best bark, finely powdered, may be divided into
twenty—four doses. These may either be made into bolusses as they
are used, with a little syrup of lemon, or mixed in a glass of red
wine, a cup of camomile—tea, water—gruel, or any other drink that
is more agreeable to the patient*.
In an ague which returns every day, one of the above doses
may be taken every two hours, or oftener during the interval of the
fits. By this method, the patient will be able to take five or six doses
between each paroxysm. In a tertian or third—day ague, it will be
sufficient to take a dose every third hour during the interval, and
in a quartan every fourth. If the patient cannot take so large a
dose of the bark, he may divide each of the powders into two
parts, and take one every hour, &c. For a young person, a smaller
* It has lately been observed, that the red bark is more powerful than
that which has for some time been in common use. Its superior efficacy
seems to arise from its being of a more perfect growth than the quill bark,
and consequently more fully impregnated with the medical properties
of the plant.

115 OF INTERMITTING FEVERS.
quantity of this medicine will be sufficient, and the dose must be
adapted to the age, constitution, and violence of the symptoms*.
The above quantity of bark will frequently cure an ague; the
patient, however, ought not to leave off taking the medicine as soon
as the paroxysms are stopped, but should continue to use it till there
is reason to believe the disease entirely overcome. Most failures in
the cure are owing to patients not continuing to use the medicine
long enough. They are generally directed to take it till the fits are
stopped, then to leave it off, and begin again at some distance of
time; by which means the disease gathers strength, and often re—
turns with as much violence as before. A relapse may be prevented
by the patient's continuing to take small doses of the medicine for
some time after the symptoms disappear. This is the most safe me—
thod of cure.
An ounce of gentian root, calamus aromaticus, and orange—peel,
of each half an ounce, with three or four handfuls of camomile—
flowers, and an handful of coriander—seed, all bruised together in a
mortar, may be used in form or infusion of tea. About half an
handful of these ingredients may be put into a tea—pot, and an
English pint of boiling water poured on them. A cup of this infu—
sion, drank three or four times a day, will greatly promote the cure.
Such patients as cannot drink the watery infusion, may put two
handfuls of the same ingredients into a bottle of white wine, and
take a glass of it twice or thrice a day. If patients drink freely of
the above, or any other proper infusion of bitters, a smaller quan—
tity of bark than is generally used, will be sufficient to cure an
ague†.
Those who cannot swallow the bark in substance, may take it
in decoction or infusion. An ounce of bark in powder may be in—
fused in a bottle of white wine for four or five days, frequently
shaking the bottle, afterwards let the powder subside, and pour off
the clear liquor. A wine—glassful may be drank three or four
* In intermitting fevers of an obstinate nature, I have found it ne—
cessary to throw in the bark much faster. The benefits arising from this
medicine, depend chiefly upon a large quantity of it being administered in
a short time. Several ounces of bark given in a few days will do more
than as many pounds taken in the course of some weeks. When this
medicine is intended either to stop a mortification, or cure an obstinate
ague, it ought to be thrown in as fast as the stomach can possibly bear it.
Inattention to this circumstance has hurt the reputation of one of the best
medicines of which we are in possession. 
† There is reason to believe, that sundry of our own plants or barks,
which are very bitter and astringent, would succeed in the cure of in—
termitting fevers, especially when assisted by aromatics. But as Peruvian
bark has been long approved in the cure of this disease, and is now to
be obtained at a very reasonable rate, it is of less importance to search
after new medicines. We cannot however omit taking notice, that Peru—
vian bark is very often adulterated, and that it requires considerable skill
to distinguish between the genuine and the false. This ought to make
people very cautious of whom they purchase it. 

116 OF INTERMITTING FEVERS.
times a day, or oftener, as there is occasion. If a decoction be
more agreeable, an ounce of the bark, and two drams of snake—
root bruised, with an equal quantity of salt of wormwood, may be
boiled in a quart of water, into an English pint. To the strained
liquor may be added an equal quantity of red wine, and a glass of
it taken frequently.
In obstinate agues, the bark will be found much more effica—
cious when assisted by brandy, or other warm cordials, than taken
alone. This I have had frequently occasion to observe in a coun—
try where intermitting fevers were endemical. The bark seldom
succeeds unless assisted by snake—root, ginger, canella alba, or some
other warm aromatic. When the fits are very frequent and violent,
in which case the fever often approaches towards an inflamma—
tory nature, it will be safer to keep out the aromatics, and to add
salt of tartar in their stead. But in an obstinate tertian or quartan,
in the end of autumn or beginning of winter, warm and cordial
medicines are absolutely necessary*.
As autumnal and winter agues generally prove much more ob—
stinate than those which attack the patient in spring or summer,
it will be necessary to continue the use of medicines longer in the
former than in the latter. A person who is seized with an inter—
mitting fever in the beginning of winter, ought frequently, if the
season proves rainy, to take a little medicine, although the disease
may seem to be cured, to prevent a relapse, till the return of the
warm season. He ought likewise to take care not to be much
abroad in wet weather, especially in cold easterly winds.
When agues are not properly cured, they often degenerate into
obstinate chronical diseases, as the dropsy, jaundice, &c. For this
reason, all possible care should be taken to have them radically
cured, before the constitution has been too much weakened.
Though nothing is more rational than the method of treating
intermitting fevers, yet, by some strange infatuation, more charms
and whimsical remedies are daily used for removing this than any
other disease. There is hardly an old woman who is not in posses—
sion of a nostrum for stopping an ague: and it is amazing with
what readiness their pretensions are believed. Those in distress
eagerly grasp at any thing that promises sudden relief; but the
shortest way is not always the best in the treatment of diseases.
The only method to obtain a safe and lasting cure, is gradually to
assist Nature in removing the cause of the disorder.
Some, indeed, try bold, or, rather, fool—hardy experiments to
* In obstinate agues, when the patient is old, the habit phlegmatic;
the season rainy, the situation damp, or the like, is will be necessary to
mix with two ounces of the bark, half an ounce of Virginian snake—
root, and a quarter of an ounce of ginger, or some other warm aromatic;
but when the symptoms are of an inflammatory nature, half an ounce
of salt of wormwood, or salt of tartar, may be added to the above quan—
tity of bark. 

117 OF INTERMITTING FEVERS.
cure agues, as drinking great quantities of strong liquors, jumping
into a river, &c*. These may sometimes have the desired effect,
but must always be attended with danger. When there is any de—
gree of inflammation, or the least tendency to it, such experiments
may prove fatal. The only patient whom I remember to have lost,
in an intermitting fever, evidently killed himself by drinking strong
liquor, which some person had persuaded him would prove an in—
fallible remedy.
Many dirty things are extolled for the cure of intermitting fe—
vers, as spiders, cobwebs, snuffings of candles, &c. Though these
may sometimes succeed, yet their very nastiness is sufficient to set
them aside, especially when cleanly medicines will answer the pur—
pose better. The only medicine that can be depended upon, for
thoroughly curing an intermitting fever, is the Peruvian bark. It
may always be used with safety; and I can honestly declare, that
in all my practice, I never knew it fail, when combined with the
medicines mentioned above, and duly persisted in.
Where agues are endemical, even children are often afflicted
with that disease. Such patients are very difficult to cure, as they
can seldom be prevailed upon to take the bark, or any other disa—
greeable medicine†. One method of rendering this medicine more
palatable, is to make it into a mixture with distilled waters and sy
rup, and afterwards to give it an agreeable sharpness with the elix—
ir or spirit of vitriol. This both improves the medicine, and takes
off the nauseous taste. In cases where the bark cannot be admini—
stered, the saline mixture may be given with advantage to children‡.
Wine—whey is a very proper drink for a child in an ague; to half
an English pint of which, may be put a tea—spoonful of the spirit of
hartshorn. Exercise is likewise of considerable service; and when
the disease proves obstinate, the child ought, if possible, to be remo—
ved to a warm, dry air. The food ought to be nourishing, and
sometimes a little generous wine should be allowed.
To children, and such as cannot swallow the bark, or when the
stomach will not bear it, it may be given by clyster. Half an ounce
of the extract of bark, dissolved in four ounces of warm—water,
with the addition of half an ounce of sweet—oil, and six or eight
drops of laudanum, is the form recommended by Dr. Lind for an
adult, and this to be repeated every fourth hour, or oftener, as the
occasion shall require. For children, the quantity of extract and
* Arsnic is among the number of these bold, injudicious remedies;
and ought never to be used in any case of intermitting fever what—
ever. (I.C.)
† When children cannot take the medicine recommended, they may
be frequently cured by giving ten or fifteen drops of laudanum, accor—
ding to the age of the patient, about half an hour before the cold stage
commences. (I.C.)
‡ See Appendix, Saline mixture. 

118 OF AN ACUTE CONTINUAL FEVER.
laudanum must be proportionally lessened. Children have been
cured of agues by making them wear a waistcoat with powdered bark
quilted between the folds of it; by bathing them frequently in a
strong decoction of the bark, and by rubbing the spine with strong
spirits, for with a mixture of equal parts of laudanum, and the sa—
ponaceous liniment.
This disease is very common, and few patients in an ague apply
to physicians unless in extremities. There are many cases in which
the disease is very irregular, being complicated with other diseas—
es, or attended with symptoms which are both very dangerous and
very difficult to understand. All these we have purposely passed
over, as they would only bewilder the generality of readers. When
the disease is very irregular, or the symptoms dangerous, the pa—
tient ought immediately to apply to a physician, and strictly to fol—
low his advice.
To prevent agues, people must endeavour to avoid their causes.
These have been already pointed out in the beginning of this sec—
tion; we shall therefore only add one preventive medicine, which
may be of use to such as are obliged to live in low marshy coun—
tries, or who are liable to frequent attacks of this disease.
Take an ounce of the best Peruvian bark; Virginia snake—root,
and orange—peel, of each half an ounce; bruise them all together,
and infuse for five or six days in a bottle of brandy, Holland—gin, or
any good spirit; afterwards pour off the clear liquor, and take a
wine glass of it twice or thrice a—day. This is recommending a
dram; but the bitter ingredients in a great measure take off the
ill effects of the spirit. These who do not choose it in brandy, may
infuse it in wine; and such as can bring themselves to chew the
bark, will find that method succeed very well. Gentian root, or
calamus aromaticus may also be chewed by turns for the same pur—
pose. All bitters seem to be antidotes to agues especially those that
are warm and astringent.
CHAPTER XV.
Of an Acute Continual Fever.
THIS fever is termed acute, ardent, or inflammatory. It most
commonly attacks the young, or persons about the prime or
vigour of life, especially such as live high, abound with blood, and
whose fibres are strong and elastic. It seizes people at all seasons
of the year; but is most frequent in the spring and beginning of
summer.
CAUSES.—An ardent fever may be occasioned by any thing
that overheats the body, or produces plethora, as violent exercise,
sleeping in the sun, drinking strong liquors, eating spiceries, a full
diet, with little exercise, &c. It may likewise be occasioned by 

119 OF AN ACUTE CONTINUAL FEVER. 
whatever obstructs the perspiration, as lying on the damp ground,
drinking cold liquor when the body is hot, night watching, or the
like.
SYMPTOMS.—A rigour or chiliness generally ushers in
this fever, which is soon succeeded by great heat, a frequent and
full pulse, pain of the head, dry skin, redness of the eyes, a florid
countenance, pains in the back, loins, &c. To these succeed dis—
ficulty of breathing, sickness, with an inclination to vomit. The
patient complains of great thirst, has no appetite for solid food, is
restless, and his tongue generally appears black and rough.
A delirium, excessive restlessness, great oppression of the breast,
with laborious respiration, starting of the tendons, hickough, cold
clammy sweats, and an involuntary discharge of urine, are very
dangerous symptoms.
As this disease is always attended with danger, the best medi—
cal assistance ought to be procured as soon as possible. A physician
may be of use at the beginning, but his skill is often of no avail
afterwards. Nothing can be more unaccountable than the conduct
of those who have it in their power, at the beginning of a fever,
to procure the best medical assistance, yet put it off till things
come to an extremity. When the disease, by delay or wrong treat—
ment, has become incurable, and has exhausted the strength of
the patient, it is in vain to hope for relief from medicine. Physi—
cians may indeed assist Nature; but their attempts must ever
prove fruitless, when she is no longer able to co—operate with their
endeavours.
REGIMEN.—From the symptoms of this disease, it is evi—
dent, that the blood and other humours require to be diluted;
that the perspiration, urine, saliva, and all the other secretions, are
in too small quantity; that the vessels are rigid, and the heat of
the whole body too great: all these clearly point out the necessity
of a regimen calculated to dilute the blood, allay the excessive
heat, remove the spasmodic stricture of the vessels, and promote
the secretions.
These important purposes may be greatly promoted by drinking
plentifully of diluting liquors; as water—gruel, or oatmeal—tea,
clear whey, barley—water, balm—tea, apple—tea, &c. These may be
sharpened with juice of orange, jelly of currants, raspberries, and
such—like: orange—whey is likewise an excellent cooling drink. It
is made by boiling among milk and water a bitter orange sliced,
till the curd separates. If no orange can be had, a lemon, a little
cream of tartar, or a few spoonfuls of vinegar, will have the same
effect. Two or three spoonfuls of white wine may be occasionally
added to the liquor when boiling.
If the patient be costive, an ounce of tamarinds, with two ounces
of stoned raisins of the sun, and a couple of figs, may be boiled in
three English pints of water to a quart. This makes a very plea—
sant drink, and may be used at discretion. The common pectoral 

120 OF AN ACUTE CONTINUAL FEVER.
decoction is likewise a very proper drink in this disease. A tea—
cupful of it may be taken every two hours, or oftener, if the pa—
tient's heat and thirst be very great*.
The above liquids, must all be drank a little warm. They may
be used in smaller quantities at the beginning of a fever, but more
freely afterwards, in order to assist in carrying off the disease, by
promoting the different excretions. We have mentioned a variety
of drinks, that the patient may have it in his power to choose
those which are most agreeable; and that, when tired of one, he
may have recourse to another. 
The patient's diet must be very spare and light. All sorts of
flesh—meats, and even chicken—broths, are to be avoided. He may
be allowed groat—gruel, panado, or light—bread boiled in water; to
which may be added a few grains of common salt, and a little
sugar, which will render it more palatable. He may eat roasted
apples with a little sugar, toasted bread with jelly of currants,
boiled prunes, &c.
It will greatly relieve the patient, especially in an hot season,
to have fresh air frequently let into his chamber. This must al—
ways be done in such a manner as not to endanger his catching
cold.
It is too common in fevers to load the patient with bed—clothes,
under the pretence of making him sweat, or defending him from
the cold. This custom has many ill effects. It increases the heat
of the body, fatigues the patient, and retards, instead of promoting,
the perspiration.
Sitting up—right in bed, if the patient is able to bear it, will of—
ten have a good effect. It relieves the head, by retarding the mo—
tion of the blood to the brain. But this posture ought never to be
continued too long: and if the patient is inclined to sweat, it will
be more safe to let him lie, only raising his head a little with pil—
lows.
Sprinkling the chamber with vinegar, juice of lemon, or vinegar
and rose—water, with a little nitre dissolved in it, will greatly re—
fresh the patient. This ought to be done frequently, especially if
the weather is hot.
The patient's mouth should be often washed with a mixture of
water and honey, to which a little vinegar may be added; or with
a decoction of figs in barley—water. His feet and hands ought fre—
quently to be bathed in lukewarm water; especially if the head is
affected.
The patient should be kept as quiet and easy as possible. Com—
pany, noise, and every thing that disturbs the mind, is hurtful.
Even too much light, or any thing that affects the senses, ought to be
avoided. His attendants should be as few as possible, and they
ought not to be too often changed. His inclinations should rather
* See Appendix, Pectoral Decoction. 

121 OF AN ACUTE CONTINUAL FEVER. 
be soothed than contradicted; even the promise of: what he craves
will often satisfy him as much as its reality.
MEDICINE.—In all this and other fevers, attended with a
hard, full, quick pulse, bleeding is of the greatest importance.
This operation ought always to be performed as soon as the symp—
toms of an inflammatory fever appear. The quantity of blood to
be taken away, however, must be in proportion to the strength of
the patient and the violence of the disease. If, after the first bleed—
ing, the fever should rise, and the pulse become more frequent and
hard, there will be a necessity for repeating it a second, and per—
haps a third, or even a fourth time, which may be done at the dis—
tance of twelve, eighteen, or twenty—four hours from each other,
as the symptoms require*. If the heat and fever be very great, forty
or fifty drops of the dulcified or sweet spirit of nitre may be made
into a draught, with an ounce of rose—water, two ounces of com—
mon water, and half an ounce of simple syrup, or a bit of loaf—su—
gar. This draught may be given to the patient every three or four
hours while the fever is violent; afterwards once in five or six
hours will be sufficient.
If the patient be afflicted with reaching, or an inclination to
vomit, it will be right to assist Nature's attempts, by giving him
weak camomile—tea, or lukewarm water to drink.
If the body be bound, a clyster of milk and water, with a little
salt, and a spoonful of sweet—oil or fresh butter in it, ought daily to
be administered. Should this not have the desired effect, a tea—
spoonful of magnesia alba, or cream of tartar, may be frequently
put into his drink. He may likewise eat tamarinds, boiled prunes,
roasted apples, and the like.
If about the tenth, eleventh, or twelfth day, the pulse becomes
more soft, the tongue moister, and the urine begins to let fall a
reddish settlement, there is reason to expect a favourable issue to
the disease. But if, instead of these symptoms, the patient's spirits
grow languid, his pulse sinks, and his breathing becomes difficult,
with a stupor, trembling of the nerves, starting of the tendons, &c.
there is reason to fear that the consequences will be fatal. In this
case, blisters must be applied to the head, ancles, inside of the legs
or thighs, as there may be occasion; poultices of wheat—bred,
mustard, and vinegar, may likewise be applied to the soles of the
feet, and the patient must be supported with cordials, as strong
wine—whey, negus, sago—gruel with wine in it, and such like.
A proper regimen is not only necessary curing the fever, but
likewise after the patient begins to recover. By neglecting this,
many relapse, or fall into other diseases, and continue valetudinary
for life. Though the body is weak after a fever, yet the diet for
some time ought to be rather cleansing than of too nourishing a
* During the time bleedings are employed, brisk purging with glau—
ber salts should not be omitted. (I. C.)
Q 

122 OF THE PLEURISY.
nature. Too much food,drink, exercise, company, &c. are careful—
ly to be avoided. The mind ought to be kept easy, and the patient
should not pursue study, or any business that requires intense
thinking.
If the digestion is bad, or the patient seized at times with feverish
heats, an infusion of bark in cold water will be of use. It will
strengthen the stomach, and help to subdue the remains of the fever.
When the patient's strength is pretty well recovered, he ought
to take some gentle laxative. An ounce of tamarinds and a dram
of sena may be boiled for a few minutes in an English pint of wa—
ter, and an ounce of manna dissolved in the decoction; afterwards
it may be strained, and a tea—cupful drank every hour till it ope—
rates. This dose may be repeated twice or thrice, five or six days
intervening betwixt each dose.
Those who follow laborious employments ought not to return 
too soon to their labour after a fever, but should keep easy till their
strength and spirits are sufficiently recruited.
CHAPTER XVI.
Of the Pleurisy.
THE the pleurisy is an inflammation of that membrance cal—
led the pleura, which lines the inside of the breast. It is dis—
tinguished into the moist and dry. In the former, the patient spits 
freely; in the latter, little, or none at all. There is likewise a
species of this disease, which is called the spurious or bastard pleurisy, 
in which the pain is more external, and chiefly affects the muscles,
between the ribs. The pleurisy prevails among labouring people,
especially such as work without doors, and are of a sanguine con—
stitution. It is most frequent in the spring season.
CAUSES.—The pleurisy may be occasioned by whatever
obstructs the perspiration; as cold northerly winds; drinking cold
liquors when the body is hot; sleeping without—doors on the damp
ground; wet clothes; plunging the body into cold water, or ex—
posing it to the cold air, when covered with sweat, &c. It may
be occasioned by drinking strong liquors; by the stoppage of usual
evacuations; as old ulcers, issues, sweating of the feet or hands,
&c. the sudden striking in of any eruption, as the itch, the mea—
sles, or the small—pox. Those who have been accustomed to bleed 
at a certain season of the year, are apt, if they neglect it, to be
seized with a pleurisy. Keeping the body too warm by means of
fire, clothes, &c. renders it more liable to this disease. A pleurisy
may likewise be occasioned by violent exercise, as running, wrest—
ling, leaping, or by supporting great weight, blows on the breast,

123 OF THE PLEURISY.
&c. A bad comformation of the body renders persons more liable
to this disease, such as a narrow chest, &c.
SYMPTOMS.—This, like most other fevers, generally begins
with chilliness and shivering, which are followed by heat, thirst,
and restlessness. To these succeeds a violent pricking pain in one
of the sides among the ribs*. Sometimes the pain extends towards
the back—bone, sometimes towards the forepart of the breast, and at
other times towards the shoulder blades. The pain is generally
most violent when the patient draws in his breath.
The pulse in this disease is commonly quick and hard, the urine
high—coloured; and if blood be let, it is covered with a tough
crust, or buffy coat. The patient's spittle is at first thin, but after—
wards it becomes grosser, and is often streaked with blood.
REGIMEN.—Nature generally endeavours to carry off this
disease by a critical discharge of blood from some part of the body,
by expectoration, sweat, loose stools, thick urine, or the like. We
ought therefore to second her intentions by lessening the force of
the circulation; relaxing the vessels, diluting the humours, and
promoting expectoration.
For these purposes, the diet, as in the former disease, ought to be
cool, slender and diluting. The patient must avoid all food that is
viscid, hard of digestion, or that affords much nourishment; as
flesh, butter, cheese, eggs, milk, and every thing that is of a heat—
ing nature. His drink may be whey, or an infusion of pectoral and
balsamic vegetables†.
Barley—water; with a little honey or jelly of currants mixed with
it, is a very proper drink in this disease. It is made by boiling an
ounce of pearl—barley in three English pints of water to two,
which must afterwards be strained. The decoction of figs, raisins,
barley, recommended in the preceding disease, is here very, proper.
These and other diluting liquors are not to be drank in large quan—
tities at a time, but the patient ought to keep continually sipping
them, so as to render his mouth and throat always moist. All his
food, and drink should be taken a little warm.
The patient should be kept quiet, cool, and every way easy, as
directed under the foregoing disease. His feet and hands ought
daily to be bathed in lukewarm water; and he may sometimes sit
up in bed for a short space to relieve his head.
MEDICINE.—Almost every person knows, when a fever is
attended with a violent pain of the side, and a quiet hard pulse,
that bleeding is necessary. When these symptoms come on, the
sooner this operation is performed the better; and the quantity
at first must be pretty large if the patient is able to bear it. A large
quantity of blood let at once, in the beginning of a pleurisy, has
a much better effect than repeated small bleedings. A man may
* In some cases of pleurisy, the pricking pain in the side precedes the
chilliness and shivering. (I. C.)
† See Appendix, Pectoral infusion.

124 OF THE PLEURISY.
lose twelve or fourteen ounces of blood as soon as it is certainly
known that he is seized with a pleurisy. For a younger person, or
one of a delicate constitution, the quantity must be less.
If, after the first bleeding, the stitch, with the other violent
symptoms, should still continue, it will be necessary, at the distance
of twelve or eighteen hours, to let eight or nine ounces more. If
the symptoms do not then abate, and the blood shows a strong huffy
coat a third, or even a fourth bleeding may be requisite. If the
pain, of the side abate, the pulse becomes softer, or the patient
begins to spit freely, bleeding ought not to be repeated. This opera—
tion is seldom necessary after the third or fourth day of the fever,
and ought not then to be performed, unless in the most urgent cir—
cumstances.
Topical bleeding has often a very good effect in this disease. It
may be performed by applying a number of leeches to the part
affected, or by cupping, which is a more certain and expeditious
method.
If the stitch continues after repeated bleedings, a blister must
be applied over the part affected. This not duly procures a dis—
charge from the side, but takes off the spasm, and by that means
assists in removing the cause of the disease. To prevent a strangury
when the blister is on, the patient may drink freely of the Arabic
emulsion * or flax—seed tea.
If the patient is costive, a clyster of thin water—gruel, or of barley—
water, in which a handful of mallows, or any other emollient ve—
getable has been boiled, may be daily administered. This will not
only empty the bowels, but have the effect of a warm fomentation
applied to the inferior viscera, which will help to make a deriva—
tion from the breast.
The expectoration or spitting may be promoted by sharp, oily,
and mucilaginous medicines. For this purpose, an ounce of the
oxymel, or the vinegar of squills, may be added to six ounces of
the pectoral decoction, and two table—spoonfuls of it taken every
two hours.
Should the squill disagree with the stomach, the oily emulsion
may be administered†; or, in place of it, two ounces of the oil of
sweet—almonds, or oil of olives, and two ounces of the syrup of
violets may be mixed with as much sugar—candy powdered, as will
make an electuary of the consistence of honey. The patient may
take a tea—spoonful of this frequently, when the cough is trouble—
some. Should oily medicines prove nauseous, which is sometimes
the case, two table—spoonfuls of the solution of gum—ammoniac in
barley—water may be given three or four times a—day§.
If the patient does not perspire, but has a burning heat upon
his skin, and passes very little water, some small doses of purified
* See Appendix, Arabic Emulsion.
† See Appendix, Oily Emulsion.
§ See Appendix, Solution of Gum—Ammoniac. 

125 OF THE PLEURISY. 
nitre and camphire will be of use. Two drams of the former
may be rubbed with five or six grains of the latter in a mortar,
and the whole divided into six doses, one of which may be taken
every five or six hours, in a little of the patient's ordinary drink.
There is one medicine which some reckon almost a specific in 
the pleurisy, viz. the decoction of the Seneka rattle—snake root*.
After bleeding and other evacuations have been premised, the pa—
tient may take two, three, or four table—spoonfuls of this decoc—
tion, according as his stomach will bear it, three or four times a—
day. It it should occasion vomiting, two or three ounces of simple
cinnamon-water may be mixed with the quantity of decoction here
directed, or it may be taken in smaller doses. As this medicine 
promotes perspiration and urine, and likewise keeps the body easy,
it may be of some service in a pleurisy, or any other inflammation
of the breast.
No one will imagine that these medicines are all to be used at
the same time. We have mentioned different things, on purpose
that people may have it in their power to choose; and likewise,
that when one cannot be obtained, they may make use of another.
Different medicines are no doubt necessary in the different periods
of a disorder; and where one fails of success, or disagrees with
the patient, it will be proper to try another.
What is called the crisis, or height of the fever, is sometimes at—
tended with very alarming symptoms; as difficulty of breathing,
an irregular pulse, convulsive motions, &c. These are apt to
frighten the attendants, and induce them to do improper things,
as bleeding the patient, giving him strong stimulating medicines,
or the like. But they are only the struggles of Nature to overcome
the disease, in which she ought to be assisted by plenty of diluting
drink, which is then peculiarly necessary. If the patient's strength, 
however, be much exhausted by the disease, it will be necessary at
this time to support him with frequent small draughts of wine-
whey, negus, or the like.
When the pain and fever are gone, it will be proper, after the
patient has recovered sufficient strength, to give him some gentle
purges, as those directed towards the end of the acute continual
fever. He ought likewise to use a light diet, of easy digestion, and
his drink should be butter—milk, whey, and other things of a cleans—
ing nature.
The Bastard or Spurious Pleurisy
GENERALLY goes off by keeping warm for a few days,
drinking plenty of diluting liquors, and observing a cooling re—
gimen. It is known by a dry cough, a quick pulse, and a difficulty
* See Appendix, Decoction of seneka root. 

126 OF A PERIPNEUMONY.
of lying on the affected side, which last does not always happen
in the true pleurisy. Sometimes indeed this disease proves obsti—
nate, and requires bleeding, with cupping, and scarifications of
the part affected. These, together with the use of nitrous and
other cooling medicines, seldom fail to effect a cure.
The Paraphrenitis,
OR inflammation of the diaphragm, is so nearly connected with
the pleurisy, and resembles it so much in the manner of treatment,
that it is scarce necessary to consider it as a separate disease.
It is attended with a very acute fever, and an extreme pain in
the part affected, which is generally augmented by coughing,
sneezing, drawing in the breath, taking food, going to stool, mak—
ing water, &c. Hence the patient breathes quick, and draws in
his bowels to prevent the motion of the diaphragm; is restless,
anxious, has a dry cough, a hickough and often a delirium. A con—
vulsive laugh, or a kind of involuntary grin, is a common symptom
of this disease.
Every method must be taken to prevent a suppuration, as it is
impossible to save the patient's life when this happens. The regi—
men and medicine are, in all respects the same as in the pleurisy.
Emollient clysters are peculiarly useful, as they relax the bowels,
and by that means make a derivation from the part affected. 
CHAPTER XVII.
Of a Peripneumony or Inflammation of the Lungs.
AS this disease affects an organ which is absolutely necessary to
life, it is always attended with danger. Persons who abound
with blood, whose fibres are tense and rigid, who feed upon gross
aliment, and drink strong viscid liquors, are most liable to a perip—
neumony. It is generally fatal to these who have a flat breast, or
narrow chest, and to such as are afflicted with an asthma, especial—
ly in the decline of life. Sometimes the inflammation reaches to
one lobe of the lungs only, at other times the whole of the organ
is affected; in which case the disease can hardly fail to prove fatal.
When the disease proceeds from a viscid matter obstructing the
vessels of the lungs, it is called a spurious or bastard peripneumony.
When it arises from a thin acrid defluxion on the lungs, it is de—
nominated a catarrhal peripneumony, &c.
CAUSES.—An inflammation of the lungs is sometimes a
primary disease, and sometimes it is the consequence of other dis— 

127 OF A PERIPNEUMONY.
eases, as a quinsey, a pleurisy, &c. It proceeds from the same causes
as the pleurisy, viz. an obstructed perspiration from cold, wet
clothes, &c. or from an increased circulation of the blood, by vio—
lent exercise, the use of spiceries, ardent spirits, and such like. The
pleurisy and peripneumony are often complicated; in which case
the disease is called a pleuroper ipneumony.
SYMPTOMS.—Most of the symptoms of a pleurisy likewise
attend an inflammation of the lungs; only in the latter the pulse
is more soft and the pain less acute; but the difficulty of breathing,
and oppression of the breast, are generally greater.
REGIMEN.—The regimen and medicine are in all respects
the same in the true peripneumony as in the pleurisy, the aliment
ought to be more slender and thin in this than in any other inflam—
matory disease. Dr. Arbuthnot asserts, that even common whey
is sufficient to support the patient, and that decoctions of barley,
and infusions of fennel roots in warm water with milk, are the most
proper both for drink and nourishment. He recommends the steam
of warm water taken in by the breath, which serves as a kind of
internal fomentation, and helps to attenuate the impacted hu—
mours. If the patient has loose stools, but is not weakened by them,
they are not to be stopped, but rather promoted by emollient
clysters. 
The spurious or bastard peripneumony, is occasioned by a viscid
matter obstructing the vessels of the lungs. It commonly attacks
the old, infirm, and phlegmatic, in winter or wet seasons.
The patient at the beginning is cold and hot by turns, has a small
quick pulse, feels a sense of weight upon his breast, breathes with
difficulty, and sometimes complains of a pain and giddiness of his
head. His urine is usually pale, and his colour very little changed.
The diet in this, as well as in the true peripneumony, must be
very slender, as weak broths, sharpened with the juice of orange
or lemon, and such—like. His drink may be thin water—gruel sweet—
ened with honey, or a decoction of the roots of fennel, liquorice,
and quick grass. An ounce of each of these may be boiled in three
English pints of water to a quart, and sharpened with a little car—
rant jelly, or the like.
Bleeding and purging are generally proper at the beginning of
this disease; but if the patient's spittle is pretty thick, neither of
them are necessary. It will be sufficient to assist the expectoration
by some of the sharp medicines recommended for that purpose in
the pleurisy, as the solution of gum ammoniac with oxymel of
squills, &c. Blisters have generally a good effect, and ought to be
applied pretty early*.
If the patient does not spit, he must be bled according as his
strength will permit, and have a gentle purge administered. Af—
* Previous to the application of blisters, cupping—glasses should be
applied to the painful part, which generally afford considerable re—
lief. (I.C)

128 OF CONSUMPTIONS.
terwards his body must be kept open with clysters, and the expecto—
ration promoted, by taking every four hours two table-spoonfuls 
of the solution mentioned above.
When an inflammation of the breast does not yield to bleeding,
blistering, and other evacuations, it commonly ends in a suppura—
tion, which is more or less dangerous, according to the part where
it is situated. When this happens in the pleura, it sometimes breaks
outwardly, and the matter is discharged by the wound.
When the suppuration happens within the substance or body of
the lungs, the matter may be discharged by expectoration; but if
the matter floats in the cavity of the breast, between the pleura and
the lungs, it can only be discharged by an incision made betwixt
the ribs.
If the patient's strength does not return after the inflammation
is to all appearance removed; if his pulse continues quick though
soft, his breathing difficult and oppressed; if he has cold shiverings 
at times, his cheeks flushed, his lips dry; and if he complains of
thirst, and want of appetite, there is reason to fear a suppuration,
and that a phthisis or consumption of the lungs will ensue*. We
shall therefore next proceed to consider the proper treatment of
that disease.
CHAPTER XVIII.
Of Consumptions.
A COMSUMPTION is a wasting or decay of the whole bo—
dy from an ulcer, tubercles, or concretions of the lungs, an
empyema, an atrophy, or a cachexy.
Dr. Arbuthnot observes, that in his time consumptions made
up above one—tenth part of the bills of mortality in and about
London. There is reason to believe they have rather increased
since; and we know from experience, that they are not less fatal
in some other towns of England than in London.
Young persons, betwixt the age of fifteen and thirty, of a slen—
der make, long neck, high shoulders, and flat breasts, are most lia—
ble to this disease.
Consumptions prevail more in England, than in any other part
of the world, owing perhaps to the great use of animal food and
malt liquors, the general application to sedentary employments,
* In cases of this kind, where several quarts of pus or matter have
been discharged from the mouth, the patient has been recovered by resi—
ding, during spring and summer, in the country, assisted by a nourishing
diet, exercise on horse—back, and the extract of bark. (I. C.) 

129 OF CONSUMPTIONS.
and the great quantity of pit—coal which is there burnt; to which 
we may add the perpetual changes in the atmosphere, or variable— 
ness of the weather.
CAUSES—It has already been observed, that an inflamma—
tion in the breast often ends in an imposthume: Consequently,
whatever disposes people to this disease, must likewise be consi—
dered as a cause of consumptions.
Other diseases, by vitiating the habit, may likewise occasion con—
sumptions; as the scurvy, the scrophula, or king's evil, the vene—
real disease, the asthma, small-pox, measles, &c.
As this disease is seldom cured, we shall endeavour the more
particularly to point out its causes, in order that people may be ena—
bled to avoid it. These are:
—Confined or unwholesome air. When this fluid is impreg—
nated with the fumes of metals or minerals, it proves extremely
hurtful to the lungs, and often corrodes the tender vessels of that
necessary organ.
—Violent passions, exertions, or affections of the mind; as
grief, disappointment, anxiety, or close application to the study of
abstruse arts or sciences.
—Great evacuations; as sweating, diarrhœas, diabetes, ex—
cessive venery, the fluor albus, an over discharge of the menstrual
flux, giving suck too long, &c.
—The sudden stoppage of customary evacuations; as the
bleeding piles, sweating of the feet, bleeding at the nose, the
menses, issues, ulcers, or eruptions of any kind.
—Injuries done to the lungs, calculi, &c. I lately saw the
symptoms of a phthisis occasioned by a small bone sticking in the
bronchæ. It was afterwards vomited along with a considerable quan—
tity of purulent matter, and the patient, by a proper regimen, and
the use of the Peruvian bark, recovered.
—Making a sudden transition from a hot to a very cold cli—
mate, change of apparel, or whatever greatly lessens the perspiration.
—Frequent and excessive debaucheries. Late watching, and
drinking strong liquors, which generally go together, can hardly
fail to destroy the lungs. Hence, the bon companion generally falls
a sacrifice to this disease.
—Infection. It is suspicious that Consumptions are caught
by sleeping with the diseased; for which reason, this should be
carefully avoided. It cannot be of great benefit to the sick, and must
hurt those in health.
—Occupations in life. Those artificers who sit much, and are
constantly leaning forward, or pressing upon the stomach and
breast, as cutlers, taylors, shoe-makers, seamstresses, &c. often die
of consumptions. They likewise prove fatal to fingers, and all who
have occasion to make frequent and violent exertions of the lungs.
—Cold. More consumptive patients date the beginning of
their disorders from wet feet, damp beds, night air, wet clothes,
R 

130 OF CONSUMPTIONS.
or catching cold after the body had been heated, than from all
other causes.
Sharp, saline, and aromatic aliments, which heat and inflame
the blood, are likewise frequently the cause of consumptions.
We shall only add, that this disease is often owing to an heredita—
ry taint, or a scrophulous habit; in which case it is generally in—
curable.
SYMPTOMS.—This disease generally begins with a dry
cough, which often continues for some months. If a disposition to vo—
mit after eating be excited by it, there is still greater reason to fear
an approaching consumption. The patient complains of a more
than usual degree of heat, a pain and oppression of the breast, es—
pecially after motion; his spittle is of a saltish taste, and sometimes
mixed with blood. He is apt to be sad; his appetite is bad, and his
thirst great. There is generally a quick, soft, small pulse; though
sometimes the pulse is pretty full, and rather hard. These are the
common symptoms of a beginning consumption.
Afterwards the patient begins to spit a greenish, white, or bloo—
dy matter. His body is extenuated by the hectic fever, and colli—
quative sweats, which mutually succeed one another, viz. the one
towards night, and the other in the morning. A looseness, and an
excessive discharge of urine, are often troublesome symptoms at
this time, and greatly weaken the patient. There is a burning heat
in the palms of the hands, and the face generally flushes after eat—
ing; the fingers become remarkably small, the nails are bent in—
wards, and the hairs fall off.                
At last the swelling of the feet and legs, the total loss of strength,
the sinking of the eyes, the difficulty of swallowing, and the cold—
ness of the extremities, show the immediate approach of death,
which the patient seldom believes to be so near. Such is the usu—
al progress of this disease, which, if not early checked, commonly
sees all medicine at defiance.
REGIMEN.—On the first appearance of a consumption, if
the patient lives in a large town, or any place where the air is con—
fined, he ought immediately to quit it, and to make choice of
a situation in the country, where the air is pure and free. Here he
must not remain inactive, but take every day as much exercise as he
can bear.
The best method of taking exercise is to ride on horseback, as
this gives the body a great deal of motion without much fatigue.
Such as cannot bear this kind of exercise, must make use of a carri—
age. A long journey, as it amuses the mind by a continual change
of objects, is greatly preferable to riding the same ground over and
over. Care however must be taken to avoid catching cold from
wet clothes, damp beds, or the like. The patient ought always to
finish his ride in the morning, or at least before dinner; otherwise
it will oftener do harm than good.
It is a pity that those who attend the sick seldom recommend 

131 OF CONSUMPTIONS.
riding in this disease, till the patient is either unable to bear it, or
the malady has become incurable. Patients are likewise apt to tri—
fle with every thing that is in their own power. They cannot see
how one of the common actions of life should prove a remedy in
an obstinate disease, and therefore they reject it, while they gree—
dily hunt after relief from medicine, merely because they do not
understand it.
Those who have strength and courage to undertake a pretty
long voyage, may expect great advantage from it. This, to my
knowledge, has frequently cured a consumption after the patient
was, to all appearance, far advanced in that disease, and where me—
dicine had proved ineffectual. Hence it is reasonable to conclude,
that if a voyage were undertaken in due time, it would seldom fail
to perform a cure*.
Such as try this method of cure ought to carry as much fresh
provisions along with them as will serve the whole time they are
at sea. As milk is not easily obtained in this situation, they ought
to live upon fruits, rye and Indian mush, and the broth of chick—
ens, or other young animals, which can be kept alive on board.
Such voyages should be undertaken, if possible, in the mildest sea—
son, and towards a warmer climate†.
Those who have not courage for a long voyage may travel into
a more southern climate, as the south of France, Spain or Portu—
gal; and if they find the air of these countries agree well with
them, they should continue there, at least till their health be con—
firmed. 
Next to proper air and exercise, we would recommend a due
attention to diet. The patient should eat nothing that is either
heating or hard of digestion, and his drink must be of a soft and
cooling nature. All the diet ought to be calculated to nourish and
support the patient. For this purpose, he must keep chiefly to, the
use of vegetables and milk. Milk alone is of more value in this dis—
ease than the whole materia medica.
Asses' milk is commonly reckoned preferable to any other; but
it cannot always be obtained; besides, it is generally taken in a
very small quantity; whereas, to produce any effects, it ought to
make a considerable part of the patient's diet. It is hardly to be
expected, that a gill or two of asses' milk, drank in the space of
* The greatest benefit derived to consumptive patients in going to sea,
is in proportion to the time they are on the ocean, the temperature of
the latitude they fail in, which should be agreeably warm. Therefore,
a long voyage, commenced at an early period of this disease, or what
would be more beneficial, a continuance for ten or twelve months,
on the ocean, a patient in such a situation, with tolerable accommoda—
tion, would in all probability effect a recovery. (I. C.)
† Though I do not remember to have seen one instance of a genuine
consumption of the lungs cured by medicine, yet I have known a West—
India voyage work wonders in that dreadful disorder. 

132 OF CONSUMPTIONS.
twenty-four hours, should be able to produce any considerable
change in the humours of an adult; and when people do not per—
ceive its effects soon, they lose hope, and so leave it off. Hence, this
medicine, however valuable, very seldom performs a cure. The rea—
son is obvious; it is commonly used too late, is taken in too small
quantities, and is not duly persisted in.
I have known very extraordinary effects from asses' milk in ob—
stinate coughs, which threatened a consumption of the lungs; and
do verily believe, if used at this period, that it would seldom fail;
but if it be delayed till an ulcer is formed, which is generally the
case, how can it be expected to succeed?
Asses' milk ought to be drank, if possible, in its natural warmth,
and, by a grown person, in the quantity of half an English pint at
a time. Instead of taking this quantity night and morning only,
the patient ought to take it four times, or at least thrice a—day, and
to eat a little light bread along with it, so as to make it a kind of
meal.
If the milk should happen to purge, it may be mixed with old
conserve of roses. When that cannot be obtained, the powder of
crabs' claws may be used in its stead. Asses' milk is usually ordered
to be drank warm in bed; but as it generally throws the patient
into a sweat when taken in this way, it would perhaps be better to
give it after he rises.
Some extraordinary cures in comsumptive cases have been per—
formed by women's milk. Could this be obtained in sufficient quan—
tity, we would recommend it in preference to any other. It is better
if the patient can suck it from the breast, than to drink it after—
wards. I knew a man who was reduced to such a degree of weak—
ness in a consumption, as not to be able to turn himself in bed.
His wife was at that time giving suck, and the child happening to
die, he sucked her breasts, not with a view to reap any advantage
from the milk, but to make her easy. Finding himself greatly bene—
fited by it, he continued to suck her till he became perfectly well,
and is at present a strong and healthy man.
Some prefer butter—milk; it is a very valuable medicine if the
stomach be able to bear it. It does not agree with every person at
first; and is often laid aside without a sufficient trial. It should at
first be taken sparingly, and the quantity gradually increased, until
it comes to be almost the sole food. I never knew it succeed unless
where the patient almost lived upon it.
Cows' milk is most readily obtained of any, and though it be not
so easily digested as that of asses' or mares', it may be rendered ligh—
ter by adding to it an equal quantity of barley—water, or allowing
it to stand for some hours, and afterwards taking off the cream.
If it should, notwithstanding, prove heavy on the stomach, a small
quantity of brandy or rum, with a little sugar, may be added,
which will render it both more light and nourishing.
Milk may for some time disagree with a stomach that has not             

133 OF CONSUMPTIONS.             
been accustomed to digest any thing but flesh and strong liquors,
which is the case with many of those who fall into consumptions.
We do not however advise those who have been accustomed to
animal food and strong liquors, to leave them off all at once. This
might be dangerous. It will be necessary for such to eat a little
once a day of the flesh of some young animal, or rather to use the
broth made of chickens, veal, lamb, or such—like. They ought like—
wise to drink a little wine made into negus, or diluted with twice
or thrice its quantity of water, and to make it gradually weaker
till they can leave it off altogether.
These must be used only as preparatives to a diet consisting
chiefly of milk and vegetables, which the sooner that the patient
can be brought to bear, the better. Rice and milk or barley and
milk, boiled with a little sugar, make very proper food. Ripe fruits
roasted, baked, or boiled, are likewise proper, as goose or currant
berry tarts, apples roasted, or boiled in milk, &c. The jellies, con—
serves, and preserves, &c. of ripe subacid fruits, ought to be eaten
plentifully, as the jelly of currants, conserve of roses, preserved
plums, cherries, &c.
Wholesome air, proper exercise, and a diet consisting chiefly of
these and other vegetables, with milk, is the only course that can
be depended on in a beginning consumption. If the patient has
strength and sufficient resolution to persist in this course, he will
seldom be disappointed of a cure.
In the populous town of Sheffield, where consumptions are very
common, I have frequently seen consumptive patients, who had;
been sent to the country with orders to ride, and live upon milk
and vegetables, return in a few months quite plump, and free from
any complaint. This indeed was not always the case, especially
when the disease was hereditary, or far advanced; but it was the
only method in which success was to be expected: where it failed,
I never knew medicine succeed.
If the patient's strength and spirits flag, he must be supported
by strong broths, jellies, and such—like. Some recommend shell—fish
in this disorder, and with some reason, as they are nourishing and
restorative*. All the food and drink ought however to be taken in
small quantities, left an overcharge of fresh chyle should oppress
the lungs, and too much accelerate the circulation of the blood.
The patient's mind ought to be kept as easy and cheerful as
possible. Consumptions are often occasioned, and always aggrava—
ted, by a melancholy cast of mind; for which reason, music, cheer—
ful company, and every thing that inspires mirth, are highly be—
neficial. The patient ought seldom to be left alone; as brooding
over his calamities is sure to render them worse.
* I have often known persons of a consumptive habit, where the
symptoms were not violent, reap great benefit from the use of oysters.
They generally ate them raw, and drank the juice along with them. 

134 OF CONSUMPTIONS.
MEDICINE.—Though the cure of this disease depends chief—
ly upon regimen and the patient's own endeavours, yet we shall
mention a few things which may be of service in relieving some
of the more violent symptoms.
In the first stage of a consumption, the cough may sometimes
be appeased by bleeding; and the expectoration may be promoted
by the following medicines. Take fresh squills, gum—ammoniac,
and powdered cardamum seeds, of each a quarter of an ounce;
beat them together in a mortar, and in the mass proves too hard
for pills, a little of any kind of syrup may be added to it. This
may be formed into pills of a moderate size, and four or five of
them taken twice or thrice a—day, according as the patient's sto—
mach will bear them.
The lac ammoniacum, or milk of gum ammoniac, as it is called,
is likewise a proper medicine in this stage of the disease. It may
be used as directed in the pleurisy.
A mixture made of equal parts of lemon—juice, fine honey, and
syrup of poppies, may likewise be used. Four ounces of each of
these may be simmered together in a sauce—pan, over a gentle fire,
and a table—spoonful of it taken at any time when the cough is trou—
blesome.
It is common in this stage of the disease to load the patient's
stomach with oily and balsamic medicines. These, instead of re—
moving the cause of the disease, tend rather to increase it, by
heating the blood, while they pall the appetite, relax the solids,
and prove every way hurtful to the patient. Whatever is used for
removing the cough, besides riding and other proper regimen,
ought to be medicines of a sharp and cleansing nature; as oxymel,
syrup of lemon, &c.                       
Acids have peculiarly good effects in this disease; they both
tend to quench the patient's thirst and to cool the blood. The ve—
getable acids, as apples, oranges, lemons, &c. appear to be the
most proper. I have known patients suck the juice of several le—
mons every day with manifest advantage, and would for this rea—
son recommend acid vegetables to be taken in as great quantity as
the stomach will bear them.
For the patient's drink, we would recommend infusions or the
bitter plants, as ground—ivy, the lesser centaury, camomile flowers
or water—trefoil. These infusions may be drank at pleasure. They
strengthen the stomach, promote digestions, and at the same time
answer all the purposes of dilution, and quench thirst much better
than things that are luscious or sweet. But if the patient spits blood,
he ought to use, for his ordinary drink, infusions or decoctions of
the vulnerary roots, plants, &c*.
There are many other mucilaginous plants and seeds, of a heal—
ing and agglutinating nature, from which decoctions or infusions
* See Appendix, Vulnerary decoction. 

135 OF CONSUMPTIONS.
may be prepared with the same intention; as the orches, the
quince—seed, coltsfoot, linseed, sarsaparilla, &c. Simple infusion or
boiling is all that is necessary, and the dose may be at discretion.
The conserve of roses is here peculiarly proper. It may either
be put into the decoction above prescribed, or eaten by itself. No
benefit is to be expected from trifling doses of this medicine. I ne—
ver knew it of any service unless where three or four ounces at
least were used daily for a considerable time. In this way I have
seen it produce very happy effects, and would recommend it wher—
ever there is a discharge of blood from the lungs.
When the spitting up of gross matter, oppression of the breast,
and the hectic symptoms, show that an imposthume is formed in
the lungs, we would recommend the bark, to support the strength
of the patient.
An ounce of the bark in powder may be divided into eighteen
or twenty doses, of which one may be taken every three hours
through the day, in a little syrup, or a cup of horehound—tea.
If the bark should happen to purge, it may be made into an
electuary, with the conserve of roses, thus: Take old conserve of
roses a quarter of a pound, bark in powder an ounce, syrup of
orange or lemon, as much as will make it of the consistence of
honey. This quantity will serve the patient four or five days, and
may be repeated as there is occasion.
Such as cannot take the bark in substance, may infuse it in cold
water. This seems to be the best menstruum for extracting its vir—
tues. Half an ounce of bark in powder may be infused for twen—
ty—four hours in half an English pint of water. Afterwards let it
be passed through a fine strainer, and an ordinary tea—cupful of
it taken three or four times a—day.
We would not recommend the bark while there are any symp—
toms of an inflammation of the breast; but when it is certainly 
known that matter is collected there, it is one of the best medicines;
which can be used. Few patients indeed have resolution enough
to give the bark a fair trial at this period of the disease, otherwise 
we have reason to believe that some benefit might be reaped from it.
When it is evident that there is an imposthume in the breast,
and the matter can neither be spit up nor carried off by absorption,
the patient must endeavour to make it break inwardly, by drawing
in the steams of warm water or vinegar with his breath, coughing,
laughing, or bawling aloud, &c. When it happens to burst within
the lungs, the matter maybe discharged by the mouth. Sometimes
indeed the bursting of the vomica occasions immediate death, by
suffocating the patient. When the quantity of matter is great, and
the patient's strength exhausted, this is commonly the case. At any
rate, he is ready to fall into a swoon, and should have volatile salts
or spirits held to his nose.
If the matter discharged be thick, and the cough and breathing
become easier, there may be some hopes of a cure. The diet at    

136 OF CONSUMPTIONS.
this time ought to be light, but restorative, as chicken—broths, sago—
gruel, rice—milk, &c. the drink, butter—milk, or whey, sweetened
with honey. This is likewise a proper time for using the Peruvian
bark, which may be taken as directed above.
If the vomica or imposthume should discharge itself into the cavity
of the breast, betwixt the pleura and the lungs, there is no way of
getting the matter out but by an incision, as has already been ob—
served. As this operation must always be perfomed by a surgeon,
it is not necessary here to describe it. We shall only add, that it
is not so dreadful as people are apt to imagine, and that it is the
only chance the patient in this case has for his life.
A NERVOUS CONSUMPTION, is a wasting or decay of the
whole body, without any considerable degree of fever, cough or
difficulty of breathing. It is attended with indigestion, weakness,
and want of appetite, &c.
Those who are of a fretful temper, who indulge in spirituous
liquors, or who breathe an unwholesome air, are most liable to
this disease.
We would chiefly recommend, for the cure of a nervous con—
sumption, a light and nourishing diet, plenty of exercise in a free
open air, and the use of such bitters as brace and strengthen the
stomach; as the bark, gentian root, camomile, horehound, &c.
These may be infused in water or wine, and a glass of it drank
frequently.
It will greatly assist the digestion, and promote the cure of this
disease, to take twice a—day twenty or thirty droops of the elixir of
vitriol in a glass of wine or water. The chalybeate wine is likewise
an excellent medicine in this case. It strengthens the solids, and
powerfully assists Nature in the preparation of good blood*.
Agreeable amusements, cheerful company, and riding about, are
however preferable to all medicines in this disease. For which rea—
son, when the patient can afford it, we would recommend a long
journey of pleasure, as the most likely means to restore his health.
What is called a symptomatic consumption cannot be cured without
first removing the disease by which it is occasioned. Thus, when
a comsumption proceeds from the scrophula or king's evil from the
scurvy, the asthma, the venereal disease, &c. a due attention must
be paid to the malady from whence it arises, and the regimen and
medicine directed accordingly.
When excessive evacuations of any kind occasion a consump—
tion, they must not only be restrained, but the patient's strength
must be restored by gentle exercise, nourishing diet, and generous
cordials. Young and delicate mothers often fall into consumptions,
by giving suck too long. As soon as they perceive their strength
and appetite begin to fail, they ought immediately to wean the child,
or provide another nurse, otherwise they cannot expect a cure.
* See Appendix, Chalybeate wine. 

137 OF THE NERVOUS FEVER.
Let all, as they wish to avoid consumptions, take as much exer—
cise without—doors as they can, avoid unwholesome air, and study
sobriety. Consumptions owe their present increase not a little to the
fashion of sitting up late, eating hot suppers, and spending every
evening over a bowl of hot punch or other strong liquors. These
liquors, when too freely used, not only hurt the digestion, and spoil
the appetite, but heat and inflame the blood, and, set the whole
constitution on fire.
CHAPTER XIX.
Of the Slow or Nervous Fever.
NERVOUS fevers have increased greatly of late years in this
country, owing, doubtless, to our different manner of living,
and the increase of sedentary employments; as they commonly
attack persons of a weak, relaxed habit, who neglect exercise, eat
little solid food, study hard, or indulge in spirituous liquors.
CAUSES.—Nervous fevers may be occasioned by whatever
depresses the spirits, or impoverishes the blood; as grief, fear
anxiety, want of sleep, intense thought, living on poor watery diet,
unripe fruits, cucumbers, melons, mushrooms, &c. They may like—
wise be occasioned by damp, confined, or unwholesome air. Hence
they are very common in rainy seasons, and prove most fatal to
those who live in dirty low houses, crowded streets, hospitals, jails,
or such—like places.
Persons whose constitutions have been broken by excessive ve—
nery, frequent salivations, too free an use of purgative medicines,
or any other excessive evacuations, are most liable to this disease.
Keeping on wet clothes, lying on the damp ground, excessive
fatigue, and whatever obstructs the perspiration, or causes a spas—
modic stricture of the solids, may likewise occasion nervous fe—
vers. We shall only add, frequent and great irregularities in diet.
Too great abstinence, as well as excess, is hurtful. Nothing tends so
much to preserve the body in a sound state as a regular diet; nor
can any thing contribute more to occasion fevers of the worst kind
than its opposite.
SYMPTOMS.—Low spirits, want of appetite, weakness
weariness after motion, watchfulness, deep sighing, and dejection
of mind, are generally the forerunners of this disease. These are
succeeded by a quick low pulse, a dry tongue without any con—
siderable thirst, chillness and flushing in turns, &c.
After some time, the patient complains of a giddiness and pain
of the head, has a nausea, with reachings and vomiting; the pulse
is quick, and sometimes intermitting; the urine pale, resembling
S 

138 OF THE NERVOUS FEVER.
dead small beer, and the breathing is difficult, with oppression of
the breast, and slight alienations of mind.
If towards the ninth, tenth, or twelfth day, the tongue becomes
more moist, with a plentiful spitting, a gentle purging, or a moisture
upon the skin; or if a suppuration happens in one or both ears, or
large pustules break out about the lips and nose, there is reason to
hope for a favourable crisis.
But if there is an excessive looseness, or wasting sweats, with fre—
quent fainting fits; if the tongue, when put out, trembles exces—
sively, and the extremities feel cold, with a fluttering or slow creep—
ing pulse; if there is a starting of the tendons, and almost total
loss of sight and hearing, and an involuntary discharge by stool
and urine, there is great reason to fear that death is approaching.
REGIMEN.—It is very necessary in this disease to keep the
patient cool and quiet. The least motion will fatigue him, and will
be apt to occasion weariness and even faintings. His mind ought
not only to be kept easy, but soothed and comforted with hopes of
a speedy recovery. Nothing is more hurtful in low fevers of this
kind than presenting to the patient's imagination gloomy or fright—
ful ideas. These of themselves often occasion nervous fevers, and
must likewise aggravate them.
The patient must not be kept too low. His strength and spirits
ought to be supported by nourishing diet and generous cordials.
For this purpose, his gruel, panado, or whatever food he takes, must
be mixed with wine, according as the symptoms may require.
Pretty strong wine—whey, or small negus, sharpened with the juice
of orange or lemon, will be proper for his ordinary drink. Mustard—
whey is likewise a very proper drink in this fever, and may be ren—
dered an excellent cordial—medicine by the addition of a proper
quantity of white—wine*.
Wine, in this disease, if it could be obtained genuine, is almost
the only medicine that would be necessary. Good wine possesses
all the virtues of the cordial medicines, while it is free from ma—
ny of their bad qualities. I say good wine; for, however com—
mon this article of luxury is now become, it is rarely to be ob—
tained genuine, especially by the poor, who are obliged to pur—
chase it in small quantities.
I have often seen patients in low nervous fevers, where the pulse
could hardly be felt, with a constant delirium, coldness of the ex—
tremities, and almost every other mortal symptom, recover, by
using in whey, gruel and negus, a bottle or two of strong wine
every day. Good old sound claret is the best, and may be made
into negus, or given by itself, as circumstances require.
In a word, the great aim in this disease is to support the pa—
tient's strength, by giving him frequently small quantities of the
above, or other drinks of a warm and cordial nature. He is not,
See Appendix, Mustard—whey. 

139 OF THE NERVOUS FEVER.
however, to be over—heated either with liquor or clothes; and his
food ought to be light, and given in small quantities.
MEDICINE.—Where a nausea, load, and sickness at sto—
mach prevail at the beginning of the fever, it will be necessary
to give the patient a gentle vomit. Fifteen or twenty grains of
ipecacuanha in fine powder, or a few spoonfuls of the vomiting
julep†, will generally answer this purpose very well. This may
be repeated any time before the third or fourth day, if the above
symptoms continue. Vomits not only clean the stomach, but, by
the general shock which they give, promote the perspiration, and
have many other excellent effects in slow fevers, where there are
no signs of inflammation, and nature wants rousing.
Such as dare not venture upon a vomit, may clean the bowels
by an infusion of senna and manna.
In all fevers, the great point is to regulate the symptoms, so as
to prevent them from going to either extreme, Thus, in fevers
of the inflammatory kind, where the force of the circulation is too
great, or the blood dense, and the fibres too rigid, bleeding and
other evacuations are necessary. But in nervous fevers, where
nature flags, and the solids relaxed, wine, with other cordials
should be plentifully administered.
It is necessary to caution people against bleeding in this disease,
as there is generally at the beginning an universal stricture upon
the vessels, and sometimes an oppression and difficulty of breath—
ing, which suggest the idea of a plethora, or too great a quantity
of blood. I have known even some of the faculty deceived by
their own feelings in this respect, so far as to insist upon being
bled, when it was evident, from the consequences, that the opera—
tion was improper.
Though bleeding is generally improper in this disease, yet blis—
tering is highly necessary. Blisters may be applied at all times of
the fever with great advantage. If the patient is delirious, he
ought to be blistered on the neck or head, and it will be the sa—
fest course, while the insensibility continues, as soon as the dis—
charge occasioned by one blister abates, to apply another to some
other part of the body, and by that means, keep up a continual
succession of them till he be out of danger.
I have been more sensible of the advantage of blistering in this
than in any other disease. Blisters not only stimulate the solids
to action, but likewise occasion a continual discharge, which may,
in some measure, supply the want of critical evacuations, which
seldom happen in this kind of fever. They are most proper, ei—
ther towards the beginning, or after some degree of stupor has come
on; in which last case, it will always be proper to blister the head.
If the patient is costive through the course of the disease, it
will be necessary to procure a stool, by giving him every other, day 
† See Appendix, Vomiting Julep. 

140 OF THE NERVOUS FEVER.
a clyster of milk and water, with a little sugar, to which may be
added a spoonful of common salt, if the above does not operate,
Should a violent looseness come on, it maybe checked by small
quantities of Venice treacle or laudanum, giving the patient for
his ordinary drink the white decoction.
A miliary eruption sometimes breaks out about the ninth or tenth
day. As eruptions are often critical, great care should be taken
not to retard Nature's operation in this particular. The eruption
ought neither to be checked by bleeding nor other evacuations, nor
pushed out by a hot regimen; but the patient should be suppor—
ted by gentle cordial, as wine—whey, small negus, sago—gruel, with
a little wine in it, and such—like. He ought not to be kept too
warm; yet a kindly breathing sweat should by no means be checked.
Though blisters, and the use of cordial liquors are the chief
things to be depended on in this kind of fever; yet, for those
who may choose to use them, we shall mention one or two of
the forms of medicine which are commonly prescribed in it†.
In desperate cases, where the hickough and starting of the ten—
dons have already come on, we have sometimes seen extraordinary
effects from large doses of musk frequently repeated. Musk is
doubtless an antispasmodic, and may be given to the quantity of a
scruple three or four times a—day, or oftener if necessary. Some—
times it may be proper to add to the musk a few grains of cam—
phire, and salt of hartshorn, as these tend to promote perspiration
and the discharge of urine. Thus, fifteen grains of musk, with three
grains of camphire, and six grains of salt of hartshorn, may be made
into a bolus with a little syrup, and given as above.
If the fever should happen to intermit, which it frequently does
towards the decline, or if the patient's strength should be wasted
with colliquative sweats, &c. it will be necessary to give him the
Peruvian bark. Half a drachm, or a whole drachm, if the stomach
will bear it, of the bark in fine powder, may be given four or five
times a—day in a glass of red port or claret. Should the bark in sub— 
stance not fit easy on the stomach, an ounce of it in powder may be
infused in a bottle of Lisbon or Rhenish wine for two or three days,
afterwards it may be strained, and a glass of it taken frequently‡.
* See Appendix, White Decoction.
† When the patient is low, ten grains of Virginian snake root, and
the same quantity of contrayerva—root, with five grains of Russian castor.
all in fine powder, may be made into a bolus with a little of the cordial
consection or syrup of saffron. One of these may be taken every four
or five hours.
The following powder may be used with the same intention: Take
wild Valerian—root in powder one scruple. saffron and castor each four
grains. Mix these by rubbing them together in a mortar, and give one
in a cup of wine—whey three or four times a—day.
‡ The bark may likewise be very properly administered, along with
other cordials, in the following manner: Of bark an ounce, orange—
peel half an ounce, Virginian snake—root two drachms, saffron one 

141 PUTRID OR SPOTTED FEVER. 
Some give the bark in this and other fevers, where there are no
symptoms of inflammation, without any regard to the remission
or intermission of the fever. How far future observation may tend
to establish this practice, we will not pretend to say; but we have
reason to believe that the bark is a very universal febrifuge, and that
it may be administered with advantage in most fevers where bleed—
ing is not necessary, or where there are no symptoms of topical
inflammation.
CHAPTER XX.
Of the Malignant Putrid or Spotted Fever.
THIS may be called the pestilential fever of Europe, as, in
many of its symptoms, it bears a great resemblance to the
plague. Persons of a lax habit, a melancholy disposition, and those
whose vigour has been wasted by long fasting, watching, hard la—
bour, excessive venery, frequent salivations, &c. are most liable to it.
CAUSES.—This fever is occasioned by foul air, from a
number of people being confined in a narrow place, not properly
ventilated; from putrid animal and vegetable effluvia, &c. Hence
it prevails in camps, jails, hospitals, and infirmaries, especially
where such places are too much crowded, and cleanliness is ne—
glected.
A close constitution of the air, with long rainy or foggy wea—
ther, likewise occasions these fevers. They often succeed great in—
undations in low and marshy countries, especially when these are 
preceded or followed by a hot and sultry season.
Living too much upon animal food, without a proper mixture
of vegetables, or eating fish or flesh that has been kept too long, are 
apt to occasion this kind of fever. Sailors on long voyage, and the
inhabitants of besieged cities, are very often visited with this dis—
ease.
Corn that has been greatly damaged by rainy seasons or long
keeping, and water which has become putrid by stagnation, &c
may likewise occasion this fever.
Dead carcases tainting the air, especially in hot seasons, are very
apt to occasion these diseases. Hence, this kind of fever often pre—
vails in countries which are the scenes of war and bloodshed. This
shows the propriety of removing burying grounds slaughter—houses,
&c. to a proper distance from great towns.
Want of cleanliness is a very general cause of these fevers. Hence
drachm. Let all of them be powdered, and infused in an English pint
of the best brandy for three or four days. Afterwards the liquor may
be strained, and two tea—spoonfuls of it given three or four times a day
in a glass of small wine or negus.

142 PUTRID OR SPOTTED FEVER.
they prevail amongst the poor inhabitants of large towns, who
breathe a confined, unwholesome air, and neglect cleanliness. Such
mechanics as carry on dirty employments, and are constantly con—
fined within doors, are very liable to this disease.
We shall only add, that malignant, or spotted fevers, are highly 
infectious, and often communicated by contagion. All persons
ought to keep at a distance from those affected with such diseases,
unless their attendance is absolutely necessary.
SYMPTOMS.—The malignant fever is generally preceded by 
a remarkable weakness or loss of strength, without any apparent
cause. This is sometimes so great, that the patient can scarce walk,
or even fit upright, without being in danger of fainting away.
His mind too is greatly dejected; he sighs, and is full of dreadful
apprehensions.
There is a nausea, and sometimes a vomiting of bile; a violent
pain of the head, with a strong pulsation or throbbing of the tem—
poral arteries; the eyes often appear red and inflamed, with a pain
at the bottom of the orbit; there is a noise in the ears, the breath—
ing is laborious, and often interrupted with a sigh; the patient
complains of a pain about the region of the stomach, and in his
back and loins; his tongue is at first white, but afterwards it ap—
pears black and chaped; and his teeth are covered with a black
crust. He sometimes passes worms both upwards and downwards,
is affected with tremors or shaking, and often becomes delirious.
If blood is let, it appears dissolved, or with a very small degree
of cohesion, and soon becomes putrid: the stools smell extremely
fœtid, and are sometimes of a greenish, black, or reddish cast.
Spots of a pale purple, dun, or black colour, often appear upon
the skin, and sometimes there are violent hæmorrhages, or dis—
charges of blood from the mouth, eyes, nose, &c. 
These fevers may be distinguished from the inflammatory, by
the smallness of the pulse, the great dejection of mind, the dissol—
ved state of the blood, the petechiæ, or purple spots, and the putrid
smell of the excrements. They may likewise be distinguished from
the low or nervous fever by the heat and thirst being greater, the
urine of a higher colour, and the loss of strength, dejection of
mind, and all the other symptoms, more violent.
Sometimes the inflammatory, nervous, and putrid symptoms are
so blended together, as to render it very difficult to determine to
which class the fever belongs. In this case, the greatest caution and
skill are requisite. Attention must be paid to those symptoms which
are most prevalent, and both the regimen and medicines adapted
to them.
Inflammatory and nervous fevers may be converted into malig—
nant and putrid, by too hot a regimen or improper medicines.
The duration of putrid fevers is extremely uncertain; sometimes 
they terminate between the seventh and fourteenth day, and at
other times they are prolonged for five or six weeks. Their dura— 

143 PUTRID OR SPOTTED FEVER. 
tion depends greatly upon the constitution of the patient, and the
manner of treating the disease.
The most favourable symptoms are, a gentle looseness after the
fourth or fifth day. with a warm, mild sweat. These, when con—
tinued for a considerable time, often carry off the fever, and should
never be imprudently stopped. Small miliary pustules appearing
between the petechæ, or purple spots, are likewise favourable, as
also hot scabby eruptions about the mouth ahd nose. It is a good
sign when the pulse rises upon the use of wine, or other cordials,
and the nervous symptoms abate; deafness coming on towards
the decline of the fever, is often a favourable symptom*, as are
abscesses in the groin or parotid glands.
Among the unfavourable symptoms, may be reckoned an excessive
looseness, with a hard swelled belly; large black or livid blotches
breaking out upon the skin; apthæ; in the mouth; cold clammy
sweats; blindness; change of the voice; a wild staring of the
eyes; difficulty of swallowing; inability to put out the tongue;
and a constant inclination to uncover the breast. When the sweat
and saliva are tinged with blood, and the urine is black, or deposits
a black footy sediment, the patient is in great danger. Starting of
the tendons, and fœtid, ichorous, involuntary stools, attended with
coldness of the extremities, are generally the forerunners of death,
REGIMEN.—In the treatment of this disease, we ought to
endeavour as far as possible, to support the patient's strength and
spirits; and to assist Nature in expelling the cause of the disease,
by gently promoting perspiration and the other evacuations.
Putrid fevers are often occasioned by unwholesome air, and of
course they must be aggravated by it. Care should be taken to pre—
vent air from stagnating in the patient's chamber, to keep is
cool, and renew it frequently, by opening the doors or windows
of some adjacent apartment. The breath and perspiration of per—
sons in perfect a health soon render the air of a small apartment
noxious; but this will sooner happen from the perspiration and
breath of a person in this disease.
Besides the frequent admission of fresh air, we recommend the
use of vinegar, verjuice, juice of lemon, Seville orange, or any ve—
getable acid that can be most readily obtained. These ought fre—
quently to be sprinkled upon the floor, the bed, and every part of
the room. They may also be evaporated with a hot iron, or by boil—
ing, &c. The fresh skins of lemons or oranges ought to be laid in
different parts of the room, and should be frequently held to the
patient's nose. The use of acids in this manner would prove very
refreshing to the patient, and tend to prevent the infection from
spreading among those who attend him. Strong scented herbs, as
rue, tansy, rosemary, wormwood &c. may be laid in different parts
of the house, and smelled to by those who go near the patient.
Deafness is not always a favourable symptom in this disease Per—
haps it is only so when occasioned by abscesses formed within the ears. 

144 PUTRID OR SPOTTED FEVER.
The patient must be kept cool, quiet and easy. The least noise
will affect his head, and the smallest fatigue will be apt to make
him faint.
Few things are of greater importance in this disease than acids,
which ought to be mixed with all the patient's food, as well as
drink. Orange, lemon, or vinegar whey, are all very proper, and
may be drank by turns, according to the patient's inclination. They
may be rendered cordial by the addition of wine in such quantity
as the patient's strength seems to require. When he is very low,
he may drink negus, with only one half water, and sharpened with
the juice of orange or lemon. In some cases, a glass of clear wine
may now and then be allowed. The most proper wine is Rhenish;
but if the body be open, red—port or claret is to be preferred.
When the body is bound, a tea—spoonful of the cream of tartar
may be put into a cup of the patient's drink, as there is occasion;
or he may drink a decoction of tamarinds, which will both quench
his thirst, and promote a discharge by stool.
If camomile—tea will fit upon his stomach, it is a very proper
drink. It may be sharpened by adding to every cup of the tea ten
or fifteen drops of the elixir of vitriol.
The food must be light, as panado or groat gruel, to which a
little wine may be added, if the patient be weak and low; and they
ought all to be sharpened with the juice of orange, the jelly of cur—
rants, or the like. The patient ought likewise to eat freely of ripe
fruits, as roasted apples, currant or gooseberry tarts, preserved
cherries, or plumbs, &c.
Taking a little food or drink supports the spirits: for which rea—
son, the patient ought frequently to be sipping small quantities of
some of the acid liquors mentioned above, or any that may be more
agreeable to his palate or more readily obtained.
If he is delirious, his feet and hands ought to be frequently fo—
mented with a strong infusion of camomile flowers. This, or an
infusion of the bark, to such as can afford it, cannot fail to have a
good effect. Fomentations of this kind relieve the head, by relax—
ing the vessels in the extremities.
MEDICINE.—If a vomit be given at the beginning of this
fever, it will hardly fail to have a good effect; but if the fever has
gone on for some days, and the symptoms are violent, vomits are
not quite so safe. The body however is always to be kept gently
open by clysters, or mild laxative medicines.
Bleeding is seldom necessary in putrid fevers. If there be signs
of an inflammation, it may sometimes be permitted at the first on—
set; but the repetition of it generally proves hurtful.
Blisters are never to be used unless in the greatest extremities.
If the petechiæ or spots should suddenly disappear, the patient's
pulse sink remarkably, and a delirium, with other bad symptoms;
come on, blistering may be permitted. In this case, blisters are to
be applied to the head, and inside of the legs or thighs. But as they 

145 PUTRID OR SPOTTED FEVER.
are sometimes apt to occasion a gangrene, we would rather recom—
mend warm cataplasms or poultices of mustard and vinegar to be
applied to the feet, having recourse to blisters only in the utmost
extremities. It is common in the beginning of this fever to give the
emetic tartar in small doses, repeated every second or third hour, till
it shall either vomit, purge, or throw the patient into a sweat. This
practice is very proper, if not pushed so far as to weaken the patient.
A ridiculous notion has long prevailed, of expelling the poison—
ous matter of malignant diseases by trifling doses of cordial or
alexipharmic medicines. In consequence of this notion, the con—
trayerva—root, the cordial confection, the mithridate, &c. have
been extolled as infallible remedies. These seldom do much good.
Where cordials are necessary, none is superior to good wine; and
we again recommend it both as the safest and best. Wine acids
and antiseptics are the only things to be relied on in the cure of
malignant fevers.
In the most dangerous species of this disease, when it is atten—
ded with purple, lived, or black spots, the Peruvian bark must be
administered. I have seen it, when joined with acids, prove success—
ful, even in cases where the petechiæ had the most threatening
aspect. But, to answer this purpose, it must not only be given in
large doses, but duly persisted in*.
The best method of administering the bark is certainly in sub—
stance. An ounce of it in powder may be mixed with half an
English pint of water, and the same quantity of red wine, and shar—
pened with the elixir or the spirit of vitriol, which will both make
it fit easier on the stomach, and sender it more beneficial. Two
or three ounces of the syrup of lemon may be added, and two ta—
ble—spoonfuls of the mixture taken every two hours, or oftener, if
the stomach is able to bear it. Those who cannot take the bark in
substance may infuse it in wine, as recommended in the preceding
disease. If there be a violent looseness, the bark must be boiled in
red wine with a little cinnamon, and sharpened with the elixir of vi—
triol, as above. Nothing can be more beneficial in this kind of
looseness than plenty of acids, and such things as promote a gentle
perspiration.
If the patient be troubled with vomiting, a drachm of the salt of
wormwood, dissolved in an ounce and an half of fresh lemon—juice,
and made into a draught with an ounce of simple cinnamon water,
and a bit of sugar, may be given, as often as necessary.
If swellings of the glands appear, their suppuration is to be
promoted by the application of emollient poultices. As soon as there
is any appearance of matter in them, they ought to be laid open,
and the poultices continued.
* In fevers of this type, accompanied with great prostration of
strength, Madeira wine should be administered with an unsparing hand,
beginning with small quantities, and gradually increasing from one to
two bottles, in the course of twenty—four hours. (I. C. )
T 

146 PUTRID OR SPOTTED FEVER.
I have known large ulcerous sores break out in various parts of
the body, in the decline of this fever, of a livid gangrenous ap—
pearance, and a most putrid cadaverous smell. These gradually
healed; and the patient recovered by the plentiful use of bark and
wine, sharpened with the spirits of vitriol.
For preventing putrid fevers, we would recommend a strict re—
gard to cleanliness; a dry situation; sufficient exercise in the open
air; wholesome food, and a moderate use of generous liquors. In—
fection ought above all things to be avoided. No constitution is
proof against it. I have known persons seized with a putrid fever,
by only making a single visit to a patient in it; others have caught it
by lodging for one night in a town where it prevailed; and some
by attending the funerals of such as died of it*.
When a putrid fever seizes any person in a family, the greatest
attention is necessary to prevent the disease from spreading. The
sick ought to be placed in a large apartment, as remote from the
rest of the family as possible; to be kept extremely clean, and to have
fresh air frequently let into his chamber; whatever comes from him
should be immediately removed, his linen frequently changed, and
those in health ought to avoid all unnecessary communication with him.
Any one who is apprehensive of having caught the infection,
ought immediately to take a vomit, and to work it off by drinking
plentifully of camomile tea. This may be repeated in a day or two,
if the apprehensions still continue, or any unfavourable symptoms
appear. He ought likewise to take an infusion of the bark and
camomile flowers for his ordinary drink; and before he goes to
bed, he may drink an English pint of pretty strong negus, or a few
glasses of generous wine. I have frequently followed this course,
when malignant fevers prevailed, and have recommended it to
others with constant success.
People generally fly to bleeding and purging as antidotes against
infection; but these are so far from securing them, that they often,
by debilitating the body, increase the danger.
Those who wait upon the sick in this disease ought always to
have a piece of spunge or a handkerchief dipt in vinegar, or juice
of lemon, to smell to while near the patient. They ought to wash
their hands, and, if possible, to change their clothes, before they go
into company†.
* The late Sir John Pringle expressed a concern left these cautions
should prevent people from attending their friends or relations when
afflicted with putrid fevers. I told him I meant only to discourage
unnecessary attendance, and mentioned a number of instances where
putrid fevers had proved fatal to persons who were rather hurtful than
beneficial to the sick. He agreed with me, that a good doctor and a care—
ful nurse were the only necessary attendants; and that all others not
only endangered themselves, but, generally, by their solicitude and ill—
directed care, hurt the sick.
† These are prudent precautions, particularly cleanliness; as to most
of the others, recommended by our judicious author, they seemed to 

[147]
CHAPTER XXI.
Of the Miliary Fever.
THIS fever takes its name from the small pustules or bladders
which appear on the skin, resembling, in shape and size,
the seeds of millet. The pustules are either red or white, and fre—
quently both are mixed together.
The whole body is sometimes covered with pustules; but they
are generally more numerous where the sweat is most abundant,
as on the breast, the back, &c. A gentle sweat, or moisture on the
skin, greatly promotes the eruption; but, when the skin is dry, the
eruption is both more painful and dangerous.
Sometimes this is a primary disease; but it is much oftener only
a symptom of some other malady, as the small—pox, measles, ardent,
putrid, or nervous fevers, &c. In all these cases it is generally the
effect of too hot a regimen or medicines.
The miliary fever chiefly attacks the idle and the phlegmatic, or
persons of a relaxed habit. The young and the aged are more liable
to it than those in the vigour and prime of life. It is likewise more
incident to women than men, especially the delicate and indolent,
who keep continually within doors, and live upon weak watery
diet. Such females are extremely liable to be seized with this disease
in childbed, and often loose their lives by it.
CAUSES—The miliary fever is sometimes occasioned by vio—
lent passions or affections of the mind; as excessive grief, anxiety,
thoughtfulness, &c. It may be occasioned by excessive watching,
great evacuations, a weak watery diet, rainy seasons, eating too
freely of cold, crude unripe fruits, as plums, cherries, cucumbers,
melons, &c. Impure waters, or provisions which have been spolied
by rainy seasons, long keeping, &c. may cause miliary fevers.
They may also be occasioned by the stoppage of any customary
evacuation, as issues, setons, ulcers, the bleeding piles in men, or the
menstrual flux in women, &c.
This disease in childbed—women is sometimes the effect of great
costiveness during pregnancy; it may likewise be occasioned by
their excessive use of green trash, and other unwholesome things,
in which pregnant women are too apt to indulge. But its most ge—
neral cause is indolence. Such women as lead a sedentary life, ef—
pecially during pregnancy, and at the same time live grossly, can
hardly escape this disease in childbed. Hence it proves extremely
fatal to women of fashion, and likewise to those women in manu—
facturing towns, who, in order to assist their husbands, fit close
have little or no effect during the late yellow fever, which provailed in
Philadelphia. We believe the best preservative, if it could be attained,
is a cheerful and undisturbed state of mind. (I. C. ) 

148 OF THE MILIARY FEVER.
within doors for almost the whole of their time. But among wo—
men who are active and laborious, who live in the country, and
take sufficient exercise without doors, this disease is very little
known. 
SYMPTOMS.—When this is a primary disease, it makes its
attack like most other eruptive fevers, with a flight shivering, which
is succeeded by heat, loss of strength, faintishness, sighing, a low
quick pulse, difficulty of breathing, with great anxiety and oppres—
sion of the breast. The patient is restless, and sometimes delirious;
the tongue appears white, and the hands shake, with often a burn—
ing heat in the palms; in childbed—women the milk generally goes
away, and other discharges stop.
The patient feels an itching or pricking pain under the skin, after
which innumerable small pustules of a red or white colour begin
to appear. Upon this the symptoms generally abate, the pulse be—
comes more full and soft, the skin grows moister, and the sweat, as
the disease advances, begins to have a peculiar fætid smell; the
great load on the breast, and oppression of the spirits, generally go
off, and the customary evacuations gradually return. About the
sixth or seventh day from the eruption, the pustules begin to dry
and fall off, which occasions a very disagreeable itching in the skin.
It is impossible to ascertain the exact time when the pustules
will either appear or go off. They generally come out on the third
or fourth day, when the eruption is critical; but when sympto—
matical, they may appear at any time of the disease.
Sometimes the pustules appear and vanish by turns. When that
is the case, there is always danger; but when they go in all of a
sudden, and do not appear again, the danger is very great.
In childbed—women the pustules are commonly at first filled with
clear water, afterwards they grow yellowish. Sometimes they are
interspersed with pustules of a red colour. When these only appear
the disease goes by the name of a rash.
REGIMEN—In all eruptive fevers, of whatever kind, the
chief point is to prevent the sudden disappearing of the pustules,
and to promote their maturation. For this purpose the patient must
be kept in such a temperature, as neither to push out the eruption
too fast, nor to cause it to retreat prematurely. The diet and drinks
ought therefore to be in a moderate degree nourishing and cordial;
but neither strong nor heating. The patient's chamber ought nei—
ther 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
cheerful. Nothing so certainly makes an eruption go in as fear, or
the apprehension, of danger.
The food must be weak chicken—broth with bread, panado, sago,
or groat—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.

149 OF THE MILIARY FEVER. 
The drink may be suited to the state of the patient's strength
and spirits. If these be pretty high, the drink ought to be weak; as
water—gruel, balm—tea, or the decoction mentioned below*.
When the patient's spirits zre low, and the eruption does not
rise sufficiently, his drink must be a little more generous; as wine—
whey, or small negus, sharpened with the juice of orange or lemon,
and made stronger or weaker as circumstances may require. 
Sometimes the miliary fever approaches towards a putrid nature,
in which case the patient's strength must be supported with gene—
rous cordials, joined with acids; and, if the degree of putrescence
be great, the bark must be given. If the head be much affected, the
body must be kept open by emollient clysters†. 
MEDICINE.—If the food and drink be properly regulated,
there will be little occasion for medicine in this disease. Should the
eruption, however, not rise, or the spirits flag, it will be necessary to
support the patient with cordials, and to apply blisters. The most
proper cordial, in this case, is good wine, which may either be ta—
ken in the patient's food or drink; and if there he signs of putre—
scence, the bark and acids may be mixed with wine, as directed in
the putrid fever.
Some recommend blistering through the whole course of this
disease; and where Nature flags, and the eruption comes and goes,
it may be necessary to keep up a stimulus, by a continual succession
of small blisters, but not above one at a time. If the pulse sinks re—
markably, the pustules fall in, and the head is affected, it will be
necessary to apply several blisters to the most sensible parts, as the
inide of the legs and thighs, &c. 
* Take two ounces of the shavings of hartshorn, and the same quan—
tity of sarsaparilla, boil them in two English quarts of water. To the
strained—decoction add a little white sugar, and let the patient take it for
his ordinary drink. 
† In the Commercium Literarium for the year 1735, we have the his—
tory of an epidemical miliary fever, which raged at Strasburgh in the
months of November, December, and January; from which we learn
the necessity of a temperate regimen in this malady, and likewise that
physicians are not always the first who discover the proper treatment of
diseases. "This fever made terrible havock ever among men of robust
constitutions, and all medicine proved in vain. They were seized in an
instant with shivering, yawning, stretching and pains in the back, suc—
ceeded by a most intense heat; at the same time there was a great loss
of strength and appetite. On the seventh or ninth day the miliary erup—
tions appeared, or spots like flee bites, with great anxiety, a delirjum,
restlessness, and tossing in bed. Bleeding was fatal. While matters were
in this unhappy situation, a midwife, of her own accord, gave to a patient,
in the height of the disease, a clyster of rain—water and butter without
salt, and for his ordinary drink a quart of spring water, half a pint of
generous wine, the juice of a lemon, and six ounces of the whitest su—
gar, gently boiled till a scum arose, and this with great success; for the
belly was soon loosened, the grievous symptoms vanished, and the patient
was restored to his senses, and snatched from the jaws of death." This
practice was imitated by others with the like happy effects. 

150 OF THE REMITTING FEVER.
Bleeding is seldom necessary in this disease, and sometimes it
does much hurt, as it weakens the patient, and depresses his spirits. 
It is never to be attempted unless by the advice of a physician. It
has been customary to treat this disease in childbed—women by
plentiful bleeding, and other evacuations, as if it were highly in—
flammatory. But this practice is generally very unsafe. Patients in
this situation bear evacuations very ill. And indeed the disease
seems often to be more of a putrid than of an inflammatory nature.
Though this fever is often occasioned in childbed—women by
too hot a regimen, yet it would be dangerous to leave that off all
of a sudden, and have recourse to a very cool regimen, and large
evacuations. Supporting the patient's spirits, and promoting natural
evacuations, is here much safer than having recourse to artificial
ones; as these by sinking the spirits, seldom fail to increase the danger.
If the disease proves tedious, or the recovery slow, the bark may
be taken in substance, or infused in wine or water, as the patient
inclines.
The miliary fever, like other eruptive diseases, requires gentle
purging, which should not be neglected as soon as the fever is
gone off, and the patient's strength will permit.
To prevent this disease, a pure dry air, sufficient exercise, and
wholesome food, are necessary. Pregnant women should guard
against costiveness, and take daily as much exercise as they can bear,
avoiding all green trashy fruits, and other unwholesome things; and
when in childbed, they ought strictly to observe a cool regimen.
CHAPTER XXII.
Of the Remitting Fever.
THIS fever takes its name from a remission of the symptoms,
which happens sometimes sooner, and sometimes later, but
generally before the eighth day. The remission is commonly pre—
ceded by a gentle sweat, after which the patient seems greatly re—
lieved, but in a few hours the fever returns. These remissions return
at very irregular periods, and are sometimes of longer, sometimes
of shorter duration; the nearer however that the fever approaches
to a regular intermittent, the danger is the less.
CAUSES.—Remitting fevers prevail in low marshy countries
abounding with wood and stagnating water; but they prove most
fatal in places where great heat and moisture are combined, as in
some parts of Africa, Bengal in the East Indies, &c. where remit—
ting fevers are generally, of a putrid kind, and prove very fatal.
They are most frequent in close calm weather, especially after rainy
seasons, great inundations, or the like. No age, sex, or constitution, 

151 OF THE REMITTING FEVER.
is exempted from the attack of this fever; but it chiefly seizes per—
sons of a relaxed habit, who live in low dirty habitations, breathe an
impure stagnating air, take little exercise, and use unwholesome diet.
SYMPTOMS—The first symptoms of this fever are generally
yawning, stretching, pain, and giddiness in the head, with alternate
fits of heat and cold. Sometimes the patient is affected with a
delirium at the very first attack. There is a pain, and sometimes a
swelling, about the region of the stomach, the tongue is white, the eyes
and skin frequently appear yellow, and the patient is often afflicted
with bilious vomitings. The pulse is sometimes a little hard, but
seldom full, and the blood, when let, rarely shows any signs of in—
flammation. Some patients are exceedingly costive, and others are
afflicted with a very troublesome looseness.
It is impossible to describe all the symptoms of this disease, as
they vary according to the situation, the season of the year, and
the constitution of the patient. They may be greatly changed by
the method of treatment, and by many other circumstances. Some—
times the bilious symptoms predominate, sometimes the nervous
and at other times the putrid. Nor is it uncommon to find a suc—
cession of each of these, or even a complication of them at the
same time, in the same person.
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 ner—
vous or putrid symptoms occur, it will be necessary to support the
patient with food and liquors of a more generous nature, such as
are recommended in the immediately preceding fevers. We must
be very cautious in using things of a heating quality, as this fever
is frequently changed into a continual by an hot regimen, and im—
proper medicines.
Whatever the symptoms are, 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 or windows.
It ought to be sprinkled with vinegar, juice of lemon, or the like.
His linen, bed—clothes, &c. should be frequently changed, and all
his excrements immediately removed. These precautions are of
more importance to the sick than practitioners are apt to imagine*.
MEDICINE.—In order to cure this fever, we must endeavour
to bring it to a regular intermission. This intention may be pro—
* Dr. Lind, of Edinburgh, in his inaugural dissertation concerning the
putrid remitting fever of Bengal, has the following observation: “The
patient's shirt, bed—clothes, and bedding, ought frequently to be chan—
ged, and exposed to the air, and all his excrements immediately remo—
ved; the bed—chamber should be well ventilated, and frequently sprin—
kled with vinegar; in short, every attend on should be paid to the patient.
I can affirm, that a physician who puts these in practice will much oftener
succeed than one who is even more skilful, but has not opportunity of
using these means.” 

152 OF THE YELLOW FEVER.
moted by bleeding*, if there be any signs of inflammation; but
when that is not the case, bleeding ought by no means to be at—
tempted, as it will weaken the patient and prolong the disease. A
vomit however will seldom be improper, and is generally of great
service. Twenty or thirty grains of ipecacuanha will answer this
purpose very well; but, where it can be obtained, we rather recom—
mend a grain or two of tartar emetic, with five or six grains of ipe—
cacuanha, to be made into a draught and given for a vomit. This
may be repeated once or twice at proper intervals, if the sickness
or nausea continues.
The body ought to be kept open either by clysters or gentle lax—
atives, as weak infusions of senna and manna, small doses of the
lenitive electuary, cream of tartar, tamarinds, stewed prunes, or
the like; but all strong or drastic purgatives are to be carefully
avoided.
By this course, the fever, in a few days, may generally be brought
to a pretty regular or distinct intermission, in which case the bark
may be administered, and it will seldom fail to perfect the cure. It
is needless here to repeat over again the methods of giving the bark;
The most likely way to avoid this fever is to use a wholesome
and nourishing diet, to pay the most scrupulous attention to clean—
liness, to keep the body warm, to take sufficient exercise, and in hot
countries, to avoid damp situations, night air, evening, dews, and
the like. In countries where it is endemical, the best preventive
medicine which we can recommend, is the Peruvian bark, which
may either be chewed, or infused in brandy or wine, &c. Some
recommend smoking tobacco as very beneficial in marshy countries,
both for the prevention of this and intermitting fevers.
CHAPTER XXIII.
Of the Yellow Fever.
THIS fever differs materially from every other species of fever
that has appeared in North—America. A minute description,
therefore, of its symptoms, and the most effectual method of cure,
may be an acceptable chapter to this work. No particular varia—
tion from what appeared in Philadelphia in the summer and au—
tumn of 1793, has since been discovered in its ravages in other
popular cities on the continent of America; we therefore shall
only detail the former, as being more generally destructive, and
more withiii the reach of our immediate observations. 
This yellow fever derives its appellation, from the yellow
* Blisters should be applied to the arms or legs at an early period of
this disease, as they have an evident good effect in procuring an intermis—
sion of the fever, [I.C.] 

153 OF THE YELLOW FEVER. 
suffusion, that often appeared in the eyes and on the skin dur—
ing the continuance of the disease. As it was not a general appear—
ance, there may be an impropriety in the term. However, as it
has been adopted, we will not contend for a word with those me—
dical gentlemen who agree with us in ideas.
Various causes have been suggested for this disease; some
have supposed it to be indigenous, and the offspring of vegetable
putrefaction; others, that it was imported from the West—Indies,
and highly contagious in its nature. The latter of these opinions,
is supported by more facts, and appears the most probable. In
its previous visitations in this country, which were in six differ—
ent periods, besides that of 1793, it was always traced to have
been imported from the West—Indies. It visited Charleston, in
South—Carolina, four times, according to the accurate Dr. Lining,
viz. in 1732, 1739, 1745, and in 1748. It appears, also, from Dr.
Lind, that it was introduced in 1740, by a trunk of wearing ap—
parel; and from the notes of Dr. Redman, it seems to have been
brought to this city in 1762, by a mariner, who arrived sick. From
that period, it was not observed in Philadelphia, till the afore—
mentioned memorable year 1793. The 3d of August was the first
day it was discovered; which was in Water—street, between Mul—
berry and Sassafras—streets, at a boarding—house, generally frequen—
ted by seamen. Many of these people belonged to the zebec pri—
vateer Sans Culottes of Nantz, which had just entered the Dela—
ware from a cruize, with the ship Flora, her prize. The voyage of
these vessels, from every circumstance that could be collected, ap—
pears to have brought the disease indirectly from the West—Indies
into this city, by exchanging part of her crew for that of the prize,
who were from the West—India islands, where this disease was
raging with violence.
The people most generally affected, were the native inhabitants
of Philadelphia, or of some or other parts of the continent of
America†. No condition or situation in life was exempted from its
violence. The timid of both sexes, the most healthy, and those
who seemed to have all the vigour of youth on their side, fell vic—
tims to it: No age scarcely escaped, from the child in the cradle
up to confirmed manhood, and even from that to extreme old age.
Women during gestation appeared to be generally susceptible of it.
In these, it often produced abortion or miscarriage. It was, how—
ever, more fatal to the male than the female sex; but, the most
cheerful, fearless and gay, of both sexes, often escaped it, as like—
wise ideots, and those who had been deranged in their minds.
* Lind on infection, page 293.
† Strangers from the West—India Islands were seldom attacked with
this disease, and the negroes originally from the coast of Africa, were
scarcely ever affected, but some of those of our own country sell a sacri—
fice to its violence. (I.C.) 
V

154 OF THE YELLOW FEVER.
SYMPTOMS.—This disease most frequently attacked people
in the course of the night, or early in the morning, with some degree
of general lassitude, loss of appetite, disagreeable taste in the mouth,
sudden prostration of strength, accompanied with universal pain and
soreness over the body, particularly about the large joints. These
were soon after succeeded by some degree of chilness, or alternate
chills and flushes of heat, but very seldom a complete rigor. Du—
ring the continuance of this state, the face appeared pallid, the fea—
tures contracted, the whole countenance exhibiting a dejected as—
pect, with a corresponding state of mind. After this, there was
perceived a slight pain in the fore or back part of the head, and fre—
quently some degree of vertigo, with a sense of fatigue commonly
about the loins, often extending towards the iliæ and pubes; to—
gether with an uneasy sensation between the shoulders and back of
the neck. These symptoms hourly increased in violence, attended
frequently with disagreeable eructations, nausea, and frequent
retching to vomit, particularly after taking large draughts of warm
or cool drinks, or upon motion of the body.
The eyes were generally highly suffused, exhibiting the appear—
ance of a painted eye or one minutely injected, accompanied with
a sensation as if irritated by sand, and generally an aversion to light.
This I have often observed to take place during the rigor, although
generally at a more advanced period of the disease, or sometimes
not at all, during the whole course of it.
After the rigor, the pulse generally became frequent, tense, and
tolerably even; at other times soft and irregular, the heat mostly a
little higher than the healthy standard. The state of the skin varia—
ble, sometimes moist, but generally dry; respiration a little more
frequent than ordinary, attended with sighing and oppression at
the præcordia, indicating great distress. These were observable
even from the accession of the rigor; at other times not until a
more advanced period.
The tongue was generally moist and white, especially in the
middle, and red or of a purplish, hue towards the edges and tip.
The bowels were generally costive, but sometimes had a diarrhœa,
urine of a higher colour than natural, and small in quantity.
As the evening approached, every symptom became aggravated,
the pulse more frequent, full and strong, heat considerably aug—
mented, pain in the head and back excruciating; in the former,
shooting from temple to temple, in the latter to the hips, and ex—
tending down the thighs; skin dry and parched, sometimes a partial
moisture, particularly when the bed—clothes were increased, but
without any abatement of the febrile symptoms.
The sickness and retching increased, with an ejection of frothy
or bilious matter, or whatever fluid was last received into the sto—
mach, accompanied with pain and soreness in the region of the
stomach, upon the least pressure, with a sensation of incessant burn—
ing, and restlessness; so that no posture afforded any relief. During 

155 OF THE YELLOW FEVER.
the exacerbation, the respiration became more frequent, with an
increase of sighing, and flight pain and throbbing in one or other
of the hypochondriac regions, with strong beating in the most con—
spicuous arterial trunks. The face was very much flushed, and the
features considerably distorted, with a flight hæmorrhage from one
or both nostrils, and an increased suffusion of the eyes.
The intellectual faculties at times appeared confused, but seldom
in a complete delirium. In the intervals of reason, the patient was
very desponding, and under dreadful apprehensions for the event.
He complained much of thirst, which was almost insatiable, for no
sooner did any fluid reach the stomach, than it was instantly reject—
ed with violence. Every morning the symptoms suffered some
abatement*, and the patient generally during the first twenty—four
or forty—eight hours complained of light shivering, which became
varied throughout the day, with vicissitudes of heat and partial
moisture on the skin. He seemed much inclined to doze, from
which he was very often awaked by frightful dreams; after which
he generally became very watchful. As the disease proceeded, the
tongue was very little altered from a state of health, except appear—
ing in furrows, or chopped and of a bluish colour; at other times
yellow or brown in the middle, and bluish at the edges and tip,
but seldom dry. Stools, when procured, were generally fætid and
frothy, but seldom bilious. The urine was variable generally of a
higher colour than natural. Some of these symptoms which mark—
ed the first stage, proceeded rapidly to increase, with a mitigation
of others, and the rise of new ones, unless an intermission super—
vened on or before the fourth day, and the patient recovered. But
most frequently, instead of this intermission, a mere composure of
symptoms only took place, which was too often fallacious. During
this, the eyes and skin sometimes became yellow, and the patient
appeared so placid to the attendants, that they often thought him
out of danger. But this treacherous tranquillity soon vanished, and
the second stage commenced with a different train of symptoms,
and with redoubled violence. The vigour which before was ex—
cessive, now declined apace, and the disease put on a different com—
plexion. The pain in the head and back, which was before exces—
sive, and almost intolerable, frequently abated on a sudden, and
the fever assumed more and more the symptoms of the nervous
kind; the pulse became less frequent, soft, and feeble, and some—
times even flower than in a state of health; the face much less
flushed, the features more tranquil, with a deadly aspect of the
countenance, or sometimes it was but little altered. The suffusion
of the eyes frequently increased; the heat became considerably
* It may not be improper to observe, that for several weeks after the
contagious fever made its appearance in Philadelphia, intermitting and
remitting fevers were met with at a short distance from the place where
the malignant fever was spreading its ravages. 

156 OF THE YELLOW FEVER.
diminished, and in some cases, less than in a state of health; skin
cool, sometimes with a clammy moisture on the face, neck, and
back of the hands; the sickness at stomach increased with a burn—
ing sensation in the region of it, and continual vomiting of frothy
matter; at other times it was bilious, streaked with blood. In the fe—
male sex, if the menses did not flow at their usual period, there was
generally a quantity of blood brought up by vomiting, accompanied
with violent stricture about the præcordia, and a sense of weight,
with great flatulency in the stomach, and the intestines, which was
very distressing; for they were generally costive, and had not ener—
gy sufficient to expel the wind either upwards or downwards. The
tongue in this stage trembled much; and with respect to colour, it
was variable; in the former, often nearly natural, at other times
covered over with mucus verging towards black, particularly in the
middle; sometimes dry, but generally moist, and not unfrequently
of a florid colour. It appeared as if rubbed over with the red
particles of the blood, with deep furrows in it or chopped. When
the patient was desired to put it out of the mouth, he would
continue it until he was told to draw it in. The thirst was much
augmented, with a continual dryness of the lips and fauces. The
confusion of the intellects increased to a complete delirium; the
restlessness became truly distressing, and the patient almost outra—
geous, and in some cases maniacal.
The skin and eyes assumed a deep yellow colour, with the same
appearance in the urine, which was small in quantity, and dischar—
ged with difficulty. When the skin was not suffused, the urine was
turbid, depositing a deep brown sediment. The respiration was
flower than natural, except when the body was much agitated by
the extreme restlessness, accompanied with heavy sighing, and much
debility in all the moving powers of the body. The patient gene—
rally lay on his back, with his feet drawn up towards his body; ne—
vertheless, he had sufficient power, when urged by the call of Na—
ture, to rise from his bed.
In the decline of this stage, the skin was sometimes covered over
with petechial eruptions, appearing like the stings of nettles, of a
dark red colour, principally about the neck and breast, accompa—
nied sometimes with hæmorrhages from different parts of the body;
but these symptoms more particularly belong to the third and last
stage. The duration of the second stage was various, generally ac—
cording to the violence of the symptoms or to the duration and
severity of the preceding stage. It seldom lasted longer than fifty
or sixty hours before death took place, and sometimes without the
occurrence of many of the symptoms of the last stage.
This stage generally commenced with the pulse becoming very
feeble intermitting, and almost imperceptible at the wrist; fre—
quently not more than thirty or thirty—five strokes in a minute.
There was also a great diminution of the heat of the whole body,
except about the præcordia, which seemed, if the expression may 

157 OF THE YELLOW FEVER.
be used, to be more tenacious of its heat than any other part of the bo—
dy, and was the last part that surrendered it up after death.
The skin became much cooler, and covered universally with a
clammy moisture; the countenance exhibited a deadly aspect; the
eyes less painful, but so dreadfully suffused, as sometimes almost to
obliterate the colour of the tunica albuginea, with great twitching of
the muscles of the face, and general startings of the tendons through—
out the body. The petechiæ increased, and became of a purplish co—
lour, between which the skin was of a deep yellow; great—delirium,
with continual restlessness succeeded. The patient lying principally
on his back, the powers not being sufficient to retain him on his sides;
the feet were generally drawn up, the whole body frequently sli—
ding down in bed; The vomiting increased, and the matter ejec—
ted was of a dark colour, resembling coffee—grounds, sometimes
mixed with blood*. The following were usual appearances;
viz. great flatulency; hæmorrhagies from the different parts of the
body; tongue frequently covered over with blood, and of a florid
colour; at other times black and dry; urine very offensive; some—
times a total suppression of it, and when stools were procured, they
were extremely black and fœtid; livid ulcers in the mouth; and
the parts where blisters had been applied, assumed a black aspect;
laborious and deep respiration, with heavy sighing and great op—
pression at the præcordia; faultering in the speech; cold and livid
extremities; involuntary discharges of the fæces; loss of swallow—
ing; coma; eyes glazy. Startings and convulsions frequently closed
the scene.
These were the appearances of the malignant fever through its
several stages. Although in its first attack it was frequently much
varied. Sometimes the patients were seized of a sudden, at other
times in the manner above described; but often, in its different
stages, it was much diversified, according to the violence and du—
ration of the symptoms, to the age, sex, and constitution of the
patient. In some, the disease terminated in death, during the
inflammatory period; in others, it was hurried so precipitately
through the stages, that they could hardly be discriminated by the
most accurate observer, before the patient's sate was determined.
In other cases, it passed with some degree of regularity, as above
marked; and the dissolution or recovery, was protracted to an un—
common period. This was particularly the case in those peo—
ple who laboured under a severe salivation from the effects of
mercury. In judging concerning the event of the malignant fever
during its first stage, the danger was generally in proportion to the
degree of inflammatory action. Of this an idea maybe formed from
the violence, and duration of the symptoms.
* From the experiments I have made on the black matter or vomit, it
seemed to have scarce any of the properties of putrid bile or blood; but
appeared to be a diseased secretion from the live, possessing but little ac—
tivity when applied in any form to an healthy human system. (I.C.)

158 OF THE YELLOW FEVER.
The febrile affection, when very considerable, was demonstra—
ted by the violent pain in the head and back, great suffusion of
the face and eyes, with obvious distortion of the features; nau—
sea and vomiting, with a sense of universal soreness, particularly
in the limbs. The danger was then imminent.
When the inflammatory stage was of short duration and of great
violence, accompanied with unusual quick respiration, heavy tigh—
ing, and great oppression at the præcordia from the commence—
ment, together with great restlessness, confusion of the intellects
and deep despondency of mind, with a dread of speedy dissolu—
tion, they were to be considered as very unfavourable symptoms.
When very great prostration of strength, or a spontaneous di—
arrhœa, appeared after bleeding, without manifest relief to the
patient, they were generally unfavourable symptoms; indicating
danger in proportion to their violence.
Should a yellow tinge in the eyes and skin appear, which is
merely an accidental circumstance, although it has been consider—
ed, by some of the tropical writers, as an unfavourable appear—
ance; by others, as expressive of the crisis of the disease; my ex—
perience does not corroborate either the one or the other, but I
am induced to consider it as a favourable, rather than an unfavour—
able occurrence. Should the retching and vomiting be much in—
creased, with dark or coffee—coloured matter ejected, death gene—
rally ensued.
Fatality commonly happened on the fourth or fifth day;
in some cases, on the twelfth, and even on the twenty—fourth and
twenty—fifth day. But these patients, in addition to the disease,
often had a severe salivation from the administration of large
quantities of calomel during their indisposition. The salivary dis—
charge, in all probability, protracted life.
A favourable prognosis may be formed in this stage of the dis—
ease, from the febrile symptoms being more moderate, together
with the absence of some of those before—mentioned ones, parti—
cularly the suffusion of ths eyes, sighing and vomiting, especially
if a flight hæmorrhagy takes place from the nostrils, with erup—
tions about the mouth, a slight cough, and an expectoration of
yellowish matter, with bilious evacuations by stool, particularly if
they afford relief to the patient, together with the formation of
abscesses in different parts of the body. These are frequently at—
tended with an abatement of almost every other symptom, and
the patient recovers.
In the second stage: If the pulse became very feeble, small
and intermitting,* with a considerable diminution of heat below
the natural standard, excessive vomiting, with great burning in the
region of the stomach, particularly if the matter ejected be black,
* In elderly people, I have found the pulse intermitting in several
cases, and they always recovered. 

159 OF THE YELLOW FEVER. 
which was frequently the case, the patient had but a short time
to live.
There was little information to be acquired in any period of this
disease, from the appearance of the urine, but when it was dark
and fœtid, the patient delirious, troubled much with flatulency,
great suffusion of the eyes, a deadly aspect of the countenance,
with vomiting of blood, which frequently occurred in the female
sex, when their menses did not flow at the usual period, and
when it happened to women at the period of life when they become
extremely irrregular, and generally cease to flow, the prognosis
will be found very unfavourable. At that time of life, the system
undergoes a very material change, being about to accommodate
itself to a new mode of action. It is scarce ever able to with stand
this, with the violence of so dreadful a disease.
When the tongue was florid, appearing as if rubbed over with
the red particles of the blood, accompanied with a clammy mois—
ture on the different parts of the body, respiration laborious,
with sighing and livid petechiæ generally spread over the skin,
the parts where blisters were applied becoming of a dark colour,
together with the posture of the patient's body indicating great
debility, with difficulty in making water, although the pulse be at
the same time tolerably even and strong, which is not unfrequent—
ly the case, they are marks of extreme danger.
A favourable prognosis in this stage, as well as in the preced—
ing, does not depend on a solitary favourable symptom, but on
several; therefore we should be guarded in giving an opinion.
If the pulse, from being extremely feeble, should acquire more
strength, and the heat, which was before considerably diminished,
becomes in general nearer the healthy standard, together with an
abatement of the violent vomiting and burning sensation in the re—
gion of the stomach and præcordia, the brain less confused,* with
a diminution of restlessness and cessation of sighing, gradual dis—
appearance of petechiæ, with an enlargement in and about the
parotid glands, disfiguring much the natural form of the visage,
occurring particularly in children, sometimes in adults, the tongue
becoming cleaner from the middle and point, towards the edges,
the patient capable of lying in any position with tolerable facility,
with incipient formation of abscesses in different parts of the bo—
dy, and a slight return of appetite, although the skin and eyes be
of a deep yellow colour, we may prognosticate with some degree
of certainty, that the event will be favourable.
In the last stage: This may be considered as only a deeper
shade in the symptoms of the latter part of the second, with the
addition of others, but replete with danger.
Nevertheless, with all the disagreeable symptoms of sighing, yel—
* If the patients became maniacal, the disease generally disappeared,
and they frequently recovered.

160 OF THE YELLOW FEVER.
lowness of the skin, delirium, black vomiting, livid ulcers in the
mouth, sphacelation of blistered parts, bleedings from the nose
and mouth, black tongue, and almost every other symptom that
this stage can produce, excepting a remarkable feeble and inter—
mitting pulse, I have seen several patients perfectly recover. The
change generally took place for the better on the ninth of tenth
day, on which the pulse became more full, strong and even,
intellects less confused, tongue more florid from the middle to—
wards, the edges, heat general, and more equally distused, cessa—
tion of vomiting and hæmorrhagies, bowels more regular, with a
slight return of appetite, and beginning absorption of the yellow—
ness and petechiæ, with a capability in the patient of lying in any
position, with increasing strength and complete recovery. These
instances were very rare, though few will deny their occurrence.
REGIMEN.—The patient should abstain from animal food;
and when any thing is required, it should be gruel, panada, &c. 
He should use cool diluting drinks, such as barley—water, apple—
water, with small quantities of ripe fruits, which tend to keep the
bowels open. The chamber of the sick should be spacious and airy,
kept cool, and frequently sprinkled with vinegar. Great attention
should be paid to these circumstances, as they are of infinite im—
portance to those who frequent the apartments of the sick, and are
highly conducive to the cure of the disease. 
MEDICINE—.In the cure of the malignant fever, it appeared
necessary; first, to moderate the inflammatory action: secondly, to
remove or alleviate certain distressing symptoms which generally
occurred, more or less, through the several stages of the disease:
thirdly, to support the tone and vigour of the system.
The inflammatory action was most effectually moderated by the
different classes of evacuants; among the most efficacious was
bleeding in the arm.
About the tenth of August, 1793, which was shortly after the
disease made its appearance in Philadelphia, bleeding was not at—
tended with success, at less among the sick under my care; there—
fore, the practice was discontinued; and I trusted, with most of my
medical brethren, to the milder class of evacuants, until the 12th
of September. Having found, on dissection, the stomach and intes—
tines highly inflamed, I resumed the practice of bleeding upon
good grounds, and with evidently better effect. The quantity of
blood to be taken away was regulated by the violence of the
symptoms, age, sex, and habit of body; for those who were
very corpulent did not bear evacuations near so well as those of a
spare make. No certain rule can be laid down, with respect to
the quantity of blood to be taken. The attempt must be subject,
to considerable error; yet the number of ounces to be abstracted
has been dictated by some authors. Dr. Williams, of Jamaica,
who wrote in 1750, advised plentiful bleeding. Dr. Hillary, of
Barbadoes, bled once or twice during the first days of the dis— 

161 OF THE YELLOW FEVER. 
ease*. Dr. Mosely informs us, that bleeding should be perform—
ed and repeated every six or eight hours, and if the symptoms be
obstinate and do not abate, it should be executed even to fainting†.
Dr. Blane observes, that if the patient had not a throbbing pulse,
with violent pain in the head and back, it should not be perform—
ed; and that without the presence of those symptoms it was ex—
tremely dangerous. Dr. Warren, who had passed a considerable
time in Barbadoes, seems much averse to bleeding in any stage
of this disease. Such are the different opinions of the tropical
writers on this subject. But during the prevalence of the malig—
nant fever in Philadelphia, which nearly resembled that described
under the appellation of the putrid bilious fever of the West—India
islands, I was influenced in the abstraction of blood, by the ten—
sion and fulness of the pulse, the season of the year, and other
circumstances previously observed, together with the abatement
which the sick experienced of the symptoms during the flowing of
the blood. But it was very seldom that one bleeding, however
profuse it may have been, would put an end to this disease; al—
though the pains in the head and back were greatly mitigated.
Yet they too often returned with additional violence. At this
time, if the pulse continued full and tolerably tense, and the
strength not much impaired, a sufficient quantity of blood may be
taken away to procure an alleviation of the symptoms. This should
be repeated as often as they recur in the inflammatory stage of the
disease; but it seldom appeared necessary to be done later than the
end of the third day. When it was employed at a more advan—
ced period, particularly near the time when the disease was passing
into its second stage, it invariably increased the train of terrible
symptoms which mark this period, with a sinking in the pulse
that no human effort was able to support. The blood drawn in
this stage of the disease, very seldom perfectly separated into the
watery and grosser parts. When it did, the former was of a na—
tural colour, though small in quantity in proportion to the latter.
The thicker part was generally of a florid arterial colour, tender
in the course of the warm weather. As the cool weather advan—
ced, and the disease became more inflammatory, it was sizy in
some cases, with a proportionable degree of contraction of its su—
perior circumference, exhibiting a cup—like appearance. Some—
times, during the warm weather, there was a thick tender sizy coat
on its upper surface, without this cup—like appearance. When
blood was drawn during the yellow suffusion of the skin, the thin—
ner part was of a corresponding colour, yet not in the, least bitter
to the taste, that could be observed in a variety of instances; and
was, like healthy serum, affected by heat and acids. To return to
the cure: At the same time that great attention was paid to blood—
letting, other remedies were not neglected. Whatever contri—
* Hillary's Observations, page 157. † Mosely, page 429. 
X 

162 OF THE YELLOW FEVER.
bated so diminish the quantity of fluids in the system, and carried
off the redundant matter in the first passages, was proportionably
efficacious in diminishing the inflammatory action. Purges, and
other evacuants, were employed, as being secondarily the most
powerful remedies, particularly when alternated with bleeding,
which appeared to be the most judicious way of using them—
Those preferred were such, on whose powerful action, reliance
could be had, and when the stomach was sick, required but a
small quantity to answer the purpose, at the same time being
agreeable to the palate. Calomel possesses most of those proper—
ties, and under certain circumstances, could be administered with
the greatest advantage. It should be given in large doses until it
has the desired effect, and might be expedited in its operation by
giving laxative clysters. When the functions of the stomach
were not much deranged, which was sometimes the case, the sa—
line purgatives were made use of, such as Glauber salt, which were
powerful, less stimulating than the calomel, and of course, better
antiphlogistics. These answered the purpose equally well, as the
object was merely to reduce the energy of the system and carry off
the bilious matter.
To relieve the violent pain in the head, blisters were employed,
after general evacuation had been used as far as appeared advisa—
ble; but previous to their application to the neck, blood was drawn
by cupping the part to be blistered. This mode of practice generally
afforded considerable relief.
Having taken notice of remedies suitable to the first indication,
I come now to the second, viz. to alleviate or remove certain dis—
tresing symptoms; such as violent vomiting, costiveness, flatulen—
cy, great restlessness and want of sleep, and also to the means used
to divert the despondency of the patient.
To moderate the excessive vomiting, often baffled every prac—
titioner. Various means were employed to effect it; which may
be divided into external and internal. Among the former, was
blistering the different parts of the body, particularly the region
of the stomach. From repeated trials, it seemed to have but little
influence on the latter. Blisters have been recommended to be
applied to the legs by Dr. Hume, of Jamaica, from which he ex—
perienced very good effects. This practice appeared here only
to torture the patient's feelings, without the least abatement of
the vomiting. Warm bathing was employed in this stage of the
disease, sometimes with a mitigation of the vomiting; yet fre—
quently it increased the sickness at the stomach, and produced
fainting. Flannels wrung out of a warm and strong infusion of aro—
matics, applied constantly to the region of the stomach, were
sometimes serviceable; but external applications seldom promised
much advantage.
With respect to internal remedies, almost every anti—emetic was
employed, that the experience of physicians had found useful, but 

163 OF THE YELLOW FEVER. 
frequently without having the desired effect; such as the saline
mixture in the state of effervescence; the infusion of columbo root,
cinnamon water with liquid laudanum; the peppermint julep with
laudanum, as also barley—water, toast—water, apple—water, lemonade,
camomile tea, and a variety of other drinks during the inflamma—
tory period. After these, small doses of tincture of Peruvian bark,
with spirit of lavender—compound, were administered with a
good effect, paticularly when the symptoms of violent inflamma—
tion of the stomach did not contra—indicate its use. It was espe—
cially serviceable to such patients who had been accustomed to an
irregular mode of life, and drank to excess of spirituous liquors;
for, when every other article was immediately rejected, it generally
continued on the stomach. The mucilaginous vitriolic mixture*
was used to advantage, and small quantities of wine, porter, cy—
der, or brandy and water, was of service, by giving tone to the
debilitated stomach.
Fresh buttermilk was frequently found grateful to the sick, and
very beneficial as an anti—emetic, even when from the symptoms it
might be concluded, that the stomach was highly inflamed. Like—
wise, a tea—spoonful of cream—tartar, dissolved in sugar and water,
was known to stay on the stomach and pass through the bowels,
when every other medicine and drink was instantly rejected. This
medicine was administered with a view to remove costiveness,
which should always be guarded against in this disease; but the
patient finding it so effectual in stopping vomiting, he frequently
had recourse to it without being costive, with the same good effect.
In several other cases it was made use of, but was too often in—
stantly rejected. Castor—oil, administered under similar circum—
stances, had the like effect; but this was not often the case, al—
though I have frequently known it to continue on the stomachs of
people violently sea—sick, and remove costiveness, when drink of
every kind was immediately thrown up. During excessive sick—
ness at the stomach, the most agreeable medicine and drinks were
less frequently rejected than those of an unpleasant quality. No
sooner did a draught of any liquid reach the stomach, than it was
instantly rejected. It is not to be apprehended that this arose from
the quality, but rather from the quantity. On this account, the
patient should not take more than a table—spoonful at a time. His
own feeling, with respect to fulness and sickness at the stomach,
should determine the frequency and quanticy of drink, however
infatiably thirsty he may be. In conjunction with these precau—
tions, the body should be—kept as quiet as possible; for the least
accelerated motion of it, frequently brought on a fit of vomiting.
Costiveness and flatulency were extremely distressing in this
disease. To remove them was always very difficult, particularly
when there was much sickness at the stomach, with vomiting; for
* Which is mucilage of gum arabic; acidulated with elixir of vitriol.

