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1 
A  TREATISE
ON
DOMESTIC  MEDICNE
AND
ft}
KINDRED  SUBJECTS:
EMBRACING
ANATOMICAL AND PHYSIOLOGICAL SKETCHES
OF THE
   HUMAN  EODY.

             -3
BY WILLIAM MATTHEWS, M. D.  /
"Many shall run to and fro, and knowledge shall be increased,"
    INDIANAPOLIS:

PRINTED BY JOHN D. DEF*REES.

        1848.
/
V 
v*» 
   to
CONTENTS.
Chapter I.   On General Anatomy.
Chapter II.   On General Physiology.
Chapter III.  On the Conditions of Health and Disease.
Chapter IV.  On Diet,  Exercise, Sleep,  Clothing,  Bathing
  &c, as means of avoiding sickness and  of  restoring inva-
  lids to health.
Chapter V.   Classification of Diseases.
Chapter VI.  Of  Fevers in general.
Chapter VII.  Of Inflammatory Diseases.
Chapter VIII. Of Anti-Inflammatory  Diseases.
Chapter IX.  Of  Specific or Contagious Diseases.
Chapter X.   Diseases not included in the  Classification.
Chapter XI.  A general view of the principles and  practice
  of Surgery.
Chapter XII.  The Materia Medica. 
 
PREFACE.
   The design of the present volume is to offer to the public,
 in a compact and inexpensive, but, it is hoped, not unintelli-
 gible form, an outline of the Anatomy and Physiology of the
 Human Body, and of the  Principles and Practice of Medi-
 cine, in  a familiar style,  suited to the capacities of those
' without previous instruction upon  these vitally interesting
 subjects.  The work makes no pretension to be considered a
 complete Treatise on these subjects, but is intended to  be
 useful and interesting, as  far as  it goes, to those for whose
 benefit and instruction it was begun.
   It has been my constant aim to avoid prolixity, and, at the
 same time, impart useful information upon subjects, which, if
 we except our immortal destiny, more immediately affect our
 happiness than all others.  For what one among us can
 be happy and  enjoy  the good  things of  time, while the
 machinery of his own body is sinking under the ponderous
 burden of Disease ?
   That any work, bearing  the title of " Domestic Medicine,"
 will ever, in  any community, wholly supersede  the necessity
 of Physicians, I do  not  indulge  the remotest hope; but I
know  of no good reason why the intelligent Farmer or Me-
chanic  should,  all his  life, remain ignorant of the simplest
and  most common-sense principles  of Medical Science;  or
why he should be constrained to call in  the family Physician
for every trifling ailment.   Besides, a little instruction in the 
6
preface.
rudiments of Medical  Literature, never fails to make  better
nurses for the sick—and a good nurse is often worth half-a-
dozen doctors.  And moreover, such instruction as I trust
this  small volume  imparts, is  well calculated to  warrant
and  defend  the public against the impositions of unprinci-
pled Quacks, who go about seeking whom they may devour.
  With  these  Prefatory remarks I  send the  work abroad,
bespeaking,  in the meantime, for it a careful perusal.
                            WILLIAM MATTHEWS.
  Eberle, Putnam Co., Ia.,  Oct., 1848. 
INTRODUCTION.
  " Man is mortal."  " From dust he is, and to dust he shall
ruturn,"  is the  solemn declaration of scripture;  and his
whole history, from the creation to  the present time, verifies
its correctness.  No one has ever, (if we except a miraculous
instance or two,) escaped the  withering pangs of mortality
  But, notwithstanding the fact of man's mortality — of the
certainty of the death  which awaits him sooner  or later, yet
he has reason to console himself, and to glory in his existence
For  the  same authority which warns him of  death,  also
declares  that, though he die, yet shall he  live again.  Nor
shall his future existence be embittered with perplexities and
curses, with pains and sorrows, with separations  and deaths ;
but he shall forever live, and that too, where " there shall be
no more death, neither sorrow nor crying, neither shall there
be any more  pain: for the former things are passed away."
Such are some of the  consolations of Christianity.  What
glorious, inexpressible comfort has that christian Sage, whose
silvery  locks  tell of  three  score years  and ten, and who
has borne  all the burdens of life, what comfort has he not,  I
say, when his tottering frame warns him of his near dissolu-
tion,  in  remembering the  gracious  words of  Holy Writ,
that " all that are in their graves shall hear His voice  and
shall come forth ?"
  Now, although reflections like these are calculated to afford
us the greatest comfort, to buoy us up in our transit through 
8
INTRODUCTION .
life, and inspire within us  "a longing after immortality,"
a hope reaching beyond the dark dungeon of death, yet to be
happy in life, and to enjoy the good  things of this world,
presuppose the enjoyment of good health.  We are so con-
stituted that pain and pleasure are incompatible ; and, as
it  is  one of the instincts of our nature, in common with
the brute  creation,  to  prolong our existence indefinitely,
we are naturally led to enquire into the best means calcula-
ted to avoid the  former, and secure the  latter.  As  might
be expected, therefore, history informs  us that  from the re-
motest periods of which  we have  correct authentic records,
mankind have busied themselves in  attempts to  discover
those means by which to wafd off disease, and to cure them-
selves when afflicted by it.   Thus, we have every reason
to believe, that the treatment of disease is coeval with man.
But  at that remote period of time,  the  simplest means
only must have been used; those only that attending circum-
stances suggested,  and which, perhaps, did little else than
amuse  the patient, while nature cured the disease."  The
Science of Medicine, as the correct understanding of disease
and the most  approved  means for its  eradication from the
human system, is  now generally styled, is  a progressive
science.  It had its origin  in  the  earlier and  ruder  ages
of the world, in necessity, and, from that time to the present,
observations and experience have continually added to it,
new  resources have been discovered for enriching it, and
thousands of men, among the brightest ornaments that have
ever  graced the world, have devoted their lives to its study.
In every civilized country upon the globe, medical literature
is cultivated ; and at no time heretofore has it attracted more
 deserved attention than now.  In  Europe it is taught as one
 of the  higher branches of human  instruction;  and, I am
 happy to say, that in this country there are many very excel-
 lent institutions for imparting its principles  to those desiring
 to acquaint themselves therewith.   But all  cannot be physi-
 cians.  All have not the education, the time, or the means to 
INTR0D UCTION .
9
be such.  Therefore it is that a few have turned their atten-
tion  to this,  and made it a profession—devoting years to
the acquisition of its principles, before entering on its practice :
These persons, thus qualified, investigate the diseases of
their  neighbors,  and  prescribe medicines for the removal
of the same.  When these persons have attended a Medical
College, have  been  examined  by  its Faculty, and found
deserving  the title,  they  are furnished  with a  Diploma,
setting forth  their qualifications to practice  medicine,  &c.
They are then entitled to the distinction of M.  D.—Doctor of
Medicine.
   Before  closing this  introduction, I feel it a  duty to speak
of the Quackery  which is  practiced upon the unsuspecting
public all over the world, (unless, indeed, prohibited by law,)
but, perhaps more extensively in |Re  Western  States.  And,
as I  shall not excuse any, I  shall speak, in the first place,
of the quacks found in the " Regular Faculty,"  and  then,
secondly^of the ignoble creatures infesting every clime, who
assume some distinctive title, beyond that of  " Doctor."  In
the " Regular Faculty " the public have no test of any ones
qualifications to practice medicine, but the degree of M. D.,
conferred  by medical colleges; yet there  are  those  of emi-
nence  and  distinction in  medical science, who  have  not   »
taken this degree.   Such are recognized, by good physicians,
as medical  men,  and are permitted to consultations with
them.  There are others, however, who have studied very
little, who have  heard no Medical Lectures, and who have
very limited  common school education.  These, beginning
practice without qualification, should not receive the sanction
of the profession.   They are dangerous characters.  Their
weapons  are of the  most formidable kind;  for  assuming
to be regular physicians, they do not hesitate  to use all  the
active  medicines, and resort to all the delicate  appliances
of those better informed.  But, being unable  to investigate
the nature of the disease  with which  they have  to do, they
go ignorantly to  work, not unfrequently frustrating  the re- 
10
INTRODUCTION.
     sources of nature — and thus, precipitating their victims into
     an untimely grave.  Our country, 1 regret  to  say, has  too
     many Doctors  of this sort in it.   Uninformed upon all sub-
     jects, and without education, how should they be expected to
     know anything of one of the  most profound and intricate
     sciences  taught in the world?   I sincerely pity them,  and
     earnestly hope, that they may not be slow in either abandon-
     ing a station so awfully responsible, or better qualify them-
     selves for filling it  honorably.   There is scarcely any one,
     unless  he be a natural dolt, that cannot, in the course  of
     a few years, prepare  himself in  such  a  manner, as  to  be,
     at least, a respectable member  of the  profession—one  of
     the noblest stations to which man  aspires.  I  repeat 1  do
     sincerely hope, that ere long, by proper coercive means, these
     professional  parasites  may  be  driven from their assumed
     positions  to  others  whicfi they  arc better qualified to fill,
     or forced to qualify themselves  for honorable  membership
     in that prematurely entered into.
      I have next  to  speak of the  second class of Quacks, to
     which I  above  alluded.  I care  not what name these may
     assume.   They are all Quacks from the high-sounding title of
     the modern " Eclectics " down  to the  vulgar epithet of this
     ancient coadjutor—The Water Doctor.   They are all Quacks,
*#  I say, and for this simple reason :  they are either inexcusably
     ignorant, or they are designing villains ; most usually, it must
     be confessed, they combine both of these detestable qualities.
     If they are ignorant, let them not attempt  to stay the hand of
     death, by senselessly and  unmeaningly tampering with hu-
     man life : if designing, they deserve  the contempt of all
     well  meaning people.   .That they are  Quacks  will further
     appear, when  the names  under  which they stalk  around
     are considered.   A  Botanic Doctor rejects, either as use-
   • less or  injurious,  all mineral  medicines.  Now, in doing
     this he shows himself to  be a  one idea man: for the expe-
     rience of the medical profession, for centuries, has sanctioned
     and almost sanctified their administration in certain diseases 
INTRODUCTION.
11
when judiciously prescribed.  The  Botanic physician rejects
this experience, and  to bolster up  his exclusive system, he
hesitates not to excite all the prejudices of the vulgar part of
community against the use of those mineral compounds, the
beneficial influence of which, when judiciously prescribed,
are known to every honorable practitioner.   He will assert
that minerals are injurious, poisonous to the human system.
So, many of them are, if given injudiciously.   But he  neg-
lects to mention that in the vegetable kingdom, and among
some  of  the articles which  he daily  uses as medicines,
there  are  some  of the  most virulent  poisons  found  upon
the  face of the earth; that in one fourth of a  drop, *or  of
a grain, of  certain  vegetable medicines,  there lurks the
elements of death !   On the contrary, the " Regular Faculty "
reject  none of those  agents which observation   and expe-
rience have showed  to  be  beneficial  in the treatment  of
disease.   They resort to  every and all means and  devices
within  their  reach,  with whose  properties  and qualities
they are acquainted; and, if the circumstances  of the case
under  management, seems to warrant their administration,
without stopping  to enquire from  what kingdom of nature
they have have been derived, they unhesitatingly give them.
But I  need not extend this notice  of impostors  further, nor
would I have alluded to them  at all, Rad not the importance
attached to them a very injurious effect upon the best inter-
ests of mankind — health.  They deserve no notice them-
selves: it is their erroneous doctrines that demand attention.
The public are uninformed on medical subjects, and it is this
fact, which enables Empirics to impose upon them.  1 have
therefore, to warn my readers against permitting themselves
to be imposed upon by these miserable creatures.
  The  arrangement which I shall follow, in  the present vol-
ume, will be, first to treat of General Anatomy;  secondly, of
General Physiology.  These are subjects, a  general  knowl-
edge of which, is of the highest importance to  the understand-
ing of that which is to follow.  Thirdly, I design speaking of 
12
INTRODUCTION.
  Health and Disease—defining  and contrasting the^c two
  conditions.  Fourthly, Diet, Exercise, Clothing &c, will de-
  mand our attention.  The fifth Chapter will be devoted to
 the classification of Diseases ; the sixth will treat of Fevers ;
  the seventh, of Inflamations, and the eighth of anti-inflama-
  tory disorders.  These three last Chapters will of necessity
  be very general; but I do not think much space necessary to
  elucidate the general characteristics of Diseases.  All that
  my readers have a right to look for, in this part of the work,
  is the commonest symptoms, phenomena &c, of diseased con-
  ditions.   I  am not writing  for the  profession, but  for the
  masses^-the public at large.  And if any of these  desire a
  more thorough knowledge of medicine than the present treat-
  ise will afford, I refer them to the  numerous excellent works
  of the Faculty.
    The ninth  Chapter will be devoted to the consideration of
  the specific, contagious,  or catching diseases, while the tenth
  will be consumed in speaking of a few diseases not included
  in either of the preceding Chapters.  In the eleventh Chap-
  ter some hints in reference to General Surgery will be offered.
  The twelth and  closing Chapter, will be devoted to an ac-
  count of  the medicines to which reference has been made  in
  the work.   Some concluding remarks will be appended.
    The style of the work  will necessarily be of  the commoner
 kind.   Written as a borA: of instruction for the public, it would
 seem  out of place to assume a  fine style, and  rigidly adhere
 to  the rules of composition designed as scholastic treatises.
 My aim is, to instruct my readers in one of the  noblest scien-
 ces ; and, in attempting  to accomplish this purpose, it shall
 be  my constant endeavor  to avoid those high-sounding phra-
 ses and technical terms which almost uniformily offend  the
 senses of persons  not accustomed to their use.   With these
remarks, I pass to  other matters. 
CHAPTER I.
               ON GENERAL ANATOMY.

   Anatomy is the science  of  organization.   What ever has
 been in possession of life, is a fit substance for anatomical in-
 vestigation.  Hence vegetable, as well as animal, organiza-
 tion admits of anatomical examination.  Nature.h^e, how-
 ever, makes the division into the two great classes:—Animal
 and Vegetable  Anatomy.  Animal Anatomy is subdivided,
 usually, into the Anatomy  of the Human Body, and the Anat-
 omy of  Inferior  animals.  The last is called Comparative
 Anatomy, because it is chiefly useful in analogical compari-
 sons between the conformations of brute beasts  and  man.
   There are two modes by which  Anatomy is studied.  The
 first, and least advantageous method, is that by verbal  de-
 scription.   Persons thoroughly acquainted with the structure
 of the human body, have written full descriptions of it; these
 are studied by others.  But knowledge thus acquired is like
 that obtained from descriptive Geography—a pretty good no-
 tion may be got of a far off country from a  correct  writer's
 description of it; yet he who has  visited  that country, and
 examined its climate, its soil, its hills and  valleys, its rivers
 and meandering brooks, must necessairly obtain a much more
 accurate knowledge of its  scenery.  So with Anatomy.   He
 who contents himself with reading what others say of the
structure of the human body, can, at most, gain but a meager
idea of  the science of  Anatomy.   But he  who  examines it 
14
GENERAL  ANATOMY.
  for himself, guided by competent instructors, lays open to
  view every hidden and secret contrivance of the human ma-
  chine ; reducing some parts ;  magnifying others, and tracing
  every  nerve, artery and vein to their origin in the respec-
  tive organs from which they arise, must soon,  if  observing,
  become a master in  Anatomy.  This last  mode is termed
 practical Anatomy, and is chiefly conducted by the actual dis-
  section of the dead bodies of  men and women.
   Upon examination  the Human body is  found to be com-
  posed of  numerous structures, "fitly framed together," mak-
 ing one wonderful whole.   These divisions, by anatomists,
 have received the appellation  of systems.  The first of these
 systems,  demanding our attention, is the Bony—styled in
 technical phraseology, the Osseous system.   There  are in the
 human body, about 250 bones.  The uses of the bones  are
 various—some  form cases for enclosing delicate structures,
 as the skull bones; others serve as levers to which  muscles
 are attached for locomotion  or moving the body in various
 directions, as those of  the arms and legs;  others again  an-
 swer for masticating  or chewing the food,  as the  teeth, &c.
 The whole system of  the bones, however, may be regarded
 as the frame work of the Human machine, upon and within
 which every other structure is placed.  Beginning with  the
 head we discover it is composed of numerous bones, so united
 together as to form a case, in which  is lodged that delicate
 organ, the  Brain;  exteriorly, when covered with other struc-
 tures, they give form and expression to the countenance, and
 serve as fixed points for the fastening of muscles.  They also
 form cases  for containing the organs of vision and hearing-
 the  eye  and the internal ear.  Passing on  downward from
 the head, we next come to examine the back bone,  or spine.
 I his may be said, in truth, to extend from the bottom or base
of the skull, to the  bottom of the hip bones, and, thus consid-
Next to be noticed are the Ribs, 24
in nurn- 
GENERAL  ANATOMY.               15
ber, 12 on either side.  These are fastened to the back bone,
and  11 of  them, 7 on either side, are  attached to a broad,
flat bone in front, called the breast bone ;  the  remaining 10,
5 on either side, have no firm attachment in front, and they
are, therefore, denominated the short or floating ribs.   At the
lower end  of the spine, and serving as a base upon which
the head and all that has already been described rest, are the
hip or haunch bones—two in  number.  These are  fastened
posteriorly, or behind to the last bones of  the  back,  and be-
ing reflected in such a manner as to  form a considerable ba-
sin or cavity, they are united to each other in front, immedi-
ately above the division of the body into the lower extremities.
A correct understanding of  these two last bones is of indis-
pensible utility to the practitioner of midwifery ; but  much
laborious study is necessary to obtain an accurate knowledge
respecting  their shapes  and  structure.  On  the exterior; or
outsides of these hip bones,  are two cup like depressions, one
on either side.   These are for the reception of  the upper end
or head of the thigh bones ; and as they form a complete ball
and socket joint, they afford to the thigh bones the greatest
possible facility of  motion  in  every direction.  Tracing the
thigh bones down to the knee joint, we find here one of the
most perfect examples of hinge-joint, in its connection with the
leg or shin bone—allowing motion only backwards and  for-
wards.   The leg has two bones—the shin and the splint bone;
the latter of which, however, being placed upon the outside
of the leg,  answers little other purpose than that of a splint,
(as its name implies) in strengthening the principle one.  To
the lower  end of the leg bones  are attached the group of
bones, numbering seven, forming the instep ; and to  these
again are attached the bones  of  the foot,  to which, in turn,
are added on, the first joint of the toes, to these the second,
&c.  But these are  too intricate to admit of accurate de-
scription in a work like this.  I can,  therefore, but allude to
them.
   Going back to the  superior  portions  of the  body, and im-
mediately on the back part of the  chest, held in their places m 
16
GENERAL  ANATOMY.
by powerful muscles, are resting the shoulder or blade bones,
one on either side.   The collar bones are fastened to these
and to the breast bone in such a manner  as  to prevent the
former from approaching the latter.   Attached to  the blade
or shoulder bone in a similar manner to the  attachment be-
tween the thigh and hip—affording perfect freedom of motion
in all directions, we find the upper arm bones, one on either
side.   Following these down to the elbow, we have another
instance  of a hinge-joint, in their attachment with the bones
of the fore arm.  The fore arm contains two bones, and these
are interesting from the fact that one of them goes  to help
form the elbow joint, while the hand, or wrist, is attached to
the other, thus giving to the hand the rotatory motion so use-
ful in almost every movement which it  performs.  The wrist
bones, as well as those of  the hand and fingers, are so simi-
lar in the general conformation to those of  the instep and
foot,  that I  shall dismiss  them without further  notice, and
with them I  shall, for the present, dismiss the bony system.
   The bones  are united together in various ways, the most
common  of which, however, is by strong bands, called Liga-
ments.  When a dead body is divested  of every thing but the
 bones and ligaments,  the ligaments preserve,  in  a great
 measure, the bones in  their  natural situation.   Being thus
circumstanced they constitute the natural skeleton of the anat-
omist, in contradistinction of those divested of their ligaments,
but held together by wire fastening, called the artificial skele-
tons.   The ligaments, then, we reckon as the  Ligamentous sys-
tem.
  Next in order comes up  for consideration, the muscular sys-
tem.  The muscles are properly the instruments  of motion,
and by their actions upon the bony system all the offices of
locomotion are performed  ; the human  body is transported
from place to place, and  whatever requires mobility is af-
fected.  The number of muscles are very numerous—amount-
ing in the aggregate to several hundred.   But before entering
further upon the muscular system it is proper to define, defi-
nitely, the meaning of the word muscle.  Every one  knows 
GENERAL ANATOMY.               17
   what a bone is ; but very vague notions are generally  enter-
   tained respecting the meaning of the word "muscle."  It may
   be stated, in general, that all fleshy substances partake of the
   nature  of muscles.  But to separate the^ fleshy masses, as
*  nature has done, into their respective portions, and trace them
   from their origins to their  attachments, is a matter of some
   nicety.   For example, taking the fore-arm for examination,
   it appears to be chiefly composed (the soft part of it) of fleshy
   matter; but upon more close inspection, this fleshy matter is
   seen to be divided into very many separate bundles; each of
   these bundles has a separate origin above—arising as it were
   out of the bone, and a separate attachment below, where  it is
   inserted into another bone than that from which it  arises.—
   Now, this bundle  of fibres—for every muscle is  composed of
   fibres, or thread like substances gathered into bundles, have
   the power of contracting or shortening themselves, by an act
   of the will, as we shall presently see.   Now it is obvious  that
   if they are fixed immoveably at the one end, while  they are
   free at  their attachment, when they contract or shorten them-
   selves,  the bones to which they are attached  have  necessa-
   rily to yield; and  thus it is  that motion is communicated to
   any part of  the system—the bones serving as levers.  I re-
   gret that my limits will not allow me to enter into any thing
   like a minute description of this interesting system. . I must
   only refer to it as a  whole.  Then, summing up the  whole
   muscular system, it may be stated in general terms, that its
   office is that of motion.  As has been already mentioned, I
   repeat, that every motion of the human body owes its imme-
   diate origin to  muscular action ; the more powerful muscular
   actions, as  well  as  those of the more delicate  sort—as  of
   winking, swallowing, speech, &c, are effected solely by mus-
   cular contractions.  Through the influence of muscular con-
   tractions the blood is  carried to the remotest  parts of the
   body, and again returned to the heart.  Breathing is carried
   on by certain muscles ;  and the wastes of the body are  ex-
   pelled from it through their respective outlets by others ;—the
               3 
is
G E N E R A L  \ N A T O M Y .
 food is conveyed into the stomach, digested and expelled from
 the general system, by the wonderful action of muscles.
   That whole arrangement of the human  organization con-
 cerned in the nourishment or nutrition of the body—in diges
 tion, and in carrying into the body whatever is intended  for
 its support, and conveying from it the useless or effete mat-
 ters, I shall denominate the Digestive  System.   But 1 must be
 very brief  in my notice of this system; as I  shall  have  to
 speak of many separate structures individually, I can devote
 biit a feM*lines to each.  These I  shall notice in  order, be-
 gining with, 1. The Mouth.  This, considered  as a part of the
 Digestive System, is a cavity for the reception and mastica-
 tion of  food, designed for the nutrition of the body  Chewed
 and  mixed with  the saliva  or spittle, which  is furnished by
 some little  bodies, (called glands,) lodged in the cheeks and
 about the tougue, it is by muscular contraction carried into 2.
 The Gullet or Swallow.  And through this it  is conveyed into 3.
 The Stomach.  This is the great reservoir of digestion, and is
 situated immediately below the breast bone, in the cavity  of
 the abdomen—the abdomen being separated from the  chest
 by a transverse band, properly a muscle, called  the Diaphragm,
 because it divides these two apartments.  The Stomach is a
 muscular bag, the food being introduced into  which, under-
 goes important changes, which fits it for others to be after-
 wards described.  The  changes which  are effected  on the
 food in the stomach  are chiefly attributable  to the  solvent
power of the gastric juice—a fluid which is prepared  in and
poured out from the inner coats of the stomach itself.  This
 gastric juice is one of the most powerfully  dissolving liquids
known; being in some animals sufficiently strong to dissolve
the hardest bones.  (It is owing to the small amount  of this
very curious liquid contained in the calf's stomach, that  it
has the property of curdling new milk, and changing it into
cheese).  The food, after remaining in the  stomach, until its
 solution is effected, (in a healthy state, from one to five or six
hours,) is by the stomach's action carried through a small val-
vular—like opening (which from its office being analagous  to 
GENERAL  ANATOMY.
19
that of a door or gate has, in technical language, got the name
of "pylorus,") into  4,  The Intestines or bowels, in which other
changes are to take place.   As the food is  passed into  the
intestines  it is a  homogeneous pulpy matter, and is called
Chyme ; but getting in the manner already intimated into the
intestinal tube, it meets with juices or liquids which convert
it into an opaque milky-like fluid that is called Chyle.  The
most  important of the fluids referred to  here, is that from the
Liver, which has received the name of  Bile.  Others of  less
importance have an  influence in preparing the chyle,  but
these are not so well understood.   Now, in the c6ndition of
Chyle, the elements of nutrition are to be found, ready fitted
to be taken up and thrown into the blood, and thus conducted
to every part of the body to administer to its wants, and to
supply it with fresh materials, in place of  those that, from
age and change, are no longer useful.
   For the purpose of conducting chyle, now fitted  to supply
the wants  of the system, into the blood, we find innumerable
little  tubes, insinuating themselves  through  the  intestinal
walls, and, by  a process of vitality, selecting from the chyle
only such materials as the body needs for nutritive purposes.
These little tubes, after leaving the outer surface of the intes-
tines, form  numerous unions,  one with another,  until,  ulti-
mately, they form one or two  considerable sized  canals or
ducts, which empty their contents  into the veins;  and thus}
is the food which  we take  into our  stomachs, by various  con-
trivances, being transformed from one  substance to another)
until  at length, reaching  the  blood, it is  continually com-
mingled with it; and, after other changes, to be indicated by
and by, it is converted into the various fabrics of which the
human body is composed—as muscle, bone, nerve, &c, &c.
The  little tubes concerned  in absorbing, or taking up the
chyle, are  called Lacteals, because they are found  filled  with
a fluid, resembling milk, the  Latin name for  which is,  Lac.
Remaining behind as a residual matter, which the  Lacteals
do not carry into the blood, is left the fecal substance, which,
being  carried downwards by the spontaneous movements 
20
GENERAL  ANATOMY.
 of the bowels, reaches the anus, and by  a muscular  effort
 is expelled therefrom.
   5. The  Liver, being concerned in digesting  the food, next
 demands brief notice.  It is situated in the right side ; under
 the points of the short ribs.  It is divided into  several lobes,
 but these have one office in common to perform; that of
 manufacturing bile.  Numerous tubes collect this  bile and
 convey it, as already intimated, into the intestines, just  be-
 low the stomach.   It is, therefore, an  erroneous opinion to
 suppose that bile is always found  in the  stomach.  On  the
 contrary, it* is perhaps, very seldom  found there, unless  the
 action of these organs is, in some measure, inverted.   Thus
 it is, that frequent  and powerful efforts at vomiting almost
 always result in the ejection of bile from the stomach—it  be-
 ing carried backwards or upwards into  this organ by the  in-
 verted action of vomiting.  The gall-bladder is a mere pouch
 or  receptacle for  containing  bile, when  more  is generated
 than the system has immediate use for.
   6.  The Spleen or Milt is found situated in the opposite (the
 left,) side from  that of the Liver.  Its  shape in the  human
 body is quite similar to that  seen in inferior animals.  The
 office which it  performs in the  animal Economy is not cer-
 tainly known.   The Spleen  is  however, of minor impor-
 tance ; for it has been  repeatedly removed from dogs and
 other animals, without inducing death, or even serious incon-
 venience.  My own opinion is, that it  is in some way con-
 nected with the nutritive process.  I might notice much more
 minutely these interesting organs, but my limits  will not per-
 mit me to do so.  The whole length of the digestive appara-
 tus, counting from the mouth  to the  anus, is not far from six
 times that  of the body.
  The Nervous System is that assemblage of matter contained
within the skull, prolonged throughout the  whole length  of
the spine  or back-bone, and from these points, reflected  to
 every part  of the body.  That matter of a soft "consistence
 and  whitish  color, contained in the cavity of the skull is,  as
every one  knows, called  the brain : a  continuation of this 
GENERAL ANATOMY,
21
down the spine, or back-bone, is called the spinal marrow;
while the divisions sent off to every part of the body, from
both these sources are called the nerves.  These nerves are.
the instruments of sensation, or  feeling; the  paths, so to
speak, along which our desires are conveyed, out from us, and
the channels to carry back to the brain impressions made upon
their extremities.  But to be more definite, I  shall make a di-
vision of this system, 1. of the Brain :  All the nervous mat-
ter contained within the skull receives the name of Brain.—
Here, in the Brain, man's noblest nature  has its seat; here
his thoughts  are manufactured, his emotions reside, and  his
propensities have their origin.  It is  the part of man, when
finely educated, that assimilates him to Angels, and inspires
him with those hopes of immortality for which he has  been
noted  in all  conditions, in savage, as well as civilized life.
Although the Brain is the immediate source of thought, and
the seat of intellect, yet it is  not, (the whole of it,) necessarily
sensitive.  Persons, as have  also inferior animals, have suffi-
ciently often recovered, even, enjoyed good health, after hav-
ing lost a considerable amount of Brain, to establish beyond
cavil  the fact, that death  is  not the  necessary result of the
removal of a certain amount of this organ.   The Brain is,
beyond doubt, the seat of the intellect,  and it presides  over,
and judges of the condition  of the whole man.  It sends off
to the eyes a part of its substance, and, impressions being
made upon this, through the very curious contrivances of the
eye, and conveyed back to the Brain, this last organ it is that
sees,  and not the eye itself.  The ear is likewise nothing but
a  mechanical contrivance, very interesting  and curious, in-
deed, for collecting sounds and conveying  them to the Brain
along a nervous  channel;  and  the Brain  hears.  So, too
with the nose.   It collects odors, and, through its connections
with the Brain, transmits them to this organ to discriminate
their qualities.   Taste and Touch are very analagous.   We
are erroneously said to feel  with  our fingers and taste with
our tongues ; but, the truth is, the Brain performs both these
offices, through  its nervous  communications with the exter- 
22           .    GENERALANATOMY.
 nal world.  Pain has, also, its true seat in the Brain;  for if
 the nerve sent to an injured part is cut in two  or tied be-
 tween the wound and the Brain, all pain is immediately sus-
 pended.   Thus we have  the  best reason for believing that
 the very essence of vitality or life, resides  in the Brain, and
 traverses  the nervous filaments, sent off from it.  Now  what
 this essence consists in, is more than human genius has di-
 vined.  It is  aa  inexplicable  as  Electricity or Lightning,
 identical  with which some consider it. We  may examine
 its effects, but cannot ascend to  its  cause.   It is  life; and
 life, as well as not, may be looked upon as an emanation from
 Deity.  This life, whether a result of organic laws, or supe-
 rior to them, may, it cannot be doubted, be  immortalized.—
 But this is a subject which it is improper for  me to  discuss in
 this place.  That we now live, and  enjoy a conscious exis-
 tence, and that we shall " again live after worms destroy this
 body," is, perhaps, enough for us to know, and all, most prob-
 ably,  that we ever shall know while sojourning in this "vale
 of tears."  I  cannot, consistently, pass  this opportunity by,
 without an allusion to* the  doctrine of Phrenology.   Phrenolo-
 gy assumes that the Brain is a very complex organ, both as
 it respects its structure and functions; that it is anatomically
 and practically compound; that every  Faculty of the  mind
 has its seat and duplication in the Brain; and that  the whole
 number of distinct  departments of the  Brain, enjoying, as it
 were, a separate existence, amount to  some  thirty  or foiMy—•
 in short, to use a familiar  comparison, that  within the  skull
is a great work-house for manufacturing thoughts,  emotions,
 propensities, &c.  Now, although, I am not a full believer in
 Phrenology, carried to the  extent to which its modern vota-
ries have carried it, yet  there are many reasons for  assenting
to its general principles.  We know that the Brain  sees, that it
hears,—that there*are two organs or seats of action brought
into action in #Qth these processes.  So, we infer that bein°-
in possession of the faculty of reverencing superior "objects
it, too, has a separate physical  existence in the Brain.   The
same may be said of other faculties, as that of memory  a de- 
                 GENERAL^NATOMY.    "           23

sire to gain wealth, &c, &c.  These, Phrenologists state, all
have  distinct  seats ; and  thus the general conformation of* "
the bones  of the head are influenced by the shape of the"
Brain, they suggesting the possibility of locating these, and
of  weighing  their respective  strengths.  It will  be  seen
from this brief statement that Phrenology is not utterly desti-* ?
tute of reason ;  and thousands can testify to the great exac-  ~
titude with which its practical advocates read the characters
of men from " the make of their bones."
   2. The Spinal Marrow is, as has already been mentioned,
nothing  but  an  extension of the Brain; indeed, it may be
looked upon as a great central nerve,—forming a medium of
connection between the Brain and the proper nervous ramifi-
cations, which  originate from it.  These last constitute the
terminal divisions of the nervous system.
   3. The Spinal Nerves.  They pass off from the Spinal Mar-
row, and are double both in form, and in office—having two
roots and performing two offices.  Along  one of these roots
and divisions, our wishesj are sent from the brain—first tra-
versing the Spinal Marrow itself, and then taking the course
of the nerve,—to the  extremest muscles; and thus are their
contractions determined at will.  While along the second di-
vision, impressions, as  of touch, pleasurable or painful, made
upon the surface of the body, are carried up  to the  Brain.—
The nervous system then, it will be perceived, holds the high-
est place in the Animal Economy.  Some, with much reason,
consider it the system to which all the other  divisions of the
body are subservient, and ar§ ■built up around it for its main-
tenance.   Be this as it may, it is the  temple and sanctuary
of the soul, and it is, therefore, of primary importance.
   The Circulatory System, has  next to be noticed briefly.   By
this system I mean the circulation of the blood and the or-
gans by which it is carried on. '.Now the heart, as most peo-
ple know, is the great central organ of circqjation, and may
very aptly be  compared to a force pump for -propelling the
blood to the remotest parts of the body.  It is a curious living-
apparatus, and is worthy of the minutest examination", but I 
  24               <; F,NERAL*ANATOMY,
 *
, , cannot bestow more than a general notice upon it here   It
  is a double organ, and for the sake of illustration, I propose
  speaking  of  it as two distinct hearts.  These are divided
  completely, from  each other, by a membranous septum, or
 . wall.
    First of the right heart.  From this arises a very larg-e blood-
  vessel, called the pulmonary, or Lung Artery.  This Artery
  is sent to the lungs (or lights) and is divided and ramified over
  the whole surface, until division seems to be no longer possible
  in consequence of the extreme tenuity to which each branch
  thus formed, is  reduced.  These minute branches  are  then
  collected gradually into the beginning of the veins, which, af-
  ter a time, like the small streams from a hill-country, coalesce
  into  three or four channels.  These are the  pulmonary or
  lung veins and pass immediately to the left heart.  Both the
  arteries  and the veins  carry  blood—the former  from the
  heart, the latter to the heart.   But before proceeding further,
  it is necessary to state that the night heart is filled with blood
  from a very large vein that collects the  blood from all parts
  of the body, and finds its way to this organ, along in front of
  the Spine. Thus supplied, the quality of the blood is of such a
  nature as to, so to speak, provoke the  heart to contract or
  close upon itself.   Now  by a curious valvular  arrangement,
  while the  blood is prevented from flowing back into the vein
  through which it is transmitted, it is forced into the pulmona-
  ry or Lung Artery;  this as already mentioned is divided and
  ramified in the Lungs ; the  blood, during the act of breathing
  is, through its very delicate covering, exposed to the air; cer-
  tain poisonous principles which have been generated, during
 its  passage through the body, are  thrown off,  while others',
 necessary  for its  purification are taken  from the air.  Being
 purified in this manner, the blood is returned through the three
 or four veins already alluded to; to the other or left  heart.—
 Here in the leff heart we find the arrangement very similar to
 that of the right.  Valves prevent  the  bload  from flowing
 backward into the pulmonary veins ; the quality of the blood
 stimulates  this cavity in like manner, to contraction, and the 
                  GENERALANATOMY.               25
                            *
 blood is propelled with a  powerful force  along  a very large
 Artery, that is distributed  to  every part of the body.  "In
 like manner to that which we have seen the  veins of the
 Lungs originate, this Artery terminates in veins, which, pass-
 ing on back towards the heart, while  tlfey increase in size
 they decrease in  number, until they ultimately empty them-
 selves into one great vein, which is in immediate communi-
 cation with the right heart, as before remarked.   To recapit-
 ulate : The blood from the whole body, is.conveyed in a large
 venous trunk, to  the right  heart.  Being impure, and there-
 fore, unfit to be sent as nutriment (for blood is the food of the
 body,) to  the body,  it is driven through the Lungs,  exposed
 to the air during the act of breathing, parts with certain nox-
 ious principles, takes from the air those necessary to its puri-
 fication, and is then returned,  through  the pulmonary veins,
 to the other—the left heart.   This heart sends it to every part
 of the body; all the organs are fed and nourished in its course;
 it is rendered thus unsuited for further use ;  but being collected
 by  the veins, it is conducted back to the right heart, receiving
 in its passage fresh  materials from the digestive  process, al-
 ready referred to, when  it is  again subjected to the same
 rounds.  It has been stated, that from the time the blood leaves
 the right  heart until it is returned to it again, there scarcely
 elapses to exceed  two or three  minutes of time.
  In its course the blood is  continually parting with certain
 of its elements.   Thus the  Kidneys, two organs situated one
 upon either side of the Spine, are furnished with  a very large
 amount of blood, from which they secrete  or take away, cer-
 tain noxious principles held in  a state of solution in a large
 amount of water.   Along  little ducts  or tubes, one for each
 kidney, this water, holding, as  just stated, in solution hurtful
 ingredients, is carried down to the  urinary bladder, occupy-
 ing a situation at  the bottom and front part  of the belly.—
 The bladder answers no other  useful purpose than that of a
receptacle for containing the urine, a greater or shorter time,
according to circumstances, and, in this  way, avoiding the
unpleasant continual dribbling  that would  otherwise follow.
                                    4 
26
(1 E N E ItAL A N A T O M Y .
  The skin is  another source by which the  blood is altered
in its character.  Sweat is a familiar phenomenon to every
one; but all do not know that at all times, and under alinosl
all circumstances, an exhalation of watery particles is taking
place from the  entire surface of the human body ; yet such
is the fact.  The naked body of any healthy person, as seen
through a microscope, seems to be completely enveloped in
a cloud of fog or vapor.  Any one can convince himself of
the truth of this  statement, by placing the ball of a  finger
very close to a perfectly clean and dry looking glass, when, af-
ter a few seconds, a cloud of minute drops will appear at the
point indicated.           ,^
  Having in this manner, examined in  a very general notice,
some of the more prominent structures  of the human body, I,
in the next place, pass on to a  more exact consideration of
the offices which they perform in a state of activity and health.
Before entering, how ever, on Chapter  2nd I must beg leave
to say a few words in description of the lungs or lights.  These
are two  spungy bodies, filling  up, in  a great measure, the
cavity of the chest—the heart occupying a position in their
centre.  The cavity for containing the lungs is a completely
closed sack,—having no communication with the atmosphere.
The  chest in which they are lodged is separated from the ab-
domen or belly by the transverse muscle—the Diaphragm.
The  act of breathing is  wholly effected by mechanical laws.
By the actions of the muscles  concerned in  respiration  or
breathing, the capacity of the chest is  enlarged, and the air
rushes down the wind-pipe to fill up the space thus formed.
Again, the muscles act,  and the capacity of the chest is forci-
bly reduced to its natural size, in consequence of the expulsion
of the air from it.   But of this subject, further hereafter. 
CHAPTER  II.
               ON GENERAL PHYSIOL O'fiY.

