'Ws^
 
NATIONAL LIBRARY OF MEDICINE




          Bethesda, Maryland
fly ''J*?***^-1^ 
ADVICE
                 TO  THE

 PEOPLE   in   General,
       WITH  REGARD  TO  THEIR


HEALTH:

But particularly calculated for thofe,  who
  are the moil  unlikely to be provided ixs.
  Time with, the befc Afliflance,  in acute
  Difeafes, or upon any inward or outward
  Accident.
                   WITH

A T A B L E of the nioft cheap, yet effectual
   Remedies, and the plaineft Directions foe
   preparing them readily.
           Tranflated from the French Edition of

 Dr. Tissot's  Avis au Peuple,  Sec.
Printed at Lyons ; with all the Notes in the Sirfl
 English Edition,  and a very few additional ones.

     By  J.  KIRKPATRICK,  M. D.
                 To which is added,

 The Art of preferving Health :
Containing the moil important Rules recommend-
   ed by Phyficians and Philofophers for the Preser-
   vation of Health in the feveral Periods and Cir-
   r*imftances of Life  : together with the Reafons
   on which thefe Rules are founded.
     By  J.  MACKENZIE,.!.]).

 In the Multitude of the People is the Honour of a King ; and for the Want
  of-People cometh the DcJliucTion of the Prtncc.      Prov. %\i. 28,

              VOLUME   I.
LONDON:  Printed in Year MDCCLXVII. 
 
THE
    TRANS L,-A TOR'S



PREFACE-

r~|p? HOUGH the great utility of thofe medical
       directions, with which the following trea-
  JL.   tife is thoroughly replenished,  will be fuf-
ficiently evident to every plain and fenSible perui-
er of it ; and the extraordinary reception of it on
the continent is recited in the very woithy Au-
thor's preface; yet fometbing, it fliould feeni, iv.:.y
be pertinently added,  with regard to this transla-
tion of it, by a perfeu who has been ilric'tly atten-
tive to the original : a work,  whofe purpofe was
truly neceffary and benevolent ;  as the execution
of it, altogether, is very happily accomplished-.
   It will be-Self-evident,  I apprehend, to every
excellent phyfician, that a radical knowledge of
the principles> and much experience %i the cxer-
ciSe of their profefuon,  were necefl'ary to accom-
modate fuch a work tn the comprehension of thofe
for whom it was  more particularly  calculated.
Such gentlemen mutt obferve, that  the  certain
axiom of nature's curing dij'eafes, which is equally
true in our day, as it was in that of Hippocrates,
lb habitually animates this  treatife, as not to re-
quire the leafl particular reference.   This Hippo-
cratic truth as certain (though much lets Subject to
general obfervation) as that difeafe, or age, is fi-
nally prevalent  over all fublunary life, the nioft
attentive phyficians difcern the fooneSl, the moft
                      A 2. 
v           The ¥ranflator s frejace.
ingenuous readily confefs r and hence Spring that
wholefeme zeal and feverity, with which Dr. Tis-
sot encounters fuch  prejudices of poor illiterate
perfons as either oppofe, or very ignorantly preci-
pitate, her operations, in her attainment of health.
Thefe prejudices indeed may feem, from this work,
to be ftill more numerous, and perhaps groffer too,
in Swifferland than among ourlelves ; though it is
certain the»e is but too much room for the appli-
cation of his Salutary  cautions and directions, even
in this capital ;  and doubtlefs abundantly more at
a great diflance from it. It may be very juflly fup-
pof'ed, for one iuftance, that in inofl of thofe cafes
in the fmall-pocks,  in  which  the mother under-
takes the cure of her child, or confides it to a nurfe,
that faffron, in a greater or lefs quantity, and fack *
or mountain whey, are generally ftill iifed in the
Sickening before eruption ; to accelerate that ve-
ry eruption, whofe gradual appearance, about the
fourth day, from  that of feizure inclufive, is fbfa-
vourable and promising to  the patient, and the pre-
cipitation of which  is  often  fb highly pernicious
to them.  ?.Ioft of, or rather all, his other cautions
and corrections feem equally neceffary here, as of-
ten as the Sick are Similarly circumftauced,under the
different acute difeafes in  which he enjoins them.
   Without the leaft  detraction however from this
excellent phyfician, it may be admitted that a few
others, in many other  countiies, might have fnfli-
cient abilities and experience for the production
of a like work, on the fame good plan.   This, we
find, Dr. Hirzel, principal  phyfician of Zurich,
had in meditation,  when the prefent treatife ap-
peared,  which he thought had fo thoroughly ful-
filled his own intention,  that it prevented his at-
tempting to execute it.   But the great difficulty
coniifted in difcovering a phyfician,  who,  with
equal abilities, reputation and practice,  fliould be
qualified with that much rarer qualification^ of car- 
             The 7 ranjiator s Preface.*          ir
ing fb much more for the health of thofe, who
could never pay him for it, than for his own pro-
fit or eafe, as to determine him to project and ac-
complifh fb neceffary, and yet fb felf-denying a
workv  For  as the Simplicity he propoled in the
iryle and manner of it,  by condescending, in the
plaineft terms,  to the humbleft capacities, obliged
him to deprefs himfelf, by writing- rather beneath
the former treatifes, which had acquired him the
reputation of medical erudition, reafoning and e-
legauce ;  we find that the love of fame itfelf,  fb
Stimulating even to many ingenuous minds, was
as impotent as that of wealth, to feduce him from
fo benign, fo generous a purpofe..  Though, upon
reflection,  it is by  no means flrange to fee wife
men found their happinefs, which all [however va-
rioufly and even oppofitely] purfue, rather in con-
fidence, than on applaufe : and this naturally re-
minds us of that celebrated expreffion of Cato,oi"
feme other excellent ancient, " that he had rather
** be good, than  be reputed fo."
   However lingular  fuch a determination may
now appear,  the number  of  reputable medical
tranflators into different languages,  which this o-
l-iginal work has employed on the continent, makes
it evident, that real merit will, feoner or  later,
have a pretty general  influence; and induce ma-
ny  to imitate that example,   which they either
eould not,  or did not, propofe.  As the truly mo-
dell Author has profeffedly difelaimed all applaufe
on  the performance, and contented himfelf with
hoping an exemption from cenfure,  through hi*
reader's reflection on the  peculiar circumstances
and addreSs of it; well may his bell,  his faithful-
ell translators, whofe merit and pains muft be of*
a very Secondary degree to his own, be Satisfied
with- a Similar exemption :  especially when joined
to the plealure that muft refult from a confeiouf^
nefs of their having endeavoured to extend the-
                      A j- 
*i           The TranJJator's Preface.

benefits of their Author's treatife, to multitudes
of their own country and language.
   For my own particular, when, after reading the
introduction to the work, and much of the fequel,
I had determined  to tranflate it; to be as jufl: as
poffible to the Author,  and to his Englifb reader?,
I determined not  to interpolate any Sentiment of
my own into the text, nor to omit one fentence of
the original, which," befides its being detraction ia
a literal fenfe,  I  thought  might imply it in its
worft, its figurative one j  for which there was no
room.   To  conform  as fully as poffible to  the
plainnefs and perfpicuity he propofed, I  have been
pretty often obliged in the anatomical  names of
feme parts,  and  Sometimes of the  Symptoms,  as
well as in feme pretty familiar, tho' not entirely
popular words, to  explain  all  fueh by the molt
common words I have  heard ufedfor them j. as afw-
ter mentioning the diaphragm, to add, or midriff-—
the trachaa—or windpipe—acrimonious, or -aery [harpr
and fb of many others.  Thi* may a little, though
but a little,  have  extended  the tranflation beyond
the  original;  as the  great affinity between  the
French and  Latin, and between- the  former  and
many Latin words borrowed from the Creek, gene-
rally makes the fame anatomical or medical term,.
that is  technical  with  us,, vernacular or common
■with them.   But this unavoidable tautology, which
may be irkfbme to many ears, thofe medical read<-
ers, for whom  it was  not  intended, will readily
forgive, from a confideration of the general ad-
drefs of the work :  while they refleift that mere
flyle, if thoroughly intelligible,  is  leafl eflential
to thofe books, which  wholly confilt of very ufe-
jful,  and generally interesting, matter.
   As many of the notes of  the editor of Lyons,  as
I have retained in this verfion (having  translated
irom the edition of Lyons)  are fubferibed E. L.  I
liave difbve»fed with feveral, feme,  as  evidently 
             The Tranflator's Preface.         \'n

lefs within Dr.  Tissot's plan, from  tending to
theorize,  however jultly or practically, where he
muft  have had  his own reafons  for omitting to
theorize :  a few others, as manifestly  needlefs,
from  what the  Author  had either  premifed, or
fpeedily Subjoined, on the very  fame circumstance:
befides a very few, from their local confinement
to the practice  at Lyons, which  lies in a climate
femewhat more difterent from our own than  that
of Laufanne.   It is probable, nevertheless, I have
retained a few more than were neceffary in a pro—
feSfed translation of the original work i but wbere-
ever I have done this,  I have generally fubjoined
my motive for it ; of whatever  confequence  that
may appear to the reader.   I have retained all tlie
Author's  own notes,  with his name  annexed to
them ;  or if ever the annotator was uncertain to
me, I have declared whofe note I fuppoS't-d it to be.
  Such as I  have  added from my own experience
or obfervation are fubferibed K, to distinguish them
from the  former ; and that the demerit of any of
them may neither be imputed  to the  learned Au-
thor, nor to his editor, i Their  principal recom-
mendation,  or  apology is, that  whatever facts  J.
have  mentioned are certainly true.   I have en-
deavoured to be temperate in their number  and
length, and to imitate that Strict pertinence which
prevails throughout the Author's work.   If any
may have ever  condefeended to  consider my  way
of writing,  they will conceive this restraint has
coSl me at leaft  as much pains, as a further indul-
gence of my own conceptions could  have done.
Ihe few prefcriptions I have included in feme of
them, have been fo conducted, as not to give the
reader  tfce  leaft confufion  with  reSpect to thoSe,
 which  the Author has given in his table of reme-
 dies, and which are referred  to by numerical fi-
 gures,  throughout the courfe  of this book.
   The moderate n.uinber of Dr. Tissot's prefcrip- 
 Viii.        The Tranflator's Preface.
 tions, in his table of remedies,  amounting but t&
 feventy-one, and the apparent fimplicity of many
 of them,  may poffibly difguft  feme admirers  of
 pompous and  compound preferiptions.   But  his
 referve, in this important refpect,  has been tho-
 roughly confiflent with his notion of nature's cu-
 ring difeafes j   which fuggefted to  him the firfl,
 the effential neceSfity of cautioning his readers a-
 gainSl doing, giving, or applying any thing, that
 might oppofe her healing operations, (a moft ca-
 pital purpofe of his work) which important point
 being gained,  the mildeft, Simplell and leaft ha-
 zardous remedies would often prove Sufficient  af-
 fiftants to her.    Neverthelefs, under more Severe
 and tedious conflicts,  he is not wanting to direct
 the mod potent and efficacious ones.   The cir-
 cumflances of the poor fubjects of his medical con-
 sideration,  became alfe a very  natural object  to
 him, and was in no wife unworthy  the regard of
 the humane translator of Bilguer on Amputati-
 ons, or rather againft the crying abufe of t?-.em i
 an excellent work, which does real honour to them
 both, and which can be difproved by  none, who  do
 not prefer the  frequently unneceffary mutilation
 of the afflicted,  to the confnmption of their time,,
 or the contraction of their empldyment.
   Some perfbns may imagine that a treatife of this
kind, compofed for the benefit of labouring peo-
ple in Swifferland, may be little applicable to thofe-
of the Britifh islands : and this, in a very few par-
ticulars, and in a fmall degree, may reasonably  be
 admitted.   But as we find their common prejudi-
 ces are often the very fame ;  as the Swift are the
inhabitants of a colder climate than France, and ge-
 nerally, as Dr.Ti 5sot often obferves, accWomed to
drink (like ourfelves) more Strong drink than the
 French peafantry ;  and to indulge more in eatino-
fleSh too, which the religion of  Berne,  like our
own, does not reftrain ; the application of his ad> 
            The Tranflator's Preface.           ix
"vice to them will pretty generally hold good here.
Where  he forbids them wine  and flefh,  all but-
chers meat, and in mofl cafes all fleSh, and  all
ftrong drink fliould be prohibited here-: efpecially
when we confider, that his directions are confined
to the treatment of acute difeafes,  of which the
very young, the youthful, and frequently even the
robuft are more generally the fubjects.  Befides, in
feme few of the Englifh tranflator's notes,  he has
taken the liberty of moderating the coolers, or the
quantities of them (which may be well adapted to
the great heats and violent Swifs fummers he talks
of) according- to the temperature of our own cli-
mate, and the general habitudes of our own peo-
plt.  It may be obferved too,  that from the fame
motive, I have  femetimes affumed the liberty of
diffenting  from the text in a very few notes, as
for inftance, on the article  of paltry, which per-
haps ii  generally better here  than in Swifferlanif,
(where  it  may  be as bad as our coarfe vile trafh
that is hawked about and fold to mere children)
as I have frequently, in preparing for inoculation,
admitted the befl paltry  (but never of meat, and
very feldom any cheefecakes) into the limited diet
of the fubjects of inoculation, and constantly with-
out the leaft ill confequence.  Thus alf'o in note *,
page 216, 217, I have prefumed to affirm the fact,
that a flrong  Spirituous infufion of  the bark has
fucceeded more fpeedily in feme intermittents, in
particular habits, than the bark in fubftance. This
I humbly conceive may be owing to Such  a men~
ftruum's extracting the refin of the bark more ef-
fectually (and fb conveying it into the blood) than
the juices  of the  flomach and of the alimentary
canal did, or could.   For  it is  very  conceivable
that the crafts, the confiffence, of the fibrous blood
may femetimes be affected with a morbid laxity or
wcaknefs. as well as the general fyitem. of the njuf-
cular fibres. 
  X,          The Tranflator's Preface.
    Thefe and any other like freedoms, I  am certain
  the Author's candour will abundantly pardon ; fince^
  I have never diffented, from him, for the fake of
  diilenting ; and have the  honour of harmonizing
  very generally in judgment with him.  If one ufe-
  ful hint or observation occurs throughout my notes,
  his benevolence will exult in that tifential adhe-
  rence to his plan, which fuggefted it to me : While
  an invariable echoing affentation throughout Such
  notes, uhen there really  was any  Salutary room
  for doubting, or for adding (with refpect to our-
  selves) would difcover a fervility,  that  i.vaft have
  difgufled  a  liberal  manly writer.   One common
  good purpofe certainly fprings from the generous
  feurce, and  replenishes the many  channels  into
^'which it is derived :  all the variety and  little de-
  viations of which may be confidered as  more ex-
  penfive diilributions of its benefits.
    Since the natural feelings of humanity general-
  ly difpofe us, but especially the more tender and
  companionate fex, to advife remedies to the  poor
  fick ; fuch a knowledge of their real difeafe, as
  wonld prevent their patrons, neighbours and afiifl-
  ants from advifing a wrong regimen, or an impro-
  per or ill-timed medicine, is  truly eSTential to re-
  lieving them: and fuch we ferioufly think the pre-
  fent work is capable of imparting,  to all common-
  ly fenfible and confiderate perulers of it.  A  vein
  of unaffected probity,  of manly  fenfe, and  of
  great philanthropy, concur to  fuftain the work :
  And whenever  the  prejudices of the ignorant re-
  quire a forcible eradication ; or the crude temerity
  and  impudence of knaves and impoftors cry out
  for their own extermination, a happy mixture of
  ltrong argument, juil ridicule,and honefl feverity,
  gives a  poignant and pleafant feafoning to the
  work, which renders it occasionally entertaining,
  as it is continually inllructive.
    A general reader may be femetimes diverted with 
             The Tranflator's Preface.           xii
  fuch cuftoms and notions of the Swijs peafants, as
  are occafionally mentioned here : and poflibly our
  meerell ruStics may laugh at the brave Simple Swifs,
  on his introducing a Sheep into the chamber of a
  very fick perfon,  to fave the life of the patient, by
  catching its own death. But the humbleft peasan-
  try of both nations are agreed in Such a number of
  their abfurd unhealthy prejudices, in  the treat-
  ment of difeafes, that it really feemed neceSTary to
  offer our own  the cautions and councils of this prin-
♦ cipal phyfician, in a very refpectable proteftant re-
  public,  in order to  prevent their continuance.
  Nor is it unreafonable toprefume, that under fuch
  a form of government, if honeftly adminiltred up-
  on its jutleft principles, the people may  be rather
  more tenderly regarded, than  under the pomp and ■;;-.
  rage  of defpotifm, or the oppreSfion of feme tu-
  multuous aristocracies.
    Befides the different conditions of * perfbns, to
  whom our Author recommends the patronage and
  execution of his Scheme, in his introduction, it  is
  conceived this book  muft be ferviceable  to many
  young country practitioners,  and to great num-
  bers of apothecaries, by furniShing them with fuch
  exact and  ftriking deferiptions  of each  acute dif-
  eafe and its fymptoms, as may prevent  their mis-
  taking it  for  any other ; a deception which has
  certainly been injurious, and femetimes even fa-
  tal : for it is dreadful  but to  contemplate the de-
  ftruction or mifery, with which temerity and ig-
  norance, fo frequently combined, overwhelm the
  fick.   Thus more fuccefs and reputation,  with
  the enjoyment of a better confeience, would crown
  their endeavours, by a more general recovery of,
  or relief to, their patients.  To effect this,  to im-
  prove every opportunity of efehewing medical e-
  vil, and of doing medical good, was the Author's


    * Of all thefe the fchoolmaiters with  us, may feem  the moft rea-
  sonably exempted from this duty. 
xii.           The Tranflator's  Preface.
avowed intention; which he  informs us  in his
preface, he has heard, from feme  intelligent and
charitable perfons,  his treatife had effected,  even
in feme violent difeafes. That the  fame good con-
fequences may every where  attend the numerous
tranflations of it, muft be the  fervent wifh of all
except  the quacks and impoftors he fejuflly cha-
racterizes in his thirty-third chapter, and parti-
cularly of all, who may be diftinguiShably  qualifi-
ed, like himfelf,  to,
•Look through nature up to nature's COD/ 
THE
   AUTHOR'**


DEDICATION-


ffo the moft flluftrious,  the moft noble
   and magnificent Lords*, the Lords Pre-
   fident and Cownfellors of the Chamber
   of Healthy of the City and Republic cf
   JSerne-


   Moft honourable Lords,

      WHEN 1 firft publifhed tlie follow-
       ing  work,  my utmoil: partiality
 to it  was  not fufficient  to allow me
 the confidence of addrefling it to your
 Lardfbips.   But your continual atten-
 tion to all the  objects,  which have any
   Vol. L           3 
The Author's  Dedication,
relation to that important part of  the
adminiftration of the (late,  which  has
been fo wifely committed to  your care,
has induced you to  take notice of it.

  You  nave  been pleafed to judge it
might prove ufeful, and that an attempt
mult be laudable, which tends to the ex-
termination of erroneous and inveterate
prejudices, thofe cruel tyrants, that  are
continually oppofmg the  happinefs  of
the people, even under that form and
conftitution of government,  which is
the beft adapted  to eftablifti and to in-
creafe it»

  Your Lordftiips approbation, and the
fplendid marks of * benevolence, with
which you have honoured  me, have af-
forded  me a jufter  difcernment of  the
importance of this treatife, and have in-
clined me to hope*  most illustri-
ous,  MOST  nOBLE,  AND  MAGNIFI-
CENT  Lords,  that you will permit
this new  edition  of it to appear  under
the fan&ion of your aufpices;  that while
the  publick is afiured of  your general
  * See the Author's preface, immediately follow-
frig this dedication, 
       The Author's  Dedication.   xv

general goodnefs and beneficence,  it
may alfo be informed of my profound-
ly grateful fenfe of  them,  on the fame
occaiion.

   May the pre fen t  endeavour then, in
fully correfponding  to my willies, effec-
tually realize  your Lorddiips utmofl ex-
pectations from it ;  while you  conde-
fcend to  accept  this fmall  oblation,  as
a very unequal expreilion of that pro-
found  relpecl:,  with which I have the
honour to be,

   Most illustrious, most  noble,
and magnificent lords,

       Tour moft humble

           And moft

              Obedient Servantr    s
  t-AUSAN WE,
  Dec. 3. 1762.
                          TISSQ.T.
B3 
 
THE
     AUTHOR'S



PREFACE.


   IF vanity  too often difpofes many  to fpeak of them*
     felves, there  are fame  occaftons,  on whic/r a to-
     tal filence might be fuppofed to refult from a ftill
higher degree of it : and the very general reception of
the Advice to  the  People  has been fuch, that  there
would be room to fufpect me  of  that moft fhocking  kind
of pride, which receives  applaufe  with indifference (as
deeming its own merit fuperior  to the greateft)  if I did
not appear  to be ftrongly impreffed with a juft fenfe of
that great favour  of the  public,  which has been  fo  very
obliging, and is fo highly agreeable, to me.
   Unfeignedly  affected with the  unhappy filiation of the
poor fick in country places in  Swifferlund, where they are
loft froma fear city of the be ft affifiance-, andfrom a fatal
fuperftuityofthe worft,  my fole purpofe in writing this
treatife has been toferve, and to comfort them. I had i?im
tended it only for  a fmall extent of country,  with a mo-
derate number of inhabitants ; and was greatly fuprifed)
to find, that within five or fix months after its publicati-
on,  is was become one of the ??ioft extenftvely publifhed
books  in Europe ; and one  of thofe tfeatifes, on a fci-
entific fubjett, which  has been  perufed  by the greateft
number of readers of all ranks and conditions.   To con*
fidtr fuch fuccefs with indifference, were to have  been
unworthy of it, which  demerit,  at leaft on this account,
J cannot f uft ly be  charged with; fince indifference  has
not  been my cafe, who have felt, as. I ought,  this gratify
canon of fe If-love ; which,  under juft and prudent n^-
                          B3 
 *viil:            The Author's Preface.
 frictions,  may perhaps be even politically cherifhed :  d?
 the delight naturally arifing from having  been approved,
 is a fource ojthat  laudable emulation, which has fome-
 times produced the moft effential good confequences  tofo-
 ciety itfeif   For my own particular,  I  can truly aver,
 that my fatisfaction has  been  exquifitely heightened  on
 this occafton, as a  lover of my fpecies : fince judging
from the fuccefs  of  this work \a j'uccefs  which has  ex-
 ceeded my utmoft expectations) of the  effects  that  may
 reafonably be hoped for from it,  I am  happily confcious
 of that fatisf act ion,  or even joy, which  every truly honeft
 man  mufi  receive, from rendering effential good offices to
 dthers.  Befides whiche,  I hxve  enjoyed, in its  utmoft
 extent? thatfatisfaction whieh^every grateful ma?i muft
 receive, from the  approbation and beneficence  of his
fovereign, when  I  was difiinguifhed with  the precious
 medal, which the illufirious chamber of health of the re-
public of Berne  honoured me  with, a few  months after
 the publication of this treatife ; together with a letter ftill'.
 more eftimable,  as it affured me of the  extraordinary fa--
 tisfaction the  republic had teftified on the imprejfion of it;
 4H circumftance,  which I could not avoid this public ac-
 knowledgment of, without the greatefi vanity and ingra-
 titude.   This has alfo ■■■been  a very  influencing  motive
 with-me,, to  exert my utmoft abilities in. perfecting this
 new edition,  in which  J  have  made many  alterations,
 that  render it greatly preferable  to  the- firft ; and  of
 which 'amendments J fhall give a  brief account, after -
faying  fomewhat of the  editions,  which-have  appeared-'
 elfewhere.
   7he firft is that, which Meffrs. Heideggers, the book-
fellers, publifhed in the  German language at Zurich, .
 about a yearfinde.   J fhould have  been highly, delighted'
 with the mere-approbation of M. Hirzel, firfi phyfician -
^f the can ton, of  Zurich, ire.  whofe fup erior and uni-
 verfal talents ; whofe profound knowledge in the theory
 ofphyfic;  and the  extent and fuccefs of whofe practice
 havejuftly elevated  him.among the fmall number-of ex-
 traordinary men  of our own  times ; he having lately ob-
tained the eft cent and the thank)  oj all Europe, for the 
               The Author's  Preface.            xbf
Hifton of one of her * fages.  But I little expected the
honour this gentleman has  done me,  in tranflating the
Advice  to the People into his own language.   Highly
fenfible  neverthetefs as I am of this honour, J muft al-
ways reflect with regret,  that  he has confumed that im-
portant  time,  in  rendering my  directions intelligible to
his countrymen, which he  might have employed much
more ufefully, in obliging the world with his own.
   He has enriched his tranflatien with an excellent pre-
face, which is chiefly  employed in  a juft and beautiful
portrait and coutraft of the true,  and of the falfe phyfi-
cian i with which I fhould have dbne  myfelf the plea-
fure to have-adorned  the prefent f edition ; if the fize
if this  work,   already too  large,  had not proved an
obflacle tofo eonfiderabie an addition ; a?id if the man-
ner in which Mr. H\ne\ fpeaks of its author,  had per-
mitted me with decency  to publijh his preface.  I have-
been  informed by fame letters, that  there have been two
other German tranflations of it; but I am not informed
■by whom.   However,   Mr.  Hirzel's preface, his own
notes, and fome additions with which I have  furnifhed
him,  renders his edition preferabletothe firfl in French,..
 and to the other German tranflations already  made.
   The fecond edition is  that,  which the younger  Didot,.
the book-feller, pubiifhed towards the  end of  the winter
at Paris.   He had requefted me to furnifh him with
fome additions to  it,  which I could not readily  comply
with.
   The third edition is, a Dutch tranflation of it, which
will be very fpeedily  pubiifhed by Mr. Renier  Arem-
berg, book-fetter  at  Rotterdam.  He had  begun the
tranflation from my firfl edition ; but  having wrote ta
know whether I had not fome additions to  make,  I defir--
ed him to- wait for the publication of this.  J  have the
good fortune to be very happy, in my tranflators  ; it be*-

  * LeSocrait rujlique, a work which' -evrery perfon fhould  read.
  f This preface is indeed premifed to this French edition, but a tranflation ■
.of it was omitted, to  avoid extending the bullc*tnd price of the work.
Dr. TISSOl muft then have been ignorant of this addition, when firft
puoliihed at Lyons* 
XX               The Authors rrejace.
ing Mr. Bikker, a celebrated phyfician at Rotterdam*
(fo  very advantagioufly known in  other  countries,  by>
his beautiful Differtation on Human Nature, through*
out which genius and knowledge proceed hand^ in hand y
who will prefent his countrymen with the Advice to the
People, in their own language : and who  will improvo
it with fuch notes, as are neceffary for a fafe and pro-
ber application of its contents,  in a climate,  different
from that in which it was wrote.   I have alfo  heard,,
there has been an Italian tranflation of it.
   After this account of the foreign editions, I return to the
prefent oner which is the fecond of the original French
treatife. I fhall not affirm it is greatly corrected, with re-
flect to fundamental points: for as I had advanced nothing
in the firft,  that was not eftabliflied  on truth and demon-
ftration, there was no room for correction, with regard
 to any effential matters.  Neverthelefs, in this  J have
made,  i.  A great number of fmall alterations in  the
diction,  and added feveral words,  to render  the  work
ftill more ftmple and perfpicuous.- 2. The typographic ad
 execution  of this  is  considerably  improved  in the type,
 the paper and ink, the  fpelling, pointing, and arrange-
 ment of the work.-  3.-/ have  made fome eonfiderabie
 additions, which are  of three kinds-.   Not a jew  of them-
 are new articles on fome of the fubject s former ly treated
 of; fuch as the- articles concerning  tarts and  other pa-
ftry ware ; the addition concerning  the regimen for per--
fons, in a ft ate of recovery from difeafes y the prepara-
 tion for the  fntall-pocks; a  long  note  on the Jefuits
 bark s another on acid fpirits •■ one on the extract of hem-
 lock : befides fome new matter which  I have  inferted;
fuch as an article with regard to proper drinks ; one  on
 the convulfions of infants ; one  on  chilblains;  another'
 on punctures from thorns; one  upon the reafon of the
 confidence repofed in quacks, and the thirty-firfl chapter
 entirely :  in which I have extended the confideration  of
fome jormer articles, that feemed to me a little too fuc-
 cintt and fhort.   There are fome alterations of this laft,.
 this additional, Mnd,  interfptrjed almoft throughout the 
                 The Author's Preface.           xxi
 vshole fubfiance of this edition ; but efpecially in the two
 chapters relating to women and children.
   The objects oj the XXXI. chapter are fuch as require
 immediate  affiftance, viz.   Swoonings,  hemorrhages,
 that is,  large fpontanelus  bleedings; the attacks of con-
 vulfions, and offuffocaiions ;  the confequences of fright
 ttnd terror ; diforders occafioned by unwholefome or dead-
 ly vapours; the effects of poifon, and the fudden  inva-
 sions of exceffive pain.
   The omiffion of this  chapter was a very material de-
 fect in the  original plan of this work.   The editor  of it-
 at Paris was very fenfible  of this chafm, or blank,  arj
 it may be called, and has filled it up very proporly : and
 if I have not made ufe of his fupplement, inftoad of en*
 iarging myfelfupon the articles of which he has treated,
 it has only  been from a purpofe of rendering the  whole
 'work more  uniform; and  to  avoid  that  odd diverfity,
 which feems fearcely to be avoided in  a treatife compofed
 ■by two perfons.  Befides which, that gentleman has Jaid
 nothing of  the articles, which employ  the greatefi part
 of that chapter, viz. the fwoonings, the confeqnenUs of
 great fear,  and of noxious vapours.
   Bef-ore I conclude, I ought to juftify wyfetf, as welt
 as poffible, to a great number of very refpettable per-
 fons both here and  abroad, {to whom I can refufe no-
 thing without great  chagrin -and reluctance}  for my not
 having made fuch additions  as they defired of me.   This
 however was impoffible,  as the objects, in  which they
 concurred,  were fome chronical dijtempers,  that are en-
 tirely out of the plan,  to which I was ftrictly attached,
for many reafons.,  The firfl is, that it  -was my original
purpofe to  oppofe the errors incurred in country places,
 in the treatment of acute  difeafes ;  and to difplay the
 heft  method of conducting fuch, as do not admit of wait-
 ing  for the arrival of dift ant fuccour ; or of removing
 the patients to cities, or targe  towns.   It is but too true
indeed, that chronical difeafes are alfo  liable to impro-
per treatment in final I country places : butthen there are
'hoth time and convenience to Convey the patients within
ihe reach of better advice;  or for procuring them /A' 
 Xx'ii             The Alienor s trejace.
 attendance of the be ft advifers,  at their own places  of
 refidence.  Befides which, fuch  difiempers are confidet*
 ably lefs common than thofe, to  which  1 had refrained
 my views : and they will become ftill lefs frequent, when-
 ever acute  difeafes, of which they are frequently the con-
fequences,fhall be more rationally andf of ely conducted.
   The fecond reafon,  which,  if alone, would have been
 a fufficient one, is, that it  is impoffible to fubject the
 treatment of chronical diftempers to the capacity and con-
 duct of perfons, who  are not phyficians.   Each  acute
 difiemper generally arifes  from one caufe v  and the
 treatment of it is fimpte and uniform ; fince thofe fytnp-
 toms, which mantfefi the malady, point out its caufe and
 treatment.   But the cafe is very differently circumfian-
 ced in tedious and languid difeafes ; each of which may
 depend on  fo  many  and various caufes (and it is only
 the real, the true caufe,  which  ought to determine us in
feletting its proper remedies)  that though  the difiemper*
 and its appellation are evidently known, a mere by-ftand-
 er may be  very  remote from  penetrating  into  its true
 eaufe ; and confequently be incapable of choofing the be ft
 medicines for it.   Jt  is this  precife and difiinguifhing
 difcernment of  the real particular caufe  \ov of' the
 contingent concurrence of more than one} that nt-
 ceffarily requires the  prefence of perfons convcrfant in
 the ftudy and the practice of all the parts of phyfick $
 and which knowledge  it is impoffible for people,  who are
 firangers to fuch ftudies, to arrive at.   Moreover, their
 frequent complexnefs; the  variety of their fymptoms ;
 the different fiages of thefe  tedious difeafes \jiot exactly
 attended to even by many competent phyficians~] the dif-
 ficulty of  afcertaining the different  dofes  of medicines,
 •whofe activity may make  the  fmalleft error highly dan-
 gerous, &c. &c. are really fuch trying circumftances, as
 render the fittefl treatment of thefe  difeafes fufficiently
 difficult and embarraffiug to the  moft experienced phyfici-
 ans, and  unattainable by thofe  who are not phyficians-.
    A third reafon is,  that, even fuppofing all thefe cir-
  cumftances m'.ght  be  made fo  plain and eafy, as to be
  comprehended by every reader}they would require  a work 
            The  Auther*s Preface.              xxiii
of an exceffive length ; and thence be difproportioned to
the faculties of thofe, for whom it was intended.   One
fingle chronical difeafe might require as large a volume
as the prefent one.
   But finally, were I to acknowledge, that this compli-
ance was both neceffary and practicable, I declare I find
it exceeds my abilities; and that  I am alfo far from
having fufficient leifure for the execution of it. It is my
wifh that other j would attempt it, and may fucceed in ac-
complishing it : but I hope thefe truly worthy perfims,
who have honoured me by propoftng the atchievement of
it to myJeIf,  will perceive the  reafons for my  not  com-
plying with it, in  all their force ; and not afcribe a refu-
fal, which arifes from the very  nature of the thing, ei-
ther to obftinacy, or to any want of  an inclination to ob-
 lige them.
   I have been informed my citations,  or rather referen-
ces, have puzzled fome readers. It was difficult to fore-
fee this,  but is eafy  to prevent it for the future.  The
work contains citations only of two forts ; one, that points
to the remedies prefcribed;  and the other, which refers
tofome paffage in  the book itfelf, that ferves to illuftrate
thofe paffage sin which I cite.   Neither of thefe refer-
ences could have been omitted.  The firft is marked  thus,
N0' with the proper figure to it, as i.  2.  &c.  This fig.
 nifies, that the tuedicim J direct is defcribed in the  table
of remedies,  according to  the  number annexed to  that
character.   Thus when we find directed, in any page of
the book, the warm infuft on  N0* I. in fome  other, the
ptifan N°* 2.-or in a third, the almond milk, or emu I ft on
N°* 4. it fignifies, that fuch prefcriptions  will be found
at the numbers 1.2.  and 4.  and this  table is printed at
the end of the book.
   If,  infiead of forming this  table,  and thus  referring
to the prefcriptions by their numbers, I had repeated each
prefcription as often  as I directed it, this treatife muft
have been doubled in bulk, and infufferably  tirefome to
perufe.  I muft repeat here, what I have already faid in
the former edition,  that the *  prices  of medicine,  or of

  • The reafons  for omitting the pikes here, fee £. 18.of this tranflatiosj 
  xxiv             The Author's  Preface*
 a great number of them, are thofe at  which the apothe*
 caries may afford them, without any lofs,  to a peafant
 in humble circumftances.  But it fhould-be remembered^
 they are  not Jet down  at the full  prices  which they
 may hone ft ly demand-, ftnce that would be  unjuft for
 fome to in ft ft on them at.  Befides, there is  no  kind of
 ti-:x in SwiSferland, and I have  no right to impofe one*
   The citations of the fecondkind are very plain and fint-
 pie. The whole work is divided into numbered paragraph*
 difiinguifhedby the mark §.   And not  to five 11 it with
 neediefs repetitions, when in one place I might have e-
 ven pertinently repeated fbmething already  obferved, in-
 fiead of fuch repetition at length,  I have only referred
 to the paragraph, where  it had been obferved.  Thus, for
 example, when  we read page 61. § 50.—When the
 diSeaSe is  fo circumllanced as we have defcribed, §
 46.—this imports that,  not to  repeat the defcription al-
 ready given,  I rtfer the  reader to. that lafl § for it.
   The ufe of thefe citations is not the  leafi innovation,
 and extremely  commodious  and eafy;.  but were  there
 only a fingle reader likely to be puzzled by them,  I ought
 not to omit  this explanation of them, as I can expect to be
generally ufeful, only in proportion as  I am clear ;  and
 it muft be  obvious, th~:t  a deftre  of being  extenftvely
 ufeful is the fole m,otive of this work.  I have long ftnce
 had the happinefs of knowing, that fome charitable and
 intelligent perfons have applied the directions it contains,
laith extraordinary fuccefs,  even  in violent difeafes t
 and I fhall arrive at. the height of my  wifhes, if I con-
tinue to be informed,  that it contributes to  alleviate  the
flufferings, and to prolong the days,  of  my rational jel- 1
Vaw creatures* 
THE
CONTENT,S
o  F
VOLUME
  Introduction          •>■     ----     page   x
   The firll caufe of depopulation, emigrations  ib.
The fecond caufe, luxury----         4
Third caufe,  decay of agriculture              J
Fourth caufe, the pernicious treatment of dif
  eaSes      ----•        —•— -     ----      9
Means for rendering this treatise ufeful        12
Explanation  of  certain physical  terms  and
  phrales      ----      ----       --->-    20

                 CHAP.   I.

The moft common caufes of popular flcknefs        23
FirSt caufe, exceSlive labour      ------       ib.
Second caufe, the  effect of cold air,  when  a
  per Son is hot-        ----        ----     24
Third caufe>  taking cold chink, whrn in a heat  2>
Fourth-can!e,  the  inconstancy and  fudden
  change of the weather-       ----■—        26'
Fifth caufe,  the Situation of inhabited houfes,
  near dunghills and-marlhes, and the bad con-
  fined air in the houfes       ——---         2/
Sixth caule, drunkennefs------       28
Seventh caufe,  the food'of country people     2<7
Eighth' caufe,  the Situation, or ex^oiiire  of
  houles      ----       _~—      ----      3 ■
Concerning tlie drink of country people       : j; 
CONTENTS.
                 CHAP.  II.
Of caufes which' in ereafe the difeafes of the people,
  with general c onflderations-------     fag e   3 c
Firit caufe, the great care employed to lorce
  the fick to fweat, and the methods taken for
  that purpofe       -------      -------      ib
The danger of hot chambers      ---.---      36
The danger of hot drinks and heating medi-
  cines      ----      ----      ----      3 7'
Second caufe, the quantity and quality of the
  food given fick perfons       -----       39
Third caufe, the  giving  vomits and purges at
  the beginning of the difeafe       ----      45,

                CHAP.  III.

Concerning what fljould be done in the beginning of
  difeafes, and the diet in acute difeafes           46
Signs which indicate approaching difeafes, with
  means to prevent them       —.            47
The common regimen, or regulations,  for the
  the Sick          ----       ----           48
The benefits of ripe found fruits    ----      51
Cautions and means to be ufed  on recovery    56

                  CHAP.  IV.
Of the inflammation of the breafl.                58
The Signs of this difeafe        -----           ib.
The advantage of bleeding        ----         61
Signs of recovery       ——.         ----     64
Of the erifes and the lymptbms that precede it 65
The danger of vomits, of purges, and of ano-
  dynes.     ----      ----      ----      66
Of the  fuppreflion of expectoration, and the
  means to reflore it      ----      ____    67
Of the formation of vomicas, or  impoSlhumes
  in the lungs, and the  treatment of them    68
Of the danger of remedies, termed balfamics 77
"The ineflicacy of the antihectic of Poter'tus     78 
CONTENTS.
 Of an empyema      —■---.        -----    79
 Of a gangrene of the luugs.------      ib.
 Of afcirrhus of the lungs       -----        8o-

                  CHAP.  V.
 Of the pleurify--------------------      81
'The danger of heating remedies     —  84 to 86
 Of frequent, or habitual,  pleurifies    —     87
 Of goats blood ;  the foot of a Hale egg, and
   of the wormwood of the alps, in pleurifies  88

                C H A P.  VI.
 Of difeafes of the throat      ------           89
 Of their proper treatment      ------       93
 Of the formation of an abfcefs there   —    96
 Of Swelled ears,  fiom the obstruction of the
   parotid  and maxillary glands   ----      08
 Of the epidemic and putrid difeafes of the
   throat, which prevailed in 1761 at Laufannt  99

                C H A P.  VII.
 Of colds        ------         ------       105
 Different prejudices concerning colds          ib.
 The danger of drinking much hot water, and
   of Strong fpirituous liquors,  ire.     —    I JO
 Means for Strengthening and curing  perfons
   very fubject to colds        ------        JI2-

                CHAP.  V1IL

 Of difeafes of the teeth       ------           II3

                CHAP.  IX.
 Of the apoplexy
Of a Sanguine apoplexy
Of a Serous, or  watery, apoplexy
Means to prevent relapfing into them
 
          CONTENTS;

                CHAP  X.
Of morbid ftrokes of the fun:       —>-----•        l25

                CHAP.  XI.
Of the rheumatifm       ----         ----    ! 3 3
Of the acute  rheumatifm, attended with a
  fever      ----      ----      ----      ib.
Of the Slow, or chronical, without a fever    140
The danger of fpirituous and greafy remedies  144

               C  H A P;   XII.
Of the bite of a mad dog      ------           J 46

                C H A P.  XIII.
Of"the fmallpocks '    •»---—.    ------       156
Of the preceding fymptoms of this difeafe     157
Of the danger of Sweating medicines    —   164
Of the treatment, of the benign diltincl fmall
  pocks      —----- '     ------±~           166
Of the ufe of bleeding ■'■<       _;-----        167
Of the fever of Suppuration      __■----     168
Of the neceflity of opening the ripe pultules   176
Of the danger of anodynes      ------      171
Of the Striking in of the eruptions      —.    173
Preparations for receiving it favourably        ib.

               CHAP.  XIV. •
Of the meafles    ---—      —-*.             177
Of their treatment and the means to prevent
  any of their bad confequerices, to          183

                C-'H A P.  XV.
Of the hot, orffurn'mg, fever      ----•          /£*

                C HAP.   XVI.

Of putrid fevers f     ----—       ___       187. 
CONTENT  S.
                 CHAP.  XVII.
 Of malignant fevers       ----,     ---- paggm  Tfe
 The danger of applying living animals in
    them      ------          ----          20I

                 CHAP.  XVIII.
 Gf intermitting fevers       —---       ____2qo
 Of Spring and autumn intermittents     __   20c
 Method of cure by the bark       ----        208
 Method of treating the patient in the  fit       209
 Of other febrifuges, befides the bark          210
 The treatment of long and obSlinate intermit-
    tents    —          _          __        j£
 Of fome very dangerous intermittents          114
 Of fome periodical diforders, which may be
   termed, fevers difguiSed------2i>
 Of prefervatives from unwholfome air     __   216

                 C H  A P" XIX.
 Of an erifipelas, or St. Anthony's/,*         2r7
 Of a frequent or habitual erifipelas            22?
 Of the Stings or bites of animals     —        ;-£

                 CHAP.  XX.
 Of inflammations of the breaft, and of the bafiard
   and bilious pleurifies     ----     _____     ~2c
 Of the falie inflammation of  the  breaft       226
 Of the falfe pleurify     ----       ____     22o

                 CHAP. XXI.
 Of cholics    ------      ______     __,      2: t
 Of the  inflammatory cholic     ______        i'j
 Of the  bilious cholic     -------     ______    23?
 Of the  cholic from  indigeltion,  and of  in-
  digestions       ,  1     ______       __    2 2 7
Of the  flatulent, or windy cholic     ______.  29
Of the  cholic, from taking cold     ___.     245 
1
          CONTENTS,

                CHAP  XXII.
Of the miferere, or iliac paffion, and of the cho-
  lera morbus     ------    ——       Page> 243
The miferere---------------------       244-
The cholera morbus-----------.—      247

               CHAP.  XXIII.
Of a diarrhcea, or loofenefs-------------251

               CHAP.  XXIV.
Of a dyfentery or bloody-flux-------------253
The Symptoms of the difeafe    ------      254
Tiie remedies again 11 it       ------•         255
Of the beneficial ufe of ripe fruits     ----   258
Of the  danger of taking a great number of
   popular remedies in it       ------         260

               CHAP.  XXV.
Of the itch      ----      ------     —     262 
INTRODUCTION.

      TH E  decreafe of the number of inhabitants,
        in  molt of the Slates of Europe, is a fact,
        which  imprelfes  e\cry reflecting  perfbn,
and is become fuch a general complaint, as is hut
too well ellabliflied  on plain calculations.  This
decrcaSe is moil remarkable in country places.   It
is owing to many caufes ; and  I Shall think my Self
happy,  if I can contribute to remove one of the
greateit of them, which L the pernicious manner
of treating fick people in country places.  This is
my Sole object, tho' I may be excuSed perhaps for
pointiug out the other concurring caufes,  which
may be all included within thefe two general af-
firmations  ; That greater numbers than ufual emi-
grate from the country ;  and  that the people in-
creaie lefs  every where.
  There are  many forts  of emigration.    Some
leave their country to eulifl in the Service of dif-
ferent Slates by fea and land ;  or to be differently
employed abroad, fome  as  traders, others as do-
meftics, ire.
  Military Service,  by land or Sea, prevents popu-
lation in various refpetts.   In the firft place, the
numbers going abroad  are always  more,  often
much more,'than thole who return.  General bat-
tles,  with all  the hazards and fatigues of war ;
detached"*encounters,  bad piovilions,  excefs in
drinking  and  eating,  difeafes that  are the con-
fequeaees of debauches,  the difbrders that are pe-
culiar to the country ;  epidemical, peliilential or
contagious dillempers, can fed by the  unwhole-
fome air of Flanders,  Holland;  Italy,  and Hun-
gary ;  l°ng cruifes,  voyages to the Eaft or WeSl
  Vo.. I.              J C 
 ■2        / N T R 0 u u l  i  i u j\.
 Indies, to Guinea, ire. deStroy a great number of
 men.  The article of detertion alSb,  the con Se-
 quences of which they dread on returning home,
 difpoles many to abandon their country for ever.
 Others, on quitting the lervice, take up with fuch
 eltablifhments,  as  it  has  occasionally  thrown in
 their way ;  and which neceflarily prevent their
 return.   But in the fecond place,  fuppofing they
 were all to come back, their country fullers equal-
 ly from their abfence ; as this very generally hap-
 pens during that period of life, when they are
 belt adapted for propagation ;  Since that qualifi-
 cation on their return is impaired  by age,  by in-
 firmities and debauches :  and even when they do
 marry, the children often periSli as vidtims to the
 exceSJei. and irregularities of their fathers : they
 are  weak, languishing, distempered,  and either
 die young, or live incapable of being ufeful to fb-
 ciety.  I< elides, that the prevailing habit of liber-
 tinage, which many have contracted, prevents fe-
 vei al of them from marrying at all.  But notwith-
 standing all thefe inconvenient  confequences are
 real and notorious; yet as the number of thofe,
 who leave their country on thefe accounts, is li-
 mited,  and indeed rather inconsiderable, if com-
 pared with t'ie number of inliabitants which mult
 remain at lioine :  as it may be affirmed too, that
 tins relinquishing of their conn try,  may have been
 even neceliary at lome times,  and  may become fb
 again, if the caufes of depopulation fhould ceafe,
 this kind of emigration is doubtlels  the leaft griev-
 ous of any, and the lalt which may  require a Strict
 consideration.
   .at that abandoning of  their country, or expa-
 triation, as it may be termed,  the objedt of which
 is a change of the emigrants condition, is more
 to be considered, being more numerous.  It is at-
tended  with many and  peculiar inconveniences
 and is unhappily become an epidemical evil, the
 ravages of wliich are ilill incieahng ;  and that 
          INTRODUCTION.        3
from  one fimple ridiculous fource, which is this ;
that the fticcefsof one individual determines aliun--
dred to run the fame rilque,  ninety nine of whom
may probably be disappointed.   They are Struck
with the apparent fuccefs of one,  and are ignorant
of the mifcaniage of others.  Suppoie a hundred
perfons might have  fet out ten years ago, to feek'
their fortune,  as  the  faying is, at the end of  fix
mouths they are all forgotten, except by their  re-
lations ; but if one  fhould return the fame year,
with more money than his own fortune, more than
he fet out with ;  or if one of them has got a mode-
rate place with little work, the whole country rings
with it,  as a fubjedt  of general entertainment.   A
crowd of young people are feduced by this and
filly  forth, becaufe not one reflects, that of  the
the ninety nine,  who  fet out with the  hundredth
perfou, one hall'has periihed, many are niiierable,
and the remainder  come  back,  without having
gained any thing,  but an incapacity  to employ
their;'.elves ufefully at  home, and in their former
occupations :  and  having  deprived their country
of a great many cultivaters, who, from  the pro-
duce  of the lands,  would  have attracted conf.de r-
able Sums of money,  and many comfortable  ad-
vantages to if.  In Short, the very linall proporti-
on  who fucceed, are continually talked  of;   tue
crowd that fink  are perpetually forgot.  This  is j,
very great and real evil,  and how lhail it be pre-
vented ?  It would be  f.iffiiicnt per nips to publi.'ii
the extraordinary  riiipie, which mav be eafily  de-
monstrated:  it would require nothing more, than
to keep an exa«jt  yearly register of all ti.tie  ad-
venturers, and,  at the expiiation of fix, eight, or
ten years, to publifh the iift, with the late, of e-
very emigrant.   1 am greatly deceived, or at.t'e
end of a certain number of years, we Ihould ucjE
fee fuch multitudes forfake their  native Sbi'.,   iu
which they might live comfortably  by working,
to go in ieajrcli of tflablifhments in others j the  un-
                       C 2 
4        INTRODUCTION.
certainty of Avhich, fuch lifts would demonflrate
to them ;  and alSb prove,  how preferable  their
condition in their own country would have been,
to that they have been reduced to.   People'would
no longer Set out,  but on almolt certain advanta-
ges : fewer would undoubtedly emigrate, more of
whom,  from that very circumltance,  mult Suc-
ceed.  Meeting  with fewer of their country-men
abroad, thefe fortunate few would ofteuer return.
By this means more inh ibitants would remain in
the country,  more would return again, and bring'
with them more  money to it.  The State would be
more populous, more rich and happy ; as the hap-
pinefs of a people, who live on  a fruitful foil, de-
pends effentially on a great number of inhabitants,
with a moderate quantity of pecuniary riches.
   But  the  population of the country is not only
neceSlarily leSIened, merely in confequence of" the
numbers that leave it;  fince even  thofe who re-
main increafe leSs, than an equal number former-
ly did.   Or, which amounts to the fame thing,
among the fame number of perfons, there  are
fewer  marriages than formerly ;   and the fame
number of marriages produce fewer christenings.
I do not enter upon a detail of the proofs, fince
merely looking about us muft furnifh a fufficient
conviction of the truth of them.  What then are
the caufes of this ?  There are two capital ones,
luxury and debauchery, which  are enemies to po-
pulation on many accounts.
   Luxury compels the  wealthy man,  who would
make a figure ; and the man oS'a moderate income,
but who is his equal in every  other refpeet, and
who will imitate him, to be afraid of a numerous
family ; the education of which mull greatly con-
tract that expence he had devoted  to parade and
oftentation :  and befides, if he mull divide his e-
State among a great many children,  each  of them
■would have  but a little, and  be unable  to keep
up the ltate and the train of the  father.   Since 
          INTRODUCTION.         j
 merit is unjuftly ellimatcd by exterior Shew and
 expence, one inuSt of to irSe endeavour to attain
 for himfelf, and to leave his children in,  a Situa-
 tion capable of fupporting that expence.   Hence
 the fewer marriages of people who are not opu-
 lent, and the fewer children among people  who
 marry.
   Luxury is further prejudicial to the increaSe of
 the people, in  another  refpect.   The irregular
 manner of life which  it introduces,  deprefles
 health ; it ruins the constitutions, and thus fenfi-
 bly affects procreation.   The preceding generati-
 on counted fome families with more than twenty
 children r  the living one counts lefs than twenty
 coufins. Very unfortunately this way of thinking
 and acting, fo preventive of increafe,  has extend-
 ed itfelf even into villages : and they are no  lon-
 ger convinced there, that the,number of children
 makes the riches of the countryman.  Perhaps the
 next  generation will Scarcely be acquainted with
 the relation of  brotherhood.   A third inconveni-
 ence  of luxury  is,  that the rich retreat from the
 country <o live in cities ;  and by multiplying their
 domeftics there  they drain the former. This aug-
 mented train is prejudicial to the country, by de-
 priving it of cultivaters,and by diminishing popu-
 lation.  Thefe domeftics,  being Seldom Sufficiently
 employed,  contract the habit of lazinefs ; and
 they prove incapable of returning to that country
 labour, for which nature intended them.   Being
 deprived of this rcfource tney fcarely ever marry,
 either from apprehending the charge of children,
 or from their becoming libertines ; and fbmetimes
 becaufe many mailers will not employ married Ser-
 vants.   Or fliould any of them marry, it is often
in the decline of life, whence the ftate mult have
the fewer citizens.
  IdleneSs of itfelf weakens them,  and difpofei ,
them  to thofe debauches, which  enfeeble  them
ftill more.   They never have more than  a few
                       C 3 
6        INTRODUCTION.
children,  and  theSe  Sickly ;  fuch as  have not
llrength to cultivate the ground ;  or who, being
biouglit up in cities, have  an aversion to the
country.
  Even thofe among them who are more prudent,
who preferve their morals, and make  fome Sav-
ings,  being accultomed to a city life,  and dread-
ing the labour of a country one (of the regulati-
on of which they are  alio ignorant) choofe to be-
come little merchants,  or trad el "men ; and this
mult be a drawback from population, as any num-
ber of labourers beget more children than an  e-
qual number of citizens ; and alio by reaS'bn, that
out of any given number, more children die  in
cities,  than in the country.
  The fame evils alSb prevail,  with regard to fe-
male  Servants.   After ten  or twelve  years  fervi-
tude, the  maid-fervants in cities cannot acquit
themfelves as good country Servants :  and fuch of
them as choofe this condition,  quickly fail under
that kind or quantity  of work, for which they are
no longer constituted.  Were we  to lee a woman
married in the country,  a year after "her leaving
town, it would be eafy to obferve,  how  much that
"way of living in the country has broke her.   Fre-
quently their firft child-bed;' in which  term they
have  not  all  the attendance  their delicacy de-
mands, proves the lofs of their health ; they re-
main iii a ftate of languor, of feeblenefs, and of
decay: they have no more  children ; and this ren-
ders their hufbands unufeful towards the popula-
lation of the ftate.
  Abortions, infants  carried out of their country
after a concealed pregnancy,  and the impofiibili-
ty of their mother's getting hufbands afterwards,
are frequently the effects of their libeitinao-e.
  It is to be apprehended too thefe bad effects are
rather increafing with us ;  fince,  either for want
of  fufficient numbers, or from ©economical views
it has become a cuitom, inftead of women fervants 
         INTRODUCTION.         7
to employ  children,  whofe manners and whofe
constitutions are  not yet formed ;  and who are
ruined in the fame manner, by their residence in
town, by their lazinefs, by bad examples, and bad
company.
  Doubtlefs much remains Still unfaid on thefe im-
portant heads; but befides my intention not to fwell
this treatife immoderately,  and the  many  avoca-
tions, which prevent me from  launching too far
into what may be lefs -within the bounds of medi-
cine,  I fhould be fearful of digrefling too far from
my fubject.  What I have hitherto Said however,
I think cannot be impertinent to it; Since in giv-
ing advice  to the people, with regard to  their
health, it was neceffary to difplay to them the cau-
fes which impaired it: tho' what I might  be able
to add further on this  head,  would probably be
thought more remote from the fubject.
  I fhall add then but a fingle hint on the occafi-
on. Is it not practicable, in order to remedy thofe
evils which we cannot prevent, to feleif: fome par-
ticular part or canton of the country, wherein we
Should endeavour by rewards, \fi, Irremovably to
Six all the inhabitants,  idly, To encourage  them
by other rewards to a plentiful and legitimate  in-
creafe.   They fhould not  be permitted to go out
of it, which muft prevent them from being expof-
ed to the evils I have mentioned.   They fliould by
no  means  intermarry  with any ltrangers, who
might introduce Such disorders among them. Thus
very probably this canton, after" a  certain  time,
would become even over-peopled, and might fend
out colonies to the others.
  One  Caufe, (till more considerable than  thofe
we have already mentioned, has, to  this very mo-
ment, prevented the increafe of the  people in
France.  This is the decay of Agriculture.  The
inhabitants of the country,  to avoid ferving in the
Militia  j to elude the day's-Service impofed by their
Lords, and the taxes j and  being attracted to the 
S        INTRODUCTION.
city by the hopes of intereft, by lazinefs and liber*
tinage, have  left the  country nearly deferted.
Thofe who lemain behind,  either  not being  en-
couraged to work, or not being fufficient for what
there is-to do, content themfelves with cultivating
juft as much as is absolutely  neceSTary for their fub-
fiftence.   They have either lived Single, or marri-
ed  but late j or perhaps,  after the example of the
inhabitants of the cities, they have refufed  to ful-
fil their duty to nature, to the Slate and to a wife.
The country deprived of tillers,  by  this expatriati-
on  and inactivity, has yielded nothing ;  and  the
depopulation of the State has daily increafed, from
the reciprocal and neceffary proportion  between
fubfillence and population,  and becauSe  agricul-
ture alone can increafe fubfillence.  A Single com-
parifon will fufficiently evince  the truth and  the
importance  of thefe principles,  to  thofe who have
not feen  them already divulged and demonstrated:
in the works of the * friend of man.
  " An old Roman, who was always ready  to re-
41 turn to the cultivation of his field, lubfifled him.
" lelf and his family from one acre of land.  A la-
" vage, who neither fews nor cultivates, confumes,
" in  his  Single perfbn, as much game as  require
41 fifty acres  to feed them.  Consequently Tullus
t( Hoftitius, on  a thoufand acres, might have five
" thoufand fubjects : while a lavage chief, limited
" to the fame extent of territoiy, could  fcarcely
" have tsventy :  fuch an iinmenle difjnopoition,
" does agriculture fu; niSh,  in favour of populati-
" on.  Obferve thefe two great extremes. A ftate
" becomes difpeopled or peopled in that proporti-
" on,  by which it recetles from  one of thefe me-
" thods, and approaches to  the other." Inded it is
evident,  that  wherever there is an augmentation
of fubfillence, an increafe of population will foon
follow ;  which again  will  ftill further facilitate
* T_e Mat %-is of Muabrao, 
         INTRODUCTION.        9
the increafe of provisions.  In a ftate thus circum-
flanced men will abound, who, after they have fur-
nished fufficient numbers for the fervice of war, of
commerce, of religion, and for arts and profeflions
of every kind, will further alfo furnifli a Source
for colonies,  who will extend the name and  the
profperity of their nation to diftant regions. There
will enlue a plenty of commodities, the fuperfluity
of which will be exported  to  other  countries, to
exchange for other commodities, that are not pro-
duced at home ;  and the balance, being received iu
money, will make the nation  rich, refpedtable by
its  neighbours,  and  happy.  Agriculture,  vigor-
oufly  purfued,  is equal to the  produdtion of all
thefe  benefits ; and the  prefent  age will enjoy the
glory of refloring  it,  by favouring and encourag-
ing cultivaters, and by  forming Societies  for the
promotion of agriculture.
  I proceed at length to the fourth caufe of depo-
pulation,  which is the  manner of  treating fick
people in the country.  This has often affedted me
with the deepell concern.   I have  been a witnefs,
tljat meladies, which, in themfelves, would have
been  gentle, have proved mortal from a pernicious
treatment : I am convinced  that this caufe alone
makes as great a havock  as the former; and cer-
tainly it requires  the utmoft attention of phyfici-
ans, whofe duty it is to  labour for the prefervation
of mankind.   While, we are employing our afiidu-
ous cares on the more poliShed and fafhionable part
of them in cities, the larger and more ufeful  moi-
ety periSh in the country ; either by particular, or
by highly epidemical, diSeafes, which, within a few
years pad, have appeared in  different villages,
and made no fmall ravages.  This  affiidting consi-
deration has determined me  to publish this little
work, which is Solely intended  for thofe patients,
who,  by their distance from phyficians, are depriv-
ed of their afliStance. I  fhall  not give a detail of
my plan,  wliich is very  fimple, in this part j but 
to       INTRODUCTION.
content myfelf with affirming, I have ufed my nt-
moft care to render it the moll ufeful I poffibly could:
and I dare hope, that if 1 have not fully difplayed
its utmoft advantages, I have at leaft fuificiently
Shewn thofe pernicious methods of treating diieaSes,
that Should inconteifcably be avoided I am thorougly
convinced, the defign might be acco npliShed more
compleatly than 1 have done it ; but tho/b who are
fo capable of^ do not attempt, it; I happen to be
lefs timid; audi hope that thinking perfons will
rather take it in good part of me,  to have pubiifh-
ed a book, the conipofing of which  is rather difa-
greeable fiom its very  facility, from,  the minute
details,  which  however are  indifpenfable ; and
from  the impoflibilicy of difeuffing any  part of it
{conliflently with the plan) to the  bottom of the
fubject; or of displaying any new and ufeSul pro-
fpect.  It may be compared,  in fome refpetts,  to
the works of a Spiritual guide, who was to write u
catechifm for little children.
  At  the fame time 1 am not ignorant there have
already been a few books calculated for country pa-
tients, who are remote from fuccour : but Some of
thefe, tho*  published wirh a very  good purpoSe,
produce a bad effect. Of this kind are all collecti-
ons of receipts or remedies, without the leaft de-
scription of the difeafe ; and of courfe without juft
diredtions for the exliibition, or  application,  of
them. Such, for example, is  the famous collection
of Madam Fouquet,  and fome more in the fame
manner. Some others approach towards my plan ;
but many of them have taken in too many dillem-
pers, whence they are become too voluminous. Be-
fides, they  have not dwelt  fufficiently  upon the
figns  of the difeafes:  upon their  caufes ; the
general regimen in them,  and  the mifinanage-
ment of them.  Their receipts are not generally as
Ample, and as  eafy to prepare,  as they ought to
be.   In Short, the  greater  part of their writers
feem, as they advanced, to  have grown tired  of 
INTRODUCTION.
their melancholy talk, and to have hurried them
out too expeditioufly. There are but two of them,
winch I muft name with refpect, and which being
propoSed on a plan very like my own,  are execut-
ed in a fuperior manner,  that  merits the higheSl
acknowledgments of the public. One of thefe wri-
ters is  M. Rosen, firft phyfician of the kingdom of
Sweden ;  who, fome years fince, employed his juft
reputation  to render the beft fervices to his coun-
try men.  He has  made them retrench from the
almanacks thofe ridiculous tales;. thofe extraordi-
nary adventures; thofe pernicious aftrological in-
junctions, which there, as well as here, anfvver no
end, but that of keeping up ignorance, credulity,
fuperftition,  and the fa lie ft prejudices on the in-
teresting articles of health, of difeafes, and of re-
medies.  He has alfo taken care to publish Simple
plain treatifes on  the moSt popular  distempers;
which he has fubllituted in the place of the former
heap of abSurdities. Thefe concife works however,,
which appear annually in their  Almanacks,  are
not yet tranflated  from the Swedifh, fb that I was
unqualified to make  any extracts from them. The
other is the Baron Van Swieten,firft phyfician to
their  Imperial  Majesties, who, about two years
finee,  has effected  for the ufe of the army, what
I now  attempt .for fick  people in  the country.
1 hough my work  was greatly advanced, when  I
firft faw his,  I have taken fome paflages from  it:
and had our  plans been  exactly alike,  I fhould i-
magine I had done the public more fervice by en-
deavouring  to  extend the reading of his  book,
than by publishing a new one.  Nevertheless, as he
is Silent on many articles, of which I have treated
diflufively ;  as  he has treated of many diftempers,
v hich did not come  within my plan ; and has faid
nothing of fome others wliich I could not omit;
our two works,  without entering into the particu-
lars of the fuperiorjnerit of the Baron's, aie very
different, with regard to the fubject of the difeafes; 
12
INTRODUCTION.
tho' in fuch as wr have both considered, I account
it an honor to me to find, we have almolt conllant-
ly proceeded upon the tame principles.
  The prelbnt work is by no means addrefled to
fuch phyfician ,  as are thoroughly accomplished in
their profeflion ; yet pofiibly ;  befides,  my parti-
cular medical  friends, fome others may  read it.
I beg the favour of all fuch fully to confider the
intention, the fpirit of the  author, and not tocen-
fure him, as a phyfician, from the compofition of
this book.  I even adyile them here rather to for-
bear perufing it; as a produdtion,  that can teach
them nothing. Such as read, in order to criticize,
will find a much greater fcope forexcerciling that
talent on the other pamphlets 1 have pubiifhed.  It
were certainly unjult  that a perSbrmance, whofe
fole abStradted object is the health and  fervice of
my countrymen, Should fubject me to any disagree-
able conSequences; and a writer may fairly plead
an  exemption from any  Severity of cenSure,  who
has had the courage to execute  a work, which can-
not pretend to a penegyric.
  Having premised thus mud  in general, I muft
enter into fome detail of thole  means,  that feem
the moft likely  to me, to  facilitate the benefical
con Sequences, which, J hope, may refult to others,
from my prefent endeavours.   I f: all  afterwards
give an explanation of fome terms wliich  I could
not avoid ufing, and which, perhaps, are not ge-
nerally uuderltood.
  The title of Advice to the People, was not  fug-
gefted to me by an illufion, which might perfuade
me, this book won Id become a piece of furniture,
as it were, in the houfe of every peafant. Nineteen
out of twenty will probably never know of its ex-
istence.  Many  may be unable to read,  and  ftill
more unable to underftand, it,  plain and fimple as
it is.  I have principally calculated  it for the peru-
fal ofintelligent and  charitable perfons,  who live
in  the country ; and who feem to have, as it were, 
         INTRODUCTION.       13
31 call from providence, to aflift their lefs intelli-
gent poor neighbours with their advice..
  It is obvious, that the SirSl gentlemen I have my
eye upon, are  the  clergy.  There is not a Single
village, a hamlet,  nor even the houfe of an alien
in the country, that has not a right  to the good
offices of Sbme one of this  order; And I aflure
myfelf there are a great number of them, who,
heartily affected with the diftrefs of  their ailing-
flocks, have wifhed many  hundred times, that  it
were in their power to give their parishioners fome
bodily help, at the very time they were difpofing
them to prepare for death ; or fo  far to delay the
fatality of the dillemper, that the Sick might have
an opportunity of living  more religioufly after-
wards. 1 (hall think myfelf happy, if fuch truly
refpectable eccleiiaftics  Shall  find any  reSburces in
this performance, that may conduce to the accom-
plishment of their beneficent intentions.  Their
regard, their love for their people; their frequent
invitations  to   vifit their principal neighbours;
their duty to root out all unreasonable prejudices,
and fupertlition ;  their charity,  their  learning;
the facility, with which their general knowledge
in phylics, qualifies them to comprehend thorough-
ly all the medical truths, and  contents of this
piece, are fo many arguments to  convince me,
that they will have the greateft influence to pro-
cure that reformation, in the adminiltration of
phyfick, to  poor country people,  which is fo ne-
ceffary, fb delirable, an object.
   In the next  place,  I  dare  allure  myfelf of the
concurrence of gentlemen of quality and opulence,
in their different parifhes and eftates, whole advice
is highly regarded  by their inferiors; Who are fo
powerfully adapted to difcourage  a wrong,  and to
promote a right practice, of which they will eafi-
ly difcern all the advantages.  The many instan-
ces I have Seen of their entering,  with great faci-
lity,  into all  tie  plan and conduct of a cure 3
Vo.i  I.                 D 
   14      INTRODUCTION.
  their readiuefs and even earneflnefs to comfort the
  lick  in their villages ; and the generolity with
  which  they prevent their  neceffities,  induce me
  to hope, from judging of thofe I have not the plea-
  sure to know, by thefe whom 1 have, that they will
  eagerly  embrace an opportunity of promoting a
  new  method of doing good  in  their neighbour-
  hood.  Real charity will apprehend the great pro-
  bability there is of doing mifehief, tho' with the
  belt intention, for want of a proper knowledge of
  material circumstances ; and the very fear of that
  mifehief, may fometimes  fufpend the exercife of
  fuch charity ; notwithstanding it muSl feize, vyith
  the moft  humane avidity, every light that can
  contribute to its own beneficent exertion,
    Thirdly, perfons who are  rich,  or at leaft in ea-
 fy circumltances, whom  their difpofition,  their
  employments,  or the nature of their property,
 fixes in the country,  where they are happy in do-
 ing good, muft be delighted to have fome  proper
 directions for the conduct and effectuation of their
 charitable intentions.
   In every village, where  there are any perfons,
 of thefe three conditions, they are always readily
 apprized  of the  diftempers in it,  by theii poor
 neighbours coming to intreat a little Soup, V* nice
 treacle, wines,  bifcuits, or any thing they ima-
 gine neceffary for their fick folks.  In confequence
 of Sbme quellions to the by-Slanders, or of a  vifit
 to the  Sick perfon, they will judge at leaft of what
 kind the  difeafe is ; and by their  prudent advice
 they may be able to prevent a multitude of  evils.
 They will  give them Sbme  nitre inStead of Venice
 treacle;  bearley, or Sweet whey, in lieu of foup.
 They will advife them to have recourfe to glyfters,
 or bathings of their feet, rather  than to  wine  ;
 and order them gruel rather than bifcuits. A man
would fcarcely  believe, till after the  expiration of
a few years, how much good  might be effected by
fuch proper regards, fo eafily comprehended, and 
           INTRODUCTION.      is
 often repeated.  At firft indeed there may be fome
 difficulty in eradicating old  prejudices,  and inve-
 terately bad cultoms ; but  whenever thefe were
 removed, good habits would Strike  forth full as
 Strong roots, and I hope that no perfbn would be
 inclined to dellroy them.
   It may be unnecclFary to  declare, that  I have
 more expectation from the  care and goodnefs of
 the ladies, than from thofe of their fpoufes, their
 fathers,  or brothers.  A  more active charity,  a
 more durable patience, a  more domestic life ;  a
 fagacity, which I have greatly admired in many
 ladies both in town  and country,  that difpofes
 them to obferve, with great exact nefs; and to un-
 ravel, as it were, the fecret caufes of the  fymp-
 toms, with a facility that would do honour to ve-
 ry good  practitioners, and with a  talent adapted
 to engage  the confidence of the patient :—Ail
 thefe, I  Say, are So many character!Stical marks of
 their vocation  in this important and neighbourly
 duty; nor are they  a  few, who fulfil  it  with  a
 zeal, that merits the highell commendation, and
 renders them excellent models for the  imitation
 of others.
   Thofe  who are intrulted with the education of
 youth, may alfo be  fuppofed Sufficiently, intelli-
 gent to take fome part in this work ;  and I  am Sa-
 tisfied that much good mipht rel'ult from their uu-
 dertakmg it.   I heartily wiSh, they would not on-
,ly Study to diftinguifh the difiemper (in which the
 principal, but by no  means an infurable, difficul-
 ty confifts; and to do which I hope I have  consi-
 derably  put  them in the way) but  I would have
 them learn alfo the manner of applying remedies.
 Many of them fhave; I have known fome who
 bleed, and who have given glyfters very expertly.
 This however all may eafily learn ; and  perhaps it
 would not be  imprudent,  if the art of bleeding
 well  and fafely  were reckoned  a neceffary  qua-
 lification, when they are examined for  their em- 
 16       INTRODUCTION.

