ARMED FORCES MEDICAL LIBRARY Washington, D. C. N \ A DISSE RTATION ON THE MEANS OP PRESERVING HEALTH, Im C H A R L E S T O Nfl ft W D TUB ADJACENT LOW COUNTRY. i}tt JJ.SAD BEFORE THE MEDICAL SOCIETY OP roUTH-CAROLI!0 A* on the 29 h op May, 179°* o o 0 o o o o 0 00 <> o o o o o o o o o <> o o o o Bv D A V I D RAMSAY, M. D. Member of the royal physical society op EoiNavRCH. a, <:<> o c» 0 «> <> 0 o o <> <> M <> 4> <* *> ' * *> •}>i'15^> ** ** CHARLESTON, SOUfH-C STT^E Printed bj Maryland & M'lviR, Nj. 47* B*y, M,DCC,XC. A D I S S E R T.A T I O N • N THE MEANS OF PRESERVING HEALTH Iff CHARLESTON, AND THE ADJACENT LOW COUNTRY. f T">HE objcd of the medical profefilon is n-c X only to heal difea es, but to prevent them. As it is my turn this evening to furnifh a fubjecl tf converfation for thef c;ety, 1 (hill, w.th g'ear de- ference, fubmit to their confideration forre pr*ci seal obfervations on the means of preventing thofe dif- eafes which are moft common in Chirief>on and the vicinity. This I do the more readily as, having enjoyed almoft uninterrupted hearth during a refidence of fixteen years in this climate, I hope that I may be allowed to have fome experimental knowledge of the fubject. The foundation of good health through life, mould be laid in a proper treatment of infants. Their limbs ihould be unconflned, and frequently rubbed. Their food ought to be plain and fimple. They mould be kept constantly clean, and never fuffered to remain wet for any length of time. Caps fbould be laid afide after the third or fourth mo&h in winter, and much fooner in fu Tu- rner. Shoes and ftockings may well be difpenfed with through the whole period of infancy. Every prudent exertion mould be early made for harden- ing the constitution againft fudden changes of the atmof )here. To this end exercif? mould be f eely and daily taken in the open air. When the weather turns fuddenly cold, fome additional cloathing may be proper; but it is often more for the intereft of children, to hab;cua.e them to all the varieties of , ? ( 4 ) . (i? our wen'her, •'nd even to expofe them to'occa-t fi ■ al rolHs, :hau by an excels ;,f ca e and tender- ing ro induce a delicacy i.f habit. In ruifi ig cradl s are hurtful They add much to the heai of 'he infants who are co fined between th-fir narrow fides. A hard matrafs is rruch cooler a».d on many accounts preferable. The youihs \vii.) are aocuft m.-d to fleep on the floor w th ba~e bLnkts, will pais though life wiefrmoie independence and with greater advantages than they who are accuftomed to the relaxing indigen- cies of (oft beds On the propriety of ufing voung children in this counf y to the cold bath, well informed pmficians hold different i pinions In f >me habi a i* certainly does good by bracing t,e ter.drr limbs and fortifying the body agiinO: fuddtn changes of the ar, wh le in others the fh >ck is too g-eat. In general it mi', neveuh lefs be fafely pffi/med that a great nvj-jrity of our children w >uld have a better chance for clcaping tlv-dileafes if infancy, if they were from an eirlv period d life h i'Mcuated to the frequeit ule of thfrcdd bath; and rhat very ffw ciies occur in which the dai'v wafh.nsj ot them i.< old water would not be of a^1v nt..ge Providence has kindly furnifhed us with an cfrlraci'rjs remedy fc.«r worrts. Pink root s one of the be ft veimuld be made of the cool morning air, but without wetting our feet with damp grafs, or other- wife expofing ou.felves to an undue ablorption of that moifturc which abounds for fume time after the rifing of the iun. As a further precaution againft the chills of the morning, it would be pru- dent never to go abroad with an empty ftomach. A glafsof cold water, or flice of bread, or a draught of fome bitter rea, taken immediately after rifing, would be beneficial. The above cautions of avoiding the morning dew may fafely be dhpenfed with in many cafes. A man who wafhes his feet in cold water every day will hardly ever fuffer from walking abroad in the morning. Nor will he who changes his fboes, and wipes his feet foon after they are wet from dewy grafs. It may farther be added, that if chil- dren were educated as they ought to be, when grown up they would have little to fear from wet feet or morning dews. Immoderate drinking mould be avoided in thii climate. To add the fiimulus of large quantities of fpirituous liquors to the heat occasioned by a warm atmolphere, is to add fuel to fire. Every evil ( 8 ) evil that naturally refults from an excefs of heat* is sTgri.vJted by a pi ntiful ufe of ardent fpirits, T'.ef«Ttend to .nfla re the blood, and oncur w"ih a warm fun ui weuiiug out the vitals, haften- in * ori a p e■-.nature eld a^e and «*n untimely death. I Ljw i'ar it w u d be Lr the oenefii: of our country t exveniiinate tieufeof diltuied (pints, I will not u..d.'rak.: to determine, dit have no hefitaticn in pronouncing, that the fum of evil reiulting from their a';ufe infi-.itel/ ou.weighs all the good that flows from tl em. The habit of immoderate drinking when once begun, hurries on its unhappy votaries almoft irrefmibiy. In the intervals oi lobriety, they feel a faintnefs and* oppreffion which is intolerably dif- treffi-g. Fir this they find no relief butVin a fecond intoxication. As the liquor loles its fii- mulus, the dofe mutt be increafed fo as 10 procure an abate ne-t ot painful