   Anatomy,it will be remembered.is defined to be the science
 of Organization.  The Anatomist takes the dead body, and
 by dissection and other means, examines its various organs,
 in  a  quiescent state.   On the contrary, Physiology is the  Sci-
 ence  of  Life.   The  Physiologist takes the living body, and
 with  all  the lights which Anatomy furnishes him, examines
 it,  in a state of  activity.   He looks into man, while yet alive
 and in the enjoyment of good health, and beholds how "won-
 derfully  and fearfully he is made."  A correct understanding
 of the functions or offices of every structure is of the utmost
 importance to the Physician.  Nor is it possible for him to
 act understandingly in his attempts to repair their aberrations
 from  health, without such knowledge.   As reasonable, almost,
 u-ould it be, to  imagine, one destitute of every principle of
 mechanics, to be able to repair a delicate watch, when out
 of order,as to suppose one ignorant of the laws of Physiolo-
 gy, competent to treat diseases.
   For taking a general view of Human Physiology, the best
 division, perhaps, that can  be  made, is  into, 1st the  head;
 2nd the chest, and 3d the  abdomen.   It is proper to premise,
 however, before  entering upon this subject, that, in the brief
 anatomical sketch given, I have been obliged to anticipate the
 offices of the structure then described, and what follows is
 therefore, to some extent, a repetition of the same.
   1.  The Head.   The Brains and the organs of the several
 senses have their seats  here.   The  Head, as was formerly
suggested,  has complete  dominion over  the  various move- 
28
GENERAL PHYSIOLOGY.
ments of the body.   It may be, with much truth, called the
home of man.   Here, secure  in his temple, and wrapped in
the solitude of his own greatness, he sends forth his thoughts,
desires, and affections; and, at his will, his physical nature
makes  them manifest to  our  senses   Of  the  physiology of
our senses, and the action of the Brain in the evolulion of in-
tellectual manifestations, we are, in a  great measure, totally
ignorant.   For example, at pleasure, I can flex or bend my
arm; but in what manner the Brain and nerves produce, or
are made to produce, the effect, I cannot tell.   The eflects of
these operations  are familiar  to every one, but  whence, and
in what manner, the cause is brought into action, the profound-
est philosopher is in the  dark.   He knows, indeed, that our
intellectual natures have their seat in  the Brain and nervous
system, and this is almost all he does know about them, other
than as he witnesses their manifestations.
   2.  The Chest.  In this cavity  many very important pro-
cesses are in a constant state  of  activity.  Here, the heart is
found, propelling, with a force almost  incredible, the  blood,
first through the Lungs for the  purpose of its  purification ;
2nd, and after receiving it from these  organs, purified and
prepared for the nutriment of the body, to every part of the
body, to the wants of which it every where ministers.  The
Lungs too, are  organs, without the kindly offices  performed
by which, we could not exist  but for a moment.  The wind-
pipe, which has a valvular  opening, partly under the control
of the will, serves the  purpose of bringing their internal sur-
faces in immediate contact  with  the  atmospheric air which
we breathe.  A surface is  thus exposed during every act of
respiration  or .breathing, of several square feet.  Over this
entire surface all the blood sent to the Lungs, (and this is all
of the blood,) is spread, and almost completely exposed to the
atmospheric air;—for nothing  supervenes between it and the
air but the most delicate vessels, of the  extremest tenuity pos-
sible.   Through the coats  of these extreme vessels changes,
absolutely indispensable to health, or even life, are habitually
taking place.  A gas, or  in  other words, an  invisible air 
GENERAL PHYSIOLOGY.
29
generated in the course of the circulation, and carried to
these organs dissolved in the blood, is here liberated, while
oxygen gas, the life-giving principle of the atmosphere, is ab-
stracted from this element, and intimately incorporated  with
the circulating,fluid.  The  poisonous gas, here referred to, is
identical with  that found in old wells, and known as  " the
choke damps."  It is generated during the process of decay of
almost every organic substance, whether exterior to, or with-
in the living body ;  and, being  considerably heavier than the
atmospheric air, it settles to the lowest places, unless driven
off by currents of wind.  Crowded and illy ventillated rooms
are, therefore, unhealthy;  and this fact is of the greatest
practical importance to be remembered.   Persons in crowded
assemblies,  collected  in closed apartments, not unfrcquently
fall down, as if dead , but these, instead of being bled, if car-
ried into pure air, speedily regain their senses and strength.
If the quantity of  the poison, however, retained or respired
into the system be  very great, or if the individual  be  sub-
jected to its influence too long, death is inevitable; nor do the
resources of medicine offer one solitary antidote  for these de-
plorable cases.
   It is, therefore, of the utmost importance  to health, that the
Lungs have perfect play and freedom of action.  They  must
be considered as the great depurating  or purifying agents of
the human body,—serving the double purpose of exhaling or
liberating from the blood a most  deadly poison, and of re
supplying its place  with  that health-giving and vivifying
principle, circulating  in the atmosphere, known  to Chemists
by the name of Oxygen gas.   Deprived of a due supply of
Oxygen gas combustion cannot go on ; a fire will grow fee-
ble and soon be extinguished.  So, with the human  body.—
Deny to it a requisite amount of this principle, and it grows
pale, the individual becomes languid and sickly; disease be-  •
gins to prey on  his enfeebled organs ; he is tormented  with
dyspepsia ;  has short and hurried breathing, and soon, death  '
extinguishes the wan and feeble flame of life.   Of what vast
importance, then, that the Lungs be maintained in a state of " 
30
GENERAL PHYSIOLOGY.
  the fullest activity, that the Chest, in which these organs are
 lodged, be left free, unconfined and untrammeled, as  Nature
 made  it!   But Fashion, the Demon of human health, and
 one of the gods of this world, has interdicted the observance
 of these admonitions.  It has so blinded the eyes of its vota-
 ries, and deadened their sensibilities, as to  pervert their taste,
 make them submissive to the most onerous burdens, and ren-
 der them insensible to the rich blessing of health.  Not satis-
 fied with the shape which God has given the human  chest, it
 strives to alter it, and by perseverance and painful eduction,
 triumphantly proclaims, it is done.  In its  natural condition
 the chest resembles a cone—a familiar example of which, is a
 sugar-loaf—with its  base below ; but, when Fashion has fin-
 ished its work, the thing is reversed;—the base is  above.—
 Thus, the  bottom  lobes of  the  Lungs are compressed; the
 transmission of air is  impeded, both in its ingress  to, and
 egress  from them; and the  heart is trammeled  and confined
 in its motions.   It would be not less abused, while a thousand
 times less  injurious, to bridle the  tongue, and restrain it in its
 freedom of action, by bandaging the mouth,  than  it is  to
 cramp  and confine the Lungs and heart, by unnaturally for-
 cing  upon them the case in  which they move,—the Chest-
 by powerful mechanical  contrivances.  Certain nations, his-
 tory informs us, apply  compresses to the  foot  while young
 and growing, for the purpose of preventing it from attaining
 its natural size,  and rendering it  beautiful; while the Chris-
 tian American, denouncing  the Pagan absurdity, applies the
 compresses and bandages to his—no, not exactly his,  but her
 waist—for this  practice, in  this country, is confined  almost
Vholly  to the  female sex,—for the purpose of rendering  it
 beautiful.  But females are  not all guilty of a practice  so at
 war  with common sense.  It is found only, in  the  highest
 state of perfection, among the wealthy and  upper ten-thousand
.class.   And these charitable creatures, moving in the  higher
more civilized  and  enlightened circles of life, are not unfre-
quently heard lamenting and  bewailing the poor drunkard's
fate.  Now  this is  too much like  picking  motes from their 
                    GENERAL PHYSIOLOGY.              31

    brethren's eyes, while beams rest in their own.   For, while the
    intemperate man  wastes his  life in  drunkeness and rioting
    the fashionable (and misshaped religious) female's is,in a less
    tumultuous manner, driven from its tenement of clay, by the
    gradual encroachments of  relentless Fashion !   Nor are the
    structures within the Chest the only sufferers  in this suicidal
    warfare.  The stomach, together with all the abdominal vis-
    cera, and its contents.  But of this I  must defer, for the  pre-
    sent, to speak, and pass to
      3.  The Abdomen, or Belly, which is bounded by the  Dia-
    phragm muscle, intervening  between,  and  separating  the
    Chest from  this cavity; below, by the basin formed  by the
    hip-bones ; in front and on the sides,  by strong muscles; and
    behind, by the spine or back-bone.   In this cavity,  as we
    have already seen, are many  very important organizations.
    Here we find  the principal structures concerned in digesting
    and fitting our food for the wants of the system.  Here we
    see the nutritious  particles  of whatever we eat, picked up, so
    to speak, while yet floating in the homogeneous mass  con-
    tained in the  intestinal tube, carried  by appropriate vessels.
    and poured into the blood.  Here the Liver manufactures its
    bile, and, through  its proper tube, empties it into the bowels.
    In short, the structures contained in the abdominal cavity are
    to animal life, what roots  and soil  are to vegetable subsis-
    tence.  A shrub can maintain its vitality  for a very short
    time only, indeed, if its roots  be cut  off.  The soil in which
    they are planted supplies them with materials of nutrition;
    they select and  appropriate these materials to the wants of
    the particular growth.  Nor does the  analogy between a veg-
    etable and an animal stop here;  for the leaves of the forr%er
    perform the same  office, precisely, which is performed  by the
•   lungs of the latter.  Every one is aware, that  it is utterly out
    of the question for a vegetable to flourish and maintain a vig-
    orous existence, unless supplied with  an  appropriate soil, ge-
    nial  warmth and free air.   So with animal life.  A vigorous
    and  healthy constitution, presupposes a  plentiful supply of
    wholesome food, and a perfectly sound condition of the ap- 
32             GENERAL PHYSIOLOGY.
 paratus  concerned in its  elimination.   Deviations, in  either
 the quantity or quality of  the one, or aberrations from health,
 in the other, are, inevitably followed by results equal to the
 causes to which they are to be referred.  Nor is too much food
 less injurious to  health, than  too little.  A vegetable, as  is
 well  known, may, by an  excess of manure, (its appropriate
 food,) be forced into an  unnatural and diseased growth ; and
 thus, thwart the very design in its bestowment.  So with the
 body of  man.  Too much, too poor, too little, or too rich food,
 taken into the digestive apparatus, may all prove sources of
 disease.  Indeed, in the stomach and bowels are to be found
 almost nine-tenths of the sources of all diseases.  No person,
 acquainted with  the physiology of digestion, will wonder at
 this statement, or think  it  extravagant, when he looks around
 him, and considers the thousand and one causes  to which
 these organs are  daily and hourly exposed, .calculated to im-
 pair their functions.  Intemperance, both in eating and drink-
 ing, may be mentioned as the most  common  among these
 causes.  Others might be enumerated at pleasure : as swal-
 lowing the food without chewing; too great a quantity  of tea
 or coffee, or, indeed, of any kind of fluid, taken at meal-time ;
 irregularities in eating; the strong savory dishes, so common
 now  a-days ;  sweetmeats and preserves, &c, &c, all  of
 which, at least when unduly indulged in, can hardly fail inbe-
 coming sources of mischief to  the tender tissues of the  stom-
 ach and  bowels.  But as I design, in the course of this  treat-
 ise to  give an account of indigestion, its causes and treatment
 for the present I shall  refer to certain mechanical impedi-
 ments, which are not unfrequent  causes of imperfect diges-
 tion.  The  most  common one of these  is, undoubtedly, that
 already referred to, and consists in pinching in and cramping
 the Chest, by the various  appliances which Fashion has in-
vented.   It is obvious, the stomach being situated immedi-
 ately  below the breast-bone, and partly encompassed by the
short  or  floating  ribs, that the violent  compression,  which
Fashion  habitually imposes upon  these parts, must interfere
with the  natural  play and functions of this organ, thrusting 
GENERAL PHYSIOLOGY.
33
it lower and lower into the abdominal cavity.  And, being
forced to take an  unnatural position here, other structures,
scarcely less important than itself, are injuriously imposed up-
on, as a secondary consequence.  The mere  statement  of
such a fact is all that I shall say on this subject at the  pre-
ent time ; but I hope, sincerely, the suggestions may not be
entirely lost, in reclaiming, from the strong arm of relentless
Fashion, at least a few of its devotees.
   As mere appendages to the body, the Legs and Arms, with
their terminals,the Feet and Hands maybe mentioned.  But
these are to be viewed  only in the light of mechanical con-
trivances, and in no way indispensable, with the divisions al-
ready noticed.  With the foregoing  remarks, then, I dismiss
the subject of this  Chapter.
5 
CHAPTER III.
         ON THE CONDITIONS OF HEALTH  AND DISEASE.

  I—Of Health.  That condition of the body in which every
part of the living machinery is in a sound state, and every
function or ^office of the different organs [is carried on with
the utmost regularity, is perfect health.   Although the slightest
variation from the definition here given is not perfect health,
yet, when those variations are so slight as to  elude observa-
tion, they are not taken into account, and ithe  individual is
said to be  well.  Born with  the seeds  of mortality already
germinating within us,  and  habitually  exposed to noxious
agents on every hand, it is, I presume, but seldom, that even
the more robust amongst us, enjoy a  perfect immunity from
the effects  of those  agencies.  It is well to remark, however,
that slight  and transient disturbances of many of the func-
tions of the body must not be  mistaken  for diseased states.
For example, the cheeks of a timid individual, unaccustomed
to genteel society, are, upon  entering  suddenly into a  ball-
room, reddened, and seen to  glow with an unnatural blush.
This reddening of the cheeks, so far from implying a disor-
dered state of the body, not  unfrequently denotes the  most
delicate health, and should be regarded as a mere fluctuation
or fluttering of the spirits within.   To maintain, constantly,
during our natural  lives, a state of perfect health, is a desid-
eratum that mankind have long striven to maintain ; but, for
the  very obvious reasons  above suggested, it appears  most
likely that all their efforts will forever prove unavailing ;  and
they will, therefore, often be found in its opposite—that  of
  2—Disease.  The definition of this term has  been antici-
pated.  It is the opposite of that of health, and is, correctly 
CONDITIONS OF HEALTH  AND  DISEASE.
35
defined, any alteration from it.  Every  derangement  of the
functions of the different organs of the human body, from the
slightest cold to the most terrible cholera, constitutes disease ;
and it is between these two extremes that the whole catalogue
of human  ailments lie.   Believing that a short space of the
present chapter might not be uninterestingly occupied in in-
quiring into the general  causes of disease, I shall accordingly
enter briefly upon their  investigation.  Amongst the more
common causes, giving  rise to disordered states of the body,
are, as has already been intimated, to be reckoned errors  in
diet, (a)  Too much food, by over-loading  the  stomach, and
burdening it with more* labor than it can  perform, is  a very
frequent cause of general disorder, (b)  Insufficient  masti-
cation or chewing, by allowing hard substances to pass into
the stomach, frequently induces disorder of the stomach, and
through it, of other functions, (c)  Improper food, or such as
is insufficient to supply the wants of the body, it is  obvious
might prove injurious, (d)  Sudden  changes from warm to
cold often impart a shock to the different functions, and may,
if the cold be long continued, prove of very serious  import.
This is, perhaps, of external agencies, the one to which more
disorders can be traced than to all others, (e)   The influence
which  inscrutable conditions of the atmosphere, at  certain
 seasons of the year, exert on the health of the body.   To
 this cause must chiefly be attributed those agues, fevers and
 fluxes, so rife during  our  autumns in the West. (/)  Specific
 contagions, by which is meant, the  ability which certain dis-
 eases possess of communication from  one person to another,
 when brought within the sphere of their action.  Small-pox,
 measles, hooping-cough,  &c, are examples  of this  class of
 causes, (g)  To the causes now enumerated, there may be ad-
 ded, with propriety, hereditary taints—-that is, the tenacity with
 which some diseases cling to family  connections,—passing,
 with lamentable fatality, down from father to son-from gen-
 eration to generation;  being stamped in  the  same  manner
 upon the constitutions of the children, as the parents' features
 are upon  their offspring.   Through this last  means we have 
36    CONDITIONS  OF  HEALTH  AND  DISEASE.
 transmitted to our race many  of the most formidable  and
 fatal maladies to which we are obnoxious.  Scrofula, with
 consumption, &g., may not unfrequently be traced to an origin
 of this kind;  and such transmissions, not being  exactly the
 disease itself, are called predispositions.   Many other causes
 of diseases might, be interestingly  enumerated, but as the
 most common have been given, I propose, in the next place,
 to speak of the nature of diseases.  The scientific physician
 is expected to know  something more  about an  individual,
 than that he is sick.   He must understand the  nature  of his
 sickness; the part or parts suffering derangement; the pre-
 cise  condition upon  which  the derangement  depends; the
 symptoms or  signs of those conditions ;  the course, termina-
 tion, &c, which is likely to ensue.  All these things he is
 expected to understand, before he is prepared to offer succor.
 Now, it is the tendency of many diseases to cure themselves,
 or rather to be cured by the  unaided efforts of the constitu-
 tion ; and this is one of the wisest designs of Beneficence.  If
 every slight affection  wandered off, farther and farther from
 health, into a more serious one, instead  of a tendency it has
 of returning into  one less serious, and  into ultimate health,
 wo would  be  to humanity !  But it  is not so.  In almost all
 disorders, the  observing physician must witness nature's plas-
 tic hand at work, making gentle, but well directed efforts to
 repair those breaches  which have, by intemperance or other-
 wise, been made in the bodily organs. Wherefore, it is, that
 the medical man's duty does not always allow him to inter-
 fere with those  natural forces, put  in motion by  a higher
 power than he  possesses, in which  he  beholds every  pang
 pointing to one  thing, the  restoration to health.   The
 physician  must examine the case thoroughly, comprehend
 it completely, note  the course it  is about to  run,  accu-
jately weigh  and estimate  the  natural forces  in action
tending to  bring  about a  crisis, before  he  enters  upon its
treatment, or decides to commit it to the constitutional forces.
Having the requisite knowledge to attain to these ends  and
forbearing  to  be  officious, where officiousness would prove 
       CONDITIONS OF  HEALTH  AND DISEASE.    37

injurious, he  is duly qualified to understand  the  nature of
disease ; and, provided he  has acquainted himself with the
properties, medical virtues, &c, of those drugs used as rem-
edial agents, he is prepared to practise medicine on scientific
principles.   As I design recurring to this subject  again in
the chapter  on inflammatory, anti-inflammatory,  &c.  dis-
eases,  I shall desist  from its further consideration at the pre-
sent time.


                       •ba1-   -.
               v      ;r«         .  ■.
             _, •          '"cons      "A  ~"'?"'' }j-
                , A   er ',vJ     " nv  " >'~      ^i 
CHAPTER  IV.
 ON DIET, EXERCISE, SLEEP, CLOTHl.il^, BATHING, &C, AS MEANS OF
   AVOIDING SICKNESS, AND ALSO OF R SPRING *NVALIDS TO HEALTH.
                         *t       Vih      i-
  JThese are sm:;«jcts, ; -right T\*?/ieritanding of which, and a
 correct appreciatron of th^n0 valu^i^j-e :vf more importance
 tc the generality of my  readers  than any a!nd all other sub-
 jects contained in the present volume.  Every one, I am sure,
 must be able, after  carefully considering what is  said here
 on these subjects, to understandingly apply those wholesome
 rules which are  to be laid down.  It is  a mistaken  notion,
 into which some medical gentlemen have fallen, to suppose
 that the intelligent public, though possessing very limited ed-
 ucation, are unable  to  appreciate physiological laws, and
 apply them advantageously  in warding off  diseases,  and in
 curing those diseases, when afflicted by them.   If public lec-
 turers, ministers of the gospel, &c, were occasionally to al-
 lude to subjects connected with health, and  explain, in  a
 plain and comprehensive manner, those  beautiful  and sub-
 lime laws upon which it depends, their services to the pub-
 lic  would be greatly enhanced ; and, although  out  of place
 here, I must express my regret that so many persons engaged
 in ministerial duties are  so profoundly ignorant, not only  of
 the common laws of physiology,—the laws which govern and
 regulate themselves as living  intelligent beings; but also, of
 the principles of the simplest sciences.  They know how  to
squabble with those of a somewhat different faith from them-
 selves ; how to get to heaven themselves, and send those  of
an opposite belief to the doleful  regions of eternal  night,
which their disordered imaginations have  conjured up ; and 
DIET,  EXERCISE,  &C
39
this is about all they do know!  To meliorate the distresses,
the pains and miseries of humanity, to inform the understand-
ings, and educate the thinking, the benevolent,  and reveren-
tial faculties of the mind,—these are subjects that they regard
as not coming within the sphere of their business:  But  the
time is coming—not far off, I hope,—when a different state
of things  will  dawn  upon  us.   Education every  where
more is than ever before, being generally diffused; narrow
hearted bigotry is yielding to a more genial system of moral
ethics, whose wide spread pinions over hover no special sect,
but embrace under their balmy shades every discription of hu
man misery, in whatever clime !  But to return from this di-
gression, I first pass to the consideration
   1—Of Diet.   The definition of this  word means  simply
those substances which, when taken into the body, nourish
and support it.  Diet is as indispensable to  life as wood or
fuel is to combustion, and has, not inappropriately been com-
pared with it.  Those substances which will not support the
life of the body, are to be regarded as either poisonous, med-
icines, or inert.  Diet or food, on the contrary, maintains life
by ministering to the wants of the body—tending to preserve
it in its  natural condition, (a) As to the quality of diet, much
indeed might be written, but after all, a few general sugges-
tions are all that can  be very profitably applied in practice.
Man, when regarded as an animal, holds a place intermediate
between those creatures that subsist alone upon vegetables,
and  those that live entirely upon flesh.   His whole confor-
mation  goes to establish the truth of the statement here made ;
and, notwithstanding I may  incur the  risk of having it dis-
puted by a certain class of men, who assume to be  Reformers,
but  who, indeed, on this  subject, deserve to be considered
Fanatics, I but reiterate that for which  almost every truly
scientific man contends.  Then, animal  flesh or meat, I do
not hesitate to put down as proper diet for individuals in the
enjoyment of health.  And even under certain circumstances
of disease, I am of the opinion that a due amount of it is far
preferable to an exclusive vegetable diet.   Already closely 
40
DIET, EXERCISE,  & C .
analagous in composition to the substances of which our own
bodies are composed, it, other things being equal, does not re-
quire the same efforts of the stomach to prepare it for enter-
ing the body, as vegetable  matters do.  It is true, that more
than the wants of the  body require, especially of the fatty
parts, is not an unfrequent cause of injury to  the in/Jividual
so partaking ; but this is intemperance—the abuse of a thing?
and of itself, must not be  construed into  an objection to its
use altogether.  The  same kind of an objection might be
urged to the blandest vegetable substance.  Closely allied in
composition to the flesh of animals is the well known sub-
stance, milk.  Upon this fluid the young  of the whole quad-
ruped race, during a certain period of their lives, have, in a
great measure, to depend  for subsistence.   Without it few,
if any, of them could be reared.  Alone, without the interpo-
sition of any other kind of food, man may support a long life
upon this, generally suppose'd to be, simple, natural product.
And I have little doubt, but that were many of the feebler of
our race entirely confined to it as a diet, while their comforts
would be enhanced, their  lives would  be greatly  prolonged.
Instead of milk being a simple fluid, it is, on the contrary, one
of the most complex substances with which we are acquainted;
and contains all the elements of nutrition, necessary to main-
tain, indefinitely, the life of the stoutest man.   It must be
confessed, however, that although milk is most highly nutri-
tious, and adapted nicely to  the wants of the  young, yet it
will not  invariably agree  with the digestive  apparatus of
every adult, when intermingled with other food.   Milk, when
introduced into a healthy stomach, is always, previous to be-
ing digested, speedily coagulated, curdled, or, in other words,
is first converted  into  cheese.   Now the inner coat  of the
calf's stomach,—which in its dried state affords the rennet—
contains a sufficiently large amount of the gastric juice, the
active agent in this process of coagulation, whether in or out
of the body, to act much more energetically than  is found to
be the case with that of the full grown cow; and hence it is
that dairy-men make use of the former. 
DIET,  EXERCISE,  & C .
41
  From the foregoing remarks under this  head, then, it will
be perceived that 1 am much in favor of milk  as being not
only a palatable, but  a highly  nutritious  beverage, adopted
with very few exceptions, to the wants of every  human be-
ing ; of course, it is to cow's milk that I refer.
   Vegetables form the chief bulk of the food usually used by
man ;  and with respect to their bland and hurtful, to their nu-
tritive and inert properties, many  comparisons might be in-
stituted.  Many vegetable substances are actively poisonous,
many  nearly inert—that  is, possess  little other properties
than simple water; while  between these extremes we find
those  natural products, the successful  cultivation of which
forms  so considerable a part of husbandry, and which are al-
most  universally used as food  for man.   Among the  various
vegetable products used as food for man, the grains undoubt-
edly stand pre-eminent.   Of the various grains, wheat has
the first rank, and, if we were to  consult western taste, we
would have to give corn the second place.  Be this as it may,
however, the difference between the different grains, in use
as food, with respect to their  nutritive and wholesome qual-
ities, is but slight, and one  may, without much  detriment,
often be substituted for  another.  They  are all, chemically
speaking, closely related.  They all contain, as their bulkiest
materials, starch and a tough  elastic sort of substance, called
gluten. Besides these two compound elements—for they each
contain in themselves several  simple elements,—these grains
contain certain mineral salts, such as potass lime, &c, with-
out a due supply of which the human  body would dwindle
and fall into a state of decay.
   Bread has been styled the  staff of life, and  it surely de-
serves the name.  When rightly made it is not only among
the most palatable  substances, but it is also, one of the most
substantial articles of food. It should always be thoroughly
baked, and certainly  ought never to be  highly seasoned, but,
on the contrary, it should  be  rendered light and porous  by
the appropriate means in so common use every where.  Nor
should it be eaten burning hot from the oven.   Bread made
              6 
42
DIET,  EXERCISE,  & C .
from the meal of corn, if rightly  seasoned and baked, is un-
doubtedly both wholesome and nutritious with many individ-
uals, yet, I think,  that some persons of delicate organization
cannot very well  digest  it;  why, 1 will not here undertake to
say.
  Both sweet and Irish potatos, beans, peas, &c, are, to some
extent, in composition akin to the grains, and may, therefore,
frequently enter into our diet without the fear of incurring the
risk of  injurious  consequences.   Parsnips,  carrots, turnips,
cabbage, &c, although amenable to the digestive apparatus
of those of strong constitutions, are not always innoxious  to
individuals, whose stomachs have  suffered impairment.   In
their use, therefore, more caution is necessary to be observed
than in the use  of the  first mentioned  articles.  After all,
however, more injury is  sustained in consequence of  imper-
fect cookery,  and  gluttonous eating, than in the  qualities of
the many articles  of diet in common use.   A very little of the
richest and most indigestible article of diet, may, almost al-
ways, be taken with impunity, by persons  whose digestive
systems are extremely feeble, whereas a great quantity, even
of the blandest food, not unfrequently is  the source of much
mischief to  those whose  digestion is esteemed unusually
good.  With regard to most of the fruits in common  use by
our people, when  ripe, and eaten in moderation, they  are  to
be considered wholesome.   But unripe fruits, the swallowing
of their seeds and skins, are perhaps, among the most fruit-
ful  causes of the disease of those children that are permitted
to have a plentiful supply  of such crude  substances of diet.
Then, to sum up  the whole matter, I suggest, as good and
wholesome rules of diet:  1. Food nutritious and wholesome.
2. Perfect cookery.  3.  The avoidance of gluttony.
  2—Of Exercise.  Man was never made to be  idle.  The
world in which he lives  affords him ample scope for the ha-
bitual exercise of  all his  functions, both physical and intellec-
tual , and the circumstances which surround him every where,
are of such a nature as to call imperatively  upon him to be
up  and doing while it is  called to-day.   His whole life should 
DI ET,  EXERCISE,  &C
43
be likened to a gentle stream, wending its way to the fath-
omless Ocean.  While unobstructed in its passage, its crys-
tal waters, interspersed with here  and there  lovely ripples,
flow gently  onward, cleansing and purifying themselves as
they move along, but hindered, obstructed in their way, they
rapidly lose their  vitality, and speedily become putrid and
stinking.  So with man.   Originally designed by his Creator
to procure his food and raiment "by the sweat of his brqw,"
and to exercise those noble thinking powers which he  alone,
of all created things, enjoys, when those incentives  are, by
the singular  absurdities of society, taken from him, he has
the aspect of a gloomy wilderness, decaying of its  own soli-
tude.  God  never designed, I repeat, man to be idle, or he
would not have required  him to  labor, either to  supply his
physical wants or  to cultivate  his  nobler powers—those of
his mind.  And what a perversion it is that men have cre-
ated, making those unnatural distinctions, into laborers and
gentlemen, lords  and  serfs, masters  and slaves!  Every one
should labor with his own hand, or he should not eat;  nor has
God given to any man the natural right  to call his  brother
his slave—" Have  we not all one Father—hath not one God
created us?"  But to the sin of idleness, Jehovah has not left
a penalty unattached.  He has said that "in the sweat of
thy brow thou shall eat bread;" and he who attempts to gain-
say this  emphatic  declaration, is  sure  to receive a just re-
compense of reward: " For many and sore are the punish-
ments of idleness."   It leads  its  votaries captive down the
declivity of time, and often thrusts them, unawares, into the
depths of degradation and ruin;  it encourages vice, allows
time to put it into successful operation, and gives ample scope
to the lowest passions. Let idleness then be discarded, and let
every one, in accordance with the Divine injunction, live by
the sweat of his brow.
   The beneficial influences of exercise are so numerous and
diverse that I can only notice  a  few of them.  Aside from
its moral bearing on society, it promotes digestion, invigor-
ates every part of the human body, expands the intellectual 
44              DIET,  EXERCISE, &C

faculties, and  renders  the individual healthful and happy.
Exclude the light entirely from an eye, and ere long it will
have lost the power of perceiving the colors and shapes  of
bodies ; confine an arm in a sling, and its muscles will become
flaccid, and dwindle to  almost nothing.   But let every  part
perform  the function  for which it was created,  and the
whole man  will be  sound.  The  mind to think, and the
body to put its thoughts into action.  It must be .confessed,
however, that too much exercise either of the mind or body,
heavy laborious, and too long continued, no less than a want
of it, is injurious.  A happy medium is a proper ground.
  3—Of Sleep.  If exercise  is indispensable to the well be-
ing of man, the same must be said of its opposite, repose  or
sleep.  We are so constituted that  a certain amount of ab-
solute rest is necessary to  calm and quiet the excitement
which hours  of activity have brought  up.   This  absolute
rest is sound and unconscious sleep.  Whenever our slum-
bers are disturbed by dreams and starts,  our repose has not
been perfect; some of our faculties have been active, whilst
others have been totally unconscious.  Thus we are said  to
dream : dreaming being merely a wakeful state of the facul-
ties of imagination, whilst those of reflection are in a state  of
unconsciousness, and do not, therefore, act as restraints to the
mind's movements.  Sleep is very much the creature of habit:
some  persons sleep half or two thirds of their time; other re-
quire  but a few hours, daily.  Bonaparte, it is said, slept but
four or five hours  of the twenty-four, and  no one enjoyed
more vigorous health than he did.   I have a distant relation,
a gentleman of the most industrious and  active habits, who
allows himself but about five hours a day for sleep, though he
is near seventy years  of age.  Such persons, it is proper  to
know, have acquired .these habits by education—by self de-
nial.  To enjoy sweet repose—" Tired nature's sweet restorer,
balmy sleep,"  as the poet has  beautifully expressed it, gen-
erally presupposes an exemption from any bodily pain or suf-
fering, and a good and quiet conscience,  void  of offence to-
wards God and man.   These are prerequisites that all should 
DIET,  EXERCISE,  &C
45
study to possess;—the first by the observance of those physi-
ological laws, the principal  among which  I  have  already
briefly pointed  out,—the second, by doing unto others  that
which they would have others do unto them.
  4—Of Clothing.  Man's intellect, in many  cases, is  in-
tended to supply, secondarily, what nature, with her own hands,
at once bestows upon inferior animals.  Thus, those  animals
that inhabit high latitudes of extreme cold, have usually not
only thick skins, but these are protected by the thickest and
finest furs imaginable ;  while those of a more southerly hab-
itation are, in a great measure, destitute  of both these pro-
tective agencies.  Man, on  the contrary, was intended to
inhabit all latitudes—all climates—to stem the burning rays
of a topical sun,  and contend with the icebergs of the poles!
Now in some measure the  difficulties of these extremes of
heat and cold he overcomes by  clothing.  The Russians and
Greenlanders wrap themselves up  during their long winters
in skins and furs, while he of the equatorial regions, clothes
himself merely in conformity to the rules of decency,—know-
ing as he does "good  and  evil."   A few suggestion as re-
spects clothing may not be amiss.  Children, during  early in-
 fancy and during almost all  seasons of this western  country,
 where there are  sudden changes  of temperature, should be,
 in some measure, protected against those changes by soft
 flannel clothing.  After they have attained however, the age
 of a few months, it is well to treat them less tenderly in this
 respect, that they may  become inured to atmospheric vicis-
 situdes.  Old  people, too, in consequence of a tendency they
 have to maintain but  a low degree of animal heat, should
 generally wear soft warm clothing.  Those, however, of stout
 robust constitutions may, as well as not, be rather thinly than
 thickly clothed.   Invalids, and those afflicted with old chronic
 complaints,  should be sedulously protected against the influ-
 ences of cold.  Shoes  and stockings are indispensable during
 our cold winters.  A good rule to be observed in the making
 of clothing and shoes or boots,  is to  avoid  tightness—not  to
 pinch and cramp any part of the body—especially  of young 
46               DIET,  EXERCISE,  &C

and growing persons.  Fashions should be disregarded, and
comfort and convenience  consulted.    It is  a ruinous,   a
wicked fashion, which subjects us, not only to inconvenience ;
but I have already alluded to this  subject in the chapter on
physiology.  Women are sometimes in the habit of clothing
themselves warmly, except upon going out  on a visit, when,
even during the coldest weather, they exchange their  heavy
garments for the thin est and lightest articles.  Such a prac-
tice many times leads to the worst  consequences, and  many
persons sacrifice  their  health  or even lives thus  foolishly.
Care,  therefore, ought  to be observed  in cold  weather, in
adopting such measures, as they may be very grave in their
consequences, indeed.
  5—Of Bathing.   The observance of cleanliness demands of
every individual the occasional ablution of the body with wa-
ter, and no less does health  demand  the same observance.
The skin is an immense organ, the office or function of which
is to extricate  or set free from the body, in the form of watery
vapor and sweat, certain effete  matters that, were they  al-
lowed to remain in the  blood,  would produce a bad state of
health.  Now, by occasional bathing, the  skin  is not only
kept white and clean, but its numerous pores or little orifices
are kept open and their action maintained in a state  of health.
There are two plans of bathing—the one in cold and the other
in warm water.   The  first frequently  has  advantages over
the latter, and may often be very beneficially practised.  In
weakly and  debilitated subjects, however, the  warmer bath
is  the  safer mode, and should, therefore, be preferred with
such persons.  Of water as a curative  agent in many dis-
eased conditions of the  body, I shall not speak further than
to say  that, when judiciously  prescribed, it  may not  unfre-
quently be used to great advantage.   Nevertheless I must
express my disapprobation of the course which certain quacks
are at this day pursuing with this  agent.  It is quackery to
attempt to cure all diseases by the  same means, and he who
makes pretensions of this kind deserves the hearty condem-
nation of every scientific physician. 
CHAPTER  V.
                CLASSIFICATION OF DISEASES.

  Nosology is a term used by physicians to  express  the  ar-
rangement of diseases into classes, orders, &c.  Many very
ingenious arrangements of this kind have been invented by
different individuals ; but for reasons obvious to every intelli-
gent physician of  this day, they have,  in a great measure,
fallen  into disuse.  Indeed, nosological  arrangements must
necessarily always remain imperfect,  and this imperfection
in classification sometimes proves very ruinous  in practice.
For example :  Dr. Cullen classes Dyspepsia under the head
of nervous diseases; but modern  practitioners well know
that the most  inveterate cases of dyspepsia  are  associated
with an inflammatory condition of the stomach,  and conse-
quently that the plan of  treatment  proper for nervous dis-  *
eases is calculated to aggravate, instead of palliate the dis-
order.   Such arrangements  have, therefore, been generally
laid aside, and a more rational and  common sense classifica-
tion, in nowise calculated to mislead the young practitioner
has been adopted.  Dr. Cullen lays down in his arrange-
ment, no less than four classes, and twenty  orders, including
one hundred  and forty-nine diseases.
  The most natural, as well as most useful, classification of
diseases is, perhaps, into four classes.  The first includes all
Fevers, except those to be included under  the fourth.  Th v
second, Inflammatory diseases in general.   The third, Anti-
Inflammatory diseases.  The fourth class includes  those Spe-
cific diseases that  are propagated by  contagion.   The dis-
eases of  this class may be either inflammatory or febrile.— 
 48        CLASSIFICATION  OF  DISEASES.

 \ow names may be multiplied, at pleasure, to diseased con-
 ditions  under any of the above heads.   But multiplications
 of this sort are not very useful, and in au'ener-al view of disease
 like the present, they should be avoided.   A physician being
 called to treat a case of sickness, examines the case to ascer-
 tain  whether or not he has to do with fever, with inflamma-
 tion or not; or whether a specific contagion.   These  points
 being settled, he then has laid down the rules of practice that
 are to guide him in the treatment of the  case.
   For the reasons,  then, which have just  been suggested, I
 shall in the four succeeding chapters, treat, first of Fevers in
 general, giving a very brief outline of their  natures,  symp-
 toms, causes, and the best means within the  reach of  those
 unacquainted with  medical science, for their management
 and relief.   The second class will come up for consideration
 next; and as it is my object to present a  very general view of
 the diseases termed inflammatory,  I  shall not enter at great
 length upon any one disease of  this class, but shall speak in
 terms which will, with few exceptions,  apply to the  whole
 class.  The third class, embracing anti-inflammatory diseases,
 will be brought forward, and some general rules given in re-
 lation to the best mode of managing the  most common affec-
 tions of this class.   Class fourth, as already intimated, em-
 braces all  those affections, conveyed from  one person  to
 another by contagion, and producing their  like, from that,
 among the most formidable of all diseases, small pox, to itch,
 scarcely  deserving notice.  But it will  not,  I hope, be  ex-
pected that I can treat in the compass of  a  few pages any
thing like minutely, of all embraced under the four foregoing
heads.  On the contrary, my remarks must be very general,
and it, therefore, behooves me to make them plain, instructive
and practicable. 
CHAPTER  VI.
                  OF FEVERS IN GENERAL.

  Class First.—"What is Fever?" is a perplexing question,
and one not very well defined by physicians themselves.   It
is a common notion that heat, a dry, hot skin, headache, rest-
lessness, thirst, &c, are symptoms which clearly indicate the
existence  of fever;  and so  they do.  But their entire ab-
sence does not necessarily imply the non-existence of fever.
An individual may have an unnaturally cold skin, he may be
free from pain, have no thirst nor much restlessness, and yet
be laboring under a dangerous  fever.  Fever, perhaps,  is
pretty well defined when we say it affects the general sys-
tem, deranging more generally than almost any other disease,
the functions of the entire  body.   There are two kinds  of
Fever, radically different from each other,  and a correct un-
derstanding of this fact, more than any thing  else,  perhaps,
contributes to give the physician  an advantage over the mis-
erable pretender.  The term fever, strictly speaking, should
be confined to those constitutional diseases in which it is the
first and most prominent symptom.  But we find fever almost
invariably associated with all inflammations of  any consid-
erable extent.   Now here the distinction is  to  be drawn.
This latter fever is clearly referable, for its cause, to  the pri-
mary inflammation.   It is, indeed, a consequence of that in-
flammation.   Cure the inflammation, and you  cure the fever
by taking away its cause.  The same  is  not the fact, how-
ever, with genuine  fever.   Here the fever is the primary
disease,—the first link in the chain  of morbid action.  In-
flammation may, and indeed  generally does, spring up in the
             7 
50
FEVERS IN  GENERAL.
course of a fever, provided it be permitted to run its course; but
the inflammation here, I grant you, is not the cause of the fe-
ver, but the consequence of it.  And although the cause of the
original disease may be amenable to appropriate  treatment,
yet-if its  consequence—inflammation—is not  obviated, the
patient may perish thereof.  It will be readily perceived then,
that the nicest discrimination is absolutely necessary in the
accurate investigation of this  class of diseases; and that
upon a correct understanding of the precise condition pre-
sent, much must depend in the management of the same.
   The causes of Fever are somewhat various;  but the most
common and fruitful of these, so far as the west is concerned,
at least, is undoubtedly, warm weather followed by  the  rot-
ting and decaying of vegetable matters,  conjoined with mois-
ture. Hence it is  that fevers  are  more rife during warm
and moist autumns, than under  any other circumstances.__
There are other causes, however, which, in concert with the
foregoing, materially increase the first mentioned.  Such are
sudden changes of the atmosphere, too  suddenly cooling the
body when over-heated, and last, but not least,  errors in  diet
—" gormandizing."
   Of the nature of Fever I need say but little.   It is a disease
that depraves the blood,  and consequently through it infects
the  whole body.   Its consequences—inflammations—as al-
ready intimated, are to be, in the majority of instances, more
dreaded than the primary fever itself.  The question is with the
physicians, has the patient simple fever, or is his fever com-
plicated with inflammation ?  The  most frequent of these
inflammatory complications  is, by far, in this country at least,
that of inflammation of the inner coat, or lining of the stomach
and bowels;  and it is from this cause perhaps,  oftener than
from any other, that our fevers destroy life.   Having now
said a sufficiency under the head  of general fevers, I shall
next proceed to notice individually, a few of the more com-
mon species of our western fevers.  And here I shall  study
brevity,  and  endeavor to make  my remarks as practicable
and plain  as may be. 
FEVERS IN  GENERAL.
51
  Seoiton I.  Of Intermittent  Fever,—vulgarly called Ague
and Fever, Chills and Fever, cVc.  This  is one  of the most
common diseases of our western country, and it must be con-
fessed, more than any other perplexing to the physician and
tedious  to the patient.  Autumn is the time it  most com-
monly makes  its  attack, but^t is not very uncommon in the
spring, and  I have occasionally seen new cases of  the disease
occur in  the  dead of winter.  It  is a  common disease in
almost all the low and marshy districts of the western coun-
try ; it is  also very  common along all our water courses and
low  sandy bottoms.  Upon the high rolling lands,  remote
from rivers  and marshes, it is  rarely seen.  These facts, with
others which  might be stated, establish, beyond cavil, that
the cause of the  disease is  generated  in localities such as
have just been indicated;  and as  it is infinitely  more com-
mon during the hot months of autumn, when" the luxuriant
vegetation is  in  a state of decay,  it has been inferred that
the cause  of intermittent fever is  generally owing  to  a
poison, which has  got the name of miasm, and which re-
quires,  for  its generation, a  combination of circumstances,
such as I have mentioned.  While I do not doubt the correct-
ness of the view here given, in the main, still I know there
are certain  facts  which go to  invalidate its universal appli-
cability to all cases of Ague and Fever: and other causes of
the disease are, therefore,  to be  sought,—but of  these I de-
sign  not to speak at present.   The symptoms, or signs, of
the Ague and Fever are so well known, when well marked, by
the  people  of the  west, that  a description is scarcely called
for; yet some, perhaps, are not  acquainted with the manner
in which it works so perfectly.
   Previous  to the  attack the individual is  apt  to be indis-
posed, to have a feeling of general soreness and weariness,
to suffer some impairment of appetite—in short, he is unwell.
After these symptoms have continued for an uncertain space
of time, the patient—for now he may have this name—feels
thirsty, is restless andslight chilliness ensues ;—he  feels cold
and hot at the same time, and  presently begins to tremble 
52
FEVERS IN  CEN ARAL.
with cold.   This coldness he attempts to alleviate by sotting
close to the fire, or being thickly covered up in bed, but all to
no purpose ; his teeth  chatter, his limbs are convulsed  in
one word,  he  shakes.   It may be, he is sick at his stomach
and vomits, or  he may even purge violently during this cold
stage of the disease, but these symptoms are rare.  Convul-
sions are not,  however, very  rare during  the  cold stage in
young and excitable children.   I have seen the cold  stage,
in these little subjects, frequently ushered in by convulsions ;
and these may  disguise the disease so as to lead to  serious
errors  in treatment.  The cold stage having continued, say
from a few minutes to several hours, the patient begins to be
warm,  the  shivering gradually ceases, his head begins to
ache, violent pains of his back, legs, &c, are developed, he
is thirsty, and  his pulse, which during the cold stage was fre-
quent, but feeble, acquires greater strength, his extremities,
as well  as his  whole body, are dry and hot, and he is often
anxious and extremely restless.  The symptoms being well
established, constitute what has, appropriately  enough, been
termed—
    The Hot  Stage.—The duration of this  stage  is uncertain ;
it may continue only for a very short time, but in severe cases
it is apt lo  last for  many hours, and the patient gets but little
rest from the time it quits him, until he suffers another  "chill."
It  is  the duration  and severity of this stage—the hot, that
characterizes the mildness or severity of the disease.  When
it lasts only a  short time, the disorder is usually trivial, but,
on the  other  hand, if it continues  for the space of  many
hours, the patient is greatly exhausted, and the disease is to
be regarded as  one of severity.   However long or short the hot
stage may be, it is  almost invariably followed,  sooner or la-
ter, by the third, or,
  Sweating Stage.—With the commencement of this stage all
the violent symptoms begin to abate,  and with  its  termina-
tion, the patient, for the time being, is restored to compara-
tive health.  This third, or sweating  stage, seems to  be the
result  of the disease, and it is to be looked upon as a salu- 
FEVERS IN  GENELAL.
53
tary evacuation, tending to relieve the suffering organs.—
The perspiration or  sweating usually begins to show itself
upon the face and forehead,  and, gradually extending, it
speedily covers and bathes the whole body.  It may lastsev-#
eral hours, during which time  the  patient  often lies  and
sleeps profoundly.  After the sweating has subsided, the pa-
tient, as already mentioned, usually feels pretty well, has an
exemption from his fever and anxieties,—has what the Doc-
tors call an intermission, which circumstance  has  given the
name to the disease.   This intermission is of uncertain dura-
tion, according to the type of the disorder.   For example : if
the disease returns  daily, and the fever has been tedious, last-
ing for many hours,— of course, but a few  hours of  compar-
ative health can be had.  But  if  the  disease returns every
other,  or, as is  sometimes the case, every third day,  thert the
intermission is  of greater length.   Why it is that the disease
returns sometimes every day, sometimes every other or every
third day with the utmost regularity, I nor any other person can
tell.  Such a fact admits of no other explication than that of
saying it is one of  the circumstances  entering into the very
constitution of  the disease itself-—an ultimate fact in its his-
tory.
   1 have thus  given a  brief, but I hope a plain^ description
of what is called a paroxysm of intermittent  fever—ague,—
such  a  description as I hope may be  of practical benefit to
my readers.  And now I have  to  warn them, that they are
not to look, in  every case of Ague, for the  symptoms so reg-
ular and well marked, as those here laid down.   On the con-
trary, much diversity is to  be looked  for—many deviations
from the course which has been laid down—as a pattern case.
  Sometimes, instead of the shake, we have the most trifling
chill;  sometimes we see little fever, although the shake may
have  been very  perfect; sometimes there is scarcely  any
sweating, but  in all cases  there must be  an intermission,  or
the disease loses its most peculiar characteristic. This is a cir-
cumstance that should not be lost sight of, and one upon which
our treatment is principally to be predicated.  Next I pass to 
54
FEVER'S IN  GENERAL.
   Tin  Tnntmnii.— This is to be conducted  on general prin-
ciples.  1 shall not propose any other means for the cure ot
this malady, than those most  simple and  most universally
efficacious ; first, because the disease, as seen in this country,
is  usually void of  danger, and of difficulty in its manage-
ment; and secondly, because,  when the means here recom-
mended fail of effecting a cure, the advice of a skilful physi-
cian should be solicited.   If  called to a  patient during a
paroxysm of intermittent lever, two indications present them-
selves.  The first  is to conduct  the  patient safely, and  as
comfortably as possible, to  a perfect intermission ; and see
ondly, to provide the system against a second or subseqent
paroxysm.   Now nature frequently fulfills the first  of these
indications so  perfectly that interference, during this stage, is
litfcte  else than  culpable  officiousness.  If,  however, there
should be present much nausea  and vomiting, it is well to
give plentifully  of warm drinks  to clear the stomach, and
then 15 or 20 drops of  Laudanum may be given to an adult,
with a prospect of much advantage.  Should the cold stage
be long and protracted, and very anxious symptoms be pres-
ent, a warm foot bath,  with mustard poultices over the breast
and stomach, is apt to cut it short.  It is best in most cases
to avoid strong drinks—such as hot teas—or what is worse,
warm juleps, as these generally aggravate the subsequent hot
stage.  During the hot stage, if there  is  much-headache,
pains of the back  and  limbs,  with restlessness, and  a con-
fined  state of  the  bowels, a full dose of salts will often  be
found  to allay these  distressing sensations.   Our  efforts,
however, to cure the disease, are to be made during the in-
termission, when  the system  is  in  its natural  condition,—
cool, calm, and free from suffering and anxiety.  A thousand
and one remedies  are recommended and  used for this pur-
pose ;  from the miserable concoctions of ignoble quacks, to
the scientific and refined prescriptions of the most eminent
physicians.  There seems recently  to have been a coinci-
dence of  action  among the  quacks of the whole  western
world, to invent a medicine, and give it the most outlandish 
                 FEVFES  IN GENERAL.              £5

name, to cure permanently, this malady, and to extract from
the dear sufferers exorbitant prices for the same.  Many  of
the nostrums, it is to  be remarked, answer the purpose for •
which they are intended very well,  because their active,  or
medical virtue, depends  upon the Quinine which they  eon-
tain, and which is, in fact, the remedy—the best ever yet discov-
ered for the cure of Intermittent diseases.   I know tke public
are apt to attach some wonderful, almost magical, virtue to the
patent nostrums of the quacks, but this is no evidence of  their
superior worth.  A few years ago "Sappington's Pills" were in
great vogue—as the very best medicine  ever used for the
cure of Ague ;  and the people, in preference to buying a pre-
scription from a physician, would pay the most extravagant
prices  for  these, although  subsequent developments  show^
that they are nothing but quinine, disguised by soaie  inert
substances.  "Smyth's Tonic" is, also, undoubtedly, little else
than  quinine,  or  the extract of the  Peruvian bark, which
amounts to near the same thing; and the same  may  be
said  of numerous  other preparations for the same  pur-
pose.                                              .m
   But there is  a rational—a scientific mode of treating this
disease, and this is the plan that the sensible physician adopts.
It is proper to  examine the  case, to investigate the present
condition of the patient.  If his stomach  be found filled with
half digested  food and vitiated  bile—indicated by a  thick
yellowish coat  of fur on the tongue, constant nausea, &c, it
is well to disgorge it by an  Emetic of Ipecac.  But  this  is
seldom to be recommended; for  although emetics are  often
extremely useful in the hands of skilful  physicians,  yet, in
other hands, they may  be  injurious—sometimes lamentably
mischievous, in consequence of being ill-timed, or given when
the stomach is highly  irritable.  The bowels are most fre-
quently, in this disease, somewhat constipated or bound, and
opening medicines are  therefore  frequently useful.   A  little
Epsom Salts, or a dose of Castor Oil  will almost always  be
safe, and  will, at the  same  time, generally answer for this
purpose very well.   Let whatever course may be pursued, 
   50              FEVERS IN GENERAL.

