Saml. Poultney 
Notes 
from 
A Course of Lectures 
on the 
Practice of Physic 
Delivered by 
Benjamin Rush. M:D:
Professor of Chemistry in the 
University of Philadelphia 
by 
Samuel Poultney
M.DCC.LXXXVI

* Instanced in Plurey Cold is the 
Remote Cause Plethora the 
Predisposing, Violent exercise 
the Recreational and Spasm 
the Proximate Cause 

1
The 
Practice of Physic 
Lectr. 1st 
By the Practice of Physic, I mean 
that branch of medicine which 
treats of distinguishing and 
curing diseases- 
A Disease is a condition of the 
body wherein the function is 
performed with difficulty or not 
performed at all- 
[crossed out]
The causes of diseases are then 
Predisposing Remote the Occasional
and the Procreate cause *
a Symptom is an apparent dervia

* Symptoms of the Cause
† Symptoms of the disease 
‡ Symptoms of Symptoms-

2
deviation from health- 
The Symptoms of diseases are 
1st Symptomata Cause * Symptomata
Morba † Symptomata
Symptomatum ‡ -
Diagnosis is all the Symptom 
taken together which disturbing 
wish a disease from all others 
Prognosis is a knowledge with regard 
to the termination of the 
disease this is to be taken 1st
from the state of the skin 2 n/y
decubitus 3rd. Countenance 4th
much has been said with regard 
to the Pulse in the Prognosis of   
diseases but moderin
Practitioners depend very little 
upon it- In [couter] Chronic 
diseases a Number of symptoms 
taken 



3
taken together we may in some 
cases come very nigh the Termination
by Prognosis- But in 
[Chronic] Acute diseases this is very different.
We are in this case totally 
ignorant of the Termination
Patients have died after a favourable 
Prognosis and have Recovered 
after sentence of death has 
been pronounced So I would 
advise you never to prognosticate 
but when you an importuned 
to say something, you  
should say that worse have 
lived and those those that appeared
to be better have been
earned off in living over a Patient 
should be the last thing 
you do but I would advise
you    



4
you never to give one over but 
dispute every inch of Ground wth
the king of Terrors-
Diseases are either Idiopathic     
or Sympathic the Idiopathic 
are what are called Primary 
and are those diseases that is
neither in consequence of nor depending 
on any other diseases
as Angina &c The sympathic 
or Secondary disease depend upon 
other diseases as the Gloubus Hysteriaes-
Diseases are again
divided into natural and artificial. 
Natural diseases are those 
that are in consequence of Old 
age the Ravages of War Thunder 
& Lightning &c. Artificial are 
all those that Doctor Cullen Treats 
off 



5.
Treats of under the head of Neurvous 
We are Apt to magnify the Powers 
of Nature In certain disease 
the powers of Nature is very 
great but as the artificial means of 
curing diseases occur their  
nature diminishes in Power 
By Nature, I mean Physical 
necessity which is truly a mechanical 
Action.-



6
Lectr: 2nd- 
The Arrangement of diseases are 
according [if] to their Cause or according 
to their Seat- The former 
I think in the most Natural 
and the one I mean to follow 
In immitation of Doctor  
Cullen. The Clases of diseases 
are first Pyrexia The Symptoms 
of this is frequent Pulse 
heat greater then Natural 
succeeding a Chill most of the 
Function disturbed Apetite
bad Secretions disturbed Excretions 
also Function of the 
Brain not performed as in Natural 
diminished Strength of ye 
Limbs Pain and Weakness of the 
Back. The Remote cause of Fever 



7
Fever may be reduced to a few
1st. Cold 2nd. Fear 3nd. Miasmata
4th. Contagion. That Cold will 
produce fever we all know as in 
Plurisey. Wether fear will produce 
fever or not we cannot be Certain 
it seems rather to act as an occational
then a Remote Cause It
produces a Cold fitt and a fever 
follows- 
Miasmata produces fever independent 
of contagion By contagion 
I mean a disease which 
is communicated from one person 
to another- Fevers are 
not only produced from contagion 
but in those persons who 
have fevers from Miasmata 
may have a contagious matter 
generated



8
generated within the Body It then 
becomes capable of communicating 
the disease to others-
We shall now speak of Miasmata
in particular- The Principle  
Source of Miasmata is from 
Manny Places these do not produce 
fever when entirely overflowd
The Matter that constitute the 
Miasmata is probably of a Vegetable 
Nature or Vegetable and  
Animal combined- Disease  
From Miasmata is less frequent 
in Europe then they used to 
be this is owing to 1st. To the 
high State of Agriculture 2nd.
Horticulture or Gardening 3rd.
Cleanliness prevails more then
formerly every kind of Vegetable 
is 



9
is more used then formerly and 
particularly sugar. It has been 
observed by Docr. Pringle that the 
Plague has not appeared in any
place where Sugar has been 
freely Used- The Epidemics
are less frequent then formerly 
in Europe. They are more frequent 
here there formerly- The 
reason of this in the City is riding 
to the change produced by 
the British by breaking down 
the Dams and letting [in] the 
Water in upon the Medows, [crossed out] 
which generates the Putrid matter 
contained in ye Miasmata 
But what is the Reason of the 
more frequent appearance of 
Epidemics in the Country 
There 



10
There may be reduced to there 
Causes 1st. The great Irregularity
of our Seasons The Rivers and Creeks 
being reduced below the Natural 
standard and sometimes 
the River was too high & in 
this care it as hurtfull as when 
too low for by overflowing the 
Meadows and leaving them Damp 
by which a great quantity of 
this Miasmata is Produced 
2nd. The Increase of mill Ponds 
it is allowed by all that in ye
Neighborhood of Mill Ponds 
it is very unhealthy 3rd. Clearing 
of the Country There is no way 
of obviating this last Cause but 
by following the Clearing by Cultivation 
that is by sowing it wth
grain 



11.
grain or grass sees and this will 
be as certain in its effects as an 
Effect will fallow a Cause The 
Town of Surrenam was very 
unhealthy until. it was cultivated. 
It then became healthy 
The inconvenientcy from Mill 
Ponds may be guarded against 
by planting a number of Trees 
aboute it and particularly the 
Willow as they will absorb the   
Miasmata that is generated by 
the Mill Pond, there is not 
a single instance of a family 
being unhealthy where there 
is a grove of Trees between the 
House and Pond in proportion 
as cultevation and Civilization
takes place the Unhealthyness diminish 



12
diminished But till we plant 
or make agriculture keep pace 
with clearing what shall we do 
In this case it is of the greatest 
to 1st. guard against Cold and 
moisture avoid evening Air and 
Sleeping with the Windows open 
for no miasmata opperates wth 
out the Assistance of Cold and 
moisture. 2d. Change your Clothes
as soon as the cool evening 
begins which is about the Latter  
end of August at this time 
you should put off linnen and 
put on wooling Linnen I am 
apt to think favours the opperation 
of Miasmata while Woolen 
cloths is an antidote to all 
the Disease of Autumn, 3 as these
Exhalations



13
Exhalation, are of a debilitating.
Nature the Living ought to 
be more generous a Small Quantity 
of wine or what is still 
better a glass of Bitter in a 
draught of water or half a pint 
of bitter Tea is of the utmost Service 
in preventing the Miasmata
from operating, Roasted meats 
should be Used in Autum
Water Mellons was said to produce 
intermitting Fever but this 
is not the Case as the Correct ye. 
Bile 4 Fire contributes much  
to destroy the Miasmata Vinegar 
has a very great tendency 
to destroy it, Green Powder has 
also been made use of with Success
and sulfur has also a Tenden 



14
Tendency to destroy the effects 
of Marsh Miasmata-



15
Lectr. 3rd- 
These Miasmata appears to 
be simple in their Nature 
The Intermitting. Remitting 
& Bilious fever are all produced 
by the same Miasmata 
But wether ye. Dyssentery is produced 
by the same Miasmata 
as fever or produced by a Miasmata 
Sui Generis is a Doubt 
but I think the matter that produces 
dyssentery arises from 
higher ground then that that 
produces fever.
The next Remote Cause is Contagion 
by contagion I mean 
a disease communicated from one 
person to anther through the 
intervenes on of the air this divided  



16
divided into infection which 
is a disease communicated by 
contract as the Itch & Plague 
& Contagions as through the Intervention 
of the Air as in Small- 
Pox & Measel. Contagious diseases   
are not so frequent in some 
places as formerly which 
may be explained on the same 
principles as those from Miasmata.
Sir observed that some Species 
of animals can Infect none 
but their own species. & it is further 
diversified by affecting particular 
ages as the Hooping Cough
which affects Children & Seldom 
or ever Adults. They are further 
diversified by affecting those of articular 
[Ages] Colours in the Year 1762 
there  



17
there was a yellow fever Raged 
in South Carolina when there 
was not a negro affected There 
is another fact shews that the 
Colour of the skin influence the 
Habit In white Settlements among
the indians the White 
people never had a diseas that 
affected the Indians an Visa 
Versa-
Cold is a Remote Cause of fever 
when combined wth Moisture
When ever the Reaction is equal
to the Cause there is little 
danger of being affected by 
the Cold. Cold acting as a  
remote Cause ought to be alternated 
by heat as Uniform 
Cold will never produce fever 
and 



18
and Uniform heat is as little 
liable to produce fever as Uniform 
Cold in certain highly cultivated 
places fevers are Unknown 
this the case [to] in St Kits Jamaica 
is the contrary Uniform 
Moist weather is not Unhealthy 
Uniform dry Weather is also health 
& it must be the Viscitudes
of these that will produce 
diseases 
For the Predisposing & Occational
Cause of fever I refer you Doctr.
Cullen & I shall say but little 
upon the Proximate Cause Debility 
is the and Spasm is the Proximate
Cause of fever & produces all the 
symptoms 



19
Symptoms of the fever 
Fevers are varied from the different
action of the Remote Causes 
or the Different Parts which it 
Effects according as it affects ye
Arterial system the Nervous system 
or the fluids.
Inflammatory fevers was said 
to be a disease of the Arterial system 



20
System Nervous fever of the Nervous 
System Putrid affects the
Fluids but they are all more or 
less affected at the same time 
But in inflammatory fever 
The Arterial System is Prime
rally effected in the Nervous fever 
Nervous System as prime rally and
principally effected. & the fluids 
is the chief seat of the Putrid 
fever- The Remote Causes are 
therefore, of a Stimulating sedative 
or septic and from their 
different action they produce 
the different kinds of fever 
Fevers are divided into Intermitting 
& Continued Contemned
are again divided into Inflammatory 
Nervous & putrid. Intermitting 



21
Intermitting is divided into Tertion
Quotidian & Quarton- The 
Tertion is again divided into a 
great many Varieties 1st. Those 
fevers when there is Apirexia this 
is further divided with regard 
to the difference of the Fitts First 
where the fit does not last twelve 
hours 2 where it does last 12 hours 
They are again divided according 
to the time they come on sometimes 
intermittent returns every day but 
have two fitts in a day And sometimes 
two fills on day and others 
only one they are further diversified 
according as they are combined 
with other symptoms sometimes 
you will see an intermitting 
fever come on like Apoplexy
sometimes 



22
somtimes with Convulsions somtimes 
Efflorescence on the Skin somtimes 
with Inflammatory affection 
Somtimes complicated with 
Worms & other Diseases-
Before we proceed to the Cure 
we will say something on Critical 
days they are the 3d, 5th, 7th, 
9th, 11th, 14th, 17th, 20th, there is a Variety
in them in proportion as 
they are connected with Inflammatory 
diathesis.-
There is I think but 2 kinds 
of fevers the Tertian & Quartan
and they appear in other 
cases only under different forms.
When they become continual 
is occationed by a stimulating 
or sedative cause either of the Inflam. 

 [crossed out]

23
Inflammatory or Septic kinds- 
There certainly is a use in attending 
to the Critical days in order 
to cooperate with Nature 
you are to Blister or give a Pahe
or to give [crossed out] Bark (on the Critical
days) according to the Nature 
of the fever, in some Cases 
a Blister will Bring on 
a Crisis on the 4 Day- 
Cure Intermittents Used to be a 
fatal disease when proper Remedies 
where not known James 
1st. & Olivar Cromwal died of it.
Cold Bath & riding on Horse Back 
has been made use of and may 
be made use of before the fitt but 
this is only a temporary Relief and 
only puts of the fit at the Preasant  



24
preasant but there are other remedies 
which cure the Disease [fit] entirely 
Astringents of Various kind has 
been Used for the Cure of this disease 
with Success as metallic 
Astringents particularly the 
Vitriols but the action of there 
is confined to the Nervous system 
& Medicines should be given that 
would act on the Blood likewise 
these are an severed by Vegetable 
Astringents. [ Vegetable Astring:]
Bitters. Astringents & Bitters Combined- 
opium has been given 
with success before the fit of an 
Intermittent it in this care act 
as a stimulus. But all those 
medicines has given way to the 
Peruvian Bark this ought to be   
give



25
given in substance and the 
dose should be in proportion 
to the state of the Patients stomach
and should be administered 
just before the fit & it is of great 
consequence to continue the 
use of the Bark after the Paroxysm
cease to returns to prevent a Relapse
and particularly on the 
day the patient used to have it 
Tincture of Bark is a dangerous 
remedy as it leads many to dram 
drinking.
There are some cases that Elude 
the Effects of Bark & in some 
it really is Injurious In these 
cases there is two remedies I would 
recommend the 1st. is Blisters 
sometimes they resist Blisters 
therin   



26
in this case you must use Bleeding
which has been put in 
practice with the greatest Success
In Intermittent after Christmas
I make it an invariable 
Rule to bleed before I give the Bark 
and the Blood is in some cases 
very Sizy. In some cases the 
Patient complains of a Pain 
in his breast his pulse is hard 
and full. I never in this Case 
saw bleeding fail to Remove
the Disease- 



27
Lectr. 4th
Continual Fever there are 
Synocha, Typhus & Synochus
Synocha heat greatly increased 
Pulse hard strong & Generally 
Quick Urine high coloured ye
Function of the Brain little disturbed-
Typhus Contagious fever Heat 
increased Pulse weak Small & 
Quick Urine little Changed function 
of the Brain Greatly disturbed 
Strength of the Body very
much diminished-
Synochus – a Contagious fever 
of an Intermediate water between 
Inflammatory and Nervous in 
the beginning Synocha at the 
end Typhus-
Cure



28
Cure of Continual fever
there must be adapted to this Inflam:
Nervous & Putrid- And 
1st. of Inflammatory. In this Case 
there is too much Action this 
must be moderates 2d to obviate 
the Effects of debility 3rd to correct
the tendency of the Fluids to Putrefaction-
The sent Indicated 
is to be answered 1st. By all thos
which diminishes the Action of the  
heart & Arteries 2nd. by those means
which take of the spasm of the  
extreme Vessels which we suppose
suppose to be the chief cause of the 
Violence of Reaction. The Action of 
the heart may be diminished 
1st. by Avoiding or moderating those 
Irritations which in one degree 
or 



29 
or other are allmost constantly applied 
to the Body as External heat 
&c. 2nd by certain sedative Powers 
as Acids. Neutrals &c. 3 by diminishing 
the Tension and Tone 
of the arterial system. This is  
done 1st by Bleeding of the necessity 
of bloodletting we judge of by
the Pulse it will not be unecessary
here to say somthing with regard 
to feelling of the Pulse. as it is by 
this that we judge of the state Pulse 
The different posture of the Body 
after the state of the Pulse if A 
person walk the Pulse will be 
quickened If standing it will 
be still less quickened lying down
[worst] slowest of all, so that it is of 
the greatest consequence to consider  



30
concider the situation of the Patient
at the time that you are 
feeling the Pulse and should always 
be felt in both Arms as 
lying on one side will oppress the 
Pulse which on the other Side
the Pulse remains free & it is 
also of Consequence in feeling the 
pulse that the arm be put in 
such a state that not one of ye
muscles be in Action. It is also 
of consequence to concede the Influence 
of the Mind upon the 
Body you should not feel the pulse
of a patient as soon as you go 
into the Rooms [ of the P] as the Sight 
of the Doctr. will in some
cases quicken the Pulse of the 
Patient. It Should not be felt 
immediately



31
immediately after speaking as 
this quickens the Pulse, Besides 
waiting for a few minutes after 
you get in feel the Pulse two or 
three times and your fingers shd.
be applied a conciderable time- 
With respect to Blood letting it is 
not to abstract Morbid matter from 
the System but to lessen the Tone 
of the heart and Arteries this 
Tension depends 1st, upon an original 
Stamina which dispose 
more to Inflammatory disorders 
then any other 2nd. 
3rd it will depend upon the [and]
Quality 



32
quality & Quantity of the food it 
will sometimes depend upon the 
state of Alimentary Canal it also
depends upon the state of the 
Uterus during Menstruation &c
The desire then of Bleeding is to 
take of the Tone & Tension of the 
Arterial System bleeding is proper 
in all ages. [they] It may be made 
Use of freely in old age as in any 
other state and it is as proper to 
Bleeding ants in inflammatory 
cases and it has been observed that 
Infants bear bleeding better then 
Adults & I am of some opinion 
Bleeding is proper at all times 
Women during pregnancy bear 
bleading better than in any other 
State some cases of obstructions 
of  



33
of the menses bleeding may be 
made Use of and when inflammatory 
disorders attach those 
women that labour under an 
obstruction of the mensis the 
obstruction is to be quite forgotten 
and the whole attention
to be upon the Inflammation 
as it is mostly the Cause and 
not the Consequence of obstructed 
Mensis-
You should allways bleed in the 
Arm when you can make it convenient 
1st from the arm you get 
a greater Quantity of Blood in 
a short time 2d. you have an oportunity
of examining the Blood as 
when a person is bled in the foot 
it is mostly in water 3d. if any 
Injuries 



34
Injuries should happen to the 
part it had better be the Arm
then the Log on foot- 4th.
You should always bleed in a 
recumbent posture as the same 
quantity of Blood taken while the 
patient is in this posture will 
be more effectual then when taken in 
any other posture-
A Large Crust on the Blood indicates 
an inflammatory diathesis 
Yellow Serum is also a Sign of 
Inflammation but this is not a 
certain criterion as the same thing 
takes place in putrid disorders 
when 



35
When Synocha & Synochus is [to]
combined there are several things 
to be taken in consideration wth.
regard to the Cure 1st. the Nature
of the Epidemic is to be considered 
if it should hapen in the 
season of the Year for Plurisy I 
would judge it to be of the Inflammatory 
nature and would 
bleed him 2 the nature of the 
Remote Cause if it comes on 
in consequence of contagion we 
should bleed with caution 3d the 
season of the year 4th the degree 
of Phlogistic diathesis presents 
5th 
6th. the Age Vigor and constitution 
of the Patient. 7th the former 
diseases   



36
diseases and habit of Blood letting 
If I was called to a patient that 
says he is used to be bled I woud.
not hesitate a minute but woud.
bleed The Inflammatory disorders 
does not bare bleeding now 
as they used to do nor will they 
Bare bleeding in hospitals now 
as they will in other Plauses



37
Lectr. 5th: 
you will find at the season of 
the year when Intermittents makes 
their appearance various disorders 
of the intermitting nature occurs 
as Head Achs &c which will give 
way to the proper remedies for 
Intermittents as Bark &c.
sometimes intermitting Toothache 
If it should come on in the Season 
of intermittent fevers Bark 
should be given. Sore Eyes 
Ear ach &c make their appearance 
in the Intermitting form wth
is to be cured as Intermitting fevers
There are in some Cases 
fith & Puking that comes on
periodically which may also be 
called a species of Intermittent 
If  



38
If a fever does not come to a 
regular intermittent proper 
evacuation Blisters should 
should be employed. If the Bark 
should fail after being properly 
employed Blisters there are attended 
with the Best Success If Blisters 
should fail and the fever is
in an inflammatory season 
Bleeding should be employed 
signs of Great debility A Patient 
Lying on his back is a sign of 
great debility If he is able to 
support himself on his side ye
debility is not so great if he lies 
straight on his back the signs of 
debility is not so great as when 
he draws his legs [?] feet drawn
up 
Respiration 



39
Respiration. if he breaths with 
his mouth open or if he makes
use of his mouth the debility is 
great and it is likewise a sign
of great debility when the Nostrils 
and Cheeks are alternately 
contracted and dilated when 
more muscles are employed 
in resperation then Natural 
it is a great sign of debility.-
The Debility is great when the 
Hands tremble or the Tongue 
falter and trembles when the 
patient attempts to put it out 
of the mouth convulsion &c at 
the Close of fevers is the greatest 
signs of debility and I never saw
a patient recover that was affected 
with convulsion towards the end 
of  



40
of the fever- When the sight 
fails the patient catching at 
things that are not in being. When 
the speach falters the debility is 
very great, the debility is discovered 
to be great when the Cheeks
falls away and the face Schrivels
& the Patient resembles his Ancestors-
Involuntary Stools
& Urine are great signs of 
debility but when the mind 
has the Power over the different 
Sphinctieres the signs of debility 
is not so great and the debility 
is not so great when the discharge 
of Wind from the Rectum 
is attended with explosion-
There is two symptoms that [ which] 
are certain which is sleep and
appitite



41
appitite for when ever the Sleep 
Returns and is Refreshing it is 
a good Sign and when the Appetite 
returns it admits of a 
the Best Prognosis-



42
Lectr 6th 
Continued Fever is a fever
without intercession [syno]
they are divided in Synocha  
& Typhus this again divided 
into nervous and Putrid I-
could you all Intermitting 
fevers were brought on by 
Marsh Miasma & that 
continual Fevers Generally 
by contagion.
Synocha or inflammatory 
fever is seldom contagious but 
it is somtimes comunicated 
in this manner Typhus 
is allways contagious. & the 
synochus which is a compound
of the Typhus & Synocha 
is also contagious- sometime 
a 



43
a nervous fever is attended wth
a chill which is a effort of 
nature to get rid of the Disease-
there is another Circumstance 
they sometimes come 
on without a Chill & I mostly
remarked that the less the 
chill in an Intermitting 
fever the greater the danger   
Cure of Synocha is to Moderate 
the Action of the heart and Arteries.
There are to be done first 
by removing irritation such 
as external heat which ought 
to be avoided by removing 
all extra ordinary bed Cloths.
The Exercise of the Body avoided 
he ought to be constantly in 
Bed the only way to Cure
this- 



44
this fever is to submit to it 
indulge it in every respect 
Some are not to be indulged 
but the patient to be aboute 
as much as posable – Exercise 
of the Mind ought to Removed 
such as intense shady disagreeable 
objects Irritations 
of all kinds to be avoided the 
Patients thirst ought to be 
removed currupted humors 
in the Stomach to be evacuated 
& medicines to be given that 
will obviate the natural Retention 
of fæces as there in an 
Irritation produced both fm.
Quantity and Quality you 
very seldom see a patient in 
an Inflammatory fever that is 
not



45
not costive you should allways 
procure two or three stool 
it ought not only to be 
given when the patient is Costive 
but repeated every two
or three days to keep the 
patient continually loose.
The Acrimony of the Fluids 
to be avoided by detecting Drinks-  
2nd Modls of moderating 
the Action of the heart and 
arteries is by the employments 
of sedatives 1 Cold is of service 
& by the use of all Refrigerating
Medicines. as ye.
Acid Neutral & metallic salt.
Acids are sedatives Neutral 
salts are also sedatives ʒss of 
Sal Nitri taken at a dose will 
makes 



46
make the pulse fall 8 or 9 stroke 
in a Minute Neutral Sts.
of all kinds are sedative Metalic
salts are generally Disused 
3rd Means of diminishing 
the tone of the system is 1st by 
Blood letting 2 by those medicines 
that will take of the Spasm.
This is done 1st. by Internel
Means as Diluents Diuretics 
and Antispasmodics 
we are not only to direct Drinks
to allay thirst but to 
contrive such as may be taken 
in the Largest Quantities A
variety of Drink has been 
Recomended Such as herb Tea 
in a common fever made of Sage 
or Balm when the Breast 
is 



47 
is affected Hissop may be added 
some prefer Camomile
Most Herb teas become Inspid 
after they have been Used for 
sometime Barley water makes 
an agreeable Drink as likewise 
does Tamrind water Current 
Gelly disolved in water makes 
a grateful Drink Availing 
ourselves of the fruits of the 
season any Give the Juices of 
them they are delight full Dhs.
particularly Cherry Water 
Peaches form a good Drink-
Neutral salts determine to ye
Skin and prove Sudorific Emet.
are also proper as Sudorific 
the Best Sudorific is the Antimonials
those Sudorifics that  
stimulate  



48
stimulate are improper in these 
cases such as Snake Root &c
Tart Emet is the Best when combined 
with a neutral Salt as 
1/6 of a grain of Emit Tart wth. 10gr of 
Sal Nitri every thing that can 
be done with James Power can
be done with this Preparation 
it exites Nasea and Sweating Under 
the head [crossed out] of Sudorifics
I shall inquire how far they are 
proper in Inflam Nervous and 
Putrid fever in Inflammatory disorders 
they act only as Antispasmodic 
those sweats that 
continue 24 hours Give Relief 
in fevers Sweat is only an
Accidental Circumstance and 
the great objects is the Solution 
of  



49 
of spasm by diminishing the 
Action of the heart and arteries 
Sweat is the Consequence and not 
the Cause of the Cure of fever
The Idea of Sweat being the 
Cure of fever took its Rise frm.
morbific Matter But thir 
was a fever Epidemic in York
Shire that went off without 
Sweating & the Solution was 
perfect Morgagni gives an Instance 
of fever that terminated 
with Sweating but terminated 
in death most of the People
that die die in a Sweat then 
is always a solution of Spasm take 
place before Death- 
Antispasmodic under head of 
External Application are Blisters  



50
Blisters and Warm Bathing Blisters
appears to opperate as Antispasmodics
and Evacuants in 
Synocha. They should not be 
applied too early in the disease 
When applied in proper time 
the Gently irritate the parts to 
which they are applied & Communicate 
their antispasmodic
power over the Whol System-
Warm Bathing ought 
to be Used with Caution & its 
warmth should be moderate 
when too hot it acts as a Stimulant- 
Typhus commonly called Nervous
fever Docr. Huxham has 
treated this subject the Best of 
any that has yet Wrote. It
is



