^ESSEgggg L.§&1 ^^ | JTl-KHjlANiVS directions&c. 'V*:?* '"■&*-i jFvX*$k ■^M\Ji ■s>fr> r-3* Surgeon General's Office v l XjQG--^ &&*'<&? I ^ &£ §5 t JMKy. ^C*"&3^* Pill %£*& &a SsBgJfe^ wyVjj KS so* m r***Bti&gH"*wstm»i y , -/s /; } ~-y . / y^i /, -r-Oi y^ Kyy/ itf*'*** /'**"■ f*t^> ■/■ y /y yy* 's/r? y/' '/%/s s.y. ' ■ / yO* i <■■ y t / y^r yy^y^y^w' f yys<<%, *szy&ts/Zy yy 7 // s&- S' S ■■■- _yy/y ■>/> ,^J y'SsS*~..< ,,/*ss*'fJ #<* '&*''' ^y/" yy/y^sTJ ss^sy^yr, svy S'™' ■ St-- ( - \ y . \ 7 / r't ' / if''/ >?s / sys.,Ouy DIRECTIONS FOR THE MEDICINE CHEST PREPARED BY LEWIS HEERMANIN. NEW-ORLEANS; PRINTED BY J~f & a , 7 Spinis of Ch.u,.,i>r, 8 Xntimonial Wine, 9 Cooling Powder, 10 Salt of Tarter, 11 dliie Vitriol. 12 vagi- of Lead, 13 Spanish Flies, 14 Paragoric ELxer, 15 Elixer of Vitriol, 16 Essence of Peppermint^ .17 Balsamic Elixer, 18 Vacant Phials, 19 Volatile Liniment, 20 Laudanum, 21 Toothache Tincture, 22 Ipecac Vomits, 23 Calomel, and Jalep, $4 Calomel Purges, ^ Rheubqrb, a6 Fever Powders, 27 Sudorific Powders^ 28 Injection powders, 29 ticking Plaister^ 30 Suppurative Ointment} 31 Cerate, 32 Blistering Ointment, 33 Mercurial Ointment* 34 Antibilious Pills, 35 Opening Pills, 36- Mercurial Pills, 37 Purging i>*tcs, 38 Flaxseed Tea, 39 Senna Leaves, 40 C.;momde Flowers. 41 All urn, 42 Gum Arabio, 43 Lancet, 44 Tourniquet, 45 Pewter P. Surringes,, 46 Injection Pipe and bag^ 47 Sponge, 48 Lint, 49 Sheep Skins*, 50 Bandages, DIRECTIONS, he. CASTOR OJL.t-ls generally prefered in colics from the genT tleness ot its operation on the bowels; but although very Usetul 01. ;iiis account, it is too slow in its operation to procure speedy relief. From one. u.ble spoon to half a wire glass full, is a dose ; and ihe best method of fc-king it, is to rinse the glass, cup or spoon previously with a little spirit of some sort or other. In fluxes, attended with much griping it is occasionally preferable to other purgatives ; but since it has no other effect, than to unload the bowels, and since in this disease as well as in the above, there is generaly an abundance of vitiated bile, one half dose or a full dose of No. 24 should be mixed with one table spoon full of it, and then it should be taken instantly, lest the white powder should sink to the bottom and hang about the patients teeth instead of getting into the stomach, 2. MAGNESIA.—Corrects acidity of the stomach, and thereby removes occasionally symptoms of indigestion ; such as sour belching^ heartburn, 8cc. One or two tea spoons full scraped fine or bruised with a knife, and taken in either sweet milk or in water, is a dose, and which according to circumstances, may be repeated three or four times a day. 3. BARK.—Is given with a view to strengthen the constitution ; and its use in these directions must be confined to the cure of agues or in- termittent fevers, in which it is to be given during the absence of ague or fever in doses of one or two tea spoons full every one, two or three hours, as the stomach will bear i\. An emetic or one or two good purgatives to cleanse the stomach and bowels, ought to have been, given before the use of the bark is attempted. If loathed at stomach, or producing sickness, the doses will have to be lessened ; or a few drops of No, 15, must be added to each dose. If it proves purgative, a few drops of No 20, may be mix«.d with each dose ; and if costiveness is the effect produced by it, it may be removed by one fourth of a dose at a time of No. 25, or by the •ddition of half a tea spoonful of No. 6, with each dose of bark. Whenever patients complain of a higher degree of headach during its employment or continue unwell, without being able to express tlieir feelings that indispose them ; or when their tongue, which previously moist jmd white, becomes dry and their skin fever- iih and p:iched, this generally useful medicine must be set aside; until another purge has prepared the system to bear better of being strengthed by itj L * 1 Periodical head achs, or such pains as come on at a particular time %very day ; or on every other day, may be treated with a vomit; and afterwards during the absence of pain, with bark. In the convalescence from severe fits of illness, bark may also be used to great advantage The easiest method of taking bark is with sweet milk ; next to that with cold and strong toffee, and occasionally witb wine, though Wate- ;s the more gcnerdly employed vehicle to convey it into the Stomach. 4 TINCTURE OF B ASK.—One tea spoon full is a dose, and may b» related three or four times a day, in all cases where bark in sub- ■ 3t 'ce * ctomme .ded, but where from weakness of stomach oruncon„ q;: Jie dishke, it c-;mot possibly be swallowed. More generally how- ever it is used us a stomachic to improve the appetite in the f«;rm of wi'ie bitter*. 5. FLOUR OF SULPHUR.—One table spoon full mixed with an equal quantity of hogs lard is an efficacious itch ointment. One tea spoon full with as much of No. 6, furnishes with molasses an easy opening medicine, particularly applicable in piles ; and when plen- tifully of some thin and warm liquid is drank after it at night, it frequently sweats off a recent cold. 6. CREAM OF TARTAR.—One tea spoon full with the same quantity of No. 5, mixed with molasses and taken every nip-ht, is a justly reputed medicine to relieve the distressing uneasiness,thr^ in or. affection of the piles proceeds from costiveness. It is independently of its opening quality, cooling and quenches thirst; and hence it forms a most palatable drink in fevers, called imperial drink ; to prepare it half a gallon of boiling water is to be poured into a pitcher over one table spoon full of cream of tartar, the peal of half a lemon and a quar- ter of a pound of loaf sugar. The whole is to be well stirred, and when cool the clear liquor is to be drankat pleasure. When put up into bottles well corked and kept a few days, a degree of fermentation takes pla«i in it, by which it is very much assimilated to the sparkling appearance and lively taste of Champaign. Cream of tartar in the quantity of one small table spoon full to a dose of No- 37, improves its taste and its cooling and purgative effects. When drank with water alone* it abates very mUch the irritation of prickly heat and other rashes, to which persons in full health are Subject in warm weather. 7. SPIRITS OF CAMPHOR.—Is rubbed in for the cure of sprains rheumatic p:iins and sick headachs. It is likewise mixed in ths quantity of two table spoons full to half a pint or a pint of lead water m sp/ains, bruises and in enlargement of teiticlcthe When the pain Si»d inflammation are on the decline. [ * ] 8. ANTIMONIAL WINE.—Two table spoons full are a doSS to produce full vomiting, but. from the combinrtion of several reasons this wine is not the most eligible medicine for this purpose. Jt is, more gei ">e;-ally employed during the hot stage of fever in doses of ?.{), 30, 40 o> 60 drops repeated f om every half hour to every two hours mixed wnh a little water or combinea with the saline draught. (See No. 10 ) In either way it has the effect to diminish the heat and force, of fever in agues and in remittents, and to bring the fits to an earlier termination by sweating. The first ntei.iioi: to produce this effect is to excite a little sqi.ie; n.isl.ness at stomach, tnt! ■when this is produced, the doses ought to be proportionally lessened or the inter- vals of time lengthened, so as not to produce vomiting unless particu- larly desirable. In the mOre malignant fevers of hot climates, attended with sick- ness at stomach and vomiting as a symtom, this remedy is not admissi- ble ; and to reduce the fever, the saline' draughts alone should be trusted to if other mor^ effectual remedies raftnot be safely employed- 9. COOLING POWDER—One tea spoon full taken night and morning in half a pint of flax seed tea or barley water, abates the scalding and frequent inclination to void urine in chip. The same quantity may also be taken, only more diluted in either of the above, in tamarind or in pure water, as a common drink during the day in pleurisies, and in fevers that arise from catching cold in the winter season. 10. SALT OF TARTAR.—As much as will lay on a nine pence. (a bit) is to be dissolved in one table spoon full of water, and suffices to do away the acidity of two table spoons full of vinegar or of the juice of half a lemon or sour orange. The above solution and the acid ought to be kept distinct in two separate teacups or wine glassess and at the very instant that the patient is prepared to swallow it, the one is to be poured into the other, when a sort of boiling takes place between them. But to give it efficaciously, this rising ought nOt to take place in the tea cup, but in the stomach ; and hence the ne- cessity of letting the^patient swallow it immediately after it has been mixed. It is employed in the progress of fevers to lessen them and to produce a little moisture on the skin, particularly if the stomach has become weak, and feels disposed to vomit other medicines Of auy article of diet or of drink given to it. It may be repeated every two hours. This mixture known by the name of saline mixture, is occasionally improved in its effects by the addition of a few drops of ho. 8 or 20. 11. BLUE VITRIOL.—Is employed for external use to suppress 8 loss of blood from tliedivisonof a small blood vessel in cut wounds. To this end as much powdered vitriol, as will lay on the sixteenth of fi dollar (half bit) is to be dissolved in four table spoons full of water* L * J ■rjid small bolsters of lint being dipt into it, are to be pressed upon thd bleeding part, at first with the fingers and when 'lie bleeding hafi stopped, with a circularly winding bandage, Care must beti.ktnnot to disturb this dressing for tliree or four days, lest the removal of the clod of congealed blood underneath it, should bring on a second bleed* ing. It must be understood however, that this method, though effectual in the suppression of small hemorrhages is not calculated-to etorXhe bleeding from a large artery, in which the tourniquet (See No 44') ought to be applied, until professional assistance can be ob- tained ; nor is it admibSib e in gunshot wounds or in wounds much torn or bruised, which from their particular nature are apt to infh.me considerably, and could besides that not bear the tight pressure as above recommended. Proud flesh rising occasionally in ulcers, much above the edge of the skin, and the hardened, elevated :md dry edges of some ulcers are destroyed by touching them, or by rubbing them gently with a pic co of blue stone. Warts also on the peni3 are destroyed in the same manner. 