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NATIONAL LIBRARY OF MEDICINE    NATIONAL LIBRARY OF  MEDICINE   NATIONAL LIBRA 

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NATIONAL LIBRARY  OF MEDICINE   NATIONAL LIBRARY OF MEDICINE  NATIONAL  LIBRARY OF  M|(
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NEW ENGLAND
POPULAR  MEDICINE.
BY GEORGE CAPRON, M. D.,
ASSISTED
BY DAVID B. SLACK, M. D.
  LIBRARY   i
SURC5FPN GENERAL'S OFFICE]

   FEiW-1905
* a4    1
    PROVIDENCE:    J

J. F. MOORE, PRINTER.

      1846. 

       Entered according to Act of Congress in the year 1846,
BY GEORGE CAPRON, M.  D.,  and  DAVID B.  SLACK, M. D.
     In the Clerk's Office of the District. Court of Rhode Island. 
•
PREFACE.
   The general diffusion of useful knowledge forms a new
era in history.  To know everything that can be known is
the ruling spirit of the age.  This is not only, in the highest
degree,  commendable, but must be supereminently happy
in its results upon even the ordinary concerns of life.  The
science or art of medicine is a species of self-knowledge,
which of every other, people really stand in the most need
of possessing.  To be sick and to know  nothing of the
nature of the disease, or of the means of curing it, places
people in the most helpless condition.
   In general, there is a profound ignorance of the human
system, and of the healing art.   This ignorance is as unfa-
vorable to the progress of medicine as to  the welfare of the
public.   It lays a foundation for every species of imposition,
and leaves people without a guide in the selection of a suit-
able medical attendant, when they are diseased.  The  Do-
mestic Medicine of Buchan, printed seventy-five years  ago,
is too old a book to be much of a guide at the present  day.
The discoveries since made, the improvements introduced,
and the alterations which have taken place in the modes of
practice, have made Medicine comparatively a new science.
   In the following work, we hope we have fulfilled the  pro-
mises contained in our prospectus.  An endeavor has been
made  to give a complete  and comprehensive description of
diseases, as well  as full  and definite  directions for their 
IV
PREFACE.
 treatment.   In the choice of a proper arrangement for the
 work, many plans presented themselves, but the one select-
ed, as the most  convenient for a book of reference, is that
 of an alphabetical or dictionary form, placing the common
 name of the disease, medicine, or  other  subject, first, and
 the corresponding systematic or professional name after it.
   The properties and effects of all the most important arti-
 cles of medicines, both simple and compound, have  been
 faithfully described, and the subjects of food, exercise, air,
 sleep, and  regimen generally, received such consideration
 as is needful for the prevention  and treatment of diseases.
 As much of the art of surgery as could be conveniently im-
 parted to the popular mind, has been concisely treated  of,
 and such parts of physiology and anatomy as are essential
 to the right understanding of the other parts of the work,
 briefly explained.   Systematic  names, and technical and
 professional terms, have been studiously avoided; the signs
 of disease described as far as we were able, in the plainest
 and most intelligible language ;  and the work in every part
 adapted to the comprehension of the common reader. 
•
NEW  ENGLAND
POPULAR  MEDICINE.
                           ABS.

  ABDOMEN—The  Belly.—The  cavity of  the  abdomen or
belly, contains the stomach, the bowels, the liver,  the kidneys,
the spleen, the pancreas, the bladder, the ome%um  or apron, the
mesentery, the membrane, to which the bowels and other organs
are attached, the descending aorta, and in females, the  uterus.
It is the largest cavity in the body, and the various organs which
it contains, are called the abdominal viscera.   The abdomen is
separated from the chest or thorax by  a partition! called the  dia-
phragm or midriff.                            *
  ABORTION.—See Miscarriage.
  ABSCESS.—A collection  of matter or pus in any part of
the body  is called an Abscess.   There is  almost an. endless va-
riety of abscesses.  Every tumor which ends in suppuration, is
properly an abscess, but  the word commonly denotes a large
cavity containing matter.  A  common  boil, carbuncle,-or felon
which has maturated, or come to a head, may be  considered an
abscess.                                               \^
  The most remarkable feature in abscesses, is the great amount
of matter which they sometimes contain. They have been known
to discharge two or three quarts at a time.  An abscess formed by
an inflammation of the female breast, not unfrequently discharges
a pint of  pus, and, sometimes, a quart.  It  is the product of
inflammation.   In sound, healthy people, an abscess will be  cir-
cumscribed, or rather the pus will  be contained in a round, or
globular cavity; but in  feeble, scrofulous people, the matter  will
spread in  any direction  where it can find an inlet.  In most
abscesses,  there is more  or less swelling above  the surface of the
flesh, but  some  are almost flat,  and others are situated in  the
chest, abdomen, and deep seated parts, where  no external tumor
is visible.
  When an abscess begins to form,  after an acute inflammation,
             2 
10
ABS.
  the event is usually denoted by chills, cessation of the pain, flushes
  of heat, and abatement of the fever.  If the abscess is upon the
^urface of the body, there will be usually a white spot in the in-
 flamed part, more prominent than the rest of the tumor; softer,
  and disposed to fluctuate when pressed with the fingers.
    One of  the happiest laws which  control the human constitu-
  tion, is the almost uniform 'disposition  of abscesses to seek the
  surface of the body for an outlet  of the matter.  Be the abscess
  situated where it may, the matter which it contains, commonly
  eats its way to  the surface of the body, where it may be inno-
  cently discharged.  If trris disposition of abscesses were reversed,
  or the matter equally disposed to run in all directions, life would
  be a  thousand times more uncertain than it is.  In  some  instan-
 ces, abscesses form in a  few days, and  in others,  they will be
 several years in forming.  In acute inflammations, the  matter
 collects very quickly, but in chronic tumors, the work of suppura-
 tion is slow.
   Domestic Remedies.—The proper treatment of abscesses con-
 sists in the application of warm poultices and fomentations, in
 order to hasten the>formation of the matter, and to soften the super-
incumbent skin and flesh.   The best poultices are made of white
bread, rye meal, |>r flax-seed meal.  The best washes or fomen-
tations, are warm water, poppy tea, milk  and water, lettuce tea.
and a liquor rnqHe of the wild indigo root, boiled.
   In general, as soon as matter can  be detected in any tumor, it is
the safest practice to open it with a lancet.  Abscesses are some-
times opened by the introduction  of a seton, or by  the applica-
tion of cauaf c.   In feeble constitutions, where the abscesses are
large,  it isjfhany times necessary to strengthen the  system with
quinine, reparations of iron, and the mineral acids, before it will
be sate to  discharge the  matter  by making an opening.  After
the matter  or pus is discharged from  abscesses, they should  still
beWered with a poultice, as long as there are any signs of active
&7r °r  \ed"es%V™ ™d s°reness. The cLity should
^ous P han^'     tQ dl6t Sh°Uld bG m°re PlentifW and nutri-
tious,  than  during the process of  inflammation.  After the in

S=5T. &;£?//'the abscess m^be —d &*£

nX":/ £r:z?ts:Tirs stimuiated ™h ™*»»
and a solution of ntoato of «M  "° ' ""t Tio1' White oak ba*>
red preeipita," alnm and L    ' « ™ r      P°Wder °f Cal°mel
  ABSORBENT -ThttT; „     ^T^ Msccss-
sel whieh has been discovertT 1  hC smallest kind <* ves-
either a white or at^I^Z^ tJ™ T  * T**»
on the inner surface of the in,  ,      c  f vess,els may be see«
The ahsorhert, .,1       t 'Mestines of dogs after a full  meal
The absorbents take up substances which aire rubbed upon  the 
ACO.
11
surface of the body, and carry them  into the blood.  They also
take up and remove  the matter of abscesses, tumors, and indu-
rations, and the fat or flesh of the body.  When a person growa
lean, it is effected by the agency of these little vessels.  The far
and the flesh  are,  by them, converted into  a fluid, carried into
the mass  of the blood,  and circulated over  the system.   These
vessels thus continue to devour the" substance of the body, when
the function of digestion is suspended by disease, until no flesh
is left upon the bones, and even the bones themselves very much
diminished.  The  absorbents, which  take up  the food or chyle
and carry it into the blood vessels, are1 called Lactcals, and those
which convey a watery matter, are called Lymphatics.
  The word absorbent is sometimes useS in a very different sense
in medicine.  Magnesia and chalk are sometimes called absorb-
ents, because  they suck up or  neutralize various fluids  in  the
stomach and bowels, such as acids, water and acid liquors.  Any
medicine is termed an absorbent, which takes up the fluids of the
stomach and bowels, or the moisture upon ofher parts of the body.
  ACCOUCHEMENT.—The  French word for  the act of  de-
livery of a woman  in childbed.  It  is now \very often used in
English, to express  the same event.
  ACETATE OF  LEAD.—See Sugar of Lead.
  ACID.—Acid means sourness.  The number of acids is very
numerous.   Some are obtained from vegetables, and others, from
minerals.   The most important acids obtained from vegetables,
are  vinegar, or acetous  acid, citric acid  obtained from lemons,
the tartaric, the prussic, and oxalic acid obtained from  sorrel.
The most essential mineral acids, are oil of vitriol, aqua fortis, and
the marine  acid.   The acids in general,  are cooling, and  much
given in fevers.  They increase the  appetite, and condense  the
fibres of the flesh.   The mineral acids diluted, are vei^strength-
ening.                                              *
  ACNE.—See Blotched Face.                       \
  ACONITE—Wolfs  Bane.—This plant  grows wild fl\ Ger-
many and Switzerland,  but  has been transported to  this country
and cultivated in gardens.  The species used in medicine,  has
long spikes of large blue flowers, and  three capsules to a  flower.
The plant is full of  leaves, which are  the broadest at the top, and
marked with a line running along them.  The fresh leaves have
but very little smell, but when chewed have an acrid taste, and
produce sharp pain in  the  tongue, which swells and becomes
numb.  The  root  is  the  most active part  of the plant.  The
Wolfs Bane,  when taken in a large  dose, produces sickness at
the  stomach,  swimming of the head, delirium,  faintness, cold
sweats, convulsions, and death.  Given in  suitable doses, it excites
a sweat, induces sleep, and increases the quantity of urine.  The
juice of the plant taken upon the tongue, excites a sensation of heat 
12                         ACU.