51
is to be cured by increasing the 
tone of the system this is but 
done by Peruvian Bark after 
the fever has continued two 
or three days when there is no 
danger of synocha Bark may 
be given in decoction. Stimulants 
Wine Aromatics &c. may 
be given Snake Root is a good 
medicine in this Case-
Synochus or Putrid fever
the Indication here is to obviate 
or correct the tendency of 
the fluids to Putrefaction
this is to be done.
1st By avoiding any new application 
of Putrid or putressent
matter the Patent to be Removed 
from the port in which he 
received 



52 
received the Contagion 
2 By correcting the air, from 
which he cannot be removed 
[Body], this is of Consequence
the Cure the Modes of doing this 
by sprinkling Vinegar on the 
floor of the Chamber by burning 
Gunpowder & Sulphur 
& by strewing branches of Willow 
aboute the Floor the purepy 
the Air of the Chamber
by throwing out dephlogisticated
air Docr. Prengle has an 
other Method for Purifying y
air in the Patient Chamber by 
decomposed common salt by 
mean of Vit Acid and sitting 
the Muriatic Acid of the salt 
float about in the Air of the 
Room  



53
fres. air is of the Utmost concequences 
the Putrid fever spreads 
more during the Winter  
then Summer owing to the Men 
being pent up in small Appartments 
During the War  
we had no Putrid fevers in 
Summer but as soon as the 
Winter Come on the fever began 
to Rage the officers very
Seldom died on account of their 
having Room provided for 
themselves fresh air is the 
Chief Tonic to be relied upon 
when the Patient cannot be 
removed-
3 by avoiding an accumulation 
of the Putrid Effluvia The Constant 
Ventilation of the Air is 
usefull  



54
Usefull but this cannot always 
be done but we can allways
have it in our power to change
the Bed Cloths & Body linnen
they ought to be changed every 
day or every other Day at furthest 
and they Cloths ought 
to be expound to the Sun The 
Bed shelf ought to be Aired- 
4th Removing all Excrementitious
Matter as soon as posable
by Urine and Stools – stools 
ought be procured as soon 
as posable sugar ought to be 
Burnt to dissipate the smels
it forms with the putrid effluvia
a Serturm Quid: 5 by avoiding 
or correcting animate
food 6 by evacuating Putrid 
matter  



55 
matter already presant in the  
Body both stomach and intestines
should be a evacuated a [puhe] 
is a remedy of the first consequence  
when there are no circumstances 
that forbid it as Pregnancy 
&c. it is not only proper in 
fever from contagion but from
Miasmata When given early 
they terminate the diseases frequently 
evacuating the Bowels 
not only opening it the 
first day but should be kept 
open a purge every 2 or 3 Day
Crem Tart or Glaub salts are ye
most proper some cautions 
may be necessary in the Advanced 
stage of the disease with 
regard to the Exhibition of Pulses 
violent   



56
Violent Vomiting somtimes 
Produces great debility which 
when it happens Disagreeable 
concequences is produced the Vomiting 
may be checked by Snake 
root Tea or Columba Root Tea 
7th by supporting the Secretions 
and excretion- 
8th Correcting the Patriot or Putressent  
Matter Already in the Body 
the Best antiseptics yt
are best in this case is Wine 
and bark Both should be Given 
in large Quantities You 
cannot give too much of there 
medicines you should allways 
begin with the Weak wines 
and advance till you get to 
the Strongest Some patients  



57
patient require a small 
quantity of Brandy to be 
mixed with the Wine thos
that have been habituated 
to Dram drinking Giving it 
in Whey or diluted in a Trifeling
Practice. I have [four] 
cases of Putrid fever which lasted 
11 days in which time 14 
Bottles of Madeira Wine was 
drank A Patient whose Excitement 
is below the Standard
as is the Case here. He will 
bear a much greater Quantity
of Spt. Liquor without being  
intoxicated.- Bark ought 
to be given in large doses and 
in substance or it will be doing 
nothing. If the stomach Rejects 



58
Rejects it is to be given in Glysters 
if it Purges Laudanum
Should be added. When the Patient 
is costive during the Exhibition 
of the Bark it ought 
to be obviated by Glyster composed 
of Glauber salts. I had 
a case of synochas where it had 
gone so fare that there issu'd
blood from the Nose and Uterus 
which was entirely Cured 
by the Bark.-
Cold air as well as fresh 
air is of the greatest consequence
at this stage of the disorder it 
has been asked wither throwing 
a Bucket of Cold water over ye.
body of the Patient would not 
be attended with the best consequence 



59
there are some cases where Wine
has been rejected by the 
Patient in this Case porter 
has the desired effect. It can
be produce good which is not 
allways the Case with Wine 
It may in some cases be used 
in Preference to wine the Wine. [crossed out] 
may not be rejected by the Patient- 
Blisters in the Nervous fever 
when there is a degree of Inflam.
diathesis Are of Use [crossed out] in [con.] 
fever produced by [contagion] Miasmata
but in Putrid fevers they 
are injurious by producing Mortification
of the Part to [garnish].
They are applied an I have 
had cases where the Patient died     



60 
in consequence of the discharge 
from a Blister- Blisters are every 
apt to heal up & dry and 
when the Patient begins to Recover 
it mostly Breaks out Again 
which is a good Symptom 
as Is likewis a Blisters that looked 
pall befor begins to Inflame.
In the applications of Blisters 
[in this case] the great benefit 
produced is by their 
Antispasmodic & simulant 
Properties. From the Tolea yt
their effects was occasioned by 
the Evacuation is absurd for 
what can the evacuation of 
such a small quantity of water 
produce. If Blisters have 
an inclination to dry let 
them 



61 
them dry and put another 
in its place stimulating application 
should never be applied 
to a Blister upon this 
account Cabbage leaves are 
improper by not only stimulating 
but a disagreeable 
smell Arises they irritate the 
Part and produce great Pain.
The Application that I make 
Use of is eaqual parts of Hugo
Lard and Wax- Under ye 
head of Cleanlyness I should 
have mentioned keeping the 
Mouth and teeth Clean by 
Washing and Rubbing them 
frequently with a Brush & 
the hands ought to be washed 
with Vinegar-
In ye 



62 
In the Nervous fever the Tongue 
is mostly dry in ye Putrid
for the most Part Moist- In
the Nervous fever the dryness 
mostly begin in the Middle 
of the Tongue and Gradually 
extends towards the Tides & 
when the fever goes of the 
tongue begin to grow moist 
at the edges first and extends 
gradually towards the Middle 
untill the tongue recovers its  
usual moisture for this Reason 
when you inspect the Tongue 
in a nervous fever you ought 
carefully to examines the sedes 
for when yo discover these to be 
growing mist, you may form 
a favorable Prognosis- There is 
another  



63
another Remark with respects
with regard to the tonge is it 
is mostly of a brown Colour 
which in some cases continues 
several days after the recovery  
of the Patient or in other 
words till all other symptoms 
disappear- The Convalessent 
state of a nervous and Putrid 
disease is supposed to be a disorder 
and ought not to be abandoned 
and care should be taken 
to prevent a Relaps In 
this state Elixer Vitriol & Bark 
should be made use off Huxhams
Tincture is a excellent 
medicine in this case a Wine 
Glass full may be Given two 
or three times a day with the 
great 



64
greatest success Porter has likewise 
been prescribed with Success 
in this Stage of yc. Disorder 
and may be very good as it affoards 
nourishment. Chocolate 
may be given as it lies on the 
Stomach and affoards nourishment- 
After sometime the Appetite 
becomes Violent and yc
Patient would eat to access if 
he was not prevented in this 
case you ought to direct small 
Meals but frequent ones- Boiled 
food ought first be made use 
off and as he recovers he may 
be allowed Roasted Meats and 
it is of consequence to get your 
patient ought to excersise as 
soon as Posable as moderate 
exercise  



65 
exercise tends to strengthen the 
Patient. It is to be observed that 
soon after a recovery from ys
disorder the Patients legs begins 
to swell which is not 
an unfavorable symptom. It 
may be Removed in a short time 
by moderate exercise-
The success in the management 
of fevers within this two Years 
is without doubt may be 
allrebuted to Docr. Cullens new  
system of the Practice of Physis 



66
Lectr. 7th.
Phlegmasia or Inflammation, 
attend with topical affection 
accompanied with fever of the 
Synocha kind as ye Plurisy
Thy symptoms are topical 
Pain structure of the Part Injured 
Blood puts one Buffy 
Coat. we shall first treat of 
the Phlogosus which is an 
Inflammation of any part of 
the Body. These are divided 
into two species the first is 
confined to particular parts 
of the Body and tend to produce 
abses the 2nd. is more differed
and has a tendency to 
form into Blisters- The 
most frequent of the Perot
kind  



67
kind is the Paronychia commonly 
called fellon or Whittled which 
affects the joint sometime the 
joint is totally destroyed it is 
an Inflammation of the Periosteum-
Cure dipping the finger 
into Boiling Vinegar never failed 
to cure it Hot water perhaps
will answer as well but has 
not been made use off as yet therefore.
I would Recommend the Use 
of Vinegar. It ought to be repeated 
often by this means the living 
principle is destroyed or 
it is lessoned Another cure is an 
Incision down to the Bone 
Some times you are called upon 
when it has began to suppurate   
In this sore some caustic is to the 
used 



68
used a Poultice of soft soap will 
answer this purpose better yn 
any thing else it is the Caustic 
alkali combined with an animal 
oil If this should fail Blue 
Vitriol or some vegetable caustic 
may be used- Absess they 
occur in the legs arms &c they 
somtimes follow a small Pox 
they ought to be discussed if Posable 
the Best application for 
this is the Lee Poultice it acts 
by promoting absorption. It 
will either discus or bring on 
suppuration according to Circumstance 
a Variety of [the] Application
have been made use of such 
as warm bathing bitter Bathing 
the Preparations of Lead
such 



69
such as Saccar: Saturn: Ag: Veg: 
mineralis has been applied wth.
success Flaxseed poultices is preferable 
to any for bringing it 
to a head Cumphry has also 
been used with advantage in 
this Case as also has Roasted 
Onion- The 2nd species is 
more troublesome then the 1st.
Burns are of this Nature some 
have applied spirits to a Burn 
this if it does good is its Great 
Stimulus being followed by Sedative 
but this is a Worthless 
Remedy Molasses has been also 
employed it acts chiefly 
by its Coldness- Scraped Potato
has also been Used with Success 
there are Cold and the Contain  



70
contain a Quantity of water to wth.
this effects are owing their action 
is entirely like that of Cold 
Water Nothing is so effectual 
as the Aqua Vegeto Miner: if yc
Inflammation is great a fotur
composed of Bread Boiled in Ag
Vegeto minerale: some small 
Quantity of oil has been added 
but it ought to be as little as 
Posable and of the Purest oils 
as they are injurious in the Inflammatory 
State of the Burk 
but will do no hurt when the 
Inflammation is gone off 
there is a species of phlogosis yt 
proceeds from Cold as frost Bitten 
Limbs &c In this case the 
Cold acts first as a stimulant but 
towards 



71 
towards the Last as a power full
Sedative and Produces Gangrene
The Remedies in this case is Cold 
applied in any form this does 
not opperate as it was supposed  
to do by some by extracting 
the frigorific Particles but 
by its stimulus increases the 
the action of the arteries But 
if a mortification has come on 
it should be scarified down to 
the sound flesh and stimulating 
applications should be 
made use off-
Anthrax this comes on in 
every part of the Body but more 
particularly at the Back of yc.
Neck and is preceded by pain  
It mostly when it opens it is 
in 



72 
in several small Places –It 
ought to be kept clean by common
digestives & if it becomes 
Gangrenous a great part of 
it ought to be cut off but 
this is not the case often 
In some cases, Peruvian Bark 
is necessary to prevent Gangrene.
When this swilling is produced 
by Acrimony it is to be 
destroy by diluents- Under 
this head of Inflammation. I 
Include all those Produced by 
the stings of Bees Wasps &c
During the Inflammation Dilution
answers a good purpose 
some have applied Vinegar wth.
success in those cases. When the 
Inflammation is great the 
Preperations 



73 
Preparation of Lead are the 
Best application that can be 
made as the Aqua Veget Mineralis-  
Imposthume. I have but 
little to say here but You are 
never to open an Absess till it 
is soft all Round- And there 
are several modes of Doing 
this a Poultice made of flour 
Honey and the Yolk of an Egg wth.
open it it if the Suppuration 
is complete another Method 
is by an Insician, when this 
is made use off it ought to be 
made in the most depending 
Part of the Absess as the contased 
matter has a better chance 
to make its Escape- 
Gang  



74
Gangrene & sppaceous is 
of the same species only in different 
degrees the only way 
of preventing Gangrene spreading 
is innocuous and stimulating.
Preparation when a Total
absence of Inflommat: Diathesis 
Bark may be given with advantage 
somtimes, it is connected 
with Inflam Diathesis these 
the bark is injurious-
The next Genus of Inflammaton
is Ophthalmic this is a Pain 
and Redness of the Eye with an 
intolerance of light- They are 
of two kinds sociopathic & symptomatic.
the Idiopathic various 
in proportion as it is situated
in the Coats of the Eye or Eyelids 
symptoma   



75
symptomatic opthalmia are 
those that are produced from 
disorders of other parts of the 
Body- The Cure of the Idiopathic 
is Bleeding Purging Topical
applications and avoiding 
irritation of all kinds- Ophthalmia
is sometimes not connected 
with Inflam Diathesis &
in this case General Bleeding 
would be unecessary Topical 
Bleeding near the Port affected 
by Cupping Leeches &c an
of the Greatest Consequence in 
this Case- Purging is attended 
with the Best effect in the Idiopathic 
Inflammation of this the Eyes
Blisters as evacuants may be applied 
mear to the Port affected- A
Variety-



76 
Variety of Topical application  
have been made use off- Cold applications 
on to be prefered Ptn.
of Lead are of the first consequence
in some cases, Laudanum may 
be added with advantage 
when there is a secretion of Acrid 
matter Laced: with a solution 
Gum Arabic is the Best 
application that cord be made 
use off Solution of opium in 
Water has given great Relief 
in this case sometime. I have 
ordered Crumbs of Bread Moistened 
with Aq: Veg: Min: wth
success It should always be
Removed when it becomes dry 
It is also the utmost use to keeps 
your Patient in a dark Room 
some



77
some have tied a handkerchief
over the Patients Eyes to Prevent 
the admittance of Light but 
this is not a good Practice for 
the Handkerchief will irritate 
the Eye as the sensibility is exquisitely
increased these Directions 
may appear to be trifeling  
but the Patient will get 
will two or three days 1h sooner 
for it Docr. Cullen has recommended 
Electricity but this cure 
is but temporary and as soon as 
it is discontinued the disease 
returns with as much Violence 
as before so it is a Remedy yt
is not to be depended upon 
Where the Preparation of Lead 
is inefectual you ore bye means 
of  



78
of an Insician in the Eyelid, both 
above and below the Eye so as to 
promote the flow of Blood 
Symptomatic Apthalmia are 
to be cured by curing the disorder  
from which they originate
as the Venereal Disease the 
Scrophula &c &c &c-   



79 
Lectr. 8th: 
Phrenitis this is divided into 
Idiopathic & Symptomatic- 
the former is a very Rare occurance
the Latter very frequent 
I do not remember of seeing more 
then one case of Idiopathic Phrenitis
that is from cold. But 
from contusion. I have frequently 
seen- Contusions is the most 
frequent occasional Cause of 
Phrensy falling on the Tea or 
from on horse back- Van
sweeten gives a case of a More 
who received a stroke on the head 
by a tile falling from a hours 
the man felt no pain after the 
stroke but 8 or 10 day after was
seized with Phrenetis-
Docr. 



80
Docr. Cullen very proper by distinguishes
delirium into two 
specis Delirium Ferox and Delirium 
mite the Delirium 
Firox is a constant attendant 
of Phrenetis the Symptoms
by which it may be most
certainly known are a Vehement
Pyrexia of the Synocha
hind Violent deep seated headach 
Redness and lungessence of 
the face and eyes an Impatience 
of Sight and Noise, a constant 
watching and a Delirium 
impetuous and furious 
There is a delirium of an opiate 
nature attending the Nervous 
fever which is owing to Debility
the other by increased excitement  



81
Cure 1st. Copious Bloodletting
the Quantity to be determined 
by the state of the Pulse the Quantity 
in this Case may be greater
then in any other case of Inflammation 
that the Human 
body is subject to [?]3xx is ye 
smallest Quantity let the disease 
proceed from what it will 
It ought to be repeated several 
times as occasion Requires 
In all Violence done to the Brained.
the Patent ought to sore blood 
in small Quantities to prevent
a Phrenitis from appearing 
as a disease is allways better 
Prevented then cured in this 
case 10 or 12 ounces may be taken 
Next to Bloodletting opening 
the 



82 
the Bowels is of the greatest consequence 
the benefit derived fm.
this is evident to every body & 
may be explained merely by 
mechanical means. When the  
Intestines is loaded with fæces 
it is evident that it compresses 
the descending aorta & 
a greater Quantity of Blood in 
consequence of it determined 
to the head which certainly 
increase the delirium so yt
the Removal of this must be 
of the greatest advantage to ye 
Patint the Intestines ought nt.
only be emptied but repeated 
Purges ought to be administered
to divert the blood from the Supirior
or into the inferior Ports and 
by 



83 
by this means Relieve the head 
& in order to prevent a determination 
to the head it ought 
to be kept high after General 
Bloodletting cupping on the 
head is of Great Use Blisters 
as an evacuate may be applied 
to the head and upon ye
account the large the Betters 
as a few ounces of fluid is evacuated
immediately from 
the part affected may be of 
the Utmost service & usual
antiphlogistic Regimen 
to be Strictly anteceded to such 
as Repeated dosed of Nitre &
Tart Emetic the Patient sd.
allway be kept in a dark 
Room and all Passions of the 
mind    



84
prevented Emolient Caleplasm
applied to the soles of the feet 
Symptomat. Phrensy you
will frequently meet with ye
species of Phrensy in a Word
every delirium that attends 
a fever that is not of the Nervous  
kind is a symptomatic 
Phrenitis. The Cure of this 
depends upon the Cure of the original 
Diseas and in proportion
as it approaches to the Idiopathic 
the Remedies Mentioned 
are to be made use of- The next 
specis of inflammatory affection 
is Cynanche of these there are 
few specis and first of the 
Cynanche Tonsilaris this is 
an inflammation of the Mucus 
membrane 



85
Membrane of the fauses especially 
that congeries of Mucus follicles 
which forms the Tonsils & 
from thence spreading along ye 
Velum & uvula so as frequently 
to affect every part of the membrane 
Symtoms swelling of the Tonsils 
Redness of the parts pain full 
Deglutition a frequent but difficult 
Excretion of Mucus & a 
fever of the Inflammatory kind- 
This is the Mildest species of the 
Cynanche it mostly occurs in the 
Winter and the Patient affected is 
able to go aboute the the swallowing 
in this case is somtimes more 
difficult then in any other Case 
and it mostly terminates in Absess
and somtimes turns to an 
ulcer    



86
Ulcer which has alarmed the Patients 
very much being suspicious 
of an Ulcerous soar throat
but this is easily deseeded it may 
be determind by the Pulse if ye 
Pulse is full & hard you may 
Depend it is not of the Ulcerous 
Natures-
Cure you are to bleed Purge 
and Blister the Blister should 
be applied around the Neck like 
a stalk, this is the best Place if 
the Patient will Submit to it 
& if this cannot be done, they 
may be applied behind the 
Ears- In some cases, when it has 
come to a suppuration neither 
evacuants nor motion will Brat 
it in this case it is to be opened by 
a Lancet 



87
a Lancet gives imediate Relief  
a bit of coffee will sometimes 
produce a discharge and a bit 
of anything getting into the Trachea 
will exite Violent Coughing 
and produce a rupture of it 
may be made to burst by 
making a person Laugh- 
Cynanche Malygna for 
to give you an exact description 
of this disease I have not time 
and for the History of I 
refer you to Fothergill & Huxhom 
which has treated the subject 
with more accuracy then
any that has yet been published
it has been confounded wth.
the Scarlatina anginosa Doctr. 
Cullen makes it a species of the 
some



88
some disease but in this Respect 
I cannot agree with him 
here for all that I have seen are 
Perfectly different
Putrid sore throat prevails 
most in winter and spring 
the Scarletina not so Cynche
Maligna in moist & warm 
Wether Scarletina not Women 
& Children more subject to Putrid 
sore throat which is not 
the Case with Scarlatina anginosa.
In Maligna Voise flat
& Rough in the Scarlatina not 
so in Malignant sore throat 
the Parts are Lax in Scarletina  



89
Angenoas not so. The Typhus 
Grave or attends the Cynanche
Maligna in Scarlatina Typhus 
Mition-
Cure 1st. to consist in an Emetic
and for this Case Turpith
Mineral is to be prefered 
or calomel with Ippecaccuanha
the Toncels in this 
Case are in a state of Laxity 
& Mercury by its Stimulus 
increases the tone of the Port
and discharges the sloughs
that are collected aboute the 
Posts affected you are not only 
to give a Mercurial Vomit 
but you are to give Repeated 
doses of Mercury we 
may say then that the Cure 
depend 1s.t upon a Vomit them 
upon 



90
upon Mercury- 3rd. Bark you 
must give this in large Doses
4th. Snake root either in Decoction
or Powder with the 
Bark or without 5th. Wine is 
Another Remedy that has been 
made use of with Success especially 
Madeira Wine it  
ought to be given in Large 
Quantities- The Throat [crossed out] 
ought not to be neglected but 
frequently Gargled and kept 
Clean by a mixture of Sage 
Tea honey and Vinegar or Current 
Gelly disolved in Water 
or Vitriolic Acid Diluted or 
diluted muriatic Acid But
sometimes gargling is not different 
to remove the sloughs 
that  



91
that collect aboute the Parts affected 
in this case you are to 
use a Rag fastened to the end 
of the stick and dipped into Honey
alone or if this is not sufficient 
Mel. Egyptecum may 
be used in its stead and If 
this fails diluted muriatic 
acid has somtimes proved 
success full in Removing them 
Fumigations of Vinegar & 
water should be made use 
off but the most Power full   
Fumigation that can be made 
use is Myrrh Boiled in Vinegar 
and the Patient to receive 
the steems in his throat Doctr.
Johnson speaks highly of purifying
the air this ought to 
be  



92
be done by sprinkling Vinegar 
and [trussing] Branches 
of vegetables on the floor &c
what I have here delivered is 
from my own observation 
I never seen this disease Epidemic
in this place but once 
which was in the year 1763 
It prevailed at Salem which 
caried off near 500 Children 
in a very short time-
Cynanche Trachealis Difficult 
Respiration & Rough Vain
is the Characteristic symptom 
of this disease this disorder 
is what is common by called 
the Hyves. It is known by a 
Vorcity of names as Cynache
Trachialic asthma Spasmodica       



93 
dica Croup Angina Membrenacia- 
&c. This disease mostly 
makes its appearance Suden  
tho sometime it makes its appearance 
gradually the Characteristic 
Symptom is not only 
difficult Breathing and a Rough
Voice but a Rough disagreeable 
Cough attends it wch.
makes a noise like the Barking 
of a dog there have been a 
Variety of dispute concerning 
the nature of this disease wether 
it was spasmodic Inflammatory 
or Humoral But I 
think it is necessary to make 
two species of it, the one spasmodic 
other Humoral Docr.
Johnson also adops the Variety   



94
the spasmodic comes on sudenlly
and attended with intervals 
It mostly comes on in the Middle 
of the Night & goes off the 
next day but returns again 
at night these are the Principle 
Pathognomonic Symptoms 
of spasmodic Hives- That 
there is a species occasioned by 
spasm I proved by the desecti.
of a child who died of that disease
in which case there was 
not the least appearance of a 
membrane- the method of Cure also strengthens 
my arguments in favour
of Spasmodic [airtime] Hyves
we first begin with Bleeding 
which evidently acts as an Antispasmodic
Pukes are antispasmodic 



95
antispasmodic and should be made 
use of opium and asafætida
may also be used- 
Humoral this comes on gradually 
the patient complains of  
Cold and is hoars for 2 or 3 days 
and the child being able to go 
aboute you are in the Humoral
to Bleed and to puke but 
there is no remedy equal to Calomel-
There is an increased 
secretion of mucus in the Bronchia 
which is hardened into 
a membranous substance 
by the action of the air You 
are to prevent this secretion 
by exiting a preternatural Excretion 
Els where as we know 
where Preparation Is in creased 



96
increased the Secretion of Urine is diminished 
and Visa Versa you 
may in this case give from 10 
15 grains of Calomel in day with 
advantage if it should Purge 
it is so much the Better for 
by this means at increases the secretion 
in all the Intestine & 
diverts the Humors from the 
Trachea. This 25 years ago was 
allways accounted a fatle disease 
but this is not the case now 
owing to this method of Treatment-
Cynanche Pharynges this 
differs from the Tonularis in only
being situated lower down 
in the throat and upon inspection
we find the tonsil, Inflamed 
The         



97
The method of treatment the [Lasme]
as in the Tonsilaris-
Cynanche Parotidius this is 
what is commonly known by 
ye. name of Mumps it is to be treated wth.  
Purges and confinement lenient 
application to the part affected 
They are apt in men to leave 
one of the Testicles swelled & 
in Women one of the Breasts 
But this in a short time will 
go off without the use of medicines.
The next disease is the 
Scarlatina Anginosa a doubt
seems to have arose with Dor. Cullen 
wither Scarlatina anginosa may  
not be brought in as a species 
of Cynanche his description 
is gust and accurate- When  



98
when it made its first appearance 
hear. We only had an Eruption
in most cases, but as the cold wether com 
on the Ulcers in the Throat began 
to appear- somtimes we had Eruptions 
and Ulcers Both and 
one symptom (when it made 
its appearance here two years 
ago) was a sickness at Stomach 
which never was absent 
in any case that fell under 
my observation & there was 
pretty generally a burning of 
the Ears now and then Coma
but not often it often went 
off with Coma when the Coma 
come on 6 or 7 days after the attact. 
I always considered it as a
fatle Symptom- some died before 