12. SUGAR OF LEAD.—-Two table spoons full ofvineg-ar, the same quantity of spirits, and three gills of rain or river water are to be poured over as much of it as can lay on a nine pence, (a bit) &. foui dou- bled linen rags beingsoaked in it are to be applied ; and should be re. ne wed evt ry quarter of an hour or oftener. The wash should always be stirred or shaken, when used. Poultices are prepared with this water, instead of common water, and are applied cold during the night, in all cases where lead water is recommended. One tea spoon full of No. 2j, d oc<_ ■isionally :;dded to one pint of lead water, to lessen excessively painful inflammation., and three or four table spoons full of No. 7, is a useful addition in extensive bruises, sprains and inflammation, from the 5th, 6th or 7th day of the injury. 13. SPANISH FLIES.—A blister ought in general o>es not to be less thansix inches by four, when iaten ed for the ancles or wrists ofhalf or quarter that size, and when used iehind the ears or upon the temples, of the size of a dollar. No. 32 is to be spread upon a piece of sheep skin or cartridge paper; and as many of the flies are strewed over it, as can be made by pressure of the thumbs to stick to the ointment. The place to be blistered, should be previously well rubbed or bathed with hot vinegar, until the skin begins to redden ; juid if the plaister should have failed to draw well, a new one must be immediately applied upon the same spot. Blisters are best ap- plied over night, and in the morning when well drawn, the 1 v.er part of them should be nipped with a pair of scissars or punctured with a necdk, and the dead skin if possible, should for the first fe.v* L 9 J aays be preserved. A collard leaf, a dry rag, or a rag moistened with Gil, should be ldd over it, and the greatest cleanliness beinf; nervssary to prevent a blister from degenerating into a foul sore, it should be bathed once or twice a day with cold w;iter or with lead water. When greatly inflamed a few days afterwards, they must be poulticedi and healed with No. 31. Blisters give rarely if ever, relief from pain and internal inflamma. fcion in the commencment of a disease attended with a full strong "pulse, before the use of bleeding or purging, or of both. Scalding of the urine and an inability to void it, sometimes sue Ceeds the employment of a blister ; & this though a highly favorable flign in dangerous fevers requires occosionally linseed tea, or barley water with No. 9 ; and sometimes when there is a total suppression of urine, bleeding, purging with No. 37, and the warm bath cannot be dispensed with; but in general, this symtom goes off soon and by degrees. 14. PARAGORIC ELIXER.—One or two tea spoons full with half a wine glass full of water and a small lump of sugar, are a dose, to be taken over night; and when a pint of thin gruel, barley water, sage, balm or elder flower tea is drank after it, it produces a profuse perspiration. • It is an excellent draught in all cases where No. 27, is recommend^ ed but it is rather more heating. The same precautions are therefore to be considered before it is employed. In slight colds, coughs ex-* cited by a tickling sensation at the upper part of the wind pipe, in difficulty of breathing and straightness of the chest from asthma, it is a highly valuable medicine Its effects as a sweating draught, are improved by" the addition of 40 or 60 drops of No. 8. 15. ELIXER OF VITRIOL.—Braces the stomach, when from a weakened state of it, indigestion and flatulence are produced. The dose is fifty or sixty drops in half a tumbler of water, twice or thrice a day. When in agues bark is loathed, or the taste of it so much dis- liked, as to produce sickness, ten or fifteen drops of this elixer are added to each dose. The tincture of bark is likewise improved both in taste and efficacy by a mixture of these drops along with it. I« scurvey, and in profuse night sweats from debility of a preceding illness it is also employed. Two table spoons full of this elixer and a gill each of vinegar, and of spirits, with two lumps of loaf sugar dissolved in them, has been for a long time a reputed wash on the continent, for fresh wounds, and has the property of stopping the blood from small'arteries. Extensive bruises are likewise bathed with this whsh to advantage. 16 ESSENCE OF PEPPERMINT—In cramp of the sto- thach and colicky pains, proceeding from an over distension of the } lo J stomach and bowels by air, this medicine give3 speedy relief in do.-?* of 20 or 30 drops upon a small lump of white sugar, and mixed with about one table spoon full of water or gin and water. 17 BALSAMIC ELIXER.—One tea spoon full may be taken twdc or thrice a day, on a lump of loaf sugar and a little water; and the phial ought each time to be well shaken. It is used in gleets and in the latter stage of the clap when the inflammation has subsided and the running continues from a weakness of the parts. The occurrence of a rash like eruption on the skin during the us«j of this medicine, requires a dose of No. 37 and an omission of the use of the drops for two or three days ; when they may be again resumed without any apprehension of producing the same effect a second time. 18. VACANT PHIAL.—For the conveniency of dispensing medi- cine in it, instead of trusting a bottle full into the careless hands of a jailor. 19. VOLATILE LINIMENT.—A tea spoon full to be rubbed 4nat nifght, and a flannel to be kept applted next to the skin where the friction has been used. It is an excellent external remedy for the. mumps, for sore throat, rheumatic pains, kink in the neck, &c. 20. LAUDANUM.—Twenty-five or thirty drops with ten drops of No 16 on a lump of loaf sugar and two table spoons full of water, is the handsomest method in which it can be exhibited as a draught to allay pain, restrain excessive vomiting or purging, and to procure 9leep. In Spasms of the stomach and in cholera morbus, the patient may take 30 or 40 drops at first, and if in half an hour there are no pros- pects of relief, 15 drops more may be given every 15 or 20 minutes by the watch, until the object for which it was, given is attained. This practice may appear bold, but without pushing it to the necessa- ry extent ; smaller quantities would rather aggravate than relieve^ the violence of the comph.int ; and it is here thought proper to re- mark, that although, no correct bounds can, in these cases be prescribe edj it is seriously recommended not to trifle with it, and to give it in every instance of indisposition* where pain and restlessness impresses the idea of giving relief by this remedy, instead of seeking it by th& use of the lancet or of purgative medicines. In obstinate agues, that have resisted the bark, or who from their recurrence every day, leave so small an interval of time, as not to al- low the use of that medicine insufficient quantity to check it, a dose of laudanum given an hour before the~fit h: s been expected, has entire- ly suspended it and given an opportunity for l .* use of the bark to cure the disease. From two to five chops of laudauum with each dosa of hark are Kecessary if it runs off by purging. t ll -1 Laudanum always produces costiveness ; and should therefore be -nr e. .u;..:iisv; either before or after it has been taken, by somQ gentle laxative medicine. In fevers attended with full pulse, red face and eyes, dry skin and costivo.ess, it ought never to be given, as it would jeopardize the life ofa;atieni by accumulating the diseased action on some part or other, necessary to the existence of life. Lalidanum is used externally in the quantity of one tea spoon full occasionallv to one pint of lead water, or to 2 table spoons full of No 19, to relieve excessive pain from irritation of inflamed parts- One tea spoon full rubbed in at the pit of the stomach, relieves ex- cessive retching and sea-sickness ; and 40 or 60 drops with a tea cup full of water is an admirable clyster in profuse purging, and in 3 retention of Urine, that may threaten the patients life. 21. TINCTURE FOR TOOTH ACHE.— \ small bit of lint, roll'-d up in the shape and size of a pea, and held upon the point of a sewingneedle, is to be moistened with this tincture, the phial having been previously well shaken. Int his manner it is to be applied into the hollow of the tooth, where it is to be retained for some time. The spittle flows copiously in consequence of it; and the head and tongue shoiil t therefore be inclined a little towards the opposite side with a view to prevent the tincture from being washed out of the lint. In rheumatic pains of the jaw, a blister behind the ears, of the shape of a crescent, or a blister applied immediately upon the jaw it6elf, lg sometimes service ible. But lancing the gum with a sharp pointed! pen-knife is, above all the best remedy in too Ji aches, next to. that of extraction. A few drops of this tincture on a- bit of cotton or lint, frequently relieves very distressing ear achs. 2 ?.. IPECAC VOMITS.—Ave useful in all cases of foul stomach and diseases depending thereon. If given about an hour before an expect. ed fit of ague, full vomitting by rousing the system intercepts it en- tirely, or at any rate mitigates it considerably. In contagious low fevers, when given at the very commencement- it fieq iently cuts the disease short at once.