fenfati. ns. The remedy' proves wo le than tl>e difeafe, and both continue to increafe in a faral progreflion from bad to worfe, fr^m oidinary grog to und lured Jamaica fpirits: even the latter become ir.fufHcient to wirm the flomnch, r.nd inftanres lometimts occur where the hotteft peppers have been added to the warmeft fpirits to t..ke off their fancied coldnefs. ToJ r numerate all the dikr.es which are brought on in this warn climate, by the abufe of araent fpirits, would far exceed tl e limits to which I muft confine rnyfelf. Eunice it to obferve, that among them is the deflrufhon of thedigeftive powers, obftrucYions rf the abdominal vifcera, dropfies and madnefs, Nothing can m^e powerfully illuftrate the per« nicious ( 9 3 nicious effects of rum than the havoc it makes among the Indians, who, from a robuft and hardy race, by the free ufe of that pernicious liquid, be- come mad, wafte away and die. They who wifh to preferve health, fhould fummon up all their re- folution to prevent the blandifhmenrs of company, or the reductions of appetite, from inducing them to deviate into the paths of intemperance; for, when once they have enteied on that courfe, their return to the practice of that moderation and fobriety which health requires, is always difficult: and ofien impcffible. Of the man) forms in which ardent lpirits are taken to the prejudice of health, none is more in- jurious than drams. Under the infidious ftiew of fortifying the body againft foggy and damp wea- ther, the practice of daily drinking drams has flain hs thoufands. It gives a temporary ftimulus to the fyftem, but this is foon followed with increafed debility. It creates a falfe appetite, and tempts to the eating of more folid food than either nature craves or the ftomach can digeft. Thefe are its firft effects. In procefs of time confequences of an oppofite nature are produced. A lots of appe- tite, at leaft for breakfaft, is a common complaint ♦ among thofe who have long been in the habit of drinking drams. To the evils rcfulting from this fource phyficians have fometimes incautioufly con- tributed by recommending the ufe of bitters." Though the bitters taken in fubftance, or in water, .nay be ufeful, the fpirits in which they are moftly orepared infenfibly lead to the pract.ce of dram- * r B drinking. ( io ) drinking. Huxham's tincture of the bark is, or thefe principles, the occafion of much mifchief. It would be for the intereft of patients that phyfi- cians mould never prefcribe the internal ufeof any medicines prepared in fpirits, except fuch as are taken in fmall dofes. They pay too dearly for being cured of fevers or bad appetires, who, by taking fpirituous tinctures for that purpole, contract a fondnefs for drams. On this fubject, it is worthy of remark, that health is often much injured by thofe who are at all hours of the day fipping fpi- •rituous liquors, though they are never intoxicated. It is a good general rule never to drink any thing flronger than water, except at our meals. _ An intemperate ufe of animal food fliould be avoided in this climate, efpecially in iummer. Excefs in eating is as bad as excefs in drinking. It excites a greater voppreffion, and requires a greater exertion of the digeftive organs. The warmer the weather, the greater is the tendency to putrefaction. It cannot be expected, that meat which becomes tainted in a few hours in market, can be much longer otherwife when it is takes immoderately into the ftomach. As often as an undue proportion of meat is taken at a meal, nature is not only oppreffed, but a foundation is laid for pmrid difeaies. Perhaps in this view of the mat- o ter, a fmall proportion of faked meat, as being lefs difpofed to putrefaction than frefh, would be more fuitable aliment in fummer than has ge- nerally been fuppofed. Inactivity ( «' ) Inactivity is another ot the evils againfl which the votaries of health fhould fix their molt deter- mined oppofition Many of our fummer difeafes arifr from fopprefied peripiranon. From whatever caufe this proceeds, languor and lafiitude are the immediate confequences. Thefe unpleafant fen-i fations ought to be inftantly removed; but to accomplifh thatdefirable object, recourfe mould immediately be had to fuch active exertions as are calculated to reftore an equable and free peifpi- ration. Our feelings on thefe occafions deceive us. They perfuade us to indulge in reft, but a regard to health leads to activity. The fenfe of wearinefs, which arifes from fupprefFed perfpira- tion, is more eafily overcome by refilling than yielding. The perfon who fits or lies down will find his laffitude to continue and increafe; but he, who in oppofition to h'u own feelings, makes a proper exertion of his active powers, will foon be relieved from it. The effects of exercife in promoting digeftion, and all the regular functions of animal life, are too well known to need illuftration. Suffice it to ob^ lerve, by way of applying the general obfervarion to our local fituation, that from the great moifture of- our atmofphere, impediments to a free perfpi- ratioh frequently occur. Thefe fhould be ain- teracted by fuch conftant, equable activity as, without hearing the body, will keep all the fe-< cretions in their due order and proportion. Among the evils refulting from indolence, a fondnefs lor drinking ardent fpirits is not the leaft. ( 12 ) leaft. Human nature is fo conftituted that it requires iomething to agitate it. Where the mind and body are both unemployed, the ftimulus of ftro g liquir becomes defirable, as a means of exciting fenfations, and of obviating the irkfome- nefs of having nothing to do. Inact.vity is thus doubly deftructive to health. Firft, by its own primary effects; and, fecondly, by leading to intemperance. Long ficungs at meals fhould be avoided in this cl mate. All the evils refulting from the fources which have been already mentioned, are increafed by the fafhionable cuftom of fpending three or four hours at the dinner table, for it leads to them all. The ufe of fegars has the fame ten- dency. They occafion a wafte of me faliva, and of courfe injure the digeftion of our food. They produce artificial ihirft, and confequently lead to tipling. By taking off that fenfe of uneafinefs which refults from having nothing to do, they de- ftroy one of the molt powerful incentives to action, and lead to habits of indolence. The fmoke of the feg rs tends to correct the moifture of the armofphere, and the ufe of them in fome confti- tuttons may advantageoufly evacuate redundant phlegm; but the lmall advantages procured in this way are outweighed by many greater evils which flow from their daily ufe. Sudden changes from hot to cold air, violent exertions, deprefling paflions, hard rides, long waks, great fatigue, and exceffes of all kinds, ftiuuld be guarded againft by thofe who arc anxious ( *3 ) anxious for the prefervation oi health. Thefe cautions are particularly neceffary in the interval between June and October; for, during that time, there is fuch a morbid irritability ot the whole fyftem, that irregularities, which in other months of the year might be harmlefs, feldom fail of im- mediately drawing after them ferious confequences. Hunting clubs fhould be wholly difcontinued through the fummer. They begin with violent exercife, and this is followed by plentiful eating and drinking. After exceffive perlpiration has been excited by thefe means, a ride late in the event ing clofes the fcene. Few fituations occur in which there is fo dangerous a combination of the caufes of our fevers as takes place on thefe occa- fions. tor fimilar reafons the game of fives, cricket, and in fhort every fpecies of diverfion or exercife that requires violent ^exertions fhould be abandoned in warm weather. V' The time of expofure to the fun fhould be fliortened as much as poffible. While we are ne- ceffarily expofed to it, we fhould abftain from ardent fpirits, and fhould avoid ftanding ftill. Ic would alfo be proper to protect our heads from the effects of hear, by wearing white hats. Thefe will be much the better fir deep crowns on fuch a con- ftruction as leaves a vacancy between the head and the hat. Fafhion, which feldoms confults either health or convenience, has lately deviared in'o what is lalutary by introducing the ufe of flapped hats on the above conftruction. Long may this fafhion ( *4 ) fafbron continue, or rather may it never ceafe to be the fafhion in Carolina. We fhould be careful of lying in damp rooms, mm linen not fufficiently dry; and we mould ahrays put on dry cloaths, as foon as poflible, after being wet. Chilling eafterly winds, night air, acd the evening dews mould be avoided. The latter are more pernicious than a thorough wetting from rain* Dew in this climate is of fuch a pene- trating nature, that no ordinary covering can be depended on for excluding it. It infinuates itfelf through our cloaths, and coming in contact with rise fkin, checks thofe difcharges which health requires.. They who indulge themfelves in fpend- ing, their evenings in open balconies, often pay dear for the hazardous gratification. The ground on which Charlefton ftands was probably gained from t&e ocean, and is but a little higher than the ordi- nary level of the fea. By digging eight or ten ftet, we every where find water. From this cir- oimftance, together with the lownefs of the ground,. and t^e abundance of Iwamps and marfhes, we breathe an air abounding with moifture. The heat of the fun fo commonly but unjuftly com- plained of, is beneficial by correcting this moifture j bat when his chearful influence 's withdrawn, the natural dampnefs of the air becomes eminently pernicious. Sleeping with open windows is, for thefe reafons, very injurious, efpecially if great changes of the atmofphere take place in the time c# fleep. Habit has fo far inured feveral perfons tu this praftice, that they fuffer nothing from if. Jt ( >5 ) It mult alro be acknowledged, that the confined air of a fmall clofe room foon becomes unfit for relpirati n. In eftimating matters of this kind, the advantages and difadvantages fhould be weighed againft each other. An opinion formed in this way would, as a general rule, be in favor of fleeping with fhut windows, efpecially iuch aa are near our beds. Perhaps the plan moft confift- ent with health and comfort would be, to fleep in a room altogether clofe, except a door which opened into an adjoining one, into which there was a free admiffion of the external air. In every cafe we fh.mld fo arrange ourfelves as to be fee ure, that wind may not blow directly on us when we are at re?