99
before it was time for the Eruptions 
to make its appearance 
that is in the course of 2 or 3 days 
after the attact. the five 
attending this disorder is the 
Typhus Mition-
Cure an Emetic is the first 
thing that is to be exheluted
here more emetics may be 
given there in Cynanche Maligna 
they may be often Repeated 
without producing 
bad effects Calomel is also 
as use full here as in the Ulcerous 
Sore throat Blisters
behind the case Injections Gargles  
are also of Use here but 
not so much as in Cynanche 
maligna in [crossed out] the symptoms 



100
symptoms of Coma Wine when ye 
Pulse is slow is use full. I have 
seldom seen the Bark necessary 
befor the 9 or 10 day- wth.
respect to bleeding I never see 
but one case where it was put 
in practice tho not by my
orders the Blood was in a very 
disolved state, when symptoms 
of synocha appear
Bleeding may be proper- 



101
Lectr. 9th
Pneumonia very properly consider  
as one Genera by Doctr.
Cullen and Pluresy and Perepneumony
is only species symptoms 
Pyrexia Pain in some 
part of the Chest difficultly
of Breathing & Cough therein
some Measure attend Both 
Plurecy and Perepneumonia
there is cases of Perepneumonia 
ending in plurecy and Plurecy  
in Perepneumonia. It is of 
concequence to extend our Idea
of this disease when we meet 
with a pain in the side we 
pronounce Plurecy but there 
have been cases of Plurecy wch
has come on by a pain in ye 
shoulder 



102 
Pain in the shoulder and in 
some cases pain in the Back 
for as the Plura surrounds every 
part of the Chest we may 
easily conceive that a pain 
may be felt in any part of 
the Thorax somtimes the Pain 
comes on very low down in 
the Back and resembling Lumbago
somtimes the Pain 
is felt very low down on 
both sides these remark is of 
consequence as there are 3
or 4 diseases which may be 
mistaken for Plurecy as a Pain 
in the shoulder attend inflammation
of the Liver in 
the Back Lumbago low down 
in the sides Colic &c.
Perepneumonia



103 
Perepneumonia the Pulse not 
always hard tho somtimes Obtuse 
Pain in the Chest Difficulty 
of Respiration both Standing 
and lying face Purple Cough
with spitting somtimes Streaked
with Blood when the Parenchematous   
Substance of the 
Lungs is affected the Pulse is Soft
but when the membranous 
parts the Pulse is Hard and full 
Perepneumonia is Idiopathic & 
symptomatic Idiopathic is 
Symple & Complicated Symple 
is Catarrhal or Perepneumonia
Notha. Catarhal is only is only 
Perepneumonia attend with 
a catarrh and you will often 
find it connected with 
Catarh 



104
Cararrh is an inflammation 
of the Mucus membrane of 
the Trachea and Bronchia 
Perepneumonia Notha is yt
species of Pere pneumonia that 
is allended with a soft Pulse 
occalloned by an obstruction of 
the Paranchemitous substance 
of the Lungs Symptom is 
difficult Respiration Anxiety
Purple face Cough moist 
frequently tinged with Blood 
you will frequently meet 
this Species of the Pneumonia
and it is thought to be the 
most fatle. It somtimes caries 
of the Patients in the 
course of 2 or 3 days after the first 
attact I have somtimes 
& 



105
& I think with propriety 
called it an apoplexy of the 
Lungs as there is a congestion 
of Blood in Lungs constituting
Perepneumonia Notha
in the Same manner as 
a congestion in the head produces 
Apoplexy Perepneumonia
is somtimes complicated
with a Variety of other 
disorders it is somtimes 
combined with Typhus [Meteor]
Gravior & Meteor to which it 
often tends hence Perepneu: Notha 
gets the name of Perip: Putradæ
Doctr. Huxham give a History
of an Epidemic Plurecy 
that would not bear bleeding
and after one Bleeding 
there 



106
there was a great Prostration 
of Strength took place this 
was a Plurecy combined with 
a Putrid Disease you’l [ofter]
find it more frequently combined 
with Typhus Meteor 
& in this Case sal Vol becomes 
necessary-
Symptomatic Perepneumonia 
you’l likewise meet with 
this often the Gout may 
produce this specis of the Disease. 
Eruptions on the skin
as small Pox Measles & there 
are what is called Perepneumonia
Exanthematica. It 
also affects Phthisical People 
and those affected with Hydrophobia 
most likely to be 
affected       



107
affected with this Disease
Plurecy Symptoms. Hard 
Pulse. Pain in the side mostly increase by inspiration
Difficult & Painful cough first 
Dry then moist.
It is divided into Idiopathic
complicated & symptomatic 
[symptomatic] Complicated is that described
by huxham under the total
Pllura perepneumonia this 
is the Plurecy complicated with 
Perepneumonia it is distinguished
from the Perepneumonia
by the hard pulse & Pungent 
Pain in the Side it is somtimes



108
somtimes combined with Typhus 
& Catarrh as well as Perepneumony 
it is als either True or 
False-
Cure the Plurecy requires the 
same method of Cure as the true 
perepneumonia that is 1st Bld.
letting this of the utmost Consequence
in Inflammation of ye
Lungs & side as they are very
apt to suppurate and in the 
side produce empema and in 
the Lungs a Vomica & it has 
said by some that half Cured 
Plurecies says the foundation 
for a most all Consumption 
Various directions has 
been given with regard to the 
Quantity of Blood to be taken 
Cloghorn 



109
Cloghorn Bleeds Largely the 
mostly at one Bleeding takes 
ʒxx some have been timeous 
with regard to bleeding those 
Pluretic Patients that had 
an Intermitting fever the Preceding
Spring those kind of 
People are More liable to be affected 
by Pleurecy & more Violint than any   
others owing to the great Irritability
produced by the fever 
this Patients ought to be largely
bled  
But as our diseases is not so 
violent as those that come under 
Clog horn notice I mostly 
Direct ℥16xys and two bleedings 
one 



110
generally sufficient but in 
Pregnant Women affected with 
Plurecy I have bled 11 or 12 times 
your Judgment with regard to 
Bleeding is to be formed from 
the Pulse while ever the Breathing 
remains difficult and the 
Pulse Hard Bleeding is necessary 
you are to treat this as 
you would an Inflammation
of the Lungs. People that 
have received wounds in their 
Lungs are to be treated exactly 
in the same Manner 25 Patient
with Balls through their Lungs 
was brought to the Hospital at 
New York out of which 24 Recovered
& soly by the free use 
of Blood letting- I have second 
a  



111
a patient recover from a wound 
through his Lungs after 
Losing ℥CXL of Blood after 
Bleeding Nauseating Diaphoretics 
Neutral salts act Powerfully 
but they act more powerfully 
when combined with 
some diaphoretic as Seneca &c 
this Last is a good Medicine it 
induces sweat without Quickening 
the Circulation there has 
been several ways of giving 
this medicine but the mode 
in which I give it is ʒy Boiled 
in a Quart of water to a Pint 
and at a table spoonfull to be 
given at a dose Glysten are 
of the utmost service in this as 
when they are drove with 
four 



112
source the Reach the greate 
Curvature of the Colon which 
Runs under the stomach and 
Relates all the Parts in the Neighbour  
hood of it merely by its
warmth when its common 
warmth is only wanted to the 
Plura it may consist of nothing 
else but warm water But if 
it is wanted to purge Common 
salt may be added
Blisters are off the Greatest consequence
especially when applied 
to the Part affected it acts 
as an evacuant and antispasmodic 
there is no use of keeping 
the Blister Running if it 
has a tendency to dry up lit 
it dry and apply another 
after sufficient



113
sufficient evacuations have 
been made the Cough still Remains 
troublesome you are 
to compose it by gentle opiates
these should be given at 
at Bed time somtimes it happens 
that the matter that is 
caried off from the Lungs abrades 
the part through which 
it passes Demulcent Drinks 
are of use but the first but 
and most easily procured is flaxseed 
Tea as it is very disagreeable 
you to direct the flaxseed 
to be washed that is pouring 
Boiling water on the seeds which 
whashes off all direst and impurities
from them which 
renders shave more fit to be 
made 



114
made use off but after these 
precautions have been observed 
the stomach somtimes Rejects
it it ought in this case to be 
combined with Hysop which 
takes off its mocrphinish taste if 
this fails lime or lemon juice 
may be added another Tea 
is what is called Bran tea here 
Refinement is necessary it will 
not yield all its demulcent
Qualities meanly by Pouring     
Boiling water upon it but it 
ought to be boild in water till 
one half is boiled away if his 
stomach is turned at there two 
Hysop tea alone may be alowd 
but if tired of all these Barley  
water with reasons boiled in it 
makes 




115
most great full drink stimulating 
tear off all kinds to be avoided 
Wine Whey is improper unless
symptoms of Typhus is preasent
Expectorants likewise to be used 
such as oxymel of squils purpose
it does not act entirely as an Expectorant
Oils are expectorants and Demulcents 
in this disorder but they 
are apt to produce sickness at 
stomach so that they ought to 
be used with Caution-
mucilage is to be preferred as a 
Demulcent but the first Expectorants 
is Vol: salts where 
the Inflammatory diathesis is 
entirely Subdued 5gr. of this medicine 



116
Medicine is the Best that can be given as 
an expectorant in this Case 
somtimes when the expectoration 
is decreased the Pulse Moderate 
a Pulse may be given 
with advantage and for this 
purpose Oxymel scillitic is ye 
best beginning with small 
doses and Increasing them till 
they put warm water in this 
case is unnecessary as it is 
not the Contents of the stomach 
we want to evacuate but 
to promote Expectoration 
about the 7 or 8th day when you 
are looking for a crisis the pulse 
should become fuller Breathing 
difficult Bleeding should 
again be put into Practice 
cure 



117
Cure of Perepneumonia Notha 
Bleed give antimonials Blister
give Expectorants &c in short 
the treatment ought to be 
similar to the other species of 
Perepneumonia pay no regard 
to the small Pulse Perepneumonia 
Notha is one of those   
cases whening Boldness is Necessary-
I myself have been 
relieved several times of this 
disease by bloodletting [which] 
I believe if this had not been 
put in practice. I should have 
expired- With Respect to 
symptomatic Perepneumonia 
those diseases of which they are 
a symptom should be Cured 
before- Vomica and 
emprema 



118
emprema are the termination 
of those diseases namely Perepneumonia 
an Plurecy
you are not to abandon on your 
patint when are a one of them 
happen as I have seen Recovries
whose there has been both 
Vomica and Empiema -



119
Lectr: 10th feby. 1786
Carditis this is an Inflammation 
of the heart but it seldom
occurs it is attended with Pain 
in the Region of the Heart difficult 
Resperation.
it is divided into Idiopathic 
& symptomatic 
Peritonitis this you will meet 
with now and there In Books 
and  seldom in Practice Child 
Bed fever comes the Nearest to 
it and youl find this Treated
in Hulm White Day’s &
writ well upon In warm Climates  



120
mates it is combined with 
Typhus Metior or Gravior and 
is to be treated like those and in 
Cold climates it is mostly attended 
with Inflammatory 
fever and is to be treated with 
a synocha in the 1st. Case Pulse 
& Tonic as task and in the 2nd.
Bleeding & the Antiphlogistic  
Regimen- the most part of those 
Cases that Happen in this city 
Require Bleeding and the Antiphlogistic 
Regimen at all times of 
the year-
Gastritis this you will often 
meet with Symptoms is 
fever of the Typhus kind Pain 
in the Epigastric Region vomiting 
Regreting. all that is taken 
into 



121
into the Stomach it is Idiopathic 
& symptomatic Idiopathic 
Proceeds from all Internal 
causes In consequence of 
Inflammation or from External 
Cause that is any thing 
Received into the stomach There 
is a species of Gastritis attend 
with Eruptions in the stomach 
in the case Pain not Violent 
fever moderate Exanthemata
in the throat Vomiting 
this is a Chronic Gastritis In
this case the Patient is able to 
walk aboute when Cold water is 
taken into the stomach it is 
immediately rejected but Warm 
water will remain on the 
stomach very sight victuals shd
be



122
should be allowed spirit disagree 
with the stomach of the Patient
Symptomatic Gastritis is from 
Morbific Matter in the stomach 
as from small Pox Incarcerated 
Hernia Gravel particularly 
when Lodged within the Kidney 
There is one cause of Trice Gastritis 
that I omitted mentioning 
which is that from Cold 
water taken into the Stomach 
In the Idiopathic occationd by 
the common causes of Inflammation 
the Cure the same as in other
cases of Inflammation mannerly
Bleeding Glysters and Tepid 
Bathing Avoiding irritation & 
If it proceeds from external Causes 
as taking Poison into the 
Stomach 



123 
stomach the first thing to be 
done is to exite Vomiting by the 
administration of an Emetic 
if it can be done [?] if not diluents
to be made use off water 
is to be preferred oil has been 
used but this acts Chemically 
& cannot be given in sufficient
quantity when a large quantity 
of an opiate is taken there 
is no other way there by pouring 
in large Quantities of warm water 
and in proportion as it is 
diluted its effects are destroyed 
but if it has already produced 
inflammation the treatment 
is to be the same as 
inflammation in Common 
large draught of Cold water not 
only  



124
only inflames the stomach but 
in some cases, the Liver & Bladder 
but mostly the Stomach. It somtimes 
taken of the Exetiment
of the whole Nervous system
in a short time In order
to produce this effect 1st the 
Body must be very warm 2nd the 
Water or Liquor very Cold & 3rd. A 
Large quantity of water is be [ Dra]
Drank at first the patient feels 
a violent Pain in the stomach 
so violent as to produce. Fainting 
and if he does not die during 
this fit he comes too and 
Relieved of Pain but after a 
short time the Pains Returns as 
violent as ever the Patient faints
again and in some cases 5 or 
6 fits  



125
6 fitts which succeed each other 
till it terminates in death 
or happy The Common Method 
employed for to Remove 
this Complaint is Vomiting 
but nothing can be so improper 
another remedy that has 
been made use of is bleeding 
this may in some cases do good 
when the brain reacts but generally  
the action of the water is 
sedative- You are to reject 
Puking and not to wait for 
Bleeding. The most power full
antispasmodics should be made 
used the best of which is Laud: 
Liquid. I never lost a Patient yt
could swallow Laudanum It 
is to be given when the Patient 
is  



126 
is clear of the fits that is between
two of them 
The Terable effects of Cold Water
[is to] may be prevented by 
1T. waiting till the body is Cold 
2nd. or untill the water gets Warm
3rd. by mixing spirits with the 
Water by receiving the shock 
of the water in some other part 
of the body and not immediately 
in the stomach, the reason 
why horses are not affected by 
drinking cold water is because 
they have their feet mostly 
in the water when they are a 
drinking. This species of Gastritis  



127
Gastritis is cured radically by 
making use of a slender Diet 
of a vegetable kind Demulcents 
particularly flaxseed tea Camomil
tea may be mixed wth. 
it to brace the Stomach and 
[hear] the Bowels ought to be 
kept Gently open. Moderate
exercise is to be made use of 
The Symptomatic Gastritis 
is to be Cured by Curing the 
Original Disease  
Enteritis symptoms Nervous 
fever a pungent twisting 
pain aboute the Navil Vomiting 
the belly obstinately 
Bound they as Idiopathic 
or 



128
a symptomatic. The Idiopathic 
are Phlegmonodea or Crasipilatosa 
this proceed from 
the usual causes of inflammation 
or from external 
causes as in the Gastritis 
The first species is to be treated 
the same as in the Gastritis 
by Lenient. Purges Demulcents 
Blisters &c
The Erasepelatora is not so 
easily subdued but the manner 
of treatment in the same 
as in gastritis by demulcents 
&c. &c.
Hepatitis Fever tension and 
pain of the Right Hypogastric 
Region sometimes pungent like 
a Pleuritic after obtuse a pain 
at  



129
at the Clavicle [and] of the Right 
shoulder a pain on Lying on 
the left side Dyspnea Dry cough
Vomiting Hiccup some have 
added a yellowness of the 
skin. It is sometime confounded 
with Plurecy & is to be 
distinguished from it by the 
pain all ways being on the 
right side and a pain in the 
shoulder on the same side the 
Pain in the Plurecy affects both 
sides Promiscuously. In the Hepatitis
the Patient can only lay 
on the side affected in the Plurecy
not there is a vomiting 
attends the Hepatitis in the 
Plurecy not Hepatitis sometimes 
come one with symptoms of Colic 



130
Plurecy not so [illegible] Varieties
in this disorder is Acute and 
Chronic Docr. Cullen gives a 
just account of the Acute Hepatitis, 
the Chronic is the same as 
the Acute only the symptoms 
are milder Eyes are more Yellow 
then in the Acute There 
is Inflammation without Pain 
or Heat Dissections have shewn 
that Suppurations & mortifications 
has been preasent in 
the kidneys without any 
pain previously attending it 
Cure Treatment of Acute Hepatitis 
is by 1st. Blooding letting very 
copious indeed as there is no inflammation 
so liable to suppurate
as that of the Liver
2



131
2d. the Bowels to kept constantly 
open 3d. Blisters to the Part
affected. 4 But our sheet Anch.
or should be Calomel begin 
early and give considerable Quantities  
up to 20 or 30 or 60 grains
untill it affects the Mouth- 
In this case it opperates as it 
does in the Croup by in creasing 
the Excretion in the Bowels 
and diminishing it in the 
Liver- somtimes in spite of 
of all [crossed out] the evacuations an 
abies well form after 10 or 12 
bleedings. When the Abcess Points 
outwards an Insicion ought 
to be made in the Liver- 
Chronic Hepatitis is to be treated 
the same way varying the 
strength 



132
strength of the medicines in proportion 
to the disorder-
Next disease is the 
Splenitis but this disease seldom 
occurs- 
Symptoms Fever heat Pain & 
tension of the [Hy] left Hypochondriac 
Region increased 
by pressure without any 
signs of Nephritis- 
Cure is the same as in other 
Inflammations. Bleeding &c



133
Lectr. 11th. 
Nephritis symptoms Inflammatory 
fever pain in the Region 
of the kidneys shooting down 
along the course of the Ureter 
A retraction of the Testicle of the 
same side and a numbness of 
the thigh at the side affected 
& Vomiting urine somtimes 
bloody- 
it is either Idiopathic or Symptomatic 
the latter happens from 
Calculi & Gout. Idiopathic  
does not happen so often as the 
symptomatic, Cure 1st. Bleeding 
very Copiously 2d. keeping the 
Bowels gently open by Lenient
Laxatives but this is best doses by 
glisters because there is frequently 
an   

an obstinate vomiting that 
prevents the exhibition of laxatives 
and from the Colon being  
directly on the kidneys the 
glyster answers the purpose 
of a warm fetus to the Inflamed
part, anodine Linaments   
& Bladders of warm water 
applyed to the Region of the 
Kidneys are very serviceable,
after the inflammation 
is removed anodines are 
serviceable to appease the 
[inflammation] irritation 
all irritating drinks and 
food are to be particularly 
[affected] avoided- The Mucus 
lining the pelvis & other parts 
in which the Calculous is  

134
lodged is abraded wherefore 
demulcent drinks should be used 
as flax seed or Mallows Tea or 
barley water to supply its [place]
you should forbid the patients 
lying on his back because of ye 
irritation from the prepuce of 
the intestines especially if felled 
with fœces Blisters are improper
applied the part as the particles 
of Cantharides absorbed 
might prove too great a stimulus 
and there by increase the 
inflammation.-
Cistetis   



135
Cistitis, Fever pain & the tension 
of the Hypogastric Region 
Painfull to the touch Painfull
pessing. & Tenesmus- 
It is either from Internal that 
is the common cause of Inflammation 
& External as from 
Calcula wounds &c in the Bladder-
It must be treated 1st. by blood 
letting copious- the Cistitis does 
not communicate Inflammatory 
diathesis to the Whole System 
tho the size on the Blood is 
greater here these in any other 
case of Inflammation Pulse 
is very hard here & according 
to Docr. Bonds opinion if bleeding 
is not need it terminates 
in



136
in abscess Schirrhi or gangrene 
Antiphlogistic regimen ought   
to be made use of. The Appetite
ought to be restrained as in this 
case the appetite still remains 
animal food ought to be forbidden 
all those should be directed 
that contain but little 
nourishment as Roasted apples &c 
Bowels to be kept open by Laxative
Emolient Glysters as  
this will relieve the Tension 
of the Parts- In cases of Violent 
Iscuria the Catheter should be 
introduced to draw of the Water 
Hysteritis heat fever tension 
pain & Tumor of the Hypogastric Region 
the Region the os uteri Painful 
to the touch: Tenesmus. 
A

* it is Acute & Chronic 

137
It is either Idiopathic or symptomatic. 
It is seldom produced 
by Cold but mostly by
Child bearing The treatment  
is the same as in other Inflammations.  
Viz Bleeding Purging 
&c when the Hypogastric Region 
is Swelled a fomentation of 
warm water to the part affected 
is of Great used.
Rheumatism Pyrexia from 
external and for the most part 
from evident cause Pain of the 
large joints particularly the 
knee following the course of the 
muscles seldom affecting the 
small joints * It is symptomatic 
& Idiopathic. The Idiopathic 
Varies wth. regard to the fat
affected 



138
affected as hip Loins &c. [symptomatic]
affects Knee Elbows 
Loins it somtimes effects the Bones 
below the Joints as Sacrum 
& it affects the Breast Producing 
false Plurecy. It is distinguished
from the Gout in not 
affecting the small joints wch ye Gout does 
as the feet hand &c but ye Large joints 
Lumbagos is sometimes confounded 
with Nephritis and sometimes 
with Plurecy but it 
is to be distinguished by having 
no cough and painfull to the Touch 
the we sometime find Rheumatism 
and Plurecy allimate wth
each other.- 
Symptomatic Rheumatism is 
very numerous- You have 
heard 



139
heard of Foundering Horns and 
I take it to be nothing but Rheumatism 
the foundering of Horns 
is accompanied with Pain in the 
Back feet &c and the Cause that  
Produce the Rheumatism in the 
Human Body after being heated 
drinking large Quantities of Cold 
Water or Eating stimulating 
food produce foundering in 
horses. The Cure exactly the 
same as in human Person by 
Bleeding &c There is another Remedy 
to turn horses out to Grass 
& there is vegetable Diet
Cure of Acute Rheumatism 
Copious Bloodletting. General 
& Topical, from the arm and 
by Leeches applied to the Port
affected



140
affected Bowels ought to be kept 
open by Neutral salts as they 
are Sedative as well as aperient
Blisters applied to the part affected 
by taking of the Spasm &c
are of the greatest service-
it is of consequence to alleviate the 
pain this may be done by Cabage 
leaves & molasses to ye Part.
affected Diet as in other inflammatory 
diseases must be 
strictly all ended to. sometimes 
all that has been recomended 
fails the Blood remaining Sizy
Mercury in this care has been 
of the greatest use it well 
in small doses act as a sedative 
and reduce inflammation 
but in Large doses it acts as 
a 



141
a stimulus Mercury never produces 
inflammatory diathesis unless 
it salivates you are therefore 
to give mercury as an aperient 
which will in 4 cases out 
of 5 in 10 or 15 days cure or relieve 
the Rheumatism.-
Chronic Rheumatism or arthrodenia
is generally in consequence 
of acue rheumatism. Remedies 
for this disease is nearly the Reverse 
of acute Bleeding is necessary 
you should exite the action 
of the Sanguiferous system 
and determine to the Skin
[flaxceed] tea should be drank-
flannel shirt flannel Drawers 
and worsted stockings and Lastly
warm Bath and where 
that  



142
that fails or has not been Used 
Exite the action of the Extreme
Vessels by volatile tincture of 
of Guiacum a table spoonfull
three times a day it exites  
the action of the Extreme vessels 
and determines to the Skin 
mercury comes under this head 
It ought to be given sufficient
to exite salisvation Cold Bath to 
exite the action of the system Hot 
Bath to act as a stimulus. It 
must be above the heat of the 
heat of the Body. Blisters have 
been recommended with advantage 
If they have any affect it is from 
their evacuant Quality It
ought to be kept Running like 
an Issue where the Part loses its
mobility



143
mobility Friction with the flesh 
Brush &c suspending weights to 
the Lime that has been reduced 
by chronic Rheumatism has 
been found of good effect-
when everything else facts we 
must have recourse to chang of 
Climate and particularly to 
a warm one and he must not 
only take a tea Voyage but must 
remain at least 2 years-
Odontalgia this is an Acute
or Chroni Rheumatism occationed
by a Canous Tooth- but it 
is somtimes without carious
Teeth and I believe the Carious      
is produced by an inflamma
of the Tooth and that this is the 
original and proxemate Cause  
and 



144
and from there argument tooth 
we see that tooth act proceed Caries-
Tooth mostly takes place in 
place in Variable Latitudes and in 
latitude that or not variable 
Tooth ach is a perfect stranger 
That is owing to inflammation
is fur thus proved from its 
occurring in inflammatory [Diathesis]  
seasons and age of life. This 
is the Acute Tooth ach- But 
you will somtimes meet wit a 
Chroni tooth ach, which a most 
dreadful disease indeed Called 
asthrodened several specis of it.   
occasioned by the gotet. Catarrh 
Pregnancy &c.- Chronic like 
the Acute Rheumatism [ of the tooth]
of the Toot is [attent] without Corse 
Bleed 



145
Bleed Blisters and Purge. If it is 
Carious extract it, if this cannot 
be done the same treatment as 
the above will be proper Decayd.
part kept Clean, If it is in Contact  
with other teeth they ought 
to be separate wit a file wth.
respect to the mode of extracting
I refer you to practicle writen 
Tho I have Remark to make 
upon this subject you should 
Never draw a tooth during the 
pain as the Inflammation is 
great during it but all prefer
that time to extract the 
tooth when the patient is totally 
free from pain.-
I will say a few words to on the 
Transplanting of teeth, the fix
in 



146
fix in the jaw mechanically just
like a Nail does in a Board 
& the jaw fixes round it in a mechanical 
manner not as some 
has supposed by the Vessels & [Viner] 
of the Tooth uniting with those 
of the jaw Docr. Spence Drew ye
Tooth of a Dog and introduced 
a piece of wood and found that 
it adhered as well as any tooth 
would have done but they never 
last more than 4 or 5 years 
and upon this Principl a dry  
tooth will last as long as fresh 
one.-
Cure of the Chronic Toothache avoid 
Cold & use [ in general] the Remedies 
we have recommended above [it] To prevent 
it sleep with a wolen night Cap-
Lectr:



147
Lectr: 12th.
Gout hereditary disease preceded 
by disorders of the stomach 
Pains of the joints of the hands & 
feet particularly the big toe seldom 
or never affects the Large 
joints alternating with disorders
of the stomach & Bowels.-
It is not hereditary from Morbific
Matter in the Habit kept by 
a certain texture of the Body 
Decent of the gouts is a little 
particular it somtimes decends 
from a grandfather to a grandson 
and somtimes escapes the 
father it appeared very early in 
when there is a hereditary predisposition 
somtimes so early 
as 7 or 8 , but 15 or 16 it frequently 



148
frequently appears it is not only Hereditary 
with Regard to men but 
also in the female sex . If a mother 
is affected with the gout it is the Daughter
that gets the disease & V.V.
it often appears in females in 
the form of ye irregular Gout 
their constitution has not tone 
enough to throw it on the Extremities.
The Goute is divided into 
4 Species 1st. Toni. 2d. Atonic 
3d. Retrocedent. 4 Misplaced.- 
The Regular or Tonic Gout is yt
species which persons one of the Joints 
it comes on in the Night 
with Pain Kidneys swelling & goes 
off [in the] with itching and scaling 
of the feet.-
Next species is Atonic which never
falls 



149
Falls upon the extremities but 
Seizer on some of the Vicera
Retroceedent where it first appears
 on the Extremities and then 
flies to the Internal Parts. 
Misplaced 
The regular gout is as much 
curable by proper, Management 
as the intermitting especially 
when acquired by high living 
The Radical cure of the Gout 
is to be affected by diet and 
exercise. The Reason why so
few radical cures is performed
is because the Patient who acquire 
it is so easy in life that 
you 



150
you cannot deter them from 
high living low diet and 
labour or Exercise. Milk is of 
the Utmost consequence the Kind
of Labour or exercise to be 
prefered is walking & working 
with the hands but moderate 
exercise with the feet is to be prefered.-
Red wines is improper 
Cyder is improper where a 
moderate Quantity of Wine is 
required old Maderia is the Best 
besides Labour and diet, there is 
another Direction there is another   
direction to be taken notes of 
which is keeping up the perspiration 
The Gout never attacks
in the Sommer but always in 
the Inflammatory seasons and
more  



151
more frequently in damp Cold Climate 
then in Moderate one. The 
Perspiration to be kept up by wearing 
a flannl shirt. a shirt 
in this case is to be preferred to a 
Waist Coat as it covers best part 
of the body but when the breast 
is only affected the waist coat 
will answer the shirt ought to 
be frequently changed and will 
obstructs Perspiration rather there 
keep it up in so much, then 
for the radical cure of the Gouts
But it is imposable to procure 
a medicine that will Eradicate 
the Gout.- During the 
fill it is to be treated as an inflammatory 
disorder Every fit 
that Runs its course atom what 
imparts



152
imparts the Habit and renders 
it more liable to be attacked by ye 
next and more deplorable species 
of it.- The Remedies proper
for this is Bleeding Laxatives Blisters 
& certain topical topical applications.-
Bleeding in the 
inflammatory stage is as effectual 
as in the Plurecy but in 
the atonic Gout it is attended 
with bad consequences- 
And after the Patient is 40 or 
45 years of age bleeding is to
used with Caution. But 
in the early and inflammatory 
stage. I would bleed plentifully 
as the Blood is covered wth.
an inflammatory crust & one 
bleeding is generally sufficient
Laxatives 



153
Laxatives must be used of the most 
lenient kind as sulphur &c
if it should not yield to Bleeding 
or the Patient will not submit 
to it or you have doubts 
concerning the Necessity of it use
Laxatives and Blisters. Blisters 
may be used later in life then 
Bleeding. if their stimulus should  
prevail they are improper but 
if they are antispasmodic they 
are the most Proper in avoide
stimulating application of all 
kind such as camphor &c I have 
known application of Liquid 
Laced: mad with success soft flannel 
in order to promote [Infla-]
Preparation is of service and 
was thought to be the only application  



154
that made use of with safety 
Dr. Small throws it out as a conjection
wither Cold applied would 
not be attended with advantage 
and he allways made it a practice 
to walk as soon as posable 
which prevents Lameness 
this Should be confined to the 
Tonic Gout so much then for 
The Tonic Gout all the Remedies
above are to be confined 
to persons under 36 years of 
Age there are very few beyond 
40 that will bare the Change 
of Diet the constitution becomes 
so habituated to high living 
Atonic Gout Should you yt
gout alternate with affections 
of the Stomach and in proportion 



155
proportion as the atonic prevails the 
stomach is more or less affected. 
Mr. Small directs a puke 
in every fit of the Gout which 
shortened it and Caried it off
sooner than common. This I 
think may be of service-
In this state of the goute the 
first thing to be done is to make 
it regular if you can 
by bathing the feet or Cataplasms 
applied as bread Milk 
& Onions but if the attack on 
the bowels is violent Stimulating
Poultices ought be applied 
as flower of Mustard it ought 
to be applied to the instep 
of the feet as the Poultices gives 
Pain take them off But you
in 




156
in this case are not to neglect internals 
The tone of the Stomach is 
is to be supported by Wine Whey 
Wine & Even Spirits Besides
those drinks recommended there 
are other medicine which is of 
the utmost service, Volatile alkali 
deserves to be first mentioned,
this is one of the Best medicines 
that can be made use of 
in these cases-
Misplaced & Retrocedent Gout.
they are to be treated as the atonic
with difference only if it should 
happen to fall upon the Lungs 
so as to produce inflammation 
a small degree of Bleeding will 
be necessary, this is a disease yt
can counterfeit any disease that 
the  



157
the human body is subject to It
mostly affects the kidneys, the Bladder 
&c in the Bladder it produces 
Catarrhus Viscæ it somtimes 
Alternate with the Hæmorhoids. Its 
somtimes seizes the throat the Jaw 
and they Ear. I once mentioned    
to Mr. James Jay that. I have known
the gout to counter fit every disease 
of the human Body but 
[the gout] a salivation but he 
told me that he had seen a Copious 
salivation Produced by yt
Gout, Besides the Remedies above 
recommended opium may be 
used. There is a remedy that has 
been made use of with Success in 
the Gout of the Stomach which 
acts as a Cordial and Tonic this 
is  



158
is London Porter wth would lay
upon the stomach when every 
thing else is cast out. There is 
one symptom which is always 
a fatle one, this is a diarrhæa 
& If he has got a diarrhea that he 
is able to go aboute with you 
may give him over for Lost 
[in this gout]. The Radical Cure 
of the Gout is never to be attempted 
you are to indulge him 
in animal food of a Weak Nature 
& Boiled when he is below 40 
but when he arives to the age of 
40 his meats cannot be seasoned 
enough Beef and mutton 
should be their Chief meets 
you are not to forbid the use 
of Wine but you are to Regulate   



159
Regulate them Red Wines and Cyder
are to be Rejected a little good 
old materia taken every day 
is of Use Gentle Exercise should 
be made use of such as walking 
and Riding on horseback. Issues 
has also been of the Utmost Service 
But joind with moderate diet 
exercise and Issues keep up ye 
Perspiration by wearing flannel 
which is of the of the Utmost Consequence
in the atonic Gouts 
Arthropeuosis Pains of the joints 
or muscular parts often after Contusion
being deep obtuse tedious either no
term our or if any very small & 
diffused no inflamn. fever first mild at 
length hectic & & finally an abces of ye Part 
Vegetable diet mercury antimonial 
& Bark keeping the 
sores clean by digestive 
med



160
medicines sometimes I find 
it Necessary to make use 
of more acrid medicines as 
Docr. Martins Powder-
The Next order of Pyrexia 
are the Exanthemata which we 
we will go on consider at 
our Next Lecture-



161
Lectr. 13th.
Exanthemata Contagious 
diseases affecting persons for 
the most Part but once in 
their Lives- 
Small Pox Symptoms Contagious 
inflamatory fever comming 
on on a certain day of 
the disorder vomiting Pain
upon pressing the Epigastric
Region a pain in the Back 
more acute then in any other 
disease Peculiar smell of the 
breath nearly like burnt Sulphur
but this last Symptom
is a certain Criterion of the small 
Pox as it happens in some 
other diseases where there is no 
small Pox on the 3d. day an Eruption 



162
Eruption begins & finishes on the 
5th. on the 8th. begins to dry and 
fall of in Scales. This definition 
is general and has many Exceptions 
for there are instances
of a Second Crop on the 8th day 
this happens somtimes in the 
Natural way but mostly to Inoculation,
but I [will] is Generally 
confined to 8 days and 
will dry away when there are 
few in number but when they 
are confluent they continue 
Longer- The Eruption somtime 
begins on the first day and somtimes 
in a few hours but this is 
a dangerous. Phenomena. 12 or 14 
days are necessary for the matter 
in the small Pox in the Natural 
way 



163
way to produce its effects it 
sometimes taken 20 days to produce  
its effects.-
The Species of small Pox are distinct 
and confluent- For particular
I refer you to Sydenham
Synocha attends the distinct 
& Typhus attends the confluent
Small Pox- It has been 
an opinion among Physicians 
that it was possable
to extirpate to extirpate the 
small pox entirely out of ye
habit this was the opinion 
of Hellery & Mead. I think myself 
that this may be done in some 
degree but not so much as these 
Gentlemen think. If the 
fever be Synocha Bleed Largly 
&



164
& if this is plentifully done 
Vomit & Purge vomiting to be began in ye Morning 
& kept up untill 12 oClock in the  
day purging untill 12 oClock 
at Night the Purge ought to 
consist of Jalap and Calomel 
But if the fever be a typhus ye
method will not answer Pneumonia 
often comes on at the turn 
of the small pox and is to be treated by 
bleeding & like that from Cold- 
aboute the turn of the Pock 
there is a Ptialism frequently 
comes on which being checked or 
obstructed togeather with a stoppage 
of the evacuation of Mucus in the 
Bronchia often occasion a speedy 
suffocation nut it may be prevented by 
a timely use of expectorants of 
which oxymel sullit is the Best  



165 
as the pock after the Eruption 
is very painfull the patient 
ought to be kept easy- Aboute 
the 7th or 8th day the Swelling 
of the face falls into the hands 
& Feet but it sometimes happens 
That is falls upon the 
throat & Lungs to prevent its 
falling on the Lungs Squills
& Bleeding on the Throat Calomel 
you are to promote ye
swelling of the hands and feet
by soaking them in warm 
water frequently and in some 
cases large Poultices of Bread & 
Milk should be applyed to the 
hands & feet, the Bowels to be 
kept open a stool to be promoted  
every day as soon as the swelling 



166
Swelling of the face begins to subside 
the Bowels ought all way to be 
kept open by sulphur. The 
Patient ought to be kept Clean 
in every stage of the diseas but 
particularly when the Pock is a 
drying to prevent marking opening 
them ought to be put into practice 
and the matter washed off 
the Part after Patient Recovers 
it is just to give two or 3 
Purges as there is a great conection 
between the Skin and Bowels- 
Confluent, you are to consider
this as a Typhus Gravies
or Metion, The Afrecano make 
use of an ointment in this Case 
composed of Kian Pepper with Great 
success and Relieve the Patient 
in



167
in two or three days after the 
Ointment has been rubbed on the 
Patient to be dipped into Cold 
Water But this appears to me 
to be a Doubt full Remedy- 
Where the damages is great. I make 
use of Bark, Wine & Cordials
of all kinds which ought to 
be given in Large Quantities I 
cannot recommend there from 
the good Success. I have had 
from the administering them in 
my own Practice But I have 
seen them used with success 
in cases where there has been 
a small degree of mortification
Chicken Pox. Symptoms [Breaking 
out] Inflammatory fever 
Pustules breaking out after 



368 
after a short slight fever like 
those of the small Pox but scarcely 
suppurating after a few 
days ending in scales without 
marks. It has been confounded 
with the small Pox
but this disease may be distinguished 
from the small Pox 
by the fever in this disease being 
not so violent the Pock is 
whites that matter more resembling 
milk there is no circumscribed
inflammation-
Nothing need be done in this 
disease except after it is gone 
a Purge or two.-
Measels Contagious inflammatory 
Fever with sneezing & hoarse & 
Weeping of the Eyes a dry Cough   



169
cough fourth day or later small
confluent Eruption hardly 
above the skin breaking out 
after three days ending in 
very small branny sacless
For the history of the descores
I refer you to practice writen
The disease is apt to affect
the throat & Lungs     



170
Lectr. 14th. 
Scarlalina Anginosa
Of this disease we have treated 
somewhere else.-
Plague I have nothing to 
say up on this subject but 
what you will find in Sydenham 
Cullen &c. from all That 
I have read upon the disease 
it appears to me not to be 
contagious but in an intermediate 
degree between infection 
and contagion this I think is 
proved by many facts there have
been instances of people 
living in a room above when 
the Plague was and never received 
the Infection. A Person
dead of the Plague never infects 
any 



171
anybody the people in Marsalis 
strip the Cloths of People 
with a hook, they then handle 
the corpes without the least Danger 
or concern if it does infect 
its is not so much as when 
alive this is owing to the loss of 
the heat of the Body which 
when present rendering the   
infection Volatile which is not 
the Case when dead.- It is 
less frequent now in every part
of the World then it Used to be 
owing to free use of Vegetable & 
Particularly Sugar.- And it 
has never been in America upon 
this account. It has been said 
that is may be avoided in Turkey 
if it ware not that the avoide doing 



172
doing anything to prevent its 
appearance & spreading there is 
another thing tends to keep it up 
in constantinoble is that the 
struts is very narrow and very 
much Crouded the Plague on ye 
account spreads rapidly and caries 
of thousands of people on ye
attack this thins the streats for 
a short time and the Plague 
does not return untill the the 
streets again become Crouded
Erysepilas Inflamy. fever of 
two or three days [only] generally 
With drowsiness often with 
delirium in some part of the Skin 
most frequently the face an [ In]
Erracepelatous inflamn. appears  
Shecies Vecien forum terminating
in large vessicles or 



173
Shingles several inflammatory 
pimple seizing principally the 
trick of the Body terminating in 
phytoene or small seaules-
some say that if the Eruption 
gets entirely Round the Body it 
proves fatle but this is not the 
case. it is likewise said that 
Black Cats Blood will cure it 
but this is also false This disease 
is to be treated by lenient Purges 
the Parts bathed by Ag Veg. Min
Miliaria this is well described
by docr. Cullen it depends
upon a hot Regimes -
Urticarial Nettle Rask Doc,
Heberden has described this Accurately.-
Pemphigus. it is attended 
with Typhus [illegible] Docr. Cullen 



174
Apthæ a Contagious disease the 
Tongue somewhat swelled ye Tongue
& fauces of a purple Colour whitish 
crusts sometimes, distinct sometimes 
confluent appeasing upon the fauses 
and margin of the Tongue- 
it much more frequent in holand
then in any other part of Europe  
It occurs in the last stage of many 
other diseases it is a bad Symptom 
in Phthisis Pulmonalis & 
in the Hypochondriac disease it 
is a fatle symptom and indeed 
it is a fatal sign in a most every 
chronic disease.-
In this disease you are to make 
use of the bark exercise & Cold Bath 
the sores ought to be kept 
Clean by blue Vitriol either in 
solution or Powder Docr. Marting
Cancer powder has in some coos 
been  



175
been used with success therefore 
when Blue Vitriol fails I would 
recommend mortices Gouder.- Infants 
are subject to apthæ and 
particularly in the first month 
[If its] It has been said by nurses 
that if the Child escapes the first 
month that is will have no 
sore throat during life It mostly
comes on in sleep with a 
little fever attended with some 
degree of Eruptions on the Skins 
called the Red Gum Ulcers appears 
in the Throat- this disease will 
mostly go off of steely Molass is as 
effectual remedy to deterge the 
ulcers as there is and if the Infants 
swallow it it acts as a gentle 
Laxative if this fails Borax may 
be 



176
be used after the disease has continued 
2 or 3 days the Patient ought 
to be purged with [ by] Bhai. It sometime 
appears about the Anus
somtimes it leaves the throat entirely 
and goes to the Anus I do not 
think that is passes through the whole 
alimentery canal to get to the Anus  
but I suppose the anus & mouth affect at the sometime 
I am apt to think that the Cause 
of this disease is the meconium
regurgitates and is pushed up by 
the Child and stimulates the Throat.
Ord 3d Hæmorrhages
Pyrexia with a flowing of Blood 
without External Cause to 
Bring it out and the Blood 
when sit at rest has an inflammatory 
court.
Hæmorrhages  



177
Hæmorrhages that occur under 
36 are called Active Hæmorrhages 
and are from an Arterial Plethora 
But beyond 36 they are 
called Passive this is occasioned by 
Vinous Plethora is from 36 to 40 
the Body is stationary and there 
is a contest between the solids & 
fluids & the arteries & Veins & 
in this stage of life, the Body is 
more subject to disease. If a 
person with a Phthisical habit 
of Body passes the Age of 40 there 
is little danger of the disorder 
getting ground and this the Care 
also with diarrhea &c you will 
somtimes meet with a head
ach in this Period of Life which 
is very distressing this is be Relieved



178
Relieved by occasional Bleeding Abstinence 
&c this disease goes of wth.
the arterial Plethora which is about 
40 the diseases of this time of life 
are all to be mitigated with Remedies 
according to their diseases
There is more people dies between
40 & 57 then in any 7 years of man
Life.- Doctr. Pheneus Bond was 
consumptives which left him at 
the age of 40.- 
Cure of Hæmorrhages in General 
In the 1st. place as it depends 
on Plethora the Cure is to be 
began by abstinence. Your
are to direct Vegetable & Reject
animal food these Vegetables shd
be of the Least Nourishing Quality 
that is those that contain 
the  



179
the least sugar & oil such food is 
potatoes which is very Mucilaginous 
and affoard little Nourishment-
first all kinds affoard 
but little Nourishment and shd.
be made use of particularly Roasted 
apples- next to these Roasted 
Potatoes, sallads of all kinds fill
the Stomach and affoard little 
Nourishment. Fluids dispose
more to Plethora then solids 
they relax the Vess and Favous 
the comming on of Plethora-
Next to abstinence Laxatives are 
use full those of the most Lenient 
kind such as ol. Ricini creem 
tart and the dict should be laxative 
as Roasted apples & To-
these medicines Exercise must be added 



180
added it gives Vigour & Tone to the system 
and prevent the arteries swelling 
Riding on horseback is to be preferred  
Cold in likewise a Remedy of 
great consequence in the Cure of 
Hæmorrhages.-
Epistaxis A pain or weight 
of the head redness of the face flowing 
of blood from the Nostrils-
It is Idiopathic. & Symptomatic 
The Idiopathic varies with the 
Age in young people it is arterial 
& old Vinous, symptomatic 
is occasioned by injuries done 
To the Part, the Bleeding of young 
People continues to discharge Blood
till the age of Puberty and then 
ceases and does not return till 
old age owing to the determination
of  



181
of Blood to the head.- Cure 
in young Men by Cold if Signs 
of Plethora open a Vein if it has 
continued any time without Plethora 
Cold may may be applied 
so as to produce a Chill which
will constringe the Vessels in ye Nose 
avoids applying cold to the Nose 
for if it fails to stop it at the 
first application it never fails 
its increase it by its stimulus 
Cold water applied to the scrotum
has been attended with Success, but 
if every thing else fails Pluggs thrust
up the Nose ought to be put in Practice
it ought to be thirst up as high
as posable and as quick as Posable 
for it the plugg becomes wet 
with blood it will not answer 
as  



182
as the Blood will drop from the Plug 
it ought therefore to be thirst up as 
dry as posable all that was said before 
of abstinence is necessary here 
the Bowels ought to be kept open 
it is not safe to Cure its old age 
without substituting some other 
discharge in rooms of it.-



183
Lectr: 15th. 
Hæmoptysis spelling of Blood 
Symptoms. Redness of the Cheeks 
Since of Pain and fullness of the 
Breast tickling at the upper end 
of the Larynx and a discharg 
of Blood.- It is Idiopathic 
& symptomatic. Idiopathic 
is 1st. from without obvious Causes
2d. Wounds and Bruises 3d. 
Phthisis from Tubercles 4th. Calculosa
which is known by a discharge 
of Calcula from is Lungs 
Next Hemolisis Vacaria as from 
hæmorrhoid or Menstrual Flux
obstructed, for a Particular 
history refer to particle Writen
Cure the 1st. Remedy is Bleeding 
when accompanied with Inflammatory 



184
Inflammatory diathesis Laxatives, as 
antiphlogistics may be given Milk 
and a Vegetable diet is to be 
made use of. Nitric has been made 
use of with great advantage. All
Irritations must be avoided speaking 
ought not to be put in practice as 
it tends to bring on hæmorrhages 
singing is also very Hurtfull not 
only singes & speak? ought to be 
avoided but avoid Lifting Heavy 
Weights as this is often known to 
bring Hæmoptisis Violent Exertive
to be avoided Running or Riding 
a trotting horse is very Bad but 
a horse pacing or Walking is [to       
be] preferred of service. Extreme 
heat or Extreme Cold is to be avoided 
particularly the Cold Bath where  
there 



185 
there is or has been a predisposition 
to an hæmopts Wine and Spirituous 
Liquors to be avoided as 
causing irritation. Common 
salt is a Moderin Remedy and 
a good one and is now universally 
mode use of the Manner in 
which it is to be used is beginning 
with a teaspoonfull and increasing 
it to a table spoonfull 3 or 4 
times a day. It may be given during 
the interval or in the Bleeding 
I heard of its being used in other hæmorrhages 
with success.- But 
In what manner does it operate 
this is a difficult Question. I have 
have sometimes supposed that it acted 
by producing Thirst and wither 
may not the Water taken 
in



186
in such Large Quantities and by
its diluting quality diminish. Inflammatory
Diathesis or may 
it act as a Sedative stimulant 
of all kinds act as Stimulants 
first but afterwards prove sedative.-
A determination to the then ought 
to be kept up as well in this 
as in the Phthisis.- In that 
occasioned by obstructed evacuation 
these Evacuation ought 
to be restored:
Connected with Hemoptysis is 
Consumption symptoms 
& emaciation of the Whole Body
with Cough hectic fever and for 
the most part with purulent Expectoration 
They are insipient Consumptions  



187
consumptions & Confirmed. The Incipient 
is where all the Symptoms 
are present but not a discharge 
of Matter. Confermata where 
there is a discharge of Pus attending 
it. It varies further.
The Causes of Convention are 
5, 1st. Hæmopts 2, abses 3 Asthma 
4. Catarrh Tubercles. 1st. The Consumption 
from Hæmopts is wth.
in the Reach of our art 2d. from 
abuses there are within the Leach 
of our Art 3 Catarrh, this may be 
cured but with more difficulty
then the above two species Asthma 
is still less Curable. The 
Consumption 



188
consumption from Tubercles is 
entirely incurable. This last 
species comes on from Causes Deplorable
and for the most part 
from scrophula, the scrofula   
begins to make its appearance 
first in the Neck and is entirely
transferd to the Lungs 
sometimes Pus is discharged somtimes 
sanies, sometimes Steatoma Meliciris & if these are 
left to stagnate, they corrode 
all the adjacent part Measles
and Laces sometime terminates 
in consumption. This disease 
is more frequent in Great 
Breton then used to be for the 
Bills of mortality say there is 22000
dies every year of Consumtion
Colds 



189
Colds are more frequent now 
then formerly Plurecys and Perepneumony,
are less frequent 
then formerly and Pleurisies
used to be Catarrhs takes there 
place. & the same Remote Causes   
that used to produce Plurecy
in our ancesters produced
in, a Catarrh, this disease 
being trefiling is neglected and a
consumtion Silently steels on 
For the History of consumption I 
refer you to Docr. Fothergill who 
has given the best account of any 
Writer that has as Yet published 
This disease is never incurable only 
when it produced from scrophula
measels [as ] Venereal Disease 
In the First stage there is a fever  



190 
fever Pain in the Breast without 
Expectoration. Second Stage 
all the above symptom 
with Chill & Night sweats &
an Expectoration of Purulent 
Matter. Third and lastly where 
all the above symptoms, Recur 
together with a diarrhæa which 
last symptom is ye Beginning of 
Death.-
Cure of Consumption 1st. Bleeding 
In the first and second stage there 
is always are inflammatory Diathesis 
The Circumstances that 
Indicate repeated Bleeding are 1st ye
degrees of Pain 2d hard Pulse Sizy
Blood. In a Confirmed Consumption
I have in the Course of 6 weeks 
bled 16 times with the greatest 
success 



191
success 2d Milk and Vegetable Diet 
but in some there is the Hypochondriasis 
attends the Phthisis Pulmonalis 
in this case the delt ought
to be of a middle nature & 
mixed with equal Quantities of Water
If his stomach should Reject 
this, he must be allowed animal 
Food. But in the true Consumption 
the Diet should be totally 
Vegetable Morgagni used a medicine 
which is made of Barley
Meal & Milk & I myself has 
used this with advantage 
3rd. the use of Medicine Vit: Acid 
has been used with Success but the 
Vegetable Acids appear to be more 
agreeable to the Stomach & I have 
recommended the sewing of a Lemon
or 



192
sour Orange with success. 4 Avoid
Irritations from all Causes as in 
Hæmopla. 5th. Cold is to be avoided   
particularly Cold feet 6 Ditermination
to the Skin ought 
to kept up we ought therefore 
to wear a flannel Shirt Issues 
and blisters are of the Greatest benefit 
particularly Issues in 
when one in made in the Arm
it is attended with the greatest 
benefit.- Blisters to the 
sides perpetual Blisters are 
pain full, but as soon as a 
blister is dried up another ought 
to be repeated somtimes on one 
side somtimes on the other and somtimes 
on the Breast. I send your 
patient to an equable Climate 
West



193
West Indian in Particular and of 
this Barbadoes is to be prefered 
and if you Expect any advantage   
from a Change of Climate, you 
must Recomend it to your Patient 
to remain there 2 or 3 years 
besides the Change of Climate Sea
Voyges is of the greatest Consequence
as it increases perspiration
but if he cannot make it convenient 
to improse this opertunity 
we must make an artificial 
Change of Climate, this is 
to be done by keeping your patient 
in a stove Room moderate 
exercise on horseback this must 
be used with Caution where 
then is an inflammatory diathesis 
it is hurt full a Journey
is   



194
is to be preferred to a short stage 
as there is always changes of object 
which takes of the Palunts attension
from the disease and a 
new association of Ideas are of 
the greatest service. It has been 
said that Mariage is life to a 
consumptive Woman but Death 
to a consumptive Man this assertion
appears trifling but it
is of the Greatest Consequence 
as in women which bears Children 
the determination is to the 
uterus which takes it of from the 
Lungs succing the Breasts is also 
of the Greatest Consequence 
A Remedy that has been Celebrated
lately and not without Grounds 
is a decoction of Bark from ye
Wild 



195
Wild Cherry & Water Beeches- With 
regard to Bark and Mercury I have 
never seen them of Service and the 
bark is hurtfull during the inflammatory 
state of the Disease Mercurials
have been used to remove  
obstruction in the Lungs. But 
this stimulus makes them hurtfull 
Mineral Waters have never 
been attended with Success The
Caught ought to be Relieved by 
by demulunt Medicines as the 
Various find of Tea Syrup then 
is medicine Composed of Sulphur
Elecampane Burnt Sugar &c to 
abate Irritation and tickling Cough 
Liquoris sugar Candy &c but 
above all Paliative Remedies Opium 
is to be preferred and they 
ought  



196
ought to be begun with as soon as 
possable. That consumption 
in this Country is contagious  
I have no doubt, Portingale 
the Persons who dies of this disease 
has his Clothes stripped
of and Burnt to prevent the 
Contagion Spreading.  