 ployment.  . Thefe  faculties, that of estimating
 the degree of a fever, and how to apply  and to
 dreSs blilters,  may  be of great  uSe  within the
 neighbourhood of their refidence.  Thtir Schools,
 which are not frequently over-crouded, employ
 but a few of their daily hours ;  the greater part of
 them have no land to cultivate ; and to v\hat bet-
 ter ufe can  they apply their leifure, than to the
 affiStance and comfort of the fick ? The moderate
 price of  their fervice may be So ascertained,  as to
 incommode no perfcn ; and this little  emolument
 might render their own Situation the more agree-
 able : befides which, thefe little avocations might
 prevent  their being drawn  afide  Sometimes, by
 reafon of their facility and frequent leifure,  fo as
 to contract a habit of drinking too often.   Ano-
 ther benefit would  alfo accrue from accuftoming
 them  to this kind of practice, which is, that being
 habituated to the care of fick people,  and having
 frequent  occasions  to write, they would  be the
 better qualify'd, in difficult cafes, to advife  with
 thofe, who were thought further neceffary to be
 confulted.
  Doubtlefs, even among labourers,  there  may
 be many, for feme fuch 1 have  known, who being
 endued with good  natural fenfe  and judgment,
 and abounding  with  benevolence,  will read this
book with attention, and eagerly extend the  max-
 ims and the methods it recommends.
  And finally I hope that many furgeons, who are
 Spread about the country, and  who practice  phy-
 fick in their neighbourhood, will peruSe it; will
 carefully enter into the principles established  in it,
 and will  conform to its diredtions ;  tho'  a  little
 different perhaps from fuch as they may have hi-
 therto pradtifccl.  They will perceive a man  may
 learn  at any age,  and  of any perfbn ; and it  may
 be hoped they will not think  it too much trouble,
 to reform fome of their notions  in a fcience, which
is not properly within their profeffion  (and to the 
         INTRODUCTION.       17
Andy of which  they were  never instituted)  by
thofe of  a perSbn, who is Solely  employed  in  it,
and who has had many  affiftances of which they
are deprived.
  Mid wives may alfo  find their attendance more
efficacious, as fbon as they are thoroughly difpof-
ed to be  better informed.
  It were heartily to be  wished, that the greater
part of them had been better iiiSlrudled in the  art
they profefs.  The instances of mifehief that might
have been  avoided, by their being better qualify-
ed, are frequent enough to make us wiSh there
maybe no  rep"titon of them, which it may be pof-
fible to prevent.  Nothing feenis impoffible, when
perfons in  authority are  zealoufly inclined to pre-
vent every fuch evil ; and it is time they fhould be
properly informed of one fb effentially hurtful to
fociety.
  The  prefcriptions  I have  given confift of the
moft Simple  remedies, and  I have  adjoined  the
manner of preparing themfb fully, that I hope no
perfbn can be at any  lofs in that refpedt.  At the
fame time, that no one may imagine they are the
lefs ufeful and  efficacious for their  Simplicity,  E
declare, they are  the fame I order in the city  for
the  moft  opulent patients.   The  fimplicily is
founded in nature : the mixture,  or rather the
confufion,  of a multitude  of drugs is ridiculous.
If they have the very tame virtues, for what pur-
pofe are they  blended ? It  were more judicious to
confine ourfelves to that, whic'i  is the moll eilec-
tual.   If their virtues are different,  the.effect of
one destroys, or  leffens, the effect of the other;
and the medicine ceafes to prove a remedy.
  I have given  no direction,  which is  not very
practicable and eafy  to txecite, neverthelefs it
will be discernible, that Sbme few are  not calcu-
lated  for the multitude, which 1 readily  <?r;:it.
However 1  hav? given  them,  becau.e I did not loje
fight  of fome perfons;  who, tho' not Strictly of
                     D  3                     cl 
 18       INTRODUCTION.
the multitude, or peafantry,  do live in the count-
 ry, and cannot always procure a phyfician as fbon,
 or for as long a time, as they gladly  would.
   A great number of the remedies  are entirely of
 the country growth, and may be prepared  there ;
 but there are others, which muft be had Irom the
 apothecaries.  I have fit down the price f at which
 1 am perfuaded all the country apothecaries will
 retail them to a  peafant, who is not  efteemed  a
 rich one.  I have marked the price, not from any
 apprehenfion  of their  being impofed on  in the
 purcliafe, for this I do not apprehend ; but, that
 feeing the cheapnefs of the prefcription, they may
 not be  afraid to buy  it.   The neceffary  dofe of
 the medicine, for each difeafe,  may generally be
 purchased for leSs money than would be expended
 on meat, wine, bifcuit, and other improper things.
 But fhould  the  price  of the medicine,  however
 moderate, exceed  the circumstances of the fick,
 doubtlefs the common purfe, or the poors-box will
 defray it.  Moreover there are  in  many country
 places noblemen's houfes, Some of whom charitably
 contribute an annual fum towards buying of me-
 dicines  for  poor  patients:  without  adding to
 ■which fum, I would  only intreat  the  favour of
 each of them to alter the objects of it,  and to al-
 low their fick neighbours the remedies and the re-
 gimen directed here, inltead of fuch as they for-
 merly distributed among them.

  t This ©economical information wis doubtlefs very proper, wheie
 our judic'o. sa> d htinane author publilhed it; but noi withstanding  his
 excellent  motives f* giving it, we think it lefs neceffary heie, where
 many country gentlemen riirnilh themfelves with larger or fmaller medi-
 cine chefts.for the benefit oK their poor fick neighbour* ; and in a coan
 try where the fettled paro.hial poor arc pro/ided with median es, as well
 a> with other necelTiries at apaiochial expence. Befidej, tho' we would
 not fuppofe our country apotheca i.$lef> considerate or kind than others,
 \ve acknowledge our apprehenfion, that fuch a valuation of their drugs
 (fome of which often vary in their price) might difpofe a few of them.
 rather to difcomtenance the extenHoa of a work, fo well intended and
 executed as Dr. TISSOT*,;  a work, which may not be wholly unufeful
 to Tom-' of the moft judkiQ_s among them, and will be really neceffary
 for t:.c reft,  K, 
INTRODUCTION.
*9
  It may ftill be objedted, that many country places
are very distant from large  towns ; from which
circumflauce  a poor peafant is incapable of pro-
curing himfelf a feafbuable and neceffary  fupply
in his illnefs.   I readily admit,  that in  fadt, there
are many  % illages very remote from fuch places as
apothecaries refide in.   Yet,  if we except a few a-
moug the mountains, there  are but very few  of
them above three or four leagues from fome little
town, where there always lives fome furgeon,  or
fome vender of drugs.   Perhaps however, even  s.t
this time, indeed, there may not  be  many  thus
provided ; but they will take  care to furnifh them-
felf with fuch materials as foon as the have a good
profpedt of felling  thein, which may conftitute a
fmall, but new, branch of commerce for them. I have
carefully  fet  down the time, for which each me-
dicine  will keep, without fpoiling.   There is a
very frequent occasion  for  fome particular ones,
and of fuch the fchool mailers may lay in a flock.
I  alio  imagine,  if they heartily enter  into my
views, they will furnifh themfelves with fuch  im-
plements, as  may be neceffary in the courfe of
their attendance.   If any of them were unable to
provide themSelves with a  fufficient  unrnber of
good lancets, an apparatus for cupping, and a glyf-
ter fyringe (for want of which lall a pipe and
bladder may  be occasionally fubftitutcd) the pa-
rish might purcliafe them, and the fame instru-
ments might do for the fucceeding fchool-mafter.
It  is  hardly  to be expected, that  all  perSbns in
that employment would be able, or even inclined
to learn the way of ufing them with addrefi; but
one perfon who did, might be fufficient for what-
ever  occafions fhould occur in this way in  feme
contiguous villages ; with very little neglect of
their functions among their fcholars.
   Daily instances of perfons, who come from dif-
ferent parts to confult me without  being capable
of aniwering the oueftious I afk them,  and the like 
 20        INTRODUCTION.
 complaints of many other phyficians on the fame
 account, engaged me to write the lall chapter of
 this work.  I Shall conclude this introduction with
 fome remarks, neceffary to facilitate the knowledge
 of a few  terms,  which  were unavoidable  in the
 courfe of it.                                   '
   The  pulfe  commonly heats in a perfbn in good
 health, from the age of eighteen or twenty to a-
 bout Sixty years,  between Sixty-Six  and Seventy
 times in a minute. It Sometimes comes fhart of this
 in old perfons, and in very young children it beats
 quicker: until the age of three or four yearsthe dif-
 ference amounts at leaft to a third : after which it
 diminishes by degrees.
   An intelligent perfon, who Shall often touch and
 attend  to his own pulfe, and frequently  to other
 peoples, will be able to judge, with fufficient ex-
 adtnefs, of the degree of a fever in a fick perfon.
 If the ltrokes are  but one third above their num-
 ber in a healthy State, the fever is not very vio-
 lent : which it is,  as often as it amounts to half as
 many more as in health.  It is very highly dange-
 rous, and  may be generally pronounced mortal,
 when there are  two Strokes in  the time of one.
 We mufl not however judge of  the pulfe, folely
 by its qiiicknefs,  but by its Strength orweaknefs ;
 its hardueSs or foftnefs ; and the regularity or ir-
 regularity of it.
   There is no occafion to define  the ftrong and
 the feeble pulfe.   The Strength of it generally af-
 fords a good prognoftic, and,  Suppoling it too
 ftrong,  it  may  eafily  be  lowered.  The  weak
 pulle is often very menacing.
   If the pulfe, in meeting the touch, excites the
 notion  of a dry flroke, as though  the artery  con-
 fided of wood, or of fbme metal,  we term it hard ;
 the oppofite to which is called foft,  and generally
 promifes better.  Ifit be ftrong aud yet foft, even
 though it  be quick, it may be confidered as a i ery
< hopeful circuinftance. But if it i* lUong and hard, 
           INTRODUCTION.       2:
 that  commonly is  a token of an inflammation,
 and indicates bleeding and the  cooling regimen.
 Should it be, at the fame time,  fmall, quick  and
 hard, the danger is indeed very prefiing.
    We call  that, pulfe regular, a continued  fuc-
 ceffion of whofe Strokes are made in equal intervals
 of time : and  in  which  intervals, net a Single
 ftroke is wanting (  Since if that is its ftate, it is
 called an intermitting pulfe. )   The  beats or pul-
 iation s are alfo fuppofed  to refemble each other
 fo exactly in quality too, that que is not ftrong, and
 the next alternately feeble. ,
    As long as the ftate of the  pulfe is promifing ;
 refpiration or breathing is free ; the brain does not
 feem  to  be greatly  alfedted; while  the  patient
 takes  his medicines,  and they are attended with
 the confequence'that was expected;  and he both
 preServes his Strength pretty well, and continues
 fenSible of  his fituation, we may reafonably hope
 for his cure.   As often as all, or the greater num-
 ber of  thefe  charadterizing  circumstances  are
 Wanting, he is in very considerable danger.
   The Stoppage of perfpiration is often mentioned
 in the courfe of this work.   We call the difcharge
 of that fluid which continually pane's off" thro' the
 pores of  the  fkin,  tranfpiratiun \ and  which, tho'
 iuvifible, is very considerable.   For if a perfon in
 health eats and drinks to the weight of eight
 pounds daily,  he does not difcharge four of them
 by Stool and urine together, tlie remainder  paff-
 ing off" by  infenSible tranSpiration. It may eaSily
 be conceived, that if fo considerable a discharge is
 flopt,  or confiderably leffened; and if this fluid,
 which ought to tranfpire through the fkin, fliould
 be transferred to any  inward part, it  mull occasi-
 on Some dangerous complaint.  In fact this is one
 of'the moft frequent caufes of difeafes.
 To conclude very briefly—all the diredtions hit he
following treatife are folely deSigued for fuch pati-
ents, as cannot have^the attendance of a phyfician! 
22        INTRODUCTION.
I am far from  fuppoSing, they ought to do inftead
of one, even in thofe diieales, of which I have treat-
ed in the fullell manner : and the moment  a phy-
fician arrives, they  ought  to  l»e  laid  aSide.  The
Confidence repofed in him Should be entire, or there
fhould be none : the fuccefs of the event is  found-
ed in that. It is his province to judge of the difcale,
to ieledt medicines againft  it ;   and  it is eafy to
fore fee  the inconveniences that may  follow, from
propofing to him to confult with any  others, pre-
ferably to thofe he may chufe to confult with ; on-
ly becaufe they have fucceeded in the treatment of
another patient,  whole cafe they fuppofe to have
been nearly the fame with  the prefent cafe.  This
were much the fame,  as  to order a Shoe-maker to
make a Shoe for one foot by the pattern of another
Shoe  rather than by the meafure he has juft taken.

  N. B.  Though a great part of this judicious int roducVion 'is lefs appli-
cable to the political circumftances of the  Britifh empire, than to thole
of the government for which it was calculated ; we think the good fenfe
and the unafTefted patriot if m which animate it, will fuperfede any apo-
logy for our tianflating it.  The ferious truth is this,  that a thorough
attent ion to population feems never to have been more expedient for oar.
felves, than after (o bloody and expenlive, though  fuch a glorious and
fuccesfnl war: while our enterprizing  neighbours, who will never be our
friends, are fo earncft to recruit  their numbers ; to increafe their agri-
culture ; and to force a vent for their manufactures,  which  cannot be
confiderabiy effected, without a fenfible  detriment to our own. Be-
fides which, the unavoidable drain from  the people  here, towards an
eftedual cultivation,  improvement, and Security of oux concerts, demand*
a further enfideration. K. 
ADVICE
                  TO THE

PEOPLE,

 With Refpecft to their HEALTH.
                 CHAP.  I.

   Of the moft ufual caufes of popular maladies.

                 Sect.  i.
      THE moft  frequent caufes of difeafes com.
       monly incident to country people are, firft,
       Exceflive labour,  continued for a very eon-
fiderabie time.  Sometimes they fink down atr once
in a ftate of exhaultion and fainlnefs, f om which
they feldom recover: but they are oftener ati ack-
ed with fome inflammatory difeafe, as a quinfey,
a pleurify,  or an inflammation of the breaft.
  There are two methodsxof preventing thefe e~
vils :  one is,  to avoid the caufe which produces
them ; but this is frequently impoffible.   Another
is,  when fuch exceflive  labour has been unavoid-
able, to allay their fatigue, by a free ufe of fome
temperate refrefliing drink ;  efpecially by fvveet 
  24             Of popular  Maladies.
  whey, by butter-milk,  or by f water,  to a quart '
  of which a wine-glafs of vinegar may be added ;
  or, inllead  of that,  the exprelied juice of grapes
  not fully ripe,  or even of gooSberries or cherries:
  Which wholelbme and agreeable liquors are refresh-
  ing and cordial.  I fhall treat, a little lower, of in-
  flammatory dilbrders.  The inanition or emptineSs,
  though accompanied with lymptons  different from
  the former,  has yet Sbme  affinity to them,  with
  reSbeet to their caufe, which is a kind of general
  exliccation or dryneSs.   I have known Sbme cured
  from this caufe by whey, fucceeded by tepid baths,
  and afterwards by cow's milk :  for  in fnch cafes
  hot medicines and high nourilhment are fatal.
    \ 2. There is another kind of exhaultion or emp- '
 tinefs, which may be termed real emptinefs,  and
 is the confequence of great poverty,  the want of
Sufficient  nourishment,  bad  food,  unwholefome
 drink, and exceflive labour.  In cafes thus circum-
 stanced, good Soups and  a little wine are very  pro-
 per.   Such  happen  however very feldom in  this
 country :  I  believe they are frequent in Some  o-
 thers, efpecially in many provinces  of France.
    § 5.  A fecond and very common  fource of dif-
 orders arifes,  from peoples lying down and repof-
 ing,  when  very hot,  in a cold place.    This  at
 once  Stops perfpiration,  the  matter of which be-
 ing thrown upon feme internal part, proves the
 caule  of  many violent  difeafes,  particularly  of
 quinfeys,  inflammations of the breaft, pleurifies,

.  "f This fuppofes they are not greatly heited,  as well as fatigued,  by
 their labour or exercife, in which circumftancc free and fudden draughts
 of cooling litjuors might be very pernicious : and it evidently alfo fup*
 pofes thefe drinks to be  thus given, rattier in fummer,  thnn in very
 coldweathei, as  the jjice of the unripe  grapes, and the other  fre.h
 fruits, fuffi.iently afcert.iin the feafonof the year.   W e think th« ad-
 dition of vinegar to their water will (carccly ever be nccc-flary 111 this
 or the adjo.nmg ifland, on fui.h occafions.  The caution  recommended
 in this note is indeed abundantly enforced by Dr. Tiflof, J 4 : but con-
 Jidering the pcrfois  to whom  this work is more pariiculai ly addrefled,
 ■we were willing to pi event every poflibility of a miliakc,-Hi fo neceira*
 ty, and fomietimes fo vital a point. K,            1 
              Of popular  Maladies.            2$

and inflammatory cholics.  Thefe evils, from this
caufe,  may always be  avoided by  avoiding the
caufe,  which is one of thofe that deftroy a great
number of people.  However,  when it has occur-
red,  as  foon as  the firft Symptoms of the malady
aie perceivable,-which Sometimes does not hap-
pen till feveral days after, the patient fliould im-
mediately be bled ; his legs fhould be put into wa-
ter moderately hot, and he Should drink plentiful-
ly of the tepid infulion marked N'~* I.  Such af-
Siitances frequently prevent the increafe of thefe
disorders ;  which, on  the contrary, are greatly ag-
gravated, if hot medicines are given to Sweat the
patient.
   § 4. A third caufe is  drinking cold water, when
a person is extremely hot.   This'acts .in the fame
manner with the Second ;  but its confequences are
commonly more Sudden and violent.  I have feetx
molt terrible examples  of it, in quinfeys,  inflam-
mations of the  breaSt, cholics, inflammations of
the liver, and all the parts of the belly, with pro-
dioious fwellings,. vomitings, fuppreSlions  of u-
rine, and inexprefliblc anguiih.   The molt avail-
able remedies in fuch cafes,  from this caufe,  are,
 a plentiful bleeding at the  onfet,  a very copious
 drinking of warm water, to wi.ich one fifth part
of whey Should be added ; or of the ptifan N' • 2,
 or of an emulfion of almonds,   all taken warm.
 Fomentations of warm water Should alio be appli-
 ed to the throat,  the bivaft  and be.iy, with glyf-
 ters of the fame, and  a little milk.   In this cafe,
 as well as  in  the preceding one,  (§  3.) a femicp.-
 um,  or half-bath of warm water  has femetimes
 been attended  with  immediate  relief.   It Seems
 really  aftonifhing,  that  labouring people  Should
 fb often habituate themfelves to this  pernicious
 cuftom, which they know  to be very dangerous
 even to their bealls.  There are none of them,
 who will  not prevent  their horfes  from drinking
 while thev are hot -,  efpecially if they are juft go-
   Vol.1/               E 
2 f>           Of the moft ufual Caufes
ing to put them up.   Each of them knows,  that
if he lets them  drink in that ftate, they might
poffibly burll with it;  neverthelefs he is not afraid
of incurring the like danger himfelf.    However,
this  is not the  only cafe,  in which the  peafant
feems to have more attention to the health of his
cattle, than to his own.
   §  5. The fourth caufe, which  indeed affects e-
very body, but more particularly the labourer, is
the  inconltancy of the  weather.    We Shift all at
once,  many times a day, from heat to cold, and
from cold to heat, in a  more remarkable manner,
and more fuddenly, than in moft other countries.
This makes diftempers from  defluxion and cold fo
common with w> : and  it fliould make us careful
to go rather a little  more warmly cloathed than
the  feafon may feem to  require ;  to have  recourSe
to our winter cloathing early in  autumn,  and not
to part with it too early in the fpring.   Prudent
labourers, who Strip while they are at work, take
care to  put on their  cloaths in the evening when
they return home*.  Thofe who, from negligence,
are  fatisfied with hanging them  upon their coun-
try  tools, frequently  experience, on their return,
the very unhappy effects of it.   There are fome,
tho' not many places,  where the air itfelf is un-
wholefome,  more from its particular quality than
from its changes of temperature,  as at Villeneuve,
 and ftill more at Noville, and in fome other villa-
 ges liquated among the marfhes which border on
 the Rhone.   Thefe countries are particularly fub-
ject to intermitting fevers,  of which  I Shall treat
 briefly hereafter.
   $  6.  Such Sudden changes are often  attended
 with  great  (bowers of rain, and  even cold rain,

   *  This fOPd advice is enforced in a note, by the editor of Lytns, who
 oVcrvcs,  it inould be ftill more clofely attended to, in places where  ri-
 vers wood', or mountains, retain, as it were, a eonfiderabie humidity;
 and  where tne evenings are, in every fealon,  cold and moift......It is a
 i-cry proper caution too in our own variable climate, and in many of our
 - ijoni^s in North America. K. 
              Of popular Maladies.            2?
in the middle of a very hot day j when the labour-
er who was bathed, as it were,  in a hot fweat, is
at once moiltened in cold water ; which occafions
the fame dillempers, as the Sudden traufition from
heat to cold, and requires the fame remedies.   If
the fun or a hot air fucceed immediately to fuch a.
Shower, the  evil is confiderably lighter : but if the
cold continues, many are often greatly incommod-
ed by it.
  A traveller is  femetimes thoroughly and una-
voidably  wet with mud ;  the ill confequence of
which is often inconsiderable,  provided he chang-
es his cloatlis immediately, when he lets up.  I
have known fatal pleurifies enfue from omitting
this caution.   Whenever the body  or the  limbs
are wet, nothing can be more ufeful than bathing
them in  warm water.   If the  legs only have been
wet, it may be fufficient to bathe them.   1 have
radically, thoroughly, cured perfons fubjedt to vio-
lent cholics, as often as their feet were wet, by
perfuading  them to purlue this advice.  The bath
proves ftill  more effectual, if a little foap be  dif-
iblved in it.
   § 7. A fifth caufe, which is  Seldom attended to,
probably indeed becauSe  it produces lcSs violent
confequences, and yet is certainly hurtful,  is the
common cuftom in all villages,  of having their
ditches or dunghills directly under their windows.
Corrupted vapours are continually exhaling from
them, which in time cannot fail of being preju-
dicial, and  muft contribute to produce putrid dif-
eafes.   Thofe who are accuftomed  to the  linell,
become infeiifible of it:  but the caufe, neverthe-
less, does not ceafe to be unwholefbmely adtive;
and fuch as are unufed to it perceive the imprefli-
 on in ail its force.
   § 8. There are fome villages, in which, after the
curtain lines  are erafed, watery marfhy places re-
main in the room of them. The effect  of this is
ftill more dangerous, becaufe  that putrify'd wa-
                        E  2 
28           Of the moft ufual Caufes
ter,  which ftagnates during the hot feafon, fufler*
its vapours to exhale-more eafily, and more abun*
chaitly, than that in the curtain lines  did.  Hav*
ing fet  oat for Pully le Grand,  in I7J0, on  ac-
count of an epidemical  putrid  fever which raged
there,  I was lenfible,  on traversing the  village, of
the  infedtion from  thofe  marfhes j nor could  I
doubt of their bcir.g the caufe of this  difeafe, as
well as of another like  it, which  had  prevailed
there five years before.   In other refpects the vil-
lage is wholefomely Situated.  It were to be wifhed
fuch accidents were  obviated  by  avoiding;  thefe
Stagnated places ;  or, at leaft, by removing  them
and the dunghils,  as far as poffible from  the fpor,
where we live and lodge.
  § 9.  To this cayfe  may  alfb be  added  the  ne-
glect of the Peafants  to air their lodgings.   It is
well known that too clofe an air occafions the moft
perplexing malignant fevers j and the poor coun-
try people  breathe 110 other in their own houfes.
Their lodgings, which are  very fmall,  and which
notwithstanding  indole, (both  day aud night)
the father, mother,  and feven  or  eight children,
befides Sbme animals, are never kept open during
fix montiis in the year, and very  Seldom during
the other fix.  I have found the air fo bad in  many
of thefe  houfes, that I  am perfuaded, if their in-
liabitants did not often go out into the free open
air, they mult all perish in a little time.  It is eafy,
however, to prevent all the evils arifing from this
fource,  by opening  the windows  daily : fb very
practicable  a precaution mult be  followed  with
the happieft conlequences,
  §' 10. I confider drunkennefs.  as a  Sixth caufe,
not indeed as producing epidemical difeafes, but
which deltroys, as it were, by retail, at all times,
and every where.   The poor wretches, who  aban-
don themfelves to it, are Subject to frequent in-
flammations of the brealt,  and to pleurifies, which
often carry them off"in  the flower of their age.  If 
              Of popular Maladies.             %}
they Sometimes efcape through thefe violent mala-
dies, they fink, a long  time before the ordinary
approach of old age, into all its infirmities, and e-
fpecially into an aflhma,  which terminates in  a
dropfy of the breall.   Their bodies worn out by
excefs, do not comply and concur,  as they ought,
with the force or operation of remedies ; and dif-
eafes of weaknefs, refulting from this caufe, are
almoft always incurable.   It feems happy enough,
that fociety  lofes  nothing  in parting with thefe
fubjects, who are  a  dishonour to  it; and whofe
brutal fouls are, in fome meafure, dead, long be-
fore their carcafes.
   § 11 The provisions of the common people are
alfo frequently one  caufe  of popular maladies.
This happens  ill, whenever the  corn, not well
ripened or not well got in,  in bad % Harvefts, has
contracted an unwholefome quality.  Fortunately
however  this is Seldom the cafe; and the  danger
attending the ufe of it may be leflened  by fbme
precautions,  fuch as thofe of wafhing and  drying
the grain compleatly ; of mixing a little wine with
the dough, in kneading it ; by allowing it  a  little
more time to fwell or life, and by baking it a little
more,  idly. The fairer  and better faved part of the
wheat is Sometimes damaged in the farmer's houtej
either becaufe he  does not take due care of it, or
becaufe  he has no convenient place to preferve it,
only from one rammer  to the next.   It has often
happened to me, on  entering one  of thefe bad
houfes, to be Struck with  the fmell of wheat that
has been fpoiled.   Nevertheless, there are known
and ealy methods to provide againfl this by a little
care ;  though I Shall not enter into a detail of them.
It is fuSIicient to  make  the people fenlible,  that
Since their chief Sbitenance confilts of corn,  their
health muft neceflarily be impaired by what is bad.

  f Thus I have ventured to tranflate Etes (Summers) to apply it to this
tiui the neighbouringiflands, Their harvefts in Siuifferland perhaps art
earlier, and may occur in Augujt, and that of fome paiticuU. grain, pro*
fcably ftill cailm.  K,
                        £3 
 $o        -  Of the moji ujuat La.ijt-t.
 3dly,  That wheat, which is good,  is  often  made
 into bad bread, by not letting it rife  fufficiently ;
 by baking it too little, and  by keeping it too long.
 All thefe errors have their troubleibme conlequen-
 ces on thofe who eat itj but in  a greater degree on
 children and valetudinarians, or weakly people.
   Tarts or  cakes may be considered as an abufe of
 bread,  and this in Some villages is increaled to a
 very pernicious height.  The dough is almolt con-
 stantly  bad,  and  often  unleavened,  ill baked,,
 greafy, aud Huffed with either fat or four ingredi-
 ents, which compound one of the moll indigeftible
 aliments imaginable.   Women and children con-
 fume the moll of this food, and are the very fub-
jects for whom it is the moft improper : little child-
 ren efpecially,  who live femetimes  for many fuc-
 ceflive days on thele tarts, arc,  for the greater part,
 unable  to digeft them perfedtly.   Hence  they re-
 ceive a -f fburce of obftrudtions  in the bowels of  *
 the belly, and of  a  flimy vifcidity or  thickiflmefs,
 throughout the mafs of humours, which throws
 them into various difeafes  from weaknefs; flow
 fevers,  a hectic, the rickets, the king's evil, and
 feeblenefs,  for the miferable  remainder of their
 days.  Probably indeed there is nothing more un-

  t The abufe juft mentioned can  fcarcely be intended to forbid th»
 moderate ule of good paltry, the dough of which is well raifed and well
 baked, the flower and other ingredients found, and the pafte not over-
 charged with butter, even though it were fweet and freih. But the abule
 of allum and other pernicious materials  introduced by our bakers, may
 too juflly be confidered as one horrible fource of thofe difeafes of chil-
 dren, &., which our humane andjudicious author mentions here.  "What
 l.e adds, concerning the paftries being rendered ftill more unwholefome
 by the four fruits fometimes baked in it, is true with refpeft  to thofe
 children and others, who are liable to complaints from.acidtities abound-
 ing in the bowels •, and for all thofe who are  ricketty or fcrophulous,from
 a cold and vifcid ftate of their humours.  But as to  healthy fanguine
 children, who are advanced and lively, and others of a fanguine or bilious
 temperament, we are not to fuppofe a moderate variety of this food in-
 jurious to them; when we  confider, that  the lharpnefs and crudity of
 the fruit is confiderably corrected by the long application of fire ; and
 that  they are the produce of fummer, when bilious difeafes are moil
 frequent.  This fuggefts  however no bad  hint againft  nuking thenj
 tinmodexately fweet.  K. 
Of popular Maladies.             -gi
wholefbme than dough not Sufficiently leavened,
ill baked, greafy, and feured  by the  addition of
fruits.  Befides, if we confider thefe  tarts in an
oeconomical view,  they muSt  be found inconveni-
ent for the peafant on that account too.
  Some other caufes of maladies may alfo be refer-
red to the article  of food, tho* lefs grievous and
lefs frequent, into a full detail of which it is very
difficult  to enter:  I fhall  therefore  couclude that
article  with this  general  remark ; that it is the
care which Peafants ufually take in  eating Slowly^
and in chewing very well,  that very greatly lel-
fens the dangers from a bad  regimen :  and I am
convinced they constitute one of the greatell cau -
fes  of that health they enjoy. We may further
add indeed the exercife which the peafant ufes, his
long  abiding in the open air, where he paffes three
fourths of his life ; befides (which are  alfo  eonfi-
derabie advantages) his happy cuftom of going foon
to bed, and of rifing very early.  It  were to be
wiShed, that on thefe refpetts, and perhaps on ma-
ny  other accounts,  the inhabitants of the country-
were effectually propofed as models for reforming
the citizens.
  \  12 We fliould not omit, in enumerating the
caufes of maladies among country people, the con-
struction of their houfes, a great many of which ei-
ther lean, as it were, dole to a higher ground, or
are funk a little into the earth. Each of thefe Situ-
ations fubjects them to  eonfiderabie  humidity ;
wliich is certain greatly to incommode  the inhabi-
tants, a;id to Spoil their provisions, if they have a-
ny quantity in Store ; which, as we have obServed,
is another, and not the leall important,  fource
of their difeafes.  A hardy labourer  is not  imme-
diately fenfible of the bad influence  of this moiSt
and marfhy habitation ;  but they operate  at the
long run, and 1 have abundantly  obferved their
moll evident bad effects,  efpecially  on women in
child-bed, on children, and in perfons recovering 
 $%         Of the moft ujuat vaujes.
 of a preceding difeaSe.  It would be  eaSy  to pre*
 vent this inconvenience,  by raising the ground on
 which  the houfe Stood, fome or Several inches a-
 bove the 1-vel of the adjacent foil, by a bed of gra-
 vel, of fmall flints, pounded bricks, coals, or fucli
 other materials ; and by avoiding to build immedi-
 ately clofe to, or, as it were, under a much high-
 er foil.  This  object, perhaps, may well deSei ve
 the attention of the public ; and I earneflly advife
 as many  as do build, to obferve the neceffary pre-
 cautions on  this head.  Another, which would
 colt Still  lefs trouble, is to give the front of their
 houfes an expofure to the fbuth-eall.   This expo.
 fure,  fuppofing all  other   circumllances  of the
 building and its Situation to  be alike, is  both the  si
 moft wholefome and advantageous.  1 have feen  *-
 it, notwithstanding  very often neglected,  with-
 out the leaft reafon being afligned for not prefer.
 ring it.
   Thefe admonitions may pcflibly  be thought of
 little conlequence by three fourths  of the  people.
 I take the liberty  of reminding them,  however,  '
 that they are more important than they may be
 fuppofed ; and fo many caufes concur to  the de-
 flrudtion of men, that none of the means Should
 be neglected, which may contribute to their pre-
 fervation.
   §  13. The country people in Swifferland drink,  '
 either 1, pure water, 2, fome wine,  3, perry, made
 from wild pears, or fometimes cyder from  apples,
 and,  4, a finall liquour which they  call piquette,
 that is  water, which has fermented with the cake
 or hufks of the grapes,  after their juice  has been
 exprefled.  Water however is their moft general
 drink :  wine rarely falling in their  way, but when
 they  are employed by' rich  folks ; or when  they
 can  fpare money enough for a debauch.  Fruit-
 wines and the \ piquettes are not ufed in allpaiu

  t This word's occurring in the plural number will probably imply, the
Jviji make mote than <me fpeties of Uu$ fnull (Link, by pouring wa» 
Of popular Maladies.                  33
 of the country ; they  are not  made in all years ;
 and keep but for foine months.
    Our waters in general,  are pretty good ; fb that
 we have little occafion to  trouble ourfelves  about
 purifying them ; and they are well known in thofe
 provinces where they  are  chiefly and  necefl'arily
 lifed.  f  The  pernicious   methods  taken to im-


 ter on the cake or remi'nder of their other fruits, after they have been
 expieiied ; as our people in the cydci, and perhaps in  the perry, counties,
 make what they cMcyderk'n. perkin,  ire.  It ftiould feem too from this
 fechon, that the laborious  countrymen in Stoifferland drink no malt-li-
 quor, thoigh tl.e ingiedients may be  fuppofed to' grow in their climate.
 Now beer, of clih'c itnt ftrcngth,  making the greater part of our molt
 common drink, it may be proper to obferve here,  that  when it  is not
 ftiong and hiid.v, but  a middling well-brewed  fmall  beer,  neither too
 new,  nor hard or four, it is full as wholefome a drink  for  laborious peo-
 ple in health as any other, and perhaps generally preferable to water for
 fuch ; which may be too thin and light for thofe who are unaccuflomed
 to it; and  more dangerous too,  when the  labouring man is very Hot,  as
 well as thirrty.  The holding a mouthful of any weak cold liquor in  the
 mouth without fwailowing 'till.it becomes warm there, and fpurting it
 out before a draught is taken  down would be prudent; and  in cafe  of
 great heat, to take the requ'uate. quantity  afterwards,  rather at two
 draughts, with a little interval between them, than to fwallow the whole
 precipitately at one, woald be more  fifet and  equally refrefliing, tho'
 perhaps lefs grateful.   K.
  t  The bad qualityof water is  another  common caufe of country dif-
 eafes ; either where the waters are unwholefome, from the foils in which
 tliey are found, as when they  flow   through,  or  fettle, on banks  of
 fnells ; or where they become fuch, from the neighbourhood of, ordrak;*
 iiigs from, dunghills and marfhes.
  When water is unclean and turbid>  it is generally fufficient to let it fet-
 tle in order to clear itfelf, by droping its fe-Ument.-   But if  that is not
 effected,  or  if it be flinty 01 muddy,  it need only be  poured into a large
 vetfel half filled with fine fand. or, for want of that, with chalk ; and
 then to fhake andfiir it about heartily for fome minutes.   When  this  a-
 gitation is over, the fand, in falling to the  bottom of the-vefleU will at-
 tract fome of the foulnefs  fufpended  in the water.   Or, which  is ftill
 better, and very eafy to do, two large vcfT'els may be fet  near together,
 one of which fliould be placed confidcrably higher than the other. The
 higheft fliould be half filled  with fand.  Into  this  the turbid, or flimy
 muddy water is to be poured j whence it will filter itfelf through the body
 of fand,  and pafs off clear by an opening or orifice made at the bottom
 of the vefl'el;  and fall from thence  isto the lower one, which fcrves  as
 a refervoir.   When the water is impregnated  with  particles from the
 beds of J'clenltes, or of any fpar (which water we call  hard, becaufe foap>
 will not eafily difTblve  in  it, and puis and other farinaceous  fubftances
grow hard inftead of foft, after boiling in it} fuch water fhould be expolV
ed to the  fun, or boiled  with the addition of fome puis, or leguminous
vegetables,  or bread toafted, or unloaded.  When water is in.  its putrid
ftate,  it may be kepi till it recovers its natural Iweet one : but if this can-
not be waited for, a little fea fait fhould bedifjblved in it,  ox fame vine-. 
 34          Of the mojt ujual Caufes, &c.

 prove or meliorate, as it is falfely called, bad wines,
 are not as yet fufficiently practiced  among us,  for
 me to treat of them here : and as our wines are not
 hurtful,  of themfelves,  they become hurtful only
 from their quantity.  The  coufumption of made
 wines and piquettes  is  but  inconfiderable,  and I
 have not hitherto  known of any  ill  effects  from
 them, fo that our liquors  cannot be confidered  as
 caufes of distempers  in our  country ;  but in pro-
 portion to our abufe of them by excefs.   The cafe
 is   differently  circumstanced ' in  fome  %  other
 countries ; and it is the province of pbvficians who
 refidein  them,  to point out to  their country-men
 the methods  of preferving their health ;  as well as
 the proper and  neceffary remedies in their  fick-JH
 nefs.                                                   X


 gar may be added, in which fome gratefkl aromatic plant has been infuf- 4
 ea.   it frequently happens, that the public wells are corrupted  by foul-
 mud at the bottom, and by different animals which tumble in and putr fy
 there.  Drinking fnow-water fhould be avoided, when the fnow is but
 lately fallen, as it feems to be the caufe of thofe fwelling wenny throats
 in the inhabitants of fome monntains ; and of epidemic  cholics in many
 perfons. As water is fo continually ufed, great care  fliould be taken
 to have what is good.   Bad water, like bad air, is one of the moft gene-
 ral caufes of  difeafes; that which produces the greater number of them,
 the moft grievous ones; and often introduces fuch as are epidemical. E. L.
 t. e.  the editor of Lyons.
  t  Many.perfons, with a defign to preferve their wines, add fhot to
 them, or preparations of lead, alum,  &c.  The government lhould for-
 bid, under the moft fevere penalties, all fuch adulterations, as tend to
 introduce the moft painful cholies, obrtruclions,  and a long train of evils..
which it fometimes proves difficult to trace to this peculiar cafe • while the*
fiiorten the lives of, or cruelly torment,  fuch over credulous purchafers,
 as lay in a flock ofbad wines, or drink of them, without diftinftion, from
 every wine merchant or tavern.  E. L.
  This  note, from the Editor at lyoas, nve have Sufficient reafon  fir r>.
 faming here,  K.                                            - 
The Caufes which aggravate Difeafes.     3?
                 CHAP.  II.
Of the caufes which aggravate the difeafes of the people.
              General conftderaticns.

                  Sect.  14.
     TH E  caufes  already  enumerated in. the fii ft,
      chapter occafion  difeafes ; and the bad regi-
men, or conduct of the people, ontheinvafion of
them, render them ftill more perplexing, and very
often mortal.              '
   There is a prevailing prejudice among  them,
which is every year attended with  the deaths of
fome hundreds in this  country, and it is this
That all diftempers are cured by  fweat; and  that
to procure fweat,  they muft take  abundance of
hot and heating things, and keep themfelves very
hot.  This is a millakein  both refpedls, very fatal
to the population of the ftate ; and it cannot be
too much inculcated into  country people ; that by
thus endeavouring to force fweating, at the very
beginning of a difeafe, they are, with great  proba-
bility,  taking pains to kill  themfelves.   I have
feen fome cafes, in which the continual care  to
provoke this fweating, has as manifestly killed the
patient, as if a  ball had been  Shot through his
brains ;  as fuch  a precipitate and  untimely dif-
charge carries off the thinner part of the blood,
leaving the mafs more dry, more  vifeid and inflam-
 ed. Now as in all acute  difeafes (if we except  a
 very few,  and thofe too  much lefs frequent) the
 blood is already too thick  ; fuch a difcharge muft e-
 vidently increafe the diferder, by  co-operating with
 its caufe.  InStead of  forcing out the watery, the
 thinner4part of the blood, we fhould rather endea-
 vour to cncreafe it. There is not a  Single peafant
 perhaps,  who does not fay, when he has a pleuri-
 fy, or an inflammation of his brealt, that his blood
 is too thick, aud that it cannot circulate. On fee- 
5,6     The  Caufes which aggravate Difeafe t,

ing it in the bafon after bleeding, he finds it black,
dry, burnt; thefe are his very words.  How  ltrange
is it then, that common fenfe fliould not allure him,
that,  far from forcing out the flerum, the  watery
part, of fuch a blood by fweating, there is a ne-
cessity to increafe it ?
  § 15. But fuppofing it were as  certain, as it is
erroneous, that fweating was beneficial at  the be-
ginning of difeafes, the means which they ufe to
excite it would not prove the lefs fatal.  The firfl
endeavour is, to Stifle the patient with the heat of
a clofe apartment, and a load of covering.   Ex-
traordinary care is taken to prevent 'a  breath of
frefh  air's Squeezing into  the room ;  from which
circumftance, the air already in it is fpeedily and
extremely corrupted ;  and fuch a degree of heat is
procured by the weight of the patient's bed-cloaths,
that thefe two caufes alone are fufficieiit to excite
a moft ardent fever,  and an  inflamation of the
bread, even in'a healthy-man.   More  than  once
have  I found myiclf  feized with a difficulty of
breathing, on entering fuch chambers, fom which'
I have been immediately relieved, on obliging them
to ope n all the windows.  Perfons of education
mull find a pleafure; I conceive,  iu  making  peo-
ple underlland on thefe occafions, which are  fa
frequent, that the air bein^  more indifpenfably
neceffary to us,  if poffible, t,\an water is to a fifh,
our health mull immediately fuller, whenever that
ceafes to be pure ; and in fining them alfo, that
nothing corrupts it iboner than  thofe"" vapours,
which continually fleam from the bodies of many
perfon %  intlofed within  a little  chamber,  from
Which t'ie ait is excluded.   The abfurdity of fuch
Conduct is a fell-evident certainty.  Let in a  little
freSli air on thefe miferable patients, and leften the
bppreffing burtiien  of their  coverings, and  you
generally fee upon the  fpot,  their fever  ?»nd op-
prefllon, their anguifli and laving, to abate. 
       The Caufes which  aggravate Difeafes.     37
   $ 16. The fecond method taken to raife a fweat
 in thefe patients is, to give them nothing but hot
 things, efpecially Venice treacle,, wine, or fome *
faltranc, the greater part  of the ingredients of
 which are dangerous, whenever there  is an evi-
 dent fever;  befides  Saffron,  which  is  Slill  more
 pernicious.   In all  feverifh  diforders we fhould
 gently cool,  and keep the belly moderately open ;
 while the medicines jult mentioned both heat and
 bind; and hence we may ealily judge of their  in-
 evitable ill confequences.  A healthy perfon would
 certainly be Sized with au inflammatory fever, on
 taking the Same quantity of wine, of Venice trea-
 cle, or of faltran:, which the peafant takes now
 and then, when he is attacked by one of thefe difor-
 ders. How then Should a lick perfon efcape dying by
 them ? Die indeed he generally does, and femetimes
 with aftoniShing fpeed.  I have  pubiifhed Some
 dreadful instances of fuch fatality fome years Since,
 in another treatife.  In fact they ftill daily occur,
 and unhappily every perfon may obferve feme of.
 them in his own neighbourhood.
    §  17. But I fhall be  told  perhaps, that  difeafes
 are often carried oft' by  fweat, and  that we ought
 to be guided by experience.  To this Ianfwer, it is
 very true, that fweating cures feme particular dif
 orders, as it were, at their very on fet, for in Stance,
 thole  Stitches  that are  called fpurious or falfe
 pleurifies,  fome rheumatic  pains, and fome colds
 or defluxions.  But this  only  happens when  the
 diforders depend fblely and  Simply on Stopt or a-
 bated perfpiration,  to  which fuch  pain inftantly
 Succeeds ; where immediate!}-, before the fever has
    Vol. I.                F

   ■f This word whiihmufl be of Oti,i>», not of French,  extraction,
 ftrirtly fignifies,  drink for a ;*ll ; as  we fay  pulvis ad caj'w, &c.
 powder for a fall, 01 a fuppofed inward bruii'c.  Dr. T 1S S O T informs
 me, it is cthe i-wife called tlie vulnerary herbs, or the Sw'fi tea; and
 that it is an injudicious farrago or medley of herbs and flower;, blended
 with bitters,  with ftimulating, harfh and aftrinsent ingredients, being
 employed indifcriminate.'y in ail their diitemptrs by tlie country people in
 Siv'-fcrl.-.i.  K. 
  38      The Caufes which aggravate Difeafes.
  thickened  the blood, and inflamed the humours ;
  and where before any internal infarction, any load,
  is formed,  fome warm  drinks  are given, fuch as
 faltranc and honey;  which, by reiloring tranfpi-
  ration,  remove the very caufe of the di (order. Ne-
  verthelefs, even in fuch a cafe, great care Should
  be had not to raife too violent a commotion in the
  blood, which would  rather reflrain,  than promote
  fweat; to effect which elder-flowers are in my opi-
  nion preferable  to faltranc. Sweating is alfo of Ser-
 vice in difeafes, when their caules are extinguished,
  as it  were, by' plentiful delution : then indeed it
 relieves, by drawing off, with itfelf, fome part of
 the distempered  humours; after which their grof-
 fer parts have palled off by Stool and by urine : be-
 fides which, the fweat has alfo Served to cany off
 that extraordinary quantity of  water, we were o-
 bliged to convey into the blood,  and  which  was
 become  fuperfluous there. Under fuch circumstan-
 ces,, and at  fuch a jundture, it is of the utmoll
 importance indeed, not to check the fweat, whe-
 ther by  choice,  or for want of care. There might
 often be as much danger in  doing this, as  there
 would have been in endeavouring to force a fweat,
 immediately  upon the invafion of the diforder;
 fince the arrefting of this difeharge, under the
 preceding circumstances, might frequently occa-
 sion a more dangerous diltemper,  by repelling the
 humours on fome inward vital part.  As much care
 therefore fliould be taken not to check imprudent-
 ly, that evacution by the fkin,  which  naturally
 occurs towards the conelufion of difeafes, as  not
 to force  it at their beginning ; the  former being
 olmoft couftantly beneficial, the latter as constant-
 ly pernicious.  Befides, were it even necellary, it
 gnight be very dangerous to force it violently; fince
 hy heating the patients greatly, a vehement fever
 is excited ;  they become Scorched up  in a manner,
 and the Skin pioves extremely dry.   Warm water,
in in art, is  the bell of fudorifies. 
        The Caufes which aggravate Difeafes.      39
   If the  fick are  fweated  very plentifully for a
 day or two, which may make them eafier for fome
 hours, thefe fweats Soon terminate, and cannot be
 excited again by the fame medicines.  The dole
 thence is doubled, the inflammation is increafed,
 and the patient expires in terrible anguifh, with
 all the marks of  a  general  inflammation.   His
 death is afcvibed to  his want of fweating ; when
 it really was the confequence of his fweating too
 much at firft ; and of his taking wine and  hot fiu-
 dorifics.   An able Swifs phyfician had long fince
 affined his countrymen,  that  wine was fatal to
 them  in  fevers ;  I take leave to repeat it again
 and aoain, and wifh it may  not be  with as little
 fuccefii.
   Our country folks, who in  health, naturally
 diflike red wine,  prefer it when  fick ; which is
 Wrong, as it binds  them up more than white wine.
 It does not promote  urine as well ;  but increales
 the force of the circulating arteries, and the thick-
 nefs of the blood, which were  alieady too eonfider-
 abie.
   $ 18. Their difeafes are alfo further aggravated
 by the food that is generally  given them.    They
 muft undoubtedly  prove weak,  in confequence of
 their being Sick ,  and the ridiculous fear  ^.f the
 patient's dying of weaknefs, diipoies their friends
 |o force them to eat; which,  inere ><ing their dif-
 order, renders the fever mortal.  Tin; tear is ablb-'
 lutely chimerical; never yet did a perfon in a fever
 die merely from weaknefs.  They may be fuppcrt-
 ed, even for fome weeks, by water only ; and are
 ftronger at the end of that time, than if they had
 taken  more folid nourishment ; fince,  far from
 Strengthening  them, their food  increafes  their
 difeafe, and thence increafes their weaknefs.
   y 10. From the firft invafion of a fever,  digef-
tion ceafes.  Whatever folid  food  is taken, cor-
rupts,  and proves  a  fouree of  putridity,  which,
addU notion g to the Strength  of  the lick* but
                     F  2. 
40      The Caufes which aggravate Dijeajes.
greatly to that of the  distemper.   There  are in:
fact a thoufand examples to prove, that it becomes
a real poifon :  and we may fenSibly perceive that
thefe  poor creatures, who are thus compelled to
eat, lofe their ftrength, and fall into anxiety and
ravings, in proportion as they fwallow.
  \ 20. They are ajfb further injured by the qua-
lity, as well as the quantity,  of their food.  They
;ire forced to fup Strong gravey Sbnps,  eggs, bif-
cuits, and even flefh, if they have but juft Strength
and refolution to chew it. It Seems  abfolutely im-
poffible for them to furvive all this rrafh.   Should
a man in perfect health be compelled to eat flink-
ing meat, rotten eggs,  Stale Sour broth, he is at-
tacked with as violent fymptons, as if he had t;vk-
en real poifon, which, in  effect, he has.   He is
ieized with vomiting, anguifh,  a violent purging,
and a fever,  with  raving,  and eruptive Spots,
which we call the purple  fever.  Now when the
very fame articles of food,  in their foundell ftate,
are given to  a perSbn in a fever,  the heat, and
the morbid matter already in his ftomach,  quick-
ly putrify them ; and after a few  hours produce
all the above  mentioned effects.   Let any man
judge.then, if the leaft fervice can be expected
from them.
   § 21. It is a truth eftabliflied by the firfl  gf phy-
ficians, above  two thouSand years pafl, and ftill
further ratified by his fucceflbrs, that as long as a
fick perfon has a bad  humour or ferment in his t
ftomach, his weaknefs increafes, in proportion to
the food he receives,  for this being corrupted by
the infected matter it meets there,  proves  incaj a-
ble of nourishing, and becon.es a conjunct or ad-
ditional caufe of the distemper.
   The moft obferving  perSbns conftantly remark,
 that whenever a f"e vei ifli patient Sups, what is com-
 monly called  feme good  broth, the fever  gathers
 Strength and the  patient weaknefs..  The giving
 fuch a foup or broth, tho' of the fieShell ibuud«SH 
        The Caufes whicB aggravate Difeafes.     41
meat,  to a man who has a high fever, or putrid
humours in his Stomach, is to do him exactly the
fame Service,  as if you  had  given him, two or
three hours later,  Stale putrid foup.
   § 22* I mull alfo affirm, that this fatal preju--
dice, of keeping up the patient's flreugth  by food,
is Still too much propagated, even among thoie
very perfons,  whole talents and whofe education
might be expected to exempt them  from any fuch
grofs error.  It weie happy for mankind,  and the
duration of their  lives would generally be more
extended,  if they could be thoroughly perfuaded
of this medical, and fb very demonftrable, truth ;
----That tlie only things which can Strengthen
fick perfons are thofe, which are able to weaken-
their difeafe ;  but  their obftinacy in this refpect is
inconceivable : it  is another  evil  fuperadded to
that of the difeafe, and Sometimes the more griev--
ous one.  Out of twenty fick perfons, who are loft
in the country, more than two thirds might often
have been cured,  if being only lodged in a place
defended from the injuries of the  air, they were
fupplied with abundance of good water.: But that
moft mistaken care and regimen I have been treat-
ing of, fcarcely fullers one of the  twenty to- fur-
Vive them.
   § 23. What further  increafes our horror at this;
enormous propenfity to  heat, dry  up, and era,a
the fick, is, that it is totally oppofite to what na-
ture herfelf indicates in Such circumSlanct. r..  Tlie
burning hear of which they complain ; the drv-
JieSs of the lips, tongue and throat ;  the flami g>-
higli colour of their urine ;.  the  grejt  longi.15
they have for cooling rhings y.  the (demure an i
fenlible benefit they enjoy fro.n frefh air, are lb-
many figns, or rather proofs,  which cry out yvit t
a  loud voice,  that we  ought  to attemper ite- an.L
ccol then moderately,  by all mean-.    fieir foul
tongues, which Shew the ftomach ro b? in the like
Condition j their loathing; their propensity to vo*-
                      *  3 
43     The Caufes which aggravate Difeafes.
mit;  their utter averfion to all folid food, and e«
fpecially to flefh ; the disagreeable Stench of their
breath ; their difcharge of fetid wind upwards and
downwards, and frequently the extracrdinaiy of-
fenfivenefs Of their excrements, demonstrate, that
their  bowels are full of putrid contents, which
mult corrupt all the aliments fuperadded to them;
and that the only thing,  which can prudently be
done, is to dilute and attemper them by plentiful
draughts of refrefliing cooling drinks, which may
promote an eafy discharge of them.  I aflirm it
again, and I heartily  wifh it  may  be thoroughly
attended to,  that as long as there is any tafte of
bittemefs, or of putrefcence ;  as long as there is
a nauflea or loathing,  a bad breath,  heat and fe*
verifhnefs,  with fetid Stools,  and little and high.
coloured urine ; fo long all fleib,   and fleSh-Sbup,
eggs, and all kinds of food compofed of them, or
6f any of them,  and all Venice treacle, wine, and
all heating things, are fo many abfblute poifons.
  § 24.  I may poflibly be cenfured  as extravagant
and exceSfive on thefe heads by the publick, and
even  by fome phyficians :  but the true and en-
lightened phyficians, thofe who attend to the ef-
fects of every particular, will find on the contra-
ry, that far from exceeding in this  relpedt, I have
rather feebly exprelled their  own  judgment,  in
which they agree with that of all  the good ones,
who have exilted within more than two thoufand
years j that very judgment  which reafon approves,
and continual experience confirms.  The prejudices
I have been contending agahill have coil Europe
Sbme  millions of lives.
  $ 25.  Neither fliould it be omitted,  that  even
when a patient has very fortunately efcaped death,
notwithftanding all this care to obtain it, the mif-
ehief is not ended ;  the confequences of the high
aliments and heating  medicines being, to leave
behind the feed, the principle, of fome low and
chronical difeafe :  which  iucreafing infenfibly, 
       The Caufes which aggravate Difeafes.     43
burfts out at length,, and finally procures him the
death he has even wished for, to put an end to his
tedious Sufferings.
  § 26. I muft alfo take notice of another danger-
ous common practice ;  which  is that of purging,
or vomiting a patient,  at-the very beginning of a
diltemper.  Infinite mifchiefs are occafioned by it.
There  are Sbme cafes indeed, in which evacuating
medicines,  at the beginning of a dileafe,  are con-
venient and even  neceffary.  Such cafes fhall be
particularly mentioned in fome other chapters-:
but as  long as we are unacquainted with them,  it
fhould  be confidered as a general rule, that they
are hurtful at  the beginning ; this being true vo-
ry often ; and always,  when the difeafes are ftridt-
ly inflammatory.
  §27. It is hoped by their afliflance, at that time,
to remove the load and oppreflion of the ftomach,
the'caufe of a difpofition to vomit, of a dry mouth,
of third, and of much-uneafinefs ;  and to  lefTen
the leaven or ferment of the  fever.   But in this
hope they are very often deceived ; fince the cauf-
es of thefe fymptoms  are Seldom  of a nature to
yield to thefe  evacuations.  By the extraordinary
vifcidity or thicknels of the humours, that foul the
tongue, we fliould form our notions of thofe which
line the ftomach and the bowels.  It maybe warn-
ed, gargled, and even  Scraped, to very little good
purpofe.  It does  not  happen, until the patient
has drank for many days, and the heat, the fever,
and the great  fizinels of the humours are abated,
that this filth  can  be thoroughly removed, which
by  degrees Separates of  itfelf.  The Slate of the
ftomach being conformable to that of the tongue,
no  method can effectually fcour and clean it  at
the beginning :  but by giving refreshing and di-
luting remedies plentifully, it gradually frees it-
felf;   and the propenfity to vomit,  with its other
effects and uneaSinefles,  go  oft' naturally, and
without purges. 
  44     The Caufks which aggravate Difeafes.
     §  28.  Neither are thefe evacuations only nega-
  tively wrong,  merely from doing no igood ;  for
  eonfiderabie  evil positively enfues from the appli-
  cation of thofe acrid irritating medicines,  which
  increafe the pain and inflammation ; drawing the
  humours upon thofe parts that were already over-
  loaded with them ;  which by no means expel the
' caufe  of the difeafe, that not being  at this time
  fitted  for expulfion,  as not fufliciently concocted
  or ripe :  and  yet which, at the fame time,  dif-
  charge the thinnell part of the blood, whence the
  remainder becomes  more thick ;  in Short,  which
  carry  off  the  ufeful,  and leave the  hurtful  hu-
  mours behind.
     §  29. The  vomit efpecially, being given in an
  inflamatory difeaSe, and even without any distinc-
  tion in all acute ones, before the humours have
  been diminished by bleeding, and diluted by plen-
  tiful Small drinks, is productive of the greatest e-
  ▼ils; of  inflammations  of the  ftomach,  ef  the
  lungs  and liver,  of fuftbeation-s  and  frenzies*
  Purges Sometimes occafion a general  inflammati-
  on of the guts, which \ terminates in death.  Some
  inltances of each  of thefe terrible confequences
  have I feen,  from  blundering temerity,  impru-
  dence  and  ignorance.  The effect  of  loch medi-
  eines,  in thefe circumftances, are much the Same
  with thofe  we might reasonably expect,, from  the

    f It is pretty cpflimon to hear of perfons recovering from inflammirV
  •rn of the hnvcli,  or guts which our ajthor moie juitly and in.netiiobfr
  ly confiders as general paft'poi ts 10 death t for it is diffiult to conceive,
  fna real and ttxfulei able iuflammation of fuch thin, membia-.o-:^ ir-
  ritable pa 1 u, lined with fuch putrefcent humours and contents, and in
  fo hot and clofe a fitcat on,  could be reftored  to a; found and hca thy
  ftate as often as rumour affiim, it.   This makes it fo important .1 point,
  to ayeit every tendency 10 an inflammation of thefe f.t dent parts,  at to
  juftify a bleeding directed,  folely, from this precaution; and whifcfc
  'might  have been no otherwifc indicated by a difeafe, a.ue ded with any
  !> mptom, that threatened Aieh an i nPammacion. hut when \ perfon re-
  el ers, there can be no anatomic a, fca.eh for fuch inf» mutiqns,  or in
  effects, the real or imaginary cure of which may well amaze the- patient,
  ».d m ft greatly redo-jnd to the ho:r>ir a( his prcfi.ribcr ;  fo that  t' ere
  »ay bejoiicy fometimes ingi/inga modejaie difeafe a ;Ui bad naw«.X. 
        The Caufes which aggravate Difeafes.      45
 application of Salt and pepper to a dry, inflamed
 and foul tongue, in order to moiften  aud clean
 it.
   §  30. Every perfon of found plain fenfe is capa-
 ble of perceiving the truth of whatever 1 have ad-
 vanced  in this chapter : and  there would be fome
 degree  of prudence, even in thofe who do not
 perceive the real good tendency of my advice, not
 to defy nor oppole it  too hardily.  The queltion
 relates to a very important object ;  and in a mat-
 ter quite foreign to  themfelves, they undoubted-
 ly owe Sbme deference to the judgment of perfons,
 who have made it the Study  and bufineSs of their
 whole lives.  It is not to myfelf that  I hope  for
 their attention,  but to the greateft phyficians,
 whofe feeble instrument and  eccho I am.  What
 interest have any of us in forbidding fick people
 to eat,  to  be Stifled,  or to  drink fuch heating-
 things as heighten their fever ? What  advantage
 can accrue to us  from  oppofing the fatal torrent,
 which  fweeps them oft : What arguments can
 perSuade people, that  fome thoufand men of  ge-
.nius, of knowledge, and of experience, who pafs
 their lives among a croud and fucceSlion of pati-
 ents ; who are entirely employed to take care  of
 them, and to obferve all that panes, have Lcen  on-
 ly amufing and  decc iving themfelves, on the  ef-
 fects of food,  of regimen and of remedies ?  Can it
 enter into any fenfible head, that a nurfe, whoad-
 vifes fbup,  an egg, ora.bifeuk, defeives a patient's
 confidence, better than  a phyfician who forbids
 them ?  Nothing can be more difagreeable  to  the
 latter,  than his being  obliged to difoute  continu-
 ally in  behalf of the poor patients  ;  and to be in
 constant terror,,left  this mortally officious attend-
 ance, by giving Such food as augments all the caul-
 ts of the difeafe, Should defeat  the efficacy of all
 the remedies he adiuinilleis to remove it ; and
 Should feller and aggravate the wound, in propor-
 tion to the pains he takes to d.efs it.   The more 
46        The Means and Diet to be ufed.

fuch abfurd people love a patient, the more they
urge  him  to  eat, which,  in effect, verifies the
proverb of killing one with kindnefs.
                 CHAP.   III.
 Of the vieans that ought to be ufed, at the beginning  of
      difeafes ; and of the diet in  acute difeafes.

