LF. TUBES ON MIDWIFERY 
AND THE 
FORMS OF DISEASE PECULIAR TO 
wmmr arid msss^Mis9 
rEL'IVERED TO 
OF TI\E ( 
B0TANIC0-MEDICXL>SCl400t( £ 
AT C O L UMB U' f \ 
BY A. CURTIS, Principal J^mpoL^ 
Professor of the Theory and Practice of Medicine, 
Lecturer on Anatomy,Physiology, Botany 
and Chemistry, ard Editor of the 
Thomsonian Recorder. ' > 
I never knew a single instance where nature had been assisted 
according to my practice, and the patient was not nble to hear 
her weight the same day of her delivery.—Samuel Thomson. 
Let Midwives know that they be Nature’s servants.—IVillo'by. 
A meddlesome Midwifery is bad.—Blundell. 
The most disadvantageous position in which the liead can 
offer, is not sufficient, either to prevent delivery, or to endanger 
the life of mother or child, so much as would be done by the 
movement of the gentlest hands.—Edinburgh Practice. 
The rash and preposterous use of instruments has proved the 
banc of thousands.—lb. 
For one instance, where the retention of the plncenta has 
been attended with dangerous consequences, its precipitous ex- 
traction has been fatal to hundreds.—lb. 
PRINTED FOR THE AUTHOR, 
BY JONATHAN PHILLIPS. 
COLUMBUS, OHIO. 
1837. Entered according to act of Congress, in the 
year 1836, by A. Curtis, in the Clerk’s Office of 
the District Court of Ohio. PLAN OF TIIE WORK. 
1. Advertisement. 
2. History of Midwifery. 
3. Introduction—Showing the reasons why wo- 
men need assistance in parturition, the kind need- 
ed and how it is to be rendered. 
4. A Complete System of Midwifery on the 
true Botanic Principles, with illustrative plates. 
5. Testimonies from the regular standard au- 
thors, proving the vast superiority of the Botanic 
Theory and Practice. 
6. Testimonies from the same, showing the er- 
rors in theory and dangers in practice of the Regu- 
lar System. 
7. Examples of the different kinds of practice, 
showing the safety and efficacy of the Botanic, the 
danger and fatality of the Regular; and, of course, 
the folly of abandoning the former and resorting 
to the latter in cases of supposed difficulty and 
hazard. RECOMMENDATIONS. 
Extract from the proceedings of the Zelo-Mathean 
Society. 
Resolved, That the members of the Botanico- 
Medical School and of the Zelo-Mathean Society 
at Columbus, wrhohave heard Dr. Curtis’s Lectures 
on Midwifery &:c., rejoice to see the proposition 
to publish them, and cordially recommend them as 
an invaluable directory to the whole Botanic Fra- 
ternity and Sisterhood. 
Extract from the minutes of the 5th Convention of 
the Friendly Thomsonian Botanical Society of 
the United States. 
WEDNESDAY, OCTOBER 19, 1830. 
Agreeably to a resolution of Tuesday, Dr. Cur- 
tis delivered a lecture on Obstetrics, after which, 
he proposed to publish, by subscription, the sub- 
stance of his Lectures to the Students of the Bo- 
tanico-Medical School at Columbus, on this subject: 
Whereupon it was 
Resolved, That this Convention cordially ap- 
prove of Dr. Curtis’s proposal, to publish his Lec- 
tures on Midwifery and the forms of Disease pecu- 
liar to Women and Children. 
03“ The members of the Convention sustained 
the resolution with a very liberal subscription. ADVERTISEMENT. 
Though Dr. Samuel Thomson has exhibited in 
his “New Guide to Health” the general plan on 
which all forms of disease are to be treated, and re- 
lief from suffering is to be obtained, yet the want 
of that experience which inspires confidence in 
any plan, and in one’s own ability and skill to ap- 
ply to the best advantage the remedial agents re- 
commended, has induced multitudes of the true 
friends ofthe Tho msonian System, to abandon its 
application for the experience of mineral practition- 
ers in cases in which, when properly applied, its 
vast superiority is most signally displayed. 
Others, fully aware of the disadvantages and 
dangers of such a course, have been, for several 
years, making inquiries of me for particular in- 
structions, especially in that branch of the prac- 
tice called Obstetrics, the letters and oral direc- 
tions in answer to which, would fill an octavo vol- 
ume. 
These inquiries being multiplied upon me in my 
new station as Editor ofthe Recorder, I took the 
first convenient opportunity to request Dr. Thom- 
son himself to give the fraternity a general answer 
in the form of a complete treatise. 
lie replied that “his supplement contained all 
the principles involved in the queries, and exam- 
ples sufficiently numerous and various to givo a 
correct idea ofthe proper mode of applying them 
in all conceivable cases; and that, if the friends of the system wanted any thing more minute, they 
must prepare it themselves.” 
Though I published in the Recorder the sub- 
stance of this answer, the “inquiries for informa- 
tion” have since accumulated upon me to such a 
degree that I have determined to publish, as an an- 
swer to the whole, my lecture's, delivered last sum- 
mer to the Students of the Botanico-Medical School 
at Columbus, embracing the most important in- 
structions on t hese subjects which the wisdom and 
ingenuity of man, either in or out of the Thomso- 
nian School, have yetdevised. 
In preparing this work for the press, I have 
made use of all the means of information within 
my reach, (and they are not scanty,) selecting from 
others, as well as from my own observations, only 
those descriptions which are essential, and giving 
only those directions as rules of practice, which 
will abide the test of experience. 
By discarding all reasonings upon unsettled the- 
ories, and modes and means of practice of doubt- 
ful efficacy, I trust it will be found that I have 
gathered into this small volume, every thing 
known on the subject of which it treats, that is 
worthy to be made the ground of implicit confi- 
dence in practice. 
I have endeavored to render this volume such 
that, if a Thomsonian should, through inexperi- 
ence, fear, in a difficult case, to apply his favorite 
practice, a reference to its pages would show him 
that the fundamental principles and most common 
and important modes of application, are advocated 
and sustained by many of the most learned and ju- 
dicious authors of the old school; while these same 
gentlemen have given to the depletive, antiphlo- 
gestic, rash, and instrumental system, the credit of 7 
almost all the mischiefs that have ever happened 
in the chamber of parturition. Take the follow- 
ing for example: 
“Midwifery is the art of assisting women in 
childbirth.” — Webster. 
“The proceedingsofnature in ripening her fruits, 
in bursting the husks of walnuts and almonds and 
opening the shells of eggs without force, when 
ripe, should teach midwives patience, and per- 
suade them to let nature alone to perform her own 
work, and not to disquiet women by their smug- 
glings; for such enforcements rather hinder the 
birth than in any way promote it. They often ru- 
in the mother and usually the child. Let mid- 
wives know that they are natures servants.”— Wil- 
loughby, Ed. Pr. vol. 5. p. 5. 
Let every candid practitioner acknowledge that, 
for one instance where the retention of the placen- 
ta has been attended with dangerous consequences, 
its precipitate extraction has been fatal to hun- 
dreds.—Ed. Pr. v. 5. p. 127. 
“The rash and preposterous application of in- 
struments [where the head is squeezed into the pel- 
vis in such a manner as to induce the belief that 
it cannot be extricated without them] has proved 
the bane of thousands.”—Ib.pa. 140. 
“The work of nature is too often spoiled by of- 
ficious hands.”—lb. p. 142. 
When I reflected on the great responsibility of 
giving directions which, if wrong, might prove 
destructive to the lives of my fellow beings, my 
heart shrunk from the undertaking. I3ut, recol- 
lecting to have seen saved by this practice, many 
lives which had been pronounced hopeless by the 
advocates of theother, I felt it an imperative duty 
to proceed, especially as 1 knew that many true 8 
Thomsonians had placed more confidence in the 
experience of the old school practitioners, than in 
their own ability and skill to apply the practice 
laid down in the New Guide, who, could they see 
the many dangers mingled with the few advanta- 
ges of this course, which even my limited knowl- 
edge and experience might present to them, would 
prefer a plan of saving thousands of lives that are 
now regularly sent from the child-bed scene, to 
the place from which no traveler returns; and 
much suffering to other thousands who escape im- 
mediate death for the lingering torment of consti- 
tutional injury, produced, as Dr. Dewees says, by 
“ill judged and rude manceuvers, under the spe- 
cious pretence of relieving” the sufferer.—Introd. 
JHid.p. XIV. 
In Dr. Rees’s Cyclopoedia, it is stated that “not 
more than one case [of childbirth] in five or six 
hundred requires the use of instruments;” and Dr. 
Dewees states, page, 20th, that he has taken hia 
measures of the deformities of the pelvis, [the most 
common cause which renders instruments neces- 
sary,] from the European Surgeons, on account of 
the fact that the most extensive practitioners in 
America, rarely witness such cases. 
I must therefore conclude that the many cases 
I have known the regular faculty to treat, as they 
would have it, in a scientific manner, by which 
either the woman or child or both suffered death 
or little less, did not really indicate any necessity 
for the “rude and ill-judged manoeuvres” of the 
“ignorant pretenders” with which they were tor- 
mented. 
I have just now heard of the death of one of my 
early associates who had suffered five or six years 
from the wretched effects of suck “rude maneeu- 9 
vrcs,” and I expect soon to hear of the termination 
of similar sufferings, in the similar fate of four or 
five more. 
As I have the most conclusive evidence that 
some eighteen or twenty others of my particular 
acquaintances have been either killed outright or 
rendered miserable for life, by the “rude manoeu- 
vres of ignorant pretenders,” and, as the authori- 
ties just quoted assure me that there is no just 
cause to fear fatal results in more than one case in 
five or six hundred in Europe, and few if any at all 
in America, I conclude that, if I can persuade the 
ladies to trust altogether to nature, and to reme- 
dies that act in harmony with her operations, to 
the entire exclusion of all “ignorant pretenders” 
and their “ill-judged manoeuvres,” I shall per- 
form an essential service to those who have “sor- 
row” enough in “bringing forth children,” with- 
out the aid of “rudo hands, forceps, crotchets” &c. 
In adducing evidence from the regular faculty, I 
have endeavored to give a fair statement of their 
best opinions, as based on their own practice. 
Uut how much more favourable to our views 
those opinions would be, were their supporters ac- 
quainted with the superiority of our practice, let 
the enthusiasm with which those who abandon tho 
old practice for the new, condemn the former and 
applaud the latter, furnish a more just intimation. 
The subject of the following pages is admitted 
to be very delicate; but the conclusion often 
drawn from this fact, that minute instruction res- 
pecting it, should not be given in books written 
expressly for the purpose of saving the persons 
concerned, the mortification ofindolicate exposure, 
is equally unreasonable in itself, and destructive 
of one of the principal objects for which these books 
are written. 10 
If we use general terms, and dark, indefinite al- 
lusions, so that our descriptions and directions are 
not understood, we confer no benefit upon the read- 
er. It is only when the case is accurately defined, 
the diseased organ carefully described, and the 
treatment clearly pointed out, that the patient 
will have confidence in her own knowledge and 
skill, sufficient to keep the case to herself and those 
immediately concerned. 
This book is intended to be a confidential friend 
to married ladies, on the management of those 
forms of disease that come more especially under 
their notice and treatment. Shall it then be silent 
on all those subjects whose delicacy renders it 
unpleasant for her to consult the experienced prac- 
titioner of the other sex in regard to them! Sure- 
ly not. 
If, instead of keeping my book out of the way of 
the common gaze of the uninterested and the cu- 
rious, to be consulted in her moments of leisure 
and seclusion, for the plans and the means of re- 
lief in emergency and danger, or for seasonable 
prophylactics; she place it on the centre table, to 
wound the delicacy of the mixed company that 
assemble around that interesting and profitable 
source of amusement, I shall be no more worthy 
of censure, than if she were to proclaim before a 
promiscuous audience, the same instructions re- 
ceived from me in the private consultation, or the 
confidential letter. 
Be this as it may, it is professedly the want of 
this minute and accurate knowledge, that has dic- 
tated the numerous and pressing calls upon me for 
information, to which the present work is intend- 
ed to give a general answer. 
I have therefore carefully described the several organs concerned, the forms of disease to which 
they are liable, the most judicious prophylactics, 
and the best means and modes of curative process. 
While my course in this, as in all my other la- 
bours, is sustained by the conseiounsness that I 
have endeavored to do my duty, I shall be happy 
if it meet the approbation, and more especially the 
wants of the Botanico-Medical Fraternity and 
Sisterhood, to whom it is most respectfully dedi- 
cated. 
Through the whole work, I have most strictly 
regarded the rights of Hr. Thomson, and am per- 
suaded that no single effort of mine will be found 
ultimately to contribute so much to the extension 
of the blessings of his invaluable, and hitherto un- 
rivaled discoveries. None can use this book to the 
best advantage, who have not purchased his right. 
HISTORY OF OBSTETRICS. 
The first midwife of whom we have any account, 
aided Rachel in the birth of her second child. We 
have, in the Hebrew Scriptures, no account of any 
other midwives than women. None but women 
arc mentioned under this appellation by the Greek 
and Roman historians. From the fact that their 
names in many difierent languages are all femin- 
ine, it is certain that, till lately, all civilized na- 
tions employed women only as midwives. 
The first services performed by men in this art, 
were to deliver those women who, it was supposed, 
could not be delivered without the aid of instru- 
ments. The first employment of a man-midwife 
in general, is said to have been by Madame Ue la Valiere, in 1663, only one hundred and seventy 
three years ago. That lady sent for Julian Clem- 
ent, a Surgeon of reputation, who was conducted 
with great secrecy into the room where she was, 
her face covered with a hood, and where, it is said, 
the king was concealed in the curtains of the bed. 
His success with her, then and on subsequent oc- 
casions, rendered fashionable the employment of 
men, who have since so generally usurped by de- 
grees, the just and natural prerogative of the other 
sex, that it is now generally thought a piece of 
imprudence almost amounting to rashness, to trust 
the management of this matter to the original and 
proper hands. 
But, it is abundantly evident, from a comparison 
of the rapid increase of ancient nations and the 
robust constitutions and extraordinary longevity 
of the people, with the destruction of scores of 
modern women and infants, and the miserable con- 
dition of multitudes that escape immediate death, 
that this change was not made for the better. 
It is true that the luxury, idleness and congre- 
gation in cities, manufactories &c., of modern 
times, have produced more deformity of frame, 
constitutional taint, and liability to disease, in the 
generations of the present age, than were found 
among those of former ages, when hunting, fish- 
ing, agriculture, war, the tending of herds, and 
the construction by the hand, of articles now made 
by machinery, were the constant employment not 
only of a few, but of the general mass of mankind, 
and whose diet was simple and coarse; still it is 
generally conceded that rash and daring efforts of 
art to improve even the slightest of nature's deform- 
ities, have resulted in more mischief than good.— 
See Ed. Pr. vol. 5, pa. 127. 13 
In view of the evidences afforded by dissections, 
Dr. Rush exclaims, “What mischief have we not 
done under the influence of false theories'!” 
The Historians of the French campaign assert 
that, when the battles were over, the work of 
death was but just begun. That more perished 
in the camp by the hands of the surgeons, than by 
the sword and the cannon on the field of battle. 
The Edinburgh Practice says, “The rash and 
preposterous use of instruments (in midwifery) has 
proved the bane of thousands.”—Vol. 5. pa. 140. 
Dr. Terry says that bleeding relieves spasms by 
destroy ing the power of life to produce them. Dr. 
Lobstein, an eminent surgeon and medical prac- 
titioner says, “so far from blood-letting being ben- 
eficial, it is productive of the most serious and fa- 
tal effects,—a cruel practice—a scourge to human- 
ity. IIow many thousands of our citizens are 
sent (by it) to an untimely grave! How many 
families are deprived of their amiable children! 
how many husbands of their lovely wives! how 
many wives of their husbands! YV ithout blood 
there is no heat—no motion of the system. In 
the blood is the life. He who takes blood from 
the patient, takes away not only an organ of life, 
but a part of life itself.” 
Dr. Hillary says, “The stimulus of the acrid 
salts of cantharides render a fever inflammatory, 
and all its symptoms worse,—that they hasten and 
increase the putrefaction of the blood; produce 
strangury &c.” . , 
Dr. Barker says, he has seen much injury done 
by the use of physic where an emetic ought to 
have been used, and Dr. Clary thinks he lost sev- 
eral cholera patients by it. 
Dr. lteece of London, says, “I know not wheth- 14 
er to hail the discovery of mercury as a blessing or 
regard it as a curse, since the diseases it entails 
are as numerous as those it cures.” But Drs. 
George, Hamilton, Hooper, Falconer, Donaldson, 
Swan, Coxe, Cheyne and hundreds of others accuse 
it of destroying countless multitudes of our race. 
Cheyne and Chapman accuse it of producing jaun- 
dice. Coxe says, in many cases it produced the 
black vomit in the yellow fever. Hooper says it 
attacks the bones, and sometimes causes violent 
purging, even of blood; that many courses in any 
form, would kill the patient, because it proves 
hurtful to the stomach and intestines. The U. S. 
Dispensatory says, it sometimes produces exten- 
sive ulceration, gangrene and even hemorrhage. 
Dr. Hamilton says there are few poisons which 
possess more dangerous powers. Dr. Rush calls 
it the Goliath of Medicine. Dr. Cox and others 
say it produces an eruption called erythema mer- 
curiale, or an excessive flow of saliva; and Dr. Big- 
elow says that this mercurial disease is self-limit- 
ed, that is, that it cannot be arrested by medical 
practice. 
Similartestimony might be adduced against the 
use of other metals as medicines, and, indeed, 
against every poison, mineral, animal and vegeta- 
ble. Hence, it appears that the improvements, as 
they are called, of surgery, venesection, vesicula- 
tion, physic and poisoning, are but sorry substi- 
tutes for the ignorance of former ages, when physi- 
cians knew only how to sweat, to nurse and to 
heal. 
Yet, reader, strange to tell, these and similar, 
are the means which men have introduced into the 
“art ol aiding women in childbirth,” on account of 
which, they claim superiority over those of the 15 
proper sex, whose highest ambition was to watch 
the indications of nature, to aid her timely and 
promptly, but never to oppose her prophylactic or 
curative efforts. Sad change! where almost con- 
stant wretchedness takes place of rare and partial 
inconvenience. 
I lay it down as a rational position, on the 
strength of historical testimony, then, as wTell as 
sound logic, that women are naturally as able as 
other animals to reproduce their species, without 
extrinsic aid; that the disabilities with which wTe 
actually find them beset, are rare, very rare mal- 
formations of the system, and more commonly, he- 
reditary, cankerous taint; but that those by far the 
most frequently observed, are the fruits of bad man- 
agement in their raising, as comprehended in 
their clothing, exercise, food, and medical treat- 
ment. 
It will perhaps be inferred that, as the chiefbu- 
siness of the advocates of temperance is to preserve 
the sober from becoming drunkards, so the most 
that can be expected of the Botanic Physician of 
the present day, is to save the rising generation 
from the evils above enumerated, which are the 
principal causes of all the fevers, tumours, cancers, 
polypes, hydatids, dropsies, rotten bones, &c., 
whose deadly hold on the patient may be compared 
to that of the bottle on the appetite of the con- 
firmed sot. 
It is, however, encouraging to know that these 
constitutional and educational evils, are far more 
manageable, in the hands of a skilful physician, 
than the most hopeful cases of inebriation are, in 
the hands of the advocate of temperance. INTRODUCTION. 
LECTURE 1. 
THE ART OF AIDING WOMEN IN CHILD-BIRTH 13 
CALLED MIDWIFERY OR OBSTETRICS. 
Bat why, it has been asked, does woman need 
assistance in the performance of that to which her 
very nature is especially adapted] Were it not 
almost as rational to say that she needs assistance 
to keep the beard from growing, or to make the 
pelvis grow larger in proportion to the rest of 
the body than it is in man, or to complete any 
other peculiarity of her frame, as that she needs 
aid in giving birth to her offspring] 
I answer, the fact is admitted on all hands that 
she does need it; and I therefore proceed directly 
to show both why she needs it, and how it shall be 
the most promptly, judiciously and effectually ren- 
dered. 
I apprehend that the necessity q for this aid is, 
Note.—The reader will observe the letter q interspersed among 
the sentences through the whole work. Thisisdone, 1st,to warn 
the student that a question will be asked him respecting the sub- 
ject of the sentence in which it is found, or the meaning of the 
word to which it is attached; and, 2nd, to aid myself and others 
who may read my book, in the examination of the student. For 
example, the first q signifies that I shall ask the student Whence 
arises the necessity? tfc. After twenty years experience in the 
use of all the various modes that have been devised for these pur- 
poses, I am persuaded that this is, in almost every respect, by fax 
the best. 17 
with few exceptions, the result of a series of inju- 
rious treatment, by which her natural ability to do 
the work without aid, has been so much abridged; 
and that, therefore, the kind q of aid she needs is 
the removal of those obstacles that have' unfitted 
her for her duty, and the restoration of those pow- 
ers of whose free and full exercise, she ought never 
to have been deprived. 
Perhaps the best method q of teaching this, aa 
well as any other art or science, is, first, to pre- 
sent a comprehensive, clear and connected view of 
the whole subject. Then q the relative import- 
ance of the various details, will be more clearly 
perceived, properly appreciated, and easily trea- 
sured up in the memory. 
It is because the female frame includes certain 
organs made for special purposes, that derange- 
ments of these organs or their operations, have 
been called “diseases peculiar to women.” q 
To enable us, therefore, to rectify q those de- 
rangements, we shall do well, first, to learn some- 
thing of the objects for which those organs were 
formed, and the nature and end of their operations 
in a healthy state. As in the superfluity of seeds 
or eggs, produced by a single plant or insect, fish 
or bird &c., which, when circumstances do not fa- 
for their being used for reproduction, may be de- 
voured by animals or returned to the earth unpro- 
ductive, so in every department of the economy of 
the Great Author of all other contrivances and 
agencies whose existence or modes of existenco 
are subjected to the influence of conditions or cir- 
cumstances, there is a superabundant provision q 
of moans, both to accomplish the great end in 
view, and to prevent that excess of means from 
doing any injury, if not to turn it into other chan- 18 
nels for good. The organs alluded to are termed q 
Uterus and Mammae and the secretions q Men- 
ses and Milk. 
After a formal array of the most plaus'ble hypo- 
theses which have been invented to account for 
the existence, nature, uses and periodical returns 
of the menses, Dr. W. P. Dewees, q Professor of 
Midwifery in the University of Pennsylvania, con- 
cludes, (page 67,) “ From what has just been 
said, it appears q that, hitherto, nothing satisfac- 
tory has been advanced upon this curious subject— 
It yet remains q for some future Haller or Hunter 
to enrich medical science with a rational explana- 
tion of it.” 
Perhaps the principal reason q why this expla- 
nation should be referred to a Haller or a Hunter, in 
preference to Dr. Dewees, is, that Haller and Hun- 
ter rejected q the trammels of medical authority, 
observed, considered and reasoned for themselves, 
and dared q to publish what they discovered ; 
though, as Hervey says, “ The hatred and envy 
of physicians should swell against them as a legion 
of devils against virtue ; and the whole society 
should dart their malice at them and torture them 
with all the calumnies imaginable, without stick- 
ing at any thing that should destroy them root and 
branch.” 
Now, though I do not pretend q to possess the 
splendid talents or attainments of a Haller or a 
Hunter, yet I do claim q the same right to the un- 
trammeled use of the little share T have ; and, as 
all I conceive necessary q to the task, is a careful 
observation of what almost any one can see, and a 
sufficient control of language to express what I 
think, I shall make q the bold attempt, and leave 
the decision of its correctness to others who can see and think as well as I. And I shall be quite 
as indifferent to the consequent charges of ignor- 
ance or quackery against me, asformerly was Hal- 
ler or Hunter. 
The principal object in the peculiar structure of 
the female body, was its adaptation to the continu- 
ance of its species. The production occasionally 
of the embryo of another self, a sort of parasite 
that should be sustained awhile by the strength of 
her own system, required q the establishment in 
woman, of peculiar organs, and also of periodical 
secretions which, when not applied q to the ob- 
jects to which they are adapted, should be dis- 
charged in such a manner as to inflict no injury on 
the organs by which they are secreted. 
For ten or a dozen, and sometimes sixteen or 
eighteen years, q these secretions find full em- 
ployment in contributing to the growth of the body 
whose maturity, on that account, is generally ac- 
complished q several years earlier in females than 
in males. 
From this perfection of the organs, completed q 
in our latitude at the age of twelve to sixteen 
years, there is q a periodical secretion from the 
uterus, occurring q most naturally and commonly, 
(but often irregularly,) once in about four weeks, 
until it is arrested, q either by disease or, as has 
been hinted, by being turned to the nourishment 
of a parasite—an errtbryo of a future man ; or, till 
the powers of life, through the worn-out capacities 
of the body, are so much reduced, and all the secre- 
tions are so much diminished in quantity, that this 
(the menstrual) is easily absorbed away, and dis- 
tributed among the others, when its distinctive 
character and locality no longer appear. 
This usually happens q somewhere between the 20 
fortieth and fiftieth year, though it sometimes oc- 
curs much earlier, and at others is postponed much 
longer. An instance q is mentioned in a New 
Orleans paper where it commenced at four years; 
and one q in Good’s Studies of Medicine where it 
occurred for the first time at 70! 
From the natural cessation of this secretion, to 
the end of life, all the secretions q diminish in 
quantity and quality, till, finally q they are insuffi- 
cient to sustain the organic action, that is, to fur- 
nish solvents for digestion, lubricating fluids &c., 
the friction stops the whole machine, and the name 
q of this condition of things is, death by old age. 
From this general view of the subject, it is evi- 
dent q that, as the peculiarities of the female frame 
were formed for the express purpose of bringing 
forth children, our efforts to aid her in the accom- 
plishment of this object, must begin where nature 
begins to fit her for the office; or, in other words, 
at the very commencement of her existence. 
In her primeval condition, q before her body was 
corrupted by any constitutional taint, that is, 
source of disease communicated from the bodies of 
her parents, woman was born free from any other 
defect than what might be brought upon her by bad 
treatment after she entered the world; but, as ci- 
vilization and moral and physical corruption q ad- 
vanced, her body partook of the latter, till q it ia 
often necessary to remove the-constitutional taint 
or canker from her frame as soon as she is born. 
The presence of this maternal defect, then, so dis- 
ables q her for the full and perfect performance of 
all her physical duties, as to become the first q rea- 
son why woman so often needs aid in the chamber 
of parturition. But, supposing her birth to have 
been timely and natural, from healthy parents, 21 
there is a direct tendency q towards that state of 
maturity in which the size and tension of all the 
absorptive, circulating and secreting vessels are so 
completely balanced, as to admit, require, produce 
and maintain an equilibrium of fluids through the 
whole system. But, immediately after birth, the 
proper secretions are chiefly engaged in contri- 
buting to the growth and perfection of each organ 
or organization, till the whole system arrives at 
maturity, when the waste-gates are opened and 
the overflowings appear. 
In the body q enclosing the organs of digestion, 
assimilation and absorption, (the fountains of cir- 
culation and vivification, and source of the organs 
of secretion,) we might expect to find the greatest 
amount of heat, and, in the extremities, q the least, 
while the child remains inactive; but, the almost 
incessant motion which it gives to its limbs, is 
sufficient, by causing a free circulation, to main- 
tain the proper equilibrium, till it is able to stand 
and walk; when the partial diminution q of this 
action, is compensated by gravitation or the natu- 
ral downward tendency of the blood, produced by 
its own weight. 
These several causes combine q to continue the 
vital action and consequent heat of the extremi- 
ties nearly or quite equal to those of the body; and 
thus all the operations of life are carried q on 
without obstruction; and the condition so main- 
tained is termed health. 
The surface q of the body is a network com- 
posed of the mouths of an infinite number of invi- 
sible tubes, whose office q is to cast oflf the ex- 
cess of heat and moisture, which, from any cause, 
may at any time accumulate in the system. This 
secretion is termed q perspiration, sensible when the water is seen in drops on the skin, and insen- 
tible when heat only is perceptible. 
The object q of clothing is, in cold weather, to 
protect the surface from the astringent action of 
the atmosphere, which it does q by retaining, for 
a while, the disengaged heat around the body; and, 
in hot weather, by reflecting or warding oft' the 
excessive heat of the solar rays. 
In the former case it prevents q the cold air, 
and in the latter the dry heat, from contracting the 
network or pores of the surface, and obstructing 
the free perspiration or escape of excessive heat 
and moisture. 
It is evident then, that, if the clothing be equal q 
all over the body, the pores will be equally open, 
perspiration will be equal every where, and health, 
so far as the proper action of the surface is con- 
cerned, will continue perfect. 
Here, then, is the moment when we begin to 
aid or hinder the female frame in its preparation 
for the reproduction of its species. 
First, then, I will ask the mothers q of our land, 
whether the manner in which many of them clothe 
their daughters from this time forward, is consist- 
ent with the dictates of reason or of common 
sensei Do they q not encumber their bodies with 
numerous bandages and oppressive clothing, while 
they leave the extremities almost destitute! What 
must be the effect of this course of conduct, q but 
to relax and expand inordinately the pores of the 
body, and to contract those of the extremities, thus 
forcing through the former all the heat and moist- 
ure that ought to be secreted from the whole sur- 
face, and giving to the atmosphere the power to 
impede the circulation of heat and moisture through 
the extremities, which impediment or obstruction must necessarily reduce their temperature? The 
arteries q of the lower extremities being contract- 
ed by exposure, those of the chest and head are 
proportionably distended by the pressure of the 
blood, that is thus forced into them, and the 
sensation q produced by this pressure, is called 
“fullness of the head,” or cerebral congestion ; 
while the distended blood-vessels necessarily 
press upon the nerves and disturb the uniformity 
of their action, producing q sometimes a confusion 
of their operations, which is termed delirium. 
Here also, we have the origin of many cold feet 
and hands, flushed countenances, &c. Though 
it is true that Some sprightly girls overcome, by 
exercise See., the deadly influence of this inequality 
of dress; yet it is equally true that, in the constitu- 
tions of many others, q is thus laid the foundation 
of disease thatfollows them to their graves. Here, 
then, is another reason why women need aid in the 
chamber of parturition. 
If asked how q I would have the extremities to 
be dressed? I answer, Let thick flannel drawers 
and woollen stockings in winter, and cotton in 
summer be worn next the skin ; let the body be 
clothed so loosely that it can easily move itself 
within the garments, which should be no warmer 
than those on the extremities. 
Another reason q why women need aid in child- 
birth, is, that young girls are allowed and some- 
times even required by their mothers, to wear 
those modern instruments of lingering torture, call- 
ed corsets, stays, &c. 
Shall it be objected q that these things cannot 
be dispensed with, if a person would look decent, 
not to say genteel? » 
I answer, after an abortion or a miscarriage. 24 
a dyspepsia or dropsy, has racked q the poor frail 
body for several years, in consequence of this folly; 
they are willingly dispensed with and no complaint 
is made of the privation. Were it not better q 
to regard, in health, the dictates of nature, of rea- 
son, and experience, and save the future suffering, 
the wreck of constitution, health and life? Lest 
I seem too severe on this fashionable corrector of 
Nature’s bungling architecture, I will give, at 
once, some of the facts and arguments that sustain 
my position. In performing this service, I may 
omit many things that might be said against it; 
but there is no fear q that I shall in any respect 
represent the evil eonsequences of its use, as more 
numerous or destructive than they really are.— 
Language cannot reach them. 
In the first place, this misery-making machine, 
q like the iron prison for the Chinese foot, prevents 
the growth of the body to its intended and ordina- 
ry size: and then q it renders cartilaginous and 
callous, those parts that were designed to be, and, 
if they were permitted to grow in their own 
way to the size of their own pleasure, would be 
muscular and elastic, calculated to admit, with- 
out pain or inconvenience, those different de- 
grees of capacity so essential to the safe carriage, 
nourishment and delivery of a healthy offspring. 
As the starving q system of treating dyspepsia 
by withdrawing the periodical internal pressure of 
a full meal, suffers the external pressure to act 
constantly on the coats of the stomach, till they 
become so permanently contracted that any in- 
crease of the dietetic potion produces pain; so the 
superficial q compression of corsets, by prevent- 
ing frequent distensions and expanding motions, 
permanently contract the chest, the diaphragm 25 
and the walls of the abdomen, to such a degree 
that the inordinate expansion necessary to the 
growth of the foetus, produces similar pains in the 
diaphragm, the parietes (walls or coats) ofthe ab- 
domen &c. The painfully distended parts q con- 
tinually strive, by their reaction, to expel the of- 
fending cause; and hence a fruitful source of abor- 
tions, miscarriages and seven months children, 
besides all the current suffering to the mother, and 
the incurable evils that so frequently attend those 
W'ho survive such dangerous conditions, to drag 
out a miserable remnant of life scarcely preferable 
to death itself. Within the range q of my recollec- 
tion, are more than a score of females in this last 
condition, who are to charge q their present suffer- 
ings, in a great measure, to early lacing, and al- 
most altogether to the combined influence of this 
cause and the several others previously and yet to 
be explained. 
Of the multitudes that have sunk under the mi- 
series attending the premature expulsion ofthe 
feetus, the dark and silent regions of the grave 
alone contain the record. I have no doubt that if 
all who have thus committed suicide, could array 
themselves before us, the effect would be insup- 
portable to the most hardened feelings of our na- 
ture. This is another reason why women need aid 
in childbirth.* 
» When physicians discover an abortion, a miscarriage or n 
premature birth, they conclude that this accident, as tiiey call it, 
is to be considered a sort of legitimate cause of a similar catas- 
trophe in future. They seem never to have dreamed that the 
first accident, was the legitimate effect of a cause whose tendency 
is to produce the same effect in every instance. And hence, in- 
stead of directing their practice against the true cause which pro- 
duced the first effect, they wait for the evidences that it is about to 
produce another, when their efforts themselves are worse tha» 
vain, because made too late and upon a wrong principle. Being 26 
Another reason q why women need aid in child- 
birth is, Their power to accomplish it without aid, 
has been early and frequently abridged by injudi- 
cious medical treatment on the slightest indispo- 
sition. 
By the carelessness of the nurse, or its own in- 
cessant motions, the infant is exposed and takes 
cold. The bowels are a little disordered, or the 
stomach is clogged, or a fever rises; it matters not 
what, the least irregularity creates alarm. A few 
draughts of warm, stimulating fluid, or at most a 
full Thomsonian course, in such cases, would put 
all things right; but no! the doctor is called, and 
forthwith, doses of calomel (from one grain to 
three, and by some practitioners, eight, ten and 
twelve) arc immediately q prescribed. This dead- 
ly drug, (like every other poison, they all agree q 
in this point,) “suddenly and rapidly extinguishes a 
great proportion of the vitality of the system.”— 
Dost. Med. and Surg. Journal, vol. 9, page 43. 
Many a time have I seen q the vital energies of 
a poor little infant, laboring underthc deadly influ- 
ence of a dose of calomel (a single grain to a healthy 
child is sufficient to prostrate all its energies.—B. 
M. & S. Journal, vol. 9, page 85) given to sup- 
press that very fever which, if q aided by a little 
stimulating tea and warmth and moisture to the 
surface, or even if left to itself, would soon put to 
flight the offending cause, and restore health and 
activity to the patient. 
Ignorant of the true cause, they arc incapable of applying the pro- 
pter remedy. 
The Thomsonian treatment warms and relaxes the extreme 
vessels, discharges the cold and the morbific matter, promotes » 
free anil general circulation of the blood, and a regular-vibration 
or action of the nerves, gives tone or contractile power to the de- 
bilitated organs, promotes digestion—in short, it removes the 
causes of disease, and restores health to the patient. But scientific q wisdom adds more and more cal- 
omel, till so much of the “ vitality of the system” 
is “destroyed,” that no danger is apprehended 
from “the fever.” Many a little sufferer q being 
kindly nourished and nursed, now steals a march 
on the doctor. Its fever rises by steps so gradu- 
al as not to bo discovered, while it works oft'the 
most of the calomel in the same silent manner; 
and it would appear to be as well as ever, but for 
the evidently increased liability to the future at- 
tacks of the same and similar affections. But alas! 
how many others q there are, who sink under the 
influence of this deadly weight, to rise no more! 
I have seen not a few perish q for no other reason, 
as I firmly believed, than simply that they had 
taken more poison to cure disease, than the system 
could bear. Their death was attributed to teeth- 
ing, to summer complaint, to measles, to croup, 
in short to any thing but the true cause ; and the 
wreck q of constitution in others that escaped 
death, was accounted for in the same irrational 
manner. 
That I may not stand alone in this judgment, I 
appeal q to the testimony respecting the injurious 
effects of mercury, as described by eminent physi- 
cians, in the Thomsonian Recorder, vol. 4, pages 
137, 38, 39. See also Dr. Robinson on medical 
poisons, Dr. Swan’s “ Inquiry into the action of 
mercury,” and Dr. Donelson’s Practice in India. 
These children grow q up still more and more 
liable to disease, and frequently attacked by it, till 
the period when, had they always been properly 
clothed, fed, exercised and doctored, the menstru- 
al discharges would have taken place. In the United 
States and under favorable circumstances, this 28 
ordinarily q happens between the twelfth and fif- 
teenth year. 
But the vitality of the patient has been so much 
reduced q by the inequality of clothing, the want 
of proper exercise, tight lacing, or by poisoning 
the system, instead of curing disease, that the 
growth of the organs is not yet mature, the prepa- 
ration q of the secretion is postponed for a while, 
or distributed among others when actually pre- 
pared. 
It is well if now some learned quack q does not 
persuade the patient’s mother to give emenagogues 
directly to force its appearance. As time passes 
on, q however, the secretion accumulates in the 
proper vessels, and the system makes an effort to 
discharge it. 
“ When the growth of the animal frame,” saya 
Dr. Good, “is completed or nearly so, the quanti- 
ty of blood and q sensorial power which have hith- 
erto been employed in providing for such growth, 
constitutes an excess, and must produce q pletho- 
ra by being diffused generally, or congestion by 
being accumulated locally. It takes q the lat- 
ter course in order to perfect the organs of gene- 
ration, which, during the principal growth of the 
body, generally remain dormant and inert. It first 
shows q itself in the ovaria, from which it soon pro- 
ceeds to the uterus, where it accumulates and ex- 
cites that organ to a new action by which q it ia 
thrown off periodically, by lunar intervals, in the 
form of a blood-like discharge; though it has hard- 
ly any common property with blood, except its ap- 
pearance—that of a liquid of a red colour.” “ It 
is not always colored at first, which may account 
for supposed feetations before menstruation.” “Nor 
is it always discharged at lunar intervals. Wo- 29 
men menstruate somewhere every day in the year 
and hour in the day.”—Dewcet. “It is not coagu- 
lable, but a fluid thrown off from the mass of blood, 
by an action of the uterus similar to that of secre- 
tion.”— lb. Hence, coagula in the fluid is proof, 
that the discharge is unnatural, laborious or pro- 
fuse. 
Among the difficulties attending this discharge, 
physicians enumerate the retension already hinted 
at, indicated q by a doughy swelling of the feet 
and ankles at night; of the eyes and face in the 
morning, spots on the hands and forehead, a pecu- 
liar sensation in the breasts, and a general senso 
of oppression, languor and dyspepsia. The mind q 
is unhinged, the appetite capricious, the extremi- 
ties cold, the forehead ofton hot, the pulse quick 
and low, breathing difficult, sleep disturbed, face 
pale, urine colourless and bowels often confined. 
The faculty have supposed q many causes for 
this secretion,(see page 18,) without pretending to 
know any thing very certain about it, and pointed 
out many modes and means of cure, without ven- 
turing to say that any of them are specifics. Still, 
they have hit upon both, without being aware of it. 
Dr. Good says, vol. 5, p. 46, “ All the symptoms 
indicate that retained menstruation is a disease of 
debility; there can be little doubt that debility is 
its primary cause—a want of energy in the secern- 
ant vessels of the uterus that prevents them from 
fulfilling their office till the increase of inability, 
from the increase of general weakness, at length 
produces a degree of stimulus [i.e. the reaction of 
the system, or fever,] sufficient momentarily to 
supply the place of strength.” 
I have therefore the testimony q of the London 
School, that I have given the true cause of the dis- 30 
ease in the “destruction of a great portion of the 
vitality of the system, by “unequal clothing,” 
tight lacing, want of proper exercise, or injudi- 
cious medical treatment, particularly the adminis- 
tration of poisons in former attacks of disease. 
Dr. Good says Yol. Y. page 49, “to cure q sup- 
pressed at first, obstructed after it has appeared, 
and laborious and difficult menstruation, we must 
increase the tone of the general system, excite the 
action of the uterine vessels where they are mor- 
bidly torpid, or relax them where they are pained 
by spasmodic constriction. Both the last, q how- 
ever, are subordinate to the first; for, if we can 
once get the system into a good state of general 
health, the balance of action will soon be restored, 
and the affected organs will fall into the common 
train of healthful order.” What a testimony in 
favor of the Botanic Theory and Practice! We 
have only to reverse the order, that is, first, relax 
the strictures, second, excite the system to throw 
out the cold and obstructions, and third, to tone 
the delibitated organs. A Tljornsonian course is 
the very tiling the good doctor wanted; and my 
own experience corresponds with that of thous- 
ands of practitioners in assuring the sufferer that 
this practice, faithfully and energetically applied, 
will do the work to admiration. 
I have quoted from the Boston Medical and Sur- 
gical Journal, Vol. 9, page 4J, because I approve 
of it, the doctrine that all poisons agree in the sud- 
den and rapid extinction of a great proportion 
of the vitality of the system. For, I apprehend 
that the vitality q of the system consists in its 
power to circulate the blood and heat in ample 
measure, to its remotest parts. As poisons q then 
diminish this power, they circumscribe in tho 31 
came proportion, the blood and heat to the regions 
of the heart, lungs, brain &c, and invite the cold 
air to take possession of the extremities, to con- 
tract the vessels and produce a permanent reduc- 
tion of their calibre. This reduction qofcapacity 
in the extreme vessels, produces a proportionate 
distension of the same character of vessels in 
those deep seated regions of the system, as the 
heart, lungs and brain, where the action ofthe vi- 
tal power is more immediate, and where the influ- 
ence of atmospheric pressure is not so easily 
brought to bear. This distention of tlie vessels is 
the dull, heavy, stupifying headache of which most 
children who are doctored much, and all dyspep- 
tic patients so constantly complain. 
The pressure ofthe atmosphere on the body, as 
a reaction upon the reduction of vitality, whether 
caused by taking" cold, losing internal heat or the 
exhibition of poisinous drugs, limits the heart and 
lungs to a smaller spaed, which makes them act pro- 
portionately quicker, (like the balance-wheel of a 
watch when its free and full rotation is retarded 
by the dirty oil about the pivot) and this more fre- 
quent action q is called ‘‘excitement of the pulse,” 
“shortness of breath” “inflamatory action, &c.” 
When the heart labors very hard, its action is 
felt on the surface, and is called “palpitation.” 
The distention of the vessels of the brain, as I 
said before, is one source of what is called head- 
ache. The pressure ofthe distended vessels on 
some of the nerves, and the stiffening by cold into 
a sort of phlegm, of the lubricating mucous, that 
surrounds others, cause q an unequal action of the 
nerves, extending to the brain. This produces 
inequalities in the time in which the different 
branches of the nervous system transmit to the 32 
brain the subjects of thought, and hence arises a 
general confusion similar to that produced by the 
unequal vibrations of discordant strings on a musi- 
cal instrument. This condition of things is called 
q delirium. 
To remove q the pressure, (conjestion) the doc- 
tors bleed and cup the patient. This it is true, 
gives q a momentary respite to the distended ves- 
sels of the heart, lungs and brain; but, by destroy- 
ing the vital energies, it also admits q a still fur- 
ther reaction of the atmosphere on the extreme 
vessels; and thus q renders a future repetition of 
the practice still more necessary than the com- 
mencement. But, since it is evident q that, if 
they were to draw out all the blood, the patient 
would die immediately, they q leave enough to 
sustain the breath of life, for the present; and when, 
after lingering in misery some hours, days, 
weeks, months or years, the patient q dies of drop- 
sy or dyspepsia, the death is attributed q to a 
chronic, “an incurable disease.” 
Not approving of it, I should not meddle with 
the practice of the faculty, were it not, as Dr. 
Bigelow says, that “the principal q business of the 
skilful physician, is often to prevent the officious 
meddling of officious quacks.” Could the Thom- 
sonian Fraternity or the public in general, be 
aware q of the mischiefs that are done by the rash, 
ignorant and officious members of the medical 
profession, no caution from me wrould be necessary 
to induce them to trust nature in every extremity, 
rather than to surrender their bodies as living sub- 
jects of reckless and dangerous experiments, foun- 
ded on'the wild vagaries of the visionary theorists 
of the schools. Another reason why womon need aid in partu- 
rition. is, the inefficiency of the system, produced by 
a want of proper exercise during the periods ofchild- 
hood and youth, the employingof servants and as- 
sistants to dress and undress children, to bring and 
carry for them even a school satchel, inshort°todo 
for thorn every thing that requires the lpast ex- 
ertion, and the too prevalent disposition to prohib- 
it athletic exercises for amusemont, as unsuitable 
for ladies, are calculated q to prevent the full de- 
velopment of tlio system, and the acquisition of 
that organic power, which are the well known ef- 
fects of constant muscular exertion. To have al- 
ways at hand q someone ready and willing to wait 
upon her, is one of the greatest evils a young lady 
can suffer; while the necessity of waiting on her- 
self, and of making a reasonable bodily exertion, is 
a real blessing that sweetens the enjoyment of ev- 
ery other. 
The miserable victim of inactivity, q is as fee- 
ble in frame, as pale in appearance, and as unfit 
for the intentions of nature, as the vino from a cel- 
lar in summer, is to endure the withering influ- 
ence of a meridian sun, and to perfect its fruit 
amidst the frosts of autumn. 
Though, by suitable attention q to the above 
hints, during the period of its growth, the full en- 
ergies of the female frame may be easily developed, 
yet reason unites with experience in declaring that, 
when neglected q till the growth of the body is 
completed, this very desirable object is not easily 
obtained; still the beneficial effects q of moderate 
and judicious exertions, even on those who have 
been inactive in early life, are worthy of the most 
prompt and persevering attention. 
Another reason why women need aid in child- 
birth is, many, I fear most mothers, from the del- 34 
icacy of the subject, “leave q their daughters,” as 
they express it, “to find out by their own experi- 
ence,” what, if timely and correctly taught them, 
might prevent much future suffering,if not save even 
life. It is not only cruelly embarrassing to a mod- 
est young lady, to be totally ignorant of the nature, 
cause and proper treatment of a disagreeable con- 
dition of her system, till it comes upon her sudden- 
ly; but it has subjected q many to the ruin of their 
health, and some to the loss of life itself. Girls, 
have been known q to go, at a critical period, into 
water, to wash their clothes, and then to stand in 
the open air to dry them, that they might not be 
detected, and laughed at by the members of the 
family. Thus they have taken cold and laid the 
foundation of disease that followed them to their 
graves. Others have been injured q for life, by 
improper medicine or manual treatment, or in oth- 
er wyays,for want of a few hours instruction which 
every mother is amply qualified to give. The 
mother, however, refuses, q from motives of deli- 
cacy; but, when the dear object of her solicitude is 
dangerously ill through this neglect, delicacy is set 
aside, and the modest girl is unscrupulously sub- 
jected to the impertinent queries of some pert son 
of Esculapius, just out of’his teens, as well as his 
nosology. This is no harm! “It is fashionable 
and necessary for the Dr. to know every thing.” 
Often, when reproving young ladies for exposing 
themselves to cold, at the commencement or re- 
currence of their monthly courses, have I been 
told q that they did not know they were doing 
wrong. Within this moment’s relollection are 
several interesting young ladies, whose bodies 
were put into such a state by imprudenco at this 
juncture, that nothing short of their lives will pay 
the forfeit. Mothers, teach q your daughters, seasonably and 
affectionately, all you know, that may save them 
future mortification, trouble or sorrow. Charge 
them q when-“unwell” to beware of taking cold 
and to take no medicine that is calculated to im- 
pede the circulation, but to wear warm clothing 
to use gentle exercise, nourishing diet, and stim- 
ulating medicines, (if any at all,) till they are en- 
tirely well. 
While I am on the subject of maternal instruc- 
tionsj I may as well add q that you oimdit by all 
means to teach them the nature, cause and treat- 
ment oftheforms ofdisease and all the inconvenien- 
ces they are to expect in the married relation. Do 
not wait till you arc certain they are about to enter 
into that state. It were better to teach them earlier 
than desirable, than that your permature and un- 
expected death should deprive them of any in- 
structions at all. Young married ladies are often 
subjected to much mortification and not rarely to 
severe suffering, which might have been easily 
prevented by the faithful and affectionate instruc- 
tions of a judicious and intelligent mother. 
LECTURE 2. 
' As tlie (Mects in, and injuries to, the female 
frame, pointed out in the introductory lecture 
have rendered necessary q a special attention to 
the art ot aiding women in child birth ” it is 
proper to commence q the developments of this 
art, with a description of the various organs most- 
ly concerned in the processes which lead to that 
event. (See plates.) Pelvis.—The bony rim, surrounding' the lower 
part of the body and lying beneath the walls of the 
abdomen, is called the Pelvis. It took its name q 
from its supposed resemblance to a basin; but it 
must be observed that it is open at the bottom as 
well as the top, and that the posterior sides are 
much higher than the front. In an adult, it con- 
sists of only three q principal bones; the back or 
posterior part, called the jBacrum, and the two 
haunch, side, and share-bones, the back arid high 
parts of which are called ossa innominata, (nameless 
bones) the sides are called ossa illia, (illiac bones) 
and their anterior or front ends, the ossa pupbis, 
(pubic bones.) To the lower part of the sacrum are 
attached several little moveable bones which, from 
their supposed resemblance to a cuckoo’s beak, were 
called os coccyx or coccygis, and from the upper 
and front part, is a projection called the promon- 
tory of the sacrum. The ossa pubis arc joined be- 
fore, by a strong, thin cartilage called the sym- 
physis pubis, or joining of the pubis. Directly un- 
der this, the pubic bones diverge into what is cal- 
led the arch of the pubis. The space included be- 
tween the upper projections of the ossa innomina- 
ta or haunch bones, is called the false pelvis, and 
that below the upper part of the illiac bones, the 
true pelvis. The upper part of the illiac and pu- 
bic bones, the promonitory of the sacrum, and the 
corresponding portions of the nameless bones 
constitute what is called the brim of the pelvis, 
and the lower portions of the same bones, surround 
what is called the outlet of the pelvis. The pas- 
sage into the brim of the pelvis, is termed the su- 
perior strait, and that through the outlet, is termed 
the inferior strait; the space between these straits, 
is called the cavity of the pelvis. Ifthe shorter di- 
ameter of the aperture, from the symphysis pubis to the sacrum, be from two and a half to four in- 
dies; and the other diameter be still longer, and 
the parts each side of this be equally proportion- 
ed and of similar shape, the pelvis is said to be 
well formed, and to present no serious obstacle to 
a natural and easy delivery. All other forms are 
said to present obstacles in proportion to the de- 
gree of their departure from this regularity, and 
are called informed pelves. 
Much has been said and written about q the im- 
portance of measuring the pelvis and the head of 
the child (to be born,) and thu3 determining be- 
forehand whether nature has been so careful to 
strike the due balance between the dimensions of 
the thing formed and the place designed for its 
egress, us to render the assistance of art unneces- 
sary; and not a few plans and instruments have 
been devised q to aid this research. While Con- 
tonly recommends his pelviinetre, Madam Boivin 
her intropelvimetre, and Baudelocque and De- 
wees the calipre,the conclusions q of all these 
authors, especially of the latter gentleman, is “We 
have reason to fear q that none (of the plans) hith- 
erto projected has attained this end. We are 
certain that the deviations from nature in the most 
careful measurement, are often more than equal to 
the exigencies of the case.” While, again, it is 
admitted q that these tutsans cannot be universal- 
ly and accurately applied in the very cases where 
thoy are most needed, Velpeau declares q that, 
“with the finger we may estimate every species 
of deformity of the pelvis, of whatever nature, and 
wherever situated.” 
But, suppose all this to be accomplished, how q 
shall we know the size and shape of the object to 
be protruded! children have been safely delivered 
q through a pelvis whose antero-sacral diameter 38 
was only two inches and a half; a diameter less 
than this would subject the woman to almost as 
much danger as would a surgical operation! 
Structures peculiar to Females—External. 
— The fleshy substance lying directly on the 
symphisis pubis, is called, mons veneris. Its 
lower or back portion is divided into two parts, 
called the labia pudendi, rima magna, or labia 
externa, which diminish in width and prominence, 
as they descend towards the coccyx. Their union 
is called the fourchettte, or fork. Between the 
fourchette and the coccyx is another aperture cal- 
led the anus. Between the anus and the four- 
chette is a septum or division called the peri- 
neum. 
On separating the labia pudendi, we observe a 
long cavity called fossa magna or navicularis. In 
the upper or front part of this opening, is a small 
spongy body in some measure resembling the male 
penis, but impervious, composed of two corpora 
cavernosa, and terminating in a glans which is 
covered with a membrane called the prepuce. On 
the sides of the fossa are two spongy folds called 
nymph® apparently much contracted, but havin'* 
the power greatly to expand, and thus enlarge the 
passage to facilitate parturition. Between these, 
and<about the middle ot the fossa magna, is the or- 
ifice of the vagina called os externum, closed in 
the virgin state, by folds and wrinkles called ca- 
runcalfc myrttformes.* .After childbearing, theso 
frequently disappear, and the interior of the va- 
gina is visible on opening the labia pudendi. About 
one third of the distance from this to the clitoris, 
cSome suppose that the carunculm myrtiformesare the remain a 
of the obliterated hymen; but f have seen both present and dis- 
tinct, in the same individual at the same time. 39 
is the meatus urinarius or orifice of the urethra (a 
tube from one to two inches long, much shorter, 
though somewhat larger than in men,) with a 
small projection at its lower edge. In infants the 
orifice of the vagina is often found partly closed 
by a thin membrane called the hymen, which is 
open sometimes in the middle, and sometimes at 
the upper edge, so as to appear like a crescent. 
Instances have been known, in which it entirely 
closed the orifice of the vagina. This should be 
opened immediately, with a sharp penknife or 
scissors, to prevent the indelicacy of a future ex- 
posure. 
Internal organs.—The Vagina.—The os exter- 
num leads into a canal called vagina, of a conical 
form, from three to six or eight inches long, about 
two inches broad at the upper end or fundus, into 
which is a small projection called the cervix uteri 
(or point of the uterus) somewhat in the manner 
in which the small pointed bottom of a wine bottle 
is projected into the vessel. The vagina is com- 
posed q of two coats, the inner, is velvet-like, Inter- 
spersed with many excretory ducts, and contracted 
into plica: or small transverse folds, particularly 
at the fore and back part. These are lessened 
and generally obliterated by Ghild bearing. The 
outer coat is firm, somewhat contractile, and sur- 
rounded by cellular membrane which connects it 
to the neighboring parts. A portion of the upper 
and posterior part, is covered by the peritoneum or 
membrane which includes the intestines. The va- 
gina is between the urethra before, and the rec- 
tum behind, to both which it is firmly attached, by 
strong cellular membrane. 
Of the Uterus.—Above, or beyond the va- 
gina, in the cavity of the pelvis, between the 
urethra and the rectum, with its lower point pro- 40 
jcctinor into the vagina, in the manner in which 
the finger might be pressed an inch or so, into the 
bottom of an India rubber or a leather bottle, is a 
spongy receptacle called tho uterus, q resembling 
in shape a compressed pear. The lower point is 
called the cervix; the upper or bottom, th c fundus, 
and the intermediate parts, the body. The whole 
is about three inches long, two broad at the fun- 
dus, and one at the cervix. Its walls are nearly 
half an inch thick at the fundus, rather more than 
half at the cervix. Though its surface is greatly 
enlarged, it is so distended with blood that it pre- 
serves about the same thickness during the whole 
period of.pregnancy. But the size of the uterus 
in different women, is so various, even when not 
impregnated, as to prevent any very great degree 
of accuracy in the measurement. The back is 
thicker and expands more during pregnancy than 
the front. The entrance q into its cervix form* a 
little protuberance called os tinccn. From the 
manner of its insertion into the vagina, the cervix 
of the uterus may change its position and direction 
at pleasure. The inner coat of the vagina, is re- 
flected over the os uteri, and continued into the 
lining membrane of the uterus. This membrane 
secretes a mucus wdiich generally closes the os 
uteri very curiously and perfectly, immediately 
after impregnation, and continues it so during preg- 
nancy. Several exceptions are on record. 
The substance of the uterus is very firm, compos- 
ed of arteries, veins, lymphatics, nerves and mus- 
cular fibres, curiously interwoven, and united by 
cellular membrane. Two broad ligaments q pass 
•from the sides of the fundus uteri, to the sides of 
the pelvis, serving to support the uterus, and to 
convey to it nerves and blood vessels. Two round 
ligaments rise from the sides of the fundus uteri, 41 
pass along within the forepart of the broad liga- 
ments, descend through the abdomnial rings, 
and terminate in the substance of the mons vene- 
ris. Though these ligaments will allow the un- 
impregnated uterus to move ouly about an inch up 
and down, yet, during pregnancy, they permit it 
to rise into the cavity of the abdomen. But,.after 
delivery, they contract with surprising quickness 
to nearly their original state. From each side of 
the inner surface of the uterus, near the fundus, a 
tube q passes through the uterus, and extends along 
the broad ligaments to the edge of the pelvis, where 
it reflects back and turns over behind the liga- 
ments, so that about an inch of its extremity hangs 
loose in the cavity of the pelvis. The extremities 
q ’of these tubes having a jagged appearance, 
are called fimbriaj. The whole tube q is about as 
long as the uterus, very small in the uterus and 
increasing in diameter towards thefimbrice. 
Ovauiks.—Near the fumbriae of each tube, and 
about au inch from the uterus, is suspended q in the 
pelvis, and covered by thb folds of the broad 
ligaments (productions of the peritonaeum,) a flat 
oval body, about an inch long, called the ovary, 
which generally means a little egg, but repres- 
ents q here rather a nest of cgg6, or berry inclosing 
seeds. 
Each of the ovaries includes q from four to 
twelve vessiclcs attached by threads to the inner 
6urfaccof the ovary, some deeper seated than oth- 
ers, filled with coagulable lymph. 
As the life oftlie female advances, q they be- 
come turgid, a kind of coagulum is formed in or 
near the surface; it increases to something like a 
quarter of an inch in diameter. In coition the 
fimbrim of the fallopian tube clasp the ova- 
ry, and press it to such a degree as to burst 42 
the delicate integument and disengage the lit- 
tle egg which passes q through the tube into the 
uterus, where it is impregnated by the male se- 
men and nourished q by a secretion from the cir- 
culation to the uterus, until it is ripe for parturi- 
tion. These ovula or little eggs, may be seen in 
the healthy ovaries of every young woman. It is 
certain q that they form the basis of every fcetus, 
as none can be found where they do not exist, and 
the scars in the ovary or nest of women that have 
had children, correspond always witli the number 
of conceptions. 
Bladder.—Attached to the inner extremity of 
the urethra, behind and above the symphisis, is 
an elastic and muscular vessel, of an egg shape, 
and capable, when distended, of holding nearly a 
pint of fluid. This vessel is called the bladder. 
Rectum.—Behind the bladder is the ute- 
rus, and, between this and the os sacrum, is the 
large tube or intestine, the extremity of which is 
called the ainus. This tube is called the rectum, 
both the anus and the urethra are surrounded by 
muscular and contractile bands called sphincters, 
which are powerfully contracted except when the 
pleasure or necessity of the person requires their 
relaxation, when they give way for a moment, but 
quickly recover their condition. 
Uses—One prominent use of the pelvis is to afford 
a firm support to the abdominal walls and viscera; 
another q is to receive the ends of the lower limbs, 
and furnish suitable locations and firmness for the 
insertion of the muscles destined to move those 
limbs. In females, the cavity of the pelvis 
seems also destined q for the-protection of the 
principal organs of generation, as the vagina, the 
uterus, the fallopian tubes, the ovaries, and also 
of the bladder and rectum. (In the 4th month of pregnancy, q the uterus quits the cavity of the 
pelvis, and rises into the abdomen; so docs it also 
rise is cases q of dropsy that djstend it beyond the 
pelvic caviity.) Some, however, of what are cal- 
led organs of generation, as the labia, &c., q arc 
without the cavity of the pelvis, even in females. 
Another q and very prominent use of the pelvis, is 
to protect from all outward pressure and injury,the 
delicate embryo of the future man, till it shall 
have acquired that organization, firmness and con- 
servative power that seem most necessary to pro- 
tect it from injuries, when encased only within 
the more plastic walls composed of abdomnial 
muscles. 
The labia pudendi, the nymph®, and the muscu- 
lar folds of the os externum (carunculic myrtifor- 
mes,) all serve qto close the passage to the uterus, 
and protect it from cold. Their spongy structure 
and elastic power q enable them to expand for the 
purpose ofparturition, to protect the child against 
injury from the pelvic bones, and afterwards to 
contract to nearly their original dimensions. 
About the nymph®, in the vagina, uterus, &c., q 
are glands and follicles which secrete, some an 
oily, others a mucus substance which serve q to 
prevent injury by friction and close contact of the 
parts. 
The vaginaq by its firm texture, and its attach, 
ments to surrounding parts, aids the broad and 
the round ligaments in supporting the uterus in 
its place, and preventing injury to the cervix from 
external pressure. 
The uterus is designed for menstruation, and 
for conception, protection, nutrition and expulsion 
of the fietus. The broad and round ligaments, aid- 
ed by the vagina, sustain it in its proper place and 
position. The fallopian tubes are evidently de- 44 
signed to conduct the ovum from its nest in the 
ovary, to the cavity of the uterus. The ovaries 
are designed to furnish the female elements of the 
future man, in regular succession during the primo 
of life of each individual. The ova are seldom less 
than 8 or more than 24, usually 10 to 14. 
By a careful inspection of the plates and refer- 
ences, the location and form of these organs will 
be more clearly preceived, and their uses better 
understood. 
LECTURE 3. 
Diseases.—Tn infants,the labia pudendi, the nym- 
ph® &zc., are often inflamed. This condition may be 
prevented or cured by washing the parts often 
with warm milk and water, and dusting them with 
fine powdered hemlock, or applying sweet oil or 
cream or fresh butter to them. Similar ap- 
pearances about the ears, groins and elsewhere, 
may be treated in the same manner. Sometimes, 
from want of attention to these matters, the labia 
pudendi, grow together. When this is observed, q 
they should be separated immediately. The best 
method of doing this, in my opinion, is to take 
hold of the labia and pull them apart. This meth- 
od is less likely than cutting to injure the minuto 
vessels of their surfaces, and is said to give but lit- 
tle pain. Dr. Denman says it will scarcely make 
the child complain. Keep the parts asunder till 
healed, by a little lint saturated with sweet oil, 
cream or butter. These are also excellent to pre- 
vent or cure chafes, &c.,any where. 
Wotk.—At tlie request of friends I shall hereafter omit theq’s. The vagiqa is liable to stricture, so as to ren- 
der it too short and small for the purposes for 
which it was designed. This may be obviated by 
injections of No, 1, slrppery elm and other emol- 
ient substances, and by dilatation with sponges, 
tents, Acc., The Thomsonian courses, injections 
and restoratives, faithfully used, will almost it not 
quite always save the necessity of mechanical dis- 
tention sometimes advised by physicians. Cohesion 
of the inner surfaces after ulceration, and the scars 
thus formed, may be treated as directed for adhe- 
sion of the labia pudendi. 
Attached to its inner surface, is sometimes found 
a species of fungus denominated polypus. It is ot 
various sizc3, shapes and textures, and variously 
situated. After some time, it generally becomes 
smaller towards the point of adhesion, when, with 
a double canula and a loop, it may be compressed 
around the neck so as to stop the circulation. In 
three to six days it will drop off, and the place 
where it was attached may be dressed with heal- 
ing salve, put on the side of a large piece of lint, 
or even let alone, and it will soon be well. A 
very bad case was lately cured by pure l'homso- 
nian courses alone. Such tumours are also some- 
times found in the uterus. 
The fiuor ablus or whites so called from its ap- 
pearance which, though at first generally milky, is 
sometimes changed to green, yelloworeven brown, 
shows itself in an irregular discharge from the ute- 
rus and vagina. It is often attended by severe 
pain in the back and loins, weakness, loss of ap- 
petite, dejection of spirits, paleness and chillness, 
and sometimes by difficult respirations, palpita- 
tions, faintings and swelling of the lower extrem- 
ities, which are, rarely, followed by prolapsus uteri 
or the “falling of the womb.’’ This disease being caused by cold, canker and 
other obstructions of the secernants, the proper 
mode of cure will be to give the patient full cour- 
ses, promptly and energetically, with generous 
diet, moderate exercise, and the best articles of 
No. 4. Great attention should be paid to injec- 
tions into the vagina, composed of witch haz.le, 
(or other canker tea, when this cannot de had) 
with a little cayanne and nervine; these Should al- 
ways be strained. The parts should be constant- 
ly protected by warm clothing from the action of 
cold. Let this practice be continued till the gen- 
eral health is restored, and the peculiar affection 
will vanish. 
'lhe qterus is liable to retroversion, by which 
is meant that the fundus is turned backwards and 
downwards upon its cervix, between the vagina 
and rectum, and the os uteri is turned forwards to- 
the pelvis, and upwards, in proportion to the de- 
scent of the fundus, so that it cannot be felt by the 
finger, at least without great difficulty. The fun- 
dus uteri may be felt between the vagina and the 
rectum, pressing the former towards the pubis, 
this generally happens about the third month of 
pregnancy, though it sometimes occurs after de- 
livery. It causes severe pain, costiveness and sup- 
pression of urine. Sometimes the bladder is so 
distended and projected into the abdomen, as to 
produce the appearance of advanced pregnancy. 
Ily inserting a catheter through the meatus uri- 
narius, into the bladder (an operation which the 
patient can perform with more ease and less in- 
convenience to herself than the administration of 
an injection) the water if necessary may be drawn 
off. Then (the patient lying on one side,) by in- 
serting the fore finger of one hand into the vagina 
and that of the other into the rectum, keeping them as near together as possible and con- 
stantly alternating gradually inward, the fundus 
uteri will be easily returned to its place, when the 
cervix will return as a matter of course. By fil- 
ling the vagina during the day, with a thick In- 
dia rubber bottle, or other soft elastic substance 
lubricated with slippery elm, after giving a course 
of medicines and injections, to strengthen the 
parts, the derangement will soon be corrected. 
The uterus is also subject to hydatids, that is, 
little bags containing a watery lluid supposed to 
surround living animalcule, and attached by a 
small neck to the surfaces. “If,” says Hooper, 
“the vires natune medicatriccs are not sufficient to 
effect a cure, the patient mostly falls a sacrifice to 
their ravages.” It is therefore evident that the 
Botanic treatment (if it should not always, as it 
certainly will generally, effect a cure,) is the best 
that can be applied; for it is calculated to aid t)ie 
vis medecatrix natural, in doing what it is of it- 
self unable to accomplish. 
Tumors or dropsical bags that obstruct the pas- 
sage of a child, should be pushed above the pubis 
if moveable; ifnot, they should he punctured with 
a sharp instrument, and they will discharge their 
contents. 
Cancers are also sometimes found in the uterus. 
They may be treated according to the Thomsonian 
plan, so far as they can be reached; or they may 
be treated with caustic potash, as hereafter des- 
cribed. With ulcers Thomsonians will have no 
difficulty. 
The ovaria aro-also liable to dropsical affections, 
to inflammation See., Physicians guess at the ex- 
istence of this form and locality of disease; and 
attempt to cure the former by tapping through the 
vagina, and the latter by the use of those anti' 48 
phlogistic means which are well calculated to pro* 
duce the former. They are subject also to hydatids 
and cancers. The dropsy usually happens about the 
cessation ofthe menses, sometimes earlier. It is 
caused by cold or other obstructions, which either 
contract or close up the pores in those parts, and 
prevent the fluids from escaping. The applica- 
tion of warmth and moisture on the Thornsonian 
plan, will relax the pores and discharge the offen- 
sive matter. 
Though the above forms of disease need not be 
feared by those who adhere strictly to the Thom- 
sonian treatment from the beginning, yet I have 
thought proper to mention them for the purpose 
of showing that, in the event they should, these of 
all difficult cases are the very ones in which ofli- 
ciousness should be avoided. A friend asks what 
we Thomsonians shall do in difficult cases which 
demand the assistance of surgeons'! I answer in 
the language of the very best surgeons. “Such 
causes' of difficulty less frequently occur than many 
authors have imagined. The rash and preposter- 
ous application of instruments has in such cases 
proved the bane of thousands.”—(Ed. Practice, vol. 
6, page 140, “and, should difficulties occur, what 
can we do but support the strength of the woman 
and wait with patience.”—lb. 141. “The work of 
nature is too often spoiled by officious hands.— 
lb. 142. Instruments should never be employed 
but when alarming symptoms occur! The asser- 
tion perhaps is not more bold than true, that, in 
general, the most disadvantageous position in 
which the head can offer, is not sufficient, no oth- 
er cause concurring, to endanger the life of mother 
or child, so much as would be done by the move- 
ment oftliG gentlest hands.”—lb. 140. I repeat it, 
then, that difficult cases and alarming symptoms 49 
rarely occur, and when they do, we have the best 
authority to prove that the best treatment, as well 
as the only safe one, is to afford nature all. the aid 
we can, but never to interrupt her operations. I 
have witnessed several instances in which the pa- 
tient and the bystanders were much alarmed, but, 
by “supporting the strength o* the woman” and 
“waiting with patience,” they were soon convinced 
of the truth of our motto, that midwives ought to 
“know that they are natures servants,” not her 
masters. 
These evils rarely happen to women that have 
not borne children, nor even to those who have, 
that have been treated according to the Botanic 
System. They are almost universally the fruits of 
“scientific skill in the chamber ofparturition.” This 
same remark is equally applicable to other forms of 
disease peculiar to women after childbirth. 
The Catamenia already described, commences 
its discharge at very different periods of life. Tn 
tropical climates, and persons of warm passions, 
it presents itself usually at 8 to 12 years; intem- 
perate, at 13 to 1G years; in cold, at 16 to 20. 
There are instances in which it has commenced 
much earlier, and one is on record where it present- 
ed itself for the first time at 70 years. 
At whatever time it commences, it usually con- 
tinues about twice as long as the person has al- 
ready lived. It at 10, it departs at about 30; it at 
15, it ceases at about 45, &c. 4 he commence- 
ment and the cessation of this discharge, are called 
the most critical periods of life to the female. It 
generally commences very moderately, and the 
next day increases. It continues from two days 
to 10, generally 3 or 4 to 6. From some persona 
the quantity discharged is much greater than from 
qthers, estimated at 4 to 8 ounces. So long, how- 50 
ever, as the discharge gives no pain nor weakness, 
and is not mingled with clotted blood, the quanti- 
not to regarded as injurious. 
I his discharge usually occurs once in about four 
weeks, and is generally supposed to be under the 
m luence of the moon. 1 know a few individuals 
who a ways have it in the increase of the moon, 
uut 1 know many in whom it pays no regard to 
the positions of that planet. Females are men - 
struating somewhere, every day in the year and 
every hour in the day. Many have it once in 
three weeks, others once in five or six. In very 
cold climates it comes on late in life, and returns 
only m summer. It is not to be expected (though 
it sometimes appears) either during pregnancy°or 
nursing. Those who discharge clotted blood with 
it, or those who do not regularly discharge it 
once in four weeks, (unless when peegnant or nur- 
sing,) seldom bear children. The discharges 
are sometimes checked by grief or disappointment, 
and produced by agreeable surprise. Whenever 
irregularity, painfulness, suppression, milky or 
bloody discharge, or any other unnatural effect, in- 
dicates a want of healthy action, the patient 
should take full courses of medicine aided by ap- 
propriate injections, and steam should be fre- 
quently applied to the lower extremities, till the 
cold phlegm, and eanker are disengaged, and then 
she should tone up the system with the various 
articles ol No, 4, or bitters, so tempered or combin- 
ed as to keep the bowels open, and with No. 2 and 
clothing, as to keep the whole body warm. When 
the general system is renovated, the particular af- 
fections will cease. 
Marriageable State.—It is pretty certain 
that women are incapable of bearing children, till 
the catamenia commences. And it is almost equally certain that they ought not to be put to 
the trial so soon by three or four years at least as 
this occurs. 
The consent of the parents, and of the moralist 
being obtained, young ladies, in the Southern 
States, arc marriageable between 1G and 20, and 
in the northern, between 18 and 25. But, if any 
know themselves to be so defective or deformed, 
as to render child-bearing evidently impossible or 
dangerous to their own lives were it possible, they 
ought by no means to marry. 
