-.* ^«RS- ®-. Surgeon General's Office f *&§*=*- N ,Z30QZ ^ THE PHYSICIAN'S VADE-MECUM : . &: Containing the Symptoms, Causes, Diagnosis, Prognosis t %• and Treatment of •< ? DISEASES. ACCOMPANIED BY A SELECT COLLECTION OF FORMULAE, AND A GLOSSARY OF TERMS. BY ROBERT HOOPER, M. D. Royi e-Ovi. Licentiate in Physic of the University of OxfoH, and the Royal College of Physicians of London; Physician to the St. M*ry-Ie-0vi»i2£ Infirmary ; and Lecturer on Medicine in London. FROM THE LONDON COPY. This Philadelphia Edition is improved by a TRANSLATION OF ALL THE LATIN PRESCRIPTIONS, And is enlarged by an alphabetical List of ALL THE MEDICINES NOW IN USE, With their Names in both Latin and English : AND BY OTHER VALUABLE ADDENDA. pSilafcelp&ia: PRINTED AND SOLD BY JAMES HUMPHREYS, , "■. , Change-walk. »t \■•> V ......... ■" x .i.^Ai,. . 'if 1809. £:^°C]V-^ SOLD ALSO BY ffiittSAtiufi* J. W. Burditt, & Co. Boston; Cushing & Appleton, SPtreni ; and.,. Thomas & Whipple, Newburyport, Massachusetts. Beers, Howe, & Co. New Haven, Connecticut. T. & J. Swords, and D. Long- . worth, New York. W. W. Woodward; Hopkin3 & Earle; Kim- bcr & Conrad; B. & T. Kite; anJ J. P. Parke, Philadelphia.", George Hill, and Samuel JefFeris, Baltimore, Maryland. J. Ken-; -edy, Alexandria; and W. Prichard, Richmond; Virginia. DISTRICT OF PENNSYLVANIA, to wit: BE IT REMEMBERED, that on the fifteenth day of Septem- ber, in the thirty-fourth year of the Independence of the United States of America, A.D. 1809, James Humphreys of the said distrift, hath deposited in this office, the Title of a Book, the right whereof he > claims as proprietor, in the words following, to wit: The Physician's Vade-Mecum: containing the Symptoms, Causes, Diagnosis, Prognosis, and Treatment of Diseases. Accompanied by a select Colleftion of Formulae, and a Glos- sary of Terms. By Robert Hopper, MND. Licentiate in Phy- sfrevf the University of Oxford, and the Royal College of Phy- sician: .'London; Physician to the St.-Mary-le-bone Infir- mary ; and Lefturer on Medicine in London. From the Lon- don Copy. This Philadelphia Edition is improved by a Trans- lation of all the Latin Prescriptions, and is enlarged by an alphabetical List of all the Medicines npw in Use, with their Names in both Latin and English: And by other valuable Addenda. In conformity to the Aft of the Congress of the United States, intituled, " An Aft for the encouragement of learning, by securing, the copies of maps, charts, and books, to the authors and proprietors of such copies during the times therein mentioned." And also to the aft, entitled *' An Aft supplementary to an Aft, entitled, " An Aft for the encouragement of learning, by securing the copies of maps, charts, and books, to the authors and proprietors of such copies du- ring the time therein mentioned," and extending the benefits thereof to the arts of designing, engraving, and etching historical and other prints." D. CALDWELL, Clerk of the Distrift of Pennsylvania. TO FRANCIS KNIGHT, ESQUIRE, INSPECTOR GENERAL OF ARMY HOSPITALS, &C &C. THIS WORK U RESPECTFULLY INSCRIBED, A8 A TESTIMONY OF GREAT RESPECT AND ESTEEM, BY HIS. SINCERE FRIEND, THE AUTHOR. $&&/ PREFACE. 'THE following concjse account of the several diseases that fall under the province of the Physician has been committed to the press, with the hope of its proving useful to Students, and those PraBitioners in medicine who, from their professional occupations, or other circumstances, may not have it in their power to consult the more voluminous works that have contributed so much to the improvement of medicine. It has been the author's objeB to compress, within a smaller compass than has hitherto been done, consistently with utility, every thing which more especially deserves attention with, a view to the treatment of diseases. In pursuing this, he has discarded all theory, and retained only those leading faBs whic}? it is absolutely necessary for a PraBitioner to be acquainted with when he approaches the bedside of his patient. He has arranged under distinB heads,* * In this arrangement the order of the Cullenian Nosology is adopt- ed, with the exception of placing Pulmonary Consumption amongst the Cachexia?. vi 1. The charaBeristic symptoms by which diseases are known. 2. The causes from which they most frequently have their origin. - 3. The circumstances that more especially point out the difference between diseases which resemble one another. i. The signs which influence the judgment informing a prognosis of their event. 5. That mode of treatment, which, in the present im- proved state of medicine, is deemed most appro- priate, and which experience has sanBioned. The seleB colleBion of Formula, and the accompanying Glossary of terms, will, he trusts, combine to render it more extensively useful. CONTENTS. TABLE of Doses for different Ages PYREXIAE Page. 9 *3 FEBRES id. Intermittent Fevers H Remittent Fever 25 Synocha 26 Typhus 32 " mitior ib. 43 48 49 Synochus PHLEGMASIA Phrenitis 5° Cynanche tonsillaris 54 58 68 69 Pneumonia ib. Gastritis 76 Enteritis 97 Hepatitis Nephfitis 83 88 Cystitis 9° Rheumatismus 94 Podagra 104 Page. EXANTHEMATA 112 Variola ib. Variola Vaccina:, or Coixj-pock ib. Varicella ib. Rubeola 120 Scarlatina 127 Ery, ipelas 13 3 Miliaria 137 Urticaria 140 Pemphigus 141 Aphtha 14 3 HEMORRHAGIC 147 Epistaxis 148 Haemoptysis 15 1 Menorrhagia 154 Hamatetnesis 157 Hematuria 158 PRO FLU VIA 160 Catarrhus ib. Dysenteria 164 NEUROSES 173 COMATA ib. Apoplexia 174 Paralysis 17 8 ADYNAMIA Pag e 184 VESANIA Pagt ' zss Syncope ib. Melancholia ib. Angina Pectoris 186 Mania 257 Dyspepsia 188 CACHEXIA 261 Hypochondriasis 195 MARCORES ib. Chlorosis 198 Phthisis pulmon alts ib. SPASM! 204 INTUMESCENTIA 267 Tetanus ib. Emyhysema ib. Epilepsia 208 Tympanites 268 Chorea Sancli Viti 216 Anasarca 273 Asthma 217 Ascites 282 Pertussis 223 Hydrothprax 284 Pyrosis - 227 Hydrocephalus \ 287 Colica 228 "Rachitis 290 Cholera Morbus 238 1MPET1GINES 293 Diarrhoea 241 Scrofula ■ ib. Diabetes 247 Scorbutus 295 Hysteria 250 Icterus 298 Hydrophobia 253 1 GLOSS ART 301 3ttiDenDa* Variola Vaccina, o/Ccw Pock Measures ana' Weights Guivaru m • Alphabetical List of all the Medicines now in Use, Vc. Abbreviations, 3*3 319 32* 323 343 IX ,The following Table is intended to show the doses of medicines proper for persons of different ages: thus, supposing one drachm of any medicine a sufficient dose for an adult, that is, for one of twenty-one years of age, then other ages will re- quire as follows : Proportionate Ages. Common Dose 3J. Doses. Weeks... 7 i i gr. iv. Months . . 7 ' i §r. v. * 14 i gr. vuj. 28 i gr- xij. Years ... 3^ i gr. xxv. 5 i 9j. or 1 scr. i ^ i 5ss. or ~ dr. 14. 2. 9ij. or 2 scr. 21 5j. or 1 dr. 63 I I gr. Iv. 77 5 Bijss. or 2-1. 100 4- Bij. or 2 scr.. THE PHYSICIAN'S ?HafeHftecum* • "1 THE PHYSICIAN'S VADE MECUM. -CLASS I. PYREXIAE; OR, FEBRILE DISEASES. CHARACTER. INCREASED heat and frequency of pulse, after a snivel ing, accompanied with a disturbance in many of the func- tions, and diminution of strength, especially in the limbs. ORDER I. FEBRES, OR FEVERS. CHARACTER. Pyrexia, without any primary local affection, preceded by 'languor, -lassitude, and other symptoms of debility. GENERA. Febris intermittens, or Intermittent fever. ■ remittens, — Remittent fever. Typhus, — Nervous fever. Synocha, — Inflammatory fever. Febris hectica, — Hectic fever. B 14 INTERMITTENT FEVFRS. INTERMITTENT FEVERS. Generic Character. Fevers consisting of paroxysms, or periods of fever ; be- tween each of which there is a distinct and perfect intermission from febrile symptoms, or an apyrexial period. A paroxysm consists of three stages ; a cold, a hot, and a svjeating stage. {I. The quotidian...having an interval of 24 hours. 2. The tertian; — — 48 hours. 3. The quartan; — — ~7, hours. SYMPTOMS. X)fthe cold stage.—Languor and sense of debility ; listless- ness ; yawning and stretching ; an aversion to motion. The face and extremities become pale ; the features shrink j the bulk of every external part is diminished ; and the skin over the whole body appears constricted as if cold had been applied -to it. Sensibility is greatly impaired ; the secretions and ex- cretions diminished ; the pulse small, frequent, and irregular ; and the respiration short and anxious. At length the patient himself feels a sensation of cold ; first arising in the back, and thence diffusing itself over different parts of the body : though sometimes it is confined to a particular part, as to the extre- mities, side of the head, &c. This is succeeded by rigors, which terminate in a universal and convulsive shaking. Of the hot stage.—After a longer or shorter continuance of shaking, the heat of the body gradually returns 5 at first ine- gularly by transient flushes, soon however succeeded by a •steady, dry, and burning heat, rising much above the natural standard. The skin, before pale and constricted, is now swollen, tense, and red j and possesses an unusual tenderness and soreness to the touch. The sensibility, which in the cold stage was diminished, now'becomes preternaturally acute; INTERMITTENT FEVERS'. m 15 pains arise in the head, and flying pains are felt over different parts of the body. The pulse is quick, strong, and hard j the tongue white j there is great thiist; the urine is high co- loured. Of thesiveatingstage.—At length a moisture is observed to- break out upon the face and neck, which extending soon be- comes an universal and equable peispiratiort. The heat now descends to its usual standard ; the pulse is diminished in fre- quency, and bedbmes full and free; the urine deposites a se- diment: the bowels are no longer constipated j respiration is- free and full ; and all the functions are restoio.l to their natu- ral order. After a specific interval (vide Species) of intermittent fever the paroxysm again.returns, commencing as above desciibed, CAUSES. i. Predisposing.-—Debility, however induced : by a watery, poor diet; great fatigue; long watching; grief; anxiety; the suppression of accustomed evacuations ; the repulsion of eruptions ; preceding disease; cold united with moisture in whatever way applied to the body. 2. Exciting.—Marsh miasma ; or the effluvia arising from i stagnant water, or marshy ground, impregnated with vegeta- ble matter in'a state of putrefactive decomposition. PROGNOSIS. When the paroxysms are of short duration ; when they aic iegu!ai in their recurrence, and leave the intervals quite free. the disease, at least in our climate, is unattended with danger. The circumstances giving rise to an unfavourable prognosis are— i. The paroxysms being of long continuance, violent, and attended with much anxiety and delirium : 2. The disease being combined with others; or other dis- eases being induced by. a protracted btateof the original inter- 16 INTERMITTENT FEVER. mittent. These are most frequently dysentery, cholera, en- largements of the liver snd spleen, ultimately inducing dropsy and jaundice; swelling.of the tonsil glands : 3. The presence of unfavourable symptoms, as convulsions occurring during the paroxysm, preceded by great coma ; ob- stinate costiveness ; hiccup with vomiting and pain upon pres- sure in the hypochondriac and epigastric regions; depraved sense, as double vision ; great prostration of strength ; verti- go; dry, black tongue; foetid excretions. TREATMENT. in the paroxysm. - 1. During the cold stage—to endeavour to induce the hot. Indications., %t Duril)g the hot stage—to promote a per- spiration. 1. By artificial warmth ; the pediluvium ; fomentations to the feet: the warm bath ; warm diluent liquids; cordial dia- phoretics ; and opiates. R. Aquae ammonia? acetatae, drX\ —— cinnamomi, ----di6tillatae, aadr.v. Syrupi corticis aurantii dr.]. Misceutfiat haustus quavis horasumendus. TRANS. Mix into a draught to be taken every hour. R. Aquae ammonia? acetatae dr.\], Mistuiae camphor* dr.x. Vini antimonii gutt. viij. Syrupi iimplicis dr.]. M. f. haustus quavis hora sumendus. Mix into a draught to be taken every hour. INTERMITTENT FEVERS. 17 HAUSTUS SALINUS COMMUNIS. R. Kali preparati scr.j. Succi limonis oz.fs. vel q. s. ad ejus saturationem Aquae cinnamomi dr.\]f ■ ' distillatse n of the lip?, tcngue, and other parts ; impeded deglutition 34 NERVOUS FEVER. by the patient lying prostr.ite on his back, with extended arms, or insensibly gliding down to the bottom of the bed ; falling of the lower jaw;, involuntary evacuations ; small, ra- pid, intermittent pulse ; hiccup ; partial sweating about the breast and head ; a peculiar yet indiscribable expression of anguish in the countenance; picking of the bed-clothes j catching at imaginary objects in the air. TREATMENT. \" i. To excite a new and general action in the system, and thereby to check, or mode- rate, the effects of the morbid impression Indications. ^ made by the cause of the disease. 2. To support the strength of the patient; where the fulfilment of the first indication has been found impracticable. i. By the operation of an emetic administered at the com- mencement of the disease ; by diaphoretics ; by cold affusion or immersion (admissible only when the hot stage is fully formed; when there is no sense of chilliness present ; when the heat of the surface of the body is steadily above the nanii ral standard ; and when there is no general or profuse perspi-? ration : Currie, Med. Reports). Pulvis emeticus communis. Page 19. Haustus emeticus communis. Page 19. R. Vini ipecacuanhas dr.x), ----antimonii dr.)^ M. pro haustu emetico. Mix for an emetic draught. NERVOUS FEVER. 35 R. Aquae ammonias acetatae dr.u] Misturae camphoiae dr.x\). Vini antimonii gutt. xx. Syrupi simplicis dr.). M. f. haustus diaphoreticus quartis horis sumendus. Mix into a diaphoretic draught to be taken every four hours- R. Pulveris antimonialis gr.lv. Nitri purificati pulverisati gr.v. Sacchari purificati pulverisati gr.v). M. f. pulvis diaphoreticus quartis horis sumendus ex quovis vehiculo crasso. Mix into n diaphoretic powder to be taken every four hours in any mucilaginous fluid. a. By the exhibition of tonics, previous to which if the skin be hot and dry, the tongue dry and crusted, the pulse hard, and the bowels constipated, mild aperients, gentle cordial diaphoretics should be given. R. Pulveris rhabarbari scr.). Cremoris tartari dr.). Pulveris aromatici gr.v. M. f. pulvis aperiens. Mix for an opening powder. R. Kali tartarisati dr.)C$. Pulveris rhaei gr.x. Infusi sennae dr.xi). Syrupi corticis aurantii, Tincturae cardamomi, aadr.). M. pro haustu aperiente. Mix for an opening draught. 36 NERVOUS FEVER. R. Pulveris rhabarbari £r.xij. Calomelanos gr.W). M. f. pulvis apeiiens ex pauxillo mellis sumendus. Mix into an opening powder to be taken in a little honey. R. Calomelanos gr.v. F. pulvis pro re nata sumendus. Make a powder to be taken when necessary. R. Extracti colocynthidis compositi j*r.fs Calomelanos gr.W). M. f. bolus aperiens : vel pilulae ties pro dosi. Mix into an opening bolus, or three pills for a dose. R. Pulveris ipecacuanhas compositi gr.v. F. pulvis diaphoreticus sexta quaque hora sumendus. Make a diaphoretic powder to be taken every six hour?. R. Misturae camphorx dr.x\j. Aquae ammonia; acetatae dr.\). Spintus ammonias compositi dr.fs. Syrupi simplicis dr.). M. f. haustus sexta quaque hora sumendus. Mix into a draught to be taken every six hours. R. Mistura? camphorae dr.xi], Vini antimonii gutt. xx. Pulveris contrayervae compositi jcr.fs. Syrupi corticis aurantii dr.) M. f. haustus sexta quaque hora sumendus. Mix into a draught to be taken every six hours. NERVOUS FEVER. 51 MISTURA CAMPHOR* FORTIOR. R. Camphorae jjr.xxv. Amygdalarum dulcium decorticatarum sex. Sacchari purificati dr.u). Optime contere, dein adde Rub thoroughly together, then add Aquae menthae sativae oz.vijfs. Ut fiant mistura. Sit dosis cochlearia tria magna. A mixture to be made, of which three table-spoonfuls are z dose. Vel R. Camphorae gr.xxv. Spiritus vini rectificati gutt. v. Fiat pulvis, dein adde Make a powder, then add Pulveris Arabici rfr.jfs. Syrupi corticis aurantii dr.u) Aquae menthae sativae oz.vij. Ut flam mistura. Sit dosis cochlearia tria ordinaria. A mixture to be made. The dose three common spoonfuls. R. Misturae camphorae fortioris dr.x. Aquae ammonias acetatae dr.u). Vini antimonii gutt. xv. Syrupi simplicis dr.). M. f. haustus quartis horis sumendus. Mix into a draught to be taken every four hours. R. Camphorae ijr.iv. Pulveris contrayervae comdositi scr.Cs- ——— antimonialis gr.]. Mucilaginis arabicae q. s. F. bolus sexta quaque hora sumendus. Make a bolus to be taken every six hours. 38 NERVOUS FEVER. These being premised—tonics:—cinchona,—angustura, co- lumba, serpentaria virginiana ;—acids :—acidum vitriolicum, acidum nitricum, acidum muriaticum, &c—wine :—red port, Madeira ;—antispasmodics :—camphor, musk and castor, and spirit, aether, vitriol.—the affusion of cold water, as before directed. R. Decocti cinchonas dr.x'n). Elixir vitrioli acidi gutt. vj. Syrupi rosae dr.) M. f. haustus quarta quaque hora sumendus. Mix into a draught to be taken every four hours. R. Decocti cinchonas dr.x'i'i). Tincturae ejusdem dr.)fs Syrupi rosae dr.jfs. Spiriius astheris nitrosi dr.Cs. M. f. haustus quartis horis sumendus. Mix into a draught to be taken every four hours. R. Radicis serpentariae virginianae, Corticis cinchonas, aa ez.fs. Aquas ferventis oz.xv). Macera per horam et cola. Macerate for an hour and strain. R. Hujus infusionis dr.xlv. Tincturae columbae dr.). Syrupi corticis aurantii ^r.jfs. M. f. haustus quartis horis capiendus. Mix into a draught to be taken every four hours. R. Decocti angustuiae dr.xU], Tincturae cinchonae dr.)(%. Confectionis aromaticae scr.). Syrupi simplicis dr.). M. f. haustus quarta quaque hora sumendus. Mix into a draught to be taken every four hours. NERVOUS FEVER. 39 As the disease advances recourse may be had to the stimu- lating operation of blisters ; nutritive diet ; the lighter kinds of animal food ; as chicken and veal bioth, calf s-foot jelly, &c. recent and acescent fruits. Sleep should be procured by opiates .united with an antimo- nial. R. Mithiidati scr.). Misturae camphoiae dr.x'n). Vini antimonii gutt. xx. Syrupi rosae dr-)k. M. pro haustu. Mix for a draught. R. Tincturae opii gutt. xx. Misturae camphorae dr.x'n]. • Spiritua aetheris nitrosi, Syrupi simplicis, aa dr.) M. pro haustu. Mix for a draught. R. Pulveris antimonialis' gr.W) ------- opii gr.) ■ tiagacanthae compositi scr.fs. M. f. pulvis. Mix into a powder. If there be delirium arising from a determination of blood to the head, as indicated by a suffused redness of the eyes ; dilated pupil, and inordinate sensibility and irritability,— . Iinponatur, nuchas capitis, vel suris externis, emplastrum cantharidie. A blister to be applied to the back of the neck, or the calves ■ of the legs. 4-0 NERVOUS FEVFR. Cataplasmata ex farina lini pedibus imponenda. A cataplasm of flaxseed to be applied to the feet. R. Spiritus astheris vitriolic! compositi oz.fsr Misturae camphoiae oz.x'x). -VI. pro lotione temporibus frequenter admovenda. Mix for a lotion to be frequently applied to the temples R. Aceti communis css.iij. Camphorae gr.v. Aquae purae oz.'\X. M. pro lotione toto capiti subinde applicanda. Mix for a lotion to be now and then applied to the head ge- nerally. If it be the low muttering delirium, or incoherence of ideas above mentioned—opium, musk, camphire, and blisters to the head. Six drops of laudanum may be added to each tonic draught, or a proportional dose of the pulvis opiatus, or confectio opiata. R. Misturae e moscho e*.vj. Cujus sumat aeger cochlearia duo magna secundis horis. Of which the patient is to take two table spoonfuls every t.vo hours. R. Mistuiae e moscho e».vij. Spiritus aetheris vitriolic! compositi dr.\). Syrupi roeae dr.W). M. f. julapium de quo capiat cochleare magnum subinde. Mix into a julap of which a table spoonful is to be taken oc- casionally. NF/RVOUS FEVER. 41 K. Misturae e moscho, ■ caraphoras fortioris, aa ok.iij, Spiritus astheris nitrosi dr.\). M. f. mistura cujus sumantur cochlearia duo magna tertia quaque hcra. Make a mixture of which two table spoonfuls are to be taken every three hours. A diarrhoea, not critical, should be-checked by the exhi- bition of opium ; of ipecacuanhae in small doses, alone, or joined with opium ; by cordials, astringents; catechu, kino, R. Pulveris opiati scr.Cs. ■ ipecacuanhas gr.), M. f. pulvis octavis horis sumendus. Make a powder to be taken every eight hours: R. Misturae e creta oz.v\). Vini ipecacuanhae dr.h) Tincturae zingiberis oz.ts. M. f. mistura. Make a mixture. R. Misturae e creta cs.vij Confectionis aromatics dr.\Cs. Tinctui as opii gutt. xxx. M. pro mistura. Make a mixture. R. Misturae e creta 'cg.vij. Confectionis opiatae dr.). M. f. mistura. Make a mixture,. j>-2 *2 NERVOUS FEVER. R. Misturas e creta o«.vj. Tincturae cardamomi oz.]* Syrupi zingiberis oz.ft. - Tinctur* opii dr.k. M. f. mistura. Make a mixture. R. Electuarii catechu (P. E.) dr.u). Decocti angusturae e«.vij. Tincturae ejusdem dr.W), M. f. mistura. Make a mixture. Three table spoonfuls of any of the above mixtures may be gi- ven every two, three, or four hours, or aftei every purging stool. Bibat aeger vinum rubrum generosissimum frequenter. Let the patient drink generous Port wine frequently. Profuse sweats are to be restrained by acidulated drink6, and by the use of the vegetable and mineral acids. R. Misturas camphorae fortiori6 ojc.vij. Elixir vitriol! acidi dr.fs. M. f. mistura cujus capiat cochlearia tria sub nde. Make a mixture of which three spoonfuls are to be taker. now and then. R. Infusi rosae, Vini rubri, aa p. ae. M. pro potu ordinario. Mix for common drink. Should the extremities become cold, sinapisms to the feet, blisters to the inside of the ancles, camphire and aether. R. Misturae camphoiae fortioris oz.vij. Spiritus asiheris vitriolici compositi dr.'x). M. f. mistura cujus sumantur cochlearia duo magna quaque hora. Make a mixture of which two table-spoonfuls are to be taken every hour. PUTRID FEVER. 43 TYPHUS GRAVIOR, OR PUTRID FEVER. SYMPTOMS. The attack of this- disease is much more sudden than that of the preceding, and its progress more violent and rapid ; the rigors are extremely severe; the prostration of strength gieater and more early, and the expression of anguish and horror more acute ; the heat of the skin is often moderate, though in some instances it soon rises to a degree greater than in any other fever, to 108° of Fahrenheit, and is peculiarly acrid and burning to the touch ; the pulse is quick, small, and possesses considerable hardness ; nausea and bilious vo- miting; intense pain in the head; tinitus aurium ; preterna- tural throbbing of the temporal and carotid arteries; ferrety redness of the eyes; extreme anxiety ; ferocious delirium; ifie tongue is dry and covered with a brown or black crust; the breath is hot and offensive ; foetid sordes accumulate about the teeth ; the urine, at first pale, then becomes ex- tremely high coloured and foetid, and in the last stage of the disease often deposites a black sediment. In the advanced stages haemorrhages break out from dif- ferent parts of the body; blood is effused under the skin, forming, petechias, maculae, and vibices. The excretions become involuntary, and extremely offensive; gangrenous aphthae appear about the mouth and throat j the pulse sinks, and intermits; the extremities grow cold; hiccups ensue; and before dissolution the patient exhibits a most compli. cated scene of misery. CAUSKS. Predisposing. All those causes inducing debility already enumerated under Typhus mitior; want of cleanliness ; con- fined air ; close and humid state of the atmosphere ; conta- - gion. 44 PUTRID FEVER BI AGIsOSIS. Fiom Typhus mitior. Vide Typhus mi tic/. ■From synocha. By the sudden and great prostration of strength which ensues on its first attack ; by the constitution of the patient ; by the brown or black tongue ; the hvid flush of the countenance ; the black and foetid sordes about the teesh ; the less degree of strength, yet greater quickness and hardness of pulse ; the acrid and mere intense heat cf ;he skin ; the symptoms of putrescency above mentioned. PROGNOSIS. Favourable. A crisis accompan ed with any of the symp- toms mentioned under Typhus mitior; an abatement of fe- brile heat and thirst; a gentle moisture diffused equally over the whole surface of the body, succeedeJ by a riringf of the pulse ; the absence cf delirium and stupor ; the prostration of strengtirnot great; tlie petechias or haemorrhages being cf a florid, red colour. Unfavourable. In addition to those already enumerated as maiking extreme debility (vide Typhus mitior}, the peculiar appearance of the puient; his tyes inflamed and staring, his speech quick, the.sound cf his voice altered ; extreme anxiety- anJ perpetual watchful p. ess ; high delirium; loss of sight; dry, black tongue; nausea, or constant vomiting ; foetid and involuntary excretions; passive haemoirhages ; dark co- louied, livid, petechial eruptions; yellowness of the skin; tension cf the abdomen; black and gangrenous aphthae; gangrene of blistered places ; partal cold and clammy sweats; cadaverous smell of the whole body. TREATMENT. fi. To moderate the excessive febrile action, Indications. } and t0 suPPort the strength of the patient. | %. To obviate the putrid tendency in the I fluids. FUTRID FEVER. 45 i. By the means recommended for the cute of the piece- ding disease; great reliance is placed by some Practitioners on the frequent affusion of cold water, employed under the re- strictions tl:eie mtntioned. Great benefit has been derived from the use of the spirit, aetheris vitriolic!compositi R. Spiritus aetheris vitrioiici compositi ^r.iij. Mistuias camphoiae oz.viifs. M. f. mistura cujus capiat aeger coch. iij. magna tertia quaque hora. Make a mixture of which the patient is to take thiee table- spoonfuls every three hours. R. Spiritus aetheris vitriolic! compositi dr.u), Misturae camphorae fortioris oa.'vij. M. f. mistura cuju3 capiat aeger cochlearia tria magna tertia quaque hora. Make a mixture of which the patient is to take three table* spoonfuls every three hours. 2. This is partly to be done by fulfilling the first indica- tion : by the utmost cleanliness ; frequent change of linen; cventilating and fumigating the apartment of the patient; frequently sprinkling the room with vinegar or camphorated spirits ; the use of acid and acescent fruits, such as currants, grapes, oranges. The exhibition of antiseptics, especially cinchona, in com- bination with acids :— R. Decocti cinchonae dr.x\). Tincturae cinchonae dr.\). Elixir vitriol! acidi gutt. x. M. f. haustus. Mix into a draught. 46 PUTRID FEVER. R. Decocti cinchonae dr.x\). Tincturae ejusdem dr.jl's. Acidi muriaticlgutt. v. M. f. haustus. Mix into a draught. R. Decocti cinchonae dr.x\], Tincturae ejusdem dr.jd. Acidi nilrici gutt. viij. M. f. haustus. Mix into a draught. R. Extracti cinchona? mollis scr.d. Decocti cinchonae dr.xi). Tincturae ejusdem dr.\). Acidi muriaticigutt. vj. M. f. haustus. Mix into a draught. One of these draughts to be taken every two, three, or four hours. The decoction of angustura, quercus, serpentaria, or cas- carilla may be used, made in the same way as the decoction of the cinchona, and employed in the same dosf, combined with tincture and acid. The intestinal canal should be assiduously cleared from any accumulated feces, by the occasional use of gentle laxa- tives, as rhubaib and cream of tartar, calomel, and mild clysters. R. Aceti communis oz.iij. Infusi riorum chamsemeli oz.v. , M. pro enemate. Mix for an enema. PUTRID FEVER. 47 R. Natri muriatici oz.fs. Aceti communis oz.)k. Infusi chamaemeli o«.vj. M. f. enema. * Mix for an enema. R. Nitri purificati dr.W). Infusi chamsemeli oz.v), Aceti communis oz.ij. M. f. enema. Mix for an enema. Acids vegetable and mineral, and carbonic acid in every form ; fermenting liquors ; yeast has been successfully tfsed ; infusion of malt; aerated waters ; clysters of carbonic acid gas, or of acidulated waters ; oxygen gas; oxygenated mu- riate of potash. R. Muriatis potascae oxygen a ti dr.fs. Tincturae cardamom: dr.\). Syrupi corticis aurantii dr.). Aquae cinnamomi o*.jfs. M. pro haustu secunda vel tert-a quaque hora sumendo. Mix for a draught to be taken every two or three hours. Phosphorus dissolved in aether or oil, and made into an emulsion with mucilage of gum Arabic, has been employed with beneficial effect in th^ last stages of typhus by.Drs. Mentz, Wolff, Leroy. and others; but ih'e difficulty of ob- taining and mixing it, and the great caution that is requi- site in the exhibition, are such as prevent its general use. If aphthae appear, the gargles recommended for cynanche maligna may be employed. , Should hemorrhages arise—the acidulated infusion of roses, in addition to other antiseptics; but more especially the oxygenated muriatic acid. .* 48 MIXED FEVER. R. Acidi muriatici oxygenati gutt. xx. Decocti cinchona; <*V.xiij. Tincturae ejusdem dr.u). M. f. haustus tertia quaque hora sumendus. * Mix into a draught to be taken every three hours. SYNOCHUS, OR MIXED FEVER. This is a compound of synocha and typhus. It com- mences wilh the symptoms of the former, and terminates in those of the latter. At first the pulse is strong and hard, the tongue white, the urine high-colouredy soon however the tongue becomes yellow, then brown ; the pulse loses its strength, yet retains its hardness, and becomes more quick ; prostration of strength supervenes; and the. disease assumes the form of typhus mitior, or gravior, as certain piedispo- nent circumstances of constitution, or cause, may happen to be present. The usual and al/nost universal cause of this fever is cold; the morbid effects of which are promoted by its union with moisture, or by a debilitated state of constitution however pre- viously induced. The treatment has been already fully described. In the commencement it will be that laid down for the cure of in- flammatory fever : the utmost caution must however be em- ployed in the use of those means which lower the tone of the system, especially bleeding, so that sufficient strength may be left to combat the succeeding stage, in which the treat- " ment will be that proper for typhus. INFLAMMATIONS. 