* In the beginning of glandular swellings* as of the groin, swelled testicle &c. it disposes them to get smaller. Jaundice from temporary obsruction is frequently entirely cured by vomiting briskly -r in bloody fluxes in lax bowels and in sore throat, it is a valuable remedy. In difficulty of breathing; and in coughs when of long continue nee and not attended with fever, vomiting has proved highly serviceable. One third of a dose is to he taken every quarter of an hour, in 9 table spoon full of warm water> untU.it has operated five or six timeesv L " 1 This medicine as an emetic is inadmissible in cases where there exists a disposition towards spitting of blood, or of a great. Uiihess of the head, indicated by redness of the eyes and flushed face, with an apparent enlargement of the features. Persons also who are sub- ject to be cramped at stomach should be cautious ; and to vomit » sier they ought to drink plentifully of we:.'' camomil" tea. Ruptured persons ought never to venture upon vomits at all. 23. CALOMEL AND JALAP.— Is chiefly and almost universal- ly to be depended upon in ihe commencement of all fevers, whether agues, bilious,rheumatic-pleurisies, or any other that more generally oc- cur. One dose is to be mixed pretty thickly with molasses or a little su- gar and water in a table spoon, and is to be given at once ; gruel, rice water or tea being directed to be drank, after the operation has com- menced. From three to five stools are generally procured from the exhibition of one dose; and if the continuance of high fever, a dark or blackish appearance of the excrements, and a sensation of a burning heat at the fundament at the time of voiding them, indicate a pre-ternatural sharpness or superabundance of bile, the repetition of a purge of No. 39, and 37, will in the generality of cases best answer on the next day.- 24. CALOMEL PURGES.—The same observations that have been made on No. 23, will apply to this medicine, and in highly bilious fevers, where the stomach does not retain No. 23, it will be re- quired to repeat one of these doses every eight hours, until an effect is produced on the bowels. In some instances of indisposition, where a purge may be deemed necessary, a dose of either No. 23 or of this me- dicine has no effect at all, or a very trifling one on the bowels; and to prevent the inconvenience of a sore mouth which sometimes follows, a dose of No. 37 should be taken to work it off. It is on this account, in part, that Calomel with Jalap or with Rheubarb, should be given in preference to Calomel simply, in common cases, with the excep- rions mentioned above in malignant fever; and in which the occur- rence of a sore mouth ought frequently to be esteemed the lesser of two impending evils. Two thirds of a dose of this medicine, added to a dose of No. 25, is equal in strength and effect to a dose of No. .23, and in many in- stances is preferable, as it neither nauseates so much or leaves that de- gree of weakness of the stomach when done operating, that No. 23 does ; but it has this disadvantage, that it operates not quite so quicklv. L '* J 25. RHEUBARB.—Is by itself, or when combined with half a dose or a full dose of No. 24, an eligible purge in lax-bowels and in dys- sentery. In weakly persons with delicate digestive powers, a dose of Rheu- barb mixed with half a teaspoon full of No. 6, is a gentle laxative. 26. FEVER POWDERS.—In the second stage of bilious or re- mitting fevers, when great quickness of pulse without fullness or hardness, and a sufficient use of the lancet, of purgative medicines, or of emetics, forbids their further employment; and when the pa/ tient gets worse, and there is no indication to a common observer for any particular remedy, he may with safety have recourse to these powders, to quiet the height of the fever. The worst effect that they can produce, is, to give a sore mouth to the patient, and from which with attention he has a chance to recover ; whereas the continuance of the fever might have distroyed him. Hot and dry skin, dry tongue to the feeling of the finger, and of a yellowish appearance, a dispo- sition towards drowsiness and delirium, are generally at this time, the most prominent symptoms. One of the powders is to be given every two or three hours, in a little molasses—and if the stomach will not bear them at this rate, they may be given every four hours ; and a plentiful use of thin drinks directed. In constant sickness at the stomach, and a spontaneous vomiting, these powders are not suitable, as they would increase it. 27. SUDORIFIC POWDERS.—-One dose is to be mixed with a little water in a table-spoon, and is to be give n over night, to procure a good nights rest, to sweat or to restrain immoderate purging in fluxes. These powders are a valuable remedy before a fever has had a fair chance of being formed—as in fevers that arise from infection, and in quite recent colds from an exposure to bad weather. They are secondly useful—when the fever has been subdued by bleedingj purging and other means, and when patients, under these circum- stances, are exhausted from a want of rest. They can thirdly be em- ployed with safety, when the disease is not accompanied by high fever, as in habitual rheumatism, and in laxity of the bowels. In the presence of high fever, a costive belly, a disposition to deli- rium or pain in the chest, they ought never to be given, from an ap-. prehension of aggravating the disease. 28. INJECTION POWDERS.—One of them is to be bruised into a uniform powder with the blade of a knife ; and to be put into a vial, into wliich by degrees, and after repeated shakings, half a pint of cold water may be poured. The injection thus prepared ought to be well shaken each time of being used ; and may be thrown up five or L 14 J Six times daily. An injection ought not to be strong enough to produce smarting ; and if this effect is perceived, particularly in the first few days of a clap, it should be weakened with water. 29. STICKING PLASTER.—Is to bespread of a thickness, nearly equal to that of the back of a knife on strong old linen or on thin sheepskin. This when cut into strips of an inch wide and four or five inches long is to be applied in such a manner, as to draw the edges of the wound as nearly into contact as possible. The number of strips thus required must be determined by the length of the wound. It is also usefully employed in superficial and indolent ulcerations of the leg, to which Sailors are often habitually subject, 30. SUPPURATIVE OINTMENT—Is to be spread on lint as an application to old and indolent sores, to opened buboes, boils and all such cases of abscess and old wounds or ulcers as cannot be filled up but by the means of healthy matter. 31. CERATE.—Is to be spread thinly on linen or lint to sores, that have filled up so far, as to admit of being dried up and skinned over. With the same view it may be made subservient to the dressing of burns or scalds, when the redness about them and great pain have abated, and of blisters when it is intended to heal them. 32. BLISTERING OINTMENT—Is to be spread pretty thickly on leatlier or on cartridge paper as a sort of paste to retain a quantity of No- 13, for the purpose of blistering. 33. MERCURIAL OINTMENT.—The size of a nutmeg may be tubbed on the inside of the thighs every other night, if it is intended to produce salivation, as for example in chancre and buboe. For the management of salivation see No. 36. In malignant or yellow fever, where this effect ought to take place in a much shorter space of time four or six times that quantity may be rubbed in at once and repeated twice every day on the inside of the thighs and legs, the top of the feet, the belly and sides, and on the innerside of the upper arms ; and if blisters in this disease have been apphed, they may be dressed with it. In sluggish sores of the leg of long standing without any appearance of alteration in them for either the better or the worse, this ointment, when used, as a dressing, is frequently curative. In the itch, tetter or ringworm and many other eruptions on the skin, it is frequently employed to advantage ; and vermin of all kinds are quickly destroyed by it. 34. ANT1BILIOUS PILLS.—A judicious composition of Dr. Perry, dec'd. a physician of great celebrity in his time at Norfolk. He recommended them in all incipient indispositions, that foreboded dis- ease from an accumulation of bile ; and manifested by sluggishness' I »5 J dull appetite, slight saueamishness, pain of the eye-balls, dull heaU ache, costiveness and sometimes slight fever. He gave three or four over night; and if by the ensuing morning they had not operated enough he directed two more. The benefit produced by them in this way has established their fame in Virginia ,- and it is conceived d>_ ■ servedly. In a higher grade of disease, or bilious fever when formed" they would as a matter of course be. superceded by more active remedies. 35. ufENING PILLS.—To remove costiveness, and its conse* quences, as giddiness and head-ache, want of appetite, disposition to cholic, flatulency &c. From three to five taken over night are a dose. Persons subject to piles had better however taken No. 1 or some other purgative dose. , 36. MERCURIAL PILLS.