If askod how they are to know this, I answer, 
the most common difficulties in parturition, arise 
from deformities of the pelvis by the disease called 
the rickets. Every one knows whether she is af- 
flicted with this disease. Many material deform- 
ities ofthe pelvis, may be discovered by exami- 
nation of tlio exterior surface; small deviations 
may be ascertained by the patient herself, or a 
confidential female friend, by examination and 
comparison with my description of a well formed 
pelvis. Velpeau, a famous French obstetrician, 
says, that all deformities of the pelvis may be as- 
certained with a sufficient degree of accuracy, by 
the touch of tlie finger. Want of genital organs, 
or monstrosity of those existing, rarely occurs. 
The want of a healthy and regular menstrua- 
ation is not a reason sufficient to deter a young 
lady from entering into the married state; for such 
a connexion is often found the best remedy for this 
disorder. But, whether married or not, a faithful 
and energetic Thomsonian treatment, added to 
the prophylactic means heretofore described, will 
seldom fail to remove this form ofdisease. 
I have already remarked that, when the hymen 
has never given way, (an exceedingly rare case) 
the catamenial secretions may remain in the va- 52 
gina and uterus, and produce the appearance of 
dropsy. This is easily detected by examination, 
and as easily removed by severing the membrane 
with a pen knife or pair of sharp scissors. It has 
been remarked that, though not removed in infan- 
cy, the hymen is almost always perforated in the 
centre, if not notched from the upper or forward 
edge to the centre. Still it has been sometimes 
found so strong and wide as to present an elfectu- 
;*1 barrier to sexual union. Instances have been 
known, in which an ignorant husband has made 
application for divorce, instead of performing the 
easy and safe operation of dividing the membrane. 
Some have supposed that the remains of the hy- 
men form the carunculre myrtiformes, or folds 
which close the mouth of the vagina; but I havo 
seen the cafunculce perfect, in a grown per- 
son, in whom the hymen was not deeply cleft. 
As the hymen, in many, is not ruptured till 
the first scjcual embrace, some havo thought it 
a necessary proof of virginity; but its total des- 
truction (if it ever existed) in infancy, is so com- 
mon, that authors who never daw it have doubt- 
ed its existence. Many well know, however, 
that “such things there arc.” 
Most authors on midwifery seem to feel bound 
to give a particular account of the nature of con- 
ception, and the modus operandi of producing it; 
but I think that they might safely leave these 
matters to instinct, when common sense is want- 
ing, especially as the more they write, the more 
clearly they exhibit their ignorance of the whole 
subject. My task shall be to teach those who 
have by any means assumed this responsibility, to 
bear it with a good grace while they can, and to 
get rid of it in the safest and the easiest way, 
when they must. I Of Fteho-oestation—T3y impregnation, in 
all ordinary cases, one of the ova is detached from 
its place in the ovary, and conducted, in tho 
course of about twenty days, through the fallopian 
or ovario-utcrine tube, into the uterus. It is sur- 
rounded by two membranes, the inner, called tho 
amnion, and the outer called the chorion; the lat- 
ter incloses a fluid in which the embryo floats. 
At first these membranes are separated a little by 
a glutinous substance, but they afterwards come 
nearly or quite in contact. The amnion is thin, 
smooth, and transparent, without the appearance 
of vessels. The chorion is nearly similar, but of 
a rougher texture. 
From the moment of impregnation, commences 
forming on the inside of the uterus, a membrane 
called, from its transient existence, the decidua, 
its situation being displaced by the introduction of 
the ovum and its membranes into the uterus. 
Soon after the ovum enters the uterus, its mem- 
branes are united with, and incorporated into, tho 
decidua, in such a manner as to be inseparable af- 
ter the second month. The decidua is also firmly 
attached to the wall of the uterus, generally at the 
fundus. See plates. When this union is effected, 
the chorion and decidua permit each other’s ves- 
sels to interlock through their whole extent, so as 
to establish, between them, a union, similar to 
that which exists between the arteries and air- 
cells of the lungs. The amnion and chorion in- 
close a fluid called the waters (liquor amnii,) in 
which the feetus floats from the commencement to 
the end of pregnancy. It is sometimes transpa- 
rent like water, atothers yellow, brown, green &c., 
and of various} consistences. It differs -much in 
quantity, from a gill or so, to two quarts or more. 
It gives uniform distention to the uterus, protects 54 
the foetus against internal injury, keeps the sur- 
faces of the amnion and the foetus constantly lubri- 
cated, and aids in expanding the passage to facili- 
tate parturition. 
Anomalous Conceptions.—Instances have oc- 
cured in which the foetus remained attached to the 
ovary, others where it stopped in the cavity of the 
pelvis, others where it lodged in the fallopian 
tubes, and yet others, where it made its bed in the 
walls of the uterus, instead of the cavity, and in all 
these situations, it has come to maturity and been 
delivered, sometimes by dying, and then rotting a 
whole through the walls of the abdomen and being 
discharged by piece meal, and others, by the knife 
of the surgeon. Such cases, however, rarely oc- 
cur.' 
Umbilicus and Placenta.—Attached to the 
umbilics of the foetus, and of various length, about 
half a yard in the full grown child, is a small chord 
composed of one vein and two arteries, and sur- 
rounded by extensions of the .chorion and amnion 
through which it passes to the decidua, where it 
expands into a circular cake of various sizes, thick 
in the middle and thin at the margin. The out- 
side is attached to the inner surface of the uterus, 
generally at the fundus, by a thin membrane so 
delicate that the least bending will crack it, 
and produce a hemorrhage. The foetal surface is 
coated all over by the chorion and amnion, 
through which may be seen the arteries and veins 
before mentioned, as composing the chord, divided 
and subdivided, sometimes diverging towards the 
margins, as rays from a point; at others, crossing 
each other in the most fantastic forms, and finally 
diminishing to invisibility. Through the chord 
uniting the placenta to the foetus,called the umbil- 
ical chord, the vein and arteries sometimes run pa- rallel for several inches, then twine around each 
other in various ways, presenting1 the appearance 
of an irregularly twisted rope. In this chord are 
observed one vein to carry blood from the placen- 
ta to the foetus, and two arteries to return it from 
the fetus to the placenta. These are imbedded 
in cellular substance, containing a ropy fluid, and 
covered by the membranes called amnion and cho- 
rion, as before observed. The capacity of the 
vein is rather greater than that of both the arte- 
ries. The placenta renovates the blood of the 
fetus, as the lungs do that ofthe child or adult. 
For this purpose the arteries and veins of the ute- 
rus so completely intercommunicate with those of 
the placenta as to bring each and every one of 
either into such a nearness to some of those of the 
other, as to render the contact similar to that of 
the air in the lungs ofthe mother with that of the 
blood. Thus the fetus is supported and built up 
by a secretion from the blood of the mother, through 
the membranes that separate the respective ves- 
sels; not by the blood of the mother circulated 
through the fetus. 
Changes in tiie Uteri/s.—As soon as an ovum 
is impregnated, a larger proportion of blood is di- 
rected to the uterus. The little crooked vessels 
enlarge and straighten, till the largest sometimes 
become, at the end of pregnancy, a half inch in di- 
ameter. 
For about seven months, the fundus and body of 
the uterus are mostly distended; after that, the 
neck continues the development, till, at the full 
period, nothing of it can be discovered save the os 
Uteri, which is generally a little open. 
Labor Pains.—The fibres comprising the ute- 
rus, relax as the size of the fetus increases, till 
their elastic power Is exhausted, when they com- mence a contractile reaction, the fcetal resistance 
to which, is the disagreeable sensation called labor 
pain. As the foetus still enlarges, these become 
more frequent and insufferable,till, by a succession 
of mighty efforts, they discharge the offending 
cause. 
The only difference betwreen the premature, or, 
as they are often called, false pains and the true, 
is, that the former take place at any period of 
pregnancy, when, from any cause, the expansion 
of the uterus does not correspond with the growth 
of the child. Thus a sudden cold contracts tho 
uterus and produces abortion. (Sec treatment of 
this form of disease.) True pains may be inelli- 
cient, on account of their not extending over the 
whole surface of the uterus. Partial and inefficient 
pains during parturition, are sometimes called 
false pains, though more severe than those in 
which every portion of the uterus acts, and the ef- 
fect is produced. 
Positions of tiie Uterus.—We have already 
remarked that, if the patient have a sound consti- 
tution and the catamenia be generally regular and 
healthy, pregnancy may besu.pected when the pe- 
riodical secretion ceases. 
Abating variations consequent on the form and 
capacity of the pelvis, the tonic or atonic state of 
the organs &c., the position ofthe os uteri for the 
first three months, will be rather lower in the va- 
gina; from thefourth to the fifth, the fundus can be 
felt outside above the pubis; at the sixth, halfway 
between this and the umbillicus; at the seventh, 
about the umbillicus; at the eighth, halfway from 
this to the pit of the stomach, which is about as 
high as it rises. Then it settles and enlarges. 
Growth of the Foeths.—For about littecn 
days no solid form is discoverable. At six or seven weeks, it is about the size of a small bee. At two 
months, it is about two inches long and weighs 
about as many ounces, the parts are distinct and 
ossification commences. At four months, it is 
five to six inches long, and its motions are usually 
felt by the mother. The first of these motions are 
called “the quickening.” The length is seven to 
nine inches. In the sixth month, the hair com- 
mences growing, the foetus weighs from one to two 
pounds, and its length is nine to twelve inches. 
During the seventh month, parts pretty fully de- 
veloped; eighth month, nails firmer, hair more Co- 
lored, weight three tofivo pounds, length 15 inches 
or more; ninth month, bones more complete, head 
large, firmer; cranial bones touch each other’s mar- 
gins, fontanelles narrower, nails extend to the 
ends of the fingers and the whole system is deve- 
loped. Its weight then varies (in Europe) usual- 
ly from five to eight pounds. Dr. Dewees, of 
Philadelphia, says that lie weighed one of fifteen 
pounds and a half; and thinks that, in this coun- 
try, they arc often as large, and that their average 
weight is over seven pounds. 
Sometimes the foetus thrives in weakly women 
and becomes proportionably very large. Sometimes 
healthy women bring forth very small children, 
that are nevertheless perfect, and sometimes the 
children arc retarded in their growth by au im- 
perfection in the development of the parts. 
LECTURE 4. 
Duration of Prkonancy.—It is generally be- 
lieved that the natural, uninterrupted period of 
pregnancy in a healthy woman, is from 3!) to 40 
weeks or about 0 months. This is about the du- ration in most cases which occur under circumstan- 
ces that leave no doubt as to the exact time. (De- 
wees, pages 139 and 134.) From various causes, 
however, some females carry the foetus seven 
months, some eight, some ten and even more. 
(Dewees, pages 128, 142.) As it is impossible, 
however, always to know when it commences, 
and, as its duration is different in different women, 
and in the same woman at different times, so there 
is no certain rule by which either the duration or 
the termination can, at all times, be determined. 
The most important matter is, always to keep the 
female ir good health, as the first and best means 
to render distinct and certain, those signs which 
have generally been relied on as indicating the ex- 
istence of utcro-gestation; to be always prepared 
for the circumstances attending its approach or 
termination, from the time that the reasons to sus- 
pect its existence are first developed, and to be- 
come so well acquainted with the signs ofapproach- 
ing parturition as to guard against improper con- 
duct and to render the subject all the attention 
which those circumstances require. 
Signs of Utero-Gestation.—The uterus is 
supposed to be the most favorable to conception or 
impregnation, directly after the periodical cessa- 
tions of the menses. Sometimes women know the 
moment it takes place; sometimes they discover its 
effects in a few days or weeks; sometimes three or 
months elapse before they discover it, and some- 
times they are in doubt even then. The same wo- 
man, in some utero-gestations, is in doubt ofher 
condition through the whole period, and in others 
aware, not only of its existence, but of the time of 
its particular stages. Many instances are known, 
in which medical men have treated pregnancy for 
dropsy, till the actual appearance of the full grown foetus discovered their mistake. One instance oc- 
curred a few years ago in Maryland. A corres- 
pondent informed me that two M. Ds. treated the 
patient a long time, and gave her up as incurable. 
The father called a Thomsonian who steamed the 
living dropsy into the world! One of my pupils in- 
formed me that a similar case fell under his own 
observation in the State of Tennessee. (See the 
quotations under the head of “Regular Mistakes,” 
or “ Scientific Quackery.” See also “ Curious 
Physiological Facts.”) 
The principal reasons for the above irregulari- 
ties, are, the different constitutional tempera- 
ments of differeut females, and the different de- 
grees of health and spirits in the same female at 
different times. When they are in perfect health, 
and their spirits buoyant, the slightest impulse on 
the delicate structure of their peculiar organs, is 
sensibly felt. 
Menses.—In women whose constitutions and 
general health are good, the monthly evacuations 
ulmost always cease immediately after conception, 
and do not reappear till sometime after parturition, 
and seldom while nursing; therefore, if the menses 
do not occur for several successive periods, it 
may be generally inferred that the subject is preg- 
nant. llut this cessation may take place in conse- 
quence of taking cold, and then bad treatment may 
prevent its. recurrence, and a consequent dropsy 
may similate pregnancy so closely as to deceive 
even experienced accouchers. (See above.) 
About the time of the final cessation of the men- 
ses, say forty to fifty years, there may be such an 
enlargement of the abdomen, irritation of the 
breasts &c., in consequence of too early a sup- 
pression, as to induce both the patient and the 
physician to suspect pregnancy. The regulars who are afraid to give their Sam* 
cons in case of gestation, are in a bad box here; 
they are obliged to wait the teachings of time, and 
let the patient suffer, lest, by their “ incompati- 
bles,” they do her an injury instead of giving her 
relief. But Nature’s physician gives her a full 
course of medicine without fear, and thus, at once, 
decides the question, and always in favor of health 
and comfort, be the condition of the what 
it may. I speak from abundant and satisfactory 
experience in this matter. 
Women, however, sometimes do menstruate dur- 
ing the first months of pregnancy, and, in rare 
cases, they have done it to the very last! “I have 
myself known women,” says Dr. Blundell, (page 
115,) in whom, during the first three or four 
months, the catamenia have continued to flow, 
though not in so largo quantity nor so long, as if 
they were not pregnant; and, in rare cases, lam 
told, but I have not seen any such case myself, 
that the catamenia may continue to flow up to the 
last month. A [medical] gentleman related to 
me the case of a lady who had had several chil- 
dren, and, in three or four of her pregnancies, tha 
catamenia continued till the last month :—in re- 
turn, in kind, and in every point except the con- 
tinuance and quantity, the flow was of the catame- 
nial character. I need scarcely add that women, 
when pregnant, are liable to red appearances, 
which are not of the nature of the catamenia.” 
The cessation of the menses is, therefore, as I 
before remarked, a valuable, but not a certain in- 
dication of pregnancy; and yet pregnancy may ex- 
ist, where the discharge still continues, one in- 
stance of which has fallen under my own observa- 
tion. Still, these cases are so rare, that Denman and Burns, both very celebrated accoucheurs, de- 
clare, that “no female, continuing to menstruate, 
can, at the same time, be pregnant,” they never 
having seen 6uch a case. 
The discharge without pregnancy, may be pre- 
vented by local obstructions, in a woman whose 
health has been generally good, or by chronic, 
general inability to furnish this fluid, in addition 
to all the other secretions. While, in consequence 
of a surplus of vitality in health, or of excessive 
weakness of the uterine secernants in chronic sick- 
ness, this secretion may become excessive at the 
expense of others thus rendered deficient. This 
is the only rational account I have ever seen of 
these seemingly unaccountable occurrences, and I 
believe it true, because it explains all difficulties 
on principles in perfect harmony with established 
laws of vitality, as well as with my view of the 
cause and design of this secretion. (See page 19.) 
Irritation of the Bladder*.—Increase in the 
size of the uterus, while it remains in the cavity 
of the pelvis, is apt to create irritation about the 
neck of the bladder, and sometimes an ineffectual 
desire to discharge the urine; this is called mictu- 
rition. Other circumstances being favorable, it is 
considered a sign of pregnancy. 
Nausea, Retching and Vomiting.—These 
suddenly occurring in women perfectly well before, 
particularly on rising in the morning, and subsiding 
more or less during the day, the patient spitting or 
throwing up, however, little else than mucus, gas- 
tric juice, or ill-digested chyme, constitute ano- 
ther concurring sign of utero-gestation. 
Swelling of the Lower Extremities.—The 
increase of the uterus in the pelvis, may cause it to 
press upon the veins and obsorbents that ascend 
from the lower limbs, and this check to the return 62 
of the fluids causes those limbs to swell. The 
same cause may check the action of the nerves, 
and render the limbs liable to become numb, or oc- 
casionally to “ go to sleep,” as it is called, and 
these things may happen too, in the latter months 
of pregnancy, when the weight of the foetus press- 
es on the brim of the pelvis. Connected with other 
concurring circumstances, these signs are of some 
value. 
Motion of the Fietus.—It is generally sup- 
posed that the motions of the foetus are a clear and 
certain proof of pregnancy. But nothing is more 
certain than that, in multiplied instances, these 
cannot be distinguished from spasmodic contrac- 
tions, the movement of wind <fec., even in women 
that have had many children; and that this doubt 
may continue to the very commencement of deli- 
very. In most cases, however, the motionsofthe 
child are felt with more or less distinctness, from 
the end of the fourth month to the day of delivery. 
Dr. Blundell says, “When the motions of the 
child [rather in the abdominal viscera; if “of the 
child,” they must be certain,] are somewhat ob- 
scure, but little reliance can bo placed upon them, 
as a sign of pregnancy; but where the child is verv 
turbulent, the motions frequent and violent, the 
sign becomes so strongly marked that, without 
looking any further, you may infer that gestation 
is undoubtedly begun.”—(Page 114.) 
Enlargement of the Abdomen.—Thoutrh va- 
rious causes, as corpulency, dropsy, wind, internal 
tumours &c., may produce an increase of size in 
the abdomen, where pregnancy does not exist; yet 
it is certain that a foetus cannot come to maturity 
without producing this effect. Therefore, when 
a sudden, gradual and considerable enlargement of 
the abdomen takes place without any other known cause than its connexion with other signs of preg- 
nancy, it may fairly be considered one of the many 
indications, and as such, have its value. Soma 
advantage may be derived from a careful attention 
to the particular kind of swelling. Swelling from 
water or air, is diffused quite equally over the 
whole abdomen, is yielding and moveable ; that 
from air is fluctuating, often entirely subsiding; 
that from fat., diffused overthe whole system; that 
from tumours, very gradual in its growth, uncon- 
nected with other signs, and located indifferent 
places; while the swelling of pregnancy commen- 
ces suddenly, about the flrst of the month, just over 
the symphisis pubis, is constant, unyielding, and 
continually increasing; and, therefore, all others 
concurring, is a valuable sign. 
State of the Breasts.—In first pregnancies, 
the breasts are apt to indicate the condition of the 
uterus, by enlargement, irritation and secretion; 
but, as the first of these may be induced by corpu- 
lency, and the second and third by the frequent ex- 
ercise of a desire that they should become so, to- 
gether with repeated trials by pressure, to ascertain 
whether there be any secretion, their indications 
are by no means certain. These appearances too, 
arc so common about the final cessation of the 
menses, as often, in connection with that, to de- 
ceive even the experienced obstetrician. 
Arecla.—Some have placed much confidence in 
the enlargement, and of the changes in color to a 
darker hue, of the areola or dark circle that sur- 
rounds the nipple, as a valuable indication, espe- 
cially of a first pregnancy. Others place but very 
little confidence in these changes. But it is man- 
ifest that none but the lady herself, her husband 
or intimate female friend, could be much benefited 
by this 6ign, were it ever so good. The physician is not required to examine each patient, sufficient- 
ly often to profit by these changes; nor are they 
very distinct or worthy of notice, after the first 
pregnancy. The change, when manifest, is from a 
narrow to a wide circle, and from a rosy tint to a 
coppery red or a mahogany brown. Dr. Blundell 
thinks it, in some cases, a very decisive concur- 
rent sign. 
Likings and Dislikings.—Most women, during 
pregnancy, are beset with certain preferences and 
aversions. They will choose those articles for 
food which might be supposed the most unsuita- 
ble, and yet seldom disagree with them, while 
they will all at once become irreconcileably op- 
posed to others of the'most inoffensive and nour- 
ishing kind. Some lose their fiesh and health, 
others the equibility of their temper, some fret and 
others cry, or exhibit some,other hysterical symp- 
toms; few indeed are, in all respects, in disposi- 
tion and action, just what they are at other times.* 
Quickening.—In the latter part of the third 
month or beginning of thp fourth, the uterus quits 
the cavity of the pelvis and ascends into the abdo- 
men. In many females the influence of this 
change is distinctly felt, in motions in the abdo- 
man, sickness of the stomach, agitation of mind 
and tendensy to fainting. In others, these effects 
are not strongly marked. 
Cessation or diminution of tiie milk.— 
When, during nursing, a sudden diminution, or al- 
most total cessation of the milk occurs, pregnancy 
may be strongly suspected, especially if there has 
been a return and then a suppression of the men- 
ses. The fact that lactation and menstrual se- 
cretion very seldom if ever proceed together, and 
that neither of them scarcely ever exists during 
pregnancy, is proof that both these secretions are engaged in contributing' to the development of the 
future man, till lie is entirely detached from the 
mother, from whose secretions he has been so long 
supported, and furnishes another strong evidence 
of the truth of the doctrine taught page 19th and 
following. 
Diseases,—Such as, nausea,diarrhoea, effusions 
of water, dyspepsia, heartburn, depraved taste, 
costivencs3, prolapsus uteri, gravel, jaundice, dif- 
ficult breathing and cough, convulsions, tooth 
ache, salivation, inflammation of the breasts, drop- 
sy ofthc ovum and of the extremities, rigidity of 
the abdominal muscles, false pains, agitations in 
the abdomen &c., have been considered signs of 
pregnancy; but, as each and every one of them is 
often present where there is no pregnancy, and, as 
pregnancy may exist, without them, they are ol 
little value assigns, except when the concurrent 
testimony of those already mentioned, gives them 
value. Regulars profess often to determine the 
matter by a manual examination; but, as this 
mode is calculated to do often more harm than good, 
and, in the Botanic practice is never wanted, I 
can not recommend its adoption. The signs they 
derive from it are, they say, “in some dubious 
cases the only certain” 6igns; and yet, with all 
the precaution against error, they can take, they 
are obliged still to confess that no one of these 
signs of pregnancy alone, is very certain, and, in- 
deed, that they cannot determine the case infalli- 
bly by the united evidences of all the signs with 
which they are acquainted. Dr. Blundell, after 
enumerating all the signs that have been found 
worthy of notice, comes to this sage conclusion, 
that, “if pregnancy be doubtful, we had better 
wait till the end often or twelve months, when, 
unless the gestation be extra uterine, or out of all rule, parturition must sooner or later occur!” 
Thus, he ends the chapteron signs nearly as he be- 
gan it, viz: “The most certain mode of knowing 
whether a woman bo pregnant or not, is by wait- 
ing till the term of nine months is completed, 
when, unless the pregnancy be extra uterine, or 
unless there occur some of those extraordinary 
and rare prolongations which have sometimes been 
made the subject of physiological or forensic liti- 
gation. if Ihe ulerus contain an ovum, it will be 
expelled!” 
Treatment.—Though I have here spoken of 
what arc called “ diseases of pregnancy,” merely 
with respect to their characters as signs of its 
existence, yet, as they are supposed, by the regu- 
lar faculty, to require a treatment when found 
in this connexion, different from what would be 
proper when the patient is not pregnant, it may 
be proper to state that all forms of disease are to 
be treated upon the same principles and with the 
same remedies when the patient is pregnant, that 
would be adapted to the case, if she were not. 
A woman of good constitution and in perfect 
health, will scarcely learn that she is pregnant 
from the evidences which the “ diseases of preg- 
nancy” afford, while she that is feeble and sickly, 
will find it as difficult to determine from wkal 
cause her continued and vexatious, hysterical 
symptoms proceed. As to nausea, it may be pro- 
duced by any things hat can irritate the stomach, 
as bad food, cold phlegm Ac., as well as by uterine 
sympathy. From whatever cause it proceeds, 
however, it is to be cured by a course or two of 
medicine, (or fifty if necessary,) with laxative bit- 
ters, Ac.) The cold phlegm above mentioned, 
may check the power of digestion, and the uterine 
irritability may fatigue the stomach before the 67 
whole of the food is reduced to chyme: In eith- 
er case, the pylorus relaxes and the undigest- 
ed food is suffered to pass into the duodenum, 
where it continues its irritation, and, of course, 
the velocity of its descent, till it is violently ex- 
pelled from the system, in connexion with the 
fluids which have been hastened by the absorbents 
too fast to be taken up; the discharges thus pro- 
duced, constitute what is termed diarrhoea. As 
this form of disease too, has its origin in the sto- 
mach, it is evident from reason, as well as from ex- 
perience, that a thorough course of medicine is the 
best cure for it. 
Dr. lllundell says, (page 121,) “among the dis- 
eases which arc either referred to pregnancy, or 
which require a modified treatment in consequence 
of their connexion with it, not the least trouble- 
some, is tiic irritability of the stomach and bow- 
els, producing, in the earlier and middle months, 
both vomitings and purgings—sometimes togeth- 
er—generally alternating. * * *. Where there 
is much irritability, the patient becomes much 
reduced by it, and she may die of exhaustion by 
vomitings and purgings, or by flooding, perhaps, 
during premature delivery. It is not always in our 
power to put a stop to these vomitings and purg- 
ings, but we may do it in many instances.” 
I have not found it more difficult to cure these 
forms ofdisease, in connexion with pregnancy than 
in its absence, because 1 have uniformly treated 
them without any reference to that state. I would 
make the same remarks in regard to all other symp- 
toms above enumerated. As 1 shall hereafter give 
particular directions in regard to the manner in 
which all the forms of disease peculiar to women 
are to be treated, I forbear to add more in this 
place. Advantages of IvNOwiNG'the condition of tha 
patient. What, I may be asked, are the advan- 
tages to be derived from certain knowledge of the 
real condition of the patient! I answer, soma 
wicked persons desire to know the fruits of one 
sin, that, by the commission of another, they may 
avoid exposure. To such persons, it would not be 
right for us to communicate the knowledge if we 
had it. Regular physicians are anxious to know it, 
that they may not prescribe for disease, a course of 
practice that would injure any woman in a state of 
pregnancy. Let them quit their poisonous and 
destructive practice, and adopt one that will cure 
all forms of disease without injuring any person, 
under any circumstances, and this knowledge will 
be less important to them. But of what use is 
this knowledge to the patient, or to nature’s phy- 
sician? Answer. It is very pleasant to be reliev- 
ed ofdoubt in any respect; and particularly when 
it is necessary to make any preparations for the 
final result. But, on the medical practice of the 
true physician, whose duty it is, at all times, to 
remove every cause of disease, whatever be tho 
condition of the patient, it can have no very im- 
portant bearing. Having given numerous and full 
courses of medicines, in every stage of utero-ges- 
tation, I am happy to assure all who may desire 
information on the subject, that 1 have never had 
the least reason to believe that any thing but good 
resulted from them. So far from being afraid to 
take full courses of medicine during pregnancy, 
every lady in that situation ought to take them so 
frequently as to keep her system free from every 
cause of disease, and in the exercise of all its prop- 
er functions, as the very best means of securing 
the full growth, hearty constitution and safe deliv- 
ery of her offspring. By giving a full course of medicino the day before delivery, I have so prepar- 
ed the system for its duty, as to render the business 
of parturition short in its duration, and compara- 
tively trilling in the aggregate of suffering. I 
have known a regular M. D., to forbid a patient the 
use of medicine, and thus prolong her complicated 
sufferings for many months, under the fear that the 
medicine proper for one form of disease, would be 
injurious to a patient laboring under the symptoms 
of another. Often have I entirely released, in a 
few hours, the miserable victim whom this spe- 
cies of medical superstition had doomed to a three, 
four, or five months suffering of the most disagree- 
able and even painful kind. How ought we to 
prize a system of practice, which may be safely, 
freely and effectually applied, for any and every 
form of disease, without the least fear of injuring 
the patient. 
Reckoning.—Supposing the commencement, or 
the quickening to be correctly established, the 
reckoning of nine months, or thirty nine weeks 
and one day, from the former, or about live months 
from the latter, will complete the term of gesta- 
tion, and indicate the time when parturition may 
be expected. This is somewhat important; for, 
ladies who are properly treated during that period, 
are often very suddenly surprised at the end of it, 
and are, of course, liable, without attention to the 
reckoning, to be caught away from home or at least 
unprepared. 
L.vbor.—Many causes may contribute to retard 
or cut short the hour of labor; therefore we should 
always be ready for the circumstances attending its 
arrival, and so well acquainted with its approach, 
as to guard against improper conduct, and to ren- 
der the patient all the attention which those cir- 
cumstances may require. 70 
Causes of Labor.—Medical men have written 
much on the supposed causes of labor, but have 
never very well agreed on any point respecting 
them. I think that the uterus is a muscular struc- 
ture; and, as such, is designed to relax, unless 
some internal cause of reaction to an ex- 
tent just sufficient to enclose a full grown fcetus, 
and then, like every other muscle, to return to its 
original dimensions. During the period of this re- 
laxation, the deciduous membrane, now called tho 
placenta, as also the fcetus, arrives at maturity, 
and, like a ripe apple, quits its strong hold upon 
the parent. The whole now become an offence, 
as would any other substance that did not belong 
there. The regular periodical contractions of tho 
uterus, (for, though a long period elapses between 
them, they are strictly periodical,) now com- 
mence, and arc increased in frequency and power, 
till they expel the contents of the uterus and re- 
duce that organ to its original dimensions. This 
doctrine clearly explains tho mystery of abortions 
and false pains, subjects that have puzzled tho 
medical world not a little, and caused them to 
scribble many a ponderous folio of nonsense and 
absurdities. 
Abortions, &c.—The truth is, the placenta is a 
hard cake, possessing,from the commencement of 
its growth, very little adaptation to contraction; 
whereas, the uterus is capable, when powerfully ir 
ritated, of contracting, at any time, in a very few 
hours, from the size to which it may be naturally 
distended, to nearly its original dimensions. The 
attachments between the placenta and the walls of 
the uterus, are so delicate that the contractions of 
the uterus, by the side ot the unyielding cake, rea- 
dily separate them. The whole contents of the 
uterus now become foreign to that organ, and, as 71 
such, are immediately expelled. This is the reason 
why a severe cold or a sudden shock, as a fall, a 
fright, grief, &c., all which act spasmodically upon 
the whole nervous system, and especially upon 
the uterus, produces abortion. This is also the 
reason why the Botanic Practice, which consists 
in relaxing constricted organs, removing the caus- 
es of irritation, and thus quieting the nerves and 
restoring a regular and natural expansion of the 
uterus and action of the general system, is so ef- 
fectual in preventing abortions and miscarriages. 
The treatment in such cases, will be given in its 
proper place. 
LECTURE 5. 
Signs of approaciiinq Labor.—As the signs 
or symptoms of pregnancy may bo similated by 
those of various forms of disease, so the signs of 
approaching labor may be similated by what are 
termed false pains, proceeding from colds or other 
local irritants. It is therefore well whenever any 
symptoms present that are suspected to be those 
of approaching labor, to commence, at once, that 
kind of medical treatment which ia calculated to 
remove every vestige of disease. If the symptoms 
proveto be those of disease; they will be removed; 
if those of actual labor, they will be increased in 
severity and frequency till no doubt will remain as 
to their cause. 
Giving canker tea, especially raspberry, and 
cayenne, applying warmth to the feet, jugsof boil- 
ing water, or bricks or rocks, heated red, and then 
cooled in water till dene hissing, and wrapped in 72 
linen cloths, (the patient, being in bed or in a 
chair by the lire;) and thus producing perspira- 
tion, or giving her a good steaming, are the pro- 
per means to decide the point. 
Sometimes, if the gestation be complete, the 
patient can perceive for two or three days be- 
fore parturition commences, a gradual sinking of 
the abdomen, which is produced by the sinking of 
the foetus into the superior strait of the pelvis. 
Micturition and tenesmus are frequently trouble- 
some. There is also, generally, a discharge from 
the vagina, of a mixture of mucous and sanguinary 
fluids, which indicates some progress; in the dila- 
tation of the os uteri. “ The mucus,” says I)r. 
lllundell, “ is from the numerous and large folli- 
cles whrch lie in the mouth and neck of the w’omb, 
and the blood consists of a small drain from a few 
capillary vessels passing from the cervix uteri to 
the membranes, and laid open by the detach- 
ment of these membranes and disruption of these 
vessels, when the lower frustrum of the ovum de- 
scends a little, and the mouth of the womb dilates. 
Hence it is because the show of blood [as well as 
mucus] is indicative of the dilatation of the os ute- 
ri and the incipient descent of the membranes, that 
this sanguineous appearance may be looked on as 
the token of commencing labor.” 
Advice when called.—If the patient have 
used the botanic remedies, and should request your 
services, you should attend as soon as possible, or 
it may be too late to be useful. I was called, one 
morning, after sunrise, to a lady in Columbus : I 
went immediately, (about a quarter of a mile.) She 
said 6he wished she knew whether her time had 
really come. I told her to take some raspberry 
and cayenne tea, and she would soon know. She 
drank some twice or three times, and in seventy- five minutes after I entered the house, she was de- 
livered and cleared. It is not often, however, that 
the work is done so speedily as this; still it is pro- 
per, as was manifest in this case, that the practi- 
tioner should be present as soon as possible after 
he is sent for. The umbillicus inay be round the 
child’s neck, or cramped between the foetal body 
and the maternal pelvic bones; or there may, in 
cases of injury, be a flooding, which will demand 
immediate attention. The desire to relieve even 
the ordinary and indispensable pains of travail, as 
speedily as possible, should always be sufficient to 
prevent your unnecessary delay. 
As soon as you arrive, let the husband or some 
familiar friend, inform the lady, and then you 
should remain in an anti-chamber till she requests, 
your presence. A sudden surprise, especially if 
attended with the fear of severe treatment, will 
greatly retard the process; and, in many cases, 
cause the foetus to retract. When you enter the 
room, let your mind be calm and collected, and 
your feelings kindly sympathize with those of the 
patient. Assure her that, though rather a severe 
duty is before her; yet she has no reason to be 
alarmed, for her peculiar organs arc adapted to 
the purpose, and are no more liable to be injured 
than any other organs, in the proper performance 
of their functions. Give an ear of attention and 
countenance of interest, to all her exhibitions of 
suffering, or her fears of it. If others complain of 
her, take her part whenever truth will justify you 
in so doing. 
Hut it is neither politic nor honest, to assure 
her that you can enable her to accomplish the 
work speedily and with but little pain. For, 
though this may sometimes be the case, yet it is 
not generally so; nor was it in the days of priini- 74 
tive society, before either “ doctor or pincers 
or calomel or opium” was known. Even when 
“ the Hebrew women were lively,” and ac- 
complished the task “before the midwives came,” 
the most severe suffering that the human body 
could endure, was said to have its parallel if not 
its superior, in the “ pain of a woman in travail,” 
especially if it be “ with her first child.” The 
declaration, therefore, on every occasion, that the 
sufferings of the patient are to be short and tri- 
lling, will frequently prove false in the result, and 
the practitioner and his practice will suffer more 
from one failure of the fulfilment of such a declara- 
tion, than they would from fifty refusals to predict 
the time and degree or amount of suffering. Who- 
ever has observed even the brutes in the act of 
parturition, well knows that they exhibit more 
Buffering under these circumstances, than under 
any others in which they can be placed. I have 
seen them severely whipped without seeming to 
care much about it; while, in the pains of labor, I 
have seen them shed tears freely, and heard them 
make the most piteous moans. Some of them too, 
exhibit signs of suffering much severer than what 
are apparently endured by others. 
The proper assurances from the practitioner, 
are, that the Botanic Practice is far more efficient, 
in itself, than any other, in mitigating the suffer- 
ings of the patient, in removing the obstacles to 
delivery, in securing its safety, in hastening its 
termination, and in protecting both mother and 
child against death or serious injury. This is all 
true. And he may with safety add, that he will 
do his best to apply this practice in the most ju- 
dicious manner. 
Directions in regulating tiie Room, Bed, 
&c.—Justify and aid the lady in making almost any change in her position that she may desire, at 
least till the labor is far advanced. Neither watch 
symptoms with manifest fear and trembling, nor 
with apparent indifference to them. Endeavor to 
inspire, in the bystanders, the same degree of 
composure that you exhibit. This is best effected 
by calmly preparing every thing that may, in any 
event, be wanted. These things may seem tri- 
fling; but I assure you they are matters of no little 
importance. All is generally believed to be well, 
when an attentive physician seems unconcerned 
about danger, and acquainted with his business, 
Let them keep up a good fire in the room if the 
weather be cold, somewhere else if it be warm. 
Let them also keep plenty of boiling water; let 
them prepare a chair, or a low bed, or protect the 
one she sleeps on, by putting several folded sheets 
between the feather bed and the lower sheet. The 
best thing yet devised for this purpose, is an India 
rubber or gum elastic spread as large as an ordi- 
nary comfortable. This is a complete protection. 
Provide means to bolster her up or lay her down, 
on the back or either side; blankets to wrap up her 
feet and legs whenever they would otherwise be 
exposed to cold. Keep constantly prepared cay- 
enne, canker and nervine tea, with No. 1 steeped, 
or «‘ld preparation ; have a pair of sharp scissors 
and a small cotton or linen string in your right vest 
pocket, and avoid making any examination till the 
pains become severe and frequent, and then exam 
ine as carefully as possible. 
Attention to Position or Presentation.— 
When the pains become frequent and severe, 
examine the abdomen, and determine whether the 
head be directly over the pelvis. If it be, all will 
be well, (unless the pelvis be known to be greatly 
deformed.) If the lower extremity of the fmtui 76 
be evidently resting on the front (pubic) or side 
(illiac) bones, lay the patient on the back or the 
opposite side, raise the pelvis a little, put one 
hand where the protuberance was and press it 
against the edge of the bone and the lower part of 
the abdomen; and, with the other hand, raise her 
up in a sitting posture in the direction of the first 
hand. This process will at once give direction to 
the fuctu? in tiie pelvis ; repeated two or three 
times, the chest, in raising, will accomplish the 
object, even though the foetus were to lie directly 
across the pelvis. When this is effected, it mat- 
ters little whether the feet or the head descend 
first. A careful comparison of the records of 
“turning,” with those of unassisted nature, has 
convinced me that attempts to turn the forehead 
back, where the face presents, are more danger- 
ous than useful. 
My friend, Dr. Tibbits, of Cincinnati, was call- 
ed to “ a difficult case.” Breach presentation. 
He endeavored to bring down the feet, but found 
it impracticable without giving pain, and even the 
risk of doing injury. Not considering himself au- 
thorized to thwart the manifest resolution of na- 
ture, he contented himself witli helping her in her 
own way. lie gave her lobelia and its helpmates, 
and she soon rid herself of a heavy burden, breach 
foremost, legs and knees on the abdomen! Thus 
we see that Botanic Physicians find little difficul- 
ty in managing those difficult presentations that 
frighten others so much. The only instrument 
that is advisable for him to carry, are a catheter, a 
syringe, and a pair of sharp scissors. Even Dr. 
Blundell, of Guy’s Hospital, London, says, “ The 
very fact that an accoucher, on all occasions, puts 
the lever into his pocket when he goes to attend 
a labor, proves that he is an officious, a meddletome and therefore to my mind, so far, a bad accoucher.” 
Should an arm (or a foot without the other) pre- 
sent, place the patient as above directed, throw 
the whole fuetus back into the abdomen; then, af- 
ter lubricating the hand with slippery elm, enter 
it into the vagina, and the fingers into the os ute- 
ri so far as to prevent the hand from descending 
before the head; or, if the feet present, to bring 
down both together, the heels forw ard if possible. 
Then restore the patient to the sedentary or the 
standing posture, the hand still preventing a wrong 
presentation. These last directions are to be fol- 
lowed only when such a case occurs, which is not 
once in a thousand instances. 1 here remark, and 
I wish it never to be forgotten, that no manual 
operations, internal or external, are ever to be 
carried to such an extent, as to cause the patient 
to forget her other sufferings and attend to these. 
Symptoms during Lauor.—Most frequently, 
especially in first labors, there is, says Dr. Blun- 
dell, “a great deal of cutting, sawing and grinding 
felt while the mouth of the uterus is gradually ex- 
panding and the ovum is pushed down. Tn ordi- 
nary cases these pains, felt in the back, front and 
sides of the abdomen, below and in the upper part 
of the thighs, attack the patient at pretty regular 
intervals of from twenty to thirty minutes : occa- 
sionally, however, we meet with women in whom 
the grinding and cutting pains are permanent, the 
patient complaining, and writhing perhaps almost 
incessantly, for hours together;” and Dr. Merri- 
nian observes that “the irritable state of the os 
uteri, during the first stage of labor [that is, tho 
expulsion of the foetus,] very often produces, from 
sympathy, shiverings and vomitings ; and, when 
the cutting pains are very frequent and severe, 
despondency and lowness of spirits generally pro- 
vail.” Now, I would remark here, that the number, du- 
ration and severity of these “cutting, sawing and 
grinding pains,” depend very much on the kind 
of treatment the patient may receive. If due care 
be taken to have the system properly and suffi- 
ciently relaxed, as will be directed in the Lecture 
on “Ways and Means;” the “ cutting, grinding 
and sawing” will be reduced to comparatively a 
6mall matter, where, if the antiphlogistic and se- 
dative treatment were pursued, it might bethought 
necessary to “aid the too feeble powers of nature, 
by the skilful use of instruments!” I need scarce- 
ly say that the relaxations should be produced by 
steamings, fomentations, lobelia liniments or poul- 
tices &c.,with warm applications to the parts, of 
bricks, rocks, boiled wood or bottles of boiling wa- 
ter &c. After these pains have continued some 
minutes or hours, seemingly without much effect, 
the woman begins seriously to exercise every mus- 
cle of her body, as if to force away the offending 
cause. She seems desirous to get a fast hold of 
something that is firm, as a by-stander’s hand, or 
a handkerchief or cord, tied to the bed post, and to 
fix her feet or knees against the same support so 
that she can pull smartly when the pains are se- 
vere. 
Natural Parturition.—When the head of 
the foetus descends first into the pelvis, and the 
efforts of nature are sufficient, (at most with a lit- 
tle assistance from medicine, and attention to the 
position and movements of the patient,) to expel 
it in a reasonable time, and with no extraordina- 
ry degree of pain and suffering (some say twenty- 
four hours time after the discharge of the waters, 
and the commencement of the labor pains) the 
parturition is said to be natural. In this case, the delivery is sometimes effected immediately, as 
in women who have borne many children, whose 
pelves are large, and in whom the parts are well 
relaxed. Instances have been known in which the 
first severe pain entirely expelled the foetus. Gen- 
erally, however, the process is more gradual and 
protracted. 
Descent of the Head into tiie Pelvis.—Dur- 
ing these muscular exertions, the head generally 
descends into the pelvis. It usually starts with 
the face and crown towards the illiac bones, and 
the cars forward and backward; and, after passing 
the upper strait, the crown (very rarely the face) 
turns forward, which direction it continues till it 
is ushered into the world. As the foetus descends 
into the pelvis, the waters of the amnion push 
that membrane before the head, in the form of a 
bag which generally opens the os uteri, descends 
into the vagina and breaks of itself, before it passes 
through the os externum, discharging generally a 
thick, ropy, sometimes thin fluid, called the am- 
nion waters. When the pains are severe, the 
membranes are tense; when ofl, they are relaxed. 
It is not best to rupture them till they protrude en- 
tirely through the os externum. The discharge 
from different persons is from a gill to a pint or 
more. 
Rupture of the Membranes.—“ It is not al- 
ways a rupture of the membranous cyst containing 
the child, that takes place at this time, for we may 
have a rupture of another receptable, this [gene- 
ral] membranous receptacle being composed ot 
three thinner tunics, one lining the other, and the 
water may issue from the bag formed between the 
decidua and the chorion, that is, the two outer 
linings; a considerable discharge may be produced 
in this manner.” It were of little importance to 80 
mention the fluid, hut to prevent alarm at its ap- 
pearance. It may be repeated in cases of plurality 
of children. After the rupture of the membranes; 
the head generally descends pretty rapidly into 
the pelvis, till the face lodges in the hollow of the 
sacrum, the crown under the arch of the pubis, the 
sagittal suture on the perinceum, and the chin 
upon the chest. 
This Perineum.—It frequently becomes now 
the duty of the practitioner to guard the perinseum 
from injury, which he may do by placing his fore- 
finger upon it, with the inside of the hand next the 
child’s head, and pressing gently downwards and 
backwards, during the existence of the pain, with 
design to get it underneath the head. In this 
way there is little danger of rupture or injury to 
the perinseum, especially if proper care has been 
taken to have the parts well relaxed. The posi- 
tion of the hand that I recommend, is much better 
than that in which the inside rests on the peri- 
nrenm, for it places the accoucher in the proper po- 
sition to attend to the feetus as soon as it is pre- 
sented. 
Umbit.t.icus.—After the head is delivered, there 
is usually a pause for a few minutes for another 
pain to expel the body. During this interval, en- 
deavor to ascertain whether the umbillical cord is 
wound round the neck; and, if so, disengage it if 
you can; if not, endeavor to keep the head and na- 
vel of the child as near as possible to the os exter- 
num of the mother till it shall be disengaged. If 
you cannot slip the loop over the head, put your 
fingers between it and the throat and hold it off a 
little, to prevent it from choakingthe child till the 
feet are disengaged, when you may turn the head 
towards the mother and easily extricate it. En- 
deavor also to disengage the face of the foetus from the membranes, and to clear the mouth and 
nose as soon as possible, lest it take the mucuB, 
water or blood, into the lungs in the act of inspira- 
tion, and thus strangulation take place. When 
the child breathes and cries strongly, and the pul- 
sation in the umbillical arteries ceases, tie a small 
string or large twine round the umbillicus, about 
a half inch from the place where it ceases to be of 
the same color as the body ofthe child, that is, gen- 
erally about an inch from the body, and another an 
inch or two from this, leaving one end of this last 
string a foot or two long. Let both be tied twice 
or three times round, and drawn so closely as to 
prevent the circulation, but not so as to cut tho 
umbillicus. 
Now cut, with a pair of 6harp scissors, the um- 
billicus, between the places where it is tied. Tho 
reason why I tie the last knot is, I have teen two 
cases in which every other part of the placenta was 
detached from the uterus before its edges were, and 
consequently it formed a sack filled with blood 
which stopped the further bleeding of those arte- 
ries in the proper way. Had the end of the umbil- 
lical arteries been open, there would undoubtedly 
have been a hemorrhage through them, till the pla- 
centa was disengaged. 
Thu Child.—It is my practice to have ready a 
pan or small tub to wash tho child in. I have also 
a tea-kettle or other vessel full of boiling water 
and a pail full of cold. From these two, I put 
into the basin, pan or tub, a gallon or two, so com- 
bining them as to make the whole neither warm 
nor cold to my own flesh at the naked elbow. As 
soon as the face appears, I endeavor to clear it of 
blood, water <Scc., which might otherwise be taken 
in with the first breath and produce strangulation. 
If the child is completely discharged and has not 82 
breathed, I dash a little sprinkle of cool water di- 
rectly along the spine. This will contract tho 
muscles that connect the ribs with the lateral pro- 
cesses of the spine, and of course expand the 
chest, which is the first step in the mechanical 
process of breathing. (Lightly rubbing the spine 
also will aid the muscles in expanding the ribs.) 
A similar sprinkling may then be dashed upon 
the breast. These must be done with water 
that is pretty cool. If the sprinklings do not suc- 
ceed, immersion in the water prepared for washing, 
but made warmer, say (95 to 100 degrees) about 
as warm as will be made comfortable to your na- 
ked elbow, will do much. In aid of these means 
put a little strong cayenne tea into the mouth, or 
into the stomach from your mouth, through the 
tracheal pipe. In most cases these processes will 
be found sufficient. Further processes will be given 
presently. 
The face must now be washed with a sponge or 
cloth dipped in the water above mentioned. If 
the child cries and breathes strongly, it may be 
severed from the mother by tying and cutting the 
umbillicusas already directed. 
Let the child now be given to some female at- 
tendant to be washed and dressed. Let her wash 
it in the water above mentioned; then put a wide 
strip of linen or cotton about the body loosely, but 
in such a manner as to keep the portion oftheurn- 
billicus of the child, with a little bunch of rags 
upon it, in its proper place. Sometimes it is ad- 
visable to make a little hole in some of the ragB 
put on, to allow room for that portion to rest in. 
Now dress it loosely and warm, not covering the 
face, and lay it in the lap or in a crib. Almost 
every where, you will be annoyed with entreaties 
tp give the child some kind of physic, to carry off the meconium, or first excretions. But you should 
reason against this conduct, affectionately but firm- 
ly, unless there is satisfactory evidence that the 
child is actually sick, as choaked with plegm or 
pained with wind or something else, when your 
treatment should be the same in character that you 
prescribe to a grown person, but milder in degree. 
In case the child has not breathed, various 
means have been resorted to and recommended, to 
aid the process. It will be remembered that Dr. 
Thomson recommends the placing of the placenta 
on embers, and stripping the umbilicus towards 
the body; but it is evident that this cannot be 
done when the placenta refuses to come away im- 
mediately. I lately attended a case where the 
child breathed and cried, eat and slept, more than 
twenty hours, before the placenta was removed. 
Some stop up the nostrils and blow into the mouth, 
either with their own mouth or with the bellows. 
Dr. lllundel says the mouth is the best, but he re- 
commends the use of a silver tube which he enters 
through the larynx, and hence he calls it the tra- 
cheal pipe. There is reason in the use of this in- 
strument, for it will inflate the lungs; whereas, 
blowing with the mouth or a bellows, is almost as 
likely to inflate the stomach as the lungs, and, of 
course, it does little good. This instrument has 
the rare recommendation that it is not likely to do 
much harm if no good. It is certainly worthy of 
trial, where it is found impracticable to accom- 
plish the object in the ways I have before recom- 
mended. Stimulants to the nose, as bayberry or 
hartshorn, may also be used to advantage. 
There is no harm in persevering in the use of 
means of this sort, for you can but fail; and in- 
stances have been known of success after more 
than an hour’s apparently fruitless labor.— [Blun- 
(Jell, page 184.] The tracheal pipe is made just like a catheter of 
a large size, and India rubber would doubtless be 
preferable to silver. “I pass the fore-finger of the 
left hand,” says the Doctor, “down upon the root 
of the tongue, and into the rima-glottidis, and then, 
with the right hand slide the tube along the sur- 
face of the finger, till, reaching the rima, I insert it 
nt the moment when the finger is withdrawn from 
it, afterwards feeling on the front of the neck 
whether the instrument is lying in the trachea 
or the sesophagus. [It should be the former of 
course.] This done, you may take the child into 
your hands and inflate its lungs from your own, 
emptying them by a double pressure with your 
hands on the thorax and the abdomen, the latter 
being necessary to raise the diaphragm.” This 
should be continued, alternately inflating the 
lungs and expelling the air till 25 or 30 respira- 
tions are performed in a minute, by the power of 
the child, when the instrument may be with- 
drawn.” 
The breathing and circulation being well estab- 
lished, the child may be committed to the femalo 
attendant as before mentioned. 
It is reasonable to suppose that the child is much 
fatigued by its severe compression, during its pass- 
age into this new world; it is therefore very pro- 
per, and perhaps always advisable, after washing 
it clean (which can bo done in a few minutes) to 
wrap it up sufficiently warm, and not attempt to 
dress it till it has had an hour or so for sleep and 
repose; and this hour, as, in general in its other 
sleeping hours, should be spent in its cradle or 
crib, or on an even bed; not in the uneven and un- 
comfortable and constantly-changing lap of the 
nurse. When it wakes, it may be dressed care- 
fully as before mentioned. Second Foetus.—Generally, each foetus has its 
separate placenta; and, in such cases, where there 
are twins, the placenta of the first born comes 
away before the birth of the second. Sometimes, 
two placentas are so connected that the one cannot 
come away without the other. In this case, di- 
rect efforts to disengage the first placenta before 
the second birth, would be improper. Always 
satisfy yourselves, therefore, that there is not ano- 
ther loctus, before you make any considerable ef- 
forts to disengage the secundines, by rubbing 
the abdomen directly over the uterus with the 
hand, not so hard as to produce pain. If there bo 
no other child, that organ will immediately con- 
tract to about the size of a child’s head, and be felt as 
such just above the pubic bones. The abdomen be- 
ing now very flaccid or loose, the hand will bo able 
to grasp the globular lump. But, if there be another 
child, the uterus will still be large, and the abdo- 
men but partially reduced in size, or the muscles in 
tension. By internal examination also, may be 
discovered, through the os uteri, the watery sac, 
formed by the membranes of another child; and the 
bursting forth of those waters insures the exist* 
ence of another foetus. The same means are to be 
used for the discharge of this foetus, that were 
used for the discharge of the former. If there be 
no other child, the placenta or the lacerated mem- 
branes alone will be felt internally. 
LECTURE G. 
Pr.ACENTA.—It now becomes the duty of the ae- 
coucher, to attend to the delivery of the placenta 
and the membranes, which, with the umbillicus, aro called the secundines. Give the patient a lit- 
tle tea of cayenne, raspberry and nervine, and wait 
for the effort of the uterus to disengage the pla- 
centa. If the pains donotoccurin fifteen or twen- 
ty minutes, rub gently with the left hand, the ab- 
domen, directly over the uterus, not so hard as to 
give pain, holding the right in readiness to re- 
ceive the secundines. The gentle friction will 
cause the uterus to contract, or, in other words, 
invite the recurrence of the pains which may bo 
aided by giving more cayenne tea. If now the 
pains be severe and ineffectual, it iseither because 
the placenta strongly adheres to the uterus, or be- 
cause the os uteri or the os externum is strongly 
closed upon or against it. If the patient is able to 
be placed over the vapor bath, this will be the best 
means of relaxing the parts, stimulating the uterus 
to action, and disengaging the offending matter. 
If not, give warming medicines and apply steam- 
ing bricks or cloths wrung out of hot water to the 
parts, and keep the feet warm. Perseverance in 
this course will finally effect the object. (In case 
of flooding, which will rarely if ever occur under 
the above treatment, give strong cayenne tea, and 
an injection of strong witch hazle and a little cay- 
enne and nervine to the vagina.) Never fear to 
wait for the efforts of nature, aided only by inno- 
cent means and processes, to disengage the pla- 
centa. Many instances have occurred in which it 
has remained not only for hours but for many 
days, even fifteen or twenty, and then come away 
without either danger or inconvenience to the pa- 
tient. 
Sometimes the placenta is detached from tho 
walls of the uterus, but still enclosed within it; 
sometimes apartofit descends into the vaginaand 
the rest is enclosed firmly in the neck of the ute- rus which collapses upon it; or it descends entirely 
into the vagina and is prevented from final disen- 
gagement by the rigidity of the external parts. 
The regulars are very much frightened at these 
things, and forthwith often attempt to effect the 
delivery by manual force. Whoever will exam- 
ine the reports of cases treated in this way, will 
be persuaded that where one has been benefited 
hundreds have been ruined by officiousness. So 
many instances have occurred in the practice of 
the Dotanic brotherhood, in which nature, a little 
assisted by relaxant and stimulant treatment, has 
done the work with ease, after a powerful force 
had been long used in vain, that it would be inex- 
cusable in us to despair of a happy result of judi- 
cious treatment, and unpardonable, in any case, 
to allow the direct force of man to be used in dis- 
engaging either the placenta or the foetus. Dr. 
Dewecs has been extremely nice in pointing out 
the various ways and times in which the uterus 
contracts, in order to expel either the foetus or 
the placenta. The whole matter, however myste- 
rious he has made it, is resolved into this: The 
only reason why the uterus relaxes or contracts 
partially is, because there is not living action 
enough in the system to produce it generally. If, 
therefore, in any stage of the labor, or after deli- 
very, the parts are too rigid, make a more liberal 
use of lobelia, nervine, and the vaporbath, or warm 
and moist applications in bed. If there be, on the 
other hand, no effectual effort, or if the efforts be 
few and far between, cayenne is your agent. Use 
these remedies with nervine, with discretion and 
steady perseverance, and you may burn all that Dr. 
D. has said about unequal contractions of the ute- 
rus, and the difficulties they oppose to partpri 
lion. 88 
In a case I lately attended, the placenta refused 
to coine away immediately. The child was born 
about 4 o’clock A. M. I satisfied myself, by slight 
trials, that efforts sufficiently violent to bring away 
the placenta, would give much pain and suffering. 
It appeared very large, and was doubtless partly 
enclosed in the neck of the womb; just what Dr. 
Dewees would consider a very bad position. Al- 
though a part of the placenta was in the vagina, 
the origin of the utnbillicus could not be reached; 
and yet it appeared to till the whole pelvic cavity. 
The lady was fed and suffered to go to sleep. Ex- 
aminations were made at three different times, to 
ascertain whether any progress had been made in 
the delivery. At 9 P. M. the external parts were 
contracted nearly to their usual dimensions, and so 
rigid and sore.that it was painful to introduce a 
finger. Warm applications were made, and the 
patient suffered to sleep again as she had done the 
most of the day. About 2 next morning, 22 hours 
after the birth of the child, the lady rose, and, 
while sitting upon a vessel, the placenta was dis- 
charged without pain. The parts relaxed of their 
own accord, and then there was ample room. On 
examination, I found the placenta studded with 
hard pillars, and, on the uterine surface, many lit- 
tle bony scales which preserved the remarkable 
size of the viscus. 
Notwithstanding my advice to keep her bed as 
long as her patience would hold out, she was about 
her house five days afterwards. I am persuaded 
that, had the placenta been taken by force, serious 
injury might have been done. 
In general the expulsion of the placenta is accom- 
panied with a discharge of blood which has accu- 
mulated either in or behind it. This is no causo of alarm, but it may be well to see that the bed is 
protected against it. 
Contractions of the Uterus.—Writers on 
Obstetrics, seem very anxious about the contrac- 
tions of the uterus, both before and after the delive- 
ry ofthe placenta. They wish these contractions 
to take place partially before the delivery, be- 
cause they know that they arc the best safeguards 
against both hemorrhage and inversion. They do 
not wish them tube complete till afterwards, lest 
the placenta be confined and produce mortifica- 
tion! Hence their great anxiety and often very 
imprudent efiorts to bring away the placenta by 
force, if it should not come away of itself within 
half an hour or an hour from the delivery of the 
child. While, therefore, they enter the hand into 
the uterus for the purpose of disengaging the pla- 
centa, they use various means to produce uterine 
contractions, as rubbing gently the abdomen, 
grasping the uterus carefully with the hand, put- 
ting the child to the breasts, administering brandy 
or some other cordial &c. If they fail to produce 
the contractions, they sometimes turn the uterus 
inside out, by bringing the fundus down through 
the mouth, into the vagina, and thus they ruin the 
patient; or, if they separate the placenta from the 
walls of the uterus, before that organ contracts, 
there commences, from the expanded mouths of 
the vessels, a hemorrhage which is often rendered 
fatal by the injudicious use of ice and sugar of 
load, to expel it! 
If the strength of the patient be supported, the 
uterus will do all its work in proper time and or- 
der. Its contractions will, at the same time, break 
the connexions between it and the placenta, close 
the mouths of the vessels thus broken, and so 90 
thicken ita walls as to render inversion impossible. 
This is all that is wanted, and nothing is better 
calculated to effect it, than the administration of 
cayenne and raspberry tea, and the slight friction 
ofthe abdomen with the hand, or, at all events, the 
judicious use of the vapor bath. Contractions thus 
effected, will be uniform, general, powerful and 
permanent. 
' “ There are four very different conditions,* 
says Dr. Blundell, “in which the womb may be 
found immediately after delivery; sometimes it is 
lax, and nearly as large as the adult head; some- 
times small and soft, not bigger than the head of a 
full grown foetus; sometimes small and rounded, 
and as hard as cartilage or the head of the foetus; 
lastly, it may be very hard at one moment and very 
soft at another.” We must determine these con- 
ditions by an external examination of the abdo- 
men. The contracted, round and permanently 
hard condition is what he likes. 
Now, as this condition is the perfectly natural 
condition of the organ when not pregnant, wo 
might well suppose, what experience proves uni- 
versally true, that the best way to produce it, is to 
promote a general, healthy action through the 
system. I have seen a case of the protruding piles 
[prolapsus anni] completely reduced by a single 
steaming, after it had long resisted almost every 
other means for its contraction. This is a means 
then, which I would recommend to be used with 
much confidence, whenever the patient is tired of 
waiting to be “cleared.” 
As I have known much mischief to be done by the 
“ forcible delivery of the placenta,” as well as of 
the child; and, as our friends will receive this 
sometime before they receive the chapter on the 
dangers ofthe “scientific treatment” of women in 91 
travail, I must be permitted to make here, a few 
quotations on this head. 
Injudicious removal of the Placenta. 
“When the placenta is rudely torn away by the 
nccoucher,thc worst consequences may be expect- 
ed. Floodings, tremendous lacerations, inver- 
sions of the uterus—such are the effects of obstet- 
ric violence—ferocious and atrocious obstetric vio- 
lence; that insatiate and gory Moloch, before 
whose shrines so many thousands have been sacri- 
fised, to be succeeded in future years, by still more 
numerous victims.” 
“Observing the awful consequences resulting from 
the artificial separation ofthe placenta,Iluysch first, 
and afterwards Denman and Hunter, recommend- 
ed that, in all cases the expulsion of the placenta, 
like that ofthe foetus, should be left to the natural 
powers; for, they a’-gued, ‘the same natural pow- 
ers which are adequate to expel the child, are 
surely adequate to expel the placenta also.’ ” 
“There is no doubt that if our women, unaided 
by art, were left to their natural powers altogeth- 
er, like the females of barbarous hordes, in a great 
majority of cases the placenta would come a°way; 
but, experience is said to have shown that, in some 
such cases, fatal consequences occur. Many cases 
arc said to have occurred in which floodings took 
place. [The cause ofthe floodings is not the pre- 
sence ofthe placenta, but the neglect of restora- 
tive treatment to the patient.] Some, in which 
the placenta was long retained, could not after- 
wards be abstracted; and, when remaining unex- 
pelled lbr two or three days under the procrasti- 
nated use of means to extricate it, the greatest in- 
jury has been inflicted. [I have seen, myself, great 
injury inflicted by the use of these means, but I am very sure that, provided the strength of the woman 
be supported, a placenta may remain and rot in 
the uterus, and be discharged in the form of pu- 
trescence, without doing so much injury to that 
organ as is often done without the least necessity, 
as Dr. Dewees says, “by the rude and ill-judged 
manoeuvres of officious hands.”] So that the prac- 
tice [of waiting for the efforts of nature] brought 
to trial in Holland under the authority of Ruysch, 
and in England by the advice of Drs. Hunter and 
Denman, lias now been laid aside, probably not 
without good reason.” 
[They laid aside the wrong part of the practice, 
the “ waiting” instead of the leaving of the pow- 
ers unassisted. The true reason, is, that, in the 
cases where injury resulted, either nothing was 
done to strengthen the woman in aid of the efforts 
ofthe uterus, stimulants and food were forbidden; 
or that means were used that were calculated di- 
rectly or indirectly to destroy those efforts, as the 
exhibition of opium to quiet the nerves, sugar of 
lead and sometimes even the use of the lancet to 
prevent flooding <tec.] 
“It seems, therefore, to be pretty well agreed, 
among those that are competentto form an opinion, 
that, though we are not to be injudiciously and 
rudely tearing at the placenta, it is necessary, ne 
vertheless, that some artificial assistance should 
be given; and the greatest and nicest, perhaps the 
most important of all questions in the management 
of a natural labor, is the discrimination ofthe mo- 
ment at which the assistance ought to be inter- 
posed! Shall we interfere immediately! Shall 
we wait for an hour! or even still longef before wo 
bring the placenta away!” 
Truly, I say also, some artificial assistanco ought to 1)3 interposed, and that assistance should 
be, first, a little good stimulating tea, and then 
rest until the living energies are refreshed: Then a 
strongerdosc of cayenne,and, if necessary, steam 
and lobelia to help it; when the work will be sure 
to be quickly done and well done. As to the ques- 
tions, Shall we interfere immediately, or after an 
hour or morel that will depend altogether upon 
the condition of the patient: if she is sinking and 
needs restoratives, give them at once; if not, let 
her rest till the fatigue of her recent labors has 
subsided; then commence your aid, not abuse, and 
it will be kindly received and properly used. Min- 
utes and hours have nothing to do in the matter. 
“ By different practitioners different rules may 
be prescribed; some recommend taking the rule 
from time ; say four hours after the birth of the 
child. Others judge by the pains without regard 
to time. Pains, they say, accompany,contractions, 
which expel the placenta, therefore they seat 
themselves at the bedside, refraining for one or two 
hours from manual interference if no pains occur, 
but, as soon as the pains occur, following the track 
of nature, our best instructress, they lay hold of the 
umbillical cord, and endeavor to bring the placenta 
away. I\or is this rule to be despised.” 
The only difference 1 make in this practice is, 
that, if the pains are postponed long, I give stimu- 
lants &c., to arouse them again, and advise little 
if any pulling at the chord. “ Others are govern- 
ed solely by the situation of the placenta. If they 
feel it in the upper part of the vagina, and espe- 
cially, if they feel its union with the umbillicus, 
they do not hesitate to remove it. But, if the um- 
billicus ascend high into the uterus, and no part of 
tire placenta can be felt, they wait. Of the threo 94 
rules above enumerated, I think, on the whole, tho 
the last is to be preferred. In ordinary cases, you 
cannot err in abstracting the placenta when lying 
in a great measure out of the uturus, while there 
is always a risk in removing it when it lies in the 
fundus of the uterus, and not only a risk, but a dif- 
ficulty. There are yet others who determine the 
propriety of interference, by the feel and condition 
of the uterus. If it present a permanently indu- 
rated and globose mass, they consider that a tho- 
rough contraction has taken place, and that the 
placenta may bo safely removed. Not to dwell 
on single indications, I would recommend a prac- 
tice forming itself under the influence of all these 
considerations, a rule of composite order. 
“ Before you think of removing the placenta, it 
is your duty to ascertain whether another child be 
lodging in the uterus; for, as a general practice, it 
is improper to remove the sccundincs of former chil- 
dren, until those remaining in the uterus have been 
expelled. Rupture of the funis, suffocation of the 
unborn foetus, in consequence of the premature ab- 
straction of the placenta, perhaps common to both, 
not to mention those floodings which wc shall 
hereafter contemplate, must in some cases ensue, 
where this caution is unwisely neglected; and you 
ought, therefore, to investigate this point with the 
nicest care, before you attempt to remove the pla- 
centa. Again, by all means, unless there be hem- 
orrhage more than ordinary, wait for half an hour 
before you operate, for, at the end of this time, you 
will generally find that the womb has reposed it- 
self, that its fibres are contracted, and that the 
placenta may be taken away. Examine further, 
with nicety, the condition of the uterus; if con- 
tracted, globose and indurated, you may extract the sccundines with more confidence; but, no flood- 
ing forbidding, you had better delay the delivery 
even beyond the hour, when the womb, whether 
contracted or capacious, is found to be soft and 
pulpy. " 
“Lastly, if you find the placenta lying so low 
that you may lay hold of its body, the half hour 
being’ expired, you may remove it with prompti- 
tude; but perhaps you had better delay the remo- 
val, even though the glass be run out, provided the 
placenta be still lying beyond the touch of tho 
finger. 
“Here then are the four cautionary points which 
I wish you to remember. Before you abstract the 
placenta, ascertain always that there is no other 
child in the uterus. Satisfy yourself that the womb 
is permanently contracted. Wait half an hour af- 
ter the birth of the foetus, no particular symptom 
forbidding; and remember that it is always desira- 
ble that you may feel [with your finger] the inser- 
tion of the funis or the body of the placenta, before 
this viscus is taken away.” 
The above, condensed from Dr. Blundell, is, I 
think, on the whole, the most judicious advice on 
the subject of the indications for removing the pla- 
centa, that are to be found among the writings of 
the regular faculty. To what docs it all amount, 
but simply this: When the energies of the uterus 
have so far recovered from the fatigue of their ex- 
ertions to expel tho child, as to becomesensible to 
the irritation of the still offending placenta, their 
first effort is to disengage it from the walls of tho 
uterus, and their second, to expel it. When it is 
discharged entirely into the vagina, the uterus 
contracts to a comfortable condition, and its pains 
cease. Waiting now for a pain to remove thepla- eenta, is useless. Labor pains are not felt in the 
vagina. If, therefore, the external orifice be con- 
tracted, and the part rigid, the placenta may re- 
main here for a longtime, without the least effort 
of the system to disengage it; but, if the patient 
stand upright, or sit in a convenient posture over 
the vapor bath, the parts will bo warmed and re- 
laxed, and the weight of the viscu3 alone will be 
sufficient for its expulsion.—Try it. 
Such have been the mischiefs produced by inver- 
sions consequent on forcible delivery, while the 
uterus is relaxed, its mouth open, and the placenta 
attached to its fundus, that most women aro 
afraid to stand on their feet directly after child- 
birth, lest the uterus “ fall through the vagina!” 
They may rest assured that, where no mechanical 
force has been used in the delivery of the child, 
and where the powers of the system are properly 
sustained by suitable food and nature’s restorative 
medicines, this justly dreaded condition of things 
can nevertake place. Dr. lllundcll very correctly 
argues that, when the uterus is properly contract- 
ed, inversion is perhaps impossible. A proper 
treatment of the patient, to the exclusion of alliwt- 
proper treatment, secures, with certainty, the pro- 
per contractions of the Uterus; and thus renders it 
perfectly safe for the patient to stand up, if she is 
able; and few will be the instances in which, if she 
is properly treated and has no debilitating dis- 
ease upon her, she will not be able. I will now 
again give a few directions which may be safely 
and successfully followed in all cases where there 
is not known to be a deformity of tho pelvis so 
great as to render parturition impossible. After the birth of the child, give a little strong 
tea of raspberry, witch liazlc and nervine, strain- 
ed, and cayenne added in quantity suited to the 
condition of the patient. Give also a little nour- 
ishing food if she have not eaten within six hours. 
Now endeavor, if it can be done without force, 
to remove the placenta. Rub the abdomen over 
the uterus, (not so hard as to give pain,) put the 
child to the breast, and, if the parts are rigid and 
the placenta refuses to come away without a force 
that gives pain, inject lobelia and slippery elm 
into the vagina. If the uterus is contracted into 
a small hard lump lying just above the pelvis, and 
the insertion of the umbillicus can be felt by the 
finger, hook the finger into the edge of the pla- 
centa and bring it away. If it refuses to come 
by the use of these means, then sit by her side, 
and require all in the room to be perfectly still, 
the windows being darkened by shutters or blan- 
kets or some such articles. Cover her warm, es- 
pecially her feet and lower limbs, put a steaming 
stone or brick, or a poultice of slippery elm &c., 
which is better, near the genitals, and let her 
sleep i/shc will, and as long' as she will, provided 
her pulse be good. (If this sink too low, which 
will 6eldotn occur, wake her and give her medi- 
cine.) When she wakes, if the placenta be in the 
uterus, there will be pains resembling those of 
labor; if, in the vagina, there will be none of any 
importance. In either case, letherrise, and walk 
or sit. Or theYneans may be used before she rises, 
to produce the contractions of the uterus, and, of 
course, the descent of the placenta at least into the 
vagina. 
If the placenta be entirely discharged, well; if not, 
apply the vapor bath, and your object will soon 
be accomplished. If the placenta be not disen- 98 
gaged from the uterus, there will be so much pain 
as to prevent sleeping; and, of course, she hadjaet- 
ter rise as soon as she feels sufficiently rested for 
that purpose, and the means above directed must 
be used. I object to pulling much at the umbilli- 
cus, because, being inserted generally in the mid- 
dle of a thick cake, it directs the discharge in such 
a way as to present the greatest possible resist- 
ance. If instead of this, you hook your finger into 
the membranes, you will present the edge of the 
placenta, and thus really facilitate the discharge. 
In several instances, being satisfied thatthe placen- 
ta was entirely in the vagina, I pulled upon the 
cord till I felt some of its fibres give way. I de- 
sisted and watched the operations of nature. She 
gradually turned the insertion of the umbillicus to- 
wards one side and out of my reach, so as to pre- 
sent one edge of the placena, when the whole was 
immediately discharged without effort or pain. 
A word to the wise is sufficient. 
As to the danger of leaving the placenta to be 
discharged by decomposition and piecemeal, it is 
all a bugbear. While it maintains its hold on the 
uterus, it retains its vitality; and, of course, will no 
more mortify that organ than the vagina or the fal- 
lopian tubes will. As soon as it or any part of it 
loses its vitality, the uterus contracts beside that 
part, and casts it off. It now becomes a foreign 
body in the uterus, and as such, the neck and the 
os uteri relax and let it pass, as they do the men- 
strual fluid or the full grown foetus. All that is 
wanted is to maintain a healthy action throughout 
the general system, and to aid it by steam, lobelia 
and other relaxants, whenever it manifests a rea- 
diness to discharge the offending matter. For 
proof of the truth of these doctrines, I need only 
refer to the facts that many women have carried children far, even a year beyond the time, and 
those children have mortified and come away, 
some of them even through the walls of the abdo- 
men, without materially injuring, much less mor- 
tifying the mother. 