49 ORDER II. PHLEGMASIA, OR INFLAMMATIONS. CHARACTTRi Synocha fever, with inflammation or topical pain ; the function of an internal part being at the same time injured ; the blood upon venesection exhibiting a buffy coat. GENERAL CAUSES, All the causes inducing local inflammation ; viz. All mechanical, chemical and nervous stimuli ; as external injuries by bruises, wounds, compression, &c. Irritation pro- duced by the presence of extraneous bodies of whatever kind. The application of cold. Any cause that determines an increased or irregular impetus of blood to the part—as violent exercise, certain diseases, an inordinate influx of nervous energy. All the causes inducing inflammatory fever. Vide Synocha. GENERAL TREATMENT. ]"■ i. To remove the remote causes when they are evident, and continue to operate. z. To lower the tone of the vascular system Indications. -I 'n genera' 5 by abstracting those natural agents or stimuli, by which it is supported. 3. To lower the tone, diminish the sensi- bility, and reduce the inflammatory ac- tion of the part in particular. 50 INFLAMMATION OF THE BRAIN. t PHRENIT1S, OR INFLAMMATION OF THE BRAIN, OR ITS MEMBRANES. SYMPTOMS. Horror; immense anxiety and sense of tension referred to the breast; Ipss of memory; frightful dreams; nausea and oppression at the stomach ; excruciating pain in the he.d ; extreme sensibility to impressions of light and sound ; pecu- liarly wild expressions of the countenance ; constant watch* fulness. The face becomes flushed and turgid ; the eyes stare, and seem as if starting from their sockets; ferocious delirium; tears sometimes burst from the eyes; sometimes there is profuse sweating from every pore, at others the skin is dry and burning; parched tongue; at first,fiery red, af- terwards becoming white, yellow, or black ; peculiarly hard and rapid pulse. Phrenitis generally terminates in stupor and insensibility ; and if protracted, in grea,t prostration of strength, and symp- toms of debility. Exposure to excessive heats, or to vicissitudes of tempera- ture; as subjecting the head uncovered to the rays of a verti- cal sun ; violent exercise ; stimulant passions of the mind • intense study ; the presence of irritating matter in the sto. mach ; external violence ; the abuse of spirituous liquors. DIAGNOSIS. From mania.—-by the one being accompanied with violent fever, the other Inot; by the speedy termination of the one, and longer duration of the other. From the delirium of synocha.—In phrenitis, the delirium is the primary affection ; in synocha it is consequent upon the INFLAMMATION OF THE BRAIN. 51 general fever; in synocha the pulse is strong and full; in phrenitis small, hard, and more rapid; phrenitis terminates when protracted in symptoms of typhus, true inflammatory fever most frequently in visceral inflammation. From the delirium oftyphus.—By the mode of the accession : the affection of the head in phrenitis comes on suddenly, and is extremely violent: the delirium of typhus is preceded by the characteristic marks of that disease, and is more moderate in degree : it is distinguished from the low muttering deli- rium, often accompanying nervous fever, by there being in this no symptoms of inflammation ; the face is pallid ; the eyes aie dull ; and all the features shrunk; the contrary \% the case in phrenitis. PROGNOSIS. Favourable.—"The appearance of a warm and equable per- spiration, when the skin has been before constricted ; diarr- hoea ; sediment in the urine ; hemorrhage from the nose; the pulse diminishing in frequency, and becoming more full and soft; the return of 6leep and consciousness; inflammation attacking a less important part. Unfavourable.—After ferocious delirium and constant watchfulness, the pupil of the eye becoming dilated ; frothing at the mouth ; grinding of the teeth ; profound insensibility ; tremors; convulsions; involuntary evacuations; the face, from being flushed, suddenly becoming pale ; suppression of urine; involuntaiy tears; the urine of a dark red or yellow colour, or covered with a pellicle ; the faeces either bilious or white and very foetid ; profuse sweats without affording re- lief; paralysis of the tongue or other parts ; inflammation of other viscera, without diminishing the symptoms of the origi- nal disease ; delirium changing to coma, while the pulse be- comes weaker. 52 INFLAMMATION OF THE BRAIK- TREATMENT. r To diminish the quantity of circulating fluids, j and lessen the tone of the vessels, in the Indication. < . , , . . . , • _ _ 1 system in general, and m the head in pai . L ticular. i. By bleeding. A copious and sudden evacuation of blood from the temporal artery, the jugular vein, or the arm, which should be repeated frequently, proportioning the quantity to the age, sex, temperament, and habits of the patient: Mittatui sanguis, plena rivo, ad sjs.xvj, et lepetatur pro re nata. Blood should be drawn in a full stream (or from a large ori- fice) to the extent of oz.xvi. and to be repeated as occasion may require. Topical bleeding also, from the head, neck, or feet: Admoveantur singulis temporibus hirudines quatuor vel sex. Half a dozen leeches should be applied to each of the temples. 2. By purging :—with neutral salts, or calomel in strong doses, so as to keep up a counter irritation, and not to excite vomiting. R. Natri vitriolati oz.). Aquae purae oz.v], Syrupi croci dr.u). M. f. mistura de qua capiat aeger cochlearia iv quavis hora donee alvus bis terve respondeat. Make a mixture, of which the patient is to take four spoon- fuls every hour, until the bowels are moved twice or thrice. R. Calomelanos gt. x. Sacchari purificati scr.). M. fiat pulvis catharticus. Mix for a cathartic powder. INFLAMMATION OF THE BRAIN. 53 R. Pulverise scammonio cum calomelane gr.xv. F. pulvis catharticus, \ Mix for a cathartic powder. R. Gambogise gr.x. Pulveris jalapii gr.xi). M. f. pulvis catharticus. Mix for a cathartic powder.^" 3. By saline diaphoretics and refrigerants. Capiat aeger haustum salinum communem (page 17) tertia quaque hora. The patient to take the common saline draught (page 17) eve- ry three hours. # R. Nitri purificati gr.x. Aquas ammonias acetatae dr.'\). - distillatae dr.xi). Syrupi rosa; dr.], M. pro haustu diaphoretico quarta quaque hora sumeudo. Mix for a diaphoretic draught to be taken eveiy four hours. R. Aquae ammonia: acetatas cs.fs. Misturae camphorae fortioris dr.x. Vini antimonii tartarisati gt. vj. Syrupi simplicis dr.). M. f. haustus diaphoreticus quartis hcris'sumendus. Mix for a diaphoretic draught to be taken every four hours. 4.. By the application of vinegar and water to the head, pre- viously shaved ; pediluvium and semicupium. 5. By the application of blisters to the head, neck, and legs, E 2 54. - INFLAMMATORY SORE THROAT. Applicetur toto capiti raso, vel nuchae capitis, vel suns externis, emplastrum cantharidis ainplum. Let a large blister be applied to the whole head first 6haved, or to the back of the neck, or the calves of the legs. The most perfect tranquillity should be observed in the pa- tient's room, ail sounds and light excluded, and no food whatever be allowed during the inflammatory period, except barley water, rennet whey, gruel, sago, panada, arrow roof, or the like. CYNANCHE TONSILLARIS, OR INFLAMMATORY SORE THROAT. SYMPTOMS. Rigors and flushing succeeding each other, and termina- ling in the hot stage of an inflammatory fever; during which inflammation is found upon the tonsils, uvula, and adjacent parts ; difficult and painful deglutiiion ; the voice becomes hoarse, sometimes almost lost; sense of burning heat and lancinating pain in the throat; copious excretion of viscid mucus and saliva; in more severe attacks the eyes are infla- med, and the cheeks swollen and florid ; pain in the ear, and not unfrequently deafness ; sometimes the inflammation from being extremely florid becomes of a dusky rose colour, and is soon interspersed with little whitish specks, which become small sloughs. It terminates in resolution—in suppuration, or in gangrene. INFLAMMATORY SORE THROAT. 55 CAUSES. All those causes which induce inflammation in general; the application of cold to the neck ; wearing damp linen ; sit- ting in damp rooms; getting wet in the feet; violent exertions of voice; blowing wind instruments; suppression of custo- mary evacuations ; acrid substances irritating the fauces. DIAGNOSI9. From cynanche maligna.—By the fever, which In the one is inflammatory, in the other typhoid ; by the absence of ulcer- ation. , From scarlatina anginosa.—See scarlatina anginosa. PROGNOSIS. Favourable.—Those circumstances indicating resolution or suppuration ; little fever; free respiration ; deglutition not much impeded ; the inflammation being of a vivid red colour ; copious salivation about the fifth day. Unfavourable.—Those circumstances indicating gangrene; which are, after unusual violence of pain, a sudden abate ment; the tonsils, before turgid, moist, and shining, sud- denly appearing dry, flaccid, unequal, and of a pale brown or livid colour ; the inflammation becoming of a dull red, and interspersed with specks of a dark colour (as long as the specks continue white, little is to be appiehended from them) ; the pulse, from being strong, becoming small, weak, and irregular ; the face, before flushed, now assuming a cada- verous appearance; clammy cold sweats and cold extremi- ties; foetid breath; great anxiety; subsultus tendinum; foam in the mouth; coma, or slight delirium; the tonsils enlarging to such a size as to threaten suffocation, 56 INFLAMMATORY SORE THROAT. 1 RE ATMEN T. The indications are those for the treatment of inflammation in general. Emetics are extremely useful in the beginning, before the febrile symptoms are very violent. The timely exhibition of an emetic often checks the complete formation of the disease. R. Antimonii tartarisati- gr.x), Sacchari albi scr,). M. fiat pulvis in partes quatuor aequales dividendus, quarum capiat unam quavis hora donee probe vomat. Mix into a powder to be divided into four equal parts, of which one is to be taken.every hour until full vomiting is occasioned. When the disease is not checked, tlie' antiphlogistic regi- men and diet must be enforced, and the inflammation attacked : i. By blood-letting, genera! and local. Mittatur sanguis ex veno jugulari ad" oK.viij. Blood to be drawn from the jugular vein to the extent of 02;.vii;. Admoveantur hirudines tres parti affectse. Three leeches to be applied to the part affected. Applicentur cucurbitulae cum ferro sub aurem laterisaf- fecti, et mittatur sanguis ad oz.iv. Scarification and cupping to be applied under the ear of the affected side, and four ounces of blood to be thus taken. INFLAMMATORY SORE THROAT. 57 i. By blisters to the throat and back, an.l rubefacients. Ulinatur linimentum ammonias vel linimentum cam- phorae compositum inpaitem affectam, sextis horis. The part affected to be baihed eveiy six hours with the linimentum ammonias, or the linimentum camphorae compositum. Emplastrum cantharidis collo qua dclet. A blister.to be applied to the painful part of the neck, %. By purging, with either of the recipes page 28. 4. By diaphoretics, such as recommended, page 39, a- gainst inflammatory fever. j. By inhaling the steams of warm water, alone, or im- pregnated with vinegar, camphor, or aether. 6. By sedative or slightly stimulant gargles •• R. Nitri purificati dr.W. Aquas hordei oz.vi), Mellis acetati dr.x\). M. f. gargarisma saspe utendum. Mix for a gargle to be frequently used. R. Infusi rosae oz.v'\), Tinctuiae myrrhae dr.W). M. f. gaigailsma. Mix for,a gargle. R. Acidi nnuiatici dr.fi Aquas hordei e*.vij. M. f. gaigansma. Mx for a gargle. 53 PUTRID SORE THROAT. If suppuration ensue—emollient cataplasms; warm emol- lient.gargles ; frequently inhaling the steams of warm water i early incision. R. Caiicarum incisarum ox.'w. Aquae distillates oz.xi]. Coque per scxtam partem horse, dein cola pro gargarismate tepide utendo. Boil for ten minutes, then strain for a gargle to be used of a tepid temperature. If a tendency to gangrene—the means enumerated under the head Cynanche maligna are to be used. If danger of suffocation—scarifications of the tumefied parts ; inhalation of aether ; bionchotomy. The strength of the patient should meanwhile be supported by nutritious clysters of animal broths, thick gruel, or a so- lution of starch* CYNANCHE MALIGNA, OR PUTRID SORE THROAT. SYMPTOMS. Cold shiverings; anxiety; nausea; vomiting; heatj restlessness ; debility; oppression at the chest; the face is flushed ; the eyes red ; sense of stiffness in the neck, with hoarseness of voice, and sore throat; when upon inspection, the whole internal fauces appear of a fiery red colour. Thi» soon changes to a dark red, and becomes interspersed with a number of specks, of some shade between a light ash, and dark brown. In some caies the first appearance which the fauces assume, is that of a large whitish coloured stain, sur- PUTRID SORE THROAT. 59 rounded by a florid margin i the stain soon becoming an ex- tensive slough. The tongue is covered wiih a thick brown fur; the inside of the lips are beset with vesicles, and a thin acrid matter distils from the mouth and nostrils, excoriating the neighbouring parts ; there is often a diarrhos., and some- times a constant discharge of an excoriating fluid from the anus ; considerable fever with an obvious evening exacerba- tion ; small, frequent, irregular pulse; prostration of strength ; coma or delirium ; yet often, even when the disease terminates fatally, the patient is free from these symptoms, and continues to walk about until a few hours before his death. About the second or third day large patches or stains ap- pear about the neck and face, of a scarlet, or fiery red co- lour; which, upon inspection, are composed of small promi- nent papulae. These, by degrees, become dispersed ovei the whole body, and after continuing for about four days, depart with a desquammation of the cuticle. In bad cases the sloughs in the throat corrode deeper and deeper, and spread throughout the whole alimentary tube, or to the trachea; the symptoms of irritation continue to in- crease, gangrene supervenes, a severe purging comes on, and the patient expires; usually before the seventh, often as early as the third or fourth day. CAUSES. v Predisposing. Weak and relaxed habit of body ; debility, however induced; autumn and the commencement of winter; long continued humid state of the atmosphere; it most fre- quently attacks children. Exciting. A specific contagion. DIAGNOSIS. It is distinguished from the preceding species of cynanche by the concomitant fever : in the one it is inflammatory, in 60 PUTRID SORE THROAT. the other putrid. By the inflammition in the throat, in one disease terminating in resolution, or suppuration ;• in the other, in gangrene. By the absence of an eruption in the one ; by ks presence in the other. From Scarlatina. See Scarlatina. PROGNOSIS. Favourable circumstances. The fever moderate, and suf- fering a remission upon the appearance of the eruption; about the fifth or sixth day, the skin, from being parched, be- coming moist and soft; and this followed by a diminution of febrile symptoms ; the eruption of a florid red colour,' and diffused equally over ths whole surface of the body ; swell- ing of the tonsils has sometimes been attended with relief. Unfavourable. At the commencement of the disease severe headaches, especially acute pain in the crown of the head; diarrhoea; coma; delirium; the eyes heavy and watery; the countenance either full ana bloated, or pale, shrunk, and dejected ; early prostration of strength ; small irregular tre- mulous pulse, whether frequent or not ; or full and unequal ; small hurried anxious respiration, interrupted by sighs ; the urine quite limpid, or very high coloured, and turbid ; the fauces of a dark rose colour, with brown spots ; an eruption of red pdstules, or purplish blotches, forerun the worst. cases. Sores or issues assuming an ill appearance ; the absence t>{ an eruption, or its early appearance; the eruption sud- denly becoming lived, or changing from a dark red to a pale colour; or altogether disappearing; when the countenance assumes a cadaverous hue, and convulsions supervene. Drop- sical swellings ; the ulcers, left af.er the separation of the" sloughs, of a fiery red colour, or suddenly becom.ng covered with a black crust; the ceasing of the discharge from the mouth and note; the evacuation of feces of a dark or black colour; the inflammation spreading to the stomach and inte*- PUTRID SORE THROAT. 61 tines, and producing symptoms of gastritis or enteritis; to the brain inducing phrenitis; to the trachea, followed by a change in the voice, and other symptoms of angina trachea- 1 is. Hemorrhages from the mouth, nose, or cars ; foetid breath; cold extremities ; clammy sweats ; hiccup. TREATMENT. ft. To check the tendency to gangrene by sup- I porting the strength of the system in I general. Indications. < ^ r^Q promote the separation of sloughs ; and to preserve a healthy state of the fauces. 13. To allay urgent symptoms. 1. By the liberal administration of antiseptics, especially bark, joined with spices and wine; it is more effectual when given in substance. R. Pulveris cinchonas scr.). ——— aromatici gr.W). Confectionis aromatics; dr.Cs, Tincturae cinchonas dr.). Decocti ejusdem dr.x\j. Syrupi zingiberis dr.) M. f. haustus quarta quaque hora capiendus. Mix into a draught to be taken every four hours. The for-nulae prescribed at page 46 against putrid fever are also proper. 62 PUTRID SORE THROAT. If the skin be hot and dry, the bark should be joined with a diaphoretic. \ R. Aquae ammonias acetatae dr.'W. Decocti cinchonas dr.x\). Tincturae cinchonas dr.)fa. , Confectionis aromaticae dr.te, Fiat haustus tertia vel quarta quaque hora sumendus. Make a draught to be taken every three or four hours. R. Ammonias preparatae scr.). Succi limonis, q. s. ad ejus saturationem. Decocti cinchonae dr.'xx. Tincturae ejusdem dr.), Confectionis aromaticae dr.(s. F. haustus tertia vel quarta quaque hora sumendus. Make a draught to be taken every three or four hours. The diet should be thick gruel; barley-water; prepara- tions of tapioca; Indian anow-root; rice; sago; panado, with red wine or brandy. The ordinary drir.k wine-whey; negus, acidulated with the juice of oranges or lemons. The chamber of the patient should be kept cool ; the floor often sprinkled with vinegar ; free ventilation; fumigations by casting pulverized nitre over a chafing-dish containing live charcoal, or with oxy-muriatic acid gas ; all sources of pu- trid effluvia should be removed, and the patient's linen often changed. Great attention ought to be paid to the state of the bowels. and irritating faeces should be prevented from accumulating by the occasional use of laxative enemas. PUTRID SORE THROAT. 63 i. By stimulant, tonic, and astringent" gargles ; such are, an infusion of capsicum, of roses acidulated, solutions of myrrh, of marine acid, of a watery extract of bark in Port wine : R. Seminis capsici annui contusi dr.Cs. Aquae ferventis ez.vij. Mellis rosas dr.W). * Tincturae myrrhas dr.v. Fiat gargarisma. To be made into a gargle. R. Infusi rosae oiz.vj. " Tincturae myrrhae oz.). » Acidi sujphurici diluti dr.). M. pro gargarismate. Mix for a gargle. R. Extracti cinchon* mollis dr.). Vini rubri generosissimi ox.yi). Fiat gargarisma. To be made into a gargle. ' Should these be insufficient, the parts may be touched with mel asruginis, with powdered myrrh or alum, by means of a camel-hair pencil, with marine acid mixed with honey. R. Acidi muriatici dr.'\). Mellis rosae dr.xW. M. Quo partes gangrenosa: saepe, ope penicilli, tangantur. With which the gangrenous parts are often to be touched by means of a piece of lint, or a camel's hair pencil. The inhalation of the steams of hot water, impregnated . with myrrh, camphor, or vinegar, may be had recourse to. 64 PUTRID SORE THROAT. 3. Dian'noer.—by opium—and astringents—such as are . ordered against diarrhoea in nervous fever at page 41. Violent vomiting—by the saline medicine in an effervescing state,—mild laxative enemas,—opium joined with camphor. HAUSTUS SALINUS EFFERVESCE N5. R. Kali praeparati scr.). Aquae cinnamomi dr.\). -----distillatae t Magnesia; vitriolatas oz.). Aquae distillatae oz.vjfs. Syrupi simplicis ox.fs. Solve ut fiant mistura cathartica : sumantur cochlearia tria magna quolibet bihoriodonee alvus rite soluta fuerit. Dissolve into a cathartic mixture i three table spoonfuls are to be taken every two hours until the bowels are thoro.ughly opened. If these purges fail of opening the bowels, the more active must be employed, and also purging clysters in large quantities. R. Calomelanos gr.'i)* Extracti colocynthidis compositi gr.x. Fiat pilulae duae secunda quaque hora sumendae cum dosi mis- turae aperientis donee alvus respondeat. Make two pills to be taken every two hours with a dose of the aperient mixture until the bowels aie opened. R. Magnesias vitriolatas o*.jfs. Decocti avenae tenuioris ox.xxx. Fiat enema. Make an enema 3. By saline diaphoretics, with mucilaginous drinks similar to those oideted in-gastritis. INFLAMMATION OF THE LIVER. HEPATITIS, OR INFLAMMATION OF THE LIVER s ■ /Acute | Chronic. SYMPTOMS. Of the acute. Pain in the right hynochondrium, increased "bypresuie, often extending high in the chest, and resem- bling pleurisy; incapacity of lying upon the left side; dry cough ; difficulty of breathing, and shooting pains in the chest resembling pleurisy; sympathetic pain in the right shoulder; sallow countenance, sometimes a yellow tinge of the tunica conjunctiva, and actual jaundice; high-coloured urine; either costiveness or diarrhoea. In some instances there is a deficiency of bile in the intestines, when the faeces are of a clay colour; sometimes a superabundance, which is then ejected by vomiting and stool. When the concave surface of the liver is affected, the pain is more obscure, and is referred to the back ; the bieathing is less anxious ; the functions of the stomach more disturbed, producing vomiting, hiccup, and other symptoms of gas- tritis. Of the chronic. Its attack is in generaJ so gradual, and the symptoms, at its commencement, so obscure, that it is long unattended to. It is marked by symptoms of dispepsia; loss of appetite; flatulence; sense of fulness and distention of the stomach; at length the health becomes impaired ; weight and obtuse pain, in the region of the liver, or more frequently referred to the back ; the countenance becomes sallow; torpor and inactivity; dejection of mind ; the functions of the prima; vix greatly disturbed; obstinate costiveness; clay-coloured stools; Bcinhus; dropsy; jaundice. Hepatitis terminate* either in resolution, about the 4th, 7th, or 1 ith day; or in suppuration and abscess. 84 INFLAMMATION OF THE LIVER. CAUSES. All the causes inducing inflammation ; biliary concretions; irritation of acrid bile; the violent operation of emetics ; ex- ternal injury ; passions of the mind ; intense heat; intempe- rance in the use of spirituous liquors. DIAGNOSIS. From pneumonia. By the pleuritic pains being less violent, and chiefly confined to the course of the phrenic nerve (ascend- ing to the top of the shoulder) ; by the pain in hepatitis being increased by pressure, in pneumonia unaffected by it; by the difficulty, in pneumonia, of lying upon the affected side, while in hepatitis pain is occasioned by lying upon the oppo- site ; by the s^llowness of countenance; by the cough being generally unaccompanied with expectoration. From gastritis and enteritis. By the seat of the disease, discovered by tenderness upon pressure; by the sympathetic pains of the clavicle and shoulder; by the less prostration of strength, and greater fulness of pulse ; by the colour of the stools and urine. From dyspepsia. See Dyspepsia. PROGNOSIS. Favourable. About the 3d, 5th, or 7th day, bilious diar- rhoea ; universal and free perspiration ; copious sediment in the urine; inflammation appearing upon an external part; hemonhage from the hasmorrhoidal veins ; these followed by an abatement of fever, and of other symptoms. Unfavourable. Intensify of pain and fever; the pain con- fined to a point; continual hiccup; cold extremities, while other parts are exoemeiy hot; obstinate constipation; severe rigor, succi.-d. J by transient flushes, and hectic fever; the symptoms of mortification ; already often mentioned. In the chronic form ; an enlargement, and preternatural hardness of INFLAMMATION OF THE LIVER. 85 the organ, obvious to the feel; the constitution impaired by previous excesses. TREATMENT. Of the acute. Indications. The same as in all visceral inflammations. The indications are best fulfilled by : >. General and topical blood-letting. 2. Blisters. 3. Cathartics, especially calomel. R. Calomelanos gr.v. Pulveris antimonialis Ph. L. gr.W). Fiat pulvis catharticus, ex melle sumendus. Make a cathartic to be taken in honey. 4. Saline and antimonial diaphoretics. See page 29. When the antiphlogistic plan has been continued for five or seven days, and the symptoms do not abate, calomel must be given frequently. R. Calomelanos gr.). Conservae rosae, q. s. Fiat pilula sexta quaque hora sumenda. Make a pill to be taken every six hours. Should suppuration take place, and an abscess form exter- nally, it must be brought forward as quickly as possible by poultices and fomentations ; a generous diet; the use of cin- chona and bitters ; and an early incision is to be made when it points. H 86 INFLAMMATION OF THE LIVER. Of the chronic. Mercury, both internally and externally applied, in smaH quantities. R. Camphorae gr.v. Unguenti hydrargyri fortioris gr.xxv. Fiat unguentum in regionem hepatis alterna quaque nocte illinendum. Make an ointment to be rubbed on the region of the liver every other night. R. Calomelanos, Sulphuris antimonii praecipitati, aa dr.). Terantur simul in mortario per horam unamintegram ut fiant pulverem subfuscum. To be rubbed together in a mortar for a whole hour into a brownish powder. R. Hujus pulveris gr.). Conservae rosae gr.v. Fiat pilula ter in die sumenda. Make a pill to betaken thrice a day. R. Calomelanos gr.fs. Succi cicutae spissati gr.iii Fi^t pilula ter in die sumenda. Make a pill to be taken thrice a day. A continued course of bitter tonics and aperients, as taraxa- cum, gentiana, quassia, or Colombo with soda. R. Radicis taraxaci recentis oz.'w Aquae distillatae /b.)fs. Coque ad libram unam. Boil to one pound INFLAMMATION OF THE LIVER. 87 R. Hujus decocti dr.xW). Natri ppt. gr.v. Fiat haustus ter in die sumendus. Make a draught to be taken thrice a day. R. Extracti taraxaci gr.v). Pulveris rhabarbari .gr.iv. Fiat pilulae duae ter in die capiendas, superbibendo haustum sequentem." Make two pills to be taken thrice a day, drinking imme- diately after the following draught. R. Infusi gentianae compositi dr.u). Aquae menthae sativae dr.x, Natri praeparati gr.iv. Fiat haUstus. Make a draught. R. Quassias incisae scr.ij. Corticis exteiioris aurantii Hispalensis dr.W). Aquas ferventis oz.xv). Per horam integram macera in vase clauso, dein cola. Macerate for one hour in a close vessel—then strain. R. Hujus colaturae dr.x\). Tincturae colotnbse dr.). Fiat haustus. Make a draught. The nitric acid of modern chymistry has been frequently of great use. R. Acidi nitrici gutt. viij. Aquae distillatae dr.x\). Syrupi simplicis **V.ij Fiat haustus ter quaterve die capiendur. Make a draught to be taken three or four times a day. 88 INFLAMMATION OF THE KIDNEY. R. Acidi nitrici dr.). Aquae distillatae ez.xij. Syrupi corticis aurantii cz.jfs. Fiat mistura quotidie sumenda, partitis hahistibu6. Make a mixture to betaken everyday in divided do9es. Removal from a warm to a cold climate is useful, and a sea voyage. NEPHRITIS, OR INFLAMMATION OF THE KIDNEY. SYMPTOMS. Pyrexia ; pain in the region of the kidney ; the pain ex- tends along the course of the ureter, and is accompanied with numbness of the leg and thigh on the affected side ; retrac- tion of the testicle; nausea and vomiting; high-coloured, sometimes mucous, or bloody urine; micturition ; dysuria. It terminates in resolution ; in abscess ; or in gangrene ; known by the ordinary symptoms that accompany these ter- minations of inflammation in other parts. CAUSES. The common causes of inflammation; acrid diuretics; calculi in the kidney ; external injury; long-continued and violent exercise on horseback; collections of hardened faeces in the colon; retrocedent or atonic gout; violent exertions; strains, &c. INFLAMMATION OF THE KIDNEY. 89 ( DIAGNOSIS. From lumhagb. . By the seat of the complaint, discovered upon pressure ; by the pain following the course of the ante- • rjor crural nerve; by the dysuria and mictuiitien; by the pain not being increased upon motion of the muscles. From gastritis. By the seat of the pain, &c. See symp- toms of gastritis. PROGNOSIS. Favourable. Remission'of pain, fever, and tension, fol- lowed by a very copious excretion of high-coloured, mucous, or purulent urine; universal equable perspiration ; haematu- i ia ; if succeeded by a remission of symptoms; haemorr- hoids. Unfavourable. Pale urine, secreted in" small quantity; great micturition; dysuria; sudden cessation from pain; hiccup ; delirium ; cold extremities ; severe rigors ; and su- pervening hectic fever. TRZATMENT. u Indications. The same as in the other phlegmasia;. They are to be fulfilled by— i. General and local blood-letting; the latter either by the use of cupping-glasses, or by the application of numerous leeches to the region of the kidney. a. Oleaginous cathartics of castor oil, manna, or oil of almonds : frequent emollient clysters. 