—One pill every night and morning unless they should gripe or operate on the bowels instead of affecting the mouth, when they may be taken only one a day. They are chiefly used in this way for the cure of the venereal disease; but will in some instances be found to answer exceedingly well in the quantity of one or two a day in the cure of an old dysentery, or of jaundice, in various eruptions of the skin, habitual rheumatism and many other complaints that are not relieved by the remedies common- ly employed for them. Where these pills absolutely disagree with the bowels, recourse must be had to No. 33 and the use of either of them must be regulated by the effect they produce : as soon for instance, as the patient when venereal becomes sensible of a coppery taste, or tenderness of the gums, the use of either of the pills or the ointment should be omitted for one or two days ; and if the soreness by that time has not increased, they may again be resumed, but in so cautious a manner, that the patient shall not be seized with a violent salivation at once. They are to be steadily persevered in, often and long enough to keep up the soreness of th? mouth for at least rbur weeks During this time patients ought to keep themselves strictly confined and warmly clad ; and their diet should consist chiefly of slops, milk, or vegetables ; whereas, when recovering from the salivation, they may by degrees venture on a more generous diet, and some cordial drink. 37. PURGING SALTS.—Two small tablespoons-ful, dissolved in half a pint or a pint of boiling water are when cooled a dose ; and may be drank at once, or better at two or three times at the distance of two «r three hours from each other. In internal bruises from falls, in spitting of blood, in dysenteries wit* I 16 J violent strainings and in many complaints of minor consideration it is a valuable medicine. Salts when exhibited by itself is a cooling purge and to improve this effect, a small tablespoon-ful of No. 6 is often added. 38. FLAXSEED.—Two tablespoons-ful make ;ibout three pints of tea. It is the in idest drink in clips and in every instance of scalding °f urine. 7~ /iolent coughs likewise, and in lax bowels it is useful. When biu -j»d and mixed with double its quantity of biscuit or crumb ofbrc-fj. . forms the best ingredient for a softening poultice, 39. SENNA LEAVES.—As many as can be held between the four fingers and thumb of one hand with one tablespoon-ful of No. 37may be put into half a pint of boiling water, and allowed to stand near the fire for half an hour. They are then to be strained, and of the clear liquot when cold, one half is to be taken immediately and the other half in two hours. This preparation known by the name of Bilepurge is one of the most easy and next to Calomel the most effectual purge to discharge bile from the bowels. 40. CHAMOMILE FLOWERS.—-As many as can be pinched up between the thumb and four fingers of one hand are to be drawn like tea in a quart of boiling water. It is drui k freely after vomits where cramp in the stomach is expected to take place from that operation. It is also an appropriate ve- hicle to take bark in, in ague ; and in lax bowels, it relieves flatulency. 41. ALUMN.—The size of a nutmeg reduced into powder and put into one pint of sage tea or into three gills of hot water and one gill of vinegar with a little molasses is a useful cleansing gargle in a sore throat; and in what is called falling down of the palate. The size of a pea of alumn finely powdered and dissolved in one gill of clear water makes a cooling application to sore eyes after the first inflamation has somewhat subsided. Alumn is likewise employed for precipitating the impurities of mud- dy water. 42- GUM ARABIC.—Has the same properties with No. 38 ; and is more agreeable to the taste. The most pleasant way of using it is to take a piece into the mouth and to suck it down by degrees ; or one tablespoon-ful may be dissolved in a quart or three pints of water for common drink. A piece of gum arabic equal in size to a nutmeg, when coarsely bruised and put into a vial of injection improves its soothing quality by sheathing the urinary passage. 43. LANCET.—In order to use this valuable instrument with an additional degree of confidence and of safety, the following directions should always be attended to. L 17 ] The first object in bleeding is to swell the vein by tying a fillet or bandage at about three or four fingers breadth above the bend of the right elbow. When this has been accomplished, and the pulse can be felt at the wrist, it is of a sufficient degree of tightness ;.. whereas it ought to be tightened if the veins do not swell ; and it ought to be slackened, if the pulse at the wrist cannot be felt. The arm of the patient is next to be extended in a streight direc- tion, when the bleeder is to grasp the arm firmly with his left hand an inch or more below the place, he intends to introduce the lancet at; and pressing with his thumb firmly upon the vein, so as to steady it, he, with the blade of the lancet at an acute angle with the handle and held steady between his right thumb and fore finger, cuts into the vein—taking care not to dip the point directly downwards, but to introduce it obliquely upwards, and raise the point, so as to bring it through the skin. The point of the lancet, if thus managed, need not at an average be buried deeper than one eight of an inch below the skin. On withdrawing the lancet and his left hand, he is to support and steady the arm, until a sufficiency of blood (from three gils to one pint at an average) shall be drawn. He then unties the fillet, places a four doubled linen rag or lint up- on the orifice, in such a manner, by stroking it from the inside of the arm outwards, as to bring the two lips of the little wound into close contact; and keeping it gently pressed upon the orifice with the thumb of his left hand, he passes the bandage. The most prominent vein will generally insure the best success \ and in proportion, as it lies more towards the outerside of the arm, in that proportion it will be more safe, since it lies most remote from the artery. But the situation of this artery may be readily ascertained by pressing the fore finger of either hand immediately upon or along side of the vein, that is intended to be opened; and if a beating or pulse can be felt very near, or immediately underneath the vein, it will be better to choose another vein, though less large ; and this trial, it is understood must be made before any pressure is applied bv the fillet above the elbow. If fuintness should be expected, or actually takes place from bleed- ing, the person ought to be laid flat upon the back with his head low, which will soon restore him. There is no difficulty in stopping the blood, when the fillet has been removed ; and if it should break out bleeding anew sometime after, it is most probably owing to too much pressure ofthe bandage, which must be applied rather looser the second time; but if this will not. succeed, a small cushion of lint placed upon the wound and pressed L 18 \ tvjth the fingei for sometime without the application of the bandage will in most instances stop it. An accident which frequently takes place in bleeding, is an immedi- ate swelling around the orifice from the size of a hazelnut to the size of a pidgeons egg. It arises from a free discharge of blood from the vein which can not find its way out through the external orifice ; and the blood therefore insinuates itself underneath the skin. It is owing either to a change of relative position between the two orifices fiom twisting the arm or from a rolling of the vein : or it is owing to a larger wound in the vein than has been made in the skin. In the first case bending the arm a little, or bringing it nearly into the same position m which it was when the lancet entered the vein favors the free dis- charge by the external wound. In the second case the further increase of the tumour is obviated by dexterously enlarging the orifice in the skin ; but if from want of resolution or confidence, neither has been done immediately; or it is found when done, that it augments so rapidly as to excite apprehension, the fillet should immediately be re- moved from above the elbow, and the arm tied up as befre directed. If bleeding is deemed indispensably necessary, it should be per- formed in he left arm, though less convenient ; or if not very urgent it may be postponed for eight or twelve hours, and be repeated in the right arm upon any vein, not surrounded with the swelling. The application of a compress fequently wetted with lead water over the tumor or a fomentation of a little vinegar and water does soon dis- perse it without any ill consequenses arising from it. In internal bruises from severe hurts, in fovers, where head-ache general pain, full and flushed countenance, red and inflamed eyes, full and strong pulse with oppression about the breast, difficult brea- thing and much thirst indicate inflamatory action, the lancet ought to be unsheathed without delay as the surest weapon to defeat the vio- lence of the disease at the onset. Repeated bleedings are often ne- cessary in dry coughs, attended with fever and with stitches on fetching a deep breath, In convulsive fits, bleeding to a large quantity is often required, before the force of the spasms can be subdued ; and in rheumatism, inflamed eyes, gun-shot wounds &c. it is frequently of the greatest service to put down, or to preve it a high degree of inflamation. Persons, who have resided several years in an unhealthy country and have been reduced by the diseases, incident to an unhealthy cli- mate, fat people, and such persons as have passed the fortieth year of age, do not Lear bleeding so well, as those of an opposite des- cription. I »» 3 44. TOURNlGyp^T.— Is to be applied by tying the webbing around the limb ; and by sere wing it with the stick above the leather until the bleeding stops. The application is to be made "above the wounded artery;—if in the lower arm, at the middle of the upper arm ;—if in the leg, at the middle or a little below the middle of the thigh. If wounded higher in the thigh, pressure must be made with the bowl of a key wrapped roud with a handkerchief at the midule of the groin ;—and if at or above the middle of the upper arm, the tourniquet must be applied as high as the armpit, since no person by description alone, can be in- structed which course the artery runs ; and how it ought to be com- pressed. The assistance of this instrument is calculated only for the imme- diate preservation of the patient, and cannot be kept applied very long, under the idea of stopping the bleeding with it permanently ; since the leg or arm would mortify from the pressure. Nothing less therefore but chirurgical assistance should be depended upon. In wounded arteries of the head, permanent and tight pressure with a bolster of lint and a bandage is sufficient to stop the bleeding; and the lint may be soaked off in six or seven dr.