164 OF THE YELLOW FEVER.
the intestines were frequently very sluggish in their action, and
the stomach generally rejected every class of purgative medicines,
When this was the case, there was no alternative but that of
keeping the bowels open by clysters. These were subject to consi—
dearable inconvenience, when they could be administered; but this
was not often the case. They frequently cleared but the lower
part of the intestines, whilst those approximating the stomach,
were generally distended with fæces, and an incessant source of
irritation to the stomach. Whenever, therefore, a chance of success
in the administration of purgative medicines occurred, they were
always attempted. They generally cleared the whole tract of in—
testinal canal, and frequently procured a mitigation of the vomit—
ing. If rejected, they were not frequently repeated, left they might
exhaust the strength of the patient without contributing to his
relief. Keeping the intestinal canal clear of fæces, in some mea—
sure, obviated flatulency. But in an advanced period of the dis—
ease, the stomach and intestines were so much debilitated, that
they frequently had not energy sufficient, when apparently clear
of fæces, to expel the wind either upwards or downwards, but
it continued, as it were, stationary, and tormented the patient. Dur—
ing this state, when the stomach was tolerably tranquil, a strong in—
fusion of fennel—seed was administered, mixed in a small quan—
tity of brandy, with advantage, particularly when alternated with
some agreeable tonic, such as the mucilaginous vitriolic mixture
already recommended, if nothing contra—indicated its use, or a 
small quantity of a strong infusion of spices. They sometimes
afforded relief; but those symptoms too frequently baffled every
attempt to remove them.
Another circumstance was, the extreme restlessness and want of
sleep. Generally, by quieting the former, the fatigue from the
long wakefulness will frequently induce the latter. This indi—
cation was most effectually answered by opium. The propriety
of employing it, has engaged the attention of many of the tropi—
cal writers. By one it is much approved of;* by another it is
condemned during the inflammatory period, as being highly sti—
mulating and acrid. The use of it, says one, must be attended 
with imminent danger†. In the subsequent stages, good effects
have been experienced from the use of opium, particularly in the
second and last stages of the disease. In the former it induced sleep,
refreshing the patient, and enabling him, in some measure, to resist
the extreme violence of the disease. In the latter, it afforded conso—
lation by lulling the inquietude, and smoothing the avenue to death.
To divert the gloomy thoughts of the patient, was attended
with almost insurmountable difficulties. However, it should be
always attempted by the most encouraging language and affur—
ance of a complete recovery; for on this, the favourable termi—
nation of the disease much depends. The patient should not be
* Hillary's Observations page 160. † Dr. Mosely. 

165 OF THE YELLOW FEVER. 
told that he has the yellow fever; for I have known a patient,
in this disease, faint from an unguarded expression, and afterwards
die apparently from a slight attack. No art could persuade him that
his dissolution was not approaching with hasty speed. Therefore,
great circumspection should be observed, and the patient encouraged
with as much consistency and boldness as possible. Most of the sick
that were slightly indisposed, would seize the least dubious expres—
sion of the physician, respecting their recovery.
I come now to the third and last indication; which is, to sup—
port the sinking tone and perishing vigour of the system. This
indication is applicable to the second, but more particularly to the
last stage of the disease. The latter, being an augmentation of the
symptoms of the former, sometimes much diversified, requires
more powerful remedies. Whenever a change was perceived in
the system, indicating that debility was commencing, the nature of
the disease must be considered as materially different, conse—
quently requiring a particular mode of treatment. The patient
should not be restricted to a vegetable diet or watery drinks, espe—
cially if there are no violent symptoms indicating inflammation
of the stomach. Stimulants should be employed both, external
and internal, such as blisters to different parts of the body, in or—
der to excite the system. The application, when deferred to a
more advanced period, was rather of disservice; for the strength
of the patient was so far exhausted, that the blistered parts
soon became black and sphacelated, sometimes attended with
profuse hæmorrhagy. Their application was discontinued in
the last , stage of the disease. Washing the whole body in brandy
and water, or when that could not be complied with, the face,
breast and hands, always proved very refreshing to the sick;
cold water thrown over the head and shoulders, morning and
evening, frequently had a good effect, by giving vigour to the sys—
tem. It likewise invariably induced sleep, with a gentle moisture
on the skin. In addition to the external stimulants already men—
tioned, mustard poultices maybe applied to the feet; and when there
are no symptoms contra—indicating the use of internal remedies,
such as violent symptoms of inflammation in the stomach, they
should be administered; and one would imagine, from the declin—
ing vigour of the system, that bark and wine would be useful.*
The former of which, in some cases, was serviceable, particularly
when the functions of the stomach were not much deranged; but
nausea and vomiting were so invariably present, that in almost all
cases, in whatever manner or form it was administered, it always,
at least in my practice, proved detrimental†. This especially hap—
* The intermittent and remittent fevers, mentioned in a note in the
history of this disease, were cured by emetics and the bark; the latter
continued very well on the stomach.
† Except to use it in small doses to quiet the perturbed stomach, giv—
en under the circumstances formerly mentioned. 

166 OF THE YELLOW FEVER.
pened, when the bark was given by the mouth. It commonly
deranged the state of the stomach in such a manner, that it was
not susceptible of retaining any other medicine or drink. When
administered in the form of clysters, mixed with London porter
and laudanum, it did not seem to have any good effect. They ge—
nerally produced a painful sensation over the whole abdomen. This
was sometimes the case, even when a common laxative clyster was
given, so that the patient could scarcely retain it a moment. Dur—
ing the time bark was employed, wine was given, beginning with
claret or any other weak wine but if there was great defect
the vigour of the system, Madeira was soon found necessary. If
wine could not be taken by the patient, brandy, diluted with wa—
ter, porter, or cyder, was substituted. These should be in—
creased in quantity, according to the state of the stomach and de—
gree of feebleness in the pulse, at the same time the elixir of vi—
triol was employed as a tonic. The bark, the most powerful of
all tonics, was found to disagree with the stomach, and was there—
fore always omitted, except during the convalescent state, and an
entire dependence was placed in the medicine recommended, to—
gether with the wine or its substitute. These should be adminis—
tered in large quantities, and continued, until the pulse, from be—
ing small and sinking, became full, round, and tolerably strong;
the heat more equally diffused, the delirium abating, and the pa—
dent becoming more cheerful. Such were frequently the effects
of those stimulants; and even when the strength appeared almost
exhausted, they would revive and keep up the spark of life, and
sometimes in the most deplorable cases, restore perfect health and 
vigour.
Great caution should be observed in the administration of wine. 
When the most urgent symptoms are mitigated, and some of
them removed, the quantity may be gradually diminished. Should 
the dangerous symptoms return it may be augmented with cau—
tion. This practice was more expedient if the patient could take
some nourishment that was light and agreeable, such as panada, or
gruel; or if there was a slight return of appetite, some preparation
of animal food should be given, such as weak broth, and at times 
a few oysters, if the stomach would bear them. Great caution was
to be observed in making use of solid food. If any is advisable, oys—
ters certainly are the most proper, as they are the most easy of di—
gestion, and afford a sufficient quantity of nourishment.
It is proper to take notice of the conduct to be observed by
the patient during the convalescent state. This was generally te—
dious. When the disease had been remedied by profuse evacua—
tions, the recovery was considerably protracted and precarious.
The patient acquired strength but slowly, and sometimes had a
tendency to the dropsy. During recovery, patients should be very
circumspect in their conduct, for fear of a relapse of fever. They
should choose food most easy of digestion; eat moderately; and 

167 OF THE SMALL—POX. 
take a dose of bark, two or three times a—day, to assist digestion,
and invigorate the debilitated system. A moderate quantity of
wine may be allowed; gentle exercise should be conjoined, the
bowels kept open, and the night—air avoided.
CHAPTER XXIV.
Of the Small—Pox.
THIS disease, which originally came from Arabia, is now be—
come so general, that very few escape it at one time of life or
another. It is a most contagious malady; and has for many years
proved the scourge of Europe. 
The small—pox generally appears towards the spring. They are
frequent in summer, less so in autumn, and least of all in winter.
Children are most liable to this disease; and those whofe food is un—
wholesome, who want proper exercise, and abound with gross
humours, run the greatest hazard from it.
This disease is distinguished into the distinct and confluent kind;
the latter of which is always attended with danger. There are like—
wise other distinctions of the small—pox; as the crystalline, the
bloody, &c. 
CAUSES.—The small—pox is commonly caught by infection.
Since the disease was first brought into Europe, the infection has
never been wholly extinguished, nor have any proper methods, as
far as I know, been taken for that purpose; so that now it has be—
come in a manner constitutional. Children who have over—heated
themselves by running, wrestling, &c. or adults after a debauch, are
most apt to be seized with the small—pox.
SYMPTOMS.—This disease is so generally known, that a
minute description of it is unnecessary. Children commonly look
a little dull, seem listless and drowsy for a few days before the
more violent symptoms of the small—pox appear. They are more
inclined to drink than usual, have little appetite for solid food, com—
plain of weariness, and, upon taking exercise, are apt to sweat.
These are succeeded by slight fits of cold and heat in turns, which,
as the time of the eruption approaches, become more violent, and
are accompanied with pains of the head and loins, vomiting, &c.
The pulse is quick, with a great heat of the skin, and restlessness.
When the patient drops asleep, he wakes in a kind of horror, with
a sudden start, which is a very common symptom of the approach—
ing eruption; as are also convulsion—fits in very young children.
About the third or fourth day from the time of sickening, the
small—pox generally begin to appear; sometimes they appear sooner,
but that is no favourable symptom. At first they very nearly resem—
ble flea—bites,and are soonest discovered on the face, arms, and breast.
The most favourable symptoms are a slow eruption, and an abate— 

168 OF THE SMALL—POX.
ment of the fever as soon as the pustules appear. In the distinct
kind of small—pox, the pustules seldom appear before the fourth day
from the time of sickening, and they generally keep coming out
gradually for several days after. Pustules which are distinct, with
a florid red basis, and which fill with thick purulent matter, first
of a whitish, and afterwards of a yellowish colour, are the best.
A livid brown colour of the pustules is an unfavourable symp—
tom; as also when they are small and flat, with black specks in the
middle. Pustules which contain a thin watery ichor are very bad.
A great number of pox on the face is always attended with danger.
It is likewise a very bad sign when they run into one another.
It is a most unfavourable symptom when petechiæ, or purple,
brown or black spots are interspersed among the pustules. These
are signs of great danger. Bloody stools or urine, with a swelled
belly, are bad symptoms; as is also a continual strangury. Pale
urine and a violent throbbing of the arteries of the neck are signs
of an approaching delirium, or of convulsion—fits. When the face
does not swell, or falls before the pox come to maturity, it is very
unfavourable. If the face begins to fall about the eleventh or
twelfth day, and, at the same time, the hands and feet begin to swell,
the patient generally does well; but when these do not succeed to
each other, there is danger. The tongue covered with a brown—
crust is an unfavourable symptom. Cold shivering fits coming on
at the height of the disease are likewise unfavourable. Grinding
of the teeth, when it proceeds from an affection of the nervous
system, is a bad sign; but sometimes it is occasioned by worms, or
a disordered stomach.
REGIMEN.—When the first symptoms of the small—pox ap—
pear, people are ready to be alarmed, and often fly to the use of
medicine, to the great danger of the patient's life. I have known
children to be bled, blistered and purged, during the fever which
preceded the eruption of the small—pox, to such a degree, that
Nature was not only disturbed in her operation, but rendered un—
able to support the pustules after they were out; so that the pa—
tient, exhausted by mere evacuations, sunk under the disease.
When convulsions appear, they give a dreadful alarm. Imme—
diately some nostrum is applied, as if this were a primary disease;
whereas it is only a symptom, and far from being an unfavourable
one, of the approaching eruption. As the fits generally go off be—
fore the actual appearance of the small—pox, it is attributed to the
medicine, which by this means acquires a reputation without any
merit*.
* Convulsion—fits are very alarming; but their effects are often salutary.
They seem to be one of the means made use of by Nature, for breaking
the force of a fever. I have always observed the fever abated, and some—
times quite removed, after one or more convulsion—fits. This readily ac—
counts for convulsions being a favourable symptom in the fever which
precedes the eruption of the small—pox, as every thing that mitigates
this fever lessens the eruption. 

169 OF THE SMALL—POX. 
All that is, generally speaking, necessary, during the eruptive fe—
ver, is to keep the patient cool and easy, allowing him to drink
freely of some weak diluting liquors; as balm—tea, barley—water,
clear whey, gruels, &c. He should not be confined to bed, but
should fit up as much as he is able, and should have his feet and
legs frequently bathed in lukewarm water. His food ought to be
very light; and he should be as little disturbed with company as, pos—
sible. Much mischief is done at this period, by confining the patient
too soon to his bed, and plying him with warm cordials or sudorific
medicines. Every thing that heats and inflames the blood, increases
the fever, and pushes out the pustules prematurely. This has num—
berless ill effects. It not only increases the number of pustules, but
likewise tends to make them run into one another; and when—they
have been pushed out with too great violence, they generally fall in
before they come to maturity.
Women, as soon as they see the small—pox begin to appear, com—
monly ply their tender charge with cordials, saffron, and marigold—
teas, wine, punch, and even brandy itself. All these are given with
a view, as they term it, to throw out the eruption from the heart.
This, like most other popular mistakes, is the abuse of a very just
observation, that when there is a moisture on the skin, the pox rise better,
and the patient is easier, than when it continues dry and parched. But
that is no reason for forcing the patient into a sweat. Sweating
never relieves unless where it comes spontaneously, or is the effect
of drinking weak diluting liquors. 
Children are often so peevish, that they will not lie a—bed with—
out a nurse constantly by them. Indulging them in this, has many
bad effects both upon the nurse and child. Even the natural heat of
the nurse augments the fever of the child; but if she, too, proves
feverish, which is often the case, the danger must be increased*.
Lying several children, who have the small—pox, in the same bed,
has many ill consequences. They ought, if possible, never to be in
the same chamber, as the perspiration, the heat, the smell, &c. all
tend to augument the fever, and to heighten the disease. It is com—
mon among the poor, to see two or three children lying in the same
bed, with such a load of pustules, that even their skins stick to—
gether. One can hardly view a scene of this kind, without being
sickened by the fight. But how must the effluvia affect the poor
patients, many of whom perished by this usage†?
* I have known a nurse, who had the small—pox before, so infected
by lying constantly a—bed with a child, in a bad kind of small—pox, that
she had not only a great number of pustules, which broke out all over her
body, but afterwards a malignant fever, which terminated in a number of
imposthumes or boils, and from which she narrowly escaped with her life.
We mention this, to put others upon their guard against the danger of
this virulent infection.
† This observation is likewise applicable to hospitals, work—houses,
&c. where numbers of children happen to have the small—pox at the
same time. I have seen above forty children cooped up in one apartment,
Y 

170 OF THE SMALL—POX.
A very dirty custom prevails among the lower class of people, of 
allowing children in the small—pox to keep on the same linen dur—
ing the whole period of that loath some disease. This is done, left
they should catch cold; but it has many ill consequences. The
linen becomes hard by the moisture which it absorbs, and frets the
tender skin. It occasions a bad smell, which is very pernicious both 
to the patient and those about him; besides, the filth and fordes,
which adhere to the linen, being resorbed, or taken up again into
the body, greatly augment the disease.
A patient should not be, suffered to be dirty in an internal disease,
far less in the small—pox. Cutaneous disorders are often occasioned
by nastiness alone, and are always increased by it. Were the pa—
tient's linen to be changed every day, it would greatly refresh him.
Care, indeed, is to be taken, that the linen be thoroughly dry. It
ought likewise to be put on when the patient is most cool. 
So strong is the vulgar prejudice in this Country, notwithstanding 
all that has been said against the hot regimen in the small—pox, that
numbers still fall a sacrifice to that error. I have seen poor women
travelling in the depth of winter, and carrying their children along 
with them in the small—pox, and have frequently observed others
begging by the way—side, with infants in their arms covered with
the pustules; yet I could never learn that one of these children
died by this fort of treatment. This is certainly a sufficient proof
of the safety, at least, of exposing patients in the small—pox to the
open air. There can be no reason, however, for exposing them to
public view. It is now very common in the environs of great towns 
to meet patients in the small—pox on the public walks. This pactice
may suit the purposes of boasting inoculators, but is dangerous to
the citizens, and contrary to the laws of humanity and found policy. 
The food in this disease ought to be very light, and of a cooling 
nature, as panado, or bread boiled with equal quantities of milk and 
water, good apples roasted or boiled with milk and sweetened with
a little sugar, or such—like. The drink may be equal parts of milk
and water, clear sweet whey, barley—water, or thin gruel, &c. Af—
ter the pox are full, butter—milk, being of an opening and cleansing
nature, is a very proper drink. 
MEDICINE.—This disease is generally divided into four dif—
ferent periods, viz. the fever which precedes the eruption, the erup—
tion itself, the suppuration, or maturation of the pustules, and the
secondary fever.
Little more is necessary, during the primary fever, than to keep 
all the while they had this disease, without any of them being admitted
to breath the the fresh air. No one can be at a loss to see the impropriety
of such conduct. It ought to be a rule, not only in hospitals for the small—
pox, but, likewise, for other diseases, that no patient should be within
fight or hearing of another. This is a matter to which too little regard
is paid. In most hospitals and infirmaries, the sick, the dying, and the
dead, are often to be seen in the same apartment. 

171 OF THE SMALL—POX.
the patient cool and quiet, allowing him to drink diluting liquors,
and bathing his feet frequently in warm water. Though this be
generally the safest course that can be taken with infants, yet admits
of a strong constitution and plethoric habit sometimes require bleed—
ing. When a full pulse, a dry skin, and other symptoms of inflam—
mation render this operation necessary, it ought to be performed;
but, unless these symptoms are urgent, it is safer to let it alone; if
the body is bound, emollient clysters may be thrown in.
If there is a great nausea, or inclination to vomit, weak camomile—
tea, or lukewarm water may be drank, in order to clean the stomach.
At the beginning of a fever, Nature generally attempts a discharge;
either upwards or downwards, which, if promoted by gentle means,
would tend greatly to abate the violence of the disease.
Though every method is to be taken during the primary fever,
by a cool regimen, &c. to prevent too great an eruption; yet, after
the pustules have made their appearance, our business is to promote
the suppuration, by diluting drink, light food, and, if Nature seems
to flag, by generous cordials. When a low, creeping pulse faintish—
ness, and great loss of strength, render cordials necessary, we would
recommend good wine, which may be made into negus, with an
equal quantity of water, and sharpened with the juice of orange,
the jelly of currants, or the like. Wine—whey, sharpened as above,
is likewise a proper drink in this case; great care, however, must
be taken not to overheat the patient by any of these things. This,
instead of promoting, would retard the eruption.
The rising of the small—pox is often prevented by the violence of
the fever. In this case, the cool regimen is strictly to be observed.
The patient's chamber must not only be kept cool, but he ought
frequently to be taken out of bed, and to be lightly covered with
clothes while in it.
Excessive restlessness often prevents the rising and filling of the
small—pox. When this happens, gentle opiates are necessary. These
ought always to be administered with a sparing hand. To an in—
fant, a tea—spoonful of the syrup of poppies may be given every
five or six hours till it has the desired effect. An adult will require
a table—spoonful to answer the same purpose.
If the patient be troubled with a strangury, or suppression of urine,
which often happens in the small—pox, he should be frequently
taken out of bed, and, if he be able, should walk across the room
with his feet bare. When he cannot do this, he may be frequently
set on his knees in bed, and should endeavour to pass his urine as
often as he can. When these do not succeed, a tea—spoonful of the
sweet spirits of nitre may be occasionally mixed with his drink.
Nothing more certainly relieves the patient, or is more beneficial in
the small—pox,than a plentiful discharge of urine.
If the mouth be foul, and the tongue dry and chopped, it ought
to be frequently washed, and the throat gargled with water and
money, sharpened with a little vinegar or currant—jelly. 

172 OF THE SMALL—POX.
During the rising of the small—pox, it frequently happens, that
the patient is eight or ten days without a stool. This not only tends
to heat and inflame the blood, but the fæces, by lodging so long in
the body, become acrid, and even putrid. From whence bad conse—
quences must unsue. It will, therefore, be proper, when the body is
bound, to throw in an emollient clyster every second or third day,
through the whole course of the disease. This will greatly cool and
relieve the patient.
When petechiæ, or purple, black, or livid spots appear among
the small—pox, the bark must immediately be administered in as
large doses as the patient's stomach can bear. For a child, two
drachms of the bark in powder may be mixed in three ounces of
common water, one ounce of simple cinnamon—water, and two
ounces of the syrup of orange or lemon. This may be sharpened
with the spirits of vitriol, and a table—spoonful of it given every
hour. If it be given to an adult in the same form, he may take at
least three or four spoonfuls every hour. This medicine ought not
to be trifled with, but must be administered as frequently as the 
stomach can bear it; in which case, it will often produce very hap—
py effects. I have frequently seen the petechiæ disappear,and small—
pox, which had a very threatening aspect, rise and fill with laudable
matter, by the use of the bark and acids.
The patient's drink ought, in this case,to be generous; as wine or
strong negus acidulated with spirits of vitriol, vinegar, the juice of
lemon, jelly of currants, or such—like. His food must consist of ap—
ples roasted or boiled, preserved cherries, plumbs, and other fruits 
of an acid nature.
The bark and acids are not only necessary when the petechiæ
appear, but likewise in the lymphatic or crystalline small—pox, where
the matter is thin, and not duly prepared. The Peruvian bark seems 
to possess a Singular power of assisting Nature in preparing good
matter; consequently, it must be beneficial both in this and other
diseases, where the crisis depends on a suppuration. I have often
observed, where the small—pox were flat, and the matter contained 
in them quite clear and transparent, and where, at first, they had
the appearance of running into one another, that the bark, acidu—
lated as above, changed the colour and consistence of the matter,
and produced the most happy effects.
When the eruption subsides suddenly, or when the small—pox
strike in, before they have arrived at maturity, the danger is very
great, In this case, blisters must be immediately applied to the wrists 
and ancles, and the patient's spirits supported with cordials.
Sometimes bleeding has a surprising effect in raising the pustules
after they have subsided; but it requires skill to know when this
is proper, or to what length the patient can bear it. Sharp cata—
plasms, however, may be applied to the feet and hands, as they
tend to promote the swelling of these parts. 
The most dangerous period of this disease, is what we call the 

173 OF THE SMALL—POX.
secondary fever. This generally comes on when the small—pox be—
gin to-blacken, or turn on the face; and most of those who die of
the small—pox, are carried off by this fever.
Nature generally attempts, at the turn of the small—pox, to re—
lieve the patient by loose stools. Her endeavours, this way, are by
no means to be counteracted, but promoted, and the patient, at the
same time, supported by food and drink of a nourishing and cordial 
nature. 
If, at the approach of the secondary fever, the pulse be very
quick, hard and strong, the heat intense, and the breathing labori—
ous, with other symptoms of an inflammation of the breast, the
patient must immediately be bled. The quantity of blood to be
let, must be regulated by the patient's strength, age, and the ur—
gency of the symptoms. 
But, in the secondary fever, if the patient be faintish, the pus—
tules become suddenly pale, and if there be great coldness of the
extremities, blisters must be applied, and the patient must be sup—
ported with generous cordials. Wine, and even spirits, have some—
times been given, in such cases, with amazing success. 
As the secondary fever is, in great measure, if not wholly, owing
to the absorption of the matter, it would seem highly consonant
to reason, that the pustules, as soon as they come to maturity, 
should be opened. This is every day practised in other phlegmons
which tend to suppuration; and there seems to be no cause why it
should be less proper here. On the contrary, we have reason to
believe, that, by this means, the secondary fever might always be
lessened, and often wholly prevented.
The pustules should be opened when they begin to turn of a 
yellow colour. Very little art is necessary for this operation. They
may either be opened with a lancet or a needle, and the matter
absorbed by a little dry lint. As the pustules are generally first ripe 
on the face, it will be proper to begin with opening these, and
the others in course as they become ripe. The pustules generally
fill again, a second or even a third time; for which cause, the opera—
tion must be repeated, or rather continued as long as there is any
considerable appearance of matter in the pustules.
This operation, rational as it is, has been neglected from a piece 
of mistaken tenderness in parents. They believe that it must give
great pain to the poor child; and, therefore; would rather see it die
than have it thus tortured. This notion is entirely without founda—
tion. I have frequently opened the pustules, when the patient did 
not see me, without his being in the least sensible of it; but, sup—
pose it where attended with a little pain, that is nothing is compan—
ion to the advantages which arise from it.
Opening the pustules not only prevents the resorption of the
matter into the blood, but likewise takes off the tension of the skin,
and, by that means, greatly relieves the patient. It likewise tends to
prevent the pitting, which is a matter of no small importance. 

174 OF THE SMALL—POX. 
Acrid matter, by lodging long in the pustules, cannot fail to cor—
rode the tender skin; by which, many a handsome face becomes
so deformed as hardly to bear a resemblance to the human figure*.
It is generally necessary, after the small—pox are gone off, to purge
the patient. If, however, the body has been open through the whole
course of the disease, or if butter—milk and other things of an open—
ing nature have been drank freely after the height of the small—pox,
purging becomes less necessary; but it ought never wholly to be
neglected.
For very young children, an infusion of senna and prunes, with
a little rhubarb, may be sweetened with coarse sugar, and given in
small quantities till it operates. Those who are farther advanced,
must take medicines of a sharper nature. For example; a child
of five or six years of age may take eight or ten grains of jalap
ever night, and the same quantity of jalap in powder next morning.
This may be wrought off with fresh broth or water—gruel, and may
be repeated three or four times, five or six days intervening between
each dose. For children further advanced, and adults, the dose
must be increased in proportion to the age and constitution†.
When imposthumes happen after the small-pox, which is not
seldom the case, they must be brought to suppuration as soon as
possible, by means of emollient poultices; and when they have be
opened, or have broke of their own accord, the patient must be
purged. The bark and a milk—diet will be useful in this case.
When a cough, a difficulty of breathing, or other symptoms of
a consumption, succeed to the small-pox, the patient must be sent
to a place where the air is good, and put upon a course of asses
milk, with such exercise as he can bear. For further directions in
this case, see the article Consumptions.
Of Inoculation.
THOUGH no disease, after it is formed, baffles the powers of
medicine more effectually than the small-pox, yet more may be
done before—hand, to render this disease favourable, than any one we
know; as almost all the danger from it may be prevented by inocu—
lation. This salutary invention has been known in Europe above
* Though this operation can never do harm, yet it is only necessary
when the patient has a great load of small—pox, or when the matter
which they contain is of so thin and acrid a nature, that there is reason
to apprehend bad consequences from its being too quickly resorbed, or
taken up again into the mass of circulating humours.
† I have of late been accustomed, after the small—pox, to give one, two,
three, four, or five grains of calomel, according to the age of the pa—
tient, over night, and to work it off next morning with a suitable dose
of jalap. 

175 OF THE SMALL—POX.
half a century; but, like most other useful discoveries, it has till of
late made but slow progress. To the honour of this country, ino—
culation has met with a more favourable reception here, than among
any of our neighbours. It is still, however, far from being general,
which we have reason to fear will be the case, s long as the prac—
tice continues in the hands of the faculty. 
No discovery can be of general utility, while the practice of it
is kept in the hands of a few. Had the inoculation of the small—
pox been introduced as a fashion, and not as a medical discovery, or
had it been practised by the same kind of operators here, as it is in
those countries from whence we learned it, it had long ago been
universal. The fears, jealousies, prejudices, and opposite interests
of the faculty, are, and ever will be, the most effectual obstacles to
the progress of any salutary discovery. Hence, inoculation never
became, in any measure, general, even in England, till taken up by
men not bred to physic. These have not only rendered the practice
more extensive, but more safe, and by acting under less restraint
than regular practitioners, have taught them that the patient's
greatest danger arose, not from the want of care, but the excess of it.
They know very little of the matter, who impute the success
of modern inoculators to any superior skill, either in preparing the
patient or communicating the disease. Some of them, indeed, from
a sordid desire of engrossing the whole practice to themselves, pre—
tend to have extraordinary secrets or nostrums for preparing persons
for inoculation, which never fail of success. But this is only a
pretence to blind the ignorant. Common sense and prudence alone
are sufficient both in the choice of the subject and management of
the operation. Whoever is possessed of these, may perform this office
for his children, whenever he finds it convenient, if they be in a good
state of health. 
This sentiment is not the result of theory, but of observation.
Though few physicians have had more opportunities of trying in—
oculation in all its different forms, so little appears to me to de—
pend on those, generally reckoned important circumstances, of
preparing the body, communicating the infection by this or the
other method, &c. that, for several years past, I have persuaded
the parents or nurses, to perform the whole themselves, and have
found that method followed with equal success, while it is free
from any inconveniences that attend the other.* 
* A critical situation, too often to be met with, first put me upon try—
ing this method. A gentleman who had lost all his children, except one
son, by the natural small—pox, was determined to have him inoculated.
He told me his intention, and desired I would persuade the mother and
grandmother, &c. of its propriety. But that was impossible. They were
not to be persuaded; and either could not get the better of their fears,
or were determined against conviction. It was always a point with me
not to perform the operation without the consent of the parties concern—
ed. I therefore advised the father, after giving his son a dose or; two
of rhubarb, to go to a patient who had the small—pox of a good kind,  

176 OF THE SMALL—POX.
The small—pox may be communicated in a great variety of ways,
with nearly the same degree of safety and success. In Turkey,
from whence we learned the practice, the women communicate
the disease to children, by opening a bit of the skin with a needle,
and putting into the wound a little matter taken from a ripe pos—
tule. On the coast of Barbary, they pass a thread wet with the
matter through the skin, between the thumb and fore—finger; and,
in some of the states of Barbary, inoculation is performed by rub—
bing in the variolous matter between the thumb and fore—finger, or
on other parts of the body. Rubbing the variolous matter upon 
the skin, has been long known in many parts of Asia and Europe,
as well as in Barbery, and has generally gone by the name of buy-
ing the small—pox.
The present method of inoculating in Britain,* is to make two
or three slanting incisions in the arm, so superficial as not to pierce
quite through the skin, with a lancet wet with fresh matter taken
from a ripe pustule; afterwards, the wounds are closed up, and
left without any dressing. Some make use of a lancet covered
with the dry matter; but this is less certain, and ought never to
be used unless where fresh matter cannot be obtained: when this
is the case, the matter ought to be moistened by holding the lan—
cet for some time in the steam of warm water.
Indeed, if fresh matter be applied long enough to the skin,
there is no occasion for any wound at all. Let a bit of thread, 
about half an inch long, wet with the matter, be applied to the
arm, mid—way between the shoulder and elbow, covered with a
piece of common sticking plaister, and kept on for eight or ten
days. This will seldom fail to communicate the disease. We
mention this method, because many people are afraid of a wound;
and, doubtless, the more easily the operation can be performed, it
has the greater chance to become general. Some imagine, that
the discharge from a wound lessens the eruption; but there is no
great stress to be laid upon this notion; besides, deep wounds of—
ten ulcerate, and become troublesome. 
We do not find that inoculation is considered as a medical ope—
ration in those countries from whence we learned it. In Turkey,
it is performed by the women, and, in the East—Indies, by the
to open two or three of the pustules, taking up the matter with a little
cotton, and, as soon as he came home, to take his son apart, and give his
arm a slight scratch with a pin, afterward to rub the place well with
the cotton, and take no farther notice of it. All this he punctually per—
formed; and, at the usual period, the small-pox made their appearance,
which were of an exceeding good kind, and so mild, as not to confine the
boy an hour to his bed. None of the other relations knew but the disease 
had come in the natural way, till the boy was well.
* The method practised in America, differs only in the number of in—
cisions: we find, that the matter inserted by one, is generally sufficient
to produce the desired effect, without the trouble and inconvenience 
of three. (I. C.) 

177 OF THE SMALL—POX. 
Brachmins. In this country, the custom is still in its infancy; we
make no doubt, but it will soon become so familiar, that parents
will think no more of inoculating their children, than at pre—
sent they do of giving them a purge.
No set of men have it so much in their power to render the
practice of inoculation general, as the clergy, the greatest oppo—
sition to it still arising from some scruples of conscience, which
they alone can remove. I would recommend it to them not only
to endeavour to remove the religious objections which weak minds
may have to this salutary practice, but to enjoin it as a duty, and
to point out the danger of neglecting to make use of a mean
which Providence has put in our power for saving the lives of our
offspring. Surely, such parents as wilfully neglect the means of
saving their children's lives, are as guilty as those who put them to
death. I wish this matter were duly weighed. No one is more
ready to make allowance for human weakness and religious pre—
judices; yet I cannot help recommending it, in the warmest man—
ner, to parents, to consider how great an injury they do their
children, by neglecting to give them this disease in the early pe—
riod of life.
The numerous advantages arising from the inoculation of the
small-pox, have been pretty fully pointed out by the learned Dr.
M'Kenzie, in his History of Health.* To those mentioned by
* “ Many and great,” says this humane author, “ are the dangers
attending the natural infection, from all which the innoculation is quite
secure. The natural infection may invade weak or distempered bodies,
by no means disposed for its kindly reception. It may attack them at
a season of the year either violently hot or intensely cold. It may be
communicated from a sort of small pox impregnated with the utmost
virulence. It may lay hold of people unexpectedly, when a dangerous
sort is imprudently imported into a maritime place. It may surprise us
soon after excesses committed in luxury, intemperance, or lewdness. It
may likewise seize on the innocent after indispensible watchings, hard
labour, or necessary journies. And is it a trivial advantage, that all these
unhappy circumstances can be prevented by inoculation? By inocula—
tion, numbers are saved from deformity as well as from death, in the
natural small—pox, how often are the finest features, and the most beau—
tiful complexions miserably disfigured? Whereas, inoculation rarely
leaves any ugly marks or scars, even where the number of pustules on
the face has been very considerable, and the symptoms by no means fa—
vourable. And many other grievous complaints, that are frequently
subsequent to the natural sort, seldom follow the artificial. Does not
inoculation also prevent those inexpressible terrors, that perpetually
harrass persons who never had this disease, insomuch, that when the
small—pox is epidemical, entire villages are depopulated, markets ruined,
and the face of distress spread over the whole country? From this ter—
ror it arises, that justice is frequently postponed, or discouraged at ses—
sion & or assizes where the small—pox rages. Witnesses and juries dare not
appear; and by reason of the necessary absence of some gentlemen, our
honourable and useful judges are not attended with that reverence and
splendour due to their office and merit. Does not inoculation, in like
manner, prevent our brave sailors from being seized with this distemper
on shipboard, where they must quickly spread the infection among such
Z 

178 OF THE SMALL—POX.
him, we shall only add, that such as have not had the small—pox in
the early period of life, are not only rendered unhappy, but like—
wise, in a great measure, unfit for sustaining many of the most
useful and important stations. Few people would choose even to
hire a servant who had not had the small—pox, far less to purchase
a slave who had the chance of dying of this disease. How could
a physician or a surgeon, who never had the small—pox himself,
attend others under that malady? How deplorable is the situa—
tion of females, who arrive at mature age without having had the
small—pox! A woman with—child seldom survives this disease: and
if an infant happen to be seized with the small—pox upon the mo—
ther's breast, who has not had the disease herself, this scene must
be distressing! If she continue to suckle the child, it is at the
peril of her own life; and if she wean it, in all probability, it will
perish. How often is the affectionate mother forced to leave her
house, and abandon her children, at the very time when her care
is most necessary? Yet should parental affection get the better of
her fears, the consequences would often prove fatal. I have known
the mother and her infant laid in the same grave, both victims to
this malady. Let parents who run—away with their children, to
avoid the small—pox, or who refuse to inoculate them in infancy,
consider to what deplorable situations they may be reduced by
this mistaken tenderness!
As the small—pox is now become an epidemical disease, in most
parts of the known world, no other choice remains, but to render
the malady as mild as possible. This is the only manner of extir—
pation now left in our power; and though it may seem paradoxical,
the artificial method of communicating the disease, could it be
rendered universal, would amount to nearly the same thing as
rooting it out. It is a matter of small consequence whether a dis—
ease be entirely extirpated, or rendered so mild as neither to de—
stroy life nor hurt the constitution; but that this may be done by
inoculation, does not now admit of a doubt. The numbers who
die under inoculation hardly deserve to be named. In the natural
way, one in four or five generally dies; but by inoculation not
one of a thousand. Nay, some can boast of having inoculated
ten thousand without the loss of a single patient. 
I have often wished to see some plan established for rendering 
this salutary practice universal. The difficulties are many; yet
the thing is by no means impracticable. The aim is great; no
less than saving the lives of one—fourth part of mankind. What
of the crew who never had it before, and where they have scarce any
chance to escape, being half stifled with the closeness of their cabins,
and but very indifferently nursed? Lastly, with regard to the soldiery,
the miseries attending these poor creatures, when attacked by the small—
pox on a march, are inconceivable—without attendance, without lodg—
ings, without any accommodation; so that one of three commonly
perishes.” 

179 OF THE SMALL—P0X. 
ought not to be attempted in order to accomplish so desirable an
end?
The first step towards rendering the practice universal, must be
to remove the religious prejudices against it. This can only be
done by the clergy. They must not only recommend it as a duty
to others, but likewise practise it on their own children. Example
will ever have more influence than precept.
The next tiling requisite is, to put it in the power of all. For
this purpose, let the faculty inoculate the children of the poor gra—
tis. It is hard that so useful a part of mankind should, by their
poverty, be excluded from such a benefit.
Should this fail, it is surely in the power of any state to render
the practice general, at least as far as their dominion extends. We
do not mean that it ought to be enforced by a law. The best way
to promote it, would be, to employ a sufficient number of operators
at the public expense, to inoculate the children of the poor. This
would only be necessary till the practice became general; after—
wards, custom, the strongest of all laws, would oblige every indi—
vidual to inoculate his children to prevent reflections.
It may be objected to this scheme, that the poor would refuse
to employ the inoculators; this difficulty is easily removed. A
small premium to enable mothers to attend their children while
under this disease, would be a sufficient inducement; besides, the
success attending the operation would soon banish all objections to
it. Even considerations of profit would induce the poor to embrace
this plan. They often bring up their children to the age of ten or
twelve, and when they come to be useful, they are snatched away
by this malady, to the great loss of their parents, and detriment
of the public.
The British legislature has, of late years, shown great attention
to the preservation of infant lives, by supporting the foundling
hospital, &c. But if one—tenth part of the sums laid out in sup—
porting that institution, had been bestowed towards promoting in—
oculation of the small—pox among the poor, not only more useful
lives had been saved, but the practice ere now rendered quite uni—
versal in this island. It is not to be imagined, what effect exam—
ple and a little money will have upon the poor; yet, if left to
themselves, they would go on for—ever in the old way, without
thinking of any improvement. We only mean this as a hint to the
humane and public—spirited: Should such a scheme be approved,
a proper plan might easily be laid down for the execution of it.
But as public plans are very difficult to bring about, and often,
by the selfish views and misconduct of those intrusted with the
execution of them, fail of answering the noble purposes for which
they were designed; we shall point out some other method by
which the benefits of inoculation may be extended to the poor.
There is no doubt but inoculators will daily become more nume—
rous. We would therefore have every parish in Britain to alloy 

180 OF THE SMALL—POX.
one of them a small annual salary for inoculating all the children
of the parish at a proper age. This might be done at a very tri—
fling expense, and it would enable every one to enjoy the benefit
of this salutary invention.
Two things chiefly operate to prevent the progress of inocula—
tion. The one is a wish to put the evil day as far off as possible.
This is a principle in our nature; and as inoculation seems rather
to be anticipating a future evil, mankind are averse to it. But this
objection is sufficiently answered by the success. Who in his senses
would not prefer a lesser evil to—day, to a greater to—morrow, pro—
vided they were equally certain?
The other obstacle is the fear of reflections. This has very great
weight with the bulk of mankind. Should the child die, they
think the world would blame them. This they cannot bear. Here
lies the difficulty; and till that be removed, inoculation will make
but small progress. Nothing, however, can remove it but custom.
Make the practice fashionable, and all objections will soon vanish.
It is fashion alone that has led the multitude since the beginning of
the world, and will lead them to the end. We must, therefore,
call upon the more enlightened part of mankind to set a pattern
to the rest. Their example, though it may for some time meet with
opposition, will at length prevail.
I am aware of an objection to this practice from the expense
with which it may be attended: this is easily obviated. We do not
mean that every parish ought to employ a Sutton or a Dimsdale as
inoculators. These have by their success already recommended
themselves to crowned heads, and are beyond the vulgar reach;
but have not others an equal chance to succeed? They certainly
have. Let them make the same trial, and the difficulties will soon
vanish. There is not a parish, and hardly a village in Britain, desti—
tute of some person who can bleed. But this is a far more difficult
operation, and requires more skill and dexterity than inoculation.
The persons to whom we would chiefly recommend the perfor—
mance of this operation are the clergy. Most of them know some—
thing of medicine. Almost all of them bleed, and can order a purge
which are all the qualifications necessary for the practice of inocu—
lation. The priests among the less enlightened Indians perform
this office; and why should a Christian teacher think himself above
it? Surely, the bodies of men, as well as their souls, merit a part
of the pastor's care; at least the greatest Teacher who ever appea—
red among men seems to have thought so.
Should all other methods fail, we would recommend it to pa—
rents to perform the operation themselves. Let them take any me—
thod of communicating the disease they please; provided the sub—
jects be healthy, and of a proper age, they will seldom fail, to suc—
ceed to their wish. I have known many instances of mothers per—
forming the operation, and never so much as heard of one bad
consequence. A planter, in one of the West—India islands, is said 

181 OF THE SMALL—POX. 
to have inoculated, with his own hand, in one year, three hun—
dred of his slaves; who, notwithstanding the warmth of the cli—
mate, and other unfavourable circumstances, all did well. Common
mechanics have often, to my knowledge, performed the operation
with as good success as physicians. We do not mean to discourage
those who have it in their power, from employing people of skill to
inoculate their children, and attend them while under the disease;
but only to show, that where such cannot be had, the operation
ought not upon that account to be neglected.
Instead of multiplying arguments to recommend this practice, I
shall just beg leave to mention the method which I took with my
own son, then an only child. After giving him two gentle purges,
I ordered the nurse to take a bit of thread, which had been pre—
viously wet with fresh matter from a pock, and to lay it upon his
arm, covering it with a piece of sticking—plaister. This remained
on six or seven days, till it was rubbed off by accident. At the
usual time, the small—pox made their appearance, and were exceed—
ingly favourable. Surely, this, which is all that is generally neces—
sary, may be done without any skill in medicine.
We have been the more full upon this subject, because the bene—
fits of inoculation cannot be extended to society by any other means
than making the practice general. While it is confined to a few, it
must prove hurtful to the whole. By means of it, the contagion is
spread, and is communicated to many who might otherwise never
have had the disease. Accordingly, it is found, that more die of the
small—pox now, than before inoculation was introduced; and this
important discovery, by which alone more lives might be saved
than by all the endeavours of the faculty, is in a great measure lost
by its benefits not being extended to the whole community.*
The spring and autumn have been usually reckoned the most
proper seasons for inoculation, on account of the weather being
then most temperate; but it ought to be considered that these are
generally the most unhealthy seasons of the whole year. Undoubt—
edly, the best preparation for the disease is a previous good state of
health. I have always observed, that children, in particular, are more
sickly towards the end of spring and autumn, than at any other
time of the year. On this account, as well as for the advantage of
cool air, I would propose winter as the most proper season for in—
oculation; though, on every other consideration, the spring would
seem to be preferable.
The most proper age for inoculation is between three and five.
Many approve of inoculating on the breast, and where no circum—
stances forbid this practice, I have no objection to it. Children,
however, are more liable to convulsions at this time than after—
* By a well—laid plan for extending inoculation, more lives might be
saved at a small expence, than are at present preserved by all the hospi—
tals in England, which cost the public such an amazing sum.

182 OF THE CHICKEN—POX.
wards; besides, the anxiety of the mother or nurse, should the
child be in danger, would not fail to heighten it by spoiling the milk.
Children who have constitutional diseases, must nevertheless be
inoculated. It will often mend the habit of body; but ought to be
performed at a time when they are most healthy. Accidental diseases
should always be removed before inoculation.
It is generally thought necessary to regulate the diet for some
time before the disease be communicated. In children, however,
great alteration in diet is seldom necessary, their food being com—
monly of the most simple and wholesome kind, as milk, water—pap,
weak broths, bread light—pudding, mild roots, and white meats.
But children who have been accustomed to a hotter diet, who
are of gross habit, ought to be put upon a spare diet before they are
inoculated. Their food should be of a light cooling nature, and
their drink whey, butter—milk, and such—like.
We recommend no other medical preparation but two or three
mild purges, which ought to be suited to the age and strength of
the patient. The success of inoculators does not depend on the
preparation of their patients, but on their management of them
while under the disease. Their constant care is to keep them cool,
and their bodies gently open, by which means the fever is kept
low, and the eruption greatly lessened. The danger is seldom great
when the pustules are few; and their number is generally in pro—
portion to the fever which precedes and attends the eruption.—
Hence, the chief secret of inoculation consists in regulating the
eruptive fever, which generally may be kept sufficiently low by the
methods mentioned above.
The regimen during the disease is in all respects the same as
under the natural small—pox. The patient must be kept cool, his
diet should be light, and his drink weak and diluting, &c. Should
any bad symptoms appear, which is seldom the case, they must be
treated in the same way as directed in the natural small—pox. Purg—
ing is not less necessary after the small—pox, by inoculation than in
the natural way, and ought by no means to be neglected.
CHAPTER XXV.
Of the Chicken—Pox.
THIS disease is more incident to children than to grown peo—
ple. It never affects the patient more than once in his life;
and then it appears so trifling as seldom to require the assistance
of a physician. The chicken—pox is a contagious disease, and is ge—
nerally caught by coming within the infected atmosphere of the
patient or from the clothes of those who have been visiting the sick. 

183 OF THE MEASLES. 
SYMPTOMS—This disease comes on with moderate symp—
toms of fever, which generally on the second day is followed by
an eruption of red pimples over the whole body. They are soon
filled with a thin whitish fluid, which sometimes assumes a yellow
colour, with a light inflamed base, but the fluid contained in the
pustules has not the property of pus or matter. After the eruption
is on the skin, the fever subsides, and, in three or four days, the pus—
tules dry, become of a brown colour, and scale off.
It is a matter of the most serious importance, to distinguish this
disease from the small—pox, as sometimes the most dangerous con—
sequences have ensued from the mistake. Children have been seiz—
ed with the small—pox and have died, when their parents thought
they had past through the disease.
This disease may be distinguished from the small pox, first, by the
eruptive fever being more moderate and of shorter duration. Se—
condly, by the pustules generally containing matter of the colour
of milk. Thirdly, by the pustules filling quicker and continuing a
shorter time on the skin, at farthest not more than four or five days,
before they become dry, of a brown colour, and scale off.
MEDICINE.—The treatment of this disease should be, by
cooling regimen, similar to that used in the small—pox. This must
be more particularly attended to, if the symptoms of fever should
be considerable, which is rarely the case. After they empty, and
become dry, the patient must be purged with jalop and cream—tartar.
CHAPTER XXVI.
Of the Measles.
THE measles appeared in Europe about the same time with
the small—pox, and have a great affinity to that disease. They
both came from the same quarter of the world, are both infec—
tious, and seldom attack the same person more than once. The
measles are most common in the spring season, and generally dis—
appear in summer. The disease itself, when properly managed, sel—
dom proves fatal; but its consequences are often very troublesome.
CAUSE.—This disease, like the small—pox, proceeds from
infection, and is more or less dangerous, according to the consti—
tution of the patient, the season of the year, the climate, &c.
SYMPTOMS—The measles, like other fevers, are preceded
by alternate fits of heat and cold, with sickness, and loss of ap—
petite. The tongue is white, but generally moist. There is a
short cough, a heaviness of the head and eyes, drowsiness, and a
running at the nose. Sometimes, indeed, the cough does not come
before the eruption has appeared. There is an inflammation and
heat in the eyes, with a defluxion of sharp rheum, and great acute—
ness of sensation; so that they cannot bear the light without pain. 

184 OF THE MEASLES.
The eye—lids frequently swell so as to occasion blindness. The pa—
tient generally complains of his throat; and a vomiting or loose—
ness often precedes the eruption. The stools in children are com—
monly greenish; they complain of an itching of the skin, and are
remarkably peevish. Bleeding at the nose is common, both before
and in the progress of the disease.
About the fourth day, small spots, resembling flea—bites, appear,
first upon the face, then upon the breast, and afterwards on the
extremities: these may be distinguished from the small—pox by their
scarcely rising above the skin. The fever, cough, and difficulty of
breathing, instead of being removed by the eruption as in the
small—pox, are rather increased: but the vomiting generally ceases.
About the sixth or seventh day from the time of sickening, the mea—
sles begin to turn pale on the face, and afterwards upon the body;
so that by the ninth day they entirely disappear. The fever, however,
and difficulty of breathing, often continue, especially if the pa—
tient has been kept upon too hot a regimen. Petechiæ, or purple
spots, may likewise be occasioned by this error. A violent looseness
sometimes succeeds the measles; in which case, the patient's life is
in imminent danger.
Such as die of the measles generally expire about the ninth day
from the invasion, and are commonly carried off by a peripneumony,
or inflammation of the lungs. The most favourable symptoms are,
a moderate looseness, a moist skin and a plentiful dischare of urine.
When the eruption suddenly falls in, and the patient is seized
with a delirium, he is in the greatest danger. If the measles turn
too soon of a pale colour, it is an unfavourable symptom, as are
also great weakness, vomiting, restlessness, and difficulty of swal—
lowing. Purple or black spots appearing among the measles are
very unfavourable. When a continual cough, with hoarseness, suc—
ceeds the disease, there is reason to suspect an approaching con—
sumption of the lungs.
Our business in this disease is to assist Nature, by proper cordials,
in throwing out the eruption, if her efforts be too languid; but
when they are too violent, they must be strained by evacuations,
and cool diluting liquors, &c. We ought likewise to endeavour to
appease the most urgent symptoms, as the cough, restlessness, and
difficulty of breathing.
REGIMEN.—The cool regimen is necessary here as well as
in the small—pox. The food must be light, and the drink diluting.
Acids do not answer so well in the measles as in the small—pox, as
they tend to exasperate the cough. Small beer, though a good drink
in the small—pox, is here improper. The most suitable liquors are
decoctions of liquorice with marsh—mallow roots and sarsaparilla,
infusions of linseed, or of the flowers of elder, balm—tea, clarified
whey, barley—water and such—like. These, if the patient be costive,
may be sweetened with honey; or, if that should disagree with the
stomach, a little manna may occasionally be added to them. 

185 OF THE MEASLES. 
MEDICINE.—The measles being an inflammatory disease,
without any critical discharge of matter, as in the small—pox, bleed—
ing is commonly necessary, especially when the fever runs high,
with difficulty of breathing, and great oppression of the breast.
But if the disease be of a mild kind, bleeding may be omitted.
Bathing the feet and legs frequently in lukewarm water, both
tends to abate the violence of the fever, and to promote the eruption.
The patient is often greatly relieved by vomiting. When there
is a tendency this way, it ought to be promoted by drinking luke—
warm water, or weak camomile—tea.
When the cough is very troublesome, with dryness of the throat,
and difficulty of breathing, the patient may hold his head over the
steam of warm water, and draw the steam into his lungs.
He may likewise lick a little spermaceti and sugar—candy poun—
ded together; or take now—and—then, a spoonful of the oil of sweet
almonds, with sugar—candy dissolved in it. These will soften the
throat, and relieve the tickling cough.
If, at the turn of the disease, the fever assumes new vigour, and
there appears great danger of suffocation, the patient must be bled
according to his strength, and blisters applied, with a view to pre—
vent the load from being thrown on the lungs; where, if an inflam—
mation should fix itself, the patient's life will be in imminent danger.
In case the measles suddenly disappear, it will be necessary to
pursue the same method recommended when the small—pox recede.
The patient must be supported with wine and cordials. Blisters must
be applied to the legs and arms, and the body rubbed all ever with
warm flannels. Warm poultices may likewise be applied to the feet
and palms of the hands.
When purple or black spots appear, the patient's drink should
be sharpened with spirits of vitriol; and, if the symptoms increase,
the bark must be administered in the same manner, as directed in
the small—pox†.
Opiates are sometimes necessary, but should never be given except
in cases of extreme restlessness, a violent looseness, or when the
cough is very troublesome. For children, the syrup of poppies is
sufficient. A tea—spoonful or two may be occasionally given, ac—
cording to the patient's age, or the violence of the symptoms.
After the measles are gone off, the patient ought to be purged.
This may be conducted in the same manner as directed in the
small—pox.
If a violent looseness succeeds the measles, it may be checked by
taking for some days a gentle dose of rhubarb in the morning, and
* I do not know any disease wherein bleeding is more necessary than
in the measles, especially when the fever runs high: in this case, I have
always found it relieve the patient.
† Wine should be allowed the patient, to co operate with the bark, in
supporting the vigour of the system. This should be the practice in all cases 
when there is a tendency, as it is commonly called, to putrefaction. (I.C)
A 2 

186 OF THE SCARLET FEVER.
an opiate over night; but if these do not remove it, bleeding will
seldom fail to have that, effect.
Patients recovering after the measles should be careful what they
eat or drink. Their food for some time ought to be light, and in
small quantities, their drink diluting, and rather of an opening na—
ture, as butter—milk, whey, and such—like. They ought also to be—
ware of exposing themselves too soon to the cold air, left a suffoca—
ting catarrh, an asthma, or a consumption of the lungs should ensue.
Should a cough, with a difficulty of breathing, and other symp—
toms of a consumption, remain after the measles, small quantities
of blood may be frequently let, at proper intervals, as the patient's
strength and constitution will permit. He ought to drink asses—milk,
to remove to a free air, if in a large town, and to ride daily on
horseback. He must keep close to a diet of milk and vegetables; and
if these do not succeed, let him remove to a warmer climate.
Of the Scarlet Fever.
THE scarlet fever is so called from the colour of the patient's
skin, which appears as if tinged with red wine. It happens at any
season of the year, but is most common towards the end of sum—
mer; when it often seizes whole families. Children and young
persons are most subject to it.
It begins, like other fevers, with coldness and shiverings, without
any violent sickness. Afterwards the skin is covered with red spots,
which are broader, more florid, and less uniform than the measles.
They continue two or three days, and then disappear; after which
the cuticle, or scarf—skin, falls off.
There is seldom any occasion for medicine in this disease. The
patient ought however to keep within doors, to abstain from flesh,
* Attempts have been made to communicate the measles, as well as
the small—pox, by inoculation; and we make no doubt, but in time, the
practice may succeed. Dr. Home of Edinburgh, says, he communicated
the disease by the blood. Others have tried this method, and have not
found it succeed. Some think the disease would be more certainly com—
municated, by rubbing the skin of a patient, who has the measles. with
cotton, and afterwards applying the cotton to a wound, as in the small—
pox; while others recommend a bit of flannel which had been applied
to the patient's skin, all the time of the disease, to be afterwards laid
upon the arm or leg of the person to whom the infection is to be com—
municated. There is no doubt, but this disease, as well as the small—pox,
may be communicated in various ways; the most probable, however,
is either from cotton rubbed upon the skin, as mentioned above, or by
introducing a little of the sharp humour, which distils from the eyes of
the patient into the blood. It is agreed on all hands, that such patients
as have been inoculated, had the disease very mildly; we therefore wish
the practice were more general, as the measles have of late become very 

187 OF THE BILIOUS FEVER. 
strong liquors, and cordials, and to drink freely of cool diluting
liquors. If the fever runs high, the body must be kept gently open
by emollient clysters, or cream of tartar and nitre, one or two
drachms of the former, with eight or ten grains of the latter, may
be taken two or three times a day.
Children and young persons are sometimes seized at the begin—
ning of this disease with a kind of stupor and epileptic fits. In this
case, the feet and legs should be bathed in warm water, a large
blister applied to the neck, and a dose of the syrup of poppies given
every night till the patient recovers.
The scarlet fever is not always so mild. It is sometimes attended
with putrid or malignant symptoms, in which case, it is always dan—
gerous. In the malignant scarlet fever the patient is not only af—
fected with coldness and shivering, but with languor, sickness, and
great oppression; to these succeed excessive heat, nausea and vomit—
ing, with a soreness of the throat; the pulse is extremely quick,
but small and depressed; the breathing frequent and laborious;
the skin hot, but not quite dry; the tongue moist, and covered
with a whitish mucus; the tonsils inflamed and ulcerated. When
the eruption appears, it brings no relief; on the contrary, the symp—
toms generally grow worse, and fresh ones come on, as purging,
delirium, &c.
When this disease is mistaken for a simple inflammation, and
treated with repeated bleedings, purging and cooling medicines, it
generally proves fatal. The only medicines that can be depended
on in this case are cordials and antiseptics, as the bark, wine, snake—
root, and the like. The treatment must be in general similar to
that of the malignant ulcerous sore throat†.
Of the Bilious Fever.
WHEN a continual, remitting, or intermitting fever is accom—
panied with a frequent or copious evacuation of bile, either by vomit
or stool, the fever is denominated bilious. In Britain, the bilious
fever generally makes its appearance about the end of summer, and
ceases towards the approach of winter. It is most frequent and
fatal in warm countries, especially where the foil is marshy, and
* If the pulse be full and hard, blood must be taken from the arm or
jugular vein. (I. C.)
† In the year 1774, during winter, a very bad species of this fever
prevailed in Edinburgh. It raged chiefly among young people. The erup—
tion was generally accompanied with a quinsey, and the inflammatory
symptoms were so blended with others of a putrid nature, as to render
the treatment of the disease very difficult. Many of the patients, towards
the decline of the fever, were afflicted with large swellings of the sub—
maxillary glands, and not a few had a suppuration in one or both ears. 

188 OF THE ERYSIPELAS,
when great rains are succeeded by sultry heats. Persons who work
without doors, lie in camps, or who are exposed to the night air,
are most liable to this kind of fever.
If there are symptoms of inflammation at the beginning of this
fever, it will be necessary to bleed, and to put the patient upon the
cool diluting regimen recommended in the inflammatory fever.
The saline draught may be frequently administered, and the pa—
tient's body kept open by clysters or mild purgatives. But if the
fever should remit or intermit, bleeding will seldom be necessary.
In this case, a vomit may be administered, and, if the body be bound,
a gentle purge; after which the bark will generally complete the cure.
In case of a violent looseness, the patient must be supported with
chicken broth, jellies of hartshorn, and the like; and he may use
the white decoction for his ordinary drink*. If a bloody flux should
accompany this fever, it must he treated as recommended under
the article Dysentery.
When there is a burning heat, and the patient does not sweat,
that evacuation may be promoted by giving him, three or four
times a day, a table—spoonful of Mindererus's spirit† mixed in a cup
of his ordinary drink.
If the bilious fever be attended with the nervous, malignant, or
putrid symptoms, which is sometimes the case, the patient must be
treated in the same manner as directed under these diseases.
After this fever, proper care is necessary to prevent a relapse.
For this purpose, the patient, especially towards the end of autumn,
ought to continue the use of the bark for some—time after he is
well. He should abstain from all trashy fruits, new liquors, and every
kind of flatulent aliment.
CHAPTER XXVII.
Of the Erysipelas, or St. Anthony's Fire.
THIS disease, which in some parts of Britain is called the rose,
attacks persons at any period of life, but is most common
between the age of thirty and forty. Persons of a sanguine or ple—
thoric habit, are most liable to it. It often attacks young people,
and pregnant women; and such as have once been afflicted with
it, are very liable to have it again. Sometimes it is a primary dis—
ease, and at other times only a symptom of some other malady.
Every part of the body is liable to be attacked by an erysipelas, but
it most frequently seizes the legs or face; especially the latter. It is
most common in autumn, or when hot weather is succeeded by
cold and wet.
* See Appendix, White Decoction.
† See Appendix, Spirit of Mindererus. 

189 OR ST. ANTHONY'S FIRE. 
CAUSES.—The erysipelas may be occasioned by violent pas—
sions or affections of the mind; as fear, anger, &c. When the 
body has been heated to a great degree, and is immediately exposed
to the cold air, so that the perspiration is suddenly checked, an ery—
sipelas will often ensue. It may also be occasioned by drinking
to excess, by continuing too long in a warm bath, or by any thing
that overheats the blood. If any of the natural evacuations be ob—
structed, or in too small quantity, it may cause an erysipelas. The
same effect will follow from the stoppage of artificial evacuations; as
issues, setons or the like.
SYMPTOMS.—The erysipelas attacks with shivering, thirst,
loss of strength, pain in the head and back, heat, restlessness, a quick
pulse, vomiting, and sometimes a delirium. On the second, third,
or fourth day, the part swells, becomes red, and small pustules ap—
pear; at which time the fever generally abates.
When the erysipelas seizes the foot, the parts contiguous swell,
the skin shines; and, if the pain be violent, it will ascend to the
leg, and will not bear to be touched.
When it attacks the face, it swells, appears red, and the skin is
covered with small pustules filled with clear water. One, or both
eyes are generally closed with the swelling; and there is a difficulty
of breathing. If the mouth and nostrils be very dry, and the pa—
tient drowsy, there is reason to suspect an inflammation of the brain.
If the erysipelas affects the breast, it swells and becomes exceed—
ingly hard, with great pain, and is apt to suppurate. There is a vio—
lent pain in the arm—pit, on the side affected, where an abscess is of—
ten formed.
If in a day or two, the swelling subsides, the heat and pain abate,
the colour of the part turns yellow, and the cuticle breaks and falls
off in scales, the danger is over.
When the erysipelas is large, deep, and affects a very sensible
part of the body, the danger is great. If the red colour changes
into a livid or black, it will end in a mortification. Sometimes the
inflammation cannot be discussed, but comes to a suppuration; in
which case, fistulas, gangrene, or mortification, often ensue.
Such as die of this disease, are commonly carried off by the fever,
which is attended with difficulty of breathing, and sometimes with
a delirium and great drowsiness. They generally die about the se—
venth or eighth day.
REGIMEN.—In the erysipelas the patient must neither be
kept too hot nor too cold, as either of these extremes will tend to
The country people in many parts of Britain call this disease a blast,
and imagine it proceeds from foul air, or ill wind, as they term it. The
truth is, they often lie down to rest them, when warm and fatigued,
upon the damp ground, where they fall asleep, and lie so long as to catch
cold, which occasions the ersiypelas. This disease may indeed proceed
from other causes, but nine times out of ten it is occasioned by cold
caught after the body has been greatly heated or fatigued. 

190 OF THE ERYSIPELAS, 
make it retreat, which is always to be guarded against. When the
disease is mild, it will be sufficient to keep the patient within doors,
without confining him to his bed, and to promote the perspiration
by diluting liquors, &c.
The diet ought to be slender, and of a moderately cooling and
moistening quality, as groat—gruel, panado, chicken or barley—broth,
with cooling herbs and fruits, &c. avoiding flesh, fish, strong drink,
spices, pickles, and all other things that may heat and inflame the
blood; the drink may be barley—water, an infusion of elder—flowers,
common whey, and such like.
But if the pulse be low, and the spirits sunk, the patient must
be supported with negus, and other things of a cordial nature. His
food may be sago gruel, with a little wine, and nourishing broths,
taken in small quantities, and often repeated. Great care must be
taken not to overheat him.
MEDICINE—In this disease much mischief is often done by
medicine, especially by external applications. People, when they
see an inflammation, immediately think that something ought to
be applied to it. This indeed is necessary in large phlegmons; but
in an erysipelas, the safer course is to apply nothing. Almost all
ointments, salves, and plasters, being of a greasy nature, tend ra—
ther to obstruct and repel, than promote and discharge from the
part. At the beginning of this disease, it is neither safe to promote
a suppuration, nor to repel the matter too quickly. The erysipelas
in many respects resembles the gout, and is to be treated with the
greatest caution. Fine wool, or very soft flannel, are the safest ap—
plications to the part. These not only defend it from the external
air, but likewise promote the perspiration, which has a great ten—
dency to carry off the disease. In Scotland, the common people
generally apply a mealy cloth to the parts affected, which is not
improper.
It is common to bleed in the erysipelas; but this requires cau—
tion. If the fever be high, the pulse hard and strong, and the pa—
tient vigorous, it will be proper to bleed; but the quantity must be
regulated by these circumstances, and the operation repeated as
the symptoms may require. If the patient has been accustomed to 
strong liquors, and the disease attacks his head, bleeding is abso—
lutely necessary. 
Bathing the feet and legs frequently in lukewarm water, when I
the disease attacks the face or brain, has an excellent effect. It
tends to make a derivation from the head, and seldom fails to re—
lieve the patient. When bathing proves ineffectual, poultices, or
sharp synapisms, may be applied to the soles of the feet, for the
same purpose.
In cases where bleeding is requisite, it is likewise necessary to
keep the body open. This may be effeacted by emollient clysters,
or small doses of nitre and cream of tartar. Some recommend very
large doses of nitre in the erysipelas; but nitre seldom fits easy on

191 OR ST. ANTHONY'S FIRE.
the stomach, when taken in large doses. It is one of the best me—
dicines when the fever and inflammation run high. Half a drachm
of it, with one or two drachms of cream of tartar, may be given in
the patients ordinary drink, four times a day.
When the erysipelas leaves the extremities, and seizes the head,
so as to occasion a delirium or stupor, it is absolutely necessary to
open the body. If clysters and mild purgatives fail to have this ef—
fect, stronger ones must be given. Blisters must likewise be applied
to the neck, or behind the ears, and sharp cataplasms laid to the
foles of the feet.
When the inflammation cannot be discussed, and the part has a
tendency to ulcerate, it will then be proper to promote suppura—
tion, which may be done by the application of emollient poultices,
such as bread and milk, or those made with flaxseed flower.
When the black, livid, or blue colour of the part shows a ten—
dency to mortification, the bark must be administered. It may be
taken along with acids, as recommended in the small pox, or in any
other form, more agreeable to the patient. It must not however be
trifled with, as the patient's life is at stake. A drachm may be given
every two hours, if the symptoms be threatening, and cloths dipped
in warm camphorated spirits of wine, of the tincture of myrrh and
aloes, may be applied to the part, and frequently renewed. It may
likewise be proper in this case to apply poultices of the bark, or to
foment the part affected with a strong decoction of it.
In what is commonly called the scorbutis erysipelas, which con—
forinues at considerable time, it will only be necessary to give
gentle laxatives, and such things as promote the perspiration. Thus,
after the inflammation has been checked by opening medicines, the
decoction of woods* may be drank, after which a course of bitters
will be proper.
Such as are liable to frequent attacks of the erysipelas, ought
carefully to guard against all violent passions; to abstain from strong
liquors, and all fat, viscid, and highly nourishing food. They should
likewise take sufficient exercise, carefully avoiding the extremes of
beat or cold. Their food should consist chiefly of milk, and such
fruits, herbs and roots, as are of a cooling quality; and their drink
ought to be small—beer, whey, butter—milk, and such like. They
should never suffer themselves to be long costive. If that cannot
be prevented by suitable diet, it will be proper to take frequently a
gentle dose of cream of tartar, the lenitive electuary, or some other
mild purgative.
* See Appendix, Decoction of Woods.

[192]
CHAPTER XXVIII.
Of the Phrenitis; or, Inflammation of the Brain.
THIS is sometimes a primary disease, but oftener only a symp—
tom of some other malady; as the inflammatory, eruptive,
or spotted fever, &c. It is very common, as a primary disease, in
warm climates, and is most incident to persons about the prime or
vigour of life. The passionate, the studious, and those whose ner—
vous system is irritable in a high degree, are most liable to it.
CAUSES.—This disease is often occasioned by night—watch—
ing, especially when joined with hard study: it may likewise pro—
ceed from hard drinking, anger, grief or anxiety. It is often occa—
sioned by the stoppage of usual evacuations; as the bleeding piles 
in men, the customary discharges of women, &c. Such as impru—
dently expose themselves to the heat of the fun, especially by sleep—
ing without doors in a hot season with their heads uncovered, are
often suddenly seized with an inflammation of the brain, so as to
awake quite delirious. When repellants are imprudently used in
an erysipelas, an inflammation of the brain is sometimes the con—
sequence. It may be occasioned by external injuries, as blows or
bruises upon the head, &c.
SYMPTOMS.—The symptoms which usually precede a true
inflammation of the brain are pain of the head, redness of the
eyes, a violent flushing of the face, disturbed sleep, or a total want
of it, great dryness of the skin, costiveness, a retention of urine,
a small dropping of blood from the nose, singing of the ears, and
extreme sensibility of the nervous system.
When the inflammation is formed, the symptoms in general
are similar to those of the inflammatory fever. The pulse indeed is
often weak, irregular, and trembling; but sometimes hard and
contracted. When the brain itself is inflamed, the pulse is always
soft and low; but when the inflammation only affects the integu—
ments of the brain, viz. the dura and pia mater, it is hard. A re—
markable quickness of hearing is a common symptom of this dis—
ease; but that seldom continues long. Another usual symptom is 
a great throbbing or pulsation in the arteries of the neck and tem—
ples. Though the tongue is often black and dry, yet the patient
seldom complains of thirst, and even refuses drink, The mind
chiefly runs upon such objects as have before made a deep impres— 
sion on it; and sometimes, from a sullen silence, the patient be—
comes all of a sudden quite outrageous.
A constant trembling and starting of the tendons is an unfavour—
able symptom, as are also a suppression of urine; a total want of 
sleep; a constant spitting; a grinding of the teeth, which last may
be considered as a kind of convulsion. When a phrenitis succeeds 

193 OF THE PHRENITIS, &c. 
an inflammation of the lungs, of the intestines, or of the throat, &c.
it is owing to a translation of the disease from these parts to the
brain, and generally proves fatal. This shews the necessity of pro—
per evacuations, and the danger of repellents in all inflammatory
diseases. 
The favourable symptoms are, a free perspiration, a copious dis—
charge of blood from the nose, the bleeding piles, a plentiful dis—
charge of urine, which lets fall a copious sediment. Sometimes the
disease is carried off by a looseness, and in women by an excessive
slow of the menses. 
As this disease often proves fatal in a few days, it requires the
most speedy applications. When prolonged or improperly treated, A
it sometimes ends in madness, or a kind of stupidity, which conti—
nues for life.
In the cure, two things are chiefly to be attended to, viz. to
lessen the quantity of blood in the brain, and to retard the circula—
tion towards the head.
REGIMEN.—The patient ought to be kept very quiet. Com—
pany, noise, and every thing that affects the senses, or disturbs the
imagination, increases the disease. Even too much light is hurtful:
for which reason, the patient's chamber ought to be a little darken—
ed, and he should neither be kept too hot nor cold. It is not neces—
sary to exclude the company of an agreeable friend, as this has a
tendency to sooth and quiet the mind. Neither ought the patient
to be kept too much in the dark, left it should occasion a gloomy
melancholy, which is too often the consequence of this disease.
The patient must, as far as possible, be soothed and humoured in
every thing. Contraction will ruffle his mind, and increase his
malady. Even when he calls for things which are not to be ob—
tained, or which might prove hurtful, he is not to be positively
denied them, but rather put off with the promise of having them
as soon as they can be obtained, or by some other excuse. A little
of any thing, that the mind is let upon, though not quite proper,
will hurt die patient less than a positive refusal. Whatever he
was delighted with when in health, may here be tried; as pleasing
stories, soft music, or whatever has a tendency to sooth the passions
and compose the mind. Boerhaave proposes several mechanical
experiments for this purpose; as the soft noise of water distilling
by drops into a bason, and the patient trying to reckon them, &c.
Any uniform found, if low and continued, has a tendency to pro—
cure sleep, and consequently may be of service.
The aliment ought to be light, consisting chiefly of sarinaceous 
substances; as panado, and water—gruel, sharpened with jelly of
currants, or juice of lemons, ripe fruits, roasted or boiled, jellies,
preserves, &c. The drink, small, diluting, and cooling; as whey,
barley—water, or decoction of barley and tamarinds, which latter
not only render the liquor more palatable, but likewise more bene—
ficial, as they are of an opening nature.
B 2 

194 OF THE OPHTHALMIA; OR,
MEDICINE.—Nothing more certainly relieves the patient
than a free discharge of blood from the nose. When this comes of
its own accord, it is by no means to be stopped, but rather pro—
moted, by applying cloths dipped in warm water to the part.
Bleeding in the temporal arteries greatly relieves the head: but
as this operation cannot always be performed, we recommend in
its stead, bleeding in the jugular veins. When the patient's pulse
and spirits are so low, that he cannot bear bleeding with the lancet,
leeches maybe applied to the temples. These not only draw off the
blood more gradually, but by being applied nearer to the part af—
fected, generally give more immediate relief.
A discharge of blood from the hæmorrhoidal veins is of great
service, and ought by all means to be promoted. If the patient has
been subject to the bleeding piles, and that discharge has been
stopped, every method must be tried to restore it; as the applica—
tion of leeches to the parts, fitting over the steams of warm water,
sharp clysters, or suppositories made of honey, aloes, and rock—salt.
If the inflammation of the brain be occasioned by the stoppage
of evacuations either natural or artificial, as the menses, issues,
setons, or such like, all means must be used to restore them as soon
as possible, or to substitute others in their stead.
The patient's body must be kept open by stimulating clyster for
smart purges; and small quantities of nitre ought frequently to be
mixed with his drink. Two or three drachms, or more, if the case
be dangerous, may be used in the space of twenty—four hours.
The head should be shaved and frequently rubbed with vinegar
and rose—water. Cloths dipped in this mixture may likewise be ap—
plied to the head*. The feet ought frequently to be bathed in luke—
warm water, and soft poultices of bread and milk may be kept
constantly applied to them.
If the disease proves obstinate, and does not yield to these medi—
cines, it will be necessary to apply a blister to the whole head.
CHAPTER XXIX.
Of the Ophthalmia; or, Inflammation of the Eyes.
THIS disease may be occasioned by external injuries; as blows,
burns, bruises, and the like. It may likewise proceed from
dust, quick—lime, or other substances getting into the eyes. It is of—
ten caused by the stoppage of customary evacuations; as the heal—
ing of old sores, drying up of issues, the suppressing of gentle morn—
ing sweats, or of the sweating of the feet, &c. Long exposure to
the night air, especially in cold northerly winds, or whatever sud—
* Even ice, when it can be procured, may be employed with advan—
tage. (I. C)

195 INFLAMMATION OF THE EYES. 
denly checks the perspiration, especially after the body has been
much heated, is very apt to cause it. Viewing snow or other white
bodies for a long time, or looking stedfastly at the fun, a clear fire,
or any bright object, will occasion this malady. A sudden transition
from darkness to very bright light, will often have the same effect.
Nothing more certainly occasions an inflammation of the eyes
than night—watching, especially reading or writing by candle—light.
Drinking spirituous liquors, an excess of venery, are very hurtful to
the eyes. The acrid fumes of metals, and of several kinds of fuel,
are also pernicious. Sometimes an inflammation of the eyes pro—
ceeds from a venereal taint, and often from a scrophulous or gouty
habit. It may likewise be occasioned by the hairs in the eye—lids turn—
ing inwards, and hurting the eyes. Sometimes the disease is epide—
mic, especially after wet seasons; and I have frequently known it
prove infectious, particularly to those who lived in the same house
with the patient. It may be occasioned by moist air, or living in
low damp houses, especially in persons who are not accustomed to
such situations. In children it often proceeds from imprudently dry—
ing up of scabbed heads, a running behind the ears, or any other
discharge of that kind. Inflammations of the eyes often succeed the
small—pox or measles, especially in children of a scrophulous habit.
SYMPTOMS.—An inflammation of the eyes is attended with
an acute pain, heat, redness, and swelling. The patient is not able
to bear the light, and sometimes he feels a pricking pain, as if his
eyes were pierced with a thorn. Sometimes he imagines his eyes are
full of motes, or thinks he sees flies dancing before him. The eyes
are filled with a scalding rheum, which rushes forth in great quan—
tities, whenever the patient attempts to look up. The pulse is ge—
nerally quick and hard, with some degree of fever. When the dis—
ease is violent, the neighbouring parts swell, and there is a throbbing
or pulsation in the temporal arteries, &c.
A flight inflammation of the eyes, especially from an external
cause, is easily cured; but when the disease is violent, and con—
tinues long, it often leaves specks upon the eyes, or dimness of fight,
and sometimes total blindness.
If the patient be seized with a looseness, it has a good effect;
and when the inflammation passes from one eye to another, as it
were by infection, it is no unfavourable symptom. But when the
disease is accompanied with a violent pain of the head, and conti—
nues long, the patient is in danger of losing his sight.
REGIMEM.—The diet unless in scrophulous cases, can hard—
ly be too spare, especially at the beginning. The patient must ab—
stain from every thing of a heating nature. His food should consist
chiefly of mild vegetables, weak broths, and gruels. His drink may
be barley—water, balm—tea,common whey, and such—like. His cham—
ber must be darkened, or his eyes shaded by a cover, so as to exclude
the light, but not to press upon the eyes. He should not look at a
candle, the fire, or any luminous object; and ought to avoid all 

196 OF THE OPHTHALMIA; OR,
smoke, as the fumes of tobacco, or any thing that may cause cough—
ing, sneezing, or vomiting. He should be kept quiet, avoiding all
violent efforts, either of body or mind, and encouraging sleep as
much as possible.
MEDICINE.—This is one of those diseases wherein great hurt
is often done by external applications. Almost every person pre—
tends to be possessed of a remedy for the cure of sore—eyes. These
remedies generally consist of eye—waters and ointments, with other
external applications, which do mischief twenty times for once they
do good. People ought to be very cautious how they use such
things, as even the pressure upon the eyes often increases the malady.
Bleeding, in a violent inflammation of the eyes, is always neces—
sary. This should be performed as near the part affected as possible.
An adult may loose ten or twelve ounces of blood from the jugular
vein, and the operation may be repeated according to the urgency
of the symptoms. If not convenient to bleed in the neck, the same
quantity may be let from the arm, or any other part of the body.
Leeches are often applied to the temples, or under the eyes, with
good effect*. The wounds must be suffered to bleed for some hours,
and if the bleeding stop soon, it may be promoted by the application
of cloths dipt in warm water. In obstinate cases, it will be neces—
sary to repeat this operation several times.
Brisk purging with glauber salt, should be produced, during the
time bleeding is used; after that, the bowels may be kept open every
other day, with a decoction of tamarinds with senna. A gentle dose
of cream of tartar, castor—oil, or any other laxative, will answer the
same end. 
If the inflammation does not yield to these evacuations, blisters
must be applied to the temples, behind the ears, or upon the neck,
and kept open for some time by the mild blistering ointment. I
have seldom known these, if long enough kept open, fail to remove
the most obstinate inflammation of the eyes; but for this purpose,
it is often necessary to continue the discharge for several weeks.
When the disease has been of long standing, I have seen very
extraordinary effects from a seton in the neck, or between the
shoulders, especially the latter. It should be put upwards and
downwards, or in the direction of the spine, and in the middle, be—
tween the shoulder blades. It may be dressed twice a day with yel—
low basilicon. I have known patients, who had been blind for a
considerable time, recover fight by means of a seton placed as
above. When the seton is put across the neck, it soon wears out,
and is both more painful and troublesome than between the shoul—
ders; besides, it leaves a disagreeable mark, and does not discharge
so freely.
When the heat and pain of the eyes are very great, a poultice
of bread and milk, softened with sweet oil or fresh butter, may be
* If leeches cannot be procured, blood may be drawn from the rem—
ple by cupping. (I. C) 

19 INFLAMMATION OF THE EYES. 
applied to them, at least all night; and they may be bathed with
lukewarm milk and water in the morning.
If the patient cannot sleep, which is sometimes the case, he may
take twenty or thirty drops of laudanum, or two spoonfuls of the
syrup of poppies, over night, more or less according to his age, or
the violence of the symptoms. 
After the inflammation is gone off, if the eyes remain weak and
tender, they may be bathed every night and morning with cold
water and a little brandy, six parts of the former to one of the lat—
ter. A method should be contrived by which the eye can be quite
immersed in the brandy and water, where it should be kept for
some time. I have generally found this, or cold water and vine—
gar, as good a strengthener of the eyes as any of the most celebra—
ted collyriums.
When an inflammation of the eyes proceeds from a schrophu—
lous habit, it generally proves very obstinate. In this case, the pa—
tient's diet must not be too low, and he may be allowed to drink
small negus, or now—and—then a glass of wine. The most proper
medicine is the bark, which may be given in substance, or prepared
as follows:
Take an ounce of the bark in powder, with two drachms of
Winter's bark, and boil them in an English quart of water to a
pint; when it has boiled nearly long enough, add half an ounce of
liquorice root, sliced. Let the liquor be strained. Two, three, or
four table—spoonfuls, according to the age of the patient, may be
taken three or four times a—day. It is impossible to say how long
this medicine should be continued, as the cure is sooner performed
in some than in others; but, in general, it requires a considerable
time to produce any lasting effects.
Preparations of mercury may be of singular service in opthal—
mias of long continuance, but they ought always to be administer—
ed with the greatest caution, or by persons of skill in physic.
It will be proper frequently to look into the eyes, to see if any
hairs be turned inwards, or pressing upon them*. These ought to
be plucked out with a pair of small pincers.
Those who are liable to frequent returns of this disease, ought
constantly to have an issue in one or both arms. Bleeding or purg—
ing in spring and autumn, will be very beneficial to such persons.
They ought likewise to live with the greatest regularity, avoiding
strong liquor, and every thing of a heating quality. Above all, let
them avoid the night air and late studies†.
* Any foreign body lodged in the eye may be expeditiously removed
by parting a small hair—pencil, between the eye—lid and the ball of the eye.
In some places, the peasants do this very effectually, by using their tongue
in the same manner.
† Almost people are fond of using eye—waters and ointments in this
and other diseases of the eyes, we have inserted some of the most appro—
ved forms of these medicine in appendix. See Appendix, Eye—water
and Eye—salve.

[198]
CHAPTER XXX.
Of the Quinsey; or, Inflammation of the Throat.
THIS disease is very common in Britain, and is frequently at—
tended with great danger. It prevails in the winter and
spring, and is most fatal to young people of a sanguine tempera—
ment.
CAUSES.—In general it proceeds from the same cause as
other inflammatory disorders, viz. an obstructed perspiration. It
is often occasioned by omitting some part of the covering, usually
worn about the neck, by drinking cold liquor when the body is
warm, by riding or walking against a cold northerly wind, or by
any thing that greatly cools the throat, and parts adjacent. It may
likewise proceed from the neglect of bleeding, purging or any
customary evacuation.
Singing, speaking loud and long, or whatever strains the throat,
may likewise cause an inflammation of that organ. I have often
known the quinsey prove fatal to jovial companions, who, after fit—
ting long in a warm room, drinking hot liquors, and singing with
vehemence, were so imprudent as to go abroad in the cold night—
air. Sitting with wet feet, or keeping on wet clothes, is very apt
to occasion this malady. It is frequently occasioned by continuing
long in a moist place, fitting near an open window, sleeping in a
damp bed, fitting in a room that has been newly plastered, &c. I
know people who never fail to have a soar throat, if they fit even
but a short time in a room lately washed.
Acrid or irritating food may inflame the throat, and occasion a
quinsey. It may proceed from bones, pins, or other sharp substan—
ces sticking in the throat, or from the caustic fumes of metals or
minerals, as arsenic, antimony, &c taken in by the breath. This
disease is sometimes epidemic and infectious.
SYMPTOMS.—The inflammation of the throat is evident
from inspection, the parts appearing red and swelled; besides, the
patient complains of pain in swallowing. His pulse is quick and
hard, with other symptoms of a fever. If blood be let, it is gene—
rally covered with a tough coat of a whitish colour, and the pati—
ent spits a tough phlegm. As the swelling and inflammation in—
crease, the breathing and swallowing become more difficult; the
pain affects the ears; the eyes generally appear red; and the face
swells. The patient is often obliged so keep himself in an erect
posture, being in danger of suffocation; there is a constant nausea;
or inclination to vomit; and the drink, instead of passing into the
stomach, is often returned by the nose. The patient is sometimes
starved at last, merely from an inability to swallow any kind of food.
When the breathing is laborious, with straitness of the breast,


199 OF THE QUINSEY.
and anxiety, the danger is great. Though the pain in swallowing be
very great, yet while the patient breathes easy, there is not so much
danger. An external swelling is no unfavourable symptom; but if it
suddenly falls, and the disease affects the breast, the danger is very
great. When a quinsey is the consequence of some other disease,
which has already weakened the patient, his situation is dangerous.
A frothing at the mouth, with a swelled tongue, a pale, ghastly
countenance, and coldness of the extremities, are fatal symptoms. 
REGIMEN.—The regimen in this disease is in all respects
the same as in the pleurisy, or peripneumony. The food must be
light, and in small quantity, and the drink plentiful, weak and di—
luting, mixed with acids.
It is highly necessary that the patient be kept easy and quiet. Vi—
olent affections of the mind, or great efforts of the body, may prove
it fatal. He should not even attempt to speak but in a low voice.
Such a degree of warmth as to promote a constant, gentle sweat,
is proper. When the patient is in bed, his head ought to be rais—
ed a little higher than usual.
It is peculiarly necessary that the neck be kept warm; for which
purpose, several folds of soft flannel may be wrapt round it. That
alone will often remove a flight complaint of the throat, if appli—
ed in due time. A judicious custom prevails among the peasants
of Scotland: When they feel any uneasiness of the throat, they
wrap a stocking about it all night. So effectual is this remedy, that
in many places it passes for a charm, and the stocking is applied
with particular ceremonies: this custom should never be neglec—
ted. When the throat has been thus wrapt up all night, it must 
not be exposed to the cold air through the day, but a handkerchief
or a piece of flannel kept about it till the inflammation be removed.
The jelly of black currants is a medicine very much in esteem
for complaints of the throat; and is of some use. It should be al—
most constantly kept in the mouth, and swallowed down leisurely.
It may be mixed in the patient's drink, or taken any other way.
When it cannot be obtained, the jelly of red currants, or of mul—
berries, may be used in its stead.
Gargles for the throat are very beneficial. They may be made of
sage—tea, with a little vinegar and honey, or by adding to half an
English pint of the pectoral decoction, two or three spoonfuls
of honey, and the fame quantity of currant jelly. This may be
used three or four times a—day; and if the patient be troubled with
tough viscid phlegm, the gargle may be rendered more sharp and
cleansing, by adding to it a tea—spoonful of the spirit of sal ammo—
smiac. Some recommend gargles made of a decoction of the leaves
or bark of the black—currant—bush; but where jelly can be had,
these are unnecessary.
In no disease is the benefit of bathing the feet and legs in luke—
warm water more apparent: that practice ought therefore never
to be neglected. If people were careful to keep warm, to wrap up

200 OF THE QUINSEY; OR,
their throats with flannel, to bathe their feet and legs in warm wa—
ter, and to use a spare diet, with diluting liquors, at the beginning
of this disease, it would seldom proceed to a great height, or be at—
tended with any danger: but when these precautions are neglec—
ted, and it becomes violent, more powerful medicines are necessary.
MEDICINE.—An inflammation of the throat being a most
acute and dangerous distemper, which sometimes takes off the pa—
tient very suddenly, it will be proper, as soon as the symptoms ap—
pear, to bleed in the arm, or rather in the jugular vein, and to re—
peat the operation if circumstances require.
The body should be kept gently open by giving the patient for
his ordinary drink, a decoction of figs and tamarinds, or small doses
of cream of tartar and nitre, as recommended in the erysipelas.
These may be increased according to the age of the patient, and
repeated till they have the desired effect.
I have often known very good effects from a bit of sal prunel,
or purified nitre, held in the mouth, and swallowed down as it
melted. This promotes the discharge of saliva, answers the end of
a gargle, while at the same time it abates the fever, by promoting
the discharge of urine, &c.
The throat ought to be rubbed twice or thrice a—day with a
little of the volatile liniment. This seldom fails to produce some
good effects. At the same time the neck ought to be carefully
covered with wool or flannel, to prevent the cold from penetrating
the skin, as this application renders it very tender. Many other
external applications are recommended in this disease, but there
is none preferable to a common poultice of bread and milk.
Some recommend the gum guaiacum as a specific in this dis—
disease. Half a drachm of the gum in powder may be made into
an electuary with the rob of elder—berries, or the jelly of currants
for a dose, and repeated occasionally.
Blisters upon the neck or behind the ears in violent inflamma—
tions of the throat are very beneficial; and in bad cases it will be
necessary to lay a blister quite across the throat, so as to reach from
ear to ear. After the plasters are taken off, the parts ought to be
kept running by the application of issue ointment, till the inflam—
mation is gone; otherwise, upon their drying up, the patient will
be in danger of a relapse. 
When the patient has been treated as above, a suppuration sel—
dom happens. This, however, is sometimes the case, in spite of all
endeavours to prevent it. When the inflammation and swelling
continue, and it is evident that a suppuration will ensue, it ought
to be promoted by drawing the steam of warm water into the
throat through a tunnel, or the like. Soft poultices ought to be
applied outwardly, and the patient may keep a roasted fig con—
stantly in his mouth.
It sometimes happens, before the tumour breaks, that the swel—
ling is so great, as entirely to prevent any thing from getting down 

201 INFLAMMATION OF THE THROAT. 
into the stomach. In this case, the patient must inevitably perish,
unless he can be supported in some other way. This can only be
done by nourishing clysters of broth, or gruel with milk, &c. Pa—
tients have often been supported by these for several days, till the
tumour has broke; and afterwards they have recovered.
Not only the swallowing, but the breathing, is often prevented
by the tumour. In this case, nothing can save the patient's life,
but opening the trachea, or windpipe. As that has been often done
with success, no person, in such desperate circumstances, ought
to hesitate a moment about the operation; but as it can only be
performed by a surgeon, it is not necessary here to give any direc—
tions about it.
When a difficulty of swallowing is not attended with an acute
pain or inflammation, it is generally owing to an obstruction of
the glands about the throat, and only requires that the part be
kept warm, and the throat frequently gargled with something that
may gently stimulate the glands, as a decoction of figs with vine—
gar and honey; to which may be added a little mustard, or a
small quantity of spirits. But this gargle is never to be used where
there are signs of an inflammation. This species of angina has va—
rious names among the common people, as the pap of the throat,
the falling down of the almonds of the ears, &c. Accordingly, to
remove it, they lift the patient up by the hair of the head, and
thrust their fingers under his jaws, &c. all which practices are at
best useless, and often hurtful.
Those who are subject to inflammations of the throat, in order
to avoid that disease, ought to live temperate. Such as do not choose
to observe this rule, must have frequent recourse to purging and
other evacuations, to discharge the superfluous humours. They
ought likewise to beware of patching cold, and should abstain from
aliment and medicines of an astringent or stimulating nature.
Violent exercise, by increasing the motion and force of the
blood is apt to occasion an inflammation of the throat, especially
if cold liquor be drank immediately after it, or the body suffered
suddenly to cool. Those who would avoid this disease, ought,
therefore, after speaking aloud, singing, running, drinking warm
liquor, or doing any thing that may strain the throat, or increase
the circulation of the blood towards it, to take care to cool gradu—
ally, and to wrap some additional coverings about their necks.
I have often known persons, who had been subject to sore throats,
entirely freed from that complaint by only wearing a ribband, or
a bit of flannel constantly round their necks, or by wearing thick—
er shoes, a flannel waistcoat, or the like. These may seem trifling 
but they have great effect. There is danger indeed in leaving them
off after persons have been accustomed to them; but surely the
inconveniency of using such things for life, is not to be compar—
ed with the danger which may attend the neglect of them. 
C 2 

202 OF THE MALIGNANT QUINSEY; OR,
Sometimes, after an inflammation, the glands of the throat con—
tinue swelled, and become hard and callous. This complaint is
not easily removed, and is often rendered dangerous by the too
frequent application of strong stimulating and styptic medicines.
The best method is to keep it warm, and to gargle it twice a—day
with a decoction of figs, sharpened a little with the elixir or spirit
of vitriol.
Of the Malignant Quinsey; Or, Putrid, Ulcerous Sore Throat.
THIS kind of quinsey is but little known in the north of Britain,
though, for some time past, it has been fatal in the more southern 
counties: It is frequently to be met with in America. Children
are more liable to it than adults, females than males, and the de—
licate than those who are hardy and robust. It prevails chiefly in
autumn, and is most frequent after a long course of damp or sultry
weather.
CAUSES.—This is a contagious distemper, and generally
communicated by infection. Whole families, and even entire vil—
lages, often receive the infection from one person. This ought to
put people on their guard against going near such patients as la—
bour under the disorder; as they endanger their own lives, and
those of their friends and connections. Whatever tends to produce
putrid or malignant fevers, may occasion the putrid ulcerous sore
throat, as unwholesome air, damaged provisions, neglect of clean—
liness, &c.
SYMPTOMS.—It begins with alternate fits of shivering and
heat. The pulse is quick, but low and unequal, and generally 
continues so through the whole course of the disease. The patient 
complains greatly of weakness and oppression of the breast; his
spirits are low, and he is apt to faint away when set upright; he is
troubled with a nausea, and often with a vomiting or purging.
The two latter are most common in children. The eyes appear
red and watery, and the face swells. The urine is at first pale and
crude; but, as the disease advances, it turns more of a yellowish
colour. The tongue is white, and generally moist, which distin—
guishes this from an inflammatory disease. Upon looking into the
throat, it appears swelled, and of a florid red colour. Pale or ash—
coloured spots, are here and there interspersed, and sometimes one
broad patch or spot, of an irregular figure, and pale white colour,
surrounded with florid red, only appears. These whitish spots or
sloughs cover so many ulcers. 
An efflorescence, or eruption upon the neck, arms, breast, and
fingers, about the second or third day, is a common symptom of
this disease. When it appears, the purging and vomiting generally
cease. 

203 PUTRID, ULCEROUS SORE THROAT. 
there is often a slight degree of delirium; the—face frequently
appears bloated, and the inside of the nostrils red and inflamed.
The patient complains of a disagreeable putrid smell, and his breath
is very offensive.
The putrid, ulcerous sore throat may be distinguished from the
inflammatory by the vomiting and looseness with which it is gene—
rally ushered in; the foul ulcers in the throat covered with a white
or livid coat; and by the excessive weakness of the patient; with
other symptoms of a putrid fever.
Unfavourable symptoms are, an obstinate purging, extreme
weakness, dimness of the fight, a livid or black colour of the spots,
and frequent shiverings, with a weak, fluttering pulse. If the erup—
tion upon the skin suddenly disappears, or becomes of a livid co—
lour, with a discharge of blood from the nose or mouth, the dan—
ger is very great.
If a gentle sweat break out about the third or fourth day, and
continue with a flow, firm, and equal pulse; if the sloughs cast off
in a kindly manner, and appear clean and florid at the bottom;
and if the breathing is soft and free, with a lively colour of the
eyes, there is reason to hope for a salutary crisis.
REGIMEN.—The patient must be kept quiet, and for the
most part in bed, as he will be apt to faint when taken out of it.
His food must be nourishing and restorative; as sago—gruel with
red wine, jellies, strong broths, &c. His drink ought to be gene—
rous, and of an antiseptic quality; as red wine negus, white wine
whey, and such like.
MEDICINE.—The medicine in this kind of quinsey is en—
tirely different from that which is proper in the inflammatory. All
evacuations, as bleeding, purging, &c. which weaken the patient,
must be avoided. Cooling medicines, as nitre and cream of tartar,
are likewise hurtful. Strengthening cordials alone can be used
with safety; and these ought never to be neglected.
If at the beginning there is a great nausea, or inclination to
vomit, the patient must drink an infusion of green tea, camomile
flowers, or carduus benedictus, in order to cleanse the stomach. If
these are not sufficient, he may take a few grains of the powder of
ipecacuanha, or any other gentle vomit.
If the disease is mild, the throat may be gargled with an infusion
of sage and rose leaves, to a gill of which may be added a spoonful
or two of honey, and as much vinegar as will make it agreeably
acid; but when the symptoms are urgent, the sloughs large and
thick, and the breath very offensive, the following gargle may be
used:
To six or seven ounces of the pectoral decoction, when boiling,
add half an ounce of contrayerva—root; let it boil for some time,
and afterwards strain the liquor; to which add two ounces of
white wine vinegar, an ounce of fine honey, and an ounce of the 

204 OF THE MALIGNANT QUINSEY, &c.
tincture of myrrh. This ought to be used as a gargle, and a little
of it should frequently be injected, with a syringe to clean the
throat, before the patient takes any meat or drink. This method is
peculiarly necessary for children, who cannot use a gargle.
It will be of great benefit if the patient frequently receives into
his mouth, through an inverted funnel, or proper inhaler, the
steams of warm vinegar, myrrh, and honey.
But when the putrid symptoms run high, and the disease is at—
tended with danger, the only medicine that can be depended up—
on is the Peruvian bark. It may be taken in substance, if the pa—
tient's stomach will bear it. If not, an ounce of bark grossly pow—
dered, with two drachms of Virginian snake—root, may be boiled
in an English pint and a half of water, to half a pint; to which a
tea—spoonful of the elixir of vitriol may be added, and an ordinary
tea—cupful of it taken every three or four hours. Blisters are very
beneficial in this disease, especially when the patient's pulse and
spirits are low. They may be applied to the throat, behind the
ears, or upon the back part of the neck.
Should the vomiting prove troublesome, it will be proper to
give the patient two table—spoonfuls of the saline julep every hour.
Tea made of mint and a little cinnamon will be very proper for
his ordinary drink, especially if an equal quantity of red wine be
mixed with it.
In case of a violent looseness, the size of a nutmeg of diascordium
or six or eight drops of laudanum, according to the age of the pa—
tient, may be taken in cinnamon water two or three times a—day;
the japonic confection may be taken two or three times a—day, or
oftener if necessary.
If a discharge of blood from the nose happens, the steams of
warm vinegar may be received up the nostrils frequently; and
the drink must be sharpened with spirits of vitriol, or tincture of
roses.
In case of a strangury, the belly must be fomented with warm
water, and emollient anodyne clysters given three or four times
a—day.
After the violence of the disease is over, the body should still
be kept open with mild purgatives; as manna, senna, rhubarb, or
the like.
If great weakness and dejection of spirits, or night—sweats, with
other symptoms of a consumption, should ensue, we advise the
patient to continue the use of the bark, with the elixir of vitriol,
and take frequently a glass of generous wine. These, together with
a milk—diet, and riding on horseback, are most likely for recover—
ing his strength. 

[205]
The Cynanche Parotidæa; Or, the Mumps.
THIS disease is known, in America, under the appellation of
the mumps: It is more particularly incident to children than to
grown people; and afflicts the patient but once in his life: It is
thought to be produced by contagion.
SYMPTOMS.-It comes on with a moderate fever: this is
soon followed with a stiffness in the neck, and a swelling about
the angle of the lower jaw. In a short time, the swelling increases,
and affects the whole neck; sometimes one side only is affected,
but generally both. It is not unfrequently attended with a slight
difficulty in swallowing. Those symptoms continue to increase
until the third or fourth day. At length the fever subsides, the swel-
ling recedes from the throat and neck; and the testicles in men,
and the breasts in women, become affected in a similar manner:
for the most part, this gradually disappears without much inconve-
nience; but when the swelling does not come on after that of the
throat and neck, the fever often becomes considerable.
REGIMEN.-This complaint seldom requires much atten-
tion; the patient  must confine himself to the house. The neck
should be defended from cold, by the application of flannel. The
diet should be spare, and the drink diluting.
MEDICINE.-The parts about the neck may be bathed with
a mixture, consisting of half a table-spoonful of sweet-oil, and
sixty drops of laudanum. The bowels must be kept open with
cream of tartar and flower of sulphur: but when the tumour has
suddenly receded from the throat, in consequence of cold, or any
other cause, and the fever becomes considerable, with pain in the
head, a full and hard pulse, blood must be taken from the arm,
and repeated as the symptoms may demand. A blister may also be
applied to the fore or back part of the neck.
CHAPTER XXXI.
Of Colds and Coughs. 
COLDS are the effect of an obstructed perspiration: Almost
every cold is  a kind of fever, which only differs in degree
from some of those already treated of.
No age, sex, or constitution, is exempted from this disease
neither can any medicine or regimen prevent it. The inhabitants;
of every climate are liable to catch cold, nor can the greatest cir-
cumspection defend them at all times from its attacks. Indeed, 

206 OF COUGHS AND COLDS.
if the human body could be kept constantly in an uniform degree
of warmth, catching cold would be impossible: but as that cannot
be effected by any means, the perspiration must be liable to many
changes. Such changes, when small, do not affect the health; but,
when great, they must prove hurtful.
When oppression of the breast, a stuffing of the nose, unusual
weariness, pain of the head, &c. give ground to believe that the
perspiration is obstructed, or, in other words, that the person has
caught cold, he ought immediately to lessen his diet, at least the
usual quantity of his solid food, and to abstain from all strong li-
quors. Instead of flesh, fish, eggs, milk, and other nourishing diet,
he may eat light bread-pudding, veal or chicken broth, panado,
gruels, and such-like. His drink may be water-gruel sweetened
with a little honey; an infusion of balm or linseed, sharpened with
the juice of orange or lemon; a decoction of barley and liquorice,
with tamarinds, or any other cool, diluting, acid liquor. His sup-
per should be light; as small posset or water-gruel, sweetened with
honey, and a little toasted bread in it. If honey disagrees with the
stomach, the gruel may be sweetened with treacle or coarse sugar,
and sharpened with the jelly of currants. Those who have been
accustomed to generous liquors, may take wine-whey instead of
gruel, which may be sweetened as above.
The patient ought to lie longer than usual a-bed, and to encou-
rage a gentle sweat, which is easily brought on towards morning,
by drinking tea, or any warm diluting liquor. I have often known
this practice carry off a cold in one day, which, in all probability,
had it been neglected, would have cost the patient his life, or have
confined him for some months. Would people sacrifice a little
time to ease and warmth, and practise a moderate degree of absti-
nence when the first symptoms of a cold appear, most of the bad
effects which flow from an obstructed perspiration might be pre-  
vented. But, after the disease has gathered strength by delay, all
attempts to remove it often prove vain. A pleurisy, a peripneu-
mony, or a fatal consumption of the lungs, are the common effects
of colds, which have either been totally neglected or treated im-
properly.
Many attempt to cure a cold, by getting drunk. But this, to say
no worse of it, is a very hazardous experiment. No doubt it may
sometimes succeed, by suddenly restoring the perspiration; but
when there is any degree of inflammation, which is frequently the
case, strong liquors, instead of removing the malady, increase it.
By this means, a common cold may become an inflammatory fever.
When those who labour for their daily bread catch cold, they
cannot afford to lose a day or two, in order to keep themselves
warm, and take a little medicine; by which means, the disorder is
often so aggravated, as to confine them for a long time, or even
to render them ever after unable to sustain hard labour. But even 

OF COUGHS AND COLDS. 207
such of the labouring poor as can afford to take care of themselves,
are often too hardy to do it: they affect to dispose colds, and as
long as they can crawl about, scorn to be confined by what they
call a common cold. Hence, colds destroy such numbers of man-
kind. Like an enemy despised, they gather strength from delay, till
they become invincible. Often travellers, rather than lose a day
in the prosecution of their business, throw away their lives by pur-
suing their journey, even in the severest weather, with this disease
upon them.
Colds may also be too much indulged. When a person, for eve-
ry slight cold, shuts himself up in a warm room, and drinks great
quantities of warm liquor, it may occasion such a general relax-
ation of the solids as will not be easily removed. It is, therefore,
proper, when the disease will permit, and the weather is mild, to
join to the regimen mentioned above, gentle exercise; as walking,
riding on horseback, or in a carriage, &c. An obstinate cold, which
no medicine can remove, will yield to gentle exercise and a pro-
per regimen of the diet.
Bathing the feet and legs in warm water has a great tendency
to restore perspiration. But care must be taken that the water be
not too warm, otherwise it will  do hurt. It should never be much
warmer than the blood, and the patient should go immediately to
bed after using it. Bathing the feet in warm water, lying in bed,
and drinking warm water-gruel, or other weak liquors, will soon-
er take off a spasm, and restore the perspiration, than all the hot su-
dorific medicines in the world. This is all that is necessary for re-
moving a common cold; and if this course be taken at the begin-
ning, it will seldom fail.
But when the symptoms do not yield to abstinence, warmth,
and diluting liquors, there is reason to fear the approach of some
other disease; as an inflammation of the breast, an ardent fever, or
the like. If the pulse, therefore, be hard and frequent, the skin hot
and dry, and the patient complains of his head or breast, it will be
necessary to bleed, and to give the cooling powders recommended
in the scarlet fever, every three or four hours, till they give a stool.
It will likewise be proper to put a blister on the back, to give
two table-spoonfuls of the saline mixture every two hours, and,
in short, to treat the patient in all respects as for a slight fever. I
have often seen this course, when observed at the beginning, re-
move the complaint in two or three day, when the patient had all
the symptoms of an approaching ardent fever, or an inflammation
of the breast.
The chief secret of preventing colds, lies in avoiding, as far as
possible, all extremes either of heat or cold, and in taking care,
when the body is heated, to let it cool gradually. These and other
circumstances relating to  this important subject, are fully treated
of, under the article Obstructed Perspiration. 

208
Of a Common Cough.
A cough is generally the effect of a cold, which has either been
improperly treated, or entirely neglected. When it proves obsti-
nate, there is always reason to fear the consequences, as this shows
a weak state of the lungs, and  is often the forerunner of a con-
sumption.
If the cough be violent, and the patient young and strong, with a
hard quick pulse, bleeding will be proper; but in weak and relaxed
habits, bleeding rather prolongs the disease. When the patient
spits freely, bleeding is unnecessary, and sometimes hurtful, as it
tends to lessen that discharge.
When the cough is not attended with any degree of fever, and
the spittle is viscid and tough, sharp pectoral medicines are to be
administered; as gum ammoniac, squills, &c. Two table-spoon-
fuls of the solution of the gum ammoniac may be taken two or
three times a-day, more or less, according to the age and constitu-
tion of the patient. Squills may be given various ways: two oun-
ces of the vinegar, the oxymel, or the syrup, may be mixed with
the same quantity of simple cinnamon-water, to which may be ad-
ded, an ounce of common water and an ounce of balsamic syrup.
Two table-spoonfuls of this mixture may be taken three or four
times a-day.
A syrup made of equal parts of lemon-juice, honey, and sugar-
candy, is likewise very proper in this kind of cough. A table
spoonful of it may be taken at pleasure.
When the defluxion is sharp and thin, these medicines rather do
hurt. In this case, gentle opiates, oils, and mucilages, are more
proper. A cup of an infusion of wild poppy leaves, and marsh-
mallow roots, or the flowers of colts-foot, may be taken frequent-
ly; or a tea-spoonful of the paregoric elixir may be put into the
patient's drink twice a-day.
When a cough is occasioned by acrid humours, tickling the
throat and fauces, the patient should keep some soft pectoral lo-
zenges almost constantly in his mouth; as the liquorice cakes, bar-
ley-sugar, the common balsmatic lozenges, Spanish juice, &c.
These blunt the acrimony of the humours, and, by taking off their
stimulating quality, help to appease the cough*.
* In a former edition, I recommended, for an obstinate tickling cough,
an oily emulsion, made with the paregoric elixir of the Edinburgh Dis-
pensatory, instead of the common alkaline spirit. I have since been told
by several practitioners, that they found it to be an excellent medicine
in this disorder, and every way deserving of the character which I had
given it. Where this elixir is not kept, its place may be supplied by ad-
ding to the common oily emulsion, an adequate proportion of the The-
baic tincture, or liquid laudanum.

OF A COMMON COUGH. 209
In obstinate coughs, proceeding from a flux of humours upon
the lungs, it will often be necessary, besides expectorating medi-
cines, to have recourse to issues, setons, or some other drain*. I
have often observed the most happy effects from a Burgundy-pitch
platter applied between the shoulders. I have ordered this simple
remedy in the most obstinate coughs, in a great number of cases,
and in many different constitutions, without ever knowing it fail
to give relief, unless where there were evident signs of an ulcer in
the lungs.
About the bulk of a nutmeg of Burgundy-pitch, may be spread
thin upon a piece of soft leather, about the size of the hand, and
laid between the shoulder-blades. It may be taken off and wiped
every three or four days, and ought to be renewed once a fortnight
or three weeks. This is, indeed, a cheap and simple medicine, and
consequently apt to be despised; but the materia medica does not
afford an application more efficacious in almost every kind of
cough. It has not indeed always an immediate effect; but, if kept
on  for some  time, it will succeed where most other medicines
fail.
The only inconveniency attending this plaister, is the itching
which it occasions; but surely this may be dispensed with, con-
sidering the advantage which the patient may expect to reap from
the application. When the itching becomes very uneasy, the plais-
ter may be taken off, and the part rubbed with a dry cloth, or wash-
ed with a little warm milk and water. Some caution is necessary
in discontinuing the use of such a plaster; this, however, may be
safely done by making it smaller by degrees, and at length quit-
ting it altogether in a warm season†.
But coughs proceed from many other causes besides defluxions
upon the lungs. In these cases, the cure is not to be attempted by
pectoral medicines. Thus, in a cough proceeding from a foulness
and debility of the stomach, syrups, oils, mucilages, and all kinds of
balsamic medicines do hurt. The stomach cough may be known
from one that is owing to a fault in the lungs, by this, that in the
latter the patient coughs whenever he inspires, or draws in his
breath fully; but in the former, that does not happen.
The cure of this cough depends chiefly upon cleansing and
strengthening the stomach; for which purpose, gentle vomits and
bitter purgatives are most proper. Thus, after a vomit or two,
the sacred tincture, as it is called, may be taken for a considerable
* The patient should wear flannel next his skin, in order to promote
perspiration. (I. C.)
† Some complain that the pitch plaister adheres too fast, while others
find difficulty in keeping it on. This proceeds from the different kinds
of pitch made use of, and likewise from the manner of making it. I ge-
nerally find it answers best when mixed with a little bees-wax, and
spread as cool as possible. The clear, hard, transparent pitch answers the
purpose best.
D2

210 OF THE WHOOPING-COUGH,
time, in the dose of one or two table-spoonfuls, twice a-day, or as
often as it is found necessary to keep the body gently open. People
may make this tincture themselves, by infusing an ounce of hiera
picra* in an English pint of white wine, letting it stand a few
days, and then straining it.
In coughs which proceed from a debility of the stomach, the
bark is likewise of considerable service. It may either be chewed,
taken in powder, or made into a tincture along with other stoma-
chic bitters.
A nervous cough can only be removed by change of air, proper
exercise, and gentle opiates. Instead of the saponaceous pill, the
paragoric elixir, &c. which are only opium disguised, ten, fifteen,
twenty, or twenty-five drops of liquid laudanum, more or less,
as circumstances require, may be taken at bed time, or when the
cough is most troublesome. Immersing the feet and hands in warm
water will often appease the violence of a nervous cough.
When a cough is only the symptom of some other malady, it
is in vain to attempt to remove it, without first curing the disease
from which it proceeds. Thus, when a cough is occasioned by
teething, keeping the body open, scarifying the gums, or whatever
facilitates the cutting of the teeth, likewise appeases the cough.
In like manner, when worms occasion a cough, such medicines as
remove these vermin will generally cure the cough; as bitter pur-
gatives, oily clysters, and such like.
Women during the last months of pregnancy, are often great-
ly afflicted with a cough, which is generally relieved by bleeding,
and keeping the body gently open. They ought to avoid all flatu-
lent food, and to wear a loose easy dress.
A cough is not only a symptom, but is often likewise the fore-
runner of diseases. Thus, the gout is frequently ushered in by
a very troublesome cough, which affects the patient for some days
before the coming on of the fit. This cough is generally removed
by a paroxysm of the gout, which should therefore be promoted,
by keeping the extremities warm, drinking warm liquors, and
bathing the feet and legs frequently in lukewarm water.
Of the Whooping-Cough, or Chin-Cough.
This cough seldom affects adults, but proves often fatal to chil-
dren. Such children as live upon thin watery diet, who breathe
unwholesome air, and have too little exercise, are most liable to
this disease, and generally suffer most from it.
The chin-cough is so well known, that a description of it is un-
necessary. Whatever hurts the digestion, obstructs the perspira-
* See Appendix, Hiera Picra. 

OR CHIN-COUGH. 211 
tion, or relaxes the solids, disposes to this disease: consequently,
its cure must depend upon cleansing 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,
good bread made into pap or pudding, chicken-broth, with other
light spoon-meats, are proper; but those who are farther ad-
vanced, may be allowed sago-gruel, and if the fever be not high, a
little boiled chicken, or other white meats. The drink may be
hyssop, or pennyroyal tea, sweetened with honey or sugar-candy,
small wine-whey; or, if the patient be weak, he may sometimes
be allowed a little negus.
One of the most effectual remedies in the chin-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. This may in
some measure depend on the patient's being removed from the place
where the infection prevails.  Most of the diseases of children are
infectious; nor is it at all uncommon to find the chin-cough pre-
vailing in one town or village, when another, at a very small dis-
tance, is quite free from it. But whatever be the cause, we are
sure of the fact. No time ought therefore to be lost in removing
the patient at some distance from the place where he caught the
disease, and, if possible, into a more pure and warm air*.
When the disease proves violent, and the patient is in danger
of being suffocated by the cough, he ought to be bled, especially
if there be a fever with a hard full pulse. But as the chief inten-
tion of bleeding is to prevent an inflammation of the lungs, and
to render it  more safe to give vomits, it is seldom necessary to re-
peat the operation; yet if there are symptoms of an inflammation
of the lungs, a second or even a third bleeding may be requisite.
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 pro-
mote this discharge, either by small doses of ipecacuanha, or the
vomiting julep recommended in the Appendix†.
It is very difficult to make children drink after a vomit. I have
often seen them happily deceived, by  infusing a scruple or half a
drachm of the powder of ipecacuanha in a tea-pot, with half an
English pint of boiling water. If this be disguised with a few
drops of milk and a little sugar, they will imagine it tea, and drink
it very greedily. A small tea-cupful of this may be given every
* Some think the air ought not to be changed till the disease is
on the decline; but there seems to be no sufficient reason for this opinion,
as patients have been known to reap benefit from a change of air at all
periods of the disease. It is not sufficient to take the patient out daily
in a carriage. This seldom answers any good purpose; but often does
hurt, by giving him cold.
† See Appendix, Vomiting Julep.  

212 OF THE WHOOPING-COUGH, &c.
quarter of an hour, or rather every ten minutes, till it operates.
When the child begins to puke, there will be no occasion for drink-
ing any more, as the water already on the stomach will be sufficient.
Vomits not only cleanse the stomach, which in this disease is
generally loaded with viscid phlegm, but they likewise promote the
perspiration and other secretions, and ought therefore to be repea-
ted according to the obstinacy of the disease. They should not
however be strong: gentle vomits frequently repeated are both less
dangerous, and more beneficial than strong ones.
The body ought to be kept gently open. The best medicines
for this purpose are castor oil, or flour of sulphur and cream of
tartar. These must be given in small doses, and repeated as occa-
sion requires.
Many people believe that oily, pectoral, and balsamic medicines
possess wonderful virtues for the cure of the chin-cough, and ac-
cordingly exhibit them plentifully to patients of every age and con-
stitution, without considering that every thing of this nature must
load the stomach, hurt the digestion, and of, course, aggravate the
disorder*.
Opiates are sometimes necessary to allay the violence of the
cough. For this purpose, a little of the syrup of poppies, or five,
six, or seven drops of laudanum, according to the age of the pa-
tient, may be taken in a cup of hyssop, pennyroyal tea, or sugar
and water, and repeated occasionally†.
The garlic ointment is a well-known remedy in North-Britain
for the Chin-cough. It is made by beating, in a mortar, garlic,
with an equal quantity of hogs-lard. With this, the soles of the
feet may be rubbed twice or thrice a-day; but the best method is
to spread it upon a rag, and  apply it in the form of plaister. It
should be renewed every night and morning at least, as the garlic
soon loses its virtue. This is an exceeding good medicine, both
in the chin-cough and in most other coughs of an obstinate na-
ture. It ought not however to be used when the patient is very
hot or feverish, lest it should increase these symptoms.
The feet should be bathed once every two or three days in luke-
warm water; and a Burgundy-pitch plaister kept constantly be-
tween the shoulders. But when the disease proves very violent,
it will be necessary, instead of it, to apply a blister, and to keep
the part open for some time with issue-ointment.
* Dr. Duplanil says, he has seen many good effects from the kermes
mineral in this complaint, the cough being frequently alleviated even
by the first dose. The dose for a child of one year old, is a quarter of a
grain dissolved in a cup of any liquid, repeated two or three times a-day.
For a child of two years, the dose is half a grain; and the quantity must
be thus increased, in proportion to the age of the patient.
† Some recommend the extract of hemlock as an extraordinary reme-
dy in the whooping-cough; but so far as I have been able to observe, it
is no way superior to opium, which, when properly administered, will
often relieve some of the most troublesome symptoms of this disorder. 