                  Sect.  31.
 I Have clearly Shewn the  great dangers of the
   regimen, or  diet, and of the principal medi-
 cines too generally made ufe of by the bulk of the
 people, on thefe occafions.  I mult  now point out
 the actual method they may purfbe, without  any
 rifque, on the invafion of fome acute difeafes, and
 the general diet which agrees with  them  all.   As
 many as are defirous of reaping any benefit from
 this treatife, Should attend particularly to this chap-
 ter ;  fince, though out the other parts of it, in or-
 der to avoid repetitions, I fhall fay nothing of the
 diet,  except the particular difiemper fhall  require
 a different one, from that  of which I am  now to
 give an exact detail.   And whenever I fhall fay in
 general, that a patient is to be put upon a regimes,
 it will fignify, that he  is to be treated  according
 to the method prescribed in this chapter ;  and all
 fuch diredtions are to be obferved, with regard  to
 air, food, drink and glyfters,  except when I  ex-
prefsly order fometbing elfe, as  different  ptifans,
 glyfters, ire.
  $ 52. The greater part of difeafes (by which I
 always understand acute and feverifli ones) often
 give fome notice of their approach a few  weeks^
 and very commonly, fome days before their actual
invafion ; fuch as a light  laflitude,  or  wearinefs,
Iliffuefs or numbnefs; lefs activity thaji ufual, !•& 
                /* accute Difeafes               47
appetite, a fmall load or heavinefs at  ftomach ;
fome complaint in the head ; a profounder degree
of Sleep, yet lefs compofed, and lefs refrefliing than
ufual j lefs gayety and  livelinefs j fometimes a
light opprefiion of the breaSt, a lets regular pulle ;
a propensity to be cold ;  an  aptnefs to fweat ; and
femetimes a fuppreSlion of a form-r difpoSition to
fweat.   At fuch  a,, term  it may be practicable to
prevent, or at leaft  considerably to mitigate, the
moft perplexing diforders, by carefully obferving
the four following points.
   I. To omit all violent  work  or labour, but yet
not fo, as to discontinue a gentle eikfy degree of
exercife.
   2.  To bring the complainant to content  him-
felf without any, or with very little,  folid food ;
and efpecially to renounce  all flefli,  fleSh-broth,
eggs and wine.
   3. To drink plentifully, that  is to fay, at leafl
three  pints, or even  four pints daily, by fmall
giaSfes at a time, from half hour to half hour, of
the ptifans N°* I and 2,  or even of warm water,
to each quart of which may  be added half a  glafs
of vinegar.  No perfon can be dellitute of this ve-
ry attainable afliltance. But Should there be a  want
eveu of vinegar,  a few grains  of common * fait
-may be added to a quart of warm water for drink.
Thofe who have honey will do  well to add two or
three Spoonfuls of it to the water.   A light infufi-
on of elder-flowers, or of thofe of the  linden, the
lime-tree,  may alfo  be advantageoufly ufed, and
even well fettled and clear fweet whey.
   4. Let the perfen, affected with fuch previous
complaints, receive  glyfters  of warm water,  or

  * Thisdireftion of our author's, which may furprife fome, probably
arifes from his preferring a fmall quantity of the marine acid to no acid at
all: For though a great proportion of fait, in faving and feafoning flefh
and other food,  generally excites thirft, yet a little of it feems to have
rather a different effect, by gently ftimulating the falivary glands: And
we find that nature very feldom leaves the great dilating clement wholly
void of this quickening, aniiputrefcent principle,  K. 
4?       The Means and Diet to  be  ufed
theglyfterN0* 5.  By purfuing thefe precaution*
fome  grievous diforders have often been happily
rooted out:  and altho' they Should not prove So
thoroughly efficacious, as  to prevent their appear-
ance, they may at laft be  rendered more gentle,
and much lefs dangerous.
   § 33. Very unhappily people have taken the di-
rectly contrary method,   from the moment thefe
previous, thefe forerunning complaints are per-
ceived,  they allow themfelves to  eat  nothing but
grofs  -meat, eggs, or ftrong  meat-foups.   They
leave off garden-ftuff and fruits, which would be
fo proper  for them;  and  they  drink  heartily
(under  a notion  of  Strengthening,  the  Stomach
and  expelling wind) of wine and other liquors,
which Strengthen nothing but the fever, and  ex-
pel what degree of health  might Still remain. Hence
all the .evacuations  are  restrained ;  the humours
cauling and nourishing the difeafes  are not at all
attempered, diluted, nor rendered proper for eva-
cuation.  Nay, on the very contrary, they become
more Sharp,  and more difficult to  be  dilcharged:
while a  fufficient quantity of diluting refrefliing
liquor, affuages and  feparates all matters foreign
to the blood, which  it purifies ; and, at the expira-
tion of fome days, all that was noxious in it is car-
ried  off by llool, by urine, or by fweat.
   §  34.  When the diftemper is further advanced,
and the patient is already Seized with that coldnefs
or Shuddering, in a  greater or lefs degree,  which
 uShers in all difeafes; and which is commonly at-
tended with an univerfal oppreffion,  and pains o-
 ver all the furface of the  body ;  the patient, thus
 circumstanced, Should be put to bed, if he cannot
 keep up ; or fhould  fit down as  quietly as poffible,
 with a little more covering than ufual: he Should
 drink every quarter of an hour a Small giafs of the
 ptifan,  N"'  1 or 2, warm ; or,   if that is  not at
 hand, of fome one of thofe liquids I have  recom-
 xnended § 32. 
              /// acute Difeafes.               ift
  $ sc. Thefe  patients  earnestly covet  a great
load of covering, during the cold  or Shivering;
but we fhould be very careful  to lighten  them as
foon as it abates;  So that  when the fucceeding
heat begins, they may have no more  than  their
ufual weight of covering. It were to be wished per-
hapMLthey had  rather  lefs.  The  country people
lie upon a feather bed, and under a downy cover-
let, or quilt,  that is commonly extremely heavy,
And the heat which is heightened and  retained by
feathers, is particularly troublefome to perfons in
a fever.   Neverthelefs, as  it  is what they are  ac-
cuftomed to, this cuftom may be complied with
for one SeaSbn of the year : but during our heats,
or whenever the fever is very violent,  they fhould
lie on  a pallet (wliich will be infinitely better  for
them) and fhould  throw away their coverings of
down, fo as to remain covered only with Sheets, or
Something elfe, leSs injurious than  feather-cover-
ings.  A perfon  could  Scarcely believe,  who had
 not been,- as I have, a  witnefs of it, how  much
comfort a patient is fenSible of, in being eafed of
 his former coverings.  rlhe diltemper immediately
 puts on a different appearance.
   $ 36.  As fbon as the  heat after  the rigor, or
 coldnefs and Shuddering, approaches,  and the fe-
 ver is manifestly advanced, we Should provide for
the patient's regimen.  And
   r. Care fliould be  taken  that the air, in  the
 room where he  lies, Should   not  be too hot,  the
 mildeft  degree of warmth being yery fufficient ;
 that there be as  little noife  as poffible,  and that
 no pSHbntpeak to the Sick, without a neceSIity for
 it.  No external circumftance heightens the fever
 more, nor inclines the patient more  to a delirium
 or raving, than the perfons in the chamber, and e-
 fpecial'y about the bed.  They leffen the Spring,
 the elafiic and refrefi.I.ig power, of the air  ; they
 prevent a fucceSfion of frefh air; and the variety
 oi'o'ojedts occupies the  brain too  much.  When-
 Vol.'I.                 G 
 £0        The  Means and Diet to lie ufed
-ever the patient has been at ftool, or has made *•
rine, thefe excrements Should be removed immedi-
 ately.   The windows Should certainly  be opened
 night  and morning,  at leafl  for a  quarter of an
 hour each time ;  when alio a door Should be open-
ed, to  promote an entire renovation or change of
the air in the room.  Neverthelefs, as the pat hint
fhould not be expoSed  at an.y time to  a  ftream or
current of air, the curtains of Ids bed fhould be
drawn on fuch occafions; and if he lay without a-
ny, chairs, with  blanklets or cloaths  hung upon
them., fhould be Substituted in the place of curtains,
and furronnd the bed ; while the windows continu-
ed open, in order to  defend the patient from the
force of the rufhing air.  If the  Seafen, however,
be rigidly cold, it  will  be  fufficient  to keep the
windows  open, but for a few minutes  each time.
In fummer, at leaStone window Should be fet open
day and night.   The pouring a little vinegar up-
on a red hot fliovel alfo greatly conduces to reflore
the Spring, and correct  the putridity, of the  air.
In our greateSl heats, when that in the room feems
nearly fcorching, and the fick perfon  is fenfibhr
and greatly incommoded by it,  the floor may be
fprinkled  now and  then ; and branches of willow
or afh-trees, dipt a little in  pails  of water, may be
placed about the  room.
   § 37. 2. With refpedl to .the patient's nourish-
ment,  he  muft entirely abflaiu from all food ;  but
he may always be allowed, and have daily prepar-
ed, the following fultenance,  which is one of the
wholefomelt, and indisputably the fimpleft one^
Take half a pound of bread, a morfel of theffreSh-
eft butter  about the Size only of a hazel nut (which
may even be omitted  tco) three pints and one
quarter of a pint  of water.  Boil them  'till  the
bre~d be entirely  reduced to  a thin  co.nfiii.ence.
Then  Strain  it, and  give the paiient one eighth
|>art of it  every three, or every  four,  lours; but*
iUU.iAore  lately,  if the fever be vehemently- high, ** 
               In acute  Difeafes.              ff
 Thofe who have groats, barley, oatmeal, or rice,
 may bjil and prepare them in  the  fame manner,
 with fome grains of fait.
   § 38.  The fick may alfo be femetimes indulged,
 in lieu of thefe different fpoou-meat^, with raw
 fruits in fummer, or in winter with apples baked
 or boiled, or plumbs and cherries dried and boiled.
 Perfons of knowledge and experience will be very
 little, or rather not at all, Surprised to fee various
 kinds of fruit diredted in acute difeafes ; the bene-
 fit of wliich they may here have frequently feen.
 Such advice can only difguft thofe, who remain Ilill
 obstinately attached to old prejudices.  But could
 they prevail on theinielves to reflect a little,  they
 muft perceive, that thefe fruits which  allay thirft ;
 which cool and abate the fever; which correct
 and'attemper  the putrid and> heated-bile ; which
 gently difpofe the belly  to  be rather open, and
 promote the Secretion and'discharge of the uri?ie,
 muft prove the propereSl nourishment Sbr perfens
 in acute fevers.  Hence  we fee, as  it  were by
 a Strong admonition, from nature herfelf, they ex-
 prefs an ardent longing for them ;  and  I have
 known feveral, who would not have recovered,
 but for their  eating Secretly large quantities of
 thofe fruits they So paflionately defired, and \\ ere
 refuSed.  As many however, as are not convinced
 by my reafoning in this refpedt, may at leaft make
 a trial of my advice,. 011  my affirmation and expe-
 rience ; when  I have no  doubt but their own will
 fpeedily convince  them of the real benefit receiv-
 ed from  this  fort of nourishment.  It will  then
 be evident, that we  may fately and boldly allow,
 in  all continual fevers, cherries red  and black,
 ftrawberries, the.beft cured raifins, rafpberries, and
mulberries; provided that all of them  be perfect-
ly ripe.  Apples, pears and plumbs  are  lefs melt-
ing and diluting, lefs  Succulent, and  rather lets
proper. Some  kinds of pears however are extreme^
ly juicy,  and  even  watery  almoit, fuch  as  the
                    G 3 
52        The  Means and Diet to be ufed
Dean or Valentia pear, different kinds of the Bu-
ree pearj the  St. Germain, the Virgoleufe, the
green fugary pear, and the Summer rcyal, which
may all be allowed; as well as a  little juice  of
very ripe plumbs, with the addition of water to it.
This laft 1 have known to afluage thirlt in a fever,
beyond any other liquor.   Care fhould be taken,
at the fame time, that the Sick fhould never be in-
dulged in a great quantity of any of them at once,
which would overload the  Stomach,  and be injuri-
ous to them ; but if they  are  given a  little at a,
time  and  often, nothing  can be  more falutary.
Thofe whofe tirrumltances will afford them china
oranges, or lemons, may be regaled with the pulp-
and juice as Successfully ;  but without eating any  '
of their peel, which is hot and inflaming.
   §  39. 3. Their drink Should  be  fuch as allays
thiift, and abates the fever ; fuch as dilutes, relax-
es, and promotes the evacuations  by Stool, urine
and perfpiration*  All thefe which  I  have recom-
mended in the  preceding  chapters,  jointly and  fe-
verally poffefs thefe qualities.   A glafs or a glaSs.
and a half of the juice of Such fruit as I have juft-
mentioned, may aiib be added to three full pints
of water.
   § 40. The fick Should   drink at leaft  twice or
thrice that quantity daily, often, and a  little at
once, between  three or four ounces, every quarter
of an hour. The coldnefs  of die drink, Should j uft
be taken off*.
   § 41. 4.  If the patient has not two motions in
the 24 hours ; if the urine be in fmall quantity and
high coloured; if he rave, the fever rage, tlie pain
of the head and of the lions be considerable, with
a pain in the belly, and a  propensity to vomit, the
clylter N°*  5. fhould be given at leaft once a day..
The people have generally an averiion to this kind
 of remedy : notwithstanding there  is not any more
ufeful  in feverish diforders, efpecially in  thole I
have j uft; recounted j  and one  glylter commonly 
               Tn acute Difeafes'              ST

gfVes more relief, than if the patient had drank
four or five times tlie quantity of his drinks.  The
ufe of glyfters ; in different difeafe-;, will be proba-
bly ascertained in the different  chapters^ which-
treat of them. But it may be obfecved in this place,
that they are never to  be given at the very  time
the patient is in a Sweat, which feems to  relieve
him.
  §  42. 5.  As long  as the  patient has fufficient
Strength for it, he fhould  lit up out of bed one hour
daily, and longer it he can bear it ;  but  at  leall
half an hour.  It has a tendency to lefl'en the fe--
ver, the head-ach, and a light-headinefs or rav-
ing.  But  he Should not be railed, while he has
a hopeful fweating :■ tho* fuch fweats  hardly ever
occur,- but at the conclusion' of difeafes, and  after
the fick has had Several other evacuations.-
  §  43.- 6. His bed fhould be made daily while he
fits up ; and  the  fheets of the bed, as* well as the
patient's linen, Should be changed every two days,.
if it can be done with fafety.  An unhappy pre-
judice has eltablifhed a contrary, and a really dan-
gerous, practice.  The  people  about the patient
dread the very thought  of his riling out of bed ;
they let him continue there in nafty linen loaden
with putrid-Steams and-humours ; which  contri-
bute, not only to keep up the difiemper, but even
to heighten it into Some  degree of malignity. I do
again repeat it here, that nothing conduces  more
to continue the fever and raving, than coufinirg
the fick con-tantly  to bed, and witholding him
-from-changing  his foul  linen: by relieving him
from both of which circumllances I have, without
the afliltance of any other remedy, put a flop to a
continual del riu 11 of twelve days uninterrupted
duration.  It is  ufually  faid,  the patient is toj
weak, but this is a very  weak reafon.  He mull be
in very nearlv  a dying condition, not to  be able
to  bear thefe fmall commotions, which, in the ve-
ry  moment  wli.u lie  permits them, increafe his
                        °3 
T4        The Means and Diet to be ufed
ftrength,  and immediately  after abate  his com-
plaints.   One advantage the Sick gain by fitting
up  a little out of bed, is tlie increafed quantity of
their urine, with greater  facility in pafiing it.
Some have been obferved  to make none at all, if
they did not rife out of bed..
  A very considerable  number of acute difeafes
have been radically, effectually, cured by this me-
thod, which mitigates them all.  Where it is not
ufed, as an aflillance at leaft, medicines are very
often of no advantage.   It were to be wished the
patient and his friends  were made to understand,.
that distempers were not to be expelled at once
with rough  and precipitate  ufage ;  that they mult
have their certain career or courfe ; and that the
life of the  violent  methods and  medicines they
chufe to employ, might indeed abridge the courSe
oc  them,  by killing the patient, yet  never other-
ways Shortened the difeafe;  but, on the contrary,,
rendered  it more perplexing, tedious  and obSli-
nate;  and  often  entailed  fuch unhappy confe-
quences on the fufferer, as left him feeble and lan-
guid for the reft of his life.
   § 44. But it is not fufficient to treat, and, as it
were,  to conduct  the  distemper  properly.   The
term of recovery from a  difeafe  requires conli«
derable vigilance  and  attention,  as it is always a
ftate of feeblenefs, and, thence, of depreffion and
faintnefs.  The fame kind of prejudice  which de-
stroys the fick, by compelling them to eat, during
the violence of the difeafe, is extended alfo into
the Stage of convalefeene, or recovery;, and either
renders it troublefome and tedious; or produces
fatal relapfes, and often chronical diftemper.. In
proportion to the  abatement, and  in tlie decline,.
of the fever the quantity of nourishment  may be
gradually increafed : but as long as there are any
remains of it, their quality  Should be thofe I have
already  recommended.  Whenever  the fever is.
completely terminated, fome different  foods may 
In accute Difeafes*            gf
De entered upon ;  fo that the patient may venture
upon a little white meat, provided it  be tender j
fome.f fiSli;  a little flefh foup, a few eggs at times,
with wine properly diluted.  It  muft be oblerved
at the Same time,  that thofe very proper aliments,
which reftore the  Strength, when taken moderate-
ly,  delay the perfect cure, if they exceed in quan-
tity, though but a little ; becaufe the action of the
ftomach, being extremely weakened by the difeafe
and the remedies is capable only, as yer, of a fmall
degree of digeftion ; and if the quantity of its ex-
tents exceed its powers, they do  not digeft but be--
eome putrid'. Frequent  returns of the fever fu-'
pervene;  a  continual faintifhnefs; head-achs;  a*
heavy drowfinefs  without a power  of fleeping
comfortably ; flying pains and heats  in the arms
and legs y inquietude;  peeviShnefs ; propensity to
vomit; loofenefs;  obstructions,  and fometimes a
a flow fever, with  a collection  of humours, that
comes to fuppuratiou..
  All thefe bad confequences are prevented, by
the recovering fick contenting themfelves, for Some
time  with a very  moderate Share of proper food.
We are not nourished in proportion to the quanti-
ty we fwallow, but to that we digeft.  A  perSbn
on  the mending hand, who eats moderately, di-
geSls it and grows ftrong from it.  He who fwal--
lows abundantly does not digeft it,  and in (lead of
being nourished and Strengthened,, he withers in-
fenfibly away..
  § 45. We  may  reduce, within the few follow-
ing rules, all that is moll efpecially to be  obferv-
ed,  in order to procure a complete, a  perfect ter-
mination of  acute difeafes;  and  to prevent their
leaving behind them any impediments to health.

  t The moft allowable of thefe are whitings,  flewnders, plaice, dabbs,
or gudgeons ; efpecially fuch of the Iaft as are taken out of clear current
flreams with gravelly bottoms. Salmon, eel?, carp, all the ikate kind,
haddock, and the like, fhould not be peimiued,  before the fick return W
their gfual diet when in health, K.     '    ' "'----    ----" 
 e6        The Means and Diet t\ be ufed
   I. Let thefe who are recovering, as well as thoie
*vho are actually fick, take very little nourilhment
at a time and take it often.
   2.  Let them take but  one fort of food at  each
meal,  and not change their food too often.
   3.  Let them chew whatever folid victuals they
eat, very carefully.
   4. Let them diminish their  quantity  of drink.
The belt for them in general is water, -j- with a
fourth or third part of white  wine.  Too great a
quantity of liquids at this time prevents the fto-*
inoach from recovering its tone and Strength ;  it
impairs  digeftion ; keeps up  weaknefs ; increafes'
the tendency to a fwelling of  the legs ;  Sometimes
even occafions a Slow fever; and throws back the-
perfon recovering, into a languid ftate.-
   c.  Let them go abroad as often as they are able,
whether on foot,  in a carriage,, or on horfeback.
This laft exercife isthe healtnielt of all,,and  three
fourths  of the labouring people in this country,
Who have it in their power to procure  it without
expence, are in  the v\ rang to negledt it.  They,,
who would pradtife it,, fhould mount before their
principal meal, which Should  be about noon,  and
never ride after it.   Exercife  taken before a meal
ftrengtjiens the organs of digeftion, which is pro-
moted by it.   If the exercile  is taken  fbon  after-
the meal, it impairs it.
   6.  As people in this ftate  are feldom quite  as
Well towards night,  in the evening they Should
take very little food.   Their  fleep will  be the lefs
dillui bed for this, and repair  them the more, and
iboiier.

  t We have known many who had an  arerfion to water, and w.'h
Whom, on that very account, it might probably agree kf,  find water
very grateful, in which a thorough'y baked  and hoi, noi burnt,  flic of
brc.id Lad been infufed, nntill it attained the colour of fine c.ear frnili.
beer, or  light ambei coloured beer, and wc  ne\er faw any inco nemeiwe
r< f It from  it. Do^ btlefa pure, untoafted elemental water m .y be pre-
ferable for thole who like, and have been awufloiijed to it. K. 
               In acute Difeafes*             57
  f. They Should not remain in bed above fovea
or eight hours.
  8  The fwelling of the legs and ancles, which
happens to moft perSbns at this time,  is not dan-
gerous, and generally difappears of itfelf; it they
live foberly and regularly, and take moderate ex-
ercife.
  9. It is not neceffary, in this ftate, that they
fhould go conftantly every day to llool ; though
they Should not be without one  above two  or
three. If their collivenefs exceeds this term, they
fliould receive a glyfter the third day,  and even
fboner, if they are heated by it, if they feel puff-
ed up, are reftlefs, and have any pains in the head.
  10. Should they, after fome time, ftill continue
very weak ; if their Stomach is difordered ; if they
have, from time to time,  a little irregular feveiy
they Should take three dofes daily of the prefcrip-
tion Nc- 14. which fortifies the digeltions, recovers
the Strength, and drives away the fever.
  11. They muft by no means return to their labour
too foon.  This erroneous habit daily prevents ma-
ny peafants from ever getting perfectly well, and
recovering their former flrength.  From not hav-
ing been able to confine themfelves to repofe and
indolence for fome days,  they never  become as
hearty hardy workmen as they had been 2 and this
premature bally  labour makes  them lofe in the
confequence, every following Aveek of their  lives,.
more time than they  ever gained, by their  over-
early refuming of their labour.   I fee every day
weakly labourers, vineroons> and other workmen,.
who date the commencement of their weaknefs
from that of fome acute difeafe, which, for want
of proper management through the term of their
recovery,  was never perfectly cured. A repofe of
Seven or eight days, more than tbey allowed them-
felves, would have prevented all thefe infirmities;
notwithstanding it is  very difficult  to make them
fenfible of this. The bulk, the body of tlie people,. 
 58      Of an Inflammation in the Breaff.
 in this and in many other cafes, look no further
 than the prefent day ;  and  never extend  their
 views to the following one.   They are for  mak-
 ing  no facrifice to futurity ; which n< verthelefs
 mult be done, to render it favourable to us.

 ^■111.....                ■            '        *


                 CHAP.  IV.
         Of an inflammation of the  brcaft.

                  Sect.  46.
       TH E  inflammation of the brcaft,  or perip*
       neumony, or a fluxion upon the breaSt,. is
       an  inflammation of the lungs,,  and moft
 commonly of one only, and confequently on one
 fide.  The figus by which it is evident, are a Shi-
 vering,  of more or lefs duration, during  which
 the  perfon affected is femetimes very reStlefs and
 in great anguifh,. an effential and infeparabk
 fymptom ;   and  which has helped  me more than
 once to  distinguish this difeafe certainly, at the
 very inftant of its invafion.   Befides this, a eon-
 fiderabie degree  of heat fncceeds  the Shivering,
 which heat,, for a few enSuing- hours,  is  often
 blended, as it were,  with fome returns of chilli*
 nefs.  The pulfe is quick, pretty  ftrong, mode-
rately full, hard-and  regular, when the difiemper
is  not very violent;  but fmall, foft and irregular,
when  it  is  very dangerous.   There is alfo  a fen-
fation of pain, but rather light and tolerable, in
one fide of the breall -r fometimes a kind of Strait-
 ening or preflure on the heart ;  at other  times
 pains  through the  whole body,  efpecially along
 the reins ;  and fome degree of oppreflion, at leait
very often  ;  for Sometimes it is but very inconfi-
 derable.  The patient  finds  a neceflity of lying
 almoft continually upon his back, being able to 
         Of an Inflammation in the Breafi.       yp

lie but very rarely upon either of his fides.  Some-
tiinei his cough is dry, and then attended with the
moll pain ;  at other times it is accompanied with
a Spitting or hawking up,  blended with more or
lefs b!ood,  and Sometimes with  pure Sheer  blood.
There is allb Some pain,  or a' leaft a fenSation of
weight and lieavinefs in the head ; and frequent-
ly a propenfity to rave.   The face is almoft conti-
nually flushed  and led: though Sometimes there
is a degree of palenels and an air of allonifhment,
at the beginning of the difeafe,  which portend no
little danger.   The lips, the tongue, the palate,
tiie fkin are all dry;  the breath hot; the urine
little and high coloured  in the firfl  Stage :  but
more plentiful, lefs flaming, and letting fall much
Sediment afterwards.   There is a frequent thiVll,
and Sometimes an inclination to  vomit ;   which
impofing on the ignorant afliftants,  have often
inclined them  to give the patient a vomit,  which
is mortal,  efpecially at this juncture. The heat
becomes univerfal.   The Symptoms are heighten-
ed almoft every night, during which the cough is
more exafperated,  and the Spitting or expedtora-
tion in lefs .quantity,  fhe belt expectoration is of
a middling confiftence, neither too thin,  nor too
Laid and tough,  like thoie which are brought up
at the termination of a  cold ;  but rather moie
yellow, anc&nixed with a little blood, which gra-
dually becomes Still lefs, and commonly difappears
entirely, before the feventh day.   Sometimes the
inflammation afcends  along the wind-pipe, and
in Sbme meafure Suffocates the  patient, painincr
him considerably in fwallowing, which make* him
think he has a  tore throat.
   § 47. Whenever  the difeafe is  very violent at
firSt, or increases to be fuch, the patient cannot
draw his breath, but when he fits up.  The pulfe
.becomes very Sinall and very quick; the counte-
nance  livid ;  the tongue black ;  the eyes Stare
wildly;  and he fullers iaexpieffible anguish, at- 
6»      Of an Inflammation in the Breafi.
-tended with  inceffant reltlefiiefs and agitation in
his bed.   One  of his arms  is femetimes affected
with a fo'.t of palfy ;  he raves without intermissi-
on,  and can  neither thoroughly wake  nor Sleep.
The Skin of his brealt and of his neck  is covered
(efpeci.dly in clofe fultry weather,  and when the
diiteinper  is extremely violent) with livid fpots,
more  or lels  remarkable, which fliould be called
petechial ones, but are imprfeperly termed the pour-
pre, or purple.  The  natural Strength becomes ex-
hausted : the difficulty of breathing increafes eve-
ry moment.;  he finks into  a lethargy,, and foon
dies a terrible death in country places,  by  the ve-
ry effects of the inflaming medicines they employ
on fuch occafions.   It  has  been known in fact;
fiat the ufe  of them has raifed the dillemper ta
fuch a height,  that the very heart has been rent
open, which the diflection of the body has demon-
strated.
   § 48. If the  difeafe ruffies on at once,  with  a
fiidden and violent attack ;  if the horror, the cold
 and Shivering laSl many hours, and are followed
 with  a nearly  Scorching degree of heat ;  if the
 brain is affected from the very  onfet ; if the pati-
 ent has a fmall purging, attended with  a tenefmus,
or Straining to fiool, often termed a needy ; if he
abhors the bed ; if he either fweat  excelfively, or
 if his Skin be extremely dry ; if his Statm-al'man'
ner and look are considerably changed ; and if he
fpits up with much  difficulty,  the difeafe is ex-
 tremely dangerous.
   § 49. He mull directly,  from the firft feizure in
 this State, be put upon a regimen,  and his drink
 muft never be given cold.   St fhould either be tho
 barley water N • 2.  the almond emulfion N*  4.
 or that of N  • 7.  The juices of the plants, which
 enter into the  laft of thefe drinks, are excellent
 remedies in this cafe ; as they  powerfully attenu-
 ate,  or melt down, tlie vifeid thick bicod, which
 caufes the inflammation. 
         Of an Inflammation of the Breafi.       6r
  As long  as  the fever keeps up extremely vio-
lent j  while the patient does not expectorate fuffi-
ciently ;  continues raving ;  has a violent head-
ach,  or raifes up pure blood,  the glyller N°* 5.
mutt be given thrice, or at leaft twice,  in twenty
four  hours.   However  the principal  remedy is
bleeding.   As Soon as ever the preceding cold af-
fault is over,  twelve ounces of blood muft be tak-
en away at  once ; and, if the patient be young and
Strong, fourteei or even Sixteen.  This plentiful
bleediug gives him more eafe, than if twenty four
ounces had been drawn, at three different times.
  \  50. When the difeafe is circumstanced as de-
fcribed (§ 46.) that  firft bleeding makes the pati-
ent  exfy  for  fome hours ; but the complaint re-
turns ; ami to obviate its violence,  as much as
pofiib'e, we muft, except things promife extreme-
ly well, repeat tlie bleeding  four hours after the
firft, taking again twelve ounces of blood,  which
pretty often proves fufficient.    But if, about the
expiration of eight or ten hours, it appears to kin-
dle up again,  it muft be repeated a third,  or even
a fourth time.   Yet,  with the affiftance of other
proper remedies,  I  have feldom been  oblioed to
bleed  a fourth time,  and have femetimes found
the  two firfl bleedings fufficient.
  If the difeafe has been of Several days duration
when  I have  firfl been  called ; if the fever is Still
very high ; if there  be a d .nculty of'breathing ;
if the patient does not expectorate at all, or brings
up too much  blood ;  without  being too folicitous
about the day of the difeafe, tlie patient fhoidd be
bled, though it were on the tenth, f
  V01. I.             H

  t We  fhould however, with the greater ■drenmfpeftion fof how
 much the lonyer Handing the difeafe has been, and by  how muh tZ
mi. c  difficult the villous humors are to be melted down and di/loAj-d*
attend toihe coftwnof the matter of expectoration; which nature does
not often caOly eff«>. and which me effects the more im,e -X °
(lowly, the weaker (he is.  Her laft efforts have of to 1  teen atVrndeH ■
witluuch high paroxyl'ms, as have impofed even upon  very com hin"
p .yiirum,', a .id have made them open a vein a Tow hour, btfor. the a-
!kt.l'» death, from their pulfcs being ftrong, hard aud frequent  E   .'' 
6b       Of an Inflammation of the Breafi.
  § 5r. In this, and in all other inflammatory dif-
eafes,  the blood is  in t» very  thick vifeid ftate:
and almoft  immediately  011 its being  drawn, a
white tough fkin, fomewhat like leather, is form-
ed on its top,  wliich  moft people have  feen, and
which  is called the pleuritic cruft.  It is  thought a
promising appearance, when at  each bleeding it
Seems lefs hard, and lefs thick, than it was at  the
preceding  ones: and this is very generally true,
if the fick feels himfelf, at the fame time, fenfibly
better: but whoever  Shall attend folelyto the  ap-
pearance of the blood, will find himfelf often de-
ceived.  It  will happen, even  in the moft violent
inflammation of the breall, that this ' rult is  not
formed, which is fiippofed to be a very  unpromit
ing fign.  There are alfo, in  this refpedt,  many
odd appearances, which  arife from the  fmallelt
circumstances j  fb that we muft not regulate  the
repetitions of our bleeding folely  by this cruft;
and in general  we mull  not be over credulous in
fuppofing,  that the appearances in .the blood,  re-
ceived into  the bafon, cau enable us  to determine,
with certainty, of its real ftate iu the body.
   § 52.  When the Sick perfon is in the condition.
deferibed (§ 47) the bleeding is not only unattend-
ed  with eafe ;  but Sometimes it is alfo pernicious,
by  the fudden weaknefs to which it reduces him,
Generally in fuch a cafe all .medicines and means
are infignificant:  and it is a very bad fign in this
difeafe, when this difcharge is not attended with
eafe and benefit to the Sick ;  or when there are
fome circumstances,  which oblige us to  be foam-
ing of it.
   | J5.  The patient's legs Should every day, for
one half hour, be put into a bath of warm water,
wrapping him up clofeiy ^ that the cold  may not
check that perforation,  which the bath promotes.

,five weaknefs is the fign, by which we may difcovcr feck unavailing ef*
/qrts to be the laft.  &• L. 
          vj a>i inpammauon oj tne Breafi.        63
   $  54. Every two hours he Should take two fpoon-
fuls of the mixture Nc# 8. which promotes all the
 diftliarges, and chiefly that oS'expedtoration.
   \  55.   When the  oppreffion  and ftraitnefs are
Considerable,  and the cough dry, the patient may
receive the vapour  of boiling  water;  to which  a
little vinegar has been added.- There are two ways
of effecting this; either by placing below his face,
after Setting him up,  a veflel filled with  Such boil-
ing  hot  water,  and  covering  the  patient's  head
and the veflel with a linen cloth, that may indole
the  (team ; or elfe by holding before his  mouth  a
fpunge dipped in the fame  boiling  liquor.  This
laft  method  is  the leaft effectual,  but it fatigues
the patient confiderably lefs.  When this bad Symp-
tom is extremely prefiiug, vinegar  alone fliould be
ufed without water;  and the vapour of it has of-
ten Saved patients, who Seemed to have one  foot
m the grave  ; but it Should  be  continued for feve-
ral hours.
   §  59.   The outward  remedies directed  in N°*
9. are alfo applied with fucceSs to the breaSt,- anal
to the throat.
   §   $?•   When the  fever  is  extremely  high,
the  fick Should take  every  hour,  a Spoonful  of
the  mixture Nc* ro.  in a cup  of the ptif'an \ but

  t The ufe of acids,  in inflammations of the  breafr, requires no little
confideratic n.  Whenever the fick perfon  has an  averfion to them;
when the tongue is moift, the ftomac-i is heavy and dift» tiered, and the
habit and teiupcramt.ni of the patient is mild and foft ; when the tough is
very fharp witho.t  great thirft, we ought toabltain from them.  But
when the infarmnation is joined to a dry tongue,- to great thirl!,  heat
and fever, they are of great  fervLe.  Slices  of China ora ge* fprinkled
with fugar may be gven firft ;  a  light Hmonade may be allowed after-
wards: andat 1*1 fmall dofes of the mixture, No. to. if it becomes ne-
ccil'ary. E. I..■•-•I ha e thofen to retain thii note of the editor of L -
ons, from having frequently feen the inefJu.tc>. and fometimesj I have
even thought, the ill effects of  auds in periptieumonies and plet.rifies,  in
aiountry far fou h of S-witfeiland ; aid whe;e thefe difeafes are very
frequent,  acute and fatal.  On the other hand I  fhall add the fubttan..e
of what Dr. T1SSOT fiys on this hea' in a note to his tabic of remedies
wherein he affirms, that he has given in this  difeafe very large dofe  of
them, lifing gradually from fmall oues and always with great fuccefs j.
a 2 
 64        Pfan Inf animation of the Br e a ft.
 without  diminishing on  this account  the ufual
 quantity of his other drinks, which may be taken
 imediately after it.
   \ 58.  As long as tlie  patient  Shall grow worfe,
 ©r only continue equally bad, the fame medicines
 are to be repeated. But if on  the third day (though
 it rarely  happens fb  Soon) or fouth, or fifth,  the
 difeafe takes a more  favourable turn ;  if the exaA,
 peration returns with  lefs violence ; the cough  be
 lefs Severe ; the matter coughed  up lefs  bloody :
 if refpiration becomes eafier ; the head be icf. af-
 fected ;  the tongue  not quite fo dry ; if the high
 colour of the urine abates,  and its quantity be in-
 creafed, it may be Sufficient  then to keep the pa-
 tient carefully to his regimen and  to give  him a
 glylter every evening. The exafperation that occurs
 the fourth day is often the higheft.
   §  59. This difiemper is moil commonly terminat*
 ed and carried off" by expectoration, and often by
 urine, which on the feventh, the ninth, or the ele-
 venth day, and  femetimes  on  the  days  between
 them, begins  to let  fall a plentiful  fediment, or
 fettling, of a pale red colour, and femetimes  real
pus or ripe matter.   Thefe difcharges are fucceed-
 ed bv fweats,  which  are as Serviceable then, ps they
 were injurious at the beginning of the difeafe.
 intreating oilier phyficians to order this acid (the fpirit of fuIphmO in t'e
 fame large dofes which he dire.--3  in this  chapter, and a (Turing himf.lf
 ef their thanks, for its good confcqnences——Now  the only ill effect I
 can fuimiae here, fiom flic wing this diver fity of opinion  in thefe tw«
learned phyficians, and my own doubts, is, that the fubjects of this dif*
 eafe in country places may prove fomewhat confufed and irrefolute by it
 in their condi.ftin fuch cafes.  But as all of us certainly concur  in the
great intention of doing all poflible good,  by the extenfive publication of
 this treatife, I fhall take leave to  cbfeive that in \\a-~. dififcfe, and in pleu-
rifies, more  folid  benefit has been received in  Carolina, Vi>t:.n'..i, ic.
from the ufe of the feneka  ratt!e-fnake root, than from any other meJi-
cine, whatever.  Bleeding indeed is necefiarily premifed to it;  but it
has often faved the neceflity of many repeated bleedings.  Tnis i' c^ic i.e
which 1= termed in latin, the polygaly Virgim'aua, is certainly rajhcrol'a
fiponaceous attenuating quality, and betrays not any marlcs of acidity,
being rather moderately acrid.  There will be occasion to mention it more
particularly in the fubfequent  chapter, as fuch liberty can need ua hdo»
logy to any philofopbical phyficiui.  £» 
        Of an Inflammation in the Breafi.      65
  £ 60. Some hours before thefe  evacuations  ap-
pear, there come on,  and not feldom, feme very
alarming Symptoms, fuch as  great anguifti ; pal-
pitations,  fome  irregularity  in the pulfe ; an in-
creafed opperffion ;  convulfive motions (this being
what is called the  crifts, the height, or  turn of
the difiemper)  but they are no ways dangerous,
provided tliey do not occafion any improper treat-
ment.   Thefe fymptoms  depend on the morbid
aud purulent matter,  which being diSIodged  cir-
culates with the humours, and  irritates • different
parts,  untill the difcharge of it lias fairly  begun :
after which all fuch fymptoms disappear, and Sleep
generally enlues.  However I cannot too ftrongly
infill on the neceSfity of great prudence  in Such
circumftauces.   Sometimes it is  the  weaknefs of
the patient, and at other times covulfions,  or Sbme
other fymptoms, that terrify  the by-ftanders.  IS",
which  is moft generally the cafe, the  abfurd pai c-
tice of directing particular remedies for fuch  ac-
cidents takes place,  fuch as Spirituous cordials,.
Venice treacle, confections, caltor and  rue ;  the
conSequence is, that nature being disturbed in her
operations, th«. crifis  or turn is not effected ;  the
matter which  Should  be discharged  by Stool, by
urine or by fweat,  is not difcharged out of  the
body ;  but is thrown upon feme internal or external
part of it.  Should  it be on Sbme inward  part,
the patient either dies at once;  or  another  dis-
temper Succeeds, more  troublefeme and incurable
than the firlt.   Should it be expelled to  Some out-
ward part, the danger indeed is lei's ;  and as Soon
as ever fuch a tumour appears, ripening  pultiees
Should be applied to bring it to ahead, aflei'which
it Should immediately be opened.
  §  61. In order to prevent  fuch unhappy confe-
quences, great care mult be taken, whenever fuch
terrifying Symptoms come on, (about the time of
the crifis)  to make no change in the diet, nor in
tlie treatment of the patient; except in givi.ig him
n 
66      Of an Inflammation of the  Breafi.
the loofening glyller N  • 5; and applying every
two hours a flannel, fqneexed out of warm water,
which may cover all the belly, and in a manner go
round the body behind the reins.  The quantity of
his drink may alfo  be  increafed a little ;  and that
of his nourishment  leflened, as long as this high
and violent State continues.
   § 62. I  have not  fpoken of vomits or purges, as
being diredtly contraiy to the nature of  this dii'.
eafe ; anodynes, or opiates, to procure  fleep are
alfo, in general, very  improper.   In a few cafes,
however,  they may poffibly be ufeful :  but thefe
cafes are So very difficult to be fuffieiently diftin.
guiShed, that opiates Should never  be admitted in
this difeafe, without the prefcnce and advice  of a
phyfician.  I have  feen many patients, who have
been thrown into an  incurable hectic, by taking
them  improperly.   When the difeafe is not lec.iv-
ed in  a mortal deo-ree, nor has been injudiouily
treated, and proceeds in a benign regular manner,
the patient may be  called very well and Safe by the
fourteenth day; when he may,  if he has an ap«
petite, be put upon the diet of people who are re-
covering.   But  if he ftill retains  an  averfion to
food; if his  mouth is foul and  furred,  and he is
fenfible of feme heavinels in his head, he Should
take the purging portion Nc* 11.
   § 63. Bleedings from  the nofe occur fometimej
naturally in this difeafe, even after repeated bleed-
ings by art; thefe are very benign and favourable,
and are commonly attended with more  eafe and
relief than  artificial  bleedings.   Such voluntary
difcharges  may  femetimes be  expected, when the
patient is feufibly mended in  many refpedts after
the ufe of the lancet; and yet complains of a great
pain in his head, accompanied w,th quick  fpark-
ling eyes,  and  a redneSs of the nofe.   Nothing
fliould be done to flop thefe vo'nntary bleedings,
fmce it would be very dangerous ; for when nature
has fulfilled her intention by  them, they ceafe of 
        Of an Inflammation  of the Breafi.,      6J
 themfelves.   At other times, Lut more rarely, tie
 difiemper is carried off* by  a natural purging, at-
 tended with moderate pain, and the discharge of
 bilious matter.
   § 6 . If the  expectoration, or hawking  up of
 matter,  Hops very fuddenly, and is not Speedily
 attended with fome o^her evacuation ; the oppref-
. lion and anguifh of the patient immediately return,
 and the danger is great  and preSling.   If the di-
 fiemper, at this juncture, is not of many  days
 Standing; if the patient is  a ftrong perfon; if he
 has not  as yet been plentifully bled; if there  be
 flill Some blood  mixed with the humour he expec-
 torates : or  if the pulfe be Strong and  hard, he
 fliould be bled immediately  in the arm ; and  con-
 stantly receive the lleam of hot water and vinegar
 by the mouth, and drink plentifully of the ptifan
 N0' 2. fometbing hotter than ordinary.  But if his
 circumstances, after this fuppreffion, are different
 from  thefe  jufl mentioned ; inftead of  bleeding
 him, two  blilters Should  be applied to the legsj
 and he Should  drink plentifully of the  ptilan
 Nc- T2.
   The caufes which ofteneft produce this fiipprefc
 (ion of his expectoration  are, I.  A fliarp  and fud-
 den cold air. 2.  Too hot a one.  3.  Over hot me-
 dicines.   4.  Exceflive fweating.   5. A purge pre-
 maturely and injudicioufly  timed.  And . Some
 immoderate paffion of the mind.
   §.65.  When the fick has not  been Sufficiently
 bled, or not foon enough;  and  even  femetimes,
 which I have Seen, when he  has been greatly weak-
 ened by  exceflive bleeding ;  fb that the difcharges
 by Stool, urine,  expectoration' and perfpiration,
 have not been Sufficiently made ; when thefe dit-
 charges have been confuted by Sbme other caufes;
 or the difeafe has been injudicioufly treated ; then
 the veflels that have been inflamed, do not unload
themfelves of the humours,  which fluff up and op-
press them :  but c here happens in the fubltance of 
6#       Of an Inflammation  of the Breafi.

the affected  lung,  the fame  circuitance we fee'
daily occur on the furface of the  body.  If an in-
flammatory tumour or fwelling does not difperfe'
itSelf, and disappears infenfibly,  it forms an ira-
pofthume or abSceSs..-  Thus exactly alio in the in-'
flamed lung, if the inflammation is not diffipated,'
it forms an abSceSs,- which,  in that part, is called-
a vomica : and the matter of that abfeefs, like the
external ones, remains  often  long iuclofed in its-
fac  or bag, without burfting open its membrane or'
cafe, and discharging the matter it contains.
  § 66.  If the inflammation was  not very deeply
feated in the inward fubllance of the difeafedlung;
but was extended to its furface, that is  very near
the ribs, the fac will burfl  on the furface  of the
lung;  and the matter contained in it mult be dif-
charged into the cavity, or hollownefs of the breaSt,
between the lung,-the ribs,.and the diaphragm or
midriff,  which is the membrane  that divides the
breaft and the belly.  But when the inflammation''
is confiderably deeper, the impoilhume burfls with-  |
infide of the lung itfelf.  If its orifice, or opening
is fb fmall, that but little can  get out  at once ;  if
fhe quantity of all the matter be inconliderable,i
and tiie  patient is at the fume time pretty Strong,.
he coughs np the matter, and is  very fenfibly re-
lieved.   But if this vomica be large, or if its orifice'
is wide,  and it throws out a great quantity of mat--
ter at  once ; or if the patient  is very weak, he
dies the very moment it burlts, and that fometimes-
when it is leaft expected. I have feen one patient
fb circumftanced expire, as he was  conveying  a
fpoonful of Soup to his mouth; and another,.while
he  was  wiping his  nofe.  There was  no prelent
fymptom in  either of thefe cafes, whence a phvfi-"
cian might fuppofe them likelier to die at that'in-
ftant, than for feme hours  before. The pufs  or
matter, is commonly discharged through the mouth
after death,  and the  bodies very  fbon become pu-
trified,                                      r 
         Of an  Inflammation of the Breafi.       o"a
    567. We call that vomica which is not bnrft, an
  occult or hidden, and that which is, an  evident or
  open one.  It is of considerable importance to treat
  exadtiy and clearly of this topic ,- as a great num-
  ber of country people die of theSe impofihumes, e-
  ven without afufpicion of the caufe of their death.
  I had  an inltance of it  feme days fince, in the
  fehool-malter of a village.  He had an occult and
  very eonfiderabie vomica  in the  left lung, which
  was the confequence of an inflammation of the
  bread, that had been treated improperlyat the be-
  ginning. He feemed to me not likely to live twen-
 ty-four hours; and really died in the  night, after
 inexpreflible auguifh.
   § 68. Whatever difiemper is included within
 the breafi of a living patient, is  neither an object
 of the fight nor touch ; whence thefe vomicas, thefe
 inward tumours, are  fb often unknown,  and in-
 deed unfulpedted.  The evacuations that were ne-
 ceffary for the cure,  or femetimes for tl.e  preven-
 tion, of them, have not taken place,  during the
 firft fourteen days.   At the end of this  term, the
 patient, far from being cured, is not  very consi-
 derably* relieved ; but, on the contrary,  the fever
 continues to be pretty high, with a pulfe continu-
 ally  quick  ; in general foft  and weaiv. ;  though
 femetimes pretty hard, and often fluctuating, or,
 as it were, waving.  His breathing is ftill difficult
 and opprelled ; with  Small cold Sliudderings from
 time to time ; an exasperation of the fever ; flush-
 ed cheeks, dry lips, and thirlt.
  The  increafe of thefe fymptoms declare, that
pus or matter is thoroughly termed :  the cough
 then becomes more continual ; being exaSperated
 with the leaft motion ; or as foon as ever the pati-
 ent has  taken  any  nourishment.  He  can lepofe
 only  on the fide affected.  It often happens, in-
 deed,-that he cannot  lie  down  at all; but is ob-
 liged to be Set up all day ; fometimes  even with-
 out daring to lean a little upon his loins, for fear 
fo       Of an Inflammation of the Breafi.
of increasing the cough and oppreflion.   He is un-
able to Sleep ; has a continual fever, and his pulfe1
frequently intermits.
  The fever is not only heightened every even-
ing ;  but the fmallelt quantify of food, the gen-
tleft motion, a little coughing, the lightefl agita-
tion of the mind, a little more than ufual heat ra-
the chamber,  feup either a little too ftrong,  or a
little too Salt,  increafe the quickneis of his pulfe
the moment they occur, or are given.   He is quite
relllefs, has fome Short attacks of the moft terrible
anguiSh, accompanied and fucceeded by fweatin^s
on his breaft,  and from Ins whole countenance.
He fweats femetimes the whole  night  ; his urine
is reddilh, now frothy, and at other times oily, as
it were.   Sudden fluShings, hot as flames, rile inr
to his whole vifage.   The greater number of the
fick are commonly fenfible of a moft difagreeable'
tafte in their mouths ; fome of old ftrong cheefe;
others of rotten eggs j and others again of Stink-
ing meat, and fall greatly away.  The thirll of
ibme is unquenchable ;  their mouths and lips are7'
parched ; their voice weak and hoarfe ; their eyes
hollow,  with  a kind of wildnefs in their looks.
They have generally a difguft to all food ; and if
they Should  afk for Sbme particular nourishment
Without feeing it, they reject it the moment it is
brought them ; and their flrength at length feems
wholly exhaulted.
   Befides thefe fymptoms,  a little inflation, or
iloatednefs, as it were,  is femetimes obferved oni
the breaft, towards the fide affedled ;  with an ah-
moSl infeuSible change  of colour.   If the vt?nictt
be fitoated  at the bottom of the affected lobe of
the lungs,  and in its internal part,  that is, near-
ly in the middle of the breaft,  feme puff nefs, or
light fwelling, may be perceived in Some bodies,
 by gently preSfing the pit of their ftomach ;  espe-
 cially when the patient coughs.   In Short, accord-
 ing to the observations of a German phyfician,.  if 
         Of an Inflammation of the Breaft.      It

4>\\e ftrike the open hand on the breaft, covered
-only with a Shirt,  it retains in the Spot,  which is
directly oppofite to the vomica, a Slat heavy found,
as if one Struck a piece of ffeih ;  while in ftihdiio-
on the other  fide it gives a clear loud  found, as
fiom a drum.   I ftill doubt however, whether tiis
observation will generally hold ttue ; and it would
be  hazardous  to  affirm there is  no abfcefs in a
brealt, which does not return this heavy found.
   § 69.  When a  vomica is formed,  as long  as it is
not emptied,  all the fymptoms 1  have  already e-
numerated increafe, and the vomica grows in Size j
the whole^fide of the  lung afledted lometimes be-
comes a  bag or fac of  matter.   The Sound  Side is
comprefled ;  and  the  patient, dies after dreadful
anguifh, with  the lung  full of pus, and without
having ever brought up  any.
   To avoid fuch fatal  conSequences, it is neceffa-
ry to  procure the rupture and discharge of this
inward abfceSs, as foon as we are certain of its ex-
iilence : and  as it is Safer it  fhould break  within
the lobe affected, from whence it may be difcharg-
ed by hawking up ; than that it Should burlt and
void itfelf into the cavity of  the brealt,  (for rea-
 fons 1 Shall give hereafter) we mult endeavour,
 that this rupture may be enected within the inter-
nal fubftance  of the lungs.
   § 70.  The moft eftedtual methods to procure this
are,  f.  To make the  patient continually receive,
,by his mouth, the vapour of warm water. 2. When
by this means that part of the fac or abfcefs  is fatt-
ened, where we could vvifh the rupture of it to hap-
pen, the patient in to  Swallow a large quantity of
the molt emollient liquid; fuch  as bailey  water,
almond  milk, light veal  broth, or milk and  water-
By this means the ftomach is kept always full:  (6
that the refinance to the lungs being eonfiderabie
on that  fide,  the abfeefs and  its contents will na-
turally  be prelled towards the  fide of the wind-
pipe,  as it will  meet with lefs refinance  ther*,, 
 72       Of an Inflammation  of the Breafi.
 This fulnefs of the ltonach will alio incline the
 patieit to cough, which may concur to produce a
 good  event.   Hence,  3. We Should endeavour to
 make the patient cough,  by making him finell to
 feme vinegar,  or even to Snuff up a little ;  or by
 injecting into his throat,  by the means of a Small
 fyringe or pipe, Such as cliiidren make out of Short,
 pieces  of elder-boughs, a little water  or vinegar.,
 4. He Should be advifed to bawl out aloud, to read,
 loud, or to laugh heartily ; all which mea».is contri-
 bute to burlt open the abfcefs, as well as thefe two
 following ones.  5.  Let him take every two hours
 a Soup-ladle of the potion N* 8.   6. He Ihould
 be put into  a cart, or  feme other  carriage;  but
 not before he has drank plentifully of fuch liquors
 as I have jafl mentioned ; after wliich  the (haking
 and jolting in the carriage have Sometimes imme-
 diately procured that rupture, or breaking of the
 bag or abfcefs,  we vvifhed for.
   § 71. S-Jiue years fince I i'a.v a country maid-fer-
 vant,  who was  left in a languishing condition af-
 ter an  inflammation of the brealt ;  without any
 perfbn's Siifpedting her ailment.  This woman be-
 ing put into a cart, that was fent for a  load of
 hay,  one of the  wheels rau violently againtt a
 tree :  She fwooned away, and <it the fame time
 brought up a great quantity of digeSted  matter.
 She continued to bring up more ;  during which I
 was informed of her cafe, and of  the accident,
 which  effectually cured her.
   A Swift officer, who ferved  in Piedmont, had been
 in a languid ltate of h'.aitu for feme months ; and  |
 returned home to fet himfelf down as eafily as he
 could,  without conceiving any considerable hopes
 of recovery.    Upon entering into his  own coun-
 try, by the way of Mount Bernard; and bein<r ob-
liged to go feme paces 011 tbot, he fell down fand
 remained in a fwoon above a quarter of an hour :
during  which time he threw n> a large quantity -
of matter, and found himfelf that very moment 
         Of an Inflammation  of the Breafi.       73
very greatly relieved.   I ordered  him a  proper
diet, and fuitable medicines:  his health became
perfectly eftabliShed ;  aud the prefervation of his
life was principally owing to this lucky fall.
  Many perfens afflicted with a vomica, faint away
the very inltant  it breaks.   Some Sharp  vinegar
fiiould  be directly held to their nofe.   This Small
affillance is generally fufficient, where the burst-
ing of it is not attended with fuch appearances as
fhew it to be mortal, in which cafe every applica*
tion is infignificant.
   \ *li. If the fick perfon was not extremely weak
before the bui Sting of the abfcefs ; if the matter
was white,  and well conditioned ; jf the fever a-
hates after  it ;  if the anguifh, oppreSfion,  and
fweats, terminate ; if the cough  is lefs violent ;
if the  patient is  fenfibly eafier in his Situation or
polture ;  if he recovers his  Sleep and appetite ;  if
his ufual Itrength returns ;  if the quantity he ex-
pectorates,  or brings up, becomes daily and gra-
dually lefs ;  and if his urine is apparently better,
we may have room to hope,  that by the afliStance
of thefe remedies I Shall immediately direct,  he
may be radically, completely cured.
   \  7?.  B.it if on the contrary ; when his flrength
is exhausted before the burfling  of the  abfcefs ;
•when  the  matter is  too thin and  traufparent,
brown,  green, yellow,  bloody, and of an offen-
sive fmell;  if the pulfe continues quick and weak;
if the patient's appetite, flrength,  and Sleep, do
not  improve, there remains no hope of a cure,
and the beSt medicines are ineffectual ; neverthe-
less we ought to make fome trial of them.
   §  7^J-  They confift of the following medicines
and regulations,   i. Give every four hours a little
barley or rice cream.  2.  If the  matter brought
up is thick  and glewy,  fe  that it is very difficult
to  be loofrned and  difcharged, give  every  two
hours  a  foup-ladle  of the  potion  N • 8 ;  and
bciween  the giving thefe  two, let  the  patient
   Vol.  I.               I 
 74      Of an Inflammation of the Breaft.
 take every  half hour a  cup of the drink N°* l%
 3. When the conliltence of the matter is fuch, that
 there is no occafion for thefe medicines to  pro-
 mote the difcharge of it, they tnufl be omitted ;
 though the fame fort and quantity of food are to
 be continued 4 but with the addition of  an equal
 quantity of milk : or, which would be ftill more
 beneficial, inftead of this mixture, we fhould  give
 an equal quantity of fweet milk,  taken from a
 good cow,  which, in fuch a cafe,  may  compofe
 the  whole  nourifhment of the  patient.   4. He
 fliould take four times a day,  beginning early in
 the  morning, and at  the di'.tance of two hours,
 a dofe of tiie powder Nc* 14. diluted  in a little
 water, or made into a bolus, or morfel,  with a lit-
 tle Syrup or honey.   His common drink Should be
 almond emulfion,  commonly  called almond milk,
 or barley water, or freSh water with a fourth  part
 milk.  5.  He  Should air and  exercife  every  day
 oa horfeback,  or  in a carriage, according as his
 flrength and his circumftances  will allow  him.
 But of all forts of exercife,  that upon a trotting
 horfe is,  beyond  all companion,  the very belt,
 and the eafieft to be procured by every body;  pro-
 vided the difeafe be not too far advanced ; Since,
 in Such a Situation, any exercife, that was only a
 little violent, might prove pernicious.
   § 75. The multitude,  who  are generally illite-
 rate, feldom conlider any thing as a remedy,  ex-
 cept they fwallow it.   They have but little confi-
 dence in regimen, or any affiftance in the way of
 diet, and ronfider riding 011  horleback as wholly
 ufelefs to them.  This is a dangerous miflake, of
 which I fliould be glad to undeceive them : fii.ee
 this  affiftance,  which  appears So infignificaiit to
 them, is probably the moft tfiectuul of  any :  it is
 that, in fact, without which they can fcarcely ex-
 pect a cure,  in the higheft degiees of this difeafe;
it is that, which perhaps alone may recover them,
provided they take no improper food.   In brief, 
        Cf an Inflammation  of the Breaft,       "J$
if is confidered,  and with reafon,  as the real Spe-
cific for this dileale.
   §" 7>. The influence of the air is of more im-
portance in this dilbrder, than in any others; for
which realon great care fliould be taken to procure
the bell, in the  patient's chamber.   For this pur-
pofe it fhould often be ventilated, or have an ad-
miiuoii oi iiefli air, be fweetned from time to time,
though very lightly, with a little  good vinegar;
and in the feaibn it fhould be plentifully fnpplicd
with agreeable  herbs, flowers and fruits.  6hould
the Sick be unfortunately Situated, and confined  in
an unwhol/bme air,  there  can  be but little pro-
fpedt of curing him, without altering it.
   §  77. Out of many perfons affected with thefe
dilorders, feme have been cured by taking nothing
whatfoever but butter milk ; others by milons and
cucumbers  only % and  others again  by Summer
fruits of  every  fort.   Neverthelef, as fuch cafes
are Singular, and have been but few, I achife the
patient to obil-ive the method I have directed here,
as the Sure St.
   § 78. It is fuff.cicnt if he have a ftool once  in
two, or even in three,  days.  Hence, there is no
leafon for him, in this cafe, to accultom himfelf
to glyfters : they might  excite a loofenefs, which
may be very dan^ero^.s.
   \  79. When the discharge of the matterfrom tie
brealt diminishes, and  the  patient is perceivahly
mended in every refpect, it  is a proof that the
wound iu the abtceSs is deterged, or clean, and that
it is diSpofed to  heal up gradually.   If the Suppu-
ration, or difcharge, continues in great quantity ;
if it feems but of an indifferent confiftence ; if the
fever returns every evening, it may be apprehend-
ed, that the wound, inltead of healing, may de-
generate into an ulcer,  which mull prove a moft
einbarraffing confequence.  Under fuch a circum-
ilance,  the patient would  fall  into a confirmed
hectic, and die after ioine mouths iieknefs^ 
7 6       Of an Inflammation  of the  Breaft.
  § 80. I am not acquainted with  any better re-
medy, In fuch a dangerous cafe, then a perfever-
ance in thefe  already directed, and efpecially in
moderate exercife on. horfeback.  In feme of them
indeed, recourfe may be had to tlie fweet vapours  •
of fome vulnerary herbs in hot water, with a little
oil of tu-pentine,  as directed N°. 15. I have feen
them fucceed ; but the  SafeSt way  is to coufult a
phyfician, who may examine and confider, if there
is not Some particular circumstance combined with.
the difeafe,  that proves an obltacle to the cure of
it.  If the cough prevents the patient from Sleep-
ing, he may take in the evening two or three table
ipoonfuls of the prefeription N". 16. in a glals of
almond milk or barley water.
  § 81. The very fame caufes which fuddenly fup-
preSs the expectoration, in an inflammation of the
brcaft, may allb deck the expectoration from a
vomica already begun : in wliich circurnflance the
patient is Speedily afflited with an oppreflion and
aii^-uiflj, a fever and eii.lent feeblenefs. We Should
immediately endeavour to  remove this Stoppage,
by the vapour of hot water ; by giving a Spoonful
of  the mixture N = . 3. every hour;  by a large
quantity  of the ptifau N°. 12.  and by  a  proper
degree of motion or exercife.  As fboi; as ever the
expectoration returns,  the  fever  and the other
fymptoms disappear.   I have feen this  fuppreffion
in Strong habits quickly followed with  au inflam-
mation about the feat of the vomica, that has o-
bliged me to bleed, after which the expedtoration.
immediately returned.
  §  82.  It happens femetimes, that  the  vomica is
entirely cleanied ; the expectoration is entirely Si-
nilhed, or drained off',  the patient Seems well, and
thinks himfelf completely cured : but foon after, the
uneafhiefs, oppreSfion, cough and fever are renewe-
ed, becaufe  the membrane or bag of the vomica rills.
again : again it empties itfelf, the patient expedto*
rates for fome days, and feezes to  recover.  Atlet 
       Of an Inflammation of the Breafi.         TT
Come time however, the fame feene is repeated ;
and this  viciffitude,  or  fucceffion,  of moderate
and of  bad  health,  often  continues  for  feme
'months and even feme years.   This happens when
the vomica is emptied, and is  gradually  deterged;
fb that its membranes, or fides touch or approach
each  other;  but without  cicatrizing or healingj
firmly ; and then there drops or leaks in very gra-
dually frefh matter, for a few days this feems no
ways to incommode the patient; but as  fbon  as a
certain quantity is accumulated, he is vifited again
with feme of the former fymptoms, till another e-
vacuation enfues.  People thus circumflanced, in
this difeafe Sometimes appear to enjoy a tolerable
Share of health.   It may be confidered as a kind of
internal iflue, which empties and cleanfes itfelf
from time to time ; pretty frequently in feme con-
stitutions, more Slowly in others; and under which
Some may attain a good middling age.    When it
arrives however at a very eonfiderabie duration, it
proves incurable.   In its earliefl ftate, it gives way
Sometimes to a milk-diet, to riding on horfeback,
and to the medicine N"# 14.
   § 83. Some may be furprifed, that in treating of
an abfeeis of  the lungs,  and of tlie hectic, which
is a confequence of it,  I fay nothing of thofe re-
medies,  commonly termed  balfamics, and So  fre-
quently employed in them, for iuftance, turpen-
tines,  balfam of  Peru,  of Mecca, frankincenfe,
maftich, myrrh, floraxr and balfam of fulphur. I
Shall however fay briefly here  (becaufe it is equal-
ly my defign to destroy the prejudices of the peo-
ple, in favour of improper medicines, and to efta-
blifh the reputation of good ones)  that I never in
Such cafes made ufe of thefe medicines;  becaufe 1
am convinced,  that their operation is generally
hurtful in fuch cafes :  becaufe I fee them daily
productive of real mifehief;   that they  protract
the cure, and often change a Slight diibrder into
an incurable difeafe.  They are incapable of per- 
j£       Of an Inflammation of the Breaft.
feet  digeftion.; they obltrudt the finplt veflels of
the lungs, whofe obftrudtions we fhould endeavour
to remove j and evidently occafion,.  except their
dofe be extremely Small, heat and oppreSfion.  I have
very often feen to a demonstration,., that pills com-
pounded of myrrh, turpentine, and balfam  of Pe-
ru, have, an hour after they were fwallowed, oc-
casioned a tumult and agitation in the pulle, high
flulhiiigs,  thirfl, and oppreflion.   In Short, it  is
demonstrable  to every unprejudiced  perlbn, that
thefe remedies, as they have been called, are tru-
ly prejudcial in this cafe : and 1 heartily wifti peo«-
pie maybe diSabufed  with refpedl to them;  and
tdiat they  may lofe that reputation fo  unhappily a«-
fcribed to them.
  I know that many perfons, very capable in o«-
ther refpedts,  daily make ufe of them in thefe dil-
tempers :  fuch however cannot fail of difuSing
them, as Soon as they Shall have obferved their ef-
fects, abstracted from tlie virtues of the other me-
dicines to which they add them,  and which miti--
gate the danger of them.  I faw a patient,  whom
a foreign  Surgeon, who lived at Grbe,  attempted.
to cure of a hectic with  melted  bacon, which ag-
gravated  the  difeafe.   This advice  Seemed,  and)
certainly was,  abfurd ; nevertheless the balfamics•
ordered in fuch cafes are probably not mere digeS-
t'ble  than fat bacon.   The powder  Nc* 14.  pof-
fea'es whatever thcTe balfamics pretend to : it is at-
tended with none of the irconveniencies they pro--
duce ; and  has all the good qualities aferibed  to
them.  Notwithilanding which,  it  mult not be-
given while the inflammation exifls ; nor when it
may tevive again ; and no other aliment fhould  Le
mixed with the milk.
  The famous medicine called the antiheclic (anti-
hetticumpotent) has not, any more than thefe balfa-,
inics, the virtues atcribc d to it in fuch cafes.  I \ e-
ry often pive it in Some obstinate coughs to infants
with their niifft, and then it v» very ufeful;  but J 
         Of an Inflammation of tftc Breafi.      yp>
have feldom feen it attended with considerable ef-
fects in grown perfons ; and in the prefent cafes I
Should be fearful of its doing mifehief.
  § 84. If the vomica, inftead of breaking with-
in the S'ubltance of the lungs affected, Should break
without it,  the pus mull  be received into the ca-
vity of the brealt.  We know when that has hap.
pened, by the fenSation or feeling ol the patient ;.
who perceives an uncommon, a fingular  kind of
movement, pretty generally accompanied with a
fainting.  The oppreffion and anguifh ceafe  at
once ; the fever abates ; the cough however com-
monly continues,  though  with let's violence,  and
without any expectoration.   But  this Seeming a-
xnendinent is  of a Short duration,  Since, from the
daily augmentation of the matter,  and its grow-
ing more acrid or fharp, tlie lungs become  oppreft-
ed, irritated and eroded.  The difficulty of breath-
ing, heat, thirlt, wakefu-lnef, i;iftatte, and deaf-
nefs, return,  with many other Symptoms unnecet-
iary to  be enumerate^, and efpecially with fie-
quent Sinkings and weaknefs.  The  patient SI.ou id
be confined to his regimen,  to retard the increaie-
of the difeafe as much as pofhble ;.  notwith^ ant-
ing 110 other effectual lemedy remains, except that
of opening the brealt between two of the  ribs, to
difcharge the matter,  and to flop the diforder it
occafions.  This is called the operation  for the em-
pyema.   I Shall  not delcribe it heie, as it fliould
not be undei taken but by  perfons of capacity and
experience, for whom this  tieati.e was not  intend-
ed.   I would only obferve,  it is lefs painful than
terrifying ; and that if it i^ delayed too long, it
proves ulefefs, and the patient dies mileiablv...
   § 85.  We may daily lee external inflammations
turn  gangrenous, or mortif .   The fame thing
occurs in the lungs, when the fever is excefine,,
the inflammation, either  in its own natuie,  ex-
tremely violent, or raifed to fuch a height by hot
Bieiiicines.   intolerable anguiuh,  extreme weak- 
&>      Of an Inflammation of the Breafi.
Iiefs,  frequent fain tings, coldnefs of the extremi-
ties, a livid and foetid thin humour brought up in-
ftead of concocted Spitting, and Sometimes black-
ilh llripes on t ie breaft, fufficiently di-ftinguifh this
miferable ltate.  I have fmelt in one cafe of this
kind, where the  parient had  been attacked with
this difeafe,  (after a forced march on toot,  hav-
ing taken Sbme wine with fpices to force a fweat)
hi. breath fo horribly lliuking,   that his wife had
many Sinkings from attending him.   When 1 faw
him,  I  could difeerri neither pulSe nor intellect,,
and ordered  him nothing.  He died an hour after-
Wards,  about the beginning of the third hour.
   § 86.  An  inflammation, may allb  become hard,.
when it forms  what we call a fchirrhus, which is a
very hard tumour, indolent, or unpainful.  This
is known to occur,  when the difeafe has not ter-
minated in any of thofe manners I have reprefent-
ed ;  and where,  though the lever and  the other
iymptoins diiappear, the rcfpiration, or breathing,
remains always a little oppreffed ; the patient 11 ill
retains  a troublelbme fenlation  in one fide of his
breaft ;  and  has,  from time to time, a dry cough,,
which increafes after exercife,  and after  eating.
This malady is but feldom cured ;  tho' fome per-
fons attacked with it laft many years, without any
ether couliderable complaint.   They fliould avoid
all occafions of over-heating themfelves ; which
Blight readily produce a new  inflammation about
this tumour, the  conSequences of which would be
highly dangerous.
   § 87.   The bell remedies againft this dilbrderr
and from which I have Seen feme good efledts, are
the medicated whey N  • 17.  and the pills N • 18.
The patient may take twenty pills, and a pint ai.cl
a half of the whey every morning for a loni»- con-
tinuance ;  and receive inwardly, now and ther,.
the vapour of hot water.
   \ 88.   Each lung,  in a perfect ftate of health,
touches  the pleura,  the  membrane,  that lines the 
                 Of the Fleurify.  -            8*
infide of the breaft ; though it is not connedted to
it.   But it often happen-,  after an inflammation,
of the breaft, after the pleurify, and in fome other
cafes, that thefe two parts adhere clofely to each
other, and are never aftewards Separated.  How-
ever, this is fcarcely to be confidered as a difeafe j
and remains commonly unknown, as the health is
not impaired by it, and nothing is ever preferibed
to remove it.   Nevertheless I have feen a few ca-
fes, in wliich this adhelion was manifeilly  preju-
dicial.
                 CHAP.   V.

                 Of the Pleurify.

                  Sect.  89.
      TH E pleurify, which is chiefly known by thefe
       four fymptoms, a Strong fever, a difficulty
 of breathing,  a cough,  and an acute pain about
 the breaft ; the pleurify,  1 fay,  is not a different
 malady from the peripueumony, or inflammation
 of the breaft,  the fubject  of the preceding chap-
 ter ;  fb that I have very little to fay of it,  parti-
 cularly, or apart.
   § 90, The caufe of this  difeafe then is exactly
 the fame with that of the former,  that is, an in-.
 fianimation of the lungs ; but  an inflammation^
 that Seems rather a little more external.  Xfee on-
 ly considerable difference in the fymptoms is, that
 the pleurify is accompanied with a moft acute pain
 under the ribs, and which is commonly termed a
flitch.   This pain  is felt indifferently over every
 pat t of the breafi ;. though more commonly about
 the Sides, under the more flefhy parts of the breaft,
 and ofteneft on the right fide.' The pain is greatly
kuaeaied, whenever the patient coughs, or draws ia 
 8l               Of the Pleurify.
fie air in breathing ; and hence a fear of increafing'
i'', by making fome patients  forbear to  cough or
refpire, as much as they poflibly can  ; and this ag-
gravates the difeafe, by flopping the courfe oi'tlie
blood in the lungs, which are loon overcharged
with it.  Hence the inflammation of  this bowel be-
tones general;  the blood mounts up to the head -r
the countenance looks deeply red,  or as it were li-
vid ; the patient becomes nearly  fuflbcated,  and
falls into the ftate defcribed § 4".
   Sometimes the pain is fb extremely violent, that;
if the cough is very urgent at the fame time,  and
the fick  cannot fuppreis  or  reflrain it,  they are
feized with convulsions, of which I have Seen ma-
ny instances, but thele occur  almoft always to  wo-
men ; though they are much lefs fubject than men
to this difeafe, and indeed to all inflammatory ones^
It may be proper however to  obferve here,  that  if
woman  Should be attacked with it  during their
monthly discharges, that circuniftance Should not
prevent the repeated and neceffary bleedings,  nor
occalion any alteration in the treatment of the dif.
eafe.  And hence it  appears,  that  the pleurify ia
really an inflammation of the lungs, accompanied
with acute pain.
   §91.! am fenSible that femetimes an inflamma-
tion of the lungs is  communicated alfii lo that
membrane, which lining the infide  of the breaft ;
is called the pleura ; and from thence to the mulcles,
the SleShy parts, over and between  the  ribs.  This
however is  not very frequently the cafe.
   § %&•► Spring is  commonly  the fealbn moft pro-
ductive of pleurifies : in general there are few in
fummer: notwithstanding that in the year 1762,
there were  a great many during the hottest fealbn,
which then was exceSfively So.  The difeafe ufually
begins with a violent Shivering, fucceeded by eon-
fiderabie heat, with a cough, and oppreffion,  and
fometimes with a fenSible ftraitning, »r contracti-
on, as. it were, all over  the brealt»  and allb witbi 
                 Of the Pleurify.               8$
 a  head-ach, a redneSs of the  cheekf, and with
 teachings to vomit.   The Stitch does  not always
 happen at the very firft 011 .et^ often not 'till after
 feveral hours trom the lii-fl coinplaiut ; femetimes
 not before the fecond or even the t.ardday. Some-
 times the patient feels two  ftitches, in different
 parts of the  fide • tho' it feldom  happens that they
 are  equally Sharp, and  the  lighteft fbon ceafes.
 Sometimes  alio the  Stitch Shifts its place,  which
 promifes well,  if the part firft attacked by it con-
 tinues -perfectly free from pain ; but it has a bad
 appearance, if, while the firft is prefent, another
 Alio fupervene;, and both continue.  The pulfe is
 .ufually very hard in this diftemper%  but in the
 dreadful cafes deferibed§ 47 and 90,  it becomes
 foft and fmall.  There  often occurs at, or very
 ■quickly after the invafion, fuch  an  expedtoration,
 or hawking np, as happens in an inflammation of
 the breaft ;  at other times there  is not the leaft ap-
 pearance of it, whence fuch are named dry pleu-
 risies,  which  happen pretty often.   Sometimes
 .the Sick cough but little, or not at all.  They often
 lie more at  eafe upon the fide affected, than on the
 found one.   The progrefs of this difeafe advances
 exactly like that deferibed in the preceding chap-
 ter : for how can they differ confiderably ? and the
•treatment of both is the Same.   Large hsemonha-
 ges, or bleedings from the nofe, frequently hap-
 pen, to the  great relief of the patient; but feme-
 times fuch difeharges confift of a kind of corrupted
 blood,  when the patient is very ill, and thefe por-
 tend death.
   \ o~>,. This diftemper is often produced by drink*
 ing cold water, while a perfon it hot; from which
 -caufe it is Sometimes fb violent, as to kill the pati-
 ent in three hours.  A young man was found dead
 at the fide  of the fpring,  from which  he had
 -quenched his thirll : neither indeed is it  uncom-
 mon for pleurifies to prove mortal within three
 days. 
84              Of the Pleurify.
  Sometimes the flitch difappears, whence the pa»
tient complains lels; but at the fame time his coiiii*
tenance changes;  he grows pale and fad;  his eyes
look dull and heavy, and his  pulfe grows feeble.
This fignifie s  a  translation of the difeafe  to  the
brain, a cafe which is almoft conllantly fatal.
  There is no dileale in which the critical Symp-
toms are more violent, and more ftrongly marked,
than in this.  It is  proper this  fhould  be known,
as it may prevent or leilen our exceflive terror.   A
perfect cure  Supervenes femetimes, at the  very
moment when death was expected.
  §  94. This malady is one of the moft common
and the molt deftroying kind, as well from its own
violent nature, as thro' the pernicious treatment
of it in country  places.  That prejudice, which
infills on curing all difeafes by fweating,  entirely
regulates their conduct in treating of pleurify ; and
as feon  as  a perfon is afffidted with  a ftitch, all
the  hot  medicines are immediately fet to  work.
This mortal error destroys  more people than gun-
powder;  and it is by So much the more hurtful, as
t.ie  diftemper is of the moft violent kind ; ancl be-
caufe, as there is commonly  not a moment to  be
loll, the  whole depends on the method immediate-
ly recurred to.
   \  95.  The  proper manner of treating this dif-
-eaSe, is exactly the fame in all refpects, with  that
-of the peripneumony ;  becaufe, 1 again affirm, it is
the  very  fame difeafe.   Hence the bleedings,  the
-foftening and  diluting drinks, the  Steams,  the
glyfters, the portion N' • 8. and the emollient poul-
tices are the real remedies. Thefe laft  perhaps are
ftill more effectual in the plcuril'v  ; and therefore
-they Should be  continually applied  over the very
ftitch.
   The firft bleeding, efpecially if there has been
a eonfiderabie discharge, almoft constantly abates
the ftitch,  and often entirely  removes it: tho' it
Wore commonly returns, after an intern.iflion of 
               Of the  Pleurify:               $f

Some hours, either in the fame Spot, or Sometimes
in another. The Shifting of it is rather favourable,
efpecially if the pain,  that was firft felt under the
breaSt, Shifts into the fhoulders, to  the back, the
flioulder-blade, or the nape of the neck.
   When the Ititch is not at  all abated, or only a
little;  or if,  after having abated, it returns as vio-
lently as at SirSl, and efpecially if it returns in the
Cime /pot, and the height of the other fymptoms
continue, bleeding  muft  be  repeated.  But if a
fenfible abatement of the ftitch continues ; and if,
tho' it returns, it fhould  be in a fmaller'degree,
and by intervals,  or in thofe places  I have menti-
oned above ; if the quicknefs, or the  hardnefs of
the pulfe,  and all the other Symptoms are fenfibly
diminished, this repeated bleeding may Sometimes
be omitted.  Nevertheless,  in a very Strong fubject,
it feems rather prudent not to omit it, fince in
fuch circumstances it can i\o  no mifehief; and a
considerable hazard may Sometimes be incurred by
the omiffion.  In very high and dangerous pleuri-
fies a frequent repetition of bleeding is neceffary;
except fome impediment to it Should arife from the
particular conltitution of the patient, from his age
or fome other circuftances.
   If,  from the beginning of the difeafe, the pulfe
is but a little quicker and harder than in a heal-
thy ftate ; if it is not manifestly ftrong; if  the
head-ach and the  ftitch are So moderate as to prove
fupportable; if the cough is not too violent ■ if
there is no  fenfible oppreffion  or flraitnefs, and
the patient  expectorate,  or  cough up,  bleeding
may be omitted.
   With refpect to the administering of other re-
medies, the  fame directions are to be  exactly fol-
lowed, which have been already given in the pre-
ceding chapter, to  which the reader is referred
 from § 53  to 66.
   § y6. When the difeafe is not very acute and
 prefling, I have often cured it in a very few day*
   Vol. I.            K                      J* 
  86              Of the  Pleurify.
  by a Single bleeding, and a large quantity of a tea
  or infufion of elder-flowers,  Sweetened with ho-
  ney.  It is in fome cafes  of this kind, that  we of-
  ten find the  water faltranc fucceed, with the addi-
  tion of fome honey, and .even of oil :  though the
  drink I have juit directed  is confiderably  prefe-
  rable.   That drink which is compounded of equal
  quantities of wine anil water, with the addition
  of much Venice treacle, annually deftroys a great
  number of people in the  country.
    §  97.  In thofe dry  pleurifies, in  which  the
  (litch, the fever, and the head-ach are ftrong and
  violent ; and where the pulfe is very hard and ve-
  ry full, with an exceflive drynefs of the fkin and
  of the  tongue, bleeding fliould be  frequently re-
 peated, and at fmall intervals from each other.
 This method frequently cures the difeafe effectu-
 ally, without ufing any other evacuation.
   \  c,8. The pleurify  terminates, like  any  other
 inward inflammation, either by fome evacuation :
 by an  abfcefs ; in a mortification or in  a fcirrho-
 fity or  hard tumour; and it often  leaves adhefi-
 011s in the breaft.
   The  gangrene or mortification  fpmetimes ap-
 pears on the third day, without having  been pie-
 ceded by very vehement pains.  In fuch cales the
 dead body often looks very black, efpecially in the
 parts near  the feat of the  difeafe ; and in  fuch
 the more fuperftitious afcribe it to Some  fuperna-
 tural caufe ; or draw feme unhappy prefage  fiom
 it,  with relpect to thofe who are yet uuattacked
 by it.  This appearance however is purely a na-
 tural confequence, quite  Simple, and cannot  be
 otherwise;  and the hot regimen and  medicines
 are the  inofl prevailing caufes of it.   I have  feen
 it thus circumstanced in a man  in the flower  of
 his  age, who had  taken  Venice treacle in cher-
ry water, and the ingredients of faltranc infilled
in wine.
  §  99.  Vopucas.are fometimes the confequences of 
                  Of the  Pleurify.               ?7
pTeurifies ; but their particular fituation  difpofes
them  more  to break  \ outwardly ; which is the
molt frequent caufe of an empyema \ S4 " To pre-
" vent ti;is,  it is  highly proper to  apply, at the
" firft invafion  of the difeafe,  to the fpot where
4< the pain chiefly rages, a fmall plailter, which
" may exactly fit it;  fince  if the pleurify fhould
" terminate in an abfcefs or impolthume, the pu-
41 ruleut  matter will be determined to that fide.
  " As fee:-, then as it is forefeeu that an  abfcefs
" is forming (fee § 68) we fhould erode, by a light
" caultic, the place where it is evicted ;  and ;.s
11 Soon as it  is removed, care  Should be  taken to
" promote fuppuration there.  By this means we
t( may entertain a reafonable hope, that the i;;a>j
" of matter will incline its courier to that .fpot,
" where  it  will  meet  w ti the least refinance,
" and be difeharged  from thence.  For  this heap
"  of  matter is often accumulated  between tl.-e
*'  pleur.r,  and the paits which adhere to it."
  This is the advice of a very  f great phvfician ;
but I nmft inform the reader, there are many ced-
es,  in which it can be of no il-i vice; neither oughc
it to be attempted, but by  peribns of undoubted
abilities.
  With regard to the fcirrhofity, or hardnefs, and
to the circumstances of adhelions, 1  can add no-
thing to what I have faid in § 86  and 87.
  §  100.  It has been  obServed that fome perfons,
who have been  once attacked by this  difeafe, are
often  liable to relapfes  of it, efpecially fuch as
drink  hard.   I knew  one man, who reckoned up
his pleurifies by dozens.  A few bleedings at cer-
tain proper interval', might  prevent thele  fre-
quent returns of it; wliich, joined to their excef-
                       K 2

  t  That U, intothe cavity of the breaf., rather than within the fub-
ft .1  c of the lungs.
  t  This ii, undoubtedly, Baron Van Sweten, with whom he had pie-
mifcd, he agittiUouiiderabiy,  in ail ihc clifcalei ihey had both tieat-
td of.  K. 
**              Of the Tlctirify.

five drinking, make them  languid and ftupid, fit
the very flower of their age.   They generally fall
into fome fpecies of an afthma,, and from  that in-
to a dropfy, which proves the melancholy, though
not an improper,  conclufion of their lives.  Such
as can confine themfelves to feme proper  precau-
tions,, may alfe prevent thefe  frequent returns of
this difeafe, even  without bleeding ;. by a tempe-
rate regimen ;  by abstaining  from time  to time,,
from eating  flefb  and drinking wine ; at which
times they Should drink whey, or  feme of thofe
diet-drinks, N°*  I, 2, 4.  and by bathing their
legs femetimes in  warm water ; especially  in thofe
feafens, when this difeafe is the moft likely to re-
turn.
  \  toi. Two medicines greatly efteemed in this
difeafe among the peafantry, and even  extolled
by feme phyficians, are the blood of a wild he-goat
and the *  foot of an egg. I do not conteft the
cure or recovery of many perfens, who have taken
thefe remedies ; notwithstanding it is not lefs truer
thai both of them  as well as the egg in which the
foot  is taken, are dangerous :  for which reafon it
is prudent, at leaft, never to make ufe of them :
as there is great probability, they may do a little
mifehief; and  a  certainty that they can do no
good. The genipt, or+• wormwood of the alps, has
alfe acquired  great reputation in this difeafe, and
occafioned  many difputes between fome very zea-
lous ecclefiaftics, and  ajuftly celebrated  phyfici-
an.  It feems not difficult however to afcertain the
proper ufe of it.  This plant  is a powerful bitter
it  heats and  excites fweat : it  feems clear,  that

  * This, with great probability, means that fmall  bJack fLbflance of-
ten vifible in a rotten egg, which is undoubtedly of  a violent, or even
poifonous quality.   Dr. TIS.SOT terms it exprefsly.......—-/a fuie dans
unoeuf. K.
  t Dr. Lewis, who has  not taken notice wf this fpecies of wormweod
in his improvement of Qiincy's difpenfatory, has mentioned U in his fcu0
Materia Medica.  K% 
            Of the Difeafes of the  Throat*           St>

 *i*°m fuch conSequences, it  fhould  never be  em-
 ployed in a pleurify, while the veffels are full, tiie
 pulfe hard, the fever high, and the blood inflam*
 ed.   In  all fuch circumflances  it mull aggravate
 the difeafe ;  but  towards  the conclusion  of it,
 When the   veflels  are  considerably emptied, the
 blood is diluted, and the fever  abated, it  may then
 be recurred to ; but with  a  conllant  recollection.
"that it is hot, and  not to be employed without re»"
 flection and prudence.  *
                    CHAP.   VI.

