► Utdidne, without principle, ii an humble art, and a degrading occupation.—Rush. REMARKS, PRELIMINARY TO THE EXHIBITION OF DR. PHELPS' PRACTICALLY ESTABLISHED A R © A N U Ha who has, for many years, exclusively directed his mind to the investigation of ft particular and favourite science, with reluctance would persuade himself, that his pow- ers, however feeble, had been employed in vain, since the faintest rays, when collected into a focus, can produce some degree of illumination. The science of medicine is not founded upon the results of accident, nor is its temple adorned with the oblations of thu ompirie. The avenues to this edifice are open to all who " strive to strew with Bowers the thorny ways of truth." Knowledge and the intellectual faculties are, in the mind of an enlightened physician, in a constant state of action and reaction, and must, according to an immutablo law of nature, increase the energy of the thinking principle. I might, in this place, paint, in the glowing and never-fading colours of truth, the great intellectual dignity of our art, and enumerate the high and lofty preroquisites nocessary to the successful and honourable pursuit of the practice of Physic. But in this I have long since been anticipated by the eloquence of a Rush, and other immortal Sydenhams of our country. It only remains for me, therefore, to make a few observations immediately connected with my object. The whole human system is compounded of minor systems of tissues and organs, whose natural and animal functions, in health, tend to one common felicity. The general health of the body, therefore, depends upon the harmony of these lesser systems, Constituting the Whole ; and any deviation from this concert of actions is denominated disease, which is at first local, and becoming general in proportion to the violence of the cause, the susceptibility and predisposition of the system to its action ; and which, if not timely arretted by the countervailing efforts of nature or art, puts an end to the life of the part, or the whole. If I were to assert, as does a certain German philosopher, that the whole human body is nothing but a crystal, the reader might, in truth, suppose me in error; but if I were to maintain that.', mummy is a mere hydrate of humanity, he mhrht also suppose me equally erroneous, until he informed himself to the contrary. Without a thorough knowledge of the anatomy of the human body, no man can con- scientiously attempt to practise the healing art, or prescribe remedies for disease. Many reasons have induced mo to prefer the anatomical to the mere symptomatical description of diseases. The former method has the advantage of brevity, perspicuity and certainty. It is, for example, much easier to describe tubercles in the lungs, and detail the signs of them, than to define the disease by the external symptoms only, and to arrange its varieties according to their causes. Emphysema of the lungs consists in an alteration of parts, which can bo described in a few words, and of which the signs can be easily recognised; while in studying asthma, according to the ancient method of ascertaining the character of this disease, we should be obliged to write a volume on generalities, before we could arrive at any thing positive. It will, perhaps, be ob- jected, that the anatomical method has the disadvantage of founding its species on dis- tinctions, the chief characters of which can only be obtained after death: but this f'Tction scarcely merits refutation. Wo might as well say, that it is useless for •uijeaii to make any distinction between dislocation of the femur, or arm-bone, ajid 2 a fracture of its neck; or that it is useless to separate, or discriminate, between a gouty toe and a pain in the head. The morbid alteration in the affected organ is, un- questionably, the least variable, and most positive, of the phenomena of local disease: It is on the nature and extent of this alteration that the danger and curability of diseases always depend; and it is this, that ought to be considered as characterizing them. On the contrary, the derangement of functions, which accompanies these alter- ations, is extremely variable : it is often the same, under circumstances entirely differ- ent j in consequence of which, it can rarely serve to discriminate different diseases. Besides, it is a mistake to consider the recognition of nosological Bpecies, founded on the data of morbid anatomy, as impracticable before death : on the contrary, thoy ara often more readily recognised during life, and certainly present to the mind something much clearer and more positive than any nosological distinction founded on the symp- toms merely. Peritonitis} or inflammation of the lining membrane of the abdomen, for example, is assuredly a disease easily distinguished during life ; and, out of twenty med- ical men acquainted with morbid anatomy, called to see a case of it, not one will make a mistake concerning its nature and name. But will this be the case with those who Are accustomed to see in diseases nothing but symptoms ? Of the twenty, shall we not find one considering the affection as ileus, another as hepatic colic, a third as puerperal fever, and so on ? Morbid anatomy must, then, I think, be considered as the surest guide of the physician, as well to the diagnosis, or symptoms, as to tho cure of dis- eases. But it must not be forgotten, that it has also its obscure points. It is, no doubt, an easy matter to distinguish striking changes of structure ; but there are many slighter alterations, among which it is difficult to ascertain what is healthy, and what diseas- ed ; what cause, and what effect; and, lastly, whether the appearances are truly the effect of disease, or merely an accident of assimilation, or circulation, that has taken place in articulo mortis, or even after death. In these cases, wo must content our- selves with what is clear and distinct; never forgetting, in practice, tho principle of Hoffman—Nuiuiuam aliquid magni facias ex mera conjectura out hypothesi; and sed- ulously guarding against the error of believing, that the mere knowledge of the scat and nature of the disease can justify our neglecting its individual character, as in- fluenced by external circumstances, or personal idiosyncracy, or peculiarity of con- stitution. Anterior to the era of Hippocrates, medicine was intrusted to the hands of women. priests, and warriors, who affected nothing beyond the application of a few empirical remedies ; and even at the present day, there are mimic women, and imitation war- riors amongst us, whose boasted panaceas and nostrums are seldom found useful; and bow often many of them are sent on errands of the most wanton and deadly destruc- tion '. But the rays of medical science, in emerging from this state of gloom to their present glory, have dispelled this empirical darkness, and the diseases of the human body are now successfully treated upon scientific and rational principles. The appro- bation of an intelligent public is secured, an approving conscience stimulates to dili- gence in the work of humanity, and Heaven smiles upon the means employed. In acts of benevolence and humanity, men should be actuated by better motives than the sordid love of gain; yet how frequently is the acquirement of wealth, evon at tha hazard of the lives of their fellow men, the sum total of their earthly glory. " For, oh ! what man's condition can be worse Than his, whom plenty starves, and blessings curse J The beggar does a common fate deplore ;— The rick poor man's emphatically poor."