INFLAMMATION OF THE STOMACH. 213
When the disease is prolonged, and the patient is free from a
fever, the bark, and other bitters, are the most proper medicines.
The bark may either be taken in substance, or in a decoction or
infusion, as is most agreeable. For a child, ten, fifteen, or twenty
grains, recording to the age of the patient, may be given three
or four times a-day. For an adult, half a drachm or two scruples
will be proper. Some give the extract of the bark with cantha-
rides; but to manage this, requires a considerable attention. It is
more safe to give a few grains of castor along with the bark. A
child of six or seven years of age, may take seven or eight grains
of castor, with fifteen grains of powdered bark, for a dose. This
may be made into a mixture with two or three ounces of any sim-
ple distilled water, and a little syrup, and taken three or four
times a-day.
CHAPTER XXXII.
Inflammation of the Stomach, and other Viscera.
ALL inflammations of the bowels are dangerous, and require
the most speedy assistance; as they frequently end in a sup-
puration, and sometimes in a mortification, which is certain death.
CAUSES.————An inflammation of the stomach may proceed
from any of the causes which produce an inflammatory fever; as
cold liquor drank while the body is warm, obstructed perspiration,
or the sudden striking in of any eruption. It may likewise proceed
from the acrimony of the bile, or from acrid and stimulating sub-
stances taken into the stomach; as strong vomits or purges, cor-
rosive poisons, and such-like. When the gout has been repelled
from the extremities, either by cold or improper applications, it
often occasions an inflammation of the stomach. Hard or indiges-
tible substances taken into the stomach, as bones, the stones of
fruit, &c. may likewise have that effect.
SYMPTOMS.————It is attended with a fixed pain and burning
heat in the stomach; great restlessness and anxiety; a small, quick,
hard pulse; vomiting, or, at least, a nausea and sickness; excessive
thirst; coldness of the extremities; difficulty of breathing; cold
clammy sweats; and sometimes convulsions and fainting fits. The
stomach is swelled, and often feels hard to the touch. One of the
most certain signs of this disease is, the sense of pain, which the
patient feels upon taking any kind of food or drink, especially if it
be either too hot or too cold.
When the patient vomits every thing he eats or drinks, and is ex-
tremely restless, has a hiccup, with an intermitting pulse, or fre-
quent fainting fits, the danger is very great.
REGIMEN.————All acrimonious, heating, and irritating food 

214 INFLAMMATION OF THE STOMACH.
and drink are carefully to be avoided. The weakness of the pati-
ent may deceive the by-standers, and induce them to give him
wines, spirits, or other cordials; but these never fail to increase
the disease, and often occasion sudden death. The inclination to
vomit may likewise impose on the attendants, and make them
think a vomit necessary; but that too is almost certain death.
The food must be light, thin, cool, and easy of digestion. It
must be given in small quantities and should neither be quite cold
nor too hot. Thin gruel made of barley or oatmeal, light toasted
bread dissolved in boiling water, or very weak chicken-broth, are
the most proper. The drink should be clear whey, barley-water,
water in which toasted bread has been boiled, or decoctions of
emollient vegetables; as liquorice and marsh-mallow roots, sar-
saparilla, &c.
MEDICINE.————Bleeding in this disease is absolutely necessary,
and is almost the only thing that can be depended on. When the
disease proves obstinate, it will often be proper to repeat this ope-
ration several times, nor must the low state of the pulse deter us
from doing so. The pulse, indeed, generally rises upon bleeding,
and as long as that is the case, the operation is safe.
Frequent fomentations with lukewarm water, or a decoction of
emollient vegetables, are likewise beneficial. Flannel cloths dipped
in these must be applied to the region of the stomach, and removed
as they grow cool. They must neither be applied too warm, nor
be suffered to continue till they become quite cold, as either of
these extremities would aggravate the disease.
The feet and legs ought likewise to be frequently bathed in
lukewarm water, and warm bricks or poultices may be applied to
the soles of the feet. The warm bath, if it can be conveniently
used, will be of great service.
In this, and all other inflammations of the bowels, an epispastic,
or blister, applied over the part affected, is one of the best reme-
dies. I have often used it, and do not recollect one instance where-
in it did not give relief to the patient.
The only internal medicines which we venture to recommend
in this disease, are mild clysters. These may be made of warm
water, or thin water-gruel; and if the patient is costive, a little
sweet-oil, honey, or manna, may be added. Clysters answer the
purpose of an internal fomentation, while they keep the body open,
and at the same time nourish the patient, who is often in this dis-
ease unable to retain any food upon his stomach. For these rea-
sons, they must not be neglected, as the patient's life may depend
on them. 

[215]
Inflammation of the Intestines.
THIS is one of the most painful and dangerous diseases that
mankind are liable to. It generally proceeds from the same causes
as the inflammation of the stomach; also, from costiveness,
worms, eating unripe fruits, or great quantities of nuts, drinking
hard windy malt liquors, as state bottled beer or ale, sour wines,
cyder, &c. It may likewise be occasioned by a rupture, by schir-
rous tumours of the intestines, or by their opposite sides growing
together.
The inflammation of the intestines is denominated Iliac Passion,
Enteritis, &c. according to the name of the parts affected. The
treatment is nearly the same whatever part of the intestinal canal
be the seat of the disease; we shall therefore omit these distinc-
tions, lest they should perplex the reader.
The symptoms here are nearly the same as in the foregoing dis-
ease; only the pain, if possible, is more acute, and is situated low-
er. The vomiting is likewise more violent, and sometimes even the
excrements, together with the clysters and suppositories, are dis-
charged by the mouth. The patient is continually belching up
wind, and has often an obstruction of his urine.
While the pain shifts, and the vomiting only returns at certain
intervals, and while the clysters pass downwards, there is ground
to hope; but when the clysters and fæces are vomited, and the pa-
tient is exceeding weak, with a low, fluttering pulse, a pale coun-
tenance, and a disagreeable or stinking breath, there is great rea-
son to fear that the consequences will prove fatal. Clammy sweats,
black fœtid  stools, with a small intermitting pulse, and a total
cessation of pain, are signs of a mortification already begun, and
of approaching death.
REGIMEN.————The regimen is in general the same as in an
inflammation of the stomach. The patient must be kept quiet,
avoiding cold, and all violent passions of the mind. His food ought
to be very light, and given in small quantities; his drink weak and
diluting; as clear whey, barley-water, and such-like.
MEDICINE.————Bleeding in this, as well as in the inflamma-
tion of the stomach, is of the greatest importance. It should be
performed as soon as the symptoms appear, and must be repeated
according to the strength of the patient, and the violence of the
disease.
A blister is likewise to be applied immediately over the part
where the most violent pain is. This not only relieves the pain of
the bowels, but even clysters and purgative medicines, which be-
fore had no effect, will operate when the blister begins to rise.
Fomentations and laxative clysters are by no means to be omit-
ted. The patient's feet and legs should frequently be bathed in
warm water; and cloths dipped in it applied to his belly. Blad-

216 INFLAMMATION OF THE INTESTINES.
ders filled with warm water may likewise be applied to the region
of the navel, and warm bricks, or bottles filled with warm water,
to the soles of the feet. The clysters may be made of barley-water
or thin gruel with salt, and softened with sweet oil or fresh butter.
These may be administered every two or three hours, or oftener,
if the patient continues costive.
If the disease does not yield to clysters and fomentations, re-
course must be had to pretty strong purgatives; but as these, by
irritating the bowels, often increase their contraction, and by that
means, frustrate their own intention, it will be necessary to join
them with opiates, which, by allaying the pain, and relaxing the
spasmodic contractions of the guts, greatly assist the operation of
purgatives.
What answers the purpose of opening the body very well, is a
solution of the bitter purging salts. Two ounces of these may be
dissolved in an English pint of warm water, or thin gruel, and a
teacupful of it taken every half hour till it operates. At the same
time, fifteen, twenty, or twenty-five drops of laudanum may be
given in a glass of peppermint or simple cinnamon-water, to ap-
pease the irritation, and prevent the vomiting, &c.
Acids have often a very happy effect in staying the vomiting,
and appeasing the other violent symptoms of this disease. It will
therefore be of use to sharpen the patient's drink with cream of
tartar, juice of lemon; or, when these cannot be obtained, with
vinegar.
But it often happens that no liquid whatever will stay on the
stomach. In this case, the patient must take purging pills. I have
generally found the following answer very well: Take jalap in
powder, and vitriolated tartar, of each half a drachm, opium one
grain, Castile soap as much as will make the mass fit for pills.
These must be taken at one dose, and if they do not operate in a
few hours, the dose may be repeated.
If a stool cannot be procured by any of the above means, it will
be necessary to immerse the patient in warm water up to the
breast. I have often seen this succeed when other means had been
tried in vain. The patient must continue in the water as long as
he can easily bear it without fainting, and if one immersion has
not the desired effect, it may be repeated as soon as the patient's
strength and spirits are recruited. It is more safe for him to go
frequently into the bath, than to continue too long at a time; and
it is often necessary to repeat it several times before it has the de-
sired effect.
It has sometimes happened, after all other means of procuring
a stool had been tried to no purpose, that this was brought about
by immersing the patient's lower extremities in cold water, or
making him walk upon a wet pavement, and dashing his legs and
thighs, with cold water. This method, when others fail, at least 

OF THE COLIC. 217
merits a trial. It is indeed attended with some danger; but a
doubtful remedy is better than none.
In desperate cases, it is common to give quicksilver. This may be
given to the quantity of several ounces, or even a pound, but
should not exceed that*. When there is reason to suspect a mor-
tification of the guts, this medicine ought not to be tried. In that
case, it cannot cure the patient, and will only hasten his death.
But when the obstruction is occasioned by any cause that can be
removed by force, quicksilver is not only a proper medicine, but
the best that can be administered, as it is the fittest body we know
for making its way through the intestinal canal.
If the disease proceeds from a rupture, the patient must be laid
with his head very low, and the intestines returned by gentle pres-
sure with the hand. If this, with fomentations and clysters, should
not succeed, recourse must be had to a surgical operation, which
may give the patient relief.
Such as would avoid this excruciating and dangerous disease,
must take care never to be too long without a stool. Some who
have died of it, have had several pounds of hard dry fœces taken out
of their guts. They should likewise beware of eating too freely of
sour or unripe fruits, or drinking stale windy liquors, &c. I have
known it brought on by living too much on baked fruits, which
are seldom good. It likewise proceeds frequently from cold caught
by wet clothes, &c. but especially from wet feet.
Of the Colic.
THE colic has a great resemblance to the two preceding dis-
eases, both in its symptoms and method of cure. It is generally
attended with costiveness and acute pain of the bowels; and re-
quires diluting diet, evacuations, fomentations, &c.
Colics are variously denominated according to their causes, as
the flatulent, the bilious, the hysteric, the nervous, &c. As each of
these require a particular method of treatment, we shall point out
their most general symptoms, and the means to be used for their
relief.
The flatulent, or wind-colic, is generally occasioned by an indis-
creet use of unripe fruits, meats of hard digestion, windy vegeta-
bles, fermenting liquors, and such like. It may likewise proceed
from an obstructed perspiration, or catching cold. Delicate people,
whose digestive powers are weak, are most liable to this kind of colic.
* When quicksilver is given in too large quantities, it defeats its
own intention, as it pulls down the bottom of the stomach, which pre-
vents it getting over the pylorus. In this case, the patient should be hung
up by the heels, in order that the quicksilver may be discharged by his
mouth.
E2 

218 OF THE COLIC.
The flatulent colic may either affect the stomach or intestines.
It is attended with a painful stretching of the affected part. The
patient feels a rumbling in his guts, and is generally relieved by a
discharge of wind, either upwards or downward. The pain is sel-
dom confined to any particular part, as the vapour wanders from
one division of the bowels to another till it finds a vent.
When the disease proceeds from windy liquor, green fruit,
sour herbs, or the like, the best medicine, on the first appearance
of the symptoms, is a dram of brandy, gin, or any good spirits.
The patient should likewise sit with his feet upon a warm hearth
stone, or apply warm bricks to them; and warm cloths may be
applied to his stomach and bowels.
This is the only colic wherein ardent spirits, spiceries, or any
thing of a hot nature, may be ventured upon. Nor indeed are
they to be used here unless at the very beginning, before any
symptoms of inflammation appear. We have reason to believe, that
a colic, occasioned by wind or flatulent food, might always be cur-
ed by spirits and warm liquors, if taken immediately upon per-
ceiving the first uneasiness; but when the pain has continued for
a considerable time, and there is reason to fear an inflammation of
the bowels already begun, all hot things are to be avoided as poison,
and the patient is to be treated in the same manner as for the in-
flammation of the intestines.
Several kinds of food, as honey, eggs, &c. occasion colics in
some particular constitutions. I have generally found the best me-
thod of cure for these was, to drink plentifully of small diluting
liquors, as water-gruel, small posset, water with toasted bread
soaked in it, &c.
Colics which proceed from excess and indigestion, generally
cure themselves, by occasioning vomiting or purging. These dis-
charges are not to be stopped, but promoted by drinking plenti-
fully of warm water, or weak posset. When their violence is over,
the patient may take a dose of salts or castor-oil, to carry off the
dregs of his debauch.
Colics occasioned by wet feet, or catching cold, may generally
be remoted at the beginning, by bathing the feet and legs in warm
water, and drinking such warm diluting liquors as will promote
the perspiration, as weak wine-whey, or water-gruel, with a small
quantity of spirits in it.
Those flatulent colics, which prevail so much among country
people, might generally be prevented, were they to change their
clothes when they get wet. They ought likewise to take a dram,
* These generally afford relief, but the greatest disadvantage attend-
ing this practice is, that the patient is apt to become intoxicated, and
liable to slide into the practice of frequent inebriation. On this account,
a dose of laudanum may be substituted, which is not quite so fascinating
to the palate; as for the patient to wish a repetition, without an absolute
necessity. (I. C.)

OF THE COLIC. 219
or drink some warm liquor after eating any kind of green trash.
We do not recommend dram-drinking, but in this case, spirits
prove a real medicine, and the best that can be administered. A
glass of good pepper-mint water will have nearly the same effect
as a glass of brandy, and, in some cases, is rather to be preferred.
The bilious colic is attended with very acute pains about the re-
gion of the navel. The patient complains of great thirst, and is ge-
nerally costive. He vomits a hot, bitter, yellow-coloured bile,
which being discharged, seems to afford some relief, but is quickly
followed by the same violent pain as before. As the distemper ad-
vances, the propensity to vomit sometimes increases, so as to be-
come almost continual, and the proper motion of the intestines is
so far perverted, that there are all the symptoms of an impending
iliac passion.
If the patient be young and strong, and the pulse full and fre-
quent, it will be proper to bleed. After which give forty drops of
laudanum, which should be repeated in an half hour if the pain does
not abate. The bowels must be kept open with castor-oil or clys-
ters. Clear whey or gruel, sharpened with the juice of lemon, or
cream of tartar, must be drank freely. Small chicken broth, with
a little manna dissolved in it, or a slight decoction of tamarinds,
are likewise very proper, or any other thin, acid, opening liquor.
Besides bleeding and plentiful dilution, it will be necessary to
foment the belly with cloths dipped in warm water; and if this
should not succeed, the patient must be immersed up to the breast
in warm water.
In the bilious colic, the vomiting is often very difficult to re-
strain. When this happens, the patient may drink a decoction of
toasted bread, or an infusion of garden-mint in boiling water.
Should these not have the desired effect, the saline draught, with
a few drops of laudanum in it, may be given, and repeated ac-
cording to the urgency of the symptoms. A small quantity of Ve-
nice treacle may be spread in form of a cataplasm, and applied to
the pit of the stomach. Clysters, with a proper quantity of Venice
treacle or liquid laudanum in them, may likewise be frequently ad-
ministered.
Such as are liable to frequent returns of the bilious colic should
use flesh sparingly, and live chiefly upon a light vegetable diet.
They should take frequently a dose of cream of tartar with tama-
rinds, or any other cool acid purge.
The hysteric colic bears a great resemblance to the bilious. It is
attended with acute pains about the region of the stomach, vomit-
ing, &c. But what the patient vomits, in this case, is commonly
of a greenish colour. There is a great sinking of the spirits, with de-
jection of mind and difficulty of breathing, which are the charac-
teristic symptoms of this disorder. Sometimes it is accompanied
with the jaundice, but this generally goes off of its own accord in
a few days. 

220 OF THE COLIC.
&c. do hurt. Every thing that weakens the patient, or sinks the
spirits, is to be avoided. If the vomiting should prove violent, luke-
warm water, or small posset, may be drank to cleanse the stomach.
Afterwards the patient may take fifteen, twenty, or twenty-five
drops of liquid laudanum in a glass of cinnamon water. This may
be repeated every ten or twelve hours till the symptoms abate.
The patient may likewise take four or five of the fœtid pills eve-
ry six hours, and drink a cup of penny-royal tea after them. If
asafœtida should prove disagreeable, which is sometimes the case,
a tea-spoonful of the tincture of castor in a cup of penny-royal tea,
or thirty or forty drops of the balsam of Peru, dropped upon a bit
of loaf-sugar, maybe taken in its stead. The anti-hysteric plaister
may also be used, which has often a good effect*.
The nervous colic prevails among miners, smelters of lead,
plumbers, the manufacturers of white lead, &c. It is very com-
mon in the cyder counties of England, and is supposed to be oc-
casioned by the leaden vessels used in preparing that liquor. In the
West-Indies it is termed the dry belly-ach.
No disease of the bowels is more excruciating than this. Nor is
it soon at an end. I have known it continue eight or ten days with
very little intermission, the body all the while continuing bound in
spite of medicine, yet at length yield, and the patient recover†.
It generally leaves the patient weak, and often ends in a palsy.
The general treatment of this disease is nearly the same with
that of the iliac passion, or inflammation of the guts. The body
is to be opened by mild purgatives given in small doses, and fre-
quently repeated, and their operation must be assisted by soft oily
clysters, fomentations, &c. Castor-oil is reckoned peculiarly pro-
per in this disease. It may both be mixed with the clysters and
given by the mouth.
Barbadoes tar is said to be an efficacious medicine in this com-
plaint. It may be taken to the quantity of two drachms three times
a day, or oftener if the stomach will bear it. This tar, mixed with
an equal quantity of strong rum, is likewise proper for rubbing the
spine, in case any tingling, or other symptoms of a palsy are felt.
When the tar cannot be obtained, the back may be rubbed with
strong spirits, or a little oil of nutmegs or of rosemary.
If the patient remains weak and languid after this disease, he
must take exercise on horseback, and use an infusion of the bark in
wine. When the disease ends in a palsy, the bath-waters are ex-
tremely proper.
To avoid this kind of colic, people must shun all sour fruits,
* See Appendix, Anti-hysteric plaister.
† As the smoke of tobacco thrown into the bowels will often procure,
a stool, when all other means have failed, an apparatus for this purpose
ought to be kept by every surgeon. 

INFLAMMATION OF THE KIDNEYS. 221
acids, austere liquors, &c. Those who work in lead ought never to
go to their business fasting, and their food should be oily or fat.
They may take a glass of sallad oil, with a little brandy or rum
every morning, but should never take spirits alone. Liquid aliment
is best for them; as fat broths, &c. but low living is bad. They
should frequently go a little out of the tainted air; and should ne-
ver suffer themselves to be costive. In the West-Indies, and on the
coast of Guinea, it has been found of great use, for preventing this
colic, to wear a piece of flannel round the waist, and to drink an
infusion of ginger by way of tea.
Sundry other kinds of this disease might be mentioned, but too
many distinctions perplex the reader. Those already mentioned are
the most material, and should be attended to, as their treatment is
very different. But even persons who are not in a condition to dis-
tinguish very accurately in these matters, may be of service to pa-
tients in colics of every kind, by only observing the following
general rules, viz. To bathe the feet and legs in warm water; to
apply bladders filled with warm water, or cloths dipped in it, to the
stomach and bowels; to make the patient drink freely of diluting
mucilaginous liquors; and to give him an emollient clyster every
two or three hours. Should these not succeed, the patient ought
to be immersed in warm water.
Inflammation of the Kidneys.
CAUSES.————This disease may proceed from any of those
causes which produce an inflammatory fever. It may likewise be
occasioned by wounds or bruises of the kidneys; small stones or
gravel lodging within them; by strong diuretic medicines; as
spirits of turpentine, tincture of cantharides, &c. Violent motion,
as hard riding or walking, especially in hot weather, or whatever
drives the blood too forcibly into the kidneys, may occasion this
malady. It may proceed from lying too soft, too much on the back,
involuntary contractions, or spasms, in the urinary vessels, &c.
SYMPTOMS.————There is a sharp pain about the region of
the kidneys, with some degree of fever, and a stupor or dull pain
in the thigh of the affected side. The urine is at first clear, and
afterwards of a reddish colour; but in the worst kind of the dis-
ease, it generally continues pale, is passed with difficulty, and com-
monly in small quantities at a time. The patient feels great un-
easiness when he endeavours to walk or sit upright. He lies with
most ease on the affected side, and has generally a nausea or vomi-
ting, resembling that in the colic.
This disease may be distinguished from the colic, by the pain 

222 INFLAMMATION OF THE KIDNEYS.
being seated farther back, and by the difficulty of passing urine,
with which it is constantly attended.
REGIMEN.————Every thing of a heating or stimulating na-
ture is to be avoided. The food must be thin and light; as pa-
nado, small broths, with mild vegetables, and the like. Emollient
and thin liquors must be plentifully drank; as clear whey, or
balm-tea sweetened with honey, decoctions of marsh-mallow roots,
with barley and liquorice, &c. The patient, notwithstanding the
vomiting, must constantly keep sipping small quantities of these
or other diluting liquors. Nothing so safely and certainly abates
the inflammation, and expels the obstructing cause, as copious
dilution. The patient must be kept easy, quiet, and free from
cold, as long as any symptoms of inflammation remain.
MEDICINE.————Bleeding is generally necessary, especially at
the beginning. Ten or twelve ounces may be let from the arm
with a lancet, and if the pain and inflammation continue, the ope-
ration may be repeated in twenty-four hours, especially if the pa-
tient be of a full habit. Leeches may be applied to the hæmor-
rhoidal veins, as a discharge from these will greatly relieve the pa-
tient.
Cloths dipped in warm water, or bladders filled with it, must be
applied as near as possible to the part affected, and renewed as they
grow cool. If the bladders be filled with a decoction of mallows
and camomile flowers, to which a little saffron is added, and mix-
ed with about a third part of new milk, it will be still more bene-
ficial.*
Emollient clysters ought frequently to be administered; and if
these do not open the body, a little salt and honey or manna may
be added to them.
The same course is to be followed where gravel or stone is
lodged in the kidney, but when the gravel or stone is separated
from the kidney, and lodges in the ureter,† it will be proper, be-
sides the fomentations, to rub the small of the back with sweet oil,
and to give gentle diuretics; as juniper-water, sweetened with the
syrup of marsh-mallows: a tea-spoonful of the sweet spirits of ni-
tre, with fifteen or twenty drops of laudanum, may be given eve-
ry three or four hours until the pain is mitigated, in a cup of the
patient's drink. He ought likewise to take exercise on horseback,
or in a carriage, if he be able to bear it.
When the disease is protracted beyond the seventh or eighth
day, and the patient complains of a stupor and heaviness of the
part, has frequent return, of chillness, shivering, &c. there is rea-
* The patient may go into the warm bath, which is more efficacious.
† The ureters are two long and small canals, one on each side, which
carry the urine from the basin of the kidneys to the bladder. They are
sometimes obstructed by small stones or gravel falling down from the
kidneys and lodging in them. 

INFLAMMATION OF THE BLADDER. 223
son to suspect that matter is forming in the kidney, and that an
abscess will ensue.
When matter in the urine shows that an ulcer is already form-
ed in the kidney, the patient must be careful to abstain from all
acrid, sour, and salted provisions; and to live chiefly upon mild
mucilaginous herbs and fruits, together with the broth of young
animals, made with barley and common pot-herbs, &c. His drink
may be whey, and butter-milk that is not sour. The latter is by
some reckoned a specific remedy in ulcers of the kidneys. To an-
swer this character, however, it must be drank for a considerable
time. Chalybeate waters have likewise been found beneficial in this
disease. This medicine is easily obtained, as it is found in every
part of Britain. It must likewise be used for a considerable time,
in order to produce any salutary effects.
Those liable to frequent returns of inflammation, or obstructions
of the kidneys, must abstain from wines, especially such as abound
with tartar; and their food ought to be light, and of easy digestion.
They should use moderate exercise, and should not lie too hot,
nor too much on their back.
Inflammation of the Bladder.
The inflammation of the bladder proceeds, in a great measure,
from the same causes as that of the kidneys. It is known by an
acute pain towards the bottom of the belly*, and difficulty of
passing urine, with some degree of fever, a constant inclination
to go to stool, and a perpetual desire to make water.
This disease must be treated on the same principles as the pre-
ceding. The diet must be light, and thin, and the drink of a
cooling nature. Bleeding is very proper at the beginning, and in
robust constitutions, it will often be necessary to repeat it. The
lower part of the belly should be fomented with warm water, or
a decoction of mild vegetables; and emollient clysters ought fre-
quently to be administered, &c.
The patient should abstain from every thing that is of a hot,
acrid, and stimulating quality, and should live entirely upon small
broths, gruels, or mild vegetables.
A stoppage of urine may proceed from other causes besides an
inflammation of the bladder; as a swelling of the hæmorrhoidal
veins, hard fæces lodged in the rectum; a stone in the bladder;
excrescences in the urinary passages, a palsy of the bladder, hy-
steric affections, &c. Each of these requires a particular treat-
ment, which does not fall under our present consideration; in all
* A violent pain in the lower part of the back is a common symptom
in this disease. 

224 INFLAMMATION OF THE LIVER.
of them, mild and gentle applications are the safest, as strong di-
uretic medicines, or things of an irritating nature, generally  in-
crease the danger. Some persons kill themselves by introducing
probes into the urinary passages, to remove, as they think, some- 
what obstructing the discharge of urine, and others bring on a 
violent inflammation of the bladder, by using strong diuretics, as
oil of turpentine, &c. for that purpose.
Inflammation of the Liver.
THE liver is less subject to inflammation than most of the other
viscera, as in it the circulation is slower; but when an inflamma-
tion does happen, it is with difficulty removed, and often ends in
a suppuration or schirrus.
CAUSES.————Besides the common causes of inflammation, are
the following, viz. excessive fatness, a schirrus of the liver itself,
violent shocks from strong vomits when the liver was before un-
sound, any thing that suddenly cools the liver after it has been
greatly heated, stones obstructing the course of the bile, drinking
strong wines and spirituous liquors, using hot spicy aliment, ob-
stinate hypochondriacal affections, &c.
SYMPTOMS.————This disease is known by a painful tension
of the right side under the false ribs, attended with some degree
of fever, a sense of weight, or fulness of the part, difficulty of
breathing, loathing of food, great thirst, with a pale or yellowish
colour of the skin and eyes.
The spmptoms are various, according to the degree of inflam-
mation, and to the particular part of the liver where the inflam-
mation happens. Sometimes the pain is so inconsiderable, that
an inflammation is not suspected; but when it happens in the
upper or convex part of the liver, the  pain is more acute, the
pulse quicker, and the patient is often troubled with a dry cough,
a hiccup, and a pain extending to the shoulder, with difficulty of
lying on the left side, &c.
This disease may be distinguished from the pleurisy by the pain
being less violent, seated under the false ribs, the pulse not so
hard, and by the difficulty of lying on the left side. It may be
distinguished from the hysteric and hypochondriac disorders by
the degree of fever with which it is always attended.
This disease, if properly treated, is seldom mortal. A constant
hiccuping, violent fever, and excessive thirst, are bad symptoms.
If it ends in a suppuration, and the matter cannot be discharged
outwardly, the danger is great. When the schirrus of the liver
ensues, the patient, if he observes a proper regimen, may never-
theless live a number of years tolerably easy; but if he indulge 

INFLAMMATION OF THE LIVER. 225
in animal food and strong liquors, or take medicines of an acrid
or irritating nature, the schirrus will be converted into a cancer,
which must infallibly prove fatal.
REGIMEN.————The regimen is in this as in other inflamma-
tory disorders. All hot things are to be carefully 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.
MEDICINE.————Bleeding is proper at the beginning of this
disease, and will often be necessary, even though the pulse should
not feel hard, to repeat it. All violent purgatives are to be avoi-
ded; the body however must be kept gently open. A decoction of
tamarinds, with a little honey or manna, will answer this purpose
very well. The side affected must be fomented in the manner di-
rected in the foregoing diseases. Mild laxative clysters should be
frequently administered; and, if the pain should still continue vi-
olent, a blister may be applied over the part affected.*  
Medicines which promote the secretion of urine have a good ef-
fect. For this purpose, half a drachm of purified nitre, or a tea-
spoonful of the sweet spirits of nitre, may be taken in a cup of the
patient's drink three or four times a-day.
When there is an inclination to sweat, it ought to be promoted,
but not by warm sudorifics. The only thing to be used for that
purpose, is plenty of diluting liquors drank about the warmth of
the human blood. The patient in this case, as well as in all other
topical inflammations, ought to drink nothing that is colder than
the blood. 
If the stools should be loose, and even streaked with blood, no
means must be used to stop them, unless they be so frequent as to
weaken the patient. Loose stools often prove critical, and carry off
the disease.
If an abscess or imposthume is formed in the liver, all methods
should be tried to make it break and discharge itself outwardly, as
fomentations, the application of emollient poultices, such as are
made of bread and milk, or flaxseed flour. Sometimes the
matter of an abscess comes away in the urine, and sometimes
it is discharged by stool, but these are efforts of Nature which no
means can promote. When the abscess bursts into the cavity of
* The most judicious practice in this disease, is, that which was first
employed in the East-Indies and China, where inflammations of the liver
are almost as prevalent as intermittent fevers are in this country. After
moderate evacuations, by bleeding and purging, or frequently without
the use of either, they charge the system with mercury as soon as pos-
sible, by rubbing two or three drachms of mercurial ointment on the
internal parts of the legs and thighs every morning and evening; like-
wise on the right side of the abdomen, a little below the pained part.
This must be continued until the gums are affected, and repeated until
the symptoms disappear. This practice I have known frequently suc-
ceed at Canton in China, and likewise in America. (I.C.)
F2 

226 CHOLERA MORBUS, &c.
the abdomen at large, death must ensue; nor will the event be
more favourable when the abscess is opened by an incision, unless
in cases where the liver adheres to the peritonæum,* so as to form a
bag for the matter, and prevent it from falling into the cavity of
the abdomen; in which case, opening the abscess by a sufficiently
large incision, will probably save the patient's life.†
If the disorder should end in a schirrus, the patient must be
careful to regulate his diet, &c. in such a manner as not to aggra-
vate the disease. He must not indulge in flesh, fish, strong liquors,
or any highly seasoned or salted provisions; but should, for the most
part, live on mild vegetables, as fruits and roots; taking gentle
exercise, and drinking whey, barley-water, or buttermilk. If he
takes anything stronger, it should be fine mild ale, which is less
heating than wines or spirits.
We shall take no notice of inflammations of the other viscera.
They must in general be treated upon the same principles as those
already mentioned. The chief rule with respect to all of them is,
to let blood, to avoid every thing that is strong, or of a heating
nature, to apply warm fomentations to the part affected, and to
cause the patient to drink a sufficient quantity of warm diluting li-
quors.
CHAPTER XXXIII.
Of the Cholera Morbus, and other excessive Discharges from
the Stomach and Bowels.
THE cholera morbus is a violent purging and vomiting, at-
tended with gripes, sickness, and a constant desire to go to
stool. It comes on suddenly, and is most common in autumn.
Hardly any disease kills more quickly than this, when proper means
are not used in due time for removing it.
* When we have reasons to suspect that the convex surface of the li-
ver does not adhere to the peritonæum of the abdomen, an incision should
be made in the most depending part, but not quite through the abdomi- 
nal muscles, in order to excite inflammation in the peritonæum, and pro-
duce adhesion. This practice takes off the resistance, and allows the
fact of matter to press against the most yielding part of the peritonæum, 
which is in the direction of the wound, so that when the abscess bursts, it
discharges itself by the incision. During the discharge of the matter, if
the patient's strength is much on the decline, it must be supported by
cordials and tonic medicine, together with a small allowance of animal
food, such as beef-steaks, &c. (I. C.)
† I know a gentleman who has had several abscesses of the liver open-
ed, and is now a strong and healthy man, though above eighty years of
age.  

CHOLERA MORBUS, &c. 227
CAUSES.————It is occasioned by a redundancy and putrid acri-
mony of the bile; cold; food that easily turns rancid or sour on
the stomach; as butter, bacon, sweet-meats, cucumbers, melons,
cherries, and other cold fruits.* It is sometimes the effect of
strong acrid purges or vomits, or of poisonous substances taken
into the stomach. It may likewise proceed from violent passions or
affections of the mind; as fear, anger, &c.
SYMPTOMS.————It is generally preceded by a cardialgia, or
heart-burn, sour belchings, and flatulencies, with pain of the sto-
mach and intestines. To these succeed excessive vomiting, and
purging of green, yellow, or blackish coloured bile, with a disten-
sion of the stomach, and violent griping pains. There is likewise
a great thirst, with a very quick unequal pulse, and often a fixed
acute pain about the region of the navel. As the disease advances,
the pulse often sinks so low as to become quite imperceptible, the
extremities grow cold, or cramped, and are often covered with a
clammy sweat, the urine is obstructed, and there is a palpitation
of the heart. Violent hiccuping, fainting, and convulsions, are the
signs of approaching death.
MEDICINE.————At the beginning of this disease, the efforts of
Nature to expel the offending cause should be assisted, by promoting
the purging and vomiting. For this purpose, the patient must drink
freely of diluting liquors; as whey, butter-milk, warm water, thin
water-gruel, small posset, or, what is perhaps preferable to any of
them, very weak chicken broth. This should not only be drank
plentifully to promote the vomiting,  but a clyster of it given every
hour to promote the purging.
After these evacuations have been continued for some time, a de-
coction of toasted oat-bread may be drank to stop the vomiting.
The bread should be toasted till it is of a brown colour, and af-
terwards boiled in spring water. If oat-bread cannot be had, wheat-
bread, or oat-meal well toasted, may be used in its stead. If this
does not put a stop to the vomiting, two table-spoonfuls of the saline
julep, with ten drops of laudanum, may be taken every hour till it
ceases.
The vomiting and purging ought never to be stopped too soon.
As long as these discharges do not weaken the patient, they are salu-
tary, and may be allowed to go on, or rather ought to be promoted.
But when the patient is weakened by the evacuations, which may
be known from the sinking of his pulse, &c. recourse must imme-
diately be had to opiates, as recommended above; to which may
be added strong wines, with spirituous cinnamon-waters, and
other generous cordials. Warm negus, or strong wine-whey, will
likewise be necessary to support the patient's spirits, and promote
the perspiration. His legs should be bathed in warm water, and
It have been twice brought to the gates of death by this disease,
and both times it was occasioned by eating rancid bacon. 

228 DIARRHŒA, OR LOOSENESS.
afterwards rubbed with flannel cloths, or wrapped in warm blan-
kets, and warm bricks applied to the soles of his feet. Flannels
wrung out of warm spirituous fomentations should likewise be ap-
plied to the region of the stomach.*
When the violence of the disease is over, to prevent a relapse,
it will be necessary for some time to continue the use of small do-
ses of laudanum. Ten or twelve drops may be taken in a glass of
wine, at least twice a day, for eight or ten days. The patient's
food ought to be nourishing, but taken in small quantities, and he
should use moderate exercise. As the stomach and intestines are
generally much weakened, an infusion of the bark, or other bit-
ters, in small wine, sharpened with the elixir vitriol, may be drank
for some time.
Though physicians are seldom called in due time in this disease,
they ought not to despair of relieving the patient even in the most
desperate circumstances. Of this, I lately saw a very striking proof
in an old man and his son, who had been both seized with it a-
bout the middle of the night. I did not see them till next morning,
when they had much more the appearance of dead than of living
men. No pulse could be felt; the extremities were cold and rigid;
the countenance was ghastly, and the strength almost quite ex-
hausted. Yet, from this deplorable condition, they were both reco-
vered by the use of opiates and cordial medicines.
Of a Diarrhœa, or Looseness.
A LOOSENESS, in many cases, is not to be considered as a dis-
ease, but rather as a salutary evacuation. It ought therefore never to
be stopped, unless when it continues too long, or evidently weakens
the patient. As this sometimes happens, we shall point out the
most common causes of a looseness, with the proper method of
treatment.
When a looseness is occasioned by catching cold, or an obstruc-
ted perspiration, the patient ought to keep warm, to drink freely
of weak diluting liquors, to bathe his feet and legs in lukewarm
water, to wear flannel next his skin, and to take every other me-
thod to restore the perspiration.
In a looseness which proceeds from excess or repletion, a vomit
is the proper medicine. Vomits not only cleanse the stomach, but
promote all the secretions, which render them of great impor-
tance in carrying off a debauch. Half a drachm of ipecacuanha in
powder will answer this purpose very well. A day or two after
the vomit, the same quantity of rhubarb may be taken, and repea-
* Should the vomiting continue obstinate, a blister or poultice compo-
sed of rye meal, flower of mustard, and vinegar, applied to the region
of the stomach, and continued until it gives pain, or even forms a blis-
ter; is frequently attended with the best effects. (I. C.)            

DIARRHŒA, OR LOOSENESS. 229
ted two or three times, if the looseness continues. The patient
ought to live upon light vegetable food, of easy digestion, and to
drink whey, thin gruel, or barley-water.
A looseness occasioned by the obstruction of any customary eva-
cuation, generally requires bleeding. If that does not succeed, other
evacuations may be substituted in the room of those which are
obstructed. At the same time, every method is to be taken to re-
store the usual discharges, as not only the cure of the disease, but
the patient's life, may depend on this.
A periodical looseness ought never to be stopped. It is always
an effort of Nature to carry off some offending matter, which, if
retained in the body, might have fatal effects. Children are very
liable to this kind of looseness, especially while teething. It is,
however, so far from being hurtful to them, that such children
generally get their teeth with least trouble. If these loose stools
should at any time prove sour or griping, a tea-spoonful of mag-
nesia alba, with four or five grains of rhubarb, may be given to the
child in a little panado, or any other food. This, if repeated three
or four times, will generally correct the acidity, and carry off the
griping stools.
A looseness which proceeds from violent passions or affections
of the mind, must be treated with the greatest caution. Vomits
in this case are highly improper. Nor are purges safe, unless they
be very mild, and given in small quantities. Opiates, and other
antispasmodic medicines are most proper. Ten or twelve drops of
laudanum may be taken in a cup of valerian or penny-royal tea,
every eight or ten hours, till the symptoms abate. Ease, cheerful-
ness and tranquility of mind, are here of the greatest importance.
When a looseness proceeds from acrid or poisonous substances,
taken into the stomach, the patient must drink large quantities
of diluting liquors, with oil or fat broths, to promote vomiting
and purging. Afterwards, if there be reason to suspect that the
bowels are inflamed, bleeding will be necessary. Small doses of
laudanum may likewise be taken to remove their irritation.
When the gout, repelled from the extremities, occasions a loose-
ness, it ought to be promoted by gentle doses of rhubarb, or other
mild purgatives. The gouty matter is likewise to be solicited to-
wards the extremities by warm fomentations, cataplasms, &c. The
perspiration ought at the same time to be promoted by warm di-
luting liquors; as wine-whey, with spirits of hartshorn, or a few
drops of laudanum in it.
When a looseness proceeds from worms, which may be known
from the sliminess of the stools, mixed with pieces of decayed
worms, &c. medicines must be given to kill and carry off these
vermin, as the powder of tin, with purges of rhubarb and calomel.
Afterwards lime-water, either alone, or with a small quantity of
rhubarb infused, will be proper to strengthen the bowels, and pre-
vent the new generation of worms. 

230 VOMITING.
A looseness is often occasioned by drinking bad water. When
this is the case, the disease generally proves epidemical. When
there is reason to believe that this, or any other disease proceeds
from the use of unwholesome water, it ought immediately to be
changed, or if that cannot be done, it may be corrected by mixing
with it quick-lime, chalk, or the like.
In people, whose stomachs are weak, violent exercise immedi-
ately after eating, will occasion a looseness. The cure of this is
obvious; yet it will be proper, besides avoiding violent exercise, to
use such medicines as tend to brace and strengthen the stomach,
as infusions of the bark, with other bitter and astringent ingredi-
ents, in white wine. Such persons ought likewise to take frequent-
ly a glass or two of old red port, or good claret.*
From whatever cause a looseness proceeds, when it is found ne-
cessary to check it, the diet ought to consist of rice boiled with
milk, and flavoured with cinnamon; rice-jelly; sago, with red
port; and the lighter sorts of flesh-meat roasted. The drink may
be thin water-gruel, rice-water, or weak broth, made from lean
veal, or with a sheep's head, as being more gelatinous than mut-
ton, beef, or chicken-broth.
Persons, who from a peculiar weakness, or too great an irrita-
bility of the bowels, are liable to frequent returns of this disease,
should live temperately, avoiding crude summer fruits, all un-
wholesome food, and meats of hard digestion. They ought like-
wise to beware of cold, moisture, or whatever may obstruct the
perspiration, and should wear flannel next their skin. All violent
passions, as fear, anger, &c. are carefully to be guarded against.
Of Vomiting.
VOMITING may proceed from various causes; as excess in
eating and drinking; foulness of the stomach; the acrimony of
the aliments; a translation of the morbific matter of ulcers, of the
gout, the erysipelas, or other diseases, to the stomach. It may like-
wise proceed from a looseness having been too suddenly stopped;
from the stoppage of any customary evacuation, as the bleeding
piles, the menses, &c. from a weakness of the stomach, the colic,
the iliac passion, a rupture, a fit of the gravel, worms; or from
any kind of poison taken into the stomach. It is an usual symptom
of injuries done to the brain; as contusions, compressions, &c. It
is likewise a symptom of wounds or inflammations of the dia-
phragm, intestines, spleen, liver, kidneys, &c.
Vomiting may be occasioned by unusual motions; as sailing,
being drawn backwards in a cart or coach, &c. by violent passions,
* After every astringent and tonic medicine has failed in the chronic
diarrhœa of warm climates, a long voyage to sea has entirely removed
the complaint. (I. C) 

VOMITING. 231
or by the idea of nauseous or disagreeable objects, especially of
such things as have formerly produced vomiting. Sometimes it
proceeds from a regurgitation of the bile into the stomach: in
this case, what the patient vomits, is generally of a yellow or
greenish colour, and has a bitter taste. Persons who are subject to
nervous affections, are often suddenly seized with violent fits of
vomiting. Lastly, vomiting is a common symptom of pregnancy.
In this case, it generally comes on about two weeks after the stop-
page of the menses, and continues during the first three or four
months.
When vomiting proceeds from a foul stomach or indigestion,
it is not a disease, but the cure of a disease. It ought therefore
to be promoted by drinking lukewarm water, or thin gruel. If this
does not put a stop to the vomiting, a dose of ipecacuanha may
be taken, and worked off with weak camomile tea.
When the retrocession of the gout, or the obstruction of custo-
mary evacuations, occasion vomiting, all means must be used to re-
store these discharges; or, if that cannot be effected, their place
must be supplied by others, as bleeding, purging, bathing the extre-
mities in warm water, opening issues, setons, perpetual blisters, &c.
When vomiting is the effect of pregnancy, it may generally be
mitigated by bleeding, and keeping the body gently open. The
bleeding however ought to be in small quantities at a time, and
the purgatives should be of the mildest kind, as figs, stewed prunes,
manna, or senna. Pregnant women are most apt to vomit in the
morning, immediately after getting out of bed, which is owing
partly to the change of posture, but more to the emptiness of the
stomach. It may generally be prevented by taking a dish of coffee,
tea, or some light breakfast in bed. Pregnant women who are af-
flicted with vomiting, ought to be kept easy both in body and
mind. They should neither allow their stomachs to be quite emp-
ty, nor should they eat much at once. Cold water is a very proper
drink in this case; if the stomach be weak, a little brandy may be
added to it. If the spirits are low, and the person apt to faint, a
spoonful of cinnamon water, with a little marmalade of quinces
or oranges may be taken.
If vomiting proceeds from weakness of the stomach, bitters
will be of service. Bark infused in wine or brandy, with as much
rhubarb as will keep the body gently open, is an excellent medi-
cine in this case. The elixir of vitriol is also good. It may be
taken in the dose of fifteen or twenty drops, twice or thrice a-day,
in a glass of wine or water. Habitual vomitings are sometimes alle-
viated by making oysters a principal part of diet.
A vomiting, which proceeds from acidities in the stomach, is
relieved by alkaline purges. The best medicine of this kind is the
magnesia alba, a tea-spoonful of which may be taken in a dish of
tea or a little milk, three or four times a day, or oftener if necessa-
ry, to keep the body open. 

232 DIABETES, &c.
When vomiting proceeds from violent passions, or affections of
the mind, all evacuations must be carefully avoided, especially
vomits. These are exceedingly dangerous. The patient, in this
case, ought to be kept perfectly easy and quiet, to have the mind
soothed, and to take some gentle cordial, as negus, or a little
brandy and water, to which a few drops of laudanum may oc-
casionally be added.
When vomiting proceeds from spasmodic affections of the sto-
mach, musk, castor, and other antispasmodic medicines, are of
use. Warm and aromatic platters have likewise a good effect.
The stomach-plaster of the London or Edinburgh dispensatory
may be applied to the pit of the stomach, or a plaster of theriaca,
which will answer rather better. Aromatic medicines may be
taken inwardly, as cinnamon or mint-tea, wine with spiceries
boiled in it, &c. The region of the stomach may be rubbed with
æther, or, if that cannot be had, with strong brandy, or other
spirits. The belly should be fomented with warm water, or the
patient immersed up to the breast in a warm bath.
The saline draughts taken in the act of effervescence are of
singular use in stopping a vomiting, from whatever cause. These
may be prepared by dissolving a drachm of the salt of tartar in an
ounce and half of fresh lemon juice, and adding to it an ounce
of peppermint-water, the same quantity of simple cinnamon-
water, and a little white sugar. This draught must be swallowed
before the effervescence is quite over, and may be repeated every
two hours, or oftener, if the vomiting be violent. A violent vo-
miting has sometimes been stopped by cupping on the region of
the stomach after all other means had failed.
As the least motion will often bring on the vomiting again,
even after it has been stopped, the patient must avoid all manner
of action. The diet must be so regulated as to sit easy upon the
stomach, and nothing should be taken that is hard of digestion.
The patient should not live entirely upon slops. Solid food, in this
case, often sits easier on the stomach than liquids.
CHAPTER XXXIV.
Of the Diabetes, and other Disorders of the Kidneys and
Bladder.
THE diabetes is a frequent and excessive discharge of urine.
It is rare among young people; but often attacks persons in
the decline of life, especially those who follow the more violent
employments, or have been hard drinkers in their youth.
CAUSES.————A diabetes is often the consequence of acute
diseases, as fevers, fluxes, &c. where the patient has suffered by 

OF A DIABETES, &c. 233 
excessive evacuations, or by great fatigue, as riding long journies
upon a hard trotting horse, carrying heavy burdens, running, &c.
It may be brought on by hard drinking, or the use of strong sti-
mulating diuretic medicines, as tincture of cantharides, spirits of
turpentine, and such-like, or by drinking too great quantities of
mineral waters. Many imagine that these will do them no service,
unless they be drank in great quantities, by which they often occa-
sion worse diseases than those they intended to cure. This dis-
ease may proceed from too great a laxity of the organs which se-
crete the urine, from something that stimulates the kidneys too
much, or from a thin dissolved state of the blood, which makes too
great a quantity of it run off by the urinary passages.
SYMPTOMS.————In a diabetes, the urine generally exceeds
in quantity all the liquid food which the patient takes. It is thin
and pale, of a sweetish taste, and an agreeable smell. The patient
has a continual thirst, with some degree of fever; his mouth is dry,
and he spits frequently a frothy spittle. The strength fails, the
appetite decays, and the flesh wastes away till the patient is redu-
ced to skin and bone. There is a heat of the bowels; and frequent-
ly the loins, testicles, and feet are swelled.
This disease may generally be cured at the beginning; but after
it has continued long, the cure becomes very difficult. In drun-
kards and very old people, a perfect cure is not to be expected.
REGIMEN.————Every thing that stimulates the urinary passa-
ges, or tends to relax the habit, must be avoided. For this reason,
the patient should live chiefly on solid food. His thirst may be
quenched with acids; as sorrel, juice of lemon, or vinegar. The
mucilaginous vegetables, as rice, sago, and salop, with milk, are
the most proper food. Of animal substances, shell-fish are to be
preferred; as oysters, crabs, &c. The drink may be Bristol-water.
When that cannot be obtained, lime-water, in which a due pro-
portion of oak-bark has been macerated, may be used. The white
decoction*, with isinglass dissolved in it, is a very proper drink.
The patient ought daily to take exercise, but it should be so gen-
tle as not to fatigue him. He should lie upon a hard bed or ma-
trass. Nothing hurts the kidnies more than lying too soft. A warm,
dry air, the flesh-brush, and every thing that promotes perspira-
tion, is of service. For this reason, the patient ought to wear flan-
nel next his skin. A large strengthening plaister may be applied
to the back; or, what will answer better, a great part of the body
may be wrapt in plaister.
MEDICINE.————Gentle purges, if the patient be not too much
weakened by the disease, have a good effect. They may consist of
rhubarb, with cardamum seeds, or any other spiceries, infused in
wine, and may be taken in such quantity as to keep the body gen-
tly open.
* See Appendix, White Decoction.
G2 

234 SUPPRESSION OF URINE.
The patient must next have recourse to astringents and corro-
borants. Half a drachm of powder, made of equal parts of allum
and the inspissated juice commonly called Terra Japonica, may be
taken four times a-day, or oftener, if the stomach will bear it. The
allum must first be melted in a crucible; afterwards they may
both be pounded together. Along with every dose of this pow-
der, the patient may take a tea-cupful of the tincture of roses*.
If the patient's stomach cannot bear the allum in substance,
whey may be made of it, and taken in the dose of a tea-cupful
three or four times a day. The allum-whey is prepared by boiling
two English quarts of milk over a slow fire, with three drachms of
allum, till the curd separates.
Opiates are of service in this disease, even though the patient
rests well. They take off spasm and irritation, and at the same time
lessen the force of the circulation. Tenor twelve drops of lauda-
num may be taken in a cup of the patient's drink three or four
times a-day.
The best corroborants which we know, are the bark and wine.
A drachm of bark may be taken in a glass of red port or claret,
three times a-day. The medicine will be both more efficacious and
less disagreeable, if fifteen or twenty drops of the acid elixir of
vitriol be added to each dose. Such as cannot take the bark in
substance, may use the decoction, mixed with an equal quantity of
red wine, and sharpened as above.
There is a disease incident to labouring people in the decline of
life, called an Incontinency of Urine. But this is very different from
a diabetes, as the water passes off involuntarily by drops, and does
not exceed the usual quantity. This disease is rather troublesome
than dangerous. It is owing to a relaxation of the sphincter of
the bladder, and is often the effect of a palsy. Sometimes it pro-
ceeds from hurts, or injuries occasioned by blows, bruises, preter-
natural labours, &c. Sometimes it is the effect of a fever. It may
likewise be occasioned by a long use of strong diuretics. This dis-
ease may be mitigated by the use of astringent and corroborating
medicines, such as have been mentioned above; but I have never
seen it cured.
In an incontinency of urine, from whatever cause, a piece of
sponge ought to be worn, or a bladder applied in such a manner
as to prevent the urine from galling and excoriating the parts.
Of a Suppression of Urine.
A SUPPRESSION of urine may proceed from various causes;
as an inflammation of the kidneys, or bladder; small stones or
gravel lodging in the urinary passages, hard fæces lying in the
* See Appendix, Tincture of Roses. 

SUPPRESSION OF URINE. 235
rectum, pregnancy, a spasm or contraction of the neck of the
bladder, clotted blood in the bladder itself, a swelling of the hæ-
morrhoidal veins, &c.
Some of these cases require the catheter, both to remove the
obstructing matter, and to draw off the urine; but as this instru-
ment can only be managed with safety by persons skilled in surge-
ry, we shall say nothing further of its use. A bougee may be used
by any cautious hand, and will often succeed better than the cathe-
ter*. We chiefly recommend, in all obstructions of urine, fomenta-
tions and evacuants. Bleeding, as far as the patient's strength will
permit, is necessary, especially where there are symptoms of topi-
cal inflammation. Bleeding in this case not only abates the fever,
by lessening the force of the circulation, but, by relaxing the solids,
it takes off the spasm or stricture upon the vessels which occasion-
ed the obstruction.
After bleeding, fomentations must be used. These may either
consist of warm water alone, or of decoctions of mild vegetables;
as mallows, camomile-flowers, &c. Cloths dipped in these may ei-
ther be applied to the part affected, or a large bladder filled with
the decoction may be kept continually upon it. Some put the
herbs themselves into a flannel bag, and apply them to the part,
which is far from being a bad method. These continue longer
warm than cloths dipped in the decoction, and at the same time
keep the part equally moist.
In all obstructions of urine, the body ought to be kept open.
This is not however to be attempted by strong purgatives, but by
emollient clysters, or gentle infusions of senna and manna. Clys-
ters in this case not only open the body, but answer the purpose of
an internal fomentation, and greatly assist in removing the spasms
of the bladder and parts adjacent†.
The food must be light, and taken in small quantities. The drink
may be weak broth, or decoctions and infusions of mucilaginous
vegetables, as marsh-mallow-roots or flax-seed. A tea-spoonful of
the sweet spirits of nitre, or a drachm of Castile soap, may be fre-
quently put into the patient's drink.
Persons subject to a suppression of urine ought to live very tem-
perate. Their diet should be light and their liquor diluting. They
should avoid all acids and austere wines, should take sufficient ex-
ercise, lie hard, and avoid study and sedentary occupations.
* In cases of total suppression of urine from strictures in the urethra,
when neither of these instruments could be introduced into the bladder,
to evacuate the urine, I have succeeded in two instances out of three, by
puncturing the bladder with a long trocar, immediately above the pubis,
and evacuating the urine through the canula, until the obstruction was
removed by the use of bougees. (I. C.)
† When the bowels have been freely opened, emollient clysters have
the most happy effect. These should be injected every two or three
hours, with one or two drachms of laudanum in each. (I. C.) 

[236]
Of the Gravel and Stone.
WHEN small stones are lodged in the kidneys, or discharged
along with the urine, the patient is said to be afflicted with the
gravel. If one of these stones happens to make a lodgement in the
bladder for some time, it accumulates fresh matter, and at length
becomes too large to pass off with the urine. In this case the patient
is said to have the stone.
CAUSES.————The stone and gravel may be occasioned by high
living; the use of strong astringent wines; a sedentary life; lying
too hot, soft, or too much on the back; the constant use of water
impregnated with earthy or stony particles; aliments of an astrin-
gent or windy nature, &c. It may likewise proceed from an he-
reditary disposition. Persons in the decline of life, and those who,
have been much afflicted with the gout or rheumatism, are most
liable to it.
SYMPTOMS.————Small stones or gravel in the kidneys occa-
sion pain in the loins; sickness, vomiting; and sometimes bloody
urine. When the stone descends into the ureter, and is too large to
pass along with ease, all the above symptoms are increased; the
pain extends towards the bladder; the thigh and leg of the affected
side are benumbed; the testicles are drawn upwards, and the urine
is obstructed.
A stone in the bladder is known from a pain, at the time, as
well as before and after making water; from the urine coming
away by drops, or stopping suddenly when it was running in a full
stream; by a violent pain in the neck of the bladder upon motion,
especially on horseback, or in a carriage on a rough road; from
a white, thick, copious, stinking, mucous sediment in the urine;
from an itching in the top of the penis; from bloody urine; from
an inclination to go to stool during the discharge of urine; from
the patient's passing his urine more easily when lying than in an
erect posture; from a kind of convulsive motion occasioned by the
sharp pain in discharging the last drops of the urine; and lastly,
from sounding or searching with the catheter.
REGIMEN.————Persons afflicted with the gravel or stone
should avoid aliments of a windy or heating nature, as salt meats,
sour fruits, &c. Their diet ought chiefly to consist of such things
as promote the secretion of urine, and keep the body open. Arti-
chokes, asparagus, spinnage, lettuce, parsley, succory, purslane,
turnips, potatoes, carrots, and radishes, may be safely eaten. Oni-
ons, leeks, and celery, are, in this case, reckoned medicinal. The
most proper drinks are whey, butter-milk, milk and water, barley-
water; decoctions or infusions of the roots of marsh-mallows,
parsley, liquorice, or of other mild mucilaginous vegetables, as lin-
seed. If the patient has been accustomed to generous liquors, he
may drink small gin punch. 

THE GRAVEL AND STONE. 237
Gentle exercise is proper; but violent motion is apt to occasion
bloody urine. We advise that it should be taken in moderation.
Persons afflicted with gravel, often pass a great number of stones
after riding on horseback, or in a carriage; but those who have a
stone in the bladder, are seldom able to bear these kinds of exercise.
Where there is a hereditary tendency to this disease, a sedentary
life ought never to be indulged. Were people careful, upon the
first symptoms of gravel, to observe a proper regimen of diet, and
to take sufficient exercise, it might often be carried off, or at least
prevented from increasing; but if the same course which occasion-
ed the disease is persisted in, it must be aggravated.
MEDICINE.————In what is called a fit of the gravel, which is
commonly occasioned by a stone sticking in the ureter or some
part of the urinary passages, the patient must be bled, warm fo-
mentations should likewise be applied to the part affected, emolli-
ent anodyne clysters administered, and diluting mucilaginous li-
quors drank, &c. The treatment of this case has been fully point-
ed out under the articles, inflammation of the kidneys and bladder, to
which we refer.
Dr. Whyte advises patients, who are subject to frequent fits of
gravel in the kidneys, but have no stone in the bladder, to drink,
every morning, two or three hours before breakfast, an English
pint of oyster or cockle-shell lime-water. The Doctor very justly
observes, that though this quantity might be too small to have any
sensible effect in dissolving a stone in the bladder, yet it may very
probably prevent its growth.
When a stone is formed in the bladder, the Doctor recommends
Alicant soap, and oyster, or cockle-shell lime-water,* to be taken
in the following manner: The patient must swallow, every day,
in any form that is least disagreeable, an ounce of the internal part
of Alicant soap, and drink three or four English pints of oyster, or
cockle-shell lime-water. The soap is to be divided into three do-
ses; the largest to be taken fasting in the morning early; the se-
cond at noon; and the third at seven in the evening; drinking,
above each dose, a large draught of the lime-water; the remainder
of which he may take any time betwixt dinner and supper, instead
of other liquors.
The patient should begin with a smaller quantity of the lime-wa-
ter and soap, than that mentioned above; at first an English pint
of the former, and three drachms of the latter, may be taken daily.
This quantity, however, he may increase by degrees, and ought to
persevere in the use of these medicines, especially if he finds any
abatement of his complaints, for several months; nay, if the stone
be very large, for years. It may likewise be proper for the patient,
if severely pained, not only to begin with the soap and lime-water
in small quantities, but to take the second or third lime-water in-
* See Appendix, Lime water. 

238 INVOLUNTARY DISCHARGES
stead of the first. However, after he has been for some time ac-
customed to these medicines, he may not only take the first water,
but, if he finds he can easily bear it, heighten its dissolving power
still more by pouring it a second time on fresh calcined shells.
The caustic alkali, or soap lees, is the medicine chiefly in vogue,
at present, for the stone. It is of a very acrid nature, and ought,
therefore, to be given in some gelatinous or mucilaginous liquor;
as veal-broth, new milk, linseed tea, a solution of gum-arabic, or a
decoction of marsh-mallow roots. The patient must begin with
small doses of the lees, as thirty or forty drops, and increase by
degrees, as far as the stomach can bear it.* 
Though the soap-lees and lime-water are the most powerful
medicines which have hitherto been discovered for the stone; yet
there are some things of a more simple nature, which in certain
cases are found to be beneficial, and therefore deserve a trial. An
infusion of the seeds of wild carrot, sweetened with honey, has
been found to give considerable ease in cases where the stomach
could not bear any thing of an acrid nature. A decoction of raw
coffee-berries taken morning and evening, to the quantity of eight
or ten ounces, with ten drops of sweet spirit of nitre, has, likewise,
been found very efficacious in bringing away large quantities of
earthy matter in slakes. Honey is likewise found to be of consi-
derable service, and may be taken in gruel, or in any other form
that is more agreeable.
The only other medicine which we shall mention is the uva ursi.
It has been greatly extolled of late, both for the gravel and stone.
It seems, however, to be, in all respects, inferior to the soap and
lime-water; but it is less disagreeable, and has frequently, to my
knowledge, relieved gravelly complaints. It is generally taken in
powder from half a drachm to a whole drachm, two or three times
a-day. It may, however, be taken to the quantity of seven or eight
drachms a-day, with great safety and good effect.
CHAPTER XXXV.
Of involuntary Discharges of Blood.
INVOLUNTARY discharges of blood often happen from va-
rious parts of the body. These are so far from being always
dangerous, that they prove often salutary. When such discharges
are critical, which is frequently the case in fevers, they ought not
to be stopped. Nor is it proper at any time to stop them, unless
* The caustic alkali may be prepared by mixing two parts of quick-
lime with one of potashes, and sutrering them to stand till the lixivium
be formed, which must be carefully filtrated before it be used. If the
solution does not happen readily, a small quantity oil water may be ad-
ded to the mixture. 

OF BLOOD. 239
they be so great as to endanger the patient's life.  Most people,
afraid of the smallest discharge of blood from any part of the bo-
dy, fly immediately to the use of styptic and astringent medicines,
by which means an inflammation of the brain, or some other fatal
disease, is occasioned, which had the discharge been allowed to go
on, might have been prevented.
Periodical discharges of blood, from whatever part of the body,
must not be stopped. They are always the efforts of Nature to
relieve herself; and fatal diseases have often been the consequence
of obstructing them. It may indeed be sometimes necessary to
check the violence of such discharges; but even this requires the
greatest caution. Instances might be given where the stopping of
a small periodical flux of blood from one of the fingers, has proved
fatal.
In the early period of life, bleeding at the nose is very common.
Those who are farther advanced in years, are more liable to hæ-
moptoe, or discharge of blood from the lungs. After the middle
period of life, hæmorrhoidal fluxes are most common; and in the
decline of life, discharges of blood from the urinary passages.
Involuntary fluxes of blood may proceed from very different,
and often from quite opposite causes. Sometimes they are owing
to a particular construction of the body, as a sanguine tempera-
ment, a laxity of the vessels, a plethoric habit, &c. At other times
they proceed from a determination of the blood towards one par-
ticular part, as the head, the hæmorrhoidal veins, &c. They may
proceed from an inflammatory disposition of the blood, in which
case there is generally some degree of fever: this likewise hap-
pens when the flux is occasioned by an obstructed perspiration, or
a stricture upon the skin, the bowels, or any particular part of the
system.
Hæmorrhages occur in malignant fevers, dysentery, scurvy, ma-
lignant small pox, &c. In these diseases, there are great discharges
of blood from different parts of the body. They may likewise be
brought on by too liberal a use of medicines, such as cantharides,
&c. Food of an acrid or irritating quality may occasion hæmor-
rhages; as also strong purges and vomits, or any thing that greatly
stimulates the bowels.
Violent passions or agitations of the mind may have this effect.
These often cause bleeding at the nose; sometimes an hæmorrhage
in the brain. Violent efforts of the body, by overstraining or hurt-
ing the vessels, may have the same effect, especially when the body
is long kept in an unnatural posture, as hanging the head very
low, &c.
The cure of an hæmorrhage must be adapted to its cause.
When it proceeds from too much blood, or a tendency to inflam-
mation, bleeding, with gentle purges and other evacuations, will
be necessary. It will likewise be proper for the patient in this case
to live chiefly upon a vegetable diet, to avoid all strong liquors,

240 OF BLEEDING AT THE NOSE.
and food that is of an acrid, hot or stimulating quality. The body
should be kept cool and the mind easy.
When hæmorrhage comes on in malignant severs, scurvy, &c.
the patient ought to live chiefly upon acid fruits with milk, and
vegetables of a nourishing nature, as sago, salop, &c. His drink
may be wine diluted with water, and sharpened with the juice of
lemon, vinegar, or spirits of vitriol. The best medicine in this case
is the Peruvian bark, which may be taken according to the urgen-
cy of the symptoms.
When a flux of blood is the effect of acrid food, or of strong
stimulating medicines, the cure is to be effected by soft and mu-
cilaginous diet. The patient may likewise take frequently about
the bulk of a nutmeg of Locatelli's balsam, or the same quantity
of spermaceti.
When an obstructed perspiration, or a stricture upon any part
of the system, is the cause of an hæmorrhage, it may be removed
by drinking warm diluting liquors, lying a-bed, bathing the extre-
mities in warm water, &c.
Of Bleeding at the Nose.
THIS is commonly preceded by some degree of quickness of
the pulse, flushing in the face, pulsation of the temporal arteries,
heaviness in the head, dimness of the sight, heat and itching of the
nostrils, &c.
To persons who abound with blood, this discharge is very salu-
tary. It often cures a vertigo, the head-ach, a phrenzy, and even
an epilepsy. In fevers, where there is a great determination of
blood towards the head, it is of the utmost service. It is beneficial
for inflammations of the liver and spleen, and often in the gout
and rheumatism. In all diseases where bleeding is necessary, a spon-
taneous discharge of blood from the nose is of more service than
the same quantity let with a lancet.
In a discharge of blood from the nose, the great point is to de-
termine whether it ought to be stopped or not. It is a common
practice to stop the bleeding, without considering weather it be a
disease, or the cure of a disease. This conduct proceeds from fear;
but it has often bad, and sometimes fatal consequences.
When a discharge of blood from the nose happens in an inflam-
matory disease, there is always reason to believe that it may prove
salutary; and therefore it should be suffered to go on, at least as
long as the patient is not weakened by it. 
When it happens to persons in perfect health who are full of
blood, it ought not to be suddenly stopped, especially if the symp- 

OF BLEEDING AT THE NOSE. 241 
toms of plethora, mentioned above, have preceded it. In this case,
it cannot be stopped without risking the patient's life.
In fine, whenever bleeding at the nose relieves any bad symp-
tom, and does not proceed so far as to endanger the patient's life,
it ought not to be stopped. But when it returns frequently, or
continues till the pulse becomes low, the extremities begin to grow
cold, the lips pale, or the patient complains of being sick or faint,
it must immediately be stopped.
For this purpose, the patient should be set nearly upright, with
his head reclining a little, and his legs immersed in water about
the warmth of new milk. His hands ought likewise to be put in
lukewarm water, and his garters may be tied a little tighter than
usual. Ligatures may be applied to the arms, about the place
where they are usually made for bleeding, and with nearly the
same degree of tightness. These must be gradually slackened as the
blood begins to stop, and removed entirely as soon as it gives over.
Sometimes dry lint put up the nostrils will stop the bleeding.
When this does not succeed, fossils of lint dipped in strong spi-
rits of wine, may be put up the nostrils, or if that cannot be had,
they may be dipped in brandy. Blue vitriol dissolved in water may
likewise be used for this purpose, or a tent dipped in the white of
an egg, well beat up, may be rolled in a powder made of equal
parts of white sugar, burnt allum, and white vitriol, and put up
the nostril from whence the blood issues*.
Internal medicines can hardly be of use here, as they have sel-
dom time to operate. It may not however be amiss to give the pa-
tient half an ounce of Glauber's salt, and the same quantity of
manna, dissolved in four or five ounces of barley-water. This may
be taken at a draught, and repeated, if it does not operate, in a
few hours. Ten or twelve grains of nitre may be taken in a glass
of cold water and vinegar every hour, or oftener, if the stomach
will bear it. If a stronger medicine be necessary, a tea-cupful of
the tincture of roses, with twenty or thirty drops of the weak spi-
rit of vitriol, may be taken every hour. When these things cannot
be had, the patient may drink water, with a little common salt in
it, or equal parts of water and vinegar.
If the genitals be immersed for some time in cold water, it will
generally stop a bleeding at the nose. I have not known this fail.
Sometimes, when the bleeding is stopped outwardly, it continues
inwardly. This is very troublesome, and requires particular atten-
tion, as the patient is apt to be suffocated with the blood, especi-
ally if he falls asleep, which he is very ready to do after losing a
great quantity of blood.
* This intention is more effectually answered by passing a bougee up
the bleeding nostril, with a piece of spunge tied near the middle of it.
This may be drawn up so as to compress the bleeding vessel, by bringing
the inner end of the bougee out of the mouth. (I. C.)
H2 

242 BLEEDING AND BLIND PILES.
When the patient is in danger of suffocation from the blood
getting into his throat, the passages may be stopped by drawing
threads up the nostrils, and bringing them out at the mouth, then
fastening pieces of spunge, or small rolls of linen cloth to their ex-
tremities; afterwards drawing them back, and tying them on the
outside with a sufficient degree of tightness.
After the bleeding is stopped, the patient ought to be kept as
easy and quiet as possible. He should not pick his nose, nor take
away the tents or clotted blood, till they fall off of their own ac-
cord, and should not lie with his head low.
Those who are affected with frequent bleeding at the nose,
ought to bathe their feet often in warm water, and to keep them
warm and dry. They ought to wear nothing tight about their
necks, to keep their body as much in an erect posture as possible,
and never to view any object obliquely. If they have too much
blood, a vegetable diet, with now and then a cooling purge, is the
safest way to lessen it.
But when the disease proceeds from a relaxed state of the vessels,
the diet should be rich and nourishing, as strong broths and jel-
lies, sago-gruel with wine and sugar, &c. Infusions of the bark in
wine ought to be taken and persisted in for a considerable time.
Of the Bleeding and Blind Piles.
A discharge of blood from the hæmorrhoidal vessels is called the
bleeding piles. When the vessels only swell, and discharge no blood,
but are exceeding painful, the disease is called the blind piles.
Persons of a loose spungy fibre, of a bulky size, who live high,
and lead a sedentary inactive life, are most subject to this disease.
It is often owing to a hereditary disposition. Where this is the case,
it attacks persons more early in life than when it is accidental.
Men are more liable to it than women, especially those of a san- 
guine, plethoric, or scorbutic habit, or of a melancholy disposition.
The piles may be occasioned by an excess of blood, by strong 
aloetic purges, high-seasoned food, drinking great quantities of
sweet-wines, the neglect of bleeding, or other customary evacua-
tions, much riding, great costiveness, or any thing that occasions         
hard or difficult stools. Anger, grief, or other violent passions, will
likewise occasion the piles, or sitting on the damp ground. A pair
of thin breeches will excite the disorder in a person who is subject
to it, and sometimes even in those who never had it before. Preg-
nant women are often afflicted with it.
A flux of blood, from the anus, is not always to be treated as a
disease. It is even more salutary than bleeding at the nose, and of-
ten prevents or carries off diseases. It is peculiarly beneficial in the

BLEEDING AND BLIND PILES. 243 
gout, rheumatism, asthma, and hypochondriacal complaints, and
often proves critical in colics, and inflammatory fevers.
In the management of the patient, regard must be had to his
habit of body, his age, strength, and manner of living. A discharge
which might be excessive, and prove hurtful to one, may be very
moderate, and even salutary to another. That only is to be esteem-
ed dangerous which continues too long, and is in such quantity as
to waste the patient's strength, hurt the digestion, nutrition, and
other functions necessary to life.
When this is the case, the discharge must be checked by a pro-
per regimen, and astringent medicines. The DIET must be cool
but nourishing, consisting chiefly of bread, milk, cooling vegeta-
bles and broths. The drink may be chalybeate water, orange-
whey, decoctions or infusions of the astringent and mucilaginous
plants, as the tormentil root, bistort, the marshmallow-roots, &c.
Old conserve of red roses is a very good medicine in this case.
It may be mixed with new milk, and taken in the quantity of an
ounce three or four times a-day. This medicine is in no great re-
pute, owing to its being seldom taken in such quantity as to pro-
duce any effects; but when taken as here directed, and duly per-
sisted in, I have known it perform very extraordinary cures in
violent hæmorrhages, especially when assisted by the tincture of
roses; a tea-cupful of which may be taken about an hour after eve-
ry dose of the conserve.
The bark is likewise proper in this case, both as a strengthener
and astringent. Half a drachm may be taken in a glass of red wine,
sharpened with a few drops of; the elixir of vitriol, three or four
times a-day.
The bleeding piles are sometimes periodical, and return regu-
larly once a-month, or once in three weeks. In this case, they are
always to be considered as a salutary discharge, and  by no means
to be stopped. Some have entirely ruined their health by stopping
a periodical discharge of blood from the hæmorrhoidal veins.
In the blind piles, bleeding is generally of use. The diet must be
light and thin, and the drink cool and diluting. The body must be
kept gently open. This may be done by small doses of the flowers
of brimstone and cream of tartar. These may be mixed in equal
quantities, and a tea-spoonful taken two or three times a-day, or
oftener if necessary. Or an ounce of the flours of brimstone, and
half an ounce of purified nitre, may be mixed with three or four
ounces of the lenitive electuary, and a tea-spoonful of it taken
three or four times a-day.
Emollient clysters are here likewise beneficial; but there is some-
times such an astriction of the anus, that they cannot be thrown
up. In this case, a vomit has had a very good effect.
When the piles are exceeding painful and swelled, but discharge
nothing, the patient must sit over the steams of warm water. He
may likewise apply a linen cloth dipped in warm spirits of wine to 

244 SPITTING OF BLOOD.
the part, or poultices of bread and milk. If these do not produce a
discharge, and the piles appear large, leeches must be applied as
near them as possible, or, if they will fix upon the piles themselves,
so much the better. When leeches will not fix, the piles may be
opened with a lancet. The operation is very easy, and is attended
with do danger.
Various ointments, and other external applications, are recom-
mended in the piles; but I do not remember any effects from these
worth mentioning. Their principal use is to keep the part moist,
which may be done as well by a soft poultice, or an emollient ca-
taplasm. When the pain however is very great, a liniment made
of two ounces of emollient ointment, and half an ounce of lauda-
num, beat up with the yolk of an egg, may be applied.
Spitting of Blood.
WE mean here to treat of the discharge of blood from the lungs
only which is called an hæmoptoe, or spitting of blood. Persons of a
slender make, and a lax fibre, who have long necks and strait breasts,
are most liable to this disease. It is most common in the spring, and
generally attacks people before they arrive at the prime or middle
period of life. It is a common observation, that those who have
been subject to bleeding at the nose when young, are afterwards
most liable to an hæmoptoe.
CAUSES.————An hæmoptoe may proceed from excess of blood,
from a peculiar weakness in the lungs, or a bad conformation of
the breast, excessive drinking, running, wrestling, singing, or speak-
ing aloud. Such as have weak lungs ought to avoid all violent ex-
ertions of that organ, as they value life. They should likewise
guard against violent passions, excessive drinking, and every thing
that occasions a rapid circulation of the blood.
This disease may proceed from wounds of the lungs. These
may either be received from without, or they may be occasioned
by hard bodies getting into the wind-pipe, and so falling down
upon the lungs, and hurting the tender organ. The obstruction of
any customary evacuation may occasion a spitting of blood; as ne-
glect of bleeding or purging at the usual seasons, the stoppage of
the bleeding piles in men, or the menses in women, &c. It may
likewise proceed from a polypus, schirrous concretions, or any
thing that obstructs the circulation of the blood in the lungs. It
is often the effect of a long and violent cough; in which case, it 
is generally the forerunner of a consumption. A violent degree of
cold suddenly applied to the external parts of the body, will occa- 
sion an hæmoptoe. It may likewise be occasioned by breathing air
which is too much rarified to be able properly to expand the lungs.
This is often the case with those who work in hot places, as fur- 

SPITTING OF BLOOD. 245
naces, glass-houses, or the like. It is likewise said to happen to
such as ascend to the top of very high mountains, as the Peak of
Teneriffe, &c.
Spitting of blood is not always a primary disease. It is often only
a symptom, and in some diseases not an unfavourable one. This is
the case in pleurisies, peripneumonies, and sundry other fevers.
In a dropsy, scurvy, or consumption, it is a bad symptom, and shows
that the lungs are ulcerated.
SYMPTOMS.————Spitting of blood is generally preceded by
a sense of weight, and oppression of the breast, a dry tickling
cough, hoarseness, and a difficulty of breathing. Sometimes it is
ushered in with shivering, coldness of the extremities, costiveness,
great lassitude, flatulence, pain of the back and loins, &c. As these
show a general stricture upon the vessels, and a tendency of the
blood to inflammation, they are commonly the forerunners of a
very copious discharge. The above symptoms do not attend a dis-
charge of blood from the gums or fauces, by which means these
may always be  distinguished from an hæmoptoe. Sometimes the
blood that is spit up is thin, and of a florid red colour; and at
other times it is thick, and of a dark or blackish colour; nothing
can be inferred from this circumstance, but that the blood has lain
a longer or shorter time in the breast before it was discharged.
Spitting of blood, in a strong, healthy person, of a sound con-
stitution, is not very dangerous; but when it attacks the tender
and delicate, or persons of a weak lax fibre, it is with difficulty re-
moved. When it proceeds from a schirrus of the lungs, it is bad.
The danger is greater when the discharge proceeds from the rup-
ture of a large vessel than of a small one. When the extravasated
blood is not spit up, but lodges in the breast, it corrupts, and great-
ly increases the danger. When the blood proceeds from an ulcer
in the lungs, it is generally fatal.
REGIMEN.————The patient ought to be kept cool and easy.
Every thing that heats the body or quickens the circulation, in-
creases the danger. The mind ought likewise to be soothed, and
every occasion of exciting the passions avoided. The diet should
be soft, cooling, and slender; as rice boiled with milk, small
broths, barley-gruels, panado, &c. The diet, in this case, can
scarce be too low. Even water-gruel is sufficient to support the
patient for some days. All strong liquors must be avoided. The
patient may drink milk and water, barley-water, whey, but-
ter-milk, and such-like. Every thing should be drank cold, and in
small quantities at a time. He should observe the strictest silence,
or at least speak with a very low voice.
MEDICINE.————This, like the other involuntary discharges of
blood, ought not to be suddenly stopped by astringent medicines.
More mischief is often done by these, than if it were suffered to
go on. It may, however, proceed so far as to weaken the patient, 

246 VOMITING OF BLOOD.
and even endanger his life; in which case, proper means must be
used for restraining it.
The body should be kept gently open by laxative diet; as roas-
ted apples, stewed prunes, and such-like. If these should not have
the desired effect, a tea-spoonful of the lenitive electuary may be
taken twice or thrice a-day, as is found necessary. If the bleeding
proves violent, ligatures maybe applied to the extremities, as di-
rected for a bleeding at the nose.
If the patient be hot or feverish, bleeding and small doses of nitre
will be of use; a scruple or half a drachm of nitre may be taken
in a cup of his ordinary drink, twice or thrice a-day. His drink
may be sharpened with acids, as juice of lemon, or a few drops of
the spirit of vitriol; or he may take frequently a cup of the tinc-
ture of roses.
Bathing the feet and legs in lukewarm water, has a very good
effect in this disease. Opiates are sometimes beneficial; but must
be administered with caution. Ten or twelve drops of laudanum
may be given in a cup of barley-water twice a-day, and continu-
ed for some time, provided they be found beneficial.
The conserve of roses is a very good medicine in this case, if
taken in sufficient quantity and long enough persisted in. It may be
taken to the quantity of three or four ounces a-day; and, if the
patient be troubled with a cough, it should be made into an elec-
tuary with balsamic syrup, and a little of the syrup of poppies.
If stronger astringents be necessary, fifteen or twenty drops of
the elixir of vitriol may be given in a glass of water, three or four
times a-day.
Those who are subject to frequent returns of this disease, should
avoid all excess. Their diet should be light and cool, consisting
chiefly of milk and vegetables. Above all, let them beware of vi- 
gorous efforts of the body, and violent agitations of the mind. 
Vomiting of Blood.
THIS is not so common as the other discharges of blood alrea-
dy mentioned; but it is very dangerous, and requires particular
attention.
Vomiting of blood is generally preceded by pain of the stomach,
sickness, and nausea; and is accompanied with great anxiety, and
frequent fainting fits.
This disease is sometimes periodical; in which case, it is less
dangerous. It often proceeds from an obstruction of the menses
in women; and sometimes from the stopping of the hæmorrhoidal
flux in men. It may be occasioned by any thing that greatly stimu-
lates or wounds the stomach, as strong vomits or purges, acrid
poisons, sharp or hard substances taken into the stomach, &c. It is 

BLOODY URINE. 247             
often the effect of obstructions in the liver, the spleen, or some
of the other viscera, or external violence, as blows or bruises, or
any of the causes which produce inflammation. In hysteric wo-
men, vomiting of blood is a very common, but no dangerous symp-
tom.
A great part of the danger in this disease arises from the ex-
travasated blood lodging in the bowels, and becoming putrid, by
which a dysentery or malignant fever maybe occasioned. The best
way of preventing this, is to keep the body gently open, by fre-
quently exhibiting emollient clysters. Purges must not be given
till the discharge is stopt, otherwise they will irritate the stomach,
and increase the disorder. All the food and drink must be of a
mild cooling nature, and taken in small quantities. Even drink-
ing cold water has sometimes proved a remedy, but it will succeed
better when sharpened with the weak spirits of vitriol*. When
there are signs of an inflammation, bleeding may be necessary;
but the patient's weakness will seldom permit it. Opiates may be
of use; but they must be given in very small doses, as four or
five drops of laudanum twice or thrice a-day.
After the discharge is over, as the patient is generally troubled
with gripes, occasioned by the acrimony of the blood lodged in the
intestines, gentle purges will be necessary.
Of Bloody Urine.
THIS is a discharge of blood from the vessels of the kidneys or
bladder, occasioned by their being either enlarged, broken, or
eroded. It is more or less dangerous according to the different cir-
cumstances which attend it.
When pure blood is voided suddenly without interruption and
without pain, it proceeds from the kidneys; but if the blood be in
small quantity, of a dark colour; and emitted with heat and pain
about the bottom of the belly, it proceeds from the bladder. When
bloody urine is occasioned by a rough stone descending from the
kidneys to the bladder, which wounds the ureters, it is attended
with a sharp pain in the back, and difficulty of making water. If
the coats of the bladder are hurt by a stone, and the bloody urine
follows, it is attended with the most acute pain, and a previous
stoppage of urine.
Bloody urine may likewise be occasioned by falls, blows, the
lifting or carrying of heavy burdens, hard riding, or any violent
motion. It may also proceed from ulcers of the bladder, from a stone
* Clysters of cold water, with forty or fifty drops of laudanum in
each, should be injected, and stillness strictly enjoined. (I. C.) 

248 THE DYSENTERY,
lodged in the kidneys, or from violent purges, or sharp diuretic
medicines, especially cantharides.
Bloody urine is always attended with some degree of danger:
but peculiarly so when mixed with purulent matter, as this shows
an ulcer some where in the urinary passages. Sometimes this dis-
charge proceeds from excess of blood, in which case it is rather a
salutary evacuation than a disease. If the discharge however be
very great, it may waste the patient's strength, and occasion an ill
habit of body, a dropsy, or a consumption.
The treatment of this disorder must be varied, according to the
different causes from which it proceeds.
When it is owing to a stone in the bladder, the cure depends
upon an operation; a description of which would be foreign to our
purpose. If attended with a plethora, and symptoms of inflam-
mation, bleeding will be necessary. The body must likewise be
kept open by emollient clysters, or cooling purgative medicines;
as cream of tartar, manna, or small doses of lenitives electuary.
When bloody urine occurs in malignant diseases, as the small-
pox, fever, or the like, the patient's life depends on the liberal use
of the bark and acids, as already shown.
When there is reason to suspect an ulcer in the kidneys or blad-
der, the patient's diet must be cool, and his drink of a soft, heal-
ing, balsamic quality, as decoctions of marsh-mallow roots with
liquorice, solutions of gum-arabic, &c. Three ounces of marsh-
mallow roots, and half an ounce of liquorice, may be boiled in
two English quarts of water to one; two ounces of gum-arabic
may be dissolved in the strained liquor, and a tea-cupful of it taken
four or five times a-day.
The early use of astringents in this disease has often bad con-
sequences. When the flux is stopped too soon, the grumous
blood, confined in the vessels, may produce inflammations, abscess,
and ulcers. If the cause be urgent, or the patient seems to suffer
from the loss of blood, gentle astringents may be necessary. In this
case, the patient may take three or four ounces of lime-water,
with half an ounce of the tincture of bark, three times a-day, or
more frequent if necessary. 
Of the Dysentery, or Bloody Flux.
THIS disease prevails in the spring and autumn. It is most com-
mon in marshy countries, where, after hot and dry summers, it is
apt to become epidemic. Persons are most liable to it, who are
much exposed to the night air, or who live in places where
the air is confined and unwholesome. Hence, it often proves fa-
tal in camps, on shipboard, in gaols, hospitals, and such-like places. 

OR BLOODY FLUX. 249
CAUSES.————The dysentery may be occasioned by any thing
that obstructs the perspiration; as damp beds, wet clothes, un-
wholesome diet, air, &c. But it is most frequently communicated
by infection. This ought to make people extremely cautious, in
going near such persons as labour under the disease. Even the
smell of the patient's excrements has been known to communi-
cate it.
SYMPTOMS.————It is known by a flux of the belly, attended
with violent pain of the bowels, a constant inclination to go to
stool, and generally more or less blood in the stools. It begins,
like other fevers, with chillness, loss of strength, a quick pulse,
great thirst, and an inclination to vomit. The stools are at first
greasy and frothy, afterwards they are streaked with blood, and at
last, have frequently the appearance of pure blood, mixed with
small filaments resembling bits of skin. Worms are sometimes pas-
sed both upwards and downwards through the whole course of
the disease. When the patient goes to stool, he feels a bearing
down, as if the whole bowels were falling out, and sometimes a
part of the intestine is actually protruded, which proves exceeding
troublesome, especially in children. Flatulency is a troublesome
symptom, especially towards the end of the disease.
This disease may be distinguished from a diarrhœa or loose-
ness, by the acute pain of the bowels, and the blood which ge-
nerally appears in the stools; and from the cholera morbus, by its
not being attended with such violent and frequent fits of vomit-
ing, &c.
When the dysentery attacks the old, the delicate, or such as
have been wasted by the gout, the scurvy, or other lingering dis-
eases, it generally proves fatal. Vomiting and hiccuping are bad
signs, as they show an inflammation of the stomach. When the
stools are green, black, or have an exceeding disagreeable cadave-
rous smell, the danger is very great, as it shows the disease to be
of the putrid kind. It is an unfavourable symptom when clysters
are immediately returned; but still more so, when the passage is
so obstinately shut, that they cannot be injected. A feeble pulse,
coldness of the extremities, with difficulty of swallowing, and con-
vulsions, are signs of approaching death.
REGIMEN.————Cleanliness contributes greatly to the reco-
very of the patient, and the safety of such as attend him. In all
contagious diseases, the danger is increased, and the infection
spread, by the neglect of cleanliness; but in no one more than
this. Every thing about the patient should be frequently changed.
The excrements should never be suffered to continue in his cham-
ber, but removed immediately, and buried under ground. A con-
stant stream of fresh air should be admitted into the chamber; and
it ought frequently to be sprinkled with vinegar, juice of lemon,
or some other strong acid.
The patient must not be discouraged, but his spirits kept up in
I2 

250 THE DYSENTERY,
hopes of a cure. Nothing tends more to render any disease mor-
tal, than the fears and apprehensions of the sick. All diseases of
this nature have a tendency to sink and depress the spirits, and when
that is increased by fears and alarms, from those whom the pa-
tient believes to be persons of skill, it cannot fail to have the worst
effects.
A flannel waistcoat worn next the skin has often a very good
effect in the dysentery. This promotes the perspiration without
over-heating the body. Great caution is necessity in leaving it off.
I have often known a dysentery brought on by imprudently throw-
ing off a flannel waistcoat before the season was sufficiently warm.
For whatever purpose this piece of dress is worn, it should never
be left off but in a warm season.
In this disease, the greatest attention must be paid to the pa-
tient's diet. Flesh, fish, and every thing that has a tendency to turn
putrid or rancid on the stomach, must be abstained from. Apples
boiled in milk, water-pap, and plain, light pudding, with broth
made of the gelatinous parts of animals, may constitute the prin-
cipal part of the patient's food. Gelatinous broth not only answers
the purpose of food, but likewise of medicine. I have often known
dysenteries, which were not of a putrid nature, cured by it after
pompous medicines had proved ineffectual*.
Another kind of food very proper in the dysentery, which may
be used by such as cannot take the broth mentioned above, is
made by boiling a few handfuls of fine flour, tied in a cloth, for
six or seven hours, till it becomes as hard as starch. Two or three
table-spoonfuls of this may be grated down, and boiled in such a
quantity of new milk and water, as to be of the thickness of pap.
This  may be sweetened to the patient's taste, and taken for his or-
dinary food†.
* The manner of making this broth is, to take a sheep's-head and
feet, with the skin upon them, and to burn the wool off with a hot iron;
afterwards to boil them till the broth is quite a jelly. A little cinna-
mon or mace may be added, to give the broth an agreeable flavour,
and the patient may take a little of it warm with toasted bread, three
or four times a-day. A clyster of it may likewise be given twice a-day.
Such as cannot use the broth made in this way, may have the head and
feet skinned; but we have reason to believe, that this hurts the medi-
cine. It is not our business here to reason upon the nature and qualities
of medicine, otherwise this might be shown to possess virtues every way
suited to the cure of a dysentery which does not proceed from a putrid
state of the humours. Whole families have often been cured by it, af-
ter they had used many other medicines in vain. It will, however, be
proper that the patient take a vomit, and a dose or two of rhubarb,
before he begins to use the broth. It will likewise be necessary to con-
tinue the use of it for a considerable time, and to make it the principal
food.
† The learned and humane Dr. Rutherford, late professor of medi-
cine in the university of Edinburgh, used to mention this food in his
public lecture with great encomiums. He directed it to be made by
tying a pound or two of the finest flour, as tight as possible, in a linen 

OR BLOODY FLUX. 251
In dysentery, the patient may be allowed to eat freely of most
kinds of ripe fruit; as apples, grapes, gooseberries, currant-ber-
ries, strawberries, &c. These may either be eaten raw or boiled,
with or without milk, as the patient chooses. The prejudice against
fruit in this disease, is so great, that many believe it to be the
common cause of dysenteries. This is an egregious mistake.
Both reason and experience show, that good fruit is one of the
best medicines, both for the prevention and cure of the dysentery.
Good fruit is in every respect calculated to counteract that ten-
dency to putrefaction, from whence the most dangerous kind
of dysentery proceeds. The patient, in such a case, ought to be al-
lowed to eat as much fruit as he pleases, provided, it be ripe*.
The most proper drink in this disorder, is whey or flaxseed tea.
The dysentery has often been cured by the use of clear whey
alone. It may be taken both for drink and in form of clyster.
When whey cannot be had, barley-water sharpened with cream
of tartar may be drank, or a decoction of barley and tamarinds;
two ounces of the former and one of the latter, may be boiled in
two English quarts of water to one. Warm water, water-gruel,
or water wherein hot iron has been frequently quenched, are all
very proper, and may be drank in turns. Camomile-tea, if the
stomach will bear it, is an exceeding proper drink. It both strength-
ens the stomach, and by its antiseptic quality, tends to prevent
a mortification of the bowels.
MEDICINE.————At the beginning of this disease, it is always
necessary to cleanse the first passages. For this purpose, a vomit
of ipecacuanha must be given, and wrought off with weak camo-
mile tea. Strong vomits are seldom necessary here.  A scruple, or
at most, half a drachm of ipecacuanha, is generally sufficient for an
adult, and sometimes a few grains will suffice. The day after the
rag, afterwards to dip it frequently in water, and to dredge the outside
with flour, till a cake or crust was formed around it, which prevents
the water from soaking into it while boiling. It is then to be boiled till
it becomes a hard, dry mass, as directed above. This, when mixed with
milk and water, will not only answer the purpose of food, but may
likewise be given in clysters.
* I lately saw a young man who had been seized with a dysentery
in North-America. Many things had been tried there for his relief,
but to no purpose. At length, tired out with disappointments from me-
dicine, and reduced to skin and bone, he came over to Britain, rather
with a view to die among his relations, than with any hopes of a cure.
After taking sundry medicines here with no better success than abroad,
I advised him to leave off the use of drugs, and to trust entirely to a
diet of milk and fruits, with gentle exercise. Strawberries was the
only fruit he could procure at that season. These he ate with milk
twice, and sometimes thrice a-day. The consequence was, that in a
short time his stools were reduced from upwards of twenty in a-day,
to three or four, and sometimes not so many. He used the other fruits
as they came in, and was in a few weeks so well as to leave that part
of the country where I was, with a view to return to America. 

252 THE DYSENTERY, &c.
vomit, half a drachm, or two scruples of rhubarb must be taken;
or, what will answer the purpose rather better, an ounce or an
ounce and a half of Epsom salts. This dose may be repeated every
other day, for two or three times. Afterwards small doses of ipe-
cacuanha may be taken for some time. Two or three grains of the
powder may be mixed in a table-spoonful of the syrup of poppies,
and taken three times a-day.
These evacuations, and the regimen prescribed above, will of-
ten be sufficient to effect a cure. Should it, however, happen other-
wise, the following astringent medicines may be used.
A clyster of starch or fat mutton-broth, with thirty or forty
drops of liquid laudanum in it, may be administered twice a-day.
At the same time an ounce of gum-arabic, and half an ounce of
gum-tragacanth, may be dissolved in an English pint of barley-
water, over a slow fire, and a table-spoonful of it taken every
hour.*
If these have not the desired effect, the patient may take four
times a day, about the bulk of a nutmeg of the Japonic confection,
drinking after it a tea-cupful of the decoction of logwood†.
Persons who have been cured of this disease are very liable to
a relapse; to prevent which, great circumspection as to diet is
necessary. The patient must abstain from all fermented liquors,
except now-and-then a glass of good wine; but he must drink no
kind of malt liquor. He should likewise abstain from animal food,
as fish and flesh, and live principally on milk and vegetables.
Gentle, exercise and wholesome air are likewise of importance.
The patient should go to the country as soon as his strength will
permit, and take exercise daily on horseback, or in a carriage. He
may likewise use bitters infused in wine or brandy, and may drink
twice a-day a gill of lime-water mixed with an equal quantity of
new milk.
When dysenteries prevail, we would recommend a strict atten-
tion to cleanliness, a spare use of animal food, the free use of sound
ripe fruits and other vegetables. The night air is to be carefully
* The indications of cure in this disease are more effectually answer-
ed, by giving a drachm of Glauber salts every hour, so as to clear the
bowels of hardened excrement, by exciting brisk purging. This plan should
be continued until the gripping and tenesmus subside, interposing every
night at bed-time one or two grains of opium, combined with two or
three of ipecacuanha to quiet the bowels and promote perspiration.
If the patient cannot take salts, one table spoonful of castor oil should
be given, and repeated every two or three hours, until it produces the
desired effect of rendering the stools more copious; and after they ap-
pear in lumps or balls, the cure must be followed up, by giving infusion
of bark, as frequent and in as large doses as the stomach will bear.
This practice is equally applicable to children, by accommodating the
doses of medicine to their age. (I. C.)
* See Appendix, Decoction of Logwood. 

THE HEAD-ACH. 253 
avoided, and all communication with the sick. Bad smells are to
be shunned, especially those which arise from putrid animal sub-
stances. The necessaries where the sick go should be carefully
avoided by those in health.
Sundry other fluxes of the belly, as the LIENTERY and CŒ-
LIAC PASSION, though less dangerous than the dysentery, yet
merit consideration. These diseases generally proceed from a re-
laxed state of the stomach and intestines, which is sometimes so
great, that the food passes through them without almost any sen-
sible alteration; and the patient dies merely from the want of
nourishment.
When the lientery or cœliac passion succeeds to a dysentery,
the case is bad. They are always dangerous in old age, especially
when the constitution has been broken by excess or acute diseases.
If the stools be very frequent, and quite crude, the thirst great,
with little urine, the mouth ulcerated, and the face marked with
spots of different colours, the danger is very great.
The treatment of the patient is in general the same as in the
dysentery. In all obstinate fluxes of the belly, the cure must be
attempted, by first cleansing the stomach and bowels with gentle
vomits and purges; afterwards, such diet as has a tendency to
heal and strengthen the bowels, with opiates and astringent medi-
cines, will generally perfect the cure.
The same observation holds with respect to a TENESMUS, or
frequent desire of going to stool. This disease resembles the dy-
sentery so much, both in its symptoms and method of cure, that
we think it needless to insist upon it.
CHAPTER XXXVI.
Of the Head-Ach.
ACHS and pains proceed from very different causes, and
may affect any part of the body; but we shall point out
those only which occur most frequently, and are attended with the
greatest danger.
When the head-ach is slight, and affects a particular part of the
head only, it is called cephalalgia; when the whole head is affected,
cephalæa; and when on one side only, hemicrania. A fixed pain in
the forehead, which may be covered with the end of the thumb,
is called the clavis hystericus.
There are also other distinctions. Sometimes the pain is inter-
nal, sometimes external; sometimes it is an original disease, and
at other times only symptomatic. When the head-ach proceeds
from a hot bilious habit, the pain is very acute and throbbing,
with a considerable heat of the part affected. When from a cold 

254 THE HEAD-ACH.
phlegmatic habit, the patient complains of a dull heavy pain, and
has a sense of coldness in the part. This kind of head-ach is
sometimes attended with a degree of stupidity or folly.
Whatever obstructs the free circulation of the blood through
the vessels of the head, may occasion a head-ach. In persons of a
full habit, who abound with blood, or other humours, the head-
ach often proceeds from the suppression of customary evacuations;
as bleeding at the nose; sweating of the feet, &c. It may likewise
proceed from any cause that determines a great flux of blood to-
wards the head; as coldness of the extremities, or hanging down
the head for a long time. Whatever prevents the return of the
blood from the head will occasion a head-ach; as looking long
obliquely at any object, wearing any thing tight about the neck,
or the like.
When a head-ach proceeds from the stoppage of a running at
the nose, there is a heavy, obtuse, pressing pain in the fore-part of
the head, in which there seems to be such a weight, that the pa-
tient can scarce hold it up. When it is occasioned by the caustic
matter of the venereal disease, it generally affects the skull, and of-
ten produces a caries of the bones.
Sometimes the head-ach proceeds from the repulsion or retro-
cession of the gout, the erysipelas, the small pox, measles, itch, or
other eruptive diseases. What is called a hemicrania generally
proceeds from crudities or indigestion. Inanition, or emptiness,
will also occasion head-achs, as in nurses who gave suck too long,
or who did not take a sufficient quantity of solid food.
There is likewise a most violent, fixed, constant, and almost in-
tolerable head-ach, which occasions great debility both of body
and mind, prevents sleep, destroys the appetite, causes a vertigo,
dimness of sight, a noise in the ears, convulsions, epileptic fits, and
sometimes vomiting, costiveness, coldness of the extremities, &c.
The head-ach is often symptomatic in continual and intermit-
ting fevers, especially quartans. It is likewise a very common
symptom in hysteric and hypochondriac complaints.
When a head-ach attends an acute fever, with pale urine, it is
an unfavourable symptom. In excessive head-achs, coldness of the
extremities is a bad sign.
When the disease continues long, and is very violent, it often
terminates in blindness, an apoplexy, deafness, a vertigo, the palsy,
epilepsy, &c.
The cool regimen in general is to be observed. The diet ought
to consist of such emollient substances as will correct the acrimo-
ny of the humours, and keep the body open; as apples boiled in
milk, spinage, turnips, and such-like. The drink ought to be di-
luting; as barley-water, infusions of mild mucilaginous vegeta-
bles, decoctions of the sudorific woods, &c. The feet and legs
ought to be kept warm, and frequently bathed in lukewarm wa-
ter; the head should be shaved, and bathed with water and vine- 

THE HEAD-ACH. 255
gar. The patient ought as much as possible to keep in an erect
posture, and not to lie with his head too low.
When the head-ach is owing to excess of blood, or a bilious
constitution, bleeding is necessary. The patient may be bled in the
jugular vein, and the operation repeated if there be occasion.
Cupping also, or the application of leeches to the temples, and
behind the ears, will be of service. Afterwards a blister may be
applied to the neck, behind the ears, or to any part of the head
that is most affected. In some cases it will be proper to blister the
whole head. In persons of a gross habit, issues or perpetual blisters
will be of service. The body ought likewise to be kept open by
gentle laxatives.
But when there is a dull, heavy, continual pain in the head,
which will neither yield to bleeding nor gentle laxatives, then
more powerful purgatives are necessary, as pills made of aloes,
resin of jalap, or the like. It will also be necessary in this case
to blister the whole head, and to keep the back part of the neck
open for a considerable time by a perpetual blister.
When the head-ach is occasioned by the stoppage of a running
at the nose, the patient should frequently smell to a bottle of
volatile salts; he may likewise take snuff, or any thing that will
irritate the nose, so as to promote a discharge from it; as the
herb mastich, ground-ivy, &c.
A hemicrania, especially a periodical one, is generally owing
to a foulness of the stomach, for which gentle vomits must be
administered, as also purges of Glauber salts or jalap. After the
bowels have been sufficiently cleared, chalybeate waters, and such
bitters as strengthen the stomach, will be necessary.
When the head-ach is so intolerable as to endanger the pa-
tient's life, or is attended with continual watching, delirium, &c.
recourse must be had to opiates. These, after proper evacua-
tions by clysters or mild purgatives, may  be applied both exter-
nally and internally. The affected part may be rubbed with
Bate's anodyne balsam, or a cloth dipped in it may be applied to
the part. The patient may, at the same time, take twenty drops
of laudanum, in a cup of valerian or penny-royal tea, twice or
thrice a-day. This is only to be done in case of extreme pain.
Proper evacuations ought always to accompany and follow the use
of opiates*.
When the patient cannot bear the loss of blood, his feet ought
frequently to be bathed in luke-warm water, and well rubbed
with a coarse cloth. Cataplasms with mustard or horseradish
ought likewise to be applied to them. This course is peculiarly
necessary when the pain proceeds from a gouty humour affecting
the head.
* When the pain is very violent, and does not yield to small doses of
laudanum, the quantity may be increased. I have known a patient in
extreme pain take three hundred drops in twenty-four hours; but such
doses ought only to be administered by persons of skill. 

256 THE TOOTH-ACH.
When the head-ach is occasioned by great heat, hard labour,
or violent exercise of any kind, it may be allayed by cooling me-
dicines; as the saline draughts with nitre, and the like.
A little of Ward's essence, dropt into the palm of the hand, and
applied to the forehead, will sometimes remove a violent head-
ach; and so will æther, when applied in the same manner.
Of the Tooth-Ach.
THIS disease needs no description. It has great affinity with
the rheumatism, and often succeeds pains of the shoulders and
other parts of the body.
It may proceed from obstructed perspiration, or any of the
other causes of inflammation, from neglecting some part of the
usual coverings of the head; or from sitting with the head bare
near an open window, or exposing it any how to a draught of
cold air. Food or drink taken either too hot or too cold is very
hurtful to the teeth. Great quantities of sugar, or other sweet-
meats, are likewise hurtful. Nothing is more destructive to the
teeth than cracking nuts, or chewing any kind of hard substances.
Picking the teeth with pins, needles, or any thing that may hurt
the enamel with which they are covered, does great mischief, as
the tooth is sure to be spoiled whenever the air gets into it.
Breeding women are very subject to the tooth-ach, especially dur-
ing the first three or four months of pregnancy. The tooth-ach
often proceeds  from scorbutic humours affecting the gums. In
this case, the teeth are sometimes wasted, and fall out without any
considerable degree of pain. The more immediate cause of the
tooth-ach is a rotten or carious tooth.
In order to relieve the tooth-ach, we must first endeavour to
lessen the flux of humours to the part affected. This may be done
by mild purgatives, scarifying the gums, or applying leeches to
them, and bathing the feet frequently with warm water. The 
perspiration ought likewise to be promoted, by drinking freely of
weak wine-whey, or other diluting liquors, with small doses of
nitre. Vomits, too, have often an exceeding good effect in the
tooth-ach. It is seldom safe to administer opiates, or any kind
of heating medicines, or even to draw a tooth, till proper evacu-
ations have been premised; and these alone will often effect the
cure.
If this fails, and the pain and inflammation still increase, a sup-
puration may be expected; to promote which, a toasted fig should
be held between the gum and the cheek; bags filled with boiled
camomile flowers, flowers of elder, or the like, may be applied
near the part affected, with as great a degree of warmth as the
patient can bear, and renewed as they grow cool: the patient 

THE TOOTH-ACH. 257 
may likewise receive the steams of warm water into his mouth;
through an inverted funnel, or by holding his head over the
mouth of a porringer filled with warm water, &c.
Such things as promote the discharge of saliva, or cause the
patient to spit, are generally of service. For this purpose, bitter,
hot, or pungent vegetables may be chewed; as gentian, calamus
aromaticus, or pellitory of Spain. Allen recommends the root
of yellow water flour-de-luce in this case. This root may either be
rubbed upon the tooth, or a little of it chewed. Brookes says
he hardly ever knew it fail to ease the tooth-ach. It ought how-
ever to be used with caution.
Many other herbs, roots and seeds, are recommended for cur-
ing the tooth-ach; as the leaves or roots of millefoil or yarrow
chewed, tobacco smoked or chewed, staves acre, or the seeds of
mustard chewed, &c. These bitter, hot, and pungent things,
by occasioning a greater flow of saliva, frequently give ease in the
tooth-ach.
Opiates often relieve the tooth-ach. For this purpose, a little
cotton wet with laudanum may be held between the teeth; or a
piece of sticking-plaister, about the bigness of a shilling, with a
bit of opium in the middle of it, of a size not to prevent the
sticking of the other, may be laid on the temporal artery, where
the pulsation is most sensible. De la Motte affirms, that there
are few cases wherein this will not give relief. If there be a hol-
low tooth, a small pill made of equal parts of camphire and opi-
um, put into the hollow, is often beneficial. When this cannot
be had, the hollow tooth may be filled with gum mastich, wax,
lead, or any substance that will stick in it, and keep out the ex-
ternal air.
Few applications give more relief in the tooth-ach than a blister
applied between the shoulders; or rather put behind the ears,
and made so large as to cover a great part of the lower jaw.
When a tooth is carious, it is often impossible to remove the
pain without extracting it; and, as a spoilt tooth never becomes
sound again, it is prudent to draw it soon, lest it should affect the
rest. Tooth-drawing, like bleeding, is very much practised by
mechanics; the operation is not without danger, and ought al-
ways to be performed with care. A person unacquainted with
the structure of the parts will be in danger of hurting the jaw-
bone, or of drawing a sound tooth instead of a rotten one*.
When the tooth-ach returns periodically, and the pain chiefly
affects the gums, it may be cured by the bark. 
Some pretend to have found great benefit from the application
of an artificial magnet. If it be found to answer, though only in
particular cases. If certainly deserves a trial, as it is attended with
* This may always be prevented by the operator striking upon the
teeth with any piece of metal, as this never fails to excite pain in the
carious tooth.
K2 

258 THE EAR-ACH.
no expence, and no harm. Electricity has likewise been recom-
mended, and particular instruments have been invented for send-
ing a shock through the affected tooth.
Persons who have returns of the tooth-ach at certain seasons,
as spring and autumn, might often prevent it by taking a purge
at these times.
Keeping the teeth clean tends to prevent the tooth-ach. The
best method is to wash them daily with salt and water, a decoction
of the bark, or with cold water alone. All brushing and scrap-
ing of the teeth is dangerous, and unless it be performed with
great care, does mischief.
Of the Ear-Ach.
THIS disorder chiefly affects the membrane which lines the in-
ner cavity of the ear called the meatus auditorius. It often occa-
sions great restlessness, anxiety, and even delirium. Epileptic sits,
and other convulsive disorders, have been brought on by extreme
pain in the ear.
The ear-ach may proceed from any of the causes which pro-
duce inflammation. It often proceeds from a sudden suppression
of perspiration, or from the head being exposed to cold when co-
vered with sweat; or from worms, or other infects getting into
the ear, or being bred there; or from any hard body sticking in
the ear. Sometimes it proceeds from the translation of morbific
matter to the ear. This often happens in the decline of malig-
nant fevers, and occasions deafness, which is generally reckoned
a favourable symptom.
When the ear-ach proceeds from insects, or any hard body
sticking in the ear, every method must be taken to remove them 
as soon as possible. The membranes may be relaxed by dropping
into the ear, oil of sweet almonds, or olive oil. Afterwards the
patient should be made to sneeze, by taking snuff, or some strong
sternutatory. If this should not force out the body, it must be
extracted by art. I have seen insects, which had got into the
ear, come out of their own accord upon pouring in oil, which
they cannot bear.
When the pain of the ear proceeds from inflammation, it must
be treated like other topical inflammations, by a cooling regimen,
and opening medicines. Bleeding at the beginning, either in the
arm or jugular vein, or cupping in the neck, will be proper.
The ear may likewise be fomented with steams of warm water;
or flannel bags filled with boiled mallows and camomile flowers
may be applied to it warm; or bladders filled with warm milk
and water. An exceeding good method of fomenting the 

PAIN OF THE STOMACH, &c. 259 
ear is to apply it close to the mouth of a jug filled with warm wa-
ter, or a strong decoction of camomile-flowers.
The patient's feet should be frequently bathed in lukewarm
water, and he ought to take small doses of nitre and cream tartar,
half a drachm of the latter, and ten grains of the former three
times a-day. His drink may be whey, or a decoction of barley
and liquorice with figs or raisins. The parts behind the ear ought
frequently to be rubbed with camphorated oil, or a little of the vo-
latile liniment.
When the inflammation cannot be discussed, a poultice of
bread and milk, or roasted onions, may be applied to the ear, and
frequently renewed, till the abscess breaks, or can be opened. Af-
terwards the humours may be diverted from the part by gentle
laxatives, blisters, or issues; but the discharge must not be sud-
denly dried up by any external application.
Pain of the Stomach, &c.
THIS may proceed from various causes; as indigestion; wind;
the acrimony of the bile; sharp, acrid, or poisonous substances ta-
ken into the stomach, &c. It may likewise be occasioned by
worms; the stoppage of customary evacuations; a translation of
gouty matter to the stomach, the bowels, &c.
Women in the decline of life are very liable to pains of the sto-
mach and bowels, especially such as are afflicted with hysteric
complaints. It is likewise very common to hypochondriac men of
a sedentary and luxurious life. In such persons, it often proves so
extremely obstinate as to baffle medicine.
When the pain of the stomach is most violent after eating, there
is reason to suspect that it proceeds from some fault either in the
digestion or the food. In this case, the patient ought to change his
diet, till he finds what kind of food agrees best with his stomach,
and should continue chiefly to use it. If a change of diet does not
remove the complaint, the patient may take a gentle vomit, and
afterwards a dose or two of rhubarb. He ought likewise to take
an infusion of camomile flowers, or some other stomachic bitter,
either in wine or water. I have often known exercise remove this
complaint, especially sailing, or a long journey on horseback, or
in a carriage.
When a pain of the stomach proceeds from flatulency, the pa-
tient is constantly belching up wind, and feels an uneasy disten-
tion of the stomach after meals. This is the most deplorable dis-
ease, and is seldom thoroughly cured. In general, the patient ought
to avoid all windy diet, and every thing that sours on the stomach,
as greens, roots, &c. This rule admits of some exceptions. Ma- 

260 PAIN OF THE STOMACH, &c.
ny persons very much troubled with wind, have received great be-
nefit from eating parched pease, though that grain is generally
supposed to be of a windy nature*.
This complaint may likewise be greatly relieved by labour, es-
pecially digging, reaping, mowing, or any kind of active employ-
ment by which the bowels are alternately compressed and dilated.
The most obstinate case of this kind I ever met with, was in a per-
son of a sedentary occupation, whom I advised, after he had tried
every kind of medicine in vain, to turn gardener; which he did,
and has ever since enjoyed good health.
When a pain of the stomach is occasioned by the swallowing
of acrid or poisonous substances, they must be discharged by vo-
mit; this may be excited by butter, oils, or other soft things,
which sheath and defend the stomach from the acrimony of its
contents.
When a pain of the stomach proceeds from a translation of gouty
matter, warm cordials are necessary, as generous wines, French
brandy, &c. Some in this case have drank a whole bottle of bran-
dy or rum in a few hours, without being in the least intoxica-
ted, or even feeling the stomach warmed by it. It is impossible to
ascertain the quantities necessary upon these occasions. This must
be left to the feelings and discretion of the patient. The safer way,
however, is, not to go too far. When there is an inclination to
vomit, it may be promoted by drinking an infusion of camomile
flowers, or carduus benedictus.
If a pain of the stomach proceeds from the stoppage of customa-
ry evacuations, bleeding will be necessary, especially in sanguine
and very full habits. It will likewise be of use to keep the body
gently open by mild purgatives; as castor oil, senna, &c. When
this disease affects women, in the decline of life, after the stop-
page of the menses, making an issue in the leg or arm will be of pe-
culiar service.
When the disease is occasioned by worms, they must be destroy-
ed, or expelled by means recommended in the following section;
When the stomach is greatly relaxed, and the digestion bad,
which often occasion flatulencies, the elixir of vitriol will be of
singular service. Fifteen or twenty drops of it may be taken in a
glass of wine or water twice or thrice a-day.
Persons afflicted with flatulency are generally unhappy unless
they be taking some purgative medicines; these, though they may
give immediate ease, weaken and relax the stomach and bowels,
and consequently increase the disorder. Their best method is to
mix purgatives and stomachics together. Equal parts of bark and
rhubarb may be infused in brandy or wine, and taken in such quan-
tity as to keep the body gently open.
* These are prepared by steeping or soaking pease in water, and af-
terwards drying them in a pot opt kiln till they become quite hard. They
may be used at pleasure. 

[26l]
CHAPTER XXXVII.
Of Worms.
THESE are chiefly of three kinds, viz. the tænia, or tape-
worm; the teres, or round and long worm; and the asca-
rides or round or 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 men-
tioned, we shall not spend time in enumerating them.
The tape-worm is white, very long, and full of joints. It is ge-
nerally bred either in the stomach or small intestines. The round
and long worm is likewise bred in the small guts, and sometimes in
the stomach. The round and short worms commonly lodge in the
rectum, or what is called the end gut, and occasion a disagreeable
itching about the seat.
The long round worms occasion squeamishness, vomiting, a dis-
agreeable breath, gripes, looseness, swelling of the belly, swoon-
ings, loathing of food, and at other times a voracious appetite, a
dry cough, convulsions, epileptic fits, and sometimes a privation
of speech. These worms have been known to perforate the intes-
tines, 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 so-
lium, which is a species of the tape-worm, viz. swoonings, priva-
tion of speech and a voracious appetite. The round worms called
ascarides, besides an itching of the anus, cause swoonings, and te-
nesmus, or an inclination to go to stool.
CAUSES.————Worms may proceed from various causes, but
they are seldom found except in relaxed stomachs, where the di-
gestion is bad. Sedentary persons are more liable to them than the
active and laborious. Those who eat great quantities of unripe
fruit, or who live much on raw herbs and roots, are generally sub-
ject to worms. There seems to be a hereditary disposition in some
persons to this disease. I have often seen all the children of a fami-
ly subject to worms of a particular kind. They seem likewise fre-
quently to be owing to the nurse. Children of the same family,
nursed by one  woman, have often worms, when those nursed by
another have none.
SYMPTOMS.————The common symptoms of worms are,
paleness of the countenance, and at other times, an universal
flushing of the face; itching of the nose; this however is doubt-
ful, as children pick their noses in all diseases; starting, and grind-
ing of the teeth in sleep; swelling of the upper lip; the appetite 

262 OF WORMS.
sometimes bad, at other times quite voracious; looseness; a sour or
stinking breath; a hard swelled belly; 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 unequal pulse;
palpitations of the heart; swoonings; drowsiness; cold sweats;
palsy; epileptic fits, with many other unaccountable nervous
symptoms, which were formerly attributed to witchcraft, or the
influence of evil spirits. Small bodies in the excrements resem-
bling melon or cucumber seeds are symptoms of the tape-worm.
I lately saw some very surprising effects of worms in a girl a-
bout 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 guts, which were
considerably inflamed; and what anatomists call an intus susceptio,
or involving of one part of the gut within another, had taken
place in no less than four different parts of the intestinal canal.*
MEDICINE.————Though numberless medicines are extolled for
expelling and killing worms,† yet no disease more frequently
baffles the physician's skill. In general, the most proper medicines
for their expulsion are strong purgatives; and to prevent their
breeding, stomachic bitters, with now and then a glass of good
wine.
The best purge for an adult is jalap and calomel. Five and
twenty or thirty grains of the former with six or seven of the lat-
ter, mixed in syrup, may be taken early in the morning, for a
dose. It will be proper that the patient keep the house all day, and
drink nothing cold. The dose may be repeated once or twice a
week, for a fortnight or three weeks. On the intermediate days,
the patient may take a drachm of the powder of tin, twice or thrice
a-day, mixed with syrup or honey.
Those who do not chuse to take calomel may make use of the
bitter purgatives; as aloes, hiera picra, tincture of senna, and
rhubarb, &c.
Oily medicines are sometimes found beneficial for expelling
worms. An ounce of sallad oil and a table-spoonful of common
salt may be taken in a glass of red port wine thrice a-day or often-
er, if the stomach will bear it. But the more common form of
using oil is in clysters. Oily clysters sweetened with sugar or ho-
* That worms exist in the human body, there can be no doubt; and
that they must sometimes be considered as a disease is equally certain:
but this is not the case so often as people imagine. The idea that worms
occasion many diseases, gives an opportunity to the professed worm-
doctors of imposing on the credulity of mankind, and doing much mis-
chief. They find worms in every case, and liberally throw in their an-
tidotes, which generally consist of strong drastic purges: I have known
these given in delicate constitutions to the destruction of the patient,
where there was not the least symptom of worms.
† A medical writer, of the present age, has enumerated upwards of
fifty British plants, all celebrated for killing and expelling worms. 