They that fear inflammation and mortification, 
will do well to refuse all aid from steel, (except in 
cases of malformed pelves, which will hereafter be 
pointed out,) and even from “the rude and ill- 
judged manoeuvres’’of the least “officious hands.” 
Floodings.—I have given no directions for re- 
moving the placenta immediately and by force, in 
consequence of floodings; for, if the directions I 
have given for the management of delivery, be 
strictly followed, floodings will rarely if ever take 
place; and, when they ds, will be arrested in a 
\ cry different manner. 13ut, as our friends will of- 
ten be called to arrest floodings that have been 
commenced by the bad management of others, I 
will here state that the plan to arrest them is, 
first, to give very hot medicine; second, apply 
warmth to the extremities ofthc surface generally, 
by steam if convenient, if not, by bricks &c.; 
thirdly, if the child is delivered, give strong injec- 
tions of witch hazle tea, nervine and a little cay- 
enne, to the vagina. Should the foetus not be dis- 
charged, this plan would not be improper in se- 
vere flooding. Ifthe time be come, it will produce 
a separation of the placenta from the womb, and of 
course parturition ; if not, it will close the mouths 
of the blood-vessels that have been laid open, and 
stop the hemorrhage, leaving the fruit to ripen 
still longer before it falls. Remember, to re- 
store equilibrium to the circulation, that is, tore- 
lax and expand the constricted blood-vessels and 
close, with astringents, the open mouths of others, 
is to check hemorrhage wherever it takes place. 100 
I have said that the patient might rite, and 
stand or walk, for the purpose of disengaging the 
placenta when you are sure that it has descended 
into the vagina. Some may be frightened at this 
direction, but I can assure them this is the way 
ladies have generally done it in such cases, under 
my management. “ When the uterus has been 
properly contracted,” says Dr. Blundell, “prolap- 
sus is scarcely possible.” If, however, from pre- 
vious disease, much fatigue at the time, a still re- 
laxed state of the uterus, or any other cause, she 
should not wish to rise, she may be lifted into a 
chair, or raised up in the bed, or relieved by warm 
injections of slippery elm and lobelia, where she 
lies, care being taken as before mentioned to pro- 
tect the bed. Any disposition to flooding must bo 
checked by takinghot medicines and by witch liazle 
injections to the vagina; and slight friction over the 
region, will cause the uterus to contract and close 
the mouths of its vessels so as to prevent hemorrh- 
age. But I insist upon -it that no artificial force 
be used, nor officious handling be allowed to dis- 
engage the placenta, that will give pain or distress 
to the patient. 
Dr. Blundell, speaking, page 172, of the appear- 
ance of a placenta which had been taken away by 
force, says, “Do not needlessly pass the hand into 
the uterus, the vagina, [or even] the genital fis- 
sure; is the voice of this preparation;—lie that hath 
ears to hear let him hear it. Ah! that violence of 
an ignorant and savage hand! After examining 
these preparations, tell me, is it too much to as*- 
sert that, in obstetrics, a thrust of the hand is more 
dreadful than a thrust of the bayonet! Could the 
field of Waterloo exhibit injuries more dreadful 
than these!” 
Let it alone till it come away of itself. A case 101 
ib reported in the ISdinburg Practice where one 
remained fifteen days, another in the Boston Med- 
ical and Surgical Journal where the placenta re- 
mained twenty-four days. They both came away 
without the least pain to the patient. I saw one 
remain six hours, another twenty-one or twenty- 
two, and then both came away themselves; but 
they generally come away in a half hour or so. 
Soon after the placenta &c. arc discharged, she 
should be put to bed as it is called, that is, washed 
where necessary, with warm water, by means of a 
sponge or cloth, her wet clothes removed and warm 
and dry ones put on her; the broad bandage may 
be put round her, and she be put either into ano- 
ther bed or a dry and comfortable part of the same. 
She should also be provided with a soft spongy 
linen or cotton cloth of many thicknesses to absorb 
whatever may be discharged, and this should be 
removed ns often as necessary. The external 
parts should be mollified with sweet oil, and a 
steaming brick or stone placed near them to pre- 
vent swelling, inflammation and soreness. This 
warmth should be kept up for several hours, say 
6ix to eighteen, or till the soreness is entirely 
gone. The cloths will of course be continued as 
long as there is occasion for them. 
She should now be fed again, and permitted to 
rest and sleep as long as she appears comfortable. 
The food should be light and nourishing and given 
in reasonable quantity. A bowl of brwad or mush 
and milk, of chicken soup &c., almost any thing 
■he ivants may make her meal. Fear not that 
humbug of the M. Ds called puerperal fever. If it 
comes, it comes as a friend to tell you of a cause 
which you must at once remove, by a course of 
medicine. 
If the application of the child produces the ae- 102 
cretion of milk, well: if not, a lobelia and slippery 
elm poultice will keep the breasts from hardening 
and inflaming, and relax the orifices and let the 
milk escape. It will be sure to prevent sore 
breasts—mark that. 
Keeping the patient warm, especially the feet and 
the pelvic region, will secure her against after- 
pains, puerperal fever &c., in all ordinary cases. 
When these means do not accomplish this object, 
remember the course of medicine. Attend to her 
for six to ten days, removing at once every difficul- 
ty, and she will, in all ordinary cases, be about 
her business. 
On page 81, I have given directions concern- 
ing the treatment of the child. I here add that 
you should be careful tcfget oft' the greasy and yet 
wax-like substance that adheres to its whole body. 
Strong soapsuds will doit; but, Dr. Dewees says, 
that the process is rendered easier by first rubbing, 
for some time, hog’s lard upon it, then using 
the soap and water, by means of a piece of flannel 
or other cloth. This should be done in a warm 
room by the fire. No spirits of any kind should be 
used. They evaporate quickly, and of course leave 
the surface cold. Butfor their stimulating proper- 
ties, instead of preventing a person from taking cold, 
as is generally supposed, few things are so well 
calculated to make one take cold. Vinegar is 
equally stimulating, without either the poison, or 
the evaporating and cooling property of the alco- 
hol; but neither is wanted in this case, unless it be 
to revive the apparently sinking child, when vine- 
gar and cayenne should be used, and a little vola- 
tile salts or camphor put to the nose. 
In dressing the child, Dr. Dewees says, “ Pass 
the remaining portion of the chord [left on the 
child] through a hole in the centre of a piece of 103 
linen rag, seven or eight inches in length and 
about two and a half broad, envelope it in a band- 
age about ten inches long,” and wide enough to 
cover it all; “ turn it up towards the breast, and 
over it the lower end of the first mentioned piece 
of rag, and secure the whole with the bandage.” 
Then dress as before mentioned, page 81. Exam- 
ine often, and take care that the dead matter be 
removed as soon as it is disengaged. If the child 
is well washed in the groins, under the arms, be- 
hind the ears &c., and a little sweet oil, or fresh 
butter melted and boiled till the water is all out, 
be rubbed on those places, it will prevent all chafes 
and soreness. Let it be repeated often, first wash- 
ing with soap suds, then greasing. 
The first discharge from the bowels of infants, 
is called meconium. It is a too general impression 
that physic ought to be immediately given to ef- 
fect it, and not a few children are much injured, 
and many are actually destroyed by treatment in 
accordance with this impression. If the mother 
afford the infant milk within a few, say two or 
three hours after its birth, that milk is best adapt- 
ed to the accomplishment of the object. But, 
whether she docs or does not, it is not necessary 
nor proper to give medicine to remove it, till the 
child gives some evidence of suffering for the want 
of such motjons. When the mother does not af- 
ford milk immediately, other food is provided for 
the child, as milk sweetened with loaf sugar &c., 
the Iasi of which is rather constricting to the bow- 
els. To prevent this, the milk should be sweeten- 
ed with molasses, the quantity of which should be 
increased till it produces the desired effect. Some 
use salt and water, some rhubarb and some aloes, 
for this purpose. I object entirely to this prac- 
tice. If the discharges do not take place after a rea- 104 
eonable time, they may be effected by an injection 
of slippery elm tea, or sweet oil, with a few grains 
of cayenne. True, Dr. Dewecs says that “the 
practice of purging off the meconium should, never 
be neglected.” Yet in the same paragraph (590) 
he refers to two cases, one observed by himself, in 
which the meconium was freely passed for many 
days, though there was no passage from the mouth 
to the stomach!—Wonder how the meconium got 
away without physic!—The Doctor, however, 
“protests against the use of any acrid purgative 
for this purpose.” The worst that he recommends 
is a tea-spoonful of castor oil. Hut he adds, (sec. 
600,) “Ottentimesmuch mischief arises from over- 
purging newly-born infants,” &c., and here I am 
happy to agree with him. 
It is also necessary to attend to the discharge of 
urine. If this be suppressed or too scanty, the 
bladder will swell, and the child will suffer. A 
little strong tea of clivers, sweetened with molas- 
Bes, and keeping the parts warm, prevents costive- 
ness and the suppression of urine. If the urine bo 
much accumulated before it is discovered, a lobe- 
lia poultice and a steaming brick to the geni- 
tals, will relax the strictures and allow it to pass; 
and keeping the parts warm and moist will pre- 
vent a recurrence. 
Doubtless the best food for the child, when the 
mother does not supply it, is milk, warm from the 
cow, when it can be had so, and a little warmed 
when not; and here again, as it is a little more as- 
tringent and not so sweet as that from the human 
breast, it is proper to add a very little molasses or 
brown sugar, to prevent it from producing costive- 
ness. Give a very small portion atatime, three to 
five or six tea-spoonsful at first, and repeated in an 
hour or two, but not so often or abundantly as to 105 
iwakc it “run over.” Nurses are apt to feed them 
a great deal too much, and to give them bread, 
crackers, or other articles besides the milk, which 
are very improper. But the child should be put 
to the breast often, and, when the milk flows free- 
ly, no other food should he given. Let the child be 
put into a cradle or crib, and if it cries do not take 
it up and stuff it with food and shake it about, but 
examine carefully whether some of its pins or 
bandages are not giving it pain, and if not, and you 
are sure that it cannot be hungry, (it should never 
be surfeited,) let it be. A piece of gauze should 
be spread over the top of the cradle or crib, not its 
face, to keep the flies from annoying it. 
LECTURE 7. 
I am here compelled to refer again to the prin- 
ciples (see Introduction) by which we are guided 
in the management of women and children, before 
I can so well point out the proper ways and means 
of applying those principles to every given case. 
We base all our medical practice, 
1st. On the self-evident proposition that, as the 
female frame is wisely adapted to the performance 
of all the duties which will ever be incumbent on it 
in the course of nature, 60, in all our medications&c. 
we are to aid when present, and imitate when want- 
ing, these several operations, and to depart from 
these principles only so often and in such cases as 
we find that, from some casual obstruction of the 
proper growth, there was a manifest departure 
rotn the course of these general laws in the origi- 
PRINCIPLES—WAYS AND MEANS. 106 
nal structure of that frame; and then our opera- 
tions must be precisely those that are calculated, 
as far as possible, to remedy the defects of such a 
structure. For example, In all cases of well form- 
ed pelves, we believe that a female may be, and 
ought to be safely delivered of her offspring, with- 
out any other aid than that of keeping her system 
free from obstructions and of strengthening her for 
the performance of her duty; that artificial inter- 
meddling here, farther than to change her position 
so as to give a proper direction to the foetus, is in 
all cases reprehensible: Hut that, when the pelvis 
is so dwarfish or distorted as to present insuperable 
obstacles to delivery, then embryotomy or the Ce- 
sarean operation may be justifiable. 
2. That, all vital action is friendly to health, 
and not to be opposed; but, that any irregularities 
in this action, are indications of the presence of 
obstructions or causes of disease (in ditTerent de- 
grees) which must be removed. 
3d. That all disease is caused by obstructions 
of some kind to the full, free and universal opera- 
tions of the living principle, and is itself, in es- 
sence, the incapacity or inability or debility of 
some organ or organs to perform its or their duty. 
4th. That these causes of disease must be re- 
moved by supplying the living machine with those 
substances’or medicaments, and aiding it by those 
processes which it is pleased to make use of in the 
accomplishment of its object. 
5th. That the intention of the system in every 
effort to remove disease, is to let out the obstruc- 
tions, generally, first, by relaxing itself, and, se- 
condly, by stimulating the vessels to an unusual 
degree of action, and, thirdly, by restoring the or- 
gans to their original tone, texture, equality of 
actions, or connexions where they have been sep- 
arated. 6th. The obstructions to vitality are, 1st, sub- 
stances arrested in the capillaries, tilling them up; 
2nd, contractions of those vessels by irritation; 
3d, substances relaxing them by opposing the ac- 
tion of motive nerves; or else, 4th, they are me- 
chanical or chemical lesions of the organs; as 
wounds, bruises, ulcers &c. 
In the 1st, 2nd &. 3d cases, which may be exempli- 
fied by the condition of the skin in fever, after tak- 
ing a sudden cold, or the state of the stomach when 
cramped, or of the bowels in constipation, or when 
the capillaries are filled through the whole sys- 
tem, as is often the case in jaundice and bilious 
fever, the means of removing them evidently are, 
First, Relax the parts obstructed. It is 
well known that a comfortable degree of warmth 
and moisture are the most natural, direct and con- 
venient means of relaxing all animaLbodies. Hence, 
when the stomach, bowels, skin, or any other 
tart of the system, is unduly contracted, cramp- 
ed or collapsed, the application of mere warm wa- 
ter will afford some relief. If that water be in a 
6tate of vapor, it will do still better; hence the va- 
por batli and steaming stones or bricks arc better 
than baths of warm water, dec. If materials that 
possess the power to relax the system, by merely 
quieting the irritation of the organs, without in the 
least injuring their power to re-act, (such as lobe- 
lia, nervine, boneset, &c. &c.,) be added to the 
warmth and moisture, the effect is still greater. 
Lobelia.—The true therapeutic action of lobe- 
lia, I think is not generally understood. Most per- 
sons are under the impression that it is the prin- 
cipal agent in producing the action \Vhicli we call 
vomiting. Rut this must certainly be incorrect. 
All practitioners, regular and irregular, who hab- 
itually use it, agree that its effect iB antispasmo- 108 
die, as it instantly relieves spasms, fits, lock-jaw 
cramp &c., and relaxes contracted sinews. 13ut 
it is also agreed that vomiting is produced by mus- 
cular contraction either of the chest, abdomen or 
stomach, or all combined. If this were the effect 
of the irritation produced by lobelia, that article 
would not be, as it certainly is, a sovereign reme- 
dy for spasm. But one will say, “How do you 
know that lobelia does not, like cayenne, produce 
alternate relaxation and contraction, perhaps by 
different properties contained in it, that act at dif- 
ferent points of time!” I answer, I know it by the 
fact that the more vitality in the system, the less 
the relaxation and the more speedy and effectual 
the vomiting after taking lobelia; and that, on the 
other hand, the less vitality in the system, the 
greater is the relaxation and the feebler the reac- 
tion; and further, when there is little vitality, as 
when the patient is dying, there is no reaction at 
all. In what are called “the alarming symptoms,” 
there is so little vitality, that the relaxing powrcr 
of lobelia completely overcomes the reacting pow- 
er, and the only reason why death does not take 
place, is, because lobelia does not injure the or- 
gans, by destroying the feeling or stopping the cir- 
culation; but only overcomes, in a greater or less 
degree, during the period of its own influence, the 
disposition to reaction. The nearer the reacting 
power of the system, is to an equality with the re- 
laxing power ofthe lobelia, the greater will be tho 
struggle and alarm. As the effort of the system 
is now to recover its tone, giving cayenne will 
aid it in producing the reaction that constitutes 
the vomiting, which, if free, always relieves the 
patient. Giving more lobelia throws the scalo 
the other way, and makes him quiet a while long- 
er, Letting him entirely alone, the lobelia, after 109 
some time, loses its power to act, and then the re- 
active energy of the system meets with no resist- 
ance, and recovers the condition of its organs as a 
matte; of course. When there is no disease, that 
is, debility of the organs, the lobelia lias not pow- 
er to relax the system much, and hence there is no 
room for any remarkable degree of reaction, and 
of course there is little or no vomiting. “ But,” 
says one, “are you sure that lobelia possesses no 
other control over the living body than simply to 
relax its several organs!” I answer, not quite 
sure; but am perfectly convinced that, if it have 
fifty other influences, this one of relaxation so far 
predominates over them all, as to throw them en- 
tirely into the shade. “But, is not lobelia a su- 
dorific!” Yes; but its mode of producing this ef- 
fect is by relaxing’ through nervous action, the 
contracted mouths of the emunctories or pores of 
the skin, and letting off the portion of the blood 
called perspiration. It also promotes the secre- 
tion ofbile and urine, by relaxing the vessels whose 
unnatural constriction is the cause of the reten- 
tion of these fluids. 
The object in giving here these facts, arguments 
and illustrations of the modus operandi of lobelia, 
which are more extensively considered in my 
“Lectures on Materia Medica,” is to establish the 
point that lobelia is to be considered, at all 
TIMES, AND UNDER ALL CIRCUMSTANCES, AND WHER- 
EVER APPLIED, NOT ONLY A PURE RELAXANT, BUT 
THE MOST POWERFUL AND INNOCENT YET KNOWN. 
1 wisli this point to be well settled, for, if it be 
proved true, it at once puts to flight, from ob- 
stetrics, the use of instruments, and even manual 
force, in every case except perhaps the very few 
patients whose pelves are known to be remarka- 
bly deformed, by rickets or some other unfortu- 
nate circumstance. (Sec further, page 115.) 110 
I must not leave this article without repeating 
the remark that, though giving more lobelia dur- 
ing the alarm produced by a course, will check the 
struggle of the system for a while, yet it rather 
prolongs the duration of the condition. Sweet 
milk or sweet oil will, by combining with it, 
check the action of what is already taken, and a 
dose of cayenne will aid the vital energies in pro- 
ducing the reaction or vomit which puts a period 
to the whole transaction. I must also remark 
that, when lobelia cannot be had, other articles 
that are known to act like it, must be used in its 
stead. Thoroughwort is an excellent article, but 
it is not, like lobelia, a pure relaxant. The the- 
rapeutic principle of a true emetic, must be, speed 
in relaxation, great volatility, and incapacity to 
injure the vitality of the organs on which it ope- 
rates. Such is that of Lobelia. It is like the 
power that pulls a bow-string: it strains the bow 
quickly, and as suddenly lets it go; thus allowing 
it to recover its condition without injury to its 
elasticity. Did it act slowly, the tone of the sys- 
tem would gradually give way to it, and suffer the 
encroachment to proceed without an effort at re- 
action. Did it not cease to act suddenly, the re- 
action of the system also would be gradual, and 
would produce no vomit. Did it continue its pow- 
er over the organs a great length of time, they, 
like the long bent bow, would lose their elastici- 
ty altogether. Such are poisonous relaxants. They 
either break the bow at once by over-straining, or 
they relax it so gradually as to excite little or no 
resistance, (as tyrants fasten their chains on their 
subjects,) or else they retain their possession till 
all the reacting power is destroyed. 
The emetic effect of antimony, copper and zinc, 
is the resistance the system makes to their intro- 111 
duction into it, as its greatest enemies to healthy 
action. They threaten “suddenly and rapidly to 
extinguish the vitality of the system,” in exact 
proportion to the quantity given. (See Boston 
Medical and Surgical Journal, vol. ix, page 43.) 
The administration of lobelia &c. in warm teas, 
either internally or externally, (in the last case it 
may be combined with poultices, slippery elm, 
oils, <Ac,) is the best means yet known to relax 
constricted or obstructed vital organs, and the 
more directly we can apply these means to the 
parts affected, the more speedily and effectually 
Bhall we accomplish our object, it will depend 
upon the circumstances of the case, how long we 
wish to continue this relaxation. The means must 
of course be used as long as we wish the effect to 
continue; as, in fever, steam should be continued 
till perspiration is free; and in cases ofparturition, 
u lobelia liniment should be used, and fomenta- 
tions or other applications of warmth and mois- 
ture, should be kept about the parts to be relaxed, 
till the end is accomplished. In cases oflocal in- 
flammation, tumors, ulcers Acc., these relaxant 
properties should be combined in poultices, which 
should bo continued till the end is accomplished. 
By the administration of articles which soothe the 
action of the nerves, the constricted vessels are 
enlarged and the fluids combine with, attenuate 
and dissolve the morbific materials that obstruct 
the passages, and now 
The next step is to stimulate these ves- 
sels to a healthy action.—For this purpose 
the acrid principle of cayenne, in combination with 
a suitable portion of heat, is the best means yet 
known. Any other stimulant that is permanent 
and innocuous, that is, that will excite the organs 
to action without losing their power too suddenly, 112 
or depriving those organs of the power to react as 
well as before, may* be combined with the cay- 
enne, or used instead of it when it cannot he had. 
The specific action of cayenne is evidently in per- 
fect harmony with the operations of the living 
power, that is, when the action is too low, cay- 
enne will raise it; when congested, it will extend 
its influence through both the nerves and the cir- 
culation, till that action is equalized. Therefore, 
whether cayenne find the system or any organ of 
it, too much relaxed or contracted, its power to 
excite the living principle, and, of course, organic 
action, is adapted to bring the living organ from 
either extreme to a healthy state. The stimulus 
of cayenne then, in a morbid condition of the body 
or any part of it, aided by the mechanical struc- 
ture of valves, is calculated to push all the circu- 
lating materials forward through their destined 
course. If applied to a relaxed stomach that is 
full of fluids, it produces vomiting; if to the bowels, 
in the same condition, dejections; if to the skin, 
when the system is full of fluids, perspiration; and, 
lastly, (which comes more particularly under our 
present consideration) if given to the stomach, 
(between which and the uterus there is an intinjato 
nervous connexion,) at the time when that organ 
is disposed, but unable, through weakness, to ex- 
pel its burden, and also, if rubbed lightly on the 
abdomen, it will wonderfully aid in facilitating 
parturition. There is, on this very account, no 
one article in the materia medica, so universally 
applicable in all cases of disease, as cayenne. I 
can conceive of but two states of the living body, 
in which its internal use is injudicious; one is when 
the skin alone is obstructed and a consequent fe- 
ver pervades the whole internal man (rather a 
rare case, when it occurs, to be cured by a plenty 113 
of bland fluids and steam,) and the other is, when 
the patient is, in all respects, in perfect health. 
Cayenne is not injurious like brandy and other poi- 
son stimulants, because, first, it does not suddenly 
raise the action to an excessive degree, and then let 
it as suddenly sink under consequent exhaustion. 
It continues the irritation for a great length of 
time, which so recruits the debilitated organs as to 
enable them to retain their power and sensibility 
alter the cause which arouses them to action, is 
discharged from the system. 2nd. It never de- 
stroys, as do opium, nitre, digitalis, mercury, 
<fcc., the power, capability or fitness of the organs 
for vital action, but rather renders them more sus- 
ceptible to that action. It is uniformly, univer- 
sally true, that the more opium, nitre, or mercury 
you give to a patient, the less vitality there will be 
in his physical organs; till paralysis, apoplexy or 
anasarca &c., close the scene : and it is equally 
true, that the longer you give a patient cayenne, 
the better effect it has upon him, and the less he 
needs, till he gets entirely well and wants it no 
longer. If cayeqne be introduced rapidly into the 
system, it will produce momentary pain, by relax- 
ing the stomach before other parts relax; but, if 
gradually introduced and the outlets of the sys- 
tem be kept free, little inconvenience can be pro- 
duced by giving it even in very large quantities. 
But for its extremely pungent and, to some, espe- 
cially inhints, very disagreeable taste, and also the 
impossibility of always getting enough of it in its 
purity, we might safely rest satisfied with it in all 
cases where a natural stimulant is required. Va- 
rious other articles, however, as ginger, xanthox- 
ylum, snakeroot itc., may be used as substitutes 
when pure cayenne cannot be had or when its taste 
is peculiarly disagreeable. 114 
Cayenne, then, should enter into the composi- 
tion of all those articles which are intended to ex- 
cite the system or any organ ofit, to a natural ac- 
tion. tlWhy then,” says an objector, “if cayenne 
always stimulates the system in the same way, 
do you prescribe it both to prevent abortion and 
to promote parturition'?” 1 answer again, cay- 
enne always stimulates the living organs to act 
in harmony with the living intention. Now 
it happens that abortion is threatened by acci- 
dental contractions of the uterus (by cold, fright 
&c., or by a partial disengagement of the placen- 
ta occasioned by excessive labor, walking, fa- 
tigue &c.,) during a period when the natural dis- 
position ot that organ is to expand to accommo- 
date the growing foetus; whereas, in parturition, 
that expansion, having been carried to the utmost 
extent of the natural law, the disposition of the 
organ now is to contract and expel the full grown 
foetus. If then, cayenne aids the intentions of na- 
ture, it must of necessity, both prevent abortion, 
by removing the cold or obstructing fluids and al- 
laying the irritation caused by fr;ght &c., and pro- 
mote parturition by enabling the uterus to detach 
itself from the placenta, and expel from its cavity, 
that which, like ripe fruit, has no longer any need 
of nourishment from the. parent rstock. Can we 
place too high a value on a medicine which almost 
supersedes the necessity of the administrator’s 
knowing much more of the condition of the patient 
than simply that she is sick? 
Some suppose that lobelia is the most important 
article in the materia medica. In this opinion I 
cannot agree: for, though I admit that there are 
some cases that cannot be'cured with cayenne 
without lobelia, yet I am sure there are more that 
cannot be cured with lobelia without cayenne, or 
something that will serve as a substitute. 115 
Indeed it may be said, that, while cayenne is 
proper in every form of disease (except the one 
just named,) it may as truly be said that lobelia is 
proper in only one form of disease, and that is, 
where relaxation is necessary. (See remarks on 
lobelia, page 107.) We would not give lobelia to 
contract a muscle after we had relaxed it to set a 
bone, to restore the tension of the viscera after we 
had reduced a hernia or a prolapse; nor would we 
give it to a patient to restore the strength after a 
course of medicine had removed the cause of his 
weakness. Hut cayenne is not only invaluable 
in all these cases; it is even so in aiding lobelia in 
all its own appropriate spheres, as in removing a 
fit and reducing a lock-jaw, &c. 6cc. 
“For all its various virtues to relate, 
Would tireev’n Fabius with eternal prate.’’ 
“ IIow then,” says the objector, “ does lobelia 
always harmonize with the living intention, if its 
sole power is exerted in relaxation? Surely we 
do not always wish to bo relaxed?” I answer: 
Lobelia is a medicine. We do not recommend it 
as a food. As a medicine it always acts according 
to a certain intention, viz. to rei.ax. When a 
patient is sick, there is always some morbific mate- 
rial (as canker) or contracting influence (want of 
heat) in the system which it is the intention of the 
living power, the vital energies, (vis vitae,) to 
remove. Hut this morbific matter or the cold fluids 
cannot be removed till the vessels in which they 
are lodged be relaxed. Therefore lobelia acts in 
harmony with the intentions of the living power, 
aiding her in the fiijst step to remove disease. 
Were lobelia able to entirely overcome the liv- 
ing power as opium dues, or to destroy their ca- 
pacity for action by continuing its deadly graep upon them as mercury does, it would be a poison, 
like them; but it only relaxes the organs, that is, 
takes off their tension till they rest awhile, to 
recommence their operations in a short time, with 
redoubled energies. Glorious medicine! It acts 
in perfect harmony with the living intentions. But 
he must be a sad blunderer in therapeutics, who 
gives it for any purpose except to relax the vital or- 
gan or organs to which he applies it. 
Canker Medicines.—In addition to cayenne, 
we have several articles that are calculated “ to 
scour the stomach and bowels, and to remove the 
thrush” or canker from the system. From what 
I have said of the relaxing power of Lobelia, the 
stimulating principle of cayenne, and what I shall 
presently say of the tonic power of bitters &c., the 
reader will perceive that all the intentions of the 
living principle in the restoration of health, are 
fulfilled by the articles above named, and, per- 
haps, be at a loss to know what peculiar office I 
shall assign to the articles that are said to be 
“ good for canker.” In elucidation of this subject, 
I remark, 
It is well known that the effect of introducing 
canker medicines into the system, is “ to stimu- 
late the glands, to cause the saliva to flow freely,” 
to detach the thrush from the mouth, and to pro- 
mote secretions wherever their influence extends. 
Now it is very certain that neither saliva nor any 
other secretion can flow freely, till the vessels 
from which it is secreted, are first relaxed to per- 
mit the discharge, and then stimulated to reaction 
to aid the valves in pushing along the fluids to the 
places of their destination. It is this alternate re- 
laxation and reaction, aided by the fluids thus put 
in motion, that disengages the canker or thrush 
from the parts on which or the pores in which, 117 
while inactive, it settles, and to which it adheres. 
It is therefore demonstrated that the canker medi- 
cines possess a compound character, combining 
the relaxing properties of lobelia with the irritant 
properties of cayenne. The astrir.gency ofsomG, 
as witch hazle, sumach and raspberry; and the bit- 
terness of others, as hoarhound, wormwood, tansy, 
camomile, bittersweet, &c., prove that they might 
also, with much propriety, be plaoed among the 
class of tonics or restoratives. It is important to 
remember these facts, as they show why it is that 
the canker medicines generally, are so efficient in 
removing disease and restoring a healthy condi- 
tion ofthe organs, without the aid of either lobelia 
or cayenne. They carry on gradually, at the same 
time, all the operations of a full course of medi- 
cine. These facts also prove, what all experience 
confirms, that cayenne itself, is the simplest and 
most efficient of all the canker medicines. It has 
been supposed that roughness is essential to a can- 
ker modicine, but this cannot be correct, as some 
of the roughest articles, when chewed, '‘leave the 
mouth dry and parched.” 
It may be asked then, “Ifcayenne is the purest 
and most efficient canker medicine known, why 
not depend on it altogether and seek no other!” I 
answer: The value of canker medicines depends 
on the acrid properties they possess, which are cal- 
culated to excite the living action. These pro- 
perties are various, stimulating the organs in 
differe ways; the effects of some being very 
disagreeable, as those of cayenne, xanthoxylum, 
gum myrrh &c., those of others very agreea- 
ble, as the juice of a delicious apple, of an orango 
and of various other fruits. Other pungent arti- 
cles may produce all other imaginable sensations, 
between the most delightful and the most disagree- 118 
able. It is onr duty as well as our pleasure and 
our interest, to select, out of this vast multitude 
of irritants, those which will produce the best ef- 
fects with the least unpleasantness in the adminis- 
tration. These will be different for different per- 
sons, and in different states of the same body. Of 
course, if a patient has a peculiar dislike to the 
taste or mode of operation, resulting from the ad- 
ministration of one kind of canker or stimulating 
medicine, weshould try another which may be less 
objectionable and equally useful. 
On this principle, we administer, to infants and 
weak patients, ginger instead of cayenne; raspber- 
ry or witch hazle, or tea of dried apples, instead of 
bayberry; poplar bark tea sweetened with molas- 
ses, instead of common bitters. 
Many substances very agreeable to the taste, 
as dried apple tea', molasses and vinegar, &c., will 
cause the saliva to flow as freely as cayenne. 
These should, therefore, be chosen instead of that 
article, when the object is merely to keep the 
mouth moist and to slake thirst. The fact that an 
article produces a most powerful and disagreeable 
sensation, is not proof that it is the most effectual 
in the cure of disease. Witch hazle tea produces 
a pleasant effect on the organs to which it is ap- 
plied, yet no article excels it in closing the relaxed 
mouths of vessels. So, sage, pennyroyal, catnep, 
and balm, all pleasant to the taste, are as good su- 
tforifics, in ordinary cases, as cayenne;' and clivers 
is as good a diuretic as tanzy. Moreover, judi- 
cious combinations of the most pleasant with the 
more acrid will so modify the latter as to 
render the whole unobjectionable to the taste, 
while the combinations themselves will be far more 
efficient in the removal of disease in general, than 
even the most efficient simples when used alone, 119 
Restoratives.—It now remains to consider 
only the last class of remedies which I here call 
restoratives. Many of them are bitter, but they 
arc not all necessarily so. It is not only import- 
ant in the restorative process, to furnish the bitter 
principle, but to keep up the reaction in cases ofre- . 
laxed organs, as after diarrhoea, and the relaxation 
in cases of too much tension, as afler costiveness. 
Hence, we need some restoratives to furnish the 
bitter principle, as balmony; others to contract re- 
laxed organs, as the astringent articles, raspberry, 
witch liazle, birch, cherry, oak &o., and yet others 
to relax constricted organs, as butternut bitter- 
root, and the like; and we often want the combina- 
tion of them all with the stimulant property of 
cayenne. This demand for general remedies, 
in almost all cases of sickness, has stamped such 
a permanent value on Dr. 'Thomson’s '‘composi- 
tion powder” which combines almost all the pro- 
perties wanted in the healing process. I may 
close this article as I did the last, with the remark 
that restoratives the most disagreeable to the 
taste and in their effects, are not necessarily the 
most efficient in the cure, and that a judicious 
combination of the several articles demanded by 
the given case, will be both more pleasant and 
more salutary, than the most irritating simple, 
unmodified by the mere mild. I account for the 
fact that they are more salutary, by supposing that 
their different properties may stimulate different 
organs, or the same organ in different Ways, and 
that they may also supply some of the materials 
whose deficiency in quantity or inaptitude for vi- 
tality may be the secondary or proximate cause of 
the disease. 
The 4th Condition of the body, organic le- 
sion, mentioned in article 6th, page 107, comes 120 
rather under the head of restorative treatment, 
than the removal of disease, inasmuch as the bu- 
siness of the practitioner is rather to aid the liv- 
ing power and protect and supply the organs with 
whatever materials they want for the performance 
of their own duty, than to remove by art, any ob- 
stacle to their operations. If, however, the lesion 
be a fresh cut, we can often so unite the parts as 
to give efficiency to the tendency of the organs 
(muscles) separated, to re-unite, and the perma- 
nent restoration of the connexions is almost imme- 
diate. In case of bruises, ulcers &c., we must 
aid the vis vita, by keeping the whole system clear 
of obstructions, protecting the parts from atmos- 
pheric action or other injury, and sustaining tho 
action of the organs at the-healthy standardT 
Having exhibited the intentions of nature in 
her attempts to remove disease, and described tho 
character of several articles which are calculated 
most effectually to aid her in the accomplishment 
of those intentions, I now proceed to show how 
these agencies of art may be brought to bear the 
most speedily and effectually in the removal oftho 
most various, complicated, powerful or inveterate 
causes of disease. In other words, I shall give 
what I conceive to be a good example of the mode 
and means of administering what is commonly 
called a 
As soon as you determine on giving a course, 
give a quarter ofa tea-spoonful ofcayenne in a lit- 
tle milk, honey or molasses to commence raising 
the action of the system. I always carry in my 
pocket, a vial of cayenne and molasses. It is an 
excellent article for this purpose, and to cure 
pains in the viscera, relaxes, and slight colds, 
A COURSE OF MEDICINE. 121 
and to convert the enemies of the system. Put 
into the fire a dozen half bricks, or as many rocks 
about their size. Into a two quart pitcher, put an 
ounce or a very large table-spoonful (heaped as 
high as you can) of canker powders or of composi- 
tion, a tea-spoonful or two of nerve powder and 
as much brown sugar. Mix them well with a 
spoon, pour on a quart or three pints of boiling 
water, and stir it up till the powder is all well 
wet. After it settles a little, pour out a tea-cup 
half full, dilute it a little with cold water, and, if 
composition, give it; if canker tea, add cayenne 
enough to make it as hot as composition would be, 
and then givo it. Pour out another cup full, and 
set it upon the table or window to cool. Pour out 
half a cup, and put into it cold water till it will 
not burn your mouth, add five tea-spoonsfull of lo- 
belia (powdered herb) or three of the seed, and let 
it stand where it will keep warm. Pour off ano- 
ther tea-cupful ofthetea, put in a tea-spoonful of 
cayenne, another of lobelia seed, and another of 
nervine, and let it 6tand by the fire to keep 
warm. Give the second cup of tea (about five to 
ten minutes from the first) and get your steam ap- 
paratus in readiness. Pourout anothercup, put into 
it half a tea-spoonful of cayenne, and give it about 
ten minutes after the second cup. Prepare also a 
quart or more of pennyroyal, sage, catnep or pep- 
permint, or some other pleasant tea to drink during 
steaming, and also during the operation of the em- 
etic, when the canker tea is particularly disagree- 
able. lly this time the steam should be ready. If 
the bowels be either constipated, much relaxed, 
obstructed or cold, or there be pressure to the head 
or lungs, an injection of the canker tea with cay- 
enne, slippery elin and a little lobelia, should be 
administered before getting over the steam. This 122 
plan is always good, as it tends greatly to equalize 
the heat of the body, and prevent the unpleasant 
sensation of fullness in the head and chest, often 
experienced during steaming. It is also an ex- 
cellent plan to wash the feet in water, scrape off 
the dead skin, throw away the dirty and fill up the 
vessel with clean water as hot as it can be borne 
to keep the feet in while steaming. 
Steaming.—Put two strips of board about two 
inches wide across the top of the largest wash tub 
about the house, in such a manner that you can 
set an open, flag, or split-bottomed chair upon 
them, with the back feet directly over the edge of 
the tub. Put into the tub a common wash bason or 
other small vessel, and then place the patient upon 
the chair, covered only with a blanket, pinned 
round the chair and tub, so as to exclude all the 
air except from the face. As soon as the patient 
is seated, open the blanket a little at the bottom, 
and pour into the bason from a tea-kettle (which 
must always be ready) about two or three quarts 
of boiling water. Now give the patient a little 
more hot tea, and take, with the tongs, a brick or 
rock from the fire, put it partly into the water, but 
still hold it fast (resting the tongs on the edge of 
the tub) till it is so much cooled by gradual 
depression into the water, that it will not make 
too much steam, when you may let it entirely 
down into the bason and leave it there till it 
ceases to make steam enough, when you should 
take it out of the bason and leave it in the tub, on 
the side where the patient feels the coldest. Give 
a little tea of some sort, with cayenne if necessary, 
every time yon change a brick. Take another 
brick and use it as you did the first. If sickness 
at the stomach occur, the patient’s face being red, 
her muscles strong, and body restless; give a lit- 123 
tie tea with cayenne, dash a little water suddenly 
in the face and on the breast, and she will soon 
vomit and be relieved. IfTaintness, weakness and 
paleness occur, lower the steam by removing the 
stone and opening the blanket about the neck, and 
dash the face, and, if necessary, the breast with 
cold water, and, ifthis is not sufficient, take hold 
of the back of the chair and pull it back, (seating 
yourself in another,) till the head is at least as low 
as the pelvis, and retain her in that position, giv- 
ing warm teas, and occasionally sprinkling the 
face suddenly with cold water, till she recovers 
her strength, when she should be raised up again 
and the steam applied till she gets warm. I have 
sometimes held a patient in my lap and arms in this 
way for two hours, letting pass under the blanket 
from a pipe just steam enough to keep the air warm 
about him. He would boas cold as clay the wliolo 
time, and unable, through weakness and chilliness, 
to lift a hand to his head, or many times, even to 
speak, till the cold fluids were all expelled and 
the heat pervaded the system, when the strength 
would return and he would sit up and receive a 
fine steam, during which he would be very amus- 
ing in conversation. 
This cold stage of steaming, has no relation to 
what are termed the alarming symptoms, a serious 
and protracted case of which I have never yet wit- 
nessed. 
I never measure my steaming by minutes or 
hours. The object of steaming is, incases of cold 
and consequent fever, to open the pores and let out 
the cold and dense fluids. In patients filled with 
cankery fluids, it is to carry out the virus that may 
be afloat in the system at the time, and to excite 
the skin to action by the stimulus of heat. The 
first will be accomplished when the patient sweats 124 
freely all over, and his flesh is hot particularly on 
the knees and the tops of the feet, just back of the 
toes. The second should be continued as long as, 
by giving freely of the pleasant tea before men- 
tioned, with occasionally a little cayenne, he can 
comfortably endure it. During the latter part of 
the steaming, let an attendant wash clean with 
warm soap suds and a cloth, every part of the body, 
to get away all the dead skin, the dirt that is 
loosened, and the morbific matter that was disen- 
gaged, that it may not be absorbed again. This 
is very important. After the washing, close the 
blanket, put in a hot rock and give a little hot tea 
to raise the action pretty high, and then dash with 
cool water, rub dry and put on the under clothes, 
and help, if necessary, the patient into the bed, 
and put a steaming stone or jug of boiling water 
to the feet. Give another cup of tea, and soon af- 
ter, a cup of the emetic first prepared. After ten 
minutes at most, whether the patient pukes or not, 
give more tea, and soon afterward, as much more 
of the emetic as you can pour off clear from the 
powder. Now follow up with teas every five min- 
utes or so, (putting into the pitchers more boiling 
water when necessary,) till the patient has puked 
at least once freely. Fill up the cup of lobelia 
with tea again, and, after it has stood awhile, 
strain and press it. Continue the teas, using the 
tea of the lobelia if necessary, till the stomach is 
settled, making them as stimulating as the case 
requires, and adding a little pearlash, sal ajratus 
or carbonate of soda, (the size of a large pea of the 
first is the best,) whenever there is acidity on the 
etomach,and rubbing the surface dry often if the 
perspiration is continued and profuse. It must 
not be forgotten to keep something warm at the 
feet; a gallon jar or other bottle of boiling water 125 
is an excellent article, much better than steaming 
stones, except in cases of burning fever. Itismoro 
equal, will last ten times as long, and is every 
where convenient. If the patient is very sick, 
full of tea and cannot vomit, give him a table- 
spoonful of the liquid out of the cup containing 
the lobelia, cayenne and nervine, and this will do 
the work. Ifliis stomach is cramped, give a cup 
of weak lobelia tea. If it burns, give a little sweet 
milk or milk porridge. Continue the process, es- 
pecially the canker tea and cayenne, till the stom- 
ach appears to be free from morbific matter and 
settled, in all weak, chronic cases using porridge 
freely after the first thorough vomiting. It will 
often seem as though the stomach were sick, when, 
in fact, the disagreeable feeling iscaused by mere 
emptiness, and will be removed by a tea-cupful or 
porridge. If the stomach refuses to settle, give 
an injection, and the patient will either get bet- 
ter or puke. If he sickens and does not puke, 
give tea and cayenne and rub the gastric region. 
If one course does not appear to give essential re- 
lief, give another after an hour or two. Keep up 
the action and advantage gained, by stimulants 
and tonics; and, while the patient improves fast, 
courses are not necessary; but if he sinks, repeat 
the courses. Wherever it can be had, a steam- 
pipe and stop-cock connected with a boiler, is 
much better than rocks and bricks, as it is far eas- 
ier to use or to regulate. 
A convenient apparatus Jor steaming, may con- 
sist of eight or ten pieces of tin or copper pipe, 
from a half to three quarters of an inch in diame- 
ter, so constructed that the small end of any one 
piece will just fit into the large end of any other. 
Two of the pieces should be knees extending 
about an inch each side of the joint, two inches 126 
long in the whole, and making an angle of 135 
degrees or a right angle and a half. Take a com- 
mon brass stop-cock, drive out the stopper and 
saw it with a keyhole saw, from one side of the 
hole down to the lower end; saw off the other side 
at the top of the hole, smoqth the remainder and 
put it back again, but do not fasten it. Let the 
coppersmith or tinner solder a tube an inch or an 
inch and a half long, to the little circular projec- 
tion directly below the stopper, the lower end of 
the tube being rathbr smaller than the upper. Let 
now a thick copper plate be made in circular form, 
large enougli to cover the top of a large tea-ket- 
tle; bore a hole through the centre cne-fourth of 
an inch in diameter, and make a screw three 
inches long with a high flat head and a flat smooth 
shoulder to fit the hole. Make a flat iron bar, 
half or three quarters of an inch wide, one-eighth 
of an inch thick, and just as long as the diameter 
of the copper plate, and cut a hole in the centre to 
fit the screw. Now* make a hole in the copper 
plate an inch from the central one, to fit the tube 
that is soldered on the under side of the stop-cock. 
Put the screw through the plate, and just insert 
it into the bar below; then put the bar into a tea- 
kettle, lift it till it touches both sides, and turn 
the screw till it brings down the copper plate 
close to the top of the kettle. To make a good fit, 
the plate should be bound round the edge with a 
strip of cloth an inch and a half wide, with fine 
twines 60 run along its edges as to tie above and 
below the plate, and draw them like the lining of a 
hat. Put the tube of the stop-cock through the 
hole of the plate, and fit the first piece of pipe on 
it. This plate has another hole at right angles 
with the centre and the last mentioned, for the 
purpose of inserting a small funnel and pouring in 127 
more hot water when necessary. This is stop- 
ped (except when fillingf the kettle) with a cork or 
piece of wood. The joints enable the practitioner 
to direct the steam either into the tub, to the floor 
or into the bed. This cap will fit on any tea ket- 
tle and constitutes a complete steam apparatus. 
By turning the 6topper you may regulate the 
steam at pleasure. The tub protects the carpets 
or floors from being wet by the perspiration and 
the water that may be dashed on the patient, and 
elevates her to a proper height above the steam, 
and prevents the cold air from coming up under 
the blanket; but, if it cannot be had, the chair 
must be put upon the floor and the process con- 
ducted as I have already directed. A narrow and 
low cot frame covered with very open cloth, should 
be provided in houses where there is a very weak 
patient that will need many steamings. I have 
6team boxes that come up to the waist, containing 
an open seat within, and requiring a blanket only 
round the neck, shoulders and chest. They hold 
water at the bottom, near which, at one end, is a 
hole to admit the steam pipe. I like these boxes, 
because they admit of the utmost convenience in 
handling the patient, and keeping the lower ex- 
tremities warm. They also allow the tying of a 
towel or handkerchief around the waist, so as to 
confine the steam below it, a practice of great im- 
portance in removing obstructions in the pelvic re- 
gions. It may be well to remark here, that steam 
confined below the waist in this manner, may of- 
ten be applied so long and so efficiently as to re- 
move obstructions from those parts, when, if it 
were permitted to come up to the chest and neck, 
it would so fatigue and exhaust the patient that 
you would be obliged to remove her before her feet 
were scarely warm. 128 
When Steaming is necessary.—Heat is a tonic. 
When the skin is cold, lax and clammy, it has lost 
its tone or tension. Steam will stimulate it to a 
natural action, and enable it to hold the heat of 
the body in quantity sufficient to keep the whole 
warm. If the skin be very hot and parched, its 
tension is too great. Sponging with lukewarm 
water and giving bland fluids in this case till the 
perspiration is free, is better than steaming, as 
there is so much heat directly under the skin that 
none is needed outside of it. After giving eme- 
tics and injections, which letdown the inward ac- 
tion, and take off the tension of the skin, the steam 
may be applied to advantage, and it will aid in re- 
moving the morbific matter from the capillaries, 
and deep-seated glands &c. If the skin be dirty 
or scurfy, though it be neither parched nor clam- 
my, steaming is necessary to cleanse it. If it be 
clean, of natural color and temperature, and so ac- 
tive that a cup or two of weak cayenne tea will 
excite a perspiration, but not be succeeded by 
chills, and the extremities be not cold or inactive, 
steaming is notnecessary. 
Food in the Course.—Weak patients and those 
that have not lately eaten, should have milk por- 
ridge, or chicken broth, or beef tea, or rice water, 
or toast water, or some such nutrient, after the 
first free vomiting. After the course is completed, 
a little pleasant bitter, as peach syrup, or some 
similar compound should be given, and then the 
patient may have a little dry toast, .* cup of tea or 
coffee or chocolate, a little broiled or fried bacon, 
or mush and milk or indeed any thing she craves, 
and at this time she will seldom be inclined to cat 
too much. The demands of the appetite at this 
time, though often very singular, are, in my opin- 
ion, our best guides to what is proper for food. 129 
LECTURE 8. 
Vk A\ S AND MEANS—Continued. 
Food after the Course.—Before T leave this sub- 
ject, I may as well give what I consider the best 
directions respecting diet for all persons at all 
times, old or young, male or female, sick or well. 
The fundamental propositions are, 
1. The feebler the digestive organs, the more 
urgent the necessity for selecting that food which 
requires the least exertions of those organs to de- 
rive from it the greatest proportion of nourish- 
ment, that is, the more nourishing and digestible 
should be the food in proportion to the quantity 
that is taken. This will not be doubted by any 
one who reflects upon it. 
2. The only means by which a patient can cer- 
tainly know what articles of food are, to him, the 
most easily digestible and will afford him the 
most nourishment, is actual experience, not the 
experience of others on others, nor his own on 
others, but of himself on himself. 
Lest this proposition be so controverted as to in- 
jure the force of conclusions I shall draw from it, 
1 think proper, at once to establish it beyond a 
doubt. 
When the news arrived in America, several 
years ago, that his Sovereign Majesty the Cholera 
proposed to make us a visit, and to abstract from 
among us all who were in any way predisposed to 
give him a welcome reception, the whole medical 
faculty throughout the length and breadth of the 
land, made up, in their separate conclaves, their 
opinions relative to what was the most and what 
the least digestible and nutritious of all the arti- 
cles of food ever devoured or thought of for con- 130 
sumption, by that omnivorous and ever-changing 
animal called man. Between these extremes,they 
arranged with the nicest care and gradation,accord- 
ing to the wisdom of “four thousand years of ex- 
rience,” all the several articles known in the cata- 
logue of eatables, from the delicate frog soup of 
the French or Italian Madame, through the train 
oil of Greenland, the codfish ofMaine, to the bacon 
and greens of \ irginia—but lo! when all these di- 
rections were assembled in mass, such was the 
praise bestowed by one set of medical philosophers 
on an article, and such the condemnation of the 
same by another, that it was found utterly impos- 
sible for the ordinary sagacity of man, to discover 
whether any given article could be eaten with safe- 
ty or not. 1 o this collection of records of medical 
discrimination, the universe contained but one 
like—I mean a library of all the nosologies, from 
the monographs in the Delphian temple, to the 
volumes ofGood and the pamphlet of Ilosack! 
With this mighty accumulation of wisdom be- 
fore them, the people began to select as best they 
could, the prophylactics of the cholera, but, la- 
mentable to tell, experience soon taught them the 
lesson that they who supposed that they had done 
the most to ward oft the stroke, had in reality 
done the most to invite an attack. 
Instructions of Authors.—In the course of my 
reading, I observed great discrepancies in the 
recommendations of eminent medical authors in 
relation to different articles of diet. Observation 
of the instructions of practitioners, also proved 
that they had learned no rules on the subject that 
could be depended on; for they not only differed 
from each other, but esch individual was constant- 
ly changing his prescriptions in this respect. I 
liave known a doctor to in the course of a 131 
few weeks, many changes of dief, to the same pa- 
tient, when there was no apparent change in the 
symptoms of the disease; the only foundation for 
his changes being simply that the former article 
did not suit the condition of the patient, which the 
doctor himself had learned only by trial. I ob- 
served, too, that almost any change in diet for a 
sick person, especially if it was what the appetite 
craved, generally proved beneficial for a while, 
and then the article not only lost its power, but 
even became disagreeable. 
Deductions.—Reflecting on the above facts, as 
well as upon the results of my own practice, and 
comparing them with the omnivorous character of 
man, I concluded that the reason why a person 
craves a particular article of food, is the same as 
that why he sometimes craves food at all, and at 
other times prefers drink, viz. that the sys- 
tem is, at that time, in actual need of at least 
some of the ingredients contained in that article, 
and that, but for the presence of other ingre- 
dients also contained in it, which may not be 
suited to the condition of the patient, the gratifi- 
cation, in reasonable quantity, of this craving of 
nature, would never prove injurious. This disco- 
very also explained the reason why an article of 
food or medicine soon lost its power to produce a 
generally beneficial effect. It does, indeed, con- 
tinue to produce its specific effect, whether good 
or bad. But, while we are directing our attention 
to one specific effect and giving a simple article of 
food or medicine to produce it, we are neglecting 
the use of the means to produce other effects 
equally important, for want of which the general 
system soon begins to languish even under influ- 
ences which at first seemed to promise all that was 
desirable. Indeed, it seemed to me perfectly rea- 132 
sonable that the body which is composed of differ- 
ent simple and compound substances, that are in 
a constant course of wasting and renewal, could 
not be sustained for any length of time, by the use 
of any one simple article, however good in itself, 
or however much needed at the time it is first ap- 
plied, and that the most effectual way to keep up 
these changes in due proportion, is to eat a rea- 
sonable quantity of a great many different articles 
of food that are known to be good for the suste- 
nance ofthe body; and so also, the most effectual 
means to remove disease and restore health, is to 
use together where proper, and where not, in rapid 
succession, all the means within my reach that 
are calculated to effect the object I have in view. 
These principles, constantly demonstrated by my 
experience to be true, led me in practice, to adopt 
the two general rules I have so often urged in the 
Recorder, viz. 
1st. Whether sick or well, never deny your- 
selves variety in fo'od, but reject only that which 
your own experience tells you is not good, and, in 
all cases, confine yourself to what is generally con- 
sidered a small quantity. Don’t eat too much, 
sick or well. 
In explanation of this rule, and to guard it 
against abuse, I must remark, that we must not mis- 
take a good effect that is temporarily disagreeable, 
for one that is in its nature bad; for the best arti- 
cles of food, as milk, sweet butter, and many ve- 
getables, will often so excite the living organs to 
an effort to throw out the canker, phlegm, morbid 
secretions &cc. from the system, as to make us feel 
very disagreeable, and induce us to suppose that 
these articles of food “hurt us,” when, in fact, they 
are acting, not only as food to nourish us, but as 
salutary medicines to rid us of disease. When, 133 
therefore, any article of food that is generally 
good for us, actually makes us sick, we may con- 
clude with certainty that we were sick before we 
eat it. and kindly warned by the disturbance it 
produces, of the propriety, if not the necessity of 
taking at once a full course of medicines, to remove 
the real occasion for that disturbance. It is pro- 
per here to remark that, when a great number and 
variety of articles are eaten at once, there is more 
danger of eating too much, than when the whole 
meal is made from a single article; because, in the 
first case, after some of the cravings, as for meat, 
bread &c. are so satisfied, that no more would 
be eaten if confined to them, there may yet remain 
some cravings or tastes which will carry down 
without disgust an additional quantity, of pies, 
puddings, sweetmeats &c. This is the reason why 
high living, is supposed to produce gout &c., not 
that spices and sweets are in themselves, in rea- 
sonable quantities, more injurious than meat or 
bread &c.; for experience proves that the aroma- 
tic spices, as cayenne, cinnamon, ginger, nut- 
megs &c., which were formerly supposed to have 
produced the gout, are, in reality, the best possi- 
ble means for curing it. Hence, when I find a pa- 
tient that will not confine himself to a reasonable 
quantity of compound food at a meal, I recommend 
to him to make each meal from a single dish and 
change, every meal, if he pleases. 
2nd. When you wish to remove obstructions or 
restore health, use together a good number of the 
best articles and processes that are calculated to 
effect the object you have directly in view ; and 
follow them immediately with a similar combina- 
tion of means and processes that are adapted to 
the fulfilment of the next intention. Being care- 
ful always that the various means used shall pro- 
duce effects in due proportion with each other. 134 
For example, cayenne in pills is calculated to 
excite the system, generate heat, remove obstruc- 
tions, pain «Scc.; but, all these operations are great- 
ly aided by putting the article into hot water, and 
the patient into the steam bath. So, lobelia alone 
will relax the nerves and muscles in such a man- 
ner that the reaction of the whole will, in general, 
produce a vomit; but, these processes are much fa- 
cilitated by the addition of boneset, pennyroyal, 
steam and cayenne. So, the bitter herb will sup- 
ply the matter of bile; but, in cases ofgreat debili- 
ty, the addition of some astringent will help the 
cause, and, if the bowels are constipated, some- 
thing laxative, as well as bitter and astringent, is 
indispensably necessary. Sprinkling cayenne into 
the stockings, or rubbing the lower extremities 
with the strong vinegar extract, will still further 
aid the process of cure. These hints will be suffi- 
cient. 
Other means of warming and relaxing the sur- 
face. Inasmuch as the modes and means of 
steaming I have recommended, are not convenient 
in all places, nor at all times to the same person, I 
here mention others which can be used as substi- 
tutes. When the skin is moist and cold, and the 
patient cannot be conveniently steamed and rub- 
bed dry, the best applications in bed, are gallon 
jugs of boiling water wrapped in a thick cloth and 
put at the feet and sides. Common flat-irons will 
answer a good purpose in this case. But, where 
the skin is dry and contracted, whether cold or 
hot, (it will generally be the latter,) wrap the bot- 
tles or irons in wet cloths, if good porous rocks or 
bricks cannot be had. Or wrap in cloths or bricks 
a dozen or so or large boiled potatoes, ears of corn 
or pieces of very porous green wood, as ash &c., 
just out of the boiling water, and apply them, re- newing as they cool. I saw boiled potatoes, and 
peppermint, catnep or sage tea, cure many a “bad 
cold” and “obstinate rheumatism,” before I ever 
heard of the New Guide. 
W hen tne ;a very hot and dry, and the heat- 
ing applications are oppress sponffe it with 
water neither so warm nor so cold as io f|jga_ 
greeable, till it becomes cool and comfortable, giv- 
ing diluted sudorific (but not heating) drinks, as 
sage, pennyroyal, catnep, balm &c., till perspira- 
tion is free and the pulse begins to diminish infre- 
quency and increase in volume, when you should 
give cayenne according to the necessity of the 
case. 
When the skin is cold, lax and inactive, use 
freely some good stimulating liniment, (see page 
148,) all over the system; and, in the bottom 
of the stockings, to keep up the action of the skin 
and prevent the feet from becoming cold. 
Intermediate Course.—It is now all-important 
to maintain the action and advantage gained. 
TheJirst step in this process, is to give, regular- 
ly, just cayenne enough to maintain constantly a 
standard action in the system. If more than is 
necessary of this article be given, it will produce 
fever, high excitement and uneasiness, or else pro- 
fuse perspiration, especially at night. So long as 
the quantity regularly given produces neither of 
these effects, it is not too great. If fever and irri- 
tability, or profuse perspiration occur, lessen the 
quantity taken of cayenne. 
I'hc next step is to furnish the system with bit- 
ter articles, which experience proves are calculat- 
ed to correct and increase the biliary secretion 
and promote digestion, and of course restore the 
natural action of the various organs. A compound 
of poplar, balmony and golden seal, equal parts, 136 
may be styled a neutral bitter, it being neither 
laxative nor astringent. This and composition 
given alternately morning and evening, and cay- 
enne on the food at dinner, are suitable restorative 
for a patient whose bowels ar» -wuner too loose 
nor too constipate1- . . 
Ifll,r iuwels are too constipated, give the same 
articles, adding enough of bitterroot, and some 
other mild and innocent relaxant, to produce from 
one motion of the bowels to three in twenty-four 
hours. 
If the voluntary dejections be bilious, that is, 
light yellow, acrid or cutting, or very offensive, 
five or six a day, for several days, will be of ser- 
vice, provided cayenne be given freely to keep up 
the action of the general system and the tendency 
to the surface, and a stimulating injection or two, 
a day, be added. After several days, or a week 
at most, these free passages of acrid bile &c.,will 
either cease of themselves or begin to weaken the 
patient. If the latter effect take place, use many 
warm and astringent injections, and give a tho- 
rough course of medicines, steaming after the eme- 
tic, and confining the steam below the waist, as 
already directed, till the lower parts be as warm 
as they can bear; then letting the steam all over 
the system till the whole body is very warm be- 
fore you dash with cold water. Indeed, thisisthe 
best mode of steaming patients in every case; for, 
while the lower parts are generally the coldest, 
and need the most heat, the tendency of that agent 
is to rise as high as it can; of course, when the 
blanket is loose round the body, it surrounds the 
head, neck and shoulders, and expands and stimu- 
lates the vessels there, more than those of the low- 
er extremities, which perhaps are the only parts 
that much need its influence. In proof of these 137 
assertions, every attentive practitioner has observ- 
ed that, in steamingin the ordinary way, the head, 
neck and breast often become uncomfortably warm, 
wrhile the knees and feet still remain cold; and, if 
he try my plan of confining the steam below the 
waist in similar cases, he will find that the upper 
parts will be sufficiently heated, through sympa- 
thy with the lower, even though the steam should 
not be permitted to surround them. 
Use of the Courses.—It should be remembered 
that the courses are intended to disengage, at once 
from the system, those accumulated morbific 
materials which the unaided efforts of the vital 
power are unable speedily to remove. There- 
fore, if the attack has been acute, and the course 
has been sufficient to remove the cause, the resto- 
ration will be speedy; but, if the case be chronic, 
and the organs much debilitated or injured, some 
time will be required to restore the tone of the or- 
gans, even after the morbific materials are remov- 
ed. If, in this case, the appetite and digestion be 
good, and the patient feel that she is relieved from 
this burthen, and gradually improves under a good 
tonic treatment, the courses need not be repeated 
until she begins to sink, or ceases to improve, and 
even then, perhaps a more energetic use of the 
tonics and stimulants will supersede the necessity 
of a course. It is a fact well established by the 
history of the llotanic Practice, that those who 
work rapidly till they remove the obstructions, 
and then keep up a thorough tonic treatment, are 
more successful with less courses, than those who 
give a course once a week, and depend upon that 
chiefly for the cure. Indeed, what is the use of 
removing half of the obstructions and leaving the 
organs too feeble to prevent the reaccumulation! 
I have entirely cured, in a very short time, many 138 
very obstinate cases, by giving a full course of 
medicine every six hours for twelve or twenty- 
four hours, and I recommend this plan in all ob- 
stinate cases. Why should we fear such rapid 
treatment! I give a course of medicine and feed 
the patient and let her rest an hour. Finding her 
better but not well, I reason thus: If one course 
has made her better by removing part of the mor- 
bific matter, another course will make her still 
better by removing more ofit. I give it, and the 
reasoning is demonstrated. I go on till the mor- 
bific matter is removed, and then find my tonic 
course to tell fast in the restoration of the organs 
to a healthy state. To know when I have given 
courses enough, I commence the tonic treatment 
directly after each course, and, when I find this 
treatment able to sustain the action and advantage 
gained, know, of course, that I have removed the 
primary cause of the disease. After this, I give 
them only when I find that the progress of the 
cure is retarded by a fresh cold, or by the patient’s 
neglect to keep up the action, or by new accumu- 
lations of obstructions through inability of the or- 
gans to prevent them. 
Poultices.—In cases where there is much sore- 
ness, inflammation or ulceration, and the ordinary 
courses are not sufficient to remove the morbific 
matter with ease,-poultices should be applied to 
the parts affected. The intentions to be answer- 
ed by poultices are two, relaxation and stimula- 
tion. The ingredients necessary to fulfil them 
are three, warmth, lubrication and irritation. It 
is further necessary that means be used to keep 
these agencies constantly at work. The warmth 
desired, may be secured either by applying some 
non-conducting substance to prevent the escape 
of the natural heat of the body, or by rubbing on 139 
some irritating article, as cayenne, dec., and the 
lubrication or moisture suited to the case is found 
in a tea of slippery elm or any other mucilaginous 
article. 
It is also necessary, in cases of ulcers, that the 
poultice be a porous body, in order to absorb and re- 
move from the system the morbific matter which it 
is calculated to aid the efforts of the vital power in 
throwing to the surface. As I have said in regard 
to food and medicines, the most effectual means 
of securing all these ends, is a judicious combina- 
tion in one application of all the agents that are 
calculated to secure any one of them. A tea of 
slippery elm, lime tree or other similar article, 
will furnish the lubricating fluid; lobelia and other 
antispasmodics will aid these in relaxing the 
pores; cayenne, ginger and the like, will stimu- 
late the nervous tissue, so as to put the vascular 
system in motion, a body of cracker, wheat flour 
or other bulky and somewhat porous article will 
absorb the morbific virus and preserve around the 
part the heat of the body generated by the action 
of the system. The thick slimy tea of slippery elm 
that remains in the poultice, dries on the outer 
surface in such a manner as.to form a sort of skin 
or crust which prevents a very speedy evaporation 
of moisture from the remainder; that part of it 
which may be taken up by the absorbents, so lu- 
bricates the inner surfaces as to enable them to 
force along, without pain, the morbific materials 
contained in them, and here we have an explana- 
tion of the mystery that the same poultice should 
sometimes “scatter” a threatening ulcer, and at 
others, “draw it to a head.” 
Inflammatory tumors, are ordinarily produced by 
the increased action of the capillaries in their ef- 
forts to move forward certain morbific materials, 140 
which, either from their own crude or non-assimi- 
lated state, or from a collapse of the capillaries 
upon them, are obstructed in their progress. Of 
course these materials will accumulate, till, in 
some way or other, the obstructions to their pass- 
age are removed. The influences of a poultice 
containing the ingredients above enumerated, ex- 
plained and illustrated, will relax the pores both 
where the morbific materials are lodged and be- 
tween them and the surface, dissolve and thin them 
and render smooth their passage, and stimulate the 
absorbents and secernants to move them along, 
some to the excretory ducts within the body, and 
others to the surface from which they will be re- 
moved by absorption into the poultice. If the 
quantity of morbific material deposited, be not too 
great or too corrosive to be discharged by all 
these means, without injury to the vessels contain- 
ing it, those who do not understand the modus op- 
erandi of poultices, suppose that it has been scat- 
tered; but, if the quantity be too corrosive to re- 
main a considerable time in the vessels without 
injuring them, the tendency of the vital action to 
force it to the surface, and the aid given by the 
poultice in relaxing the external secernants more 
than the internal, combine to produce what is call- 
ed a suppuration or ulcer; and, with few excep- 
tions, the more corrosive or poisonous the morbific 
material, the more speedy will be the progress to 
the surface, and the less extensive the swelling. 
From the above explanations and facts, it is evi- 
dently unphilosopical to talk about one poultice as 
a “drawing poultice” and another as a “scatter- 
ing poultice,” because all kinds of poultices that 
are worthy of the name, act upon the same princi- 
ples. A poultice that would contract the surface 
and stop its action, would have the same effect on 
the vessels deeper seated, and, of course, produce 141 
an ulcer like the other, only under more aggravat- 
ed and painful circumstances. It is also evident 
that it matters little what are the particular mate- 
rials of which you make the poultice, provided 
they are known to contain the principles of relaxa- 
tion, lubrication and stimulation, and will protect 
the part from atmospheric influence and absorb the 
virus that the action of the system I.as forced into 
contact with it. These consider., ons are very 
important, as they do away all the necessity for 
searching after specific articles for a poultice, pre- 
vent the culpable neglect to apply one when need 
ed, for the want of those articles, and enable the 
practitioner to select, from nature’s botanic gar- 
den, with speed and judgment, such articles as he 
wants, whenever he cannot readily obtain those 
with which he is familiar. Thus, for example, 
when I could not obtain lobelia to relax, I would 
take any other article (not poison) that I knew to 
be nauseous or sickening to the taste. For slip- 
pery elm, I would use basswood bark, (Tilia) or 
the herb saponaria, or any other vegetable of the 
caryophillous tribe, or any other plant that has 
very succulent or slimy leaves or roots, as lilies &c. 
For cayenne or ginger, I would take snakeroot, 
prickly ash or any other article (not poisonous) 
that would produce a permanent stimulating and 
heating effect, when rubbed in my hands &c. 
These directions are not given to induce persons to 
be continually experimenting with new articles, 
but to enable them to accomplish the humane and 
benevolent object of healing the sick, at all times 
and under all circumstances, even though they 
may not have at hand, the best means of doing it, 
Remedies—Simple.—From what I have said on 
the subject of vital action, on the simplicity of its 
intentions, (notwithstanding the great variety of 
its modes or symptoms which the fruitful and er- 142 
ring fancy of man has transformed into so many 
evidences of a great number and variety of invad- 
ing and active enemies to life and health,) and on 
the three classes of remedies that are calculated 
the most effectually to remove all obstructions, it 
is evident, that the best means ofknowing and ap- 
plying our remedies, are to keep these classes, as 
far as it can well be done, in their most simple 
state. For example, if we keep lobelia in the 
seed, and cayenne, bayberry and bitter root, by 
themcelves, either crude or powdered by our own 
hand or under our own inspection, we are better 
able, in the first place, to judge of their genuine- 
ness, purity, quality and power, or the character 
and degree of their effects on the system, than if 
they are combined with any other articles; and, in 
the second, to unite them in a moment in such a 
manner as to suit the condition of each and every 
patient. It is therefore evidently better to keep 
all our remedies in a separate state, except where 
their specific action can be rendered more speedy 
and powerful, by combination with something else. 
For articles in their simplest form, classed ac- 
cording to their powers and intentions, as anti- 
spasmodics, stimulants, laxatives, astringents, bit- 
ters, demulcents, diuretics, diaphoretics, &c., to 
which arrangement I shall hereafter aid you, 
will always provide you with the best means of 
bringing all the powers of your science and your 
art to bear in the most effectual manner upon any 
given case. Thus, to unite all the simply relaxant 
or simply stimulant, or simply astringent, or sim- 
ply diaphoretic modes and means in the same pro- 
cess, is to produce a much greater specific effect, 
than to use any of these means and processes in 
connexion with others. 
But I have already proved that most vegetables 
contain various active properties, and, of course, 143 
'hat the effects they produce on the system, are 
lot the specific effects of any one property, but the 
predominant effect of some over others, or, perhaps 
nore properly, the resulting effect of the combina- 
;ion. lathis sense, many single vegetable prepa- 
rions, as an astringent bitter, like birch; a bitter 
cathartic, as bitter root; or an astringent stimu- 
ant, as bayberry; are actually compound medi- 
dnes. If we could separate one of these princi- 
ples from the other, the medical effect of each 
would be different from that of the combinations 
and more powerful in its own way. To do this, as 
far as we can, is certainly desirable. I would 
therefore recommend the procuring of essential 
oils by distillation, of extracts by boiling down the 
decoctions, compressing the juices &c., preserv- 
ing them in spirits or oils. 
There are, however, many articles that cannot 
be made to act speedily and powerfully in their 
simple state, and these we are obliged to combine 
with others that are calculated to prepare their 
properties for absorption into the system. Forex- 
ample, gum myrrh is not so suited to the imme- 
diate wants of the system, till either digested or 
dissolved in alcohol. The relaxing property of 
lobelia seed, is more available in sudden emergen- 
cies, in the concentrated tincture of the 3d prepa- 
ration, than in the form of powder, and, of course, 
when combined on scientific principles, the more 
condensed and better suited to assimulation, the 
more speedily will its benefits be felt. 
Compounds.—I consider the compounds made 
by Dr. Thomson as among-the most judicious that 
can be made. They are so, because they were 
framed by experience, and are calculated, of 
LECTURE 9. 144 
course, to be generally useful. It is true that their 
usefulness can be increased by the condensation 
of their powers, so far as that can be effected with- 
out altering their nature; but, it is equally true 
that any condensations are objectionable which, 
on account of the trouble or expense of effecting 
them, open the door for designing, avaricious and 
unprincipled men, to injure, destroy and corrupt oi 
adulterate them, and thus, by monopolizing the 
6ale at a high price of what cost them little or no- 
thing, to make themselves sick at the expense of 
the credulity, fhe health and ultimately the life of 
the people. I would therefore recommend to all 
practitioners and to every family, 
1st. To collect or purchase, in their cruih 
slate, all the valuable remedies within their reach, 
and to prepare, of each, at least as much as they 
may probably want for their own use, in the most 
condensed and efficient form that their knowledge 
will suggest, and their means will enable them to 
effect. Some will be able to do much more ofthis 
work than others; but I solemnly warn every man 
that the moment lie commences to trust to the 
knowledge, skill, means and faithfulness of ano- 
ther, to do what he cannot effect himself, that mo- 
ment he takes the first step which may end in risk- 
ing his life in the hands of an unprincipled villain. 
The wisdom and benevolence manifested by Dr. 
Thomson, in exhibiting the ingredients and pro- 
portions of his compounds, and in recommending, 
teaching and permitting every man to prepare 
them for himself, cannot be too highly commended. 
Though no man who understands the real value of 
the blessing thus conferred, will think it overbal- 
anced bypayingthe paltry sum of twenty dollars for 
the little “Guide to Health,” or will, for any trif- 
ling reasons, abandon it for other means of doubtful 145 
character and value, still, on the other hand, no one 
who is able to give greater efficiency to Dr. T’s 
means, or to aid them by others of similar charac- 
ter, or of superior efficacy, if such be found, will 
hesitate to do it, for fear that he should be brand- 
ed with degrading epithets for attempting “im- 
provements on perfection!” If any man is able to 
make real improvements even on what is by many 
counted “perfection,” I say let him doit. All I 
want is, to be sure that it is an improvement. But 
improvements that are available only to a few 
choice spirits, even though good in themselves, can 
scarcely be considered, on the whole, desirable. 
They compel the few that devise them, often to 
use inferior articles, to satisfy the increasing de- 
mand, if not to endeavor, for the sake of fame and 
filthy lucre, to destroy the confidence of the many 
in the value of that which is not only as good, but 
within the reach of all. 