in the lips, gums, palate and throat, and a general tremor and chilli-
ness in the whole frame.  In a large dose, it ^excites a  violent
vomiting and purging.  The proper dose of the fresh extract, is
  falf a grain made into  a small pill.  The plant in every part is
  nfit for use after it is a year old.  The Aconite is given in Rheu-
matism, palsy, glandular swellings, venereal nodes, spinal disease,
fits, and various nervous affections.   The inspirated juice or ex-
tract, is the form in  common use.  A tincture  may be made by
digesting an ounce of the leaves in a gill and a half of new rum.
A dose of the tincture is from five to ten drops, which may be
gradually increased to forty drops in  the course of two or  three
weeks.  This medicine  requires much caution in its use.
  ACTUAL  CAUTERY.—This is a  surgical operation  per-
formed with a red hot iron.   In former ages, before the method
of tying an artery with a thread was discovered, the actual cau-
tery was the  only way  known of stopping bleedings.  A small
rod of iron was heated  to redness and  applied to the  bleeding
vessel.  It contracts  the bleeding vessel and the blood  ceases to
flow.  This method  is in many instances successful.  In  cutting
tumors and cancers  from the tongue,  mouth,  and  throat, it is
practiced at the present day.   The Actual Cautery is much more
in use among  the French,  than  among the  English and the
United  Statesians.   In  many chronic inflammations and disea-
ses, it is unquestionably a potent, though a painful remedy.   In de-
stroying the nerves of the teeth, it often succeeds better than other
means.  It is soVnetimes a substitute for blisters.   The moxa,
which, as used /mong us, is a little roll of cotton wool, set on fire
and allowed tojburn down to the flesh, is another method of using
the Actual Cautery.   The idea of substituting a burn for another
disease, appears to have  come from the Asiatic nations.
   ACUPUNCTURE.—From acus,  a needle, and pungo to
prick—The operation of making  small punctures in the  body
with aKeedle  for the  relief  of  pain and  the  cure of disease.
This operation  is much practiced in  Siam,  Japan, and other ori-
cntaKcountries, for the cure of headaches, lethargies, convulsions,
colics, &c.  It  has  been extensively tried by some European
physicians of eminence,  several  of whom are extravagant in
their "expectations  of  what may be done by the  thrust  of a
needle."   Acupuncture has been practiced in this country to some
extent, and in a number of cases which have  fallen under the
author's observation, has been attended with  marked  success.
The  number of diseases in  which it is said to have been suc-
cessful, is very considerable ; but the only cases in which we can
rationally expect any benefit to result from it, are chronic  rheu-
matism, especially when seated in the fleshy parts, neuralgic or
nervous affections, such  as sciatica, tic douleureux, nervous head-
ache, local paralysis, and some tumors which contains fluids, as 
iET.                          13
ganglion and hydrocele.  By inserting needles into these tumors,
a degree of inflammation is  excited, the fluid is absorbed, and a
cure sometimes  follows.  "Needles  made for this  purpose  are
from one to four or five inches k>ng, with round or annular heads
to prevent them from slipping" below the skin;"  but ordinary
sewing  needles may be used.  From one to twenty may be  in-
serted at a time  and allowed to  remain, from  a few minutes to
several hours, or even days.   The distance to which they should
penetrate, must depend upon the nature<and  seat of the disease
for which they are employed.   Even deep seated  organs have
been penetrated  by some rash experimen|ers, but in the present
state of  our knowledge, this  practice should not  be  imitated.
It is the opinion of some, that one needle allowed to  remain an
hour or two, is  more  efficient than  several when  permitted to
remain but a few minutes.   When we consider how popular  this
remedy is in some  countries, and  by what Tiigh authority it is
advocated, we cannot avoid  the inference, that it really has some
claims as a remedial agent; and that it will therefore be subjected
to a more extensive trial than it has yet had in New England.
   ADHESIVE  PLASTER.—This  is more commonly called
sticking  plaster.  It is made by adding half a pound of yellow
resin to three pounds of lead plaster.  Having melted the lead
plaster over a slow fire, add the resin in powder' and stir them
together.  This plaster is used where the flesh  has been cut or
torn, to bring the sides of the wound together that it  may heal
without  ulcerating.   It is a principle in  surgery, that  the closer
the lips or sides of a cut or wound are brought together, the more
quickly and safely it will heal.   The sticking piasters an admi-
rable invention for this purpose.  In  most cases, it savers the pain
and disfiguration of taking stiches or  sewing up cuts ancrwounds,
as was formerly the practice.  It gives, in many cases, a mechan-
ical support  to the flesh, and is  of excellent use in bringing the
sides of old ulcers together, whereby adhesions  may take place.
The plaster is spread upon narrow strips of new cotton cloth^
or wash leather, and  one  end  of the strip  after being a little'
warmed, is pressed upon one side of the cut,  wound or sore, and
then having brought the divided  skin and  flesh together, the other
end or part of the strip. is pressed hard upon  the other side.   In
this way, one, two or more  strips are laid on, with  a little space
between them to allow the matter, if any is formed, to escape.
   ADULT  AGE.—Manhood or womanhood, the period between
youth and old age.  In medicine, a person is considered an adult
who has arrived to maturity.
   iETHOPS  MINERAL.—Aethops  Mineral is   composed of
sulphur and quicksilver, ground  together in a mortar.   This  me-
dicine is much used  in diseases  of the skin,  such as affect chil-
dren in early infancy, and in  glandular disorders, such as scrof- 
14
AFT.
ula, and indurations of the  glands.  It is alsp  given for worms.
The dose for a child one or two  years old, is  two grains.  For
an adult, seven grains.   It is the least likely to salivate of all the
mercurial preparations.  It is  a black powder,  and looks very
much like charcoal.  In this form it is the most frequently given,
mixed with syrup or molasses.
  AFFECTION.—Affection, in medicine, means the same as the
words disorder, disease,' distemper and malady.
  AFFUSION.—The .feet of pouring  water or other fluids upon
the surface of the body/ Cold  and warm affusions arc much used
in the treatment of diseases.   In typhus and scarlet fevers, the
cold affusion  is esteemed an invaluable remedy,  during  the first
stage of those diseases.  Where it does not cure the disease, it
makes the patient more comfortable and easy.   The patient may
be placed in a tub  <jjr other  convenient situation, and cold  water
poured upon  him..  He should then be wiped dry and put into
bed.  The cold affusion should always be  employed in the hot
stage of the fever,' when the excitement is the highest, and never
when there is any  chilliness or depression of the strength.   Cold
bathing in whatever way  practiced, will  always be injurious,
when the system is not in a condition  to react, that is, to become
warmer and more vigorous in all its functions.
  AFTERBIRTH—Placenta.—This is the  substance which
comes away from the mother after the birth of a child.  It is an
organized body, of a glandular appearance, circular form, and
about  six inches in  diameter, and as thick as the palm of the
hand.  Its  office is to  secrete  the blood from the womb of the
mother, and to convey  it to the blood-vessels of the foetus.   It is
filled with  arteries and veins,  and, in  appearance, resembles the
spleen^  The  navel  string  of  the child, which  is,  in  general,
abouAffialf a yard in length  and as large round as the little finger,
pro#eds from the aiterbirth, and enters the belly of the child.
The afterbirth has  two sets  of blood-vessels; one takes the blood
from the mother, and the other conveys it to, and returns it from
the child.  The navel-string,  funis, or chord  as  it is variously
called, contains two arteries and one vein.  The vein  conveys
the blood from the mother to the child, and  the two arteries con-
vey the blood from  the child  back to the  mother.  These arte-
ries  beat in consonance with  the beating of the  child's  heart.
The afterbirth during the growth of the child  in  the womb, ad-
heres intimately to its substance.  But after  the child  is born,
the afterbirth separates and   comes off with the  membranes
which enclosed the child before birth.  These membranes, three in
number, often adhere together  in such a manner, that they appear
to be only one.  They are called the amnion,  the chorion, and
the decidua.   The afterbirth  is convex on the  side which ad-
heres to the  womb, and concave on the other.   It commonly 
AIR.
15
adheres to the fundus of the womb,' although it may, and  often
does, adhere to almost every other part.  It usually comes  away
from the  mother in the course of half an hour or an hour, after
the child  is born.   In some instances, it is expelled at the same
time with the child, and the membranes which contain the  child,
are unbroken.  After the birth of the child, there is a short cessa-
tion of the pains, but they soon return and expel the afterbirth.
   AFTER-PAINS.—In child-birth, there are three distinct  spells
of pain.   The first comes on to expel the child, the second to
expel the afterbirth, and  the  third  to expel the  clots of  blood
which accumulate in the uterus after the expulsion of the  after-
birth, and to contract the organ to its natural size.  The  after-
pains begin after the expulsion of  the afterbirth.   In some cases
these pains are very slight, especially witk the first child.   In
other cases, they will be almost as hard as those which expel the
child.  They commonly  cease  after about  twenty-four  hours,
but will sometimes continue for two or three days.  If  any part
of the afterbirth has been left, the pains may continue until it is
expelled.   The  after-pains are  commonly harmless, but  when
they are severe,  and prevent sleep, it is usual to give twenty-five
or thirty  drops of laudanum or morphine,  which will moderate
them.  A table-spoonful of paregoric, or a  plentiful draught of
hop or poppy tea, will answer the same purpose.'m
  AGRIMONY.—This plant is a native of the!United States.
Its blossoms are yellow and appear in July.  The leaves of this
plant are  said to be laxative and tonic.  The tea made of the
leaves and  stalks, is of a dark yellow color,  and mixed  with
whey, affords  an agreeable drink.  The Indians are said to have
used a tea made of the roots, in inflammatory fevers.*^
  AGUE.—See Fever and Ague.
  AIR.—Bad air is as detrimental to health, as bad  food or bad
water.  But people in general are much less concerned about the
properties and constitution of the air which they breathe^than
about almost anything else which affects their bodily welfare.
  Pure air  is composed of three ingredients, or  three kinds of
air combined together.  These  three kinds of air or gasses, are
all invisible to the  eye, but still are capable of being submitted to
examination by a proper apparatus or instruments.   Twenty-one
parts by measure of the pure air, consist of a gas called oxygen.
It is this part of the air  which supports life, and gives the florid,
red color to the blood in passing through the lungs.   The  other
parts of the air will not  support life for a  moment;  if people
attempt to breathe them, they faint and die immediately.   More
than  three-quarters of the  air, or about seventy-eight parts in a
hundred,  consist of a gas called nitrogen.   The other gas,  or
third ingredient  of common air, is carbonic acid, such as flies off
from a tumbler of soda-water, or from a bottle of beer.  There is 
16
AIR.
but a small proportion of this latter gas in the common air, not
more than a thousandth part.  This gas when absorbed by water,
forms an acid which has a smart, sourish taste, and may be taken
into the  stomach with impunity.  A lighted lamp placed  under
a vessel of this gas, immediately goes out, and an animal placed
in the same situation, immediately  expires.  It  is heavier than
the other two gasses,  and always sinks below  them.   It settles
into old  wells and  unventilated cellars, and sometimes destroys
the lives of those who descend into them.
  If several lamps are pkept burning in a  small  tight room, the
vital part of the air or oxygen  is soon  burned out, and nothing
remains but the nitrogen, and the carbonic acid gas.   The lights
first begin to burn dimly, and then go out.   If there should hap-
pen to be a person aslfeep in this room, he faints and soon expires.
If the room is large  and not very  tight,  the  person only feels
weak, faint, and dizzy, or  sick  at the  stomach.  If any one
should attempt to live in such a room, his health would be grad-
ually undermined,  and sooner  or later  some incurable disease
be induced,  which  would carry him  off.
  The health  of the body is affected by changes in the tempera-
ture, weight, m<jtature and constitution of the air.
  Many diseases of the body are produced by changes from heat
to cold, and from cold to heat.   Almost all inflammatory diseases
appear, in a giater or less degree, to be produced by changes in
the temperature of the air.  The only way to avoid the extremes
of these  changes, is to pay proper attention to our clothing, our
dwellings, and the degree of heat and cold which we are capable of
supporting with  comfort.  Living long in a very hot air,  drains
the body of its  moisture, and disposes it to fevers,  diseases of
the liver, and cholera morbus.   Living  long  in an extremely
cold air, exhausts the heat, and weakens all the vital functions. It
is the sudden  changes which people are chiefly to guard against.
  Tlje air affects  our health by changes  in its weight.   It is
sometimes  much heavier than at others.   The  difference in
the pressure of  the atmosphere upon the body  of an ordinary
sized man at  different times, is equal to a ton weight.   When
it is heavy, it renders the  flesh and fluids of the body denser
and firmer.  When it is light, the flesh,  the vessels,  and the
fluids expand, and the whole body  is rendered  tumid.   In very
windy weather, the  air is always light,  and  people, at such
seasons, always feel remarkably uneasy.  The nerves in particu-
lar  are very much  affected by the weight of the air.  Hysterics.
hypochondria, and all nervous  affections, are very much  aggra-
vated by the changes which are indicated by the Barometer.
The human body contains a large quantity of air incorporated in
every tissue, and when the pressure of the eternal air  is dimin-
ished, the air  within  expands, and forces asunder every fibre in 
AIR.
17
 the  system.   Disease in some shape or other, is no doubt  often
 produced by this cause alone.
   For this evil there is no known remedy;  but, a knowledge of
 the  fact may help us to explain  many symptoms which can be
 accounted for  in no  other way.  It is probably owing to this
 cause, that many sick people and invalids  become bloated and
 look much fuller of flesh than they really are.
   The air is often filled  with moisture and wet.   Damp  air is
 extremely inimical  to  health.  People who live in cellars, and
 low, damp places, are invariably  unhealthy.  Inflammations,
 dysenteries, and putrid fevers, are  almost  sure to overtake the
 inhabitants of cellars, and damp, wet  houses.  The  damp, wet
 air,  not  only operates  upon  the surface of the body, but being
 breathed  into the lungs, is almost  sure to excite  inflammation.
 People should  be prohibited by law from living in all places un-
 der ground, or  in damp, wet  cellars.  In the choice of locations
 for dwelling-houses, dry  situations should always be selected;
 and  when moist places are built upon, the houses should be raised
 very high from the ground, and the air allowed to circulate under
 them.   A house built over a damp, wet cellar, where the air is
 entirely prevented from circulating, must always be an unsuitable
 dwelling.  The  air confined under houses is very damp, and
 loaded with noxious vapors.
   There is a wide difference between  the open air, and the still,
 stagnant air of dwelling houses, hospitals, churches, and school-
 houses.   The  confined, still  air in  the rooms of houses, besides
 being  exhausted of a considerable portion  of its vital part by
 being breathed over by the family, by burning lights, and other
 modes of consumption, possesses much less elasticity and purity
 than the open air; it becomes charged with  the perspiration, and
 all the other  effluvia of the body.
   People confined day and night to the house, become pale, faint,
 and  debilitated.  They lose  their appetite, and their  vigor both
 of body and  mind.   The  sleep is unsound,  and  the functions of
 the body are  performed with difficulty.  The windows and doors
 of dwelling-houses, and of all public buildings where people con-
 gregate, should be often thrown open, and the air suffered to pass
 freely through them.  The air is a great solvent of all  impurities,
 and  will cleanse the filthiest places.   Beds and bed-clothes should
 be allowed to lie exposed to a current of air every day, for some
 time, before  they are  made up.   Sick rooms  should  always be
well ventilated.  The sick suffer  more for the want of a change
 of air, than  from exposure to colds when  the  open air  is ad-
 mitted.
   All sores heal better, and all  diseases recover better in a pure
 than an  impure air.   We subsist almost as much upon  air, as
 upon food, and the quality of the air we breathe, is as important
              3 
IS
AIR.
as the quality of the food we eat.  The foundation of many dis-
eases is laid by staying too  much in the  house and breathing a
dead still filthy air.  All people should strive as much as possi-
ble to live in the open air.  There is as much difference between
the air  of a  common dwelling-house, church, or school-house,
and the open air, as there  is between the water of a dead, still
pond, and that of a running brook or  living spring.   It  is very
fortunate that  the  rooms in our  manufacturing establishments
generally, are very large and full of  windows, which may admit
an abundance of air as well as of light.
   When people become better  acquainted with the properties of
the air,  the function of respiration, and the part which the vital
air or oxygen plays in the  subsistence, the vigor and the health
of the body,  they will be much more abroad in the open air, and
take vastly more pains  to supply their habitations and places of
resort with an element so  essential  to life  and to health.  We
have sufficiently explained the difference between the open air and
the still air of houses.
   There arg three other kinds of air  which possess qualities more
or  less  distinct.  These are the  sea air, the  land  air, and  the
marsh or lake air.   The sea air is allowed  on all hands,  and by
universal observation, to be  the most  pure, healthy and  invigo-
rating.   The sea air is not only a promoter of good health, but of
good spirits and a cheerful mind.   This air is the freest of foreign
gases and vapors,  and of course,  contains the most of the vital
air in the same bulk.  All fevers are milder, and all sores, ulcers
and diseases  heal quicker at sea than upon the land, if the same
kind of aliment is afforded.   Islands, which are in the situation of
ships at sea, are proverbially more healthy than  places upon the
continent; and the  sea-shore is, for the same reason, more heal-
thy than inland towns.
   The  sea air has an instantaneous  and a wonderful effect upon
the digestive  organs.   It sharpens the appetite and quickens the
conversion of the  food into blood.  For  dyspepsia, nervous dis-
eases, liver  complaints, sores, ulcers, abscesses, diarrhoea, dysen-
tery, the bowel complaint of children, dropsy  and all  chronic
diseases, with the  exception of consumption, the air of  the sea-
shore and the islands of our union, is much better than the inland
air; and in the summer time, the sea-shore air of New England
is better than that of the southern states, inasmuch as it is cooler.
   The land air is charged  with a variety  of odors, gasses and va-
pors, which  arise from the  earth in the decomposition of animal
 and vegetable substances.   In some seasons, the decay  of these
 substances is so rapid  and  extensive, as  to produce a  malignant
 state of the air.  Fevers are proverbially more prevalent in inland
 towns, and especially in places where vegetation is abundant and
 rapid in growth, than upon the sea-shore or islands. 
AIR.                          19
   But the sickliest places upon the land are, in the neighborhood
of marshes, ponds, lakes, and large rivers, which overflow exten-
sive intervales or  meadows.   From such places  there arises  a
miasm  or putrid air, which never fails to generate the fever and
ague, bilious fever, and malignant dysenteries.  In all such places,
the houses  should be set high,  either upon  piles, or upon  the
highest and driest soil.   The night  air should  be studiously
avoided;  the  body should be well defended from sudden chills,
and the food should be abundant  and wholesome.
   Sandy, dry places, though not so  fertile and prolific, are more
healthy than moist, clayey, and alluvial soils.
   But although the country is less pure than the  sea air, it is
vastly more healthy than the city air.  Many more  children are
raised in  the  country than in  the cities, in proportion to their
numbers.   The air of cities  is not only more  confined and still,
but is mixed with a thousand  noxious gasses, odors, vapors, and
smokes.   The mere smoke of chimneys occupies no small space
in the atmosphere  of cities.   The perspiration  and effluvia which
arise  from such a dense population of men and  animals, must
also largely contaminate the air.  In addition to this, there is  the
decay and putrefaction of large stores of fish,  meats, and grains,
and the vast accumulations of filth  and dirt  in the streets and
sewers.  From all these sources, a steam of deadly gasses con-
stantly goes up into the  air to be breathed by the  inhabitants,
and happy is it, if the city is situated upon some high and dry
land or promontory upon the  sea-shore,  where the air can be
changed by  daily breezes, and these  deadly  poisons fanned away
upon  the  open sea, or dispersed among the  clouds.  Ventilation
should be the^study of those who live in cities; and every hour
that can be spared from business,  should be  spent in  the country.
The practice of doing business in the city and sleeping  in  the
country, is the best which can be adopted, both for health and
enjoyment.   But  even  in cities,  if  children are  allowed  to go
abroad, to romp and  play in the open air, it is vastly better for
them, than to be  shut up in the house away from the light and
breezes, and deprived of exercise.  Exercise, by quickening  the
circulation of  the  blood,  makes up, in a measure, for the want of
a pure  air.   People who live much  in the open  air, uniformly
sleep  better, have better  appetites, more strength, fewer diseases,
and enjoy longer  lives,  than those  who are  confined to their
houses.
  AIR SWELLINGS—Tympany.—Air  swellings or  bloatings,
are affections which were  noticed much more by our ancestors
than  they are by  us.  When a cupping-glass  is applied to any
part of the skin, a  swelling immediately arises under the  glass.
The  air which is contained in  the  skin and muscles expands
when the  weight of the atmosphere is removed by the cupping- 
20
AIR.
glass, and a bloating or air swelling immediately arises.   What
is called the bloating of the face, and of the abdomen, and other
parts, is produced in a similar way, but with  this difference,  a
weakness  or relaxed state of the fibres of  the muscles and  mem-
branes, allows the  air  which they contain to  expand, without
the removal of the weight of the external air.  Some people, in
the morning, will look quite  full faced and fleshy, who, a little
while after, will appear thin and sunken.
  But the disease which more  particularly takes  the  name of
Tympany, is a  constant  accumulation of air  in  the  abdomen,
which renders the belly full, hard, and  elastic, like the head of a
drum.  When the  belly is pressed upon with the fingers, there
remains no impression  or  indentation, as in the case of a watery
swelling.   The  air is sometimes in the cavity  of the  addomen,
without the intestines, and, at others, in  the tube of the  intes-
tines themselves, or between the different layers of membranes
which compose the coats of the intestines.  Ordinarily, tympany
is a dense  accumulation of wind in the colon, a portion of  the
large intestine.   It has sometimes been drawn off by inserting a
long gum-elastic tube into the rectum.   It will often be relieved
by gentle  cathartics, particularly the spirits of turpentine  mixed
with castor oil.  Relief may also be obtained by cathartic  injec-
tions.  The most  proper  remedies  are those which  strengthen
the whole sytem, such as iron,  the  mineral  acids, quinine and
bitters in general.  But exercise and temperance  appear to us to
be the fundamental conditions which  promise  a  cure.  When a
dense accumulation of air takes place in  the abdominal  cavity
without the intestines, relief is much harder to  be obtained,
though, ejren  in such  cases,  we should  not despair of a cure.
Exercise  carried to the degree  of raising a gentle perspiration
every day; a selection  of the  most digestible and nourishing arti-
cles of food; and a constantly open state  of the bowels, will do
much towards a cure.
  It has been a question with many, whether air  ever exists in a
free state  in the arteries and veins.   It appears  to us very proba-
ble that it does,  and that it sometimes produces an irregularity of
the pulse.   The blood contains air, as well as the muscles and
solid parts of the body; and  this air may  be sometimes liberated
in the blood-vessels, as  well as in the skin, muscles, and the large
cavities of the body.   When the atmospheric air  has been intro-
duced into the arteries and veins, it has produced instant death;
but such an effect may be produced by air suddenly introduced
by art, and not  by a liberation of the  air, which  is an ordinary
constituent of the blood itself.  In  the latter  case, it only pro-
duces disease, whereas in the former, it produces death.
   We conceive  also, that the lacteals  and the lymphatics may
secrete air; and that, in this way, air may be introduced into the 
ALO.
21
blood vessels and excreted into the different cavities of the body.
It is of the utmost importance, therefore, to  produce a healthy
state of the digestive organs and a regular action of the bowels.
Costiveness must certainly aggravate, if it does not produce the
disease.
   ALBUMEN.—One example of this substance is the white of
an egg.   It is one of the  immediate principles of animals and
vegetables.   It is contained in the watery part of the  blood, in
the juices of the joints, and in the chyle.   It is one of  the chief
constituent principles of the flesh, and of all the solid parts of the
body.   Heat coagulates it, and renders it solid.  It  is also ren-
dered solid by agitating it with ten or twelve  times its weight of
alcohol.
   ALCOHOL.—See  Spirits of Wine.
   ALDER—BLACK.—The bark and the berries are  the parts
of this shrub which are used as medicine. The berries  are red
and bitter.  The bark is astringent as well as bitter.  The black
alder is very common in New England.   It grows in swamps
and marshy places.   The berries may be  infused in brandy and
given in diarrhoea, or looseness of the bowels.   The bark made
into  a tea, is a great strengthener of the stomach and bowels.  In
diseases of the skin, it is said to be a potent medicine.   A tea
made of the bark, may be used as a wash to sores and ulcers.
   ALKALI.—Crude  potash, soda, and the spirits of hartshorn
are alkalis.  If the lye  procured from  wood ashes be  boiled
down, it  makes  potash.   Soda is obtained  from the ashes of
burnt sfla-weed, and ammonia or hartshorn is obtained from the
horns of the Hart.   The alkalis and acids mixed together, form
a great 'number of salts.  Oil of vitriol mixed with soda, makes
Glauber's salts.  The marine acid combined with soda, makes
our common table salt.  The aqua fortis mixed or combined with
potash,  makes saltpetre.   The carbonic acid, such  as flies off
from a tumbler of soda in  the  form of a  gas or air, mixed with
ammonia, makes the salts of hartshorn.   The alkalis are  used in
medicine to correct or neutralize sourness of the stomach.  They
are also stimulating.
   ALMOND OIL—Oleum  Amygdali Communis.—This oil is
obtained from  fresh sweet  almonds, by  boiling  them  and ex-
pressing them in a hempen bag.   The oil is laxative, and soothing
to inflamed parts.  It is often given in the dose of a tea-spoonful
to children in the croup, lung fever,  influenza, and other affec-
tions of  the  throat and lungs.  It promotes expectoration and
quiets a  cough.  It  is often mixed with  squills and balsam of
tolu, and  given as a  loosener of a cough.  It is much used in
gonorrhoea.
   ALOES.—The aloes which we use is the  inspissated juice of
a  perennial plant which grows in the warm latitudes of each 
22
ALV.
quarter of the globe.   It is brittle, very bitter, and melts in a
moderate heat.   The best kind of aloes comes from the island of
Socotora, on the eastern coast of Africa, and is wrapped in skins.
It is in small pieces of  a reddish brown color, and when reduced
to powder, is of a bright golden yellow.   It has an aromatic fla-
vor, and an agreeable  odor.   The  Barbadoes aloes is in  large
masses, of a lighter color, and has an odor much stronger.  Aloes
is a warm, stimulating  purgative.  It appears to operate almost
entirely upon the lower portion of the bowels, where costiveness
is the oftenest situated.  In the piles and  fistula, it is an unsuita-
ble  medicine, but in all affections of the stomach, liver and womb,
it is an  invaluable purgative.   In  the  common headache,  three
or four aloetic pills are almost  sure of procuring relief.   Aloes is
one of the most potent  remedies in female obstructions.  We are
very sure that the famous Anderson pills are nothing more than
aloes.  We have noticed that  these pills  melt in warm weather.
This they  would not  do, if they were  mixed  with any  other
powder or substance, in any considerable quantity.   The dose of
aloes is any quantity between five and fifteen grains, for an adult.
The dose for a child from one to four grains.   Four pills of the
common size, made by warming  the  aloes  by the  fire, are an
ordinary dose.  One pill will  operate upon  many people ;  some
require two, and others, three.   In all cases of mere costiveness,
aloes will be found a safe and serviceable purgative.
  ALUM.—This substance or salt, is composed of the acid called
oil  of vitriol, or sulphuric acid, and argil or  pure  clay, with a
small portion of potash.  It is found in a native state, or may be
manufactured artificially.  Alum comes to us in large masses ;  it
has a sweetish, astringent taste, and  is transparent.   It readily
dissolves in cold water, and is soluble in  twice its weight of hot
water.  It is one of the most  potent astringents in the materials
of medicine.  Dissolved in water, it makes  an excellent  lotion
for  the skin, and a wash for weak, inflamed  eyes.
  The powder of alum is a speedy emetic in the dose  of a table
spoonful, and is one of the best medicines which we have ever
used in the croup.   The dose  for a child a year old, is  a tea-
spoon heaping full, of the powder.  Given in a larger dose, it ope-
rates both as an emetic and a  cathartic.  It has a peculiar prop-
erty of emulging the glands of the throat, and of making  them
pour forth a large quantity of  watery mucus.  In bleedings from
the uterus, bowels, and nose,  it is one of the very best styptics
which we possess.  The best  form of giving it internally, is that
of  alum whey, made by adding  two drachms of the powder to a
pint of hot milk.  The dose of the whey, is  from half a gill to
a gill. As an emetic, alum operates easily, safely, and thoroughly.
  ALVINE  CONCRETIONS-Intestinal Calculi.—Hard sub-
stances occasionally found  in the  intestines.  These substances 
ALV.
23
are of various sizes, from that of a pea to that of an orange, and
of different degrees of hardness, sometimes approximating to the
solidity of stone.   They have in some instances been discharged
spontaneously, or by the operation of medicines when  their ex-
istence was  not suspected; in others, they have been discovered
by an  examination of the bowels, having the feel of a hard tu-
mor ;  but in the larger proportion of cases, they have been taken
from bodies examined after death, when there was no suspicion
of their existence.   These concretions usually form around  a
nucleus of some hard,  indigestible substance,  such as a  small
piece of bone, the husks of seeds, fruit stones,  &c, and consist
for the most part of  concrete bile, indurated, tenacious mucus,
intermingled with earthy and other extraneous matters.  In other
cases  they are altogether of an  earthy composition, consisting of
magnesia or carbonate of lime,  (chalk) which had been taken to
neutralize acidity in the stomach.   There  are rarely more  than
two, though  twelve have been  observed in the same individual.
When existing in the stomach,  which  sometimes happens,  their
number may be  more considerable than in the bowels; from ten
to thirty have been met with in  this organ.  It has been observed
of Al vine Concretion, that they derange the functions of the ali-
mentary canal, create griping, obstinate and long continued colicy
pains, and more or less obstruct the passage of the aliment through
the intestines ; and that they sometimes change  their  situation,
pass down into  the rectum or lower  bowel, occasioning acute
pain and weight in the lower  part of  the back and fundament,
with a  constant desire to go to stool,  which the patient cannot
gratify.  When  in  this situation, they may be  extracted by the
introduction of the finger or some  suitable instrument.  When
very large and impacted, they cannot be moved from their situa-
tion, except by an incision into the bowel, an operation which is
liable  to be followed by serious consequences; neither is there
any chance of dissolving them by any medicine given internally.
Under these circumstances-, the bowels are finally completely ob-
obstructed, inflammation supervenes,  and the patient  dies with
symptoms like those of colic.  When the nature of the case is
suspected before these concretions have arrived to any considera-
ble magnitude,  they may be  removed by copious  draughts of
flax  seed or slippery elm tea,  half pint doses of sweet oil, and
other mucelaginous and oily substances, combined with a course
of cathartic medicines.   Should they lodge in the lower bowel,
they must be artificially extracted.   A case is  related, in which
an immense accumulation of cherry-stones was found in the caes-
cum and a part of  the colon, below which there  was a stricture,
which had intercepted their transmission.   During life the tumor
caused by the accumulation, gave to the hand a feeling of crepi-
tation like air in  the flesh, which was found to be caused by fric- 
24
AMM.
tion of cherry-stones upon each other.  It was proved  that the
fruit must have been eaten a twelvemonth before the decease of
the individual.   This case suggests the propriety of briefly alud-
ing to a very prevalent error in regard to swallowing cherry-
stones.  It is generally believed that cherries are  less hurtful
when the stones are  swallowed, than when they are rejected;
but nothing can be further from the truth.   Thse substances are
as indigestible as pebble-stones, and must pass through the whole
tract of intestines unaltered;  in doing which, besides disturbing
the stomach and bowels, producing diarrhoea, cholera morbus, or
colic, they not unfrequently lodge and lay the foundation of in-
curable  disease.   A case  similar to the  one quoted, occurred  in
this city several years ago ; but the stricture being situated lower
down in the rectum,  the patient was  relieved,  not,  however,
without great difficulty and  suffering.  The quantity of cherry-
stones which  had been pent up back of the stricture many months,
was not less than a gill.   The subject of this case has died within
the last year of the stricture,  which was much aggravated, if not
caused by the cherry-stones.   A well known revolutionary Cap-
tain in this vicinity, lost his life some years since by swallowing
a large number of cherry-stones, under the mistaken impression
that they would prevent  the cherries from injuring him.  The
stomach  and  bowels were disordered, with sickness, diarrhoea,
griping pains, &c. ; his appetite was depraved, digestion  suspend-
ed, debility and  emaciation induced, and he died  three months
from the time the cherries were  eaten.   The true cause of his
indisposition was not suspected, until he vomited up from twenty
to thirty cherry-stones  five  weeks after they were swallowed.
Cases frequently occur, in  which death is produced in a few days,
especially in  children, whose stomach and bowels  are more irri-
table, and consequently predisposed  to disease,  than  those  of
adults.
   It is hoped that the above briefly stated  facts and observations,
will have the effect, in some  measure, to do away with this un-
natural, unphilosophical and dangerous practice.
   AMAUROSIS.—A total loss of the sight without any visible
alteration of the eye.   It  is a palsy of the  optic nerve or retina,
whereby the  sight is destroyed without  injury to the other parts
of the eye.   It is produced by severe pains in the  head, nervous
affections, and blows upon the head.  This disease is at first in-
dicated by the appearance of particles floating in  the air before
the eyes, which  the person will attempt to brush away  with the
hand.  See Dimness of Sight.
   AMENORRHEA.—See Green Sickness.
   AMMONIA.—This  substance is a volatile alkali, pungent  to
the smell, and absorbed by water.  It is a transparent, colorless,
invisible gas.  It is obtained  from the salt, called muriate of am- 
AMP.
25
monia, by adding lime, and applying heat to the mixture.  These
substances are mixed with water  and distilled in a glass retort.
The alkaline air  combines with  the watery vapor, and forms
what is called  the  water of ammonia, hartshorn or smelling-
drops.   Ammonia, or the water of ammonia, combines with oils,
and forms soaps and volatile linaments.  It has a burning, caustic
taste, like potash; and combined with the acids, forms a variety
of salts, such as the salts of hartshorn, sal ammonia, and acetate
of ammonia.
  The water of ammonia applied to the skin, raises a blister.  It
is a powerful stimulant and promoter of sweat.  The dose for an
adult is twenty drops, in a gill of water.;  The dose for a child
between one  and  four years of age, is three or four drops,  well
diluted  with water.   In fits, fainting, and headache, applied  to
the nostrils, the amnioniacal  gas often produces relief.   In com-
bination with sweet oil, it forms  the  notable volatile linament.
Nothing neutralizes the  sourness of the stomach more effectually,
than a few drops of the  water of ammonia well diluted.
  The spirit  of  ammonia is a different preparation, made by add-
ing the  spirits of wine to the other ingredients, and distilling the
whole in a glass retort.
  AMPUTATION.—Accident and disease sometimes render the
sacrifice of a limb, the  female breast,  or some other part of the
body, necessary to life or health; and  the cutting off or removal
of such part, is  called amputation.   It is not always easy to de-
cide upon the necessity  or propriety of this operation, or the  time
when,  or place where, it should  be performed ;  but the operation
itself, when  determined upon, is one  of the simplest and  least
dangerous that the surgeon  is called upon to perform.  It is not
uncommon for people to put themselves to much trouble  and un-
necessary expense, in sending a great  distance for a surgeon  to
amputate a limb in case of an accident, for instance, when per-
haps, the nearest physician at hand might  do it equally as well,
with no more pain to the patient, and a great saving of time, and
prevent the danger sometimes attendant upon delay.
  Cases requiring amputation are numerous, and various in their
character ; some of which are gangrene, white swelling, necrosis,
caries,  compound fractures and  dislocations,  gun shot wounds,
cancers and malignant tumors.
  The instruments usually employed in the operation, are a tour-
niquet, amputating knives, scalpel, saw, tenaculum, forceps, cat-
liu, scissors  and sponges; and for  dressing the stump, adhesive
plaster, linen compresses, lint and roller bandages.
  Substitutes for several of these  instruments, may be  found  in
almost any house  or village  in  the country.  The  place of the
tourniquet may  be supplied by a strap with a buckle, or a hand-
kerchief put  around  the limb, and a stick passed through  it  in
              4 
26
AMP.
  such a manner, that a twist may be taken upon it.   A razor, with
  the handle made  permanent, may be used for a knife, and a fine
  carpenter's saw answers a very good purpose for sawing the bone ;
  so that a physician who  has a pocket case containing a tenacu-
  lum, scalpel and forceps,  would be in a condition to perform the
  operation successfully.
   The patient should be  placed in a convenient and comfortable
  position, where there is a good  light, and the tourniquet applied
  over the principal artery, and screwed up until no pulsation can
  be felt below it.
   High up near the arm-pit, is  the place usually  chosen for the
 application of the tourniquet when the arm is to  be cut off, and
 near the body on the thigh, when the leg is to be  operated upon.
 There are several ways of making the first  cut or incision, but
 what is called the circular incision is the one most  frequently em-
 ployed.
   An assistant grasping the limb with both  hands above where
 the incision is to be made, should draw  up the skin and cellular
 substance as far  as possible, and hold them in that situation,  while
 the operator standing on the outside of the limb, and passing the
 knife under and up on the inside, commences the incision at such
 a point, as to be able with a single circular stroke, to divide them
 down to the red flesh or muscles.  The assistant should continue
 to draw the integuments upwards, while the  operator dissects
 them off from the muscles to such an extent as is necessary, to
 have them completely cover the  stump when the limb is severed.
 Before the assistant relaxes his hold upon the skin, the muscles
 should be divided  close to the edge of it down to the bone, by
 one  stroke of the  knife, beginning as before, on  the upper 'and
 inner side of the limb, and continuing it round beneath and  up on
 the outside, until it terminates where it commenced.
   In order to be certain to have the end of the bone well covered
 the muscles are now to be separated from it and drawn upwards'
 to a greater or less distance, according to  the size of the limb by
 means of a  narrow strip of firm cloth, slit one half its  length
 called a  retractor.   The width of the retractor should be in pro-
 portion  to  the  size of the limb, and being properly applied  it
 will  also  protect the  flesh from being wounded in sawing the
 bone.  After dividing the periostium with a knife, and the limb
 being properly supported by an assistant, the  bone is divided bv
a few long, light and steady strokes of the saw.   The end of the
bone should be  smoothed if there be  any roughness,  the stump
cleansed  with warm water, and the arteries  secured with small
strong ligatures,  one end of which should be left long enough to
hang out of the wound when dressed.   The tourniquet should
now be  loosened, and if any vessels bleed, they must be  tied
and if necessary, it  must be tightened  again, to prevent an un- 
AMP.
27
necessary loss of blood.  Being assured that there is no further
danger of bleeding, the flesh  and skin  are to be brought accu-
rately tpgether over the bone, and retained by strips of adhesive
plaster.
  A compress of lint and folded linen are to be  applied over the
wound, and the dressing finished by the application of a cross
bandage and roller.  Except there should be secondary bleeding,
the dressings will not require  to be removed before the fourth or
fifth day, after  which, if  there be much discharge of matter,
they should be changed daily, until the  ligatures come away and
the wound be healed.
  In amputations of the fingers and toes, the bones of the hands
and feet, the wrist and lower part of the-leg, where there is com-
paratively but little flesh and integument, great care and calcu-
lation are necessary, to preserve a suitable covering for the re-
maining portion  of bone.  The usefulness of the stump is a con-
sideration of the first importance, and the best that circumstances
will permit should be done, to prevent it from appearing unsightly
and disgusting.
  When the operation is performed on the arm below the elbow,
and below the knee on the leg where there are two bones, a nar-
row two-edged knife, called a catlin is used, to pass through and
divide the flesh between them.  It is seldom necessary to ampu-
tate at the  joints, and should  always be avoided when it can be
done with safety.   The operation should never  be performed at
the elbow or  knee, and  it  is  better to  lose a few inches of the
arm or leg, than to operate at  the wrist  or ankle.
  The pain of the operation is undoubtedly great, but not insup-
portable.  The first  incision gives very acute  pain, and dividing
the muscles, nerves, &c, gives a severe  shock to the system;
but the common opinion that sawing the  bone is very painful, is er-
roneous, as the bones in a healthy state are insensible ; and except
the saw heat, the only sensation is that  of a disagreeable jarring.
  During the cure of the wound after amputation, the patient
should be kept perfectly quiet, and due attention be paid  to the
general  health.  The diet should be light and nutritious; inflam-
mation and fever be  guarded against, by keeping the bowels free,
and other means usually recommended  for that purpose.   When
the operation  has been performed on account of any particular
disease, the treatment must be  regulated  accordingly.  As it is
not in  accordance with the design of this work, to enter fully
into all the operations in surgery, except those which  may be
performed without the aid of a physician, we shall conclude this
brief article by referring those who may desire  to be further in-
formed upon this subject, to some of the numerous works which
are  expressly  devoted to it,  among  which may  be mentioned
Hooper's Surgical Dictionary. 
28
ANE.
  ANASARCA—Dropsy of the skin and flesh.—See Dropsy.
  ANASTOMOSIS.—Communication between two vessels, by
means of joining their mouths.
  ANCHYLOSIS.—This disease is a stiffness of the joints.  It
is produced  by a permanent contraction of the muscles in conse-
quence  of rheumatism,  white swellings, palsy and mechanical
injuries.  Sometimes  the  ends of the bones grow together in
consequence  of an  inflammation from  fractures,  bruises  and
burns.   Sprains  and dislocations often  produce  stiff joints.
Young  people  will  sometimes recover from this  disease,  but
where it happens  in middle aged or old people, it rarely becomes
better.  We once saw a stiff knee produced  by a violent rheu-
matic affection, but which,  after a year or two, became  as pliable
as ever.   It occurred in a young woman who was obliged to work
hard,  and who was consequently often thrown into a profuse per-
spiration, which operated favorably to  the removal of the disease.
While any inflammation  exists in a joint, the greatest pains should
be taken to  reduce it.  This should  be  done by steaming the
joint, by poultices, by leeches, and by blisters.  Warm vinegar
and rum kept constantly applied by means of  flannel to the part,
is an excellent solvent  of  chronic inflammations of the joints.
Sweet oil and the spirits of turpentine, opodeldoc and  the vola-
tile linament,  will all be  found extremely useful in many in-
stances.  The use of mercurial ointment should not be omitted
where other applications fail.  But above all,  friction or rubbing
of the joint  and adjacent muscles, should  be practiced every day
for an hour  or two at a  time.  No opportunity should  be lost in
trying to  move the  joint,  and to exercise it in  various  ways.
Motion  has a peculiar power in calling the blood into a part, and
in rendering it pliable.   A plaster of shoemaker's  wax, mixed
with just enough of the  powder of the arminian bole to render it
stiff, and worn around the  joint, has often removed the stiffness.
The hot sulphur  bath has sometimes proved a cure where other
remedies have failed.
  ANEURISM.—An aneurism is a pulsating tumor, situated in
a section of  an artery.  The inner coat of the artery is ruptured
or gives way to the pressure of the blood,  and a dilatation is the
consequence.  In some cases, all the coats of an artery are injured
or weakened by disease or  wounds, and an aneurism is the con-
sequence.
  In the commencement of an aneurism, there will be  perceived
an extraordinary beating or pulsating in a portion of some partic-
ular artery.  At the throbbing point there  will be found a tumor
which will  entirely  disappear when  pressed by the  hand, but
which returns again when the pressure is removed.   There is no
change  in the  color of the skin over the tumor, nor any pain felt
in the part.   The only unnatural appearances, are the  swelling 
ANG.
29
and the throbbing.  Aneurismal tumors make their appearance
in all parts of the body, but most commonly in the large arteries.
In an aneurism of the aorta, the  pulsation is felt through the
belly.   These  tumors, which are filled  with blood and liable to
burst at any moment after they become large, take place in the
caroted arteries and in the large arteries of the legs.  The popli-
teal  aneurism,  situated in the knee  joint, is one of  the  most
common.
   Some aneurisms are circumscribed and defined, while  others
are diffused and present a dilatation of a long portion of an artery.
When an aneurism has once  commenced, it continues to enlarge
until it bursts, or attains a large size.  Some of them present bags
or sacs of blood as large as a  two quart bowl.
   The part of the artery below the aneurism usually diminishes
in size, and the circumjacent  parts are emaciated.  In proportion
as the tumor enlarges, the  pulsation becomes  more faint and in-
distinct.   The  pressure of the tumor upon the  surrounding parts,
produces indurations, ulcerations and caries.  The danger of an-
eurisms, is their bursting and causing sudden death by bleeding.
Before they burst, the part about to give way becomes more tense,
elevated, thin,  soft,  and of a dark  purple  color.   The spurious
aneurism is owing to the  rupture of an artery and the escape of
blood into the surrounding texture.
   The treatment of aneurism consists in compressing the artery
above the tumor, and applying pressure  to  the tumor itself.  An
instrument called the tourniquet is applied to the artery above
the tumor, which  prevents the flow of the blood  into the tumor,
and gives it a chance to decrease.   When aneurisms are situated
internally,  their progress is arrested by blood-letting, cathartics,
and a spare diet.
   Almost the only chance of a cure consists in taking up the ar-
tery and tying it  with a ligature.  The artery is  cut down upon
a little way above the aneurism, lifted up, and a string tied very
tight around it.   The blood is  stopped from flowing into the sac,
which immediately begins to decrease in size,  and the  artery be-
low the ligature becomes obliterated by  absorption.
   Aneurisms are  sometimes produced by careless bleeding in the
arm.   The artery is punctured, and the  blood  flows into the sur-
rounding texture ; the arm becomes purple, and, sometimes, mor-
tification ensues.
   If  an aneurismal tumor bursts suddenly, the thumb  should be
pressed upon the  artery above, hard enough to stop the flow of
the blood.   In this  way the  artery must  be pressed, until better
assistance can be procured.   A tolerable tourniquet can be made
by rolling  up a piece of cloth, placing  it  upon the artery, and
binding it tight with a bandage.
   ANGELICA.—This plant is called the garden Angelica.  It 
30                         ANG.
 is a large biennial, umbelliferous plant, and in Alpine countries
 grows upon  the  banks of rivers.  It is called Angelica from its
 supposed angelic virtues.  There is a kind indigenous to this
 country, called masterwort.   It grows  spontaneously in all parts
 of the  country, in meadows, and  marshy woods.   The flowers
 appear in June and July, and are of a greenish white color.  The
 juice  of the  fresh root is acrid and somewhat  poisonous.  The
 whole plant  is medicinal and the acridness  of  the  root is  dissi-
 pated by drying.   The  angelica is  stimulant, aromatic, and
 strengthening.
   The seeds are often given in the country  in the case of  wind
 colics, and griping pains in the bowels and stomach.   An infu-
 sion is made of the seeds, and from a table-spoonful to a tea-cup
 full given from time to time, as the case may require.
   ANGINA  MALIGNA.—See Canker Rash.
   ANGINA  PAROTIDEA.—See Mumps.
   ANGINA  PECTORIS.—This is a painful, and sometimes, an
 agonizing affection of the  heart.  It is commonly felt as a pain
 in the breast, without referring it to any particular part.  It is
 known  to be an affection of the  heart by dissection  after death.
 Its attacks commence very suddenly.  An  acute pain is felt at
 the lower end of the breast bone, extending a little to the left
 side, precisely over the position of the heart  in the chest; a loss
 of breath or a sense of suffocation, and  great anxiety follow the
 pain.   The countenance becomes  deadly pale  ; the pulse sinks ;
 and the surface of the body is covered with a cold sweat.   Such
 is the sinking of  the vital powers  that life itself seems  about to
 be  suspended.  In the commencement  of the disease, the fits of
 distress  are relieved by lying down, and a little  repose, or only by
 standing still ;  but, at length, they grow more severe,  and can
 only be  relieved by the most powerful anodynes.  The affection
 is at first discovered by ascending a hill or by suddenly running
 up stairs.  Sudden emotions of the mind, and inordinate bursts
 of temper induce  it.   Where the disorder becomes violent the
 pam extends  from the heart to the middle of the arm.
   On  dissection, the arteries, which supply the heart itself with
 blood, are usually found to be ossified ; but a  functional disease
of the heart, lungs, and stomach, is each thought, by some to
 produce it.                                               '
   The spells of anxiety and distress will  often  last for half an
 hour at a time, accompanied with  a violent palpitation of the
 heart,   lhe paroxysms appear to be produced frequently by eat-
 ing a full meal.   A light vegetable  diet is, therefore, of the first
 importance in preventing a recurrence of the affection.
  A mixture  of equal parts  of laudanum  and ether, is found to
relieve the affection the most  effectually of anything.  A tea-
spoonful of each  may be taken at a time  in a little cold water 
ANI.
31
 An issue made upon each thigh is said to have cured the disease.
 Blisters have been  found serviceable, if applied to the chest.
 The cultivation of a quiet, even temper of mind ; the avoidance
 of  all sudden and violent exertions of the strength ; a vegetable
 diet ; cold water for drink ; early rising and moderate exercise
 are the necessary conditions both of relief and of cure.   Wind in
 the stomach and bowels frequently accompanies angina pectoris,
 and when  this is  the case,  peppermint, camphor, paregoric, the
 essence of cinnamon or of aniseed,  should be given.
   ANGINA TONSILLARIS.—Inflammatory Sore Throat.—In-
 flammation of the tonsils.  See Sore Throat.
   ANGINA  TRACHEALIS.—Inflammation of the  windpipe.
 See Croup.
   ANIMAL HEAT.—The temperature of inanimate bodies and
 of cold blooded animals, rises and falls with the temperature of
 the bodies which surround  them.   But  the human body main-
 tains a certain degree of heat  in all situations compatible  with
 life.  If the external heat of the sun and atmosphere is  greater
 than that of the body, the body still maintains its usual  degree
 of heat, which is about ninety-eight degrees, by the thermome-
 ter ; or if the temperature of the sun and atmosphere is less  than
 that of the body, instead of becoming as  cold as the surrounding
 medium like  other  bodies, the human system  retains its accus-
 tomed warmth.   It  has a source of heat within itself.   Where
 the source  of heat is situated, and what the nature of the process
 is, which  generate  it, have been  subjects of inquiry for many
 ages.   Amid the cold of winter and the heat of summer, we
 know that  the human body is of the same temperature.
  In the human body there  is a constant evolution or disengage-
 ment  of heat; and it has been ascertained with some degree of
 certainty, that the source of this heat, is the mutual action be-
 tween the  elements  of the food and the oxygen or vital  part of
 the air conveyed by  the circulation of the blood to every part of
 the body.
  It is  conformable  to common observation and has been  con-
 firmed by numberless experiments, that a solid body in becoming
 fluid must  absorb heat to maintain it in a fluid  state, and that, a
 fluid  body in  becoming  solid  gives out heat, or disengages it.
 We know  that ice will not melt or become fluid unless  a large
 quantity of heat is supplied.  This heat is absorbed by the water
 and retained by it, until it is placed in a very cold situation or
atmosphere which absorbs again the  heat from the water,  and
converts it into ice.   Water becomes ice or a solid body by giving
up its  heat to the surrounding air, and  ice  becomes water  or a
fluid body  by  absorbing heat from  the surrounding air or from
 some  heated body.
  Heat is also evolved or disengaged  when vapor or gas  is  con- 
32                         ANI.
verted into a fluid.  In a distillery, the  steam passes  through a
cold leaden pipe which absorbs the heat  from the steam, and the
steam is converted into water or fluid ; in other words, the steam
gives out its heat to the worm or leaden pipe.  In becoming a
fluid, the  steam parts with its heat, and this is the cause of its
conversion into water.  Water in becoming steam absorbs a great
quantity of heat.  A kettle of water must be  kept at a boiling
point a long time before the water will all be converted  into
steam.  All the heat which is applied to the kettle  goes into the
steam, and is there retained  until the steam is converted  back
into water.  The heat becomes latent in the steam.  The steam
is no hotter than boiling water.   When ice is melted,  if no more
heat is employed than barely to melt it, the water is of the same
temperature or degree of heat by the thermometer as the ice, the
heat which has been employed to melt the  ice is all absorbed by
the water and retained in a latent state.  If  more  heat is added
to this water, it will rise in temperature until it begins to boil,
when, it will  rise no higher.  In the expansion of  water into
steam there is always absorbed from the  fire, a certain  amount of
heat, which  amount is evolved or given  out in the  condensation
of the steam into water.
   Every kind of gas, air, steam, or vapor, in becoming a fluid or
a solid body, follows this  law—Heat  is  evolved.  And every
solid or fluid body in its conversion  into a gas, air,  or  steam, ab-
sorbs heat or requires heat to convert it into that state.
   In the combustion or burning  of  a body, a certain amount of
the  oxygen  of  the  air  combines with the  body burnt.  In the
burning of charcoal one part of the charcoal combines with about
two parts or twice its weight of oxygen, and forms carbonic acid
gas.  In  the conversion of the oxygen gas into carbonic acid, the
oxygen evolves or parts with a portion of its latent heat.  The
carbonic  acid is a heavier gas and requires  a less heat than oxy-
gen to maintain it in the gaseous state.   Lavoisier burnt charcoal
or carbon in a hollow globe of ice, and found that the  burning of
one pound of charcoal melted ninety-six  pounds of ice  ; and con-
sumed two pounds and a half of  oxygen.
   In the  process of breathing, there is a certain quantity of the
oxygen of  the air consumed,  and about the same quantity,
in  volume,  of carbonic acid formed  or  breathed out of  the
lights.  The conversion of this oxygen  into carbonic acid gas in
the lights, has,  ever since the time of Dr. Crawford, who invent-
ed the hypothesis, been  supposed  to be the  principal source of
the heat of the body.   It is supposed that the venous  blood con-
tains carbon in a fluid state, and, that, this carbon combines with
the oxygen of the inspired air and forms the carbonic acid which
is constantly expired.  In  the  formation of  the carbonic  acid,
heat is evolved upon the same principle  as when carbon or charl 
ANO.                         33
coal is burned in the air, and distributed by means of the circu-
lation of the blood to every part of the body.
  Leibig has lately enlarged the dimensions of Crawford's hypo-
thesis, and resolved the production of animal heat into the com-
bustion of carbon and hydrogen in the body at large.  The food
furnishes  the carbon and  hydrogen, and the air, the oxygen.
  His theory is, that the animal  heat is derived from the combi-
nation of oxygen with the carbon and hydrogen of the metamor-
phosed tissues, which proceed ultimately from the food.
  The combination of oxygen with these two combustible bodies,
he  assumes to be the cause of the heat of the animal body.
According  to  the experiments of Lavoisier, the combustion or
oxidation of the hydrogen would be superfluous, but Leibig con-
tends that the combination,  (which he  makes equivalent to a
combustion of these elements,)  is  a necessary  result  of the
composition of the food, the blood, and of the air respired.  The
food he calls the fuel;  and the oxygen produces the heat.  The
theory is highly ingenious, but wants the conclusiveness of de-
monstration.   It still remains to be demonstrated that the oxygen
consumed  in  breathing, combines with  the  carbon and  forms
carbonic acid, since  this acid  may  be secreted, already formed,
from  the  blood.   We also need much more  proof than  Leibig
has given  us, that hydrogen unites with oxygen and forms water
in the body.   We need experimental demonstration.
  It is a curious fact, that thirteen ounces of carbon or charcoal,
in the form of gas, should be evolved daily from the lungs, and
that thirty-seven ounces of oxygen should be consumed  in the r
same time in the process of breathing, and that just this quantity
of oxygen is found united  with the expired carbon.
  Agreeably to the law of heat, by  which, when a fluid  body is
converted  into vapor,  heat is absorbed  into the vapor,  if the
warmth of the atmosphere is greater  than  the warmth  of the
body, a perspiration  is produced or a secretion of water  by the
skin, and  this perspiration, or water, being  converted into vapor
by the heat of the body and of the  atmosphere, the heat of the
body is abated as fast as it accumulates.
  ANODYNE.—All those medicines which ease pain and pro-
cure  sleep are called anodynes.  Opium, laudanum, morphine,
Dover's powder,  poppy tea, hop tea,  lettuce tea, belladonna, pare-
goric, ether, camphor, prussic  acid, musk  and castor, with many
other articles, are of this class of medicines.
  ANODYNE BALSAM.—This mass  is composed of equal
parts of camphor, castile soap and opium,  beat together in a mor-
tar.   One pill  of  the common size is the usual dose.  This form
improves the effect of the  opium very much.   Some people can
take the anodyne balsam who can not take opium.   It is used in
bowel complaints  and  all painful diseases which prevent sleep.
              5 
34                        ANT.
In coughs and affections of the lungs, it is often found to be more
serviceable than opium alone.
  ANTHELMINTICS.—All medicines used to dislodge worms
from the stomach and bowels are called anthelmintics.
  ANTIEMETIC.—Medicines which prevent or stop vomiting.
The most effectual  antiemetics are, opium in some of its forms,
camphor, peppermint, essence of cinnamon, essence of tansy, and
the carminatives in general.
  ANTIMONIAL POWDER.—This  material is supposed to be
the same thing as the James' powder.  The powder, when good
is white  and without  nfuch of  any taste.  The  grey powder is
an inferior article.   The antimonial  powder is obtained  by heat-
ing the sulphuret of antimony and the shavings of hartshorn first,
to a red, and afterwards, to a white  heat in an earthen  crucible.
It is composed of  the  rust or oxide of antimony, and the phos-
phate of  lime.   The sulphuret of antimony is a native  ore, of a
metallic lustre, and bluish color.  The phosphate of lime is the
material of which bones are chiefly composed as well as  horn.
  The antimonial powder is one of the most valuable articles in
the catalogue  of  medicines.  It has  the  property of raising a
sweat in a  very  high  degree.  In a  large  dose, it acts as an
emetic and cathartic.  It doubtless  has a tendency to increase all
the secretions.  In  fevers, it is one of our  principal remedies.
By  way of eminence, it has been called the fever powder.  In
low, malignant  fevers, it is not so  appropriate as in those of an
inflammatory nature.
  The ordinary dose of the antimonial powder, for an adult, is six
grains.  For a child a year old, one grain.  For a child from two to
four years old, two grains, and from four to twelve years  old, four
grains. The powder may be given in syrup, molasses, or thick gruel.
  ANTIMONY.—See  Tartar Emetic.
  ANTIPHLOGISTIC—Everything which  lessens the heat of
the body and diminishes inflammation is called antiphlogistic.
  ANTISCORBUTIC—Medicines which cure the scurvy. All
the acids both  mineral  and vegetable are antiscorbutics.  The
citric acid or the juice of lemons is the most curative.  All green,
fresh vegetables and fruits, are antiscorbutic, such as celery, dan-
delions, and cabbages ; apples,  oranges and cocoanuts.   The
wood sorrel is a good antiscorbutic.
  ANTISPASMODIC—Any   medicine   which  will   relieve
spasms, cramps, and convulsions, is called antispasmodics.  The
most  powerful  antispasmodics are  opium, ether,  and  camphor.
Next to these, are valerian,  musk, castor, belladonna, cicuta, am-
monia, assafoetida, Hoffman's anodyne liquor, and chloric ether.
Many other agents will act as antispasmodics, such as cold water,
ice, quinine, blue  vitriol, and emetics of all kinds.
  ANTRUM OF  HIGHMORE.—Antrum Maxillaj Superioris.— 
AOR.
35
" A large  cavity in the middle of each superior maxillary or up-
per jaw-bone, between the eye and the roof of the mouth, lined
by mucus membrane, and communicating with the nose.''
  This cavity is sometimes diseased.  The most common disease
of the Antrum is inflammation terminating in an abscess, or a col-
lection of matter.   A formation  of matter  is generally preceded
by acute pain and swelling of the cheek,  with some degree of
fever.   After maturation  has taken place,  the  symptoms  of in-
flammation and fever subside, but a constant aching pain or unea-
siness will be felt, and the swelling gradually increase until the
matter is discharged.  Inflammation in^ this cavity as well as in
other situations may arise from cold, or take place without any
apparent cause, but is generally produced\by the irritation of de-
cayed  teeth, or from blows upon  the cheek.  Abscesses in the
antrum sometimes  break through  into the mouth or nostril, or
they may point externally and discharge through the cheek; but
generally, an artificial opening  will  be required.  When it  is
ascertained or strongly suspected that there is a collection  of pus
in this  cavity, the  mouth should  be examined, and if  either of
the molar or double teeth on the upper jaw be loose, carious, or
p/eternaturally sensitive,  it should  be extracted, and a free open-
ing made  by passing a trocar or some strong sharp pointed  instru-
ment up through the socket into the antrum ; but, if all the teeth
are sound or have all been extracted before, an incision should be
made through the membrane of the mouth above the socket of
the second double  tooth, with a trocar or strong pair of scissors.
The cavity should be syringed with warm water, soap and water
or a weak solution of chloride of soda.  Should the discharge be
profuse or fetid there will be reason to suspect that there is some
loose piece of bone, for  which search should be made with  a
probe, and if any such be found it must be removed without de-
lay, the aperture being enlarged, if necessary.
   " Dropsy of the Antrum.—The antrum  may become enor-
mously distended  and its parietes (walls)  thin and cracking on
pressure, in consequence of an accumulation of its natural  clear
mucous secretion, if the aperture in the nostril has become oblite-
rated."  In these cases an opening must be made in the manner
above described.  Malignant and non-malignant tumors are some-
times developed in the antrum, each of which requires a particular
mode of treatment, but to go into the particulars of these is unne-
cessary in a work of this nature.
   ANUS.__The lower extremity of the bowels.  It is the outlet
of the body, the fundament.   It is surrounded with a strong mus-
cle which contracts after a discharge from the bowels, and closes
the passage.  This  part  is subject to various diseases, such as the
piles, relaxation, falling down, ulceration and cancer.
   AORTA.__The aorta is the  largest  blood-vessel in the body. 
36                         APO.
 It is an artery.  The blood passes through this vessel to all parts
 of the body.  It  receives the blood from the left ventricle of the
 heart, takes a turn  in the chest, there it gives off.the  arteries
 which supply the head and upper part of the body; it then de-
 scends in the belly along the left side of the back bone, and at the
 bottom of  the belly, divides into two smaller arteries, called the
 iliacs.  When the belly becomes emaciated and thin, the beating
 of the aorta can be distinctly felt.  This vessel is liable to an-
 eurisms or a rupture of its coats.
  APOPLEXY.—Usually, in  a fit of the apoplexy, the person
 falls down and becomes insensible;  the face is red  and swelled,
 the eyelids are half closed and  fixed, and the veins of the temples
 and neck are enlarged and full  of blood.   In most cases,  the per-
 son makes a snoring noise, as if in a profound sleep, and lies as
 motionless as in  death, although in  rare  instances, there will be
 some convulsive motions.   The pulse and breathing all the while
 continue, although  the breathing is unnaturally  laborious.   In
 this state the person will often continue for several days, and some-
 times recover, although in the majority of cases, the disease proves
fatal.  The patient  does  not  froth at  the mouth, as in epileptic
 fits, and  the apoplexy is much longer in its duration.  The con-
 tinuance of the pulse and of the breathing distinguishes apoplexy
 from  fainting.  This disease is apt to  affect  one side of  the sys-
 tem more than the other, and the side which is least affected will
 be the more convulsed.  The muscles of the face will be  some-
 times exceedingly convulsed, and give to the face the most fright-
 ful  expression, especially the  expression of the  eyes which will
 be twitched and drawn in every possible direction.  In some
 instances, the face  will become  purple;  in  other  instances, the
 disease will come on gradually; the face will be pale and bloated,
 and  the  insensibility will steal on  by degrees,  beginning with
 loss of memory, drowsiness, difficulty of speaking, and dizziness,
 and the person will seem to be only a little lost or delirious.  The
 extremities will  be cold and  the pulse weak, small and intermit-
 tent.   A palsy of some part of the body is very apt to follow, or
 to be produced  by a fit of the apoplexy.  The faculties of the
 mind  are  generally injured  and sometimes destroyed.   The
 memory and the faculty of speech  are the  most  apt to suffer.
 The whole of one  side will  often become  almost as motionless
 as if  dead ; this is called hemiplegia.
  If  the fit continues very long, and the  snoring  and breathing
 becomes louder  and more labored;  the  power  of swallowing
 lost;  the insensibility more profound, and  the  person  has ad-
 vanced beyond his sixtieth year, it will be very likely to termi-
 nate  fatally.  But if the person recovers entirely, or in any de-
 gree from the first attack,  he  is very liable to be attacked again
 and again, until death ends the scene.   The apoplexy is not, how- 
APO.
37
ever, so fatal a disease as it is commonly supposed to be; recov-
eries do take place,  and sometimes,  though  rarely,  they are
complete.
  Domestic Remedies.—The first thing to be done in a fit of
the apoplexy, is to loosen the clothes,  especially anything about
the neck, and  to  place the person on a bed, or  in some place
where  he can  lie in  a  horizontal position.  Cold water should
then be dashed on the face and head, and if the person  can swal-
low, some of it should be given him to drink.  If no  practiced
person is near to let blood, an injection of^common table salt dis-
solved in warm water, should be immediately resorted to.   If the
fit has  come on just  after a full meal, anv emetic of ipecac or of
powdered alum should be given, in order to remove the pressure
upon the stomach, and lighten the digestive powers.  A tea-spoon
even full of the ipecac will generally prove sufficient, or a heap-
ing tea-spoonful of the  powdered alum.   Fifteen grains of the
powdered leaves of lobelia may be used, where the other articles
cannot be  speedily obtained.  But no emetic should  be given}
unless  the  stomach of  the person has been recently overloaded
with food or indigestible substances.   Mustard poultices should
be placed upon the feet, and leeches, if they can be obtained, and
any one can manage them, should be applied to the temples.
  If the person is able to swallow, a full dose of oil, salts or
aloes should be given, and a free evacuation of the bowels pro-
cured.   If  nothing can be swallowed,  the bowels must be  emp-
tied by the  use of purgative injections, such as senna  and  salts,
ipecac  or antimony.   Stimulating injections, such as the spirits
of turpentine, after a proper evacuation of the bowels, have a strong
tendency to awaken the vital powers.
  Professional Remedies.—If the person is attacked in the plen-
itude of strength and of health, and the condition of the blood-
vessels of the face and neck  indicate that  the brain is oppressed
with blood, blood should be immediately  drawn from the  arm,
and if  the first  bleeding does not remove the state of insensibil-
ity, a second bleeding should be performed in the course of eight
or  ten hours.   It  is safer, perhaps, to apply leeches to the  tem-
ples and head, than to draw blood, by venesection, a third  time,
where  the abstraction of more blood seems to be  required.   The
quantity of blood drawn should  always  be graduated  by the
habits and the previous state of the health of the patient.  If the
person has  been  previously out of health, or in a feeble state;
the face pale, and the blood-vessels of the  face and temples not
turgid, and the pulse weak  and  intermitting, blood  should be
drawn  sparingly,  if drawn at all, and should always be done by
leeching, if possible.   Where the  head is hot or warmer  than
natural, cold vinegar and water  should be kept constantly applied.
If the kidneys are bound, the water should be quickened by the 
38
APO.
 use of the nitrate of potash and cream of tartar.   Or if the skin
 should be dry, small doses of ipecac  or of antimony should be
 given at proper intervals, to  excite a gentle  perspiration.  The
 drink should be cold water, gruel, bread-water or balm tea.   No
 stimulating drinks, such as brandy, wine or rum, should ever be
 given.   When the patient begins to recover, if debility remains,
 the strength should be restored by camomile tea, quinine, columbo
 root, and  the  mineral acids,  broths, soups,  and a nourishing
 diet.
  , In some cases, where the fit is followed by a paralysis, stimu-
 lating things, such  as  mustard seed,  the  tincture of guaicum,
 camphor, ammonia, and the volatile oils made into essences, will
 become  necessary.  But none of these things should be given
 while there is any congestion of the brain.
   Intoxication, and the effects of opium and other narcotics, will
 often so nearly resemble apoplexy, that it will  sometimes become
 difficult  to distinguish  between them.  The effects of an over-
 dose of opium, especially,  are very nearly those produced by an
 apoplectic  fit.   The  judgment must be  determined  by circum-
 stances,  and the  testimony  of friends and acquaintances.   A
 stroke of the sun is supposed to be the same disease, and requires
 a similar treatment.
   The  prevention of diseases, in general, is found to consist in
 the avoidance of those causes which produce them.   This is the
 only way to prevent a fit of the apoplexy.   This disease is pro-
 duced by intemperance either in  eating or  drinking.   Apoplexy
 arises from an effusion of blood- or of serum, which is  the watery
 part of the blood, upon the brain, and whatever  strongly forces
 the blood upon the brain, will  produce the  disease.   We knew
 of one case which was produced by the position and the exertion
 of drawing on a boot.   Violent fits of passion, intense  study, and
 all  great mental efforts, whether at the bar, in the pulpit, or  in
 the mechanic's workship, will occasion the disease.   Exposure
 to intense  heat  or  cold, will often bring on  the fit, as well  as
 blows, wounds,  and concussions.   Great anxiety, loss of sleep,
 and disappointment, by exhausting the nervous system, are often
 the occasion  of apoplexy.  On dissection of  those  who have
 died of the disease, there is commonly  found either a quantity of
 water or of blood which has been let loose upon the brain.
  A person therefore who  suspects any disposition to apoplexy
 should avoid, as far as possible, all the causes  which  produce  it!
It is said that people of large heads,  short necks,  and of  a gross
habit, are more liable to it than others; it therefore becomes peo-
ple of such a make, to be  more studious in  avoiding  the causes
of the disease.   Dizziness, drowsiness, obscurity of the sight, and
thickness of hearing, are supposed in many instances to be symp-
toms of an approaching fit.   A timely loss of blood may, in such 
ARR.
39
cases, counteract the disease; but temperance and suitable exer-
cise will do more.
  APPLE PERU—Datura Stamonium.—This plant  is more
commonly called  the thorn apple, because it bears a fruit some-
what resembling a green apple, covered with thorns.  It is very
common in New England, and known to almost everybody.  It
grows in  the rich, fertile spots about barns and houses, and may
be gathered in the months of August and September.  There are
two  kinds of the thorn apple ; the flower of one, a clear white, and
of the other,  purple, but the virtues  of each are  nearly the same.
The leaves are shaped like an egg, and have a nauseous taste, and
sickish  smell.  In both varieties,  the stem is erect, forked, and
from two to  four  feet in height.   The  leaves,  branches, stem,
fruit, seeds,  and  root of this  plant, are  strongly narcotic,  and
taken in  any considerable  quantities, are very poisonous.  An
over dose of  this  substance produces dizziness,  delirium, stupor,
trembling, dilated pupils, a small, weak pulse, fainting and death.
  The  thorn apple is a  medicine much  more  used  and better
known in this country than  in England.  In epileptic fits, it has
been long celebrated.   In asthma, its reputation is equally high.
The dose of the powdered leaves for an adult, is one grain grad-
ually increased; of the  powdered  seeds, half a grain ; of the
inspirated juice or extract, one grain ; and a dose of the tincture
is from fifteen  to twenty drops.   The tincture  is  made  by  put-
ting  one ounce of  the dried  leaves into half a pint of new rum,
letting it  stand for a week, and then straining it.   The tincture
is the most suitable preparation for children.  The dose for a child
from two  to four years old, is from two to four drops.
  This medicine  has  been  employed in palsy, painful menstrua-
tion, rheumatism,  tic  doloreaux, nervous headaches, tetanus or
locked jaw, and many other painful affections.  It formerly had
great repute in the case of insanity.   The  leaves are sometimes
made into segars  and smoked for the asthma,  or they may be
smoked in a pipe.  It alleviates the distress and helps the breathing.
  APTH^.—See Canker.
  AQUEOUS  HUMOR.—This substance is  a  watery fluid
which fills both chambers of the eye.  It amounts in weight to
five  or six grains.  When the  eye is punctured, this humor  runs
out,  but if the puncture heals kindly, the humor is renewed again.
It is  enveloped in a fine membrane.  There  are two other hu-
mors in the eye, one is called the crystaline humor, and the other
the vitreous humor.
  ARACHNOIDES.—This is a thin membrane of the brain,
without blood-vessels and  nerves, situated between two other
membranes,  called the dura mater  and  the  pia mater.   It  sur-
rounds the whole  brain, and the oblong, and  spinal marrow.
  ARROW  ROOT.—The  arrow root in use among us, is the 
40                         ART.
 product of a plant which  originally came from the East Indies,
 but  is now cultivated in  the  British West  India  Islands.   The
 plant from which the root is taken, grows  to half a yard  in
 height, is perennial, has an upright stalk, terminated by bunches
 of flowers.   The roots of this plant are thick and exceedingly
 knotty.   The plant  is propagated  by parting the roots in the
 spring.
   The arrow root is the most nutritious root which has ever  been
 discovered.   The powdered root affords a very nourishing diet
 tor children.  Boiled in water, it forms a transparent  jelly; and
 mixed with milk, it Makes a very palateable and  easily digested
 porridge.   To make a jelly of the arrow root,  take a table-spoon
 full of the powder, and as much  cold water as will make it into
 a paste; then pour on half a pint of  boiling water, stir it briskly,
 and boil it a few moments, when it  will  become a clear, smooth
 jelly.  This jelly is sometimes mixed with calf s foot jelly, and
 given to debilitated, weak  children, and invalids.
   The  arrow root makes  excellent  starch.  In the West India
 Islands the starch is made by digging up the roots of a year old,
 washing them Well in water, beating  them in a  large, deep, wood-
 en mortar to a pulp, and then throwing the pulp into a large tub
 of clean water: the whole is then well stirred, and the fibrous
 part wrung out  with the hands and  thrown away.  The milky
 liquor is passed  through a  hair sieve, allowed  to settle and the
 clear  water drained off.  At the  bottom of the vessel is a white
 mass  which is again mixed with  clear water and drained.   The
 mass  is then dried on sheets in  the sun, and is pure starch.
   In  the bowel  complaint  and  other diseases of young children
 the arrow root gruel is the best food which can be  given them.'
 It is the lightest and easiest digested of any vegetable substance
 m use.  In fevers, it is peculiarly suitable.   It neither  heats the
 body, nor disturbs the irritable stomach.   If children are troubled
 with wind, a little nutmeg, or two or three drops of the essence
of caraway seed  may be added  to the gruel.
   ARTERY.—The blood vessels are  of  two kinds, arteries  and
veins.   The structure of the arteries is materially different from
that of the veins.   The  sides of  the arteries are stiff  and  hard
and do not collapse or fall  together when empty.   The sides of
the veins are soft and flabby and readily fall together when emp-
tied of the blood.   In cutting into a piece of lean boiled beef, we
often  see an open artery, sometimes  large enough  to  thrust the
httle finger into   The veins are never  seen open in dead animals.
The blood in the  arteries is  of a light red ;  that in the veins of
a purple color.   The blood in the arteries is the vital blood ; that
in the veins will  not  support life.   If the  purple  blood in  the
veins, at any tune, gets into  the arteries, and circulates throueh
the brain, it destroys  life  immediately.  The face turns purple. 
                            ASS.                          41