   however, having reference to the bowels, as soon as the fever
   has principally gone  oil,  and  after the paroxysm is  over,
   quinine is to be given with a view of preventing a recurrence
   of the shake or chill.  An adult should take,  during the  in-
   termission,  from 10 to 20 grains;  and I prefer giving this
   amount in about four doses, a few hours intervening between
   each dos«.  I usually divide  12 grains into four parts, and
   direct one to be taken once in two, three, four or six hours,
   according to the expected length of the intermission.  This
   course hardly every fails in putting a speedy stop to the dis-
   ease,  and  the patient, in a  few days, seems but little the
   worse, for the attack.  About the end of the second week,
   most generally, however, it is well to remark,  the disease has
  q. well known tendency to return.   It is, therefore, necessary
   to be cautions about this time ; and if the slightest symptoms
   of the disease show themselves, it is proper to evacuate the
   bowels by a little-oil or salts, or some gentle pills, and to
   again take a few doses of the quinine, as before.  This, with
   avoidance of exposure, of fatiguing labor, and proper atten-
   tion to, the rules of diet that have been  laid down in a pre-
   vious chapter, is, in  my judgment, the very best that  can be
•  adopted for the  removal of the Ague.  Bitters, notwithstand-
   ing the great use made of them during convalescence from
   this disease, are often useless—nay, decidedly mischievous ;
   and, as a general rule, I do not prescribe them.
     Throughout the whole course of the disease, and even for
   weeks after apparent health has been restored, it is  well to
   observe the most scrupulous caution about eating.   No one
 •need expect to avoid relapses  of Ague, if, after the disease
   has been arrested, he begins immediately to indulge himself
   in eating crude, half ripe fruits and heavy indigestible articles
   of diet.  Such a course never fails in impairing the functions
   of the stomach,  already debilitated by previous  disease, and
  through it the whole bodily functions sutler.  Equitable cloth-
  ing  and moderate exercise are, too, to be observed.  For  a
  lack of these observances, patients  with ague  relapse  again
   and again; new medicines are  tried;  the physician  con- 
                 FEVERS  IN  GENERAL.              57

demned, tec,  when the  patient himself is at fault.  Ague
should not be  permitted to  run on unchecked for weeks or
months.   Incurable diseases are frequently the consequence
of a neglect to promptly arrest this affection ; Dropsies, en-
larged spleen (ague cake) Dyspepsia, &c, tec, are no unfre-
quent sequellas of neglected Intermittents.
  II.   Of  Congestive Fever.—Congestive Fever is nothing
but a form of  the last disease  treated  of—Ague.  The Con-
gestive Chill—Sinking Chill as it is frequently called, is the
most perfect  and violently dangerous  form of Congestive
Fever.   It makes its attack precisely like Ague.   The pa-
tient is, after some days, it may be, of indisposition, seized
with  rigors, or  slight chilliness, and these are accompanied
with  great anxiety, or sensation of  impending  sinking or
smothering, his  extremities,  hands and  feet,  are  cold, his
pulse is sometimes very slow and distinct—at others, fre-
quent and almost imperceptible.   These symptoms, continu-
ing to augment, a cold clammy  sweat  breaks out  over the
greater part  of  the body, the breathing is  more laborious,
until death suddenly closes the scene.   This is, I repeat, per-
fect Congestive Fever, and demands the promptest treatment,
1. To bring about  reaction  and restore warmth to the ex-
tremities ; and  2. To guard the patient against a second
paroxysm ; for after the cold stage has  been replaced by the
hot, it is to be expected  that  the disease will return in the
same way as  does ague.   The first of these indications is to
be fulfilled by  applying heat to the extremities, with brisk rub-
bing or friction;  mustard poultices should be put  over the
chest, to the back of the neck, and to the ankles and  wrista.
But if these means fail to bring up the requisite  warmth of
the parts, the  patient should drink some warm toddy, or what
is better, pepper tea; and I do not hesitate to give large doses
of quinine at  the  same time.  With the use of means of thia
kind, promptly applied, there are but few patients that wirfrnot
rally.   Now as soon as signs  of  returning warmth begin to
manifeet themselves, it is proper to discontinue the stimulants
and the case is then to be conducted, during the hot stage, as
              8 
•>s               FEVERS  IN GENERAL.

a  case of  simple ague.  To fulfill the second  indication
that is, to guard the system against a second chill, quinine is
to be freely used; not less than 20 grains  should be given in
the course  of the day to' an  adult.  If the bowels are con-
fined, a spoonful or two of castor oil ought to be given, but
this must not interfere with  the quinine—it  must be  taken,
whatever other course is adopted.   A skilful physician, how-
ever, I presume will be sent for, whose judgment will be ad-
equate; but before he can be got the patient may perish, un-
less attended to as above directed.  In some cases,  such as
have been just described, or in attacks less  violent, the pa-
tient partially, but not wholly, rallies from the cold stage or
chill.   Partial warmth is restored to the extremities, the body
and head are hot, violent pains of the head and limbs  re-
main ;—in  short, neither the hot nor sweating stage come on.
Now this is what physicians generally call Congestive Fever;
and it usually requires their discrimination to treat cases of
this kind.   Quinine is the most useful medicine here, although
it  is frequently indispensable that other  means be resorted
to; but a proper selection of these generally requires the dis-
criminating judgment of a medical gentleman.  Then, I pre-
sume, advice will be sought.
   III.  Bilious Fever,—properly Remittent Fever.—This dis-
ease, in many respects, very closely resembles  the Intermit-
tent or Ague.  Its course is the same, and its symptoms, in
the beginning, are identical  with those of Ague.  Its preva-
lence is  almost  exclusively confined to  the latter part of
summer,  and to autumn ; and it is evidently the offspring, in
a vast majority of instances, as is  Ague, of a miasm or poison
in the atmosphere of certain regions.   In this affection,  in-
stead of  a  shake or distinct chill of ague, we have only the
slightest  sensation  of coldness, generally  occurring every
morning, followed by a persistent fever, which, after  many
hours,  usually suffers some abatement,—remits,  but does
not terminate in general profuse sweating, like  ague  or  in-
termittent  disease.  The  remission usually lasts but for a
short time,  the slight cold stage above pointed out coming on. 
FEVERS IN  GENERAL.
59
This course may continue for many days, and may,  through
the inherent powers of nature, come to a salutary termina-
tion.  But it is not rare for all the* symptoms to gradually
become aggravated; the fever becoming more continuous,
the remission less  perfect, the  different  functions more de-
ranged, the appetite entirely lost, offensive discharges from
the bowels take place, a thick brownish coat is,on the tongue,
delirium, (craziness,) and cold clammy sweat, pulse very fre-
quent or entirely obliterated—death closes the scene.
   Bilious  or Remittent Fever  is  a disease, which,  when
rightly managed, is, in  this climate, very generally curable ;
but, if neglected, or what is infinitely worse, if mismanaged,
it is one of a serious character, and not rarely of fatal termi-
nation.  My advice is, therefore, that in  all cases of this mal-
ady, portending to severity, a Physician's advice be requested.
Purgative  medicines are often  improper, because the bowels
are already disposed to be purged.   On  the contrary it is fre-
quently advisable to give  laudanum to check the inordinate
action of the bowels.   The stomach is sometimes very irri-
table, and much difficulty is encountered in quieting  it—ef-
forts  at vomiting being incessant.   Now, although  these ef-
forts  at vomiting  would seem  to indicate that the stomach
contains  impurities which should  be disgorged,  it is many
times exceedingly  improper to administer emetic medicines ;
for the fact is, it is most often  an  inflammatory tendency in
the stomach, which is  the cause of its undue excitation, and
not impurities, as too often imagined ; and as emetics never
fail to aggravate this  inflammatory tendency,  it is obvious
that  here they are improper.   1 have known much damage
done by their injudicious use.
   A  matter, then, of primary importance in the treatment of
this affection is to remove costiveness, if it exists, by the use
of mild laxative medicines.  A little castor oil will  be found
the safest, as well as a good medicine for this purpose.  But
if the bowels are too open—the patient being*greatly purged
—a little laudanum, 15 or 20  drops, repeated every two or
three hours—should be given to check  them.  To allay the 
60
FEVERS IN  GENERAL.
irritability of the stomach, theWt means are the avoidance
of drinking more water than a few  spoonfuls  at a time ,  a
mustard poultice applied over the  stomach  will sometimes
be found beneficial;  a few drops of  laudanum—four or live
—in a teaspoonful of cold water, often repeated, will prove
efficacious when other means  fail.
  Quinine here, as well as in the preceding varieties of fever,
is, however, the most powerful weapon with which to combat
this disease.  I am in the habit of prescribing  it freely—two or
three grains every two hours, as soon as the stomach and
bowels are sufficiently quieted to receive it, throughout the re-
mission, beginning as early as possible on its accession, and re-
peating it until the fever comes up, when it is best to discon-
tinue the quinine, allow the patient cool air  and drinks, &c.
At the decline of the violence  of the fever, the quinine should
be  again  repeated,  and this  is generally sufficient to  cure
most cases.  But, as already suggested,  a skilful  physician
should be called in.
   As to the patient's diet while laboring under Bilious fever,
nothing should be allowed whatever of  a strong  or beating
nature.  Corn  meal gruel, rice-water with a litttle milk boiled
with it, weak tea  or coffee with toast,  and these in  small
quantities are amply sufficient to be used as nourishment in
most febrile  disorders.  After the  patient has recovered so
as to walk about, his diet may be gradually increased; and
he may take exercise, so far as compatible with his feelings,
in the open air.  Bitters are rarely serviceable, during conva-
lescence from this fever, in  restoring strength; but they are
frequently injurious.  A diet such as has just been suggested,
with out-door exercise, is all  that,  in general, is  necessary.
Ague is sometimes a consequence of Bilious  Fever, but as it
requires the same kind of management as when a primary
disease, I need  add nothing further  to what has been said
under its proper head.  Quinine must be given to arrest its
course, and the constitution restored by attention to diet and
the bowels.
   IV.  Yellow Fever  demands from  me,  in  this place, little 
FEVERS IN  GENERAL.
61
attention, other than mere mention.  It is  a disease of the
South, and I have never seen a case of it.  There are, how-
ever, in my opinion, good reasons for regarding it in every es-
sential particular, as  a Bilious Remittent Fever, aggravated
by a southern Climate.  The symptoms are not unlike those
of an ordinary Bilious Fever, but they are greatly aggravated.
Incessant vomiting is one of the  worst symptoms of this ter-
rible  affection, and  its arrestment a principle indication in
the treatment.  A  deep yellow tinge,  which  the skin ac-
quires in the course of the affection, and  which  is an evi-
dence of very great derangement of the  Liver's  office, has
given it its characteristic name.   Calomel in enormous doses,
with quinine and other adjuvants, is recommended as the
best mode of treatment, but it must be confessed that Yellow
Fever in its aggravated form has hitherto, in a great measure,
baffled the skill of the most eminent physicians in the world. 
CHAPTER  VII.
            OF INFLAMMATORY  DISEASES.

   Class Second —By inflammatory diseases is meant all those
affections in which inflammation is the seat and cause.   Fe-
ver, as already stated, may result in inflammation, but in an
inflammatory  disease the fever is secondary, and  is depend-
ent upon the inflammation—the inflammation being  the pri-
mary disorder.  But  what is inflammation ?  It is, I  answer,
a state of a part or parts of  the living body, characterized by
redness, heat, swelling, and pain.
   The simplest illustration, perhaps, that can be given of in-
flammation is seen in cases of local injury.  For example:
a thorn is run into the skin on the back of the hand; very
slight pricking pain  is experienced in the part;  a  diffused
redness of the part quickly ensues ; the part feels hot, slight
tumefaction or swelling takes place, a burning  pain is felt in
and about the injury.  Now this  is inflammation, and the at-
tending phenomena  are thus explained : The pricking  pain
is  in consequence of  the direct laceration and pushing aside
of the minute nervous filaments of the injured  part;  the red-
ness is owing  to the undue quantity of blood, which, by a law
of life, is deterimned or driven to the injured or irritated part;
the heat is, in a  great measure, at least, produced  by the
great quantity of blood circulated in the part; and the burn-
ing pain is to be explained by the swelling of the part, press-
ing upon the nervous ramifications.  Inflammation is apt to
terminate in one of four ways; First, in Resolution—that is,
after it has existed for an indefinite time, the  swelling sub-
sides, the pain, heat,  and redness disappear, and the part re
turns to its natural condition.  Of all the terminations of in- 
              INFLAMMATORY DISEASES.            63

flammation that  by resolution  is  the most fortunate,  and
means, therefore, should always be  used to promote it.  Sec-
ondly : Inflammation may terminate in suppuration, or mat-
tering.  This is rather an effect of  inflammation, than a ter-
mination.  Instead of terminating  by resolution, as in the
first instance, the tumefaction increases until matter, or pus,
as the surgeons call it, begins to be  poured out in the affeclfcd
part; this matter goes on accumulating, until it destroys the
textures in so much as to discharge  itself, or until an artificial
opening is made into it.   A common boil serves to illustrate
this termination, very well.  The third termination of inflam-
mation is in granulation ; that is, where a part has been de-
stroyed, by suppuration, for example, the space thus formed
is filled up by little  granules or atoms of new growth, until
the  part is restored  to original conformation.   This  is a ter-
mination, too, of inflammation that is to be encouraged, as it
uniformly repairs the breach made  in the affected part.   The
fourth termination of inflammation is, of all others, the most
unfortunate and most to be dreaded: it is mortification, or the
death of the part.   A tumefied and  painful swelling, suddenly
losing its  sensibility,  turns purple or black, crackles  when
rubbed with the finger, and gives out a putrid odor,—this is
mortification, and the part must inevitably perish.   Now if
this condition be very extensive,or the  mortification be seated
upon a very vital part of the body, the patient is  apt to sink
under it;  but, on the contrary, if the mortified part be  small
and circumscribed, or be not fixed  upon some vital part, and
the constitutional power be not greatly enfeebled, the morti-
fication is apt to be  separated  and fall  off from the  living
part, and granulation fills up the void thus occasioned.
   Having presented  the foregoing remarks respecting the
phenomena, local appearances, and terminations of inflam-
mation, it  is proper, in the next place, to allude to the consti-
tutional symptons, which, in all cases of severity,  are accom-
paniments of this  affection.   If the inflammation be trivial,
seated upon some  part of the body not important to the life
of the individual, then  I grant you, no constitutional symp- 
 64            1 N F L A M M A T OR V  ft I S E A S E S .  .
                                             •-.
 toms may be manifest; but if the inflammation be extensive,
 and, especially, if it be seated  upon or m some structure,   *;
 whose integrity is of absolute necessity to the well-being of
 life, then constitutional symptoms, sometimes of a very vi-
 olent character, are speedily  developed,  and  these,  in  the
 management of such cases, are of primary  importance.
   ^he constitutional symptoms accompanying inflammation,
 are, in a majority of instances, in the  beginning, rigors  or
 chills, followed, after  a short time, by  fever,—that is, a dry
 hot skin, pain of the head, and frequently of the back and
 limbs, thirst, a deranged condition of the pulse, a white coat
 on the tongue, nausea, and sometimes vomiting, scanty, high
 colored urine, and, most often, costiveness.   These are symp-
 toms, common to extensive inflammation, but  they are often
 considerably varied, according to the seat and magnitude of
 the inflammation.  The causes of inflammation are very nu-
 merous.  It may, as I have already several times suggested,
 be a  result—a termination, so to speak, of Fever, proper.
 It is frequently the result of mechanical injury, as in the case
 of the thorn, above referred to.  Chemical agents, such as
 poison, applied to, or taken into the body, often  produce  in-
 flammation.  Burns, as well as  frost-bites, never fail to ex-
 cite inflammation.   Of all causes, however, productive of this
 affection, changes  and vicissitudes of temperature are, un-
 doubtedly, the most prolific.  People residing in moist and
 changeable climates, are particularly prone to inflammatory
 affections.  What amounts to near the same  thing,  as the
 last cause alluded to, is suddenly cooling the  body, and re-
 maining in a cold and chilly condition  too long, soon after
 having taken violent exercise, or having  been over-heated.
   As regards  the  Treatment proper in inflammation, though
 admitting of a good many exceptions, there are certain gen-
 eral principles that are to be our chief guide.   And, in this
 place, it is my design to speak only of those  means to  be
used, and rules proper to be observed, in almost  all inflamma-
tory disorders, wherever situated.  But I should observe, be-
fore entering on this subject, that I shall pass by, for the pre- 
              INFLAMMATORY DISEASES.            65

sent, those elight local  inflammations that do not in any-wise
affect the general system, and  speak of those, only, that are
of sufficient magnitude to excite constitutional disturbances.
To combat the febrile  or feverish  symptoms, as a general
rule, where the patient is stout and  of  good constitution,
blood-letting stands preeminent.  In many instances, indeed,
it cannot, with safety to the patient, be neglected,—but it is
a powerful remedy, and one, the indiscriminate use of which,
cannot be too severely reprobated.  And I cannot, without
some misgivings, recommend to my readers a measure, which,
in unprofessional hands might  be, not only  mischievous, but
which, untimely and ignorantly put into practice, might lead
to fatal consequences.   I, therefore, feel  strongly inclined to
suggest, that in all cases, sufficiently desperate  to warrant,
in the opinion of the friends of the patient, a  resort to the
lancet, medical advice  be  requested.  Blood-letting is not,
however, even in aggravated instances of inflammation, al-
ways absolutely necessary ; and we  are in possession of other
means, while they are almost  uniformily safe, are, of them-
selves, very often sufficient to  procure  the patient much re-
lief,  and not  unfrequently  lead to a  perfect cure.   Such
means, are quiet, rest, low diet, cooling drinks, and purgative
medicines.   These, when properly  persevered  in, and con-
joined with the  natural inherent powers of the constitution
to overcome diseased action, will, I am persuaded from long
observation, in  a vast majority of instances prove efficient.
Indeed, there is in the world, and some of  them are  in  our
country, a set of medical men, calling themselves  Homeopathic
Physicians, who in their efforts to  cure  disease, while they
amuse their patients with inert doses of medicine, in truth,
depend wholly upon rest, or exercise, as the case  may be, die-
tetic restrictions, and upon the natural resources of the sys-
tem ; and their success has been a matter of astonishment to
those Physicians who have been in the habit of dosing people
with drugs for any and the slightest indispositions.  The pub-
lic are too fond of taking medicine,  and are apt to attribute
too much to its  curative  influence.   Medicine, like every
             9 
66
INFLAMMATORY  DISEASES.
  thing else, is good in its place, but it is not always, and un-
  der all circumstances, good  to  make  Apothecaries' Shops of
  people's stomachs !
    In the management of almost  every variety of inflamma-
  tion, with the one exception  of that of the stomach and bow-
  els, gentle purgative medicines are more or less useful; and
  among  these  medicines, there  is  none, which, at the same
  time that it is  safe in the hands of almost every one, com-
  bines more advantages than the common Epsom Salts, so
  generally in use.  It  evacuates the  bowels pretty perfectly,
 . and by making a powerful drain on the blood-vessels, empties
  them something in the same way that bleeding does.  Next
  in importance to purgatives, and  many times, in the slighter
  affections of inflammation,  preferable  to them, is a low diet.
  A patient laboring under a severe inflammatory disease, ought
  never, by any means, to be  allowed any other nourishment
  than that of the simplest and least stimulating kind.  Corn
  meal gruel, rice, and rice-water, a little toast, an Irish potato
  boiled milk, tec, will prove  amply sufficient in these affec-
  tions, to  sustain an adequate amount of strength, and they
  will not heat up the body, as rich  soups, broths., and flesh are
  apt to do.   In  the treatment of many inflammations, rest is
  one among our most  valuable  resources.   Position, too
  should, as far as practicable, be attended to.   The inflamed
 part, should, if  possible, be  so elevated as  to be on a level,
 with the  heart,  if not raised above it.   An observance of this'
 kind cannot be  too  strictly attended to in inflammations of the
 head, and of the extremities of the body—the hands and feet.
   Not designing to enter into the histories, the phenomena
 and treatment  of all the inflammatory disorders—deeming
 such a course unnecessary, after having laid down as has al-
 ready been done, a general  view of those  subjects,  I shall
 proceed to notice, individually, some of the more prominent
 affections belonging to the inflammatory class of diseases, in
 as concise and  plain a manner as I am master of:-having
first  fully considered the propriety or impropriety of giving in
a domestic work, like the present, a prolix "account !f^ 
INFLAMMATORY DISEASES.
67
disorder, which, after all, is, with few exceptions, to be man-
aged on those general principles just advised.
  Section 1.  Of Inflammations of the  Brain.   Beginning with
the superior parts of the body, it is  natural  to consider  the
diseases of the head  in the first place.  The Brain is encased
in thin solid walls, and its physiological condition, being  not
very well understood, the diseases peculiar  to it, we would
readily infer, are of difficult discrimination; and it  is not  un-
common, therefore, for Physicians themselves  to misjudge  the
affections.   But this is more apt to be the case in  the disea-
ses of children, in whom we often witness symptoms, strongly
indicative of brain-disease, when,  in truth, the brain is in a
state of perfect integrity and health.
  Nevertheless,  there are  certain symptoms that  do, with
considerable certainty, point out inflammation of the  Brain ;
but these, in consequence of  different structures  contained
within the skull when inflamed producing diseased symptoms,
admit of some variation.  Inflammation of the  Brain is  not
very often an original disease, but is a frequent result of oth-
er affections; yet, however  caused, and in whatever part of
its structure the disease be  seated, we expect to find  a deep
seated and persistent pain  within  the head;  and this pain is
generally accompanied by an exceedingly disagreeable throb-
bing sensation; the eyes, too, are, in  general,  painful, and  the
patient is, in a manner, unable to bear the light of day; they
are red aftd watery.   Sometimes a wild and  raving delirium
or insanity is an  accompaniment of this  disease, but this is
not, by any means, a uniform circumstance.   A frequent con-
comitant of this affection, is nausea  and vomiting—and it is
almost impossible, sometimes,  to get any  thing to  lie on  the
stomach.   Costiveness will most often be found to be present.
The pulse is usually slow and full, beating strong; there is
not very commonly,  I think,  any great heat of the body and
extremities ;—indeed, they may be unnaturally cold; but  the
head  is  always too  hot.  These are the  most characteristic
symptoms of inflammation in the head.  But sometimes, it is
to be  remarked, the patient suffers little  or no  pain, has no 
B8            INF I. A M.MAIORV DISEASES.
  delirium, but, on the contrary, is all the time in a stupid or
  sleepy  condition, from  which, with difficulty  he  can  be
  roused:—this condition going on increasing until, finally, the
  long sleep of death closes up the avenues of life.
    Respecting the causes of inflammation of the head, they
  are numerous, and I need not narrate them very particularly.
  Whatever  is  capable of inducing inflammation, may, under
  favorable circumstances, excite it in the structures of the
  head.   Cold, operating upon a system illy circumstanced to
  bear it, is one of these; mechanical injuries of the  head,—
  fractures of the skull—is another.   A full and plethoric con-
  stitution, gluttony, &c, &c., favor the development of this, as
  well as all other  inflammatory affections.  Having,  already
  several times, alluded to inflammatory diseases, as a result of
  primary fevers, I will merely remark, in concluding this brief
  notice of the causes of the disease under consideration, that
  fever is, so far  as my observation extends, by far the most
 common cause,—thus making the present disease, the sequel
  of another.
    The  Treatment of inflammation of the  brain  in robust and
 plethoric constitutions, and in those cases in which the disease
 is primary, consists in the vigorous application of those rem-
 edies and means which have been recommended,  in a pre-
 ceding part of this chapter, as proper in general inflammatory
 affections.  A physician will, in cases of the above descrip-
 tion, generally resort to active depletion by the lancet,  but, as
 I have already intimated,  I am inclined to the opinion that
 physicians only, should judge of the necessity of blood  let-
 ting.  Purgative medicines are very generally, in this affec-
 tion, of essential service; and they  should be prescribed in
 large and repeated doses, until free purging ensues. The
 object being to drain the system as much as may be, Epsom
 Salts, as they usually induce  copious watery stools,  should
be used for this purpose, provided the  stomach  will retain
them  If it is exceedingly irritable, mustard poultices, the
toot bath, cold drinks, &c, may  be prescribed, with, at least,
a prospect of benefit.  The head of the patient .hould be  el- 
INFLA.MMA T O R V I) I S I. A S E S .
69
evated, and rest upon a hard pillow, and it is a good plan to
keep it constantly wet with the coldest water, while warmth
is to be kept assiduously applied to the feet. The room should
be darkened, as much as  possible,  and  the strictest silence
should be enjoined upon the  patient's nurse ; nor should the
room, on any account, be suffered to be crowded by noisy vi-
siters.   By the way, this is a matter that I have not,  I believe,
hinted at.  It is a great error, almost a wicked sin,  to crowd,
with unnecessary and noisy visiters, the chambers  of the
sick ;—an error, because injurious to the sick, and  a sin, be-
cause  such assemblies subject  families, at a time they de-
serve rest, to the most laborious  drudgery, to wait, not upon
their  sick friends, but upon hosts of, too often, officious  and
unnecessary visiters.  But, returning from this  digression, I
have  yet to  speak of the diet proper for a patient affected
with disease of the  kind  under  consideration.  It  should be
of the simplest  sort,—indeed, it isbest,during the more active
stage of the disease, to allow the patient little or no nourish-
ment.   A few  spoonfuls of well-cooked gruel are sufficient to
sustain life, and this is all that should be  allowed.   When in-
flammation supervenes as a consequence of pre-existing dis-
ease, the treatment must be modified accordingly; and it will
be  proper, in all cases of  this kind, to  call in able medical
advice, for in spite of the most rational treatment, I am sorry
to say, many cases  of secondary inflammation of the Brain,
terminate in death.
  Sect.—2.  Of Quinsey.  Quinsey is  an  inflammation of
the tonsils, two glandular bodies situated, one on  each side,
far back in the  mouth.   The symptoms which announce it
are sometimes  quite severe; and the disease, though not often
attended with peril, occasionally destroys life.  Washington,
the venerable statesman, perished, I believe, of Quinsey.  A
chill is frequently a premonitory symptom of this  affection.
With or without this, however, the individual attacked expe-
riences slight soreness of the throat, which, in a short time,
is  followed by an internal swelling.  Now, most  often, but
one tonsil is  inflamed, and, therefore, the swelling will be 
70
I N F L A M M A T O RV  I) I S E \S1!S.
 partial and confined to the  affected side, for  it is the tonsil
 itself that is the seat of the swelling.  Difficulty of swallow-
 ing and breathing  are other symptoms, and, both glands be-
 ing inflamed and swelled, these are symptoms  of  serious im-
 port, because the  swelling may so block up the throat as to
 suffocate the sufferer, unless relieved by art.  Fever of a high
 grade is apt to be present from the very beginning—the patient
 being hot and restless, without the ability, not uncommonly,
 to swallow a few drops of water to quench his  burning thirst.
 Upon looking far back into the mouth, beyond  the root of the
 tongue, the inflamed and swelled  tonsil or tonsils, as the case
 may be, may be seen,  very greatly enlarged, and  usually
 presenting patches of a greyish  mattery  appearance.  The
 danger attending the disease, in most cases, is of these glan-
 dulous  bodies  becoming so enlarged as to completely chink
 up the throat, and  thereby prevent  the ingress of air  to  the
 Lungs; but this does not  very often happen, first, because
 but one  is usually affected, and, secondly, because,  before
 they attain to this size, they very  commonly burst spontane-
 ously and discharge, to the immediate relief of the patient, a
 large amount of very offensive ' matter  that  has collected
 within them.   After an  individual has suffered  an attack of
 Quinsey, he is thereafter, during life, more liable to suffer re-
 turns of this affection, upon exposing himself to its causes,
 than those who have never had it.
   The  causes that most often give rise  to the disease are,
 long exposure to cold and damp air, getting wet and remain-
 ing so until chilliness comes on, and I have, I think, seen the
 disease prevail in consequence of  an epidemical or inscruta-
 ble  condition of the  atmosphere,  of a  like nature to that
 which causes fever.
   Of the Treatment, I need not say much.  It is  a diesase that
 mns a rapid course, and if the inflammation is to be subdued
 at all and terminate in resolution, the promptest  treatment is
 to be practised.  With this intention active purgatives may
steam oT T    "^ C°m~-* of the attack, and the
steam of warm vinegar and water must be inhaled from tfie 
I N F L A M M A T O R V D I S E A S E S .            ? 1
Bpout of a tea or coffee-pot, or the throat perseveringly gar-
gled with warm milk and water.  But these means often
fail, and nothing but  the  formation of matter  and its  dis-
charge, will  relieve the  patient.  The persevering use of
gargles, and  the inhalation  into  the  throat of  the steam,
should be continued, and  the purgatives left off.  A Physi-
cian, after the formation of matter, will often with the point
of a lancet, open  the abscess and let the matter out, and thus,
instantly relieve  the sufferer,—but a  Physician  alone will
venture to perform  the operation.  When the matter is once
got shut of,  further treatment is, generally, unnecessary, as
all the urgent symptoms immediately disappear.
  Sec—3.   Of Croup.  This affection is  chiefly confined to
children, and consists in an inflammation of the inner mem-
brane or lining of  the  wind-pipe,—the tube leading to  the
lungs or lights.  Like the preceding disorders, it runs a rapid
course, and is always attended with danger.  It occurs gen-
erally during the changeable seasons of the  year, as spring
and winter, and is,  undoubtedly, in a vast majority of instan-
ces, the offspring of cold, acting on the delicate constitutions
of children.   Indeed, many times, it is preceded by a catarrh,
or bad-cold.
  Symptoms.  The child is hoarse and has a deep, dry, and pe-
culiar cough, perhaps for some hours, or even days before it is
attacked. The attack usually comes on at night:—the child is
found to be restless; it has  fever and is thirsty, coughs  more,
emitting a whistling  sound, somewhat like  the  interrupted
noise of  a flute  or  fife; it  throws its  head back in such a
manner as to put the wind-pipe on the  stretch.  If the attack
is one of severity, and the disease is allowed to go on, un-
checked, the cough grows worse, the breathing becomes more
and more difficult, the face and lips assume a livid or purple hue,
the extremities are  cold, and a clammy sweat bathes the lit-
tle  sufferers  face, and, death, about the third  or  fourth day,
puts a stop to its agonies.  There is a  disease which closely
resembles Croup, and which is, sometimes mistaken  for it.—
It  is however, not  attended with much heat, and is almost 
 72            I N V L A MMATURV  DISEASES.

 exclusively confined  to children during the time of life when
 they are cutting their  teeth.  Moreover, it  comes on more
 suddenly,  and is, in nine cases out of ten,  the result  of
 over-loading  the  stomach with crude and indigestible sub-
 stances.  But as the treatment I shall lay down is equally
 applicable  to  both these affections, I need not attempt to
 draw the distinction  between them.
   The  Treatment.  I  shall not dwell  upon the Treatment of
 Croup, because, after well-seated, it is a  desperate disease,
 and  requires  the  timely  application of those  heroic means,
 whose  administration should be directed by competent Phy-
 sicians.  Nevertheless, in many instances, the disease may be
 warded off, before it gets a firm hold, by means, in  the use
 of which  no  risk is to  be  incurred, and which every one
 might be able to command at any time.
   In the very  beginning  of the disorder an  emetic, followed
 by a purgative medicine, will hardly fail to cut it short.
   For fulfilling these indications, I can recommend no better
 medicine than Cox's Hive Syrup, and Castor Oil.   Cox's Hive
 Syrup  is a compound Syrup of squills, and may be obtained
 from almost any Apothecary.  I would advise those  having
 children, to keep  a vial of it continually by them.  A com-
 mon tea-spoonful  is to be given to a child of two or three
 years of age, every half hour until puking is excited.   After
 the  child's  stomach  has  become settled, it will be proper to
 prescribe Castor Oil as a purge.   Bathing the child's whole
 body in warm water  is a simple, and, conjoined  with the di-
 rections already given, useful assistant in resolving this affec-
 tion.   Now the foregoing directions  having been  put in prac-
 tice, and failing to procure relief,  the advice of a competent
 practitioner should be solicited, for the circumstances  augur
 an unfavorable case,  and one that will probably,  if long neg-
 lected, end in death.
   The cause of death in Croup is generally a clogging up of
the wind-pipe and other air passages, with  a glairy mucus,
which, not unfrequently has been seen to become organized
into lining tissue.  When this has happened all hope is most 
INFLAMMATORY  DISEASES.
73
often vain, for the records of medicine furnish but few instan-
ces of recovery from this terrible condition.  The wind-pipe
has been opened by an operation, under such hopeless cir-
cumstances, and it is said, with occasional success, but few
Physicians will resort to so desperate means especially when
they know, at best, they afford but a chance.
   Sec.—4. Of Inflammation in the  Chest.   I pass, in the next
place, to consider the diseases of the Chest.  These comprise
a  numerous group, extending from the merest cold, to that
most unmanageable of all diseases, Consumption; but it will
not comport with the design of this work, to enter at large up-
on any of these.   A few plain practical remarks are all that
are likely to be of solid service  to my readers.  Physfcians have
of late, discovered new and valuable resources for correctly
discriminating the affections peculiar to the Chest.
   One of these resources is the percussion of the Chest,—that
is tapping or sounding it with the tip of the fingjgrs  to as-
certain,  by the sound it gives out, whether this structure or
part  is diseased, and the form of the disease, should any ex-
ist.   Another  of their resources is the  direct application
of the ear, or of a hollow tube to the Chest, for the purpose of
ascertaining the obstructions  which these diseases are  likely
to occasion in the Lungs.   But experience and much  study
are pre-requisites to expertness in auscultation, as this art is
stiled.
   (a) Catarrh  or Cold.  This is the most trivial, but at the
same time, the most common, disease of  the  air passages.—
It is  what, at least, in the West, the people universally call a
Bad Cold, and consists in the lowest form of inflammation, of
the lining, or inner coat of the Lungs, the throat, the mucous
surfaces  of the nose and eyes :—the lowest form of inflamma-
tion, I say, but instead of the  word inflammation, to express
the same thing, medical men  are in the habit of calling con-
ditions like the one in question, irritation ; and with them this
latter term is preferable.   For the  present, however, I prefer
impressing my readers mind that these light colds are of  an
inflammatory nature, and that they are even liable to become
           10 
71
INFLAMMATORY DISEASES.
 aggravated, and pass into the severer affections to be after-
 wards described.
   The causes of these catarrhal affection or colds are too well
 known to require particularizing, especially here in the West.
.Every one knows that sudden changes in  the state of the
 weather  are liable to excite them ; and that  imprudent expo-
 sure does the same thing.
   Of  their  Treatment, too, it is unnecessary that  much  be
 said.  That invisible agent, sometimes  called by medical
 men the Vis Medicatrix Naturae, and  recognized  by every
 one as the Medicine or Doctor of Nature—the natural efforts
 of the constitution &c, is, if  not foiled in its manceuvers, al-
 most always amply  sufficient to relieve  the suffering system
 in the course of a few days.  To aid  nature in her efforts,
 however, we must enjoin  rest, an unirritating diet; and, if
 the bowels are any  way constipated, and, more especially, if
 there be headache, with other febrile symptons, some  Epsom
 Salts  should be taken.  I have  frequently seen these colds
 almost completely cured, in  the  course of a single night, by
 bathing the feet well in warm water, and taking, if an adult,
 ten  grains of Dover's powder, (see  this  head,) on going to
 bed.   Every one must have seen bad colds, by a want  of pro-
 per precaution, pass off into  more serious affections ; and for
 this reason if no other, I would urge the necessity of atten-
 ding to them in season.
   (b.)  Influenza, is another disorder of the air passages, and
 in no  way differs from the last, only in severity, and  in  the
 cause which  gives  rise to  it.  The  symptoms  are  identical
 with those of catarrh, more  than in influenza we  generally
 have a troublesome cough, and, in the severe cases, consider-
 able fever is  superadded.   There is, also, in  influenza, much
 debility, and sometimes, a loss of appetite for food.  Moreover,
 the cause of this disorder seems to be an inscrutable epidem-
ical poison floating in the air.  The disease rages more com-
monly  during Spring  and Winter, and  the population  of
whole  towns and neighborhoods  are, during its prevalence
in some instances, more or less under its influence.   It rarely 
              INFLAMMATORY  DISEASES.           75

proves fatal, but it is not uncommonly a disease of severity
and sometimes it is protracted and tedious.
   The Treatment proper to be pursued in this affection is pal-
liative, and not curative, for  do what we will, it, like mea-
sles, whooping-cough &c, will run a definite course, and our
efforts should, for this  reason, be chiefly directed to conduct-
ing it along  safely in its course.   The  patient should keep
within doors, abstain from  all stimulants, and eat nothing but
the simplest farinaceous diet—such as rice, corn-meal gruel
a roasted potatoe, &c,—with or without, milk, as he  may
prefer.   Opening  medicines should  be taken from time to
time, and  Castor  Oil  upon the  whole, is the  best article for
this purpose.   In  cases of considerable violence the  family
Physician's advice should be requested.  The duration of the
disease is generally from one to two weeks.
   (c.) Bronchitis.  Every one  has heard of Bronchitis,—but
few perhaps have  correct  notions respecting  its nature. It
is, like the two last disorders, a disease of the air tubes—an
inflammation of their mucous or inside coat, and it differs in
no essential particular from a cold, other than in point of se-
verity.   Indeed, Catarrhs  often  precede, and pass insensibly
into Bronchitis.  The inflammation in bronchitis is well mar-
ked, and  constitutional  symptons  are  apt to be present;—
whereas, in colds these symptoms are altogether absent, or, if
present, only in a very slight degree.  There  are two forms,
or rather, I should say, two stages of Bronchitis—the acute,
or active, and  the chronic, or long seated.   The  latter is
sometimes the consequence of the  former, or  acute disease,
but it is oftener the result of neglected, or illy managed colds,
The active or acute disease  is generally ushered in  with a
chill, pain in the chest of a dull heavy kind, followed by a se-
vere pain of the forehead, tightness across the chest,  cough}
more or  less severe, attended with the expectoration or
spitting up of  a  very tough glairy mucos  which is often
streaked with  blood.  In  the active form of Bronchitis, the
patient  often  experiences  great difficulty of breathing, a
sensation of impending suffocation,  inability to  lie in bed:
and his face  is generally of a purple hue, or blotched over 
76
I N 1 I. A M M A T O R Y  I) 1 S E A S I. S
 with dusky spots.   Old and feeble  persons, and  little chil-
 dren are apt to perish  with this disorder, in  consequence of
 an inability, for want of strength, to expectorate or throw off
 from their Lungs the glairy viscid mucus which is  constantly
 accumulating  in them.  If, however, proper treatment be
 used, and the  patient coughs  and  throws from the Lungs a
 large quantity of this mucos, and especially, if this, after a
 few days, assumes  rather a whitish, or pus like appearance,
 there may be reasonable hopes entertained for the patient's
 recovery.  The other functions of the body are not necessa-
 rily greatly deranged during Bronchitis, but some fever is
 in all cases of  severity, present, and the pulse frequently va-
 ries very greatly from its natural standard.
   In chronic  Bronchitis the cough is, in general, the  most
 characteristic,  as well as  the  most  troublesome sympton.—
 And it is a cough of this kind, that is so  often mistaken for
 Consumption, and that enables Quacks to pratise their frauds
 so successfully upon a confiding  public.  This cough is very
 frequently curable, whereas that, in genuine Consumption
 is hardly ever so.   Quacks—I mean the more crafty and bet-
 ter informed of them—take  advantage of this circumstance,
 and, if they are successful in relieving a case of this Bronchi-
 al disease, it is  published to the four winds, and the  certificate
 of Rev. Such-a-one, or Hon. Some body, is adduced to prove
 that Consumption can be cured.  Chronic Bronchitis is simply
 a long seated, low form of inflammation, or irritation, if you
 will, of the inner coat of the Lungs—the Bronchi.  Consump-
 tion is more than  this.  Appropriate  medicines  frequently
 benefit or  entirely relieve the first:—unfortunately, medical
 men  are  acquainted with no  medicines that will, with any
 certainty, produce permanent relief in the latter affection.
  The causes that  give  rise to this disease, will, after what
has  been said, readily suggest themselves.   Colds  may lead
to it, but they oftener result in the chronic  than in the acute
disease.   The vicissitudes of temperature, which the body is
often doomed  to suffer, is the  principal cause of the acute
disorder.  Public speakers, especially Ministers of  the  Gos-
pel,  are particularly obnoxious to the chronic form of this af- 
              INFLAMMATORY DISEASES.            77