I would not be understood to say that, in no 
case are we to trust to the honesty and fidelity of 
others,'for what we cannot prepare for ourselves— 
we are under the indispensable necessity of doing 
it in many cases. The principle I advocate is, 
that we should do it as little as possible, and least 
of all in preparing food and medicine, in which 
our health and life are concerned. The reason is 
this. In proportion as the manufacture is confined 
to the few, in just that proportion will the demand 
on the few increase: As the demand is increased, 
so will increase the difficulty of obtaining genuine 
and efficacious simples for the manufacture. In- 
different articles will be considered better than 
none. The security which compounds afford 
against detection of fraud, even when the ingre- 
dients and proportions are professedly made 
known, the greater profit made on the mass com- 146 
posed of cheap ingredients, and the lasting influ- 
ence of a fame acquired, perhaps at first justly, by 
the manufacture and sale of a good article—all 
combine to deteriorate a compound food or medi- 
cine, whether secret or not, and consequently to 
jeopardize the health and life of him who buys and 
uses it. 
To illustrate.—I go to the fields and gather the 
seeds of lobelia, I raise my peppers in my garden, 
and gather my myrtle or bayberry from the bogs, 
my balmony from the water courses, and my bit- 
ter root from the uplands or sandy intervales. I 
now know what I have, and can estimate their 
power and depend on their effect. If I buy these 
articles of my neighbor, I am not sure that he may 
not have gathered, through mistake, if not design, 
some of the seeds of campanula or of the poison 
cardinal flower for lobelia inflata. The cayenne 
brought by the merchant, may be much adulterat- 
ed by the introduction of other fruits of similar 
shape and color, especially if ground. My bayber- 
ry may be the bark of the branches instead of the 
root, if not even much alloyed with that of some 
other bush; my balmony and bitter root may suffer 
as much, if it be in no other way than being gath- 
ered in the wrong season.—Indeed, what attentive 
practitioner has not observed that the most of the 
simple articles of the Botanic Materia Medica 
have actually diminished in power, as the demand 
for them has increased] Take another step into 
the liabilities to deterioration and abuse, and who 
has not observed that it is now far more difficult to 
get good composition, spice bitters &c., than it 
was five years ago] Is it not then, evident, that 
the more complicated and difficult to be made, the 
compound, whether for want of the whole ingre- 
dients in their purest state, or of the ability or 147 
honesty of the maker to be faithful, the less likely 
is the medicine to be genuine and good? And do 
we not actually find it so? Is it not sometimes the 
case that a skilful practitioner fails by the use of 
medicines which he purchased, and of which, for 
that reason, he did not know the genuineness and 
the power; when, had he gathered and prepared the 
articles with his own hand, he might have suc- 
ceeded! 
If such things happen where the whole matter is 
open to inspection, and that too without charging 
any purchaser, manufacturer, vender or practition- 
er with deliberate design to do wrong, what are we 
to expect from rushing with our eyes wilfully 
blindfolded into the arms of those who manufac- 
ture nostrums, in 6uch a manner as toelude the de- 
tection offraud, withoutthe possibility of any other 
motive than the mere monopoly to themselves of 
all the money that can be made by it? every mo- 
tive of philanthropy urging them, if they have 
really made any valuable discovery, to make a fair 
disclosure to the world! 
I would then conclude this article by repeating 
the recommendation to every one to gather all the 
simples that he can, and make as many as he can 
of all the compounds that he wants. When he 
must purchase of others, let it be in as crude a 
state as will answer his purpose, and always use 
first in practice those simples or compounds with 
the nature and powers of which he is the best ac- 
quainted. A strict adherence to this advice, will 
soon enable him to arrive at almost entire inde- 
pendence of others, and freedom from hazard, in 
the supply of his own medical wants and those of 
his household, and confer on him and his, the 
greatest blessing limited to earth, a sound and 
healthy body, through which the immortal spirit 148 
can have free and perfect exercise, in the accom- 
plishment of all her vast and philosophic aims. 
Instructions for making Compounds.— In ac- 
cordance with the principles just laid down, I 
proceed to give some specimens of my practice 
for the consideration and profit of all who prefer 
knowing what they do and why they do it, to be- 
coming the mercenary tools of others who, by 
withholding these important matters, literally say 
that men are not worthy to be trusted with the 
knowledge of the means of preserving life and 
health. 
Eighteen years before I became acquainted with 
the excellent system of Practice of Dr. Thomson, 
I had been for the eighteen months previous af- 
fected with a pain at night in my arm. Being in- 
formed by an old gentleman too familiar with the 
complaint, that it was rheumatism and proceeded 
from cold, I determined to burn it out. I obtained 
ed a number of red pepper pods, put them into a 
pint of vinegar and boiled them till there was but 
a small quantity of the fluid, with which I bathed 
my arm for half an hour, heating it in by holding a 
hot shovel near it. I then took out the dregs, put 
them on a large piece of flannel, bound them round 
my arm and went to bed; but, such was the intole- 
rable irritation that I felt no disposition to sleep 
till about daylight, when I drowsed a little. So 
much of the article was absorbed that it produced 
a burning heat and redness which spread over my 
whole side, neck, face and head, and did not en- 
tirely cease its action for more than a week. But 
I felt not another vestige of the disease for three 
years, when it returned again in the same place. 
I repeated the experiment, with the same success. 
I felt no more of the disease till I commenced the 
Thomsonian Practice, when the frequent andsud- 149 
den changes from a hot room and a free perspira- 
tion, to a driving on horseback through a keen 
northwester, or a cold, damp and dreary north- 
easter, gave me colds and produced rheumatic 
pains, not only in the arm but in other parts of 
my body. I now bathed with Dr. Thomson’s 
Rheumatic Liniment, and took No. 6 according to 
his directions, but it did not touch the disease. I 
doubled the portion of cayenne, but still failed. I 
again resorted to my old plan of bathing with vin- 
egar as strong of cayenne as I could make it, and 
was soon cured, and still remain so. 
Stimulating Liniment.—Cayenne has ever since 
been my stimulator; its strength being obtained 
either by boiling it in vinegar or in neatsfoot or 
goose oil or fresh butter, and pressing it out hard. 
The oils enable it to retain its power longer, and 
they aid, by lubrication, the action of the capilla- 
ries. This liniment may be concealed by aro- 
matics, injured by gums, and counterbalanced by 
poisons; but it will not be much improved by them. 
1 object to gum myrrh in a mere stimulating lini- 
ment, to be used where there is only inaction and 
no danger of putrefaction, for it tends to close up 
the pores. There are, indeed, other stimulating 
articles that would aid the cayenne, if combined 
with it; but, as they are not indispensable nor al- 
ways convenient, I omit to mention them. Spirits 
are too cooling for any case but a hot skin, and it 
is much better to dispense with them, even in 
this, than to keep them in the house. The soft 
animal oils are preferred, because they do not 
prevent the perspiration; and volatile oils evapo- 
rate and cool the surface too quick except in cases 
of fever. The vegetable oils, as oil of sassafras, 
t'uniper, origanum &c. are good; but, as they must 
ie bought from the merchant who, in his turn, 150 
obtained them of the distiller or presser, how can 
we be sure that they are good! Some may think 
there is little danger of their being impure; but I 
can assure them, that it is no easy matter to ob- 
tain them in their purity, and the more valuable 
they are, the more likely they are to be adulte- 
rated. 
A lady fell upon a chair and bruised her eye 
very much. It turned quite black. After suffer- 
ing it to extend for several days, she applied for 
relief. I bathed it frequently with No. 6 which 
relieved it some. I then put a tea-spoonful of 
cayenne into a half ounce phial full, and directed 
her to put it on often enough to keep the part con- 
stantly smarting. In twenty-four hours it was 
entirely natural. From these and a multitude of 
similar facts, I can assure you that cayenne, al- 
though when strong it is very unpleasant to bear, 
will, in no form in which you can apply it, pro- 
duce a blister or mortification, but that, on the 
contrary, it is not excelled by any known article 
in its power to prevent both. This should be 
used in all bruises and places where the blood set- 
tles and turns purple, and put into old sores, espe- 
cially if they contain proud flesh. 
Ant Spasmodic Liniment.—If it could be obtain- 
ed insufficient quantities, the oil of lobelia would 
probably be the best article for this purpose; but 
that is not yet certain; for, as other parts of the 
plant than the oil are certainly relaxant, their 
properties may be advantageously employed in the 
composition of the liniment. 1st. Take, then, the 
bruised seeds of lobelia and powdered nervine, 
and make a saturated tincture in vinegar. This 
is an excellent article to open the skin in cases of 
swelling, fever or inflammation. 2d. Put the pow- 
dered seeds of lobelia into twice as much neats- 151 
foot or goose oil, sweet oil or fresh butter, and 
keep them warm but not scalding hot, for five or 
six hours, then press with a very heavy weight, 
through a strong cloth and preserve it for use. 1 o 
cure sores on the surface, or counteract the effects 
of corrosive poisons, the above cayenne and lobe- 
lia preparations of similar character should be 
united. 
Tonic Liniment.—It is very evidentthat, for the 
contraction of relaxed parts, some kind of astrin- 
gent is necessary; but, as it is also certain that 
vital action is indispensable to the restoration of 
a healthy condition of the debilitated organ, as- 
tringents alone will not answer all the indications 
for the use of this species of liniment. We must 
therefore not only prepare some of the most as- 
tringent articles either in liquids or oils, but we 
must add to them the stimulant properties of cay- 
enne &c. A strong decoction of witch hazle, red 
oak bark, common galls, birch bark, or any similar 
article, with cayenne, will effect this object. Eve- 
ry body in the country is acquainted with some 
powerfully astringent, yet innocent article to which 
he may resort for such a purpose. If he can add to 
it others that are valuable, let him do so, but let 
him not hesitate to use one good article, because 
he has not at hand all the others that may be re- 
commended to accompany it. It is painful to mo 
to receive, almost daily, from Thomsonians in dif- 
ferent parts of the country, from Maine to Texas 
and from Florida to Wisconsin, the lamentation, 
that the people must call in an M. D. because they 
cannot get all the articles necessary to make the 
several compounds, so much praised by some of 
the fraternity, nor even the few very simple, but 
very useful ones recommended by Dr. Thomson, 
when I am fully convinced that, were one who 152 
thoroughly understood the principles I have here 
presented, the science of Botany, caught in 
any of those four quarters, or any spot of ground 
within the compass of a line that should surround 
them all, and deprived of every accredited article 
in the Botanic Materia Medica, he would soon 
muster from the fields of that region, remedies 
sufficient to cure nine-tenths of all the forms of 
disease to which the inhabitants of the place are 
liable. I therefore impress again on your minds, 
the importance of becoming well acquainted with 
the true principles of medical science with the sci- 
ence of Botany, and the art of applying the reme- 
dies effectually in the prevention and cure of dis- 
ease. 
Unless this is done, avaricious and unprinci- 
pled men will impose on the public, by preparing 
worthless compounds and vending them at enor- 
mous prices; practitioners will fail in their attempts 
to cure with these preparations; confidence in the 
whole system will be lost or greatly shaken, the 
regulars will cry “I told you so,” and the whole 
world will again fall into the cruel tender mercies 
of calomel, opium and the lancet. 
But, I may be asked if the obviously good ef- 
fect of a medicine is not an all-sufficient reason for 
us to believe it good in itself, whether we know 
its constituent principles or not! I answer no, by 
no means. This is the rock on which all learned 
quacks have split—the very foundation stone of 
the boasted four thousand years experience. 
The Doctors say, “Bleeding removes spasms;” 
it is true. They continue, “Calomel opens the 
bowels”—true again. “Opium eases restlessness 
and pain”—even so. “Sugar of lead stops bleeding 
and diarrhoea”—still correct. “Ice cools a fe- 
ver”—can’t dispute it. 153 
Now what Thomsonian is ready for the conclu- 
sion, that, therefore, bleeding should be prescrib- 
ey for spasms, calomel for costiveness, sugar of 
lead for cholera and dysentery, ice for fever, and 
opium for delirium and pain! Surely none. Of 
what use then to the practitioner, is the criterion 
so boastfully set forth by a certain celebrated nos- 
trum maker, that no remedies purporting to be his, 
are genuine, unless they immediately relieve pain? 
We know that pain may be removed in two 
ways—by removing the cause of it, and by de- 
stroying the power of the nervous system to be 
sensible of it. Opium and strammonium, and 
many other articles, will surely relieve pain, but, 
is it a matter of no importance in which of these 
ways they do it ! Suppose the action of the living 
principle should recover, in some, yes, in many 
cases, the healthy tone of the organs, in spite of 
the bleeding, calomel, opium, lead, ice, strammo- 
nium &c., is it right to attribute to all articles 
called medicines, the good results that may have 
been produced by the sanative efforts of nature in 
opposition to the specific tendency of those arti- 
cles! It is well known too, that a majority of good 
articles in a compound, will often entirely over- 
rule the evils which the minority of bad are cal- 
culated to produce. This was the case in the 
cholera medicine of the celebrated Dr. S. Cart- 
wright of Natchez, Mississippi, who was reward- 
ed with the honor of a service of plate, for mixing 
so much cayenne with his calomel, that the medi- 
cine cured a great many patients, in spite of both 
the disease and the poison! Who does not see 
that the only way in which we can rightly esti- 
mate the value of any compound, is to become 
thoroughly acquainted with each and every ingre- 
dient in its separate state! 154 
Lastly, when a practitioner is ignorant of the 
true therapeutic principles, and uses secret nos- 
trums or even compounds professedly made after 
a well known recipe, If lie should tail in a given 
case, how shall he know whether the failure is to be 
attributed to the science, the skill, the general re- 
medy or some ingredient in it, or to the only pro- 
per and legitimate cause, the total loss of vitality 
in the essential organs! and, if he know not where 
the fault lies, how, I ask, can he apply the proper 
remedy! 
It is not the object of this little book, to exhibit 
the entire materia medica, nor to teach the whole 
theory and practice of medicine. It is presumed 
that all who purchase it, will possess some other 
work in which these subjects are more minutely 
set forth. I shall merely insert the catalogue of 
articles prepared by my friend Dr. A. C. Logan, 
and published in the 2nd volume of the Thomson- 
ian Recorder, page 351, with the addition of their 
several predominant powers or properties, so far as 
I am able to determine them. 
Those that relax the nervous and muscular fibre, 
I shall call antispasmodic and relaxant; those 
that contain tannin and contract it, I shall call as- 
tringent; those that contain acrid principles 
which so irritate the nerves as to produce both re- 
laxation and contraction, I shall call stimulant; 
those that furnish the bitter principle, I shall call 
bitter; those that have a very slimy or mucous 
parenchyma, I shall term emollient; those that 
strengthen the system, or restore the power ofthe 
organs, I shall call tonic: and I shall, in general, 
endeavor to arrange these in the order of their 
predominating properties. The difficulty of this 
last task may subject me to some errors, but I am 
happy to say that these errors are of little im- 
portance. 155 
I would remark, in general, 
1st. That, as all relaxants open the pores of 
the system, they must necessarily be measurably 
secernant and deobstruent; that is, they must indi- 
rectly promote salivation, gastric and biliary dis- 
charges, the internal secretions and perspiration. 
On this principle we find that lobelia increases the 
saliva, the perspiration, and sometimes even the 
urinary and alvine discharges. 
2nd. That all stimulants, because they reco- 
ver the action of the system, must necessarily be 
more or less deobstruent and tonic, or restorative; 
these effects, with proper nourishment, being all 
that is necessary to bring the system to a healthy 
state. Hence we find cayenne to be so valuable 
in the removal of canker, and in the restorative 
treatment. 
3d. That the only reason why canker medi- 
cines are so useful in the removal of obstructions, 
is, because they contain such varied combinations 
of irritating properties as to promote both relaxa- 
tion and contraction, or action and reaction, which 
are but other terms for stimulation. The acrid 
effect of bayberry on the glands of the mouth, is a 
striking illustration of this position. 
4th. That it is improper to use pure astring- 
ents while there is much canker in the system to 
be removed—The fact that the regulars could never 
cure the dyspepsia with bitters, nor the diarrhoea, 
dysentery or cholera with opium, may serve to il- 
lustrate this remark. 
5th. That it is equally improper to use anti- 
epasmodics and relaxants, when it is our sole ob- 
ject to tone up the system, and, 
6th. That when we are in perfect health, stim- 
ulants are not wanted and of course improper. 156 
MATERIA ME DICA. 
CLASSIFICATION OF PRINCIPLES. 
Division 1st.—Simples. 
Class 1—Relaxants. 
This class includes those that merely reduce the 
tension of the organs. 
The purest and most powerful known to us, that 
is also perfectly harmless, is Lobelia Inflata. 
It may be aided by all the articles that move 
the bowels, promote perspiration or any other se- 
cretion, and make the person feel weak and free 
from excitement. 
Class 2—Stimulants. 
This class includes those that neither relax nor 
contract specifically, but stimulate the system to 
the performance of whichsoever is needed at the 
time. 
The purest is Cayenne, to which we may add 
Ginger, lied and Black Pepper. 
Class 3—Bitters. 
That which comes the nearest to a simple or 
pure bitter, isBalmony, Golden Seal, Aspen bark, 
Barberry and Peach and Cherry barks, leaves and 
kernels, are approximations towards it. 
Division 2—Natural Compounds. 
Class 4—Astringents. 
Tannin is the principle of vegetable astringen- 
cy, but it is not found pure in any one article. It 
predominates in Witch Hazle, Sumach, Marsh 
Rosemary, the leaves of Birch, Alder and forest 
Poplar, Hemlock bark, and any other article 
which, when chewed, will dry up the saliva, and 
permanently contract the muscular fibre of the 
tongue, cheeks &c. 157 
Class 5. 
Articles containing many properties, the princi- 
pal of which are mentioned in connexion with 
each. 
The following are prominently Antispasmodic, 
partaking also of the other properties named. 
1. Lobelia Thomsonia or Emetic herb. Mus- 
cular, relaxant, antiasthmatic, sialogogue,and gen- 
eral secernant, through relaxation. Its effects are 
followed by reaction of the stomach and chest, or 
emesis. 
51—52. Verbena Ilaslala, Verbena Urticifo- 
lia. Blue and White Vervain. Nearly similar, 
but stimulant, (not used.) 
19. Cypripedium Pubescens, vel Parvijlorum, 
vel Luteum el IInmile,vel Acaule. Umbil or Va- 
lerian. Nervine and bitter tonic. 
68. Panax Quinquefolia. Ginseng. Nervine, 
stimulant and secernant. 
4. Nymphcca Odorata. Skunk Cabbage. An- 
tiasthmatic, stimulant and secernant. 
41. Arum Tryphillum. Wake Robin. Stim- 
ulant and secernant. 
The following are variously and prominently 
stimulant. 
2. Capsicum Annuum. Cayenne. A pure 
stimulant, of course, secernant, deobstruent and 
tonic. 
21. Zingiber Ammomum. Stimulant, secern- 
ant, deobstruent and tonic. 
22. Piper Nigrum. Black Pepper. Like, but 
inferior to Ginger. 
24. Oleum Terebinthincc. Spirits of Turpen- 
tine. Balsamic and tonic. 
11. Erigeron Purpureum. Squaw Weed. De- 
obstruent and tonic. 
23. Laurus Camphora. Camphor. Astringent. 158 
25. Mentha Piperita. Peppermint. Secern* 
ant and deobstruent. 
26. Mentha Veridis. Spearmint. Antispas- 
raodic and nervine. 
27. Salurcice Horten sis, vel Salureja Horten- 
tis. Summer Savory. Secernant and tonic. 
23. Hedeoma Pulegeoides. Pennoroyal. Se- 
cernant and tonic. 
37. Matricaria Vulgaris, vel Chrysanthemum, 
Parthenicum. Featherfew. Secernant and tonic. 
43. Geum Virginianum. Evan Root. De- 
obstruent and tonic. 
45. Abies, vel Pinus Balsamea Balsam Fir. 
Balsamic and tonic—healing. 
48. Sinapis Alba, el Nigra. Mustard. Se- 
cernant and tonic. 
47. Aristolochia Scrpcntaria. Snakeroot.— 
Do. do. 
53. Solidago Odora. Golden Rod. Balsamic 
and tonic. 
49. Cochlearia Armoracia. Horse Radish. 
Secernant and tonic. 
54. Pyrola Umbellata. Pipsissiway (green,) 
Do. do. 
55. Pyrola Maculala. Do. (white) 
56. Cnicus Officinalis. Bitter Thistle. Bit- 
ter, secernant and tonic. 
57. Rumex Crispus. Yellow Dock. Acrid 
and cathartic. 
58. Carduus Benedictus, vel Cenlaurea Bene- 
dicta. Blessed Thisle. Bitter, secernant and 
tonic. 
59. Zanthoxylon Fraxineum. Prilkly Ash. 
Secernant and tonic. 
60. Pyrola Rolundifolia. Wild Lettuce. 
Do. do. 
62. Helonias Dioica. Colic Root. Do. do. 159 
65. Lycoput Vulgaris, vel Europius, Arch- 
angel, (light green.) Do. do. 
69. JJyrica Gale. Meadow Fern. Balsamic 
and tonic. 
70. Trifolium Pratcnse. Red Clover. Mild 
escharotic. 
The following are prominently bitter: 
12. Chelone Glabra. Balmony. Secernant 
and tonic. 
34. Antlicmis N’obilis. Chamomile. Secern- 
ant, stimulant and tonic. 
31. Anlhemis Colula. Mayweed. Do. do. 
29. JIarrubium Vulgare. * Iloarhound. An- 
tispasmodic and tonic. 
30. Inula Helenium. Elecampane. Demul- 
cent and tonic. 
13. llerberis Vulgaris. Barberry. Stimulant, 
deobstruent and astringent. 
14. Amygdalus Persica. Peach. Stimulant, 
deobstruent and tonic. 
15. Apocynum Androscemifolium. Bitterroot. 
Laxative, stimulant and tonic. 
16. Frasera Verlicillala. Golden Seal. Lax- 
ative and tonic. 
17. Hydrastis Conadensis. Yellow root, Puc- 
coon. Laxative, stimulant and tonic. 
18. Prunus Virginiana. Cherry. Stimulant, 
astringent and tonic. 
20. Amyris lCalaf, vel Jlyrrha. Stimulant, 
antiseptic and tonic. 
32. Arlemissa Absymthium. Wormwood. Sti- 
mulant, deobstruent and tonic. 
3. Jilyrica Cerifera. Bayberry. Stimulant, 
deobstruent and astringent. 
33. Tanacetum Vulgare. Tansey. Stimu- 
lant, secernant and tonic. 
38. Bclula Lenta. Black Birch. Astringent 
and stimulant. 160 
39. Celastrus Scandens. Bittersweet. Stim- 
ulant, secernant and tonic. 
42. Eupatorium Perfoliatum. Boneset. Re- 
laxant, stimulant, emetic and tonic. 
50. Juglans Cinerea. Butternut. Stimulant 
and cathartic. 
61. Aletris Farinosa. Unicorn. Acrid, Stim- 
ulant, secernant and tonic. 
63. Coptis Trifolia. Gold Thread. Stimu- 
lant, secernant and tonic. 
64. Lycopus Firginicus.— Far: Ruber. xYrch- 
angel, (dark.) Bitter stimulant and tonic. 
66. Populus Balsamifera. Balsam Poplar. 
Balsamic, stimulant and tonic. 
The following are prominently astringent. 
8. Ilamamelis Firginica. WitchHazle. Stim- 
ulant and, when green, demulcent and tonic. 
9. Rubus Strigosus. Red Raspberry (wild.) 
Stimulant and, when green, demulcent and tonic. 
6. Statice Caroliniana. Marsh Rosemary. Sti- 
mulant and tonic. 
7. Rhus Glabrum. Sumach. Stimulant, se- 
cernant and tonic. 
5. Abies, vel Pinus Canadensis. Hemlock. 
Stimulant, secernant and tonic. 
10. Populus Trepida, vel Tremuloides. Pop- 
lar (yellow.) Stimulant and secernant. 
42. Eupalorium Perfoliatum. Boneset. Bitter, 
deobstruent, stimulant, emetic and tonic. 
44. Galium Ferum el Aparine. Cleavers. 
Stimulant and secernant. 
The following are prominently emollient. 
46. Ulmus Fulva, or Slippery Elm. Basswood,, 
Comfrey, Saponaria, Adder Tongue, Field Sorrel, 
Hollyhock, Mallows. All excellent in poultices. LECTURE 10. 
Though, by reference to the principles, page 
105 and onward, and a practice accordant with 
them, all the forms of disease peculiar to women 
and children, if taken in time, may be removed; 
yet I shall now present the principal forms to 
which they are liable, making further remarks on 
some that have been mentioned, and prescribe 
what I deem a judicious and effectual mode of 
treatment. 
Disease, Peculiar to Females Adhesion of 
the Labia Pudcndi. Inflammation of the external 
parts. See Lecture 3, page 44, and onward. 
Constant cleanliness of these parts, merely wash- 
ing them in warm water two or three times a day, 
and then greasing them with sweet oil, or butter 
melted before it has been salted, will preserve 
them from soreness. A general purification of the 
system by the canker teas, cayenne and frequent 
steamings or washings with warm water, will 
prevent the supply of the canker which constitutes 
sores in these, as well as all other parts. The in- 
flammations, suppurations, swellings, tumours, 
warts, polypes, &c., found in these parts and in 
the vagina, are made up of the cankery humors 
and morbid secretions that lurk here for want of 
attention to the free action of the system, and to 
cleanliness oftho parts. 
Sores.—If cleansing and greasing and a free 
use of canker teas and the course, should not be 
sufficient to cure any sores that may break out 
about the external parts, or to reduce any swel- 
ling, poultices of slippery elm, ginger, cracker and 
lobelia, (adding a little cayenne if necessary,) 
should be applied till the disease is removed. The 
form of disease called pruritus, which so much 
traubles the apprehensions of the learned gentry, 162 
and baffles their skill, will readily yield to this 
course of treatment. When disease is in the va- 
gina, it must be met by injections suited to its cha- 
racter. Except the above, and others before men- 
tioned, the forms of disease with which females are 
attacked, present little that is peculiar to them, till, 
about the age of puberty, especially if care be ta- 
ken, according to our directions, to keep them 
equally comfortable all over as to their clothing. 
If this latter point be neglected, then the female 
may expect, as a certain consequence, sooner or 
later, an ample reward for her folly, in a postponed 
and suppressed, or a painful and irregular men- 
struation. 
During the period from infancy to puberty, care 
should be taken to keep the lower extremities 
warm by wearing cotton drawers in warm weath- 
er, and flannel, and thick shoes and stockings in 
cold; and, if girls should be so unfortunate as to 
take a little cold, instead of giving them calomel, 
that (I had almost said) greatest enemy to the fe- 
male frame that ever bore the name of medicine, 
let them take hot, ginger, cayenne, composition or 
other stimulating and sudorific teas, keeping the 
feet warm till a free perspiration throws it off, or, 
if necessary, let them take a full course of medi- 
cine. 
Swellings—Swellings of all kinds, wherever 
they occur, arise from obstructions of some sort, to 
the action of the organ or organs affected. Thus 
the dropsy in the flesh, is occasioned by a collapse 
in the skin that prevents the serum of the blood 
from escaping in the form of perspiration. In- 
flamed tumors may arise from this collapse, but 
more commonly from the lodgment of morbific ma- 
terial in the parts. They may also succeed organic 
lesion. I say, these things and others may be the 
occasion of various forms of disease; but, let it ever be remembered, that the true cause of all ac- 
tion in the system, (except mortification—chemi- 
cal action,) is the presence of vitality or life; and, 
that the action of the organs will always be proper 
or improper, in proportion to the capacity or con- 
dition of those organs to be acted upon. 
All poisons, in any quantity, diminish, and, in 
larger quantities, destroy entirely, the capacity of 
the organs (o be acted upon. This is proved by 
the fact that the more they are taken, even in small 
quantities, the less striking is the apparent result, 
that is, the less able is the living power to bring 
the organs to operate upon them. This is the rea- 
son why it is so much more difficult to restore a 
patient to sound health after he has been treated a 
long time with calomel, opium &c., even though 
he should not appear very sick, than to cure one 
that bus just been attacked, though ever so vio- 
lently, by disease in almost any form. 
To cure swellings, then, of every description, 
relax the parts, generally if the swelling be gene- 
ral, and locally if it be local, and then stimulate 
the organs to a healthy action to remove the mor- 
bific matter, (See “Ways and means,” page 
107—140. The swelling of the lower limbs in fe- 
males, is sometimes caused by the weak and re- 
laxed state ofthe veins and absorbents, which, in- 
stead of forcing the fluids up into the body, en- 
large and allow too great a quantity to remain in 
them at a time. The frequent and faithful appli- 
cation of the stimulating and astringent liniments, 
(pages 149, 151,) after the system has been tho- 
roughly cleansed by courses, will correct these 
evils. Sometimes, particularly during pregnancy, 
the lower 11mbs swell because the foetus presses 
on the veins and lymphatics in the pelvis; this 
may be removed any time by lying down awhile. with the pelvis and lower limbs higher than the 
shoulders. Ladies thus affected, should notallow 
themselves to be constantly walking. Let them 
frequently assume, for a short time, the position 
above mentioned. 
Menstruation, as a form of Disease.—I have 
already remarked that the early or tardy appear- 
ance, the small quantity, or the profuse discharge 
of the menses, is no proof of disease, without some 
ether concurrent symptom, as, general debility, 
congestion in the head, palpitation of the heart, 
cold feet and hands, clots of blood in the discharge, 
too frequent occurrence &c. &cc. It is obvious, 
therefore, that a mere retention of this fluid beyond 
the usual time, is not to be considered disease, 
much less to be treated on any other than general 
principles, and with those universal remedies that 
are calculated to promote the general health and 
remove all the causes of disease without regard to 
name. When the retention is connected with se- 
rious derangements of vital action, as evinced by 
cold extremities, flushed countenance, palpitation 
of the heart &c., great pains should be taken to 
heat thqroughly the cold extremities, by confining 
the blanket round the waist in steaming, wearing 
flannel drawers &c., and by using stimulating lin- 
iment. (See page 194.) Direct efforts should 
also be used to relax the parts constricted, by 
warm fomentations, injections of lobelia &c. If 
the uterus swells so as to indicate an accumulation 
of the secretion in its cavity, and the general treat- 
ment does not succeed in a reasonable time, in- 
troduce a catheter and discharge it. If a mem- 
brane cover the os uteri, (a very rare occurrence,) 
it-must be pierced by a sharp pointed instrument. 
Regular physicians recommend and practise in 
the above cases, bleeding, purging, low diet &c., 165 
and warn their Btudents and patients against tak- 
ing stimulating remedies and generous food; but, 
after all, nothing is more common in medical prac- 
tice, than for patients who have exhausted all their 
skill to no good purpose, to go to the Thomsonians 
and be steamed, puked, stimulated with cayenne, 
and fed with nourishing diet, and thus, in a few 
weeks or months at most, recover sound health. 
Dr. Dewees finds the patient “laboring under se- 
vere headache, pulse full and a little quickened; 
tongue slightly furred, appetite impaired and bow- 
els costive;” suppression caused by “standing on 
a damp brick-paved cellar in a hot day, at the 
warm employment of preserving.” Her mother 
“put her feet in warm water and gave pennyroyal 
tea which removed the chills, but did not restore 
the discharge.” For three months, she took 
“remedies” (doctors’ emenagogues, 1 suppose,) 
and then called him, who found her aB above stat- 
ed. llad he been a friend of vapor, cayenne and 
lobelia, three hours would in all probability have 
been sufficient to relax the parts and restore the 
discharge; but he “directed her to lose 12 ounces 
of blood, to be freely purged by senna and to con- 
fine herself to rennet whey, barley water, or thin 
tapioca for nourishment.” The next day he re- 
peated the order for purging, directed a continu- 
ance of the diet, and added the aloetic pill every 
night. After several days, her menses appeared. 
The Doctor supposes that his treatment was 
the cause of the cure in this case, though he must 
have seen hundreds in which it would have failed. 
Indeed he admits just before, that the same treat- 
ment might, in another case, have not only been 
unavailing, but injurious. Because his guess-work 
here, did not hinder nature from performing her 
work, he concludes that he must have guessed right. Cut what is the reason that similar guess- 
work did not cure or rather did actually cause the 
suppressions in the dozens which we, and the hun- 
dreds which our friends have been obliged, after 
the doctors had exhausted all their skill, to cure 
with steam, lobelia and good food! 
Excessive Menstruation.—This is the re- 
verse of retention. Instead of being closed so as 
to prevent the discharge, the uterine vessels are 
too much relaxed, and, in case of bloody discharg- 
es, some of them are even ruptured. This easy 
egress invites the fluids to this organ at the ex- 
pense of the healthy performance of some other 
function. The vessels from which the fluids are 
abstracted and diverted, areof course collapsed, and 
hence there is a rontinued pressure to the uterus. 
Though the principle of cure, viz. to relax the 
constricted vessels and restore equilibrium to the 
circulation and proper tone to each organ, is the 
same as in retention; yet the locality of the opera- 
tion will be reversed. Astringents must be di- 
rected to the vagina, and the general system must 
be warmed and expanded so as to direct the fluids 
from the uterus and restore the full action of the 
other secretions, particularly the perspiration. 
This will regulate every thing as nature requires. 
The doctors use all possible efforts to make the 
people tremble at the thought of using hot medi- 
cine in this case and in floodings; but, never mind 
their learned folly; experience, the best of all 
teachers, uniformly proves that this is the true way 
to do the work. 
Difficult or Painful Menstruation, is to be treat- 
ed, in all respects as I have directed for retention 
of the menses.—Page 50. 
Decline of the Menses.—Were the general 
health always attended to, the final cessation of the menses would he so gradual as seldom even to 
disturb the animal economy; but, by a sudden cold 
or a bad medical treatment of cold or some other 
term ot disease, this secretion is often suppressed 
before it should be, and then the system suffers. 
Being entirely ignorant of the whole philosophy of 
this discharge, (Dewees, page G7,) the regulars 
have adopted a mode of treatment calculated to in- 
crease the evil rather than correct the difficulty; 
and this haa induced females to suppose it among 
the most dangerous forms of disease. By the plan 
I have recommended for the retention of the dis- 
charge, I have not only soon relieved petients in 
ordinary cases, but, eventually restored some to 
health, who had been tormented several years by 
that bane of the female system, the lancet, calo- 
mel, opium, assafeedita, musk, belladonna and col- 
chicum practice! One patient had been thus af- 
flicted for several years, when the doctor told her 
he had “tried every thing he could think of” for 
her case, till he knew of nothing that would bene- 
fit her in one respect that would not injure her in 
another! We might well suppose that, when a 
learned doctor had given her all the poisons he 
could think of, she must have been in a deplorable 
state; and truly she was little better than a raving 
maniac. But, unwearied diligence in the use of 
the Botanic remedies, eventually restored her to 
comfortable health. 
Bloody Menstruation.—This arises from the 
same causes as hemorrhage from any of the capil- 
laries, viz. collapse or obstructions of other ves- 
sels and pressure towards these; and must be treat- 
ed as we treat excessive or too'frequent menstrua- 
tion, only more vigorously, collapsing by astrin- 
gents the expanded or ruptured capillaries, relax- 
ing constricted parts and equalizing the circula- 
tion. Hemorrhages.—These, wherever found, arise 
either from a relaxed state of the capillaries, or a 
lesion of the larger vessels from which the blood 
flows. The relaxation is caused by actual debility 
of the parts; but the lesion is either from direct 
violence, or from the pressure of the fluids forced 
from other collapsed parts to the region whence 
the hemorrhage comes. 
The regulars bleed to take off the pressure, and 
use sugar of lead and other mineral and occasion- 
ally, vegetable astringents, and often aid them 
with ice or cold water to the parts. I have known 
them put, at once, a half bushel of ice around a 
female pelvis, to stop a severe hemorrhage! It is 
no wonder that death so often follows. It is cer- 
tainly better—much better to do nothing at all for 
the patient, than to treat her with this savage 
cruelty. Very few if any would continue to bleed 
till they died, if left entirely to themselves: and, 
suppose they did, is it not better to die of dis- 
ease than to perish at the point of the lancet! Uut, 
Once let the equilibrium be restored by warm- 
ing the patient with hot teas and steam, and the 
blood, no longer forced by collapse of the vessels 
in one part, to congest in those of another, will re- 
main in the system in hydrostatic balance (as wa- 
ter in a sponge,) without any disposition to dis- 
charge itself. Now, by astringents, collapse the 
parts affected, and keep the system in this condi- 
tion for a time, till the injured vessels regain their 
integrity or the weakened their tone, and you 
have effected your object. Cayenne, tonics and 
food will do tbe rest. This plan is to be pursued 
in all cases of flooding, without regard to circum- 
stances. If it take place in or before the com- 
mencement of childbirth, no fears need be appre- 
hended of the consequences of this treatment. Give cayenne and bayberry, and the uterus will 
contract and close the vessels, expelling the foetus, 
disengaging the placenta, closing the vessels and 
stopping the discharge. Do it and fear not. Among 
the best astringents within the compass of my ex- 
perience, are a strong tea of witch hazle, red oak 
bark, red raspberry or running blackberry root. 
Alum water is sure to stop the hemorrhage; and I 
have never known it to do any injury. Blood root 
is said by our friends to be excellent. I have never 
tried it. 
Nausea, Vomiting Salivation &c.—On these 
subjects I have treated in general terms, (page 
60.) I add only here, that thorough courses, be- 
ing careful to keep up the determination to the 
surface during the intervals, until the stomach is 
evidently cleansed, have, in the Botanic practice, 
proved not only all-sufficient to subdue these disa- 
greeable symptoms, and secure a comfortable de- 
gree of health; but also to enable the female to nou- 
rish and, afterwards, safely to bring forth, an off- 
spring free from canker and hereditary taint. 
1 Heartburn is caused by the fermentation and 
souring of the food and the corruption of the gas- 
tric juice before digestion can take place. Dr. 
Dewecs says, “It is generally very distressing and 
very difficult to subdue.” He has tried so many 
“remedies” for it with 60 little effect, that he 
“thinks it better, in bad cases, to abandon the at- 
tempt to neutralize the acid.” (Females, page 212) 
How scientific! Can’t cure nor even palliate the 
heartburn which proceeds from a foul or inactive 
stomach! 
Salivation is caused by the nervous sympathy of 
the stomach and the salivary glands with the ir- 
ritated and expanding uterus. I have observed 
that, where the stomach had been kept thoroughly 170 
cleansed, the salivary discharge, though a little 
increased in quantity, was not very troublesome or 
disagreeable. The length of its duration will de- 
pend much on the treaiment it receives. If the 
regulars treat it, we may expect it to be “self- 
limited” and “run its course,” which is sometimes 
the whole period of pregnancy. I once broke it 
up in aweek, in a lady who had generally suffered 
from it during a large portion of her utero-gesta- 
tion. 
Pain in the right side, during pregnancy. Dr. 
Dewees informs us that, “after, seldom before the 
fifth month, the woman is sometimes attacked 
with a deep seated, rather obscure pain in the right 
side,” especially troublesome at night, lie says 
that, having treated it with “blood-letting, leech- 
ing, cupping and blistering without,” as far as he 
has observed the slightest advantage, he “has 
now ceased to prescribe for it!” This pain is 
doubtless caused, as he says, by the.pressure of the 
ascending and expanding uterus on the liver, and 
we can assure him that a fine steaming and a little 
lobelia now and then, will so relax the walls of 
the abdomen as to give room for the uterus to en- 
large and ascend without encroaching on that or- 
gan and producing pain. Will he dare to try it? 
Restlessness at nioiit.—It is really amusing 
to notice thq various “regular” opinions of the 
cause of this alfection during pregnancy. Some 
attribute it to fullness of blood, others to a defi- 
ciency; and each treats it according to his notion 
of its cause. All of them consent to bleeding, 
purging, low diet, cooling &c., and object to all 
heating stimulants. Some prescribe opium in 
large doses, others in very small ones, and in a pe- 
culiar form. This restlessness, watchfulncs, and 
generally febrile slate of the system, no doubt ari- ses from the new irritability of the nervous system, 
and the pressure on some nerves and vessels, by 
the expansion of the uterus and its dependents; 
but, instead of bleeding &c., to cure it, the true 
plan is to relax the general system so that its ca- 
pacity may increase in proportion to the augment- 
ed quantity of the material secreted for, and em- 
bodied in the constantly enlarging foetus. This 
may at any time be effected by a judicious course 
of medicine, if nothing else ail the patient. 
Costiveness.—This arises during the early pe- 
riods of pregnancy, from the pressure of the en- 
larging uterus on the rectum in the pelvis; and 
also from the circumstance that the irritable state 
of the stomach prevents much eating, and throws 
up some of the little that is eaten. These com- 
bined causes render it so long before the fceces 
collect in the rectum in quantity sufficient to de- 
mand a passage, that they become so hardened 
and dry as to be still longer impeded in their pro- 
gress. The rectum is less irritable, chiefly be- 
cause a smaller portion of irritating matter is per- 
mitted to descend into it. 
Let a lady not pregnant, in ever so good health, 
eat as small a quantity of food for days or weeks, as 
many a female does when laboring under this irri- 
tation of the stomach, and she will generally be- 
come costive. To cure this costiveness, first re- 
lieve it for the present by emollient and stimulant 
injections; second, cleanse the stomach and restore 
the appetite, so that a reasonable quantity of food 
can be eaten and digested; third, eat such food as 
will keep the bowels open, (experience will tell 
you what,) and take cayenne enough to aid the 
operation when necessary. Always relieve the 
bowels by injections whenever they have been mo- 
tionless for more than 30 hours. An excellent 172 
substitute for injections, where it may be incon- 
venient to administer them, is a small piece of(Jas- 
tile soap first rolled in a few grains of cayenne and 
introduced into the rectum. It will soon produce 
a passage. In a very obstinate case of costiveness 
that came under my observation, the lady took a 
fancy to eating chocolate in the cake. She eat it 
freely. It corrected the acidity of the stomach, 
nourished the system abundantly and kept the 
bowels free, after all the other means tried had but 
partially accomplished these desired effects. Cos- 
tiveness also occurs in the latter months from the 
pressure of the more grown foetus on the rectum 
where it passes the brim of the pelvis. Let it be 
relieved as often as it occurs, and be careful that 
no other cause unite with this to produce it. 
Hemorrhoids or Piles.—Costiveness is the 
principal cause of this very painful complaint; of 
course, strict attention to the foregoing directions 
will generally prevent it, as well as be very ser- 
viceable in curing it whenever it occurs. It pre- 
sents itself first in the descent of the inner coat of 
the intestine. If immediately poulticed withslip- 
pery elm &c., it will soon return, and seldom de- 
scend again until forced down by hardened foeces. 
If this be neglected, and the organ remain protrud- 
ed, it soon swells, inflames, becomes very sore 
and turns purple. Some of the regulars now re- 
commend making a longitudinal slit in it; others, 
tying a string round it and letting it mortify and 
fall off*; others, leeching or puncturing it &c.; but 
I have cured very bad cases, by perseverance 
with the poultice, and keeping the bowels free. 
This is certainly the best plan. Emollient injec- 
tions, as slippery elm, should be used immediately 
before every passage in this case, and after the 
passage, a strong decoction of some astringent, as 173 
witch hazle, red oak bark, galls, or any other inno- 
cent, powerful and permanent vegetable astrin- 
gent, to contract the organ to its proper dimen- 
sions. Steaming and full courses of medicine, I 
have found the best means of reducing it. A little 
6oft grease, as neatsfoot or sweet oil, frequently 
applied, is an excellent preventive of piles. 
As causes of piles, Dr. Dewees enumerates cos- 
tiveness, pressure of the uterus on the pelvic ves- 
sels, sedentary habits, soft cushions for seats, and 
long standing on the feet. (Diseases of Women, 
page 223.) I think these are all probable causes. 
Many hypotheses are then adduced from differ- 
ent authors, and strictures are made upon them, 
after which comes the treatment, viz. emollient 
poultices, purging, puncturing, leeching, hot, and 
cold applications, (even ice,) opiates, injections of 
sugar of lead, and finally “the knife.” If, howe- 
ver, the inflammation should be subdued and the 
organ reduced by the bread and milk poultice, cas- 
tor oil injections, light food and mild physic; then 
the doctor thinks “the vegetable astringents” will 
do much to effect a cure. Of these, nut-galls, the 
dust of puff-balls and opium are considered among 
the best. It is not a little strange that while the 
piles are considered the effect of costiveness, and 
costiveness the effect of diminished vitality, the 
cure should be expected from the use of opium 
and sugar of lead, some of those deadly “poisons 
which all agree in suddenly and rapidly extin- 
guishing a great proportion of the vitality of the 
system!” But nothing is too absurd to be believed 
or recommended by a regular doctor. No cau- 
tion is deemed necessary by Dr. D., in the use 
of these; but, stimulating" vegetable astringents 
must be administered with a discriminating judg- 
ment, lest they should restore the vitality of that 174 
sluggish organ the rectum, which would prevent 
costiveness and of course piles, that proceed from 
it! When will doctors learn that, to keep the sys- 
tem clear of canker, the digestive powers in order, 
and to take a reasonable quantity of good food and 
moderate exercise, are the sure means of prevent- 
ing disease or curing it! 
-Dr. Cullen learns, of “an empyrical practition- 
er,” the great value of balsam copaiva. Dr. Good 
does not believe it, though he has “tried it often 
and varied the dose.” “When the tubercles are 
not very sore,” he says, “they will often yield to 
a layer of gypsum, or, what is better, fuller’s earth 
rubbed into a soft paste.” But these things, he 
intimates, will not answer in a bad case. 
Now what can be the reason why the learned 
doctors differ so much in their opinions respecting 
the value of different remedies in this or any other 
form of disease! It is simply because the different 
conditions of the body render it in some cases 
more, in others less susceptible to the action of all 
remedies; and, of course a remedy will be effectual 
in the cases of some patients, or in some attacks 
of disease on the same patient, and not in others. 
The doctors who see the good effects, praise the 
remedy; those who see the failures condemn it, 
while the true nature and effect of that remedy 
must forever remain the same in all cases. If a 
medicine ever has a tendency to remove disease, it 
always has that tendency, and is proper to be ad- 
ministered whenever the state of the system de- 
mands its peculiar action. If it is ever adapted to 
destroy life or injure the system, it lias that fit- 
ness; and, when its evil tendencies (as is some- 
times the case) are overruled for good, the credit is 
due not to the poison nor the skill or the adminis- 
trator, but to the power of the system to defend it- self against all encroachments upon its sanative 
operations. The business of the physician then, 
is to learn the true nature and effects of all the 
remedies he uses, and to study the condition and 
demands of the system, and then apply the best 
remedy for that condition, in quantity and fre- 
quency adequate to the demand. With these 
rules for his guide, he will never reduce directly, 
by blood letting, the arterial action, in order to aid 
the vital power in removing obstructions; nor will 
he administer, to restore the action of a sluggish 
organ, any of those scientific remedies of the doc- 
tors, which, however different their action in other 
respects, “all agree in suddenly and rapidly extin- 
guishing a great proportion of the vitality of the 
system.” (Boston Medical and Surgical Journal, 
vol. ix., page 4-1.) 
The people of the United States have much rea- 
son to be grateful for the improvements which the 
fame of the Botanic practice has effected, even in 
the regular practice where it.s humble self can find 
no admission. The doctors are now often most 
sadly hampered, as they ask for a bowl and a 
towel or a piece of paper, by the solemn charge, 
“Doctor, you must not bleed me; Doctor, don’t 
give me your calomel; I won’t take mercury nor 
opium.” Unless, now, he can persuade the pa- 
tient that cupping or leeching is not bleeding, that 
blue pills are not mercury, and morphine is not 
opium, as he sometimes does, he is reduced to the 
extremity of saying, “Ifyou know better than I 
do what should be done, you must take care of 
yourself.” 
Palpitation, at the Heart.—Whatever much 
disturbs the nervous action, or obstructs the frep 
and universal circulation of the fluids, will produce' 
that labored motion of the heart, called palpitation. 176 
I have before shown that the more free the system 
from canker, and the more relaxed, warm, active 
and supple the parietes or walls of the chest and 
the abdomen, and the nervous vessels of the pel- 
vis, the less disturbance can take place in the ac- 
tion of the vascular and nervous systems. Of 
course reason unites with experience in dictating 
the propriety of full courses of medicine, with spe- 
cial attention, (see Ways and Means) to those 
parts of the system, as the pelvis and lower limbs, 
that seem most obstructed. Equalize the action 
of the system, and you stop palpitation. The ex- 
tremities must be heated, stimulated, kept clean 
and clothed warm, and the chest clothed more 
lightly and loosely. 
Displacement of the Uterus.—Of retrover- 
sion I have spoken, on page 46. The uterus is 
sometimes inverted, that is, the fundus descends 
through the os tincce into the vagina. To cure it, 
give a course of medicines, with thorough applica- 
tion of strong lobelia and slippery elm tea (nothing 
else) to the vagina, keep the patient in bed, with 
the pelvis high, and it will soon return. Now use 
injections of strong witch hazle, or nut-galls, rasp- 
berry, blackberry briar or sumach, or any inno- 
cent strong astringent, and tone up the general 
system. 
Sometimes the uterus sinks too low in the va- 
gina and even through the external orifice, with- 
out turning inside out. Give injections of bayber- 
berry or other canker teas and cayenne, and follow 
them with the astringents as above. This course 
will contract the upper parts of the vagina and the 
round and broad ligaments, the weak, relaxed state 
of which is the principal cause of the affection. 
When the fundus of the uterus falls forward or 
LECTURE 11. 177 
backward cr sideways, the plan cf restoring it is 
the 6ame, viz. raise the pelvis and administer an 
injection of labelia and slippery elm to the vagina. 
If the bladder is distended by urine, it should first 
be emptied by a catheter. The rectum should be 
emptied by an injection before if it can; if not, af- 
ter the reduction. 
I am aware that, if regulars read my book, they 
will condemn me as “ignorant,” because I have 
not carefully distinguished between inversion of 
the uterus and polypus, and given the precise treat- 
ment. My first reason is, if ladies reject their de- 
structive practice, and apply the true life-preserv- 
ing, anti-poison system, they will never be trou- 
bled with either. My second is, that, with all the 
researches the regulars have made, they have ar- 
rived only at the sage conclusion, that, “though in- 
verted uterus and polypus may readily be con- 
founded, and the mistake either way may give 
rise to very different results, yet the diagnostics 
of the inverted uterus, and a polypus of this or- 
gan, as laid down by writers, are both vague and 
discrepant. This has,created no small embarrass- 
ment and uncertainty to the surgeon who is about 
to undertake the removal of the tumor occupying 
the vagina, since he cannot satisfy himself of the 
real nature of the disease he has to contend with. 
Mr. Newnham appears to have felt all this uncer- 
tainty in its fullest force when he was about to ap- 
ply the ligature upon the uterus. To aid his judg- 
ment in this interesting and perplexing case, he 
laboriously consulted almost all the authorities 
extant; and, after carefully collating their opin- 
ions, he reduces them to the following summary.” 
(Dewees on Females, page 252.) 
“It is generally remarked, that inversio uteri 
may be distinguished from polypus of that or- 
gan by the os uteri not encircling the former tu- 178 
mor in cases of complete inversion, and by the im- 
possibility of passing the finger arourd the neck of 
the tumor, between it and the os uteri, where the 
inversion has been only partial; by the form of the 
tumor, the polypus being broad at its base, and at- 
tached by a narrow peduncle, while the inverted 
uterus is broader above than below; by the insen- 
sibility of the tumor in the one case, and by its 
extreme sensibility in the other; by the compara- 
tive fixity of the one tumor, and the extensive 
sphere of motion of the other; by the rough and 
fungous surface of inversion, contrasted with the 
smooth and polished surface of polypus; and by the 
previous history of the patient’s disease.” “But 
it is clear, that these diagsostics are liable to a 
great degree of uncertainty,” as he proves by most 
ample quotations. 
l)r. Dewees says, “We are a little surprised at 
this distinction; for certain it is, we have never 
witnessed an instance “of the inverted uterus,” 
being “broader above than below;” nor can we 
imagine how it can exist. We are every way 
sure, that the same relative proportions exist 
between the fundus and the body, and that of the 
neck, in both the natural and inverted condition of 
this organ; consequently, the mark mentioned by 
Mr. N. cannot be present, but by some unusual 
arrangement; and, of course, must not be consider- 
ed a diagnostic.” 
“Mr Newnham has collected, as we have re- 
marked, with great industry, nearly all that has 
been said upon the diagnostics of these two com- 
plaints; and, from all that can be learned from 
these various sources, a conclusion must be drawn 
that there are none which are absolutely certain. 
Mr. N. says, “On reviewing the foregoing testi- 
monies, we Bhall be induced to couclude that it is 179 
always difficult, and sometimes impossible, with 
our present knowledge, to distinguish partial and 
chronic inversion of the uterus from polypus: since, 
in both diseases, the os uteri will be found encir- 
cling the summit of the tumor, and, in either case, 
the linger may be readily passed around it. And 
if, in order to remove this uncertainty, the whole 
hand be introduced into the vagina, so as to allow 
the fingers to pass by the side of the tumor, to the 
extremity of the space remaining between it and 
the os uteri; and if we find that the finger soon ar- 
rives at this point, it will be impossible to ascer- 
tain whether it rests against a portion of the ute- 
rus, which has been inverted in the usual way, or 
by the long-continued dragging of polypus upon its 
fundus. And if, under these embarrassing circum- 
stances, we call to our assistance our ideas con- 
cerning the form of polypus, its enlarged base and 
narrow peduncle, we must also recollect the abun- 
dant evidence to prove that the neck of such a tu- 
mor is often as large, and sometimes larger, than 
its inferior extremity; and we shall still bo left in 
inexplicable difficulty.”—Page 82. 
Now, suppose we, Botanies, admit that we*aro 
not sufficiently learned or skilful to discover the 
difference between polypus uteri and prolapsus 
utori, how far should we be, in this respect, behind 
our “scientific” brethren, even according to their 
own showing! But the fact is, we have vastly 
the advantage of them; for, by following the plan 
I have recommended, all cases of real prolapsus 
will be easily and speedily reduced; while the po- 
lypes will increase in size till there is no dcubt of 
their real character, when they often ripen and 
dropoff, or may be safely removed either by sup- 
puration produced by the vegetable caustic, or by 
ligature, as described,page 45. 180 
Facts and Cases.—After trying1 various means to 
cure a case of inversio uteri, Dr. Dewees and his 
“consultation” resolved to apply the ligature, “but 
the patient died before the operation could be per- 
formed!” One case only ever came under my 
knowledge; that was made by a “learned” doctor 
in pulling away the placenta; it was treated by the 
same and others “in consultation” for four years 
or more, and finally the patient died under the 
influence of this learned quackery, in the full per- 
suasion that “the will of the Lord” was fully ac- 
complished! On the other hand, I do not know of 
any instance (and many have been reported to me, 
besides several that have come under my own 
treatment,) where derangement and exerescences 
of the userus have not been entirely cured by our 
treatment. One of the cases I treated, had been 
under the management of the most eminent regu- 
lars for more than six years, and had become truly 
deplorable; the nervous system was nearly ruined. 
But how can the M. Ds be expected Jp cure by 
their quackery, what they had first made quackery? 
Where upon the earth were such forms ever se- 
rious, till the patient had been treated a while for 
these or some other affections, by the sons of iEs- 
culapius? Again, T say, let the ladies abandon all 
medical poisons and “obstetric violence,”—“fero- 
cious and atrocious obstetric violence,” and adopt 
the cayenne, vapor and lobelia system, and they 
may dismiss their fears of the“ghaists an’ witch- 
ed” of polypus and prolapsus uteri. These, with 
the lancet, calomel, opium, and other poisons, as 
remedies for disease, are destined soon to be num- 
bered among “the things that were.” 
Disease of the Uterus and its dependencies.—OF 
these, Dr. Dewees says, (Females, page 254,) 
“The whole of the internal organs of generation 181 
are liable to disease, the most of which may bo 
considered incurable. To describe minutely the 
whole that are known, would of itself require a 
volume; and, if this were done, we might be dis- 
posed, in many instances, to enquire for the cui 
bono [whom would it profit,] as regards the suc- 
cess of medical treatment. 
This testimony is fully sustained by Dr. Mack- 
intosh, (page 667.) 
“Ovarian Disease.—In the exercise of our pro- 
fession, nothing is more disagreeable and even hu- 
miliating, than to be obliged to witness, from day 
to day, for a period of months or years, the suffer- 
ings of patients, under a disease like this, without 
being able to do more than palliate symptoms by 
means of narcotics. Sometimes we have the addi- 
tional mortification to find that temporary tran- 
quillity is produced at the expense of increased af- 
ter suffering;'’ so that there really is something to 
tempt an individual with an enterprising spirit to 
the performance even of the horrible operation of 
opening the abdomen from the ensiform cartilage 
to the pubis, in the hope of being able to effect a 
radical cure! This operation has now been per- 
formed several times by 3Ir. Lizars of Edinburgh, 
and I have no doubt, from his anatomical know- 
ledge and experience in operating, it was done in 
all the cases with the greatest dexterity, and that 
no means were neglected which could insure suc- 
cess. But mark the results: 
“The first woman died in 48 hours, and nothing 
was discovered but flatus in the intestines. The 
second was laid open, the uterus and ovaria were 
sound and healthy, but it was discovered the wo- 
man was very fat. She escaped with her life al 
that time, although stated often to be severely tor- 
tured with pain. The third had also ascites; a 182 
large tumor was taken from the left side, but one 
on the opposite side was left untouched, from the 
extent of the adhesions to surrounding parts. She 
survived the operatior, but died three years after. 
The fourth case, Mr. Lizar3 took away a tumour, 
separated adhesions between it and the viscera; 
but she died from mortification. The fifth case, 
the tumor was so completely attached to the sur- 
rounding viscera, with so many large blood ves- 
sels in the way, he was forced to abandon it and 
stich up. She survived the operation. The sixth 
case, a tumor was cut away projecting from the 
fundus of the uterus, which was thought to be au 
ovarium; she died in a few days from inflamma- 
tion. The ovaria were found quite snug and sound 
in their proper situation. 
“The following are the reasons why I con- 
sider this operation unadvisable—1st. It is diffi- 
cult to tell whether there is a tumor or not in the 
abdomen—See two cases out of six in which no 
disease was found to account for the tumefaction of 
the abdomen. 2ndly. If there is a tumor, it is im- 
possible to determine if it is in the uterus, ovaria, 
or some other part. In another case, examined per 
vaginam, by many M. Ds, all pronounced it ova- 
rian disease. She died six months after and was 
dissected. The ovaries were found quite healthy, 
but the liver was enormously enlarged, which was 
the cause of the tumefaction of the abdomen. Ano- 
ther case was most unhesitatingly pronounced to 
arise from ovarian disease. She died some time 
after,and, on opening the body, the uterus and ova- 
ries were perfectly sound, but extensive disease 
existed in the 6tomaeh, colon, liver and kidneys. 
3dly. It is impossible to tell if the diseased ova- 
rium is attached to surrounding parts, which is al- 
ways an insurmountable objection; for, should there 183 
be extensive adhesions, which require to be sepa- 
rated during’ the operation, such separation, whe- 
ther effected by the knife or by the fingers, must 
seal the fate of ninety-nine out of a hundred. 
Even in a dead body, half an hour has been taken 
in separating an ovarian tumor, from its adhesions, 
which was not effected without wounding many 
largo blood vessels. 4thly. It ought to be consid- 
ered whether the dangers arising from the opera- 
tion are not greater than from allowing the disease 
to remain undisturbed. First, we have to consi- 
der the chance of the patient dying immediately 
Irom the shock, or from hemorrhage, or afterwards 
from inflammation, after She had undergone the 
horrid torture occasioned by an incision from the 
sternum to the pubis, independently of that pro- 
duced by exposing and handling the viscera and 
cutting away the tumor, not to speak of the diffi- 
culty ofrestraining the protrusion of the intestines, 
botli during the performance of, and after the ope- 
ration. To give my opinion in the shortest man- 
ner possible, 1 simply state that I regard a recove- 
ry, after such an operation, as almost miraculous, 
and to be considered more in the light ofanescape, 
than a recovery to be expected.” 
The instruction then derived from the above ex- 
tracts from the most celebrated Pathologists of the 
age, of the schools of Philadelphia and Edinburgh, 
amounts to simply this, that the regular faculty 
know not the causes nor the seats of the most com- 
mon forms of disease; that they have no certain 
remedies for its cure; that they often perform the 
most dangerous surgical operations which destroy 
many lives, on the strength of a mere guess that 
these operations are needed to save life; and, last 
but not least, that it is much safer to trust to nature 
in all cases of disease, than to employ the most die- 184 
tinguished among them, unless he has abandoned 
the rules and instructions of authors and profess- 
ors, and limited his practice to simple and inno- 
cent means! With all due respect for the benevo- 
lence of physicians as a class of men, and admis- 
sion of the usefulness of many of this latter class, 
so fully are we convinced of the pernicious tenden- 
cy of “the science of medicine,” as they understand 
it, we solemnly declare that no morbid condition of 
our body could induce us to prefer the practice of 
“the regular physician,” to the unaided efforts of 
nature. Let us die at once by the violence of dis- 
ease, rather than be poisoned to death, or ruined 
for life by the desperate remedies of the popular 
medical and surgical practice. 
Do our female friends suppose that we are about 
to leave them in this dilemma, this “glorious un- 
certainty, or rather inglorious certainty]” No; 
we can assure them that the Botanic Practice is 
so sure and safe in all “diseases of the genitive or- 
gans,” that, under its judicious and persevering 
application according to our directions, the chan- 
ces for death from any one of them, are so few and 
far between, as to cease to be a legitimate object 
of dread. The most conclusive proofs ofthe truth 
of this declaration, may be found in almost every 
number of the Thomsonian Recorder issued for 
the last five years. 
While I lived in Richmond, Va., a lady in the 
country wrote me a letter in which she described 
her case. According to the opinions of her nu- 
merous physicians, several of whom were among 
the very heads of “the profession,” she had been 
at different times afflicted with almost every form 
of disease to which the peculiar structure of the 
female frame is liable. I put away the letter with 
intent to use it in this place, so safely that I can- 185 
not now lay my hand upon it. So thrilling was 
the description of her “miserable” and truly de- 
plorable condition, that I could scarcely read it, 
even a second or a third time, without shedding 
tears of sympathy for a suffering fellow being. 
Truly, thought I, (confident that her afflictions 
were chiefly the results of the fashionable poison- 
ing and depletive medical practice,) 
“Man’s inhumanity to m*n, 
Makes countless thousands mourn.’’ 
The last affection she mentioned, if memory 
serves me, was ovarian disease. It being imprac- 
ticable for her to come to my Infirmary for some 
weeks, she entreated me to prescribe something 
that would relieve her immediate sufferings, from 
which death would have been, as Dr. Good says, 
“a friendly stroke” to relieve her. 
Her letter indicating that she was a very intel- 
ligent and judicious lady, I wrote her a long letter 
prescribing the proper course, and advising her to 
commence it at once, and have it applied by her 
husband or other members of her own family, and 
by herself so far as she was able. Some months 
afterwards, I saw a gentleman from the same 
neighborhood, who said that she had followed the 
prescription to the letter, and was at that time 
perfectly well. That she had preserved my letter, 
and was in the habit of showing it to her intimate 
friends as her “medical diploma,” which she val 
ued beyond all price. The directions given were 
substantially the same that have been given in 
previous numbers of this work. Much stress was 
laid on the very frequent use of canker ehemas to 
the vagina, and keeping the pelvic region and all 
below it warm. 
I have attended in person many other ladies 
whose female organs had been so much deranged by “learned quackery” that “the most gifted sons” 
of this hypocritical science, could not determine 
what particular organ was affected; such were the 
number, variety and contrariety of the symptoms 
in the case. Yet I never lost one of them when I 
was the sole physician. The proper indications 
of cure have been developed in the principles, and 
the modes of operation will bo found in the chap- 
ter on “Ways and Means.” 
To the account of the above reported cure by 
our prescription, we might add multitudes from 
the Recorder; but, suppose a patient had no confi- 
dence in our remedies or our judgment of the real 
nature of these cases, and should go to the regu- 
lars for advice. Sotne might say that we Revo- 
lutionists were “ ignorant quacks, more likely 
to kill than to cure—that they have all the sci- 
ence, and can cure if the disease be curable.” I5ut 
what do the wisest of them say, on this subject, to 
their brethren and pupils! Let Dr. Dewees an- 
swer this question. 
Of the ovaries, he says, (Females, see page 
256,) “They seem to be so far removed from the 
general sympathies of the system; so insulated in 
position; so independent in function, that the com- 
mon agents for the removal or control of disease, 
seem to waste themselves in unavailing attempts 
to influence their actions or to modify their affec- 
tions. Who flatters himself that he has removed 
a dropsy, resolved a scirrhus, or interrupted sup- 
puration of these bodies! We believe, if he be 
candid, none will declare he has.” [TVe know, 
whether they confess it or not, that the regular 
practice has»mc?e many such affections.] “Little 
more then, is ascertained, than that these parts 
arc very liable to disease [about as much so as 
the patient is to fall into the regular practice,] and 187 
but very little euscepticle of cure.” [while she 
despises and rejects the Botanic.] He mentions 
live different affections, as discovered by dissec- 
tion, and adds, “unfortunately, they have much 
more frequently furnished subjects for the anato- 
nusts knife, than triumphs to the physician’s 
Of the Fallopian or utero-ovarian tubes, he says 
(page 257,) we have every thingyet to learn as re- 
gards the diagnostics of the diseased tubes; for, to 
tnis moment, we are altogether unacquainted with 
the portions of the body with which they sympa- 
thise.” 1 
How, we ask, can ladies expect to gain import- 
ant information from persons who confess that 
they “have every thing yet to learn!” We 
assure them that Thomsonians have learned at 
least one thing about these affections; that is 
how to cure them. But, one will ask how I know 
that Thomsonians have cured them, seeing we do 
not understand pathology sufficiently wolf to de- 
tect the peculiar characters of internal diseases! 
I answer, The regulars have declared that many 
patients had these diseases, and were consequent- 
ly incurable. The Botanies neither affirmed nor 
denied the testimony, but cured the patients. Now 
it follow's of course, either the doctors cannot de- 
tect these diseases, or they are the witnesses that 
the Botanies can cure them. They may choose 
either horn of the dilemma. 
Of the particular diseases of the uterus, says I)r. 
Dewees, as carcinoma, cauliflower excrescence 
corroding ulcer &c., “a short account will be* 
sufficient, as we are unfortunately acquainted with 
little more than their ravages.”—Pages 253 9. 
Carcinoma uteri is a tumor on, or thickening of 
the cervix uteri, which is disposed to ulcerate. 188 
Several have been cured by Thomsonians. “It 
eeems doubtful,’’ says the Doctor, “to those best 
acquainted with this complaint, whether a cure or 
mere suspension of this disease has ever been ef- 
fected;” but, he thinks the best treatment is “local 
bleeding, severe diet and absolute rest. Leeching 
immediately from the uterus is incomparably bet- 
ter than more remote leeching, and notwithstand- 
ing the great aversion of our American ladies to 
this mode of depletion, we are happy to say ice 
have, in a number of instances, been able, to over- 
come this aversion!” So it seems that, “ in a 
number of instances, our American ladies” have 
allowed a learned doctor to cram the vagina full 
of leeches, that they might get hold of the cervix 
uteri. For conscience sake, let us hear no more 
about the vulgarity of the Thomsonian practice. 
Proper diet, constant cleanliness and suitable and 
frequent rest, I can cordially approve. I am, 
however, fully persuaded that the antiphlogistic 
plan of treatment recommended by Dr. Dewees, 
in these cases, is better calculated to render ex- 
isting cases fatal and to produce others, than to 
prevent or cure any. 
Hydatids.—After having proved that their ori- 
gin and nature are involved in total obscurity, Dr. 
I). says, “No remedy has hitherto been discover- 
ed for the relief of hydatids,” but fortunately it is 
a form of disease rarely to be found. Madame 
iloivin uses stimulating injections; Dr. Clarke 
uses cold applications and astringents; Dr. De- 
wees, his hand, and the poison and destructive er- 
got or spurred rye!—So they go. They agree only 
in one thing, they all cause the patient much 
pain and suffering, while the benefits they confer 
are few and far between. While Dr. D. advises 
the insertion of the hand into the uterus, he says, 189 
“violence mu&t never be employed in this or any 
other instance, in passing the hand into the savity 
of the uterus!” Wonder what the Doctor means 
by the term “violence!” can it be any thing short 
of breaking the patient’s neck! 
Treatment of Uterine Affections.—Let it bo 
remembered that the affections of the uterus and 
its dependents, to which I have just alluded, are 
very rarely found, seldom more than two or three 
instances of each, and often not one, in the whole 
practice of the most experienced accoucheurs— 
that they are generally the most common in the 
fashionable and idle circles of life; and, lastly, that 
they are the most dreadful and fatal under the 
treatment of the regular faculty. Among the Bo- 
tanic fraternity, (except those who may have re- 
tained them as a memorial of their former alle- 
giance to the lancet, bleeding, poison and starva- 
tion,) they are seldom found; and, where they are 
permitted to arise through neglect to attend to the 
general and particular internal and external 
cleansing of the system, they may be soon cured 
by a judicious medical treatment. But, if this bo 
true, I may be asked why are they professedly in- 
curable in the hands of the regulars'? I answer, 
simply because the course they pursue, is calculated 
to make disease, not to cure it. Let me prove this. 
To prevent ulceration, their plan is to destroy the 
“local inflammation which,” they say, “is essen- 
tial to the disease; to diminish the circulation of 
the blood, and to abate arterial action.” Here, 
they start upon a fatal blunder, in taking an effect 
of the disturbed vital action, for the cause which 
produced the disturbance. I need not say that all 
conclusions drawn from false premises, are erro- 
leous; but, let me present the facts, as they are 
>ften more conclusive than argument, however 190 
Found. Dr. Dewees says. (Fern,, page 263,) 
“These ends will be found best answered, by blood- 
letting, general and local; by purging, by abste- 
mious diet, by cleanliness, by rest.” True, “these 
means,’’- especially the first three, are effectual to 
accomplish “these ends.” But are these truly the 
ends to be accomplished!—That is the question. 
All admit that the vital action is the only conser- 
vative power of the organized body against putre- 
faction. Therefore, I argue, the greater the dimi- 
nution of this vital power, the more danger of its 
total extinction, by the encroachments of mortifi- 
cation. Example.—Bind a ligature round any 
organ and stop the circulation in it, and it imme- 
diately. mortifies or dies: yet Dr. Dewees advises 
us to diminish the circulation in an organ “to 
prevent ulceration” or mortification! The bleed- 
ing and purging check vital action, and prevent it 
from pervading the affected organ; of course it 
checks the warfare for the time, between the con- 
servative power of life, and the chemical power of 
decomposition. If, then, decomposition docs not 
soon take place, in every instance, it must bo, be- 
cause the conservative power is not, as in the case 
of the ligature, entirely destroyed, but is continu- 
ally rallying its forces and trying to repel the en- 
croachments of chemical decomposition, or, in 
other words, of mortification. 
To either prevent or cure these affections, it is 
evident, from reason as well as the facts that tho 
regular plan renders them “incurable,” while the 
Botanic Practice either prevents or cures them, 
that the “ends” above, are the true causes of 
death instead of life to the part, and, therefore, are 
cot the true ends to be accomplished. 
What then, are the true ends to be accomplish- 
ed! Evidently to relax the strictures, and re- 191 
move the obstructions which disturb or repel vital 
action. This will equalize the circulation of the 
blood, when it will be found that there will be no 
necessity for “diminishing its quantity.” The 
arterial action” is always sufficiently “abated,” 
when the circulation of the blood is free and uni- 
versal, and the absorbents, secernants and excern- 
ants are in good order. Therefore, we, Botanies, 
reverse all the Doctor’s prescriptions. Instead of 
withdrawing vital action from the part we fear 
will “ulcerate,” we stimulate it directly to the 
performance of its duty; instead of “diminishing 
the quantity” of the vital fluid, we promote its 
equal and universal diffusion; instead of removing 
the organ to get rid of the obstructions that hinder 
the due performance of its functions, we remove 
the obstructions to save the organ. For the plan 
and process proper in the case, see “Ways and 
Means.” 
Irritability of the Uterus.—Doct. DeweeR 
classes this property among diseases. 1 should 
be glad to be told the use of a uterus that is not 
“irritable.” It surely could never perform any 
of its proper functions. But Dr. Gooch calls it “a 
painful and tender state of the uterus,” something 
rather more intelligible. Dr. D. says, “Thegen- 
eral symptoms are, an increased frequency and a 
preternatural firmness of the pulse;” that it “is al- 
ways more frequent and corded than usual.” But 
Dr. G. says, “The pulse is soft und not much 
quicker than natural”—a direct contradiction, but 
that is a small affair among doctors. Dr. D. adds, 
“headache, pale and white tongue, dry skin, irri- 
table stomach, scanty and high colored or pale 
and abundant urine.” 