and the person  instantly loses his senses.  The hollow or inside
of the arteries is entirely smooth; the cavity of the veins is filled
with little valves, arranged at short  distances from each other, so
as to hold the blood after it has passed them, and prevent it from
going back.  These valves are  little  membranes which  cut the
veins into so many separate chambers.   It is very important for
people to know the difference between the arteries and the veins,
and to distinguish  the light red, or vital blood, from the purple,
or dark red blood.   The two fluids are widely different in their
properties.
   The  arteries beat in company with the heart, and give rise to
the pulse.  By ascertaining the number of times which the pulse
beats in the  wrist, in a minute, we at the  same time, find how
many times the heart beats, and the degree of swiftness of the
circulation.   The  pulse is not only felt in  the wrist, but in any
part  of the body  where an  artery runs near  the surface.  The
temporal artery will give us the state of the pulse, nearly as well
as the artery  in the wrist.   The puncturing of an artery is much
more dangerous than  the pricking of a vein.  From the heart,
proceed two  large arteries, the  pulmonary and the aorta, which
branch  out over  the  whole body,  into an  endless  number of
smaller ones.  The pulmonary artery issues from the right ventri-
cle of  the heart, and goes to  the lungs, where, by the process of
breathing, the venous  blood is changed in its  color, and receives
its vitality ; the aorta  issues  from the left ventricle of the heart
and  distributes its branches  to every part  of  the body.   When
an artery is pressed  together by the  fingers, it will spring into
shape  again ; but a vein  has  no  elasticity.   The  arteries are
vessels  which convey the blood from the heart, and the veins re-
turn it to the heart.
   ASCARIDES.—Pin worms,  or thread worms which burrow
about the lowest  portion  of  the bowels, or rectum.   They are
never more than about half an  inch in length, and of the size of
a cambric needle.   They molest children and feeble  people and
produce an intolerable itching about the  anus.   They may be
destroyed by a dose of aloes.   See  Worms.
   ASCITES.—Dropsy of the belly.   A tense, inelastic swelling
of the abdomen, from accumulation of water.   The fluctuation of
the  water  in the  belly is often very perceptible, especially on
turning from one side to the  other.   It  comes on with the same
symptoms which accompany  dropsy in general, and the treatment
is the same.   See Dropsy.
   ASSAFETIDA.— This is the most powerful of all  the fetid
gums.   It is  brought from Persia in irregular masses, composed
of various little shining lumps which  are partly of a reddish,
partly of a whitish and partly  of a violet  color.   Those masses
are the  best which are clear,  and of a pale  reddish color, variega-
               6 
42
AST.
ted with a great number of elegant white tears.  It is excessively
fetid, and extremely volatile, on which account, it cannot be kept
long without losing more or less of its strength.   It yields all its
virtues to spirits of wine or new rum.
  The gum  is obtained  from the roots of the assafetida plant.
The roots are tapped,  and the gum oozes out and hardens in the
sun.
  The gum  has a  bitter, acrid, pungent  taste, and melts in a
moderate  heat.   The .dose of  the  pure gum  is any quantity be-
tween five, and twenty grains.   It mixes with water and makes
a milky mucilage.   The  best  form of giving it, is the  tincture.
Pills are easily made by gently heating the gum and rolling little
pieces with the fingers.  Two  pills of the  common  size are an
ordinary dose for an adult.  Children  should take the mixture or
the tincture.   The  tincture is  made  by putting  two ounces of
the gum, broken into pieces, into a pint and one gill of new rum,
and allowing it to stand for one week.   Strain the  liquor, and it is
fit for use.  The dose for an adult, is any number between ten
and sixty drops.   The dose of the tincture, for a child of two or
four years old, is from two to five drops.
  The assafetida is given in all nervous  affections, but is the
most celebrated in removing the hysterics and hypochondria.  It
quiets the nerves and induces sleep.  It is good for a cough, and
catarrhal affections.   In all cases of spasms, it is a very potent
remedy.
  ASTHMA.—The asthma is a disease of all countries and cli-
mates.  It affects the young  and the  old, but for the most  part
does not discover itself until after the  age of puberty.   It affects
alike every kind of  temperament.  Its attacks are periodical, and
in this respect, it resembles many other diseases which afflict
mankind.
  The asthma generally  attacks people in the night time, soon
after they have  retired to rest, but it sometimes comes on in the
day time.   A want  of breath is commonly the first notice which
the person has of its onset, and he is obliged  immediately to rise
up in bed.   He feels a great tightness  across the chest and wants
more air.  The respiration is laborious and accompanied with a
wheezing noise.  The wheezing  can generally  be  heard over
the whole house, and speaking is very difficult.   There is often
a disposition to cough.   There is sometimes such a  want of

^antStL°nghVhe 11PS  rV^ a PUrple C0l0r> as lf  a Pa^l
strangulation had occurred; but notwithstanding the frightful-
The natiem ;jmPtom/'the.dlseas^ rarely,  if ever, proves" fatal.
uvand that hf ? i^ ™ VTeh °f the lun°s were a11 clos^
up  and that he should soon choke,  but  after awhile,  towards
morning, the breathing becomes a little freer and the  senTe of
suffocation gradually abates.   Perhaps, a little mucous is cough- 
AST.                         43
ed up, some relief takes place, and the exhausted sufferer falls
asleep.  In some cas^s of the asthma, the pulse is not disturbed,
but more commonly it is frequent and small.  There  is apt to be
both heat and thirst.   The urine is in the beginning, pale, and
increased  in quantity, but on the departure of the fit it is high
colored and deposits a sediment.  The face is generally pale and
shrunk.
   Through the day the  patient will often remain comparatively
free from distress, but at the approach of evening, the wheezing,
the suffocating breathing and the sense of tightness in the chest,
return and  continue about as long as they did the night before.
Where there has been a considerable respite during the day, some
little sleep may be obtained in the fore part  of the night, but
morning  seldom comes round without having had a suffocative
fit sometime during the night.   In this way the asthma goes on,
for three, four or five days, and  sometimes for a week or a fort-
night  without much  abatement.  The sooner the expectoration
commences, the shorter will be the process of the disease.  Relief
is quite sure to come with the free secretion of the mucus of the
lining membrane of the lungs.   And this resolution of the disease
by the secretion of mucus, shows the asthma to be an inflamma-
tion of the mucus membrane of the lungs as much as a similar
resolution in an influenza or catarrh, shows that disease to be an
inflammatory one.   The asthma, in general, goes off gradually ;
 the expectoration increasing  every day, and the fits  growing less
 violent every night, until it entirely disappears.  Where a person,
however, has  once been the subject of this disease, he is pretty
 sure to be tormented with returns of it through life.  In some
 instances of the asthma, there will be no expectoration of phlegm.
 These instances are called the dry asthma, where the disease is
 resolved without the mucus secretion.   Such instances have been
 called spasmodic asthma, but they furnish no more evidence of
 spasm than any other  inflammation which  is  resolved without
 suppuration or some  extraordinary  secretion.   In  the asthma
 there  is  always some  degree of fever, which is evinced by a
 furred tongue, increased  heat, thirst, and loss of appetite.  In
 some instances of this disease, people  during the day time, will
 be about their usual occupations and  feel nearly as well as usual,
 but suffer severe paroxysms during the night.
    The  whooping  cough, measles, and other affections of the
 lungs often lead the wav to the asthma.  People  appear to be
 born  with a disposition to this disease in the same way that they
 are to many other disorders.   The texture of their lungs  is des-
 tined to be affected in  this particular way.   The external  causes
 which bring it on are  better  known than the condition of  the
 lungs, which fits these causes to operate.   The sudden suppres-
 sion  of  the  perspiration is  probably  the  most frequent  cause. 
41                         AST.
  Cold and weet feet, damp rooms, the changes of the atmosphere,
  and all excesses in eating and drinking will produce the disease.
  Going  from the town to the  country or from the country  to the
  town will  often bring it on.   The disturbance of the passions
  and feelings also produces it.   Some people experience a return
  of  it every fall on the  appearance of cool weather and  frosts,
  others will have it in the spring, and others again in the summer
  time.   Either cold, heat, or moisture, appear to produce it equally
  alike.
   Domestic Remedies.—On first ascertaining the nature of the
  disease, an  emetic of ipecac  should  be  immediately  given, or
  vomiting should be immediately excited by some other means.
 A wine-glass full of lamp oil is sometimes given.   A tea-spoonful
 of powdered alum mixed with molasses, and repeated every fif-
 teen minutes  until it operates is a very effectual remedy.   The
 Lobelia has, however, been used with singular success.   An  ounce
 of the dried leaves may be steeped in a pint of water and a table-
 spoonful given  every fifteen minutes until vomiting is produced.
 Warm flaxseed tea should be given for drink, or any kind of herb
 tea which will  produce a sweat.  Breathing the steam of hot water
 will sometimes relieve the feeling of  suffocation, and  moderate
 the  fit.  Burning in the room  a piece of paper which  has  been
 soaked in a solution of saltpetre and dried by the fire, will  often
 afford instant relief.   But the chief reliance  must be placed upon
 vomiting.   Some people  have taken an emetic every day for a
 fortnight.   The syrup of squills given in tea-spoonful doses  every
 half hour will generally procure relief and moderate the violence
 of the fit.   But the most effectual remedy  which we have ever
 tried is a tea-spoonful of  ether  mixed with forty drops of lauda-
 num in a wineglass of water.   This should not be given oftener
 than once in four or six hours, and not repeated more than  three
 times without  an interval of eight hours.   Goose  oil  is a very
 good thing to give to relieve the wheezing.   Small doses of ipe-
 cac,  or two  grains at a time, repeated every two hours, will  often
 succeed  in  producing a perspiration and moistening the lungs
 Dr. Cullen relied principally upon laudanum alone, in  thirty or
 forty drop doses.  He  thought, however, that there were  some
 cases where it could not be given, being too much of an inflam-
 matory order.  Strong hot coffee has been  found to relieve the
 fits.   Intoxicating drinks  only  add fuel to  the fire  and always


 Sh?Jth \          * Shppery Glm bark or of %um arabic- sweet-
 f,?n«   t      7 ?" SUgar  Promotes the secretion of mucus in the
 IW SL \l genera1' the most cert*in expectorants, will be attend-
ed with  the  most certain  abatement of the  disease.  In violent
cases, leeches should be applied to the  chest, succeeded  by  large 
AST.                         45
  Professional Remedies.— Although, in general,  blood  letting
is needless and often  hurtful, there will be  instances where it
must be resorted to.  It is a remedy which  always has been  and
always will be used.   So  long as people  observe  that spontane-
ous bleeding  from the nose or any  other part of the body is
attended with relief or produces a cure of  the headache  or  any
other pain, the same effect will be imitated  by art.  In young
people, of  a plethoric  habit, bleeding is often  attended with in-
stantaneous relief.   The  tincture of  digitalis is a remedy of pe-
culiar  efficacy and will often  succeed in allaying the distress of
breathing when other  means have failed.   But in the use of the
digitalis  great  caution must be  employed not to surcharge the
system with it.  .Smoking the leaves  of the stramonium or bitter
apple, moderates  the violence of  the  fits.  Almost all old  asth-
matics get into the habit of smoking tobacco.   Tobacco undoubt-
edly alleviates the disease, although it rarely, if ever cures it.
Antimonials  are  extremely effectual  in softening  the  skin, pro-
moting the secretion  of  the mucus  and moderating the pulse.
The  Hive Syrup, prepared by  Dr.  Cox,  of  Philadelphia,  is  a
compound of great value in  the asthma.   A tea-spoonful of it
may be taken once in two hours  until the breathing is relieved.
The food should be light  and nourishing after the subsidence of
the fits, and where  debility remains, the quinine, Colombo root,
and other strengthening medicines should  be resorted to.  Flan-
nel should be worn next to the skin the whole year round, and the
strictest  temperance should be practised both in eating and in
drinking.
   The idea that the asthma is ever a nervous disease, according
to the classification of Dr. Cullen, appears to us a mere conjec-
ture.   What disease of the nerves merely, ever  eventuates in  a
functional secretion, like the mucus expectoration of the asthma ?
Mere spasm requires no such mode of relief.   As well might we
call an inflammation of the eyes which ends with a mucus secre-
tion of the lachrymal glands, a nervous disease, as the  asthma.
Some attacks of  the  asthma go off  without expectoration, and
so  do some  inflammations of the membranes and  other  parts
without affecting the ordinary function of the part.  The ery-
sipelas will  appear and  disappear without  suppuration or any
visible  change of the function of the skin.   The redness and
swelling  subside, and the skin is left  to  all appearance, in the
same state as it was in before the disease commenced.
   A free  state of the  bowels is an object  of the highest import-
ance in every stage of the asthma.  Castor oil, or some gentle ca-
thartic, where the other medicines do  not move the bowels, should
be  given  as often as every other  day.  Sleep, if  possible, should
be  procured  every night, by Dover's powder, or lactucarium,  or
some other means, and the strength supported with plum por- 
46                         AXI.
 rige, broths, and gruel.  Almost all asthmatics sit in bed support-
 ed by pillows.  But whatever position the patient takes to induce
 sleep and procure rest, he  should  keep himself well  covered,
 and  the room well ventilated and free from smoke  and suffoca-
 ting vapors.
   ASTRINGENT.—Whatever substance puckers  the mouth or
 contracts the fibres of the flesh, is termed an astringent.  Sub-
 stances endowed with the property of^astringency, render the
 flesh, membranes, and tissues, denser and firmer.  They draw the
 living fibres into a smaller compass and increase their strength.
 When the bowels, for instance, are in a relaxed state, it is proper
 to give astringents.   Alum, sugar  of lead, borax, creosote, white
 vitriol, blue vitriol, galic acid, nut  galls,  logwood and white oak
 bark, are some of the most potent of this class of medfeines.  In
 the disease of women called the whites,  astringent injections are
 among the best remedies.   In diabetes,  or an excessive flow of
 the urine, astringents  are indispensable.
   AURA EPILEPTICA.—A sensation  felt by epileptic people,
 or those subject to falling fits, as if cold air were creeping along
 from  one part of the body to another.  Sometimes this sensation
 is felt in the arm, and, at other  times, in the leg or body.   It is
 the forerunner of a fit.  By pressing  hard  upon the part from
 which it starts, or by placing a ligature round the limb, the fit is
 supposed, in  some instances, to be  prevented.  It always begins
 below, and travels upwards to the brain.
  AUSCULTATION.—This term signifies in medicine, the act
 of listening to  the sounds produced by the motion of the heart,
 and by the function of breathing.  To assist the hearing, an in-
 strument has been invented called  the  Stethoscope.   By placing
 the ear closely upon the chest and listening attentively, the natu-
 ral sound made by breathing can be learned, and this can be com-
 pared with the  sounds produced by the lungs in a diseased state.
 If the lungs  are  ulcerated, a hollow,  cavernous sound will be
 heard, and a rattling, made by  the air in  passing  through the
 matter.  Other sounds denote different states of disease.  The
 Stethoscope renders the sounds made in  breathing very distinct
 In consumption and  other affections of the lungs, many physi-
cians acquire  much skill in detecting the precise condition of that
organ.  This instrument should be  in the hands not only of every
physician  but of every person who wishes to become acquainted
with the diseases of the body.   The  Stethoscope is much used
 t>y Ur. James Jackson of Boston, one  of the most eminent physi-
cians in our country.
  AXILLA—The arm-pit—In the  arm-pits, are situated  the
axillary glands, which secrete  a fluid of a  peculiar odor,  and
which stains  linen of a yellowish color, and  destroys the colors 
BAL.
47
of clothing.  One person may easily be distinguished from an-
other, by the odor of this secretion.
  AZOTE.—This is one of the constituents of the atmosphere
which we breathe.  It composes seventy-eight parts in a hun-
dred of the common air; the other constituent is oxygen.  Azote
is sometimes called nitrogen.  No animal can live in it, and no
substance will burn in  it.   Azote is rather lighter than the vital
part of the air.   It enters largely into the composition of all ani-
mal substances.   If a burning lamp is placed  in a tub of water
and a large tumbler inverted over it, the oxygen or vital air will
be  consumed in a short time, and the light will go out.  The
azote will  be left in the tumbler, together with the smoke, and
the water will rise in the glass about one-fifth of its height, which
shows that a part of the air has been consumed.
                             B.

  BALLSTON MINERAL SPRING.—The water of this spring
contains  a large quantity of carbonic acid  gas, salts, and  iron.
Both the acid and the air are strengthening, and create  a strong
appetite.   In dyspepsia, nervous complaints, king's evil or scrofula,
chronic diseases of the liver, dropsy, and  almost all  disorders
without  fever, the Ballston spring water is found very healing.
The village of Ballston, whence the spring takes its name, is situ-
ated in Saratoga County, New York, about ten miles southwest
of the Saratoga  Springs.  This spring is much frequented  from
all  parts  of the Union.  There is a sulphur spring in the  same
place.
  BALSAM.—The word balsam is applied  to substances which
are supposed to possess  peculiar healing qualities.  Some bal-
samic substances are found in a natural state,  such as balsam of
Tolu, balsam copaiva, balsam Peru, balsam storax, balsam opolo-
sam, all which are liquid.   Benzoin, dragon's  blood, and storax,
are balsams congealed into a solid state.  There are many artificial
medicines sold under this name, such as balsam of life, and ano-
dyne  balsam.  The natural balsams have a strong aromatic taste
and smell, and are commonly of the  consistence of molasses.
Balsams  are of an oily, resinous nature.
  BALSAM  COPAIVA.—This balsam oozes from the bark of a
tree which grows in the West India Islands and South America.
It is of a yellowish color, and about as thick as honey.  It has
an aromatic smell, and an  acrid, pungent taste.   It  is ropy and
tenacious.  It is soluble in  alcohol and the essential oils.
  This balsam has the property of increasing the discharge of 
48
BAL.
 the urine.   To produce this effect, it must be given in a dose of
 thirty drops, three  times a day.  It should be dropped  upon a
 tea-spoonful of fine sugar.   In a large dose, it operates upon the
 bowels.   It has been esteemed an excellent medicine in coughs
 and consumptions.   Eight or ten drops may be given to a child
 two years old.  The balsam copaiva has, by a chemical process,
 been reduced to a solid state, and may be given in the form of
 pills.  This is, in many  instances,  the  best  way of giving  it.
 The  copaiva  gives to the urine a violet smell, and, in  a large
 dose, produces strangury.   In the  disease of females called  the
 whites, it is accounted one of the best medicines in use.
   Dr.  Chapman of  Philadelphia,  ranks  the  balsam of copaiva
 among the most effectual means of curing the clap or gonorrhea.
 His method of giving it, is to take two  tea-spoonful of the bal-
 sam of copaiva,  one tea-spoonful of spirits of red lavender, one
 tea-spoonful of  the  sweet spirits  of nitre, one tea-spoonful of
 laudanum, two ounces of gum arabic, and a gill of water, and
 mix them all  together in a phial.   Of this mixture, he  gives a
 table-spoonful, morning,  noon, and night.   Taken in  this way,
 it will effect a cure in three or four days.   " But to obtain this
free and prompt operation of the medicine, the patient must hon-
 estly abstain from every stimulating  article of diet or drink, and
 impose upon himself a complete state of  rest."  We  believe this
 remedy of Dr. Chapman often  fails from the sheer want of atten-
 tion to the injunction which he has added respecting  the diet,
 drink, and more  especially rest.
   BALSAM OF FIR.—This balsam exudes from the trunk of
 the Hemlock  Fir, which  grows in Canada.   It is  obtained by
 making incisions into the  bark.   It is of a light  yellow color,
 aromatic smell, and  pungent taste.   It increases the flow of the
 urine, opens the bowels, and loosens the phlegm in a cough, very
 much like the balsam of copaiva.   The dose for an adult is from
 thirty to forty drops.  It  is used in the cure of gonorrhea, the
 whites of females, and diseases of the lungs.  The dose  for a
 child two years old, is ten drops.
   BALSAM OF  TOLU.—The Tolu  balsam comes in  little
 gourd-shells from the Province of Tolu  in South America.   It
 is obtained from the trunk of a tree by making  cuts into the
 bark.   It exudes from the tree in a liquid form, but thickens by
 age, and finally concretes  into a solid mass.   It  has a fragrant
 odor, and a warm sweetish taste.  It readily dissolves in alcohol,
 and imparts its smell and taste to water.   In the shops, it is sold
 in the  form of a syrup, under  the  name  of the syrup of balsam
 of Tolu, but more commonly balsam of Tolu.  The balsam is first
 dissolved  in spirits, in the proportion of an ounce and a half of
 the balsam, to a pint of new rum or diluted alcohol.  The spirit-
 uous solution  or tincture, is then  mixed with simple syrup,  in 
BAT.                         49
 the proportion of an ounce of the tincture to two pounds of the
 syrup.   The  dose for an adult is  two tea-spoonsful; for a child,
 one tea-spoonful.   It  is one of the most  agreeable cough medi-
 cines in use.   For infants and little children it is a good medi-
 cine, on account of its mildness.  It is used almost entirely for
 coughs, but is no doubt favorable  to ulcerations of the  stomach,
 and bowels.  Its balsamic properties are much milder than those
 of the  copaiva, fir, and Peru, and there is but very little danger
 of taking an  over-dose.  Equal parts  of  the  syrup and almond
 oil, forms a verv good expectorant.
   BASILICON  OINTMENT.—The basilicon ointment is made
 by taking equal parts of yellow resin, yellow wax, hog's lard, and
 sweet  oil, melting them together, and allowing the mixture to
 cool.   The ointment can be made by melting together eight parts
 of hog's lard, five parts of resin of pine, and two parts of yellow
'wax; but this way of making it is apt to give it too much  hard-
 ness for cold  weather.   The basilicon ointment is much used for
 healing sores, wounds  and corrosions of the skin.  For  fresh
 wounds, it is too  stimulating, but in sores which are rather slow
 in healing, it is a very good dressing.
   BATHING.—There can be no doubt but cleanliness promotes
 health and prevents diseases; especially diseases of the skin.   If
 people are  much in the open air, temperate, labor constantly, and
 perspire much, they seem  to do much  better without bathing,
 than those who are housed  continually, sedentary, and seldom
 secrete by the skin.  Perhaps such people acquire a hardness of
 constitution  and a degree  of health, which  defy the ordinary
 causes of disease.   The peasants of the north of Europe,  espe-
 cially in Russia, are said to be extremely healthy, although they
 are excessively dirty, and pay no manner of attention to bathing,
 or cleansing  the skin in any other way.  If people constantly
 wear clean clothes, and change  them often, it assists very  much
 in keeping the  skin  clean, and prevents, in some measure,  the
 necessity  of  bathing.  But  when we  reflect that the  skin is a
 secretory  organ, made up of an endless number of glands which
 open upon the surface and  continually  deposit a great  mass of
 excrementitious matter, which not only  blocks up the  mouths ot
 exhalent  vessels themselves, but is, in a greater  or less degree,
 re-absorbed  into the  system, unless timely removed, everybody
 of common  discernment must  perceive, the propriety  and be-
 nefit of frequent bathing.   For this purpose,  it is not neces-
 sary to have a bathing tub and a bathing  house, but a common
 tub, or a basin of water with a piece of sponge, or an  old linen
 or cotton  rag, will answer all the purpose where  greater conve-
 niences cannot be obtained.  So far as mere cleanliness is con-
 cerned, it  matters but little whether  the water  is warm or cold.
 Warm 'water is the most solvent, and soonest removes the inspis-
               7 
50
BAT.
 sated sweat.   In a state of tolerable health, well water will answer
 both for summer and winter.
   The warm bath brings  the blood to the surface, and for  the
 time being, increases the perspiration.   It softens the skin, opens
 the pores, and renders the joints and muscles more supple.  In
 chronic inflammation of the internal organs, the frequent recall of
 the blood to the surface, is no doubt of the greatest  advantage.
 It serves the  purpose of  a warm poultice to the whole skin.   To
 produce  much effect, however, a  person must,'in such cases, re-
 main for some time in the bath, and resort to it often.
   In nervous diseases, hypochondrism, epilepsy, hysterics, palsy
 and insanity, warm bathing affords the most essential relief, and
 is more restorative  than almost any  other  remedy.  The warm
 bath to be of service, should be  used  as often as once a week,
 and, in many instances, it will be advisable to resort to it daily,
 or at least, twice or three times a week.
   The hot bath is, in some cases,  more beneficial than the warm
 bath.  The effect of the hot bath  is to raise a sweat.   The water
 must be  raised  to  blood-heat,  and. as much  hotter as the na-
 ture of the case may require.  The hot bath is used for cold con-
 stitutions and chronic complaints, such as rheumatism, gout, and
 old complaints of the stomach, liver, bowels, kidneys, joints and
 muscles.  It  seldom fails of producing a profuse perspiration and
 a more rapid circulation of the  blood.   In acute inflammations,
 unless they happen to be very slight  and confined to the surface
 of the body,  the hot bath is decidedly dangerous.
  The steam bath  is of  the same  nature with the hot  bath.  No
 greater degree of heat can be applied to the body by the means
 of steam, than of  hot water.   The  agency of vapor upon  the
 skin, is also the same with that of heated water.   The vapor or
 steam  bath, has, however, of late,  come greatly into vogue,  and
 as it produces about the  same effect as the hot bath, it is entitled
 to the  same credit.   Steam can be applied  by sitting  over a tub
 of hot water, with a blanket thrown over  the head and  body
 1 he most effectual way of using the steam or vapor bath  is  by
means of  a box large enough to stand upright in, and  by admit-
ting the steam through  a hole in the box.  The head and neck
are put through a hole in the top of  the box, and  the body and
iTtv? T °S  ; ?hu Vap°r bath is used for the ™ complaints
 as the hot water bath.                                  r
   The cold bath is not only used  to preserve the health, but to
 cure diseases.  In almost all fevers, not attended with activein-
 £ST£' lV? the m°St happy effect'   * lessen* the burning
 heat oi the body  moderates the  thirst, alleviates restlessness
 abates the force of  the circulation, and induces sleep.   ThTCo!d
 bath should never be used in the cold ft of a fever, or in any dis-
 ease where there is  a deficiency of heit.   There  s no remedy Tn 
BAT.
51
the treatment of fevers productive of better effects, if rightly and
perseveringly used, than the cold bath.   The  most convenient
way of using it, is by washing the body over with a sponge or a
cloth.   This can be done as often as the symptoms of the fever
become aggravated, and by people in every condition of life.  To
use the cold bath with the same efficiency with which we use
other remedies in febrile diseases, it should be employed once  in
every two  or three hours.  It  should  never be employed when
there is any considerable degree of perspiration, or when the
pulse is feeble and small.
   The cold bath is peculiarly efficacious in subduing  the vio-
lence of scarlet fever.  It may be employed in every stage of the
disease, where the heat and pulse are above what is natural, and
with the greatest freedom.   In the warm season, the bodies of
children sick of the scarlet fever, may  be sponged with cold wa-
ter every half hour.
   Baths are often medicated with neutral salts, sulphur, acids, and
other  substances.  Sea  water  may be  considered a medicated
bath.   The salts which it contains are medicinal, and will some-
times cure obstinate diseases of  the skin.   The sulphur bath is
the most used of any of the medicated baths.  This bath is em-
ployed warm, and is adapted to diseases of the skin, chronic rheu-
matism, gout, stiffness of the joints and muscles, palsy, green sick-
ness, and obstinate  affections of the internal organs.  The acid
bath composed  of aqua fortis  and  marine acid, has been  found
serviceable in many obstinate diseases of the liver, peritoneum and
bowels.  Common salt  infused into warm water, makes  a very
good bath  for  rheumatism, king's  evil, and  dyspepsia.   The
composition of mineral waters, is commonly imitated, in the for-
mation of medicated baths.
   The efficacy of bathing, very much  depends upon the con-
stancy and perseverance with which it is used.   In  obstinate dis-
eases of the skin, it must often be  practiced for months, before
any decided impression can be made.
   In warm  climates bathing is more practiced, and, probably, is
more necessary than  in  cold  climates.  In Italy,  Greece and
Egypt, public  baths were  formerly instituted.  Many attempts
have been made among the moderns to  establish public baths in
the north of Europe, especially in Paris and London, but whether
the climate is too cold, and the perspirable season of the year too
short, or the utility of bathing  is not so well understood by us as
by the ancients, the attempt has always failed.
   But were the health and beauty of the skin alone concerned,
the practice of  bathing  must still  be  considered an  inestimable
benefit to mankind.   In the hot season, boys in New  England
need no inducement to bathe, but girls are almost entirely out of
the way of this practice.   The benefit to girls is as great as  to 
52
BAU.
  boys, and some plan should be adopted to make it as convenient
  for them to bathe  as for boys.   The cold bath  is the most suita-
  ble for healthy people.  It acts as  an astringent upon the flesh,
  and renders all parts of the body denser and firmer.  It hardens
  the body against the  extreme  changes  of the atmospheric  tem-
  perature, and  fortifies it against disease. We would here, how-
  ever, add a caution which should always be heeded.  It is always
  hazardous to go into a cold bath in a state of exhaustion,  or when
  a person is very tired, or when the  system is in a profuse perspi-
  ration.  The  cold bath is  always unsafe for people who  are in a
 cold, debilitated, weak state of health.   Females who have  been
 weakened for  a long time  by any disease peculiar to them, will
 be seriously injured by the cold bath.   If the person is subject to
 cold hands and feet, or is pale and enervated, the cold bath will
 not be likely to answer a useful purpose.
   The proper  time to use the cold bath, is when the skin is warm
 and dry.
   The proper time to use  the warm bath, is when the system is
 somewhat  exhausted and  deficient in  heat.  But whether the
 bath is used in the morning, at noon, or  in the evening, is a mat-
 ter of secondary consequence.   In general,  the bath, whether
 warm  or cold, should not  be taken before  breakfast, unless for
 some  particular disease, when the time must be  regulated by the
 heat of the body, the fever, and other circumstances.
   The most extraordinary  effects may be produced by a  skilful
 use of cold, hot, and medicated baths.  The most violent inflam-
 mations may often  be entirely subdued,  by the constant applica-
 tion of cold water, and water congealed  to ice.  Warm water, in
 certain states  of  an inflammation,  is  equally  powerful.  Cold
 water  is  one of the greatest antiphlogistics which we possess.
 We have often reduced a violent inflammation of the eyes  by cold
 water alone.  In fevers, we have seen it remove the  heat  and
 violence of the disease, like a charm.  It seems to quench the
    of a fever as it quenches the  thirst; and  operates  upon  a
 parched skin as it operates upon an inflamed stomach.   We be-
 lieve that a fever may be  cured by the cold  bath  alone.  The
 mode  of using the  cold bath is a matter of minor importance.
 Ihe shower bath is preferred by some, the bathing tub by others,
 and laving the  body with a  wet sponge or cloth, by others. Each
 way may have its  advantages, but convenience  will  probably