-, and efpecially when we are compofed for fleep. The body of a man afleep is in itfelf confiderably cooler than when he is awake. There is, therefore, great danger from that undefigncd fl ep which often fteals upon us in confequence of thofe lollings in which, when the weather is hot, we are prone to indulge ourfelves. They who wifh to preferve health fhould refill all temptations to fieep, except in circumftances where proper precautions are taken for defending the body from that abatement of animal heat which refults from fleep itfelf, and ftill more from changes of the atmofphere. The greateft care fhould be taken for the prefervation of cleanlinefs in our perfons, houfes, kitchens, yards, (tables, pumps and ftreets. The drains fhould be kept conftantly free from^obftruc- tions; but if this cannot be done, the grates over them them mould be covered to keep down the effluv.a that would otherwife iffue from them to the great danger of the inhabitants. Tha low grounds of this city, in which water ufually ftagnates, fhould be filled up*. All offenfive and putrifying fubftances fhould be burnt up, or at leaft removed, fo as to prevent their poifoning the air we breathe. The number of dead animals, and the quantity of putrid vege- tables in our ftreets, is a nuifance of the mofl dangerous kind. The expence ot keeping the city clean would be much lefs than what is ex- pended in curing the difeafes tfyat are foftered by the filth of our ftreets. The weeds which furround the planters houfes in the country fhould, for the fame reafon, be burned in that ieafon of the year when they begin to rot. Coftivenefs ought to be particularly avoided in; this climate. Regularity in the alvine difcharges is of tl e laft confequence. Their retention, by difturbing the whole animal ceconomy, proves a fource of many evils. Whenever thele difcharges do not return at their proper period, efficacious methods fhould be immediately adopted to aid the languid bowels in the difcharge of their neceffary functions. Rifing early is one of the beft means of obviating coftivenefs. The cool morning air tends • Thii might be done to a confiderable extent, with little trouble or expence. If hoofekeepers would charge themfelves with filling up the ponds before their own doors and in their own yards, a faving would foon be made in their Doctors bills' which would amply rcimburfe them. ( i7 ) tends to throw the excrementitious humors on the bowels, and to hafien their difcha-ge. The re- verfe is the cafe with fuch perfons as fpend an undue proportion of their time in a recumbent pofture, and particularly thole who lie in bed after lunrife. Attention to the ftate of the bowels is particularly indifpenfible in the fummer and firft months of the autumn. In moft of the difeafes between June and November, the bile is more or lefs injurioufly predominant, and fhould be daily difcharged. In the beforementioncd per od every < article of meat or drink, known by experience to generate a furplufage of bile, fhould be eithep wholly laid afide, or fparingly ufed; and coftivenefs mould be obviated by the ufe of laxative food. Perhaps no fimple in the power of every perfon is m ,re efficacious, in preventing bilious complaints, than raw eggs b.at up into an agreeable mixture and taken every morning. If notwithstanding all our precautions to the contrary, a fever is beginning to form, inftead of indulging the vain hope, that it will go off itfelf, we fhould inftantly retreat to our chambers, and tr.ke lomething, that by reftoripg an equable per- foration will turn the current of humors from within outwardly. Nothing does this fo effectually as a vomit. A proper medicine of that kind taken in time, when the introductory fymptomsibrebode a fever, will often dedroy it in embryo, prevent a fit of ficknefs, and the nccefiity of taking a variety of other medicines. , C In tf ( I* ) In enumerating what ought to be done to prc- ferve health, the advantages of temperance and exercife are obvious; but inftead of dilating on principles fuited to every fituation, it will be more proper to dwell on fuch as efpecially apply to our own. For eight months of the year, South-Caro- lina is as healthy as any part of the globe. Our winters are delightful, and our greateft fummer heats are far from being intolerably diftrefling. The mercury in the thermometer rifes every year as Thigh in Bofton, New York and Philadelphia, as in Charlefton. I have lived in both of the latter cities, and can with truth declare, that I have fuf- fered more from hear, in each of them, than I ever did in Charlefton. If our fummers are longer, and render us lefs able to bear continued fatigue, this fc amply compenfatcd by the Superior mildnefs of our winters and the fuperior fertility of cur foil, which requires lefs labor for procuring fubfiftence. The inhabiiantsof this ftate are in general, at all times, leis liable to rheumatifms, coughs, colds, and in- flammatory diiorders, than thofe who live in colder climatts. Confumptions, except a few from ca- tarrh, are feldom feen amongft our own cit'zens. * Gravel and ftone* are comparatively rare in this country. But to fevers of the low kind, we are particularly expofed, efpecially in the interval between June and November ' As thefe may be confidered to be the endemic of the country, I beg leave to offer fome practical cbfervations on the means of preventing them. Our fummer and autumnal fevers, as far as they depend on local fuuation, ( .19 ) fituation, chiefly arife from the feparate or combined influence of heat, moifture, and maifh miaimata. To fecure the body againft the tffcfls of thefe enemies to health, is, or ought to be, an object of general attention. With this view, I would ie- commend the wearing of flannel next the fkin. It has already been obferved, that in fun mer per- foration is great. Perhaps it is fortunate for us that it is lo, for as many of our humors are by heat rendered m i bid, the feafonable difcharge of them is highly beneficial. Where a perfon is immedi- ately overed with linen, the perljgjrable matte , as faft as thrown off, is collected and?kept in contact with the ducts from which in exufed. On the other hand, flannel, by abforbingthe fame, removes much of it from the fkin. As thetififcharge of this excrementitious matter is beneficial, the reten- tion of it muft be injurious. The gentle fridion of flmnel, which foon ceafes to be difagreea' le,t acts like a fiefii brufh, and promotes an agreeable regular peifpiration, than which nothing is more conducive to health. Where the trunk of the body is immediately covered with woollen of any kind, the chance offuffeiing from fudden changes of th* atmofphere is greatly kffened. Summer colds are infinitely more dangerous than thofe which take place in winter. To thele we are particularly ex- pofed in the latter end of the warm wea her, when the niphts begin to grow cool. They who confult only prefent gratification, are apt to difenrumber themfelves from the bed cloaths, and in thar fix- ation thev go to fleep. This, though harmlefs in S ( 20 ) the firft part of the night, often'becomes injurious before day, either from fuaden changes of the at- niofphere, or from that gradual cooling of it which takes place towards autumn. He who fleeps in flannel has a conftant defence againft thofe changes, and is thereby fortified againft a common exciting caufe of the diiorders of ue feafon. Such as can- not reconcile themfelves to the wearing of flannel conftantly,,, fhould at leaft put it on when they are particularly expofed. The inhabitants of Charlef- ton going to jhe country when fevers are rife, would do wejyRto obferve this precaution, while they are out'of! the cit>, efpecially if their bufinefs leads them to^e much in rice fields, or in the vie nity of Stagnant waters. Cold balflpg, under proper regulations, is an excellent preventive of the difeafes cf this country. As heat relaxes, it is obyious that cold muft brace. .Once in twenty-four hours, to immerfe the body in cold water, rnoft powerfully ftrengthens the whole fyftem. Perfpiration, though for a mo- ment checked, increafes with the returning glow, which immediately follows when the bathed perfon is wiped dry and begins to take exercife. If this is done in the evening, it leldom fails of procuring a good night's reft: if in the morning, it fortifies the body for bearing the heat of the following day. By bracing the whole iyftcm, it deftroys that pre- difpofition to difeafes, which is brought on by the relaxing qualities of heat and moifture. It is farther Serviceable by keeping the fkin constantly clean. Such is the exceffive perfpiration in this country, C at ) country,.in the fummer, that frequent wafhings are indifpenfably neceffliry to p'eferve cleanlinefs. This precaution is too often neglected where peri- cdical bathings are difufed. The advantages from even a partial ufe of the cold bath aie great. Colds in the head are very uncommon when it is daily wafhed in cold water. The eyes of a perfon who frequently plunges them, wide open, into cold water, will feldom be either weak or inflamed. Difeafes of the throat raiely attack thofe who daily wafh their necks with cold water. Frequent walkings of the mouth prevent much of the tooth- ache. It has already been obferved, that the perfon who daily wafhes his feet in cold water, will hardly ever fufler from expofing himfelf to the dews of the mc rning. So many difeafes might be pre- vented, and fo much good might be done by a judicious ufe of bathing, that every ger tleman ought to have an apparatus in his houfe for that purpofe. Sometimes cold water, and fometimes tepid, ought to be ufed. In other cafes wafhing would be preferable to bathing. To adjuft thefe, and feveral other particulars, and to prevent the mifchiefs that might arile from indifcreet bathing, the advice of a phyfician is often neceffary. The aliment ufed in fummer fhould be anti- feptic and generous. The influence of what we cat and drink is vety great. Butter and fat meats tend evidently to clog the Stomach and vitiate the bile, and therefore fhould be laid afide,or fparingly ufed in hot weather. A due proportion of meat and vegetables is proper. Pepper, and the other warm ( 22 ) warm condiments, which are ufed in feafoning, though in theory they feem to be improper, m a country where heat abounds, are found by expe- rience to be wholef >me. They are for the molt part the productions of warm climates, and we find that the productions of all countries fuit beft with their inhabitants. As no difh is more com- mon am^ng negroes than pepperpot, fo none 18 more wholefame. Dr. Lind obferves, that " thel negroes in the torrid zone commonly mix the, moft ftimulating, poignant fauces with their ordi- nary light food, a.:d this is experimentally foun| fuitable to their