—Cowley. The object of the liberal, intelligent, and honourable practitioner of medicine; there- fore, is not solely the " love ofgain," but tho " love of doing good," and relioving the. distresses of his fellow men. Galen, speaking of Hippocrates, the father of medicine, observes, " there was but one sentiment in his soul, and that was the love of doing good, and in the course of his long life but a single act, and that was the relieving the sick." If noble examples like these, therefore, are not delightful objects for emulation, what is there in this life, that can offer a sufficiently powerful incentive to good. Who, then, in the enjoyment of his reasoning faculties, will maintain, that" good ean come out of evil," knowledge out of ignorance, and health be the result of both. I cannot believe, that truth is seen less clearly by men, whose intellectual powers have been illuminated by knowledge, and cultivated by exercise,—whose noblest sentiments have been refined and exalted,—whose livos are devoted to the service of humanity,— and who are tempted to do good rather than evil. Can the physician, therefore, who has examined and studied with deep attention that wonderful frame which contains an immortal soul—the most complex and beau- tifully noble of the works of its Creator—believe, for a moment, that its numerous and intricate parts were thus happily united, in their efforts for existence, by the fortuitous concourse of atoms ? or that the discordant actions, or diseases, to which this mighty fabric is doomed by its Maker, are to be arrested, and that harmonious concert of fe- ticities restored, by the fortuitous concourse of remedies or empirical nostrums? Cos be, who is engaged in contemplating tho beauties of the spangled heavens, the wonders of the mighty deep, the hidden treasures and useful productions of the earth, have less exalted views of the glory and dignity of his Maker ? The study of natural and revealed philosophy enlarges our conceptions of the glory and dignity of the Deity, and represses superstition and ignorance. Why are we less addicted to these evils and absurdities now, but because we are better instructed in philosophy than our progeni- tutl? So, the more resplendent our minds arc with know ledge, the less liable are we tu the intrusion of idle dreams and visionary horrors. Suffer me to ask you, if you would confide yourself, your offspring, or your fortune, to an ignorant and inexpe- rienced pilot, on the merciless billows of a stormy and unknown ocean i I answer, you would not!....But, if embarked with the experienced and intelligent navigator, whose course is safely directed over the mountain wave by his intimate knowledge of the unorring beacons of the heavens, then, should angry tempests assail you, and the foaming billows of the deep rage, with all their fury, against the bark, who can doubt the mariner's skill ?—Need I ask you, then, if you are willing to place your life, or the lives of your family, in the hands of ignorant pretenders to medicine? I will now attempt to give the reader some information with regard to the various sympathies, in diseases of the human body, the Modus Operandi and Physiology of Di- gestion ; together with a succinct history, as well as the symptoms, of a few of the most prominent diseases, immediately connected with my object, as collected from observa- tion, and the best medical authorities. OF SYMPATHY. All the body is sympathetically connected together, and dependant the one part upon the rest, constituting a general sympathy. But, sometimes, we find particular parts more intimately dependant upon each other, than upon the rest of the body, constitu- ting a particular sympathy. Action cannot be greatly increased, in any one organ, without being diminished in some other ; but certain parts are more apt to be affect- ed by the derangement of particular organs than others ; and it was the observance of this fact, which gave foundation to the old and well-known doctrine of sympathy, which was said to proceed, " turn ob communionem et similitudinem generis, turn oo ticiiuam." It may be thought, that this position of action, being diminished, in one organ, by its increase, either in the rest, or in some other part, is contradicted by the existence of general diseases, or actions, affecting the whole system. But in them ws find, in the first place, that there is always some part more affected than the rest. This local affection is sometimes the first symptom, and affects the constitution in a secondary way, either by the irritation it produces, or by an extension of the specific action. At other times, the local affection is coeval with the general disease, and is called sympathetic. It is observed, in the second place, that, as there is some part which is always more affected than the rest, so, also, is there some organ which has its action, in consequence of this, diminished lower than that of the rest of the system, »nd most commonly lower than its natural standard. From the extensive sympathy of the stomach with almost every part of the body, we find that this most frequently suf- fers, and has its action diminished in every disease, whether general or local, provided that the diseased action arises to any considerable degree. There are also other organs, which may, in like manner, suffer, from their associa- tion or connexion with others, which become diseased. Sympathy is divided into, first, the sympathy of equilibrium, in which one part is weakened by the increased action of another ; and, secondly, the sympathy of associa- tion, in which two parts act together at the same time. The sympathy of association is produced suddenly, and for a short time. The sympathy of equilibrium is produced more slowly, and continues to operate for a much longer time. The liver and stomach are intimately connected with each other. When tho liver is inflamed, or has its no- tion increased, the stomach is weakened, and dyspeptic symptoms take place. When the stomach is weakened, as, for instance, by intoxication, then the action of the liver is increased, and a greater quantity than usual of bile is secreted. The sarna takes place in warm climates where the stomach is much debilitated. If the liver hag its action thus frequently increased, it assumes a species of inflammation, or becomes, as it is called, scirrhous. This is exemplified in the habitual dram-drinkers, and in those who stay long in warm countries, and use freedoms with the stomach. The liver likewise sympathizes with the brain; for when this organ is injured, and its action much impaired, as in compression, inflammation and suppuration have been often known to take place in the liver. Besides the connexion of the stomach with the liver, it is also very intimately dependant on the brain, being weakened when the ac- tion of the brain is increased ; as we see in an inflammation of that organ. The brain again is affectod with pain when the stomach is weakened by intoxication, or other causi: and this pain will lie often relieved by slowly renewing the action of the stomach, by such stimuli as are natural to it. A slight increase of action in the stomach, at least, if not of a morbid kind, affects the brain so as to produce sleep, diminishing its action. 