 ^v^^****  0uradvice' is'nevertosp-

 cvfrt^d7nThTSt if0"1"1011 ubUt  Ufful  herb Srows in  almos*
IzZZ1 SL   Aaf Someihin# of  the  sme11 of the lemon,  and
a grateful taste   A tea made of  the baum is a very good drink
m fevers  especially where the nervous system is very much  ex-
cited.   It is cooling, soothing, and a  gentle promoter of the pers- 
BIL.
53
 piration.   In common headache, if drank hot and freely, it often
 produces complete relief.  Some people of delicate nerves find it
 a much better drink than cold water, or the China teas.
   BAYBERRY.—The bayberry is a bush  which bears thick
 bunches of a greasy kind of berries, which remain after the leaves
 have fallen.   It grows from two to six feet in height.   The ber-
 ries yield a kind of wax, of which candles are sometimes made.
 It is sometimes made into an ointment.   The root of the bay-
 berry  reduced  to  a fine powder, makes  a very powerful snuff,
 useful in the catarrh  and painful affections of the head.   The
 snuff made  from  this root  has been highly recommended  in
 Amaurosis or affections of the optic nerve.   In domestic practice,
 it has been much  used as a remedy in jaundice.  In small doses
 it is warming,  and stimulant;  in large  doses it  operates as  an
 emetic.  It  has some  of the properties  of ipecac, and  being a
 native of our climate,  should receive a more  extended and accu-
 rate examination than has hitherto been given it.
   BILE.—This  secretion is often  called gall.  There are two
 kinds of bile in the liver and gall bladder, one is called hepatic
 bile because  it  is contained in the proper  ducts  of  the liver, and
 the other the cystic bile, because it is contained in a cyst called
 the gall bladder.   The hepatic bile is  thin, of  a faint  yellow
 color, without smell and very slightly bitter.  The cystic bile or
 that contained in the gall bladder is thicker and more  acrid, and
 of a yellow,  green color.   It is  of the consistence of  oil.   The
 gall bladder  is a reservoir.   The hepatic bile  only flows into the
 intestines during  digestion ; at other times, it  retreats into the
 gall bladder.   After digestion is over, the mouth of the common
 duct which carries the bile into the intestines, contracts, and  no
 more bile  can pass until  digestion  begins  again.  There  are
 three ducts in the  liver.  The first takes the bile which is secre-
 ted in the liver and carries it into the common duct, called ductus
 communis choledochus, which  receives  it, and conveys  it into
 the first portion of the intestines.  This is the second duct.  But
 there is a third duct which leads from the common duct into the
 gall bladder.   Through this duct, the bile retreats from the com-
 mon duct  and  issues  out again when it is needed, or when the
 gall  bladder  becomes  filled, it  contracts, and emits it into  the
 common duct.
  The  bile  enters into the intestines about  four or five  inches
 below the stomach.
  When the  bile flows into the  stomach as it often does, it causes
 sickness and  vomiting.  When it is taken up  into the system  by
the absorbent or secretory vessels, it gives to the  skin and the
whites of the eyes a yellow color.   It also stains the urine and
the perspiration.   Poured into the intestines, it assists in exciting
a motion which carries down the alimentary contents.   The bile 
54                          BIL.
 gives to the feces the yellow color.   If  the entrance of the bile
 into the bowels is stopped or impeded, the feces become of a clay
 color and  the motion of the bowels is slow; more or less unea-
 siness is felt, and at length, a serious disease is  the consequence.
   On the contrary, an excessive flow of bile into the bowels, pro-
 duces a rapid motion, or what is called a bilious diarrhoea.   The
 bile is  evidently of  a  purgative  nature.  Its  deficiency causes
 costiveness, and  its  excess  causes too quick  a motion of the
 bowels, and finally disease.
   The bile is composed of water, albumen, resin, a yellow color-
 ing principle, soda, salts, and an acid called the choleic acid.
   Leibig contends, that, the bile is the product of the metamor-
 phosis of the flesh and tissues ; and that its proper function  is to
 support respiration and produce animal heat by presenting carbon
 and  hydrogen in a very soluble form to the oxygen of the arte-
 rial blood.
   When sweet  oil is  taken into the stomach and bowels, the bile
 combines with it and  forms a kind of  soap which  appears  in
 numberless little  balls.   Mixed with  water, bile is sometimes
 used instead of soap to wash woolen cloth.
   When live animals are opened  and the mouth of the duct ex-
 posed which carries the bile into the  bowels, the yellow fluid is
 seen to issue from it in drops.   Vomiting  has  an extraordinary
 effect in the expulsion of the bile.  In animals who have died  in
consequence of poisons, the  gall  bladder is found empty.   Hot
 weather  appears  to  hasten the secretion of the bile, and  cold
 weather to  retard it.
   BILIOUS  FEVER—Remittent Fever.—This  fever is  not
very common in the  New England States, but in the middle, and
 especially, in the southern and western  states, it  is  one of the
 most common  and formidable  diseases with which  the  inhabi-
 tants have  to contend.   Its  nature, treatment, and  symptoms,
 were not formerly very well understood,  but of late years, since
 the settlement of the south-western and western states, where it
 prevails more or less, annually, its history has been better ascer-
 tained and the treatment of it more successful.  In its symptoms,
 it  bears a considerable  resemblance to the  fever  and ague.  In
 the fever and ague there is a complete intermission in the parox-
 ysms, once in 24, 48, or 72 hours, but in the bilious or remittent
 fever there is only a remission  or abatement of the  symptoms  ■
 the fever never entirely disappears until recovery takes place.
   This fever commences with a sense of  languor, anxiety, and
 an indisposition to motion, pain in the head  and back, frequent
 flushes of cold and heat, but not with that degree of shaking and
 chattering of the teeth which  ushers in  an intermittent  fever  or
 lever and ague ; there is thirst and difficulty of breathing, furred
 tongue  and dejected spirits, sickness at the stomach and bilious 
BIL.
55
vomiting.  The skin and eyes will often be tinged with yellow,
which circumstance has led many physicians to think this kind
of fever to be of the same nature with the yellow fever.  The
pulse will be  frequent, hard, and small, though  sometimes full
and soft.  These symptoms will  continue  awhile and an abate-
ment will take place. A partial sweat will occur, the heat and thirst
will be less violent, and all the symptoms will remit in a degree.
   Delirium in the beginning of this fever, shows  the disease  to
be of the most violent kind.  Dissections  demonstrate that the
stomach, head and liver, are often the seats of inflammation.   In
this country, an inflammation of  these  organs, is almost always
discoverable.  It is a  disease which always  calls  for a prompt,
persevering and decided treatment.   In the south and west, it is
a gigantic enemy to human life.
   The causes of this disease as, of fevers in  general, are hid in
very deep  obscurity.   In low, level, wet, woody, marshy places,
this] fever prevails the most, and we think it more'prevalent  in
clayey soils, than in sandy ;  and  the more  southern the latitude
and the greater the degree of heat, the more frequent will be the
occurrence and the more  malignant  the fever.  Like the fever
and ague, it is supposed to originate from some malign emanation
from the earth, or from a decomposition of  the vegetable, watery
and animal substances which cover it.   This  emanation is called
malaria,  or miasm.   And  surely the earth  is  as capable of origi-
nating a noxious matter which shall penetrate and disorder the
whole system  as is the human body itself.   Several contagions
originate in the human body itself, and much more may we ex-
pect the earth with all its  vegetable and animal substances upon
it, acted upon by the  continued  heat of the  sun, to foment and
mature aerial poisons capable of diseasing the human body.
   Domestic Remedies.—The first thing to  be done in a domestic
way, is to relieve  the  stomach and bowels by a dose of physic.
For this purpose, a tumbler full of strong thoroughwort tea, should
be given every two hours until it operates ;  the  feet should  be
well bathed in hot water, and a tea-spoonful  of the sweet spirits
of nitre in a little water should be given every three hours until
the fever abates.   Emetics are not deemed  very proper in this
disease, unless there should be a bilious vomiting or a constant
nausea.   If, however, there should  be much  sickness at the
stomach, a  gentle emetic  of ipecac should be given before the
administration of a cathartic.   If there is much heat and pain in
the head, an application  of cold vinegar  and water should  be
made to the head and continued for some hours.
   If the skin is hot and dry, and  the weather  is warm, cold water
should be applied over the whole  body, two or three times a day,
until some abatement of the disease takes place.  The water may
either be thrown upon the  body, or applied with a wet cloth or 
56
BIL.
  sponge.  This remedy should never be forgotten or omitted.   It
  abates the  heat, relieves  restlessness, and produces sleep.  It is
  often more of an anodyne than opium itself.   When no local  in-
  flammation is manifest, cold water may be drank as freely as it is
  used externally, and for the same reason.
    Cold water, let us repeat it, that, cold water is one of the best,
  safest and most efficacious remedies in the treatment of bilious or
  remittent fever.  It must not be forgotten however, that its use
  should be omitted when  any degree of chilliness or perspiration
  is present.  Many a life has been saved by a proper, timely, and
  persevering  use of this greatest, best gift to man.
    If the patient is out of his head or delirious, mustard poultices
  should be applied to the feet and a large  blister placed between
  the shoulders.  The blister  should, at least, be eight inches in
  length and six in breadth ; one of a less size will seldom do any
  good.   The nourishment should be nothing more than gruel and
  bread water, barley water, rice water or some other liquid, vegeta-
  ble substance ; the drink,  cold water, tamarind water, lemonade,
 soda powders,  and rochelle powders, which last will answer the
 purpose of cleansing the  bowels and of abating the thirst and
 heat.   Indeed, the rochelle powders are a valuable  modern dis-
 covery in  the  treatment of this and of all other kinds of fever.
 Cold water, saline effervescing draughts, leeches, instead of bleed-
 ing from the arm, and the  discovery of the quinine, are great and
 inestimable improvements  which modern  physicians and chem-
 ists have made in the cure  of fevers and of many other diseases.
 The sick of  this disease, should be excluded as much as possible
 from all noise  and confusion.  The light should be excluded
 and the room kept cool, and often replenished with fresh air.   '
   The  bilious or remittent fever generally runs  from five  or six
 to  fourteen days  before  symptoms of recovery take place   In
 the southern states its course is shorter, and the disease more
 violent than in the northern.
   Professional Remedies.—In the  early  stage  of  the  disease,
 blood-le ting  either by leeching or from the arm, has  been found
 of singular efficacy m relieving, shortening, and curing the fever
 In  the  northern  and particularly, in the  middle states, one or
 two gentle bleedings, have been  found to  be attended with  the
 happiest effects.  After  bleeding and suitable evacuations of  the
 !w£   in a  v°WeIS' ^  °piate may be resorted t0 unless forbid-
 den by  the delirium and  height of the fever

sinffnlT PfRCSpeCially ln  uhe S°Uthern States> has been f™nd of
singular efficacy as a cathartic : it is given in doses of ten or

SM \TTd afoften as the quantit^of bilious and
 eculent matter of the bowels appears to require it.   It is some-
times used  in combination with an equal weight of jalap or rhu-
barb.   To  open the pores of the skin and keep up a perspiration 
BIL.
57
antimonial medicines are used, and often prove peculiarly benefi-
cial.  Some of the profession rely upon them almost entirely.  The
surest and the best way of using antimony, is either in solution,
in the dose of a quarter of a grain of the tartrite, or in the form
of James' powder, pulvis antimonialis.   The James' powder is
given in six grain doses, and repeated once in two or three hours.
But these remedies, as good as they are, cannot be given if nausea
or vomiting prevail.   The sal nitre is a medicine  which many
physicians prefer to antimonials.  This  salt acts more upon the
kidneys than  upon the skin, and  relieves the fever by a flow of
urine almost as  much as antimonials  do by exciting a sweat.
The sweet spirits of nitre when given in sufficient doses, and at
frequent intervals, is also  a remedy of  much efficacy.   In doses
of a tea-spoonful, administered every hour during the rage of the
fever, it will work  wonders.   It is not a little remarkable how
much a physician  may accomplish by a single medicine when he
has become thoroughly acquainted with  the  use of  it, and with
all  its effects and properties.   We have sometimes thought it
better for a physician to become  acquainted with a single remedy,
than to have a partial acquaintance with  many.   We always
prefer the use of  simple  preparations to the use of compounds.
The virtues of a compound commonly depend upon the testimony
of one or two physicians or individuals, whereas the properties of
a simple are generally known, and their  effects liable to less  fal-
lacy.  In hot climates, where there is a distinct, periodical re-
mission which  generally  takes  place, in  two or four days, the
quinine is in very common use.  This  is given in  one or two
grain doses, every two or  three hours, through the whole  remis-
sion, and the nearer  the fever approaches to a fever and ague
or intermittent  fever, the more certain  will the quinine be of
curing the disease.
  The stomach  is always  an organ to which the attention of the
physician should be  particularly directed.  If the sickness  and
vomiting continue for any length of time, great prostration of the
strength will  be sure to follow, consequently every effort should
be made to quiet, and to restore this organ, at least, to a compara-
tive state of soundness. Undoubtedly, leeching  is the remedy of
most power in the present state  of our knowledge.   A dozen or
a dozen and a half of good leeches applied, six  at a time, to  the
pit of the stomach, will often be attended  with the happiest relief.
A  large  blister  will  sometimes  be  equally  efficacious.  Large
warm poultices  made of  poppy leaves boiled in water are more
innocent, and often  excellent means of allaying the disturbance
of the stomach.   If the liver should discover signs of tenderness
and  inflammation, a similar treatment will be applicable to that
organ.  But in spite of all remedies, this  disease will sometimes
be so malignant; the delirium will be so great; the prostration
               S 
58
BIT.
 of strength so sudden, and the affection of the whole system so
 deep  as to baffle the effects of all remedies, and the utmost skill.
 The  only safety when the disease becomes epidemic and malig-
 nant, is in flight from the infected district.
   BISMUTH,  OXIDE  OF.—The  Bismuth  from  which  the
 oxide  is made,  is a white  metal, very brittle, and easily melted.
 The oxide is made or formed  by combining one part  of bismuth
 with  three parts of nitric acid, aquafortis, diluted with an equal
 weight of water.  After the acid has combined  with the metal, a
 pure white powder is formed, which  resembles  the  antimonial
 powder.   This  powder is one of the very best remedies  in  the
 cure  of dyspepsia,  and chronic affections of the  stomach and
 bowels.  The proper dose for  an adult is five grains, twice a day.
 The  dose  for a child between six months and two years  old is
 one  grain  a  day.   Upon what principle  the oxide of bismuth
 operates, whether as a discutient of  inflammation, or  as a tonic,
 we are not prepared  to say, but we have  been convinced from
 ample experience of its efficacy in curing the dyspepsia.   It can
 be made into pills with  a crumb  of bread, or  taken  in powder
 with a little syrup or molasses.  The benefit derived from it, in
 our hands, has been the most unequivocal.
  BITTERS.—Bitters may be prepared either by steeping them
 in water, by dissolving them in new rum, brandy, or  alcohol, or
 they may be taken in the form of a pill.   It was the old fashion
 to take bitters in rum, brandy, or wine, but this is not at all ne-
 cessary to secure the full effect of the bitters.  Water will extract
 the virtues of most bitter substances as well as spirituous liquors.
 Most bitter substances furnish an extract, which may  as well be
 taken in the form of a pill as in any other way.   The advantage
 of dissolving bitters in spirits,  consists  principally in the disposi-
 tion  of spirituous  solutions  to keep for a long  time.   The
best bitters are quinine, peruvian bark, Colombo, gentian, quassia,
 cascarilla bark, chamomile  flowers, the inner bark of the wild
 cherry tree, and  wormwood.
  BITTER  SWEET—Solanum Dulcamara.—This plant  is
found  in moist,  sheltered  situations, where its roots can  have a
free supply of water.  Its stalks are woody and brittle, climbing
upon fences and  bushes, or running upon the ground.   The ber-
ries are oval, of a bright scarlet color, and continue to hang in
bunches after the leaves  have fallen in autumn.   The twigs and
roots have  both a bitter and a sweet  taste, as the name of the
plant imports.  A tea made  of the  twigs, or roots, is the common
way of using it.  A wine-glass full of the tea  is a full dose to
begin with, but the dose may gradually be increased.  It is both
an emetic  and  narcotic.   Its  greatest celebrity consists  in the
cure of diseases of  the skin, especially  a scaly, dry humor called 
BLA.
59
the leprosy.  It is taken  three times a day, and  the  skin is at
the same  time  washed with it.
   The bark of  the root simmered with fresh butter and cream,
makes a very healing ointment for sore nipples.  In the cure of
tetter and syphilitic diseases, it holds a high rank.   In a large
dose, it produces convulsions, delirium, and insensibility.
   BLACKBERRY.—The low, or  running blackberry, is  the
species commonly used in medicine.  The roots are the most
medicinal.  The  blackberry is an active astringent, and may be
given in looseness of the bowels and all other  complaints where
astringents are required.   In dysentery, diarrhoea, and the bowel
complaint  of children, it  will  often  effect a perfect cure.   The
dose for a  grown person, is a tea-cupful of the strong tea made by
steeping the root.  The  dose for a child, of the same  tea,  is a
table-spoonful,  several  times a day.  It  makes a very suitable
drink for a person affected with the diabetes or excessive flow of
the urine.   It makes also  a good gargle for the sore mouth, both
of children and grown people.  The blackberry jam made from
the berries, has been used for the gravel.   Mixed with water it
makes a very agreeable and suitable drink in dysentery and diar-
rhoea.   The jam itself may  be taken as  nourishment.   The
blackberry tea  drank frequently in the course of the day,  and
followed  for several days in  succession, will  restrain the most
obstinate looseness.
   BLACK  DROP.—The black  drop is  made by adding  four
ounces of  pure opium to a pint of sharp vinegar or lemon juice.
The  solution must be allowed to stand three weeks, and then
must be  added saffron, cloves, nutmegs,  cinnamon, of each an
ounce, coarsely powdered.  The whole must be allowed to stand
a week longer, strained through a flannel, and  the liquor evapo-
rated to the consistence of syrup.   The black drop  has all the
effect of laudanum without the headache, giddiness, and nausea
which often attend it.  Where  the  laudanum  and morphine do
not agree  with  a  person, the black drop should be tried.  Since
the discovery of the denarcotised opium, and of morphine, the black
drop has been much less used.  The proper dose of the black drop
is twelve  drops.  The  dose for a child two years  old,  two drops.
   BLADDER.—The  bladder is situated  in the pelvis or basin,
and in front of  the lower  portion of the bowels,  which is called
the rectum.  The bladder when taken out of the  body, is nearly
transparent, and capable of being blown up or distended with air
to a very great size.   In  the  living body, it is capable  of great
distention, but is  less extensible than after death.   The urine  is
received into the  bladder by means of two ducts leading from
the kidneys, called ureters.  The external coat of the bladder is
strong and fibrous.  The  internal  coat is drawn into  a multipli-
city of  wrinkles which makes it thick and shaggy.   The inner 
60                         BLE.
 coat secretes a mucus which defends it from the corrosive ness of
 the urine.  The  ureters  enter the back part of the bladder ob-
 liquely.  The urine is retained in the bladder by means of a
 circular muscle called  the  sphincter, which contracts until the
 bladder becomes so filled as to render its longer retention painful.
 The pain relaxes  the sphincter,  and the urine issues through the
 duct called the urethra, and finds a passage^ out.
   The  bladder is attached to the rectum, to  the hip-bones, to
 the peritoneum, and to the navel by means of ligamentous fibres.
 When the biadder is full, it rises above  the pelvis and can be felt
 in the lower part of the belly.   In females, the bladder is separa-
 ted  from the rectum by the uterus, or, in other words, the uterus
 or womb is situated between the bladder and rectum.
   This organ appears to be a mere receptacle of the urine.  For
 what purpose  the  urine is retained in this receptacle, it is difficult
 to discern.  If, however, the urine had  no such reservoir, it must
 be constantly  dribbling away, and produce great inconvenience.
   BLEEDING  OR VENESECTION.—In letting blood, which
 is commonly performed  in  the  arm, it is best  to  select  a vein
 which rolls the least under the skin.  If there is a beating felt
 in the vein, or perceived by the  eye, it  should not be selected, if
 it can be avoided, because the  beating shows  that there is an
 artery situated under it,  which would be  in  danger of being
 pricked.   The veins do not beat, of themselves, but the beating
 is communicated to them by some adjoining artery.
   The veins which lie  nearest  the surface  are  not always the
 best to open.
   The first thing  to be  done  is to tie  a fillet or bandage with
moderate  tightness, round the  arm, a  little above  the  elbow.
The object of this, is, to stop the blood from flowing through the
veins upon the surface, without impeding the blood in the artery
otherwise the veins could not be  rendered turgid.              '
   The operator should  have a  sharp lancet, entirely free  from
ruSt* uHr i"™?1,6? th^ vein' as  much as he can» by Pacing the
thumb of his left hand a little below the place where he intends
to introduce  the lancet.  More depends upon  the manner of using
this  instrument than upon its shape.  It should be pushed  into
the vein  in  an oblique  direction, and, when its point is a little
within the cavity  of the vessel,  it is  not  to be  pushed  further,
but to be brought  obliquely upward and forward until the point
is brought out again.  More is learned by seeing a good opera o
^Trnir6?T^T^™ by a th0USand Ascriptions1^i
t»W HTVh0U^ h0M hlS arm °Ut strai§ht' and suPPort it by
taking hold  of a stick.  In order to make the blood flow more
freely, the fingers and the muscles of the arm should he kept £
motion by opening and shutting the hand.   If the openfn*  n
the vein becomes blocked up b/the coagulation of the bbod  a 
BLE.
61
snap with the finger will set the blood to running.  In cases of
rupture or strangulated herniae, and dislocations of the joints, a free
opening should be made in order that the blood may flow fast.
  After a due quantity of blood has been drawn,  the fillet is to
be loosened and removed.  If the stream of blood does not cease
by the removal of the ligature, the thumb of the left hand should
be pressed upon the vein below  the orifice, which will stop it
effectually.   The arm should then be washed, and a pledget of
lint, or a roll of old cotton or linen cloth, placed upon the orifice,
the lips of  the incision brought closely together, and secured by
a bandage.
  If the arm gets to bleeding, it can  always be stopped by press-
ing upon the vein below the orifice, or upon the orifice itself.
In  this condition, it can be held by  the person  himself,  until
assistance can be procured.
  BLEEDING  FROM  THE  BLADDER AND  KIDNEYS—
Hematuria.—Voiding of blood  from the urinary organs is not a
common disease, unless the bladder  and kidneys are irritated by
the presence of gravel stones.  It may happen from blows upon
the abdomen and back, and from violent exercise by riding or
jumping.   We believe, however, against the opinion of  Dr. Cul-
len, that it does  happen without  the aid of any mechanical vio-
lence, either of gravel stones, or accidental blows, or overstrained
exercise.   We have known it to be voided without pain or dis-
tress of any kind.  The urine  is sometimes so high  colored, or
of such a deep  red, as to be mistaken for blood;  but if a piece
of linen cloth be wet with  the doubtful discharge, the fact may
be easily ascertained.  If the urine is bloody,  a stain will be left
upon the cloth;  if it is  only highly colored, no bloody deposite
will remain.  Another  criterion of blood in the urine, is its co-
agulating by the heat of boiling water, whereas the urine when
it is free of blood, does not coagulate by that degree of heat.
  When the  voiding of  blood  arises  from small gravel  stones
lodged in the ureters, the blood is apt to be somewhat coagulated,
and the sediment of the urine will be  dark brown or coffee colored.
  In cases  of bloody urine, there is commonly  acute, excruciating
pain in the small of the back ;  great difficulty in making water;
sometimes great sickness at the stomach, and vomiting.  If the
blood comes only from the bladder, there will  be a sense of heat
and pain at the lower part of the abdomen, and in the neighborhood
of the  rectum.   This complaint is  always attended with  some
danger, particularly if purulent matter is discharged at the same
time.
  Domestic  Remedies.—We believe the best  remedy which can
be administered in bleeding from the urinary organs, is a dose of
laudanum.    There is usually great distress and pain in passing
the water, which we have never seen relieved until an  opiate 
62                         BLE.
 had been given.   An adult should  take from  40 to  60 drops of
 laudanum, or a table-spoonful of paregoric.  After the  violence
 of the disease has been allayed by an opiate, either a warm bath
 should be taken, or cloths wet with hot water or new  rum should
 be applied to the  part.   Warm flaxseed tea should be given for
 drink, and an injection of Epsom salts  dissolved in warm  water
 immediately administered.   The salts of nitre  in  eight grain
 doses, or the sweet spirits of nitre, ought to be given, every two
hours.   The ura  ursi is an excellent diuretic in such cases.  A
tea should be made of it and drank every half hour.   Mullen tea
drank plentifully,  will often obviate the difficulty of passing the
urine.
   Professional Remedies.—If the force of the pulse should  be
 above the natural  standard, blood should be  drawn  either  by
 leeches upon the back or lower part of the abdomen, or from the
 arm.  If the stomach is disturbed, that organ should be quieted
 by an anodyne, and the bowels moved either  by a Rochelle pow-
 der, calcined magnesia, or a pill of aloes.  The spirits of turpen-
 tine will  sometimes obviate the obstructions in the urinary pas-
 sages.  Mucilaginous drinks should be constantly given, and a
 liquid diet adhered  to.   A tea made of peach leaves, and drank,
 at the rate of a pint a day, succeeded  in one case, where many
 other medicines had failed.  Where the discharge of blood  pro-
 ceeds from the gravel, entirely, it cannot be cured until the dis-
 ease is removed.
   BLEEDING FROM THE BOWELS.—A discharge of blood
 from the bowels is quite a common occurrence, even where there
 are no signs of dysentery or of the  bleeding piles.   It often takes
 place without much, if any pain at  all.   The  blood voided by
 the rectum will, sometimes, be fresh,  and, at  others, coagulated,
 dark, and decomposed.  Intemperate  people  are peculiarly sub-
ject to this complaint.  Some portion of the bowels, no  doubt,
 becomes excessively irritated by the force of the constant  stimu-
 lation, and blood is  poured forth into the common canal.   In the
 dysentery, the discharges are mixed with mucus and  hardened
feces, and are attended with griping and pain,  but in  pure hemor-
rhage,  the blood is scarcely mixed with the contents of the bow-
els, and comes away without  pain.  In voiding blood  from the
bowels, there is usually a great loss of strength, fainting, and pale-
ness of the skin.   It  sometimes comes on gradually or by dis-
charging small quantities at a time, and at others, very suddenly
and by voiding large quantities.                               '
  Domestic Remedies.—"The patient should be placed in bed and
kept perfectly quiet.  An injection of alum  water  mixed with
a tea-spoonful of laudanum, should be given, and a dose of castor
od swallowed immediately after it.   Lemonade or cold  water
should be given for drink;  and gruel,  toast water, and barley 
BLE.                         63
 water, for diet.   The room ought to be kept cool and well aired.
   Professional  Remedies.—Drawing blood from  a vein or by
 leeches in this  disease, is  scarcely allowable, if  ever required.
 The practice must consist mainly in the use of astringents, styp-
 tics, and refrigerents.   Opium, in some form, will be found the
 most effectual of  anything.   After an opiate has been given,
 some gentle  cathartic will be necessary  to free the bowels of any
 offending matter which may possibly occasion the hemorrhage.
 But after  the bowels have once been emptied, they should not be
 again disturbed until a trial has been  made  of astringent and
 styptic medicines.   The creosote will probably be the most ap-
 propriate and efficacious.  The sugar of lead and the sulphate of
 zinc, can  also be used.  Soda water, and the acetate of ammonia,
 should be given in a state of effervescence.  Powdered charcoal
 has sometimes been given with success.  In one  case which
 came under  our  notice, small  doses of  ipecac, given every two
 hours, were followed by a gradual abatement of the disease, and,
 finally, by an entire cure.   With  the exception of blood-letting,
 the remedies recommended for hemorrhages in general,  will be
 proper in  hemorrhage of the bowels.
   BLEEDING  FROM THE  LUNGS  OR  LIGHTS—Hae-
 moptysis.—Spitting of  blood is one of the most  alarming inci-
 dents to which we are  liable.   It very often occurs without any
 warning, and proceeds from no assignable cause. A slight tickling
 in the throat, a little cough, probably produced by the blood let
 loose in the  air cells of the lungs,  and a slightly saltish taste in
 the mouth, are all the  inconvenience commonly felt  in spitting
 blood.  In  some  cases, there  will be feverishness, headache,
 quick  pulse, alternate  sensations of heat and cold,  a sensible
 tightness in  the chest, wakefulness and a  degree of restlessness,
 flashings of the neck and face, and thirst.   Sometimes the blood
 will be  spit  up in  small quantities, and at other  times, in large
 mouthfuls.   It is of a light  red color, and usually frothy.  The
 blood which  comes from the stomach is always of a dark color,
 and comes up by vomiting.   The blood which comes from the
 lungs is always of a light red color, and comes up by coughing.
 It will be  observed, therefore, that the coughing of blood, and the
 vomiting of  blood, are  two  very  different  disorders, both as re-
 spects the organs from which the blood  proceeds, and the degree
 of  danger to which the patient  is exposed.   When the blood
 comes up  into the mouth by vomiting, but very little or no  dan-
 ger is to be  apprehended; but  when it comes  up by coughing,
 the case is much more serious and doubtful.
  In bleeding from the lungs, the degree of danger is, by no
means, in  proportion to  the quantity of blood which is coughed
up  at a time.  Recovery takes  place quite as well  and as often,
where large quantities of blood have been raised, as where they 
64
BLE.
  have been small.  People are most liable to  spit blood about the
  age of puberty, or between puberty and thirty-five years of age;
  and females are more liable to it than males.   The system about
  the age of puberty is peculiarly excitable; the blood-vessels have
  not yet acquired their full degree of cohesiveness or strength, and
  the force  of the circulation is  at that age  suddenly increased.
  Blood is sometimes discharged from the  mouth, back part of the
  nose  and the throat, and is liable to be confounded with  raising
  it  from the lungs.  When  it  comes  from  the mouth  merely,
 there  is no coughing or vomiting, and when it comes from the
 upper part of the throat and  the posterior nares, it  is brought out
 by mere hawking, and if the throat is examined,  blood  may be
 seen issuing  from the capillary vessels.
   Nothing is more remarkable in this complaint,  than that one
 person is much more prone to it than another.  Although, in this
 respect, it  is like most other disorders and derangements of the
 human system, it has been remarked, in  all ages, to attack those
 whose respiratory organs are not so fully developed as the other
 organs of the body.  People of a sanguine,  sensitive, excitable
 temperament, are oftener the subjects than any others.  In some
 cases of bleeding from the lungs, recovery readily takes place, and,
 in others, the complaint proceeds on to ulceration and suppuration,
 and ends in consumption.
   Domestic Remedies.—-In the  act of spitting blood, the  patient
 should be placed in an easy chair or on a bed, with the head and
 shoulders raised, as blood cannot so easily issue from  the vessels
 of the lungs  in this position,  as when he lies  down.   He should
 be directed not to speak loud, or to use  exertion of  any kind. He
 should be allowed free air and only a light covering.  A dose of
 Epsom salts should be immediately given, or  in case  this article
 is not  at hand, a tea-spoonful of common table salt  should be
 given.   The efficacy of common salt has  been questioned, but as
 it produces nausea  and a sense of cold in the stomach, it  is at
 least as good as nauseating medicines in general.  We have seen
 bleeding from the lungs  stopped, immediately, by  administering
 a strong  injection of the  Epsom salts  dissolved in simple  warm
 water.   We  believe it to be  the most effectual remedy which
can be administered.  The course of the  blood is changed much
quicker in  this way than  any other which we can adopt    We
 have seen a saline injection succeed in  stoppage the hemorrhage
 ten or twelve times  in succession.  Eight grains of nitre or silt
petre,  m solution, should be given  every two hours ; o  two