constitutions." In ufing fruit the' following cautions ihould be obferved. It fhould be thoroughly ripe, and taken only in moderation, and baked or Stewed rather than raw. A total abftinence, for fome time after recovering from fevers, would be beft for convalefcents. Water- melons are not only innocent but ufeful. They may fafely be taken in many fever?, and im ]er qualified circumftances, tend to prevent tha difeafes u'ually prevalent when they are in feafon, Water is Nature's diluent. It is the only drink that can be fafely taken at all times and by all perfons; but, neverthelefs, men in every age and country, and in every State of fociery, have fough^ for fomething that was more ftimulant. Of all the additions made to water for that purpofe, rum is the moft pernicious. It contains no nourifh* nvnt, bat like a flow poifon infenfibly undermines the fprings of life. As mankind will not content] themiclves with nature's beverage, it is the duty of ( *3 ) of phyficians to direct them to fuch fubftirures at bring the greatest benefits with the leaft irjuiy. Of this clafs are liquors which are piepared by fermentation, and alfo thofe which are exprtff d from vegetables. Of the drinks ufed among us, none are equal to porter and wine for preventing fevers. 1 he former, by its bitternefs, Strengthens the Stomach, while it proves highly nutritious, and at the fame time moderately evacuant. Obftinate vomitings are fometimes cured by ir, more effectu- ally than bv the moft celebrated officinal compo- fit.ons. Within ten years p.ift, in which the inha- bitants ot this city have genera'ly exchanged punch for porter, they have grown much more healthy. Complaints of the bowels have fenfibly leffened* Phvficians are not now called upon to attend one patient with the dry belly-ache for every ten they formerly vifited. Punch, when weak and taken in moderation, and no ofrener than occasionally, is falurary and refrefhing, but by no means fuits for common drink. The fame obfervation holds good with rcfpect to cyder. Mineral acids, diluted with water, correct bile, and refift our fummer difeafes i but this cannot be affirmed of drinks prepared with limes and fuch like vegetable acids when freely and frequently taken. Thele re- marks, though generally well founded, admit of exceptions. The temreratc ufe of good fcund wine is one of the moft effectual, as well as one of the pleafanteft, antidotes to fevers. It is highly analeptic, and bctb prevents and cures putrid difeafes. It is much ( «4 ) much more worthy of the appellation of a cordial, than any of the boafted officinal comrofi ions, which are called by that name. Different consti- tutions require different wines, but in general old Madeira agrees beft with the inhabitants of Caro- lina. All phyfkians know, that in low fevers a liberal ufe of wine is an effential part of the cure. In order to get the full benefit of this moft defi- i rab\e preventive of our fummer difeafes, it Should" not be drank every day. If it was laid afide in thes j winter and fpring, and refumed on the approach of fummer, and continued in daily ufe, only for three or four months, its efficacy in preventing fummer and autumnal dileafes would be greatly increafed. The perfon who, with the above limi- tations, d.inks from half a pint to a pint of wine every twenty-four hours cannot, in this climate,' be juftly deemed intemperate. The daily ufe of Strong warm teas is pernicious. Many refpectable medical authorities might be produced, which concur in reprefenting Eaft-India tea as unfriendly to the nerves. Be this as it may, ail muft acknowledge, that the warm water, which is ufed as its vehicle, muft be unfuitable to this climate. Cheerfulnefs is of particular fervicein prelerving health. Many of our difeafes flow from bile, and fretfulnefs never fails to caufe an increafed flux of that acrid humor into the Stomach. Thofe who watch their own feelings may obferve, that when • any wayward event breaks in on the peace of their minds, a bitter tafte is immediately felt. This proceed* ( *5 ) proceed* from an overflowing of bile. Bilioufl pcrfons are for the moft part peevifh, and peevifh perfons are for the moft part biiious. Bile and fretfulnefs feem to be reciprocally caule and effect, and both predifpofe to dangerous diforders. The eyes are fomermes obferved to turn luddenly yel- low, in a guft of paffion. They who are bleffed with a conftant, equable flow of cheerful fpirks, are exempted from one of the occafional caufes of fevers: On the other hand, fuch as give way to peevifhnefs, or to the depreffing pafiions, are par- ticularly expofed to the difeafes,which a low, moift country is apt to produce. 