} s with cold water. 45, PEWTER SYRINGE.—Persons who use it, ought to hold it, when filled with injection between the thumb and middle finger of the right hand, and push the piston down with the fore-finger The other,hand should be employed in making a firm pressure with the thumb and fore-finger at the root of the penis so as to prevent the injection from going higher up than three or four inches . 46. INJECTION PIPE AND BAG.—Two tablespoons-full of No. 1 and of No. 37 with three gills of warm water are, when dis- solved to be put into theb^g and the upper part of it tied up. The end of the cork string is to be left out; and when the pipe previously o-reased has been introduced its whole length into the fundament, and is steadied there, this cork string is to be pulled at; and when the cork has been disengaged, firm pressure is made upon the bag with the right hand whilst with the left, the pipe is steadied -nd supported in the fundament The person who receives the injection ought not at the time hold his breath or bear down, whi-h would prevent the injection from passing freely into the intestine. They are highly recommendable in violent colics, and in pains and uneasiness that arise from costiveness in persons too much weakened to be freely purged. The failure of the effect calls for a repetition of the injection as often until stools are procured. Thinly boiled starch, or linseed tea, with No. 20 is the most eftectwal and preferable method of giving ease and of restraining immoderate L ™ ] phi-^ng in persona who are affected with looseness, and who are not ab!e to bear these evacuations from weakness ; but in the first stage of bloody fluxes, the addition of No. 20 ought to be omitted in the in. jection. 47- SPONGE.—In washing a wound or ulcer, milk warm water is employed, and the sound skin round about it should at each dressing iie cleaned, by stroking the moistened sponge in every direction to- wards the sore, so as not to tear it ; and the sore or wound is to be rinsed clean by pressing a filled sponge at some distance above it. 48. LINT.—The softness of its pressure and the readiness with which it absorbs the matter from wounds and ulcers, renders it- the :itte:itcovering to dress them with. In immoderate or excessive bleeding also, from external injury, it forms, from the close manner in which it lies to the wound, and the blood which coagulates in it, a very good plug to stop the bleeding. 49. SHEEP-SKIN.—Designed for blistering and sticking plaster, which are spread on the rough side of it. 50. BANDAGES—Are used in the common operation of bleeding at the arm, and they are employed for the retention of dressings to wounds and ulcers. Poultices and dressings at the groin are best se- cured by passing one handkerchief circularly around the body above the hips, and .mother between the thighs, the ends of which are to be fastened to the first. A handkerchief also, made triangular by doubling it, forms a tole- rable good bandage for the head, when tied on in the manner of a night-cap ; but if great pressure at a particular part of the head should be desirable, a handkerchief when folded like a cravat, is to be applied with one turn, and tied with a single knot nearly opposite to the part wounded ; and the ends are to be reversed upon the first turn, and tied tightly with a double knot, or a slip knot opposite to the first and single knot. " A handkerchief like v. ise, folded in the manner just mentioned, is frequently used to support the testicles, which are to be suspended at the middle of the bandage, or equi-distant from either end ; and the ends themselves are to be passed above the hips around the body^ and tied behind. APOPLEXY. TREATMENT—Immediate and large blood-lettmg, (see No. 43.) purging freely with No 23. A cool birth, with head Sc shoulders pretty well elevated. An early repetition of bleeding or purging, if not recovering, if disposed to relapse, or if the pulse continues full and hard, and there remains palsy of some part of the body. Blisters next C L 2l *J into the neck ; friction of the palsied parts with No. 19, and a conti, nuation of purgatives are to be depended upon. Low and vegetable diet. BLOOD, SPITTING OF.—If the quantity lost has not reduced too much thc pulse and strength of the patient, bleed, (see No. 43.) and give of No. 6 and No. 37, or of No. 37 with an addition of No. 15. If the pulse is weakened and a return of it is apprehended, a table spoonful of com. mon salt, taken into the mouth drv, and swallowed, is to be" immedi- ately directed. The person is also to be kept cool, on low diet, and at rest. BOILS. TREATMENT.—Give No. 23, apply warm poultices, and when ripe and opened, dress them with No. 30, and afterwards with No. 31. BRUISES AND SPRAINS OF JOINTS. TREATMENT-—Keep the joint perfectly at rest until recovered ; apply to it lead water, (see No. 12.) When pain, swelling or redness lessen, No. 7 may be added to it; and when on the recovery No. 7 by itself, and plentiful rubbing. For internal bruises see hurts and falls. CHOLERA MORBUS. CHARACTER.—Sudden and violent vomiting and purging of bilious matter with cramp, at first in the stomach and bowels, and after wards extending to the calfs of the legs, great anxiety about the sto. mach and loss of strength. TREA TMENT 1st. Immediate large draughts of weak camomile tea, (see No. 49.) of warm water, with well browned toasted brea^ soaked in it, weak warm chicken water, or water thickened a little with No. 42, or with starch or sago, are to be directed ; and if the pulse is very full in the beginning and the pain excruciating, bleeding and a dose of No. 24. 2ndly. When by these means a great quantity of bilious fluid has been discharged, and the vomiting continues, it is to be stopped by giving of No. 20 in a little warm grog, or in some hot and strong coffee by rubbing in at the stomach No. 19 combined with No. 20, by bathing the legs and feet in warm water, and by applying warm bricks or warm flannels, sprinkled with No. 7, to the stomach. The occurrence of cold sweats, and of cold feet and hands, wilfc great weakness and a shrinking of the countenance, demands the greatest resolution and perseverance in adopting and pushing the se. eond method of treatment at once, without encouraging any further vomiting by thin slops.—Refer to No. 23. I 22 j To prevent the disorder from turning into inflammation of the bower* or bilious fever, the patient when recovering from the violence of the symptoms, is to be purged with half doses of No. 24, given every 6 or 8 hours ; and in a few days afterwards, when the stomach and his strength will bear it, with No. 39 and No. 37. The occurrence of fever, with a quick and hard, though at the same time a small pulse, with a burning sensation at the stomach, requires the use of the lancet in addition to the above remedies. COLIC. TREA TMENT.—If accompanied with a rumbling noise and occa- sional belching, it is frequently relieved by No. 16 alone, or in conjunc- tion with No. 20. If the pain is moderate, and costiveness has prece- ded it, one, two, or three injections, (see No. 46.) given one immedi- ately after the other, and a dose of No. 1, are sufficient to remove it. But if the severity of the pain cannot be endured till the purging effect by these remedies is produced, a large dose of No. 20,. and repeated in less quantity if necessary, must be had recourse to. And if the Colic arises from viscid bile, which it frequently does in warm climates, p. table spoonful of No. 1, with a dose of No. 24, is the best calculated to remove it; and may be given an hour before or an hour after a suffi- cient quantity of No. 20 has been exhibited. If it should fail to purge offthe bile in i2 or eighteen hours from the time it has been given No. 37 alone, or along with No. 39, should be administered ; and injec- tions (No. 46) should be persevered in. External warmth also, applied to the belly, is of great service. CONVULSIONS. TREATMENT.—Bloodletting in sufficient quantity (.see No. 43) to overcome the spasms at the time, and afterwards No. 23 ; followed up, if necessary, in a day or two by a repetition of the same or of No. 37 ; and sarnetimes, if head ache and giddiness indicate it, a blistet (see No. 13 and 32) into the nape of the neck. COUGH AND COLD. TREATMENT.— According to the degree of illness bleed, and purge with No. 23 or No. 39 and 37 ; and take at night, if still fever- ish, sixty drops of No. 8 in a bowl-of gruel, sage, balm or elder flower ,tea. If only slightly affected, take one of the above purges without being bled, and a dose of No. 14 and of No. 8 at night; and if slighter still, the night draught alone with plentiful of warm, slops and bathing the feet in warm water will relieve the indisposition. DEBILITY OR WEAKNESS. If the effect of a previous spell of sickness, the pantry and a mode- rate use of generous wine, good ardent spirit or malt liquor, are the L ^ 3 a;ost suitable remedies : If arising from weakness of stomach, to crave and to digest the food No. 3 and No. 15 are excellent remedies : if from general and tedious indisposition, accompanied with costiveness, purgine with No. 2o and half a dose of No. 24 or with No. 6 : If it is -a. symptom in the commencement of a pleurisy or a bilious fever, such remedies as are directed for their management without any apprehen* sion of the existing weakness, which in these cases is always I'-wnini by bleeding and purging. DIARRHOEA OR LOOSENESS. CHARACTER.