ournose  T™'1°™' *  <*» Same **»' Wl11  answer'a slnS
purpose  A gentle nausea moderates the force of the circulation
iTmonal8 b "5"* *" fl°W °f the bl°od'   Sour drink»?SSas
lemonade  barberry  water, and tamarind  water cool the blood
and obviate the tendency  to febrile excitement.  Cold  water can 
BLE.
65
be freely drank to allay the thirst.   A light vegetable diet should
be strictly adhered to until all appearances of bleeding have ceas-
ed.  The bleeding will often return every day, or every few
days, for several weeks  in  succession.   It  commonly increases
until  it reaches  a certain point, and then gradually decreases
until  a sound state of the lungs is regained.
   Professional  Remedies.—Where  the  force of the  circulation
appears to be greater  than natural, which must be judged of by
the pulse, color, &c, blood  should be taken from the arm.   But,
in the artificial abstraction of  blood, it  should  not be forgotten
that a great loss of blood in any way, produces a degree of vital
debility which prevents, instead of hastening the healing of the
diseased portion of the lungs.  Alum, sugar of  lead, sulphate of
zinc, and other astringents will occasionally be found effectual.
Blisters should be applied to the chest, and some saline cathartic
should be  administered every day.   A solution of tartar emetic
in small doses should be repeated as often as the force of the cir-
culation appears to require  it.  Blood drawn from the chest by
leeches or cupping is often  preferable to the abstraction of  it by
opening a vein.  A cloth wet with the  spirits of turpentine and
allowed  to evaporate upon  the chest, so as to inhale the vapor,
has been highly recommended.  In obstinate cases, the solution
of creosote in five or six drop doses, is said  to  have been suc-
cessful.   In one trial which we made,  it succeeded  after many
other means had been used.  The digitalis  has become a popular
remedy  in hemorrhage  from the  lungs.  It has great power in
weakening the force of  the pulse, but it has always appeared to
us to weaken the vital or healing  power of  the system in a
similar proportion, and, on this account to be  a doubtful medi-
cine.  The greatest benefit may be expected from quietude of
body and mind, and a long persistence in  a vegetable diet and strict
temperance.  Riding on horseback, has been sometimes errone-
 ously recommended by physicians  who  confound hemorrhage
 from the lungs with actual consumption, than  which there can
 be no greater error.  We  knew  an alarming hemorrhage from
 the lungs to have been produced in a young lady by riding on
 horseback, and finally to  have ended in a consumption.  In all
 cases of hemorrhage from  the lungs, whether the bleeding pro-
 ceeds from tubercles and ulceration, or from simple exhalation of
 the blood vessels, riding on horseback  is an  improper and dan-
 gerous experiment.  In all the kinds of consumption which are
 riot attended with bleeding, the horseback exercise may be proper
 and  salutary, but, in cases of  spitting blood, it is only adding to
 the occasion, instead of effecting the cure, of  hemoptysis.  All
 exercise of the mind and of the  body should ba of the gentlest
 kind, such as riding in an easy carriage,  sailing,  and moderate
 walking.  The causes most likely to produce bleeding from the
            9 
66
BLE.
lungs, are great heat, and violent exertions of the strength.  More
instances of hemoptysis occur in the spring of the year and sum-
mer, than in autumn and winter.  A waistcoat made of  wash-
leather, and worn next the skin or over the shirt, has been found
an excellent expedient to resist the changes of the atmosphere.
We have heard of more  cures in consequence of wearing the
leather shirt or waistcoat than from all other means put together.
The hydrocianic or prussic acid has lately been recommended in
hemorrhage from the lungs.   In one case of bleeding  from the
lungs, which had occurred several times and continued for three
or four weeks at a time, we prescribed the leather waistcoat and
stockings, and an entire  vegetable diet with the exception  of salt
fish.  Both prescriptions were  followed  strictly  for two  years,
when the patient was entirely cured, and has ever since contin-
ued well, a period of eight or nine years.   He  lived principally
on hominy and molasses, and salt fish.  He eat other vegetables,
such as potatoes, beans, peas, asparagus, brown, and coarse wheat
bread,  but  his living  was almost entirely the articles we have
named.
  We  think  that  bleeding from the lungs is  a  more frequent
complaint in New England and the  Northern States, generally,
than in any other part of the world.   From the notice which the
English and the other European writers have taken of it, it does
not appear to hold that important place among European diseases,
which the frequency of its occurrence and the nature of its symp-
toms assign to it among  us.   We meet with few  diseases  which
demand more attention and study than hemoptysis, and perhaps
there is none which is more within the reach of remedial agents.
  BLEEDING  FROM THE NOSE—Epistaxis.—Bleeding at
the nose is in general  attended with but very little danger.   It is
often a relief to the headache and the fulness of the blood vessels
of the brain.  Where the bleeding is  moderate and does not often
occur, no remedies are required.  Children and young people are
principally the subjects of it;  but all ages, of a sanguine tempera-
ment and of a full habit, are  occasionally liable  to it.  It most
commonly occurs  about the age of  puberty, when the force of
the circulation has become strong, and before the blood vessels
have  acquired  that cohesiveness or toughness  which enables
them to resist the force of the moving blood.   The blood vessels
of the lining of the nostrils, are the tenderest and the most fran-
gible, of any in the whole body.  A  mere picking of the nostrils
or pushing the  finger into them will let loose a quantity of blood
   Bleeding at the nose is generally  preceded with  something of
a feverish  state.   There will be a dizziness or swimming of the
head ; a flushed countenance, and a sense of tightness across the
 wuge °1t1theJnose » headache, and a rushing of blood to the head
 Where bleeding from the  nose becomes periodical and profuse  if 
BLE".
67
produces a habitual paleness of the skin, weakness of the system,
and  a disposition  to dropsy.   In such cases, immediate means
should be used to check and to cure the disease.  In slight cases,
it  is only necessary to apply cold water or to  snuff up a little
alum water  or the fine powder of alum.   A plug of dry linen
lint will sometimes stop the  blood where cold water and alum
fail.   The person  should  avoid the fire and keep still until  the
hemorrhage has ceased.  Raising the arms above the head  and
keeping them  in that position for ten or fifteen minutes, has been
lately recommended by a French physician, M. Negrier, as a very
sure expedient in arresting the bleeding.   Whether it will gene-^
rally succeed  or not, we are  unable to say, but it is one of the
most philosophical agencies which has ever been  employed in
the art of medicine.  By raising the arms, the heart  is obliged to
labor so much the  harder to propel the blood to the head, and of
course,  the  blood in the  arteries leading to the head and nose
will be moved so much the slower.
   In young, full-blooded  people, bleeding  at the arm has been
found to succeed in curing the hemorrhage.   Cooling medicines,
such as the  rochelle powders, epsom salts,  and the mineral acids
are in general use in this complaint.   In  addition to alum, the
white vitriol,  and sugar of lead are very effectual when dissolved
in cold water  and snuffed up the nostrils.  The worst case which
we ever saw,  and which had continued for twelve hours in spite
of several common expedients which had been used,  was stopped
effectually by snuffing lead water for only a few moments.  The
creosote has lately  been much used, and highly recommended as
a styptic.   In bleedings from the  lungs, the creosote has been
administered  internally and with  much apparent success.   But
the  blood sometimes rushes so forcibly from the  nose as to re-
quire, strong  compression.  This is done by winding a piece of
linen cloth around a probe and crowding  it up the nostril until
it completely fills and presses  the  sides  of the  nostril.   It
must often  be pushed clear  through into  the  back part of the
nostril.   In  aggravated  cases,  a light vegetable   diet should
be adopted;  all violent  exercise, and  all stimulating  food  and
 drink  studiously  avoided,  and  febrifuge medicines used.   In
cases of debility,  iron, in the form of muriate or in some other
way, should be given  to strengthen the system and to repair the
lost tone of the digestive  organs.
   BLEEDING FROM  THE  STOMACH.—Hematemesis.—
Vomiting of  blood is much more common among  women than
among men.  It commences with  pain and distress in the pit of
the  stomach, sickness, restlessness, and weakness.   It  is some-
times called spasms in the stomach ;  it is probably better known
by this name than any other, especially among females.  There
is a sense of extreme fulness of the stomach, and a dying sickish- 
68                         BLE.
 ness, which are somewhat relieved by  vomiting, but  return,
 a<*ain  every hour or two.  The patient  is  pale  and restless;
 often wrinCTing and twisting the hands and throwing  about the
 feet.   There is almost a  constant nausea and retching.  After
 throwing up more or less of blood, sometimes quite clear, and at
 others mixed with the ordinary contents  of the stomach, there
 will be a short respite ; but the spasms and vomiting soon return
 and continue until the strength is apparently exhausted, when
 the spasms remit and the vomiting  abates again.   These appear-
 ances,  unless checked by proper remedies, will often continue for
 several days and nights.   But they are always more alarming
 than dangerous.   Death will sometimes  ensue from vomiting of
 blood,  though not often.   Medical writers have assigned a great
 many reasons for bleeding at the stomach, but none appear to be
 entitled to any great weight.   Most probably the stomach is in a
 similar state to the lungs and the lining of the nose when bleed-
 ing takes place from those organs.   There appears to be a violent
 local irritation, which continues for a certain length of time, and
 then subsides.  A sudden suppression of the menstrual  discharge,
 is supposed to occasion this affection of  the  stomach.   A cessa-
 tion of other discharges are also enumerated  among the  causes
 which  produce a vomiting of blood.   These causes may have an
 effect in  deranging the exhalent vessels of the stomach, but as
 the bowels, lungs, kidneys, bladder, nose and uterus are all sub-
ject to hemorrhage, we may  rationally  conclude,  that, for  the
 most part, it is a peculiar derangement of the stomach,  primarily.
 A derangement of  the stomach is much more likely to affect the
other organs of the body than a derangement of the other organs
to  affect  the stomach.  In examinations of the stomach after
 death,  if  the disease have been  short and violent, no trace of rup-
 tured  blood vessels is to be found, but in other cases, the lining
 of the  stomach has been found black and its vessels  distended
 with blood.  A rupture of the blood vessels has  seldom been
 found  in any case.   The  spleen has occasionally been found
 much distended with blood.
  An exposure to cold, which stops the perspiration, and getting
 the feet  wet, are  the  most common  causes which bring on an
attack  of hematemesis.  Violent passions; corrosive substances
 taken into the stomach ;  and blows about the region of  the
 stomach  will bring on a bleeding from that organ.  This affec-
 tion of the stomach will continue from 24 hours, to  eight or nine
 days.   It appears to increase for a day or two, and then gradually
 w    f { th! ™mitinS  becoming less  severe, and the spasms
 less painful and frequent, until  the whole affection ceases.
  Domestic Remedies.—Where bleeding from the stomach  pro-
 ceeds from corrosive substances swallowed, the  first thing to be
 done is to remove  or neutralize them by emetics and oils   In 
BLE.
69
such cases an  emetic of  ipecac will  always be safe, and if the
ipecac should not be at hand, a table-spoonful of powdered alum
will be equally proper.  After the operation of the emetic, a dose
of castor oil w ill be necessary to operate downwards, to clear the
bowels.  Cold  water, and sour drinks will  be proper ;  and also
bathing  the feet in warm water.  Mustard  poultices should be
applied to the feet, and in severe  cases, to the stomach.  .
  , But where  the spasmodic  pains  are  severe and  the  vomit-
ing  of   blood  frequent,  the remedy which will be found  to
succeed  the oftenest,  is a tea-spoonful of laudanum  and a tea-
spoonful of ether mixed together  and  swallowed in a little water.
If the first dose does not allay  the  vomiting of blood and  the
spasms, it  may be repeated at the end of one hour ; and if  the
second dose does not succeed, it may be  repeated the third time,
at the end of three hours more.   In moderate cases a couple of
tea-spoonfuls of laudanum may be  laid upon the  stomach  by
wetting a piece of flannel with it.
   The diet should be nothing  more than barley water, gruel, or
toast water.  Soda  water,  and  the  rochelle powders, in small
doses, will have a tendency both to stop  the bleeding and allay
the irritation which occasions it.  In bleeding from the stomach
there is seldom  any fever.   The blood which is brought up is
either clotted or very dark colored.   It will, sometimes, however,
look quite new, and we  believe, where it is preceded by  spasms,
 it is generally  fiesh.
   Professional Remedies.—-If, in this affection of the stomach,
 the force  of the pulse  is  more than natural, and  the  distress
 considerable, blood  may be taken from the arm, or which may
 be more proper, by  eight or  ten leeches  applied over the  part
 affected.  Astringent medicines  should be tried, such as the tinc-
 ture of the muriate of  iron ;  creosote in doses of three or  four
 drops, diluted  with  alcohol and water; alum, sugar of lead,  or
 the tincture of  galls.  Saline cathartics and anodynes  will be
 found of signal benefit.   Where there is great loss of strength, it
 will be necessary to  make use of injections.  The diet should be
  liquid,  and  the  drinks  mucilaginous.   All heating, stimulating
  medicines should be studiously  avoided.  After the vomiting of
  blood has ceased, if  the strength has been  much  impaired by it,
  tonic medicines will be very  proper, such as quinine, columbo,
  and tinctnre of muriate of iron.  Those who are subject to this
  affection should  be  exceedingly cautious of wet feet, and every
  species of intemperance.   The  intemperate  are especially liable
  to it.  Most of the cases among males, proceed from this cause
  alone.  A temperate diet, dry feet, gentle but free exercise in the
  open air, open bowels, and a flannel waistcoat worn next to the
  skin, will generally lessen where the regimen does not entirely
  cure the disease. 
70
BLE.
   BLEEDING FROM THE  WOMB.—Menorrhagia.—Bleed-
 ing from the womb may proceed from a great number of causes,
 each of which would  require a particular mode of  treatment.
 Among  the causes producing this  affection  may be  mentioned,
 child-birth, miscarriages, accidents and diseases incident to preg-
 nancy ;  cancer, polypus, cauliflower excresence, and  ulcerations
 of the womb, all of which will be noticed under their respective
 heads.   In the present article, that kind of bleeding only which
 may be considered as an excessive flow of the monthly discharge,
 or menses, will be treated of.  An excessive  flow of the menses
 may occur in various ways ;  they may return too  frequently  or
 too copiously, amounting to an absolute bleeding, in which clots
 will form as in bleedings from other causes ; or, they may come
 on at unusual  periods, as during pregnancy, and  suckling.   In
 estimating the quantity discharged we must take into considera-
 tion the  constitution of the patient, and the climate ; what would
 be natural menstruation  in one  individual, would be profuse  in
 another ; and so in regard to climate, what would be profuse in a
 cold climate, would be only natural  in a warm one.   There ap-
 pear to be three distinct  forms under which this affection mani-
 fests itself, each of which has its acute and its chronic  characters.
 In the first form, the discharge is of the natural quality, but the
 quantity or the frequency of the recurrence is greatly increased.
 In the second, the discharge is more considerable and mixed with
 clots of blood.  In the third, the loss of blood is sometimes very
 great, and attended with marked  changes in the size and position
 of the womb, a circumstance  not observed in the two former
 varieties.  The first variety usually sets in with a sudden  gush
 of blood  from the womb, after which it stops for a few hours and
 then perhaps recurs, and this alternation  may go on for a number
 of days.  Sometimes, however, the discharge is regular in its re-
 turn, but lasts twice or thrice the usual length of time.   In other
 cases, it is not  extraordinary at one  time, but returns every two
 or three  weeks, instead  of the  ordinary period  of four  This
 form of the  disease is often met with in  young and even unmar-
ried  women, and is  generally accompanied with leucorrhea or
whites during  the intervals.   The second form of the disease
differs from the first in the greater  amount of blood  discharged
in a given time, and in the formation of clots, which are mixed
 with the natural secretions.   It is usually met with in  women of
a leucophlegmatic  temperament, and those whose constitutions
have been impaired by disease, or frequent  child-bearing.   Wo-

Shtoson? Uand6r tthi7 If^  °f agG' th°Ugh  occasionally the
fort*tL h    ^ aS hable  t0 2t as those between thirty and
aDDearinl at H  * 1°™* °U Sradually> °ne or two small clots
appearing at first, perhaps scarcely  noticed by the patient and
 then there may be an intermission, and  then a recurrence  in an 
BLE.                         71
aggravated quantity.   After  continuing on in this way for some
time, the loss of blood often  becomes so great as to produce ex-
treme exhaustion and  even fainting.   The  third form in which
this disorder shows itself, and which is much the most scarce, is
usually  observed  in women who are from forty to fifty, and  in
whom the menses are about to cease.   All the symptoms in this
variety, both general and local, are much more grave, than in the
two former ;  the womb is more or less disordered in its structure
and position, and the case is infinitely more difficult.  No kind
of constitution is exempt from it.  It may attack the plethoric or
debilitated, the melancholic  or the sanguine.  Some  degree  of
irregularity of the menses, either in time, quantity, or duration,
and leucorrhea during the intervals, generally precede the attack.
Ordinarily, the natural evacuation appears first,  and continues
about twenty-four hours before the clots of blood begin to be ex-
pelled.  The quantity of blood lost is sometimes very great, pro-
ducing  extreme exhaustion, and causing serious apprehensions as
to the result.  The first attacks of flowing, in this manner, last
from  seven to ten days only, but where the disease  is  of long
standing,  they may continue  two or three  weeks,  or  even a
month  almost  without any  intermission.   There is generally
difficulty in voiding the urine, the bowels are costive, the appe-
tite depraved, the surface of the body is blanched, and the gene-
ral health suffers severely.  A relapse of the disease after an appa-
rent recovery is not unusual.   The principal causes assigned for
this variety, are the peculiar changes which take place in  the sys-
tem about the period  at  which it makes  its  appearance, and
the condition giving rise to it is thought to  be  a congestion or
over fulness of the blood vessels of the womb.   The general or
constitutional symptoms, which are similar in all the  forms, are
languor, exhaustion, weakness across the hips and loins, a dislike
of exertion, paleness of the countenance, headache, throbbing in
the temples,  ringing in the ears, giddiness, and in some instances
feverishness, irritability, and a deranged state of the stomach and
bowels.  In  the  more aggravated cases  there is  often an aching
pain in the side, extending round the lower  part of the abdomen,
the headache is intense, there is melancholy and other  nervous
symptoms, swelling of the feet and legs, diarrhea, faintness and
a deathlike countenance.  The blood in this disease is altered
and attenuated, and this attenuation predisposes to still further
losses.   Among the causes producing an excessive flow of blood
from the womb may be enumerated, over-heated rooms, too warm
clothing, sleeping upon feather  beds, warm  bathing  in  excess,
excessive indulgences, frequent child-bearing, over-nursing, cold,
over-exertion, and violent mental emotions.   As regards  the dan-
ger to life, the prognosis in these affections is favorable,  as most
cases by proper  management  are curable.   Sterility  and a pre- 
72                         BLE.
 disposition  to' abort are occasional  though  not very frequent
 consequences ; but a relaxation of the passage and a falling of the
 womb or prolapsus, are not unfrequently induced.  In attempting
 to cure menorrhagia the first step to be taken, is, if  possible, to
 remove the cause, as, except this  be done, success cannot be ex-
 pected to attend our efforts, however well directed.  During the
 continuance of the discharge, especially if  excessive, the patient
 should be kept perfectly quiet, and as much as possible in a hori-
 zontal position, on a cool, hard bed  or mattress.  The clothes
 should be light and loose ;  the drink should be cool and acidula-
 ted with lemon, elixir vitriol, cream of  tartar,  or tamarinds.  An
 infusion of cinnamon and other spices is among the most popular
 remedies, and in debilitated habits its use may be attended with
 benefit, but perhaps there is no domestic remedy better adapted
 to these  cases than alum  whey.  It  is  made by dissolving  a
 quarter of an ounce of alum in a pint of warm milk,  and it may
 be taken with great  freedom.  A  decoction of logwood is  also a
 medicine  of much value in these  cases.  In sudden  and severe
 attacks, cold spirits, vinegar, or water should be freely applied to
 the lower part of the abdomen and genitals by means of cotton
 or linen  clothes, which  should be changed as often as  they be-
 come warm, until the discharge is checked.  Should these means
 fail, and the woman have been married or had children, a strong
 solution of alum in water, or decoction of oak  bark should be in-
jected into the passage, and repeated, often, if  necessary, or what
 will be quite as effectual, this or some  other  astringent may be
 applied by means of a wad  of cotton, sponge, or old linen, insert-
 ed into the vagina  in  sufficient bulk  to prevent the escape of
 blood.  When this remedy is used it may be allowed to remain
 twelve or twenty-four hours, or until the discharge cease and the
 woman revive from the faintness.  A  lump of alum applied in
 the same  manner near the  mouth  of the womb, will  also some-
 times have the happiest effects.   These  substances can be readily
 withdrawn,  and their use is not attended with the least danger
 The patients strength should be supported with a light but nutri-
 tious  diet, and during the intervals, a moderate use of good port
 will be allowable.   A wine-glass full of chamomile tea,  with ten
 drops of elixir vitriol, or  tincture of iron, three times a day is a
 valuable tonic, and will contribute to a permanent cure   Riding
 ma carriage, sailing, sea air and sea-bathing,  or if these are not
 attainable, sponging the loins and  lower part of the body with a
 strong solution of salt in  brandy, vinegar, or water, will be found
 valuable auxiliaries.
  Physicians, in adapting their remedies to this disease, recognise
 two  different and  someweat opposite  conditions  under-which it
 manifests  itself, that of a surcharged or congested state of the
 blood vessels, especially of the womb, attended  with  more or 
BLE.
73
less excitement of the arterial system and other febrile symptoms,
and that of debility and relaxation, accompanied with  a feeble
circulation and an  attenuated state of the blood, allowing it to
flow more readily through the mouths of the vessels opening into
the cavity of the womb.   In the former of these conditions, re-
peated small bleedings practised just before the expected return
of the menses, leeching, cupping and blistering about the loins,
injections of cold water,  and a cooling or antiphlogistic regimen
are sometimes of the most essential service.   When tonics are
used in these cases  during the intervals, the time when the most
permanent benefit is to be expected from remedies, they should
be  those  that are the least stimulating  and be combined with
sedatives.   The  precipitated carbonate, the sulphate and  the
phosphate of iron are often given in these cases, either alone or
in combination with aloes and myrrh, or with soda, as in the
Griffith's mixture, and may occasionally be beneficial; but the sul-
phates of zinc and copper, (white  and blue vitriol) elixir vitriol,
and other mineral acids are to be preferred.  A pill composed of
equal parts of white vitriol, rheubarb, and extract of cicuta, from
a grain to a gram and a half of each, is well adapted to this form
of  the  disease ;  one  pill to be taken three or four times a day.
The following solution is  also often given with marked advan-
tage, blue vitriol six grains, laudanum' and elixir vitriol each two
drams or  120 drops, water an ounce and a half; dose from thirty
to fifty drops, or  what the stomach will bear without  producing
sickness,  three times  a day.  This is also a good  styptic, given
during the discharge, and at such times it may be increased until
 it produce nausea.   In the latter condition of the system referred
to, that of unequivocal debility, although it may be occasionally
necessary to obviate  local congestion by dry cupping, blistering,
a gentle  cathartic, or a few leeches upon the loins or lower part
of the  back or bowels, the general  treatment must be  decidedly
strengthening.   The preparations of iron, peruvian bark, quinine,
 port wine, and in those  cases where there is much pain, opium,
 hyoscyamus, and cicuta, are among the most appropriate remedies.
 Should there be  troublesome nervous symptoms, the milk of let-
 tuce (lactucarium,) valerian, or Hoffman's anodyne maybe given
 according to circumstances.  In severe  attacks, during the  con-
 tinuance of the discharge, in addition to the means heretofore
 mentioned, the remedy most in repute among physicians is opium
 and sugar of lead, from  one to two grains of the former to from
 two to five grains  of tl^e latter  made into a pill, one of which is
 given every three or four hours, as the  case may require.   The
 ergot, spurred eye, which has the specific action of contracting
 the womb, is admirably adapted  to these  cases.   It is com-
 mended by the highest authority, and we have frequently used it
 with great  success.   One dram  should be  steeped in a gill of
               10 
74
BLI.
 boiling  water, and  a table-spoonful given every half  hour,  in
 dangerous cases, and every three or four hours in those that are
 less severe, as long as the urgency of the symptoms demands.
   BLEEDING PILES—See Piles.
   BLISTERS.—Much prejudice has of late years been excited
 in the minds of many people against  the  use of blisters.  But
 there is  no remedy productive of  less mischief and more benefit,
 in certain cases, than a well-applied blister.   There  is nothing
 better settled in the science of astronomy, chemistry, and natural
 philosophy than, that, a blister of suitable dimensions will  relieve
 pain, and lessen soreness, swelling, and inflammation.   A blister
 will not cure all diseases, and may,  in many cases, be productive
 of little  or no benefit.  But  when  a blister is skilfully used, or
 rightly adapted to the nature and magnitude of the disease, it
 operates with as much certainty in producing relief as any medi-
 cine which has ever been used.  The indiscriminate and methodi-
 cal use  of  blisters, has probably led people  to  doubt of  their
 utility ;  but  they have certain remedial properties ascertained by
 experiment and observation, and, however, prejudice  or fashion
 may operate  against them for a season, they will finally vindicate
 themselves and resume their proper place among  the materials of
 medicine.
   If blisters  are applied to the body in a state of high fever when
 the whole skin is parched,  the pulse quick and elastic, and all
 the secretions dried up, they seldom prove beneficial, and,  some-
 times, aggravate the  disease.   It is  not until  the vehemence  of
 the fever is over,  and the heat and acuteness of the disease some-
 what abated,  that blisters are demanded or prove  serviceable.   It
 has been customary  to apply blisters in all inflammatory affec-
 tions with as much uniformity, as to practice  blood-letting or to
 prescribe sudorifics.   This only shows a want of discrimination.
 It is not  supposable that they will effect a cure in all cases.
   We believe that blisters are adapted to the cure of diseases of
a certain extent and  degree of severity.  If we attempt to cure
 inflammations or  disorders of greater magnitude with them, we
shall be liable to fail.  In a mere pleurisy where  only the  mem-
brane, called  the pleura, is inflamed,  a large  full-drawn blister or
two upon the side will lessen  the pain, soreness, and  disease of
the part.   But when the whole substance of the  lungs comes to
be inflamed, as in peripneumony, a blister does not hold the same
proportion to the  disease, and  of course, has less  control over it
 It, however, only a portion of the lungs is inflamed, a large, full-
drawn  blister will have more  effect.  In many deep-seated, ex-
tensive  inflammations, it would  be impossible   to blister  the
surtace of the body in proportion to the magnitude of the disease
In more  superficial  inflammations and local affections, blisters
often produce complete relief.   To cure  any disease, the means 
BLO.                         75
 must be adapted  to the  end.  The indiscriminate use of  any
 remedy will be sure to bring it into disrepute.  Time, observa-
 tion, and experience have sanctioned the use of blisters, and, by
 accurate observers, they will be ranked  among the most charm-
 ing  remedies.   In headaches, pain and soreness of the joints,
 bones and muscles, inflammations of the membranes, palsy, epi-
 lepsy, rheumatism, and almost  all local, chronic  diseases,  they
 are  indispensable.  In  the  diseases of the eye and  the ear, and,
 in dyspepsia, blisters seldom fail to produce relief.   No remedy
 oftener relieves the toothache than a well-drawn blister.
   Blisters are often used to  produce an issue.   The blister is first
 drawn,  the water let out by pricking, and the bare surface of the
 place spread over with the savine cerate, or the powder of tartar
 emetic.  In chronic inflammations, the irritation and the running
 of the issue,  have  sometimes, produced the happiest effects.
   Blisters  are  commonly produced by  the agency  of  Spanish
 flies. The flies are powdered, sifted, and made into a salve  with
 sweet oil and  beeswax, and a  little  resin.  Several other sub-
 stances will  raise  a blister, such as mustard, horseradish, garlics,
 red  pepper, and spurge.
   Blisters have the power of checking mortification.
   BLOOD.—There are two kinds of blood in all breathing  ani-
 mals, the arterial and the venous.   The blood in  the arteries is
 of a light red color, and that in the veins of a  dark red or purple
 color.   The  arterial blood  supports life ; the  venous blood de-
 stroys life.   Although the external properties of these two kinds
 of blood so nearly resemble each other,  they differ as widely in
 their vital  properties as either of them differs from the perspira-
 tion or the bile.  The moment the venous blood begins to circu-
 late  in  the arteries, and  to  be  carried to the  brain, the person
 turns purple and dies.  Milk or any other fluids introduced  into
 the  arteries,  would support life as well  as venous blood.   The
 arterial  blood  receives its  vital properties in  the lungs, from a
 combination with the  oxygen  of  the  air.   The venous  blood
 circulates  through the lungs,  and in the process of breathing
 combines with the vital portion of the air, is changed to a lighter
 color, and prepared to support life, and to supply each part of the
 body with its constituent  principles.
   The quantity of venous blood in  the human body is four times
 greater  than that  of the  arterial blood.   The  whole amount of
 both venous and  arterial blood in a common sized person, is
 twenty-eight pounds, or about one fifth part of the whole weight
 of the  body.  The motion of the blood in the  veins is much
 slower than  in the arteries.  Both the  arterial and  the venous
 blood, when drawn from the body and allowed  to stand for a
 short time, coagulates, and separates into two distinct substances,
or parts.   One  portion is watery and looks like whey:  it is called 
76
BLO.
 serum.   The other portion is thick and tenacious, and swims in
 the serum :  this portion is called the coagulum or crassamentum.
 The coloring matter of the blood, adheres to the  crassamentum,
 but  can be Entirely washed  out of it with water.  After  the
 coloring matter is washed out of the crassamentum, the remain-
 ing mass is white, transparent, and fibrous.   This is supposed to
 be°the substance of which all  the fibrous parts of the body,  the
 muscles, &c, are composed.
   The serum or watery part of the blood heated to 156° coagu-
 lates or settles into a mass which resembles  the white of an egg,
 boiled.   Indeed, it is the  same substance, and is one important
 constituent of the human body.  It is called albumen.   It is of
 the same eolor and hardness of fibrin, but is not fibrous.
   The medium temperature of the blood is  one hundred and two
 degrees.   In  all animals  which  breathe the  air, the  blood is
 warmer than the medium which they inhabit; but in those who
 do not breathe the air, like fishes and reptiles, the  blood is nearly
 as cold as the temperature in which they are placed.
   The coloring  matter of the  blood, or that which gives it the
 red color, is readily dissolved in water,  appears to consist of glo-
 bules like the other fluids of  the body, and burns with a flame,
 leaving a coal which is very difficult to reduce to ashes.
   The blood undergoes  great changes  even in the blood-vessels,
 without destroying life.  In some instances, it is very thick and
black, and, in other instances,  it will be very  thin, watery, and
 of a light red color even in the veins.  In many intemperate
 people,  the color of the venous blood will be as light red as
 the color of the blood in the arteries, and the quantity of crassa-
 mentum  will  not be more than  one-third its usual amount.   In
cases of inflammation, there is a peculiar appearance in the blood
 after it has coagulated.  This consists in a  coat of horny, trans-
 parent looking jelly which rises above the rest of  the coagulum,
and forms a crust:  it is called the buffy coat.  The same appear-
 ance takes place in the drawn blood of pregnant women.  We
 believe the matter of the buffy coat has never been  chemically
 examined.  The presence of this coat  in the coagulation of the
 blood, is considered a very good evidence of inflammation.  The
 coagulation  of the  blood is  a singular  phenomenon.  It was
 once supposed that, it was owing to its  being cooled.  But blood,
 which has been  frozen  and thawed, will still coagulate.   It is
 contended that the blood  possesses life, and that  its coagulation
 may be owing to some operation of the  living principle.
   Blood has, sometimes, been transfused from the arteries of one
 person into those of  another.   Soon  after the circulation of the
 blood was discovered, it was thought that all diseases were owing
 to the state of the blood, and that  by renewing the blood by  in-
 fusing into the vessels the blood of a well person, or of some 
BLO.                         77
 other animal, life might be prolonged indefinitely.  After curing
 several horses and dogs  in  this way, an attempt was made in
 France to restore an idiot to  his reason by infusing into his veins,
 the blood of a calf.  It was thought at first that his reason was
 restored, but on making another trial, the idiot was seized with a
 bleeding  from the  kidneys,  and died in a state of apoplexy.  It
 was said that a leprous person, and a quartan ague were cured by
 this means.   A trial was  made upon a young prince of the blood
 royal, which proved fatal.   The transfusion of  blood was  soon
 after prohibited by  law.   Some attempts have  been made of late
 years, which are said to have been more fortunate.
   BLOOD-LETTING.—From time  immemorial, blood-letting
 has  been employed as a remedy  in diseases.  In  inflammatory
 diseases, it seems to be dictated by the nature  of the symptoms.
 The blood vessels are full and hard, and the force of the pulse,
 always an index of the force of the heart, is much greater  than
 in a state of health.  The action of the heart is not  only more
 forcible than in health, but  throws  the blood into the arteries
 much faster.   Both the quickness and the size of the pulse are
 increased.   The surface of  the  body has more color, and all the
 blood-vessels which are in sight are engorged with blood.   Ves-
 sels  which were small before, in a violent inflammation, will be-
 come  enlarged, not only  in  the seat of the  disease, but in other
 parts of the body.   In this state of the system, it would seem to
 be one of the most  natural deductions of reason, to open a blood-
 vessel and let out some of the blood.   Indeed, the blood, in some
 instances, forces its  own way through the extremities of the blood-
 vessels, and moderates the violence of the disorder.   In imitation
 of this effort which the system makes to relieve itself, artificial
 blood-letting has been invented, and in nothing  does the art of
 medicine appear to  more advantage than in this discovery.
  Blood-letting will, in many instances, entirely remove the con-
 dition of the system which we have described ;  and where there
 is pain, excessive heat and  universal  distress, a pint or two of
 blood taken out of  the blood-vessels will relieve  them all.   The
 blood in some way  or other is the  cause of the heat of the body,
 and  in inflammatory disorders, an excess of heat is one  of the
 symptoms, and probably one of the causes of the inflammation.
 By lessening the quantity of the blood, the  heat  is suddenly les-
 sened also.
  There is nothing better settled in  any of the sciences, than
 that  blood-letting will ease pain and distress, and still leave  the
 system in a condition to  recover  the temporary loss of strength
which it occasions.   It will  relieve pain and distress where  the
most powerful anodynes will only increase them.  Blood-letting
may sometimes do  harm, but so will  everything else which we
can  do.   We often do harm, and lose  life, by doing nothing. 
78
BLO.
  Disease is always attended with more or less danger;  the time
  which we can employ in the cure is often short, and the severity
  of the pain  and distress urgent for relief, and we are apt  to em-
  ploy remedies from a kind of instinct  or intuition ;  we have
  no doubt  but blood-letting is often employed from the necessity
  of the case, even where people do not understand the nature of
  its operation upon the system.
    In many cases, the patient will have a hot, dry, parched skin,
  a burning thirst, and a universal distress; the blood will  circu-
  late rapidly, and the whole surface will look red.   A suitable
  bleeding will bring a moisture to the skin, abate the thirst, lessen
  the heat, and operate as favorably upon the internal organs  as
  upon the  surface.   This  experiment has been tried as  often  as
  any experiment in natural philosophy or chemistry, and although
  not attended with the same degree of uniformity, the effect will,
  in many instances, just as surely follow the operation.
   Blood-letting, to be employed in the right cases only, requires
 sagacity and observation.  It is capable of being reduced to much
 more certain and obvious rules than its application has ever yet
 been governed by.  We have no disposition to recommend it  as
 an indiscriminate and universal  remedy for ail diseases; we only
 wish to rescue it from that disrepute into which pretenders  to
 medical skill, seem disposed to bring it.  No  remedy has  stood
 the  test of ages so well as blood-letting.  Whether  any  other
 remedy is destined to take its place, is impossible to foretell •  it
 is very certain that none as yet has been discovered.   So long as
 a spontaneous bleeding from the nose will relieve a pain in the
 head the effort will be imitated by art in pains and inflammation
 of other parts of the body.   The other organs have not so safe
 and easy an outlet when crowded with blood, as the brain  • nor
 does this organ always relieve itself when dangerously oppressed
 with blood   Here, human sagacity, itself an ordination of nature,
 must supply what has been left unprovided for in a more direct
 way.
  The cases  in which blood-letting is proper to be  practised

 Tit a^rble1" the deSCr,PUOn °f ,hC " *"-<• ^
  We wish to add one important remark upon this subject  that
 blood-lemng has been very properly withheld of late yekrs m

 STrf^t1™ Whete  n°fie are stunned. and in" her
 Xrs of life hi  7  "^T.T abstracti°"  *  blood,  unfl the
 amTall 11  Irl■ c°mPle'eIy ™™^, the pulse beeome  full,
 ^stomarvto J  f """^  haV,e d,saPP<^ed.   It was formerl^
withoTreJ 'f f  uaS  S00n as the oP^ation could be performed
Son le Sot? vhaconditi°» °f 'he patient.  A littleVecTon

wU hastr^e  ij^sarj^^rs.; 
BIL.
79
year will probably add more or less improvement in the applica-
tion of blood-letting to other cases.   No remedy should be dis-
carded or discouraged which  affords the least prospect of saving
human  life,  or  of curing disease.   The man who abandons
himself to the use of a  single remedy, abandons himself to a
phantom.
   Another improvement in the abstraction of  blood consists in
the more extended use of leeches and cupping.   In local distem-
pers, leeching is more  effectual and more safe  than venesection.
The Spanish and German leeches are now imported in large quan-
tities, and a still more general  and frequent use of them would
render them very  cheap.  They ought  to be rendered  as cheap
as blood-letting can be performed with the lancet.
   BLOOD  ROOT.—The stalk of the blood root, is six or eight
inches long, and of the size of a quill.  It grows everywhere in
the United  States, and is a native to our country.   The leaves
are roundish, one  only to a stalk and deeply indented ;  the stems
are  naked,  and the  blossoms white.  The root is of a pale  red
color.   The juice of  the root is a pretty good flesh paint.  The
root possesses the  chief medicinal  virtues of the plant.  Its pro-
perties are those of an emetic.
   To produce vomiting, eight grains of the powdered root is  the
medium dose.  In doses of fifteen to twenty grains, it  occasions
vomiting and prostration  of  the  strength ;  faintness and vertigo
 or swimming of the head.  It  is  much used  by people in  the
 country for the cure of coughs, influenza, and diseases of the
 lungs.  In these complaints, it is used in  small doses, which pro-
 duce only  nausea and relaxation of the system.  A nauseating
 dose of the powdered root is from one to three  grains.
   The blood-root has been given with success in the croup. The
 fresher the root is, the more powerful the  effect.  It is of little
 or no value after it is a year old.  The best mode of giving it in
 the croup, is in the form  of a tea or infusion.  One drachm of
 the bruised root should be added to a gill of boiling water, and al-
 lowed to stand for twenty minutes.   One tea-spoonful of this tea
 should be given to the child every fifteen  minutes, until it vomits
 freely.  To children, four or five  years old,  two  tea-spoonsful
 may be given.
   Consumptive people often derive signal benefit from this medi-
 cine, in the moderation of the cough and loosening of the phlegm.
 The fine powder of the blood-root, is sometimes applied external-
 ly,  to ulcers and cancers.  Mixed with an equal portion of calo-
 mel and taken  as a snuff, it is said to have  cured the polypus.
    BLOTCHED  FACE—Acne.—Between the ages  of fifteen
 and thirty, the face,  neck, shoulders and  back, are often more or
 less covered with red,  hard,  pointed blotches.  This eruption,
 seldom appears before the age of puberty, and commonly disap- 
80
BLO.
pears by the age of thirty.  It seldom affects the chest or abdomen,
or the lower part of the body.  The little tubercle or blotch be-
gins with a small hard lump,  about the size of a common'shot,
under the skin, and gradually increases in size until it reaches the
size of a pea.  As it rises above the skin,  it grows red and sore ;
and in the course of a week or two, the top of it looks yellowish,
and if  slightly pressed,  emits a small  particle  of matter, almost
always quite hard.  Sometimes a dozen or twenty of these blotches
will appear on the face at once, especially about the chin, lower
part of the face, and under the jaws.   At  other times two or three
of them  will run  together, and the largest blotch will maturate
and break ; and the smaller  ones subside without suppuration.
The matter which is pressed  out  of these blotches,  often looks
very much like a little worm, and has led many people to suppose
that it really was such, but it is only the shape, which the matter
assumes in appearance, of a worm.   Many of the pimples do not
form matter,  but increase to  a certain size, become red or pur-
plish, and sore, and then subside, leaving a dark red, disagreeable
spot in the skin; but which in time becomes white again.  These
blotches will continue to come and go in a greater or less number
during the whole period, from puberty to manhood, unless cured
by some process of nature or  art.   Married people are less liable
to this disease of the skin than single ones.  The back and shoul-
ders will  sometimes be as  thickly covered as  the face.  The
blotches  will,  sometimes,  almost entirely disappear for a consid-
erable length of time, and then break out again  as  bad as ever.
  Medical writers have divided this eruption into several different
species, but as they all require about the same mode of treatment,
and only appear to be different degrees of severity in the same
eruption, it will be unnecessary to describe them.
  The blotched  face or blotched skin, is  purely a disease of the
skin.  The subjects of this eruption, generally enjoy good health.
Occasionally, there will be some little disorder of the stomach,
such as acidity, or a temporary indigestion—but, in the main, the
general health is unimpared.   This eruption, very much lessens
the beauty of the skin, or fairness of the complexion, and should
always be counteracted by  all the means  in the person's power.
  Domestic Remedies.—The frequent bathing of the whole skin,
both with warm and  cold  water,  is one of the most powerful
means of clearing the  skin of all eruptions.  A young person, in
health, can hardly bathe too much.  For this purpose a bathing
tub  is  by no means  necessary, although  very  convenient.   A
sponge or a cloth will always answer the  purpose.  Warm water
is the most solvent and cleansing, and cold water the most strength-
ening.   In case of a blotched skin, the subject should wash, first
in warm water, and then in cold, and should practice it every day'
as long as the eruption lasts.  Where  the disease is not entirely 
BLO.
81
cured by the bath, it will be very  much lessened.   The person
should take a good deal of exercise and avoid stimulating drinks.
The  living should be  plain and nourishing.   If the  disease is
not conquered by bathing and rubbing, which last, is almost of as
much importance to a  healthy skin as bathing—the skin as far
as the eruption extends, should be thoroughly washed, every day,
in new  rum, and after this has  been practised for some time,
alcohol should be used.   People often  wash in rum, or alcohol
for a few days and then  lay  them  aside—but  if a cure is to be
made, these washes should be continued daily as long as the erup-
tion continues.   Where  these fail, the spirits of camphor should
be used  in the same way.  Stimulating lotions are much better
than astringent  embrocations.  Alcohol  stimulates the action of
the  whole skin,  and fortifies it against all disease ; whereas  as-
tringent medicines only act temporarily,  and  make  the skin
rough.   Cologne water, however, has considerable efficacy in les-
sening  eruptions of the skin.   Vinegar is a good wash in some
cases.  Boiling water poured upon apiece of sulphur and allowed
to stand for ten or twelve hours, also makes a very healing wash
for the skin.  Salts and a variety of purgative medicines are often
used with the  view of  purifying  the  blood, but, in general, all
cathartic medicines are injurious, and only aggravate the eruption.
   Professional  Remedies.—The idea that all eruptions upon the
skin proceed from a disorder of the stomach or impurity of  the
blood, we hope has become obsolete, at least, among the profes-
sion.  Where the stomach discovers no disorder, we have no right
to infer any ; and where the constitution, in general, betrays no
affection, we have no reason to suspect any impurity in the blood ;
for, an impure blood could hardly avoid diseasing every  part alike.
To  suppose the skin  to  be diseased from an impure state of the
blood, while every other part of the body is sound, is a mere as-
sumption.  We  hope,  therefore,  that no medical man, in  the
present state of our knowledge, will assume that the stomach, or
the  blood is the seat of disease,  unless they discover positive
proofs of derangement.   In cases of general weakness  of the sys-
tem, tonic medicines will be very  proper.  The tincture of mu-
riate of iron, or the carbonate of iron, in pills, may be taken, every
day.  The quinine,  or  columbo  may  also be given.   A  wash,
made of the muriate of mercury dissolved in alcohol, is sometimes
found to  succeed in restoring the skin, where other expedients
have failed.  Turner's   cerate  will occasionally prove effectual,
where a little of it is rubbed on, every night, and washed off in
the  morning.  The citrine ointment,  which is made  of nitrous
acid, quick-silver, lard and olive oil, is an old,  but very good ap-
plication.  The sugar of lead, sulphate of zinc,  muriatic acid,  and
other cooling lotions, in obstinate cases,  should be tried.   Some
              11 
82                         BOI.
 one article will  often be found to succeed, where several others
 have failed.
   The red nose which is produced by intemperance, can only be
 cured by removing the cause.  It sometimes occurs in temperate
 people, but the case is very rare.   The same local remedies, which
 we have recommended in the blotched face and skin, are applica-
 ble to the inflamed surface of the nose.   This form of disease is
 sometimes  relieved by  a mild course of mercury, particularly
 where  the  liver  is  affected.  Fowler's  Solution,  in eight drop
 doses given every day for two or three weeks, has been found of
 much service.  Where the local inflammation is considerable, and
 attended with swelling, poultices and fomentations will be required.
   BLUE FLAG, OR FLOWER DE LUCE.—The medicinal
 part of the plant is the root.   In the dose of a few grains only, it
 is a strong purgative.  It is also a diuretic.   The stem is two or
 three feet high, bearing from two to six beautiful flowers.   It is
 highly esteemed in the cure  of the dropsy.   Dose of the  pow-
 dered root, is, from fifteen to  twenty grains.  It  is found in bog
 meadows and swamps.  According to the testimony of Dr.  Bige-
 low, it is apt to occasion a distressing nausea and prostration of
 strength.
   BLUE OINTMENT.—See mercurial ointment.
   BLUE VITRIOL—Sulphate of Copper.—This article is made
 by burning sulphur among plates of copper.   The sulphur is con-
 verted into an acid, and combines with the copper.  It has a
 sweetish,  styptic taste, and upon the raw flesh, is corrosive.   Ta-
 ken internally, it  operates powerfully as an emetic.  The powder
 of blue vitriol sprinkled upon old sores and ulcers, destroys the cal-
 lous edges, and prepares them to heal.  It is much used as an eschar-
 otic.  The dose for an emetic is from two to five grains.  A solution
 of it in water, in the proportion of a scruple of the  vitriol to eight
 ounces of water, is often used as an injection, in protracted cases
 ol tile clap.  The powder applied to chancres, will heal them,
 but mercury must be used internally at the same time
   The blue vitriol, as an emetic, has often been used in the cure
 of consumption.   Dr. Senter, of Newport,  considered it one of
 the safest and best remedies in the cure of that disease.   He ad-
 vises  seven grains of it to be mixed with  as  many grains of
 ipecac and made into pills.   This dose is  to  be taken  everv