4 This is exemplified in the effects of a full meal. Tho stomach likewise sympa- thizes with the throat, squeamishncss and anorexia being often produced by inflam- mation of the tonsils. This inflammation is frequently abated by restoring or in- creasing the action of the stomach. Hence the throat, in slight inflammation, is fre- quently easier after dinner ; hence, likewise, the effects of emetics in cynanche. The extremities of bones and muscles also sympathize in the same manner. When one end of a bone is inflamed, the action of the other is lessened, and pain is produced: for a painful sensation may result both from increased and diminished action. Whan the tendon of a muscle is inflamed, the body of that muscle often is pained, and vict versa. Lastly, the external skin sympathizes with the parts below it. If it be in- flamed, as in erysipelas, the parts immediately beneath are weakened, or have their natural action diminished. If this inflammation affect the face, or scalp, then the brain is injured ; and headache, stupor, or delirium supervene. It is a well-established fact, that when any particular action disappears suddenly from a part, it will often speedily affect that organ which sympathizes most with the part that was originally diseased. From the united testimony of all the facts, Mr. Burns, of Glasgow, maintains the doctrine just delivered, and proposes to introduce it into pathological reasonings. In the whole animal economy, wo discover marks of the wisdom of the Deity, but, per- haps, in no part of it more than in this, of the existence of the sympathy of equilib- rium ; for if a large part of the system were to have its action much increased, and all the other parts to continue acting in the same proportionate degree as formerly, the whole must be soon exhausted ; fur an increased action would require for its sup- port an increased quantity of energy. OF DIGESTION. The circumstances necessary to effect a healthy digestion of the food are—I. A cer- tain degree of heat of the stomach. 2. A free mixture of saliva with the food in the mouth. 3. A certain quantity of healthy gastric juice. 4. The natural peristaltic mo- tion of the stomach. 5. The pressure of the contraction and relaxation of the abdomi- nal muscles and diaphragm.—From these circumstances, the particles of the food are softened, dissolved, diluted, and intimately mixed into a soft pap, called chyme, which passes through the pylorus, or lower opening of the stomach, into the duodenum, or first intestine. The fluid, which is termed gastric juice, is separated by the minute ar- teries opening into the cavity of the stomach. From various experiments of physiol- ogists, it is ascertained that the gastric juice reduces the aliments into a uniform pap or paste, even out of the body; that it acts in the same manner after death ; and that it is the chief agent in the progress of digestion. Animals only are invested with organs of digestion ; every one, from man to the polypus, presents an alimentary canal differently formed ; the existence of a digestive apparatus, then, could be given as an essential character of animal life. In man, this consists of a long canal or tube extending from the mouth to the anus, into which open the excretory ducts of various glands, situated in the vicinity, that secrete liquors, necessary to alter, liquefy, and animalize alimentary matter. It would be useless to recapitulate the hypotheses formed to explain digestion ; they may be reduced to coc- tion, fermentation, trituration, putrefaction, and maceration of the food received into the cavity of the stomach. Physiologists are generally agreed, at present, in consider- ing digestion in the stomach as a solution of the aliment by the gastric juice. This liquid, copiously poured on the internal surface of tho stomach, when this viscus is irritated by the presence of food, is the production of arterial exhalation ; it is neither an acid nor alkali, and seems to be of a nature nearly analogous to saliva ; the gastric juice, possessing great solvent properties, penetrates into the alimentary matter on all sides, sepe.ates and divides its particles, combines with it, changes its composition, and impresses qualities very different from those it possessed before this mixture. In fact, if a mouthful of wine or food be returned from the stomach some minutes after it has been received, the odour, taste, and all the qualities, both physical and chemical, of these substances, are so altered, that we can with difficulty distinguish them ; and Tinous liquors, more or less acid, are no longer susceptible of spirituous fermentation. The energy of the power of the gastric juice, perhaps exaggerated by some physiologists, is sufficient to reduce to a soft mass the hardest bones, on which certain animals sub- sist : it is very probable that its chemical composition is different and variable ; and that it is acid, alkaline, or saponaceous, according to the nature of tho aliment. Al- though gastric juice is the most powerful agent of digestion in the stomach, its disol- vent power has need of assistance from the action of several secondary causes, as heat, which seems to augment and concentrate itself in the epigastric, or region of the stomach. So long as the exertion of the stomach continues, there is a sort of in- testine fermentation, which should not, however, be, in the full sense, compared to the motion by which fermentation and putrescent substances are decomposed ; there is also a moderate aud peristaltic motion pf the fibres of the stomach, wbicb press the alintaat 5 on all sides, and perform a slight trituration, while the gastric moisture softens and macerates the food before it is dissolved ; it may, then, be affirmed, that the process of digestion is at the same time chemical, vital, and mechanical ; the authors, there- fore, of various theories to explain this function, have erred, by attributing to one cause only, as heat, fermentation, putrefaction, trituration, maceration, and the gastrio taice, that which is the aggregate result of all those causes united. The aliment re- mains a greater or less time in the stomach, agreeably to the facility or difficulty of the necessary changes taking place. Gosse, of Geneva, has proved on himself, that the animal and vegetable fibre, the