197
Hæmorrhoids Lectr. 16th, 
Weight & Pain of the head Vertigo
Pains of the Loins and Anus  
painfull livid Tubercles aboute
the Anus from which flows 
Blood which somtimes even 
drops from the Anus without 
any apparent tumor.-
It somtimes comes on from procedentic
Aric in this case the intestine 
must be returned immediately 
for somtimes when neglected it 
inflames Mortifies and the Patient 
Dies fomentation and Emolient
Cataplasms are very proper to 
relax the parts and Cure the disorder 
the should be treated with great 
caution in the Evening of Life 
in   



198
in old people subject to apoplexies 
and Palsy’s also in Women at the 
Sessation of the Menses as they then 
frequently occur & prove very 
servesable in persons of a Cancerous 
diathesis I would not stop them 
as cancers mostly come on late 
in Life & Women are more subject 
to cancers of the Womb after the 
Cessation of the Menses. I would  
not stop them in old persons who 
[nerves] have had an Hæmoptoæ for 
fear of bringing it on again they 
occur much oftener during Vinous
then Arterial Plethora Costiveness  
is the Predisposing cause of this 
disease and must be by all Means 
avoided, Post & Sea faring People are 
alway subject to Costiveness from are 
in 



199
insensibility of the Rectum induced
by the habitual stimmulus 
of the focus.- The Bowels must 
be frequently opened by lenient 
Laxatives as Caster oil Sulphur &
By opening fruits as Pruins Tamarinds 
&c. & Bread made of 
equal parts of Indian Riptheal
aloes is the Wont of mediums 
this disorder and as an habitual 
purge it may bring on the Piles
and increase them when on its  
action is confined to the Rectum 
and dont begin like other at the 
Stomach, going to stool every 
day at a particular hour especially 
in the morning is pauper to 
obviate Costiveness opening the 
Bowels is the first thing to be 
done 



200
lenient applications are very proper 
to obviate Costiveness [opening] 
as a Cataplasm of Bread & Milk 
with a Solution of opium in water 
make a very good application 
white lead and oil is very good 
an ointment of equal parts of Tar 
and Mutton suit is very good in 
the Piles a stiptic applications 
a saccariene saturni in oil is 
very good. Port wine & Bark 
internally are also proper -



201



202



203
Menorrhagia 
Pain of the Back Loins & Belly 
like those of Women in Labour 
a more copious flow of the Menses 
or of Blood Preternatural from 
the Vagina it comes on during 
the Arterial Plethora & the Menses 
cease flowing when the Venous 
Plethora comes on. When more 
then ℥4 of Blood is discharged at 
a time or when it occurs more 
then once in a month it may be 
called Menorrhagia some women 
menstruate all the while during 
pregnancy. Bleeding and opening 
the Bowels will Cure it if this 
does not answers and irritation 
is suspected to continue the flow
an  



204
Anodines may be properly given 
Rest must above all things enjoind
the patient who should lie 
still in on position so 3, 4 or 5 days 
togeather Anodines are the first 
remedies in Menorrhagia threatening  
abortion if all these fail a Chill 
must be brought on the Patient 
by exposing her to a strem of very
cold air when this cannot be used 
Cold water applied to the abdomen 
is very good its preferable to 
Cold Vinegar as it can be made 
Colder. When Cold fails a pan full
of flower applied to the Vagina 
so that some of it may be insinuated 
into the Vagina often stop
it, when nothing Else will. Dr. 
Young 



205
Dr. Young never knew a Menorrhagia 
during pregnancy prove fettle 
unless proceeded by abortion or 
till after parturition after all 
the above Remedies have failed 
Blisters are very proper & often 
Cure it they must be applied high
up the thighs perhaps their effects 
are owing to the stimulus of 
the Blisters giving tone to the 
Relaxed parts and also a derivation 
to the Evacuation but 
may be improper somtimes by 
reason of the stimulus on the Neck
of the Bladder being communicated 
to and affecting the uterus, so far 
for Active menorrhagia from
arterial Plethora to prevent this 
disease 



206
disease the Remedies above Recomended 
are proper with abstinence 
exercise Laxative and 
occasional Bleeding. I cured   
a lady subject to many miscarriages 
(who had lost many children)
by ordering bleeding once every 
month which entirely prevented 
a further miscarriages and she brot.
fourt a live Child, immediately 
after she found, she was pregnant 
she got Bled for the last 7 months 
of her Pregnancy once every month 
Every kind of imitation must 
be avoided Cold Bath Exercise 
Bark and Steel are they best means
to prevent restrain and Cure Passive 
Menorrhagia but bark and 
Steel are 



207
are improper in active Menorrhagia 
you will never find hard Labouring 
women. Affected with Menorrhagia 
sence Labour & Exercise are very 
Proper to prevent it.-
Hematemesis is suspended by 
vinegar & Water but your remedies 
must be continued after the 
Vomiting has Ceased for you are 
to Conceder the Veins are still Pouring 
out Blood. -



208
Lectr. 17th: Ordr 4th, 
The Next order of Pyrexia is the 
Profluvia Pyrexia increased 
secretion Naturally not 
Bloody.-
Catarrh Pyrexia somtimes 
from contagion with an increased secretion 
of Mucus from the Mucus 
Membrane of the Nose and Bronchia 
the species are 1st. from Cold 2d. from 
contagion. This disease is commonly 
known by the Name of a Cold In 
the Infancy of Society Plurecy was ye
most frequent disease but now 
Catarrh is the most frequent.
Cold or Catarrh is not to be considered
as trifelling disorder it is somtimes 
attended with Serious Consequences. 
It has been asserted by 
some 



209
some of the ablest Physicians 
the most of the Consumptions is 
produced by half Cured Catarrh 
Pluresys & Perepneumonia.-
There are Various ways that Catarrh
is produced by Cold as Cold 
feet, sleeping between Wet Sheets
& Dampness in a small degree 
will produce Catarrh but when 
the patient is wet to the skin
he will not be injured Gentle
moisture debilitates and produces 
no reaction but in a great 
degree Reaction is produced & obviates 
the effects of debility. Violent 
Exercise produces sweat 
and a cold succeeded from the 
dampness occasioned by the 
sweat. Young people bear Cold 
better 



210 
better then the aged or Middle aged- 
That the [Contagion] Catarrh  
is contagious is certain. The disease 
which is known by the name 
of influensa is nothing but a Catarrh 
from contagion. I recolect  
a Catarrh in 1761 that spread from 
one end of the Continent of America
to the other. This contagion is from 
a Human Origin Savages are 
unacquainted with it but is peculiar 
Sivilized Nation there is 
a catarrh that attacks Adults & 
not infants and that attacks 
Brutes and Not Human species 
Cure Never call a Cold Ire felling  
the First thing to be done is Blood 
letting & if there is an inflammatory 
Diathesis prevails it shd.
be   



211
be repeated Next abstinence from 
Animal Food & if this is indulged it 
must be in the state of Broth but 
you must recommend Gruel Panada
Coffee Tea Bead & Milk &c
Next diluting drink the must also 
be demulcent as Flaxseed Tea Barley
Water Decoction of Reasons Liquorish
Ball sugar Candy but your whole 
stress is to be laid upon diluents
as Large quantity of diluent drink 
no matter what it is will Cure a Cold 
as Tea or Coffee simple or Barley Water 
hot or Cold Gentle or Laxatives 
all that we have said upon Consumptions 
applies here after what 
has been recommended above Fails as 
keeping up Perspiration by means 
of a Flannel shirt.- Catarrh 
from  



212
from sommer Cold is worse then show 
from winter owing [th] to them 
being Neglected. -
Dysentery Contagions fever 
frequent Mucus and Bloody stools 
the natural faces for the most 
part Retained Griping Tenesmus.
It varies as it is attended with a 
discharge of Worms or with bets 
of a Membrane.- At certain seasons 
of the Year it is accompanied 
with an Inflammatory diathesis &
at other seasons with Typhus Meteor
at others Typhus Gravies and at 
other seasons with the Intermitting 
Fever.- It is seldom that it occurs    
with inflammatory diathesis 
and few cases Required Bleeding- 
I think that there is an original 
Idiopathic 



213
Idiopathic dissentery but it is 
not a frequent disease in this City- 
High situations dispose 
to the dissentery. There are Mountain 
in this Country at the  
Bottom there is a continual fever 
at the Middle Intermittent 
& at the Top dissentery 
In all cases of dissentery there is 
a constriction of the intestines & 
a Pulse action & Retention of the Alvine
fæces. 
Cure to be begun by gentle
Laxatives as salts. Manna crem.
Tart & Caster Oil, a little Crem
Tart



214
Tarter makes salts lay better on 
the stomach & Cremer Tartar is 
a good. medicine in all disease of 
the Bowels. Borax to about the 
1/20 makes salts so soluble that it
will devolve in half the Quant. of then it otherwise goould 
After giving Purges which should be in the Mornd Anodines m- 
not be given at Night you are 
to continue to purge every day 
while the stools remain Mixed 
with a great Quantity of Mucus 
& Blood.- Emetics are good in 
dessentery when combined with 
a Bilious Fever and Nauseating
Doses of Emetics ought to be first 
made use of Ippecacuanna has 
been made use of for this purpose 
but Tart: Emit answers better 
Demulcent drinks are of service 
flaxseed 



215
flaxseed tea Broths of all kinds 
Mallows Tea Bran Tea Mutton 
Suet & Milk, this Last is demulcent 
& Emolient to a very great
degree by giving moist Glystem
with a little Lard added to them 
Blisters are of Great consequence 
in this disease here they 
act as antispasmodics especially 
when applied to the Abdomen 
but blisters to the Wrists will 
also answers- This treatment  
is proper in every Case of symptomatic 
dyssentery another Remedy 
is the Bark in all Cases in 
which the above Remedies fail 
and where it is worse every other 
day [It] I then conceive it to pertake 
of the intermitting fever 
In



216
In this as well as every disease I 
keep the Epidemic of the Season in 
View. Where you are doubtfull of the 
Nature of the disease you may have 
a suspicion of its pertaking of the Nature 
of the Epidemic Dysentery
affecting Children from 3 to 4 years 
old is more obstinate then in grown 
Persons.- It Varies as it is attended 
with worms, without Blood you 
will often see it & in this cases it 
is to be treated as above.-
With this then we finish the Class 
of Pyrexia & Proceed next to treat 
of the 2 class or 
Neurosis Class IId
Perhaps it may be thought improper 
to call any class of disease Nervous 
as every disease to which the 
human



217
human body is subject affects ye
Nerves more or less but in [by] this Class 
I comprehend all those diseases 
in which the since and motion 
is injured without any Primary 
Fever. -
Ordr. 1st. Coma a diminution 
or Lessoning of the Volentery motions
Stupidity wth. absence of the 
Sences.-
Gen 42d. Apoplexy allmost all 
the Volentery Motion Suspended 
a more then common inclination 
to sleep Vital Motion Remaining 
perfect.- The Idiopathic 
are first the Sanguineous & serous 
occurring in old People. Species 
Apop: Hydrocephalus. Apop: Atrabiliaria
Apoplexy from Worms 
Apoplexy 



218 
Apoplexy from Poison. Apoplexy
from Poison. Apoplex. Cataleptica 
Symptomatic Apoplexies are from 
Intermittent. & Continual fever
& from scurvy &. 1st. Idiopathic 
The treatment of it during the 
fitt, the sanguineous is either from
Extravasation & Intravasasation
1st. Bleeding very copiously 
you are to take in some case ℥30
and from both arms at the same 
time. Next inquire into the state 
of the Bowels. They are to be 
opened by a Clyster. A Large Blister 
should be applied to the Neck 
Cataplasms to the feet Stimmulating 
or not Stimmulating 
according to the state of the Patient 
Pulse full: Emolient Poultices 



219
Poulices should be made use of 
If the Pulse is weak they ought 
to be stimulating, there is a Remedy 
which has been made use of wth
success wth is burning with a 
hot Iron the Crown of the Head 
& sole of the feet.- 
Preventatives A man with a 
short neck. Plethoric head complains  
of Giddiness Eye sight affected 
Deafness &c. Preventatives are first 
moderate exercise as walking 2d Moderate 
diet particularly vegetables 
as they will fill the stomach without 
affoarding much. Nourishment  
this will obviate Plethora when Animal 
food is allowed it should be of 
the Least. Nourishing kind and but 
one Meal a day. Milk and Bread 
should 



224
faculty is perfect and the external
Senses absent.- Apoplexies from 
suffocation as Drowning & Hanging 
is of this Species these are occationed
by suffocation. The Treatment is friction  
and every means to produce 
heat & Exite circulation by blowing 
into the Lungs by which Means
the Action of the Lungs is Restored 
Injecting Acrid Glysters or even 
inflating the bowels with Air 
has suddently restored persons 
seemingly dead to life when there 
are appearances of life Salt of 
Hearts Horn &c applied to the Nose
are of service.-



225
Lectr. 18th 
Symptomatic Apoplexies 
1st. from the intermitting I have 
seen apoplexies occationed by the 
Intermitting fever when this is 
the Care a Blisters to the Neck and 
Stimmulating cataplasm to the 
feet are of Service.- 
2d. Continual fever somtimes 
comes on in this manner that is 
with symptoms of Apoplexy the 
treatment the same as the above 
3d. The Inflammatory fever comes on 
somtimes with symptom of Apoplexy 
in this Case Bleed &c &c
She Exanthemata somtimes comes 
on with symptoms of Apoplexy 
Blisters and Stimulating 
application will somtimes 
should 



220
should be allowed. Roasted apples 
Bowels to be kept open constantly 
by the administering of Laxatives 
if the Person is habituated to piles
they should be brought on if posable
the determination to the surface 
should be kept up but if all 
those fails and some symptoms of 
apoplexy appears Bleeding in small 
quantities should be practiced.-
The Posision of the Body is of some 
consequence the Patient ought to 
sleep with his head high, Recomend
never to sleep upon the 
Back as there is a very great Sessation
of Muscular Motion wth.
is extended to the Arteries. They ought
not to be confined to one side 
but may change the Position. &
lastly  



221
lastly Seatons or Issues in the 
Arm or Neck is of use. If they have 
been habituated to smoaking 
snuffing or Chewing Tobacco and 
have left it off they should Return 
to the use of it as it has been the 
occation of preventing many apoplexys 
that would have otherwise 
come on. Suppressed issues shd.
be restored to their usual & is charge
Apoples: Atrabil, no peculiar Treatment 
is from Wounds the part
should be examined where the 
head is injured the scalp should 
be laid open & Traupan applied if 
Necessary. Apoples: from Narcotic 
Substances of all kind as fired 
Air &c Cold Drink. From a Drunken  
fitt or Apoplexy from Drinking 



222
Drinking cold water thrown upon ye
Body will Relieve them, there is 
another Remedy in Apoplexy [Simulenta]
which fear or the effect 
of Surprise. I have seen instance 
of Punishment Cure drunkenness.-
From Fixed Air the 
Remedies are the same as in drunkenness.
Particularly Cold 
You are constantly to detest ye
Use of Charcoal as this has destroyed
Many by the Mefitic Air 
separated from it, Apoplexy 
from Insolation Cold & stimulants
and Particularly friction.
Ap: from Cold 1st. by the 
Stimulus of Cold. from snow 
from Cold water, if these fail 
recourse must be had to friction 



223
friction he must be rubbed for hours 
Apoplexy from Cold has been 
cured by swallowing tobacco Juice 
Apoplexy Mentalis this is 
an apoplexy from the sudden
taking off of the Exetement of ye 
Brain by Violent fitts of joy 
that Anger will produce Apoplexy 
without a doubt several Cases 
happened in this City Sear 
will produce Apoplexy, apoplex.
is Cataleptics, this is an inferior 
species of apoplexy the Patient 
setting motionless in the Chair
his eyes fixed and insensible of every 
thing around them.- 
I think we may explain Drums 
and Trances in this Manner 
where the internal or thinking 
fa



226
succeed sometimes Hysteria comes 
on with symptom of apoplexy 
the treatment as above and wth.
the Patient can swallow Hyster: 
Mid: will be propor. Epilepsy has  
in some cases, been attended with 
symptoms of Apoplexy- 
Gout may produce apoplexy by 
sudden transition to the Brain wn.
The powers that throw it on the 
Extremities is too weak in this 
Case blisters stimulat: Cataplasms 
Aplied to different. Parts Vol. Salt. 
&c taken into the stomach. Cataplasms 
in this case ought to be 
made of Mustard. Worms like 
hysteria produces. Various diseases 
in the system in this Case 
begin with Blisters Cataplasms
& 



227
& when they can swallow Worm
Medicine should be given.-
Gen 48d a Palsy, diminution of 
Volentery Motion somtimes with 
sleepiness. The species are Idiopathic 
& symptomatic. The 
Idiopathic 1st. Partial 2d. hemiplegia
this last is an affection of 
one side of the Body and is the most 
frequent species of Palsy it varies 
in proportion as it is attended wth.
Plethora or inflammatory diathesis 
3d. Paraplegia a Palsy of the 
Lower half of the Body on Certain 
[fumes] destroy the mobility of ye
system and Produce Palsy in some
cases it is taken into the stomach
by drink this I think is most 
frequently the Case.-
Symp. 



228
Symptoms of Palsy are Numerous 
tremor docr. Cullen has 
brought in as a symptom of 
Palsy 3d. species made by him is 
Tremor: or symptomatic Paralisis
In our Cure we are to attend to 
Two Proximate Causes 1st. from 
distension or Effusion 2d or ye
mobility of the Brain destroyed 
The Effusion is from Blood or 
Water this is either Extravasation
or Intravastation. If I am 
called to a patient with a Paralesis
attended with Plethora 
the Presumption is an Intra or 
Extravasation of Blood but if 
in a Luclosp legimatic habit the 
presumption is an Effusion of 
Water Where it has proceeded form   



229
from Effusion either Blood or 
Water & Particularly Blood Bleeding 
is to be put in practice 
this may be used in effusion of 
Serum if the Pulse is full but 
if the disease is attended with 
a weak Pulse and Lucophlegmatic 
habit bleeding must be hurtfull 
and ought not to be used- 
Next to bleeding Purges of the 
drastic kind and particularly 
Aloeties as these is a great connection 
between the brain and 
Bowels and by evacuating the 
Bowels the Blood is determined from 
the Heat Blisters are likewise 
of service in this disorder 
applied near to or on the head Restoring 
all Evacuations as Menses
Issues  



230
Issues Saliva &c the defect of 
the Last is owing to Living of tobacco 
to them that is habituated to it 
If it rises from want of Excitement
this may be known by 
its not being Liable to Change
as from any other Cause.-
if after 2 or 3 months the above Medicines 
fails you must make use of
Rubefacientia Nettles mustard x
Electricity has been used in this species 
of Palsy with success you never 
ought to use Electricity in 
any other case but this and never 
when it is owing to Effusion you 
are to use it as a Moderate stimulus 
by gentle Shock continued 
for two hours Hot and Cold Water 
have frequently produced Excitement 



231
Exitement in the Nervous System Hot Water 
particularly which will not Answer  
when only warm but must 
be hot Cold Water has been used 
with success Lifting Weights 
may be found of use. The Palsy 
may be prevented by all the 
Preventatives that was recommended 
in Apoplexy. -
Ordr: 2d Adinamia In voluntary
Motions either Vital and 
Natural Diminished.-
Syncope Diminished motion 
or total stoppage of the Action 
of the heart & Arteria & Lungs.
Cardiaca without any manifest 
Cause that is when the Cause 
exists in the heart itself 2d. Occationalis
from a Manifest Caus
occationed 



232 
occationed by an affection of the whole 
system when it arises from an 
affection of the heart it is beyond our 
art, when from Causes Main
fit or connected with the Whole 
system it becomes a subject of our 
art.- When a certain Tone 
of The Brain is destroyed which 
is constantly kept up in health 
fainting is the Consequence which 
is produced by sudden evacuation 
of either Blood or Water &c
this acts in part but the tension 
of the Nervous system is taken 
off in Tapping as well as it 
is in the Arterial system and 
in suddently letting the matter out 
of a bile will produce fainting 
which is certainly taking off the 
tension 



233  
tension of the Brain. A large discharge, 
By Urine or Stool has 
produced fainting fatigue Produces 
fainting passions of the 
Mind in some Ceases produce 
Syncope. All Causes that takes 
of the tension of the Brain produces 
syncope as Certain 0 doses 
here there is a sedative applied 
to the Brain Certain disagreeable 
sight produce this disease 
as the sight of Blood.- 
Cure as it a disease of the 
Whole System the Remedies 
should be applied to the whole 
System as Cold Bath Tonic Medicines 
these have been Used wth.
success from 0 doses it may be Cured 
by Resolution & Habit The 
mode 



234
mode of managing under a 
fitt is by laying him in a horizontal
postures throwing Cold 
water in his face smiling volatile 
salt: Pubbing should 
not be neglected with Lavender
Symptomtic you will often
meet with this in fever
the Treatment the same as 
Recommended above -



235
Lectr, 19th. 
Dyspepsia of this disease 
I shall not very much as I shall  
Put into your hands a small 
pamphlet which will make it 
Unnecessary. The Symptoms 
are. Anorexia Nausea Vomiting 
Flatulence Eructations Rumination
Heart brush & Pain of ye
Stomach with Costiveness and 
without any other disorder of 
the stomach or other Parts.
It is divided into Idiopathic
& Symptomatic of the Idiopathic
there are a great many 
thecies as from foreign matter 
from [ flam] Phlegm from Affections 
of the stomach itself and 
other parts of the System one 
of    



236
of the Most frequent Cause is from 
spirituous Liquor which is not 
taken Notice of by docr. Cullen 
Cure of this disease in General 
in every case of dispepsia these 
are two things to be observed wch
are medicine & Diet. It is common
to begin with Emetics wn.
oppressed with Sabusa but it 
is of More consequence to brace up ye
Stomach and this may be done 
by tonics of all kinds Betters & 
Aromatics some of the Metalic Tonics 
May be made use of Particularly 
Chalibeates from ʒss to 
℥ss you may nice with them 
bitters or Aromatics of all kinds 
besides these Elixir Vitriol may be 
given tho the stomach is troubled    



237
troubled with an Acid, it is of a Vegetable 
Nature & a Mineral Acid 
Destroys it Costiveness to be 
obviated by drastic Purgatives 
as Aloes Rhæi &c whose good affects 
is assisted by their Better 
a composition Gention Juniper 
Berries, Orange, Peal: & Aloes may 
be made Use of with Success In 
the intervals of taking medicine 
drink quantities of Cold Commit
or Columbo Root Sea.-
But diet in this Case is of more 
use then Medicine abstinence
from Vegetables of all kinds 
Roasted meets particularly Beef
& Mutton with Bread toasted 
Should be given young 
meets are more improper here 
there 



238
there midle Aged, you may 
make Use of the Yolks of Eggs 
and throw away the White part
as the Yolk being more Aromatized
then the White somtimes 
it goes to such a degree 
that they cannot retain their 
Aliment when the use it with Drink 
in this Case Liquids is to 
be forbidden, fermented Drink 
off all kind but one is to be abandoned 
this is Porter which 
will somtimes lay upon the Stomach 
when everything else fails 
if this should be Rejected [?]
Madeira Wine may be made 
Use of if this is Ryceted Toast &
Water Neither Diet Nor Medicine 
will do anything without 
exercise



239
Exercises particularly on horseback, 
Some of the most Pressing 
Symptoms ought to be 
removed as heart burn this 
may be paliated Magnesia
and Pepermint Water 
Gastrodinea, by opiates Docr.
Cullen in this Case Uses Muriatic 
acid mixed with salt 
& water this he makes use of 
Paliate every symptom 
There are one or two symptom 
in dispepsia. 1st. Vomiting Gravidarum
or Nasea Gravidarum 
but how for it is to Cure is Uncertain 
but many begin the Cure 
by vomits of the Ipecacuanna and 
drink Columbo Root Tea & Chees 
that Root.-
AN 



[240]
AN
ENQUIRY
INTO THE 
EFFECTS
OF 
SPIRITUOUS
LIQUORS
UPON THE 
HUMAN BODY, 
And their INFLUENCE upon the 
HAPPINESS of SOCIETY.
By BENJAMIN RUSH, M.D.
Professor of CHEMISTRY in the University of 
Philadelphia.
PHILADELPHIA:
Printed by Thomas BRADFORD, in Front-street, four 
Doors from the Coffee House.