Now, we ask, if the above symptoms are pecu- 
liar to the uterus, why are they as common to 192 
males as to females'? If not peculiar, of what use 
are they, but to perplex the practitioner and lead 
to an erroneous course of practice? The Doctor 
then gives the local, symptomatic descriptions; af- 
ter which he quotes those of Drs. Gooch and Addi- 
son, and says, “to be convinced that these gentle- 
men have added many symptoms that do not belong 
to this affection, it will only be necessary to com- 
pare their descriptions” with his! Very modest, 
indeed. lie goes on through twelve octavo pages, 
reporting the opinions of various authors, coming, 
as usual, at last to no conclusion for himself, 
though fully establishing, in the mind of every re- 
flecting reader, the declaration of his worthy col- 
league, Dr. Chapman, (Therapeutics, vol. l,page 
23,) “To harmonize the contrarieties of medical 
doctrines is, indeed, a task as impracticable as to 
arrange the fleeting vapors around us, or to recon- 
cile the fixed and repulsive antipathies of na- 
ture.” 
Having fully established the certainty of “the 
highest degree of uncertainty” in the knowledge 
of “the faculty” in regard to the nature and symp- 
toms of this form ofdisease, Dr. Dewees commen- 
ces an exposition of the regular treatment; (“The 
remote and predisposing causes are involved in 
great obscurity;”) and then, (notwithstanding the 
regular hue and cry against the Thomsonian fra- 
ternity for treating all forms ofdisease on the same 
plan and with the same general remedies,) we have 
the same old tune of “bleeding, purging, blister- 
ing and rubefacients, narcotics, injections of ni- 
trate of silver, opium, sugar of lead &c., starving 
and rest. But mark, it is by no means certain that 
this course of treatment will do any other good than 
make a long doctor’s bill: for he says, (page 326,) 
“From the length of time required to overcome 193 
the disease, and the privations to which the wo- 
man must submit who looks forward to its cure, 
patience becomes exhausted, and confidence in the 
efficacy of remedies is too quickly destroyed; for 
relief is not only almost always tardy, but is too 
often uncertain; ** for, however judiciously rem- 
edies may be advised, or however faithfully they 
maybe applied, they are far from being speedy and 
uniform in their effects. This is the declaration 
of the several authorities before us, and but too 
certainly confirmed by our own experience ; 
months, nay years are sometimes required to ac- 
complish a cure; and, if it be effected even after a 
very long trial of means, the woman may felicitate 
herself that she has been able to procure health 
even at so great a price.” 
The Doctor gives us three cases which he treat- 
ed; the first was so far relieved as to enjoy “a 
very comfortable state of health,” the second “was 
entirely restored in seven months,” the third “was 
relieved in about five months;” she, however, did 
not “persevere three or four months longer” under 
the “reasonable expectation that it [the plan] 
would have proved still more beneficial.” Hut, 
“notwithstanding the success that attended the 
cases just related, [only one was cured, and that 
after having suffered seven months,] as well as 
many more that we could mention, it is but fair to 
acknowledge that there have been others in which 
no such benefit was received, though remedies, 
generally speaking, were faithfully used, and eve- 
ry reasonable precaution taken to ensure suc- 
cess.”—Page 336. 
I have copied thus extensively from Dr. De- 
wees, for three reasons; 1st, because he says, 
(page 327,) he has “detailed all that experience 
haB hitherto suggested for its relief;” 2nd, be- 194 
cause, being “Professor of Midwifery in the Uni- 
versity of Pennsylvania,” he is a standard author- 
ity in the United States; and 3d, because, by so 
doing, I fully redeem my pledge given in the first 
number, to prove that if, in the use of the Botanic 
Practice, there should be, in any case, the fear of a 
failure of success, a resort to the regular, would 
almost certainly ensure wreck and misery to the 
constitution, and loss of health and happiness, if 
not even lifeitselfto the patient. 
But, must I leave this subject of “irritable ute- 
rus,” as I find it in the hand of Dr. Dewees'? I 
hope not. I enquire then, What is “irritable 
uterus?” Answer, such a complication of local 
or general affections, that “the faculty,” as we 
have seen, can neither tell what it is, what is its 
cause, nor how it should be treated. What are its 
symptoms? Answer, “Inflammation,” to be sure, 
and “great tenderness in the first stages,” with 
“danger of suppuration &c.” Now, what is the 
cause of inflammation? Answer, it is the accumu- 
lation of vital action. But vital action cannot be 
accumulated, where there are no obstructions to 
the free operations of vitality. Therefore, ob- 
structions are the cause of this disease as well as 
every other. 
What then is the proper treatment? I answer, 
relax the parts constricted, remove obstructions 
from the vessels that are clogged, and restore a 
healthy action to the organs. 
But how shall we know, any better than the M. 
Ds, amidst the multitude of conflicting symptoms, 
what particular organs are diseased? 
Answer. Here it is that we have the advan- 
tage of them. We commence with general reme- 
dies, means that are calculated to remove obstruc- 
tions wherever found, and which cannot, like their 195 
specifics, do mischief where we do not intend they 
shall operate. A repetition or continuance of this 
course, by removing, one after another, the differ- 
ent causes of the various symptoms, soon redu- 
ces them to so few in number, and confines them 
to such narrow limits, as to leave no doubt what 
is the organ primarily diseased, what is the nature 
of its affection, or the proper local treatment. As 
fast as we thus determine the seat and character 
of the affection, just so fast we apply the proper 
modes and means of removing the obstructions to a 
healthy action of the organ, and thus our patient is 
soon restored, in all cases where the vitality ofthe 
organ is not extinct. For the proper mode of do- 
ing this, see ‘‘Ways and Means.” I add only in 
this place, that the practitioner is to remember, 
in all cases of disease within the pelvis, that the 
vapor bath, confined below the waist, and injec- 
tions of the required character to the part affected, 
are powerful means of removing obstructions and 
promoting healthy action; that nothing is equal to 
a poultice of lobelia and slippery elm, for relaxing 
“inflamed surfaces” and removing the causes of 
their “tenderness;” and that few things are easier 
in practice than to fill the vagina, and of course, 
surround the cervix uteri, with such a poultice. 
It cannot do the least harm, may be confined at 
pleasure with “a cloth,” and easily washed out 
with a syringe as often as it is proper to renew it, 
which should always be as often at most as every 
twelve hours. After all the “inflammation and 
tenderness” are removed, the injections should 
contain the astringency of witch hazle, and the 
stimulus of cayenne or ginger enough to be felt. 
The above is a course which, in its essential 
features, I have actually pursued with complete 
success, without being compelled to acknowledge, with the learned Dr. D., the intervention of a multi- 
tude of failures. Similar advice also, sent in pri- 
vate letters to individuals, has been attended with 
similar results. In fine, I remark that a judicious 
and faithful practice will not require “some 
months” to exhibit evidences of its utility, or to 
afford “reasonable expectation” of final success. 
LECTURE 12. 
Hemorrhage of the Uterus.—I have alrea- 
dy given a sufficient account of the causes and na- 
ture of this form ofdisease, with directions for its 
treatment, which, if followed fearlessly and faith- 
fully, will be found amply sufficient for its man- 
agement. But the evil consequences of the great 
terror which it generally carries to the heart of 
the patient and her friends, have induced me to 
add, here, a few remarks which prove that nearly 
all the causes of alarm are to be found in the bad 
management of the regulars, from which, if she ab- 
stain, she shall do well. 
Of the connexion of the ovum with the foetus, 
Dr. Dewees says, “Soon after the ovum is depo- 
sited in the uterus, its external covering, or cho- 
rion, shoots out innumerable vascular fibres, and, 
on the internal face of the wumb, is produced a soft, 
spongy, vascular substance, called decidua; these, 
when connected, serve as the bond of union between 
the ovum and the uterus. These minute vessels in- 
terlock with each other, after a certain period, so 
firmly that they cannot be well separated without 
rupture. Therefore, should a portion of the ovum 
be detached, in the earlier months, the quantity 
of blood that will issue, will be commensurate 197 
with the surface, especially if it be from the fun- 
dus, and proportioned to the advancement of preg- 
nancy.” (Condensed from pages 33G—7. Dr. D. 
must pardon this liberty here and elsewhere. I 
have not patience to copy liis unmeaning verbiage, 
nor any disposition for mere book-making.) 
It is agreed by all, that the separation of some 
part of this connexion is the principal, if not the 
sole cause of hemorrhage during pregnancy.— 
Whatever can produce this separation, as mechan- 
ical violence, unequal circulation and disease in 
any form, should be carefully avoided. 
Doctors enumerate plethora among the causes 
of the separation, and hence they direct bleeding 
as the remedy. But their error lies in mistaking 
inequality of circulation or local congestion, for 
excess of fluids, on this mistake they build the 
practice of drawing entirely out of the body, that 
blood which they ought rather to invite to places 
where it is deficient, as the true mode of relieving 
the system from danger. Dr. Dewees thinks that 
abortion is generally produced directly by the con- 
tractions of the uterus, whatever be the remote 
causes of those contractions. I think so too. Dr. 
Burns thinks it impossible to prevent them after 
they commence, and of no use to try. Dr. D. doubts 
this position, and thinks he ought to try in every 
case, though he should succeed in only one in 
twenty! In only one case does he “never inter- 
fere,” that is, where the breasts have become tu- 
mid, and then pretty suddenly subside”—“The 
only symptoms that mark the death of the ovum, 
with a certainty that has stood the test of expe- 
rience ever since the days of Hippocrates.” The 
Doctor says he “must confess that he has known 
the ovum to be expelled where this 6ign of death 
was wanting,” yet he believes the expulsion was 198 
owing to “the indomitable nature of the contrac- 
tions of the uterus.” He too thinks, that the con- 
tractions may be prevented after they commence; 
for he brings cases of the expulsion of one foetus 
prematurely while the other of the same gestation 
remained to maturity. Therefore, he concludes 
that the contractions may be prevented and the 
hemorrhage stopped, though it be but of one casein 
twenty. The ways and means by which he at- 
tempts to prevent these contractions, will suffi- 
ciently explain the reason why he is so unsuc- 
cessful. 
Among the first steps in his curative process, is 
the use ot “ice water &c.” “No stimulating sub- 
stance of any kind should be permitted. All 
changing of clothes, “puttingthe bed to rights, or 
altering her position should be strictly forbidden.” 
This done, if plethora present, “blood should be 
taken from the arm, in a quantity proportionate to 
the arterial system; remembering that we do lit- 
tle or no good by the operation, if we do not de- 
cidedly diminish the force of its action.”—Page 
347. 1 ake an example of the manner in which 
the Doctor treats these cases. 
“In 1 / 96, Mrs. 11. was much exhausted with ute- 
rine hemorrhage, in the 4th month of gestation. 
I'.arly on the lbth of January, the usual means 
were employed; and, for the time, the discharge 
was arrested. At 5 P. M. it returned and was 
soon flowing very rapidly. There being a high 
arterial action, she was instantly bled from the 
arm until there was a reduction of the force and 
frequency of the pulse: the abdomen was covered 
with ice and snow. 4 here was an abatement in 
the discharge, followed by slight alternate pains 
in the back, shooting towards the pubis. Forty- 
five drops of laudanum were now given; and strict 199 
injunctions left, that the patient should be kept as 
quiet as possible. On the morning' of the 19th the 
patient was free from fever, and almost free from 
discharge. About 5 I*. M. the whole scene, as 
described before, was renewed; she was again 
bled; ice was applied and laudanum repeated. On 
the 18th at 8 A. M. she had a return of fever with 
hemorrhage; she was again bled &c. In this man- 
ner did matters proceed for several days; when it 
was observed that the arterial exacerbations ob- 
served no regular periods; but that the floodings 
were uniformly continued during the excitement. 
To interrupt this recurrence, I placed a young 
gentleman at the patient’s bedside, with orders to 
bleed her the moment he perceived an increase of 
pulse; this was done; and, from each bleeding de- 
cided advantage was discovered. The loss of five 
or six ounces of blood, was sure to stop the uterine 
discharge in a few minutes; and sometimes even to 
prevent its appearance. Proceeding in this man- 
ner till the 23d, entirely relieved the patient from 
this distressing complaint. She was bled seven- 
teen times, and lost, by computation, one hundred 
and ten ounces of blood in the course of seven days.'' 
Page 348. 
Had I not known some cases that were treated 
in the same manner, I could scarcely believe that 
any man could be so cruel; and did I not know the 
strong tendency of the living power to maintain 
the possession of its citadel, I could not rea- 
dily believe the Doctor’s additional remark that 
the patient “gradually gathered strength, and was 
safely delivered at the proper time.” Having 
known so many to be delivered by this kind of 
treatment, of their own lives, instead of living 
children, I must regard this, as Dr. Mackintosh 
says, as rather a miraculous escape from a des- 200 
tructive medical practice, than a cure of hemor- 
rhage. 
But the Doctor is not yet done with the course— 
hear him through:— 
“The acetate of lead should now be given, [that 
is, after the reduction of the pulse by bleeding,] in 
doses and frequency proportionate to the extent of 
the discharge. From two to three grains, qualifi- 
ed with opium, must be given every half hour, or 
less frequently, as circumstances may direct; per 
anum, in case the stomach be irritable. Twenty 
or thirty grains may be dissolved in a gill of wa- 
ter, to this must be added a drachm of laudanum 
and this be repeated, pro re nata, (in caseofeiner- 
gency,)&c. If pain attend, opium should be giv- 
en until a decided impression be made upon the 
uterine contractions; or till it appears to be totally 
unavailing. Should the discharge be profuse, a 
large bladder two-thirds filled with ice and wa ter, 
should be applied to the pubes, and a tampon 
[sponge] should be introduced without delay”— 
page 348. 
But, fair reader, severe as this practice appears, 
we are told, “thedischarge from the uterus, when 
very profuse, will not always yield to these reme- 
dies.” What a story! Has the doctor so little 
sense as to suppose that blood can still flow from 
the uterus after it has been all drawn out of the 
body through the veins! 
This is “scientific practice” with a vengeance. 
A person takes cold, the vitality ofcertain organs 
is diminished, the circulation is deranged, con- 
gestion takes place, a fever rises, delicate and dis- 
tended vessels are ruptured and hemorrhage oc- 
curs. To cure it, the cold is increased, and of 
course the congestion, the vitality of the organs is 
still further diminished by the poisons, sugar of 201 
lead and opium; the blood already flowing with 
dangerous rapidity, is made to flow still faster, by 
opening other vessels, till there is not enough in 
the system to flow at all! If now, one patient in 
twenty survive this murderous practice, it is con- 
sidered sufficient to sanction it on nineteen others 
whom it kills.—See Fein., page 340. 
Suppose the hemorrhage were left undisturbed, 
could it continue after all tlie fluid was exhausted! 
Hut, says the regular practice,‘‘taking itfrom an- 
other quarter diverts it from the uterus, and the 
application of cold to that organ contracts the rup- 
tured vessels, and then they have time to heal.” 
If this be the case only once in twenty, under that 
practice, it can be easily proved that death by 
flooding, where this practice is not used, does not 
occur in one case in twenty! The chance is there- 
fore forty to one in favor of having no interference 
at all, rather than the regular practice. 
Let me not he understood to attribute to Dr. 
Dewees any bid motive for prescribing such a 
course. 1 believe that he is a humane man, as 
ready, at least as myself, to relieve the sufferings 
of the distressed. My warfare is against the er- 
rorsof his head, not h heart. 
Will the reader now believe that I have taken 
such a case as l)r. D. describes, given a strong 
dose of cayenne &c., put her directly over the 
vapor while flooding, continued the stimulants, 
raised the heat of the bath to a hundred and twen- 
ty degrees, (by which I stopped the hemorrhage 
in fifteen minutes ) washed off, rubbed dry, gave 
an emetic, witch hazle injections, with cayenne, 
and followed with restoratives, and the next day 
repeated the course, and thus cured a patient in 
whose case the most of Dr. D’s prescriptions had 
been followed for several weeks before, with no 202 
other effect than to aggravate the fever and the 
hemorrhage! Never since I commenced practice 
on this plan, have I failed completely to subdue a 
uterine hemorrhage in less than one hour, whate- 
ver were the cause of the discharge or the condi- 
tion of the patient. Those who wish ocular de- 
monstration of the sovereign power of this plan, 
have only faithfully to try it in similar cases. 
True the regulars cry, “not a particle of stimulus 
should be used,” but what should this weigh 
against our own positive experience! 
But, does the propriety of our practice rest sole- 
ly on the mere fact that some have been so treated 
and escaped death! By no means;—this fact is 
the principal if not the only evidence on which 
rests the practice I have just condemned in Dr. D. 
The regular course is justly condemned because all 
the means used are calculated to destroy the life 
of the most healthy. In the first place, the patient 
is bled to death to prevent her from bleeding to 
death; then she is treated with snow and ice to 
cure her cold; now it is expected that opium and 
sugar of lead which all admit are calculated to 
“suddenly and rapidly extinguish a great propor- 
tion ofthe vitality of the system,” will give to tho 
minute vessels lacerated, the vital power to con- 
tract their walls and join their edges! Can more 
direct paradoxes be found in language, or more 
consummate folly be pronounced philosophy! 
But what is the philosophy of our plan! Ansr. 
The patient caught cold, which caused collapse of 
the extreme and external vessels, and congestion 
in the larger and deeper seated. The uterus par- 
ticipating in the general spasm, contracts and thus 
separates itself, in part at least, from the placen- 
ta, if one exist; or, if none exist, the minute ves- 
sels are ruptured by the pressure. Our practice 203 
reverses all these unnatural conditions. We warm 
and relax the surface and let out the cold fluids, 
the extreme and the superficial vessels being thus 
expanded, their enlarged capacity invites back 
the blood from the places of congestion, on the 
principle of hydrostatic balance. Then the stim- 
ulants and astringents, increase instead of “dimin- 
ishing” the vitality of the injured parts, and ena- 
ble them to contract and soon to knit again; and 
this is often done without the smallest injury to 
the uterus or the ovum. 
The generality of mankind seem not to be aware 
that the blood, in all parts of the body, has imme- 
diate access by pores, to some internal or external 
surface; that the healthy tone or contraction of 
these pores is more than equal to the pressure of 
the blood in its efforts to escape through them and 
seek its gravitating level; that all hemorrhages by 
rupture, niu.-t of course arise from excessive con- 
tractions in some parts and congestions in others, 
and must therefore be cured by restoring the equi- 
librium. Let the public meditate a 6hort time on 
this manifest truth, and they will not much longer 
suffer a fever to be discharged or a hemorrhage 
suppressed, by reducing the quantity of the blood, 
and destroying the vitality of the organs, instead 
of equalizing the circulation and aiding the cura- 
tive process. 
I must be excused for a seeming wantonness in 
opposing the practice of Dr. Dewees, against 
whose character as a well meaning philanthropist, 
I bring not the slightest accusation. It is because, 
being Professor of Midwifery in the University of 
Pennsylvania, his work is at the head of authori- 
ties for all the regular physicians in the United 
States. “If, therefore, the light he gives be dark- 
ness, how great is that darkness!” and how im- 204 
portant that it should be dispersed by the light of 
true medical science! 
It is proper, however, to admit that there may 
be, though it very rarely happens, a case of flood- 
ing which is not so easily subdued. It is that in 
which the placenta is attached directly over the 
neck of the uterus. In this case, it would seem 
that hemorrhage must take place duringthe latter 
months of pregnancy, when the neck of the uterus 
commences its expansions, but this conclusion is 
not inevitable, for the placenta may expand in 
its centre to accommodate itself to the emergency, 
or the rupture may be of such a nature as not to 
expose many large vessels. Hut, suppose the worst, 
the management I have directed will, in all pro- 
bability save the mother, even though the foetus 
be prematurely expelled. 
Nothing can be more diverse than the opinions 
of different Professors of Midwifery, on the propri- 
ety of meddling or not meddling mechanically in 
flooding cases. Some advise measures for the 
immediate expulsion of the ovum, and yet dread 
the hemorrhage that will probably ensue from the 
relaxed state of the vessels of the uterus; while 
others object to the abortion on account of the dif- 
ficulty of removing the young and advesive pla- 
centa. 
I remark, first, that, if we treat the patient aright, 
that is, according to nature, with means and pro- 
cesses in harmony with her operations, either the 
placenta will be disengaged by uterine contrac- 
tions, and it and the foetus will rome away to- 
gether, or else it will strongly adhere to the ute- 
rus; in which case, as the tone of the uterus is res- 
tored, the hemorrhage must cease. ‘‘Hands off,” 
then, (in all those cases where the foetus may not 
be arrested in full growth, by wrong position) 205 
ought to be the inviolable motto. If authority were 
of any use to us who have absolved ourselves from 
all allegiance to what is generally called authori- 
ty, Dr. Devvees and many of his brethren would 
fully sustain us here. “That the most mischiev- 
ous consequences have followed the practice of 
those who forced the hand into the uterus and im- 
mediately effected delivery, we have the authority 
of Pasta who deprecates the practice as both cruel 
and dangerous; of Kok w’ho who says he has seen 
it followed by inflammation of the womb; of Le- 
roux who declares it to be dangerous to both mo- 
ther and child; of Baudelocque who insists that 
nothing can justify the accoucher who persists to 
deliver while the neck of the uterus retains its 
natural thickness and firmness, and I may add my 
own experience, as I once witnessed death as the 
consequence of this proceeding.”—On Females, 
pages 1350—7. 
After this testimony against violence, Dr. D, 
recommends plugging the vagina closely with 
sponge, which could do no harm; (but. would be un- 
necessary in our treatment.) and lastly, delivers 
by force, (arte non vi, says Blundell,) though with 
little expectation of saving the patient’s life. To 
this last, I say no—let the patient die if need be, 
but not by my violence. Let me not do to save 
life, what is of itself sufficient generally to de- 
stroy it. 
Some suppose opium to be good to stop hemor- 
rhage. Dr. 1). says, he “has not recommended it, 
simply because it has never merited the smallest 
commendation in his hands, nor does he believe 
that it deserves the encomiums which have been 
so lavishly bestowed upon it by others.” So agree 
Denman and Barlow. He also condemns the cold, 
(except merely enough to abate local influmma- 206 
tion and act as a uterine astringent,) and says, “it 
has acquired so much popularity among the vul- 
gar [who but the Doctors gave it that popularity'!] 
as to render it unsafe for the practitioner who has 
omitted it in his treatment ofthis complaint. [Do 
they still retain their popularity!] “The inject- 
ing of cold water, cold alum water, the solution of 
acetate of lead, the introduction of ice into the 
vagina, and even into the uterus, have been prac- 
tised; and, it is said, with advantage. The mer- 
its of such applications must rest on the authority 
of those who recommend them. I have no expe- 
rience in either of them.”—Page 300. 
I have devoted a large space to the subject of 
hemorrhage or flooding, because no affection of 
the female system excites so much alarm, and be- 
cause it is generally aggravated if not most fre- 
quently induced by what is called “scientific 
practice.” I finish the whole with this direction— 
Equalize the circulation, use astringent but not 
cold injections to the vagina, remove morbific 
matter from the stomach &c., keep the action of 
the system up, and the extremities warm. For 
the plan of doing it, see “Ways and Means.” 
LECTURE 13. 
Inflammation of the Uterus.—This is another 
of the forms of disease which, produced as it gene- 
rally is, by violent artificial means to hasten or 
facilitate delivery, and aggravated as it is by mal- 
treatment, often becomes a terror if not destruc- 
tion to the sufferer, and a disgrace to the practi- 
tioner and his science. In reality, however, it is 
an affection little to be dreaded when the proper 207 
means of prevention and cure are seasonably and 
faithfully applied. 
1. When no “instruments nor rude hands” are 
used in delivery, inflammation of the parts will 
seldom occur. 2. Where care has been taken to 
keep the pelvic region warm and relaxed, by 
clothes, fomentations, the direct application and 
the taking of lobelia &c., it will occur still less 
frequently—and, 3. Wherever it occurs, and from 
whatever cause, a thorough course or two, added 
to the above local applications, will soon remove 
it. Constantly warm, moist, and slightly stimu- 
lating applications, are sure to reduce inflamma- 
tion and remove soreness, wherever seated. The 
divisions of the symptoms, by authors, rest upon no 
foundation that requires any variation in our plan 
or remedies, nor in fact do they much affect the 
“regular treatment” which is uniformly, “bleed- 
ing, purging, blisters, opium, &c.; with now and 
then an incidental prescription of fomentations, 
sudorifics and the like. In proof of the above I 
need only state that, among the causes, I)r. De- 
wees mentions four grand divisions, the principal 
of which are, 2nd. “Violences committed in the 
use of instruments of any kind, injuries sustained 
in the act of turning, or ill-directed manoeuvres 
executed on the neck of the uterus, in attempting 
its dilatation,or too frequent handling.” 3d. “Le- 
sions of the internal face of this organ from a sud- 
den, rude and unnecessary interference in the sep- 
aration of the placenta,” &cc.—Fern., page 260. 
Hence, if ladies are anxious for an attack of this 
formidable affection, which carries multitudes of 
them to the grave, they have only to call a regu- 
lar doctor, who, to show his superior skill, will 
first bleed them: this will so reduce their power to 
deliver themselves, that “the action of the forceps” 208 
will be “indicated.” Then, according to the above 
statement, the “injuries sustained” will secure 
inflammation of the uterus. Now, for “the hairot 
the dog that bit you,” viz. “bleeding,” to cure 
this affection of which it was, itself, the remote 
cause! 
As to ths other causes, “the rigidity of the soft 
parts, caused by colds, the violent action of the 
uterus &c., we know that these may be easily ob- 
viated by fomentations, vapor, lobelia and cay- 
enne. The more local and definite the symptoms, 
of course the more attention must be paid to local 
warmth, moisture, fomentations and injections. 
The locality of the pains and soreness, w;.ll distin- 
guish inflammation from the general fever, com- 
monly called puerperal, and indicate all the neces- 
sary difference in the treatment. This affection, 
like most others, if allowed to progress, will soon 
involve the whole constitution in the suffering, and 
give rise to a great number and variety of symp- 
toms which it is unnecessary to detail; first, be- 
cause they are not, in any two cases, in all re- 
spects exactly similar, and secondly, because a 
judicious general treatment is the only cure for 
them. 
Puerperal Fever.—“This species of fever,” 
says the Edinburgh Practice, “is usually the most 
fatal of all the disorders to which the sex is liable. 
But, notwithstanding its prevalence in all ages, its 
real nature has remained to the present time a 
subject of dispute and uncertainty. Some writers 
have considered it as proceeding entirely from in- 
flammation of the uterus, others from an obstruc- 
tion to the secretion of the milk, and still more 
from a suppression of the lochia. Perhaps it is 
not the necessary consequence of any of the causes 
above mentioned.”—Page 542. 209 
“It generally occurs within forty-eight hours 
after delivery, though it may occur many days 
later.”—lb. 
A minute description is unnecessary here, for 
we, Botanies, consider it (as we do all other fe- 
vers) an indication of the presence of obstructions, 
which must be removed. The only reason why I 
need give particular directions about it is, that la- 
dies are so generally deterred from a proper course 
of treatment, by the fear of the awful consequen- 
ces, popularly supposed to be necessary to any con- 
siderable disturbance of bodily repose, so soon af- 
ter parturition. Nothing, however, is so good for 
it, as a thorough course of medicine, (see page 
120,) giving a good vapor bath both before and af- 
ter the emetic, and an enema or more before the 
first bath. Keep up the action of the system and 
the warmth of the extremities, (see page 125,) 
and repeat the course if necessary. This fever fre- 
quently indicates not only an obstructed perspira- 
tion, but the presence of much morbific matter, 
both in the stomach and bowels, and is attended 
with an irritability which is calculated, unless it 
be speedily arrested, to carry off the dejections so 
fast as to overcome the tendency to the surface 
and draw the determining powers inward, as in 
cholera morbus. Hence, it is important to give 
the course promptly, to keep up the action of the 
system steadily witli cayenne, and to soothe the 
stomach and bowels with mucilaginous substances 
as soon as the cold, tough phlegm and the bilious 
or putrescent matter are discharged. 
Among the immediate causes enumerated by au- 
thors, “are the stoppage of perspiration, neglect 
to procure stools after delivery, and too hasty sep- 
aration of the placenta.”—(Ed. Practice, p. 545.) 
As the cure is often “gradually effected by spon- 210 
taneons vomiting, or by a long continued discharge 
by stool, of that oorraceous matter, the existence 
of which in the stomach is usually evinced at the 
first attack of t he disease, the most unfavorable 
prognostic arises from such a weakness of the pa- 
tient as renders her unable to support so ted ious an 
evacuation as that by which the disease is over- 
come.”—Page 544. 
Hence, it is evident that an emetic in the onset 
will clear the stomach, and check the formation or 
supply of “porraceous matter,” while the cayenne 
will inaintuir the determination to the surface, 
and prevent all the dangerof sinking; and the reg- 
ular action of the bowels, procured by injections, 
will prevent the accumulation there. So much for 
the cure of this puerperal fever, caused by ob- 
structed perspiration, “the action of the forceps, or 
injudicious handling, either in removing the child 
or the placenta;” or by “porraceous matter” ac- 
cumulated in the stomach and bowels. In no 
case of labor that I have attended, has this fever 
presented any alarming symptoms, nor have I 
ever heard of a death from it under the adminis- 
tration of the true Botanic practice. 
After an elaborate essay on Puerperal Fever, 
its causes &c.. Dr. Dewees remarks, (page 387,) 
“From all this, it would appear that the subject is 
still open for enquiry; and we would earnestly re- 
commend it to those whose practice will furnish 
them with opportunities, to enquire into the fact, 
and endeavor to discover the c «use why a tedious 
and protracted labor should beany way instrumen- 
tal in diminishing the liability to puerperal fe- 
ver. For we may well ask how it is that long suf- 
fering, and, very certainly, lesion of some kind, 
and to various extents, should diminish the pre- 
disposition to this disease, or abate the force of ex- 
citing causes!” 211 
We answer the Doctor, that even our little ob- 
servation on fevers in general, (we have seen only 
slight symptoms of this in particular) affords us an 
answer to his queries, as clear as the noon-day, 
and as easily and certainly demonstrable, as any 
conclusion drawn from the principles of other phy- 
sical sciences. Will he give it a candid consider- 
ation] It is this: All the reason why medical 
men have not ascertained the reason of this medi- 
cal fact long ago, is, they have made all their ob- 
servations and conducted all their arguments un- 
der THE GUIDANCE OF THE FALSE PRINCIPLE Til AT 
fever is disease! Let them just abandon this 
error, and all their difficulties will at once vanish. 
Let them receive the truth that fever is an extra 
effort of the system to remove obstructions to or- 
dinary and proper action; and it will follow of 
course that the more vigor in the system, the 
more likely it will be to show irritation from ob- 
structions; and that the lower the power of the 
system is reduced by “a tedious and protract- 
ed labor,” the less nble it will he to make 
any sudden and powerful effort against obstruc- 
tions. The system, under these circumstances, 
must rise by slow and almost imperceptible de- 
grees, and such also must be the removal of the 
obstructions if they are ever removed at all! More: 
The reason why bleeding ever reduces this or any 
other fever, is not because it diminishes, in the 
smallest degree, either the disease or the cause of 
the disease; but because it. acts like a tedious labor, 
in checking if not destroying the power of the sys- 
tem to war against disease. On the truth ofthese 
propositions, we are willing to stake our medical 
reputation—disprove them by demonstration, and 
we will never write another line against the 
regular theories of fover, or the modes of treat- 212 
ing it, nor will we for any consideration, give a 
grain of cayenne to any sick patient who is so for- 
tunate as to be too low to “have a fever.’’ 
But, dear sir, we have so much faith in your 
benevolence that, could you visit with us, a pa- 
tient suffering under the influence of the form of 
disease which, from your experience in treating 
it, you have so much reason to dread, and see us 
remove all the alarming symptoms in an hour or 
two, without doing the slighest injury to the pa- 
tient, we are confident that you would be the first 
man to commit to the flames, all your recommend- 
ations of the lancet and of leeches in the caso. 
Yes, sooner would you cut off your right hand 
than allow your book to continue a standing au- 
thority for shedding rivers of the vital fluid from 
the frail, fair and will-be happy daughters of our 
country, when physicians shall have learned to 
relieve their special sufferings. I am aware that 
you have quoted Dr. Armstrong to prove that “the 
6tinnilant treatment is at once the most delusive 
and dangerous that can be adopted,” and have 
stated that Dr. Denman, though once an advocate 
ofthe stimulating treatment,” finally “renounc- 
ed it with much magnanimity, and a candor which 
all must admire, though few may imitate it;” 
page 4*25; and I am as ready as you to admit, page 
426, that “it is a great error to suppose that, when 
a case will not bear depletion with profit, it then 
absolutely requires the opposite treatment.”— 
Though I believe that no disease is ever removed 
or organ cured without stimuli, either natural or 
artificial; yet I am far from supposing that the sys- 
tem always needs the latter. It was this suppo- 
sition and a correspondent practice, that discou- 
raged Dr. Denman, and made him abandon the 
whole plan ; whereas, if he had been satisfied 213 
with the natural action of the system when suffi- 
ciently strong, and directed his attention, with 
proper means, to the aid oftliat action in disengag- 
ing the morbific materials which disturbed or dis- 
placed it, he would have had the pleasure of see- 
ing liis patients recover rapidly and almost uni- 
versally. The failures of the stimulating treat- 
ment were not then nor are they now, att ributable 
to error in principle, but to injudicious means and 
modes; while the “esraprs” from the depleting 
system are to be ascribed, not to any virtues of 
that system, (for its whole tendency is to the de- 
struction of life,) but to the power of life, the vis 
vitie, often to overcome the attacks of both dis- 
ease and a destructive treatment: for no man will 
dispute that depletion, carried out, will universal- 
ly destroy life; while all sound medical men agree 
that nature alone cures, either by her own power 
(stimulus) or sometimes by the aid of artificial ir- 
ritants. The question then is, not whether the 
stimulating treat ment is the correct one; that ia 
immovably settled; but by what means and in what 
way, and to what extent it shall be applied! And 
the answer to this question is simple, viz. When 
the living action is altogether too low, raise it; 
when disturbed or displaced, remove the cause of 
the derangement; and when confined, remove the 
obstructions to its diffusion; and do all these by 
means and modes that experience has proved will 
do them, without injury to any of the organs. 
Such are the means and modes prescribed by the 
Botanic System, and success will almost univer- 
sally be the reward of their timely and judicious 
application. 
But you cite cases to condemn the stimulat- 
ing practice and commend the depleting. These 
cases are among the “false facts” of which Dr. 214 
Cullen said there were more than of false theories 
in medicine. Let us examine them. 
In order that you may understand my explana- 
tions of the cases, I must entreat you to adopt, 
as a key, while you read them, 
The principle that excessive or disturbed action 
or fever is vital, not morbific action, and always 
friendly to life and health, inasmuch as its object 
is to remove obstructions to healthy action. I 
know that this will be difficult for you, and per- 
haps you will tell me that Cullen and others be- 
lieved it long ago, but their practice did not prove 
it true. I answer, their practice did not prove it 
false; for. while they believed that the vis medica- 
trix ought to be aided in removing disease, they 
attempted to render the aid by means and process- 
es directly hostile to its action—they still gave 
poisons and depleted. Ilad they known the cha- 
racter and use ofthe Botanic remedies of the pre- 
sent day,.Dr. Dewees would not now have been 
an advocate of depletion. While, then, they were 
more correct in theory, they were less consistent 
in practice accordant with their theory; hence, 
physicians of the present day suppose that the 
science of medicine, as they teach it, has improved 
Bince the days of Cullen; whereas, in fact, the most 
important truth which was then believed, is now 
abandoned, while a deadly practice is retained. 
Consider then, fever as a friend, and the whole of 
the following explanations will be clear as the sun, 
and conclusive as mathematical demonstration. 
You say of the first case, that the stimulus of 
the ICth day “reduced the pulse” from 120, and 
made her better. Now you well know that no 
stimulus reduces the pulse, unless it promotes 
some confined secretion. In this case, though 
you do not say what, it was probably perspiration; 215 
for the previous involuntary discharge of urine is 
proof < f suppressed nerspiration, and the present 
correction of this discharge, is proof that the fluids 
found their way through the surface, as you men- 
tion no diarrhoea. (Jr else, as we suspect, the poi- 
son destroyed the energies of" the system, and thus 
checked the pulse and the urine without any se- 
cretion. On the 11th day, although the pulse was 
still 1( 6, the physicians gave more stimuli, which 
raised the pulse to 120, increased the*"**heat,” 
and so overcame the living energies by excessive 
action, that “the patient became gradually weak- 
er, her pulse was accelerated more and more, and 
her urine was again discharged involuntarily. 
She lived two days in great anxiety and restless- 
ness, and died” the 5th day of their practice. 
I'his death you attribute to the stimulating prac- 
tice, although you admit, page 426, that the first 
stimulus given was “exactly suited to the sys- 
tem!” and “happily achieved an improvement.” 
1 his case being one of “derangement” and 
“excitement” of some organs, proves that some 
other organs were deficient in the performance of 
their duty, and that the latter needed suitable 
stimuli to enable them to perform that duty, so 
that the former need not perform excessive duties; 
for we know that a free, universal and equal per- 
formance of all the functions, constitutes a state 
of health. In this case, the skin was closed and 
inactive, perhaps other secretions were obstruct- 
ed, and hence, that of the urine sustaining all the 
pressure of vitality, was inconsolable. The skin 
therefore demanded moisture to relax it, the stim- 
ulus of heat it already possessed. A cool, pleas- 
ant bath would have given vent to the accumulat- 
ed heat, and a free use of warm drinks, as soon as 
they were demanded, would have washed out the 216 
morbific obstructions that checked the perspira- 
tion; the fluids being diverted to the surface, 
would no li nger rush to the bladder, and now, a 
cleansing of the stomach with an emetic, and of 
the bowels by injections, and the administration 
of a few laxative bitters, and a little stimulus to 
excite tiie wearied organs, would have completed 
the cure. But no. The stimulators did not un- 
derstand their business. They failed to give the 
succor needed. 
True they relieved by injection the bowels of 
morbitic matter, which was right, as is proved by 
the fact that the system, thus relieved, directed a 
Etill stronger power to the contracted surface. 
This they erroneously considered making her 
worse, notwithstanding the increased effort of the 
system to relax the surface, raised the pulse to 132, 
and forced again an involuntary discharge of 
urine! Frightened at these effects, so contrary to 
their notions of “better,” the practitioners, in- 
stead of relaxing the surface and aiding the pulse 
to reduce itself, administered a deadly poison (sul- 
phuric ether) which, you all agree, “suddenly and 
rapidly diminished a great portion of the vitality of 
the system,” (Boston Medical and Surgical Jour- 
nal, vol. ix., page 43, and Hooper, on poisons,) 
without removing a part'de of the obstructions 
which excited that vitality. This reduces the 
pulse to 106, (I repeat, not by relieving it, but by 
destroying its power to act,) and this condition of 
the patient you all pronounce “better,” though, in 
fact, it was worse; for, while the obstacles to be 
overcome remained the same, the power to sur- 
mount them was diminished. Still it was not too 
late to save the patient, had they relieved the sur- 
face. But, they raised the action of the system, 
already, as you agree with me, high enough, and 217 
kept it up, not only till the organs became fa- 
tigued with excessive action, but till the morbific 
materials in the system which ought at first to have 
been removed, had accumulated a chemical power 
superior to the over fatigued and consequently de- 
bilitated vitality, and commenced the process of 
decomposition which of course soon terminated in 
death. 
Now, Doctor, T assure you, I have treated (on 
the stimulating plan) many such cases, and should 
think myself much to be censured if, my prescrip- 
tions being strictly followed, I should lose one in 
a hundred of them. As you will doubtless agree 
with me that no plan ought to be condemned for 
its mal administration, so you will agree (indeed 
you have virtually agreed) with me that the stim- 
ulating plan in this case was, “doing well,” 
“achieving happily,” so long as it was judicious- 
ly administered. 
The reason why the patient died, is, the stim- 
ulating was done internally instead of externally, 
and, at first, with a deadly poison, (see Toxicolo- 
gy, Art. Nitre,) instead of an innocent sudorific; 
and the stomach and bowels were left full of mor- 
bific matter, instead of being cleansed by lobelia, 
cayenne &c. 
Let us examine the second case, where you sup- 
pose that the depleting system was triumphantly 
sustained. 
“On the 10th day, the patient appeared very 
low, and her pulse was frequent and feeble. Her 
tongue was dry and brown, and her teeth were 
encrusted withsordes. Her head was yet affected 
with pain, but she made but little complaint of 
her body. It was, however, enlarged, and,though 
not very tender, was sensible to pressure. The 
symptoms of active inflammation having given 218 
place to those of a typhoid character, the purga- 
tives had been omitted, and the evacuations had 
consequently decreased. “I recommended,” says 
Mr. Hey, “such a repetition of the purgitive as 
might procure an evacuition about once in four 
hours, and a continuation of the saline mixture in 
a state of etfervescence. The strength of the pa- 
tient was supported by a light but nutritious diet, 
such as broths, jellies, chocolate and milk. This 
plan was regularly pursued for four days, when 
the patient was convalescent.” 
You seem to triumph in the success of the case, 
as though it had been treated on your depletive 
plan; but, in fact, it was treated on the stimulating 
plan, less injudiciously than the other, but not 
half so judiciously as it might and ought to have 
been. The bowels were full of morbific matter 
which was removed by dejections every four hours; 
(in the other case they were left undisturbed;) be- 
ing careful to support the system, by the stimulus 
of nutricious diet, such as broths, jellies, chocolate 
and milk, which are well calculated to promote 
also a tendency to the surface. The “saline mix- 
ture,” being about as stimulating as it was cooling, 
was of little importance any way, except to fur- 
nish fluid for the use of the system. This case 
had three important advantages over the other, 
which are, first, no deadly poison (nitre) was given 
in the commencement; 2nd, the morbific matter 
was removed from the alvine canal; fid, the sys- 
tem was supported by food instead of barks and 
wine. To these we may probably add a fourth, 
perspiration was doubtless produced by the 
draughts, broths &c., as nothing is said about the 
“pulse being 132,” or the “heat increasing” or 
the “urine being discharged involuntarily.” That, 
had she been more judiciously treated, she might 219 
have been cured sooner, I believe; or that, had she 
been treated as the other was, she might have died 
also, I am disposed to admit; but how it can be 
shown that she was treated on the depleting plan, 
and that her recovery justifies you and Dr. Clarke 
in abandoning stimulants and operating freely with 
the lancet and direct antiphlogistics, I cannot 
comprehend. The fact that many escape the dan- 
gers of extensive and deep-seated injuries, or of 
violent attacks of disease, by the mere recupera- 
tive efforts o nature, is proof enough of her power 
to resist injuries; but no reason why still greater 
injuries should be heaped with design to remove 
the former, on those who have been so unfortu- 
nate as to suffer some by accident. 
But you will ask, shall I not try a plan that has 
6aved more than this stimulating one, even though 
I know it to be sometimes injurious! I answer no, 
positively no. This principle of doing positive 
evil in the hope that good may come, has been the 
greatest hindrance that medical science ever 
had to encounter. What then shall I do, say you? 
I answer again, reject both practices, and, in the 
guidance of principles known to be correct, expe- 
riment with many means and in modes known to 
be innocent, till you hit a better plan. You well 
know that, to bleed as you direct, till no more 
blood will run, even when invited by warm water, 
and to physick till the bowels, overcome by the 
chemical agency of poisonous drugs, cease their 
action, and to destroy the sensibility of the nerves 
to pain, with opium, as others recommend, will 
greatly endanger, if not certainly destroy, the life 
of a well person, whatever it may do with the 
sick. Away then, with that practice in any form 
of disease, which loses every ninth patient, as did 
that you detail presently; or, if it loses every fif- 220 
tieth, search diligently for and promptly reject 
the deleterious article or process that causes the 
failure. 
On pages 430 and 432, you give comparisons of 
cases treated, some with and some without deple- 
tion, in which you show that the larger proportion 
of recoveries was of the former. Hence, you draw 
the conclusion that judicious depletion is always 
a proper course of treatment for the disease; where- 
as it only proves that it was, on the whole, less 
destructive in those cases, than the other. 
The truth is, that bleeding, being in its nature 
calculated to destroy life, can never be the proper 
means of restoring health, however much more de- 
structive some other course may be. The deaths 
of the patients treated without depletion, may 
have been, and doubtless were effected by giving 
poisons as stimulants, a plan more certainly de- 
structive than the rash and daring use of the lan- 
cet, can be. In some cases, failure might also 
follow an injudicious use of the proper stimulants. 
Does the fact that what you call depletion, which 
signifies a pretty severe evacuation of blood from 
the veins, and an excessive discharge of excretory 
matter from the bowels, was less destructive than 
the stimulation with poisons in the cases quoted; 
prove that the depletive plan is, in itself, either 
right, or preferable to the stimulating plan with 
proper means, properly applied? 
Had the stimulating plan been used with proper 
means and in a proper time and manner, it would 
probably have saved all those patients. At least, 
the Uotanic practice of the present day, whenever 
judiciously administered, fully sustains us in this 
belief. It is always wise to avoid that which is 
calculated, in itself, to destroy li'e, (as bleeding 
and poisoning,) and, if we must make experiments, 221 
to make them with means and in ways that can 
do no harm if no good. 
In the cases you report of those that had been 
depleted, out of eleven, three died; of thirty-three, 
three dued; of forty-three, five died; and of fifty, 
five died. Here are 187 cases of puerperal fever, 
treated witli depletion, of which sixteen died, one 
out of every eight and a half! And this is called 
skilful treatment, and justifiable in every case 
where the symptoms are urgent! 
Suppose the Botanic Doctors of the U. States 
should lose every ninth patient that happened to 
have a fever after child birth, what a hue and cry 
should we hear about “quackery,” and “murder 
by steam and lobelia!”and with what a good grace 
would it originate, as it always does, directly or 
indirectly, with regular physicians! When a cer- 
tain Botanic accoucher had attended the 200th 
case, he had not lost the first mother or child. 
Lochia.—After the delivery of the sccundines, 
the extremities of the uterine vessels being 
open, there will be a discharge from them which 
will continue during the sloughing, of pieces 
of the placenta, or the membranes that may be 
left behind and until the uterus is entirely clear, 
and the lacerated capillaries are healed. This 
discharge is called the Lochia. If it flows con- 
stantly, and continues to change from a bloody to 
a light color and to diminish in quantity, keep up 
the action of the system, see page 185, cleanse 
the parts at least once a day with injections of 
canker tea, and afterwards slippery elm, and all 
will be well. If it become bloody and profuse, 
treat it as directed for hemorrhage, page 168. 
If it be suppressed, and pain and inflammation fol- 
low, treat it as directed, page 164, for suppressed 
menstruation. 222 
Milk Leg—(Phlegmasia Dulens.)—“Its patho- 
logy/’ says Dr. Dewees, “ is still unsettled.” 
“We have five different hypotheses, [respecting 
the cause,] of either of which it would be difficult 
to make choice.” He “believes neither to be the 
true proximate cause.” The symptoms are heat, 
pain and swelling, commencing in the hip, groin 
or back, and proceeding down only one leg at a 
time. Swelling elastic, white and exquisitely sen- 
sible; total inability to move the limb, and great 
suffering when moved. After some time the sen- 
sibility diminishes and the swelling becomes cede- 
matous, (watery, leaving a pit after pressure,) and 
then the same symptoms and effects are felt in the 
other leg and side of the pelvis. The milk usu- 
ally diminishes and sometimes disappears.” 
I consider that the causes of this affection are, 
either a cold taken, or the cooling and sedative 
treatment of the fashionable practice. It has never 
supervened in a single case that I have attended. 
To prevent or cure it, steam the lower extremi- 
ties as directed, (“Ways and Means,”) give afull 
course, and repeat it if necessary; maintain the 
power gained, and it will soon “run its course.” 
When the limb is already swelled and tender, a 
poultice of lobelia, slippery elm and cracker, will 
aid in the cure. 
Phlebitis.—This is an inflammation of the coats 
ofthe veins or a filling up of their cavities, so as to 
obstruct the return ofthe blood to the heart. In- 
stead of being loose and general in the whole 
structure, the cold humors or cankery materials 
are here lodged in definite localities. The veins 
first become tender and corded or hard, and then 
the flesh swells because the blood is arrested in its 
return. This form of disease, being more difficult 
to cure than the other, will require a more rigor- 
LECTURE 14. 223 
ou3 and persevering1 treatment, but of the same 
character. The morbific matter must be loosened 
from the veins by relaxants and stimulants. The 
surface should be frequently rubbed with equal 
parts of the antispasmodic and stimulating lini- 
ments. 1 need not remark that the regular prac- 
tice in this, as in every other infl iinmatory affec- 
tion, is depletion-, ‘‘blood-letting, leeching, cup- 
ping, purging, blisters, opium” &c. Nothing is 
so good, intimates Dr. Dewees, as to promote a 
perspiration of the whole limb by “steaming it 
with hot bricks, “loaded by plunging them in vin- 
egar, folded with cl ths and put at the side of 
the leg and the foot,” the limb being covered with 
the bed-clothes raised from it by a rick of half hoops 
fastened at right angles to longitudinal strips. 
But, unfurtunatelv this cannot be effected till, by 
bleeding, leeching, purging &c , the arterial ac- 
tion [of the veins!] is “reduced to the sweating 
point!'’ Fortunately this affection is of rare oc- 
currence in the regular practice, and seldom if 
ever found in the true Botanic. 
Sore Breasts.—Under the head of poultices 
and inflammatory tumors, pages 188—9, I have 
given an account of the principles on which this 
disease should be treated, and the means of reduc- 
ing the tumor. On a review, I perceive that I omit- 
ted to state that, when there is heat and soreness 
already in the tumor, the stimulating article is not 
wanted in the poultice. Stimulation is necessary 
only when the flesh is cold and clammy, as in oede- 
ma, anasarca, and the like. A simple lobelia and 
slippery elm or basswood (Tillia or lime bark) 
poultice, is all that is wanted for sore breasts or 
any other tumor that is hot and painful. If the 
heat and pain are very great, the poultices should 
be kept cool and moist, by frequent applications of 
cold water, till the temperature of the tumor be re- 224 
duced to nearly or quite the healthy standard; 
when the organs will be released, and then the 
morbific humors will be either excreted by perspi- 
ration or absorbed away, and the milk will be soft- 
tened and thinned, and discharged. The practi- 
tioner on fever and inflammation, should always 
bear it in mind that too much action in a part may 
dry and contract the skin, and cause the accumu- 
lation of too much heat (the extreme of which is a 
burn) as well as that too little action in the part 
may leave it to become cold, inactive and obstruct- 
ed; and that his duty is to equalize the action.— 
“Hold there,” says the regular, “you are coming 
over to our side! /Te teach that the action and 
the heat must be equalized!” So you do; and, 
were you to practise what you teach, all would be 
well. We never left those “sides” in which you 
teach truth. It is only your errors that we aban- 
don. We all teach that the tone of the organs 
must be regulated, and their action and the heat 
equalized: but you do it by destroying their pow- 
er to act at all, and we, by removing the cause of 
the disturbance. You “kill the fever” by bleed- 
ing and poisons; we remove the obstructions that 
disturbed vitality, by relaxing the strictures, with 
means that inflict no organic injury. 
I have never had a case of suppuration of the 
breasts; I have always prevented it by removing 
the cause in season. Should one occur in iny prac- 
tice, I should treat it exactly as I do every other 
inflamed tumor, with moist, cool and relaxing 
poultices, courses if necessary; and, lastly, if much 
swelled, painful and evidently full of matter, I 
should lance it and discharge the pus, and poul- 
tice again. Ladies who will keep out cold and 
canker from their systems, and nurse their chil- 
dren, or, if they have none, draw the breasts often, 
need have no apprehensions of this painful affection. 225 
Hysterics.—When, in the course of “medical 
manceuvering,” most commonly—very rarely of 
neglect to attend to herself in cases of slight cold, 
&cc., (or by the indulgence of a fretful or crooked 
disposition, of which I do not mean to say that one 
of them ever is actually guilty; but only to hint 
what would happen if they should be,) a lady’s 
whole nervous system becomes so deranged that 
the doctor cannot determine what plan of treat- 
ment to pursue, where to begin it, or what reme- 
dies to use; it is fashionable to style the whole, 
hysterics, and place it among the opprobria rnedi- 
corum (reproaches of the faculty,) diseases, the 
cause of which they do not know and for which 
they have no remedy, and to hold forth as a reason 
for refusing to treat it, not their ignorance and in- 
ability, but the declaration that it is a disease of 
the imagination, not of the body. The true defi- 
nition of the name is, disease in, or inseparably 
connected with, the uterus; and, of course, wholly 
confined to females. But, even the sapient no- 
menclators sometimes forget its origin, and apply 
it to similar symptoms in our sex, which circum- 
stance, while it is not a little ridiculous in them 
is a positive proof to others, that they are ignorant 
of its nature. 
Of all the diseases both of males and females 
that I have ever treated, this general derangement 
of the system, indicated by irregular, fitful and 
anomalous, nervous action, has been the most 
common. As either this or death isgenerally the 
end of the “bold and energetic” regular treatment 
of all acute forms of disease, so it is the form with 
whish our Botanic brotherhood throughout the 
country, are most frequently called to grapple; 
I shall, therefore, be pardoned for devoting a num- 
ber of pages to the consideration of it. ° The first difficulty you meet in the treatment of 
this universal chronic, is, the popular doubt thrown 
over your ability to cure it, by your manifest ina- 
bility to give it an appropriate and specific name. 
To obviate this, you should make extensive and 
minute inquiries respecting the symptoms, and 
then name it, as you find it in fact, a complication 
of affections, a universal derangement of the 
system. This will not only be admitted, but fill 
to be true; and will inspire confidence in your 
prescripton of a general and thorough treatment, 
as the proper means of checking the sympathetic 
affections, and enabling you to discover and era- 
dicate the original causes. 
Another difficulty is discouragement, arising 
from the slow progress of cure, even after the re- 
mote causes are removed; the recovery being pro- 
tracted by the inability of the organs to regain 
their tone and vitality. Because the patient is 
notin constant agony from acute pain, she thinks 
she is not very sick; and, because she does not 
rapidly recover, she doubts the propriety of the 
practice, and begins to lose confidence. To 
prevent this difficulty, assure her before you 
commence, of what I am supposing to be true, 
that, though she is not in any apparent danger of 
immediate death, yet she must, in reality, be very 
sick, or the means already used by others or her- 
self, would have cured her; that she is sinking, and 
will continue to sink unless more energetic means 
be used to save her. If she doubts this, while you 
know it to be fact, you had better do nothing for 
her till she is convinced of it; otherwise you may 
labor in vain as to the cure, and be afterwards 
abused for your lenience. If, however, she sees her 
condition clearly, and, after 6ome weeks or months 
of resolute practice, finds even that she only is no 227 
worse, she will still be encouraged, as she might 
have been dead without it. If, now, a given 
general treatment prevents her from growing 
worse on the whole, it will be found, by 6trict 
examination, that she ifi, in sundry important 
respects, materially better; that, in other re- 
spects, chronic symptoms are exchanged for acute, 
which, though not more agreeable to bear, are cer- 
tain indications of return to the healthy state 
from which she has so far departed; and, of course, 
that a prompt increase in the energy and fre- 
quency of the prescriptions, will soon turn the 
scale in favor of the patient. This looks reason- 
able enough to induce atrial; and, fortunately for 
the practitioner and the patient, the practice cor- 
roborates the reasoning. In time, patient and en- 
ergetic perseverance are rewarded with success. 
Such at least has been my experience. In seve- 
ral instances, two or three years have accomplish- 
ed what one year’s faithful effort hardly seemed to 
begin. To a vigorous and unremitted general 
treatment, I kept constantly adding direct appli- 
cations to local derangements, till the vitality or 
circulation and action of the whole system was 
equalized, and the organs enabled to maintain, by 
their natural operations, what they had been ena- 
bled to regain only by the aid of our art. 
In the treatment of this affection, or this com- 
pound of almost all affections, care must be taken 
to obviate every local dilliculty as fast as it ari- 
ses; as, to remove costiveness, a slight cold or a 
sick stomach &c.; and so to vary the articles of 
general and constant prescriptions as to prevent 
the patient from getting tired of any one thing. 
The reason of this, I have not room here to ex- 
plain; I only state the fact that, when a good med- 
icine answers well the design for which it was 228 
given, but does not accomplish all that is wanted, 
we should endeavor to supply the deficiency with 
another, but we should not abandon entirely the 
use of the former, lest we lose what we had gain- 
ed. All the remedies should be rendered as agree- 
able as possible to the taste. The compound call- 
ed restorative bitters, which I shall presently men- 
tion, is agreeable, and a person will cheerfully eat 
enough of it to keep up the action of the system. 
In this- chronic affection, as in almost all others, 
the action of the system is partial, and the pro- 
gress of remedial influence is slow; therefore it is 
important to apply the means at as many points as 
possible. While general cleansers and restora- 
tives are regularly given, the surface should be 
stimulated to action by an occasional vapor bath 
followed by free use of the stimulating liniment, 
pa. 149; and a small but pretty active enema should 
be administered occasionally when the bowels aro 
empty, to rouse them from their torpidity. If it 
irritates them more than is intended, give another 
of slippery elm. The feet should be kept constant- 
ly stimulated till they cease to be cold and clam- 
my. If the urine is vitiated, give the diurstics, 
as cleavers &c., freely; if these do not soon cor- 
rect the difficuly, inject with a small syringe, 
through a catheter, a little of the tea of these and 
of bayberry and cayenne into the bladder. Make 
up a compound of equal parts of as many of the dif- 
ferent approved bitters as you can get; add of 
slippery elm, of bayberry, nervine and cayenne, 
same quantity as of each of the others; half as much 
cinnamon and cloves, if you have them, and sugar 
enough to make the whole agreeable to the taste. 
Mix well in dry, fine powder, and take a tea- 
spoonful three to six times a day, dry, if the bow- 
els are too loose; in cold or hot water, if too costive. 229 
Watch the effects. If the whole compound is too 
astringent, mix in more bitter root, or butternut 
extract; if too laxatire, putin a 6trong astringent, 
as woods poplar, &c., till you temper it to suit 
the case. IS'o man is tit to be a general practition- 
er, who is not well enough acquainted with the 
several conditions of the body in sickness, the 
principles that should govern his practice, and the 
qualities and powers of his remedies, to enable 
him to proportioned apply them so as to suit the 
case before him. To depend alwayson compounds 
made to our hand, and on giving them according 
to a written prescription, is to fail in many a case 
where the exercise of our own judgment might 
have given us the victory. 
It is freely admitted that many of these hysteri- 
cal cases are very difficult to cure. The organs 
have been so long and so much debilitated by the 
presence of obstructions, either naturally or arti- 
ficially introduced, that the prospect of restoring 
their energies is gloomy indeed, and would be to- 
tally abandoned, but for the certainty that death 
is the only alternative to perseverance. I have, 
therefore, in many instances persevered in the 
expectation of only keeping the patient comforta- 
ble while she lived; and, in not a few, have seen 
success awarded to perseverance, rather than to 
any change to an apparently more energetic or ju- 
dicious course of practice. Hence it is, that I 
have so often advised persons not to let any unfa- 
vorable circumstances discourage them. If the 
case does not improve under a judicious and ener- 
getic practice, it is certainly hopeless under none. 
And diligence and faithfulness may be crowned 
with success. I have already remarked that, had 
I ceased, after three years constant and faithful 
practice against mercury, that panacea of the fac- 230 
ulty, tliat Moloch of medical error, 1 should have 
lost one patient whose present life and health and 
comforting companionship are an ample reward for 
all my exertions to preserve them, had they been 
ever so far greater. Be sure then, when you have 
a bad case, that you are doing that which is best 
calculated to aid nature in the recovery, and per- 
severe, till death arrest your efforts, or health re- 
ward your toils. 
Injuries suffered by Parturition.—I have 
stated that, when the patient is properly treated, 
both during pregnancy and at the close of it, mate- 
rial injury is seldom inflicted on any of the organs 
concerned in any part ofthe process. But it is not 
every one who is thus treated. For want of pro- 
per attention in relaxing the system, the parts 
concerned are sometimes lacerated in parturition, 
communications have been made between the va- 
gina and the rectum or the bladder, the uterus ha3 
been torn by the fingers, the perineum has been 
sometimes entirely divided, and sad work lias 
been made by the forceps on the pelvic muscles 
and ligaments. 
When these are not so injured as to cut off the 
connexion and destroy Nature’s means of applying 
the healing process, constant, moist and soothing 
applications to the parts, and a general sustaining 
treatment of the whole system will in time effect 
recovery. In lacerations of the recto-vaginal par- 
tition, if we see them while fresh, we must fasten 
in coni act the adjoining edges, cither by stitches 
with lead wire or white silk, or, what is better, if 
they can be made to stay, by strips of adhesive 
plaster, at short distances from each other, on the 
vaginal side. If their lacerated edges are healed, 
we must flay them afresh, and then join them. 
The system must be prepared for this operation, 231 
by thoroughly emptying the stomach with eme- 
tics, and the bowels with injections, and then con- 
tinued in a quiet and unoppressed, irritless state, 
by giving the patient only food enough to sustain 
her, and that in a liquid state, until the adhesions 
are complete and firm. This plan has been adopt- 
ed and Ins succeded.—See cases by Dr. J. P. Met- 
tauer, in the Boston Medical and Surgical Jour- 
nal. 
But my advice was lately asked in a case where 
the accoucher, in an attempt at embryotomy, or 
cutting away the fetus by piecemeal, made the 
tmall mistakes of cutting out a piece of the neck 
of the bladder on one side, and of opening a pass- 
age to the rectum outlie other! The latter diffi- 
culty comes under the above treatment; but, for 
the former, a remedy is scarcely possible; t\v?. pre- 
ventive of such disasters, is to keep off men who 
“aid delivery” with knives and forceps. Even in 
this case, however, I should endeavor to pass a ca- 
theter through the external part of the urethra, 
across the separation, and through the remaining 
part into the bladder. If, now, the cut ends of 
the urethra could be reached through the vagina, 
scraped till they were raw, brought together and 
confined till they should firmly adhere, well; if 
not, possibly a silver tube might be constantly 
worn there to some advantage. But the urine 
would be continually fi twing, unless the healing 
could be effected and the tube removed. 
The debility of the organs, even where there is 
no lesion, produced by the use of fingers, forceps, 
crotchets and blunt hooks, is often the cause of di- 
arrhoea, incontinence of urine, prolapsus uteri <fec.; 
to correct which, the parts should be kept well 
cleansed, and properly lubricated and toned. By 
compression of the nerves, or actual lesion of 232 
them, these means often produce spasmodic or pa- 
ralytic affections which are more easily prevented 
than cured. In cases where the supports of the 
uterus have been so weakened as to permit its ver- 
tex to descend to the perineum, I have been able, 
by a long and thorough course of restorative prac- 
tice on the general system, and of cleansing and 
astringent applications to the vagina, to effect a 
cure. But the regular practice has sometimes ta- 
ken away parts of the vagina, and at others, rup- 
tured its body, or turned it, wrong side outwards, 
and then cut it off. I know of no cure for those 
forms of disease! We must learn to prevent them. 
Sometimes, from the swelling that follows in- 
jury to the pelvic organs, the urethra is closed, 
and the urine accumulates. Efforts are frequently 
made to draw it off through a catheter, but the in- 
sertion of the instrument, in this condition of the 
organ, is painful. The same means should bo 
used as for a dysuria or retention of the urine, at 
other times; viz,, emollient and relaxing injections 
to the vagina, poultices of powdered and sifted 
slippery elm made in strong lobelia tea, inserted 
into the vagina, sustained by a cloth and bandage, 
and washed out clean every twelve hours, with 
warm water, injected from the common syringe. 
Keep up the action of the system, and place a half 
gallon bottle or jug full of boiling water, wrapped 
in a large towel, with its side in contact with the 
external parts during the night. This practice 
will soon relax the pores and remove the swelling, 
or a stricture from any cause, and will let the wa- 
ter escape. On the other hand, the sphincter of 
the urethra may become relaxed, and the urine will 
flow involuntarily. In this case, use astringent 
injections, as witch hazle, oak bark &c., after 
having first cleansed with bayberry and a little 
cayenne. 233 
If hectic fevers occur, it is proof either that the 
action of the system i6 low and unsteady, or that 
there are obstructions which should be removed. 
Equalize the action and retain it. and remove the 
obstructions if any. If the fever be intermittent, 
alternated with chill, and succeeded by perspira- 
tion, the surface is too open; it must be kept clos- 
ed by frequently rubbing dry, and the strength 
must be supported. Syncope or fainting, or a fre- 
quent sense of sinking is proof of either much in- 
ternal obstruction or of much debility of the deep- 
seated organs, or of a very lax surface. The indi- 
cations are to cleanse the general system, and 
close the surface by friction. 
If the lacerated parts show a strong tendency 
to putrescence, or if the system exhibit much 
eruption, it is proof of the presence of corroding 
canker, which must be removed by our ordinary 
method, remembering that, after a general cleans- 
ing of the system, a constant and steady aid must 
be afforded to maintain the action as nearly at the 
healthy standard as wo can. The morbific matter 
that is distributed throughout the system, must be 
removed by the regular course of absorption, and 
secernance or excretion; and this process requir- 
ing some time, the organs should not be so over- 
exercised as to become fatigued before the labor 
is accomplished. 
Palpitation, sinking, panting for breath, vertigo 
frc.—These are a series of symptoms that, gene- 
rally if not universally, have their causes in the 
mal-practice of depletion. By abstracting an un- 
due portion of the fluids of the system, the hydros- 
tatic pressure is every where diminished; the pow- 
er of the cool atmosphere, in some cases, and the 
obstructed condition of the organs in others, col- 
lapse the extreme vessels and force the fluids to 234 
those parts that are less influenced by these cau- 
ses: hence, there is a pressure of the blood to the 
large veins and heart, and an opposition to its re- 
propulsion through the arteries. Const quently it 
accumulates in the heart, lungs &c., producing 
congestion and causing the heart to labor fruit- 
lessly “in back water.” The symptoms thus pro- 
duced are called palpitation. It takes place at the 
commencement, during the progress, or at the ter- 
mination of exercise, because it is then that this 
inequality of distribution of the fluid is most 
powerfully resisted. The power of the system 
to overcome it, will be exerted to fatigue and 
sometimes to absolute prostration, which will 
be indicated by the sinking of strength, pant- 
ing for breath, &c. The vertigo or swimming of 
the head, arises from the same cause, pressure of 
the fluids, but upon different organs, viz. the ner- 
vous system, instead of the vascular. Some of the 
nerves are harder pressed, and, of course, more 
impeded in their action than others. This makes 
a difference in the time in which the different ex- 
ternal objects and parts of objects are impressed 
upon the mind; hence these objects themselves ap- 
pear to be in motion, now towards, and now from 
us. We imagine ourselves falling towards those 
that appear to approach, and we make efforts to 
balance ourselves accordingly. These efforts, to- 
gether with our real weakness, make us really 
stagger, and sometimes throw us entirely down. 
Poisons of every description, tend to destroy the 
vitality of every organ on which they are permit- 
ted to produce their natural effects. This needs 
no proof. It is universally conceded that it is only 
when the system is able to throw off both them 
and the cause of the disease for which they are 
given, their administration is justifiable ; and 235 
that, when they remain long in the system, they 
do it a real injury. See the disease called “mer- 
curial.” In proportion, then, as mercury or any 
other poison, fastens upon any ganglion, plexus, 
ramification or fibre of the nervous system, it 
checks the vitality of that part; what is the neces- 
sary consequence but confusion in the combined 
action of the whole! Thus, calomel is frequently 
the cause of this derangement, yet how oiten do 
we 6ec, instead of an attempt to remove the calo- 
mel, another poison, as opium &c., administered, 
to check the action of the remainder, and thus 
equalize the nervous excitement! 
Such treatment reminds me of the conduct of 
some wicked boys who found the head, fore-legs 
and body of a toad making powerful and uncom- 
mon efforts, because its hind-feet were deep in the 
throat of a serpent that was about to swallow the 
whole. To quiet this unusual action, they very 
scientifically cut off the head of the toad, instead 
of that of the serpent. 1 need not say that their 
skill was crowned with a success quite equal to 
that of the administration of poisons to cure deli- 
rium and congestion! It sometimes happens, how- 
ever, that the blow at the head, however destruc- 
tive its nature, or mistaken its intensions, does 
not entirely answer the aim; and, after afewmore 
struggles, the poor animal escapes the two-fold 
danger, with only a scar on the head, and the loss 
of the use of only his lower limbs. But who will 
contend that the blow itself, or the intention ia 
giving it, is the means of saving the poor animal s 
life! 
I would not be understood to say that 
but poisons in the system can be the occasion ot 
delirium. Any substance that can produce une- 
equal pressure upon the different nerves of sensa- tion and motion, will produce the same irregular 
action for a time; but there is this difference, that 
the irregularity produced by the latter, as it sus- 
pends or impedes only the action, not the capacity 
to act, is easily removed; while that produced by 
the former is lessor more permanent, according to 
the partial or total destruction of organic capacity. 
Of course, the delirium that proceeds from mere 
obstructions to nervous action, will be cured by 
simply removing those obstructions. That which 
proceeds from partial or total destruction of nerv- 
ous capacity, will be but partially cured, if cured 
at all. I know this will sound harsh to many “be- 
lievers in calomel, opium, nitric acid, digitalis, 
cicuta, &c. &c.; but I feel it my duty, as their 
friend, to warn them that these deadly poisons 
are what first make nine out often of the chronic 
diseases in our country, and then render them “in- 
curable;” to say nothing of the “countless hosts” 
that are sent to the grave from infancy, childhood, 
youth and manhood, by the same destructive in- 
struments, administered so rapidly or under such 
circumstances as to destroy the whole, instead of 
a part of the vitality of the system, and thus pro- 
duced a more speedy death. But even this is 
certainly preferable to a lingering existence, 
unprofitable to the world and a burthen to one’s 
self, from which, as Dr. Mason Good says, 
“Death, with a friendly stroke, finally puts a pe- 
riod to one’s sufferings.” And then, what renders 
this course the more reprehensible, is, the blame 
is laid to the will of that kind Providence who, in- 
stead of ever telling us to use poisons to cure dis- 
ease, actually told 11s that poisons are themselves 
the consequence of wickedness; that we are to eat 
only of what is “good for food,” and cure our dis- 
eases only with healing balms; and more than all 237 
this, who has scattered these healing balms, in rich 
profusion, wherever man is found with a malady, 
for cure! 
The description of the causes and pathology of 
these affections, will suggest the plan of cure. The 
particulars are given in the Lectures on “Ways 
and Means.” The steaming should be confined 
longer to the lower than the upper extremities, 
the obstructions removed and the circulation 
equalized, not by destroying the little action that 
remains, but by stimulating the sluggish organs 
to come up to the performance of their duty. All 
the difficulty in these cases, is, like the preserva- 
tion of civil liberties, they require (almost) “eter- 
nal vigilance” in the practice. Long persever- 
ance is often rewarded with success, after the 
•most vigorous treatment for a time, seemed to do 
no other good than merely to postpone the dissolu- 
tion. 
LECTURE 15. 
DISEASES OF CHILDREN. 
I have already shown, in the introductory lec- 
ture, that many diseases of children, such as scro- 
fula, erysipelas, consumption, syphilis, &c., may 
have their origin in the parent. It is therefore 
evident that the first medical treatment of chil- 
dren should be exercised on their parents, whose 
blood and tlesh should be kept constantly free from 
all impurities. It is a mistaken notion that “it is 
dangerous to doctor women during pregnancy.” 
If “the science of medicine teaches the art of pre- 
venting and .curing disease,” whore can be the 238 
harm of exercising it in any case? If experience 
has proved that what is commonly practised as this 
Rrt, actually makes disease instead of preventing 
it, then it may be and ought to be abandoned, not 
only when persons are very liable to be seriously 
injured by it, but when they are the least suscepti- 
ble ot injury. But, does this prove that means 
calculated to effect the end in a proper way, should 
not, at all times, be used! Surely not. Let the 
parents then be kept in good health, and their off- 
spring will be blessed with a sound constitution, 
as surely as a flourishing, healthy plant will pro- 
duce a perfect seed. 
I have already spoken extensively and carefully 
on the treatment of the new-born infant, pages 80, 
—,rL 102—5. lo wash off’ the sticky matter 
trom the foetus, Dr. Eberle says that the yolk of 
an egg is better than the soap and lard of Dr. De- 
wees; that the water should be at least lukewarm, 
in all cases, and warmer where the infant is feeble. 