 came"L°fW   ^ ^ "T^' faSti^'   In one case' which
 wTare attVT' ^  T^*  pr°Ved comP^ly successful.
consSSZrw  Tv? ?hysicians have no belief in the cure of
^^v ^i^^ m ltS Garly StagGS' h a CUrable d'se*se.
 everybody considered this man to be  in a consumption and we
fcr7 reaS°n t0 believe  that he was cured by ?he medicine
  urn? a^?etllC eVery d^ for two or three w«eks.  medlCme-
  HUlL.-rhe boil is a painful,  hard, circular, red swelling 
BON.
83
 which generally maturates, and discharges, together with pus, a
 kind of core.  In most cases,  they come singly,  and are not of-
 ten larger than a pullet's egg.  But, in some  cases, they infest
 every part of the body, insomuch that motion is painful and even
 lying in bed extremely uncomfortable.
   The pain may be somewhat alleviated by a dose of morphine
 or laudanum ; and motion much better  performed by covering
 the  boil or boils with a  plaster of lead  salve,  called diachylon.
 A lead plaster has always been our standing remedy for a boil.
 The plaster should more  than cover the boil, in order to  support
 the skin and flesh for some distance around it.  It  lessens the
 soreness very much ;  abates the pain ; and defends it from the
 rubbing of the clothes and other injuries.
   In some instances, where the pain is excessive, a white bread
 poultice, with a tea spoonful of laudanum in it,  will be  advis-
 able.  It is generally useless to try  to  dispel  them.  Bleeding,
 purging, and a low diet are required in some constitutions. Lead
 water, strong vinegar, and opodeldoc are sometimes used to dispel
 them.
   The common plaster of shoe-maker's wax, operates upon the
 same principle with the diachylon plaster, and may be used where
 the other cannot be obtained.
   Boils are most apt to affect children and young  people.   They
 follow the bowel complaint, fevers, small pox, measles, and some
 other diseases.   The quinine must sometimes be used to strength-
 en the system.   In  general, it is best to  open them with a lancet.
 See carbuncle.
   BONES.—The total number of bones in the human body, is
 two hundred and forty-eight.   The skull, which appears to be
 one bone, is composed of eight.  The number of bones in the
 spine is twenty-four.   There are  seven in  the neck, twelve to
 which the  twenty-four ribs  are attached, and five lumber bones.
   The twenty-four spinal bones, are called vertabrae.   In each of
 the vertabrae, there is a hole or foramen, about the size of the fore
 finger, through which the spinal marrow passes,  from the brain
 down to the base of the trunk.
   In the shoulder,  arm,  wrist  and fingers, there are thirty-two
 bones, or sixty-four bones in both the upper extremities.  In both
 of the legs, from the thigh bone down, there are sixty-eight bones,
or thirty-four bones  in each of the lower extremities.  In the  feet
and toes, there are forty-six bones.
  Twenty-five bones in addition to the twelve spinal bones, form
the frame work of the chest, viz : the sternum or breast bone and
twenty-four ribs.  There are fourteen long ribs and ten short ones.
The long ribs, seven on each side, join the sternum or breast-bone.
The long ribs are called true, and the short ones are called false.
The pelvis or basin  is formed by two semi-circular, thick, strong 
84                         BON.
 ones, called the ossa innominata or unnamed bones, and  by the
 sacrum.
   There are thirty-two teeth; eight cutting teeth, four dog or canine
 teeth, and twenty double teeth.  There are eight little bones in
 the mechanism of the ear, four in each, which form a small chain.
 Fourteen bones compose the frame-work  of the face.  The tongue
 has one bone at its base,  in the shape of a horse-shoe,  or the let-
 ter  V.  There are two bones  which form the lower termination
 of the spinal column, one is called  the sacrum, and the other the
 os coccygis.  The sacrum joins the  two hip-bones or ossa innomi-
 nata.
   Some of the bones  are hollow and others are solid.   The bones
 are  the basis of the system.   To them the muscles are  attached,
 and they support all the  other parts of the body.   They give a
 shape to the body and contain and defend all the vital  organs.
   The bones of different  individuals differ in length,  size and
 thickness.  The bones of some people compose  a great  part of
 the  weight of  the body,  while  those of others are remarkably
 slender and light.
   The bones can be stained with a  red color, while in  the living .
 animal.   This is done by  eating for two  or three weeks, a sub-
 stance called madder.
   Cartilages,  membranes, and bones, are, in the formation of
 the system, all of  the same structure and substance.  Membrane
 is a sheet of gelatine  or jelly,  interspersed  with vessels  and
 nerves, and containing a small proportion of albumen, which gives
 it  a  degree of firmness.  Cartilage  is membrane,  with a larger
 proportion of  albumen, which gives it  a  still greater degree&of
 firmness.   The stiffness and strength of bone,  are owing to  the
 addition of lime or earthy  matter to  the cartilage.   The cartilage
 secretes earthy matter from the blood and becomes gradually hard-
 ened. ^ In young animals,  in calves, for instance,  the  bones are
 mere jelly or gristle, but  as they grow  older,  earthy  matter is
 gradually  deposited, which renders them hard.
   The surface of bones is hard and compact,  but the inside is
 spongy, and admits the entrance of numerous blood-vessels  Thev
are covered with a tough membrane  called the periosteum,' which
strongly adheres to them, and affords a bed for blood-vessels   Tn
a state of health, the bones  are insensible, but they are suscentible
 of inflation, like the soft parts, and in this ^K
cutely Sensitive-of this the teeth are a striking example

of Ilood vTssels" ThTb7 ^^  filled w^h a great number
01  dioou vesse  s.  The bones are composed of fifty one mrf*  in
a hundred, of jelly  or gelatine,  thirty-seven parts of the phffiS
of lime ten parts of the carbonate of lime or chalk, wfth one nr
two parts of magnesia.  Lime  and magnesia, are  the la thv^h
stances, which give bones  their hardness                 y SUb" 
BOW.
85
  Between each bone, composing the spine, there is a thick layer
of ligamentous substance which forms  a  bed for every seperate
bone.  The weight of the  superincumbent  body pressing upon
this substance during the day, while the person is in an erect po-
sition, brings the bones of the spine nearer together, so that he is
an inch,  or so, shorter at night than in the morning.  Tall people
appear to the most advantage, in the  evening.
  BORAX.—This substance is crystalline, transparent, and of a
greasy feeling.   In the East  and in South America, borax is found
in a native state.  There is no medicine for  which  we have a
greater partiality than for borax.  It appears  to us to be as healing__
internally, as externally.  Applied to sores  and ulcers upon the
surface of the body, either,  in the form of solution, or powder, it
is one of the best of remedies.   Its chemical composition is bora-
cic acid and soda.   Its taste and nature  are styptic and  astringent.
It. dissolves in  six times its weight of  hot water.  Cold water
does not dissolve more than one  third  as much.   The  borax is
the  best known in the cure of  the sore mouth.  In the bowel
complaint  of children, attended  with  apthse or sore mouth, we
have found the borax as friendly to the disorder of  the bowels as
to that of  the mouth.  Two grains  of the  powder, or about as
much as can be taken  upon  the point of a penknife, dissolved in
a table-spoonful of warm water, may be given to a child between
six months and  two years old, every  four  hours.   The  canker
appears in many instances to extend to the stomach and bowels,
and the  borax is an appropriate remedy. To larger children, it
should be given in larger doses.
   Nursing women will find as much benefit from this medicine,
in the canker, as little  children.   The borax,  taken in a dose of
five or six grains,  every three  or four hours,  through the day, dis-
solved in cold or warm water, will often effect the most signal
cures.   It allays the  heat,  moistens the  mouth, and disposes the
canker spots to  heal immediately.  We would not part with this
old remedy, for all the new ones which  we have ever tried.  In
the  canker, both of adults  and children,  it appears to us neeessa^
ry that the borax should be swallowed.  It can be used as a wash
 or gargle, either in powder or solution, but is more efficacious, if
 taken internally.  In swallowing it,  it  has all  the effect of a gar-
gle, in addition to its operation upon the  stomach and bowels.
   In the venereal sore throat, taken in  the same way, it is the best
remedy, which we have ever employed.   A drachm of it should
be dissolved in ten table-spoonsful of water, and one table-spoon-
 ful swallowed every three hours, during  the day time.  A strong
 gargle should be used at the same time.
   BOWEL COMPLAINT OF  CHILDREN—The complaint
 which we wish here to designate, is a  mixture of cholera morbus,
 dysentery,  and diarrhea.   In  this complaint, there is always a 
S6
BOW.
 looseness of the bowels, and in the beginning of it, there is, some-
 times sickness of the  stomach,  and  vomiting.   The discharges
 from the bowels, in some cases, consist of a  great proportion of
 Water, mixed with the natural  feces, and tainted with a rotten
 kind of smell.  In other cases there will  be  a large  quantity of
 mucus or slime, instead of vVater.   In a third  species  of the com-
 plaint, there will be small dots of fresh  blood, mixed  with the
 half digested  contents of the bowels.  In many cases, there will
 be a mixture of slime, blood,  feces, bile,  and a wheyey kind of
 substance, which is probably composed of the juices,  secreted by
 the digestive organs.  In children  at the breast,  who subsist, on
 milk, the discharges often  consist  of curdled, undigested milk,
 Which is often of a grey or clay color, and scanty in quantity.
   Children in  this complaint, show evident signs of griping and
 pain, although the appetite, in some cases, will remain quite good.
 There is more or less thirst, a scantiness  of urine, and, in  most
 cases, a dry skin.  There is not always an excess of heat, although
 a hot skin is a common attendant.  In protracted cases, the legs,
 feet, hands and arms, are, for the  most part, cold.
   A uniform symptom, in this disease, is a wasting of the flesh.
 The child is worrisome, cross, restless, and seldom refreshed with
 sound sleep.   If much vomiting  attend the disease, the child  is
 soon cut off.
   In grown people, the cholera morbus, dysentery, and diarrhea,
 are, for the most part,  distinct diseases, but in children they all
 Unite in the bowel complaint, and form one disease.  If a child
 is attacked with a pure cholera morbus, or cholera infantum, as it
 is sometimes called,  it  is much oftener fatal than in grown per-
sons.  But a  pure  diarrhea, or a pure dysentery, in children, is
 Hot much more fatal than in adults.
  The bowel  complaint of children, is a  disease  of the summer
 and autumn ; especially, the latter part of summer and beginning
of autumn.  It attacks children of all ages, but is most common
and most severe, during the period of  teething, which,  together
 with the heat of the  season, appear to be the principal causes
in producing and keeping up the disease.  Where these two causes
are absent, children go through with the disease about as well as
adults.
  The canker, in children,  appears to be produced by the same
feauses, and is always a great aggravation to the bowel complaint.
 In some instances, the  stomach and bowels of children appear to
participate in the canker of the mouth.  Where teething, canker,
and the bowel complaint, all unite in the same child, they com-
pose a formidable disease.
  If the disease  comes on in the form of cholera morbus c
puking and purging, there is always a fever.   If it is a dysent'erv
or a discharge of bloody matter, principally, there is also more or
or
ry
or 
                           BOW.                         87

less fever, but if it is a simple diarrhea or looseness, there is sel-
dom much fever, and much less disturbance of the appetite, than
in cholera morbus and  dysentery.
   Domestic Remedies.—In whatever way the disease commences,
whether by  vomiting or purging,  or  both, we think it is best to
stop the disease  by laudanum or paragoric.
   Five drops of laudanum in  a table-spoonful of  castor oil
is our  usual  dose for a child a year old.   A child between
two and  three years, should  take from  seven  to  ten drops
of laudanum in  the same quantity of oil.   In most cases this
will be enough  to still the  bowels, relieve  tho  pain,  and
cure  the  sickness  at  the stomach.  But in some  instances,  it
will be necessary to repeat the same  dose  at the end of eight
hours ;  but  if the oil operates freely, only the laudanum should
be repeated.
   The  dose of oil and laudanum should be given  every day, as
long as the  disease continues.  In  mild cases, it will not be re-
quired  oftener than every other  day.  The object in this  treat-
ment is to check entirely the diseased motion of the bowels, and
to have nothing pass  them but what  is the effect of the oil or
other physic.  If the  child is used*to  taking  laudanum  or pare-
goric, a still larger dose of laudanum will be required.  Children
older than three years  may take from ten to twelve drops of lau?
danum in a table-spoonful of castor oil.
   We believe oil to be the best purgative which can be  given
to a  child  in  the bowel complaint,  but other purgatives will
answer where the oil cannot be retained or does not remove the
 disease.
   Professional Remedies.—The  purgative, which  is the  surest
to stay upon  the stomach,  is calomel.  Three grains  may be
given to a child from  six months to a year  old ; and five grain?
to a child from one to five years old.   Where  there is  sickness
and vomiting, it will be sometimes  necessary to give this medi-
cine, merely, on account of its disposition  to remain upon the
 stomach  in  spite of the vomiting.
   A mixture of  laudanum and sulphate of zinc  in solution, and
 Dover's powder with minute doses of calomel, will often be found
 effectual  in this disease.
   If the discharges are tainted with sourness perceptible to the
 smell, a dose, or a tea-spoonful of the  calcined magnesia may be
 given instead of the oil.
   In some  obstinate,  protracted  cases, two grains of  the powder
 of ipecac in molasses or some other vehicle, giyen once a day for
 a week or  a fortnight in succession,  has produced many cures.
 Next to  the  oil and  laudanum,  we esteem  the ipecac  the best
 remedy.  The  ipecac is given  without the laudanum or any
 other anodyne.  Two grains of  ipecac may be given to  children 
  88                        BOW.

  at  any age between  six months and three years old.   In  this
  dose, it operates as a purgative.
    In some cases, we have substituted the dover's powder instead
  of the laudanum, in a dose of three to five grains.
    In cases of canker, one or two grains  of borax, in powder, or
  dissolved  in water, should be  given to  the child,  morning  and
  evening.  A  mere  gargle is  of  little  service.   The  borax is
  friendly both to the  stomach and bowels, which are  often in
  the same condition with the  mouth.
   If the child nurses, no other nourishment is necessary, but  the
 Child should be restrained to much  less  than its usual  quantity
 even of breast milk.  For older children,  boiled milk mixed with
 one half water, is the  best nourishment.    Flour and arrow-root
 gruel may be given where there is much fever.
   The drink  may be cold water, or bread water, and a solution
 of gum arabic in water.
   The body should be often  washed with lukewarm water ;  and
 if there isymuch pain and soreness in the  belly, the bowels should
 be bathed  with warm brandy, or hot herb teas.  A few drops of
 Jaudanum may be rubbed upon the stomach and bowels.
   Injections of flaxseed tea, starch, and other soothing substances
 will often be found useful.  Laudanum and other medicines can
 sometimes be insinuated into  the bowels in this way, when they
 are rejected by the mouth.
   Vegetable astringents are better for children than the mineral.
 The  best vegetable astringents are the  logwood,  catechu, and
 kino.  These  medicines, dissolved in water, may be given with
 considerable freedom.   The borax is, however, a mineral astrin-
 gent of much power, and very harmless in its effects.
   Blood-letting, in this disease, is not often required, but when
 necessary, it had better be done by leeching.
   The morphine, being  deprived of the  astringent  property of
 the opium, is much less suitable to this complaint than laudanum
 or paragoric.
   If the disease  becomes chronic  or continues a long while a
grain of quinine,  once a day,  for a week  or two, has sometimes
effected a cure.
u ^0WELS.—The bowels  are contained  in the cavity of the
belly.  They extend from the stomach through the body  They
are wound into a ring like the worm of a distillery.   The bowels
are one entire  tube, but are divided into  four different portions
on account of certain anatomical and functional differences which
these portions discover.   The portion next to the stomach, which
is only about a foot in length,  is called the duodenum.  Into this

near 1 midd^  Vh^ *** ^ thr°Ugh a duCt whlch entefS *
near its middle   The pancreatic juice also flows into the same
portion of the bowels.  The chyme received into the duodenum 
BOW.                          89
from the stomach, mixes with the bile and pancreatic juice, and
from some chemical action of  the whole together, the  chyle  is
formed.  This is a white fluid resembling milk, and is taken up
from the bowels by a set of minute vessels  called lacteals, and
conveyed into the veins through a common vessel  called the
thoracic  duct.  This duct enters the vein of the left arm near its
junction with the jugular vein, and is about the size of a crow's-
quill.
   The  upper portion of the bowels, is much smaller than the
lower  portion.  The  common diameter  of  the upper portion  is
not more than one inch,  while that of the lower portion, is three
or four inches.   The  small intestine or the  first portion  of the
bowels,  is,  in length,  at  least  four times  greater  than the
large portion.  The whole  length of the intestines, in man, has
been estimated at  twenty-six  feet, or about five times  his own
length.   In children, they are ten times  the length of the child.
   The portion of the intestine next to the duodenum, has been
called  the  jejunum, a latin  name  meaning empty,  because it  is
always  found in that  state.  This portion lies coiled in a circle
in the  centre of the belly.   The  inner  coat of the jejunum  is
lined with lacteal vessels.
   The next portion of the bowels is called the ileum, the breadth
of fifteen hands in length,  or about five feet.   It  is  commonly
found  filled  with  fluid  fecal  matter.  This portion  enters the
large intestine transversely, or into  its side, leaving a small portion
of the large  intestine above, which is called the caecum or blind
pouch.   This part, called  the  head of the colon, is about three
inches in length, and  runs up above  the place where the ileum
enters.   At the entrance of the  ileum into  the large portion of
the bowels, there  is a valve to prevent  the  return of the feces
from below.
   The large portion of the bowels is divided, anatomically, into
two  other parts called the colon and rectum.   The colon makes
one turn round the belly and ends in the rectum, which is short
and  straight.
   The colon and rectum contain  hard feces.   When a fluid in-
jection is given, it never ascends above the valve of the colon or
the  large intestine, being  prevented  from going further  by the
valve ;  although  by the .use of a  force pump, it  is thought that
this  valve may be surmounted.
   The bowels have a motion of their own, like the heart.  This
motion, called the vermicular  motion or peristaltic motion, urges
along  their contents  until  they are  finally expeled.   In  grown
people, the  food  stays  in  the  bowels about twenty-four hours.
The  food which we eat one day,  is not  expeled until the next.
Digestion is perfoimed in about three hours, but the refuse of the
            12 
90
BRA.
  food or the excrement, takes some time  to  travel  through the
  whole length of the bowels.
    The bowels are composed of three  coats, a membranous coatj
  formed  by the  peritoneum or lining of the bellyj a fibrous coatj
  and a villous or inner coat.  They are attached to and kept in
  their place by the mesentery, a large thick membrane which pro-
  ceeds from the back.  The mesentery is composed of a duplica-
  ture  of  the peritoneum.   Over the bowels in front, hangs the
  omentum  or caul.
   In animals that live upon vegetable food, the bowels or intes-
 tines are long, and in those that feed upon flesh, they are  short;
 The  length of the bowels in man, would  seem to indicate that
 he should  live upon a large proportion of  vegetable food.   The
 bowels in  the human  subject are not so long as those of many
 animals that live entirely upon vegetables, as, of the  ox for in-
 stance, but are very much longer than those of the lion or tiger,
 that  live upon  flesh.   Vegetables seem to require  a long  tract
 of intestine to  digest and convert  them  into blood, but  flesh
 which is nearly in a state  of nutriment, demands only a short
 process and a snorter journey.
   BRAIN.—The texture of the brain is Very  different from that
 of the other parts of the  body.  An idea  of  the texture of the
 human brain  may be formed from the brain of a calf or  of a
 sheep, which  is often  dressed for food.   The  brain is divided
 into two distinct parts, separated by a thick membrane or parti-
 tion.   The upper part  is called cerebrum* and the  lower part
 cerebellum.  The cerebrum is about eight  times larger than the
 cerebellum.  The  brain is also separated into halves  by another
membrane  which divides both the  cerebrum and  partially the
 cerebellum  from the top  to the base  of   the skull.   The two
 halves of the  brain, the right and the left  half, are formed pre*
 cisely alike and  are of an equal size.  The outside of the brain
 is of the color of wood ashes, and is called the cineritious  sub*
stance, and the inside is of a white color, and is called the  med-
ullary substance.   The cineritious part, which is also called the
cortical part, is not very essential  to life.   Portions of it  have
been destroyed,  and life  still  preserved.   The brain has a curi-
ous structure ; the constituent parts of which are  quite nume-
rous, and their uses or offices but very little understood.  To ex-
plain  the offices of the brain, would confer upon the discoverer
immortal honor.
   There  are three  cavities  in the brain ;  one situated in each
side or in each half; and a third cavity situated between the two
beds of nervous  matter, from wnich the optic nerves  originate
in a dropsy of the brain,  these  cavities  are often  found filled
Tth T161,    1S needless here t0 notice the several prominences 
BRA.
91
  The whole of the brain is enveloped in three membranes, or
sheets of fibrous  matter.   The  outside membrane  is thick  and
strong, and  is called the dura mater.   The  middle membrane,
called arachnoides, is destitute of vessels, and is thin.  The third
or innermost membrane, called the pia mater, is vascular.  Nearly
in the centre of  the  brain, there is situated a small body, called
the pineal gland, which, by some, has  been supposed to be the
centre of thought, or seat of the  soul.
   From the brain, proceeds the spinal marrow, which is one and
the  same substance with the brain.   The brain  also gives off
nine pairs of nerves.  The spinal  marrow gives off thirty pairs
of neryes.  The nerves  proceed out of the brain through little
holes or foramena,  perforated through the skull  bones.  The
nerves which go to the right side of the body originate from the
left side of the brain, and  those which go to  the left side of the
body arise from the right  side of  the brain.  This explains the
reason why a blow received upon  one side of the head will para-
lyze the opposite side of the body.
   The  brain is supplied  with an extraordinary number of blood-
vessels.   These vessels are large and convoluted.   The brain is
supposed  to contain one eighth part of the whole  blood in the
body.   The brain and the nerves which proceed from it are the
seat of  sensation and  thought.   The  brain, spinal marrow, and
nerves  are all one and the same substance, and discharge a similar
office,
   BRAIN  FEVER—Phrenitis.—The disease  called the brain
fever is an inflammation of the substance of the  brain and of the
membranes which enclose it.  It is not, strictly speaking, a fever,
although  accompanied with a very high degree of fever.   The
fever is a consequence of the disease, but does not  constitute the
disease itself.   It  is better for everybody to  have  right  than
wrong  notions upon any subject,  and where  common names do
 not convey the truth, they must be explained.  That the brain
 fever is an inflammation, or in other words, that the substance of
 the brain and its membranes are red, swelled, and  painful to the
 touch,  in this disease, as  in  other inflamed parts  and organs,  is
 known not only by the inflammatory symptoms which  accom-
 pany it, but by the  appearance of the  brain on dissection.  After
 death,  the brain, in these cases, presents all the redness, engorge-
 ment  of  the blood-vessels, and  thickening of the  membranes
 which  characterize  inflammations of other parts.
   The brain fever  comes on with a violent, deep-seated pain in
 the head, an inability to sleep,  redness and swelling of  the eyes
 and  face, an impatience  of  the  light and also of noise, and a
 raving delirium.  There is also a violent heat in the head, which
 extends over the whole  body, a strong, hard, quick pulse, furred
 tongue, and a scantiness of the  urine.   The eyes are wild, raving 
92
BRA.
 and sparkling, and the patient neither knows where  he is, nor
 what he is about.   He only mutters  and moans, or utters inco-
 herent sentences.  The  breathing is  deep, and the restlessness
 great.
   Where an inflammation of the brain is the sequel of  other dis-
 eases, as of fevers,  bowel complaints, and inflammatory  affections
 of other organs, which finally extend to the brain,  the eyes and
 face will be pale instead  of  red, and the features will be shrunk
 instead  of being bloated.  The pulse  will be small,  hard and
 rapid.  An inflammation of  the brain, which  happens  in conse-
 quence  of other diseases, has been denominated symptomatic;
 and  an  inflammation of  the braki which comes on in a state of
 general health, an idiopathic inflammation.
   The brain fever is produced  by an  exposure of the bare  head
 to  the hot sun, by excessive study,  by mental  excitement of
 every kind, religious, political or convivial, by intoxication  and
 intemperance, by severe exercise and  overheating  the  body, by
 blows upon the head or concussion by falling, and  the suppres-
 sion of accustomed evacuations, such  as the menses, the milk,
 and the piles.   To  these causes  may be added,  excessive venery'
 long want  of sleep,  and many acute diseases.
   The brain fever may be  distinguished from mental  derange-
 ment, by the deep-seated pain  in the  head, the furred tongue
 and the high fever ; and from the common delirium which  hap-
 pens in  low, nervous fevers, by the redness of the countenance
 and of the  eyes.
   Remedies.—Very little  can be done with propriety in this
 disease until the patient has been bled.   In no disease  is bleed-
 ing of more importance  than in the brain fever.   The opening of
 the vein  should be  large in order  to secure a full stream and a
 quantity should be taken,  sufficient to make an impression upon
 the whole system.  There will be no harm in producing a slight
 degree of faintness  by the loss of  blood.  The  head should be
 immediately shaved and cold  water constantly applied to it • and
 where ice can  be obtained, iced water  should  be  used  ' The
 bowels should be drained by salts or some strong purgative • and
 a quarter of a grain of tartar  emetic and six grains of nitrate of
 potass should be given in solution, every hour, until a moisture
 is produced upon the skin.  The drink should be  cold water
soda  powders in solution,  and the acetate of ammonia in a state'
 of effervesence.   The acetate of ammonia is a powerful sudo ific

 Suchls tr Ur'  a refTrent t0 the  ^mach and h S
 thut\ ti?   ugre,e °f heat and fever ln the onset of this disease
 that  bathing the feet in hot water might only increase t  ™7r '