white or albuminous part of an egg, boiled, whita ind tendinous parts, paste kneaded with butter, sebaceous substances, and thoso things which are not fermented, or very little fermentative, make greater resistance to the gastric juice, than the gelatinous parts of vegetables and animals, fermented bread, &c. ; that the latter class of substances requires only an hour for their com- plete dissolution, while the digestion of the former is not completed at the end of several hours. During the time of digestion, both orifices of the stomach are closed ; no pis, disengaged from the aliment, ascends through the asophagus, or passage to the mouth, (unless incases of bad digestion,) slight chills are felt, the pulse becomes quicker and stronger, and the powers of life seem diminished in 6ome organs, to be ctrried to the sent of the digestive process. The parietes of the stomach soon be- gin to act; their circular fibres contract in different parts of its extent: the peristal- tic oscillations, at first vague and uncertain, become more regular, and are directed from above downwards, from left to right; that is, from the cardia, or upper opening of the stomach, towards the pylorus ; its longitudinal fibres also contract, and thus ap- proximate both terminations. In these different motions, the stomach becomes paral- lel with the pvlorus, and the angle formed by the duodenum is almost totally oblitera- ted, which renders the passage of food easier. It has been remarked, that digestion proceeds better during sleep, when we lie on the right side, than on the left ; and this difference has been attributed to the compression made by the liver on the stomach. It should rather be considered, that on tho right side the passage of food is accelerated by its own gravity ; the situation of the stomach is naturally oblique, from left to right, and becomes more so in consequence of changes induced by food. The aperture of the pylorus is furnished with a muscular ring, covered by a duplicature of mucous mem- brane ; this kind of sphincter keeps it closed during the time of digestion in the stomach, and does not give passage to the aliment until it has undergone a very mate- rial alteration. The pylorus, possessing a peculiar and extremely delicate sensibility, may be consider- ed as a sort of vigilant sentinel, that prevents any thing from passing that has not luffercd proper changes. Many authors, quoted by Haller, havo been well aware that the food did not pass from the stomach successively in the same manner as it was received, but agreeably to its greater or less facility of digestion. It would appear that there is a real selec- tion of food in the stomach, for those aliments that admit of an easy digestion are directed towards the pylorus, which gives passage to them ; while, on the contrary, such as are not sufficiently digested are not permitted to pass, but kept back in the stomach. This delicate feeling, which we attribute to the pylorus ; this exquisite sense, by which it exerts a kind of choice on the food that passes through, may be, per- haps, objected to ; pieces of money, however, or other extraneous indigestible bodies, remain a longer or shorter time in the stomach before they go into the intestines, and present themselves several different times at the orifice of the pylorus, and do not get through till after it has been accustomed to their contact. It is the same with tho gastric system as with a secreting gland; and, in the same manner, the commence- ment of excretory duels, possessed of a sort of elective sensibility, do not receive the secreted liquor before it has undergone necessary preparations in the glandular pa- renchyma ; so the pylorus, which may be considered the excretory duct of the stomach, does not admit the food, nor suffer it to pass into the intestines, until it has been suffi- ciently elaborated by the action of this organ. In proportion as the stomach becomes empty, the spasm of tho skin ceases, a mode- rate heat succeeds the shiverings, the pulse becomes more evident and elevated, the quantity of insensible perspiration increases; digestion then produces a general mo- tion, analogous to a feverish paroxysm; and this digestive fever, described also by the ancients, is most easy to be observed in women of great sensibility. Nothing positive can be established on the duration of digestion in the stomach. The aliments go out of the stomach with more or less celerity, in proportion u they offer a greater or less resistance to those powers which serve to dissolve them, and agreeably to the energy and strength of the stomach, and activity of the gastrio juice: five hours, however, may be considered the ordinary time of their presence. The action of the parietes of the stomach ceases when this viscus is entirely liber- ated from the aliments that were in its cavity, but not before; the gastric juice, the secretion of which is not augmented by any stimulus, is no longer poured out by its arteries; and the parietes, which come into contact with each other, are only lubri- cated by the mucus copiously secreted by its internal coat. 1* 6 HEPATITIS, OR INFLAMMATION OF THE LIVER, Besides the causes producing other inflammations, such as the application of cold. external injuries from contusions, blows, &c. this disease may be occasioned by cer tain passions of the mind, by violent exercise, by intense summer heats, by long-con. tinued intermittent and remittent fevers, and by various solid concretions in the sub- stance of the liver. Inflammation, torpidity, and congestion of the liver, are diseases of more common occurrence than is generally supposed, and are more frequently connected with, or the cause of, other diseases than is commonly imagined. The innumerable sympathies existing between this organ and other important parts of the body, as the stomach, lungs, brain, spleen, pancreas, mesentery, etc., beside various other connexions, prove, almost to a demonstration, the liability of this viscus to frequent derangement, as well as that of its being the cause of a variety of symptomatic and sympathetic affections. In warm climates, this viscus is more apt to be affected with inflammation than, per- haps, any other part of the body, probably from the increased secretion of bile which takes place when the blood is thrown on the internal parts, by an exposuro to cold ; or from the bile becoming acrid, and thereby exciting an irritation in the part. The chronic, or species of long standing, is usually accompanied with a morbid complex- ion, loss of appetite and flesh, costiveness, indigestion, flatulency, pains in the stom- ach, a yellow tinge of the skin and eyes, clay-coloured stools, high-coloured urino, depositing a red sediment and ropy mucus ; an obtuse pain in the region of the liver, extending to the shoulder, and not unfrequently with a considerable degree of asthma. These symptoms are, however, often so mild and insignificant, as to pass almost un- noticed ; as large abscesses have been found in the liver, upon dissection, which, in