fection, and it seems, in them, to be excited by too long and
loud speaking.
   Treatment.  Both  acute and  chronic  Bronchitis ought to
be  treated  by medical  men.  The acute, because  it is fre-
quently a disease attended  with  imminent  danger;—the
chronic, because  none but medical  men, can accurately dis-
criminate between it  and Consumption, and none  but they
are likely to treat it correctly.  Neverfieless, it  may afford
my readers some satisfaction to relate the treatment usually
put in practice  by them.  In the  acute disease they think
proper, occasionally, to use the lancet: Calomel is often pre-
scribed, sometimes as  a purgative, but most frequently in
small  and  repeated doses, as an  anti-inflammatory agent ■
tartar emetic, in nauseating  doses, is given to control  the
febrile excitement, and to act as an expectorant—that is, to
assist nature in  relieving the Lungs by throwing off the un-
natural secretions which are constantly accumulating upon
them; blisters they apply to the Chest to call, or entice, as
much as possible, the inflammation from the suffering organs
within.  Active purgatives should generally be withheld, es-
pecially after the first few days of the disorder.
   When  Bronchitis  has become chronic, or fixed firmly  on
the Lungs, the treatment is to be varied according to circum-
stances.  Those  medicines called expectorants,together with
counter or  external  irritation to the Chest, by blisters, &c3
are now our chief resources.   Cox's Hive Syrup is one of the
best  expectorants in  many instances, of the  chronic form of
Bronchitis.  The pine Balsams — of Copaiba, Tolu, Fir, and
the like,  are very often  of  service.  Sometimes, in conse-
quence of constitutional derangements of other parts than
the Lungs, other medicines of different kinds may be useful;
but the foregoing are the means most to be relied  on.  It is
to be remarked in conclusion, that, in old persons who have
long labored under bronchial diseases, attended with trouble.
some coughing, medicines are often unavailing.
   (d.) Of Pneumonia, or Inflammation of the  Lungs, and of
Pleurisy.   These two disorders I shall consider in conjunction, 
78           INFLAMMATORY DISEASES.
because in truth, it is seldom, indeed, that they are  not both
present at one and the same time — sometimes one  predom-
inating and sometimes the other.  Pneumonia consists in an
inflammation of the  substance or body of the Lungs, — Pleu-
risy in an inflammation of their covering or enveloping mem-
brane ; but these two structures being in immediate contact,
in ninety-nine cases otit of a hundred, an inflammation begin-
ning  in the one, rajRdly extends or passes into  the other.
The case may be a Pleurisy in  the  beginning — that is, may
be  confined to the  pleura or  investing  membrane of the
Lungs, but  presently the patient spits blood, thus, clearly
evincing that it, the  inflammation, has  passed into  the sub-
stance of the Lungs themselves.  So an inflammation of the
Lungs, passes, almost certainly, sooner or later, to their cov-
ering,—the pleura, as it  is called.  The  Symptoms of these
affections  resemble,  closely, those of acute Bronchitis, and
none but medical men can, in all cases, distinguish between
them  and the latter  disorder.   In Pneumonia and Pleurisy,
however, the pain  is apt to be much more acute, and very
commonly one  Lung or side of the Chest is the  seat of the
suffering; while in Bronchitis the whole of the Lungs suffer
simultaneously.  Many patients laboring under these affec-
tions  cannot lie down at all, in consequence of the aggra-
vating, the lancinating pains they suffer.    The sputa or spit
coughed up in Pleuro-pneumonic complaints, is not generally
so glairy and tough as  that of  Bronchitis, and instead of be-
ing merely streaked  with blood, it is intimately mixed with
it, and thus rendered, in  appearance, a dirty uniformly red-
dish looking semi-fluid mass.   We  refer the  pain, which is
sometimes inexpressibly sharp — in this compound inflamma-
tion, to the pleura or  covering of the Lungs; for in the pure
forms of Pneumonia the pain is trifling, being pungent rather
than sharp and lancinating.
  The constitutional  disturbances in these inflammations are
generally  very  considerable.   Most often both Pneumonia
and Pleurisy are preceded by  a chill, accompanied, or soon
followed by pain, usually confined to one side of the Chest, 
             INFLAMMATORY  DISEASES.           79

or even to a very circumscribed spot of one side ; but some-
times it is diffused  over  the  whole of it.   Cough  is always
an attendant of these disorders,but, in cases of a more purely
pleuritic character, the patient, owipg" to it greatly  aggra-
vating the pain, attempts as much as  possible to suppress or
stifle it—smothering it, so  to speak.  Nausea and vomiting
are not uncommon, but the bowftls are ^ften constipated; the
pulse  is apt to be not very frequent^Pit full and strong:
headache too, is generally present; the urine is scant and
high-colored.  Now the  most favorable signs of a salutary
termination of the affections under  present consideration,
are a gradual subsidence or giving way of those constitution-
al symptoms, attended with  a more abundant purulent or
matter-like discharge from the Lungs, in the form of expecto-
ration.  The worst consequences, on the  other hand, are to
be apprehended when the breathing becomes more and more
labored, when the constitutional  symptoms  are aggravated,
the  sputa is glairy and tough, &c.
   Of the Causes that give rise to these diseases, little need be
 said, after having already, repeatedly alluded to them in the
 preceding sections of this Chapter.  They are, in a vast ma-
jority of instanoes, identical  with the common causes of in-
 flammation— viz.: sudden vicissitudes of temperature of the
 body, however  produced, whether by getting wet, a  change
 of air, exposing the body  to night air.   Or  they may.be the
 effect of mechanical injuries  inflicted, upon the chest.
   The treatment of both Pneumonia and Pleurisy, because
 they are dangerous affections, should be entrusted to med-
 ical hands only.  I know not how to begin to give directions
 and rules by which  these  formidable complaints  can  be
 safely conducted by those  unacquainted, in a great measure,
 not only with their intimate  natures,  but, also, with the prop-
 erties and peculiar modes of  action of the medicines most
 useful in their management.  It is  not to be expected that
 the farmer, the mechanic,  or the tradesman,  is sufficiently in-
 formed upon the intricate subject of disease, to incur, willingly,
 the responsibility that must  rest  upon  every Practitioner of 
   80            INFLAMMATORY DISEASES.
                 •
   the  Healing Art.   Nay, even medical men  themselves, who
   have beeh out of practice for a fewyears, wiM often, only with
   the greatest  reluctance, take upon  themselves the manage-
   ment of a sickfriend's^case.   It is only at the price of "eter-
   nal  vigilance,"  in  every department of medicine, that the
   physician need expect to triumph in his rencounters with the
   hydra-monster, disease, artd Escape the lashings of a  guilty
   conscience,—guilty^p inexcusable  ignorance, or for culpable
   neglect. The medical man*—I  mean the man who has to do
   with human life, must ever  be a student, and the expiration
   of his pupilage, if he would be great and good in his pro-
   fession, must be the termination of  his professional life.  He
   must, to a grea't extent at least, forego worldly pleasures, and
   deny himself those hours and days of idleness, that indolent
   and fashionable people  so  highly  value.  He should every
   day endeavor to become a wiser physician, a truer philoso-
   pher and a purer  philanthropist, that he may more success-
   fully contend  with the " great destroyer," better  guard the
   temple  of science, and exercise a holier, charity.
     But, to return from this digression, and come  to the treat-
   ment of these  pleuro-pneumonic affections, I need only re-
   mark, thftt their management is, in a great -measure, to be
   conducted  upon the  same  general principles, as those laid
   down for the cure of bronchitis in its acute form.   Blood-let-
   ting is,-in a majority of instances, much better borne in pleu-
   risy and pneumonia than in bronchitis.  Calomel, too, in small
   and ojten repeated doses may, in  general, be carried to a
   greater length in those affections, than  in the latter disease.
   Purgatives are not to be too freely  indulged in, but the tar-
   tar emetic  is one of our most valuable means in resolving
   these deep seated  inflammations.  Blisters are  sometimes,
*»  according to  good  authority, extremely useful, but I confess,
   I have not been well  satisfied with their  effects in my own
   practice.  Indeed, they have  appeared to me, in some in-
   stances  at least,—especially when applied too early, to exert
   an.injurious influence.  Rest and the strictest quiet are to be
   scrupulously observed. And the patient's diet must be of the 
             INFLAMMATORY  DISEASES..          81

simplest  kind.  Rice  and rice-water are, during the active
stage of  these diseases, ample nourishment for  the stoutest
person.
  (e)  Asthma is an affection, the nature pf which, I believe, is
not very  well understood by physicians themselves.   Many
children, and some adults suffer l^abituallv with this disorder.
It is periodic, coming on most commonrvjtparoxysms or fits,
and is known by the common name (^phthisic:- It would
appear to be a spasmodic or nervous disease, but  many  re-
gard it to a certain extent, inflammatory ; and I have, accord-
ingly, placed it here.   The smyptoms are—great difficulty of
breathing, coming on suddenly and without warning.  It is
not  necessarily attended with fever; the patient, the adult
patient, cannot  many times lie down, for days together con- %
fining himself to his  chair; a wheezing  noise is present at
each effort at breathing, the   pipes seeming to be  almost
closed up; the appetite is not often much impaired.  In a
few words, the symptom of asthma is, sudden attacks of labo-
rious breathing, seeming to threaten life all at once.  These
attacks or fits, last an uncertain length of time, and they are
apt to recur again and again-  I see, annually, many'young
children affected with pure  asthmatic disease,"and  it  can
often, it  has appeared to me, be traced in these little subjects,
to an origin in improper diet  and the consequence thereof—
ill digestion.  In adult subjects, it is frequently difficult, or
even impossible, to arrive at the cause or causes  in which the
disease originates.  Constipation of the bowels and ill diges-
tion, certainly favor its development, in  the  first place ;  but
why it is that it returns  again and  again, after these condi-
tions have been  obviated, I know  not.   The disease is not
often attended with much danger, at least to the immediate
destruction of life.
   The Treatment. ' The best that I can recommend within the
 reach of those for whose benefit I write, is  the clearing of the
 stomach by  an emetic, and the bowels by some gentle, though
 efficient purgative.   Ipecacuanha (see index,)  will  answer
 to fill the first indication, and the " Aloetic Pills," (see index,)*
              11 
82           I NFL AM M\ TORY  DISEASES.

will be found an excellent medicine for fulfilling  the second.
If the disease still persist, however, after the course here ad-
vised has been put in practice, then a teaspoonful of the Tinc-
ture of Lobelia, repeated every half hour till the stomach  is
made sickLwill often be found of service.   In adults, liable
to repeated fits of asthma, some bitter tonics should be used
to invigorate the s#tem.  ^n the  cases of children, a few
castor oil purg^p, ~^m, in general, relieve them.
  (f) Consumption is, as every one knows, when firmly seated
on the lungs, a disease .lamentably fatal,—one  that  all the
records of medicine fail to furnish a remedy that even in a
tolerable number of instances, can be  depended upon,  as,
at most, more than mere palliatives.   And what renders  it
infinitely more terrible, is its very common  prevalence in all
ranks of society.  It is, however, unquestionably more fre-
quent in the higher, more refined, and fashionable circles,
than in the less  artificial, more useful, and humble walks  of
life.   Indeed, by many, and with  a show of reason, too, con-
sumption is regarded as a consequence of infractions of the
laws of our being imposed upon mankind, probably, as a pun-
ishment for the wicked  sin of conforming to the thousand and
one of our senseless and murderous fashions and formalities of,
so called, civilization.  The aborigines of this country, as well
as every barbarous and savage nation under  the sun enjoy.
I believe, almost complete exemption from the malady now
in question.  No cruel stays, or  strong cords are  ever  by
them used to distort their frames,  cramp their lungs, and ruin
their health.  But on the contrary, their simple  dresses and
diet, the free exercise which they are accustomed to take  in
the open air, invigorate their bodies and inure them to the
innumerable hardships, toils and  privations, which their wild
and  romantic lives impose upon them.  It is to be lamented,
deeply, that learning as well as almost every  useful science
and invention of civilized life, has, by a perversion, truly un-
accountable, come in our day, to be regarded as incompatible
with the simplicity of nature.  It  is true, we attempt to cul-
tivate our minds—our thinking powers—but the efforts which 
INFLAMMATORY DISEASES.            83
we make to accomplish an end so desirable, as society is now
constituted, are almost uniformly of such a character as  to
wound and cripple  our physical energies,—the  integrity  of
which must be preserved, if we would  enjoy  the vigor and
force of intellect that the Creator made  it possible for us, by
prudence, by temperance, and by following the plain dictates
of nature, to exercise.  But I am again«digressing—usefully,
I hope.                               #
   Consumption is sometimes lit up in the lungs  by some of
the varieties of the foregoing inflammations of these organs ;
but in all  such cases, it is just to infer, that a  pre-existing
disposition   already existed in the  system  to  take on the
peculiar disease now under investigation.   This predisposi-
tion is very often hereditary, being handed down from gener-
ation to generation, and it is styled  by professional men, the
scrofulous  habit, diathesis, or constitution.  Now it would be
difficult for me to point out, clearly, those characteristics that
mark the scrofulous, or in other words, the consumptive habit
of body.  Scrofula or consumption is itself, I grant you, when
once set up, not very difficult of detection ;  but the  signs that
announce its approach are  not, by  any  means, very easy  of
recognition.  Most authors put those persons of extreme sen-
sibility,  of  thin, fair and delicate skin and features, light hair
and blue  eyes,  down as  those obnoxious, more  than any
others, to consumptive  or scrofulous affections.  But I am
free to confess that, in my comparatively limited observation
I have most often seen the disease in persons of an opposite
description.  Those of dark hair and eyes, brawny  skins, and
deeply marked  features are the subjects, very frequently, of
the disorder now in question.  Consumption is not a contagious
disease, although some have  fancifully concluded that such is
the fact.  During every stage of life, from early infancy to ex-
treme old age. it is liable to be developed in, and destroy the
human body.
   Consumption  is, undoubtedly, during its  active   stage,  at
least an inflammatory disorder.  It is proper to remark, that
scrofula and consumption  are terms used to designate one 
81
INFLAMMATORY DISEASES.
 and the same disease, under somewhat different forms.  Thus,
 when it affects the glandular system,—the glands of the neck,
 of the armpits, groins, and especially when it attacks the car-
 tilages, (gristles,) and bones, it gets the name of scrofula, or
 king's evil.  And on  the other hand, when the chief seat of
 the affection is in the  lungs, it is called consumption.   The
 former may with sortie propriety be styled external and the
 latter internal scroffta.  Swelling of the glands, (kernels,) of
 the neck, armpits, groins, &c, evince a disposition to take an
 external  scrofula.  Now should  these  structures pass  into
 suppuration, or mattering, forming thus, ugly, ill conditioned
 sores, which discharge  a thin  serum-like fluid; and  espe-
 cially,  if  constitutional symptoms, such as  feebleness  of
 strength, and wasting away of the body, show themselves,
 the patient will be unhesitatingly pronounced by medical men
 as one  laboring  under a  scrofulous complaint.  These are
 symptoms not to be  mistaken, and they augur ill for the pa-
 tient, inasmuch  as  he has no security  that the disease may
 not pass speedily to his lungs.   Again, we  frequently have
 added to the signs of scrofula, a diseased state of the bones,
 affecting  the  larger joints, and  constituting what is called
 white swelling.   Patients laboring under this latter form of
 scrofula, frequently  perish in consequence of the excessive
 irritation which it is apt to give rise to.
   But scrofula is particularly prone to fall  upon the lungs,
 and when  it does  this, we have  a very different  train of
 symptoms from those above narrated,—a train which consti-
 tutes the diseased condition known as consumption.  Now
 cough,  although it must not be considered the  characteristic
 symptom of consumption, is one of the most common attend-
 ants upon it.  A patient laboring under consumption has al-
 most invariably a cough; but he  has  more.  That  peculiar
 predisposition already alluded to, exists in  the system: a
 cough generally dry  and hard in the early stages of the com-
 plaint, occasionly troubles the patient; there  is usually some
 pain of one side of the chest—most often of the upper part of
the left  side; slight chills now and then, at rather uncertain 
             INFLAMMATORY  DISEASES.            85

intervals,  followed by heat, burning of the palms of the
hands  and soles of the  feet, accompanied, occasionally, by
nausea and vomiting.  During these paroxysms of fever, the
cheeks are apt to be splotched  or have a flushed appear-
ance.  As the disease advances, the cough generally becomes
more and more troublesome, and it is apt to be, towards the
fatal termination, accompanied by a copious expectoration of
a thick pus or water-like substance; tlfe chills and the par-
oxysm of fever are more distinct, and  the flesh  gradually
wastes away, or is  consumed,—a  circumstance which gave
name  to  the disease, consumption.   It is very  common,
moreover, a short time before death, for the bowels to become
lax, and this circumstance, not unfrequently hurries the patient
off.  The duration of the disease  is from a few weeks to many
years; being in many instances, a slow wasting  or consu-
ming of the body, but sometimes, though rarely, rapidly fatal.
Before the fatal termination of  consumption, the  patient is
usually very greatly emaciated  and enfeebled, and has after
each paroxysm of fever is over, heavy and exhausting sweats.
He often  experiences the most acute pain in his chest.  But
all this time,  it is proper  to remark, that the appetite remains
good.  Worn out finally, however, by the exhausting nature
of the malady, his  life  is gradually extinguished, like  the
flame  of  the  exhausted lamp, and he sinks quietly into  the
arms of death, or more suddenly  it may be, he is hurried off
in consequence of a rupture of a blood vessel within  the
lungs.
   Tlie nature of consumption is  now very perfectly under-
stood.   Different parts of the textures of the body are, in those
of scrofulous  or consumptive habits, liable to  have lodged in
them a deposition of a peculiar  kind of semi-organized mat-
ter. These deposites, forming little hard tumors, are by med-
ical men, styled tubercles, and the disease to which they give
rise, when lodged  in the lungs, is called " tubercular  con-
sumption."  Now certain textures, as already intimated, are
more liable to  suffer deposites  of the tubercular  matter to
take place within them, than others.  Among these  are the 
 86           INFLAMMATORY  DISEASES.

 lungs in particular,—thus originating  consumption  proper;
 and  the absorbents,—the glands, Sec, are the next  organs
 most liable to be  affected in this  manner,—thus, giving  rise
 to scrofula, proper. Tubercles, being in the foregoing manner
 deposited in the lungs, may remain  for a very considerable
 length of time, without giving rise to  any very unpleasant
 symptoms ; but much more commonly, alter a time, they ex-
 cite in these organs a low degree of inflammation, the result
 or effect of which is, to bring the  softening or reduction into
 a sort of putrid matter, of the tubercular tumors here referred
 to.  And the cough, it would seem, nature institutes for the
 purpose of throwing off or expelling the matter thus circum-
 stanced from the lungs.   Or  the  tubercular matter here re-
 ferred to, being lodged in other  parts of the  body than  the
 lungs, although it undergoes the same process  as when seated
 in them, the disease thus resulting  is, as has been before
 stated, styled scrofula, and is not so  immediately dangerous
 to the patient's life.
   The Treatment.   When consumption is once firmly fixed
 upon the  lungs, it is an incurable  disease.   All treatment is
 then, in a vast majority of instances,  perfectly unavailing, at
 least, if directed to the cure of the disorder.   Palliatives it in
 proper  to  use to calm  and quiet struggling nature, and
 smooth the  pillow  of death, but  active drastic medicines,
 under these circumstances, only serve to distress the patient,
 and hurry him to the end of  that  course, which fate has de-
nounced as his earthly doom.  All that the physician will ven-
ture  upon in these desperate  and inevitably fatal cases, is to
 guard the patient against every cause liable to aggravate his
 disorder, to advise an unirritating, though nutritious diet, to
 direct exercise as far as compatible with the strength  of the
patient, to prescribe gentle tonics to sustain his sinking pow-
ers, and lastly, when death is making its inroads amid ago-
nies  and suffering, to devise soothing and palliative medicine
for the purpose,.as far as possible, of paving the rugged path
to the home of the body—the grave.   This is  all, I  repeat,
that  physicians  will  attempt to do in cases  of  confirmed 
INFLAMMATORY DISEASES.
87
consumption.   Quacks may  attempt  more, but alas,  for
their patients !   Death already inevitable, how cruel it is to
ruffle the ebbing tide  of life in its comparatively quiet  re-
treat from the turmoils of time, by ignorance or inexcusable
rapacity.  Rather commend the confiding  patient,—I neg-
lected to say in the proper place, that consumptives often  en-
tertain hopes of recovery, even to their last moments,—to  the
Great Physician of souls, than dose him on strong  and  im-
proper drugs, and feed him on unwarrantable flatter}".
   It is during the latent stage, or in other words, in the com-
mencement of consumption, that any reliance need be placed
upon medicinal treatment—when the  individual is merely
threatened with the  disease.  Here those medicines which
experience has discovered useful in scrofulous affections may
be resorted  to with some  prospect of advantage.  Sarsapa-
rilla, wild cherry tree bark, tar, and  especially iodine, are to
be reckoned as among the most useful of these.  In conjunc-
tion with the use of  these, warm clothing, daily exercise on
horseback, if practicable, a good and nourishing diet, and es-
pecially  the removal to a warm  and healthful climate, will
be, in general, the very best course that those predisposed to
consumptive attacks can adopt.   At this stage or period of
the disease, or rather  of a threatening of it, change of cli-
mate may  prove beneficial; but after  it is confirmed such
a change is not only  useless, but, on many  accounts, deci-
dedly  objectionable.   The  disease is thereby, after inflam-
matory symptoms manifest themselves,  hurried to a fatal  ter-
mination.   Moreover,  patients  laboring under consumption,
sent into foreign countries, suffer many privations, and cannot
have around them in their last moments,kind and sympathiz-
ing friends, to minister to their wants, console them, and render
their exit from  time to eternity peaceful and happy.  It is
cruel then, I repeat, to send patients off to die in foreign
countries among strangers, too often, cold and indifferent to
the sufferings of others.
   For the treatment of external scrofulous affections—ulcers,
glandular affections, &c, when  accompanied by  constitu- 
88
INFLAMMATORY  DISEASES.
 tional symptoms,  the  same  general  course as that above
 suggested, is to be advised.  Tonics, in conjunction with sar-
^saparilla and the  mineral substance, iodine, are the means
 most to be relied upon.  A simple cold infusion of the sarsa-
 parilla, made by steeping the roots in cold water, and perse-
 veringly used for weeks  or months  at a time, is as good a
 mode of administering it as any other.   To this infusion the
 iodine may be  added.  The ulcers themselves, though fre-
 quently ugly  and ill-conditioned, demand no  great  deal  of
 attention.   If the constitution can be righted, these are apt
 to heal of  their own accord.   A little simple  salve may be
 applied to  them from time to time; and this will be found
 about as useful as the more elegant plasters, ointments, &c,
 so much in vogue among the quacks, as cures for scrofula
 or king's evil.  But I need add no more, for I must presume
 that physicians will, in a majority  of cases, be  called to their
 management.
   (g) The heart is obnoxious to certain inflammatory disor-
 ders, but as physicians themselves do not very well under-
 stand the symptoms that point them out, I deem it unneces-
 sary to dwell upon them.  Much  of late has  been said and
 written on this subject by the  most eminent men of the med-
 ical profession, but as  yet, I am sorry to add, no very  clear
 and definite conclusions have  been arrived at.  Therefore, 1
 pass by, altogether, this  variety of inflammation;  and shall
 in the next place, consider some of the more prominent and
 interesting diseases of inflammation, which affect the adjoin-
 ing chamber to the chest below,—the  abdomen or belly—
 which is, as will be  remembered,  separated from the chest,
#by a thin  membranous  muscular partition, called  the dia-
 phragm, skirts, orstriffen.
   (a) Inflammation of the Abdomen in general.  The abdomen
 or cavity of the body below the chest, and divided from  it by
 the  diaphragm muscle, is liable to be  attacked by  a diffuse
 or general inflammation, and to  produce  thus one  of the
 worst and most dangerous diseases to which man is obnox-
 ious.  This general inflammation is, almost  always, confined 
INFLAMMATORY DISEASES.
89
   to the  inside lining  or investing  membrane, which, after
   lining the walls of the  abdominal cavity, is reflected off to
   cover every organ or  structure of the belly, and form a bond *
   of union between them.  An inflammation, thus  extensive,
   is apt to excite great constitutional disturbance, and is, al-
'   ways, attended with imminent peril to the patient's life.
     The symptoms which announce the existence of this terri-
   ble inflammation are generally  sufficiently  characteristic to
   create no difficulty in its detection.  It is nearly  always, in
   its acute or active form, ushered in by a rigor or chill, which
   sometimes, is of great severity, but  which, in other instances,
   is only slight.   This  is, sooner  or  later, followed by febrile
   symptoms, such as, heat of the surface, headache, thirst, rapid
   pulse, &c, accompanied with a general soreness  or tender-
   ness of the  belly, especially, if pressed upon.  Sometimes
   this soreness exists even prior to the chill referred to, and is
   so great that the patient can  scar«ely bear the weight of the
   bed clothes.   He usually lies  in the bed  with his legs drawn -
   up toward the body, so as to relax-the tension  of the belly *
   Another symptom which is almost uniformly present in the
   affection now in question, is  tumefaction or swelling of the
   abdomen.   This is in many cases truly enormous,  and unless
   it can be removed, it augurs ill for the patient. It depends upon
   an accumulation of wind in the stomach and bowels, which
   they are unable to expel in consequence of the external in-
   flammation, under which they are  laboring, interfering with
   their normal functions. The bowels most  often  are consti-
   pated, but sometimes the reverse  of this is the case.  The
   tongue is  covered with a white  fur, and  its edges and tip are
   usually florid or red.   Headache in this as in the other severe
   inflammatory disorders, is apt to be present.
     The common causes that produce this affection are the same
   with those which give  rise to other species of inflamation, as
   cold, &c.  But, in addition to the common  causes, there is a
   cause peculiar to this disorder, which much more often excites
   it than any  and all others put together, and which serves to
   complicate and render it one of the most terrible and danger-
                12 
90
INFLAMMATORY DISEASES.
ous of diseases.  It is parturition or child-birth to which  1
refer.  The most, difficult and  over-powering cases of child-
bed fever are nothing but abdominal inflammation, excited by
the disturbance and injuries this part is  doomed to suffer in
giving birth to the young of our species.  And in consequence
of the delicate condition of females at this critical time, mo-
thers frequently fall a sacrifice to this formidable disorder.
   The treatment consists in the vigorous application of those
remedies that experience has sanctioned, and almost sanctified,
as the most appropriate for subduing deep seated inflamma-
tions.  I will  mention some of them :  Blood-letting stands
first; calomel in union with opium, second. Blisters and warm
fomentations or poultices over the  abdomen are also, fre-
quently, serviceable.  These, I say, are the remedies, but even
these sometimes fail;  and for this  reason, I hope my  reader
will not incur the responsibilty of treating abdominal inflam-
mation, when medical aid can be procured.  The  diet here,
as  in  other acute inflammations, should be little else than
rice-water, or thin corn meal gruel, and  the  strictest quiet
should be enjoyed.
  (b)  Inflammation of the Stomach in its acute form, affecting
as it does a structure whose integrity is absolutely indispen-
sable to life, is a momentous disease, and one that demands
more than almost any  other, correct management to procure
its removal.  Many diseases will get well without treatment,
and many more, in spite of improper treatment.  Of these
two modes in inflammation of the stomach, that of trusting
the disease wholly to the sanative powers of nature, is infi-
nitely preferable.  Ignorant officiousness  in  the present af-
fection, hardly ever fails to  aggravate  all its symptoms,
and even hurry it to a fatal termination.
  The symptoms of the  disease are, a burning  pain  of the
stomach, resembling, as patients  express it themselves, that
of some hot substance in this  organ—a  continual effort at
vomiting j insatiable thirst for cold water, which, when swal-
lowed, is usually in a  few minutes thrown up scalding hot;
headache, heat of body, &c.   The pain of inflammation of 
INFLAMMATORY DISEASES.           91
 the stomach, unlike  that  of colic, is aggravated when pres-
 sure is made over the abdomen.  The  bowels are generally
 bound.
   Causes.—These are  various; but the most common, per-
 haps, is errors in diet.   It will be recollected that the stomach
 is more  exposed to  disturbances thus  originating, than any
 other structure of the human body.  It is a  common reser-
 voir into which good, bad, and indifferent articles are pro-
 miscuously thrusted.  The blandest and most nutritious ar-
 ticles of  nourishment, no less than the  most virulent poisons)
 are introduced into the general system through the stomach.
 Impressions upon its walls are frequently  the injurious  con-
 sequences of this various range of offices—irritations and in-
 flammations are extremely common among these consequen-
 ces.  Acute inflammation is sometimes the effect of poisons
 taken into the stomach; it is, also, one of the many penalties
 affixed to the sin of  gluttony.   The more  chronic inflamma-
 tions of  the stomach  constitute many cases of  the disease
 called Dyspepsia, but for reasons which I  shall then explain,
 I will defer the consideration of this disease to another place.
 Inflammation of  the stomach,  oftener than any other inflam-
 matory complication, is the result of our western autumnal
 fevers.
   The Treatment  of  acute  inflammation of  the  stomach is
 not, in general, if taken in time, attended with great diffi-
 culty, yet many cases result unfavorably for want of prompt
 treatment, or what is worse, in consequence of ill treatment.
 Physicians frequently bleed in  this complaint, both generally
 from  the arm,—and locally from the  stomachic  region, by
 means of cups or leeches.  They give Opium combined with
 minute doses of Calomel, and they will not allow the patient
 any  other nourishment than rice-water or  thin corn  meal
 gruel, and these only in very  small  quantities.  Purgatives
here are  apt to be injurious, from the fact of those medicines
communicating to the stomach additional irritation to that
 ahead) present, which the chief aim of our efforts is to allay.
This objection  to purgatives,  however, cannot  be   urged 
92           INFLAMMATORY  DISEASES.
against the use of Clysters or  injections.  Blisters are some-
times used.   Now the foregoing is the treatment of inflamma-
tion of the stomach; admiting, it is true, of slight variations.
When greatly varied, however, the patient's life must be en-
dangered.  Emetics are sometimes erroneously given ; active
purgatives to overcome costiveness, too, are sometimes pre-
scribed;  hot  teas, and even spirits, old women occasionally
think fit to drench the patient  with,  to  stop the puking, but
these are reprehensible.   Cold water taken in  small  quanti-
ties, and at short intervals, is the best drink in a majority of
instances.
  (c)  Inflammation of the Bowels is like that of the stomach, a
common and, though not so dangerous as the latter affection, a
very troublesome disease.  It  is liable to affect persons of all
ages  and at all seasons of the year, and it depends upon so
very great a  variety of circumstances,  that no Aery  definite
description of it can be given in a treatise like the present.
All affections of the bowels, from the most trifling diarrhoea*
(or lax,) to the most distressing dysentery, or  blooy flux, de-
pends upon inflammation of  the  bowels.  Diarrhoea, or lax,
is a symptom of the lowest form of this inflammation,—it is,
indeed, generally regarded as  simple irritation.  The symp-
toms of this condition  are frequent, thin and watery dischar-
ges from the bowels, debility,  loss of appetite,  and  a wasting
of flesh, if the disease lasts long; little or no pain or  sore-
ness is experienced under these circumstances.  Infants  are
particularly liable to attacks of diarrhoea, and it is a disease
frequently of serious import to  these little subjects.  Improper
articles of diet and gluttony  are, in nine cases out of ten,
when conjoined with warm weather, the causes of  diarrhoea.
Abandon or leave off  the cause, and in a few days nature
will generally restore the patient to health.  If this direction
should fail, however, a few drops of laudanum, ten  to twenty,
for an adult should be given and repeated until its restrain-
ing effect is  obtained.  Physicians, it is true, often are re-
quired to do more than what I have now directed  in these
bowel affections, because the  disease, as it  falls into their 
INFLAMMATORY DISEASES.            93
hands, is in many instances no longer simple.  Having been
excited in the manner above mentioned, or in consequence of
the long and intemperate use of ardent spirits, it has passed
beyond the simple irritation alluded  to as the most  common
condition, giving rise to these watery evacuations  from  the
bowels, and is now to be looked upon as a thickened or ulce-
rated state of the inner coat  of the  intestinal structure.
When this is the case the purging is  persistent  and hard to
control, because its course is now  no longer transient,  but
permanent, and cannot be removed except by the most correct
management conjoined with time.
   Respecting  the bowel affections of infants, they are many
times obstinate,  and it is not at all uncommon for them to un-
dermine the delicate constitutions of these little and tender
subjects, and  by their persistence destroy  their lives.   The
very best treatment that can be adopted, as a  general rule,
applicable to the public, is to clear their bowels  with a  small
amount of castor oil, after which an  astringent medicine will,
in  most cases, prove beneficial.  Take a table spoonful of
alum, and add it to half a dozen times its bulk of loaf sugar,
(the brown sugar will do,) dissolve these ingredients in half
a pint  of water, and boil into a thick syrup.  Ginger and
spice will make the syrup more pleasant. Of this syrup give
an infant one  or two years  old half a teaspoonful every three
hours until the purging is arrested.  The dose may be  in-
creased or diminished according to the age of the child, and
the effects of the  medicine.   Calomekis a  remedy  of  much
 efficacy in the bowel complaints of  children, but as it is  one
of those substances that may be serviceable or  injurious, ac-
cording  to circumstances,  physicians should generally pre-
scribe it, and take upon themselves the accruing responsibil-
ity.  I am much in the habit of using it, and I have not,  I
can safely say, seen it mischievous when judiciously given.
   A more aggravated form of inflammation of the bowels,
 and one that in many cases threatens  life, is  Dysentery, or
Flux.  This inflammation is chiefly confined to the  lower
bowels, and the symptoms of  it are sufficiently characteristic 
94
INFLAMMATORY DISEASES.
to preclude the possibility of mistaking it for any other affec-
tion.  Feverish symptoms are, in all cases of  severity,  ac-
companiments of  acute  flux or  dysentery.  The patient is
hot, and has a dry and parched skin ; he has headache, pain
of his bones, great thirst, loss of appetite,  a foul tongue, Arc.
Moreover, his abdomen or belly is hard to the touch, and upon
pressure he evinces signs of an increase of pain,—there be-
ing very generally constant soreness present.  He  suffers
paroxysms of severe griping pains throughout the lower part of
his belly, and frequently, I  may  say almost constantly, he
has the most urgent inclination to go to  stool.   If any doubt
could exist previously respecting the nature of the disease)
a medical man, upon examining the stools of  a dysenteric
patient, has that doubt speedily removed.  These are invaria-
bly and uniformly characteristic.  They are either slimy,  re-
sembling the white of  an egg, streaked  with blood,  or they
are, in a great measure,  composed  of  blood;  and they are
nearly  always scant,  unless  indeed, chiefly  composed of
blood, when they amount sometimes to a considerable quan-
tity.   In addition, a negative symptom of  this  inflammation,
is' the absence of natural matter in the stools.
   The Causes of this  disease have already been referred to
so far as they extended;  but there is one cause of a genera'
nature that frequently excites this inflammation as an epidem-
ical  disease,   affecting whole neighborhoods  at the  same
time.   That cause is some invisible  agency floating in the
atmosphere, not unlike that which  excites intermittent and
remittent fevers.  Dysentery or flux is from this circumstance
sometimes  thought to be  catching or contagious, but this is
certainly an erroneous  opinion.   When patients die of  acute
dysentery or bloody flux,  upon examination of the body after
death, the lower division  of the intestines are found in a dis-
organized condition, full of ulcers and abraded surfaces. The
duration of this disorder  is  uncertain—sometimes  termina-
ting in a few  days, and again lasting, it  may be, for months
or even years.
   The Treatment of dysentery is simple, and,  if well  man- 
INFLAMMATORY DISEASES.
95
aged, the disease is not, as it occurs in this country at least,
attended with very great danger.   In the south,  however, it
is a disease full of peril.  The most rational course of treat-
ment that can be adopted by a non-professional man, in this
disease, as met with annually in this country, is to combine for
an adult, from twenty to thirty drops of laudanum with a  ta-
blespoonful of castor oil, to be given and repeated at inter-
vals,  until  the passages assume a natural appearance, or  at
least are mixed with the natural fecal matters of the intes-
tines.  Then the oil is to be discontinued, and the laudanum
continued  according to its effects, for the  purpose of allaying
the pain and soreness, and  arresting the frequency of  the
discharges.  This course it may be proper to repeat after
one, two or three days.  Hot poultices kept  constantly ap-
plied to the abdomen is often followed by good effects.  Con-
joined with the treatment of dysentery, a matter of primary
importance, both to the patient  and the reputation of  his
physician, is proper dietetic  regulation.   A patient affected
with dysentary  must  not  be allowed more than a little rice
and rice-water, or a little gruel, on any account, as nourish-
ment.  Of rice-water he  should be even  solicited to take a
few spoonfuls from  time to  time.  Physicians are  much in
the  habit  of using calomel in this disease, especially  in
southern dysentery, but I think that in the milder disease, as
it occurs in our country, this calomel treatment is often  un-
necessary—not to say injudicous.  Blisters do  good, doubt-
less,  sometimes, when the disease is pretty  well subdued, but
in my opinion these, too, are frequently injudiciously resorted
to, and serve rather to annoy the  sufferer than to resolve his
disorder.
   (d) Inflammation of the Liver.  Though the liver is, by many,
thought to be the seat of half the  ailments to which human
flesh is heir, yet, in  truth, it is but seldom that after death in-
spection exhibits any traces of disease in this structure.   The
liver  complaints,  about which quacks  and  empirics have so
much to say, is  very generally dyspepsia.  Still the liver is
sometimes the seat of disease, and occasionally  of acute in- 
96            INFLAMMATORY DISEASES.
flammation.   The symptoms of an inflamed liver are a s  arp
or obtuse pain of the right side, located just below the points
of the short ribs ;  pain in or about the shoulders is frequently
present; the  signs of fever are often present, the  tongue is
foul, and the stomach, in  many instances, irritable.   The
 skin is often of a dusky hue, and sometimes the whole  sur-
 face, even the eye balls, are tinged yellow; the urine is high
 colored and scanty.   The bowels are sometimes inordinately
 active, and the stools are apt to be unnatural—generally  clay
 colored.  These  are the common symptoms of the disease in
 question, which,  if permitted to run on unchecked, is not un-
 frequently attended  with dangerous consequences.  Pus or
  matter may form in the liver as in other parts of  the body,
  and when this happens, although the result is not necessarily
  fatal, yet the patient's life is in great  jeopardy.  Should the
  abscess burst internally, and discharge its contents into the
  abdomen, death  is almost inevitable.  But the abscess does
  not always open into the abdomen, and here we are enabled
  to  behold one of nature's wisest provisions.  Instead of the
 abscess making its way through the thin covering of the liver,
 it most often, perhaps, makes its way  through the thick mus-
 cles of the abdomen, and points externally.  When this hap-
 pens, by opening the abscess, and sustaining the  patient's
 strength by appropriate tonic  medicines, recoveries are not
 very rare.
   I need say little of the causes of this disease.  They are,
 I believe, frequently quite obscure and evade every effort at
 detection.   Cold, operating on  an over-heated body, is no
 doubt a cause.
   The  treatment must be conducted upon general principles.
Blood-letting is frequently practiced by physicians.   Calomel
is given, in union  with opium, till the patient is salivated;
cups and blisters they  sometimes apply over the seat of the
diseased organ.  When matter forms—which is  announced
by a throbing sensation in the part, and frequently slight con-
stitutional chills-they endeavor  to call it to the surface of
the body by keeping up a soreness of the part, or even  by 
INFLAMMATORY DISEASES.
97
cutting down near to the liver itself.   The bowels, during the
whole course of the disease, should be kept gently open, and
the patient's strength Js to be sustained—especially after the
evidences of the formation of matter exist, by  a nutritious
diet and tonics, such as the elixir vitriol, quinine, and the  bit-
ter barks.  This is  all that I deem it necessary to say of in-
flammation of the liver at present, I may allude  to it again
when 1  come to speak of  dyspepsia or indigestion.
   (e) The kidneys are like other fleshy structures, obnoxious ot
inflammatory attacks, but these are rare.  In a  practice of
some years  I  have not  seen  one single  example of  well
marked inflammation of the kidneys.  Should we  have  the
symptoms  of acute inflammation  of these organs, situated
one on  either side of the spine, immediately below the last rib,
purgatives should be prescribed, and all the other useful  aids
with which we are acquainted be employed,  if required, to
procure the resolution of  the inflammation, before  it passes
into a  suppurative stage.  In every  case of inflammation
of the  kidneys, the urine will be  found in some way de-
ranged,—there is generally not enough of it,  sometimes com-
plete suppression.
   (f)  The bladder, too, is liable to be affected by  inflamma-
tion, but it is rare, indeed, that we meet with it  in practice,
unless the  effect of some irritating substance taken into the
stomach, such  as spirits of turpentine, or the tincture of the
Spanish fly.   In cases of this kind some salts or  oil to clear
the bowels, should be prescribed, and, after their effects have
been obtained, laudanum will be apt to allay the burning
distress and  frequent inclination to pass  urine.   Symptoms
of inflamed bladder  are sometimes  excited in persons  of
loose morals, in consequence of infection of the sexual organs
from, impure connections, but as it is not my design  to treat
of affections of this kind in the present volume, I pass to
   (g)  TJie spleen, which is, in our western country, often found
diseased.  Ague  and bilious  fevers, both not unfrequently,
derange this organ very greatly.   What is commonly called
ague cake is nothing but an enlargement of the  spleen ; and
              13 
98
INFLAMMATORY  DISEASES.
  this is so great as to be distinctly felt, or even  seen, through
  the walls of the abdomen, just under the points of the short
  ribs of  the left side.  Acute inflammation of  the spleen is
  not often met with, but this enlargement, which appears to be
  a result of a pre-existing low  grade of inflammation, is so
  common in aguish districts, as to excite but little fear among
* the subjects of it.  The best means of cure that I have found is
  to effectually eradicate  the cause of the ague from the sys-
  tem, by the judicious use of quinine and mercury.
    (h) Inflammation of the eyes.  (Ophthalmia).   I have omitted
  saying  any thing  of  this external and local inflammation
  until now.  In the  eye, while inflamed, we may behold the
  appearance of other inflamed structures that are out of sight.
  Here we see in this delicate organ, the redness, the swelling,
  &c, the work of inflammation.  There are many  forms of
  inflammation of the eye, and  many causes for these, but  I
  shall allude to but one, and one cause for it.  Catarrhal in-
  flammation of the eye is, as its  name implies, generally re-
  garded  to be the  effects  of  cold.  It is liable to attack all
  persons, from infancy to extreme old age.  The symptoms
  are a sensation  of stiffness and roughness of the eyes—feel-
  ing as if sand were in them, redness, heat, swelling; pain;
  and these symptoms are usually attended with constitutional
  disturbances in cases of severity.  The eye or eyes, for both
  are apt to suffer at the same time, usually pour out matter
  or scalding hot tears.  In very severe cases of this disease
  I have seen the  eyes completely closed, and  the  ball itself,
  when examined, by prying the lid open, looks like a globe of
  blood more than an eye,—the patient  being entierly blind for
  the time being.
    The Treatment.   This  must often be constitutional.  If the
  inflammation  be severe, blood should be frequently abstracted
  from the arm.   Epsom salts are  a good medicine for reduc-
  ing, or assisting to  reduce, this painful and  alarming disor-
  der.  The  patient should be freely purged with them, and his
  bowels kept open, until the disease is measurably removed,
  by repeated small  doses.  The eyes,  during the first days of 
INFLAMMATORY  DISEASES.
99
the attack, should be bathed and washed, from time to time
in warm water or  milk  and water, and the light of  day
should be excluded from them by green spectacles, or a black
handkerchief.   After the  inflammation has,  by the above
means, been  somewhat reduced,  astringent eye-waters are
frequently useful.  The best of these, agreeably to my expe-
rience, is a solution of  Lunar Caustic;  Sugar of Lead, Blue
Vitriol, &.c., are sometimes used for this purpose.  Four grains
of the lunar  caustic, to an  ounce of pure rain  water,  will
form a solution of the requisite strength.   I have seen inflam-
mation of the eyes, of very aggravated character, somehow
connected  with the cause of fever; nor could 1 relieve pa-
tients thus afflicted, until I exhibited to  them quinine. Cases
of the nature of these occur, generally, during the fall of the
year.
  I have, in the foregoing manner, treated briefly of the most
common pure inflammatory diseases. In many respects these
have, I am aware, been hastily and imperfectly considered,
but, I hope, enough has been said to prove of some  service
to my readers in those hours of bodily pain and affliction that
all, sooner or later,  are  doomed  to  suffer.   In  accordance
with the plan previously laid down, I pass next to the con-
sideration of anti, or non-inflammatory diseases.   These are
to come under class third of my arrangement. 
CHAPTER  VIII.
           OF ANTI  OR NON-INFLAMMATORY  DISEASES.