[241]

242
An ENQUIRY into the EFFECTS of 
SPIRITUOUS LIQUORS
Upon the HUMAN BODY, &c.
By spirits I mean all those liquors which are obtained by 
distillation from the fermented juices or substances of any  
kind. These liquors were formerly used only in medicine.-
They now constitute a principal part of the drinks of many 
countries. 
Since the introduction of spirituous liquors into such general 
use, physicians have remarked that a number of new diseases 
have appeared among us, and have described many new symptoms 
as common to old diseases. Spirits in their first operation 
are stimulating upon the system. They quicken the circulation 
of the blood, and produce some heat in the body. Soon afterwards
they become what is called sedative; that is, they diminish 
the action of the vital powers, and thereby produce 
languor and weakness.
The effects of spirituous liquors upon the human body in
producing diseases are sometimes gradual. A strong constitution,
especially if it be assisted with constant and hard labour, 
will counteract the destructive effects of spirits for many 
years, but in general they produce the following diseases:
1. A sickness at the stomach, and vomiting in the morning. 
This disorder is generally accompanied with a want of appetite 
for breakfast. It is known by tremors in the hands, insomuch
that persons who labour under it are hardly able to lift a 
teacup to their heads ’till they have taken a dose of some cordial 
liquor. In this disorder, a peculiar paleness, with small 
red streaks appear in the cheeks. The flesh of the face at the 
same time has a peculiar fulness and flabbiness which are very 
different from found and healthy fat. 
2. An   

[ 243]
2. An universal dropsy. This disorder begins first in the 
lower limbs, and gradually extends itself throughout the whole 
body. I have been told that the merchants in Charleston, in 
South-Carolina, never trust the planters when spirits have produced 
the first symptom of this second disorder upon them. It is 
very natural to suppose, that industry and virtue have become 
extinct in that man whole legs and feet are swelled from the 
use of spirituous liquors.
3. Obstruction of the liver. This disorder produces other 
diseases such as an inflammation, which sometimes proves suddenly 
fatal- the jaundice – and a dropsy of the belly.
4. Madness. It is unnecessary to describe this disease with 
all its terrors and consequences. It is well known in every 
township where spirituous liquors are used.
5. The Palsy and 6. The Apoplexy compleat the group 
of disease produced by spirituous liquors. I do not assert that 
these two disorders are never produced by any other causes, but 
I maintain that spirituous liquors are the most frequent causes 
of them, and that when a predisposition to them is produced 
by other cause, they are rendered more certain and more dangerous 
by the intemperate use of spirits.
I have only named a few of the principal disorders produced 
by spirituous liquors. It would take up a volume to describe 
how much other disorders natural to the human body are increased
and complicated by them. Every species of inflammatory 
and putrid fever is rendered more frequent and more obstinate 
by the use of spirituous liquors.
The danger to life from the diseases which have been mentioned 
is well known. I do not think it extravagant therefore 
to repeat here what has been often said, that spirituous liquors 
destroy more lives than the swords. War has its intervals of 
destruction – but spirits operate at all time and seasons upon
human life. The ravages of war are confined to but one part 
of the human species, viz. to men, but spirits act too often 
upon persons who are exempted from the dangers of war by 
age of sex; and lastly, war destroys only those persons who 
allow the use of arm to be lawful, whereas spirits insinuate
their fatal effects among people whole principles are opposed 
to the effusion of human blood. 
Let us next turn our eyes from the effects of spirits upon 
health and life to their effects upon property; and here fresh 
scenes of misery open to our view. Among the inhabitants of
cities, they produce debts – disgrace and bankruptcy. Among 
farmers they produce idleness with its usual consequences, such 
as houses without windows – barns without roofs – gardens 
without 

[244]
without enclosures –fields without fences – hogs without yokes 
-sheep without wool- meagre cattle – feeble horses – and half 
clad dirty children without principles, morals or manners -.
This picture is not exaggerated. I appeal to the observations 
of every man in Pennsylvania, whether such scenes of wretchedness 
do not follow the tracks of spirituous liquors in every 
part of the state. 
If we advance one step further and examine the effects of 
spirituous liquors upon the moral faculty, the prospect will be 
still more distressing and terrible. The first effects of spirits 
upon the mind shew themselves in the temper. I have constantly 
observed men who are intoxicated in any degree with 
spirits to be peevish and quarrelsome; after a while they lose 
by degree the moral sense. They violate promises and engagements 
without shame or remorse. From these deficiencies
in veracity and integrity, they pass on to crimes of a more 
heinous nature. - It would be to dishonour human nature 
only to name them.
Thus have I in a few words pointed out the effects of spirituous 
liquors upon the lives, estates and souls of my fellow-
creatures – Their mischiefs may be summed up in a few 
words. They fill our church yards with premature graves-
they fill the Sheriff‘s docket with executions, they croud our 
jails, and lastly they people the regions, but it belongs to
another profession to shew their terrible consequence in the
future world.
I shall now proceed to combat some prejudices in favor of 
the use of spirituous liquors.
There are tire occasions in which spirits have been thought 
to be necessary and useful.
1. In very cold weather 
2. In very warm weather. And 
3. In times of hard labour.
1.	There cannot be a greater error than to suppose that spirituous 
liquor lessen the effects of cold upon the body. On 
the contrary, I maintain that they always render the body 
more liable to be affected and injured by cold. The temporary 
warmth they produce is always succeeded by chilliness. 
If anything besides warm cloathing and exercise is necessary 
to warm the body in cold weather, a plentiful meal of wholesome 
food is at all times sufficient for that purpose. This by
giving a tone to the stomach invigorates the whole system,
while the gentle fever created by digestion adds considerably
to the natural and ordinary heat of the body, and thus renders 
it less sensible of the cold. 
2. It

[245]
2. It is equally absurd to suppose that spirituous liquors lessen 
the effects of heat upon the body. So far from it, they rather
encrease them. They add an internal heat to the external 
heat of the sun; they dispose to fevers and inflammations of 
the most dangerous kind; they produce preternatural sweats 
which weaken, instead of a uniform and gentle perspiration 
which exhilarates the body. Half the diseases which are said 
to be produced by warm weather, I am persuaded are produced 
by the spirits which are swallowed to lessen its effects upon the 
system.
3. I maintain with equal confidence, that spirituous liquors do 
not lessen the effects of hard labour upon the body. Look at 
the horse – with every muscle of his body swelled from morning  
till night in the plough or the team, does he make signs 
for spirits to enable him to cleave the earth, or to climb a hill?
-No.- He requires nothing but cool water and substantial 
food. There is neither strength nor nourishment in spirituous 
liquors. If they produce vigour in labour, it is of a transient 
nature, and is always succeeded with a sense of weakness and 
fatigue. These facts are founded in observation; for I have 
repeatedly seen those men perform the greatest exploits in 
work both as their degrees and duration, who never tasted 
spirituous liquors.
But are there no conditions of the human body in which 
spirituous liquors are required? Yes, there are; 1st. In those 
cases where the body has been exhausted by any causes, and 
faintness, or a stoppage in the circulation of the blood has 
been produced, the sudden stimulus of spirits may be necessary.
In this case we comply strictly with the advice of Solomon, 
who confines the use of “strong drink” only to him “that is 
ready to perish!” And 2dly. When the body has been long 
exposed to wet weather, and more especially if cold be joined 
with it, a moderate quantity of spirits is not only proper but 
highly useful to obviate debility, and thus to prevent a fever.
I take these to be the only two cases that can occur in which 
spirituous liquors are innocent or necessary. 
But if we reject spirits from being part of our drinks, what 
liquors shall we substitute in the room of them? For custom-
the experience of all ages and countries, and even nature herself 
all seem to demand drinks more grateful and more cordial
than simple water.
To this I shall reply, by recommending in the room of 
spirits in the first place
1. CYDER. This excellent liquor contains a small quantity 
of spirit, but so diluted and blunted, by being combined with as 
acid 

[246]
acid and large quantity of sacharine matter and water, as to 
be perfectly inoffensive and wholesome. It disagrees only with
persons subject to the rheumatism, but it may be rendered
inoffensive to such people by extinguishing red hot iron in it,
or by diluting it with water. It is to be lamented that the
late frosts in the spring often deprive us of the fruit which
affords this liquor. But the effects of these frosts have been
in some measure obviated by giving an orchard north-west
exposure, so as to check too early vegetation, and by kindling 
two or three large fires of brush and straw to windward of
the orchard the evening before we expect a night of frost.
This last expedient has in many instances within the compass 
of my knowledge, preserved the fruit of an orchard, to the 
great joy, and emolument of the ingenious husbandman.
2. BEER is a wholesome liquor compared with spirits. The
grain from which it is obtained is not liable, like the apple,
to be affected with frost, and therefore it can always be procured
at moderate expence. It abounds with nourishment
- hence we find many of the common people in Great-Britain
endure hard labour, with no other food than a quart or three
pints of this liquor, with few pounds of bread a day. I have
heard with great pleasure of breweries being set up in several
of the principal county towns of Pennsylvania, and esteem it
a sign of the progress of our state in wealth and happiness, 
that single brewer in Chester county fold above 1000 barrels 
of beer last year. While I wish to see a law imposing the
heaviest taxes on whisky distilleries, I should be glad to see
breweries (at least for some years) wholly exempted from
taxation.
3. WINE is likewise wholesome liquor compared with
spirits. The low wines of France I believe could be drank 
at less expence than spirits in this country. The peasants in
France who drink these liquors in large quantities, are healthy
and sober body of people. Wines of all kinds yield by
chemical analysis the fame principles as cyder, but in different 
proportions, hence they are both cordial and nourishing.
It is remarked that few men ever become habitual drunkards
upon wine. It derives its relish principally from company,
and is seldom like spirituous liquors drank in chimney corner 
or in closet. The effects of wine upon the temper are
likewise in most cases directly opposite to those that were
mentioned of spirituous liquors. It much be a bad heart indeed 
that is not rendered more chearful and more generous 
by a few glasses of wine. 
4. VINEGAR 

[247]
4. VINEGAR and WATER sweetened with sugar or molasses 
is the best drink that can be contrived in warm weather.
I beg leave to recommend this wholesome mixture to reapers in
a particular manner. It is pleasant and cooling. It promotes
perspiration, and resists putrefaction. Vinegar and water
constituted the only drink of the soldiers of the Roman republic, 
and it is well known that they marched, and fought in a
warm climate, and beneath load of arms that weighed sixty
pounds. Boaz, wealthy farmer in Palestine, we find treated
his reapers with nothing but bread dipped in vinegar. Say
not that—spirits have become necessary in harvest from habit
and the custom of the country. The custom of swallowing
this liquid fire is bad one, and the habit of it may be broken.
Let half a dozen farmers in a neighborhood combine to allow
higher wages to their reapers than are common, and a sufficient 
quantity of any of the liquors I have recommended; and
they may soon abolish the practice of giving them spirits.
They will in little while be delighted with the good effects
of their association. Their grain will be sooner and more
carefully gathered into their barns, and an hundred disagreeable 
scenes of sickness and contention will be avoided, which
always follow in greater or less degree the use of spirituous
liquors. Under this head, should not neglect to recommend
butter-milk and water, or sour milk (commonly called bonneclabber) 
and water. It will be rendered more grateful by
the addition of little sugar. PUNCH is likewise calculated to
lessen the effects of heat, and hard labour upon the body. The
spirit in this liquor is blunted by its union with the vegetable
acid. Hence it possesses not only the constituent parts, but
most of the qualities of cyder, and wine. To render this liquor 
perfectly innocent and wholesome, it must be drank 
weak —in moderate quantities—and only in warm weather.
There are certain classes of people to whom I beg leave to
suggest a caution or two upon the use of spirituous liquors.
1. Valetudinarians, especially those who labour under disorders
of the stomach and bowels, are very apt to fly to spirits
for relief. Let such people be cautious how they repeat
this dangerous remedy. I have known many men and women, 
of excellent characters and principles, who have been
betrayed by occasional doses of gin or brandy to ease the cholic,
into a love of spirituous liquors, insomuch that they have
afterwards fallen sacrifices to their fatal effects. The different
preparations of opium are thousand times more safe and innocent 
than spirituous liquors in all spasmodic affections of the
stomach and bowels. So apprehensive am I of the danger of
contracting

[248]
contracting love for spirituous liquors, by accustoming the
stomach to their stimulus, that think the fewer medicines
we exhibit in spirituous vehicles the better.
2. Some people from living in countries subject to the intermitting 
fever, endeavour to fortify themselves against it by
two or three glasses of bitters made with spirits every day. -
There is great danger of men becoming sots from this practice.
Besides, this mode of preventing intermittents is by no means
certain one. A much better security against them is to be
found in the Jesuits bark. A tea-spoonful of this excellent medicine, 
taken every morning during the sickly season, has in
many instances preserved whole families in the beighborhood
of rivers and mill-ponds from fevers of all kinds. Those who
live in sickly part of the country, and who cannot procure the
bark, or who object to taking it, would advise to avoid the
morning and evening air in the sickly months—to kindle fires
in their houses on damp days, and in cool evenings throughout
the whole summer, and to put on woollen cloathing about the
first week in September. The last part of this direction applies 
only to the inhabitants of the middle states. These cautions 
I am persuaded will be more effectual in preventing autumnal 
fevers than the best preparations can be made from
bitters in spirits.
3. Men who follow professions that require constant exercise 
of the mind or body, or perhaps of both, are very apt to
seek relief from fatigue in spirituous liquors. To such persons
I would beg leave to recommend the use of TEA instead of spirits. 
Fatigue is occasioned by the obstruction of perspiration.
Tea, by restoring perspiration, removes fatigue, and thus invigorates 
the system. I am no advocate for the general or
excessive use of tea.- When drank too strong it is hurtful, especially
to the female constitution; but when drank of a moderate 
degree of strength, and in moderate quantities with sugar 
and cream or milk, believe it is in general innocent, and
at all times to be preferred to spirituous liquors. One of the
most industrious schoolmasters I ever knew, told me that he
had been preserved from the love of spirituous liquors by contracting 
a love for tea in early life. Three or four dishes
drank in an afternoon, carried off the fatigue of whole day’s
labour in his school. This gentleman lived to be 71 years of
age, and afterwards died of an acute disease in the full exercise
of all the faculties of his mind.
To every class of my readers, I beg leave to suggest caution
against the use of TODDY. I acknowledge that I have
known some men who by limiting its strength constantly by
measuring

[249]
measuring the spirit and water, and who by drinking it only
with their meals, have drank toddy for many years without
suffering in any degree from it; but have known many
more who have been insensibly led from drinking toddy for
their constant drink, to take drams in the morning, and have 
afterwards paid their lives as the price of their folly. I shall
select one case from among many that have come within the 
compass of my knowledge, to shew the ordinary progress of
intemperance in the use of spirituous liquors. A gentleman,
once of fair and sober character, in the city of Philadelphia,
for many years drank toddy as his constant drink. From this
he proceeded to drink grog- after while nothing would satisfy
him but slings, made of equal parts of rum and water, with a 
little sugar. From slings he advanced to raw rum- and
and from common rum to Jamaica spirits. Here he rested for
few months; but at last he found even Jamaica spirits were
not strong enough to warm his stomach, and he made it a constant
practice to throw table-spoonful of ground pepper into
each glass of his spirits, in order (to use his own expressions) 
“to take off their coldness.” it is hardly necessary to add, 
that he soon afterwards died martyr to his intemperance, 
I shall conclude what has been said of the effects of spirituous
liquors with two observations.- 1. A people corrupted by
strong drink cannot long be free people. The rulers
of such a community will soon partake of the vices of that
mass from which they are secreted, and all our laws and governments 
will sooner or later bear the same marks of the 
effects of spirituous liquors which were described formerly upon 
inviduals. I submit it therefore to the consideration of
the Legislature of Pennsylvania, whether more laws should
not be made to increase the expense and lessen the consumption 
of spirituous liquors, and whether some mark of public
infamy should not be infected by law upon every man convicted 
before a common magistrate of drunkenness.
The second and last observation I shall offer is of a serious
nature. It has been remarked that the Indians have diminished
every where in America since their connection with the Europeans. 
This has been justly ascribed to the Europeans having
introduced spirituous liquors among them. Let those men
who are every day turning their backs upon all the benefits of
cultivated society, to seek habitations in the neighborhood of
Indians, consider how far this wandering mode of life is produced 
by the same cause which has scattered and annihilated
so many Indian tribes.- Long life, and the secure profession 
of property, in the land of their ancestors, was looked upon
as

[250]
as blessing among the ancient Jews.- For a son to
mingle his dust with the dust of his father, was to act worthy 
of his inheritance; and the prospect of this honour often
afforded consolation even in death.- However, exalted
my countrymen, your ideas of liberty may be, while you expose 
yourselves by the use of spirituous liquors to this consequence, 
of them, you are nothing more than the pioneers,
or in more slavish terms, the, “hewers of wood” of your
more industrious neighbours.
If the facts that have been slated, have produced in any of
my readers who have suffered from the use of spirituous liquors
a revolution to abstain from them hereafter, must beg 
leave to inform them that they must leave them off suddenly and
entirely. No man was ever gradually reformed from drinking
spirits. He must not only avoid tailing, but even smelling 
them, until long habits of abstinence have subdued his affection 
for them. To prevent his feeling any inconveniences
from the sudden loss of their stimulus upon his stomach, he
should drink plentifully of camomile or of any other bitter
tea, or few glasses of found old wine every day, have
great pleasure in adding, that have seen a number of people 
who have been effectually restored to health- to character- 
and to usefulness to their families and to society
by following this advice. 

[251]

252
Seasickness this disease has 
engaged the attention of many Physicians  
some say that the Peristallic 
Motion of y Intestines is inverted this accounts 
For the Vomiting but not  
for the Costiveness, but for my 
part I think the Cause is seated 
in the Brain it is chiefly felt 
when the skep descends but how 
the brain is affected is hard
to tell there is a fact that makes
this mode of Reasoning more 
probable is that laying the head 
lower there the feet which prevents 
the disease. To ty anything 
round the bowels will prevent it 
another Remedy which is taking 
a purge before you go to sea Bloodletting
has been used, Keeping the 
stomach



253
Stomach constantly full of solid 
food is the Best preventative that 
I know, Porter will also prevent
it. I have never known it prove 
fatle but it is a very distressing 
disease. Where the Pain is very 
Acute opiates may be administered
with Success -
Lectr. 20th 
Hypochondriasis dyspepsia 
with Languor sadness and fear 
from unequall causes in the Melancholic
Temperament it is either 
Idiopathic or Symptomatic -
Idiopathic Men are affected with 
hypochondriac disease more then 
Women tho the latter is sometime 
Lectr. 20 

sometimes affected with Hypochondriac 
disease and the former 
with Hysteria the Hypochod.
disease is distinguished from ye 
Hysteria by the latter being attended 
with the Globus Hysterics wch 
is never the care in the Hypoch 
irritability & sensibility constitutes 
disease and a complication 
of them makes mobility which 
allways occur in Hysteria Torpor
is a defect of irritatecly & stupor  
of sensibility they occur in Hyps
The Primæ Viæ loose their sensibility 
& Irritability in Hypochondriasis 
hence the dyspepsia & Costiveness 
in Hysteria the stomach intestines 
& Uterus are accompanied with 
Mobility & are exactly the Reverse
of what occurs in Hypochondriasis 
the Hysteria and Hypochondriasis are 

254
[Lectr. 20 th]
[Hypochondriasis Dyspepsia]
for greatly combined together [altho] 
generally separate this combination
is known from the persons being affected 
with slight impressions thus if an 
Hypochondriac is startled with the 
Shutting of a doore he may be considered
to have the Hysteria . The Hypochonds. 
& Hysteria are further distinguished 
in the former theres an antipathy 
sovereign to all kinds of Motion on 
variety & Pleasure & a desire for solitude 
& in the latter a desire for Variety
Pleasures & company, In hypochond
there may be an aversion for food 
& in other an [esateable] desire 
the inordinate apatite is owing to 
the depraved state of the gastric 
Guise which evidently under goes
a    

a Change and becomes Acrid 
since all the humours & all ye
exertions are remarkably & 
more Acrimonious in old then in 
young Nature kindly in the evening 
of life renders the gas tree Guise
more acrid hence the greater apetite 
to counter ballance the falling out of 
the teeth and the inibility to exercise 
old people in general eat 
more food & of a more gross and apparently  
indigestible kind then 
young people. Nature has 
given us two pleasures in a 
very great degree Viz the desire 
of knowledge which is the food of 
the mind and a great appetite 
or the Pleasure of eating which 
old people enjoy in a very great 
degree 

255
degree. When there is no Costiveness
there is generally a derhœa
this Doctor Cullen takes no 
Notice off.
Symptomatic as in Hysteria Phthisis.
Dispepsea &c somtimes you 
will find it a symptom of Hysteric
disease other times of Consumption 
which is very difficult to remove the 
Diet in this case should be of a Mixed 
nature.- I have taken the Liberty 
of adding another species of 
of the Hypochondriasis called Hypochond: 
Revolutionum it is known 
is south Carolina by the name 
of Protection fever in New York the 
Independent 



256
Independent fever. I have known 
many Cases of this species of the 
disease Brought on by the Revolution 
which was principally occationed
by the depreciation of the 
Mony & the loss of Property. I had a patient 
under my care that of this disease
( in consequence of having continental money   
paid him instead of hard money) who Died 
Cure must be attempted by bitters gentle Aromatics
Bark & steel are not so proper as Aromatics 
& Bitters warm drinks to be preferred 
to Cold ones & warm Climate to Cold 
ones, Exercise is of the Utmost Consequence 
as it takes of the attention from his 
affairs Change of objects too is of the Utmost 
consequence. The Exercise to be prefered 
is riding a large Journey and a road that 
he has never travelled before and with a 
companion



257
companion that he has never seen 
before his Cloths ought to be changed 
there is no one Medicine to be compared 
to Calomel in this disease by 
promoting the secretion and Excretions 
it stimulates gentely
you ought to begin with small 
doses and Repeat it till a salivation 
is produced. The diet the same   
as in dispepsia. -
Chlorosis symptoms dispepsia
a a longing for things not eatable
a paleness or discoloration of the skin 
the Veins Less full then common soft 
tumour of the Body Asthenia palpitation 
and a Retention of the Menses
This disease has been known by ye 
Name of green sickness & There 
is an Apetite for things that has 
no 



258
no nourishment as lime Coats
ashes &c this may be accounted for 
by corrosiveness of the Gastric Guise 
which cannot be destroyed by ye 
common food but must have something 
more power full this disease 
is often connected with Hychondr:
disease the cause is mostly a disappointed 
Love or some other secret 
Cause as far as it is connected wth-
Passion of the Mind the same Regimen 
as Medicines as in the 
Hypochondriac disease are proper as 
Bitter Cold Bath: flesh Brush 
&c.-
The next order is spasms which 
we shall go on to conceder at 
our next Lecture. -

259
Lectr. 21st.
Ordr. 3d Spasms 
Irregular Motions of the Muscles
or Muscular fiber. -
1st. Tetanus spasmodic Rigidity
off all most the Whole Body 
it varies with regard to the parts 
affected as opisthotinos & Empristhotinor   
there are other species
as Trimus or Lock jaw, There 
are two causes which produce 
trismus 1st. from Wounds 2d are 
from birth there are many species 
of symptomatic Treania
as in Hypochond: Hysteria & arthritis 
is sometime attend with 
Lock jaw.-
Observations on the Cause and Cure
of Telanexs by Dery Rush Md.
During my attendance in the Military 
hospitle in the Course of the 
late 

260
late was I met with several Cases 
of Tetanus. I have frequently 
met with this disorder in Private
Practice and am sorry to say 
that I never succeeded with the 
ordinary remedy of opium in 
any one case that come under 
my care. I found it equally Ineffectual
in the Army.- Baffled 
in my expectations from 
a remedy that has been so much 
Celebrated. I began to investigate
more Particular on the nature of 
the disorder-. I found it to be a 
disorder of warm Climates and 
warm seasons and that it occurd  
most frequently in habits that 
had been debilitated by Labour
long marches watching and the 
take this led me to ascribe it to relaxation
& I resolved to allempt ye
cure by another set of Medicines in 
some 

161
some measure opposite to most of 
the Remedies that has been employed 
in that disorder soon after 
I had adopted this Resolution. 
I was called to Colonel John 
Stone who was wounded through 
the foot at the battle of German
Town in Octobr. 1777 he was on 
the third day afterwards affected 
with this disorder his spasms 
where Violent and his pains so exquisit 
that his Cries was heard 
100 Yards from his Quarters his 
head was thrown a little Backwards 
his Jaw began to be stiff
and contracted he was under the 
care of a skillfull surgeon who 
was pouring down opium in 
very Large Quantities without 
Effect.- Duty and Friendship 
both led me to do my utmost 
to

162 
to save the life of this Valuable 
officer I immediately dismissed
the Opium and gave him Large 
quantities of Wine and Bark in 
a few hours. I was delited with 
their affects his spasms and Pains 
were less Pungent and less violent 
and he slept for several Hours wch
he had not done for several days & 
Nights before with the same indication
I applied a Blister between 
his Shoulders and Rubbed in two 
or three Ounces of Mercurial Ointment
upon the outside of his 
throat he continued to mend Gradually 
under the opperation of 
those medicines so that in ten days 
he was out of danger altho. the 
spasms continued in his wounded 
foot for several Weeks after 
In the summer 1782. I was called to 
visit a servant girl of Mr. Alexr.
Todds 

263 
Todds of this City who had brought 
on a tetanus by sleeping in the 
evening on a damp brick Pavement  
after a day when the Mercury
in farenheit Thermometer
stood at 90° the Case was nearly 
as violent and alarming as that 
I have gust mentioned. I treated her 
in the same manner and with ye
same success to the above named 
medicines. I added only the Oil of 
amber which she took in Large 
doses after I suspected the stimulus 
of the Wine began to lose 
its effects the good effects of the 
oil was very obvious she recovered 
gradually and since continued 
in good health.-
In the summer of the Insuring year.
I was called to a joiner who had 
run 

264 
run a Nail in his foot. I found 
him the day after in extreme Pain 
with small convulsions and 
now and then a twinge in the 
Jaw the wound in his foot was 
without swelling or inflammation.
I dilated the Wound and filled 
it with the Spirit of Turpentine
this in a little while produced 
a good deal of Inflammation 
and great Pain in his foot while 
I was preparing to treat him in 
the same manner I had treated ye 
former cases his pains and spasms 
suddenly left him and in 24 hours  
after I seen him he complained of 
Nothing but the pain and swelling 
of his Foot which continued 
for several weaks and did not leave 
him till it ended in suppuration 
From the History of these three Cases I 
beg leave to make the following Remark 

265
marks 1st. that the Predisposition 
to Tetanus depends, upon Relaxation 
this Relaxation is generally 
produced by heat excessive Labour 
wachings marches or fatigue 
from any cause all produce it 
Likewise, & hence we find it more
frequent from wounds Received 
in Battles then from similar 
wounds received in any 
other way these wounds more 
certainly produce the Tetanus 
if they have been preceded by 
warm weather.
Docr. shift Physician to the Anspach
troops that served at the 
seize of York in 1781 informed me 
of a singular fact upon this subject 
upon conversing with the French 
surgeons after the capitulation 
he was informed by them that 
the 

266
the troops who arived just before
the surge from the West indies wth
the Count be grass were the only 
troops belonging to their Nation yt
suffered from the Tetanus there 
was not a single instance of that 
disorder among the troops who spent 
the winter on Rhode Island
2d. as the Tetanus seems to be occasioned
by Relaxation the Medicine ideated
to cure it are such only 
as are calculated to remove this Relaxation 
and restore tone to the 
system the Bark and Wine appears 
to act in this way the operations 
of the Blisters is of a more 
complicated Nature.- That they 
are sedative and antispasmodic 
in fever is Universally acknowledged 
but in this particular state 
of Irritability which occurs in 
the Tetanus perhaps their effects are 
more    

267
more simply Stimulating 
but I will go one step further 
in order to cure this disorder, it 
is not only necessary to produce 
the ordinary Tone in the 
System but something like Inflammatory 
diathesis. The absence of 
this diathesis is taken notice of by
by all Authurs Particularly by 
Docr. Cullen Mercury appears to 
act only by promoting this diathesis
hence it never does any 
service unless it be given in 
time to produce a salivation 
The Irritation and Inflammation 
exited in the mouth and Thro at 
seldom fails of producing that 
inflammatory Diathesis which 
the Blood drawn during a salivation 
has repeatedly shewn. I apprehend 
that the Oil of amber acts 
as 

268
as a stimulant chiefly in this 
disorder. I have heard of the Tetanus
being Cured in the Island 
of Granada by large doses of Mustard 
Docr. Roturts of the Island 
of Dominicqua says that s Physician 
in one of the West india Island 
had performed many cures of the 
Tetanus by the Cold Bath Both 
these remedies certainly act as Stimmulants 
& Tonics it is to be 
lamented that the Season of the 
year in which this disorder 
usually occurs Deprives us 
of the aids of Electricity by reasoning 
a priori I conceive it 
would be found to be a Powerfull
Remedy.-
3rd As a general inflammatory
diatheses dispose to topical. Inflammations 
so topical Inflammation 
disposes to general Inflammatory 

269
Inflammatory diathesis wound 
upon this account are less
apt to inflame in Summer then 
in winter. In the Tetanus. I have 
Uniformly observed an absence 
of all inflammation in the 
wound or injured Part a splinter 
under the Nail Produces no
convulsion if Pain inflammation 
and suppuration attends 
it or fallows the Accident. It is by 
exiting Pain and inflammation 
that I apprehend the spirits of 
Turpentine acts in all wounds & 
Punctures of Tendinous Parts 
I have never known a single 
Instance of Tetanus where this 
remedy has been employed in 
time was to exite an inflammation 
on the foot of the Joiner that 
I dilated the wound and filled it with 
Spt. 