              Of the Difeafes of the Throat.


                    Sect.   102*

      THE throat is fubject  to many  difeafes r one
        of the molt frequent and  the moft  dange-
 rous, is that inflammation of ir, commonly termed
 a quiuley.   This in  effect is a diftemper of the
 fame nature with an inflammation of the breaSt ;
 but as it occurs in a different part,  the Symptoms,
 of courfe, are very cliff.'rent. They  alfo vary, and
 not  a  little, according to the different parts  of
 the throat which are inflamed.

                       H 3

  * This being a proper place for dircfHm* the feneVa rattle fnake root,
 I (hill obf. . c, thai the beft way of exhib ting it is in  deio.ti-m,  by
 f, adually Jlmmeiing md boiling two ounce., of it in grof> powder, in two
 piiUa .md a halfm* watc , to a pmt ond.i quai u ; and then gi.ing thee
 fpoonful;. of it to a grown perfon, e.ery fix Iioj.i.   If the ltc.i fhoj d
 continue, Or reuiui, a'icr taking it. bleeding, which ihould be preinif-
 ed to it, muft be oaafto:ially repeated -r though ii feidoin pro/es neceil'a-
 ry; after a few dofes of it.  It greatly prom .a expect'nut ion, keeps
the body geatly open, aid fome times operates by mine aid by fweat ;
 very feldom pioving at all emet c indecocl.on,  Tiie regimen of dnn.es
diieclcd here in pleurifies are to  be gircn a. ufual,   Dr. T,m:a-ii, tie
 introducer of this vali.abic medium., conlded fo'ely ii i, :n oaitard
peripncuiaonie», without bleediufc-Uliltsjing, oc  a.iy other medicines. K, 
 90       ' Of the Difeafes of the Throat.
   §  103.  The general  fymptoms of an  inflam»
 mation  of the throat are, the Shivering, the fub-
 fequent heat, the fever, the head-ach, red  high-
 coloured urine, a eonfiderabie difficulty, and feme-
 times even an impoflibility,  of fwallowing  any
 thing whatever.   But if the nearefl  parts to the
 glottis, that is, of the enterance into the windpipe,
 or conduit through which we breathe, are attack-
 ed, breathing becomes  exceffively difficult; the
 patient  is fenfible of extreme anguift, and great
 approaches to fufFocation; the difeafe is then ex-
 tended to the glottis, to the body of the wind-pipe,
 and even to the  fubSlance of tlie lungs, whence
 it becomes fpecdily fatal.
   The inflammation of the other parts is attended
 with  leSs danger; and this danger becomes Still
 leSs, as the difeafe is more extended  to the  out-
 Ward and fuperficial-parts.  When the inflamma-
 tion is general, and feizes all the internal  parts
 of the throat, and particularly the tonfils or al-
 monds, as they are called, the uvula, or procefs of
 the palate, and the bafis, or remoteft deepest part
 of the tongue,  it  is one of the moft dangerous and
 dreadful maladies. The  face is then fwelled up
 and inflamed ;  the whole infide of the throat is
 in the fame  condition ;  the patient can get no-
 thing down ; he breaths with a pain and anguifh, ♦
 which concur,  with a Stuffing or obstruction in
 his brain, to throw him into a kind of furious deli-
 rium,  or raving.  His tongue is bloated up, and is
 extended out of his mouth ; his noftrils are dilat-
 ed, as though it were to aflift him in his breathing;
 the whole neck,  even to  the  beginning  of the
breaft, is exceffively tumified  or fwelled up; the
 pulfe  is  very quick,  very weak, and often inter.
 mits: the miferable patient is deprived of all his
 flrength, and commonly dies the fecon•! or third
 day.  Very fortunately this kind, or degree of it,
 which I have often feen in Languedoc, happens very
 rarely in Swifferlandt where the difeafe is lefs vio* 
           Of the Difeafes of the Throat.        pi
lent; and where I have only feen people die of it,
in confequence of its being  pernicioufly treated ;
or  by reaSbn of Sbme accidental  circumftances,
which were   foreign to the difeafe  itfelf.  Of.
the multitude of patients I have attended in this
dilbrder, I have  known but one to fail under it,
whofe cafe I Shall mention towards the dofe of this
chapter.
  \  104. Sometimes the difeafe Shifts from the in-
ternal to the external parts :  the fkin of the  neck
and breaft grows very red,  and becomes painful,
but the patient finds himfelf better.
  At other times the diforder quits the throat, but
is transferred to the brain, or upon the lungs.  Both
thefe translations of it are mortal, when tke bell
advice and affiftance cannot be, immediately pro-
cured ; and it mult be acknowledged, that  even
the beft are often ineffectual.
  § 105. The moft ufual kind of this difeafe is that
which affects only the tonfils (the almonds) and the
palate,, or  rather its procefs, commonly called the
palate.  It generally firft invades one of the ton-
fils, which  becomes enlarged, red and painful,
and does not allow the afflicted to fvvallow, but
with great pain. Sometimes the dilbrder is confin-
ed  to one fide; but moll commonly it is extended
to the uvula, (the palate) from whence it is extend-
ed  to the other  tonSil.   If it be of a mild kind, the
tonlil firfl affected  is generally  better, when the
fecond is attacked.   Whenever they  are both af-
fected at once the  pain, and the  anguiSh of the
patient are  very considerable; he  cannot  fwal-
low, but with great diSfiulty and complaint, and)
the torment of this is  fb  vehement, that 1  have
feen women affected with  convulfions,  as often as
they endeavoured to fwallow their fpittle, or any
other  liquid.  They continue, even  for Several
hours femetimes, unable to take any thing what-
ever ^  all the upper inward part of the mouth, ike 
9»         Of the Difeafes of the Throat.
bottom of the palate, and the defeending part of
the tongue become lightly red, or inflamed.
  A considerable proportion of perfens under this
difeafe fwallow liquids more difficultly than Solids;
by reafon that liquids require  a greater  action of
fome part of the mufeles, in order to their being
properly directed into their  conduit or  chanel.
The deglutition (the fwallowing) of the fpittle is
attended with ilill more unealinels than  that of o-
ther liquids, becaufe it is a little more  thick and
vifeid, and flows down with lefs eaSe.  This diffi-
culty of S wallowing, joined to the quantity thence
accumulated,   produces  that  alinoft   continual
hawking up, which opprefles Sbme patients fo much
the more, as the infide. of their cheeks, their whole
tongue, and their lips are often  galled,  and even
fiead as it were. This alfo prevents their Sleeping,
which however  feems no considerable evil; Sleep
being fotnetimes but of little fervice in difeafes at-
tended with a fever ; and I have often feen thofe,
who thought their throats almoft entirely well in
the evening, and  yet found them veiy bad after
fome hours fleep.
  The fever, in this  fpecies of the difeafe, is fbme-
times very high;  and the Shivering often endures
for many hours.  <It is fucceeded by considerable
heat, and a violent  head-ach,  which yet is Some-
times attended  with a drowfinefs.  The fever is
commonly pretty high in  the  evening, tho' feme-
times but inconsiderable, and by the morning per-
haps there is none at all.
   A light invafion of this difeafe of the  throat of-
ten precedes the ihiveiing ; tho' moft  commonly it
does not become manifeit till  after it, and at the
fame time when the  heat comes on.
  The neck is Sometimes a little inflated,  or puff-
ed up ;  and many of the Sick complain of a pret-
ty fm art pain in the  ear of that fide, which is moft
affedled.   I have but very feldom obferved  that
they had it in both. 
            Of Difeafes of the Throat.         93
   $ io6\  The inflammation either difappears by
degrees, or an abfeeSs is formed in the part which
was  chiefly affected.   It has never happened,  at
Jeajft- within my knowledge, that this fort of the
difeafe,  prudently treated,  has ever  terminated
either in a mortification,  or a fehirrhus :  but I
have  been a witnefs to either of thefe fuperven-
ing, when fweating was extorted in the beginning
of it, by hot medicines.
   It is alfo very rare  to meet with thofe highly
dangerous tranflations of this difeafe upon  the
lungs, Such as are defciibed in that fpecies of it
from  § 103, 104.   It is true, indeed, it does not oc-
cur moi e frequently, even in that fpecies, when-
ever the difeafe is thrown out upon the more ex-
ternal parts.
   § 107. The treatment of the <mnifey, as well as
of all other inflammatory difeafes, is the fame with
that of an inflammation of the breaft.
   The fick is immediately to be put upon a regi-
men ;  and in that Sort defciibed \ 103, bleeding
jnuft  be repeated fbur or five times within  a few
hours ;  and femetimes  ttere is a neceflity to recur
ftill oftner to it.   When it aflaults the patient in
the moft vehement degree, all medicines, all means,
are very generally ineffectual : they  fliould be tried
however.  We fliould igiveas much as.can be tak-
en of the drinks Nc# 2. and 4.    But as the quan-
tity they are able to fwallovv is often very incon-
siderable, the glyfter Nc* 5. Should  be repeated e-
very three hours; and  their legs fliould be put itt-
to a bath of warm water,  thrice a day.
   § 108. Cupping giafies,  with fcarjtfication, ap-
plied  about the neck, after  bleeding twice or
thrice,  have often been experienced to be highly
•ufeful.   In the moft defperate cafes,  when the
neck is exceffively fwelled, one or two deep incifi-
ons made with a lazor, on this external tumour,
have femetimes faved a patient's life.
   § 109.  In that kind, and thofe circumstances, 
94         Of the Difeafes of the Throat.
of this difeafe,  defcribed § 105. we mult have ve-
ry frequent reconrfe to bleeding ; and it Should
never be omitted,  when the pnlie is very perceiy-
ably hard and  full.   It is of  tiie  utmoft confe-
q'lence to do it inllantaneoully ;  fince it  is the
only means to  prevent  the abfeefs, which forms
very readily, if bleeding has been neglected, on-
ly for  a few hours.   Sometimes it  is neceffary to
repeat it a fecond time,  but very rarely a third.
  This difeafe is frequently fo-gen tie and mild, as
to be  cured without bleeding,  by the means  of
much  good management. But  as many as are not
matters of their own time, nor in fuch an eafy fi«
tuation, as to be properly attended, ought, with-
out the leaft hefitation,  to be bled diredtiy, which
is Sometimes fufficient to remove  the  complaint;
efpecially if, after bleeding,  the  patient  drinks
plentifully of the ptifan N • 2.
   In this light degree of the difeafe,  it may Suf-
fice  to bathe the  legs,  and to receive  a glyfter,
once a day each ; the fiift to be ufed in the morn-
ing, and the laft in the  evening.    Befides the ge-
neral remedies  againll inflammations,  a few par-
ticular ones, calculated  precisely for this difeafe,
may be applied in  each  kind or degiee of it.  The
belt are, 1.  The emollient poultices, Nl • 9. laid over
the whole neck.*   Some have highly  extolled the
application  of fwallows  nefts in this difeafe ; and
though I make no objection to it,  I think it cer-
tainly lefs  efficacious than any of thofe which I
direct.
   2. Of the gargarifms, Nr* 19. a great variety
may be prepared,   of pretty much the  fame pro-
perties, and of equal efficacy.  Thofe 1 direct here

  * The Englijb avail themfelves  confiderably, in this difeafe, of a mix-
 ture of equal parts of fallad oil, and fpiiit of fal ammoniac p or of oil
 and fp'rit of hartlhorn, a» a liniment and applicat on round the neck.
 *lhi. remedy correfponds with many indication ; and deferves, perhaps,
 the firft pace amongit local application* a^aiiut Uie imlammatory quia-
 Uy,  E. A. 
           Of the Difeafes of the Throat.         95
are what have fucceeded beft  with me, and they
are very fimple.-f-
   3.  They fleam of hot water,  as directed  § 55;.
fliould be repeated Jive or Six times a day ; a poul-
tice Should be, constantly  kept on, and often re-
newed ; -and the patient fliould often gargle.
  There are feme perfons,  befides children,  who
cannot gargle themfelves: and in fact the  pain
occasioned by it makes  it the more difficult.  In
fuch a cafe, in Head of gargling,  the Same garga-
rifm, (Nc* 19.) may be injected  with  a Small Sy-
ringe.   The injection reaches further than  garg-
ling, and often caufes the patient to  hawk  up a
considerable quantity of glairy matter  (which has
grown ltill  thicker  towards the  bottom of the
throat) to his fenSible relief. This injection fliould
be often  repeated.   The little hollowed pipes of
elder wood,  which all the children in the country
can make, may be conveniently employed for this
purpofe.   The patient fhould breathe  out, rather
than in Spire, during the injection.
   § 1 ro. Whenever tlie difeafe terminates without
fiippuration, the fever,  the head-ach,  the heat in
tlie throat, and the pain in fwallowing, begin to
abate  from the  fourth day,  femetimes from the
third, often only from the fifth ;  and from fuch
period that abatement increafes at a great  rate j
fb that at the end of two,  three, or four days,  on
the fixth,  feventh, or eighth,  the patient is en-
tirely well.  Some few however continue to feel a
light degree of pain, and that only on one fide,
four or five days longer, but without  a fever, or
any considerable unealinefs.
  § 111. Sometimes the fever and the other fymp-
toms abate,  after the bleeding and other  reme-
dies ; without any fubiequent  amendment in the

  t  Dr. Prin.le Is apprehenfive of fome ill effe&s from adds in garga-
rifim, [luhhh is probably jrom their Juppofed repelling property]  and
prefers a deco&ion of figs in milk and water, to wh ch he adds a fmafl
quantity of fpirit of fal ammoniac.  £, j,. 
 p$         Of the Difeafes of the Throat.
 throat, or any Signs of fuppuration.   In fuch cafe*
 we muft chiefly perfill in the gargarifms and the
. fleams ; and where an experienced and dexterous
 fur-eon can be procured, it were proper he Should
 icarify the inflamed tonlils.  Thefe difcharge, in
 fuch cales, a moderate quantity of blood ; ana this
 evacuation relieves, very readily, as many as make
 ufe of it.
   §  11a.  If the inflammation is no ways difpofed
 to difjierfe, fo that an abfcefs  is formiug, which
 almoft ever happens, if it has not been obviated
 at the invafion of the difeafe ; then the fymptoms
 attendiug the  fever continue, tho* raging a little
 lefs after  the fourth day : the throat continues red,
 but of a lefs florid and lively redm-fs : a pain alfe con-
 tinues, tho* lefs acute, accompanied Sometimes with
 pulfations, and at other times entirely without a-
 ny ; of which it is proper to take notice : the pulfe
 commonly grows a little Softer; and on the fifth
 or Sixth day,  and femetimes Sooner, the abfeeSs is
 ready to break. This may be  difeovered by  the ap-
 pearance of a  fmall white and foft tumour, when
 the mouth  is  open, Which commonly  appears a-
 bout the center or middle of the inflammation.  It
 burtts of itfelf; or, fhould it not, it muft be open-
 ed.  This is effected by ftrongly fecuring a lancet
 to one end of a fmall Slick or handle, and envelop-
 ing, or wrapping up the whole blade of it, except
 the point and  the length of one fourth or a third
 of an inch, in fome folds of foft linen ; after which
 the abfcefs is pierced with the point of this lancet.
 The inftant it is opened, the mouth is  filled with
 the difcharge of a quantity of pus, of the moft iu-
 tollerable favour and fmell. The patient Should
 gargle himfelf, after the difcharge of it, with the
 deterfive, or cleanfing gargarifm N°* 19. It is fnr-
 prifing femetimes to fee the quantity of matter
 difeharged from this impoSlhumation.   In  general
 there is but one; tho' fome times I have feen two of
 them. 
         Of the  Difeafes of the Throat.        97
  § II-?. It happens, and not feldom, that the mat-
ter is not collected exactly in the place, where the
inflammation  appeared, but in fome  left expofed
and lels- vifible place;  whence a facility or fwal-
lowing is almoft entirely restored ; the fever abates,
the patient Sleeps ; he imagines he is cured, and
that no inconvenience remains, but fuch as ordina-
rily occurs in the earlielt Stage  of recovery.  A
perfon who is neither a phyfician, nor a furgeon,
may eafily deceive himfelf, when in this State. But
following figus  may enable him to dilcover that
there is an abfeefs, viz.  a certain inquietude and
general uneafiueSs ; a pain throughout the mouth;
Some  Shiveiings from  time to time;  frequently
Sharp, but Short and transient,  heat.; a pulfe mode-
rately feft, but  not in  a  natural State;  a feiifati-
011 of thicknefs ancl heavinefs in the tongue ;
fmall white eruptions on the gums, on the infide
of the cheek,  on the infide and outiideof the lips,
and  a difagteeable talte and odour.
  \  114.  In fuch cafes milk or warm water Should
frequently be retained in the mouth : the vapour
of hot water Should be  conveyed  into it ; and e-
inollient cataplafins may be applied about the neck.
All thefe means concur to the  Softening and break-
ing of the abfeefs.  The finger may alfo be intro-
duced to feel for its fituation, and when discover-
ed, the furgeon may  eafily open it.   I happened
once to break one under my finger, without hav-
ing  made the  lealt effort to  do it.  Warm water
may  be injected  pretty  forcibly,  either by the
mouth or the noltrils :   this femetimes occafions a
kind of cough, or certain efforts  which tend to
break it, and which I have feen happen even from
laughing.   As to  the  reft, the patient fliould not
be too anxious  or uneafy about the event,   i ne-
ver faw a fmglc iuftance of a perfon's dying of a
quinfey of this kind ;  and after the fuppuration h
truly effected ^neither ha, it happened perhaps af-
ter the time it is forming: for fupmiration.
   V01. I.             L 
9?          Of the Difeafes of the Throat.
  \  I if. The glairy matter with which the throat
is over-charged, and the very inflammation of that
part, which, from its irritation,  produces the Same
effect, as the introduction of a finger into it, occa-
fions Sbme patients to complain of inceffant  pro-
pensities to vomit.  We mutt* be upon  our  guard
here, and not fuppofe that this heart-fickneSs, as
feme have called it, rel'ults from a diibrder of, or
a load within,  the Stomach, and that it requires a
vomit for its removal. The giving one here would
often prove a very unfortunate  mistake.  It might,
in a high inflammation, further aggravate it ; or
we might  be obliged  (even during the operation of
the vomit) to bleed, in order to  lefl'en the violence
of  the  inflammation.   Such imprudence with its
bad conSequences, often leaves the  patient, even
after the difeafe is cured, in a State of langour and
weaknefs for a considerable time.   Neverthelefs,
there are  fome particular diforders of the throat,
attended with  a fever, in which  a vomit may be
prudently given. But this can only be, when there
is no inflammation,  or  after is is difjpefpfed ; and
there ftill  remains  feme putrid  matter in the firfir~  '
paflages.  Of fuch cafes I Shall fpeak hereafter. *
  k  116. We often fee in Swifferlandau diibrder dif- ' '
fcrcnt from thefe of the throat, of which we have
jull treated ; tho' like thefe,  attended with a dif-
ficulty of fwallowing.   It is termed  in French the
Oi eilions,  and often the Ourles, or fwelled ears.  It
2s an overfulnefs and  obstruction of thofe glands
a.-.;:! their tubes,  which  are to furnifh the fativia or
i'oittle;  and particularly  of the two large glands
which lie  between the ear and the jaw, wliich are

  '* In difeafes of the throat, which have been preceded by fuch exccfTes
,-if Ovt or ftrong drink, as occur too often in many countries, when tr.e
' ;''.«.nt has very ftrong reaching} to vomit, and the tongue  is moift at the
fame t -ne ; we lbou'd not heflitrr, after appealing  the firft fymptoms
of the inflammation [by furficient  betdiiv, ,  err.] to affiil the efforts of
rnare and to give a final! dofe of tartar emetic, diJlblved in fome fpoon-
j "is- a; \va;cr.  Thu remedy in this cafe, promotes the difperfion of the
'\?.j.:...-.i.:'ion, beyond an) ctLc.  E. L. 
          Of the Difeafes of the Throat.          po
called the parotides ; and of two  under the jaw,
called the maxillares.   All thefe being considerably
fwelled iu this difeafe, do not only produce a great
difficulty of fwallowing, hi.t alio pret cut the mouth
from opening; as an attempt to do it is attended
with violent pain.  Young children r.ie much more
liable to tiiis difeafe than  grown perfons.   Being
feldom attended with a fever, there is no occaliou
for medicines:  it  is fiiificient to defend the  parts
affected from the external air; to apply Some pro-
per poultice over  them ; to lelfeii the quantity of
their food  considerably, denying them flefh and
wine ; but  indulging them plentifully in  feme
light warm  liquid, to dilute their humours and re-
store perfpiration.  I cured myfelf of this difbidcr
in 1754, by drinking nothing,  for four days,  but
bawm tea, to which I added one fourth part milk,
and a little bread.  The Same  regimen has often
cured me of other light complaints of the throat.
   §  11 7. In the fpring of 1 76 j, there were an a-
flonithing number of perfons attacked with difor-
ders of the throat, of two different kinds.  Some of
them were feized  with that common Sort which I
have already defcribed. Without adding any thing
more particularly, in refuect to  this Species, it hap-
pened frequently to grown perfons, who were per-
fectly cured by the method already recited.   The
other fpecies, on which I fhall be more particular in
this place (becaufe I know they have abounded in
fome villages, and were very fatal) invaded adults,
or  grown peifbns, alfo ; but especially children,
from the age of one year, and even under that, to
the age of twelve or thirteen.
   The firft  Symptoms were the fame with  thofe
of the common quinfey, fuch as the Shivering, the
enfuing heat or fever, dejection, and  a complaint
of the throa* : but the following fymptoms diftiii-
giifhed thefe from the common inflammatory quin-
fey s.
                     L  2 
100         Of the Difeafes  of the Throat.
  t. The fick had often fometbing of a cough, and
a little oppreffion.
  2. The pulfe was quicker, but lefs hard, and lets
Strong, than ulually  happens in difeafes of the
throat.
  3. The  patients were afflicted with  a Sharp,
flinging  and dry heat,  and  with  great  rcftlels-
neffs.
  4. They  Spat  1. is  than is  ufual  in  a common?
quinfey ;  and their tongues were extremely  dry.
  5. Though they had feme pain 111 f a allowing,
this v-ar»  not the principal complaint, and  they
could drink Sufficiently.
  6. Tlie ■ Swelling andi redncfs of the tonfils, of the
palate, and of its procels were not eonfiderabie ;
but  the parotid'and maxillary glands,  and especi-
ally the former, being  extremely fwelled and in-
flaiu'-ci, the pain th?y ehiclly  comphiiiied of,  was
.in-, o.itward one.
  7. When the cii;i\ife proved confiderably danger-
ous, t!ie whole neck  f.v.eiled ;  and Sometimes even
-.he  veins, which return the blood from the train,
bei'.Tg  overladen, a1; it were, tV-  fick had fome de.-
trree «>i die-ivihic-ls, and of a delirium, or raving.
  i. The o-ivoxyfins,  or returns, of the fever were
t c n ileI tr ; v. b I y i 1 reg u la 1 ■.
  0. The urine appeared to be lefs inflamed, than
iu c< fiier difeafes of the throat.
   to. Bleeding and other medicines did not relieve
them,  as ibon as in  the other kind ; and the dif-
eafe itfelf continued  a  longer  time.
   11.  It did not  terminate in a Suppuration like o-
ther quinfeys,  but femetimes the tonfils were  ulce-
rated.
   12.  * Almoft  every  child,'  and indeed a  great
many  of the grown perfons allaulted with this diS-
e.ue, threw out, either on the firft day, or on fome

  •  This f-.sems to have been the fame kind of qiinfey,  of whicjh D».
 Huxhiim, Fothergi', L<.-::;>:, aud others wrote,  tho' under different  a^«
 pcllatioin.  -S--             T 
         Of the Difeafes of the Throat.         104
fucceeding one, within the Sit ft fix days, a certain
eSnoreScence, or eruptions, refembling the mealies
considerably  in feme, but of a lefs  lively colour,
and without any  elevation, or riling  above the
fkin.   It appeared firSl  in  the *ace, next in the
arms, and defeended to the legs, thighs and trunk ;
difappearing gradually at the end of two or three
days, in the fame order it had obferved in breaking
out.  A few others (I have  feen but five inltances
of it)  fullered  the moft grievous  fymptoms before
the eruption ; and threw out the genuine purpura,
or white miliary eruption.
  13. As Soon  as  thefe efflorefeence or eruptions
appeared, the fick general y found themfelves bet-
ter.   That, laft mentioned, continued four, five,
or  fix days,  and  frequently  went off' by fweats.
Such as had not thefe ebullitions, which was the
cale of many adults, were not cured without very
plentiful  Sweats  towards the termination of the
difeafe :  thofe  which occured at the invafion of it
being certainly unprofitable, and always hurtful.
   14. I have feen  Some patients, in whom the com-
plaint of the throat, difappeared entirely, with-
out  either eruption or fweats: but fuch  Slill re-
maine ! in very great inquietude and anguifh, with
a quick and fmall pulfe.  I ordered them a Sudori-
fic drink,  which being Succeeded  by the eruption,
or  by fweating, they Sound themfelves fehlibly
relieved.
  15. But whether the fick had, cr had not, thefe
external rednefies  or eruptions, every one of them
parted with their  cuticle or fearft'fkin, which tell
ofF, in large fcales, from the whole furface of the
body; fo p eat was the acrimony  or  fharpnefs of
that matter, which was to be difeharged through
the fkin.
  • 6. A great number fuffered a fingular  alterati-
on in (heir voice, different from that which cccurs
in common quinfeys, the infides  pf their nollrils
being extremely dry.
                      I. 5 
 102        Of the Difeafes of the'Throat.
   i 7. The fick recovered with more difficulty after
 this,  than  after the common  quinSeys :  and if
they were negligent or irregular, during their re-
covery ;  particularly, if they expoied themlelves
too fbon  to the cord, a relapfe enS'ued, or feme dif-
ferent fymptoms; inch as  a fluffing with oppreffi-
on, a Swelling of the belly, windy fwellings  in
different parts ;  weaknels, loathings, ulcerations
behind the  ears, and fomething of" a cough and
hoarfenefs.
   i&. I have been fent for to children, and alfe to
feme  young  folks,  who,  at  the  end  of Several
weeks, had  been  taken with a general inflamma-
tion of the whole body, attended  with  great op-
preffion,  and a considerable abatement of their  u-
rine, which was alfo high coloured and  turbid,  or
without feparation.  They Itemed  alfb  in a very
lingular  State of indifference, or  ditregard, with
rel'pedl to any object,, or circumstance.   I recover-
ed every  one of them entirely by blifters, and the
Powder N1* 25. The  firlt  operation  of this medi-
cine was to  vomit them ;. to this fucceeded a dif-
charge by urine,  and at laft very plentiful  fweat-
ing, which  tompleated the cure.   Two patients
only, of a bad eonftitution, who were a little ric-    j
ketty,, and  difpofed  to glandular fchirrhofky  or
knottinefs, relapled and died, after being recover-
 ed of the difeafe  itfelf for  fome days.
   §  118. I have bled  fome adult  perfons, and
made uSe of the cooling regimen,  as long as there
Was an evident inflammation : it was neceffary af-
ter this, to unload the firft paSfages ;. and at laft to
excite moderate Sweats. The fame powders Nc* 2 J.
have  oS'ten  effected  both   thefe discharges,  and  ,
with entire fuccefs. In other caScs I have made ufe
of ipecacuanha, as diredted Nu*  35.
   In feme fubjects there did not appear any in«
f.ammatory  fy inptom ;  and the diftemper refulted
folely from a load of putrid matter in the firlt pal-   ,
fages.  Some patients alfo discharged worms.   la 
           Of the Difeafes of the Throat.        103
fuch cafes I never bled ;  but the vomit had an ex-
cellent effect, at the very ontet of the difeafe ; it
produced a perceivable abatement of all the fymp-
toms ; fweating enfued  very kindly and natural-
ly, ancl the patient recovered entirely a few hours
after.
  § 119.  There were feme places,  in which  no
fymptom or character of inflammation appeared  ;
and in which it  was neceffary to omit bleeding,
which was attended  with bad conSequences.
  I never directed infants to be bled. After open-
ing the firlt paSfages, Witters, and diluting drinks,
proved their only remedies.  A Simple infufion of
elder flowers, and thofe of the lime tree, has done
great fervice to thole who drank  plentilully of it.
  § I2Q.  1 am fenfible that in many villages a great
number of perSbns have died, with a prodigious in-
flation or Swelling of the neck.   Some have alfe
died in the city, and among others a young woman
of twenty years  of  age,  who had taken nothing
but hot  fweating medicines and red wines, and
died the fourth day, with violent fuflbcations, and
a large discharge of blood from the nofe.  Ot' the
great number I have Seen in perSbn, only two died.
One was a little girl of ten months old.   She had
an efflorefcence which very Suddenly disappeared  :
at this time I was called  in ; but the humour had
retreated to the brealt, and tendered her death in-
evitable.  The other was a ftrong youth from fix-
teen to feventeen years old,  whole Sudden attack
from the dileale manifested, from tlie very begin-
ning,  a  violent degree of it.   Nevertheless, the
fymptoms fubliding,  and the fever near]} termi-
nating,  the fweats which approached would pro-
bably  have  faved him ;  but he would not fufiier
them  to  have their  courfe, continually  Stripping
Iiimfelf quite naked.  The inflammation was im-
mediately repelled upon the lungs, and dellroyed
liim within the (pace of thiity hours.  1 never law
a pei ion die with lb very dry a fkin.  The vomit 
104       Of t^e Difeafes of the Throat.
affected him very little upwards, and brought on a
purging.  His own bad conduct feems to have been
the occafion of his  death :  and  may this Serve as
one example of it.
   § 121.  1 chofe to expatiate on this difeafe, as it
may happen to  reach other places,  where it may
be ufeful to have been apprifed of its  marks, and
of its treatment,  which agrees as much with that
of putrid fevers,  of which I Shall Speak hereafter,
as with  that of the inflammatory  difeafes  I have
already confidered : Since in Sbme fubjects the com-
plaint of the throat has evidently been a Symptom
of a putrid fever, rather than of the chiefly  appa-
rent difeafe, a quinfey.f             i^
   § 122. Diforders of the throat are, with reSpect
to particular perfons, an  habitual diSeafe returning,
every year, and fometines oftner than once a year.
They may be prevented by the fame means, which
I have cliredted  for the prefervation from habitual
pleurifies § roo.  and by defending the  head and
neck from  the cold ; efpeciall\  after being heat-
ed by  hunting, n any violent exercife, or even by
finging h>n}> and loud,  which may be  confidered
as an extraevdinary exercife of fomepaits affected
in this difeafe.

  t I referve fome other interefling reFrcVons on this difeafe, for the
fecond td lion of my treatife on fevers; and the editor at Pan's has ve-
ry well obferv- d, that it i.a^ f rre itlation to the gangrenous fore iluoat,
js'l.ich hai b en epkkmi, :il tlefe twenty years pall, in many paiti %S
Hurope.—TnU note is from Dr. T1SSQT himfelf. 
Of Colds.               105
                CHAP.  VII.
                    Of Colds.

                 Sect.  123.
     THERE are many erroneous prejudices, with
       regard to colds,  all of which may be at-
tended with pernicious  confequences.  The firft
is, that a cold is never dangerous;  an error which
daily deftroys the lives of many.   I have  already
complained of it for many years paft ; and 1 have
lince beheld a multitude  of fuch examples of it,
as have  but too fufliciently warranted  my com-
plaints.
  No perfon, however, it  is certain,  dies merely
of a cold, as long'as it is nothing  but a cold lim-
ply ;  but when,  from inattention  and neglect, it
is thrown upon, ancl  occafions diflempers of* the
breaft^ it may, z.;.A often does, jiv.ve iv.viicil., Gotdr
defray mote than plagues,  was the anfwer of a very
Sagacious and experienced phyfician to one of his
friends,  who, being afked, how he was in health,
replied,  Very well,  1 have nothing but a cold.
  A fecond erroneous prejudice is,  that colds re-
quire  by no means, no medicines,  and that they
laft  the  longer for being nurfeel, or  tampered
with.   The fall article  may be true indeed with
refpedt to the" method, in which the perfon affect-
ed  with  them treats  them ;   but the  principle
itfelf is  falfe.  Colds, like other diforders, have
their proper  remedies ;  ancl  are  removed with
more or lefs facility, as they are conducted better
or wor-fe.
  § 1:4.  A third miftake is, that they are not on-
ly confidered as not dangerous,  but are even fup-
pofed wholefome too.  Doubtlefs a man had bet-
ter have  a cold than a, more grievous difeafe ; tho*
it muft be Still  better to have neither of them.
The mpft that can be reasonably faid and admitted 
106                Of Colds.
on this point, is, that when a checked, or an ob«
ftrudted perforation becomes  the  caufe of a dif-
temper,  it is fortunate that it produces rather  a
cold, than any very dreadful difeafe, which it fre-
quently does : though it were to be wifhed,  that
neither the caufe, nor its effect, exilted.   A cold
conllantly produces feme diforder or defect in the
functions of feme part or parts of the body,  and
thus becomes the caufe of a difeafe.   It is iudeed
a real diferder itfelf, and which,  when in a vio-
lent degree,  makes a very perceivable affault up-
on our whole machine.  Colds, with their deftuxi-
ons, considerably weaken the  breaft,  and fooner
or later considerably impair the health.   Perfons
fubject to frequent colds are never robull or ftrong;
they often fink into languid diforders ;  and a fre-
quent aptitude to take cold is a proof,  that their-.
perfpiration may be eafily checked and restrained f'
whence the lungs become opprefled and obstruct-
ed, which muft always be attended with eonfider-
abie danger.
  § 125.  We may be convinced of the weaknefs
and fallacy of thefe prejudices, by considering at-
tentively the nature of colds ;  which are  nothing
elfe than the very difeafes already defciibed in the
three preceding chapters, though in their  greatest
degree only.
  A cold in truth is almoft conllantly an inflam-
matory difeafe;  a light inflammation of the lungs,
or of the throat ; of the membrane, or very thin
fkin, w hich  lines the noltrils,  and the infide  of
certain cavities in the bones  of  the cheeks and
forehead.  Thefe cavities  communicate with the
nofe,  in fuch a  manner, that when one  part  of
this membrane  is affected with an inflammation,
it is eafily communicated $p the other parts.
  § t2/>.  It is  Scarcely necelfary  to defcribe the
fymptoms of a  cold, and it may be Sufficient  to
rem-irk,  I.  f hit their c lief caufe  is the Same with
that,  which, moft commonly produces the difeafes 
                    Of Colds.               107
already treated of, that is, an obstructed perfpira-
tion, and a  blood  Somewhat inflamed.   2. That
Whenever thefe diieafes affect great numbers, ma-
ny colds prevail  at the  fame time.  3.  That the
fymptoms whicli  manifest a violent cold,  greatly
relemble thole which precede or ufher in thefe dif-
eafes.   People are rarely attacked by great colds,
without a (hivering and fever;  wliich lafl feme-
times continues for many days.  There is a cough,
a dry cough, for feme time ; after which fome ex-
pectoration enfues, which allays the cough, and
lightens the oppreSfion ; at which  time the  cold
may be Said  to be maturated, or ripe.  There are
pretty  often flight Stitches,  but unfixed or fly-
ing about,  vrith a little complaint  of the throat.
,When the noftrils happen to be the feat of the dif-
>*rder, which is then very improperly termed a cold
of the brain, it is often attended with a vehement
head-ach, that femetimes depends 011 an irritation
of the membrane, which  lines the cavities in the
bone of the forehead, or the maxillary finuiles,
that is, the cavities in the jaws.   At SirSl the  run-
ning from the nofe is very clear,  thin and Sharp ;
afterwards,  in proportion to the abatement of th»
inflammation, it becomes thicker ;  and  the  co.
fiflence and  colour of it refemble thofe of what o-
thers cough  up.   The fmell, the tafte and the ap-
petite are commonly impaired by it.
   § 127.  Colds feem to be of no certain duration
or continuance.   Thofe of the head or brain ge-
nerally laft but a few days ; of the breaft longer.
Some colds neverthelefs terminate  in four or five
days.   If they extend beyond this term they prove
really hurtful.   1. Becaufe the violence  of the
cough diforders the whole machine ; and particu-
larly, by forcing np the blood to the head.  2. By
depriving the perfon afflicted of his ufual Sleep,
which is almoft conllantly diminished by it. 3. By
impairing the appetite,  and confuting the d'xgef-
tion, which  is unavoidably leflened by it.  4. By 
roS                   Of Colds.
weakening the very lungs, by the  continual agi-
tation from coughing; whence all the humours,
which grow vifeid there ;  the refpiration is over-
loaded and opprefled ; a Slow fever appears ;  nu-
trition almoft  ceafes; the patient  becomes  very
weak i finks into a wafting, an obSlinate wakeful-
ness and anguifh, and often  dies in a Short time.
5. By reafon that  the fever, which almoft  con-
stantly accompanies great cold, concurs to wear
the body down.
   §  128. Wherefore, fince a cold is  a difeafe of the
fame kind with quinfeys,  peripneu-monies and in-
flammations of the breaft, it ought-to be treated in
the fame manner. If it is a violent one, blood fhould
be t.^keu from the arm, which  may coniiderably
fhorten its duration :  ancl this becomes more ef-
fentially  neceffary,  whenever  the patient is ojf"
a  fanguineous ruddy  complexion, abounds  with
blood, and has a Strong cough, and  great head-ach.
The drinks N°*  1,  2,  3, 4, fhould  be very plenti-
fully ufed.   It  is  advantageous to bathe the feet
in warm water every night at going to bed.*  In a
word, if the patient is put into a regimen, the cure
is very Speedily effedted.
   § 129. The diibrder indeed, however, is often So
very Slight,  that it may be thought to require very
little, ■ if any,  medical treatment, and  may be
eafily cured without phytic, by abstaining from
flefli,  eggs,  broth, and wine ; from all food that is
fharp, fat and heavy ; and by dieting upon bread,
puis,  fruit,  and water; particularly by eatiug lit-
tle  or no fupper;  and drinking, ifthirfty, a Sim-
ple ptifan of barley,  or  an infiifion of elder flow-
ers, with the  addition of a third or fourth part of
milk.  Bathing the feet, and the  powder  N°. 20.

   *  It fiequently happens, that the bathings alone remove the head-ach,
 and the cough too, by relaxing the lower part?, and the, entite fuifir.e of
 the body.  If the patient  is collive, he fhould teceive gly iters of warm
 water, in which fome bran has been boiled,  with the addition of a l.ttie
 common foap or butter. £■ L. 
                      Of Colds.                  100

 contribute to difpofe the patient to fleep.  Five
 tea cups of an infufion of the red, or wild poppy
 loaves may alfe be ventured on Safely.
    §  130. When the fever, heat and inflammation
 wholly difappear; when the  patient  has kept to
 his regimen for  feme days, and his blood is well
 diluted, if the cough and want  of fleep ftill con-
 tinues, he may take it in the  evening a dofe  of
 llorax * pill, or of Venice treacle with elder flow-
 er tea,  after bathing his feet,   Thefe remedies
 by Hilling the cough, and refloring perfpiration,
 frequently cure the cold in the  Space of one night.
 I confefs at the fame time, I have feen bad confe-
 quences from fuch opiates, when given too  early
 in the complaint.   It is alfe neceffary, when they
 are given, that the patient fliould  have fupt but
 "Very  moderately,  and that his  fupper  fliould be
 digelled
    §  131. An immenfe number of remedies are cri-
 ed up for the cure of colds ; fuch as ptifans of ap-
 ples or pippins,   of liquorice,  of dry  raifins,  of
 figs,  of  borage,  of  ground-ivy,   of veronica  or
 fpeedwell, of hyfop,  of nettles,  ire.  ire  I have
 no defign to  depreciate them;  as all of them may
 polfibly be ufeful: but  unfortunately, thofe who
 have feen any particular one of them fucceded  in.
 one cafe, readily  conclude it to be the moft excel-
 lent of them all;  which is a  dangerous error, be-
 caufe no  one cafe is a fufficient foundation to de-
    Vol.  I.             M

   * Under thefe circumftances of a tickling cough from a cold, without a
 fever,  and v/ith very little inflammation,  I have  known great and very
 frequent fuccefs,  from a  dofe of elixirpare.(orUum, taken at bed-time.
 after a very light thin fjpper.  If the parent be fanguine, ftrong and
 <_oftive, bleeding in a fuitabie quantity, and a gentle opening potion, or
■ purging glyfter, may be prudently premifed to it.  Grown perfons may-
 take from 30 to 80, or even 100 drops of it, in barley watt", or any o-
 t.1:./pectoral drink; and children i;i the chincough from five to  twenty
 drops ; h.ilf an ounce of it by meafure en uaininR about one grain of opi-
 um, which is the quantity co.itained  in lefs than quite fix grain; of  tlrs
 ftorax pill; this laft bcinga very available pectoral opiate 100 in l,\.,,.'i.
 from a di.'iilation, in more adult bodies, who puy alfo pref:r a ntr'i
 cine iu that fmall fizc, and form.  K. 
 xio                Of Colds.
 cide upon : which befides none are qualified to do,
 who have not often feen a great  number of fuch
 cafes ;  and who do not  So  attentively obServe the
 effects  of different medicines,  as to determine on
 thofe whicli moft frequently agree with the difor-
 der and which, in my j udgment, are thofe I have juft
 enumerated.  I have known a  tea or infufion of
 cherry ftalks, which is not a difagreeable drink, to
 cure a  very inveterate cold.
   §  132. In colds of the  head or brain, the fleam
 of warm  water alone, or that  in  which elder
 flowers, or Sbme other mild aromatic  herbs, have
 been boiled, commonly affords  a pretty Speedy re-
 lief.  Thefe are alio Serviceable in colds fallen on
 the breafi.   See \  5 5.
   It has been a  practice, though of no very long
 ftanding, to give the fat of a whale in thefe cafes^.
 but this is a very crude indigeftible kind  of fat,
 and greafy oily medicines feldom agree with colds.
 Befides, this whale's fat  is  very diSagreenble and
 rancid, that is rank ; fe that it were better to for-
 bear  ufing it:  I have  femetimes  feen ill  effects
 from it, and rarely any good ones. *
   §  133.  Such perfons as abate  nothing of the u-
 fual quantity of their food,  when Seized  with  a
 cold, and who fwallow down large  quantities of
 hot  water,  ruin their health.   Their digeftion
 ceafes; the cough begins to  affect  the Stomach,
 without ceafing to afflict the breaft :  and they in-
 cur a chance of  finking  into  the condition  de«
fcribed  § 127, Nc# 4.
   Eur-nt brandy  and fpiced wine are  very perni-
cious in the beginning of colds, and the omiffion
of them mull be a very prudent omiffion.  If any

  » This feems but too applicable to the very popular afe offpermaceti,
ftc. in fuch tafef, whh:h can o.ily  greafe the  pafTage to the  ftomach;
muft impair itsdigeftivc faculty, and cannot operate aj»ainft the caufe of
a i old;  tho* that the curs of it, which i-> <■ rr'c&ed by the oeconomy of
nature indue time, is often afcribed to fj;':. rsudi.incs, »i may rathei
bave retarded it.  K. 
                     Of Colds.               m
 good effects have  ever been known to attend the
 ufe of them, it has been  towards the going off'of
 the cold ;   whtn the diibrder maintained  its
 ground, Solely from the weaknefs of the patient.
 Whenever this is  the cafe, there is not the leail
 room  for  faither relaxation :  but the  powders
 N°* 14.  fhould be taken  every  day  in  a little
 wine; and  lhould the humours Seem likely  to be
 thrown upon the lungs, blisters ought to  be appli-
 ed to the flelhy part of the legs.
   § 134. Drains, or liqueurs, as they are called in
 French, agree fo very little in this laft State, that
 frequently a very  fmall  quantity of them revives
 a cold that  was juft expiring.  There really are
 feme perfons who  never drink them without tak-
 ing cold, which is not to be wondered at, as they oc-
 casion a light inflammation in the breaft, which is
 equivalent to a cold or distillation.
   Neverthelefs, people in this diforder Should not
 expole themfelves to violent cold weather, if there
 is a poffibility of avoiding it : though they  fhould
 equally guard too againll exceflive  heat.  Thofe,
 who inclofe themfelves in  very hot rooms, never
 get quite cured ;  and how is it poffible they Should
 be cured in Such a fituation ?  Such  rooms, ab-
 ftradled from the danger of coming out of them,
 produce colds in the fame  manner that drams do,
 by producing a light inflammation in the breaft.
   §  135. Perfons Subject to frequent colds,  which
 habits  are Sometimes termed fluxionary, or liable to
 distillations, imagine, they ought to keep  them-
 felves very hot. This is an error  which thorough-
 ly  deflroys their  health.   Such a difpofition to
 take cold  arifes from two caufes :  either becaufe
 their perSpiration is eafily impaired : or Sometimes
from the weakneSs  of the  Stomach or the  lungs,
 which  require particular  remedies.   When the
 complaint arifes from the perforation's being ea-
 fily diflurbed and  leffened,  the hotter  they keep
 themfelves,  the more they  fweat,  and  increafe
                   M 2 
 lis                  Of Colds.
 their complaint the more.  Thisinceffivntly warm
 air lets  down  and weakens  the  whole machine,
 and  more particularly the lungs ; where the hu-
 mours finding lefs refiftance, are continually de-
 rived, and are accumulated there.  The fkin, be-
 ing conllantly bathed in a fmall  fweat,  becomes-
 relaxed, Soft,  and incapable  of compleating its
 functions : from which failure the flightelt. caufe-
 produces a total  obstruction of perfpiration ; and
 a multitude of languid diforders enfue.
   Thefe patients thus *circumftanced,  redouble
 their precautions againSt? the cold, or  even the
 coolnefs of the air, while  their  utmoft  cautions
 are but fb many effectual  means  to lower  their
 health ;  and  this  the  more certainly,  as  their
 dread of the free air neceflarily fubjedts  them to
 a fedentaryjife, which increafes all their fymtoms ;
 while the hot drinks they indulge in  com pleat
 their Severity.   There is but one method to cure
 people  thus Situated ;  that  is,  by accuftoming
 them gradually to the air;  to keep them out of hot
 chambers ; to leflen their cloathing by degrees ;
 to make them  Sleep cool ;  and to let them eat or
 drink nothing but. what is  cold, ice itfelf being
 wholefome in their drink : to make them ufe much
 exercife  : and finally, if the diforder be inveterate,
 to give them for ft eonfiderabie time  the powder
 Nc* 14, and make  them ufe the cold bath.  This
 method fucceeds equally too with thofe,  in whom
 the difeafe originally depended on a weaknefs of
 the Stomach, or of the lungs : and in fact, at the
 end of a certanin  period,  thefe three  caufes are
 always combined.   Some perfons  who have  been
fubject, for many years,  to catch colds  through-
out the winter ,  and who,  during that fealbn,
never went out, and drank  every thing warm,
have been  evidently the bettei> during the wint-
ers of 1761, and 1762, for the directions  I  have
given here.  They  nov«r  walk  out every day ; 
         Of the Difeafes  of the Teeth.          113
drink their liquids cold ; and by this means en-
tirely  efeape   colds, and enjoy perfect  health.
  §  136. It is  more cuftomary  indeed in town,
than  in the country, to have  different troches,
and compositions in'the  mouth.  I am not for ex-
cluding this habit ; though I think nothing is fb
efficacious as juice of liquorice ; and provided a
fufficient dofe be  taken, it affords certain relief. I
have taken an ounce and an half in one day,and have
felt the good conSequences of it very remarkably.
                CHAP.  VIII.
            Of the Difeafes of the Teeth.

                 Sect.  137.
      TH E difeafes of the teeth, which are femetimes
      fo tedious and fb violent, as  to  caufe oblli-
 nate wakefulness, a eonfiderabie degree of fever,
 raving,  inftamniations,  abcefles,   rottennefs  of
 the bones, convulsions  and  faintings,  depend on
 three principal caufes.  1. On a caries or  rottennefs
 of the teeth.  2. On an inflammation of the nerves
 of the teeth,  or of the membrane  whicli  in veils
 and covers them ;  and wliich affects the membrane
 of the gums.   3. A cold humour or defluxion that
 is determined to the teeth, and to their nerves and
 membrane.
   §  1 38. In tlie firft of thefe cafes,  the caries hav-
 ing eat  down  to, and expofed the naked  nerve, the
 air,  food and drink irritate, or, as it were, ftino
 it; and  this irritation is attended with pain more
 or lefs violent. Every thing that increafes the moti-
on or action of the affected part, as exercife, heat, cr
food, will be attended with the fame confequence.
   When the tooth is grearly decayed, there is no
•ther cure befides that by  extractiug it, without 
 114       Of the Difeafes of the Teeth.
 which the pain continues ; the breath becomes ve-
 ry offensive ; the gum is eat down ; the other teeth,
 and femetimes even the jaw-bone,  are  infected
 with the rottennefs : befides that it  prevents the
 ufe of the other teeth, whic'i are infeSted with a
kind of tartarous matter, and decay.
  But when the diibrder is lei's considerable, the
progrefs of it may  femetimes  be restrained,  by
burning the tooth with a hot iron, or by filling it
with lead, if it is fitted to receive and to retain it.
Different corroding  liquids are fbmetimes uSed on
thefe occasions, aqua fortis itfelf,  and fpirit of vi-
triol :  but fuch applications are highly dangerous,
and ought to be excluded.  When  the patients,
from dread, reject the operations juft mentioned,
a little oil of cloves  may be  applied, by introdu-
cing a fmall pellet  of cotton,  dipt  in it, to the
rotten hollow tooth ; which often  affords eonfider-
abie eafe, and refpite.  Some make uSe of a tinc-
ture of opium, or laudanum, after the fame man-
ner ; and indeed thefe two medicines may be ufed
together in equal quantities.  I have often fuc-
ceeded  with  Hoffman's mineral anodyne liquor j
which feemed indeed for a few moments, to en-
creafe the pain ;  but eafe  generally  enfues aSter
fpitting a little time.  A gargarilin made of the
herb argentina, that is Silver-weed  or wild tanfey,
in water, frequently appeafes the pain that refults
from a caries  of the teeth :  and in fuch cafes many
people have found themfelves at eafe, under a con-
stant ufe of it.  It certainly is an application that
cannot hurt,  and is  even beneficial to the gums.
Others have been relieved by rubbing their faces
over with honey.
  §  139. The fecond caufe is the inflammation of
the nerve within the  fubStance, or of the mem-
brane on the  outfide, of the tooth.  This is difeo-
vered by the patient's temperament, age and man-
ner of living.  They who are  young, Sanguine,
who heat themfelves  much, whether by labour, by 
          Of the Difeafes of the Teeth.        tte
their food, their drink, by fitting up late, or by
any other excefs : they who have been accuftomed
to any difeharges or eruptions of blood,  whether
natural or artificial, and who ceafe to have  them
as ufual, are much expofed to the tooth-ach, from
this caufe.
   This pain, or rather torment, if in an acute de-
gree, commonly happens very fbddenly, and often
after feme heating caufe.  The pulfe is ftrong and
full; the countenance considerably red ; the mouth
extremely hot: there is often a pretty high fever,
and a violent head-ach.  The gums, or fome part
of them become inflamed, fwelled, and femetimes
an abfeefs appears.   At other times  the  humours
throw themfelves upon the more external parts j
the cheek fwells, and the pain abates.  When the
•heek fwells, but without any diminution of the
pain, it then becomes an augmentation, but no ef-
fential change, of the diibrder.
   §  140.  In this fpecies of the  difeafe,  we muft
have recourfe to the general method of treating
inflammatory diferders,  and directing  bleeding,
which often produces immediate eafe, if perform-
ed early.  After bleeding the  patient Should gargle
with barley water,  or milk and water;  and apply
an emollient cataplafin to the cheek. If an abfeeSs
or little impofthurtie appears, the  Suppuration or
ripening of it is to be promoted, by holding con-
tinually in the mouth Sbme hot milk, or  figs boil-
ed in Some milk :  and as foon as ever it Seems ripe,
it fliould be opened,  which  may be done eafily,
and without any pain.  The diforder,  when de-
pending on this caufe, is femetimes not fo violent,
but of a longer duration, and returns whenever the
patient heats himfelf; when he goes to bed ; when
he eats  any heating food, or drink, wine or cof-
fee.  In this cafe, he Should  be bled, without which
his other medicines will have little effect;, and he
fhould bathe his feet in warm water for feme even-
ings fucceSfively,  taking one dofe of the powder 
U6          Of the Difeafes of the Teeth.

N°. 20.  Entire abstinence from wine  and  meat,
efpecially  at night,  has cured Several perfons of
inveterate and obltinate maladies of the teeth.
   In this fpecies of tooth-ach, all  hot remedies are
pernicious ;  and it often happens  that opium, Ve-
nice treacle, and llorax pills,  are fo far from pro-
ducing the relief expected from  them, that  they
have aggravated  the  pain.
   §  141. When the difeafe arifes  from a cold dif-
tillation, or  humour, tending to  thefe parts, it is
commonly (tho'  equally painful)  attended  with
lefs violent fymptoms. The pulfe is neither ftrong,
full nor quick ; the mouth is lefs heated,  and lefs
fwelled.  In Such cafes, the afflicted Should be purg-
ed with the  powder Nc* 21.  whicli has  femetimes
perfectly cured very  obltinate complaints  of this
fort.  After purging  they fliould  make ufe  of the
diet  drink of the woods N°* 22.  This  has cured
tooth-achs, which have  baffled other attempts for
many  years ;  but  it mull be  added, this  drink
would  be  hurtful in  the  difeafe  from a different
caufe.   Blillers to the nape of the  neck,, or* elfe-
where, it matters not greatly where,  have often
extraordinary good effects, by diverting the hu-
mour,  and relloring  a  compleat  perfpiration. In.
Short, in this fpecles,we may employ, not only with
fafety, but with fuccefs  (especially after due purg-
ing) pills of florax, opium and Venice treacle. A-
crid Sharp remedies,  fuch as hard-fpun *  tobacco,

  •* A fmall blifter behind the ear of the affected flde,or both ears, has
tc-.y often removed the pain,  when fiom a defluxion.  It is pretty com-
mon  for  the fubjects of this difeafe to be very coftive, daring the
exacerbations of it, which I have fometimes experienced to be pretty re-
gjlarly aid feverly quotidian, for a week or two. The cuftom  of fmoak-
nig tobacco very often, whii-h  the vehemence of this pain has fometimes
introduced, often difpofes to a blacknef,  and premature decay of tha
teeth, to  which the chewers of it feem lefs obnoxious : and this differ-
ence may  refultfrom fome particles of its chemical oil riling by fumigati-
on, and being retained in the teeth, which particles arc  not extracted by
miftication. Bat with regard to the.habuual ufe of this very acrid and
internally violent herb, for, bat chierly after, this d fcafe, it mould be
ronfidered well, whether in fome constitutions it may iiot pare the way to
aisw*dar>geroa« oj'.e# th*n it was introduced toremov*-.  K 
           Of the Difeafes  of the Teeth.        Ii f
 root of pellitory of Spain,  ire. by exciting much
 Spitting, difcharge part of the humour which cauf-
 es the difeafe, and hence diminish the pain.  The
 fmoke of tobacco alfo fucceeds now and then in
 this diforder; whether this happens from the dii^-
 charge of the rheum or fpittle it occafions ;  or
 whether  it is owing to any anodyne efficacy of this
 plant, in which it refembles opium.
   § 142.  As this laft caufe is often the confequence
 of a weaknefs in the ftomach, it daily happens that
 we fee fome people, whofe diibrder from this cauSe
 is augmented, in proportion as they indulge in a
 cooling-,  refVefhing way of living.   The increafe
 of the diSbrder diSpofes them to increafe the dofe
 of what  they millake for its remedy,  in proporti-
 on to which their pain only increafes.  There is a
 neceflity that fuch perfons fliould alter this me-
 thod ;  and make ufe of fuch medicines as are pro-
 per to Strengthen the Stomach, and to reftore per-
 fpiration.   The powder N°* 14. has often produ-
 ced the beft confequences, when I have ordered it
 in thefe  cafes ; and it never fails to diflipate that
 tooth-ach very fpeedily, which returns periodical-
 ly at Slated days ancl hours.   I  have alfo cured
 fome  perfons  who never drank wine, by advifing-
 them to  the ufe of it.
   § 14}.  But befides the  difeafes of the teeth that
 ate owing to  thefe three principal cauSes, which
 are the moll common ones j there are fome very
tedious and moll tormenting diforders of them,
that are  occafioned by  a  general acrimony,  or
great Sharpnefs,  of the mafs of blood,  and which
are never cured by any other medicines,  but fuch
as are proper to correct that acrimony.   When it
is  of a fcorbutic nature,  the wild  horfe-radiSh,
(pepperwort)  water crefles,  brooklime, ferrel, ancl
wood-Sbrrel coned:  and cure it.  If it is of a dif-
ferent nature, it requires difterent remedies. But
very particular details do not come within the plan
of this work.   As the malady is of the chronical- 
 1*8        Of the Difeafes of the Teeth.
 or tedious kind, it allows time to confider and con-
 fult more particularly about it.
   The gout  and the rheumatifm are fometimes
 transferred to the teeth, and give rife to the nioft
 excruciating  pains :  which mult be  treated like
 the difeafes from which they uiife.
   § 144.  From what has been  Said on this difor-
 der,  the reader  will difcern, in what that imagi-
 nary oddnefs may conSift, which has been afcribed
 to it, from the  fame application's relieving one
perfen in it,  and not affording  the Jealt relief to
 another.    Now  the plain  reaSbn  of this is, that
 thefe applications are always directed, without an
 exact  knowledge of the particular  caufe of the
 difeafe,   in different fubjects and  circuniltances ;
 whence the pain from  a rotten tooth, is treated
 like that from an inflammation ; that from an in-
 flammation,  like the pain from a cold humour or
 fluxion ;  and this laft like a pain caufed by a fcor-
 butic acrimony : fo that the difappointment is not
 in the leaft furprifing.  Perhaps phyficians them-
 felves do not always attend distinctly enough to
 the nature of each particular diforder :  and even
 when they do, they content themfelves with di-
 recting fome of the lefs potent medicines,  which
 may be inadequate to accomplish the neceffary ef-
 fect.  If the  diftemper truly be of an inflammato-
 ry difpofition, bleeding is indifpenfible to the cure.
   It happens in fact, with regard to the difeafes
 of the teeth, as well as to all other difeafes, that
 they arife from different caufes; and if thefe caufes
 are not oppofed  by medicines fuited to them, the
 difeafe,  far from being cured,  is aggravated.
   I have cured  violent tooth-achs,  of the lower
 jaw, by  applying a plaifter of  meal,  the white of
 an egg, brandy and maftich, at the corner of that
 jaw, over the fpot where the  pulfation of the ar-
 tery may 'be perceived : and I have alfo mitigated
 the moft excruciating pains of the head, by ap-
 plying the fame plaifter upon the temporal artery* 
Of the Apoplexy.             IIJ
                CHAP.  IX.
                Of the Apoplexy.

                Sect.   145.
    EVERY perfon has fome idea of the difeafe
      termed an apoplexy,  which is a fudden pri-
vation or lofs of all fenfe,  and of all voluntary
motion ; the pulfe at the fame time being kept
up, but refpiration or breathing being opprelfed.
I Shall treat of this difeafe only  in a brief manner,
as it is not common in our country villages ;  and
as I have expatiated on it in a different manner in t
a letter to Dr. Haller, published in 1761.
   § 146. This difeafe is generally ditlingniShed
into two kinds, the fanguineous and ferous apo-
plexy.  Each of them refults from an overfulnefs
of the blood veffels of the brain, which preSTes up-
on,  and prevents or impairs the functions of the
nerves.  The whole difference  between thefe two
fpecies confifls in  this, that the fanguineous apo-
plexy prevails among ftrong robult perfbns, who
have  a rich, heavy, thick and inflammable blood,'
and that in a large quantity : in which circum-
flance it becomes a genuine inflammatory diftem-
per.   The ferous,  or humoral apoplexy invades
perfbns of a lefs robuft conftituion ;  whofe blood
is  more dilute or  watery ;  and rather vifeid, or
lightly gelatinous, than heavy or rich ;  whole vef-
fels are in a more relaxed Hate  ; and who abound
more in other humours than in  red blood.
   § 147.  When the firft kind of this  difeafe exifts
in its moft violent degree,  it  is then femetimes
termed, an apoplectic Stroke, or thundering apo-
plexy, which kills in a moment or inStantanebufly,
and admits of no remedies.   When  the affault is
lefs violent, and we find the  patient with a ftrong,
full and  railed pulfe, his vifage red  and bloated,
aud his neck fwelled up ; with an opprelfed and 
12©             Of the Apoplexy.
loud hoarfe refpiration ; being fenfible of nothing,
and capable of no other motions, except Some ef-
forts to vomit, the cafe is not always equally def-
perate.  We muSl therefore immediately,
   r. Entirely uncover, the  patient's head,  cover-
ing the reft of his body but very lightly ; procure
hi in inltantly  very frelh free air,  and leave his
neck quick unbound and open.
  2. His head fliould be placed as high as may be,
with his feet hanging down.
  3. He muft lofe from  twelve to  fixteen ounces
of blood, fiom a free open orifice in the arm ;  the
flrength or violence with which the blood fallies
out, Should determine the  furgeon to take a few
ounces more or lefs.   It fliould be repeated to  the
third or fourth time, within the fpace of three or
four hours,  i$ the fymptoms feem to require it,
either in the arm,  or in the foot.
  4.  A glyfter fhould  be given of  a decoction of
the firft  emollient opening herbs that can  be got,
with four fpoonfuls of oil,  one fpoonful of fait :
and this fhould be repeated every three hours.
  5. If it is poffible, he Should  be  made to fwal-
low water plentifully,  in each pot of which three
drams of nitre are to be diflblved.
  6. As  foon as  the height and violence of  the
pulfe abates, when his breathing becomes \e*s op-
prelfed and difficult, and his countenance  lefs in-
flamed,  he fliould take the decodtion N°* 23 ;  or,
if it cannot be got ready in time,  he fliould take
three quarters of an ounce of cream of tartar, and
drink  whey plentifully after it.   This medicine
fucceeded extremely well with me in a cafe where
I could not readily procure any other.
  7.  He fhould avoid  all ftrong liquor, wine, di-
ftilled fpirit, whether inwardly or by outward ap-
plication,  and Should  even be prevented  from f
fmelling them.

  t  I have been very authentically sfTurdd of the  death of a hale man,
which happened in the very aft of pouring out a Urge quantity of diftill-
cd fpirits, by gallons or bucketfuls, from one veflel into another. K. 
                Of the ApopJexy.             I2jt

  8. The patient fliould be Stirred,  moved,  or e-
Ven touched,  as little as it is poffible :  in a word,
every thing muft be avoided that can give liim the
lead, agitation.  This advice, I am fenfible,  is di-
rectly contrary to the common practice; notwith-
ftanding which it is founded iu reafon,  approved
by experience, and abfolutely neceffary.  In fact,
the whole evil refults from the blood being forced
up with-too much force, and in too great a quan-
tity, to the brain ; which being thence in a ftate
of compreffion, prevents every movement and e-
very influence of the  nerves.  In order, therefore,"
to re-eftablifh thele movements, the brain muft  be
unloaded,  by diminishing the force of the  blood.
But Strong liquors,  wines, fpirits, volatile falts, all
agitation ancl frictions, augment it,  and by that
very means increafe  the load,  the einbarraflment
of the brain, and thus heighten the difeafe itfelf.
On the contrary,  every thing that calms the cir-
culation, contributes to recall fenSation and  vo-
luntary motion the fooner.
   9.  Strong ligatures Should be made about the
thighs under the ham : by this means the blood is
prevented iu ks  afeent from the legs, and  lefs is
carried up to the"head.
   If the patient feems gradually,  and in propor-
tion as he takes proper medicines, to advance inlo
a lefs violent State, there may be Sbme hopes. But
if he rather grows worfe after his earliell evacua-
tions,  thecate is defperate.
   \ 148. When nature and art effect his recovery,
bis fcnfes return : tho' there frequently remains a
little delirium or wandering for fbrrie time; and
alinoll always a paralytic defect, more or lefs,  of
the tongue,  the arm, the leg, and the mufeles of
the fame Side of the  face.  This pally Sometimes
goes oft* gradually, by the help of cooling purges
from time to time, and a diet that  is but very mo-
derately and lightly  nourishing.  All hot  medi-
cines are extremely hurtful iu this cafe, and uiav
   Vol. 1.               N 
122              Of the Apoplexy.
pave the way to a repeated attack.  A vomit might
be even fatal, and has been  more than once fo.  It
fhould  be abfolutely forbidden ;  nor Should we  e-
ven promote, by draughts of warm water,  the ef-
forts of the patient  to vomit.   They do not any
ways depend on auy humour  or mafs in the Sto-
mach ;  but on the oppreSfion  and embarraffinent
of the brain :  and the more eonfiderabie Such ef-
forts are,  the more fuch oppreffion is increafed ;
by reafon that as long as they continue,  the blood
cannot return from the head, by which means the
brain remains overcharged.
  § 149. The other fpecies of apoplexy is attended
with the like fymptoms, excepting the pulfe not be-
ing fo high nor ftrong ; the countenance being alfe
lefs red, fometimes even pale ; the breathing feems
lefs opprelfed ; and fometimes the fick have a great-
er facility to vomit,  and difcharge more  upwards.
  As this kind of the difeafe attacks  perfbns who
abound left in blood ; who are lefs  ftrong, and lets
heated or inflamed ; bleeding is not often at all ne-
ceffary ; at leaft the repetition of it is Scarcely ever
fo ;  and Should the pulfe  have but  a fmall fulnels,
and not the  leaft unnatural  hardnefs,  bleeding
might even be pernicious.   .
  1. The patient however Should be placed as was
directed in  the former mode of this difeafe ;   tho*
it feems not equally  neceffary here.             ^ ,
  2. He fhould receive a glyfter, but  without oil,""
with double the quantity of fait, and a bit  of foap
of the  Size of a fmall egg  ; or with  fbur  or five
fprigs of hedge hyflbp.   It may be repeated twice
a day.
  3. He fliould be purged with the powder N°* 21 .*

  * Vomits which are fo pernicious in the fangr.ineous apoplexy,  where
the patientVcountenance  and eyes ire inflame'  ; and v.hich me ;lfo
dangeious or ufeiefs, when a pe; fon his  been veiy  moderare i>i his me. ?,
or i- weakened by a«e or othe, circumftance , and whofe ftonuch is far
frombei.ig overloaded with alimc ,t, are :,t>erthei( f> ve y proper fo grofs
fe^er*. -vl.o are aauftonicd ro ex.cecd at t.u '<.-, ..-iioha.t. nd^e'tini)', and
have a mafs of vfcid glairy humours iu t^sir ftomach,; more  efpecially, 
                 Of the  Apoplexy.                12?
   4.  His common drink  may be a ftrong infufion
of leaves of bawm.
   5.  The purge fhould be repeated the third day.
   6.  Blifters fhould immediately be applied to the
fiefhy part  of the  legs,  or between the Shoulder
blades.f
   7.  Should nature feem difpofed to relieve her-
felf by fweatiugs, it  Should be encouraged ;  and 1
have often' known an infufion of the carduus beue-
diflus,  or bleffed thiStle,  produce this effect very
fucceh-fully.   If this method  be entered upon, the
fweat ought to be kept up (without Stirring if pof-
fible) for many days.  It has then fometimes hap-
pened,  that at the end of nine days,  the patient
has been totally freed from the palfy, which com-
monly fuccceds this  Species of the apoplexy, jull
as it does the other.
   §  150. Perfons who have been attacked with ei-
ther kinds of this difeafe are liable  to fubfequent
ones ;  each of which is more dangerous than that
preceding:  whence  an  endeavour  to obviate  or
prevent fuch relapfes becomes of the utmoft impor-
tance.   This is to be effected in each Sort by a ve-
ry exact, and rather fevere diet, even to diminifh-
ing the  ufual quantity of the patient's food ; the
moft effential precaution, to be obferved by  any
who have been once  affaulted with it, being en-
                           N 2
if fuch a one has a little while  before indulged himfelf exceffively, whence
he has vomited  without any other evident caufe, or at leaft had ve-
ry ftrong naujcas, or loathings.  In brief, vomits are the true fpecific for
apoplexies, occafioned by any narcotic or ftupifying poifons, the pernici-
ous effefts of which ceafe the moment' the perfons fo poifoned vomit
them up. An attentive confideration of whac has occurred to the patient
before his feiaure ; his natural fmall propenfity to this difeafe, and great
and inceffant loathings,  render it manifeft, whether it has been can fed
by fuch poifons, or fuch poifonous  exceftes,  In thefe two laft cafes .x
double dofe of tartar emetic (houid be diilolved in a goblet or cup of wa-
ter,  of which the patient fhould  immediately  take a large fpoonful ;
which fhould be repeated every quarter of an hour till it operates. E.L.
   f Thefe bliilers may  be preceded by cupping with fcarification on  the
nape of the neck.   This remedy, often ufed by the ancient phyficians.
but too little practifed in F> ancer is one of the moft fpeedy, and not  the
Uaft efficacious, applications in both fanguine and  feio*rapon.exie;>. E.L. 
 134             Of the Apoplexy.
 tirely to leave offfuppers. Indeed thofe, who have
 been once attacked with the firft, the fanguineous
 apoplexies, fliould be ftill more  ixadt, more upon
 tlieir guard,  than the  others.   They Should deny
 themfelves whatever is Hch and juicy, hot or aro-
 matic,  Sharp, wine, diffilled liquors and  coffee.
 They fhould chiefly confine  themfelves to garden-
 fluff, fruits and acids ; fuch fliould eat but little
 fiefh, and only  thofe called  white ; taking every
 week two or three doles of the  powder N' • 24. in
 a morning falling, in  a giafs of water.  They
 Should be purged twice or thrice a year  with  tlie
 draught Nc*  17,. ufe  daily exercife; avoid very
 hot rooms, and the violent heat of the fun.   They
 Should go to  bed   betimes,  rife  early,  rejcrlie
 in bed above eight hours:  and if it is-obferved
 that their blood increafes considerably, and  has
 a tendency towards the head, they Should be bled
 without hefitation ; and for Sbme days reftrain
 themfelves entirely to  a thin  and low  regimen,
without taking any folid  food.  In thefe ciicum-
 Itances warm bathings are hurtful.  In  the other,
the  Serous,  apoplexy,  inftead  of purging with
 Nr*  2>. the patient Should take the purge Nc* 21.
  §  151. The Sar.ie means, that are proper to pre-
vent a relapfe, might  alfo obviate or keep oft" a
 primary or firft affault, if employed in  time ;  for
notwithstanding it may happen very fuddently,
yet this difeafe foreflu ws itfelf many weeks, fome-
 times  many months, nay even  years belore-hand,
 by vertigos, hcavincii  of the head ;  fmall  defects
of the  tongue or  Speech ; Short and momentary
palfies, fometimes  of one, fometimes of another,
part: fometimes by loathings   and  teachings to
vomit; without fuppofing any  obltrudlion or load
 iu the firft pa Stages,  or any other  caufe  iu  the
 ftomach, or the adjoining parts.  There happens
 alfo  Sbme  particular change in  the looks and  vi-
 f age not eafy  to be deferibed ; Sharp and Short pains
 about the region of the heart -, an abatement of the 
              Of Strokes of the Sun.           12 C
Strength, without any  difcernible caufe  of fuch
abatement.   Befides there  are  ftill fome  other
figns, which fignify the afeent of the humonrs too
much to the head, and fbew, that the functions of
the brain are embrafled.
  Some perfbns are liable to certain fymptoms and
appearances, which arife from the fame caufe as
an apoplexy ; and which indeed  may be  confider-
ed as  very light mild apoplexies,  of wliich they
fultain many attacks, and yet without any  consi-
derable  annoyance of their health.  The blood,
all at once as it  were,  flufhes up to  their heads:
they  appear heedlefs  or blundering;  and  have
fometimes difgufts and naufeas, and yet without a-
ny abatement of their understanding, their fenfesj
or motion of any fort.   Tranquillity of mind and
body, one bleeding,- and a  few glyfters ufually
carry it off'foon  after its invafion. . The returns of
it m-iy be prevented by the regimen directed § T50.
and elpecially by a  frequent ufe  of the powder
Nr# 24.   At the  long run however, one of thefe
attacks  commonly.degenerates into a mortal apo-
plexy : though this may be retarded for a very long
time by an exact regimen, and by  avoiding all
Strong  commotions  of the  mind, but' efpecially
that of anger or violent rage.
                 C H A P.  X.
   Of the violent Influence,  or Strokes'of  the Sun.