   Class Third.—I am fully aware that there is much difficulty
encountered in drawing a line  between inflammatory and
non-inflammatory diseases.  It is true that the name of a dis-
ease is of little consequence,  or  to  what class it is referred,
as long as we do not  permit  ourselves to be misled thereby
respecting the nature  of such disease. We should carefully
investigate the symptoms and nature of the ailment, with
which we have to do, and predicate our treatment according
to the result of such an investigation.  If,  however, we allow
ourselves to be imposed upon by any one's classification, and
without due forethought refer this train of symptoms to that
class of disease, and that train to this class, we are liable to
be continually misled and bewildered in our treatment.   For,
one and the same  disease may depend upon quite different
conditions of the system.  It is for these reasons that much
caution in investigating disease, is necessary.  I shall, in the
present case, begin with  the non-inflammatory diseases of
the brain; and I shall not consume much time and space in
their investigation.
   (<z) Apoplexy is one of those diseases that frequently, almost
instantaneously destroy life.   A person  may be in the en-
joyment of perfect  health, and be  engaged in his  ordinary
occupation, when, in an instant,  and  sometimes without the
least warning, he falls down, and, after a few moments' un-
conscious sleep, "sleeps the sleep  that knows  no waking."
This is the worst form of apoplexy.  It most often, however,
makes its approach somewhat differently.  For a time previ-
ous to the attack, the individual has fits of sudden blindness, 
           NON-INFLAMMATORY DISEASES.        101

with swimming of the head and roaring in the ears, and then
falls down only partially robbed of sensibility and  conscious-
ness.   It may be that he sleeps and  snores  profoundly, but
that he can, for a  moment, be  roused from  this state, when
again, after a careless look about  him,  he relapses into his
former lethargic state.  This lethargy may become more and
more profound, until death closes  the scene ; or, on the con-
trary, the patient may  gradually recover  his consciousness,
and, after a few hours, or days, go  about his work as before.
Nevertheless, apoplexy is apt to leave traces behind it ; palsy
of one entire side  of the body may be its consequence, or the
face may be palsied so  as  to be greatly drawn to one side ;
or again, an arm may suffer a loss of power or  sensibility.
All classes and conditions of life are subject to apoplexy, but
certain persons  are much more obnoxious to it than others.
Those of full habits, stout chests,  and short necks, are par-
ticularly prone to  be  thus  affected.  Old persons  are oftener
the subjects of apoplectic attacks  than those of middle life or
youth.
   Causes.   Too much blood in the body, generated by eating
too much and living on rich diet, and strong mental emotions,
with the predisposition already alluded to, are the most common
causes.   Overloading the stomach with green hard fruits, and
other indigestible  matters, sometimes produces apoplexy; and
the intemperate use of ardent  spirits, is, likewise, a cause of
the complaint, in some instances.
   The Nature of apoplexy is  now well understood.  Exam-
ination of the brain of those who have fallen victims to this
complaint, clearly demonstrates that it is caused by too much
blood in the brain.  In fatal  cases of apoplexy, the  small
blood vessels of the brain are very frequently found ruptured
or bursted, and the effused blood poured out upon  this organ.
When the disease has  resulted in this  manner,  no hope of
the  patient's recovery need  be entertained.   In  less violent
cases, and where  no considerable  blood vessel has been rup-
tured, apoplexy does not invariably result unfavorably.
   The Treatment.   The indications to be fulfilled in the treat- 
102        NON-INFLAMMATORY DISEASES.

ment of apoplexy are, to empty  the brain of the inordinate
quantity of blood that is thrown to it, and restore the balance
of circulation.  If this can be accomplished prior to the blood
escaping from its proper vessels,  the  patient recovers:—if
not, he  dies.  Now bleeding from the arm may fulfil both
these indications, but though a patient  be  bled to death, yet
this means, alone, sometimes fails.  Strong purgatives should
be prescribed, to call, as  much as possible,  the force of the
circulation from the head to  the  intestines, but the patient
cannot always swallow.  Apply  heat and  mustard poultices
to the arms and legs; and the head may  be kept cold, and
it should always be elevated.   I have thus given, briefly, the
principles and the treatment of this head affection; but in
spite  of all our efforts,  it is proper to remark, when it has
made its attack, and  especially in old  persons, much doubt
must be entertained with regard to the patient's safety.  Even
should he recover from  one seizure, a  second or third is apt
to carry  him off.   Apoplectic subjects  should, therefore, be
exceeding careful to  guard themselves, as far as possible,
against the exciting causes of the  disease in question.   Live
low, be temperate, and avoid strong mental emotions.   And
should premonitory symptoms, at  any time, arise, prognostic
of the attack, they  should  take  opening  medicines—salts.
The late celebrated statesman, eloquent orator,  and profound
scholar, John Q. Adams,  died of  apoplexy;—the second or
third attack, I believe.
  (b)  Epilepsy, or Epileptic Fits. This is, like apoplexy, a dis-
ease, of the nervous system; and it is one of the  most curious.
as well as  most lamentable, disorders  of  the  human body.
It comes on a good  deal similar to apoplexy, but instead of
the patient, laboring under a fit of it, resembling a person in
a profound sleep, he is so violently convulsed that the strength
of several men is inadequate to restrain his involuntary move-
ments ;  he  froths at the  mouth, often thrusts his tongue out
between his teeth, and it is often  bitten ; during this time he
is wholly unconscious of  every thing going on around him.
The fit often  seizes  the  patient at night, while he is in bed 
           NON-INFLAMMATORY  DISEASES.      103

asleep, and he remembers nothing about it; but it sometimes
comes on when he is about his ordinary occupation, and, in
this case, he usually has, at least, a moment's warning, though
sometimes not sufficient to remove himself from danger, and,
in consequence of this circumstance, he sometimes pitches
headlong into the fire, or falls from heights, dreadfully wound-
ing and mutilating himself.  Another peculiarity of epilepsy
is, that it is often periodic in its  returns, after it has once in-
vaded the system.  Many persons  suppose, from this  fact,
that epilepsy is controlled by the moon, but an opinion of this
kind is without facts to sustain it—utterly unfounded.
   In relation to the causes and exact nature of this affection,
both are, to a great extent, enveloped in obscurity.   It is true
that in some cases the cause can be traced out; but it is equally
true that in  even a  majority of instances, no satisfactory
cause can be  assigned, after the most careful scrutiny.  Worms
are, in some  instances, a cause of epilepsy among children ;
so is crude indigestible food.   But the convulsions of infants
are not to be confounded with epilepsy.  The most charac-
teristic symptom, perhaps, distinguishing these two diseases,
is the periodic nature,—the  recurrence, after a greater  or
shorter length of time, again and again, of epilepsy; where-
as, simple convulsions are not very apt to return after they
have once left the system.  Dissection  fails to give, at least
very often fails, any  satisfactory evidence of the exact nature
of epilepsy.   It is a  disease of the nervous system ; this we
know.
   The Treatment.  When the cause of epilepsy can be ascer-
tained and removed, provided the disease be not of too long
standing, it may be cured.  These, then, are the first things to
be thought of, in the  treatment  of this affection—the cause
and its  removal.  If it has originated from bad digestion,
this is to be corrected; if from worms, they should be removed.
But unfortunately, the cause,  too  often, eludes our scrutiny,
and then, our efforts to  cure  must  be chiefly in the dark.
Many medicines, nevertheless, having occasionally cured epi-
lepsy, have got the reputation of "cures for fits."  Among 
104        N $N -INFLAMMATORY  DISEASES.

these, first of all, perhaps, is to be  reckoned the Nitrate of
Silver, or Lunar Caustic.   Other mineral substances have
been used with beneficial results, occasionally, but everything,
it is right to remark, too often fails, and nothing but the cold
arm of death relieves the patient  from  his  wretchedness.
Empirics are eternally lauding  to the  world new cures and
remedies for this lamentable  disorder, but they should never
be countenanced; selfish motives, in nine cases out of ten,
are their sole prompters.  When every other resource fails,
one of the very best means with which  I am acquainted, for
putting of the fits, or suspending them from time to time, is
the habitual use of some purgative  medicine;  and for this
purpose, castor oil will be found preferable to any other arti-
cle.   Unlike other medicines, the long  continued use of this
oil imparts no injurious effects to the constitution.
  (c)  Hysteria or Hysterics.   This is  another of those inscru-
table nervous disorders.  Certain females of excitable habits
and delicate constitutions are the proper subjects of it, but a
disorder, very similar indeed, is sometimes  met with in  the
male subject.   Hysteria assumes two forms —passive and
active.   In the  first, the  patient imagines herself badly dis-
eased; she fancies that she will not live long, and that no
one sympathises with her in her (imaginary) sufferings.  She
is low spirited  often, and is apt to be tormented with a pal-
pitation or fluttering of the heart; she complains of a sensation
of smothering,  and sometimes imagines that there is a some-
thing which rises up in her throat and threatens to choke her
instanter.  Again, she is apt to complain of pain, especially
of the left side, and sometimes of exceedingly sharp-shooting
pains in every direction through the  abdomen.  Her tongue
is generally foul and flabby  like, but  most frequently,  the
appetite is pretty good.   An  irregular  state of the  bowels is
very generally an accompaniment of this  affection;  and it is
often the case that, upon inquiry, some derangement in the
urine or genital organs will be found to  be present.
  Now this passive form of the disease is sometimes suddenly
made to assume the active by slight causes.  The husband 
          NON-INFLAMMATORY  DISEASES.        105

provokes his wife, or some ill news is brought to  her;  or, it
may be, she eats too much bacon and cabbage, or something
of that sort.  All at once, all the foregoing symptoms are
aggravated.  The patient now  imagines  that her time has
come ; she feels that she soon will die;  that the smothering
and choking sensations are,  for  once, in earnest; her heart
beats violently ; she screams or howls outright, laughs or
sings, it may be, then cries, and calls her friends to look  upon
them for the last time.  About this  time she is apt to begin
to be cramped ; her hands are firmly clenched, her limbs ex-
tended, and she sends out from  her  eyes such a wild raving
sort of maniacal look, that it is almost enough to scare the Doc-
tor himself off; she is, or fancies herself, unable to swallow ;
she is, in her own, and in the  opinion  of her friends, just
gone ; and now there is such a howling lament raised as al-
most to call tears from stones.  Perhaps  the  Doctor arises
about this time,—for he is  sure to be sent for, night or day,
rain or shine,—and to a table-spoonful of the tincture of As-
safoetida, he adds 20 or 30 drops of laudanum, and pours the
whole down the woman's  throat, in  spite of the  entreaty of
her friends, who suppose he  is now too late to do any  good.
In a few minutes, she opens her eyes, casts them carelessly
about the room, the  cramp  or  spasm leaves  her, she sighs
deeply, and, upon being  asked how she is, replies she feels
better.   The next day she goes about her work as  usual; but
the same scene, it may be, is to be  enacted over again and
again.
   Hysteria, as  will have  been  inferred, is not a  disease at-
tended with danger; hysterical patients will not die  of their
disorder, but they will, as long as they are the subjects of it,
be  uncomfortable to themselves, and troublesome to  their
friends ;  and, after a great length of time, their constitutions
being enfeebled by this, other  affections  may more  readily
carry them off.   It is, therefore, fit that the disorder be treat-
ed.   And I know of no  treatment, so often beneficial, as a
long  continued course of  mild  purgation.   There  are,  al-
most always, in these cases, evidences of intestinal disorder,
           14 
106        NON-INFLAMMATORY DISEASES.

such as foul tongue and breath, irregular state of the bowels,
variable appetite, &c, to correct which, nothing will be found,
in general, more useful than the "Aloetic pills," so frequently
already advised.   A  sufficient number of  these  should  be
taken every other, or every third night, to  procure  one or
two gentle movements  of the bowels  the  succeeding day.
After these have been persisted in for some time, some bitters,
such as wild-cherry-tree, poplar, and dogwood barks, in equal
quantities put into whisky—or what is  better, the carbonate
of iron, may be used with advantage.  The  diet should be
nourishing.  Lean meat,  milk,  weak  tea  and  coffee, light
wheat bread, and fruits, in moderate  quantities,  may  be al-
lowed.  Daily exercise in the open air, and even moderate
labor should be enjoined.   The use of Tobacco in this complaint,
as well as in all others, and in health, is decidedly injurious.
These directions, put into practice and accompanied with good
cheerful habits, are in most eases, successful in mitigating
hysterical habits.   If evidence  of worms should be present,
the pink root should first be given, according to the rules laid
down under the head of Worms.
  (d) Indigestion or Dyspepsia.   A disease extremely common,
and one that, from the extensive range of symptoms and un-
pleasant accompaniments that attend it, deserves careful in-
vestigation, is Dyspepsia or Indigestion.  It will not, howev-
er, comport with the design of the author of the present vol-
ume, to enter at large upon the examination of  a disorder,
that requires all the sagacity of medical men to understand
the nature and causes of  the  various and  multiplied symp-
toms that often attend it.   In the west, indigestion is extremely
common, and its prevalence is, undoubtedly, in a great meas-
ure, due to two circumstances—first, to the injurious  eflects,
operating upon every one within its influence, of  the  atmos-
pheric cause of our autumnal  fevers.   This  is a cause over-
looked, very often, but it is a cause of derangementin the func-
tions of the digestive  apparatus, and  consequently of ill di-
gestion.   Secondly, a coarse, heavy, indigestible diet.  These
two causes are often  conjoined in the  same individual, and 
           NON-INFLAMMATORY  DISEASES.        107

then they are apt to excite a condition of which it is troub-
lesome to get rid.
  Of the nature of Indigestion,  I  may say it is pretty well
understood.  In its earlier stages, it seems to depend upon a
deranged condition of the nerves of the stomach.   This nerv-
ous derangement is of such a nature as to prevent the stom-
ach from performing its functions properly.  Now, food taken
into  a disordered stomach, instead of undergoing the changes
necessary to its elaboration into the general system, lies heav-
ily there until it, in some measure, putrefies, when it, of itself;
becomes a source of disease, and an irritant to the tender
coats of the stomach.   The  stomach  may reject food thus
circumstanced by vomiting, or rather gulping it up ; and food
when thrown up, in this manner, is nearly always found in a
soured or putrid  sort of state.  The stomach  being in this
condition, and more food being continually  forced  upon it
than it can digest, inflammation  of a  low form is presently
excited in its coats,—and this,  not unfrequently, extends to
the liver, and constitutes what is commonly called '•'■Liver com-
plaints?''   It is the opinion of many that dyspepsia necessarily
implies a spitting or gulping of food, but such is not necessa-
rily the case.  A dyspeptic may, it is true, and often does spit
or gulp up what he has  shortly  before taken, but many dys-
peptics do not, during  the  whole course of their ailment, do
so.   Any deranged state of the  stomach, interfering with its
office, is properly a dyspeptic or indigestive  disorder.  The
half digested food, in such  cases, ma)'  be carried off through
the bowels, instead of being  thrown upward, by an inverted
action of the stomach.   Be this as it may,  however, in all
cases of  dyspepsia that  do not speedily destroy life,—and it
is very rare, indeed, that the disease runs anything of a rapid
course,—barely  a sufficiency of food, and sometimes not even
this much, is, by  the  action  of  the  stomach and bowels, so
changed as to prepare it for entering into the general system
as nutriment to supply its wants, and  the overplus has to be
disposed of, as already mentioned, in a soured or half putrefied
state, either naturally down through  the bowels, or unnat-
urally, up through the mouth.   And right here, as well as 
108        NO N-INFLAMMATORY DISEASES.
anywhere, I may make the practical remark, that one morsel
more food than can be healthily digested, must, necessarily,
be in some measure, more or less, injurious.  Fragments of
undissolved food, in their  long travel along the intestinal ca-
nal, must be, I repeat, a  source  of irritation to the tender
surface over which they pass.  Hence, the necessity of using
just a sufficiency of food, and no more, to supply the  absolute
wants of the system, or  to correspond to the ability of the
digestive system, for macerating and carrying it, thus prepared,
into the blood.  The health  of  thousands of children is an-
nually sacrificed for want of an observance of this kind.   Al-
most before their eyes  are opened, it is, too often, the custom
with the kind-hearted old ladies, to fill their tender stomachs
with some  rich  and indigestible soups.   These are sure to
decompose and  sour, sometimes in the course of a few  min-
utes, thereby producing colic and griping pains in the bowels:
the child cries, and the nurse,  taking  this as a criterion for
hunger, repeats  the  dose again and again, until finally the
little creature dies in excessive agony, in the midst of convul-
sions, or, what oftener happens, insulted nature relieves  it by
vomiting or purging the excess thus  accumulated  upon its
feeble and untutored powers of digestion.
  Respecting the symptoms of Indigestion, they are so discrepant
that a general view of them is  all that I shall attempt.  It
sometimes happens, as has  already  been stated, that sooner
or later, after eating, the food, slightly changed, is gulped or
Bpit up.  This, though  not by any  means  a uniform, when it
is present is an  unmistakable symptom of dyspepsia.  An-
other symptom,  scarcely less  certain, is, shortly after eating,
the occurrence of  pain about the  stomach, and belching of
putrid gas or wind.  This pain is  sometimes  trifling, while,
at others, it is most acute and excruciating.  The bowels are
most often bound, but they  are sometimes too  open ; the
tongue is very uniformly coated or otherwise deranged ; and
the urine is almost always high-colored—frequently resembling
lye.   The skin is often yellow or dusky, and some soreness is
very commonly found to exist at the  pit of the stomach.  It
is extremely common for  dyspeptics  to be  tormented  with 
           NO N-INFLAMMATORY  DISEASES.        109

headache, and,  in a majority  of instances, the sick headache
is nothing more nor less than a symptom of a dyspeptic or dis-
ordered state of the stomach.   Physicians are habitually con-
sulted concerning sick-headache; persons supposing it to be a
disease, separate and apart from  all others, whereas, it is,
most often, but a reflexion, so to speak, from the stomach to
the head.   Correct the stomach, interdict gluttony and the use
of heavy, indigestible diet, and we  cure the disease  either
temporarily or  radically, according to the fortitude of the pa-
tient in denying him  or  herself.  Nervous symptoms of an-
other kind often manifest themselves.  Thus, females may
have palpitation of the  heart, and sometimes regular fits of
Hysterics.   Males are apt to be low spirited, to  fancy  them-
selves  as the recipients  of the most serious complaints, as
consumption, &c.  Indeed, insanity, I have good reason for
thinking, is often the offspring of this  affection—the patient
first becoming morose, absent, melancholy, and insane.  Many
poor fellows, suffering from indigestion,  are so crabbed, so
easily  excited and put out  of  fix,  that they are not only un-
happy to themselves, but also disagreeable  to their too fre-
quently cold-hearted friends.
   The Causes  most commonly concerned in giving origin to
dyspepsia, have been anticipated.   Improper diet and over-
eating, are  by  far the most  fruitful; but long living in un-
healthy situations, frequent  attacks of our western fevers,
when conjoined with these, are powerful auxiliaries in  bring-
ing this affection about.  Tight lacing,  by cramping the
stomach, as well as some of the organic functions of this
organ itself, may give rise to  all the unpleasant symptoms of
indigestion.
   Of  the  Treatment.—Almost every dyspeptic has  it com-
pletely in his power to cure himself, if he but  comprehend
the principles  of treatment,  and  possess the fortitude  and
selfdenial to put them into practice.  The natural action or
powers of the stomach must  be restored.  Now if weliave
a horse greatly enfeebled  by too  much  work, laden  with a
great burden, how shall we so effectually restore his strength, 
110        NON-INFLAMMATORY  DISEASES.

as by taking off his load, and giving him rest ?  Put more
upon him, load him heavier, and drive  him faster, and what.
are the obvious results ?   Likewise, it is with the stomach of
man.  By abuse, already enfeebled,  it  must have rest, or it
goes on, departing farther and farther from health—becom-
ing more and more enfeebled—until, finally, it refuses to per-
form its office altogether ; and the patient perishes, because
the very root of his existence  has been destroyed.  But,  on
the contrary, let it have rest;  remove from it, as far  as pos-
sible, every source of irritation ;  give it no more labor to per-
form than it can accomplish without fatigue, and soon it will
be, ten to one, restored to its  natural strength; and through
it, the whole sympathising organisms to their original uni-
son  of action.   Dietetic regulations, then, it would seem
form the first and chief indication of cure in all cases of  in-
digestion.  Now there are certain articles used as food  for
man, which are dissolved with much more ease and facility
than others are.  Great  pains have been taken to ascertain
what these  are, and  to  institute comparisons between the
various articles of diet, as to their digestibility and nutritious
properties.  The results  of experiments of this kind are very
satisfactory.  Among all the articles of diet in  general use,
there is none, which,  while it is superlatively rich in nutri-
tion, is so bland and  nutritious  as milk.   If, therefore, upon
trial it is found to agree with the stomach, good sweet milk
should form a part, indeed, a  great part, of the dyspeptic's
diet.  And even this, in many instances, should be taken in
very small quantities—only a  few spoonfuls at a time.   In
union with the milk, a little well cooked rice, or what, per-
haps, is equally good, a  little  well made light bread may be
taken, from time to time.   I would advise  these simple arti-
cles to be taken in quantities sufficiently small to insure their
retention on the stomach; because it is infinitely more  ra-
tional to do this, than to  so load the stomach as to offend it
and cause it to reject, by vomiting or gulping up, the greater
part of its contents, or to run the risk of iritating the  bowels
by crowding  along their  tender surfaces  the  half digested 
           NON-INFLAMMATORY DISEASES.        Ill

and putrid substances, which the stomach was unable to dis-
solve.   Lean and tender well cooked meat, in small quanti-
ties, it will be proper to allow once a day.  So, also, it may
be said  of a cup of weak tea or coffee; but much "fluid, of
any kind, should not be used, either during or between meals.
All fatty or greasy substances  should  be scrupulously  ab-
stained  from.   Well ripened and mellow acid fruits, provided
the seeds and skins  be avoided, may, I conceive, be  moder-
ately indulged  in; an Irish potato may, also, occasionally be
allowed ; and  so, also, may a softly poached egg.   So much
for diet.
   Unless proper dietetic  laws  be observed, it is worse than
useless  for dyspeptics to take medicines at all.  Their appe-
tites are often  morbidly sharp, but if they expect to ever re-
gain their health, they must not pamper them too  highly.
And this remark is particularly  applicable to  those of them,
who are continually haunting doctor shops.  As I  assume in
this volume to advise no  other  than safe and  simple medi-
cines, I will not venture to  speak of mercury as  an  appro-
priate means for combating certain disordered states of  the
liver, that are  apt to be present in indigestion.  Nor shall I
 advise  the indiscriminate use of strong bitter tonics.  They
 may now and  then be useful, but my experience enables me
 to say,  with confidence,  that they  are often  hurtful.  It is
 proper that physicians themselves  prescribe them.   But the
 same objections cannot with propriety, be urged  against the
 use of an occasional purgative.  To  obviate costiveness,
 therefore, an occasional dose of mild  purgative  pills should
 be taken at bedtime.   For  this purpose  there can be found
 no preparation, which, for  safety and  simplicity,  is equal to
 the " Aloetic Pills"—see  this  head. But these need  not be
 taken oftener  than once or twice a week; or only, according
 to the indication to be fulfilled by their exhibition.  Among
 all the pills with which I am acquainted, I know of none so
 pleasant, mild, and at the same time so effectual in their op-
 eration as a simple cathartic, as these  Aloetic Pills.  Mr. P.
 J. Nicholson of this county, who learned how  to  prepare 
 112       NO N-I NFLAMMATORY  DISEASES.

 them from a physician  of some notorietv—but who, like a
 genuine quack, keeps his light under a bushel;  had the good-
 ness  to  communicate  to me the necessary information  for
 their preparation.  To correct the acidity or sourness of the
 stomach a solution of  a  few grains of saleratus, or  a  little
 weak lye will be good.  To restrain the diarrhoea or lax state
 of the bowels that sometimes accompanies  indigestion, the
 most useful direction is, to  eat  less.  If, however, this is not
 successful, a few spoonfuls of the Alum Cordial, (see alum) may
 be of benefit.  To relieve the severe headache, sick-headache,
 that frequently attends ill digestion, a dose of salts, or castor
 oil will generally be promptly successful.  Opium is now and
 then useful in allaying the paroxysms of pain in the stomach,
 but its use should be  cautiously indulged.   With these re-
 marks, I take leave of indigestion and pass on to a brief ex-
 amination of its kinsman—
  (e)  Jaundice.   Now,  as was  intimated above, a yellowish
 tinge of the skin and of the  whites of the eyes, is in some
 cases, signs of indigestion, and demands no  farther notice
 than that already bestowed upon this latter  affection.  But
 persons in the enjoyment of comparatively good health, are
 occasionally attacked with  Jaundice.   Their skins, eyes, and
 even  their tongues are deeply tinged yellow.   Their bowels
 are apt to be rather lax,  and the stools present an unnatural
 white color—clay color; the  urine is  of  a  deep lye color;
 appetites impaired, their heads may ache, but fever does not
 necessarily form a part of the disease ;  a bitter taste  is very
 apt to be complained of.  A dull heavy pain is now and then
 felt under the points of the short ribs of the right side ; this
 pain is  sometimes sharp and acute   These  are the most
 common symptom.? of jaundice,  but they are occasionally
 discrepant.  The disease is not  often  attended with much
 danger, but it does in some instances, run  a tedious course,
 and, by impairing important functions, may carry the patient
 off.   In a majority of cases of simple jaundice, a light  and
unstimulating diet with rest, will, in a few days, relieve the
system.  It is well, nevertheless, to use an occasional  dose 
           NON-INFLAMMATORY  DISEASES.        113

of gentle purgative pills, such as those referred to in the last
section.  In more obstinate cases, calomel or the  blue pill
should enter into the  purgative  medicine.   The  causes  of
jaundice frequently elude the most careful investigation, but
they, in some way, operate upon the liver, so as to obstruct
the flow of bile into the intestines ;  and, being thus impeded
in its natural course, it is  carried somehow  backward into
the blood, whence  it was  abstracted, giving thus, to  every
structure, an  undue amount of bile, and tinging every part
with its peculiar  coloring matter.
   CO  Of Worms.—I may as well, in  this  place, as in any
other, give some  account of intestinal worms.  Although they,
of themselves, do not  constitute  a  disease proper, yet their
effects and complications are such as not unfrequently to re-
quire our interference.   There are  at  least four varieties of
worms that infest the human intestines.  In this country
three of these are rare, but the other is exceedingly common.
   1. The Tape Worm is  a very curious creature, occasionally
of many yards in length.  It presents a jointed appearance,
resembling, somewhat, a string of gourdseeds, placed end to
 end.  It is rarely the case that it is  passed away whole, be-
ing usually broken up into many pieces.  I have never seen
 but one of these creatures, and that was preserved in alco-
 hol, and exhibited to the students of Rush Medical College.
   2. The Maggot-like Worm.—Ascarides Vermicularis, is not
 often met with.  It is quite small, not measuring  more than
 one or two lines in length, and is almost uniformly found in
 the lower portion of the bowels, wadded with others in such
 a manner as to be formed into a ball.  Immense numbers of
 these are  sometimes found thus congregated, and the most
 characteristic symptom of their presence is the unpleasant
 itching produced by them  about  the anus.
   3. The Maw  Worm, is also, comparatively rare, and holds
 a place, as  to size, between the last  and the fourth, or next
 to be noticed.   They vary in length from  half an inch to
 several inches;  and, in  thickness, they are little larger than
 a horse hair.
              15 
 114        NON-INFLAMMATORY  DISEASES,

   4.  The Common Round  Worm—Ascarides Lumbricoides, is
 so common in this country as scarcely to require description.
 A vast majority of all the children of this country, and in-
 deed, many grown  up persons, are, to  a greater, or less  ex-
 tent, the subjects of these ugly and troublesome intruders.
 I have practiced medicine for near six years, and I can safely
 declare," that, during this  time, I have scarcely ever prescri-
 bed a worm medicine to any child, without carrying off more
 or  less worms; not unfrequently enormous quantities.   A
 few days  ago, I prescribed a worm medicine to a child six-
 teen months of age, and, as the father subsequently informed
 me, with the effect  of bringing away more  than two hun-
 dred worms of the present species. Nor do I neglect in most
 cases of the diseases of children, be their nature what they
 may, to attempt to rid the bowels  of worms, should circum-
 stances lead me to suspect their existence.  The present va-
 riety of worms are in general found in  the upper portion of
 the intestines,  and in the stomach.  Of course, they vary
 greatly in length; while some are but a few  inches,  others
 are, not uncommonly, more than a foot.
   Symptoms.—Unless we judge from the occasional passage
 of a worm through the bowels, or from their being vomited,
 which  sometimes happens, I  may safely say, we have no
 certain, infallible  sign of the presence of worms in the hu-
 man subject.  It is true, nevertheless, that we  infer their ex-
 istence from a combination of symptoms  and circumstances.
 If the individual under examination, whether a  child  or an
 adult, have a full tumid abdomen, a wan and sickly appear-
 ance, a foul breath, an irregular state of the  bowels, picks
 the lips and nose, has a voracious appetite, sleeps illy, com-
 plains of sudden and sharp pains through the bowels, and
 discharges a muddy sort  of urine, we infer worms. But, if,
with these symptoms, worms are now and then voided, either
from the bowels or  by vomiting, this inference is  strength-
ened into proof positive.
  About the" origin of  intestinal worms, a great deal  has
been said  and written, but, I am sorry  to add, that as  yet, 
           No N-INFLAMMATORY  DISEASES.        115

as far as 1 know, the whole subject is one of complete mys-
tery.  While one contends that they  are spontaneously gen-
erated in the bowels themselves,  another, with more show
of rationality, concludes that the germ, which produces them
is somehow, introduced from without.  But this latter theory
as well perhaps, as the former,ds completely overthrown by
the single fact, that they have been found in  the bowels of
new born infants.  One fact, however, and it is of practical
importance, is well established concerning the presence of in-
testinal worms.  It is, that they  stand, at least, in  a  very
great majority of instances, in relation  to a preexisting de-
rangement, as  an effect.  I conceive that they originate, on-
ly, in consequence of a previous  disordered state of the di-
gestive  aparatus ; yet their presence, undoubtedly, increases
and adds  to that  disordered state, and very  often,  even so
disguises  and obscures it,  as to become the most  prominent
symptom, and to  require our  first attention in treatment.  I
am aware that it is the opinion of many persons, that a cer-
tain number of intestinal worms are  necessary to the health
and well  being of every child ; but  such an opinion is ab-
surd in  the extreme.  On  the contrary, their presence inva-
riably evinces a deranged state of the digestive organs.
  Treatment.—Now  although I do  not  doubt that  intesti-
nal worms are, in most cases, an effect or  accompaniment
of disorder of the stomach and bowels, yet all attempts to
right  such  a  disordered  state, without first  removing the
worms themselves, will prove abortive.  It is, therefore, un-
der almost  all  circumstances, proper to prescribe a worm
medicine, whenever we infer the presence of worms  in chil-
dren ; and the same remark is equally applicable to  adults.
Then, after the bowels have been freed from these parasites,
it will be proper, by dietetic regulations, and medicines, if need
be,  to correct the cause which, in the first place, favored their
production.  To fulfil the  first indication, the Spigelia Root,
commonly called Carolina  Pink, will, in general,  answer an
admirable purpose.  The  following  is a very good   method
for administering it:  Take from half an ounce to an ounce 
 116       NON-INFLAMMATORY DISEASES.

 of the root, to which add a pint of boiling water, and, after
 it has been permitted  to simmer  for half an hour, the tea
 should be strained, so  as to separate it from the root.   Of
 the tea, thus  prepared, being first  made pleasantly sweet,*a
 child of two years old, should take the amount of two large
 tablespoonfuls every hour or .so, until  six  doses have been
 used.  If, in a few hours after the  last dose has been swal-
 lowed, the bowels are not opened, a full dose of Castor Oil
 should be given; but, if the bowels are  in a lax state, the
 oil may be neglected.  A course  of this  kind hardly ever
 fails to expel worms, when  they are present in the bowels.
 The doses here recommended should be varied according to
 circumstances.
   " B. A. Fahnestock's  Vermifuge,"  so  extensively sold
 throughout the western country, is, undoubtedly, one  of the
 very best worm  medicines ever invented; and, were  it not
 that Fahnestock, instead of heralding the recipe, by which he
 prepares it, to the world, as the  free gift  of a benevolent
 heart, carefully conceals it in his own selfish bosom, he would
 deserve a place among the  first benefactors  of the present
 age.  But, as it is, his name should go down to posterity ob-
 scured, as  well by the shame, as brightened  by  the fame
 which he has gathered around it.  Since writing the  above,
 I have had an opportunity of observing the effects of " Mc-
•Lane's Vermifuge,"  a preparation very similar to that of
 Fahnestock;  and, although the same remarks  applicable to
 Fahnestock, are equally so to  McLane, yet candor compels
 me to confess, that its  effects have been highly satisfactory ;
 indeed, astonishing !  Both these medicines owe their virtues,
 chiefly to the Oil  of Wormseed, which they contain.
   After the worms have been expelled, a  nutritious, but not
 gluttonous diet should be allowed ; and if some of the  milder
 preparations of iron  be administered until the child's color is
 restored,  the worms  will hardly again be  generated.  The
 treatment here proposed is not equally  applicable for the ex-
 pulsion of  every variety of worm ; it is the most proper for
 the most  common; the long round worm.  The spirits  of 
           NON-INFLAMMATORY DTSEASES.        117

turpentine, in large doses, is perhaps, the best medicine we
possess for the expulsion of the T,ape Worm; and the same
may be  said of Aloes, for expelling the" small maggot-like
worm that inhabits the lower bowel.  But it is only seldom
that we meet with either of these latter worms.   Physicians
should, therefore be consulted when they are suspected.  The
symptoms are, in a great measure, analagous in all.
  (g)  Of  Colic.—Physicians recognize two or three kinds of
colic, but  as these  are not  very diverse, and require  only
slight modifications  in treatment, I shall examine them all
under one  head.   When the liver is greatly disordered, and
the patient vomits frequently,  the  disorder is usually styled
bilious colic, whereas, when these  symptoms, are  absent, the
simple name colic, is applied.   Now it may be laid down as
a truism that, were there no undigested food, or  compound
substances undergoing changes in the stomach  or  bowels,
we would never meet with a case of colic.  It is, therefore,
a disease, or rather an effect of some decaying or  decompo-
sing substance in  the  intestines or stomach.   And gas, or
wind, thus generated, is essentially the  disease itself.   And
all the symptoms, however distressing and agonizing, while
the disease is  yet colic, are owing, and to be referred to the
distension thus occasioned.  Every one knows that certain
articles of diet will invariably produce  colic in certain  indi-
viduals.   This fact explains fully the  nature of colic.  The
substance, whatever it may be, instead of undergoing the
solution and digestion, necessary to convert  it  into chyle,
runs rapidly off into a putrefactive state, parts with a gas,
(air,) which fills or distends, to a greater or less extent, the
digestive  canal, and often gives rise to all the excruciating
symptoms of colic.  Digestion being in this manner arrested,
the cause, as well as the symptoms, goes on increasing, the
patient suffers exceedingly, his abdomen swells  smartly, he
rolls about over the room, presses his belly upon some  hard
substance, moans, &c. &c, until, at length, he vomits, belch-
es up, or discharges down a  quantity of wind, when he  is
immediately greatly relieved, or he is relieved by the appro- 
  118        \ () N - I N F L A M M A T O R V DISEASES.

  priate medicines; or lastly, inflammation  is developed, and
  the disease is no longer simple colic. From what has been said
  it is readily seen how it is that dyspeptics  are so often the
  subjects  of colicky pains.  Little  children are apt to suffer
  very greatly, in  the same way, the cause of which is, nine
  times in ten, over feeding.
   Colic is to be distinguished from inflammation of the stom-
  ach and  bowels; 1. By  the  suddenness  of the  attack.  2,
  By the absence  of fever, and of an increase  of pain when
 pressure is made on the belly.  Indeed, pressure  often gives
 relief in colic, but, on the contrary, it increases the suffering
 in inflammations within the  abdomen.
   For the  relief of colicky affections, I know  of  no remedy
 that, in a majority of instances, will be found so effectual as
 castor oil, in union  with the spirits of turpentine.  To an
 adult give 30 drops  of the turpentine, mixed with  a table-
 spoonful of oil, every two  or three  hours until purging  is ex-
 cited.   It sometimes happens however, that the  stomach is
 so irritable that it rejects every thing of this  kind.   When
 this is the case, 15 or 20 drops of laudanum should be given
 every half hour,  and the  stomach  poulticed with mustard,
 until it is quieted.  Great  caution should be exercised in diet
 for a few days after  an attack of colic ; and  indeed, every
 article should be abstained from, for  life, that  has, upon re-
 peated trials, been found  to excite  colicky pains.  For  chil-
 dren only a few drops of the turpentine  should be added to
 a teaspoonful  of the oil, to be repeated according to circum-
 stances.   When inflammatory symptoms arise, the disease
 is to be regarded as  momentous, and medical aid should be
 sought.
  (h)  Rheumatism, perhaps should have been placed among
 the inflammatory diseases, yet as it is often met with when
 neither swelling nor heat appears,  I  have placed it in the
 present class.  Many persons are  predisposed  to  rheumatic
 attacks, but the  effect of  cold, operating  on the body is, I
believe, always the efficient cause in setting the disease up.
There are two forms of rheumatic disease—the acute or ac-
tive, and the chronic or seated. 
            NON-INFLAMMATORY  DISEASES.        119

   The acute variety commonly  comes  on suddenly, and  is
 characterized by pain, redness, heat,  and swelling of one or
 more joints, attended with  febrile  symptoms, as headache,
 thirst, high colored  urine, and  costiveness.  The  inflamed
 joints are extremely painful, and the ability to move the af-
 fected limbs is often almost wholly destroyed.  The disease
 may be confined to a  single  joint, or it may, on  the other
 hand, be general  and affect a great number at  the  same
 time.   In the chronic variety, being frequently a consequence
 of the acute disorder, there is pain, but not commonly much
 heat or swelling, and in most cases, the constitution remains
 undisturbed.   Chronic rheumatism is not always  a conse-
 quence of the  acute.  It  is  sometimes a  primary affection,
 coming on suddenly or gradually, affecting first this joint, and
 then that; passing from the wrist to  the ankle, it maybe, in
 the  course of  a few  minutes, the one being simultaneously
 with the attack on the other.  If this form of rheumatism
 continues a very great length of time, the  affected joints are
 apt  to become enlarged, and the  limbs contracted  or  drawn
 so as, in a great measure, to make  a permanent cripple of
 the patient.  Moreo\er, his constitutional  powers, in conse-
 quence of pain, irritation, and want of (rest,  for night is the
 time that the pains are almost sure to become very greatly
 aggravated,) are apt to be so undermined as to destroy  life,
 after the lapse of many years.  This  form  of rheumatic  dis-
 order, let the nature  of the acute be what it may, in many
 respects bears  a close  resemblance to the nervous diseases.
 But  I will not argue the  point here.   Both acute and chronic
 rheumatism spend their force, chiefly, upon the ligamentous
 tissues, the bonds of union of the joints.
   Treatment.—In  acute  rheumatism, active  treatment  will
 frequently cut the disease short.   Physicians are apt to bleed
 in the  very beginning  of the  disease, but they are aware
 that  bloodletting of itself, is  inadequate  to effect a cure.  I
 advise my reader to purge his patient, in the first place, pretty
 freely with epsom salts, and then, to keep  his  bowels  loose
with equal parts of the flower of sulphur and cream of tartar. 
120       NON-INFLAMMATORY DISEASES.

Of a mixture of this kind, a teaspoonful should be used from
time to time, so as to keep up a lax state of the bowels.  The
swelled joints may be bathed  and steamed with  flannels
wrung out of hot water, with a prospect of benefit.  If this
course fails to relieve the patient, after a few days trial, the
Dover's powder, (see Index,) should be commenced  with, in
three grains doses,  to be continued until a general perspira-
tion is  excited, or until the pain is abated.
  If the disease becomes chronic, the swelling and heat hav-
ing disappeared, but the pain remaining unrelieved; or should
the attack be  one  of a  primary chronic  form, the patient
should wear flannel next his skin  both summer and winter;
his bowels should be kept open with the mixture  advised
above, and he should use a tablespoonful of the " Tincture
of Guaiacum" three or more times daily ;  and, if he suffers
much at night, five grains of the Dover's powder taken just
before retiring, will be apt to procure him rest.  The tincture
here alluded to, may be procured at any drug store.  Diet in
both cases should be light, but in  the  chronic form, it should
also be nutritious ; meat, in reasonable quantities, being al-
lowed.
  (i) Dropsy.—A dropsy, in its medical and restricted  sense,
means an accumulation of  a watery fluid within some natu-
ral or artificial cavity of the body.  For example, we  have
dropsies of the chest, of the abdomen,  and  of the brain. We
have also, either  connected with these  conditions, or inde-
pendent of them, a general dropsical  affection, in which the
water is  effused into the  muscular structures, causing  them
to present a puffy or bloated appearance.  Dropsy may be,
and often is, the result of inflammatory diseases.  Thus, the
most common  cause of  the disease  styled  dropsy of the
brain, is inflammation.  The same may be  said of dropsy
of the chest, and also of abdominal dropsy.   It is, therefore,
in many instances, a symptom of another  disease, or rather,
I should say, an effect.   When it comes on people, however,
who are in the enjoyment of health, and who have not re-
cently had any serious inflammatory disorder ; when in short, 
           NON-INFLAMMATORY DISEASES.       121
        *       **
we have no Evidence that anything else is  the matter, other
than the dropsy, then  we pronounce the disease to be pri-
mary, "independent of previous disorders.
  The   existence of dropsy is  to  be inferred more by the
eye than by any other means.  When, with a bloated state
of the whole muscular system, we  see  the belly distended,
we infer abdominal dropsy ; this  inference is  strengthed,
when upon inquiry, we find that the urine  is scanty.   But I
need not dwell upon the  symptoms of dropsy, for the public
do not recognize the disease until it is visible to the eye ; nor
can  any very accurate description be given to them, where-
by to detect it otherwise.
   In all dropsies, whether  primary or  secondary, the  imme-
diate cause, whatever be the remote one, is a want of bal-
ance between the bloodvessels and the absorbents, or that
system of vessels, whose office it is to pick  up and carry  off
the  wastes and more  fluid parts of the body, which, not be-
ing  thus removed, collect in the part or parts,  and in this
 way, in time, form, the ctropsical accumulations, in question.
   Now the proper treatment of dropsy, plainly consists in  re-
 storing the loss of balance in the  two sets of vessels,  above
 referred to.  To fulfil this indication, those purgatives which
 produce copious watery stools are to be  unremittingly pre-
 scribed.   The  cream of tartar, in union  with rhubarb  or
jalap, answers this purpose very  well; and,  at  the same
 time, it is  apt to act upon the urinary organs so as to increase
 the quantity of urine.   When the  disease is secondary, that
 is, when it depends for  its cause  upon a  previous disease,
 the primary condition is entitled to our  first consideration.
 It must first be attended  to, and  if possible,  removed,  and
 with its disappearance, the dropsy is, also, apt  to disappear.
 It is proper to remark, that sometimes every means  directed
 to the removal  of the disease, fails, and for the  removal of
 the accumulated fluid we have to  adopt the dernier, but tem-
 porary remedy of tapping the body, as you would a sugar-
 tree ;  and, in this way  drawing from it  the  excess of fluids
  that it contains.  I said temporary, because nearly  always,
               16 
122        NON-INFLAMMATORY DISEASES.

after this operation is begun, it has to be repeated, again and
again, during the  whole  of the  patient's  subsequent  life.
This is especially true, in the  abdominal  form of this affec-
tion.
  In conclusion, I remark, that  in  the  whole catalogue of
diseases, there is not one more  deserving the physician's at-
tention than dropsy.  It may depend upon such a multiplic-
ity of diseased conditions, some of the  symptoms attending
it are so anomalous, and all the rules of treatment,  that can
be laid down are so liable to modifications  and  exceptions,
that I am  constrained  to conjure my reader, as the very
best advice I can give him, to call able medical counsel in,
at as early a date as  possible,  when he has good reason to
suspect the existence of dropsy.
  (J) Cholera-Morbus.—I need not occupy much space in in-
vestigating this  affection.  Every one is familiar with the
symptoms of cholera-morbus.  It is an affection that  prevails
as a general rule, during the heat of summer,  and appears
to be the effect of improper diet,  conjoined with the heat of
our seasons.  Let it be caused, however, as it may, the symp-
toms are vomiting and  purging,  accompanied  in  many in-
stances, with cramps  of the  belly, legs, &c, and the  most
excruciating pains of the bowels.  The vomiting is frequent-
ly incessant, and the stools are  copious and watery.   It is a
disease that now and then results rapidly fatal; the patient
sinking and dying of exhaustion.
  The treatment of cholera-morbus is, for the most part sim-
ple, but it is frequently indispensable to the patient's safety,
that it be prompt.   Opium—laudanum; is the great remedy
for relieving the pain, checking  the  purging, and suspending
thejvomiting, in  almost all cases of cholera-morbus.  But this
medicine is to be facilitated in its operation by certain other
auxiliary means. Mustard poultices should  be placed over
the stomach and to the  wrists and  ankles.   The  laudanum
should be given  in doses of thirty drops, repeated every  half
hour until relief is obtained.  It is not unfrequent  that the
patient vomits the laudanum almost as soon as it  is swal- 
           NON-INFLAMMATORY  DISEASES.        123

lowed.  When this happens the medicine should be repeated
again and again, until it is retained in  sufficient quantities,
to fulfil the object for which it was exhibited ;  in the mean-
time the auxiliary means above  pointed out, being put into
practice.  Cholera-morbus is, on some occasions, followed by
a continued sort of fever, kept up chiefly, perhaps, by the low
form of inflamation of the bowels that  generally supervenes
on the subsidence  of the affection.   Low diet  with blisters
to the abdomen are the leading indications of cure. 
                     CHAPTER  IX.