1 n particular habirs, the daily ufe of jefuit's baric, from July 111 October, is advifeable. Three doles of it, combined with a little rhubarb if neceffary, taken in fubftance$ every day or every Other day, where ordinary precautions are taken, may in ge- neral be relied upon as an effectual antidote to the fummer and autumnal fevers of this country. Throughout the fummer and the firft month of the autumn, fires are more ufeful in damp days, than in the dry cold weather of winter. They correct the exceffive moifture of the atmofphere, and counteract the exciting caufes of the complaints moft ufual in the before mentioned feafons. In the construction of our houfes, we facrfice health to profit and convenience, by digging cellars underneath them. The walls at their fides, and covers 'o their bottoms, lefTen the evils that might othe< wife reSult from them, but it would be better if there was not a cellar in the city. The I> evils ( 26 ) -evils arifing from this fource are of fuch ft magni- tude, as to need the interposition of the city coun- cil. A law to compel all the inhabitants to pump the water out of their cellars, as foon as it begins to Magnate, would be lalutary. It muft have frequently occurred to every attentive obferver, that, in wet feafons, the cellars in the low pa»t of this city emit fuch putrid exhalations, as are lenfibly offensive even to paficngers. They who live over fuch cellars, or in the vicinity of them, muft, therefore, be particularly expofed to difeafes, and when Sick, are with difficulty cured, unlefs they remove to a purer atmofphere. The practice of planting trees before the doors cf dwelling houfes, is recommended by found medical reafoning. It has been demonftrated, that trees abforb unhealthy air, and difcharge it in a highly purified State, in the form of what modern chymifts call dephlogifticated air. It is only to be lamented, that the cuftom is not univerfal, and that fome uniformity is not obferved in the difpofition of thefe beneficial ornaments. Should the prefent city council make effectual arrangements for plant- ing magnolias, or fuch like trees, every twelve or fifteen feet, on each fide of our Streets, through their whole lengm, they would merit the thanks of the rifing generation. Whether paving the ftreets of Charlefton would conduce to the health «f the inhabitants, has been doubted by many. It might add to the heat of the air, but would lefTen its morbid qualities, by reprefiing exhalations. As dry heat alone is a much ( »7 ) much lefs evil than heat, moifture and miafmata combined, it is probable, that the inhabitants would be gainers, on balancing the advantages againft the difadvantages that would refuit from paving the ftreets of this city. In conftructing our city houfes, we fhould en- deavor to make them, efpecially on 'heir north, fouth and weft fides, as open as poffible to favor the circulation of frefh air. A man in health pol- lutes a gallon of air in a minute, to fur h a degree, as to render it unfit for the purpofes of life. The danger of breathing confined,unventilated air, muft be therefore felf-evident. On thefe principles, the ufe of curtains, other than thofe for excluding mufquitoes, may be advantageoufly difpenfed with. They feldom or never do any good, and by con- fining and heating the air often do harm. The late practice of adding an attic Story to low houfes, is not only ornamental but beneficial. Ic increafes the chances for health. The higher we afcend into the atmofphere, the cooler it is, and tjie farther are we removed from thofe poifonous exha- lations which, though they rife from the earth and Stagnant waters, feldom or never afcend to any considerable height. It is on thefe accounts pru- dent to fleep in the highcft apartments of our houfes, unlefs where their low pitch and converging fides make them warmer than thefe which are on the lower floors. Wooden houfes are moft fuitable to this cli- mate. They are much drier, and confequently healthier, than thofe which are built with brirk. ( *• ) The latter abforb and retain, for a long time, much of that moiftuie with which our atmofphere abounds. The fpecdy rotting of paper on brick walls proves their danipnefs. This is particularly the cafe, when fome of their fides are inacceffible to the fun. In fuch Situations they are feldom, for any confide, able length of time, thoroughly dry. On this account, fuch of the inhabitants of this city as are troubled with rheumatic pains, coughs and complaints of the breaft, Should hot live on that part of the Bay which is between its foutbern extremity and Broad -Street". The houfes there are moftly built with brick, and are fo cMely con- nected together, that two, and often three, of their fides are, Tor the greatest part of the day, fhrlterecj from the direct rays of the fun Moifture there predominates, and, in conjunction with easterly winds, is very unfavorable to children and fuch as Have weak lungs.' Brick houfes would be much dier than the) ufually are, if a vacancy was left between the walls and rhe plaftering on their in- fides 1 his might eafily be done by means of ftuds projecting but a few inches from the walls. The piXuion of our country houfes, with relpect to fwamps, ought to be attended to; for the fmr- mer winds, fweeping along their furface," waft deftrudt on to the inhabitants. In general, the planters w>uld do well to encourage the growing of trees, between their houles and the reighboring fwamps j and to construct their houfes lo as to have ntither doors nor windows fronting on maifhy ground j but as this cannot always be done, the? " fhould t 29 ) fhould build on the fouth fides of their rice fields and other waters. The winds in the fummer months are for the moft part fourherly. To be under aneceffity of breathing air, faturated with the noxious tffluvia acquired in paffing over Stag- nant waters, muft be highly injurious. Indeed if health wa«, as it ought to be, preferred to riches, the planters wOuld build their dwelling houfes at a distance from the rivers. ' The