3. Mild diaphoretics, especially frequent and copious draughts of mucilaginous and diluent liquids, as barley-wa- ter, decoction of marsh-mallows, linseed-tea, with a little nitre. H2 90 INFLAMMATION OF THE BLADDER. 4. Opiate clysters when the pyrexia is somewhat abated and the pain excessive. R. Decocti marantae (Arrow root) w.vj. Tincturae opii dr.). Fiat enema. Make an enema. 5. The warm bath, repeated according to the violence of the pain ; and fomentations to the region of the kidney. Blisters are very prejudicial, inducing strangury. CYSTITIS, OR INFLAMMATION OF THE BLADDER. Species. 4 Acute. Chronic. SYMPTOMS. Of the acute. Pyrexia, acute pain, tension, and tumour, in the region of the bladder; pain and soreness, increased upon pressure above the pubes, or in the perinaeum ; micturi- tion ; painful discharge of urine, in small quantities; or complete obstruction to its passage; tenesmus; vomiting. Of the chronic. In this case the mucous membrane of the bladder, by repeated or continued irritation, produced by calculus, by stricture, by the disease of the prostate, or other cause, has become thickened, indurated, ulcerated; and pours out a large quantity of mucus and pus; which, added to the urine, gives to it the appearance of whey. Often there ii a discharge of blood. INFLAMMATION OF THE BLADDER. 91 CAUSES. Mechanical injury ; local irritation by calculus; the in- flammation of gonorrhoea extended along the urethra ; spas- modic or permanent stricture ; all the usual causes of inflam- mation. TREATMENT. Indications. The same as in the other phlegmasia;, and are to be fulfilled nearly in the same way :— i. By general and topical blood-letting, the application of leeches to the peiinaeum and region of the pubes. z. By oleaginous purges and emollient clysters. 3. The warm bath and fomentations. 4. The exhibition of opium with diaphoretics. 5. The other means recommended fn nephritis. The chronic species. By stimulants, and injecting the bladder with emollient- decoctions. R. Balsami copaivas oz.fi. Vitellum unius ovi. Sacchari purificati oz.).. M. dein adde paulatim Mix, then add gradually Aquae menthae sativae oz.v). Ut fiant emulsio cujus capiat aeger cochlearia tria magna ter in die. To make an emulsion of which the patient is to take three table spoonfuls thrice a day. 92 IFLAMMATION OF THiL BLADDER.. R. Terebinthir.se de Chip gr.W], Saponis Hispauici gr.lv. fy Pulveris cojumbas q. s. - Fiat pilulae duae ter in die sumendae. Make two pills to be taken thrice a d3y. R. Saponis HIspanici gr.r. Extracti lactuca; virosae gr.'W], Pulveris rhaei q. s. Fiat pilulae dua? ter in die sumendae. Make two pills to be taken thrice a day. R. Resinae flavae £r.vj. Succi cicutas spissati gr.W). Balsami Canadensis q. s. Fiat pilulae duas ter in die sumendae. Make two pills to be taken thrice a day. R. Olei lini recentis oz.ft. Aquae calcis oz.'iv, M. pro injectione. Mix for an injection. R. Amyli dr.l). Aquas ferventis ox.v. Tinctuis opii dr.). Fiat injectio. Make an injection. INFLAMMATION OF THE STOMACH. 93 R. Aquae lythargyri acetati dr.). '" distillatae o*.iv. Tinctuias opii dr.). Fiat injectio. Make an injection. R. Aquae lithargyri acetati dr.)fa. Olei Imi recentis oz.fs. Aquas calcis oz.lv. Fiat injectio. Make an injection. 94>: RHEUMATISM. RHEUMATISMUS, OR RHEUMATISM. {Acute. Chronic. SYMPTOMS. Of the acute. Lassitude and rigors, succeeded by heat, thjrst, anxiety, restlessness, a hard, full, and quick pulse and all the usual symptoms of synocha ; sense of weight, and coldness of the extremities ; great restlessness ; obstinate costiveness; after a short time, (in the course of one, two, or three days), inflammation, with acute pain, tumor, and tension, makes its appearance in one, or more, of the larger joints of the body. The pain is transitory, shifts from joint to joint, and leaves the part it occupied, swollen, red, and extremely tender to the touch. The pulte is full, and hard ; the blood, when drawn from a vein, exhibits the inflamma- tory surface; the tongue preserves a steady whiteness; the body is usually obstinately costive ; the urine high-coloured ; sometimes there is profuse sweating, unattended by relief. Of the chronic. The chronic form of rheumatism may be either a consequence and termination of the acute; or it may be independent of it. In the first case, the parts which were affected with inflammation are left weak, rigid, in some in- stances cedematous, and the pain, before moveable, is now usually confined to particular parts :—sometimes, however, it still shifts from joint to joint, but without occasioning any RHEUMATISM. 95 inflammation or fever. In the latter, from exposure to cold, or other cause, pains arise in the head, shoulders, knees, loins, wrists, or other paits ; which often continue for a con- siderable time, and at length go off, leaving the seat they oc- cupied in a state of debility : not unfrequently of paralysis. CAUSES. Obstructed perspiration ; occasioned ejther by wearing wet clothes, lyitig in damp linen, or damp rooms, or by being exposed to cold air, after having been much heated by exer- cise. DIAGNOSIS. The pathognomonic symptoms are, synocha, with pains and inflammation in the larger joints, under which the integu- ments become distended, smooth, and of a particularly pale red colour. From podagra. By its generslly attacking the larger joints pnly ; by the pain shifting its seat; and following the course of the muscles in its translation to other parts ; by the disease not having been preceded by symptoms of dyspepsia ; by its occurring at any p.-nod of life ; whereas gout is usually con- fined to the adult period. PROGNOSIS. Favourable symptoms. A general, but not unnaturally pro- fuse, perspiration ; the deposite of a lateritious, or furfura- ceous, sediment in the urine; eruptions on the skin ; mode- rate haemorrhage of florid blood from the nose or other parts. Unfavourable. The inflammation becoming erysipelatos, and assuming a dark red, or rose colour ; and this followed by vesications ; delirium ; pale urine ; metastasis of the in- flammation to the head, chest, abdominal viscera, dia- 96 RHEUMATISM. phraghm ; producing the symptoms of the idiopathic diseases of these organs. TREATMENT. Of acute rheumatism. The indications are the same with those of the phlegmasia;, and are to be fulfilled :«— i. By general and topical blood-letting. General bleeding is to be had recourse to in all cases where the vascular action is strong, the heat considerable, the con- stitution robust, and the patient not advanced in years. It should be repeated according to the violence of the symptoms, the firmness of the coagulum, and the appearance of the blood previously drawn. The reduction of vascular action is more particularly to regulate the repetition than the buffy appearance of the blood, which in many cases continues to increase, notwithstanding the abstraction of blood, and is not diminished by bleeding. Topical blood-letting by leeches, and cupping, is useful, when the disease produces considerable pain and tumefaction about a joint or limb. a. By occasional purgatives of castor oil, magnesia vitri- olata, natron vitriolatum, kali tartarisatum, rhubarb, and cream of tartar or calomel, or laxative clysters : those recom- mended at pages 28 and 29. 3. By diaphoretics. The antimonial sudorifics with opium are in general the most effectual in promoting perspiration and allaying the pain ; but in mild cases the saline diaphoretics are sufficient, such as aie recommended for the cure of syno- cha; see p. 29 and 30. To these opium is a useful addition when the pain is considerable ; or one of the following may be exhibited :— RHEUMATISM. 9f R. Opii purificati gr.). Pulveris antimonialis Londinensis gr.W). Conservae rosae gr.iv. Fiat pilula quarta vel sexta quaque hora sumenda cum haus- tu salino communi. Make a pill to be taken every fourth or sixth hour with the common saline draught. R. Opii purificati pulverisati gr.). Calomelanos gr.fy. Pulveris antimonialis Londinen*ie - &-^ij. ~ Sacchari purificati £r.viij. M. pro pulvere sexta quaque hora sumendo ex quovis vehicu- lo crasso. Mix into a powder to be taken every sixth hour out of any viscid or mucilaginous vehicle. R. Pulveris ipecacuanhae gr.viij. Sacchari purificati gr.x. Fiat pulvis sextis horis capiendus ex pauxillo mellis, superbi- bendo haustum communem salinum. Make a powder to be. taken every six hours in a little honey, drinking immediately afterwards the common saline draught. 4. By narcotics. The opiates already prescribed. Cicuta, byosciainus, aconitum, digitalis, are sometimes employed with success, especially the first, with small doses of calo- mel, after having freely evacuated the bowels. , R. Succi cicutae spissati gr.v. Calomelanos gr.\. Fiat pilula quarta quaque hora sumenda. Make a pill to be taken every four hours. I "98 RHEUMATISM. R. Succi hyosciami spissati gr.v. Fiat pilula quarta quaque hora capienda. Make a pill to be taken every four hours. R. Succi aconiti spissati £r.ij. Fiat pilula ter in die adhibenda. Make a pill to be given thrice a day. R. Pulveris ipecacuanha compositi gr.v. - . _._ . tragacanthae compositi gr.xi). Tincturae digitalis gutt. x. Misturae camphorae scr.xiij. Syrupi simplicis dr.). Fiat haustus sextis horis adhibendus. Make a draught to be given every six hours. 5, By fomentations of bitter herbs with poppy-heads, or any narcotic herb, as cicuta, lactuca virosa, hyosciamus or belladonna, and camphorated liniments, which are more use- ful when a limb or joint is principally affected. R. Camphorae oz.fs. Olei olivas optimi oz.W. Fiat embrbcatio camphorata. Make a camphorated embrocation. As soon as any remission can be perceived ; or where there has been much perspiration accompanied by a deposite or sedi- ment in the urine; or where the exacerbations of the disease have been from its commencement strikingly periodical, Pe- ruvian bark is serviceable, either alone or with ammonia or guajacum. RHEUMATISM. 99 R. Decocti cinchonae dr.xiv. Extracti ejusdem gr.x. Tincturae cinchonae composite dr.), Syrupi corticis aurantii" dr.). Fiat haustus quartis horis, in apyrexia, sumendus, Make a draught to be taken every four hours during the apy- rexia. R. Spiritus ammonias compositi dr.), Tinctuias cinchonae compositi dr.)h. —Decocti cinchonas ic\. and reproduc- tion takes place a great number of times before the final so lution of the disease. CAUSES. Predisposing. Cold and moisture ; debility. Exciting. Most frequently a derangement of the intestinal canal. PROGNOSIS. Favourable. The aphthae appearing of a white, pearly colour; falling off early, and leaving the parts they occupied 144 THE THRUSH. clean, red, and moist. Salivation or moderate diarrhoea, at the period of separation. When the disease is long protracted, repeated crops are more favourable than the permanence of the original. Unfavourable. The disease affecting internal parts ; pro- ducing violent hiccup, oppression, pain referred to the sto- mach, vomiting, and sense of suffocation; the aphthae being, from the first, of a brown colour, or becoming so in the course of the disease ; their sudden disappearance ; the mouth and fauces unusually pallid previous to the eruption ; violent diarrhoea; coma; great prostiation of strength; any of the symptoms of putridity, accompanying cynanche maligna. See Cynanche. TREATMENT. Ji. To remove or moderate the concomitant fever. | i. To produce a separation of the aphthae. The.first indication must be fulfilled,— By the means laid down for the treatment of synocha, ty- phus fever, and cynanche maligna. The second,— I. By emetics, when other means are resisted. 2. Gentle laxatives, as manna, rhubarb, and castor-oil. R. Mannasoptimae oe.fs. Aquae anethi oz.). Solve : capiat infans cochleare medium subinde. Dissolve : the dose for an infant is a dessert spoonful occa- sionally. THE THRUSH. 145 R. Olei amygdalae dr.v. Syrupi roFae dr.x. M. cujus detur cochleare minimum pro re nata. Make a mixture, of which a tea spoonful is to be given as oc- casion may require. R. Mannae optimas dr.v). Pulveris rhabarbari dr.fs. Infusi sennae dr.ix. M. sit dosis cochleare medium. Mix. The dose a dessert spoonful. 3. Copious emollient clysters. R. Decocti avenas tenuioris oz.ii}. Olei olivae oz.fs. M. pro enemate octava quaque hora adhibendum.' Mix for an enema to be exhibited every eight hours. Veal broth also, with turnip radishes boiled in it, 4. By tonic and stimulant gargles. R. Decocti cinchonae oz.ij. Elixir vitrioli acidi dr.fs. Fiat gargarisma. Make a gargle. R. Decocti quercus oz.i). Pulveris Arabici dr.). Botacis purificati dr.). F. gargarisma. Make a gargle. N .y •' "^^Hs 14>6 THE THRUSH. R, Boracis purificati dr.)fs. Aquas florum sambuci oz.v], Tincturae myrrhae, Mellis rosae, aaox.fs. F. gargarisma. Make a gargle. ,^| R. Mellis ^eruginis ox.fs. ' rosae eas.jfs. , M. partibus affectis, ope penicilli, quarta quaque hora admo- vendum. Mix. The affected parts are to be touched with it by means of a camel's hair pencil every four hours. INVOLUNTARY DISCHARGE OF BLOOD. 147 ORDER IV. HEMORRHAGIC, OR INVOLUNTARY DISCHARGES OF BLOOD. CHARACTER. Pyrexia, with a profusion of blood, without any external violence; the blood drawn from a vein having the same ap- pearance as in the phlegmasia:. GENERAL CAUSES. External heat; sudden diminution o£ the weight of the at- mosphere; whatever increases the force of circulation; as, violent exertions of the body in general, or violent action in a particular part; particular postures of the body ; ligatures producing local congestion ; exposure to cold; external vio- lence. GENERAL TREATMENT. f*i. To put a stop to the discharge of blood. j 4. To Drevent its recurrence, by removing the Indications. < ..... • . causes by which it was excited. L3. To destroy the inflammatory diathesis. US HEMORRHAGE FROM THE NOSE. EPISTAXIS, OR H^M^RRHAGE FROM THE NOSE. SYMPTOMS. Sense of weight, and obtuse pain in the head; redness of the cheeks; inflation of the face, and of the vessels of the neck and temples; tinnitus aurium ; heavy pain, prominence and dryness of the eyes; vertigo ; itching of the nostrils, and sense of weight about the root of the nose ; in some instances, disturbed sleep and dreadful dreams; costiveness ; diminished secretion of urine; coldness of the extremities ; tension of the right hypocondrium ; these succeeded by a profusion of blood from the nostrils* CAUSES. Predisposing. A ceitain age ; i. e. the period puberty, and the decline of life; plethoric state of the system; peculiar weakness of the vessels of the part. Exciting. External heat; violent exertion; cold applied to the body ; particular postures of the body ; external vio- lence, TREATMENT. The indications mentioned in the general treatment of Hae- morrhage will be answered :— i. By the local means recommended in surgical works; erect position of the body, with the head somewhat reclined HEMORRHAGE FROM THE NOSE. 14,9 backwards; free exposure to cold air; cold applied to the neck, or immersion of the head in water impregnated with ammonia muriata; affusion of cold water over the genitals;. and astringent injections. R. Zinci vitriolati dr.>. Aquas distillatae oz.x. Fiat injectio. Make an injection. R. Tincturae ferri muriati dr.). Aquae distillatae ox.vj. Fiat injectio. Make an injection. R. Aluminis dr.'i). Aceti distillati oz.). Aquas distillatae oz.v). Fiat injectio. Make an injection. ^The second and third indications will be fulfilled by,— i. The means that obviate plethora, as the antiphlogistic diet, general and. local blood letting, purging, and diaphore- tics. These remedies are. more particularly required when the fever is considerable and the pulse strong. a. Refrigerants and diaphoretics; as, nitre and antimoniuni tartarisatum, N2 150 HEMORRHAGE FROM THE NOSB. R. Nitri purificati gr.vj. Vini antimonii tartarisati gutt x. Aquae distillatae dr.xl). Syrupi croci dr.). Fiat haustus sextis horis sumendus. Make a draught to be taken every six hours. 3. Astringents ; especially vitriolated zinc, alum, aceta< ceruse with opium. R. Zmci vitriolati gr.\- Aluminis purificati gr.x. Infusi rosas dr.xWj. Syrupi ejusdem dr.). Fiat haustus sextis horis capiendus. Make a draught to be taken every six hours. R. Cerussas acetatae gr.j. Tincturae opii gutt. x. Aquae cinnamomi dr.v. -----distillatae dr.x. Syrupi simplicis dr.). Fiat haustus octavis horis sumendus. Make a draught to be taken every eight hours. 4. Sedatives; especially digitalis and nitre. R. Tincturae digitalis gutt. x.—xxx. Nitri purificati gr.vj. Aquas menthae sativae dr.x'W). Syrupi croci dr.). M. pro haustu sexta quaque hora sumendo. Mix for a draught to be taken every six hourd. SPITTING OF BLOOD. 151 HEMOPTYSIS, OR SPITTING OF BLOOD. SYMFTOMS. Sense of weight and oppression in the chest; dry tickling cough ; peculiarly hard jerking pulse; difficulty of breath- ing; sense of pain and heat, referred to the sternum ; saltish taste in the niouih ; Hushed countenance; constant irritation at the top of the larynx, which excites hawking aud cough- ing, during which the profusion of blood takes place. CAUSES. Predi>pos::ii. A certain age; i. e. from the period of pu- berty to the thirty-fifth ye.r; sanguineous temperament j great sensibility and irritability; suppression of usual evacu- ations ; narrow conformation of the chest; previous affections of the same disease ; hereditary predisposition ; plethora. Exciting. Excessive heat of the atmosphere; violent ex- ercise ; inordinate exertion of the organs of respiiation ; ex- ternal violence. DIAGNOSIS. The blood being brought up by hawking and coughing; of a florid red colour; and mixed with a little frothy mucus ; reference to the predisposing causes. From hamatemesis. The blood thrown up in haematemesis is usually in much more considerable quantity ; of a darker colour; more grumous; mixed with other contents of the stomach ; and usually unattended with cough, 152 SPITTING OF BLOOD. PROGNOSIS. Favourable. The disease arising from common causes on- ly, and not from hereditary predisposition, or inalconforma- tion of the pulmonary system. The blood being small in quantity, and of a bright red colour. Its not being followed by cough, dyspnoea, pain, or other affection of the lungs. Unfavourable. The reverse of the above. TREATMENT. Indications. See general treatment of Haemorrhage. The indications will be answered by,— i. Carefully avoiding heat, and every kind of bodily exer- tion. s. Making'use of a light vegetable diet. 3. Bleeding, where symptoms of inflammatory diathesis are indicated by the hardness and peculi.ir jerk of the pulse; the constitution of the patient; the florid colour of the blood eva- cuated from, the lungs. Qn the contrary, where there are marks of debility and laxity, and the blood is of a dark colour, depletion isimpro. per. Dr. Percival. 4. Cooling purges, of magnesia vitriolata, or natron vi- triolatum, in infusion of roses. R. Infusi rosae oz.vij. Magnesias vitriolatas dr.v). Spiritus pimento oz.fs. M. cujus capiat aeger cochlearia iv sexta quaque hora. Make a mixture of which the patient is to take four spoonfuls every six hours. SPITTING OF BLOOD. 153 5. Refrigeiants ;—nitre;—sulphuric.acid 5—ammonia mu- riata. R. Infusi rosae oa.ij. Nitri purificati jrr.fs. Tincturas opii gutt. v. M. fiat haustus tertia vel quarta quaque hora sumendus. Mix into a draught to be taken every three or four hours. R. Acidi sulphuric! diluti dr.fs. Aquas distillatae dr.xv. Tincturae opii gutt. v—xv. Syrupi rosae dr.). Fiat haustus tertia vel quarta quaque hora capiendus. Make a draught to be taken every three or four hours. R. Cremoris tartari dr.ii). Nitri purificati dr.l). M. capiat aeger dr.fs. pro dosi ex cyatho parvo aquae hordei. Mix. The patient to take half a drachm for a dose in a small cup of barley water. Draughts of cold water acidulated with lemon-juice. 6. Astringents {—vitriolic acid ;—cerussa acetata ;—tine- tura saturnina, R. Cerussa; acetatae gr.vj. Opii purificati gr.iij. Conservae cynosbati q. s. ut fiant pilulas nun.tro sex. Sit dosis una vel altera bis, ter, quaterve in dies. One or two doses to be taken twice, thrice, or four times a day. 154 MENORRHAGIA. The cerussa acetata draught, page 150. R. Tincturae saturninas gutt. xx---xl. , Aquas distillatae dr.x'i). - Syrupi simplicis dr.). Fiat haustus ter in dies sumendus. m Make a draught to be taken thrice a day. 7. Sedatives ;—digitalis ;—hyoscyamus. 8. Emetics are recommended by Dr. Darwin. 3. Nauseating medicines;—antimonium tartaiisatum in small and repeated doses. 10. Inhaling sedative airs ;—hydro carbonate. 11. Limited use of liquids. 12, Cold lotions externally applied ;—vinegar and water; a solution of ammonia muriata. Where symptoms of debility prevail—blisters to the chest; bark; opium; chalybeates. MENORRHAGIA, OR IMMODERATE FLOW OF THE MENSES. A flow of the menses is to be considered as immoderate, when it either returns more frequently than what is natural, continues longer than ordinary, or is more abundant than is usual with the same person at other times. It may be the effect of two different and opposite states of the system: plethora with inordinate arterial vigour; and general relaxation or debility. MENORRHAGIA. 155 SYMPTOMS. - An immoderate flow of the menses, arising from plethora, is usually preceded by rigors, acute pains in the head and loins, thirst, turgid flushed countenance, universal heat, and a strong, hard pulse: on the contrary, where the symptoms of debility are prevalent in the system, the pulse is small and feeble, the face pallid, the respiration small and homed on the slightest effort ; the general, leucophle..matic appearance of the patient indicates a laxity of every muscular fibre ; the pains of the back and loins are rather aching than acute. causes. The causes which predispose to the disease are plethora ;— a laxity or debility of the organ, arising from frequent child- bearing ;—difficult and tedious labours, ur repeated miscar- riages; a sedentary and inactive life, indulging much in grief and despondency ; living upon a poor, low diet; drinking freely of warm enervating liquors, such as tea and coffee ; and living in warm chambers. The exciting causes of menorrhigia are, violent exercise, mon- especially in dancing; strokes or concussions on the belly ; strains ; passions of the mind ; violent straining at Stool; excess in venery, particularly during menstruation j —the application of wet and cold to the feet; organic affec- tions of the uterus, such as scirrhus, polypus, &c. PROGNOSIS. Menorfhagia, when it is the effect cf plethora, rarely proves fatal ; but when it occuis in habits much reduced by previous disease, or is produced by a laxity of the vessels of the organ, is profuse, long continued, or of frequent recurrence; if the lips, nails, and other parts, be pale; if the extremities become cold, and with these symptoms the patient falls into 156 MENORRHAGIA. syncope, especially if there be any convulsions of the limbs, the danger is very great. When it arises from an organic af- fection of the part, which is frequently the case after the age of forty-five, it is usually incurable. TREATMENT. The cure of menorrhagia consists in :— i. Strictly confining the patient to an horizontal posture; especially avoiding every exertion both of body and mind. a. Keeping the body gently open by laxative medicines that have but little stimulus. R. K*!i tartarisati oz.fs. Manna; cpnmae dr.v). Aquas ferventis oz.v). Tincturae lavendul* compositas oz.fs. Fiat mistura cujus capiat asger cochlearia tria pro re nata. Make a mixture of which the patient should take three spoons ful as occasion may require. R. Magnesias vitriolatas Gr.iij. Aquae frigidas oz.x. Fiat enema. Make an enema. 3. Administering draughts of acidulated cold liquors fre* quently, as infusion of roses, lemonade, and the like. 4. The internal use of styptics, especially cerussa acetata, as directed against haemoptysis, page 153. 5. When symptoms of debility are present, tonic astrin- gents .• cinchona, cascarilla, kino, quercus, and wine. 6. The constant application of astringents to the vagina and hypogastric region j especially ice, very cold water, vi- negar and water. 157 H./EMATEMESIS, OR VOMITING OF BLOOD. An hemorrhage of dark coloured, grumous blood from the stomach, in considerable quantity, mixed with alimentary matter, and preceded by a sense of weight and obtuse pain or anxiety in the region of the stomach. CAUSES. The general causes of haemorrhage, as plethora—suppres- sion of evacuations, &c—tumors compressing the liver or spleen ;—external violence :—obstructions in any neighbour- ing visous.' TREATMENT. Indications. See the general treatment of Haemorrhagy. If accompanied by symptoms indicating inflammatory dia- thesis,—bleeding, and the antiphlogistic regimen, with digi- talis. If not,—tonics and astringents ; vitriolic acid with opium. Opium in large doses is recommended by Dorffinuller. Cerussa acetata, as directed CHARACTER* An evacuation of urine, mixed with blood, preceded, when not the effect of injury, by pain, and sense of weight, in the loins ; pain and heat in the region of the kidney. cause. It is most frequently symptomatic of other renal affections. See Nephritis, and Calculus Rmalis.—Ox it arises from ex- ternal violence, or great exertion. It may be produced by any of the causes of haemorrhage before enumerated. PROGNOSIS. It is distinguished from the high-coloured urine, attendant on many diseases, by the deposite of a coagulum to the bot- tom of. the vessel, and by its staining linen of a red colour. TREATMENT. If the disease be the consequence of injury, or the patient be of a full plethoric habit,—bleeding,—^refrigerants,—as ad- vised under the head of haemoptysis. Saline purges of magnesia or natron vitriolatum. Astringents ;—infusion of roses with an additional quanti- ty of vitriolic acid. Uva ursi, in powder s one scruple three times a day. The double acidulated soda-water for a common drink. HEMATURIA 159 Opium, in small doses, every four or six hours. Decoction of peach^leaves. - If it arise from irritation of the kidney by calculus, together with the remedies proper for that disease, frequent draughts of mucilaginous liquids; as thick barley-water, solution of gum Arabic, decoction of marsh-mallows sweetened with honey.— ' Opium ;— copious emollient clysters. Should there be concomitant symptoms of debility, power- ful astringents ;—*alum;—tinctura ferri muriati;—terebii*- thina, &c, 16ft ORDER V. PROFLUVIA, OR FLUXES WITH PYREXIA. CHARACTER. Pyrexia, with an increased secretion, not naturally bloody. CATARRHUS, OR CATARRH. C Catarrhus ajriaore, common cold. Species. J . , ■ n 1 j . — contagious, the influenza. An increased secretion of mucus from the mucous mem- brane of the nose, fauces, and hronchiae, attended with py- rexia. SYMPTOMS. . Pyrexia ;—weight and pain in the head ;—oppression of the chest, and impeded respiration ;—sense of fulness and stopping' up of the nose ;—watery inflamed eye.-* ;—coryza ;—cold shi- verings, succeeded by transient flushes of heat;—soreness of CATARRH. 161 the fauces and trachea ;—cough ;—pains about the chest;— rheumatic pains in the neck and head ;—increased secretion of mucus from the mucous membrane of the nose, fauces, and bronchias. CAUSES. Remote. Cold applied to the body ;—contagion. Proximate. An inflammation of the mucous membrane of the nose, fauces, bronchias, &c. PROGNOSIS. It is seldom attended with danger, when in the mild form, and arising from common causes. Unfavourable. Predisposition in the constitution to phthi- sis ;—tendency to asthma, or peripneumonia. TREATMENT. ,. .. ,.- J To reduce the febrile action of the system. Indications. \ . - _ l_To allay the irritation of the affected parts. General bleeding may be necessary, if the type of the fevei be synocha], and the symptoms are violent : in such 'cases purges will be beneficial, saline diaphoretics, and the antiphlo- gistic diet, as recommended against synocha, or inflammato- ry fever. When the system evinces typhoid actions, the contrary must be observed. ' The second indication require?,— i. Frequent use of tepid diluents, mucilaginous and oily demulcents. , 02 162' CATARRH. R. Spermatis ceti dr.i). Vitellum ovi unius. Syrupi simplicis og.fs. Aquae cinuamomi oz.i). ----distillatae oz.tv. Fiat mistura cujus capiat aeger cochleare magnum frequenter. Make a mixture of which the patient is to take a table spoon- ful frequently. R. Olei amygdalae dr.v). Syrupi tolutani ox.). Aquae distillatae oz.v. ——- kali preparati q. 8. Fiat emulsio cujus sumantur cochlearia duo secunda quaque hora, vel urgenti tusse. Make an emulsion of which two spoonsful are to be taken every two hours, or when the cough is troublesome. R. Mucilaginis Arabici oz.jfs. Aquae cinuamomi oz.v. Syrupi mori oz,). M. cujus sit dosis cochleare medium urgenti tusse. Make a mixture of which the dose is a dessert spoonful when the cough is troublesome. z. Mild expectorants and diaphoretics. R. Aceti scillae dr.). f Aquae menthae satiVas oz.v. Syrupi croci e».j.. M. cujus sumat cochleare magnum quando raucedo urget. Make a mixture of which a table spoonful is to be taken when the hoarseness is troublesome. CATARRH. 