Care Should be taken to get the unctuous sub- 
stance from the joints, armpits, groins &c., but not 
to fatigue the child too much the first time. Infants 
should bo washed at least once a day, over every 
part of the body and always rubbed dry witli a soft 
cloth: then a little sweet oil, or oil made by melt- 
ing unsalted butter, rubbed into the groins, arm- 
pits, and wherever else chafes are likely to occur, 
will prevent them. The lower part of the body 
should be washed clean twice a day, and at other 
times as circumstances require. Dr. Eberle thinks 
that the bandage should be worn “four or five 
months,” and longer if “the parts about the navel 
appear to be weak and readily to yield to the 
pressure of the viscera.” These parts should be 
examined often, and kept dry and clean. It can- 
not be too strongly urged on those who have the 239 
care ofinfants to “keep the feet warm, the head 
cool,” the clothing loose, and the body free and 
easy, to change the clothes to 6uit the variations 
of the weather, and not to let them sleep in a cot- 
ton or flannel worn during the day. 
Disease is often produced in infants, by unsuita- 
ble food, or by a too frequent or a too liberal use of 
that which is good. The new-born infant is not 
in so great a hurry to “eat or take physic’-’ as 
most persons imagine. It may, if vigorous, pass 
live or six hours after birth, without either food or 
injury; and, when food is given, if the mother does 
not supply it, new milk, sweetened with a little 
molasses, is doubtless the best. No remarks 
would be added here to what have been made here- 
tofore, but to correct an error which Dr. Eberle 
seems to have committed in supposing that, be- 
cause the mother frequently supplies no milk for 
some time, we are to conclude that the child does 
not need nourishment till she docs supply it. But 
I would not do him injustice. He “does not mean 
to inculcate that nourishment is always to be with- 
held until the milk is secreted;” but that, “with 
healthy infants, several hours at least should be 
suffered to pass after the birth, before any aliment- 
ary substances are introduced into the stomach;” 
and then he “would most strenuously insist on the 
importance of giving but small portions at a time, 
and at such intervals as will obviate all risk of 
overloading the stomach. A few tea-spoonsful of 
some very bland and weak fluid, could not be de- 
trimental, though given immediately after birth; 
but the usual practice of filling the stomach to 
overflowing, and keeping it in this state of ful- 
ness and distension, is most ruinous to the health 
and comfort of the child.” I perfectly agree with 
the Doctor, in all but the supposition that “the 240 
supply” will generally be furnished as soon as the 
want is felt. This ability of nature to do her ori- 
ginal duty, in spite of the impediments thrown in 
her way by the refinements of the age, as luxury, 
idleness, corsets, silk stockings; bleeding and phy- 
icking out the plethora, and checking, with poi- 
sons, the tendency of the system to produce it in 
the idle and luxurious, has been examined in the 
first Decture, where it is rendered at least ques- 
tionable. As but a small quantity of food, howe- 
ber, is requisite to support the system, and as the 
digestive apparatus is unaccustomed to its intend- 
ed exercise, much caution is necessary as to the 
nature, quantity and frequency of the food that 
seems requisite before the child is furnished by the 
mother. When it is necessary to feed the infant, 
Dr. Eberle says “ two parts of fresh cow’s milk 
and one of warmwaier is the best.” And this he 
thinks, should be “the only food” for the infant 
during the first three or four months,” when it 
cannot be supplied by the mother or a wet nurse. 
Nursing.—When, from any cause, the child 
cannot be entirely supported from the breast of the 
mother or the nurse, small quantities at a time of 
the milk or milk and water, should be given it, 
and it is better that it should be drawn from a vial 
or little bottle, through an artificial nipple, or, 
when this cannot be had, a piece of clean linen 
rag an inch wide and long enough, when rolled up 
closely, to fill the mouth of the vial, may be used. 
This will prevent the child from eating too fast, 
and give the stomach time to become satisfied be- 
fore it has received too much. It must be un- 
wound and washed in scalding water once or twice 
a day. 
After six months, even when the mother nurses 
the child, it may be well to commence giving 241 
milk, in small quantities, two, three or four times 
a day, to gradually accustom the child to derive its 
food from other sources than the breast. Light 
bread may be, by degrees, finely crumbled and 
mingled with the milk; and thus the lightest food 
may succeed from time to time, till the child will 
not only become accustomed and able to subsist 
without the mother, but be very willing to do it. 
There are many things that may be given to it in 
infancy, \\ ith impunity, provided they he not given 
in too great quantity. Barley water, rice water, 
milk porridge, fine white corn mush and milk, &c. 
But milk is the best, and this should be given by 
the judgment of the parent, not to stop the cries 
of the child. The common practice of nursing or 
feeding a child to stop it from crying, or to put it 
to 6leep, is not only very injurious to the infant, 
but unwise in the person who does it; as the cry 
is not unfrcquently an indication of pain produced 
by previous over-feeding; and, of course, more 
stuffing only makes the matter worse. \\ hen a 
child cries, that is known to have eaten enough 
for the abundant support of nature, it would be 
much better to endeavor to ascertain whether the 
cause may not be the irritation of a pin in the 
clothes, or some uncomfortable position, tight band- 
age, or the like. 
Nurses.—Though it is generally supposed that 
it is about as well to obtain a wet nurse for the 
child, as for the lady to nurse it herself, yet I am 
inclined to think that, in general, the disadvanta- 
ges of “bringing a child up by the bottle,” (I 
don’t mean the rum bottle) are far less than those 
of entrusting it to nurses. In the first place, their 
milk is not so suitable, especially if they have not 
just then begun to afford it. The first milk, says 
Dr. Dewees, is the most appropriate “natural phy- 242 
sic to the child.” Secondly, they may have some 
disease in the blood, as syphilis, tetter, itch, &c., 
which they may communicate to the child. Third- 
ly, they draw away its attention and attachment 
from the mother. Fourthly, they do not so well 
attend to the child as the mother would, either as 
it regards its food, clothing, comfort or cleanliness. 
They are impatient of the necessity of incessant 
watchfulness, feed it too much at one time and too 
little at another, leave it too long in the same po- 
sition, and handle it too roughly when they con- 
descend to move it at all. They not unfrequent- 
ly, too, give it some vicious anodyne to keep it 
quiet and make it sleep. 
But, bad as these evil are, they can scarcely be 
considered the worst. Nurses communicate to the 
child the influence of all their evil tempers and ex- 
amples, and teach them false and vicious notions of 
right and wrong; for it must not be forgotten that 
infants begin to observe and to receive deep and 
lasting impressions from the moment they open 
their eyes. If there were no other objection to 
employing a nurse, than simply the disadvantage 
to the mind and manners, I should strenuously op- 
pose it in all cases except those in which the nurse 
were a better woman than the mother! cases 
that do sometimes occur. In other cases, even 
where a nurse is employed, it will be profitable 
both to the child and the mother, that the lat- 
ter should take the former at all times except 
when at the breast. A nurse of vicious passions 
even viciates her milk as well as her example, 
and renders it not only totally unsuitable to the 
infant, but positively injurious: Such, therefore, 
should always be avoided. In some cases, howe- 
ver, of very weakly or premature children, all ef- 
forts to raise them by feeding, prove fruitless. 243 
Then the beet nurse that can be had should be ob 
tained, and dismissed as soon as she can be 
spared. 
After the teeth begin to appear, it is proper 
enough to commence giving the child a little mut- 
ton or chicken soup, and small portions of boiled 
beef or mutton, or chicken may be chewed; but 
greasy food, and what is hard to digest, as veal 
and pork, should be avoided. A few articles that 
are plain and nourishing, are the best food for 
children. . They may eat four or five times a day 
if they do not eat too much. Milk and water when 
young, and water alone afterwards, should be their 
only drink. The pulp of ripe peaches and apples, 
is good for food; but an infant should never be per- 
mitted to eat the seeds, the core, or the skins of 
these, or any other fruits. Currants, cherries, 
whortleberries, grapes, raisins &c., are particu- 
larly objectionableon that account. Tough, smooth 
skins should never be eaten. Being indigestible, 
they irritate the stomach and bowels, and create 
serious derangements. The little seeds of rasp- 
berries and strawberries are indigestible; of course 
they will irritate the internal canal and become 
sources of disease; but the juice expressed from 
them or other similar fruits, is good. In short, no- 
thing should be given to infants or young children 
that is known to be difficult to digest; for, whate- 
ver is not well digested, is pretty sure to produce 
diarrhoea. Nothing, however, is better for this 
affection, than the raspberry or blackberry juice, 
or a tea made of the roots or leaves, sweetened 
with loaf sugar and a little milk in it. This last 
may also be given by injection. The principal 
reasons why any of the ordinary fruits are inju- 
rious, is, either they are given unripe, or in a hard, 
solid state; or the skins, cores or seeds that can- 244 
not be digested at all, are not removed. Clear 
these from the rest, reduce the remainder to a 
pulp or jelly-like substance, free from shreds or 
fibrine as well as hard coriaceous or bony substan- 
ces, and the remainder of any fruits that are good 
to eat by any persons, under any circumstances, 
may be eaten by infants with impunity. It is the 
want of proper mastication that renders many 
vegetables, as potatoes, turnips, parsnips, car- 
rots, peas, beans &c., often injurious. I have re- 
peatedly been told by a sick person, that he or she 
had an almost insatiable desire for certain vege- 
table food, as potatoes or turnips, but that they 
were sure to produce diarrhoea, that is, “to come 
away as they were eaten.” In hard lumps'? said 
I. “Yes, mingled with watery fluid.” It appear- 
ed to me that the fault was altogether in their 
not being masticated so that the gastric juice could 
act upon them. Passing in ragged, angular forms 
through the intestines, they produced an irritation 
which forced them along rapidly; and the fluids, 
which generally pass so slowly as to give time for 
absorption, were carried along with them. I di- 
rected these very articles to be thoroughly boiled, 
then bruised till all the lumps disappeared and 
forced through a fine seive, to get out all but the 
parenchymatous substance. Of this I permitted 
the patient to eat freely, and I never knew an in- 
stance of injury from it. Children may eat the 
expressed juice or the fibreless pulp of any fruits 
that are good for the parent. There is, therefore, 
no painful necessity of denying them any fruits or 
vegetables which they see their parents eat. Peas, 
beans, snaps, cherries, and all sucli things are in- 
nocent, delightful and nourishing, when thus treat- 
ed. Pears are supposed to be more indigestible 
than apples; and all dried fruits than fresh. Tha 245 
only reason is, they contain more hard or stringy 
substance in proportion to the parenchyma, than 
others do. Ilruise and strain the pears, or dried 
fruits, and they are quite as good as the fresh ap- 
ples; far better, unless they too are thus prepared. 
You may cure in children, with the expressed and 
clear juice of raspberries and blackberries, the 
very diarrhoea which was produced by the irrita- 
tion of the seeds of those same fruits, when eaten 
whole. Hence, it is not only necessary that chil- 
dren and the sick adult, should have good food, but 
this this food should be properly prepared. I give a 
Bick person a little of any thing he craves; but I 
take care that it is properly prepared for his re- 
ception. I have seen a patient eat with impunity 
the expressed juice of a raw turnip, when there 
was neither appetite to eat nor ability to digest 
the fibrous pulp of a boiled one. 
Even particles of matter that is not very fibrous, 
as boiled potatoes, artichokes, &c., may be so firm- 
ly united by cohesion that they will not all, except 
when well masticated, be submitted to the pro- 
cess of digestion, of course they become irritants 
to the alvine canal. The reason why a roasted 
potato is more wholesome than a, boiled one, is 
simply that the dry heat disengages the water 
from them, separates their particles and gives free 
admission to the gastric juice among them, lienee 
they are reduced to solution, and rendered subser- 
vient to the nourishmentof thesystem, while their 
power to irritate mechanically, is destroyed. I 
have never known good Irish potatoes do harm 
when they were ripe and well roasted, and skin- 
ned and thoroughly bruised before they were eaten* 
and I have frequently prescribed them in this way 
for very weak stomachs. 
Medicine—For Children.—In the Introductory 246 
Lecture, I mentioned some of the evil effects on 
children, of improper medicine, and wrong inodes 
of practice. As they have, generally, a more 
healthy constitution than grown persons, it will 
require a far smaller portion of medicines to cure 
them, or of poison to kill them. The organs being 
more readily roused into action, a larger portion 
of the medicine is used at the same time, and, of 
course the effects are more alarming. In giving 
medicine, therefore, to children, great care should 
be taken that nothing poisonous or in any respect 
hurtful, should be used, and that no excessive 
quantity should be given, even of that which is in- 
nocent and good. None but the attentive practi- 
tioner can determine just how much should be giv- 
en in any particular case, the action of the pulse 
and the state of the stomach, bowels, extremities 
and surface, when well understood, will give a 
clue to the proper quantity of medicine, and the 
time and mode of administration. The true way 
is to begin with a little, and increase or vary the 
dose, as the circumstances and effects require. In 
general, I have found ginger sufficiently stimulat- 
ing for infants, and they are much less displeased 
with this than cayenne. Raspberry leaves too, are 
excellent for them, and bavberry, if good, is often 
sufficiently stimulating without cayenne. It may 
be remembered that, while there is a high fever 
and a burning surface, there is more need of exter- 
nal relaxants than of internal stimulants, till the 
pulse begins to sink, when stimulating fluids may 
be given more freely. There are cases, however, 
which will require the energy of a half tea-spoon- 
ful of cayenne at a time and even several times re- 
peated. Il'necessary to sustain the system, let it 
be given, and as long as required. 
As it is very difficult to make children take med- 247 
icine of suitable kind and in sufficient quantity, 
particular attention should be paid to giving it by 
the bowels, and applying it to the surface, when- 
ever there is a prospect of its acting with equal 
comfort and benefit that way. Nauseous medicine 
should never be given to open the bowels. It is 
much better as well as quicker done by an injec- 
tion, only slightly stimulating, and repeated if ne- 
cessary. Tlie necessary articles may also be 
much disguised by putting milk, sugar, and some 
pleasant aromatic in the tea. Milk may procras- 
tinate the time, and moderate the violence of their 
effects; but will not materially diminish their 
value. Hut I insist that children should never be 
cheated as to the sensible qualities or the intended 
effects of what is given them. They should be told 
candidly the danger of their condition, the taste 
of the medicines and the effects which it is intend- 
ed they shall produce. Then they should be per- 
suaded to take them, if they can be; forced to take 
them if they must. To cheat them often is the 
way to make them troublesome. 
Exercise.—However feeble the first motions of 
the infant, nothing should be permitted to impede 
them. Its dress should be free, and no heavier 
than is necessary to keep it warm. When asleep, 
it may of course be covered with more clothes than 
might be convenient when in active exercise; but, 
when inclined to be restless, it should be laid upon 
a mattress or hard wide pillow, and suffered to use 
its feet and hands as freely and as long as it plea- 
ses. In cool weather its arms and legs should be 
LECTURE 1G. 248 
covered with cotton, and, in cold, with flannel, and 
thick woollen socks. It should also be carried 
about in the arms, but not required for two or three 
months, to support itself upright, without assist- 
ance to keep its backand head straight. Its position 
should be changed frequently, as from one arm to 
the other, that it may neither grow crooked nor be- 
come tired. Its spine is too weak to support its 
body erect for the first three or four months, nor 
is its neck strong enough to hold the head up long 
at a time even then, without fatigue and pain. 
Therefore, when carried in the arms, all parts 
should be supported as much as possible. Those 
that handle the little infant, should remember that 
it is not accustomed to rough treatment, to being 
so suddenly raised and depressed several times its 
length, as almost to deprive it of breath; and, es- 
pecially, they should remember that its arms are 
not so strong as to justify the frequent lifting ofits 
whole weight by them. All sudden jolting or jar- 
ring of infants, as dandling them severely on the 
knee and letting the heel strike the floor, or strik- 
ing them with the hand on the back, or rocking 
them violently in a cradle, in short, all operations 
by which the whole or parts of their bodies are sud- 
denly and severely shaken, are injurious, and 
should be discountenanced. 
The custom of giving infants air and exercise 
in little wagons, is good. I have thought that the 
air so near the ground may not be so refreshing, as 
it is well known, at some times, and in some coun- 
tries, to be very injurious to health, when that 
which is inhaled at the height ofa man, is good. 
Perhaps the best mode of carrying an infant about, 
is to place it on a pillow in an oblong basket, 
hung upon the arm, or string it by a belt under 
one arm and over the opposite shoulder. The bas- ket may be pushed forward under the noarcst 
breast. The holding by the arm to the neck 
of the nurse, as it is commonly carried, is cal- 
culated to deform the shoulder, especially un- 
less it be frequently changed from one arm to the 
other. Whatever be the mode of artificial exer- 
cise for infants, it should be frequent, moderate in 
character and short in duration, and under such 
circumstances that all its limbs may be free for 
whatever motion they may be inclined to make. 
All uncomfortable motions should be carefully 
avoided. It is often the case that an infant is sad- 
ly shaken about, jolted or rocked to prevent it from 
crying, when the fatigue and suffering it lias alrea- 
dy endured in consequence of former shaking, may 
be the cause of its crying. 
“Creep before you walk,” says the proverb. 
Cribs are preferable to cradles, if they are not 
made too high and too liable to turn over. The 
upright posts are fine things for the infant to try 
the strength of its hands and arms upon. It will 
often seize them, (they should be small, round and 
plain) and pull just as much or as little as it 
should, and let go when it is tired. In this way, 
the development of the muscular power of the 
hands and arms, will commence much sooner,and be 
more gradual and more effectual,than when confined 
in a smooth sided cradle which it cannot seize with 
its fingers. It should never be taken up nor even 
supported when up, by one hand or arm, nor should 
it ever be lifted by its arms at all till it has been 
observed to raise itself upon its feet by their use, 
and even then it should not be held long by them. 
To develop the strength of its feet and legs, the 
foot of the crib should be a solid board, and the 
bed should be made so near it, that the feet may 
push against it when the legs are straight. The 250 
head can be filled up with pillows. It will be soon 
observed that the child takes great pleasure, at a 
very early period, in pulling at the pillars and 
kicking the foot board of the cradle, and much 
time will be spent in this way, which would be 
passed in crying in an ordinary cradle with the 
bed made close to the head. When the child 
becomes so strong as to hold its head firm and 
erect, and to balance its body in the cradle with- 
out holding to the pillars or rails, it may be placed 
upon the carpet, and watched, relieved and stayed 
often, till it has learned to sit firmly, when va- 
rious play-things should be put into its lap. It 
will presently begin to lose, and reach and move 
itself after them, and, in a few days, will creep all 
over the floor. The articles may then be put into 
a little chairto induce it to climb after them, and 
it should be watched and prevented from falling in 
its first attempts, till it has acquired so much 
pleasure and skill in the exploit, as to encourage 
its frequency and secure its safety. Let the arti- 
cles now be placed upon a common chair, and it 
will raise itself upon its feet, where it should not, 
at first, be permitted to remain long at a time. By 
degrees it will learn to let itself down again, 
when it becomes tired, and now it may be per- 
mitted to rise, stand, or sit at pleasure. It will 
now commence walking round the chair, and, 
when it is strong enough to steady itself by one 
hand, it will attempt to pass from one chair to ano- 
ther that may be within its reach. It may then be 
held by both hands and induced to step after a per- 
son; and, after this is done with ease, two persons 
may teach it to walk by itself from one to the 
other, near together at first; afterwards at greater 
distances. These exercises must not be continued 
long at a time, but may be frequent. But I repeat 251 
it that, children should not be pulled and whirled 
about by their arms, nor tossed high and suddenly 
into the air; nor should their bodies be subjected 
to any exercise much more violent than themselves 
are capable of m iking. They are often materially 
injured in their form and future growth by these 
means. When they have learned to walk, they 
should be permitted to do it as much as they 
choose, out of doors, whenever the ground is dry. 
For this purpose every nursery should have a small 
piece of grass near it. Which should be free from 
stones, sticks&c.. and not permitted to grow high, 
and here it should be permitted to rise, walk and 
fall too, as much as it pleases. 
I have 6aid that children ought never to be 
pulled about by their arm or arms. Dislocations, 
sprains, and deformities are the frequent results of 
such conduct. 1 have seen nurses, in leading 
a child by one arm, pull so hard as to cause 
it to fall forward, not being able to set its 
feet firmly on the ground, and then of course its 
whole weight would be suspended upon one arm. 
Not unfrequentlv, too, does the nurse lift it in this 
way over a drain, a log, or up or down a step. 
Those who handle children in this way do not 
seem to reflect that it would not be very com- 
fortable for themselves to be thus pulled about by 
the arm with a power and velocity adequate to the 
task. Yel what reason have they to believe that 
children can bear it better than adults! They may 
rely upon it that the cause of much of the fretful- 
ness and crying of children and of many a deform- 
ed shoulder, may be found in this violent dealing 
with infants, perhaps for the purpose of prevent- 
ing their crying. Not only are infants thus treat- 
ed by a careless unfeeling nurse, when unobserved 
by the parents, but I have often seen it in the 252 
mother herself. She cannot be supposed to “for- 
get her child,” but it were much better that she 
should at times neglect it, than to treat it so rashly 
as she frequently does. 
“After children have acquired the entire use of 
their legs,” says Dr. Eberle, very justly, “tcalk- 
ing is decidedly the best exercise they can take. 
When the weather is fine, they should be taken out 
daily, and freely indulged in running and walking 
out under the superintendence of a careful nurse. 
These little excursions, if prudently conducted, 
have a highly salutary influence on the infantile 
system. Children that are raised in the country, 
are, in general, much more robust, healthy and ac- 
tive than those that are brought up in cities: and 
this difference is mainly to be ascribed to the great- 
er freedom which the former usually enjoy, of 
walking, running and tumbling about the grass 
plats; enjoyments often in a great measure denied 
to the latter. In taking this kind of exercise, chil- 
dren should not be accustomed to rely too much 
on the assistance of others. If the ground is soft, 
or covered with grass, and free from stones, tim- 
ber &c., they should be permitted to have their 
way. A few falls will do them no injury; but, on 
the contrary, make them less timid, and teach 
them better than any other instruction how to 
avoid a similar accident in future. Children that 
are never suffered to surmount, by their own ef- 
forts, the little difficulties which may occur in their 
sports, -and are continually warned against trif- 
ling accidents, seldom fail to become unduly timid, 
helpless and irresolute in their actions. Parents 
ought not to intimidate their children by inspiring 
them with a constant dread of falling and hurting 
themselves. The custom of exaggerating the dan- 
gers incident to their usual sports, and of plying 253 
them continually with admonitory injunctions 
against accidents, when they are engaged in their 
amusements, is calculated to favor the occurrence 
of the very uccidents which they are meant to ob- 
viate, by the timidity which these perpetual les- 
sons of caution and fear almost inevitably inspire. 
When the ground is soft, it is much better to let 
the child take the chance of two or three falls, and 
give it full scope for the exercise of its limbs, by 
running and gamboling about till it is satisfied. 
Nothing can be more invigorating to the whole 
organization than this kind of unrestrained exer- 
cise, in suitable situations, and under the super- 
intendence of a prudent nurse. When they hap- 
pen to fall or hurt themselves, they should not be 
soothed by expressions of extreme pity and sorrow, 
which tend very effectually to render them effemi- 
nate and timid. Children thus commiserated, sel- 
dom fail to acknowledge the tender sympathy in 
straining their little lungs to the utmost by crying, 
on the reception of every slight injury. 
After they have passed through the primary pe- 
riod of dentition they should be encouraged in the 
pursuit of active amusement out of doors, as an es- 
sential and regular part of physical discipline. 
Nothing contributes more effectually to enfeeble 
the body, and to lay the foundation of permanent 
constitutional infirmity, than confinement within 
doors and want of active exercise at this tender 
period of life. The development of the moral and 
physical energies of children, can in no way be 
more effectually promoted, than by permitting 
them to engage freely in the usual sports of child- 
hood, in the fresh and open air. The practice of 
obliging them to remain within doors, and to con 
over their lessons between school hours, is by no 
means commendable. These intervals should be 254 
devoted to innocent amusement and bodily exer- 
cise. 
CLOTniNo, Air, Exercise, &c.—In the Pre- 
liminary Lecture, I 6poke especially of the evils 
that follow a want of proper clothing, pure air and 
abundant exercise. I must insist here, that chil- 
dren that are constantly deprived of either of the 
above named comforts, are seldom healthy, and 
never have a good constitution. Nothing is more 
important, whether we desire the development of 
thejphysical power or the mental energies,than that 
the system be protected from the excessive action 
of the atmosphere, the sun or the shower, by suit- 
able clothing, comfortably adapted to the figure 
and motions of the body, and then permitted to en- 
joy the pure air, from which it may derive oxygen 
for the perfecting of the blood, and be subjected to 
steady and varied exercise during the whole pe- 
riod of its growth. Children that have been bred 
in the house in idleness, or in factories where the 
air was impure, or in the depths of that poverty 
which deprived them of comfortable apparel, are 
seldom able to bear, with impunity, the labors and 
privations of those reverses of fortune to which all 
are exceedingly liable, while those that have been 
accustomed to labor on a farm (on the whole the 
best exercise in the world) more or less every day, 
during the whole period of their growth, are sel- 
dom afterwards broken down by any severity of 
either bodily or mental exercise. The clothing 
should not only be warm or cool, according to the 
season, but it should be properly distributed and 
comfortably attached. The feet, legs and arms 
should be clothed as warm as the body. No band- 
age should be drawn so tight round any part of 
the system, as to leave a mark after removal. The 
shoes should be always loose and comfortable; in 255 
infants very soft, and the feet should always be 
kept dry as possible. All children should wear 
drawers under their clothes, adapted to their ne- 
cessities-, cotton in summer, and flannel in winter. 
Thus appareled and comfortably fed, there need be 
little fear of their taking cold on exposure to any 
ordinary temperature of the atmosphere, while 
they should be frequently employed in the greatest 
convenient variety of useful exercises, in which it 
may be supposed that they will ever be necessarily 
or profitably employed. When the weather is 
damp and chilly, they should have an opportunity 
to play in a large room. They may be permitted 
to walk or run through passages and draughts of 
air, but never to lie, sit or stand long in them. 
They should not be tied a long time in a little 
armed chair, but allowed to run about and tumble 
over the floor, any thing against which they might 
injure themselves being removed. For several 
years, girls should have the liberty to play out of 
doors with the boys. Nor do I see any good rea- 
son why they should not, till they are ten or a do- 
zen years old. 15ut, if any think that they should 
be separated before this time, I earnestly insist 
that the girls be not deprived of exercise by them- 
selves in the open air. The keeping of them in the 
house or always covered with a long close bonnet 
when out, may give them a whiter and more deli- 
cate skin, but it deprives them of that robust and 
hardy constitution which is of far greater value. 
Neither girls nor boys, however, should be per- 
mitted to stand, sit or lie, long at a time on the 
damp ground. There is little danger of taking 
cold while exercising; but, when the exercise is 
over, care must be taken that they do not cool too 
suddenly. They should be required to walkabout 
till the perspiration has ceased, and by no means 256 
permitted to drink more than a swallow of water at 
a time. If they are very warm, a cup of warm 
water and milk is far better. Washing the hands 
and face in cool water directly after severe exer- 
cise in hot weather, is not only a sure remedy 
against taking cold, but will allay the thirst in a 
very great measure. The clothing that may have 
been thrown ofF before exercise, should always be 
immediately put on afterwards, that the heat 
which is then escaping too fast, may be retained 
round the body till the pores close gradually, and 
exclude the chilly air. 
The Nursery.—Where children are kept in the 
room with the other members of the house, as is 
most commonly the case, especially in this coun- 
try, the rooms are so often opened as to keep the 
air pure and wholesome, unless, indeed, the house 
is so small as to require many to huddle in one 
room, and sometimes even to cook there. But 
most families who have the conveniences ap- 
propriate to the children and their attendants, 
have a certain room they call a nursery. Into this 
they are frequently pretty well crowded, together 
with their dirty clothing and every thing that per- 
tains to them. This room is frequently made near- 
ly air tight, lest they take cold; many are suffered 
to crowd into it and corrupt the atmosphere by ab- 
sorbing the oxygen, and what is worse than all, 
the children’s clothes are changed and, if only wet, 
are suffered to dry in the room; if dirty as well as 
wet, they are frequently suffered to remain in the 
room till they have rendered the air totally unfit 
for respiration. Instead of all this, the room should 
never be thronged with those who do not belong 
in it, (the larger children being compelled to tak-a 
their exercise in more open places, and to “play 
with the baby” when brought to them, or to be but 257 
few at a time in the nursery,) should be so con- 
structed as to be easily and freely ventilated at any 
time; should often be deserted while a current of 
air is permitted to pass through it, by door and 
window for half an hour or so; should be very fre- 
quently washed, always kept free from any and 
every tiling offensive, even a wet diaper, and con- 
stantly ventilated by lowering the upper window- 
sash a little, if no more. However damp, cold or 
unwholesome may be the air without, that within 
will soon be more so, unless it bo often changed. 
The room should never be entirely close, either 
at night, or in the coldest weather in winter. It 
is well to keep a thermometer in the room, and 
never to raise the heat above 65 to 70 degrees. 
But there should, if possible, be two rooms for this 
purpose. It were much better that a nursery be di- 
vided into two a part merits, even though they should 
be small, as the children may sleep in one and play 
in the other, and be changed from one to the other 
while washing, sweeping or ventilating. Still it 
is desirable that both should be large, airy and 
well lighted and ventilated. An upper room is 
preferable. It may be warmed either by a fire 
place or a 6tove, provided the latter be not heated 
too hot, and a basin of water be kept upon it, so 
that the evaporation shall prevent the air in the 
room from becoming too dry. Let the stoves be 
properly proportioned in size to the rooms, and 
there will not be much danger that there will be 
too much heat. But this heat is, in my opinion, 
far preferable to that of a fire in the chimney, as 
it is much more equal all over the room. A high 
fender should surround the stove or fire place, so 
that the children cannot get at it to burn them- 
selves on it. The room in which they spend the 
day, should have little furniture in it except a 258 
pood,thick, woollen carpet to prevent the children 
from injuring themselves by falls. Now fill it 
with useful play-things, such as balls, and various 
geometrical figures made of cork and painted, and 
with any thing else that is calculated both to 
amuse and instruct them. Their little eyes may 
as well become accustomed tmseeing, at once, 
something that is useful, as something that is 
worthless. If attended by an intelligent person, 
they may learn, even in early infancy, the nature, 
operations and names of all the geometrical figures, 
and a thousand elements of useful science, merely 
as matters of amusement. But, of all the requi- 
sites in the nursery, none is so really important as 
that which is frequently least thought of, viz. a 
person to direct the amusements and attend to the 
wants of children, who is well acquainted with 
human nature, and qualified by experience and 
self-government to mould the infant mind in the 
way it should be formed. I have not a doubt that 
a large majority of infants commence, before they 
are eighteen months old, that course of subjection 
either of the judgment to the passions or the pas- 
sions to the judgment, which is rarely changed in 
character during the whole course of after life. 
And yet, how often do we see them taught, during 
this period of their pupilage, to indulge the most 
revengeful spirit, allowed to “whip” or command 
the nurse to whip those persons or things that are 
supposed to have annoyed them; to get almost any 
thing or license they want, provided they will cry 
long, loud and pitifully enough to weary the pa- 
tience of the attendant; and to get rid of the per- 
formance of any duty by merely making a firm and 
persevering resistance. What can be expected of 
the child that has commenced its mental disciplino 
in this manner] Yet such it will be, unless the 259 
nurse be both able and disposed to teach it better. 
Cleanliness.—Nothing is more important in 
the preservation of health and the prevention of 
disease, than cleanliness. 15y this remark, I do 
not wish to be understood that a child should be 
prevented from going where it would be likely to 
get dirty. It will become as dirty from the drying 
of its own perspiration on the surface, as from any 
other cause or exposure. The surface should be 
cleansed often, and that too, not merely by wiping 
with a damp cloth. Children should be taken into 
a warm room, every night, before going to bed, 
the doors of the room closed to prevent currents of 
cold air fromstriking them, and should be stripped 
and thoroughly washed in a tub of warm water, 
and with a little soap; then rubbed dry, dressed in 
clean night clothes, and put to bed, at least till 
they are weaned; and it should be continued often, 
by the nurse, till they can do it themselves, when 
they should be required to do it, till they do it 
willingly, for the pleasure and comfort it affords. 
Some are afraid that this will give their children 
a cold, but I am sure sickness has occurred ten 
times for the want of this frequent ablution where 
it ever did in consequence. Children that are per- 
mitted to get ever so dirty during the day and are 
thoroughly washed every night, do not, in reality, 
get half as dirty as those that are supposed to be 
kept so constantly clean as to need no general 
washing at all. The custom of wiping instead of 
washing, and thus leaving the acrid fluids or the 
still more solid and offensive materials about the 
groins and hips of children, is the principal cause 
of chafes and eruptions in those parts. 
A dirty, waxed up, or contracted skin, too, is 
sure to check the perspiration and produce de- 
rangement of the stomach and bowels. It predia- poses to internal and eruptive forms of disease, by 
checking the vital opposition to them, and makes 
them much more dangerous by retaining longer in 
the system, the morbific matter that induces them. 
The vrater in which the child is washed should be 
as warm as is comfortable; and, after three or four 
months, the washing may be finished by a dash of 
water a little cooler, in the manner of our cold dash 
after steaming, proportioning the heat so as only 
to make the child startle a little at the change of 
temperature. It should then be wiped dry imme- 
diately and dressed warm, and, if it be thought at 
any time that there is any danger of taking cold, 
it should have a little warm tea and be induced to 
commence some active exercise, to raise a perspi- 
ration before the skin becomes cold and contract- 
ed. Warm baths and cold dashes should be given 
to children frequently, till—even their second 
childhood is ended! Physicians recommend wash- 
ing with cool water after the child becomes older; 
this may he well, but the warm batli with the cold 
dash is doubtless far preferable at any time. If the 
cool bath is used, it should not be while the body 
is perspiring. They think the warm batli the most 
desirable to benefit the constitution, and the cold, 
the best calculated to secure against taking cold. 
Our plan unites both these advantages. I have no 
objection to a sudden plunge into cold water, when 
the tendency to the surface is strong; but I am 
persuaded that it is injurious to let the body re- 
main long in a bath much cooler than its own tem- 
perature. To wash the body in warm or tepid 
water and leave the skin relaxed, would tend to 
debilitate it; but the sudden cold dash restores the 
tone, retains the heat, and greatly strengthens the 
system. LECTURE 17. 
Weaning.—“ The obvious correspondence,” 
eays Dr. Eberle, “which exists between the suc- 
cessive appearance of the teeth and the develop- 
ment of the digestive powers, affords us a safe 
guide in relation to this subject.” The artificial 
nourishment may be commenced with the appear- 
ance of the first teeth, and gradually increased in 
quantity and quality, till the incisor teetli have 
made their appearance, (seldom sooner than the 
eighth or later than the twelfth month,) when, the 
child being pretty healthy, it may be taken from 
the breast altogether; and its digestive organs will 
have acquired sufficient activity and power to ena- 
ble them to digest what the system demands, viz. 
a more substantial nourishment than that of the 
breast, llut the change should be very gradual, 
first to a very simple fluid, then to more dense, 
and then to solids. “When the period of weaning 
is approaching, small portions of milk, thickened 
with bread, rice or flour of rice, chicken, mutton 
or beef tea &c., should he allowed the child two 
or three times a day, whilst,at thesame time, the 
intervals of sucking should be more and more pro- 
longed.” The same kind of food should he conti- 
nued some time after the child is taken from the 
breast. The first meat that is generally allowed 
is chicken, mutton or beef. I remark that these 
ought to be boiled, and the fluid only given, for 
tome time. When meat is boiled till it falls off 
the bones, the nutritious parts are chiefly in the 
fluids, very little is left in the fibrine, which is now 
indigestible and ought not to be eaten. Care 
should be taken not to give too much at a time. 
In case of the death of the mother, or her inabi- 
lity to furnish milk, the child must of course be either intrdsted to a nurse or fed from the phial; 
but the materials must be such as have been alrea- 
dy recommended. Sometimes, however, the mo- 
ther gives abundance of milk, but its quality is vi- 
tiated by disease; as scrofula and other morbific 
humors. It is apt to be bad when menstruation 
occurs, as it sometimes does during lactation. So 
it happens too, occasionally, when little but debil- 
ity appears to affect the mother. In all these 
cases, the health of the child will generally be se- 
riously affected. It must be withdrawn from her 
breast and nourished from some other source. 
When its constant drains from her breast, seem 
greatly to exhaust the mother, it must be with- 
held from her for her own sake. Many females, 
especially young and delicate, are able to supply 
only a part of the nutriment that is wanted. They 
should be permitted to supply what they can com- 
fortably, and the deficiency should be made up by 
feeding: But the period of lactation should seldom 
be prolonged beyond twelve months, on any ac- 
count. When children show very great unwil- 
lingness to quit the breasts, they may be induced 
to do it by putting some bitter substance on the 
nipple, as butternut extract, gum myrrh Arc. 
Tongue-tie.—Sometimes there is a thin, wide 
membrane extending under the tongue of infants 
almost to the tip, so as to hold the tongue from 
projecting beyond the tops of the under teeth. 
This membrane should be carefully cut with a pair 
of blunt pointed scissors. Examine carefully and 
not cut so far as to take what ought to be left, in 
which there are arteries and veins to sever which 
might produce dangerous hemorrhage, besides the 
mischiefs that would be done to the motions of the 
tongue, by cutting off the that attach- 
es it to the arch of the lower jaw bone. 263 
Thus far, I have treated on the prevention of 
disease in children, which I consider a matter of 
the first importance. Unless these hints be re- 
garded, it will be very difficult either to cure sick 
children, or to keep them well after they are cured. 
But, if they are carefully obeyed, I am persuaded 
that there will be but very little sickness to cure. 
I have treated also, in the preceding pages, of sev- 
eral forms of disease peculiar to children. I shall 
here now mention the symptoms and treatment of 
most others of any importance, and give direc- 
tions which will answer for all, of however mi- 
nor consequence. 
Eruptions.—Eruptions of various names some- 
times come out upon children, and sadly frighten 
doctors, if not old women. They are called, jaun- 
dice, erysipelas, measles, scarlet fever, chicken 
pox, and other “exanthematic affections,” &c. 
These are said to be more or less “acute,” ac- 
cording to the degree of fever that attends them. 
Our plan is to treat them all upon the same prin- 
ciple and with different degrees of energy accord- 
ing to the urgency of the case. The best plan is 
to give an emetic and emp.y the bowels at once 
in our peculiar way, accompanying both adminis- 
trations with just stimulus enough to keep up a 
moderate tendency to the surface. If the internal 
canal is very foul, we repeat this, until it is pret- 
ty clear; then continue the determination gently to 
the surface, which must be kept clean by occa- 
sional steamings or washings in warm water, when 
steaming cannot be practised; and the patient will 
soon be well. The only error I have seen commit- 
ted by our friends, in their treatment of these forms 
of disease, is such an effort to drive the obstruc- 
tions out so soon that, in some cases, the skin was 
opened too freely and the patient rendered too lia- ble to take cold; and in others, the fever was rais- 
ed unnecessarily high, before the surface was 
opened at all. One or two gentle emetics in the 
beginning, and a few injections, followed, not pre- 
ceded, by a judicious steaming, will, in all ordi- 
nary cases, break the power of these forms of dis- 
ease: and then a steady course of stimulation just 
energetic enough to keep up a healthy action, is 
the best course. In measles, expectorants should 
be given to loosen the phlegm; and, ifthere be much 
irritation, emollients, as slippery elm or flaxseed 
tea, should be drank. In this and in scarlet fever, 
generally, some mild sudorific, as sage, boneset, 
pennyroyal, catnep, peppermint, is sufficiently 
stimulating. In the putrid sore throat, a gargle 
made of tincture of cayenne and gum myrrh, not 
so strong as Dr. Thomson’s No. 6-, should be fre- 
quently used. The bowels should be kept free by 
enemas, and the extremities warm. I have had 
patients of all these forms of disease, and treated 
them as above, without the loss of one. The 
symptoms do not decide so that a regular physi- 
cian would be sure which it is, till a Botanic, fol- 
fowing the above plan, would have any of them 
half cured. The eruptions are all preceded by more 
or less fever, some by chills &c., but these do not 
determine which it is to be, soon enough to be of 
use to the practitioner who knows how to cure 
them all in the best way. “He sees nature strug- 
gling against [obstructions, the cause of] dis- 
ease,” which are threatening to produce disease, 
and “and he raises his club and strikes,” but not 
“at random.” He has a club assure as a Ken- 
tucky rifle, that is terrible and dangerous only to 
the enemy of health and life. He takes certain 
aim and disease alone is slain. The scarlet fever 
and the measles, require three or four to six or 265 
eight clays to get entirely out of the system; the 
jaundice, erysipelas and small pox, some longer: 
but none of these forms of disease are much to be 
dreaded if properly treated. The Rotanics do not 
lose one in fifty ofthem. Regular physicians often 
make a great noise about our commencing prac- 
tice on every one of these forms of disease, before 
we are certain which it will prove to be; but noth- 
ing is more certain than that we can break the 
power of any one of them before they can decide 
the same, to us, little important question. Our 
practice for one, is not, like theirs, injurious to any 
other. Rut, as for those who teach that “scarlet 
fever is best subdued by the most powerful bleed- 
ings in the onset,” and that some of the others 
“are of a typhoid character.” in which “even mod- 
erate depletion would be death,” we admit that 
they are right in waiting till they are sure that 
bleeding will not be death, even though the dis- 
ease should become, by such delay, far more diffi- 
cult to cure. 
The Urine.—Cold or obstructions may con- 
tract the urethra, and check or entirely stop the 
discharge of urine. After these causes have been 
in operation for some time, the spincter urethrse 
may relax and allow the urine to pass involuntari- 
ly. In all these cases the parts must be relaxed 
a little and stimulated to such a degree as to dis- 
engage and eject the obstructions. This is best 
done by applying warmth and (if necessary) mois- 
ture to the parts, and then giving freely diuretics, 
as cleavers bayberry, ginger, sumach, cayenne, 
asparagus, or water mellon-seed tea, or the aro- 
matics, as the mints &c., and in a short time these 
difficulties will all vanish. See page 228. To 
prevent them, children should be induced to dis- 
charge the urine late at night and early in the 266 
morning and to sleep on the side. These forms of 
disease, are supposed to be very difficult to cure, 
but I think that it depends altogether on their 
treatment. I have had but little difficulty with 
them. 
ThbBowbt.s.—Costiveness, Relax, Piles, Colic 
be. No physic should ever be given merely to 
open the bowels. Injections are not only the most 
speedy and effectual remedies in the case, but 
they are the most easily administered. They will 
always open the passage, and, if they are made of 
cayenne and bayberry, lobelia and slippery elm, 
they will correct the morbid state of those visce- 
ra so as to prevent recurrence. When the bowels 
are too lax and the stools watery, containing un- 
digested food, the stomach is in fault, and the 
child should have an emet:c and then injections. 
The state of the skin should be examined, cleans- 
ed and kept open. If the stools are slimy or bloody, 
and seldom contain natural foecal matter, the bow- 
els are in fault, and must be cleansed with injec- 
tions of canker teas, and then a small injection of 
slippery elm. If they are painful, slippery elm 
will relieve them; if they descend in the form of 
piles, use astringent injections alter the cleansing 
ones, and then the slippery elm. If they are sore, 
grease them with sweet oil, goose grease or fresh 
butter. See Piles, page 127. Injections with a 
little cayenne are the best means of relieving wind 
in the bowels or cholic, w'th which children are 
very apt to be afflicted, when the abdomen some- 
times swells quite large and is very elastic. 
Dentiton.—The teeth, as they appear in infan- 
cy, are four incisors or cutting teeth, two bicuspid 
or eye teeth, and four grinders or double teeth in 
each jaw, in all 20. The two front teeth general- 
ly appear about the fifth or six month; sometimes the second or eighth! Some children have been 
born with their front teeth protruded, others have 
lived nearly two years without them! Three or 
four weeks afterwards, those above them. Then 
follow, generally, the other incisors, the first 
eye teeth, and, lastly, the second grinders—the 
lower of each pair preceding the upper. 
The chief symptoms are the widening and flat- 
ening, reddening and swelling of the top of the 
gums, the disposition to bite the finger, a fretful 
temper, starting in sleep, salivation, sometimes 
fever and diarrhoea &c. Dr. Eberle thinks that 
this disease, “although a process of physical devel- 
opment, and, therefore, strictly in accordance 
with the regular process of nature,’ gives the body 
“an increased susceptibility to the injurious influ- 
ence ofirritating causes, and hence all diseases, 
whatever be their cause or origin, are apt to as- 
sume a more violent character during dentition 
than at other periods. From this circumstance, 
as well as from the direct tendency of dentition to 
originate violent affections, the period during which 
this process is going on, is justly regarded as one 
of the most perilous stages of life. It has been 
computed that one-tenth, at least, of all the deaths 
that occur during childhood, may be fairly ascrib- 
ed to dentition, and it does not appear to me that 
the estimate is exaggerated.” Now it seems ra- 
ther strange to me that “a process strictly in ac- 
cordance with the arrangement of nature,” should 
naturally kill one-tenth of all nature’s children. 
There must be some other reason for their death! 
Let us see what it is. 1st. This disease has been 
so formidable in the fashionable circles, in the 
mouths of doctors, and college text books, and 
“Domestic Medicines,” that a doctor is generally 
cent for to cure it. He begins by saying that the “febrile symptoms,” the slight irritation in the 
system anil derangement in the circulation, caused 
by the pressure and pain in the part of the gum 
pressing on the top of the tooth, this sensitiveness 
of nature to expel from the system any thing and 
every thing that opposes her uniform and univer- 
sal action, is “the disease” that is to be cured! 
So, to work he goes, (certainly very consistently 
with this theory,) “to diminish the irritability 
(tiie vital action) by bleeding, purging, poisoning 
&c., and he follows up this practice as far as ho 
dares without the danger of immediate destruction 
to the patient. Nay, he frequently gives, within 
a short space, what he knows to be enought of this 
poison to kill two or three well children when 
given at once. True the child often dies, but it is 
so far more* scientific to attribute the death to “a 
process strictly in accordance with a development 
of physical nature,” than to poisons, the legiti- 
mate enemies of vitality, that the doctor, instead 
of being called by his right name, a man-slayer, 
gets great praise for his science and skill ! I ac- 
cuse no man of evil intention in this matter, but I 
do accuse of the most consummate stupidity every 
man that gives a poison to cure “a process of na- 
ture.” 
But I am asked, Why the diarrhoea just at that 
time! I answer, the diarrhoea takes place, because 
the system, being irritated generally, by the ten- 
derness of the gums, is more sensible to the pre- 
sence oftriding obstructions which, when less ac- 
tive, it would disregard. Why are other diseases 
so much worse? They are riot. Greater excite- 
ment in the system is proof of greater sensibility to 
the irritation of obstructions, but by no means to 
the greater danger of the case. Is a smart fever 
from a violent cold, more dangerous or difficult to 269 
cure, than the consumption, the dyspepsia or the 
hysterics] Regulars “guess” so; but we know 
better. But, say they, the diarrhoea relieves the 
febrile symptoms, and checks the violence of arte- 
rial action by diminishing the quantity of the 
blood, and thus proves that depletion is good. No, 
I answer. The diarrhoea removes the morbific 
matter that was deposited in the vascular system, 
for want of that action, which the febrile stimulus 
of dentition excites, and hence the real cause of 
disease, not the imaginary one, is removed, while 
the symptoms of dentition only, remain. 
“When the gums become inflamed, swollen and 
painful, the secretion of saliva scanty, with torpor 
of the bowels, the whole organization generally 
sympathizes strongly with the local affection, the 
nervous system, especially, is liable to great and 
dangerous irritation. Indeed, when, from the in- 
fluence of previous morbific causes, the system has 
become feeble, and unnaturally irritable, the most 
alarming consequences sometimes result from the 
irritation of the advancing teeth, before any signs 
of irritation and inflammation are discoverable in 
the gums.” 
These “consequences” of dental irritation are 
“alarming” only to those who have adopted the 
principle that fever and irritation are disease, and 
that depletion and poison are the proper cures. 
The numerous deaths, under this faith and prac- 
tice, arc indeed alarming, but I am not disposed to 
ascribe them to “a physical development strictly 
accordant with the designs of nature.” It seems 
to me a very blundering design that contemplates 
and renders unavoidable the destruction of one- 
tenth ofall the ends it was made to subserve. It 
is 6urely not the work of Him who is wise in 
counsel and infinite in power. 270 
But it is said that one cause of these alarms is, 
that the fretfulness of the child induces the nurse 
to feed the stomach too frequently and with indi- 
gestible materials, which derange the functions of 
that organ and induce dyspepsia. Very true, but 
then the fault is in the nurse, not in dentition. 
Still, Dr. Eberle insists that “the risk of [even 
these] consequences from dentition is always very 
considerable.” Surely no one will dispute the 
soundness of such scientific logic! It is added, 
that stimulants increase the danger of this dis- 
ease, by increasing the irritation. I answer, no: 
they increase the danger of the patient by inciting 
the doctor to an effort to destroy the vitality of the 
organs instead of removing the causes which dis- 
turb their action. But “the practice of covering 
the head with caps and keeping the child confined 
in impure air, make the consequences of teething 
more alarming.” They have no consequences of 
their own it seems! If these things are attended 
with bad consequences, (and they certainly are,) 
condemn them as severely as you please; but lay 
not all their sins to dentition; for, as this cannot 
be prevented, there is no hope of cure. 
“The morbid sympathetic effects of difficult den- 
tition are very various.” Why! Because all the 
effects, whatever their origin, that happen about 
that time, are ascribed to this as a cause. But 
it is here that excessive local irritation is calculat- 
ed to check the action of some of the important 
functions, and render excessive that of others, as 
that of anxiety grief &c., checks digestion and ex- 
cretion, and increases cerebral action; and, there- 
fore, disagreeable consequences ensue, for which 
sc instiling ought tube done. And what is it! 
Ai.swer 1. Clear out all morbific matter from the 
system, and leave nothing to obstruct the action 271 
exerted by the dental irritation; then give none 
but suitable food in reasonable quantity. For the 
manner of doing it, see “Course of Medicine,” 
page 120 and onward. This being done; and the 
patient being secured against the danger of tak- 
ing poisons or losing blood, the system will be 
left solely to tiie effects of “a process of nature de- 
signed for the development of the system,” which 
cannot well produce death, without going out of 
its appointed course. If the child be permitted to 
have, among its playthings, something of proper 
shape, a piece of smooth wood or polished and 
rounded bone, fastened to a ring or cross piece, like 
the handie of a gimblet or an ivory ring to prevent 
it from getting too far into the mouth, and to bite 
it as soon and as often as it pleases, the teeth will 
be cut through in due season, without much “dis- 
turbance to the general system.” The child will 
show a disposition to relieve itself, by biting the 
nipple or the linger, when it should be taught to bite 
the wood or ivory which it will soon much prefer. 
The teeth will thus make way for themselves as 
fast as they grow, and little disturbance will be 
produced in the circulation. If, however, the gum 
should swell and be painful, and yield very unwil- 
lingly to the pressure of the tooth, it should be 
lanced directly on the top, which may be known 
both by the feeling, and by a little white mark 
produced by the compression of the capillaries 
over the end of the tooth. The incision must be 
made entirety to the tooth, and as long as the tooth 
is wide. Wnen convulsions attend dentition, they 
should be treated as at any other time. A course 
of medicine is the relief, and a regular restorative 
treatment the cure. Attend strictly to the above 
instructions, and few will be the victims of the 
tithing disease cailed dentition. 272 
Dr. Eberle says, “Nothing tends more strongly 
to favor the occurrence of convulsions during den- 
tion, than gastric or intestinal irritation from the 
use of improper articles of nourishment, or from 
overloading the stomach. I am inclined to think 
that the majority of instances of convulsions usu- 
ally ascribed to the sole irritation of dentition, 
are, in fact, excited by the improper or immoder- 
ate use ofalimentary ingesta. When the diarrhcea, 
which frequently accompanies dentition, is sud- 
denly arrested by astringents, opiates &c., the 
liability to convulsions is always much increased; 
more especially in robust and plethoric infants. 
The same thing occurs when, from cold or any 
other cause, the salivary secretion is suddenly 
checked’or suspended, and the bowels remain cos- 
tive.” 
“Various eruptions on the skin are among the 
most common morbid consequences of difficult 
dentition.” This is because the ‘ general irrita- 
tion” moves forward more rapidly to the surface, 
the various morbid humors and morbific substan- 
ces that are lodged in the system then, than at 
other times. “Fever is perhaps the most common 
sympathetic affection of difficult dentition. It sel- 
dom, however, assumes a vehement character, 
unless there are other sources of febrile irritation 
present. It is generally slow, irregular, change- 
able, intermitting or remitting, presenting the usu- 
al phenomena of chronic, irritable fever from slight 
local affections.” This shows that, in fact, denti- 
tion alone is not capable of creating anv great dis- 
turbance in the system. “The majority of instan- 
ces of fever that occur during dentition, are excit- 
ed or at least greatly promoted by other causes.” 
Then pray, why lay them all to the charge of 
dentition! 273 
Dr. E.’s plan of prevention is air, exercise, cool 
head, warm feet, free bowels &c. \ery good— 
“avo dingall stimulants!” For the cure—strong 
purges do “much harm.” “When habitual cos- 
tiveness,” says the Doctor, “is attended by a defi- 
cient secretion of bile, from one to two grains of 
calomel should be given every third or fourth eve- 
ning, and a moderate dose of castor oil or magne- 
sii on the following morning;” but, “great care 
should be taken that it be not carried to the ex- 
tent of inflaming the gums and producing a gene- 
ral mercurial action on the system. I have wit- 
nessed several highly distressing instances of ex- 
tensive ulceration and sloughing of Ihe gums and 
cheeks, in consequence of employing calomel &c. 
I suppose that the Doctor intends that we shall 
“takecare” to stand and watch the operation, and 
forbid it from producing such an effect! “Slough- 
ingofthegums and cheeks,” however, can be 
borne with from calomel, more patiently than a 
few moments smarting from cayenne! The Doctor 
prescribed the calomel with ipecac and chalk, in 
one case in which “nothing of a dangerous cha- 
racter occurred except a diarrhoea which, in a 
short time, became extremely violent and prostrat- 
ing.” Thus “moderating the complaint to a suffi- 
cient extent, he advised a decoction of the root of 
geranium maculatum in milk. The bowel com- 
plaint was soon entirely arrested. In about ten 
hours after the complaint was thus stopped, a vio- 
lent paroxysm of convulsions occurred which ter- 
minated in a torpid or comatose condition; and, al- 
though an active purgative and repeated enemata 
were administered, a second fit of convulsions ter- 
minated the life of the little sufferer.” (Drying 
up sores produces similar effects.) 
This child doubtless died because not only the 274 
effort of the diarrhoea to throw off irritating sub- 
stances was arrested, but poison (calomel) was 
given to destroy vitality, by this scientific doctor! 
A very little calomel given when the system was 
exhausted by over excitement, was sufficient, it 
senis, to destroy life. The spasms or convulsions 
were nothing more nor less than fruitless efforts )f 
the system to recover its wonted action. The 
Doctor recommends blisters behind the ears, in 
some cases, to prevent inflammation in the brain. 
But, to prevent sanguineous congestion, and con- 
vulsive action in the brain, 0^/=“thesimultanebus 
application of a cloth dipped in cold water, to the 
head, and a warm bath to the feet and legs, is, in 
general, more prompt and certain in giving relief 
than any other remedy we possess.” 
Here then is the declaration of a Professor, sup- 
ported by cases of his own reporting, that, while 
his poisoning, purging and constrictions produce 
death, the Botanic remedies, the cool bath to the 
head and the warm bath to the lower regions, 
badly as they apply them, equalize the circula- 
tion, and are the most prompt and certain reme- 
dies they possess. Alas for the four thousand 
years experience, and the war against steam and 
lobelia! Choose your practice, friends! Good and 
evil, life and death are set before you. 
Erysipelas.—This form of disease is common 
to infants and adults. It is supposed, by physi- 
cians, to have some peculiar connexion with or af- 
finity for the first four or five weeks of infancy. 
It is characterized by the presence of small blis- 
ters on the surface, occupying different places at 
different times, and sometimes separating and pro- 
ducing mortification; in short, it is an itinerant 
whose visits are rather unwelcome in any place. 
From all that has been written on the subject, no 275 
decided points can be learned respecting’ its ori- 
gin, nature or cure. It is extremely doubtful to 
physicians, whether the fever that attends it, is 
really “active”or “typhoid;” and.ofcourse, wheth- 
er they should deplete or stimulate. They decide 
this point according to the general strength of the 
patient. 
Dr. Eberle, to whose work on children I refer 
for the truth of what I have just said, on the dis- 
ease, or may yet say on the regular treatment, 
thinks that four leeches may draw blood enough 
from an infant in any case. He thinks it generally 
of a typhoid character, not admitting active de- 
pletion. The remedies mentioned by him are cal- 
omel, castor oil, ipecac, bicarbonate of soda, 
James’s Powders, quinine, hyoscyamus, chalk, 
laudanum, ammonia, spirits of turpentine, &c. 
The “calomel,” he says, “can seldom be omitted 
with propriety,” in “the early stage,” “though it 
is apt, at this tender age, to give rise to dangerous 
irritation of the stomach and intestinal canal,” 
page 156. In the typhoid stage, quinine and am- 
monia are his best remedies. Of the value and 
use of external applications, “the weight of good 
testimony is decidedly in favor,” though writers 
“ofrespectability” say “they are generally unne- 
cessary if not prejudicial.” However, as the poi- 
sons and leeching before mentioned, frequently 
fail, (no! they do their work very surely,) the af- 
fected surface must be treated with “blisters, [to 
cure blisters! like bleeding to cure hemorrhage!} 
Lead-water mercurial ointment, corrosive subli- 
mate and nitrate of silver [the last two must be 
put on with a brush, feather or pencil, lost it eat 
off the fingers that apply it!] must be successively 
tried. Last, but not least “scientific,”“tho prac- 
tice ofmakingfree incisions,through the inflamed skin and subjacent cellular and adipose [fleshy] 
structures, has recently been greatly extolled as a 
means of arresting the progress of phlegmonous 
[inflamed] erysipelas!This answers “when the 
case is a proper one for the practice! and the state 
of the patient admits of its being fairly tried!” 
Some recommend “one long incision through the 
whole inflamed part;” others, “several short ones, 
an inch or an inch and a half long,” &c. When, 
by these means, they make large sores and bring 
on mortification, then “a poultice of charcoal, oak 
bark and yeast forms a valuable application,” 
though there is little hope of cure in these cases! 
Is not all this very learned'! I assure the reader 
it is the only legitimate child of the celebrated pa- 
rent of 4,000 years! 
I have never treated this form of disease in in- 
fants; but, as the Doctor says it is the same in 
adults, I will close this subject by giving a case. 
Mrs. Purkinson, of Richmond, Va., had been af- 
flicted with this disease, every summer, for three 
years. It was more aggravated and continued 
longer at each successive season, than at the pre- 
ceding, the attack of 1803, continuing, under “re- 
gular” treatment nearly all summer. In the 
spring of 1834 she applied to me. Her face was 
so swollen that she could scarcely see, and blis- 
ters an inch long, more or less, were raised all over 
it. I directed an emetic and a sweat, relief to 
the bowels, and a poultice of bayberry, slippery 
elm &c., to the face. The next day she was about, 
and, in less than a week entirely well. No traces 
of the disease had been seen when I left Rich- 
mond, the latter part of the nextsummer. I ad- 
vise, then, first, a course of medicine; secondly, 
poultices of bayberry, lobelia, slippery elm and 
cracker to the sores, and repeat till they all disap- 277 
pear; th?n the “intermediate course;” and I advise 
it with full confidence of success. 
LECTUR E 18. 
Skin Rinding.— A. form of disease in which the 
skin commences drying and hardening about the 
pubes and the thighs, and spreading on the body, 
till it finally so coniines the action as to 6top res- 
piration. It is very uncommon, seldom occur- 
ring in this country. I notice it only because 
Dr. Eberle says it is nearly allied to erysip- 
elas, and that “the aqueous vapor bath is de- 
cidedly the most valuable remedy that has hith- 
erto been recommended for the cure of this affec- 
tion. 
Aphthae, Thrush or Sorb Mouth.—This is a 
very common as well as a very troublesome affec- 
tion of infants, and not unfrequently of their moth- 
ers too. Sometimes it appears at. first, in small 
white spots on the tongue or inside of the mouth, 
as the cheeks, fauces &c., the spots increasing in 
number and size &c., ripening, detaching and 
falling off; at other times turning brown, becom- 
ing harder and more extensively diffused down 
the throat. It is the canker of Dr. Thomson, the 
effects of obstructed perspiration, and effectually 
treated with bayberry, barberry, gold-thread, slip- 
pery elm, the vapor bath &c. The cure is very 
easily effected by the llotanic practice. Emol- 
lients, as slippery elm, should be freely used, both 
to soften the crusts and to protect from irritation 
the tender skin after the thrush or old coat has 
been removed. This should not be rubbed off 
rudely before a new coat is formed under it.— Light and easily digestible food should be given, 
if the child is not supported by the breast. 
Sometimes the mouth is troubled with ulcers of 
a more malignant character and a darker hue; but 
they are to be treated as directed above—remove 
the canker, keep the surface free, and soothe the 
irritation—you know how. Notwithstanding that 
physicians are so much afraid of inflammation, 
and so constantly proclaiming that our poison (cay- 
enne &c.) will produce it; yet, while they pre- 
scribe cayenne gargles in putrid sore throat, they 
recommend, in tlie above cases, the giving of “Do- 
ver’s Powders” (opium &c.) and washes of “sugar 
of lead, nitrate of silver, sulphate of copper” &c. 
In one case, Dr. Eberle “ordered five grains of 
ipecac, and twograinsof calomel. Active vomit- 
ing was induced and three or four alvine dischar- 
ges followed;” but, he adds, “In using calomel, 
great care ought to be taken lest it affect the 
gums—an occurrence which could hardly fail to 
impart a dangerous character to the ulcerations.” 
Dr. Good of London, and Dr. Abercrombie of Ed- 
inburgh, say, of calomel and other poisons, that it 
depends on the operation of causes in the system 
entirely beyond the reach of our observation, 
whether these articles act at all, act in accordance 
with our wishes, or in opposition to them, “with 
dangerous violence.” Still, Dr. Eberle does not 
think the disease itself very “dangerous,” except 
in hospitals, and very crowded places where many 
are afflicted with it. A writer in the Boston Med- 
ical and Surgical Journal, lately inquired whether 
some one had not found out a more excellent way 
to cure this “chronic thrash” as it is vulgarly 
called, than is generally known to the profession. 
Another answered, as is usually done in such 
cases, that he had succeeded in saving sundry 279 
cases, (that is, he did not kill them,) by varying 
the quantity and proportion of the old doses, and 
by some other similar “modern improvements!” 
In conclusion of the article, I remark, I have 
known a great many children, and mothers too, 
die of something called chronic thrush, or aphthae, 
under the regular treatment, and T have seen a 
number of cases cured in t hree to 6ix days, by the 
Botanic practice, that had been continually grow- 
ing worse under the regular, for as many months. 
Colic.—Pain in the stomach or bowels, occa- 
sioned by gas accumulating in fend distending 
them. The immediate cause is imperfect diges- 
tion. A more remote cause is improper food or too 
much of what is good, or both. Some of it re- 
mains so long undigested in the stomach, that it 
ferments and generates gas, which accumulates 
and produces the effects just mentioned. If so, 
regulate the stomach and bowels, and correct the 
quality and diminish the quantity of food. If it 
proceed from a bad state of the nurse’s system, 
take the child from her, and feed it with cow’s 
milk. If from injury done to the alvine canal, by 
the use of purgatives or opiates, abandon them. 
Says Dr. Eberle, “Active purging is often deci- 
dedly injurious. The habitual use of opiates in in- 
fantine colic, almost always leads to very unfavor- 
able, and often to very distressing and dangerous 
consequences. The dose must be progressively 
increased; and thus a habit is soon formed which 
renders its discontinuance a source of inexpressi- 
ble inquietude, whilst its continuance in increas- 
ing doses, never fails to operate perniciously on 
the whole organization. Under the habitual use 
of these treacherous palliatives, constipation scon 
ensues; the appetite and digestive powers fail; the 
body emaciates and the skin becomes sallow, dingy 280 
and shriveled; the countenance acquires an ex- 
pression of languor and suffering; and a general 
•tate of apathy, inactivity and feebleness ensues, 
which ultimately leads to convulsions, dropsy in the 
head, glandular indurations, incurable jaundice or 
fatal exhaustion of the vital energies. The pain 
may indeed be lulled by the anodyne, but the in- 
fant is evidently under the influence of highly dis- 
agreeable sensations, as is manifested by the sud- 
den startings, unnatural, whining cry, and the ex- 
ceedingly irregular respiration, now very hurried 
for a moment, then slow and moaning, with occa- 
sional intermissions of so protracted a duration 
that ‘one would think the breathing had ceased al- 
together.’ All the usual soothing mixtures, such 
Godfrey’s cordial, Dalby’s carminative, so much 
employed for allaying colic pains and griping of 
infants, contain more or less opium, and innumera- 
ble infants have been irritrievably injured by the 
habitual use ofthese popular nostrums.” 
I believe this because I have actually seen it; 
but what a commentary is it on the invaluable re- 
medy, opium!—a “ treacherous palliative,” that 
produces “fatal exhaustion of the whole vital en- 
ergies, irretrievably injurious to innumerable in- 
infants!” What a curse to our country is opium! 
The person that gives it in any form, to an innocent 
and defenceless infant, after such testimony from 
such high authority, ought to be cropped, branded, 
gibeted and shot! Yet the very good Doctor him- 
self recommends its use by physicians, in almost 
every form of disease! Surely “much learning has 
made him mad!” for he continues this wickedness 
alter the “ignorant,” (such as ourselves, gentle- 
men, and “old women”) have discarded it forever. 
It must not be forgotten that the “active” in- 
gredient iu Dover’s powders, laudanum, parego- ric, morphine, and all the “anodyne drops,” aye, 
and the “styrax pills” of Drs. Wood «fe Bache, 
too, II. S. Dispensatory, page 934, is this very 
“accursed thin",” called opium. 
To cure this colic, then, when trifling, a little 
ginger tea or cayenne or No. 6, will relieve the 
stomach from pa in or even pressure on that organ, 
and a mildly stimulating injection will relieve it 
from the bowels. Taking the child up by the body, 
holding the pelvis for a very short time higher 
than the chest, and pressing the viscera in different 
places alternately, will remove it from tiie bowels, 
the head must not be held down till the face turns 
dark with venous blood, nor need it be held much 
lower than the pelvis at any time. If it return, 
give a full course of medicine and be more careful 
about the quantity and quality of the food taken. 
I have always found ginger and raspberry, or, at 
most, a little bayberry, amply sufficient for cour- 
ses to infants; though cases may occur where cay- 
enne and composition may be necessary. 
Give no poisonous physic, feed with good food 
in reasonable quantity, and colic will rarely hap- 
pen. When it does happen, remove it by the above 
simple means: if it returns and is troublesome, 
give courses of medicine and strengthen the sys- 
tem. 
Constipation or Costiveness.—Torpor of the 
bowels is common among infants, and though it 
may sometimes continue to seven or eight days 
without materially injuring the general system, 
yet I would recommend that in no case it be permit- 
ted to continue beyond the second day. The cause 
is said, by physicians, to be sometimes constitu- 
tional habit, at others the improper character of 
the food, or accidental “circumstances.” Doctor 
Eberle says, “the giving of opiates to make them 282 
sleep, that they may not require much attention 
during the night, is a frequent source of obstinate 
and injurious costiveness,” Dr. Dewees says that 
“nurses are now so familiar with this drug, [who 
taught them'!] that they as regularly carry it about 
them as their scissors or thimble, and consider it 
much more indispensable to their comfort, than 
either of those emblems ofindustry. If the child 
does not go to sleep, or ifit is even feared that it 
will not at the exact moment when it will suit the 
arrangements of the nurse; or if it cry, from any 
cause, so as to give any additional trouble, lauda- 
num is given so as to make ‘assurance doubly 
sure.’ ” This “very frequent cause ofcostiveness,” 
I suppose, wiil trouble none of the friends of Bo- 
tanico-Medical reform, except the par excellent 
“scientific” ones ot the Beacli and Worthington 
School, who use it very freely. The treatment, 
according to Drs. D. and E., consists chiefly in 
cathartic or opening medicines, castor oil, senna, 
magnesia, calomel &c ; but, say they, “In mode- 
rate cases of constipation, relief may frequently be 
obtained by the daily introduction of a soap suppo- 
sitary, or of laxative enemata,” instead of ape- 
rients; “for a long continued and frequent 
ployment of even the mildest laxatives, is apt to 
injure the digestive functions, and give rise to 
some degree of intestinal irritation.”—Eberle, 
page 204. 
As, therefore, in the worst cases, the opiates 
.generally begin the “habit,” and the physic to 
cure it produces a still worse condition, we will 
just reject these two, and use the proper enemata, 
diet and exercise, and the disease will not be trou- 
blesome. The enemata should be made of lobelia, 
bayberry, slippery elm, nervine and a little cay- 
enne, from a wine-glass full to a half pint, and re- 283 
peated till the effect is produced. For diarrhoea, 
witch hazle or raspberry, and cayenne should be 
used. 
Vomiting.—This is a vital operation and ealu- 
tary in its tendency, but, like all other disturbed 
actions, is an indication that something is wrong. 
When the infant is otherwise healthy and cheerful, 
the vomiting indicates only that the stomach is 
overloaded, and the cure will consist in prevent- 
ing it from taking so much. It should be stopped 
from sucking or eating as soon as it manifests the 
least indifference in these matters. It is a habit 
that ought not to be acquired, though no medicine 
should be given to stop it. When vomiting arises 
from irritation of the stomach, the suppression of 
morbid discharges, the introduction of proper food 
<Vc., clear it by a lobelia emetic, and regulate the 
diet both as to quantity and quality. No sedative 
should ever be given to stop the vomiting, as lau- 
danum and paregoric; as recommended by Doctor 
Eberle. 
Diahrhcga.—The diarrhoea, watery or mucous 
and frequent stools of children, generally proceeds 
from eating too much, or from eating things indi- 
gestible, or from taking cold. In the first case, 
check the appetite, that is, limit the quantity; in 
the second, change the diet. In both these cases, 
cleanse the stomach and bowels, and restore the 
tone. When it proceeds from cold, open the pores 
by the vapor bath or perspiration in some form. 
Diarrhoea is also a frequent result of givingpoi- 
sonous physic to cure costiveness. To cure it when 
it arises from this cause, cayenne must be used 
pretty freely after the courses. 
Diarrhoea is very often a result of a sudden check 
to perspiration, and may be almost as certainly 
corrected as that secretion is restored. Physicians 284 
enumerate many species of diarrhoea, proceeding’ 
from numerous causes, as indicated by a great va- 
riety of symptoms, and requiring different treat- 
ment; and they ridicule us for treating them all 
upon the same general plan and with only some 
twenty or thirty different remedial articles or pro- 
cesses. But what we ask, is the use of all their 
hair-splitting about the causes of the affection, 
when, at last, they actually use less remedies than 
we, and in a manner less varied! Calomel, mag- 
nesia, rhubarb, castor oil, ipecac, nitre, opium, 
blackberry, geranium, tartar, antimony, hyoscya- 
inus, charcoal, cantharides, and a few others; but 
calomel and opium are the great articles more 
used and relied on than all the rest. 
After prescribing, with great nicety, the quanti- 
ty of the above poisons, especially opium and calo- 
mel, which seem to be the “sheet anchors” of pro- 
phylactics, and the great levers of the curative pro- 
cess, in measures, proportions, grains, fourths or 
eighths of grains, according to the color, consist- 
ency, character, quantity and frequency of the 
the stools, (for the medical indications of which 
physicians who can seldom see them, depend upon 
the testimony of patients or attendants no doubt 
often quite as ignorant of these scientific distinc- 
tions, as the most ignorant steam doctors in the 
land!) and especially cautioning his pupils against 
giving these poisons “injudiciously” or in too 
large quantities, Dr. Eberle says, that the root of 
Geranium Maculatum, boiled in milk and a strong 
decoction of blackberry root, have been the most 
efficient remedies in his hands, in the cure of some 
forms of this disease, and that they possess the im- 
portant recommendation that they may be used 
freely without danger. Of running blackber- 
ry briar root, I can say, from my own knowledge, 285 
that its aid in the cure of diarrhoea is invaluable-, 
not merely because it is astringent, but because it 
removes canker from the whole canal. Of gera- 
nium, I know at least that it is astringent and not 
poison. 
J n addition to full courses for diarrhoea, dysente- 
ry and other looseness of the bowels, 1 have found 
that a syrup made of a strong decoction of equal 
parts of goden seal and nervine, is excellent. After 
boiling the ingredients half an hour, strain, press, 
add a fourth as much No. 6, and the 6ame mea- 
sure of loaf sugar, boil it to a syrup and use a tea- 
epoonful at a time for a child, or a table-spoonful 
for a grown person. 
Worms.—One of the most trouble complaints 
to children is worms. “Concerning their origin,” 
Bays Eberle, “much has been conjectured, but lit- 
tle ascertained.” There are five different species. 