inhabitants of a houfe in the pine barren has a much better chance for health, than he whofe manfion is erected in the neighbourhood of any body of water, either Stag- nant or running. Health and wealth feem to be at variance. The fame qualities of the foil which make it fruitful, make it alfo unwholfome, while the dry fur face of pine barren 'prefents compara- tively a pu'e and whoffome air. Befides, the refin of the pine trees in itlelf contributes to the falubrity of the atmofphere. It is an old and well authen- ticated obfervation, that perfons, whether white or black, employed in burning tar-kilns, are always healthy. The method practiled by Indians and negroes of living in fmoke, is conducive tohea'th; but the inconvenience of fuch a Situation will for- ever operate againft its being introduced into common ufe among our citizens; but, neverthelefs, fome considerable analogous benefit, with little expence or inconvenience, might be procured to thofe who refide in the country, from fires kindled round or near ther houfes. Thefe will be more necefTary when the wind is easterly, and more beneficial if made with rcfinous pine-wood. On ( y> ) On thefe principles, there is no difficulty in ac- counting why Charlefton is more healthy than the neighboring parishes. It has long been obferved in low countries, that they who refide in towns, are more healthy than thofe who live difperfed in. the country, and that the inhabitants of the central* parts of towns are healthier than thofe who live in their extremities. The fire and fmoke from feveral hundred contiguous kitchens cannot fail of dimw nifhing the moiftnefs of the atmofphere.- Tha irequent ringing of bells, the flowing of the tides,, the motion of carriages and of perfons, occafions; a brifker circulation of air in this city, than in the,* adjacent country. The policy of removing, on the approach of fummer, from the country to Charlefton, is therefore wife. The proper time for making this change varies in different years. In general it may be obferved, that it fhould be early, if a wet fpring is followed by a dry fummer. While fucceffive rains keep the waters in motion, the danger is little; but when w'arm and dry wea- ther continues for lone time after heavy iains have fallen, fevers will probably foon begin to rage. Strangers who propofe to refide in this country, and our own citizens who have been long abfeat, when intending to return, fhould make a point of arriving here about the month of November. They would then have at leaft half a year to be aSTimi- j lated to the climate, before their health would be endangered by any thing peculiar to it. The fudden deaths among us of perfons difufed to our country, are to be referred co an injudicious choice of t 3« ) of time for coming to it, and ftill more to their own imprudence, combined with the htifpltality of the inhabitants. To be invited almoft daily to the plentiful tables of their friends and acquaint- ances, is the misfortune of fuch perfons. A fever, rapid in its progrefs, ahd fatal in i(s iflue, is fre- quently the confequence. Strangers coming into this country fhould be doubly on their guard, but inftead thereof they too often fuffer fhemfelves to be feafted into fevers, and not unfrequently out of their lives. On a review of the whole Subject, it may be oblerved, that inftead of faying, " this capital is more fickly than the other maritime towns of the United States," it ought only to be faid; •f thaj more care is neceffary on the part of its Inhabitants for the piefervation of their health." By proper attention to our children, and efpe- cially by Steady, difcreet management of mo- thers, much of the mortality of infants might be prevented, and a new generation be reared, which would be much hardier and better adapted to the climate than many of the prefent. In fami- lies where children have been properly brought up, many of both fexes have as good constitutions as are enjoyed by thofe who live in more northern latitudes. The honors of old age are often attained by our citizens. Indeed the chance of life to a !1 perfon who is above fixty years old, is confiderably : in favor of the inhabitants of warm countries. It muft be acknowledged, that the variablenenefs and ; fudden changes of our atmofphere make caution indifpenfable$ indifperhblei but this as enforc'ng the necefliry of a Sober, orderly life, ought to be -fecrnc * ar. advantage. None,of the bi'fi: PJ of tfii? world can be attained without care. It is, therefore, ur;«eaf;r iMe to Irnk for health on ":^^ terms, Much attentions receSTary to pr-.er/e, .even, a. goodI efta e, ftorr nnnirg to write i he fame is requisite for guarding a iound confwution ag3inft dileafes. Ah well may the pian:°r, w* r»rn -;iy v,fir.i his plantation, -expect a ^od crop, aj the man who lives at random, look for the continued en- joyment of health. vuch as arc for a Short life and . & merry one, muft . dc by the confequences of their choice. Butthey who con ouc-I with prudence* anJ have fe'f-iVnial to abftain frr-m 'uch pr?fcices as experience n_ have proved to be hurtfii', and fteadin iL to foJuv. what by the fame unerring rula t1-■« y have found to be iahiiary, may live as health* ily, andv i lo :g ia this city, as in any parr of ths **OikL" . THE JND< *. WZ XI0 \W0 * * ARMY * * MEDICAL LIBRARY Cleveland Branch NLM010380436