somewhat abated.   If the inflammation and the violence of tkf
symptoms are not subdued by one bleeding, anotnTmust be re- 
BRA.                         93
sorted to.   Where leeches can be procured in great plenty, it will
be preferable to abstract blood by them, but it requires the aid
of a great many of  them ;  at least, a dozen and a half at a time,
for two or three successive operations.
   Ether applied to  the head will  sometimes be found superior to
cold water in reducing the  heat and fever.   Opiates, in every
shape,  are found»to  be inadmissible in this disease.   As a substi-
tute, Hoffman's anodyne liquor, in tea-spoonful doses, every two
hours,  will avail much in easing the pain and procuring sleep.
The sweet spirits of nitre will sometimes prove a  sedative.  Four
or five grains of camphor and as many grains of  James' powder
or the  pulvis antimonalis  made into a pill, will have a tendency
to quiet the commotion of the brain and to open the pores of the
skin.
   After the violence of the disease has somewhat abated, a large
blister should be applied to the nape of the neck,  and repeated, if
relief is not procured by the first.   Blisters must be applied to the
arms, between the elbows and shoulders, if the motion of the head
in consequence of the delirium and restlessness, prevents the appli-
cation  to  the head.  Digitalis, and  hyoscyamus or the henbane
have been advised in this disease, but we have never tried them.
It has  been advised that  the patient  should be kept in an erect
posture as much as possible by pillows and cushions placed under
the head and shoulders.   The light should be excluded from the
room,  and all confusion  avoided.  The  room  should be  kept
comfortably cool and well supplied with fresh air.  The nour-
ishment should  be bread water, rice water, arrow-root and Indian
gruel.
   The symptomatic brain fever, which  follows upon other dis-
eases, requires a less active treatment  than that which arises in a
state of general health.   But this form of the  disease, if it is in
its first stage,  and accompanied  with much  pain, and a quick,
hard pulse, will require the abstraction of blood either by leeches
or the  lancet.   The purgatives, however, should  be of a milder
nature, and administered less frequently.   In some instances, the
dispensation of an injection will bo sufficient.  Rochelle powders
may be given instead of more drastic purgatives.
   This disease  is always  dangerous, especially when it arises  in
consequence of falls, blows, and concussions.   It often proves
fatal  between  the  third  and seventh day ; and where it lasts
longer, is apt to end in mental derangement, idiocy, or some de-
gree of mental imbecility.
   The fatal symptoms are a fluttering pulse, cold  sweat, startings
of the  flesh or muscles, and grinding of the teeth.
   There  is one  symptom of this disease, especially where it arises
from injury done to the brain, which has not been much noticed
by medical writers, and  that is, a nausea  and  sickness at the 
94                         BRE.
  stomach,  and sometimes  a  bilious vomiting.  This is an  affec-
  tion very difficult to control.   If we give opium to allay the
  sickness, it  only increases the inflammation of the brain and the
  matter is made worse.  And very often,  calomel is  the   only
  medicine which will  be found  to stay upon the  stomach, and
  should be given freely.   Effervescing draughts  can be given to
  allay the irritation  of the stomach.              •
    BREASTS—Mammae.—The breasts of females are glandular
  organs like the liver,  kidneys, and pancreas.  The  office which
  they perform is conditional; in  this, they are unlike the  other
 glands.  Pregnancy seems to  be a necessary condition to the execu^
 tion of their office.   These glands consist of a white spongy sub^
 stance, and congeries of veins, arteries, and lacteal or milk vessels.
 After the  milk is  secreted from the arterial blood, it is  poured
 into  thirteen or fourteen little  ducts or canals, which end in a
 common tube which passes out at the nipple.
   About the third day after delivery, the milk begins to be secre-
 ted in abundance.  If the mother live upon a mixture of  animal
 and vegetable  food, the milk does not turn sour spontaneously
 like cows milk, but if  she live upon vegetable food alone, it be^
 comes sour by the  ordinary degree  of heat and standing.  Some
 mothers will not give more than a pint  of milk,  a day, while
 others will give twice  or three times  this quantity.   After a
 woman has once began to give  milk, she will continue to nurse
 for several years, if not interrupted by the birth of another child.
 The  longer  children  are kept to the breast and Jive upon the
 mother's milk, the  stronger  and healthier they will be; or, in
 other language, the longer the time between the birth of child^
 ren, the better health  they will enjoy and the more likely  they
 will be to live.
   BREATH.—Nothing  is more disagreeable to others than a
 foul breath.  The lustre  of both  beautv and  accomplishments is
often obscured by  the foulness of  the breath.   Decayed teeth
and ulcerated gums often give it the smell of putrefaction.    In
such cases, the ulcerous teeth should be pulled, or filled ; and all
the dying roots removed.   An ulcerated throat will also taint the
breath.  But  the worst smell  often comes from the stomach.    In
such cases there must  either  be a new secretion in the stomach
or the juices and contents of that organ must  undergo a putrefac-
 tive process.
   The best medicine  to sweeten the breath, is ten or twelve
drops of a solution of chloride of soda or of lime, in a spoonful of
water,  l his medicine taken, two or three times a day, and  used
as a gargle for the mouth and throat, will  effectually neutralize
the fetidness of the  breath.  Charcoal used to rub the teeth  and
gums with, has a similar tendency.   A tea-spoonful of the  fine
powder of charcoal  swallowed into the stomach, will also sweet- 
BRE.
95
 en the breath.   A fetid breath is always owing to some  disorder
 of the stomach or the parts of the alimentary canal above it.  We
 have known the breath of a person to become  sweet in a very
 short time by some alteration in the health.
   BREATHING—-Respiration.—Everybody knows that  life is
 supported by breathing, but in what manner it is done, is known
 only to those who  have a knowledge of the  human system and
 of the science of chemistry, or at least, the properties of the air.
 The lungs are the organs of breathing.   They are  contained in
 the chest, and consist of two lobes which are separated from each
 other by a strong, thick membrane or fleshy sheet which divides
 the  chest  into  two chambers.  The  anatomical name of this
 fleshy partition is mediastinum.  The lungs are spongy  and full
 of little cells.   The air is drawn into the lights or lungs through
 the  windpipe.   The  windpipe as it descends  into  the  lights
 divides  into two smaller  pipes called the bronchia, one going to
 each lobe  of  the lungs.  These two  smaller pipes divide  into
 numberless other still more minute pipes, and  these last  end
 in little air cells.  The  blood is thrown from the  heart  imme-
 diately  into the lungs, where it comes in  contact with the air
 cells.  In this  situation, the vital part  of the air combines with
 the  blood and prepares it to support  life.  As the food is digest-
 ed and  changed into chyme in the  stomach,  so is the venous or
 purple blood  digested,  and changed  into arterial blood in the
 lights.  The Whole venous blood of  the   system enters the
 lights, of a purple  color, and comes out of  them,  of a  bright
 red,  or  scarlet color.   It is  the bright  red  blood  which vivi-
 fies  and supports the  system ; the venous or purple blood  will
 not  support life for a moment.   The  lungs perform the  same
 office for the venous  blood which the  stomach performs for the
 food.
   It is well known that a person can not breathe over the same
 air without feeling  faint;  and if compeled  to  breathe it over
 several  times, he dies.   This fact shows that the  air in  being
 breathed over, loses a portion of its vital substance, or becomes
 changed in some way or other.
   The  air, by a chemical process, has  been  separated into  two
 distinct elements or elemental airs.  Both these kinds of elemen-
 tal air, are  colorless and  invisible, but are known by their diffe-
 rent  effects and weight.  One kind causes  bodies  which have
 been ignited to burn with much greater  rapidity than common air,
 and when breathed by men and  animals, produces  the  highest
 degree of exhilaration and life..  In the other kind of elemental
air, nothing will burn, and  no animal  can breathe  it and live.
The  air  which  causes bodies to burn and which  supports life, is
called oxygen, and the other nitrogen.   The  oxygen causes iron
and other metals to rust, but nothing can rust in nitrogen.   The 
90
BRO.
  common  air contains twenty-one  parts by measure of oxygen,
  seventy-eight parts of nitrogen, and one part,  of a deleterious
  air, or gas called carbonic acid gas.
    In air which has been breathed, and submitted to examination,
  it has been found that a portion of its oxygen has been extracted,
  and in the same air,  is found a quantity of carbonic acid gas or
  choke  damp, as it  is vernacularly called,  just equal to the quan-
  tity of oxygen which was subtracted from the air.  Hence, in the
  process of breathing, it is evident that the blood has subtracted
  from the air, a portion of oxygen, and resigned a portion of car-
 bon or charcoal.   A part of the oxygen or vital air is supposed to
 have united with  the carbon of the blood and formed carbonic
 acid  gas, and  another portion to have united with the venous
 blood itself, and to have transformed it into arterial blood.   In
 this process, it is supposed that the heat of the body is elaborated.
   One fact is very  certain, that, the  more oxygen there is in the
 air, the  more heat is produced and the more lively are  all the
 motions of the mind and body.
   A man breathes, that is, draws in and expels  the air from the
 lungs, about twenty times in a minute ;  and the quantity of air
 in every breath is about three hundred and twenty-seven cubic
 inches.  In twenty-four hours, he breathes forty-eight pounds of
 an;, and subtracts from it, about two pounds of oxygen.
   The breathing, or rather the motion of breathing is performed
 by the  contraction and relaxation  of  the midriff, the muscles
 of the belly, and  the  intercostal  muscles or those which  move
 the ribs.  The midriff or diaphragm  is the chief agent in expand- '
 ing the chest, and the  muscles of the belly, in contracting it,  and
 expeling the air.   The intercostal  muscles  act as an  assistant.
 The ribs, in breathing, move upward and downward, and inward
 and outward.
   The  breath  when  it  issues from the  lights, is loaded with
 vapor.   This vapor is secreted in the air cells of the lights,  and
 absorbed by the inspired air.
   The carbonic air which is discharged from the lights in breath-
 ing is a real acid; very acrid, and corrosive, and when breathed
 without  mixture, excites a violent  coughing.   Air,  therefore,
which has been breathed over and over again, must be very irri-
tating to the organs of  breathing.   The freer the air is, from this
gas, the more congenial it is to the lungs.
   BRONCHIA.—The  windpipe,  before it  enters the  lungs,
divides mt0 two tubes, one of which enters the  right portion of
the lungs,  and the other the left  portion.  These two cartilagi-
nous tubes  are called bronchia.   In entering the lungs the bron-
chia diVHle into an endless  number  of  smaller  tubes, which
still divide until they  become invisible.  The termina ions  of
the bronchial vessels, form the air cells of the lungs.  The inside 
BRO.
97
of the bronchial tubes are filled with little glands which secrete
a mucus.   The  bronchia are the seat of the disease called bron-
chitis, or inflammation of the bronchia.   It is many times the
seat  of cough and  difficulty of  breathing.  Being composed of
cartilage like the rest of the windpipe, the bronchia do not col-
lapse, but remain constantly open.
   BRONCHITIS.—An inflammation of the mucous membrane
lining the air passages leading into the lungs.  Ancient physi-
cians appear to have been unacquainted with the nature and seat
of this disease, and though  referred to under different names by
Hoffman, L>utaud, Sauvages;, Morgagnj and Cullen, the profession
generally had  no definite knowledge of it, before Dr. Badham,
professor of the practice of physic in the University of Glasgow,
published a small work  upon the subject, comparatively, but a
few  years  ago.   Bronchitis appears  under two different forms,
that of acute and chronic.   The acute form is characterised by
Gold chills, followed by fever ; hoarseness, difficulty of breathing,
tightness or sense of stricture in the  chest, and oppression at the
pit of the  stomach, prostration of strength, and costive  bowels.
The pulse is quick and hard in the first stage ; there is always a
dry croupy cough,  and an  aggravation of all the symptoms at
night.  Affer  a  few days, expectoration  or raising takes place,
and  there is a temporary mitigation of the symptoms ; the respi-
ration often, however, soon becomes more difficult, the tightness
about the  chest increases; there is  a sense of suffocation, the
pulse becomes very rapid ; there is a deadly paleness or lividness
of the lips and cheeks j the  countenance  is anxious, and the pa-
tient desires to be raised up and to have more air ; there is a loud
wheezing and at length a rattling in the throat, insensibility and
cold  perspirations; the extremities become cold and livid, and
death closes the scene.   This  disease is very  fatal  in  infancy
and  childhood,  and is often mistaken for croup, which it very
much resembles, but from which it may be distinguished by its
being seated lower down, at the upper end of the breast  bone,
whereas in croup the obstruction and noise in  breathing are
higher up in  the windpipe.  In children, the disease comes on
like a common  cold; the throat is often sore ; there is severe
pain caused by  coughing, and  the cough is suppressed  as much
as possible by an action of the will; the shoulders are  in great
and constant motion  from the efforts  made  in breathing ; the
nostrils  draw in, and there is a loud wheezing.  The child re-
fuses  food, but  drinks greedily, though it can take  but two or
three  swallows  at a time, for the want of breath.   The phlegm
is frequently  vomited up spontaneously  as in  hooping cough,
with temporary  relief—but it soon reaccumulates, and the suffer-
ings  return.   If at the  breast, the  infant can nurse but a few
seconds at a time, it bites the nipple, throws the head back forci-
              13 
98                         BRO.
bly and cries: the voice is shrill as in croup.  Should the disease
be unsubdued, all the symptoms become aggravated, the extremi-
ties swollen and livid, and the child dies from suffocation. Great
oppression,  feeble and rapid pulse,  absence of heat and pain,
a deathlike countenance, and a swollen and purple appearance of
the face and extremities are almost certain  signs of  a fatal termi-
nation.   We have had occasion to witness a number of cases of
this alarming affection in children from two to eight years of age,
which proved suddenly fatal, and the painful impressions made
upon  our mind by the agonizing distress  of the little sufferers,
can never be effaced.   This, however, is the gravest form of the
disease :  it often manifests  itself in a milder form, which readily
yields to  suitable  remedies, and between these two extremes, it
assumes every degree of  severity.  The causes of bronchitis are
the same  as those of colds,  catarrhs  or influenzas:  in fact, it is,
in  most  cases,  nothing  more  or  less  than  a  cold  located
upon  the  bronchia,  and thereby producing  a  peculiar train  of
symptoms.   Sometimes, however, it  supervenes  upon  scarlet
fever  and other eruptive diseases, and is probably caused by an
extension  of  diseased action to this part.    These cases are gene-
rally fatal.  Dissolution may take place in two or three days  in
violent cases, or in those that are  of a milder character it may be
delayed to ten or fifteen days.
   Treatment  of Acute  Bronchitis.—Mild  cases,  may be  suc-
cessfully combated, by domestic treatment; but if  the attack be
severe, there should be no delay in  calling an experienced phy-
sician.  The circulation should  be  equalized, and perspiration
promoted, by bathing the feet in hot water, followed by mustard
poultices,  and copious draughts of warm  balm  or  flax-seed tea,
vinegar whey, or hot lemonade ; and,  if there be pain in the chest,
the part should be fomented with a decoction of chamomile flow-
ers, or other bitter herbs.   Mild emetics of  thoroughwort, ipecac,
lobelia,  or hive-syrup, should  be given two or three  times in
twenty-four hours, and their operation aided by large quantities
of warm water.   During the intervals between the emetics, nau-
seating doses  of the  hive  syrup, ipecac  or antimony, should be
repeated every two or three  hours, until the violence of the dis-
ease is subdued.   Gentle emetics, will be useful in every stage of
the disease,  and are our most potent remedies ; but in the last
stage, keeping up severe and constant nausea, is liable to depress
the system too much, and should be avoided.  Should the emetics
not move the bowels freely,  a dose of castor oil  or  other physic,
snould be administered,  and repeated, as  the case  may require.
in violent attacks, bleeding will be indispensable, and should be
practised  promptly and efficiently.  There is no remedy, of so
much importance,  none  to  which the disease yields so readily
and with so much certainty,  but it must be done in the first stage 
BRO.
99
as in the second, it is of doubtful propriety, and in the last, is posi-
tively inadmissible.  Bleeding from the arm is generally the best
mode, though in very young children,  and when it  is necessary
to repeat  the operation, leeching may be preferable.   The best
criterion, as to the quantity to be drawn, and the repetition of the
operation, will be the amount of pain and constriction  in the
chest,  and the pulse.   If the pulse be  hard and full, the pain
acute, and the constriction great, the abstraction of blood will be
beneficial.  The inhalation of the steam of water, or a decoction of
emolient herbs, is a remedy of great value, and should be frequently
practised.   In the  second and last stage of the complaint, blister-
ing the chest and frequent doses of syrup of squills, lac ammoniac,
decoction of seneka root, and hive syrup, which is well adapted
to every stage, are among our most valuable remedies.  No solid
food will be required, but the system should be supported with
water gruel, rice water, or arrow-root.  The apartment in  which
the patient lies,  should be warm, but airy, and free from dust and
the gas of coal, and if a close stove be used; a constant evaporation
should be kept up, from a vessel of water placed upon it.  Great
care  will be necessary, during convalesence, that the patient do not
take  cold, as the disease may relapse or degenerate into chronic
bronchitis.
  Chronic bronchitis frequently succeeds the acute,  but it some-
times comes on slowly  and insidiously, without any manifest
symptoms  of inflammation or fever.  It affects persons  of  all
ages, but is most frequently met with,  in  those  whose occu-
pations expose them  to  the inhalation of dust and  gases.    It
frequently co-exists with diseases of the heart, and like the acute
form, may follow eruptive fevers.  It resembles consumption, and
may be mistaken for  that  disease; it is a concomitant  of some
forms of asthma,  and dropsy.   The symptoms which ordinarily
attend this form of disease, are a constant cough, and an  expec-
toration of matter from the lungs; difficulty of breathing, frequent
pulse and night sweats;  the symptoms are aggravated at night,
and  the sleep disturbed.  The patient is  very  sensible to the
changes of the weather.  A damp atmosphere, night air, easterly
winds, indigestible food, and costive bowels, are very sure to pro-
duce an aggravation  of the complaint, and at such times, the
voice will be hoarse, the breathing more difficult, the cough croupy,
and  the whole system  affected with  the symptoms of fever.
There is shortness of breath,  and wheezing  when taking exer-
cise,  and  inability to  lie down; dust,  or  gas is insupportable.
Expectoration, however, soon comes on, bringing almost immedi-
ate relief, and the  patient is soon restored to his former condition.
The matter expectorated, is various in appearance and consisten-
cy.  It may be viscid and colorless, corrupted, yellow or greenish,
according  to the degree and stage of  the inflammation.  Chronic 
100
BRO.
bronchitis may terminate  favorably, in a short time, or what is,
perhaps, more common, be protracted for many weeks or months.
On examining the bodies of those that have died of this affection,
it has been found, that the trachea and bronchia, are filled with the
same kind of matter that had been raised ; the lining  membrane
thickened, and sometimes intensely  red.  In some instances, a
false membrane has been found lining the bronchia, like that
which forms in croup.   The surface of the lungs is lighter colored
than natural, and has the appearance of  having air effused under
the pleura or investing membrane, and the lungs do not collapse
as is usual,  when death  takes place from other causes.   When
the disease  has been of long standing, it is not unusual to find
the bronchial tubes very much  enlarged, forming considerable
cavities in the lungs.   These  cavities  have been  mistaken for
cavities produced by ulcerations or abscesses,  and the great extent
of the lining surface,  accounts for the  astonishing quantities of
matter, that are sometimes secreted and raised, when the substance
of the lungs is in a perfectly healthy condition.  These cavities;
called by physicians, dilitations  of  the bronchia, may exist for
many years, without serious consequences, and are probably one of
the causes of that kind of habitual cough to which old people are
subject, and which do not appear to abridge  their term of life.
   Treatment of Chronic Bronchitis.—This disease; is often  dif-
ficult to cure; medicines seem, in  some cases, to have but little'
effect upon it, though we  occasionally meet with those that yield
readily to medication. Counter irritation, by blistering, croton oil;
or what is preferable, the tarter emetic ointment, and the occasion-
al  use of expectorants, combined with hyoscyamus, lettuce, cicuta
or opium, may be serviceable.   Perhaps there is  no internal
medicine, better entitled to a thorough trial, than the muriate of
ammonia, sal ammoniac. It may be given in four or five grain doses
four or five times a day, combined with minute doses of antimo-
ny, or ipecac, and extract of liquorice.   The copaiva, and other
balsams are highly recommended, and deserve a trial.  Occasion-
al emetics,  and mild cathartics, are absolutely  necessary, and
should be resorted to, whenever the lungs are oppressed,  or the
bowels confined.   The inhalation of the vapor  of tar, has been
recommended as a sovereign remedy, and we have often witness-
ed very  pleasant effects from it, in  this, and other chronic lung
affections.   Bleeding is rarely necessary; but may be occasionally
useful in moderate quantities; when the difficulty of breathing is
great, and attended with pain in the chest, and febrile symptoms.
All the causes that are liable to occasion an aggravation  of  the
complaint,  should be studiously  avoided.  The clothing should
be warm ; a flannel or leathern jacket, and drawers should be worn
next to the skin, and the night  and damp air be avoided.
   During the inclement seasons, the use of the respirator, when 
BUB.
101
much exposure is unavoidable, will be useful, in preventing the
bad effects of the cold air and sudden changes.  A change of the
seasons, from cold to warm and dry, often cures or alleviates the
disease, like a charm, and in imitation of this, when circumstances
will permit, the invalid should remove to a warm climate, during
the cold  season.   The situation  chosen, for a residence, should
be high and dry,  and as far remote  from  the sea, and other large
bodies of water as is practicable.  The diet  must be plain, easy
of digestion, and nutritious, and the strictest temperance be ob-
served.
   BRONCHOCELE.—This disease is sometimes called the goi-
tre.   It is a fleshy tumor which grows upon the front side of the
neck.  We never saw but two cases of it in this city.  In some
countries it is  said to be common.   The growth  of the tumoi
throws the head  back, and turns the face upward.  It was once
thought  to be produced by the use of ice  and snow  water  for
drink, but this was only conjecture.  It was also  supposed to be
confined to mountainous  countries, but it is often seen in other
situations.  It  probably originates like  other  fleshy or sarcoma-
tous tumors, and is curable by the  same  means.  Lead and mer-
curial plasters  are commonly applied to them.  Friction  with
camphor, opodeldoc, and other stimulating medicines should be
tried.  These tumors are commonly harmless, although unsightly.
   BRONCHOTOMY.—This is  a  surgical  operation to open a
passage for the air into the windpipe in cases of croup, or suffo-
cation from  substances drawn into the  throat.  It is sometimes
performed to inflate the lungs in cases of drowning or suspended
animation.  It is one of the  most formidable looking operations
in  surgery, but openings  are often made into the windpipe by
wounds and accidents, and heal up without much difficulty.  In
France,  the operation of late has become quite common, in cases
of croup.  The English seldom perform  it, and the United States-
ians still more rarely.
   BUBO.—A  venereal bubo is a swelling of one of the external
 glands of the  body.  It  usually appears either in  the groin, or
 under the arm.  It is produced by  the absorption of the virus of
 chancres and  syphilitic ulcers.  A bubo begins  with pain and
 soreness  in the  groin, succeeded by more  or  less swelling and
 hardness ; the swelling, at first, is not  larger  than a  bean,  but
 continues to increase in  size, until  it becomes as large  as a hen's
 egg, and sometimes, as  large  as a goose egg.  A bubo is gene-
 rally attended with a throbbing, deep redness of the skin, and
 painfulness, though,  sometimes,  there will not be much  acute
 pain.  In a short time, the swelling  maturates, and discharges a
 large quantity of pus; the pain,  redness, and soreness gradually
 disappear, and the sore heals.  Occasionally, a bubo will subside
 without  suppuration,  or  it will turn to a  scirrhus.  Care must 
102
BUB.
be taken not to mistake a bubo for other swellings which some-
times come in the groin, such as aneurism, rupture, and lumbar
abscess.  If the swelling has been preceded by the clap or chan-
cre we may pretty safely conclude that it  is a bubo ; or if the
swelling has began very small and gradually increased, a similar
conclusion  may be formed.   A bubo  is not commonly attended
with  much danger, unless the subject happens to  be of a bad
habit of body, when  it,  sometimes,  runs into a gangrenous
ulceration,  and spreads to a great extent into the adjoining flesh.
  The.  first object to be attended to in a bubo, is to endeavor to
disperse  it  by cooling  lotions, poultices  mixed with lead water,
and the application of four or five leeches.   Linen pledgets wet-
ted with lead water should be kept on during the day, and poul-
tices during the night.   A dose of salts  should be  taken, daily,
and a perspiration excited by the use of warm herb teas.  If the
swelling has not yet become red and  painful, the blue ointment
should be rubbed into the inside of the thigh, which, when  thor-
oughly  used,  will often prevent the tumor from proceeding to
suppuration.   A little mass of the  mercurial ointment, about the
size of a walnut,  should be  rubbed into the part, just under the
tumor, every night, until all  the hardness and swelling have gone
away.   If the use of the ointment should occasion any soreness
of the mouth, a gargle, made of borax, dissolved in warm water,
should be employed, three or four times a day, and a small dose of
oil, salts, aloes, or some gentle physic, should be taken, each  day,
to keep the bowels pretty well open.
  In  the meantime, two grains of the blue pill or of calomel,
should be  taken, daily, until the tumor is entirely dispersed, or
the abscess healed, or until a coppery taste is perceived in the
mouth.   If the salivation becomes severe, the ointment should be
lessened  in quantity, or entirely omitted for a few days.
  When the bubo has got to  be of such a size, that  it cannot be
dispersed, it should  be brought to a head, by the  use of warm
bread and milk, or flax-seed  poultices.  It should not be allowed
to break of itself,  but should be opened with a lancet.  If opened,
artificially,  it is apt to heal much better.   In scrofulous constitu-
tions, buboes are  sometimes  difficult to heal; the inflamation is
apt to spread, and to form ill-conditioned, and foul, spongy ulcers.
Such ulcers, should be  cleaned, two or three times a day, with a
decoction of the wild indigo  root; and poultices made of it, mix-
ed with rye meal, should be  worn every night.   A little calomel
or red precipitate, sprinkled upon the ulcer, will often set  it to
healing.  Where  it becomes  offensive to  the smell,  powdered
charcoal should be scattered  over the surface of it.   The consti-
tution at the same time, should  be strengthened with quinine
bitters, the mineral acids, and a nourishing diet.   Opium is often
found of essential benefit. 
BUR.
103
  BUBONOCELE.—This is a rupture of the groin, called ingui-
nal hernia.   In this  disease, the bowels protrude  through the
walls of the belly, at a point called the abdominal ring.  The
larger the opening is,  the safer the rupture will prove.  When
this accident happens, the  person should lie immediately upon
his back, and endeavor to push the bowels back.   It commonly
happens in consequence of leaping, falling, lifting, or straining the
body in that particular part.  See Rupture.
   BUCKTHORN.—This article  is commonly called the purging
buckthorn.   It is one of the  tallest kind of shrubs ;  growing of-
ten to the height of sixteen feet.   The berries are chiefly used in
medicine.   The celebrated Dr. Hewes, formerly  of this place,
was in the  practice of making a barrel of the buckthorn syrup,
every year.   He esteemed it one  of the best purgatives which
the earth affords.   It is a drastic purgative, and,  in dropsies,
rheumatism, affections of the skin, and suppressions of the month-
ly secretion, it is doubtless a good remedy.   Twenty of the fresh
berries prove a brisk  purgative.   The  berries have  a  nauseous,
bitter taste, and a disagreeable smell.   The buckthorn, is attended
with nausea, and a disagreeable dryness of the throat and mouth,
often with griping.
   The syrup of buckthorn  is an  excellent  medicine in the cure
of salt-rheum.   From one to four tea-spoonsful of the syrup should
be taken, for three days, and omitted for as many more, and then
taken again, for the same time, and continued for several weeks.
The eruption, at the  same time, should be anointed daily,  with
Turner's cerate.
   The dose for an adult, is a drachm of the dried berries, or two
drachms steeped in water.   The dose for a child, two  years old,
is eight grains of the  dried berries, or about  five of the  dried ber-
ries  steeped in water.
   The syrup of buckthorn,  is formed by boiling two pounds of
the juice of the  clean berries, with one pound of refined sugar,
until they are perfectly combined.  The dose of the  syrup is two
table-spoonsful, for an adult.  The dose for a child, two years old,
one tea-spoonful.
   BURDOCK.—This plant grows in rich places around the house,
and by the road side.   It has a very broad leaf, and  produces an
abundance of burs, which are apt to stick to  the clothes.  The
seeds have a bitterish, hot taste, and are, sometimes, given to pro-
mote the secretion of urine, in the quantity of a drachm, reduced
to powder or made into an emulsion.  They have been used in
rheumatic, gouty, and venereal disorders  instead of sarsaparilla.
The green leaves are thought to be  very cooling to the skinu
They excite a perspiration in the part to which they are applied,
and  lessen  the  heat.    The  root  made into a syrup,  has  been
highly recommended  for a cough. The burdock appears to have 
104
BUR.
 something of  the  nature  of  the squill.  It is laxative, diuretic,
 sudorific.  For this purpose, an ounce of the root should be boiled
 in a pint of water, and drank  at four or five different times.
   BURGUNDY PITCH.—This substance comes from Norway.
 It is the product of the common spruce fir tree, and is obtained
 by making incisions into the  trunk.   The pitch runs out  and is
 collected in vessels made for the purpose,   ft is boiled in a small
 quantity of water, strained, and set aside to cool.  It soon settles
 into a resin.   When Ghewed, it excites the saliva.  It melts easily
 by heat, and spread on  leather, makes an excellent plaster  for
 many local affections.
   We have great faith in pitch plasters, but to be of service, they
 must be large.   The  good effect  of pitch  plasters, are lost by
 making them too small.  In the case of a cough, if a plaster is
 made large enough to nearly cover the whole chest,  or the upper
 part of the back, it will often be of the greatest service, but if
 only a little patch is stuck on, it produces no benefit at all.   Jn
 the lumbago or rheumatism in the small of the back, a pitch plas-r
 ter, large enough to cover  that  part, will often cure the disease.
 In  soreness of  the flesh, and rheumatic pains,  a pitGh plaster is
 almost sure to  afford comfort.  Pitch is  warming, and  when
 spread upon pieces of leather or cloth, serves to retain the heat of
 the body.   By retaining the heat  of diseased parts, we often
 place them in a condition to heal or recover.  A pitGh plaster is a
 good  application to the stomachs of children  in  the whooping
 cough.
   BURNS.—Burns include all injuries produced upon the system,
 by heated bodies, whether  by hot  water,  hot iron, or  burning
 coals.  The injury done to  the part, by scalding water, is precise-
 ly of  the same  nature with that which is done by melted iron, or
 a coal  fire.   Some burns are so slight as to require but little or no
 attention.  Burns which raise  a blister, or remove  the skin, in
 general, require some kind of  medical treatment..   Burns do not
 appear to differ much from lacerated  wounds, where the flesh is
 torn and disorganized by other agents.  Fire or heat, in reality,
 tears asunder the texture of the flesh, very much as  it is torn by
 a nail, or any other solid body.  In slight burns, where the skin
 is not blistered  or pealed off, and the part affected is small in cir-
cumference, no fever  or constitutional  effect is produced;  the
 place  looks  red, and, for a short time, may be very painful', but
 the pain soon ceases, and no further inconvenience is felt.
  Domestic Remedies.—In slight cases, the  application  of cold
 or ice water, scraped potato, or a cold poultice, made  of sugar of
 lead water, will be all the local means necessary.  In young chil-
 dren, however,  which are very liable  to be  affected with convul-
 sions, it is always best to give them a little paregoric or laudanum
 In severer cases, where the place scalded or burned  is larger and 
                            BUR.                        105

deeper, and the skin blistered or pealed off, the best thing which
can be done,  is immediately to  cover the burn with a soft bread
poultice, made simply of white  bread and warm water; rye meal
or flaxseed meal, will answer nearly as well.  The poultice should
be blood warm, and as  soft as it can be made ;  and renewed as
often as it  grows at all hard.   Its  efficacy will  mainly depend
upon its frequent renewal.   Of the thousand  remedies which
have been recommended for burns, none will be found equal to
this  ; and be  the burn ever so large, the whole  space should be
covered in this  way.  The  solvent  power of a bread and water
poultice, made without  milk, oil, or any other greasy material,
is the greatest of  any substance which we have ever seen.  Oil
or grease, spread over a poultice, operates very much like oil or
grease applied alone ; it chokes up  the exhalent vessels, and con-
fines the heat.  Fomentation with warm water, answers the same
intention as a bread poultice, and if it could be constantly applied,
day  and night, perhaps it would even answer better than a poul-
tice.   Fresh  wounds, which often have a frightful appearance,
people are apt to  cover up, and not  to uncover them, for two or
three days, merely  because  it  is painful  to look at them.   We
fear  that this  kind of timidity,  has dictated much  of the absurd
practice which has  been followed in the  treatment of burns  and
scalds.  Burns  about the face,  neck, and body, are  much more
dangerous than they are  upon the limbs, especially the feet and
the hands.  It will be necessary, in  all  large, painful burns, to
take opiates immediately.   A dose  of laudanum,  or of morphine,
which perhaps is  preferable, should be given as often as once in
six or eight hours. In children, this recommendation should never
be forgotten.   When a  child  has fallen into the fire, or been
scalded with  a pot of boiling water, or burned by its  clothes  tak-
ing  fire, as soon  as the burning substances have been removed
from its body, a dose of laudanum, paragoric,  or morphine should
be the  first  thing  given.  Warm water  should then be sopped
upon the burned place, until a  poultice can be  made.   The pa-
tient should be kept comfortably warm, and no more.  The drinks
should be cool and the diet light.  The  bowels  should  be kept
open by castor oil,  salts,  or some mild physic, and the poultices
or fomentations constantly renewed.  Linseed oil  and cotton, or
sweet oil and cotton, are an application  much in vogue, but we
think the  bread  and water  poultice or fomentation  with pure
warm water, much better.   A liniment made of linseed oil  and
lime water, we  think  to be preferable to oil and cotton.   Some
physicians have   recommended the application  of  turpentine,
alcohol, and new rum, but they have not been generally adopted,
It is thought,  by many, that all  local  applications  ought to be
cold; but unless the burn be superficial,  the effect  of the cold
can be of no use in restoring  the part to its natural  state.
           14 
106
BUR.
  In the course of two or three days, after the burn has occurred,
the flesh begins to suppurate, or to throw off a large quantity of
yellowish matter,  which commonly covers the whole surface of
the ulcer.  Small granulations begin to form, and the healing pro-
cess commences.  In this  state of the burn, the poultices may
either be continued,  or a salve made of bees-wax and sweet  oil,
may be applied to  the sore.   The calamine ointment or  Turner's
cerate, will sometimes promote the  healing  better than the sim-
ple cerates.  If the sore is slow in healing, or if proud flesh forms
in it, it may be sprinkled over with burnt alum,  calamine pow-
der, or calomel.  If a foul ulcer takes place, the  sore should be
stimulated by sprinkling upon it a little red precipitate.   I n  the
worst kind of burns, peices of dead flesh will separate  from  the
living, and the ulceration extend not only very deep,  but very
wide, and a high fever, and inflammatory symptoms will  affect the
Whole system.   In such cases, it will be necessary to  give  the
sweet spirits of nitre,  the  rochelle powders,  and other cooling
medicines.   The ulcer  must be cleansed with a wash of wild
indigo root, or a solution of the pyroligneous acid.
  If,  after two  or three days, the inflammation of the  burn-
ed  surface should become  great,  the  pulse  forcible,  and  the
thirst,  and heat of the  system much  increased,  it may be  ad-
visable to draw a  little blood, although  we believe  it  will sel-
dom be  found  necessary.   Sudorifics of antimony, ipecac,  or
sal nitre, should be given, until  a moisture is excited  upon  the
skin, and the pulse is reduced.  The patient should be kept upon
a liquid, vegetable  diet,  and acidilated drinks, such as lemonade,
barberry and tamarind water.  In some burns, such will be  the
extent of the injury,  that the whole system  will appear to be
overcome with the violence of the shock.   In these cases, after
giving an opiate, it will be necessary  to administer wine, cam-
phor, ether, and  other carminatives and stimulants ;  this treat-
ment must be pursued, until the vital powers recover.   The pulse,
in bad burns, will  generally be small, weak, frequent, and some-
times vibratory.   In  burns, too, the breathing is apt to be affected
more than in other injuries  of the body.
  It is of the greatest  consequence; in deep burns, to assist  the
closing up of the wound by adhesive plasters.   The surrounding
skin and flesh, should be drawn as near together, as the  case will
admit of, and kept in this  state, until the new skin  has formed.
Where the strength of the patient begins to  fail, the system must
be supported with  wine, porter, quinine, and  a nourishing diet.
If several of the fingers or toes are burned, they should be sepa-
rated by a piece of linen cloth, spread with simple cerate, to pre-
vent their growing together ; and so with the eyelids and nostrils.
All those parts, which are liable to grow together, should be care-
fully separated.  If the  knee joint should  be likely to become 
CAL.
107
stiff,  the leg should be  straightened; and  if the elbow joint
should appear to be liable  to  the  same accident, the arm should
be bent, as it will be more convenient for the leg  to be straight,
and the arm to be bent, in case they become stiff.
  BUTTERNUT.—.There is no better  domestic purgative, for
common use, than the extract of butternut.   The extract is made
by  boiling the unripe fruit, or the inner bark of the butternut, in
water ;  straining the liquor, and  then  boiling it  down,  over  a
slow fire, to the consistence of honey.   When the extract cools,  it
settles into a black, thick mass, suitable to make into pills.  It  is
a mild, easy purgative, and leaves the  bowels in a natural state.
The ordinary dose of the extract, for a grown person, is from ten
to thirty grains.  Five or six pills of the common size, are a pro-
per dose.   A child two years old, may take five grains.
  The  extract of butternut, is very suitable for common costive-
ness; for pregnant women, and dysentery.   In the piles, there are
few remedies which succeed so well.  Mixed  with calomel, it  is
a good  remedy for bilious affections.  Equal parts  of calomel and
the extract of butternut, are scarcely inferior,as a purgative, to the
celebrated dose of calomel and jalap. .
                              C

   CACHEXIA.—A bad condition of the body, such as exists in
the  scurvy,  scrofula, dropsy, and several other diseases.   It is a
vitiation of the fluids and solids of the blood and the flesh.
   CAJAPUT OIL.—The cajaput, is a  highly  volatile oil, ob-
tained by a distillation of the leaves and fruit of the cajaput tree,
which grows in the East Indies.   The oil, has a green or yellow-
ish color, a fragrant odor, and an extremely hot, pungent taste.
It is a highly diffusible stimulant and  antispasmodic.  It is used
in palsy, chronic rheumatism, hysterics, and tympanites or air
swellings.  It is also applied externally, to relieve  violent pains
of the head and other parts.   In the cure of the toothache, it is a
potent remedy.   A dossil of lint, charged with two  three drops of
it, and placed in the cavity of the tooth, is often found effectual.
   Its dose, when taken internally, is three  or four drops in a spoon-
ful of water.
   CALCINATION.—/To convert bodies into powders, and ox-
ides, by  the  application of heat.  If a strong heat is applied to
lump magnesia, the carbonic acid gas is driven off, and  the sub-
stance is reduced to a fine white powder, called calcined magnesia.
A piece of lime stone, treated in the same way, becomes quick lime.
Iron, when reduced to a cinder, is calcined, or converted into an 
108
CAL.
  oxide or rust.  If bones are burned in a hot fire, they are con-
  verted into lime and phosphoric acid.   The acid flies off and the
  lime remains in the fire.
    CALAMINE—Carbonate of Zinc.—This is a natural ore, found
  in Wales, and several parts of Europe.  It  is of a dark red color,
  heavy, moderately hard, and brittle.   That which is obtained in
  the British Isle, is allowed by the best judges  to be superior to
  that of most  other countries.  It is a native carbonate  of zinc.
  It is found to be a valuable article of medicine.   It is purified by
  roasting it.  In its native state, it is  combined  with a small por-
  tion of arsenic and sulphur.  It comes  to us in  the shape of  a
  redish  colored  powder.  Combined  with simple cerate, it forms
  the celebrated Turner's cerate, one of the  best ointments in use
  for the piles, and several eruptions of the skin.   Dissolved in rose
  water, it makes an excellent wash for inflamed and sore eyes.  It
  is astringent and cooling.  The ointment made of it, is an excel-
  lent application to inflamed surfaces, and burnt or excoriated
 flesh.
   CALOMEL—Sub-muriate of Mercury.—This substance, the
 dread of some, and the admiration of others, is made of  quicksil-
 ver and  the  marine acid.   The marine acid is obtained from
 common  salt, and  the  quicksilver is  found a native ore in the
 earth.  When prepared for use, it is called sub-muriate of mer-
 cury, because an extra quantity  of mercury  is added to the muri-
 ate of mercury.   Calomel is a  yellowish white  powder, and  is
 mildly corrosive when  applied to the denuded surface in a suffi-
 cient quantity.  Properly used, it is one of the most healing sub-
 stances which has ever been invented  or discovered.  Its healing
 virtues  may easily be discovered by applying it to an unhealthy
 sore or ulcer, or to almost any eruption upon the skin. Its essen-
 tial  operation appears  to consist in promoting or increasing the
 secretions.  It increases the  secretion of the saliva to a very ex-
 traordinary degree, and where it produces no  ulceration of the
 throat and  mouth, it creates no fever.   Nor does it quicken the
 circulation of the  blood.   Whether it  increases all the other
 secretions in as great a degree as that  of the saliva it is difficult
 to determine.   The secretion of the bowels, and of the liver are
evidently very much increased ; and  probably that  of  the skin
and of the kidneys are  both increased at the same time   It is
pretty well determined that the  secretion of mucus in the lungs
and  windpipe,  is  increased whenever the salivary glands are

   When calomel is given in the small dose of one  grain, night
mTfT?'  f°u Several da^s in accession, a coppery, metallic
taste is felt in the mouth, and if continued beyond this, it will
produce redness and swelling of the gums  and fauces, soreness
and  finally white canker spots.   Its efficacy as a med cine  con! 
CAL.
109
sists in such a use  of it as to produce salivation without inflam-
mation and soreness of the mouth.  If skilfully and adroitly used,
it is a  charming medicine, but if misapplied and unskilfully used
it may do injury.   The fear and disapprobation of it which have
lately  been generated in the public mind, are entirely groundless.
We have, on our tables every day, and use, with great freedom,
a condiment which possesses nearly as active and dangerous pro-
perties as calomel, we mean common salt or the  muriate of soda,
and yet nobody exclaims against the abuse of salt.  Calomel is a
choice remedy, but it requires a nice sagacity and close  observa-
tion to know how and when to use it.
   In a dose of eight or ten grains it operates as a purgative,
and, often, in a much smaller dose.
   In affections of the skin, in the venereal disease, in the  liver
complaint, in many chronic inflammatory diseases, and in fevers,
it is employed to  create a new condition  of  the system,  and,
thereby, to shorten or cure the disease.  We have every reason
to  suppose, that, if its action can be extended to the  internal
organs, and we know that it  can to the throat, stomach,  and the
remaining part of the alimentary canal, it will operate in the same
way as when applied  to ulcerations and sores upon the surface of
the body.  But the difficulty lies  in giving the right quantity of
the medicine, when the  disease for which we give it is out of
sight.  If we never carry the effect  of the medicine beyond a
slight  increase  of the  saliva, or a coppery, metallic taste in the
mouth, we shall never do harm, and may often produce the  hap-
piest results.
  At one time,  calomel came well nigh being esteemed a  cure for
all  diseases, and was  given with  a  culpable  degree of freedom.
Nothing short of a very sore  mouth was a signal to discontinue
the use of  it.   It was seldom weighed, and nothing but the eye
determined the quantity for a dose.   Such an abuse of the  best
remedy which  has ever been discovered, would  ultimately bring
it into disrepute.
  Calomel is very diffusible.   Introduced  into  any part of the
system, its  effect is  soon communicated  to every other part.
Taken into the mouth, the substance  itself has been transmitted
through the skin.
  As a purgative, in many instances, it has no  superior.  There
are many cases, especially among children, where no  other  sub-
stance  can be made to stay upon the stomach.  The mere weight
or gravity of calomel, will often  retain it when everything  else
will be thrown up.
  The ordinary dose, when  used to change the condition of the
system, is for an adult,  one  grain, dispensed twice a day.   In
chronic diseases, and, in many acute  affections, we believe the
dose should be limited to half a  grain, once or twice  a day.  It 
110
CAM.
  may take  a  little  more time to excite the secretions, but  its
  effects will be  better  regulated and its corrosive operation more
  certainly avoided.
    A thousand  evils have  been  laid to this medicine, which it
  never produced. Many of the ordinary consequences of a fever
  for instance, we have  often heard, attributed to the use of calo-
  mel, such as  the loosening, decay, and loss of  the teeth, an in-
  creased tenderness of the  system, and a greater disposition  to
  take cold.  In the  venereal disease, the  medicine is used in the
  same way, and with even more freedom, without the production
  of any such effects.  During the dispensation of the medicine, the
  gums will often be red, tender and sore, but the teeth, we be-
  lieve, are very seldom  affected.
   Calomel is used as an alterative, as a purgative, as an ointment
  and as an external  application to  sores and ulcers.   As a purga-
  tive for a child, between one and three years old, the dose should
  be from three  to five grains.
   Calomel is used in combination with other purgatives, such as
 jalap, rheubarb, aloes, and butternut.   After taking several doses
 oi it, it is always best to follow it with a dose of castor oil, salts
 or an infusion  of senna and  manna.                          '
   CAMPHOR.—This  substance is a transparent, hard gum, ob-
 tained from a tree which grows in the island of Japan.  It exists
 in the wood of  the roots and branches of the camphor tree in
 distinct  grains.  The grains  of camphor are found  lodged in
 great abundance  in all the vacant  places in the tree.   The gum
 1«Z™6d-fl^distillation  .in ™  ^pure state, and  undergoes
 another purification  after it is transported to Europe.   The roots
 dLillfr7' ^!me' 'osemary» and marjoram  afford camphor by
 olant,   ?; • * 1S alS°  eXtmCted  fr0m many othe' ^ubs and
 plants.   It is a proximate principle of vegetables.
 taste   ft?, pv"  *a StTg' r^mg  smell, and an acrid, hot
 exposed totheJrm§ f r^' and S°°n l0Ses its virtues whe*
 exposed to the air.   It has an unctuous feel and burns with a
 very whlte fl      Watef wm not ^^^   butdltb~^th a

 m isL^wrthiz-Jt  comes to.us in  ia^  th-ryi
 sKi^;S£?r rum *can be reduced  to a p°wd-by