270
spt of Turpentine. I was not surprised
at its good effects in this 
Case for I was prepared to expect 
them if the facts tat have stated
be true & the inference that has 
been drawn from the just how 
shall we account for the action 
of opium in curing this disorder- 
I do not deny its good effects 
in many cases but I believe
it has failed in 4 Cases out of 5
in the hands of most Practitioners.- 
It is remarkable that it succeeds 
only when given in very large 
doses in these cases. I would 
suppose that its sedative Powers 
were last in its stimulating 
It is upon a footing therefore in one 
respect with the Stimulating Medicine 
that have been mentioned but 
from its being combined with a sedative 

271
sedative quality it is probably inferior
to many of them. I am the 
more inclined to adopt this oppinion
from an account. I once Received 
from Dr. Roberts who informed 
me that after having cured a negro
man [woman] of the Tetanus, he was afterwards 
seized with a disorder of his 
stomach of which he died in a 
few days upon opening him he 
found his stomach inflamed and 
Mortified. I do not forbid the use 
of opium all together in this disorder 
I think small doses may be 
given to ease pain as in all other 
spasmodic disorder but as its 
Qualities are complicated and its 
effects doubtfull. I think it may 
yield to more simple & more Powerfull 
Remedies.-
To this account of the Tetanus 
I beg lieve to subjoin a few words 
upon a disorder called the jaw fall
in 

272
in Infants which is nothing but 
a Tetanus. I have met with three 
cases of it in this City all of which 
proved fatal. The stage of the disorder 
in which I was called and ye 
age and weakness of the Infants 
all forbade to attempt any thing 
for their Relief. I have introduced 
the subject of this disorder in 
children only for the sake of mentioning 
a fact communicated to 
me by the late Docr. Cadwalider 
Evans of this City the Gentlen. Practiced 
Physic in Jamaica where he had 
frequent opportunities of seeing ye 
Tetanus in the black Children he 
found it in every case in curable he 
supposed it to be occasioned by a 
Retension of Meconium in the 
Bowels this led him invariably 
to purge every Child that was born
upon the Estate committed to his 
care   

273 
Care after he had addopted this 
practice he never met with a 
single instance of tetanus among 
the Children.- 
Perhaps it may lend to enlarge
our Ideas of the Tetanus to promote 
a spirit of Enquiry and Experiment 
to add that this disorder  
is not confined to the human 
Species. I have known two instances 
of it in horses from 
nails running in their feet 
and one from a sore under his 
taile occasioned by a tite crupper 
in each of these cases the disorder 
proved fatal.-
From Mr. Jno. Hunter Lectures 
on Surgery when a person is 
affected with a lock Jaw the 
first symptom is a stiffness 
in 

274
in the lower Jaw and the patient 
generally, immagines he 
has taken Cold and does not for 
two or three days suspect the Disease 
the contraction increases & 
after sometime the Masseter Muscles 
feels hard the Muscles of the 
Neck and cycleds afterwards become 
affected the external Muscles  
of the head become contracted 
as the disease comes on and the head 
is drawn backwards which  
contraction extends to the back & 
the whole becomes a Concave arch 
the Abdominal Muscles then also 
become affected feel hard and a 
pain in the Sternum which probably 
arises from a Contraction  
of the deaphragma the Pain is 
like that which attends Cramp
&  

275 
& spasms occur in allmost every 
Muscle the patient is uneasy 
cannot largon his back but in 
other 
Cure opium to aleviate symptoms 
Cold Remedies with those 
that restore strength but if the 
disorder arises from weakness or 
heat put the patient into an 
Ice house or remove him to 
a Cold Climate counteracts the  
contraction by mechanical fourse. 
Sacc: Saturn has been 
given with a view to diminish 
the power of acting and its success 
deserves a furthers Trial.-
Mr. Hunter relates several cases 
where opium Bark and Red Port 
Wine has been given some of the 
Patient died others Recovered tho
he does not sappose this was 
affected 

276
affected by the Medicine-.
Convulsions a Clonic Irregular 
contraction of the Muscles without 
sleep. In order to understand 
convulsions there is a certain 
state and tension of the Nervous 
and arterial System & many 
things are necessary to keep up 
this tone as a certain quantity 
of blood in the Blood vessels Diminish
this convulsions Issue   
atonia disposes to convulsions 
The Cure consists in restoring tone 
to the System. during the 
Paroxism opium is to be given 
and is the most Powerfull 
after this Cold Bath may be made 
use of.-
Chorea Children of both Sexes 
Especially before the Tenth or 
Fourteenth Year of their Age are 
Seized   

277
seized with convulsive motions 
partly volentery for the most past 
of one side or the other resembling 
stage Players in the Motion 
of the hands & Arms in thus walk 
rather dragging then raising 
one foot after the other. It is 
very often connected with Worms 
in this case begin with 
worm medicines as steel and if 
it should not happen to be occationed 
by worms Steel will 
be proper. In most cases Cold 
Bath and Steel has succeeded.
Cramp a disease that is apt
to come on in the Night & affects 
the Lower more then the Upper 
extremities. The reason yt
it comes on in the night is from 
the great relaxation produced during 
Sleep. When no Muscles
is   

278
is in action It mostly comes
on in those place where the Muscles 
are most Relaxed as the 
Calf of the Legg &c.-
Cure 1st. Grasping a role of sulphure
in the hand this acts not by
attracting the cramp but to the 
tone that is given to the system 
by pressing a body with the hand
but any other hard body 
will answer as well [?] Skins 
have been made use of those act 
by obstructing the reflux of the 
Blood from the Extreme parts 
When a person is seized with the 
cramp in Bed Jumping out 
and walking about never fails to 
remove it how far the fleet brush is 
necessary. I am uncertain.-
Epilepsy 



278
Epilepsy Convulsion of the 
Muscles with Sleep it is Idiopathic 
& symptomatic The 
person attacted is suddenly deprived 
of since & Motion he is 
agitated with violent convulsions  
variously moving the 
Limbs and trunk of the Body 
It occurs very often & when it 
depends upon a particular organisation 
of the Brain it is 
very difficult to cure and palliatives 
ought to be given but 
when it is symptomatic it may 
be cured. Cure Tonics in the 
first place these are either Vegetable
or Mineral Vegetable very 
little effect in curing. Mineral
is of service as Cuprum Ammoni    



280
ammonium Zinc. Iron &c
Cold Bath. Setons has sometimes 
suspended this disorder this 
must be administred with great 
caution. The next remedies is Change 
of Climate wither from Cold 
to hot or from hot to Cold, they Change 
ought to be for 2 or 3 years nature 
sometimes cures this disorder 
There are some instances of Children
having had Epilepsy which 
went off at the age of Puberty this  
ought to be assisted by all the Artificial 
Remedies that have been Recommended
above as Zinc Cold Bath &c
sometimes it is a companied with 
plethora & inflammatory diathesis 
in this case you must Bleed 
and the low diet particularly vegetables 



281
vegetables sometimes there is a preternatural
Relaxation here generous  
diet is to be preferred and a Vegetable 
Diet would be hurtfull 
where it comes on from worms ye 
Are to be destroyed when from the 
Itch the disorder is to be eradicated
and in the same manner with other 
eruptions. From Cruditerin ye 
stomach a Vomit will cure it Terror 
will somtimes produce Epilepsy 
in this case the forms remedies are 
proper [in this care] as cold Bath
Line &c.-
With Respect to palpitation of 
the heart I refer you to docr. Cullen 
when Idiopathic it is incurable 
when symptomatic it may 
in some cases, be Removed.-
Lectr



282
Lectr: 22d:
Asthma Difficulty of Breathing 
coming on at intervals with a 
since of [Wages] straightness aboute ye 
Breast and sonorous wheezing respiration 
difficult Cough at the 
Beginning of the Paroxisms and more 
free towards the ends often wth
a copious Mucus spitting.
there are three species 1st. spontaneous 
wth. comes on without any 
evident cause 2d cranthematica
coming on from diseased of the shew 
3d Plethoricum. They are distinguished
into. Spasmodic Humoral.-
Cure If accompanied with 
Plethora Bleeding & there is seldom 
a case that is not accompanied with 
Plethora in the Lungs Next to bleedg.
vomiting



283
Vomiting the Common Vomit made 
use of is oxymel sullits Anodines 
and Antispasmodic to be used 
after a puke. Antispasmodi.
are Opii Assafœtida, Oxymel sull.
may be given as an Expectorant 
But as a Radical Cure sea tons  
are of the Utmost use.- In Humid 
Asthma Moist Air is Hurtfull 
But in spasmodic it is absolutely 
necessary th dry air Caries 
off all the Moisture from the 
Lungs and produces a cough In 
the Island of Providence a Gentleman 
affected with Asthma has 
slept a great deal better in a damp 
cave then he did in his own 
house for 4 years before and of 
the flight in that cave every Night. 



284 
Pregnancy sometimes cures the asthma
by taking off the determination 
from the Lungs -
Dyspnæa a perpetual difficulty 
of breathing without a sense 
of straightness or rather of Repletion 
of the breast Frequent Cough 
through the whole Course of the 
disease species 1st. from Catarrh 2d
the Dry Dyspnea 3d. from Certain 
states of the atmosphere 4th Dysp.
Serra 5th Dysp: from fat. 6th Dysp.
Exanthemata. 7th Dysp: Thoraces
they are all to be treated like asthma 
or Consumption according which 
they resemble most.-
Hooping Cough it is a contagious 
disease it spreads like The small 
Pox and Measles it is confined chiefly  



285
chiefly to children but somtimes 
it affects Adults.- It is a spasmodic 
disease where this spasmodic
affection is is doubtfull But
I suppose it to be seated in the Trachea
and Bronchia it differs from 
Hyves in not being of the Tonic
Nature but Clonic & not attended
with fever it mostly continues 
6 Weaks it somtimes produces Convulsion- 
Cure has not as 
yet been discovered, but the disease 
may be render milder and 
of shorter duration by the Use of 
proper Remedies and there is no 
disease that has so many Remedies 
as the hooping cough is supposed 
to have excepting the Tooth
ach.- Fear proves a Remedy in 
some 



286
some cases. But the best Remedies 
are bleeding. [ Purging & Vomits] 
vomits & Purges as Rheubarb
Calomel &c. Antispasmodics as 
Asafœtida. Ol: Sucein: &c. Tonics
has been found use full in this disease  
especially in the last stage 
when there is no inflammatory diathesis 
under this head comes cold Bath. 
Sedatives has been used as opium 
Under this head. Fear may 
be in numerated, Stimmulants
may be used with success a Pitch
Plaster applied to the Shoulders has 
been used with advantage Exercise 
is of the Greatest Consequence in 
this disease Particularly Riding on horse 
back Chang of air from town to Countrys
V:V: is of the great Benefit.
Pyrosis 



287
Pyrosis accompanied with heart
Burn & flowing a Quantity of aqueous 
(somtimes Acrid but mostly
insipid) humor from the Stomach 
it come on suddenlly and is connected 
with a debility of the Stomach.-
Cure I have often removed this 
disease with Bitters but if the Patient 
is Costive a few Grains of Aloes 
ought to be given it is best on account 
of its bitterness-
Colic is a spasmodic disease 
the symptoms is pain felt in 
the lower belly it is seldom 
fixed and pungent in one Part 
with a sence of twitching [in a 
part] about the Navid the Integuments 
of the Belly is drawn in 
and often the Muscle of the Belly is 
Spasm  



288
spasmodically affected.- Women 
are more subject this disease then 
Men probably from their making Use 
of so many slops & leading a sedentary 
Life.- Cure must be begun 
by bleeding as it is frequently 
connected with plethora next Anodynes 
are proper & & Repeated Laxatived 
Medicine must be given and 
these of the most lenient kind as Crem.
Tart. Ol Recini and Glauber salts 
Glysters must not be neglected particularly
that of Tobacco Smoak 
Warm Bath Bliters to the Belly 
as thighs are of the Utmost service 
When applied to the thighs they 
answer as well as to any part of ye 
Body- is Preventative first Regulate 
the diet. Acids as injurious
Diet  



289
Diet animal food and Dry Bread 
Bitten must be recommended the Bowels 
must be kept open by Lenient.
Purges Preparation must be kept 
up omit in diet poark this 
is improper when fresh. Perspiration 
to be promoted by wearing flannel.
Cold Bath: Exercise particularly 
on horseback, for species see
Docr. Cullen and from the Remedies 
above described Relief must be 
given.- 
Cholera the Cure is symple I never 
New are instance of a Person 
Dying with it tho it is a violent 
disease. Diluting drinks to be given 
untill the Bowels are empty 
then Laud. Liquid is to be made 
use of Toast and water to be Drank 



290
Anodine Plasters applied to the stomach 
and Glyster with Liquid Laudanum 
to be administered. -
Diarhæa Scares people of all ages 
when it attacts it is of long 
duration sometimes continues two 
or three years. It mostly occurs between 
the age of 30 & 40 during 
the struggle between the Arterial 
& Venous System.- Symptom 
A frequent going to stool not contagious 
no Primary fever.-
Cure must be 1st. Purging the best 
of which is Rhai it is Laxative 
and astringent. Toasted Rhubarb
is to be preserved to the common Rhai
Next Vomits particularly Ipecacuanna
Astringents are use full
Particularly white oak Bark. Demulcents 



291
Demulcents are use full as White Decoction 
flax seed tea Gum: Arabic &c
Diluents are also Use full attention
must be paid to diet. If the stools  
are Black Vegetable Diet is proper
when green animal food must be made 
Use off - Exercise is of use in ye 
disease seavoyge is necessary for spicier 
I refer you to Docr: Cullen- 
diabetes I have nothing to say of 
this disease but what you will find 
in Authors. It is a disease that seldom 
occurs Next.-
Hysteria symptoms Rumbling 
of the Belly sensation of a Ball Baling 
aboute in the abdomen tow 
as do the [power] stomach & fauces
the strangling sleep convulsions 
profuse Quantity of Urine the Mind 
in       



292 
involuntery subject to vipetuated 
The Remedies the same as in Epilepsy 
There is on fact Relating to 
this that is worth mentioning that 
is the stableness of the mind During 
the Rebelion of Scotland there was note 
a Hysterias case known so
that. If the Mind can be fixed in a 
Hysterical Patient there is little 
danger of a Fitt.-
Hydrophobia this is certainly a 
Spasmodic disease. & Would not the
same remedies that are used in the Tetanus 
be of service in this disease yt 
is by dilating the Wound and keeping 
it open for 40 or 50 Days and in this 
case there ought not only a Running to 
be produced a degree of Inflammation
ought to be Exited.-
Lectr.



293
Lectr. 23d
Ordr. 4th Vesania 
this is a disease in which the Intelects
are impaired without Pyrexia 
or coma & is one of the difficultest 
at of diseases the human species 
is subject to. -
Amentia weakness of the Intelectual
Power in which the patients 
either do not conceive or remember 
the Relation or connection  
of things. There is a certain concistantcy
in the Brain that is 
lower in the Amentia then in ye 
Natural state but in Mdness it
is raised dissections have shewn 
the Brain to harder & somtimes 
softer then in the Natural state 
species are 1st congenita continued 
from 



294
from birth 2d. senilis judgment 
and memory imppaired from old 
age Acquiseta seizing people 
of sound [constitution] Faculties 
from extremal Evident Causes -
1st. of Congenita children is Born     
In this state of Amitea 2 of senilis    
I think that whatever is 
Lodged the human Mend is 
never lost & in proof of this A 
woman related by the Phylosophical
Transactions who was 
succled by a welsh women in
her younger days & had learned 
to talk welsh but forgot it as she 
grew up so entirely that she could
not speak a word of it it happened 
one day that she was very ill and 
during her illness she talked nothing 
else 



295 
else but welsh which she again 
forgot as soon as she Recovered -
Another Instance is of a Person who 
spoke french his father learned him 
french when he was young which 
he had forgotten when he had grown 
up but one Night as I was walking 
with him when he was intoxicated 
with Liquor he spoke the Language 
very fluently which he forgot wn
he was sober The Inference from 
these arguments are of the greatest 
consequence 1st. how encouraging it 
is to fill our mind with use full 
knowledge which is never to be forgotten   
and the danger of filling the 
mind with evil thoughts 2 there is 
another inference from this if the 
Ideas gottin early life occurs to us in 
old 



296
old Age of what service must be 
of to us. 3d. Acquanetta fatuity is 
somtimes acquired from a blow
[in this case] It is within the Power 
of [Nature] Medicine ye Congenita 
in particular, but the Senitis is 
beyond our art in some degree Acquisita
is still more in the power 
of our art. It is somtimes cured 
by nature, which is a proof that 
it may be cured by [nature] Art 
Cure tonics cold Bath Exercise & 
Cold Air.- In Children of Rusetty
habits the faculties advance 
very slowly you increase their 
progress by brasing up the system 
by tonic medicines Milton
could never Rite Poetry in the 
Summer -



297
Melancholia partial Insanity 
without dyspepsia. It is 
a false perception of any one subject 
It varies 1st. there in a false perception 
concerning his own Body 
or affairs this you will frequently 
meet with a man supposes 
he has a stone in his bladder 
or Labouring under a disease that 
he has not or he thinks his affairs 
are worse then they Really 
are Next is a false perception wth
regard to pleasers a man thinks 
he is a king. Next is Love if a 
young man Maries before he Arrives
at Puberty or Maries an 
old Women or an Ugly Woman 
or an expectation of more hapiness
then his mistress is able to give him 
this



298
this is certainly a species of Madness 
These diseases are certainly 
under the powers of Medicines 
as many have been cured by a 
disease after the proper remedies 
for this disease have failed.- 
Cure Journey absence and all 
the Remedys that has been recommended 
in the Hypochondriac 
disease and consumption. When 
from Love Ovid Recommends another 
mistress.- You will often 
meet with Melancholia from 
superstitious or Religious Melancholia
this species you will find frequently
more so then most other      
this species is either accompanied 
with distress or joy. There is no conception
that man can have 
of the deity that is contrary to 
scripture 



299
scripture is to be conceded as a 
disease as a Man entertains a 
notion that he has sinned against 
the holy ghost he is to be treated as 
deranged in his mind in This disease 
is to be cured by Bleeding in 
some cases Purging Blistering 
Exercises is of the Utmost consequence 
Industrious persons never 
are seized with this disease & 
the Indolent and inactive where 
seized with it a Variety of Company 
and Journeys all way Cures 
this disease as in that Arising 
from Love. Next is a disinclination 
to motion which is to be 
cured like the [of] Before mentioned 
species. Next Melancholia Erratum
from change of situation 
as frequently moving from   
one



300
from one country to another 
in this Case Bleeding blistering 
and Labour will Cure him 
some Men have it with Respect 
to their occupation Next Species 
is the Melancholia Tedium
Vitæ that is a person being tired
of Life some way that it is in 
some cases caused by other 
diseases. Next is a Mistake concerning 
a Mans own species conceiving 
himself to be a cock or a crow
&c &c the cure the same as for the 
other species. The next disease is 
The Mania which shall be the 
subject of our next Lecture. 