—Frequent and loose stools, without much sickness pain or fever. TREATMENT—If want of appetite attend it, or indigestible food o;- bileds the cause, vomit with No. 22 ; and if the looseness coninues along with a soar taste in the mouth, direct a dose of No. 25, with a teaspoon-ful of No, 2. Should the stools appear of a greenish brown or light clay colour, it will be best to encourage them by mixing No. 24 and 25 very intimately, and to give a third or a fourth part of the whole twice or three times a day. But if the person has for a long time been affected with the disease, half it dose of No. 22, one dose of Mo. 25, and two teaspoonsful of No. 2 are to be mixed together, and ti e whole of it divided into six parts, one of which may be taken every tliree hours in the day. And after, several days continuance of this medicine, it may be set aside, and a dose of No. 27 directed to be ta. ken over night. But if the great weakness of the patient and the two groat frequency of stools, should render any of the above purgative medicines improper, dependance is to be had on starch injections (see No. 46 and J»o. 20) and on the exhibition of one third or one half of -d dose of No. 27 two or three times a day, and a full dose of the same, if requisite, at night. Vegetables and sour fruit should be avoided as hurtful ; and boiled milk, thickened with 1:our, starch, oi arrow-root, is the best diet. Where mi'k cannot be obtained, rice, sago or tapioe;-. are requisite, arj No. 38 or No. 42 answer exceedingly well for common drink. If in consequence of stepping a looseness too quickly, fever, loss of r.ppe. tite or pain should come on, the bowels aught immedintely to be Aliened by the ;':;>.': cltss of medicines, above recommended. DROWNING. In person?, recently dvov.r.ed every attempt to discharge water from the stomach by tilting them on the head, rolling them on a cask Sec- ought to be set asidfe as'un injurious practice, and the following direr. tions should be Strictly attended to. 1st. In removing ih«- ncrsonfrom the waterside, the body sugbt " I 24, "1 be kept extended and lying on the back, whh the Iflead and shoulders i little elevated. 2d. All wet cloths are to be stripped or cut off as soon as possible, and the person wiped dry. 3d. If the sun shines out, the body should be exposed to its rays ; and if it does not afford sufficient warmth the person is to be carried near a fire and wrapped up in warm blankets, which are frequently to be renewed. A warm bath of 100°. Fahrenheit, or burying the body in a dunghill, has sometimes been successful in diffusing gtr.:r?.\ warmth over the surface. 4th. A few tablespoonsful of ardent spirit are to be poured into the back part of the mouth ; and by elevating a little the head and shoul- ders, and by an artificial imitation of swallowing in raising the tongue towards the roof of the mouth, the fluid does in part find its way into the stomach. Injections, by the fundament, likewise of warm grog, are to be recommended. 5th. From a want of knowledge how to draw blood to greater i..d vantage from one of the jugular veins, a gill and a half of blood is to be" taken from the arm. 6th. Whilst the previous arrangements are prepared and practised.) a handkerchief is to be wrapped around the beak of a pair cf bellow; or of a hollow tube of any sort, and fitted into the mouth to throw ajr into the lungs ; and this being an object of the first importance in the recovery of drowned persons, it aught to claim the earliest attention Whilst the bellows are compressed or a person is blowing with his mouth into the tube, the fore-finger of another person is to press upon the bony protuberance of the throat, (known by the name of the core or Adams apple) to prevent the air from going into the belly, which- would prevent the resuscitation of the person r.aher than promote it ,- aiid the nostrils ire in like maimer to be closed to prevent the escape o- iur by them. When a portion of air (say a pint in bulk) has by this process found its way into the lungs, the chest and belly iire to be com- pressed with expanded hands to force the air out; and the inflation is next again renewed : so that by alternately blowing air into the lungs and by forcing it out, the natural process of breathing is as close- ly imitated as possible- Some physicians conceive that the insertion of the tube by one of the nostrils is more direct and better calculated than to introduce it bv the mouth ; and in this case the other nostril and the mouth are to be kept closed, and the apple of the throat com- pressed as above directed. : 7th. During all this time confusion is to be avoided, and no more pevro"'- :.Vjuld be admitted tVy; are absolutely necessary and useful. I 2* J and some of these should be employed in rubbing the person wil^ their warm hands or with flannel underneath the blankets, so as not to expose the body to the cold ; and the blankets, as before remarked, are to be often exchanged for warm ones. Warm bricks may also be applied to the feet, hands, and armpits, or hot salt in bags. 8thly. These attempts should be persevered in, for at least two hours ; and if a sort of sighing becomes percegtible, Jiopes may be. entertained of an entire recovery. DYSENTERY, OR FLUX. CHARACTER.—Violent griping, frequent inclination to go to stool without being able to effect a discharge, accompanied with straining. The stools are small in quantity, frequent, slimy, and mixed with blood, with little or none of the common excrement along with them, and consisting chiefly of small hard lumps. At the first onset of the disease, fever generally attends it; when of several months duration, there is commonly no fever ; but it makes again its appearance when the patient is getting low in consequence of its long continuance. TREATMENT—Whenever the pulse is full and hard, and the skin feverish, immediate bleeding is sure to give relief; if the sto- mach is affected with sickness and want of appetite, give No. 22 on the same day : if it operates only upwards, give on the following day a dose of No. 25 with half a dose or a full dose of No. 24. But if No. 22 has operated freely downwards also, postpone No. 24 and 25 till the next day but one. If the griping and straining still continue violent, purge with No. 37; and depend afterwards chiefly on a sixth part of a close of No. 22 given every three or four hours in the day; and at night No. 27 may be exiiibited to ease pain and to procure rest Sometimes the distress of this disease does not admit of the means in the above order ; and to quiet the excessive griping and straining, a double dose of No. 27 with one dose of No. 24 is to be given over night at first; and this may be worked off on the following morning with No. 27- The r.fier-treatment consists entirely in keeping the bowels open with the above remedies, and in quieting much griping with No. 27. Yet it must be understood, that although No. 27 gives immediate and apparent relief, an entire dependence upon it would confirm the disense ; because it is a chief object to dislodge a vasj quantity of excrement and hard lumps, that are locked up in the in- testines, when nothing1 but slime and blood can be voided ; and when the patient haying for some time abstained from all solid food, impose a belief that no solid excrement can be retained. Straining and frc. quert inclinations to go to s'cc! arc therefore always relieved in pro- L -& 1 . lion to the quantity of hard lumps that are discharged by purging .cely. In dysenteries of long standing, after the exhibitition of No. 2? uver night, and a free evacuation by No. 37, or by No. 24 and 25, cr by No. 1 and No. 24, on the following day a pill of No. 36 may be directed twice or thrice a day, until a slight tenderness of the gums gives evidence of a constitutional effect having been produced by 'hem ; and they should then be given in less number, but be continued with for some time. In unctions of No. 33, in old standing cases, aid this intention ; and they are always preferable to the pills, when they produce too much griping. The great pain and restlessness in these cases, and the too frequently habitual use of opium renders No. 27, in conjunction with the above remedies, an indispensible me. dicine. A tea made of No. 40 is also an excellent remedy to abate that swelling up of the belly from wind which is apt to occur, parti- cularly at night. Clothes wrung out of hot water, and applied to the belly, give great relief. Injections of starch, or of No. 38 with No. 20, are a most admirable remedy, [see No. 46] and they supersede in a great measure the necessity of No. 27. But the most judicious treatment in this dreadful complaint often fails ; and would not avail at any time, if a patient were not to be put on the strictest diet. All solids, without exception, and meat in par- ticular, must be abstained from; rice-water, barley-water, and the like, are the only allowable articles of diet for some time from the commencement of the disease. When there is no feverish disposition* and the patient from weakness requires a more strengthening d*iet> he may be indulged with weak chicken water or mutton broth well skimmed. In the further advance of the disease, milk, thickened With starch or flour, is often the best diet; and where the disease has baffled every effort of cure, and continues from habit with an inordi. nate and craving appetite for solid food, salt herring boiled, or the smallest quantity of finely minced bacon ham, has agreed better with patients, than even medicines themselves. ERUPTIONS OF THE SKIN. ITCH.—Give" a dose of No. 23. Refer for the necessary ointment to No. 5, which is to be rubbed in every night and washed offevery morning with strong soapsuds. RASHES.