       OF SPECIFIC  OR CONTAGIOUS DISEASES  IN GENERAL.

  Class Fourth :—This is a somewhat numerous class of dis-
eases, including  as it does, every  distemper  that is, by any
means, communicable  from one person  to another.  There
are many affections of  this class that, to be  communicated
from one individual to  another, requires  nothing but a near
approach to the persons laboring  under them, as  Measles,
Small Pox, Whooping-Cough, &c,  while others require actu-
al touch, as Clap, &c.  This latter variety is  usually termed
infectious.   My design however, is, in the present  place, to
notice only the first variety here mentioned — those affections
which are conveyed  at some distance from the affected per-
son.  Now there are several curious things  connected with
these catching distempers.   In the first place, they pursue a
definite course, — that  is, they come on, after exposure to
contagion,  uniformly after a certain number of days; the fe-
ver which attends them reaches  its height  on the second,
third &c, days, according to the nature of the particular dis-
ease in question, and they decline and pass away  at a regu-
lar  stated time.  Nor can any treatment or management cur-
tail  or shorten their course.  It is, therefore, obviously  the
Physician's duty to  guide,  direct  or convey them on this
course, and by no means, by a bold  and reckless  stroke, at-
tempt to force them from the system before they have reached
their destination.  An attempt  of this kind is  exceedingly
improper and  cannot  be too severely  reprobated.  Many
young Physicians, and  indeed, some of  riper years, but no
more discretion, commit the  egregious  error of  doing  too 
CONTAGIOUS  DISEASES.             125
much in these specific affections; — thereby not unfrequently
thwarting nature and trammeling her in her efforts to relieve
the suffering  organism.   A rather singular and interesting
fact connected with the history of  the present  class of disea-
ses, is that a  turn or an  attack of them forever  afterwards,
as a general rule, protects the system against a second attack.
   Of the Cause of this class of diseases we  know absolutely
nothing.   We see it only as it manifests itself to our senses
in the effects it produces.  It is somehow  generated in the
body of one person, and, being conveyed through the medium
of the atmosphere, when inhaled by another, like leaven or
yeast, after a certain time, renews itself or generates its like
again.  In many respects, in its effects, it certainly bears
some analogy to yeast.   After being introduced into the blood
of a well person in an effluvial state, and after lurking there
for a certain length of time in a state of incubation or hatch-
ing, so to speak, it disturbs the whole system, manifesting it-
self in this form in this disease, and in that, in that disease.
   Of the Nature  of the diseases themselves, however, we are
not unknowing.  Whooping-Cough we know is a disease that
chiefly affects the air passages; that Measles is  a fever that
impairs  more or less,  almost all the bodily  functions;  that
Small Pox spends its force mainly on the mucous membranes
 and the skin, and that Scarlet Fever is an inflammatory dis-
 ease, of a low type, possessing an undeniable  tendency  to
 putridity and mortification.   These are  facts, tangible to ev-
 ery medical  man, and they are of much practical interest.
   Having premised these general remarks, without further
 tediousness,I pass to a brief notice of some of the individual
 diseases composing this fourth group of disorders.
   (a.) Small  Pox.   I  need say very little  respecting Small
 Pox, first, because, it is a frightful disease, secondly, because
 when prevalent in a neighborhood it never fails to be recog-
 nized ; and thirdly, because no one, 1 think, in the enjoyment
 of his senses, will neglect to call in medical  aid, if it can be
 procured, in its management.   Small Pox is exceedingly con-
 tagious ;  so much so, indeed, that it has been conveyed, or 
126            CONTAGIOUS  DISEASES.
rather the contagion which gives rise to it, carried hundreds
of miles in clothing or adhering to merchandize.   While a
Student of Medicine, I recollect hearing Professor Fitch re-
late the following circumstance, illustrative of the extremely
active  nature  of Small Pox  contagion.  He stated that in
attending a Small Pox patient in the  earlier part of his  pro-
fessional career, having removed some of  the scabs from his
face, he enclosed them in beeswax.  Next, boring a hole in
a gate-post, he inserted the bolus and drove a pin tightly upon
it.  Years afterward, when the Professor had forgotten all
about his thoughtless piece of work, the post becoming mea-
surably rotten, the  wax, thus stowed  carefully  away,  was
accidentally discovered, broken  open and examined, the con-
sequence of which examination  was, a case of Small Pox ex-
cited in the person of the unfortunate finder !
  The  Symptoms of  Small Pox  are,in from ten days to  two
weeks after the distemper has been contracted, the individual
is seized with  a burning fever, attended  with excruciating
pains of the head back  and limbs ; soreness of the throat,
thirst, nausea, and vomiting.   After these symptoms have ex-
isted for the space of about three  days, the peculiar  Small
Pox eruption begins  to make its  appearance, first on the face,
then the neck, &c, until extending itself, it finally spreads
to the whole body.  The eruption  upon its first appearance
resembles small red pimples.  These  go on, gradually in-
creasing in size, till  about the eighth day, at which time they
are  found to be filled with matter: they are now termed pus-
tules,— that is, little boils.   From this time these  pustules
usually begin to break — discharge their  contents — and scabs
are  formed which in four or five  days, fall  off.  About the
time the eruption makes its first appearance, the suffering of
the  patient and the febrile symptoms abate somewhat; but
about the time the pustules fill with matter the fever is apt to
be renewed; and it is at this time that the  greatest danger is
to be apprehended.   This is termed the secondary fever, be-
cause it seems to be a mere consequence of the excessive ir-
ritation communicated to the system by the numerous pustules, 
ft
               CONTAGIOUS  DISEASES.            1<g7

overspreading the whole body.  When the eruption is very
trifling, presenting but here and there a pustule, as is some-
times the case, the  whole  course  of  the disorder is com-
monly very mild, — the secondary fever being of little conse-
quence.   But, on the other hand,  if the  eruption be very
abundant, converting the whole surface  into one almost solid
mass of sores, the face being greatly swollen  and the eyes
completely hidden, we predict for the patient a case of great
severity, — the secondary fever  not unfrequently destroying
life.  Should the patient recover however, the scabs dry and
fall off, leaving behind them, thus, pits,  peculiar to this affec-
tion, which remain for life and constitute " pock-marks."
   The  Treatment consists in not doing too much.  The  pa-
tient must not be heated up and stimulated by close rooms,
heavy clothing, and  hot teas; but, on  the contrary, he is to
be kept  cool, his room being very well  ventilated ;  and he
 should, from time tc time, take  gentle  purgative  medicines,
 Opium is sometimes useful, and should be  given to allay ex-
 cessive  irritation, and to procure sleep.  The diet ought to
 be the same as that recommended in the worst inflammatory
 diseases, because it is the  inflammatioon of the skin that is
 the chief source of danger,  and  to keep this within bounds, a
 cooling, bland, and  even stint diet is among our most efficient
 simple means.   But the Doctors will be consulted invariably.
 I  presume, in the treatment of  Small  Pox, and they will, in
 some instances, resort to other means than those here recom-
 mended.  I have given the Treatment.  It may require auxil-
 liaries in this case, restrictions in that, but the principles are
 not to be deviated from with impunity.
    (b)   Of tlie Kine, or Cow-pox.   This disease, if indeed it de-
 serves the name of disease, is one of intense interest to every
 human being.   Much  cavilling among medical men has long
 been kept uj>, respecting its origin.  My own opinion is, pre-
  dicating it upon the best evidences that I have been able to
  collect, that the Cow-pox  is nothing  «iore nor less than the
  Small-pox modified by its transmission  through  the Cow.—
  For example : A cow contracts Small-pox,  somehow, by be- 
 128             CONTAGIOUS  DISEASES.

 ing milked by the hands of one who is laboring under the dis-
 ease, or otherwise,—from the human subject.  It takes hold
 of the-cow as it does* of the human bemg,,«nd pustules are de-
 veloped upon her bag  or udder.  Now, matter taken from
 these pustules and introduced into the body of man, instead
 of exciting in him Small-pox, gives rise to that mild and mod-
 ified disease in question—the Cow-pox, or in medical lan-
 guage, Vaccine disease.  But we do not go back to the cow
 to get a second  supply of matter.  The disease excites  its
 like again in the human body^and we may extend it, at plea-
 sure, from individual to individual, ad infinitum, in  the same
 manner that the brewer keeps up  his yeast, by transmitting
 small quantities of it from one cask  to another. Such, I re-
 peat, is my opinion.
   Let Cow-pox, however, originate as it may have done, to
 Dr.  Jenner the world owes  the discovery of  its protective
 agency against. Small-pox.  InJthe year 1796, having noticed
 that certain milkers wens;affected with a pustular disease,, ap-
 parently contracted from the cow, and,-observing further, that
 such persons did not readily contract small-pox,—he inferred
 the possibility of protecting all against the contagion of this
 latter disease, by introducing into their systems, by inocula-
 tion, the pustular disease taken-directly from the udde^ or bag
aof the cow; and, accordingly, began immediately to experi-'
 ment upon the human subject.  His experiments  were, as
 eveiy one knows, crowned with  the completest success.  For
 a time it was supposed that the vaccine disease, Cow-pbx, af-
 forded, in all cases, perfect protection against Small-pox ; but
 subsequent observation has proven this to  be erroneous.  It
 in true, that in  a majority  of instances, where vaccination has
 been successfully  practised, complete protection against
 Small-pox has been secured; yet, in sojne cases, it must be
 confessed, that although vaccinatioq^does not ptevent the in-
 dividual from taking the disease, it almost unifonmly renders
 it so mild—stifling it, as it were—that it is, in a great meas-
 ure, divested of  all its  terrors.   It was .the custom  of physi-
 cians, prior to the discovery of Jenner, to inoculate with the 
          ,      CONTAGIOUS DISEASES.             129

Small-pox matter itself, and, thus to excite disease at will;
but, although the disease excited in this way dpes not usually ;
prove severe or fatal, ydt, owing to its doing so occasionally,
and its  liability to be propagated  by contagion to  others, it
was always an exceedingly objectionable mode of  avoiding,
in after life, one of the most dreadful distempers to which hu-
man beings are obnoxious.   The  discovery of the illustrious
Jenner  obviates both of these objections ; for the vaccine dis-
ease scarcely ever—not one time in a thousand cases—pro-
duces serious consequences, while its protective influence, as '
has been illustrated innumerable times, is  so perfect  that
death, though Small-pox  should afterward occur, is so very
rare as not to  deserve notice.   Nor  is the Cow-pox, by any
means, other than by being introduced into the system by
the aid of inoculation or vaccination, contagious.
   The  proper  manner of  introducing the vaccine disease
intotne human body deserve^-a moment's notice.  We usu-
ally use tho^humanized matter—that is,  matter that is pro-
cured  from the  human subject.  This matter is obtained in
two forms :  tftfe fluid, while yet in the arm, and the solid, as
the scab after it has fallen from the arm.  If we have an op-
portunity of using the former,  it is only necessary to scratch
the skin of the person to be  vaccinated, and, opening the pus-
tule of the one now laboring under  the disease, we take a»
small bit of the matter on the point of a lancet, and appty if *>
.to the scratch.   If the scab is  to be used, taking a smatt bit
of it and reducing it to powder with a knife-blade, we add
just a sufficiency of water to form a pasty mass, when  it is
to be introduced in the same  manner, already indicated.—
Now it mattsrs not where the  matter is introduced, whether
in  the toe or in the forehead,  but custom has assigned the
middle of the left arm,  and it is well enough to observe tjjis
.uniformly.             '*'*-
   In about three days after matter has thus been applied to
:he  arm, some redness and slight soreness with a pimpled ap-
pearance «is seen to be present at the seat of the scratch,
which  gradually increases, until about the ninth day, when
             47 
130
C O N T A C I O U S DISEASES.
the part bears some resemblance to a common boil,  standing
upon  a widely inflamed base.  This is the vaccine pustule,
and it is  at this stage usually filled with a greyish  sort of
matter, presents a pitted or depressed spot just upon its top.
Gradually shrinking,  this pustule  dries into a  scab, which is
apt to separate and fall from its  hold about the fifteenth or
twentieth day from the vaccination, leaving behind a charac-
teristic cicatrix or scab that remains,  in  most cases, during
life thereafter.   It is  usual  for fever to be present in  young
and irritable subjects from  the  eighth to  the  eleventh or
twelth day, but this  is commonly trifling.   Some opening
medicines and low diet are all that need be done, in general,
for its palliation.   With regard  to re-vaccination,  I do not
think it necessary after it has once been successfully effected,
as I am not of the opinion that its protective agency is ever
lost.  Very young children I would not vaccinate, unless  of
necessity, to guard them from immediate danger, nor would I
introduce vaccine matter into the system of an invalid with-
out a similar reason.
  (c)   Chicken-pox.  This is a disease  of some interest, as it
may be mistaken for Small-pox, and, in this way, give  rise to
an unnecessary stir and bustle in  neighborhoods.  Constitu-
tional symptoms, such as slight pain of the head and back, some
heat of the body, thirst, with loss of appetite, usually precede
this affection.   The  eruption  shows itself earlier than in
Small-pox, the pustules never contain matter as  in Small-
pox, but  on the contrary, a thin yellowish fluid only; they
never form deep sores, and are usually beginning to dry up
about the third day from the first  appearance.  Chicken-pox
is regarded by many physicians as being  contagious.  Little
treatment, in general, is required in this affection.   To mod-
emte  the fever some small doses of salts may be beneficially
prescribed, but it is seldom necessary  to interfere at all.
  (d)   Measles  is frequently  a serious affection, and some-
times, owing  to unfavorable complications, or  to improper
treatment, a fatal one.  I know of no other disorder which,
while it requires little treatment, is so often mismanaged.— 
CONTAGIOUS  DISEASES.
131
Measles  is a specific fever, the most characteristic symptom
of which is, the peculiar eruption that attends it.  It is a con-
tagious disease, and usually makes its  attack about the tenth
day  after exposure to its contagion.   The  symptons which
precede the eruption are analagousto those of influenza, and I
once knew an eminent medical professor to pronounce a case
of Measles, prior to the appearance of the rash thereof, to be
an influenza, and to prescribe accordingly.  The patient com-
plains of debility, of aching pains of the back and joints; loss
of appetite, heavy and dull pain of the head; he is now and
then chilly, has thirst, a bad taste in his mouth ; his eyes are red
and watery; he coughs almost incessantly, sneezes, runs at
the nose, &c.   Now  these are the symptoms of Measles,
as they are, also, of a bad cold ; but I have seen them in some
cases greatly aggravated.  Occasionally a persistent burning
fever, nausea and vomiting, entire loss of appetite, &c, &c,
are the  premonitory or foreboding symptoms of the rash of
Measles.  Even convulsions, in young subjects, are not very
rare  during  the febrile stage of the disease.  The peculiar
eruption or  rash is almost sure to show  itself on  the fourth
day  of the fever.  It  is usual for this to be visible, first upon
the forehead or face, and to spread thence to the entire body,
not reaching the lower extremities, in general, before the  sixth
day of the disease.  The appearance of the eruption is some-
what difficult of description.   It bears some resemblance to
flea-bites, the patches—for it is distributed in patches—being
only  very slightly elevated above  the surrounding surface.—
These patches or blotches of the rash  are most commonly
irregular in shape, and have been, not inaptly, styled horse-
shoe shaped.   With the appearance of the eruption the  most
distressing symptoms  commonly disappear.   The tongue, in
this  affection, is, very uniformly, thickly coated,  and the pa-
tient is apt to loathe every description of food ; the bowels are
not often deranged.   In one or two days from the first ap-
pearance of the rash, it is usual for it to begin to fade, and,
at the end of four days, it has  chiefly disappeared; but the
patient still has red  eyes, a cough, and feels feeble and bad. 
132
CONTAGIOUS DISEASES.
Measles spreads its force  almost altogether upon the inner
linings of the air passages of  the stomach and bowels,  and
upon the mucous coverings of the eyes, nose, 6cc.  It is, in-
deed, a specific inflammation of these parts.
  Of the Treatment.   Measles is a disorder which runs a cer-
tain definite course, and, do what we will, we cannot  shorten
this course.  It is, therefore, obviously our duty—sole  duty, to
watch it, guide and direct  it safely to the end of this  course ;
and he who assumes to do  more than this, is to be looked
upon as an intruder upon nature and common sense.  He
may remove obstructions, palliate symptoms, assist nature,
&c, but he must not  break in,  and, with a bold and reckless
hand, attempt to change the whole current of  the distemper.
In the first place, it is well to clear the bowels, and  for this
purpose Castor Oil answers a good purpose.  The patient is
to be confined to his room,  but he  should not be kept too
warm, nor loaded with bed-clothes ; he may be allowed cool-
ing drinks, and should, from time to time, be solicited to take
a few spoonfuls of rice-water or thin corn-meal gruel.  A lit-
tle boiled milk with light bread in it may, also, be allowed, if
relished by the patient.  Patients laboring under the Measles
are apt to  crave acids;  to indulge them moderately, a little
pure vinegar weakened and sweetened, may be taken  without
detriment.  After the bowels have been opened, and where the
patient remains restless,  a few grains of the Dover's powder—
3 to 5, for an adult—may be prescribed with a prospect of ad-
vantage.   It sometimes happens that,  after the rash is well
out, it fades prematurely,  and that the  patient becomes anx-
ious, has great difficulty of breathing,—in  short, seems to be
on the brink of dissolution. To relieve  these distressing, and,
indeed, dangerous  symptoms, heat should be applied to the
patient's extremities, mustard poultices over his chest;  and
he should take, as soon as possible,—if an adult—20 or 30
drops of Laudanum  in  union with a teaspoonful or  two of
spirits  of Camphor, and  this dose should be repeated, if relief
is not obtained in the space of half an hour.
  Measles  may become  complicated with  other affections,— 
CONTAGIOUS DISEASES.
133
particularly with inflammation of the lungs and with croup ;
and such complications, it is useless to add, are momentous-
The treatment proper for these latter diseases has already
been referred to, but 1 advise the family physician to be sent
for without delay, when they do occur.   A tedious and trou-
blesome cough sometimes remains after all the other unplea-
sant effects of Measles have passed away ; and this may ul-
timate in incurable diseases of the Lungs—as Chronic Bron-
chitis,  or  even Consumption itself.   To guard against such
consequences, and attempt to remove the cough when it does
exist, the patient should  go warmly clad, and he should use
Cox's Hive. Syrup, as advised for Chronic  Bronchitis.  With
these remarks, I pass to a far more serious affection :
  (e)   Scarlet Fever.   This disease, in  its most  malignant
form, is  the terror of both  friends  and physicians ; for  the
tears of the former, and the skill of the latter are, alike, una-
vailing.  In its mildest form, however, it is so trifling as scarce-
ly to deserve the name of a disease at all.   It is an affec-
tion, the severity of which,  falls, almost entirely, upon young
persons and children ; and,  in some of its visitations, the fa-
tality attending it is  truly enormous.  During a single year
there died in the city of London above four thousand persons
of the present distemper.  Again, it is proper to remark, that
it is in some of its visitations quite mild, and few, only, fall
a sacrifice to it.  Scarlet Fever  is a contagious disease,  but
all  cases of it cannot be  traced to an origin of this kind, and
we are, therefore, forced into the conclusion that particular,
though inscrutable states of the atmosphere favor its propaga-
tion, and that it is, thus, frequently excited independently of
its well known contagious source.  It is a disease, therefore,
that is propagated in two ways—by contagion, and by epi-
demic or atmospheric influence.   When taken in the conta-
gious manner, from four to  six days intervene  from the time
of exposure to its cause, before the fever or disease manifests
itself.
   The Symptoms of scarlet  fever are not, in general very dif-
ficult of detection.  In cases  of moderate severity the  pa-
tient is generally attacked  with symptoms of a common fe- 
134
CONTAGIOUS  DISEASES.
 ver.  He has chills intermingled with flushes of heat, pains
 of the limbs, back, and head ; presently he is intensely hot,
 and often vomits strongly.   He complains of stiffness of the
jaws, and some soreness of his throat.  Upon  opening the
 mouth the tongue is found to be covered over with a  white
 fur, through which little red elevations, resembling the sur-
 face of a strawberry, show  themselves ; its edges  are also,
 apt to be red and fiery. Looking further back into the throat,
 this part is seen to be swollen and of a vivid red appearance.
 The pulse is frequent, but not very full and strong.  These
 are the most prominent symptoms of scarlet fever, prior to the
rash, and it will be seen that they differ from those of measles
 in the absence of the cough and catarrhal complications of this
latter affection.  For i:i scarlet fever, cough, running  at  the
nose, sneezing, &c, are rare in  its earlier  stages.  Authors
tell us that the peculiar rash of scarlet fever shows itself, in
general, about the end of the second day;  but my own ob-
servation has not borne this statement out.   On the contrary,
in those cases that I have observed, the rash has  very gener-
ally made its appearance at a much earlier date than that
here indicated.  Indeed, it has appeared to me to  be coeta-
neous with the disease itself.  The eruption appearing when
it may, however, in all cases tending to a favorable issue, it
begins to recede in two or three days  from the  date  of its
first appearance, and, in two or  three  more, the  skin has, in
a great  measure, regained  its  natural color.  In  cases  of
greater severity, however, the scarf skin usually falls off in
branny-like scales, the process of which is not fully completed
for some weeks.  Of the appearance  of the eruption itself,
it is useless to say much; for one single examination will be
worth more to the reader, than half a dozen pages of words.
It more nearly, perhaps, resembles the  rash of measles than
any other skin affection, but the experienced physician will
instantly discriminate between the two.  In scarlet fever the
redness is more uniformly spread over the surface, less in
patches, and hardly ever assumes the half circular horse-shoe
shape that it does in measles.  About the time  the rash 
CONTAGIOUS DISEASES.             135
makes its  appearance,  considerable  itching and  irritation
are, in some instances, present.
  Now I have described, rather imperfectly, a case of scar-
let fever  of middling severity, the eruption, the fever, and all
passing away about the end of the  first week, leaving the
patient debilitated, but not much the worse for the  attack.
Cases much milder than the one here described, sometimes
occur.   In such cases only very slight soreness of the throat,
a fever so trifling  as to elude observation, and the peculiar
eruption are all the evidences of the existence of the disease ;
restraint often being necessary to keep the child within doors.
This mild form of scarlet  fever, I  repeat, scarcely deserves
the name disease, but as it is only the stifled workings of a
poison that,  under other  and  less favorable  circumstances,
hardly fails to  destroy life, this one  circumstance entitles it
to the most  anxious consideration.   And if there is an  ex-
ceedingly mild form of the disease  in question, there is also
one of extreme severity, attended with  the utmost danger ;
nay, even with the certainty of death. For I am of the opin-
ion that certain aggravated forms of this terrible distemper,
are at the present time,  necessarily  fatal in their consequen-
ces ;  though it is to be hoped,  that at no distant day a rem-
edy adequate to control  them  may be discovered.  In those
aggravated cases  the attack is  similar to that of those al-
ready delineated, but, instead  of the disease declining at the
end-of two or three days,  the  fever persists, the swelling of
the throat increases, delirium,  or craziness frequently ensues,
 a diarrhoea is apt to  set in, great heat and dryness of the
 skin, a thin ichorous kind  of matter  escapes from the nostrils ;
 and,'upon examination, the  throat  is  found to  be greatly
swollen, of a dark color, and ulcerated.  I need hardly say
that under these circumstances, swallowing, and even breath-
 ing, is very difficult; and  I  have seen the former  of these
 processes entirely interrupted.  The  patient sometimes dies
 as early as the fourth or  fifth day  of the  disease, but more
 commonly he  survives until about the ninth or tenth, when,
 worn out with excessive irritation, he sinks, it may be, sud- 
 136            CONTAGIOCS  DISEASES.

 denly and  without warning.   It sometimes happens that
 bleeding from the nose, in  the last  stage  of scarlet lever,
 suddenly carries the patient off.
   The after consequences of scarlet  fever are often to  be
 dreaded.  Even for weeks after apparent recovery from this
 affection, there is a constant liability to  the supervention of
 other serious diseases, the consequences  of the fever.  Drop-
 sies are the most common of these secondary affections, but
 others, more serious, make their encroachments, not unfre-
 quently ; also, such as inflammation of the lungs &c.
   Of tlie nature  of scarlet fever, I will not speak further than
 to say, that  it appears essentially to  consist in the  workings
 of a poisonous ferment, which the constitution in  its efforts
 to relieve itself,  throws to the surface, and out upon the mu-
 cous  coatings  of the  internal  structures.   These mucous
 linings, are, therefore, in one sense of the word, to be looked
 to as the seat of the  disease ; and  are,  during  its  activity,
 in a state of inflammation;  but this  is of a specific kind.
   Of the treatment of scarlet fever neither need  I say much.
 It is well, however, to warn  the  reader against  doing too
 much.  I would rather, infinitely rather, trust a child of mine,
 affected with the present distemper, to the silly or loathesome,
 though inert and harmless prescriptions of an old lady, than
 to the care  of the most  eminent medical  adviser-, provided
 he, with active  and powerful  medicines, attempt  to cut it
 short.  The former does not interfere with the operations of
 nature, while the latter discards its service  altogether.  But
 physicians now  begin to know their duty,  in these specific
 affections, better than  formerly ; and they should, therefore,
in general, be consulted.  I say physicians,  and do not mean
 mere pretenders or ignoble quacks. Every one who deserves
the name of physician must be  aware that his  sole duty in
the treatment of specific affections  consists in  aiding and
abetting nature, in assisting and fostering her, in her strug-
gles to rid herself of the poison which  is, essentially the
cause of the disease; and which, such efforts  tend  to  expel
from the suffering organism. The man, therefore, who comes 
CONTAGIOUS  DISEASES.
137
in to treat scarlet fever with his lancet unsheathed in the one
hand, and a vial of calomel and another of antimony in the
other, must be looked to not as an angel of mercy, carrying
with him healing  balm, but as the  minister of destruction,
bearing about him the instruments of death.
   Emetics are sometimes useful, if properly timed, in the ear-
lier stages of scarlet fever, but my experience leads me to sus-
pect the propriety of their administration in a majority of cases.
The same remark applies with equal force, with respect to the
propriety of bleeding ; though inflammation is undoubtedly,
present,  it is so modified in  its nature as rarely to require
bleeding for its subjugation. A gentle purgative of castor oil,
provided the stomach retain it, will generally prove serviceable
in the earlier stages of the disease, and may occasionally be
repeated with profit.  The cold bath has been highly recom-
mended, but although useful in certain cases,  and at Certain
stages of the disease, I cannot advise its use indiscriminately
in all cases. Sponging the body frequently, during the hight of
the fever, with warm vinegar and water   is  both safe  and
grateful to the patient.  As a local  wash  for the  throat, to
be used from time to time, a moderately strong pepper tea,
made of the common red  pepper, is, perhaps, as  a general
rule, as  good  as  any other.  With a  tea  of this  kind  the
throat should be  gargled from  time  to time, and, provided
 the fever be not too high, it will be well to permit  some of it
 to be swallowed  at each gargling.   After the severity of the
 disease has gone by, and the patient  begins  to recover, he
 should not, even for some weeks, expose himself to change-
 able and damp states of  the atmosphere; and caution should
 also, be observed about his diet,  avoiding all  heavy indigest-
 ible substances.
    The dropsical effusions, inflammations, &c, that some-
 times follow, as  consequences  of scarlet  fever, demand, as
 a general rule, active constitutional treatment, and the fam-
 ily physician should therefore, be consulted.
    Now to sum up the treatment of scarlet fever, it amounts
 to about this:  In the mildest form  of the disease nothing, in
               18 
138
CONTAGIOUS  DISEASES.
general, is required.  It is well to  confine  the  child  to the
house, to open the bowels with a little castor oil, and  to en-
join a light diet, such as  boiled milk, rice, A:c.   In eases  of
greater severity, emetics, bleeding, gentle  purgation, spong-
ing the patient's body with warm vinegar and water, or cold
water itself, are all means that may, under certain circum-
stances, be profitably resorted to ;  as may, also, the  pepper
gargles.  In the worst and most malignant form of the dis-
ease, the simple, the active, and the medium modes of treat-
ment, I regret to declare,  are too often, alike unavailing, and
the little patient, for 1 presume the patient to be a child, the
tender object of anxious parents, falls a victim  to the  biting
grasp of scarlet fever.
  (e)  Whooping-cough.—Every  one  knows something  about
whooping-cough.  Some  are dreadfully  afraid of it, while
others solicit its acquaintance, thinking it  better for their
children to have it  while  young, than run the  risk of con-
tracting it in after life.  It is an  affection of the lungs and
air  passages, and  the only characteristics, distinguishing  it
from  an influenza or severe cold, are  the peculiar " whoop"
and the  paroxysmal  nature  of the cough, coming on as it
does in  paroxysms or fits.  Now, I repeat, it is the peculiari-
ties of the cough, alone, that serve to distinguish whooping-
cough from certain other disordered conditions of the air pas-
sages ;  but it is  a week, or even weeks, after the cough be-
gins to trouble the patient, before the peculiarities here indi-
cated manifest  themselves ;  and it is therefore, frequently
impossible, during the early stage of the disease, to say with
certainty, whether the particular case in  question is influenza
or wdiooping-cough.  It is true, whooping-cough is contagious,
and influenza is not;  but  children—for they are the subjects
chiefly of the former affection, do  not always  contract the
disease when exposed to its contagion, nor can  all cases  of
whooping-cough be traced, without  difficulty to this  cause.
Consequently, some  caution  should always  be  exercised in
pronouncing this case to  be, and that not to be, whooping-
cough.   When it prevails in  our neighborhood, and a child 
CONTAGIOUS  DISEASES.
139
gets a severe  cough, coming on  in paroxysms  or fits, and
when one knows it has had a chance of catching the disor-
der, we infer whooping-cough.  But when, after  the persist-
ance of the cough  for one  or  more weeks, the child begins
to give out during  its fits of coughing a peculiar shrill sound,
a whoop, we do not hesitate  to  declare outright that the case
is one of whooping-cough.
  The symptoms of the present affection  are  so well marked
and so characteristic, after  its  full development, that I need
not rehearse them  particularly.   The contagious nature, the
paroxysmal cough, and the peculiar whoop, are symptoms
not to be, mistaken.  The space of time that intervenes from
the time of  exposure to its  contagion, to the'commencement
of the cough, varies;  the  medium number  of  days  being
about ten.   The duration of the disease itself, is also uncer-
tain.  It may last  but six weeks,  yet it  is not unusual for it
to  extend to six months.  In pure, uncomplicated whoop-
ing-cough,  fever forms no  part of the disease.   The  cough
above constitutes the whole  deviation from the state of health ;
for, between the paroxysms of this, the  child is, apparently,
in good health.  If it is  not, we are warranted  in the con-
clusion that the  cough is complicated with another, or other
diseases.   And these complications are  always serious ; of-
ten fatal in their issues.  I  neglected to say, that during the
fit of coughing, the patient frequently bleeds at  the nose, or
vomits, or both.  These discharges, other things being equal
are favorable indications.
   The nature of whooping-cough is not very well  defined.
That its seat is in the lungs and upper part of the windpipe,
all  agree.   But while some assert it is  a spasmodic disease,
others contend that it is inflammatory.   In most instances, I
conceive, that both these conditions are present at one and
the same time.  The whoop depends upon the rapid passage
of air into  the lungs through the  chink  in the upper end of
the windpipe, it being partially spasmodically closed at the
time.
  With respect  to  the  treatment of whooping-cough,  in the 
140
CONTAGIOUS  DISEASES.
pure uncomplicated disease, very little is required, other than
the enjoinment of a light  diet, avoidance  of all sources  of
colds, and the occasional administration  of a small  dose  of
castor oil, so as to keep the bowels in a lax state.   In the
latter stages of the disease, however, should much  phlegm
collect about the pipes, the alum cordial, (see alum,) given  in
teaspoonful doses, repeated three  times daily, to a  child  of
two years of age,  will be found serviceable.  When the dis-
ease becomes complicated  with inflammations, or with con-
vulsions, as is  the case  in some instances, the  appropriate
treatment for these affections must be put into practice.  But
medical aid should now be  sought, if it has  not previously
been  obtained.
   (/) Mumps consists of  an inflammation  of a glandular
body—the parotid gland—situated  near the angle  of the
lower jaw, and is, at least in some  instances,  propagated
from one person to another  by contagion.   Though a some-
what painful affection, mumps is rarely of much consequence,
unless,  as happens sometimes, a translation of the swelling
from the jaws to  the  testicles in males, or  to the breasts  in
females, takes place.   When this takes place these parts are
apt to become considerably  swollen and very painful, while
the original affection has entirely disappeared.
   Simple  mumps  scarcely requires  any treatment.  A dose
or two of salts, light diet, and rest, are  in  general sufficient
to carry the disease off in a few days.  When, however, com-
plicated as above, more active purgation, and strict  rest  in
the lying posture, with warm  fomenting  applications to the
painful parts, and  mustard  poultices to the jaws, over the
original seat  of  inflammation,  are proper  remedies,  and
should not be neglected to be put in requisition. A few drops
of laudanum, to allay restlessness will also be apt to do good.
   (g) Erysipelas—(St. Anthony's  Fire.)—This is a disease
that spends its force, at least  in a great measure, upon the
skin ;  the covering envelop of  the body.   And it is, undoubt-
edly, under certain circumstances, a contagious  or catching
disorder ;  yet, in some of its forms, it cannot be looked upon 
CONTAGIOUS  DISEASES.
141
as an affection of a contagious nature.  As the disease  oc-
curs in its sporadic or accidental form, without  a contagious
cause,  the symptoms are, a bright redness and slight eleva-
tion of some part of the skin, perhaps  of the face, attended
with a burning pain of the parts.  The redness is apt to ter-
minate  abruptly, and the adjoining skin looks quite  of its
natural color.  When pressure is made upon the affected
part the redness  disappears  for a moment, but speedily re-
turns upon  the pressure being removed.  Small blisters are
apt  to form upon the inflamed surface, which, after a short
time give way and discharge a thin  acrid fluid. Now should
the disease extend itself, which  it usually does, it travels
slowly from one part to  another, thus  involving  new tissue,
and adding to the patient's suffering and danger as it  pro-
ceeds.  Constitutional symptoms do not always  accompany
this local variety of erysipelas, but  if the inflammation be
extensive, they very generally do. Such symptoms are head-
ache, nausea, sometimes vomiting, with  other disagreeable
febrile attendants.  Matter sometimes forms underneath the
inflamed skin, and this is to  be  regarded, in general, as an
unfavorable indication; for as long as this is going  on, an
irritative fever is necessarily kept up ; and a loss of appetite
with emaciation, and death may result.
   The treatment  of this  accidental,  [so to  speak,]  variety of
 erysipelas, consists in depletory  measures during the  earlier
 stages of its course, and of these, in  conjunction with tonic
 medicines, should the system fall into a debilitated condition,
 and the disease run a tedious course.   In mild cases a few
 doses of salts, rest, and a light diet will generally be found
 sufficient to carry the disease off in a few days.  Should evi-
 dent signs of debility,  such as  great weakness, a frequent
 small pulse, loss of appetite, &c., ensue, it will  be proper to
 prescribe a grain or two of quinine, three times  daily, with a
 few grains of Dover's powder at night.  But in  severe cases
 of this kind, the advice af a physician should be  asked.  A
 genuine erysipelatous inflammation is sometimes excited by
 " poison vine." 
142
CONTAGIOUS  DISEASES.
   Of the epidemic variety of erysipelas a great deal has been
said and written of late.  Some contend that it is not a con-
tagious disease, while others, with better evidence on their
side, assert, unequivocally, that it is.  Now, with the best
lights that, I can collect before me, I am led to believe that it,
like scarlet fever, is, under favoring circumstances, propaga-
ted both by contagion, and through the medium  of the  air.
It is a disease that has, of late  years, ravaged extensively,
the western country,  and has, in  many  sections, proven la-
mentably fatal.  Several names have been applied to it, as
black tongue, epidemic sore throat, &zc, from the malignancy
with which it frequently attacks these parts ; falling, as they
often do, into a state of mortification  before the death of the
patient takes place.   In many respects the present disease
resembles scarlet fever, and, indeed, some have considered it
a mere modification of this latter affection, involving more
particularly the skin than the usual forms of scarlet fever do.
It is, unquestionably, a specific fever, spending its  force some-
what after the manner of smallpox, upon the skin, the  inter-
nal lining structures, the throat, &c.
   The symptoms of epidemic erysipelas are a good deal anal-
agous  to those of scarlet fever, with this difference :  In the
former the rash is supplied very generally, but not uniformly
by an inflamed condition  of the  skin, of that  description
above  delineated.  This erysipelatous  inflammation, showing
itself perhaps first upon the face, is  apt to involve, in its
course, a considerable surface of the body, and indeed, in
some instances, it is  said to  have extended itself over  the
greater part of this ; and in cases of this kind, that terminate
fatally, a rotting and  falling off of the flesh from the bones
actually takes place.   The throat, the tongue, and all  the
mucous coverings of the mouth  and  throat turn black, and
are perhaps in a state of gangrene.
  I have here given it as my opinion that the present variety
of erysipelas is propagated both through  the medium  of an
impure air, and by contagion, from one  person to another.
Now, in support of such an opinion, I am in possession of a 
CONTAGIOUS  DISEASES.
143
sufficiency of proof to warrant me in adopting it.   We know
that the disease is communicable from one person to another
by inoculation.  That it has been thus conveyed, undeniable
evidence has been afforded by bleeding persons with lancets
that have recently been used with erysipelatous patients;
and, in this  way, communicating the  disease  to such  per-
sons.
  It is proper to remark that in some of the cases  of the
present disease, inflammation  of  the skin  is not present.
In such cases the disease appears  to  spend its force  mainly
upon  the internal structures, and they are, therefore, more to
be dreaded than the more common form of the disease.
   The treatment of  this form of erysipelas, is  in a great meas-
ure, to be conducted in the  same manner  as if  the case were
one of the former,  or accidental variety.  It is well to be cau-
tious, and not purge  too much.  Emetics and bloodletting
have  been recommended in the  very  beginning of the  dis-
ease, and calomel  and opium at a later period ; but the  em-
ployment of these herculean remedies belongs,in my opinion,
exclusively to medical men.  My former preceptor, very in-
genious and estimable friend, Dr. H.  E. Talbott, of  Green-
castle, informs me that the external application of the com-
mon tobacco has appeared to him more highly useful, in the
present affection, than any other remedy.  And from its well ,
known power of producing a most decided relaxant effect
upon the living system, I am inclined to think favorably of
its reputed virtues in  this complaint.   He moistens  the  to-
bacco and applies it to the skin above the stomach, &c, un-
til a decided impression—its depressing effect — is made up-
 on the  system.  It is then  to be  removed, to  be  again ap-
 plied as soon as its distressing effects have  passed away.
 The best external application, upon the whole perhaps, that
 can be made to the inflamed skin  is sweet  pure hog's lard ;
 with which the  parts should be smeared from time to  time.
 It, in some  measure, serves to allay the burning pain.
   '(//,)  Continued Fever, Winter Fever, properly Typhoid Fever.
 It may be  thought strange that I  should place here, apart 
144
CONTAGIOUS  DISEASES.
from the true febrile diseases, a disease that, in point of se-
verity, holds a first place in primary fevers.  But as 1 regard
this disease to be one  of a contagious nature, I  could riot,
without violence to the arrangement of this work, have inclu-
ded  it under any other  head.   Then, 1   have already said
enough to commit myself in favor o/ the opinion of its con-
tagious nature.  Many medical men do not regard this as a
catching disorder, but I  have seen  enough myself, if  I had
no other authority, to declare unhesitatingly, that it is a dis-
ease, that under favoring circumstances, is  communicable
from one who is laboring under it to another  who is  not.
This is all, then, that I shall  say respecting this matter, in
this place.   When the disease has appeared, got a start in a
neighborhood or town, it is apt to spread from the sick to
those in immediate communication with them, by means of
its contagious character.
  The symptoms of the disease, when  well marked, are very
evident, and by the experienced physician are not apt to be
mistaken for those of any other affection.  The fever comes
on most commonly with  slight chills, pains of the head, back,
and limbs, heat of the  body, a white coated  tongue, more
or less sickness of the stomach ;  and the bowels are very of-
ten—not always, lax, and  have wandering pains  and sore-
ness through them.   In the course of a few days the  chilly
sensations wholly disappear, the heat and dryness  of the
skin increase, and, if not before, the  patient now  takes to
bed.  His pulse is not commonly much varied from its  natu-
ral standard; his tongue, though slightly coated over  does
not look bad ; if he has thirst, it is not very great, nor is his
appetite apt to be  totally destroyed.   But he sleeps illy, is
disturbed, perhaps talks  a great  deal of foolishness over in
his  sleep ; his eyes  are dull, and his manners  quite unnatu-
ral ; indeed, by close observation his mind, even when awake?
is found to be not right, he is half deranged.
  Now the characteristic symptom of typhoid  fever from this
time to its termination, either in  health or death, is a  disor-
dered state of the mind.   And  the disease is  apt to  run a 
contagious 'diseases.            145
 rotracted course,  lasting from two to  six weeks or even
longer.   There are other symptoms, it is true, of much value
in distinguishing this  from other diseases.  One of these is
an eruption or rash of a peculiar kind, resembling semewhat
fleabites, that is almost uniformly developed at some  time
during an attack of winter fever; most often, about the first
of the second week of indisposition.  The disordered  state
of the mind above referred to, provided the disease be severe,
terminating in a tedious convalescence  or in death, is, in
general, very marked, amounting, most often, to an idiotic
sort of delirium.  The patient is continually muttering in his
sleep about this thing and that, and, sometimes, about things
that he never before heard of. ■-■■ He reaches his hands about
him, and appears to be picking  at or hunting for something
about the bedclothes.   Presently he begins to talk  wdiile yet
awake; he fancies that things are so and so ; he imagines
that this is a near relative, and that a total stranger.  He is
apt to be concerned about  his  business affairs.   Now this
state  of his mental faculties either increases or  decreases
with the  age of the disorder.  If the patient  is about to  re-
cover, he  gradually regains his understanding;  comes to
himself, and coetaneously with the improvement of his mind
all the disordered functions of his body return to a state of
health.   If, however, the disease is  about to  result in the t
death of the  patient, he becomes more and more  delirious,
he presently knows no one, nor  notices anything that is trans-
piring around him;  nevertheless, he talks and mutters inces-
santly, having his eyes half closed and picking at imaginary
flocks or  motes that seem to haunt  him all the while.   His
bowels are commonly much deranged ; and it may be, and is
indeed, often  the case, that the unmanageable purging carries
him  off sooner than the exhausting nature of the fever oth-
erwise would do.  Under such circumstances, his tongue and
all the inside of his mouth assume a dark color, and become
covered with a waxy  sort of scurf. Presently  he dies, it may
be at the end of two,  three, seven, or even ten weeks  from
the time  of the attack.
             19 
146
CONTAGIOUS  DISEASES.
   Upon an examination of the body after death, the greatest
 destruction seems to be confined to the inner coating of the
 bowels.  In certain portions, they are often seen in a disor-
 ganized, ulcerated, or  even mortified state.   But other parts
 are also, frequently the seats of disorganization.   The brain
 is sometimes marked with evidences  of previous  inflamma-
 tion.   In short, typhoid fever is a general disease, involving,
 in its course, every structure, but falling with more particular
 severity upon the inner  linings of the  bowels.  This fever,
 as its name implies, is an affection that is oftenest met with
 during the  winter months.   Nevertheless, it sometimes hap-
 pens  that it reaches back to the latter part of fall,  or extends
 forward to early  spring.   It is always a serious disease, and
 not unfrequently  destroys life.
   Treatment.   In the very commencement emetics may now
 and then be useful, but bleeding and  purgatives are  seldom
 so.  To allay the irritability of the bowels, and to quiet the
'disordered state of the mind, opium given from time  to time
 is very generally serviceable, to  which, should  there be ex-
 cessive purging, sugar of lead in one or two grain doses
 should be added.  Though purgatives are hardly admissible
 in this disorder, should much costiveness be present, an oc-
 casional dose of  castor oil, containing ten or fifteen drops of
 laudanum  may  be advantageously prescribed,   watching
 and checking if necessary,  its effects with opium.  Blisters
 over the bowels, stimulating frictions, such as  strong  pepper
 tea with common salt  added thereto, over the whole body,
 are very often of much service.   These are the principles of
 treatment, but to put them  into practice, my advice  is that
 physicians be employed.   No one but a  physician, in cases
 of winter fever, can judge correctly of the  patient's condi-
 tion ;  nor can any one  so accurately  proportion doses, give
instructions  as to diet,  &c,  as  he.   Then I  hope the reader
will not hesitate to employ, at the very onset of this terrible
malady,  reliable  medical advice.   It is  seldom necessary,
 should the disease run  a tedious course, that daily visits be
made, after  the first few days.  Days and weeks often pass 
CONTAGIOUS DISEASES.
147
away with  but slight alteration in the  patient's condition.
The diet of the patient should be  nutritious, rich soups not
unfrequently being  required  to support  the  strength.  His
room should be kept cool, dark  and perfectly quiet;  all offi-
cious and unnecessary visitors and tattlers being perempto-
rily excluded. 
CHAPTER  X.
   DISEASES NOT INCLUDED IN ANY OF THE FOREGOING CLASSES.