the person's life-time, had created little or no inconvenience, and which we may presume to have been occasioned by some previous inflammation. This disease, like other inflammations, may end in resolution, suppuration, gan- grene, or scirrhus ; but its termination in gangreno is a rare occurrence. When sup- puration takes place, as it generally does before this forms an adhesion with some neighbouring part, the pus is usually discharged by the different outlets with which this part is connected, as by coughing, vomiting, purging, or by an absce»s breaking outwardly ; but, in some instances, the pus has been discharged into the cavity of the abdomen, where no such adhesion had been formed. On dissection, the liver is often found much enlarged, and hard to the tonch; its colour is more of a deep purple than what is natural, and its membranes are more or less affected by inflammation. Dissections, likewise, show that adhesions to the neigh- bouring parts often take place, and large abscesses, containing a considerable quan- tity of pus, are often found in its substance. SYPHILIS, OR VENEREAL DISEASE. This disease takes its name from a shepherd, who fed tho flocks of Alcithoiis, who, proud of their number and beauty, insulted the sun, as a punishment for which, fable relates that this disease was sent on earth. Towards the close of the memorable fifteenth century, about the year 1494, or 1495, the inhabitants of Europe were greatly alarmed by the sudden appearance of this dis- ease. The novelty of its symptoms, and the wonderful rapidity with which it was propagated throughout every part of the known world, soon made it an important object of medical inquiry. When syphilitic matter gets into the system, some local symptoms of it may often be observed in the course of a few weeks, or probably sooner ; but in some cases, it will continue in the circulating mass of fluids for many months before any visible signs of its effects are produced. The system being completely contaminated, it then occasions many local effects In different parts of the body, and shows itself under a variety of forms, many of which put on the appearance of a distinct disease. Many presume this variety depends wholly on the difference of constitution, the different kind of parts affected, and the different state these parts were in at the time the syphilitic virus was applied. The first symptoms usually show themselves on the skin, and in the mouth or throat. When on the .skin, reddish and brownish spots appear here and there, on the surface, and symptoms of a copper colour are dispersed over different parts of the body, on the top of which there soon forms a thick scurf or scale. This scurf falls off after a short time, and is succeeded by another, and, the same happening several times, and at length casting off deep scabs, an ulcer is formed, which discharges an acrid, fetid 7 matter. When the matter is secreted in the glands of the throat and month, the tongue will often be affected so as to occasion a thickness of speech, and the ton- sils, palate, and uvula will become ulcerated, so as to produce a soreness and diffi- culty of swallowing, and likewise a hoarseness in the voice. In a syphilitic ulcer of the tonsil, a portion of it seems as if it was dug out ; it is, moreover, very foul, and has a thick, white matter adhering to it, which cannot be washed off. By these characteristic marks it may, in general, readily be distinguished from any other species of ulceration in these parts. If the disease affects the eyes, obstinate inflammation, and sometime* ulceration, will also attack these organs. The matter sometimes falls on deep-seated parts, such as the tendons, ligaments, and periosteum, and occasions hard, painful swellings to arise, known by the name of nodes. When the disease is suffered to take its own course, and not counteracted by proper remedies, the pa- tient will, in th*" course of time, be afflicted with severe pains, but more particularly In the night time ; his countenance will become sallow, his hair will fall off, he will lose his appetite, strength, and flesh ; his rest will be much disturbed by night, and a small fever, of the hectic kind, will arise. The ulcers in the mouth and throat be- ing likewise suffered to spread, and to occasion caries of the bones of the palate, an opening will be made from the mouth to the nose, and the cartilages and bones of the nose being at length corroded away, this will sink on a level with the face. Some constitutions will bear up for a considerable time against the disease, whilst others, (gain, will soon sink under a general weakness and irritation produced by it. If the disorder is recent, and the constitution not impaired by other diseases, a perfect cure may easily be effected; but when it is of long standing, and accompanied with symp- toms of irritation, which have been mentioned, the cure will prove more tedious. The general appearances to be observed on dissection of those who die of lues or syphilis, arc, caries of the bones, but more particularly those of the cranium, often communicating ulceration to the brain itself, together with enlargements and indu- rations of the lymphatic glands, scirrhus of several of the organs, particularly the liver and lungs, and exostosis of many of the hardest bones. RHEUMATISM. Chronic rheumatism is distinguished by pain in the joints, without pyrexia or fever, and is divided into three species ; lumbago, affecting the loins ; ischias or sciatica, af- fecting the hip ; and arthrodynia, or pains in the joints. Rheumatism may arise at all times of the year, when there are frequent vicissitudes of the weather, from heat to cold, but the spring and autumn are the seasons in which It is most prevalent; and it attacks persons of all ages ; but very young people are less subject to it than adults. Obstructed perspiration, occasioned either by wear- ing wet clothes, lying in damp linen, or damp rooms, or by being exposed to cool air, when tho body has been much heated by exercise, is the cause which usually produces rheumatism. Those who are much afflicted with this complaint are very apt to be sensible of the approach of wet weather, by finding wandering pains about them at that period. Chron- ic rheumatism is attended with pains in the head, shoulders, knees, and other large joints, which at times are confined to one particular part, and at others shift from one joint to another, without occasioning any inflammation or fever ; and in this manner the complaint contiuues often for a considerable time. SCROFULA, OR KING'S EVIL Dr. Cullen, in his N««nlogy, distinguishes four species : 1. Scrofula vulgaris, when it is without other disorders external and permanent. 2. Scrofula mesenterica, when internal, with loss of appetite, pale countenance, swelling of the abdomen, and an nnnsual fetor of the excrements. 