163 R. Oxymellis scillae oz.C*. Spiritus aetheris nitrosi * dr.'i). Aquas menthae sativae oz.v. Syrupi corticis aurantii Gr.iij. Fiat mistura de qua capiat asger cochleare magnum subinde. Make a mixture of which the patient is to take a table spoon- ful now and then. R. Nitri purificati dr.). Lactis amygdali oz.vi), Tincturae scillas dr.). Syrupi tolutani oz.fs. M. sit dosis cochleare magnum subinde. H Mix. The dose a table spoonful now and then. 3. Mild opiates and diaphoretics when the inflammatory diathesis is reduced. R. Syrupi papavetis albi oz,). Nitri purificati dr.). Aquae menthae sativae oz.v). Fiat mistura. M:;ke a mixture. R. Syrupi papaveris albi oz,). Oxymellis scillae oz.fs. Aquas menthae sativae ox.v). Fiat mistura cujus sumantur cochlearia duo magna tertia qua- que hora. Make a mixture of which two table spoonsful are to be taken every three hours. 164 DYSENTERY. R. Pulveris ipecacuanhae compositi gr.ijli,. Conservae rdsae q. s. Fiat pilula quarta quaque hora sumenda. Make a pill to be taken every four hours. The trochisci glycyrrhizas cum opio. R. Decocti hordei compositi o«.xivfs. Syrupi papaveris albi ea.jfs. M. cujus capiat aeger cyathuin vinosum parvum secunda qua- que hora. Make a mixture of which the patient is to take a small wine glass every two hours. . -4. Blisters to the, breast, if there be uneasiness thera, or pain, or difficult expectoration, or sev-.se of oppression. 5. Inhaling the steam of warm water. DYSENTERIA, OR DYSENTERY. „ SYMPTOMS. The disease sometimes comes on with cold shiverings and other symptoms of fever 5 at Others, the local affection is first perceived. Costiveness ; unusual flatulence in the bowels; severe griping ; frequent inclination to go to stool; tenes- mus ; loss of appetite ; nausea; vomiting; febrile heat, and frequency of pulse; frequent discharge of a peculiarly fetid matter from the anus, varying in appearance; being some- times pure mucus, or mucus mixed with blood ; pure unmixed blood 5 pus, or a putrid sanie3, proceeding from ulcerated or DYSENTERY. 165 gangrenous parts ; and often films of a membranous appear- ance, or small sebacious masses, floating in a large quantity of liquid matter. Masses of indurated faeces are likewise sometimes passed by stool. Great emaciation and debility 5 quick and weak pulse; sense of burning heat, and intolerable heaiing down of the parts; hiccup; and not unfrequently a fatal termination etisue. CAUSES. Remote. A specific contagion. All those causes capable of inducing spasm and ulceration; much moisture, succeed- ing quickly to intense heat; unwholesome and putrid food ; noxious exhalations and vapours. Proximate. Spasmodic constriction and ulceration of the colon. PROGNOSIS. Favourable. A gentle diaphoresis ; the stools becoming yellow, and less frequent; the strength little impaired; se- diment in-the urine; the disease arising from common causes. Unfavourable. The disease having become habitual by long continuance ; violent and distressing tenesmus and tor- mina; vomiting; hiccup; aphthae; difficult deglutition; convulsions; cold extremities; delirium; cold and partial Sweats; the tongue preternaturally red and 'dry ; the pain suddenly ceasing; great prostration of strength ; the faeces extremely fetid ; petechias ; involuntary evacuations ; inter. mining pulse ; the disease being complicated with others; as with affections of the liver, with intermittent fever, &c. 166 DYSENTERY. TREATMENT. i. To remove the concomitant fever. 2. To evacuate the matter contained in the intestines. 3. To lessen irritation, and to restore the tone of the intestines. To fulfil the first indication, the type of the fever roust be ascertained. If it be synocha, and the inflammatory diathesis prevail, blood-letting and the antiphlogistic regimen must be re- sorted to, but this will seldom be necessary, for the fever mostly assumes a putrid tendency, when the treatment proper for typhus will be required. If it assume the intermittent form, cinchona and tonics must be resorted to. 1 The second indication requires,— I. An emetic of ipecacuanha or vitriolated zinc. The haustus emeticus communis, page 19, R. Zinci vitriolati scr.). Aquas distillatae ozij. Fiat haustus emeticus. Make an emetic draught. 2. Cathartics. Of this class of medicines rhubarb has been very much preferred : calomel has also been highly ap- proved ; and where there is a tendency to inflammation, or the dejections manifest a total absence of bile, no other ca.thar tic will be so effectual. Indications. DYSENTERY. 167 R. Olei lini, Tincturae rhabarbari, aadr,\). M. fiat haustus semel vel bis quotidie sumendus. Mix into a draught to be taken once or twie? a day R. Pulveris rhabarbari dr.fs. Confectionis aromaticae ser.). Tincturae rhabarbari dr.'\fe. Aquae menthae piperitidis oz.)i$ Syrupi croci dr.). Fiat haustus. Make a draught. The refrigerent cathartics alone, or conjoined with manna, have been long employed, especially by the army physicians, with the greatest advantage. R. Magnesias vitiiolatae dr.v). Infusi rosae oz.v). Syrupi zingiberis oz.fs. Fiat mistura cujus capiat aeger cochlearia quatuor pro re nata. Make a mixture, of which the patient is to take four spoons- ful occasionally. R. Magnesias vitriol. ■ as dr.v). Mannae optimas oz.). Aquas menthas piperitidis ox.v). M. cujus sit dosis cochleiria quatuor. Make a mixture of which a d se is four spoonfuls. The nation vitriolaium, and soda pho-phorata, may bf used in the same doses a« the vitriolated magnesia. The oleum ricini is a very excellent purge. 168 DYSENTERY. Ipecacuanha, administered in such doses as not to prove emetic, but to act on the bowels, is perhap6 the most effectual cathartic in dysentery. 3. Large emollient clysters :— R. Amyli dr.x'i). Aquae feventis Os.xvj. Fiat enema bis terve die injiciendum. Make an enema to be injected twice or thrice a day. Clysters of mutton broth and arrow-root. 4. Emetic and purgative medicines combined. R. Magnesias vitriolatas oz.). Antimonii tartarisati gr.iij. Infusi sennas' cz.vj. Syrupi rosae oz.fs, Fiat mistura cujus adhibeantur cochlearia tria magna -pro re nata. Make a mixture, of which three table spoonfuls are to be - given occasionally. To fulfil the last indication, several remedies are used. 1. Mucilaginous demulcents; as, solutions of.gum Arabic in milk ; preparations of barley, arrow-root, linseed, Salop, and the like : the wax emulsion : R. Cera? flavae Gr.iij. Saponis Hispanici dr.). Aquae distillatae oz.fs. Leni calore, post solutionem, adde— After dissolving in a mild heat, add Aquae distillatae lb.)fs. Syiupi ex~althaea- oz.i). \Jt fiat emulsio, cujus sit dosis cyathum parvum subinde. To make an emulsion, of which a small cupful is to be taken now and then. DYSENTERY. 169 R, Gummi Arabici in pulverem triti oz.\). Decocti hordei Ib.i) Succi limonis oz.i) Bibat aeger pro potu ordinario. The patient to drink the above for his common drink. 2. Fomentations and embrocations to the abdomen. A strong decoction of poppy-heads. R. Camphorae *ir.vj. Opii optime pulverisati dr.Y). Olei palmas vel macis oz.iij. Fiat unguentum cujus illinenduni sit quantitasnucis moschatse ter quotidie. Make an ointment, of which the size of a nutmeg is to be rubbed on thrice daily. R. Linimenti saponis dr.xi). Tincturae opii Gr.iij. Olei essentialis caryophyllorum aromatico- rum dr.). Fiatembrocatio subinde utenda. Make an embrocation to be used occasionally. 3. Mucilaginous clysters with opium ;— The starch clyster, with a drachm of laudanum, every six or eight hours. 4. Diaphoretics; especially Dr. Dover's powder. R. Pulveris ipecacuanhae compositi gr.iij, Conservas rosae q. s. Ut fiat bolus quarta quaque horaadhibendus^ To make a bolus to be given every four hqrjrg, P 170 BYSENTERY. Jt. Pulveris ipecacuanhas compositi gr.x—xx. Conservas rosae q. s. Fiat bolus singulis noctibus sumendus. Make a bolus to be taken every night. 5. Opium ; alone, or united with antimony or nitre. 6. Antimonials : the vitrum antimonii ceratum, as recom- mended by Sir John Pringle, 7. Tonics and astringents, at a more advanced period of the disease, when the frequency of the dejections seems rather to proceed from a weakened and relaxed state of the bowels than from any remains of malignancy; especially quassia, angustura, Colombo, cascarilla, simarouba, verbascum, ca* techu, kino, mix vomica, arnica, hasmatoxylum, lime-water, bignonia capriolata, baked bread, nitrous acid with opium. R. Corticis angusturae contusae dr.i). * exterioris aurantii Hispalensis, Radicis colombse, aa dr.). Aquae ferventis lb.). Macera, et liquorem frigefactum cola. . Macerate and strain the liquor when cool. R. Infusi colati dr.xii). Tincturae cardamomi composite dr.). Tincturas opii gutt. x. Fiat haustus octava quaque hora capiendus. Make a draught to be taken every eight hours. The cascarilla and other tonics above mentioned may be made into an infusion in like manner. DYSENTERY. 171 R. Acidi nitrosi dr.i). Opii purifica*ti gr.ij. Aquas distillatae dr.xv). M. capiat asger cochleare minimum quater in die, ex cyatho parvo aquas hordei. Make a mixture, of which the patient is to take a tea spoonful four times a day, in a small cup of barley water. R. Extracti hasmatoxyli dr.) Misturas cretaceae oz.iv. Tincturae catechu dr.l). Spiritus nucis moschatae oz.). M. cujus sit dosis cochlearia tria magna tertia vel quarta qua- que hora. * Make a mixture, of which the dose is three table spoonsful, every three or four hours. R. Confectionis aromaticae dr.'i). Aquas cinnamomi oz.v. Spiritus pimento ox.). Tincturae kino dr.i). Fiat mistura singulo dosi cujus adde guttas x, tincturae opii pro re nata. Make a mixture ; to each dose of which add ten drops of tine- tura thebaica as occasion may require. There has been much difference in opinion with respect to the propriety of administering cinchona in dysentery; Its use is more particularly serviceable in those cases where the at- tendant fever assumes the remittent form, or where the, disease is complicated with typhus, or with intermitting or remitting fevers. Sir John Pringie recommends the cinchona to be joined with serpentaria Virginiana, and Dr. Akenside gave it com- bined with a cathartic. 172 DYSENTERY. On the continent, the mix vomica, arnica montana, bigno- nia capriolata, and sulphur, in large and frequent doses, are the favourite remedies. Dr. Thomas informs us, in his Practice of Physic, that, during a residence in the West Indies, he was in the habit of recommending a strong decoction of logwood, with the bark of the pomegranate and cherry-tree, as an astringent drink, from which his patients seldom failed to experience a good effect. The means above, mentioned will be found totally inade- quate to the cuiecf chronic dysentery, if a dusky sallow hue ' of countenance, tenderness upon pressure in the region of the liver, and a clayey appearance of what faeces happen occa- sionally to be voided, manifest the presence of a diseased ©r obstructed state of the l'ver. In such cases mercury is the only remedy ; and this should be pushed to such an extent, as to keep up a gentle affection of the mouth until the symptoms I begin to be mitigated. ' Every kind of food which tends to putridity should be r.voided, also spirituous liquors; and the strength should be supported by light preparations of barley, rice sago, Indian arrow-root, flour, panada, and gelatinous broths. . 173 fir +< SYNCOPE, OR FAINTING. ■{ Syncope accidentalis. Species. ^ ■ ■ cardiaca. —anginosa. SYMPTOMS. Remarkable anxiety about the heart, followed by a sudden deprivation of til the animal and vital powers and actions : of puise, of sense, and motion. Sometimes the less of sense is incomplete (leipothymia), when the patieRt turns cold and,, pale, yet the pulse continues to beat, or rather to tremble, and respiration is just perceptible ;—at others (asphyxia), not FAINTING. 185 the smallest sign of life can be perceived ; the face hath a deathlike paleness, fhe extremities are cold, the eyes shut, the mouth sometimes shut and sometimes open, the limbs flaccid, and the strength quite gone. A recovery is announced by deep and heavy sighs ; and is frequently accompanied with vomiting. It sometimes terminates in epilepsy and convul- sions. Predisposing. Nervous irritability and delicacy of consti- tution ; debility, however induced ; profuse evacuations, es- pecially of blood ; violent passions of the mind ; surfeits ; excessive pain ; organic diseases of the heart or large vessels. Proximate, D minvshed action of the heart and arteries; or their total quiescence. TREATMENT. Indications. i. During the paroxysm, to excite the re. turn of the action of the heart and ar- teries. a. In the interval, to prevent the r.ecur rence of the disease. The first indication requires,— i. Bleeding, when the disease has arisen from any other than a debilitating cause ; in that instance evacuations would be prejudicial. - i. Emetics, if the patient be capable of swallowing ; moie especially indicated in 6>ncope arising from any cause of sa- burra. Vomiting may be sometimes excited by tickling the fauces with a feather dipped in some stimulant liquor. 186 FAINTING. 3. Acrid stimuli applied to the nose; and taken internally, as soon as the capacity of swallowing riturns; such as the ammonia preparata, and liquor volatilis cornu cervi. When syncope is induced by large evacuations of blood*, diffusive stimuli are prejudicial. To fulfil the second indication,— 1. the causes must be removed by which it was induced.— If debility, by tonics ; as bark, steel, &c.—antispasmodics. a. Other remedies, adapted to the several causes above enu- merated. When fainting fits are produced by organical affections ot the heart, or neighbouring viscera, all that can be done is to palliate syirptoms of fainting, and endeavour to lemovethe primary disease. Of Syncope Anginosa, or Angina Fectork. SYMPTOMS. Upon exercise, especially when walking up an ascent, and after a full meal, a sudden and violent pain across the chest, extending down the arm as far as the insertion of the dehoid muscle, accompanied w'th a sense of stricture, so acute as to thi^aten immediate destruction. The patient is instantly 'obliged to stand still, and the moment he does so, all the ANGINA PECTORIS. 187 symptoinb vanish. After repeated attacks of the disease, it is excited by slighter-causes, and the paroxysms become more violent. Tlie pulse sinks, and becomes weak and irregular; the countenance pale ; cold sweat; constant cough ; expec- toration of viscid mucus ; the patient becomes incapable of lying down ; at length a fit more violent than usual, puts an end to his miserable existerke. Ossification of the coronary arteries ; yet many dissections have shown this not to be invariably attendant. Ossification * of the valves of the heart ; morbid accumulation of fat; inca- pacity of action in the heart; excited by every thing which hurries the circulation, and accelerates the passage of the blood to the depraved organ ; as violent exertion, certain passions of the mind, sneezing, coughing, stiaining at stool, &c. TREATMENT. Indications. [" i. In the paroxysm, to alleviate the di;. tressing symptoms above described. I 2. In the interval, to prevent the return of [_ DYSPEPSIA, OR INDIGESTION. SYMPTOMS. Want of appetite ;—distention of the. stomach ;—flatulent' eructations :—gereul debility, languor, and aversion to mo- tion ;—dejection of spirits; spasmodic pains in the region of the stomach ; nausea ; acrid eructations;—sometimes rumi- nation ;--sense of oppression and sinking after eating ^—-heart- burn ;—irregularity of appetite ;—either obstinate costiveness,. ,., or diarrhoea ;—small slow pulse, quickened upon the slightest exertion ;—palpitation ;—flushed countenance after a meal ;— the tongue dry, and generally white in the morning ;—pale urine ;— cold extremities ;—sallow countenance ;—various af- ; fec|ions of the senses ;—d-praved vision, &c. Pain in the head and breast 5--.dry skin ; sometimes, however, profuse INDIGESTION. 189 diaphoresis or salivation ; disturbed sleep ; frightful dreams ; hectic fever; symptoms of hypocondriasis. CAUSES. Everything which debilitates the system in general, or the stomach in particular; narcotics; as opium taken in immo- derate quantities, spirituous liquors, tea, tobacco, &6\ the frequent use of warm relaxing liquids; sedentary life; imper- fect mastication ; certain depressing affections of the mind ; too flatulent or farinaceous diet; excessive evacuations; the too powerful operation of emetics and purgatives ; diseases of the liver; hysteria; hypochondriasis; aliment taken into the Stomach in too large quantities ; excess in venery; exposure to moist and cold air ; deficiency in the secretion of bile, sa- liva, or gastric juice. DIAGNOSIS. From hypochondriasis.—See Hypochondriasis. TREATMENT. . | i. To remove those causes which are obvious, I and continue to operate. Indications. -^ z. To palliate urgent symptoms. J 3. To restore the tone of the stomach, and I prevent the recurrence of the disease. The first and most important step to be taken in the cure of dyspepsia is to point out to the patient the indispensable necessity of removing such habits and pursuits as may have tended to give rise to the disease, and continue to aggravate it: until this has been effected, remedies will be found of no avail, 190 INDIGESTION. The cure will then consist,— i. In the occasional exhibition of a gentle emetic, to remove crudities from the stomach, indicated by nausea, sense of weight and oppression, and eructations of imperfectly digest- ed food. a. In correcting morbid acidity, by alkalies and absorbents alone, or united with laxatives. ' R. Aquae kali puri dr.i). — - calcis os.vjfs. M. cujus capiat aeger cochleare magnum bis in die ex poculo jusculi bovini. Make a mixture, of which the patient must take a tabic spoonful twice a day, in a cup of beef broth. R. Misturae cretaceae oz.)fs. Spiritus myristicas ., dr.i). Syrupi zingiberis dr.). Fiat haustus mane seroque sumendus. Make a draught to be taken morning and evening. R. Kali prepafati dr.]fs, Myrrhae contusae dr.). Aloes socotrinas dr.)f$. Croci dr.fs. Aquae distillatae lb.]. Coque ad oz.xij. et liquori colato adde— Boil down too*.xij. and to the strained liquor add Tincturas cardamomi composite es.iv. Sit dosis cochlearia duo magna bis die. The dose two table spoonfuls twice a day. INDIGESTION. 191 3. In obviating costiveness by warm and gentle laxatives. R. Rhabarbari in pulverem triti, Magnesias ustas, utriu&que dr.W], Corticis cinnamomi contusi dr.). Aquae ferventis oz.x. Magnesia et rhabarbaro prius rite contritis, in vase idoneo macera, et liquorem cola, dein adde— The magnesia and rhubarb, being first well rubbed up to- gether, are to be macerated in a proper vessel, and the liquor strained : then add Tincturas corticis aurantii1 ox.). Sumantur cochlearia tria singulis auroris. Three table spoonfuls are to be taken early every morning. R. Aloes socotrinae, Pulveris rhabarbari, aa dr.)fs. Saponis veneti dr.fs. Syrupi zingiberis q. 5. Fiat massa in pilulas L dividenda, quarum sumat duas rel tres pro re nata. Make a mass to be divided into fifty pills, of which two or three are to be taken occasionally. R. Pulveris rhabarbari gr.xij. Calomelanos gr.iv. Pulveris zingiberis gr$. Fiat pulyis aperiens. Make an aperient powder. 192 INDIGESTION. R. Extracti colocynthidis compositi scr.). Pilulae galbani compositas Jrr.ij. Fiat pilulas xviii. quarum sumat ties pro re nata. Make eighteen pills, of which three are to be taken occa- • sionally. R. Pilula? ex aloe cum myrrha dr.). Extracti gentianae dr.fs. Fiat pilulas xviii. quarum sumat tres pro re nata. Make eighteen pills, of which three are to betaken occa sionaily. R. Pulveris aloes cum ferro dr.). Extracti taraxaci dr.)fs. Fiat pilulas xxx. quarum sumat tres pro dosi. Make thirty pills, of which three are to be taken for a dose. 4. In relieving pain by demulcents, carminatives, antispas- modics, and opiates. R. iEtherjs vitriolici dr.fs. Tincturae opii gutt. xv. Aquas cinnamo'mi dr.x. M. pro haustu in dolore sumendo. Mix for a draught to be taken when in pain. R. Pulveris tragacanthae compositi dr.). Tincturae cardamomi compositas oz,fs. Confectionis aromaticae dr.). Aquas menthae pipentidis oz.vi). Syrupi zingiberis oa.fs. M. cujus sumat aeger cochlearia tria magna urgenti flatu vel dolore. Make a" mixuuej of which the patient is to take three table spoonsful when the flatulency or pain is distressing. INDIGESTION. 193 R. Magnesias ustas drj. Aquae calcis oz.vij. Tincturae cardamomi oz.fs. Fiat mistura cujus sumat asger cochlearia tria magna in do. lore. . Make a mixture, of which the patient is to take three tabl spoonsful when in pain. R. Confectionis aromaticae dr.). Spiritus astheris vitriolici compositi oz.fs. Misturas camphorae oz.vij, Syrupi zingiberis oz.fs. M. sumantur cochlearia tria magna in dolore. Mix : three table spoonsful to be taken when in pain. 5. In removing diarrhoea, should it accidentally occur, by absorbents ; and if the faeces be of an unnatural clay-like or whitish colour, by mercury, especially calomel. R. Confectionis aromaticae dr.fs. Misturas cretaceas dr.x. Tincturas opii gutt. x. -Fiat haustus urgenti diarrhoea capiendus. Make a draught, to be taken when the diarrhoea is trouble- some. R. Hydrargyri cum creta gr.x. Fiat pulvis bis terve die sumendus. N> Make a powder to be taken twice or thrice a day. 6. In restoring the tone of the stomach by bitters combi- ned with astringents and aromatics ; the mineral acids; cha- lybeates; by universal temperature; cold bathing; by the use of mineral waters, more particularly those of Buxton and. R 194 INDIGESTION. Seltzer; by a diet consisting of light animal food, carefully avoiding the more indigestible foods and farinaceous vegeta- bles ; by abstaining from malt liquor, and employing soda- water and toast and water, weak brandy and water, or water mixed with the least aceseent wines, as Madeira, or Sherry, as common drink; and, lastly, by warm clothing, more espe- cially about the feet and legs. R. Quassias rasuras dr.). Corticis aurantii Hispalensis dr.jfs. Aquae ferventis lb.). Stent in vase aperto per horae spatium et cola. Infusi colati capiat aeger cochlearia quatuor bis quotidie. To stand in an open vessel for the space of an hour, and then to be strained. The patient to take four table spoonfuls of the strained infu- sion twice daily. R. Radicis colombae, ■ • gentian*, ■ ■• calami aromatici Corticis aurantii Hispalensis, aa dr.i). Vini albi Hispanici Ib.i). Infundantur per dies octo : hujus infusi capiantur cochlearia tres ter in die. To be infused for eight days: of this infusion three table spoonsful are to betaken thrice a day. R. Infusi gentianae compositi dr.x. Natri preparati gr.v. Spiritus pimento, Tincturas colom'iae, aa dr.). Fiat haustus bis quotidie, jejuno ventriculo,. sumendus. Make a draught to be taken fasting, twice a day. VAPOURS, OR LOW SPIRITS. 195 R. Elixir vitrioli acidi dr.jfs. Tincturas cinchonae compositas ox.ij. M. capiat aeger cochleare unum vel alterum minimum bis in dies ex cyatho parvo aquae purae. Mix : the patient to take one or two tea spoonsful twice a day in a small cup of pure water. R. Vini ferri dr.i). Tincturas colombae dr.). Infusi quassias dr.x. Fiat haustus ter in die sumendus. Make a draught to be taken twice a day. HYPOCHONDRIASIS; VAPOURS, OR LOW SPIRITS, SYMPTOMS. Dyspepsia ; sense of heat and pain in the hypochondria ; languor; listlessness ; want of resolution and activity; dis- position to seriousness, sadness, and timidity as to future events ; an apprehension of the worst, and most unhappy state Of them, and therefore upon slight grounds a dread of great evil. Particular attention to health ; and, upon any unusual feeling, a fear of imminent danger, and even death itself. In respect to all these feelings and apprehensions, the most obstinate belief and persuasion. 196 VAPOURS, OR LOW SPIRITS. Predisposing. The melancholic temperament. Exciting. All the causes of dyspepsia (see Dyspepsia) ;— every sedative impression upon the mind. Proximate. A torpid state of the brain and nervous sys- tem. DIAGNOSIS. From dyspepsia. By the affection of the mind being greater, that of the stomach less, than in idiopathic dyspepsia. Hypo- chondriasis occurs only in the melancholic temperament, at the middle period of life, and is increased as age advances; dyspepsia chiefly occurs in the sanguineous temperament, at an early period of life, and is diminished by time. PRpCNOSIS. Unfavourable. The melancholic temperament exquisitely formed, as indicated, previously to the disease, by the usual mental and corporeal characteristics, when, not unfrequently, it terminates in confirmed melancholia ; combined with other diseases, which are aggravated by a diminished energy of the brain and nervous system ; the long continuance of the disease often inducjng scirrhus of the viscera, and various cachectic affections. Judications. •* TREATMENT. To restore the energy of the brain and nervous system; and to obviate the morbid association of ideas, by which the disease is characterized. To remove the dyspepsia and other con- comitant symptoms. VAPOURS, OR LOW SPIRITS. 197 The first indication can alone be accomplished by diverting the attention of the patient from his own feel;ngs by change of tcene ; engaging his attention by new and interesting objects ; convivial society ; various amusements and rural sports ; mo- derate and regular exercise ; gaining his confidence; condo- ling with him rather than ridiculing his foibles ; and persua- ding him of a gradual recovery from his ideal illness, by some innocent medicaments regularly administered. The second, by ; — i. The treatment laid down for the cure of dyspepsia. 2. Chalybeate mineral waters. 3. Tonics and antispasmodics; particularly Peruvian bark; preparation of steel,—castor,—camphor,—valerian,—assafas- tida,—opium. 4. Blisters, and sinapisms. 5. Mercurial purges. 6. Mercury, even carried so far as to affect the mouth, has been attended with much success. 7. Warm and cold bathing. 8. The mineral waters recommended for dyspepsia, and also Harrowgate water. 9. Light nutritive diet; as common drink, wine and water, or brandy and water, should be substituted for malt liquors. The violent pain in the head and stomach, to which hypo- chondriacs are subject, maybe idieved by aether, musk, and opium, separately or combined. R2 198 CHLOROSIS, OR RETENTION OF THE MENSES. SYMPTOMS. Heaviness; listlessness to motion and fatigue on the least 'xercise; palpitations of the heart; pains in the back, loins, andhips ; flatulency and acidity in the stomach and bowels, and many symptoms of dyspepsia. •The appetite is singularly depraved ; lime, chalk, and other absorbents, are greedily eaten, when the accustomed food is rejected. As the disease advances, the lips lose their colour; the eyes are encircled with a livid areola ; the face becomes pale, assumes a yellowish hue, and the whole body has a leu- cophlegmatic appearance, with every indication of wanttof power and energy in the constitution. The feet are affected with cedematous swellings ; the breathing is hurried by the slightest exertion ; the pulse is quick but small; the patient is affected with various symptoms of hysteria, cough,*and sometimes confirmed hectic fever. CAUSES. Debility or laxity of the constitution in genera], and of the uterine system in particular. TREATMENT. . ,. . I ii To invigorate the system in general. Indications. < _ '.* .,.. , la. To excite the action of the uterine vessels. CHLOROSIS. *•' 199 To fulfil the first indication. "■'' . i. A nutritive diet, and the moderate use of wine ; regular exercise on horseback, taking care not to induce fatigue; cheerful society. 2. An emetic of ipecacuanha, or white vitriol. 3. A gentle aperient, of aloes, myrrh, and bitters. R. Pilulae ex aloe Cum myrrha dr.). Calomelanos gr.iij. Fiat pilulae xii. quarum sumat segra unam vel duas pro re nata. Make twelve pills, of which the patient is take one or two oc- casionally. * R. Pulvwis aloes cum ferro dr.). Saponis Hispanici scr.ij. Syrupi zingiberis q. s. Fiat massa in pilulas xxiv. dividenda, quarum sumantur duae alterna quaque nocte. Make a mass to'be divided into twenty-four pills, of which two are to be taken every other night. R. Extracti gentianae, --------colocynthidis compositi, aa dr.fs. • Fiat pilulae xii. sit dosis duae pro le nata. Make twelve pillst the dose two occasionally. 4. Tonics, especially preparations of iron, either alone, or j oined with myrrh, quassia, gentian, and aromatics ; adding an alkali, where it is chymically admissible, to obviate cardi- algic symptoms : the best chalybeates are, the vitriolated iron, the muriated iron, ammoniacal iron, and tartarized iron. 200 CHLOROSIS. R. Myr'hsc dr..). F?; i ■ :!rionti gr.xxiv.. Kali jj-opaiati dr.). Mucilaginis A-.-.-bici crc.fsv Decocii g'jcyrrhizae ferveniij oz.xiv. Tinctuise pimento <-z.). Myrrham et ferrum vitriolatum cum kali prepararo el muci- lagine tere donee perfecte commisceantur, dein gradatim adjice decoctum et denique tincturam. The four first mentioned ingredients are to be rubbed up toge-, ther until they are peifectly mixed, the decoction is then gradually to be added, and finally the tincture. This mixture is an improved recipe on that of Dr. Moses (Jrriflith ; and the following pills are the best substitutes when it cannot be taken in the fluid form : R. Ferri vitriolati scr.). Myrrhae optima?, Natri preparati, aascr.l). Fiat massa in pilulas xxiv. (vel mediocres) distribuenda, qua- rum sit dosis duas ter in die. Make a mass to be divided into twenty-four moderate sized pills, of which the dose is two, thrice a day. R. Ferri vitriolati gr.v). Kali preparati gr.x«j. Pulveris myrrha? dr.fs. Aquae pimento oz.jfs. Syrupi zingiberis dr.i). Fiat haustus ter in die sumendus. Make a draught to be taken thrice a day. CHLOROSIS. 201 R. Ferri vitriolati gr.xij. Extracti gentianas duri dr.). Pulveris aromarici dr.fs. 