OF WORMS. 263
ney, are very efficacious in bringing away the short round worms
called ascarides, and likewise the teres.
The Harrowgate water is an excellent medicine for expelling
worms, especially the ascarides. As this water is impregnated with
sulphur, we may hence infer, that sulphur alone must be a good
medicine in this case;  which is found to be a fact. Many prac-
titioners give flour of sulphur in very large doses, and with great
success. It should be made into an electuary with honey or treacle,
and taken in such quantity as to purge the patient.
Where Harrowgate water cannot be obtained, sea-water may be
used. If sea-water cannot be had, common salt dissolved in wa-
ter may be drank. I have often seen this used by country nurses
with very good effect. Some flour of sulphur may be taken over
night, and the salt-water in the morning.
But worms, though expelled, will soon breed again, if the sto-
mach remains weak and relaxed; to prevent which, we would re-
commend the bark. Half a drachm of bark in powder may be
taken in a glass of red Port wine three or four times a-day, after
the above medicines have been used. Lime-water is likewise good
for this purpose, or a table-spoonful of the chalybeate wine taken
twice thrice a-day. Infusions or decoctions of bitter herbs may
likewise be drank; as the infusions of tansy, water trefoil, camo-
mile-flowers, tops of wormwood, the lesser centaury, &c.
For a child of four or five years old, six grains of rhubarb five
of jalap, and two of calomel, may be mixed in a spoonful of syrup
or honey, and given in the morning. The child should keep the
house all day, and take nothing cold. This dose may be repeated
twice a-week for three or four  weeks. On the intermediate days,
the child may take a scruple of powdered tin, and ten grains of
æthiops mineral in a spoonful of treacle twice a-day. This dose
must be increased or diminished according to the age of the pa-
tient.
Bisset says, the great bastard black hellebore, or bear's foot, is a
most powerful vermifuge for the long round worms. He orders
the decoction of about a drachm of the green leaves, or about fif-
teen grains of the dried leaves in powder, for a dose to a child be-
tween four and seven years of age. This dose is to be repeated
two or three times. He adds that the green leaves, made into a
syrup, with coarse sugar, is almost the only medicine he has used
for round worms for three years past. Before pressing out the
juice, he moistens the bruised leaves with vinegar, which corrects
the medicine. The dose is a tea-spoonful at bed-time, and one or
two next morning.
I have frequently known these big bellies, which in children are
commonly reckoned a sign of worms, quite removed, by giving
them white soap in their pottage, or other food. Tansy, garlic, and
rue, are all against  worms, and may be used various ways. We
might here mention many other plants, both for external and in- 

264 THE JAUNDICE.
ternal use, as the cabbage-bark, &c. but think the powder of tin,
and the purges of jalap and calomel, are more to be depended on.
Ball's purging vermifuge powder is a very powerful medicine.
It is made of equal parts of rhubarb, scammony, and calomel,
with as much double-refined sugar as is equal to the weight of all
the other ingredients. These must be well mixed together, and re-
duced to a fine powder. The dose for a child, is from ten grains
to twenty, once or twice a-week. An adult may take a drachm
for a dose*.
Parents, who would preserve their children from worms, ought
to allow them plenty of exercise in the open air; to take care that
their food be wholesome and sufficiently solid; and as far as pos-
sible to prevent their eating raw herbs, roots, or green trashy fruits.
It will not be amiss to allow a child who is subject to worms, a
glass of red wine after meals; as every thing that braces and
strengthens the stomach, is good both for preventing and expel-
ling these vermin†.
CHAPTER XXXVIII.
Of the Jaundice.
THIS disease is first observable in the white of the eye, which 
appears yellow. Afterwards the whole skin puts on a yellow
appearance. The urine too is of a saffron hue, and dies a white 
cloth of the same colour. There is likewise a species of this dis- 
ease called the black jaundice. 
CAUSES.————The immediate cause of the jaundice is an ob- 
struction of the bile. The remote or occasional causes are, the bites
of poisonous animals, as the viper, mad dog, &c. the bilious or
hysteric colic; violent passions, as grief, anger, &c. Strong pur-
ges or vomits will likewise occasion the jaundice. Sometimes it
proceeds from obstinate agues, or from that disease being prema-
turely stopped by astringent medicines. In infants, it is often occa-
* A powder for the tape-worm resembling this was long kept a secret
on the continent; it was lately purchased by the French King, and will
be found under the article Powder, in the Appendix.
† It is necessary to warn people of their danger who buy cakes, pow-
ders, and other worm medicines, at random, from quacks, and give
them to their children without proper care. The principal ingredient
in most of these medicines is  mercury, which is never to be trifled
with. I lately saw a shocking instance of the danger of this conduct. A
girl who had taken a dose of worm powder, bought of a travelling
quack, went out, and perhaps was so imprudent as to drink cold water
during its operation. She immediately swelled, and died on the follow-
ing day, with all the symptoms of having been poisoned.

THE JAUNDICE. 265
sioned by the meconium not being sufficiently purged off. Pregnant
women are very subject to it. It is likewise a symptom in several
kinds of fever. Catching cold, or the stoppage of customary eva-
cuations, as the menses, the piles, issues, &c. will occasion the
jaundice. 
SYMPTOMS.————The patient at first complains of excessive
weariness, and has great aversion to every kind of motion. His
skin is dry, and he generally feels a kind of itching or pricking
pain over the whole body. The stools are of a whitish or clay co-
lour, and the urine, as was observed above, is yellow. The breath-
ing is difficult, and the patient complains of an unusual load or
oppression on his breast. There is a heat in the nostrils, a bitter
taste in the mouth, loathing of food, sickness at the stomach, vo-
miting, flatulency, and other symptoms of indigestion.
If the patient be young, and the disease complicated with no
other malady, it is seldom dangerous; but in old people, where
it continues long, returns frequently, or is complicated with the
dropsy, or hypochondriac symptoms, it generally proves fatal.
REGIMEN.————The diet should be cool, light, and diluting,
consisting chiefly of ripe fruits and mild vegetables; as apples
boiled or roasted, stewed prunes, preserved plumbs, boiled spinage,
&c. Veal or chicken-broth, with light bread, are likewise very pro-
per. Many have been cured by living almost wholly for some days
on raw eggs. The drink should be butter-milk, whey sweetened
with honey, or decoctions of cool opening vegetables; or marsh-
mallow roots, with liquorice, &c.
The patient should take as much exercise as he can bear, either
on horseback, or in a carriage; walking, running, and even jump-
ing, are likewise proper, provided he can bear them without pain,
and there be no symptoms of inflammation. Patients have been
often cured of this disease by a long journey, after medicines had
proved ineffectual.
Amusements are likewise of great use in the jaundice. The dis-
ease is often occasioned by a sedentary life, joined to a dull me-
lancholy disposition. Whatever therefore tends to promote the
circulation, and to cheer the spirits, must have a good effect; as
dancing, laughing, singing, &c.
MEDICINE.————If the patient be young, of a full sanguine
habit, and complains of pain in the right side about the region of
the liver, bleeding will be necessary. After this a vomit must be
administered, and if the disease proves obstinate, it may be re-
peated once or twice. No medicines are more beneficial in the
jaundice than vomits, especially where it is not attended with in-
flammation. Half a drachm of ipecacuanha in powder will be a
sufficient dose for an adult. It may be wrought off with weak
camomile-tea, or lukewarm water. The body must likewise be
kept open by taking a sufficient quantity of Castile soap, or the
pills for the jaundice recommended in the appendix. 
L2

266 THE DROPSY.
Fomenting the parts about the region of the stomach and liver,
and rubbing them with a warm hand or flesh-brush, are likewise
beneficial; but it is still more so for the patient to sit in a bath
of warm water up to the breast. He ought to do this frequently,
and should continue in it as long as his strength will permit.
Many dirty things are recommended for the cure of the jaun-
dice; as lice, millipedes, &c. But these do more harm than good,
as people trust to them, and neglect more valuable medicines;
besides, they are seldom taken in sufficient quantity to produce
any effects. People always expect that such things should act as
charms, and consequently seldom persist in the use of them. Vo-
mits, purges, fomentations, and exercise, will seldom fail to cure
the jaundice when it is a simple disease; and when complicated
with the dropsy, a schirrous liver, or other chronic complaints, it
is hardly to be cured by any means.
Numberless British herbs are extolled for the cure of this dis-
ease. The author of the Medicina Britannica mentions near a hun-
dred, all famous for curing the jaundice. The disease often goes
off of its own accord; in which case, the last medicine is always
said to have performed the cure. I have seen considerable benefit,
in a very obstinate jaundice, from a decoction of hempseed. Four
ounces of the seed may be boiled in two English quarts of ale, and
sweetened with coarse sugar. The dose is half an English pint
every, morning. It may be continued for eight or nine days.
I have likewise known Harrowgate sulphur water cure a jaun-
dice of very long standing. It should be used for some weeks, and
the patient both drink and bathe.
The soluble tartar is a very proper medicine in the jaundice.
A drachm of it may be taken every night and morning in a cup of
tea or water-gruel. If it does not open the body, the dose may be 
increased. A very obstinate jaundice has been cured by swallow-
ing raw eggs.
Persons subject to the jaundice ought to take as much exercise
as possible, and to avoid all heating and astringent aliments.
CHAPTER XXXIX.
Of the Dropsy.
THE dropsy is a preternatural swelling of the whole body, or
some part of it, occasioned by a collection of watery humour.
It is distinguished by different names, according to the part affec-
ted, as the anasarca, or a collection of water under the skin; the
ascites, or a collection of water in the belly; the hydrops pectoris, or
dropsy of the breast; the hydrocephalus, or dropsy of the brain, &c. 

THE DROPSY. 267
CAUSES.————The dropsy is often owing to an hereditary dis-
position. It may proceed from drinking ardent spirits, or other
strong liquors. It is true almost to a proverb, that great drinkers
die of a dropsy. Hence it is justly reckoned among the diseases of
the sedentary. It often proceeds from excessive evacuations, as
frequent and copious bleedings, strong purges often repeated, fre-
quent salivations, &c. The sudden stoppage of customary or ne-
cessary evacuations, as the menses, the hæmorrhoids, fluxes of the
belly, &c. may likewise cause a dropsy.
I have known the dropsy occasioned by drinking large quantities
of cold, weak, watery liquor, when the body was heated by vio-
lent exercise. A low, damp, or marshy situation is likewise a fre-
quent cause of it. Hence it is a common disease in moist, flat, fen-
ny countries. It may also be brought on by a long use of poor
watery diet, or of viscous aliment that is hard of digestion. It is
often the effect of other diseases, as the jaundice, a schirrus of
the liver, a violent ague of long continuance, a diarrhœa, a dysen-
tery, an empyema, or a consumption of the lungs. In short, what-
ever obstructs the perspiration, or prevents the blood from being
duly prepared, may occasion a dropsy.
SYMPTOMS.————The anasarca generally begins with a swel-
ling of the feet and ancles towards night, which for some time dis-
appears in the morning. In the evening, the parts, if pressed with
the finger, will pit. The swelling gradually ascends, and occupies
the trunk of the body, the arms and the head. Afterwards the
breathing becomes difficult, the urine is in small quantity, and the
thirst great; the body i  bound, and the perspiration is greatly
obstructed. To these succeed torpor, heaviness, a slow wasting
fever, and a troublesome cough. This last is generally a fatal symp-
tom, as it shows that the lungs are affected.
In an ascites, besides the above symptoms, there is a swelling of
the belly, and often a fluctuation, which may be perceived by
striking the belly on one side, and laying the palm of the hand
on the opposite. This may be distinguished from a tympany by the
weight of the swelling, as well as by the fluctuation. When the
anasarca and ascites are combined, the case is very dangerous. Even
a simple ascites seldom admits of a radical cure. Almost all that
can be done is, to let off the water by tapping, which seldom af-
fords more than a temporary relief.
When the disease comes suddenly on, and the patient is young
and strong, there is reason however to hope for a cure, especially
if medicine be given early. But if the patient be old, has led an
irregular or a sedentary life, or if there be reason to suspect that
the liver, lungs, or any of the viscera are unsound, there is great,
ground to fear that the consequences will prove fatal.
REGIMENT.————The patient must abstain, as much as possible,
from all drink, especially weak and watery liquors, and must quench
his thirst with mustard-whey, or acids, as juice of lemons, oranges, 

268 THE DROPSY.
sorrel, or such like. His aliment ought to be dry, of a stimulat-
ing diuretic quality, as toasted bread, the flesh of birds, or other
wild animals roasted; pungent and aromatic vegetables, as gar-
lic, mustard, onions, cresses, horse-radish, rocambole, shalot, &c.
He may also eat sea-biscuit dipt in wine or a little brandy. This
is not only nourishing but tends to quench thirst. Some have
been actually cured of a dropsy by a total abstinence from all li-
quids, and living entirely upon such things as are mentioned above.
If the patient must have drink, the Spa-water, or Rhenish wine,
with diuretic medicines infused in it, are the best.
Exercise is of the greatest importance in a dropsy. If the pa-
tient be able to walk, dig, or the like, he ought to continue these
exercises as long as he can. If he is not able to walk or labour,
he must ride on horseback, or in a carriage, and the more violent
the motion, so much the better, provided he can bear it. His bed
ought to be hard, and the air of his apartments warm and dry.
If he lives in a damp country, he ought to be removed into a dry
one, and, if possible, into a warmer climate. In a word, every
method should be taken to promote the perspiration, and to brace
the solids. For this purpose it will likewise be proper to rub the
patient's body, two or three times a-day, with a hard cloth, or the
flesh-brush; and he ought constantly to wear flannel next his skin.
MEDICINE.————If the patient be young, his constitution
good, and the disease has come on suddenly, it may generally be
removed by strong vomits, brisk purges, and such medicines as
promote a discharge by sweat and urine. For an adult, half a
drachm of ipecacuanha in powder, and half an ounce of oxymel
of squills, will be a proper vomit. This may be repeated as often
as necessary, three or four days intervening between the doses.
The patient must not drink much after taking the vomit, other-  
wise he destroys its effect. A cup or two of camomile-tea will be
sufficient to work it off.
Between each vomit on one of the intermediate days, the pa-
tient may take the following purge: Jalap in powder, half a
drachm, cream of tartar, two drachms, calomel, six grains. These
may be made into a bolus with a little syrup of pale roses, and ta-
ken early in the morning. The less the patient drinks after it the
better. If he be much griped, he may take now and then a cup
of chicken-broth.
The patient may likewise take every night at bed-time the fol-
lowing bolus: To four or five grains of camphor add one grain
* Anasarca in young people has sometimes been cured by bleeding,
when the pulse has been full and strong; but in ascites, which most ge-
nerally comes on at an advanced period of life, when the constitution is
considerably impaired, frequently by an irregular mode of life, bleed-
ing appears to be improper, and even in ascites, when the patient
has been young, I have seen this evacuation used early with manifest
disadvantage. (I. C.) 

THE DROPSY. 269
of opium, and as much syrup of orange-peel as is sufficient to
make them into a bolus. This will generally promote a gentle
sweat, which should be encouraged by drinking now and then
a small cup of wine-whey, with a tea-spoonful of the spirits of
hartshorn in it. A tea-cupful of the following diuretic infusion
may likewise be taken every four or five hours through the day:
Take juniper berries, mustard-feed, and horse-radish, of each
half an ounce, ashes of broom half a pound; infuse them in a
quart of Rhenish wine or strong ale for a few days, and afterwards
strain off the liquor. Such as cannot take this infusion, may use
the decoction of seneka-root, which is both diuretic and sudorific.
I have known an obstinate anasarca cured by an infusion of the
ashes of broom in wine.
The above course will often cure an incidental dropsy, if the
constitution be good; but when the disease proceeds from a bad
habit, or an unsound state of the viscera, mercury should be used;
and at the same time the strength supported by warm and nou-
rishing cordials.
The secretion of urine may be greatly supported by nitre.
Brookes says, he knew a young woman who was cured of a drop-
sy by taking a drachm of nitre every morning in a draught of ale,
after she had been given over as incurable. The powder of squills
is likewise a good diuretic. Six or eight grains of it, with a scru-
ple of nitre, may be given twice a-day in a glass of strong cinna-
mon-water. Ball says, a large spoonful of unbruised mustard-seed
taken every night and morning, and drinking half an English pint
of the decoction of the tops of green broom after it, has perform-
ed a cure after other powerful medicines had proved ineffectual.
I have sometimes seen good effects from cream of tartar in this
disease. It promotes the discharges by stool and urine, and will at
least palliate, if it does not perform a cure. The patient may be-
gin by taking an ounce every second or third day, and may in-
crease the quantity to two or even to three ounces, if the stomach
will bear it. This quantity is not however to be taken at once,
but divided into three or four doses.
To promote perspiration, the patient may use the decoction of
seneka-root, as directed above; or he may take two table-spoon-
fuls of Mindererus's spirit in a cup of wine-whey three or four
times a-day. To promote a discharge of urine, the following infu-
sion of the London hospitals will likewise be beneficial: 
Take of zedoary-root two drachms; dried squills, rhubarb,
and juniper-berries bruised, of each a drachm; cinnamon in pow-
der, three drachms; salt of worm-wood, a drachm and a half;
infuse in an English pint and a half of old hock-wine, and when fit
for use, filter the liquor. A wine-glass of it may be taken three
or four times a-day.
In the anasarca it is usual to scarify the feet and legs. By this
means, the water is often discharged; but the operator must be 

270 THE GOUT.
cautious not to make the incisions too deep: they ought barely to
pierce through the skin, and especial care must be taken, by spi-
rituous fomentations and proper digestives, to prevent a gan-
grene.
In an ascites, when the disease does not evidently and speedily
give way to purgative and diuretic medicines, the water ought to
be let off by tapping. This is a very simple and safe operation,
and would often succeed if it were performed in due time, before
the system become too much debilitated.*
After the evacuation of the water, the patient is to be put on
a course of strengthening medicines; as the bark; the elixir of
vitriol; warm aromatics, with a due proportion of rhubarb, in-
fused in wine, and such like. His diet ought to be dry and nou-
rishing, such as is recommended in the beginning of the chapter;
and he should take as much exercise as he can bear without fa-
tigue. He should wear flannel next his skin, and daily use the
flesh-brush.
CHAPTER XL.
Of the Gout.
NO disease shows the imperfection of medicine, or sets the ad-
vantages of temperance and exercise in a stronger light,
than the gout. Excess and idleness are the true sources from
whence it originally sprung, and all who would avoid it must be
active and temperate.
Though idleness and intemperance are the principal causes of
the gout, yet many other things may contribute to bring on the
disorder in those who are not, and to induce a paroxysm in those
who are subject to it; as intense study; too free an use of acidu-
lated liquors; night-watching; grief or uneasiness of mind; an
obstruction or defect of any of the customary discharges, as the
menses, sweating of the feet, perspiration, &c.
SYMPTOMS.————A fit is generally preceded by indigestion,
drowsiness, belching of wind, a slight head-ach, sickness, and
sometimes vomiting. The patient complains of weariness and
dejection of spirits, and has often a pain in the limbs, with a sen-
sation as if wind or cold water were passing down the thigh. The
* The very name of an operation is dreadful to most people, and
they wish to try every thing before they have recourse to it. This is the
reason why tapping so seldom succeeds to our wish. I have had a patient
who was regularly tapped once a month for several years, and who used
to eat her dinner as well after the operation, as if nothing had happen-
ed. She died at last rather worn out by age than by the disease.

THE GOUT. 271
appetite is often remarkably keen a day or two before the fit, and
there is a slight pain in passing urine, and sometimes an involun-
tary shedding of tears. Sometimes these symptoms are much more
violent, especially upon the near approach of a fit; and some ob-
serve, that as is the fever which ushers in the gout, so will the fit
be; if the fever be short and sharp, the fit will be so likewise, if
it be feeble, long, and lingering, the fit will be such also. But
this observation can only hold  with respect to very regular fits of
the gout.
The regular gout generally makes its attack in the spring, or be-
ginning of winter, in the following manner: About two or three
in the morning, the patient is seized with a pain in his great toe,
sometimes the heel, and at other times in the ancle or calf of the
leg. This pain is accompanied with a sensation as if cold water
were poured upon the part, which is succeeded by a shivering,
with some degree of fever. Afterwards the pain increases, and
fixing among the small bones of the foot, the patient feels all the
different kinds of torture, as if the part were stretched, burnt,
squeezed, gnawed, or torn in pieces, &c. The part at length be-
comes so exquisitely sensible, that the patient cannot bear to have
it touched, or even suffer any person to walk across the room.
The patient is generally in exquisite torture for twenty-four
hours, from the time of the coming one of the fit: he then becomes
easier, the part begins to swell, appears red, and is covered with
a little moisture. Towards morning he drops asleep, and generally
falls into a gentle breathing sweat. This terminates the first pa-
roxysm, a number of which constitutes a fit of the gout; which
is longer or shorter according to the patient's age, strength, the
season of the year, and the disposition of the body to this disease.
The patient is always worse towards night, and easier in the
morning. The paroxysms generally grow milder every day, till at
length the disease is carried off by perspiration, urine, and the
other evacuations. In some patients, a few days; in others, weeks,
and in some, months are required to finish the fit. Those whom
age and frequent fits of the gout have greatly debilitated, seldom
get free from it before the approach of summer, and sometimes
not till it be pretty far advanced.
REGIMEN.————No medicines yet known will cure the gout;
we shall confine our observations chiefly to regimen, both in and
out of the fit.
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, and should take frequently a
cup of strong negus, or a glass of generous wine. Wine-whey is
a very proper drink in this case, as it promotes the perspiration
without greatly heating the patient. It will answer this purpose 

272 THE GOUT.
better, if a tea-spoonful of sal volatile oleosum, or spirits of harts-
horn, be put into a cup of it twice a-day. It will likewise be pro-
per, to give at bed-time, a tea-spoonful of the volatile tincture of
guaiacum in a large draught of warm wine-whey. This will great-
ly promote perspiration through the night.
As the most safe and efficacious method of discharging the gou-
ty matter is by perspiration, this ought to be kept up by all means,
especially in the affected part. For this purpose, the leg and foot
should be wrapt in flannel, fur, or wool. The last seems to answer
the purpose better than any thing else. The people of Lancashire
look upon wool as a  kind of specific in the gout. They wrap a
great quantity of it about the  leg and foot affected, and cover it
with a skin of soft dressed leather. This they suffer to continue
for eight or ten days, and sometimes for a fortnight or three
weeks, or longer, if the pain does not cease. I never knew any ex-
ternal application answer so well in the gout. I have often seen
it applied when the swelling and inflammation were very great,
with violent pain, and have found all these symptoms relieved by
it in a few days. The wool is generally greased, and carded or
combed. They choose the softest which can be had, and seldom
or never remove it till the fit be entirely gone off.
The patient ought to be kept quiet and easy during the fit. Eve-
ry thing that affects the mind disturbs the paroxysm, and tends to
throw the gout upon the nobler parts. All external applications
that repel the matter are to be avoided as death. They do not cure
the disease, but remove it from a safer to a more dangerous part
of the body, where it often proves fatal. A fit of the gout is Na-
ture's method of removing something that might prove distruc-
tive to the body, and all that we can do, with safety, is to promote
her intentions, and assist her in expelling the enemy in her own
way. Evacuations by bleeding, stool, &c. are likewise to be used
with caution; they do not remove the cause of the disease, and
sometimes by weakening the patient, prolong the fit: but, where
the constitution is able to bear it, it will be of use to keep the bo-
dy gently open by diet, or even mild laxative medicines.
Many things will indeed shorten a fit of the gout, and some
will drive it off altogether; but nothing has yet been found which
will do this with safety to the patient. In pain, we eagerly grasp
at any thing that promises immediate ease, and even hazard life
itself for a temporary relief. This is the true reason why so many
infallible remedies have been proposed for the gout, and why
such numbers have lost their lives by the use of them. It would be
as prudent to stop the small-pox from rising, and to drive them in-
to the blood, as to attempt to repel the gouty matter after it has
been thrown upon the extremities. The latter is as much an ef-
fort of Nature to free herself from an offending cause as the for-
mer, and ought equally to be promoted.
When the pain is very great, and the patient restless, thirty or

THE GOUT. 273
forty drops of laudanum, more or less, according to the violence of
the symptoms, may be taken at bed-time. This will ease the pain,
procure rest, promote perspiration, and forward the crises of the
disease.
After the fit is over, the patient ought to take a gentle dose or
two of the bitter tincture of rhubarb, or some other warm sto-
machic purge. He should also drink a weak infusion of stomachic
bitters in small wine or ale, as the bark with cinnamon, Virginian
snake-root, and orange-peel. The diet at this time should be
light, but nourishing, and gentle exercise ought to be taken on
horseback, or in a carriage.
Out of the fit, it is in the patient's power to do many things
towards preventing a return of the disorder, or rendering the
fit, if it should return, less severe. This, however, is not to
be attempted by medicine. I have frequently known the gout
kept off for several years by the bark and other astringent medi-
cines; but, in all the cases, where I had occasion to see this tried,
the persons died suddenly, and, to all appearance, for want of a re-
gular fit of the gout, which, to some constitutions, in the decline
of life, is rather salutary than hurtful.
Though it may be dangerous to stop a fit of the gout by me-
dicine, yet if the constitution can be so changed by diet and ex-
ercise, as to lessen or totally prevent its return, there certainly can
be no danger in following such a course. The whole habit may
be 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, sufficient exercise*.  By this we do not mean sauntering
about in an indolent manner, but labour, sweat, and toil. These
only can render the humours wholesome, and keep them so. Go-
ing early to bed, and rising betimes, are also of great importance.
It is likewise proper to avoid night-studies, and all intense thought.
The supper should be light, and taken early. All strong liquors,
especially generous wines and sour punch, are to be avoided.
We would likewise recommend some doses of magnesia alba and
rhubarb to be taken every spring and autumn; and afterwards a
course of stomachic bitters, as tansey or water-trefoil tea, an in-
fusion of gentian and camomile flowers, or a decoction of burdock
root, &c. Any of these, or an infusion of any wholesome bitter
that is more agreeable to the patient, may be drank for two or
three weeks in March and October twice a-day. An issue or per-
petual blister has a great tendency to prevent the gout. If these
* Some make a secret of curing the gout by muscular exercise. This
secret, however, is as old as Celsius, who strongly recommends that
mode of cure; and whoever will submit to it, in the fullest extent, may
expect to reap solid and permanent advantages.
M2 

274 THE GOUT.
were more generally used in the decline of life, they would not
only often prevent the gout, but also other chronic maladies. Such
as can afford to go to Bath, will find great benefit, from bathing
and drinking the water. It both promotes digestion, and invigo-
rates the habit.
Though there is little room for medicine during a regular fit of
the gout, yet when it leaves the extremities, and falls on some of
the internal parts, proper applications to recall and fix it become
absolutely necessary. When the gout affects the head, the pain of
the joints ceases, and the swelling disappears, while either severe   
head-ach drowsiness, trembling, giddiness, convulsions, or deli-
rium come on. When it seizes the lungs, great oppression, with
cough and difficulty of breathing, ensue. If it attacks the stomach,
extreme sickness, vomiting, anxiety, pain in the epigastric region,
and total loss of strength will succeed.
When the gout attacks the head or lungs, every method must
be taken to fix it in the feet. They must be frequently bathed in
warm water, and acrid cataplasms applied to the soles. Blisters
ought likewise to be applied to the ancles or calves of the legs.
Bleeding in the feet or ancles is also necessary, and warm stoma-
chic purges. The patient ought to keep in bed for the most part,
if there be any signs of inflammation, and should be very careful
not to catch cold.
If it attacks the stomach with a sense of cold, the most warm
cordials are necessary; as strong wine boiled up with cinnamon
or other spices; cinnamon water; peppermint-water; and even
brandy or rum. The patient should keep his bed, and endeavour
to promote a sweat by drinking warm liquors; and if he should
be troubled with a nausea, or inclination to vomit, he may drink
camomile tea, or any thing that will make him vomit freely.
When the gout attacks the kidneys, and imitates gravel-pains,  
the patient ought to drink freely of a decoction of marsh-mallows,
and to have the parts fomented with warm water. An emollient
clyster ought likewise to be given, and afterwards an opiate. If
the pain be very violent, twenty or thirty drops of laudanum may
be taken in a cup of the decoction.
Persons who have had the gout should be very attentive to any
complaints that may happen to them about the time when they
have reason to expect a return of the fit. The gout imitates many
other disorders, and by being mistaken for them, and treated im-
properly, is often diverted from its regular course, to the great
danger of life.
Those who never had the gout, but who, from their constitution
or manner of living, have reason to expect it, ought to be very
circumspect with regard to its first approach. If the disease, by
wrong conduct or improper medicines, be diverted from its pro-
per course, the patient has a chance to be ever after tormented 

THE RHEUMATISM. 275
with head-achs, coughs, pains of the stomach and intestines; and
to fall at last a victim to its attack upon some of the more noble
parts.
Of the Rheumatism.
THIS disease has often a resemblance to the gout. It generally
attacks the joints with exquisite pain, and is sometimes attended
with inflammation and swelling. It is most common in the spring,
and towards the end of autumn. It is usually distinguished into
acute and chronic; or the rheumatism with and without a fever.
CAUSES.————The causes of a rheumatism are frequently the
same as those of an inflammatory fever, viz. an obstructed perspi-
ration, the immoderate use of strong liquors, and the like. Sud-
den changes of the weather, and all quick transitions from heat to
cold, are very apt to occasion the rheumatism. The most extraor-
dinary case of a rheumatism that I ever saw, 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 rheumatisms have likewise been brought on by per-
sons not accustomed to it, allowing their feet to continue long wet.
The same effects are produced by wet clothes, damp beds, sitting
or lying on the damp ground, travelling in the night, by excessive
evacuations, or the stoppage of customary discharges. It is often
the effect of chronic diseases, as the scurvy, the lues venerea, obsti-
nate autumnal agues, &c.
The rheumatism prevails in cold, damp, marshy countries. It
is most common among the poorer sort of peasants, who are ill
clothed, live in low damp houses, and eat coarse unwholesome
food, which contains but little nourishment, and is not easily di-
gested.
SYMPTOMS.————The acute rheumatism commonly begins
with weariness, shivering, a quick pulse, restlessness, thirst, and
other symptoms of fever. Afterwards the patient complains of
flying pains, which increase by the least motion. These at length
fix in the joints, which are often affected with swelling and in-
flammation. If blood be let in this disease, it has generally the
same appearance as in the pleurisy.
In this kind of rheumatism, the treatment of the patient is near-
ly the same as in an acute or inflammatory fever. If he be young
and strong, bleeding is necessary, which may be repeated accord-
ing to the exigencies of the case. The body ought to be kept open
by emollient clysters, or cool opening liquors; as decoctions of
tamarinds, cream of tartar whey, senna tea, and the like. The di-
et should be light, and in small quantity, consisting chiefly of 

276 THE RHEUMATISM.
roasted apples, groat-gruel, or weak chicken broth. After the fe-
verish symptoms have abated, if the pain still continues, the patient
must keep his bed, and take such things as promote perspiration;
as wine-whey, with spiritus Mindereri, &c. He may likewise take,
for a few nights, at bed-time, in a cup of wine-whey, a drachm
of the cream of tartar, and half a drachm of gum guaiacum in
powder.
Warm bathing, after proper evacuations, has often an exceed-
ing good effect. The patient may either be put into a bath of
warm water, or have cloths wrung out of it applied to the parts
affected. Great care must be taken that he do not catch cold after
bathing.
The chronic rheumatism is seldom attended with any consider-
able degree of fever, and is generally confined to some particular
part of the body, as the shoulders, the back, or the loins. There
is seldom any inflammation or swelling in this case. Persons in the
decline of life are most subject to the chronic rheumatism. In
such patients, it often proves extremely obstinate, and sometimes
incurable.
In this kind of rheumatism the regimen should be nearly the
same as in the acute. Cool and diluting diet, as stewed prunes,
coddled apples, currants or gooseberries boiled in milk, is most
proper. Arbuthnot says, "If there be a specific in aliment for the
rheumatism, it is certainly whey;" and adds, "that he knew a
person subject to this disease, who could never be cured by any
other method but a diet of whey and bread." He says, "that
cream of tartar in water-gruel, taken for several days, will ease
rheumatic pains considerably." This I have often experienced,
but found it always more efficacious when joined with gum guai-
acum, as already directed. In this case, the patient may take the
dose formerly mentioned twice-a-day, and likewise a tea-spoonful
of the volatile tincture of gum guaiacum, at bedtime, in wine-
whey.
This course may be continued for a week, or longer, if the case
proves obstinate, and the patient's strength will permit. It ought
then to be omitted for a few days, and repeated again. At the
same time leeches or a blister may be applied to the part affected.
What I have generally found answer better than either of these,
in obstinate fixed rheumatic pains, is the warm plaister*. I have
likewise known a plaister of Burgundy pitch worn for some time
on the part affected, give great relief in rheumatic pains. Dr. Alex-
ander, of Edinburgh, says he has frequently cured very obstinate
rheumatic pains, by rubbing the part affected with tincture of can-
tharides. When the common tincture did not succeed, he used
it of a double or treble strength. Cupping upon the part affected
* See appendix, Warm Plaister. 

THE RHEUMATISM. 277
is often very beneficial, and is greatly preferable to the application
of leeches.
Though this disease may not seem to yield to medicines for some
time, yet they ought still to be persisted in. Persons subject to fre-
quent returns of rheumatism, will often find their account in
using medicines, whether they be immediately affected with the
disease or not. The chronic rheumatism is similar to the gout in
this respect, that the most proper time for using medicines to ex-
tirpate it, is when the patient is most free from the disorder.
To those who can afford the expense, I recommend the warm
baths of Buxton or Matlock in Derbyshire. These have often, to
my knowledge, cured very obstinate rheumatisms, and are always
safe either in or out of the fit. When the rheumatism is compli-
cated with scorbutic complaints, which is not seldom the case,
the Harrowgate waters, and those of Moffat, are proper. They
should both be drank and used as a warm bath.
Several of our own domestic plants may be used with advan-
tage in the rheumatism. One of the best is white mustard. A table-
spoonful of the seed of this plant may be taken twice or thrice
a-day, in a glass of water or small wine. The water-trefoil is like-
wise of great use in this complaint. It may be infused in wine or
ale, or drank in form of tea. The ground-ivy, camomile, and seve-
ral other bitters are beneficial, and may be used in the same way.
No benefit is to be expected from these, unless they be taken for
a considerable time. Excellent medicines are often despised in this
disease, because they do not perform an immediate cure; whereas,
nothing would be more certain than their effect, were they duly
persisted in. Want of perseverance in the use of medicines is one
reason why chronic diseases are so seldom cured.
Cold bathing, especially in salt water, often cures, the rheuma-
tism. We also recommend riding on horseback, and wearing flan-
nel next the skin. Issues are very proper, especially in chronic
cases. If the pain affects the shoulders, an issue may be made in
the arm; but if it affects the loins, it should be put in the leg
or thigh.
Persons afflicted with the scurvy are very subject to rheumatic
complaints. The best medicines in this case are bitters and mild
purgatives. These may either be taken separately or together, as
the patient inclines. An ounce of bark, and half an ounce of rhu-
barb in powder, may be infused in a bottle of wine; and one,
two, or three wine glasses of it taken daily, as shall be found neces-
sary for keeping the body gently open. In cases where the bark
itself proves sufficiently purgative, the rhubarb may be omitted.
Such as are subject to frequent attacks of the rheumatism ought
to make choise of a dry, warm situation, to avoid the night-air,
wet clothes, and wet feet, as much as possible. Their clothing
should be warm; they should wear flannel next their skin, and
make frequent use of the flesh-brush. 

278
CHAPTER XLI.
The Scurvy
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 dis-
position, are most subject to it. It proves often fatal to sailors on
long voyages particularly in ships that are not properly ventila-
ted, have many people on board, or where cleanliness is neglec-
ted.
It is not necessary to mention the different species into which
this disease has been divided, as they differ from one another chief-
ly in degree. What is called the land scurvy, however, is seldom
attended with those highly putrid symptoms which appear in pa-
tients who have been long at sea and which, we presume are
rather owing to confined air want of exercise, scarcity of water,
and the unwholesome 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 long 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 customary evacuations; as the
menses, the hæmorrhoidal flux, &c. It is sometimes owing to a
hereditary taint, in which case, a very small cause will excite the
latent disorder. Grief, fear, and other depressing passions, have a
great tendency both to excite and aggravate this disease. The same
observation holds with regard to neglect of cleanliness; bad cloth-
ing; the want of proper exercise; confined air; unwholesome
food; or any disease which greatly weakens the body.
SYMPTOMS.————This disease may be known by unusual wea-
riness, heaviness, and difficulty of breathing, especially after mo-
tion; rottenness of the gums, which are apt to bleed on the slight-
est touch; a stinking breath; frequent bleeding at the nose;
crackling of the joints; difficulty of walking; sometimes a swel-
ling, 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 rottenness of the teeth, hæmorrhages, or dischar-
ges of blood from different parts of the body, foul obstinate ulcers,
pains in various parts, especially about the breast, dry, scaly erup-
tions all over the body, &c. At last, a wasting or hectic fever
comes on, and the patient is often carried off by a dysentery, a
diarrhœa, a dropsy the palsy, fainting fits, or a mortification of
some of the bowels.
CURE.————-We know no way of curing this disease but by 

THE SCURVY. 279
pursuing a plan directly opposite to that which brings it on. It is
occasioned by errors in diet, air, or exercise; and this cannot be
removed but by a proper attention to these important articles.
If the patient has been obliged to breathe a cold, damp, or con-
fined 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. he must take, daily, as much exercise in the open
air as he can bear, and his mind should be diverted by cheerful
company and other amusements. Nothing has a greater tendency
either to prevent or remove this disease, than constant cheerful-
ness and good humour. But persons afflicted with the scurvy, are
generally surly, peevish, and morose.
When the scurvy comes on by a long use of salted provisions,
the proper medicine is a diet consisting chiefly of fresh vegetables;
as oranges, apples, lemons, limes, tamarinds, water-crisses, scurvy-
grass, brook-lime, &c. The use of these, with milk, pot-herbs,
new-bread, and fresh beer or cyder, will seldom fail to remove a
scurvy of this kind, if taken before it be too far advanced; but to
have this effect they must be persisted in for a considerable time.
When fresh vegetables cannot be obtained, pickled or preserved
ones may be used; and where these are wanting, recourse must
be had to the chemical acids. All the patient's food and drink,
should, in this case, be sharpened with cream of tartar, elixir of
vitriol, vinegar, or the spirit of sea-salt.
These things, however, will more certainly prevent than cure
the scurvy; for which reason, sea-faring people, especially on long
voyages, ought to lay in plenty of them. Cabbages, onions, goose-
berries, and many other vegetables, may be kept a long time by
pickling, preserving, &c. and when these fail, the chemical acids,
recommended above, which will keep for any length of time, may
be used. We have reason to believe, if ships were well ventilated,
had good store of fruits, greens, cyder, &c. laid in, and if proper
regard were 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 malignant fevers, which are so fatal to
that useful set of men; but it is too much their temper 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.
It must indeed be owned, that many of them have it not in
their power to make the provision we are speaking of; but in this
case it is the duty of their employers to make it for them; and no
man ought to engage in a long voyage without having these articles
secured.
I have often seen very extraordinary effects in the land-scurvy
from a milk diet. This preparation of nature, a mixture of ani-
mal and vegetable properties, is the most fit for restoring a decay-
ed constitution. But people despise this wholesome and nourishing 

280 THE SCURVY.
food, because it is cheap, and devour with greediness, flesh, and
fermented liquors, while milk is only deemed fit for hogs.
The most proper drink in the scurvy is whey or butter-milk.
When these cannot be had, sound cyder, perry, porter or spruce-
beer, may be used. Wort has been found a proper drink in the
scurvy, and may be used at sea, as malt will keep during the longest
voyage. A decoction of the tops of the spruce fir is likewise pro-
per. It may be drank in the quantity of an English pint twice a-
day. Tar-water may be used for the same purpose, or decoctions
of any of the mild mucilaginous vegetables; as sarsaparilla, marsh-
mallow roots, &c. Infusions of the bitter plants, as ground-ivy,
the lesser centaury, marsh-trefoil, &c are beneficial. The peasants
in some parts of Britain, express the juice of the last-mentioned
plant, and drink it with good effect in those foul, scorbutic erup-
tions with which they are often troubled in the spring season.
Harrowgate-water is certainly an excellent medicine in the
land-scurvy. I have often seen patients who had been reduced to
the most deplorable condition by this disease, greatly relieved by
drinking the sulphur-water, and  bathing in it. The chalybeate-
water may also be used with advantage, especially with a view to
brace the stomach after drinking the sulphur-water, which, though
it sharpens the appetite, never fails to weaken the powers of
digestion.
A slight degree of scurvy may be carried off by frequently suck-
ing a little of the juice of a bitter orange, or a lemon. When the
disease affects the gums only, this practice, if continued for some
time, will generally carry it off. We recommend the bitter orange
as greatly preferable to lemon; it seems to be as good a medicine,
and is not near so hurtful to the stomach. Perhaps our own sorrel   
may be little inferior to either of them.
All kinds of sallad are good in the scurvy, and ought to be eaten
very plentifully, as spinage, lettuce, parsley, celery, endive, rad-
ish, dandelion, &c. It is amazing to see how soon fresh vegeta-
bles: in the spring cure the brute animals of any scab or foulness
which is upon their skins. It is reasonable to suppose that their
effects would be as great upon the human species, were they used
in proper quantity for a sufficient length of time.
I have sometimes seen good effects in scorbutic complaints of
very long standing, from the use of a decoction of the roots of wa-
ter-dock. It is usually made by boiling a pound of the fresh root
in six English pints of water, till about one-third of it be consum-
ed. The dose is from half a pint to a whole pint of the decoction
every day. But in all the cases where I have seen it prove benefi-
cial, it was made much stronger, and drank in larger quantities.
The safest way is, for the patient to begin with small doses, and
increase them both in strength and quantity as he finds his sto-
mach will bear it. It must be used for a considerable time. I have
known some take it for many months, and have been told of others 

THE SCROPHULA, OR KING'S EVIL. 281
who had used it for several years, before they were sensible of any
benefit, but who nevertheless were cured by it at length.
The leprosy, which was so common in this country long ago,
seems to have been near a-kin to the scurvy. Perhaps its appear-
ing so seldom now, may be owing to the inhabitants of Britain eat-
ing more vegetable food than formerly, living more upon tea, and
other diluting diet, using less salted meat, being more cleanly, bet-
ter lodged and clothed, &c.—-For the cure of this disease, we re-
commend the same course of diet and medicine as in the scurvy.
The Scrophula, or King's Evil
CHIEFLY affects the glands, especially those of the neck. Chil-
dren, and young persons of a sedentary life, are very subject
to it. It is one of those diseases which may be removed by proper
regimen, but seldom yields to medicine. The inhabitants of cold,
damp, marshy countries are most liable to the scrophula.
CAUSES.————This disease may proceed from a hereditary
taint, from a scrophulous nurse, &c. Children who have the mis-
fortune to be born of sickly parents, whose constitutions have been
greatly injured by the pox, or other chronic diseases, are apt to be
affected with it. It may proceed from such diseases as weaken the
habit, as the small-pox, measles, &c. External injuries, as blows,
bruises, and the like, sometimes produce scrophulous ulcers; but
we believe, when this happens, that there has been a predisposi-
tion in the habit to this disease. In short, whatever tends to relax
the solids, paves the way to the scrophula; as the want of proper
exercise, too much heat or cold, confined air, unwholesome food,
bad water, the long use of poor, weak, watery aliments, the ne-
glect of cleanliness, &c. Nothing tends more to induce this dis-
ease in children, than allowing them to continue long wet*.
SYMPTOMS.————At first, small knots appear under the chin
or behind the  ears, which gradually increase in number and size,
till they form one large hard tumour. This often continues for a
long time without breaking, and when it does break, it only dis-
charges a thin sanies, or watery humour. Other parts of the body
are  likewise liable to its attack, as the arm-pits, groins, feet,
hands, eyes, breasts, &c. Nor are the internal parts exempt from
it. It often affects the lungs, liver, or spleen; and frequently the
glands of the mysentery are greatly enlarged by it.
Those obstinate ulcers which break out upon the feet and hands
with swelling, and little or no redness, are of the scrophulous kind.
They seldom discharge good matter, and are exceedingly difficult
* The scrophula, as well as the rickets, prevails in large manufac-
turing towns, where people live gross, and lead sedentary lives.
N2

282 THE SCROPHULA, OR KING'S EVIL.
to cure. The white swelling of the joints seems to be of this kind.
They are with difficulty brought to a suppuration, and when open-
ed, they only discharge a thin ichor. There is not a more general
symptom of the scrophula than a swelling of the upper lip and
nose.
REGIMEN.————As this disease proceeds, in a great measure,
from relaxation, the diet ought to be generous and nourishing, but
at the same time, light and of easy digestion; as well fermented
bread, made of sound grain, the flesh and broth of young animals,
with a glass of generous wine, or good ale. The air ought to be
open, dry, and not too cold, and the patient should take as much
exercise as he can bear. This is of the utmost importance. Chil-
dren who have sufficient exercise are seldom troubled with the
scrophula.
MEDICINE.————The vulgar are remarkably credulous with
regard to the cure of the scrophula; many of them believing in
the virtue of the royal touch, that of the seventh son, &c.  We
know but little of the nature or cure of this disease, and where
reason or medicines fail, superstition always comes in their place.
Hence, in diseases which are the most difficult to understand, we
generally hear of the greatest number of miraculous cures being
performed. Here, however, the deception is easily accounted for.
The scrophula, at a certain period of life, often cures of itself;
and, if the patient happens to be touched about this time, the
cure is imputed to the touch, and not to Nature. In the same way,
the insignificant nostrums of quacks and old women often gain ap-
plause when they deserve none.
Nothing is more pernicious than the custom of plying children
in the scrophula with strong purgative medicines. People imagine
it proceeds from humours which must be purged off, without con-
sidering that these purgatives increase the debility and aggravate
the disease. It has indeed been found, that keeping the body gen-
tly open for some time, especially with sea-water, has a good ef-
fect; but this should only be given in gross habits, and in such
quantity, as to procure one, or at most, two stools every day.
Bathing in the salt water has likewise a very good effect; espe-
cially in the warm season. I have often known a course of bathing
in salt water, and drinking it in such quantities as to keep the bo-
dy gently open, cure a scrophula, after many other medicines had
been tried in vain. When salt water cannot be obtained, the pa-
tient may be bathed in fresh water, and his body kept open by
small quantities of salt and water, or some other mild purgative.
Next to cold bathing, and drinking the salt water, we recom-
mend the bark. The cold bath may be used in summer, and the
bark in winter. To an adult, half a drachm of the bark in powder
may be given in a glass of red wine four or five times a-day. Chil-
dren, and such as cannot take it in substance, may use the decoc-
tion made in the following manner.

THE ITCH. 283
Boil an ounce of Peruvian bark and a drachm of Winter's bark;
both grossly powdered, in an English quart of water to a pint:
towards the end, half an ounce of sliced liquorice-root, and a hand-
ful of raisins may be added, which will both render the decoction
less disagreeable, and make it take up more of the bark. The li-
quor must be strained, and two, three, or four table-spoonfuls, ac-
cording to the age of the patient, given three times a-day.
The Moffat and Harrowgate waters, especially the latter, are
likewise very proper medicines in the scrophula. They ought not
to be drank in large quantities, but so as to keep the body gently
open, and must be used for a considerable time.
Hemlock may sometimes be used with advantage in the scrophu-
la. Some lay it down as a general rule, that the sea-water is most
proper before there are any suppuration or symptoms of tabes; the
Peruvian bark, when there are running sores, and a degree of hec-
tic fever; and the hemlock in old inveterate cases, approaching
to the schirrous or cancerous state. Either the extract or the fresh
juice of this plant may be used. The dose must be small at first,
and increased gradually as far as the stomach can bear it.
External applications are of little use. Before the tumour breaks,
nothing ought to be applied to it, unless a piece of flannel or some-
thing to keep it warm. After it breaks, the sore may be dressed
with some digestive ointment. As the yellow basilicon mixed with
about a sixth or eighth part of its weight of red precipitate of mer-
cury. The sore may be dressed with this twice a-day; and if it be
very fungous, and does not digest well, a larger proportion of the
precipitate may be added.
Medicines which mitigate this disease, though they do not cure
it, are not to be despised. If the patient can be kept alive by any
means till he arrives at the age of puberty, he has a great chance
to get well; but if he does not recover at this time, in all probabi-
lity, he never will.
There is no malady which parents are so apt to communicate
to their offspring as the scrophula, for which reason, people ought
to beware of marrying into families affected with this disease.
For the means of preventing the scrophula, we must refer the
reader to the observations on nursing at the beginning of the
book.
The Itch
IS commonly communicated by infection, yet it seldom pre-
vails where due regard is paid to cleanliness, fresh air, and
wholesome diet. It generally appears in form of small watery pus-
tules, first about the wrists, or between the fingers; afterwards 

284 THE ITCH.
it affects the arms, legs, thighs, &c. These pustules are attended
with an intolerable itching, especially when the patient is warm a-
bed, or sits by the fire. Sometimes, indeed, the skin is covered with
large blotches or scabs, and at other times with a white scurf, or
scaly eruption. This last is called the dry itch, and is the most dif-
ficult to cure.
The itch is seldom, a dangerous disease, unless when rendered
so by neglect, or improper treatment. If suffered to continue too
long, it may vitiate the whole mass of blood, and, if suddenly
drove in, without proper evacuations, it may occasion fevers, in-
flammations of the viscera, or other internal disorders.
The best medicine for the itch is sulphur, used both externally
and internally. The parts most affected may be rubbed with an
ointment made of the flowers of sulphur, two ounces; crude sal
ammoniac finely powdered, two drachms; hog's lard, or butter,
four ounces. If a scruple or half a drachm of the essence of lemon
be added, it will entirely take away the disagreeable smell.
About the bulk of a nutmeg of this may be rubbed upon the ex-
tremities at bed time twice or thrice a-week. It is seldom neces-
sary to rub the whole body; but when it is, it ought not to be
done all at once, but by turns, as it is dangerous to stop too ma-
ny pores at the same time.
Before the patient begins to use the ointment, he ought, if he
be of a full habit, to bleed or take a purge or two. It will likewise
be proper, during the use of it, to take every night and morning
as much of the flour of brimstone and cream of tartar, in a little
treacle or new milk, as will keep the body gently open. He should
beware of catching cold, should wear more clothes than usual, and
take every thing warm. The same clothes, the linen excepted,
ought to be worn all the time of using the ointment; and such
clothes as have been worn while the patient was under the disease,
are not to be used again, unless they have been fumigated with
brimstone, and thoroughly cleaned; otherwise, they will commu-
nicate the infection anew*.
I never knew brimstone, when used as directed above, fail to
cure the itch; and I believe that if duly persisted in, it never will
fail; but if it be only used once or twice, and cleanliness neglec-
ted, it is no wonder if the disorder returns. The quantity of oint-
ment, mentioned above, will generally be sufficient for the cure of
one person; but if any symptoms of the disease should appear a-
gain, the medicine may be repeated. It is both more safe and effi-
* Sir John Pringle observes, that though this disease may seem trifling,
there is no one in the army that is more troublesome to cure, as the in-
fection often lurks in clothes, &c. and breaks out a second or even a
third time. The same inconveniency occurs in private families, unless
particular regard is paid to the changing or cleaning of their clothes,
which last is by no means an easy operation. 

THE ITCH. 285
cacious when persisted in for a considerable time, than when a
large quantity is applied at once. As most people dislike the smell
of sulphur, they may use in its place the powder of white hellebore
root made up into an ointment, in the same manner, which will
seldom fail to cure the itch.
People ought to be extremely cautious left they take other erup-
tions for the itch; as the stoppage of these may be attended with
fatal consequences. Many of the eruptive disorders to which chil-
dren are liable, have a near resemblance to this disease; and I
have often known infants killed by being rubbed with greasy oint-
ments that made these eruptions strike suddenly in, which Nature
had thrown out to preserve the patient's life, or prevent some other
malady.
Much mischief is likewise done by the use of mercury in this
disease. Some persons wash the parts affected with a strong solu-
tion of the corrosive sublimate. Others use the mercurial ointment,
without taking the least care either to avoid cold, keep the body
open, or observe a proper regimen. The consequences may be ea-
sily guessed. Mercurial girdles have produced bad effects, and I
would advice every person, as he values his health, to beware how
he uses them. Mercury ought never to be used as a medicine
without the greatest care. Ignorant people look upon these gir-
dles as a kind of charm, without considering that the mercury en-
ters the body.
It is not to be told what mischief is done by using mercurial
ointment for curing the itch and killing vermin; yet it is unne-
cessary for either: the former may be always more certainly cured
by sulphur, and the latter will never be found where due regard
is paid to cleanliness.
Those who wish to avoid this detestable disease, ought to beware
of infected persons, to use wholesome food, and to study universal
cleanliness*. 
* The itch is now by cleanliness banished from genteel family
in Britain. It still prevails among the poorer sort of peasants in Scot-
land, and among the manufacturers in England. These are not only suf-
ficient to keep the seeds of the disease alive, but to spread the infection
among others. It were to be wished, that some effectual method could
be devised for extirpating it altogether. Several country clergymen
have told me, that by getting such as were infected cured, and strongly
recommending an attention to cleanliness, they have banished the itch
entirely out of their parishes. Why might not others do the same?

286
CHAPTER XLII.
The Asthma
IS a disease of the lungs, which seldom admits of a cure. Per-
sons in the decline of life are most liable to it. It is distinguish-
ed into the moist and dry, or humoural and nervous. The for-
mer is attended with expectoration or spitting; but in the latter,
the patient seldom spits, unless sometimes a little tough phlegm
by the mere force of coughing.
CAUSES.————The asthma is sometimes hereditary. It may
likewise proceed from a bad formation of the breast; the fumes
of metals or minerals taken into the lungs; violent exercise, es-
pecially running; the obstruction of customary evacuations, as
the menses, hæmorrhoids, &c. the sudden retrocession of the gout,
or striking in of eruptions, as the small-pox, measles, &c. vi-
olent passions of the mind, as sudden fear or surprise. In a word,
the disease may proceed from any cause that either impedes the
circulation of the blood through the lungs, or prevents their being
duly expanded by the air.
SYMPTOMS.————An asthma is known by a quick laborious
breathing, which is generally performed with a kind of wheezing
noise. Sometimes the difficulty of breathing is so great, that the
patient is obliged to keep in an erect posture, otherwise he is in
danger of being suffocated. A fit or paroxysm of the asthma ge-
nerally happens after a person has been exposed to cold easterly
winds, or has been abroad in thick foggy weather, or has got wet,
or continued long in a damp place under ground, or has taken
some food which the stomach could not digest, as pastries, toast-
ed cheese, or the like.
The paroxysm is commonly ushered in with listlessness, want
of sleep, hoarseness, a cough, belching of wind, a sense of heavi-
ness about the breast, and difficulty of breathing. To these suc-
ceed heat, fever, pain of the head, sickness and nausea, great op-
pression of the breast, palpitation of the heart, a weak and some-
times intermitting pulse, an involuntary flow of tears, bilious vo-
mitings, &c.  All the symptoms grow worse towards night; the
patient is easier when up than in bed, and is very desirous of cool
air.
REGIMEN————The food ought to be light and of easy diges-
tion. Boiled meats are to be preferred to roasted, and the flesh of
young animals to that of old. All windy food, and whatever is apt
to swell in the stomach, is to be avoided. Light puddings, white
broths, and ripe fruits, baked, boiled, or roasted, are proper.
Strong liquors, of all kinds, especially malt liquor, are hurtful.
The patient should eat a very light supper, or rather none at all, 

THE ASTHMA. 287
and should never suffer himself to be long costive. His clothing
should be warm, especially in the winter-season. As all disorders
of the breast are much relieved by keeping the feet warm, and
promoting the perspiration, a flannel shirt or waistcoat, and thick
shoes, will be of singular service.
But nothing is of so great importance in the asthma as pure and
moderately warm air. Asthmatic people can seldom bear either
the close heavy air of a large town, or the sharp, keen atmos-
phere of a bleak hilly country; a medium therefore between these
is to be chosen. The air near a large town is often better than at
a distance, provided the patient be removed so far as not to be af-
fected by the smoke. Some asthmatic patients breathe easier in
town than in the country; but this is seldom the case, especially
in towns where much coal is burnt. Asthmatic persons who are
obliged to be in town all day, ought at least to sleep out of it.
This will often prove of great service. Those who can afford it,
ought to travel into a warmer climate. Many asthmatic persons,
who cannot live in Britain, enjoy very good health in the south of
France, Portugal, Spain, or Italy.
Exercise is of very great importance in the asthma, as it promotes
the digestion, preparation of the blood, &c. The blood of asthma-
tic persons is seldom duly prepared, owing to the proper action
of the lungs being impeded. For this reason, such people ought
daily to take as much exercise, either on foot, horseback, or in a
carriage, as they can bear.
MEDICINE.————Almost all that can be done by medicine in
this disease, is to relieve the patient when seized with a violent
fit. This, indeed, requires the greatest expedition, as the disease of-
ten proves suddenly fatal. In the paroxysm or fit, the body is ge-
nerally bound; a purging clyster, with a solution of asafœtida,
ought therefore to be administered, and if there be occasion, it may
be repeated two or three times. The patient's feet and legs ought
to be immersed in warm water, and afterwards rubbed with a
warm hand, or dry cloth. Bleeding, unless extreme weakness or
old age should forbid it, is highly proper. If there be a violent
spasm about the breast or stomach, warm fomentations, or blad-
ders filled with warm milk and water, may be applied to the part
affected, and warm cataplasms to the soles of the feet. The pa-
tient must drink freely of diluting liquors, and may take a tea-
spoonful of the tincture of castor and of saffron mixed together,
in a cup of valerian-tea, twice or thrice a-day. Sometimes a vo-
mit has a very good effect, and snatches the patient from the jaws
of death. This, however, will be more safe after other evacuations
have been premised. A very strong infusion of roasted coffee is
said to give ease in an asthmatic paroxysm.
In the moist asthma, such things as promote expectoration or
spitting ought to be used; as the syrup of squills, gum ammoniac,
and such-like. A common spoonful of the syrup, or oxymel of 

288 THE APOPLEXY.
squills, mixed with an equal quantity of cinnamon-water, may be
taken three or four times through the day, and four or five pills,
made of equal parts of asafœtida and gum-ammoniac, at bed time*.
For the convulsive or nervous asthma, antispasmodics and bra-
cers are the most proper medicines. The patient may take a tea-
spoonful of the paregoric elixir twice a-day. The bark is sometimes
of use in this case. It may be taken in substance, or infused in
wine†. In short, every thing that braces the nerves, or takes off
spasm, may be of use in a nervous asthma. It is often relieved by
the use of asses' milk. I have likewise known cow's milk, drank 
warm in the morning, have a very good effect in this case.
In every species of asthma, setons and issues have a good effect.
They may either be set in the back or side, and should never be al-
lowed to dry up. Not only in the asthma, but in most chronic
diseases, issues are extremely proper. They are a safe and effica-
cious remedy; and though they do not always cure the disease, yet
they will often prolong the patient's life.
CHAPTER XLIII.
Of the Apoplexy.
THE apoplexy is a sudden loss of sense and motion, wherein  
the patient is to all appearance dead. The heart and lungs
however still continue to move. This disease proves often fatal; yet
it may sometimes be removed by proper care. It chiefly attacks se-
dentary persons, of a gross habit, who use a rich and plentiful diet,
and indulge in strong liquors. People in the decline of life are
most subject to the apoplexy. It prevails most in winter, especial-
ly in rainy seasons, and very low states of the barometer.
CAUSES.————The immediate cause of an apoplexy is a com-
pression of the brain, occasioned by an excess of blood, or a collec-
tion of watery humours. The former is called a sanguine, and the
latter, a serous apoplexy. It may be occasioned by any thing that
increases the circulation towards the brain, or prevents the return
* After copious evacuations, large doses of æther have been found
very efficacious in removing a fit of the asthma. I have likewise known
the following mixture produce very happy effects: To four or five
ounces of the solution of gum-ammoniac, add two ounces of simple
cinnamon-water, the same quantity of balsamic syrup, and half an ounce
of the paregoric elixir. Of this, two table-spoonfuls may be taken eve-
ry three hours.
† When a paroxysm or fit of asthma has gone off, cold bathing maybe
employed, to co-operate with the tonic medicines recommended, to
prevent a return of the paroxysm. (I. C.) 

THE APOPLEXY. 289
of the blood from the head; as intense study; violent passions*;
viewing objects for a long time obliquely; wearing any thing too
tight about the neck; a rich and luxurious diet; suppression of
urine; suffering the body to cool suddenly after having been great-
ly heated; continuing long in a warm or a cold bath; the exces-
sive use of spiceries, or high-seasoned food; excess of venery; the
sudden striking in of any eruption; suffering issues, setons, &c.
suddenly to dry up, or the stoppage of any customary evacuation;
a mercurial salivation pushed too far, or suddenly checked by cold;
wounds or bruises on the head; long exposure to excessive cold;
poisonous exhalations, &c.
SYMPTOMS, and method of cure.————The usual forerunners
of an apoplexy are giddiness, pain and swimming of the head;
loss of memory; drowsiness; noise in the ears; the night-mare;
a spontaneous flux of tears, and laborious respiration. When per-
sons of an apoplectic make observe these symptoms, they have rea-
son to fear the approach of a fit, and should endeavour to prevent
it by bleeding, a slender diet, and opening medicines.
In the sanguine apoplexy, if the patient does not die suddenly,
the countenance appears florid, the face is swelled or puffed up,
and the blood-vessels, especially about the neck and temples, are
turgid; the pulse beats strong; the eyes are prominent and fixed,
and the breathing is difficult, and performed with a snorting noise.
The excrements and urine are often voided spontaneously, and the
patient is sometimes seized with vomiting.
In this species of apoplexy, every method must be taken to lessen
the force of the circulation towards the head. The patient should
be kept perfectly easy and cool. His head should be raised pretty
high, and his feet suffered to hang down. His clothes ought to
be loosened, especially about the neck, and fresh air admitted into
his chamber. His garters should be tied pretty tight, by which
means the motion of the blood from the lower extremities will be
retarded. As soon as he is placed in a proper posture, he should be
bled freely in the neck or arm, and, if there be occasion, the ope-
ration may be repeated in two or three hours. A laxative clyster,
with plenty of sweet oil, or fresh butter, and a spoonful or two of
common salt in it may be administered every two hours†, and a
* I knew a woman, who, in a violent fit of anger, was seized with a
sanguine apoplexy. She at first complained of extreme pain, as if dag-
gers had been thrust through her head, as she expressed it. Afterwards
she became comatose, her pulse sunk very low, and was exceeding slow.
By bleeding, blistering, and other evacuations, she was kept alive about
a fortnight. When her head was opened, a large quantity of extravasa-
ted blood was found in the left ventricle of the brain.
† A clyster, consisting of three ounces of glauber salts dissolved in a pint
of warm water, with an ounce of antimonial wine, and a suitable quan-
tity of oil, would have a more powerful effect in relieving the head.
(I.C.)
O2 

290 THE APOPLEXY.
blister applied between the shoulders, and to the calves of the
legs.
As soon as the symptoms are a little abated, and the patient is
able to swallow, he ought to drink freely of some diluting opening
liquor, as a decoction of tamarinds and liquorice, cream-tartar
whey, or common whey with cream of tartar dissolved in it. Or
he may take any cooling purge, as Glauber's salts, manna dissolved
in an infusion of senna, or the like. All spirits and other strong
liquors are to be avoided. Even volatile salts held to the nose do
mischief. Vomits, for the same reason, ought not to be given, nor
any thing that may increase the motion of the blood towards the
head.
In the serous apoplexy, the symptoms are nearly the same, only
the pulse is not so strong, the countenance is less florid, and the
breathing less difficult. Bleeding is not so necessary here as in the
former case. It may generally be performed once with safety and
advantage, but should not be repeated. The patient should be
placed in the same posture as directed above, and should have blis-
ters applied, and receive opening clysters in the same manner.
Purges are likewise necessary, and the patient may drink strong
balm-tea. If he be inclined to sweat, it ought to be promoted by
drinking small wine-whey, or an infusion of carduus benedictus.
A plentiful sweat kept up for a considerable time has often carried
off a serous apoplexy.
When apoplectic symptoms proceed from opium, or other nar-
cotic substances taken into the stomach, vomits are necessary.
The patient is generally relieved as soon as he has discharged the
poison in this way. 
Persons of an apoplectic make, or those who have been attack-
ed by an apoplexy, ought to use a very spare and slender diet,
avoiding all strong liquors, spiceries, and high seasoned food.
They ought likewise to guard against all violent passions, and to
avoid the extremes of heat and cold. The head should be shaved,
and daily washed with cold water. The feet ought to be kept
warm, and never suffered to continue long wet. The body must
be kept open either by food or medicine, and a little blood may
be let every spring and fall. Exercise should by no means be ne-
glected; but it ought to be taken in moderation. Nothing has a
more happy effect in preventing an apoplexy than perpetual issues
or setons; great care however must be taken not to suffer them
to dry up, without opening others in their stead. Apoplectic per-
sons ought never to go to rest with a full stomach, or to lie with
their heads low, or wear any thing too tight about their necks.

291
CHAPTER XLIV.
Of Costiveness, and other Affections of the Stomach and
Bowels.
WE do not here mean to treat of those astrictions of the bow-
els which are the symptoms of diseases, as of the cholic,
the iliac passion, &c. but only to take notice of that infrequency
of tools which sometimes happens, and which in some particular
constitutions may occasion diseases.
Costiveness may proceed from drinking rough red wines, or
other astringent liquors; too much exercise, especially on horse-
back, or from a long use of cold insipid food, which does not suffi-
ciently stimulate the intestines. Sometimes it is owing to the bile
not descending to the intestines, as in the jaundice; and at other
times it proceeds from diseases of the intestines themselves, as a
palsy, spasms, torpor, tumours of the intestines, &c.
Excessive costiveness is apt to occasion pains of the head, vomit-
ing, colics, and other complaints of the bowels. It is peculiarly
hurtful to hypochondriac and hysteric persons, as it generates
wind and other grievous symptoms. Some people can bear costive-
ness to a great degree. I know persons who enjoy pretty good
health, yet do not go to stool above once a-week, and others not
above once a-fortnight. I have heard of some who do not go above
once a-month.
Persons who are generally costive should live upon a moisten-
ing and laxative diet, as roasted or boiled apples, pears, stewed
prunes, raisins, gruels with currants, twitter, honey, sugar, and
such-like. Broths with spinage, leeks, and other soft pot-herbs,
are likewise proper. Rye-bread, or that which is made of a mix-
ture of wheat and rye together, ought to be eaten. No person
troubled with costiveness should eat white bread alone, especially
that which is  made of fine flour. The best bread for keeping the
body soluble is what in some parts of England they call meslin. It
is made of a mixture of wheat and rye, and is very agreeable to
those accustomed to it.
Costiveness is encreased by keeping the body too warm, and by
every thing that promotes the perspiration; as wearing flannel,
lying too long a-bed, &c. Intense thought and a sedentary life,
are likewise hurtful. All the secretions and excretions are promo-
ted by moderate exercise without doors, and by a gay, cheerful,
sprightly temper of mind.
The drink should be of an opening quality. Ardent spirits, aus-
tere and astringent wines, as port, claret, &c. ought to be avoi-
ded. Malt-liquor that is fine, and of a moderate strength, is very 

292 WANT OF APPETITE.
proper. Butter-milk, whey, and other watery liquors, are likewise
proper, and may be drank in turns, as inclination directs.
Those troubled with costiveness, ought, if possible, to remedy
it by diet, as the constant use of medicines for that purpose is at-
tended with many inconveniencies, and often with bad consequen-
ces*. I never knew any one get into a habit of taking medicine
for keeping the body open, who could leave it off. In time, the
custom becomes necessary, and generally ends in a total relaxation
of the bowels, indigestion, loss of appetite, wasting of the strength,
and death.
When the body cannot be kept open without medicine, we re-
commend gentle doses of castor-oil, flour of sulphur, and cream
of tartar, to be taken twice or thrice a-week. This is not near so
injurious to the stomach as aloes, jalap, or the other drastic pur-
gatives so much in use. Infusions of senna and manna may like-
wise be taken, or half an ounce of soluble tartar dissolved in water-
gruel. About the size of a nutmeg of lenitive electuary taken
twice or thrice a-day generally answers the purpose very well.
Want of Appetite.
THIS may proceed from a foul stomach; indigestion; the want
of free air and exercise; grief; fear; anxiety; or any of the de-
pressing passions; excessive heat; the use of strong broths, fat
meats, or any thing that palls the appetite, or is hard of digestion;
the immoderate use of strong liquors, tea, tobacco, opium, &c.
The patient ought, if impossible, to make choice of an open dry
air; to take exercise daily on horseback or in a carriage; to rise
* Dr. Arbuthnot advises those who are troubled with costiveness to
use animal oils, as fresh butter, cream, marrow, fat broths, especially  
those made of internal parts of animals, as the liver, heart, midriff,
&c. the expressed oils of mild vegetables, as olives, almonds, pastaches,
and the fruits themselves; all oily and mild fruits, as figs; decoctions
of mealy vegetables; these lubricate the intestines; some saponaceous
substances which stimulate gently, as honey, hydromel, or boiled honey
and water, unrefined sugar, &c.
He observes, that such lenitive substances are proper for persons of
dry atrabilarian constitutions, who are subject to astriction of the belly,
and the piles, and will operate when stronger medicinal substances are
sometimes ineffectual; but that such lenitive diet hurts those whose
bowels are weak and lax. He observes, that all watery substances are
lenitive, and that even common water, whey, sour milk, and butter
milk have that effect;—-that new milk, especially asses milk, stimulates
still more when it sours on the stomach; and that whey turned sour
will purge strongly;-—that most garden fruits are likewise laxative;
and that some of them, as grapes, will throw such as take them immo-
derately into a cholera morbus, or incurable diarrhœa. 

THE HEART-BURN. 293
betimes; and to avoid all intense thought. He should use a diet of
easy digestion; and avoid excessive heat and fatigue.
If want of appetite proceeds from errors in diet, or any other
part of the patient's regimen, it ought to be changed. If nausea
and reachings shew that the stomach is loaded with crudities, a vo-
mit will be of service. After this a gentle purge or two, of any of
the bitter purging salts, may be taken. The patient ought next to
use some of the stomachic bitters infused in wine. Though gentle
evacuations be necessary, yet strong purges and vomits are to be
avoided, as they weaken the stomach, and hurt digestion.
Elixir of vitriol is an excellent medicine in most cases of indiges-
tion, weakness of the stomach, or want of appetite. From twenty
to thirty drops of it may be taken twice or thrice a-day in a glass
of wine  and water. It may likewise be mixed with the tincture of
the bark, one drachm of the former to an ounce of the latter, and
two tea-spoonfuls of it taken in wine or water, as above.
The chalybeate waters, if drank in moderation, are generally
of considerable service in this case. The salt water has likewise
good effects, but must not be used too freely. The waters of Har-
rowgate, Scarborough, Moffat, and most other Spas in Britain,
may be used with advantage. All who are afflicted with indiges-
tion and want of appetite, should repair to these places of public
rendezvous. The very change of air, and the cheerful company,
will be of service; not to mention the exercise, dissipation, amuse-
ments. &c.
The Heart-Burn,
AS it is commonly called, is not a disease of that organ, but
an uneasy sensation of heat or acrimony about the pit of the sto-
mach, which is sometimes attended with anxiety, nausea, and vo-
miting.
It may proceed from debility of the stomach, indigestion, bile,
the abounding of an acid in the stomach, &c. Persons liable to
this complaint ought to avoid stale liquors, acids, windy or greasy
aliments, and should never use violent exercise soon after a plen-
tiful meal. Many persons have the heart-burn if they ride soon af-
ter dinner, provided they have drank ale, wine, or any fermented
liquor; but are never troubled with it when they have drank rum
or brandy and water without any sugar or acid.
When the heart-burn proceeds from debility of the stomach, or
indigestion, the patient ought to take a dose or two of rhubarb;
afterwards he may use infusions of the bark, or any other of the
stomachic bitters, in wine or brandy. Exercise in the open air
will be of use, and every thing that promotes digestion. 

294 NERVOUS DISEASES.
When bilious humours occasion the heart-burn, a tea-spoonful
of the sweet spirit of nitre in a glass of water, or a cup of tea, will
generally give ease. If it proceeds from the use of greasy aliments,
a drachm of brandy or rum may be taken.
If acidity or sourness of the stomach occasions the heart-burn,
absorbents are the proper medicines. In this case, an ounce of pow-
dered chalk, half an ounce of fine sugar, and a quarter of an ounce
of gum-arabic, may be mixed in an English quart of water, and a
tea-cupful of it taken as often as is necessary. Such as do not choose
chalk may take a tea-spoonful of prepared oyster-shells, or of the
powder called crabs-eyes, in a glass of cinnamon or pepper-mint
water. But the safest and best absorbent is magnesia alba. This not
only acts as an absorbent, but likewise as a purgative; whereas
chalk and other absorbents of that kind, are apt to lie in the intes-
stines and occasion obstructions. This powder is not disagreeable,
and may be taken in a cup of tea, or a glass of mint-water. A large
tea-spoonful is the usual dose; but it may be taken in a much great-
er quantity when there is occasion. These things are now generally
made up into lozenges for the conveniency of being carried in the
pocket, and taken at pleasure.
If wind causes this complaint, the most proper medicines are
carminatives; as aniseeds, juniper-berries, ginger, canella alba,
cardamom seeds, &c. These may either be chewed, or infused in
wine, brandy, or other spirits. One of the safest medicines of this
kind is the tincture made by infusing an ounce of rhubarb, and a
quarter of an ounce of the lesser cardamom seeds, in an English
pint of brandy. After this has digested for two or three days, it
ought to be strained, and four ounces of white sugar-candy added
to it. It must stand to digest a second time till the sugar be dissolv-
ed. A table-spoonful of it may be taken occasionally for a dose.
I have frequently known the heart-burn cured, particularly in
pregnant women, by chewing green tea.
CHAPTER XLV.
Nervous Diseases
ARE, of all those incident to mankind, the most complicated
and difficult to cure. A volume would not be sufficient to
point out their various appearances. They imitate almost every dis-
ease; and are seldom alike in two different persons, or even in the
same person at different times. They are continually changing shape;
and upon every fresh attack, the patient thinks he feels symp-
toms which he never experienced before. Nor do they only affect
the body; the mind likewise suffers, and is often rendered extreme-
ly weak and peevish. The low spirits, timorousness, melancholy, 

NERVOUS DISEASES. 295
and sickleness of temper, which generally attend nervous disor-
ders, induce many to believe that they are entirely diseases of the
mind; but this change of temper is rather a consequence, than
the cause of nervous diseases.
CAUSES.————Every thing that tends to relax or weaken the
body, disposes it to nervous diseases, as indolence, excessive vene-
ry, drinking too much tea, or other weak watery liquors warm,
frequent and copious bleeding, purging, vomiting, &c. Whatever
hurts the digestion, or prevents the proper assimilation of the food
has likewise this effect; as long fasting, excess in eating or drink-
ing, the use of windy, crude, or unwholesome aliments, an unfa-
vourable posture of the body, &c.
Nervous disorders often proceed from intense application to
study. Few studious persons are entirely free from them. Nor is
this to be wondered at; intense thinking not only preys upon the
spirits, but prevents the person from taking proper exercise, by
which means the digestion is impaired, the nourishment preven-
ted, and the solids relaxed. Grief and disappointment likewise pro-
duce the same effects. More nervous patients date the com-
mencement of their disorders from the loss of a husband, a favou-
rite child, or from some disappointment in life, than from any
other cause. Whatever weakens the body, or depresses the spirits,
may occasion nervous disorders, as unwholesome air, want of
sleep, great fatigue, disagreeable apprehensions, anxiety, vexation,
&c.
SYMPTOMS.————We shall only mention some of the most
general symptoms of these disorders, as it would be both an use-
less and an endless task to enumerate the whole. They generally
begin with windy inflations or distentions of the stomach and in-
testines; the appetite and digestion are usually bad; yet sometimes
there is an uncommon craving for food, and a quick digestion.
The food often turns sour on the stomach; and the patient is
troubled with vomiting of clear water, tough phlegm, or a black-
ish-coloured liquor, resembling the grounds of coffee. Excruci-
ating pains are often felt about the navel, attended with a rumbling
or murmuring noise in the bowels. The body is sometimes loose,
but more commonly bound, which occasions a retention of wind
and great uneasiness.
The urine is sometimes in small quantity, at other times very
copious and quite clear. There is a great straightness of the breast,
with difficulty of breathing; violent palpitations of the heart;
sudden flushings of heat in various parts of the body; at other
times a sense of cold, as if water were poured on them; flying
pains in the arms and limbs; pains in the back and belly, resem-
bling those occasioned by gravel; the pulse very variable, some-
times uncommonly slow, and at other times very quick; yawning,
the hiccup, frequent sighing, and a sense of suffocation, as if from
a ball or lump in the throat; alternate fits of crying and convul- 

296 NERVOUS DISEASES.
five laughing; the sleep is unsound and seldom refreshing; the
patient is often troubled with the night-mare.
As the disease increases, the patient is molested with head-achs,
cramps, and fixed pains in various parts of the body; the eyes are
clouded, and often affected with pain and dryness; there is a
noise in the ears, and often a dullness of hearing; in short, the
whole animal functions are impaired. The mind is disturbed on
the most trivial occasions, and is hurried into the most perverse
commotions, inquietudes, terror, sadness, anger, diffidence, &c.
The patient is apt to entertain wild imaginations and extravagant
fancies; the memory becomes weak, and the judgment fails.
Nothing is more characteristic of this disease than a constant
dread of death. This renders those unhappy persons who labour
under it, peevish, sickle, impatient, and apt to run from one physi-
cian to another; which is one reason why they seldom reap any
benefit from medicine, as they have not sufficient resolution to
persist in any one course till it has time to produce its proper ef-
fects. They are likewise apt to imagine that they labour under
diseases from which they are quite free; and are very angry
if any one attempts to set them right, or laugh them out of their
notions.
REGIMEN.————Persons afflictest with nervous diseases ought
never to fast long. Their food should be solid and nourishing, but
of easy digestion. Fat meats and heavy sauses are hurtful. All ex-
cess should be carefully avoided. They ought never to eat more at
a time than they can easily digest; but if they feel themselves weak
and faint between meals, they ought to eat a bit of bread, and drink
a glass of wine. Heavy suppers are to be avoided. Though wine
in excess enfeebles the body, and impairs the faculties of the mind,
yet taken in moderation, it strengthens the stomach, and promotes
digestion. Wine and water is a very proper drink at meals; but if
wine sours on the stomach, or the patient is much troubled with
wind, brandy and water will answer better. Every thing that is
windy or hard of digestion must be avoided. All weak and warm
liquors are hurtful, as tea, coffee, punch, &c. People may find a
temporary relief in the use of these, but they always increase the
malady, as they weaken the stomach and hurt digestion. Above
all things, drams are to be avoided. Whatever immediate ease the
patient may feel from the use of ardent spirits, they are sure to ag-
gravate the malady, and prove certain poison at last. These cau-
tions are the more necessary, as most nervous people are peculiarly
fond of tea and ardent spirits; to the use of which many of them
fall victims.
Exercise in nervous disorders is superior to all medicines. Rid-
ing on horseback is generally esteemed the best, as it gives motion
to the whole body without fatiguing it. I have known patients
with whom walking agreed better, and others who were most be-
nefited by riding in a carriage. Every one ought to use that which 

NERVOUS DISEASES. 297
he finds most beneficial. Long sea-voyages have an excellent ef-
fect; and to those who have sufficient resolution, we recommend
this course. Even change of place, and the sight of new objects,
by diverting the mind, have a great tendency to remove these
complaints. For this reason, a long journey, or a voyage, is of
much more advantage than riding short journeys near home.
A cool and dry air is proper, as it braces and invigorates the
whole body. Few things tend more to relax and enervate than
hot air, especially that which is rendered so by great fires, or stoves
in small apartments. But when the stomach or bowels are weak,
the body ought to be well guarded against cold, especially in win-
ter, by wearing a thin flannel waistcoat next the skin. This will
keep up an equal perspiration, and defend the alimentary canal
from many impressions to which it would otherwise be subject,
upon every sudden change from warm to cold weather. Rub-
bing the body frequently with a flesh-brush, or a coarse linen
cloth, is beneficial, as it promotes the circulation, perspiration,
&c. Persons who have weak nerves ought to rise early, and take
exercise before breakfast, as lying too long a-bed cannot fail to
relax the solids. They ought to be diverted, and kept as easy and
cheerful as possible. Nothing hurts the nervous system, or weak-
ens the digestive powers, more than fear, grief, or anxiety.
MEDICINES.————Nervous diseases are seldom radically cured,
yet their symptoms may sometimes be alleviated, and life render-
ed more comfortable by proper medicines.
When the patient is costive, he ought to take a little rhubarb,
or some other mild purgative, and should never suffer his body to
be long bound. All strong and violent purgatives are to be avoi-
ded, as aloes, jalap, &c. I have generally seen an infusion of sen-
na and rhubarb in brandy answer very well. This may be made
of any strength, and taken in such quantity as the patient finds
necessary. When digestion is bad, or the stomach relaxed and
weak, the following infusion of bark and other bitters may be
used with advantage:
Take of Peruvian bark an ounce, gentians-root, orange-peel,
and coriander-seed, of each half an ounce; let these ingredients
be all bruised in a mortar, and infused in a bottle of brandy or
whiskey, for the space of five or six days. A table-spoonful of
the strained liquor may be taken in half a glass of water, an hour
before breakfast, dinner, and supper.
Few thing tend more to strengthen the nervous system than cold
bathing. This practice, if duly persisted in, will produce very ex-
traordinary effects; but when the liver or other viscera are obstruc-
ted, or otherwise unsound, the cold bath is improper. It is there-
fore to be used with very great caution. The most proper seasons
are summer and autumn. It will be sufficient, especially for per-
sons of a spare habit, to go into the cold bath three or four times 
B

298 MELANCHOLY.
a week. If the patient be weakened by it, or feels chilly for a long
time after coming out, it is improper.
In patients afflicted with wind, I have always observed the great-
est benefit from the elixir of vitriol. It may be taken in the quan-
tity of fifteen, twenty, or thirty drops, twice or thrice a-day in a
glass of water. This both expels wind, strengthens the stomach,
and promotes digestion.
Opiates are generally extolled in these maladies; but as they
only palliate the symptoms, and generally afterwards increase the
disease, we advise people to be extremely sparing in the use of them,
lest habit render them at last absolutely necessary.
It would be an easy matter to enumerate many medicines which
have been extolled for relieving nervous disorders; but whoever
wishes for a thorough cure must expect it from regimen alone;
we shall therefore omit mentioning more medicines, and again re-
commend the strictest attention to diet, air, exercise, and amuse-
ments.
Melancholy
IS that state of alienation or weakness of mind which renders
people incapable of enjoying the pleasures, or performing the du-
ties of life. It is a degree of insanity, and often terminates in ab-
solute madness.
CAUSES.————It may proceed from an hereditary disposition;
intense thinking, especially where the mind is long occupied about
one object, violent passions or affections of the mind, as love, fear,
joy, grief, overweening pride, and such-like. It may also be occa-
sioned by excessive venery; narcotic or stupefactive poisons; a se-
dentary life; solitude; the suppression of customary evacuations;
acute fevers or other diseases. Violent anger will change melan-
choly into madness; and excessive cold, especially of the lower ex-
tremities, will force the blood into the brain, and produce all the
symptoms of madness. It may likewise proceed from the use of
aliment that is hard of digestion, or which cannot be easily assi-
milated, from a callous state of the integuments of the brain. To
all which, we may add gloomy or mistaken notions of religion.
SYMPTOMS.————When persons begin to be melancholy, they
are timorous; watchful; fond of solitude; fretful; captious
and inquisitive; solicitous about trifles; sometimes niggardly, and
at other times prodigal. The body is generally bound; the urine
thin, and in small quantity; the stomach and bowels inflated with
wind; the complexion pale; the pulse slow and weak. The func-
tions of the mind are also greatly perverted; the patient often
imagines himself dead, or changed into some other animal. Some
have imagined their bodies were made of glass, or other brittle 

MELANCHOLY. 299
substances, and were afraid to move left they should be broken to
pieces. The patient, in this case, unless carefully watched, is apt
to put an end to his own life.
When the disease is owing to an obstruction of customary eva-
cuations, or any bodily disorder, it is easier cured than when it
proceeds from affections of the mind, or any hereditary taint. A
discharge of blood from the nose, looseness, scabby eruptions, the
bleeding piles, or the menses, sometimes carry off this disease.
REGIMEN.————The diet should consist chiefly of vegetables
of a cooling and opening quality. Animal food, especially salted
or smoke-dried fish or flesh, ought to be avoided. All kinds of
shell-fish are bad. Aliments prepared with onions, garlic, or any
thing that generates thick blood, are likewise improper. All kinds
of fruits that are wholesome may be eaten with advantage. Boer-
haave gives an instance of a patient, who, by a long use of whey,
water, and garden fruit, recovered, after having evacuated a great
quantity of black-coloured matter.
Strong liquors of every kind ought to be avoided as poison. The
most proper drink is water, whey, or very small beer. Tea and
coffee are improper. If honey agrees with the patient, it may be
eaten freely, or his drink may be sweetened with it. Infusions of
balm-leaves, penny-royal, the roots of wild valerian, or the flow-
ers of the lime-tree, may be drank freely, either by themselves, or
sweetened with honey, as the patient shall choose.
The patient ought to take as much exercise in the open air as
he can bear. This tends to remove obstructions, promotes the per-
spiration, and all the other secretions. Every kind of madness is
attended with a diminished perspiration; all means ought there-
fore to be used to promote that necessary and salutary discharge.
Nothing can have a more direct tendency to increase the disease
than confining the patient to a close apartment. Were he forced
to ride or walk a certain number of miles every day, it would tend
greatly to alleviate his disorder; but it would have still a better
effect, if he were obliged to labour a piece of ground. By dig-
ging, hoeing, planting, sowing, &c. both the body and mind would
be exercised. A long journey, or a voyage, especially towards a
warmer climate, with agreeable companions, has often very happy
effects. A plan of this kind, with a strict attention to diet, is a
much more rational method of cure, than confining the patient
within doors and plying him with medicines.
MEDICINE.————In the cure of this disease, particular atten-
tion must be paid to the mind. When the patient is in a low
state, his mind ought to be soothed and diverted with variety of
amusements, as entertaining stories, pastimes, music, &c. This
seems to have been the method of curing melancholy among the
Jews, as we learn from the story of Saul; and it is a very ration-
al one. Nothing can remove diseases of the mind so effectually,
as applications to the mind itself, the most efficacious of which is 

300 MELANCHOLY.
music. The patient's company ought likewise to consist of such
persons as are agreeable to him. People in this state are apt to
conceive unaccountable aversions against particular persons; and
the very sight of such persons is sufficient to distract their minds,
and throw them into the utmost perturbation.
When the patient is high, evacuations are necessary. In this
case, he must be bled, and have his body kept open by purging
medicines, as manna, cream of tartar, or the soluble tartar. I have
seen the last have very happy effects. It may be taken in the dose
of half an ounce, dissolved in water gruel, every day, for sundry
weeks, or even for months, if necessary. More or less may be
given according as it operates. Vomits have likewise a good ef-
fect; but they must be pretty strong, otherwise they will not ope-
rate.
Whatever increases the evacuation of urine or promotes per-
spiration, has a tendency to remove this disease. Both these se-
cretions may be promoted by the use of nitre and vinegar. Half a
drachm of purified nitre may be given three or four times a-day
in any manner that is most agreeable to the patient; and an ounce
and a half of distilled vinegar may be daily mixed with his drink.
Dr. Locker seems to think vinegar the best medicine that can be
given in this disease.
Camphire and musk have been used in this case with advantage.
Ten or twelve grains of camphire may be rubbed in a mortar,
with half a drachm of nitre, and taken twice a-day, or oftener, if
the stomach will bear it. If it will not fit upon the stomach in this
form, it may be made into pills with gum asafœtida and Russian
castor, and taken in the quantity above directed. If musk is to be
administered, a scruple or twenty-five grains of it may be made
into a bolus with a little honey or common syrup, and taken twice
or thrice a-day.  We do not mean that all these medicines should
be administered at once, but which ever of them is given, must
be duly persisted in, and where one fails, another may be tried.
As it is very difficult to induce patients, in this disease, to take
medicines, we shall mention a few outward applications, which
sometimes do good; the principal of these are issues, setons, and
warm bathing. Issues may be made in any part of the body, but
they generally have the best effect near the spine. The discharge
from these, may be greatly promoted, by dressing them with the
mild blistering ointment, and keeping what are commonly called
the orrice pease in them. The most proper place for a seton is be-
tween the shoulder-blades; and it ought to be placed upwards
and downwards, or in the direction of the spine. 

301
The Palsy
IS a loss or diminution of sense or motion, or of both,
in one or more parts of the body. Of all the affections called
nervous, this is the most suddenly fatal. It is more or less dan-
gerous, according to the importance of the part affected. A palsy
of the heart, lungs, or any part necessary to life, is mortal. When
it affects the stomach, the intestines, or the bladder, it is highly
dangerous. If the face be affected, the case is bad, as it shows
that the disease proceeds from the brain. When the part affected
feels cold, is insensible, or wastes away, or when the judgment and
memory begin to fail, there is small hope of a cure.
CAUSES.————The immediate cause of palsy is any thing that
prevents the regular exertion of the nervous power upon any par-
ticular muscle or part of the body. The occasional and predispo-
sing causes are various, as drunkenness; wounds of the brain, or
spinal marrow; pressure upon the brain or nerves; very cold or
damp air; the suppression of customary evacuations; sudden fear;
want of exercise; or whatever greatly relaxes the system, as drink-
ing much tea*, or coffee, &c. The palsy may likewise proceed
from wounds of the nerves themselves, from the poisonous fumes
of metals or minerals, as mercury, lead, arsenic.
In young persons of a full habit, the palsy must be treated in the
same manner as the sanguine apoplexy. The patient must be bled,
blistered, and have his body opened by sharp clysters or purgative
medicines. But, in old age, or when the disease proceeds from re-
laxation or debility, which is generally the case, a quite contrary
course must be pursued. The diet must be warm and invigorating,
seasoned with spicy and aromatic vegetables, as mustard, horse-ra-
dish, &c. The drink may be generous wine, mustard, whey, or
brandy and water. Friction with the flesh-brush, or a warm hand,
is extremely proper, especially on the parts affected. Blisters may
likewise be applied to the affected parts with advantage. When
this cannot be done, they may be rubbed with the volatile lini-
ment, or the nerve ointment of the Edinburgh dispensatory. One
of the best external applications is electricity. The shocks, or ra-
ther vibrations, should be received on the part affected; and they
ought daily to be repeated for several weeks.
Cephalic snuff, or any thing that makes the patient sneeze, is
* Many people imagine, that tea has no tendency to hurt the nerves,
and that drinking the same quantity of warm water would be equally
pernicious. This, however, seems to be a mistake. Many persons drink
three or four cups of warm milk and water daily, without feeling any
bad consequences; yet the same quantity of tea will make their hands
shake for twenty-four hours. That tea affects the nerves, is likewise
evident, from its preventing sleep, occasioning giddiness, dimness of the
sight, sickness, &c. 

302 TETANUS.
likewise of use. Some pretend to have found great benefit from
rubbing the parts affected with nettles; but this does not seem to
be any way preferable to blistering. If the tongue is affected, the
patient may gargle his mouth frequently with brandy and mustard;
or he may hold a bit of sugar in his  mouth wet with compound
spirits of lavender. The wild valerian-root is a very proper medi-
cine in this case. It may either be taken in an infusion with sage-
leaves, or half a drachm of it in powder may be given in a glass of
wine three times a-day. If the patient cannot use the valerian, he
may take of sal volatile oleosum, compound spirits of lavender, and
tincture of castor, each half an ounce; mix these together, and
take forty or fifty drops in a glass of wine three or four times a-day.
A table-spoonful of mustard-seed taken frequently is a very good
medicine. The patient ought likewise to chew cinnamon-bark,
ginger or other warm spiceries.
Exercise is of the utmost importance in the palsy; but the pa-
tient must beware of cold, damp, and moist air. He ought to wear
flannel next his skin; and if possible, should remove into a war-
mer climate.
Tetanus, or the Locked-Jaw.
UNDER this term may be comprehended the spasmodic af-
fections, called emprosthotonos, opisthotonos, and trismus, be-
ing one disease, differing only in the degree of its violence. When
the body and head are bended forwards, it is called emprosthoto-
nos; when they are carried backwards, and immovably fixed, it
bears the appellation of opisthotonos; and when the body is sus-
tained in an erect position, by the muscle on the sore and back
part of the trunk acting with equal strength, the disease is called
tetanus. When the muscles of the jaw become more particularly
affected, it is called trismus, or locked jaw.
These spasmodic complaints affect both sexes, and no age is ex-
empted from their violence. They affect the male oftener than the
female, and more particularly those people who inhabit warm
climates, and every climate at the warm season of the year. Some-
times they occur in winter, independent of wounds.
CAUSES.————Wounds in any part of the body are sometimes
succeeded by this disease. But more particularly from those in
tendons, where a trifling injury will not unfrequently produce
this complaint, when it is least expected. Whereas, at other times,
a wound of considerable magnitude, under apparently similar cir-
cumstances, will have no such effect: and, even after operations
in tendenous parts, it is by no means a frequent occurrence; when
at other times, a simple fracture of the leg will produce it in all

TETANUS. 303
its force. Cold, when accompanied with moisture, will produce
this disease; particularly when the body is exposed while asleep,
on a damp pavement, or in a damp cellar, immediately after be-
ing heated and fatigued by exercise. Children are frequently
seized with this disease in a short time after delivery.           
SYMPTOMS.————This disease, if it is from the effects of cold,
generally comes on of a sudden. But when from a wound, it gra-
dually approaches about the tenth, fourteenth, or twentieth days
after the accident. It often comes on at a time when the wound
gives but little uneasiness, and is nearly healed. The patient first
complains of an uneasy sensation at the lower part of the breast
bone, with a stiffness in the back part of the neck and muscles, of
the lower jaw, which increase with a painful sensation at the root
of the tongue, and a slight difficulty in swallowing. But no appear-
ance of swelling can be observed in the throat. The muscles of
the back now become rigid. This rigidity in a short time extends to
those of the neck, attended with a pain in the direction of the
spine of the back. At length the head, neck, and back bone are
forcibly bent backwards. The body becomes fixed in that position.
The muscles of the jaw are now violently affected, attended with
an impossibility of swallowing. Even liquids are thrown forcibly
back through the nose. These symptoms generally take place on
the second or third day, when the body is frequently seized with
violent convulsive spasms; and the pain at the lower part of the
breast bone increases, which shoots through towards the back.
The muscles of the limbs now become rigid, and the body is so
much bent backwards as to rest on the back part of the head and
heels. As the disease advances, the convulsive spasms become more
violent. At length tetanus is produced, from the muscles on the
fore and back part of the trunk, acting with an equal degree of
vigour, sustaining the body in an erect position. The pulse is ge-
nerally frequent with the other symptoms of fever, particularly
when the disease is the consequence of cold. The bowels are ge-
nerally costive, attended with a retraction of the belly. The urine
is discharged with difficulty, and sometimes a suppression of that
evacuation takes place. The face appears pale, expressive of great
anxiety and distress. The patient is seldom, if ever, delirious, al-
though he slumbers but little, from which he frequently awakes on
a sudden, with violent spasms. At length, the muscular system be-
comes more generally affected, and one universal convulsion closes
the miserable existence of the patient.
MEDICINE.————In our attempt to cure this disease, the indi-
cations are nearly the same, when produced from cold or the conse-
quence of a wound, except when the wound is without swelling
and inflammation. It should then be dilated and dressed, with lint
dipped in warm basilicon, or any other stimulating application. Af-
ter this, two, three, of even four grains of opium should be given
three or four times a day, according to the urgency of the symp- 

304 THE EPILEPSY, &c.
toms, and tendency to induce sleep; for astonishing quantities of this
medicine may be given without having the least tendency to make
the patient slumber. This remedy should be administered early, as
well as large quantities of Madeira wine, before the swallowing be-
comes interrupted; and the system should be charged with mercury,
with as much expedition as possible. For this purpose, two or three
drachms of mercurial ointment must be rubbed into the inside of
the legs, thighs, and arms, morning and evening, and likewise into
the muscles more particularly affected with spasms. To co-operate
with those medicines, the cold bath must be used, or cold water
thrown over the body. The bowels should be kept open with calo-
mel, castor-oil, and clysters. All those remedies must be used at an
early period of the complaint, so as to make as formidable an attack
as possible on this very formidable disease, which too frequently
terminates in the death of the patient, in spite of every effort to save
him.
When it is about to take place in infants, the bowels must be
opened with calomel or castor oil. But where it has actually taken
place, little can be done. However, a similar plan may be used
with that recommended in grown persons.
Of the Epilepsy or Falling Sickness.
THE epilepsy is a sudden deprivation of all the senses, wherein
the patient falls suddenly down, and is affected with violent convul-
sive motions. Children, especially those who are delicately brought
up, are most subject to it. It more frequently attacks men than wo-
men, and is very difficult to cure. When the epilepsy attacks chil-
dren, there is reason to hope that it will go off about the time of
puberty. When it attacks any person after twenty years of age, the
cure is difficult; but when after forty, a cure is hardly to be expec-
ted. If the fit continues only for a short space, and returns seldom,
there is reason to hope; but if it continues long, and returns frequent-
ly, the prospect is bad. It is a very unfavourable symptom when the
patient is seized with the fits in his sleep.
CAUSES.————The epilepsy is sometimes hereditary. It may
likewise proceed from blows, bruises, or wounds on the head; a
collection of water, blood, or serous humours in the brain; a poly-
pus; tumours or concretions within the skull; excessive drinking;
intense study; excess of venery; worms; teething; suppression
of customary evacuations; too great emptiness or repletion; vio-
lent passions or affections of the mind, as fear, joy, &c; hysteric af-
fections; contagion received into the body, as the infection of the
small-pox, measles, &c. 

THE EPILEPSY, &c. 305
SYMPTOMS.————An epileptic fit is generally preceded by un-
usual weariness; pain of the head; dullness; giddiness; noise in the
ears; dimness of sight; palpitation of the heart; disturbed sleep;
difficult breathing; the bowels are inflated with wind; the urine is
in great quantity, but thin; the complexion is pale; the extremi-
ties are cold; and the patient often feels, as it were, a stream of cold
air ascending towards his head.
In the fit, the patient generally makes an unusual noise; his
thumbs are drawn in towards the palms of his hands; his eyes are
distorted; he starts, and foams at the mouth; his extremities are
bent or twisted various ways; he often discharges his seed, urine,
and fæces involuntarily; and is quite destitute of all sense and rea-
son. After the fit is over, his senses gradually return, and he com-
plains of a kind of stupor, weariness, and pain of his head; but has
no remembrance of what happened to him during the fit.
The fits are sometimes excited by violent affections of the mind,
a debauch of liquor, excessive heat, cold, or the like.
This disease, from the difficulty of investigating its causes, and its
strange symptoms, was formerly attributed to the wrath of the gods,
or the agency of evil spirits. In modern times it has often, by the
vulgar, been imputed to witchcraft. It depends as much upon na-
tural causes as any other malady; and its cure may often be effec-
ted by persisting in the use of proper means.
REGIMEN.————Epileptic patients ought, if possible, to breathe
a pure and free air. Their diet should be light but nourishing. They
ought to drink nothing strong, to avoid swine's flesh, water fowl,
and likewise all windy and oily vegetables, as cabbage, nuts, &c.
They ought to keep themselves cheerful, carefully guarding against
all violent passions, as anger, fear, excessive joy, and the like.
Exercise is likewise of great use; but the patient must be careful
to avoid all extremes either of heat or cold, all dangerous situations,
as standing upon precipices, riding, deep waters, and such like.
MEDICINE.————The intentions of cure must vary according
to the cause of the disease. If the patient be of a sanguine tempera-
ment, and there be reason to fear an obstruction in the brain, bleed-
ing and other evacuations will be necessary. When the disease is oc-
casioned by customary evacuations, these, if possible, must be resto-
red; if this cannot be done, others may be substituted in their place.
Issues or setons in this case have often a very good effect. When
there is reason to believe that the disease proceeds from worms,
proper medicines must be used to kill, or carry off these vermin.
When the disease proceeds from teething, the body should be kept
open by emollient clysters, the feet frequently bathed in warm wa-
ter, and, if the fits prove obstinate, a blister may be put betwixt the
shoulders. The same method is to be followed, when epileptic fits
precede the eruption of the small-pox, or measles, &c.
When the disease is hereditary, or proceeds from a wrong forma-
tion of the brain, a cure is not to be expected. When it is owing 
Q2

306 THE HICCUP.
to a debility, or too great an irritability of the nervous system, such
medicines as tend to brace and strengthen the nerves may be used,
as the Peruvian bark, steel, &c.
The flowers of zinc have of late been highly extolled for the cure
of the epilepsy. This medicine will not answer the expectations
which have been raised concerning it, yet in obstinate epileptic ca-
ses, it deserves a trial. The dose is from one to three or four grains,
which may be taken either in pills or a bolus, as the patient inclines.
The best method is to begin with a single grain four or five times
a-day, and gradually to increase the dose as far as the patient can
bear it. I have known this medicine, when duly persisted in, prove
beneficial.
Musk has sometimes been found to succeed in the epilepsy. Ten
or twelve grains of it, with the same quantity of factitious cinna-
bar, may be made up into a bolus, and taken every night and
morning.
Sometimes the epilepsy has been cured by electricity.
Convulsion-fits proceed from the same causes, and must be treat-
ed in the same manner as the epilepsy.
There is one particular species of convulsion-fits which common-
ly goes by the name of St. Vitus's dance, wherein the patient is
agitated with strange motions and gesticulations, which, by the com-
mon people, are generally believed to be the effects of witchcraft:
This disease may be cured by repeated bleedings and purges; and
afterwards using the medicines prescribed above for the epilepsy,
viz. the Peruvian bark and snake-root, &c. Chalybeate waters are
found to be beneficial in this case. The cold bath is likewise of sin-
gular service, and ought never to be neglected when the patient can
bear it.
The Hiccup
IS a spasmodic or convulsive affection of the stomach and mi-
driff, arising from any cause that irritates their nervous fibres.
It may proceed from excess in eating or drinking; from a hurt
of the stomach; poisons; inflammations or schirrous tumours of
the stomach, intestines, bladder, midriff, or the rest of the viscera.
In gangrenes, acute and malignant fevers, a hiccup is often the
forerunner of death.
When the hiccup proceeds from the use of aliment that is flatu-
lent, or hard of digestion, a draught of generous wine, or a drachm
of any spirituous liquor, will generally remove it. If poison be the
cause, plenty of milk and oil must be drank, as has been formerly
recommended. When it proceeds from an inflammation of the sto-
mach, &c. it is very dangerous. In this case, the cooling regimen
ought to be strictly observed. The patient must be bled, and take  

CRAMP OF THE STOMACH. 307
frequently a few drops of the sweet spirits of nitre in a cup of wine-
whey. His stomach should likewise be fomented with cloths dipped
in warm water, or have bladders, filled with warm milk and wa-
ter, applied to it.
When the hiccup proceeds from a gangrene or mortification, the
bark, and other antiseptics, are the only medicines which have a
chance to succeed. When it is a primary disease, and proceeds from
a foul stomach, loaded with a bilious humour, a gentle vomit and
purge, if the patient be able to bear them, will be of service. If it
arises from flatulencies, the carminative medicines directed for the
heart-burn must be used.
When the hiccup proves very obstinate, recourse must be had to
the most powerful aromatic and antispasmodic medicines. The prin-
cipal of these is musk; fifteen or twenty grains of which may be
made into a bolus, and repeated occasionally. Opiates are of ser-
vice; but they must be used with caution. A bit of sugar, dipped in
compound spirits of lavender, or the volatile aromatic tincture, may
be taken frequently. External applications are sometimes also bene-
ficial; as the stomach plaister, or a cataplasm of the Venice treacle
of the Edinburgh or London dispensatory, applied to the region of
the stomach.
I lately attended a patient who had almost a constant hiccup for
above nine weeks. It was frequently stopped by the use of musk,
opium, wine, and other cordial and antispasmodic medicines, but
always returned. Nothing gave the patient so much ease as brisk
small-beer. By drinking freely of this, the hiccup was often kept off
for several days, which was more than could be done by the most
powerful medicines. The patient was at length seized with a vomit-
ing of blood, which soon put an end to his life. Upon opening the
body, a large schirrous tumour was found near the pylorus or right
orifice of the stomach.
Cramp of the Stomach.
THIS disease often seizes people suddenly, is very dangerous,
and requires immediate assistance. It is most incident to persons in
the decline of life, especially the nervous, gouty, hysteric, and hypo-
chondriac.
If the patient has any inclination to vomit, he ought to take some
draughts of warm water, or weak camomile-tea, to cleanse his sto-
mach. After this, if he has been costive, a laxative clyster may be
given. He ought then to take laudanum. The best way of adminis-
tering it is in a clyster. Sixty or seventy drops of liquid laudanum
may be given in a clyster of warm water. This is much more cer- 

308 THE NIGHT-MARE.
tain than laudanum given by the mouth, which is often vomited,
and in some cases, increases the pain and spasms in the stomach*.
If the pain and cramps return with great violence, after the effects
of the anodyne clyster are over, another, with an equal or a larger
quantity of opium, may be given; and every four or five hours a
bolus, with ten or twelve grains of musk, and half a drachm of the
Venice treacle.
In the mean time, the stomach ought to be fomented with cloths
dipped in warm water, or bladders, filled with warm milk and wa-
ter, should be constantly applied to it†. I have often seen these pro-
duce the most happy effects. The anodyne balsam may also be rub-
bed on the part affected; and an antihysteric plaister worn upon it
for some time after the cramps are removed, to prevent their re-
turn.
In very violent and lasting pains of the stomach, some blood ought
to be let, unless the weakness of the patient forbids it. When the
pain or cramps proceed from a suppression of the menses, bleeding
is of use. If they be owing to the gout, recourse must be had to
spirits, or some of the warm cordial waters. Blisters ought likewise,
in this case, to be applied to the ancles. I have often seen violent
cramps and pains of the stomach removed, by covering it with a
large plaister of Venice treacle.
Of the Night-Mare.
IN this disease, the patient, in time of sleep, imagines he feels an un-
common oppression or weight about his breast or stomach, which he
can by no means shake off. He groans, and sometimes cries out, though
oftener he attempts to speak in vain. Sometimes he imagines him-
self engaged with an enemy, and in danger of being killed, attempts
to run away, but finds he cannot. Sometimes he fancies himself
in a house that is on fire, or that he is in danger of being drowned
in a river. He often thinks he is falling over a precipice, and the
dread of being dashed to pieces suddenly awakes him.
This disorder has been supposed to proceed from too much bloods
from a stagnation of blood in the brain, lungs, &c. But it is rather
a nervous affection, and arises chiefly from indigestion. Persons of
weak nerves, who lead a sedentary life, and live full, are most com-
monly afflicted with the night-mare. Nothing tends more to pro-
duce it than heavy suppers, especially when eaten late, or the pa-
tient goes to bed soon after. Wind is a very frequent cause of this
* Laudanum should always be tried by the mouth in large doses, as
it can be given without delay; which is of the utmost consequence in
so dangerous a disease. (I. C.)
† The patient may go into the warm bath, which is more effica-
cious. (I. C.) 

309 SWOONINGS.                  
disease; for which reason, those who are afflicted with it, ought to
avoid all flatulent food. Deep thought, anxiety, or any thing that
oppresses the mind, ought to be avoided.
As persons afflicted with the night-mare generally moan, or make
some noise in the fit, they should be waked, or spoken to by such as
hear them, as the uneasiness generally goes off as soon as the patient
is awake. Dr. Whytt says, he generally found a dram of brandy,
taken at bed-time, prevent this disease. That, however, is a bad
custom, and in time loses its effect. The patient should rather de-
pend upon the use of food of easy digestion, cheerfulness, exercise
through the day, and a light supper taken early, than accustom him-
self to drams. A glass of peppermint-water will often promote di-
gestion as much as a glass of brandy, and is much safer. After a per-
son of weak digestion, however, has eaten flatulent food, a dram
may be necessary; in this case, it is the most proper medicine.
Of Swoonings.
PEOPLE of weak nerves or delicate constitutions, are liable to
swoonings or fainting fits. These are seldom dangerous when duly
attended to; but when wholly neglected, or improperly treated,
they often prove hurtful, and sometimes fatal.
The general causes of swoonings are, sudden transition from cold
to heat; breathing air that is deprived of its proper spring or elas-
ticity; great fatigue; excessive weakness; loss of blood; long
fasting; fear, grief, and other violent passions or affections of the
mind.
Persons who have been long exposed to cold, often faint or fall
into a swoon, upon coming into the house, especially if they drink
hot liquor, or sit near a large fire. This might easily be prevented
by people taking care not to go into a warm room immediately af-
ter they have been exposed to the cold air, to approach the fire gra-
dually, and not to eat or drink any thing hot, till the body has been
gradually brought into a warm temperature.
When any one, in consequence of neglecting these precautions,
falls into a swoon, he ought immediately to be removed to a cooler
apartment, to have ligatures applied above his knees and elbows,
and to have his hands and face sprinkled with vinegar or cold water.
He should likewise be made to smell to vinegar, and should have a
spoonful or two of water, if he can swallow, with about a third-
part of vinegar mixed with it, poured into his mouth. If these should
not remove the complaint, it will be necessary to bleed the patient,
and afterwards to give him a clyster.
As air that is breathed frequently loses its elasticity or spring, it
is no wonder, if persons who respire in it, often fall into a swoon or
fainting fit. They are, in this case, deprived of the very principle 

310 SW00NINGS.
of life. Hence it is, that fainting fits are so frequent in all crowded
assemblies, especially in hot seasons. Such fits, however, must be
considered as a kind of temporary death; and, to the weak and de-
licate, they sometimes prove fatal. They ought, with the utmost
care, to be guarded against. The method of doing this is obvious.
Let assembly-rooms, and all other places of public resort, be large
and well ventilated; and let the weak and delicate avoid such places,
particularly in warm seasons.
A person who faints, in such a situation, ought immediately to
be carried into the open air; his temples should be rubbed with
strong vinegar or brandy, and volatile spirits or salts held to his nose.
He should be laid upon his back with his head low, and have a little
wine, or some other cordial, as soon as he is able to swallow it,
poured into his mouth. If the person has been subject to hysteric fits,
castor or asafœtida should be applied to the nose, or burnt feathers,
horn, or leather, &c.
When fainting-fits proceed from mere weakness or exhaustion,
which is often the case after great fatigue, long fasting, loss of
blood, or the like, the patient must be supported with generous cor-
dials, as jellies, wines, spirituous liquors, &c. These, however, must
be given at first in very small quantities, and increased gradually as
the patient is able to bear them. He ought to be allowed to lie
quite still and easy upon his back, with his head low, and should
have fresh air admitted into his chamber. His food should consist
of nourishing broths, sago-gruel with wine, new milk, and other
tilings of a light and cordial nature. These thing are to be given
out of the fit. All that can be done in the fit is, to let him smell to
a bottle of Hungary-water, eau de luce, or spirits of hartshorn, and
to rub his temples with warm brandy, or to lay a compress dipped
in it to the pit of the stomach.
In fainting-fits that proceed from fear, grief, or other violent pas-
sions or affections of the mind, the patient must be very cautiously
managed. He should be suffered to remain at rest, and only made
to smell some vinegar. After he is come to himself, he may drink
freely of warm lemonade, or balm-tea, with some orange or lemon-
peel in it. It will likewise be proper, if the fainting-fits have been
long and severe, to clean the bowels by throwing in an emollient
clyster.
It is common in fainting-fits, from whatever cause they proceed,
to bleed the patient. This practice may be very proper in strong
persons of a full habit; but in those who are weak and delicate, or
subject to nervous disorders, it is dangerous. The proper method
with such people is, to expose them to the free air, and to use cor-
dial and stimulating medicines, as volatile salts, Hungary-water,
spirits of lavender, tincture of castor, and the like. 

311
Of Flatulencies, or Wind.
ALL nervous patients, without exception, are afflicted with wind
or flatulencies in the stomach and bowels, which arise chiefly from
the want of tone or vigour in these organs. Crude, flatulent ali-
ment, as green pease, beans, coleworts, cabbages, and such-like, may
increase this complaint; but strong and healthy people are seldom
troubled with wind, unless they either overload their stomachs, or
drink liquors that are in a fermenting state, and consequently full
of elastic air. While, therefore, the matter of flatulence proceeds
from our aliments, the cause which makes air separate from them,
in such quantity as to occasion complaints, is almost always a fault
of the bowels themselves, which are too weak either to prevent the
production of elastic air, or to expel it after it is produced.
To relieve this complaint, such medicines ought to be used as
have a tendency to expel wind, and by strengthening the alimen-
tary canal, to prevent its being produced there *.
The list of medicines for expelling wind is very numerous; they
often disappoint the expectations of both the physician and his pa-
tient. The most celebrated among the class of carminatives are ju-
nipar-berries; the roots of ginger and zedoary; the seeds of anise,
caraway, and coriander; gum asafœtida and opium; the warm wa-
ters, tinctures, and spirits, as the aromatic water, the tincture of
woodfoot, the volatile aromatic spirit, æther, &c.
Dr. Whytt says, he found no medicines more efficacious in ex-
pelling wind than æther and laudanum. He generally gave the lau-
danum in a mixture with peppermint-water and tincture of castor,
or sweet spirits of nitre. Sometimes, in place of this, he gave opi-
um in pills with asafœtida. He observes, that the good effects of
opiates are equally conspicuous, whether the flatulence be contain-
ed in the stomach or intestines; whereas, those warm medicines,
commonly called carminatives, do not often give immediate relief,
except when the wind is in the stomach.
With regard to æther, the Doctor says, he has often seen very
good effects from it in flatulent complaints, where other medicines
failed. The dose is a tea-spoonful mixed with two table-spoonfuls
of water †. In gouty cases, he observes, that æther, a glass of French
brandy, or of the aromatic water, or ginger, either taken in sub-
* Many nervous people find great benefit from eating a dry biscuit,
especially when the stomach is empty. This is one of the best carmina-
tive medicines in all complaints of the stomach, arising from flatulence,
indigestion, &c.
† Though the patient may begin with this quantity, it will be neces-
sary to increase the dose gradually as the stomach can bear it. Æther
is now given in considerably greater doses than it was in Dr. Whytt's
time. 

312 FLATULENCIES, OR WIND.
stance or infused in boiling water, are among the best medicines
for expelling wind.
When the case of flatulent patients is such as makes it impro-
per to give them warm medicines inwardly, he recommends exter-
nal applications, which are sometimes of advantage. Equal parts
of the anti hysteric and stomach plaister may be spread upon a
piece of soft leather, of such size as to cover the greater part of
the belly. This should be kept on for a considerable time, provi-
ded the patient be able to bear it; if it should give great uneasi-
ness, it may be taken off, and the following liniment used in its
stead:
Take of Bates's anodyne balsam an ounce; of the expressed oil
of mace half an ounce; oil of mint two drachms. Let these be
mixed together, and about a table-spoonful well rubbed on the
parts at bed-time.
For strengthening the stomach and bowels, and lessening the
production of flatulence, the Doctor recommends the Peruvian
bark, bitters, chalybeates, and exercise. In flatulent cases, he thinks
some nutmeg or ginger should be added to the tincture of the bark
and bitters, and that the aromatic powder should be joined with
the filings of iron.
When windy complaints are attended with costiveness, which
is often the case, few things will be found to answer better than
four or five of the following pills taken every night at bed-time.
Take of asafœtida, two drachms; succotrine aloes, salt of iron,
and powdered ginger, of each one drachm; as much of the elixir
proprietatis as will be sufficient to form them into pills.
On the other hand, when the body is too open, twelve or fifteen
grains of rhubarb, with half a drachm, or two scruples of the Japo-
nic confection, given every other evening, will have very good of-
fects.
In those flatulent complaints which come on about the time the
menses cease, repeated small bleedings often give more relief than
any other remedy.
With regard to diet, the Doctor observes, that tea, and all flatu-
lent aliments, are to be avoided; and that for drink, water with a
little brandy or rum is preferable to malt liquor, and in most cases
to wine.     
Dr. Whytt has paid great attention to this subject; his senti-
ments upon it, in a great measure, agree with mine. I shall only add
to his observation, that exercise is, in my opinion, superior to all
medicine, both for preventing the production and likewise for ex-
pelling of flatulencies. These effects are not to be expected from
sauntering about, or lolling in a carriage; but from labour, or such
aaive amusements as give exercise to every part of the body.