The long thread-worm, an inch and a half to two 
inches; the small thread worm, white, from two to 
five inches long; the long round worm, from two 
to twTelve inches; the long tape-worm, sometimes 
thirty to forty feet long and nearly an inch wide, 
white, fiat and jointed; and the gourd-seed tape- 
worm, which generally comes away in pieces, 
sometimes single, sometimes many feet of them 
together. 
I3ut, says the Doctor, “observation has revealed 
to us many circumstances that favor their produc- 
tion and increase. The principal of these are, a 
general debility of the system, and a feeble or de- 
ranged condition of the alimentary canal. What- 
ever, therefore, disposes to these states, consti- 
tutes a remote cause of worms.” 
Now, as the Doctor had previously informed us, 
that frequent doses of opium and of calomel, oil, or 
any kind of physic, were calculated to produce just 286 
these effects on the internal canal; therefore, I con- 
clude, from his facts and argument, that calomel, 
opium and other poisons, (fur they all check vital- 
ity) are “among the principal causes of worms!” 
and that the most of the cases of worms found in 
practice, might have been prevented by refusing 
all poisons as medicines! However, I must not 
stop here. These worms are often found where no 
poisonous medicine or food has been knowingly ta- 
ken. The question is, then, rather, how shall 
they be removed? I)r. Eberle says, by the exhi- 
bition of calomel and other physic, the principal 
“remote causes”of their origin or existence! This 
may be good science with regulars; I have not 
sense enough to perceive its consistency or propri- 
ety. My plan is to clear out all the morbific mat- 
ter, by lobelia, cayenne, canker medicines, steam 
&c., and then give strong laxative bitters, with 
cayenne, which always drive them from the sys- 
tem. Not having killed any one by this process, 
1 have made no post mortem inspection to discover 
whether the internal canal was “burned up” by it; 
but if it was, I suppose, according to Dr. Eberle’s 
argument, it might as well have created inflam- 
mation and cured it.; as calomel and other poisons 
can be both the “remote cause” and the “proxi- 
mate” cure of worms! The bitters I have used, 
were boneset, hoarhound, motherwort, balmony, 
poplar, golden seal, bitter root, butternut, pride of 
China, gum myrrh &c.; placing great dependence 
upon hoteneinata. The compound just mentioned 
for dysentery, is first rate for worms. I once cured 
a case with two tea-cupsful of composition, af- 
ter a regular had administered calomel, wormseed 
oil, spirits of turpentine &c., in vain, till he said 
“she could not bear any more medicine;” and I 
believed him, for she could not bear upright, even 
her own head! 287 
The sort of worms called ascarides, very small 
and short, are found low in the rectum. To re- 
move these, make a poultice of the bitterest herbs 
you can get, as bs>lmony, tansey, motherwort, 
bitter root &e., cracker, cayenne and No. 6, or ra- 
ther the dregs of No. 6. Use three to six or eight 
times a day, three or four injections of the decoc- 
tion of the herbs, and, immediately after tiieirope- 
ration, apply the poultice to the outside and bind 
itclose. At the same time, give the same bitter 
tea, or the decoction above named to produce a 
slight action of the bowels, or, at all events, to 
meet the worms, should they attempt to rise in the 
canal out of the reach of the lower applications. 
Give a full course if necessary. Follow this plan 
immediately and faithfully, and you will not need 
to follow it long. If this course fails, you may 
consult the scientific Dr. Eberle, Professor of the 
Theory and Practice of Medicine, late in the Ohio 
Medical College, now in Transylvania University, 
Kentucky. 
“The complete removal of these worms (asca- 
rides) is a work of great difficulty. The ordinary 
vermifuges are of little avail in their destruction, 
acting more particularly upon the upper portions 
of the intestinal tube, they lose their virtue before 
they arrive at the location of these animals. Even 
the most active cathartics are insufficient to ex- 
pel them. Aloes, however, from the peculiar in- 
fluence it exerts on the lower portion of the bow- 
els, frequently causes their expulsion in large 
quantities, especially if assisted by the action of 
proper enemata. 
My usual mode of proceeding for the removal of 
these troublesome worms, is to prescribe three or 
four aloetic purgatives every second day, with two 
or three enemata composed with a mixture oflime- 288 
water and milk in equal proportions, daily. In- 
jections of a solution of aloes or of infusions of any 
of the above named vegetable anthelmintics, will 
generally succeed in bringing away great num- 
bers. In a few instances I have procured their 
expulsion, by large quantities, by injections com- 
posed of a tea-spoonful of spirits of turpentine 
mixed with a gill of milk. Injections of any of 
the common oils will oftentimes soothe the ex- 
treme irritation, and also destroy the worms. Ac- 
cording to Rozin, a drachm of refined sugar, dis- 
solved in warm milk, has been injected with great 
success. [Both of these had just been prohibited 
in the diet, on accountof their tendency to produce 
worms; hence, their great success in destroying 
those animals!—in perfect keeping with the use of 
poisons to cure the sick and to kill the well!] An- 
other remedy highly spoken of is a bougie smeared 
over with mercurial ointment, and introduced into 
the rectum. Dr. Vanvert asserts that flower of 
sulphur, taken in the morning on an empty stom- 
ach, is one of the most etficacious remedies for the 
distribution and expulsion of ascarides. In ob- 
Btinate cases, the fumes of tobacco, or an infusion 
of the male fern has been recommended by Dr. 
Bremser. The same author states that injections 
of cold water, with a small portion of vinegar, is 
the best remedy we possess.” [All common rem- 
dies, recommended directly after stating that they 
are of little avail.] 
Is not the above vastly scientific'? or will my 
readers agree with me that it is a tissue of quack- 
eries for the recommendation of which to the trial 
of young physicians, Dr. E. ought to have been 
expelled from the Ohio Medical College, if he had 
not been called to Transylania. 289 
Do our friends in “the great Western valley” 
really know that such is the beauty, such the cer- 
tainty of the medical practice to be spread over 
this whole wide western world, from that great 
source of medical science to which the Doctor has 
lately been with much applause translated! Hu- 
miliating fact! 
Ophthalmia, or Sore Eyes.—Infants are very 
liable to have sore eyes. At first, the eye-lids are 
glued together in the morning, slightly swelled 
and red. As the redness and the swelling pro- 
gress, the light is painful and “a thick, puru- 
lent matter begins to issue from the eyes.” It 
sometimes extends to the ball, destroys the coats, 
discharges the humors and ruins the eye. Doctor 
Eberle thinks the exciting cause to be “some 
acrid or morbific secretion in the vagina of the 
mother, applied to the infant’s eyes” in parturi- 
tion; as “its occurrence is almost universally con- 
fined to the two first weeks after birth, and, in a 
vast majority of cases, comes on as early as the 
4th day.” If this be the cause, our Botanic friends 
who keep the mothers free of “morbid secretions” 
during pregnancy, need not fear it. But it is 
sometimes ascribed to applying the light to the 
new born infant. On this subject, Dr. Eberle re- 
marks; “It may be observed that the good and all- 
wise Author of nature has endowed every creature 
with a capacity to accommodate itself to the inevi- 
table changes and transitions, which it is destined 
to undergo, in the regular process of its develop- 
ment; and it seems inconsistent with the perfect 
adaptation of the appointment of Providence, that 
the new-born infant should be liable to serious in- 
convenience or injury from this cause; though it 
cannot be doubted that unnecessary exposure of the 
infant’s eyes to a bright and heated light [asafire 290 
or a candle] may do much mischief.” What a 
pity that the Doctor could not reason as well on 
every subject. 
Treatment.—Cleanse the eyes thoroughly at 
birth, and keep them so. Wash them often with 
milk and water and canker teas; and, if the dis- 
ease is obstinate, apply the ginger, cracker and 
elm poultice, adding bayberryto it. Give also the 
teas to cleanse the system. “The occasional ad- 
ministration of a gentle emetic in the early stage 
of the complaint, sometimes proves decidedly ben- 
eficial,” says Dr. Eberle. So say I; therefore keep 
the stomach and bowels clean and the skin open, 
the eyes clean and oiled, and there will be no diffi- 
culty. 
The fact is, the cause of sore eyes, sore ears, 
sore neck, sore hands &c., in infants, is morbific 
matter in the system. True this morbific matter 
is of different characters, as the scrofulous, the 
ophthalmic, the erysipelatous, &c.; but the plan 
of removing it is in all cases the same, viz., give it 
vent by warm, moist and slightly stimulating ap- 
plications, absorb into poultices the virus discharg- 
ed, and take proper measures to cleanse the can- 
ker from the alvine canal, and to force to the sur- 
face that which may be already in the circulation. 
Nothing is more important than to remove from the 
body every drop of poison virus as fast as it is’dis- 
charged; lest, by its corrosive power, it increase 
the size of the orifices whence it issues, or produce 
new lesions or sores, where none before existed. 
A case of sore ears, last summer, that had con- 
tinued a long time under mercurial treatment, 
was soon cured by the application of absorbing 
poultices and the drinking of a little canker tea. 
When, however, these slight applications prove 
insufficient, the thorough treatment recommended 291 
before, will not fail to do the work, wherever there 
ie a constitution to build upon. 
Cholera Infantum.—Sudden and violent vom- 
iting and purging, generally commencing nearly 
together, but rapidly exhausting the strength and 
extinguishing vitality. “At first, the discharges 
from the bowels usually consist of a turbid, frothy 
fluid, mixed with small portions of green bile, or 
of a nearly colorless water, and containing small 
fllocculi of mucus. After the disease is fully de- 
veloped, the evacuations very rarely exhibit any 
traces of bilious matter; that secretion being evi- 
dently entirely suspended.” In some instances, 
death occurs in a single day. This form of dis- 
ease undoubtedly proceeds from some very irritat- 
ing cause in the alvine canal. It is of little use to 
know exactly what, but it is very important to 
know that its effect is to contract the folds and 
pores in which it is lodged, so as to keep up a con- 
stant irritation without producing its ejection, as 
in cholera. 
The error in the treatment, to which our Kotan- 
ic friends are most liable, is the supposition that 
the vomiting and purging should be stopped by 
any other means than by giving lobelia and injec- 
tions! Give lobelia in warm canker teas: this will 
relax the contracted folds and pores, from which 
the irritating virus will be released and soon be 
thrown out by a vomit, when the stomach will be- 
come quiet, and may be fed with porridge &c. Do 
the same with the bowels, and they will cease 
their action. Now, (not at first,) promote perspi- 
ration and give cayenne, lobelia seed, bitter root 
and nervine, equal parts in pills, to act upon the 
liver. This and good nursing, will soon effect a 
cure from the first stages. If the case be of long 
standing, we must persevere. This course, sea- 292 
sonably, judiciously and faithfully tried, is sure. 
Even Dr. Eberle says, no means will do any good 
that do not tend “to correct the morbid condition 
of the liver and skin.” But I beg leave to be ex- 
cused from using his calomel and blisters for these 
purposes. 
Fevers.—These, we know, whatever be their 
varieties, are the results of efforts of the system to 
remove morbific obstructions; not disease itself, 
but mere symptoms of disease. They are all known 
by inordinate heat, quickness of the pulse, rest- 
lessness, and, generally, thirst and pain. The plan 
of cure is to remove all obstructions to every se- 
cretion, carefully observing what part of the sys- 
tem, whether the head, the stomach, the lungs, 
the bowels, the skin, &c., is most obstructed, and 
directing the proper means immediately to these, 
at the same time that we use them to protect the 
general system and aid it in removing all offensive 
matter. 
Dr. Gregory says that, though fever is not pres- 
ent in every case of disease, it is, so generally, 
that “the physician ought to be always prepared 
to expect it.” If this fever is found to attend teeth- 
ing, 1 have already shown how to treat it. 
Remittent Fever.—If it is of the remittent kind, 
that is, constant but variable, care must betaken 
not only to clear out the morbific causes, but to 
keep up the action of the system to the healthy 
standard, during the intervals. Inthisform of fe- 
ver, there is generally a hot, dry skin, and much 
uneasiness; loss of appetite, costiveness &c. If 
the action of the pulse is too quick and the body 
hot from head to foot, much stimulus at first would 
be improper. Let the stomach and bowels bo 
cleansed with emetics and injections, and the skin 
be relaxed by moistening with warm water, and 293 
this state be kept up till the circulation is free and 
general, and the appetite is restored. The head 
should be kept cool and the feet warm. As long 
as the fever is kept up without the aid of artificial 
stimulus, so long you maybe sure that there yet 
remain obstructions somewhere. When the stom- 
ach and bowels appear to be clear, and the skin to 
be easily opened, and yet the dejections are of a 
light color and the feverishness continues, there is 
probably no action of the liver. Make pills of equal 
parts of lobelia seed, bitter root, cayenne, nervine, 
and slippery elm moistened, rolling them, if neces- 
sary, in butternut extract, and give enough of them 
to cause two or three dejections in 24 hours. Keep 
up the strength with bitters and cayenne, and light, 
nourishing food. 
Catarrh Fever.—This is the form of fever 
that seems to proceed from cold in the head, 
though, in reality, it as often proceeds from cold, 
wet feet, and is attended with much running of a 
watery fiuid from the nose and eyes, with hoarse- 
ness, stopping of the nose and difficulty of breath- 
ing. This form requires more stimulation than 
the other, as will be clear to any attentive observ- 
er who sees a case of each. Steaming, or warm 
fomentations, or warm flannels, about the neck and 
head, and breathing in the vapor of vinegar, will 
be particularly serviceable, and expectorants 
should be used to clear out the phlegm &c. Be 
careful also to keep the feet warm and the alvine 
canal free. The restorative treatment as above. 
Bronchitis.—This is an inflammation of the 
mucous tissue of the bronchial tubes, and an ac- 
cumulation of phlegm, in these and the air cells 
of the lungs. The cough, difficulty of breath- 
ing &c., make it sufficiently evident that the lungs 
are obstructed. 294 
In addition to an emetic, or even before, if it 
can be done speedily, the vapor of vinegar should 
be freely inhaled, and the neck and chest should be 
enveloped in the same, or some warm and moist 
application should be made to them to relax the 
strictures and loosen the phlegm. A small quan- 
tity of cayenne in the vinegar from which the va- 
por is inhaled, will enable the lungs to remove the 
phlegm and cankery coat, and cough it up. Con- 
tinue this course with the emetics, keeping the 
whole system warm. In this way the judicious 
Botanic will cure all the cases to which he is call- 
ed in due season. The regulars give us little hope 
in this case. “The progress of the disease,” says 
Eberle, “is generally rapid. In some instances, 
it terminates fatally as early as the third day; 
more frequently, however, its course is protracted 
to the sixth day. Great drowsiness or coma al- 
most invariably precedes the fatal termination.” 
Children, page 328. It must be recollected that 
this rapid progress and fatal termination are what 
take place under the “blood-letting,” “leeching,” 
“blistering,” “calomel,” “antimonial,” “opiate” 
and “hyoscyamus” treatment recommended by Ur. 
Eberle—See pages 330 and 331. The course of 
practice which I have recommended, being en- 
tirely different, must necessarily produce different 
effects. And, as the final effect of the Doctor’s 
treatment, according to his statement, is general- 
ly death, so it will be found that the general result 
of ours will be health. 
Pleurisy.—The symptoms of this form of dis- 
ease, are much like those of the preceding, with 
the addition of pain and soreness in the side, 
breathing rather in the abdomen that the chest, the 
mucus in the lungs not quite so much, but some- 
times tinged with blood. In this case, the same 295 
course of bleeding1 and poisoning is recommended 
by the regular faculty. I have treated it with 
emetics, sudorifics, injections and warm applica- 
tions to the side, and cured it in two or three days, 
in cases where it was said, by persons professedly 
very wise in these matters, that the patient must 
die. 
Mumps, Swelled Neck <foc. (Cynanche Paro- 
tidcea.)—A course or two, and warm applications 
to the neck, on the first appearance of the symp- 
toms of this form of disease, will disarm it of its 
terrors, and reduce it to “a small affair.” If any 
swelling occur, let it be fomented with a steam 
from vinegar, and covered with relaxant poultices. 
Keep the patient comfortably warm, (though not 
excluded from fresh air,) and the secernants and 
excernants free of obstructions. Let the treatment 
he moderate, but steady, and adapted to the cur- 
l'ent symptoms. 
(Quinsy, (Cynanche Tonsillaris.)—An inflam- 
mation of the tonsils and fauces, attended with a 
stinging, cutting pain, first, only on swallowing; 
afterwards, more constant. The tonsils swell, 
and, unless preventives be used in time, ulcerate 
and suppurate. The treatment of this form of dis- 
ease, should be like that of mumps, adding gar- 
gles of diluted No. 6. Iftlie system be well cleans- 
ed at once by courses, the morbific matter will be 
removed, and the ulceration prevented. Expec- 
torants should be used from the beginning. These 
may consist of skunk cabbage, hoarhound, cay- 
enne and a little lobelia, made into a syrup. 
Croup—(Cynanche Trachealis,) maybe defined; 
“an inflammation of the glottis, larynx and upper 
part of the trachea, attending with a hoarse and 
ringing cough, sonorous respiration, and a sense 
of impending suffocation.”—Eberle. This is one of the forms of disease which Dr. Bigelow says, is 
“self-limited;” that is, that “it is not known to 
be shortened in duration or materially mitigated 
in violence, by any [regular] medical treatment.” 
Its principal predisposing cause, is sudden cold on 
the lungs, on the suspension of violent exercise «r 
on a very relaxed state of the system from some 
other cause. It is sometimes attended with in- 
flammation and the supposed consequent formation, 
in the bronchi®, of a false membrane. But,as I have 
known a severe attack only one hour after the pa- 
tient appeared perfectly well; and this attack, 
amounting almost to suffocation, broken in less 
than another hour, and entirely cured in five or 
six more, by steam, lobelia &c., I cannot think 
that much inflammation existed in these cases. 
Be that as it may, steam and lobelia are seldom 
known to fail of a cure, when promptly and faith- 
fully applied. The steam of vinegar and water, 
should be applied to the neck and received into the 
lungs. When the poroxysm is relieved and the 
breathing becomes easy, give a full course of medi- 
cines, and strengthen the system. Dr. Eberle 
says, “In the whole catalogue of inflammatory af- 
fections, there is no disease in which bleeding, 
when promptly and efficiently practised, is more 
likely to prove beneficial.” Now, it will hardly 
be disputed that steam and lobelia are far more 
successful than the regular practice, in the treat- 
ment of croup; therefore, blood-letting is, in no 
case, either necessary or proper in the treatment 
of any form of disease; as other more innocent 
means are proved to be greatly superior. Dr. Eb- 
erle says, (on children, page 359,) have, 
in some cases, administered the lobelia inflata, 
with a view to its emetic operation, with the hap- 
piest effect. From its well known powerful influ- 297 
ence on the respiratory functions in asthma, inde- 
pendent of its emetic effects, there is reason for 
presuming that, in relation to the present disease, 
it may possess peculiar virtues; and my limited 
experience with it, inclines me to this opinion.” 
\Yrhat a wonder the Doctor did not kill his pa- 
tient with this (ffj-“among the most deadly poi- 
sons in the materia medical However, we must 
recollect that the article was used in connexion 
with so many others that were calculated to neu- 
tralize its effects, that it could not be held respon- 
sible, even if mischief had followed. We cannot, 
after this, be surprised to hear the same gentle- 
man say, page 367, “among the remedies that 
may be usefully employed for the reduction of tra- 
cheal inflammation, the warm batli deserves to be 
particularly mentioned!” 
Similar affections, that is, inflammations or 
spasmodic affections of the larynx, should be treat- 
ed as above. 
Dr. Eberle says, page 367, “Although blood- 
letting does not often procure any prominent ben- 
fit, in this affection, it is unquestionably decidedly 
indicated, and ought always to be promptly and 
efficiently practised.” Is not this “scientific]” 
It is unquestionably demanded because “it does 
not often procure any prominent benefit!” 
Dropsy of thu Brain—(Hydrocephalus.— 
Symptoms, irritable temper, irregular bowels, va- 
riable appetite, irritated and quick pulse, wake- 
fulness, frowning expression of the countenance, 
followed by pain in the bowels, nausea and vomit- 
ing, feverishness, distressed expression of the 
countenance, sudden waking from sleep, transient 
and severe pains in the abdomen, alternating with 
similar pain in the head, dislike for light, noise 
&c., then becoming drowsy, numb on one side, vi- 298 
sion deranged, eye-lids paralyzed, and, finally co- 
matose or sleepy, and convulsive. 
To regular physicians, this is a most frightful 
form of disease. I once took with me a converted 
regular to see a case. After examination, he feared 
it could not be cured. I asked him to treat it ex- 
actly as I would prescribe, and I would “take the 
responsibility.” As a child had lately died of the 
same form of disease, the parents of this were very 
anxious. The head was hot and dirty and covered 
with a cap, and the child exhibited the symptoms 
of the last stage. I took off the cap, called for cold 
vinegar and a comb, wetted the head and combed 
it till I had gotten off all the scruff that had been 
left “to prevent the child from taking cold.” Be- 
fore I had half cleaned and cooled the head, the 
child fell asleep; and the before constant motions 
of the head and hands ceased. The bowels were 
swelled, hot and sore. I directed an injection to 
them, and moistened cloths to the abdomen, to keep 
the feet warm, and to cool the head with the vine- 
gar whenever hot, till it should be comfortable. 
The effects of these two processes, were prompt 
and great relief. A tea of ginger and raspberry 
leaves, was then given, and perspiration induced; 
and, by the use of these and similar articles, in 
three days the child was entirely well. I forget 
whether I directed an emetic of lobelia or not; 
but 1 certainly should have done so, had not these 
measures proved amply sufficient. My advice is, 
keep the feet warm, the head cool, the stomach 
and bowels clear of morbific matter, and the skin 
open. Do it and succeed. 
Dr. Eberle says, “The instances of recovery 
are, indeed, exceedingly few. In the course of 
twenty years practice, I have known but two ful- 
ly developed cases, which terminated in health, 299 
and it has fallen to my lot to have seen and pre- 
scribed for a very considerable number of patients 
ill with this appalling disease.” 
Notwithstanding this bad success, the Doctor 
still prescribes the same course of bleeding and 
poisoning which has so often stuck a dagger to 
the very heart of his professional ambition. He says 
“The temporal artery or a vein in the arm should 
be opened, and the blood allowed to flow, until a 
very obvious impression is made on the system,” 
Then “leeches” and “purgatives are among 
our most useful means;” Then, “mercury is un- 
doubtedly a remedy of valuable powers in the 
treatment.” “Dover’s Powders have found ad- 
vocates,” and “James’s Powders have been spo- 
ken very favorably of,” and “tartar emetic has 
also been used with great advantage.” For what 
purpose, I ask, in mercy to the hecatombs of vic- 
tims yearly sacrifised to this practice, for what 
have all these remedies, been so useful? Dr. E. 
says, virtually, To kill all the patients but two, that 
he has treated in twenty years! The man that, 
after such a succession of results, would not aban- 
don a practice under which they occurred, even 
though he should know no other, ought to be con- 
sidered no better than a thoughtless murderer! 
Peritonitis and Dropsy Inflamed peritone- 
um and consequent effusion of serum into the cav- 
ity of the abdomen. Known by swelling, and rat- 
tling of water in the abdomen. 
Treatment.—Cleanse the general system, and 
then give the warming medicines with but little if 
any fluid, as in pills, the bread of life &c. 
Vaccination, or Cow Pox.—This is supposed to 
be the origin of the variola or small pox, continued 
through the bodies of beasts, and of persons not 
much predisposed, till it has assumed a mild form. 300 
This is quite probable, and accounts for the action 
of the one preventing the occurrence of the other. 
To inoculate, take the virus from the sore and put 
it into a puncture in the arm. To preserve the 
matter, draw a needle full of silk slowly through 
the full pustule, or press a little lint upon the mat- 
ter, and inoculate with bits of these, or preserve 
the scab, and pulverize it for use. It begins to in- 
flame and fester the second day, grows larger and 
sorer, but seldom produces any considerable de- 
rangement of the system till the 8th or 9th. Keep 
the determination to the surface, and the system 
clear of morbific matter, and no evil will arise. 
Children ought to be vaccinated whenever there is 
danger of their taking the small pox, which disease 
it will render milder, if it does not entirely pre- 
vent it. Care should be taken that the virus be 
obtained from a healthy person. 
Small Pox, [Variola,) Chicken Pox, (Vari- 
cella,) Measles, [Rubeola,) and Scarlet Fever, 
[Scarlatina.)—Each of these forms of disease, is 
produced by a specific virus which tends to the 
surface, from which it leaves the system. Their 
appearance on the surface is preceded by fever and 
evident internal derangement. 
If there is evidence of much morbific matter 
within, I commence the treatment with emetics 
and injections. These first cleanse the alvine ca- 
nal, and then throw the remaining virus to the sur- 
face, to which a slight tendency should now be 
constantly kept by mildly stimulant sudorifics. The 
vapor bath is good, till the eruption comes out, but 
better omitted while it remains on the surface. 
Expectorants should be used to clear the bron- 
chial tubes, fauces and glands, and gargles of cay- 
enne tea, or dilute No. 6, when these are sore. 
There is no necessity or prepriety in raising the 301 
action of the system very high, at any time, but 
to keep it steady, is the most important point, in 
the treatment of these affections. If the action 
be made at one time too great, there will follow a 
fatigue and dangerous depression. If perspira- 
tion be made too profuse, it will be followed by 
too much absorption. Therefore, cleanse well the 
internal canal before the breaking out, and then 
keep up a moderate but steady tendency to the 
surface till all traces of the virus have departed. 
In scarlet fever, cayenne, gum myrrh and kercu- 
ina, should be freely used as a gargle for the 
throat. 
Before the virus appears on the surface, the 
symptoms of these different forms of disease, that 
is, the effects produced bv the different species of 
morbific matter that thus obstruct the vital ac- 
tion, have so little peculiarity about them, that 
the most experienced practitioners generally find 
it very difficult and often impossible, from these 
alone, to decide which is present. Hut, as the 
means to-develop any one, are equally applicable 
to the exhibition of all the rest, the early decision 
is not very important. When the eruptions ap- 
pear; those of small pox are coarse, and some- 
times cover nearly the whole surface of certain 
parts, particularly the face; but, more commonly, 
they are isolated, there being sometimes not more 
than half a dozen pustules on the whole body. The 
chicken pox is much like the small pox in charac- 
ter, but more mild in effect. The measles extend 
more generally still over the surface, but rise 
only a little above it, while the exanthema of scar- 
let fever does little more than inflame and scale off 
the skin. Under the regular practice, the small 
pox and chicken pox often much disfigure the 
countenance; but, under a judicious Botanic treat- 302 
ment, this seldom happens. I have treated many 
cases of all these affections, except small pox; 
and, though one died of phthisis and measles, and 
another of marasmus, dropsy and scarlet fever, 
combined; I have yet to lose the first patient of 
any one of these affections alone. Of more than 
thirty cases of measles, I have lost none, nor found 
any difficulty in restoring them shortly, on the 
above plan. 
Whooping Cough.—This is another of what 
Dr. Bigelow calls “self-limited diseases.” This 
cough is convulsive and suffocating, and accompa- 
nied by a shrill, reiterated whoop. If the treat- 
ment proper for its premonitory symptoms, which 
are quite similar to those of catarrhal fever, be 
promptly and efficiently applied, this form of dis- 
ease will be rendered quite mild, and its duration 
much shortened, if it should not be altogether pre- 
vented. Let it be remembered, as a well known 
fact, that some persons are much more liable to 
contagious affections than others, and much more 
affected by them when attacked, (because their 
systems are already diseased;) and it follows of 
course, that, if you keep the system clear of mor- 
bific matter, it will be much more able to ward 
off an attack, or to sustain its actual pressure. I 
knew not a single instance of an attack of the chol- 
era, in Richmond, Virginia, in 1832, on a pa- 
tient that had lately been taking courses of medi- 
cine. 
The proper process for croup, will of course be 
thorough relaxation and cleansing by steam &c., 
then the proper tonics. Some antispasmodic and 
expectorant preparation should be administered 
almost continually, till the affection entirely cea- 
ses. Keep the chest and neck comfortably warm. 
Convulsions.—Dr. Eberle says that convul- 303 
pions are among the most fruitful causes of death 
among infants; and this arises from the great sus- 
ceptibility of their nervous systems to irritation. 
So far, I agree with him, and hence draw an argu- 
ment for keeping the infantile system free from 
all those deadly drugs with which, if we were to 
follow his advice, we should be stuffing them, on 
every appearance of a little ailment. I have not 
a doubt that calomel, administered according to 
his directions, is the cause of more infantile con- 
vulsions than all other irritating agents combined. 
To this, add his other drugs, and you will have 
at least three quarters of all the causes of convul- 
sions to which infants are liable. Now our Bo- 
tanic friends do not need to be told how to avoid 
these causes of disease. But they may be told, 
and oh, that I could make them and others feel it, 
from the crown of the head to the sole of the foot, 
that, when once the calomel gets in, it is a hard 
matter to prevent its specif c effects or even to era- 
dicate it from the system. Even Dr. Eberle says, 
page 156, though “calomel can seldom be omitted 
with propriety in infantile erysipelas,” yet “it is 
necessary to proceed with caution in its use;” for, 
“when given freely, at this tender age, it is apt to 
give rise to dangerous irritation of the stomach 
and intestinal canal.” On page 185, he says, “In 
using calomel in this affection, (ulceration of the 
mouth,) great care ought to be taken lest it affect 
the gums—an occurrence which could hardly fail 
to impart a dangerous character to the ulcera- 
tions.” But what sort of “care” can be taken in 
the easel Dr. Graham of Edinburgh, says, page 
137, “An improper or excessive use of the gene- 
rality of medicines, is recovered from without dif- 
ficulty; but it is not 60 when the same error is 
fallen into in regard to the mercurial oxides. They 
affect the human constitution in a peculiar man 304 
ner, taking, so to speak, an iron grasp of all its 
systems, and penetrating even to the bones, by 
which they not only change the healthy action of 
its vessels, and general structure, but greatly im- 
pair and destroy its energies; so that their abuse 
is rarely overcome. When the tone of the stom- 
ach, intestines, or nervous system generally has 
been once injured by this mineral, according to my 
experience, (and I have paid considerable atten- 
tion to the subject,) it could seldom afterwards be 
restored. I have seen many persons to whom it 
has been largely given for the removal of different 
complaints, who, before they took it, knew what 
indigestion and nervous depression meant, only by 
the description of others; but they have since be- 
come experimentally acquainted with both, for 
they now constantly complain of weakness and ir- 
ritability of the digestive organs, of frequent low- 
ness ofspirits and impaired strength; of all which, 
it appears to me they will ever be sensible. In- 
stances of this description abound. Many of the 
victims of this practice, are aware of this origin 
of their permanent indisposition, and many more 
who are at present unconscious of it, might here 
find, upon investigation, a sufficient cause for 
their sleepless nights and miserable days. We 
have often every benevolent feeling called into 
painful exercise, upon viewing patients already 
exhausted by protracted illness, groaning under 
the accumulated miseries of an active course of 
mercury, and by this forever deprived of perfect 
restoration. A barbarous practice, the inconsist- 
ency, folly and injury of which no words can suffi- 
ciently describe.”—Page 138. 
Mow all this might pass with me, for mere opin- 
ion, were it not that I have long seen and daily 
see the same thing with my own eyes. I lately 
say a patient die under a most dreadful mercurial 305 
salivation .and ulceration, who had not taken a 
grain for five years; and there now sits by me a 
gentleman whose gums are so sore that he cannot 
eat solid food, and lias been under a free salivation 
for several days, though lie has taken no mercury 
for 9 years. The mercury was given, in both these 
cases, with great “professional skill.” So much 
of Dr. E.’s “care” was taken, that no great mis- 
chief was immediately perceptible. But, in the 
one case, there has followed a life of five years 
suffering far worse than death, and finally death 
itself. In the other, a limb is forever ruined, and 
misery entailed upon the system from which. I be- 
lieve with J)r. Graham, he will scarcely ever re- 
cover. Oh the curse of mercury as a medicine! 
The sword, the pestilence, the famine, yes, and 
even the dram bottle, all fail in the comparison 
with it, in the destruction of the health and life of 
civilized society! Beware of it, fellow-citizens as 
the deadly bohon upas of the desert! It bitetli 
like a serpent and stingeth like an adder. 
But these convulsions must be treated on our 
plan of relaxing the system and removing the ob- 
structions; lobelia, cayenne, the vapor bath, can- 
ker teas, &c., are the articles; and they must be 
faithfully applied till the system is cleansed, and 
then the tonics must be used to keep what is 
gained. 
Epilepsy, or falling, sudden Exhaustion <S-c.— 
These arise from internal obstructions, when the 
surface is much relaxed. The heat and moisture 
escape from the surface faster than the supply is 
furnished within. The balance of power is lost. 
To correct them for the moment, lay the patient 
on the back, with the head lower than the body, 
dash cold water on the face and breast, and give hot 
medicine within. As soon as the balance is res- 
tored, give a regular course, or more if necessary. TESTIMONIES 
Of the Regular Faculty against their own Theory 
and Practice and in favor of ours. 
Natural Labors.—After the bold and free use 
of the lancet, cool regimen, spare diet, opium, 
cantharides and profuse evacuations from the bow- 
els, “ifconvulsions succeed, they are generally mor- 
tal. The vis vitae, in such circumstances, must be 
supported by replenishing the vessels with the ut- 
most speed; this is to be done by pouring in nour- 
ishing fluids as fast as possible by the mouth and 
by clyster; warm applications should also be made 
to the stomach and feet.”—Edinburgh Practice, 
vol. 5, page 105. 
Abortion is not easily prevented, as it is often 
preceded by an apparent symptom, till the rupture 
of the membranes and evacuation of the waters an- 
nounce the approaching expulsion of the foetus. 
Either to remove threatening symptoms, or to pre- 
vent miscarriage when there is reason to appre- 
hend it, often baffles our utmost skill; because it 
generally happens, that there is a cessation of 
growth in the ovum; or, in other words, the ex- 
tinction of life in the foetus, for some time previous 
to an appearance of abortion; but, for the most 
part, very little can be done in the way of medi- 
cine. Manual assistance is seldom or never ne- 
cessary during the first five months of pregnancy; 
the exclusion of foetus and placenta should very 
generally be trusted to nature. The medical treat- 
ment of abortion, must therefore be considered with 308 
ft view only to the prophylactic cure. “The pre- 
ventive means, to which I would wish to solicit 
the attention of practitioners in midwifery, consist 
in strengthening' the habit previous to a subse- 
quent pregnancy.”—Pages 114 and 115. 
Of Natural Labor.—“All efforts to press or 
strain, except what nature excites, are improper, 
hurtful, and should be avoided; the membranes, if 
possible, ought not to be ruptured till they almost 
protrude at the os externum.”—Page 124. 
“The separation of the placenta is also the work 
of nature, and seldom requires more force to bring 
it along than if it lay entirely loose in the cavity 
of the uterus. Thus, in pulling, no greater force 
should be employed than is just sufficient to put 
the funis on a stretch; for, if it is already separat- 
ed, no violence is necessary to extract it; and, if 
the adhesion is very firm, all violent efforts are 
improper, and often followed with the most dan- 
gerous consequences.”—Page 125. 
“Though bad consequences sometimes follow 
from the retention of the placenta, yet it is much 
to be questioned, if these are not less to be dread- 
ed than the dangerous floodings, convulsions, de- 
liquia, inflammation of the uterus, fever &c., that 
may be induced from the too prevalent practice of 
passing the hand to make the extraction. Where 
the adhesion is so firm as to require force, or where 
its place of attachment is out of the reach of the 
finger, by which, for the most part, the edge may 
be brought down, is it not by far the safest, and the 
most rational practice, universally to trust to na- 
ture! Should the mouth or body of the uterus be- 
come constricted before the separation is effected, 
no matter; little is to bo dreaded: it will after- 
wards kindly dilate, and the separation and expul- 
sion will spontaneously be accomplishsd with aa 309 
much safety as in other animals, where no force is 
ever used. Let every candid practitioner acknow- 
ledge, that for one instance where the retention of 
the placenta has been attended with dangerous 
consequences, its precipitate extraction has proved 
fatal to hundreds.”—Page 120 and 127. 
[I have read of one case in which the placenta 
was retained fifteen days; of another where it re- 
mained 24 days; and I had one myself, last winter, 
where it was retained 22 hours. In all these 
cases, the patients suffered no injury from this 
cause. In the last, 6he was about the 5th day.] 
“In natural labors, almost our whole business 
consists in encouraging the patient, and prevent- 
ing the fourchette or frenum labiorum from being 
torn, when the head is protruded through the os 
externum. For, although it is commonly said, that 
6uch a woman was laid [delivered] by such a per- 
son, the delivery is generally performed by the la- 
bor pains; and, if we wait with patience, Nature 
ofherself will do the work. We ought riot, there- 
fore, to fatigue the patient by putting her too soon 
in labor, according to the common phrase; but to 
attend carefully to the operation of the pains; and, 
in most cases, we shall have nothing else to do but 
receive the child.”—Page 129. 
Laborious Parturition.—“When a woman is 
nervous, low spirited, or weakly, from whatever 
cause, in general her strength must be supported; 
the pains at last will become strong and forcing, 
and the delivery, even where the patient is very 
weakly, will often have a safe and happy termina- 
tion. In these tedious labors, if the strength of 
the woman be properly supported, every thing al- 
most is to be expected from nature.”—Page 185. 
“From mismanagement in time of labor, often 
arises great debility; so that the patient’s strength 310 
is exhausted, the pains at length entirely cease, 
and the head of the child remains locked up in the 
pelvis, merely from want of force or pain to push 
it forward. It is of the greatest consequence, and 
the advice cannot be too much inculcated, to avoid 
exhausting the woman’s strength too much at first. 
Page 137. 
Alas! and must her strength be exhausted af- 
ter she has gone safely through! This is making her 
sick for fear she will get well too soon. How long 
will the fair sex consent to be made sick for fear 
they will enjoy too much health! 
“Dryness and Constriction of the Vagina.”— 
“Here all stretching and scooping is to be avoid- 
ed. The natural moisture is to be supplied by lu- 
bricating with pomatum or butter, or by throwing 
up injections of warm oil; the parts are likewise to 
be relaxed by the application of warm stupes, or 
by warm steam directed to them. Thickness and 
rigidity of the os tinea:, is to be relaxed in the 
same way.”—Pages 338 and '39. 
“If no obstacle appears, but the presenting of 
the fontanella, the labor will, by proper manage- 
ment, generally end well; and much injury may be 
done by the intrusion of officious hands.” 
“Face cases are the most difficult and laborious 
of all kinds of births; and our success in this will 
7chiefly bepend upon a prudent management, by 
carefully supporting the strength of the woman.” 
Page 140. 
“The os uteri, rarely, if ever, is capable of con- 
tracting upon the neck of the child, and thus pre- 
venting the advance of the shoulders; and, should 
this be the case, what can we do but wait with 
patience!”—Page 141. 
“Besides these,” [cases cited] says Dr. Smellie, 
I have assisted in a great number of cases where 311 
the membranes have opened the os externum, and 
the head has been delivered before they broke. 
Indeed, in all natural labors, I wait for this opera- 
tion, which renders the passage of the child much 
more easy.”—Pages 129, ’30 and ’31. 
“We should always be exceedingly cautious of 
having recourse to the common expedient of break- 
ing the membranes, which ought never to be done 
till we be certain the difficulty depends upon this 
cause;and, even then, the head ofthe child should 
be well advanced, and the membranes protruded 
almost as far as the os externum.” 
“Many inconveniences arise from a premature 
evacuation of the waters; for thus the parts be- 
come dry and rigid, a constriction of the os uteri 
for a time ensues, the pains often either remit or 
become less strong and forcing, though not less 
painful and fatiguing; the dilatation goes on so 
slow, and the labor becomes 60 severe, that the 
woman’s strength and spirits, by the unprofitable 
labor, are quite overcome and exhausted; so that 
the head remains confined in the passage, merely 
for want of force or pain to push it forward. The 
woman, in the beginning of labor, should there- 
fore be treated with the utmost delicacy and gen- 
tleness. The work of nature is too often spoiled 
by officious hands. She should be seldom touched 
while the membranes are whole, lest they should 
be ruptured; and, even when touching is necessa- 
ry, this should only be done when the pains begin 
to remit, and the tense membranous bag to relax.” 
Pages 141 and ’42. 
“When the funis umbillicus is toolong, it forms 
circumvolutions round the child’s neck, but it is 
time enough, in general, after the child is born, to 
slip the noose over the shoulders or head; there is 
seldom occasion to divide the chord on the birth; a 312 
practice that may be attended with trouble and 
hazard.—Page 142. 
“To push up the head, and turn the child with 
a view to preserve its life, as many authors re- 
commend, is a practice by no means advisable; wo 
should seldom,in this position, be enabled to save 
the child; and turning, under such circumstances, 
can never be done but at the immediate hazard of 
losing the mother.”—Page 149. This relates to 
the prolapsus of the funis before the head. 
“In many women I have known the membranes 
broke several days, weeks, and even months be- 
fore labor; and, provided they were not much 
weakened, they have been delivered with ease.”— 
Page 148. 
“An ineffectual attempt to pull away the child, 
with a noose over the head—which was safely de- 
livered by the natural pains—with the head galled 
and inflamed.”—Case 5, page 184. 
“A safe delivery, by trusting to nature, after the 
lady had been delivered of four dead children—by 
force.”—Case 4, page 191. 
“The unfavorable position of the head, is of it- 
self a cause insufficient to justify the use of de- 
structive instruments.”—Page 205. 
“In whatever manner the breech presents, the 
delivery should be submitted to nature, till the 
child be advanced as far as the thorax, when the 
feet are to be brought down and laid hold of, the 
child, if necessary, pushed up, the mechanical 
turns effected, and the delivery otherwise con- 
ducted as in a footting case. There is much less 
hazard in general, agreeably to an old observation 
of Mauriceau,in allowing the child to advance dou- 
ble, than in precipitating the extraction by push- 
ing up to bring down the feet before the parts have 
been sufficiently dilated; a practice difficult and 313 
troublesome to the operator; painful and sometimes 
dangerous to the mother; and by which the child 
is exposed to the risk of strangulation, from the 
retention of the head after the delivery ofthe body. 
If the child be small, though doubled, it will easily 
pass in that direction; if large, though the labor 
bs painful, the natural throes are less violent, and 
less dangerous than the preposterous help of the 
accoucher.”—Page 283. 
“A great effort was made to deliver a child with 
a breech presentation, but, not succeeding, the pa- 
tient was nourished, and soon delivered with great 
ease by the natural pains.—Case 17, page 303. 
Hash and preposterous management by an ac- 
coucher who had acquired much celebrity.—Case 
9, page 339. 
Heart-moving and disgusting scenes recorded 
upon pages 360, 361, 362, 363 and 364. 
lly their frtiits ye shall know them—Fruits in 
abundance recorded on pages 364, 365, 366, 367, 
368 and 369. 
From page 372 to 379 inclusive, important les- 
sons are to be learned. 
From page 384 to 389 and ’90, are illustrated 
the injurious effects of too great haste. 
The Doctor pulled at the lower jaw and body 
until he felt them give way—then said he could 
not save its life (after he had broken its Jieck)— 
The woman did well until—she died!—Pages 394 
and 395. 
The danger of turning in utcro.—“Long-contin- 
ued efforts have sometimes succeeded in turning 
the child; but too frequently the event has been fa- 
tal: sometimes the uterus has been ruptured in the 
operation, and sometimes where the misfortune has 
not been known to have happened, the uterus has 
suffered so much that fever and death have been the 314 
consequence. The more experience I have had, 
the more I have been desirous of rather bringing 
away the child in any way I could, than running 
the risk of these very difficult turnings.” Dr. Sims 
of London.—Page 405. 
“It may not be amiss to remark here, that, 
whenever there are strong labor pains present, 
turning ought not to be attempted; and that not 
only an account of the increased difficulty and dan- 
ger of the operation; but because, whenever there 
are strong forcing pains present, a favorable issue 
may, under all circumstances, be expected; for, as 
if Nature felt her own inability to accomplish the 
delivery in cross presentations, there are rarely 
any pains; and where these exist to a certain de- 
gree, I have always found that, from the small size 
of the child, or, which amounts to the same, the 
large dimensions of the pelvis, the child was about 
to be expelled double, or that the head or breech 
were coming down with the arm, though not 
within the reach of the finger. Often, when there 
are no pains whilst the patint is left to herself, the 
uterus is immediately thrown into strong action 
by the irritation which the attempt to introduce 
the hand must occasion, and this circumstance al- 
ways adds to the difficulty and danger of the ope- 
ration.”—Page 405. See, also, Dr. Clark’s let- 
ter to Dr. Sim, page 407. 
“The number of foetuses eventually destroyed 
with the intent of preserving the life of the parent, 
are incidents of the utmost importance to the com- 
munity, and claim a proportionate share of consid- 
eration from every accoucher concerned in these 
unfortunate occasions.”—Page 434. 
“The implicit act of turning and delivering by 
the feet, is a practice, even in the most promising 
situations, always attended with danger to the 
foetus.” 315 
“I think no one excusable who attempts prema- 
ture delivery, in cases of habitual miscarriage at a 
certain period of gestation beyond which the foe- 
tus is supposed to die, as instances are not want- 
ing, where, after a number of periodical immature 
births, the woman has at length gone her full pe- 
riod of nine months, and become mater familias.” 
Pages 434 and 435. 
“The uterus is an organ in no respect governed 
by the will, and the efforts of that viscus are most 
regular when left uninterrupted.”—Page 435. 
“Should hemorrhage take place in the early 
part of labor,” lloudelocque says, and I fully con- 
cur with him, “Whateverabundance of blood the 
woman may lose, nothing could justify the conduct 
of the accoucher who would persist in endeavor- 
ing to deliver without delay; for it would only be 
creating new difficulties, instead of relieving the 
existing one.”—Uewees’s Midwifery, page 236. 
“I believe that the frequent mention of difficult, 
dangerous, and rare operations, leads oftentimes 
to the unnecessary use of instruments, not always 
so much from the necessity of the case, as the eclat 
which attends them, however unsuccessful.”—De- 
wees’s Sys. Mid., page 307. 
The delivery of the Placenta.—“It would be in 
vain to attempt the delivery of the placenta by any 
exertion made upon the cord, though this is almost 
always resorted to-, and, as the whole of the uterus 
will sink lower in the pelvis by the effort, the in- 
perienced practitioner imagines that the placenta 
is descending—he continues his traction under this 
illusion, and, thinking a little more force will 
overcome the difficulty, he multiplies it; the cord 
is ruptured, and his difficulties are increased; he 
now becomes alarmed, and the panic spreads to 
the patient and her friends; every thing is thrown into confusion; a consultation is demanded; and a 
rival practitioner robs him of the little reputation 
he may have acquired, and thus interrupts his pro- 
gress in business. Or, fearing the consequences 
a discovery of this accident might produce, he 
disingenuously conceals it; and attempts, without 
method, the delivery of the imprisoned placenta, 
to the immediate torture and subsequent injury of 
the patient—not knowing exactly what causes the 
delay, or the nature of the difficulties which oppose 
him, after excruciating his patient, by unavailing 
efforts, he, in a paroxysm of mental anguish, aban- 
dons her, and declares the case must be left to na- 
ture.”—Dewees’s Sys. Mid., Page 447. 
Behold how these regulars love their patients! 
how kind they are to them, and careful not to do 
them any injury! How kind to one another, and 
how willing to assist each other! How scientific 
and learned, to bring their patients into so deplor- 
able a condition, by their folly and rashness!! Who 
can but love such physicians and such a science! 
“Turning must always be looked upon as of 
doubtful safety to the child; its adoption must 
therefore be constantly regardad as a choice of 
evils. In the case of prolapsus funis, it should be 
resorted to with great caution, especially as there 
is no question that children are frequently born 
alive after the cord had been prolapsed, and when 
the progress and the termination of the labor teas 
confined to the natural powers. While, on the con- 
trary, the fact is equally well established, that 
they have perished during the extraction; and I 
believe we may safely say, with Boudelocque, 
‘and all this, in cases where they might have been 
born alive, notwithstanding the exit of the cord, 
had the delivery been left to nature.’ It is not suf- 
ficient, because the pains are frequent and long in 317 
returning, to make us conclude that the powers of 
nature are incompetent to the end, and make us re- 
sort to the doubtful expedient of turning.”—De- 
wees, page 525—’7. 
“Even under favorable circumstances, turning 
is, to the child, a hazardous operation; under per- 
verse ones, it is but too often fatal to it; and that 
it must ever be looked upon as a doubtful alterna- 
tive, rather than as a probably safe resource.”— 
Dewees, page 551. 
“Nothing can justify a violent entry into the 
cavity of the uterus.”—Dewees, page 544. 
“The laborious and difficult labors, are by no 
means so frequent as those who are inexperienced 
are apt to imagine.”—Blundell’s Obstetricy, page 
141. 
“I strenuously dissuade you from making fami- 
liar companions of your instruments; because they 
are not wanted. Noscitur asociis— (lie is known 
by his companions.) The very fact that an ac- 
coucheur, on all occasions, puts the lever into his 
pocket when he goes to attend a labor, proves that 
lie is an officious, meddlesome, and, therefore, in 
my mind, so far, a bad accoucheur. Some men 
seem to have a sort of instinctive impulse to put 
the lever or forceps into the vagina. ‘Lead your- 
selves not into temptation;’ if you put your instru- 
ments into your pocket, they are very apt to slip 
out of your pocket into the uterus. Patience and 
good nature, are two useful obstetric instruments 
which may be fearlessly carried to every labor.”— 
Blundell, page 443. 
“When it was the custom to bring away the pla- 
centa immediately after the birth of the child, 
three reasons were assigned for the practice; 
first, that it was a dead substance, without any 
power like that which was supposed to be inhe- 318 
rent in the child; 2ndly, that it was an extrane- 
ous mass, which became pernicious every moment 
it remained; and, 3dly, that, if not immediately 
extracted, it would be almost impossible to bring 
it away, the os uteri closing in such a manner as 
absolutely to prevent the introduction of the hand 
for the purpose of extracting it. These opinions 
are proved to be groundless, for the placenta, we 
know, may remain many hours or several days 
(15 or 20) without doing any mischief to the ute- 
rus; and the opinion of the os uteri closing so soon 
after the birth of the child, is without foundation, 
as that seldom of never happens.”—Page 445. 
A case recorded upon page 494, of a complete 
inversion of the uterus, without the labia, caused 
by the placenta having been too forcibly extract- 
ed. 
Another page, 495, “where Dr. Smellie was 
called to a woman, who died before his arrival. 
He found the uterus inverted, pulled quite without 
the external parts, and the placenta adhering firm- 
ly the fundus. This misfortune was occasioned 
by the midwife pulling at the placenta with too 
great force. 
“No excretion is of more consequence to the 
patient’s recovery, after delivery, than a free per- 
spiration; which is so absolutely necessary, that, 
unless she has a moisture continually on the sur- 
face of her body for some days after the birth, she 
seldom recovers to advantage: her health, there- 
fore, in a great measure, depends upon her enjoy- 
ing undisturbed repose, and a constant breathing 
sweat, which prevents a fever by carrying off the 
tension and assists the equal discharge of the lo- 
chia when these are obstructed, and a fever en- 
sues with pain and restlessness, nothing relieves 
the patient so effectually as rest and moderate 
sweating.—Page 522. 319 
Puerperal or Child-bed Fever.—“ Notwith- 
standing the prevalence of this disease in all ages, 
its real nature has remained to the present time, a 
subject of much dispute and uncertainty. The cure 
is gradually effected, either by a spontaneous vom- 
iting, or a long-continued discharge by stool of 
porraceous matter, the existence of which in the 
stomach is usually evinced at the first attack of 
the disease. The five principal causes of this 
disease are, ‘the endeavors to dilate the os inter- 
num, a stoppage of perspiration, too hasty sep- 
aration of the placenta, and binding the abdomen 
too tight, and the neglect of procuring stools after 
delivery.’ Within these few years, this fever has 
been treated by several writers, most of whom 
have differed from each other, and it has likewise 
been the fate of puerperal fever, that no disease has 
more divided the sentiments of physicians in re- 
gard to the method of cure. The apparent indica- 
tions and contra indications of bleeding and other 
remedies, arising from a complication of inflamma- 
tory and putrid symptoms; the equivocal appear- 
ance of the vomiting and purging, and the differ- 
ent causes whence symptoms similar to each oth- 
er may arise in pregnant women; all these cir- 
cumstances concur to involve the subject in great 
obscurity and indecision.”—Pages 452—5. 
On the effects of the treatment of officious regu- 
lars— 
“By frequent and incautious touching, the glands 
furnishing the fluid to lubricate the vagina and os 
uteri, are over stimulated, nay, sometimes become 
inflamed. In this case, the secretion ceases, and 
the parts become tender and swollen, especially 
the mouth of the uterus, should it not be fully di- 
lated; the pains are less frequent and less protru- 
sive; the woman is restless, and enjoys no calm 320 
in the intervals of the pains; fever is excited; head- 
ache, thirst, and a hot skin follow; in a word, a 
new condition of the system arises, and almost 
suspends the business of labor. This state of 
things can only be altered by rest, and free blood- 
letting. To the latter, we must have immediate 
recourse, if we wish to subdue the unnecessarily 
provoked inflammation; and to restore the uterus 
to the re-enjoyment of its suspended powers, in 
many cases like those just mentioned, I have seen 
this remedy act with the certainty and prompti- 
tude of a charm.”—Dewees’s System of Midwife- 
ry, page 174. 
It seems then, that Dr. D., in “many cases,” 
by h is “incautious” and improper “touching,” 
produces the most alarming symptoms, and sus- 
pends the business of labor, but (oh, what a beau- 
tiful science!) these dreadful effects can be remov- 
ed like “a charm'’ by “free blood-letting.” How 
long would the intelligent ladies of Philadelphia 
employ buch an accoucheur, provided they knew 
that, by his “frequent and incautious touching,” 
lie produced such distressing effects, which he re- 
moves like a “charm,” by bleeding them almost to 
death! 
“In the management of labors, much judgment 
and caution are required, that a simple and natural 
case, may not be converted into a laborious and dan- 
gerous one. And, unfortunately for the interest of 
humanity, it requires more knowledge not to be 
officious, than falls to the share of many of those 
who pretend to practise midwifery. It is a vulgar 
prejudice, that great and constant benefit can be 
derived from the agency of an accoucheur, espe- 
cially during the active state of pain; and this feel- 
ing is but too often encouraged by the ignorant 
and designing, to the injury of the patient, and to 
the disgrace of the profession.—Page 185. 321 
A small Mistake.—“A gentleman, once calling 
at my house, told me, not without some earnest- 
ness, that he had under his care a case of labor 
about which he was very anxious. ‘The mouth of 
the womb,’said he, ‘is beginning to open, and I 
can feel the child, but the patient is somewhat 
weak, and labor makes but little progress.’ On 
my enquiring how long delivery had been 
ed—a few hours was the reply, and he added, that 
there was no very pressing symptom. A meddle- 
some midwifery is bad, I rejoined; therefore, it 
is better to wait, and not unwisely and rashly dis- 
turb the best accoucheur—Nature—the mother of 
us all. A day or two passed away, after which he 
called on me again, observing that his patient, still 
undelivered, was getting weaker and weaker, and 
that he wished me to give her a visit. On enter- 
ing the apartment, I saw the woman lying in a 
state, with nurses, accoucheur, and all the formal- 
ities attending a delivery; one small point only 
was wanting to complete the labor, which was, 
that she should be pregnant-, for, although the 
practitioner, one of the omnipotent class, had dis- 
tinguished the child’s head in the uterus, there 
was, in reality, no foetus there. A few hours af- 
ter, the patient died, and, on examining the abdo- 
men, we found the peritoneum full of water, but 
the womb, clearly unimpregnated, was no bigger 
than a pear.”—Blundell's Obst., page 153. 
“To burst the membranes with the finger, in- 
stead of waiting for their spontaneous rupture, is 
faulty.”—Page 154. 
“In labors generally, it is of very little import- 
ance whether the practitioner knows or not what 
is the presentation; because, in general, it is a 
natural one, and, notwithstanding his ignorance, 
the child will safely enough come away.—Page 155. 322 
“In ordinary labors, it matters little whether you 
are acquainted or not with the situation of the 
cranium.”—Page 156. 
“A meddlesome midwifery is always condemna- 
ble.” “When the head is in the world, do not 
lay held of the neck and endeavor to draw down 
the shoulders; for here, as ever, a meddlesome 
midwifery is bad. The natural efforts, if fairly 
tried, will, in ordinary labor, expel this part 
of the child; and it is found that, 'when the efforts 
are left, in this manner, to expel the shoulders as 
well as the head, the womb contracts afterwards 
more kindly and effectually, and the placenta be- 
comes more safely detached. When the child’s 
head is come into the world, therefore, remember 
that a prudent practitioner ought not to interfere; 
but must still suffer the uterus to act in its own 
way, when, by the natural efforts, the shoulders 
will be expelled.”—Page 158. 
“Rarely is it requisite to examine whether de- 
livery be or not begun. With the rupture of the 
membranes, the less you interfere, the better.” 
Page 161. 
“Where the placenta is rudely and injudiciously 
torn away by the hand of the accoucher, the worst 
consequences may be expected to ensue. Flood- 
ings, tremendous lacerations, inversions of the ute- 
rus—such are the effects of obstetric violence— 
ferocious and atrocious obstetric violence; that in- 
satiate and gory Moloch, before whose bloody 
shrines so many thousands have been sacrifised, 
to be succeeded, in future years, by still more nu- 
merous victims. Observing these awful conse- 
quences resulting from the artificial separation of 
the placenta, lluysch first, and afterwards Den- 
man and Hunter, recommended that, in all cases, 
after the birth of the child, the expulsion of the 323 
placenta, like that of the foetus, should be commit- 
ted to the natural powers; for, they added, ‘the 
same natural powers which are adequate to expel 
the child, are surely adequate to expel the placen- 
ta also!’ And there is no doubt that, if our wo- 
men, feriuo more, unaided by art, were committed 
to the natural powers altogether, like the females 
of barbarous hordes, in the great majority of cases 
the placenta would come away.”—Page 167. 
“I hope that no one will needlessly thrust his 
hand into the uterus, yet I have my misgivings. I 
hope, after all I have said, of the tearing and la- 
cerating and sloughing of these parts, you will 
never needlessly have recourse to this barbaric 
practice. .Some of my obstetric friends, and whose 
talents I esteem, fall into this error; they grate my 
ears, by boasting how frequently they have carried 
the hand into the uterus, and with what facility 
the placenta has been removed: that this operation 
may be easily effected, I have no doubt; but de- 
pend upon it, if you do carry your hand into the 
uterus on every occasion, to get away the placenta, 
some women will die at last, and dm the victims of 
your mismanagement; at this moment, perhaps, 
some amiable but ill-fated creature, blooms the 
light and life of her admiring circle, who must 
hereafter fall an untimely sacrifice to some cruel 
and ruthless arm.”—Pages 171—’2. 
“I have the preparation of a uterus in my mu- 
seum, in the uncontracted state; and, looking on 
the inner surface to which the placenta cohered, 
you find there is a number of large unclosed vas- 
cular orifices, yawning, as it were, destruction on 
the patient. .Now this preparation shows the con- 
dition in which the vessels are, if you tear away 
the placenta before the womb is contracted, exhi- 
biting the formidable openings at which the effu- 324 
eions of blood occur. But another preparation 
which is contracted, if you look at the blood-ves- 
sels, you will find them all closed at the abbrevia- 
tion of the surrounding fibre, as by so many liga- 
tures, and this is the best prevention against hem- 
orrhage; it is Nature’s tourniquet, her system of 
living ligatures. You see, then, that it is not 
without good reason that I am so anxious, before 
you abstract the placenta, that you should secure 
the contraction of the womb. 
Do not needlessly thrust the hand into the ute- 
rus; that is the voice that issues from this prepa- 
ration:—he that has ears to hear, let him hear it. 
Do not needlessly thrust the hand into the va- 
gina, is the voice that issues from this prepara- 
tion:—he that has ears to hear, let him hear it. 
Do not needlessly pass the hand into the genital 
fissure; is the voice that issues from this prepara- 
tion:—he that hath ears to hear, let him hear it. 
Ah! that violence of an ignorant and savage hand! 
After examining these preparations, tell me, is it 
too much to assert that, in obstetrics, a thrust of 
the hand is more dreadful than the thrust of a bay- 
onet! Could the field of Waterloo exhibit injuries 
more dreadful than these!” Page 172. 
“When the face is lying forward on the sym- 
phisis throughout the labor, many difficulties are 
occasioned; what is it then that the accoucheur 
can do in order to diminish, surmount or remove 
them! What is there that he can with prudence 
do, and without committing the unpardonable sin 
of midwifery; the sin, I mean, of those obstetric 
reprobates, the meddlesome and the pragmatic! 
That turning the child is universally unjustifiable 
when the case is indisputable, the dexterity great, 
and the circumstances are conducive, I will not 
venture. And, when the softer parts relax, and 325 
the pelvis is capacious, and our dexterity, from 
long practice, such that we can introduce the 
hand into the cavity of the uterus, and lay hold of 
the child’s legs, and bring it away with facility, 
by the operation of turning; I will not say that un- 
der such circumstances, we may not7)oio and then 
be justified in making the attempt. Decidedly, 
however, and in the strongest language I can use, 
I would reprobate this turning as a general prac- 
tice even in these cases.” Page 180. 
“As a general rule of practice in face cases, with 
the whole weight of authority I may possess with 
you, I condemn it. Do it ninety-nine times, suc- 
cessfully, and I condemn it still, because you are 
meddling—because you are cramming your hand 
into the uterus without any sufficient cause; be- 
cause you are, as it were, doing your best to tear 
the vagina; because ninety-nine operations unde- 
servedly successful, may lead to the hundredth 
and the destruction of your patient. It is the 
same with respect to rectification.” 
“In presentations of the face, the stoical rule 
will apply; a rule which might be whispered into 
the ear at all times, when you are at the bed side, 
naturam seyucre (follow nature;) delivery is a natu- 
ral process; give, therefore, a fair trial to the na- 
tural efforts. When, then, you find a face case, 
frequently, nay generally, you have little to do; 
you need not send for another practitioner; you 
need not allow your minds to get into a state of 
perturbation, as if you had some mighty feat to 
achieve. You have only to sit quietly at the bed- 
side, to support the confidence ct the woman, to 
let the uterus act, to protect the perinceum, to 
open your hands, as it were, to receive the child 
which Nature deposits in them.” 
“Ear presentations also occur, but they are so 326 
rare or so easily conducted on the principles laid 
down, that I consider it unnecessary to enlarge on 
them.” Blundell’s Obstetrics, Pages 182—’3. 
“Under breech presentations, if you give a fair 
trial to the natural efforts, in most instances the 
foetus of itself descends the outlet, the accoucheur 
happily having little to do, except to sit at the 
bed-side, and to abstain from injury or mischief.” 
Page 190. 
“The first stage of labor, in breech presenta- 
tions, is frequently very slow; for, though the 
nates and thighs do not take up so much room as 
the head, yet either they do not readily adapt 
themselves to the shape of the pelvis, or the action 
of the uterus is slower or less regular, in conse- 
quence of the awkward position of the foetus. No 
means, however, can with propriety be employed 
to hasten the progress of the labor, and by degrees 
the dilation of the parts is effected, and the nates 
are forced lower and lower into the pelvis, till at 
length they protrude through the os externum.” 
Dr. Merriman’s Synopsis, 4th edition, page 73. 
Cases of Transverse Presentation.—“I was call- 
ed, some few months ago, to a case in the neigh- 
borhood of the London Hospital, a presentation of 
the arm, attended by a gentleman of some ob- 
stetric tact and talent. In two minutes after I en- 
tered the room, with scarcely a complaint on the 
part of the woman, the arm presenting, the child 
was brought away. As my predecessor had been 
laboring without success to deliver, this speedy 
abstraction of the child occasioned no small morti- 
fication of surprise; and, when we were apart, my 
friend asked me how it was possible I could deli- 
ver her so easily and speedily, after he had labor- 
ed so much and to so little purpose"? To say the 
truth, said I, I did not deliver her at all; for, on 327 
reaching the bed-side, I found the spontaneous 
evolution was nearly completed, and I had only to 
hold forth my hands till the child dropped into 
them. To another case I was called, where two 
practitioners had tried to turn the child and failed, 
and where I tried myself, and failed too. Finding 
that perseverence would burst the uterus, let us 
wait, J said, to see what the natural efforts will 
accomplish; if they do not effect the delivery, fur- 
ther measures may be used; but do not let us dis- 
trust our great and kind mother too soon. In the 
course of an hour the child came away, under a 
spontaneous evolution, effected by the natural 
powers, and the woman did very well; and we all 
found that we did more service by sitting down at 
the dinner table than by working at the bed-side.” 
“However clumsy, and however rough, and 
however dangcroxis the practice, yet, I am com- 
pelled to admit that” sometimes “in shoulder pre- 
sentations, the practitioner must take off his coat, 
remove the sleeve of the shirt, lubricate the arm 
and particularly the hand, and then arte, non vi, 
with the fear of lacerating the womb before your 
eyes, relentingly, tremblingly, 1 had almost said, 
if indeed a surgeon may tremble, you carry the 
hand into the uterus, and draw down the feet of 
the child, always with the risk of tearing the gen- 
itals, when you operate in a manner the most skil- 
ful and dexterous.','> Blundell’s Obstetrics, page 
133. 
“For once, even in floodings,a meddlesome mid- 
wifery is bad.” Page 207. 
“I acknowledge, whatever opinion might be 
formed by those about me, for myself, however, I 
had rather feel within that the patient perished 
under the operations of nature, than that my med- 
dlesome hand was unhappily auxiliary to her de- 
struction.” Page 218. 328 
“For the sake of humanity, allow me again to 
remind you that, from whatever cause the flood- 
ing arises, whether in the earlier or the latter 
months, before or after the birth of the child, be- 
fore or after the birth of the placenta, so long as 
the woman is lying in the state approaching to 
asphyxia, the disturbance of your hand is death! 
Ah, how I commiserate those unsuspecting but ill- 
fated victims, who are destined to perish by your 
forgetfulness of this caution! At this moment 
live the women who must 6ink under this mal- 
practice.” Page 227. 
“Should you carry your hand into the cavity of 
the uterus, now, over and over again, not however 
too often, I have told you that such practice is to 
be condemned; and if, in defiance of warnings, any 
one of you still addict himself to these malprac- 
tices,lethim takethe consequences; on his head bo 
her blood! My hands are free, whatever befalls 
the patient.” Page 234. 
“The blood chills and curdles at the thought of 
tearing out the intestines of a living foetus. By 
the people of England—the censors and monitors 
of nations—wild beasts are caged, but wsrse than 
these, the accoucheur, meddlesome and violent, 
yet responsible to none, has been unwisely let loose 
upon society, with all his instruments about him.” 
Page 236. 
“The tremendous and heart-sickening opera- 
tion of opening the cranium in the uterus, can ne- 
ver be necessary, till foetal life is extinct. Thou 
shalt do no murder. These words cannot too often 
tingle in obstetric ears. Page 238. 
“Dreadful lacerations may result from rash at- 
tempts to introduce the hand.” Page 246. 
“A thrust of the hand, is contusion, laceration, 
destruction, death.” 329 
“The grand error to which you are obnoxious, 
the error against which you have been cautioned 
so often on other occasions, is, the use of too much 
force—arte, nonvv, ferocious, attrocious violence, 
is to be exploded from midwifery. Contusions, 
inflammations, lacerations, fractures, decapita- 
tions—these are the tremendous consequences re- 
sulting from the error—consequences at once fa- 
tal to the mother and child. Laceration of the 
womb, laceration of the vagina, extensive lacera- 
tion of the perinaeum; one or other of these cer- 
tainly will occur if you operate rudely, and now 
and then, perhaps, when turning is performed with 
the nicest care. Those make a mock of turning 
who have never seen its dangers; it is at best a 
fearf ul operation.” Pages 150—’1. 
“Beware of impatience and violence. Beware 
of lacerations. Have mercy upon the patient: 
again, 1 say, have mercy upon her. Remember 
that a thrust of the hand is as fatal as a thrust of 
the bayonet. Wounds more dreadful are not in- 
Jlicled in the field of battle. When the hand is 
carried into the os uteri to perform the operation 
of turning, you may find it necessary to repress a 
little the presenting part; to push the foetus back 
hastily and extensively, is fatal; and you must not 
think of it; you will tear the vagina, lacerate the 
uterus—do both perhaps—how easily too—but 
can you afterwards repair them!” Page 154. 
“In all cases, the use of instruments contrived 
for the extraction of the foetus, is to be looked 
upon as a great evil.” Page 295. 
“In the general, as I have observed on preced- 
ing occasions, the best accoucheurs are those who 
interfere the least with the finger or hand.” 
“I now repeat what I observed once before; in 
obstetrics, a thrust of the hand into the uterus 330 
may prove as fatal, and will, generally, produce a 
more extensive wound than the thrust of the bayo- 
net.” Page 294. 
“I do not like to see an elegant pair of forceps. 
Let the instrument look like what it is, a formida- 
ble weapon.” Page 312. 
“Force kills the child, force bruises the softer 
parts, force occasions mortification, force bursts 
open the neck of the bladder, force crushes the 
nerves; beware of force.” Page 317. 
“The cases in which patients may suffer be- 
cause instruments have not been employed when 
they have really been required, are by no means 
frequent in their occurrence, and therefore it is 
impossiblefor men, in general practice, to err fre- 
quently even by abstaining altogether from the use 
of instruments in all cases.” Page 327. 
“If you must err, then, take my advice, and err 
rather by the neglect or rejection of instruments, 
that their too frequent use, for the cases in which 
you may use instruments, without need, are as 
numerous as the cases that may fall under your 
care, with the exception ot the few, very few, in 
which these weapons are really required.” Page 
327. 
“Of all obstetric operations, there is none, per- 
haps, more easily performed, than that of perfora- 
tion, or craniotomy; and many a life, I fear, has 
fallen a sacrifice to this facility of execution. Of 
all the operations of our art, however, there is 
none more dreadful, not to say more awful; never 
suffer your minds, on any account, to be divested 
of that salutary horror, with which I conceive it 
ought at all times to be contemplated.” Pages 
330—’1. 
“Cases have happened in which the cranium has 
been opened, and a part of its contents have been 331 
removed, the child coming into the world alive, 
to look, as it were, into the face of the operator, 
and reproach him for his cruel ignorance or negli- 
gence. The very image of these horrors is enough 
to make the blood curdle.” Page 334. 
“I knew an instance in which the fillet had been 
used, and actually scalped the child; and another, 
in which the child’s under jaw had been cut to the 
bone by the force of pulling.” Blundell’s Obstet- 
rics, page 223. 
“I was employed in a case where, by using great 
force, in order to save both mother and child, the 
os uteri was torn; the woman died soon after, 
from loss of blood, as I then imagined, proceeding 
from the torn vessels of the uterus.” Page 316. 
“In the number of those diseases which the skill 
of the physician or the hand of the surgeon is not 
able to cure, may be counted those dropsies pecu- 
liar to females, which originate in the appendages 
of the uterus. These dropsies are not unfrequent.” 
Page 508. 
“Puerperal fever is not unfrequently produced 
by too hasty separation of the placenta; the conse- 
quence is generally a copious discharge of blood.” 
Page 546. 
Anthelmintic Medicines.—“The anthlemintic 
medicines which have been recommended by differ- 
ent physicians, are in a manner innumerable; but 
the best are Quicksilver. This is very efficacious 
against all kinds of worms, either taken in the 
form of calomel or corrosive sublimate. But, says 
Dr. Rush, “It has long been a complaint among 
physicians, that we have no vermifuge medicine 
which can be depended upon. Even calomel fails 
in many cases where there are the pathognomonic 
signs of worms in the bowels.” Edinburgh Prac- 
tice, vol. 5, page 612. 332 
“Let ub beware how we interrupt the operation 
of nature by rude and uncalled for handling.”— 
Dewees’s Practice of Midwifery, page 174. 
“Much mischiefisoccasioned by the method too 
generally adopted immediately after birth. A 
child is scarcely dressed, when a tea-spoonful of 
castor oil is wantonly forced down the throat; or a 
great deal of sugar and water is given for the un- 
necessary purpose of purging away the dark mat- 
ter which collects in the large intestines during 
the last two months of its uterine life. We ought 
to be in no hurry in producing the expulsion of 
this matter, as if it were a poison, the retention of 
which would carry death to the vitals. We fre- 
quently see fatal bowel complaints produced by 
this cause, and it is no uncommon thing to discov- 
er that drastic purgatives have been employed. 