'SiwX. massa in pilulas xviii. dividenda, quarum capiat aegra duat ter in die, superbibendo hauStultim infusi alicujus amari. Make a mass to be. divided into eighteen piils, of which the patient is to take two thrice a day, drinking afterwards a 3mall draught of any bitter infusion. R. Ferri tartarisati dr). Extracti chamaemeli dr.)fs. i Balsami Peruviani q. s. Fiat massa in pilulas xxxvi. dividenda, e quibus capiat aegra' quatuor bis terve in dies. Make a'mass to be divided into thirty-six pills, of which the patient is to take four twice or thrice a day. R. Tincturae ferri muriati dr.). Cujus adhibeantur guttae sex ter quaterve die ex proculo ali- cujus liquoris idonei. Of which six drops are to be taken three or four times^a day in a cup, of any appropriate liquid. , R. Ferri ammoniacalis gutt. iv. Aquae cinnamomi dr.xi). Fiat haustus ter in die sumendus. Make a draught to be taken thrice a day. 5. Sea bathing, cold bathing, and the internal use of the Bath, Tunbridge-well, Pyrmont, or Spa waters. 202 CHLOROSIS. The other indication is best fulfilled,— i. By walking, jumping, dancing, frequent friction; pe- diluvium; heat applied by steam, or otherwise, to the region of the uterus. %. By electric shocks through the pubic region. 3. By purges that act especially upon the rectum ; as aloes and scammony. R. Aloes socotrinae dr.). Lactis communis o*.vj, Solve pro enemate bis in septimanis adhibendo. Dissolve for an enema to be given twice a week. R. Scammonii pulverisati dr.fs. Saponis Hispanici dr.\fs. Aquae ferventis ez.viij. Fiat enema quarta quaque nocte injiciendum. Make an enema to be injected every fourth night. R. Tincturae aloes compositas oz.fs. Pro dosi alternis auroris. For a dose early every other morning. R. Pulveris e scammonio cum calomelane dr.). Syrupi zingiberis q. s. Fiat massa in pilulas xii. dividenda, quarum tres pro dosi su-. mendas. Make a mass to be divided into twelve pills, cf which three are to betaken for a dose. CHLOROSIS. 203 4. By Spanish flies, hellebore, and savine. R. Tincturae cantharidis dr.\). cardamomi dr.iv. M. cujus sumat aegra guttas lx. vel cochleare minimum ter in die ex quovis vehiculo idoneo. Make a mixture, of which the patient is to take sixty drops or a tea spoonful thrice a day in any proper vehicle. R, Extracti hellebori nigri scr.). ——- gentianae scr.I). M. fiat pilulae xii. quarum sumantui duas nocte maneque. Mix : and make twelve pills, of which two are to be taken night and morning. R. Pulveris myrrhas compositi scr.fs. Balsami Peruviani q. s. Fiat bolus ter in die sumendus Make a bolus to be taken thrice a day. 5. By inhaling two gallons of oxygen gas three times a day* ORDER III. ' SPASMI, OR SPASMODIC DISEASES. ■. CHARACTER. Irregular motions of the muscles, or of the muscular fi- -bres. -.—-~^^tWB c^>^~-- ;* V i TETANUS. SYMPTOMS. Sense of stiffness in the back part of the neck, rendering the motion of the head difficult and painful;—difficulty of swallowing;—pain, often violent, referred to the sternum, and thence shooting to the back ;—spasm of the muscles of the neck, pulling the head strongly backwards ;—rigidity of the lower jaw, which increasing, the teeth become so closely set together, as not to admit of the smallest opening, when the disease is called Trismus, or Locked Jaw. 204 TETANUS. 205 If the disease proceed further, a greater number of muscles become affected ; as those of the spine, bending the trunk •f the body forcibly backwards ; in this state the tetanus is termed Opisthotonos;—or forwards, when it constitutes the Emprosthotonos. At length every organ of voluntary motion partakes of the disease; the extremities are rigidly extended ; the abdominal muscles are strongly retracted; hence costiveness and sup- pression of urine are generally produced ; the eyes are im- moveable in their sockets ; the tongue often protruded beyond the teeth ; the forehead is drawn up into furrows ; the cheeks backwards towards the ears, and the whole countenance ex- hibits the most shocking distortion. The stiffened parts arc affected with violent contractions, which occasion the most excruciating pain. A remission of thet,e occasionally takes place every ten or fifteen minutes, but they are renewed, with aggravated tarture, from the slightest causes, even the least motion of the patient, or the touch of an attendant. At leng'h one universal spasm puts a period to a most miserable state of existence. CAUSES. Remote. The male-sex; robust and vigorous constitution ; warmth of climate. Exciting. Vicissitudes of temperature ; exposure to cold, united with moisture ; or to excessive heat; injuries of nerves or tendons, by puncture or laceration ; the presence of irri- tating substances in the stomach or alimentary canal ; irrita- tion of the extremities of the nerves ; affections of the mind. PROGNOSIS Will ever be most unfavourable ; more so when the disease arises from injury of nerves than when proceeding from cold , when it comes on suddenly, and quickly advances to a violent S 206 TETANUS. degree, than when slow in its progress; when the spasmodic' contractions quickly succeed each other, and are excited by very slight causes, than when there is a considerable interval, and the rigidity forms the chief of the disease. TREATMENT. / /• *• To remove causes that are obvious. 1 z. To allay the inordinate action of the brain Indications. < and ner.vous system; or to excite a new J and powerful action, and thereby super- ^ sede the original and morbid one. When the disease is the consequence of a puncture or small wound, it has been supposed to arise from the partial division of a nerve. In this case a free dilatation of the wound should be made. If arising from local irritation, the nervous com- munication with the "brain should, if practicable, be cut off- The second indication requires,— I. The most powerful antispasmodics, as opium with musk, camphor, and aether. R. Camphoras, Moschi, aa dr.fs. Fiat pulvis ex quovis vehiculo idoneo capiendus omni trihorio, Make a powder to be taken every three hours in any proper vehicle. R. Camphor* gr.viij. Moschi gr.vj. Pulveris opii gr.ij. Fiat pulvis secunda vel tertia vel quarta quaque hora sumen- dus. Make a .powder to be taken every two, three, or four hours» TETANUS. 207 R, Misturas camphoras fortioris ez.vij. Spiritus aPtheris vitriolici compositi, Syrupi simplicis, da ox.fi. Tincturae opii dr.). M. sit dosis cochlearia tria magna. Mix. The dose three table spoonsful. R. iEtheris vitriolici dr.i). Misturae camphors fortioris oz.vij. Syrupi simplicis oz.fs. Fiat mistura :—dosis cochlearia tria ordinario, Make a mixture : the dose three common spoonsful. 2, The cold bath, or affusion of cold water; successful cases of the use of which are related by Dr. Cochrane, in the Medical Commentaries; Dr. Wright, in the London Medi- cal Observations ; Dr. Currie, in his Medical Reports ; and by others. 3. Mercury; administered both externally and internally, so as to excite salivation. It was also successfully employed by Dr. Clarke, as a preventive, after wounds and punctures. 4. Peruvian bark; and wine in large quantities. This plan was found successful, by Dr. Rush, in the Transactions of the American Philosophical Society ; Dr. Hossack, in the New York Repository ; and Dr. Currie, in his Reports. 5. Alkalies and alkaline bath ; a hot bath impregnated with kali or quick-lime. Dr. Stutx, Medical and Physical Jour- nal. 6. Meadow narcissus. Dr. Dufresnoy. 7. The tinctuia ferri muriati has been successfully used, and the petroleum or oleum petrolei. 208 EPILEPSIA, OR THE EPILEPSY. '.YMITOMS. Sudden less of sense, and power of motion, "so that, if the p;;tient be standing, he 'immediately falls, cr wjth convul- sions is thrown to the ground, frequently with a violent cry. During the fit there are strong convulsive motions of the limbs and trunk of the body* and spasms of the muscles of the face and eyes, producing various distortions of the coun- tenance. After a longer or shorter continuance of the con- vulsions, they cease altogether, and leave the patient motion- less, still in a state of absolute insensibility, and under the appearance of a profound sleep. The fit is frequently pre- ceded by pain in the head ; lassitude ; some disturbance of the senses; unquiet sleep; unusual diead ; noise in the ears; palpitation of the heart; coldness of the joints : sensation of a cold air, the aura epi/eptica, arising in some part of the extremities, and gradually creeping upwards, until it reaches the head, when the patient is instantly deprived of his senses, and falls as above described. , i CAUSES. Predisposing. Great irritability of the nervous system j hereditary predisposition. Exciting. Mechanical, chemical, cr mental stimuli; espe- cially the effects of joy and surprise ; sudden fright; fits of THE EPILEPSY. 209 passion, or any vehement emotion of the mind; plethora of the vessejs of. the head ; worms ; dentition ; acute pain ; ex- cessive evacuations ; suppression of accustomed discharges ; tumors compressing the brain, or any part of the nervous system. diagnosis. . From convulsion. By its terminating in profound sleep j by the total abolition of the senses. From apoplexy. By the voluntary motions in the one dis- ease being increased ; in the other, totally suspended. From hysteria. See Hysteria. prognosis. Favourable. The disease being sympathetic, occurring before the age of puberty, and arising from causes easy of removal ; there being no hereditary predisposition ; an inter- mittent fever, or cutaneous eruption, has sometimes effected a cure. Unfavourable. The reverse of the above. When the dis- ease comes on after the age of puberty, when it has arisen from an hereditary piedisposittan, or by frequent repetition has become confirmed, the probability of cure is slight; es- pecially where the memory and judgment have become im- paired. . TREATMENT. T i. To abate the violence and shorten the Indications. \ .duration of the paroxysm. £ 2. To prevent its recurrence. If there be symptoms of determination of blood to the head, or if the patient be of a full plethoric habit, bleeding from thA arm, jugular vein, or from the temporal artery. s 2 210 THE EPILEPSY. If, on the contrary, the presence of debility is obvious, the most powerful antispasmodics ; sinapisms to .the lower extre- mities ; anodyne and antispasmodic clysters. In general lit- tle else can be done, during the paroxysm, than to" use the necessary precautions to prevent the patient injuring himself in the violence of the convulsions. R. Tincturas assafcetidae oz.fs. ■ opii dr.). Aquae distillatae oz.viij. Fiat enema. Make an enema. The recurrence of the paroxysm is sometimes prevented,— i. By removing causes that continue to operate; as worms, dentitior, &c. 2. By avoiding the occasional or exciting causes ; as, over- distension of the vessels of the head, however induced; fits of passion, or other violent emotions of the mind, &c. 3. If the paroxysms be preceded by the aura epileptica, it hns been advised to apply blisters or caustic to the part from which the sensation arises : to destroy the communication with the brain, by dividing the nerve, or by means of a liga- ture applied round the limb, will often be successful. 4. If the patient be of a plethoric habit, by occasional bleeding : abstemious diet; issues or setens in the neck ; fre- quent purges, &c. 5. If weak and irritable, by tonics,; as cinchona, zincum cak natum and zincum vitriulatum, cuprum ammoniatum, nip rum vitriolatum ; argentum nitratu-m." THE EPILEPSY. 211 R. Pulveris cinchonas t*.'s. «- •-•> '— vaie. ri;-x scr,f- Fiat pulvis ter irt uie suint'.u.us Make a powder to be taken thrice a day. R. Tincturas cinchonas compositas, —— valeriar.ae ammoniata?, aa dr.), Infusi quassias (dr.). ad lb.).) dr.xi). Fiat haustus ter in dies capiendus. • Make a draught to be taken thrice a day. R. Zinci calcinati gr.vj. Extracti gentianas gr.iv. Syrupi zingiberis q. s. Fiat pilulae duas ter in die capiendas cum haustulo infusi cha- masmeli. Make two pills to be taken thrice a day with a draugh* of the infusion of chamomile. • R. Zinci vitriolati gr.\. Extracti chamaemeli gr.x. Fiat pilulae duas ter in die sumendas. Make two pills to be taken thrice a day. R. Zinci vitriolati gr.j. Extracti cascarillas gr.viij Olei essentialis caryophyllorum aromaticorum gr.ij Fiat pilulas duas ter in die sumendae. Make two pills to be taken thrice a day. R. Cupri ammoniati gr.ij Conservas rosae gr.v. Fiat pilula ter quotidie capienda. Make a pill to be taken thrice every day. -!!-' THE EPILEPSY. R. Cupri vitriolati gr.ij . Conserves rosae dr.). Pilulae ex opio scr.) _ Optime misceantur in massam in pilulas xxiv. dividendam, quarum capiat aeger unam vel duas ter in die. To be well mixed into a mass and divided into twenty four pills, of which the patient is to take one or two thrice a day. ' \ R. Argenti riitrati gr.) Conservas rosas gr.v. Fiat pilula ter in die deglutenda. Make a pill to be taken thrice a day. 6. By regular exercise. 7. By cold bathing. 8. By antispasmodics ; as valerian, castor, musk, aether, oleum animale, opium. R. Pulveris Valerianae scr.]. Tincturas Valerianae ammoniatas, Syrupi corticis aurantii, aa dr.i) Aquae pimento dr.xi). Fiat haustus ter quotidie adhibendus. Make a draught to be given thrice daily. R. Radicis Valerianae incisas oz.). Canellae albas contusas dr.i). Aquas ferventis lb.). Macera per horas duas, dein cola. Macerate for two hours and then strain. R. Hujus colaturas dr.xi). Tincturas Valeriana; dr.). Fiat haustus ter in die sumendus. Make a draught to be taken thrice a day. THE EPILEPSY. 213" R. Castorei, Moschi, aagr.iv. Olei animalis gutt. ij. Fiat pilulae duae ter in die dtglutendas, supeibbendo haustu- Ium alicujus liquoris idonei. M; ke two pills to be taken thrice a day, taking after them a small draught of any proper liquor. R. j^iheris vitriolici dr.fs. Tincturae opii gutt. xv. Misturae camphorae dr.xi). Syrupi croci dr.). ' Fiat haustus ter in die sumendus. , Make a draught to be taken thrice a day. 9. When the attack of the disease can be foreseen by certain well-known feelings of the patient, an emetic given an hour before its approach has been known to prevent the fit; a large dose of opium also, or other powerful antispasmodic, admi- nistered in the same manner. Haustus emeticus communis. R. Tincturas opii gutt. xx—xi. Misturae camphoiae dr.xi), Syrupi rosae dr.). Fiat haustus. Make a draugh', 2H TAE EPILEPSY. R. Spiritus setheris vitriolici compositi dr.u Tincturas opii gutt. xx—-XL. Misfuras camphoiae dr.xi). Syrupi croci dr.). Fiat haustus ineunte paroxysmo capiendus. Make a draught to be taken at the commencement of the paroxysm. 10. By digitalis, particularly if there be an accelerated pulse, when it should be given in doses, gradually increased, until the pulse is influenced by it. u. The rhus radicans, in the praise of which Dufresnoy and Hufeland have written, has occasionally cured epilepsy. la. By the cicutaria, which is said by Dufresnoy to be useful. « 13-. The carbonate of potash is recommended by DfS. Mi- ■ chaelis and Wiedemann. 14. By mercury, as an alterative s—• R. Calomelanos gr.\. Conserve? rosae gr.v. Fiat pilula ter in die sumenda. Make a pill to be taken thrice a day. R. Pilulae ex hydrargyro gr.v. Fiat pilula quavis nocte capienda. Make a pill to be taken every night. R. Calomelanos, Sulphuris antimonii precipitati, singulorum gr.fs. Conservae rosae q. s. Fiat pilula ter in die sumenda. Make a pill to be taken thrice a day. THE EPILEPSY. 215 15. By thotnux vomica, which has often been, successful. R. Nucis vomicae contusae dr.). Aquas ferventis lb.). Macera per horam, dein cola. Macerate for an hour, then strain. R. Hujus infusi dr.xi). Tincturae cardamomi dr.). M. pro haustu ter quotidie capiendo. Mix for a draught to be taken thrice a day. R. Pulveris nucis vomicae gr.iij. " Conservae rosae gr.v. Fiat pilula ter in die deglutenda. Make a pill to be taken thrice a day. 16. By the internal use of arsenic. R. Solutionis arsenicalis Di. Fowler gutt. iv—vj. Tincturae cinnambmi dr.). Syrupi simplicis dr.). Aquae pimentq dr.xi). M. fiat haustus ter in die sumendus. Mix and make a draught to betaken thrice a day. 17. By electricity. 18. By the viscus quercinus, or missletoe, recommended by Dr. Frazier. 19. By oxygen gas, extolled by Dr. Girtanner. • 20. The gratiola officinalis, praised by Dr. Sommer, in his treatise De Virtute Gratiolas. 21. By change of climate and mode of life. 21C • CHOREA SANCTI VITl, OR THE DANCE OF ST. VITUS. * SYMPTOMS. The disease is marked by convulsive motions, somewhat varied in different persons, but generally affecting the leg and arm of one side only. The lower extremity is mostly first- affected ; there is a kind of lameness and imbecility in one of- the legs ; and, though the limb be at rest, Uie foot is often agitated by involuntary motions, turning it alternately out- wards and inwards. In walking, fhe affected leg is seldom lifted as usual, but is dragged along, as if the whole limb were paralytic ; and when it is attempted to be lifted, that ,. motion is unsteadily performed, the limb becoming irregularly . and ludicrously agitated. The motions of the arm likewise are variously performed, or it is drawn by convulsive retrac- tions in a direction contrary to that intended. CAUSES. General weakness and irritability of the nervous system ; occurring between the tenth and fifteenth years of age. It is induced by various irritations ; as teething, worms, offensive smells, poisons, affections of the mind, fright, horror, an- ger. ASTHMA. 217 PROGNOSIS. It is never attended with danger, unless very violent in de- gree, when fever supervenes, and it often kills : it passes not unfrequently into epilepsy. TREATMENT. Indication, { To increase the tone of the muscular system. After the administration of an emetic and mild aperient; Tonics ; especially zincum vitriolatum,—cuprum ammoni- atum,—argentum nitratum, as recommended against epilepsy. Cold bathing, and electricity. Terror has sometimes effected a cure. The antispasmodics, and other remedies enumerated under ■the head Epilepsy. ASTHMA. SYMPTOMS. The attack is usually preceded by sense of fulness about the Stomach ; lassitude j depression of spirits ; drowsiness, and pain in the head ; little, however, regarded by the patient. On fhe approach of the succeeding evening, a sense of tight- ness and stricture is perceived across the breast, with distres- T 21$ ASTHMA. sing straitfless of the lungs, impeding respiration. The diffi. culty of breathing continues to increase for some length of time; both inspiration and expiration are performed slowly, and with a wheezing noise ; the speech becomes difficult and uneasy; a propensity to coughing succeeds, followed by the most anxious difficulty of breathing ; the patient is threatened with immediate suffocation, and is obliged instantly to rise from an horizontal position ; the face is sometimes turgid, and of a livid hue ; at others it " morbidly, pale and shrunk. These symptoms usually continue till towards the approach of morning, when a copious expectoration of mucus comes on, the breathing becomes less laborious, and moie fall, the patient speaks, and. coughs, with greater ease, and, feeling every way relieved, soon, fajjs asleep. The dyspncea and tightness across the chest remain for some days, after the at- tack, and for several succeeding evenings an exacerbation oc- curs similar to that above described.. CAUSES. Hereditary predisposition; cold and moist atmosphere; sudden changes of temperature; retrocedent gout; suppres- sion of long-accustomed,, evacuations; intense study; certain fevers; irritation of the bronchial system by aerial acrimony or other causes; irritation of the stomach, uterus, or other viscera. » Proximate cause. Supposed to be spasm by Dr. Cullen; the presence of irritating causes .according to Dr. Bree. DIAGNOSIS. The pathognomonic symptoms are, paroxysms generally coming on at night, in which there is frequent and extremely anxious respiration; together with a wheezing noise, and Sense of tightness across the chest. ASTHMA. 219 PROGNOSIS. Favourable. The disease occurring in an early period of life, and in an unimpaired constitution. Arising from acci- dental causes, it is more easy of cure than when spontaneous, or the consequence of predisposition. Unfavourable. The disease coming on at an advanced pe- riod of life'; frequent return of paroxysms, and their long continuance ; symptoms indicating a tendency to phthisis pul- monalis, or to hydrothorax; anasarcous swellings of the lower extremities; paralysis of the arms ; tremulous respira- tion ; weak iiregular pulse; syncope; palpitation of the heart; paucity of urine ; cold cxuemiilcs. n sometimes has induced an aneurism of the heart and large vessels; and not unfrequently terminates in pneumonia, • TREATMENT. Indications. S *" To moderate the violence of the paroxysm. To prevent its recurrence. The violence of the paroxysm is moderated by,— i. Bleeding, where the habit is plethoric; the disease of no long standing ; the face flushed, &c. On the contrary, in elderly persons, where the disease has become habitual; or where the face during the attack is preternaturally pale and shrunk ; bleeding is inadmissible. It must be remembered, however, that the propriety of blood-letting in any species of asthma has been much doubt- ed ; and in those cases which appear to demand it, it is better to take away small quantities at intervals, in order to allow the contractile power of the vessels to be exerted in proportion as the vessel loses it contents. 220 ASTHMA. 2. Gentle aperients, especially such as are recommended to obviate costfvene,ss in dyspepsia at page joi ; and antispas- modic clysters. R. Lactis assafcetidas os.viij. Fiat enema pro re nata adhibendum. Make an enema to be given occasionally. 3. The application of blisters to the chest. 4.. Antispasmodics :—opium, vitriolic aether, or both uni- ted ; assafcetida, in cases where spasmodic difficulty of breath- ing is obvious. R. Spiritus aetheris vitriolici compositi dr.). Xincturas opii gutt. v. ' Misturas camphorae fortioris dr.xii). Syrupi corticis aurantii dr.). Fiat haustus quarta vel sexta quaque hora sumendus. Make a draught to be taken every four or six hours. R. ^theris vitriolici gutt. xxx. Tinctura* opii gutt. v. Mistu as camphorae dr.xW). Syrup croci dr.). Fiat haustus quartis vel sextis horis capiendus. Make a draught to be taken every four or six hours. 5. Expectorants, where expectoration is difficult, of squills ; tartarised r ntimonv} and ammoniacum; tinctura nicotian*, in nauseating doses. ASTHMA. 22J R. Aquas ammonias acetatae oz.fi. ----- menthae sativae df.x. Vini antimonii tartarisati gutt. xv. Syrupi simplicis dr.). Fiat haustus quartis vel sextis horis sumendus. Make a draught to be taken every four or six hours. R. Lactis ammoniaci dr.v. Aqux menthae piperitidis dr.x. Tincturae scillae gutt. x. Fiat haustus sextis horis capiendus. Make a draught to be taken every six hours. R. Lactis ammoniaci, — assafatidas, aa dr.iv. Aquas cinnamomi dr.v). Fiat haustus sextis horis adhibendus. Make a draught to be taken every six hours. R. Pilulas e scilla gr.x. Fiat pilulas duae octavis horis capiendae. Make two pills to be taken every eight hours R. Pilulae e scilla gr.vj. Pulveris digitalis gr,%. Fiat bolus sextis horis sumendus. Make a bolus to be taken every six hours. T2 222 ASTHMA. R. Aquas ammonias acetatae dr.W). Misturae camphorae dr.x. , Tincturas nicotians gutt. xxv. Syrupr croci dr.). M. pro haustu ter in die sumendo. Mix ; for a draught to be taken thrice a day. R. Aceti scillae dr.). * Spiritus aetheris asnitrosi dr.i). Mellis acetati oz.fs. Aquas menthae sativae oz.v). Fiat julapium de quo capiat asger cochleare unum magnum uigenti tusse vel dyspnoea. Make a julap, of which the patient is to take a table spoonful when the cough or dyspnoea are troublesome. 6. Pediluvium, and the warm bath. 7. Coffee. The recurrence of the paroxysm is prevented,— 1. By avoiding the exciting causes. 2. By issues, or occasional blisters. 3. Gentle aperients of rhubarb, manna,, and magnesia. 4. Emetics, given a short time before the expected pa- roxysm, have in some instances prevented its attack. 5. Diaphoretics, particularly the pulvis ipecacuanhae com- positus- 6. Expectorants ; as squills,—ammoniacum,—myrrh,— antimonium tartarisatum,—a decoction of seneka. 7. Opium combined with a diaphoretic. >. 2. Digitalis. 9. Oxygen gas. 10, Inhaling the vapour of aether. HOOPING-COUGH, 223 n. The smoking or chewing of tobacco. 12. The occasional use of stomachic bitters and absor- bents; Peruvian bark, chalybeate(waters, and other remedies recommended for dyspepsia. The flatulence accompanying asthma is often relieved by a small portion of acetous acid. 13. Light and nutritive diet; avoiding flatulent and indi- gestible aliment. 14, Warm clothing. 15. Regular exercise; on horseback, or by swinging, or tailing. 16. Removal from a cold to a warm climate. PERTUSSIS, OR HOOPING-COUGH. SYMPTOMS. , The disease comes on with slight difficulty of breathing, thirst, quick pulse, hoarseness, cough, and all the symptoms of common catarrh. In the second or in the thiid week after the attack, it puts on its peculiar and characteristic symptoms. The expiratory motions, peculiar to coughing, are made with more rapidity and violence than usual ; and, after several of these expirations thus convulsively made, a sudden and full inspiration succeeds, in which, by the air rushing through "the glottis with unusual velocity, a peculiar sound is caused, which has obtained the name of hoop. When this sonorous inspiration has happened, the convulsive coughing is again renewed, and continues in the same manner as before, till a 224 HOOPING-COUGH. quantity of mucus is thrown up from the lungs, or the con- tent, of the stomach are evacuated by vomiting, which gene- rally teiminates the fit: the patient is then most frequently enabled to return to the amusements he was* employed in be- fore !ts accession-, and often expresses a desire for food ; but when the, attack has been severe, it is succeeded by much fa- tigue, hurried respiration, and general languor and debility. After a longer or shorter continuance of the disease, the pa- roxysms become less severe, and at length entirely cease. In some instances it has, however, been protracted for several months, and even for a year. CAUSES. Children are most commonly the subjects of the disease; and it is supposed to depend on a specific contagion. DIAGNOSIS. It is distinguished from every other disease by the convul- sive cough, followed by the peculiar sonorous inspiration above described ; and terminating in vomiting or expectora- tion. . PROGNOSIS. Favourable. Moderate and free expectoration ; the strength little impaiied; the fits neither frequent nor violent; in the interval, the.re6piration free ; the appetite good ; the absence of fever ; moderate haemorrhage from the nose. Unfavourable. The disease occurring in children under two years of age; in children born of phthisical or asthmatic parents; much fever, with symptoms of pneumonia ; very copious or scanty expectoration ; great debility j convulsions. HOOPING-COUGH. 225 TREATMENT. ri. In the early stage of the disease, to mo- derate its viuhsnce, and to palliate ur- gent pymptoms. Indications. -^ z. In the advanced period, to interrupt its course; and put a stop to the disease ! sooner than it would have spontaneous- ly ly ceased. The first indication is to be effected by,— i. Bleeding; if there be much pyrexia, or great difficulty of breathing, especially by leeches to the chest, 2. Emetics and nauseating medicines; of tartarized anti- mony, in divided doses. R. Vini antimonii dr.i). Fiat haustus emeticus. Make an emetic draught. R. Vini ipecacuanhae oz.fs. Fiat haustus emeticus. Make an emetic draught. R. Aquas ammonias acetatae oz.). Vini antimonii tartarisati dr.i). Aquas menthae sativae oz.vfs. Mellis acetati oz.fs. M. cujus capiat seger cochleare unum magnum quartis vel sextis horis. .» Make a mixture, of which the patient is to take a table spoon- ful every four or six hours. 256 HOOPING-COUGH. R. Aceti scillae dr.i). Mellis acetati o«.ij. M. cujus sit dosis cochleare minimum subinde. Mix : the dose a tea spoonful now and then. R. Succi clcutas spissati gr.j.—iv. Fiat pilula quavis nocte sumenda. Make a pill to be taken every night. 3. Gentle laxatives of senna, manna, and the like. 4. Blisters to the chest. 5. Inhaling the steam, of hot water; alone, or medicated with aether. 6. Tepid bath ;—pediluvium. 7. Tinctura cantharidis ; alone, or united with tinctura opii camphorata; and so administered as to produce a slight degree of strangury. The second indication is to be fulfilled,— 1. By tonics; Peruvian bark; preparations of steel and zinc; arsenic, proportioning the dose to the age of the, pa- tient. 2. Antispasmodics ; opium,—musk,—assafcetida,—amber, —castor, administered in like manner. 3. Narcotics; as, cicuta,—hyoscyamus,—aconite,—bella donna,—digitalis. A grain of the extract of cicuta and hyo- scyamus may be given every six hours, and a quarter of a grain of the others, and gradually and cautiously increased. 4. Change of air. THE 1VATER-BRASH. 227 fYROSIS, OR THE WATER-BRASH. SYMPTOMS. The disease usually comes on in the morning or "forenoon, when the stomach is empty ; commencing with ardent pain at the pit of the stomach, with en«c < f constriction, as if that organ were drawn towards the back. The pain is increased by an erect position, and therefore the body is bent forward. After a short time an eructation takes place of a thin watery fluid in considerable quantity ; sometimes of an acid taste, often quite insipid. The eructation is frequently repeated, and at length gives relief to the pain, and puts an end to the fit. CAUSES. Predisposing. It principally attacks those of a middle age . females more frequently than males; and generally the un- married ; people in low life, who live much on milk and a farinaceous diet, rather than those in better condition ; fluor albus. Exciting. Application of cold to the lower extremities; violent emotions of the mind. Proximate. Spasm of the muscular fibres of the stomach, its blood-vessels and exhalants, 228 THE COLIC. TREATMENT. Pyrosis requires the removal of the exciting causes, and the exhibition of antispasmodics, especially aether ; opium ; musk; castor; volatile alkali; nux vomica; the "smoking er chew- ing of tobacco; and the occasional use of the mineral alkali with absorbents, which should be given as recommended in the treatment of dyspepsia. COLICA, OR THE COLIC. - i. Colica spasmodica; with retraction of the navel, - and spasms of the abdominal muscles. ——— stercorea, in persons subject to costiveness after long continued constipation. accidentals, from acrid matter in the in- testines. ,Sj j 4. ......pictdnum; a sense of weight in the lower - belly, colic pains, continual, with pain in the arms and back, ending in palsy. ' 5. ■ ■ nv-onialis, in new-born children. 