[313]
Of Low Spirits.
ALL who have weak nerves are subject to low spirits in a grea-
ter or less degree. Generous diet, the cold bath, exercise, and
amusements are the most likely means to remove this complaint. It
is greatly increased by solitude and indulging gloomy ideas; but
may often be relieved by cheerful company and sprightly amuse-
When low spirits are owing to a weak relaxed state of the sto-
mach and bowels, an infusion of the bark with cinnamon or nut-
meg will be proper. Steel joined with aromatics may be used with
advantage; but riding, and a proper diet, are most to be depended on.
When they arise from a foulness of the stomach and intestines,
or obstruction in the hypochondriac viscera, aloetic purges will be
proper. I have known the Harrowgate sulphur-water of service in
this case.
When low spirits proceed from a suppression of the menstrual or
of the hæmorrhoidal flux, these evacuations may either be restored,
or some others substituted in their place, as issues, setons, or the
like. Dr. Whytt observes, that nothing has such sudden good effects
in this case as bleeding, if the strength of the patient will admit of
it.                                              
When low spirits have been brought on by long continued grief,
anxiety, or other distress of mind, agreeable company, variety of
amusements, and change of place, especially travelling into foreign
countries, will afford the most certain relief.
Persons afflicted with low spirits should avoid all kinds of excess,
especially of venery and strong liquors. The moderate use of wine
and other strong liquors is by no means hurtful; but when taken to
excess, they weaken the stomach, and depress the spirits. This cau-
tion is the more necessary, as the unfortunate and melancholy often
fly to strong liquors for relief, by which means they never fail to
precipitate their own destruction.
Of Hysteric Affections.
THESE likewise belong to the numerous tribe of nervous disea-
ses, which may be justly reckoned the reproach of medicine. Wo-
men of a delicate habit, whose stomach and intestines are relaxed,
and whose nervous system is extremely sensible, are most subject to
hysteric complaints. In such persons, an hysteric fit, as it is called,
may be brought on by an irritation of the nerves of the stomach or
intestines, by wind, acrid humour, or the like. A sudden suppres-
sion of the menses often gives rise to hysteric fits. They may likewise 
R

314 HYSTERIC AFFECTIONS.
be excited by violent passions or affections of the mind, as fear
grief, anger, or great disappointments.
Sometimes the hysteric fits resemble a swoon or fainting fit, du-
ring which the patient lies as in a sleep, only the breathing is so low
as scarce to be perceived. At other times the patient is affected
with catchings and strong convulsions. The symptoms which pre-
cede hysteric fits are likewise various in different persons. Some-
times the fits come on with coldness of the extremities, yawning
and stretching, lowness of spirits, oppression and anxiety. At other
times the approach of the fit is foretold by a feeling, as if there
were a ball at the lower part of the belly, which gradually rises
towards the stomach, where it occasions inflation, sickness, and
sometimes vomiting; afterwards it rises into the gullet, and occa-
sions a degree of suffocation, to which quick breathing, palpitation
Of the heart, giddiness of the head, dimness of the sight, loss of hear-
ing, with convulsive motions of the extremities and other parts of
the body, succeed. The hysteric paroxysm is often introduced by 
an immoderate fit of laughter, and sometimes it goes off by crying.
Indeed, there is not much difference between the laughing and cry-
ing of an highly hysteric lady.
Our aim in the treatment of this disease must be to shorten the
fit or paroxysm when present, and to prevent its return. The lon-
ger the fits continue, and the more frequently they return, the dis-
ease becomes the more obstinate. Their strength is increased by ha-
bit, and they induce so great a relaxation of the system, that it is
with difficulty removed.
It is customary, during the hysteric fit or paroxysm, to bleed the
patient. In strong persons of a plethoric habit, and where the pulse
is full, this may be proper; but in weak and delicate constitutions,
or where the disease has been of long standing, or arises from ina-
nition, it is not safe. The best course in such cases is to rouse the
patient by strong smells, as burnt feathers, asafœtida, or spirits of
hartshorn, held to the nose. Hot bricks may be applied to the soles
of the feet, and the legs, arms, and belly may be strongly rubbed
with a warm cloth. But the best application is to put the feet and
legs into warm water. This is peculiarly proper when the fits pre-   
cede the flow of the menses. In case of costiveness, a laxative clys-
ter with asafœtida will be proper; and as soon as the patient can
swallow, two table-spoonfuls of a solution of asafœtida may be
given *.
The radical cure of this disorder will be best attempted at a time
when the patient is most free from the fits. It will be greatly pro-
* When hysteric fits are occasioned by sympathy, they may be cured
by exciting an opposite passion. This is said to have been the case of a
whole school of young ladies in Holland, who were all cured by being
told, that the first who was seized should be burnt to death. But this
method, of cure, to my knowledge, will not always succeed. I would
therefore advise, that young ladies who are subject to hysteric fits, should
not be sent to boarding schools, as the disease may be caught by imita-  
ion. I have known madness 

315 HYSTERIC AFFECTIONS.          
moted by a proper attention to diet. A milk and vegetable diet
when duly persisted in, will often perform a cure. If however the
patient has been accustomed to a more generous diet, it will not be
safe to leave it off all at once, but by degrees. The most proper
drink is water, with a small quantity of spirits. A cool dry air is the
best. Cold bathing and every thing that braces the nerves, and in-
vigorates the system, is beneficial; but lying too long in bed, or
whatever relaxes the body, is hurtful. It is of the greatest impor-
tance to have the mind kept constantly easy and cheerful, and, if
possible, to have it  always engaged in some agreeable and interes-
ting pursuit.
The proper medicines are those which strengthen the alimentary
canal and the whole nervous system, as the preparations or iron, the
Peruvian bark, and other bitters. Twenty drops of the elixir of vi-
triol, in a cup of the infusion of the bark, may be taken twice or
thrice a-day. The bark and iron may likewise be taken in sub-
stance, provided the stomach can bear them; but they are generally
given in too small doses to have any effect. The chalybeate waters
generally prove beneficial in this disorder.
If the stomach is loaded with phlegm, vomits will be of use;
but they should not be too strong, nor frequently repeated, as they
tend to relax and weaken the stomach. If there be a tendency to
costiveness, it must be removed either by diet, or by taking an
opening pill as often as it shall be found necessary.
To lessen the irritability of the system, antispasmodic medicines
will be of use. The best antispasmodic medicines are musk, opium,
and castor. When opium disagrees with the stomach, it may either
be applied externally, or given in clysters. It is often successful in
removing those periodical head-achs to which hysteric and hypo-
chondriac patients are subject. Castor has in some cases been found
to procure sleep where opium failed; for which reason, Dr. Whytt
advises, that they should be joined together. He likewise recom-
mends the antihysteric plaister to be applied to the abdomen *.
Hysteric women are often afflicted with cramps in various parts
of the body, which are most apt to seize them in bed, or when
asleep. The most efficacious medicines in this case are opium, blis-
ters, and warm bathing or fomentations. When the cramp or spasm
is very violent, opium is the medicine most to be depended on. In
milder cases, immersing the feet and legs in warm water, or apply-
ing a blister to the part affected, will often be sufficient to remove
the complaint. In patients whose nerves are uncommonly delicate
and sensible, it will be better to omit the blister, and to attempt the
cure by opiates, musk, camphire, and the warm bath.
Cramps are often prevented or cured by compression. Thus
cramps in the legs are prevented, and sometimes removed, by tight
* Though antispasmodics and anodynes are universally recommended
in this disease, yet all the extraordinary cures that I ever knew in hys- 
teric cases were performed by means of tonic and corroborating medi-
cine.

316 HYPOCHONDRIAC AFFECTIONS.
bandages; and when convulsions arise from a flatulent distention
of the intestines, or from spasms beginning in them, they may be
often lessened or cured by making a pretty strong compression up-
on the abdomen by means of a broad belt. A roll of brimstone
held in the hand is frequently used as a remedy for cramps. Though
this seems to owe its effect chiefly to imagination; yet, as it some-
times succeeds, it merits a trial *. When spasms or convulsive mo-
tions arise from sharp humours in the stomach and intestines, no
lasting relief can be procured till these are either corrected or ex-
pelled. The Peruvian bark has sometimes cured periodic convulsions
after other medicines had failed.
Of Hypochondriac Affections.
THIS disease generally attacks the indolent, the luxurious, the
unfortunate, and the studious. It becomes daily more common in
this country, owing, no doubt, to the increase of luxury and seden-
tary employments. It has so near a resemblance to the immediate-
ly preceding, that many authors consider them as the same disease,
and treat them accordingly. They require however a very different
regimen; and the symptoms of the latter, though less violent, are
more permanent than those of the former.                     
Men of a melancholy temperament, whose minds are capable of
great attention, and whose passions are not easily moved, are, in the
advanced periods of life, most liable to this disease. It is usually
brought on by long and serious attention to abstruse subjects, grief,
the suppression of customary evacuations, excess of venery, the re-
pulsion of cutaneous eruptions, long-continued evacuations, obstruc-
tions in some of the viscera, as the liver, spleen, &c.
Hypochondriac persons ought never to fast long, and their food
should be solid and nourishing. All acescent and windy vegetables
are to be avoided. Flesh meats agree best with them, and their drink
should be old claret, or good Madeira. Should these disagree with
the stomach, water with a little brandy or rum in it may be drank.
Cheerfulness and serenity of mind are by all means to be culti-
vated. Exercise of every kind is useful. The cold bath is likewise
beneficial; and, where it does not agree with the patient, frictions
with the flesh-brush or a coarse cloth may be tried. If the patient
has it in his power, he ought to travel either by sea or land. A voyage
or a long journey, especially towards a warmer climate, will be
of more service than any medicine.
* Some persons afflicted with cramps pretend to reap great benefit
from small bundles of rosemary tied all night about their feet, ancles,
and knees.       

317 HYPOCHONDRIAC AFFECTIONS.     
The general intentions of cure, in this disease, are to strengthen
the alimentary canal, and to promote the secretions. these inten-
tions will be best answered by the different preparations of iron and
the bark, which, after proper evacuations, may be taken as directed
in the preceding disease.
If the patient be costive, it will be necessary to make use of some
gentle opening medicine, as pills composed of equal parts of aloes,
rhubarb, and asafœtida, with as much of the elixir proprietatis as is
necessary to form the ingredients into pills. Two, three, or four,
of these may be taken as often as it shall be found needful, to keep
the body gently open. Such as cannot bear the asafœtida may sub-
stitute Spanish soap in its place.
A cheerful glass may have good effects in this disease, but all
manner of excess is hurtful. Intense study, and every thing that de-
presses the spirits, are likewise pernicious.
Though the general symptoms and treatment of nervous disor-
ders were pointed out in the beginning of this chapter; yet, for the
benefit of the unhappy persons afflicted with these obstinate and
complicated maladies, I have treated several of their capital symp-
toms under distinct or separate heads. These are not to be consider-
ed as different diseases, but as various modifications of the same
disease. They all arise from the same general causes, and require
nearly the same method of treatment. There are many other symp-
toms that merit particular attention, which the nature of my plan
will not permit me to treat of at full length. I therefore omit them,
and conclude this chapter with a few remarks on the means of pre-
venting or avoiding nervous disorders.
In all persons thus afflicted, there is a great delicacy and sensi-
bility of the whole nervous system, and an uncommon degree of weak-
nefs of the organs of digestion. These maybe either natural or ac-
quired. When owing to a defect in the constitution, they are hardly
to be removed; but may be mitigated by proper care. When in-
duced by diseases, as long or repeated fevers, profuse hæmorrhages,
or the like, they prove also very obstinate, and will yield only to a
course of regimen calculated to restore and invigorate the habit.
But nervous affections arise more frequently from causes, which
it is, in a great measure, in our power to avoid, than from diseases,
or an original fault in the constitution, &c. Excessive grief, intense
study, improper diet, and neglect of exercise, are the great sources
of this extensive class of diseases.
Grief indulged, destroys the appetite and digestion, depresses the
spirits, and induces an universal relaxation and debility of the whole
system. Instances of this are daily to be seen. The loss of a near
relation, or any other misfortune in life, often occasions the most
complicated series in nervous symptoms. Such misfortunes are not
to be avoided, but their effects, by a vigorous and proper exertion
of the mind, might be rendered less hurtful. We refer the reader to
the article GRIEF, in the chapter on the passions.

318 DISORDERS OF THE SENSES.
The effects of intense study are pretty similar to those occasioned
by grief. It preys upon the animal spirits, and destroys the appetite
and digestion. To prevent these effects, studious persons ought, ac-
cording to the poet, to toy with their books *. They should never study
too long at a time; nor attend long to one particular subject, es-
pecially if it be of a serious nature. They ought likewise to be at-
tentive to their posture, and take care frequently to unbend their
minds by music, diversions, or going into agreeable company.
With regard to diet, nervous diseases may be induced either by
excess or inanition. Both of these extremes hurt the digestion.
When Nature is oppressed with fresh loads of food, before she has
had time to digest and assimilate the former meal, her powers are
weakened. On the other hand, when the food is not sufficiently
nourishing, or is taken too seldom, the bowels are inflated with
wind. These extremes are with equal care to be avoided. They
both tend to induce a relaxation, and debility of the nervous sys-
tem, with all its consequences.
The most general cause of nervous disorders is indolence. The
active and laborious are seldom troubled with them. They are re-
served for the children of ease and affluence, who generally feel their
keenest force. The means of prevention and cure are both in their
power. If the constitution of human nature be such, that man must
either labour or suffer diseases, no individual has a right to expect
exemption from the general rule.
Those who are willing to take exercise, but whose occupations
confine them to the house, and perhaps to an unfavourable posture,
deserve pity.
We have, in the former part of this book, endeavoured to lay
down rules for their conduct; and where these cannot be complied
with, their place may, in some measure, be supplied by the use of
bracing and strengthening medicines, as the bark, with other bit-
ters; the preparations of steel; the elixir of vitriol, &c.
CHAPTER XLVI.
Disorders of the Senses.
WE do not mean to give a description of the organs by which
the senses are performed; but to point out some of the
diseases to which these organs are most liable, and to shew how they
may be prevented or remedied.
* Armstrong on health. 

[319]
Of the Eye.
NO organ of the body is subject to more diseases than the eye;
nor is there any one of which the diseases are more difficult to cure.
Though more ignorant persons pretend to cure these than any other
class of diseases; yet a very superficial acquaintance with the
structure of the eye, and the nature of vision, will be sufficient to
convince any one of the danger of trusting to them. These diseases
often exceed the skill of the most learned physician; hence we may
infer the danger of trusting them to ignorant quacks, who put out
more eyes than they cure. But, though the diseases of the eye can
seldom be cured, they might often, by due care, be prevented; and,
even where the sight is totally lost, many things might be done,
which are generally neglected, to render the person both more use-
ful to himself and to society *.
The eyes are hurt by viewing bright or luminous objects; keep-
ing the head too long in a hanging posture; violent head-achs; ex-
cessive venery; the long use of bitters; the effluvia from acrid or
volatile substances; various diseases; as the small-pox, measles, &c.
but, above all, from night-watching, and candle-light studies. Long
fasting is likewise hurtful to the eyes, and frequent heats and colds
are no less pernicious. The eyes are often hurt by the stoppage of
customary evacuations; as morning sweats; sweating of the feet;
the menses in women; and the bleeding piles in men. All kinds
of excess are hurtful to the sight, particularly the immoderate use of
ardent spirits and other strong liquors.
In all diseases of the eyes, especially those attended with inflam-
mation, the cool regimen ought to be observed. The patient must
abstain from all spirituous liquors. The smoke of tobacco, smoky
rooms, the vapours of onions and garlic, and all vivid lights and
glaring colours, are carefully to be avoided. The drink may be wa-
ter, whey, or small beer; and the aliment must be light and of ea-
sy digestion.
For preventing disorders of the eyes, issues and setons are of
prime use. Every person, whose eyes are tender, ought to have one
or more of these in some part of the body. It will likewise be of use
to keep the body gently open, and either to bleed or purge every
* It is pity those who have the misfortune to be born blind, or who
lose their sight when young, should be suffered to remain in ignorance,
or to beg. This is both cruelty and want of economy. There are many
employments of which blind persons are very capable, as knitting, card-
ing, turning a wheel, teaching languages, &c. Nor are instances want-
ing of persons who have arrived at the highest pitch of learning, with-
out having the least idea of light. Witness the, late famous Nicholas
Sanderson of Cambridge, and Dr. Thomas Blacklock of Edinburgh.
The former was one of the first mathematicians of his age, and the lat-
ter, besides being a good poet and philosopher, is matter of all the
learned languages, and a very considerable adept in the liberal arts.

320 OF THE EYE.
spring and fall. All excess and night studies are to be avoided. Such
as do not choose a seton or an issue, will find benefit from wearing a
small Burgundy-pitch plaster between their shoulders.
A gutta serena, or amaurosis, is an abolition of the sight without
any apparent cause or fault in the eyes. When it is owing to a decay
or wasting of the optic nerve, it does not admit of a cure; but when
it proceeds from a compression of the nerves by redundant humours,
these may in some measure be drained off, and the patient reliev-
ed. For this purpose, the body must be kept open with the laxative
mercurial pills. If the patient be young and of a sanguine habit, he
may be bled. Cupping, with scarifications on the back part of the
head, will likewise be of use. A running at the nose may be pro-
moted by volatile salts, stimulating powders, &c. But the most like-
ly means for relieving the patient, are issues or blisters kept open for
a long time on the back part of the head, behind the ears, or on the
neck. I have known these restore sight, even after it had been for a
considerable time lost. Should these fail, recourse must be had to a
mercurial salivation *.
A cataract is an obstruction of the pupil, by the interposition of
some opaque substance, which either diminishes or totally extin-
guishes the sight. It is generally an opacity of the chrystalline hu-
mour. In a recent or beginning cataract, the same medicines are to
be used as in the gutta serena; and they will sometimes succeed.
But when this does not happen, and the cataract becomes firm, it
must be couched, or rather extracted. I have resolved a recent ca-
taract by giving the patient frequent purges with calomel, keeping
a poultice of fresh hemlock constantly upon the eye, and a perpetu-
al blister on the neck.
The myopia, or short-sightedness, and the presbyopia, or seeing only at  \
too great a distance, are disorders which depend on the original struc-
ture or figure of the eye, therefore admit of no cure. The inconve-
niencies arising from them may however be, in some measure, re-
medied by the help of proper glasses. The former requires the aid
of a concave, and the latter of a convex glass.                   
A strabismus or squinting, depends upon an irregular contraction
of the muscles of the eye from a spasm, palsy, epilepsy, or an ill ha-
bit. Children often contract this disorder by having their eyes un-
equally exposed to the light. They may likewise acquire it by imi-
tation from a squinting nurse or play fellow, &c. As this disorder 
can hardly be cured, parents ought to be careful to prevent it. Al-
most the only thing which can be done for it, is to contrive a mask
for the child to wear, which will only permit him to see in a straight
direction.
Spots or specks on the eyes are generally the effect of inflammation,
and often appear after the small-pox, the measles, or violent ophthal-
* Electuary has been known to have a good effect in this disease, par-
ticularly when applied to parts near the eyes. (I. C.) 

321 THE EAR.
mias. They are very difficult to cure, and often occasion total blind-
ness. If the specks are soft and thin, they may sometimes be taken
off by gentle caustics and discutients; as vitriol, the juice of celan-
dine, &c. When these do not succeed, a surgical operation may
be tried: the success of which is always very doubtful.
The blood-shot eye may be occasioned by a stroke, a fall, retching,
vomiting, violent coughing, &c. I have frequently known it happen
to children in the hooping-cough. It appears at first like a hit of
scarlet, and is afterwards of a livid or blackish colour. This disor-
der generally goes off without medicine. Should it prove obstinate,
the patient may be bled, and have his eyes bathed with rich led wa-
ter, and the body should be kept open by gentle purgatives.
The watery or weeping eye is generally occasioned by a relaxation
or weakness of the glandular parts of that organ. These may be
braced and strengthened by bathing the eye with brandy and wa-
ter, Hungary-water, rose-water with white vitriol dissolved in it,
&c. Medicines which make a revulsion are likewise proper; as mild
purgatives, perpetual blisters on the neck, bathing the feet frequent-
ly in lukewarm water, &c.
When this disease proceeds from an obstruction of the lachrymal
duct, or natural passage of the tears, it is called a fistula lachryma-
lis, and can only be cured by a surgical operation.
Of the Ear.
THE functions of the ear may be injured by wounds, ulcers, or
any thing that hurts its fabric. The hearing may likewise be hurt
by excessive noise; violent colds in the head; fevers, hard wax, or
other substances sticking in the cavity of the ear; too great a degree
of moisture or dryness of the ear. Deafness is very often the effect
of old age, and is incident to most people in the decline of life.
Sometimes it is owing to an original fault in the structure or for-
mation of the ear itself. When this is the case, it admits of no
cure; and the person not only continues deaf, but generally likewise
dumb for life *.
When deafness is the effect of wounds or ulcers of the ears, or
of old age, it is not easily removed. When it proceeds from cold
* Though those born deaf are generally suffered to continue dumb,
and consequently are, in a great measure, lost to society, yet nothing is
more certain than that such persons may be taught not only to read and
write, but also to speak, and to understand what others say to them.
Teaching the dumb to speak will appear paradoxical to those who do
not consider that the formation of sounds is merely mechanical, and
may be taught without the assistance of the ear. This is hot only capa-
S2

322 THE EAR.
of the head, the patient must be careful to keep his head warm, es-
pecially in the night; he should likewise take some gentle purges,
and keep his feet warm, and bathe them frequently in lukewarm
water at bed-time. When deafness is the effect of a fever, it gene-  
rally goes off after the patient recovers. If it proceeds from dry,
wax sticking in the ears, it may be softened hf dropping oil into
them*; afterwards they must be syringed with warm milk and
water. 
If deafness proceeds from dryness of the ears, which may be
known by looking into them, half an ounce of the oil of sweet al-
monds, and the same quantity of liquid apodeldoch, or tincture of
asafœtida, may be mixed together, and a few drops of it put into  
the ear every night at bed-time, stopping them afterwards with a
little wool or cotton. Some, instead of oil, put a small slice of the  «
fat of bacon into each ear, which is said to answer the purpose ve-
ry well. When the ears abound with moisture, it may be drained 
off by an issue or seton, which should be made as near the affected
parts as possible.             
Some, for the cure of deafness, recommend the gall of an eel
mixed with spirit of wine, to be dropped into the ear; others,
equal parts of Hungary-water and spirit of lavender. Etmuller ex-
tols amber and musk; and Brookes says, he has often known hard-  
ness of hearing cured, by putting a grain or two of musk into the
ear with cotton-wool. But these and other applications must be va-
ried, according to the cause of the disorder.  
Though such applications may sometimes be of service, yet they
much oftener fail, and frequently they do hurt. Neither the eyes nor
ble of demonstration, but is actually reduced to practice by Mr. Thomas 
Braidwood, of Edinburgh. This gentleman has, by the mere force of 
genius and application, brought the teaching of dumb persons to such a 
degree of perfection, that his scholars are generally more forward in
their education than these of the same age who enjoy all their faculties.  
They not only read and write with the utmost readiness, but likewise
speak, and are capable of holding conversation with any person in the  
light. What a pity anyofthe human species should remain in a state of idi-
otism who are capable of being rendered useful and intelligent. 
We mention this not only from humanity to those who have the misfor-  
tune to be born deaf, but also injustice to Mr. Braidwood, whose suc-
cess has far exceeded all former attempts this way; and indeed it ex-  
seeds imagination itself so far, that no person who has not seen and ex-  
amined his pupils, can believe what they are capable of. As this gentle- 
man, however willing, is only able to teach a few, and as the far great-
er part of those who are born deaf cannot afford to attend him, it would 
be an act of great humanity, as well as of public utility, to erect an 
academy for their benefit.                                          
* Good effects have been derived from wearing a conical plug in the 
ear, made of the stalk of a green cabbage, which will, after a while, give 
out its water, and be more constantly applied in dissolving the wax, so as
to prepare it for syringing with milk and water. (I. C.) 

323 TASTE  AND SMELL.           
ears ought to be tampered with; they are tender organs, and re-
quire a very delicate touch. I chiefly recommend in deafness to keep
the head warm. From whatever cause the disorder proceeds this is
always proper; and I have known more benefit from it alone, in
the most obstinate cases of deafness, than from all the medicines I
ever used.
The Taste and Smell
ARE not of so great importance to man in a state of society, as
the sight and hearing; yet, as the loss of them is attended with, in-
conveniency, they deserve our notice. They are seldom to be re-
stored when lost; which ought to make us very attentive to their
preservation, by carefully avoiding whatever may injure them. As
there is a very great affinity between the organs of tasting and smel-
ling, whatever hurts the one generally affects the other.
Luxury is highly injurious to these organs. When the nose and
palate are frequently stimulated by fragrant and poignant dishes,
they soon lose the power of distinguishing tastes and odours with
any degree of nicety. Man, in a state of nature, may perhaps have
these faculties as acute as any other animal.
The sense of smelling may be diminished or destroyed by disease;
as, the moisture, dryness, inflammation or suppuration of that mem-
brane which lies the inside of the nose, commonly called the olfac-
tory membrane; the compression of the nerves which supply this
membrane, or some salt in the brain itself at their origin. A defect,
or too great a degree of solidity, of the small spungy bones of the
upper jaw, the caverns of the forehead, &c. may impair the sense
of smelling. It may be injured by a collection of fœtid matter in
those caverns, which keeps constantly exhaling from them. Few
things are more hurtful to the sense of smelling than quantities of
snuff.
When the nose abounds with moisture, after gentle evacuations,
such things as tend to take off irritation, and coagulate the thin, sharp
serum, may be applied; as the oil of anise mixed with fine flour;
camphire dissolved in oil of almonds, &c. The vapours of amber,
frankincense, gum-mastic; and benjamin, may likewise be received
into the nose and mouth.
For moistening the mucus when it is too dry, some recommend
snuff made of the leaves of marjoram, mixed with the oil of amber,
marjoram and aniseed; or a sternutatory of calcined white vitriol;
twelve grains of which may be mixed with two ounces of marjoram-
water, and filtrated. The steam or vapour of vinegar upon hot iron 

324 THE TOUTCH.
received up the nostrils, is of use for softening the mucus, opening
obstructions, &c.
If there is an ulcer in the nose, it ought to be dressed with some
emollient ointment, to which, if the pain be very great, a little lau-
danum may be added. If a venereal ulcer, it is not to be cured with-
out mercury. In that case, the solution of the corrosive sublimate in
brandy, may be taken, as directed in the gutta serena. The ulcer
ought likewise to be washed with it; and the fumes of cinnabar
may be received up the nostrils.
If there be reason to suspect that the nerves which supply the or-
gans of smelling, are inert, or want stimulating, volatile salts, strong
snuffs, and other things which occasion sneezing, may be applied to   
the nose. The forehead may likewise be anointed with balsam of
Peru, to which may be added a little of the oil of amber.
The taste may be diminished by crusts, filth, mucus, aphthæ,
pellicles, warts, &c. covering the tongue: it may be depraved by a
fault of the saliva, which, being discharged into the mouth, gives  
the same sensation, as if the food, which the person takes, had real-
ly a bad taste; or it may be entirely destroyed by injuries done to
the nerves of the tongue and palate. Few things prove more hurt-
ful either to the sense of tasting or smelling than obstinate colds, es-
pecially those which affect the head.
When the taste is diminished by filth, mucus, &c. the tongue
ought to be scraped and frequently washed with a mixture of water,
vinegar, and honey, or some other detergent. When the saliva is
vitiated, which seldom happens unless in fevers or other diseases,
the curing of the disorder is the cure of this symptom. To leave it
in the mean time, if there be a bitter taste, it may be taken away by   
vomits, purges, and other things which evacuate bile. What is cal-
led a nidorous taste, arising from putrid humours, is corrected by 
the juice of citrons, oranges, and other acids. A salt, taste is cured by
plentiful dilution with watery liquors. An acid taste is destroyed by
absorbents, and alkaline salts, as powder of oyster-shells, salt of
worm-wood, &c.                                               
When the sensibility of the nerves which supply the organs of  
taste is diminished, the chewing of horse-radish, or other stimulating
substances, will help to recover it.
Of the Touch.
THE sense of touching may be hurt by any thing that obstructs
the nervous influence, or prevents its being regularly conveyed to   
the organs of touching; as pressure, extreme cold, &c. It may like-
wise be hurt by too great a degree of sensibility, when the nerve is
not sufficiently covered by the cuticle or scarf-skin, or where there 

325 SCHIRRUS AND CANCER.           
is too great a tension of it, or it is too delicate. Whatever disorders
the functions of the brain and nerves, hurts the sense of touching.
Hence it appears to proceed from the same general causes as palsy
and apoplexy, and requires nearly the same method of treatment.
In a stupor, or defect of touching, which arises from an obstruc-
tion of the cutaneous nerves, the patient must first be purged; afte-
wards such medicines as excite the action of the nerves, or stimu-
late the system, may be used. For this purpose, the spirits of harts-
horn, sal volatile oleosum, horse-radish, &c. may be taken inwardly;
the disordered parts, at the same time, may be frequently rubbed
with fresh nettles or spirit of sal ammoniac. Blisters and sinapisms
applied to the parts will likewise be of use, as also warm bathing,
especially in the natural hot baths.
CHAPTER XLVII.
Of a Schirrus and Cancer.
A SCHIRRUS is a hard indolent tumour seated in some of
the glands; as the breasts, the arm-pits, &c. If the tumour
becomes large, unequal, of a livid, blackish, or leaden colour, and
is attended with violent pain, it gets the name of an occult cancer.
When the skin is broken, and a sanies or ichorous matter, of an
abominably fœtid smell is discharged from the sore, it is called an
open or ulcerated cancer. Persons after the age of forty-five, par-
ticularly women, and those who lead an indolent sedentary life, are
most subject to this disease.
CAUSES.—It is often owing to suppressed evacuations; hence
it proves frequently fatal to women of a gross habit, particularly
old maids and widows, about the time when the menstrual flux
ceases. It may be occasioned by excessive fear, grief, anger, religious
melancholy, or any of the depressing passions. Hence, the unfortu-
nate, the choleric, and those persons who devote themselves to a
religious life in convents or monasteries, are often afflicted with
it. It may be occasioned by the long-continued use of food that is
too hard of digestion, or of an acrid nature; by barrenness; celibacy;
indolence; cold; blows; friction; pressure, or the like. Women
often suffer from the last of these, by means of their stays, which
squeeze and compress their breasts so as to occasion great mischief.
Sometimes the disease is owing to an hereditary disposition.
SYMPTOMS.—This disorder seems often very trifling at the
beginning. A hard tumour about the size of a hazle-nut, or per-
haps smaller, is generally the first symptom. This will often con-
tinue for a long time without seeming to increase, or giving the pa-
tient great uneasiness; but if the constitution be hurt, or the tu- 

326 SCHIRRUS AND CANCER.
mour irritated by pressure, or improper treatment of any kind, it
begins to extend itself towards the neighbouring parts, by pushing
out a kind of roots or limbs. It then gets the name of cancer, from
a fancied resemblance between the limbs and the claws of a crab.
The colour of the skin begins to change, which is first red, afterwards  • ]
purple, then bluish, livid, and at last black. The patient complains
of heat, with a burning, gnawing, shooting pain. The tumour is
very hard, rough, and unequal, with a protuberance, or rising, in
the middle; its size increases daily, and the neighbouring veins be-
come thick, knotty, and of a blackish colour.
The skin at length gives way, and a thin, sharp ichor begins to   
flow, which corrodes the neighbouring parts till it forms a large
unsightly ulcer. More occult cancers arise, and communicate with   
the neighbouring glands. The pain and stench become intollerable;
the appetite fails; the strength is exhausted by a continual hectic
fever; at last, a violent hæmorrhage, or discharge of blood, from
some part of the body, with faintings, or convulsion fits, generally
put an end to life.
REGIMEN.—The diet ought to be light, but nourishing. All
strong liquors, and high-seasoned or salted provisions, are to be
avoided. The patient may take as much exercise as he can easily
bear; and should use every method to divert thought, and amuse
his fancy. All kinds of external injury are carefully to be guarded
against, particularly of the affected part, which ought to be defen-
ded from all pressure, and even from the external air, by covering   '
it with fur or soft flannel.
MEDICINE.—For this disease no certain remedy is known.
Its progress may sometimes be retarded, and some of its most dis-
agreeable symptoms mitigated, by proper applications. One misfor-
tune attending the disease is, that the patient often conceals it too
long. Were proper means used in due time, a cancer might often
be cured; but after the disorder has arrived at a certain height, it
generally sets all medicine at defiance.
When a schirrous tumour is first discovered, the patient ought to
observe a proper regimen, and to take twice or thrice a-week, a dose   ^
of common purging mercurial pills. Some blood may also be let, and
the part affected may be gently rubbed twice a-day with a little of
the mercurial ointment, and kept warm with fur or flannel. The
food must be light, and an English pint of the decoction of woods
or sarsaparilla may be drank daily. I have sometimes discussed hard
tumours, which had the appearance of beginning cancers, by a course
of this kind.
Should the tumour not yield to this treatment, but become larger
and harder, it will be proper to extirpate it, either by the knife or
caustic. Indeed, whenever this can be done with safety, the sooner
it is done the better. It can answer no purpose to extirpate a cancer
after the constitution is ruined, or the whole mass of humours cor-
rupted by it. This is the common way, which makes the operation 

327 SCHIRRUS AND CANCER.           
so seldom succeed. Few people will submit to the extirpation till
death stares them in the face; whereas, if it were done early, life
would not be endangered by the operation, and it would generally
prove a radical cure.
When the cancer is so situated that it cannot be cut off, or if the
patient will not submit to the operation, such medicines as will
mitigate or relieve the most urgent symptoms may be used. Dr.
Home says, that half a grain of the corrosive sublimate of mercury,
dissolved in a proper quantity of brandy, and taken night and mor-
ning, will often be of service in cancers of the face and nose. He
likewise recommends an infusion of the solanum, or night-shade, in
cancers of the breasts.
The medicine most in repute for this disease is hemlock. Dr.
Stork, physician at Vienna, has of late recommended the extract of
this plant as very efficacious in cancers of every kind. The Doctor
says, he has given some hundred weights of it without ever hurting
anybody, and often with manifest advantage. He advises the patient,
however, to begin with very small doses, as two or three grains,
and to increase the dose gradually till some good effect be perceived,
and there to rest without further increase. From two or three grains
at first, he says he has increased the dose to two, three, or four
drachms a-day, and finds that such doses may be continued for se-
veral weeks without any bad consequences.
The regimen which he recommends during the use of the medi-
cine, is to avoid farinaceous substances not fermented, and too acrid
aromatics. He says, good wine will not be hurtful to those who are
accustomed to it, nor a moderate use of acids; and adds, that the
patient should live in a pure, free air, and keep his mind as quiet
and cheerful as possible.
He does not pretend to fix the time in which a cancer may be re-
solved by the use of hemlock, but says, he has given it for above
two years in large doses without any apparent benefit; nevertheless,
the patient has been cured by persisting in the use of it for half a-
year longer. This is, at least encouragement, to give it a fair trial.
Though we are far from thinking hemlock merits those extravagant
encomiums which he has bestowed upon it, yet, in a disease which
has so long baffled the boasted powers of medicine, ought always
to be tried.
The powder of hemlock is by some preferred to the extract. 
They are both made of the fresh leaves, and may be used nearly in
the same manner. Dr. Nicholson of Berwich, says, he gradually in-
creased the dose of the powder from a few grains to half a drachm,
and gave near four drachms of it in the day, with remarkably good
effects. The hemlock may also be used externally either as a poul-
tice or fomentation. The sore may likewise be kept clean by inject-
ing daily a strong decoction of the tops and leaves into it.
Few things contribute more to the healing of foul sordid ulcers of
any kind than keeping them thoroughly clean. This ought never to

328 SCHIRRUS AND CANCER.
be neglected. The best application for this purpose seems to be the
carrot poultice. The root of the common carrot may be grated,
and moistened, with as much water as will bring it to the consis-
tence of a poultice or cataplasm. This must be applied to the sore,
and renewed twice a-day. It generally cleans the sore, eases the
pain, and takes away the disagreeable smell, which are objects of
no small importance *.
Wort, or an infusion of malt, has been recommended, not only as a   
proper drink, but as a powerful medicine, in this disease. It must be
frequently made fresh, and the patient may take it at pleasure. Two,
three, or even four English pints of it may be drank every day for   
a considerable time. No benefit can be expected from any medicine
in this disease, unless it be persisted in for a long time. It is of too
obstinate a nature to be soon removed; and, when it admits of a
cure at all, it must be brought about by inducing an almost total
change of the habit, which must always be a work of time. Setons
or issues in the neighbourhood of the cancer have sometimes good
effects †.                                                          
When all other medicines fail, recourse must be had to opium,
as a kind of solace. This will not indeed cure the disease, but it  
will ease the patient's agony, and render life more tolerable while it
continues.
To avoid this disorder, people ought to use wholesome food; to
take sufficient exercise in the open air; to be as easy and cheerful
as possible; and carefully to guard against all blows, bruises, and
rvery kind of pressure upon the breasts or other glandular parts ‡.
* London Medical Essays.
† In a cancer which had set all medicines, and even surgery, at de-
fiance, I lately saw remarkable effects from an obstinate perseverance
in a course of antiseptics. I ordered the deep ulcers to be washed to   
the bottom, by means of a syringe, twice or thrice a-day, either with  
an infusion of the bark, or a decoction of carrot, and that the patient  
should take, four or five times a-day, a glass of good wine, with half a  
drachm of the best powdered bark in it. The sores, after being wash-
ed, were likewise sprinkled with the same powder. When the patient
began this course, her death was daily expected. She continued it for
above two years, with manifest advantage; but being told by an emi-  
nent surgeon, that the bark would not cure a cancer, and that the sores
ought not to be washed, she discontinued the practice, and died in a
few weeks. This course was not expected to cure the cancer, but to
prolong the patient's life, which it evidently did almost to a miracle.
‡ As hemlock is the principal medicine recommended in this disease,  
we would have given some directions for the gathering and preparing
of that plant; but as its different preparations are now kept in the shops,
it is much safer for people to get them there, with proper directions
for using them. 

[329]
CHAPTER XLVIII.
Of Poisons.
EVERY person ought, in some measure, to be acquainted with
the nature and cure of poisons. They are generally taken un-
awares, and their effects are often so sudden and violent, as not to
admit of delay, or time to procure the assistance of physicians. Hap-
pily no great degree of medical knowledge is here necessary; the
remedies for most poisons being generally at hand, or easily obtain-
ed, and nothing but common prudence needful in the application
of them.
The vulgar notion, that every poison is cured by some counter-
poison, as a specific, has done much hurt. People believe they can
do nothing for the patient, unless they know the particular antidote
to that kind of poison which he has taken. Whereas the cure of
all poisons taken into the stomach, without exception, depends chief-
ly on discharging them as soon as possible.
There is no case wherein the indications of cure are more obvious.
Poison is seldom long in the stomach before it occasions sickness,
with an inclination to vomit. This shews plainly what ought to be
done. Indeed common sense dictates to every one, that, if any thing
has been taken into the stomach which endangers life, it ought im-
mediately to be discharged. Were this duly regarded, the danger
arising from poisons might generally be avoided. The method of
prevention is obvious, and the means are in the hands of every
one.
We shall not take up the reader's time with a detail of the ridi-
culous notions which have prevailed among ignorant people in dif-
ferent ages with regard to poisons; neither shall we mention the
boasted antidotes, which have been recommended either for pre-
venting or obviating their effects; but shall point out the poisons
most common in this country, and the means of avoiding their dan-
gerous consequences. 
Poisons either belong to the mineral, the vegetable, or the animal
kingdom.
Mineral poisons are commonly of an acrid or corrosive quality;
as arsenic, cobalt, the corrosive sublimate of mercury, &c.
Those of the vegetable kind are generally of a narcotic or stu-
pefactive quality; as poppy, hemlock, henbane, berries of the dead-
ly night-shade, &c.                           
Poisonous animals communicate their infaction either by the bite
or sting. This poison is very different from the former, and only
produces its effects when received into the body by a wound.
MINERAL POISONS.—Arsenic is the most common of
this class; and, as the whole of them are pretty similar both in their 
T2

330 POISONS.
effects and method of cure, what is said with respect to it will be
applicable to every other species of corrosive poison *.
When a person has taken arsenic, he soon perceives a burning
heat, and a violent pricking pain in his stomach and bowels, with
an intolerable thirst, and an inclination to vomit. The tongue and
throat feel rough and dry; and, if proper means be not soon adminis-
tered, the patient is seized with great anxiety, hiccupping, faintings,
and coldness of the extremities. To these succeed black vomits
fœtid stools, with a mortification of the stomach and intestines,
which are the immediate forerunners of death.
On the first appearance of these symptoms, the patient should
drink large quantities of new milk and sallad-oil till he vomits; or
he may drink warm water mixed with oil. Fat broths are likewise
proper, provided they can be got ready in time. Where no oil is to
be had, fresh butter may be melted and mixed with the milk or wa-
ter. These thing are to be drank as long as the inclination to vomit
continues. Some have drank eight or ten English quarts before the
vomiting ceased; and it is never safe to leave off drinking while one
particle of the poison remains in the stomach.                    
These oily or fat substances not only provoke vomiting, but like-
wise blunt the acrimony of the poison, and prevent its wounding
the bowels; but if they should not make the person vomit, half a
drachm, or two scruples of the powder of ipecacuanha must be
given, or a few spoonfuls of the oxymel or vinegar of squills may be
mixed with the water which he drinks. Vomiting may likewise be
excited, by tickling the inside of the throat with a feather. Should
these methods, however, fail, half a drachm of white vitriol, or five
or six grains of emetic tartar, must be administered.
If tormenting pains are felt in the lower belly, and there is reason
to fear that the poison has got down to the intestines, clysters of
milk and oil must be very frequently thrown up; and the patient
must drink emollient decoctions of barley, oat-meal, marsh-mallows,
and such-like. He must likewise take an infusion of senna and man-
na, a solution of Glauber's salts, or some other purgative.
After the poison has been evacuated, the patient ought, for some
time, to live upon such things as are of a healing and cooling quality;
to abstain from flesh and all strong liquors, and to live upon milk,
broth, gruel, light puddings, and other spoon-meats of easy digestion.
His drink should be barley-water, linseed-tea, or infusions of any
of the mild mucilaginous vegetables.
VEGETABLE POISONS, besides heat and pain of the sto-
mach, commonly occasion some degree of giddiness, and often, a
kind of stupidity or folly. Persons who have taken these poisons
must be treated in the same manner as for the mineral or corrosive.
* Corrosive sublimate is an exception when this poison has been tak-
en, the patient ought to drink large quantities of pot-ash or salt of tar-
tar, dissolved in water to re-compose the poison and render it inactive.
(I. C.)        

331 BITES OF POISONOUS ANIMALS.      
Though the vegetable poisons, when allowed to remain in the sto-
mach, often prove fatal; yet the danger is generally over as soon as
they are discharged. Not being of such a caustic or corrosive nature,
they are less apt to wound or inflame the bowels than mineral sub-
stances: no time ought to be lost in having them discharged.
Opium, being frequently taken by mistake, merits particular at-
tention. It is used as a medicine both in a solid and liquid form
which latter commonly goes by the name of laudanum. It is, in-
deed, a valuable medicine when taken in proper quantity; but as
an over-dose proves a strong poison, we shall point out its common
effects, together with the method of cure.
An over-dose of opium generally occasions great drowsiness, with
stupor and other apoplectic symptoms. Sometimes the person has so
great an inclination to sleep, that it is almost impossible to keep him
awake. Every method must, however, be tried for this purpose. He
should be tossed, shaked, and moved about. Sharp blisters should
be applied to his legs or arms, and stimulating medicines, as salts
of hartshorn, &c. held under his nose. It will also be proper to let
blood. At the same time, every method must be taken to make him
dicharge the poison. This may be done in the manner directed above,
viz. by the use of strong vomits, drinking plenty of warm water
with oil, &c.
Mead, besides vomits in this case, recommends acid medicines
with lixivial salts. He says, that he has often given salt of worm-
wood mixed with juice of lemon in repeated doses with great
success.
If the body should remain weak and languid after the poison has
been discharged, nourishing diet and cordials will be proper; but
when there is reason to fear that the stomach or bowels are in-
flamed, the greatest circumspection is necessary, both with regard
to food and medicine.
Of the Bites of Poisonous Animals.
WE shall begin with the bite of a mad dog, as it is both the most
common and dangerous animal-poison in this country.
The creatures naturally liable to contract this disease are, as far as
we yet; know, all of the dog kind, viz. foxes, dogs, and wolves.—
Hence it is called the rabies canina, or dog madness. It so seldom
happens that any person is bit by the first, that they scarce deserve
to be taken notice of. If such a thing should happen, the method
of treatment is precisely the same as for the bite of a mad dog.
The symptoms of madness in a dog are as follow: At first he
looks dull, shews an aversion to food and company: he does not
bark as usual, but seems to murmur, is peevish, and apt to bite 

332 BITES OF POISONOUS ANIMALS.
strangers: his ears and tail droop more than usual, and he appears
drowsy: afterwards he begins to loll out his tongue, and froth at
the mouth, his eyes seeming heavy and watery: he now, if not
confined, takes off, runs panting along with a kind of dejected air, 
and endeavours to bite every one he meets. Other dogs are said to
fly from him. Some think this a certain sign of madness, supposing
that they knew him by the smell; but it is not to be depended on.
If he escapes being killed, he seldom runs above two or three days,
till he dies exhausted with heat, hunger, and fatigue.
This disease is most frequent after long, dry, hot seasons; and
such dogs as live upon putrid, stinking carrion, without having 
enough of fresh-water, are most liable to it.
When any person has been bit by a dog, the strictest inquiry ought
to be made, whether the animal was really mad. Many disagreeable;
consequences arise from neglecting to ascertain this point. Some
people have lived in continual anxiety for many years, because they
had been bit by a dog which they believed to be mad; but as he 
had been killed on the spot, it was impossible to ascertain the fact.
This should induce us, instead of killing a dog the moment he has
bit any person, to do all in our power to keep him alive, at least till
we can be certain whether he be mad or not.
Many circumstances may contribute to make, people imagine a
dog mad. He looses his master, runs about in quest of him, is set 
upon by other dogs, and perhaps by men. The creature thus frigh-
tened, beat and abused, looks wild, and lolls out his tongue as he
runs along. Immediately a crowd is after him; while he, finding
himself closely pursued, and taking every one he meets for an ene-
my, naturally attempts to bite him in self-defence. He soon gets
knocked on the head, and it passes currently that he was mad, as it
is then impossible to prove the contrary.
This being the true history of, by far, the greater part of those
dogs which pass for mad, is it any wonder that numberless whim-
sical medicines have been extolled for preventing the effects of their
bite? This readily accounts for the great variety of infallible re-
medies for the bite of a mad dog, which are to be met with in al-
most every family. Though not one in a thousand has any claim to
merit, yet they are all supported by numberless vouchers. No won-
der that imaginary diseases should be cured by imaginary remedies.
In this way, credulous people first impose upon themselves, and
then deceive others. The same medicine which was supposed to pre-
vent the effects of the bite, when the dog was not mad, is recom-
mended to a person who has had the misfortune to be bit by a dog
that was really mad. He takes it, trusts to it, and is undone.
To these mistakes we must impute the frequent ill success of the
medicines, used for preventing the effects of the bite of a mad dog.
It is not owing so much to a defect in medicine, as to wrong appli-
cations. If proper medicines were administered immediately after
the bite is received, and continued for a sufficient length of time,
we should not lose one in a thousand of those bit by a mad dog. 

333 BITES OF POISONOUS ANIMALS.
This poison is generally communicated by a wound, which, never-
theless, heals as soon as a common wound; but afterwards it begins
to feel painful, and as the pain spreads towards the neighbouring
parts, the person becomes heavy and listless. His sleep is unquiet,
with frightful dreams; he sighs, looks dull, and loves solitude. These
are the forerunners, or rather the first symptoms of that dreadful
disease, occasioned by the bite of a mad dog. But as we do not pro- 
pose to treat fully of the disease itself, but to point out the method of 
preventing it, we shall not take up time in showing its progress from
the first invasion to its commonly fatal end.
The common notion, that this poison may lie in the body for
many years, and afterwards prove fatal, is both hurtful and ridicu-
lous. It must render persons bit, very unhappy, and can have no
good effects. If the person takes proper medicines for forty days
after the time of his being bit, and feels no symptoms of the disease,
there is reason to believe him out of danger.
The medicines recommended for preventing the effects of the
bite of a mad dog, are chiefly such as promote the different secre-
tions, and antispasmodics.  
Dr. Mead recommends a preventative medicine, which he says
he never knew fail, though in the space of thirty years he had used
it a thousand times. It is as follows:
"Take ash-coloured ground liver-wort, cleaned, dried, and pow-
dered, half an ounce; of black pepper powdered, a quarter of an
ounce. Mix these well together, and divide the powder into four
doses; one of which must be taken every morning fasting, for four
mornings successively, in half an English pint of cows milk warm.
"After these four doses are taken, the patient must go into the
cold bath, or a cold Spring or river, every morning fasting, for a
month; he must be dipped all over, but not stay in (with his head
above water) longer than half a minute, if the water be very cold.
After this he must go in three times a-week for a fortnight longer.
"The person must be bled before he begins to use the medicine *."
We shall next mention the famous East-India specific, as it is cal-
led. This medicine is composed of cinnabar and musk. It is esteem-
ed a great antispasmodic; and, by many, extolled as an infallible
remedy for preventing the effects of the bite of a mad dog.
"Take native and factitious cinnabar, of each twenty-four grains,
musk sixteen grains. Let these be made into a fine powder, and
taken in a glass of arrack or brandy."
This single dose is said to secure the person for thirty days, at the
end of which it must be repeated; but if he has any symptoms of
the disease, it must be repeated in three hours.
* Though we give this prescription on the credit of Dr. Mead, yet
we would not advise any person, who has reason to believe that he has
been bit by a dog which was really mad, to trust to it alone. Mead
was an able physician, but he seems to have been no great phylosopher,
and was sometimes the dupe of his own credulity. 

334 BITES OF POISONOUS ANIMALS.
The following is likewise reckoned a good antispasmodic medicine:
"Take of Virginian snake-root in powder, half a drachm, gum
asafœtida twelve grains, gum camphire seven grains; make these
into a bolus with a little syrup of saffron."
Camphire may also be given in the following manner:
"Take purified nitre, half an ounce, Virginian snake-root in
powder, two drachms, camphire, one drachm; rub them together  
in a mortar, and divide the whole into ten doses."                  
Mercury is likewise recommended as of great efficacy, both in
the prevention and cure of this kind of madness. When used as a   
preventative, it will be sufficient to rub daily a drachm of the oint-  
ment into the parts about the wound.                             
Vinegar is likewise of considerable service, and should be taken
freely, either in the patient's food or drink.
These are the principal medicines recommended for preventing
the effects of the bite of a mad dog. We would not advise people to
trust to any one of them; but from a proper combination of their
different powers, there is the greatest reason to hope for success.
The great error in the use of these medicines lies, in not taking
them for a sufficient length of time. They are used more like charms,
than medicines intended to produce any change in the body. To this,  
and not to the insufficiency of the medicines, we must impute their
frequent want of success.                                        
Dr. Mead says, that the virtue of his medicine consists in promo-  
ting urine. But how a poison should be expelled by urine, with only
three or four doses of any medicine, however powerful, it is not easy
to conceive. More time is certainly necessary, even though the me-
dicine were more powerful than that which the Doctor prescribes.
The East-India specific is still more exceptionable on this ac-
count.
As these and most other medicines, taken singly, have frequent-
ly been found to fail, we shall recommend the following course:
If a person be bit in a fleshy part, where there is no hazard of
hurting any large blood-vessel, the parts adjacent to the wound may
be immediately cut away *. But if this be not done soon after the
bite has been received, it will be better to omit it.
The wound may be washed with salt and water, or a pickle made
of vinegar and salt, and afterwards dressed twice a-day with yellow
basilicon, mixed with the red precipitate of mercury.
The patient should begin to use either Dr. Mead's medicine, or
some of the others mentioned above. If he takes Mead's medicine,
he may use it as the Doctor directs for four days successively. Let
him then omit it for two or three days, and again repeat the same
number of doses as before.
During this course, he must rub into the parts about the wound
* Caustic has been recommended to be applied to the part, but
this should never be employed when the knife can be used, for it is
liable to frustrate the intention by not destroying the whole of the
wounded part. (I. C.)

335 BIT£S OF POISONOUS ANIMALS.
daily, one drachm of the mercurial ointment. This may be done
for ten or twelve days at least.
When this course is over, he may take a purge or two, and wait
a few days till the effect of the mercury be gone off. He must then
begin to use the cold bath, into which he may go every morning
for five or six weeks. If he should feel cold and chilly for a long
time after coming out of the cold bath, it will be better to use a te-
pid one, or to have the water a little warmed.
In the mean time, we wouJd advise him not to leave off all in-
ternal medicines, but to take either one of the boluses of snake-root,
asafœtida, and camphire; or one of the powders of nitre, camphire,
and snake-root, twice a-day. These may be used during the whole
time he is bathing.
During the use of the mercurial ointment, the patient must keep 
within doors, and take nothing cold.
A proper regimen must be observed throughout the whole course.
The patient should abstain from flesh, and all salted and high-sea-
soned provisions. He must avoid strong liquors, and live mostly up-
on a light and rather spare diet. His mind should be kept as easy and
cheerful as possible, and all excessive heat and violent passions  
avoided with the utmost care.
I have never seen this course of medicine, with proper regimen,
fail to prevent the hydrophobia, and cannot help again observing,
that the want of success must generally be owing either to the ap-
plication of improper medicines, or not using proper ones for a suf-
ficient length of time.
Mankind are extremely fond of every thing that promises a sud-
den or miraculous cure. By trusting to these, they often lose their
lives, when a regular course of medicine would have rendered them
absolutely safe. This holds remarkably in the present case. Num-
bers of people, for example, believe if they or their cattle be once
dipped in the sea, it is sufficient; as if the salt water were a charm
against the effects of the bite. This, and such like whims, have
proved fatal to many.
It is a common notion, if a person be bit by a dog which is not
mad, that, if he should go mad afterwards, the person would be af-
fected with the disorder at the same time; but this notion is too
ridiculous to deserve a serious consideration. It is a good rule, how-
ever, to avoid dogs as much as possible, as the disease is often upon
them for some time before its violent symptoms appear. The hydro-
phobia has been occasioned by the bite of a dog which shewed no
other symptoms of the disease but listlessness and a sullen disposition.
Though we do not mean to treat fully of the cure of the hydro-
phobia, yet we are far from reckoning it incurable. The notion that
this disease could not be cured, has been productive of horrid con-
sequences. It was usual either to abandon the unhappy persons, as
soon as they were seized with the disease, to their fate, to bleed them
to death, or to suffocate them between matrasses or feather beds, &c. 

336 BITES OF POISONOUS ANIMALS.
This conduct certainly deserved the severest punishment! We hope,
for the honour of human nature, it will never again be heard of.
I have never had an opportunity of treating this disease, and
therefore can say nothing of it from my own experience; but Dr.
Tissot says, it may be cured in the following manner:
1. The patient must be bled to a considerable quantity; and
this may be repeated twice, thrice, or even a fourth time, if circum-
stances require it.
2. The patient should be put, if possible, into a warm bath; and
this should be used twice a-day.                            
3. He should every day receive two, or even three emollient  
clysters.
4. The wound, and the parts adjoining to it, should be rubbed 
with the mercurial ointment twice a-day.
5. The whole limb which contains the wound should be rubbed
with oil, and be wrapped up in an oily flannel.
6. Every three hours, a dose of Cob's powder should be taken in
a cup of the infusion of lime-tree and elder-flowers. This powder 
is made, by rubbing together in a mortar, to a very fine powder, of
native and factitious cinnabar, each twenty-four grains; of musk,
sixteen grains*.                                               
7. The following bolus is to be given every night, and to be re-
peated in the morning, if the patient is not easy, washing it down
with the infusion mentioned above: Take one drachm of Virginian  
snake-root in powder; of camphire and asafœtida, ten grains each;
of opium, one grain; and, with a sufficient quantity of conserve,
or rob of elder, make a bolus.                       
8. If there be a great nausea at the stomach, with a bitterness in
the mouth, thirty-five or forty grains of ipecacuanha, in powder,
may be taken for a vomit.
9. The patient's food, if he takes any, must be light; as pana-
do, soups made of farinaceous or mealy vegetables, &c.
10. If the patient should long continue weak, and subject to ter-  
rors, he may take half a drachm of the Peruvian bark thrice a-day. 
The next poisonous animal which we shall mention is the VIPER.
The grease of this animal rubbed into the wound is said to cure the 
bite. Though that is all the viper-catchers generally do when bit,  
we should not think it sufficient for the bite of an enraged viper. It
would surely be more safe to have the wound well sucked †, and af-  
* The Ormskirk medicine, as it is called, seems to me to consist chief-
ly of cinnabar. Though it is said to be infallible, as a preventative; yet
I would not advise any one to trust to it alone. Indeed, it is ordered to
be taken in a manner which gives it more the appearance of a charm
than of a medicine. Surely, if a medicine is to produce any change in
the body, it must be taken for some considerable time, and in sufficient
quantity.
† The practice of sucking out poisons is very ancient; and indeed
nothing can be more rational. Where the bite cannot be cut out, this
is the most likely way for extracting the poison. There can be no dan-
ger in performing this office, as the poison does, no harm, unless it be         

337 VENEREAL DISEASE.            
terwards rubbed with warm sallad-oil. A poultice of bread and milk,
softened with sallad-oil, should likewise be applied to the wound;
and the patient ought to drink freely of vinegar-whey, or water-
gruel with vinegar in it, to make him sweat. Vinegar is one of the
best medicines which can be used in any kind of poison, and ought
to be taken very liberally. If the patient be sick, he may take a vo-
mit. This course will be sufficient to cure the bite of any of the
poisonous animals of this country.
With regard to poisonous insects, as the bee, the wasp, the hornet,
&c. their stings are seldom attended with danger, unless when a
person happens to be stung by a great number of them at the same
time; in which case something should be done to abate the inflam-
mation and swelling. Some, for this purpose, apply honey, others
lay pounded parsley to the part. A mixture of vinegar and Venice
treacle is likewise recommended; but I have always found rubbing
the part with warm sallad-oil succeed very well. Indeed, when the
stings are so numerous as to endanger the patient's life, which is
sometimes the case, he must not only have oily poultices applied to
the part, but should likewise be bled, and take some cooling medi-
cines, as nitre, or cream of tartar, and should drink plentifully of
diluting liquors.
It is the happiness of this island to have very few poisonous ani-
mals, and those which we have are by no means of the most virulent
kind. Nine-tenths of the effects attributed to poison or venom in
this country, are really other diseases, and proceed from quite dif-
ferent causes.
We cannot, however, make the same observation with regard to
poisonous vegetables. These abound every where, and prove often
fatal to the ignorant and unwary. This, indeed, is chiefly owing to
carelessness. Children ought early to be cautioned against eating any
kind of fruit, roots, or berries, which they do not know, and all poi-
sonous plants to which they can have access, ought, as far as possible,
if to be destroyed. This would not be so difficult a task as some peo-
pie imagine.
CHAPTER XLIX.
Of the Venereal Disease.
IT is unfortunate for the unhappy persons who contract this dis-
ease, that if lies under a sort of disgrace. This renders disguise
necessary, and makes the patient either conceal his disorder altoge-
taken into the body by a wound. The person who sucks the wound
ought however to wash his mouth frequently with salad-oil, which will
secure him from even the least inconveniency. The Psylli in Africa,
and the Marsi in Italy, were famed for curing the bites of poisonous
animals by sucking the wound; and we are told that the Indians in
North-America practise the same at this day.
V2

338 VIRULENT GONORRHŒA.
ther, or apply to those who promise a sudden and secret cure; but
who in fact only remove the symptoms for a time, while they fix the
disease deeper in the habit. By this means, a slight infection, which
might have been easily removed, is often converted into an obstinate
and sometimes incurable malady.
Another unfavourable circumstance attending this disease is, that
it assumes a variety of different shapes, and may with more propri-
ety be called an assemblage of diseases than a single one. No two
diseases can require a more different method of treatment than this
does in its different stages. Hence, the folly and danger of trusting
to any particular nostrum for the cure of it. Such nostrums are
however generally administered in the same manner to all who ap-
ply for them, without the least regard to the state of the disease, the
constitution of the patient, the degree of infection, and a thousand
other circumstances of the utmost importance.
The venereal disease may be communicated to the innocent as
well as the guilty. Infants, nurses, midwives, and married women
whose husbands lead dissolute lives, are often affected with it, and
frequently lose their lives by not being aware of their danger in due
time. The condition of such persons will certainly plead our excuse,
if any excuse be necessary, for endeavouring to point out the symp-
toms and cure of this too common disease.
To enumerate all its different symptoms, and to trace the disease
minutely through its various stages, would require a much larger
space than falls to this part of my subject. I therefore confine my
observations chiefly to circumstances of importance, omitting,
such as are trifling, or which occur but seldom.
The Virulent Gonorrhoea
IS an involuntary discharge of infectious matter from the parts of
generation in either sex. It generally makes its appearance within
eight or ten days after the infection has been received: sometimes
in two or three days, and at other times not for four or five weeks.
Previous to the discharge, the patient feels an itching, with a small
degree of pain in the genitals. Afterwards a thin glary matter be-
gins to distil from the urinary passage, which stains the linen, and
occasions a small degree of titillation, particularly in the time of
making water; this arises at length to a degree of heat and pain,
which are chiefly perceived about the extremity of the urinary pas-
sage, where a slight degree of redness and inflammation likewise be-
gin to appear.
As the disorder advances, the pain, heat of urine, and running
increase, while fresh symptoms daily ensue. In men, the erections
become painful and involuntary, and are more frequent and lasting 

339 VIRULENT GONORRHŒA.         
than when natural. This symptom is most troublesome when the
patient is warm in bed. The pain which was at first only perceived
towards the extremity, now begins to reach all up the urinary pas-
sage, and is most intense just after the patient has done making wa-
ter. The running gradually grows yellow, and at length puts on
the appearance of matter.
When the disorder has arrived at its height, all the symptoms are
more intense; the heat of urine is so great, that the patient dreads
the making water; and, though he feels a constant inclination this
way, yet it is rendered with the greatest difficulty, and often only
by drops: the involuntary erections now become extremely, pain-
ful and frequent; there is also a pain, heat, and sense of fulness
about the seat, and the running is plentiful and sharp, of a brown,
greenish, and sometimes of a bloody colour.
By a proper treatment, the violence of the symptoms gradually
abate; the heat of urine goes off; the involuntary and painful erec-
tions, and the heat and pain about the seat, become easier; the run-
ning also gradually-decreases, grows whiter and thicker, till at last
it entirely disappears.
By attending to these symptoms, the gonorrhœa may be general-
ly distinguished from any other disease. There are however some
few disorders for which it may be mistaken, as an ulcer in the kid-
nies or bladder, the fluor albus, or whites in women, &c. But in
the former of these, the matter comes away only with the urine, or
when the sphincter of the bladder is open; whereas, in a gonorr-
hœa, the discharge is constant. The latter must be known chiefly
from its effects, as pain, communicating the infection, &c.
REGIMEN.—When a person suspects that he has caught the
venereal infection, he ought most strictly to observe a cooling re-
gimen, to avoid every thing of a heating nature, as wines, spiritu-
ous liquors, rich sauces, spiced, salted, high-seasoned and smoke-
dried provisions, aromatic and stimulating vegetables, as onions,
garlic, shallot, nutmeg, mustard, cinnamon, mace, ginger, and such
like. His food ought chiefly to consist of mild vegetables, milk,
broths, light puddings, panado, gruels, &c. His drink may be bar.
ley-water, milk and water, decoctions of marsh-mallows and liquo-
rice, linseed tea, or clear whey. Of these, he ought to drink plenti-
fully. Violent exercise of all kinds, especially riding on horseback,
and venereal pleasures, are to be avoided. The patient must beware
of cold, and when the inflammation is violent, he ought to keep
his bed.
MEDICINE.—A virulent gonorrhœa cannot always be cur-
ed speedily and effectually at the same time. The patient ought not
to expect, nor the physician to promise it. It will often continue
for two or three weeks, and sometimes for five or six, even where
the treatment has been very proper.
Sometimes a slight infection may be carried off in a few days, by
bathing the parts in warm milk and water, and injecting frequent- 

340 VIRULENT GONORRHŒA.
ly up the urethra a little sweet oil or linseed-tea about the warmth
of new milk. Should these not succeed in carrying off the infection,
they will at least have a tendency to lessen its virulence.
To effect a cure, however, astringent injections will generally be
found necessary. These may be various ways prepared, but I think
those made with the white vitriol are both most safe and efficacious.
They can be made stronger or weaker as circumstances may require;
but it is best to begin with the more gentle, and increase their
power if necessary. I generally order a drachm of white vitriol to
be dissolved in eight or nine ounces of common or rose-water, and
an ordinary syringe full of it to be thrown up three or four times
a-day. If this quantity does not perform a cure, it may be repeated,
and the dose increased *.
Whether injections be used or not, cooling purges are always
proper in the gonorrhœa. They ought not however to be of the
strong or drastic kind. Whatever raises a violent commotion in the
body increases the danger, and tends to drive the disease deeper in-
to the habit. Procuring two or three stools every second or third
day for the first fortnight, and the same number every fourth or
fifth day for the second, will generally be sufficient to remove the
inflammatory symptoms, to diminish the running, and to change the
colour and consistence of the matter, which gradually becomes more
white and ropy as the virulence abates †.
* Although it is now very common to cure the gonorrhœa by astrin-
gent injections, there are still many practitioners who do not approve
this mode of practice. I can, from much experience, assert, that it is
both the most easy and efficacious method of cure; any bad consequences
arising from it must be owing to the ignorance or misconduct of the prac-
titioner himself, and not to the remedy. Many, for example, use strong
preparations of lead, all of which are dangerous when applied to the in-  
ternal surfaces of the body; others use escharotics, which inflame and
injure the parts. I have known a gonorrhœa actually cured by an in-  
jection made of green-tea, and would always recommend gentle me-
thods where they will succeed.                                     
† If the patient can swallow a solution of salts and manna, he may  
take six drachms, or, if his constitution requires it, an ounce of the
former, with half an ounce of the latter. These may be dissolved in an
English pint of boiling water, whey, or thin water-gruel, and taken
early in the morning.
If an infusion of senna and tamarinds be more agreeable, two drachms
of the former, and an ounce of the latter, may be infused all night in an
English pint of boiling water. The infusion may be strained next morn-
ing, and half an ounce of Glauber's salts dissolved in it. A tea-cupful of
this infusion may be taken every half hour till it operates.
Should the patient prefer an electuary, the following will be found
to answer very well. Take of the lenitive electuary four ounces, cream
of tartar two ounces, jalap in powder two drachms, rhubarb one drachm,
and as much of the syrup of pale roses as will serve to make up the
whole into a soft electuary. Two or three tea-spoonfuls of this may be
taken over-night, and about the same quantity next morning, every
day that the patient chooses to take a purge.
The doses of the above medicines may be increased or diminished ac- 

341 VIRULENT GONORRHŒA.
When the inflammatory symptoms run high, bleeding is always
necessary at the beginning. This operation, as in other topical in-
flammations, must be repeated according to the strength and consti-
tution of the patient, and the vehemence and urgency of the symp-
toms.
Medicines which promote the secretion of urine, are proper in
this stage of the disorder. For this purpose, two ounces of pounded
arabic may be mixed with half an ounce of cream tartar, and di-
vided into twenty-four doses, one of which may be taken every
morning and evening in a cup of the patient's drink. I have ge-
nerally found this answer extremely well, both as to the diuretic,
and for keeping the body gently open.
When the pain and inflammation are seated high towards the
neck of the bladder, it will be proper frequently to throw up an
emollient clyster, which, besides the benefit of procuring stools,
will serve as a fomentation to the inflamed parts.
Soft poultices, when they can conveniently be applied to the
parts, are of great service. They may be made of the flour of lin-
seed, or of wheat bread and milk, softened with fresh butter or sweet
oil. When poultices cannot be conveniently used, cloths wrung
out of warm water, or bladders filled with warm milk and water,
may be applied. I have often known the most excruciating pains,
during the inflammatory state of the gonorrhœa, relieved by one
or other of these applications.
Few things tend more to keep off inflammation in the spermatic
vessels, than a proper truss for the scrotum. It ought to be so con-
trived as to support the testicles, and should be worn from the first
appearance of the disease till it has ceased some weeks.
The above treatment will sometimes remove the gonorrhœa so
quickly, that the person will be in doubt whether he really labour-
ed under that disease. This, however, is too favourable a turn to
be often expected, and ought never to be adopted.
When the above treatment has removed the heat of urine, and
soreness of the genital parts; when the quantity of running is con-
siderably lessened, without any pain or swelling in the groin or tes-
ticle supervening; when the patient is free from involuntary erec-
tions; and lastly, when the running becomes pale, whitish, thick,
void of ill smell, and tenacious or ropy; when all or most of these
symptoms appear, the gonorrhœa is arrived at its last stage, and we
may gradually proceed to treat it as a gleet with astringent medi-
cines.
cording as the patient finds it necessary. We have ordered the salts to be
dissolved in a large quantity of water, because it renders their operation
more mild. 

[342]   
Of Gleets.
A GONORRHŒA frequently repeated, or improperly treated,
often ends in a gleet, which may either proceed from relaxation, or
from some remains of the disease. It is of the greatest importance
in the cure, to know from which cause the gleet proceeds. When
the discharge proves very obstinate, and receives little or no check,
from astringent medincines, there is ground to suspect that it is owing
to the latter; but if the drain is inconstant, and is chiefly observable
when the patient is stimulated by lascivious ideas, or upon strain-  
ing to go to stool, we may reasonably conclude that it is chiefly 
owing to the former.                                            
In the cure of a gleet, proceeding from relaxation, the principal
design is to brace, and restore a proper degree of tension to the de-
bilitated and relaxed vessels. For this purpose, besides the medi-
cines recommended in the gonorrhœa, the patient may have re-
course to stronger and powerful astringents, as the Peruvian bark *,
allum, vitriol, galls, tincture of gum kino, &c. The injections may
he rendered more astringent by the addition of a few grains of al-
lum, or increasing the quantity of vitriol as far as the parts are able
to bear it.
The last remedy which we shall mention in this case is the cold
bath, than which, there is not perhaps a more powerful bracer in the 
whole compass of medicine. It ought never to be omitted in this spe- 
cies of gleet, unless there be something in the constitution of the
patient which renders the use of it unsafe. The chief objections to
the use of the cold bath are, a full habit, and an unfound state of the
viscera. The danger from the former may always be lessened, if not re-
moved, by purging and bleeding; but the latter is an insurmountable
obstacle, as the pressure of the water, and the sudden contraction of
the external vessels, by throwing the blood with too much force up-
on the internal parts, are apt to occasion ruptures of the vessels, or  j
a flux of humours upon the diseased organs. But where ho objection
of this kind prevails, the patient ought to plunge over head in wa-
ter every morning fasting, for three or four weeks together. He  
should not stay long in the water, and should have his skin dried as
soon as he comes out.
The regimen proper in this case is the same as in the last stage
of the gonorrhœa: the diet must be drying and astringent, and the
drink, Spa, Pyrmont, or Bristol waters, with which a little claret
or red wine may sometimes be mixed. Any person may now afford
* The Peruvian bark may be combined with other astringents, and
prepared in the following manner:
Take of Peruvian bark bruised, six drachms, of fresh galls bruised, two
drachms; boil them in a pound and an half of water to a pound: to the 
strained liquor add three ounces of the simple tincture of the bark. A
small tea-cupful of this may be taken three times a-day, adding to each
cup fifteen or twenty drops of the acid elixir of vitriol. 

343 THE SWELLED TESTICLE.          
to drink these waters, as they can be every where prepared at almost
no expence, by a mixture of common chalk and oil of vitriol.
When the gleet does not in the smallest degree yield to these me-
dicines, there is reason to suspect that it proceeds from ulcers *. In
this case, recourse must be had to mercury, and such medicines as
tend to correct any predominant acrimony with which the juices
may be affected, as the decoction of China, sasaparilla, sassafras, or
the like.
Mr. Fordyce says, he has seen many obstinate gleets of two, three,
or four years standing, effectually cured by a mercurial inunction,
when almost every other medicine has been tried in vain. Dr. Chap-
man seems to be of the same opinion; but says, he has always found
the mercury succeed best in this case when joined with terebinthi-
nate and other agglutinating medicines. For which reason, he re-
commends pills made of calomel and Venice turpentine †; and de-
fires that their use may be accompanied with a decoction of guaia-
cum or sarsaparilla.
For the cure of ulcers in the urinary passage, suppurating can-
dies or bougies are prepared various ways, and are generally to be
bought ready made. It is needless to spend time in enumerating
the different ingredients of which they are composed, or teaching
the manner of preparing them. Before a bougie be introduced in-
to the urethra, it should be smeared all over with sweet oil, to pre-
vent it from stimulating too suddenly; it may be suffered to conti-
nue in from one to seven or eight hours, according as the patient
can bear it. Obstinate ulcers are not only often healed, but tumours
and excrescences in the urinary passages taken away, and an ob-
struction of urine removed by means of bougies.
Of the Swelled Testicle.
THE swelled testicle may proceed from infection lately contrac-
ted, and may happen both in the first and second stages of a gonorr-
hœa; particularly when the running is unseasonably checked, by
* This conjecture should be well-founded, as the same effect may be
produced from different causes, such as a stricture in the urethra or sim-
ple relaxation of the excreting vessels of that canal; in both of these
cases, mercury would be improper, particularly in the former, which
tan only be removed by a diligent use of bougies. (I. C.)
† Take Venice turpentine, boiled to a sufficient degree of hardness,
half an ounce, calomel, half a drachm  Let these be mixed and formed
into sixty pills, of which five or six may be taken night and morning. If,
during the use of these pills, the mouth should grow sore, or the breath
become offensive, they must be discontiuued till these symptoms disap- 
pear.

344 BUBOES.
cold, hard drinking, strong drastic purges, violent exercise, the too
early use of astringent medicines, or the like.
In the inflammatory stage, bleeding is necessary, which must be
repeated according to the urgency of the symptoms *. The food
must be light, and the drink diluting. High-seasoned food, flesh,
wines, and every thing of a heating nature, are to be avoided. Fo-
mentations are of singular service. Poultices of bread and milk,
softened with fresh butter or oil, are very proper, and ought con-
stantly to be applied when the patient is in bed; when he is up,
the testicle should be kept warm, and supported by a bag or truss, 
which may easily be contrived in such a manner as to prevent the
weight of the testicle from having any effect.
If it should be found impracticable to clear the testicle by the
cooling regimen now pointed out, and extended according to cir-
cumstances, it will be necessary to lead the patient through such a
complete antivenereal course, as shall ensure him against any future
uneasiness. For this purpose, besides rubbing the mercurial ointment
on the part, if free from pain, or on the thighs, as directed in the
gonorrhœa, the patient must be confined to bed, if necessary, for
five or six weeks, suspending the testicle all the while with a bag
or truss, and plying him inwardly with strong decoctions of sarsa-
parilla.
When these means do not succeed, and there is reason to sus-
pect a scrophulous or cancerous habit, either of which may sup-
port a schirrhous induration, after the venereal poison is corrected,
the parts should be fomented daily with a decoction of hemlock,
the bruised leaves of which may likewise be added to the poultice,
and the extract at the same time taken inwardly †. This practice is
strongly recommended by Doctor Stork in schirrous and cancerous
cases; and Mr. Fordyce assures us, that by this method he has cu-
red diseased testicles of two or three years standing, even when ulce-
rated, and when the schirrous had begun to be affected with prick-
ing and lancing pains.
Buboes
ARE hard tumours seated in the groin, occasioned by the vene-
real poison lodged in this part. They are of two kinds; viz. such
as proceed from a recent infection, and such as accompany a con-
firmed lues.
* I have been accustomed for some time past to apply leeches to in-
flamed testicles, which practice has always been followed with the most
happy effects.
† The extract of hemlock may be made into pills, and taken in the
manner directed under the article Cancer. 

345 CHANCRES.
The cure of recent buboes, that is, such as appear soon after im-
pure coition, may be first attempted by dispersion, and, if that should
not succeed, by suppuration. To promote the dispersion of a bubo,
the same regimen must be observed as was directed in the first stage
of a gonorrhœa. The patient must likewise be bled, and take some
cooling purges, as the decoction of tamarinds and senna, Glauber's
salts, and the like *. If, by this course, the swelling and other in-
flammatory symptoms abate, we may safely proceed to the use of
mercury, which must be continued till the venereal virus is quite
subdued †.
But, if the bubo should, from the beginning, be attended with
great heat, pain, and pulsation, it will be proper to promote its sup-
puration. For this purpose, the patient may be allowed to use his
ordinary diet, and to take now and then a glass of wine. Emollient
cataplasms, consisting of bread and milk, or flax-seed flour, soften-
ed with oil or fresh butter, may be applied to the part; and, where
the tumour advances slowly, white lily-roots boiled, or sliced onions
raw, and a sufficient quantity of yellow basilicon, may be added to
the poultice.
When the tumour is ripe, which may be known by its conical
figure, the softness of the skin, and a fluctuation of matter plainly
to be felt under the finger, it may be opened by either caustic or a
lancet ‡, and afterwards dressed with digestive ointment.
Sometimes buboes can neither be dispersed nor brought to a sup-
puration, but remain hard, indolent tumours. In this case, the in-
durated glands must be consumed by caustic. If they should be-
come schirrous, they must be dissolved by the application of hem-
lock, both externally and internally, as directed in the schirrous tes-
ticle. 
Chancres
ARE superficial, callous, eating ulcers; which may happen ei-
ther with or without a gonorrhœa. They are commonly seated
about the glands, and make their appearance in the following man-  
ner: First a little red pimple arises, which soon becomes pointed
* During the continuance of this practice, one drachm of the mercu-
rial ointment should be rubbed every night, into the inside of the thigh,
below the bubo. (I. C.)
† For the dispersion of the bubo, a number of leeches applied to the
part affected, will be found equally efficacious as in the inflamed tes-
ticle.
‡ The latter is more advantageous than the former; if the bubo be
simply punctured, and the matter discharged gradually, so as to imitate
its spontaneous rupture. This mode should always be prefered, when
tbe patient cannot wait for it to break of itself.
X2

346 CHANCRES.
at top, and is filled with a whitish matter inclining to yellow. This
pimple is hot, and itches generally before it breaks; afterwards it 
degenerates into an obstinate ulcer, the bottom of which is usually
covered with, a viscid mucus, and whose edges gradually become
hard and callous. Sometimes the first appearance resembles a simple
excoriation of the cuticle; which, if the cause be venereal, soon
becomes a true chancre.
A chancre is sometimes a primary affection, but it is much oft-
ner symptomatic, and is the mask of a confirmed lues. Primary
chancres discover themselves soon after impure coition, and are ge-
nerally seated in parts covered with a thin cuticle, as the lips, the
nipples of women, the glans penis of men, &c *.
When a chancre appears soon after impure coition, its treatment
is nearly similar to that of the virulent gonorrhœa. The patient
must observe the cooling regime, lose a little blood, and take some
gentle doses of salts and manna. The parts affected ought frequent-
ly to be bathed, or rather soaked in warm milk and water, and if
the inflammation be great an emollient poultice or cataplasm may
be applied to them. This course will, in most cases, be sufficient to
abate the inflammation, and prepare the patient for the use mer-
cury.
Symptomatic chancres are commonly accompanied with ulcers
in the throat, nocturnal pains, scurfy eruptions, about the roots of
the hair and other symptoms of a confirmed lues. Though they
may be seated in any of the parts mentioned above, they commonly
appear upon the private parts, or the inside of the thigh. They are
also less painful, but frequently much larger and harder than pri-
mary chancres. As their cure must depend upon that of the pox, of
which they are only a symptom, we shall take no further notice of
them till we come to treat of a confirmed lues †.
Thus we have related most of the symptoms which accompany
or succeed a virulent gonorrhœa, and have also given a short view
of their proper treatment; several others sometimes attend this dis-
ease, as a strangury or obstruction of urine, a phymosis, paraphymo-
sis, &c.  
A strangury may be occasioned either by a spasmodic constric-
tion, or an inflammation of the urethra and parts about the neck of
* When venereal ulcers are seated the lips, the infection may be
communicated by kissing. I have seen very obstinate venereal ulcers in
the lips, which I had all the reason in the world to believe were com-
municated in this manner.
Nurses ought to beware of suckling infected children, or having their
breasts drawn by persons tainted with the venereal disease. This cau-
tion is peculiarly necessary for nurses who reside in the neighbourhood.
of great towns.
† I have found it answer extremely well to sprinkle chancres twice
a-day with calomel. This will often perform, a cure without any other
application whatever. If the chancres are upon the glans, they may be
washed with milk and water, a little warm, and afterwards the calomel
may be applied as above.

347 CHANCRES.                   
the bladder. In the former case, the patient begins to void his urine
with tolerable ease; but, as soon as it touches the galled or inflam-
ed urethra, a sudden constriction takes place, and the urine is void-
ed by spurts, and sometimes by drops only. When the strangury is
owing to an inflammation about the neck of the bladder, there is a
constant heat and uneasiness of the part, a perpetual desire to make
water, while the patient can only render a few drops, and a trouble-
some tenesmus, or constant inclination to go to stool.
When the strangury is owing to spasm, such medicines as tend
to dilute and blunt the salts of the urine will be proper. For this
purpose, besides the common diluting liquors, soft and cooling
emulsions, sweetened with the syrup of poppies, may be used.
Should these not have the desired effect, bleeding, and emollient
fomentations, will be necessary.
When the complaint is evidently owing to an inflammation
about the neck of the bladder, bleeding must be more liberally per-
formed, and repeated according to the urgency of the symptoms.
After bleeding, if the strangury still continues, soft clysters, with a
proper quantity of laudanum in them, may be administered, and
emollient fomentations applied to the region of the bladder. At the
same time, the patient may take every four hours a tea-cupful of
barley-water, to an English pint of which six ounces of the syrup of
marsh-mallows, four ounces of the oil of sweet almonds, and half
an ounce of nitre, may be added. If these remedies should not re-
lieve the complaint, and a total suppression of urine should come
on, bleeding must be repeated, and the patient set in a warm bath up
to the middle. It will be proper in this case to discontiuue the diu-
retics, and to draw off the water with a catheter; but as the patient is
seldom able to bear its being introduced, we rather recommend the
use of mild bougies. These often lubricate the passage, and greatly
facilitate the discharge of urine. When they begin to stimulate or
give any uneasiness, they may be withdrawn.
The phymosis is such a constriction of the prepuce over the glans,
as hinders it from being drawn backwards; the paraphymisis, on
the contrary, is such a constriction of the prepuce behind the glans,
as hinders it from being brought forward.
The treatment of these symptoms is so nearly the same with that
of the virulent gonorrhœa, that we have no occasion to enlarge up-
on it. In general, bleeding, purging, poultices, and emollient fo-
mentations are sufficient.
Sometimes in spite of all endeavours to the contrary, the inflam-
mation goes on, and symptoms of a beginning mortification appear.
When this is the case, the prepuce must be scarified with a lancet,
and, if necessary, divided, in order to prevent a strangulation, and
set the imprisoned glans at liberty. We shall not describe this ope-
ration, as it ought always to be done by a surgeon. When a mor-
tification has actually taken place, it will be necessary, besides per-
forming the above operations, to foment the parts frequently with 

348 A CONFIRMED LUES.
cloths wrung out of a strong decoction of camomile-flowers and
bark, and to give the patient a drachm of the bark in powder every
two or three hours.
With regard to the priapism, chordee, and other distortions of the
penis, their treatment is no way different from that of the gonor-
rhœa. When they prove very troublesome, the patient may take a
few drops of laudanum at night, especially after the operation of a
purgative through the day.
Of a Confirmed Lues.
WE have hitherto treated of those affections, in which the vene-
real poison is supposed to be confined chiefly to the particular part
by which it was received, and shall next take a view of the lues in
in its confirmed state; that is, when the poison is actually received
into the blood, and circulating with it through every part of the
body, mixes with the several secretions, and renders the whole ha-
bit tainted.
The symptoms of a confirmed lues are, buboes in the groin, pains
of the head and joints, which are peculiarly troublesome in the
night, or when the patient is warm in bed; scabs and scurfs in va-
rious parts of the body, especially on the head, of a yellowish co-
lour, resembling a honey-comb; corroding ulcers in various parts of
the body, which  generally begin about the throat, from whence
they creep gradually, by the palate, towards the cartilage of the nose,
which they destroy; excrescences or exostoses arise in the middle
of the bones, and their spongy ends become brittle, and break upon
the least accident; at other times they are soft, and bend like wax;
the conglobate glands become hard and callous, and form, in the
neck, armpits, groin, and mesentery, hard moveable tumours, like
the king's evil; tumours of different kinds are likewise formed in
the lymphatic vessels, tendons, ligaments, and nerves, as the gum-
mata, ganglia, nodes, tophs, &c.; the eyes are affected with itching,
pain, redness, and sometimes with total blindness, and the ears with
a singing noise, pain and deafness, whilst their internal substance is
exulcerated and rendered carious; at length all the animal, vital,
and natural functions are depraved; the face becomes pale and li-
vid; the body emaciated and unfit for motion, and the patient falls
into an atrophy or wasting consumption.
Women have symptoms peculiar to the sex; as cancers of the
breast; a suppression or overflowing of the menses; the whites;
hysteric affections; an inflammation, abscess, schirrus, gangrene,
cancer, or ulcer of the womb; they are generally either barren or
subject to abortion; or, if they bring children into the world, they
have an universal erysipelas, are half rotten, and covered with ul-
cers.      

349 A CONFIRMED LUES.             
Such is the catalogue of symptoms attending this disease in its
confirmed state. They are seldom all to be met with in the same
person, or at the same time; so many of them, however, are gene-
rally present as are sufficient to alarm the patient; and if he has rea-
son to suspect the infection is lurking in his body, he ought imme-
diately to set about the expulsion of it, otherwise the most tragical
consequences will ensue.
The only certain remedy hitherto known in Europe, for the cure
of this disease, is mercury, which may be used in a great variety of
forms, with nearly the same success. Some time ago it was reckon-
ed impossible to cure a confirmed lues without a salivation. This
method is now generally laid aside, and mercury is found to be as
efficacious, or rather more so, in expelling the venereal poison,
when administered in such a manner as not to run off by the sali-
vary glands.
Though many are of opinion, that the mercurial ointment is as
efficacious as any other preparation of that mineral; yet experience
has taught me to think otherwise. I have often seen the most ob-
stinate venereal cases, where great quantities of mercurial oint-
ment had been used in vain, yield to the saline preparations of mer-
cury. Nor am I singular in this opinion. My ingenious friend, Mr.
Clare, an eminent surgeon of this city, assures me, that for some
time past, he has employed, in venereal cases, a saline preparation
of mercury with most happy success. This preparation, rubbed
with a sufficient quantity of any mild powder, he applies, in small
portions, to the tongue, where, with a gentle degree of friction, it
is immediately absorbed, and produces its full effect upon the sys-
tem, without doing the least injury to the stomach or bowels; a
matter of the greatest importance in the application of this most
active and powerful remedy *.
It is impossible to ascertain either the exact quantity of medicines
that must be taken, or the time they ought to be continued, in or-
der to perform a cure. These vary according to the constitution of
the patient, the season of the year, the degree of infection, the time
it has lodged in the body, &c. It is difficult to determine a priori,
what quantity of mercury will be necessary to cure this distemper
completely, yet it may be judged of a posteriori, from the abate.
ment and ceasing of the symptoms. Astruc says, that commonly
* The best method of introducing mercury into the system to reme-
dy this disease, is by mercurial ointment, as it is less liable when used
in this manner to pass off by the bowels. One or two drachms of this
ointment, should be rubbed on the insides of each thigh every night
until the gums are affected; when the ointment cannot be convenient-
ly used, one of the mercurial pills (See Appendix.) must be taken every
night and morning, combined with a quarter of a grain of opium, to re-
tain the mercury in the bowels. This practice must be continued until
the symptoms disappear, and for ten or fifteen days afterwards. I. C. 

350 A CONFIRMED LUES.
not less than two ounces of the strong mercurial ointment is suffi-
cient, and not more than three or four ounces necessary.
The only other preparation of mercury which we shall take no-
tice of, is the corrosive sublimate *. This was some time ago brought
into use for the venereal disease, in Germany, by Baron Van Swie-
ten; and was soon after introduced into Britain by Sir John Prin-
gle. The method of giving it is as follows: One grain of corrosive
sublimate is dissolved in two ounces of French brandy or malt spi-
rits; and of this solution, an ordinary table-spoonful, or the quan-
tity of half an ounce, is to be taken twice a-day, and to be conti-
nued as long as any symptoms of the disorder remain. To those
whose stomach cannot bear the solution, the sublimate may be gi-
ven in form of pill †.
Several roots, woods, and barks, have been recommended for
curing the venereal disease; but none have upon experience an-
swered the high encomiums bestowed upon them. Though no one
of these is to be depended upon alone, yet, when joined with mer-
cury, some of them are found to be very beneficial in promoting a
cure. One of the best is sarsaparilla, which may be prepared and
taken according to the directions in the appendix‡.
The mezereon-root is found to be a powerful assistant to the sub-
limate, or any other mercurial. It may be used along with the sar-
saparilla, as directed in the appendix, or by itself. Those who choose
the mezereon by itself, may boil an ounce of the fresh bark, taken
from the root, in twelve English pints of water to eight, adding to-
wards the end an ounce of liquorice. The dose of this is the same
as of the decoction of sarsaparilla.
We have been told that the natives of America cure the vene-
real disease, in every stage, by a decoction of the root of a plant
called the Lobelia. It is used either fresh or dried; but we have
no certain accounts with regard to the proportion. Sometimes they
mix other roots with it, as those of the ranunculus, the ceanothus, 
&c.; but whether these are designed to disguise or assist it, is doubt-
ful. The patient takes a large draught of the decoction early in the
morning, and continues to use it for his ordinary drink through
the day §.
* This preparation of mercury is thought to be more efficacious than
any other, in venereal affections of the skin. I. C.
† The sublimate may be given in distilled water, or any other li-
quor that the patient chooses. I commonly order ten grains to be dissolv-
ed in an ounce of the spirit of wine, for the conveniency of carriage,
and let the patient take twenty or thirty drops of it night and morning
in half a glass of brandy or other spirits. Mr. Debraw, an ingenious
chemist of this place, prepares a salt of mercury much more mild and
gentle in its operation than the sublimate, though equally efficacious.
‡ See Appendix, Decoct. of Sarsaparilla.
§ Though we are still very much in the dark with regard to the me-
thod of curing this disease among the natives of America, yet it is ge-
nerally affirmed, that they do cure it with speed, safety, and success,
and that without the least knowledge of mercury. Hence it becomes
an object of considerable importance to discover their method of cure.

351 A CONFIRMED LUES.            
Many other roots and woods might he mentioned which have
been, extolled for curing the venereal disease, as the china-root,
the roots of soap-wort, burdock, &c. as also the wood of guaiacum
and sassafras; but, as none of these possess virtues superior to those
already mentioned, we shall pass them over, and shall conclude our
observations on this disease, with a few general remarks concerning
the proper management of the patient, and the nature of the infec-
tion.
General Observations.
THE condition of the patient ought always to be considered pre-
vious to his entering upon a course of mercury in any form. It
would be rash and dangerous to administer mercury to a person la-
bouring under any violent acute disease, as fevers, pleurisy, perip-
neumony, or the like. It would be dangerous in some chronic ca-
ses; as a slow hectic fever, or the last stage of a consumption.
Sometimes, however, these diseases proceed from a confirmed lues;
in which case, it will be necessary to give mercury. In chronic dis-
eases of a less dangerous nature, as the asthma, the gravel, and such
like, mercury, if necessary, may be safely administered. If the pa-
tient's strength has been greatly exhausted by sickness, labour, ab-
stinence, or any other cause, the use of mercury must be postponed,
till, by time, rest, and a nourishing diet, it can be sufficiently re-
stored.
Mercury ought not to be administered to women during the
menstrual flux, or when the period is near at hand. Neither should
it be given in the last stage of pregnancy. If the woman be not
near the time of her delivery, and circumstances render it necessa-
ry, mercury may be given, but in smaller doses, and at greater in-
tervals than usual: with these precautions, both the mother and
child may be cured at the same time; if not, the disorder will at
least be kept from growing worse, till the woman be brought to
bed, and sufficiently recovered, when a more effectual method may
be pursued, which, if she suckles her child, will in all probability be 
sufficient for the cure of both.
Mercury should be administered to infants with the greatest cau-
This might surely be done by making trials of the various plants which
are found in those parts, and particularly of such as the natives are
kown to make use of. All people in a rude state take their medicines
chiefly from the vegetable kingdom, and are often possessed of valuable
secrets with regard to the virtues of the plants, of which more enlight-
ened nations are ignorant. Indeed, we make no doubt but some plants
of our own growth, were proper pains taken to discover them, would
be found as efficacious in curing the venereal disease as those of Ameri-
ca. It must however be remembered, that what will cure the venereal
disease in one country, will not always have equal success in another. 

352 A CONFIRMED LUES.
tion. Their tender condition unfits them for supporting a salivation,
and makes it necessary to give even the mildest preparations of mercu-
ry to them with a sparing hand. A similar conduct is recommended
in the treatment of old persons, who labour under a confirmed lues.
The infirmities of age must render people less able to undergo the
fatigues of a salivation; but this, as formerly observed, is never ne-
cessary; besides, we have generally found, that mercury had much
less effect upon very old persons than on those who were younger.
Hysteric and hypochondriac persons, and such as are subject to
an habitual diarrhœa* or dysentery, or to frequent and violent at-
tacks of the epilepsy, or who are afflicted with the scrophula, or
the scurvy, ought to be cautious in the use of mercury. Where any
one of these disorders prevails, it ought, if possible, to be cured, or
at least palliated, before the patient enters upon a course of mercu-
ry. When this cannot be done, the mercury must be administered
in smaller doses, and at longer intervals than usual.
The most proper seasons for entering upon a course of mercury
are, the spring and autumn, when the air is of a moderate warmth.
If the circumstances of the case will not admit of delay, we must
not defer the cure on account of the season, but must administer the
mercury; taking care at the same time to keep the patient's cham-
ber warmer or cooler, according as the season of the year requires.
The next thing to be considered is the preparation to be observed
before we proceed to a course of mercury. Some lay great stress
upon this circumstance, observing, that by previously relaxing the
vessels, and correcting any disorder which may happen to prevail
in the blood, not only the mercury will be disposed to act more
kindly, but many other inconveniencies will be prevented.
We have already recommended bleeding and gentle purges, pre-
vious to the administration of mercury, and shall only now add,
that these are always to be repeated according to the age, strength,
constitution, and other circumstances of the patient. Afterwards, if
it can be conveniently done, the patient ought to bathe once or
twice a-day, for a few days, in lukewarm water. His diet in the
mean time must be light, moist, and cooling. Wine, and all heating
liquors, also violent bodily exercise, and all great exertions of the
mind, are carefully to be avoided.
A proper regimen is to be observed by such as are under a course
of mercury. Inattention to this not only endangers the patient's life,
but often also disappoints him of a cure. A much smaller quantity
of mercury will cure a person who lives moderate, keeps warm, and
avoids all excess, than one who cannot endure to put the smallest
restraint upon his appetites: indeed it but rarely happens that such
are thoroughly cured.
* In lues venerea, when the patient is troubled with diarrhœa, mer-
cury should be introduced into the system by friction of mercurial oint-
ment on the inside of the thighs. I. C.

353 A CONFIRMED LUES.  
There is hardly any thing of more importance, either for pre-
venting or removing venereal infection than cleanliness. By an
early attention to this, the infection might often be prevented from
entering the body; and, where it has already taken place, its of-
fects may be greatly mitigated. The moment any person has rea-
son to suspect that he has received the infection, he ought to wash
the parts with water and spirits, sweet oil, or milk and water; a
small quantity of the last may likewise be injected up the urethra,
if it can be conveniently done. Whether this disease at first took
its rise from dirtiness is hard to say; but wherever that prevails,
the infection is found in its greatest degree of virulence, which
gives ground to believe that a strict attention to cleanliness would
go far towards extirpating it *.
When the disease has been neglected, or improperly treated, it
often becomes a disorder of the habit. In this case, the cure must be
attempted by restoratives, as a milk diet, the decoction of sarsapa-
rilla, and such like, to which mercury may be occasionally added.
It is a common practice in North Britain to send such patients to
drink goat-whey. This is a very proper plan, provided the infection
has been totally eradicated before-hand; but when that is not the
case, and the patient trusts to the whey for finishing his cure, he
will often be disappointed. I have frequently known the disease re-
turn with all its virulence after a course of goat-whey, even when
that course had been thought quite sufficient for completing the
cure.
One of the most unfortunate circumstances attending patients in
this disease, is the necessity they are often laid under of being soon
* I have not only often seen a recent infection carried off in a few
days by means of cleanliness, viz. bathing, fomentations, injections,
&c. but have likewise found it of the greatest advantage in the more ad-
vanced stages of the disease. Of this I had lately a very remarkable in-
stance, in a man whose penis was almost wholly confnmed by venereal
ulcers: the mutter had been allowed to continue on the sores, without
any care having been taken to clean them, till, notwithstanding the use
of mercury and other medicines, it had produced the effects above men-
tioned. I ordered warm milk and water to be injected three or four
times a-day into all the sinuous ulcers, in order to wafh out the mat-
ter; after which they were stuffed with dry lint to absorb the fresh mat-
ter as it was generated The patient at the same time took every day
half a grain of the corrosive sublimate of mercury, dissolved in an ounce
of brandy, and drank an English quart of the decoction of sarsaparilla.
By this treatment, in about six weeks, he was perfectly cured; and,
what was very remarkable, a part of the penis was actually regene-
rated.
Doctor Gilchrist has given an account of a species of the lues venerea
which prevails in the west of Scotland, to which the natives give the
name of Sibbins or Sivvins. He observes, that the spreading of this dis-
ease is chiefly owing to a neglect, of cleanliness, and seems to think, that
by due attention to that virtue it might be extirpated. The treatment
of this disease is similar to that of a confirmed lues or pox. The yaws, a
disease now very common both in America and the West-India islands,
may be cured in the same manner.
Y2

354 A CONFIRMED LUES.
well. This induces them to take medicine too fast, and to leave it
off too soon. A few grabs more of medicine, or a few days longer
confinement, would often be sufficient to perfect the cure; where-
as, by neglect of these, a small degree of virulence is still left in the
humours, which gradually vitiates, and at length contaminates the
whole mass. To avoid this, we would advise the patient never to
leave off taking medicine immediately upon the disappearing of the
symptoms, but continue it for some time after, gradually lessening
the quantity, till there is sufficient ground to believe that the dis-
ease is entirely eradicated.
It is not only difficult, but impossible, to ascertain the exact de-
gree of virulence that may attend the disease; for which reason, it
will always be much safer to use medicine too long, than to leave
it off too soon. A modern practitioner of some note for the venereal
disease, always orders his patient to perform a quarantine of at
least forty days, during which time he takes forty bottles of, I sup-
pose, a strong decoction of sarsaparilla, or some other anti-venereal
simple. Whoever takes this method, and adds a sufficient quantity
of corrosive sublimate, or some other active preparation of mercury
to the decoction, will seldom fail to cure a confirmed lues.
It is unfortunate for the cure of this disease, that not one in ten
of those who contract it, are able or willing to submit to a proper
plan of regimen. The patient is willing to take medicine; but he
must follow his business, and, to prevent suspicions, must eat and
drink like the rest of the family. This is the true source of nine-
tenths of all the mischief arising from the venereal disease. I never
knew the cure attended with any great difficulty or danger where
the patient strictly followed the physician's advice: but a volume
would not be sufficient to point out the dreadful consequences
which proceed from an opposite conduct. Schirrous testicles, ulce-
rous sore throats, madness, consumptions, carious bones, and a
rotten progeny, are a few of the blessings derived from this source.
There is a species of false reasoning, with regard to this disease,
which proves fatal to many. A person of a sound constitution con-
tracts a slight degree of the disorder. He gets well without taking
any great care, or using much medicine, and hence concludes that this
will always be the case. The next time the disease occurs, though
ten times more virulent, he pursues the same course, and his consti-
tution is ruined. The different degrees of virulence in the small-pox
are not greater than in this disease, though, as Sydenham observes,
in some cases the most skilful physicians cannot cure, and in others,
the most ignorant old woman cannot kill the patient in that disor-
der. A good constitution is always in favour of the patient, yet
too great stress may be laid upon it. It does not appear from ob-
servation, that the most robust constitution is able to overcome the
virulence of the venereal contagion, after it has got into the habit.
In this case, a proper course of medicine is always indispensably ne-
cessary. 

355 DISEASES OF WOMEN.           
Although it is impossible, on account of the different degrees of
virulence, &c. to lay down fixed and certain rules for the cure of
this disease, yet the following general plan will always be found
safe, and often successful, viz. to bleed and administer gentle pur-
ges with diuretics during the inflammatory state, and as soon as the
symptoms of inflammation are abated, to administer mercury, in
any form agreeable to the patient. The same medicine, assisted by
the decoction of sarsaparilla, and a proper regimen, will not only
secure the constitution against a further progress of a confirmed
pox, but will generally perform a complete cure.
CHAPTER L.
Diseases of Women.
WOMEN, in all civilized nations, have the management of
domestic affairs, and it is very proper they should, as Na-
ture has made them less fit for the more active and laborious em-
ployments. This indulgence, however, is generally carried too far;
and females, instead of being benefited by it, are greatly injured,
from the want of exercise and free air. To be satisfied of this, one
need only compare the fresh and ruddy looks of a milk-maid with
the pale complexion of those females whose whole time is spent
within doors. Nature has made an evident distinction between the
male and female, with regard to bodily strength and vigour, yet she
certainly never meant, either that the one should be always with-
out, or the other always within doors.
The confinement of females, besides hurting their figure and
complexion, relaxes their solids, weakens their minds, and disor-
ders all the functions of the body. Hence proceed obstructions,
indigestion, flatulence, abortions, and the whole train of nervous
disorders. These not only unfit women for being mothers and nur-
ses, but often render them whimsical and ridiculous. A sound mind
depends so much upon a healthy body, that where the latter is
wanting, the former is rarely to be found.
Women who are chiefly employed without doers, in the different
branches of husbandry, gardening, and the like, are almost as hardy
as their husbands, and their children are likewise strong and heal-
thy. But as the bad effects of confinement and inactivity upon both
fexes have been already shewn, we shall proceed to point out those
circumstances in the structure and design of females, which subject
them to peculiar diseases; the chief of which are, their monthly eva-
cuations, pregnancy, and child-bearing. These indeed cannot properly
be called diseases, but from the delicacy of the sex, and their being
often improperly managed in such situations, they become the
source of numerous calamities. 

[356]
Of the Menstrual Discharge.
FEMALES generally begin to menstruate about the age of fif-
teen, and leave it off about fifty *, which renders these two periods
the most critical of their lives. About the first appearance of this
discharge, the constitution undergoes a very considerable change,
generally indeed for the better, though sometimes for the worse.
The greatest care is now necessary, as the future health and happi-
ness of the female depends in a great measure upon her conduct at
this period †.
If a girl about this time of life be confined to the house, kept
constantly sitting, and neither allowed to romp about, nor employed
in any active business, which gives exercise to the whole body, she
becomes weak, relaxed, and puny; her blood not being duly pre-
pared, she looks pale and wan; her health, spirits, and vigour de-
cline, and she sinks into a valetudinarian for life. Such is the fate
of numbers of those unhappy females, who, either from too much
indulgence, or their own narrow circumstances, are, at this critical
period, denied the benefit of exercise and free air.
A lazy disposition proves likewise very hurtful to girls at this pe-
riod. One seldom meets with complaints from obstructions amongst
the more active and industrious part of the sex; whereas, the indo-
lent are seldom free from them. These are in a manner eaten up by
the chlorosis, or green-sickness, and other diseases of this nature. We
recommend it to all who wish to escape these calamities, to avoid
indolence and inactivity, as their greatest enemies, and to be as
much abroad in the open air as possible.
Another thing which proves very hurtful to girls about this pe-
riod of life, is unwholesome food. Fond of all manner of trash, they
often indulge in it to excess. Hence ensue indigestions, want of ap-
petite, and a numerous train of evils. If the fluids be not duly pre-
pared, it is utterly impossible that the secretions should go properly
on. Accordingly, such girls as lead an indolent life, and eat great
quantities of trash, are not only subject to obstructions of the menses,
but likewise to glandular obstructions; as the scrophula or king's  
evil, &c.                                                        
* In America, generally about forty-five. I. C.
† It is the duty of mothers, and those who are intrusted with the
education of girls, to instruct them early in the conduct and manage-
ment of themselves at this critical period of their lives. False modesty,
inattention, and ignorance of what is beneficial or hurtful it this time,
are the sources of many diseases and misfortunes in life, which a few
sensible lessons from an experienced matron might have prevented.
Nor is care less necessary in the subsequent returns of this discharge.
Taking improper food, violent affections of the mind, or catching cold
at this period, is often sufficient to ruin the health, or to render the fe-
male ever after incapable of procreation.          

357 THE MENSTRUAL DISCHARGE.       
A dull disposition is also very hurtful to girls at this period. It is
rare to see a sprightly girl who does not enjoy good health,
while the grave, moping, melancholy creature, proves the very
prey of vapours and hysterics. Youth is the season for mirth and
cheerfulness. Let it therefore be indulged. It is an absolute duty.
To lay in a stock of health in time of youth, is as necessary a piece
of prudence as to make provision against the decays of old age.
While wise Nature prompts the happy youth to join in sprightly
amusements, let not the severe dictates of hoary age forbid the usual
impulse, nor damp, with serious gloom, the season destined to mirth
and innocent festivity.
Another thing very hurtful to females about this period of life
is strait clothes. They are fond of a fine shape, and foolishly ima-
gine this can be acquired by lacing themselves tight. Hence, by
squeezing the stomach and bowels, they hurt the digestion, and oc-
casion many incurable maladies. This error is not indeed so com-
mon as it has been; but, as fashions change, it may come about
again: many females, to this day, feel the direful effects of that
wretched custom which prevailed some years ago, of squeezing eve-
ry girl into as small a size in the middle as possible. Human inven-
tion could not possibly have devised a practice more destructive to
health.  
After a female has arrived at that period of life when the men-
ses usually begin to flow, and they do not appear, but, on the con-
trary, her health and spirits begin to decline, we would advise, in-
stead of shutting the poor girl up in the house, and dosing her with
steel, asafœtida, and other nauseous drugs, to place her in a situa-
tion where she ran enjoy the benefit of free air and agreeable com-
pany. There let her eat wholesome food, take sufficient exercise,
and amuse herself in the most agreeable manner; and we have little
reason to fear, but Nature, thus assisted, will do her proper work.
She seldom fails, unless where the fault is on our side.
This discharge in the beginning is seldom so instantaneous as to
surprise females unawares. It is generally preceded by symptoms
which foretel its approach; as a sense of heat, weight, and dull
pain in the loins; distension and hardness of the breasts; headach;
loss of appetite; lassitude; paleness of the countenance; and some-
times a slight degree of fever. When these symptoms appear about
the age of which the menstrual flux usually begins, every thing should
be carefully avoided which may obstruct that necessary and saluta-
ry evacuation; and all means used to promote it; as sitting fre-
quently over the steams of warm water, drinking warm diluting
liquors, &c.  
After the menses have once begun to flow, the greatest care should
be taken to avoid every thing that may tend to obstruct them. Fe-
males ought to be exceeding cautious of what they eat or drink at
the time they are out of order. Every thing that is cold, or apt to
sour on the stomach, ought to be avoided; as fruit, butter-milk, 

358 THE MENSTRUAL DISCHARGE.
and such like. Fish, and all kinds of food that are hard of digestion,
are also to be avoided. As it is imposible to mention every thing
than may disagree with individuals at this time, we would recom-
mend it to every female to be very attentive to what disagrees with
herself, and carefully to avoid it.
Cold is extremely hurtful at this particular period. More of the sex
date their disorders from colds, caught while they are out of order,
than from all other causes. This ought surely to put them upon
their guard, and to make them very circumspect in their conduct at
such times. A degree of cold that will not in the least hurt them at
another time, will at this period be sufficient entirely to ruin their 
health and constitution.
The greatest attention ought likewise to be paid to the mind,  
which should be kept as easy and cheerful as possible. Every part of  
the animal economy is influenced by the passions, but none more
so than this. Anger, fear, grief, and other affections of the mind,
often occasion obstructions of the menstrual flux, which prove ab-   
solutely incurable.
From whatever cause this flux is obstructed, except in the state of
pregnancy, proper means should be used to restore it. For this pur-
pose, we recommend sufficient exercise, in a dry, open, and rather
cool air; wholesome diet, and, if the body be weak and languid,
generous liquors; also cheerful company, and all manner of amuse-
ments. If these fail, recourse must be had to medicine.
When obstructions proceed from a weak relaxed state of the solids,
such medicines as tend to promote digestion, to brace the solids and
assist the body in preparing good blood, ought to be used. The princi-
pal of these are iron and the Peruvian bark, with other bitter and af-
tringent medicines. Filings of iron may be infused in wine or ale,
two or three ounces to an English quart, and after it has stood for
two or three week's, it may be filtered, and about half a wine glass   :
of it taken twice a-day: or prepared steel maybe taken in the dose
of half a drachm, mixed with a little honey or treacle, three or
four times a-day. The bark and other bitters may either be taken
in substance or infusion, as is most agreeable to the patient.
When obstructions proceed from a viscid state of the blood; or
from women of a gross or full habit, evacuations, and such medicines
as attenuate the humours, are necessary. The patient, in this case, 
ought to be bled, to bathe her feet frequently in warm water, to
take now and then a cooling purge, and to live upon a spare, thin  
diet. Her drink should be whey, water, or small-beer, and she
ought to take sufficient exercise. A tea-spoonful of the tincture of
black hellebore may be taken twice a-day in a cup of warm water.
When obstructions proceed from affections of the mind, as grief, 
fear, anger, &c. every method should be used to amuse and divert
the patient. And that she may the more readily forget the cause of  
her affliction, she ought, if possible, to be removed from the place
where it happened. A change of place, by presenting the mind    

359 THE MENSTRUAL DISCHARGE.     
with a variety of new objects, has often a very happy influence in
relieving it from the deepest distress. A soothing, kind, and affable
behaviour to females in this situation, is also of the last impor-
tance.
An obstruction of the menses is often the effect of other mala-
dies. When this is the case, instead of giving medicines to force that
discharge, which might be dangerous, we ought, by all means, to en-
deavour to restore the patient's health and strength. When that is
effected, the other will return of course.
But the menstrual flux may be too great as well as too small.
When this happens, the patient becomes weak, the colour pale,
the appetite and digestion are bad, and cedematous swellings of the
feet, dropsies, and consumptions often ensue. This frequently hap-
pens t» women about the age of forty-five or fifty, and is very dif-
ficult to cure. It may proceed from a sedentary life; a full diet,
consisting chiefly of salted, high-seasoned, or acrid food; the use of
spirituous liquors; excessive fatigue; relaxation; a dissolved state of
the blood; violent passions of the mind, &c.
The treatment of this disease must be varied according to its
cause. When it is occasioned by any error in the patient's regimen,
an opposite course to that which induced the disorder must be pur-
sued, and such medicines taken as have a tendency to restrain the
flux, and counteract the morbid affections of the system from whence
it proceeds.
To restrain the flux, the patient should be kept quiet and easy
both in body and mind. If it be very violent, she ought to lie in bed
with her head low; to live upon a cool and slender diet, as veal or
chicken broths with bread; and to drink decoctions of nettle-roots,
or the greater comfrey. If these be not sufficient to stop the flux,
stronger astringents may be used, as Japan earth, allum, elixir of
vitriol, the Peruvian bark, &c *.
The uterine flux may offend in quality as well as in quantity.
What is usually called the fluor albus, or whites, is a very common
disease, and proves extremely hurtful to delicate women. This dis-
charge, however, is not always white, but sometimes pale, yellow,
green, or of a blackish colour; sometimes it is sharp and corrosive,
sometimes foul and fœtid, &c. It is attended with a pale complexion,
pain in the back, loss of appetite, swelling of the feet, and other
signs of debility. It generally proceeds from a relaxed state of the
body, arising from indolence, the excessive use of tea, coffee, or
other weak and watery diet.
* Two drachms of allum and one of Japan earth, may be pounded
together, and divided into eight or nine doses, one of which may be
taken three times a-day.
Persons, whose stomachs cannot bear the allum, may take two table-
spoonfuls of the tincture of roses three or four times a-day to each
dose of which, ten drops of laudanum may be added.
If these should fail, half a drachm of the Peruvian bark, in powder
with ten drops of the elixir of vitriol, may be taken, in a glass of red
wine, four times a-day.

360 PREGNANCY.
To remove this disease, the patient must take as much exercise as
fhe can bear without fatigue. Her food should be solid and nourish-
ing, but of easy digestion; and her drink rather generous, as red
port or claret, mixed with Pyrmont, Bristol, or lime-water. Tea
and coffee are to be avoided. I have often known strong broths
have an exceeding good effect; and sometimes a milk diet alone
will perform a cure. The patient ought not to lie too long a-bed.
When medicine is necessary, we know none preferable to the bark,
which, in this case, ought always to be taken in substance. In warm
weather, the cold bath will be of considerable service.
The period of life at which the menses cease to flow, is like-
wise very critical to the sex. The stoppage of any customary eva-
cuation, however small, is sufficient to disorder the whole frame,
and often to destroy life itself. Hence so many women either fall
into chronic disorders, or die about this time. Such of them, how-
ever, as survive it, without contracting any chronic disease, often
become more healthy and hardy than they were before, and enjoy
strength and vigour to a very great age.
If the menses cease all of a sudden, in women of a full habit,
they ought to abate somewhat of their usual quantity of food, es-
pecially of the more nourishing kind, as flesh, eggs, &c. They ought
likewise to take sufficient exercise, and to keep the body open. This
may be done by taking, once or twice a week, Glauber's salts or
castor-oil; and if the pulse be full and hard, ten or twelve ounces
of blood should be taken from the arm. 
Women of a gross habit, at this period of life, have often ul-
cerous sores break out about their ancles, or in other parts of the
body. Such ulcers ought to be considered as critical, and either
suffered to continue open, or have artificial drains substituted in
their stead. Women who will have such sores dried up, are of «n,
soon after, carried off by acute diseases, or fall into those of a
chronic nature.
Pregnancy
IS not a disease, yet that state is often attended with a variety
of complaints which merit attention, and requires the assistance of
medicine. Some women indeed, are more healthy during their
pregnancy than at any other time; but this is by no means the ge-
neral case: most of them breed in sorrow, and are frequently indis-
posed during the whole time of pregnancy. Few fatal diseases,
however, happen during that period; and hardly any, except abor-
tion, that can be called dangerous. We shall, therefore, pay parti-
cular attention to it, as it proves generally fatal to the child, and
sometimes so to the mother.               