                Sect.  152.
     THIS appellation is applied to thofe diforders*
      which arife from too violent an influence of
the heat of the fun, immediately upon the head ;
and which in one word may be  termed  inflation.
  If we confider that wood,  ftonc and nieuls.

                     N 3 
 126           Of Strokes of the Sun.
when long expoled to the fun, become very hot,
and that even in  temperate climates,  to  Such a
degree, that they can fcarcely be touched with-
out fome fenSation of burning,  we may  eafily
conceive the rifle a  perfon  undergoes, in  having
his head expofed to the fame degree of heat.  The
blood-veiiels grow dry, the blood itfelf becomes-
condenfed or thickened, and a real  inflammation
is formed,  wliich has proved  mortal in a very lit-
tle time.  It was this diftemper,  a  Stroke  of the
fun,  winch killed Manaffes  the huSBand cl Judith.
4 For as he was amon» the labourers who bound up
' the Sheafs in the fields, the heat ftiuck upon  his
' head, and he was taken,ill : he went to bed and
' he died.'   Tlie Signs  which precede and  attend
this difeafe are, being  expofed  in a place  where
the fun lhines forth with great force and ai clour ;
a violent head-ach, attended with a very hot and
extremely dry fkin  : the eyes are allb dry and red,
being  neither  able to remain  open, nor  jet to
bear the light ;  and fometimes there is a  kind of
continual and involuntary motion in the eye-lid :
while fome /degree of relief is perceivable  from
the application of any cooling liquor.  It often
happens that fome cannot polhbly Sleep ;  and at
other times they  have a great drowfinefs  but  at-
tended with ou.rageous wakenings: there is a very
Strong fever ;  a gieat faintnefs, and  a total dif-
relifh and loathing. Sometimes the patient is very
thirfty, and at other times net at all :  and the fkiu
of his face often looks  as though it were  burnt.
  § 153. People may be affected  with  fhe  difeafe
from this caufe, at two different feafons  of the
year ; that is, either in the Spring,  or during the
very racing heats;  but their events are very dif-
ferent.  Country people and labourers are but little
liable to the former. They chiefly afledt~the  inha-
bitants  of  cities,  and  delicate perfons v, ho have
ufed very little exercife in the winter, and  abound
with luperfluous humours.   It thus circumitauced 
             Of Strokes of the Sun.           12?
they expofe themfelves  to the fun, as even in the
fpring lie attains  a "eonfiderabie  force ;  and, by
tlie courfe of life they have led,  their humours are
already much difpofed to mount to the head ; while
the coolnefsof the foil, efpecially when it has rain-
ed, prevents their feet from being io eafily warm-
ed ; tlie power of the fun acts upon their head like
a bliller, attracting a great quantity of humours
to it.   This produces excruciating pains of the
head  frequently accompanied with quick and vio-
lent fhootings, and with  pain in the eyes,  not-
withstanding this degree  of the  malady is feldom
dangerous.  Country people,  and  even fuch inha-
bitants of cities ancl towns, as have not forbore to
exercife themfelves in  winter, have no fort of
dread of thefe ftrokes of  the fun, in the fpring of
the \ car.  Its Summer Strokes are much more trou-
blesome,, and vehement,  and affault labourers and
travellers,  who  are for a long time expoSed to the
fervour of it.  Then it is that the  difeafe is ag-
gravated to its  bighell pitch, thofe who  are  thus
llruck often dying upon the Spot.   In the hot cli-
mates this caufe deltroys  many in  the very ltreetsj
and makes dreadful havock among armies on the
march, and at lieges.   Some tragical effects  of it,
on fuch occafions, are feen even  iu  the temperate
countries.   After having  marched a whole day in
the fun, a man Shall fall into  a  lethargy, and die
within feme hours, with  the fymptoms of raving
maduefs. 1 have  feen a tyler in a very hot day, com-
plaining to his comrade of a violent pain in  his head,
Wiiich increafed almoft every moment; and at the
very inltant when he purpofed to retire cut of the
fun, he funk down dead,  and fed down from the
houfe he was Hating.  This  fame caufe produces
very  often in the  country feme molt dangerous
phrenzies,  which  are called there hot or burning
fevers, th ery year furnilfies but too many  of them.
   §  154 The vehemence of the Sun is Still  more
dangerous to thoie, who venture to Sleep  expof'ed 
*28           Of Strokes of the Sun.
to it. Two mowers who fell afleep on a haycock, be*
ing wakened by fome others, immediately on wak-
cning.ftaggered, and pronouncing a few incoherent
unmeaning words,died. When the violence of wine
and that of the fun are combined,  they  kill very
fuddenly : nor is there a fingle year in which pea-
fants are not found  dead on the high roads ; who,
being drunk,  endeavoured to lie  down in feme
corner,  where they  perished by an apoplexy, from
the heat of the fun  and of ftrong drink.  Thole
of them who  efcape  fo fpeedy and premature a
death, are fubject for the remainder of their lives,
to chronical or tedious head-achs; and to fuffer
fome little diforder and confufion in their ideas. I
have feen fome cafes, when after violent  head-achs
of Sbme days continuance, the difeafe has beentranf-
ferred to the eye-lids, which continued a  long time
red and distended, lb that they could not be kept
afunderoropen. It has alfe been known,  that fome
perfons have been ft ruck by the fun into a  delirium or
raving,  without a fever, and without complaining
of a head-ach. Sometimes aguttaferena has been its
confequence ;  and it is very common to fee people,
whofe long continuance under the Itron;; light and
influence of the fun, has made fuch an  impreffion
upon the eyes as prefents them with  different  bo-
dies flying about in  the air, which dillradt and
confule their fight.
  A man of forty-two years of age, having been
expofed for feveral hours to the violent heat of the
fun, with a very fmall cap or bonnet; and having
pall the following night  in the open  air, was at-
tacked the next day with a moft fevere  head-ach,
a burning fever, Teachings to vomit, great anguifh,
and red and Sparkling eyes.  Notwithstanding the
bell affiftance of feveral phyficians, lie became
phrenitic on the fifth day, and died on  the ninth.
Suppurated matter was difeharged  from  his mouth
one of his noltrils, and his right ear, a  few  hours
before his death ; upon diflection a fmall abfcefs 
              Of Strokes of the Sun.           I2JJ
was found within the  Skull;  and the whole brain?
as well as all the membranes  inclofing it, were en-
tirely  con up ted.
   §  155. In very young children,  who are not, or
never fhould be, expofed for any long time to fuch
exceflive heat (and whom a flight caufe will often
affect)  this malady difeovers itfelf by a heavy deep
drowfinefs, which laits for feveral days ;  alfo by in-
ceffant  ravings  mingled with rage  and  terror,
much the fame as  when they are affected with vi-
olent fear; and fenfetimes by cohvulfive twitch-
ings ; by head-achs which return at certain periods,
ancl continual vomitings.   I  have  feen children,
who after a Stroke of the fun, have beenharraffed
a long time with a little cough.
  \  156. Old  men who often expofe themfelves
imprudently to the fun, are little  apprifed  of all
the danger they incur by it.  A  certain perfon,
who purpofely funned himfelf for a  considerable
time, in the clear day of  an  intermitting tertian
fever, underwent the afiault of an apoplexy, which
carried him off" the following day.  And even when
the difeafe may not be fb Speedy and violent, yet
this cultom (of funning in hot weather) certainly
difpofes to an  apoplexy, and to diforders of the
head.   One of the ffightell effects of much folar
heat upon  the  head  is, to  caule a  definition from
the brain,  a Swelling of the  glands  of  the neck,
and a drynefs of the eyes,  which  fometimes con-
tinues  for a eonfiderabie term after it.
   §  157. The effect of too  much culiuary, or com-
mo 1: fire,  is of the fame quality with that  of the
fun.  A man who fell  afleep with  his head direct-
ly oppofite, and probably,  very near to the fire,
went off in an apoplexy, during his nap.
  \  158. The action of too  violent a fun  is not
only pernicious, when  it falls upon the head ; but
it is allb hurtful to  other  parts ;  and thofe who
continue lon^. expofed to it, tho'their heads fhould
not be affected, experience violent pains,  a difiv* 
I30            Of Strokes of l t  Sun.
gre cable fenfation of heat, and a considerable rtiff-
nefs in the parts  that have been, in Some manner,
parched by it ; as  in the legs, the knees, the thighs,
reins and arms; and Sometimes they prove fe\erilh.
  §159. In contemplating the c-ife of a patient,
fun-f/ruck, as we may term it, we mult endeavour
to diltinguilh, whether there may not be alfo Some
other joint caufes concurring to the effe.'t    A ti a-
valler, a labouring man, is often as much ahected
by tiie fatigue of his journey, or of his labour, as.
he is by the influence of Solar heat.
  § 160. It is neceffary to Set aboat the cure  of this
difeafe, as feon as ever we are fatisfied of its exist-
ence : for fuch as might  have been eafily preferved
by an early application,  are considerably endang^
ered by a neglect of it.  The method of treating
this is very much  the fame, with that of the inflam-
matory difeafes  already  mentioned ;  that  is,  by
bleeding, and cooling medicine^ of various kinds
in their drinks, by bathings, and by glyfters. Ancl
1. If the  difeafe  be very high and urgent, a large
quantity  of blood Should be taken away and occa-
sionally repeated.  Lewis the XIV. was bled nine
times to prevent  the fatality of a Stroke of the fun, ,
which he received  in hunting in 1658*
  2. After bleeding,  the patient's  legs fhould be
plunged into warm water.  This is one of the ap-
plications that affords the moft fpeedy relief; and
I have feen the head-ach go off and return again,
in proportion to  the repetition, and the duration
of thefe bathings of the legs.  When  the diforder
is highly  dangerous, it  will be neceifary to treat
the patient with femicupia, or warm baths, in which
he  may fit up to  his hips ; and in the  moft  dange-
rous degrees of it,  even  to bathe the whole body :
but the water in this cafe, as well as in bathings
of  the feet, Should be only fenfibly warm :  the uSb
of hot would be highly pernicious. %
  3. Glyfters made from a decoction of any of the
 emollient herbs are alfo very effectual. 
             Of Strokes of the Sun.            l^I
   4.  The patient Should drink plentifully of al-
 mond emulfion Nc* 4.;  of limonade,  which  is  a
 mixture of the juice of lemons and water, (and
 is the bell drink in  this difeafe) of water and vi-
 negar,  which  is a very good Substitute for limo-
 nade ;  and of,  what is ilill more efficacious, very
 clear whey,  with the addition of a little vinegar.
 Thefe various drinks may all be taken cold ; linen
 cloths, dipt in cold water and vinegar of rofes may
 be applied to the forehead, the temples, or all o-
 ver the head, which is equivalent to every other
 application ufed upon fuch occasions. Thofe which
 are the moll cried up, are the juice of purflain, of
 lettuce, ofhoufeleek, and of vervain.  The drink
 N°*  32.  is alio ferviceable, taken every morning
 falling.
   §  161. Cold baths have fometimes recovered  per-
 fons out of fuch violent fymptoms, from this caufe,
 as have been almoft quite defpaired of.
   A man twenty years of age, having been a  very
 long time expofed to the Scorching fun, became vi-
 olently delirious, without a fever, and proved re-
 ally  mad. After repeated bleedings, he was thrown
 into a cold bath, which was alfo frequently  repeat-
 ed ; pouring cold water, at the fame time, upon
 his head.   With fuch affiftance he recovered,  tho*
 very gradually.
   An officer who had rode poft for feveral days  fuc-
 ceffively, in very hot weather, fwooned away,  im-
, mediately on difmounting ; from whicli he could
 not be recovered by the ordinary affiftance  in  fuch
 cafes.  He was faved however,  in  confequence of
 being plunged into a bath of freezing water.  It
 fliould be observed however, that in thele caSes the
 cold bath Should never be recurred to, without  pre-
 vious bleeding.
   §  162. It is pall doubt, that if a perfon Stands
 ftill in the violeut heat of the Sbn, he is more liable
 to be Struck with it, than if he walks about ;  and
 and the ufe of white hats, or of foine folds of clean 
isa            Cf Strokes  of the Sur.
white paper under a black one, may  fenfibly con-
tribute to prevent any injury from the eonfiderabie
beat of the fun ;  tho'  it is a very  incompetent  de-
fence againll a violent degree of it,
   The  natural coultitution, or even th it constitu-
tion, which has been Sbrn.ed Srom  long cultom
and habit,  make a very great difference  between
the effects of Solar heat on different perfbns. Peo-
ple infenfibly accuftom themfelves to the impreffi-
ons of  it, as they do to thofe of all  tlie other bo-
dies ancl element-.,  which are continually  adting
upon us ; and by degrees we arrive at a power of
fultaiuing his violent heat with impunity-:  jult as
others arrive at the hardinefs of  bearing the moll
rigid colds,  with very little complaint or inconve-
nience.   The human body is capable of f upport-
ing many  more  violences and extremes, than it
commonly does.   Its natural force is Scarcely ever
ascertained among civilized nations;  becaufe their
education  generally tends to  impair and  lefien it,
and always Succeeds in this refpedt.    If we were
inclined to confider  a purely natural,  a  limply
phyfical man,  we muSt look for him among lavage
nations ; where only  we  can  difcover what we are
able to be,  and to bear.   We certainly could not
fail of being  gainers, by adopting their corporal
education ;  neither does it  Seem as yet to have
been infallibly demonftrated,  that  we Should be
great lofers in commuting  our  moral education
for theirs. *

   * As fome may think an apology necefTary for a tranflation of this
chapter on a difeafe, which never,  or very fddom,  exilts in tl.is or the
adjacent iflmd,  I fhall obferve here, that, abfti acted ft om  the immora.
lity of a narrow and local folicitude only lor ourfel"es, we are political-
ly intereficd as a nation alway> in trade,  and o'ttn at war,  (aid whofe
fjbjeds are extended into very diham and different climates; to pro-
vide againft a fudden and acute ilnlemper,  to which our armies, our fail-
o.s and colonies are  certainly often  expofed.  A fatality from this caufe
b not retrained to oar iilands within the tropic, where feveral inflancej
cf it la e occurred during the late wa, ;  but it has a,f j b.-cn known to
.prevail a, far noi thward as Peufylvan:.i, in i-Jtii fmners, and even in
their harvefts.   I once received a fenfible' C.u.d on the bant, of my thumb, 
0f tl-se Rheumatifm.            133
                 CHAP.  XI.
                Of the Rheumatifm.

                 Sect.  163.

      TH E rheumatifm  may exift  either with  or
      without a fever.  The firfl of thefe may be
elafled among the difeafes, of which I have alrea-
dy treated ; being  an inflammation which is ma-
nifested by a violent fever, preceded by Shivering,
a fubfequent heat, hard  pulfe,  and a head-ach/.
Sometimes indeed an extraordinary coldneSs, with
general uneafinefs  and inquietude, exiSls  feveral
days before tlie fever  is perceived.   On  the fe-
cond or third  day, and  fometimes even  on  the
firft, the patient  is feized  with  a violent pain
in fome part of his  body,  but efpecially about
the  joints, which  entirely prevents their motion,
and  which is often accompanied  with  heat, red-
jiefs  and a fvvelling  of the part.  The  knee  is
often the firlt part attacked,  and  fometimes both
the  knees  at once.    When  the pain is fixed,
vn\ abatement of the fever  frequently happens ;
though in fome perfbns it  continues  for feveral
days, and increafes every evening. The pain di-
minishes in one part after a duration of Some days
and then invades feme  other.   From .the  knee it
defceuds to the foot, or mounts to the hip, to the
loins, the Shoulder-blades, elbow, wrift, the nape
of the  neck, and frequently is felt in  the inter-
mediate parts.   Sometimes one part is quite free
from pain,  when  another is attacked ; at other
times manyJ^arts are feized nearly at the fame in-
   Vol.I. *             O

 from the  fun fnddenly darting out throngh a clear hole,  as it  were, in z
 cloud, aficra fhon and impetuous fhower in fummer ; which fcald msni-
f'oftly  bliffcrcd within fome minutes after.   Had this  concentered "ray
been darted on my bare head, the confequence might  have  been more
 dangerous; or perhaps as fatal  as fome of the  eafes  recorded by Dr
 TJot, in this chapter.  K.                         '   * 
 *3*           Of the Rheumatifm.
 ftant ;  and 1 have fometimes feen every joint af>
 flitted at once.  In this cafe the patient is in a ve-
 ry terrible fituation,  being incapable of any mo-
 tion, and even  dreading the affiftance of his at-
 tendants, as he can Scarcely admit of touching,
 without a fenfible aggravation of his pains.   He
 is unable to  bear  even the weight of the bed-
 cloaths,  which muft be, as it  were, arched over
 his limbs by a proper contrivance, to prevent their
 preffure  : and the very walking  acrofs  the cham-
 ber  increafes  his torments.  The parts in  which
 they are the moft excruciating ancl obltinate,  are
 the region of the loins, the hips, and the nape or
 hinder part of the neck.
  § 164. This difeafe is alfo often  extended over
 the fealp and the furface of the head ;  and'there
 the pains are exceflive.  1 have  feen them affect
 the eye-lids aud the teeth with inexpreflible tor-
 ment.  As long as the diftemper  is Situated in the
 more external parts,  the patient, however pain-
 ful his fituation  may prove, is in 110 great danger,
 if he be properly treated : but if by  fome  acci-
 dent, feme error,  or by any latent caufe, the dif-
 eafe be repelled upon an internal pait or organ,.
 his cafe  is extremely dangerous.   If the brain is
 attacked, a  frantic raging delirium is the confe*
 quence ; if it falls upon the lungs, .the patient is
fuffocated ; and  if it  attacks the ftomach or the
 bowels, it is attended with the  molt alloniShing
 pains, which are caufed by  the  inflammation of
 thofe parts ;  and whicli inflammation,  if violent,
 is * fpeeeily fatal.
  About  two years fince I was called to a robuft
man, whole guts were already in  a|gangrenou*
ftate, which was the confequence of a rneuniatifin,
that firft  attacked one arm and one knee ; the curp
 of wliich had been attempted by fweating the
patient with fome hot  remedies.    Thefe indeed
*• See na;e to page 44. 
                    Of the Rheumatifm".            135
     brought on a plentiful fweat ;  but the inflamma-
     tory humour feized the inteftines, whofe inflam-
     mation degenerated into a gangrene,  after a du-
     ration of the mbfl acute pain for thiity-fix hours ;
     his torments terminating in death.two hours after
     I faw him.
       § 165. This malady however is often in a left
   *  Violent degree ; the fever is but moderate,  and
     ceafes entirely when the pain begins ; which is al-
     fo  confined tb one, or not more than two parts.
        § 166.  If the difeafe continues fixed, for a eon-
     fiderabie time, in one joint, the motion of it  is
     impaired for life.   I have feen a perfen, who has
     now $. wry neck,  of twenty years ftanding, in
     confequence of a rheumatifm in the nape of the
     neck ;  and I alfo faw a poor young man from ju-
     rat, who was bed-ridden,  and  who had loll the
     motion of one hip  and both knees.  He could nei-
     ther Hand nor fit,  and there were but a few pof-
     tures in which he could even lie in bed.
        § 167.  An obstructed perfpiration,  and inflam-
     matory thicknefs of the blood, conllitute the molt
     general caufe of die rheumatifm.   This laft con-
    Acurring caufe is that we muft immediately encoun-
     ter ; fince,  as long as that  fubutt's, perfpiration
     fennot be perfectly re-eltablifhed, wliich  follows
     of courfe, when the inflammation is cured.   For
f»  •  which reafen this diftemper muft be conducted like
     the other inflammatory ones, of which I have al-
     ready treated.
        § 168.  As foon as it is Sufficiently manifeft, the
     glyfter N°* 5. fhould be injected :  and  twelve oun-
     ces of blood be taken from the arm an hour after.
     The patient is to enter upon a regimen, and drink
     plentiful! *of.the ptifanN0* 2. and of almond milk
     or emulfion N°* 4.   As this laft medicine may be?
     too coftly in country places for the poor peafant--
     ry, they may drink, in lieu of it, very clear whey,-
     lweetened with a  little honey.   I have known a*
     rery fevere rheumatifm cured,  after twice bleed-*
                           O  2 
 13*            Of the Rhetmatiftn-
 ing, without any other food or medicine, fbr the
 fpace of thirteen days.  The whey alfo may be
 happily ufed by way of glyfter.
   § 169. If the diftemper is not  considerably af-
 fuaged by the firft bleeding, it fhould be repeated
 fome hours after.   I have ordered it four times
 within the firft two days ; ancl fome days after I
 have even directed a fifth bleeding.   But in gene-  ft
 ral the bardnefs of the pulfe becomes lefs after the  7
'fecond : and notwithstanding the pains may conti-
 nue as fevere as before, yet the patient is fenfible of
 lefs inquietude.   The glyfter mufl be repeated e-
 very day,  and even twice a day,  if each of them
 is attended only with a fmall difcharge ; and  par-
 ticularly if there be a violent head-ach.   In fuch
 cafes as are exceffively painful, the patient  can
 fcarcely difpofe  himfelf into a proper attitude or
 poiture to receive glyfters :  and  in fuch circum-
 itances bis drinks Should be made as opening as
 poffible ; and a dofe of the cream of tartar N °. 24.
 tliould  be  given night and morning.  This very
 medicine,  with the affiftance of whey, cured two
 perfons  I  advifed it to,  of rheumatic pains, of
 which they had been infeSted with  frequent re-4,
 turns for many years, ancl whicli were attended
with a fmall fever.                             m
  Apples coddled, prunes ftewed,  and well ripen-
ed fumnner fruits,  are the propereft  nourishment   |
in this difeafe.
  We may Save the fick a good deal of pain, by
putting one ftrong towel always under their back,
and another under their thighs, in order to move
them the  more  eafily.   When their hands are
without pain, a third  towel hung upVn. a cord^
which is fattened acrofs the bed,  my ft Xonlidera-
bly aflift them in moving themfelves.
  $ 170. When the fever entirely difappears, and
the hardnefs of the pulfe is removed, I have or-
dered the purge  Nc* 23. with a very good effect ;.
and i$ it is attended with five or fix motions,,  the 
*                  Of the Rheumatifm.            J 3 7"
   patient is very fenfibly relieved.   The day but
   one after, it may be repeated fuccefsfully,  and a
   third time, after an interval of a greater number.
   of/lays.
     § 171. When the pains are extremely violent,
   they admit of no application : vapour^baths how-
   ever may be employed,  and provided they are of-
   ten ufed, and for a confidernble time, they prove
   very efficacious.- The  purpofe  of thefe baths  is
   only'to convey the lteam of boiling water to the
   parts affedted ; which may always eafily be bffedt-
   ed, by a variety of fimple and eafy contrivances ;
   the choice of which muft depend on the different
   circumstances  and fituation of the fick.
     Whenever it is poffible, feme  of the emollient
   applications N°* 9* fhould be continually employ-
   ed.  A half bath, or an  entire bath of warm wa-
   ter, in which the patient fhould remain an hour,
   after fufficient bleedings and many glyfters, af-
   fords the greatetl relief.  I  have feen a patient,
   under the moft acute pains  of the  loins, of the
   hips,  and of one knee, put into one.  He conti-
   nued ftill under extreme torment in the bath, and
   tin being taken out of it: but an hour after he had
   been  put to  bed,  he  fweated, to  an incredible
   quantity, for thirty-fix hours, and was  cured. ■
•   The bath fliould never be  made ufe of,  until af-
   ter repeated bleedings,  or at leaft ether equiva--
   lent  evacuations: for otherwife timed, it  would-
   aggravate the. difeafe.
     y 172.  The  pains are generally moft fevere in
   the night ;  whence it has been ufual to give coin--
   poling Soporific medicines. This however has-been
   very erroneous, as opiates really augment the caufe
   of the difeafe,  and detlroy the efficacy of the pro-
   per remedies :  and,  even not Seldom, far from a(-
   fiiaging the pains, they increafe them.   Indeed '
   they  agree fo  little in this difeafe,  that even the
   patient's natural fleep at the invafion of this com-
   plaint, is rather to his detriment.   They feel, the
                          O * 
  13 8             Of the Rheumatifm.
  very moment they are dropping atleep,  fuch vio-
  lent jirks as awaken them with great pain : or \$
  they do fleep a few  minutes,  the pains are ftrong-
  er when they awake.
    § 173* The rheumatifm goes off* either by ftool,
  by turbid thick urine which drops a great propor-
  tion of a yellowifh fediment,  or by  fweats :  and it  %
  generally happens that this lall difcharge prevails-   ^
  towards the conclufion of the difeafe.   It may be    #
  kept up by drinking an infufion of elder flowers.
  At the beginning however fweating is pernicious.
    §  174-  It happens alfo, though but very feldom,
  that rheumatifins determine by depofiting a Sharp
  humour upon the legs ; where it forms vefk ations, '
  ©r a kind of blifterings, which burtt open and form
  ulcers, that ought not to be  healed and dried up
  too haftily j as this would occafion a fpeedy return
  •f the rheumatic pains.  They are dilpoled to heal
  naturally of themfelves, by the afliStance of a tem-
  perate regular diet,  and a few gentle purges.
   §  175.   Sometimes again,  au abfeefs  is formed
 either in the affected part, or in  fome neighbour-
 ing one.   I have feen a vineyard drefler,  who af-,
 ter violent pains in the loins, had an abfeefs in the    |
 upper part of the thigh,  whicli he  neglected for a
 long time.  When I few him it was of a monftrous-
 fize.  I ordered it to be opened, when at  once a- M
 hove three pots of* matter rufhed out of it; but  '
 the patient, being exhaufled,  died fome time af-
 ter it.
   Another crifis of the rheumatifm has happened
 by a  kind of itch, which breaks out upon all the
 parts adjacent to  the feat  of this difeafe.  linme-     1

  ■* This, according to our author's efllmation  of the pot-meafure at     I
 Berne, which is that he always means, and which he fays, contains exact-     j
ly (of water we fuppofe;  fifty-one ounces and a quarter (though without     I
 a material error it may be computed at three pounds and a quarter) will
 amount at leaft toniue pounds  and three quarters of matter, fuppofing
 this no heavier than water.  By mcafure it will want but Lttle of five of
our quarts: a very extraordinary difj-arge indeed of pus at once, anil
aotunUkely to be attended by the evtnt which, fooa followed.  K, 
                Of the Rheumatipn.            *?£ "
 diately after  this eruption the  pains vanifh : but
 the puSlules femetimes continue for feveral weeks.
   § i 76. I have never oblerved  the  pains  to laft,
 with considerable violence, above fourteen days,
 in this fpecies of the  rheumatifni ; though there
 remains a weaknefs, nirmbnefs,  and feme inflati-
 on, or puffing, of the adjoining parts: and it will
 alfo be  many  weeks, and fometimes even months ;
 efpecially if  the diftemper  attacked them in the
 fall, before the fick recover  their ufual  flrength,
 I  have  known  fome  perfons, who, after a  very
 painful  rheumatifm, have been troubled with a
 very difagreeable fenSation  of laflitude ; which
 did not go off till after a great eruption,  all  over
 the body, of little vesications or blillerings, full of
 a  watery humour ; many of them burft open, and
 others withered and dried up without bursting.
   § 177. The return of Strength into the parts af-
 fected may be promoted by  frictions night and
 morning, with flannel or any other woollen ftuff *
 by ufing exercife; and by conforming exactly to
 the directions given in the  chapter on convale-
 fcence,   or  recovery from acute difeafes.   The
 rheumatifm may alfo be prevented by the means
 I  have pointed out, in treating of pleurifies and
 quinfeys.
   §  178.  femetimes the rheumatifm with a fever,
 invades  perfbns who are not fb fanguine, or  a-
 bounding in blood ; or whofe blood is not fo much
 difpofed to  inflammation ; thofe whofe flefh and
 fibres are fofter; and in whofe humours there is
 more thinnefs, and  fharpnefs, than vifeidity and
 thicknefs.  Bleeding proves lefs  neceffary for per-
 fons fo  conftitued, notwithstanding  the  fever
 fhould be very Strong.  Some  constitutions require
 more difeharges by Stool ; and after they are pro-
perly evacuated, fome blillers Should be applied,
which often afford them a fenfible relief as foon as e-
yer they begin to operate, Neverthelefs they fhould 
- *4°            Of the Rheumatifm
  never be ufed where the pulfe is hard.  ThepoW"
  der N°* 25. anfwers very well in thefe cafes.
    § 179.  There is  another kind of rheumatifm,
  called chronical, or lafting.  It is known  by the
  following characters or marks.   1.  It is common-
  ly unattended with a fever.  2. It continues a ve-
  ry long time. •  3. It feldom attacks fo many parts
  at once as the  former.  4.  Frequently  no  vifible
  alteration appears in the  affected  part, which is
  neither more hot, red, or fwelled than in its heal-
  thy ttate ; though fometimes one or other of tnefe
  fymptoms is evident.   5. The former, the inflam-
  matory,  rheumatifm atfaults Strong, vigorous,  ro-
  bull perfons  : but this rather invades people arriv-
  ed at a certain period of life, or fuch as are weak-
  and languishing,
     § 180. The pain of the chronical  rheumatifm^.
  when left to itfelf, or injudicioufly treated, lafts
  fometimes many months, and even years.  It is
  particularly and-extremely obltinate, when it is ■
  exerted on the  head, the loins, or on the hip, and-
  along the thighs, when it is called the fciatica. There-
  is no part indeed which this pain may not invade ;
  fometimes it fixes itfelf in a fmall fpot, as in one*
  corner of the head ;  the  angle of the jaw: the/
  extremity of a finger ; in one knee ; on one  rib,,
  or on  the breaft, where  it often  excites  pains,
  which makes the patient apprehenlive of a cancer.'.
  It penetrates alio to the internal parts.  When it
  affects-the lungs,  a mofl  obltinate cough is  the
  confequence; which  degenerates at length into.
  very dangerous diforders of the  breaft.   In the
  ftomach and bowels it  excites moft violent pains.
  like a cholic ; and  in  the bladder, fymptoms fo.
  greatly refembling thofe of the iloue,  that per--
  fbns,  who are neither deficient in knowledoe nor
  experience, have been more than once deceived by
  them.
     §  18r. The  treatment  of this chronical rheu-
  matifm does  not  vary coniidei ably from, that of 
                  Of the Rheumatifm.              1/ft

 the former.  . Nevertheless,  in the  firft place, if
 the pain is very acute, and  the patient robuft, a
 Single bleeding at  the onfet is very proper  and
 efficacious.  2.  The humours ought  to be diluted,
 and their acrimony or Sharpnefs fhould be  dimi-
 nifhed,  by a very plentiful ufe  of a ptifan  of *
 burdock  roots  N°' 26.  3.  Four or five days  after
 drinking abundantly of this, the purging -f  pow-
 der N.  21 may be taken with fuccefs.  In this fpe-
 cies of the rheumatifm, a certain medicine is feme-
 times found  Serviceable.   This has acquired  Some
 reputation, (particularly in the place from whence
 they bring it,  Geneva;)  under  the title of  the
 opiate for the  rheumatifm, tho' I cannot fay  for
 what reafen  ;  as it is indeed neither more nor lets
 than the  electuary caryocoftinum, which may   be
 procured at our apothecaries.  I Shall obferve how-
 ever, that this  medicine has  done mifehief in the
 inflammatory rheumatifm, and even in  this,  as of-
 ten as the perfons afflicted with it are feeble, thin
 aud of a hot temperament; and either  when they
 have not previously  taken  diluting drinks,   or
 when it has been ufed too long.  For,  in  Such a
 eircumltance,  it is  apt to throw the patient into
 an irrecoverable weakneft.   The compofition con-
 fits of the  hottell fpices, and of very fharp  pur-
 gatives.

  *  Half a pint of a pretty ftrong infufion of the leaves of buckbean,
 which grows wild here, taken once a day rather before  noon, has alfo
 been found very ferviceable in that fpecies of a chronical rheumatifm,
 which confiderably refults froma fcorbutic ftate of the lonftitution.  K.
  t Another very good purge, in this kind of rheumatifm, may  alfo be
 compounded of the belt gum guiacum in powder from 25  to 40 grains;
 dilfolved in a little yolk of a frelh egg; adding, from 5 to to grains cf
 jallap powdered, and from 3 to 5 grains of powder ginger,  with as muc.'i
 plain or furfeit water,  as will make a purging draught for  a ftronger or
 weaker grown patient. Should the pains frequently  infeft the ftomach,
 while the patient continues collide, and there is no other fever than  fach.
 a fmall fymptomatic one, as may arife folely fiom pain, he may fafelytake
if grown up and ftrong. from 30 1040  drops of the  volatile tinfture of
gumgui.icum, inanydi^p',,. infufion, that may not coagulate or feparate the
jpm.  It generally dil,' res at firft to a gentle diaphorefis or  fweat,
 and feveral hours nftcr to one, and fometimes to it fecond ftool, with little
 *r no griping. K. 
T42           Of the Rheumatifm.
  § 182. When general remedies have been  ufed£
and the diforder ftill  continues, rtcourie Should
be had to fuch medicines,  as are available to re-
store perfpiration ; and thefe lhould be perfitte:!
in for a  considerable  time.  The pills  N'. i8i
with a ftrong  infufion of  elder  flowers, have of«-
ten fucceeded iu this refpedt :  and then altera
long continuance of diluting drinks, if the fever is
entirely fnbdued ; if the Stomach exerts ;ts-fundti»
ons well ; the patient is no_ways collive ; if he  is
not ofa dry habit of body, and the part aLeitcd re-
mains without inflammation, the patient may fafe-
ly take the powder-N°. 29. at night going to bed,
with a cup or two of an infufion  of carduus besicdic-
tus, or the bleffed thiftle,  and a mcrfel of Venice
treacle of the fize of  a hazel nut, or a filberd*
This  remedy brings  on  a very  copious fweating
which often  expells the * difeafe. The fweats may
be rendered ftill more etfedtual, by wrapping up
the affected part in a flannel dipt in the  decoction
N°* 27.
   § 183. But of all thefe pains, the fciatica is one of
the moft tedious and obltinate.   Neverthelefs I
have feen the greateSl  fuccefs, from  the applica-
tion of feven or eight cupping-glatfes on the tor-
mented part; by which, without the afliSlance  of
any other remedy, I have cured, in a few hours*
fciaticas of many years Handing, which had baf-
fled other remedies.   Blisters, or any  fuch ftimu-
lating plaifters,  as bring on a fuppuration and dif-
charge from the afflicted part, contribute alfo fre-
quently to the cure ; though lefs  effectually than
 cupping which  fhould be repeated feveral  times,.
 Green cere-cloth, commonly called oil-cloth, (whe-
 ther the ingredients be fpread on taffety  or on lin-
 en) being applied to the difeafed part, difpofes it
 to fweat abundantly, and  thus to difcharge the*

   * Gum guiacum, given from fix to ten grains morningand night, isof-'
 tea very fnccefsful in thefe cafes.  It may be made intopiils or boluflsS»
 wiilt ihe rob of elder, ox with the extract of juniper. £. L. 
            Of >fhe Rheumatifm.              443
,ffiarp humour which occafions'the pain. Sometime*
 both thefe applications, hut efpecially that Spread
 on Silk (which  may be applied more exactly and
 clofely to the part, and which is  alfo Spread with
 a different compofition) raife a little veficatiou on
 .the part as blilters do. A plaifter of quicklime and
 honey blended together  has cured inveterate Sci-
 aticas.   Oil of eggs  has  fometimes fucceeded in
 fuch cafes.  A feton has alfo been  fucccfsfully made
 in the lower part of the thigh.  Finally fome
 pains, which have not yielded to any of thefe ap-
 plications, have been cured by actual burning, in-
 flicted on the very fpot, where  the molt violent
 pain has been felt,; except feme  particular realon,
 drawn from an anatomical knowledge of the part,
 fhould determine the furgeon not to apply it there.
 The feull or head lhould never.be cauterized with
 a burning iron.
   § 184. The hot baths of Bourbon, Plombiers, Aix-
 la-Chapelle and many others are often very efficaci-
 ous in thefe chronical  pains: notwithstanding I
 really think,  there  is  no rheumatic pain that
 may not be cured without them.  The  common
 people fubftitute to thefe a bath made of the hufk
 of  grapes, after their juice is  exprefled,  which
 cure feme by making  them fweat  abundantly.
 Cold baths however are  the bell to keep  off this
 difeafe; but then they cannot  always be fafely
 ventured on.  Many circumftances render the ufe
 of them impracticable to particular perfons. Such
 as are fubject to this chronical rheumatifm, would
 do very well to rub their whole bodies every morn-
 ing, if they could,  but especially  the afflicted
 parts, with flannel.   This habit  keeps up perfpira-
 tion beyond any other affiftance ; and indeed fome-
 times even increafes it too  much.  It would be
 ferviceable alfo, if fuch fubjects of this cruel dif-
 eafe wore flannel all over their  Skin, during the
 winter.
   After a yioleat rheumatifm, people fhould long 
 *44             Of the Rheumatifm.
 be careful to avoid that cold and moift air,  which
 difpofes them to relapfe.
   \ 185. Rheumatic people  have too frequent a
 recourfe to very improper and hurtful medicines,
 in this diftemper, whicli  daily produce  very bad
 confequences. Such are fpirituous medicines, bran-
 dy, and arquebufade water.   They  either render
 the pain more obltinate and fixed, by hardening
 the Skin; or they repell the humour to Some in-
 ward part.  And inltances are not wanting of per-
 fons who have died Suddenly, from the application
 of Spirit of wine upon the parts, that were violent-
 ly afflicted with the rlieumatifin.  It alfo happens
 fometimes that the humour having no outlet thro'
 the fkin, is  thrown internally on the bone and af-
 fects it. Avery fingular fadt occurred in this re-
 spect,  an account of which may be ferviceable to
 fome pertbns  afflicted with the difeafe.  A woman
 at night was chaffing the arm of her hufband, who
 had the rheumatifm there, with the Spirit of wine ;
 when a very lucky accident prevented  the mif-
 ehief She might have occafioned by it. The Spirit
 of wine took fire from the flame of the candle fhe
 made  ufe of, and burned the  difeafed part.  It
 Was dreft of courfe, and the  fuppuration that -at-
 tended it, entirely cured the rheumatifm.
   Sharp and greafy unctions or ointments produce
 Very bad effects, and are equally dangerous. A ca-
 ries, a rottennefs of the bones, has  enfued upon
 the ufe of a medicine  called,  the balfam of ful-
 phur with turpentine.  I was confulted in  1750,
 three days before her deceafe, aboutja woman, who
 had long endured acute rheumatic pains.   She
 had taken various medicines, and, among the reft,
 a  considerable quantity of a  ptiSan,  in which an-
 timony was  blended with fome purging medicines,
 and a greafy fpirituous balfam  had  been rubbed
 into the part.   The fever, the pains, and the dry-
 nefs of the Skin foon increafed; the  bones of the
thighs and arms  became carious: and in moving 
             Of the Rheumatifm.            145
the patient no more than was neceffary fbr her re-
lief and convenience, without taking  her out of
her bed, both thighs and one arm broke. So dread-
ful an  example lhould make people cautious of
giving or applying medicines inconsiderately, even
in fuch difeafes, as appear but  trifling in them-
felves.   I mull alfo inform my readers, there are
fome rheumatic pains, whicli  admit of no appli-
cation ; and that almoft every .medicine aggravates
them.   In fuch cafes the  afflicted muft  content
themfelves with keeping the parts affected from the
impreflions of the air, by a flannel, or die fkin of
fbmc animal with the fur on.
   It is almoft more advifeable fometimes to leave a
fuflerable and inveterate pain  to itfelf, efpecially
in old or weakly people, than to employ too many
medicines, or fuch violent ones, as fliould affect
them more importantly than the pains did.
   § 186. If the duration of the  pains fixed in the
fame place fliould caufe fome degree  of Stillhefs
in the joint affected, it fliould be expofed  twice a
day to the vapour of warm water,  and dried  well
afterwards with hot linen : then it fliould be well
chaffed, and laltly touched over with ointment of
marlh-mallows.   Pumping, if fuperadded to this
Tapour, considerably increafes its  efficacy.  I di-
rected, for a cafe  of this fort, a very  fimple ma-
chine of white tin,' or lattin,  which combined the
application of the fleam and the pump.
   § 187. Very young children are fometimes fub-
jedt to fuch violent and extended pains, that they
cannot bear touching iu any part,  without excef-
five crying.  We muft be careful to avoid mistak-
ing thefe cafes,  and not to treat them like rheu-
matiiins.  They Sometimes are  owing  to worms,
and go off when thefe have been discharged.
Vol.  I.             P 
146        Of the Bite of a mad Dog.
                 CHAP.  XII.
            Of the  Bite of a mad Dog.

                 Sect.   188.
       ME N may contract the particular and raging
       Symptom, which is very generally peculiar
 to this difeafe from this caufe, and even without
 any bite ; but this  happens very rarely indeed.  It
 is  properly a diftemper belonging to  the canine
 genus,  cpnfifling of the  three  fpecies of  dogs,
 wolves, and foxes, to whom only  it Seems  inhe-
 rent and  natural;  feareely ever arifing in  other
 animals,  without  its being  inflicted  by  them.
 Whenever there occurs one of them who breeds it,
 he bites others, and thus the poifon, the caufe of
 this terrible difeafe, is ditfufed.  Other animals
 betides the canine fpecies, and  men themfelves be-
 ing expofed to this accident, do fometimes con-
 tract the difeafe iu  all its rage and horror : though
 it is not to be fuppofed, that this is always an un-
 failing confequence.
   § 189.  If a dog who ufed to be lively and active,
 becomes all at once moapifh and morofe ; if he has
 an averfion to eat; a particular and unufual look
 about  his eyes ; a reftleflhefs, which appears from
 his continually running to and  fro,  we may be ap-
 prehenfive he is likely to prove mad ; at which ve-
 iy inftant he ought to be tied up Securely, that it
 may be in our power to deStroy him as Soon as the
 diftemper is evident.   Perhaps it might be even
 ilill fafer to kill him at once.
   Whenever the  malady is certain,  the  fymptoms
 heighten pretty foon.  Hisaveriion to food, bute-
 fpecially to drink, grows Stronger.   He no longer
 feems to know his mafter, the found  of his voice
 changes;  he fullers 110 perfen to handle  or ap-
proach him ; and  bites thofe who  attempt it.   He 
          Of the Bite  of a mad Dog.          T47
 quits his ordinary habitation,  marching on with
 his  head  and  his tail hanging downwards; his
 tongue lolling half out, and covered with foam or
 Slaver,  which indeed not feldom happens indiffer-
 ently to all dogs. Other dogsfcent him, not feldom
 at a eonfiderabie dillance, and fly him with an air of
 horror, which is a certain indication of his difeafe.
 Sometimes he  contents himfelf v/ith  biting only
 thofe who happen to be near him : while at other
 times becoming more enraged,  he fprings to the
 right and left on all men and  animals about him.
 He hurries away with  inanifeil dread from what-
 ever waters occur to him : at length he falls down
 as Spent and exhaufted; fometimes he rilesup again j
 and drags himfelf on for a little  time, commonly
 dying the third,  or,  at the lateft, on the fourth
 day after the manifell appearance of  the difeafe,
 and fometimes even Sooner.
  \  190. When a perfon is  bit by fuch a dog, the
 wound  commonly heals up as readily,  as if it  was
 not in the leaft poifbnous : but after the expirati-
 on of a longer or  fliorter term, from   three weeks
 to three months; but  molt commonly  in  about
 Six weeks, the  perfon bitten begins to  perceive, in
 the  Spot that was bit,  a certain dull obtufe pain.
 The fear of  it fwells,  inflames, burfts open, and
 weeps  out a fliarp,  foetid, and feuious, or fome-
 what bloody humour.  At the fame time the pati-
 ent becomes fad and  melancholy : he feels a kind of
 indifference, infenlibility, and  general numbneSs;
 an almoft inceffant coldnefs ; a difficulty of breath-
 ing ; a continual anguifh and pains in  his bowels.
 His pulle is weak ancl irregular, his Sleep reftlefs,
 turbid and confufed with ravings, with Starting
 up in furpriie,  and with terrible frights.  His dis-
 charges by Stool are often much altered and irre-
gular,  and fmall cold  fweats appear at very fhort
intervals.  Sometimes  there is alfo a flight pain or
uneaiineis in tlie throat.  Such is the  full degree 
148         Of the Bite of a mad Dog.
of" this difeafe, and it is called by feme phyfieian*
the dumb rage, or madnefs.
  § 1 91. Its fecond degree,, the confirmed or down-
right madnefs,is attended with the following fymp-
toms. The patient is afflicted with a violent thirft,
and a pain in drinking.  Soon after this he avoids
all drink, but particularly water, and within fome
hours after, he even abhors it.   This horror be-
comes fo violent,  that the bringing water near his
lips, or into his fight, the very name of it,or of any
other drink ; the fight of objects, which, from their
transparence, have any refeinblance of water, as a
looking gla'Sire. afflidts him with extreme anguifh,
mid fometimes even with convulsions.  They con-
tinue however ftill to  fwallow (tho' not  without
violent difficulty) a little meat or bread, and Some-
times a little foup. Some even get down the liquid
irv^Jicine: thnr are pvefcribed them, provided there
be no appearance of water in them ; or that water
is not mentioned  to them, at the fame time. Their
urine becomes tl-kh  and high-coloured, and fbmc-
times there is a fuppreffion or Stoppage of it. The
voice either'grows hoa/fe, or is almoft entirely a-
bolilhed ;  but the  reports of the bitten  barking
like dogs, are ridiculous and fuperitilious fictions,
void of any foundation ; as- well as yiany other fa-
bles, that have been blended with  the hiftory of
this diftemner. The baiici !,:_>• of doas however is"
very difagreeable to them. Tncy are troubled with
ihort  dtliriums or ravinpr,  which  are fometimes
mixed with fury.  It is at luch. times that they fpit
all around them; that they attempt  alfo to bite,
and fometimes unhappily effect it. Their looks are
fixed, as it were,  and fomewhat furious, ancl their
vifage  frequently red.  It is pretty  common for
thefe miferable patients to be fenSible of tiie ap-
proach of their raging fit,  and to conjure the by-
flanders to be upon their  guard;   Many of ti.ein
never have an inclination to bite.  The increasing
anguifh and pain they feel become  inexpreflible : 
          Of the Bite of a mad Dog.          14J
they earnestly with for death, and  fome of them
have even dettroyed themfelves, when they had the
means of effecting it.
   § 192. It is with the fpitfle, and  the Spittle c$i-
ly, that  this dreadful poifon  unites itfelf.  And
here it may  be obferved,  1. That if the wounds
have been made thro' any  of the patient's cloaths,
they are  lefs dangerous than thofe inflicted imme-
diately on the naked  fkin.  2. That animals who
abound in wool, or have very thick hair,  are often
preferved from the mortal imprelfion of the poifon ;
becaufe in thefe various circumftauces, the cloaths,
the hair, or  the wool  have wiped,  or even dried
up, the llaver of their teeth.   3. The bites inflict-
ed by an infected animal,  very fbon after he has
bitten  many others, are  lefs dangerous than  the
former bites, becaufe their fiaver is leffened orex-
haulted.   4.  If the bite happens in the face, or iu
the neck, the danger is greater, and the operation
of the  venom is quicker too ; by  reafen the Spittle
of the perfon fo  bit  is  fooner infected,    c. The
higher the degree of the difeafe  is advanced,
th~ bites become  proportion ably more dano-erous.
From what I have jull mentioned here it may be
difcerned, why, of many who have been bitten by
the fame fuflerer, feme have  been iiifected  with
this dreadful difeafe,  and others not.
   § 195. A great number of remedies have  been
highly cried  up,  as famous in1 the cure of this dif-
eafe ; and, in Swifferland particularly,  the  root of
the eglantine or wild role, gathered at feme parti.
cular times,  under the favourable aspects cf the
moon, and dried with feme extraordinary precau-
tions'.  There is alio the  *  powder of Falmarius, of
calcined  egg Shells, that of the lichen terrellris, or
ground liverwoit with one third  part of pepper, a.
                      P 3

  • This coniTfted of equal parrs of me, vervain, p'antain, pntopodv.com-
m.ri ivfiimneori. mugwon, ballard baum,. betony, bt. jrj/'vj.Vwoit, u».i
ki:e: ..eu.ijry to£i, to which Dejaut: ac'ds ca.}ili;\. 
150          Cf the BiteVf* mad Dog.
remedy long celebrated in England; powder  of
oylter-Shells ; of vervain ; bathing in fait water ;
St. Hubert's key, ire. ire. But the death of a mul-
titude of thofe  who  have been bitten,  nothwith-
ilanding their taking the greateft part of all thefe
boalted antidotes ; and the certainty of no one's e-
fcaping,  who had been attacked  with the high
raging Symptom, the hydrophobia, have demonftrat-
ed the inefficacy of them all to all Europe.   It  is
inconteltible that to the year  1730, not a fingle
patient efcaped, in whom the difeafe was indifpu-
;tably manifest; and that every medicine then em-
ployed againll  it  was  ufelefs.   When medicines
had been given before the great fymptom appear-
ed, in fome of thofe who took them, it afterwards
appeared, in others  not.   The fame different  e-
Vents occurred  alfo to others who were bitten, and
who took not the lealt medicine ; To that upon the
whole, before  that  date, no medicine feemed  to
be of any confequence. Since that time,, we have
had the happinefs to be informed of a  certain re-
medy, which is mercury joined to a few others.
   § 194. In Short there is a neceflity for destroying
or expelling the poifon itfelf, which mercury ef-
fects, and is confequently the oounter-poifon of it.
That poifon produces a general irritation  of the
nerves; this is  to be removed or aflwaged, by anti-
ipafmodics : fo  that in mercury or qnickfilver,join-
ed to antifpmodics, confifls the whole that is indi-
cated in the cure of this difeafe. There really have
been many instances of perfons  cured  by thefe
medicines, in whom the distemper had been mani-
fest inits rage  and violence j. and as many as have
unfortunately  received the  caufe of it in a bite,
fliould be firmly  perfuaded, that in taking, thele
medicines,  and nfing all other proper precautions,
they fhall be entirely fecured from all its ill con-
 fequences.   Thofe alfo in whom the rage and fu-
ry of this diftemper is  manifefl^  ought to ufe thflr 
            Of the  Bite  of a  mad Dog;.             icr

fame medicines with entire * hope and confidence,
which may juflly be founded on the many cures ef-
fected by them.  It is  acknowledged however, that
they have  proved ineffectual  in a  few cafes;  but
what  difeafe is there, which  does not fometiines-
prove  incurable ?
   §  195.   The very  moment  after receiving the
bite,  if it  happens to be in the fleth,  and if it can
fafely be  effected, all the part afledted fliould be
cut -\  away.  The antients directed it to be cauter-
ized,  or burnt with a  red hot iron (meer fcarificati-
 on being  of very little effect)  and  this   method
 would very  probably  prove  effectual.   It  requires
 more  refblution,  however, than  every patient is
endued with.  The wound  fhould  be waShed and
 cleanfed a  eonfiderabie time  with  warm water,
with a little fea-falt diflolved in it.  After this, in-
 to the lips and edges of the wound,  and  into the
 furlace of the part all about it, Should be rubbed a

   * This advice is truly prudent and judLious ; hope, as I have obferved
 on a different occafior, being a powerful, tho* impalpable, cordial: and
 in fuch  perilous fltuations, we  fhould excite the molt agreeable expectati-
 ons we poflibly can in the patient : that nature, beingundepreffed by any
 defpondingmelancholy  ones, may exert her f'unctons the more firmly, mid
 co-operate effectually with the medicines, againit hex internal  enemy. K.
   t 1 knew a brave worthy gentleman abroad, who  above  forty years
 pall thus pitferved his life, after receivingthe bite of a !ar.^c rattle- fnake,
 by refoluteiy cutting it and the Heft) forrounding it out, with a (harp point-
 ed penknive.—Perhaps thofe whowould not fnffer the application of the
 actual cautery, that is, of a red hot iron (/which certainly promifes well-
'for a cure}  might be perfnadcd to admit of a potential cautery, where the
 b le was inflicted on a  flefhy part.  Tho'even this is far from being un-
 painful, yet the  pain  coming  on  more gradually, is lefs terrifying arid
 horrid.   And when it had been applied quickly after, and upon the bite,
 and k» pt on for three or four hour;, the difcharge, after cutting the efchar,
 womd fooncr  enfue, and  in more abundance,  than that from the actual
 cautery ; the only preference of which feems to confift in its being capable
 perhaps of abfoibing, 01 otiic. wife confuming, all the poifonons Jalivia at
 onci .   This iflue Ihouid be drefl'ed afterwards according to our author's
 direction ; and in the gradual healing of the ulcer, it may be properly de-
 terged b> adding a littL- precipitate to the digeftive.  Neither would this
 interfere with the exhibition of the tonquhi powder N*1* 30. nor the an-
 tifpafmodic bolus I\v- 31, if they  ihouid be judged neceffary.  And thefe
 perhaps might pro-c the moft ceitaln means ot preventing the mortal ef-
 fects of this lingular annnal poifon, which it is fo iinpofllble to analyze,
 and fo extremely difficult to form any rfiitcriai idea of;, but which is n«t
 the caft of fOroe other poifons.  JC 
 iC2            Of the Bite of a mad Dog.

quarter of an ounce of the ointment N°* 28. and
the wound Should be dreffed  twice daily, with the
foft lenient ointment N°- 29. to promote Suppura-
tion ;  but that of N°* 28. is to be ufed only once a
day.
   In point of regimen,  the  quantity of nourish-
ment fhould be Id's than ufual, particularly in the
article of* fleSh r he Should abflain from wine, fpi-
rituous liquors,  all ferts of fpices and hot inflam-
ing food.   He fliould  drink only  barley-water, or
an infufion of the flowers of the lime-tree.   He
fliould be guarded againll  coftivenefs by a foft re-
laxing diet, or by glyfters, and bath his legs once
a day in warm water.   Every third day one dofe
of the medicine N°* 30. Ihouid  be taken ;  which
is compounded of mercury, that counterworks the
poifon, and of inulk which  prevents the fpafms,
or  convulsive  motions.   I confels at the fame time
that 1  have lefs dependance on the mercury  given
in  this form,  and think the rubbing iu of its oint-
ment confiderably more efficacious, which I  Should
hope may always prevent the  fatality of this dread*
ful,  furprifing difeafe. \

  * It feems not amifs to try the effects  of a folely vegetable diet, (and
 that peihaps confuting more of the acefcent than alcalefcent herbi and
 roots) in this difeafe, commencing immediately from the  bite of a known
 mad dog.  Thefe carnivorous animals, who naturally 1 eject all vegetab'e
 food, are the only  primary harbingers or breedeis  of it ; though they
 are capable of tranfmitting it by a bite to graminivorous and granivorous
 ones.  The virtue of vinegar in this difeafe, Paid to have been acciden-
 tally difcovered on the continent,  feems not  to have been hitherto ex-
 perienced amongft us ;  yet,  in cafe of fuch a morbid accident, it may
 require a trial; though not fo far, as to  occafion tie omiftion  of moie
 cei tarily experienced remedies,  with fome of which it  might be impro-
 per.  K.
   t The great nfefulnefs of mercurial frictions, we may even fay, the
 certain fecurity which they procure for the patients, in tLefc cafes, pro-
 vided they are applied very foon after the bite, have been demondauri
 by their fuccefs in Provence,  at Lyons, at JMontpellier,  at Pondiihe: i;.,
 and in many other places.  Neither have thefe happy events been inva-
 lidated by any obfervations or  inltances to the contrary.  It car.r.r.t
 therefore be too ftrongly inculcated to thofe who have been bitten by
 venemous animals,  to comply with the ufe of them.  They ought to be
 ufed in fuch a quantity, and after fuch a  manner, as to excite a mode-
 rate falivation, for fifteen, twenty, or even thirty days.  E. L.
  Though this practice may juitly be  purfued from great caution, whea 
             Of the Bite of a mad Dog.        153
   § I96. If the raging fymptom, the dread of wa-
 ter, has already appeared, and the patient is ftrong,
 and abounds with blood, he Should,  1.  Be bled to
 a considerable quantity, and this may be repeated
 twice,  thrice,  or even  a fourth time,  if  circum-
 stances require it.
   2.  The patient Should be put, if poSfible, into a
 warm bath; and  this fhould be ufed twice  daily.
   3.  He fliould  every day receive  two,  or even
 three of the emollient glyfters Nc- 5.
   4. The  wound and  the parts  adjoining to it
 Should be rubbed  with the ointment  N • 28. twice
 a day.
   c. The whole  limb which contains the wound
 fhould be rubbed with oil, and be wrapped up  in
 an oily flannel.
   6. Every three  hours a dole of the powder N°»
 30. fliould  be  taken in a cup  of the infufion  of
 lime-tree and elder flowers.
   7.  The firefeription N°# 31. is to be given every
 night, and to  be  repeated in the morning, if the
 patient is not eafy, waffling it down with the fame
 infution.
   8.  If there  be  a great nau.feoufnefs at ftomach,
 with a bitternefs  in  the mouth, give the  powder
 Nc- 35. which brings up a copious  difcharge  of
 glewv and  bilious humours.                     %
   9,  There is very little occafion to  fay any thing
 relating to  the patient's food,  in fuch a fituation.
 Should he alk for  any, he may be allowed panada,
 light foup, bread, foups made of farinaceous or
 mealy vegetables, or a little milk.
   § 197. By the ufe  of  thefe remedies  the fymp-
 toms  will be obferved to leflen, and to difappear
 by degrees; and, finally, health will be re-ella-
 bliflied.   But if the patient fhould long continue

no cautery had been fpeeCKly applied to, and no fuch difcharge had been
•btained from, the bitten  pait ; yet wherever it had,, this long and c\e~
prcf.'ing faihation, I conceive, wornd be  very feldom neceilary ; and
might be hurtful  to wcuk w.ntiiuiio.is. £% 
»54         &f t^8 Bite of a mad Dog.
weak,  and Subject to terrors,  he may take a dofe
of the powder N°' 14. thrice a day.
  § 198. It is certain that a boy, in whom the ra-
ging Symptom of this difeafe had juft  appeared,
was  perfectly cured, by bathing  all  about the
wounded part with fallad-oil, in which fome cam-
phire and opium were dilfolved ;  with the additi-
on of repeated frictions of the ointment Nc* 28.
and making him take fome eau de luce with a little
wine.  This medicine, a coffee-cup of which may
be given every four hours, allayed the great inqui-
etude and agitation  of the patient; and brought
on a very plentiful fweat, on which all  the fymp-
toms vanished*.
  § 199. Dogs may be cured by rubbing in- a tri-
ple quantity of the  fame ointment directed for
men, and by giving  them the bolus Nc* 33.   But
both thefe means Should be ufed as foon as ever they
are bit.    When the great fymptom is manifest,
there v/ould be too much danger in attempting to
apply one, or to give the other ;  and they Should
be immediately killed.  It might be well however
to try if they  would  fwallaw down  the  bolus, on
its being thrown to them.
  As foon as ever dogs are bit, they fliould be late-
ly tied up, and not let loofe again,  before the ex-
piration of three or four months.
  § 200. A falfe ancl  dangerous prejudice has pre-
vailed with regard to the bites from dogs,  and it
is this----That if a  dog who had bit any perfon,
without being mad at the time of his biting, fliould
become mad afterwards, the perfon fo formerly bit-
ten, would prove mad too at the fame time.  Such
a notion is full as abfurd, as it would be to affirm,
that if two perfons  had Slept in  the  fame  bed,
and that  one of them  Should  take the itch, the
fmall-pocks, or any other contagious difeafe, ten or
twelve years afterwards, that the other fliould al-
fo be infected  with that  fie took,  and at the fame
time too, 
            Of the Bite of a mad Dog.         155

  Of two circumstances, whenever a perfon is bit,
one muft certainly be, either the dog which gives
the bite, is about to be mad himfelf, in which cafe
this would be  evident in a few days, and then it
muft be faid the perfon was bitten by a mad dog :
or elfe, that the dog was abfelutely found, Slaving
neither conceived, or bred in himfelf, nor receiv-
ed from without the caufe, the principle, of mad-
nefs :  in which laft cale 1 afk any man in his fenfes,
if he could communicate it ?   No perfen, no thing
imparts what it has not.  This falfe and crude no-
tion excites thofe who  are poffefled with it  to a
dangerous action : they  exercife that liberty  the
laws unhappily allow them of killing the dog; by
which means they are left uncertain of his ftate,
and of their own chance.  This is a dreadful un-
certainty, and may be attended with embarraffing
and troublefome confequences, independant of the
poifon itfelf.  The reafonable conduct would be
to fecure and obferve the dog very clofely,  in or-
der to know certainly whether he is, or is  not,
inad.
  § 20 r.  It is no longer  neceffary to reprefent the
horror, the barbarity and guilt of that cruel prac-
tice, which prevailed, not very long fince, of fuf-
focating perfons in the height of this difeafe, with
the bed-cloaths, or between matraffes.  It is now
prohibited in moft countries ;  and doubtlefs will be
punifhed, or,  at leaft ought  to be, even in thofe
where as yet it is not.
  Another cruelty, of which we hope to fee 110 re-
peated iuftance, is that  of abandoning thofe mi-
ferable patients to themfelves, without the leaft re-
fource or affiftance :  a moSt detestable cultom even
in thofe times, when there was not the leaft hope
of Saving them;- and Still more criminal  in  our
days,  when they may be recovered effectually.   I
do again affirm, that it is not very often thefe af-
flicted patients are difpofed to bite ; and that even
when they are,  they are afraid of doing it;   and 
t5»               Of the Small-Pocks.

requeft the byftanders to keep out of their reach:
fo that no danger is iucurred ; or where there is a-
ny, it may eafily be avoided by a few precautions.
                    CHAP.    XIII.

                   Of the  S/nall-Focks.


                     Sect.   202.