  In the four classes of diseases, now gone over, I have pur-
posely omitted several disorders that it may be expected that
I should say something on.   I omitted  mentioning  one of
these, under the original classification, first, because I am not
well satisfied as to which class it properly  belongs;  and, sec-
ondly, because I have never seen a case of it myself. I allude
to Asiatic  Cholera,—that terrible  disease, which, for many
years, has been devastating the old world,  and, on one  or two
occasions, has paid its respects to our own country,—leaving
its foot-prints indelibly impressed upon the memories of thou-
sands of our fellow-citizens.   Its name would indicate that it
originated in Asia, but I believe,  at  present, we know little
of its rise.   That it is not a contagious disease, I believe am-
ple evidence can be adduced ; yet, from its  universal preva-
lence, affecting,  as it does, on  some occasions, almost every
one within the range of its influence, the public are apt to
conclude that it is catching from one to another.   Cholera is,
in several respects, both a curious and an inexplicable disor-
der.  For example: it usually travels from east to west, against
winds and tides.  Thus, some years ago, arising in the coun-
tries to the east of Europe, it travelled in a westerly direction,
and, passing through  and desolating  almost all  the crowded
cities of this latter  country, it reached the Atlantic Ocean.
Nor did this impede it in its onward  march, but mocking as
it were, on the wings of the wind, it crossed over and began
 ts work of destruction in the large towns bordering its shores
in our own country.   Continuing  its  course, it  swept along 
OTHER DISEASES.
149
from one city or country  to another, until, finally, it seemed
to have been lost or buried in our own beloved west.
  The symptoms of Asiatic Cholera are of such a nature as
not to be mistaken when the disease is in the country, provided
a little  self-possession and presence  of mind be exercised.
But, unfortunately, when Cholera,  a few years ago, visited
this country, and carried so  many to their graves, not only
individuals, but whole communities, were so affrighted, that
the most trivial ailment was apt to be mistaken for Cholera >
and  I  have  not the  slightest  doubt that hundreds and
thousands of persons were so reduced and enfeebled by that
least valuable of all  our passions—/ear—as to actually pre-
dispose them to the disease; and, in this way, numerous were
they  who died of fear.   Let  us but have courage, stand up
and boldly face our foes, and ten to one if they do not cower?
sneak oft; and leave  us  unharmed.  But, on the contrary, if
we turn pale with fear, and  attempt to hide ourselves from
 them, they are apt to seek us, and  when they lay hold of us,
 timidity forbids us making even a tolerable effort to free our-
 selves from  their grasp.   These  are wholesome hints  and
 should be remembered.   But to  return to  the  symptoms  of
 Cholera.  In some instances, without previous  warning, the
 individual is seized with vomiting, violent spasms of the mus-
 cles  of the  abdomen—sometimes of  the  extremities—and
 frequent watery stools.   The  stools  are  frequent and large,
 and in appearance resemble rice-water—hence the patient is
 said to have rice-water discbarges.  A state of exhaustion
  and sinking speedily ensues, termed collapse—characterized by
  a  cold and shrunken condition of the whole surface, and an
  obtundity of all the faculties, both corporeal and  mental.
  Out of this collapsed state the patient scarcely can be rallied,
  but, sinking lower and  lower, he  dies in the space of a few
  hours.  In this manner, almost all cases of  Cholera termi-
  nate, unless relieved by  art in the very onset of the com-
  plaint.  But all cases do not set in as here indicated.  On
  the contrary, premonitory symptoms of a certain character are
  apt to precede  the attack  hours  or even days.  The most 
150
OTHER DISEASES.
common of these forerunning or premonitory symptoms is a
lax or diarrhceal state of the bowels.   And  now is, let me
remark, the proper time for preventing, by medicinal treat-
ment, the full development  of the  malady.  During this pe-
riod, a little rest,  a few drops of laudanum, occasionally re-
peated, in union with small doses of sugar of lead or calomel,
will, in general, be sufficient to check the bowels and ward
off those desperate consequences that are, otherwise, almost
inevitable.   After the disease is, so to speak, in full operation
—copious rice-water discharges being  every  few  minutes
poured from the bowels—after vomiting and spasms  are pre-
sent, but little hope is to be entertained for the patient;  for,
in a few hours,  or even minutes, collapse and  death are to be
apprehended.   Were I called, however, to a case thus reduced
to a state of desperation, my treatment would be, most prob-
ably, mustard poultices, together with dry warmth and fric-
tion to the body  and extremities ; and, internally,  I would
prescribe large, even mammoth doses of opium and the sugar
of lead, designing to arrest, as speedily as possible, the action
of the  bowels, and this indication being fulfilled, I  would then
give calomel, in union with such quantities of opium as the
circumstances of the case would warrant.  These medicines
I would continue until I  had  evidence that the liver was
roused into action.  With these brief remarks, I dismiss the
disease, with the hope that  I  may never be called upon to
treat cholera other than I have done here—upon paper.
  2. Itch.   This is an infectious disorder ;  and, being purely
local, confined to the skin, and  its  cause being, unquestiona-
bly, an invisible insect, it is most  proper, perhaps, that it be
considered apart from the contagious class of affections.  \i
is an extremely common disease, one troublesome to get rid
of, and, as already intimated, dependent for its existence upon
a microscopic insect which  burrows itself in the skin.  Innu-
merable of these  insects, thus concealing themselves  beneath
the skin, are capable  of exciting considerable irritation and
itching of the  parts  which  they infest.   The skin of the af-
fected  parts is, in this  way, rendered  scaly;  little blisters 
OTHER DISEASES.                151
(vesicles)  filled with  a sort  of  puriform  matter, and even
sores  of  considerable magnitude, are  frequently formed-
These sore and abraded surfaces the individual is apt to ag-
gravate by scratching, and in a  few instances, in young and
tender subjects, very  extended  and troublesome  sores  are
created in this way.  The itch insect, here referred to, prefers
carrying on its work in thin and tender skins, and accordingly
children suffer more from  it than grown up persons, and the
thinnest and most delicate portipn  of  the skin—as between
the fingers,  under the  arms, &c,—more than other parts of
the body.  But still it is an affection that most persons, both
young and old, are obnoxious to.  It is infectious only through
the agency  of the itch insect.  It is capable of passing from
one body to another,  when brought into contact, or of being
transmitted through the medium of clothing or bedding, to which
it appears, in some instances,  to adhere, with considerable
tenacity,  and for some time.
   With the Treatment of Itch, most  persons  are familiar.—
Brimstone,  sulphur, will kill  the cause of it, and cleanliness
will, usually, prove a preventive to its re-appearance.   Other
things, beside sulphur, are occasionally  used, and now and
then  with success, but sulphur is the proper remedy—the safest,
and when perseveringly  used, a  never-failing  cure ; it is a
 specific for itch.   Then, to an ounce or two of the flowers of
 sulphur—or the beaten up brimstone will do—add two or three
 times its  weight  of hog's lard,  and mix thoroughly.   With
 this preparation, for two  or three nights in succession, smear
 the affected parts, having previously washed  the body off
 with soap and water.   After this course has been gone through
 with, wash off, put on other clothing, both on beds and bodies,
 and the chances are against the army of little intruders.  Itch
 is a loathsome and filthy  disease,  and as every one  affected
 by it has it completely in his power to remove  its cause in the
 course of a few  days, without danger to  himself, he is culpa-
 ble if he neglect to do so.
   3.  Ringworm,  Being a very common and somewhat trouble-
 some circumscribed  affection of the skin, demands a few ob- 
152
OTHER  DISEASES.
servations as to the proper mode of its cure.  I need not de-
scribe its appearance.  Its name  implies  its shape, and its
vesicated and traveling nature are too well known to deserve
attention from me.  To relieve it, a  weak  solution of Blue
Vitriol may be applied from time to time to it.   If this fails,
the strength of the solution should be increased.  The man-
ner of forming the solution is to add to an ounce of rain-wa-
ter an  amount of Bluestone about  equal in bulk to a hazle-
nut.  A solution of the Lunar  Caustic, is also, an effectual
remedy for ringworm.
  Nettlerash.   This is an affection, also, of the skin, but nearly
always depends upon some constitutional cause.  It is some-
times occasioned by particular articles of diet, but it is often-
er, perhaps, the consequence of vitiated accumulations in the
stomach and bowels.  And I have seen a few cases of the
disease that were, in some way, connected with fever of the
intermittent kind.  Whatever may give rise to it, however, it
is characterized by a sudden tingling  of the  skin, perhaps of
the whole surface,  accompanied with flushes of heat.   In a
short time,  a most unbearable itching begins, and the individ-
ual is apt to claw and scratch himself with all his might,  and,
perhaps,  as I  once did, he  employs a bystander to assist him.
The characteristic eruption now begins to appear, and if the
complaint has not hitherto been understood, the eruption now
reveals its true nature.  It resembles the stings of insects,
rising up suddenly  in hard wheals, and having upon their
summits a white flattened appearance.  These wheals scarce-
ly  ever form sores, but are  apt to pass away, along with every
other unpleasant symptom, in the course of a few hours.   The
eruption sometimes gets into the eyes, and a few rakes with
the finger nails, during a fit of the disease, are generally suf-
ficient  to bring it out on any part of the body.   Nettlerash is
occasionally intermittent  in its  character, and returns every
night, especially upon retiring to rest.  When this is the case
the patient being prevented from rest, the disease is not only
troublesome, but may, by  its  persistence, greatly reduce the
constitutional powers. 
OTHER  DISEASES.
153
  Little else is  necessary for  the  effectual  removal of* the
acute variety of this  affection  than a few  purges of some •
mild cathartics.   Ten grains  of  rhubarb added  to a  tea-
spoonful of the cream of tartar, answers well for this purpose.
If, however, the affection be connected  with ague, quinine
must be given.   In the intermittent or chronic variety of the
complaint, other means  of treatment will be proper.  Arse-
nic, of all known remedies, will  be found, in  this form of
Nettlerash, most to be depended upon.   But medical men—
and  they of the better class, too—should prescribe this pow-
erful drug, which, even in very small doses, requires the most
careful watching.
  I have now gone over with most of the commoner diseases
incident to this climate.  In many respects, I am aware, they
have been imperfectly dealt with.  But imperfections I could
not hope to avoid, in a work prepared, like the present, for
the benefit of those unacquainted, in a great measure, with
the subjects upon which  it treats.  If, however, I have been
able, as I trust I have, to instruct—to introduce useful matter,
in a style plain and familiar,  then I  have accomplished all
that I could anticipate  and hope for.
             20 
CHAPTER  XL
  A GENERAL VIEW OF THE PRINCIPLES AND PRACTICE OF SURGERY.

  Surgery, though taught and practised in some places as a
distinct branch  of  science, is, in reality, so intimately con-
nected with medicine as not to  be separated from it without
violence.  It is impossible  to practise  surgery with success,
without first acquainting ourselves with Anatomy and Phys-
iology, and with the  principles and practice of physic.  Nor can
any one  practise, with any kind of success, this latter branch,
without necessarily  becoming acquainted with the rules and
regulations that govern the surgeon in his operations.
  It is in  consequence  of this intimate  connection that
practitioners of medicine  and  surgeons are  continually in-
fringing, upon the departments of each other;  it is impossible
that it should be otherwise.  But, before proceeding further,
it may be w^ell to define, somewhat definitely, the province
of the  surgeon.  He, in his practical capacity, performs all
bloody cutting  operations, from opening an  abscess to the
capital operation of  amputating or cutting off the thigh. He
reduces dislocation  or displacements of the different joints,
and adjusts broken  bones, retains them in situ, and  procures
their reunion.   All  wounds, burns, frost bites, bites of poison-
ous reptiles, insects, &c, are the legitimate objects belonging
to his branch of medicine.
  Now it will not be expected that I should speak separately of
all the offices of the surgeon. It would require a volume, or even
volumes,to do so. All that I shall aim at, in the present chapter,
will be to notice, briefly, a few of the most common, as well 
PRACTICE  OF  SURGERY.
155
as the most simple, diseases and accidents that fall within the
scope of surgery.  And I shall endeavor to be more full and
explicit as regards their treatment, than the phenomena that
attend them as symptoms.
   (a) Whitlow or Felon.  This is not only a very painful affec-
tion, but also, one that not unfrequently results in the loss of one
or more joints of the fingers or thumbs.  Its approach is an-
nounced by heat and swelling of the  finger or thumb, and
pain of a pungent, throbbing, and unremitting kind. So severe,
indeed, is this pain in many instances,  as to prevent the suf-
ferer from sleep for days and nights together.  These symp-
toms, as the  disease advances, are augmented until, gener-
ally, after the lapse  of  many days, openings  form upon the
swollen joint,  and give exit to an ill-conditioned bloody mat-
ter, when an abatement of the severity of the pain usually
takes place.   But the sore does not, in general, heal kindly;
on the contrary, it is apt  to continue for a  long time, un-
less properly treated, to discharge an ill-looking matter, and
within it  ugly unhealthy  granulations—proud flesh—are al-
most sure to sprout up ; the whole end  of the finger or thumb
diseased, becomes hollow, rots, to use a common expression,
out, and the bone itself is  thus exposed, and not unfrequently
destroyed.  Constitutional symptoms are occasionally devel-
oped, but these are rare unless the disease has run a very
protracted course.
   As respects the treatment, after evidences of matter  in  the
part, exist—such as  considerable tension and swelling, com-
municating to the touch an elastic feel,—the best means that
can be adopted is to lay the  swelling  freely  open,  and  thus
let out the matter.  In  the very commencement of the pain
and swelling, a brisk  purge of salts, with the application
of a tight bandage  wound  around  the  finger, beginning
at its end  and carrying the turns up  to  the  hand,  as a pre-
ventive means, I think worthy  of trial.   Such  means  are
worth, at least, as much as all the pow-wowing of conjurers,
so often sought in affections of this nature.  Should the sore,
however, after the part has been opened, either artificially 
156            PRACTICE  OF  SURGERY.
or naturally, give  out proud flesh, this should be  touched
from  time to time, either with caustic potash, lunar caus-
tic, or with a red hot iron.  Applications of this kind hardly
ever fail of being  immensely serviceably  in  correcting the
unhealthy character of the ulcer, and  disposing it to put on
the healing process.  Laudanum, in 20 or 30 drops' doses,
repeated, if necessary, at suitable intervals, should be given
to assuage pain and procure sleep.
   (b) Akin to whitlow, and  demanding the  same  general
treatment, is carbuncle.  This usually begins exteriorly upon
the skin, and extending downwards into the structures be-
neath, often proves both tedious and painful, and sometimes
destructive of the   diseased parts.  Externally, it presents,
a very ugly appearance, having numerous openings  upon its
surface, from  which issues a large amount of filthy matter,—
leaving the parts  hollow  underneath.  Proud  flesh, too, is
almost sure to spring from these openings.
   Carbuncle may form upon almost any part of the body, but
the hands, are, perhaps, the most frequent seat of it.   When
it  is very extensive and situated near the head, constitutional
disturbance is almost necessarily  an  accompaniment of it.
Paleness, loss of appetite, &c, are the  most common of these
symptoms.
   The treatment must be measurably the sameas that directed
for whitlow.   The proud  flesh must be removed by some
caustic  application.  The  powers of the system must  be
maintained by bitter  tonics, such  as  Peruvian or dogwood
bark; the pain and irritation of the constitution are to be  al-
layed by laudanum, if rest cannot be procured without it.
The abraded surface of this affection, as well as that of whit-
low, should be protected  by some simple salve  or ointment,
The following is among the best:  Take of beeswax one part;
of fresh hog's lard  four parts ; melt them together and strain.
This is  a simple and very useful salve, and will answer most
of the purposes for which salves are used.
   (c) Boils are painful tumors, too well known to require any
special  description.  They nearly always result in mattering. 
PRACTICE  OF  SURGERY.
157
And they seem, in some instances, to originate in a constitu-
tional defect;  for successive crops of them, one after another
may rise, and no other cause can be assigned as their origin,
but  that of a general one, acting through the  medium of
the constitution.  In  some instances, they undeniably origi-
nate from contusions  or bruises, but this is not often the case.
   To correct the tendency to their formation, the avoidance of
sweetenings of all kinds shoujo^be observed, and the individual
should take, from time to time, small  amounts of saleratus.
If constipation of the bowels be present, small doses of salts
should be used, so as to keep up a regular action of these
organs.
   The boils themselves, after they have become hard and pain-
 ful, should be poulticed with some warm and soft substances.
 Applications  of this  kind not only assuage pain, but  also
 hasten the boils to maturation.  When they present a pointed
 appearance, and are soft to the touch, a lancet should be in-
 troduced into them,  so as to evacuate their  contents com-
 pletely.  A simple salve, such as directed in the last section,
 will answer a very good purpose for dressing them.
    (d)  Scalds  and burns  are very common  accidents,  and in
 many instances, not only involve extensive surfaces of the
 body, but destroy life itself.  They may be usefully  divided
 into three varieties :  First, into those superficial burns that
 produce considerable pain  and redness of the part, but do
 not result in the destruction, or  even  blistering  of the skin.
 Secondly, into those cases that do destroy the contiguity of
 the skin,—resulting  in blistering, and leaving behind an ex-
 posed and very tender surface.   In the third variety, the life
 of the skin and subjacent parts are wholly destroyed, and a
 deep cinder  is left upon the injured surface.
    In the superficial or even the  second variety  of burns, un-
  less a large extent of surface be  involved, constitutional
  symptoms are not necessarily developed ; but in the third va-
  riety, and especially if the seat of the  accident is near any of
  the vital organs, or a wide extent of surface is destroyed,—
  the constitutional symptoms  are well marked.   The patient 
158
PRACTICE  OF  SURGERY.
 complains but little of the injury itself, but he has shiverings
 for several hours, it may be.  The pulse is feeble, and it may
 be irregular or intermittent; the breathing is hurried, or oth-
 erwise  unnatural.  The  patient  may die immediately from
 the effects of the shock, and in the cases of children, convul-
 sions are to be apprehended.   If  he  recover, however, from
 the shock, fever is speedily evolved, and this, owing as it is,
 to an extensive injury, may wear down the vital powers, and
 bring the patient to his grave.
   The Treatment.   In superficial burns of the first class cold
 water is not only soothing, but, when perseveringly applied,
 by means of cloths, it will, in general, in the course of  a few
 hours, permanently relieve the  patient's sufferings.   Raw
 cotton, such as the  batting now in common use, if applied to
 burns of this discription, or even to those upon the surface of
 which blisters form, and retained in its situation, hardly ever
 fails to afford, after a short time, complete relief.   If blisters,
 however, seem inevitable, constituting the second variety of
 burns, soft warm poultices, thickened milk, for example, should
 be applied to the inflamed surface, and continued until the
 inflammation, pain, and redness, have in some measure, sub-
 sided, observing care not to remove the skin further than ne-
 cessary to evacuate the blisters of their water.   When the
 pain, redness, &c, &c, have partially subsided, the simple
 salve, already referred to in the present chapter several times,
 spread on old soft cotton or linen  cloths, will form an appro-
 priate dressing, and should be continued until the cure is  ef-
 fected.   With respect to the management of the third variety
 of burns, warm soft poultices are to be  applied to the injury
from time to time, until the sloughs or cinders are separated;
 and then the simple salve will answer a  very good  purpose
for protecting the sore;  and time will  be a useful ingredient
in effecting the cure.  It will be well in all cases of burns to
prevent,  if possible, the  contractions  and distortions of the
 parts that are so liable to follow the healing up of the  inju-
ries.  Common sense must be our chief guide  in  endeavors
 of this kind, as no directions can be laid down. 
PRACTICE  OF  SURGERY.
159
         But in cases in which constitutional disturbances are pre-
       sent, these demand our first attention.   To relieve the shiv-
       ering and shock which extensive burns communicate to the
       system at large, and rally the patient's constitutional powers,
       laudanum will be found  of essential  service.  It should be
       given in doses of  20 or 30 drops, and repeated if necessary,
       to an adult, immediately upon the receipt of the burn.
         Should there, after after a time, be excited a  considerable
       degree  of fever, marked by heai'of surface, flushed face, head-
       ache, &c,—the bowels should  be evacuated;  and for the
       purpose of doing this, I would prefer a spoonful or twro"of
       castor oil.  It sometimes happens, and this is especially liable
       to be the case with young and tender children, that from the
       irritation resulting from the burnt surface, convulsions, or a
       threatening of them occur.  Now, in my opinion, although not
       supported by the opinions  of many physicians, I am aware,
       opium  is  the proper  remedy.  Therefore,  to quiet and  re-
       lieve these symptoms, a few drops  of laudanum should, ac-
       cording to my experience, be given, and repeated if relief is
       not obtained.  Should the parts  injured discharge a  large
       quantity of matter, the addition of a few grains of the sugar
       of lead to the dressing salve will be found beneficial.
         I have, in the foregoing manner, given the best method of
       treating accidents of the kind in question, in at  least a ma-
       jority of instances, but in all serious cases, it will be proper
       to consult the physician.   He will be  better  prepared, if he
       be skilful, to give advice in the particular case than I or any
►       one who does not see it, and who consequently can scarcely
       hope, in a general direction, to include the  peculiarities and
       complications that may be present.   And  I take this oppor-
       tunity to admonish my readers in cases  of burns, (or, indeed,
       in any other cases,) not to be led away after the lo ! here, or
       lo ! there, of anybody,but to pursue steadily that course which
       their own common sense dictates, or the physician has ad-
       vised.   There are in every neighborhood a  sufficient number
       of doctors ; and I care not whether  they wear petticoats  or
       breeches, if their officious  advice be followed, to not only put 
160
PRACTICE  OF  SURGERY.
the friends of the burnt child (or adult, as the case may be,)
to unnecessary trouble, running after this or that one's salve
or poultice, " to draw the fire out," but also to  aggravate the
burn, and worry the condition of the sufferer.  Some of these
" doctors "  pretend to have some supernatural power—to be
in possession of some magic by which they are able to draw
out fire, relieve pain, staunch blood, ccc.   Against becoming
the dupes of such silly fools, I need not caution the intelligent
and informed reader, but there are those who have, as it were,
drawn in with their mother's milk, notions extremely prepos-
terous ; and these are so fixed in the mind, that the experi-
ence of their whole lives, is insufficient to erase them there-
from.  Every well meaning person should discountenance,
on all suitable occasions, these vulgar superstitions of what-
ever kind.  God has given to one person no more magic than
to another.  He never gave the  power  of conjuring away
disease—no, never.   Faith without works is dead ; but faith
and works  are mighty and most often prevail.
  (e) Of Wounds.  By wounds I  mean  to designate  such
accidents as  are of  every  day occurrence,  from a  trivial
cut, up to  the most fatal lacerations and mangling of the
limbs or bodies of men, by machinery or otherwise.  Wounds
may be  usefully  divided into several classes or  varieties,
for example,—into incised,  when inflicted by a smooth cut-
ting instrument;  punctured, when  made  by  sharp pointed
and small  instruments, as thorns,  &c; contused, when the
effect of blows,  producing deep  bruises ;  lacerated, when
torn asunder by some powerful force, or  divided by a dull
and tearing instrument; poisoned,  when inflicted  by poi-
sonous insects or reptiles, or  by  the introduction, into a
wound, in any other way, animal,  vegetable, or  mineral poi-
sons.
   1. Incised wounds  are such as are made by cutting instru-
ments, and may or may not destroy life.   General rules only
can be given for their management.  If the wound is a sim-
ple flesh cut, merely penetrating  and laying open the skin,
the divided surface  should  be  drawn together immediately, 
PRACTICE  OF  SURGERY.
161
and held in situ by a simple bandage.  Thus treated, without
daubing the part with any  salve or poultice, too often prac-
tised, the  cut is, in the course of a few days, as a general
rule, united without having caused the individual more than
the slightest pain or inconvenience.  But should the  wound
be more extensive, and give out a good deal of blood, it will
be proper before dressing it, in the manner here directed, to
arrest, in some measure, the bleeding.   With the design of
accomplishing this purpose, cold water may be freely pouped
upon the part, when, after  a few minutes, provided no con-
siderable blood vessel be divided, the bleeding is usually ar-
rested.  Then the wound is tobe dressed as above.  But again,
supposing the wound bleeds profusely and the simple means
here recommended fail to arrest the flow of blood—supposing
it comes away in an interrupted, jetting stream, what then is
to be done ?  I answer, the wound should be drawn tightly to-
gether, and if it be situated on either of the extremities, the pul-
sating artery above the cut vessels, that is towards the body,
should be so firmy pressed  upon by the fingers as to  prevent
the blood from flowing along it.   The proper vessel, artery,
of the arm will be found upon examination, pulsating above
the elbow joint, on the inside of the arm, and may be traced
and  easily compressed up to near the body.   The proper  ,
vessel of the leg may, in like  manner, be found  at the supe-
rior or upper part of the thigh, just in the groin, pulsating  or,
beating  strongly,  and may, by applying considerable force,
where it passes over the  broad bone, be  very  successfully
compressed.  This done, relieves the patient from immediate
danger, when a messenger should be despatched, in haste,
for a physician, whose duty it may be to tie up the divided
vessels,—an operation  that none  but skilful persons should
 undertake to perform.   Should incised wounds fail to unite
readily, become very painful and swollen, poultices of some
soft materials  should be applied, until  these conditions are -,
 improved, when the simple salve dressing  should  be substi-
 tuted for them.
   2  Punctured wounds, though very trivial in the first place,
              21 
162            PRACTICE  OF  SURGERY.
yet they are, in their after consequences, frequently accidents
resulting in much mischief.  For.example : a pin, needle, or
thorn,  is run  into  the  ball of the  thumb.   The  accident
causes but little pain after a few "minutes, and may be of
no further consequence, yet should the external wound heal,
before  the internal  and  deep-seated, and especially, should
matter be poured out, as the effect, into the sheaths and ten-
dons of the part, it becomes confined and all the painful cir-
cumstances of the whitlow will follow.  To relieve cases of
this kind, it is  proper to lay the part  freely Open and let the
matter out.  Should fragments of splinters or  thorns be left
in wounds of this description, they should be carefully sought
and removed, if possible; if  impossible at first, when the
part matters they are apt to be discharged with this fluid.
  3. Contused wounds, are such as are inflicted by blows—
the skin not necessarily being broken.  They may be serious
or not, according to the  parts implicated, and the  severity of
the stroke or strokes. They require  to be treated, in the first
instance, by evaporating and cooling lotions, among the sim-
plest and best of which, a solution of sugar of lead, in cold
water, may be mentioned.  The bruised surfaces should be
kept wetted with this from time to time.  If a bloody matter
collects under the  bruised skin, a  small opening should be
made with the point of a lancet, and  it may in  such instances
be proper to poultice the part. When constitutional symp-
toms manifest themselves, they demand either a stimulating
or a reverse plan of treatment. Immediately upon the receipt
of an injury of this kind, stimulants may be necessary to rouse
the system from the state of depression that is apt to ensue,
after which, should febrile symptoms appear,—heat of sur-
face, headache, &c, purgatives will  be  proper, and these
should be conjoined with rest  and a  light unirritating diet.
   4. Lacerated wounds,  are such as  have been inflicted by
some tearing process, or with a blunt dull instrument.   Thus,
the tearing a limb assunder by machinery, or the  passage of
a ball  or some blunt missile through the flesh, serves for an
example.  Of course this description of injury  may be, or 
RRACTICE  OF  SURGERY.             163
may not be, attended with risk, according  to the  nature  of
the accident; but there is more danger attending wounds  of
this  class, other things being  equal, than  simple incised
wounds.  Large blood vessels are liable to be torn across  in
wounds of the  lacerated variety, but it is  a remarkable,  as
well a very fortunate fact, that, as a general rule, they do not
give out much blood, and few  patients only, comparatively
speaking, bleed to death as a result of such accident.  Gen.
Shields, at the  battle of Cerro Gordo in Mexico, was shot
through one side of the chest with a large bullet, which must
have, necessarily, torn into two many blood-vessels of con-
siderable magnitude, and yet, it is  gratifying to  his country-
men to know that he made a rapid and perfect recovery.
   The treatment of wounds of the lacerated kind consists  in
the removal, as far as possible, of all foreign bodies from the
wound itself, and in simple dressings,—poulticing if local  in-
flammation runs  very high.  But our chief dependence, in
severe  injuries of this kind, must  be placed upon judicious
treatment.  Stimulants, in the first place, are often necessary
to bring up the vital powers, and afterward, purgatives, rest,
and low diet, to restrain them in proper bounds.  The remo-
val of limbs, when these have been the parts injured, by am-
putation, is sometimes obliged to be practised.   But of these
capital operations it were needless for me to speak, as none
but medical men will undertake to  perform them.
   5.  Poisoned Wounds.1 These are produced in several ways.
Thus, by the bite of a rabid animal, a poisonous snake, or  the
 sting  of  an insect; or lastly, by the introduction, through a
 wound into the body, of any mineral or vegetable poison. The
 stings  of poisonous insects rarely require any active treat-
 ment.   A strong  solution  of common  salt applied  to »the
 wound, is said .to afford relief,—at least in many instances.
 But  a better application is the spirits  of hartshorn,  which,
 when pretty freely  applied to the stung  part, almost always
 relieves  it promptly.   When a, person has been stung by  nu-
 merous bees or other poisonous insects, and the parts have
 become greatly swollen and very painful, brisk purging with
 epsom salts should be immediately instituted. 
164
PRACTICE  OF  SURGERY.
   A thousand and one remedies have been recommended and
used for the  cure of snake bites, but  I am  warranted in
saying that after the poison has once entered the circulation,
and been carried to the  different parts of the body, an anti-
dote—that is, a medicine that will promptly destroy the pois-
on, is unknown to  man.   Prior, however, to its absorption into
the system at large, some local measure may be used with a
prospect of success.  Were I  present on the receipt of a
snake bite, I  would, with permission,  remove immediately,
by incision, the bitten part.   But unfortunately, this procedure
is rarely practicable;  and other and less efficient means have
to be resorted to.  Sweet oil, freely applied to the bitten part,
has been recommended  by  numerous  persons, and from the
character of the testimony  in support  of its good effects, 1
should be inclined  to give  it a trial. If used at all, the part
is not only to be feeely bathed with it, but it is, in spoonful
doses, at short intervals, to  be given internally.  Should evi-
dence of a disposition to sink supervene soon after the bite
has been inflicted,  let the patient drink freely  of  whisky  or
brandy, until his pulse becomes full and regular, and the sur-
face of his body has restored to it  a natural warmth.   The
carbonate of ammonia, commonly called the volatile smelling
salt, or salt of hartshorn, has been highly recommended by
several physicians, as an internal medicine, in cases of snake-
bites ; and as it is  a powerful stimulant,  1 have no doubt of
its usefulness in those instances in which great depression
follows soon after the wound has been inflicted. Purgatives,
are,  when febrile symptoms appear, useful agents in mode-
rating these, and should therefore be given, provided the  bow-
els have not been freely  opened  by  the sweet oil—if it was
prescribed.  Arsenic in  pretty large doses was recommended
and highly lauded, some years  ago, by a Mr. Ireland, as a
remedy of considerable powers in cases of snake-bites ; oth-
ers beside him have given to. the practice their praise.   It is
known to be a powerful tonic, and may, perhaps, by bolster-
ing up the system  against the depressing effects of the poi-
son,  operate favorably, in the same way that stimulants are 
PRACTICE  OF  SURGERY.
165
believed to do; and thus enable  the constitutional efforts to
expel the  poison through the natural  outlets—the skin, the
urine, and fetal matters—from the body.
   Of the bites of  mad dogs,  and the disease resulting from
them, I need say nothing further  than  that  the disease is an
incurable affection; but that, taken in time,  its development
may, generally, be prevented, by  cutting out every vestige of
the wounded part, and then  searing the new wound with a
red-hot iron; or, what amounts to the same thing, by destroy-
ing, by the iron, or with a powerful caustic, such as oil of vit-
riol, aqua-fortis, or the caustic potash, the whole of the bitten
part.   Now it is proper to remark, before quitting this sub-
ject, that many cases, both  of snake-bites  and the bites of
mad dogs, do not result in such dreadful effects as are to be
apprehended  and feared.  Thus, even a rattle-snake  may
bite an individual, fairly inflicting a wound through the skin,
and yet no bad  effects may  possibly ensue.  And the same
remarks apply with greater truth to  the bites of dogs, unde-
niably mad.   For it is well  known that not one-half of the
persons bitten by mad dogs, contract the disease.   Hence the
numerous means recommended for the  cures of these acci-
dents.  Now these circumstances are  to be accounted for in
two ways.  First, serpents  are not  always equally charged
with poison, and, secondly,  though they be exceedingly ven-
omous, it is not always  the case that the  virus  enters the
wound ; for it may be discharged, either when the teeth are
passing through the clothing, should this be interposed, or it
may even enter the wound, and be immediately washed out
by the sudden gush of blood  that usually  follows the bite.
Mad dogs nearly always bite through the clothing, which ar-
ticle frequently very perfectly brushes the teeth, and removes,
almost completely, the slaver therefrom ;  and it is in this
slaver, or slobber, to speak more plainly, that the poison is
contained.  It is not well, however, let me say in conclusion,
in cases of the bites  of rabid animals, to conclude that be-
cause nine  have escaped contracting  the dreadful disorder,
that the tenth one will escape also.  Better maim the patient, 
166
PRACTICE  OF  SURGERY.
needlessly, than rest on a hope so precarious.  I should greatly
prefer removing the arm or leg of a friend of mine, than see
him affected by the horrible signs of Hydrophobia.
  (/) Ulcers.  These are, frequently, both painful and troub-
lesome sores, and  deserve the  careful consideration of the
surgeon.   The simplest form of  an ulcer is that in which a
small scratch or pimple  has resulted  in a deep, ragged, and
painful eating  or  running sore, that is  liable  to continue;
not for years only, but for life.  Though ulcers may form up-
on any part of the body,  they are most commonly met with
upon the legs ;  and more frequently in broken  down consti-
tutions—occasioned by long intemperance—than in persons
reversely  circumstanced.   Ulcers  are either painful or not
painful.  When painful they are termed irritable ; when not
attended with pain indolent ulcers.
  In the treatment of the irritable ulcer, the constitution usually
demands our first attention.  Purgative medicines should be
given from time to time, and  the  patient's diet  should be re-
stricted to vegetable food.  At the same time  that the con-
stitution is receiving attention, it will be proper to apply to
the ulcer itself warm poultices of bread and milk ;  and it will
be best that these be not so large and cumbersome as to be in-
convenient.  If the sore be either upon the leg  or arm, the
part should be elevated, so as to drain, as much  as possible)
the blood from the part.   By treatment of this kind, in the
course of a few days, the very tender and painful nature of
the sore can generally be  removed.   Then a bandage, about
three inches wide, should be applied, provided the limb be
the part upon which the  sore is situated, tightly, or as tight,
at least, as can be borne,  around the whole limb, beginning
always at the toes or fingers, and only about one-half of the
width of the bandage should be gained each twist.  Over
the sore itself, whiqh is to be included under the  bandage, a
little of the simple salve should be interposed.   An appliance
of this kind is capable, in the course of a few days, of making
a very great alteration for the better in the appearance of
of the sore, disposing it to heal kindly and even rapidly. 
               PRACTICE  OF SURGERY.            167

  The bandage should be be kept constantly  applied, only
adjusting it as occasion may demand ; but should the part, as
sometimes happens, be  indisposed to heal,  notwithstanding
the management here  advised, it will be proper to sprinkle
upon it some calomel in dry powder, and continne the use of
the roller or bandage.  Calomel,  thus  applied, from time to
time, and aided in its operation by a roller, as  here suggest-
ed, is  almost uniformly capable of exerting a powerful cura-
tive influence over the foulest and most ill-conditioned ulcers,
bringing up speedily from their surfaces healthy  granulations.
I had occasion to remark the  excellent effects  of the treat-
ment  here laid down, in numerous cases, even among persons
of the most dissolute habits, while in attendance as a student,
in the Chicago Hospital, during the last winter—1847-8.
   The indolent ulcer demands the  same  treatment as that
above given, with the exception that constitutional treatment
and poulticing can usually  be dispensed with.   It is well to
remark, before quitting the subject of ulcers, that those of the
leg, even for a long time after they have, to all appearance,
been  effectually healed,  are disposed  to  break out anew or
re-appear.   It will be advisable, therefore, to continue the use
of the bandage for a considerable  length  of  time after the
patient has been dismissed for cured.   Also, it is well to say,
that ulcers are now and then met with which owe their origin
to genital diseases, and that, then, they are exceedingly dif-
ficult, and sometimes impossible,  of cure.
   (g) Fractures and Dislocations.  By the word  Fracture, sur-
geons mean the breaking  of bones, and  by Dislocation or
Luxation, they mean the displacement of the bones from their
natural situations, without their fracture.   Now  it is useless
for me to attempt to give  directions, and lay down rules, by
which either fractures or luxations  are  to  be  treated, yet it
may be both interesting and useful  to allude to some points
connected with accidents of the  character here in question.
Fractures are of  two kinds—first, where the bone alone is
broken-^secondly, where the soft parts  are injured, also.  The
first are called simple fractures—the second compound fractures. 
 168            PRACTICE OF SURGERY.