—Refer to No. 6, and No. 37, and use frequent ablutions if cold water. ST. ANTHONY'S FIRE is usually ushered in by slight chills and a little fever, and the part affected; but more particularly some part of the face or head becomes red in irregular blotches, extending in size, or leaving one part for another, attended with smarting and a burning heat; and sometimes drowsiness and difficulty ot breaUhn0. it tor'. minates most fa- out-ubly, when the skin peals off like bran, and leso so when it blisters ; and sometimes it terminates in mortification. If pulse is hard and full, bleed ; but take not more than half a pin1 at first, or at most 3 gills—purge freely with No. 37 and No. 6 com- bined; and If general heat of skin demands cooling medicines after- wards, give No. 6 as a common drink, and add to it one teaspoon ful °f No. 8. The inflamed part is to be kept cool and wet with cold water ; and the patient is not to expose himself with it to the sun.— When the redness grows of a dark and livid colour, instead of getting paler, and when the pulse gets small and quick, the tongue yellowish, and the heat of the part increases, mortification is to be apprehended ; and in this case give No. 3, and apply warm poultices. TETTER.—Anoint them with No. 33, or touch them with No. 11 repeatedly, until an increase of inflammation requires the omission of 'his practice. , EYES INFLAMED. If necessary, bleed, and give No. 23 ; apply a soft poultice of bread a.il milk over night between soft linen, and blister behind the ears , and after the violence of the disease is abated, use eye-water of No. 4l, or dissolve a powder of No. 28 in a bottle full of clear water ; and keep the eye:; wet with it by means of four doubled linen rags, lai^ over them* A slight degree of inflammation may be cured by eye- water only. . FEVER, INFLAMMATORY. CHARACTER.—Slight chills, followed by violent and con. tinued heat, flushed countenance, red eyes, frequenl, strong, and full pulse, acute pain of the head and back, white, rough, and dry tongue, thirst, high coloured mine, disturbed sleep,.&c.—It is called Pleurisy when preceded, accompanied, or succeeded with a sudden attack of pain of some part of the chest, with difficulty of breathing and with cough, at first short and dry, and afterwards with a dis- charge of flegm, sometimes streaked with blood.——Intense pain and a sense of fulness of the head, impatience of bearing light and noise, continued watchfulness, and fierce delirium, constitute Inflammation of the brain.—With redness and swelling of the throat, and difficulty of swallowing, it is Quinsy —And the symptoms of inflammatory fe. ver denote Inflammation of the liver, when attended with violent and tensive or dull and heavy pain about the short ribs on the right side, increased on pressing it with the hand, or taking in a long breath, or on laying on the left -ide, pain of the rigid shoulder, oppression anj* streightness about the pit of the stomach, and occasionally dry coug atid a sallow countenance. L 28 ] TREATMENT. Blood-letting of a pint or more gives uniformly fcelief :*t tue onset of the disease ; and is to be repeated as often &s the continuation or increase of symptoms demands. ;?nd the strength of the pulse will bear. Purgatives of No. 23 should at the same time be commenced with ; and their effect, if not sufficient, increased by the cuccessivc employment of No. 37 with No. 39, or of No. 37 with No. 6 When by the unintimidated perseverence of these means the vioh ce of the fever has been broken, the local symptoms are to be relieved by a blister o the painful part of the chest, throat, or side» or into th.e nape of the neck, according to the part particularly affect- ed No. 8 now also taken every two or three hours, the saline mix- ture, (see No. 10) or No. 26 are must usefully employed to keep down the fever, by sweating the patient with the assistance of a plen. tiful allowance of barley or tamarind water, r.f No. 38, of lemonade, Or of cold water simply. In the commencement occasionally of in- flammatory fever under any of the above heads, the pulse is small in proportion to the intensity of the pain or the violence of the other symptom* ; and it is in these cases observable, that the force of the pulse does increase, soon after the vein has been opened ; and this is a very good criterion to judge by, that the disease requires blood-let- ting in particular for its cure. Faintness also occurring when but little blood has been ut the pit of the stomach. His sweats are partial and of a fain* L ° i smell; he is watchful, and sometimes delirious. In a few days the pulse becomes weaker, and|the heat of skin lessens; hislips, tongue, and teeth are encrusted with black and sooty matter, the retching is al- most constant, and a coffee coloured fluid is brought up : hiccup, also, yellowness of skin, stupor, or violent delirium, attend the last stage. Yellov} fever may be considered a higher grade of the above bilious fever, common to tropical climates; and it is more violent in its at- tack, and comes sooner to a termination. TREATMENT.—A full and hard pulse in the commencement of ^he fever imperiously demands the interposition of the lancet, and re- peated purgatives, [see No. 23, No. 24, &c] are to be given without delay. A bucket full, also, of cold Water poured over the patient, when the skin is excessively hot, parched, and dry, is an admirable remedy, and need not be feared as a dangerous practice. The patient is immediately after to be wiped dry and put to bed; and the same affusion is to be repeated as often as excessive heat and dry skin does indicate the propriety of it. The mixture of No. 10 also may be ad- vantageously employed ; and, if the state of the stomach admits of it, No. 26. But if the patient appears to get worse, endeavour to relieve delirium with a blister into the nape of the neck, vomiting, with a blister to the stomach, &c.; and dress these and anoint with No. 33 very extensively. No. 20 proves occasionally a necessary medicine to abate the affection of the stomach; but the management of it in this fever, and the failure in many instances, renders it a doubtful remed for indiscriminate use. Blood-letting in many cases, therefore, in the first instance, repeat- ed purgatives, cold water, mercury, and blisters, are the most valua- ble remedies to be put in practice. FOUL STOMACH, Indicated by sickness, headache, bad taste, and want of appetite ; relieved by No 23, or by No. 24 and 25 combined; or more directly by No. 22. GRAVEL. Every uneasy sensation or difficulty in voiding urine is erroneously believed to arise from the above cause ; but since soothing medicines can only be used in all such cases where no medical aid can be obtain- ed, it is recommended to attend to the directions given in the last pa- ragraph of No. 13 ; and when these fail, to dissolve one small tea. spoonful of No. iO in one pint of water, and to take half a gill or a gill three times a day. HEAD-ACHE. If from foul stomach, puke; if from too great a fulness of blood bleed ; if from costiveness, purge; if nervous, take No. 22, and af" terwards No. 20- If recurring every day or on every other day at about the same time, treat it like intermittent fever. £See No. 3.] L 9l J HEAD, INJURIES 6> dlLARACTER.—Severe falls or blows on the head produce either instantly or some days after the accident, sickness or vomiting, priva-^ tion of sense and voluntary motion, besides a train of other symp- toms, less perceptible to common observers. TREATMENT—Bleed largely and repeatedly, purge with No. 23, give purgative injections, and keep the patient on a low diet. HURTS OR FALLS. Bleed, [see No* 43] give No. 6 and 37 as a purge, use lcad-watej? externally, if any outward part is bruised; or rub in No. 7. JAUNDICE. CHARACTER.—Yellowness of the skin, commencing in the eye* and roots of the nails, deeply coloured urine, bowels costivf or loose, Stools pale or clay coloured, languor > drowsiness, and impaired ap- petite. TREATMENT—Refer to No. 22, 23, 24, and 25 ; to No. 34, 35,. and 36. INDIGESTION. TREATMENT—If costive, No. 25 and 24 ; if bowels lax, No- 22 and afterwards No. 25. If belching attends it, No. 2, or No, 2 & No. 25 combined, or No. 15.—The aforesaid medicines having an- swered their intention, strengthen the stomach with No. 4 alone, or combined with No. 15. Diet should be light and nutritious, vegetables and malt liquor should be used in less quantities than animal food ; and moderate ex- ercise is in particular to be attended to. MORTIFICATION. CHARACTER.—A tumid and blushing appearance of the skin, ending in blisters, filled with water or a turbid fluid; and the parts underneath it loosing their sense of feeling, becoming dark and black, and being at last thrown off. It occurs in wounds, bruises, and ulcers , and is in the majority of instances preceded by a high degree of inflammation. Delirium, small arid quick pulse, a high degree of restlessness, and "circularly flushed cheeks, denote daifger. 77?EA TMENT.--To abate the excess of inflammation is the first object by the application of poultices, of linen rags dipped into spirit and water, by general blood-letting, and a dose of No. 23. But when mortification has commenced, the patient must be supported by No. 3, 8 nd when the heat of the skin admits of it he may be allowed wine, porter, or ardent spirits. At night 30 or 40 drops of No. 20 may be administered to procure rest. The mortifying parts are to be covered with a warm poultice, or fomented with warm water; and they may be treated, if extensive, with a poultice made of port wine or of spirit and water. { 32 j PILES. Re/er to No. 5 and No. 6; and when they are very distressing, puncturing the largest of them at the fundament gives relief and L without danger. RHEUMATISM. TREATMENT.