      THE fmall-pocks is the moft frequent, the moft
        extenfive of all  difeafes ; Since out of a  hun-
dred perfons there are not more  than * four  or five
exempted from it.  It is equally true however, that
if it attacks almoft  every } erlbn,  it  attacks thein
but  once,  fo  that  having  efeaped  through  it,
they are  always  Secure from  -\ it.    It muSt  be ac-


   * As far as the number, of inoculated perfont, who remained enrircly
uninfected, (fome very few after a  fecond inoculation,) has enabled me, I
have calculated the proportion naturally exempted from this, difeafe, tho'
rcfiding within the influence  of it,  to be full ?5 in  tooo.  See Anulyfis
of Inoculation, edit. 2d. p. 157. Mote *.  K.
   t 'It has fometimes been Ibfcrved (and  the obfervation has been f.cli,
as not to be doubted) that d|very mild dieting fmalrpock. has fometims
invaded the fame perfon twice: but fuch iniiancei are fo very rare, that
we may  very generally affirm, thofe who have had it once, will never have
it again. E. I..                             ,
   In deference to a few particular authorities, I have alfo fuppofed fuch
 a repeated infection, (Anaiyfis of  Inoculation, edit. 2d, p. 43.)  though
I have really never feen any  fuch myfelf; nor ever heard moie  than two
 phyficians aftim it, one at Versailles, and another in London ; the laft of
 whom declared, he took it upon the credit of a country phyfician, tho-
 roughly acquainted with this difealc, and a witnef. to the repetition of
 it.   Hence  we imagine  the editor of this v.oik  at Lyons might have
 juftly termed this re-infcction exttimely raie, which wojld i.a.e a ten-
 dency to  r«corjci;c  the fubjects of the fmail-pocJu,  more gen.rally, to
the molt falutary practice of inoculation.   Doubt.cis feme other eiup-
tive fevers, particularly, the chicken pock--, ciyfrai;-, ire. nave been of-
 ten miftaken for the real fmall-pocks by incompetent judges and fome-
times even by perfons  better  qualified, >cl who were lcl» attentive tn
 the fymptoms and piogrcf* of the  former.  But whoever will be at the
pains to read Dr. Oe Hat.-'  Patallclc de  la pti:te verole v.a uralle avec
I artifitielle, or a practical  abftract of part of.it  iu the Monthly Re-
view, vo'.xxv. p. 307. to 311.  will find.fuch a juft, cleai ana ufeful dis-
tinction ot them, as may prevent many future deccpuo::s on this frcquent-
J/micreiiinftfubjeft. A". 
               Of the Small-Pocks.            I$ft
Icnowledged, at the fame time, to be one of the
molt deilrudtive difeafes ;  for if in fome years or
feafons, it proves to be of a very mild and gentle
fort, in others  it is almoft as fatal as the plague :
it being demonftrated,  by calculating the confe-
quences of its molt raging,  and its gentletl preva-
lence,  that it kills one feventh of the number it
at'acks.
   § 20}. People generally take the fmall-pocks in
their infancy,  or in their  childhood.   It is very
feldom known to attack only one perfen in or,2
paace ; its invafions  being very generally epidemi-
cal, and Seizing a large proportion  of thofe who
have fuffered it.   It commonly ceafes at the end
of feme weeks, or of Sbme months,  and rarely e-
ver appears again in the Same place, until four,
fivp, or Six years after.
   § 204.  This  malady often gives feme intimation
of" its  approach, three or four days before the  ap-
pearance of the fever, by a little dejection ;  by
lefs vivacity and gaiety than ufual ;  a great pro-
pcnfity to fweat;  lets appetite ; a llight alteration
of the countenance, and a kind of pale livid  co-
lour about the eyes :  notwithstanding which, in
cliiidren of a  lax and phlegmatic conftitution,  I
have known a mod rate agitation of their blood,
(before their Shivering approached) give them  a
* vivacity, gaiety, and a rofy improvement of their
c/implexion, beyond what nature had given them.
   Certain fhort viciflitudes of heat or coldnefs Suc-
ceed the former introductory appearances,  and at
length a considerable Shivering, of the duration of
one,  two, three,  or four hours :  this is fucceedc-d
bv violent heat,  accompanied with pains of  the
head, loins, vomiting, or at leaft with a frequent
propenlity to  vomit.
   Vol. i.               Q,

   * The fame appearances very often o;cur in fiich f.ibiefb by inscol—
 tion, before actual (kkening, as I have cbiu .xd and ia.U.uccl, Aai.yiu
edit, lit, p.tf;. edit. ;d, p. 7;, 7S. 
 IJ8            Of the Small-Pocks.            #,
  This (late continues for fome hours, at the ex-
 piration  of wliich the fever  abates a little in a
 fweat, which is fometimes a very large  one : the
 patient then finds himfelf better, but is notwith-
 standing call down, torpid or heavy, very Squeam-
 ish,  with a head-ach and pain in the  back, and a
 difpofition  to be drowfy.  The laft  fymptom, in-
 deed, is not very  common, except in children lefi
 than feven  or eight years of age.
  The abatement of the fever is of fmall durati-
 on ;  and  fome  hours after, commonly towards the
evening,  it returns with all its attendants,  and
terminates again by fweats, as before.
  This ftate ot the difeafe laSts three or four days :
at the end of which term,  and feldom later, the
firft eruptions appear among the Sweat, which ter-
minates the paroxfym or return of the fever.  I
have generally observed the earlieft  eruption  to
 appear in the face,  next to that on  the hands, on
the fore part of the arms, on the neck, and on the
upper part  of the breaft. As foon as this eruption
appears,  if tlie diftemper is of a gentle kind and
diipofition, the fever almoft entirely vanifhes : the
patient continues to fweat a little, or traufpire ;
the number of eruptions increafes,  others coming
out on the back,  the fides, the belly, the thighs,
 the legs, and the feet.  Sometimes  they are push-
ed out yery numeroufly even to the  foles of the
 feet; where, as they increafe in fize, they often
 excite  very Sharp pain, by realon of the great
 thicknefs and hardnefs of the fkin in  thefe parts.
  Frequently on the firft and fecond day of erup-
 tion  (Speaking hitherto always  of  the mild kind
 and  degree of the difeafe) there returns again a
 very gentle revival of the fever about the even-
 ing, which, about the termination of it, is attend-
 ed with a eonfiderabie and final eruption : though
 as often as  the fever terminates perfectly after the
 earlieft eruption, a very diftinct and very fmall
 one is a pretty certain confequence.  For though 
                Of the Small-Pocks.            I$9
 the eruption is already, or fhould prove only mo-
 derate,  the fever, as 1 have before Said,  does not
 totally difappear j a Small degree of it Ilill remain-
 ing, and heightening a little every evening.
   Thefe pultules,  or efflorescences, on their firft
 appearance,  are  only  fo  many very iittle  red
 Spots,  conliderably refembling a flea-bite, but dif-
 tinguiihable by  a fmall white point  in tlie middle,
 a little raifed above the reft,  which gradually in-
 creafes in Size, with tiie rednefs extended about it.
 They become whiter, in proportion as they grow
 larger;  and generally upon the Sixth day, includ-
 ing  that of their firfl eruption,  they attain, their
 utmoft magnitude, and are full 01 pus  ov matter.
 Some of thein grow to the fize of a pea, and fome
 ftill  a little larger ;  but this never happens to the
 greateft  number of them.   From thi» time tliey
 begin to look  yellowilh, they gradually become
 dry, and fall off in brown feales, in ten or eleven
 days from their firft appearance.  As their erupti-
 on occurred on different days, they alio wither and
 fall  off fucceSfively.   The face is fometimes cle^r
 of them, while putules ftill  are Seen upon  tl.-e
 legs, not  fully ripe, or fuppurated :  and thofe
 in the fbles of the feet often remain, much longer.
   § 205. The fkin is of courfe extended or llretch-
 ed out by the pultules;  and after the appearance
 of a certain quantity,  all the interltites, or parts
 between  the puftules, are red and bright, as it were,
 with a proportionable inflation or fwelfing  of the
 fkin.   The face is the firlt part that appears bloat-
 ed, from the pultules, there firft attaining  their ut-
 moft Size : and this inflation is femetimes fb con-
 siderable, as  to look  monttrous ; the like happens
 alfo to the neck, and the eyes are entirely doled
up by it.   The Swelling of the face abates in pro-
portion to the feabbing ancl drying up of the pm-
tules ; and then the hands are puffed up procligi-
ouily.   This happens fucceSfively to the legs,  the
                      0: 2 
160            Cf the Small-pocks.
tumour or fvvelling being the confequence of the
pnftules attaining their utmoft fize, which hap-
pens by S'utceSIion, in theft- dif erent parts.
  § ao6.  Whenever there is a veiy eonfiderabie e-
ruption, the fever is  heightened at the time  of
Suppuration, which is not to be wondered at ; one
tingle boil excites a fever :  how is is poffible then
that fome hundreds, nay fouie thoufands, of thefe
little abfeefles fliould net excite one  ?   This fever
is the moft dangerous  period,  or time of the dif-
eafe, and occurs between the ninth and the thir-
teenth days; as  many circumftauces vary the term
of fuppuration,,  two or three days.   At this pain-
ful and perilous feafen then, the patient becomes
very hot,  and thirfty :  he is liarrafl'ed with pain ;
and finds it  very difficult to difcover a favourable
eafy polture.   If the  malady runs very high,  be
has no ileep; he raves, becomes greatly oppitTYd,
is  Seized with a heavy drowfinefs; and when he
dies, he dies either Suffocated or lethargic, and
iometimes in a ftate  compounded of both thefe
fymptoms.
   The pulfe, during this fever of fuppnration, is
fometimes of an aftonifhing quicknefs,  while the
.fwelliiiir of the  wrifts  makes it feem, in fome fuK
j--its, to be very  fmall.   Tlie moft  erit.cal and
dangerous time is, when the fwellings of the f re,
head and neck, are in their highelt decree. Whcl-
ever the fwelling beoins to Sail,  the Scabs on the
face to diy, [fuppoftug neither  cf thefe to be toofud-
den and premature, for the vifiblc quantity of the puf-
tules'} and tlie fkui to Shrivel, as it were, the quick-
neSs of the pulfe abates a little, and the danger
diminishes.   When the puftules are very few,  this
fecond,  fever is fo moderate, that it requires fome
attention to difeern it, fb that the danger is next
 to none.
   § 207.  Befides thefe fymptoms, there are feme
 others, which require considerable  attention and
 vigilance.   One  of thefe is the forenefs of  the 
                Cf the Smalt-Pock's.             *6i
throat, with which many perfbns"in tiie fmall-pocks
are  afflicted, as foon  as the fever  grows  pretty
Strong.  It continues for two or three days ; feels
very flrait and troublefome  in the action  of fwal-
lowing ; and  whenever the difeafe is  extremely
acute it entirely prevents (wallowing.  It is com-
monly  afcribed-to the eruption of pultules in the
throat; but this is a miftake, fuch puftules being
almoft couflantly * imaginary.  It begins moll fre-
quently, before the eruption appears; if this com-
plaint is in a light degree,  it terminates upon  the
eruption ;  and whenever it revives again  in  the
courfe of the difeafe, it is always in proportion to
the  degree of the fever.-  Hence  we may infer it
does not arife from the  pultules,- but is owing to
the inflammation ; and  as often as it is of any eon-
fiderabie duration, it is almoft ever attended with'
another fymptom, the  falivation, or a difcharge
of a great  quantity  of 1 pit-tie.   This Salivation
rarely exifts,  where  the difeafe is very  gentle, or
the  patient very young ; and is full as rarely  ab-
feut, where it is Severe, and the patient is paSl Se-
ven or eight years old:  but  when the eruption is
very confluent, and the patient- adult, or grown
up, the difcharge is furprifing.   Under thefe  cir-
cumstances it flows out inceffantly, allowing  tlie'
afflicted patient no reft or refpite ; and  often  in-
commodes himmore than any other fymptom of the
diftemper ; and lb much the more, as after itsco.i-
tinuance for fome days,, the lips, the infide of the
cheeks, the tongue, and the roof of the mouth are
entirely peeled or fiead, as it were.  Neverthelefs,
                         SL  3
  * As pnftoles are,-and not  very feldom,  viflble* on the tongue, and
fometimc!. on the roof, even to its proctfs called the palate, which 1'have
plainly feen ; it feems not very eafy, to lifign any infftperable obftacle
to the exif'ence-of a few within the  throat; though this fcarcely ever
cccjr-, in tho diflinft fmaii-pocks.  Doubtlefs however, a eohfiderable
iulammation of that put will be as likely to produce the great difficulty
of fwallowing,  as  the irKiftence of piiflules'tlieu."; «hk!i our learned
author does no; absolutely reject, and corifeiiuently will forgi-.e this fup-
pnfition of them-, efpecially  if he credits the ocular u.l'.i.T.o.iy of Dr "
WilaHtc, cited in the Analyiis, Ed. ii  p. 71.  K.              *' 
 162           Of the Small-Pocks.
 however painful and enibarraffinp this difcharge
 mav prove, it is very important and falutary.  Mere
 infants are lefs fubject to it, fome of them having
 a loofenefs, in lieu ot it : and yet I have obferved
 even this  laft dilcharge  to be  confiderably lets
 frequent in them, than a falivation is in grown
 people.
   § 20S. Children, to the age of five or fix years,
 are liable  to convulsions, before eruption :  thefe
 however are not dangerous, if they are not ac-
 companied with other grievous and violent Symp-
 toms.   But fuch  convulfions as  fupervene, either
 when eruption having already occurred, fuddenly
 retreats, or ftrikes in, according to the common
 phrafe; or during the courfe of  the  fever of fup-
 puration, are greatly more terrifying.
   Involuntary difeharges  of blood from the nofe
 often occur,  in the firfl flages of this diftemper^
 which are extremely fervieeable, and commonly
 leflen, or carry off,  the head-ach.  Mere  infants.
 are lefs fubject to this difcharge ;  though  they
 have fometimes a little of it : ancl 1  have known a
 eonfiderabie ftuper or drowfinefs, vanifh immedi-
 ately after this bleeding.
   5 209. The fmall-pocks is commonly distinguish-
 ed  into two kinds, the  confluent and the distinct,.
 fuch a diftinction really exiting in nature : but as
 the treatment of each of them is the fame ; and as.
 the quantity or dofe of  the medicines is only to be
 varied, in proportion to the danger of the-patient
 (not to enter here into very tedious details, and
 fuch as might exceed the  comprehention of many
 of our readers ; as well  as whatever might relate
 particularly to the malignant fmall-pocks) I fhall
limit myfelf within the defeription 1 have premi feds,
 which includes all the fymptoms common to both
 thefe kinds of the fmall-pocks..   1 content  myfelf
with adding here,  that we may expect a very con-
fluent and dangerous pock, if, at the very time of
Seizure, the patient is immediately attacked  with 
            ' Of the Small-Pocks.             163
many violent fymptoms ;  more efpecially if his eyes
are extremely quick, lively, and even gliflening,
as it were ; if he vomit.s almoft continually ; if the
pain of his loins  be violent;  and if he fuffers at
the fame time great anguifli and  inquietude : if in
infants there is great ftupor or heavinefs ; if erup-
tion appears on the third day, and fometimes even
on the fecond : as the haSlier eruptions in this dif-
eafe Signify the moft dangerous kind  and degree
of it ;'and on the contrary, the flower eruption is,
it is tlie fafer too ; fuppofing this  flownefs of the
eruption not to have been the confequence of great
weaknefs, or of feme violent inward pain.
   §  2to. The diibrder is  fometimes fo very mild
and Slight, that eruption appears with Scarcely a«
ny fufpicion of the child's having the leaft ailment,
and the event is as favourable as the invafion. The
pultules appear, grow  large, fuppurate and attain
their maturity, without confining the patient to
his bed,  or lellening either his Sleep or appetite.
   It is very common to fee children in the country
(and they are feldom more than children who have
it So very gently) run about in the open air, thro*
the whole courfe of this difeafe,  and feeding jufl
as they do in health.   Even thofe who take it in a
fomewhat higher degree, commonly go out when
eruption is finished, and give themfelves up, with-
out relerve,  to the voracity of their hunger. Not-
withstanding all this neglect, many get perfectly
cured; though fuch  a conduct Should never be
propoSed for imitation, fince numbers have expe*
rienced its pernicious confequences;  and feveral
of thefe children have been brought to me, efpe-
cially from Jurat, who after  fuch neglect  in  the
courfe of the mild and kindly fort of this diftemp-
er, have contracted complaints and infirmites of
difterent kinds,  which have been found very diffi-
cult to fubduc.
   §  211. This ftill continues to be one of thefe
diitempers, whole danger has long been increafed 
I64            Of the Small-Pocks.
by its improper treatment, and efpecially by  for*
cing the patients into fweats, and it Still continues
to be increafed, particularly among country peo-
ple.  They have feen  eruption appear, while the
patient fweats, and obferved he found himfelf bet-
ter after its appearance; and hence they conclude
that, by quickening and forcing out this eruption,
they contribute to his relief; and  fuppofe, that by
increasing the quantity of his fweats, and the num-
ber of his eruptions,  the blood is the  better clear-
ed and purified from the poifon.   Thefe are mor-
tal errors, wliich daily experience has demonftrat-
ed, by their tragical confequences.
   When the contagion or poifon, which generates
this difeafe, has been admitted into the blood,  it
requires a certain term to produce its ufual effect*:
at which  fime  the blood being  tainted by the ve-
nom it has received,  and by that which  fuch ve-
nom has  formed  or  aflimilated from  it,  nature
mikes an effort to free herfelf of it, and to ex pell
it by the fkin, precisely at the time when every
thing is predifpofed for that purpole..  This effort
pretty jgeiieFally fucceeds, being very often rather
too rapid, and. violent, and very Seldom too weak.
Hence it  is evident, that whenever this effort is de-
ficient, it ought not to be heightened by hot me-
dicines or means,  which  make it  too violent,and
dangerous : for when it already exceeds in  this re-
fipett,  a further increafe of fuch violence mult ren-
der it  mortal.  There are but few cafes in which--
the efforts of nature, on  this oceafion,, are too
languid and feeble, efpecially in the country ; and-
whenever fuch rare caSes do occur, it is very dif-
ficult to forma juft and proper ellimation of them.:
for which realon we  Should be very  referred and
cautious in the ufe of heating medicines,, whicli are
fo mortally pernicious in this difeafe.
   Wine,  Venice treacle;  cordial  confections, hot
 air, and  loads of bed-cloaths, annually fweep off
thousands of children; who might have recovered) 
               Of the Small-Pocks.           165

if they had taken nothing but warm water :  and
every perfen who is  interefled  in the recovery of
patients in this diftemper, ought carefully to pre-
vent the fmallelt ufe of fuch drugs;  which, if they
Should not immediately aggravate it to a fatal de-
gree,  yet will certainly increafe tlie feverity and
torment of it,  and annex the  molt unhappy and
tragical confequences to it.
   The prejudice in  this point  is fo ftrongly root-
ed, that a total eradication  of it muft be very dif-
ficult : but I only defire people would be convinced
by their own eyes,  of the different fuccefs of the
hot regimen, and of that I fhall propofe.   And
here indeed I muft confeSs,  I found more attenti-
on and docility on this point,  among  the inhabi-
tants of the city, and  especially in the laft epide-
mical  fpreading of the fmall-pocks,  than 1 pre-
fumed to  hope for.  Not only as many as confult*
ed me on  the invafion of it, complied exactly with
the  cooling  regimen  I advifed  them  ;  but their
neighbours allb had recourfe to it, when their chil-
dren fickened : and being often called in when it
had been many  days advanced, I obferved  with
great pleafure, that in many houfes, not one heat-
ing medicine had  been given ;  and great care had
been taken to keep the air  of  the patient's cham-
ber refrefhingly cool and temperate.  This encou-
rages me  to expect, that this method hereafter will
become general here.  What certainly  ought moft
effeutially to conduce to this is, that notwithtland-
ing the diffusion or Spreading  of this  difeafe was
as numerous and  extenfive as  any of  the former,
the mortality,  in  confequence  of it, was evident-
ly left.
   §  212.  At the very beginning of the  fmall-pocks
 (which may be  reafonably fulpedted,  from  the
prefence of the fymptoms 1 have already deferibed;
fuppofing the  perSbn complaining  never to have
bad it, and the difeafe  to prevail near his resi-
dence) tlie patient is immediately to be put on a 
166            Of the Small-Poch.
ftridt regimen, and to have his  legs bathed night  *
and morning  in  warm  water.   '1 his  is  the  moft
proper and promifing method to leflen the quan-
tity of eruption in the face and  head,  and to faci-
litate it  every where elfe on  the furface.   Glf-
fteis alfo greatly contribute to abate the h ad ach,
and to  diminish the Teachings to vomit,  and  the
actual vomitings, which greatly dillrefs  the pati-
ent ; but which however it  is highly  abfurd  and
pernicious to flop by any  Stomachic cordial con-
fection, or by  Venice treacle ;  and itill more dan-
gerous to attempt  removing the caufe of* them,
by  a y-omit or purge, which are hurtful in  the be-
ginning of the fmall-pocks.
  If the  fever  be moderate, the bathings  of the
legs on the firft day  of fickening, and one gyliter
may Suffice  them.   The patient muft be restrain-
ed to his regimen j and inllead of the ptifan N°# I,  j
a,  4, a very young child Should drink nothing but  \
milk, diluted  with two thirds of  elder flower  or   I
lime-tree tea,  or with  bawm tea, if there be  no
perceivable  fever : and in fliort, if they have ana-
verfion to the talle of them all, with only the fame
quantity of good  clear * water. An apple coddled
or baked may be added to it; and if they complain
of hunger a little bread may be allowed ;  but they
muft be denied any meat, or meat broth, eggs and
ftrong drink :  fince it has appeared  from observa-
tions frequently repeated, that  children- who had

  *  A negro girl, about five or fix years old, under a coherent pock,
Hole by night out of the garret where fhe lay, into a kitchen out of doors,
where fhe drank plentifully of cold water.  How often fhe repeated thefe
n ghtly cooling potions I never could certainty learn, though they occurred
in my own hoafe  in Souih'Ca,otina in fummer.  But it is certain the child
recovered as  fpeedily as others, whofe eruption was more diftinrt, and
who drank barley-water,  very thin  rice or indian corn grewel, bawm tea,.
© the like.  In fact, throughout the conrfe of this  vifitation from  thw
fmall-pocks in Carolina in 1738, we had but too many deraonftrations of
the fatal co-operation of violent heat with, their contagion ; and not a very
few furprizing inltances of the lalutary effects of being necefTarily and in-
vomtaiily expofed to fome/ery cooling accidents  after infection, and in
fome cafes after eruption too : which I then moiw particularly mentioned ia
a fmaii contiovctfiai  tra& primed there.  K. 
                Of the Small-Pocks.            167
 ,been indulged with fuch  diet, proved the  worfe
 for it, and recovered  more flowly  than  others.
 In this early llage  too, clear whey alone may ferve
 them inftead of every  other drink, the good ef-
 fects of which I have frequently been a witnefs to ;
 or feme buttermilk  may  be allowed.   When the
 diftemper is of a mild fpecies, a  perfect cure  en-
 fues, without  any other  affiftance or medicine:
 but we Should not  neglect to purge the patient as
 foon as the pultules  are perfectly Scabbed on  the
 greater part  of his face, with  the  prefcription
 N' •  it.  which mult be repeated fix day.,  after.
• He Should not be  allowed ftefh 'till after this fe-
 cond purge: though after the firfl he may be al-
 lowed fome well-boiled-puis, or garden-ituff and
 bread, and in fuch a quantity, as not to be pinch-
 ed with hunger, while  he recovers from the  dif-
 eafe.
    §  215.  But if the fever  fliould be  ftrong, the
 pulfe hard, and the pain of the  head and loins
 Should be  violent, he  muft, 1. Immediately  lofe
 blood from the arm ; receive a glyfter two hours
 after ; and, if the fever  continues, the  bleeding
 mutt be repeated.   1 have directed a repetition of
 it even to  the fourth time, within the  two firfl:
 days, to young people under the age of eighteen ;
 and it is more efpecially neceffary in fuch perfbns
 as, with a hard and full pulfe, are alfe affected ,
 with a heavy drwofinefs and a delirium, or raving.  *
    2. As long as  the fever continues violently two,
 three,  and even four glyfters fhould be given in
 the 24 hours;  and the legs fliould be bathed twice.
    3. The patient  is to  be taken out  of bed, and
 fupported in a chair, as long  as he can  tolerably
 bear it.
    4. The air of his chamber fhould frequently be
 renewed, and if it be too hot, which it often is in
 fummer, in order  torefreSh  it and the patient, the
 means muft be employed  which are diredted § 36.
    c  He is to be reftrained to the ptiians  Nc* 3 or 
I6S              Of the Small-Pocks.

4.  and if that does  not  fufficiently  moderate  the
fever, he fliould take every  hour,  or every  two
hours, according  to the urgency  of the  cafe, a
fpoonful of the mixture N  •  10.  mixed with  a
cup of ptifan.  After the eruption,  the fever being.
then abated, there is  lefs occafion   for medicine ;
and fliould it even  entirely disappear  the  patient
may be regulated, as directed, §  212.
   § 214. When, after a  calm, a remiflion  or in-
termiSiion of Some days, theproc; S's of Suppuration
revives the  fever, we  ought  firfl,  and efpecially,
to keep the * body very open.   For this  purpofe,
a.  an ounce  of catholicon fhould be  added  to  the
glyfter; or they  might be limply made  of whey,
with honey, oil and fait.  ".  Give the patient three
times every morning at  the interval of two hours
betwen  each, three glaffes of the ptifan  N'#  52.
y  Purge him after two days, with the potion N'*23«
but  on that  day  lie muft  not  take  the  ptifan
Nc«  32.


   * We mult remember that Dr.  TISSOT is treating here  of the higher
Or confluent degrees of this  difeafe; for in the  diftinct fina I-pocks, k is
common to finr' perfons fo.  feveral diys without a ftoo, and withott tlie
leait perceiveable diforelei for want of one (their whole nouriihmc-nt be-
ing very light and liijuidj in which  r^alc-, while matters proceed wil.inall
other refpects, there feems little oecafion Tor a gieat folicitude abo. t
ibools: bn if one  fhould be judged netefiary after four or fivedavscof-
tivenels, accompanied with a tiglunefs-or hardriefs of the belly, do bt«
lefs the glyfter ihouid be of the lenient k nd (as thof.  directed by our an.
thor are) and not calculated to produce more than a fecond ftool at tlie ve-
ry molt.  Indeed, whei e there is  reafon to apprehend a ftrong fecondiry
fever, from tbe quantity of eruption, and a pieviouily high inflammation,
it is more prudent to provide for a miti.vuion of it, by a  moderately  o-p
pen belly,  than to fuffer a  long coitivenefs ; yet fo as to  incur very 'it-
tie hazard of abating tWe falivano.i, 01 retarding the growth or fnppuratioa
of thepuftules, by a fuperp-jrgation, which it may be too eafy to excite
in fome hibits.  If the  difcharge by fpitting. and the brightnefs  and
quantity of fuppuration, have been in proportion to the number of erup-
tions ; though the conflict  from the fecondary  fever,  where thefe have
been numerous, is often acute and high ; and the patient, who is  in great
anguilh is far from being out of danger, yet nature pretty generally proves
stronger than the difeafe, in fuih circamftances.  As the elect,  ca-kili'
can is little ifed, or made here, the lenitive electuary of our difpenfatorr
maybe fubftitutedfor it, or that of. the Edinburgh difpenfatory, which
 was calculated particularly  for glyfters.  ,£. 
              Of the Smalt-Pocks.             ify
   3. He muft, if the  diftemper be very violent,
take a double dofe of the mixture Np* io.
   3. The patient Should be taken out of bed,  anfl
kept up in a room well aired day and night,  un-
tSll the fever has abated.   Many perfbns will pro-
•bably be furprized at this  advice ;  neverthelefs ic
is that which  I have often experienced to be  the
moft efficacious, and without which the others are
ineffectual.   They will fay, how Shall  the,patient
fleep at this rate ? To which it may be anfwered,
fleep is' not  neceffary, nay, it is hurtful  in  this
Hate and ftage of the difeafe.  Befides, he is really
unable to Sleep : the continual falivation ;  pre-
vents it, and it is very neceffary  to keep up  the
falivation ; which is facilitated by  often injecting
warm water  and honey into his throat.  It is alfo
of eonfiderabie fervice to throw feme up hisnoflrils,
and often thus to  cleanfe the  fedbs which form
within them. A  due regard to thefe circumllances
not only contributes to leffen the patient's uneafi-
nefs, but very effectually allb to his cure.
   4. If the  face and neck are greatly  "fwelled*
emollient cataplafms ought to be  applied to the
foles of the  feet ; and if  thefe fhould have  very;
little  effect, finapifins  fhould be applied.  Thefe
 are a kind of plaifter or  application compofed o"f
yeaft, muSlard-flower, and feme  vinegar. They
fometimes occafion Sharp and almoft burning pain,;
but in proportion to the Sharpnefs and increafe of
thefe pains,  the  head and neck  are remarkably
relieved.
   § 215. The eye-lids are puffed  up and levelled
when the difeafe runs high, fo as  to conceal the
eyes,  which are clofed up  fall for feveral days, no-
thing further fliould be attempted, with refpect to
this cricumllance, but the frequent moiftening of
 them with a little warn milk and water.  The pre-
 cautions which fome take  to ttroke them with faf-
 fron, a gold ducat, or rofe-waterare equally child-
 ifli and  irtfignlficant.   What chiefly  conduces to
   Vol. I.             R 
 170          Of the Small-Pocks.
 prevent the rednefs or inflammation of the eyes
 after the difeaS'e, and in oeneral all its other bad
 conSequences, is to be content for a considerable
 time, with a very moderate quantity of food,  and
 particularly to abltain from  ftelh and wine.   In
 the very bad fmall-pocks, and  in little children,
 the eyes are clofed up from the beginning of the
 eruption.
  §  216. One extremely ferviceable affiftance, and
 which has not been made  ule of for a long time
 pall, except  as a means to preferve  the fmooth-
 nefs and beauty of the face ; but yet wliich has the
 greateSl tendency to preferve life itfelf, is the o-
 Jiening  of the pultules, not  only upon the face,
 but all over the body.  In the firlt place, by open-
 ing them the lodgment  or  retention of pus is pre-
 vented,, which may be fuppoSed to prevent any ero-
 fion, or eating down, from it; whence tears, deep
 pits and  other deformities  are  obviated.   Se-
 condly, in giving a vent  to the poifon, the  re-
 treat of it into the blood is  cut off, which removes
 a principal caufe of the danger of the fmall-pocks.
 Thirdly* the  fkin is relaxed  ; the tumour  of the
 face and neck diminish in proportipn to that relax-
 ation; and thence the return  of the blood from the
 brain is facilitated, which muft prove a great ad-
 dvantage.  The puftules Should be opened every
 where,  fuccefiTvely as they  ripen.   The  precife
 time of doing it is when they are entirely white;
 when they juft begin to  turn but  a very little
 yellowifh; and when the red circle  furrounding
 them is quite pale.  Tbey fhould be opened with
 very fine Sharp-pointed fciSfars ; this does not give
the patient the leaft pain ;  and when a certain
 number of them are  opened, a fpunge dipt in a
little warm water is to be repeatedly applied to
 fuck up and remove that j>us,  which would foon i»e
 dried up  into feabs.   But as tlie puftules, when
 emptied thus, foon fill again, a difcharge of this
 irefh matter muft be obtained in the fame  manner 
S'v               Of the Small-Pocks.               171
':  fome  hours after ; and this muft femetimes be re-
  repeated five or even fix times fucceflively.   Such
  extraordinary  attention in this  point  may  pro-
  bably be confidered  as minute,  and  even  trivial,'
  by feme; and is very unlikely  to become a * gene-'
  ral practice :  but  I do again  affirm it to be of
  much more importance than  many may imagine ;.
  and  that as often  as  the  fever  attending  Sup-
  puration is violent and menacing,  a very gene-
  ral, exadt  and  repeated  opening, emptying, and
  absorbing of the lipened puftules, is a-remedy of
  the utmoft importance and efficacy ;  as  it removes
  two very eonfiderabie  caufes of the danger of this
  difeafe, whicli are the  matter  itfelf, and the great
  tenfion and fliffnefs of the fkin.
     § 217.  In the treatment of this-difeafe,  I  have
  faid nothing with refpedt to anodynes, or fuch me-
  dicines  as procure fleep, which I am fenfible are
  pretty generally  employed in it ;   but which  I
  fcarcely ever diredt  in this violent degree of the
  difeafe, and the dangers  of which medicine  in it
  T have demonftrated in the letter to Baron Hallerr
  which 1 have already mentioned.   For which rea-
  fon, wherever the patient is not under the care and
                           R 2

    * This praftir- which I had  heard of,  and even fuggefted to  myfelfi
  but never feen actually enterprifed,  feems  fo very rational as highly to
  deferve a fair trial in the confluent degrees of the fmall-pocks [for in the
  very diftinct it can fcarcely be neceffary]  wherein every probable affift-
  ance fhould be employed, and in which the  moft potent medicines are
  freqaeutly unfuccefsful.  "We have but too many opportunities of trying
  it fufficiently ; and it certainly lus a more  promifing afpect than  a prac-
  tice fo highly recommended many years ago,  of covering all the puftules
   (which is fometimes the wMble  furface of the patient; in melilot,  or fup-
  pofe any other fuppurating,  plaifter ;  which muft effectually prevent all
  perfpiration« and greatly increafe the forenefs, pain and embarrafTment
  of the patient, at the height of the difeafe.  I can conceive but one bad
  confequence that might poflibly  fometimes  refult from the former ;  but
  this (befides the means that may be ufed to avert h) is rather remote,
  and fo uncertain, until the trial is repeatedly  made, that I think it oughc
  not to be named, in competition with the  benefits that may arife front
' it in fuch cafes, as feem, otherwife, too generally irrecoverable.  I own
  however, that Dr.  G*tii gives  his fuffrage ftrongly agatalk this praftko
   iu his late tract concerning inoculation.  &» 
* TX              Of the  Small-Pocks.

direction of a phyfician, they fhould very carefully
abstain from the ufe of Venice treacle, laudanum,
diacodium, that is the Syrup of white poppies, or e-
ven of the wild red poppy :  fyrup of  amber, pills
of Slorax, of cynogloffum or hounds-tongue ; and,, in
one word, of every medicine which produces fleep.
But ftill more efpecially fhould their ufe be entire-
ly  baniShed, throughout  the duration  of the Se-
condary  fever, when  even natural  Sleep itfelf is
dangerous.   One  circumllance in which their ufe
may fometimes be  permitted,  is  in  the cafe  of
weakly children,  or fuch as are liable to convulsi-
ons, where eruption is  effected  not without diffi-
culty.    But 1  mult again inculcate the greatefl
circumSpection in  the ufe of fuch inediiines, whofe
effects are fatal,f when the blood-vellels are  turgid
©r full; whenever there is inflammation, fever, a
great distention of the fkin ;  whenever the patient
raves,  or complains oc heaviness  and oppreffion  ;
and when  it is neceffary that the belly Should be


  fThe ufe of opiates iathis difeafe undoubtedly requires no fmall con-
fideration, the great  Sydenham  himfelf not teeming alway. futficientiy
 guarded  in the. exhibition of them; as far as experience ftnce his day has
enabled phyficians to. judge of this matter.  In general our author's li-
mitations of them feem very juft  ; though we have feen a few clear in-
stances,  in which a light raving,, which evidently arofe from want of
fleep, (joined to fome dread of the event of the difeafe by iuoculaii j  ;
was happily removed, with-every other conlidcrab.e complaint, by a mo-
derate opiate.   In fore  and fretful children  too, under a large "or mid-
dling eruption, as the time  gained to relt i.i taken fiom pain,  and from
waiting their fpirits in crying and  clamour, I have feen fuppuration very
benignly promoted by di.vodium.  But in the crifis of the fecondary fe-
ver in the continent or coherent pock, when there is a morbid fulnefs,
 and nature is ftruggling  to unload herfclf by fome other outlets than
 thofe of tlie fkin,  which now  are totally obstructed,  (and which feems-
 the only evacuation that  is not  retrained by«op,iate>; the giving and re-
 peating them then, as has too often been praclfcd,  feems importantly
 erroueous; for 1 think Dr. Swan  has taken a judicious liberty o  difTent-
 ing from the great author he tranflates, in forbidding an opiate, if the
 fpitting  abates,  or grows fo tough and ropy,  as to endanger fulfocation.
 As ,the difference of oar ceconomy in the adminiltration of phytic from
 that in Siuijferland,  and Dr. Tiffot's juft reputation may difpofe many,
 country  practitioners  to perufe  this treatife, I take the lioerty of reier-
 rhigfucb readers, for a recollection, of fome of my fentiments on opiates,
 long before the appearance of this work in French, to the fecond edition
 of the Analyfts, from g.  ?4> to 07, ©•<-,  &, 
                Of the Small-Pocks.-           *f$
fcpen ;  the urine plentifully difeharged";  and the
falivation be freely promoted,
   § 2if?.  If eruption Should fuddenly retreat, or
ftrike in>- heating, Soporific, fpirituous^ and vola-
tile remedies Should carefully be avoided : but the
patient may drink plentifully of the infufion N°#
12. pretty hot, and Should be blillered on the fleShy
part of the legs*  This is a very embarraSSing and-
difficult cafe,; and- the different circumllances at*
tending it may require different means and appli-
cations, the detail and difcuffion of winch are be-
yond my  plan here.-  Sometimes a tingle bleeding
has effectually recalled eruption at once,
   § 219. The only certain method of furmounting
all the danger of this malady, is to inoculate.  But
this moft-Salutary method, which ought to be re-
garded as a particular and gracious difpenfationv
of providence, can feareely be attainable by, or
Serviceable to, the bulk of the people, except in
thofe countries,- where hofpitals* are deftined par-
ticularly for inoculation.  In thefe where  as yet
there are  none,  the "only refburce that is left for
children who cannot be inoculated at home, is to
difpofe them happily for the diftemper, by a Sim-
ple eafy preparation.-
   § 220. This preparation confifts, upon the whole,
in removing all waut of, and all  obftrudtions to,
the health of the perfon  fubjedt to this difeafe, if
he have any fuch ; and in bringing him into a mild'
and healthy, but not into a very robuit and vigo-
rous State ; • as this diftemper is often exceedingly
violent in the laft.
   It is evident,  that fince the defects of health'
are very different in  different bodies, the prepara-
tions  of them muft as often vary ; and that a child
                        K3

  • That I have long fince had the honour of agreeing with our learned
author,  in this confideration for the benefit of tlie body of the people,-
which is the benefit of the ftate, will appear from p. aBB, of Analyiij, >
edit, ift, and from p. 3/1, 37 i,' of the 2d,  A* 
174             Of the Small-Pocks.
fiibjedt to fome habitual diforder, cannot be pre*
pared in the fame method with another who has. a
very oppofite one.   The detail and cfiftindtions
which are neceffary on this important head, would
be improper here,  whether  it might be owing to
their  unavoidable length -T  or to the impoffibiiitjf
of giving perfons, who are not phyficians, fuffici-
ent  knowledge  and information to qualify them
for determining on, and preferring, the molt pro-
per preparation in various cafes.  Neverthelefs, I
will point out fome fuch as  may be very likely to
agree, pretty generally,, with refpetlt to ftrong and
Jiealthy children. -)»
   The firft flep then is an abatement of their ufu-
al quantity of food.   Children  commonly eat  too>
much.   Their limitation fhould be in proportion]
to their fize and growth, where we could  exact-
ly afcertain them  : but with  regard to all, or to
much the greater number of them,  we may be al-
lowed to make  their f upper very light, and very
fmall.
   Their fecond advantage will confift in the choice
of their food* . This  circumllance  is lefs within
the attainment of, and indeed lets neceflaiy for,
the common people, who are of courfe limited to a
very few, than to the rich, who have room  to make
great retrenchments  on  this account..  The diet
of country  people being of the limpleft kind, and;
almoft folely confilling of vegetables and of milk-
meats, is the moll proper diet towards preparing
for this difeafe..  For this reafon, fuch perfons have-
little  more to attend to in this refpedt, but thaC

   i The fnbftance of this fection flows from the combination of an ex-
cellent underltanding with great experience, mature reflection, and real
probity-;  and fundamentally-expofes both the abfurdity  of fu«.h as uni»
verfally decry any preparation of any  fubject previous to  inoculation,
(whicli is faid to be the practice of a prefent very popular inocnlator in
Pai's) and the oppofite abfurdity of giving one and the very, fame pre-
paration to all fubjects, without t'iftinetion ;  though this was avowed to
have been fuccefsfolly practifed in Penjylvania, fr.ve years fince ; which
the reader may fee Aaalyf. edit, zd, from p. 320, to )j(« and the note
there.  K. 
                Of the Small-Pods-.            I je
fuch aliments be found and good in their kind ;
that their bread be well baked ;  their puis dreffed
without bacon, or rancid, ftrong fat of any fort ;
that then* fruits Should be well ripened ; that their
cliiidren  Should have no cakes or tarts, fJBut fee
note f, p. 7 o.J and  but little cheeSe.   Thefe Am-
ple  regulations may be  fiifficient, with regard to
this article of their preparation.
   Some  judgment may be formed of the good
confequences of their care in thefe two points,
concerning the quantity and quality of the chil-
dren's diet, by the moderate Shrinking of  their
bellies :  as they will be rendered more lively and
active by this alteration  in their living ; and  yetr
notwithstanding,  a  little lefs ruddinefs in their
complexion, and  fome  abatement  of their com-
mon plight of body, their  countenances, upon
the whole,  will feem improved.
   The third  article 1 would recommend,  is to
bathe their legs now and then in  warm  water, be-
fore they go to bed.   This promotes perfpiration,
cools, dilutes  the  blood,  and allays the fharpnefs
of it, as often as it is properly timed.
   Tlie fourth  precaution, is the frequent ufe off
very clear whey.   This agreeable remedy,, which
conSiSts of the juices  of herbs filtred through,  and
concocted, or, as it were, fweetened by the organs
of a healthy animal, anfwers every vitible indica-
tion : (I am Ilill Speaking'here of Sound and hearty
children) it imparts  a flexibility, or SbupleneSs to
the vefl'els ;. it abates the denfity, the heavy con*
liStence and thicknefs of the blood ; which being
augmented by the action of the poifonous caule
of the fmall-pocks, would degenerate into a molt
dangerous inflammatory * vifeidity or  thickneSV.
It removes all obftrudtions in the vifcera, or bowel*

  • There  may certainly b« an inflammatorv acrimony  or thinnefs> a»
torch a>- thicknef» of the blood ; and many medical readers may think *
jBOibrU f'ufion of the red globules  tg be a oumc iicQ,uem ettccfc of' ik&f 
>7u            Of the Small-Poch.-
of the lower cavity, the belly.   It opens the paft
fages which Strain off the bile ; Sheaths, or blunts,
its Sharpnefs, gives  it a proper fluidity, prevents
its putridity,  and fwee tens whatever exceflive a-
crimony may re fide throughout the mafs of hu-
mours.  It likewife promotes Stools,  urine,  and
perfpiration v and,  in a word,  it communicates
the moll favourable difpofition to the body, not
to be too violently impreffed- and  agitated- by the
operation of an inflammatory poifon : and  with
regard to fuch children as I have mentioned, for
thofe who are either fanguine, or bilious,- it is be-
yond all contradiction, the moft effectual prepara-
tory drink, and the moft proper to make them a-
mends for the want of inoculation.
  I have already obferved, that it may alfo be ufed
to great advantage,  doting the courfe of the dif*
eafe :  but I muSl alfo obferve, that however falu*
tary it is,  in the cafes for which  \ have directed-
it,  there are many others in which it would bd
hurtful.   It  would be. extremely pernicious to
order  it to weak, languishing, fchirrhous,  pate
children, fubject  to vomitings, purgings, acidi-
ties, and to all difeafes which prove their bowels
to be  weak, their humours to be Sharp: fo than
people muft be very cautions not to regard it as an
univerfal and infallible remedy,  towards prepare
ing for the fmall-pocks.  Thofe  to whom it is ad-
vifed,  may take a few glafies every mbwiing,  and
even drink it daily, for their common drink ; they
may alfo fop it with bread-for breakfalt,  for fup-
per, and indeed- at any time.
   If country people will puxfue thefe directions,
which are very eafy to obferve and to comprehend,
whenever the fmall-pocks rages,! am perfuadedit
mult Lelien the mortality attending it.  Some will

contagion, than an increafed vifeidfty, or denfity of them* SeeAhalyf,
edit. 3d, p.*73»to$3. But this tranlktion, conforming to the fpiiit of
its original, admits very little theory, and ftittkfs coauoveify*  inwltt
plan.  Jt. 
                 Of the Meafles.            T.77

certainly experience the benefit of  them ;  fuch I
mean as are very fenfible and difereet, and Strong-
ly influenced by the trueSl love of their children.
Others there are, alas!  who  are too Stupid to dif-
cern the  advantage of them, and too unnatural to
take any juSt care of their families,
               C K A  P.   XIV.
                 Of the Meafles.

                Sect.   221.
     THE meafles, to which the human fpecies are
      as generally liable, as to the fmall-pocks, is
a- diftemper considerably related  to it ;  though,
generally fpeaking, it is lefs fatal; notwithftand-
ing which, it is not a little deftrudiive  in fome
countries*  In Swifferland we lofe much fewer,  im-
mediately in the difeafe, than from the confecjuen**
ces of it.
  It happens now and then that the fmall pocks7
and the meafles rage at the fame time, and in  the
fome place ; though I have more frequently obferv~
ed, that each of them was epidemical in different
years.   Sometimes it alfe happens that both thefe
difeafes are combined at once in the fame perfen j
and that one  fbpervenes before the other has fi-
nished its courfe, which makes the cafe very  pe-
rtllous.
  § 222.  In fome constitutions the meafles gives
notice of its approach, many days before its evi*
dent invafion, by-a fmall, frequent and dry cough,
without any other fenfible complaint ; tho? more
frequently  by a general uneafinefs ; by fucceflions
of Shivering and of heat; by a fevere head-ach in
grown perfons;  a heaviness in children ; a consi-
derable complaint of tlie  throat ;  and, hy whae 
178             Of the Meafles.
particularly characterizes this diftemper, an in-
flammation and a eonfiderabie heat in the eyes,
attended with a fwelling of the eye lids, with a
defluxion of Sharp tears, and fo acute a fenfation,
or feeling of the eyes,  that they cannot bear the
light y by very frequent fneezings, and a dripping
from the nofe of the fame humour with that which
trickles from the eyes.
  The heat and the fever increafes with rapidity ;
the  patient is afflicted with a cough,  a fluffing,
with anguiSh, and continual Teachings to vomit ;
with violent pains in the loins ;  and  Sometimes
with a loofeneSs, under which circumftauces he is
lefs  perfecuted with vomiting.   At other times,
and  in other fubjects,  fweating chiefly prevails,
though in lets abundance than in the fmall-pocks.
The tongue is foul and white ; the th*rft is often
Very high ;  and the fymptoms are generally more
violent than in the mild fmall-pocks.
  At length, on the fourth or fifth day, and fome-
times about the end of the third, a Sudden erup-
tion appears,  and in  a very great quantity,  efpe-
cially about the face; which in a few  hours is co-
vered with fpots,  each of which refembles a flea-
bite ; many of them foon joining form red llreaks
or fuffufions larger or {mailer, which  inflame the
fkin, and produce a veiy perceivable  fwelling of
the face; whence the very eyes are fometimes clof-
ed.   Each fmall fpot  or fuffufion is railed a little
above the furface, efpecially in the face, where
they are manifest both to the  fight and the touch.
In the  other parts of the body,  this elevation or
rifing is fcarcely perceivable by any circumftance,
but  the roughnefs of the fkin.
   The eruption, having firfl appeared in the face,
is afterwards extended to the breaft, the back, the
 arms, the  thighs  and legs.  It generally fpreads-
 very plentifully over the breaft and the back, and
 fometimes red fuffufions are found upon the brealt,
 before any eruption has appeared in the face* 
                Of the Meafles.              170
  The patient is often relieved, as in fmall-pocks,
by  plentiful difeharges of blood  from the nofe,
which carry off the complaints of the head, of the
eyes, and of the throat.
  Whenever this diftemper appears in its mildeft
character, almoft every fymptom  abates after e-
ruption, as it happens in the fmall-pocks ; though,
in general, the change for  the  better is not as
thoroughly perceivable, as it is in the fmall-pocks.
It is certain the reachings and vomitings ceafe al-
moft entirely ; but the fever, the cough, the head-
ach continue ; and I have fometimes obferved that
a bilious  vomiting,  a  day  or two after the e-
ruption, proved a more eonfiderabie relief to the
patient than the eruption had.  On the third or
fourth day of the eruption, the rednefs diminish-
es ; the fpots or very  fmall puftules, dry up and
fall off in very little branny Scales ; the cuticle, or
fuperficial fkin alfo fhrivels off, and is replaced by
one lii cceding beneath it.  On the ninth day, when
the progrefs of the malady has been  fpeedy  and
on  the eleventh when it has been very flow,  no
trace of the rednefs is to be found ; and the furface
immediately relumes its ufual appearance.
  §  223.  Notwithftanding all which  the patient
is not Safe, except,during the courfe of the diftem-
per, or immediately after it, he has had fome eon-
fiderabie evacuation ; fuch as the vomiting I have
juft mentioned ; or a bilious loofenefs; or eonfider-
abie difeharges by urine ; or very plentiful fweat-
ing.   For when any of thefe evacuations fuper-
venes the  fever vanifhes;  the patient  refumes
his flrength, and perfectly recovers.  It happens
fometimes too,  and  even without  any  of thefe
perceivable difeharges,  that in fenfible  perfpira-
tion expels the relics of the poifenous caufe of
this difeafe, and the  patient recovers his health.
 Yet it occurs too often, that this venom not hav-
ing been entirely expelled (or its internal effects
mot having  been thoroughly effaced) it is repe- 
flfto             Of the  Meafles.
.led upon  the lungs, where  it produces  a flight
 inflammation.  In confequence of this the oppief-
iion, the cough,  the  anguifh and fever return,
 and the patient's fituation becomes very danger-
 ous.  This outrage  is frequently lefs vehement,
•bnt4t proves tedious and chronical, leaving a very
 obltinate  cough behind it, with many releinblan-
 ces of the hooping cough. In 1758 there was a ve-
 ry  epidemic  ftate of  the mealies at Laufanne,
 which affedled great numbers :  almoft all wi>o had
 it,  and who were not  very carefully and  judici-
 ously attended, were feized in confequence of it
 with that cough, which proved  very violent and
 obltinate.
   §  224.  However, notwithstanding  this  be the
 frequent progrefs and confequence of this difeafe,
 when left entirely to ittelf, or erroneouily treated,
and more particularly when treated with a hot re-
 gimen ; yet when proper care was taken to mode-
 rate the fever at the beginning, to dilute,  and to
 keep up the evacuations, fuch unhappy confequen-
 ces have been  very rare.
   §  225.  The  proper method of conducting this
 diftemper is much the fame with that of the fmall-
 pocks.
   1. If the fever be high, the pulfe hard,-the load
 and oppreffion heavy, and all the Symptoms vio-
 lent, 1 the  patient muft be bled once or twice.
   1. His  legs  mutt  be bathed, and he muSl  take
 fome glySlers: the vehemence of the fymptoms
 mufl'i-egulate'the-number of each.
   3. The ptifans Nl# 3 or 4 muft.be taken, or a
 tea of elder and lime-tree-flowers, towluch a fifth
 part milk may'be added,
   4. The vajfou r, the Steam of warm water fhould
 alfo be employed, as very conducive to  aflwage
.the cough, the forenefs of the throat, and  the op-
 preffion the patient labours under.
   5. As foon as the etflorence, the rednefs becomes 
                 Of the  Meafles.                  j/8i
 pale,  the patient is to be purged with the draught
 N°« 23.                                          s
    6. He is ftill to be kept Strictly to  his regimen
 for two days after this purge ; after which he is to
 be put upon the diet of thofe who are in a ftate of
 recovery.
    7-  If during the eruptions fuch fymptoms fuper-
 vene as occur  [at the lame  term] in  the fmall.
 pocks, they are to be treated in the manner alrea-
 dy directed there.
    §  226. Whenever this method has  not been ob-
 ferved,  and the  accidents delcribed  §  223  fuper-
 vene,  the diftemper muft be treated like an iuflam"
 mation in its  firlt ftate,  and all  mull be  done as
 directed § 225.   If the difeafe is not  vehement  *
 bleeding may be omitted.  Hit is of feme ftandino-
 m groSs children, loaded  with humours, inactive"
 and pale, we  muft add to  the medicines  already
 prefcribed the potion Nc* 8. and bfiftersto the le<vS
    § 227. It often happens  from  the dillance'of
 proper advice, that the relics, the dregs as it were
 of the difeafe have been too little regarded, efpe-
 cially the cough ; in which  circumitance it' forms
 a  real  fuppuration in the lungs,  ..tteuded wit 1  a
 flow fever.   I have feen many children in country
 villages deltroyed by this neglect.   Their cafe is
 then of  the fame nature with  that  deferibed & 68
   Vol.  I.                 S                    '

   * Our author very prudently limits this difcharge, and the reno,;,;™.
 Of it, in  this difeafe tf 225; as an erroneous exceftof it haf f™
prevailed.  I have feen a very epidemical feaOn of'the iSq« w^
bleeding was not indicated in one third of the iufcW-ed,  An/™,  £
known fuch an abufe of bleed „g in it, *hat being" repeated m J ,,*?
once in a cafe before eruption (the meafles probably not beinn falL-lS!
tr.c- eruption was retarded feveral days ; and the patient, a Yoaa , , , %
condition, remained exceedinj; low, faint andficK-fh-  till after %   °
ing a very little,  the mealies appeared, and fhe  recovered  r,. ,'u,t,"
of a lax fibre, where the mealies  hadappeared,  a  fevAvh „* y°,U'" '
bleed!.,; was ordered on a ftitch in the r,de,fUpei.vcning f om  ilTto'
early dtiappearinc and the cafe feemed  very doubtful   Bur  ,
continued very obltinately favourable in this ymuh. who at l,„„ 1,  ,l"l
very flowly, rco,ered.  His circulation remained fo*^Meo«?
v.-ith his jm.:«, foexhaufted, that he w.., nnny weeks before he eo, M
fit  upright in a chair ; behvi obliged to nuke ufe of a core!  dene H
f.oin the ceiling, ro raife himlclf erectly in hh feat.  K.         B 
 *8a             Of the Meafles.
 and &2, and terminates in the fame manner in a
 loofenefs,  (attended  with very little  pain)  and
 fometimes a very foetid one, which caries oil the pa-
 tient.  In fiich cafes we muft recur to the remedies
 prefcribed § 74. article 3, 4,  5. to the powder N°'
 14. and to milk and exercife.  But it is fo very diffi-
 cult to make children take the powder, that it may
 be fometimes neceffary to trult to the  milk with-
 out it, which I have often feen in fuch fituaiions
 accomplish a very difficult cure.  1 muft advife the
 reader at the  fame time, that it has not fo com-
 plete an effect, as when it is taken folely unjoined
 ay any other aliment; and that it is  of the  lafb
importance not to join it with any, which has the
leaft acidity or Sharpnefs.   Perfons in eafy circum-
ilances may fuccefsfully  take,  at  the fame time,
 Pfoffer, * Seltzer, Peterfta I, or fome other light wa-
ters, which are but modorately loaded with mine-
ral  ingredients.  Thefe are alfo  fuccefsfully em-
ployed in all the cafes, in which the cure I have
mentioned is neceffary.
  § 228. Sometimes there remains, after the courfe
of the meafles,  a ftrong  dry cough, with great
heat in the breaft, and throughout the whole body,
with thirft, an  exceflive dry nefs of the  tongue,
and of the whole furface of the body.   I have cu-
red perfons thus indifpofed  after this diilemper,
by making them breathe  in the vapour of warm
water; by the repeated ufe of warm baths : and
by allowing them to take nothing for feveral days
but water and milk.
  Before I take leave  of this  fubject, I  allure  the
 reader again, that  the contagious caufe of  the
meaSles is of an extremely Sharp and acrid nature.
It appears to have fome refemblance to the bilious
 humour, which produces the erifipelas, or St, An-
 thony's fine j and thence it demands our particu-
 lar attention and vigilance ;  without which very
 troublefome and dangerous confequences |may be

 * BriHol water will bejnu.Jaai fabftiuu far an/ of thefe in fochcafes.K. 
          {jj the ardent or burning Fever         s%%

apprehended.  I have feen,  not very long fince,
a young girl, who was in a very languid ftate af-
ter the  meafles, which  fhe had  undergone three
years before : It was at length  attended with an
ulceration in her neck, which was cured,  and her
health finally rellored by farfaparilla with milk and
water.
   \  229.  The  meafles have  been  communicated
by * inoculation  in ibme countries where it is of
a very  malignant diipofition ;  and that  method
might alfo be very advantageous in  this  difeafe.
But what we have already  obleryed, with  refpedt
to the inoculation of the fmall-pocks, viz.  That
it cannot be extended to the general benefit of the
people,   without  the foundation of hofpitals for
that very purpofe,  is equally applicable to the  ino-
culation of the meafles.
                  CHAP.  XV.

          4)f the ardent  or  burning Fever.


                   Sect.  230.

      TH E much greater  number of the difeafes I
       have hitherto considered, refult from an in-
flammation of the blood, combined with  the par-
                         S 2

  * The only account I -have read of  this practice, is in the learned Dr.
H O ME'i medical ails and experiments, pubiifhed in  1759, which ad-
rn.u, that bu. nine out of fifteen of the fubjects of this practice took,
Cotton dipt in the blood of a patient in the mealies was inferted into the
arms of twelve; and  three received the cotton into their noltrils. after
the Chinefe manner of infilling the fmolr-pocks -, but of thefe  laft  not
one took, and one of thofe who had taken, had the meafles again two
months after.  We think the fhai p Lot lymp-h diftilling from the  inflam-
ed eyes of perfons in this difeafe, a likelier vehic.e to communicate it
than the blood, efpecially the dry  blood, which was fometimes tried;
(fiiec the human 'erum feems the fliid more  particularly affected by it?
and this muft have been evaporated when the biood grew dry.  A  few
practical Urictures on this work, and particularly on th.s practice defcrib-
ciiait, appeared in the monthly review vol. 5CXI. 9 • 6B. t» 75*  K. 
 184      Of the ardent  or burning Fever.
ticular inflammation of fome part ; or occafioned
by fome contagion or poifon, which muft be eva-
cuated. But when the blood is folely and ftrongly
ii flamed, without  an  attack on any particular
pait, this fever, wliich we term hot or burning, i^
the confequence,
  §  2^1. The Signs which make  it evident are, a
hardnefs and fulnefs of  the pulfe in a higher de-
gree than happens in any  other "malady :  an ex-
ceflive heat;  great thirlt ;  with  an  extraordinary
drynefs of the eyes, noltrils, lips, of the tongue,
and of the throat; a violent head-ach ; and fome-
times a raving at  the height of  the paroxyfm, or
increafe of the fever, which rifes confiderably e-
very evening.  The refpiration  is alfo fomewhat
©pprelTed, but efpecially at the return of this pa-
roxyfm,  with a cough   now  and then-; though
without any pain in the  breaft,  and without any
expedtorafion, or coughing up..  The body is cof-
tive ; the urine very high coloured, hot,  and in
a fmall quantity.   The  tick are alfo liable to Start
fometimes, but efpecially when they feem to fleep j
for they have little found refrefliing fleep. but ra-
ther a kind of drowfinefs, that makes them very
little attentive to, or fenfible of,.whatever happens
about them, or. even of their own condition. They
have fometimes a little fweat or moifture ; though
commonly a  ve ry dry fkin; they are manifestly
Weak, and have either little or no fmell or tafte.
  §  232. This difeafe, like all other inflammatory
ones, is produced by the caufes which thicken the
blood, and increafe its motion ;  fuch as exceflive
labour, violent heat, want of fleep,  the abufe of
wine or other ftrong liquors ; the long  continu-
ance of a dry constitution of the air, excefs of e-
very kind, and heating inflaming food.
  §  233. The patient, under thefe circumftances,
ought, 1.  Immediately to be put  upon a regimen ;
to have the food  allowed him given only  every
eight hours, and, in fome cafes, only tjyice a day ; 
         Of the ardent or burning Fever.       tS$
and indeed, when the attack is extremely violent,
nourishment may be wholly omitted.
  2. Bleeding fhould be performed and repeated,
'till the harduefs  of the pulfe is fenfibly abated*
The firft discharge fliould be considerable, the ib*
cond fliould be made four hours after. If the pulfe
is feftened by the firlt, the fecond may be Sufpend*
ed, and not repeated before it becomes fuffieiently
hard again, to  make us appreheufive of danger;
but Should it continue ftrong and hard, the bleed*
ing may be repeated on the  fame day to a third
time, which often happens to be the utnloft repe*
titioii that is neceffary.
  3. The glyfter Nc* 5. Should be given twice, or
even thrice, daily.
  4. His legs are to be bathed twice a day in warn*
water :  his hands may be bathed in the Same wa-
ter.  Linen or flannel cloths  dipt in warm water
may be applied over the breaft, and upon the bel-
ly : and  lie fhould  regularly drink the almond
milk N°- 4. and the ptifsuvN0- J.   The pooreSt
patients may content themfelves with the laft, but
mould drink very plentifully of it; and after the
bleeding properly repeated, frelh aiv and the plen-
tiful continuance of fmall  diluting  liquors gene*
rally eltablilh the health of the patient.
  5. If iiotwithftanding the repeated bleedings,
the fever ftill rages highly, it may be leffened by
giving a fpoonful of the potion N  • 10. every hour,
'till it abates ;  and afterwards every three hours,
until it becomes very moderate.
  § 234.  Haemorrhages, or bleedings,  from  the
note frequently occur in this  fever, greatly to tue
relief and Security of the patient.
  The firSl appearances of amendment are a Soft-
ening of the pulfe, (which however does not whol-
ly lofe all its hardnefs, before the difeaie entirely
terminates) a fenfible abatement of the head-ach ;
a great quantity of urine,  and  that lefs nigh co-
loured ;  and a jnanifieftly approaching naoilturc
                    S  3 
 lB6      Of the ardent or burning Fever.
 of the tongue.  Thefe favourable  figns keep  in*
 creating in their degree, and there frequently en*
 fues between the ninth and the fourteenth day,
 and often after a  flurry of fome hours continu*
 ance,  very large evacuations by  llool:  a great
 quantity of urine,  which lets fall a palely reddiSh
 fedimentj the urine above it being very clear, and
 of a natural colour j  and thefe accompanied with
 fweats in.a lefs or greater quantity.   At the fame
 time the noltrils and the mouth grow moift : the
 brown and dry cruft which  covered the tongue>
 and which was hitherto infeparable  from it, peels
 off of itfelf; the thirfl is diminished, the clear-
 nefs of the faculties rifes ; the diowfinels goes off,
 it is fucceeded by comfortable fleep, and the na-
 tural  flrength  is rettored.  When things  are evi-
 dently in this way, the patient fhould take the po»
 tion N0# 23. and  be-put upon the- regimen of
 thofe who are in a Jlate of recovery. It Should be
 repeated at  the end of eight or ten days.  Seme
 patients have perfectly recovered from  this fever,
 Wathcut the leaft fediment in their urine.
   §  23 c. The  augmenting  danger  of  this fever
 may be  difcerned,  from the continued hardtiels
 of the pulfe, though with • an abatement  of its
 flrength:  if the brain becomes more  confufed ;
 tiie  breathing more difficult; if the ey^s, nofe,
 Kps and tongue  becomes Ilill more  dry, and the
 Voice more altered.  If to thefe fymptoms there be
 alio added a  fvvelling of the belly ; a diminution
 of the quantity of urine ; a conltant ravingj great
 anxiety, and a certain wildnefs of the eyes, the
 cafe is in  a  manner defperate; and. the patient
 cannot furvive many  hours.  The hands  and fin-
 gers at this period are inceflantly in motion, as if
 feeling for Something upon the bed-cloaths, which
is commonly termed, .their hunting for  flies. 
Of putrid Fevers.              *$7
               CHAP.  XVI.
               Of putrid. Fevers.

                 Sect.   236.
    HAVING treated of fuch feverish distempers, as
     arife from an inflammation of the  blood, I
fhall here treat of thofe produced by corrupt hu-
mours, which Stagnate in  the ftomach, the guts,
or other bowels of the lower  cavity, tlie  belly;
or which have  already  patfed  from them into
the  blood.   Thefe are  called putrid  fevers,  or
fometimes bilious fevers,  when a certain degene-
racy or corruption of the bile feems chiefly to pre*
vail in the difeafe.
  § 2^7.  This diftemper frequently gives  notice
of its approach,, Several days before its manifest  at*
tack ; by a great dejection, a heavinels of the head;
pains of the loins  and knees ; a foulnels of the
mouth in the- morning; little appetite;  broken
flumber;  and fometimes by an exceSfive head-ach
for many days, without any  other fymptom.  Af*-
ter this,  or  thefe ditbrders, a Shivering conies onj
followed  by  a Sharp and dry heat : the  pulfej
which was Small  and quick  during the lhiveringj
is railed  during the heat, and is often very Strcng>
though is is not attended with the fame hardnefsj
as in the preceding fever ; except the putrid fever
be combined with an inflammatory one, which it
fometimes is.   During this time, that is the dura*
tion  of the heat,  the head-ach  is commonly ex-
tremely violent; the patient is almoft conllantly
affected with loathings, and fometimes even with
vomiting; with thirft, difagreeable  rifings, a bit*
ternefs in the mouth j.and very little urine.   This
heat continues for many  hours, frequently the
whole  night; it  abates a little in  the  morning,
and  the  pulfe, though-always feverish,  is then 
* $ 8              0f" ^&/r/'</ Fevers.
fometbing lefs  fo, while the patient  fuffers left,
though Ilill greatly dejected.
  The tongue is white and furred, the  teeth are
foul,  and the  breath  fmells very  difagreeably.
The colour, quantity and confillence of the urine,
are very various and changeable. Some patients are
collive, others frequently have fmall Stools,   with-
out the leaft relief acruing from them.  The fkin
is fometimes dry, and at other times there is fome
fenfible perfpiration, but without any benefit at-
tending it.  The fever  augments every day, and
frequently at  unexpected irregular  periods.  Be-
fides that great  paroxyfm or  increafe, which is
perceivable in all the fubjects of this fever, fome
have alfo other lefs intervening ones.
  § 238.  When the difeafe is left to itfelf, or in-
judicioufly treated ; or when it proves m*rre pow-
erful than the remedies againll it, which is by no
means feldom the cafe,  the aggravations of  it be-
come longer, more frequent and irregular. There
is Scarcely an interval of eaSe.  The patient's belly
is fwelled out like a foot-ball: a delirium or raving
comes on ; he proves infenfibie of his own  evacua-
tions,  which come away involuntarily $  lie rejedts
aSfiitance,  and keeps muttering continually, with
a  quick Small irregular pulfe.  Sometimes little
foots of a brown, or of a Kvid colour  appear on
the furface, but particularly about the neck, back
and breaft.  All the difeharges from ins  body have
a  moft foetid fmell; comvul&ve motions  attb Su-
pervene, efpecially in the face; he lies down on-
ly on his back, finks down infenfibly  towards tlie
feet of the bed, and picks about, as if catching
flies, brspwlfe becomes fo quick and fo fmall, that
it cannot be perceived without difficulty, and can*
not be counted.  His anguifh feems rnexpreffibie ;
his fweats stream down from  agony;  his  brcaft
fwells out as if dittended by fullnefs, and he dies
jniferably.
   § 230. When this diftemper is lefs violent; of 
                  Vf Puiria fevers.           1P9
 more judicioufly treated, and the  medicines  fuc-
 ceed well, it continues for fome days in the ftate
 deferibed \ 237. without growing worfe, though
 without abating.   None of thefe fymptoms how-
 ever appear, defciibed §  238. but, on the cont-
 rary all the fymptoms become milder, the parox-
 yfms, or aggravations are  fhorter and lefs violent,
 the  head-ach more fupportable ;  the difeharges
 by Stool are lets frequent, but more at once,  and
 attended with relief to the patient.  The quanti-
 ty of urine is very eonfiderabie, though it varies
 at different times in colour and  confiltence, as be-
 fore. The patient foon begins to get a little fleep,
 and grows more compofed and eafy.  The tongue
 difengage3 itfelf from its filth and furrinets, and
 health gradually, yet daily,  advances.
   5  240. This fever feems  to have no critical time,
 either for its termination in recovery, or in death.
 When it is very violent, or very badly conducted,
 it proves fometimes fatal on the ninth day.  Per-
 fons  often die of it from the eighteenth  to the
 twentieth ; fometimes only about the fortieth ; af-
 ter" having been alternately better  and worfe.
   When it happens but in a light  degree, it  is
 fometimes cured within a few days,  after the ear-
 lieft evacuations.   When it is of a very  different
 character, fome patients are not out of danger before
 the end of fix weeks,  and  even ftill later.  Never-
 thelefs it is certain that thefe fevers, extended to
 this length of duration, often depend in  a great
 meaihre on the manner of treating them ;  and
that in general their courfe mufl be determined,
 foine time from the fourteenth to the thirtieth
 day.
   §  2 41.  The treatment of  this fpecies of fevers
is comprized in the following method and  medi-
cines.
   I The patient muft be put into a regimen ; and
lio.twithltanding he is far from coftive, and fbme-
 tiines has even a fmall purging, he Should receive 
                 Of putrid Fevers.           190
one glyfter -daily.  His common drink  fhould be
lemonade, (which is made of the juice of lemons,
fugai and water) or the ptifan N'# 3. Inftead of
juice of lemons, vinegar may be occafionally fub-
ltituted, which with  fugar and water, makes an
agreeable and very wholefome drink in  thele fe-
vers.
  2. If there be an inflammation alfo, which may
be  difcovered by the ttrengtl* and  hardnefs of
the pulle, and by  the temperament and complexion
of the patient: if he is naturally vobult, and has
heated himfelf by  any  of the -caules deferibed,
\ 232. She fhould be bled once,  and even a fecond
time, if neceffary, fome  hours after.  I  muft ob-
ferve however, that  very frequently there is no
fuch inflammation,  and that in Such a cafe, bleed-
ing would be hurtful.
  3. When the patient has drank very plentifully
for two days of  thefe liquids, if  his mouth  ftill
continues in  a very foul ftate, and he has  violent
Teachings to vomit, he muft take the powderN°34.
diflblved in half a f pot of warm water; a * glafs of
it being to be drank every half quarter of an hAur.
But as this medicine vomits, it muft  not be taken
except we are certain the patient is not under any
circumftance, which  forbids the ufe  of a vomit;
all which circumftances fhall be particularly men-
tioned in the chapter, refpedting the ufe of Such
medicines, as are taken by way of precaution, or
prevention.    If  the firft glafles excite a plentiful
vomiting, we muft forbear giving another, and be
content with obliging the patient to drink a consi-
derable quantity  of warm water. But if  the form-
er glaffes do  not  occafion vomiting, they mutt be
repeated, as already directed, until they do. Thofe
who are afraid of taking this medicine,  which  is
ufually called the emetic, may take that of N '• 35.
alfo drinking warm  water plentifully during it*

  tThat U about two ounces more than a pint and a half of our aeafuie.
                 * About three maces. 
             Of putrid Fevers.                lot
■operation :  but the former is preferable, as more
prevalent, in dangerous cafes.    We muft caution
our readers at the Same time, that wherever there
is an inflammation of any part, neither of tliele
medicines mult be given, which might prove a real
poifon in fuch a  ciicuinllance :  and even if the
fever is extremely violent, tho* there fliould be no
particular inflammation, they Ihouid not be given.
   The time of giving them is toon after the end of
the paroxyfm, when the fever is at the loweft. The
medicine N°* 34. generally purges, after it ceafes
to make the patient vomit : But N • 35 is leldom at-
tended with the fame effect.
   When the operation of the vomit is entirely over
the fick fhould return to the  ufe of the ptifan ; and
great care mult  be taken to prohibit them from
the ufe of flefh broth, under  the pretext of work-
ing off a purging with it.   The fame  method is
to be continued on the  following days  as on the
firft ; but as it is of importance to keep the body
open,  he Should take every  morning- Sbme of the
ptifan N°- 32. Such, as this would be too expenfive
for,  may fibllitute, in  the  room of it, a  fourth
part of tlie powder N~*  34. in  five or fix glaffes of
water, of which they are to take a cup every two
hours, beginning early in the morning. Neverthe-
lefs, if the fever be very high, N°. 32.  fhould be
preferred to it.
   4. After the operation of the vomit, if the fever
ftill continue, if the llools are remarkably foetid,
and if the belly is tente and  dirtended as it were,
and  the quantity of urine is fmall, a fpoonful of
tlie potion N°* 10. Should be given every two hours
which checks the putridity and  abates the fever.
Should the diftemper become violent,  and very
preffing, it ought to be taken every hour.
^ 5. Whenever,notwithltanding the giving all thefe
medicines as directed, the fever continues obltinate j
the brain is manifeSlly disordered ; there is a vio-
lent head-ach, or very great reitleftuefs, two blif- 
I92                Of putrid Fevers.
tering plaifters N°* 36. muSt be applied to the in-
fide and flefhypart of the legs, and  their fuppura-
tion  and difcharge Should be continued as long as
polfible.
  6. If the fever is extremely violent indeed, there
is a neceffiy abfolutely to prohibit the patient from
receiving  the lealt nourifhinent.
  7.  When it is thought improper, or unfiife, to
give the  vomit,  the  patient  fliould  take in  the
morning,  for two fucceflive  days, three  dozes  of
the powder N • 24. at the interval of one hour be-
tween each:  Tuts medicine produces feme bilious
ftools, wliich greatly abate the fever, and consider-
ably leffen the violence of all the other fymptoms
of the difeafe.   This  may be done with fuccefs,
when the  exceSfive height of the fever prevents us
from  giving the vomit; and we Should limit our-  '
Selves to this medicine, as often as we are uncertain
whether the circumftauces of the difeafe  and  the
patient will admit of the vomiting ; which may al-
fo be difpenfed with in many  cafes.
  8. When the diftemper has  manifeftly and con-
Gderably declined ; the paroxyfms are more flight;
and the patient continues without any fever for  \
feveral hours, the daily ule of the purging opening
drinks fliould be discontinued.  The common ptifans
however  fhould  be ftill made ufe of,  aiid it will  '
be proper  to give every other day two clozes of  ]
the powder  N1"* 24. which fuffieiently obviates e-
very ill confequences from this deceafe.
  9.  If the fever has  been clearly off for a long
part of the day ;  if the tongue appears in a good
healthy ltate ; if the patient has been well purged ;
and yet one moderate paroxyfm of the  fever re-
turns every day, he fhould take four dozes of the
powder N°'  14 between the end of one return and
the beginning of the  next,  and continue this re-,
petition fome days.  People who cannot eafily pro-
cure this medicine, may fubflitute, inftead of it,
the bitter decoction N°* 37-  four glaffes of which 
               Of malignant Fevers.              193

may be taken at equal intervals, between the two
paroxyfms or returns of the fever.
   10. As the organs of digeftion have been confide-
rably weakened thro* the courfe of this fever, there
is a neceflity for the  patient's conducting himfelf
very prudently and regularly long after it,with re-
gard both to the quantity and quality * of his food.
If- Should alfo ufe due exercife as foon as his flrength
will permit ; without which  he may  be liable to
fall into fome chronical and languifhing diforder,
productive of considerable langour and weaknefs.
                 CHAP.  XVII.