361 PREGNANCY.                 
Pregnant women are often afflicted with the heart burn. The
method of treating this complaint has been already pointed out.
They are, likewise, in the more early periods of pregnancy, often
harrassed with sickness and vomiting, especially in the morning.
The method of relieving these complaints has also been shewn.
The head-ach and tooth-ach are very troublesome symptoms of
pregnancy. The former may generally be removed by keeping the
body gently open, by the use of prunes, figs, roasted apples, and
such-like. When the pain is very violent, bleeding may be neces-
sary. For the treatment of the latter, we must refer to that article.
Several other complaints incident to pregnant women might be
mentioned, as a cough and difficulty of breathing, suppression and
incontinency of urine, &c.; but all these have been taken notice
of before.
Every pregnant woman is more or less in danger of abortion.
This should be guarded against with the greatest care, as it not on-
ly weakens the constitution, but renders the woman liable to the
same misfortune afterwards *. Abortion may happen at any period
of pregnancy, but it is most common in the second or third month.
Sometimes it happens in the fourth or fifth. If within the first
month, it is usually called a false conception; if after the seventh
month, the child may often be kept alive by proper care.
The common causes of abortion are, the death of the child;
weakness or relaxation of the mother; great evacuations; violent
exercise; raising great weights; reaching too high; jumping, or
stepping from an eminence; vomiting; coughing; convulsion-
fits; strokes on the belly; falls; fevers; disagreeable smells; ex-
cels of blood; indolence; high living; or the contrary; violent
passions or affections of the mind, as fear, grief, &c.
The signs of approaching abortion are, pain in the loins, or about
the bottom of the belly; a dull heavy pain in the inside of the
thighs; a slight degree of coldness, or shivering; sickness, palpita-
tion of the heart; the breasts become flat and soft; the belly falls;
and there is a discharge of blood or watery humours from the
womb.
To prevent abortion, women of a weak or relaxed habit should
use solid food, avoiding great quantities of tea, and other weak and
watery liquors; rise early and go soon to bed; shun damp houses;
take frequent exercise in the open air, but avoid fatigue; and ne-
ver go abroad in damp foggy weather, if they can shun it.
* Every woman who procures an abortion does it at the hazard of
her life; yet there are not a few who run this risk, merely to prevent
the trouble of bearing and bringing up children. It is surely a most un-
natural crime, and cannot, even in the most abandoned, be viewed
without horror; but in the decent matron, it is still more unpardona-
ble. Those wretches who daily advertise their assistance to women in
this business, deserve, in my opinion, the most severe of all human pu-
nishment.
Z2

362 CHILD-BIRTH.
Women of a full habit ought to use a spare diet, avoiding strong
liquors, and every thing that may tend to heat the body, or in-
creafe the quantity of blood. Their diet should, be of an opening
nature, consisting principally of vegetable substances. Every wo-
man with child ought to be kept cheerful and easy in her mind.
Her appetites, even though depraved, ought to be indulged as far
as prudence will permit.
When any signs of abortion appear, the woman ought to be laid
in bed on a mattrass, with her head low. She should be kept quiet,   
and her mind soothed and comforted. She ought not to be kept
too hot, nor to take any thing of a heating nature. Her food should
consist of broths, rice and milk, jellies, gruels made of oat-meal,   
and the like, all of which ought to be taken cold. If she be able to
bear it, she should lose at least half a pound of blood from the arm.
Her drink ought to be barley water sharpened with juice of lemon;
or she may take half a drachm of powdered nitre, in a cup of wa-
ter-gruel, every five or six hours. If seized with a violent looseness,
she ought to drink the decoction of calcined hartshorn prepared.
If she be affected with vomiting, let her take frequently two table-
spoonfuls of the saline mixture. In general, opiates are of service;
but they should always be given with caution.
Sanguine robust women who are liable to miscarry at a certain
time of pregnancy, ought always to be bled a few days before that
period arrives. By this means, and observing the regimen above
prescribed, they might often escape that misfortune.
Though we recommend due care for preventing abortion, we
would not be understood as restraining pregnant women from their
usual exercises. This would generally operate the quite contrary
way. Want of exercise not only relaxes the body, but induces a
plethora, or two great a fulness of the vessels, which are the two
principal causes of abortion. There are, however, some women of   
fo delicate a texture, that it is necessary for them to avoid almost
every kind of exercise during the whole period of pregnancy.
Of Child-Birth.
MANY diseases proceed from the want of due care in child-bed; 
and the more hardy part of the sex are most apt to despise the ne-
cessary precautions in this state. This is peculiarly the case with
young wives. They think, when the labour-pains are ended, the
danger is over; but in truth, it may only then be said to be begun.
Nature, if left to herself, will seldom fail to expel the fætus; but
proper care and management are certainly necessary for the reco-
very of the mother. No doubt mischief may be done by too much
as well as by too little care. Hence females who have the greatest 

363 CHILD-BIRTH.                  
number of attendants in child-bed, generally recover worst *. But
this is not peculiar to the state of child-bed. Excessive care always
defeats its own intention, and is generally more dangerous than
none at all †.
During actual labour, nothing of a heating nature ought to be
given. The woman may now and then take a little panado, and
her drink ought to be toast and water, or thin groat-gruel. Spirits,
wines, cordial-waters, and other things which are given with a
view to strengthen the mother, and promote the birth, for the most
part, tend only to increase the fever, inflame the womb, and retard
the labour. Besides, they endanger the woman afterwards, as they
often occasion violent and mortal hæmorrhages, or dispose her to
eruptive and other fevers.
When the labour proves tedious and difficult, to prevent inflam-
mations, it will be proper to bleed. An emollient clyster ought
likewise frequently to be administered; and the passage ought to
be gently rubbed with a little soft pomatum or fresh butter. If na-
ture seems to sink, and the woman is greatly exhausted with fa-
tigue, a draught of generous wine, or some other cordial, may be
given, but not otherwise. These directions are sufficient in natural
labours; and in all preternatural cases, a skilful surgeon or man-
midwife, ought to be called as soon as possible.
After delivery, the woman ought to be kept as quiet and easy as
possible‡. Her food should be light and thin, as gruel, pannado,
&c. and her drink weak and diluting. To this rule, there are ma-
ny exceptions. I have known several women, whose spirits could
not be supported in child-bed without solid food and generous li-
* No more attendants should be admitted than are absolutely neces-
sary; and it is to be wished that those would never converse about la-
bours that have been accompanied with greater danger. Such conver-
sation seldom fails to make the patient extremely unhappy, and conse-
quently impedes the labour. (I. C.)
† Though the management of women in child-bed has been practised
as an employment since the earliest accounts of time: yet it is still in
most countries on a very bad footing. Few women think of following
this employment till they are reduced to the necessity of doing it for
bread. Hence not one in a hundred of them have any education, or
proper knowledge of their business. Most women in child-bed require
to be managed with skill and attention, and they are often hurt by the
superstitious prejudices of ignorant and officious midwives. The mis-
chief done in this way is much greater than is generally imagined; most
of which might be prevented by allowing no woman to practise mid-
wifery but such as are properly qualified. Were due attention paid to
this, it would be the means of saving many lives.
‡ We cannot help taking notice of that ridiculous custom which still
prevails in some parts of the country, of collecting a number of wo-
men together upon such occasions. These, instead of being useful, serve
only to crowd the house, and obstruct the necessary attendants. Besides,
they hurt the patient with their noise; and often, by their untimely
and impertinent advice, do much mischief. 

364 CHILD-BIRTH.
quors; to such, a glass of wine and a bit of chicken must be al-
lowed.
Sometimes an excessive hæmorrhage or flooding happens after
delivery. In this case, the patient should be laid with her head low,
kept cool, and be in all respects treated as for an excessive flux of
the menses. If the flooding proves violent, linen cloths, which have
been wrung out of a mixture of equal parts of vinegar and water,
or red wine, should be applied to the belly, the loins, and the thighs:
these must be changed as they grow dry; and may be discontinu-
ed as soon as the flooding abates *.
If there be violent pains after delivery †, the patient ought to
drink plentifully of warm diluting liquors, as groat-gruel, or tea
with a little saffron in it; and to take small broths, with carraway
seeds, or a bit of orange-peel in them; an ounce of the oil of sweet
almonds may likewise be frequently taken in a cup of any of the
above liquors; and if the patient be hot or feverish, one of the fol-
lowing powders may be taken in a cup of her usual drink every
five or six hours ‡.
An inflammation of the womb is a dangerous and not unfrequent
disease after delivery. It is known by pains in the lower part of the
belly, which are greatly increased upon touching; by the tension
or tightness of the parts; great weakness; change of countenance,
a constant fever, with a weak and hard pulse; a slight delirium or
raving; sometimes incessant vomitting; a hiccup; a discharge of
reddish, fœtid, sharp water from the womb; an inclination to go
frequently to stool; a heat, and sometimes total suppression of
urine.
This must be treated like other inflammatory disorders, by bleed-
ing and plentiful dilution. The drink may be thin gruel or barley-
water; in a cup of which half a drachm of nitre may be dissolved,
and taken three or four times a-day. Clysters of warm milk and
water must be frequently administered; and the belly should be
fomented by cloths wrung cut of warm water, or by applying
bladders filled with warm milk and water to it.
A suppression of the lochia, or usual discharges after delivery,
* In a violent flooding after delivery, I have seen very good effects
from the following mixture: Take of penny-royal water, simple cin-
namon-water, and syrrup of poppies, each two ounces, elixir of vitriol
a drachm. Mix and take two table-spoonfuls every two hours, or oftner,
if necessary.
† One grain or more of opium should be administered. (I. C.)
‡ Take of crabs claw; prepared, half an ounce, purified nitre, two
drachms, saffron powdered, half a drachm; rub them together in a
mortar, and divide the whole into eight or nine doses.
When the patient is low-spirited, or troubled with hysterical com-
plaints, she ought to take frequently twelve or fifteen drops of the tinc-
ture of asafœtida in a cup of penny-royal tea.       

365 CHILD-BIRTH.                  
and the milk-fever, must be treated nearly in the same manner as an
inflammation of the womb. In all these cases, the safest course is
plentiful dilution; gentle evacuations, and fomentations of the parts
affected. In the milk-fever, the breasts may be embrocated with a
little warm linseed-oil, or the leaves of red cabbage may be applied
to them. The child should be often put to the breast, or it should
be drawn by some other person.
Nothing would tend more to prevent the milk-fever, than put-
ting the child early to the breast. The custom of not allowing chil-
dren to suck for the first two or three days, is contrary to Nature
and common sense, and is very hurtful both to the mother and
child.
Every mother who has milk in her breasts, ought either to suckle
her own child, or to have her breasts frequently drawn, at least for
the first month. This would prevent many of the diseases which
prove fatal to women in child-bed.
When an inflammation happens in the breast, attended with red-
ness, hardness, and other symptoms of suppuration, the safest appli-
cation is a poultice of bread and milk, softened with oil or fresh-
butter. This may be renewed twice a-day, till the tumour be either
discussed or brought to suppuration. The use of repellents, in this
case, is very dangerous; they often occasion fevers, and sometimes
cancers; whereas a suppuration is seldom attended with any danger,
and has often the most salutary effects.
When the nipples are fretted or chapt, they may be anointed
with a mixture of oil and bees' wax, or a little powdered gum-arabic
may be sprinkled on them. I have feen Hungary-water, applied to
the nipples, have a very good effect. Should the complaint prove
obstinate, a cooling purge may be given, which generally re-
poves it.
The miliary fever is a disease incident to women in child-bed.
Hoffman observes, that this fever of child-bed women might gene-
rally be prevented, if they, during their pregnancy, were regular
in their diet, used moderate exercise, took now and then a gentle
laxative of manna, castor-oil, or cream of tartar; not forgetting to
bleed in the first months, and avoid all sharp air. When the labour
is coming on, it is not to be hastened with forcing medicines,
which inflame the blood and humours, or put them into unnatural
commotions. Care should be taken, after the birth, that the natu-
ral excretions proceed regularly; and if the pulse be quick, a lit-
tle nitrous powder, or some other cooling medicines, should be
given.
The most fatal disorder consequent upon delivery, is the puerperal,
or child-bed fever. It generally makes its attack upon the second
or third day after delivery. Sometimes indeed, it comes on sooner,
and at other times, though rarely, it does not appear before the fifth
or sixth day.
It begins, like most other fevers, with a cold or shivering fit, 

366 CHILD-BIRTH.
which is succeeded by restlessness, pain of the head, great sickness
at stomach, and bilious vomiting. The pulse is generally quick, the
tongue dry, and there is a remarkable depression of spirits and loss   ,
of strength. A great pain is usually felt in the back, hips, and re-
gion of the womb; a sudden change in the quantity or quality of
the lochia also takes place; and the patient is frequently troubled   
with a tenesmus, or constant inclination to go to stool. The urine,
which is very high-coloured, is discharged in small quantity, and
generally with pain. The belly sometimes swells to a considerable   
bulk, and becomes susceptible of pain from the slightest touch.
When the fever has continued for a few days, the symptoms of in-
flammation usually subside, and the disease acquires a more putrid  
form. At this period, if not sooner, a bilious or putrid looseness,
of an obstinate and dangerous nature, comes on, and accompanies
the disease through all its future progress.
No disease requires to be treated with more skill and attention
than this; consequently, the best assistance ought always to be ob-
tained as soon as possible. In women of plethoric constitutions,
bleeding will generally be proper at the beginning; it ought, how-
ever, to be used with caution, and not to be repeated, unless where
the signs of inflammation rise high; in which case, it will also be
necessary to apply a blister to the region of the womb.
During the rigour, or cold fit, proper means should be used to
abate its violence, and shorten its duration. For this purpose, the
patient may drink freely of warm diluting liquors, and, if low, may
take now and then a cup of wine-whey; warm applications to the
extremities, as heated bricks, bottles or bladders filled with warm
water, and such-like, may also be used with advantage.
Emollient clysters of milk and water, or of chicken water, ought   
to be frequently administered through the course of the disease.—  
These prove beneficial by promoting a discharge from the intestines,
and also by acting as a kindly fomentation to the womb and parts
adjacent. Great care however is requisite in giving them, on account   
of the tenderness of the parts in the pelvis at this time.
To evacuate the offending bile from the stomach, a vomit is ge-
nerally given. But as this is apt to increase the irritability of the   
stomach, already too great, it will be safer to omit it, and to give in   
its stead, a gentle laxative, which will both tend to cool the body,
and to procure a free discharge of the bile.
The medicine which I have always found to succeed best in this
disease, is the saline draught. This, if frequently repeated, will of-
ten put a stop to the vomiting, and, at the same time, lessen the
violence of the fever. If it runs off by stool, or if the patient be
restless, a few drops of laudanum, or some syrup of poppies; may
occasionally be added.
If the stools should prove, so frequent as to weaken and exhaust
the patient, a starch clyster, with thirty or forty drops of laudanum
in it, may be administered as occasion shall require; and the drink            

367 CHILD-BIRTH.                 
may be rice-water, in every English pint of which half an ounce
of gumarabic has been dissolved. Should these fail, recourse must
be had to Columbo-root, or some other strong astringent.
Though in general the food ought to be light, and the drink
diluting, yet when the disease has been long protracted, and the
patient is greatly spent by evacuations, it will be necessary to sup-
port her with nourishing diet and generous cordials.
It was observed, that this fever, after continuing for some time,
often acquires a putrid form. In this case, the bark must be given,
either by itself, or joined with cordials, as circumstances may re-
quire. As the bark in substance will be apt to purge, it may be
given in decoction or infusion, mixed with the tincture of roses, or
other gentle astringents; or, a scruple of the extract of bark with
half an ounce of spirituous cinnamon-water, two ounces of com-
mon water, and ten drops of laudanum, may be made into a draught,
and given every second, third, or fourth hour, as shall be found
necessary.
When the stomach will not bear any kind of nourishment, the
patient may be supported for some time, by clysters of beef-tea, or
chicken-water.
To avoid this fever, every worn in in child-bed ought to be kept
perfectly easy; her food should be light and simple, and her bed-
chamber cool, and properly ventilated. Nothing is more hurtful
than being kept too warm. She ought not to have her body bound
too tight, nor rise too soon from bed after delivery; catching cold
is also to be avoided; and a proper attention should be paid to
cleanliness.
To prevent the milk-fever, the breasts ought to be frequently
drawn; and if they are filled previous to the onset of a fever, they
should, upon its first appearance, be drawn to prevent the milk from
becoming acrid, and its being absorbed in this state. Costiveness is
to be avoided. This will be best effected by the use of mild clysters
and a laxative diet.
We shall conclude on child-bed women, by recommending it to
them, above all things, to beware of cold. Poor women, whose cir-
cumstances oblige them to quit their bed too soon, often contract
diseases from cold, of which they never recover. It is a pity the poor
are not better taken care of in this situation.
But the better sort of women run the greatest hazard from too
much heat. They are generally kept in a sort of a bagnio for the
first eight or ten days, and then dressed out to see company. The
danger of this conduct must be obvious to every one.
The superstitious and contemptible custom of obliging women to
keep the house till they go to church, is a very common cause of
catching cold. All churches are damp, and most of them cold;
consequently they are the very worst places to which a woman
can go to make her first visit, after having been confined in a warm
room for a month.

[368] 
Of Barrenness.
BARRENNESS may be very properly reckoned among the dif-
eases of females, as few married women who have not children en-
joy a good state of health. It may proceed from various causes, as
high-living, grief, relaxation, &c. but it is chiefly owing to an ob-  -
struction or irregularity of the menstrual flux.
It is very certain that high living prevents fecundity. We seldom
find a barren woman  among the labouring poor, while nothing is
more common among the rich and affluent. The inhabitants of eve-
ry country are prolific in proportion to their poverty; and it would
be an eafy matter to adduce many instances of women, who, by be-
ing reduced to live entirely upon a milk and vegetable diet, have
conceived and brought forth children, though they never had any
before. Would the rich use the same sort of food and exercise as the
better sort of peasants, they would seldom have cause to envy their
poor vassals and dependants the blessing of a numerous and healthy
offspring, while they pine in sorrow for the want of even a single
heir to their extensive domains.
Affluence begets indolence, which induces a general relaxation
of the solids; a state highly unfavourable to procreation. To re-
move this, we would recommend the following course: First, suf-
ficient exercise in the open air; secondly, a diet consisting chiefly
of milk and vegetables *; thirdly, the use of astringent medicines,
as steel, allum, dragon's blood, elixir of vitriol, the Spaw or Tun-
bridge waters, Peruvian bark, &c.; and lastly, above all, the cold
bath.
Barrenness is often the consequence of grief, sudden fear, anxiety,  
or any of the passions which tend to obstruct the menstrual flux.
When barrenness is suspected to proceed from affections of the
mind, the person ought to be kept as easy and cheerful as possible;
all disagreeable objects are to be avoided, and every method taken
to amuse and entertain the fancy.
* Dr. Cheyne avers, that want of children is oftner the fault of the  
male than of the female, and strongly recommends a milk and vegeta-
ble diet to the former as well as the latter; adding, that his friend Dr.  
Taylor, whom he calls the Milk-doctor of Croydon, had brought sun-
dry opulent families in his neighbourhood, who had continued some
years after marriage without progeny, to have several fine children, by
keeping both parents, for a considerable time, to a milk and vegetable
diet.

[369]
CHAPTER  LI.
Diseases of Children.
MAN comes into the world more helpless than any other ani-
mal, and stands much longer in need of the protection and
care of his parents; but this care is not always bestowed upon him;
and when it is, he often suffers as much from improper manage-
ment as he would have done from neglect. The officious care of
parents, nurses, and midwives, becomes one of the most fruitful
sources of the disorders of infants *.
It must be obvious to every attentive person, that the first diseases
of infants arise chiefly from their bowels. Nor is this in the least to
be wondered at, as they are in a manner poisoned with indigestible
drugs and improper diet, as soon as they come into the world. Eve-
ry thing that the stomach cannot digest may be considered as a poi-
son; and unless thrown up, or avoided by stool, it must occasion
sickness, gripes, spasmodic affections of the bowels, or what the
women call inward fits, and at last convulsions and death.
As these symptoms evidently arise from somewhat that irritates
the intestines, doubtless the proper method of cure must be to ex-
pel it as soon as possible. The most safe and effectual method pf
doing this is by gentle vomits. Five or six grains of the powder of
ipecacuanha may be mixed in two table-spoonfuls of water, and
sweetened with a little sugar. A tea-spoonful of this may be given
to the infant every quarter of an hour till it operates.
This medicine will not only cleanse the stomach, but will gene-
rally likewise open the body. Should this however not happen, and
if the child be costive, some gentle purge will be necessary: for this
purpose, some manna and pulp of cassia may be dissolved in boiling
water, and given in small quantities till it operates; or, what will
answer rather better, a few grains of magnesia alba may he mixed in
any kind of food that is given to the child, and continued till
it has the desired effect. If these medicines be properly administer-
ed, and the child's belly and limbs frequently rubbed with a warm
hand before the fire, the will seldom fail to relieve those affec-
* Of the officious and ill-judged care of midwives, we shall adduce
only one instance, viz. the common practice of torturing infants by
squeezing their breasts. to draw off the milk, as they call it. Though a
small quantity of moisture is generally found in the breasts of infants, yet,
as they are certainly not intended to give suck, this ought never to be
drawn off. I have seen this cruel operation bring on hardness, inflamma-
tion, and suppuration of the breasts; but never knew any ill consequen-
ces from its being omitted. When the breasts are hard, the only appli-
cation that we would recommend, is a soft poultice, or a little of the
diachylon plaister, spread thin upon a bit of soft leather, about the size
of half a crown, and applied over each nipple. These may be suffered to
continue till the hardness disappears.
A3         

370 THE APHTHÆ OR THRUSH.
tions of the stomach and bowels from which infants suffer so
much.
These general directions include most of what can be done for
relieving the internal disorders of infants. They will likewise go a
considerable way in alleviating those which appear externally, as
the rash, gum, &c. These, as was formerly observed, are prin-
cipally owing to too hot a regimen, and consequently will be
most commonly relieved by gentle evacuations. Indeed, evacua-
tions of one kind or other constitute a principal part of the medi-
cine of infants, and will seldom, if administered with prudence, in
any of their diseases, fail to give relief.
Of the Meconium.
THE stomach and bowels of a new-born infant are filled with
a blackish coloured matter of the consistence of syrup, commonly
called the meconium. This is generally passed soon after the birth,
by the mere effort of Nature; in which case it is not necessary to
give the infant any kind of medicine. But if it should be retained,
or not sufficiently carried off, a little manna or magnesia alba may be
given, or, if these should not be at hand, a common spoonful of
whey, sweetened with a little honey, or raw sugar will answer the
purpose.
The most proper medicine for expelling the meconium is the mo-
ther's milk, which is always at first of a purgative quality. Were
children allowed to suck as soon as they shew an inclination for the
breast, they would seldom have occasion for medicines, to discharge
the meconium; but even where this is not allowed, they ought ne-
ver to have daubs of syrup, oils, and other indigestible stuff, cram-
med down their throats.
The Aphthæ or Thrush.
THE aphthæ are little whitish ulcers affecting the whole inside
of the mouth, tongue, throat, and stomach of infants. Sometimes
they reach through the whole intestinal canal; in which case, they
are very dangerous, and often put an end to the infant's life.
If the aphthæ are of a pale colour, pellucid, few in number, soft,
superficial, and fall easily off, they are not dangerous; but if opake,
yellow, brown, black, thick, or running together, they ought to be
dreaded.
It is generally thought that the aphthæ owe their origin to acid
humours; but they are frequently owing to too hot a regimen both

371 ACIDITIES.
of the mother and child. It is a rare thing to find a child who is
not dosed with wine, punch, cinnamon-waters, or some other hot
and inflaming liquors, almost as soon as it is born. These will oc-
casion inflammatory disorders even in adults; is it any wonder then
that they should heat and inflame the tender bodies of infants?
The most proper medicines for the aphthæ are vomits, such as
have been already recommended, and gentle laxatives. One drachm
of magnesia alba may be divided into six doses, one of which may
be given to the infant every four or five hours till they operate.
These powders may either be given in the child's food, or a little of
the syrup of pale roses, and may be repeated as often as is found
necessary to keep the body open. It is common in this case to ad-
minister calomel; but as that medicine sometimes occasions gripes,
it ought always to be given to infants with caution.
Many thing have been recommended for gargling the mouth and
throat in this disease; but it is not easy to apply these in very
young infants; we recommend it to the nurse to rub the child's
mouth frequently with a little borax and honey; or with the follow-
ing mixture: Take fine honey an ounce, borax a drachm, burnt al-
lum half a drachm, rose-water two drachms; mix them together. A
very proper application in this case, is a solution of ten or twelve
grains of white vitriol in eight ounces of barley-water. These may
be applied with the finger, or by means of a bit of soft rag tied to
the end of a probe.
Of Acidities.
THE food of children being for the most part of an acescent na-
ture, it readily turns four upon the stomach, especially if the body
be any way disordered. Hence most diseases of children are accom-
panied with evident signs of acidity, as green stools, gripes, &c.
These appearances induce many to believe, that all the diseases of
children are owing to an acid abounding in the stomach and bow-
els; but whoever considers the matter attentively, will find that
these symptoms of acidity are oftener the effect than the cause of
their diseases.
Nature evidently intended, that the food of children should be
acescent; and unless the body be disordered, or the digestion hurt,
from some other cause, we will venture to say, that the ascescent qua-
lity of their food is seldom injurious to them. Acidity, however, is
often a symptom of disorders in children, and, as it is sometimes a
troublesome one, we shall point out the method of relieving it.
When green stools, gripes, purgings, sour smells, &c. shew that
the bowels abound with  an acid, the child should have a little
small broth, with light white bread in it; and sufficient exercise to
promote the digestion. It has been customary in this case to give the 

372 GALLING AND EXCORIATION.
pearl-julep, chalk, crabs eyes, and other testaceous powders. These,
by their absorbent quality, may correct the acidity; but they are apt
to lodge in the bowels, and occasion costiveness, which may prove
very hurtful to the infant. For this reason, they should never be giv-
en unless mixed with purgative medicines; as rhubarb, manna, or
such like.
The best medicine which we know, in ail cases of acidity, is the
powder of magnesia alba. It purges, and at the same time corrects the
acidity: by which means it not only removes the disease, but car-
ries off its cause. It may be given in any kind of food, or in a mix-
ture.
When an infant is troubled with gripes, it ought not at first to
be dosed with brandy, spiceries, and other hot things, but should
have its body opened with an emollient clyster, or the medicine
mentioned above; and at the same time, a little brandy may be rub-
bed on its belly with a warm hand before the fire. I have seldom
seen this fail to ease the gripes of infants. It it should happen, how-
ever, not to succeed, a little brandy or other spirits may be mixed
with thrice the quantity of warm water, and a tea-spoonful given
frequently till the infant be easier. Sometimes a little pepper-mint-
water will answer this purpose very well.
Galling and Excoriation.
THESE are very troublesome to children. They happen chiefly
about the groin and wrinkles of the neck, under the arms, behind
the ears, and in other parts that are moistened by the sweat or
urine.
As these complaints are, in a great measure, owing to want of
cleanliness, the most effectual means of preventing them are, to wash
the parts frequently with cold water, to change the linen often, and,
in a word,to keep the child in all respects thoroughly clean. When
this is not sufficient, the excoriated parts may be sprinkled with ab-
sorbent or drying powders, such as powdered starch, burnt hartshorn,
tutty, chalk, crabs' claws prepared, and the like. When the parts
affected are very sore, and tend to a real ulceration, add a little su-
gar of lead to the powders; or anoint the place with camphorated
ointment. If the parts be washed with spring-water, in which a lit-
tle white vitriol has been dissolved, it will dry and heal them very
powerfully. One of the best applications for this purpose, is to dis-
solve some fuller's earth in a sufficient quantity of hot water; and
after it has stood till it is cold, to rub it gently upon the galled parts
once or twice a-day.

[373]
Stoppage of the Nose.
THE nostrils of infants are often plugged up with a gross mucus,
which prevents their breathing freely, and likewise renders it dif-
ficult for them to suck or swallow.
Some, in this case, order, after a suitable purge, two or three grains
of white vitriol dissolved in half an ounce of marjoram-water, and
filtered, to be applied now and then to the nostrils with a linen rag.
Wedelius says, if two grains of white vitriol, and the same quan-
tity of elaterium, be dissolved in half an ounce of marjoram-water,
and applied to the nose, as above directed, that it brings away the
mucus without sneezing.
In obstinate cases, these things may be tried; but I have never
found any thing necessary, besides rubbing the nose at bed-time
with a little sweet oil, or fresh butter. This resolves the filth, and
renders the breathing more free.
Of Vomiting.
FROM the delicate state of children, and the great sensibility of
their organs, a vomiting or looseness may be induced by any thing
that irritates the nerves of the stomach or intestines. Hence, these
disorders are much more common in childhood than in the more
advanced periods of life. They are seldom however dangerous, and
ought never to be considered as diseases, unless when they are vi-
olent, or continue so long as to exhaust the strength of the pa-
tient.
Vomiting may be excited by an over-quantity of food; by food
that is of such a nature as to irritate the nerves of the stomach too
much; or by the sensibility of the nerves being so much increased
as to render them unable to bear the stimulus of even the mildest
element.
When vomiting is occasioned by too much food, it ought to be
promoted, as the cure will depend upon cleansing the stomach.
This may be done either by a few grains of ipecacuanha, or a few
drops of antimonial wine. When it is owing to food of an acrid or
irritating quality, the diet ought to be changed, and aliment of a
milder nature substituted in its stead.
When vomiting proceeds from an increased degree of sensibili-
ty, or too great an irritability of the nerves of the stomach, such
medicines as have a tendency to brace and strengthen that organ,
and abate its sensibility, must be used. The first of these intentions
may be answered by a slight infusion of the Peruvian bark, with
the addition of a little rhubarb and orange-peel; and the second 

374 A LOOSENESS.    
by the saline draughts, to which a few drops of liquid laudanum
may be occasionally added.
In obstinate vomitings, the operation of internal medicines may
be assisted by aromatic fomentations made with wine, applied warm
to the pit of the stomach; or the use of the stomach-plaister, with
the addition of a little theriæca.
Of a Looseness.
A LOOSENESS may generally be reckoned salutary when the
stools are sour, slimy, green, or curdled. It is not the discharge, but the
production of such stools, which ought to be remedied. Even where
the purging is thin and watery, it ought not to be checked too
suddenly, as it often proves critical, especially when the child has
caught cold, or an eruption on the skin has disappeared. Some-
times an evacuation of this kind succeeds a humid state of the at-
mosphere, in which case it may also prove of advantage, by carry-
ing off a quantity of watery humours, which would otherwise tend
to relax the habit.
As the principal intention of the cure of a looseness is to evacu-
ate the offending matter, it is customary to give the patient a gen-
tle vomit of ipecacuanha, and afterwards to exhibit small and fre-
quent doses of rhubarb; interposing absorbent medicines, to miti-
gate the acrimony of the humours. The best purge in this case, is
magnesia alba. It is absorbent and laxative, and operates without ex-
citing gripes.
The antimonial wine, which acts both as an emetic and purge,
is also an excellent medicine in this case. By being diluted with
water, it may be proportioned to the weakest constitution; and,
not being disagreeable to the palate, it may be repeated as often as
occasion requires. Even one dose will frequently mitigate the dis-
ease, and pave the way for the use of absorbents. If the patient's
strength will permit, the medicine ought to be repeated every six or
eight hours, till the stools begin to assume a more natural appear-
ance; afterwards a longer space may be allowed to intervene be-
tween the doses. When it is necessary to repeat the medicine fre-
quently, the dose ought always to be a little increased, as its effica-
cy is generally diminished by use.
Some upon the first appearance of a looseness, fly to absorbent
medicines and astringents. If these be administered before the of-
fending humours are discharged, though the disease may appear to
be mitigated for a little time, it soon afterwards breaks forth with
greater violence, and often proves fatal. After proper evacuations,
however, these medicines may be administered with considerable
advantage.

375 PURGING OF  CHILDREN.
Should any gripings or restlessness remain after the stomach and
bowels have been cleansed, a tea-spoonful of the syrup of poppies
may be given in a little simple cinnamon-water, three or four times
a-day till these symptoms have ceased.
Of the Vomiting and Purging of Children.                   
THIS disease is nearly the same which occurs in grown people.          
It is produced by the like causes, and requires a similar method of
cure.
It frequently appears in the month of June, hut becomes more
frequent in July, August and September, when the weather is ve-
ry warm, or soon after there has been a sudden change to cool wea-          
ther, attended with a north-east wind. The latter often takes place          
during the summer months in North-America.                           
In a short time after this change, and not unfrequently in the         
course of one night, a number of children are taken down with
this disease.                      -                                    
But the disease often occurs, independent of this change, when         
the weather is very warm, and it is generally brought on by over-
charging the stomach with food, which, either from its quality, or        
quantity, and sometimes from both, irritates the stomach, and pro-         
duces violent vomiting and purging.                                     
Children are affected with this disease, from an early period in
life, until they are two or three years old; but it more especially          
exerts its destructive influence on the children of cities, and seldom
affects those who reside in the country.
It most frequently comes on in the evening, or early in the morn-
ing; when the patient is usually seized of a sudden with violent vo-
miting. This is soon succeeded by purging, accompanied with a
fever generally of the remitting kind. The matter discharged in this
stage of the disease, is generally of a green or yellow colour, large
in quantity; but sometimes the stools assume the appearance of those
evacuated in a dysentery, or flux, and attended with much griping.
Towards evening the symptoms generally increase. The vomiting
and purging are considerably augmented, with an evident exacer-
bation of fever. This is attended with head-ach, restlessness, re-
traction of the navel, great thirst, a quick and feeble pulse, the
countenance flushed, particularly during a fit of vomiting, when
the patient is in a profuse perspiration, and the skin feels cool and
clammy. Every morning the symptoms suffer some abatement. As
the disease advances, the patient becomes more exhausted, and has
a general appearance of emaciation. The vomiting or purging some-
times ceases, but generally both continue. The stools become less
copious, very fœtid, and frequently of a water colour. The pulse is
generally irregular and feeble, the eyes languid, and they appear to 

376 PURGING OF CHILDREN.
be sunk in their orbits. There is also a swelling in the feet and
legs. The breathing becomes difficult; the patient drowsy and in-
sensible. The voice undergoes a considerable alteration. Delerium,
difficulty in breathing, extremities, cold, eyes glassy, and at length
convulsions follow, till death concludes the scene.
This is generally the progress of the disease, when it terminates
in death, but it is sometimes protracted to an uncommon period.
This is the case when the symptoms are more moderate, or have
been interrupted by a short continuance of cool weather. But at
last they return with increasing violence. The patient becomes ex-
cessively extenuated. The swelling of the limbs and belly increase
with livid spots on the skin. There is a hectic blush on the cheeks,
during the exacerbation of fever, and the disease is frequently ac-
companied with a sore mouth, which almost always precedes the-
dissoiution of the patient.
MEDICINE.—The cure of this disease can generally be of-
fected, if assistance is called early. The first step should be to evacu-
ate the offending matter from the stomach and bowels, particular-
ly if the patient is not much exhausted, and if we have reason to
believe that the irritating matter is not discharged. This should be
accomplished by ordering the patient to drink large quantities of
warm water, or warm tea of any kind. But when this cannot be
complied with, a few grains of ipecacuanha may be administered,
which will empty the stomach, and clear the bowels. Should it not
have the latter effect, castor-oil, calomel, or magnesia may be giv-
en. When the stomach refuses those medicines, clysters may be
employed with advantage.
When the irritating matter has been evacuated, either by the na-
tural efforts of the system, or by art, the vomiting must be restrain-
ed by giving ten or fifteen drops of laudanum, or in quantities pro-
portioned to the age of the patient. The laudanum should be mixed
in mint tea, or cinnamon water. The former, or toast and water,
should be the constant drink. This medicine will have the desired
effect, and mitigate pain. When the vomiting is with difficulty re-
strained, flannels rung out of aromatics infused in brandy, must be
constantly applied warm to the stomach. Where these fail, a blister
applied to the region of the stomach, has sometimes the most hap-
py effect.
After the disease has subsided, the body must be invigorated by
stimulants and tonics. The drink must be wine and water, or
brandy and water, the latter having the addition of sugar. The pa-
tient should also take one tea-spoonful, or half a table-spoonful of
a light infusion of bark, with aromatics once in every two or three
hours. The food must be light and nourishing, as sago, or gruel.
Beef steaks, or almost any animal food, may be taken in small quan-
tities.
The patient should reside in the country, and ride every day.
This tends much to restore the health. Nay, when every other re- 

377 ERUPTIONS.                  
medy has failed, a change of air and exercise has entirely removed
the disease. When it is not convenient, for the patient to ride out,
he may be carried into the country during the most agreeable part
of the day.
The best way to prevent this disease, is for children, when at
the age liable to it, to reside, during the summer months, in the
country, to avoid every excess in eating, and to be cautious to ac-
commodate their dress to every change of weather.
Of Eruptions.
CHILDREN, while on the breast, are seldom free from erup-
tions of one kind or other. These are not often dangerous, and
ought never to be dried up, but with the greatest caution. They
tend to free the bodies of infants from hurtful humours, which,
if retained, might produce fatal disorders.
The eruptions of children are chiefly owing to improper food
and neglect of cleanliness. If a child be stuffed at all hours, with
food that its stomach is not able to digest, such food, not being
properly assimilated, instead of nourishing the body, fills it with
gross humours. These must either break out in form of eruptions
upon the skin, or remain in the body, and occasion fevers and
other internal disorders. Neglect of cleanliness is a very general
cause of eruptive disorders. The children of the poor, and of all
who despise cleanliness, are almost constantly found to swarm with
vermin, and are generally covered with a scab, itch, and other
eruptions.
When eruptions are the effect of improper food, or want of
cleanliness, a proper attention to these alone, will generally be suf-
ficient to remove them. If this should not be the case, some drying
medicines will be necessary. When they are applied, the body
ought, at the same time, to be kept open, and cold is carefully to
be avoided. No medicine is more safe for drying up cutaneous
eruptions than sulphur, provided it be prudently used. A little of
the flour of sulphur may be mixed with fresh butter, or hog's lard,
and the parts affected frequently touched with it.
The most obstinate of all the eruptions incident to children are,
the tinea capitis, or scabbed head, and chilblains. The scabbed head
is often exceeding difficult to cure, and sometimes indeed the cure
proves worse than the disease. I have frequently known children
seized with internal disorders, of which they died, soon after their
scabbed heads had been healed, by the application of drying medi-
cines *. The cure ought always first to be attempted, by keeping
* I some time ago saw a very striking instance of the danger of sub-
stituting drying medicines in the place of cleanliness and wholesome food,
B3

378 THE HIVES.
the head very clean, cutting off the hair, combing and brushing
away the scabs, &c. If this is not sufficient, let the head be shaved
once a-week, washed daily with soap-suds, and gently anointed
with a liniment made of train-oil, eight ounces, red precipitate, in
fine powder, one drachm. And if there be proud flesh, it should
be touched with a bit of blue vitriol, sprinkled with a little burnt
allum. While these things are doing, the patient must be confined
to aregular light diet, the body should be kept gently open; and
cold, as far as possible, ought to be avoided. To prevent bad con-
sequences from stopping this discharge, it will be proper, especi-
ally in children of a gross habit, to make an issue in the neck or
arm, which maybe kept open till the patient becomes more strong,
and the constitution be somewhat mended.
Chilblains commonly attack children in cold weather. They
are generally occasioned by the feet or hands being kept long wet
or cold, and afterwards suddenly heated. When children are cold,
instead of taking exercise to warm themselves gradually, they run
to the fire.
To prevent this disease, violent cold and sudden heat must be
equally avoided. When the parts begin to look red and swell, the
patient ought to be purged, and have the affected parts frequently
rubbed with mustard and brandy, or something of a warming na-
ture. They ought likewise to be covered with flannel, and kept
warm and dry. Some apply warm ashes between cloths to the
swelled parts, which frequently help to reduce them. When there
is a sore, it must be dressed with Turner's cerate, the ointment of
tutty, the plaister of cerus, or some other drying ointment. These
sores are indeed troublesome, but seldom dangerous. They gene-
rally heal as soon as the warm weather sets in.
Of the Hives.
THIS disease in Scotland is called the croup, but in America
it is best known by the name of hives. It may be divided into two
kinds, the humid and spasmodic. The former is the present sub-
in the foundling hospital as Ackworth, where the children were grie-
vously afflicted with scabbed heads and other cutaneous disorders. Up-
on inquiry, it was found, that very little attention was paid either ta
the propriety or soundness of their provisions, and that cleanliness was
totally neglected; accordingly, it was advised, that they should have
more wholesome food, and be kept thoroughly clean. This advice,
however, was not followed. It was too troublesome to the servants,
superintendants, &c. The business was to be done by medicine; which
was accordingly attempted, but had nearly proved fatal to the whole
house. Fevers and other internal disorders immediately appeared; at
length, a putrid dysentery, which proved so infectious, that it carried off
a great many of the children, and spread over a considerable part of
the neighbouring country.

379 SPASMODIC HIVES.             
ject of consideration, and may be known by a peculiar croaking
found of the voice, like the barking of a dog, or, by some, com-
pared to the crowing of a cock, attended with a difficulty of brea-
thing.
This disease generally affects children under nine years of age,
but no age is exempt from its violence. It generally seizes chil-
dren during foggy weather, or early in the spring when damp
weather succeeds the winter cold.
SYMPTOMS.—It comes on gradually; the patient is ob-
served to lose his usual gaiety, and symptoms of fever appear,
with defective, appetite, attended by a slight difficulty of breath-
ing; a dry, short cough with hoarseness, and the bowels are gene-
rally costive. The countenance appears heavy, and indicates dis-
tress. The breathing becomes quick and interrupted, and a pecu-
liar croaking found of the voice is heard, particularly when the
patient attempts to cough, at which time the face appears high-
ly flushed and almost livid. The carotid and temporal ar-
arteries throb greatly. The pulse is, sometimes hard, and generally
quick. As the disease advances, the patient becomes very restless.
The breathing is more interrupted and laborious, with a rattling
of phlegm in the throat. The nostrils expand and contract, the
shoulders are strongly elevated at every inspiration, and the cheeks
distended with air at every expiration, accompanied with great
anxiety and sense of suffocation. The pulse becomes extremely
feeble; skin clammy; the extremities cold and livid. At length
the patient is exhausted and dies.
MEDICINE.—In the cure of this disease, if the pulse is full
and hard, blood should be taken from the arm or jugular vein, but
the most promising effects are to be expected from large doses of
calomel. Eight or ten grains of this medicine should be early ad-
ministered, combined with as many of jalap, according to the age
of the patient, in order to produce copious evacuations; after
which, if the symptoms should not subside, the patient must be
vomited with tartar emetic or ipecacuanha, and the calomel should
be repeated. Blisters must be applied to the sore part of the neck.
These remedies should be continued until the symptoms disappear.
The patient's strength should then be restored, by nourishing diet
and tonic medicines, such as bark, steel, cold bathing, assisted by
exercise.
Spasmodic Hives.
THIS disease bears some resemblance to the preceding, in af-
fecting children under similar circumstances, but differing in its
manner of attack. It most generally comes on of a sudden during 

380 TEETHING.
the heat of the day, without any apparent previous indisposition;
or in the course of the evening, when children frequently awake
from their sleep with hoarseness, slight cough, and great difficulty
in breathing, which obliges them to assume an erect posture, for
fear of suffocation. The face is generally flushed, and its being dis-
torted, exhibits strong signs of anxiety and distress. These symptoms
are accompanied with a peculiar croaking tone of the voice in cough-
ing; full and quick pulse, with an increase of heat; considerable
thirst; and, towards the close of the disease, a rattling of phlegm may
be heard in the throat. The breathing becomes more interrupted and
laborious, with a strong elevation of the shoulder at every inspi-
ration; great restlessness; pulse quick, and extremely feeble;
the extremities become cold, and every hope of recovery soon va-
nishes.
This is the progress of the disease when it terminates in death,
which generally takes place on or before the third day. But some-
times its attack is moderate, and only lasts a few hours, and re-
turns again the following evening. The seat of this complaint
appears to be in the muscles surrounding the larynx, or upper
part of the wind-pipe, which are no doubt violently and sometimes
permanently affected with spasm, which strongly points out the
propriety of the following mode of relief. If the pulse is full and
hard, blood must be taken from the arm or jugular vein, and the
patient immediately put into the warm bath, or the feet and legs
bathed in warm water. Should the symptoms not subside, a blister
must be applied to the forepart of the neck, and laudanum must
be administered, to co-operate with the other remedies in remov-
ing the spasm. The bowels should be kept open, with calomel and
jalap, and when the phlegm in the wind-pipe impedes the breath-
ing, an emetic may be given. These medicines must be used dur-
ing a fit or paroxysm, after which the system must be invigorated,
to prevent a return of the disease, by tonics and stimulants, such
as bark, wine, steel, and cold bathing, assisted by nourishing food,
and suitable exercise.
Of Teething.
Dr. ARBUTHNOT observes, that above a tenth part of infants
die in teething, by symptoms proceeding from the irritation of the
tender nervous parts of the jaws, occasioning inflammations, fevers,
convulsions, gangrenes, &c. These symptoms are in a great mea-
sure owing to the great delicacy and exquisite sensibility of the ner-
vous system at this time of life, which is too often increased by an
effeminate education. Hence, children delicately brought up, al-
ways suffer most in teething, and often fall by convulsive disorders. 

381 TEETHING.
About the sixth or seventh month the teeth generally begin to
make their appearance; first, the incisores, or fore-teeth; next,
the canini, or dog-teeth; and, lastly, the molares, or grinders. About
the seventh year, there comes a new set; and about the twentieth,
the two inner grinders, called dentes sapientiæ, the teeth of wisdom.
Children, about the time of cutting their teeth, slaver much, and
have generally a looseness. When the teething is difficult, especially
when the dog-teeth begin to make their way through the gums, the
child has startings in his sleep, tumours of the gums, watchings,
gripes, green stools, the thrush, fever, difficult breathing, and con-
vulsions.
Difficult teething require nearly the same treatment as an in-
flammatory disease. If the body be bound, it must be opened either
by emollient clysters or gentle purgatives; as manna, magnesia al-
ba, senna, or the like. The food should be light, and in, small quan-
tity; the drink plentiful, but weak and diluting, as infusions of
balm, or of the lime-tree flowers; to which about a third or fourth
part of milk may be added.
If the fever be high, bleeding will be necessary; but this in very
young children ought always to be sparingly performed. It is an
evacuation which they bear the worst of any. Purging, vomiting,
or sweating agree much better with them, and are generally more
beneficial. Harris, however, observes, that when an inflammation
appears, the physician will labour in vain, if the cure be not begun
with applying a leech under each ear. If the child be seized with
convulsion fits, a blister may be applied between the shoulders, or
one behind each ear *.
Sydenham says, that in fevers occasioned by teething, he never
found any remedy so effectual, as two, three, or four drops of spirits
of hartshorn in a spoonful of simple water, or other convenient ve-
hicle, given every four hours. The number of doses may be four,
five, or six. I have often prescribed this medicine with success, but
always found a larger dose necessary. It may be given from five
drops to fifteen or twenty, according to the age of the child.
In Scotland, it is very common, when children are cutting their
teeth, to put a small Burgundy-pitch plaister between their shoul-
ders. This generally eases the tickling cough which attends teeth-
ing, and is by no means an useless application. When the teeth are
cut with difficulty, it ought to be kept on during the whole time
of teething. It may be enlarged as occasion requires, and ought to
be renewed, at least once a fortnight.
Several things have been recommended for rubbing the gums,
as oils, mucilages, &c.; but from these, much is not to be expected.
If any thing of this kind is to be used, we would recommend a lit—
tle fine honey, which may be rubbed on with the finger three or
* The child should be put into the warm bath, and a suitable dose of
laudanum administered. (I. C.)

382 RICKETS.
for times a-day. Children are generally at this time disposed to
chew whatever they get into their hands. For this reason, they ought
never to be without somewhat that will yield a little to the pressure
of their gums, as a crust of bread, a wax-candle, a bit of liquorice-
root, or such like.
With regard to cutting the gums, we have seldom known it of
great benefit. In obstinate cases, however, it ought to be tried. It
may be performed by any sharp body which can be with safety in-
troduced into the mouth; but the lancet, in a skilful hand, is the
most proper.
To render the teething less difficult, parents ought to take care
that their children's food be light and wholesome, and that their 
nerves be braced by sufficient exercise without doors, the use of the
cold bath, &c. Were these things duly regarded, they would have
a much better effect than teething necklaces, or other nonsensical
amulets worn for that purpose.
The Rickets
GENERALLY attack children between the age of nine months
and two years. It appeared first in England about the time when
manufactures began to flourish, and still prevails most in towns
where the inhabitants follow sedentary employments, by which
means they neglect either to take proper exercise themselves, or to
give it to their children.
CAUSES.—One cause of the rickets is diseased parents. Mo-  
thers of a weak relaxed habit, who neglect exercise, and live upon  
weak watery diet, can neither be expected to bring forth strong and
healthy children, or to be able to nurse them after they are brought
forth. Accordingly, we find, that the children of such women ge-
nerally die of the rickets, the scrophula, consumptions, or such like
diseases. Children begotten by men in the decline of life, who are
subject to the gout, the gravel, or other chronic diseases, or who
have been often affected with the venereal disease in their youth,  
are likewise very liable to the rickets.                            
Any disorder that weakens the constitution, or relaxes the habit
of children, as the small-pox, measles, teething, the hooping-cough,
&c. disposes them to this disease. It may be occasioned by impro-
per diet, as food that is either too weak and watery, or so viscid
that the stomach cannot digest it.
Bad nursing is the chief cause of this disease. When the nurse
is either diseased, or has not enough of milk to nourish the child, it
cannot thrive. But children suffer oftner by want of care in nurses
than want of food. Allowing an infant to lie or fit too much, or
not keeping it thoroughly clean in its clothes, has the most pernici-
ous effects.         

383 RICKETS.                    
The want of free air is likewise very hurtful to children in this
respect. When a nurse lives in a close, small house, where the air
is damp and confined, and is too indolent to carry, her child abroad
into the open air, it will hardly escape this disease. A healthy child
should always be in motion, unless when asleep; if it be suffered to lie,
or sit, instead of being tossed and dandled about, it will not thrive.
SYMPTOMS.—At the beginning of this disease the child's
flesh grows soft and flabby; its strength is diminished; it loses its
wonted cheerfulness, looks more grave and composed than is natu-
ral for its age, and does not choose to be moved. The head and
belly become too large in proportion to the other parts; the face
appears full, and the complexion florid. Afterwards the bones be-
gin to be affected, especially in the more soft and spungy parts.
Hence the wrists and ancles become thicker than usual; the spine
or back-bone puts on an unnatural shape; the breast is likewise
often deformed; and the bones of the arms and legs grow crook-
ed. These symptoms vary according to the violence of the disease.
The pulse is generally quick, but feeble; the appetite and digestion
for the most part bad; the teeth come slowly and with difficulty,
and they often rot and fall out afterwards. Ricketty children gene-
rally have great acuteness of mind, and an understanding above
their years. Whether this is owing to their being more in company
of adults than other children, or to the preternatural enlargement
of the brain, is not material.
REGIMEN.—As this disease is always attended with evident
signs of weakness and relaxation, our chief aim in the cure, must
be, to brace and strengthen the solids, and to promote digestion, and
the due preparation of the fluids. These important ends will be
best answered by wholesome nourishing diet, suited to the age and
strength of the patient, open dry air, and sufficient exercise. If the
child has a bad nurse, who either neglects her duty, or does not
understand it, she should be changed. If the season be cold, the
child ought to be kept warm; and when the weather is hot, it ought
to be kept cool; as sweating is apt to weaken it; and too great a
degree of cold has the same effect. The limbs should be rubbed
frequently with a warm hand, and the child kept as cheerful as
possible.
The diet ought to be dry and nourishing, as good bread, roasted
flesh, &c. Biscuit is generally reckoned the best bread; and
pigeons, pullets, veal, rabbits, or mutton roasted or minced, are
the most proper flesh. If the child be too young for flesh-meats, he
may have rice, millet, or pearl-barley boiled with raisins, to which
may be added a little wine and spice. His drink may be good cla-
ret, mixed with an equal quantity of water. Those who cannot
afford claret, may give the child, now and then, a wine-glass of mild
ale, or good porter.
MEDICINE.—Medicines are here of little avail. The disease
may often be cured by the nurse, but seldom by the physician. In 

384 CONVULSIONS.
children of a gross habit, gentle vomits, and repeated purges of
rhubarb may sometimes be of use, but they will seldom carry off
the disease; that must depend chiefly upon such things as brace
and strengthen the system: for which purpose, besides the regimen
mentioned above, we recommend the cold bath, especially in the
warm season. It must, however, be used with prudence, as some
ricketty children cannot bear it. The best time for using the cold
bath is in the morning, and the child should be well rubbed with a
dry cloth immediately after he comes out of it. If the child should
be weakened by the cold bath, it must be discontinued.
Sometimes issues have been found beneficial in this disease.—
They are peculiarly necessary for children who abound with gross
humours. An infusion of the bark in wine or ale would be of ser-
vice, were it possible to bring children to take it. Many other me-
dicines have been recommended for the rickets; but there is far
more danger in trusting to these than in neglecting them altogether.
We recommend a proper regimen as the thing chiefly to be de-
pended on.
Of Convulsions.
THOUGH more children are said to die of convulsions than of
any other disease, yet they are, for the most part, only a symptom
of some other malady. Whatever greatly irritates or stimulates the
nerves, may occasion convulsions. Hence, infants, whose nerves are
easily affected, are often thrown into convulsions by any thing that
irritates the alimentary canal; likewise, by teething; strait clothes;
the approach of the small-pox, measles, or other eruptive diseases.  
When convulsions proceed from an irritation of the stomach or  
bowels, whatever clears them of their acrid contents, or renders
these mild and inoffensive, will generally perform a cure: where-
fore, if the child be costive, the best way will be to begin with a  
clyster, and afterwards to give a gentle vomit, which may be re-
peated occasionally, and the body in the mean time kept open by
gentle doses of magnesia alba.
Convulsions which precede the eruption of the small-pox or
measles, generally go off upon these making their appearance. The 
principal danger in this case, arises from the fears and apprehen- 
sions of those who have the care of the patient. Convulsions are  
very alarming, and something must be done to appease the affright-  
ed parents, nurses, &c. Hence the unhappy infant often undergoes  
bleeding, blistering, and several other operations, to the great dan-
ger of its life, when a little time, bathing the feet in warm-water,
and throwing in a mild clyster, would have set all to rights.
When convulsion-fits arise from the cutting of teeth, besides
gentle evacuations, we recommend blistering, and the use of an- 

385 WATER IN THE HEAD.                
tispasmodic medicines, as the tincture of foot, asafœtida, or castor.
A dose of laudanum maybe mixed in a cup of white-wine whey,
and given occasionally.
When convulsions proceed from any external cause, as the pres-
sure occasioned by strait clothes or bandages, &c. these ought im-
mediately to be removed; though, in this case, taking away the
cause will not always remove the effect, yet it ought to be done.
It is not likely that the patient will recover, as long as the cause
which first gave rise to the disorder continues to act.
When a child is seized with convulsions, without having any
complaint in the bowels, or symptoms of teething; or any rash or
other discharge which has been suddenly dried up, we have rea-
fon to conclude that it is a primary disease, and proceeds immedi-
ately from the brain. Cases of this kind happen but seldom, which
is very fortunate, as little can be done to relieve the patient. When
a disease proceeds from an original fault in the formation or struc-
ture of the brain itself, we cannot expect that it should yield to me-
dicine. But as this is not always the cause, even of convulsions
which proceed immediately from the brain, some attempts should
be made to remove them. The chief attention to be pursued for
this purpose, is to make some derivation from the head, by blister-
ing, purging, and the like. Should these fail, issues or setons may
be put in the neck, or between the shoulders.
Water in the Head, or a Dropsy of the Brain,
MAY affect adults as well as children, yet, as the latter are
more peculiarly liable to it, we thought it proper to place it among
the diseases of infants.
CAUSES.—A dropsy of the brain may proceed from injuries
done to the brain itself, by falls, blows, or the like; from an original
laxity or weakness of the brain; from schirrous tumors, or excre-
scences within the skull; a thin, watery state of the blood; a dimi-
nished secretion of urine; and, lastly, from tedious and lingering
diseases, which waste and consume the patient.
SYMPTOMS.—This disease has at first the appearance of a
slow fever; the patient complains of a pain in the crown of his
head, or over his eyes; he shuns the light; is sick, and sometimes
vomits; his pulse is irregular and generally low: though he seems
heavy and dull, yet he does not sleep: he is sometimes delirious,
and frequently sees objects double; towards the end of this com-
monly fatal disease, the pulse becomes more frequent, the pupils of
the eyes are generally dilated, attended with squinting; the cheeks
flushed, the patient becomes comatose, and convulsions ensue.
C3 

386 WATER IN THE HEAD.
MEDICINE.—No medicine has hitherto been found suffi-
cient to carry off a dropsy of the brain. It is laudable, however, to
make some attempts, as time or chance may bring many things to
light, of which at present we have no idea. The medicines gene-
rally used are, purges of rhubarb or jalap with calomel, and blis-
ters applied to the neck or back part of the head. To which we
beg leave to add diuretics, or medicines which promote the se-
cretion of urine, such as are recommended in the common dropsy.
A discharge from the nose ought likewise to be promoted, by
causing the patient to snuff the powder of asarum, white helle-
bore, or the like.
Some practitioners have, of late, pretended, to cure this disease
by the use of mercury. I have not seen a cure performed in a con-
firmed dropsy of the brain *; but in so desperate a malady, every
thing deserves a trial †.
* The cure of this disease may sometimes be effected, by attending
to the following circumstance, and directing the remedies accordingly:
If the pulse is full, and the fever considerable, which is usually the case,
in the first stage of this disease, blood should be taken from the arm, and
the operation repeated if necessary. The quantity, to be taken must de-
pend upon the urgency of the symptoms and age of the patient: during
the time of bleeding, purging should be produced with calomel and ja-
lap, and every part of the cooling regimen strictly enjoined. Blisters
must be applied to the neck, with the previous application of cupping-
glasses; the blisters should be suffered to discharge, until a reduction of
the inflammatory symptoms has been effected, or until the disease has pas-
sed into the second stage. In which, an effusion of water is suspected to
have taken place in the brain. This may be conjectured, from a quick
and feeble pulse; together with a continuance of the dilated pupil and
squinting eye; the treatment must be then varied, and the system charged
with mercury, in order to promote the absorption, and carry off the
water; for this purpose, one or two drachms of mercurial ointment
must be rubbed into the inside of each thigh, every morning and even-
ing, until the gums are affected: This practice must be continued until
the symptoms are removed. After this, the debilitated system should
be invigorated by tonics, such as bark, steel, exercise, nourishing food,
and cold bathing. I. C.
† One reason why this disease is seldom or never cured, may be,
that it is seldom known till too far advanced to admit of a remedy. Did
parents watch the first symptoms, and call a physician in due time, I
think that something; might be done. But these symptoms are not suf-
ficiently known and are often mistaken even by physicians themselves.
Of this, I lately saw a striking instance, in a patient attended by an
eminent practitioner of this city, who had all along mistaken the disease
for teething. 

[387]  
CHAPTER LII.
Of Surgery.
TO describe all the operations of surgery, and point out the
different diseases in which they are necessary, would extend
this article far beyond the limits set to it; we therefore confine
our observations to such cases as most generally occur, and in which
proper assistance is either not asked, or not always to be obtained.
Though an acquaintance with the structure of the humane body
is indispensably necessary to qualify a man for being an expert
surgeon; yet many things may be done to save the lives of their
fellow-men in emergencies by those who are no adepts in anatomy.
The peasants daily perform operations upon brute animals, which
are not of a less difficult nature than many of those performed on the
human species; yet they seldom fail of success.
Every man is in some measure a surgeon whether he will or not.
He feels an inclination to assist his fellow-men in distress, and acci-
dents happen every hour which give occasion to exercise this feel-
ing. The feelings of the heart, however, when not directed by the
judgment, are apt to mislead. Thus one, by a rash attempt to save
his friend, may sometimes destroy him; while another, for fear of
doing amiss, stands still, and sees him expire without attempting to
relieve him, even when the means are in his power. As every good,
man would wish to steer a course different from either of these, it
will, no doubt, be agreeable to him, to know what ought to be
done upon such emergencies.
Of Bleeding.
NO operation of surgery is so frequently necessary as bleeding;
it ought, therefore, to be very generally understood. But though
practised by midwives, gardeners, blacksmiths, &c. very few know
when it is proper. Physicians themselves have been so much the
dupes of theory in this article, as to render it the subject of ridi-
cule. It is an operation of great importance, and must, when sea-
sonably and properly performed, be of singular service to those in
distress. 
Bleeding is proper at the beginning of all inflammatory fevers, 
as pleurisies, peripneumonies, &c. It is likewise proper in all to- 
pical inflammations, as those of the intestines, womb, bladder, sto-
mach, kidnies, throat, eyes, &c. as also in the asthma, sciatic pains,
coughs, head-achs, rheumatisms, the apoplexy, epilepsy, and
bloody flux. After falls, blows, bruises, or any violent hurt re- 

388 BLEEDING.
ceived either externally or internally, bleeding is necessary. But
in all disorders proceeding from a relaxation of the solids, and an
impoverished state of the blood, as dropsies, cacochymies, &c.
bleeding is improper.
Bleeding for topical inflammations ought always to be perfor-
med as near the part affected as possible. When this can be done
with a lancet, it is to be preferred to any other method; but where
a vein cannot be found, recourse must be had to leeches or
cupping.
The quantity of blood to be let must always be regulated by the
strength, age, constitution, manner of life, and other circumstan-
ces relating to the patient. It would be ridiculous to suppose that
a child could bear to loose as much blood as a grown person, or
that a delicate lady should be bled to the same extent as a robust
man.
From whatever part of the body blood is to be let, a bandage
must be applied between that part and the heart. As it is often  
necessary, in order to raise the vein, to make the bandage pretty
tight, it will be proper in such cases, as soon as the blood begins
to flow, to slacken it a little. The bandage ought to be applied at
least an inch, or an inch and half from the place where the wound
is intended to be made.
Persons not skilled in anatomy ought never to bleed in a vein
that lies over an artery or a tendon, if they can avoid it. The for-
mer may easily be known from its pulsation or beating, and the
latter from its feeling hard or tight, like a whip-cord under the
finger.      
It was formerly a rule, even among regular practitioners, to
bleed their patients in certain diseases till they fainted. A more
ridiculous rule could not be proposed. One person will faint at   
the very sight of a lancet, while another will loose almost the whole   J
blood of his body before he faints. Swooning depends more upon   
the state of the mind than of the body; besides, it may often be   
occasioned or prevented by the manner in which the operation is
performed.
Children are generally bled with leeches. This, though some-  
times necessary, is a very troublesome and uncertain practice. It Is
impossible to know what quantity of blood is taken away by  
leeches; besides, the bleeding is often very difficult to stop, and
the wounds are not easily healed. Would those who practise
bleeding take a little more pains, and accustom themselves to bleed  
children, they would not find it such a difficult operation as they
imagine.
Certain hurtful prejudices, with regard to bleeding, still prevail 
among the country people. They talk, for instance, of head-veins,
heart-veins, breast-veins, &c. and believe that bleeding in these
will certainly cure all diseases of the parts from whence they are
supposed to come; without considering that all the blood-vessels 

389 INFLAMMATIONS AND ABSCESSES.    
arise from the heart, and return to it again; for which reason,
unless in topical inflammations, it signifies very little from what
part of the body blood is taken. But this, though a foolish preju-
dice, is not near so hurtful as the vulgar notion, that the first
bleeding will perform wonders. This belief makes them often
postpone the operation when necessary, in order to reserve it for
some more important occasion, and, when they think themselves
in extreme danger, they fly to it for relief, whether it be proper or
not. Bleeding at certain stated periods or seasons has, likewise,
bad effects.
It is, likewise, a common notion, that bleeding in the feet draws
the humours downwards, and consequently cures diseases of the
head and other superior parts: but in all topical affections, blood
ought to be drawn as near the part as possible. When it is neces-
sary to bleed in the foot or hand, as the veins are small, and the
bleeding is apt to stop too soon, the part ought to be immersed in
warm water, and kept there till a sufficient quantity of blood
be let.
We shall not spend time in describing the manner of perform-
ing this operation: that will be better learned by example than
precept. Twenty pages of description would not convey so just an
idea of the operation as seeing it once performed by an expert
hand. Neither is it necessary to point out the different parts of the
body from whence blood may be lee, as the arm, foot, forehead,
temples, neck, &c. These will readily occur to every intelligent;
person, and the foregoing observations will be sufficient for deter-
mining which of them is most proper upon any particular occa-
sion. In all cases where the intention is only to lessen the general
mass of blood, the arm is the most commodious part of the body
in which the operation can be performed.
Of Inflammations and Abscesses.
FROM whatever cause an inflammation proceeds, it must ter-
minate either by dispersion, suppuration, or gangrene. It is impos-
sible to foretel, with certainty, in which of these ways any parti-
cular inflammation will terminate, yet a probable conjecture may
be formed with regard to the event, from a knowledge of the pa-
tient's age and constitution. Inflammations happening in a slight
degree upon colds, and without any previous indisposition, will
most probably be dispersed; those which follow close upon a fe-
ver, or happen to persons of a gross habit of body, will generally
suppurate; and those which attack very old people, or persons of
a dropsical habit, will have a strong tendency to gangrene.
If the inflammation be slight, and the constitution found, the
dispersion ought always to be attempted. This will be best pro- 

390 INFLAMMATIONS AND ABSCESSES.
moted by a slender diluting diet, plentiful bleeding, and repeated
purges. The part itself must be fomented, and if the skin be very
tense, it may be embrocated with a mixture of three-fourths of
aweet-oil, and one-fourth of vinegar, and afterwards covered with
a piece of wax-plaister.
If, nowithstanding these applications, the symptomatic fever
increases, and the tumour becomes larger, with violent pain and
pulsation, it will be proper to promote the suppuration. The best
application for this purpose is a soft poultice, which may be re-
newed once a-day. If the suppuration proceeds but slowly, a raw
onion cut small or bruised may be spread upon the poultice. When
the abscess is ripe or sit for opening, which may easily be known
from the thinness of the skin in the most prominent part of it, a
fluctuation of matter, which may be felt under the finger, and,
generally speaking, an abatement of the pain, it may be opened
with a lancet, or by means of caustic.
The last way in which an inflammation terminates, is in a gan-
grene, or mortification, the approach of which may be known by
the following symptoms: The inflammation looses its redness,
and becomes, duskish or livid; the tension of the skin goes off, and
it feels flabby; little bladders filled with ichor of different colours
spread all over it; the tumour subsides, and from a duskish com-
plexion, becomes black. A quick low pulse, with cold clammy
sweats, are the immediate forerunners of death.
When these symptoms first appear, the part ought to be dressed
with cataplasms made of lixivium and bran. Should the symptoms
become worse, the part must be scarified, and afterwards dressed
with basilicum softened with oil of turpentine. All the dressings
must be applied warm. With regard to internal medicines, the
patient must be supported with generous cordials, and the bark
exhibited in as large doses as the stomach will bear it. If the mor-    .
tified parts should separate, the wound will become a common ul-   
cer, and must be treated accordingly,                            
This article includes the treatment of all those diseases, which,
in different parts of the country, go by the names of biles, impost-
humes, whitloes, &c. They are all abscesses in consequence of a
previous inflammation, which, if possible, ought to be discussed;
but when this cannot be done, the suppuration should be promo-   
ted, and the matter discharged by an incision, if necessary; after-   
wards the sore may be dressed with yellow basilicum, or some other
digestive ointment. 

[391]
Of Wounds.
NO part of medicine has been more mistaken than the treat-
ment or cure of wounds. Mankind, in general, believe that
certain herbs, ointments, and plaisters are possessed of wonderful
healing powers, and imagine that no wound can be cured without
the application of them. It is, however, a fact, that no external
application, whatever, contributes towards the cure of a wound,
any other way than by keeping the parts soft, clean, and defend-
ing them from the external air, which may be as effectually done
by dry lint, as by the most pompous applications, while it is ex-
empt from many of the bad consequences attending them.
The same observation holds with respect to internal applica-
tions. These only promote the cure of wounds as far as they tend
to prevent a fever, or to remove any cause that might obstruct or
impede the operations of nature. Nature alone cures wounds.—
Art can only remove obstacles, and put the parts in such a condi-
tion as is most favourable to Nature's efforts.
With this simple view, we shall consider the treatment of wound,
and endeavour to point out such steps as facilitate their cure.
The first thing to be done when a person has received a wound,
is to examine whether any foreign body be lodged in it, as wood,
stone, iron, lead, glass, dirt, bits of cloth, or the like. These, if
possible, ought to be extracted, and the wound cleaned, before any
dressings be applied. When that cannot be effected with safety,
on account of the patient's weakness, or loss of blood, they must
be suffered to remain in the wound, and afterwards extracted
when he is more able to bear it.
When a wound penetrates into any of the cavities of the
body, as the breast, the bowels, &c. or where any considerable
blood-vessel is cut, a skilful surgeon ought immediately to be cal-
led, otherwise the patient may loose his life. But sometimes the
discharge of blood is so great, that if it be not stopt, the patient
may die even before a surgeon, though at no great distance, can
arrive. In this case, something must be done by those who are
present. If the wound be in any of the limbs, the bleeding may
generally be stopt by applying a tight ligature or bandage round
the member a little above the wound. The best method of doing
this, is, to put a strong broad garter round the part, but so slack as
easily to admit a small piece of stick to be put under it, which must
be twisted, in the same manner as a countryman does a cart-rope
to secure his loading, till the bleeding stops. Whenever this is the
case, he must take care to twist it no longer, as straining it too
much might occasion an inflammation of the parts, and endanger
a gangrene.
In parts where this bandage cannot be applied, various other
methods may be tried to stop the bleeding, as the application of 

392 WOUNDS.
styptics, astringents, &c. Cloths dipped in a solution of blue vi-
triol in water, or the styptic water of the Dispensatories, may be
applied to the wound. When these cannot be obtained, strong spi-
rits of wine may be used. Some recommend the agaric * of the
oak as preferable to any of the other styptics; and, indeed, it
deserves considerable encomiums. It is easily obtained, and ought
to be kept in every family, in case of accidents. A piece of it
must be laid upon the wound, and covered with a good deal of
lint, above which a bandage may be applied so tight as to keep it
firmly on.
Though spirits, tinctures, and hot balsams may be used, in or-
der to stop the bleeding when it is excessive, they are improper at
other times. They do not promote but retard the cure, and often
change a simple wound into an ulcer. People imagine, because hot
balsams congeal the blood, and seem, as it were, to solder up the
wound, that they therefore heal it; but this is only a deception.
They may stop the flowing blood, by searing the mouths of the
vessels; but, by rendering the parts callous, they obstruct the
cure.
In slight wounds, which do not penetrate much deeper than the
skin, the best application is a bit of the common black sticking-
plaister. This keeps the sides of the wound together, and prevents
the air from hurting it, which is all that is necessary. When a
wound penetrates deep, it is not safe to keep its lips quite close:
this keeps in the matter, and is apt to make the wound fester. In
this case, the best way is to fill the wound with soft lint, commonly
called caddis. It, however, must not be stuffed in too hard, other-
wise it will do hurt. The caddis may be covered with a cloth dip-
ped in oil, or spread with the common wax-plaister †; and the
whole must be kept on by a proper bandage. Common sense will
suggest the most commodious method of applying it.
* Dr. Tissot, in his Advice to the People, gives the following direc-
tions for gathering, preparing, and applying the agaric. "Gather in
autumn," says he, "while the fine weather lasts, the agaric of the oak,
which is a kind of fungus or excrescence issuing from the wood of that
tree. It consists at first of four parts, which present themselves succes-
sively: 1. The outward rind or skin, which may be thrown away. 2.
The part immediately under this rind, which is the bell of all. This is
to be beat well with a hammer, till it becomes soft and very pliable.—
This is the only preparation it requires, and a slice of it of a proper size
is to be applied directly over the bursting open blood-vessels. It con-
stringes and brings them close together, stops the bleeding, and gene-
rally falls off at the end of two days. 3. The third part, adhering to the   
second, may serve to stop the bleeding from the smaller vessels; and the   
fourth and last part, may be reduced to powder, as conducing to the same
purpose."—Where the agaric cannot be had, sponge may be used in its
dead. It must be applied in the same manner, and has nearly the same
effects.
† See Appendix, Wax-plaister. 

393 BURNS.
The first dressing ought to continue on for at least two days;
after which it may be removed, and fresh lint applied as before. If
any part of the first dressing sticks so, close as not to be removed
with ease or safety to the patient, it may be allowed to continue,
and fresh lint, dipped in sweet oil, laid over it. This will soften it,
so as to make it come off easily at next dressing. Afterwards the
wound may be dressed twice a-day in the same manner till it be
quite healed. Those who are fond of salves or ointments, may,
after the wound is become very superficial, dress it with the yel-
low basilicum;* and if fungous, or what is called proud flesh, should
rise in the wound, it may be checked, by mixing with the oint-
ment a little burnt alum or red precipitate of mercury.
When a wound is greatly inflamed, the most proper application
is a poultice of bread and milk, softened with a little sweet oil or
fresh butter. This must be applied instead of a plaister, and should
be changed twice a-day.
If the wound be large, and there is reason to fear an inflamma-
tion, the patient should be kept on a very low diet. He must ab-
stain from flesh, strong liquors, and every thing of a heating na-
ture. If he be of a full habit, and has lost but little blood from the
wound, he must be bled; and, if the symptoms be urgent, the ope-
ration may be repeated. But when the patient has been greatly
weakened by loss of blood from the wound, it will be dangerous
to bleed him, even though a fever should ensue. Nature should
never be too far exhausted. It is more safe to allow her to struggle
with the disease in her own way, than to sink the patient's
strength by excessive evacuations.
Wounded persons ought to be kept perfectly quiet and easy.
Every thing that ruffles the mind or moves the passions, as love,
anger, fear, excessive joy, &c. are very hurtful. They ought, above
all things, to abstain from venery. The body should be kept gently
open, either by laxative clysters, or a cool vegetable diet, as roas-
ted apples, stewed prunes, boiled spinage, and such-like.
Of Burns.
IN slight burns which do not break the skin, it is customary to
hold the part near the fire for a competent time, to rub it with
salt or lay a compress upon it dipped in spirits of wine, brandy,
or cold vinegar. But when the burn has penetrated so deep as to
blister or break the skin, it must be dressed with some of the lini-
ment for burns, mentioned in the Appendix, or with the emol-
lient and gently drying ointment, commonly called Turner's
* See Appendix, Yellow-basilicum.
D3

394 BURNS.
cerate.* This may be mixed with an equal quantity of fresh olive
oil, and spread upon a soft rag, and applied to the part affected.
When this ointment cannot be bad, an egg may be beat up with
about an equal quantity of the sweetest salad oil. This will ferve
very well till a proper ointment can be prepared. When the burn-
ing is very deep, after the first two or three days, it should be
dressed with equal parts of yellow basilicum and Turner's cerate,
mixed together.
When the burn is violent, or has occasioned a high degree of in-
flammation, as there is reason to fear a gangrene or mortification,
the same means must be used to prevent it as are recommended in
other violent inflammations. The patient, in this case, must live
low, and drink freely of weak diluting liquors. He must likewise
be bled, and have his body kept open. But if the burnt parts should
become livid or black, with other symptoms of mortification, it
will be necessary to bathe them frequently with warm camphorated
spirits of wine, tincture of myrrh, or other antiseptics, mixed with
a decoction of the bark. The bark must be taken internally, and
the patient's diet must be generous.
As example teaches better than precept, I shall relate the treat-
ment of the most dreadful case of this kind that has occurred in
my practice. A middle-aged man, of a good constitution, fell into
a large vessel full of boiling water, and scalded about one-half of
his body. As his clothes were on, the burning in some parts were
very deep before they could be got off. For the first two days, the
scalded parts had been frequently anointed with a mixture of lime-
water and oil, which is a very proper application for recent burn-
ings. On the third day, when I first saw  him, his fever was high,
and his body costive, for which he was bled, and had an emollient
clyster administered. Poultices of bread and milk, softened with
fresh butter, were likewise applied to the affected parts, to abate
the heat and inflammation. His fever still continuing high, he was
bled a second time, was kept strictly on the cooling regimen, took
the saline mixture, with small doses of nitre, and had an emollient
clyster administered once a-day. When the inflammation began to
abate, the parts were dressed with a digestive, composed of brown
cerate and yellow basilicum. Where any black spots appeared, they
were slightly scarified, and touched with the tincture of myrrh;
and, to prevent their spreading, the bark was administered. By this
course, the man was so well in three weeks, as to be able to attend
his business.
* See Appendix, Tuner's cerate.

[395]
Bruises
ARE generally productive of worse consequences than wounds.
As danger from them does not appear immediately, they are ne-
glected. We proceed to point cut the method of treatment.
In slight bruises it will be sufficient to bathe the part with warm
vinegar, to which a little brandy or rum may occasionally be ad-
ded, and to keep cloths wet with this mixture constantly applied
to it. This is more proper than rubbing it with brandy, spirits, or
wine, or other ardent spirits, which are commonly used in such
cases.
When a bruise is very violent, the patient ought immediately to
be bled, and put upon a proper regimen. His food should be light
and cool, his drink weak, and of an opening nature; as whey
sweetened with honey, decoctions of tamarinds, barley, cream-
tartar-whey, and such-like. The bruised part must be bathed with
vinegar and water, as directed above; and a poultice made by
boiling crumbs of bread, elder-flowers, and camomile-flowers, in
equal quantities of vinegar and water, applied to it. This poultice
is peculiarly proper when a wound is joined to the bruise. It may
be renewed two or three times a-day.
As the structure of the vessels is totally destroyed by a violent
bruise, there often ensues a great loss or substance, which pro-
duces an ulcerous sore very difficult to cure. If the bone
be affected, the sore will not heal before an exfoliation takes
place; that is, before the diseased part of the bone separates, and
comes out through the wound. This is often a very slow operation,
and may even require several years to be completed. Hence it
happens, that these sores are frequently mistaken for the king's evil,
and treated as such, though, in fact, they proceed soley from the
injury which the solid parts received from the blow.
Patients in this situation are pestered with different advices.
Every one who sees them proposes a new remedy, till the sore is so
much irritated with various and opposite applications, that it is of-
ten at length rendered absolutely incurable. The best method of
managing such sores is, to take care that the patient's constitution
does not suffer by confinement, or improper medicine, and to ap-
ply nothing to them but some simple ointment, spread upon soft
lint, over which, a poultice of bread and milk, with boiled camo-
mile-flowers, or the like, may be put, to nourish the part, and keep
it soft and warm. Nature, thus assisted, will generally in time ope-
rate a cure, by throwing off the diseased parts of the bone, after
which the sore soon heals. 

[396]
Ulcers
MAY be the consequence of wounds, bruises, or imposthumes
improperly treated; they may likewise proceed from an ill state of
the humours, or what may be called a bad habit of body.
In the latter case, they ought not to be hastily dried up, other-   
wise it may prove fatal to the patient. Ulcers happen most com-
monly in the decline of life; and persons who neglect exercise, and
live grossly, are most liable to them. They might often be prevented
by retrenching some part of the solid food, or by opening artificial
drains, as issues, setons, or the like.
An ulcer may be distinguished from a wound by its discharging
a thin watery humour, which is often so acrid as to inflame and
corrode the skin; by the hardness and perpendicular situation of its
sides or edges, by the time of its duration, &c.
It requires considerable skill to be able to judge whether or not
an ulcer ought to be dried up. In general, all ulcers which proceed
from a bad habit of body, should be suffered to continue open, at
least till the constitution has been so far charged by proper regimen,
or the use of medicine, that they seem disposed to heal of their own
accord. Ulcers, which are the effect of malignant fevers, or other
acute diseases, may generally be healed with safety after the health
has been restored for some time. The cure ought not to be at-
tempted too soon, nor at any time, without the use of purging
medicines and a proper regimen. When wounds or bruises, have,
by wrong treatment, degenerated into ulcers, if the constitution be
good, they may generally be healed with safety. When ulcers either
accompany chronical diseases, or come in their stead, they must be   
cautiously healed. If an ulcer conduces to the patient's health, from
whatever cause it proceeds, it ought not to be healed; but if, on the
contrary, it wastes the strength, and consumes the patient by a slow
fever, it should be healed as soon as possible.
We recommend a strict attention to these particulars, to all who
have the misfortune to labour under this disorder, particularly
persons in the decline of life; as often people throw away their
lives by the want of it, while they vere extolling, and generously
rewarding those, whom they ought to have looked upon as their
executioners.
The most proper regimen for proper promoting the cure of ulcers, is to  
avoid all spices, salted and high-seasoned food, all strong liquors,
and to lessen the usual quantity of flesh-meat. The body ought to
be kept gently open, by a diet, consisting chiefly of cooling, laxa-
tive vegetables, and by drinking butter-milk, whey, sweetened with
honey, or the like. The patient ought to be kept cheerful, and
should take as much exercise as he can easily bear.
When the bottom and sides of an ulcer seem hard and callous, 

397 DISLOCATIONS.
they may be sprinkled, twice a day, with a little red precipitate of
mercury, and afterwards dressed with the yellow basilicum oint-
ment. Sometimes it will be necessary to have the edges of the
ulcer scarified with the lancet.      
Lime-water has frequently been known to have very happy of-
fects in the cure of obstinate ulcers. It may be used in the same
manner as directed for the stone and gravel.
Dr. Whytt strongly recommends the use of the solution of cor-
rosive sublimate of mercury in brandy, for the cure of obstinate ill-
conditioned ulcers. I have frequently found this medicine prove
very successful. The dose is a table-spoonful night and morning;
at the same time washing the sore twice or thrice a-day with it.
The Doctor informed me, "That he observed washing the sore
thrice a-day, with the solution of a triple strength, was very bene-
ficial *."
A fistulous ulcer can seldom be cured without an operation. It
must either be laid open so as to have its callous parts destroyed
by some corrosive application, or they must be entirely cut away
by the knife; but as this operation requires the hand of an expert
surgeon, there is no occasion to describe it. Ulcers about the anus
are most apt to become fistulous, and, are very difficult to cure.—
Seme, indeed, pretend to have found Ward's Fistula paste very
successful in this complaint. It is not a dangerous medicine, and
being easily procured, it may deserve trial; but as these ulcers
generally proceed from an ill habit of body, they will seldom yield
to any thing except a long course of regimen, assisted by medicines,
fitted to correct that particular habit, and to induce an almost to-
tal change in the constitution.
CHAP. LIII.
Of Dislocations.
WHEN a bone moved out of its place, or articulation, so
as to impede its proper functions, it is said to be luxated
or dislocated. As this often happens to persons in situations where
no medical assistance can be obtained, by which means, limbs,
and even lives, are frequently lost, we shall point out the method
of reducing the most common luxations, and those which require
immediate assistance. Any person of common sense and resolution,
who is present when a dislocation happens, may often be of more
service to the patient, than the most expert surgeon can, after the
swelling and inflammation have come on. When these are present,
* In ulcers of the lower limbs, great benefit is often received from
tight rollers or wearing a laced stocking, as this prevents the flux of
humours to the sores, and disposes them to heal. 

398 DISLOCATION OF THE JAW.
it is difficult to know the state of the joint, and dangerous to at-
tempt a reduction; and by waiting till they are gone off, the mus- 
cles become so relaxed, and the cavity filled up, that the bone can
never afterwards be retained in its place.
A recent dislocation may generally be reduced by extension
alone, which must always be greater or less according to the
strength of the muscles which move the joint, the age, robustness,
and other circumstances of the patient. When the bone has been
cut of its place for any considerable time, and a swelling or inflam-
mation has come on, it will be necessary to bleed the patient, and,
after fomenting the part, to apply, soft poultices, with vinegar to
it, for some time, before the reduction is attempted.
All that is necessary, after the reduction, is to apply cloths dipt
in vinegar, or camphorated spirits of wine to the part, and to keep
it perfectly easy. Many bad consequences proceed from the ne-
glect of this rule. A dislocation seldom happens without the ten-
dons and ligaments of the joint being stretched, and sometimes
torn. When these are kept easy till they recover their strength and
tone, all goes on very well; but if the injury be increased by too
frequent an exertion of the parts, no wonder if they be found
weak and diseased ever after.
Dislocation of the Jaw.
THE lower jaw may be luxated by yawning, blows, falls, chew-
ing hard substances, or the like. It is easily known from the pa-
tient's being unable to shut his mouth, or to eat any thing, as the
teeth of the under jaw do not correspond with those of the upper;
besides, the chin either hangs down, or is thrown toward one side,
and the patient is neither able to speak distinctly, nor to swallow
without considerable difficulty.
The usual method of reducing a dislocated jaw, is to set the pa-
tient upon a low stool, so as an assistant may hold the head firm,
by pressing it against his breast. The operator is then to thrust his
two thumbs, being first wrapped up with linen cloths, that they
may not slip, as far back into the patient's mouth as he can, while
his fingers are applied to the jaw externally. After he has got
firm hold of the jaw, he is to press it strongly downwards and
backwards, by which means the elapsed heads of the jaw may be
easily pushed into their former cavities.
The peasants in some parts of the country have a peculiar way
of performing this operation. One of them puts a handkerchief
under the patient's chin, then turning his back to that of the pa-
tient, pulls him up by the chin, so as to suspend him from the
ground. This method often succeeds, but we think it is dange-
rous, and, therefore, recommend the former. 

[399]
Dislocation of the Neck.
THIS may happen by falls, violent blows, or the like.—
In this case, if the patient receives no assistance, he soon dies,
which makes people imagine the neck was broken: it is, however,
for the most part, only partially dislocated, and may be reduced
by almost any person who has resolution enough to attempt it. A
complete dislocation of the neck is instantaneous death.
When the neck is dislocated, the patient is immediately depri-
ved of all sense and motion; his neck swells, his countenance ap-
pears bloated ; his chin lies upon his breast, and his face is gene-
rally turned towards one side.
To reduce this dislocation, the person should immediately be
laid upon his back on the ground, and the operator must place
himself behind him so as to be able to lay hold of his head with
both hands, while he makes a resistance by placing his knees against
the patient's shoulders. In this posture he must pull the head with
considerable force, gently twisting it at the same time, if the face
beturned to one side, till he perceives that the joint is replaced,
which may be known from the noise which the bones generally
make when going in, the patient beginning to breathe, and the
head continuing in its natural posture.
This is one of those operations which it is more easy to per-
form than describe. It has been happily performed even by wo-
men, and often by  men of no medical education. After the neck
is reduced, the patient ought to be bled, and should be suffered to
rest for some days, till the parts recover their proper tone.
Dislocation of the Ribs.
AS the articulation of the ribs, with the back-bone, is very
strong, they are not often dislocated. It sometimes happens.—
When a rib is dislocated either upwards or downwards, in order
to replace it, the patient should be laid upon his belly, on a table,
and the operator must endeavour to push the head, of the bone in
its proper place. Should this method not succeed, the arm of the
disordered side may be suspended over a gate or ladder, and, while
the ribs are thus stretched asunder, the heads of such as are out of
place may be thrust into their former situation.
Those dislocations wherein the heads of the ribs are forced in-
wards, are both more dangerous and the most difficult to reduce,
as neither the hand nor any instrument can be applied internally
to direct the luxated heads of the ribs. Almost the only thing
that can be done, is, to by the patient upon his belly, over a calk,

400 DISLOCATION OF THE SHOULDER.
or some gibbous body, and to move the fore-part of the rib in-
ward towards the back, sometimes shaking it; by this means, the
heads of the luxated ribs may flip into their former place.
Dislocation of the Shoulder.
THE humerus, or upper bone of the arm, may be dislocated in
various directions: It happens most frequently downwards, but
very seldom directly upwards. From the nature of its articulation,
as well as from its exposure to external injuries, this bone is the
most subject to dislocation of any in the body. A dislocation of it
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 down-
ward, or forward, the arm is elongated, and a ball or lump is per-
ceived under the arm-pit; but when it is backward, there appears
a protuberance behind the shoulder, and the arm is thrown for-
wards toward the breast.
The usual method of reducing dislocations of the shoulder, is,
to seat the patient upon a low stool, and to 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 gradu-
ally extends it. The operator then puts a napkin under the pa-
tient's arm, and causes it to be tied behind his own neck: by this,
while a sufficient extension is made, he lifts up the head of the
bone, and, with his hands, directs it into its proper place. There
are various machines invented for facilitating this operation, but
the hand of an expert surgeon is always more safe. In young and
delicate patients, I have generally found it a very easy matter to
reduce the shoulder, by extending the arm with one hand, and
thrusting in the head of the bone with the other. In making the
extension, the arm ought always to be a little bent.
Dislocation of the Elbow.
THE bones of the fore-arm may be dislocated in any direction.
When this is the case, a protuberance may be observed on that side
of the arm towards which the bone is pushed, from which, and the
patient's inability to bend his arm, a dislocation of this joint may
easily be known.
Two assistants are generally necessary for reducing a dislocation
of the elbow; one of them must lay hold of the arm above, and
the other below the joint, and make a pretty strong extension,
while the operator returns the bones into their proper place. Af- 

401 BROKEN BONES, &c.            
terwards the arm must be bent, and suspended for some time, with
a sling about the neck.
Luxations of the wrist and fingers are to be reduced in the same
manner as those of the elbow; viz. by making an extension in dif-
ferent directions, and thrusting the head of the bone into its place.
Dislocation of the Thigh.
When the thigh-bone is dislocated forward and downward, the
knee and foot are turned out, and the leg is longer than the other;
but when it is displaced backward, it is usually pushed upward at
the same time, by which means, the limb is shortened, and the
foot is turned inwards.
When the thigh-bone is displaced forward and downward, the
patient, in order to have it reduced, must be laid upon his back,
and made fast by bandages, or held by assistants, while, by others,
an extension is made by means of slings fixed about the bottom of
the thigh, a little above the knee. While the extension is made, the
operator must push the head of the bone outward, till it gets into
the socket. If the dislocation be outward, the patient must be laid
upon his face, and, during the extension, the head of the bone
must be pushed inward.
Dislocations of the knees, ancles and toes, are reduced much in
the same manner as those of the upper extremities, viz. by mak-
ing an extension in opposite directions, while the operator replaces
the bones. In many cases, the extension alone is sufficient, and the
bone will slip into its place merely by pulling the limb with suffi-
cient force. It is not hereby meant, that force alone is sufficient
for the reduction of dislocations. Skill and address will often suc-
ceed better than force. I have known a dislocation of the thigh re-
duced by one man, after all the force that could be used by six
had proved ineffectual.
CHAP. LIV.
Of Broken Bones, &c.
THERE is, in most country villages, some person who pretends
to the art of reducing fractures. Though in general such
persons are very ignorant, yet some of them are very successful;
which evidently proves, that a small degree of learning, with a suf-
ficient share of common sense and a mechanical head, will enable
a man to be useful in this way. We advise people never to employ
E3

402 BROKEN BONES, &c.
such operators, when an expert surgeon can be had; but when
that is impracticable, they must be employed; we, therefore, re-
commend the following hints to their consideration:
When a large bone is broken, the patient's diet ought, in all  
respects, to be the same as in an inflammatory fever. He should,
likewise, be kept quiet and cool, and his body open by emollient
clysters; or, if these cannot be conveniently administered, by food
that is of an opening quality; as stewed prunes, apples boiled in
milk, boiled spinage, and the like. Persons accustomed to live high,
are not, all of a sudden, to be reduced to a very low diet. This
might have fatal effects. There is often a necessity for indulging
even bad habits, in some measure, where the nature of the disease
might require a different treatment.
It will generally be necessary to bleed the patient immediately
after a fracture, especially if he be young, of a full habit, or has,
at the same time, received any bruise or contusion. This operation
should riot only be performed soon after the accident happens, but 
if the patient be very feverish, it may be repeated next day. When
several of the ribs are broken, bleeding is peculiarly necessary.
If any of the large bones which support the body are broken, the
patient must keep his bed for several weeks. It is by no means ne-
cessary, however, that he should lie all that time, as is customary,
upon his back. This situation sinks the spirits, galls and frets the
patient's skin, and renders him very uneasy. After the second week
he may be gently raised up, and sit several hours, supported by a
bed-chair, or the like, which will greatly relieve him. Great care
must be taken in raising him up, and laying him down, that he
make no exertions himself, otherwise the action of the muscles may
pull the bone out of its place *.
It is of great importance to keep the patient dry and clean while
in this situation. By neglecting this, he is often so galled and excori-
ated, that he is forced to keep shifting places for ease. I have
known a fractured thigh-bone, after it had been kept straight for
above a fortnight, displaced by this means, and continue bent for
life, in spite of all that could be done.
It has been customary, when a bone was broken, to keep the limb
for five or six weeks continually upon the stretch. But this is a bad
posture. It is both uneasy to the patient, and unfavourable to the
cure. The best situation is to keep the limb a little bent. This is
* Various pieces of machinery have been contrived for counteracting
the force of the muscles, and retaining the fragments of broken hones;
but as descriptions of these, without drawings, would be of little life,
I shall refer the reader to a cheap and useful performance on the nature
and cure of fractures, lately published by Mr. Aitken, surgeon in Edin-
burgh; wherein that gentleman has not only given an account of the
machines recommended in fractures by former authors, but has like-
wise added several improvements of his own, which are peculiarly use-
ful in compound fractures, and in cases where patients with broken
bones are obliged to be transported from one place to another.     

403 BROKEN BONES, &c.             
the posture into which every animal puts its limbs when it goes to
rest, and in which fewest muscles are upon the stretch. It is easily
effected, by either laying the patient upon his side, or making the
bed so as to favour this position of the limb.            
Bone-setters ought carefully to examine, whether the bone be not
shattered or broken into several pieces. In this case, it will some-
times be necessary to have the limb immediately taken off, otherwise
a gangrene or mortification may ensue. The horror which attends
the very idea of an amputation often occasions its being delayed in
such cases till too late. I have known a limb, where the bones were
shattered into more than twenty pieces, that was not amputated be-
fore the third day after the accident, when the gangrene had pro-
ceeded so far as to render the operation useless.
When a fracture is accompanied with a wound, it must be dres-
sed, in all respects, as a common wound.
All that art can do towards the cure of a broken bone, is to lay
it perfectly straight, and to keep it quite easy. All tight bandages
do hurt. They had much better be warning altogether. A great ma-
ny of the bad consequences which succeed to fractured bones are
owing to tight bandages. This is one of the ways in which the ex-
cess of art, or rather the abuse of it, does more mischief that would
be occasioned by the want of it. Some of the most sudden cures of
broken bones which were ever known, happened were no bandages
were applied at all. Some method must be taken to keep the mem-
ber steady; but this may be done in many ways without bracing it
with a tight bandage.
The best method of retention is by two or more splints made of
leather or pasteboard. These, if moistened before they be applied,
soon assume the shape of the included member, and are sufficient,
by the asistance of a very slight bandage, for all the purposes of re-
tention. The bandage which he would recommend, is, that made
with twelve or eighteen tails. It is much easier applied and taken
off than rollers, and answers all the purposes of retention equally
well. The splints should always be as long as the limb, with holes
cut for the ancles when the fracture is in the leg.
In fractures of the ribs, where a bandage cannot be properly
used, an adhesive plaister may be applied over the part. The pa-
tient, in this case, ought to keep himself quite easy, avoiding every
thing that may occasion sneezing, laughing, coughing, or the like.
He ought to keep his body in a straight posture, and should take
care that his stomach be constantly distended, by taking frequently 
some light food, and drinking freely of weak watery liquors.
The most proper external application for a fracture is oxycrate,
or a mixture of vinegar and water. The bandages should be wet
with this at every dressing.

[404]
Of Strains.
STRAINS are often attended with worse consequences than
broken bones. The reason is obvious; they are generally neglected.
When a bone is broken, the patient is obliged to keep the member
easy, because he cannot make use of it; but when a joint is only
strained, the person, finding he can still make a shift to move it, is
sorry to lose his time for so trifling an ailment. In this way, he de-
ceives himself, and converts it into an incurable malady, what might
have been removed by only keeping the part easy for a few days.
Country people generally immerse a strained limb in cold water.
This is very proper, provided it be done immediately, and not kept
in too long. But the custom of keeping the part immersed in cold
water for a long time is certainly dangerous. It relaxes instead of
bracing the part, and is more likely to produce a disease than re-
move one.
Wrapping a garter, or some other bandage, pretty tight about
the strained part, is likewise of use. It helps to restore the proper
tone of the vessels, and prevents the action of the parts from increas-
ing the disease. It should not, however, be applied too tight. I have
frequently known bleeding near the affected part have a very good
effect: but what we would recommend above all, is case. It is more
to be depended on than any medicine, and seldom fails to remove
the complaint *.
Of Ruptures.
CHILDREN and very old people are most liable to this disease.
In the former, it is generally occasioned by excessive crying, cough-
ing, vomiting, or the like. In the latter, it is commonly the effect
of blows or violent exertions of the strength, as leaping, carrying
great weights, &c. In both, a relaxed habit, indolence, and an oily
or very moist diet, dispose the body to this disease.
A rupture sometimes proves fatal before it is discovered. When
sickness, vomiting, and obstinate costiveness give reason to suspect
an obstruction of the bowels, all those places where ruptures usu-
ally happen ought carefully to be examined. The protrusion of a
* Many external applications are recommended for strains, some of
which do good, and others hurt. The following are such as may he used
with the greatest safety, viz. poultices made of stale beer or vinegar
and oatmeal, camphorated spirits of wine. Mindereru's spirit, volatile
liniment. volatile aromatic spirit diluted with a double quantity of wa-
ter, and the common fomentation, with the addition of brandy of spirit
of wine. 

405 RUPTURES.                    
very small part of the gut will occasion all these symptoms; and if
not returned in due time, will prove mortal.
On the first appearance of a rupture in an infant, it ought to be
laid upon its back, with its head very low. While in this posture,
if the gut does not return of itself, it may easily be put up by gen-
tle pressure. After it is returned, a piece of sticking-plaister may be
applied over the part, and a proper truss or bandage must be con-
stantly worn for a considerable time. The method of making and
applying these rupture-bandages for children is pretty well known. 
The child must, as far as possible, be kept from crying, and from
all violent exertions, till the rupture is quite healed.
In adults, when the gut has been forced down with great vio-
lence, or happens from any cause to be inflamed, there is often great
difficulty in returning it, and sometimes the thing is impracticable
without an operation; a description of which is foreign to our pur-
pose. As I have been fortunate enough, however, always to suc-
ceed in my attempts to return the gut, without having recourse to
any other means than what are in the power of every man, I shall
briefly mention the method which I generally pursue.
After the patient has been bled, he must do laid upon his back,
with his head very low, and his breech raised high with pillows. In
this situation, flannel-cloths, wrung out of a decoction of mallows
and camomile flowers, or, if these are not at hand, of warm water,
must be applied for a considerable time. A clyster made of this de-
coction, with a large spoonful of butter and a little salt, may be af-
terwards thrown up. If these should not prove successful, recourse
mnst be had to pressure. If the tumour be very hard, considerable
force will be necessary; but it is not force alone which succeeds
here. The operator, at the same time that he makes a pressure with
the palms of his hand, must with his fingers artfully conduct the
gut in by the same aperture through which it came out. The manner
of doing this can be much easier conceived that described. Should
these endeavours prove ineffectual, clysters of the smoke of tobacco
may be tried. These have been often known to succeed where every
other method failed.
By persisting in the use of these, and such other means as the
circumstances of the case may suggest, most hernias might be re-
duced without an operation. Cutting for the hernia is a nice and diffi-
cult matter. I advise surgeons to try every method of returning the
gut before they have recourse to the knife. I have once and again
succeeded by persevering in my endeavours, after eminent sur-
geons had declared the reduction of the gut impracticable without
an operation *.
* I would here beg leave to recommend it to every practitioner, when
his patient complains of pain in the belly with obstinate costiveness,
to examine the groins and every place where a rupture may happen, in
order that it may be immediately reduced. By neglecting this, many 

406 CASUALTIES.
An adult, after the gut has been returned, must wear a steel ban-
dage. It is needless to describe this, as it may always be had ready
made from the artists. Such bandages are generally uneasy to the
wearer for some time, but by custom, they become quite easy. No
person who has had a rupture after he arrived at man's estate,
should ever be without one of these bandages.
Persons who have a rupture, ought carefully to avoid all violent
exercise, carrying great weights, leaping, running and the like. They
should avoid windy aliment and strong liquors; and carefully guard
against catching cold.
Of Casualties.
LIFE, when to all appearance lost, may often, by due care,
be restored. Accidents frequently prove fatal, merely because 
proper means are not used to counteract their effects. No person
ought to be looked upon as killed by any accident, unless where the
structure of the heart, brain, or some organ necessary to life, is evi-
dently destroyed. The action of these organs may be so far impair-
ed, as even to be for some time imperceptible, when life is by no
means gone. In this case, however, if the fluids be suffered to grow
cold, it will be impossible to put them again in motion, even though
the solids should recover their power of acting. Thus, when the
motion of the lungs has been stopt by unwholesome vapour, the ac-
tion of the heart, by a stroke on the breast, or the functions of the
brain, by a blow on the head, if the person be suffered to grow cold,
he will in all probability continue so; but if the body be kept warm,
as soon as the injured part has recovered its power of acting, the
fluids will again begin to move, and all the vital functions will be 
restored.
It is a horrid custom immediately to consign over to death every
person, who, by a fall, a blow, or the like, is deprived of the appear- 
ance of life. The person, instead of being carried into a warm house,   
and laid by the fire, or put to a warm bed, is generally hurried
away to a church, or a barn, or some other cold damp house, where,
after a fruitless attempt has been made to bleed him, perhaps by
one who knew nothing of the matter, he is given over for dead,
and no further notice taken of him. This conduct seems to be the
result of ignorance, supported by an ancient superstitious notion,
which forbids the body of any person killed by accident to be laid
in an house that is inhabited. This conduct is contrary to all the
principles of reason, humanity, and common sense.
perish who were not suspected to have had ruptures till after they were
dead. I have known this happen, where half a dozen of the faculty
were in attendance. 

407 SUBSTANCES STOPT, &c.
When a person seems to be suddenly deprived of life, our first
business is to enquire into the cause. We ought carefully to ob-
serve whether any substance be lodged in the windpipe or gullet;
and, if that is the case, attempts must be made to remove it. When
unwholesome air is the cause, the patient ought immediately to
be removed. He may be immersed in warm water, or rubbed
with warm cloths, &c. to promote the circulation. When the cause
cannot suddenly be removed, our great aim must be, to keep up
the vital warmth, by rubbing the patient with hot cloths, or salt,
and covering his body with warm sand, ashes, or the like. 
As to those accidents, which, without immediate assistance,
would often prove fatal, and the most likely means for relieving
the sufferers, I have been anticipated by Dr. Tissot. I shall con-
tent myself with selecting such of his observations as seem to be
the most important, and adding such of my own as have occurred
in the course of practice.
Of Substances stopt between the Mouth and Stomach.
ACCIDENTS of this kind are very common, and extremely
dangerous, yet they are generally the effect of carelessness. Chil-
dren should be taught to chew their food well, and to put nothing
into their mouths which it would be dangerous for them to swal-
low. But children are not the only persons guilty of this impru-
dence; many adults put pins, nails, and other sharp-pointed sub-
stances in their mouths upon every occasion, and some even sleep
with the former there all night: a fit of coughing, or twenty
other accidents, may force over the substance before the person is
aware *.
When any substance is detained in the gullet, there are two ways
of removing it, viz. either by extracting it, or pushing it down.— 
The safest and most certain way is to extract it; but this is not always
the easiest; it may be more eligible sometimes to thrust is down,
especially when the obstructing body is of such a nature, that there
is no danger from its reception into the stomach. The substances,
which may be pushed down without danger, are all common
nourishing ones, as bread, flesh, fruits, and the like. All indiges-
tible bodies, as cork, wood, bones, pieces of metal, and such-like,
ought, if possible, to be extracted, especially if those bodies be sharp
pointed, as pins, needles, fish-bones, bits of glass, &c.
When such substances have not passed in too deep, we should
endeavour to extract them with our fingers, which method often
* A woman, in one of the hospitals of this city, lately discharged a
great number of pins, which she had swallowed in the course of her
business, through an ulcer in her side. 

408 SUBSTANCES STOPT BETWEEN
succeeds. When they are lower, we must make use of nippers, or
a small pair of forceps, such as surgeons use. But this attempt to
extract rarely succeeds, if the substance be of a flexible nature, and
has descended far into the gullet.
If the fingers and nippers fail, or cannot be duly applied, crot-
chets, a kind of hooks, must be employed. These may be made at once,
by bending a piece of pretty strong iron-wire at one end. It must
be introduced in the flat way; and, for the better conducting it,
there should likewise be a curve or bending, at the end it is held by,
to serve as a kind of handle to it; which has this further use, that
it may be secured by a string tied to it, a circumstance not to be   
omitted in any instrument employed on such occasions, to avoid
such ill accidents as have sometimes ensued from these instruments
slipping out of the operator's hand. After the crotchet has passed
below the substance that obstructs the passage, it is drawn up again,
and hooks up the body along with it. The crotchet is also very
convenient, when a substance, somewhat flexible, as a pin or fish-
bone, sticks across the gullet, the hook, in such cases, seizing them
about their middle part, crooks, and thus disengages them; or, if
they are very brittle substances, serves to break them.
When the obstructing bodies are small, and only stop up a part
of the passage, and which may either easily elude the hook, or
straiten it by their resistance, a kind of rings, made either of wire,
wool, or silk, may be used. A piece of fine wire, of a proper length,
may be bent into a circle, about the middle, of about an inch di-
ameter, and the long unbent sides brought parallel, and near each
other: These are-to be held in the hand, and the circular part or
ring introduced into the gullet, in order to be conducted about the
obstructing body, and so to extract it. More flexible rings maybe
made of wool, thread, silk, or small pack-thread, which may be
waxed, for their greater strength and consistence. One of these is
to be tied fast to a handle of iron-wire, whale-bone, or any kind of  
flexible wood, and by this means introduced, in order to surround 
the obstructing substance, and to draw it out. Several of these
rings, passed through one another, may be used, the more certainly
to lay hold of the obstructing body, which maybe involved by one,
if another should miss it. These rings have one advantage, which
is, that when the substance to be extracted, is once laid hold of, it
may then, by turning the handle, be retained so strongly in the
ring thus twisted, as to be moved every way, which must, in many   
cases, be a considerable advantage.                                
A material employed on these occasions is the sponge. Its pro-   
perty of swelling considerably on being wet, is the principal foun-
dation of its usefulness here. If any substance is stopt in the gullet,
but without, filling up the whole passage, a bit of sponge may be
introduced into that part which is unstopt, and beyond the sub-
stance. The sponge soon dilates, and grows larger in this moist situ-    

409 THE MOUTH AND STOMACH.
ation; and, indeed, the enlargement of it may be forwarded, by
making the patient swallow a few drops of water. Afterwards it
is to be drawn back, by the handle to which it is fastened, and as
it is now too large to return through the small cavity by which, it
was conveyed in, it draws out the obstructing body along with it.
The compressibility of sponge is another foundation of its use-
fulness in such cases. A pretty large piece of sponge may be com-
pressed or squeezed into a small size, by winding a string of tape
closely about it, which may be easily unwound, and withdrawn,
after the sponge has been introduced. A bit of sponge may like-
wise be compressed, by a piece of whale-bone split at one end; but
this can hardly be introduced in such a manner as not to hurt the
patient.                         
I have often known pins, and other sharp bodies, which had stuck
in the throat, brought up, by causing the person to swallow a bit
of tough meat tied to a thread, and drawing it quickly up again.
This is safer than swallowing sponge, and will often answer the
purpose equally well.
When all these methods prove unsuccessful, there remains one
more, which is, to make the patient vomit: but this can scarcely be
of any service, unless when such obstructing bodies are simply en-
gaged in, and not hooked or stuck into the sides of the gullet; as in
this case, vomiting might occasion some further mischief. If the pa-
tient can swallow, vomiting may be excited by taking half a drachm
or two scruples of ipecacuanha in powder, made into a draught.
If he is not able to swallow, an attempt may be made to excite
vomiting, by tickling his throat with a feather; and, if that should
not succeed, a clyster of tobacco may be administered. It is made
by boiling an ounce of tobacco in a sufficient quantity of water:
this has often been found to succeed, when other attempts to ex-
cite vomiting had failed.
When the obstructing body is of such a nature, that it may with
safety be pushed downwards, this may be attempted by means of
a wax-candle oiled, and a little heated, so as to make it flexible;
or a piece of whale-bone, wire, or flexible wood, with a sponge fas-
tened to one end.
Should it be impossible to extract even those bodies which it is
dangerous to admit into the stomach, we must prefer the least of
two evils, and rather run the hazard of pushing them down, than
suffer the patient to perish in a few minutes; and we ought to
scruple this resolution the less, as a great many instances have hap-
pened, where the swallowing of such hurtful and indigestible sub-
stances has been followed by no disorder.
Whenever it is manifest, that all endeavours to extract or push
down the substance must prove ineffectual, they should be discon-
tinued; because the inflammation, occasioned by persisting in them,
might be as dangerous as the obstruction itself. Some have died 
F2

410 SUBSTANCES STOPT, &c.
in consequence of the inflammation, even after the body which
caused the obstruction had been entirely removed.
While the means recommended above are used, the patient
should often swallow, or, if he cannot, he should frequently re-
ceive, by injection, through a crooked tube or pipe that may reach
down to the gullet, some emollient liquor, as warm milk and wa-
ter, barley-water, or a decoction of mallows. Injections of this
kind not only soften and sooth the irritated parts, but, when thrown
in with force, are often more successful in loosening the obstruction  
than ail attempts with instruments.                              
When, after all our endeavours, we are obliged to leave the ob-
structing body in the part, the patient must be treated as if he had
an inflammatory disease. He should be bled, kept upon a low diet,
and have his whole neck surrounded with emollient poultices. The
like treatment must also be used, if there be any reason to suspect
an inflammation of the passages, though the obstructing body be re-
moved.
A proper degree of agitation has sometimes loosened the inher-
ing body more effectually than instruments. Thus, a blow on the back
has often forced up a substance which stuck in the gullet; but this
is still more proper and efficacious, when the substance gets into
the wind-pipe. In this case, vomiting and sneezing are likewise to
be excited. Pins, which stuck in the gullet, have been frequently
discharged, by riding on horse-back, or in a carriage.
When any indigestible substance has been forced down into the
stomach, the patient should use a very mild and smooth diet, con-
sisting chiefly of fruits and farinaceous substances, as puddings,
pottage, and soups. He should avoid all heating and irritating
things, as wine, punch, pepper, and such-like; and his drink
should be milk and water, barley-water, or whey.
When the gullet is so strongly and fully closed, that the patient
can receive no food by the mouth, he must be nourished by clys-
ters of soup, jelly, and the like.
When the patient is in danger of being immediately suffocated,
and all hope of freeing the passage is vanished, so that death seems
at hand, if respiration be not restored, the operation of broncho-
tomy, or opening of the wind-pipe, must be directly performed.   
As this operation is neither difficult to an expert surgeon, nor very
painful to the patient, and is often the only method which can be
taken to preserve life in these emergencies, we mention it, but it
should only be attempted by persons skilled in surgery. 

[411]
Of Drowned Persons.
WHEN a person has remained above a quarter of an hour un-
der water, there can be no considerable hopes of his recovery. But
as several circumstances may happen to have continued life, in such
an unfortunate situation, beyond the ordinary term, we should ne-
ver too soon resign the unhappy, object to his fate, but try every
method for his relief, as there are many well attested proofs of the
recovery of persons to life and health, who had been taken out of
the water, apparently dead, and who remained a considerable time
without exhibiting any signs of life.
The first thing to be done, after the body is taken out of the
water, is, to convey it, as soon as possible, to some convenient
place, where the necessary operations for its recovery may be per-
formed. In doing this, care must be taken not to bruise or injure
the body, by carrying it in any unnatural posture, with the head
downwards, or the like. If an adult body, it ought to be laid on a
bed, or on straw, with the head a little raised, and carried on a cart
or on men's shoulders, and kept in as natural and easy a position as
possible. A small body may be carried in the arms.
In attempting to recover persons apparently drowned, the prin-
cipal intention to be pursued is, to restore the natural warmth, upon
which all the vital functions depend; and to excite these functions
by the application of stimulants, not only to the skin, but likewise
to the lungs, &c.
Though cold was by no means the cause of the person's death,
yet it will prove an effectual obstacle to his recovery. For this
reason, after stripping him of his wet clothes, his body must be
wiped dry, and placed between two blankets, made warm, with
the head a little elevated; and no more attendance admitted than
are absolutely necessary to execute these directions.
To renew the breathing, a strong person may blow his own
breath into the patient's mouth, with all the force he can, holding
his nostrils at the same time. When it can be perceived, by the ri-
sing of the chest or belly, that the lungs are filled with air, the per-
son ought to desist from blowing, and should press the breast and
belly, so as to expel the air again; and this operation may be re-
peated for some minutes, alternately inflating and depressing the
lungs, so as to imitate natural respiration.*
If the lungs cannot be inflated in this manner, it may be at-
tempted by blowing through one of the nostrils, and at the same
* Every time the lungs are expanded, electricity should be applied,
if a machine can be obtained. This is most effectually done about the
region of the heart, or between the fourth and fifth ribs. The shocks
should be frequently repeated, in order to stimulate the heart to action. 
[I. C.]

412 DROWNED PERSONS.
time, keeping the other close. Dr. Monro, for this purpose, recom-
mends a wooden pipe, fitted at one end for filling the nostril, and
at the other for being blown into by a person's mouth, or for re-
ceiving the pipe of a pair of bellows, to be employed for the same
purpose, if necessary.* 
When air cannot be forced into the chest by the mouth or nose,
it may be necessary to make an opening into the wind-pipe for this
purpose. It is needless, however, to spend time in describing this
operation, as it should not be attempted unless by persons skilled in
surgery.
The body should now be rubbed with coarse linen cloths, made
warm, and as soon as some warm salt, sand, ashes, grains, or such-
like, can be procured, they should be diligently used with friction
to every part of the body. Strong volatile spirits should be fre-
quently applied to the nose, and stimulating powders, as that of to-
bacco, may be blown up the nostrils.† Tissot mentions an instance
of a girl who was restored to life, after she had been taken out of
the water, swelled, bloated, and, to all appearance dead, by laying
her naked upon hot ashes, covering her with others equally hot,
putting a bonnet round her head, and a stocking round her neck
stuffed with the same, and heaping coverings over all. After she
had remained half an hour in this situation, her pulse returned, she
recovered speech, and cried out, I freeze, I freeze; a little cherry-
brandy was given her, and she remained buried, as it were, under
the ashes for eight hours; afterwards she was taken out, without
any other complaint except that of lassitude or weariness, which
went off in a few days. The Doctor mentions, likewise, an instance
of a man who was restored to life, after he had remained six hours
under water, by the heat of a dunghill.
Till the patient shews some signs of life, and is able to swallow,  
it would be useless and even dangerous to pour liquors into his
mouth. His lips, however, and tongue, may be frequently wet  
with a feather dipt in warm brandy or other strong spirits; and, as  
soon as he has recovered the power of swallowing, a little warm
wine, or some other cordial, ought, every now and then, to be ad-
ministered.‡
Some recommend a vomit after the patient is a little re-animated;
but if he can be made to puke, without the sickening draught, it
* This can be effected with more certainty by introducing a large
flexible tube or catheter, perfectly open at both extremities, into the
wind-pipe, and fixing the pipe of a bellows to the outer end. This mode 
of inflating the lungs has the advantage over that advised by our judi-
cious author, by expanding the lungs without distending the stomach.
[I. C.]
† This practice must be persisted in as long as there is the most distant
prospect of returning life. [I. C.]
‡ Bleeding, purging, and even clystering, before and after signs of
life appear, must be employed with extreme caution, and never without
the advice of a physician. [I. C.]        

413 NOXIOUS VAPOURS.             
will be more safe: this may generally be done by tickling the
throat and fauces with an oiled feather, or some other soft sub-
stance, which will not injure the parts. Tissot, in this case, re-
commends the oxymel of squills, a table-spoonful of which, diluted
with water, may be given every quarter of an hour, till the patient
has taken five or six doses. Where that medicine is not at hand, a
strong infusion of sage, camomile-flowers, or carduus benedictus,
sweetened with honey, or some warm water, with the addition of
a little salt, may, he says, supply its place. The Doctor does not
intend that any of these things should be given in such quantity
as to occasion vomiting. He thinks emetics, in this situation, are
not expedient.
We are by no means to discontinue our assistance as soon as the
patients discover some tokens of life, since they sometimes expire
after these first appearances of recovering. The warm and stimu-
lating applications are still to be continued, and small quantities of
some cordial liquor ought frequently to be administered. Lastly,
though the person should be manifestly re-animated, there some-
times remain an oppression, a cough, and feverishness, which ef-
fectually constitute a disease. In this case, it will be necessary to
bleed the patient in the arm, and to cause him to drink plentifully
of barley-water, elder-flower tea, or any other soft pectoral in-
fusions.
Such persons as have the misfortune to be deprived of the appear-
ances of life, by a fall, a blow, suffocation, or the like, must be
treated nearly in the same manner as those who have been, for
some time, under water. I once attended a patient who was so
stunned, by a fall from a horse, that, for above six hours, he
scarcely exhibited any signs of life; yet this man, by being bled,
and proper methods taken to keep up the vital warmth, recovered,
and, in a few days, was perfectly well. Dr. Alexander gives an
instance to the same purpose, in the Edinburgh Physical and Lite-
rary Essays, of a man who was, to all appearance, killed by a blow
on the breast, but recovered upon being immersed, for some time,
in warm water. These, and other instances of a similar nature,
which might be adduced, amount to a full proof of this fact, that
many of those unhappy persons who loose their lives by falls,
blows, and other accidents, might be saved by the use of proper means
duly persisted in.
Of Noxious Vapours.
AIR may be many ways rendered noxious, or even destructive
to animals. This may either happen from its vivifying principle
being destroyed, or from subtle exhalations with which it is im-
pregnated. Thus air that has passed through burning fuel is nei- 

414 NOXIOUS VAPOURS.
ther capable of supporting fire not the life of animals.  Hence the
danger of sleeping in close chambers, with charcoal fires. Some,
indeed, suppose the danger here proceeds from  the sulphureous
oil contained in the charcoal, which is set at liberty and diffused all
over the chamber; while others imagine it is owing to the air of
the room being charged with phlogiston. Be this as it may, it is
a situation carefully to be avoided. Indeed, it is dangerous to
sleep in a small apartment with a fire of any kind. I lately saw
four persons, who had been suffocated by sleeping in an apartment
where a small fire of coal had been left burning.
The vapour which exhales from wine, cyder, beer, or other li-
quors, in the state of fermentation, contains something poisonous,
which kills, in the same manner, as the vapour of coal. Hence
there is always danger in going into cellars where a large quantity
of these liquors is in a state of fermentation, especially if they have
been close shut up for some time. There have been many instances
of persons struck dead on entering such places, and of others who
have with difficulty escaped.
When subterraneous caves, that have been very long shut, are
opened, or when deep wells are cleaned, which have not been
emptied for several years, the vapours arising from them produce
the same effects. For this reason, no person ought to venture in-
to a well, pit, cellar, or any place that is damp, and has been long
shut up, till the air has been sufficiently purified, by burning gun-
powder in it. It is easy to know when the air of such places is
unwholesome, by letting down a lighted candle, throwing in
burning fuel, or the like. If these continue to burn, people may
safely venture in; but where they are suddenly extinguished, no
one ought to enter till the air has been first purified by fire.
The offensive stink of lamps and of candles, especially when
their flames are extinguished, operate like other vapours, though
with less violence, and less suddenly. There have, however, been
instances of people killed by the fumes of lamps which had been
extinguished in a close chamber, and persons-of weak delicate
breasts generally find themselves quickly oppressed in apartments
illuminated with many candles.
Such as are sensible of their danger in these situations, and re-
treat seasonably from it, are generally relieved as soon as they get
into the open air, or, if they have any remaining uneasiness, a little
water and vinegar, or lemonade, drank hot, affords them relief.
But when they are so for poisoned, as to have lost their feeling and
understanding, the following  means must be used for their re-
covery:
The patient should be exposed to a very pure, fresh, and open
air; and volatile salts, or other stimulating substances, held to his
nose. He should next be bled in the arm, or if that does not suc-
ceed, in the neck. His legs ought to be put into warm water, and
well rubbed.  As soon as he can swallow, some lemonade, or wa-   

415 EFFECTS OF EXTREME COLD.       
ter and vinegar, with the addition of a little nitre, may be given
him.
Sharp clysters may be made, by adding to the common clyster,
syrup of buckthorn and tincture of senna, of each two ounces;
or, in their stead, half an ounce of Venice turpentine dissolved in
the yolk of an egg. Should these things not be at hand, two or
three large spoonfuls of common salt may be put into the clyster.
The same means, if necessary, which were recommended in the
former part of this chapter, may be used to restore the circulation,
warmth, &c.
Mr. Tossach, surgeon at Alloa, relates the case of a man suffo-
cated by the steam of burning coal, whom he recovered by blow-
ing his breath into the patient's mouth, bleeding him in the arm,
and causing him to be well rubbed and tossed about. And Dr.
Frewen, of Sussex, mentions the case of a young man who was
stupified by the smoke of sea-coal, but was recovered by being
plunged into cold water, and afterwards laid in a warm bed.
The practice of plunging persons suffocated by noxious vapours
in cold water, would seem to be supported by the common experi-
ment of suffocating dogs in the grotto del cani, and afterwards re-
covering them, by throwing them into the neighbouring lake.
Effects of extreme Cold.
WHEN cold is extremely severe, and a person is exposed to it
for a long time, it proves mortal, in consequence of its stopping
the circulation in the extremities, and forcing too great a propor-
tion of blood towards the brain; so that the patient dies of a kind of
apoplexy, preceded by great sleepiness. The traveller, in this situa-
tion, who finds himself begin to grow drowsy, should redouble his
efforts to extricate himself from the imminent danger he is exposed
too. This sleep, which he might consider as some alleviation of his
sufferings, would, if indulged, prove his last.
Such violent effects of cold are not common in this country; it
frequently happens, however, that the hands or feet of travellers
are so benumbed or frozen, as to be in danger of a mortification,
if proper means are not used to prevent it. The chief danger in
this situation arises from the sudden application of heat. It is very
common, when the hands or feet are pinched with cold, to hold
them to the fire; yet reason and observation show, that this is a
most dangerous and imprudent practice.
If frozen meat, fruits, or roots of any kind, be brought near the
fire, or put into warm water, they will be destroyed, by rottenness,
or a kind of mortification; and the only way to recover them, is 

416 EFFECTS OF EXTREME HEAT.
to immerse them, for some time, in very cold water. The same
observation holds with regard to animals in this condition.
When the hands or feet are greatly benumbed with cold, they
ought either to be immersed in cold water, or rubbed with show,
till they recover their natural warmth and sensibility: after which,
the person may be removed into an apartment a little warmer, and
may drink some cups of tea, or an infusion of elder-flowers sweet-
ened with honey. Every person may observe, when his hands were
even but slightly affected with cold, that the best way to warm them
was by washing them in cold water, and continuing to rub them
well for some time.
When a person has been so long exposed to the cold, that all ap-
pearances of life are gone, it will be necessary to rub him all over
with snow or cold water; or, what will answer better, to immerse
him in a bath of the very coldest water. There is the greatest en-
couragement to persist in the use of these means, as we are assured
that persons who had remained in the snow, or had been exposed
to the freezing air during five or six successive days, and who had
discovered no marks of life for several hours, have, nevertheless,
been revived.
I have always thought, that the whitloes, kibes, chilblains, and
other inflammations of the extremities, which are so common
among the peasants, in the cold season, were chiefly occasioned by
their sudden transitions from cold to heat. After they have been
exposed to an extreme degree of cold, they immediately apply their
hands and feet to the fire, or, if they have occasion, plunge them
into warm water; by which means, if a mortification does not
happen, an inflammation seldom fails to ensue. Most of the ill
consequences from this quarter might be easily avoided, by only ob-
serving the precautions mentioned above.
The Effects of extreme Heat
ARE no less-fatal, and much more sudden than those of cold.
In hot countries, people frequently drop down dead in the streets,
exhausted with heat and fatigue. In this case, if any warm cordial
can be poured into the mouth, it ought to be done. If this cannot
be effected, they may be thrown up in form of a clyster. Volatile
spirits, and other things of a stimulating nature, may be applied to
the skin, which should be well rubbed with a flesh-brush, a coarse
cloth, or other stimulating things. 