301 
Lectr: 24th
Mania Insanity false Judgment 
upon all Subjects as a man 
Mistaking his friends for his Enemies 
Species 1st. Mentalis 2d Corposea 3d   
Obscura certain passions of the Mind 
produces Mania as anger &
and all those Passions that produce 
Melancholia produces Madness 
as Religion Love &c not only passions  
of distress but great gay produces
it intense study as to Music 
Mathematics &c but Mathematics 
most seldom in this disease 
as in Melancholia it is seated 
in the judgment sometimes the Moral 
faulty is required & somtimes 
not Madness sometimes happens 
from blows on the head five Particularly 
puerperal Fever the General 
Cause is a more moderate flux of 
ye  



302 
ye Lochia then Natural-
Cure there is a Delirium that attends 
Some cases of Mania which 
depends upon debility and another 
upon exitement. The treatment
in each is very different in Mania 
Mitis the Pulse is feeble attended wth 
debility in Mania Teros these is 
a strong Pulse & in that species
that is attended with high Tone 
the Remedies proper are 1st. Bleeding 
2d Blisters 3d Purges of the Drastic 
kind 4 th Violent Exercises in this 
species the tone is very high & if Bleeding 
Blistering & Purging wont 
do you must make use of Violent 
Exercise as it is very fatiguing and 
fatigue is a sedative Docr. Gregory 
mention a farmer at Alasdair threat
used 



303
Used to Cure Maniac Patients by 
working them in places in the 
same manner as one would do 
Horses. They ought to be separated 
from their own friend But I cannot 
conceive that the Cell in wth 
those Creatures are confined are of any 
use. In Mania Mite. Stimulants 
Blisters to be used Purging to be avoided 
Vol. Salt. Oil of Amber & should be 
used. The facts in support of 
this disease being Here daisy are Numerous 
the Next disease is -
Oncirodinia a More vehement 
and troublesome Immagination in 
sleep. It is owing to a want 
of curies Heavy suppers: Plethora 
disorders of stomach: Worms & Irritation
of any kind  -
but distressing and troublesome Drams  



304
Drams are to be considered as disease
for there are some people that has
never Dreamed at all the Country 
people Dram Little as is likewise 
the Case with the Indians. Walking 
in the sleep is the effect of a Partial 
Colaps of the Brain troublesome 
drams is also the Effect of 
Imperfect sleep.- For sound sleep 
two things are necessary &
fatigue Produces sound sleep. Eating 
supper acts as a stimmulus &  
prevent [ this] sleep. Abstaing from   
supper then must be a means of producing 
sound sleep -
I have taken the Liberty to add 
two more species of Vesania to Dr.
Cullers Number wth. Macronomia
& Anomia 1st. one is a partial Exercise 



205 
Exercise of the Moral Faculty 
2d. or Anomia the Total want of
the Moral faculty.-
Class 3d. Cacheay. -
A depraved habit of the Whole or 
great part of the Body without a Primary 
or Nervous fever.-
ordr. 1st. Marcores a general Waste 
of the Whole Body from scrophula &c
too great evacuation scarcity of food 
wither with fever or without treatment 
is the same. Country Air    
Exercise Tonics & Nourishing Diet 
Ord. 2d. Intermescentiæ all or 
great part of the Body swelled outwardly 
they are divided into swelling 
by fat. Air water or a preternatural
Enlargement of the Substance of the 
Part itself. Polysarcia in the early 
part of life before 30 years age is a 



206
real disease for those people are either 
short lived or very unhealthy unless 
they avert it by constant moderate 
Exercises & Great temperance. A certain  
degree of fat is necessary for health 
fat after 40 is very beneficial keeps 
the body warm Nourishes it and adds 
greatly to its beauty and prevents 
the appearance of age by filling up ye
wrinckles and giving a full plump 
appearance to the whole body. The 
Causes of it as a disease are fevers  
which relax the system very much 
Intemperance in eating and drinking 
as of great Quantities of Animal
food and drinking plentifully 
of Porter & Madera Wine sedentary 
life intense application 
to study and a sudden sessation
of accustomed evacuation 
fat on the same principal both 
defends 



207
from external heat & 
adds to the Warmth of the Body.
Cure by altering all the Causes 
that have been commonly applied 
Remedies is as thought to be of [the utmost] soak in great quantities
Vinegar is of the utmost consequence 
but docr. Cullen says that there are 
combined with Temperance never 
cured the disease & I think they 
are hurt full.- Tho the symptoms 
Resist Long it will not always 
resist but be overcome somtime
 ☿ has been recommended but I 
have never seen this cure. Exercise 
on horseback is of the utmost  
consequence Rising early is of 
great service that is laying in bed 
as small a time as possable- 
On flatulent swelling nothing 
to say but what you will find 
in Anther. 
Water   

a case of spina Bifida that fell under the 
inspection of Doctor Say, for particulars 
see note Book Nomr 6 page 9  
[illustration]

208
Watery Disorders I have little to 
say her Mercury is the best Remedies 
that I have ever made use of 
I have seen a Case of Ascites that 
was cured by drinking Quantities 
of Nitric disolved in water There 
is a publication out Lately that 
Recommends tobacco. To do any thing 
with mercury it must be used 
until it salivates and that 
Profusely. It must be used internally 
& Externally.-
With Respect to Hydrocephy I refer
you to Dor. Whyte Fothergill &c
Spina Bifida a soft Tumour
above the Vertebra of the Loins. It is 
born with the Children I have known 
a case that was cured by taking 
it out with a courtied.
Drop 



209
Dropsy of ye Womb this I have 
seen once which was cured by spt. 
of Turpentine.-
I have nothing to say concerning 
the Hydrocele. I have allways 
used the Caustic. -
Physconea a tumour occupying 
particularly some part of ye
Abdomen neith: Sonorous nor fluctuating
increasing by Degrees 
Mercury is the Best Remedy cold 
Bath &c-
Rickets a large head swelled 
before especialy Depressed Ribs 
swelled Belly the other parts wasted -
it is a frequent disease 
in Scotland but is Seldom to be 
met with in this Country -
Common Remedies are steel cold 
Bath

* ꝶ Ung: Mere ℈ij
Muc: G: Aral: ℈i
Yolk of an Egg M 
disol in Aqua q: s: f Inject  
† Bals Copive }
Steel Pills } Internal 
Bark Peruv }
Cold Bath. -
‡ Gentle Astringents are best 
such as an Infusion of white 
oak Bark. Saccharium saturnic
is Pernicious
port Wine diluted is a very 
good injection in there Cases 

310
Bath generous Diet Bathing the 
body with hags or oil is of the utmost 
consequence in this disease 
Gonorrhea is certainly a distinct
disease from sciphelus there are 
three modes in which it may be taken 
1st. Coition 2 Contact without 
Coition 3d. from Bruises from the 
difficult or Exceptive use of venery 
Cure a weak solution of the Caustic
Alkali to be injected which 
is a powerfull dissolver of Mucus 
Mercurial Injections is usefull 
and preferable these are madly
dissolving Mere. Oint made without 
turpentine [mixed with] in the Yolk 
of an Egg * Lenient Purges. Glut
must be removed by Internal 
astringent † or astringent Injections 
‡



311
the best is Caret & Water -
If the Gleet is occasioned by ulcers 
in the urethra nothing but the 
use of Calomel Internally will
answer.-
Lectr. 25- 
Class 4th Locales
Ordr. Dyspaenia
Diseases of the Eyes for the Particulars 
of these diseases I refer you 
to practical Writers. -
Deafness when it is owing to Wax
that is to be extracted by injections 
of warm water mixed with a Quantity 
of Milk.- Tenias aurum 
yields to purging bleeding. & a Blister 



312
Blister applied to the Ear when it 
is Idiopathic.-
Defect of Smell the sensation of 
smell is formed by the Mixture of
different Odores with the Mucus 
of the Nose when this Mucus is defective 
the smelling injured & fluid 
Injection ought to be made 
Use of.-
Defect of Taste Taste is owing 
to the mater dissolving [to] in the 
Saliva which renders it more Capable 
of Being Applied to the Extremities
of the Nerves when this is 
defective these taste Vanishes 
and is to be restored by any Aqueous
or Mucilaginous fluid 
Ordr. Dyspraxia The Appetite
defective or Wrong.-
Bulemia 



313
Bulemia an Apetite for a greater 
quantity of Esculent substances
than is necessary or then can
be digested, There are scarcely any 
disease where the Patient has a good 
Apetite for his Breakfast species 
1st Ileluonum 
2d. Syncopalis a person fainting 
when his stomach is empty. When 
the Stomach is Toned the whole System 
is in the same state. The 
Best way of managing this disease 
is to eat a little frequently as constantly 
Chewing Biscuit & Bread 
and perhaps it is better to make many 
meals a day then few If one Meal
a day is eaten only it is best to Eat 
it



314
it in the Evening as rest a Erect 
Posture favours digestion more yn
Labour & fatigues & I would advise 
the Patient to sleep in an Arm
Chair.- 3 Bulimia Emetica 
Remedies in dispepsia is proper
here. -
Polydipsia Inordinate Thirst
Cure a Very Large Quantity of Comsalt 
has Cured it -
Pica a longing after improper food 
or that that is not nourishing 
owing to the Corroding Quality of 
the Genres of the Stomach ache.



315 
Lectr. 26th 
For the order of Dyssienesia I refer 
you to practical Writers 
Ordr. 4 Apocenoies a flux either 
blood or other human more than usually    
Plentifull without fever 
or an increased impetuous of ye Fluids 
of this order. I shall say little 
Ptialismus a flux of saliva
sometime brought on by other Diseases 
Nausea produces it it somtimes  
produced by hypochond. Diseas. and   
somtimes takes place in Pregnant 
Women. Cure by purging with 
Sulphure & sucking Orangioes 
Catarrh Veciea (of Lute) This Disease
is a very distinct disease from 
Gonorrhea. It affects the Neck of ye 
Bladder with the Urethra the Matter 
discharged 



316
discharged in this disease is Winter 
these that from a Gonorrhea 
Cure Tonics as Bitters steels &c
Cantharides may be given in small 
doses these act by giving tone 
to the Bladder &c-
Seminal Weakness 
When this is occationed by an intemperate 
Use of Venery it is cured 
by abstinence from Women: Tonics
as Betters cold Bath &c.-
Ordr. 5. Epischesis a suppression
of Exertion & Evacuation 
costiveness is a Retention of fæces 
for more then 24 hours. There 
are a Variety of Causes that bring 
on this disease as Astringent Drinks 
as port Wine &c Pregnancy Produces
it. The diseases Caused 
by



317
by Costiveness is head ach Pales &c 
Cure the first thing to be done in 
costiveness is to desire your patient 
to go to the Necessary every Day 
Diet should be Vegetable summer 
fruits. Indian Meal.- Medicines 
are first aloctris these are 
not the best as they are apt to produce 
Piles. Lenative Electuary is ye 
Best medicine in this disease that 
can be used.-
Ordr. B. Tumoris. The Magnitude
of the part increased without inflammation.-
Schirrups a hard tumor of a part 
mostly Glandules without pain 
and unkindly suppurating
Cure Mercurial Ointment External
friction & the Caustic-
Can



318
Cancer a schirrhous Tumour pain 
full & ending in a bad conditioned 
ulcer. Arsenic is the most efficacious 
of all applications. -
Bubo a suppurating Tumour of a 
conglobate Gland. Cure Rub Mercurial
ointment above & Below 
Lupia a soft immovable indolent Tumour 
under the shire feeling like 
a piece of cloth without any Inflammation    
somtimes it suppurates wth 
that is the Case it should be opened by 
the Caustic-
Hydasthras or white swelling, swell 
in of the Joint oftener the knee then 
any other at first a little Elevated 
in colours like the skin of the healthy 
parts very pain full & Diminishing
the Motion of the joints. It depends 



319
depends upon a preternatural Enlargement
of the Capsular Ligament 
and often with Corruption of the 
Ligament and from the Ligament 
extended to the bone.-
Cure. (Do. Akensides) a variety of 
Remedies have been applied as a 
perpetual Blister all Round the 
part to be kept Running 3 Months 
I am not sure wither the pain is not 
the Remedy and not the discharge
for blisters stimulate & give Tone 
to the Relaxed fibres If you can
not apply a Blister with Convenience  
apply a Caustic to the diseased 
Part.-
of the order 7 of Ectopia a part 
removed from its proper salutation
making a Tumour  



320 
Ordr. 8. Dialyses a solution of 
continuity manifest to the sight and 
Touch.
Ulcer a Purulent or Ichorous solution  
of a soft part. These are very 
troublesome things, they are to be Cured 
by obstinacies [ and] a Gentle Escarotic 
& Tight Bandage. You are 
to heal up the Ulcer with caution 
and Previous to this Reduce the 
Pletora of the system- 
Cuticular Eruptions a great many 
small pimples or Ulcers collected together 
in Cluster & Craping. They are 
to be Cured by total abstinance from 
Animal food abstain from 
butter. Diet to consist entirely of vegetables.
Medicines. Mercury and 
Antimony to be used internally Topical  



321 
Topical application Mercury, Lime Water 
Martins Powders solution of Arsenic 
Tenia Capetis, upon the skin at 
the roots of the hairs very small 
Ulcer exuding a humour that terminates 
in a white Brittle Crust 
the cure may sometime be obtained by 
a Mercurial Wash and a little Medicine
internally if this fails cut of ye 
hair and use tan ointment this last 
never fails.-
Heh pustules & small ulcers Hehing 
& Infections sorely affecting
the hands. Cure Bathing the Body 
with sulp mixed with Haggs 
Lard. -
Vomiting & Purging 
This disease is peculiar in some 
Measure to the United States It 
seldom 



322
seldom makes its appearance before 
may and continues untill July.-
It begins with Bilious & Green 
Vomiting & Purging which for 
The most part begins in the Evening 
Cause, Dentition has been supposed 
the cause of this disorder But 
that this is not the Cause is evident 
from its making its appearance 
before dentition and after dentition
but is much exasperated by it worms some say is the Cause   
but they are not but the disease 
is much exasperated by them. As for 
my part I take this disease to be 
nothing but a Bilious Remitting 
Fever of the same nature that affects 
adults but make its appearance 
in Children 2 month [before]
before the Usual times of its appearance 



223
appearance in adults Cure the same 
as bilious Remitting fever 1st. the 
Bile must be discharge by an Emetic 
& a single one is not sufficient 
but must be repeated untill the 
Bile is all Evacuated 2d. Purges must 
be administered to evacuate Bile Down
wards Ol. Ricini. Manna &c is the 
Best for this purpose when the Bile 
Is all evacuated and a Remission has 
taken Place some gentle Astringent
Tonic & Antispasmodics must be given 
as Huxhams Tincture if this 
is a prevailing Acid in the stomach 
absorbents a decoction of Blackberry 
roots may be given as it is 
Emolient & Astringent Glysters 
of starch with a little Venis Treakle. 
or Laudanum. Blisters when 
the



324
when the Typhus Diathesis prevails 
Cold bath Country air the  
Best Remedies from the City to 
the Country. Convulsion is thought 
to be a sure sign of Death but 
I have seen them recover that was affected
with convulsions by the country 
air. In order to prevent the 
disease Country Air is necessary 
Cleanlyness is of the Utmost service 
wash them often in cold water. The 
country people are very little affected 
with disease owing to fresh air 
and salt Provisions. Wine is a good 
preservative against this Disease 



325
[Wor] Lectr. 27th, 
Worms: there is scarcely a disease 
the Human Body is subject 
but what may be counterfeited by 
Worms.- They may be in the Habit  
a long time without Producing 
disease the Disease the Produce is 
mostly of the Nervous kind such 
as Colic &c but they never produce 
a fever. -
Medicines all medicines that is 
used for the Expulsion of Worms may 
be Reduced to two heads those 
which act Mechanically and those 
which act Chemically.-
Mechanical, Vomit, Purges Particularly 
Jallap Powder of Tin 
& steel. Cow itch. Bark. Rhoi Bitters 
of all kinds.-
Chemical 



326
Chemical 1 salts. These are Acids 
Alkali Neutral & Metallic Salts Particularly 
common salt a Teaspoonfull
given at a dose 2d. saccharine 
substance as all times are of service 
& juice of Black Cherries a 
quantity of this will kill Worms 
in five minutes. 3d. Narcotics, prick
Root &c but in to large Doses 
it is injurious ʒy injured in water 
and given at several Draughts 
Cabage Tree Bark ℥i Boild in a 
Quart of water to a Pint a table spoonfull
of this may be taken every 
morning.- 4th Fœtid substances 
as asafetida in this a Worm will 
live 25 minutes. & but 3½ minutes 
in onion Guise. 5th. Oils in sweat
oils the worm will liven an hour
but Essential oil kills in a very 
short time a worm will live in 
a solution of Arsenic Three hours

327
after giving the Medicines a Purge ought 
to be administered to discharge the 
Worms-
Valedictory 
I shall conclude this short and imperfect 
course of Lectures with a few 
directions to assist you in [gather] establishing yourselves
in business and conducting yourselves 
properly to your Patients 
There are three methods of getting 
into business 1st by opposing every 
Prejudice of Mankind by proclaiming 
war against the Laws and Religion
of our country by avoiding decencey
in behavour and conversation 
and saying nothing like other People 
above all Ridiculing the Christian 
Religion and prostituting the sacred
Writings to purposes of Wit & Impiety
this species of character will often 
succeed with the weak and Vulgar minds 
Parceleus was the original of it  

328
he has had many immitators 
in every part of the World such 
as Doctr. Radcliff of London Dor.
Piteam of Eden bought Docr. Frenchen
of Geneva & Docr. Macgrace  
of this Country These men commanded
respect only from their abillities
but was of the same nature 
with the Homage the Indians 
paid to the Devil such Physicians 
are a disgrace to our profusion to 
sosuity & Human Nature. 
a second mode of getting into Business 
is to assume as much Gravity 
as posable let the heart be 
kept Closely confined within its 
ordinary Limits bit it should be 
lost in Sympathy and Grief The 
Dress and behaviour of such a Physician   
must be solemn & formal 
a smile would degrade the dignity
of 

329
such a character for ever is some 
countries a Wigg and a Cain will 
add greatly to the importance 
of such a character a Physician 
of this discription is esteemed only 
for his skill and is valued by his 
patient like a usefull family
dog or horse for the services he is capable 
of Rendering.-
The Third made of getting into Practice 
is to engraft the Physician into 
the man to feel the Obligations 
and practice the duties of Humanity 
and Religion upon all occations 
and to concider the Profession as agreeable 
as it enables us to make 
our follow creatures Happy toast 
in the capacity agrarian angles 
to our patients to make not only 
their sickness but wants our own 
to

330 
to act in every respect to our patients 
as we would wish them 
in like Circumstanced to act towards 
us such Characters have
existed in the World Doctr. Slahl
Docr. Hoffman, Dr. Boar haave, Dr. 
Sydenhan. Docr. Fothergill, Sir
In Pringes. Dcr. Rullerfobe. Dr. Cullen
& Dr. Letsem where all friend to
Religion & instead of being distinguished 
from the Last kind 
in dress and Manners where 
known only from their Amiable
manner & Extensive Benevolence. 
These are the men I wod.
recomend to your immitation
they are all Benefaction of Mankind 
& they have justly been placed by 
the gratitude of their respective 
Countrymen among those Illustrious 
who have rescued &
dig

331
dignified Human Nature- 
In order to assist you in getting into
Business as well as rendering you 
more extensively usefull. I beg Leave 
to recomend to you to Exempt 
the following discretion of People 
from charges 1st. Physicians and 
Physician Families 2d. The Clergy
of all denominations with all 
that has been said of them, they 
are a usefull body of men and 
as by the nature of their Profession 
they are precluded from all opportunities
of improving their fortunes 
it would be cruel to tax them wth.
their Docr Bill the favours confir'd 
or rather the debt Paid to this Body 
of men produce ample. Returns 
no body of Men have half the Influence in 
Sosciety & I know of 
no [other] more speedy or effectual 
method     

332
method [ of getting] for a young man 
to get into busyness then by Receiving 
the friendship of the Clergy 
3d Schoolmaster from the self denial
as well as the Utility of their 
profession have a Large. Claim upon 
the Benevolence of a Physician 
they should therefore be exempt
from charges 4th Hired Maids 
servents of all kinds in familys
that rewards us generously have 
a large claim likewise upon our 
charity from the Extremes of heat
& Cold & Labour to which they are 
exposed are subject to many more 
diseases then people in easy Circumstances 
how cruel then to 
exact from them their little Prittence
they earn at expense of their 
health Remember Gentlemen wn
you climb to cold & Dreary Garrets 

333
Garrets in which these Poor Creatures 
are thrown in sickness the
Relation they bear to you a fellow 
creature. The poor Coachman who 
rises his hand with difficulty to offer you 
his pulse, he is your Brother & the
Kitchen maid whose fever and 
Pains have been brought on by 
damps and Colds at unseasonable 
hours is your sister for 
man kind you know are of a 
family 5th. Midwives & Wet Nurses- 
The poor of every class & 
description are the objects of 
our Care Doc. Boarhaave Used to 
say that they were his best Patients
because god was their Pay 
Master. The first Physicians I have 
ever known have found the Poor 
the Scaling ladder on which the 
have 

334
have ascended to business eminence
& Reputation. Disease among 
the lower class of men are generally 
Symple here they Exhibit to 
Physicians The Best cases of all 
Epidemics which cannot fail 
of adding to his abilities of 
investigating and curing the more 
complicated disease of the Rich 
and indolent there is an inseparable
conection between a mans
duty & Interest whenever you are 
called to visit a poor patient therefore 
imagine you have these Words 
of our saviour sounding in 
your Ears take care of him I will
repay this & because those hast 
been faithfull unto few I will  
make the rules over Many I now 
shall give you some directions 
with respect to changing when 
we consider the expense of a Medical 

335
medical Education the sacrifices a 
Physician is obliged to make of 
ease company and even health to 
his profession and especially the 
Anxiety that it is imposable for 
a patient sufficiently & justly
to reward his Physician But 
it becomes us to consider on the 
other hand that sickness deprives 
men of means of acquiring money 
that it increases all the Expenses
of Living & high charges drives Patients
from Regular Bred Physician 
to Quacks these considerations 
should lead us to make 
charges as moderate as possible 
and to conform to the following 
state of things avoid measuring 
your services by scruples Drachms 
or Ounces it is an illiterate mode 
of Charging on the Contrary let 
the  

336
the number of times of your Visits 
and the Nature of your Patients 
disease Diamine the figures 
in your Bill it is certainly 
Just to charge more for curing 
an apoplexy then an intermitting
fever you have a great regret to 
be paid too for risqueing your 
own life in visiting a Patient 
in a contagious Disease therefore
charge higher for curing a 
Putrid fever then an Apoplexy 
even where the number of Medicines 
& Visits are the same you 
have a Right likewise to be paid 
for your anxiety charge the same 
services therefore higher to the Master
or mistress of a family or to an 
only son or Daughter who call for 
all your feeling & industry then 
to a 

337
to a Slave whose life is of much 
less consequence to a family or community
If a Rich Man demands 
more constant and Punctual
attendance which is both 
common and natural then a poor 
man if he imposes the Restraint 
of keeping you to hours by 
calling in another Physician to 
consult with you make him 
pay accordingly for it. I have 
only to add to this head that 
the sooner you send in your 
Bill after his Recovery the Better 
there is nothing thought of with 
so much gratitude as the services
of a Physician in sickness 
these is nothing remembered with 
less after the Recovery of your Patient 
I will here let you 
into 

338 
into a secret with respect to the 
description of your patients 1st wn
a Man calls for you to go immediately 
to a case which requires 
no such expedition 2dly when he 
tells you the Patient will have 
no other Docr. But you and above 
all 3dly when he tells you you 
shall be will Paid for your Trouble 
depend upon it such persons 
mean to impose upon you. Indeed 
I have mostly found them 
the most Troublesome Patients & 
the most backward in paying the 
accounts. A man who really 
intends to pay his physician
wisely chuses to have as few unnecessary
visits as possable- 
as the Best Mode of improving
yourselves in the Practice of Physic

339
Physic. I believe to recomend to 
you to open all the dead Bodies 
you can without doing violence 
to the feeling of your Patients or 
the Prejudice of the common [People]
Preserve a Register of the Weather 
and above all Record the  
Epidemics of the season their 
time of appearance disappearance 
and the Connection of the 
weather with them both these 
should be done as regular at the Close 
of the Month as you Post your 
Books keep a Book likewise 
for Chronic diseases Record the 
name age and occupation of 
your patient in it describe 
the disease and every change in 
it and mention particularly the 
doses of every medicine you give 
it is imposable to tell you 
how 

340
how much improvement and 
facility in practice you will 
derive from following this Practice.
In the conduct to your 
patient make it a rule never
to give a patient over in an 
acute disease where life end & 
Death Begins dispute every Inch
of Ground with the king of Terrors
Hundreds of Patients have 
recovered that have been pronounced
incurable to the great 
disgrace of our profession make 
it a rule never to be angry with 
a Patient or to resent anything 
a sick man can do or say to 
you some divines consider them 
as half [man] Beast & Half 
devil Polititions consider them 
as Pecus Humanum as Human 
Cattle 

341
Cattle it is the busyness of Physicians 
to consider them under 
more delicate & human is characters 
of Madmen sickness often 
adds to the degree of madness we 
are therefore to bear with all 
the Reproaches and insults of 
our patients with meakness
and Silence it’s a folly to 
resent injuries at any time 
but is cowardice in the full 
to resent an Injury from a
sick man for he is not in a 
situation from his weakness 
& dependence on you to contend 
with you on equal terms you 
will find you well find it 
difficult to tie your patients to 
you by the Obligations of friendship 

342
friendship you will often find 
those families most disposed to leave 
you in which you have displayed 
the highest degree of skill 
& Humanity these acts of 
neglect & Ingratiated should never 
exert from you the least mark
of dispute or resentment 
by taking no notice of such injuries 
you will often find ye
same caprice that led them off 
from you will bring them 
back again to you.-
I have now Gentlemen only 
to thank you for the great attention
wth wch you have been 
pleased to honour these Lectures 
and to asure that I shall 
ever esteem myself happy 
in rendering you all the services 

343 
that lay in my Power in 
any way you are pleased to 
command me accept of my 
best wishes for your hapyness 
and may the blessings 
of hundreds and Thousands yt
is ready to perish be your 
portion in life your Comfort
in Death and reward in the 
world to come - 
Finis. 

Index
A Page
Anthrax ... 71
Arthropeceosis ... 159    
Apthæ ... 174 
Apoplexies ... 217 
Adinamia ... 231
Asthma ... 282
Amentia ... 293
Aquosæ ... 308 
B
Bulimia ... 313
C
Cynanche ... 84
-Tonularis ... ibid     
-Malygna ... 87
-Trachealis ... 92
-Pharynges ... 96 
Cynanche 

Index Page
Cynanche Parotideus .. 97
Carditis ... 119
Cistitis ... 135
Chicken Pox ... 167
Catarrh ... 208
Coma ... 217
Chlorosis ... 257
Convulsions ... 276
Chorea ... ibid 
Cramp ... 277
Colic ... 287
Colesa ... 289
Cachexy ... 305
Costiveness ... 316 
Cancer ... 318
Culicular Eruptions ... 320
D
Disease (what) ... 1 
- Cause (what - ibid 
- Symptom (what ibid  

Page
Disease the diagnosis … 2 
- Prognosis … ibid 
- Division … 4  
- Arrangement … 6 
Debility signs of … 38
Dysentery … 212 
Dyspepsia … 235 
Dyspnea … 284 
Diarrhea … 290 
Diabetes … 291 
Dysorexia … 312 
Deafness … 311
Dialysis … 320  
E
Enteritis … 127 
Exanthemata … 161 
Erysipelas … 172 
Epistaxis … 180
Epilepsy … 278
Eyes diseasesis of … 311
Epischesis … 316   
Ectopic … 319 

F Page 
G
Gangrene … 74
Gastritis … 120
Gout … 147 
Gonorrhæa … 310 
H
Hepatitis … 128 
Hysteretic … 96 
Hæmorhages … 176  
Hæmoptesis … 183
Hæmorrhoid … 197
Hypochondriasis … 258
Hooping Cough … 284
Hysteria … 291 
Hydrophobia …  292 
Hydarthros … 318
Hemalimesis … 207
I
Imposthume … 73
Inlumesentia … 305
L
Locales … 311
Lupia … 318

M Page 
Miliaria … 173 
Menorrhagia … 203 
Melancholia … 297 
Mania … 301 
Marcores … 305 
N
Nephritis … 133
Neurosis … 216
O
Ophthalmia … 74
Odontalgia … 143
Oncirodinea … 303 
P
Practice of Physis (what) 1 
Pyrexia … 6 
[fever] Remote Cause of fever 7
Predisposing … 18
Varieties … 19
Division … 20 
Intermitting … 21 
Continuel … 27
Synocho … 42 
Typhus … 50
Synochus … 51

Page
Polysarcia … 105
Phlegmasia ... 66
Phlogosis … 66
Phrenitis … 79 
Pneumonia … 101 
Perepneumonia … 103 
Plurecy … 107
Peritonitis … 119
Plague … 170
Pemphigus … 173
Phthisis … 186
Proflubia … 208
Palsy … 227
Palpitation … 281 
Pyrosis … 287
Polydipsia … 314 
Pica … ibid 
Psara … 321 
R
Rheumatism … 137
S
Sphacelous … 74 
Searlatina Anginora … 97
Splenitis … 132    

Small Pox … 161 
Shingles … 172 
Syncope … 231
Spirits (an Enquiry into) … 240 
Sea Sickness … 252 
Spasms … 259 
Smell defective … 212 
Scherries … 317  
Spines Bifida … 308
T
Tetanus … 259
Taste defective … 312
Teneus Aurum … 311
Tenia Capotes … 321
U
Urticaria … 173
Vesania … 293
Ulcer … 320
Vomiting & Purging … 321 
Valedictory … 327
W
Worms … 325



















[illustration]