                  Of malignant Fevers.

                   Sect.  242.

     THOSE fevers are termed malignant, in which
      the danger is more than the fymptoms would
ipakt us apprehenfive of: they have frequently a
fatal event, without appearing fo very  perilous ;
0:1'which account it has been  well Said of this  fe-
ver, that it is a dog whicli  bites  without barking
   §  243.  The distinguishing  criterion or  mark of
malignant fevers is a  total  lofs  of the patient's
flrength, immediately on their firft attack.  They
   Vol.  I.              T

  * As our jail, Vo^pital, and camp  fevers may often be ranged in this
clnfa, as  of the mo'l putrid kind, and not feldom occafioned by bad food,
b i;l air,  unclean, unwholefome lodging, &c, a judicious ufe iiiay certainly
be made of a fmall quantity ol fcnuiiK', and not ungenerous wine in fuch
of them,  a- a;.- i.r>: blende.I .1 t\an  inftimmatory jatfe, or inflimrr.ible
coiftitutioi, or -.'. hichdo not gui.iy  refirlt from a bihois caufe;  tho' in
thefe-.ii1f where theie is maniieit iownefs and di jtci O!., perhaps a little
rl.c :ilii might be p;ope:!y inurpufed between the lemonade and other
dri.-ks directed } >4 I. ■  Douhtlt fs Dr. TISSOT was perfectly appnfed of
ti.s faluta y ufe i.f it in fon-e low fevers; but the neceflity of its beirg re-
gu ia ted by tlie pre fence 01a  phyfician has probably dilpofed him rather
to omit mentioning it, tl.uii toxaie  the allowance of it to  th<. dli^tioa
of a f..:.jlc cuiii'.i) nailcit, -j.- U, ijjr.u.-a.i.  ulfii: -n'.i.  &• 
194            Of malignant Fevers.
arife from a corruption of the humours,  which
is  noxious to the very Source ancl princijde  of
flrength,  the impairing or destruction  of  which
is the caufe of the feeblenefs of the fymptoms ; by
reafen none of the organs  are Strong enough  to
exert an opposition Sufficiently vigorous, to fubdue
the caufe  of the diftemper.
  If, for iuftance or illultration, we were to fup-
pofe,  that when two armies were on the point of
engaging, one  of them fhould be nearly deprived
of all their weapons, the contell would not  appear
very violent, nor attended with great noife or tu-
mult, tho' with a horrible maflacre. The Spectator,
who, from being ignorant of one of the armies be-
Ung difarmed, would not be able  to calculate the
carnage of the  battle, but in proportion  to  its
noife and  tumult,muft.be extremely deceived in his
conception of it.  The number .of the llain would
be atlonilhing,  which might have  been  much lets
(tho* the  noife  and clangor of it had been greater)
if each ai my had been equally provided for the
combat.
   § 244. The caufes of this difeafe are a long ufe
of animal food or flefh alone,  without puis, fruits
or acids ;  the continued ufe of other bad  provifions,
fuch as bread made of damaged corn or grain, or
very flale meat.  jSight  perfons who dined toge-
ther on corrupt fife, were all feized with a malig-
nant fever,which killed five ©f them,notwithftand-
iug the endeavours  of the moft able phyficians.
Thefe fevers are alfo frequently  the confequence
of a great dearth or famine ;  of too hot and moift
an air, or an air, which highly partakes of thefe
two qualities;  fo that they happen to fpread moft
in hot years, in places abounding with marlhes and
Standing  waters.  They are alfe.the effects of a ve-
ry clofe and flagnant air, efpecially if many per-
fons are crouded together in it, this being a caufe
that particularly tends to corrupt the air. Tedious 
             Of malignant  Fevers.            i$$
grief and  vexation alio contribute  to  generate
thefe fevers. .
   5  245. The fymptoms of malignant fevers  are,
as I have already obferved, a total and Sudden lofs
of flrength, without any evident  preceding caufe,
fufficient to produce Such a privation of Strength :
at the fame time there  is allb an utter dejection of
the mind, which becomes almoft inlenfible and inat-
tentive to every thing,  and even  to the difeafe it-
Self; a fudden alteration in the countenance, efpe-
1 i.fily in the  eyes ; fome Small fhivciings, which
are varied throughout the fpace of  twenty-four
hours, with little paroxySkis  or viffitudes of heat ;
Sometimes there is  a great head-ach and a pain in
the loias; at other times there is no  perceivable
pain in any pait ;  a kind of Sinkings or faintings,
immediately from  the  invafioiv of  tlie difeaie,
wliich is always very unpromising ; not  the leaft
refrelhing fleep ; frequently a kind of half Sleep,
or drowfinefs ; a light and Silent or inward ia\ii>y,
which difeovers itfelf in the unufual and attouiin-
ed look of the patient; who feems profoundly  em-
ployed in  meditating  on Something, but really
thinks of nothing,  or  net  at all: Some patients
have, however,  violent ravings :  molt have a  len-
fation of weight or oppreffion, and at other times
of a binding or tightnefs about, or around,  the pit
of the ftomach.
  The tick perfen Ceems to labour under great an-
guifh : he has fometimes flight convultive motions
and  tvvitchings in his face and his hands, as well as
in his arms and legs.- His fenfes teem torpid, or as
it were benumbed. I have teen many who had  loft,
to all appearance,  the whole five, and yet feme of
them recover.  It is not uncommon  to meet with
fome, who neither fee, underltand,  nor fpeak.
Their voices change, become weak, and are lbme-
times quite loft.  Some of them have a fixed pain
in Some part of the belly :  this ariles  from a Stuf-
fing or obstruction,  and often ends in a gangrene,,
                      T 2 
l©6            Of malignant Fevers.
whence this fymptom is highly dangerous ami
perplexing.
  The tongue is fometimes very little altered from
its appearance in health j at other times  covered
over with  a yellowish brown  humour %. but  it is
more rarely dry in this fever than in the others:
and yet it Sometimes does referable  a tongue that
has been long fmoaked.
  The belly is fometimes very  foft,  and at other
times tenfe and hard.  The pulfe is weak, feme-
times pretty regular, but always more quick,  than
in a natural ttate,  and  at fometi.nes even very
quick : and fuch  I have always  found it, when the
belly has been distended.
  The fkin is often neither hot, dry,  nor moift : it
is frequently overfpread with petechial or eruptive
fpots (which are  little foots of  a  reddifli livid co-
lour) efpecially on the neck, about the Shoulders,
and upon the back.  At  other  times .the Spots are
larger  and brown, like the colour of wheals from
the Itrokes of a ftick.
  The urine of the fick is almoft conllantly crude,
that is of a lighter colour than ordinary.  1 have
feen fome,which could not be distinguished, merely
by the  eye,from|milk. A black and ltinking purging
fometimes attends this fever, which  is mortal, ex-
cept the fick be evidently relieved by  the difcharge.
  Some of the patients are infelted  with livid ul-
cers on the infide of .the mouth, and on the palate.
At other times abfeeffes  are formed  in the glands
of the  groin, of the arm-pit, in thofe between the
ears and the jaw ; or a  gangrene may  appear in
fome part, as on the feet, the hands, or the back.
The flrength  proves entirely fpent, the  brain is
wholly confuted : the miferable patient Stretched
out on his back,  frequently expires under convul-
sions, an enormous fweat,  and  an opprelfed brealt
and refpiration.  Haemorrhages alfo  happen feme-
times and are mortal, beingalmolt unexceptionably
fuch in this fever.  There is allb in  this, as in ail 
             Of malignant Fevers.            T97
Other fevers, an aggravation of the fever in the e-
Vening.
  § 746. The duration and  crifis of thefe malig-
nants as well as thofe of putrid fevers, are very ir-
regular.  Sometimes the fick die on the feventh or
eighth day, more commonly between the twelfth,
and the fifteenth, and not infrequently at the end
of five or fix weeks.  Thefe different durations re-
fult from the different degree and llrength of the
difeafe.  Some of thefe fevers, at their firft invafi-
on are very flow;  and  during a few of the firft
days, the patient,  tho' very weak, and with a ve-
ry different look and manner, feareely thinks him-
felf fick.
  The term or period of the cure or the recovery,.
is as uncertain as that of death, in this diftemper.
Some are out of danger at the end of fifteen days,
and even feoner ; others not before the expiration
of Several weeks.
  The Signs which  portend a recovery are, a little
more Strength in the pulfe ;  a more concocted u-
rine;  lefs  dejection and difeouragement; a lets
confuted brain; an equal kindly  heat; a  pretty
warm or hot fweat in a moderate quantity, with-
out inquietude or anguifli; the revival of the dif-
ferent fenfes that  were extinguished, or  greatly
fiifpended,  in the progreSs of the difeafe ;  though
the deafnefs is not  a very threatening fymptom, if
the others amend while  it continues.
  This malady commonly leaves the patient  in a
very  weak condition; and a long interval will en-
fue between the end of it,  and their recovering
their full ftrength.
  § 247.  It is, in the firtl place,  of greater im-
portance in this diftemper than in any other, both.
for the benefit of the patients,  and thofe who atr
tend  them,  that the air fhould be renewed and pu-
rified.   Vinegar fhould often  be evaporated from
a hot tile or iron in the chamber, and one window
kept almoft conllantly open.
                      T 3- 
XQ.3            Of malignant Fevers.
   2. The diet fhould be light:  and  the juice of
fori el may be mixed  with their water;  the juice
of lemons may be added to foups prepared from    (
different grains  and puis ;  the patient may eat
Sharp  acid  fruits,  fuch as tart juicy * cherries,
goofeherries, Small black cherries ; and thofe who
can afford them,, may be allowed lemons, oranges,
achd pomgranates.
   3. The patient's linen fliould be changed every
two d tys.
   4. Bleeding is very rarely neceffary, or even pre*
per, in this fever-, the exceptions to which are.ve*
Xy few,  and cannot be thoroughly afeertained, as
fit and proper exceptions to the omiffion of bleed-
ing, without a phyfician, or feme otlier very fk.il—
ful perfon's feeing the patient.
   J. There is often very little occation fbr glyf-
ters, which are fometimes dangerous in this fever.
   6. The patient's common drink Ihouid be bar*-
ley water, made acid with the fpiri-t Nc*  10. at the-
rate of one quarter of  an ounce  to  at  leaft full
three pints of the water, or acidulated  agreeably
to his tatle.   He may alfo drink lemonade.
   7. It is neceffary to open and evacuate the bowels
where a great quantity of corrupt humours is ge*
nerally lodged.   The powder N-°# 35. may be giv-    !
en fbr this purpofe,  after the operation  of which
the patient generally finds himfelf better, at leaft
for feme hours.    It is of importance not to omit - v!
this at the beginning of the difeafe ;  though if it
has been omitted at firtl, it were belt to give it e*
ven later, provided no,particular inflammation has
fupervened, and the patient has Ilill fome Strength*

  *The Freach word is xriottes, which Boyer englifhes, the a%rict,,the >ed
or four cherry ; and Chambattd, the fwcettr large black cherry 0' >,:.i.^,ird.
B<it a^ Dr. Ttjfot was recommending the ufs of audi, it is n.o.e proba-
bly the firfl of thefe; fo that our moreilas,  which make a. pleafant pre-
ferve, may be a good fubltitute to thtm,  fuppoftng them not to be the
fame. Our barbery jam, and jelly of red currants, may be alfo employ-
ed to anfwer the fame indication.  K. 
              Of malignant Fevers.           IC-p
I have given it,  and with remarkable fucceSs, on
the twentieth day.
  8. Having by this medicine expelled a eonfider-
abie portion of the bad humours, which contribute
to feed and keep up the fever, the-patient Should
take every other day,  during the continuance of
the difeafe,  and fometimes  even every day,  one
dofe of the cream of tartar and rhubarb N°- 38.
This remedy evacuates the corrupt humours, pre-
vents the cqrruptiou of the others  ;  expells the
worms that  are  very  common in  thefe  fevers,
which the patient fometimes difeharges upwards
and downwards;  and which frequently conduce
to many of the odd and extraordinary fymptoms,
that are obferved  in malignant fevers.   In Short,.
it Strengthens the bowels, and  without  checking  __
the neceffary evacuations,  it moderates the loofc-
nefs, when it is hnrtfnl.
  9. If the Skin be dry, with a loofenefs, and that
by checking it, we delign to increafe perfpiration,
inftead of the rhubarb,  the cream of tartar may
be blended with the ipecacuanna, Nc* 39,  whicli,
being given in fmall and frequent dofes, reftrains
the purging, and promotes perfpiration-  This me-
dicine, as the former, is to be taken in the morn-
ing;  two hours after,  the fick muft  begin with
the potion N°* 40. and  repeat it regularly eveiy
three hours ; until it be interrupted by giving one
of the medicines  Nc* 3g. or 30. after which the
potion is to be repeated  again,  as already direct-
ed, till the patient grows contiderably better.
  IO.  If the flrength of the  fick be very contider-
ably depreffed, and he is in great dejection and an-
guifh,  he Should  take, with  every draught of the
potion, the bolus, or morfel, Nc' 41.  If the diar-
rhea, the purging, is violent, there Should be add-
ed, once or twice  a day to to the bolus, the weight
of twenty grains, or the Size of a very fmall bean,
of diafcordium ; or, if that is not readily to be got,
as much Venice treacle. 
300           Of malignant Fevefsi
   II. Whenever, notwithftanding all  this affift-
ance, the patient continues in a ftate of weaknefs
and intenfibility, two large blifters fhould be ap-
plied to the SieShy infides of the legs, or a large
one to the nape of the neck :  and Sometimes,  if
there be a great drowfinefs,  with a manifeft em-
barraSfinent of the brain, they may be applied with
great fuccefs over the whole head.   Their fuppu--
ration and difcharge is to be promoted abundant-"
1) :  and, if they dry up within a few  days, others
are  to be  applied, and their  evacuation is to be
kept up for a eonfiderabie time.
   12.  As foon as the diftemper is fuffieiently abat-
ed,  for the patient to remain fome hours with ve-
ry little or no fever,  we muft avail  ourfelves of
this interval,  to give him fix,  or at leall five dofes
of the medicine Nc* 14, and  repeat the fame the
next day, which may prevent  the  return of the
fever : *  after which it may  be fufficient to  give
daily only two dofes for a few days.
   13. When the fick continue entirely clear of a'
fever, or any return,  they are  to be put into the
regimen of perfons in a ftate of recovery.  But if
his llrerigtb returns very flowly, or not at all ; in or-
der to the Speedier ettabliflnnent and confirmation
of it, he may take three dofes a day of the theria-
ca pauperum, or poor man's treacle, N0' 42-. the firll
of them.fafting, and the other twelve  hours after.-
It were to be wifhed indeed, this medicine was in-
troduced into all the apothecaries fhops,  as an ex--
cellent ftomachic ; in which refpedt it is much pre-
ferable to Venice treacle, which is an  abfurd coin-
pofition> dear,  and often dangerous.  It is true it
does not dilpofe the  patients to tleep  ;  but when
we  would  procure them fleep,  there are better

  *Obfervation and experience have demonftrated the advantage of the
bark,  to obviate a gangrene, and prevent the putrefafilon of animal fub-
ftances.  We therefore conclude it may be nfcfully employed in malig-
nant fevers, as foon as the previous and neceflary evacuations (hall have
taken place. E. I.-—Provided there be very clear and regular ie>n>Jitnt-
at leaft.  K, 
              Of malignant Fevers.           2or
medicines than the treacle to anfvver that purpofe.
Such as may not think the expence of the medi-
cine N°« 14. too much,  may take three dofes of it
daily for Some weeks, inftead of the medicine Nc*
42  already directed.
  § 248. It  is neceffary to  eradicate a prejudice
that prevails among country people,  with regard
to the treatment of thefe fevers ; not only becaufe
it is falfe and ridiculous, but even dangerous  too.
They imagine that the application of animals can
draw out the poifon of the difeafe ; in confequence
of which they apply poultry, or pigeons,  cats, or
fucking pigs, to the feet, or upon the head of the
patient,  having firfl fplit the living animal open.
Some hours after they remove their ftrange applica-
tion, corrupted, and limiting very offensively ;  and
then afcribe fuch corruption and horrid ftink to the
poifon they fuppole their application to be charged
with; and which they fuppofe to be the caufe of this
fever.   But in this fuppofed extraction of poifon
they are groftly miltaken, fince the flefh does not
ftink in confequence  of any fuch extradtion, but
from its being corrupted thro* moilture and heat:
and they contract no other fmell but what they
would have got, if they had been put in any other
place,  as well as on the patient's body, that was e-
qually hot and moilt.   Very far from drawing out
the  poifen, they augment the corruption of the
difeafe ; and it would be fufficient to communicate
it to a found perfon,  if he was to fuller many of
thefe animal bodies,  thus abfurdly  and ufelelsly
butchered, to be applied to various parts of his bo-
dy in bed ; and  to lie ftill a  long time with their
putt ified carcafes fattened about him, and corrupt-
ing whatever air he breathed there.
  With the fame intention  they  fatten a living
fheep to the  bed's-foot  for fevei al hours ;  which,
though not equally dangerous,  is in feme meafure
hurtful ;  fmce  the more animals there are in a
chamber, the air of it is proportionably corrupt- 
302           Of malignant Fevers.
ed,  or altered at leaft from its natural Simplicity,
by their refpiration and exhalations :  but admit-
ting this  to be lefs pernicious,  it is equally  ab-
furd.  It is certain, indeed, t'-e animals, who are
kept very near  the  tick perfen,  breathe in  the
poifenous or noxious vapours which exhale from
his body, and may be incommoded with  thein
as well as his attendants :  but  it is  ridiculous
to fuppofe their being kept near the fick caufes
fuch poifen to come out of their bodies.   On the
very contrary, in contributing ftill further to the
corruption of the air, they  increafe the difeafe.
They draw  a falfe confequence, and no wonder,
from a falfe principle ;  fiiying,  if the fheep dies
tlie fick will recover.   Now, moll frequently the
fheep does not die ;  notwithstanding which  the
fick femetimes recover ; and fometimes they bothi
die.
  § 249. The caufe of malignant fevers is, not in-
frequently,  combined with other difeafes, whofe
danger it extremely increafes.   It is blended, for
inilauce, with the poifen of the fmall-pocks, or of'
the meafles.   This may be known by the union of
thofe fymptoms,  which carry the marks of malig-
nity,  with the fymptoms  of the other difeafes.
Such combined  cafes are extremely dangerous ;
they demand the utmoft attention of the phyfici-
an ;  nor is it poffible to preferibe their exadt treat-
ment here ;  fince it confills in  general of a mix-
ture of the treatment of  each difeafe ;  though
the malignity commonly demands the greateft at-
tention. 
Of intermitting Fevers,.          203
1
                 € H A P.   XVIII.

               Of intermitting Fevers.

                   Sect.  250.
    Ntermitting fevers, commonly called here  fe-
     vers and agues,  are thofe, which, after an in-
  vafion and continuance for feme hours, abate ve-
  ry pcrceivably, as well as all the fymptoms attend-
  ing them, and then entirely ceafe ; neverthelefs
,  not without Sbme periodical or Slated return  of
  them.
    They were very  frequent with us fome years
  fince ;  and indeed might even be called epidemi-
  cal :  but for the five or  fix laft years,  they have
  been  much lefs frequent throughout the  greater
  part of Swifferland: notwithftanding they ftill con-
  tinue in 110 fmall number in all places, where the
  inhabitants breathe  the air that prevails in all the
  marfhy borders of the Rhone, and in fome other fi-
  xations that are expofed to much the fame humid
  air and exhalations.
    \ 251.  There are  feveral kinds of intermitting
  fevers,  which take their different names from the
  interval or different foace of time, in which the
 fits return.
    If the paroxyfm or fit  returns every day, it  is
 either a true quotidian, or a double tertian fever :
  the firft of thefe may be diiliiiguifhed  Srom the
 laft by this circumstance, that in the quotidian, or
 one day fever,  the fits are long ;  and correfpond
.pretty regularly to each  other in degree and du-
 ration.    This,  however, is lefs frequent in Swif-
ferland.   In the double tertian, the fits are fhorter,
 one being alternately light, and the other more fe-
 yere.
   In the fimple  tertian,  or third day's fever, the
 fits return every other day ; fo that three days in-
elude  one paroxyfm, and the return of another. 
304          ®f intermirting  Fevers.
   In a quartan,  the fit returns every fourth day,
including the day of the SirSt and that of the fe-
cond attack :  So that the patient enjoys two clear
days between the two Sick ones.
   1 he  other  kinds of  intermittents  are  much
rarer.   I have feen, however, one true quintan,
or fifth day ague, the  patient luivi ig three clear
days between two fits ;  and one regularly weekly
ague,  as it may  be called, the visitation of eveiy
return happening every Sunday.
   § 252. The firlt attack of an intermittent fever
often happens, when the patient thought himfelf
in perfect health.  Sometime?, however, is is pre-
ceded by a fenfation of cold,  and a kind of numb-
nefs,  which continue  feme days before the mani-
fetl invafion of the  fit.   It  begins with frequent
yawnings,  a laflitude, or fenfation oS' wearinefs,
with a general weaknefs, with coldnefs, Shivering
and Shaking : there is alfo a palenefs of the ex-
treme parts of the body,  attended with loathings,
and femetimes an adtual vomiting.   The pulfe is
quick,  weak, and finall,  and there is a eonfider-
abie degree of thirit.
   At the end of an  hour or  two,  and but feldom
fo long as  three or four hours, a heat fucceeds,
which increafes infenfibly, and becomes violent at
its height.   At this period the  whole body grows
red, the anxiety of the patient abates ; the pulfe
is very ftrong and large,  and his thirit proves ex-
ceflive.  He complains of a violent head-ach, and
.of a pain in all his limbs ; but  of a different fort
of pain from that he was fenSible  of,  while his
coldnefs continued,  finally, having endured this
 hot ftate,  foui, five,  or  fix  hours, lie tails yito a
 general fweat for a few more : upon which all the
 fymptoms  already  mentioned  abate,  and feme-
 times llcep fupervenes.
   At the conclufion of this nap the patient often
wakes without any fenfible fever; complaining on-
 ly of laflitude and weaknefs.  Sometimes his pulfe 
              Of intermitting Fevers.         2-OC
returns entirely to its natural ftate between the
-wo fits ; though it often continues a little quick-
er than in perfect health ; and does not recover its
firfl diflinctnefs and flownefs,  till feme days after
the laft fit.
   One fymptom, which moft particularly charac-
terizes thefe feveral fpecies of intermitting fevers,
is  the quality of the urines which the lick pats af-
ter the fit.   They are of a reddifh colour, and let
fill a fediment, or fettling, winch exactly refem-
bles brick-duft.   They are fometimes frothy too,
and a pellicle, or thin filmy fkin, appears on the
top, and adheres to the fides of the glafs that con-
tains  them.
   $ 253. The  duration  of each Sit  is of no fixed
time or extent, being various according to the par-
ticular  fort  of intermittents,  and through many
other circumftauces.  Sometimes they return pre-
cifely at the very fame hour;  at other times they
come one,  two, or three hours fooner ;  and in o-
ther inltances as much later than the former.  It
has been imagined that thofe fevers, whofe parox-
yfms returned fooner than ufual, were feoner final-
ly terminated: but there feems to  be no general
rule in  this cafe.
   § 254. Intermitting fevers are distinguished into
thofe of fpring and autumn.   The former gene-
rally  prevail from February to June : the latter are
thofe which  reign  from July to  January. Their
effential nature and characters are  the very fame,
as they are not different diflempers ; though the
various circumftauces attending them deferve our
confideration.  Thefe circutnftances depend on the
feafon itfelf, and the constitution of the patients,
during fuch feafon.  The fpring intermittents are
fometimes blended  with an inflammatory difpofi-
tion,  as that  is the difpotition of bodies in  that
feafon; but as the weather then advances daily in-
to an improving ftate,  the fpring fevers are com-
monly of a Shorter duration.   The autumnal fe-
   Voi. I.   -           U 
206         Of intermitting Fevers.
vers are frequently combined and aggravated with
a principle of putrefradtion ; and as the air of that
feafon rather degenerates, they are more tedious
and obltinate.
  § 255. The autumnal fevers feldom begin quite
fo early as July, but much oftner in Augull : and
the duration to which  they are often  extended,
has increafed the terror which the people enter-
tain of fevers that begin in that month.  But that
prejudice which afcribes the;r danger to the influ-
ence of Auguit, is a very abfurd error ; fince it is
better they Should fet in then, than in the follow-
ing months ; becaufe they  are obltinate in pro-
portion to the tardinefs, the flownefs of their ap-
proach.  They fometimes appear at firft confider-
ably in the form cf putrid fevers, not affiiming
that of intermittents till fome days after their ap-
pearance :  but  very happily there is little or  no
danger in mistaking them for putrid fevers,  or in
treating them like  fuch.  The brick-coloured  fe-
diment, and particularly the pellicle or film 011 the
furface of the urine, are very common in autum-
nal intermittents, and are often wanting in the u-
rine of putrid fevers.   In thefe latter,  it is gene-
rally let's high-coloured,  and  leaning rather to a
yellow, a kind of cloudinefs is fuSpended in the
middle of it.   Thefe alfe depofite a white fedi-
ment, which affords no  bad prognoftic.
  § 256. Generally foeaking,  intermitting fevers
are not mortal;  often  terminating in health of
their  own  accord  (without the ufe of any medi-
cine)  after feme fits.  In this laft refpect intermit-
tents  in the fpring differ confiderably from thofe
in the fall, which continue a long  time, and feme-
times even until fpring,  if they are not removed
by art, or if they have  been improperly treated.
  Quartan fevers are always more obltinate and  in-
veterate than tertians ;  the former Sometimes per-
fevering in certain conilitutions for whole years.
When thefe forts of fevers occur in boggy marlhy 
               Of intermitting Fevers.            207
countries, they are not only very chronical or te-
dious,  but perfons infefled with them are liable
to frequent relapfes.
   §  257.  A few fits of an intermittent are not ve-
ry injurious,  and it happens fometimes, that they
are  attended with a favourable alteration  of the
habit in point of health ;  by their exterminating
the caufe  or principle of fome languid and tedious
diforder ;  thou oh it is erroneous to confider them
as ialutary.   It" they prove tedious and obltinate,
and the fits are long and violent, they weaken the
whole body, impairing all its functions,  and par-
ticularly the digeftions :  tliey make the humours
Sharp  and unbalmy,  and introduce feveral  other
maladies,  fuch as  the  jaundice,  dropfy, aflhma,
and Slow walling fevers.  Nay Sometimes  old per-
fons, and thole who are very weak, expire in the
fit ;  tho* fuch  an event never happens  but in the
cold fit.
   §  258.  Very happily nature has afforded  us a
medicine, that infallibly  cures thefe  fevers ;  this
is the  Kinkina, or Jefuits bark ; and as we are  pof-
felfed of  this certain remedy, the only remaining
difficulty  is to difcover,  if there  be not  feme o-
ther difeafe combined  with  thefe  fevers,  which
difeafe might be aggravated by the bark.   Should
any fuch exifl, it mull be  removed by  medicines
adapted to if,  before the bark is given. *
                        U 2

  * This admirable medicine was unknown in Europe, till about one hun-
dred and twenty years paft -, we were obliged to the Spaniards lor it, who
found it in the pro.ince of Quito in Peru ; the councefs of tkinchon being
the firft European who ufed it in Ameiica, whence it was brought to
Spain, under the name of the countefs's powder.  The Jefuits  having
foon difperfed anddiitributed it  abroad, it became ftill more public by
the name of the Jefuits powder : and fince it has been  known by that
of Kinkina or the Peruvian bark.  It met with great oppolition at  firft;
fome deeming it a poifon, while  others confidered it as a divine remedy?
fo that the prejudices of many being heightened by their animoi'ity, it was
nearly a full century, before its true virtue  and  its afe were agreed to;
and about twenty years fince the moft  unfavourable prejudices againlt it
pretty generally fubfided. The infufficience of other medicines in feve-
ral cafes; its great efficacioufnefs ; and the  many and furprifing cures
ul.iLii it d.J,  and daily does effect ; the number  of diltempers; the dif- 
 208            Of intermitting  Fevers.
   \ 259.  In the vernal, or fpring-fevers, if the fits
 are not  veiy  fevere; if the  patient  is  eridently
 well in the intervals ;  if his appetite, his flrength,
 and his fleep continue  as  in health,  no  medicine
 Should be given, nor any other method  be taken,
 but that of putting the perfon, under fuch a gen-
 tle intermittent, upon  the regimen directed  for
 perfons in a ftate of recovery.   This  is fuch a re-
 gimen as  pretty, generally agrees with all the fub-
jects of thefe fevers : for if they fliould be reduced
 to the regimen proper in acute difeafes, they would
 be  weakened  to no  purpofe  and perhaps be  the
 Worfe for it.   But at the fame time if we were not
 to retrench from the  quantity, nor  femewhat  to
 vary the quality of their ufual  food  in  a ftate  of
 health ; as there is not the leaft digeltion made  in
 the  ftomach, during the  whole term of the fit;
 and as the ftomach is always weakened a little by
 the difeafe,  crude and indigefted humours would
 be produced, which might afford a fuel to  thedif-
 tafe.   Not the leall folid  food  fhould be allowed,
 for at leaft two hours before  the ufual   approach
 of the fit.
  \  260.  If the fever  extends beyond the fixth,
 or the feventh fit,  and the patient leems to have
 no occafion for a purge  ; which may be learned by
 attending to the chapter, which treats of remedies

 ferent kinds of fevers, in which it proves the fovereign remedy ; its ef-
 fects in the moft difficult chirnrgical cafes; thecomfort, the Itrength and
 fpirits it gives thufe who need and  take it, have  at length  opened eveiy
 perfon'seyes: fo that it has almoft unanimoully obtained the firft repu-
tation, among the moft efficacious medicines.  The world  is  no longer
 ainufed with apprehenfions of its injuring the ftomach ; of iu fixing, or
fbutiit.?, up the fever (as the phrafe has been; without curing it •,  that  it
 Ihuts up the wolf in the flieep-foid ; that it throws thofe who take it in-
 to the fuirvy, the afthma, the dropiy, the jaundice.  On  lie contrary
 they are perfuaded it prevent? thefe very difeafes ; and, tha- if it is ever
 hurtful, it is only when it is either adulterated,  as moft great remedies
 have  been ;  or has  been wrongly prefcribed, or improperly  tuken : or
 laftlyi when it meets with fome latent, fome unknown particularities li:a
 conftitution, which phyfician* term an iditSyncrajy, and which  prevent or
 pervei t its very general effects.  Tiyt. 
              Of intermitting Fevers.            209
to be taken by way of precaution ; * he may take
the bark,  that is in the powder N°# 14.  If it is a
quotidian, a daily fever, or a double  tertian,  fix
dofes,  containing  three quarters of  an ounce,
fhould be taken between the two fits ; and as thefe
intermiffions  commonly  confift of but  ten or
twelve,  or  at  the moft  of  fourteen  or fifteen
hours, there fliould be an interval of only one hour
and a half between each dofe.  During this inter-
val the tick  may take two of bis ufual refrefh-
ments or fuppings.
  When  the fever is a tertian, an  ounce Should be
given between  the two fits: which makes  eight
dofes, one  of wliich is to  be taken every  three
hours.
  In a quartan  I direct one ounce and a half, to
be taken in the fame manner. It is mere trifling to
attempt preventing the returns with fmaller dofes.
The frequent failures of the  bark are  owing to o*
ver fmall .dofes.   On fuch occafions the medicine
is cried down,  and cenfured  as ufelefs,  when the
difappointment is folely the fault of thofe who dc*
not  employ  it  properly.   The laft dofe is  to be
given two hours before the ufual return of the fit.
  The dofes juft mentioned, frequently prevent the
return of the  fit;  but whether it returns or not,
after the time of its ufual duration is pall,  repeat
the fame quantity in  the fame number of dofes,
and intervals, whicli certainty  keeps off another.
For  fix days following,  half the  fame  quantity,
                        U  3

  *  It happens very feldom that intermitting- fevers require f no purge
to.vards their cure, efpecially inplxces, wliich are difpofcd to generate
putridity.  There is a.ways feme material caufe efTential to thefe fever«,
of which nature difembarrafTes herfelf more eafily by ftools, than by a-
ny othsr difcharge ; and as there is not  the lead danger to be ap-
prehended from a gentle purg.-, fuch  as thofe of NJ. 11.01-23. wc
think it would be pitident always to premife a dofe or two of either to
the bark. E. L.
  f Yet I have kwyn r-.-.ny in whom no purze tins neceffary, a-id have
feen Some rcidee.1 m) e o-'Jlinate and chronical by erroneous  purging^
But a vomit is very gen.:.-liy nectJJ'ary i.-fjr.- the bajk is given.  &, 
2io          Of intermitting Fevers.
muft be  continued,  in  the intervals that would
have occurred between the fits,  if they had re-j
turned :  and  during  all  this time  the patient*
fhould inure  himfelf to as much exercife, as he
can well  bear.
   §  261.  Should the fits be very ftrong, the pain of
the head violent, the vifage red, the pulfe full and
hard; if there is any  cough ; if, even after the
fit is over, the pulfe ftill isperceivably hard ; if the
"urine is inflamed, hot and high coloured, and the
tongue very dry, the -patient muft  be bled, and
drink plentifully of barley water Nr# 3. Thefe two
remedies generally bring the patient into the ftate
deferibed § 259.  in which tlate he may  take  on  a
day, when the fever is  entirely off, three or four
dofes of the powder N°* 24. and  then leave the
fever to purfue its own courfe for the fpace of  a
a few fits.  But fhould  it not then terminate of it-
felf, the  bark muft be recurred to.
  If the patient, even  in the  interval of tho re-
turns,  has a  foetid, furred mouth, .a loathing,
pains in the loins, or in the knees, much anxiety,
and bad nights,  he fhould be purged with the
powder Nc* 21.  or the potion N0' 23. before he
takes the bark.
  § 2.62.  If fevers in autumn appear to be of the
continual kind,  and very little putrid fevers, the
patients fhould drink abundantly of barley water ;
and if at the expiration of two or three days, there
ftill appears to be a load or oppreffion at the fto-
mach, the powder N°*  34. or that of 35. is to be
given (but fee §  241):  and if, after the operation
of this, the figns of putridity continue, the body
is to be opened with repeated dofes of the powder
N * 24. or where the  patients are  very robuft,
with N '•  21.  and when the fever becomes quite
regular, with  diltinct remifftons at leaft, the bark
is to be given as directed § 2A0.
  But as  autumnal fevers are moft obltinate ; after
having difcontiuued the bark for eight days : and 
               Of intermitting Fevers.          an
 notwithstanding there has been no  return of the
 fever, it is proper to refume the bark, and to give
 three  dofes  of it daily for the  fucceeding eight
 days,  more  especially  if it  was a quartan : in
 which fpecies I have ordered it to be repeated, e-
 very other eight days, for fix times.
   Many people  may find  it  difficult  to  comply
 with  this method of cure, which is unavoidably
 expenfive,  through  the price of  the bark.   I
 thought however this ought  not to prevent  me
 from averring it to be the only certain one ; fince
 nothing can be an equivalent Juccedaneum or fub-
 ftitute to this remedy, whicli is the only fure and
 fafe one in all thefe  cafes.   The  world had long
 been prepofl'efled with prejudices to the contrary 3
 it was fuppofed to be hurtful to the ftomach : to
•prevent wliich it has been ufual to  make the fick
 eat fometbing an hour after it. Neverthelefs,  ve-
 ry far from  injuring the ftomach,  it is  the belt
 medicine in the univerie to flrengthen it: and it is
 a  pernicious cultom, when a patient is obliged to
 take it often, to eat an  hour after it.   It had alio
 been imagined to caufe obftrudtions, and that it fub-
jedted patients to a dropfy : but at prefent we are
 convinced, it is the obltinate and  inveterate dura-
 tion of the intermittent, that  caufes obftrudtions,
 and paves the way to a dropfy. The bark, in con-
 fequence  of its fpeedily curing the fever, does not
 only prevent the former difeafe; but when it con-
 tinues, through an  injudicious  omiffion of  the
 bark, a proper ufe of it is ferviceable in the drop-
 fy.  In  a  word, if there  is  any  other  malady
 combined with  the  fever, fometimes that indeed
 prevents the fuccets   of the bark, yet without ren-
 dering it hurtful. But whenever  the intermitting
 fever is fimple and uneombined, it  ever has,, and
 ever will  render tlie patient  all  poffible fervice.
 In another place I fhall  mention fuch  means and
 methods as may  in fome degree,  though but ina-
 dequately, be fubilituted iaftead of it. 
2T2           Of intermitting Fevers.
  After the  patient has begun with the bark, he
muft take no purging medicine,  as that evacuati-
on would, with the greateSl probability, occalion
a return of the fever.
  § 263. Bleeding is never, or extremely feldom
indeed, neceffary in a quartan ague, which occurs
in the fall oftner  than  in the  fpring ; and with
the fymptoms of putridity, rather than of inflam-
mation.
  § 264. The patient ought, two hours before the
invasion of the fit, to drink a fmall glafs of warm el-
der flower tea, fvveetened with honey, every quar-
ter of an hour,  and to walk about moderately ;
this difpofes him to a very gentle fweat, and thence
renders the enfuing coldnels and the whole fit mild-
er.  He is to  continue the  fame drink  throughout
the duration of  the cold  fit; and  when the  hot
one approaches, he may either continue the fame,
or fubftitute that of N"* 2. which is more cooling.
It is not neceffary however, in this  ftate, to drink
it warm, it  is fufficient  that it be not over cold.
When the fweat, at the termination of the hot fit,
is concluded, the patient fhould be well wiped  and
dried, and may get up.  If the  tit was very long,
he may be allowed a little gruel,  or  fome other
fuch nourilhment during the fweat.
  § 265. Sometimes the firft, and a few fucceflive
doles of the bark purge the  patient.  This is no
otherwife an iil confequence, than by its retard-
ing the cure ; tince, when it purges, it does not
commonly  prevent the  return of the  fever: fo
that thefe  dofes  may be  considered as to no pur-
pofe, and others fliould be repeated,  which, ceaf-
ing to purge, do prevent it.  Should the looieiiefs
notwithftanding continue, the bark  muft be  dif-
continued for one entire day, in order to give the
patient half a quarter of an ounce of rhubarb : af-
ter which the bark is  to be refumed again, and if
the loofenefs Still perferves, fifteen grains of Venice
treacle fhould be added to each  dofe, but not o- 
               Of intermitting Fevers.         2r3
 therwife.  All other medicines whicli  are  fuper-
 added, very generally ferve only to increafe the
 bulk of the dofe, while they lcflen its virtue.
   J 266. Before our  thorough experience of the
 bark  other bitter medicines  were  ufed fbr the
 fame purpofe : thefe indeed were not detlitute of
 virtue  in  Such cafes,  though they  were conside-
 rably lets available than the bark.  Under Nc* 43.
 fome valuable  preferiptions of that kind may be
 feen, whofe efficacy  1 have  often  experienced :
 though at other times I have been obliged to leave
 them off, and recur to the bark more fuccefsfully.
 Filings of iron, which enter into the  third  pre-
 feription, are an excellent  febrifuge in particular
 cafes and  ciicuniftances.  In  the middle  of tlie
 winter 1 753, I cured a patient of a  quartan ague
 with it, who would not be prevailed on to take
 the bark.  It mull  be  confeffed he  was perfectly
 regular inobferving the regimen directed for him ;
 and that  during the molt  rigid feverity  of the
 winter, he got every day on horfeback, and took
 fuch a degree of other exercife in the open air, as
 difpofed him to perfpire abundantly.
   §  267.  Another  very  practicable  eafy method,
 of which I have often  availed my patients,  under
 tertian  fevers (but which  fucceeded  with me only
 twice in quartans)  was to procure the  fufferer a
 very plentiful fweat, at the very time when  the
 fit was  to return, in  its ufual courfe.   To effect
this he is to drink,  three or four hours before it is
expected, an infufion of elder flowers fweetened
with honey, which  I have already recommended
§ 264. and one hour before  the ufual invafion of
the Shivering,  he is to go into bed,  and take, as
hot ns he can drink it, the prefcription Nc*  44.
  I have alfo cured  feme  tertians and even  quar-
tans, in 1751 and 1752, by givingthem, every four
hours between  the  fits, the powder  N°'  45.  But
I muft acknowledge that, befides its  having  often
failed me,  and its never Succeeding  fo lpeedily as 
214           Of iniermttting tevers.
the bark, I have found it weaken fome patients ; i/
diforders, or difagrees  with their ftomachs :  and
in two cafes, where it  had removed the fever, I
was obliged  to call in the bark, for a thorough e-
flablifhment of the patient's health.   Neverthelefs
as thefe medicines are very cheap and  attainable,
and often do fucceed, I thought I could not  pro-
perly omit them.
   § 268. A multitude of other remedies are cried
tap for the cure of fevers : though none of them
are equally  efficacious with thofe 1 have direct-
ed ;  and as many of them are even dangerous, it
is prudent to abltain from them.  Some years Since
certain powders were fold heie,  under the name
of the Berlin powders ;  thefe are  nothing but the
bark mafqued or difguiied (which has fometimes
been publickly difcovered) and have always been
fold  very dear :  though the bark  well  chofen,
and frefhly powdered when wanted is greatly pre-
ferable.
   § 269. I have often  known peafants who had
laboured for feveral months under intermitting
fevers ; having made ufe of many bad  medicines
and mixtures for them, and obferved no manner
of regimen.   Such I  have  happily treated by giv-
ing them the remedies  N°* 34. or 35. and after-
wards, for fome days, that of N°* 38. at the end
of which time,  I have ordered them the bark (fee
§  260.)  or  other  febrifuges, as  at §  266,  267.
and then  finally directed  them for fome  days,  to
take morfels of the poor man's treacle (fee  §  247.
art. i3.)to ftrengthen and confirm their digeftions,
whicb I have found very weak and irregular.
   § 270.  Some intermittents are  distinguished as
pernicious or malignant, from every fit's being at-
tended with the moft violent fymptoms.  The pulfe
is fmall and  irregular, the patient exceedingly de-
jected, and frequently fwooning ;  afflicted with in-
expreflible anguifli, convullions, a deep drowfinefs,
and continual efforts to go to llool, or make urine. 
             Of intermitting Fevers.           215
but ineffectually.   This difeafe is highly preffing
and dangerous ;  the patient may die in the third
fit, and rarely Survives the Sixth, if he is not very
judiciously treated.  Not a moment fliould be loll,
and there is no other Step to be taken, but that of
giving the bark continually, as directed § 260. to
prevent the fucceeding fits.  Thefe worll kinds of
intermittents are often combined with a great load
of putrid humours in the firll pafTages : and as of-
ten as fuch an aggravating combination is very e-
vident, we fhould immediately after the end of
one fit, give a dofe of ipecacuanna N°* 3$.  and,
when its operation is finifhed, give the bark.  But
I choofe to enter into very few details on this fpe-
cies of intermittents,  both as  they occur but fel-
dom, and as the treatment of them is too difficult
and important, to be fubmitted to the condudt of
any one but a phyfician.   My intention has only
been to reprefent them fuffieiently, that they may
be fo dittinguiShed when they do occur, as to ap-
prize the people of their great danger.
   \ 271. The fame caufe whicli produces thefe in-
termitting fevers, frequently alfo occafions difor-
ders,  which return periodically at the fame hour,
without Shivering, without heat, ancl often with-
out any quicknefs of the pulfe. Such disorders ge-
nerally preferve  the intermiffions of quotidian or
tertian fevers, but much feldonier thofe of quar-
tans.   I have feen violent  vomitings,  and Teach-
ings to vomit, with inexpreflible anxiety ; the fe-
verell oppreflions, the moft racking cholics; dread-
ful palpitations and exceflive tooth-achs ; pains in
the head,  and very often an unaccountable pain
over one eye,  the eye-lid,  eye-brow,  and temple,
on the fame  fide of the face ; with a rednefs of
that eye, and a continual, involuntary trickling
of tears.  I have alfo feen fuch a prodigious fwell-
ing of the affedled part, that the eye projedted, or
ttood out, above an inch from the head, covered
by the  eye-lid, which was allb extremely inflated 
216         Of intermitting Fevers.
or puffed up.   All thefe  maladies begin precisely
at a certain hour, laSl about the ufual  time of a
fit; and terminating without any fenfible evacua-
tion, return exadtly  at the fame hour,  the next
day, or the next but one.
  There is but one known medicine that can ef-
fectually oppofe this fort, which is the  bark,  giv-
en as directed § 260.  Nothing affords relief in the
fit, and no other medicine ever futpends or puts it
off.   But I have cured feme of thefe diforders with.
the bark,  and  efpecially  thofe affecting the eyes,
which happen oftuer than the other fymptoms, af-
ter their duration for many weeks,  and alter the
ineffectual ufe of bleeding,  purging,  baths, wa-
ters,  bliIters, and a great number of other medi-
cines.  If a fufficient dofe of it be given, the next
fit is very  mild; the fecond is prevented;  and  I
never faw  a relaple  in thefe cafes,  which  fome-
times happens  after the fits of common intermit-
tents feeined cured.
  § 272. In tituatioiis where the constitution of the
air renders thefe fevers very common, the inhabi-
tants Should frequently  burn in their  rooms, at
leaft in their lodging rooms, fome aromatic wood
or herbs.    They Should  daily chew fome juniper
berries,  and diink a fermented infufion of  them.
Thefe two remedies  are  very effectual  to fortify
the weaketl ftomachs, to prevent obftrudtions, and
to promote perfpiration.   And  as thefe are the
caufes which  prolong thefe  fevers  the  moft ob-
ftinately ; nothing is a more certain prefervation
from them  than thefe cheap and obvious afliftan-
ces. *

  * I have feen feveral cafes in very marfliy maritime countries, with
 little .good drinking  water, and far fouth of Hiuifferland. where inter-
 mitting fevers, with  agues at different intervals, are annually  endemic,
 very popular, and often fo obltinate as 10 return repeated'y, whenever
the weeidy precautionary dofes of the bark have been omitted (through
the patient's naufeaiing the fre-iuent fwallowing of ir)  fo that the dif-
eafe hi) fometimes r-eeu extended beyond the term of a  full year, and
eisea far into a fecond, including the temporary removals of it by -the 
Of the Erifipelas,  &c.            217
                  CHAP.   XIX.

     Of the Erifipelas, and the Bites of Animals.


                    Sect.   273.

      TH E erifipelas,  commonly called in  English
       St. Anthony's fire,  and in  Swifferland,  the
violet,  is fometimes but  a very flight indifpofition
which appears on  the fkin, without-the perlbn's
being fenfible of any other diforder ;  and it moft
commonly breaks out either in the face,  or on  the
legs.   The fkin becomes tenfe, or fliff, rough and
red ;  but this  rednefs difappears on  preffing  the
fpot with  a finger, and  returns on removing it.
The patient feels in  the  part affected a burning
heat,  which makes  hiin  unealy,  and  fometimes
binders him from Sleeping.  The disorder increaf-
es for the fpace of two or three days j  continues at
its height  one  or two,  and  then abates.   Soon af-
   Vol. I.                 X

bark. Neverthelefs, in fome fuch obftinate intermittents, and particu-
larly quartans there, wherein the bark aionc has had but a fhort and im-
perfeft effect,  I have known the following compblition, after a good vo-
mit, attended with-fpeedy and final fuccefs, i-iz. Take of frelh faflafias
baric, of Kir£i'»«<t'fnake-root, of roch-alloin, of nutmeg,  of daphoietic
antimony, and of fait of w-ormwood, -of each one draci.m.   To thefe
 well rubbed together into fine powdei, add tlie weight of the whole, of
 the beft and ficihcft bark ; then drop in three drops of the chemical oil
of mint, and with fyrup of cloves make it into the confluence of an elec-
 tuary or bolus, for 12 dofes for a grown perfon, to be taken at the dif-
tanre of three or four hours from each other, while the patient is awake.
 according to the longer or fhoi ter inteimilfion of the fever.
   I have alfo known, particularly in obltinate autumnal agues there, an
 infufion of two ounces of the belt bark in fine powder,  or two ou.uesi
 and a half in  grofs powder,  in a quart of the beft brandy,  for three or
 four days, (a fmail wine giafs to be taken by grown  perfons at the dif-
 tance of from four  to fix hours) effectually and fpeedily terminate fucit
 inveterate agues, as had  given but little way to the bark in fubftance.
 This wa> certainly  moft fuitable for thofe who were not of a light deli-
 cate habit and temperament, and who lud not been remarkable for their
 abftinence from ftrong liquois: the  inebriating force of the brandy '•<. i;.g
 remarkably leffened by the addition and long infufion of the bark.   Thefe
 fad* which I faw,  are the lefa to be wondered at, as in fuch inveterate,
  but perfectly clear and diftinct intermittent^, bofh the (late of the fluids
 and folids feem very oppofite to their ftate ia an acutely infiaramatory
 difeafe.   K* 
 318          O'f the  Erifipelas,  and
 ter this, that pait of the  fkin that was affected,
 falls off" in pretty large Scales,  and the diforder
 entirely terminate*.
   \ 2-1 l\. But femetimes this malady is considera-
 bly more fevere,  beginning with a violent fliiver-
 ing, which is fucceded by a burning heat, a vehe-
 ment head-ach, a ficknefs at heart, as it is com-
 monly termed, or Teachings to vomit,  which con-
 tinue till the  erifipelas appears, which fometimes
 does not happen before the fecond, or even the
 third day.   The fever then abates, and the lick-
 nets goes off,  though frequently a lets degree of
 fever, and of ficknefs or loathing remain,  during
 the whole  time, in which  the difeafe  is in its in-
 ereafing ftate.  When the eruption  and inflamma-
 tion happen in the face, the head-ach continues
 until the decline,  or going  off", of the difeafe.
 The eye-lid fwells, the eye  is clofed,  and the pa-
 tient has not the leaft eafe  or tranquillity.   It of-
 ten partes  from one cheek  to the other, and ex-
 tends fucceflively over the forehead, the neck, and
the nape of the neck  ; under which ciicumftance
 the difeafe  is  of a more than ordinary duration.
$ometimes alfo when it  exitls in a very high de-
 gree, the fever continues,   tlie brain is obltrudted
and opprelfed » the patient  raves ; his cafe becomes
extremely dangerous; whence fometimes, if he is
 not very judicioully affifted,  he  dies, efpecially if
 of an advanced age.   A violent erifipelas  on the
 neck brings on a quinfey,  which may prove very
 grievous, or even fatal.
   When it attacks the leg, tlie whole leg fwells
 up ;  and the heat and irritation from it is extend-
 ed up to the thigh.
  Whenever this tumour is eonfiderabie, the part
 it feh.es is  covered with  fmall puftules filled with
 a clear  watery humour, refembling thofe which
 appear  after a burn,  and  drying afterwards and
 fcaling  oft*.   I have femetimes obferved, efpecial-
ly when this diftemper affected the  face, that the 
              the Bites of Animals.           219
humour, which iffued from thefe little puftules,
was extremely thick or glewy, and formed a thick
Scurf, or fcabs nearly refeinbling thofe of fucking
cliiidren :  they have continued fall on the face
many days before they fell off.
  WSien the difeafe may be termed violent,  it
fometimes continues eight, ten, twelve days at'tlie
Same height ;  and  is at laft terminated by  a very
plentiful fweat,  that may fometimes be predicted
by a re.tlefsneis  attended with Shivering*, and a
little anxiety of fome hours duration.  Tiuough-
out the progrefs of the difeaie, the whole  iLiu is
veiy dry, and even the inii.ie of the mouth.
  § 27J. An erifipelas rarely comes to fuppuration,
and  when  it does, the  Suppuration is always un-
kindly, and much  dilpofed to degenerate into an
ulcer.   Sometimes a malignant kind of erifipelas is
epidemical, feizing a great number of peribus, and
frequeiitlyrttercninating in gangrenes.
  § 276. This diftemper often Shifts its fituation ;
it fometimes retires fuddeuly  ;  but the patient is
uneafy  and diibrdered ; he has a propenfity to vo-
mit, with a fenfible anxiety and heat :  the enfpe.
las appears again in a different part, and he set is
himfelf quite  relieved from the preceding fymp-
toms.   But if inttead^of re-appearing on fome o-
ther part of the furface, the humour is thrown up-
on the brain,  or the breaft,  he dies within a few
hours ;  and thefe  fatal  changes and translations
fometimes occur, without the leaft reafon or colour
for aferibing them  either to any error of the pati-
ent,  or of  his phyfician.
 ' If the humour has been transferred to the brain,
the patient immediately becomes delirious,  with a
highly  flufhed  vifage, and very quick fparkling
eyes : very foon after he proves downright frantic,
and goes off" in a lethargy.
  If the lungs are attacked, the oppreffion, anxi-
ety,  and heat are inexpreflible.
  j.  277. There are fome constitutions fubject  to
                      X  2 
520            Of the  Erifipelas, aud
a very frequent, and, as it  were,  to an habitual
erifipelas.  If it often  affects the face, it is gene-
rally repeated on the fame fide of it ;  and that eye
is, at length, confiderably weakened by it.
   § 278. This diftemper refuIts from two caufes ;
the one, an acrid Sharp humour, which is common-
ly bilious, diflufed thro' the mafs of blood ;  the o-
ther confilts in that humour's not being fuffieiently
difeharged by perfpiration.
   § 279. When this difeafe is of a gentle nature,
fuch as it is deferibed \ 273, it will be fufficient to
keep up a very free perfpiration, but without heat-
ing the patient ; and the beft  method  to  anfwer
this purpofe is putting him upon the regimen fo of-
ten already referred to, with a plentiful ufe of ni-
tre in elder-flower tea.  Flefh, eggs, and wine are
prohibited  of courfe, allowing  the patient a little
pulle and ripe fruits.  He fhould drink elder-flow-
er tea abundantly, and take half a drachm of nitre
every three hours ; or, which amounts to the fame
thing, let three drachms of nitre be diflblved in as
much infufion of elder-flowers, as  he can drink in
twenty-four hours.  Nitre may be given too  in a
bolus with  conferve of elder-berries.  Thefe medi-
cines keep the body open, and  increafe  urine and
perfpiration.
   § 2S0.  When the diftemper prevails in a  Severer
degree, if the fever is very high, and  the pulfe
at the fame time ftrong or hard, it may behiecelTary
to bleed once : but this fhould  never be permitted
in a large quantity at a time in this difeafe; it be-
ing more advileable, if a fufficient  quantity has net
been taken at once, to bleed a fecond time,  and c-
ven a third, if the fever fhould prove very high,
as it often does, and that fometimes in fo violent a
degree, as  to render it  extremely dangerous : and
in a few fuch cafes, nature has Sometimes faved the
patients by effecting a large haemorrhage, or bleed-
ing, to the quantity of four or five pounds.  This
conduct  a very  intelligent and prudent phyfician 
              the Bites of Animals.            211
may  prefume to imitate; but  I dare not adviSe
the Same conduct to that elals  of  phySicians, ror
Which only I write : it being fafer for them to ufe
repeated bleedings in fuch cafes,than one in an ex-
ceSfive quantity.  Thefe  erifipelatous fevers are of-
ten excited by a perfon's being too long over-heat-
ed.
   After bleeding the patient is to be reftrained to
his regimen ;  glyfters are to ,be given until  there
is a fenSible abatement of the fever; and he fliould
drink the barley  water freely, Nc*  3.
   When the fever is femewhat  diminifhed, either
the purge  N'* 23. fliould be given,  or a few' dofes
of cream of tartar N°' 24. every morning.  Purg-
ing is abfolutely neceffary to carry ofFthe llagnant
bile,  which i-s generally the firlt caufe of the vio-
lent degrees of this diftemper.   It  may fometimes
be really neceffary too, if the difeafe is very tedi-
ous ;  if the loathing and ficknefs at ftomach is ob-
ltinate ;  the mouth ill-favoured, and the tongue
foul,  (provided there be only a flight fever, and
110 fear of an inflammation) to give the medicines
N • 34. or 35. which, in  confequenre of the agita-
tion,  the fhaking they occafion, remove thele im-
pediments ftill better than purges.
   It commonly happens that  this difeafe is more
favourable after thefe evacuations; neveithelefs it
is femetimes neceffary to  repeat  them  the next
day, or the next but one  ; efpecially if the malady
affects the head.  Purging i, fhe true evacuation
for curing it, whenever it  attacks this part. By
carrying off the caufe of the difeafe, they diminish
it, and prevent its  worft events.
   Whenever, even after thefe evacuations, the fe-
ver ftill continues to be  very fevere, tlie  patient
Ihouid take every two hours, or, occafionally, cft-
»er, two Spoonfuls of the prefcription N  • 10. add-
ed to 1 glafs of |. titan.
   It will be very  ufeful,  when this difeafe is feafed
in the head or face, to bathe the legs frequently m
                     X 3 
 222           Of the'Erifipelas, and
 yam water; and, where it is violent there, alfo
 to apply SinapiSins to the foles of the feet.  I have
 feen this application, in about four hours attract,
 or draw down an erifipelas to the legs, which had
 fpread over the nofe, and both the eyes. When tiie
 diftemper once begins to  go off by fweating, this
 fliould be promoted by elder-flower tea and nitre,
 (See § 279.) and  the fweating may be encouraged
 to advantage for feme hours.
   § 281. The belt applications that  can be made
 to the Liffected part arc ill,  the herbrobert, a kind
 of geranium, or crane's-bill; or chervil, or parfley,
 or elder-flowers ; and  if the complaint be of a ve-
 ry  mild difpoSirion, it may be fufficient to apply a
 ▼ery foft fmooth  linen over it, which  louie people
 dull over with a  little dry meal.
   2. If there is a very eonfiderabie inflammation,
 and the patient is to  circumltanced as to be very
 tractable and  regularly attended, flannels  wrung
 out of a ftrong decoction  of elder-flowers and  ap-
 plied warm, afford him the fpeediett eafe and re-
 lief.  By this fimple application 1 have appealed
 the molt violent pains  of  a St. Anthony's fire,
 vr .ieli is tlie moft cruel fpecies of an erifipelas, and
 has fome peculiar marks or  fymptoms extraordi-
 nary.
   3. Tlie plaifter  of  Smalt, and fmak  itfelf N°»
 46. are alfo very fucceisfully employed in this difr-
 eafe.   This powder,  the farinaceous,  or mealy
 ones, or others cried up for it, agree  beft when a
 thin watry humour diltils or weeps from the little
 vesications* attending it, which it is convenient to
 abforb by fuch applications; without which pre-
 caution it might  gall,  or  even ulcerate, the part.
  All other planters, which are partly compound-
 ed of greafy, or of refinous fubftances, are very
 dangerous; tliey often repel, or ftrike in the eri-
fipelas, occasioning it to ulcerate, or even to gan-
 grene.  If people who are naturally fubject to this
 difeafe Should apply any fuch plaifter to their fkin, 
             the  Bites of Animals.            itj
 even in its feundeft ftate, an erifipelas is the Speedy
 confequence.
   § 282.  Whenever the  humour occasioning the
 diftemper is repelled, and thrown upon the brain,
 the throat, the lungs, or any  internal part, the
 patient Should  be bled ; blilters  muft be applied to
 the legs ; and  elder tea, with nitre dilfolved in  it,
 fliould be plentifully drank.
   § 283. People who are liable to frequent returns
 of an erifipelas, fhould very carefully avoid ufing
 milk,  cream, and  all fat and  vifeid, or clammy
 food, pies, brown meat,  fpices, thick and heady-
 liquors, a Sedentary life, the more active paffions, e-
 fpecially  rage, and, if poffible, all chagrin too.
 Their food Should chiefly confiSt  of herbage, fruits,
 of fubltances  inclining  to acidity,  and  which
 tend  to keep  the body open ; they fhould drink
 Water,  and Some of the light white  wines j by no
 means omitting the frequent ufe of cream of tar-
 tar.  A careful conformity to thefe regulations is of
 real importance, as, befides the  danger of the fre-
 quent visitations of this difeafe, they denote Some
 flight indifpofitions of the liver  and the gall-blad-
 der ; which, if too little attended to, might in time
 prove very troublefome and pernicious.
   Such mineral waters as are gently opening are
 very  proper tor thefe  constitutions, as well as the
juice offuccory, and clarified whey, of which  they
 fliould take about three pints every morning, dur-
 ing the five or  fix Summer months.  This becomes
 ftill more efficacious, if a little cream of tartar and
 honey be added to it.
     Of the Stings, or little Wounds, by Animals.
   § 284.  The  flings or little  tites of animals, fre-
 quently producing  a kind of eriflpeias, 1  Shall add
 a very few words concerning them in this place.
   Of the Serpents in this country none but the vi-
 pers are poifenous j and  none of thefe are found
except at Baume3 where  there is a viperary, if we 
 324            Of the Erifipelas, and
 may be allowed that word. We have no Scorpions'
 which are fomewhat poifbnous ; our toads are not
 in the leaft fo:  whence the  only Slings we are ex-
 pofed to, are thoie of bees, waSps,  hornets, muSki-
 tos or gnats, and dragon * flies ; all of which are
 fometimes attended with fevere pain,  a fwelling,
 and a  very  eonfiderabie erifipelatous  rednefs;
 which, if it happens in the face, fometimes entire-
 ly clofes the eyes up ; occasioning alio a fever, pains
 of the  head,  reftlefsnels, and  ficknefs at heart;
 and, when the paius are in a violent degree, faint-
 ings and convulfions, tho' always without any mor-
 tal confequence.  Thele fymptoms go off natural-
 ly within a few days,  without any  afliltance ;  ne-
 verthelefs they may either be prevented, diminish-
 ed in degree, or Shortened in duration.
   I. By extracting the fling of the animal, if it is
 left behind.
   a. By a continual application of one of the re-
 medies directed § 281.article I. and a. particularly
 the infufion of elder-flowers, to which a little Ve-
 nice treacle is added ; or by covering  the  part af-
 fected with a poultice, made of crum of bread,milk,
 honey,  and a little Venice treacle.  \
   3. By bathing the legs of the perfen flung  re-
 peatedly in warm water.
  4. By retrenching a little of their cuftomary food,
 efpecially at night,  and by making them drink an
 infufion of elder-flowers, with  the addirion  of a
 little nitre.  Oil, if applied very quickly after the
 iling, fometimes prevents the appearance of any
fwelling, and from thence the pains that attend it.

  * Thefe, in fome parts of America, are called Mufkito hawks; burwe
<lo not 1 <- 1.oi.ett the e biting there.  K.
  t Pounded pauiey « one  of the moft availing applkation* in fuch at-
eiacnii.  £. L, 
   Of fpuriaus, or falfe Inflammations,  &c.    22>

                CHAP.  XX.
Of fpurious,  or falfe Inflammations of the Breaft, and
           offpuriuus, bilious, Pleurifies.

                 Sect.  285.
     TH E inflammation of the breaft and that pleu-
      rify, which is called bilious, are the fame dif-
eafe.   It is properly a putrid fever, attended with
an infarction or fluffing of the lungs, tho' without
pain ;  in which circumstance  it is called a putrid
or bilious peripneumony :  but when attended with
a pain of the fide, a ftitch,  it is called a fpurious
or bafiard pleurify.
   § 286. The figns which distinguish thefe difeafes
from  the  inflammatory ones  of the fame name,
deferibed chap. IV. and V. are a lefs hard and lets
ftrong, but a quicker pulfe, though unaccompanied
with the fame fymptoms which constitute the in-
flammatory ones (See § 47.  and 90.) The mouth is
foul, and has a fenfation of bitternefs ; the patient
is infefled with  a fharp  and  dry heat:  he  has  a
feeling of heavinefs and anxiety all  about his fto-
mach, with loathings : he is lefs flu Shed and red in
thefe,  than in the inflammatory difeafes, but ra-
ther a little yellow.  He has a dejected wan look ;
his urine refembles that in'putrid fevers, and not
that of inflammatory ones ; and he has very often
a fmall bilious loofenefs, which is extremely offen-
sive.   The fkin  is commonly very dry in this dif-
eafe ; the humour fpit up is lefs thick, lefs reddifh,
and rather more yellow, than in the inflammatory
difeafes of the fame names.
   §  287.  They  mull be  treated after the manner
of putrid fevers, as in § 241.  Suppofing feme lit-
tle degree of inflammation to be combined with
the difeafe, it may be removed by a tingle  bleed-
ing.   After this the patient is to drink barley wa-
ter NL* 3.  to make ule of glyfters;  and  as foon  as 
236   Of fpurious,  or falfe Inflammations,  Sec.
all fymptoms of any inflammation wholly disap-
pear, he  is to take the  vomiting and  purging
draught N°* 34.  But the utmoft caution muft be
taken not to give it, before every appearance of a-
ny inflammation is totally removed ;  as  giving it
fooner would be certain death to the tick : and it
is dreadful but to think* of agitating by  a vomit,
lungs that are  inflamed, and  overloaded with
blood, whofe  veffels burfts and difcharge  their.-
felves, only from the force of expectoration.  Af-
ter an interval  of fome  days he may be purged
again with the medicine Nc* 23. The prefcription
N  • 25. fucceeds  alfo very well  as a vomit.  If
the fever is violent, he muft drink plentifully of
the potion N""• 10.
  Blilters  to the legs are veiy ferviceable, when
the load and oppreffion  are not conliderably abat-
ed after general evacuations.
  § 288. The falfe inflammation  of the breaft is
an overfulnefs or obftrudtion in the lungs, accom-
panied with  a fever;  it  is  caufed by extremely
thick and tenacious humours ; and not by a really
inflammatory  blood, or by any putrid or bilious
humour.
  5 289. This diftemper happens  more frequent-
ly in the fpring, than  in  any other feafon.   Old
men, puny,  ill-conttitutioned children, languid
Women, feeble young men,  and particularly fuch
as have worn their conftitutions out by drinking,
are the fubjects molt frequently attacked by it; e-
fpecially  if  they have ufed but little exercife
throughout the  winter; if they have fed on vif-
eid,  meafy and fat.aliments,  as paltry,  chtelnuts,
thick milk or pap, and cheefe.  All   their  hu-
mours have contracted a thick glutinous quality  ;
they are circulated with difficulty, and when.heat
or exercife in  the fpring increafes their motion at
once, the humours, already fluffing up the lungs,
ftill uioie augment that plenitude, whence thefe 
     Of fpurious,  or falfe Inflammations, &c.   227
vital  organs are fatally extended,  and  the pa-
tient dies.
  § 290. This diftemper is known to exift,
  1. By the previous  exittence of the caufes al-
ready mentioned.
  2. By the fymptoms which precede and ufber it
in.   For example, the patient many days before-
hand has a flight cough ; a fmall oppreffion when
he moves about ;  a little reftlefsnefs,  and is feme-
times a little choleric or fretful.  His  counte-
nance is higher coloured than in  health ; he has
a propenfity to fleep, but attended with confufion
and without refreshment,  and has fometimes an
extraordinary appetite.
  3. When this tlate has continued for fome days,
there comes on a cold fhivering, though more con-
siderable for its  duration  than its violence;  it is
fucceeded by a moderate degree of heat; but that
attended with much inquietude and  oppreffion.
The Sick perfon cannot confine himfelf to the bed;
but walks to and  fro in his  chamber, and is great-
ly dejected.  The pulfe is  weak and pretty quick ;
the urine is  fometimes but  little changed from
that in health ; at other times it is difeharged but
in a fmall quantity, and is higher  coloured: he
coughs  but moderately, and does not expectorate,
or cough up, but with difficulty.   The vifage be-
comes very red,  and even almoft livid ;  he can
neither  keep awake, nor fleep well ; he raves for
fome moments, and then his head grows  clear a-
gain. Sometimes it happens, efpecially to perfons
of advanced age, that this tlate fuddenly termi-
nates in a mortal fwoon or fainting ; at other times
and in other cafes, the oppreffion and anguifli in-
creafe ;  the patient cannot breathe but when fitting
up, and that with great difficulty and agony : the
brain is utterly dillurbed and embarrafled; this
ftate lalls for fome hours,  and then terminates  of
a fudden.
  § 291. This is a very dangerous diftemper j  be- 
228   Of fpurious, or falfe Inflammations, See.
caufe, in  the firft place, it chiefly attacks thofe
perfons  whofe temperament and constitution are
deprived of the ordinary retburces for health  and
recovery: in the fecond place, becaufe it is of a
precipitate nature, the patient fometimes  dying
on the third day, and but feldom fin viving the fe-
venth ;  while the caufe of it  requires a more eon-
fiderabie term for its removal, or mitigation.  Be-
fides  which, if fome indications prefent, tor the
employment of a remedy,  there are frequently o-
thers which forbid it; and all that  feems to be
done is, as follows ;
   I.  If the patient has ftill a pretty good Share of
health ; if he is not of too advanced an age; if
the pulfe  has a perceivable  hardnefs, and yet at
the fame time feme flrength, if the weather is dry,
and the wind blows from the north,  he fhould be
bled  once,  to  a moderate quantity.  But if the
greater part of thefe circumftauces are  wanting,
bleeding  would be very prejudicial.  Were we o-
bliged to  eftablifh feme general and potitive rule
in this cale, it  were better to exclude  bleeding,
than to admit it.
   2.  The Stomach and  the bowels fhould be unload-
ed from their vifeid glutinous contents ; and the
medicines which  fucceed  the  belt in this  re Spec":
are  N  • 35. when  the fymptons Shew there is a
great neceflity for vomiting, and there is no in-
flammation ; or the prefcription Nc*  25. which af-
ter  vomiting,  purges  by  llool, promotes urine,
breaks  down and divides the vifeid humours, that
occalion the difeafe,  and increafes  perfpiration.
When we are  afraid of hazarding the agitations
of a vomit and its confequences, the potion N°»
 II. may be given ; but we muft be very cautious, in
regard to old men, even  with this;  as fuch may
expire  during  the operation of it.
   3. They fhould,  from  the beginning  of the
difeafe, drink plentifully of the ptifan  N°* 26.
which is the belt drink in this difeale i or that of 
      Of fpurious, or falfe  Inflammations, &c.   229

N°» 12. adding half a drachm  of nitre  to every
pint of it.
  4. A cup of the  mixture N°- 8. muft  be taken
every two hours.
  5- Blifters are to be applied to the infides of the
legs.
  When the cafe is very doubtful and perplexing,
it were beft to confine ourfelves to the three laft-
mentioned remedies,  which have often been fuc-"
cefsful in fevere degrees of this difeafe j and which
can occafion no ill confequence.
  § 292. When this  malady invades old people,
though they partly recover, they never recover
perfedtly, entirely, from  it: and if due  precauti-
on is not taken, they are  very liable to fall into a
dropfy of the breaft after it.
  \ 293. The fpurious or falfe pleurify is  a diftem-
per that does not affect the lungs;  but  only the
teguments, the fkin,  and the mufeles which cover
the ribs.  It is the  effect of a rheumatic humour
thrown upon thefe parts, in wliich, as it produces
very fharp pains refembling that which is called a
flitch, it has, from this circumltance, been termed
a pleurify.
  It is generally fuppofed by the mere multitude,
and even by fome of'a different rank, that a falfe
pleurify is more dangerous than a genuine, a true
one ;  but this is a mi (take.  It is often ufhered in
by a Shivering,  and almoft  ever attended  with a
little  fever, a fmall cough,  and a flight  difficulty
of breathing ; which, as well as the  cough, is oc-
cafioned from the circumltance  of a patient's (who
feels pain in refpiration,  or breathing)  checking
breathing as much as he can ; this accumulates a
little too much blood in the lungs; but yet he has
110 anguifh, nor the other fymptoms  of acute true
pleurifies.  In fome patients this pain is extended,
almoft over the whole breaft, and to the nape of
the neck.  The fick perfon cannot repofe himfelf
eu the fide affected.
   Vot.  I.           V 
4
230   Of fpurious, or falfe Inflammations, Ice.
   This diferder is not more dangerous than a rheu*
matifm, except in two cafes ; I. When the pain is
fo very fevere, that the patient ftrongly endeavours
not to breathe at all, which brings on a  great in-
farction or Itoppage in  the lungs.  2-  When this
humour, like any other rheumatic one, is transfer-
red to feme internal part.
   § 294. It mult be treated exactly like a rheuma*
tifm.  See § 168, and 169.
   After  bleeding once or  more, a blifter  applied
to the affedted part is often attended with a  very
good effect :• this being indeed the kind of * pleu-
rify, in which it particularly agrees.
   § 29J. This malady fometimes gives way  to the
firft bleeding ; often  terminating on the third,
fourth or fifth day, by a very plentiful fweat, and
rarely lalling beyond the  feventh.   Sometimes it
attacks  a  perfon very fuddenly, after a Itoppage
of perfpiration ; and then, if at once before the
fever commences, and has time to inflame the blood,
the patient takes fome faltrank, it effects a fpeedy
cure by relloring perfpiration.  They  are  fuch
cales as thefe,  or that mentioned \ 96. which have
given this compofition the reputation it has obtain-
ed in this difeaSe : a reputation neverthelefs, which
has every year proved tragical in its  confequences
to  many peafants, who being deceived by fome
mifleading refemblances  in  this diftemper, have
raShly and ignorantly made ufe of it in true in-
flammatory pleurifies.