[417] 
Effects of Drinking Cold Water in Warm Weather.
WE have opportunities almost every summer, of observing the
deleterious effects of cold water on the labouring part of our inha-
bitants, and in particular on foreigners newly arrived in this coun-
try, who are unacquainted with the danger, which commonly en-
sue, from swallowing large draughts of cold water, when the body
is heated from exercise or labour.
This fluid should never be drank cold in a warm day, even when
mixed with spirits, or any other liquor, as it is always accompanied
with imminent danger, which frequently manifests itself during
the time of drinking, or immediately after; when the patient is
seized with vertigo, dimness of sight, violent pain, and cramp in
the stomach, and sometimes will fall down at the pump, or stagger
away to throw himself down in the shade. There he becomes rest-
less, and tosses about in excruciating pain, attended with difficulty
of breathing, retraction of the navel, the face suffused and turged
with blood, nausea, and violent efforts to vomit. As the disease
advances, the vigour declines, and the patient, if not relieved soon,
exhibits the phænomena of dying. The breathing becomes more
interrupted and laborious, the cheeks and nostrils expand at every
expiration, with a rattling noise in the throat: The face at times
looks pale and deadly, the patient becomes delirious, and the tone
of the voice much altered; the extremities cold, pulse quick, and
almost imperceptible at the wrist, with an impossibility to swallow.
At length, death takes place in a short time from the attack.
MEDICINE.—The chief remedies in this complaint, are
bleeding, and large doses of laudanum. If the pulse is full and
strong, with a flushed appearance of the face, twelve or fourteen
ounces of blood should be taken from the arm, in order to relieve
the difficulty of breathing, and diminish the flow of blood to the
head; during this evacuation, forty or fifty drops of lauda-
num, or a quantity proportioned to the age of the patient,
should be administered, and in  half an hour, a smaller or
larger dose must be repeated, according to the urgency of the
symptoms. If laudanum cannot be procured, three or four
ounces of rum or brandy may be substituted. If the patient cannot
swallow, a tube, or a flexible catheter should be passed down the
osophagus or gullet, and the laudanum or brandy poured through
it into the stomach. When this operation cannot be performed,
clysters of warm water, with laudanum, must be injected. These
remedies frequently succeed, particularly, if they are applied early
in the complaint.
When assistance is called, and the powers of life appear suspended,
every means must be exerted to restore them, as directed in the
chapter drowning.
G3 

[418] 
CHAPTER LVI.
Of Fainting Fits, and other Cases which require immediate
Assistance.
STRONG and healthy persons, who abound with blood, are
often seized with sudden fainting fits, after violent exercise,
drinking freely of warm, or strong liquors, exposure to great heat,
intense application to study, or the like.
In such cases, the patient must be made to smell to some vinegar.
His temples, forehead, and wrists ought, the same time, to be
bathed with vinegar, mixed with an equal quantity of warm wa-
ter; and two or three spoonfuls of vinegar, with four or five times
as much water, may, if he can swallow, be poured into his mouth.
If the fainting proves obstinate, or degenerates into an abolition
of feeling and understanding, the patient must be bled. After the
bleeding, a clyster will be proper, and then he should be kept easy
and quiet, only giving him every half hour a cup or two of an infu-
sion of any mild vegetable, with the addition of a little sugar and
vinegar.
When swoonings, which arise from this cause, occur frequently
in the same person, he should, in order to escape them, confine him-
self to a light diet, consisting chiefly of bread, fruits and other vege-
tables. His drink ought to be water or small beer. He should sleep
but moderately, and take much exercise.
But fainting fits proceed much oftener from a defect than an ex-
cess of blood. They are ready to happen after great evacuations of
any kind, obstinate watching, want of appetite, or such-like. In these,
an almost directly opposite course to that mentioned above, must be
pursued.
The patient should be laid in bed, with his head low, and being co-
vered, should have his legs, thighs, arms, and his whole body, rub-
bed strongly with hot flannels. Hungary water, volatile salts, or
strong smelling herbs, as rue, mint, or rosemary, may be held to his
nose. His mouth may be wet with a little rum or brandy; and, if he
can swallow, some hot wine, mixed with sugar and cinnamon, which
is an excellent cordial, may be poured into his mouth. A com-
press of flannel dipt in hot wine or brandy, must be applied to the
pit of his stomach, and warm bricks, or bottles filled with hot wa-
ter, laid to the feet.
As soon as he recovers a little, he should take some strong soup
or broth, or a little bread or biscuit soaked in hot-spiced wine. To
prevent the return of the fits, he ought to take often, but in small
quantities, some light, yet strengthening nourishment, as panado
made with soup instead of water, new laid eggs, lightly poached,
chocolate, light roast-meats, jellies, and such-like. 

419 FAINTING FITS, &c.
Fainting-fits, which are the effect of bleeding, or of the violent
operation of purges, belong to this class. Such as happen after
artificial bleeding, generally terminate as soon as the patient is laid
upon the bed; indeed, persons subject to this kind, should always
be bled lying, in order to prevent it. Should the fainting, how-
ever, continue longer than usual, volatile spirits may be held to the
nose, and rubbed on the temples, &c.
When fainting is the effect of too strong or acrid purges or
vomits, the patient must be treated, in all respects, as if he had
taken a poison. He should be made to drink plentifully of milk,
warm-water, and oil, barley-water, or such-like; emollient clys-
ters will be proper, and his strength should afterwards be recruited,
by giving him generous cordials, and anodyne medicines.
Faintings are often occasioned by indigestion. This may either
proceed from the quantity or quality of the food. When the for-
mer of these is the cause, the cure will be best performed by vomi-
ting, which may be promoted by causing the patient to drink a
weak infusion of camomile-flowers, carduus benedictus, or the like.
When the disorder proceeds from the nature of the food, the pa-
tient, as in the case of weakness, must be revived by strong smells,
&c. after which he should be made to swallow a large quantity of
light, warm fluid, which may serve to drown the offending matter,
to soften its acrimony, and either to effect a discharge of it by
vomiting, or force it down into the intestines.
Even disagreeable smells will sometimes occasion swooning,
especially in people of weak nerves. When this happens, the pa-
tient should be carried into the open air, have stimulating things
held to his nose, and those substances, which are disagreeable to
him, ought immediately to be removed. We have already taken
notice of swoonings which arise from nervous disorders.
Fainting-fits often happen in the progress of diseases. In the be-
ginning of putrid diseases they generally denote an oppression at
stomach, or a mass of corrupted humours, and they cease after
evacuations either by vomit or stool. When they occur at the be-
ginning of malignant fevers, they indicate great danger. In each
of these cases, vinegar used both externally and internally is the
best remedy during the paroxysm, and plenty of lemon-juice and
water after it. Swoonings which happen in diseases accompanied
with great evacuations, must be treated like those which are owing
to weakness, and the evacuations ought to be restrained. When
they happen towards the end of a violent fit of an intermitting
fever, or at that of each exacerbation of a continual fever, the pa-
tient must be supported by small draughts of wine and water.
Delicate and hysteric women are very liable to swooning or
fainting-fits after delivery. These might be often prevented, by ge-
nerous cordials, and the admission of fresh air. When they are oc-
casioned by excessive flooding, it ought, by all means, to be ref-
trained. They are generally the effect of mere weakness or ex- 

420 FAINTING FITS, &c.
haustion. Dr. Engleman relates the case of a woman in child-bed,
"who, after being happily delivered, suddenly fainted, and lay up-
wards of a quarter of an hour apparently dead. A physician was
sent for; her own maid, in the meanwhile, being out of patience
at his delay, attempted to assist herself, and extending herself upon
her mistress, applied her mouth to her's, blew in as much breath
as she possibly could, and in a very short time the exhausted wo-
man awaked as out of a profound sleep; when proper things being
given her, she soon recovered. The maid being asked how she
came to think of this expedient, said she had seen it practised
at Altenhurgh, by midwives, upon children, with the happiest
effect."                                               
We mention this case, chiefly, that other midwives may be in-
duced to follow so laudable an example. Many children are born
without any signs of life, and others expire soon after the birth,
who might, without all doubt, by proper care, be restored to life.
From whatever cause fainting-fits proceed, fresh air is always
of the greatest importance to the patient. By not attending to this
circumstance, people often kill their friends while they are endea-
vouring to save them. Alarmed at the patient's situation, they call
in a crowd of people to his assistance, or perhaps to witness his ex-
it, whose breathing exhausts the air, and increases the danger.
There is not the least doubt, but this practice, which is very com-
mon among the lower sort of people, often proves fatal, especially
to the delicate, and such persons as fall into fainting-fits from
mere exhaustion, or the violence of some disease. No more per-
sons ought ever to be admitted into the room where a patient lies
in a swoon, than are absolutely necessary for his assistance, and the
windows of the apartment should always be opened, at least as far
as to admit a stream of fresh air.
Persons subject to frequent swoonings, or fainting-fits, should
neglect no means to remove the cause of them, as their consequen-
ces are always injurious to the constitution. Every fainting-fit
leaves the person in dejection and weakness; the secretions are
thereby suspended, the humours disposed to stagnation, coagula-
tions and obstructions are formed, and if the motion of the blood be
totally intercepted, or very considerably checked, polypuses are some-
times formed in the heart or larger vessels. The only kind of
swoonings not to be dreaded, are those which sometimes mark the
crisis in fevers; yet even these ought, as soon as possible, to be re-
moved. 

[421] 
Of Intoxication.
THE effects of intoxication are often fatal. No kind of poison.
kills more certainly than an over-dose of ardent spirits. Sometimes,
by destroying the nervous energy, they put an end to life at once;
but in general, their effects are more flow, and in many respects,
similar to those of opium. Other kinds of intoxicating liquors may
prove fatal when taken to excess, as well as, ardent spirits; but they
may generally be discharged by vomiting, which ought, always to
be excited when the stomach is overcharged with liquor.
More of those unhappy persons, who die intoxicated, lose their
lives from an inability to conduct themselves, than from the des-
tructive quality of the liquor. Unable to walk, they tumble down,
and lie in some awkward posture, which, obstructs the circulation.
or breathing, and often continue in this situation till they die. No
drunk person should be left by himself, till his clothes have been
loosened, and his body laid in such a posture as is most favourable
for continuing the vital motions, discharging the contents of the
stomach, &c. The best posture for discharging the contents of the
stomach is, to lay the person upon his belly; when asleep, he may
be laid on his side, with his head a little raised, and particular care
must be taken that his neck be no way bent, twitted, or have any
thing too tight about it.
The excessive degree of thirst occasioned by drinking strong li-
quors, often induces people to quench it by taking what is hurtful.
I have known fatal consequences from drinking freely of milk after
a debauch of wine or sour punch: these acid liquors, together with
the heat of the stomach, having coagulated the milk, in such a man-
ner, that it could never be digested. The safest drink after a de-
bauch is, water with a toast, tea, infusions of balm, sage, barley-
water, and such-like. If the person wants to vomit, he may drink
a weak infusion of camomile-flowers, or lukewarm water and oil;
but, in this condition, vomiting may generally be excited by only
tickling the throat with the finger or a feather.
Instead of giving a detail of all the different symptoms of intoxi-
cation which indicate danger, and proposing a general plan of treat-
ment for persons in this situation, I shall briefly relate tire history of
a case which lately fell under my own observation, wherein most
of those symptoms usually reckoned dangerous concurred, and
where the treatment was successful.
A young man, about fifteen years of age, had, for a hire, drank
ten glasses of strong brandy. He soon after fell asleep, and continu-
ed in that situation for near twelve hours, till at length, his uneasy
manner of breathing, the coldness of the extremities, and other
threatening symptoms, alarmed his friends, and made them send
for me. I found him still sleeping, his countenance ghastly, and his 

422 SUFFOCATION AND STRANGLING.
skin covered with a cold, clammy sweat. Almost the only signs of
life remaining, were, a deep laborious breathing, and a convulsive
motion or agitation of his bowels.
I tried to rouse him, but in vain, by pinching, shaking, applying
volatile spirits, and other stimulating things to his nose, &c. A few
ounces of blood were likewise taken from his arm, and a mixture
of vinegar and water was poured into his mouth; but, as he could
not swallow, very little of this got into the stomach. None of these
things having the least effect, and the danger seeming to increase, I
ordered his legs to be put into warm water, and a sharp clyster to be
immediately administered. This gave him a stool, and was the first
thing that relieved him. It was afterwards repeated with the same
happy effect, and seemed to be the chief cause of his recovery.
He then began to shew some signs of life, took drink when it was
offered him, and came gradually to his senses. He continued,
however, for several days weak and feverish, and complained much
of a soreness in his bowels, which gradually went off, by a slender
diet, and cool mucilaginous liquors.
This young man would probably have been suffered to die with-
out any assistance being called, had not a neighbour, a few days be-
fore, who had been advised to drink a bottle of spirits to cure him
of an ague, expired under very similar circumstances.
Suffocation and Strangling
MAY sometimes proceed from an infraction of the lungs, pro-
duced by viscid, clammy humours, or a spasmodic affection of
that organ. Persons who feed grossly, and abound in rich blood,
are very liable to suffocating fits from the former of these causes.
Such ought, as soon as they are attacked, to be bled, to receive an
emollient clyster, and to take frequently, a cup of diluting liquor
with a little nitre in it. They should likewise receive the streams of
hot vinegar into their lungs by breathing.
Nervous and asthmatic persons are most subject to spasmodic
affections of the lungs. In this case, the legs should be immersed in
warm water, and the steams of vinegar applied as above. Warm
diluting liquors should likewise be drank; to a cup of which, a
tea-spoonful of the paregoric elixir may occasionally be added.
Burnt paper, feathers, or leather, may be held to the patient's nose,
and fresh air should be freely admitted to him. Infants are often
suffocated by the carelessness or inattention of their nurses *. An in-
* These acidents are not always the effects of carelessness. I have
known an infant over-laid by its mother being seized in the night with
an hysteric fit. This ought to serve as a caution against employing hys-   

423 SUFFOCATION AND STRANGLING.    
fant, when in bed, should always be laid so, that it cannot tumble
down with its head under the bed-clothes; and, when in a cradle,
its face ought never to be covered. A small degree of attention to
these two simple rules would save the lives of many infants, and
prevent others from being rendered weak and sickly all their lives,
by injuries done to their lungs.
Instead of laying down a plan for the recovery of infants who
are suffocated, or overlaid by the nurses, I shall give the history of a
case related by Monsieur Janin, of the Royal College of Surgery at
Paris, as it was attended with success, and contains almost every
thing that can be done on such occasions.
A nurse having had the misfortune to over-lay a child, he was
called in, and found the infant without any signs of life; no pul-
sation in the arteries, no respiration, the face livid, the eyes open,
dull, and tarnished, the nose full of snivel, the mouth gaping; in
short, it was almost cold. Whilst some linen cloths and a parcel of
ashes were warming, he had the boy unswathed, and laid him in a
warm bed, and on the right side. He then was rubbed all over with
fine linen, for fear of fretting his tender and delicate skin. As soon
as the ashes had received their due degree of heat, Mr. Janin
burried him in them, except the face, placed him on the side oppo-
site to that on which he had been at first laid, and covered him
with a blanket. He had a bottle of eau de luce in his pocket, which
he presented to his nose from time to time; and between whiles,
some puffs of tobacco were blown up his nostrils: to these suc-
ceeded the blowing into his mouth, and squeezing tight his nose.
Animal heat began to be excited gradually; the pulsations of the
temporal artery were soon felt, the breathing became more fre-
quent and free, and the eyes closed and opened alternately. At
length, the child fetched some cries, expressive of his want of the
breast, which being applied to his mouth, he catched at it with avi-
dity, and sucked as if nothing had happened to him. Though the
pulsations of the arteries, were, by this time, very well re-establish-
ed, and it was hot weather, yet Mr. Janin thought it advisable to
leave his little patient three-quarters of an hour longer under the
ashes. He was afterwards taken out, cleaned, and dressed as usual;
to which a gentle sleep succeeded, and he continued perfectly  
well.
Mr. Janin mentions, likewise, an example of a young man who
had hanged himself through despair, to whom he administered
help, as effectually as in the preceding case.
Mr. Glover, surgeon in Doctors Commons, London, relates the
case of a person who was restored to life after twenty-nine minutes
hanging,and continued in good health for many years after.
The principal means used to restore this man to life, were, open-
ing the temporal artery, and the external jugular; rubbing the
teric women as nurses; and should likewise teach such women, never
to lay an infant in the same bed with themselves, but in a small adjacent
one. 

424 CONVULSION FITS.
back, mouth, and neck, with a quantity of volatile spirits and oil;
adminstering the tobacco clyster, by means of lighted pipes, and
strong frictions of the legs and arms. This course had been conti-
nued for about four hours, when an incision was made into the
wind-pipe, and air blown strongly through a canula into the lungs.
About twenty minutes after this, the blood at the artery began to
run down the face, and a slow pulse was just perceptible at the
wrist. The frictions were continued for some time longer; his
pulse became more frequent, and his mouth and nose being irri-
tated with spirit of sal ammoniac, he opened his eyes. Warm cor-
dials were then administered to him, and in two days, he was so
well, as to be able to walk eight miles.
Of Persons falling into Convulsion Fits.
THESE often constitute the last scene of acute or chronic disor-
ders. When this is the case, there can remain but small hopes of the
patient's recovery after falling into a fit. But when a person, who
appears to be in perfect health, is suddenly seized with a convul-
sion fit, and seems to expire, attempts ought to be made to restore
him to life. Infants are most liable to convulsions, and are often
carried off very suddenly, by one or more fits about the time of
teething. There are many well-authenticated accounts of infants
having been restored to life, after they had, to all appearance, ex-
pired in convulsions; but we shall only relate the following in-
stance, mentioned by Dr. Johnson, in his pamphlet on the practi-
cability of recovering persons visibly dead.
In the parish of St. Clements in Colchester, a child of six
months old, lying upon its mother's lap, having had the breast,
was seized with a strong convulsion fit, which lasted so long, and
ended with so total a privation of motion in the body, lungs, and
pulse, that it was deemed absolutely dead. It was stripped, laid
out, the passing-bell ordered to be tolled, and a coffin to be made:
but a neighbouring gentlewoman, who used to admire the child,
hearing of its sudden death, hastened to the house, and upon ex-
amining, found it not cold, its joints limber, and fancied, that a
glass she held to its mouth and nose was a little damped with the
breath; upon which she took the child in her lap, sat down before
the fire, rubbed it, and kept it in gentle agitation. In a quarter of
an hour she felt the heart begin to beat faintly; she then put a
little of the mother's milk into its mouth, continued to rub its
palms and soles, found the child begin to move, and the milk was
swallowed; and in another quarter of an hour, she had the satisfac-
tion of restoring, to its disconsolate mother, the babe quite recover-
ed, eager to lay hold of the breast, and able to suck again. The       

425 CONVULSION FITS.               
child throve, had no more fits, is grown up, and at present alive.
These means, which are certainly in the power of every person,
were sufficient to restore to life, an infant to all appearance dead,
and who, in all probability, but for the use of these simple endea-
vours, would have remained so. There are many other things
which might be done in case the above should not succeed; as rub-
bing the body with strong spirits, covering it with warm ashes or
salt, blowing air into the lungs, throwing up warm stimulating
clysters, or the smoke of tobacco, into the intestines, and such-
like.
When children are dead-born, or go off in a fit soon after the
birth, the same means ought to be used for their recovery, as in
circumstances similar to those mentioned above. These directions
may likewise be extended to adults, attention being always paid
to the age and other circumstances of the patient.
The foregoing cases and observations afford sufficient proof
of the success which may attend the endeavours of persons to-
tally ignorant of medicine, in assisting those who have life suspen-
ded by an accident or disease. Many facts of a similar nature
might be adduced, were it necessary; but these, it is hoped, will
be sufficient to call up the attention of the public, and to excite
the humane and benevolent, to exert their utmost endeavours for
the preservation of their fellow men.
The Society for the recovery of drowned persons, instituted at Am-
sterdam, in the year 1767, had the satisfaction to find that 150
persons, in the space of four years, had been saved by the means
pointed out by them, many of whom owed their preservation to
peasants, and people of no medical knowledge. But the means
used with so much efficacy in recovering drowned persons are, with
equal success, applicable to a number of cases where the powers of
life seem in reality to be only suspended, and to remain capable of re-
newing all their functions, on being put into motion again. It is
shocking to reflect, that for want of this consideration many persons
have been committed to the grave, in whom the principles of life
might have been revived.
The cases wherein such endeavours are most likely to be attended
with success, are all those called sudden deaths from an invisible
cause, as apoplexies, hysterics, faintings, and many other disorders,
wherein persons, in a moment, sink down and expire. The various
casualties in which they may be tried, are suffocations, from the
sulphureous damps of mines, coal-pits, &c.; the unwholesome air
of long unopened wells or caverns; the noxious vapours arising
from fermenting liquors; the steams of burning charcoal; sul-
phureous mineral acids; arsenical effluvia, &c.
The various accidents of drowning, strangling, and apparent
deaths, by blows, falls, hunger, cold, &ec. likewise furnish oppor-
tunities of trying such endeavours. Those, perhaps, who to ap-
pearance are killed by lightning, or by any violent agitation of the
H3 

426 COLD BATHING, AND
passions, as fear, joy, surprise, and such-like, might also be fre-
quently recovered by the use of proper means, as blowing strongly
into their lungs, &c.                                       
The means to be used for the recovery of persons suddenly de-
prived of life, are nearly the same in all cases; they are practicable
by every one who happens to be present at the accident, and re-
quire no great expense, and less skill. The great aim is to restore
the warmth and vital motions. This may in general be attempted
by means of heat, frictions, bleeding, blowing air into the lungs,
administering clysters and generous cordials. These must be varied
according to circumstances. Common sense, and the situation of
the patient, will suggest the proper manner of conducting them.
Above all, we recommend perseverance. People ought never to
despair on account of discouraging circumstances, or to leave off
their endeavours as long as there is the least hope of success.
Where much good, and no hurt can be done, no one ought to
grudge his labour.
CHAPTER LVII.
Cautions concerning Cold Bathing, and Drinking the
Mineral Waters.
IT is now fashionable for persons of all ranks to plunge into the
sea, and drink the mineral waters, I am desirous of rendering
this work more extensively useful, by some practical remarks on
these active and useful medicines.
No part of the practice of medicine is of greater importance, or
merits more the attention of the physician, as many lives are lost,
and numbers ruin their health, by cold bathing, and an imprudent
use of mineral waters.
Without a proper discrimination with regard to the disease and
constitution of the patient, the most powerful medicine is more
likely to do harm than good. The same physician, who, by cold
bathing, cured Augustus, by an imprudent use of the same medi-
cine, killed his heir. This induced the Roman senate to make laws
for regulating the baths, and preventing the numerous evils which
arose from an imprudent and promiscuous use of those elegant and
fashionable pieces of luxury. But as no such laws exist in this coun-       

427 DRINKING MINERAL WATERS.     
try, every one does that which is right in his own eyes, and of course.
many must do wrong.
People are apt to imagine that the simple element of water can
do no hurt, and that they may plunge into it at any time with im-
punity. In this, they are much mistaken. I have known apoplexies
occasioned by going into the cold bath, fevers excited by staying
too long in it, and other maladies so much aggravated by its conti-
nued use, that they could never be wholly eradicated. Nor are ex-
amples wanting, either in ancient or modern times, of the baneful
consequences which have arisen from an injudicious application of
the warm bath; but as warm baths are not so common in this
country, and are seldom used but under the direction of a physi-
cian, I shall not enlarge on that part of the subject.
Immersion in cold water is a custom which lays claim to the
most remote antiquity: indeed, it must have been coeval with man
himself. The necessity of water for the purposes of cleanliness,
and the pleasure arising from its application to the body in hot
countries, must, very early, have recommended it to the human
species. Even the example of other animals was sufficient to give
the hint to man. By instinct, many of them are led to apply cold
water in this manner; and some, when deprived of its use, have
been known to languish, and even to die.
The cold bath recommends itself in a variety of cases, and is
peculiarly beneficial to the inhabitants of populous cities, who
indulge in idleness, and lead sedentary lives. In persons of this de-
scription, the action of the solids is always too weak, which induces
a languid circulation, a crude indigested mass of humours, and
obstructions in the capillary vessels and glandular system. Cold
water, from its gravity as well as its tonic power, is well calcula-
ted either to obviate or remove these symptoms. It accelerates the
motion of the blood, promotes the different secretions, and given
permanent vigour to the solids. But all these important purposes
will be more essentially answered by the application of salt water.
This ought to be preferred on account of its superior gravity, and
for its greater power of stimulating the skin, which promotes the
perspiration, and prevents the patient from catching cold.
Cold bathing is more likely to prevent, than to remove obstruc-
tions of the glandular or lymphatic system. Indeed, when these
have arrived at a certain pitch, they are not to be removed by any
means. In this case, the cold bath will only aggravate the symp-
toms, and hurry the patient into the grave. It is therefore of the
utmost importance, previous to the patient's entering upon the
use of the cold bath, to determine whether or not he labours un-
der any obstinate obstructions of the lungs or ether viscera; and 

428 COLD BATHING, AND
where this is the case, cold bathing ought strictly to be prohi-
bited *.
In what is called a plethoric state, or too great a fulness of the
body, it is likewise dangerous, to use the cold bath, without due
preparation. In this case, there is great danger of bursting a blood-
vessel, or occasioning an inflammation of the brain, or some of the
viscera. This precaution is the more necessary to citizens, as most
of them live full, and are of a gross habit. Yet, what is very re-
markable, these people resort in crowds every season to the sea-
side, and plunge in the water without the least consideration. No
doubt they often escape with impunity; but does this give a func-
tion to the practise. Persons of this description ought by no
means to bathe, unless the body has been previously prepared by
suitable evacuations.
Another class of patients, who stand peculiarly in need of the
bracing qualities of cold water, is the nervous. This includes a
great number of the male, and almost all the female inhabitants
of great cities. Yet even those persons ought to be cautious in
using the cold bath. Nervous people have often weak bowels, and
may, as well as others, be subject to conjestions and obstructions
of the viscera; and in this case, they will not be able to bear the
effects of the cold water. For them, and for all delicate people,
the best plan would be to accustom themselves to it by the most
pleasing and gentle degrees. They ought to begin with the tem-
perate bath, and gradually use it cooler, till at length the coldest
proves quite agreeable. Nature revolts against all great transitions;
and those who do violence to her dictates, have often cause to re-
pent of their temerity.
Where cold bathing is practised, there ought likewise to be
tepid baths for the purpose mentioned above. Indeed, it is the
practice of some countries to throw cold water over the patient as
soon as he comes out of the warm bath; but though this may not
injure a Russian peasant, we dare not recommend it to the inhabi-
tants of this country. The ancient Greeks and Romans, we are
told, when covered with sweat and dust, used to plunge into rivers,
without receiving the smallest injury. They might often escape
danger from this imprudent conduct, yet it was certainly contra-
ry to found reason. Many robust men throw away their lives by
such an attempt. We would not advise patients to go into the
cold water when the body is chilly; as much exercise, at least,
* The late celebrated Dr. Smollet has said that, if he were persua-
ded he had an ulcer in the lungs, he would jump into the cold bath:
he evidently shows more courage than discretion; and, that he was
more a man of wit than a physician, every one will allow.  A nervous
asthma, or an atrophy, may be mistaken for a pulmonary consumption;
yet, in the two former, the cold bath proves often beneficial, though I
never knew it so in the latter. Indeed, all phthisical patients I ever
saw, who had tried the cold bath, were evidently hurt by it.       

429 DRINKING MINERAL WATERS.    
ought to be taken, as may excite a gentle glow all over the body,
but by no means so as to overheat it.
To young people, and particularly to children, cold bathing is
of the last importance. Their lax fibres render its tonic powers
peculiarly proper. It promotes their growth, increases their
strength *, and prevents a variety of diseases incident to child-
hood. Were infants early accustomed to the cold bath, it would
seldom disagree with them; and we should see fewer instances of
scrophula, rickets, and other diseases, which kill many, and make
others miserable for life. Sometimes these disorders render infants
incapable of bearing the shock of cold water; but this is owing
to their not having been early and regularly accustomed to it. It
is necessary here to caution young men against too frequent bath-
ing; many fatal consequences result from the daily practice of
plunging into rivers, and continuing there too long.
The most proper time of the day for using the cold bath is, no
doubt, the morning, or at least before dinner; and the best mode
that of quick immersion. As cold bathing has a constant tenden-
cy to propel the blood and other humours towards the head, it
ought to be a rule always to wet that part as soon as possible. By
due attention to this circumstance, violent head-achs, and other
complaints, which frequently proceed from cold bathing, might
be often prevented.
The cold bath, when too long continued in, occasions too great
a flow of blood towards the head, cramps the  muscles, and wholly
defeats the intention of bathing. Hence, by not adverting to this
circumstance, expert swimmers are often injured, and sometimes
even lose their lives. All the beneficial purposes of cold bathing
are answered by one immersion at a time; and the patient ought
to be rubbed dry the moment he comes out of the water, and
should continue to take exercise for some time after.
When cold bathing occasions chilness, loss of appetite, liftless-
ness, pain of the breast or bowels, a  prostration of strength, or
violent head-achs, it ought to be discontinued.
Though these hints are by no means intended to point out all
the cases where cold bathing may be hurtful, nor to illustrate its
extensive utility as a medicine; yet it is hoped they may serve to
guard people against some of those errors into which from mere
inattention they are apt to fall, and thereby not only endanger
their own lives, but bring an excellent medicine into disrepute.
* Galen says, that immersion in cold water is fit only for the young
of lions and bears; and recommends warm bathing, as conducive to
the growth and strength of infants. How egregiously do the greatest
men error whenever they lose sight of facts, and substitute reasoning in
physic in place of observation and experience!

[430] 
Of Drinking the Mineral Waters.
THE internal use of water, as a medicine, is no less an object
of the physician's attention than the external. Pure elementary
water is, indeed, the most inoffensive of all liquors, and consti-
tutes a principal part of the food of every animal. But this element
is often impregnated with substances of a very active and pene-
trating nature; and of such an insidious quality, that, while they
promote certain secretions, and even alleviate some disagreeable
symptoms, they weaken the powers of life, undermine the consti-
tution, and lay the foundation of worse diseases than those which
they were employed to remove. Of this, every practitioner must
have seen instances; and physicians of eminence have more than
once declared, that they have known more diseases occasioned
than removed by the use of mineral waters. This doubtless, has
proceeded from the abuse of these powerful medicines, which
evinces the necessity of using them with caution.
By examining the contents of the mineral waters which are most
used in this country, we shall be enabled to form an idea of the
danger which may arise from an improper application of them,
either externally or internally, though it is to the latter of these that
the present observations are chiefly confined.
The waters most in use for medical  purposes in Britain, are
those impregnated with salts, sulphur, iron, and mephitic air, ei-
ther separately, or variously combined. Of these the most power-
ful is the saline sulphureous water of Harrowgate, of which I
have had more occasion to observe the pernicious consequences,
when improperly used, than of any other. To this, therefore, the
following remarks will more immediately relate, though they will
be found applicable to all the purging waters in the kingdom which
are strong enough to merit attention.
The errors which so often defeat the intention of drinking the
purgative mineral waters, and which so frequently prove injurious
to the patient, proceed from the manner of using them, the quan-
tity taken, the regimen pursued, or using them in cases where they
are not proper.
A very hurtful prejudice still prevails in this country, that all
diseases must be cured by medicines taken into the stomach, and
that the more violently these medicines operate, they are the more
likely to have the desired effect. This opinion has proved fatal to
thousands, and will, in all probability, destroy many more before it
can be wholly eradicated. Purging is often useful in acute diseases,
and, in chronical cases, may pave the way for the operation of other
medicines; but it will seldom perform a cure; and by exhausting
the strength of the patient, will often leave him in a worse condi-
tion than it found him. That this is frequently the case with re-    

431 DRINKING THE MINERAL WATERS,   
gard to the more active mineral waters, every person conversant in
these matters will readily allow.
Strong stimulants applied to the stomach and bowels for a length
of time, must tend to weaken and destroy their energy; and what
stimulants are more active than salt and sulphur, especially when
these substances are intimately combined, and carried through the
system by the penetrating medium of water? These bowels must
be strong indeed, which can withstand the daily operation of such
active principles for months together, and not be injured. This is
the plan pursued by most of those who drink the purging mineral
waters, and whose circumstances will permit them to continue
long enough at those fashionable places of resort.
Many people imagine that every thing depends on the quantity
of water taken, and that the more they drink they will the sooner
get well. This is an egregious error; for while the unhappy pati-
ent thinks he is by this means eradicating his disorder, he is often
in fact undermining the powers of life, and ruining his constitu-
tion. Indeed, nothing can do this so effectually as weakening the
powers of digestion by the improper application of strong stimu-
lants. The very essence of health depends on the digestive organs
performing their due functions, and the most tedious maladies are
all connected with indigestion.
Drinking the water in too great quantity, not only injures the
bowels and occasions indigestion, but generally defeats the inten-
tion for which it is taken. The diseases for the cure of which mi-
neral waters are chiefly celebrated, are mostly of the chronic kind;
and it is well known that such diseases can only be cured by the
flow operation of alteratives, or such medicines as act by inducing
a gradual change in the habit. This requires length of time, and
never can be effected by medicines, which run off by stool, and
operate chiefly on the first passages.
Those who wish for the cure of an obstinate malady from the
mineral waters, ought to take them in such a manner as hardly to
produce any effect whatever on the bowels. With this view a half-
pint glass may be drank at bed-time *, and the same quantity an
hour before breakfast, dinner, and supper. The dose, however,
must vary according to circumstances. Even the quantity mention-
ed above will purge some persons, while others will drink twice as
much without being in the least moved by it. Its operation on the
bowels is the only standard for using the water as an alterative. No
* When I speak of drinking a glass of the water over night, I must
beg leave to caution those who follow this plan against eating heavy
suppers. The late Dr. Daultry of York, who was the first that brought
the Harrowgate waters into repute, used to advise his patients to drink
a glass before they went to bed; the consequence of which was, that
having eat a flesh supper, and the water operating in the night, they
were often tormented with gripes, and obliged to call for medical as-
sistance. 

432 DRINKING THE MINERAL WATERS.
more ought to be taken than barely to move the body; nor is it
always necessary to carry it this length, provided the water goes off
by die other emunctories, and does not occasion a chilness, or fla-
tulency in the stomach or bowels. When the water is intended to
purge, the quantity mentioned above may be all taken before break-
fast.
I would not only caution patients who drink the purging mine-
ral waters over night to avoid heavy suppers, but also from eating
heavy meals at any time. The stimulus of water, impregnated with
salts, seems to create a false appetite. I have seen a delicate person,
after drinking the Harrowgate waters of a morning, eat a break-
fast sufficient to have served two ploughmen, devour a plentiful
dinner of flesh and fish, and, to crown all, eat such a supper as
might have satisfied a hungry porter. All this, indeed, the stomach
seemed to crave; but this craving had better remain not quite sa-
tisfied, than that the stomach should be loaded with what exceeds
its powers. To starve patients was never my plan; but in the use
of all the purging mineral waters, a light, and rather diluting diet
is the most proper; and no person, during such a course, ought to
eat to the full extent to what his appetite craves.
To promote the operation of mineral waters, and to carry them
through the system, exercise is indispensably necessary. This may
be taken in any manner that is most agreeable to the patient; but
never to excess. The best kinds of exercise are those connected
with amusement. Every thing that tends to exhilarate the spirits,
not only promotes the operation of the waters, but acts as a medi-
cine. All who resort to the mineral waters, ought, therefore, to
leave every care behind, to mix with the company, and to make
themselves as cheerful and happy as possible. From this conduct,
assisted by the free and wholesome air of those fashionable places of  
resort, and also the regular and early hours which are usually kept,
the patient often receives more benefit than from using the waters.  
But the greatest errors in drinking the purging mineral waters
arise from their being used in cases where they are absolutely im-
proper, and adverse to the nature of the disease. When people hear
of a wonderful cure having been performed by some mineral water,
they immediately conclude that it will cure every thing, and ac-
cordingly swallow it down, when they might as well take poison.  
Patients ought to be well informed, before they begin to drink the
more active kinds of mineral waters, of the propriety of the course,
and should never persist in using them when they are found to ag-
gravate the disorder.
In all cases where purging is indicated, the saline mineral waters
will be found to fulfil this intention better than any other medi-
cine. Their operation, if taken in proper quantity, is generally
mild; and they are neither found to irritate the nerves, nor debi-
litate the patient so much as other purgatives.
As a purgative, these waters are chiefly recommended in diseases   

433 DRINKING THE MINERAL WATERS.   
of the first passages, accompanied with, or proceeding from, inacti-
vity of the stomach and bowels, acidity, indigestion, vitiated bile,
worms, putrid sordes, the piles, and jaundice. In most cases of this
kind they are the best medicines that can be administered. But
when used with this view, it is sufficient to take them twice, or at
most, three times a-week, so as to move the body three or four
times; and it will be proper to continue this course for some
weeks.
But the operation of the more active mineral waters is not con-
fined to the bowels. They often promote the discharge of urine,
and not unfrequently increase the perspiration. This shews that
they are capable of penetrating into every part of the body, and of
stimulating the whole system. Hence arises their efficacy in re-
moving the most obstinate of all disorders, obstructions of the
glandular and lymphatic system. Under this class is comprehended
the scrophula or king's evil, indolent tumours, obstructions of the
liver, spleen, kidnies, and mesenteric glands. When these great
purposes are to be effected, the waters must be used in the gradu-
al manner mentioned above, and persisted in for a length of time.
It will be proper, now and then, to discontinue their use for a
few days.
The next great class of diseases, where mineral waters are found
to be beneficial, are those of the skin, as the itch, scab, tetters, ring-
worms, scaly eruptions, leprosies, blotches, foul ulcers, &c. Though
these may seem superficial, yet they are often the most obstinate
which the physician has to encounter, and not unfrequently set his
skill at defiance: but they will sometimes yield to the application of
mineral waters for a sufficient length of time, and in most cases of
this kind, these waters deserve a trial. The saline sulphureous
waters, such as those of Moffat in Scotland, and Harrowgate in
England, are the most likely to succeed in diseases of the skin;
but for this purpose, it will be necessary not only to drink the wa-
ters, but likewise to use them externally.
To enumerate more particularly the qualities of the different
mineral waters, to specify those diseases in which they are respec-
tively indicated, and to point out their proper modes of application,
would be an useful, and by no means a disagreeable employment;
but as the limits prescribed to these remarks will not allow me to
treat the subject at more length, I shall conclude, by observing,
that whenever the mineral waters are found to exhaust the strength,
depress the spirits, take away the appetite, excite fevers, distend
the bowels, or occasion a cough, they ought to be discontinued.
I3 



APPENDIX;
CONTAINING
A List of Simples, and of such Medicinal
Preparations, as ought to be kept in
Readiness for private Practice;
The Method of preparing and compound-
ing such Medicines, as are recommended
in the former Part of the Book, with the
Addition of several others of a similar
Nature:
Remarks on the Doses, Uses, and Manner
of applying the different Preparations. 
 



INTRODUCTION,
IGNORANGE and Superstition: have attributed extraordinary medi-
cal virtues to almost every production of nature. That such virtues
were often imaginary, time and experience have sufficiently shewn. Phy-
sicians, however, from a veneration for antiquity, still retain in their lifts
of medicine, many things which owe their reputation entirely to the super-
stition and credulity of our ancestors.
The instruments of medicine will always be multiplied in proportion to
men's ignorance of the nature and cause of diseases: when these are suffi-
ciently understood, the method of cure will be simple and obvious.
Ignorance of the real nature and permanent properties of those sub-
stances employed in the cure of diseases, is another reason why they have been
so greatly multiplied. Physicians thought they could effect, by a number of
ingredients, what could not be done by any one of them. Hence arose those
amazing farragos, which have so long disgraced the  medical art, and
which were esteemed powerful in proportion to the number of simples that
entered their composition.
The great variety of forms into which almost every article of medicine
has been manufactured; affords and her proof of the imperfection of the
medical art. A drug which is perhaps most efficacious in the simplest
form in which it can be administered, has been nevertheless served up in
so many different shapes, that one would be induced to think the whole
art of physic lay in exhibiting medicine under as many different modes as
possible.
Different forms of medicine, no doubt have their use; but they ought
never to be wantonly increased. They are by no means so necessary as is
generally imagined. A few grains of powdered rhubarb, jalap, or ipeca-
cuanha, will actually perform all that can be done by the different prepa-
rations of these roots, and may also be exhibited in as safe and agreeable
a manner. The same observation holds with regard to the Peruvian bark,
and many other simples of which the preparations are very numerous.
Multiplying the ingredients of a medicine, not only renders it more
expensive, but also less certain, both in its dose and operation. Nor is this
all. The compound, when kept, is cpi to spoil, or acquire qualities of a
different nature. When a medicine is rendered more safe, efficacious, or 

438 APPENDIX.
agreeable, by the addition of another, they ought, no doubt, to be joined; in
all other cases, they are better kept asunder. The combination of medi-
cines embarrasses the physician, and retards the progress of medical know-
ledge. It is impossible to ascertain the precise effect any one medicine, as
long as it is combined with others, either of a similar or dissimilar na-
ture.
In the exhibition of medicine, regard should not only be had to simplici-
ty, but likewise to elegance. Patients seldom reap much benefit from things
that are highly disagreeable to their senses. To taste or smell like a drug
is become a proverb; and to say truth, there is too much ground for it.
Indeed, no art can take away the disagreeable taste and flavour of some
drugs, without entirely destroying their efficacy: it is possible, however,
to render many medicines less disgustful, and others even agreeable; an
object highly deserving the attention of all who administer medicine.
The design of the following pages is to exhibit such a list of drugs and
medicines as may be necessary for private practice. They are considerably
more numerous than those recommended in the former part of the book,
but still greatly within the number contained in the most reformed dis-
pensatories. The same medicine is seldom exhibited under different forms;
and where different medicines answer nearly the same intention, there is
commonly no more than one of them retained. Multiplying forms of me-
dicine for the same intention, tends rather to bewilder than assist the young
practitioner, and the experienced physician can never be at a loss to vary
his prescriptions as occasion requires.
The chemical and other difficult preparations are for the most part
emitted. All of them that are used by any private practitioner are not
worth preparing. He will buy them much cheaper than he can make them.
Great care however is necessary to obtain them genuine. They are often
adulterated, and ought never to be purchased unless from persons of known
veracity. Such of them as are in common use are infected in the list of
drugs and medicines. Their proper doses, and manner of application, are
mentioned in the practical part of the book, wherever they are prescribed.
Such articles of medicine as are to be found in the house or garden of
almost every peasant, as barley, eggs, onions, &c. are likewise for the most
part omitted. It is needless to swell a list of medicines with such things
as can be obtained whenever they are wanted, and which spoil by being
kept.
The preparations made and sold by distillers and confectioners are also
generally left out. These people, by operating upon a larger plan, general-
ly make things better, while it is in their power to afford them much
cheeper, than they can be prepared by any private hand.
The quantity ordered of every medicine is as small as could well be pre-
pared, both to prevent unnecessary expense, and that the medicine might          

439 APPENDIX.                     
not spoil by keeping. Almost every medicine suffers by being kept, and should
be used as soon after it has been prepared as possible. Even simple drugs
are apt to spoil, and should therefore be laid up in small quantities; they
either rot, are consumed by infects, or evaporate so as to lose their peculiar
taste or flavour, and often become quite insignificant.
In the preparation of medicines, I have generally followed the most im-
proved dispensatories; but have taken the liberty to differ from them
wherever my own observations, or those of other practical writes, on
whose judgment I could depend, suggested an improvement.
In several compositions, the ingredient on which the efficacy of the me-
dicine principally depends is increased, while the auxiliaries, which are ge-
nerally ordered in such trifling quantities as to be of no importance, are left
out, or only such of them retained as are necessary to give the medicine a
proper consistence, or the like.
The colouring ingredients are likewise for the most part omitted. They
increase the bulk and price of the medicine; without adding any thing to
its value. It would be well if they were never used at all. Medicines are
often adulterated for the sake of a colour. Acrid and even poisonous sub-
stances are, for this purpose, sometimes introduced into those medicines
which ought to be most bland and emollient. Ointment of elder, for exam-
ple, is often mixed with verdegrise to give it a fine green colour, which
entirely frustrates the intention of that mild ointment. Those who wish
to obtain genuine medicines should pay no regard to their colour.
Some regard is likewise paid to expense. Such ingredients as greatly in-
crease the price of any composition, without adding considerably to its vir-
tue, are generally either omitted, or somewhat less expensive substituted in
their place. Medicines are by no means powerful in proportion to their
price. The cheapest are often the best; besides, they are the least apt to be
adulterated, and are always most readily obtained.
With regard to the method of compounding medicines, I have general-
ly followed that which seemed to be the most simple and natural, mention-
ing the different steps of the process in the same order in which they ought
to be taken, without paying an implicit regard to the method of other dis-
pensatories.
For many of the remarks concerning the preparation, &c. of medicines,
I have been obliged to the author of the New dispensatory. The other ob-
servations are either such as have occurred to  myself in practice, or have
been suggested in the course of reading, by authors whose names l am not
able distinctly to recollect.
I have followed the alphabetical order, both with regard to the simples
and preparations. A more scientific method would have been agreeable to 

440 APPENDIX.
some persons, but less useful to the generality of readers. The different
classes of medicine have no great dependence upon one another; and, where
they have, it is hard to say which should stand first or last; no doubt the
simple preparations ought to precede the more compound. But all the, ad-
vantages arising from this method of arrangement do not appear equal to
that single one, of being able, on the first opening of the book, to find out
any article, which, by the alphabetical order, is rendered quite easy.
The dose of every medicine is mentioned whenever it appeared neces-
sary. When this is omitted, it is to be understood that the medicine may be
used at discretion. The dose mentioned is always for an adult, unless when
the contrary is expressed. It is not an easy matter to proportion the doses
of medicine exactly to the different ages, constitutions, &c, of patients; but
happily for mankind, mathematical exactness here is by no means necessary.
Several attempts have been made to ascertain the proportional doses for
the different ages and constitutions of patients; but, after all that can be
said upon this subject, a great deal must be left to the judgment and skill
of the person who administers the medicine. The following general pro-
portions may be observed; but they are by no means intended for exact
rules. A patient between twenty and fourteen may take two-thirds of the
dose ordered for an adult; from fourteen to nine, one-half; from nine to
six, one-third; from six to four, one-fourth; from four to two, one-sixth
from two to one, a tenth; and below one, a twelfth.
dispensatories are usually written in the Latin language. Even au-
thors who write in English, generally give their prescriptions in Latin;
and some of them shew so great an attachment to that language, as first to
write their recipes in it, and afterwards translate them; while others, to
compromise the matter, write the one half in Latin and the other in Eng-
lish. I have used the plainest English I could, and hope my prescriptions
will succeed no worse for it.
N. B. The apothecary's weights, and the English wine measures, are
used throughout the whole book, the different denominations of which will
appear from the following table:
A pound contains twelve ounces.
An ounce—eight drachms.
A drachm—three scruples.
A scruple—twenty grains.
A gallon contains eight pints.
A pint—sixteen ounces.
An ounce—eight drachms.
A table-spoonful is the measure of half an ounce.
A tea-spoonful is one fourth of a tablespoonful.
Sixty drops make one tea-spoonful. 

[441]
A LIST of SIMPLES, and of such MEDICINAL PRE-
PARATIONS, as ought to be kept in Readiness for
private Practice.
AGARIC
Alum
Antimony, crude
—cinnabar of
—sulphur of
Balsam of Capivi
—of Peru
—of Tolu         
Bark, cascarilla
—cinnamon
—Mezerion
—Peruvian
—Winter's, or canella alba
Borax
Calamine stone, levigated
Castor, Russian
Caustic, common
—lunar
Earth, Fuller's
—Japan
—Armenian bole
—French ditto
Extracts of gentian
—of guaiacum
—of hellebore, black
—of hemlock
—of jalap
—of liquorice
—of Peruvian bark
—of poppies
—of wormwood
Flowers of camomile
—colt's foot
—elder
—rosemary
—damask roses
—red ditto
Fruits, almonds
—bitter apple
—cassia fistularis
—Curssao oranges
—figs, dried
—French prunes
—Jamaica pepper
—juniper berries
—nutmegs
—tamarinds 
Gum, aloes
—ammoniac, in tears
—arabic
—asafætida
—camphor
—galbanum
—gamboge
—guaiacum
—kino
—myrrh
—opium
Hartshorn, calcined
—shovings of
Herbs, lesser centaury
—peppermint
—spearmint
—penny-royal
—savin
—trefoil
—uva ursi
—wormwood
Lead, Litharge
—white
—sugar of
Lemon-peel
Mace
Magnesia alba
Manna
Mercury, crude
—calcined
Æthiop's mineral
—calomel
—corrosive sublimate
—red precipitate
—while ditto
Musk
Oil, essential, of amber
—of anise
—of cinnamons
K3
 

442 LIST OF SIMPLES, &c.
Oil, essential, of juniper
—of lemon-peel
—of peppermint
—expressed, of almonds
—of linseed
Oil of olives, or Florence oil
—of palms
—of turpentine
Orange-peel
Oyster-shells prepared
Poppy-heads
Resins, benzoin
—flowers of
—Burgundy pitch
—dragon's blood
—frankincense
—liquid florax
—white, or rosin
—scammony
Roots, birthworth
—calamus aromaticus
—contrayerva
—garlic
—gentian
—ginger
—hellebore, black, white
—jalap
—ipecacuanha
—lily, white
—liquorice
—marsh-mallow
—mezerion
—rhubarb
—sarsaparilla
—seneka
—squills
—tormentil
—turmeric
—Virginian snake
—wild valerian
—zedoary
Saffron  
Sal ammoniac, crude
—volatile
Salt, Epsom
—of Glauber
—of hartshorn
—nitre, purified, or prunel
—Polychrest
—Rochel
of tartar
Seeds, anise
—carraway
—cardamom
—coriander
—cummin
—mustard
—sweet fennel
—wild carrot
Senna
Spanish flies
Spermaceti
Spirits, athereal, or æther
—of hartshorn
—of lavender, compound
—of nitre
—ditto dulcified
—off al ammoniac
—off sea salt
—of vinegar
—of vitriol
—of wine, rectified
—volatile aromatic
Steel, filings of
—rust of, prepared
—soluble, salt of
Sulphur vivum
—balsam of
Sulphur, flowers of
Tar
—Barbadoes
Tartar, cream of
—emetic
—soluble
—vitriolated
Tin prepared
Tutty, levigated
Turpentine, Venice
Verdegrease
Vitriol, green
—blue
—white
Wax, white
—yellow
Woods, guaiacum
—logwood
—sassafras
—saunders, red
—Zinc, flowers of 

[443]
MEDICINAL PREPARATIONS.
BALSAMS.
THE Subject of this section is not the natural balsams, but certain compositions,
which, from their being supposed to possess balsamic qualities, generally go by
that name.                                                         
This class of medicine was formerly very numerous, and held in great esteem:
modern practice has reduced it to a very narrow compass.
Anodyne Balsam.
Take of white Spanish soap, one ounce; opium, unprepared, two drachms; rec-
tified spirit of wine, nine ounces. Digest them together in a gentle heat for three
days; then strain of the liquor, and add to it three drachms of camphor.
This balsam is intended to ease pain. It is of service in violent strains and rheu-
matic complaints, when not attended with inflammation. It must be rubbed with
a warm hand on the part affected; or a linen rag moistened with it may be applied
to the prrt, and renewed every third or fourth hour, till the pain abates. If the
opium is left out, this will be the saponacious balsam.                   
Locatelli's Balsam.
Take of olive oil, one pint; strasburg turpentine and yellow wax, of each half a
pound; red saunders, six drachms. Melt the wax with some part of the oil over a
gentle fire; then adding the remaining part of the oil and the turpentine; after-
wards mix in the saunders, previously reduced to a powder, and keep them stirring
together till the balsam is cold.
This balsam is recommended in erosions of the intestines, the dysentery, hæmor-
rhages, internal bruises. and in some complaints of the breast. Out wardly it is used
for healing and cleansing wounds and ulcers. The dose, when taken internally is
from two scruples to two drachms.
The vulnerary Balsam.
Take of benzoin, powered, three ounces; balsam of Peru, two ounces: hepatic
aloes, in powder, half ounce: rectified spirit of wine, two pints. Digest them
in a gentle heat for three days, and then strain the balsam.
This balsam, or rather tincture, is applied externally to heal recent wounds and
bruises. It is likewise employed internally to remove coughs, asthmas, and other
complaints of the breast. It is said to case the colic, cleanse the kidnies, and to heal
internal ulcers, &c.
The dose is from twenty to sixty drops.
This, though a medicine of some value, does not deserve the extravagant encomi-
ums which have been bestowed on it. It has been celebrated under the different
names of The Commanders Balsam, Persian Balsam, Balsam of Berne, Wade's Balsam,
Friar's Balsam, Jesuit's Drops, Turlington's Drops, &c.
BOULSES.
AS boulses are intended for immediate use, volatile salts and other ingredients
improper for being kept are admitted into their composition. They are gene-
rally composed of powders, with a proper quantity of syrup, conserve, or mucilage.
The lighter powders are commonly made up with syrup, and the more ponderous,
as mercury, &c. with conserve; but those of the lighter kind would be more conve-
niently made up with mucilage, as it increases their bulk less than the other addi-
tions, and likewise occasions the medicine to pass down more easily. 

444 APPENDIX.
Astringent Bolus.
Take of alum, in powder, fifteen grains; gum kino, five grains; syrup, a suffici-
ent quantity to make a bolus.
In an excessive flow of the menses, and other violent discharges of blood proceeding
from  relaxation, this bolus may be given every four or five hours, till the discharge
abates.                                              
Diaphoretic Bolus.
Take of gum guaiacum, in powder, ten grains; flowers of sulphur and cream of
tartar of each one scruple; simple syrup, a sufficient quantity.
In theumatic complaints, and disorders of the skin, this bolus may be taken twice
a-day. It will also be of service in the inflammatory quinsey.
Mercurial Bolus
Take of calomel, six grains; conserve of roses, half a drachm. Make a bolus.
Where mercury is necessary, this bolus may be taken twice or thrice a week. It may
be taken over night; and if it does not operate, a few grains of jalap will be proper
next day to carry it off.
Bolus of Rhubarb and Mercury.  
Take of the best rhubarb, in powder, from a scruple to half a drachm; of calomel,
from four to six grains; simple syrup, a sufficient quantity to make a bolus.
This is a proper purge in hypochondriac constitutions; but its principal intention
is to expel worms. Where a strong purge is necessary, jalap may be used instead of
the rhubarb.
Pectoral Bolus.
Take of spermaceti, a scruple; gum ammoniac, ten grains; salt of hartshorn, six
grains; simple syrup, as much as will make them into a bolus.
This bolus is given in colds and coughs of long standing, asthmas, and beginning
consumptions of the lungs. It is generally proper to bleed the patient before he be-
gins to use it.
Purging Bolus.
Take of jalap in powder, a scruple; cream of tartar, two scruples. Let them be
rubbed together, and formed into a bolus, with simple syrup.
Where a mild purge is wanted, this will answer the purpose very well. If a stronger
dose is necessary, the jalap may be increased to half a drachm or upwards.
CATAPLASMS AND SINAPISMS.
CATAPLASMS possess few or no virtues superior to a poultice, which may be
so made, as in most cases, to supply their place. They are chiefly intended ei-
ther to act as discutients, or to promote suppuration; and as they may be of service
in some cases, we shall give a specimen of each kind.
Discutient Cataplasm.
Take of barley-meal, six ounces; fresh hemlock leaves bruised, two ounces; vine-
gar, a sufficient quantity. Boil the meal and hemlock in the vinegar for a little, and
then add two drachms of the sugar of lead.
Ripening Cataplasm.
Take of white lily root, four ounces; fat figs and raw onions, bruised, of each one
ounce; yellow basilicum ointment, two ounces; gum galbanum, half an ounce;
linseed meal, as much as necessary. Boil the roots along with the figs in a sufficient
quantity of water; then bruise and add to them the other ingredients, so as to form
the whole into a soft cataplasm. The galbanum must be previously dissolved with
the yolk of an egg. 

445 APPENDIX.
Where it is necessary to promote suppuration, this cataplasm may be used by those
who choose to be at the trouble and expose of making it. I have found no application
more proper for this purpose than a poultice of bread and milk, with a sufficient
quantity of either boiled or raw onion in it, and softened with oil or fresh butter.
Sinapisms.
Sinapisms are employed to recal the blood and spirits to a weak part, as in the palsy
end atrophy. They are also of service in deep seated pains, as the sciatica, &c. When
the gout seizes the head or the stomach, they are applied to the feet to bring the dis-
order to these parts. They are likewise applied to the patient's soles in the low state
of fevers. They should not be suffered to lie on, however, till they have raised blis-
ters, but till the parts become red, and will continue so when pressed with the finger.
The sinapism is only a poultice made with vinegar instead of milk, and rendered
warm and stimulating by the addition of mustard, horse-radish, or garlic.
The common sinapism is made by taking crumb of bread and mustard-seed in pow-
der, of each equal quantities; strong vinegar, as much as is sufficient, and mixing
them so as to make a poultice.
When sinapisms, of a more stimulating nature are wanted, a little bruised garlic
may be added to the above.
CLYSTERS.
THIS class of medicines is of more importance than is generally imagined.
Clysters serve, net only to evacuate the contents of the belly, but also to convey
very active medicines into the system. Opium, for example, may be administered
in this way when it will not fit upon the stomach, and also in larger doses than at any
time it can be taken by the mouth. The Peruvian bark may likewise be, with good
effect, administered in form of clyster to persons who cannot take it by the mouth.
A simple clyster can seldom do hurt, and there are many cases where it may do
much good. A clyster even of warm water, by serving as a fomentation to the parts,
may be of considerable service in inflammations of the bladder, and the lower intes-
tines, &c.
Some substances, as the smoke of tobacco, may be thrown into the bowels in this
way, which cannot by any other means whatever. This may be easily effected by
means of a pair of hand-bellows, with an apparatus fitted to them for that purpose.
Nor is the use of clysters confined to medicines. Aliment may also be conveyed in
this way. Persons unable to swallow, have been, for a considerable time, supported
by clysters.
Emollient Clyster.
Take of linseed tea and new milk, each six ounces. Mix them.
If fifty or sixty drops of laudanum be added to this, it will supply the place of the
Anodyne Clyster.
Laxative Clyster.
Take of milk and water, each six ounces; sweet oil and fresh butter, and brown
sugar, of each two ounces. Mix them.
If an ounce of Glauber's salt, or two table-spoonfuls of common salt be added to
this, it will be the Purging Clyster.
Carminative Clyster.
Take of camomile flowers, an ounce; anise-seeds, half an ounce. Boil in a pint
and a half of water to one pint.                                   
In hysteric and hypochondriac complaints this may be administered instead of the
Fœtid Clyster, the smell of which is so disagreeable to most patients.
Oily Clyster.
To four ounces of the infusion of camomile flowers,  add an equal quantity of
Florence oil. 

446 APPENDIX.
This clyster is beneficial in bringing off the small worms lodged in the lower parts
of the alimentary canal. When given to children the quantity must be proportion-
ably lessened.                                           
Starch Clyster.
Take jelly of starch, four ounces; linseed oil, half an ounce. Liquify the jelly
over a gentle fire, and then mix in the oil.                 
In the dysentery or bloody flux, this clyster may be administered after every loose
stool, to heal the ulcerated intestines and blunt the sharpness of corroding humours.
Forty or fifty drops of laudanum may be occasionally added; in which case, it will
generally supply the place of the Astringent Clyster.
Turpentine Clyster.
Take of common decoction, ten ounces; Venice turpentine, dissolved with the
yolk of an egg, half an ounce; Florence oil, one ounce. Mix them.
This diuretic clyster is proper in obstructions of the urinary passages, and in cho-
licky complaints, proceeding from gravel.
Vinegar Clyster.
This clyster is made by mixing three ounces of vinegar with five of water-gruel.
It answers all the purposes of a common clyster, with the peculiar advantage of
being proper either in inflammatory or putrid disorders, especially the latter.
We think it unnecessary to give more examples of this class of medicines, as
ingredients adapted to any particular, intention may be occasionally added to one or
other of the above forms.
COLLYRIA or EYE-WATERS.
EYE-WATERS have been multiplied without number, almost every person pre-
tending to be possessed of some secret preparation for the cure of sore eyes. I
have examined many of them, and find that they are pretty much alike, the basis of
most of them being either alum, vitriol, or lead. Their effects evidently are, to
brace and restore the tone of the parts; hence they are principally of service in
slight inflammations, and in that relaxed state of the parts which is induced by ob-
stinate ones.               
Camphor is commonly added to these compositions; but as it seldom incorporates
properly with the water, it can be of little use. Boles, and other earthy substances,
as they do not dissolve in water, are likewise unfit for this purpose.
Collyrium of Alum.
Take of alum, half a drachm; agitate it well together with the white of one egg.
This is the Collyrium of Riverius. It is used in inflammation of the eyes, to allay
heat, and restrain the flux of humours. It must be spread upon linen, and applied to
the eyes; but should not be kept on above three or four, hours at a time.
Vitriolic Collyrium.
Take of white vitriol, half a drachm; rose-water, six ounces. Dissolve the vi-
triol in the water, and filter the liquor.                                         
This, though simple, is perhaps equal in virtue to most of the celebrated collyria.
It is an useful application in weak, watery, and inflamed eyes. Though the slighter
inflammations will generally yield to it, yet in those of a more obstinate nature, the
assistance of bleeding and blistering will often be necessary.
When a strong astringent is judged proper, a double or triple quantity of the vi-
triol may be used. I have seen a solution of four times the strength of the above used
with manifest advantage.
Collyrium of Lead.
Take sugar of lead, and crude sal ammoniac, of each four grains. Dissolve them
in eight ounces of common water. 

447 APPENDIX.
Forty or fifty drops of laudanum may be occasionally added to this collyrium,
Those who chuse may substitute instead of this the collyrium of lead recommended
by Goulard; which is made by putting twenty-five drops of his Extract of Lead to
eight ounces of water, and adding a tea-spoonful of brandy.
Indeed, common water and brandy, without any other addition, will in many
cases answer very well as a collyrium. An ounce of the latter may be added to five
or six ounces of the former; and the eyes, if weak, bathed with it night and morning.
CONFECTIONS.
CONFECTIONS containing above sixty ingredients are still to be found in some
of the most reformed dispensatories. As most of their intentions, however,
may be more certainly, and as effectually answered by a few glasses of wine or grains
of opium, we shall pass over this class of medicines very slightly.
Japonic Confection.
Take of Japan earth, three ounces; tormentil root, nutmeg, olibanum, of each
two ounces; opium dissolved in a sufficient quantity of Lisbon wine, a drachm and a
half; simple syrup and conserve of roses, of each fourteen ounces. Mix and make
them into an electuary.
This supplies the place of the Diascordium.
The dose of this electuary is from a scruple to a drachm.
CONSERVES AND PRESERVES
POSSESS very few medicinal properties, and may rather be classed among
sweetmeats than medicines.—They are sometimes, however, of use, for reduc-
ing into boluses or pills some of the more ponderous powders, as the preparations of
iron, mercury, and tin.
Conserves are compositions of fresh vegetables and sugar, beaten together into an
uniform mass. In making these preparations, the leaves of vegetables must be freed
from their stalks, the flowers from their cups, and the yellow part of orange-peel
taken off with a rasp. They are then to be pounded in a marble mortar, with a
wooden pestle, into a smooth mass; after which, thrice their weight of fine sugar is
commonly added by degrees, and the beating continued till they are uniformly mix-
ed; but the conserve will be better if only twice its weight of sugar be added.
Those who prepare large quantities of conserve generally reduce the vegetables to
a pulp by the means of a mill, and afterwards beat them up with sugar.
Conserve of Red Roses.
Take a pound of red rose buds, cleared of their heels; beat them well in a mor-
tar, and, adding by degrees two pounds of double-refined sugar, in powder, make a
conserve.                                                  
After the same manner are prepared the conserves of orange-peel, rosemary-flowers,
sea-wormwood, of the leaves of wood-sorrel, &c.                   
The conserve of roses is one of the most agreeable and useful preparations belong-
ing to this class. A drachm or two of it, dissolved in warm milk, is ordered to be
given as a gentle restringent in weakness of the stomach and likewise in phthisical
coughs, and spitting of blood. To have any considerable effects, however, it must
be taken in larger quantities.
Conserve of Sloes.
This may be made by boiling the sloes gently in water, being careful to take them
out before they burst; Afterwards expressing the juice, and beating it up with three
times its weight of fine sugar.
In relaxations of the uvula and glands of the throat, this makes an excellent gargle,
and may be used at discretion
Preserves are made by steeping or boiling fresh vegetables first in water, and after-
wards in syrup, or a solution of sugar. The subject is either preserved moist in the
syrup or taken out and dried, that the sugar may candy upon it. The last is the
most usual method.

448 APPENDIX
Candid Orange Peel.
Soak Seville orange-peel in several waters, till it loses its bitterness; then boil is
in a solution of double-refined sugar in water. till it becomes tender and transparent.
Candid lemon-peel is prepared in the same manner.
It is needless to add more of these preparations, as they belong rather to the art of
the confectioner than that of the apothecary.
DECOCTIONS.
WATER readily extracts the gummy and saline parts of vegetables; and though
its action is chiefly confined to these, yet the resinous and oily being intimately
blended with the gummy and saline, are in great part taken up along with them.
Hence watery decoctions and infusions of vegetables, constitute a large, and not un-
useful, class of medicines. Although most vegetables yield their virtues to water,
as well by infusion as decoction, yet the latter is often necessary, as it saves time, and
does in a few minutes what the other would require hours, and sometimes days, to effect.
The medicines of this class are all intended for immediate use.
Decoction of Althœa.
Take of the roots of marsh-mallows, moderately dried, three ounces; raisins of
the sun, one ounce; water three pints.
Boil the ingredients in the water till one third of it is consumed; afterwards strain
the decoction and let it stand for some time to settle. If the roots be thoroughly
dried, they must be boiled till one half of the water be consumed.
In coughs, and sharp defluctions upon the lungs, this decoction may be used for
ordinary drink.
The Common Decoction.
Take of camomile flowers, one ounce; elder flowers, and sweet fennel seeds, of
each half an ounce; water, two quarts. Boil them for a little, and then strain the
decoction.    
A medicine equally good may be prepared by infusing the ingredients for some
hours in boiling water.
This decoction is chiefly intended as the basis of clysters, to which other ingredients
may be occasionally added. It will likewise serve as a common fomentation, spirit
of wine or other things being added in such quantity as the case may require.
Decoction of Logwood.
Boil three ounces of the shavings, or chips of logwood, in four pints of water, till
one half the liquor is wasted. Two or three ounces of simple cinnamon-water may
be added to this decoction.
In fluxes of the belly, where the stronger astringents are improper, a teacupful of
this decoction may be taken with advantage three or four times a-day.
Decoction of the Bark.
Boil an ounce of the Peruvian bark, grossly powdered, in a pint and a half of
water to one pint; then strain the decoction. If a tea-spoonful of the weak spirit of
vitriol be added to this medicine, it will render it both more agreeable and efficacious.
Compound  Decoction of the Bark.
Take of Peruvian bark and Virginia snake-root, grossly powdered, each three
drachms. Boil them in a pint of water to one half. To the strained liquor add an
ounce and an half of aromatic water.
Sir John Pringle recommends this as a proper medicine towards the decline of ma-
lignant fevers, when the pulse is low, the voice weak, and the head affected with
a stupor but with little delirium.
The dose is four spoonfuls every fourth or sixth hour. 

449 APPENDIX.
Decoction of Sarsaparilla.
Take of fresh sarsaparilla root, sliced and bruised, two ounces; shavings of guai-
acum wood, one ounce. Boil over a slow fire, in three quarts of water, to one;
adding towards the end, half an ounce of sassafras wood, and three drachms of liquo-
rice. Strain the decoction.
This may either be employed as an assistant to a course of mecurial alteratives,
or taken after the mercury has been used for some time. It strengthens the stomach,
and restores flash and vigour to habits emaciated by the venereal disease. It may also
be taken in the rheumatism, and cutaneous disorders proceeding from foulness of the
blood and juices. For all these intentions it is greatly preferable to the Decoctions of
Woods.
This decoction may be taken, from a pint and a half to two quarts in the day.
The following decoction is said to be similar to that used by Kennedy, in the cure
of the venereal disease, and may supply the place of the Lisbon diet drink:
Take of sarsaparilla, three ounces; liquorice and mezerion root, of each half an
ounce; crude antimony, powdered, an ounce and a half. Infuse these ingredients in
eight pints of boiling water for twenty-four hours, then boil them till one half of the
water is consumed; afterwards strain the decoction.
This decoction may be used in the same manner as the preceding.
Decoction of Seneka.
Take of seneka rattle-snake root, one ounce; water, a pint and a half.   
one pint, and strain.                                                       
This decoction is recommended in the pleurisy, dropsy, rheumatism, and some ob-
stinate disorders of the skin. The dose is two ounces, three or four times a-day, or
oftener, if the stomach will bear it.
White Decoction.
Take of the purest chalk, in powder, two ounces; gum arabic, half an ounce;
water, three pints. Boil to one quart, and strain the decoction.                
This is a proper drink in acute diseases, attended with, or inclining to a looseness,
and where acidities abound in the stomach, or bowels. It is peculiarly proper for
children when afflicted with sourness of the stomach, and for persons who are subject
to the heartburn. It may be sweetened with sugar, as it is used, and two or three
ounces of simple cinnamon-water added to it.                          
An ounce of powdered chalk, mixed with two pints of water, will occasionally
supply the place of this decoction, and also of the chalk julep.
DRAUGHTS.
THIS is a proper form for exhibiting such medicines as are intended to operate im-
mediately, and which do not need to be frequently repeated; as purges, vomits,
and a few others, which are to be taken at one dose. Where a medicine requires to
be used for any length of time, it is better to make up a larger quantity of it at once,
which saves both time and expense.
Anodyne Draught.
Take of liquid laudanum, twenty-five drops: simple cinnamon-water, an ounce,
common syrup, two drachms. Mix them.                       
In excessive pain, where bleeding is not necessary, and in great restlessness, this
composing draught may be taken and repeated occasionally.
Diuretic Draught.
Take of the diuretic salt, two scruples; syrup of poppies, two drachms; simple
cinnamon-water, and common water, of each an ounce.
This draught is of service in an obstruction or deficiency of urine.
Purging Draughts.
Take of manna, an ounce; soluble tartar, or Rochel salt from three to four
drachms. Dissolve in three ounces of boiling water: to which add Jamaica pepers
water, half an ounce.
L3 

450 APPENDIX.
As manna sometimes will not fit upon the stomach, an ounce or ten drachms of the
purging salts. dissolved in four ounces of water, may he taken instead of the above.
Those who cannot take salts may use the following draught:
Take of jalap in powder, a scruple; common water, an ounce; aromatic tincture
six drachms. Rub the jalap with twice its weight of sugar, and add to it the other
ingredients.
Sweating Draught.
Take spirit of Mindererus, two ounces; salt of hartshorn, five grains; simple
cinnamon-water, and syrup of poppies, of each half an ounce. Make them into a
draught.
In recent colds and rheumatic complaints, this draught is of service. To promote
its effects, however, the patient ought to drink freely of warm water-gruel, or of
some other weak diluting liquor.
Vomiting Draughts.
Take of ipecacuanha, in powder, a scruple; water, an ounce; simple syrup. a
drachm. Mix them.                                            
Persons who require a stronger vomit, may add to the above half a grain, or a
grain of emetic tartar.
Those who do not chuse the powder, may take ten drachms of the ipecacuanha
wine; or half an ounce of the wine; and an equal quantity of the syrup of squills.
ELECTUARIES.
ELECTUARIES are generally composed of the lighter powders, mixed with
syrup, honey, conserve, or mucilage, into such a consistence that the powders
may neither separate by keeping, nor the mass prove too stiff for swallowing. They
receive chiefly the milder alteratives medicine, and such as are not ungrateful to the
palate.
Astringent electuaries, and such as have pulps of fruit in them, should be prepa-
red only in small quantities; as astringent medicines lose their virtues by being kept
in this form, and the pulps of fruits are apt to ferment.
For the extraction of pulps it will be necessary to boil unripe fruits, and ripe ones
if they are dried, in a small quantity of water till they become soft. The pulp is
then to be pressed out through a strong hair sieve, or thin cloth, and afterwards
boiled to a due consistence, in an earthen vessel, over a gentle fire, taking care to
prevent the matter from burning by continually stirring it. The pulps of fruits that
are both ripe and fresh may be pressed out without any previous boiling.
Lenitive Electuary.
Take of senna, in fine powder, eight ounces; coriander seed, also in powder, four
ounces; pulp of tamarinds and of French prunes, each a pound. Mix the pulps and
powders together, and with a sufficient quantity of simple syrup, reduce the whole
into an electuary.
A tea-spoonful of this electuary, taken two or three times a-day, generally proves
an agreeable laxative. It likewise serves as a convenient vehicle for exhibiting more
active medicines as jalaps, scammony, and such like.
This may supply the place of the electuary of Cassia.
Electuary for the Dysentery.
Take of the Japonic confection, two ounces; Locatelli's balsam, one ounce;
rhubarb, in powder, half an ounce; syrup of marshmallows, enough to make an
electuary.
It is often dangerous in dysenteries to give Opiates and astringents, without inter-
posing purgatives. The purgative is here joined with these ingredients, which ren-
ders this a very safe and useful medicine for the purposes expressed in the title.
About the bulk of a nutmeg should be taken twice or thrice a-day, as the symp-
toms and constitution may require.
Electuary for the Epilepsy.
Take of Peruvian bark, in powder, an ounce; of powdered tin, and wild vale-
iran root, each half an ounce; simple syrup, enough to make an electuary. 

451 APPENDIX.
Dr. Mead directs a drachm of an electuary similar to this to be taken evening and
morning, in the epilepsy, for the space of three months. It will be proper, how-
ever, to discontinue the use of it for a few days every now and then. I have added
the powdered tin, because the epilepsy often proceeds from worms.
Electuary for the Gonorrhœa.
Take of lenitive electuary, three ounces; jalap and rhubarb, in powder, of each
two drachms; nitre, half an ounce; simple syrup, enough to make an electuary.
During the inflammation and tension of the urinary passages, which accompany a
virulent gonorrhœa, this cooling laxative may be used with advantage.
The dose is a drachm, or about the bulk of a nutmeg, two or three times a-day;
more or less, as may be necessary to keep the body gently open.
An electuary made of cream of tartar and simple syrup will occasionally supply the
place of this.
After the inflammation is gone off, the following electuary may be used:
Take of lenitive electuary, two ounces; balsam of capivi, one ounce; gum
guaiacum and rhuburb, in powder, of each two drachms; simple syrup, enough to
make an electuary. The dose is the same as of the preceding.
Electuary of the Bark.
Take of Peruvian bark, in powder, three ounces; cascarilla, half an ounce; sy-
rup of ginger, enough to make an electuary.
In the cure of obstinate intermitting fevers, the bark is assisted by the cascarilla. In
hectic habits, however, it will be better to leave out the cascarilla, and put three
drachms of crude sal ammoniac in its stead.
Electuary for the Piles.
Take flowers of sulphur, one ounce; cream of tartar, half an ounce; treacle, a
sufficient quantity to form an electuary.
A tea-spoonful of this may be taken three or four times a day.
Electuary for the Palsy.
Take of powdered mustard-seed, and conserve of roses, each an oance; syrup of
ginger, enough to make an electuary.
A tea-spoonful of this may be taken three or four times a-day.
Electuary for the Rheumatism.
Take of conserve of roses, two ounces; cinnabar of antimony, levigated, an ounce
and a half; gum guaiacum, in powder, an ounce; syrup of ginger, a sufficient
quantity to make an electuary.
In obstinate rheumatisms, which are not accompanied with a fever, a tea-spoonful
of this electuary may be taken twice a- day with considerable advantage.
EMULSIONS.
EMULSIONS, beside their use as medicines, are also proper vehicles for certain
substances, which could not otherwise be conveniently taken in a liquid form.
Thus camphor, triturated with almonds, readily unites with water into an emulsion,
Pure oils, balsams, resins, and other similar substances, are likewise rendered mis-
cible with water by the intervention of mucilages.
Common Emulsion.
Take of sweet almond, an ounce; bitter almonds, a drachm; water two pints.
Let the almonds be blanched, and beat up in a marble mortar; adding the water
by little and little, so as to make an emulsion; afterwards let it be strained. 

452 APPENDIX.
Arabic Emulsion.
This is made in the same manner as the above, adding to the almonds, while
beating, two ounces and a half of the mucilage of gum arabic.
Where soft cooling liquors are necessary, these emulsions may be used as ordinary
drink.
Camphorated Emulsion.
Take of camphor, half a drachm; sweet almonds, half a dozen; white ugar,
half an ounce, mint water, eight ounces. Grind the camphor and almonds well
together in a stone mortar, and add by degrees the mint water; then strain the liquor,
and dissolve in it the sugar.
In fevers, and other disorders which require the use of camphor, a table-spoonful
of this emulsion may be taken every two or three hours.
Emulsion of Gum Ammoniac.
Take of gum ammoniac, two drachms; water, eight ounces. Grind the gum
with the water poured upon it by little and little, till it is dissolved.
This emulsion is used for attenuating tough, viscid phlegm, and promoting expec-
toration. In obstinate coughs, two ounces of the syrup of poppies may be added to
it. The dose is two table-spoonfuls three or four times a-day.
Oily Emulsion.
Take of soft water, six ounces; volatile aromatic spirit, two drachms; Florence
oil, an ounce; shake them well together, and add, of simple syrup, half an ounce.
In recent colds and coughs, this emulsion is generally of service; but if the cough
proves obstinate, it will succeed better when made with the paregoric elixir of the
Edinburgh dispensatory, instead of the volatile aromatic spirit. A table-spoonful of
it may be taken every two or three hours.
EXTRACTS.
EXTRACTS are prepared by boiling the subject in water, and evaporating the
strained decoction to a due consistence, By this process some of the more active
parts of plants are freed from the useless, indissoluble earthy matter, which makes
the larger share of their bulk. Water, however, is not the only menstruum used in
the preparation of extracts; sometimes it is joined with spirits, and at other times
rectified spirit alone is employed for that purpose.
Extracts are prepared from a variety of different drugs, as the bark, gentian, jalaps,
&c.; but as they require a troublesome and tedious operation, it will be more con-
venient for the private practitioner to purchase what he needs of them from a profes-
sed druggist, than to prepare them himself. Such of them as are generally used are
inferted in our list of such drugs and medicines as are to be kept for private practice.
FOMENTATIONS.
FOMENTATIONS are generally intended either to ease pain, by taking off ten-
sion 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 water, and the second by cold. Certain substances, however, are usually added
to water, with a view to heighten its effects, as anodynes, aromatics, astringents, &c.
We shall therefore subjoin a few of the most useful medicated fomentation, that peo-
ple may have it in their power to make use of them if they choose.
Anodyne Fomentation.
Take of white poppy-heads, two ounces; elder flowers, half an ounce; water,
three pints. Boil till one pint is evaporated, and strain out the liquor.
This fomentation, as its title expresses, is used for relieving acute pain. 

453 APPENDIX.
Aromatic Fomentation.
Take of Jamaica pepper, half an ounce; red wine, a pint. Boil them for a little,
and then strain the liquor.
This is intended, not only as a topical application for external complaints, but al-
so for relieving the internal parts. Pains of the bowels, which accompany dysente-
ries and diarrhœas, flatulent colics, uneasiness of the stomach, and reaching to vo-
mit, are frequently abated by fomenting the abdamen and region of the stomach
with the warm liquor.
Common Fomentation.
Take tops of wormwood and camomile flowers, dried, of each two ounces; wa-
ter, two quarts. After a slight boiling, pour off the liquor.
Brandy or spirit of wine may be added to this fomentation, in such quantity as the
particular circumstances of the case shall require; but these are not always necessary.
Emollient Fomentation.
This is the same as the common decoction.
Strengthening Fomentation.
Take of oak bark, one ounce; granate peel, half an ounce; alum, two drachms;
smith's forge water, three pints. Boil the water with the bark and peel to the con-
sumption of one-third; then strain the decoction, and dissolve it in alum. 
this astriagent liquor is employed as an external fomentation to weak parts; it
may also be used internally.
GARGLES.
HOWEVER trifling this class of medicines may appear, they are by no means
without their use. They seldom indeed cure diseases, but they often alleviate
very disagreeable symptom; as parchedness of the mouth, foulness of the tongue
and fauces, &c. they are peculiarly useful in fevers and sore throats. In the latter,
a gargle will sometimes remove the disorder; and in the former, few things are more
refreshing or agreeable to the patient, than to have his mouth frequently washed with
some soft detergent gargle.
One advantage of these medicines is, that they are easily prepared. A little barley-
water and honey may be had any where; and if to these be added as much vinegar
as will give them an agreeable sharpness, they will make a very useful gargle for
softening and cleansing the mouth.
Gargles hare the best effect when injected with a syrup.
Attenuating Gargle.
Take of water, six ounces; honey one ounce; nitre, a drachm and a half. Mix
them.
This cooling gargle may be used either in the inflammatory quinsey, or in fevers,
for cleansing the tongue and fauces.
Common Gargle.
Take of rose-water, six ounces; syrup of clove July-flowers, half an ounce; spirit
of vitriol, a sufficient quantity to give it an agreeable sharpness. Mix them.
This gargle, besides cleansing the tongue and fauces, acts as a gentle repellant,
and will sometimes remove a slight quinsey.
Detergent Gargle.
Take of the emollient gargle, a pint; tincture of myrrh, an ounce; honey, two
ounces. Mix them.                                                    
When exulcerations require to be cleansed, or the excretion of tough viscid saliva
promoted, this gargle will be of service. 

454 APPENDIX.
Emollient Gargle.
Take an ounce of marshmallow roots, and two or three figs; boil them in a quart
of water till near one half of it be consumed; then strain out the liquor.
If an ounce of honey, and an half an ounce of spirit of sal-ammoniac, be added to
the above it will then be an exceeding good attenuating gargle.
This gargle is beneficial in fevers, where the tongue and fauces are rough and par-
ched, to soften these parts, and promote the discharge of saliva.
The learned and accurate Sir John Pringle observes, that in the inflammatory
quinsey, or strangulation of the fauces, little benefit arises from the common gargles
that such as are of an acid nature do more harm than good, by contracting the
emunctories of the saliva and mucus, and thickening those humours; that a decoction
of figs in milk and water has a contrary effect, especially if some sal ammoniac be ad-
ded; by which the saliva is made thinner, and the glands brought to secrete more
freely; a circumstance always conducive to the cure.
INFUSIONS.
VEGETABLES yield nearly the same properties to water by infusion as by de-
coction; and though they may require a longer time to give out their virtues
in this way, yet it has several advantages over the other; since boiling is found to
dissipate the finer parts of many hitter and aromatic substances, without more fully
extracting their medicinal principles.
The author of the New dispensatory observes, that even from those vegetables
which are weak in virtue, rich infusions may be obtained, by returning the liquor
upon fresh quantities of the subject, the water loading itself more and more with the
active parts; and that these loaded infusions are applicable to valuable purposes in
medicine, as they contain in a small compass, the finer, more subtile, and active
principles of vegetables, in a form readily miscible with the fluids of the human bo-
dy
Bitter Infusion.
Take tops of the lesser centaury and camomile flowers, of each half an ounce;
yellow rind of lemon and orange peel, carefully freed from the inner white part, of
each two drachms. Cut them in small pieces, and infuse them in a quart of boiling
water.
For indigestion, weakness of the stomach, or want of appetite, a tea-cupful of this
infusion may be taken twice or thrice a day.
Infusion of the Bark.
To an ounce of the bark, in powder, add four or five table-spoonfuls of brandy,
and a pint of boiling water. Let them infuse for two or three days.
This is one of the best preparations of the bark for weak stomachs. In disorders
where the corroborating virtues of that medicine are required, a tea-cupful of it may
be taken two or three times a-day.
Infusion of Carduus.
Infuse an ounce of the dried leaves of carduus benedictus, or blessed thistle, in a
pint of common water, for six hours, without heat; then filter the liquor through
paper.
This light infusion may be given, with great benefit, in weakness of the stomach
where the common bitters do not agree. It may be flavoured at pleasure with cin-
namon, or other aromatic materials.
Infusion of Linseed.
Take of linseed, two spoonfuls; liquorice root, sliced, half an ounce; boiling
water, three pints. Let them stand to infuse by the fire for some hours, and then
strain off the liquor.
If an ounce of the leaves of colt's-foot be added to these ingredients, it will then be
the pectoral infusion. Both these are emollient mucilaginous liquors, and may be ta-
ken with advantage as ordinary drink in difficulty of making water; and in coughs
and other complaints of the breast. 

455 APPENDIX.
Infusion of roses.
Take of red roses, dried, half an ounce; boiling water, a quart; vitriolic acid
commonly called oil of vitriol, half a drachm; loaf sugar, an ounce.
Infuse the roses in the water four hours, in an unglazed earthen vessel; after-
wards pour in the acid, and having strained the liquor, add to it the sugar.
In an excessive flow of the menses, vomiting of blood, and other hæmorrhages, a
tea-cupful of this gently astringent infusion may be taken every three or four hours.
It likewise makes an exceeding good gargle.
As the quantity of roses used here can have little or no effect, an equally valuable
medicine may be prepared by mixing the acid and water without infusion.
Infusion of Tamarinds and Senna.
Take of tamarinds, one ounce; senna, and crystals of tartar, each two drachms.
Let these ingredients be infused four or five hours in a pint of boiling water; after 
wards let the liquor be strained, and an ounce or two of the aromatic tincture added
to it. Persons who are easily purged may leave out either the tamarinds or the crys-
tals of tartar.
This is an agreeable cooling purge. A tea-cupful may be given every half hour
till it operates
This supplies the place of the decoction of tamarinds and senna.
Spanish Infusion.
Take of Spanish juice, cut into small pieces, an ounce; salt of tartar, three drachms.
Infuse in a quart of boiling water for a night. To the strained liquor add an ounce
and an half of the syrup of poppies.
In recent colds, coughs, and obstructions of the breast, a tea-cupful of this infusion-
may be taken with advantage three or four times a-day.
Infusion for the Palsey.
Take of horse-radish root shaved, mustard seed bruised, each four ounces; outer
rind of orange peel, one ounce. Infuse them in two quarts of boiling water, in a
close vessel, for twenty-four hours.
In paralytic complaints, a tea-cupful of this warm stimulating medicine may be
taken three or four times a-day. It excites the action of the solids, proves diuretic,
and, if the patient be kept warm, promotes perspiration.
If two or three ounces of the dried leaves of marsh-trefoil be used instead of the
mustard, it will make the antiscorbutic infusion.
JULEPS.
THE basis of juleps is generally common water, or some simple distilled water,
with one-third or one-fourth its quantity of distilled spirituous water, and as
much sugar or syrup as is sufficient to render the mixture agreeable. This is sharpened
with vegetable or mineral acids, or impregnated with other medicines suitable to the
intention.
Camphorated Julep.
Take of camphor, one drachm; gum arabic, half an ounce; double refined sugar,
an ounce; vinegar a pint. Grind the camphor with a few drops of rectified spirit of
wine till it grows soft; then add the gum, previously reduced to a mucilage with
equal its quantity of water, and rub them together till they are perfectly united. To
this mixture add, by little and little, the vinegar with the sugar dissolved in it, still
continuing the trituration.                                   
In hysterical and other complaints where camphor is proper, this julep may be ta-
ken in the dose of a spooful or two as often as the stomach will bear it.
Cordial Julep.
Take of simple cinnamon-water, four ounces; Jamaica pepper-water, two ounces;
volatile aromatic spirit, and compound spirit of lavender, of each two drachms; syrup
of orange-peel, an ounce. Mix them.
This is given in the dose of two spoonfuls three or-four times X-day, in disorders
accompanied with great weakness and depression of spirit. 

456 APPENDIX.
Expectorating Julep.
Take of the emulsion of gum ammoniac, six ounces; syrup of squills, two ounces.
Mix them.
In coughs, asthmas, and obstructions of the breast, two table spoonfuls of this julep
may be taken every three or four hours.
Musk Julep.
Rub half a drachm of musk well together with half an ounce of sugar, and add to it,
gradually, of simple cinnamon and pepper-mint water, each two ounces; of the vola-
tile aromatic spirit, two drachms.
In the low state of nervous fevers, hiccupping, convulsions, and other spasmodic af-
fections, two table-spoonfuls of this julep may be taken every two or three hours.
Saline Julep.
Dissolve two drachms of salt of tartar in three ounces of fresh lemon-juice, strained
when the effervescence is over, add, of mint-water, and common water, each two
ounces; of simple syrup, one ounce.
This removes sickness at the stomach, relieves vomiting, promotes perspiration,
and may be of some service in fevers, especially of the inflammatory kind.
Vomitting Julep.
Dissolve four grains of emetic tartar in eight ounces of water, and add to it half
an ounce of the syrup of clove July-flowers.
In the beginning of fevers, where there is no topical inflammation, this julep may
be given in the dose of one table-spoonful every quarter of an hour till it operates.
Antimonial vomits serve not only to evacuate the contents of the stomach, but like-
wise to promote the different execrations. Hence they are found in fevers to have
nearly the same effects as Dr. James's Powder.
MIXTURES.
A MIXTURE differs from a julep in this respect, that it receives into its com-
position not only salts, extracts, and other substances dissoluble in water, but
also earths, powders, and such substances as cannot be dissolved. A mixture is sel-
dom an agreeable medicine. It is nevertheless necessary. Many persons can take a
mixture, who are not able to swallow a bolus or an electuary: besides, there are me-
dicines which act better in this than in any other form.
Astringent Mixture.
Take simple cinnamon-water and common water, of each three ounces; spiriti-
ous cinnamon-water, one ounce and a half; Japonic confection, half an ounce. Mix
them.                                                               
In dysenteries which are not of long standing, after the necessary evacuations, a
spoonful or two of this mixture may be taken every four hours, interposing every se-
cond or third day a dole of rhubarb.
Diuretic Mixture.
Take of mint-water, five ounces; vinegar of squills, six drachms; sweet spirit of
nitre, half an ounce; syrup of ginger, an ounce and a half. Mix them.
In obstructions. of the urinary passages, two spoonfuls of this mixture. may be taken
twice or thrice a-day.
Laxative Absorbent Mixture.                
Rub one drachm of magnesia alba in a mortar with ten or twelve grains of the best
Turkey rhubarb, and add to them three ounces of common water; simple cinnamon
water, and syrup of sugar, of each, one ounce.
As most diseases of infants are accompanied, with acidities, this mixture may ei-
ther be given with a view to correct these, or to open the body. A table-spoonful
may be taken for a dose, and repeated three times a-day. To a very child
half a spoonful will be sufficient.

457 APPENDIX.
When the mixture is intended to purge, the dose may either be increased, or the
quantity of rhubarb doubled.
This is one of the most generally useful medicines for children with which I am
acquainted.
Saline Mixture.
Dissolve a drachm of the salt of tartar in four ounces of boiling water; and, when
cold, drop into it, spirit of vitriol, till the effervescence ceases; then add, of pepper-
mint-water, two ounces, simple syrup, one ounce.
Where fresh lemons cannot be had, this mixture may occasionally supply the plate
of the saline julep.
Squill Mixture.
Take of simple cinnamon-water, five ounces; vinegar of squills, one ounce; syrup
of marshmallows, an ounce and a half. Mix them. 
This mixture, by promoting expectoration, and the secretion of urine, proves ser-
viceable in asthmatic and dropsical habits. A table-spoonful of it may be taken fre-
quently.
OINTMENTS, LINIMENTS, AND CERATES.
NOTWITHSTANDING the extravagant encomiums which have been bestowed
on different preparations of this kind, with regard to their efficacy in the
cure of wound, sores, &c. it is beyond a doubt, that the most proper application to
a green wound is dry lint. But though ointments do not heal wounds and sores, yet
they serve to defend them from the external air, and to retain such substances as may
be necessary for drying, deterging, destroying proud flesh, and such-like. For these
purposes, however, it will be sufficient to insert only a few of the most simple forms,
as ingredients of a more active nature can occasionally be added to them.
Yellow Basilicum Ointment.
Take ef yellow wax, white resin, and frankincense, each a quarter of a pound;
melt them together over a gentle fire; then add, of hogs'-lard prepared, one pound.
Strain the ointment while warm.
This ointment is employed for cleansing and healing wounds and ulcers.
Ointment of Calamine
Take of olive oil, a pint and a half; white wax, and calamine stone, levigated, of
each half a pound. Let the calamine stone, reduced into a fine powder, be rubbed
with some part of the oil, and afterwards added to the rest of the oil and wax, pre-
viously melted together, continually stirring them till quite cold.
This ointment, which is commonly known by the name of Turner's Cerale, is an
exceeding good application in burns and excoriations, from whatever cause.
Emollient Ointment.
Take of palm oil, two pounds; olive oil, a pint and a half; yellow wax, half a
pound; Venice turpentine, a quarter of a pound. Melt the wax in the oils over a
gentle fire; then mix in the turpentine, and strain the ointment.
This supplies the place of Althæa Ointment. It may be used for anointing inflamed
parts, &c.
Eye Ointments.
Take, of hogs'-lard prepared, four ounces; white wax, two drachms; tutty pre-
pared, one ounce; melt the wax with the lard, over a gentle fire, and then sprinkle
in the tutty continually stirring then till the ointment is cold.
This ointment will be more efficacious, and of a better consistence, if two or three
drachms of camphor be rubbed up with a little oil, and intimately mixed with it,
M5 

458 APPENDIX.
Another.
Take of camphor, and calamine stone levingated, each six drachms; verdegrease
Well prepared, two drachms; hogs'-lard, and mutton suet prepared, of each two
ounces. Rub the camphor well with the powder; afterwards mix in the lard and
suet, continuing the triture till they he perfectly united.
This ointment has been long in esteem for disease of the eyes. It ought, however
to be used with caution, when the eyes are much inflamed, or very tender.
Issue Ointment.
Mix half an ounce of Spanish flies, finely powdered, in six ounces of yellow basili-
cum ointment.
This ointment is chiefly intended for dressing blisters, in order to keep them open
during pleasure.            
Ointment of Lead.
Take of olive oil, half a pint; white wax. two ounces, sugar of lead three drachms.
Let the sugar of lead, reduced into a fine powder, be rubbed up with some part of the
oil, and afterwards added to the other ingredients, previously melted together, con-
tinually stirring them till quite cold.
This cooling and gently astringent ointment may be used in all cases where the
intention is to dry and skin over the part, as in scalding, &c.
Mercurial Ointment.
Take of quicksilver, two ounces; hogs'-lard, three ounces; mutton suet, ope ounce.
Rub the quicksilver with an ounce of the hogs'-lard, in a warm mortar, till the glo-
bules be perfectly extinguished; then rub it up with the rest of the lard and suet, pre-
viously melted together.
The principal intention of this ointment is to convey mercury into the body by
being rubbed upon the skin.
Ointment of Sulphur.
Take of hogs'-lard prepared, four ounces; flowers of sulphur, an ounce and a
half; crude sal ammoniac, two drachms; essence of lemon, ten or twelve drops.
Make them into an ointment.
This ointment rubbed upon the parts affected, will generally cure the itch. It is
both the safest and best application for that purpose, and, when made in this way,
has no disagreeable smell.
White Ointment.
Take of olive oil, one pint; white wax and spermaceti, of each three ounces.
Melt them with a gentle heat, and keep them constantly and briskly stirring toge-
ther, till quite cold.
If two drachms of camphor, previously rubbed with a small quantity of oil, be
added to the above, it will make the White camphorated Ointment.
Liniment for Burns.
Take equal parts of Florence oil, or of fresh drawn linseed oil, and lime-water;
shake them well together in a wide-mouthed bottle, so as to form a liniment.
This is found to be an exceeding proper application for recent scalds or burns. It
may either be spread upon a cloth, or the parts affected may be anointed with it
twice or thrice a-day.
White Liniment.
This is made in the same manner as the white ointment, two-thirds of the wax
being left out.
This liniment may be applied in cases of excoriation, where, on account of the
largeness of the surface, the ointments with lead or calamine might be improper. 

459 APPENDIX.                     
Liniment for the Piles.
Take of emollient ointment, two ounces; liquid laudanum, half an ounce. Mix
these ingredients with the yolk of an egg, and work them well together.
Volatile Liniment.
Take of Florence oil, an ounce; spirit of harshorn, half an ounce. Shake them
together.
This liniment, made with equal parts of the spirit and oil, will be more efficacious,
where the patient's skin is able to bear it.
Sir John Pringle observes, that in the inflammatory quinsey, a piece of flannel
moistened with this liniment, and applied to the throat, to be renewed every four
or five hours, is one of the most efficacious remedies; and that it seldom fails, af-
ter bleeding, either to lessen or carry off the complaint. The truth of this obser-
vation I have often experienced.
Camphorated Oil.
Rub an ounce of camphor, with two ounces of Florence oil, in a mortar, till
the camphor be entirely dissolved.
This antispasmodic liniment may be used in obstinate rheumatisms, and is
some other cases accompanied with extreme pain and tension of the parts,
PILLS.
MEDICINES which operate in a small dose, and whose disagreeable taste, or
smell, makes it necessary that they should be concealed from the palate are
most commodiously exhibited in this form. No medicine, however, that is in,
tended to operate quickly, ought to be made into pills, as they often lie for a con-
siderable time on the stomach before they are dissolved, so as to produce any ef-
fect.
As the ingredients which enter the composition of pills are generally so con-
trived that one pill of an ordinary size may contain about five grains of the com-
pound, in mentioning the dose, we shall only specify the number of pills to be ta-
ken; as one, two, three, &c.
Composing  Pill.
Take of purified opium, ten grains; Castile soap, half drachm. Beat them to-
gether, and form the whole into twenty pills.
When a quieting draught will not fit upon the stomach, one, two, or three of
these pills may be taken as occasion requires.
Fœtid Pill.
Take of asafœtida, half an ounce; simple syrup, as much as is necessary to form
it into pills.
In hysteric complaints, four or five pills, of an ordinary size, may be taken
twice or thrice a-day. They may likewise be of service to persons afflicted with
the asthma.
When it is necessary to keep the body open, a proper quantity of rhubarb,
aloes, or jalap, may occasionally be added to the above mass.
Hemlock Pill.
Take any quantity of the extract of hemlock, and adding to it about a fifth part
of its weight of the powder of the dried leaves, form it into pills of the ordinary
size.
The extract of hemlock may be taken from one grain to several drachms in the
day. The best method, however, of using these pills, is to begin with one or two,
and to increase the dose gradually, as far as the patient can bear them, without
any remarkable degree of stupor or giddiness, 

460 APPENDIX
Mercurial Pill.
Take of purified quicksilver and honey, each half an ounce. Rub them together
in a mortar till the globules of mercury are perfectly extinguished; then add, of
Castile soap, two drachms, powdered liquorice, or crumb of bread, a sufficient
quantity to give the mass a proper consistence for pills.
When stronger mercurial pills are wanted, the quantity of quicksilver may be
doubled.                                                             
The dose of these pills is different, according to the intention with which they
are given. As an alterant, two or three may be taken daily. To raise a salivation
four or five will be necessary.
Equal parts of the above pill and powdered rhubarb made into a mass, with a
sufficient quantity of simple syrup, will make a Mercurial purging pill.
Mercurial sublimate Pill.
Dissolve fifteen grains of the corrosive sublimate of mercury in two drachms of
the saturated solution of crude sal ammoniac, and make it into a paste, in a glass
mortar, with a sufficient quantity of the crumb of bread. This mass must be form-
ed into one hundred and twenty pills.
This pill, which is the most agreeable form of exhibiting the sublimate, has
been found efficacious, not only in curing the venereal disease. but also in killing
and expelling worms, after other powerful medicines have failed.
For the venereal disease, four of these pills may be taken twice a-day, as an al-
terant three, and for worms two.
Plummer's Pill.
Take of calomel, or sweet mercury, and precipitated sulphur of antimony, each
three drachms; extract of liquorice, two drachms. Rub the sulphur and mercury
well together; afterwards add the extract, and, with a sufficient quantity of the
mucilage of gum arabic, make them into pills.
This pill has been found a powerful, yet safe, alterative in obstinate cutaneous
disorders; and has completed a cure after a salivation had failed. In venereal cases
it has likewise produced excellent effects. Two or three pills of an ordinary size
may be taken night and morning, the patient keeping moderately warm, and drink-
ing after each dose a draught of decoction of the woods, or of sarsaparilla.
Purging Pills.
Take of succotorine aloes, and Castile soap, each two drachms; of simple syrup,
a sufficient quantity to make them into pills.
Four or five of these pills will generally prove a sufficient purge. For keeping
the body gently open, one may be taken night and morning. They are reckoned
both deobstruent and stomachic, and will be found to answer all the purposes of
Dr. Anderson's pills, the principal ingredient of which is aloes.
Where aloetic purges are improper, the following pills may be used:
Take extract of jalap, and vitrioiated tartar, of each two drachms; syrup of
ginger, as much as will make them of a proper consistence for pills.
These pills may be taken in the same quantity as the above.
Pill for the Jaundice.
Take of Castile soap, succotorine aloes, and rhubarb, of each one drachm.
Make them into pills with a sufficient quantity of syrup or mucilage.
These pills, as their title expresses, are chiefly intended for the jaundice, which,
with the assistance of proper diet, they will often cure. Five or six of them may
be taken twice a-day, more or less, as is necessary to keep the body open, it
will be proper,  however, during their use, to interpose now and then a vomit of
ipecacuanha or tartar emetic.
Stomachic Pill.
Take extract of gentian, two drachms: powdered rhubarb and vitriolated tar-
tar, of each one drachm; oil of mint, thirty drops; simple syrup, a sufficient
quantity.

461 APPENDIX.                      
Three or four of these pills may be taken twice a-day, for invigorating the
stomach, and keeping the body gently open.
Squill Pills.
Take powder of dried squills, a drachm and a half; gum ammoniac, and car-
damom seeds, in powder, of each three drachms; simple syrup, a sufficient quan-
tity.
In dropsical and asthmatic complaints, two or three of these pills may be taken
twice a day, or oftner, if the stomach will bear them.
Strengthening Pill.
Take soft extract of the bark, and salt of steel, each a drachm. Make into pills.
In disorders arising from excessive debility, or relaxation of the solids, as the
chlorosis, or green sickness, two of these pills may be taken three times a-day.
PLAISTERS.
PLAISTERS ought to be of a different consistence, according to the purposes
for which they are intended. Such as are to be applied to the breasts or
stomach ought to be soft and yielding; while those designed for the limbs should
be firm and adhesive.
It has been supposed, that plaisters might be impregnated with the virtues of
different vegetables, by boiling the recent vegetable with the oil employed for
the composition of the plaister; but this treatment does not communicate to the
oils any valuable qualities.
The calces of lead boiled with oils unite with them into a plaister of a proper
consistence, which makes the basis of several other plaisters. In boiling these
compositions, a quantity of hot water must be added from time to time to prevent
the plaister from burning ar growing black. This, however, should be done with
care, left it cause the matter to explode.
Common Plaister.
Take of common olive oil, six pints; litharge reduced to a fine powder, two
pounds and a half. Boil the litharge and oil together over a gentle fire, conti-
nually stirring them, and keeping always about half a gallon of water in the vessel;
after they have boiled about three hours, a little of the plaister may be taken out
and put into cold water, to try if it be of a proper consistence: when that is the
case, the whole may be suffered to cool, and the water well pressed out of it with
the hands.
This plaister is generally applied in slight wounds and excoriations of the skin.
It keeps the part soft and warm, and defends it from the air, which is all that is
necessary in such cases. its principal use, however, is to serve as a basis for other
plaisters.
Adhesive Plaister.
Take of common plaister, half a pound; of Burgundy pitch, a quarter of a
pound. Melt them together.
This plaister is principally used for keeping on other dressings.
Anodyne Plaister.
Melt an ounce of adhesive plaister, and, when it is cooling, mix with it a drachm
of powdered opium, and the same quantity of camphor, previously rubbed up
with a little oil.                                         
This plaister generally gives ease in acute pains, especially of the nervous
kind.
Blistering Plaister.
Take of Venice turpentine, six ounces; yellow wax, two ounces; Spanish flies
in fine powder, three ounces; powdered mustard, one ounce. Melt the wax, and 

462 APPENDIX.
while it is warm, add to it the turpentine, taking care not to evaporate it by too
much heat. After the turpentine and wax are sufficiently incorporated, sprinkle
in the powders, continually stirring the mass till it be cold.
Though this plaister is made in a variety of ways, one seldom meets with it of
a proper consistence. When compounded with oils and other greasy substances,
its effects are blunted, and it is apt to run; while pitch and resin render it too
hard and very inconvenient.
When the blistering plaister is not at hand, its place may be supplied, by mix-
ing, with any soft ointment, a sufficient quantity of powdered flies; or, by form-
ing them into a paste, with flour and vinegar.
Gum Plaister.
Take of the common plaister, four pounds; gum ammoniac and galbanum,
strained, of each half a pound. Melt them together, and add, of Venice turpen-
tine, six ounces.
This plaister is used as a digestive, and likewise for discussing indolent tumours.
Mercurial Plaister.
Take of common plaister one pound; of gum ammoniac, strained, half a pound,
melt them together, and, when cooling, add eight ounces of quick-silver, previ-
ously extinguished by triture, with three ounces of hog's lard.
This plaister is recommended in pains of the limbs arising from a venereal cause.
Indurations of the glands, and other violent tumours, are likewise found some-
times to yield to it.
Stomach Plaister.
Take of gum plaister, half a pound; camphorated oil, an ounce and a half;
black pepper, or capsicum, where it can be had, one ounce. Melt the plaister,
and mix with it the oil; then sprinkle in the pepper, previously reduced to a fine
powder.
An ounce or two of this plaister, spread upon soft leather, and applied to the
region of the stomach, will be of service, in flatulencies arising from hysteric and
hypochondriac affections. A little of the expressed oil of mace, or a few drops of
the essential oil of mint, may be rubbed upon it before it is applied.
This may supply the place of the Antihysteric Plaister.
Warm Plaster.
Take of gum plaister, one ounce; blistering plaister, two drachms. Melt them
together over a gentle fire.
This plaister is useful in the sciatica, and other fixed pains of the rheumatic
kind: it ought, however, to be worn for some time, and to be renewed, at least
once a-week. If this is found to blister the part, which is sometimes the case, it
must be made with a smaller proportion of the blistering plaister.
Wax Plaister.
Take of yellow wax, one pound; white resin, half a pound; mutton suet, three
quarters of a pound. Melt them together.
This is generally used instead of the Melliot Plaister. It is a proper application
after blisters, and in other cases where a gentle digestive is necessary.
POWDERS,
THIS is one of the most simple forms in which medicine can be administered.
Many medicinal substance, however, cannot be reduced into powder, and
others are too disagreeable to be taken in this form.
The lighter powders may be mixed in any agreeable, thin liquor, as tea or wa-
ter-gruel. The more ponderous will require a more consistent vehicle, as syrup,
conserve, jelly, or honey.
Gums, and other substances which are difficult to powder, should be pounded. 

463 APPENDIX.
along with the drier ones; but those which are too dry, especially aromatics,
ought to be sprinkled, during their pulverization, with a few drops of any pro-
per water.
Aromatic powders are to be prepared only in small quantities at a time, and
kept in glass vessels, closely stopped. Indeed, no powders ought to be exposed to
the air or kept too long, otherwise their virtues will be, in a great measure, de-
stroyed.
Astringent Powder.
Take of alum and Japan earth, each two drachms. Pound them together, and
divide the whole into ten or twelve doses.
In an immoderate flow of the menses, and other hæmorrhages, one of these
powders may be taken every hour, or every half hour, if the discharge be violent.
Powder of Bole.
Take of bole armenic, or French bole, two ounces; cinnamon, one ounce; tor-
mentil root and gum arabic, of each six drachms; long pepper, one drachm.
Let all these ingredients be reduced into a powder.
This warm, glutinous, astringent powder, is given in fluxes, and other disorders
where medicines of that class are necessary, in the dose of a scruple, or half a
drachm.
If a drachm of opium be added, it will make the powder of bole with opium,
which is a medicine of considerable efficacy. It may be taken in the same quan-
tity as the former, but not above twice or thrice a day.
Carminative Powder.
Take of coriander-seed, half an ounce; ginger, one drachm; nutmegs, half a
drachm; fine sugar, a drachm and a half. Reduce them into powder for twelve
doses.
This powder is employed for expelling flatulencies arising from indigestion, par
ticularly those to which hysteric and hypochondriac persons are so liable. It may
likewise be given in small quantities to children in their food, when troubled with
gripes.
Diuretic Powder.
Take of gum arabic, four ounces; purified nitre, one ounce. Pound them to-
gether, and divide the whole into twenty-four doses.
During the first stage of the venereal disease, one of these cooling powders may
betaken three times a-day, with considerable advantage.
Aromatic Opening Powder.
Take of the best Turkey rhubarb, cinnamon, and fine sugar, each twe drachms.
Let the ingredients be pounded, and afterwards mixed well together.
Where flatulency is accompanied with costiveness, a tea-spoonful of this pow-
der may be taken once or twice a-day, according to circumstances.
Saline Laxative Powders.        
Take of soluble tartar, and cream of tartar, each one drachm; purified nitre,
half a drachm. Make them into a powder.
In fevers, and other inflammatory disorders, where it is necessary to keep the bo-
dy gently open, one of these cooling laxative powders may be taken in a little
gruel, and repeated occasionally.
Steel Powder.
Take filings of steel, and loaf-sugar, of each two ounces; ginger, two drachms.
Pound them together.
In obstructions of the menses, and other cases where steel is proper, a tea- 

464 APPENDIX.
spoonful of this powder may be taken twice a-day, and washed down with a little
wine or water.
Sudorific Powder.
Take of purified nitre and vitrioiated tartar, of each half an ounce; opium and
ipecacuanha, of each one drachm. Mix the ingredients, and reduce them to a
fine powder.
This is generally known by the name of Dover's Powder. It is a powerful su-
dorific. In obstinate rheumatisms, and other cases where it is necessary to excite
a copious sweat, this powder may be administered in the dose of a scruple or half
a drachm. Some patients will require two scruples. It ought to be accompanied
with the plentiful use of some warm diluting liquor.
Worm-Powder.
Take of tin reduced into a fine powder, an ounce; Æthiop's mineral, two
drachms. Mix them well together, and divide the whole into six doses.
One of these powders may be taken in a little syrup, honey, or treacle twice a-
day. After they have been all used, the following anthelmintic purge may be pro-
per.
Purging Worm-Powder.
Take of powdered rhubarb, a scruple; scammony and calomel, of each five
grains. Rub them together in a mortar for one dose.
For children, the above dose must be lessened according to their age.
If the powder of tin be given alone, its dose may be considerably increased.
The late Dr. Alston gave it to the amount of two ounces in three days, and says,
when thus administered, that it proved an egregious anthelmintic. He purged his
patients both before they took the powder and afterwards.
Powder for the Tape-Worm.
Early in the morning the patient is to take in any liquid, two or three drachms,
according to his age and constitution, of the root of the male fern reduced into a
tine powder. About two hours afterwards he is to take of calomel and resin of
scammony, each ten grains; gum gamboge, six grains. These ingredients must be
finely powdered, and given in a little syrup, honey, treacle, or any thing that is
most agreeable to the patient. He is then to walk gently about, now and then
drinking a dish of weak green tea, till the worm is passed. If the powder of the
fern produces nausea, or sickness, it may be removed by sucking the juice of an
orange or lemon.
This medicine, which had been long kept a secret abroad for the cure of the tape-
worm, was some time age purchased by the French King, and made public for
the benefit of mankind. Not having had an opportunity of trying it, I can say
nothing from experience concerning its efficacy. It seems, however, from its ingre-
dients, to be an active medicine, and ought to be taken with care. The dose here
prescribed is sufficient for the strongest patient; it must, therefore, be reduced ac-
cording to the age and constitution.
SYRUPS.
SYRUPS were some time ago looked upon as medicines of considerable value,
They are at present regarded chiefly as vehicles for medicines of greater effi-
cacy, and are used for sweetening draughts, juleps, or mixtures; and for reduc-
ing the lighter powders into boluses, pills, and electuaries. As all these purposes
may be answered by the simple syrup alone, there is little occasion for any other;
especially as they are seldom found but in a state of fermentation; and as the dose
of any medicine given in this form is very uncertain. Persons who serve the pub-
lic must keep whatever their customers call for; but to the private practitioner
nine-tenth. of the syrups usually kept in the shops are unnecessary. 