6. —— taiculosa, with a fixed hardness in a parti- cular part of the abdomen ; calculi ejected by the anus. u 7. "'■ vermmosa, from worms. THE COLIC. 229 SYMPTOMS. Violent pain and distension of the abdomen, attended with a peculiar sense of twisting or wringing around the navel ; which, with the teguments of the belly, is frequently drawn inwards; and often the muscles are spasmodically contracted in separate portions, giving the appearance of a bag full of round balls. Obstinate costiveness; frequently there is a bitter taste in the mouth ; thirst; slight febrile heat, and other symptoms, which indicate the presence of bile in the alimentary canal ; frequently there are hiccup, and flatulent eructations. Vomiting in some cases continues frequent and bilious; and in some instances stercoraceou* matter is thrown up, when generally a high degree of inflammation follows* and the disease is called Ileus, and also Volvulus. CAUSES. Cold applied to the surface of the body, especially to the lower extremities and abdomen; austere, acid, or indigesti ble aliment; redundance of acrid bile; collections of indu- rated fasces, or of calcareous concretions, in the alimentary canal ; flatus ; certain metallic poisons, as lead; hysteria ; translation of gout; the imprudent use of astringents in di- arrhoea and dysentery ; all these increased by a constitutional irritability of the intestines. Another exciting cause of colic to be noticed in this place, is WORMS. The human primas viae are infested by five kinds of worms. i. Ascaris vermicularis : the small white thread, or maw- worm. 2. Ascaris lumbricoides: the lumbricus teres, or long round worm. 230 THE C6LIC. 3. Trichuris : the long hair-tailed thread-worm. 4. Taenia osculis marginalibus : the solium, or tape-worm. 5. Taenia osculis supeificialibus : the broad tape-worm. The ascarides have usually their seat in the rectum ; the lumbrici occupy the small intestines, and sometimes the sto- mach; the trichurides the caecum 5 the taeniae the whole tract of the intestines, more especially the ileum. Worms mostly produce symptoms of colic, and very frer quently other symptoms; as variable appetite ; foetid breath; picking of the nose ; hardness and fulness of the belly ; sen • sation of heat and itching in the anus; pieternaturally red tongue, or alternately clean and covered with a white slimy mucus ; grinding of the teeth during sleep ; short dry cough ; frequent slimy stools : emaciation ; slow fever, with an even- ing exacerbation ; irregular pulse ; s6metimes convulsion fits. Worms appear more frequently in those of a relaxed habit; those whose bowels contain a preternatural quantity of mucus or slimy matter ; in those who live on vegetable food ; in the dyspeptic ; the eating of unripe fruit is a frequent cause of their production. They are evolved from ovula that exist in the human body, and in no other situation. For further information on this subject, consult " An Attempt to an Arrangement of -human intestinal Worms,'"' published by the author in the fifth volume of the Memoirs of the London Medical Society. Proximate causes of colic. Spasm of some part of the ali- mentary canal. DIAGNOSIS. From enteritis. By the peculiar twisting pain, and retraction of the navel; by the absence of fever, in the early part of the disease; by the pain in enteritis being increased, in colic alleviated by pressure; by the irregular contractioa ef the abdominal muscles. THE COLIC. 231 The same characteristic symptoms distinguish it from in- flammation of other abdominal viscera. PROGNOSIS. Favourable. The pain remitting or changing its situation ; discharges of wind and fasces, followed by an abatement of symptoms. Unfavourable. Violent fixed pain ; obstinate costiveness ; sudden cessation of the pain, followed by more frequent hic- cup, gieat watchfulness, delirium, syncope, cold sweats, weak tremulous pulse ; the pulse becoming peculiarly hard- see Enteritis ; and the pain before relieved, now much in- creased, upon pressure ; volvulus : all the symptoms indica- ting supervening inflammation and mortification, from the ac- cession of which the chief danger arises. TREATMENT. T x. To relax the spasm.' Indications. < 2. To remove the causes, and procure eva- [_ cuations. The first indication requires,— 1. Bleeding, if the concomitant strength of constitution and fulness of vessels, with strong pulse, are present; but it ls seldom necessary. 2. Carminatives and antispasmodics j opium in large doses, cordial and opiate confection, cardamoms, &c. R. Confectionis aromaticae dr.fs. Pulveris rhabarbari gr.xviij. Aquae menthae piperitidis dr.xi). Tincturae cardamomi dr.)fs. Syrupi zingiberis dr.). Fiat haustus. Make a draught. 232 THE COLIC. R. Tincturas cardamomi compositas dr.\ •• , opii gutt. xx. Syiupi croci dr.). Aquae menihae piperitidis dr.xij. R. Confectionis opiatas scr.fs. Olei essentialis carui gutt. ij. ' Pulveris rhasi q. s. Fiat bolus. Mal^e a bolus. 3. Warm bath ; semicupium, and fomentations to ihe ab- ^domen. 4. Blisters, and warm plasters. 5. Opiate clysters. 6. If there be great irritation of the stomach, with frequent vomiting, the saline medicine in an effervescing state. 7. Colic from the presence of flatus is often relieved by some aromatic cordial, or a small portion of brandy. Evacuations must be procured,— 1. By cathartics; at first by the more mild ; as rhubarb, magnesia, natron vitriulatum, oleum ricini : if these prove ineffectual, calomel united with extractum colocynthidis com- positum, especially where there has been bilious vomiting. R. Pulveris rhabarbari dr.). Magnesias albas tage ; and to promote the heal- ing of ulcers after suppuration has ta- ken place. i. By small and repeated bleedings, regulated by the strength of the patient and the period of the disease, unless the disease bear more evident marks of a scrofulous tendency. PULMONARY CONSUMPTION. 265 2. Gentle laxatives, of cassia, manna, Rochelle salts. 3. Mild diaphoretics, of aqua ammonias acetatae, or pulvis ipecacuanhae compositus. 4. The occasional exhibition of an emetic : the zincum vi- triolatum is preferred ; and the cuprum vitriolatum is recom- mended by Senter, in the Transactions of the College of Philadelphia; and by Adair, in the Medical Commentaries. 5. Blisters, issues, or setons, opposite to the part affected with pain, are highly serviceable. 6. Nitre, in .small and frequent doses. 7. Inhaling the vapour of hot water, alone, or impregnated with aether and cicuta : this is recommended by Dr. Pearson, in the Medical Commentaries. 8. By inhaling certain factitious airs: Dr. Beddoes, and other pneumatic physicians, rt commend hydrogen, and hydro- carbonate. 9. Cicuta; beginning with small doses, and gradually in- creasing it. 10. By digitalis; in the praise of which Dis. Beddoes, -♦Drake, Towler, and others, have written. It is sometimes serviceable, more frequently otherwise. The tincture is the best preparation ; the dose should be small at first, from ten to fifteen drops, and it should be gradually increased until it reduce the energy and frequency of the pulse. 11. Tonics and chalybeates have been administered with advantage ; particulaily myrrh alone, or with ferrum vitrio- latum. 12. The phelland|ium aquaticum is praised by Drs. Hertz and Michaelis, in Hufeland's Journal. 13. Thcagancus p»peratu8 and deliciosus, by Dr. Dufres- rtoy. 14. Colliquative sweats should be checked by vegetable and mineral acids. 15. Diarrhoea, by the mistura cretas cum opio, resina aca- 'oidis; or by diaphoretics. ' See Diarrhoea. 7 266 PULMONARY CONSUMPTION. 16. The cejigh, by opiates, especially the syrupus papa- veris albi ; and by demulcents. See Catarrhus. ,^v, 17. A light and nutritive diet: the farinaceous vegetable^; milk, especially that of the ass; acescent fruits ; the lichen islandicus boiled with milk ; the different kinds of shell-fish ; 'are most esteemed for the general diet. x8. Removal to a warm climate; to Lisbon, to Madeira, to the south of France, or to the more temperate parts of our own. Moderate exercise, either by swinging, on horseback, * or by sailing; carefully guarding against a suppression of cutaneous perspiration, in consequence of the application of cold, by constantly wearing flannel next the skin ; a sea voyage ; Bristol and Seltzer waters j stabling with cows. 267 ORDER II. - INTLTMESCENTIjE. CHARACTER. External tumor of the whole, or of the greater part of the body. EMPHYSEMA. This disease consists in a collection of air in the cellular membrane. It is in general confined to one place ; but in a few cases, spreads universally over the whole body, and-occa- sion3 a considerable degree of swelling. It is attended with an evident crackling noise, and eslasticity upon pressure ; and sometimes with much difficulty of breathing, oppression, and i anxiety. CAUSES. Wounds of the lungs. It sometimes arises spontaneously, or comes on immediately after delivery, without any evident cause. 26,3 - TYMPANY. TREATMENT. The air is to be evacuated by scarifications into the ct'j- lular membrane, assisted by proper pressure with the hand. Violent dyspnoea^and anxiety are to be relieved by bleeding and laxatives ; and the pain and uneasiness, arising from dis- tention, by relaxing applications to the skin ; as the unguen- tum spermatis ceti. TYMPANITES, OR TYMPANY. rTympanites abdorainalis ; or collection of .. • j air in the cavity of the peritoneum. j .i..ii , — intestinalis; or collection of -* [_ air in the cavity of .the intestines. SYMPTOMS. Of the tympanites intestinalis. The disease sometimes comes on suddenly; at others it is more ,slow in its progress, and preceded by unusual flatulency,—borborigmus, and a frequent expulsion of air upwards and downwards, attended with colic pains ; the ahdomen becomes considerably distended, tense, and elastic; costiveness; dysuria, and in some instances even ischuria ; impaired appetite ; thirst; heat; emaciation i hectic fever; not unfrequently dropsy or gangrene. TYMPANY. 269 Of the tympanites abdominalis. The swelling is more equal than in the former species ; the tension greater; it is more elastic ; and, upon percussion, sounds like a drum or bladder filled with air. There are no emissions of flatus. Loss of tone in the intestinal canal; errors in diet ; abuse of spirituous liquois; suppression of customary evacua- tions ; a crude vegetable aliment; hysteria ; gangrene. DIA GNOSIS. From ascites. By the absence of fluctuation, and of those symptoms which characterize the hydropic diathesis. See Ascites, PROGNOSIS. Favourable, An unimpaired constitution ; the air contained within the cavity of the intestines, is more favourable than when it is accumulated within the cavity of the peritoneum ; explosions of flatus. Unfavourable. The disease being of long standing ; great debility; emaciation; difficult respiration; cdugh; hectic fever. The abdominal species mostly proves fatal. TREATMENT. Indications. t To evacuate the air. To prevent its again accumulating. To fulfil the first indication recourse must be had to,— x. Antispasmodics and carminatives; opium, aether, oleum f.nisi, assafcetida, raphanos. z2 270 TYMPANY. R. Spiritus artheris vitriolici compositi dr.ii). Misturae camphorae cz.vij. Syrupi zingiberis oz.fs. Tincturae opii camphoratas oz.fs. M. cujiis sumantur cochlearia tria magna quarta quaque hora. Make a mixture, of which- three table spoonsful are to be taken every four hours. R. Olei essentialis anisi gutt. xij. Pulvis Arabici dr.iv. Syrupi rosas oz,f$. Aquas anisi ex.vi). Fiat mistura, cujus sumat asger cochlearia duo magna urgenti dolore vel flatu. Make a mixture, of which the patient is to take two table spoonsful when the pain or flatulence are troublesome. R. Assasfcetidas .gr.vj. Pulveris rhari gr.iv. Olei essentialis anisi gutt. ij. Fiat pilulae duas quarta vel'sexta quaque hora sumenda?. Make two pills to be taken every four or six hours. R. Pilulae ex opio jr.jfs. Piperis Cayennensis gr.iij. Olei essentialis fceniculi gutt. j. Fiat pilula sexta qunque hora sumenda. Make a pill to be taken every six hours. 2. Warm purgative medicines and clyster^. TYMPANY. 271 R. Pilulas ex aloe cum myrrha gr.vj. Piperis Indici gutt. iij. Fiat pilulas duae. Make two pills. R. Extracti colocynthidis compositi gr.vj. Pilulas galbani compositas gr.iij. Olei essentialis carui gutt. j. Fiat pilulas duas. Make two pills. R. Pulveris aloes cum guaiaco gr.viij. Olei essentialis anisi gutt. ij. Fiat pilulas duae. Make two pills. R. Tincturae sennae oz.j. Vini aloes oz.ij. Aquae menthae piperitidis e#.iij. Syrupi zingiberis oz,). M. cujus capiantur cochlearia duo pro re nata. Make a mixture, of which two spoonsful are to be taken oc- casionally. R. Kali tartarisati oz.fs. Infusi sennae oz.vfs. Tincturas ejusdem oz.)fs. Syrupi zingiberis oz.fs. M. sumantur cochlearia tria pro dosi. Mix : three spoonsful to be taken for a dose. 272 TYMPANY. R. Seminis fceniculi contusi oz.iij. Aquas ferventis o».xvj. Macera pro horam, dein cola pro enemate. Macerate for an hour, then strain for an enema. R. Infusi fceniculi css.xij. Tincturas assaefcetidas oz,f%. Fiat enema. Make an enema. 3. The application of co.ld to the abdomen, of ice or snow,, or of warm stimulating plasters. R. Olei maeis oz.fs. Cerati saponis ox.ij. Fiat emplastrum toto abdomini imponendum. * Make a plaster to be applied to the whole abdomen. R. Succi cicutas spissati oz.i). Olei anisi dr.fs. Fiat emplastrum. Make a plaster. 4. Fiiction with warm liniments.. R. Camphorae dr.i). Olei olivae oz.]. Spiritus terebinthinae. rectificati es.fs. Fiat embrocatio. Make an embrocation. IJROPSY OF THE CELLULAR MEMBRANE. 27$ R. Olei cajaputae ox.). Spiritus terebinthinae rectificati dr.i]. Fiat embrocatio. Make an embrocation. 5. Encircling the abdomen wjth a tight bandage. 6. In the tympanites intestinorum, advantage is occasion- ally obtained by the introduction of a fistula into the rectum, and suffering it to remain for sometime. 7. In the latter species, paracentesis with a very small trochar or lancet has been recommended ; but whether it.has been performed or not, and with what advantage, I know not. The second indication requires,— 1. Tonics; such as are recommended against dyspepsia-, 2. Regular exercise. 3. Carefully avoiding all food of a flatulent nature. 4. The occasional use of stomachic aperients. J ANASARCA, OR DROPSY OF THE CELLULAR MEMBRANE. CHARACTER* A preternatural collection of serous or watery fluid in the cellular membrane of the whole, or part of the body. 274 DROPSY OF THE CELLULAR MEMBRANE. SYMfTOMSi The disease generally commences in the lower extremities, and first shows itself towards evening with a swelling of the feet and ancles, which by degrees ascends, and successively occupies the thighs and trunk of the body. When it has be- come very general, the viscera are affected in a similar way; the cellular membrane of the lungs partakes the affection; the breathing becomes difficult, and is accompanied by cough, and the expectoration of a watery fluid. T^* urine is small in quantity, high coloured, and deposites a reddish sediment i sometimes, however, it is of a pale whey colour, and more copious. Costiveness; insatiable thirst; the skin is gene- rally pale and acrid; though sometimes a slight yet general inflammation takes place, when it becomes tense and shining. The water often oozes through the pores of the cuticle, or raises it in the form of small blisters ; the countenance be- comes sallow; torpor ; heaviness; troublesome cough ; slow fever. Causes. Predisposing. An hydropic diathesis. ' Exciting. Certain organic diseases, producing an obstruc- tion to the free circulation of the blood ; excessive discharges ; suppression of customary evacuations ; exposure to a moist atmosphere ; the sudden striking in of eruptive complaints ; crude and indigestible aliment; drinking large quantities of watery fluids ; abuse of spirituous liquors; certain preceding diseases, as inflammation, the exanthemata, especially scar* latina; jaundice; diarrhoea; dysentery; phthisis; gout; in- termittents of long standing. Proximate. Increased effusion i diminished absorption; or both united. DROPSY OF THE CELLULAR MEMBRANE. 275 « DIAGNOSIS. From emphysema. By the swelling in anasarca being cede- matous; in the emphysema, elastic and accompanied with crepitus; by the particular state of the urine and other symp- toms above mentioned, PROGNOSIS. Favourable. The disease having been induced by causes which admit of easy removaL; the strength little diminished; the constitution of the patient previously unimpaired; the appetite remaining* entire; the respiration free; no great thirst; a gentle moisture on the skin. Unfavourable. Concomitant organic disease; great emaci- ation ; erysipelatous inflammation; much drowsiness; pete- chias and ecchymoses; haemorrhage; feverish heat; great thirst; quick small pulse. TREATMENT. , .. fi*. To evacuate the collected fluid. Indications. < ^ „, . . . | 2. To prevent its again accumulating. The collected fluid is evacuated by,— i. Scarifications and punctures. 2. Blisters. 3. Friction. 4. Emetics, and nauseating medicines ; especially antimo- nium tartarizatum and squills. The haustus emeticus communis. 276 DROPSY OF THE CELLULAR MEMBRANE. R. Vini ipecacuanhae cs.fs. Tincturae scillae dr.i). Fiat haustus emeticus. Make an emetic draught, 5. Cathartics; of gamboge, elaterium, jalap, colocynth, calomel, gratiola, crystals of tartar. R. Elaterii' gr.ij. Sacchari purificati dr.). Optime terantur simul, dein in pulveres octo aequales dividan- tur, quorum capiat asger unum* omni horae quadrante donee adsit catharsis. To be rubbed well together, and then divided into eight equal powders, of which the patient is to take one every quarter of an hour until purging is produced. R. Extracti colocynthidis compositi, ——— jalapii, aa dr.). Gambogias .scr.fs. Olei juniperi gutt. iv. Fiat pilulae xii. quarum capiantur tres omni hora donee alvus ter quaterve respondeat. Make twelve pills, of which three are to be taken every hour until the bowels are moved three or four times. R. Calomelanos gr.v. Conservae rosae q. s. , Fiat pilula mane sumenda cum haustu cathartico salino. Make a pili ;o to be taken in the morning with the cathartic ' saline draught. DROPSY OF THE CELLULAR MEMBRANE. 277 R. Pulveris scammonii cum calomelane scr.). Fiat pulvis catharticus. Make a cathartic powder. R. Extracti gratiolae gr.xv. Tincturas sennas dr.i). Infusi sennas dr.x). - Syrupi zingiberis dr.'i). Kali vitriolati scr.). Fiat haustus catharticus. - Make a cathartic draught. R. Herbae gratiolae incisiae oz.iij. Foliorum sennas ess.jfs. Succi glycynhizas oz.iij. Electuarii e cassia oz.l). Aquae distillatae lb.)f$. Lenitur coque per quadrantum horas, addendo sub finem coc- tionis, v Boil gently for a quarter of an hour, adding at the end of the decoction, Myrrhas optimae dr.). Kali vitriolati dr.)fs. Cola pro uso : et sumat aeger cyathum parvum pro re nata. Strain for use, and let the patient take a small cupfull occa- sionally. Aa 278 DROPSY OF THE CELLULAR MEMBRANE. R. Cremoris tartari oz.i). ' Pulveris zingiberis dr.). Syrupi simplicis q. s. Fiat electuarium molle, de quo capiat asger cochleare medium omni quadrante horae donee alvus copiose respondeat. Make a soft electuary, of which the patient must take a des- sert spoonful every quarter of an hour until the bowels are copiously moved. 6. Diuretics; of colchicam, squills, kali acetatum, digi- talis, cream of tartar, spiritus aetheris nitrosi, cantharides, juniperus, raphanus rusticanus, sinapi, genista, the lactuca virosa, tinctura nicotianas. R. Aceti colchini oz.fs. Syrupi corticis aurantii oa.jfs. Fiat syrupus, cujus sumat aeger cochleare minimum omni biho- rio vel subinde donee nauseam promoveat. Make a syrup, of which the patient must take a tea spoonful every two hours, or now and then until it produces a nausea. R. Pilulae e scilla gr.x. Fiat pilulae duas sexta quaque hora suirundas. Make two pills to be taken every six hours. R. Pilulas e scilla gr.v). -------ex hydrargyro gr.ijfs. . Fiat pilulas duas nocte maneque capiendo. Make two pills to be taken night and morning. R. Pulveris digitalis gr.fs—i. Calomelanos gr.{—fe. Pilulas e scilla gr.v). Fiat bolus ter in dies adhibendus. Make a bolus to be taken thrice a day. DROPSY OF THE CELLULAR MEMBRANE. 279 R. Pulveris scillae gr.j. Pilulae ex hydrargyro gr.ijfs. , Extracti taraxaci gr.vj. Olei juniperi gutt.). Fiat pilulae duas ter in die sumendae. Make two pills to be taken thrice a day. R. Tincturae scillae gutt. xx. Kali preparati gr.v). Misturae camphorae dr.xi). Syrupi zingiber** dr.). Fiat haustus ter in die sumendus. Make a draught to be taken thrice a day. Aceti scilla? gutt. xx—lx. Ter in die ex quovis vehiculo idoneo capiendus. To be taken thrice a day in any proper vehicle. R. Kali acetati scr.). Infusi quassias dr.xi). Tincturas digitalis gutt. x. Fiat haustus ter in die capiendus. Make a draught to be taken thrice a day. R. Kali preparati scr.). Aceti distillati ferventls q. s. ad saturationem ejus. Misturx camphorae dr.x. Tincturas digitalis gutt. x. Syrupi zingiberis dr.). ' Fiat haustus ter in die sumendus. Make a draught to be taken thrice a day. 280 DROPSY OF THE CELLULAR MEMBRANE. R. Cremoris tartari dr.). - Kali vitriolati gr.x. Pulveris rhaei gr.ij. Fiat pulvis ter in die sumendus. Make a powder to be taken thrice a day. R. Tinctuiae cantharidis gutt. x—*xl. Spiritus aetheris nitrosi dr.). Misturas camphorae dr.xi). Syrupi zingiberis dr.). Fiat haustus ter in die sumendus. !&ak.c a draught to be taken thrice a day. R. Tincturae nicotian* gutt, x—lx. Infusi gentianas compositi dr.v). Aquae pimento dr.x. Fiat haustus ter in die sumendus. Make a draught to be taken thrice a day. R. Succi lactucse virosae spissati gr.x.: Fiat pilulae duas ter in die capiendae. Make two pills to be taken thrice a day. R. Succi lactuca: virosae spissati jcr.jfs. Infusi gentianas compositi dr.x. Aquae menthae piperitidis dr.iv. Spiritus juniperi compositi dr.). Fiat haustus ter in die sumendus. Make a draught to be taken thrice a day. DROPSY OF THE CELLULAR MEMBRANE. 281 R. Radicis raphani rusticani excisas oz.i). Seminis sinapeos albas oz.)fs. Baccas juniper! contusas oz.W). Vini albi Hispanict Ib.W). Digere per dies octo, dein cola :—capiat asger cyathum par- vum vinosum bis quotidie. Digest for eight days, and then strain':—the patient to take a fmall wine glass full twice a day. 7. Diaphoretics; pulvis ipecacuanhae compositus; cam- phor ; antimony ; assisted by tepid diluents ; the vapour bath ; the copious use of aqueous diluents ; water impregnated with tinctura ferri muriati. 8. Bandage. 9. Mercury ; so exhibited as just to affect the gums. The second indication demands,— 1. A light nourishing diet, with pungent aromatic vegeta- bles ; garlic, mustard, onions, cresses; Rhenish wine. 2. Tonics; cinchona, angustura, quassia, preparations of steel, as recommended for dyspepsia. 3. The occasional use of diuretics and aromatics. 4. Regular exercise. 5. Cold bathing. A a 2 282 ASCITES, OR DROPSY OF THE ABDOMEN. # Peritoneal. Encysted. SYMPTOMS. Of the peritoneal. It often comes on with loss of appetite J sluggishness ; inactivity ; dryness of the skin ; oppression of the chest; cough ; diminished urine ; costiveness ; shortly after a protuberance is perceived in the hypogastrium, which gradually extending, at length occupies the whole abdomen, which uniformly becomes swelled and tense, in a small degree elastic, and communicates 10 the hand, when struck against it, the sensation of its containing an undulating fluid. See Paracentesis Abdominis in works on surgery. As the distenion increases, the difficulty of breathing be- comes more considerable ; the countenance exhibits a pale or bloated appearance; immoderate thirst; dry parched skin ; high-coloured, thick, and scanty urine; depositing a late- ritious sediment; the pulse sometimes quickened, sometimes preternaturally siow and soft. The disease seldom continues long without inducing an anasaicous state of the lower extre- mities. The encysted dropsy is seldom preceded, or in the first in- stance accompanied, with any cachectic state of the system ; .t is distinctly observed to begin in a particular part of the ab- domen, and -thence gradually to diffuse itself througliout the A'hole cavity ; the strength of the patient is long unimpaired ; Species. DROPSY OF THE ABDOMEN. 283 and the appetite and respiration continue good ; until the bulk and pressure of the fluid brings on various constitutional ef- fects, which usually attend the true ascites in its early stages. In addition to the general causes of dropsy (see Anasarca), certain local affections, as diseases of the viscera of the abdo- men; scirrhosities of the liver, spleen, or pancreas ; enlarge- ment of the mesenteric glands; loss of tone in the peritoneum after pregnancy, or from atonic inflammation j local injury. DIAGNOSIS. The fluctuation of the contained fluid ; the diminished urine; the general leucophlegmatic appearance of the patient. From tympanites."-See Tympanites. From pregnancy—Consult the signs of pregnancy delivered by authors on midwifery. rROGNOSIS. Favourable. The urine little diminished, or becoming more copious ; the swelling of the abdomen diminishing ; the skin ceasing to be dry ; the respiration becoming free ; the strength originally little impaired. Unfavourable. Great emaciation ; sympathetic fever ; in- tense local pain; coma; the disease having been induced by a state of the liver, brought on by the abuse of spirituous li- quors ; or the constitution otherwise impaired. TREATMENT. C i. To evacu?te the fluid. Indications. j ^ Tq preycnt a .econd accumulation. 284 DROPSY OF THE CHEST. The first is effeaed by,— i. Purgatives, such as are recommended against ana^a;cj. 2. Diuretics, similar to those ordered for anasarca. 3. FricYton of the abdomen with camphorated oil. 4. After a fair trial has been given to these remedies, which increase the natural secretions, without effect, and the pressure and tension of the abdomen become insupportable, recourse must be had to paiacentesis of the abdomen ; the performing of which belongs to surgeons. The re-accumulation is sometimes prevented,— 1. By removing the causes which induced the disease; and fc by strengthening the tone of the parts in particular, and of the system in general. 2. If the disease proceed from chronic visceral obstruction, by mercury, administered both internally, and externally by friction to the abdomen ; the union of squill wilh calomel; or of calomel with antimony. 3. If from relaxation, by tonics, aromatics, stimulants; as directed for anasarca. HYDROTHORAX, OR DROPSY OF THE CHEST. Species. \ *' In the cavit? of the P,eura- I a. In the cavity of the pericardium. SYMPTOMS. Of water in the cavity of the pleura. Great difficulty of breathing, increased upon exertion ; and most considerable during the night, when the body is in an horizontal posture; distressing sense of weight and oppression at the chest; the DROPSY 0* THE CHEST. 285 countenance is pale; sometimes, however, it has the asthma- tic purple tinge, and conveys a peculiar and striking expres- sion of anxiety ; the urine is in small quantity ; great thirst ; anasarca of the upper extremities ; the pulse is irregular ; of- ten intermitting for two, sometimes for three strokes ; palpi- tation of the heart; sometimes so great as to be both seen and f heard ; cough, with expectoration generally tinged with blood ; in describing his complaint, the patient frequently mentions his having the sensation of breathing through water; difficul- ty of lying upon one side ; and when the disease exists in both cavities of the chest, the patient is incapable of lying down at all, and is obliged to be supported by pillows in an erect. position ; his sleep is disturbed by dreadful dreams, of fire, of drowning, of falling down precipices, &c ; and frequently he awakes with a sense of suffocation, suddenly starts from his bed, and is some time before he recovers his recollection ; the arm of the side in which the water is collected is generally cold and torpid, and often affected with numbness. Of water in the cavity of the pericardium. In addition to many of the above symptoms, the heart in this disease is great- ly enlarged, so as to be felt to palpitate, even as low as the seventh'or eighth rib. The inegulai ity of the pulse is more remarkable ; at one instant it is imperceptibly small and ra- pid, in the next a remarkably hard wire. The difficulty of breathing often assumes an intermittent form, and in the pa- roxysm is much more severe and distressing. Anasarca of the extremities takes place in the advanced period of the disease; and there is the same starting from sleep as in the true hydro- thorax. CAUSES . The general causes of dropsy (see Anasarca) ; obstruction to the free circulation of the blood through the lungs, by dis- ease of,the thoracic viscera, or loss of tone in the membranes lining the chest. 