Not long ago I was called to see a child under a 
fortnight old, who was taking half a grain of calo- 
mel and two of scammony twice a day, although it 
had from fifteen to twenty stools during the course 
of twenty-four hours, notwithstanding the exhibi- 
tion of occasional doses of chalk mixture. In such 
cases, the drastic purgatives are given in the first 
instance to “clear out the bowels,” and after- 
wards persevered in to ‘improve the evacuations.’ ” 
“Another cause of the bowel complaints of chil- 
dren, pruceeds from the absurdities constantly 
committed with respect to their food. Soon after 
the castor oil has been exhibited, food is given, 
consisting of thick gruel, which the stomach is to- 
tally incapable of digesting; flatulency is the con- 
sequence; they cry; Dalby’s Carminative is resort- 
ed to for relief, which produces ease for a time, 
but by inducing constipation, which renders ano- 
ther dose of castor oil necessary; this, in its turn, 
frequently gripes. This is attributed to wind in 333 
the stomach and bowels; and again thick indigest- 
ible food is given, to drive out the wind, which, in 
its turn, again requires Dalby’s Carminative. Tn 
this manner, the functions of the stomach and 
bowels are too often impeded, and not only im- 
peded for a time, but the children are rendered 
ever afterwards liable to complaints in the stom- 
ach and bowels.” 
“Daily do I see the advantage of pursuing an 
opposite plan with new-born children. I allow 
no laxative to be given, unless an infant suffers 
from distension of the abdomen, which is to be as- 
certained by examination.” Mackintosh’s Pathol- 
ogy, page 219. 
“There is oftentimes much mischiefarising from 
over-purging newly born infants; they not only 
require very mild remedies, but proper doses of 
such remedies.” Dewees’s System of Midwifery, 
page 21(5. 
“My friend Dr. Parrish, and myself, were called 
to attend a child ten days old. It was a healthy 
baby when born, and had had several sparing 
stools, of a very dark green color; two tea-spoons- 
full of castor oil were given in the morning. Two 
more tea-spoonsful of castor oil were given in the 
evening. The child, however, gradually declined 
from our first visit, and died on the third day af- 
ter.” Page 217. 
.More of the Excellencies of applying the Forceps. 
“They oftentimes become very painful to the 
patient, by including, while locking, either a por- 
tion of the soft parts, or some of the capilli of the 
pudendum; thus creating a great deal of pain. 334 
“It is, however, insisted that this objection can 
always be removed, by carefully passing the finger 
round the lock; but this is a mistake; for it is in 
the act of locking that this inclusion takes place. 
Now, it is certain that the locking of the instru- 
ment requires the use of both hands; consequently, 
we cannot pass a finger round the locking portion, 
so as to extricate the soft parts, or capilli, if in- 
cluded, or prevent them from insinuating them- 
selves between the joint; as the hands, and of 
course, the fingers, are otherwise employed at this 
moment. It is true, we may search for the includ- 
ed part or parts, before we commence extracting; 
but, to relieve the soft parts, would require the 
separation of the blades to a certain extent, and 
this without any security that it will not happen 
again, when the handles are again pressed togeth- 
er; and the capilli can only be relieved with cer- 
tainty, by breaking them, which would be painful, 
or by cutting them, which is not altogether de- 
cent.” Page 278. 
“The proper application of the forceps, in each 
situation of the head, has ever been considered an 
achievement of difficulty. It will be necessary to 
the success of the operation, that the practitioner 
understands the construction and mode of action 
of his instruments, and have, by practice, acquired 
some facility in placing them. It has been consi- 
dered by Dr. Denman, as uncertain, whether the 
art of midwifery has been benefited, or injured, by 
the introduction of instruments into its practice. 
That much mischief has been done by the ill- 
judged, and worse conducted application of the 
forceps, I have had reason to know. Put it would 
be unfair to charge all the mischief which has fol- 
lowed the use of forceps, to the ignorance of those 
who employ them; or to the action of the instrument 335 
itself— much is justly attributable to the views 
which many celebrated, men have taken of their ne- 
cessity or utility, as well as the rules they have 
laid down for their application. A severe proba- 
tion awaits an upright and consciencious man, upon 
his introduction into the practice of midwifery; 
for, if he be such, it will be a long time before he 
will dare to flatter himself that he can do what is 
best for his patient.” Pages 282, 283. 
[Some of the advantages of using the forceps, 
are illustrated in the case recorded by Dr. De- 
wees, Page 283.] 
“Dr. Denman, more perhaps than any other 
man, is chargeable with perpetuating errors in the 
use of the forceps, because he is considered the 
highest British authority upon the subject. In his 
attempt at precision, he has created confusion; 
and, in his desire to generalize, he has made so 
many exceptions, that his Aphorisms are no longer 
rules.” [lleally, what has Dr. Denman written 
that is so very displeasing to the Professor in 
Philadelphia!] “Ilis aversions to instruments, 
made him restrict their power to such narrow lim- 
its, a to render them scarcely subservient to the art; 
and he reduced the cases proper for their applica- 
tion to so few, and so peculiar, that they are scarce- 
ly to be met with.” Page 284. 
Here is the rub. This learned Professor would 
soon be out of business, if the ladies in the United 
States knew, that the cases that call for the use 
of instruments are “so few, and so peculiar, as 
scarcely to be met with.” American obstetricians 
are determined to make the people believe that it 
is necessary for them to examine and finger over 
every case for fear that it be difficult, when not 
one in a thousand ever needs their assistance. Dr. 
Denman, as well as every other high-minded, dig- 336 
nified man, has come very near the truth; but, alas! 
his opinions must be opposed and condemned, lest 
they shall become known to the discerning people 
of this Republic, and our lamous accoucheurs 
should be compelled to seek a living in some other 
way. But again, says Dewees, page 288, “Dr. 
Osborn carries his reluctance to the use of forceps 
still further than Dr. Denman, but he has not done 
equal mischief, because his authority was not 
equal.” 
“I was once called upon to determine whether 
anything could be done for a newly born child, 
which had been most unskilfully” [but scientifical- 
ly, and by a regular M. D.] “delivered by the for- 
ceps. The frontal bone was severely indented by 
te edge of the forceps; and one eye entirely de- 
stroyed, by the extremity of the blade being fixed 
upon it; yet it was born alive. The case was, of 
course, a hopeless one; and the child fortunately 
died in a few hours after its birth. I was once 
shown a blade of the forceps, which had been ex- 
cessively bent, by an endeavor to make it lock! In 
this case, the forceps were exhibited in triumph” 
[By whoml Oh, a scientific M. D.] “as a proof of 
the great difficulty the operator had to encounter, 
in effecting the delivery; and, as an additional evi- 
dence of this, he declared, that no strength was 
sufficient to deliver the head, as both his (and he 
was a powerful man) and that of another practi- 
tioner [equally ignorant,] wereunavailingly exert- 
ed, alternately and collectively. lie at last deli- 
vered her with the crotchet, after having expe- 
rienced very great difficulty in withdrawing the 
bent blade of the forceps. I have seen the whole 
length or nearly the whole length of the frontal 
bone cut through, by one of the sharp edges of the 
forceps, by an effort to compress it; and, in another 337 
instance, I have seen the parietal bone in thesamo 
wretched plight, from the same cause.” Dewees, 
pages 294 and 294. 
“I was once called to a poor woman who had 
had a considerable portion of the internal face of 
the right labium removed, by its having been in- 
cluded in the joint of the short forceps.” De wees, 
page 299. 
“I am aware that many respectable practition- 
ers are in the habit of introducing the hand and 
bringing down the feet, in all cases of breech pre- 
sentation; but 1 am abundantly convinced that, as 
a general rule, it saves the mother nothing, and 
that it is highly dangerous to the child.” Page 
320. 
“In difficult labors, arising from a rigidity of 
the os uteri, there is an unnatural resistance to be 
overcome; and to effect this, unfortunately, me- 
chanical and other equally improper means are re- 
sorted to, which, so far from fulfilling the intention 
in view, oftentimes increases the very evil, and 
converts an otherwise safe labor (were it properly 
managed) into one of great danger, or at least into 
one of great tediousness.” Page 356. 
“When the os uteri remains unyielding for a 
long time, it is an evidence that the natural pro- 
cesses, which so beautifully, kindly and safely ef- 
fect the change, have, from some cause or other, 
been interrupted. And, though mechanical force 
may be made to usurp the organic function, it ne- 
vertheless will always be at the expense of the 
health, or even the integrity, (be this more or less,) 
of that portion of the uterus to which force is ap- 
plied.” Page 356. 
“I have lately been informed from very good au- 
thority,(namely, a man to whom one of these cases 
occurred,) of the three unhappy instances of error 338 
in forcing delivery too soon, which happened some 
years ago to three surgeons of established reputa- 
tion, who, from the success they had met with in 
delivering several who were reduced to the last 
extremity, were encouraged to attempt it where 
but very little blood had been lost, (by Hooding) in 
hopes that their patients’ constitutions would suf- 
fer less injury, and their recovery be more speedy, 
which, till the experiment was made, was a very 
reasonable supposition—the women died, and they 
seemed convinced that their deaths were owing to 
the violence of being delivered too soon, and not 
to the loss of blood, or any other cause.” Page 
290. 
“There appears to be excited, at the present 
time, a passion for novelty in the treatment of ute- 
rine hemorrhage; but no remedy or means that has 
hitherto reached our knowledge, appears to have 
any decided efficacy in themselves, in arresting 
this discharge. Both therapeutical and mechani- 
cal agents are anxiously sought after; and each 
inventor of a new mode of fulfilling an old and ne- 
ver-to-be-deserted principle, vaunts his supposed 
improvement with a confidence that almost bids 
defiance to scepticism, until trial is made of its 
boasted powers; it is then found to have no supe- 
riority over the remedial agents already known, 
and heretofore relied upon. In all these attempts, 
it appears to be forgotten, that the only indication 
in a threatening hemorrhage, after the delivery of 
tiie child, is, to procure the tonic contraction of 
the uterus; yet, some of the means had recourse to, 
are but ill calculated for this end. Of this kind, 
is “transfusions,” the “filling of the uterus with 
rags,” the “compression of the aorta,” “injecting 
the umbilical vein,” &c. &c. And the therapeu- 
tical means, such as the introduction of vinegar 339 
or the acid of lemons, have no other power perhaps 
upon the flaccid uterus, than as a kind of vehicle to 
the mechanical agents, if we may so express it; 
and a variety of these can unquestionably be em- 
ployed with at least equal success without their 
assistance.” 
“Messrs. Gorat, Evart, &c., propose the imme- 
diate application of the citric acid to the internal' 
surface of the uterus, with a view to arrest hemor- 
rhage after delivery. They describe this method 
in the following terms; they strip a lemon of its 
skin, and, having cut one end of it, they carry it 
into the uterus, and then express the juice on the 
sides of its cavity. They allow the decorticated 
lemon to remain, until the irritation produced by 
the juice, and the foreign body, excites the uterus 
to contraction, which, constringing the tissue of 
that organ, stops the hemorrhage, and the lemon 
is expelled with the coagulum formed about it. 
“This is one of the late improvements in the 
treatment of this formidable complaint, and to 
which we have just alluded.” Dewees, pages 
410—’ll. 
“A woman aged thirty-two was taken in labor 
with her first child, on the 12th ofFebruary, 1825. 
The pains soon ceased, and, on the 15th, M. Be- 
del, physician at Schirmack, was consulted, who 
speedily delivered her with the forceps, of a dead 
child. The hemorrhage was so considerable, that 
he determined to deliver the placenta immediate- 
ly;but the uterus did not contract, and the bleeding 
continued, together with tremblings, syncope, cold 
sweats &c. Irritation on the internal surface of 
the uterus, cold water to the abdomen, injections 
into the uterus of cold wTater and vinegar, were 
unavailing.” 
“Plugging the vagina, and also the uterus, were 340 
now resorted to, as the only remaining means of 
safety. The uterus was filled with rags, for fear 
the patient could not sustain the loss of blood ne- 
cessary to fill the cavity; while a methodic com- 
pression was at the same time made upon the ab- 
domen. This is another instance of attempting to 
arrest an alarming uterine hemorrhage in anew 
way.” Page413. 
[An instance is recorded on pages 436, ’37 and 
*38, Edinburgh Practice, where the bladder was 
opened and a hole made into the rectum, by the 
force employed to hasten delivery. The woman 
lived forty years with a constant dribbling of the 
urine, and in a most deplorable situation. The 
writer remarks “that the wonderful power of the 
constitution to support life under the pressure of 
such a train of accumulated injuries, seems truly 
astonishing; and that accidents of this nature, are 
by no means uncommon. And what may not be 
expected from an unskilful use of instruments]” 
I ask, How happened it that this “scientific ac- 
coucher” was unskilful] If he could not use them 
skilfully, who can! None! None!! None!!!] 
Of Puerperal Convulsions. 
“ This truly frightful disease may attack a wo- 
man, perhaps at any period of utero-gestation; 
but more frequently after the sixth month. The 
causes assigned for convulsions have been various; 
some have supposed they arise from some peculiar 
irritation of the uterine fibre during pregnancy; 
others considered them truly epileptic; while 
others regard them as nervous or hysterical. 
This difference in views, necessarily leads to a 
difference in treatment—the first, makes safety 
consist alone in immediate delivery; the second, 
forbids this practice; whilst the third relies upon 
the use of opium. 341 
To be successful in the management of this com 
plaint, it is necessary that attention be paid to the 
species of this disease with which the woman may 
be attacked.” Dewees, page 452. 
Here follow cases quoted at length from this 
learned Professor, which show the practice as 
taught in the College at Philadelphia : 
“Mrs. aged seventeen, pregnant with her 
first child, complained, on the 20th of July, 1824, 
of slight pains resembling labor; and also a general 
ly diffused pain, but severest in the limbs; so much 
so, in these parts, as to render her almost incapa- 
ble of moving them; some fever, though slight. 
Dr. Shaw, under whose care she was, ordered her 
to be bled and purged. 29th, 3 o’clock P. M. 
she was attacked with labor pains; at first they 
were slight; but had much increased by the time 
the Doctor was called. Upon examination, the os 
uteri was found a little opened; at 8 A. M., she 
was attacked with strong convulsions, which were 
repeated about every twenty minutes. She was 
bled about twenty ounces; convulsions continued to 
recur. At ten o’clock the same morning, the os 
uteri was pretty well dilated; and, from a belief 
that convulsions were at least maintained by ute- 
rine distention and irritation, Dr. Shaw ruptured 
the membranes, with a hope of tranquilizing 
them. 
At this time 1 was called in. I found the pa- 
tient totally insensible to any sensibility after the 
second fit; breathing with much difficulty, and snor- 
ing pretty loud. The pulse was full, frequent and 
hard, and the skin hot. Upon examining per va- 
ginarn, the head of the child was found at the low- 
er strait, presenting with the posterior fontanelle 
behind the left foramen ovale, and entirely within 
the uterus—up to this time, about Ihirty-Jivc oun- 342 
cea of blood were drawn. She was attacked with 
a fit soon after examination. There was some- 
thing remarkable in the character of the convul- 
sions; her eyes were but little agitated; the pupils 
much contracted; her face was but little suffused; 
there was less frothing at the mouth, and less si- 
bilation than is usual. 
I applied the forceps, and delivered her in a few 
minutes without the slightest difficulty. She re- 
mained after this for two hours without a fit; at 
the expiration of this time, they recurred about 
every half hour, until 9 o’clock P. M. when they 
ceased, but without any amendment in the condi- 
tion of the patient; she appeared completely apo- 
plectic. She continued much in this situation un- 
til six o’clock in the evening of the olst, at which 
time she died. Leave could not be obtained to in- 
spect the body. She did not complain of headache 
until the 29th, and this but a short time before she 
became convulsed. She lost, altogether, [only] 
eighty-two ounces of blood; was freely purged, and 
once cupped.” Dewees’s System of Midwifery, 
Page 455—’6. 
Case 11. Mrs. , a delicate small woman, 
twenty-three years of age, pregnant with her first 
child, was attacked on the Kith of November, 
1809, at 8 o’clock A. M. with epileptic convul- 
sions. I saw her in an hour after the attack; pre- 
viously to my seeing her, she had had three fits, 
and a fourth was just coming on as I entered the 
door. Three or four days previously to the at- 
tack, she complained of a violent jaw or toothache, 
which was looked upon as rheumatic, and no at- 
tention was paid to it. On the fifteenth, that is, 
the day before her illness, she was seized with an 
extremely acute headache; and, during the night, 
and just before the onset of the fits, she was vio- 343 
lently sick at stomach, and vomited a large quan- 
ity of thick glairy mucus; immediately after this, 
she said 6he could not see, and was, in a few min- 
utes more, seized with convulsions. She labored 
under these violent and terrific symptoms in an ex- 
treme degree. I instantly bled her from a large 
orifice in the arm, thirty-five ounces; this, as I 
have just said, was at 9 o’clock A. M. Eleven 
o’clock, had two fits during my absence, and was 
now in the third—bled twelve ounces. Ordered a 
strong infusion of senna as an enema—os tincce a 
little opened, but rigid. One o’clock P. M.; had 
two fits since la6t visit; injection operated; pulse 
still active; face flushed; very restless and uneasy, 
arising, I believe, from the pains in the uterus—os 
tincce rather more dilated—to be bled by cups 10 
ounces. Four o’clock P. M.;one fit; cups drew 
well; senna operated again two or three times; very 
comatose—ordered cold applications to the head by 
means of a large bladder, partly filled with wster 
and some ice—blisters to the legs. Seven o’clock 
P. M.; no fit since last visit; pulse very active; 
very restless, constantly trying to get out of bed; 
os tincce not much more dilated; took ten ounces of 
blood; senna continued to operate. Ten o’clock 
P. M .; no fit since last visit; pulse still too active; 
took ten ounces more of blood; cold applications.” 
[Only seventy-seven ounces of blood taken from a 
very “delicate, small woman” in 13 hours!] 
“Seventeenth. Mr. Purnell, now Dr. Purnell, 
one of my pupils, staid all night with the patient. 
He said she had one fit, after which he took ten 
ounces of blood; senna continued to operate. At 
10 o’clock A. M., I saw her; stupor much less; re- 
cognized her friends, and asked some questions; 
she did not look so well, a slight squinting was ob- 
servable. Seven o’clock P. 5l., better; pulse less 344 
active; but had three stools since the morning visit. 
Eighteenth. Mr. De la Motha, now Ur. De la 
Motha, another of my pupils, staid with the pa- 
tient last night. She passed a good night, was 
tranquil and rational; no return of fits during the 
night; two stools. Saw her at 10 o’clock A. M.; 
skin dry and hot; face a little swelled, but perfect- 
ly collected. Eight o’clock P. M.; face more swol- 
len, and a little flushed; much headache, pulse very 
active; great thirst; took ten ounces of blood— 
much relieved by it; pulse softened, and diminish- 
ed in frequency; cold applications continued. 
Nineteenth; passed a good night, free from fever 
and pain; no return of convulsions; bowels rather 
tardy; ordered senna tea. Continued much in this 
condition until the 28th, twelve days from the 
first attack; this morning was seized with brisk 
labor pains, and was soon delivered of a dead 
ch,Id. From the degree of putridity, it is pre- 
sumable that the child died early in or before the 
atUck. There is by no means any certain proof 
that the child died before this.” Dewees, pages 
447—’8. 
[Only ninety-seven ounces of blood taken in 
three days! Really, what did kill the child!] 
Case 2. “Mrs. , aged twenty-six years, 
pregnant with her first child—a large plethoric, 
robust woman, was, on the ninth of September, 
1811, about five o’clock A. M., taken with labor 
pains, and sent for her midwife; before the mid- 
wife arrived, she was seized with terrible convul- 
sions, and I was immediately sent for. The fits 
were frequently repeated, and were, from their 
extreme violence, very threatening; her face was 
immoderately swelled; her eyes fairly protruded 
from their sockets; her tongue terribly wounded, 
&c. I iustautly bled her from the jugular vein 345 
more than forty-eight ounces; examined her, and 
found labor approaching; ordered a brisk injection; 
saw her two hours after; had had several severe 
tits; pulse extremely active; labor advancing; bled 
her twenty ounces; injection repeated; a stream of 
cold water was poured on her head during the in- 
terval of the tits. Eleven o’clock A. M.; fits not 
so severe, but pretty frequent; pulse still very ac- 
tive; took [only] sixty-four ounces of blood more; 
apparently much relieved; lay more quiet. One 
o’clock P. M.; had had two or three fits; very rest- 
less; mourned every few minutes; desirous of get- 
ting from the bed; bled her twelve ounces; examin- 
ed, and found the head low in the pelvis, and deli- 
vered with the forceps; she had two or three fits 
after delivery, and remained insensible to every 
thing for forty-eight hours. She now began to 
show some signs of returning sensibility: was bled 
twice in the interval—[How much, Doctor! sixty- 
four ounces each time!]—cold was applied to the 
head, and legs blistered; she was purged freely 
with senna tea. After this she gradually recover- 
ed her senses. She was left completely blind for 
two weeks; she then began to see imperfectly, but 
was six weeks before she could distinctly discern 
objects. It may not be amiss to observe, the child 
was still living/” Page 460. 
[Does any one wonder that the Doctor was sur- 
prised to find the child living! If nature can en- 
dure this, what can she not withstand! Fits are 
efforts of nature to recover from prostration; is it 
any wonder she should make them as long as she 
is able, and cease them when all her strength is 
exhausted by bleeding! No; but it is a wonder 
that she should so often recover after the exercise 
of this barbarous practice!] 
Case 4. “Mrs. was seized, at 1 o’clock 346 
P. M., November 10th, while at the ironing1 table, 
with vertigo. She fell, and wag immediately at- 
tacked with convulsions. I was living near, and 
was instantly sent for. I found her laboring under 
the general symptoms of this disease. I bled her 
from both arms at once, to the amount of about 
sixty-four ounces. She appeared for a time much 
relieved; that is, the convulsions were abated. An 
injection was ordered, which operated well; about 
an hour after the bleeding, her pulse rose very 
much; her breathing was more labored and ster- 
torous, and some convulsive twichings over the 
body. Fearing a repetition of the convulsions, I 
again tied up the arms, and took about twenty-Jive 
ounces more of bleed; this seemed to moderate the 
symptoms! 
Four o’clock P. M. the convulsions were renew- 
ed with considerable violence—twenty ounces more 
of blood were taken; cold water was poured upon 
the head; she was more tranquil, but not less co- 
matose. Six o’clock P. M., had had several fits, 
but [for want of power] not so violent as at first; 
pulse still too active ; took eighteen or twenty 
ounces of blood. As the pulse was considerably 
reduced, applied a pair of blisters to the legs, and 
sinapisms to the feet.” [lleally, after taking one 
hundred and thirty ounces of blood in the space of 
five hours, I should think it would do to begin to 
warm the feet with a mustard poultice.] “At ten 
o’clock she was sick and made an effort to vomit. 
At 6 o’clock next morning I was suddenly called, as 
her breathing was becoming more laborious and 
loud, and face more flushed, with some convulsive 
agitations; pulse rathertoo active; took ten ounces 
of blood and applied a large blister plaster be- 
tween the shoulders. She gradually recovered her 
recollection, but remained until some time after 347 
the delivery (one month after) with imperfect vi- 
sion, especially with one eye. She was, for many 
years after this, subject to violent headaches, 
which must be removed by bleeding. [The cruel 
practice that first caused it.] Page 461. 
Case 5.—“Mrs. , October 5th, 1803, had 
been in labor several hours; she had every appear- 
ance of being happily delivered, when, during a 
strong pain, she instantly cried out “my head!” 
and immediately fell into convulsions. She was 
under the care of another physician, to whose aid 
1 was instantly called by his own desire; the con- 
vulsions were strong and often repeated; she was 
largely bled; on examination, the child was found 
to be far advanced, and was speedily delivered by 
the aid of forceps; the convulsions, however, con- 
tinued in spite of every exertion to relieve them, 
and she died in about three or four hours after the 
attack.” Page 462. 
[I am astonished, Dr. J)., that a man, so ac- 
customed to use the lancet, with an assistant 
equally skilled, should let a woman die because 
he could not let blood fast enough to save her life, 
when he had three or four hours to do it in. Why 
did you not open both jugular veins and “tie up 
both arms” and open their veins; and, if that was 
not enough, you should have opened the carotids 
and brachial and femoral arteries, and then, it ap- 
pears to me, you might have let blood enough to 
save her life, as you assert that blood-letting is 
“the cure for convulsions.” If this theory is true, 
and your statement be correct, it follows that this 
woman died because you were too indolent to let 
blood fast enough to save her life. I would have 
cut her head off, if I could not have let blood fast 
enough without, rather than had her die in my 
hands, because I was afraid to act according to 
my principles in blood-letting.] 348 
Another Case.—“I was called on the 16th of 
April, 1810, to Mrs. , said to be in strong 
convulsions. I was from home when the messen- 
ger came, but went as soon as it was in my pow- 
er. When I went into the sick chamber, I found 
Dr. with the patient. He told me “Mrs. 
had been attacked about two hours before 
w?th convulsions, and was in the ninth month 
of pregnancy; that, previously to the attacks of the 
tits, she had complained of violent pain in the fore- 
head, which she told her husband she could cover 
with her finger. She was now lying senseless 
and without motion on the bed; she breathed very 
heavily, and snored loudly—the pulse frequent 
and small, and the extremities cold. I enquired 
what had been done, and was informed by Dr. 
he had given her, twice, sixty drops of laudanum 
at a time; and that, since the last dose, she had had 
no tit, and was, in his opinion, very much better, 
requiring nothing but sleep to restore her. I told 
him very plainly, that I thought he had mistaken 
the patient’s case, and had, in my opinion, sealed 
her fate by the use of laudanum. He appeared 
alarmed but not altogether convinced. We did 
every thing that we thought might be useful; but 
all exertion was unavailing, and the patient died 
in about three hours.” Page 463. 
[All the convulsions, in all the foregoing cases, 
might have been relieved by a few doses of the 3d 
preparation of lobelia, and the patients soon 
cured.] 
“Examinations of women who have died during 
labor, or soon after delivery, are not so frequent 
as their importance seems to demand.” One of 
the principal reasons why they are not more fre- 
quent, is to be attributed “to the disingenuous 
conduct of the attending physician himself, who may not wish the cause of death to be ascertained, 
lest it shoul do injury to his character, either from 
his not having known or suspected the true one, or 
by exposing some lesion for which he fears he would 
be held accountable.” Page 406. 
“It is almost universally believed, that an un- 
due force applied to the cord for the delivery ofthe 
placenta, is the principal cause of the untoward 
and too fatal accident, the inversion of the uterus.” 
Page 496. 
Presentation of the Arm.—“There is no pre- 
sentation that gives rise to so much bad practice, 
as the presentation of the arm; for its mechanism 
is generally but very ill understood. The arm it- 
self, is almost constantly supposed to offer great 
difficulties, by its presence in the vagina; hence 
it has been scarified, twisted off, or amputated, to 
the disgrace of the profession. It is true that, in 
most instances, these severe operations have been 
performed after the supposed death ofthe child; 
but, in many other cases, we fear that the life of 
the child has not been taken into consideration. In 
arm presentations, the amputation, or other opera- 
tions upon it, should always be forbidden; espe- 
cially as the signs of death are, in many instances, 
equivocal, as the evidences of life are obscure. Dr. 
Chapman relates an instance, where an accoucheur 
amputated the arm on the presumption that the 
child was dead; it was however, alive, and lived 
to manhood. And, more recently, a surgeon was 
6ued for amputating the protruding arms of a 
child which he supposed had been long dead, but 
proved to be alive.” 
“It is therefore best not to meddle with the de- 
scended arm; for, if turning be attempted, it of- 
fers no difficulty to the passage of the hand.” 
Page 508. 350 
“When the arm presents in a labor, turning and 
bringing by the feet, is the only operation that can 
be performed with a view to the safety both of mo- 
ther and child.” Page 512. 
“As regards turning, it must not be disguised, 
that it is an operation of hazard to the child, even 
under the most favorable circumstances of the ute- 
rus or position of the child; and, of course, the 
risk will be in proportion to the departure from 
the best conditions.” Page 515. 
“During labor, the uterus every now and then 
is ruptured; and, perhaps, even oftener than at 
present we dare assert. Sometimes this accident 
is concealed, from ignorance, and, at other times, 
from design; hence, many cases must occur of 
which the public remains uninformed. Conceal- 
ment often arises from a previously adopted theory 
upon the subject, and the supposed risk of profes- 
sional reputation.” Page 5115. 
“It must, however, not be concealed, that these 
instruments (forceps) are not safe, under the cir- 
cumstances we are now considering, (a deformity 
of the pelvis,) but in the hands of a few; and are 
only rendered so to them, by their superior pro- 
fessional attainments, and the long habit of using 
them. To the inexperienced practitioner, they 
should be entirely forbidden; not only because they 
may destroy the child, but also because the mother 
may be severely or irreparably injured by their 
use.” Page 552. 
[It seems then, that those do not know how to 
use the forceps “scientifically” who have not been 
in the habit of killing people with them, by way of 
acquiring skill “in their use! Who are the vic- 
tims of this quackery ? The poor deluded patients 
who have resorted to the hospitals and the alms- 
houses, and others who are the first subjects of 
every upstart doctor’s obstetric skill.] 351 
“The most difficult operation on the living1 sub- 
ject, is the scientific application ofthe forceps, when 
the head of the child has descended so low as to oc- 
cupy the vagina. 
“How much greater eclat do most of the opera- 
tions of surgery obtain, than a delivery by for- 
ceps! Yet we do not fear, nor do we hazard a con- 
tradiction when we say, there is no operation in all 
surgery, that is not of more easy attainment than 
the rational and just application of the forceps. 
We feel that it is proper that some delicate effort 
should be made to elevate the character ofthe well 
instructed accoucher, and to have a just value set 
upon the most difficult operation, in the range of 
medical science.” Page 555. 
[It is doubtless best to have a law passed that 
only one in a hundred gentlemen of the faculty, 
shall ever use this scientific instrument; that he be 
called to every case in which nature is a little tar- 
dy, and receive from 10to 500 dollars, “according 
to the ability ofthe patient, "for bruising the head, 
lacerating the labia;, or tearing out the capilli «fec. 
&c.! Ur. D. should be made President of this 
company of “celebrated accoucheurs!”] 
“The too implicit reliance upon certain of the 
signs which are said to characterize the death of 
the child in utero, has been the cause of the immo- 
lation of thousands.” Page 614. 
“We may with much trutli declare, that the iner- 
tia of the uterus is very apt to follow the use of 
such stimulants as opium, oil of cinnamon, volatile 
alkali &c.,or the mechanical stimulus of the for- 
ceps, vectis,orthe hand. Thus we witness hem- 
orrhage sometimes follow the use of either of the 
remedies just named, though they may have been 
successfully exerted, as regards the mere delive- 
ry.” Page 616. 352 
Secale Cornutum.—“More children, I am satis- 
fied from what I have seen and heard, have alrea- 
dy perished by the injudicious use of ergot, during 
the few years which have followed its introduc- 
tion into the practice of this country, than have 
been sacrifised by the unwarrantable use of the 
crotchet for a century past." Page 621. 
“We have known the ‘ergot’ given where the 
pains were natural and powerful, to render them 
more effectual, when the uterus became exhausted 
by being thus unduly urged; and the only resource 
ultimately has been in the forceps.’’ Page 625. 
“The too free use of the ‘ergot’ in a certain phy- 
sician’s practice in this city, has occasioned very 
many cases of prolapsus uteri.’’ Page 626. 
“Contusion, laceration, sloughing, decapitation, 
dislocation, fractures—these are the dreadful evils 
to which brute force may give rise.” Page 185. 
How the Regulars treat their Patients after 
Delivery. 
Elizabeth Clark, aged 30, was delivered (scien- 
tifically) and soon after complained of sickness, 
and had a slight vomiting; but, by means of an an- 
odyne, these symptoms abated, when she was im- 
mediately affected with universal coldness over 
the whole body, which also abated by the applica- 
tion of warm irons to the feet. Next morning at 
2 o’clock, she complained of considerable pain, 
for which she was bled, and an injection adminis- 
tered, but without effect; for her pain increased, 
pulse became frequent, she was hot, and complain- 
ed of drought. At 7 P. M. same day, the injection 
was repeated, but with no better success; eight 
ounces more of blood were taken from the arm; a 
third injection given which also failed to evacuate 
the fceces, and the pulse rose to 128. Her pulse 353 
being fuller at noon, she was bled again. At 3 
P. M. her pulse rose to 140. .She was much op- 
pressed and complained offa intishness, but the pain 
still increasing, twelve ounces of blood were taken 
away. At 8 P. M. her pulse was small and feeble, 
she looked ghastly, and soon expired.” Page 
453. 
Thus, in the space of 18 hours this delicate lady 
was bled largely four times, had five injections 
administered, took medicine constantly at “short 
intervals,” and was in constant suffering, until 
death closed the dreadful scene. She had a long 
and tedious labor and was greatly fatigued, and 
this is merely the closing scene. Now what was 
the cause of her death? Her long, tedious labor, 
or the treatment after parturition? What lady, 
setting aside the weakened and exhausted condi- 
tion of the individual in the above case, could bear 
four large bleedings, five scientific injections, be- 
sides quantities of poisonous drugs, in the short 
space of eighteen hours? 
“I was called,” 6ays Dr. Smellie, “to a woman 
who was above eight months gone with her fourth 
child, when she was taken with a violent flooding 
which almost filled her chamber pot. When I came, 
the flooding was stayed, she was easier and not 
much weakened. I told her friends the danger to 
which she was exposed, if the flooding returned, 
and exhorted them, in that case, to send for me 
immediately. In the mean time I ordered ten oun- 
ces of blood to be taken from the arm!” The flood- 
ing returned (of course,) the Doctor was called, 
when he says, “I could scarcely distinguish the 
pulse; her extremities were cold; a cold sweat 
spread all over her face and breasts, and she could 
scarcely speak. I immediately ordered a cordial, 
gave her some warm red wine. Her blood vessels 354 
were much emptied. I ordered ligatures above the 
knees and elbows, and warm cloths and bricks to 
her feet. All these steps were taken in order to 
recover her strength and spirits; but, before my 
directions could be putin practice, she expired.— 
Page 463. 
“Treatment of Elizabeth Thompson, aged 32, 
after she had endured much suffering and been de- 
livered ‘secundum artem.’ After she was deliver- 
ed, on Monday night about ten o’clock, an opiate 
was administered, after which her pulse beat 100 
strokes in a minute. On Tuesday 3 grains of cal- 
omel, and one grain of purified opium were given, 
pulse 108. Wednesday at 7 A. M., pulse 120; 
five grains of calomel were ordered. . At 4 P. M., 
pulse 144; half an ounce of castor oil was given, 
and an injection given in which were two drachms 
of tobacco. At 9 P. M. same evening her pulse 
was 140; five grains of calomel and one grain of 
purified opium were ordered and a blister applied 
to the abdomen. 
Thursday, 7 P. M., pulse 150. Till then the 
antiphlogistic regimen had been pursued, but now 
a stimulating one was adopted. A suppository of 
soap was ordered. At 2 P. M. her pulse was 160; 
ten grains of hartshorn and ten grains of musk were 
ordered, and were to be repeated in four hours; 
soon after which her pulse was exceedingly weak 
and feeble, and she soon died. 
Post mortem examination revealed gangrene in 
the cervix uteri, and the physician gravely con- 
cluded that was the cause of her death! Page 170. 
I think any young lady would have the gangrene 
somewhere if she should submit to such treatment 
for three or four days! The above course is re- 
commended as scientific by the first accoucheurs in 
the world, and a rule to direct the student in med- 
icine. 355 
A Scientific Specimen, of the way to make Puer- 
peral Fever.—“All women, during1 and immedi- 
ately after delivery, lose more or less blood, from 
the quantity of half a pound to that of a pound or 
even two; but, should it exceed this, the patient is 
in great danger of her life.” Page 528. 
“A lady aged 28, and of a delicate habit of body, 
was delivered on the 7th of July. The birth was 
not attended with any dangerous or uncommon cir- 
cumstance. She was easy after delivery and rest- 
ed well at night. The next (8th) day she com- 
plained of headache, which was not relieved. 9th, 
headache worse, with acute pain in her right side; 
and, in the afternoon, there was great internal 
heat across the breast and stomach, with coldness 
of the extremities. Her pulse was exceedingly 
quick, headache violent, tongue white and dry &c. 
Half an ounce of blood was taken away, and anti- 
monial powders given, and ordered to be repeated. 
A clyster was administered, and bladders of warm 
water put to her sides and the soles of her feet. 
There was no abatement of pain that night.” [No 
wonder, Doctor, after you had taken from this lady 
of“delicate habit of body” half a pound of blood 
and poisoned the remainder with antimony. But 
let us see what must be done next.] “10th, pulse 
full, hard and frequent ; skin dry, and respiration 
difficult and painful. Half a pound of blood was 
again drawn, antunonial powders repeated every 
four or five hours, and a blister [of poisonous can- 
tharides] applied. She was ordered to drink plen- 
tifully of common emulsion with nitre!” [Well, 
Doctor, how did she rest after this kind treat- 
ment!] “She had no sleep that night.” 
11th. Is she not easy and well this morning, 
Doctor! “Pain in the head and difficulty ofbreath- 
ing still increased.” [What next!] “Nearly an©- 356 
ther half pound of blood was taken. At this time 
she began to be troubled with cough, was much 
oppressed with phlegm, and expectorated with 
great difficulty. Saline draughts, emulsion of ni- 
tre, clysters &c. were repeated. At night all the 
feverish symptoms returned with violence. She 
was again bled as before.” [A pretty day’s work 
for “a delicate lady,” I should think.] 
“12th. A little better in the morning; but, in 
the afternoon, the pain returned, with difficulty of 
breathing, for which she was again bled.” Page 
470. 
[Now, Doctor, you have, yourself, taken more 
than two pounds of blood from a “delicate lady,” 
after all she had lost in parturition, which you say 
is always from a half to two pounds, at the ut- 
most, and that, should more than this quantity be 
lost, the “patient is in the utmost danger of her 
life.” How shall I reconcile such statements 
with the treatment! If I believe your first state- 
ment, I must believe that all this suffering, pain 
and distress, were caused by your abominable 
treatment.] 
“In the Westminster new Lying-in Hospital, 
between the 30th of November and the 15th of 
May, 63 women were delivered, nineteen of whom 
had the child-bed fever, of which number 13 died.” 
Page 477. 
The reader may wonder why I give so much 
testimony from the professors in Edinburgh, Lon- 
don and Philadelphia. I answer, because these 
colleges are the three points from which radiate 
the principles and practices of medicine that gov- 
ern the conduct of practitioners, wherever the 
English language is the vehicle of thought. If 
such be the practice of these great professors, what 
must he that of their satellites! Have I not re- 357 
deemed my pledge; viz. to give such a specimen of 
medical iniquity in obstetricy, as to deter from a 
regular process, every sensible lady in the land? 
Still the stock of materials is scarcely broached! 
Many of the above extracts are -condensations of 
more prolix accounts, by the omission of unim- 
portant matter, to bring them within our space; 
but no injustice has been done to the authors, as 
may be seen by reference to the original works. Pages. 
Plan of the Work 3 
Recommendations 4 
Advertisement; want of confidence in Dr. T.’s 
General Instructions; application to Regu- 
lars; ditto to the Author; Request to Doct. 
Thomson, and his reply 5 
Origin and plan of this Work 6 
Midwifery, by Webster and Willoughby 7, 16 
Placenta, retention of; Rash extraction of 7 
Instruments, evils of 7, 8 
Responsibility of medical writers; why I dared 
attempt 7 
Officious handling 7, 8, 9 
Statements or Regulars; delicacy of the sub- 
ject 9 
Terms and definitions; Character of the Book; 
use and abuse of it * 10 
Dedication; Rights of Dr. Thomson; History 
of Obstetrics; the first Mid wife, female 11 
The first Accoucheur, male ; Effects of em- 
ploying men; Effects of civilization and re- 
finement 12 
Effects of medical improvements! Ditto in 
Surgery; ditto Instruments; ditto Bleeding 
ditto Cantharides; ditto Physic 13 
Effects of Mercury &c. 14 
The parturient power; Progress of reforma- 
tion 15 
CONTENTS. 360 
I NTRODUCTION . 
LECTURE 1. 
Pages* 
Reasons why women need aid in parturition 16 
Rest method of teaching; “Diseases peculiar 
to Women” 17 
Design of the female organs 17, 19, 20 
Uterus, Mammae, and their secretions; Men- 
ses, Dr. Dewees on, 18; ditto, Dr. Good on, 
26; ditto, Dr. Curtis on 18, 19, 20, 21, 49 
Menses, Symptoms of suppression 29 
Hervey, on the opposition of the Faculty to Im- 
provements 18 
Period of fecundity 19 
Original condition of the female frame; Prim- 
itive taint 20 
Health; equilibrium of fluids; skin; perspira- 
tion 21 
Clothing, object of; abuse of; the first reason 22 
Delirium 22, 31, 32 
Second reason why women need aid in partu- 
rition; Directions for clothing infants; Third 
reason; Corsets, evil effects of; Abortion, 
causes of < 23 
Fourth reason; Mal-practice* 26, 28 
Calomel 26, 27, 28 
Thomsonian treatment 26 
Dr. Good’s opinion 30 
Poisons, their character 30 
Headache and delirium 30, 31, 32 
Cupping and bleeding; trust to nature 32 
Fifth reason; Want of physical exercise in 
childhood and youth; Disadvantages of ser- 
vants; advantages of exercise, though late 33 
Sixth reason; Culpable want of maternal in- 
struction; it leads to indelicate exposures 33 361 
LECTURE 2. 
Pages. 
Pelvis 36 
Description of the organs peculiar to females; 
External organs 38 
Internal organs, vagina, uterus; their appen- 
dages 39, 40 
Ovaries 41 
Bladder, rectum, uses of the organs 42 
LECTURE 3. 
Diseases and their treatment; Chafes, adhe- 
sion of the nymphae 44 
Structure of the vagina; Polypus; Fluor albus 45 
Retroversion of the uterus 46 
Hydatids, tumors, cancers, dropsy of the 
ovaries 47 
Regular testimonies in favor of our treatment 
and opposed to learned quackery 48 
Catamenia or Menses; commencement, dura- 
tion and end 49 
Description, character and treatment 5 
Marriageable state 50 
Objections, real or imaginary; imperforate 
hymen 51 
Conception 52 
Utero-gestation; Changes in the cavity of the 
uterus; Ova, decidua, chorion, amnion 53 
Anomalous conceptions; Umbillicus and Pla- 
centa 54 
Changes in the substance of the uterus; Labor 
pains, premature; Abortion, difference 55 
Positions of the uterus in different periods of 
gestation; Growth of the foetus 56 
The quickening; Weight of foetus 57 362 
LECTURE 4. 
Pages. 
Duration of pregnancy 57 
Time and signs of commencement; Mistakes 
of Regulars respecting it; calling it dropsy 58 
Reasons of difficulty 58 
Menses, interruption of; ditto, final cessation 
of; 59; occasional during pregnancy; Regu- 
lar practice in; Superiority of the Botanic 60 
Cessation not a sure sign of pregnancy 60, 61 
Bladder, irritation of; Nausea, retching and 
vomiting; Swelling of the lower limbs 61 
Motions of the foetus; Enlargement of the ab- 
domen 62 
State of the breasts; Areola 63 
Likings and dislikings; Quickening; Cessation 
or great diminution of the milk 64 
Diseases as signs; Manual examination 65 
Medical treatment of signs: Diarrhoea; Nausea 66 
Vomitings and purges, easily subdued 67 
Advantages of knowing 68 
Thorough treatment good in all cases 68, 69 
Reckoning, Labor 60 
Causes of labor; Abortions 79 
LECTURE 5. 
Labor, signs of its approach; treatment 71 
Advice when called 72 
Visit promptly, approach modestly, sympa- 
thize kindly, promise not too much 72—74 
Directions for bed, room &c 74 
Attention to position 75 
Turning, ill effects of; Case of breech presen- 
sentation; Objections to instruments by Dr. 
Blundell 76 363 
Pages. 
Directions for correcting a bad presentation; 
Symptoms during labor; Prepare the pa- 
tient 77 
Sawing, cutting and grinding pains depend 
much on the treatment; Natural parturition 78 
Descent of head into pelvis, and rupture of 
the membranes 79 
Perinseum, umbillicus 80 
Child, attention to (first) 81 
Child resuscitation, cleansing, dressing 81,83,102 
Second foetus 85 
LECTURE 6. 
Placenta, removal of 85 
“ Contractions of uterus for 89 
“ Opinions of authors on 89, 100 
“ Injudicious removal, mischievous ef- 
fects of 91—96 
“ Proper directions for removal of 95 
“ No danger in leaving 98 
“ Inflammation, mortification, floodings 99 
“ Danger of force 100 
“ Long retentions of 101 
“Putting to bed;” Puerperal Fever; Secre- 
tion of milk 101 
Attentions to Women; Child—cleansing and 
dressing 102 
Chafes, to prevent; Meconium 103 
Urine, food, medicine 105 
LECTURE 7. 
Ways and Jlleans. 
First Principles 105—*8 
Aid Nature; depart from her only where she 
has departed from her own laws. There 
justifiable 105—6 364 
Pages. 
Vital action, disease, causes of disease, indi- 
cations 106 
Obstructions, various; plans of removal; 1st, 
relax; Means—warmth, moisture, lobelia 
and other relaxants, reaction 107—8 
Alarm, how produced, and continued or stop- 
ped, why not kill; Modus operandi of Lobe- 
lia; Poultices, steam 109, 110, 111 
Poison emetics, antimony,copper, zinc 110 
2nd. Stimulate. Cayenne, heat &c. Ill, 113 
Action and value of cayenne 112, 113, 114 
Substitutes for 113 
Poison stimulants—Brandy opium, nitre, di- 
gitalis, mercury; how act 113, 153, 163 
Cayenne, in abortion and parturition, com- 
pared with lobelia 114, 115 
Use and abuse of lobelia; Canker medicines, 
action of 116 
Compound nature, roughness, stimulating 
qualities various; taste of 117 
Choice of; combination of 118 
Restoratives; Bitters; Character and action; 
advantages of judicious compounds 119 
Organic lesion, how treated 119, 120 
Course of Medicine 120, 128 
Steaming 122, 134, 136 
“ When necessary 128 
“ Convenient apparatus for 125 
Food, in the course 128 
LECTURE 8. 
Ways and Cleans—Continued. 
Food, after the course 1*39 
Diely general directions for; ditto, recommend- 
ed for cholera 129—30 Pages. 
Diet, different opinions on; decuctions from 
the above 131—32 
1st General rule 132 
2nd General rule 133 
Further means of warming and relaxing the 
surface; skin moist and cold 134 
Skin hot and dry; do. cold, lax and inactive; 
Intermediate course 135 
If bowels constipated; If dejections bilious and 
profuse; steaming below the waist 130 
Use of the courses 137 
Poultices, principles of; ingredients necessa- 
ry; mode of operation 138 
Inflammatory tumors 139, 140 
•Simplicity of remedies; how to keep them 141—2 
Compound nature of single articles 143 
LECTURE 9. 
Compounds•—Dr. Thomson’s 143 
Advantages and disadvantages of compound- 
ing and condensing medicines 144, 145 
To obtain and retain pure articles 144 
Improvements, cannot be trusted 145 
tiuackery, origin of 145—6 
“ how to avoid 147 
How to make useful compounds 148 
Stimulating liniment 149 
Extravasation cured; Antispasmodic liniment 150 
Tonic liniment; All the ingredients not al- 
ways necessary 151 
Importance of knowledge of principles 152—’4 
Cause of defeat to the Practice in many places 152 
The effects that follow the use of a remedy, 
not always a test of its value! 152—’3 
Classification of remedies . 154i—’5 366 
Pages. 
Relaxants, stimulants, bitters, astringents 156 
Antispasmodics &c.; Stimulants &c. 157 
Bitters &c. 159 
Astringents 160 
and Gallium are here rein- 
serted through mistake. Their qualities, 
except astringency, are correctly given. 
Boneset is bitter; Gallium, diuretic &c. 
Emollients &c. 160 
LECTURE 10. 
Diseases peculiarto females; Sores, inflamma- 
tions, chafes &c. 161 
Clothing, menstruation, colds, treatment, cal- 
omel, teas, swellings, dropsies, lesions 162 
Cause of animal action; Poisons—how act. 
To cure swellingsof all kinds 163 
Menstruation (retained,) treatment; Regular 
practice in, (Dr. Dewees) 164 
Explanation 16§ 
Excessive menstruation; Difficult and painful 
ditto; Decline of menses 166 
Rloody menstruation 167 
Hemorrhages 168, 169 
Nausea, vomiting, salivation, heartburn 169 
Pain in the right side; restlessness at night 170 
Costiveness 171 
Piles,or hemorrhoids 172 
Opinions of M. Ds., various 173—4 
Reasons for their differences 174—5 
Influence of the Rotanic Practice even where 
it cannot go; Palpitation of the heart 175 
LECTURE 11. 
Displacement of the uterus 176 
Polypus, difficulty of distinguishing; mis- 
takes 177— 9 367 
Pages. 
Advantages of the Botanic Practice 179 
Facts and cases; Disease of uterus and appen- 
dages 190 
Ovarian disease 181 
Operations in, dangerous and useless 181—3 
Reflections on, (trust nature) 183—4 
Success of the Botanic Practice 184—6 
Doctors can’t cure (Dewees) 186—7 
Botanies can and do; Carcinoma uteri 187 
Delicate application of leeches; Hydatids, (no 
remedy!) 188 
Treatment of uterine affections; Effects of 
tnal-practice; Mortification caused by bleed- 
ing &c. 189 
The ends to be accomplished 190 
Irritability of the uterus 191 
Regular opinions and treatment 191, 194 
Botanic treatment, (reasons) 194—95 
LECTURE 12. 
Hemorrhage of the uterus 196, 200 
Growth of the ovuin,placenta and membranes, 
ruptures 196 
Causes of hemorrhage; Plethora—error of the 
Doctors; causes of abortion; death of foetus 197 
Regular Practice—cases 198 
(Second line page 199,19th should be 17th.) 
Effects of this practice 199, 200 
Bleeding to cure bleeding! 200 
The true cause of hemorrhage 201, 202—’3 
How proved, (regular absurdities) 202—’3 
Equilibrium of the blood; apology to Dr. De- 
wees 203 
His light in darkness 201, 203 
Placenta over the neck of uterus 204 368 
Pages. 
Hands off"(authority) 204, 205 
Evil consequences of handling; opium, in hem- 
orrhage; cold applications in ditto 205 
Condemned by Dr. Dewees; Botanic treat- 
ment 206 
LECTURE 13. 
Inflammation of the uterus 206 
Causes of inflammation; means of preventing; 
proof 207—’8 
Puerperal fever, (fears of) 208—’9 
Causes of treatment 209—10 
Emetics good in ; not understood by the 
M. Ds. 210 
Explained by the Botanies 210—11 
Doctors do not unlearn their errors, because 
they see no correct practice. Invive them 
to see ours, and they will abandon theirs 212 
Former stimulant treatment condemned, be- 
cause the means were not used judiciously; 
how should be used 213 
Cases examined; they used poisons for stimu- 
lants 214 
Other errors 215—16 
Cause of death 217 
Case 2nd; a worse case better treated, suc- 
cessful 217—18 
Ecapes, no justification of rash mal-treatment; 
war not by guess against known principles 219 
Bleeding and poisons never right; experiment 
with innocents ; success of the Botanic 
Practice 220—r21 
Lochia; nature and treatment of 221 
LECTURE 14. 
Milk leg, causes and cure; Phlebitis or filling 
•of the veins 222 369 
Pages. 
Regular way to produce sweat! Sore breasts 223 
Different ways and means; suppuration of 
breasts 224 
Hysterics, non-descript; mal-practice; usual 
cause 225 
Difficulty of naming it; slow progress of cure; 
advice to the practitioner 225 
Perseverance the only hope 227 
Treatment, judicious, unremitting, univer- 
sal 227—8 
Restorative compound 228 
Temper it to the case; this practice the only 
alternative 229 
Injuries produced by mal-practice in obstet- 
rics; how to repair lacerations 230 
A horrible case! 231 
Horrid work of instruments; how to relieve 
the effects 232 
Palpitation, sinking, panting for breath, ver- 
tigo &c. 233 
Poisons and their effects 234 
Delirium,causes of 235 
Chronic diseases, causes of; Mercury, Doct. 
Good on 236 
Treatment of its affections 237 
LECTURE 15. 
Diseatet of Children; should be treated first 
in their parents 237 
To cleanse afoetus; dressing and bandages 238 
Causes ofdisease, food &c. 239 
Proper food, nursing; nursing with the bottle 240 
Nurses, and their milk; diseases of; moral 
character of 242 370 
Pages. 
Food, different kinds; fruits; diarrhoea, and 
its cure 243 
How to prevent it; to make food whole- 
some 244—45 
Medicine for children 246 
How administered; children should not be 
cheated 247 
LECTURE 16. 
Exercise 247 
Handling; cradles, creeping, lifting 248—49 
Teaching it to rise, walk &c. 250—51 
Effects of rough handling 251 
Walking, running &c. 252—53 
Plays, out of doors 253 
Clothing, air, exercise; evils of confinement 254 
Cautions about taking cold 255 
The nursery, open, airy, clean 256—57 
Exercise, and company in it 258 
Cleanliness, how maintained 259—60 
LECTURE 17. 
Weaning and teething; Death of mother, or 
disease in her milk 261—62 
Deficiency of; Tongue-tie 262 
Eruptions, of all kinds; description and treat- 
ment 263 
Early symptoms deceptive. Measles, scarlet 
fever 264 
Mineral and Botanic treatment ; Urinary or- 
gans 265 
Bowels, diseases of 266 
Dentition or teething 266 
“ Regular treatment 267 371 
Pages, 
Dentition, Diarrhoea during 268 
“ Reasons 269 
“ Mal-practice 270 
“ False estimate of symptoms 270 
“ Proper treatment 270—71 
“ Rad feeding, eruptions 272 
“ Examples of mal-practice 273 
Erysipelas, and regular treatment 274—75 
“ proper treatment 276 
LECTURE 18. 
Skin-binding; Thrush or sore mouth 277 
Calomel 273, 275, 278, 284, 303, 305 
Colic, opium 279—80 
Dover’s Powders, laudanum, paregoric, mor- 
phine, anodyne drops, styrax pills, 6cc. &c. 
all preparations of opium 280 
Cure for colic; Costiveness or constipation 281 
Costiveness, cured by opium! cured by injec- 
tions &c. 182 
Vomiting, diarrhoea 283 
Simplicity of Regular Practice 284 
Syrup for diarrhoea 285 
Worms, regular treatment 285, 287—’9 
“ correct practice, case 286 
Ophthalmia, sore eyes 289 
“ treatment, cause 290 
Cholera infantum 291 
Fevers, remittent 292 
“ catarrhal 293 
Rronchitis; pleurisy 294 
Mumps, quinsy and croup 295 
Lobelia in, by Dr. Eberle! 296 
Warm bath, by “ ditto 297 372 
Pages. 
Bleeding docs no good, but must be practised! 
Dr. Eberle, Dropsy in the brain 297 
Bleeding, Case of cure; bad, regular success 298 
“ Bad,regular reason, Peritonitis &c. 
vaccination or cow pox 299 
Smallpox 300 
Whooping cough, croup 302 
Convulsions 303 
“ treatment 305 
Epilepsy; falling, exhaustion 305 
Of the Regular Faculty SfC. 
Abortions 307 
Accoucheur’s business 309 
“ worse than wild beasts 328 
Arm mangled 349 
Bleeding 307, 320, 331, 341—’48 
Breech presentations 312, 326 
Bowel complaints, cause 332 
Craniotomy 328, 330 
Calomel, won’t cure 331 
“ will make disease 332 
Convulsions, Puerperal 340—’48 
Deception from ignorance 316 
Difficult labors rare 317, 330, 337 
Diagnosis 321, 351 
Examination of women who have died during 
labor, not common, for fear of exposing mal- 
practice! 349, 355 
Elevate the forcepial profession! 351 
Ergot or rye spur 3521 
TESTIMONIES 373 
Pages. 
Forcing delivery 312, 315, 318, 322, 324, 3<-9, 
ooTj oO—'• 
Face cases ooo 
Follow nature 339 
Floodings **87, 3~ > 
Foetus, destroying JIO, 8- 
Forceps, a formidable weapon 330, 333, ooo 
“ Drs. Denman and Osborne, against, 335—3b 
“ Dr. Dewees, pro and con. 
“ Difficulty of using 35°""qq7 
Feet, pulling them down 337 
Handling 307, 308, 312, 314, 315, 317, 319, 
Hemorrhage 315, 334, 338 
Hand, worse than bayonet! 324, 328, 32.!, 33t 
Instruments 312, 317, 329 
“ worse than useless 300 
“ why often used 315 
“ better left at home 317 
“ patience and good nature 317 
Inflammation, cause 
Improvements, scientific 338 39 
Lancet, see bleeding. 
Laborious labors, cause 300, oo< 
Lacerations 322, 328, 329, 3 
Membranes, rupture of 308, 311, 312, 321, 3~~ 
Meddling, see handling. 
Mistake 
Nature beats the doctors . 
Opium makes disease 332, 3ol 
Placenta 308, 315, 317, 318, 3^,2 
Premature delivery 315 
Perspiration 
Puerperal fever! 319. Cause 331 
Pregnant or not, “that’s the question” 321 
Presentation 321, 322, 326. Arm 374 
Pages. 
Physic for child 332—33 
Rye spur 352 
Strengthening the system 307, 309, 310 
Straining 308 
Stretching of strictures 310, 337 
Skilful hands, whose! 340 
Scientific treatment, by Dr. Dewees 340—48 
Turning 312—13—14, 316, 324—25, 326—27, 
349, 350 
“ Mischiefs concealed 350 
Umbillicus 311, 316 
Uterus 315, 317, 318, 323, 828, 331, 337 
“ Preparations of 323—24 
What can I do! 324 
Worms, no cure for 331 GLOSSARY. 
Antiphlogistic. Reducing and cooling, by bleed- 
ing, cathartics, saline waters, ice &c. 
Amnion. The inner membrane that encloses the 
foetus. 
./Esophagus. The windpipe. 
Accoucheur. Male obstetrician. 
Absorbent. Taking up, receiving. 
Antispasmodic, defined, page 154. 
Astringent, defined, page 154. 
Antiasthmatic. Opposed to asthma. 
Ascites. Dropsy of the abdomen. 
Anasarca. Dropsy in the flesh, generally. 
Anodyne. Producing quiet or sleep. 
Anthelmintic. Opposed to worms. 
Asphyxia. Want of pulse. 
A. 
B. 
Bronchia. The tube leading from the windpipe 
into each side of the lungs. 
c. 
Crotchets. Obstetric instruments. 
Cantharides. Spanish flies, for blisters. 
Congestion. Compression of fluids in parts of the 
body. 
Calipre. An instrument to measure the dimen- 
sions of the pelvis. 
Carunculaj myrtiformes. Defined, page 38. 
Catheter. A tube to draw oflf the urine. 376 
Cranium. The head or skull. 
Chyme. The food as it leaves the stomach. 
Chorion. Defined, page 196. 
Coma. Drowsiness, stupor. 
Contusion. Bruise. 
Craniotomy. The science of piercing the skull of 
foetuses, and letting out the brains, in cases 
where nature has forgotten to prepare the size 
of the head to that of the passage through wtiich 
it must be discharged. See pages 328, 330. 
Coagulum. Clotted blood, or other thickened 
fluids. 
D. 
Delirium. Defined, page 23. 
Duodenum. Second stomach, small intestines. 
Diarrhoea. See page 67. 
Decidua. Defined, page 196. 
Diaphragm. Dividing membranous muscle be- 
tween the chest and the abdomen. 
Diuretics. Medicines that promote the discharge 
of urine. 
Diaphoretics. Medicines that aid in producing 
insensible perspiration. 
Deobstruent. Removing obstructions. 
Diagnostic. Deciding the disease by symptoms. 
Deliquia. Fluids suddenly reduced from solids. 
E. 
Emenagogue. Promoting menstruation. 
Emesis. Vomiting. 
Escharotic. Caustic, a caustic. 
Embryotomy. Defined, page 231. 
Erysipelas. Defined, page274. 
Exanthematic. Producing cutaneous eruptions. 
Expectorant. Promoting discharges from the lungs 377 
F.mollient. soft, slimy, lubricating. 
Enemata. Injections. 
Epileptic. {Suddenly falling. 
F. 
Forceps. Instruments for clasping the head of the 
child and forcing delivery. 
Fourchette. Defined, page 38. 
Fontanelles. The spaces in the foetus, where the 
seams of the skull unite or cross each other, be- 
low the crown and on the top of the head. 
Funis. Navel cord. 
Fomentations. Warm and moist applications. 
Fissure. Notch, or long, narrow, external cavity. 
Frontal. Before the head. 
G. 
Ganglion. Knot in the nerves. 
Genital. Relating to organs peculiar to males or 
females. 
II. 
Hydatids. Defined, page 47. 
Hymen. Defined, page 39. 
Hemorrhage. Bleeding. 
I. 
Intropelvimeter. See calipre. 
Inversion. See page 176. 
Ingesta. Food. 
Immolation. Sacrifice. 
Lymphatics. Vessels that commence with ope® 
tubes in all the fleshy parts of the body, resem- 
L. 378 
ble the veins in structure, gather up or absorb 
the morbific materials or fluids, and carry them 
into the veins, to be thrown out by the secem- 
ants. 
Labia Pudendi. Defined, page 38. 
Larynx. Upper part of the windpipe. 
Lochia. Defined, page 221. 
M. 
Mammee. Breasts. 
Micturition. Defined, page 61. 
Meconium. Defined, page 103. 
Monograph. A treatise on a particular disease or 
genus of diseases. 
Morbific. Tending to produce disease. 
Marasmus. Wasting of the flesh, health and 
strength, without an apparent specific cause. 
N. 
Nosology. Classification of disease. 
Nymphse. Defined, page 38. 
Nomenclators. Those who give names to things. 
o. 
Obstetricy. Midwifery. 
Ovaries. Defined, page 41. 
Ossification. Turning to bone. 
Ossa Innominata, 06sa illia, ossa pubis, os coccyx. 
Defined, page 36. 
Os uteri, os tincce. Defined, page 40. 
Os externum. External orifice or opening. 
CEdematous. Swelling with water, so as to leave 
a pit after pressure. 379 
p. 
Placenta. The cake that unites the umbillicua to 
the uterus. 
Pelvis. The bony rim that supports the abdomen. 
Prophylactics. Preventives of disease. 
Polypes. Projecting tumors from internal cavities. 
Plethora. Fullness of blood &c. 
Pelvis. Defined, page 536. 
Pelvimetre. See calipre. 
Perimeum. Defined, page 38. 
Prolapsus uteri. Descent of the cervix through 
the vagina to the perinffium. 
Pylorus. Lower orifice of stomach. 
Parturition. Childbirth. 
Pruritus. Itching about the genitals. 
Pathology. Doctrine of disease. 
Phlebitis. Defined, page 222. 
Paralytic. Benumbing, destroying sensibility or 
muscular motion. 
Palpitation. Defined, page 233. 
Plexus. A bundle of nerves. 
Parenchymatous. Pulpy, fleshy. 
Porraceous. Greenish, resembling leeks. 
Purulent. Pus-like. 
Phthisis. Pulmonary consumption. 
Peritoneum. The membrane that includes the 
Intestines. 
Pathognomonic. Characteristic of specific dis- 
eases. 
Parietal. Inclosing like walls, as the high side 
bones of the cranium. 
Puerperal. Relating to child-birth. 
R. 
Retroversion. Defined, page 46. 
Rima Glotidis. Rim of the opening of the wind- 
pipe. 380 
Rubefacients. Irritants that being rubbed on it, 
will make the surface red. 
Rectum. The lower division of the alvine canaL 
S. 
Strangury. Griping pain in the bladder, with 
dribbling of the urine. 
Symphisis pubis. Defined, page 36. 
Sacrum. Defined, page 36. 
Sedative. Q,uieting excitement. 
Sagittal suture, 'l'lie seam between the back and 
the upper bones of the head. 
Secundines. Defined, page 85. 
Sudorific. Producing perspiration. 
Secernant. Carrying off obstructions. 
Sialagogue. Discharging saliva. 
Suppuration. Changing from inflammation to an 
ulcer or sore. 
Schirrus. Cancer, in its first stages. 
Sphincter. An elastic band that, by contraction, 
closes up a tube. 
Scrofula. A tumefaction and suppuration of the 
conglobate glands in different parts of the body, 
particularly the neck. 
Syphilis. The venereal disease. 
Sloughing. Dropping away in pieces undissolved. 
Symphisis pubis. The connection between the 
front ends of the pelvic bones. 
Syncope. Fainting. 
Sibilation. A hissing sound. 
Sinapism. Mustard plaster. 
T. 
Tenesmus. Agriping which prevente stool. 
Trachea. The windpipe. 
Therapeutic. Curative, indicating cura. 381 
Tetter. The ring-worm &c. 
Tourniquet. An instrument to compress a limb, 
or vessel, and stop the flow of blood. 
Transfusion. The transfer of blood from a well 
person to one that is bleeding, to supply the 
waste. 
u. 
Uterus. Defined, page 39. 
Umbillicus. The navel cord. 
Urethra. The neck of the bladder. 
V. 
Venesection. Hlood-letting. 
Vesiculation. Blistering. 
Vagina. Defined, page 39. 
Vertigo. Defined, page 234. 
Vermifuge. A medicine that expels worms. RECIPES. 
LAXATIVE BITTERS. 
Cayenne, Nervine, Bayberry, Poplar, Golden 
Seal, Balmony, Bitter Root, Boneset, Slippery 
Elm, equal quantities, all in powder, mix well. A 
tea-spoonful every night is calculated to keep the 
bowels free. When not sufficient to produce this 
effect, increase the Bitter Root, Boneset and Gold- 
en Seal. If very costive or the liver torpid, add 
powdered lobelia seed. It may be taken in a little 
cold water or molasses, or may be prepared in hot 
water, and suffered to cool and then drank. Or 
half as much powdered sugar may be added, and 
then it can be eaten dry, which is an excellent 
way. If a little Bitter Root be added to the com- 
mon Spice Bitters, the mixture will answer well 
for this purpose. ilv 
Physic.—There seems to be much diversity of 
opinion among our Botanic friends about the pro- 
priety of using physic in any case. As is usual 
with enthusiasts, the champions on each side, 
lean as far from those on the other as their rope 
will let them. Some say that physic is poison 
and death; others say that catharsis is one of na- 
ture’s most common modes of removing disease. 
For myself, I believe that the truth is just about 
midway between them. Spontaneous purging is 
quite as common, and therefore quite as natural, 
as spontaneous vomiting. I never give cathartic* 
merely to open the bowels. I always prefer ene- 
mata. Nor do I give them to clear the stomach— 
I much prefer emetics. But I now and then find a 384 
case in which, after the stomach and lower bowels 
are well cleared, there seems to be a want of ac- 
tion in the middle region, especially in the liver. 
The above compound takes hold of this inactive 
part. The bitter root, boneset and lobelia relax 
the parts; and the cayenne and the bayberry stimu- 
late them to action and keep up the determination 
to the surface, and most of the articles furnish the 
bitter principle to correct the bile. Cayenne itself 
produces, in most cases, all the action that is ne- 
cessary on the bowels. Though I have seen much 
good done by butternut physic, yet, in general, I 
prefer emetics and enemata. I have given very 
few compounds in this book, because I wish the 
reader to study the principles so well that he can 
make up at any time, something to suit the case, 
whether he has all the articles or not. 385 
PLATE 1. 
k WELL FORMED PELVIS, 
Front view, as in the skeleton. A A, (upper) 
Ossa innominata. A A, (lower) Iliac bones. 13, 
Ischiatic bones. O D, Os sacrum. E, Os coc- 
cyx. F, Lower vertebra. K, Promontory of 
sacrum, a a, Iliac fossae, or false pelvis. H, 
Symphisis pubis, or joining of the pubic bone* over the arch l l. lb, P P, b l, Brim of the 
true pelvis. V, Head of femur. m, Acetabu- 
lum. u, Ischiatie holes. 1 2 3 4, Holes through 
which the nerves pass into the pelvis. 
PLATE 2. 
PERPENDICULAR VIEW OF THE UPPER STRAIT. 
A B, Short of sacro-pubal diameter. D C, 
Long or Iliac diameter. a a, iliac fosste. b, 
c. Lower vertebra, d, Upper part of os sacrum. 
Prom, sacrum, e e, Sacro-illiac Symphisis, f f, 
Parts over the acetabula. g, Symphisic. PLATE 3. 
AN ILL-FORMED PELVIS. 
a Ossa Ilia, c c, Ossa Ischia, d d, Last 
vertebra, pressing obliquely into the of sacrum. 
/, Oh ilia. h h, Foramina ovalia. Here the 
diameter 11 1J, is nearly the right, length ; 
A A, too narrow; C C, quite too narrow, and D i), 
rather too wide. Such pelves are sometimes form- 
ed by the rickets, but that disease is not common 
in this country. PLATE 4. 
A posterior section of the pelvis, containing the 
internal organs. A, The last vertebra. 11, Ossa 
innorninata. C, Acetabula. 1), Lower edges of 
the ossa ilia. E, Fleshy parts covering the coc- 
cyx. G, Vagina cut and stretched open. II, part 
of the bladder. I, The neck of the uterus. K, 
The fundus. L, Fallopian tubes. M, Ovaries. 
N, Broad ligaments. O, Upper parts of rectum. 
The fallopian tubes and the ovaries are elevated 
from their natural position beside the body of the 
ttterus, that they may be seen. 389 
PLATE 5- 
A B, Front view of a posterior section of the 
uterus at tlie first month of pregnancy. A, fundus; 
B, neck; (J, cervix. II K, G F, Same view as 
plate 4th, with the uterus, K. K, as it appears at 
the second or third mouth of pregnancy. II II, 
Parts of the bladder. G, Vagina, witli the cervix 
uteri depending in it. The foetus is floating in tha 
waters with the placenta attached to the fundua 
uteri between K and K. 390 
PLATE 6. 
A, Tlie gravid uterus in the 8th nr 9th month, 
stretched by the waters, tiie fetal head in the 
false pelvis, pressing down. II, The os uteri, the 
neck being obliterated. G, The vagina. K, The 
placenta. Lt The membranes. 391 
PLATE 7. 
A lateral view of thelumbar regions, pelvis and 
foetus, when labor has commenced. C E F, Dif- 
ferent forms of the uterus before the discharge of 392 
the waters. D, Same after the discharge. H,Os 
uteri opening before the sac of waters. I, The 
vagina. K, The left nympha. L, The left labia 
pudendi. M, Part of bladder. N, Anus. O P, 
Left hip and thigh. E, The uterus, as in a pendu- 
lous abdomen. F, The uterus, in this case, press- 
es on the diaphragm and produces vomiting, dis- 
pncea &c. PLATE 8. 
This is the most convenient and common posi- 
tion. A, The uterus, after tho discharge of tha 
waters. B C, Lateral view of lower vertebra 
and the ischium. 1, Os pubis. W, Os externum. 
UBOK FAR AOVAMCKP. 394 
PLATE 9. 
TWINS. 
A front view of the posterior half of the pelvis, 
as in plates 4, 5, 6) with twins, their umbilical 
cords, placentas &c., at the beginning of labor. 
H, Os uteri just opening by the presence of the 
waters. U, Vagina. 395 
PLATE 10. 
A face presentation. A, Lateral section of the 
vertebra?. G, Uterus. B, Os coccyx. E, Peri- 
neum. C, Os pubis. F, Right labium pudendi. 
The chin presents at the os externum. .More te- 
dious, but a natural and not dangerous presenta- 
tion. PLATE 11. 
A Breech preecntation with the back in front 
and the umbillicus wound round the neck and 
body. 397 
PLATE 12. 
Breech presentation with the face forward. 398 
PLATE 13. 
The head pressing through a distorted pelvis, 
causing the parietal bones to overlap each other. PLATE 14. 
i, Placenta. 2, Parta of the exterior membranes. 3, Part of the chorion. 4, Veins of the placenta uniting 
to form a trunk. 5, Umbillical vein. 6, Branches of this vein sent to the liver. 7, Vente portarum. 8, Hepatic 
branches. 9, Ductus venosus. 10, Vena; cava inferior. 11, Renal veins. 12, Hepatic veins. 13, Verne cava 
superior. 14, The heart drawn to the right side. 15, Right ventricle. 16, Pulmonary artery. 17, The ante- 
rior duct uniting with the aorta. 18, Lett pulmonary artery, cut. 19, Left pulmonary vein. 20, Left, or pulmonary 
auricle. 21, Left, or aortic ventricle. 22, The aorta. 23, Arteria innominata. 24, Left carotid artery. 25, 
Left subclaviun artery. 26, Descending aorta. 27, Coeliac artery, cut. 28, Superior mesenteric artery. 29, 
Inferior mesenteric artery. 30, Left renal artery. 31, Common iliac arteries. 32, Hypogastric arteries. 33, 
Kxternal iliac arteries. 34, Umbillical arteries, ascending towards the umbillical ring. 35, Twigs of the urina- 
ry bladder. 37, The umbillical arteries, in a twisted wreathen form, passing into the placenta. 38, The liver 
turned aside. 39, The gall bladder. 40, The kidneys. 41, The supra renal glands.