  * The Seneka rattle-fnake-root, already recommended in true pJeurh
fies, wiii, with the greateft probability, be found not icfs effeftual in thefe
falfe ones, in which the inflammation of the blood is lefs.  1 he method
of giving it may be feen p. 89, note *, by Dr.  lISSOT's  having
ncicr mentioned thisvaluablefimplethrougho-.it his work, it may be pre-
sumed, that when he wrote it, this remedy had not occn admitted UHO
the apothecaries ihops in Sw'Jferiand, K.
 
       Of the Cholic and its different Kinds.    231

                CHAP.  XXI.
       Of the Cholic and its different Kinds,

                 Sect.  296.
     TH E appellation of a cholic is commonly  giv-
      en to all pains of the belly indiscriminately;
but I apply it in this place only to fuch as attack
the ftomach, or the iuteltiues, the guts.
  Cholics may ancl do refuIt from very many cauf-
es ; and the greater number of cholics are chronical
or tedious complaints, being more common among
the inactive inhabitants of cities, ancl workmen in
fedentary trades, than  among  country  people.
Hence I fhall treat here only of the fmall variety of
cholics, which happen the moft ufually in villages.
I have already proved that the fatal events of ioine
distempers  were occafioned  by endeavouring to
force the patients into  fweats; and the fame un-
happy confequences have attended  cholics, from
accufloming the fubjects  of this  difeafe to drams,
and hot inflaming fpirituous liquors, with an in-
tention to expel the wind.
            Of the inflammatory Cholic.
  § 297. The moll violent and dangerous kind of
cholic is  that, wliich arifes from an  inflammation
of the ftomach,  or  of the inteflines.   It begins
moft commonly without any  Shivering, by a vehe-
ment pain iu the belly,  which gradually becomes
ftill more fo.  The pulfe grows quick and  hard ;
a burning pain  is felt through the  whole region
of the belly; fometimes there  is a watery diarrhea,
or purging ; at other times the belly is rather cof-
tive,  which is  attended with vomiting,  a   very
embarrafling and dangerous fymptom :  the coun-
tenance  becomes highly  fluShed ; the belly tenfe
and. hard;  neither  can  it be touched fcarcely
Without  a  cruel augmentation  of the patient's
                        Y 2 
2? 2    Of the Cholic and its  different Kinds.
pain, who is alfo afflicted with extreme reftleflnefs;
his thirSt is very great, being unquenchable  by
drink ;  the pain often extends to the loins, where
it proves very Sliarp, and Severe; little urine is
made, and that very red, and with a kind of burn-
ing heat.  The tormented patient has  not  a mo-
ment's reft, and now and then raves a  little.   If
the difeafe is  not  removed or moderated, before
the pains rife to their utmoft height and violence,
the patient begins at length to complain lefs y the
pulSc becomes leSs Strong and lefs hard than before,
but quicker :  his face firft abates of its fluSli and
rednefs,  and foon after looks pale ; the parts un-
der the eyes become livid ; tfie patient finks in-
to a low  Stupid kind of delirium, or  raving; his
Strength entirely deferts him ;  the face,  hands,
feet,  and the  whole body, the belly only except-
ed, become cold : the furface of the belly appears
bluifh j extreme weaknefs follows, and the patient
dies.  There frequently occurs, juft a moment be-
fore he expire?,  an abundant difcharge of excef-
fively foetid matter by flool;  and during this eva-
cuation he dies, with his inteflines quite gangren-
ed, or mortified.
  When the diftemper  aflaujts the ftomach,  the
fymptoms are  the very fame, but the pain  is felt
higher up, at  the pit of the ftomach.   Almoft e-
very thing that is Swallowed is call up again j  the
anguifli of the tortured patient is  terrible, aiid the
xaving comes on very fpeedily. rl his difeafe proves
mortal in a few hours.
  § 298. The  only  method of fucceeding in  the
cure of it is as follows :
  1.  Take a  very  large quantity of blood from
the arm ; this almoft immediately diminifhes  the
violence of the pains, and allays the vomiting i,
befides its contributing to the  greater  fuccefs of
the other remedies.  It is often neceffary to repeat
this bleedi lg within the fpace of two hours.
  2. Whether the patient has a loofenefs, or  has 
        Of the Cholic and its different Kinds.     2 ? 3
■lot,  a glyfter of a decoction of mallows,  or of
barley water and oil, fhould be given every  two
hours.
  .3.. The patient fliould drink very plentifully of
almond milk Nc§ 4.  or a ptifan of mallow flowers,
or of barley,  all which fhould be warm.
   4.  Flannels  dipt in hot, or very warm water,
Should be continually applied over the belly, Shift-
ing them every hour, or rather oftner ; for in this
cafe they very quickly grow dry.
   c.  If the difeafe, notwithllanding all this,  con-
tinues very  obltinate and  violent,  the patient
fliould be put into a warm water bath, the extra-
ordinary fuccefs of which  I have obferved.
   When the diftemper is over, that is to fay, when
the pains have terminated, and the fever has ceaf-
ed,  fo that the  patient recovers a little  itrength,
and gets a little  fleep, it will be  proper to  give
him a purge, but a very gentle one.  Two ounces
of manna, and a quarter of an ounce of Sedlitz *
fait dilfolved in a glaSs of clear whey, are gene-
rally fufficient, at this period,  to  purge the  moSt
robuSl and hardy bodies.  Manna alone may Suffice
for more delicate conftitutions: as all acrid Sharp
purges would be highly dangerous, with regard to
the great  fenfibility and tender condition of the
itomach  and  of the inteflines, after this  difeafe.
   \ 299  It is Sometimes the effect of a general in-
flammation of the blood ; and is  produced, like
other inflammatory difeafes,  by extraordinary la-
bour, very great heat, heating meats or drinks,
ire.   It  is often the confequence of other cholics
Which have been injudicioufly treated, and which
otherwife would not have degenerated into inflam-
matory ones ; as I have many times feen thefe  cho-
lics intr->duced after the ufe of heating medicines;
one iuftance  of which may be feen V164.
                       Y  3
  * Glauber or Epfom falt'may be fubftituted, where the other is not
to-be readily nrotuied.  X. 
 t?4    Of the Cholic and its different Kinds.
   \ 300. Ten  days after I had recovered a we%
 man out of a fevere cholic, the pains returned vio-
 lently in the night.  She fuppofing them to arife
 tonly from wind, hoped ko appeafe them by drink-
 ing a deal of diltilled walnut water; which, far
 from producing any fuch effect, rendered themj
 more outrageous.   They foon were heightened to
 a furprifing degree,  whicli might reafbnably be
 expected.  Being  font for very early  in the morn-
 ing, I found her pulfe hard, quick, fhort ; her bel-
 ly was  tenfe and hard :  She  complained greatly
 of her loins : her urine was almoft entirely Stopt.
 She pad but a few drops, which  felt as  it  were
 fcalding hot, and thefe with exceflive pain.  She
 Went very frequently to theclofe-ftool, with fearee-
 ly any  effect ; her anguiSh, heat,  thirft,  and the
 drynefs of her tongue were even terriSy ing ;  and
 her wretched  Slate,  the effect of the ftrong hot
 liquor the had  taken, made me very  apprehenfive
 fbr her.   One bleeding, to the quantity of four-
 teen ounces, fome  what  abated  all the pains ; fhe
 took feveral glyfters, and drank off*a few po s of
 trgeat in a few hours. By thefe means the difeafe
 Was a little mitigated / by  continuing the  fame
 drink and the glyfters, the loolenefs abated j the
 pain of the loins went off,  and  the palled  a eon-
 fiderabie quant-ty of urine, which proved turbid,
 and then letting fall a  fediment, the patient re-
 covered.   Neverthelefs  I  verily  believe,  if the
 bleeding had been delayed two hours longer, this
 foirituous walnut water would have  been the death
 of her.  During the progrefs of this violent difeafe
 no food is to be allowed ;  and we Should never be
 too inattentive to  fuch degrees of pain, as  fome*
 ti nes remain  after their feverity  is  over ;  left  a
fchirrus, an inward  hard tumour, Should be gene-
 rated, which  may occafion the moft inveterate and
 tedious maladies.
   ')  10 r. An infla nmation of the inteflines,  and
 o.i.  o * :':? .'.3 :.a 1, may alfo terminate in an ab- 
        Of the Choltc and its different Kindt.    %%%
icels, like an inflammation of any other part j and
it may be apprehended that one is forming, when,
though the violence of the pain abates, there Still
remains a flow, obtufe, heavy pain, with general
inquietude, little appetite, frequent fliiverrngs $
the patient at the feme time not recovering any
flrength.   In fuch cafes the patient Should be al-
lowed no other drinks, but what are already di-
rected in this chapter, and fome foops made of puis,
or other farinaceous food.
  The breaking of the abfeefs may fometimes be
difcovered  by a flight fwoon or fainting tit ;  at-
tended with a perceivable*cetfation  of a weight of
heavinefs in the part, where it was lately felt: and
when the pus, or ripe matter, is effuled into  the
gut, the patient femetimes has Teachings to vomit,
a vertigo, or fwimming in the head, and the mat-
ter appears in the next ftools.  In  this cafe there
remains an ulcer within the gut, which, if either
neglected,  or improperly treated,  may pave  the
way to a flow wafting fever, and even to death*
Yet this I have cured by making the patient live
folely upon Skimmed milk,  diluted with one third
part water, and by giving every other day a glyf*-
ter, confitting of equal parts of milk  and water,
with the addition of a little honey.
  When the abfcefs breaks on the outfide of  the
gut, and difeharges its contents into the cavity of
the belly, it  becomes a very miferable cafe, and
demands fuch further aSfiftance as cannot be par-
ticularised here.
              Of the bilious Cholic*
  \ 302. The bilious cholic difeovers itfelfby yerf
acute pains, but is feldom accompanied with a fe-
ver ; at leaft  not until it has  lafted a day or two.
And even if there  fhould be fome degree of a fe-
ver, yet the pulfe, though quick, is neither ftrong
nor hard :  the belly is neither tenfe or Stretched
as it were, nor burning hot, as in the former clio- 
33°    Of the Cholic and its different Kinds.
lie : the urine comes away with more eafe, and is
Jefs high-coloured.  Neverthelefs the inward heat
and thirit are eonfiderabie ;  the mouth is bitter ;
the vomiting or purging, when either of them at-
tend it, difeharges a yellowish humour or excre-
ment ;  and the  patient's head is often vertiginous
or dizzy.
  § 303. The method of curing this is,
  I. By injedting glyfters of whey and honey ; or,
if whey is not readily procurable, by repeating the
glyfter N • 5.
  2. By making the fick drink confiderably of the
lame whey, or of a ptifan made of the root of dog's
grafs  (the common grafs) and a little juice of le-
mon,  for want  of which a little vinegar and ho-
ney may be fubllituted inftead of it. *
  3* By giving  every hour one cup of the medi-
cine N"* 32. or, where this is not to be had, half
a drachm of cream of tartar at tlie fame Short in-
tervals.
  4. Fomentations of warm water and half-baths
are alfo very proper.
  c. If the pains are fharp and violent, in a ro-
bull ftrong perfon, and  the pulfe is Strong and
tenfe,  bleeding  Ihouid be ufed to prevent an in-
flammation.
  6. No other nourishment fhould be given,  ex-
cept fome maigre foops, made from vegetables,
and particularly of Sorrel.
  7.  ASter plentiful  dilution  with  the  proper
drink, if no fever fupervenes  ; if the pains  ltill
continue, and the patient difeharges but little by
Stool, he Should take a moderate purge.  That di-
rected N°* 47. is a very proper one.
  § 304. This bilious  cholic is habitual to many
perfons ; and may be  prevented or greatly miti-
gated by an habitual ufe of the powder N  * 24. by

.  • Pullet,  or rather  chicken water, but very weak,, may often do in-
ftead of ptifan, or ferye for a link variety of dunk to fome patients. 
        Of the Cholic and its different Kinds.     23 J
 lubmitting to a moderate retrenchment in the ar-
 ticle of flelh-meat ; and by avoiding heating and
 greafy  food, and the ufe of milk.

   Of Cholics from Indigeftions,  and of Indigeftien.
 ,  §  305.  Under this appellation I comprehend all
 thofe cholics, which are either owing to any over-
 loading quantity of food  taken at once ;  or  to a
 mafs or accumulation of aliments formed by de—•
 grees in fuch ftomachs, as dlgelt but very imper-
 fectly ;  or which refult from  noxious mixtures of*
 aliment in tlie ftomach,  fuch as that of milk and
 acids ; or from food either not wholefome in itfelf,
 or degenerated into an unwholefome condition.
   This kind of cholic may be known from  any
 of thefe caufes having preceded it ; by its pains,
 which are accompanied with great rettlefsnefs,
 and come on by degrees, being lets fixed than in
 the  cholics before treated  of. Thefe cholics are
 alfo without any fever, heat or thirft, but  accom-
 panied  with  a  giddinefs of the head,  and efforts
 to vomit, and rather with a pale,  than a high-co-
 loured vifage.
  § 306.  Thefe diforders,  from thefe laft caufes,
 are fcarcely ever dangerous in themfelves ;  but
 may be made fuch  by injudicious  management,
 and doing more than is neceffary or proper : as
 the  only thing to be done is to promote the di£>
 charges by warm drinks.   There are a eonfider-
 abie variety of them,  which  feem equally  good,
 fuch as warm water, or even cold water  with  a
 toaft, with the addition either of a little fngar, or
 a little fait :  a light  infufion of chamomile, or off
 elder-flowers,  common tea, or baum, it  imports
little which,  provided the patient drink plentiful-
 ly of them :  iu confequence of which the offend-
ing matter is difeharged, either by vomiting, or
 a eonfiderabie purging ; and the fpeedier and more
in quantity thefe difeharges are,  the fooner the
patient  is relieved- 
338     Of the Cholie and its different Kinds.
   If the belly is remarkably full and coflive, glyf-
ters of warm water and Salt Ihouid be injected.
   The expulfion of the obstruct ing matter is  alfo
facilitated, by rubbing the belly heaitiiy with hot
cloaths.
   Sometimes the humours, or other retained con-
tents of the belly, are more pernicious fro.n their
quality,  than  their quantity ;  and then the mala-
dy may be diSfipated without the former difeharg-
es, by the irritating Sliarp humour being diluted,
o** even drowned,  as it were, In the abundance ui
fmall watery drinks.  When the pains invade  firlt
the ftomach, they become'lels  fli.irp, and the pa-
tient feels lefs inquietude,  as foon as the caufe of
the pain has detcended out of the  ftomach into
the inteflines, whole fenfations are fometbing lets
acute than, or fomewhat different from, thofe of
the ftomach.
  It is often found that after  thefe plentiful  dif-
eharges, aud  when the pains are over, there re-
mains a very difagreeable taSte in the mouth,  re-
fembling the favour of rotten eggs.  This may be
removed by giving fome dofes of the powder  N •
24. and drinking largely of good water.
  It is an effential point in thefe cafes to take no
food,' before a perfect recovery.
   § 307- Some have been abfurd enough in them,
to fly at once  to feme  heating  cordial confection,
to Venice treacle,  anifeed water, Geneva,  or red
wine, to Hop thefe evacuations ; but there  cannot
be a more fatal practice :   fince thefe evacuations
are the only thing which can cure the complaint,
and to Hop them is to deprive the perfen, who was
in danger of drowning, of the plank which might
fave him.   Nay,  fhould this  endeavour of flop-
ping them unhappily  fucceed,  the patient is ei-
ther thrown into a putrid  fever, or fome chroni-
cal tedious malady ;   unlets nature,  much wifer
than fuch a miferable afliltant, Should prevail over
the obstacles oppoi'ed to her recovery,  and reftorc 
      Of the Cholic and its different Kinds.     J39
 the obftriicted evacuations  by her own ceconomy,
 in the fpace of a few days.
   § 308. Sometimes an indigeflion happens, with
 very little pain or cholic, but with violent Teach-
 ings to vomit, inexpreflible anguifh, faintings, and
 cold fweats: and not feldom  alto the malady be-
 gins, only with  a very fudden and unexpected
 fainting : the patient immediately  lofes  all his
 fenfes,  his face is pale and wan ; he has feme hic-
 cups rather than  Teachings to vomit,  which joined
 to the fmallnefs of his pulfe, to the ealinefs of his
 refbiring, or  breathing, and to the  circumltance
 of his being attacked immediately, or very  foon,
 after a  meal,  makes this diforder diftinguifhable
 from a real apoplexy.  Neverthelefs,  when it rifes
 to  this* height, with thefe terrible fymptoms,  it
 fometimes kills in a few  hours.  The firft thing to
 be done is to  throw  up  a Sharp glyfter, in which
 fait and foap are to be diffblved: next to get down
 as much fait and  water as he can fwallow ; and if
 that is ineffectual, the powder N • 34. is to be dif-
folved in three cups of water ; one half of which is
 to be given directly ; and, if it does not operate in
a quarter of an hour,  the other  half.  Generally
Speaking  the  patient's fenfe begins  to' return, as
 foon as  he begins to vomit.

          Of the flatulent or  windy Cholic.

   § 509.  Every particular  which conftitutes our
food, whether folid or liquid, contains much air,
but Sbme of thein more than  others.  If they do
not digeft foon enough, or but badly, which occa-
fions a fenfible efcape of fuch air; if they are fucli
as contain an  extraordinary quantity of air ; or if
the guts being flraitened or comprefled any where
in the courfe of their extent, prevent that air from
being equally diffufed  (which muft occafion  3
greater  proportion of it in fome places) then the
ftomach and the guts are diltended by this wind ; 
340     Of the Chofic and its different Kinds.
and  this detention occafions thefe  pains, Which
are called flatulent,  or windy.
  This fort of cholic rarely appears alone and Sim-
ple ; but is often complicated with, or added, as
it were, to the other forts, of which it is a confe-
quence ; and  is more efpecially joined with the
cholic  from indigeftions, whofe fymptoms it multi-
plies and heightens.  It maybe known, like that, by
the caufes which have preceded it, by its not being
accompanied either with fever, heat, or thirft ; the
belly's being large and full, tho' without hardnef,
being unequal in its largeneSs, which prevails more
in one part of it than in another, forming fome-
thiiig like pockets of wind, fometimes in one part,
fometimes in another ; and by the patient's feeling
fome eafe merely from the rubbing of his belty, as it
moves the wind about;  which elcaping either up-
wards  or downwards affords him ftill a greater re-
lief.
  §  310. When it is combined with any different
fpecies of the  cholic, it reqnires no  diltindl treat-
ment from that fpecies ; and it is removed or difli-
pated  by the medicines which cure  the  principal
difeafe
  Sometimes however it does happen toexift alone,
and  then it depends  on the windings of the Solid
ancl  liquid food of the perfon affected with it, fuch
as the muft or  new wine,  beer, efpecially very new
beer,  certain  fruits and garden-lluff.  It  may be
curpd by a glyfter;  by chaffing the  belly with hot
cloths ; by the ufe of drink moderately fpiced ; and
efpecially by chamomile tea, to which a little cordi-
al confedtion, or even Venice treacle, may be add-
*d.   When the pains are almoft entirely vanished,
and there  is no fever, nor any unhealthful degree
of heat ;  and if the patient is fenfible of a weak-
nefs at Stomach, he may take a little aromatic, or
fpiced wine,  or  even a  fmall cordial  Stomachic
dram.  It Should be obferved, that thefe are not to
he allowed in any other kind of cholic. 
            Of the the ChoUra-tnorbuf.          24c
   §  31 T. When any perfon is frequently fubject to
cholic-like pains, it is a proof that the digeltive
faculty is impaired, the rettoring of which Should
be carefully attended to ;  fince, without this, the
health of the patient muft fuSfer considerably, and
he mult be very likely to  contract many  tedious
and troublefome diforders.
                Of Cholics from Cold.

   \  312. When any perfon has been very cold, and
efpecially in his feet,  it is not uncommon  for him
to be attacked, within a few hours after it,  with
violent cholic pains, in which heating and Spiritu-
ous medicines are very pernicious : but wliich are
eafily cured  by rubbing the legs well with hot
cloths, and keeping them afterwards for a eonfi-
derabie time in warm water; advifing them at the
feme  time  to drink freely of a light  infufion of
chammornile or elder-flowers.
   The cure will be effected the  fooner, if the  pati-
ent is put to bed  and  fweats a little, efpecially in
the legs  and feet.
   A woman who had put her legs into a pretty cool
fpring,  after travelling in the height of fummer,
was very quickly after attacked with a moft violent
 cholic.   She took different hot medicines; She be-
came ftill worfe ; the was purged, but the diftem-
per was ftill further aggravated.   I was called  in
on the third  day, a few hours before her  deceafe.
   In fuch cafes,  if the pain be exceflive, it may be
necetfary to bleed ;  * to give a glyfter of warm wa-
ter ; to keep the legs feveral hours over the Steam
   Vol.  I.                 Z

' • Bleeding fliould not be determined pn too haftiry Jnihis fortof cholic,
lut rather be omitted, or deferred at leaft, till-there  be an evident ten-
dency loan inflammation,  £. L.
  The prop, iety or impropriety of bleeding 'm\ a cholic, from his caufe,
fliould be determined, I think,  from the ftaie of the perfon it happens to:
 fo that'bleeding a ftrong perfon with a firm fibre, and a hard pulfe, may
ke very prudent and precautionary: but if it be a weakly lax f;.bjc& with
a foft and low pulfe, there jnay be iowjj eiitex feu omiuioi, <U  for fuf-
 ptndui&it.  Ji.                                   ' 
242      Of the Cholic and its different Kinds,
of hot water, and afterwards in the water ; to drink
plentifully of an infufion of the flowers of the lime
tree, with a little milk ; and if the diftemper is not
fubdued by thefe means, blilters fliould be  applied
to the legs, which I have known to be highly effi-
cacious.
  §  313. It appears, through the courfe of this
chapter,  that it is neceSfary to be extremely on our
guard, againll permitting  the ufe of heating and
fpirituous medicines in cholics, as they may not on-
ly aggravate, but  even render them mortal.  In
(hurt they Should never be  given, and when  it is
difficult to difcover the real caufe of the  cholic, I
advife country people to confine themfelves to the
three following remedies, which cannot be hurtful
in any fort of cholic, and may remove as many as
are not of a violent  nature.  Firft then, let  g'lyfc
ters be frequently repeated.  2.  Let the patient
drink warm water plentifully, or elder-flower tea.
3. Let the belly be often fomented in pretty warm
water, which is the molt preferable fomentation
of any.
   \ 314. I have laid nothing here of the ufe  of a-
ny oils in this difeafe, as they agree but in very few
fpecies of cholics, and not at all in thofe of which I
have been treating. For this reafon I advife a total
difufe of them, fmce they may be of bad confe-
qu. nee in many refpects.
  fc 31 c. Chronical difeafes not coming within the
plan of this work,  I purpofely forbear treating of
any kind of thofe tedious cholics, which afflict Sbme
people lor many years : but I think  it my duty to
admoniSh fhch,  that their torments being very ge-
nerally occafioned by obftrudtions in the vifcera, or
different bowels of the belly, or by fome other fault,
and more particularly in thofe organs, which are
intended to prepare the bile, they Should, 1. Avoid
with the greateSl care,  the ufe of Sharp,  hot, vio-
lent medicines,  vomits, ftrong purges, elixirs, &c»
3. Tbey fhould  be thoroughly on their guard a- 
           Of the Iliac  Paffion, be.          243
gainfl: all thofe,  who promife them a very fpeedy
cure, by the affiftance  of fome fpecific remedy ;
and  ought to look upon them as mountebanks, in-
to whofe  hands  it is highly dangerous to truSt
themfelves.   3. They Should be perfwaded, or ra-
ther convinced, that they can entertain no reafon-
able  hope of being cured, without an exadt confor-
mity to a proper  and judicious  regimen ; and a
long perfeverence in a courfe of mild and fafe re-
medies.  4.  They fhould  continually reflect with
themfelves, that there is little difficulty in doing
them great mifehief; and that their complaints are
of that fort, which require the greateSl knowledge
and  prudence in thofe perfons, to whom the treat-
ment and cure of them are confided.
               CHAP.  XXII.

   Cf the Iliac Paffion,  and of the Cholera-Morbus.

                 Sect.  316.
     THESE violent difeafes are fatal to many coun-
      try people, while their neighbours are fre-
quently fo ignorant  of the caufe of their  death,
that fuperftition  has afcribed it to  poifon, or to
witchcraft.
   ^  317. The firft of thefe,  the miferere, or iliac
paffion, is one of the mott excruciating distempers.
If any part of the inteflines, the cavity of the guts
is clofed  up,  whatever  may have  occafioned it,
the courfe or defeent of the food they contain  is
neceflarily Hopped ; in  which cafe  it frequently
happens, that the continual motion obferved in the
guts of a living animal diSfedted,  and which was
intended to detrude, or force their contents down-
wards,  is propagated in a diredtly contrary man-
ner, from the guts towards the  mouth.
                      Z 2 
244         Of the Iliac Paffion, and
  This difeafe fometimes begins after a conftipa-
tion, or cottivenefs, of fome days ; at other times
without that collivenefs having been preceded by
pains in any part of the  belly, efpecially around
the navel ; but which pains,  gradually increafing
after their commencement, at length become ex-
treme>y violent, and throw the patient into exce£
five anguifh.  In fome of thefe cafes a hard tumour
may be felt, which Surrounds the belly like a cord.
The flatulences within become very audible, feme
of them are difeharged upwards ; in a little time
after, vomitings come on, which  increafe till the
patient has thrown up all he had taken in, with a
ftill further augmentation of the exceflive pain.
With the firft of his vomitings he only brings up
the laft food he  had taken, with  his  drink  and
fome yellowifh humour :  but what comes up after-
wards proves fliiiking ; and  when  the difeafe  is
greatly heightened, they have what is called the
fmell of excrement or dung ;  but which rather re-
fembles that of a putrid dead  body.  It happens too
fometimes, that if the fick  have  taken glyfters
compofed of materials of a ftrong fmell,  the fame
fmell is difceruable in the matter  they vomit up.
I coxifefs however 1 never faw either real excre-
ments, or the fubSlance of their glyfters,  brought
up, much lefs the fuppofitorics that  were introdu-
ced into the fundament :  and were it credible that
inltances  of this kind had occurred, they mult be
allowed very difficult to account fbr.  Throughout
this whole term of the difeafe, the patient has not
a tingle difcharge by ftool; the belly is greatly aif-
tended ; the urine not feldom fuppretled, and at
other times thick and foetid.  The pulfe,  whicli at
firft was pretty hard, becomes quick and fmall ; the
flrength entirely vanifhes: a raving conies  on ; a
hiccup almoft  conftantly fupervenes, and fome-
times general  convulfions ;  the  extremities grow
cold, the pulfe is fcarcely perceivable; the paia 
              Of the Iliac Pajftoh,             24$
 and the vomiting ceafe> and the patient dies very
 quickly after.
    §3ic?. As this difeafe  is highly dangerous, the?
 moment it is ftrongly appvehended,. it is neceffary
 to oppofe it by proper means and remedies : the
 fmallefl error may be of fatal confequence, and hot
 inflaming liquids have been known to kill tlie pa-
 tient iu a few hours. I was called in the Second
 day of the difeafe to a young perfon,  who had ta-
 ken a good deal of Venice treacle r nothing could
 afford  her  any relief, and She  died early on  tlie
 third day.
   This difeafe Should be treated preeifely in the
 fame manner as an inflammatory cholic % the prin-
 cipal  difference being, that in the former there
 are no flools, but continual vomitings.
   I. Firft of all then the patient Should be plenti-
 fully bled, if the phyficiau has been called  in early
 enough, and before the fick has loft his Strength.
   2. He Should receive opening glyfters made of a
 decoction of barley water, with five or fix ounces
 of oil in each.
   3. We fhould endeavonr to allay the violent ef>
 forts to vomit, by giving  every two hours a Spoon-
 ful of the mixture  Nc- 48.
   4. The  fick fliould drink plentifully, in very
 fmall  quantities, very often repeated, of an ap-
 pealing,  diluting,  refrefliing drink, which tends at
 the fame time to promote both Hoote and urine.
 Nothing is preferable to the whey N0* 40. if it can
 be had  immediately : if not, give fimple clear whey
 fweetened with honey, and the drinks prefcribed
 §  20.8. Art.  3.
   5. The patient is  to be put into a  warm  bath,
 and kept there as long as  he can bear it> repeating
 it as often daily too, as his flrength will permits
   6. After bleeding, warm bathing, repeated glyA
 ters and fomentationsy if each and all of thefe have
 availed nothing; the fume or fmoak of tobacco
'jnay be introduced in the manner of a glyfter, of 
 ttfi         Cf the Iliac Paffion, and
 which I Shall fpeak further, in the chapter on per*
 fons drowned.
   I cured a  perfon of this  difeafe,  by conveying
 liim into a bath, immediately after  bleeding him,
 and giving him a purge on his going into the bath*
   § 319. If the pain abates before the patient has
 quite loft his flrength ; if the pulfe improves at
 the Same time ;  if the vomitings are lets in num-
 ber, and in the quantity of the matter brought up;
 if that matter feems in a lets putrid ofleniive ftate ;
 if he feels fome commotion and  rumbling in his
 bowels; if he has fome  little  difcharge by ftool;
 and if at the fame time he feels  himfelf a little
 ftronger than before,  his cure may reafonably  be
 expected;  but if he  is otherways circumftanced
 he  will foon depart.  It frequently  happens, a
 fingle hour before death,  that  the pain feems to
 vanifh,  and a furprifing  quantity  of extremely
 foetid matter is difeharged  by ftool:  the patient
 is Suddenly Seized with a great weaknefs  and link-
 ing, falls into a cold fweat,  and immediately  ex-
 pires.
  \ 320. This is the difeafe which  the common
 people  attribute to, and  term, the twifling  of the
guts ; and in which they make the patient fwallow
 bullets, or large quantities of quick-Silver.  This
 twiSling, tangling, or knotting of the guts is an
 litter, an impoSfible chimera; for how  can they
 admit of fuch a circumllance, as one of their ex-
 tremities, their ends,  is connedted to the ftomach,
 and the other irremoveably fallen ed to the fkin  of
 the fork or cleft of the buttocks I In fact this dif-
eafe refults  from a variety of caufes, which have
 been difeovered on a dilfection of thofe who have
 died of it.   It were to be wished indeed  this pru-
 dent cutlom, fo  extremely  conducive to enrich,
 and to perfect,  the art of phytic, were to prevail
 more generally;  and  which we ought  rather  to
 confider as a duty to comply with, than a difficul-
 ty to fubmit to 3  as it is our  duty to contribute td- 
               Of the Cholera-morbus*          247
 the perfection of a Science,  on which the happi
 nets of mankind fo considerably depends.  I fhall
 not enter into a detail of thefe caufes ; but what-
 ever they are, the practice of fwallowing bullets
 in the difeale is  always pernicious,  and the like
 ufe of mercury mull be  often fe.  Each of thefe
 pretended remedies may aggravate the difeafe,
 and contribute an infurmountable obftacle to the
 cure    Of that iliac paffion, which  is fometimes
 a confequence of  ruptures, I fhall treat in another
 place.

              Of  the Cholera-morbus*
   $ "21.  Thisdifeafe is  a fudden, abundant, and
 painful evacuation by vomiting and by ftool.
   It begins with  much  flatulence, or wind, with
 fwelling and flight pains in the belly,  accompanied
 with great dejection ; and followed with large e-
 vacuations either  by ftool or by vomit at firft, but
 whenever either  of them has begun the other
 quickly follows.   The matter evacuated  is either
 yellowifh, green,  brown, whitifh, or black; the
 pains in the belly  violent; the pulfe, almoft con-
 stantly feverifh, is fometimes ftrong at firft, but
 foon finks into weaknefs, in  contequence of the
 prodigious difeharge. Some patients purge a hun-
 dred times in the  compafs of a few  hours:  they
 may even be feen to fall  away ; and if the difeafe
 exifts in a violent  degree, they are fcarcely to he
 known within three or four houis from the com-
 mencement of  thefe difeharges.   After a great
 number of them they are afflicted with fpafms, or
 cramps, in their  legs, thighs, and arms, which
 torment them as much as the pains in  the belly,
 when the  difeafe rages too highly  to be affuaged,
 hiccups, convulfions, and  a  coldnefs of  the ex-
 tremities approach ; there is a fcarcely intermit-
 ting fucceffion of  fainting, or fwooning tils, the
patient dying either iu one of them, or  in con*
vuluons* 
 94&          Cf the ChoUra-morbut.
   \  32a.  This difeafe which conllantly  depend*
 on a bile raifed to the highelt acrimony, common-
 ly prevails towards the end of July and in Auguft:
 efpecially if the heats have been very violent, and
 there have been little or no fummer  fruits, which
 greatly conduce to attemper and allay the putref-
 cent acrimony of the bile.
   §  323.  Neverthelefs,  however  violent  this difc
 temper may be, it is lefs dangerous,  and  alfo lefs
tormenting than the  former, many  perfons  reco-
 vering from it.
   1. Our firft endeavour fliould be to dilute,  or e-
 ven  to drown this acrid bile, by draughts, by de-
 luges, of the moft  mitigating drinks ; the irrita-
 tion being fo very great, that every thing having
 the leafl Sharpnefs is injurious. Wherefore the pa-
 tient Should continually take in, by drink, and by
 Way of glyfter, either barley-water, almond-milk,
 or pure water, with one eighth part milk, which
 has  fucceeded very well in  my practice. Or he
 may ufe a  very  light decoction, or ptifan,  as it
 were, of bread,  which is made  by gently boiling
 a pound of toatled bread in three or four pots of
 Water for half an hour.   In Swifferland we prefer
 oat-bread.  We alfe fuccefsfully ufe  pounded rye,
 making a light ptifan of it.
   A very light thin  foup made of a pullet, a duck -
 en,  or  of one pound of lean veal,  in three pots.
 of water, is very proper too in this difeafe. Whey
 is alfo employed to good  purpofe ;  and  in  thofe
 places, where it can eafily be had, butter-milk is
 the  beft  drink  of  any.   But, whichever of thefe
 drinks Shall be thought preferable, it is a neceffa-
 ry point to drink very plentifully of it;, aud the
, glyfters fhould be given every two hours.
   2. If the patient is of a robutt constitution, and
 fanguine complexion, with a ftrong pulfe at  the
 time of the attack, and the pains are very fevere,
 a firft,  and in fome cafes a fecoud bleeding, very
 early in the invafion, afluagei the violence of  the 
                  Of the Cholera-morbus.          249
    malady and, and allows  more leifure for the af-
    fiftance of other remedies.  I have feen the vomit-
    ing ceafe almoft entirely, after the firft  bleeding.
      The rage  of this difeafe abates a little after a
    duration of five or fix hours : we muft not, how-
    ever, during this remitfion,  or abatement, forbear
    to throw in proper remedies ; fince it returns foon
    after with great force,  which  return however in-
    dicates no alteration of the method already enter-
    ed upon.
      3.. In general,  the warm bath refrethes the pa-
    tient while he continues in  it; but the pains fre-
    quently return foon after he is taken out, which,
    however is no reafon for omitting it, fince it has
    frequently been found to give a more durable re-
    lief.  The patient Should continue in it a conside-
    rable time ; and,  during that time, he Should lake
    fix or feven giaSfes of the potion N°* 32. whichnas
    been  very efficacious in this difeafe. By thefe means
    the vomiting has been flopt; and the patient, up-
    on  going out of the bath, has had feveral large-
    ftools, which very considerably diminished the vio-
    lence of the difeafe.
     4. If the patient's attendants are terrified by thefe
    great evacuations, and  determine to check them
    (however prematurely) by Venice treacle, mint
•   water, fyrup of white  poppies, called diacodium,
    by opium or mithridate, it either happens, that
    the difeafe and all  its  fymptoms are heightened,
   .to which I have been a witnefs; or, if the evacu-
    ations fhould actually be flopt, the patient, in con-
   fequence of it, is thrown into a more dangerous
   condition. I have been obliged to give a purge,
   in order to renew the difeharges, to a man,  who
   had been thrown into a  violent fever attended with
   a raging delirium, by a  medicine compofed of Ve-
   nice treacle,  mithridate and oil.  Such medicines
   ought not to be employed, untill  the fmallneft of
   the pulfe, gieat  weaknefs,  violent  and almoft
   continual  cramps, and  even the infufficitnee of 
9 CO           Of the Cholera-morbus.
the patient's efforts to vomit, make us apprehen-
sive of his finking irrecoverably.  In fuch circum-
ftauces  indeed he lhonld take every quarter  or
half  quarter  of an hour,  a  fpoonful of the
mixture N°*  50. Still continuing the  diluting
drinks.   After the firft hour, they fhould only  be
given every hour, and that only to the extent  of
eight dofes.  But I defire  to infill upon it here,
that this medicine fhould not be given too early in
this diftemper.
   § 3 ,.4. If the patient is likely to  recover, the
pains and  the evacuations gradually abate ; the
tfiirft is lefs ;  tlie pulfe continues very quick, but
it  becomes  regular.   There have been inltances of
-their propensity to a heavy kind of drowfinefs at
■this time ;  tor pertedt refrefliing Sleep advances but
flowly after this difeafe.   It will ftill be proper to
pdnevere in the medicines already directed, tho*
fbmewhat  lefs frequently.   And now we may be-
gin to  allow the patient a few foups from farina-
ceous mealy fubftances; and as foon as the eva-
luations accompanying this difeafe are evidently
ceafed, and the pains are vanished ;  tho' an acute
-fennbility  and great Weaknefs continues,  befide
fuch foups, he may be allowed fome new-laid eggs,
very lightly boiled,  or even raw,  for fome days.
.After this he muft be referred to the regimen fb   •
irequently recommended to perfbns in a ftate of
recovery :  when the concurring ufe of the pow-
der Nc* 24. taken twice a day, will greatly afhlt
 to batten and to eitablnb hi* health; 
Of a Diarrhea, or Loofenefs.       151
              CHAP.   XXIII.
          Of a Diarrhaa, or Loofenefs.

                Sect.  32c,
    EVERY one knows what is meant by a loofe-
    nefs or purging, which the populace frequent-
ly call a flux, and fometimes a cholic
  There are certain very chronical, or tedious and
obftinate ones, which arife .from fome effential
fault in the constitution.   Of fuch, as foreign to
my plan, 1 fhall fay nothing.
  Thofe which come on fuddenly without any pre-
ceding diforder, except fometimes a flight qualm or
Short loathing,  and a pain in the loins and knees ;
which are not attended with fmart pains nor a fe-
ver, (and frequently without  any pain, or any o-
ther complaint) are oftener of Service than preju-
dicial.  They cai ry off a  heap of matter that may
have  been long amaffed and corrupted in the bo-
dy ; which,  if not difeharged, might have produ-
ced fome diftemper ;  and, far from weakening the
body, fuch purgings as thefe render it more ftrong,
light and active.
   § 32/>. Such therefore ought by no means to be
(lopped, nor even fpeedily checked : they general-
ly ceafe of themfelves, as foon as all the noxious
matter is discharged ; and  as they require no me-
dicine, it is only neceffary to retrench considera-
bly from the ordinary quantity of nourishment ;
to  abstain from  fleSh, eggs,  aud wine,  or other
ftrong drink ; to live only on fome foups, on pulfe,
or 011 a little fruit, whether raw or baked, and to
drink rather lefs than ufual.  A Simple ptifan with
a little fyrup of capillaire, or maiden-hair,  is fuf-
ficient in thefe purgings, which require no Venice
treacle, confection, nor any drug whatever.
   \ 327.  But Should it continue more than five or
fix days,  and iuaniieitly  weaken  the  patient,  if 
$C2        Of a Diarrhea, or Loofenefs.
the pain attending it grows a little fevere;  and e-
fpecially if the irritation,  the urging to ftool,
proves more frequent,  it becomes leafbnable  to
check, or to Slop, it.   For this purpofe the patient
is to be put into a regimen ; and if the loofenefs
has been accompanied with a great loathing, with
rifings or wamblings at Stomach,  with a foul fur-
red tongue, and a bad tafle in the mouth, he mutt
take the powder N • 35.   But if thefe Symptoms
do not appear,  give him that of Nc* 51.  and du-
ring the three following hours, let him take, eve-
ry half hour, a cup of weak light broth, without
any fat on it.
  If the purging, after being restrained  by this
medicine,  fliould return within  a few  days, it
would ftrongly infer, there was Still Sbme tough
vifeid  matter  within,  that reqaired evacuation.
To effect this he Should take the medicines Nc • 24.
25. or 27.  and afterwards take falling,  for two
fucceffive mornings,  half the powder Nc*  51.
  On the evening of that day when the patient
took N * 35. or N°*  §i. or  any other purge,  he
may take a fmall dofe of Venice treacle.
  5 328. A purging is often neglected for a long
time,  without obferving the leaft regimen, from
which neglect they degenerate into tedious, and
as it were, habitual, perpetual ones,  and entirely
weaken the patient.   In fuch cafes, the medicine
N°' 35. Should  be given firft ;  then, every other
day,  for  four  times fucceffively, he fliould take
N°* 51. during all which time he  fliould live on
nothing but panada, (fee $  5 7.) or 011 rice  boiled
in weak chicken-broth.   A Strengthening Stoma-
chic plaifter has fometimes been fuccefsfully ap-
plied, wliich may be often moistened in a decocti-
on of herbs boiled in wine.   Cold  and moilture
fhould be carefully avoided in thefe cafes,  which
frequently occafion immediate relapfes, eyen after
the loofenefs had ccafed for many days. 
Of the Dyfentery, or Bloody-flux.      2y$
               CHAP.  XXIV.
         Of the Dyfentery, or Bloody-flux.

                Sect.   329.
     TH E dyfentery is a flux or loofenefs of the
      belly, attended with great refllefsnefs and
anguifh, with fevere gripings, and frequent pro-
penfities to go to ftool.   There is generally a lit-
tle blood in the flools,  though this is not a con-
stant fymptom, and is  not effential to the exift-
ence of a dyfentery ; notwithltanding it may not
be  much lefs  dangerous, fbr the ablence of this
fymptom.
   \ 330. The dyfentery is  often epidemical; be-
ginning fometimes at the end of July, though oft-
ner in Augufl, and going off when the frolls fet
in.   The  great preceding heats render the blood
and the  bile acrid or Sharp ;  and though, during
the continuance of the  heat, perfpiration is kept
up, (fee Introdudt. p. 21.) yet as foon as the heat
abates, efpecially in the mornings and eveniii«-s
that discharge is  diininiflied ; and by  how much
the more vifcidity or tbicknefs the humours have
acquired,  in confequence of the violent heats, the
difcharge of the lharp humour by perfpiration be-
ing now checked, it is thrown upon the bowels
which it iiritates, producing pains in, and evacu-
ations from them.
  This kind of dyfentery may happen at all times
and in all  countries.; but if other caufes, capable
of producing  a putridity of the humours,  be com-
plicated  with  it ; Such as the crowding-  np a great
number of people into  veiy little room, and very
clofe quarters, as in hofpitals, camps,  or priSbns
this introduces a malignant principle into the hu-
mours, which, co-operating with the fimpler caufe
of the dyfentery, renders it the more difficult and
dangerous.
  Vol. I.             A a 
254      fy rf'e Dyfentery, or Bloody-flux.
  § ,331- This difeafe begins with a general cold-
nefs rather than a  Shivering,  which lalls fome
hours ;  the patient's flrength foon abates,  and he
feels Sharp pains in his belly, which fometimes con-
tinue for feveral hours before the flux begins.  He
is affected with vertigos, or Swimmings in the head,
with Teachings to vomit, and grows pale ; his pulfe
at the fame being very little ; if at all,  feverilh,
but commonly Sinall, and at length the purging
begins.   The firlt Stools are often thin,  and yel-
lowish ;  but in a  little time they are mixt with a
vifeid ropy matter,  which  is often  tinged with
blood.  Their colour and confiftence are various
too, being either brown, greenifh or black, thinner
or thicker, and foetid. The pains increafe before
each of the difeharges, which grow very frequent,
to the number of eight, ten, twelve,  or fifteen in
an hour :   then the  fundament becomes cofidera-
bly  irritated, and the  tenefmus (which is a great
urgency to go to ftool,  though  without any ef-
fect)  is  joined to the dyfentery or flux, and often
brings on a protrufion  or falling down of the fun-
dament, the patient being  now moft feverely af-
flicted.  Worms are  fometimes voided, and glairy
hairy humours, refembling  pieces or peelings of
guts, and fometimes clots of blood.
  If the diftemper rifes  to  a violent  height, the
guts become inflamed, which terminates either in
fuppuration or in mortification -, the miferable pa-
tient difeharges pus, or black and  foetid  watery
itools :  the hiccup fupervenes ; he grows delirious;
his pulfe finks ;  and he falls into cold fweats and
faintings,  which terminate  in death.
*i». A kind of phrenzy, or raging delirium, fometimes
comes on before the  minute  of expiration.   I have
feen a very unufual fymptom accompany this dif-
eafe in two perfons, which  was an impoflibility of
fwallowing,  for three days  before death.
   But iu general this difiemper is not fo extreme-
ly violent; the difeharges are lefs frequent, being 
         Of the Dyfentery, or BlooJj-flux.       255
from twenty-five to forty within atday and night.
Their  contents are lets  various and uncommon,
and mixed with very little blood ;  the patient re-
tains more flrength ; the number of itools gradual-
ly decreafes ; the  blood difappears ; the confiftence
of the difeharges  improves ;  lleep and appetite re-
turn,  and the fick recover.
  Many  of the fick have not the leaft degree of
fever, nor of thirit, which perhaps is lefs common
in this difeafe, than in a fimple purging or loofe-
nefs.
  Their  urine fometimes is  but in a finall quanti-
ty : and many patients have ineffectual endeavours
to pat's it, to their no fmall afflidtion and reltlefs-
liefs.
   § 332.  The moft efficacious remedy for this dif-
eafe is a vomit.   That of N°* 34, (when there is
no prefent circumltance that forbids the giving a
vomit)  if taken immediately on the firft invafion,
of it, often removes it at once; and always fhort-
ens its duration.  That of N°* 35.  is not lets ef-
fectual ;  it has been confidered for a long time,
even as a certain fpecific,  which it  is not,  tho' a
very ufeful medicine.  If the llools  prove lefs fre-
quent after the operation of either of them,  it is
a good Sign ;  if  they are no ways diminished, we
may apprehend the difeafe is like to be tedious and
obftinate.
  The patient is to be ordered to a regimen, ab-
staining  from  all flefli-meat with the ttridtett at-
tention,  until the perfect cure of the difeafe.  The
ptifan  N°* 3. is the befl drink for him.
  The day after the vomit,  he mull  take the pow-
der Nc#  51. divided into two dofes :  the next day
he fliould take 110 other medicine but his ptifan ;
on the fourth the rhubarb mull be repeated, after
which  the violence of the difeafe commonly abates.
His diet during  the difeafe is neverthelefs to be
continued exactly for  fbme days ; after which he
                     A  a 2 
  3$<J      Of the Dyfentery or Bloody-flux.
  may be allowed to enter upon that of perfbns in a
  ftate of recovery.
    5 333-  The  dyfentery fometimes  commences
  with an inflammatory fever;  a feverifh,  hard, full
  pulfe,  with a violent pain in  the head, and loins,
  and a Stiff distended belly. In fuch a caSe the pa-
  tient muft be bled once ;  and daily receive three
  or even four of the glyfters Nc* 6. drinking plen-
  tifully of the drink N°* 3.
   When all dread of inflammation is entirely over,
 the patient is to be treated in the manner juft re-
 lated ;  though often there is  no neceflity for  the
 vomit:  and if the inflammatory  fymptoms have
 run high, his firfl purge  fhould be that of Nc* 11.
 and the ufe of the rhubarb may be poflponed, till
 about the manifest conclusion of the dileafe.
   I have cured many dyfenteries,  by ordering the
 fick no other remedy,  but a cup of warm water e-
 very quarter of an hour ;  and it were better to re-
 ly only on this fimple remedy, which muft be  of
 fome utility, than to employ  thofe, of whofe  ef-
 fects country people are ignorant, and which are
 often produdtive of very dangerous ones.
   §  334.  It fometimes happens that the dyfente-
 ry is combined with a  putrid  fever, which  makes
 it neceffary, after the vomit, to give the purges Nc*
 23. or 47.  and feveral  dofes of N  • 24. before the
 rhubarb i<= given.  Nc« 52 is excellent in  this com-
 bined cafe.
  There was in Swifferland, in  the autumn of 1 75 c.
 after a  very numerous prevalence of epidemical
 putrid fevers had ceafed,  a multitude of dyfente-
 ries, which had no fmall affinity with, or relation
 to, fuch fevers.   I treated them firft with  tho pre-
 fcriptiou N • 34. giving afterwards Nc-  32. and I
 directed  the rhubai b only to  very few,  and that
 towards the conclufion of  the difeafe.  By  much
the greater number of them were cured at the end
 of four 01 five days.  A fmall  proportion of them,
 to whom I couid not give the vomit, or whole caf- 
          Of the Dyfentery or Bloody-flux.       2 £7
 es were more  complicated, remained languid a
 eonfiderabie time, though without fatality or dan-
 ger.
    §  335".  When  the dyfentery is blended  with
 fymptoms of malignity (fee § 245.)  after pnemif-
 ing the prefcription N0*- 35. thofe of Nc* 38* and
 39. may be called in fucceSsfulIy.
    §  346. When the difeafe has already been of
 many days ftanding, without  the patient's having
 taken any medicines, or only  fuch as were injuri-
 ous to him,  he mull be treated as if the diftemper
 had  but jull commenced ;  unlefs feme fymptoms,
 foreign to the nature  of the  dyfentery, have  fu-
 pervened upon it.
    §  337. Relaples fometimes occur in dyfenteries,
 fome few days after the patients appeared well ;
 much the greater number of which are occafioned
 either by fome error in diet, by  cold air, or by-
 being  confiderably  over-heated.  They are to be
 prevented by avoiding thefe caufes of them ;  and
 may be removed by putting the patient on his re-
 gimen, and giving him one dofe of the preferip-
 tion N,# ci.  Should it return even  without any
 fuch difeoverable caufes, and if it maiiifetts itfelf
 to be the fame diftemper renewed, it mult be treat-
 ed as fuch.
    §  338. Ti'iis difeafe  is fometimes combined too
 with an intermitting fever; in which cafe the dy-
 fentery  mult be removed firft, and  the intermit-
 tent  afterwards,  Neverthelefs, if at  each  accefs
^he fits  of the fever have  been very ftrong, bark
 mutt be given as directed,  § 259.*'
    §  339. One  pernicious  prejudice, which  ftill
 generally prevails is, that  fruits are noxious in a
 dyfentery,  that they even  give k, and aggravate
 it ; and this perhaps is an extremely ill-grounded
 one.   In truth bad fruits, and fuch as have not ri-
 pened well, in imfeafonable years may really  oc-
 cafion cholics, a loofenefs ( though  of tner  a cof-
 tivenefs) anil diforders of the  nerves, and of  the
                       A a  3 
2 j8      Of the Dyfentery or Bloody-flux.
fkin ;  but never  can occafion an epidemical  dy-
fentery or  flux.  Ripe fruits, of whatever fpeci-
es, and efpecially fummer fruits, are the real. pre-
fervatives from this difeafe.  The greateft miSchiet
they can effect, muft  refult from  their thinning
and washing down the humours, efpecially the thick
glutinous bile,  if they are in fuch  a Slate ; good
ripe fruits being the true diilblvents of fuch ;  in
confequence of which indeed they  may bring on a
purging, but fuch a one, as is  rather a guard a-
gainft a dyfentery.
  We had a great, an  extraordinary abundance
of fruit in  17:9 and 1760. but fcarcely any dyfen-
teries.  It has even been obferved to be more rare,
and lefs dangerous than formerly ;  and if the fact
is certain,  it cannot be attribu:ed to any thing
more propably, than to the  very numerous  plant-
ations of trees, which  have rendered fruit very
plenty, cheap  and common.  Whenever   I have
obferved dyfenteries to prevail, I made it a rule to
eat lefs flefh,  and plenty of fruit > 1 have never
had theflighteft attack of one? and feveral phyfi-
cians ufe the fame caution with the fame fuccefs.
  I have feen eleven  patieuts in  a dyfentery in
one  houfe, of whom nine  were  very tractable;
they  eat fruit  and recovered.  Tlie grandmother
and one child, whom fhe loved more than the reft
were carried off.  She managed the child after her
own fafhion, with burnt wine,, oil, and feme fpie-
es  but no fruit.  She conducted fierielf in the ve-
ry fame manner, and both died.
   In a country feat near Berne, in the year 1 v; t»
when thefe fluxes made great havock, and people
were leverely  warned  againll  ihe ufe of fruits,
out of eleven perfons in the family, ten  cat plen-
tifully of plumbs, and not one of them was feized
with it : the poor coachman alone rigidly  obferv-
ed that abftinence from fruit injbkied by this pre-
judice, and took a terrible  dyfentery.
   This fame  diitteiuper  had  nearly destroyed a 
           Of the Dyfentery, or Bloody-flux.      25 f
 Swifs regiment in garrifon in the fouth of France ;
 the captains purchafed the  whole crop  of feveral
 acres of vineyard : there they  carried the fick fol-
 diers, and gathered the  grapes  for fuch as could
 not bear being carried into the vineyard ; thofe
 who were well eating nothing elfe : after this not
 one more died, nor were any more even attacked
 with the dyfeptery.
    A clergyman was feized with a dyfentery, which
 was not in  the leaft mitigated by  any  medicines
 he had taken.   By mere chance he faw fome red
 currans; he longed   for them, and   eat three
 pounds of them between   feven  and nine o'clock
 in the morning; that very day he became  better,
 and was entirely well on the next.
    I could greatly  enlarge  the number  of fuch in-
 ltances ;  but thefe may  Suffice to convince the moil
 incredulous,  whom I thought it might be of Some
 importance  to  convince.   Far from forbidding-
 good fruit,  when  dyfenteries rage, the patients
 fhould be encouraged to eat them freely  ; and the
 directors of the police, inltead of prohibiting them,
 ought to fee ihe markets well provided witli them.
 It"is a fact of which  perfons who have carefully
 informed themfelves, do not in the  leaft  doubt.
 Experience demonstrates  it, and it  is  founded in
 reafon,  as good fruit counter-operates all the cauf-
 es  of dyfenteries *.
  * The experience of all countries and times To ftrongly confirms thefe
 important tiuihc, thai they cannot be too often repeated, too generally
 pubiifhed, whenever and wherever this difeafe rages. Tlie fjccelfion of
 cod fliowers to violent heats; to) moiil  a comUtution of the air ; an
 excefs of animal  food; uncleanlinefs and contagion, are  the frequent
 caufes of epidemical fluxes. E. L.
  1 have retained the preceding note, abridged  from this gentleman, as
 it contains the fuffrage of another experienced phyfician, againft  that
 prejudice of ripe fruits occafioning flaxes, whLh is to> popular umong
 ourfelves, and probably more fo in the country  than in Ltndon.  1 ha*e
 been alfo very credibly afl'ured, that  the fon of a learned phyfician was
 perfeftly cured of a very obftinate purging, of a yeai's continuance fin
 fpite of all the ufual officinal remedies;  by  his devouring large quan-
 tities of ripe mulberries, for which he ardent!y longed, and drinking very
 freely of their exprefod juice. Trie fa& octunedafter his father** de-
ceafe.  and  was amxmed to incbya gentleman intimately acquainted w'uk
 them both.  K. 
j6o       Of the Dyfentery,  or Bloody-flux.
   §  340. It is important, and even neceflary, that
each fubject of this difeafe Should have a clofe-ttool
or convenience apart  to himfelf ; as  the matter
difeharged is  extremely infectious:  and  if they
make ufe of bed-pans, they Should  be carried im.
mediately out of the  chamber, the  air  of which
fliould  be continually renewed, burning vinegar
frequently in it.
   It is alfo very neceflary to  change the patient's
linen frequently ;  without all which  precautions
the diftemper becomes more violent,  and  attacks
others who live in  the fame houfe.   Hence it is
greatly to be wifhed the people in general were
convinced of thefe truths.
   It was Boerh a ave's opinion, th-»t all  thewate*
whicli was drank, while dyfenteries were epide-
mical,  fliould  be fummed, as we term it, or Sul-
phurized *.
   §  341. It has happened,  by fome  unaccountable
fatality, that there is 110 difeafe, for which a great-
er number of remedies are  advifed, than fbr the
dyfentery.   There is feareely  any  perfen  who
boafts not of his own prefcription, in preference to
all the reft, and who does not boldly engage to
cure,  and that within a few hours,  a tedious fe-
vere difeafe (of which he has formed no juft. no-
tion) with foiue medicine or compofition, of whofe
operation he is totally ignorant :  while the  poop
fufferer, rettlefs and  impatient, fwallovvs every
body's recommendation, and gets poilbned either
through fear,  downright difguil or wearinefs, or
through entire complaifance..   Of  thefe many

  + Our learned author, or his medical editor ax Lyons, obferves here*
that  in the edition of this treatife at Paris, there was an eitemial mtf-
take,  by making Boerhaaive recommend the add,tion of brnl:, Eait de-
vie, inftead of Itummng or- fulphui a.ng it, for which this not;, and the
text,  to ufe the veib bra iter, which word we do ljot find in any dictiona-
ry.  We are told, however, it mean-.,, to impregnate thrcafkj in which
the water is referved, with the vapour of falphur, and  then Hopping
ttiem ; in the fame mannei that vef'eis are managed in fome countries,
for the keeping of wine.  H^  obferves the purpofe of this is to  oppofe-
Sprru^tion by the acid (learns of the fulphur.. K... 
          Of the Dyfentery, or Bloody-flux.     '  a6j
 boafred  compositions,  feme are only indifferent,
 but others pernicious.  I fhall not pretend to detail
 all I know myfelf, but after repeatedly affirming,
 that the only true method of cure  is that  I have
 advifed here, the purpofe of which is evacuating
 the offending matter ; 1 alfo affiim  that  all thofe
 methods, which  have a different fcope or drift,
 are pernicious ; but fhall particularly obferve, that
 the method molt generally followed, which is that
 of Slopping the  Stools by allringents,  or by opi-
 ates, is the worll  of all, and even fo mortal a one,
 as to deftroy a multitude of people  annually, and
 "Which throws others into incurable difeafes.   By
 preventing the difcharge of thefe ftools,  and  in-
 clofing the wolf in  the fold, it either follows,  I.
 that this * retained matter irritates and inflames
 the bowels,  from which inflammation excruciat-
 ing pains arife, an acute inflammatory cholic, and
 finally a mortification and death j or a fchirrhus,
 which degenerates into a cancer,  of which I have
 a dreadful inflance)  or elfe an abfcefs, fuppurati-
 on and ulcer.  Or, a. this arretted humour is  re-
 pelled elfewhere,  producing a fchirrhus in the liver,
 or althmas,  apoplexy, epilepSy,  or falling fick-
 nefs ; horrible rheumatic pains,  or incurable dif-
 orders of the eyes, or  of the teguments, the fkin
 and furface,
   Such are the confequences of all the aftringent
 medicines, and  of thofe which  are  given  to pro-
 cure fleep  in this difeafe,  as Venice treacle, mi-
 thridate  and diafeordium, when given too early in
 dyfenteries.
   I have been eonfulted on account of a -terrible
 rheumatifm,  which enfued  immediately  after  ta-
 king a  mixture of Venice treacle and plantain, on
 the fecond day of a dyfentery.

  • A firft or fecond dofe of glauber fait has been known to fucceed in
the epedimical fummer fluxes of the hotter clima>es, when repeated dofes
of rhubarb and oputes had failed.  Such inftances feem a collateral con-
firmation of Dr. TISSO'l  '$ rational and fucccfaful ufe oi cooling open-
ing fruits in them.  K. 
262 "              Of the Itch.
.  As thofe who^advife fuch medicines, are certain-
ly unaware of their confequences, I hope  tins ac-
count of thein will he  fufficient to'pievent their
repetition.
  § 342. Neither are purges without  their  abufe
and danger ;  they determine the courfe of all the
humours more  violently  to  the tender afflicted
parts;  the  body becomes  exhausted ;  the digesti-
ons fail ; the  bowels are weakened, and fometimes
even lightly ulcerated, whence incurable diarrheas
or purgings  enfue, and prove  fatal  after  many
years affliction.
  § 343. If the evacuations prove exceflive,  and
the diftemper tedious,  the patient is likely to fall
into  a dropfy ;  but if this is immediately oppofed,
it may be removed by regular and drying diet, by
ftrengthners, by friction and proper exeicife.
               CHAP.  XXV.
                  Of the Itch.
                 Sect.  344.

     TH E itch is an infectious diforder, contracted
      by touching infected perfons or cloaths, but
not imbibed from the air: fo that by carefully a-
voing the medium, or means of contagion, the dif-
order may be certainly efcaped,
  Though any part  of the body may be infefted
with the  itch,  it commonly thews  itfelf on the
hands,  and  chiefly between tiie fingers.  At firfl
one or two little pimples or pultules appear, filled
with a kind of clear water, and excite a very difa-
gi eeable itching.  If thefe puftules are broke by
fcratching them, the water oozing from them in-
fects the neighbouring parts.  At the beginning of
this infection it can fcarcely be  distinguished, if 
                Of the Itch.                 263
a perfon is not well apprized of its nature ; but
m the progrefs of it, the little puftules increafe
both in number and Size ; and when they are open-
ed by feratching, a loathfome kind of feab is form-
ed, and the malady extends over the whole furface.
Where they continue long, they produce fmall ul-
cers, and are at that time highly contagious.
  \ 345. Bad diet,  particularly  the ufe of falted
meat, bad unripe fruit, and  uncleanlinefs occafi-
on this difeafe ; tho' it is oftneft taken by conta-
gion.  Some very good phyficians fuppofe it is ne-
ver contraded otherwife ; but 1 mult take leave to
diflent, as  I have  certainly feen it exifl without
contagion.
   When it happens to a perfon, who cannot  fnf-
pedt he has received it by contact, his cure fhould
commence with a  total abftinence from all Salt,
four, fat, and Spicy food.  He fliould drink  a pti-
fan of wild and bitter fuccory,  or that of N • 26.
five or fix glaffes of which may be daily taken ; at
the end of four or five days, he may be purged with
N°* 21. or with an ounce of'fedlitz \ov epfom~\ fait.
His abftinence, his regimen  to be continued ; the
purge to be repeated after fix or feven days ; and
then all the  parts affected,  and thofe very near
them, are to  be rubbed in  the morning falling,
with a fourth part of the ointment N"- 52.  The
three following days the fame friction is to be re-
peated, after which the fame quantity of ointment
is to be procured, and ufed in the fame proportion ;
but only every other day,  It happens but feldom
that  tliis method fails  to remove this difagreeable
malady ; femetimes however it will return, in
which cafe the patient mutt be purged again,  and
then recur to the  ointment, whofe good effects I
have experienced, and continually do.
   If the difeafe has been  very lately contracted,
and moft certainly by  contact, the  ointment may
be fearlefsly employed, as foon as it is difcovered,
without taking any purge  before it.  But if, oa 
 264                  Of the  Itch.

 tlie contrary,  the difeiSe has been long  neglected,
 and has role to a high degree, it will be neceilary
 to reflrain the patient a long tune to the regimen
 I have directed ;  he mull be repeatedly purged, and
 then drink plentifully of the ptifan N • 2*>. before
 the ointment is rubbed  in.   When the  malady is
 thus circuinltanced, 1 have always begun with the
 ointment N  •  28. half a quarter of whicli is to be
 ufed every morning.   I  hat e alfo frequently omit-
 ted the ufe of that N°. 52. having always found the
 former as certain, but a little flower in its effects.
   § 346. While thele medicines are employed, the
 patient mull avoid  all cold  and  wet,  efpecially if
 he makes ufe of NL* 2?.  *  in which there is quick-
 silver ;  which,  if fuch precautions were neglected,
 might  bring on a fwelling of the throat and gums
 and even rife  to  a falivation.   Yet this ointment
 has one advantage in its having no Smell, and be-
 ing fufeeptible of an agreeable one ;  while it is ve-
 ry  difficult to dilguife the disagreeable odour of
 the other.
   The linen of a perfon in this difeafe ought to be
often changed ;   but  his upper  cloaths muSl not
 be changed : becaufe thefe  having been infected,
 might, when  worn again, communicate the itch
 to  the  wearer again, after he had been  cured.

  * I have feen a pretty fingular contequence from the abufe of mercurial
 im&ion lor the itch ; whetrier it happened from the flrength or quantity of
 the ointment, or from taking cold after applying it, as this fubject, a heal-
 thy youth of about fixteen, piobably did, by riding three or four miles
 through the rain. But without any other previous complaint, he awoke
 quite blind one morning,  wondering, as  he faid, when it  would be day.
 His eyes were very rlear, and frfce from  inflammation,  but the pupil was
 wholly immoveable,  as in zgutta Jerena.  I effected the ci-re by fome mo<
 derate purges repeated a few times; by difpofing him to  fweat, by lying
 pretty much in bed (it being towards winter) and by promoting his perfpi.
 ration, chiefly with fulphur: after which the fhaved fcalp was embro-
 cated wifh a warm nervous mixture, in which ba'fim  of Peru was a
 eonfiderabie ingredient. In fomething lefs thaii tfyiee weeks he could dif-
 cern a glowing fire, or the bright flame of a candle, As his fight increafed,
 he difcerned other objefts, which appeared foi fome days inverted to him,
 with their colours confufed ; but red was molt diftinguifhible.  He difco-
 veredthe aces fooner than other cards ; and in about fix or feven weeks
 recovered his full fight in all its aacuraiit/epgih, whwh nc no.v enjoys, K. 
                   Of the  Itch'.-              26$
   Shirts, breeches and llockings, may be fumigat-
ed with fulphur, before they are put on ; and this
fumigation fhould be made in the open air.
   § 347. If this diforder becomes very  inveterate
and tedious, it exhaulls the patient in confequence
of its not fufiering him to fleep at nights, as well
as by his reltlefs  irritation; and fometimes even
brings on  a fever, fo that he falls  away in flefh,
and his tlrength abates..
   In  fuch a cafe he muft take, I. a gentle purge.
   2.  Make ufe frequently of warm baths.
   3.  He muft be put on the regimen of  perfons in
a ftate of recovery..
   4.  He muft take morning and evening, fifteen
days fucceSfively, the powder N'J* 53. with the pti-
fan Nc* 26.
   This  malady is often very obftinate,  and then
the medicines muft be varied according  to the cir-
cumftauces,  the detail of which 1 avoid  here.
   § 348. After giving repeated purges in fuch ob-
ftinate cafes,  mineral waters abounding with ful-
phur, fuch as * thole of Tverduu, &c. often effect
a cure ; and fimple cold bathings in rivers or lakes
have  fomelimes lucceeded in very inveterate cafes
of this diforder. •
   Nothing conduces more to the long continuance
of this malady, than the abufe  of hot waters, fuch
as iiifuSioiis of tea, toe.
   \ 349: I Shall conclude this chapter, with a re-
peated injunction not  to be too free or raSh in  the
ufe of the ointment Nr* 52. and other outward re-
medies for extiiiguifhing the itch.  There is hard-
ly any complaint  but  what has been found  to  be
the confequence of too fudden a removal of this
diforder by  outward applications, before due eva-
cuations have been  made,  and a moderate abate-
ment of tiie fliarpiiefs  of the humours has been ef-
fected.
                                         r
  * Sea Water, and thofe of Dulivich, Harrigate, Shad-well, S;c,  will
be full as effectual.  K.
     Vol. 1.           Bb 
 
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