286 DROPSY OF THE CHEST. DIAGNOSIS. The distinguishing symptoms aie, the extreme difficulty of breathing ; the incapacity of lying upon one, sometimes upon either side; the sudden starting from sleep; the peculiar pulse before described ; the striking appearance of the countenance; the numbness of the arms; palpitation of the heart. From collections of matter and blood. By the characteristic marks enumerated by writers on surgery, when treating of such diseases of the chest. From syncopeanginosa. The one disease consists of distinct paroxysms ; each of which is brought on by certain exciting causes (see Syncope Anginosa). In the other the symptoms are usually permanent; the peculiar serfsation of heat extend- ing to the arms, which takes place in syncope anginosa, is rarely felt in hydrothorax. When syncope has long existed, and the symptoms have become less marked than in its first attack, a distinction is extremely difficult to be formed. PROGNOSIS Will always be unfavourable; more especially when hydro- thorax is the consequence of organic disease ; when it occurs in a shattered constitution ; when the symptoms become more and more severe, and are attended with coma and spitting of blood. TREATMENT. i - The same evacuant plan is here to be pursued as recommend- ed for the cure of anasarca and ascites. The diuretics most usually employed are, digitalis, squill, crystals of tartar. See Treatment of Anasarca. If there be much debility, myrrh combined with spiritus aetheris nitrosi, or other Ionics and diuretics united ; with the addition of frequent blisters to the chest. , WATER IN THE HEAD. 287 R. Myrrhas optimae scr.fs. Spiritus aetheris nitrosi dr.). Infusi rosas mucilaginous vehicle. 3. Diaphoretics ; especially antimonials. 4. Nitre in large doses with digitalis. B b 290 RICKETS. R. Nitri purificati gr.vj. Tincturae digitalis gutt. x.—xl. Aquae ammonias acetatae dr.i). —•— distillatae dr.v. Syrupi croci dr.). Fiat haustus infanti ast. 4 adhibendus tertia quaque hora. Make a draught to be given to an infant of four years of age every three hours. 5. Blisters, and cold applications to the head; cloths wet. ted with cold water, or vinegar and water, and so applied as not tcrinterfere with blistering. The second indication requires,— 1. Mercury; mercurial friction externally, calomel taken internally. a. Digitalis; either alone, or united with calomel. 3. Tonics; the ferrum ammoniacale, femim vitriolatum, or those recommended for the cure of anasarca. RACHITIS, OR RICKETS. This disease is peculiar to infants and childien, between the sixth month and the second year of their age. Its usual symptoms are weakness; a white or leucophlegmatic appear- ance of the whole body ; a bloated or very florid countenance; soft flesh ; disinclination and dislike to motion ; enlarged ab- domen, head, and joints ; the wrists and ancles enlarge first, then all the bones as it were swelj and become soft, especial- ly the more spongy ones. The pulse is quick and feeble; the appetite and digestion usually bad. Dentition is generally RICKETS. 291 late, though not frequently difficult, but the teeth decay soon after they appear, and fall out. When the disease has made much progress, the cylindrical bones bend; the ribs also, and even the spine, incurvate. CAUSES. Scrofula ; any cause inducing general weakness and relax- ation. It frequently arises from unhealthy parents ; especial- ly from mothers who pass too sedentary a life in bad air, and feed upon a poor and watery diet; from children's food being weak, watery, or too viscid to be properly digested ; but, a- bove all, pet haps from bad nursing, or children being left wet, dirty, or exposed to a cold moist air without sufficient cover- ing ; from want of proper exercise, arm from close and crowd- ed apartments ; from being kept too long at the breast; from sucking a nurse whose milk is impoverished by irregularity ; lastly, from the constitution being enfeebled by disease in early infancy, especially weak bowels. TREATMENT. C t. To brace and strengthen the solids. Indications. \ *• To promote digestion and the formation of L a good chyle. These ends will be promoted by,— i. Wholesome and dry food ; good bread or biscuit, and roasted meats rather than boiled, with a little port wine. Should the child be too young to eat flesh meats, its diet ought to consist of milk, rice, millet, pearl-barley, salop, arrow- root, semolina, with spices, &c. a. Good nursing, with regular exercise in a pure dry air. 3. Chalybeates and tonics ; especially steel wine, muriater iron, carbonated iron, bark, Colombo, and myrrh. •29? RICKETS. R. Vini ferri dr.). Natri preparati gr.ij. Aquas distillatae dr.i). Syrupi simplicis dr.). Fjat haustulus ter in die adhibendus. Make a draught to be given thrice a day. yR* Tincturas ferri muriati gutt. ij. 'Syrupi rosae dr.). Fiat syrupus ter in die capiendus. Make a syrup to be taken thrice a day. R. Salis essentialis cinchona; gr.v. i .. " Vini rubri dr.i). Fiat haustulus ter in Aie exhibendus. 'Make a draught to be given thrice a day. R. Myrrhas optima?, Pulveris colombae, aagr.iv.—x. Fiat pulvis ex pauxillo syrupi bis quotidie adhibendtis. Make a powder to be given in a little syrup twice a day. 4. Cold bath, and friction with warm flannel. 5. The mineral and vegetable alkalies are also esteemed by some. 6. Phosphorated medicines have lately been exhibited with advantage, especially the phosphate of lime and phosphate of soda. If the child be of a gross habit, a calomel purge should be given occasionally. 29S ORDER III. IMPETIGINES. CHARACTER. Cachexy, chiefly deforming the skin and external parts of *he body. <£> SCROFULA. The various external and local appearances produced by this disease are described by writers on surgery. Its first appearance is usually between the third and seventh years of age, or at any period before the age of puberty ; af- ter which it seldom makes its first attack. It most common- ly affects children of a lax habit, with smooth, soft, and fine skins; fair hair; a peculiar fulness and rosy appearance of the face; large eyes, and very delicate complexions. It is also apt to attack such children as shew a disposition to rachi- tis ; marked by a protuberant forehead, enlarged joints, ami tubid abdomen. B b £ 294< SCROFULA. CAUSES. It seems to be peculiar to cold and variable climates; it is the effect of an hereditary predisposition ; and is excited by crude indigestible food, bad water, living in damp l°w situ- ations, debility however induced, syphilis. ' TREATMENT. The remedies which have been employed with the greatest success are,— » i. Sea bathing, and living by the sea side. 2. Mineral waters, the sulphureous and chalybeate. 3. Tonics; especially Peruvian bark, mynh, ferrum vitri- olatum, ferrum ammoniacale. 4. The inhalation of oxygen gas. 5. The juice of the fresh leaves, or strong decoction of the dried leaves, of the tussilago. N 6. Mercurial alteratives; the hydrargyrus cum sulphure, Plummer's pill, calomel. 7. Antimonials, with decoctions cf guaiacum, sarsaparilla, sassafras, mezereon, and dulcamara. 8. Muriated barytes, and muriate of lime'. 9. Cicuta. 10. Lime-water. 11. Alkalies; especially soda with Peruvian bark. 12. Burnt sponge, light, nutritive, and generous diet, pure dry air, friction, moderate exercise. 295 SCORBUTUS, OR THE SCURVY. SYMPTOMS. Heaviness, weariness, dejection of spirits, anxiety and op- pression at the prascordla. As the disease advances, the coun- tenance becomes sallow and bloated ; respiration is hurried by the least exertion ; the breath becomes offensive; wandering pains are felt in different parts of the body, particularly du- ring the night; the pulse is small and frequent; the gums swell, become spongy, and bleed upon the slightest touch ; they separate from the teeth, which become loose ; petechias and maculae appear in various parts ; the slightest scratches degene- rate into foul and ill-conditioned ulcers ; spontaneous ulceration likewise takes place upon the gums, and upon the surface of the body; the joints become swelled and stiff; the tendons of the legs rif.id, contracted, and exceedingly painful ; the bow- els are either obstinately constipated, or there is a dianhcea ; the urine is high coloured, covered with an oily pellicle, and changes vegetable blues to a green colour ; great emaciation ensues; passive hxmoirhagies lake, place from the nose, the ears, the anus, and even from the extremities of the fingers; all the excretions become intole.ably fetid; still, however, the aopetite frequently remains entire, and the patient retains his intellectual faculties, until death relieves him from a horrid complication of misery. 296 THE SCURVT. Defect of nourishment; diet of salted or putrescent food, with deficiency of vegetables ; want of cleanliness ; cold uni- ted to moisture, or the transition from a warm to a cold tem- perature ; want of exercise ; depressing passions of the mind. DIAGNOSIS. From malignant fever. By the absence of feverish symp- toms; by the intellectual faculties being little impaired.; by the disease coming on more gradually, and continuing a much longer time; by its not being contagious. PROGNOSIS Will be drawn from the severity of the disease; the situa- tion of the patient with respect to vegetable diet, or other pro- per substitute. Favourable circumstances. The constitution not having been weakened by previous disease; little reduction of strength ; moist skin ; bilious diarrhoea ; the patient capable of muscular motion; slow pulse; the petechias, if any appear, being of a bright red colour ; the absence of ulceration. Unfavourable. Great piostration of strength; redness of the eyes; flushed countenance; quick weak pulse ; profuse haemorrhages of dissolved blood ; petechiae and maculae of a dark livid colour; extreme oppression at the prascordia; fetid and involuntary evacuations. TREATMENT. Indications. < " i. To correct the septic tendency of the fluids. 2. To palliate urgent symptoms. u 3. To restore the tone of the solids. THE SCURVY. 297 The first indication is fulfilled by :— i. Vegetable food of every description ; the vegetable acids ; as the orange, the lime, the lemon, or the citric acid in a con- crete form; it there be great prostration of strength, they may be united with wine. 2. Fermented and fermenting liqtiors; as ale, cyder, spruce beer, infusion of malt, fermenting wines, Sec. the subacid fruits ; sugar. 3. Oxygen; which maybe biealhed or given in the oxygen- . ated muriate of potash. 4. A solution of nitre in common vinegar. 5. Mineral acids ; more particularly the oxygenated muri- atic, the nitric, and sulphuric. 6. The utmost attention to cleanliness. 7. Diaphoretics ; especially the serum sinapeos. 8. Occasional aperients of infusion of tamarinds, cream 6f tartar. With regard to the second indication,— Ulcerations of the gums require astringent gargles of alum, muriatic acid, mel asruginis, decoction of bark, the steam of vinegar. Acute pains are relieved by opium. Oppression at the chest, and difficulty of breathing, by blisters. Contractions of the muscles of the legs, by fomentations of vinegar and water, or emollient cataplasms ; frictions. Scorbutic ulcers upon the surface of the body, by the means recommended in practical works on surgery. The third indication requires,— 1. Pure, temperate, and dry air, 2. Regular exeicise. 3. A nutritive diet of recent animal and vegetable food* 298 JAUNDICF. 4. Tonics and astringents, of Peruvian bark, the mineral acids, preparations of iron. 5. Stimulants, of raphanus rusticanus, wine, &c. ® ICTERUS, OR JAUNDICE. SYMPTOMS. Languor; inactivity; loss of appetite ; sense of uneasiness er pain in the right hypochondrium ; heat and pricking of the skin ; bitter taste in the mouth ; the tunica conjunctiva of the eye is perceived to become of a yellow colour, and soon after- wards the whole surface of the body ; the urine is higb-co- Ioured, and tinges linen yellow; nausea ; vomiting; obstinate costiveness or diarrhoea ; the stools are of a clay colour ; the pulse is generally slow, yet sometimes, especially where the pain is acute, it becomes quick and hard, and there is a fever- ish heat and dryness of the skin. Should the disease be long protracted, petechiae and maculae sometimes appear in different parts of the body; the skin, before yellow, turns brown, or livid ; even passive haemorrhages and ulcerations have broken out, and the disease has in some instances assumed the form of scurvy. t CAlStS. Biliary calculi in the gall bladder, or its duft ; inspissated bile; spasmodic contraction of the ducts themselves, often from passions of the mind ; pressure upon the ductus commu- nis choledocus; either by colleaions of hardened faeces, b\ JAUNDICE. 299 tumors of neighbouring viscera, as of the pancreas, of the mesenteric glands, of the pylorus of the stomach, &c. diseases of the liver itself; as inflammation, partial scirrhus, &c. the active operation of some poisons and purgatives ; morbid re- dundance of bile. Proximate. The absorption or regurgitation of bile into the sanguifeious system. DIAGNOSIS. The characteristic symptoms which distinguish this from every other disease, are, the yellow colour of the skin, more especially observable in the tunica conjunctiva of the eye; the bitter taste in the mouth ; ihe yellow tinge communicated to linen by the urine; the white or clay-celoured fasces; added to the sense of pain or uneasiness in the right hypo- chondrium. PROGNOSIS. Favourable. The disease having arisen from a cause that admits of easy removal; as spasm, accumulated fasces, the temporary pressure during pregnancy, &c. &c. the strength and appetite little impaired ; the disease suddenly appearing; cessation of local pain, followed by bilious diarrhoea. Unfavourable. Circumstances leading to the suspicion of the disease having originated in a scirrhous state, either of the liver itself, or of the neighbouring viscera ; as the previous irre- gular life of the patient, long-continued local pain and tumor, &c. Symptoms of hectic ; colliquative evacuations ; symp- toms showing a determination to the head ; as vertigo, flushed countenance, headache; supervening anasarca; its being complicated with any other disease. 300 JAUNDICE. TREATMENT. f* i. To remove the cause of obstruction to the Indications. X passage of the bile into the duodenum. (_ 2. To palliate symptoms. If it arise from calculus, from spissitude of the bile, or spasm, and is attended by much pain, or symptoms of fever, recourse must be had to,— i. The warm bath ; fomentations and blisters to the hypo- chondria. z. Gentle emetics, where the local pain is not acute. 3. Cathartics ; aloes, castor oil, soap, calomel. 4, Emollient clysters. 5. Opium, cicuta, hyoscyamus, tepid diluents, where the pain is evidently spasmodic. 6. Lithontriptics, of natron, soap; also raw eggs, turpen- tine with aether, and stomachic bitters—Colombo, gentian. 7. Bath and Cheltenham waters. If from inflammation,—by the means laid down for the cure of hepatisis.* If from scirrhous tumors,—mercury, internally and exter- nally, by friction, upon the abdomen ; cicuta ; electricity, and other means elsewhere recommended. If from accumulations of hardened fasces in the intestines,— brisk cathartics ; copious enemas ; dashing cold water upon the extremities. Should the disease assume the scorbutic form,—acids, and other remedies adapted to that complaint, must be had re- course to. &tfoenfca. I variola: vaccinje. COW POCK'AND VACCINATION. THE truth so interesting to the human race, that Vaccination may with confidence be resorted to as a Preventive of Small Pox, was first completely brought before the public, and satisfactorily proved, by the ingenious and indefatigable JENNER. In the investigation of this most important subject he spent many years of his valuable life, and expend- ed a considerable portion of his private fortune, for which he will, no doubt, be ultimately amply remu- nerated by the gratitude of the British nation, and the plaudits of an admiring World. We mu^t refer to his writings as well as to those of Bryce, Willan, and Adams, for fuller informa- D d 314 COW FOCK, tion on this subject than can be given in the limits we are necessarily confined to by the nature of this work. Our chief object here must be to give INSTRUCTIONS FOR-VACCINE INOCULATION COMMONLY CALHD VACCINATION. In doing this we shall of course be obliged to give such a description of the Vaccine disease, or rather process, as may answer all the claims of the young student, or practitioner, for whom this work is chiefly intended. It is now universally allowed, that Vaccination effectually prevents the -Small Pox, is never dan- gerous, requires no particular diet nor medicine, and may be practised at all ages, and at every season of the year. To collect the Vaccine Matter or Fluid. The Vaccine Fluid may be taken from a pustuJe or vesicle that is making its progress regularly, and which possesses the true Vaccine character, to be hereafter explained, by puncturing with a lancet or needle in several points, and charging small square pieces of glass with it, by gently pressing them on the opened puncture, and putting two of them to- gether, with the sides containing the matter in con- tact: they are then to be carefully put up in a piece of paper, and preserved as much as possible from heat and moisture. OR VACCINATION. 315 The period most proper for taking the vaccine fluid is from the seventh to the ninth day, or before the efflorescence or secondary inflammation takes place, as unnecessary irritation is thereby avoided. But the ttirus taken even after this period, contrary to the opinion of Dr. Jenner, will produce the genuine pock,—as is proved by the internal or central part of the first scab that falls off, which is the true vaccine scab, being now used by physicians in vaccinating With the most complete success. In this way the matter may be kept in a cool dry place for several months, and sent to considerable distances without losing its efficacy. To introduce the Virus. The most proper places for introducing the virus is about midway of the arm or fore-arm. The best mode of doing it is by impregnating the point of a clean sharp lancet with the virus, and inserting if, by means of a very slight scratch, or small puncture, and wiping the point of the lancet on the punctured part. As little blood should be drawn as possible, lest the virus should be too much diluted or washed away. Fluid virus taken from a vesicle and imme- diately inserted without dilution is the best mode of ensuring success. In employing the matter on the glasses, first restore it to its fluid state by dissolving it in a small portion of cold water taken upon the point of a lancet; and when using the scab scrape oft some of the dark, internal central parr, and mix it with a little cold water on a piece of glass. "»1« COW POCK, Signs of Genuine Vaccination. A small red spo,t generally appears on the punctus. red part on the third day, which on the fourth or fifth day becomes a small vesicle, and goes on in- creasing, with a depression in its centre, until the ninth or tenth day, when it is generally surrounded with a rose coloured circumscribed circle, or efflores- cence, which remains nearly stationary for a day or two. This efflorescence is called the Areola :—it is commonly in size rather larger than a dollar. On the ninth day there is frequently some pain running from the pustule along the course of the larger lym- phatics. The glands under the arm swell and be- come painful. Soon after or about this time fever commences;, which is known by chilliness, dizzi-- ness, shuddering, general heaviness, and lassitude, soreness.in the limbs, and pain about the loins; some- times by a painful tension, or uneasiness about the pit of the stomach, and not unfrequently in the up- per part of the thorax. In the greatest number of cases, the indisposition is so slight as not to prevent from following usual occupations; and in a few, the sickness ij scarcely perceptible—-and this last is particularly the case with infants. On or about the eleventh or twelfth dav the efflo- rescence begins to fade away, the pustule appears to be drying up, and gradually becomes a hard glossy - scab of a dark, mahogany colour. The progressive stages of the pustule are common- ly compleated in fourteen or fifteen days from the OR vaccination. 31T period of vaccination, and one pustule only is pro- duced for every puncture. Spurious Pustule. The most frequent deviation from the perfect pus- tule is that which finishes its progress much within the time-limited for the genuine vesicle. Its commencement is marked by a troublesome itching ; and it forms a premature efflorescence, sometimes extensive, but seldom regularly circum- scribed, or of so vivid a tint as that which surrounds the compleat and genuine pustule ; and it exhibits one peculiar characteristic mark of degeneracy, by appearing more like a common festering, produced Uy any small extraneous body sticking in the skin, than a pustule excited as before described by the vaccine virus. The regular appearance of the vac- cine vesicle is frequently destroyed, and its progress rendered uncertain, by being rubbed,—hence this should be always sedulously guarded against. An attention to the progress of the genuine vaccine inoculation impresses on the mind of a practitioner the perfect character of the vaccine pustule. There- fore, when a deviation of any kind arises, common prudence points out the necessity of Re-vaccina- tion wilh virus of the most active kind, and if pos- sible, taken fresh from the vaccine pustule. We have already mentioned, that to prevent the patient from suffering inconvenience in the vaccina- ted part, it is necessary that it should not be rubbed. It should be entirely loose, uncovered, and exposed to the air, particularly during the formation and ex- istence of the areola. Dd 2 318 cow pock, &C The arms of adults are often inflamed from their wearing tight clothes, or using too much exercise at fhe period of efflorescence. This might be easily prevented by avoiding the cause. If the pustule is rubbed and becomes a sore, Dr. Jenner recommends dropping into it a drop or two of Goulard's * extract. It may also be washed fre- quently with a solution of the acetate of lead, and covered with Goulard's f cerate spread on a piece of fine old linen or lint. This should be properly con- fined on the arm. > * Aqua lithargyri acetati. f Ceratiim lithargyriacefif'. OF WEIGHTS, MEASURES, be. Particularly addressed to Students. IN Troy Weight and Avoirdupois we remark this difference, that in one pound of the former are con- ' tained only twelve ounces, but in the latter sixteen. The ounces too differ; and though the former pound is less than the other, yet the ounce is greater.* The preparation of all medicines and compounds in the Dispensatory, as well as the extemporaneous prescriptions^ medical practitioners, are adapted to the troy weight only; therefore^ the incautious usage of the avoirdupois ounce or half^unce weight, with the troy drachm and its subdivisions, should be avoided, otherwise the exacl proportions, as they are set down, cannot be accurate, and by such means, the effects of a medicine may in some measure be defeat- ed. The weight used in dispensing medicines is thus divided :— The Pound contains Twelve Ounces, The Ounce ----- Eight Drachms. The Drachm ■ Three Scruples. The Scruple ----- Twenty Grains. The Measure employed in Medicine is that called Wine Measure ; which is thus divided : The Pint contains Sixteen Ounces. The Ounce .----- Eight Drachms. The Gallon ----- Eight Pints. * The Troy ounce contains 480 grains, the Avoirdupois only 437$, by which we find the latter to fall short of the ounce troy weight qz\ grains: and therefore 10 oz. troy are nearly equal to 11 oz. avoir. 320 WEIGHTS, MEASURES, &C. Further it should be noticed, that mortars, mea- sures, funnels, and vessels employed in the evapora- tion of liquids, being made of copper, lead, brass, or any mixed metal, should be used with great caution and attention to cleanliness. This observation should be particularly attended to in the use of mortars, for the rubbing any of even the softer substances in a bell-metal mortar, usually imagined not easily liable to abrasion, infallibly gives them a cupreous quality; which will appear evident by adding to them a little common volatile alkali. And as to vessels made of lead, and its compounds, the deleterious effects of their use are universally* known and acknowledged. ~ Nor are marble mortars altogether free from objec- tion, on account of the calcareous particles which form their basis. If these be used in the combina- tion of some medicines, where a mineral or vegeta- ble acid is meant to be predominant, we shall fre- quently find the acid completely neutralized, by an admixture of the component parts of the marble. As a proof of this, let a few drops of any of the acids be deposited in a mortar of this kind, and a certain degree of effervescence will be immediately obser- ved, and a chymical union will take place, so as to defeat the intention of a practitioner. Vessels and mortars should have a decided preference which are not easily acted upon, such as glass; and perhaps no mortars are more free from objection, than those of the ware invented by Mr. Wedgwood. GALVANISM. GALVANISM, being but a recent discovery, is yet perhaps, far from having attained that repute, at which it bids fair to arrive. So far as its medical effects have been proved, it has been found of the greatest utility in many obstinate local affections: particularly in deafness, gulta serena, sciatica, and paralysis. As a stimulant, it appears to be more powerful than the electric fluid, operating much more sensibly on the nervous system j and where the limbs have suffered from muscular or tendinous contractions, it has been often applied with unprece- dented success. ALPHABETICAL LIST THE MEDICINES NOW IN USE. their virtues and doses. LATIN NAMES. Abrotani folia. Ablinthium. < Acetum diftillatum. 11 ■ i I'cillae; elm acetum fcil- liticum. Acidum acetofum. Acidum, muriaticum; olim fpi- ritus falis marini Glauberi. ... nitrofum. .--------———— dilutum. vitriolicum. . ■ dilutum. Aconitum. /Ether vitriolic us. Agrimonia. Aloes. Alumen. .. uftum. ENGLISH NAMX«. Southernwood leaves. Wormwood. Vinegar, diftilled. . of fquill. Acid, acetous. Acid, muriatic ; formerly Glau- ber's fpirit of fea fait. . ■ . nitrous. .. — diluted. ii vitriolic. —-------diluted. Alkohol. Allium. Blue wolf's-bane. /Ether, vitriolic. Agrimony. Aloes, gum. Alum. . burnt. Alkohol. Garlic. 324 "LATIN NAMES. Althea. Ammonia preparata ; dim fal volatilis falis ammoniaci. Ammoniacum. Anethi femen. Angelicas folia. Anifi femen. Antimonium ealcinatum; dim calx antimonii. ' ———— tartarifatum; dim tar- tarum emeticum. ■ vitrificatumj aim vi- trum antimonii. Apii hortenfis radix. Aqua aluminis compofita. '■ ' ammonia j olim fpiritus falis ammoniaci. —— ammonias acetatae; dim fpi- ritus Mindereri. ■ ammonia? purae,; olim fpiri- tus falis ammoniaci cum calce. ——— anethi femlni?. cakis. ' cinnamomi; olim aq. cinna- momi simplex. —— diftillata. ■■ ■ fceniculi. ' kali; dim lixivium tartari. Aqua lithargyri acetati; olim ex- tra&um faturni. ^———— compofita. i - menthae piperitidis. 'i ■■ fativae. —— picis. ENGLISH NAMES. Marfhmallows. Prepared ammonia j formerly vola- tile fait of fal ammoniac. Ammoniacum, gum. Dill feed. Angelica leaves. Anife feed. Calcined antimony; formerly calx of antimony. Tartarized antimony j formerly emetic tartar. Vitrified antimony ; formerly glafs of antimony. Garden parfley root. Compound alum water. Water of ammonia ; formerly fpi- rit of fal ammoniac. —— of acetated ammonia ; for- merly fpirit of Mindererus. ■ ■ of pure ammonia; formerly fpirit of fal ammoniac with lime. ---- of dill-feed. Lime water. Cinnamon water; formerly Ample cinnamon water. Diftilled water. Fennel water. Water of kali j formerly lixivium of tartar. Water of acetated litharge j for- merly extract of Saturn. Compound water of acetated li- tharge ; generally called Gou- lard's vegeto-mineral water. Peppermint water. Spearmint water. Tat water. 325 LATIN NAMES. Aqua pimento. ■ ■ pulegii. ■ ■ rofae. Aribicum gummi. Argentum nitratumi ■»'«« caufti- cum lunare. Arfenicum. Afari f&lia. A venae femen. Balfamum capaiva. ———— Canadenfe. ■ Peruvianum. i ■' i 11 Tolutanum. Bard an a. Barilla. Benzoe refina. BUtortae radix. Bolus Galljcus. Borax. Calomelas. Calamus aromaticus. Calaminaris. Calx hydrargyri alba ; dim mer- curius precipitatus albus. Calx viva. Campechianum lignum. Camphora. Canella alba, vel cortex Winte- ranus. Cantharis. Cardamine. Cardamomum minus. Carduus benedidtus. ENGLISH NAMXS. Pimento water. Pennyroyal water. Rofe water. Gum Arabic. Nitrated filverj formerly lunar cauftic. Arfenic. Afarabacca leaves. Oatmeal. B Balfam of capivi. Balfam of Canada. Balfam of Peru. Balfam of Tolu. Burdock. Pearl ath. Gum Benzoin, Biftort root. French bole. Borax. C Calomel. Sweet flag. Calamine. White calx of quickfilver j former- ly white precipitated quickfilver. Quick lime. Logwood. Camphor. White canella, or Winter's bark. Spaniih fly. Lady's fmock. Lefl'er cardamom. Blefled thiftle. e e 326 LATIN NAMES. Carica. Carui femen. Caryophyllus aromaticus. i 11 ruber Cafcarilla, vel eleatherii cortex. Caflia fiftularis. Caftoreum Rufficum. Cataplafma cumini. ————— finapeos. Catechu, vel terra Japonica. Centaureum minus. Cera. Cerufla. ■■ acetata ; dim faccharum faturni. Chamajmeli floret. Chelae cancrorum. Cicutae folia. Cinnamomum. > Cinarae folia. Cineres clavellati. Coagulum aluminofum. Coccinella. Cochlearia hortenfis. Colchicum. Colocynthis. Colomba radix. Confectio aromatica; dim con- fectio cardiaca. Confectio opiata ; dim philonium Londinenfe. Contrayervae radix. Corallium rubrum. Coriandri femen. Cortex Peruvianus, vel cinchonae. Cornu cervi uftum. Conferva abfinthii maritimi. ENGLISH NAMES. Figs. Carraway feed. Cloves. Clove July-flower» Cafcarilla, or eleutheria bark. Pulp of caflia. Ruffian caftor. Cataplafm of cummin. ————— muftard. Catechu, or Japan earth. Lefler centaury. Wax. Cerufe. ' , acetated j formerly fugar of lead. Chamomile flowers. Crabs claws. Hemlock leaves. Cinnamon. Artichoke leaves. Pearl, or pot allies. Alum curd. Cochineal. Garden fcurvy-grafs. Meadow fafFron. Coloquintida, or bitter apple, the Columbo root. pith. Aromatic confection j formerly cor- dial confection. Opiate confection; formerly Lon- don philonium. Contrayerva root. Red coral. Coriander feed. Peruvian bark. Burnt hartfliorn. Conferve of fea wormwood. 