3. Scrofula fugax. This is of the most simple kind; it is seated only about the neck, and, for the most part, is caused by absorp- tion from sores on the head. 4. Scrofula Americana, when it is joined with the yaws. Scrofula consists in hard, indolent tumours of the conglobate glands in va- rious parts of the body j but particularly in the neck, behind the ears, and under tho chm, which, after a time, suppurate and degenerate into ulcers, from which, instead of pus, a white curdled matter, somewhat resembliiig the coagulum of milk, is dis- diarged. The first appearance of the disease is most usually between the third and seventh year of the child's age ; but it may arise at any period between this and the age of piv berty ; after which, it seldom makes its first attack. It most commonly affects chil- dren of a lax habit, with smooth, fine skin, fair hair, and rosy cheeks. 8 It likewise is apt to attack such children as show a disposition to rachitis, mark- ed by a protuberant forehead, enlarged joints, and a tumid abdomon. Like this dis- ease, it seems to be peculiar to cold and variable climates, being rarely met with in warm ones. Scrofula is of a hereditary nature, and is often entailed by parents on their children. That a peculiar temperament of body, or predisposition in the constitution to some diseases, may extend from both father and mother to their offspring, is, ob- serves Dr. Thomas, very clearly proved. For examplo, we very frequently meet with gout in young persons, of both sexes, who could never have brought it on by intem- perance, sensuality, or improper diet, but must' have acquired the predisposition to it in this way. Where there is any predisposition in the constitution to scrofula, and the person happens to contract a syphilitic taint, this frequently excites into action the causes of the former. The late Dr. Cullen supposed scrofula to depend upon a peculiar constitution of the lymphatic system. Tho attacks of the disease seem much influenced by the periods of the seasons. They begin, usually, some time in the win- ter and spring, and often disappear, or are greatly amended, in summer and autumn. The appearance of the disease is, commonly, in that of small oval or spherical tu- mours under the skin, unattended by any pain or discoloration. These appear, in general, upon the sides of the neck, below the ear, or under the chin : but, in some cases, the joints of the elbows or ankles, or those of the fingers and toes, are the parts first affected. In these instances, we do not, however, find small, movable swellings ; but, on the contrary, a tumour almost uniformly surrounding the joint, and interrupting its motion. After some length of time, the tumours become lurger and more fixed, the sk>n which covers them acquires a purple or livid colour, and, being much inflamed, thoy at last suppurate, and break into little holes, from which, at first, a matter, somewhat puriform, oozes out; but this changes by degrees into a kind or riscid, serous discharge, much intermixed with small pieces of a white substance, re- sembling tho curd of milk. In more virulent cases, the eyes are particularly the scat of the disease, and are affected with ophthalmia, giving rise to ulcerations in the tarsi, and inflammation of the tunica adnata, terminating not unfrcquently in an opaci- ty of tho transparent cornea. In similar cases, the joints become affected ; they swell, and are incommoded by ex- cruciating, deep-seated pain, which is much increased upon the slightest motion. The swelling and pain continue to increase ; the muscles of tho limb become at length much wasted. Matter is soon afterwards formed, and this is discharged at small openings made by the bursting of the skin. Being, however, of a peculiarly acrimonious naturo, It erodes the ligaments and cartilages, and produces a caries of the neighbouring bones. By an absorption of the matter into the system, hectic fever at last arises, and, in the end, if not relieved, proves fatal. When scrofula is confined to the ex- ternal surface, it is by no means attended with so much danger, although, on leaving one part, it is apt to be renewed in others ; but when the ulcers are imbued with a sharp acrimony, spread, erode, and become deep, without showing any disposition to heal; when deep-seated collections of matter form amongst the small bones of the hands and feet, or in the joints, or tubercles in the lungs, with hectic fever, arise, the consequences will, without relief is afforded, be fatal. On opening the bodies of per- sons who have died of this disease, many of the viscera are usually found in a dis- eased state, but more particularly the glands of the mesentery, which are not only much tumefied, but often ulcerated. The lungs are frequently discovered beset with a number of tubercles or cysts, which contain matter of various kinds. Scrofulous glands, on being examined by dissection, feel somewhat softer to the touch than in their natural state, and when laid open, they are usually found to con- tain a soft curdy matter, mixed with pus. 9 ■ A wicked messenger falleth into mischief; but a faithful embassador is Health."—Proverbs xiii. 17. GENERAL DIRECTIONS, TO Bt OBSERVED IN USING THAT HIGHLY MEDICATED AND EFFICACIOP8 PREPARATION OF MEDICINE, THE ARCANUM- This valuable medicine is not dependant on boasted authority for its present or future usefulness. It is the offspring of scientific investigation and practical experience, which, being founded in truth, needs not the feeble support of " ambiguous" names for its fame, or to shield its existence from the power of accident. It would be proper to remark, that this preparation of medicine has greater claims to the appellation of Panacea than any other, it being of genuine medical origin ; but as the word panacea, in ancient mythology, meant a nostrum that would " cure every thing," every intelligent mind will at once see the impropriety, absurdity, and object of such an empirical appellation. Unfortunately, at the present day, there are no such remedies. The "Arcanum," by long experience, is found to be happily adapted, in its combination of properties, to the removal of disease in many structures or tissues of the human body, and has succeeded in effecting the cure of a variety of obstinate dis- eases, after all other known remedies had been abandoned as useless, and of no effect. It is given in chronic affections, or diseases of long standing, with the greatest suc- cess, by observing, particularly, the following general rules and directions,—a system as essential in the therapeutic or curative plan of disease, as the knowledge of the means we employ. In prescribing remedies for disease, the power of discriminating the particular stages at which they are admissible is so essential, that, without it, they seldom prove useful. The knowledge of selecting remedies, and their modus operandi on the human body, is no less important to the success of the prescription. An intimate acquaintance with the anatomical nature of diseases, their cause and character, the particular structures or tissues of the human body which they occupy, is not only necessary, but absolute. The fibrous tissue, for example, is the seat of rheumatism, which