—If the person is robust or otherwise in strong heahh, bleed, give a dose of No. 23, direct No. 19 to be rubbed in, and give for common drink No. 6, with about one teaspoonful of No, 8, during the day, and if the pulse is after these remedies not too full, administer No. 27, and direct plentiful warm drink to be taken over night to sweat. When unattended with fever or redness of the part, the same treatment applies to it, with the exception of bleed- ing ; and when the pain has been confined for some time steadily to one and the same joint, it may be blistered. SCALDS AND BURNS. The most important circumstance to be attended to in a scald is to preserve the blisters entire ; and when they have broke of their own accord, to preserve the skin at any rate. They are to be very freely fomented with lead water, ["see No, 12 ;'] and if the skin should have been removed by accident or unavoidably, and the inflammation is very great, rags dipped in linseed • il may be used ; and in a day or two, when the tenderness of the part is enabled to bear the weight of a poultice, it may be employed; and be treated like a blister in a state. of inflammation. [See No. i3-3 In ^urns where not only the skin, but a good deal of substance, has been destroyed, spirit of turpentine is used to advantage ; and when- ever there is observed much chill or fever, or excessive and continued pain, and sometimes delirium, No. 20 or No. 27 in sufficient dose to procure rest is necessary. In explosions of gunpowder, as much of the powder should be picked out with the point of a needle as can be done without giving much pain ; and a poultice may be applied afterwards. SCURVY. CHARACTER.—Languor, lowness of spirits, fetid breath, 9pongy and.bleeding gums, apalid and bloated countenance, stiffness of the hams, and blue and purple spots underneath the skin, like bruises, 8tc. TREATMENT.—A nutritive diet supersedes all medicines ; but No. 3 and No. 15 may be given to advantage. Porter or small beer, made from a decoction of rice^ hops, or barley, with molasses and porter, and fermented for three or five days is grateful and of advan- tage. SICKNESS AT STOMACH. £ec Foul 5\".'7i«c/i.-~BiU when it is ? symptom in the iecond stage L 33 ] of a highly bilious fever, it demands the greatest attention r and a bli» t.er to the stomach with the saline mixture, [see No. 10).] internally, are perhaps best calculated to remove it. SORE MOUTH AND TONGUE, Depends generally upon a disordered state of the stomach, and af- ter exhibiting a dose of No. 24 and 25, or of No. 22, a mouth-water of No. 41, &c. relieves it; but sometimes the internal use of No. 3 is requisite to cure it entirely. SORE THROAT. If attended with much fever, bleed ; give a dose of No. 23, and on the next or on the third day a dose of No. 37 and No. 6; and use on those days that none of the above medicines are given, No. 8 in quan- tity of 30 or 40 drops, &c. Externally No. 19 or a blister is of the greatest service; and a gargle made according to the directions of No. 41 is to be frequently used. ULCERS. / "Whilst attended with considerable redness of the surrounding skin, and whilst their surface has a dirty grey or dark appearance, poultice them and give a dose of No. 231 and afterwards dress them with No. 30 and No. 31. Occasionally No. 33 succeeds best in old standing ul- cers ; and when they continue at a stand without a disposition to heal^ their edges are occasionally to be touched with No. 11. No. 29 also is a very appropriate dressing ; and sometimes in scorbutic habits, vine- gar poultices are of use. VENEREAL DISEASE. CLAP.—During the height of the disease from the commencement of it> dip rags into lead water, wrap them around the penis, and re- r.ew them frequently. Take also one tablespoonful of No. 37 and two teaspoonsful of No. 9, dissolve them in a black-bottle^ful of water, and drink one fourth of it every night and morning to keep the bowels open. Scalding and pain is abated by the use of No. 9, No. 38, and No. 42 ; and if excessive and not relieved, take three times a day as much of No. lO as will lay on a 9d. (a bit) in half a pint of water or in common drink. Chordee is to be treated with No. 33, rubbed in underneath the penis ; or No. 20 may be added to the preparation of No. 12. If the violence of the symptoms still progresses, use warm fomentations to the genitals and the lower part of the belly; and as soon as they abate, and not before, have recourse to No 28 and No. 45 ,- and should the discharge continue in the form of a gleet withou pain, use No. 17, and continue with No. 28, prepared with rather lesa water than is directed. SWELLED TESTICLE—At about the time that the symptoms of clap lessen, one of the testicles is apt to become painful and swell- *d: it ought therefore to be a golden rule in clap to suspend them t 34 1 £ see No. 50] at the very onset of indisposition. But when the swell- ing has taken place, it is to be kept wet and cool with No. 12 ; and sometimes, where this does not agree, apply warm poultices. Con- finement upon the back, and an entire omission for the time of No. 28, are requisite. The penis ought however to be frequendy bathed with warm water; and if fever attends, blood-letting should be recommend- ed to lessen it. No. 37 also, or No. 25 with No. 24, will be effectual remedies to lessen the inflammation. CHANCRE begins in the form of a small white pimple, which on breaking leaves a deep ulcer with irregular and hard edges. In this infection No. 33 and No. 36 are indispensibly necessary; and should be commenced with after a dose of Ne. 24 has been exhibited. But sometimes the height of inflammation produces great swelling of the foreskin, which cannot be pulled back ; and then it is advisable to de^ sist from the above remedies, to give No. 23 and to apply warm poul. tices, until the dropsical affection of the foreskin is abated, when they again should be resumed. A similar swelling of the foreskin, when confined behind the head of the penis, so as to leave the head bare, without being able to pull it forward, is not to be treated with warm applications, but with the preparatiou of No. 12. [These affections of the foreskin occur likewise in clap ; and are to be reduced by the same means.] No. 30 or No 33 are the fittest dressings for a chancre ; and if in the course of three or four weeks it shows no disposition to heal, it may be touched occasionally with No. 11. Cleanliness of the ulcer with strong soapsuds is above all things necessary. BUBOE is a common but uncertain consequence of chancre ; and may likewise take place without having been preceded by chancre; No. 33 and 36 are the chief means to be depended upon ; and lo- cally the preparation of No. 12 is to be employed. The access of much redness on the surface of the swelling, requires a dose of No. 33, the diligent application of No. 12, and probably bleeding; where- asjNo. 33 and 36 should be set aside for three or four days, until this ap- pearance vanishes. But if in spite of this attention, the redness increases, the swelling is affected with a beating pain, and begins probably to get soft, discontinue every remedy above recommended, apply warm poultices & give No. 3 three times a day, until it is soft enough to the feel to be opened, which ought to be done at the lowest part of the soft place to be felt, by a simple puncture with the lancet. Three , c four days after this, No. 3 is no longer necessary, and No. 33 and No. 36 must be persevered in. No. 30 is the usual dressing employed for the sore, and which in like manner ought to be kept as clean as pos- sible by frequently washing it. WOUNDS. The most simple wound? are those mado. with any sharp cutting- L 55 j instrument. They should be rinsed and washed clean; and their" edges, when drawn together, be retained by slips of No 29; a bit of lint lau: over them, and confined with a bandage. With this dress* \ng, if tolerably easy, the wound should be left undisturbed for 4 or 5 days, and when on opening it, it looks partly healed, and is not much inflamed, the dressings are to be renewed in the same way ; but if the parts are inflamed, highly painful, separated, and soaked in mat- ter, No 29 should be exchanged for warm poultices ; and the cure perfected by ointments. x When an artery has been wounded, it is known from a spouting of the blood, which alternately is thrown to a greater or a less distance- [See No. 44.] The effusion of blood from a small artery is often stopped by the coagulated and clotted blood that lies over it: and in this case it would not be prudent in gentlemen not medical, to remove it by washing out the blood. Besides securing a blood-vessel, by passing a double or treble waxed thread around it, and tying it; and which could not be easily accomplished but by a surgeon, it is ad- vised to make pressure upon the bleeding part by layers of lint and a bandage : andif this alone proves ineffectual, to strew «md fill up the wound with common flour, and then by lint and bandage to confine it, until surgical assistance can be obtained. [See also No. 11 & No. 15.] In wounds, that are bruised or torn, in punctured and in gun-shot wounds, much inflammation must be expected; and blood-letting, therefore, low diet, and frequent applications of warm poultices, are required until matter has been formed in them, when they may be dressed with common ointments. If in gun-shot wounds the bullet Can be felt immediately underneath the skin, it might without danger be cut upon by almost any person; but if otherwise, it should be left entirely undisturbed. A punctured wound in the sole of the foot by a nail, f. i. or any other pointed weapon, is to be dressed with spirits of turpentine, un- less it is very painful, when it should be poulticed. The infliction of a wound into the lungs is known from a^discharge of frothy blood by the mouth, brought up by hawking, and from a difficulty of breathing that attends it. Immediate and repeated blood- lettings are in no instance more requisite, than in a case of this kind i and the external wound, if bleeding freely, ought by no means to be plugged up, and the escape of blood from it outwardly prevented: If a cut has penetrated into the beily, and any of the intestines pro- trude by it, they should, after having been rinsed clean with luke. warm water, be reduced into the belly, and be prevented,from falling out again by uniting the wo. ,.d. Bleeding, low diet, gentle purga- tives, and clysters, form the treatment. H^i. \A\st. 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