327 LATIN NAMES. Conferva aii. ——— corticis aurantii Hifpa- lenfis. ———— cynolbati. ■ lujulae. ——— pruni fylveflris. ' - rofae rubris. ——— fcillae. Creta preparata. Crocus Anglicanus. Crocus antimonialis medicinalis. Cubebas. Cucumis agreftis. Cumini femen. Cupri aerugo. Cuprum vitriolatum. ■ Curcumae radix. Cydonii femen. Cynofbatus. Dauci fylveflris femen. Decoctum cornu cervi; olim de- coctum album. _——— cinchonae. i — pro enemate. ——— pro fomento. 11 hellebori albi. - hordei; olim aqua hor deata. __________hordei compofitum; olim decoctum pectorale. Decoctum farfaparillae. . farfaparillae compofitui __——. ulmi corticis. Digitalis purpurea. ENGLISH NAMES. Conferve of cuckow pint. ——— Seville'orange peel. ■ hips. i wood forrel. i floes. ——— red rofes. ■ ■ fquills. Prepared chalk. Engliih faffron. Medicinal faffron of antimony. Cubebs. Wild cucumbe". Cummin feed. Verdigreafe. Blue vitriol, or fulphat of copper. Turmeric root. Quince feed. Dog rofe, or hip. D Wild carrot feed. Decoction of calcined hartihorn ; formerly white decoction. —— of Peruvion baik. —— for a clyfter. —— for fomentation. ■ of white hellebore. . —— of barley ; formerly barley water. Compound decoction of barley; for- merly pectoral decoction. Decoction of farfaparilla. n.Compound decodtion of farfaparilla. Decoction of elm bark. Purple foxglove. 328 LATIN NAMES. Elaterium. Elemi, refina. Eledtuarium Caffiae. 1 , kammonii. ————— fennae; dim eledtua rium lenitivum. Eleutheriae coriex. Emplaftrum ammoniaci cum hy- i.'rargy!„'. - ■ car.th jri Jlr.; dim eni- *plaftram veficatorium. — ' cumini. ———— ladani; dim emplaf- trum ftomachicum. '• ■ lithargyri; o'ga em- plaftrum commune. ————— cum gummi. ■ ■ cum hydrargy- ENGLISH NAM.E3.. E Elaterium. Elemi, the refin. Electuary of caffia. ---------of fcarnmony. ----------of fenna j formerly lenl-- tjve electuary. Eleutheria bark. Plater of ammoniacum with quick"* fil ver. -----of Spanifli fly j formerly bliftering plafter. —— of cummin. of laudanum; formerly ft"p- machic plafter. —— of litharge; formerly coln>- mon plafter. ■ with gum. .1 i. , with quickfik- ro; dim emplaftrum mercuriale. i lithargyri cum refina; dim emplaftrum adhe- fivum. ver; formerly mercurial plafter. Plafter of litharge with refin ; for merly adhefive plafter. picis Burgun- Plafter of Burgundy pitch. dicae. faponis, thuris. Enulae campanae radix. Eryngii radix. Extradtum cacuminis genifts. ——— cafcarilla?. . chamsemeli. i « colocynthidis compofi- tura ; olim extradtum catharti- cirm. ■ cinchona;. , mi. i cinchonae cum refina:. S'oap plafter. Plafter of frankincenfd. Elicampane root. Eryngo root. Extract of broom tops. i of cafcarilla. —— of chamomile. Compound extract of colocyntlr, formerly cathartic extract. Extract of bark. ■' of bark with the refin. 329 LATIN NAMES. Extradtum gentianse. ■ glycyrrhizae. ' ■ ■ ■ helleboris nigri. ■ ligni campechiani. ■ ' — rutae. ■ ■ fabinae. ———— fennae. Ferri rubigo ; dim chalyb'u rubi- go preparata. Ferrum ammoniacale; dim flores martiales. Ferrum tartarifatum. i ■■ vitriolatum; dim fal martis. Faeniculi dulcis feme-n. Fenugraeci femsn. Filicis radix. Flcres benzoes. — fulphuris loti. Fowleri folutio arfenici. Galbanum. Galla. Gambogia, gummi refina. Geniftae cacumina et femina. Gentianae radix. Ginfengi radix. Glycyrrhiz* radix. Granati cortex et flores. Gratiola. Guaiacum lignum, cortex, et gummi-refina. Grana Paradifi. ENGLISH NAMES. Extract of gentian. ——^— of liquorice. ——— of black hellebore. ——• of jalap. ■ ■ of logwood. ■ of rue. ——— of favine. —— of fenna. F Ruft of iron ; formerly prepared ruft of fteel. Ammoniacal iron ; formerly mar- tial flowers. Tartarifed iron. Vitriolated iron; formerly fait of fteel. Sweet fennel feed.. Fenugreek feed. Male fern root. Flowers of benzoin. Waftied flowers of fulphur. Fowler's folution of arfehic. G Gum Galbanum. Gall nuts. Gamboge. Broom tops and feeds.. Gentian root. Ginfeng root. Liquorice root. Pomegranate, the fliell and flowers. Hedge hyfiop. Guaiacum wood, bark, and gum. Grains of Paradife, E e 2 330 L A i' I K N A M E S. Helleborafter. Hellebori albi radix. nigri radix. Horde ■ perlatum. Hydrargyrus acetatus. ————— cum creta. - " cakinatus. Hydrargyri calx. Hydrargyrus cum fulphure ; olim /Ethiops mineralis. " muriatus; olim cor- rpfivus fublimatus. ' i mitis ; olim calome- ENGLISH NAMES. H Bears foot. White hellebore roqjr/ Black hellebore root. Barley. Pearl barley. Quickfilver, acetated. ' ' with chalk. ————— calcined. ————— calx of. ■ ■ with fulphur; for^ merly /Ethiops mineral. ■ muriated; formerly 1 corrofive fublimate. mild; forme r- las. »" ' nitratus ruber; olim mercurius precipitatus ruber., • ' purificatus ; olim ar- ly calomel. ——— red nitrated ; former- ly red precipjtated mercury. ----------purified ; formerly gentum vivum. " fulphuratus ruber; quickfilver. olim cinnabar'13 fadtitia. ——— vitriolatus ; olim tur- pethum minerale, vel mercu- rius emeticus flavus. Hypericum, Jalapii radix. Infufum gentianas compofitiyi); olim infufum amarum fimplex. 1 rofae ; dim tindtuia rofa- rum. ■■ fennae fimrrex. n tartarifatum. Ichthyocolla. Ipecacuanhae r^dix. —— fulphurated ; former- ly factitious cinnabar. — vitriolated; formerly turpeth mineral, or yellow eme- tic mercury. St. John's wort. "^ & J Jalap root. Compound infufion of gentian ; formerly fimple bitter infufion. . of rofes ; formerly tincture of rofes. Simple infufion of fenna. Tartarifed infufion of fennat Ifinglafs. Ipecacuanha root. 331 LATIN NAMES. ENGLISH NAMES. Iridis Florentine radix. Florentine orris root. Juniperi baccse. Juniper berries. K Kali preparatum ; olim sal tarta- Prepared kali; formerly fait of ri. tartar. acetatum ; olim fal diureti- Acetated kali ; formerly diuretic cus. fait. ——Durum; vulgo alkali vege- Pure kali, or cauftic vegetable labile fixum caufticum. alkali. — fulphuratum ; olim hepar Sulphurated kali; formerly liver of fulphuris. fulphur. — tartarifatum ; olim tartarum Tartarifed kali; formerly foluble folubile. tartar. ——• vitriolatum ; olim tattarum Vitriolated kali; formerly vitrio- vitriolatum. lated tartar. Kino gummi. . Gum kino. " L •Lac ammoniac". Milk of ammoniac. ____amygdalae ; olim emulfio ----- of almonds; formerly corrl- communis. "ion emulfion. Lapis calaminaris. Calamine (tone. Ladani gummi. Gum lad3™"1' Linimentum ammoniae; olim li- Liniment of ammonia; formerly nimentum volatile. volatile liniment. .________________L_ fortius.------rJ---------------ftronger. ^____________________camphorae. ---------—— of camphor. -----------faponis. ——---------°f foaP' Lichen Iflandkus. Iceland liverwort. Liquor acidus fuccini j olim fpi- Acid liquor of amber ; formerly ritus fuccini. fp'"t of amber. _____i.*iii. cornu cervi; dim Volatile liquor of hartfhorn ; for- fpiritus cornu cervi. merly fpirit of hartfhorn. Lini femen. Linked. 33* LATIN NAMES. Macis. Magnefia alba. ———— vitriolata ; dim fel ca- tharticus amarus. . ufta. Majoranae folia. Malvoe. Manna optima. ■i Siciliana. Marrubium album. Mel. 11 rofae. ----fcillae. Meliffae folia. Mezerei radix et cortex. Millepedes. Miftura camphorata; olim)\\- lepum e camphora. 11 '■ cretacea; olim julepum e creta. mofchata; olim julepum e mofcho. Morus. Mofchus. Mucilago amyli. ■ Arabaci gummi. i feminis cydonii mali. Natron preparatum; olim fal fodae. f > tartarifatum ; o/ys fal Rupellenfik. i vitriolatum ; dim fal ca- tharticus Glauberi. ■—«- boracitatum; olim borax. ENGLISH NAMES. Mace. Magnefia. ■ vitriolated ; formerly bitter purging fait. ■ calcined. Marjorum leaves. Mallows. Flake manna, f Sicilian manna. White horehound. Honey. ——— of rofes. ——— of fquills. Balm leaves. Mezereon root and bark. Woodlice. Camphorated mixture; formerly camphor julep. 'Cretaceous mixture; formerly ju- lep of chalk. Mufk mixture; formerly julep of mufk. Mulberry. Mufk. Mucilage of ftarch. ■■ of gum Arabic. ' - of quince feed. N Prepared natron; formerly fait of foda. Tartarifed natron ; formerly Ro- chelle fait. Vitriolated natron ; formerly Glauber's purging fait. Boracitated natron; formerly bo- rax. 333 LATIN NAMES. Nicotiani folia. Nitrum purum. Nux mofchata, feu myrifticac. -----vomica* ENGLISH NAMES. Tobacco leaves. Purified nitre. Nutmeg. * — vomica. Oleum amygdalae. ——— animate. ——— anifi. ■■ baccae juniperi. i carui eflentiale. ■ caryophylli aromatici. ——- cinnamomir .I lavendulae. —— limonum ; olim effentia limoni. i lini, e feminibus. —. menthae piperitidis. , fativae. —- nucis mofchata:. Oil of almonds. Animal oil. Oil of anifeed. — of juniper berries. — of cairaway feeds. — of cloves. — of cinnamon. — of lavender. — of lemons; formerly effence of lemons. — of linfeed. — of peppermint. — of fpearmint. ■— of nutmeg. expreffum ; dim Expreffed oil of nutmeg; formerly oleum macis. i olivae. _—— origani. ——— petrolei. ' pulegii. ■ ricini, vulgo ca&.rii, ■ - rorifmatini. . faffafras. ______ finapeos. _. fuccini. _______ fulphuratum ; ol'.m bal famum fulphurii. _____ t.Mcbinthinae. ____— vini. Olibanum gummi redtiticatum. oil of mace. — of olives. Oil of origanum. — of petroleum. — of pennyroyal. Caftor oil. Oil of rofemary. — of faffafras. — of muftard. — of amber. Sulphurated oil; formerly balfam of fulpliur. Oil of turcentine. -______ . rectified. ., of wine. Gum olibanum- 334 LATIN NAMES. ENGLISH NAMES. Opium purificatum; olim extrac- Opium purified; formerly thebaic turn thebaicum. extract. Opoponax gummi. - Gum opoponax. Oftrearum teftae. Oyfter fliells. Oyxmel /Eruginis; olim mel Oxymel of verdigris ; formerly ^Egyptiacum. ./Egyptian honey. ——— colchici. —.—- of meadow faffron. —— fcillae. ... n i of fquills. ——— fimplex. ——— fimple. Papaver albus. ————■ erraticus. White poppy. Red poppy. Pareira brava. Pellitory of the wall. Rock oil. Parfley feeds. Pareira brava. Parietaria. Petroleum. Petrofelini femina. Petroleum fulphuratum; e/'«bal- Sulphurated petroleum; formerly famum fulphurim Barbadenfe. Barbadoes balfam of fulphur. "Pilulae ex aloe. Pills of aloes. 1 cum myrrha ; dim pi- .......... with myrrh j. lulae Rufi, formerly Rufus's pills. galbanicompofitae; olim Compound galbanum pills; for- pilulae gummofae. ex hydrargyro; olim pilulae merc'uriales. ex opio. e fcilla. Pimento. Piper longum. •—— album. Plx Burgundica. Pulvis aioes cum canella hiera picra. ■ cum ferro. --------- ■ ■ cum guaiaco, —— antimonialis. olim merly gum pills. Pills of quickfilver; formerly mercurial pills. —— of opium. — of fquill. Allfpice. Long pepper. White pepper. • Burgundy pitch. Powder of aloes with canella ; for merly hiera picra. ------- " with iron. ■with guaiacum. Powder, antimonial. 335 LATIN NAMES. Pulvis aromaticus; dim fpecies aromatica. ——— afari compofitus ; olim pul- vis fternutatorius. ■ ■ ■ ceruffae. ■i chelarum cancri compofitus. — contrayervae compofitus. • ——— cretae compofitus. — cretae, cum opio. ——• ipecacuanhae compofitus; olim pulv. Doveri. — myrrhae compofitus. . opiatus. ——— fcammonii compofitus. —..... cum aloe. —— i cum calomelane. — fennae compofitu"s. —— tragacanthae compofitus. Pyrethri radix. Pix liquida. Quaffiae lignum. Quercus cortex. Raphani rufticani radix.* Refina flava. Rhabarbari radix. Rubiae radix. Rutae folia. Sabinae folia. Sagapenum gummi. Sal volatilis cornu cervi. Sal fuccini puriricatus. ENGLISH NAMES. Powder aromatic, formerly aro- matic fpecies. ——-—— of a'farabacca compound ; formerly fternutatory powder. ————- of cerufle. ■■ of crabs claws, compound. ———— of contrayerva, compound* " of chalk, compound. ■ of chalk, with opium. '- of ipecacuanha, compound; formerly Dover's powder. ■ of myrrh, compound. i opiate. ■ ■■ of fcammony, compound. ————- of ftammony with aloes. , i of fcammony with calomel. ——— of fenna, compound. ————- of tragacanih, compound. Pellitory of Spain root. Tar. Quaffia wood. Oak bark. P.. Horfe radifli root. " Yellow refin. Rhubarb root. Madder root. Rue leaves. S. Savine leaves. Gum fagapenum. Volatile fait of hartfiiorn. Purified fait of amber. 336 LATIN NAMES. Sal tartari; vide kali. Sanguis draconis. Santonici femen. Sarcocolla-gummi. Sarfaparillae radix. Saffafras lignum et cortex. Scillae radix. Scammonium, gummi refina. Sennae folia. Serpentariae Virginianae radix. Sevum ovillum. Simaroubae cortex. Solutio Mineralis Fowlerii. Spermaceti. Spigelise Marylandicae radix et folia. Spiritus ammoniae; olim fpiritus falis ammoniaci dulcis. »n compofitus j vice fpiritus volatilis aromatici. » ■ fcetidus; olim fpiritus volatilis fcetidus. ■ fuccinatus; •vulgo eau de luce. anifi compofitus; olim aqua anifi fgirituofa compofita. ——————aetheris vitriolici f olim fpiritus vitrioli dulcis. — ■ aetheris vitriolici com- pofitus ; dim liquor anodynus mineralis. ,i i ■ i ■ ■ i nitrofi ; olim fpiritus nitri dulcis. ' camphoratus ; olim fpi- vitus vin&fus camphoratus. ENCLISH NAMES. Salt of tartar ; fee kali. Dragon's blood. Worm feed. Gum farcocolla. Sarfaparilla root. Saffafras wood and bark. Squill root. Scammony. Senna leaves. Virginian fnake root. Mutton fuet. Simarouba bark. Fowler's mineral folution. Spermaceti. Indian pink root and leaves. Spirit of ammonia ; formerly dul- cified fpirit of fal ammoniac. ' compound; in- ftead of volatile aromatic fpirit, or fal volatile. ————————— fetid ; formerly fetid volatile fpirit. Succinated fpirit of ammonia ; commonly called eau de luce. Compound fpirit of anifeed, for- merly compound fp'uhuous ani- feed water. Spirit of vitriolic sther ; formerly fweet fpirit-of vitriol. Compound fpirit of vitriolic aether; formerly mineral anodyne liquor. Spirit of nitrous aether -y formerly fweet fpirit of nitre. Camphorated fpirit; formerly camphorated fpirit of wine. 337 LATIN NAMES. Spiritus carui; dim aqua carui feminum fpirituofa. 1 ■ cinnamomi; olim aqua cinnamomi fpirituofa. • juniperi coAipofitus; dim aqua juniperi compofita. ■' lavendulae ; olim fpiri- tus lavendulae fimplex. 1 compofita. ■ menthae pigeritidis; olim aqua menthae piperitidis fpirituofa. —— —— fativae ; dim aqua menthae vulgaris fpirituofa ——— nucis mofchatae; olim aqua nucis mofchatae fpirituofa. --------pimento. '■ pulegii; dim aqua pu« legii fpirituofa. . raphini compofitus ; , olim aqua raphani compofita. • rorifmarini. ■ vinofus maximc recti • ficatus sive alkohol. ■ vinofus redtificatus. ■ vinofus tenuior. Spongia ufta. Starmi pulvis. Staphifagriae femen. Styracis refina. Succus baccae fambuci fpiffatus. —— cicutae fpiffatus ; -vulgo extradtum cicutae. ■ cochleariae compofitus j olim fucci fcorbutici. —a-—- limOn'lS fpiffatUi. ENGLISH NAMES.. Spirit of carraway feed ; formerly* fpirituous carraway feed water. — of cinnamon ; formerly fpiri- tuous cinnamon water. Compound fpirit of juniper; for- merly compound juniper water. Spirit of lavender; formerly laven- der water. Compound fpirit of lavender. Spirit of peppermint; formerly fpirituous peppermint water. —— of fpearmint;. formerly fpi • rituous fpearmint water. — of nutmeg ; formerly fpiritu- ous nutmeg water. —— of pimento. —— of pennyroyal; formerly fpi- rituous pennyroyal water. Compound fpirit of horfe radiih ; formerly compound horfe radiih water. Spirit of rofemary. Highly rectified vinous fpirit, or alcohol. Rectified vinous fpirit. Weak vinous, or proof fpirit. Burnt fponge. Powdered tin. Stavefacre feed. Storax. Infpiffated juice of elder berries. —— —— of hemlock; com- monly extract of hemlock. Compound juice of fcurvy grafs; formerly fcorbutic juices. Infpiffated lemon juice. S f 338 LATIN NAMES. Succus ribis nigri fpiffatus. Sulphur precipitatum ; olim lae fulphuris. —— antimonii precipitatum ; olim fulphur auratum antimonii. Syrupus altheae. ——— caryophylli rubri. —— corticis aurantii. croci. limonis fucci. —— mori. i papaveris albi ; dim fy- rupus e meconio. ———-----erratici. ribis nigri. rofae. rubi idaei. fpinae cervinae. tolutanus; vice fyrupu9 ENGLISH NAMES. Infpiffated juice of black currants. Precipitated fulphur; formerly milk of fulphur. . of antimony ; for- merly golden fulphur of antim. Syrup of marfhmallows. i of cloves. ■ of orange peel. —— of faffron. ■ of lemon juice. i of mulberries. —— of white poppies; former- ly fyrupiof diacodium. — of red poppies. —— of black currants. ——— of rofes. ——_— of rafpberries. —— of buckthorn. ~— of Tolu ; inftead of the balfamicus, ■ violae. .1 ' zingiberis. balfamic fyrup. i of violets. — of gingrr. Tamarind! fructus. Tanaceti flores. Taraxaci radix. Tartari cryftalli. Terebinthina vulgaris. ■I. chia. Thus, refina. Tinctura aloes. compofita; dim elixir aloes. ■11 affafcetidae ; olim tinctura fcetida. i balfami Peruvian!. ■ ■ ■ Tolutani. Tamarinds. Tanfy flowers. ■ Dandelion root. Cryftals of tartar. Common turpentine. Chio turpentine. Frankincenfe. Tincture of aloes. ■ i i !■■' compound; for- merly elixir of aloes. —»— of aflafeetida; formerly fetid tincture. ii i of balfam of Peru. i ■ i —■ ... ■ Tolu. 339 LATIN NAMES. ENGLISH NAMES. Tindtura benzoes compofita ; olim Tindture of benzoin, compoun balfamum traumaticum. ■ cantharidum. " cardamomi. ■ compofita; dim formerly traumatic balfam. -----of cantharides ' of cardamoms. tindtura ftomachica. ■ cafcarillae. —— caftoiei. . catechu ; olim tindtura Japonica. ——— cinnamomi. . i compofita; olim tindtura aromatica. —— colombae. i corticis aurantii. - cinchonae; sive corticis Peru vi ani. . cinchonae compofita; sive corticis Peruvian! compoffto. ——————————— compoun formerly ftomachic tindture. —— of cafcarilla. i" of caftor. ■ of catechu; formerly Ja- ponic tindture. ——— of cinnamon. compound formerly aromatic tindture, —— of columba. —— of orange peel. ■ of Peruvian bark. _______________ compound ; formerly Huxham's tincture 01 Peruvian bark. of muriated iron; inftead of the tindt. of fteel in fp. of fait. —- of fox glove. .1 of galbanum. ___ of gentian, compound ; formerly bitter tincture. i guaiacum ; formerly vola- ——. ferri muriati; vice tinctu- rae martis in fpiritu falis. ■ digitalis. — galbani. ——-gentianae compofita; olim tinctura amara. _____ guaiaci; dim tinctura guaiacina volatilis. _—— helle'jori nigri; olim tindtura melampodii. _______jalapii. __— of jalap. _——- lavendulae compofitus j vide fpiritus iavendulse compofitus. . _ myrrhae. Tincture of myrrh. _______opii; olim tindtura the. - opium ; formerly the baica. baic tindture _____—— camphorata; vice tile tincture of guaiacum. __— of black hellebore. camphorated ; elixir paregoncum. inftead of the paregoric elixir. 340 LATIN NAMES. Tindtura rhabarbari. - —--- ' c >mpofita. . fabinae compofita; oHw elixir myrrhas compofitum. ------- fcillsr. ——— fennae. ——— ferpentariae. ■ ■ Valerianae. zingiberis ENGLISH NAMES. Tindture of rhubarb. ——————— compound. Compound tindture of favine; for- merly compound elixir of myrrh. Tindture of fquills. —— of fenna. ——— of fnakeioot. i of.valerian. ' ammoniatetf. ginger. Tragacantha. Trochifci amyli; dim trochifci bechici albi. ■ i cretaf; olim tabellae car- dialgicae. » glycyrkizae; olim trochifci bechici nigri. ——— magnefise. —— nitri. . fulphuris. Tormentillae radix. Tuffilaginis folia. Gum tragacanth. Tro,ches of ftarch ; formerly pec- toral lozenges. ■ of chalk ; formerly hearts- burn lozenges. . of. liquorice; formerly black pectoral lozenges. -----— of magnefia. —— of nitre. ■ of fulphur. Tormentil root. Coltsfoot leaves* Valerianae fylveftiis radix- Wild Valerian root. Vinum aloes; olim tinctura facra. Wine of aloes ; formerly facred1 tindture. . ■- — antimonii. — of antimony. i tartarifati. ■ ■ of tartarifed antimony. ———- fetri; dim vinum chaly- — of iron ; formerly fteel wipe. beatum. — ipecacuanhas. — of ipecacuanha. Vinum rhabarbari; olim tindt ura —of rhubarb; formerly vinous rhabarbari vinofa. tincture of rhubarb. Viola; flores. Violet flowers. Vim! cortex internus. The ifltat bark of the elm. 341 LATIN NAMES. Unguentum adipis fuillae; olim unguentum fimplfx. ——-----cakis hydrargyri albi; olim unguentum e mercurio pre- cipitato. Unguentum cantharidis; vice unguenti al veficatoria. - cerae ; olim unguentum album. ■ ceruffae acetatae; olim unguentum faturninum. ————— elemi compofitum. ————— hellebori albi. . hydrargyri fortius ; vice ENGLISH NAMES. Ointment of hog's lard ; formerly fi.ripli ointment. Oi.v.mcnt of white calx cf quick- filver; formerly oir'ment of pre- cipitated mercury. Ointment of cantharides ; inftead of the buffering ointment. ' ■ of wax ; formerly white unguenti caerulei fortioris. ■ mitius; vice unguenti caerulei mitiori. . i i hydrargyri nitrati. ——— picis. i refina? flavae; olim un< guentum bafilkum flavum. ■ fambuci; dim unguen- tum fambucinum., . fulphuris. --------tutiae. ——— of acetated cerufe ; for- merly faturnine ointment. ——— of gum elemi. ———— of white hellebore. ———— of quickfilver ftronger; inftead of the ftronger blue oint. ' ...... ■ milder; inftead of the milder blue ointment. ■ . ' » of nitrated quickfilver. . of tar. i of yellow refin ; former- ly ointment of yellow bafilicon. ■■ of elder; formerly elder Urticae folia. Uva urfi. flower ointment. ——— of fulphur. ■ of tutty. Stinging nettle leaves. Bear's whortleberry. Zedoariae radix. Zedoary root. Zincum cakinatum; vulgo flores Calcined zinc; commonly flowers zinci. of zinc ._______ vitriol »tum; olim fal vi- Vitriolated z!nc ; formerly fait of trioli. vitriol. Zingiberis radix. Ginger root. Ff 2 EXPLANATION OF TERMS AND ABBREVIATIONS, R- Recipe.........Take of. aa. Unius cujusque.....Equal Quantities] oz* Uncia......... . An Ounce. scr. Scrupulus........A Scruple. dr. Drachma........A Drachm. gr.' Granum........ . A Grain. gt. Gutta..........A Drop. q. s; Quantum sufficit ..... Sufficient Quantity. j.—one. ij.—two. iij.—three, v.—five. Xc. Ke.' INDEX. A. . Abdomen, dropsy of , peritoneal dropsy of ' , encysted dropsy of Accidental cholera ■ colic Acute rheumatism Adynamiae Ague —, quotidian ———, tertian ■ ', quartan Alphabetical list of medicir now in use (Addenda) Anasarca Angina pectoris Aphthae Apoplex'a Apoplexy ■ sanguineous i serous Ascaris vermicularis ■ lumbricoides Ascites Asthma Atonic gout B Benign mealies 120 Bilious diarrhoea 241 Bitter tonics 23 Bladder, inflammation of 90 . acute inflammation of ib. ——, chronic inflam. of ib. ____—, haemorrhage from 158 Bleeding from the nose 148 —— from the lungs 151 ——— from the stomach 157 _____ from the bladder 158 _——, involuntary 147 Blood, involuntary discharge of ib. Page 282 ib. 284 238 228 94 184 H ib. ib. ib. les 3^3 .273 186 *43 '74 ib. ib. ib. 229 ib. 282 217 105 Page Bowels, inflammation of 97 ——, erysipelatous infl. of ib. ——, phlegmonous infl. of ib. Brain, inflammation of 50 Broad tape-worm 230 Cachexiae 261 Calculous eolic 228 Camphire, strong mixture of 35 Canine madness 253 Catarrh 160 Catarrhus ib. ——— a frlgoie ib, ■, contagiosus ib. Cellular membrane, dropsy of 273 Chest, dropsy of 284 Chicken pox 11* Chlorosis 198 Chnlera morbus 238 ~ spontanea ib, —— accidentalis ib. Chorea Sandti Viti 216 Chronic inflam. of the liver 83 ————————— of the bladder 90 Chronic rheumatism 94 Coeliac diarrhcea 24 r Colic 228 Colica ib. —— spasmodica ib. — stercorea ib. — accidentalis ib. —— meconialis ib. —— calculosa ib. —— verminisa a3S —— pidtonum 234 Comata 173 Common saline draught 17 Confluent small-pox 112 Consumption, pulmonary 261 Cough, hooping 223 Cow-pock {Addenda) 3*3 344 1'age Cramp 204 Crapulous dianhaa 241 Cynanche tonsillaris 54 ———— maligna 58 1 tracheali s 65 ——— pha^yngea 68 1 parotidea ib. Cystitis 90 D. Dante of St. Vitus Diabetes —— mellitus ———— insipidus Diarrhcea ———— crapulosa ————— biliosa ■ mucosa —————— coeliaca ————— lienteria J —— hepatirrhcea Discharge bl.od, involuntary Diseases, febrile 216 247 ib. ib. 241 ib. ib. ib. ib. ib. . ib. H7 '3 from depraved habit 261 112 P Distinct small-pox Doses, Table of Dropsy of the chest 1 of thj pleura ib. 1 of the pericardium • ib. ——— of cellular membrane 273 ■ of the abdomen 282 ———— encysted, of abdomen 284 ■ peritoneal, of do. 282 Dysenteria 164 Dysentery ib. Dyspepsia 188 E. Effervescing saline draught 64 Emetic powder 19 Emphysema 267 Emphrosthotonos 205 Em yema 69 Encysted dropsy of abdomen 284 Ente-itis ' 97 Epilepsia 208 Epilepsy ib. Epistaxis 148 Erysinelas 133 ' ■ ■■ vesiculosum ib. Page J33 >b. Erysipelatous infl. of stomach 77 ----------infl. of intestines 97 Erysipelas ph!ycta?nodes --------infantum F. Fainting 1.84 Febres 13 Febrile diseases ib. Fever, inflammatory . 26 —«—, low nervous 32 ——, mixed 48 ——, nervous 32. ----, putrid 43 ——, remittent 25 Fevers 13 ——, intermittent 14 Flooding 154 Flow of menses, immoderate ib. Flux 165 Fluxes with pyrexia 160 Furious madness 257 Galvanism (Addenda) 321 Glossary 301 Gastritis 76 I Gout 104 I —, atonic _, ib. —, fixed ib. ----, misplaced ib. ----, retrocedent ib. Greensickness 198 H. Haematemesis 157 Hematuria 158 , Haeiioptysis 151 Haemorrhage from the nose 14.8 ————— from the lungs 151 --- ■ from the uterus 154 1 from stomach 157 ■ from bladder 158 hapmorrhagiae 147 I M .jsuus salinus communis 17 l -' emeticus 19 | ——— salinur effervescens 64 . Head, wa er in 287 Hemipleg'.c paralysis 178 | Hepatic diarrhcea 241 345 Page Hepatitis 83 Hooping-cough 223 Hydrocephalus 287 Hydrophobia . 253 Hydrolhorax 284 Hypochondriasis 195 Hysteria 238 Hysterics ib. I. Icterus 298 Ileus 228 Iliac passion ib. Immoderate flow of menses 154 Impetigenes 293 Indigestion 188 Infants, erysipelas of 133 Inflammation of the pharynx 6 ■ ■of the lungs ■ of the stomach • of the Intestines . of the liver . of the kidney . of the bladder . of bladder, acute 69 76 97 «3 88 90 ib. of bladder, chronic 91 83 86 49 26 54 165 '4 97 —— of liver, acute —— of liver, chronic Inflammations Inflammatory fever _____—— sore-throat Influenza Intermittent fevers Intestines, inflammation of ———, erysipelatous in flammation of .--------, phlegmonous in- flammation of Intumescentiae Involuntary difcharges blood Jaundice Jaw, locked ib. 267 '47 204 K. Kidney, inflammation of 88 Page Liver, iryflammation of 83 ——, acute inflammation of 83 ———, chronic inflammation of 86 Looked jaw 204 Long round worm 229 ■ hair-tailed thread worm ib. Looseness 241 Low nervous fever 32 Low spirits io, Lumbricus teres 229 Lungs, inflammation of 69 M. Madness Menorrhagia Malignant measles ——— sore throat Mania Marcores Maw-worm Measles ------, benign , malignant 257 253 »54 120 5» 257 261 229 120 it. ib. 228 Lienteric diarrhcea 241 Meconial colic Meconium, colic from re- tention of ib. Melancholia 255 Melancholy ib. Medicines, alphabetical list of (Addenda) 313 Menses, immoderate flow of 154 Mild typhus 24 Miliaria *3^ Misplaced gout 105 Mistura camphorae fortior 35 Mixed fever 4^ Morbilli ' **a Mucous diarrhoea 24* Mumps 655 N. Nephritis Nervous fever low fever 8^ 32 ib. Nettle rash J4° Neuroses *73 Noufer's (Madame) cure for tape-worm 237 346 Opisthotonos Page 205 P. Painters' colic Palsy Paralysis —' partialis ' hemij.legka " parajlegica ————— venenata Parapleric paralysis Parotideal cynanche Partial paralysis Pemphigus Pericardium, dropsy of Peripneumonia Peritoneal dropsy of abdomen Pertussis Pharyngeal cynanche Phary;.x, inflammation of Phlegmasia; Phlegmonous inflammation of the intestines Phleg nonous inflammation of the stomach Phrenitis Phthisis pulmonalis Pleura, inflammation of ———, water in the cavity of Pleuritis Pneumonia Pock, chicken Podagra Profluvia Pulmonary consumption Pulvis emeticus communis Putrid fever ■ sore throat Pyrexia -, fluxes with Quartan ague^ Quotidian ague Qc Rachitis Ra^'n, nettle Raving roadn' Regular gout R. 234 178 ib. ib. ib. ib. ib. ib. 68 178 141 285 69 282 223 68 ib. 49 234 76 5° 261 69 285 69 ib. 68 104 16- 261 19 43 S« *3 160 290 140 257 IC4 Remittent fever Retention of the menses of the meconium, colic from Rctrocedent gout R:ckets Rheumatism , acute ., chronic Rubeola Page 24 198 228 104 290 94 ib. ib. 120 S, St. Anthony's fire 133 St. Vitus's dance 216 Saline draught, common 17 , effervescing 64 Sanguineous apoplexy 173 Scarlatina 127 '■ simplex ib. ———----cynanchica ib. Scarlet fever 127 Scorbutus 295 Scrofula 293 Scurvy 295 Serous apoplexy 174 Si kness, green 198 Small white thread-worm 229 S.mail-pox 112 --------, distinct ib. ———, confluent ib. Solium 113 Solutio arsenicatis Di. Fowler 23 Spasmi 204 Spasmodic diseases ib. ■ colic 228 Spirits, low 195 Spitting of blood 151 Spontaneous cholera 238 Stercoraceous colic 2»8 Stomach, inflammation of 76 —, erysipelatous infl. of 77 ———, phlegmonous infl. of 76 ——, haemorrhage from 157 Syncope 184 1 anginosa 186 " - atudentalis 184 ■ cardiaca ib. Synocha 26 Synochus 48 Syrupus cinchonae • 21 347 T. Page Taenia, Madame Noufer's remedy against 237 1 osculis marginalibus 230 osculis superficia- libus Tape-worm ■ ■ , broad Tertian ague Tetanus Throat, inflammation of Thrush Tonics, bitter Tonsillar cynanche Tracheal cynanche Trkhuris Trismus Tympanites ———————— abdominalis ■ ■ intestinalis Tympany Typhus mitior ■ ■ gravior ib. ib. ib. 204 54 H3 23 5» 65 229 205 268 ib. ib. ib. 32 ib. Vapours Varicella Variola ———— discreta ' confluens Page !95 112 ib. ib. ib. Variolae Vaccinae (Addenda) 313 Vesicular fever j^j Venenate paralysis 178 Verminous colic 220 Volvulus ib. Voiding of blood by urine 158 Vomica 69 Vomiting of blood \t-j W. Water in the cavity of the pleura 285 ■ in the cavity of the pericardium ib. ——— in the head 287 Weights and measures (Add.) 319 Worms 228 THE END. VJ 'SI & rx ;r-< Ni