is com- posed of the muscles, tendons, and ligaments, surrounding the joints. There are twen- ty-one distinct and different tissues, all of which are primarily the seat of peculiar and separate diseases; yet it is not to be doubted, that the whole system may become affected, or participate in a greater or lesser degree, in proportion to the extent and violence of the cause, tho susceptibility and predisposition of the various parts to its action. (See article on Sympathy.) In the diet, or mode of living, too much circum- spection cannot be observed ; especially in those cases having a feverish or inflam- matory disposition. Any unnecessary exposure to the vicissitudes or changes of the weather should be avoided as much as possible. Inattention to a congested, or costive state of the bowels, or alimentary canal, is always productive of mischief, and, in a diseased con- dition of the body, serious consequences. The dose of the Arcanum, for an adult, or full grown person, is from a table-spoonful to half a wine glass full. It should bo taken before eating, or when the stomach is nearly empty, and is to be increased to the number of three or four doses a day, the last of which should be taken on going to bed. The dose, and number of them, should, however, be increas- ed and diminished as circumstances may roquire. These circumstances are, general ly, caused by idiosyncrasy, or peculiarity of constitution, in which one person is af- fected by certain agents, which, if applied to a hundred others, would produco no effect; thus, some people cannot seo a finger bleed without fainting, and thus violent Inflammation is induced on the skin of some persons by substances that are perfectly innocont to others, etc. For children, or young persons, the dose should be propor- tioned accordingly. 10 This medicine is equally efficacious and admissible in chronic diseases of the young as the aged. The dose is small, and of an agroeable taste. In short, it is not only a much less expensive medicine, but, at the same time, the most valuable remedy ever offered to the public. In bilious diseases, of long standing, the best effects have been produced by a judi- cious administration of this medicine, and, particularly, in those chronic affections of the liver, and other chylopoetic viscera, incident to the inhabitants of tho southern states and climates. In Syphilis, or Venereal disease, the Arcanum has proved itself superior to any other preparation, and worthy of the fame it has honestly acquired, even under circumstances of the most appalling character. This disease I have often seen very forbidding in its aspect, not only in private practice, but in hospitals ; par- ticularly when it has been neglected, or improperly treated in its acute or forming state. Syphilitic diseases are frequently aggravated by the interposition of imitation doctors, and mimic doctresses, who, to my own knowledge, have added to the sufferings of the patient a formidable train of symptoms, which have nearly, and frequently, proved fatal. "Nay," says the shrewd and observant Lord Bacon, " we sec the weakness and credulity of men is such, as they will often prefer a mountebank or witch before a learned physician." This formidable disease, then, demands efficient treatment. By observing the annexed directions, the Arcanum will be found adequate to the under- taking, and " a faithful embassador of Health." In Rheumatic, Scrofulous and cutaneous affections, and anomalous diseases incident to life, this medicine has distinguished itself, and obtained a reputation above the power of accident. In mercurial affections, it has succeeded in hospital and private practice, when the most effective remedial means of the medical and "imitation" practitioners have failed. The " Arcanum" was used, in private practice, under the immediate inspection of many of our most distinguished medical gentlemen, for many years previous to its being brought before the public, and its virtues fairly tested by the infallible ordeal of experience and practical application. A sense of humanity, seconded by duty, and the frequent solicitations of the sages of medicine, are, I trust, sufficient inducements for this offering to mankind. The demand for this medicine has been great, and is rapidly increasing. For the accommodation and benefit of those who are anxious to obtain a valuable, and purely medicated preparation, I have obtained a number of agents for the sale of the Arcanum, in different parts of the United States and South American States, West Indies, etc., who are composed of medical gentlemen, intelligent apothecaries and druggists. DUPLICATES, VERBATIM ET LITERATUM. The following, from a variety of the most respectable testimonials, are submitted to the public for the express purpose of proving, to the satisfaction of every candid and Impartial mind, and, especially, those in pursuit of health and a scientific preparation of medicine, the superior powers, efficacy, and cheapness of the Arcanum, to any medicine ever offered for sale in America. Credential of Dr. Clayton, of North Carolina, dated, Dr. Phelps, Wilkksboro', Oct. 9,1824. Mr health is yet delicate, and likely to remain so, and has caused me more unea- siness of mind and body than 1 have ever experienced before. About the time I reached home from Philadelphia, last spring, the tonsils of my mouth ulcerated, and blotches appeared on the skin. My condition was an awful one, and I went to using mercury again, and kept it up for three weeks. I set out upon my journey to the south, and was travelling about a month, when the tonsils broke out again. I immediately commenced tho old remedy, which was in May, and used it till the last of July, at which time I Buffered it to go off, with the most violent saliva/ion you ever saw, of about twenty days, and hoped I was well of the cursed disease, and took measures to recruit the system in general, which was very much emaciated. My throat and epiglottis are again ulcerated, and, consequently, I am again under the use of mercury. My casa is a singular one. I used one bottle of Swaim's Pana- cea, but thought I got worse under its use, and quit it. I have also drank sarsapa- rilla tea, and am still using it. Thus, you see, my condition is a miserable one, and I am almost ready to despair of ever getting well, and am afraid, that I shall ultimately bring on a mercurial disease, which is generally worse than the original. If this course of treatment does not cure me, f shall render my life into the hands of ambiguous nature and a merciful God." 11 Dear Sir, Jasper County, Geo. Aug. 15.1827. Mr health is now as good as it ever was ; but I bad made u5e of nearly all the reme- dies of which the materia medica could boast, as efficacious, in the cure of my disease, without effect, and, until you forwarded me the ' Arcanum,' 1 had despaired of re- covery. This is an elegant preparation, and, in my opinion, an invaluable medicine. The Arcanum has been used only in private practice, as I am informed in your letter accompanying it ; but I must lie candid in telling you, that it is an imperative duty you owe to mankind, to bring this medicine before the public. My gratitude on this occasion is inexpressible, and I can only repeat to you, that my knowledge of your abilities justifies me in saying, you havo in your power the means of conferring much honour on our profession, and a glorious remedy to mankind, for the cure of Syphi- lis, Mercurial Rheumatism, etc. Yours, truly, R. CLAYTON, M. D. P. S.