465 APPENDIX.                      
Simple Syrup
Is made by dissolving in water, either with or without heat, about double its
weight of fine sugar.
If twenty-five drops of landanum be added to an ounce of the simple syrup, it
will supply the place of diacodium, or the syrup of poppies, and will be found a
more safe and certain medicine.
The lubricating virtues of the syrup of marshmallows may likewise be supplied,
by adding to the common syrup a sufficient quantity of mucilage of gum arabic.
Those who chuse to preserve the juice of lemons in form of syrup, may dissolve
in it, by the heat of a warm bath, nearly double its weight of fine sugar. The
Juice ought to be previously strained, and suffered to stand till it settles.
The syrup of ginger is sometimes of use as a warm vehicle for giving medicines
to persons afflicted with flatulency. It may be made by infusing two ounces of
bruised ginger in two pints of boiling water for twenty-four hours. After the li-
quor has been strained, and has stood to settle for some time, it may be poured off,
and a little more than double its weight of fine powdered sugar dissolved in it.
TINCTURES, ELIXIRS, &c.
RECTIFIED spirit is the direct menstruum of the resins and essential oils
of vegetables, and totally extracts these active principles from sundry substan-
ces, which yield them to water, either not at all, or only in part.
It dissolves likewise those parts of animal substances in which their peculiar
smells and tastes reside. Hence, the tinctures prepared with rectified spirits form an
useful and elegant class of medicines, possessing many of the most essential virtues of
simples, without being clogged with their inert or useless parts.
Water, however, being the proper menstruum of the gummy, saline, and saccha-
rine parts of medicinal substances, it will be necessary, in the preparation of several
tinctures, to make use of a weak spirit, of a composition of rectified spirit and water.
Aromatic Tincture.
Infuse two ounces of Jamaica pepper in two pints of brandy, without heat, for a
few days; then strain off the tincture.
This simple tincture will sufficiently answer all the intentions of the more costly
preparations of this kind. It is rather too hot to be taken by itself; but is very proper
for mixing with such medicines as might otherwise prove too cold for the stomach.
Compound Tincture of the Bark.
Take of Peruvian bark, two ounces; Seville orange-peel and cinnamon, of each
half an ounce. Let the bark be powdered, and the, other ingredients bruised; then in-
fuse, the whole in a pint and a half of brandy, for five or six days, in a close vessel; af-
terwards strain off the tincture.
This tincture is not only beneficial in intermitting fevers, but also in the slow ner-
vous, and putrid kinds, especially towards their decline.
The dose is from one drachm to three or four, every fifth or sixth hour. It may be
given in any suitable liquor, and occasionally sharpened with a few drops of the spi-
rit of vitriol.
Volatile Fætid Tincture.
Infuse two ounces of assafœtida in one pint of volatile aromatic spirit, for eight days,
in a close bottle, frequently shaking it; then strain the tincture.
This medicine is beneficial in hysteric disorders, especially when attended with
lowness of spirits, and faintings. A tea-spoonful of it may be taken in a glass of wine,
or a cup of penny-royal tea.
Volatile Tincture of Gum Guaiacum.
Take of gum guaiacum, four ounces; volatile aromatic spirit, a pint. Infuse with-
out heat, in a vessel well stopped, for a few days; then strain off the tincture.*
* A-very good tincture of guaiacum for domestic use, may be made infusing two or three
ounces of the gum in a bottle's rum or brandy.
N3 

466 APPENDIX.
In rheumatic complaints, a tea-spoonful of his tincture may be taken in a cup of
the infusion of water-trefoil, twice or thrice a-day.
Tincture of Black Hellebore.
Infuse two ounces of the roots of black hellebore, bruised, in a pint of proof spirit,
for seven or eight days; then filter the tincture through paper. A scruple of cochi-
neal may be infused along with the roots, to give the tincture a colour.
In obstructions of the menses, a tea-spoonful of this tincture may be taken in a cup
of camomile or penny-royal tea twice a-day.
Astringent Tincture.
Digest two ounces of gum kino, in a pint and a half of brandy, for eight days; af-
terwards strain it for use.
This tincture, though not generally known, is a good astringent medicine. With
this view, an  ounce, or more, of it may be taken three or four times a-day.
Tincture of Myrrh and Aloes.
Take of gum myrrh, an ounce and a half; hopatic aloes, one ounce. Let them be
reduced to a powder, and infused in two pints of rectified spirits, for six days, in a
gentle heat; then strain the tincture.
This is principally used by surgeons for cleansing foul ulcers, and restraining the
progress of gangrenes. It is also, by some, recommended as a proper application to
green wounds.
Tincture of Opium, or Liquid Laudanum.
Take of crude opium, two ounces; spirituous aromatic water, and mountain wine,
of each ten ounces. Dissolve the opium, sliced, in the wine, with a gentle heat, fre-
quently stirring it; afterwards add the spirit, and strain off the tincture.
As twenty-five drops of this tincture contain about a grain of opium, the common
dose may be from twenty to thirty drops.
Sacred Tincture, or Tincture of Hiera Picra.
Take of succotorine aloes in powder, one ounce; Virginian snake-root and gingar,
of each two drachms Infuse in a pint of mountain wine, and half a pint of brandy,
for a week, frequently shaking the bottle, then strain off the tincture.
This is a safe and useful purge for persons of a languid and phlegmatic habit; but
is thought to have better effects, taken in small doses as a laxative.
The dose, as a purge, is from one to two ounces.
Compound Tincture of Senna.
Take of senna, one ounce; jalap, coriander seeds and cream of tartar, of each half
an ounce. Infuse them in a pint and a half of French brandy for a week; then strain
the tincture, and add to it four ounces of fine sugar.
This is an agreeable purge, and answers all the purposes of the Elixir salutis, and
of Dassy's Elixir.
The dose is from one to two or three ounces.
Tincture of Spanish Flies.
Take of Spanish flies, reduced to a fine powder, two ounces; spirit of wine, one
pint. Infuse for two or three days; then strain off the tincture.
This is intended as an acrid stimulant for external use. Parts affected with the
palsy or chronic rheumatism may be frequently rubbed with it.
Tincture of the Balsam of Tolu.
Take of the balsam of Tolu, an ounce and a half; rectified spirit of wine, a pint
Infuse, in a gentle heat, until the balsam is dissolved; then strain the tincture
This tincture possesses all the virtues of the balsam. In coughs, and other com-
plaints of the breast, a tea-spoonful or two of it may be taken in a bit of loaf sugar.
But the best way of using it is in syrup. An ounce of the tincture, properly mixed
with two pounds of simple syrup, will make what is commonly called the Balsamic
Syrup.

467 APPENDIX.
Tincture of Rhubarb.
Take of rhubarb, two ounces and a half, lesser cardamom seeds, half an ounce;
trandy, two pints. Digest for a week, and strain the tincture.
Those who choose to have a vinous tincture of rhubarb, may infuse the above in-
gredients in a bottle of Lisbon wine, adding to it about two ounces of proof spirits.
It half an ounce of gentian root, and a drachm of Virginian snake-root be added to
the above ingredients, it will make the bitter tincture of rhubarb.
All these tinctures are designed as stomachics and corroborants as well as purga-
tives. In weakness of the stomach, indigestion, laxity of the intestines, fluxes; cho-
licky and such-like complaints, they are frequently of great service. The dose is
from half a spoonful to three or four spoonfuls or more, according to the circumstan-
ces of the patient, and the purposes it is intended to answer.
Paregoric Elixir.
Take of flowers of benzoin, half an ounce; opium, two drachms. Infuse, in one
pound of the volatile aromatic spirit, for four or five days, frequently shaking the
bottle; afterwards strain the elixir.
This is an agreeable and safe way of administering opium. It eases pain, allays
tickling coughs, relieves difficult breathing, and is useful in many disorders of chil-
dren, particularly the hooping cough.
The dose to an adult is from fifty to a hundred drops.
Sacred Elixir.
Take of rhubarb cut small, ten drachms; succotorine aloes, in powder, six
drachms; lesser cardamom seeds, half an ounce; French brandy, two pints. Infuse
for two or three days, and then strain the elixir.
This useful stomachic purge may be taken from one ounce to an ounce and a half.
Stomachic Elixir.
Take of gentian root, two ounces; Curassao oranges, one ounce; Virginian snake-
root, half an ounce. Let the ingredients be bruised, and infused for three or four days
in two pints of French brandy; afterwards strain out the elixir.
This is an elegant stomachic bitter. In flatulencies, indigestion, want of appetite
and such-like complaints, a small glass of it may be taken twice a-day. It likewise,
Relieves the gout in the stomach, when taken in a large dose.
Acid Elixir of Vitriol.
Take of the aromatic tincture, one pint; oil of vitriol, three ounces. Mix them
gradually, and after the fæces have subsided, filter the elixir through paper, in a glass
funnel.
This is one of the best medicines which I know for hysteric and hypochondriac pa-
tients, afflicted with flatulencies arising from relaxation or debility of the stomach and
intestines. It will succeed where the most celebrated stomachic bitters have no effect.
The dose is from ten to forty drops, in a glass of wine or water, or a cup of any bitter
infusion, twice or thrice a-day. It should be taken when the stomach is most empty.
Camphorated Spirit of Wine.
Dissolve an ounce of camphor in a pint of rectified spirits.
This solution is chiefly employed as an embrocation in bruises, palsies, the chronic
rheumatism, and for preventing gangrenes.
The above quantity of camphor, dissolved in half a pound of the volatile aromatic
spirit, makes Ward's Essence.
Spirit of Mindererus.
Take of volatile sal ammoniac, any quantity. Pour on it gradually, distilled vine-
gar till the effervescence ceases.
This medicine is useful in promoting a discharge both by the skin and urinary pas-
sages. It is also a good external application in strains and bruises.
When intended to raise a sweat half an ounce of it in a cup of warm gruel may be
given to the patient in bed every hour till it has the desired effect. 

[468] 
VINEGARS.
VINEGAR is an acid produced from vinous liquors by a second fermentation. It
is an useful medicine both in inflammatory and putrid disorders. Its effects are,
to cool the blood, quench thirst, counteract a tendency to putrefaction, and allay in-
ordinate motions of the system. It, likewise, promotes the natural secretions, and,
in some cases, excites a copious sweat, where the warm medicines, called alexiphar-
mic, tend rather to prevent that salutary evacuation.
Weakness, faintings, vomitings, and other hysteric affections, are often relieved by
vinegar applied to the mouth and nose, or received into the stomach. It is of excellent
use, also, in correcting many poisonous substances, when taken into the stomach; and
in promoting their expulsion, by the different emunctories, when received into the
blood.
Vinegar is not only an useful medicine, but serves, likewise, to extract, in tolerable
perfection, the virtues of several other medicinal substances. Most of the odoriferous
flowers impart to it their fragrance, together with a beautiful purplish or red colour.
it also assists, or coincides with the intention of squills, garlic, gum ammoniac, and
several other valuable medicines.
These effects, however, are not to be expected from every thing that is sold under
the name of vinegar, but from such as is found and well prepared.
The best vinegars are those prepared from French wines.
It is necessary, for some purposes, that the vinegar be distilled, but as this opera-
tion requires a particular chemical apparatus, we shall not insert it.
Vinegar of Litharge.
Take of litharge, half a pound; strong vinegar, two pints. Infuse them together
in a moderate heat for three days, frequently shaking the vessel; then filter the li-
quor for use.
This medicine is little used, from a general notion of its being dangerous. There
is reason, however, to believe, that the preparations of lead with vinegar are posses-
sed of some valuable properties, and that they may be used, in many cases, with
safety and success.
A preparation of a similar nature with the above has, of late, been extolled by Gou-
lard, a French surgeon, as a safe and extensively useful medicine, which he calls the
Extract of Saturn, and orders to be made in the following manner:
Take of litharge, one pound; vinegar, made of French wine, two pints. Put
them together into a glazed earthen pipkin, and let them boil, or rather simmer, for
an hour, or an hour and a quarter, taking care to stir them all the while with a wood-
en spatula. After the whole has stood to settle, pour off the liquor which is upon the
top into bottles for use.
With this extract, Goulard makes his vegeto-mineral water,* which he recommends
in a great variety of external disorders, as inflammations, burns, bruises, sprains, ul-
cers, &c.
He, likewise, prepares with it a number of other forms of medicine, as poultices,
plaisters, ointments, powders, &c.
Vinegar of Roses.
Take of red roses, half a pound; strong vinegar, half a gallon. Infuse in a clost
vessel, for several weeks, in a gentle heat; and  then strain off the liquor.
This is principally used an embrocation for head-achs, &c.
Vinegar of Squills.
Take «f dried squills, two ounces; distilled vinegar, two pints. Infuse for ten
days or a fortnight in a gentle decree of heat, afterwards strain off the liquor, and
add to it about a twelfth part its quantity of proof spirits.
This medicine has good effects in disorders of the breast, occasioned by a load of
viscid phlegm. It is also of use in hydropic cases for promoting a discharge of urine.
The dose is from two drachms to two ounces, according to the intention for which
* See Collyrium of Lead. 

469 APPENDIX.
It is given. When intended to act as a vomit, the dole ought to be large. In other
cases, it must not only be exhibited in small doses, but also mixed with cinnamon-wa-
ur or some other agreeable aromatic liquor, to prevent the nausea it might other-
wise occasion.
WATERS BY INFUSION, &c.
Lime-Water.
POUR two gallons of water gradually upon a pound of fresh burnt quicklime;
and when the ebullition ceases, stir them well together; then suffer the whole
to stand at rest, that the lime may settle, and afterwards filter the liquor through pa-
per, which is to be kept in vessels closely stopt.
The lime-water from calcined oyster-shells, is prepared in the same manner.
Lime-water is principally used for the gravel; in which case, from a pint to two
or more of it may be drank daily. Externally it is used for washing foul ulcers, and
removing the itch, and other diseases of the skin.
Compound Lime-Water.
Take shavings of guaiacum wood, half a pound; liquorice root, one ounce; sassa-
fras bark, half an ounce; coriander seeds, three drachms; simple lime-water, six
pints.
Infuse without heat for two days, and then strain off the liquor.
In the same manner may lime-water be impregnated with the virtues of other ve-
getable substances. Such impregnation not only renders the water more agreeable
to the palate, but also a more efficacious medicine, especially in cutaneous disorders,
and foulness of the blood and juices.
It may be taken in the same quantity as the simple water.
Sublimate Water.
Dissolve eight grains of the corrosive sublimate in a pint of cinnamon-water.
If a stronger solution is wanted, a double or triple quantity of sublimate may be
used.
The principal intention of this is to cleanse foul ulcers, and consume proud flesh.
Styptic Water.
Take of blue vitriol and alum, each an ounce and a half; water, one pint. Boil
them until the salts are dissolved, then filter the liquor, and add to it a drachm of the
oil of vitriol.
This water is used for stopping a bleeding at the nose, and other hæmorrhages;
for which purpose cloths or dossils dipt in it must be applied to the part.
Tar Water.
Pour a gallon of water on two pounds of Norway tar, and stir them strongly to-
gether with a wooden rod: after they have stood to settle for two days, pour off the
water for use.
Though tar-water falls greatly short of the character which has been given of it,
yet it possesses some medicinal virtues. It sensibly raises the pulse, increases the secre-
tions, and sometimes opens the body, or occasions vomiting.
A pint of it may be drank daily, or more, if the stomach can bear it. It is generally
ordered to be taken on an empty stomach, viz. four ounces morning and evening,
and the same quantity about two hours after breakfast and dinner.
SIMPLE DISTILLED WATERS.
A GREAT number of distilled waters were formerly kept in the shops, and are
still retained in some dispensatories. But we consider them chiefly in the light
of grateful diluents, suitable vehicles for medicines of greater efficacy, or for render- 

470 APPENDIX.
ing disgustful ones more agreeable to the palate and stomach. We shall, therefore,
infert only a few of those which are best adapted to these intentions.
The management of a still being now generally understood, it is needless to spend
time in giving directions for that purpose.
Cinnamon Water.
Steep one pound of cinnamon bark, bruised, in a gallon and a half of water, and
one pint of brandy, for two days; and then distil off one gallon.
This is an agreeable aromatic water, possessing, in a high degree, the fragrance
and cordial virtues of the spice.
Pennyroyal Water.
Take of pennyroyal leaves, dried, a pound and a half; water, from a gallon and a 
half to two gallons. Draw off, by distillation, one gallon.
This water possesses in a considerable degree, the smell, taste, and virtues of the
plant. It is given in mixtures and juleps to hysteric patients.
An infusion of the herb in boiling water answers nearly the same purposes.
Peppermint Water.
This is made in the same manner as the preceding.
Spearmint Water.
This may also be prepared in the same way as the penny-royal water.
Both these ate useful stomachic waters, and will sometimes relieve vomiting, espe-
cially when it proceeds from indigestion, or cold viscid phlegm. They are likewise
useful in some colicky complaints, the gout in the stomach, &c. particularly the pep-
permint water.
An infusion of the fresh plant is frequently found to have the same effects as the
distilled water.
Rose Water.
Take of roses fresh gathered, six pounds; water, two gallons. Distil off one
gallon.
This water is principally valued on account of its fine flavour.
Jamaica Pepper Water.
Take of Jamaica pepper, half a pound; water, a gallon and a half. Distil off one
gallon.
This is a very elegant distilled water, and may, in most cases, supply the place  of
the more costly spice waters.
SPIRITUOUS DISTILLED WATERS.
Spirituous Cinnamon Water.
TAKE of cinnamon bark, one pound; proof spirit, and common water, of each
one gallon. Steep the cinnamon in the liquor for two days; then distil off one
gallon.
Spirituous Jamaica Pepper Water.
Take of Jamaica pepper, half a pound; proof spirit, three gallons; water, two
gallons. Distil off three gallons.
This is a sufficiently agreeable cordial, and may supply the place of the Aromatic 
Water.

[471] 
WHEYS.
Alum Whey.
BOIL two drachms of powdered alum in a pint of milk till it is curdled; then
strain out the whey. 
This whey is beneficial in an immoderate flow of the menses, and in a diabetes, or ex-
cessive discharge of urine.
The dose is two, three, or four ounces, according as the stomach will bear it, three
times a-day. If it should occasion vomiting, it may be diluted.
Mustard Whey.
Take milk and water, of each a pint; bruised mustard-seed, an ounce and a half.
Boil them together till the curd is perfectly separated; afterwards strain the whey
through a cloth.
This is the most elegant, and by no means the least efficacious method of exhibi-
ting mustard. It warms and invigorates the habit, and promotes the different secre-
tions. Hence, in the low state of nervous fevers, it will often supply the place of
wine. It is also of use in the chronic rheumatism, palsy, dropsy, &c, The addition of
a little sugar will render it more agreeable.
The dose is an ordinary tea-cupful four or five times a-day.
Scorbutic Whey.
This whey is made by boiling half a pint of the scorbutic juices in a quart of cow's
milk. More benefit, however, is to be expected from eating the plants, than from
their expressed juices.
The scorbutic plants are, bitter oranges, brooklime, garden scurvy-grass, and wa-
ter-cresses.
A number of other wheys may be prepared nearly in the same manner, as orange
whey, cream of tartar whey, &c. These are cooling, pleasant drinks in fevers, and
may be rendered cordial, when necessary, by the addition of wine.
WINES.
THE effects of wine are, to raise the pulse, promote perspiration, warm the habit,
and exhilarate the spirits. The red wines, besides these effects, have an astrin-
gent quality, by which they strengthen the tone of the stomach and intestines, and
by this means prove serviceable in restraining immoderate secretions.
The thin sharp wines have a different tendency. They pass off freely by the differ-
ent emunctories, and gently open the body. The effects of the full-bodied wines are,
however, much more durable than those of the thinner.
All sweet wines contain a glutinous substance, and do not pass off freely. Hence,
they will heat the body more than an equal quantity of any other wine, though it
should contain fully as much spirit.
From the obvious qualities of wine, it must appear to be an excellent cordial medi-
cine. Indeed, it is worth all the rest put together.
But to answer this character it must be found and good. No benefit is to be ex-
pected from the common trash that is often sold by the name of wine, without posses-
sing one drop of the juice of the grape. Perhaps, no medicine is mere rarely ob-
tained than genuine wine.                                                   
Wine is not only used as a medicine, but is also employed as a menstruum for extruct-
ing the virtues of other medicinal substances; for which it is not ill-adapted, being a
compound of water, inflammable spirit, and acid; by which means it is enabled to
act upon vegetable and animal substances, and also to dissolve some bodies of the
metallic kind, so as to impregnate itself with their virtues, as steel, antimony, &c.
Anthelmintic Wine.
Take of rhubarb, half an ounce; worm-seed, an ounce. Bruise them and infuse
without heat in two pints of red port wine for a few days, then strain off the wine. 

472 APPENDIX.
As the stomachs of persons afflicted with worms are always debilitated, red wine
alone will often prove serviceable: it must, however, have still better effects when
joined with bitter and purgative ingredients, as in the above form.
A glass of this wine may be taken twice or thrice a-day.
Antimonial Wine.
Take a glass of antimony, reduced to a fine powder, half an ounce; Lisbon wine,
eight ounces. Digest, without heat, for three or four days, now and then shaking
the bottle; afterwards filter the wine through paper.
The dose of this wine varies according to the intention. As an alterative and dia-
phoretic, it may be taken from ten to fifty or sixty drops. In a larger dose it generally
proves cathartic, or excites vomiting.
Bitter Wine.
Take of gentian root, yellow rind of lemon-peel, fresh, each one ounce; long pep-
per, two drachms; mountain wine, two pints. Infuse without heat for a week, and
strain out the wine for use.
In complaints arising from weakness of the stomach, or indigestion, a glass of this
wine may be taken an hour before dinner and supper.
Ipecacuanha Wine.
Take of ipecacuanha, in powder, one ounce; mountain wine, a pint. Infuse for
three or four days; then filter the tincture.
This is a safe vomit, and answers extremely well for such persons as cannot swal-
low the powder, or whose stomachs are too irritable to bear it.
The dose is from one ounce to an ounce and a half.
Chalybeate, or Steel Wine.
Take filings of iron, two ounces; cinnamon and mace, of each two drachms; Rhe-
nish wine, two pints. Infuse for three or four weeks, frequently shaking the bottle;
then pass the wine through a filter.
In obstructions of the menses, this preparation of iron may be taken, in the dose of
half a wine-glass twice or thrice a-day.
The medicine would probably be as good if made with Lisbon wine, sharpened
with half an ounce of the cream of tartar, or a small quantity of the vitriolic acid.
Stomach Wine.
Take of Peruvian bark, grossly powdered, an ounce; cardamom seeds, and orange
peel, bruised, of each two drachms. Infuse in a bottle of white port, or Lisbon wine,
for five or six days; then strain off the wine.
This wine is not only of service in debility of the stomach and intestines, but may
also be taken as a preventative, by persons liable to the intermittent fever, or who re-
side in places where this disease prevails. It will be of use, likewise, to those who re-
cover slowly after fevers of any kind, as it assists digestion, and helps to restore the
tone and vigour of the system.
A glass of it may be taken two or three times a-day. 

A GLOSSARY.
ALTHOUGH terms of art have been sedulously avoided in the com-
positien of this treatise, it is impossible entirely to banish technical
phrases when writing on medicine, a science that has been less general-
ly attended to by mankind, and continues, therefore, to be more infect-
ed with the jargon of the schools, than, perhaps, any other. Several
persons having expressed their opinion, that a Glossary would make this
work more generally intelligible, the following concise explanation or
the few terms of art that occur, has been added in compliance with
their sentiments, and to fulfil the original intention of this treatise, by
rendering it intelligible and useful to all ranks and classes of mankind.
Abdomen. The belly.
Absorbents. Vessels that convey the nourishment from the intestines,
and the secreted fluids from the various cavities into the mass of
blood.
Acrimony. Corrosive sharpness.
Acute. A disease, the symptoms of which are violent, and tend to a
speedy termination, is called acute.
Adult. Of mature age.
Adust. Dry, warm.
Antispasmodic. Whatever tends to prevent or remove spasm.
Aphthœ. Small whitish ulcers appearing in the mouth.
Astriction. A tightening or lessening.                       
Atrahilarian.  An epithet commonly applied to people of a certain tem-
perament, marked by a dark complexion, black hair, spare diet
&c. which the ancients supposed to arise from the atra bilis, or the
black bile.
Bile, or Gall. A fluid which is secreted by the liver into the gall-blad-
der, and from thence passes into the intestines, in order to promote
digestion.
Cacochymie. An unhealthy state of the body.
Caries. A rottenness of the bone.             
Chyle. A milky fluid separated from the aliment in the intestine, and
conveyed by the absorbents into the blood to supply the waste of the
animal body.                        
Chronic.  A disease whose progress is slow, in opposition to acute.
Circulation. The motion of the blood, which is driven by the heart
through the arteries, and returns by the veins.
Comatose. Sleepy.
Conglobate Gland. A simple gland.
Conglomerate. A compound gland.
Contagion. Infectious matter.
Cutis. The skin.
Cutaneous. Of or belonging to the skin.
Crisis. A certain period in the progress of a disease, from whence a de-
cided alteration either for the better or the worse takes place.
Critical. Decisive or important.
O3 

474 A GLOSSARY.
Critical days. The fourth, fifth, seventh, ninth, eleventh, thirteenth,
fourteenth, seventeenth, and twenty-first, are, by some authors, de-
nominated critical days, because febrile complaints have been ob-
served to take a decisive change at these periods.
Debility. Weakness.
Delirium. A temporary, disorder of the mental faculties.
Diaphragm. A membrane separating the cavity of the chest from that
of the belly.
Diuretic. A medicine that promotes the secretion of urine.
Drastic is applied to such purgative medicines as are violent or harsh
in their operation.
Empyema. A collection of purulent matter in the cavity of the breast.
Endemic. A disease peculiar to a certain district of country.
Epidemic. A disease generally infectious.
Exacerbation. The increase of any disease.
Fœces. Excrements.
Fœtid. Emitting an offensive smell.
Fœtus. The child before birth, or when born before the proper period,
is thus termed.
Flatulent. Producing wind.
Fungus. Proud flesh.
Gangrene. Mortification.
Gummata. 
Ganglia. 
Veneral excrescences.
Gymnastic. Exercise taken with a view to preserve or restore health—
The ancient physicians reckoned this an important branch of me-
dicine.
Hectic Fever. A slow consuming fever, generally attending a bad habit
of body, or some incurable and deep-rooted disease.
Hæmorrhoids. The piles.
Hæmorrhage. Discharge of blood.
Hypochondriacism. Low spirits.
Hypochondriac viscera. The liver, spleen, &c. so termed from their situ-
ation in the hypochondriac or upper and lateral parts of the belly.
Ichor. Thin bad matter.
Imposthume. A collection of purulent matter.
Inflammation. A surcharge of blood, and an increased action of the ves-
sels, in any particular part of the body.
Ligature. Bandage.
Lixtvium. Ley.
Miliary Eruption. Eruption of small pustules resembling the seeds of
millet.                                                  
Morbific. Causing disease, or diseased.
Mucus. The matter discharged from the nose, lungs, &c.
Mysentery. A double membrane which connects the intestines to the
back bone.
Nervous. Irritable.
Nausea. An inclination to vomit.
Nodes. Enlargement of the bones produced by the venereal disease.  

475 A GLOSSARY,            
Pestoral. Medicines adapted to cure diseases of the breast.
Pelvis. The bones situated at the lower part of the trunk; thus named
from their resembling, in some measure, a bason.
Peritonæum. A membrane lining the cavity of the belly and covering
the intestines.                                                
Pericardium. Membrane containing the heart.
Perspiration. The matter discharged from the pores of the skin in form
of vapour or sweat.
Phlogiston is here used to signify somewhat rendering the air unfit for
the purposes of respiration.
Phlegmatic. Watery relaxed.
Plethoric. Replete with blood.
Polypus. A diseased excrescence, or a substance formed of coagulable
lymph, frequently found in the large blood-vessels.
Pus. Matter contained in a bile.
Regimen.  Regulation of diet.
Rectum. The straight gut, in which the fœces are contained.
Respiration. The act of breathing.
Saliva. The fluids secreted by the glands of the mouth.
Sanies. A thin bad matter, discharged from an ill-conditioned sore.
Schirrous. A state of diseased hardness.
Slough. A part separated and thrown off by suppuration.
Spasm. A diseased contraction.
Spine. The back bone.
Styptic. A medicine for stopping the discharge of blood.
Syncope. A fainting-fit attended with a complete abolition of sensation
and thought.
Tabes. A species of consumption.
Temperament. A peculiar habit of body, of which there are, generally
reckoned four, viz. the sanguine, the bilious,  the melancholic, and
the phlegmatic.
Vertigo. Giddiness.
Ulcer. An ill-conditioned sore.
Ureters. Two long and small canals,  which convey the urine from the
kidnies to the bladder.                              .
Urethra. The canal which convey the urine from the bladder. 

INDEX,
A
ABLUTIONS. Jewish and Mahometan, well calculated for
the preservation of health, page 84.
Abortion, causes and symptoms of, 361. Means of prevention, ibid.
Proper treatment in the case of, 362.
Abscesses, how to be treated, 225. 389.
Accidents. See' Casualties.
Acids, of peculiar service in consumptions, 134. In putrid fevers,
143. Not suitable to the measles, 184.
Acidities, in the bowels of infants, the origin of, 371. Method of
cure, 372.
Ackworth, foundling hospital at, cause of the children there being
afflicted with scabbed heads, and fatal consequences of their ill
treatment, 377, note.
Addison, his remark on the luxury of the table, 79.
Æther, very serviceable in removing fits of the asthma, 288. is
excellent for flatulencies, 311.
Africans, their treatment of children, 29, note.
Agaric of the oak, its merit as a styptic, 392. Method of gather-
ing, preparing, and applying it, ibid. note.
Agriculture, a healthful, constant, and profitable  employment, 52.
Is two much neglected in favour of manufactures, ibid. Gar-
dening, the most wholesome amusement for sedentary persons, 54.
Ague, a species of fever no person can mistake, and the proper
medicine for, generally known, 112. Causes of, ibid. Symptoms,
113. Regimen for, ibid. Under a proper regimen will often go
off, ibid. Medical treatment of, ibid. Often degenerates into ob-
stinate, chronical diseases, if not radically cured, 116. Peruvian
bark the only medicine to be relied on in, 117. Children how
to be treated in. ibid. Preventive medicine for those who live in
marshy countries, 118.
Air, confined, poisonous to children, 41. A free open air will
sometimes cure the most obstinate disorders in children, 42. Oc-
cupations which injure the health by unwholesome air, 41. 52.
The qualities of, act more sensibly on the body than is generally
imagined, 67. The several noxious qualities of, specified, ibid.
In large cities, polluted by various circumstances, 68. The air
in churches, how rendered unwholesome, ibid. Houses ought to              

477 INDEX.                      
be ventilated daily, 69. The danger attending small apartments,
ibid. Persons whose business confines them to town, ought to
sleep in the country, kid. High walls obstruct the free current
off air, 70. Trees should not be planted too near to houses, ibid.
Fresh air peculiarly necessary for the sick, ibid. The sick in hos-
pitals in more danger from the want of fresh air, than from their
disorders, 71. Wholesomeness of the morning: air, 73, The
changeableness of, one great cause of catching cold, 98. Those
who keep most within doors, the most sensible of these changes,
99. Of the night, to be carefully guarded against, 100. Fresh
air often of more efficacy in diseases than medicine, 107. Its im-
portance in fevers, 111. 120. States of, liable to produce putrid
fevers. 141. Must be kept cool and fresh in sick chambers under
these disorders, 144. Change of, one of the most effectual reme-
dies for the hooping cough, 211. The qualities of, a material
consideration for asthmatic patients, 287. The various ways by
which it may be rendered noxious, 413. Confined, how to try,
and purify, 414. Method of recovering persons poisoned by foul
air, ibid. Fresh, of the greatest importance in fainting-fits, 419.
Airken, Mr. his treatise on the nature and cure of fractures, recom-
mended, 402, note.
Alcali, caustic, recommended in the stone, 238. How to  prepare
it, ibid. note.
Aliment is capable of changing the whole constitution of the body,
60. Will, in many cases, answer every intention in the cure of
diseases, ibid. The calls of hunger and thirst, sufficient for regu-
lating the due quantity of, ibid. The quantity of, how injured,
ibid. A due mixture of vegetables necessary with our Animal
food, 62. To what the bad effects of tea are principally owing,
ibid. Water, good and bad, distinguished, 63. Inquiry into the
qualities of fermented liquors, with instructions for the due
making of them, 64. The qualities of good bread, and why
adulterated by bakers, ibid. General rules for the choice of food,
65. Ought not to be too uniform, ibid. Meals ought to be taken
at regular times, 66. Long fasting injurious both to old and
young, ibid. Breakfasts and suppers, ibid. Changes of diet ought
to be gradually made, 67.
Amaurosis. See Gutta serena.
American Indians, their method of curing the venereal disease, 350.
Amusements, sedentary, improper for sedentary persons, 53. Ought
always to be of an active kind, 74.
Anasarca. See Dropsy.
Anger, violent fits of, injurious to the constitution, 89. Tranquility
of mind essential to health, 90.
Animal food, cautions in giving it to children, 33. Animals that
die of themselves, unfit for food, 61. Overdriven cattle render-
ed unwholesome, ibid. The artifices of butchers exposed, ibid.
Too great a quantity of, generates the scurvy, 62.
Animals and plants, the analogy in the nourishment of, stated. 79. 

478 INDEX.
Anthony's fire, St. See Erysipelas.
Aphthæ. See Trush.
Apoplexy, who most liable to this disorder, 288. Causes, ibid. Symp-
toms and method of cure, 289. Cautions to persons of an apo-
plectic make, 290.
Apothecaries weights, a table of, 440.
Apparel, See Clothing.
Appetite, want of, causes and remedies for, 292.
Arbuthnot, Dr. advice in the inflammation of the lungs, 127.  His
advice for persons troubled with costiveness, 292, note.
Arsenic, the effects of, on the stomach, 329. Medical treatment
when the symptoms appear, 330.
Arts. See Manufactures.
Ascites. See Dropsy.
Asses' milk, why it seldom does any good, 131. Instructions for
taking it, 132.
Asthma, the different kinds of this disorder distinguished, with its
causes, 286. Symptoms, ibid. Regimen, ibid. Medical treatment,
287. Remedies proper in the moist asthma, ibid.
Atmosphere. See Air.
B
Ball's purging vermifuge powder, preparation of, 264.
Balsams, how to prepare.  Anodyne balsam, 423. Locatelli's bal-
sam, ibid. Vulnerary balsam, ibid.
Bandages, tight, produce most of the bad consequences attending
fractured bones, 403.
Bark, Peruvian, the best antidote for sailors against disorders on a
foreign coast, 51. How to be administered in the ague, 114.
Distinction between the red bark and quill bark, ibid. note. A
decoction or infusion of, may be taken by those who cannot swal-
low it in substance, 115. Is often adulterated, ibid. note. Is the
only medicine to be depended on in agues, 117. How it may be
rendered more palatable, ibid. May be administered by clyster,
ibid. Cold water the best menstruum for extracting the virtues
of this drug, 135. How to be administered in the putrid fever,
145; and in the erysipelas, 190. In an inflammation of the eyes,
197. Its efficacy in a malignant quinsey, 204. In the hooping
cough, 213. A good medicine in vomiting, when it proceeds.
from weakness of the stomach, 231. Its efficacy in a diabetes,
and how to take it, 234. Is good against the piles, 243; and
worms, 263. Its use dangerous for preventing a fit of the gout,
272: A good remedy in the king's evil, 282; and in the stuor
albus, 259.
Barley water, how made, 123.
Barrenness in women, the general causes of, 368. Course of relief,
ibid. Dr. Cheyne's observation on, ibid. note.
Bath waters, good in the gout, 247.
Bath, cold, the good effects of, on children, 40. Recommended to 

479 INDEX.
the studious, 60. Is peculiarly excellent for strengthening the
nervous system, 297. Therefore should never be omitted in gleets,
342. Is good for rickety children, 384. Cautions, concerning the
improper use of, in adults, 426. 429.
Bath, warm, of great service in an inflammation of the stomach,
214.
Bathing, a religious duty under the Judaic and Mahomitan laws,
84. Is conducive to health, ibid.
Bears foot, recommended as a powerful remedy against worms, 263.
Beds, instead of being made up again as soon as persons rise from
them, ought to be turned down and exposed to the air, 69. Bad
effects of too great indulgence in bed, 73. Damp, the danger
of, 100. Soft, are injurious to the kidnies, 233. 235.
Beer, the ill consequences of making it too weak, 64. Pernicious
artifices of the dealers in, ibid.
Bells, parish, the tolling them for the dead, a dangerous custom, 91.
Biles, 399.
Bilious cholic, symptoms and treatment of, 219.
Bilious fever. See Fever.
Bite of a mad dog. See Dog.
Bitters warm and astringent, antidotes to agues, 115. Are service-
able in vomiting when it proceeds from weakness in the sto-
mach, 231.                                   
Bladder, inflammation of, its general causes, 223. Medical treat-
ment of, ibid.
Bladder, stone in. See Stone.
Blast. See Erysipelas.                  
Bleeding, cautions for the operation of, in fevers, 111. In the
ague, 114. Its importance in the acute, continual fever, 121.
In the pleurisy, 123. When necessary in an inflammation of the
lungs, 127. Caution against, in a nervous fever, 129. In the
putrid fever, 144. In the miliary fever, 150. When necessary in
the yellow fever, 160. When necessary in the small-pox, 171,
When useful in the measles, 184. When necessary in the bilious
fever, 188. Under what circumstances proper in the erysipelas,
190. Mode of, proper in an inflammation of the brain, 194. Is
always necessary in an inflammation of the eyes, 196. When
proper, and improper, in a cough, 298. When proper in the
hooping-cough, 211. Is almost the only thing to be depended
on in an inflammation of; the stomach, 214. And in an inflam-
mation of the intestines; 215. Is necessary in an inflammation, of
the kidnies, 222. Its use in a suppression of urine, 235. Is pro-
per in an asthma, 287. Is dangerous in fainting-fits, without
due caution, 310. Cautions proper in the puerperal fever, 366. 
Is an operation generally performed by persons who do not
understand when it is proper, 387. In what cases it ought to be,
had recourse to, 392, The quantity taken away, how to be regu- 

480 INDEX.
lated, 388. General rules for the operation, ibid. Objections to
bleeding by leeches, ibid. Prevailing prejudices relating to bleed-
ing, ibid. The arm the most commodious part to take blood
from, 389.
Bleeding at the nose, spontaneous, is of more service, where bleed-
ing is necessary, than the operation with the lancet, 240. Ought
not to be stopped without due consideration, ibid. How to stop
it when necessary, ibid. Cautions to prevent frequent returns
of, 242.
Blind persons, when born so, might be educated to employments
suited to their capacity, 319, note.
Blisters, peculiarly advantageous in the nervous fever, 130. When
only to be. applied in the putrid fever, 144. When proper in
the miliary fever, 150. Seldom fail to remove the most obstinate
inflammation of the eyes, 196. A good remedy in the quinsey,
200. Proper for a violent hooping-cough, 212. Is one of the best
remedies in an inflammation of the stomach, 214. Are effica-
cious in the tooth-ach, 257.
Blood, involuntary discharges of, often salutary, and ought not to
be rashly stopped, 238. The several kinds of these discharges,
with their usual causes, 239. Methods of cure, ibid.
Blood, spitting of, who most subject to, and at what seasons, 244,
Its causes, ibid. Symptoms, 245. Proper regimen in, ibid. Me-
dical treatment, 246. Cautions for persons subject to it, ibid.
Blood, vomiting of, its causes and symptoms, 246. Medical treat-
ment, 247.
Blood-shot eye, how to cure, 321.
Bloody-flux. See Dysentery.
Boerhaaze, his observation on dress, 78, note. His mechanical ex-
pedients to relieve an inflammation of the brain, 193.
Boluses, general rules for the preparing of, 443. The astringent
bolus, 444. Diaphoretic bolus, ibid. Mercurial bolus, ibid. Bo-
lus of rhubarb and mercury, ibid. Pectoral bolus, ibid. Purging
bolus, ibid.
Bones, the exfoliation of, a very slow operation, 395 Bones broken,
often successfully undertaken by ignorant operators, 401. Re-
gimen to be adopted after the accident, 402. Hints of conduct
if the patient is confined to his bed, ibid. Cleanliness to be re-
garded during this confinement, ibid. The limb not to be kept
continually on the stretch, ibid. Cautions to be observed in set-
ting a bone, 403. Tight bandages condemned, ibid. How to
keep the limb steady by an easy method, ibid. Fractures of the
ribs, ibid.
Bowels, inflammation of. See Stomach.
Braidwood, Mr. his skill in teaching the dumb to speak, 321, note.
Brain, inflammation of, who most liable to it, with its causes and
symptoms, 192. Regimen, 193. Medical treatment, 194.
Bread, proper food for children as soon as they can chew it, 33. 

481 INDEX.                 
A crust of, the best gum-stick, ibid. The best modes of prepar-
ing it in food for children, 34. Good, the qualities of, and for
what purpose adulterated by the bakers, 64. Toasted, a decoc-
tion of, good to check the vomiting in a cholera morbus, 227.
Brimstone. See Sulphur.
Broth, gelatinous, recommended in the dysentery, how to make,
250.
Bruises, why of worse consequence than wounds, 395. Prope
treatment of, ibid. The exfoliation of injured bones a very
How operation, ibid. How to cure sores occasioned by, ibid.
Buboes, distinguished, with their proper treatment, 344. What
ought to be done, ibid, note.
Burdens, heavy, injurious to the lungs, 47.
Burgundy pitch, a plaister of, between the shoulders, an excellent
remedy in a cough, 209. In a hooping-cough, 212. And for
children in teething, 381.
Burials, the dangers attending their being allowed in the midst of
populous towns, 68.
Burns, slight, how to cure, 393. Treatment of, when violent,
ibid. Extraordinary case of, 394. Liniment for, 458.
Butchers, their professional artifices explained, and condemned, 62.
Butter ought to be very sparingly given to children, 35.
C
Camphor, why of little use in eye-waters, 446.
Camphorated oil, preparation of, 459.
Camphorated spirit of wine, 467.
Camps, the greatest necessity of consulting cleanliness in, 84.
Cancer, its different stages described, with the producing causes,
325. Symptoms, ibid. Regimen and medical treatment, 326,
Dr. Storck's method of treating this disorder, 327. Cautions
for avoiding it, 328.
Cancer scroti. a disorder peculiar to chimney sweepers, owing to
want of cleanliness, 82, note.
Carriages, the indulgence of, a sacrifice of health to vanity, 72.
Carrot, wild, recommended in the stone, 238.
Carrot poultice for cancers, how to prepare, 328.
Casualties, which apparently put an end to life, necessary cautions
respecting, 406, 411, 413, 417, 425.
—substances stopped in the gullet, 407.
—drowning, 411.
—noxious vapours, 413.
—extremity of cold, 415.
—extreme heat, 416.
—drinking cold water in warm weather, 417.
Cataplasms, their general intentions, 444. Preparation of the dif-
cutient cataplasm, ibid. Ripening cataplasm, ibid.
Cataract, the disorder and its proper treatment described, 320
P3 

482 INDEX.
Cattle, stall fed, are unwholesome food, 61. Over-driven, are
killed in a high fever, ibid. Artifices of butchers exposed, 62.
Cellars, long shut, ought to be cautiously opened, 69. And sunk
stories of houses, unhealthy to live in, 101. Of liquors in a
state of fermentation, dangerous to enter, 414. How to puri-
fy the air in, ibid.
Celsus, his rules for the preservation of health, 104.
Chancres, described, 345. Primary how to treat, 346. Symp-
tomatic, ibid.
Charcoal fire, the danger of sleeping in the fume of, 414.
Charity, the proper exercise of, 49.
Cheyne, Dr. his persuasive to the use of exercise, 72. His judg-
ment of the due quantity of urine not to be relied on, 97. His
observations on barrenness, 368, note.
Chilblains, cause of, 37S. How to cure, ibid.
Child-bed women, how to be treated under a miliary fever, 150.
Child-bed fever. See fever.
Child-birth, the season of, requires due care after the labour-pains
are over, 363. Medical advice to women in labour, ibid. Ill
effects of collecting a number of women on such occasions,
ibid note. Plow to guard against the miliary fever, 365. Symp-
toms of the puerperal fever, ibid. Proper treatment of this
fever, ibid. General causes for women at this season, 367.
Children, their diseases generally acute, and delay dangerous, 26.
Their disorders less complicated, and easier cured than these of
adults, ibid. Are often the heirs of the diseases of their pa-
rents, ibid. These born of diseased parents, require peculiar
care in the nursing, 28. Are often killed or deformed by inju-
dicious clothing, ibid. How treated in Africa, 29, note. The
usual causes of deformity in, explained, ibid. heir clothes
ought to be fastened on with strings, 30. General rules for
clothing them, 31. Cleanliness an important article in their
dress, ibid. The milk of the mother the most natural food for,
32. Absurdity of giving them drugs as their first food, ibid.
The best method of expelling the meconium, ibid. How they
ought to be weaned from the breast, 33. A crust of bread the
best gum-stick for them, ibid. How to prepare bread in their
food, ibid. Cautions as to giving them animal food, ibid. Cau-
tions as to the quantity of their food, 34, note. Errors in the
quality of their food more frequent than in the quantity, ibid.
The food of adults improper for children, ibid. Strong liquors
expose them to inflammatory disorders, 35. Ill effects of un-
ripe fruit, ibid. Butter, ibid. Honey, a wholesome article of
food for them, ibid. The importance of exercise to promote
their growth and strength, 36. Rules for their exercise, ibid.
Poverty of parents occasions their neglect of children, 37. The
utility of exercise demonstrated from the organical structure of
children, 38. Philosophical arguments shewing the necessity 

483 INDEX.                  
of exercise, ibid. Ought not to be sent to school too soon, ibid.
Nor be put too soon to labour, 39. Dancing an excellent ex-
ercise for them, 40. The cold bath, 41. Want of wholesome
air destructive to children, ibid. To wrap them up close in cra-
dles pernicious, 42. Are treated like plants in a hot-house,
ibid. The usual faulty conduct of nurses pointed out, 43. Are
crammed with cordials by indolent nurses, ibid. Eruptions ig-
norantly treated by nurses, 44. Loose stools, the proper treat-
ment of, ibid. Every method ought to be taken to make them
strong and hardy, 45. Indications of the small-pox in, 167.
Chin-cough. See cough.
Cholera morbus, the disorder defined, with its causes and symp-
toms, 226. Medical treatment, 227. If the vomiting continue
obstinate, what to be applied, 228, note.
Churches, circumstances that render the air in, unwholesome, 68.
Churching of women after lying in, a dangerous custom, 367.
Church-yards, bad consequences of having them in large towns, 68.
Cities, large, the air in, contaminated by various means, ibid. The
bad effects of burying the dead in, ibid. Houses ought to be
ventilated daily, 69. The danger attending small apartments,
ibid. All who can, ought to sleep in the country, ibid. Disor-
ders that large towns are peculiarly hurtful to, ibid. Cleanliness
not sufficiently attended to in, 82. Should be supplied with
plenty of water, 85, note. The best means to guard against in-
fection in, 86.
Clare, Mr. his method of applying saline preparations of mercury
in venereal cases, 349.
Cleanliness, an important article of attention in the dress of chil-
dren, 31; and to sedentary artists, 54. Finery in dress often co-
vers dirt, 78. Is necessary to health, 82. Disorders originating
from the want of, ibid. Is not sufficiently attended to in large
towns, 83. Nor by country peasants, 84. Great attention paid
to by the ancient Romans, ibid, note. Necessity of consulting
cleanliness in camps, Ibid. Was the principal object of the whole
system of the Jewish laws, ibid. Is a great part of the religion of
the eastern countries, ibid. Bathing and washing greatly condu-
cive to health, ibid. Cleanliness peculiarly necessary on board of
ships 85, and to the sick, ibid. General remarks on, ibid. Many
disorders may be cured by cleanliness alone, 108. The want of,
a cause of putrid fevers, 141. Is a great preservative against vene-
real infection, 353; and against galling in infants, 372.
Clergy exhorted to remove popular prejudices against inoculation,
177. Might do great good by undertaking the practice of it
themselves, 180.
Clothing, the only natural use of, 28. That of children has be-
come a secret art, ibid. Ought to be fastened on infants with strings
instead of pins, 30. Pernicious consequences of stays, 31. Im-
portance of cleanliness to children, ibid. The due quantity of, 

484 INDEX.
dictated by the climate, 76. Should be increased in the decline of
life, ibid, and adapted to the seasons, ibid. Is often hurtful by
being made subservient to the purposes of vanity, 77. Pernicious
consequences of attempting to mend the shape by dress, ibid.
Stays, ibid. Shoes, ibid. Garters, buckles, and other bandages, 78.   
The perfection of, to be easy and clean, ibid. General remarks   
on, ibid. Wet, the danger of, and how to guard against it, 99.
Clysters, a proper form of, for an inflammation of ihe stomach, 214.
And for an inflammation of the intestines, 215. Of tobacco
smoke, its efficacy in procuring a stool, 220. note. Of chicken
broth salutary in the cholera morbus, 227. their use in the sup-
pression of urine, 235. Ought to be frequently administered in
the puerperal fever, 366. Of tobacco, to excite a vomit, 409.
The general intention of, 445. Preparation of the emollient cly-
ster, ibid. Laxative clyster, ibid. Carminative clyster, ibid. Oily
clyster, ibid. Starch clyster, 446. Turpentine clyster, ibid. Vi-
negar clyster, ibid.
Cœliac pession, proper treatment for, 253.
Coffee berries recommended in the stone, 238.
Cold, extreme, its effects on the human frame, 415. The sudden
application of heat dangerous in such cases, 416. How to re-
cover frozen or benumbed limbs, ibid.
Cold Bath. See Bath.
Colds frequently occasioned by imprudent changes of clothes at
the first approaches of summer,78, note. Various causes of, spe-
cified, 98. Their general causes, 102. Proper regimen on the
symptoms of, appearing, ibid. Danger of neglecting the disor-
der, 206. The secret for avoiding, 207.
Cholic, different species of, 217. Medical treatment of, according
to their species and causes, 218. Bilious cholic, 219. Hysteric
cholic, ibid. Nervous cholic, 220. Cautions necessary to guard
against the nervous cholic, ibid. General advice in cholics, ibid,
Colyria. See Eye-waters.
Commerce often imports infections disorders, 87. Means sugges-
ted to guard against this danger, ibid, note.
Confections often very needlessly compounded, 447. Preparation of
the Japonic confection, ibid.
Conserves and preserves, general remarks on, and their composition,
ibid. Of red roses, ibid. Of sloes, ibid. Candied orange-peel, 438.
Constitution, good or bad, the foundation of, generally laid during
infancy, 23.
Consumptions. the increase of this disorder may be attributed to
hard drinking, 81. Who most liable to, and its causes, 128.
Symptoms, 130. Regimen, ibid. Riding, ibid. Much benefit to
be expected from going a long voyage, 131. Travelling, ibid.
Diet, ibid. Great efficacy of milk in, ibid. Medical treatment, 134.
Consumptions, nervous, defined, and the persons most liable to, 136.
Proper treatment of, ibid.     

485 INDEX.                  
—Symptomatic, the treatment must be directed to the
producing cause, ibid.
Convulsions, why new-born infants are so liable to, 30. Those pre-
ceding the eruption in the small-pox favourable symptoms, 167.
The general causes of, 384. Proper treatment of, ibid. Extra-
ordinary recovery of an infant seemingly killed by, 425. Farther
instructions in like cases, ibid.
Cook, captain, the circumnavigator, his means of preserving the
health of his men, 51, note.
Cookery, the arts of, render many things unwholesome, that are
not naturally so, 63.
Cordials ought not to be given to infants, 32. Are common refuge
of nurses, who neglect their duty to children, 44. Are often
fatal in an inflammation of the stomach, 214. When good in
the cholic, 218. Ought not to be given to a pregnant woman
during labour, 363.
Corn, damaged, will produce the putrid fever, 141.
Corns in the feet are occasioned by wearing tight shoes, 77.
Cortex. See Bark.
Costiveness, a frequent recourse to medicines for the prevention of,
injurious to the constitution, 95. Is rather to be removed by diet
than by drugs, ibid. Its general causes, and ill effects, 96. Regi-
men, ibid. Remedies for, ibid.
Cough, the proper remedies for, 206. A plaister of Burgundy-pitch
laid between the shoulders an excellent remedy for, 209. The
stomach-cough, and cough of the lungs, distinguished, ibid.
Flannel should be wore next the patient's skin to promote per-
spiration, 209, note. Treatment for the nervous cough, 210.
Cough, hooping, who most liable to, with its disposing causes, ibid.
Remedies, 211. Is infectious, ibid. Vomits, their use, and how
to administer them to children, 212. Garlic ointment a good re-
medy for, ibid.
Cough, phthisical, incident to sedentary artificers, from their breath-
ing confined air, 52.
Cradles, on many accounts, hurtful to children, 42.
Cramp, proper remedies for, 315.
Cramp of the stomach, who most subject to, 307. Medical treat-
ment of, ibid. Going into the warm bath, very efficacious, 380,
note.
Crotchets, how to use for extracting substances detained in the gul-
let, 408.
Croup or hives, its symptoms and treatment, 379, 380.
Cyder, the ill consequences of making it too weak, 64.
Cynanche Parotidæa; or the Mumps, is most incident to children;
its symptoms, regimen and medicine, 205.
D                       
DANCING, an excellent kind of exercise for young persons, 40.
Dancus sylvestris. See Carrot.

486 INDEX.
Deafness, when a favourable symptom in the putrid fever, 143.
note. Methods of cure, according to its causes, 321.
Death, the evidences of, sometimes fallacious, and ought not to be
too soon credited, 406. 411. 413. 417. Means to be used for
the recovery of persons from, nearly the same in all cases, 425.
Decoctions, general remarks on, 448. Preparation of the decoction
of althæa, ibid. Common decoction, ibid. Of logwood, ibid. Of
bark ibid. Compound decoction of bark, ibid. Of sarsaparilla,
449. Of seneka, ibid. White decoction, ibid.
Deformity often occasioned by the injudicious manner of dressing
children, 28. Is seldom found among savage nations, 29. The
usual causes of, explained, ibid.
Dews, night, dangerous to health, 100.
Diabetes, who most liable to this disorder, 213. Its causes and
symptoms, ibid. Regimen and medical treatment, 214. Distin-
guished from incontinency of urine, 234.
Diarrhœa. See Looseness.
Diet will often answer all the indications of cure in diseases, 107.
Illustrations, 98. See Aliment.
Digestion, powers of, equally impaired by repletion or inanition,
65.
Diseases, hereditary, cautions to persons afflicted with, 28. Pecu-
liar disorders attending particular occupations, 45;. Many of them
infectious, 86. The knowledge of, depends more upon experi-
ence and observation, than upon scientifical principles, 105. Are
to be distinguished by the most obvious and permanent symptoms,
ibid. The difference of sex, age, and constitution, to be consider-
ed, 106. Of the mind, to be distinguished from those of the
body, ibid. Climate, situation, and occupation to be attended to,
ibid. Other collateral circumstances, ibid. Many indications of
cure, to be answered by diet alone, ibid. Cures often effected by
fresh air, by exercise, or by cleanliness, 107. Nervous diseases, of
a complicated nature, and difficult to cure, 294.
Dislocations should be reduced before the swelling and inflamma-
tion come on, and how, 397. Of the jaw, 398. Of the neck,
399. Of the ribs, ibid. Of the shoulder, 400. Of the elbow,
ibid. Of the thigh, 401. Of the knees, ancles, and toes, ibid.
Diuretic infusion for the Dropsy, how to prepare, 269.
Dog, symptoms of madness in, 331. Ought to be carefully pre-
served after biting any person, to ascertain whether he is mad or
not, 332. Is often reputed mad when he is not so, ibid. Symp-
toms of the bite of a mad dog, ibid. The poison cannot lay ma-
ny years dormant in the body, as is supposed, 333. Dr. Mead's
receipt for the bite, ibid. The famous East-India specific, 334.
Other recipes, ibid. Vinegar of considerable service in this dis-
order, ibid. Medical course of treatment recommended, ibid.
Regimen, ibid. Dipping in the sea not to be relied on, 335. Dr.
Tissot's medical course for the cure of the hydrophobic, 336. 

487 INDEX.                   
Remarks on the Ormskirk medicine, ibid, note.
Doses of medicine, the relative proportion of, for different ages, 440.
Drams ought to be avoided by persons afflicted with nervous dis-
orders, 296.
Draught is the proper form for such medicines as are intended
for immediate operation, 449. How to prepare the anodyne
draught, ibid. Diuretic draught, ibid. Purging draught, ibid.
Sweating draught, 450. Vomiting draught, ibid.
Dress. See Clothing.
Drinking, persons who are seldom intoxicated may nevertheless in-
jure their constitutions by, 81. The habit of drinking frequent-
ly originates from misfortunes, ibid. Frequently destroys the
powers of the mind, ibid. Persons often forced to it by mistaken
hospitality, ibid, note. Leads to other vices, 82.
Dropsy, the several distinctions of, with its causes, 266. Symp-
toms, 267. Regimen, ibid. Medical treatment, 268. Bleeding
when proper and when improper, ibid, note. Tapping, a safe
and simple operation, 270.
Dropsy of the brain. See Water in the head.
Drowned persons ought not to be given up for dead, 411. Proper
trials for the recovery of such, ibid. When electricity should be
applied, and where most effectually done, ibid, note. The ef-
fects of a large flexible tube or cathetar for inflating the lungs,
412, note. A caution given in bleeding, purging, and clyster-
ing, ibid, note. Endeavours ought not to be suspended upon the
first returns of life, 413. Success of the Amsterdam society for
the recovery of, 425.
Drunkenness. See Intoxication.
Dumb persons taught to read, write, and discourse, 321, note.
Dysentery, where and when most prevalent, 248. Its causes and
symptoms, 249. Regimen, ibid. Fruit, one of the best remedies
for, 251. Proper drink for, ibid. Medical treatment for, ibid.
Indications of cure, how  more effectually answered, 252, note.
Cautions to prevent a relapse, ibid.
E.
EAR, the several injuries it is liable to, 321. Deafness, medicinal
treatment of, according to its causes, 322. Ought not to be tam-
pered with, ibid. Good effects have been derived from wearing
a conical plug in the ear, made of the stalk of a green cabbage,
ibid, note.
Ear-ach, its causes, and proper treatment for, 258. How to drive
infects out of, ibid.
Education of children should be begun at home by the parents, 383
note. That of girls hurtful to their constitution, 29.
Effluvia, putrid, will occasion the spotted fever, 141.
Electricity beneficial in the palsy, 301.
Electuaries, general rules for making, 450. Preparations of leni-
tive electuary, ibid. Electuary for the dysentery, ibid. For the 

488 INDEX.
epilepsy, ibid. For the gonorrhœa, 451. Of the bark, ibid. For
the piles, ibid. For the palsy, ibid. For the rheumatism ibid.
Elixir paregoric, how to prepare, 467. Sacred elixir, ibid. Sto-
machic elixir, ibid. Acid elixir of vitriol, ibid.
Emulsions, their uses, 451. Preparation of the common emulsion,
ibid. Arabic emulsion, 452. Camphorated emulsion, ibid. Emul-
sion of gum ammoniac, ibid. Oily emulsion, ibid.
Engleman, Dr. his account of the German method of recovering
persons from fainting-fits, 420.
Entrails. See Intestines.
Epilepsy, the disorder defined, 304. Its causes, ibid. Symptoms,
305. Due regimen, ibid. Medical treatment, ibid.
Eruptions in children often free them from bad humours, but are
mistaken and ill treated by nurses, 44. Ought never to be stop-
ped without proper advice, ibid. In fevers, how to be treated,
140, 143, 148. In the small-pox, 169, 170. In children, the
causes of, 377. How to cure, ibid.
Erysipelas, a disorder incident to the laborious, 48. Its causes ex-
plained, and who most subject to it, 188. Its symptoms, 189.
Regimen, ibid. Medical treatment, 190. The scorbutic erysipe-
las, 191. Instructions for those subject to this disorder, ibid.
Evacuations of the human body, the principal, specified, 95. By
stool, ibid. Urine, 97. Perspiration, 98.
Exercise, the importance of, to promote the growth and strength of
children, 36. All young animals exert their organs of motion as
soon as they are able, ibid. The utility of it proved from ana-
tomical considerations, 38, and from philosophical deductions,
ibid. Benefits of dancing, 40. Is better for sedentary persons un-
der lowness of spirits than the tavern, 54. Gardening the best
exercise for the sedentary, ibid. Violent, ought not to be taken
immediately after a full meal, 59. Is as necessary as food for the
preservation of health, 71. Our love of activity an evidence of
its utility, ibid. Indolence relaxes the solids, ibid. The indul-
gence of carriages as absurd as pernicious, 72. Is almost the on-
ly cure for glandular obstructions, ibid. Will prevent and re-
move those disorders that medicine cannot cure, ibid. Is the best
cure for complaints in the stomach, 73. How to be taken with-
in doors, when not to be done in the open air, ibid. Active
sports better than sedentary amusements, 74. Exercise should
not be extended to fatigue, ibid. Is as necessary for the mind as
for the body, 93. Is often of more efficacy than any medicine
whatever, 107. The best mode of taking it in a consumption,
130. Is of the greatest importance in a dropsy, 268. Muscular,
for the gout, 273. Is necessary for the asthmatic, 287. Is supe-
rior to all medicine in nervous disorders, 296.  And in the pal-
sy, 302. Is proper for pregnant women, unless they are of a very
delicate texture, 363.  Want of, the occasion of rickets in chil-
dren, 382. 

489 INDEX.                  
Extracts, general rules for making; but are more conveniently
purchased ready made, 452.
Eyes, inflammation of the, its general causes, 194. Symptoms, 195.
Medical treatment, 196. How to be treated when it proceeds
from a scrophulous habit, 197. Advice to those who are subject
to this complaint, ibid. Are subject to many diseases which are
difficult to cure, 319. The means by which they are frequently
injured, ibid. General means of prevention, ibid. The severel
disorders of the, with their medical treatment, ibid. Good ef-
fect of electuary when applied near the eyes, 320, note.
Eye-waters, general remarks on, and their principal intentions, 446.
Collyrium of alum, ibid. Vitriolic collyrium, ibid. Collyrium of
lead, ibid.
F
FAINTING-FITS, how to cure, 309, 414. Cautions to persons
subject to them, 418.
Falling-sickness. See Epilepsy.
Fasting, long, injurious to those who labour hard, 49. Is hurtful
both to old and young, 66.
Fathers culpably inattentive to the management of their children,
25. Their irregular lives often injure the constitution of their
children, 27.
Fear, the influence of, very great, in occasioning and aggravating
diseases, 90. Its various operations, ibid.
Feet injured by wearing tight shoes, 78. The washing of, an agree-
able article of cleanliness, 84. Wet, the danger of, 99. Bathing
them in warm water, a good remedy in a cold, 207. And in the
hooping-cough, 212.
Fermentation, the vapour of liquors in a state of, noxious, 414.
Fevers, of a bad kind, often occasioned among labourers by poor
living, 50. Frequently attack sedentary persons after hard drink-
ing, 54. Nervous, often the consequence of intense study, 57.
Putrid and malignant, often occasioned by want of cleanliness,
83. The most general causes of, enumerated, 108.  The dis-
tinguishing symptoms of, 109. The several species of, ibid. Is
an effort of nature, which ought to be assisted, ibid. How this
is to be done, ibid. Cordials and sweetmeats improper in, 110.
Fresh air of great importance in, 111. The mind of the patient
ought not to be alarmed with religious terrors, ibid. Cautions
as to bleeding and sweating in, ibid. Longings, the calls of na-
ture, and deserve attention, 112. Cautions to prevent a relapse,
ibid.
Fever, acute continual, who most liable to, 118. Causes, ibid.
Symptoms, 119. Regimen, ibid. Medical treatment, 121. Symp-
toms favourable and unfavourable, ibid. Regimen to be observ-
ed during recovery, 122.
Fever, bilious, general times of its appearance, 187. Proper treat-
ment of, according to its symptoms, 188. 
Q3

490 INDEX.
Fever, intermitting. See Ague.
Fever, miliary, from what the name derived, and its general appear-
ances, 147. Who most liable to it, ibid. Causes, ibid. Symp-
toms, 148. Regimen, ibid. Account of a miliary fever at Stras-
burgh, 149, note. Proper medical treatment, ibid. Cautions for
avoiding this disorder, 150. How to prevent, in childbed wo-
men, 365.
Fever, milk, how occasioned, ibid. How to prevent, 366.
Fever, nervous, why more common now than formerly, and who
most liable to it, 137. Its causes, ibid. Symptoms and proper
regimen, 138. Medical treatment, 139.
Fever, puerperal, or childbed, the time of its attack, and symptoms,
365. Medical treatment of, 366. Cautions for the prevention
of this fever, 367.
Fever, putrid, is of a pestilential nature, and who most liable to it,
141. Its general causes, ibid. Symptoms of, 142. Other fevers
may be converted to this by improper treatment, ibid. Favoura-
ble and unfavourable symptoms of, 143. Regimen, ibid. Me-
dical treatment, 144. Cautions for the prevention of this disor-
der, 146.
Fever, remitting, derivation of its name, 150. Its causes and symp-
toms, ibid. Proper regimen, 151. Medical treatment, ibid.
Cautions for avoiding this fever, 152.
Fever, scarlet, why so named, and its usual season of attack, 186.
Proper treatment of, ibid. Is sometimes attended with putrid
and malignant symptoms, 187. Medicines adapted to this stage
of the malady, ibid. Bleeding necessary, if the pulse be full and
hard, ibid, note. History of a fever of this kind at Edinburgh,
ibid, note.
Fever, secondary in the small-pox, proper treatment of, 173.
Fever yellow, derivation of its name, and general appearance, 153.
Its causes, ibid. Symptoms, 154. Regimen, 160. Medicine, ibid.
Flatulencies in the stomach, remedies against, 259. The causes of,
311. Medical treatment of, ibid.
Flatulent colic, its causes, and seat of the disorder, 217. Remedies
for, 218.
Flower-de-luce, the yellow water, the root of, recommended for the
tooth-ach, 257.
Fluor-albus described, with its proper treatment, 359.
Fomentations, how to make and apply, 452. General intentions of,
ibid. Anodyne fomentation, ibid. Aromatic fomentation, 453.
Common fomentation, ibid. Emollient fomentation, ibid.
Strengthening fomentation, ibid.
Food. See Aliment.
Forgiveness of injuries ought to be practised from a regard to our
health, 90.
Fractures. See Bones broken.
Frozen limbs, how to recover, 416, 

491 INDEX.   
Fruit, unripe, very hurtful to children, 25. One of the best medi-
cines both for the prevention and cure of a dysentery, 251.
Funerals, the great number of visitors attending them, dangerous
to their health, 86.
G
GALLING, in infants, the cause of, 372.
Gangrene, proper treatment of, 389.
Gardening a wholesome amusement for sedentary persons, 54.
Gargles for the throat, how to make, 199, 203, 204. General in-
tentions of, 453.  Method of making the attenuating gargle, ibid.
Common gargle, ibid. Detergent gargle, ibid. Emollient gargle,
454. For the mouth of infants in the thrush, ibid.
Garlic ointment, a North British remedy for the hooping-cough,
how to apply it, 212.
Generals of armies, how they ought to consult the health of the men
they command, 49.
Gilders. See Miners.
Ginger, syrup of, how to prepare, 465.
Girls, the common mode of education prejudicial to their consti-
tution, 39. Means of rectifying it recommended, ibid.
Gleet, how occasioned, and its symptoms, 342. Method of cure,
ibid. Regimen, ibid. Obstinate gleets cured by mercurial in-
jections, 343. Caution when suspected to proceed from ulcers,
ibid, note. How to apply bougies, 344.
Glover, Mr. his course of treatment for the recovery of a hanged
man, 423.
Gonorrhœa, virulent, the nature of, and its symptoms, 338. Regi-
men, 339. Medical treatment, ibid. Is often cured by astringent
injections, 340. Cooling purges always proper in, ibid. Mer-
cury seldom necessary in a gonorrhœa, 341. How to administer
it when needful, ibid.
Goulard, M. preparation of his celebrated extract of Saturn, 468.
His various applications of it, ibid.
Gout, the general causes of, 56. How to treat a looseness occasion-
ed by repelling it from the extremities, 228. The sources of this
disorder, and its symptoms, 270. Regimen for, 271. Wool the
best external application in, 272. Why there are so many nos-
trums for, ibid. Proper medicines after the fit, 273. Proper regi-
men in the intervals between fits to keep off their return, ibid.
How to remove it from the nobler parts to the extremities, 274.
General cautions to prevent danger by mistaken it for other
disorders, ibid.
Gravel, how formed in the bladder, 98. How distinguished from
the stone, 236. Causes and symptoms, ibid. Regimen, ibid.
Medical treatment, 237.
Green sickness originates in indolence, 356.
Grief, its effects permanent, and often fatal, 92. Danger of the
mind dwelling long upon one subject, especially if of a disagree-

492 INDEX.
able nature, 93. The mind requires exercise as well as the body,
ibid. Innocent amusements not to be neglected, ibid. Is pro-
ductive of nervous diseases, 294.
Gripes in infants, proper treatment of, 371.
Guaiacum gum, a good remedy for the quinsey, 200; and rheu-
matism, 276.
Gullet, how to remove substances detained in, 407. Caution for
the use of crotchets with this intention, ibid. Other mechanical
expedients, 408. Treatment if the obstruction cannot be moved,
410.
Gums of children, applications to, during teething, and how to cut
them, 382.
Gutta serena, proper treatment of, 320.
H
HÆMOPTOE, spitting of blood. See Blood.
Hœmorrhages. See Blood.
Harrowgate water, an excellent medicine for expelling worms, 263.
And for the jaundice, 266. In the scurvy, 280.
Head ach, the species of, distinguished, 253. Causes of, 254. Re-
gimen, ibid. Medical treatment, 255.
Health of the people in general, a proper object of attention for the
magistrates, 11. Ought to be attended to in matrimonial con-
tracts, 27. Is often laboured for after it is destroyed, 59. Rules
given by Celsus for the preservation of, 104.
Heart-burn, the nature of this disorder, with its causes, and reme-
dies for, 293.
Heat, extreme, how to recover persons overcome by, 416.
Hemlock, a good remedy in the king's evil, 283. Is recommended
by Dr. Storck for the cure of cancers, 327.
Hemp-seed, a decoction of, good in the jaundice, and how to pre-
pare it, 266.
Hiccup, its causes, and method of treatment, 306.
Hives, described, 378. Symptoms and medicine, 379.
Hives, spasmodic, 379. Symptoms and treatment, 380.
Hoffman, his rules for guarding child-bed women against the mili-
ary fever, 365.
Honey, a wholesome article of food for children, 35. Is recom-
mended in the stone, 238.
Hooping-cough. See Cough.
Hospitals, the want of fresh air in, more dangerous to the patients
then their disorders, 72. Cleanliness peculiarly necessary in, 85.
Often spread infection by being situated in the middle of popu-
lous towns, 87. How they might be rendered proper receptacles
for the sick, 88. Particularly in infectious disorders, 89. The
sick in, ought not to be crowding together, 169, note.
Horse-radish, the chewing of, will restore sensibility to the organs
of taste when injured, 324.
Houses, instead of contrivances to make them close and warm, 

493 INDEX.                  
ought to be regularly ventilated, 69. In marshy situations un-
wholesome, 70. Ought to be built in a dry situation, 101. Dan-
ger of inhabiting new-built houses before thoroughly dry, ibid.
Are often rendered damp by unseasonable cleanliness, ibid. Are
dangerous when kept too close and hot, 103.
Husbandmen, the peculiar disorders they are exposed to, from the
vicissitudes of the weather, 47.
Huxham, Dr. recommends the study of the dietetic part of medi-
cine, 12.                              '
Hydrocephalus. See Dropsy.
Hydrophobia, Dr. Tissot's method of curing, 336.
Hydrops pectoris. See Dropsy.
Hypochondriac affections frequently produced by intense study, 57.
Their causes, and who most liable to them, 319. The general
intentions of cure, ibid. Regimen, 317.
Hysterics, a disorder produced by the habitual use of tea, 62. Ge-
neral causes of, 313. Symptoms, 314. Proper treatment of,
ibid. Regimen, 315. Medicines adapted to, ibid.
Hysteric cholic, symptoms and treatment of, 219.
I
JAILS, why malignant fevers are often generated in them, 69.
Often spread infection by being situated in the middle of popu-
lous towns, 87. Ought to be removed, 83.
Janin, M. his relation of the recovery of an overlaid infant, 423.
And of a man who had hanged himself, ibid.
Jaundice, the different stages of its appearance, with the causes of
this disorder, 264. Symptoms and regimen, 265. Medical
treatment, ibid.
Jesuits Bark. See Bark.
Jews, the whole system of their laws tending to promote cleanli-
ness, 87, 88.
Iliac passion, a particular kind of inflammation of the intestines,
215.
Imposthume in the breast, in consumptions, how to make it break
inwardly, when not to be discharged by other means, 136. Im-
posthumes after the small-pox, proper treatment of, 174.
Incontinency of urine, distinguished from a diabetes, 234. Expe-
dient for relief, ibid.
Indigestion is one consequence of intense study, 57. General causes,
and remedies for, 291.
Indolence, its bid effects on the constitution, 71. Occasions glan-
dular obstructions, 72. Ill consequences of too much indulgence
in bed, 73. Is the parent of vice, 74. Is the general cause of
most nervous disorders, 318.
Infancy, the foundation of a good or bad constitution generally
laid in this season of life, 23.
Infants, nearly one-half of those born in Great-Britain, die under 

494 INDEX.
twelve years of age, 23. Perish mostly by art, 24. Ought not
to be suckled by delicate women, ibid. Importance of their be-     
ing nursed by their mothers, ibid. Often lose their lives, or be-   
come deformed, by errors in clothing them, 28. How the art of   
bandaging them became the province of the midwife, 29. How
treated in Africa, ibid, note. Philosophical observations on their  
organical structure, and on the causes of deformity, ibid. Why    
they so frequently die of convulsions, 30. Why exposed to fe-    
vers, 31. And colds, ibid. Rules for their dress, ibid. Their
food, 32. Reflections on the many evils they are exposed to,   
369. Why their first disorders are in their bowels, ibid. How    
to cleanse their bowels, ibid. The meconium, 370. Thrush, ibid.
Acidities, 371. Gripes, ibid. Galling and excoriation, 372.    
Stoppage of the nose, 373. Vomiting, ibid. Looseness, 374.
Vomiting and purging, 375. Eruptions, 377. Scabbed heads,
ibid. Chilblains, 378. The hives, ibid. Spasmodic hives, 379.
Teething, 380. Rickets, 382. Convulsions, 384. Water in the
head, 385. How to recover infants seemingly dead, 419. Ought
never to sleep in the same bed with their mothers or nurses,
422, note. Case of the recovery of an overlaid infant, 423. Case
of an infant seemingly killed by a strong convulsion-fit, and re-
covered, 424. See Children.
Infection, the danger of, incurred by injudicious or unnecessary at-
tendance on the sick, 86. And on funerals, ibid. Is often com-
municated by clothes, ibid. Is frequently imported, 87. Is
spread by hospitals and jails being situated in the middle of
populous towns, ibid. How to prevent infection in sick cham-
bers, 88. Physicians liable to spreed infection, ibid. note. In
what respect the spreading of infection might be checked by the
magistrate, ibid. Bleeding and purging, increase the danger of,
by debilitating the body, 146. Small-pox, 167.
Inflammations, how the laborious part of mankind expose them-
selves to, 48. Proper treatment of, 389.
Inflammation of the bladder. See Bladder.
—of the brain. See Brain.
—of the eyes. See Eyes.
—of the intestines. See Intestines.
—of the kidnies. See Kidnies.
—of the liver. See Liver.
—of the lungs. See Peripneumony.
—of the stomach. See Stomach.
—of the throat. See Quinsey.
—of the womb. See Womb.
Infections, advantages of, over decoctions, 454. How to obtain rich
infusions from weak vegetables, ibid. Preparation of the bitter
infusion, ibid. Infusion of the bark, ibid. Infusion of carduus,
ibid. Of linseed, ibid. Of roses, 455. Of tamarinds and senna,
ibid. Spanish infusion, ibid. For the palsy, ibid. 

495 INDEX.
Inns, the great danger of meeting with damp beds in them, 100.
The sheets in, how treated to save washing, 101.
Inoculation of the small-pox, more favourably received here than
in neighbouring counties, 175. Cannot prove of general utility
while kept in the hands of a few, ibid. No mystery in the pro-
cess, ibid. May safely be performed by parents or nurses, ibid.
Various methods of doing it, 176. The clergy exhorted to re-
move the prejudices against the operation, 177. Arguments ci-
ted from Dr. Mackenzie in favour of inoculation, ibid. note.
Ought to be rendered universal, 178. Means of extending the
practice of, 179. Two obstacles to the progress of, stated, ibid.
Might be performed by clergymen, or by parents themselves,
180. The proper seasons and age for performing it, 181. Will
often mend the habit of body, 182. Necessary preparation and
regimen for, ibid.
Infects, when they creep into the car, how to force them cut, 258.
Poisonous, the bites of, how to be treated, 337.
Intemperance, one great cause of the diseases of seamen, 50. The
danger of, argued from the constructions of the human body,
79. The analogy in the nourishment of plants and animals, ibid.
Is the abuse of natural passions, ibid. In diet, ibid. In liquor and
carnal pleasures, 80. The bad consequences of, involve whole
families, ibid. Effects of drunkenness on the constitution, ibid.
Persons who seldom get drunk, may nevertheless injure their
constitutions by drink, 81. The habit of drinking frequently ac-
quired under misfortunes, ibid. Is peculiarly hurtful to young
persons, 82. Leads to all other vices, ibid.
Intermitting fever. See Ague.
Intestines, inflammation of, general causes from  whence it pro-
ceeds, 215. The symptoms, regimen, and medical treatment,
ibid. Cautions to guard against it, 217.
Intoxication produces a fever, 80. fatal consequences of a daily
repetition of this vice, ibid. Persons who seldom get drunk, may
nevertheless injure their constitution by drinking, 81. Getting
drunk, a hazardous remedy for a cold, 206. Often produces
fatal effects, 421. Proper cautions for treating persons in liquor,
ibid. The safest drink after a debauch, ibid. Remarkable case,
ibid.                                            
Johnson, Dr. extraordinary recovery of an infant seermingly killed
by a strong convulsion-fit, related by, 424.
Issues,how to make them take the best effect, 300.  
Itch, the nature and symptoms of this disease described, 283. Sul-
phur, the best remedy against, 284. Great danger of the inju-
dicious use of mercurial preparations for, 285. Cleanliness the
best preservative against, ibid. note.
Juleps, the form of explained, 455. Preparation of the camphora-
ted julep, ibid. Cordial julep, ibid. Expectorating julep, 436.
Musk julep, ibid. Saline julep, ibid. Vomkmg julep, ibid. 

496 INDEX.
K
KERMES  mineral, recommended by Dr. Duplanil for the
hooping-cough, 212, note.
Kidnies, inflammation of, its general causes, 221. Its symptoms
and proper regimen, ibid. Medical treatment, 222. Where it
proceeds from the stone and gravel, ibid. Caution for those sub-
ject to this disorder, 223. See Gravel.
King's evil. See Scrophula.
L
LABORIOUS employments, the peculiar disorders incident to,
47. The folly of men emulating each other in trials of strength,
ibid. Disadvantages attending their diet, 50. How they expose
themselves to inflammations, 48. Danger of sleeping in the sun,
ibid. Long falling hurtful to them, 49. Injuries arising from
poor living, ibid. Many of the diseases of labourers not only
occasioned, but aggravated by poverty, ibid.
Labour should not be imposed too early on children, 40.
Labour in child-bed, medical advice for, 363. Inconveniencies of
collecting a number of women at, ibid, note.
Laudanum, its efficacy in fits of an ague, 113, note. Its efficacy in
giving to children, 117, note. How to be administered in a cho-
lera morbus, 228. In a looseness, 229. In a diabetes, 234. When
proper for the head-ach, 255. How to apply, for the tooth-ach,
257. Will ease pain in the gout, 272. How to administer for
the cramp in the stomach, 307. Is good for flatulencies, 311.
Effects of an over-dose of, 331. Medical treatment in this case,
ibid.
Leading-firings, injurious to young children, 37.
Leeches may be successfully applied to inflamed testicles, 344, note.
And to disperse buboes, 345, note. Are proper to apply to chil-
dren where inflammations appear in teething, 381. Objections
to bleeding with them, 388.
Lemons. See Oranges.
Leprosy, why less frequent in this country now than formerly, 281.
Requires the same treatment as the scurvy, ibid.
Lientery, proper treatment for, 253.
Life may frequently be restored, when the appearances of it are
suspended by sudden casualties, 406. 409. 413. 425.
Lightning, persons apparently killed by, might possibly be re-
covered by the use of proper means, 425.
Lime water recommended to prevent gravel in the kidnies from
degenerating to the stone in the bladder, 237. Is a good remedy
for worms, 263. Happy effects of, in the cure of obstinate ul-
cers, 397.                                   
Lind, Dr. his prescription to abate fits of an ague, 113, note. His
directions for the treatment of patients under putrid, remitting
fevers, 151, note.                                                       

497 INDEX.                
Liniment for burns, preparation of, 458. White liniment, ibid.
For the piles, 459. Volatile liniment, ibid.
Liquors, strong, expose children to inflammatory disorders, 35.
Fermented, the qualities of, examined, 64. The bad consequen-
ces of making them too weak, ibid. Why all families ought to
prepare their own liquors, ibid. Cold, the danger of drinking
when a person is hot, 102. 417.
Liver, schirrus, produced by sedentary employments, 56.
Liver, inflammation of, its causes and symptoms, 224. Regimen
and medical treatment, 225. Abscess in, how to be treated. ibid-
Means to be used when the convex surface of liver does not ad-
here to the peritonæum of the abdomen, ibid, note. The most ju-
dicious practice employed in the East-Indies and China, ibid,
note. Cautions in the event of a schirrus being formed, 226.
Lobelia, an American plant used by the natives in the venereal dis-
ease, 350.
Lochia, a suppression of, how to be treated, 364.
Lock-Jaw. See Tetanus.
Longings, in diseases, are the calls of nature, and often point out
what may be of real use, 110.
Looseness, habitual, general directions for persons subject to, 96. Its
general causes, 228. A periodical looseness ought never to be
stopped, 229.  Medical treatment of, according to its various
causes, ibid. Means of checking it when necessary, 230. A long
voyage to sea has entirely removed the complaint, after every
astringent and tonic medicine has failed in the chronic diarrhœa
of warm climates, ibid. note. In children, proper treatment of, 376.
Love, why perhaps the strongest of all the passions, 94. Is not rapid
in its progress, and may therefore be guarded against at its com-
mencement, ibid. To pretend so it for amusement, cruelty to
the object, ibid. Children often real martyrs between inclination
and duty, ibid, note.
Lues, confirmed, symptoms of, 348. Mercury the only certain re-
medy known in Europe for this disease, 349. Saline preparations
of mercury more efficacious than the ointment, ibid. The best
method of introducing mercury into the system to remedy this
disease, explained, ibid, note. How to administer corrosive sub-
limate, 350. This preparation is thought to be more efficacious
than any other, ibid, note. American method of caring this dis-
ease, ibid-
Lungs injured by artists working in bending postures, 53. Studi-
ous persons liable to consumptions of, 56.
Luxury highly injurious to the organs of taste and smell, 323.
M
MACKENZIE, Dr. his arguments in favour of inoculating in the
small-pox, 177, note.         
Mad dog. See Dog.
R3 

498 INDEX.
Magnesia alba, a remedy for the heart-burn, 294. Is the best me-
dicine in cases of acidity, 372.
Magnets, artificial, their reputed virtue in the tooth-ach, 257.
Malt liquors hurtful in the asthma, 286. See Beer.
Man, why inferior to brutes in the management of his young, 23.
Was never intended to be idle, 74.
Manufactures, the growth of, produced the rickets in children, 36.
More favourable to riches than to health, 40. Some, injurious to
health by confining artists in unwholesome air, 46. Cautions to
the workmen, ibid. Compared with agriculture, 52. Are injuri-
ous to health from artists being crowded together, 53. And
from their working in confined postures, ibid. Cautions offered
to sedentary artists, ibid. Sedentary arts better suited to women
than to men, 73, note.
Matrimony ought not to be contracted without a due attention to
health and form, 27.
Mead, Dr. his famous recipe for the bite of a mad dog, 333. His
character as a physician, ibid, note.
Meals ought to be taken at regular times, 66. Reasons for this
uniformity, ibid.
Measles have great affinity with the small-pox, 183. Cause and
symptoms, ibid. Proper regimen and medicine, 184. Bleeding
necessary in the, 185, note. Inoculation of, might prove very sa-
lutary, 186, note.
Mechanics ought to employ their leisure hours in gardening, 55.
Meconium, the best mode of expelling it, 32. 370.
Medicine, the origin of the art of, 12. The operation of, doubtful
at best, ibid. Is made a mystery of, by its professors, 15. The
study of, neglected by gentlemen, ibid. This ignorance lays men
open to pretenders, 16. Ought to be generally understood, 17.
A diffusion of the knowledge of, would destroy quackery, 19.
Objections to the cultivation of medical knowledge answered, 20.
The theory of, can never supply the want of experience and ob-
servation, 105.  
Medicines have more virtue attributed to them than they deserve,
107. Ought not to be administered by the ignorant, nor with-
out caution, 108. Want of perseverance in the use of, one rea-
son why chronic diseases are so seldom cured, 277. Many re-
tained, which owe their reputation to credulity, 437. Are mul-
tiplied and compounded in proportion to ignorance of the causes
and nature of diseases, ibid. Disadvantages of compounded me-
dicines, ibid. Are often adulterated for the fake of colour, ibid.
The relative proportions of doses of, for different ages, 439. A
list of such medical preparations as ought to be kept for private
practice, 441.
Melancholy, religious, its effects, 95. Leads to suicide, ibid. De-
fined, with its causes, 298. Symptoms and regimen, ibid. Me-
dicinal treatment, 299.        

499 INDEX.                  
Menstrual discharge in women, the commencement and decline of,
the most critical periods of their lives, 356. Confinement injuri-
ous to growing young women, ibid, and tight lacing for a fine
shape, 357. Symptoms of the first appearance of this discharge,
ibid. Objects of attention in regimen at this time, 358. Ought
to be restored whenever unnaturally obstructed, and how, ibid.
When an obstruction proceeds from another malady, the first
cause is to be removed, ibid. Treatment under a redundancy of
the discharge, 359. Regimen and medicine proper at the final
decline of the menses, ibid.
Mercury may be given in desperate cases of an inflammation of
the intestines, 217. Cautions for administering it, ibid, note.
Great caution necessary in using mercurial preparations for the
itch, 285. Is the only certain remedy known in Europe for the
cure of a confirmed lues, 349. Saline preparations of, more ef-
ficacious than the mercurial ointment, ibid. How to administer
corrosive sublimate in venereal cases, 350. Necessary cautions in
the use of mercury, 351. Proper season for entering on a course
of, 352. Preparations for, ibid. Regimen under a course of, ibid.
Mezereon root, a powerful assistant in venereal cases, 350.
Midwives, historical view of the profession, 28. How they became
intrusted with the care of bandaging infants, with the ill effects
of their attempts at dexterity in this office, ibid. Instance of
their rashness and officious ignorance, 369, note.
Miliary fever. See Fever.
Milk, that of the mother, the most natural food for an infant, 32.
A good substitute for, 33. Cows milk, better unboiled than boil-
ed, ibid. Is a good antidote against the scurvy, 62. Of more
value in consumptions than the whole Materia Medica, 131. Its
great efficacy in the scurvy, 279. A milk diet proper both for
men and women, in cases of barrenness, 368.
Milk fever. See Fever.
Mind, diseases of, to be distinguished from those of the body, 106.
See Passions.
Miners exposed to injuries from unwholesome air, and mineral par-
ticles, 45. Cautions to, 46.
Mineral waters, the danger of drinking them in too large quanti-
ties, 233. Are of considerable service in weaknesses of the sto-
mach, 293. Cautions concerning the drinking of, 430. 433.
Mixtures, general remarks on this form of medicines, 456. Compo-
sition of the astringent mixture, ibid. Diuretic mixture, ibid.
Laxative absorbent mixture, ibid. Saline mixture, 457. Squill
mixture, ibid.
Molasses, an intoxicating spirit much used by the common people
at Edinburgh, 81, note.
Mothers, preposterous, when they think it below them to nurse
their own children, 23. Under what circumstances they may be
really unfit to perform this task, 24. Importance of their suck- 

500 INDEX.
ling their own children, ibid, note. Delicate mothers produce
unhealthy short-lived children, 27. Their milk, the best food for
children, 32. Ought to give their children proper exercise, 37;
and air, 41.
Mouth, cautions against putting pins or other dangerous articles
into, 408.
Mumps. See Cynanche Parotidœa.
Muscular exercise, a cure for the gout, 273.
Music, the performance or, recommended as a proper amusement
for studious persons, 59.
Musk, extraordinary effects produced by, under particular circum-
stances, in the nervous fever. 140. It a good remedy in the epi-
lepsy, 306. And for the hiccup, 307. Deafness cured by, 322.
Mustard, white, a good remedy in the rheumatism, 277.
N
NAIURAL history, the study of, necessary to the improvement
of agriculture, 15. 
Nervous diseases, the most complicated and difficult to cure of all
others, 291. General causes and symptoms of, 295. Regimen,
296. Medical treatment, 297. A cure only to be expected from
regimen, ibid. The several symptoms of, though differently
named, all modifications of the same disease, 317.
Nervous colic, its causes & symptoms, 220. Medical treatment of, ib.
Nervous fever. See Fever.
Night-mare, its causes and symptoms described, 308. Proper treat-
ment of, 309.
Night-shade, an infusion of, recommended in a cancer, 327.
Nitre, purified, its good effects in a quinsey, 200. Is an efficacious
remedy for the dropsy, 269. Promotes urine and perspiration,
300.
Nose, ulcer in, how to cure, 323. Stoppage of, in children, how to
cure, 373. See Bleeding at.
Nurses, their superstitious prejudices in bathing of children, 41.
The only certain evidence of a good one, 43. Their usual faults
pointed out, ibid. Should be clear of all deformities of the eyes,
ibid, note. Administer cordials to remedy their neglect of duty
towards children, 44. Their mistaken treatment of eruptions,
ibid. And loose stools, ibid. Are apt to conceal the disorders of
children that arise from their own negligence, ibid. Ought to be
punished for the misfortunes they thus occasion, 45. Sensible,
often able to discover diseases sooner than persons bred to phy-
sic, 105. Are liable to catch the small-pox again from those they
nurse in that disorder, 169, note.
Nursery ought to be the largest and best aired room in a house, 42.
O
OIL, an antidote to the injuries arising from working in mines or
metals, 46. Sallad oil, the best application to the bite of a wasp-
ce bee, 337. Camphorated, how to prepare, 459.        

501 INDEX.
Oils, essential, of vegetables, the proper menstruum for, 465.
Ointment for the itch, 284. Use of ointments when applied to
wounds and sores, 457. Preparation of yellow basilicum, ibid.
Ointment of calamine, ibid. Emollient ointment, ibid. Eye oint-
ments, ibid. Issue ointment, 458. Ointment of lead, ibid. Mer-
curial ointment, ibid. Ointment of sulphur, ibid.  White oint-
ment, ibid. See Liniment.
Ophthalmia. See Eyes.
Opiates, efficacious in a cholera morbus, 228. In a diabetes, 233.
When proper for the head-ach, 256. Recommended for the
tooth-ach, ibid. Are delusive remedies in nervous disease, 298.
See Laudanum.
Orange and lemon peel, how to candy, 448. How to preserve
orange and lemon juice in the. form of syrup, 465.
Ormskirk medicine for the bite of a mad dog, remarks on, 336, note.
Oxycrate, the most proper external application in a fracture, 403.
Oysters of great service in consumptions, 133, note.
P
PAINTERS. See Miners.
Palsy, the nature of this disorder explained, with its causes, 301.
Medical treatment, ibid.
Paraphrenitis, its symptoms and treatment, 126.
Parents, their interested views in the disposal of their children in
marriage, often a source of bitter repentance, 94, note. See Fa-
thers and Mothers.
Passions, intemperance the abuse of, 79. Have great influence both
in the cause and cure of diseases, 89. Anger, ibid. Fear, 90.
Grief, 92 Loved 94. Religious melancholy, 95. The best me-
thod of counteracting the violence of any of the passions, ibid.
Peas, parched good in cases of flatulency, 260.
Peruvian bark. See Bark.
Penis, ulcerated, cured, and partly regenerated, by a careful atten-
tion to cleanliness, 353, note.
Peripneumony who most subject to, 126. Its causes, ibid. Symp-
toms and proper regimen, 127.
Perspiration, insensible, the obstruction of, disorders the whole
frame. 98. The various causes of its being cheeked, ibid. Changes
in the atmosphere, ibid. Wet clothes, 99. Wet feet, ibid. Night
air, 100. Damp beds, ibid. Damp houses, 101. Sudden transi-
tions from heat to cold, 102.
Philosophy, advantages resulting from the study of, 17.
Phrenitis. See Brain.
Phymosis described, and how to treat, 347.
Physicians, ill consequences of their inattention to the management
of children, 26. Are liable to spread infection, 88, note. Their
custom of prognosticating the fate of their patients, a bad prac-
tice, 91. Are seldom called in until medicine can give no re-
lief, 119. 

502 INDEX.
Pickles, provocatives, injurious to the stomach, 63.
Piles, bleeding and blind, the distinction between, 242. Who most
subject to the disorder, ibid. General causes, ibid. Medical treat-
ment of, 243. Periodical discharges of, ought not to be stopped,
ibid. Proper treatment of the blind piles, ibid. External oint-
ments of little use, 244.
Pills, purging, proper form of, for an inflammation of the intes-
tinss, 216. The general intention of this class of medicines,
459. Preparation of the composing pill, ibid. Fœtid pill, ibid.
Hemlock pill, ibid. Mercurial pill, 460. Mercurial sublimate
pills, ibid. Plummer's pill, ibid. Purging pill, ibid. Pill for the
jaundice, ibid. Stomachic pill, ibid. Squill pills, 461. Strength-
ening pills, ibid.
Pins ought never to be used in the dressing of children, 30. Swal-
lowed, discharged from an ulcer in the side, 407, note.
Plaisters, the general intentions of, and their usual basis, 461. Pre-
paration of the common plaister, ibid. Adhesive plaister, ibid.
Anodyne plaister, ibid. Blistering plaister, 462. Gum plaister,
ibid. Mercurial plaister, ibid. Stomach plaister, ibid. Warm
plaister, ibid. Wax plaister, ibid.
Pleurisy, the nature of the disorder explained, with its causes, 122.
Symptoms, regimen, and medical treatment, 123. A decoction
of Seneka reckoned a specific in, 125. Bastard pleurisy, ibid.
Plumbers. See Miners.
Poisons, the nature and cure of, a general concern, and easily ac-
quired, 329. Mineral poisons, ibid. Corrosive sublimate, an ex-
ception when this poison has been taken; what the patient
ought to drink, 330, note. Vegetable poisons, 330. Bites of
poisonous animals, 331. Bite of a mad dog, ibid. Bite of a vi-
per, 336. The practice of sucking the poison out of wounds re-
commended, ibid, note. Poisonous plants ought to be destroyed
in the neighbourhood of towns, 337.
Poor living, the dangers of, 49.
Porters subject to disorders of the lungs, 48.
Postures, confined, injurious to the health of sedentary artists, 53.
Poverty occasions parents to neglect giving their children proper
exercise, 36. Destroys parental affection, 37, note. Not only oc-
casions, but aggravates, many of the diseases of labourers, 49.
The poor, great sufferers by the sale of bad provisions, 61. And
by bad air in large cities, 69.
Poultices proper for inflamed wounds, 393.
Powders, general instructions for making and administering, 462.
Astringent powder, preparation and doses of, 463. Powder of
hole, ibid. Carminative powder, ibid. Diuretic powder, ibid.
Aromatic purging powder, ibid. Saline laxative powder, ibid.
Steel powder, ibid. Sudorific powder, 464. Worm powder, ibid.
Purging worm powder, ibid. Powder for the tape-worm, ibid.
Pox, small, who most liable to, and at what season, 167. Its causes 

503 INDEX.
and symptoms, ibid. Favourable and unfavourable symptoms
in, ibid. Regimen, 168. How the patient ought to be treated
during the eruptive fever, 169. Children in this disorder ought
not to lie together in the same bed, ibid. Should be allowed
clean linen, 170. Patients under this disorder, ought not to ap-
pear in public view, ibid. Medical treatment, ibid. The secon-
dary fever, 172. When and how to open the pustules, 173. Of
inoculation, 174. Difference in the method practised in Ame-
rica, 176, note.
Pox, chicken, who most liable to, and causes, 182. Symptoms, how
distinguished, and medical treatment, 183.
Pregnancy, how to treat vomiting when the effect of, 231. Rules
of conduct for women under the disorders incident to, 361.
Causes and symptoms of abortion, ibid. How to guard against
abortion, ibid. Treatment in cases of abortion, 362. Child-
birth, ibid.
Prescriptions, medical, patients exposed to danger by their being
written in Latin, 19.
Provisions, unsound, the sale of, a public injury, 61.
Puerperal fever. See Fever.
Purges, the frequent use of them renders the habitual use of them
necessary, 96. Their efficacy in agues, 114. Proper form of,
for an inflammation of the intestines, 216. Cooling purges al-
ways proper in a gonorrhœa, 340. Form of a gentle purge for
infants disordered in the bowels, 369. For the thrush, 370.
Pustules in the small-pox, favourable and unfavourable appearances
of, 168. The suppuration of, to be promoted, 170. When and
how to open, 173.
Putrid fevers. See Fever.
Q
QUACKS put out more eyes than they cure, 319.
Quackery, how to destroy, 19.
Quakers, their mode of dressing recommended, 78.
Quinsey, a common and dangerous disorder, and to whom most fa-
tal, 198. Its causes and symptoms, ibid.  Regimen, 199. Me-
dical applications, 200. How to promote suppuration, ibid. How
to nourish the patient when he cannot swallow, 201. Advice to
persons subject to this disorder, ibid.
Quinsey, malignant, who most subject to, and its causes, 202. Its
symptoms, ibid. Regimen and medical treatment, 203.
R
REGIMEN ought to co-operate with medicine to accomplish the
cure of diseases, 11. Will often cure diseases without medicine,
108. See Aliment.
Religion, true, calculated to support the mind under every afflic-
tion, 95. The instructions in, ought not to dwell, too much on
gloomy subjects, ibid.
Remitting fever. See Fever. 

504 INDEX.
Repletion impairs the digestive power, 66. Diseases occasioned by,
67. How to treat a looseness produced by, 228.
Resentment, the indulgence of, injurious to the constitution, 90.
Resins, and essential oils, the proper menstruum for, 465.
Respiration, how to restore in a drowned person, 411.
Rheumatism, acute, and chronic, distinguished, 275. Causes, ibid.
Symptoms, ibid. Medical treatment, ibid. Cautions to persons
subject to this disorder, 277.
Rickets, the appearance of, in Britain, dated from the growth of
manufactures and sedentary employments, 36. The causes of,
382. Symptoms, 383. Regimen and medical treatment, ibid.
Rollers, pernicious tendency of applying them round the bodies of
infants, 29.
Romans, ancient, their great attention to the cleanliness of their
towns, 83, note.
Roses, conserve of, its great virtue against hæmorrhages, 243. 246.
Rosemary, the external application of, a popular remedy for the
cramp, 316, note.
Ruptures are chiefly incident to children and very old persons, 404.
The causes respectively, ibid. Method of treatment, 405. Cut-
ting should be avoided if possible, ibid. Cautions for persons af-
flicted with a rupture, 406. Often prove fatal before discoverd,
ibid, note.
Rutherford, Dr. his preparation for cure of a dysentery, 250, note.
S
SAILORS, their health injured by change of climate, hard weather,
and bad provisions, 50. Many of their diseases spring from in-
temperance, ibid. Ought to guard against wet clothes, ibid. How
the ill effects of salt provisions might be corrected, ibid. Peruvi-
an bark the best antidote to sailors on a foreign coast, 51. Clean-
liness greatly conducive to their health, 84.
Sal prunellæ, its good effects in a quinsey, 200.
Saline draughts, of good use for stopping a vomiting, 213. Prepa-
ration of, for thus purpose, ibid. Peculiarly good in the puer-
peral fever, 366.
Salivation not necessary in the cure of the venereal disease, 349.
Sarsaparilla a powerful assistant in venereal cases, 350.
Scabbed head in children, difficult to cure, 377. Medical treatment,
378.
Scarlet fever. See Fever.
School sending children there too young, its bad consequences, 38.
Ought to be seated in a dry air, and not to be too much crowded,
42.
Schirrus in the liver, proper regimen in the case of, 226. See Cancer.
Scrophula, nature of this disease, and its causes, 281. Symptoms,
ibid. Regimen and medical treatment, 282.
Scurvy, why prevalent among the English, 62. Where most preva-
lent, and the two distinctions of, 278. Causes of, ibid. Symp-         

505 INDEX.                 
toms and cure, ibid. Instructions to sea-faring men, 279. Extra-
ordinary effects of milk, ibid. Proper liquors, 280.
Sedentary life includes the greater part of the human species, 51.
Few persons follow agriculture who are capable of other busi-
ness, 52. Sedentary and active employments ought to be inter-
mixed, for the fake of health, ibid. Artists suffer from unwhole-
some air, by being crowded together, 53. The postures artists
are confined to, injurious to health, 54. Disorders produced by,
ibid. Cautions offered to the sedentary, ibid. Sedentary amuse-
ments improper for sedentary persons, ibid. Hints relating to
improper food, 55. Exercise a surer relief for low spirits than
drinking, ibid. Gardening a wholesome amusement for the se-
dentary, ibid. Disorders occasioned by intense study, 56. Diete-
tical advice to the sedentary, 65. Sedentary occupations better
adapted to women than men, 73, note.
Sea water, a good remedy in the king's evil, 282.
Senses, disorders of, 319.
Seton sometimes has extraordinary effects in an inflammation of the
eyes, 196. Is of service for preventing apoplexies, 290. The best
method of making it, 300.
Shoe, tight, the bad consequences arising from, 78. The high heels
of women's shoes, ibid.
Sibbins, a venereal disorder, so termed in the west of Scotland, how
to cure, 350, note.
Sick, the mutual danger incurred by unnecessary visitors to, 86. Per-
sons in health to be kept at a distance from the sick, 87. Proper
nurses ought to be employed about them, 88. Instructions for
avoiding infection, ibid. Physicians too unguarded in their visits
to them, ibid, note. Tolling of bells for the dead very dangerous
to, 91. Their fears ought not to be alarmed, 92.
Sight injured by studying by candle-light, 57.
Simples, a list of those proper to be kept for private practice, 441.
Sinapisms, the general intentions of, 445. Directions for making
of, ibid.
Sleep, the due proportion of, not easy to fix, 75. How to make it re-
freshing, ibid. Complaints of the want of, chiefly made by the
indolent, ibid. Heavy suppers cause uneasy nights, ibid. Anxiety
destructive of sleep, 76. That in the sore-part of the night most
refreshing, ibid. Early risers the longest livers, ibid, note.
Sleeping in the sun, the danger of, 48.
Small-pox. See Pox.
Smell, injuries to which the sense of, is liable, with the remedies ap-
plicable to, 423.
Soap, Alicant, recommended in the stone, 237. Soap lees, how to
take, 238.
Solanum. See Nightshade.
Soldiers exposed to disorders from the hardships they undergo, 49.
Spine often bent by artists working in unfavourable postures, 53.
S3

506 INDEX.
Spirit, rectified, the direct menstruum for resins and essential oils
of vegetables, 465. Of wine, camphorated, how to prepare,
467. Spirit of Mindererus, ibid.
Spirits, lowness of, the general forerunner of a nervous fever, 137.
The proper remedies for, 313. Cautions to persons under this
complaint, ibid.
Spirituous liquors, when good in the colic, 218. And for gouty
complaints in the stomach, 260. Should be avoided by all per-
sons afflicted with nervous disorders, 296. The use of, often fa-
tal, 421.
Spitting of blood. See Blood.
Sponge may be used to supply the want of agaric as a styptic, 392,
note. Its use in extracting substances stopped in the gullet, 408.
Sports, active, far more wholesome than sedentary amusements, 74.
Spots in the eye, how to treat, 320.
Squinting, how to correct the habit of, ibid.
Stays, a ridiculous and pernicious article of female dress, 31. 77.
The wearing of, tends to produce cancers in the breast, 325.
Sternutatories, preparations of, recommended for restoring lost
smell, 423.
Sticking Plaister is the best application for slight wounds, 392.
Stomach, exercise the best cure for disorders of, 73. Inflammation
of, a disorder that calls for speedy assistance, 213. Its causes,
ibid. Symptoms, ibid. Regimen, ibid. Medical treatment, 214.
Pain in, its causes, 259. Remedies for, ibid. Instructions for
persons subject to, 260.
Stone, the formation of, in the bladder, explained, 97. This disor-
der how distinguished from the gravel, 236. Causes and symp-
toms, ibid. Regimen, 237. Medical treatment, ibid. Alicant
soap and lime-water, how to take for this disorder, ibid. The
uva ursi, a remedy in present request for, 238.
Stool, loose, the benefit of, to children, 44. Proper treatment of,
when excessive, ibid. The discharge by, cannot be regular, if
the mode of living be irregular, 95. One in a day generally suf-
ficient for an adult, 96. How to produce a regularity of, ibid.
Frequent recourse to medicines for costiveness, injurious to the
constitution, ibid.
Storck, Dr. his method of treating cancers, 327.
Strabismus. See Squinting.
Strains, proper method of treating, 404. The safest external ap-
plications, ibid, note.
Strangury, from a blistering plaister, how to guard against, 124. In
the small-pox, how to relieve, 171. From a venereal cause, de-
scribed, with its proper treatment, 346.
Strangulation, course of treatment for the recovery of persons from,
423.
Strasburgh, successful treatment of a miliary fever there, 149, note.
Strength, the folly of trials of, from emulation, 46. 49.       

507 INDEX.                     
Study, intense, injurious to health, 55. The disorders occasioned
by, 56. Character of a mere student, 57. Hints of advice to
studious persons, 58. Danger of their having recourse to cor-
dials, 59. Health often neglected while in possession, and la-
boured for after it is destroyed, ibid. No person ought to study
immediately after a full meal, 60. Dietetical advice to the stu-
dious, 65. The general effects of, on the constitution, 295.
Sublimate, corrosive, how to administer in venereal cases, 350. Very
efficacious in venereal affections of the skin, ibid, note.
Suffocation, by the fumes of charcoal, liable to happen in close
chambers, 414. General causes of suffocation, 423. Overlaying
of infants, ibid.
Sugar, an improper article in the food of children, 34.
Sulphur, a good remedy for expelling worms, 263. And for the
itch, 284.
Suppers ought not to destroy the appetite for breakfast, 66. Heavy
suppers sure to occasion uneasy nights, 75.
Surgery, many of the operations of, successfully performed by per-
sons unskilled in anatomy, 387. Humanity induces every one
more or less to be a surgeon, ibid.
Sweating, generally excited in an improper manner, in fevers, 111.
120.
Swoonings, the several causes of, described, 304. Proper treatment
of this disorder, 310. 420. Cautions to persons subject to them,
ibid.                                                    
Sydenham, Dr. his method of treating fevers in children from teeth-
ing, 381
Symptoms, diseases better distinguished by, than by the systematical
arrangement of, 105. The differences of sex, age, and consti-
tution to be considered, 106. Diseases of the mind to be distin-
guishsd from those of the body, ibid.
Syrups, the general intention of, 464. How to make simple syrup,
and to modify it for particular purposes, 465.
T
TACITUS, his remark on the degeneracy of the Roman ladies, 25.
Tallow-chandlers, and others working on putrid animal substances,
cautions to, 46.
Tapping for the dropsy, a safe and simple operation, 270.
Tar, Barbadoes, its efficacy in the nervous colic, 220.
Tartar, soluble, a good remedy for the jaundice, 266. Cream of,
a good remedy in a dropsy, 268. And rheumatism, 275.
Taste how to restore the sense of, when injured, 324.
Tailors are exposed to injuries from breathing confined air, 53.
Are subject to consumptions, ibid, note. Often lose the use of
their legs, ibid. Hints of instruction offered to them in regard
to their health, 54.
Tea the customary use of, injurious to female constitutions, 27.
Destroys their digestive powers, and produces hysterics, 62. 

508 INDEX.
The bad qualities of, principally owing to imprudence in the
use of it, ibid. Green, chewing of, a remedy for the heart-burn,
294. Has a powerful effect upon the nerves, 301, note. Is bad
for persons troubled with flatulencies, 312.        
Teething, the disorders attending, 381. Regimen, and medical
treatment in, ibid. Applications to the gums, and how to cut
them, 382.
Temperance, the parent of health, 70.
Testicles, swelled, the cause of, 343. Regimen and medicine in,
344. Treatment under a cancerous or scrophulous habit, ibid.
Tetanus, or the Lock-Jaw, the causes, 302. Symptom and medi-
cine, 303.
Thirst, how it may be quenched when a person is hot, without
danger, 102.
Thought, intense, destructive of health, 55.
Thrush in infants, the disorder and its causes described, 371. Me-
dical treatment of, ibid.
Tinctures and elixirs, the proper medicines to exhibit in the form
of, 465. Preparations of the aromatic tincture, ibid. Com-
pound tincture of the bark, ibid. Volatile fœtid tincture, ibid.
Volatile tincture of gum guaiacum, ibid. Tincture of black hel-
lebore, 466. Astringent tincture, ibid. Tincture of myrrh and
aloes, ibid. Tincture of opium, or liquid laudanum, ibid. Tinc-
ture of hiera picra, ibid. Compound tincture of senna, ibid.
Tincture of Spanish flies, ibid. Tincture of the balsam of Tolu,
ibid. Tincture of rhubarb, 467.
Tissot, Dr. character of his Avis au Peuple, 13. His medical course
for the cure of the hydrophobia, 336. Instances from, of the
recovery of drowned persons, 412.
Tobacco, a clyster of a decoction of, useful to excite a vomit, 409.
A clyster of the fumes of, will stimulate the intestines, and pro-
duce a stool, 220, note,
Toes, the free motion of, destroyed by wearing tight shoes, 77.
Tooth-ach, the general causes of, 256. Medical treatment of, ibid.
When recourse must be had to extraction, 257. Directions for
cleaning the teeth, 258.
Touch, injuries to which the sense of, is liable, with the remedies
applicable to, 325.
Towns, great, the air of, destructive to the children of the poor,
41. Children bred in the country ought not to be sent too early
into towns, 42. Cleanliness not sufficiently attended to in, 85.
Ought to be supplied with plenty of water for washing the
streets, ibid, note. The best means to guard against infection
in, 87.
Trades, some injurious to health by making artists breathe un-
wholesome air, 45. 53.
ansitions, sudden, from heat to cold, the ill-effects of, to the
constitution, 102. 

509 INDEX.
Travellers, the use of vinegar recommended to, 50. Ought to be
very careful not to sleep in damp beds, 100. Fevers why often
fatal to, 110.
Trees should not be planted too near to houses, 70.
Trefoil water, a good remedy in the rheumatism, 277.
Tumours, proper treatment of, 390.
Turner's cerate, preparation of, 457.
V.
VAPOUR of fermenting liquors, noxious nature of, 413.
Vegetables, wholesome corrections of the bad qualities of animal
food, 62. Their extraordinary effects in the scurvy, 280.
Venereal disease,unfavourable circumstances attending this disorder,
337. Virulent gonorrhœa, 388. Gleets, 342. Swelled testicles,
343. Buboes, 344. Chancres, 345. Stangury, 346. Phymosis,
347. A confirmed lues, 348. American method of curing this
disease, 350. General observations, 351. Cleanliness a great
preservative against, 353. The use of medicines ought not to be
hastily dropped, 354. Is often too much disregarded, ibid.
Ventilators, the most useful of all modern medical improve-
ments, 69.
Vertigo often produced by intense study, 57.
Vinegar, a great antidote against diseases, and ought to be used by
all travellers, 50. Should be sprinkled in sick chambers, 88. 120.
143. Is of considerable service in the bite of a mad dog, 334.
and in any kind of poison, 337. Its medical properties, 468. Is
of use to extract the virtues of several medicinal substances,
ibid. How to prepare vinegar of litharge, ibid. Vinegar of roses,
ibid. Vinegar of squills, ibid.
Viper, the bite of, the sufficiency of the grease for the cure of,
doubted, 337. Method of treatment recommended, ibid.
Vitriol, elixir of, an excellent medicine in weaknesses of the sto-
mach, 293. And for windy complaints, 298.
Vitus, St. his dance, method of cure, 306.
ulcers, proper treatment of, according to the different natures,
396. Lime water, a good remedy, 397. Dr. Whytt's method
of treating them, ibid. Fistulous ulcers, ibid.
Vomits, their use in agues, 114; and in the nervous fever, 139.
Caution for administering in the putrid fever, 146. Ought by
no means to be administered in an inflammation of the stomach,
213. Are useful in cases of repletion, 228. Are the first object
to be pursued when poison has been received into the stomach,
330. Their use in the hooping-cough, and how to administer
them to children, 212. Form of a gentle one for infants, dis-
ordered in their bowels, 369.
Vomiting, the several causes of, 230. Medical treatment of, 123.
Saline draught for stopping of, 232. Causes of, in children,
373. How to be treated, ibid. Of blood. See Blood. 

514 INDEX.
Voyage, a long one frequently cures a consumption, 131. Voyages
have an excellent effect on persons afflicted with nervous disor-
ders, 296.
U
URETERS, and their use described, 222, note.
Urine the appearances and quantity of, too uncertain to form any
determined judgment from, 97. Dr. Chyne's judgment as to
the due quantity of, not to be relied on, ibid. The secretion and
discharge of, how obstructed, ibid. Bad consequences of retain-
ing it too long, 98. Too great a quantity of, tends to a con-
sumption, ibid. Stoppage of, its general causes, 223. Caution
as to the treatment of, 224. Diabetes, 232. Incontinency of,
234. Suppression of, ibid. Medical treatment in, 235. Cautions
to persons subject to this disorder, ibid. Bloody, causes of, 147.
Medical treatment of, 248.
Urine doctors, their impudence, and great success from the credu-
lity of the populace, 97, note.
Uva ursi, a remedy in present request for the stone, 238.
W
WALLS, high, unwholesome, by obstructing the free current of
air, 70.
Ward's essence, preparation of, 467. His fistula paste, a popular
remedy that may deserve trial, 397.
Wars occasion putrid fevers, by tainting the air with the effluvia
of dead carcases, 141.
Wasps, hornets, or bees, how the bite of, ought to be treated, 337.
Water, frequently unwholesome by mineral impregnations, 63.
Cautions for the choice of, ibid. Cold, the effects of drinking in
warm weather, 417. Cautions to avoid, and medical treatment,
ibid.
Water in the head is a disorder chiefly incident to children, 385.
Its causes, symptoms, and proper treatment, ibid. Remedies to-
wards effecting a cure of this disease, 386, note. The nature of
the disorder seldom discovered in due time for cure, ibid, note.
Waters by infusion, how to prepare: Lime water, 469. Com-
pound lime water, ibid. Sublimate water, ibid. Styptic water,
ibid. Tar water, ibid.
Waters, simple distilled, their medical uses, 469. Preparation of
cinnamon water, 470. Pennyroyal water, ibid. Peppermint wa-
ter, ibid. Spearmint water, ibid. Rose water, ibid. Jamaica pep-
per water, ibid.
Waters, spirituous distilled, how to prepare: Spirituous cinnamon
water, 470. Spirituous Jamaica pepper water, ibid.
Watery eye, how to cure, 321.
Weaning of children from the breast, the proper mode of, 33. 34.
Weather, states of, which produce the putrid fever, 141. 

511 INDEX.
Wells, cautions to persons going down into them, 69, note. Deep,
ought not to be entered until the air in, is purified, 414.
Whey, an excellent drink in a dysentery, 251; and in the rheuma-
tism, 276. Orange whey, how to make, 119. Allum whey,
234. 471. Mustard whey, ibid. Scorbutic whey, ibid.
Whitlow, 390.
Whytt, Dr. his remedies for flatulencies, 311.
Wind. See Flatulencies.
Windows, the danger of throwing them open on account of heat,
and sitting near them, 103.
Wine, good, almost the only medicine necessary in a nervous fever,
138. Should be plentifully given in the Spotted fever, 145, note.
Wines, the medical properties of, 471. Their use in extracting the
virtues of medicinal substances, ibid. Preparation of anthel-
mintic wine, ibid. Antimonial wine, 472. Bitter wine, ibid.
Ipecacuanha wine, ibid. Chalybeate or steel wine, ibid. Sto-
machic wine, ibid.
Womb, inflammation of, its symptoms, 364. Medical treatment of,
365.
Women, errors in their education pointed out, 25. Why subject
to hysterics, 62. Are better adapted to follow sedentary occu-
pations than men, 73, note. In child-bed, often die from their
apprehensions of death, 91. Their disorders rendered epidemi-
cal by the force of imagination, ibid. Every thing that can alarm
them to be carefully guarded against, ibid. Evil tendency of toll-
ing bells for the dead, ibid. How exposed to a miliary fever du-
ring pregnancy, 147. Their constitutions injured by living too
much within doors, 355. Those who work in the open air al-
most as hardy as men, ibid. Advice to, with reference to the
menstrual discharge, 356. At the commencement, ibid. Fluor
albus, with its proper treatment, described, 359. Advice to, at
the ceasing of the menses, 360. Rules of conduct during preg-
nancy, 361. How to guard against abortion, ibid. Treatment
in case of abortion, 362. Instructions at the time of child-birth,
363. Cause of the milk, fever, 365. How to guard against the
miliary fever, ibid. The puerperal fever, ibid. General cautions
for women in child-bed, 367. Causes of barrenness, 368.
Wool, the best external application in the gout, 272.
Workhouses poisonous to infants, 41.                       
Worms, how to treat a looseness produced by, 229. Three princi-
pal kinds of, distinguished, 261. Symptoms of, ibid. Causes,
ibid. Medical treatment for, 262. Remedy for children, 263.
General cautions for preserving children from them, 264. Dan-
ger of taking quack medicines for them, ibid. note. 
Wort, recommended for the scurvy, and proper to drink at sea,
280. Is a powerful remedy in cancerous cases, 328.
Wounds, are not cured by external applications, 391. Are cured
by nature, ibid. Proper course of treatment, ibid. How to stop 

512 INDEX.
the bleeding, 392. Caution against improper styptics, ibid. Me-
thod of dressing them, ibid. Poultices for inflamed wounds,
ibid. Regimen in, ibid.
Writing, hints of advice to those who are much employed in, 57, 58.
Y
YAWS, general hint for the cure of, 353, note.
Young animals all exert their organs of motion as soon as they are
able, 36.
Z
ZINC, the flowers of, a popular remedy for the epilepsy, 306.
ERRATA.
In page 183, for jalop, read jalap.
303, for basilicon, read basilicum.
In the note, page 320, for Electuary, read Eletricity.
330, for recompose, read decompose.
333, for greater,  read great.
PRINTING
Done with Care and Fidelity, by
RICHARD FOLWELL,
No. 33, Carter's Alley.