 A simple fracture, other things being equal, is, as a matter of
 course, much less serious than a compound one.   Sometimes
 the bones are literally  crushed  to  atoms,  and the soft parts)
 also, greatly mangled.  Though not  always demanding re-
 moval, limbs thus circumstanced often require amputation, as
 the best treatment.  To set, adjust, and confine in their proper
 situations broken bones, requires more knowledge  and dex-
 terity than people  generally possess  in matters of this sort
 and it is  impossible, without, at least, a tolerably correct no-
 tion of anatomy, to be prepared to perform these  duties.
 There can  be no rules laid down for the adjustation and treat-
 ment of  accidents of broken bones, applicable to the public
 at large, more profitable than  that embraced in the general
 direction of .treating them on common sense  principles.  Should
 the arm be broken,  it is to be extended—and sometimes very
 considerable force  is necessary to do this—by gently and
 steadily pulling  at it, in a  straight line,  until its length and
 natural appearance are restored ;  then a bandage, beginning
 at the fingers, is to  be run around it, and splits, with soft pads
 beneath them, placed above this, are to retain it in the proper
 position.   The bandage must not be drawn too tightly, else
 considerable pain and even mischief may be the result.  Such
 are as good directions as can be given to unprofessional per-
 sons—to straighten the broken limb, and to  retain it in its
proper situation  by  those means which the ingenuity of most
 persons will enable  them  to  supply.  But medical aid, as a
 general rule, should be solicited.
  A broken bone re-unites, provided the ends are kept in co-
 aptation, as a  general rule, in from two  to six weeks, and
 the bones of young and healthy subjects  form much readier
 unions than those more advanced in }^ears, and of less vigor
 of constitution.  Much more  time, however, than that here
 mentioned, is required,  before very firm  and strong unions
 are made.   Even for the space  of a year cr more, the broken
 part is more easy of fracture than the adjacent portions that
 have suffered no fracture.  Inflammation  seems to  be a ne-
 cessary part of the  process of reparation of the brbken bones; 
PRACTICE  OF  SURGERY.
169
nor can they, under any circumstances, probably, unite with-
out a certain amount of it.  Pain, therefore, it will be inferred,
is an accompaniment of  the healthy re-union of all fractured
bones.   This sometimes  is excessive and the inflammation
passes far beyond that characterized as necessary.   To allay
pain and reduce inflammation, are,  therefore, indications
that deserve attention.  The first  is,  after the  fever and in-
flammation have been somewhat abated, by  purging, low
diet, and even brood-letting, if this is advisable, to be fulfilled
by the administration of the Dover's powder, in doses of three
or four grains, repeated as occasion may require.  When the
fracture is  compound, and the soft parts are extremely impli-
cated,  the case is much more desperate.  Much depends, in
cases of this character, upon the constitution of the patient.
If he be robust, and in  the  enjoyment of good health, the
chances are generally in his favor, for however mangled the
parts may  be, Nature, untrammeled in her efforts,  will very
often triumph, and re-union  and restoration, to some extent,
at least, will ensue.   But, on the other hand, when the con-
stitutional  powers are feeble, or the patient  of intemperate
habits, do  what we will,  and death will  often be the result.
   Respecting the management  of Luxations, or Dislocation,
the remarks upon Fractures  are,  also,  equally applicable to
them.   Common sense, alone, must  guide those  unacquainted
with the insertions, origins, and line of action of the muscles,
in attempts at reducing  displacements of the different bones
 from their sockets.   It is proper to remark that, even in cases
 in which the heads  of bones are  not removed permanently
 from their natural positions, but  which have  been severely
 sprained—the bands and ligaments having been put greatly
 upon  the stretch, or broken  up, are, as  a  general rule, not
 only exceedingly painful, but,- also, are often more  tedious in
 regaining their natural actions than are broken bones them-
 selves.  In the management of such cases, time is the great
 and reliable agent, but it is the general custom of surgeons
 to amuse  their patients, and in some sort kill the tediousness
 of the cure,—effected measurably by nature, to apply to the
              22 
170            PRACTICE OF SURGERY.
strained  joint,  various liniments, ointments, &c,—that,  in
truth, do very little good.  Rest and time,  I  repeat, are the
great agents of cure in cases of this kind; and he who at-
tempts to hurry them along their tedious course, most usually
meets with disappointment.
  (h) Of Cancers, and other malignant tumors, I will not speak
further than merely to mention them.  It were useless that I
should do more; for the very best description that could be
given would prove  perfectly  inadequate to  the public, as a
means of distinguishing them.  Indeed, their origin is a mat-
ter of doubt in tne minds of professional men, and their ma-
lignancy and tendency  to  a fatal  termination are too well
known to the public to  warrant them  in permitting quacks,
under the specious title of "Cancer Doctors," from interfering
with tumors that are suspected of  being cancerous in their
character.  Every wart or corn is not  a cancer, the decision
of "cancer doctors" to  the  contrary notwithstanding; and it
is well for humanity that  such is the  fact.   Were it not so,
fewer cures of terrible cancers by conjuration, faith, &c, &c,
would, I am very sure, be heralded to the world.   Warts and
such like excrescences are apt to go away spontaneously, and
so are cancers, that, in truth,  are nought but simple warts !
  (i)  Wens—Encysted  Tumors, properly  speaking—are very
different in their  nature  from cancer, and are not, by any
means, to be confounded with  this latter complaint.   They
are composed, solely, of shut sacks or bags, which secrete  or
pour  out from their inside a watery fluid; and their increase
in size is wholly attributable  to the  increase of fluid continu-
ally  accumulating within, and distending them.  Moreover,
they are inconvenient only on account of their size, and dan-
gerous only when they come to press on, and interrupt the
offices of important  organs.   Their treatment consists in re-
moving them with the knife,  when  this is practicable ; or in
puncturing and letting out their contents,  when their removal
is out of the question.
   Tooth Ache is too well known to deserve a description here,
and  its proper treatment is no ways equivocal.  If the tooth 
                PRACTICE  OF  SURGERY.            171

be hollow—which is generally the case with aching teeth—if
it can be extracted, this is  certainly the shortest and least
painful mode of getting shut of an extremely painful affec-
tion. • But I would advise the reader to permit no bungler to
undertake the extraction of a strong back tooth.  The pulling
of teeth is always attended  with pain, and, unskillfully per-
formed, may  result  in serious injury to the jaw bone.  No
one should undertake to use the tooth-key, in common use,
without a pretty correct knowledge,  both  of its mechanism,
and of the conformtion of the parts concerned in its applica-
tion.  When a sound tooth aches, which has not been addicted
to  aching, or when  the  situation of  the  person suffering is
such as to forbid the extraction  of a tooth, some purgative
medicines should be prescribed;  and a mustard  poultice to
the face may probably  prove  serviceable.  I am convinced
from some experience, that many teeth are habitually extracted,
which, had a course of the kind  here recommended been fol-
lowed, would have  been not only permanently relieved, but
also of service in after life.  Children shed their  teeth after
they have attained the age of a few years, and other perma-
nent teeth come to  supply their places.  It is proper, there-
fore, when the  teeth of children become loose, to  remove
them, which is easily done, in general, by cutting with a sharp
pointed knife the gum, and picking them out either with the
fingers, or by tying  a string fast around  them, and pulling
them suddenly out.   When  this  is neglected, the permanent
tooth is sometimes diverted from its course, and ugly and in-
convenient "snaggles" are the  consequence.
  I have now ended all I  have to say in this place on the
diseases and their  treatment, both surgical and medical.  I
have purposely omitted the mention of some, and have only
alluded to others.  In those diseases that I adjudge physicians
should always treat, the symptoms,  the causes, the nature
and the treatment  were severally  very briefly stated; and t
did this for the sole purpose of affording the community the 
172
PRACTICE  OF  SURGERY.
general principles  of  the  nature  and treatment of diseases,
and of admonishing them of the danger and the responsibility
that would attach to them, should they undertake to perform
that, a requisite knowledge for accomplishing which they do
not possess.  And, on the other hand, in those trivial affec-
tions, that are, in some instances, alarming to the uninformed,
but which, nevertheless, are devoid of danger, I have, after a
plain description, attempted to lay down concise rules to man-
age them by, which,  when followed out, scarce ever fail in
bringing relief to  the patient, and  at the same time, save
expense and avoid a great  deal of trouble.   Besides, the
remarks contained in this  small volume, I hope, if  they sub-
serve no other purpose in many instances, will, in others, be
at least, in some measure, a satisfaction to those persons who
have not had previous opportunities of  making acquisitions
in medical knowledge, from more elevated sources than the
present treatise can boast.
  Having made these explanatory  remarks,  I pass, in the
next place, to the  twelfth and last chapter, to consider, in ac-
cordance with the plan already laid down, a few of the arti-
cles used as medicinal agents ; and  it is my  design to notice
only  those recommended in the foregoing chapters which are
both simple and safe in the hands of those who do not make
the profession of medicine their vocation in life. 
CHAPTER  XII.
                THE MATERIA MEDICA.

  By "The Materia Medica" is,  in plain English, meant the
materials or agents used in the cure of diseases—the materi-
als of Medicine.  Without a knowledge of them, of their phys-
ical  and medical  properties—of  the effects which they proc
duce upon the human body in a  state both of health and dis-
ease, the boasted  science of  medicine would  well nigh be an
empty sound—ay, quite, were not the natural resources of the
constitution, in many instances, adequate of themselves to  re-
pair the inroads and breaches that are so often made upon our
bodies by extraneous agencies.
  Now, all that is known respecting the medical properties
of any substance whatever, is the result of  observation and
experience.  For example :  no one, however learned or wise,
can possibly, by a simple examination, arrive as the conclu-
sion that the Peruvian Bark is capable  of curing Ague ;  yet
that it is, the evidence of thousands can easily be adduced.
Nor is it possible that any philosopher  can arrive at the fact
that Rhubarb  purges, when taken into the stomach, other
than through and by the experience and observation of those
who have witnessed  its effects.  Then, it will be seen that
this branch of medical science is built wholly upon observa-
tion and experience, that it is progressive, being the accumu-
lated work of thousands of honest, honorable and intelligent
persons.  What folly it is, therefore, for ignorant, unlearned,
and superstitious people to reject by a mere ipse dixit, evi-
dence of a character so elevated, and declare that this medi-
cine is improper,  that injurious,  and the other rank poison ?
Physicians are well aware that all their most useful medicines 
174
MATERIA  MEDICA.
are poisonous.  Indeed, this very property  entitles them to
the name of medicine.  A potato is not a medicine, because
when taken into the stomach, this organ transforms and  ap-
propriates it to the wants and nutrition of the system ; it pro-
duces a natural effect.   But, on the contrary, the root of the ip-
ecacuanha plant, when taken into the stomach, produces an
unnatural effect.  This organ does not  act upon it, but it acts
upon the stomach, in so much as to prevent entirely its nat-
ural office and produce vomiting.  In this way a division of
certain substances is easy into two classes—naturals and  un-
naturals :—The first includes every nutritous substance, which
during the digestive process, is capable of such transforma-
tions as to prepare it to enter into and sustain the bodily func-
tions :—The second, all those substances which the stomach
is incapable of transforming in this manner, but which are  ca-
pable of  effecting some change upon  the stomach itself, or
through  it upon the body at large.   It  may be laid down,
therefore, as a truism—with few exceptions—that whatever
substances, upon being introduced into the system at large,
are capable of working a change upon  it, are properly medici-
nal agents ; wiiile those that, in entering into the system, in-
duce no  disturbance  or inversion of action  therein, are  not
medicinal, being either nutritive or inert.
  It has therefore  been the custom of  almost  all  writers on
Domestic Medicine to notice, at length,  a host of medicinal
plants, giving their histories and medical virtues, or supposed
virtues,—recommending this for the cure of that disease, and
that for the cure of this.  Now such a course, I believe to be
not only  useless,  but  in its tendency decidedly mischeivous.
There is  already a proneness on the part of the public to hunt
out new  cures, and to experiment upon  themselves or their
friends, with new  remedies.  And it is obvious that a trea-
tise, such for example, as that given by Dr. Gunn, is calcula-
ted to foster and keep  up such a state of things, which, so far
from advancing the science of medicine, impede it.  The illit-
erate  and unlearned are not the proper persons for conduct-
ing researches of this kind.  A knowledge, of Botany, of 
MATERIA  MBDICA.  •  '           175
Chemistry, and of the organic laws relating to life, are indis-
pensable prerequisites to investigations of a sort similar to
those in question.   F»r these reasons, with others not  speci-
fied, I shall introduce  in the  following sections  those medi-
cines only with whose properties and peculiarities of  action
the public must necessarily have an  acquaintance, approxi-
mating, at least, to correctness.  People, I repeat, what I
have before  repeatedly  declared, had better,  infinitely, let
medicine  alone altogether,  and wholly trust to the sanative
resources of nature, than to prescribe it ignorantly, and, per-
haps, incompatibly with those salutary tendencies.  But there
are medicines, which, comparatively  speaking, are innocent,
but which, when administered with a view to  accomplishing
some simple purpose, become highly useful, as well in  unpro-
fessional as in professional hands.  Such  conditions as 1 im-
agined these simple medicines to be useful in, I have attemp-
ted to point out, so that " the wayfaring  man though a fool
need not err therein;" and  I  pass  now, in the next and last
place, to  put down most or all of the articles,  or remedial
agents referred to in the foregoing chapters.
   I.  Emetics.  Emetics are substances which, when taken into
 the  stomach, excite it to contract, or  close upon itself and ex-
 pel  its contents.   They are frequently useful  in freeing the
 stomach of indigestible food, and in expelling from it the vitia-
 ted secreticns that often gather in  it.   But I do not think
 them admissible, at all, unless symptoms urgently demand
 their use.   In some inflammatory affections, as Croup, for ex-
 ample, they exert  a very beneficial influence, but they do this
 chiefly, perhaps, in consequence o£  the nausea  and state of
 debility which accompany their  operation—amounting, in
 some measure, to  the more active means for  reducing  fever
 and controlling the heart's  action.  Emetics  are medicines,
 which, considering their mode of action, the nicety of judg.
 ment frequently required to  prescribe them judiciously, their
 liability to prove mischievous, &c, should generally be direc-
 ted by profession al persons.  Persons are apt to  imagine that,
 because an individual has nausea, complains of a loaded or 
176               MATERIA  MEDICA.
burning sensation of the stomach, or is making continual ef-
forts to vomit, the stomach is foul, and an emetic is indicated.
Now these are the symptoms of inflammation of the stomach)
and  the exhibition of an emetic in this affection never fails to
aggravate all its unpleasant symptoms.   I, therefore, not un-
frequently having witnessed the ill effects of emetics, admon-
ish my readers not to prescribe these substances, without the
exercise of considerable caution,  under the mistaken notion
that  they never do harm.  Tartar-Emetic, Ipecacuanha,  and
Lobelia, are the substances most frequently employed as emet-
ics.  Warm water, taken in large quantities, in cases  atten-
ded with much nausea,  frequently answers the  purpose of
emetics; and to  its use, in such  cases, no objection can be
raised.
   II.  Of Purgatives.  These are substance which, when in-
troduced into the stomach and bowels, stimulate these organs
to an unnatural  state of activity, causing them to discharge
their contents, as well  as an additional amount of fluid mat-
ters  which they excite them to pour out, with more than usu-
al activity.   Many ingredients, both of the vegetable  and
mineral kingdoms of nature, possess a purgative principle;—
about the intimate nature of which, however, but little is
known.  Some of the ingredients here referred to  possess this
principle in a state of great activity, while others possess it
in a much milder degree.  The  former are styled active or
drastic, the latter mild purgatives.   Again, purgatives are divi-
ded by physicians into those which produce copious watery  dis-
charges, and  those whose chief action consists in  a mere has-
tening on of the feculent matters that the intestines happen to
contain at the time of their exhibition.  I shall notice but the
milder of these divisions, because I cannot, consistently with
the body of this work, do more.—I cannot conscientiously ad-
vise  my friends to employ, without the advice of a medical
practitioner, medicines that I myself am continually liable to
abuse; and which are  habitually doing mischief to the con-
stitutions, and even destroying the lives of many of my  coun-
trymen, from injudicious administrations. 
M E T E R I A  MEDICA,
177
  Purgatives, when judiciously given, may prove serviceable
in various ways.   1st.  They clear the bowels of vitiated ac-
cumulations which, not uncommonly both give rise to and ag-
gravate  various diseased  conditions.   2d.   They  are indi-
rectly, when perseveringly administered, agents calculated to
weaken  and debilitate the body, by abstracting from it its
source of nutrition,  and even of instituting  a drain directly
upon the blood itself.   3d.  They call the undue quantities
of blood that flow to, or are accumulated in the head and
other organs, from these parts by making strong  impressions
on the coats of the stomach and bowels, draining the blood
vessels, in this way, of a considerable amount of their more
fluid contents.  Such is particularly the case with respect to
the beneficial influence of purgatives in affections of the brain.
  (a)  Epsom Salts.   These are formed by dissolving  indefi-
nite  proportions  Magnesia in the Oil of Vitriol—Sulphuric
Acid—hence, they are, properly speaking, a Sulphate of Mag-
nesia.  They are  neutral,—that is, they possess  none  of the
properties  either of the Vitriol or of the Magnesia.  They
possess the property of a  sure and somewhat active purga-
tive, when given upon an  empty stomach, in doses of about
an ounce or, a large tablespoon heaping full.   They should be
dissolved in  a considerable amount of water, either cold or
warm—to suit the taste of the patient.   A smaller dose than
that here specified will, in general, prove sufficiently  active,
if taken upon an  empty stomach. The dose for children to
be in proportion to their age.
  (b)  Castor Oil, as is generally known, is procured from
Castor  Oil  beans by  expressing it in a manner similar to
that for obtaining Linseed Oil  from the seed of flax. It is
one  of our mildest and most useful'purgatives, acting, in gen-
eral, without pain or nausea, and yet, with much certainty
and  a good  deal  of efficiency.   In the diseases  of  children,
when purgatives  are indicated, this is often particularly ap-
plicable.   Nor is there, in the whole Materia Medicae, another
cathartic of so much value in dysentery and  other inflamma-
torv diseases of the bowels, in which, nevertheless,  an evac-
             23 
178
MATERIA  M E DI 0 A .
uant is desirable.  In dysentery there  is much pain and irri-
tation of the bowels with frequent slimy or bloody discharges,
unaccompanied, however, with the natural secretions of these
organs, which, along with the  feculent matter, it is often ab-
solutely indispensable to carry off.  For this  purpose Castor
Oil, to which, as a general rule,  a few  drops of Laudanum
may be added with advantage, is the best means in our reach.
In Colic, again, it is, in combination with Laudanum or Spir-
its of Turpentine, one of our surest remedies.   In conclusion,
I recommend every family to  keep a  bottle of this valuable
Oil constantly by them.  Dose for an  adult, a table spoonful,
more or less.  Children, a teaspoonful, repeated, if need be.
  (c) Aloes.   This substance, like the preceding, belongs  to
the vegetable kingdom.  It comes to us from beyond the seas,
and, in appearance, resembles pretty nearly  common Rosin-
It is extremely bitter, but in other respects, is not very offen-
sive to the taste.  There are several species of Aloes, but
they do not differ greatly either in appearance or in their ac-
tion upon  the system.  They are  all the inspissated or hard-
ened juice of several varieties of the same  plant, and are,
perhaps, somewhat differently treated  in their preparation.
  Aloes is one of our very best purgatives in almost all  cases
connected with  a sluggish state  of the bowels.  In indiges-
tion it is, in  a vast number of  cases, of itself, when aided by
a rational diet, sufficient to remove disease.   In some of the
affections  peculiar to females Aloes is very frequently a most
valuable medicine; in others it is not.  Almost all the  pat-
ent quack pills  of a purgative   character which  flood our
country from time to time, are chiefly composed of Aloes, dis-
guised by  the cunning work of the impostor.   Hence, the use-
fulness of these  pills in  dyspeptic cases.
  Aloes is modified, to a considerable  extent, in  its action
upon the  human system by long boiling.  By this means it
seems to be  rendered milder and  more pleasant in  its opera-
tion.  I have, in the foregoing chapters, repeatedly referred
to an Aloetic Pill, the mode of the preparation of which I now
proceed to give.   Boil the aloes, in a considerable quantity of 
M A T E R I E  MEDIt'A,
179
water, down to a thick syrup, removing the impurities, should
any be present.  The  syrup is then to be removed from the
fire, and, when partially cool, a sufficiency of Castile Soap, in
fine  shavings, is to be added, to insure the adhesion of the
pills after they have become dry.  Only a small amount is re-
quired for this purpose.  In the last place, the mass is to be
divided  into pills, rolling them in a little flour or starch.  If
there be added to the aloes, previous to boiling, some pulver-
ized Ginger and  a little  Cayenne Pepper, I think, the value
of the preparation will be enhanced.
  The dose of these is from one to four or five, taken upon retir-
ing to rest at night.  From considerable experience with pills,
formed in the above manner, I am convinced that no prepera"
tion, with which I am acquainted, has advantages over them,
in the pleasantness and efficiency of their operation.  By
the addition of  a few grains of calomel they become very
useful in stimulating the liver to pour out more than its ordi.
nary  amount of bile.  In the body of the worl§reference has
been  repeatedly made to these pills, and it is unnecessary,
therefore, to speak more fully concerning them in this  place.
  (d) Rhubarb.  Of this medical root there are several vari-
eties  in use by physicians, but these are  quite  analagous in
their operation.   The common broad leafed pie-plant, now
everywhere extensively cultivated as an esculent vegetable
for making tarts,  affords a tolerably  good article  of rhu-
barb.  As a purgative, in the hands  of skilful physicians,
rhubarb may, in certain  cases, be very advantageously sub-
stituted for other purgatives, but as a simple cathartic, de-
signed chiefly to evacuate the bowels, I do not regard it equal
to those already recited.  It possesses, along with its purga-
tive  property, an  astringent  principle, and it is apt, on this
account, to leave the bowels in a costive state; but this very
circumstance  frequently renders it highly serviceable, partic-
ularly in cases in which a  tendency to  diarrhoea exists, but
which, nevertheless, demands an evacuant plan of treatment.
A good laxative bitter may be  formed by adding to an ounce
of Colombo root, one half  its  weight  of rhubarb, to  which 
180
MATERIA  M E D1 (' A .
one pint of whisky is to be added.  A tablespoonful of  this
taken before  eating, two or three times daily, both invigorates
the bowels, and obviates costiveness.
  (e)  Cream of Tartar.  This is composed of potash, in union
with a vegetable acid, called Tartaric Acid,  and is properly
a Tartrate of Potash.  It, therefore, combines in itself  an in-
gredient from both  kingdoms  of  nature—the  mineral  and
the vegetable.  In febrile diseases it is  sometimes allowed to
patients as a pleasant cooling  drink.  In large  doses,  and
especially when combined with another purgative, as Jalap,
for example, it acts as a strong, and, indeed, oftentimes as a
powerful purgative.   But I am of the opinion that physicians
ought, generally, to prescribe it, unless, as is sometimes the
case, persons only slightly indisposed, crave a pleasant sour
drink, when a teaspoonful  of the  article in question, mixed
in a glass of cold water, will be found refreshing and grate-
ful.
  (/)  Calomek   It is proper that  I should say a few words
with respect to this very important medicinal agent; but as I
have  not recommended  it to be used, except by physicians
themselves, it is unnecessary that I extend this notice to great
length.   Calomel is prepared from Mercury or  Quicksilver,
and a gas (air) known to chemists as "Chlorine gas." which
is one of the  principles contained in table salt.   It is a pur-
gative, but it is not always given with  a design to its cathar-
tic operation.  Most often when designed to purge, it is given
in combination  with some  vegetable  substance, as jalap,
rhubarb, or aloes, the actions of which it very greatly mod-
ifies.   It is a medicine having a decided tendency to act upon
and rouse  the liver  to unnatural  activity, and is very often
prescribed  chiefly  for this purpose.    In inflammatory  dis-
orders, however, it should be prescribed with a  design  to its
anti-inflammatory effect upon the system.  It combines with,
and impoverishes the blood, and for this very reason is a
powerful agent  in  controlling  those  diseases  that depend
upon too rich a blood, as almost all pure inflammatory disor-
ders do.  To  accomplish his aim, the physician  has often to 
MATERIA  MEDICA.
181
give calomel in small doses, until its constitutional effects
begin to manifest  themselves in  the gums of  the  patient,
when, as a general  rule, the medicine  should be discontinued,
lest  a troublesome  salivation should ensue.  Opium is, in
numberless instances, very usefully combined with calomel.
  Calomel has  long been of essential service  to quack doc-
tors, as  the notion of a far off endless hell has ever been to
quack preachers.   Both serve the purpose of scaring the vul-
gar and superstitious parts of the community into subjection.
The doctor tells the dear people that calomel is  a dreadful
poison, and will, if  taken, make shipwreck of their constitu-
tions, while the preacher holds up his darling as the future eter-
nal abiding place of all  who refuse to bow in implicit obe-
dience to the provisions of his narrow creed.  And both are
equally successful in making disciples, or rather, I should say,
dupes !   But apart  from  jesting, the  fact that,  even in the
hands of skilful physicians, calomel sometimes creates trouble-
some sore  mouths,  and  too  long continued  acts  injuriously
upon the general system, is seized by unprincipled empiricks,
and putting  aside  all good it is capable of achieving when
judiciously prescribed, they assert that  it ruins and breaks
up constitutions, gets into  the bones, destroys life, &c, &c.
I once heard of an empiric who, having an old  skeleton, the
bones of which were partly rotten, held their  crumbled ends
up as an example of the action of Mercury upon  the bones
—first asserting that the person to whom they once belonged
had, during his life, suffered a salivation!   And the admiring
crowd gulped it all down, surprised at the wonderful sagacity
 of the doctor!   It must be confessed*however, that  calomel,
 injudiciously prescribed, is capable of doing much mischief,
 and of acting injuriously upon the constitution, but it is, also,
 capable of doing much good, and even, not unfrequently,  of
 saving life;  and no respectable physician  will ever throw it
 away altogether,  because  ignoble quacks and vulgar fools
 abuse and cry out  against it.  All medicine may,  under cer-
 tain circumstances, prove more or less injurious, and may,
 with equal propriety with calomel, be pronounced poisonous, 
182
M A T E R I A  M E D I C A .
 ifcc.  But it is well to remember that the very  practice of
 physic is founded upon necessity.  The physician has, not
 unfrequently, to choose between evils—to either  let his  pa-
 tient die for w^ant of treatment,  or to interpose and try to
 save his life by a mode of treatment,  heroic and powerful j
 and it is his duty ever, and under all circumstances to choose
 the latter.
   III.  Diaphoretics are such medicines and means  as  are
 used for  reducing fever and  over  heated states of the body
 by exciting  perspiration or sweating.  They  are useful in
 most febrile diseases, and some of them being always at hand,
 should be used in all cases of severity—such  are  cold water
 and fresh air.  One of the most useful medicines of this class
 is the Dover's Powder, so often recommended in  this work.
 Though not identical  with the original recipe  for preparing
 this powder, the following is the one I usually prefer:   Take
 of opium and ipecacuanha,  in fine powder, each  one  dram;
 of nitre, (salt-petre) one ounce.  Grind the ingredients and
 mix them thoroughly in a mortar, till the mixture  assumes a
 uniform color.  It is then fit for use, and should  be kept in
 closely stopped bottles.  Of this powder, two or three grains
 taken every two hours, will hardly fail, after a few doses, es-
 pecially if assisted by warm and gently stimulating teas, to
 excite  a very general and pleasant sweat.  In many cases
 of disease, the Dover's powder is one of the surest and most
 powerful means of bringing about their resolution.  While it
quiets  and soothes, it, at  the same time, opens the pores  of
the skin, and thus permits effete and injurious fluid matters to
escape.  Physicians combine it variously, with  calomel, an-
timony, sugar of lead, &c, according to the peculiarities of
the particular case under treatment.  Antimony—the  Tartar
 Emetic—is a good and powerful diaphoretic, but owing to  its
great activity, and the dangerous symptoms which it  some-
times gives rise to, none but skilful  physicians should, by any
means, prescribe it.   There are several common vegetable
substances that serve a valuable purpose as diaphoretics in
certain cases,—those  not complicated  with any serious  in- 
MATERIA  M E DIC A .
183
flammation.  Such substances are Pennyroyal, Peppermint,
Sage, Catnip, Bone-set, and especially the Black Snake root
of this country.   These should be given in the form of weak
tea, warm, and drunk in large quantities.  Slight  colds are
often speedily removed by adopting a coursfe of this sort.  In
cases attended  with considerable fever, however, I cannot
recommend these stimulating teas; they may prove mischiev-
ous in such cases.
   IV.   Expectorants.  These are medicines which  excite the
inner or lining  membrane of the lungs, to exhale or throw
off a more than natural quanity of mucus; and they are
chiefly useful in cases of dry coughs and other states of the
lungs, wherein the natural mucous exhalation is deficient  or
otherwise  deranged. I need mention but a few articles  of
this class, for although they are numerous, yet a few only are
in much repute. The Tartar emetic, and the Dover's pow-
der are both frequently used as expectorants, but  considera-
ble discrimination is to be exercised in  their administration.
The preparation called Cox's Hive Syrup, to which reference
was made in the section on croup, is one among the best ex-
pectorants in simple cases of dry cough.  It is prepared from
 the Seneca Snake root  and  Squills, and  it, also, contains
 a small amount of Tartar emetic,—the whole being  formed
 into  a syurp  with honey.  The dose is from 20 to 60 drops
 for an  adult, three or four times daily.  It may be obtained
 from any drug store. Lobelia—the tincture,  is also occasion-
 ally useful as an expectorant. Dose the same as that of the
 last mentioned  article.
   V.   Sedatives are such medicines or  agents as  produce a
 soothing effect  upon the system, and ease or lull pain.  Opi-
 um stands at the head of medicines of this class.   It  is the
 solidified juice of the poppy, and is chiefly imported to  this
 country from Turkey.  In the practice of medicine, without
 this drug, the physician's hands would be, in a great meas-
 ure, tied; he might behold pain and wretchedness, but would
 be without means to give relief;  he might witness the pangs
 of mortality, but could not smooth the  pillow of death.   Yet 
184
MATERIA  M E D I C A .
its proper administration is frequently a point of much nicety,
and none but experienced persons can hope to  give  it in
all  cases  with due discrimination.  There are but few dis-
eases, indeed, in which opium, at some period of their course,
is not useful, but,l repeat, the judgment of experienced  per-
sons is often required to prescribe it timely,  I  have already
referred to  it as  one of the constituents of the famous Do-
ver's powder, and having, in the foregoing chapters, repeat-
edly advised laudanum, I will now give the receipt for forming
this useful liquid.   It is a simple solution, called a tincture, of
opium in good whisky.  I  care not how it is formed, provided
as  much (or more) opium added to  the  whisky  as it can
dissolve.   The clear liquid  is then  always  of  a uniform
strength, and  may be depended upon as good strong laud-
anum.  The dose of laudanum proper for  an adult varies
greatly.   Twenty drops is, perhaps, a medium dose, but in
a few cases I  have given it in one or two  teaspoonfuls at a
time.  And I  once knew a man who, from habit, could drink
it like water.   Children do not bear opium well, and a  child
of one year old should not take more than one or  two drops
at a time, to be repeated, if need be.
  (b) Gum  Camphor.   Camphor comes to us from across the
ocean, whence it is obtained from the camphor tree, in a
manner similar to that which our  countrymen employ for ob-
taining lamp black from the pine tree.   The gum, resin,
more correctly, is scarcely ever used by the  common people
in its solid form, but when dissolved in whisky  it is to be
found in almost every house, and is used for relieving all ac-
cidents, from a sprained toe to a broken back, besides being
given internally to save life under a thousand circumstances.
And although, in  truth, the spirits of camphor is oftener used
than necessary, it is a simple, safe, and sometimes prompt
medicine in cases of sudden fainting, of slight colic or sick-
ness of the stomich; and as an external embrocation in slight
bruises and sprains.   It is  well to remark, however, in this
connection, that  the proper treatment of sudden fainting,
from whatever cause,  is to lay the patient down with his 
                   MATERIA  MEDIC A.               loO

keels up hill, so to speak, so  as to bring his head low, and
to dash cold water forcibly in his face.  The camphor bottle
is almost always employed in such cases, but by no means
uniformly with advantage to the patient.  Mothers frequently
weaken a few drops of the spirits of camphor, and feed it to
their babies to relieve them of colic, and it is  frequently used ■
for this purpose.  In  the  hands of physicians the solid cam-
phor is,  in many diseases, of essential  service.  But I need
say no more upon this substance at  present.   Being  greatly
innocent and safe in the hands  of  every one, I  need not
point out the proper dose.
  VI.  Stimulants.  Whatever, upon being swallowed, imparts
warmth  to  the body, and increases the frequency  of the
pulse is properly a stimulant.   For accomplishing these pur-
poses physicians  employ  numerous substances, at the head
of which I may mention  the spirituous liquors, as  brandy,
whisky, wine, &c.   The  whole catalogue of aromatic teas,
as peppermint, sage, &c, belong  to  this class of medicine.
Stimulants are  occasionally useful, and in some states of the
body they are imperiously demanded  to sustain flagging na-
ture, but they are liable to be abused, and are often abused
by physicians themselves.  They should be used, perhaps, as
a general rule, in those cases only, in which a judicious diet
(provided there be  any  relish  for food) aided by  external
warmth, fails to  sustain  and keep  up  the  circulation, and
the  patient is in imminent danger of falling into a fatal col-
lapse.  But that man who habitually uses stimulants, espe-
cially, those of the spirituous kind, needlessly, and  perhaps
I should say, murderously excites nature and infringes upon
her  operations, the penalty for which, in nine cases out  of
ten, is premature decay.  Besides drunkenness—for I allude
to this now—is a positive sin, engendering as it does, not on-
ly the destruction of the drunkard's life, but implicating also,
the Welfare and happiness of his friends.
   VII. Tonics.  These are substances that  are  often of im-
mense value in the  treatment of disease,  especially of the
 western country.   When the  vital  powers  have sunk low,
              24 
186               M A T E R 1 A  M E D I (  A .

the patient being greatly enfeebled, and  after he  has been
prepared for  their reception, then tonics, by imparting tone
and energy to the drooping system, prove highly serviceable.
All those medicines and means, and they are numerous, that
increase the energies of the body, and give tone to its vari-
ous functions, are  properly tonics.  The  numerous prepara-
tions of iron  are tonic in their operations upon  the system.
So, also, of many  other mineral substances.   But all these,
in my opinion, demand  the  discriminating judgment of the
physician as  to the  propriety of their  exhibition.  In the
vegetable kingdom of nature, also, innumerable  productions
exert, when taken  internally, a genuine tonic influence over
the enfeebled body.  Some of these exert this, however, in
a much higher degree than others ;  and at their head stands,
undoubtedly,  the cinchona or Peruvian bark.
   The tree which  furnishes this  bark grows  abundantly in
South America, particularly in Peru;  hence its name.  It is
imported in large quantities into the United States, and im-
mense cargoes of  it are sent to the European countries,—
more especially to  France, where from it  is manufactured the
invaluable drug, so useful in the  treatment of our western
diseases—quinine.  Formerly the bark itself was used as a
general tonic, and as a remedy in cases of ague ; but, although
the bark in substance, in a few cases  may be found more ef-
fectual than the quinine, yet its very offensive and nauseous
taste and irritating properties render it in others, greatly infe-
rior to its active  principle, the quinine.   I  need not detail the
method by which quinine is  manufactured. It is only proper
that I inform the  reader that it is a chemical compound,
formed by uniting  oil of vitriol, (sulphuric acid,) with the ac-
tive principle of the bark, called quinine.   Hence, the chem-
ical name of sulpJiate  of quinine, by which it  is  everywhere
known.  I have already, in the "course of this work, spoken
of the value  of quinine  in the management of diseases, and
I need not therefore, refer to the same  here.  A prejudice fos-
tered by the hordes of quacks everywhere  to  be  found, has
been got up against the use of this valuable, and  compara- 
MATERIA  M £ D I C A .
is:
tively innocent medicine.  Certain persons imagine that it
acts injuriously upon the constitution.  Now, although qui.
nine may be  abused, as  everything else is abused, and  un-
der certain circumstances  may even  destroy life, yet I am
bold to  declare, that, notwithstanding I have  prescribed it
thousands of times, I have never, but in one single instance,
seen it excite very unpleasant symptoms.  But I have seen,
and even had, in the. earlier part of my professional  career,
many persons die for the want of it    And it  affords me the
deepest consolation, amid the many trials of my professional
life, to look back and recount the numerous lives that a cor-
rect estimate of the medicine now in  question, has  enabled
me to rescue from  impending death.   I repeat, that I have
seen people  die  for the want of quinine—never from  its  use.
It is useful, in small and often repeated doses, as a  general
tonic; and, in more efficient doses, in all periodic affections,
recurring daily, or at regular intervals, as  is  the case with
 ague and our paroxysmal autumnal fevers, it is, many times,
 an absolutely indispensable  curative agent.   Knowing, as I
 do, the great value of quinine in the diseases of our country, I
 do hope that the reader, if he possess predilections unfavorable
 to its exhibition, he  will divest  himself of prejudice, and no
 more  assist in impressing error upon the public mind.  It is
 the very depth of madness to declare that " I  will never  take
 another grain of it."  It may be, at no distant day, that you
 may be called upon to make choice  between  a dose or two
 of quinine and death!  When the question will no longer be,
 " is it injurious," but, " will it save my life ?"
    Allied to the Peruvian  bark, in medical properties, is the
 bark of our own indigenous dogwood.  Though inferior  in
 several respects, to  the Peruvian bark, it may not unfrequent-
 ly be substituted for it;  and it is probable that, at no distant
 day, its active principle—corninc—will be extensively manu-
 factured and used as a  substitute for  quinine.  The bark is
 frequently used in  whisky as a bitter, and when the circum-
 stances of the particular  case require a tonic, this may be  a
 very good one.  Colombo, both the American  and imported, 
188
MATERIA  MEDIC A.
Gentian, and an  extremely bitter  wood called Quassia are
useful bitter tonics, and  are frequently prescribed by physi-
cians for this purpose.   But it is unnecessary  that I  particu-
larize these, or dwell upon their distinctive medical properties.
No profit would result from such recitations, as medical men
themselves should discriminate minutia of this kind.  I,
therefore, conclude what I  have to say of tonics, and  with
them I close the body of this work—the object of which has
been to impart to the reader something  of a correct under-
standing of the structure of the human body, of the various
functions  or offices belonging thereto,  of the nature  and
treatment of diseases and accidents, &c.; together  with an
account of  a few of the more common and useful medicines. 
CONCLUSION.
  Before bringing the present volume to  a close, I feel it
incumbent upon me to allude briefly, to the relations existing
between the medical profession  and the public.  To  avoid
unpleasant consequences and misunderstandings, it is  ex-
tremely proper that a few suggestions, appertaining to reci-
procity of action on the part of both, be laid down.
  1. It is the duty of every person, upon  becoming the pa-
tient of any respectable physician, to hear and heed his ad-
vice, and strictly observe and obey all his  directions.
  2. It is the duty of the patient's friends (or nurses) to  ob-
serve most scrupulously every office with which the physi-
cian may entrust them, in any way pertaining to the man-
agement of his patient;  and,  as far as possible, to encourage
and fortify him (the patient) against the depressing influence
which an unfavorable case  might exercise upon  his  feeble
powers.
  3. It is their duty to instil  into the patient confidence in
the skill and ability of his medical attendant.
  4. It is their duty to exclude from the  patient's  room,  offi-
cious tattlers and useless visitors ;  and to peremptorily for-
bid, in  the presence  of the  patient, every species  of low
whispering.
   5. The nurses  and  friends of the sick  should, moreover,
wear cheerful countenances,  and treat the patient with the
utmost kindness, attending promptly to his every want.
   6.  In case of the unavoidable absence of the regular or fam- 
190
CONCLUSION.
 ily physician, it is right and proper that another be called in,
 but the case should, as a general rule, be restored to the first
 in attendance, whenever he shall be able to take charge of
 the same.
    7. The friends  of any sick person have a right to call in a
 consulting physician, with  whom, should he be a reputable
 practitioner, it  is  the duty of the attending physician to con-
 fer in a friendly and  courteous manner respecting the case
 under treatment.
    8. The public have no right to fall out with, discard,  and
 abandon a physician merely because  of the loss of a patient.
 Some  diseases  from their very onset, are necessarily fatal in
 their consequences, while others, surrounded by a multiplicity
 of unfavorable circumstances, are  liable to be so.  No im-
 putations should, therefore, be thrown out against the medi-
 cal attendant for  this cause alone.  If the  physician is a re-
 putable  practitioner, a moral, steady, and sober man—hu-
 mane and tender; if he have been assiduous in his attention
 upon the patient, if he have, at the solicitation of the friends,
 warned  them  of the probable  issue of  the case, then, it is
 to be presumed, that he should be exculpated from all blame.
  But, on the other hand, if he  promised unreservedly to cure
 the patient; if he flattered  the friends  of the patient, and,
 especially, if he is known to publish  cards  or handbills, sig-
  nifying his ability to cure consumption, scrofula, cancer, ague,
  without quinine, and the  liver  complaint without mercury,
 then, it is fair to  infer that he is a quack, and that the patient
 has been carried off of empiricism.
    It is proper to remark, in this connection, that I am not in-
  sensible to the imperfection of the  present treatise, but from
* the circumstances attending  its composition, I could not hope
  to avoid  some seeming incongruities.  It were impossible
  that it could be otherwise.  For  the  volume  was written t0
  benefit those, whom the author  had to presume, unacquain-
  ted, in a great measure, with the subjects upon which it treats.
  Therefore, it has been his  study to simplify the various top-
  ics upon which he has written ;  and  if he has occasionally, 
CONCLUSION.
191
carried his simplifying too  far to please  the few, he indulges
the hope that the many, whose wants have been chiefly con-
sulted, may profit by it.  No one more than the author de-
tests, in conversation with  unprofessional friends, the use, or
rather, abuse of medical technical terms, and high sounding
phrases ;  and he has therefore, aimed at least, in the present
treatise to avoid them  altogether, or when used, to plainly
define their meaning.
   In conclusion, the author asks  the indulgence of a liberal
community".  The style of  his work, he is aware, is  open to
criticism; but if it prove acceptable to the public, if it im-
part to those, for whom it  was begun, useful information in
those hours of bodily pain and affliction, which all are doomed
to suffer, sooner or later;  and, above all, if through its in-
strumentality a  single human being shall be  rescued from
impending death, then the  author must rest satisfied.
THE END. 
 
                    INDEX.



 Anatomy, General,.......13
 Ague,..........51
 Asthma,    -        .......81
 Abdomen, inflammation of,......gg
 Ague-cake,.........97
 Apoplexy,.........100
 Aloes — Aloetic Pills,  -    -    -    -    -     .    -178

 Bathing,.........46
 Brain, inflammation of, -     -    -    -     -    .  .  57
 Bronchitis,.........75
 Bowels, inflammation of,......92
 Bladder, diseases of,  -    -    -    -     -    -    -  97
 Burns and scalds,........157
 Bark, Peruvian,........186

 Croup,.....                   .  71
 Chest, inflammation of.......73
 Catarrh, or Cold,........73
 Consumption. -.........82
 Colic,..........117
 Cholera-morbus,    -    r......122
 Chicken-pox,........130
 Cholera, Asiatic,........148
 Carbuncle, ----*.--..  155
Cancer,  -->---.....170
Castor Oil,.........177
            25 
194                     INDEX.

Cream of Tartar,........180
Camphor,   -                        .... 184
Calomel,.........180
Clothing,  ---------  45

Diseases, causes of,.......35
Diet,..........39
Diseases, classification of,  -    -    -    -    -*   -  47
    "%   inflammatory,.......62
    "    contagious,      -    -    -    -    -    -124
Diarrhoea, or lax,.......92
Dysentery, or flux,......-  93
Dyspepsia,.....-     -    -    - 106
Dropsy,  -    -........120
Dislocations, &c,  -    -    -    -    -    -    --167
Diaphoretics,........182
Dover's powder,........182

Exercise,.........42
Eyes, inflammation of,.......98
Epilepsy, or Fits,.......102
Erysipelas, or St. Anthony's Fire,.....140
Emetics,.........175
Expectorants,.........183

Fahnestock's Vermifuge,     -    -    -    -       - 116
Fevers, in general,.......49
   "   intermittent,.......51
   "   congestive,.......57
   "   bilious,........58
   "   yellow,  --------60
   {    scarlet,.......- 133
   "   winter, or typhoid,  -    '.....143
Flux,..........93
Felon, or whitlow, -    -......155
Fractures and dislocations,......167 *

Health and disease, conditions of,.....34 
INDEX.
195
   • Heart, diseases of,.......88
     Hysterics,.........104

     Introduction,........7
     Influenza,    -    -    -     -     -    -    -    --74
     Indigestion,     -    -    -     -     -    -    -    -106
     Itch,    -----.....150

     Jaundice,   -     -    -    -     -     -    -    -    -112

     Kidneys, diseases of,    -......97
     Kine or cow-pox,     -    -     -     -    -    -    -127

     Lungs, inflammation of, -          -    -    -    -  -   77
     Liver, inflammation of,     -     -     -    «■    -    -   95
     Laudanum,   -     -    -             * -    -    -  -  184

     Measles,.....         -    -    -  130
     Mumps, -     -     -    -     -     -  - -    -    -  -  140
     Materia Medica,.....-    -    -  173
     Mad dogs, bites of,     -     -     -    -    -    -  -  165

     Nettlerash,   -     -    -     -     .    -    -    -  -  152

     Opium and Laudanum,......183

     Physiology, general,.......27
     Pleurisy,.........7s?
     Phthisic,.........81
     Purgatives, --.......176

     Quinsey,........-69
     Quinine,.........186

     Rheumatism,   --         .....118
     Ring-worm,.........151
     Rhubarb,.........179

     Sleep,..........44
     Stomach, inflammation of,......90
•     Spleen, diseases of,     -     -     -    -    -    -  -   97 
      196                       INDEX.

      Small-pox,.......-    - 125  .
      Scarlet fever, -    -     *     -     -     -     -    -  - 133
      St. Anthony's Fire,.......140
      Surgery, general view of,     -     -     -         -  - 154
      Scalds and  burns,    -     -    -    -    -    -    - 157
      Sprains,  -     -    -         -'.....169
      Salts, Epsom,    -     -     -.....177
      Sedatives,.......   -   #-  -  183t
      Stimulants,.........185

      Tooth-ache,........I70
      Tonics,..........185

      Ulcers,     -    .     -     -     -         "    -    " 166
                     •
      Worms,    -    -     -     "     "    "    "         - 113
      Whitlow, or felon,........155
£*    Wounds,.........160
          "    incised,  -     -     -     -    ; '    -    -  - I60
          "    punctured,.......161
          "    contused,......- 162
          "    lacerated,.......162
          "    poisoned,......- 163
      Wens, &c. -    -.......170
      Whooping  Cough,.......138
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