—I have given the 'Arcanum,'in several cases of long-protracted liver com- plaints, which, you know, in this climate, are very obstinate and unyielding, and I find it equally successful and certain in its effect, as in my own case,—a further evidence of its superiority to any medicine I have ever met with. These cases had resisted the most approved medical treatment, independent of a variety of popular nostrums. Credential of Dr. Moran, of Louisiana, dated, Sir, New Orleans, July 7,1828. A private conveyance offering, 1 gladly embrace it, to inform you of the success I have obtained in the administration of the medicine you forwarded me per the Chilo. For the purpose of testing its virtues, (which is the only way of ascertaining the good, bad or indifferent qualities of any medicine.) I selected from my patients the most obstinate and complicated cases of disease. To some of these I gave the ' Arcanum,' agreeably to your accompanying directions. To others I increased the dose, until I had arrived at double the quantity prescribed. I find it has far surpassed my most sanguine expectations. It is the most power- ful, safe, and judicious medicine I have ever given in my life, in aggravated and hopeless diseases, so frequently occurring in this latitude ; and the good effects it has produced in several chronic cases, that were considered incurable, is to me astonishing. The smallness of the dose, and its pleasant taste, render it, in my opinion, the more desirable to invalids, and appropriate to the indigent. Yours, very respectfully, To Da. Phelps. J. V MORAN, M. D. Credential of Dr. Hay, of South Carolina, dated, Dr. Phelps, Charleston, Aug. 3,1828. The medicine you sent me in May came duly to hand, and, in compliance with your request, I have given it a trial in about half a dozen cases, some of which were of the most obstinate character. The diseases in which I made use of it, consisted of Bilious Rheumatism, chronic Liver complaints, and one aggravated case of Syphilis, which was hitherto so completely unmanageable, that myself, as well as patient, considered it incurable. I have no hesitation in giving it as my decided opinion, that the ' Ar- canum' is tho best medicine in chronic diseases within my knowledge, which is proven, not only to my satisfaction, but to those who have experienced the good effects of it, under the most gloomy circumstances. I shall take much pleasure in recommending it, as worthy of the confidence and patronage of the public, who have been (especial- ly in this part of the country) too frequently duped by worthless, and often barba- rous nostrums, prepared by ignorant aspirants to notice. Wishing you much success, I ain, your very obedient servant, S. C. HAY, M. D. Credential of Dr. Tompkins, of Maryland, dated, Dear Sir, Baltimore, June 10,1828. You have, doubtless, expected to hear from me before this time, but, in consequence of unavoidable circumstances, I have been prevented writing. I have given your medicine what I conceive to be the test of its virtues, and am fully satisfied in my own mind with the results. The several diseases in which I prescribed it were those of Rheumatic, Scrofulous and Mercurial, and, without any intention of flattering, I have to inform you, that my hopes have been more than realized in its efficacy. It is my belief, that the Arcanum is far preferable to any preparation now in use in this country, and its pharmaceutical neatness betokens not a little, also, in favour of its legitimate medical origin. It is a medicine capable of acquiring its own distinguish- ed reputation, even amongst the envious, and your knowledge of theoretical and prac- tical medicine affords the ample means of promoting its usefulness. Your friend, R. M. S. TOMPKINS, M. D. 12 Credential of Dr. Livingston, of New York, dated, Dr. Phelps, New York, March 31,1828. The ' Arcanum,' per the packet Mirror, you were so kind as to send me, was re- ceived in December, since which time I have given it to a number of patients, and carefully watched its effects, as you requested. I have prescribed it in mild, as woll as in the most inveterate diseases, and I am pleased with its operation. You cer- tainly have been fortunate in the combining of articles constituting your medicine. I have, both in country and city practice, used nearly all the remedies I ever heard of, in obstinate cases, that would not yield to ordinary treatment; but I have no re- collection of any medicine, combining so effectually and certainly, the essential virtues of the ' Arcanum.' In chronic affections, I would not hesitate to give it the pref- erence to any medicine whatever. There are many compounds and nostrums vend- ed throughout the country ; but there are few, if any, in which I have much confi- dence. It is very seldom that valuable productions, either in the arts or sciences, are the result of ignorance and superstition. I speak from experience and observa- tion : you will not be surprised, therefore, at the remark. In those cases of Syphilis, in which I have exhibited your medicine to the great- est extent, I have succeeded in every instance, and somo of them were of the worst kind. In complicated diseases, I think the Arcanum is no less effectual. On the whole, I admire the neatness of the preparation, and am of opinion, that it only wants industry and attention to render it a most popular and useful medicine. Your success is attended with my best wishes. Respectfully, yours, _ GEO. A. M. LIVINGSTON, M. D. Credential of Dr. Huntar, of Virginia, dated, Doct. Phelps, Philadelphia, April 15,1828. Previous to my departure for the western country, which will be in a few days, I will give you a brief history of what has transpired relative to the ' Arcanum' you sent me last fall, the receipt of which I acknowledged in due time. As your object was to have the merits of your medicine fairly ascertained, I have prescribed it in the most abandoned and difficult cases in the city. Many of my friends have folt a cu- riosity on the subject, in consequence of which, considerable exertion has been made to have a thorough-going investigation. We find that the Arcanum is superior to any remedy wo have ever seen nsed, and merits the highest approbation of all those acquainted with it, and as it is a medicine of scientific origin, we have no reason to doubt its complete success, and satisfaction to the public. . . ... , . . . You shall hear from me on the subject more particularly at soma future period, when I am more at liberty In the mean time, I am, Your very respectful servant, J. HUNTAR, M. D.