ram.     7     S    0Unce of camphor to a pint of alcohol or

thrTehep«sUby  weiZde„fbL'ritUfiDS °ne pa" °f CamPh°' ™">

  Camphor i5 very vivifying.  Eve„ thc 5mell of it wiU rdievc 
CAN.                        Ill
 faintness, and when taken into the stomach in the  dose of eight
 or  ten grains, it has still more effect in restoring the powers of
 life.   It is a diffusible stimulant, carminative, and  sedative.   In
 spasms, convulsions, hysterics, and  nervous affections, camphor
 is a powerful sedative.  In these  diseases,  it should be given in
 a dose of fifteen grains, every three or four hours.  Some physi-
 cians give it in still larger doses.  In small  doses, it has but little
 effect.  Camphor is given in typhus  fever,  and in all diseases of
 debility to  support the powers of life.  Taken in the ordinary
 dose of ten grains, repeated every  two or three hours, it will cure
 the most obstinate headache.  The tincture of camphor is an
 excellent external  application in pains and  soreness of the flesh
 and bones.   Applied to an inflammation upon the surface of the
 body, it will resolve it, in many instances, better than any other
 medicine.
   The dose of the gum for a child between one and  three years
 old, is from two to five grains.  A dose of  the spirits or tincture,
 from ten to fifteen drops.
   The spirit of camphor is an antispeptic.   It  has a  strong ten-
 dency to check mortification, both as a local application  and an
 internal remedy.   It will relieve strangury of the water, produced
 by blisters ; and  produce sleep in cases of violent pain and ner-
 vous distress.  It moderates the pulse, increases the perspiration,
 and composes the mind.   In healing many sores, and in rheuma-
 tic complaints and sprains, it is exceedingly balsamic.
   CANCER.—A cancer is a painful eating  ulcer.  Instead of
 thick, yellow matter,  it discharges a thin, watery,  acrid fluid.
 The edges of the sore  are generally hard, thickened, and  ex-
 tremely painful.   The flesh which surrounds the ulcer will often
 present the appearance of the teeth of a saw.  A cancerous sore
 or ulcer, is commonly attended with a fetid and offensive  smell
 and a disgustful  appearance.  It proceeds,  in general, from  scir-
 rhous tumors, warts, and other hardened swellings and pimples.
 The scirrhus from which it commonly proceeds, is a hard, irregu-
 lar lump which forms  under the skin, in the breasts  of women,
 and in the lips, testes and cheeks of both men and women.  Any
 part of the body may be the seat of cancer,  although the glandu-
 lar parts are the most  subject to it.   In men, it most commonly
 attacks the lips,  face, tongue, palate and testes.   In women, the
 breasts and  the  womb,  and  in children,   it  attacks the  eyes.
 Cancer is for the  most  part, a disease of  the old; the young  are
 rarely affected with it: seldom, if ever, does it make its appear-
 ance before  the  age of twenty-five.  When  a scirrhous tumor
upon the breasts,  for instance, is attended with a burning, shoot-
:ng pain, and the  skin  over it, has  become dusky, purple or livid,
 t has become a confirmed cancer.   The tumor sometimes grows
to a large size ; it has an irregular, knotty appearance, the nipple 
112
CAN.
 sinks in, and there are seen purple veins running in every direction
 over  it   Any little wart or pimple on the  face or other parts of
 the body, on becoming irritated, at particular periods of life, and
 in a particular state of the body, may become a cancer.  Scirrhous
 tumors do not always become cancerous ;  they will often lie dor-
 mant during the whole life of the  person.
   Just before a scirrhous tumor  breaks out into an open cancer,
 the skin around it will become contracted  and wrinkled, and its
 surface will  have  a black and blue  appearance.   After it becomes
 an open sore, and a thin, watery, eating fluid begins to run from
 it, the proud flesh will  rise up  above the skin  and often grow
into large excrescences.   The raw surface will  often  bleed and
look exceedingly angry.   The  pain at the same time increases,
and the patient grows thin.   In  some cancers, particularly of the
breasts, nearly all the glands  of the body will become affected.
 The skin and muscles for a considerable distance around the
cancer, will  become  hard,  stiff and contracted.  The axillary
glands and  the arms will swell and become stiff and hard, and
the whole body will partake of the disease.   Sometimes, there
will be sickness at the stomach  and a total loss of appetite, and
at other times, the appetite will  become  ravenous.   In some,
the progress of the  disease is rapid, and  in others, exceedingly
slow.
   Treatment.-—Almost the  only hope of a cure  in this disease is
 found in having it removed by the knife. This, in cancers of the lips,
tongue, and face,  will often effect a cure ;  but  in the breasts and
other large glands, the operation is not so  successful.   The  ope-
ration will, however, often  delay their progress  for a long  time.
The pain  must be relieved by opium or laudanum.   Laudanum
poultices will often produce perfect relief from the pain ; a watery
solution of opium is however  better than  laudanum for this pur-
pose.   The  cicuta and the belladonna will often accomplish the
same  or a better  purpose.   The  best external  applications are
carrot poultices, decoctions of hemlock, powdered charcoal, yeast
poultices, creosote, pyroligneous  acid, a solution  of arsenic, weak
solutions of the  chlorides of lime  or soda, a watery solution  of
opium, liquid tar, and washes  of sugar of lead and the sulphate
of zinc.  We have always found the powdered charcoal strowed
on, once a day, and washed  off with rain water, to be the  best
dressing we  have  ever employed.   It keeps the  ulcer sweet and
clean, and neutralizes the acrimonious  discharge.   ,
  Cancers are sometimes extirpated by the actual cautery, and
by caustic potash, lunar caustic, the mineral acids, verdigris, red
precipitate, and blue vitriol.   One  of the  best caustics in use is
composed of one  ounce of corrosive sublimate,  one third of an
ounce of opium powdered, and sulphuric acid enough to make it
into a thin paste.   A small quantity to be applied daily. 
CAN.                        113
  A vegetable diet and a strictly temperate life will tend greatly
to delay the progress of the disease.  The most essential change
which can be produced in the constitution, is by a change of the
aliment.   Every alimentary article  which aggravates inflamma-
tion, in general, will aggravate the condition of a cancer, and on
the contrary, every species of food which  resolves and abates  in-
flammation, will ameliorate  the  condition of a cancer.  All salt
food,  and stimulating things of every kind aggravate the disease.
In a word, the  drink should be water, and the aliment  fresh and
wholesome vegetables.
  It is of the greatest importance that all hard and warty tumors
upon the body, and, especially upon the  face and  neck, should
not be cut  or wounded in any way.  Many a little  hard bunch
under the skin, by irritating it, has become a cancer, when, if it
had been left  alone, would have lain  dormant for life.  Warts,
and other hard  and knotty growths upon the face and other  parts,
whenever they become unsightly, should be covered constantly
with  a plaster  of white diachylon, or which  is better, the lead
plaster known by  the  name of Lord  Noel's leaden  plaster, it
having  once cured  that  nobleman of  a cancerous tumor.  In
shaving, particular care should always be taken  not to wound a
warty, hard excrescence.
   The  rose cancer, or fungus hematodes, assumes a variety of
forms, and  attacks all those parts which are the seat of the true
cancer.   In the commencement of it, it is only a soft  tumor or
swelling of a part, very elastic to the feel and often very painful.
When it ulcerates, it spreads out into a form which resembles  a
red rose, rises  considerably above the surrounding  surface,  and
presents a large mass of bloody fungus or sponge-like substance.
It is  very apt to bleed, and always  presents an unsightly appear-
ance. The same remedies which are employed in the treatment
of the true cancer, are employed in the cure of this.  We believe
the charcoal in a fine impalpable powder, strewed over it  every
day after it ulcerates, is the best  application which can be  made
to it.  It should be often washed with warm rain water, and if
ointments are  used for dressings, they should be of the mildest
and  most simple  kind.   When a cancer  bleeds  excessively, the
bleeding should be restrained by the liquor of sugar of lead,  or a
powder  of  the same.   Alum, sulphate of zinc,  and creosote, all
have a similar effect.   Sometimes the application of lint will be
sufficient to check the hemorrhage.  A removal of this distemper
by the  knife, in  its early stage, is  the  only remedy upon which
reliance can be placed.  Other means are often tried, but  the
highest  and most  reliable medical authority decides in favor of
 the extirpation of the disease by the knife.  The host  of cancer
 remedies which are vended under different names, are, in general,
            15 
114
CAN.
 the inventions  of  extremely weak and  ignorant  people, with
 whom observation and experience are never a guide.
   CANINE MADNESS—Hydrophobia.—The  dog,  when  he
 first begins to show signs of madness, is stupid, surly, and snap-
 pish.  He looks dull, hangs his head and  tail, and eats nothing
 for several days.  He  then begins to pant,  breathe  short and
 laboriously, and  to  loll his tongue  out of his mouth.   He froths
 at the mouth, runs about from  distress, and bites at every body
 that comes in his way.   He often  leaves home, and runs off for
 many  miles.  He becomes more furious the longer the disease is
 upon him, and his bite grows more infectious.   It was formerly
 supposed  that every animal which he bit, became mad, but this
 is ascertained not to be  the case.   It is only  man  and the dog
 kind that appear very liable to take the infection by the bite.
   After a person has been bitten by a mad dog, it is generally
 thirty  or forty   days  before  he   becomes  affected  with the
 disease.   The bitten part first  becomes painful, and then the
 whole system begins to be affected.  The person is uneasy and
 listless, cannot sleep; sighs ; and wants to be left  alone.   The
 bitten  part becomes  hard  and elevated, and pains begin to  shoot
 from it along up to the throat.   There is a constant sensation of
 choking, and the greatest horror at the sight of  water, probably
 on  account of some  difficulty in swallowing a liquid  substance.
 The patient can  swallow solid food, but no liquids.  Spasms and
 tremors  agitate  the whole system.   He  is thirsty, but cannot
 drink.  He starts back at  the very  name of water.
  When a person has been  bitten by a mad dog, the part bitten
 should be immediately cut out.  The treatment of this disease
 when it has commenced, is somewhat obscure, as no one remedy
 has ever been found to afford much relief, much less a cure. We
 should say that leeches applied to the throat, succeeded by bread
 poultices  mixed  with  laudanum,  were the best topical means
 which could be   used.   After being bitten, Dr.  Cullen, recom-
 mends immediate salivation with  mercury as  the best hope  of
 neutralizing the  poison in  the  blood, before it affects the system
 Large  doses of opium and the warm bath should be used  after
 the madness has  commenced.  Musk, camphor  and castor, in this
as in other spasmodic diseases, will  be proper.   Arsenic has  been
 said to be efficacious in the cure of canine madness.  Various
other medicines have been said to cure the disease, but they have
not been  found  so  on a second trial.  It is siirl tw 1 ~
affected whh hydrophobia, rarely, if ever   os    hi  l^s "Z




tlhr.y  thousand, inhabn/nts, .C^  to?  beeT Z*Z 
CAN.                        115
 case, and that  happened  about fifty years ago ;  and we presume
 that the hydrophobia does not occur oftener, in proportion to the
 number of inhabitants,  in  other  places.  The actual  danger,
 therefore, of having the  hydrophobia, is  not a twentieth part so
 great as of being struck with lightning, about which people have,
 comparatively, but very little concern.
   In conclusion, we will  repeat the precaution of having the bit-
 ten part removed  by the  knife as soon as possible after the acci-
 dent has happened ; and where it is impossible to have this done,
 to have the blood sucked out by the  mouth or cupping glasses ;
 to wash the bite thoroughly with warm water or salt and water;
 and, afterwards, to apply two or three leeches every day, for five
 or six days, in  succession.  .
    CANKER — Thrush,   .Aptha,   Stomatitis.— Notwithstand-
 ing the very prevalent use of the word Canker in New England,
 the  term  is seldom used by medical authors.  We are  not
 aware that it  is met  with  in this sense in European works,
 either ancient  or modern.   Thrush is  the term by which this
 class of diseases of the  mucous membranes is  extensively and
 generally designated.  This  want  of uniformity in the use  of
 these terms has given  rise to some  confusion in  popular medical
 language.  It  is not unusual  for a physician practising here, who
 has  studied his profession abroad, to be sadly  at a loss to un-
 derstand  his  patients  when  they  ask  him the very common
 question, hav'nt I got the  canker? or,  what  is good  for the
 canker  ?  It is a term which is  in everybody's  mouth, but  no
 body can define it, and we  may venture to say that  there are
 few, if  any, subjects connected with the medical  art, upon which
 the views of medical men even,  are more vague and  indefinite
 than  that  under consideration.   It ;is by individual experience
 only, that the  physician makes himself familiar with canker as it
 prevails in New England.
  There are several varieties of  this disease, all of which have
 some symptoms in common, but which  differ  considerably in
 others, and in the circumstances under which they are developed.
 They are all vesicular in  their forming stage, bearing a resem-
 blance  to vesicular diseases  of the skin ; they  affect  the same
 membranes or  textures,  and  are prone to  run  into  superficial
ulcerations after the rupture  of the vesicles; but the length of
 time which they run, the  conditions of the system giving rise to
them, their prognosis, etc., differ  sufficiently to  entitle them to
the character of distinct varieties, requiring  corresponding modi-
fications in the treatment.   In order, however, to present  the
subject  in as clear and practical a view as the present state of our
knowledge will permit, it  will be necessary to consider the most
common and important varieties separately.
  Variety first.   Canker of infants, Aptha Infantum.—This affec- 
116
CAN.
 tion is peculiar to early infancy.  It is commonly called baby's
 sore mouth.   Tt generally makes its appearance in the course of
 the second or third week.  The eruption appears first on the un-
 der lip and angles of the mouth in very minute roundish vesicles,
 or blisters, which soon become very numerous, spread, and often
 run together so as to cover the whole lining surface of the mouth
 with a whitish  crust.  In the course of a few days these little
 vesicles  burst, or  the  fluid which they contain is absorbed,  and
 the delicate membrane, called the epithelium, which covers them
 is broken up and loosened.  The mouth and tongue at this time
 have the appearance of being covered with a thin layer of curdled
 milk.  When the disease is  severe, this crust is of a brownish
 color, and extends over every part of the mouth and throat.   In
 the course of a few days this curdly, and often stringy matter, is
 completely separated and cast off, leaving the mouth and tongue
 somewhat reder than  natural, but it is  usual  for two  or three
 successive crops of the eruption to come on and run through a
 similar  course before  the child  entirely recovers.   The child
 slavers  and is embarrassed in sucking ; it  betrays signs of pain
 and general indisposition.  This disease extends to the stomach
 and bowels, the discharges are acrid and greenish, and the break is
 excoriated.   Previous to the appearance  of  the eruption,  the
 stomach and bowels are more or less deranged, and a disposition
 to sleep is so constant a premonitory symptom, that nurses  fre-
 quently observe  " that the child is  sleeping for a sore  mouth."
 As to the cause of this disease but little  is known: it comes on
 spontaneously like many other diseases of children, and probably
 affects the same  child but once.   There is no  evidence that it is
 contagious.  The eruption or efflorescence, perhaps, is symptoma-
 tic of a constitutional affection peculiar to this period of  life, and
 bears the same relation to it as the eruption in measles, chicken-
 pox, etc., does to those disorders.   It may be an effort of nature
 to throw off  some morbific matter,  the nature of which is  not
 known.
   Remedies.—Like  many other diseases, especially the erup-
 tive, this  disease  appears to be self-limited, and not sufficiently
 under the control of medicine to prevent it from running a deter-
 minate course, though something  may be  done  to  palliate  the
 most distressing symptoms.  A consideration of the first  impor-
 tance in every stage of the complaint, is the state of the stomach
 and bowels, a deranged condition of  which constitutes one of its
 most essential characters.   Should the bowels be costive  or  the
discharges green or otherwise unnatural, minute doses of calcined
magnesia, super  carbonate  soda and rheubarb, castor oil sweet
oil,  or some other mild physic should be given every day or two
until the  bowels are corrected.  Physicians often give for  this
purpose, very minute doses of calomel and  prepared chalk  and 
CAN.
117
calomel and  rheubarb, with  excellent effect.  After these have
had a moderate  operation and all offensive and irritating  matters
have been  removed, should the bowels be loose and griped, the
chalk  mixture will be  found one of the best  remedies.   The
super carbonate  of soda in a weak infusion of aniseed or catmint
with or without the addition of a drop or two of paragoric as the
case may require, is a valuable  medicine in correcting the  dis-
charges and quieting the child.  A great variety of local applica-
tions is in  repute both among physicians and nurses, a very few
of which are of the least possible advantage ;  in fact, it is a mat-
ter of doubt whether the great proportion of  them are not  deci-
dedly injurious.   To hurry off the sloughs by harsh  astringents
and  stimulants, as  is frequently done, will do nothing  towards
bringing the disease to a crisis, and  by leaving the parts naked
and exquisitely sensitive, the sufferings of the child will be aggra-
vated and another crop of the eruption will be more likely to be
produced than if the case had been left to nature.   In the  early
stage of the  disease the only local applications necessary are the
mucilages  of gum arabic, flaxseed, or slippery elm ; these, by
being frequently applied, will have a soothing effect, and make
the little patient more comfortable while kind nature is curing
the  disease.
   In the second stage, some  mild  astringents  may be serviceable
in promoting a healthy action  in the diseased  membrane, and
restoring it to its natural  condition.  Among those best adapted
to this purpose are a weak solution of borax or alum, in water
sweetened with honey or molasses ; infusion of red raspberry or
rose  leaves,  or a weak decoction of  marsh rosemary or sage wil-
low roots.  Small  quantities of these may be applied by means
of a small soft  swab, or tipped  into the  mouth with a teaspoon.
If an unnecessary large Quantity is not used, no danger will arise
from swallowing either of the above medicines.
  CANKER OF NURSING WOMEN—Aphtha Lactea.—Variety
second.  The technical term, aptha lactea, has, by  some authors,
been  applied to the first variety, the  canker of infants, but as
that  disease  attacks those infants that do not nurse as well as
those that enjoy this  inestimable privilege, that is  evidently a
misapplication of the term,and we have ventured without authority
to apply it to this variety.   It is true, indeed, that  the canker of
nursing women may be perpetuated after  the secretion of milk
has  ceased, but it will, we think, be admitted by every one at all
conversant with the subject, that it invariably makes its first ap-
pearance when  the system is in a condition to furnish this secre-
tion, that is, while the  woman is nursing, or in the  latter months
of pregnancy.   Admitting  this,  and the well established  fact,
that  to put a stop to this secretion by weaning, is  the surest and
sometimes the  only remedy for  the disease, the  conclusion is 
118
CAN.
unavoidable that this condition of the system is necessary to its
development, and, therefore, that  the term is appropriate in this
sense.   Having had occasion several  years since to examine  the
standard medical authorities upon this subject, in the preparation
of a dissertation read before the Medical Society  of this State, we
found  that this variety was not distinctly referred to by any one
to which we had access.  This circumstance, and  the fact that
according to our observations, this disease has been  gradually
growing more prevalent in the course of the  last twenty-five
years, have led to the inference that it is of comparatively modern
origin.  If it has always, or for a long time existed, it must have
been limited to certain countries or climates, and unaccountably
have escaped that close observation and investigation which have
been bestowed upon most other diseases, and,  have been con-
founded with  other  forms of  the  disease) a supposition that is
hardly admissible.
  The duration of this kind of canker is unlimited, a cure seldom
taking  place spontaneously, except after the weaning.  Its  ten*
dency is to undermine the constitution ; and if allowed to go on
a great  length of time and a diarrhea supervene, a state of disease
and consequent emaciation and exhaustion will  be  induced  that
will defy  all  remedies.  Though   ordinarily confined  to  the
mouth,  stomach, and  intestinal canal> every portion of the mu-
cous  membrane is obnoxious  to  its attacks.  The  windpipe,
lungs, vagina, urethra, are sometimes affected by it.  When the
windpipe  is affected,  it  is accompanied with a very troublesome
strangling  cough.   The first symptom that is observed in many
cases, is a burning sensation  in the  esophagus or stomach after
taking 'hot or acrid drinks  and food,  This symptom often  in-
creases in severity, so that in a short time  the mildest liquids and
food produce uneasiness and pain.   In tile meantime, the mouth
and throat become more or less thickly covered with small white
vesicles or blisters, having hard and inflamed  bases, which soon
burst,  leaving  circumscribed, superficial  ulcers with inflamed
edges.   These  ulcers are exquisitely sensitive, and sometimes
painful.  Their  number varies exceedingly, there being in some
cases  not more  than two  or  three ;  but  in  others, the  mouth,
tongue, and throat are almost entirely covered by them, and the
inflammation and swelling are so great that the whole face has a
bloated appearance.  There is an unusual  secretion of saliva and
acrid fluids into the mouth, causing a constant  desire to hawk
and spit, or to swallow, either of  which is an extremely painful
operation:  the   taste is depraved,  and the  appetite  impaired.
Though the above is the ordinary course of the disease, there
is no certainty as to  the part that will first be affected.  When
the mouth  is first attacked it often creeps down into the stomach
or lungs j and its presence may be suspected in the bowels when 
CAN.                         H9
there is unusual tenderness and a disordered condition of those
organs.  When the urinary organs are affected, there is a frequent
desire  to  urinate, which  is attended with  a scalding pain and
smarting,  and it probably often produces the disease called pruri-
tus.  Mild cases will sometimes  run on for weeks  or  months
until  the  child is weaned, as a matter  of  course, without pro-
ducing  any  serious  consequences, but in  those  that are more
severe, the painful and disordered state of the mouth and stomach
prevent a sufficient quantity of food from being taken and digest-
ed to sustain the system, emaciation goes on rapidly, an irritative
fever ensues, a diarrhea sets in and  the  patient is exhausted  by
sleepless  nights  and comfortless  days.  Notwithstanding, how-
ever, the  inroads made upon the mother's constitution, the child
may thrive as well as it would at the breast of the most healthy
woman—showing that the milk is not deteriorated by the disease,
but  rather that this  secretion abstracts  from the  blood its nutria
tious and conservative properties.   Like most diseases to which
the human body is subject, this puts on a considerable variety of
appearances.   The  ulcerations, though  usually distinct  and cir-
cumscribed,  are  by  no means uniformly so.  We frequently  see
the mouth and tongue of a uniform  glossy red color, resembling
what is observed in some cases of typhus fever, without any  apr
 pearance  of ulceration, or any previous blistering having been
 observed.
   Remedies.^As we  have  no standard authority to which to
 refer upon the subject of the treatment of this form of can-
 ker, every physician treats it according to his own  views of its
 nature; and  as would be expected, under these circumstances,
 perhaps there are no two who  treat  it exactly alike.  The plan
 of treatment here recommended, is founded principally upon per-
 sonal  experience, and partly upon the suggestions of others, and
 it is believed to be the most successful  heretofore proposed.   In
 some  cases  in which the secretions are acrid, and the stomach
 disordered, a gentle emetic of ipecac, white vitriol, alum, lobelia,
 or thoroughwort will have a beneficial effect in restoring a healthy
 action to the stomach; it will afford temporary relief, and prepare
 the system for other remedies.  The  emetic may be repeated
 from time to time if the case  prove obstinate.  After the opera-
 tion of the  emetics, should it be  thought necessary  to give  one,
 small doses of rheubarb and  super carbonate of soda or calcined
 magnesia, should  be given,  two or three times a day, in mo-
 lasses  or honey.   Small doses of  six or eight grains  each of
 the soda and rheubarb, repeated  several  times  a day, are pre-
 ferable to  larger doses  less  frequently repeated, as this medi-
 cine  appears to have a favorable  effect as a local  application
 to the diseased surfaces, as well as in correcting the stomach
 and bowels.   Active purgatives, and especially senna1,  are  un- 
120
CAN.
 necessary and injurious, but  the  doses of the  rheubarb  and
 soda may be  increased if the  bowels continue  costive, or a
 small dose of castor oil, or some other mild cathartic  occasion-
 ally administered.  An infusion of red raspberry or rose leaves,
 or a decoction of blackberry roots, may be taken as freely as com-
 mon drinks.
   Where the mouth is  very raw and sensitive, the patient will
 derive great  comfort from the free  use of gum water, mucilage
 of  slippery elm, flaxseed, etc.; by  forming a kind  of coating,
 they protect  the  inflamed  parts from the contact of the air and
 other irritants, and  thereby contribute to the cure.
  An important indication in the treatment of  this disease, is to
 promote cicatrization or healing of the diseased  surfaces, and thus
 restore the membranes to their  natural, healthy action.  For this
 purpose, perhaps there is no medicine equal to the creosote.  We
 have given this article in this  complaint and  others, somewhat
 extensively, for many years,  and notwithstanding  the popular
 opinion to the contrary, believe it to  be a perfectly safe medicine
 when given in a proper manner.  The use of it is not incompati-
 ble with the course above prescribed.  In order to  obtain  the
 best effects from creosote, it should be mixed in its  undiluted
 state with a thick mucilage of gum arabic and loaf sugar, in the
 proportion of twelve drops to the ounce ; of  this a desert spoon-
ful  is to be taken three or four times a day.  It should be held
 in the mouth for a moment in such a manner as to come in con-
 tact with the ulcerated surfaces, and then swallowed.   The burn-
ing occasioned by it may be rather severe for a  few minutes, but
for this  the patient is fully compensated by the  easing and sooth-
ing effects which  almost  immediately follow.  The lunar caustic,
nitrate of silver, is another medicine of inestimable value for this
 purpose.  In cases  of long standing, and especially if there be
diarrhea, we  know  of no substitute  for it.   The form in which
 we have usually given it, is that of  pills composed of one-third
of a grain of  the caustic, one and a half grains  of rheubarb, and
three-fourths of a  grain of opium ; one of these pills maybe taken
three or four times a day; and the good effects will be increased,
when the mouth is very sore,  by allowing some of them to par-
 tially dissolve in the mouth before being swallowed.   This sub-
 stance may be used in solution either by itself,  or with the addi-
 tion  of  a few drops of laudanum to each dose, both  as a local
application and a general  remedy.  Among the many other medi-
 cines that have been tried in  these  cases, the  one perhaps the
 most worthy of notice is  a very weak preparation of the chloride
 ol soda.  The dose of this medicine is from fifteen (o twenty-
 hye  drops  in a cupful of water,  repeated several times a day.
 When used as a local application, only to the mouth and throat
 the same quantity may be put into half of the above quantity of 
CAN.
121
water.  By frequently washing the mouth with this, the condi-
tion  of the ulcers  will  generally be improved in a few days.
White vitriol, alum, borax, marsh rosemary, sage willow,  gold
thread, green  tea, and various other astringents, are in popular
use as local applications,  and they may occasionally be beneficial,
and  as they are  harmless in their nature,  should  be tried when
the remedies heretofore  recommended are  not successful or can-
not be readily obtained.   The diet should be easy of digestion,
nutritious, and free from all irritating qualities.  The best arti-
cles are rice, buckwheat, rye,  tapioca, arrow-root,  soda  crackers,
etc.   If any meat be eaten, that which  is tender  and free  from
oil, and not highly seasoned, should be preferred.
   Exercise in the open  air, traveling, and such other  means as
are calculated to improve the  general health and strength of the
system, will materially aid  the good effects of medicines.   We
believe this kind of canker curable in a great proportion of cases,
by a  well regulated course of treatment,  without weaning the
child  prematurely ;  but  should  all other means fail,  and the
woman's  constitution  appear  to be  suffering irreparable injury,
this  measure must be adopted.   After removing  the cause, the
disease will yield much more readily to remedies, or will be cured
spontaneously, if it have not  been permitted to run so long as to
destroy the constitution.
   Variety Third.—Common Canker—Aptha Communis—Aptha
Acuta—(Inflammatory Canker.)—Nothing  is more common than
for persons of all ages, and  both sexes, to be  troubled with soli-
tary ulcers upon the tongue, inside of the lips and cheeks, which
remain a few days  and then disappear  spontaneously, without
any notable derangement of  the  general health.   These  ulcers
are preceded by small vesicles or  blisters,  which,  not being very
sensitive, are  unobserved until they break  and ulceration begins.
Ordinarily, this  affection is  of but little importance, requiring no
other treatment than the application of a little alum, borax, white
or blue vitriol, or lunar caustic;  but it sometimes happens, espe-
cially with children, during the first and  second  dentition, that
the ulcerations are extensive,  and the inflammation is so great as
to produce a very troublesome  disease. There is considerable swel-
ling, exquisite tenderness,  preventing any  kind  of food  from
being taken;  the breath is  offensive, and  the  mouth constantly
filled with saliva, which is  constantly running out  for the want
of ability to dispose of it in the ordinary manner.
   Remedies.—As a disordered state of  the stomach is probably
the  most  frequent cause of  this affection,  it will be  proper to
commence the treatment with an emetic of ipecac or white vitriol,
and  after  this to give a  dose  of rhubarb and calcined magnesia,
or epsom salts, every day or  two until  the inflammation is sub-
dued.   Should  it be suspected  that the  irritation  of  worms is
            16 
122
CAN.
 the cause, a dose of pink root, or worm seed, may be administer-
 ed in conjunction with the  above medicines.  When  occurring
 during  dentition,  and attended with a disordered state  of  the
 bowels, as is often the case, after the operation of a dose of rhu-
 barb and magnesia, the chalk mixture, with the addition of a few
 drops of  laudanum, will  be found a valuable remedy.   While
 there is much inflammation and  the mouth very sensitive,  the
 best local applications are the mucilages of gum arabic, slippery
 elm, and flax-seed, but after the tenderness has subsided in some
 measure, the ulcerated surfaces may be touched with a solution
 of lunar caustic, or  blue vitriol; and a wash or  gargle of  white
 vitriol, alum, borax,  chloride of soda, green tea, or some  of  the
 astringents recommended in the  other varieties, be frequently
 used.   The greatest attention should be  paid to the diet, as im-
 proprieties in  diet, are undoubtedly one of the  principal  causes
 which produce in the system a predisposition  to the disease.   If
 the child  nurse, it should not be fed  at all, and if  it have been
 weaned, only the  mildest kinds  of farinaceous  food should be
 given.  This  form of thrush is said sometimes to prevail epidem-
 ically among  children,  "and has also been known to rage in
 hospitals devoted to young children."
  Fourth Variety.—Chronic Canker—Chronic  Thrush—Aptha
 Chronica.—The term chronic thrush  has  been used not only to
 designate  the variety of canker here  intended to be treated  of,
 but several other varieties, though there is no one from which it
 does not  essentially differ in some of its characters.  This is
 always the concomitant or consequence of some  chronic disease
 which is undermining the general health,  and the almost certain
 tendency of which is, sooner or later, to destroy the life of the
 patient.   It is sometimes difficult to determine which is the pri-
mary affection, the thrush or the concomitant disease.  We wit-
nessed a case of this kind several years ago, in a gentleman who
 had died of chronic diarrhea of  many years standing.   Upon ex-
 amination, the lining membrane of the duodenum, second stomach,
 which was enormously enlarged, and other portions of the ali-
 mentary canal, it was found almost entirely destroyed by ulce-
rations.    The body was extremely emaciated,  and death had
undoubtedly been caused by the  destruction of the membrane
 having  prevented a sufficient quantity of  nutriment from being
 taken up by the lacteals and conveyed into the blood, to sustain
life; but which was the primary disease, the canker or diarrhea,
 could not be determined.
 hwleryrhi0n °f lJe mUC0US memDr*ne is liable to be attacked
 attracted ^?rnrw°f  '^ '* bUt the  attention is §euerally first
 attracted to it by its appearance in the mouth.  Numerous small
vesicles or blisters, at first distinct, but afterwards coalescing cov
enng in some instances the entire surface of the mouth and throat. 
CAR.                        123
In the course of a few days these vesicles rupture, and the broken
and loosened membrane which covered them, give to the  parts
affected, the appearance of being covered with a ragged layer of
curdy matter.   After a short time, this matter sloughs off, leaving
the parts naked and of a deep flesh color, and is again and again
reproduced in the same manner.   Generally speaking, the sensi-
bility of the  mouth, in this  state, is  not  as  great  as might be
expected, as it frequently happens that the patient  can take any
kind  of food or drink without inconvenience  from this cause,
though  the reverse of  this is sometimes the case.   The  appear-
ances of the  disease are by no means uniform; it varies in its
symptoms and severity.  It sometimes comes on suddenly and at
others slowly and  insidiously.  Sometimes it makes its appear-
ance but a few days before death, and at others many weeks or
months.  All chronic  diseases are liable, and in fact generally
are, attended with this kind of parasitic  affection, in their last stage.
Consumption, diseases  of the liver, kidneys, heart, and especially
chronic diseases of the  bowels, seldom terminate before this dread
omen shows itself.  It were vain to attempt the cure of this form
of canker except we  could cure  the  disease upon which it de-
pends;  but it  may be  palliated, and the patient rendered  more
comfortable by the use of the same means that have been recom-
mended in the other varieties.
  CANKER RASH—Scarlet Fever.—See Scarlet Fever.
  CARBON—Charcoal.—To obtain  carbon  pure, wood should
be charred, in an iron retort;  but pure charcoal, burned in a  pit, if
dry, and procured from maple, birch, oak, alder, or chestnut wood,
will answer  for medical purposes.  Taken  internally, in a fine
powder, it checks putrefaction of the stomach, bowels, and of the
solids and fluids, generally.   Dose, a table-spoonful.
  CARBONIC ACID.—This acid is commonly observed in the
form of gas.  It can be made by burning charcoal.  It is a combina-
tion of charcoal, and the oxygen of the air.  No animal can breathe
this gas, nor will it support combustion.  The most common way
of making this gas or acid, is to pour oil of vitriol upon pounded
marble.   The  oil of vitriol, unites with one  part of the marble,
and forms a new substance, called sulphate of lime, and the car-
bonic acid gas, which composes  the  other  part of the marble,
flies off, and may be caught in bottles or glass receivers.  Water
absorbs this gas, which makes it slightly sour.   In this state, it
is sold in  soda  fonts, mixed with the lemon syrup, and syrups of
various other fruits.  In soda water, beer, and champaigne wine,
it is the escape of this gas, that produces the foaming.  This gas,
although so obnoxious to the lungs, is friendly to the stomach.
Like  the  other acids, it is  cooling,  tonic,  and febrifuge.  In
cases of mortification of the  bowels, it is an object to administer
as much of it as possible, as it is a great corrector of putrefaction. 
124
CAR.
The carbonic  acid gas, is contained in yeast and emptings;  and
in this form  is often  given in those  diseases, which tend to pu-
trescency.   The soda and rochelle powders let loose abundance
of it.  In marble and  many other solid substances, this gas or air
exists  in a solid state, but  expands into  air, as soon as the sub-
stance with which it is united, combines with some other ele-
ment.  The other element, which composes marble is lime, hence
when  the oil of vitriol is poured upon it, the vitriolic acid com-
bines with the lime and forms the plaster of paris.
  CARBUNCLE—Black Boil—Anthrax.—A carbuncle is a hard,
painful, dark  red, oval tumor, resembling a common boil.  It is
preceded by a  pain in the part where it is about to take place, and
a swelling of considerable hardness.   The surface  soon assumes
a livid redness, and a spongy feel; a white discharge takes place
through a  number  of little orifices,  formed in the  tubercle; a
black core  appears in  the centre ; and a fetid smell gives intima-
tions of dead matter beneath the surface.   The discharge resem-
bles whey with atoms of curd in it.
  There  is considerable commotion of the whole  system, pros-
tration of strength; sickness; loathing of food; headache;  and
other symptoms, of a  low, febrile character.  In the worst cases,
there is syncope, delirium, and extieme anxiety.
  Carbuncles most commonly appear on the face, neck, and back,
and are very frequent  in warm climates, where the plague is most
prevalent.  In our climate, it  is not often fatal, especially if the
size and situation  of the tumor are favorable.
  It is in vain to attempt to disperse the tumor ; emollient poul-
tices and fomentations must  be used in the beginning.  Rye or
flax-seed  meal, mixed with the strong tea of the white poppy
heads,  or lettuce leaves, makes the most  suitable  poultice.   In
this affection, the strength must be supported with camphor, ether,
opium, quinine, fresh air, and a nutritious diet.   The bowels
must be  moved with mild cathartics, and everything  done to
tranquilize the system.   A tea-spoonful  of Hoffman's  anodyne
liquor,  and a table-spoonful of valerian tea may be  given, every
two hours.
  A crucial incision should be made into the tumor, to assist the
escape  of the dead  core, and every means used to destroy the ac-
rimony of the discharge.
  CARDIAC  ORIFICE.—The upper orifice of the  stomach,
where the meat-pipe terminates.  The lower opening of the stom-
ach is called the pylorus.
  CARDIALGIA—Heart-Burn.—It is a painful, though not very
dangerous affection  of the stomach, denoted by a burning sensa-
tion, pain, sour eructations, a discharge of a ropy, watery fluid
upward, and sometimes faintness, inclination to vomit, and a
heavy load at the  pit of the stomach.   See Heart-Burn 
CAS.
125
  CARDITIS—Inflammation of  the heart.   See Inflammation
of the heart.
  CARIES—Ulceration  of the bones.—This disease is known
by a deep seated pain which is felt to proceed from the bone.  There
will be a tenderness to the  touch ; a swelling of the bone, or  the
periosteum, a transparent  membrane which covers it ;  a loose and
flabby feel to the flesh;  and a dark or purple color of the skin.
When the bone is laid bare, it appears  like any other ulcerated
part.  The dead part of the bone, will  often separate from  the
portion which is alive, and make  its way to the surface through
the flesh and skin.  Dr.  Good mentions a case, where the tibia
or  shin bone of each leg, mortified, and came out in  pieces,
through its whole extent,  and its place supplied by a callous,
which in process of time, became as hard as a bone.  The treat-
ment  of this disease,  consists  in  laying open the bone,  and in
keeping up a free passage, by means of  lint plugs, covered with
salve, for the exit of the dead parts, and in counteracting the inflam-
mation by antiphlogistics. Poultices made of the liquor of the wild
indigo root, are probably the best applications which can be made,to
a caries of the bone. The pyroligneous acid and the creosote have
sometimes been employed to stimulate  the  dying parts.  The
general strength should be carefully supported in these cases by a
nourishing aliment, and,  sometimes, by the use of wine, quinine,
and of 'Other tonics and  stimulants.  The powdered  charcoal is
sometimes sprinkled upon the diseased bone to correct the fetor,
and prevent the  extension of the disease.  The  chlorides  of lime
and of soda, have the  property, in a peculiar degree, of removing
the offensive smell arising from diseased  and  dead  parts,  and
may assist in arresting the  progress of this disease.  The disease
is caused by  wounds,  blows, and a bad condition of the body.
  CARMINATIVE.—A  medicine which allays  pain and expels
wind  from the stomach and bowels. The essences of peppermint,
cinnamon, tansy, tincture  of  camphor,  spirits  of red lavender,
ether,  ginger, red  pepper,  mustard,  gin,  cardamom,  caraway,
and anise seeds, are the most common and efficacious carminatives.
  CASCARILLA.—This  bark is taken from a tree,  growing in
the Bahama Islands, which grows to the height of about  twenty
feet.  It comes to us in curled pieces, rolled up into short quills,
about an inch in length.   It is a pure bitter and tonic ; less liable
fo produce disturbance of the stomach and bowels than the peru-
vian bark.  The cascarilla, in powder,  in a dose of  from ten to
thirty grains, administered every four, or  six hours, has been found
extremely serviceable  in chronic diseases of the stomach and bow-
els, typhus fever, and  many other diseases of weakness.   Its  vir-
tues are extracted partially by hot water, and  entirely by new
rum.  The cascarilla has  less astringency than most other bitters.
  CASEINE—The chief  constituent of milk.—It  is identical 
126
CAS.
 in composition with fibrine and albumen, the chief constituents of
 blood.   It  is found in  plants,  such as peas, beans, and lentils.
 Vegetable, and animal caseine, are ascertained to be the same in
 all their properties.   Caseine is not coagulated by heat, and is much
 more soluble than either fibrine  or albumen.   It contains a much
 larger proportion of the earth of bones than blood, and in a more
 soluble form.  It is the chief principle of nourishment of all young
 animals who live on milk.   Animal  caseine contains, by analysis,
 fifty-four parts, in a hundred, of carbon, seven of hydrogen, fifteen
 of nitrogen, and twenty-two of oxygen and sulphur.  The vege-
 table caseine contains the same elements.   Fibrine and albumen
 contain almost exactly the same proportions of carbon, hydrogen,
 nitrogen, oxygen and sulphur.  Gelatine, a fourth constituent of
 animal matter, contains nearly the same chemical elements, and
 in the same proportions.  The vegetable fibrine, albumen, caseine,
 and  gelatine, taken into the stomach, in  our food, probably  go
 without any essential change, into the formation of the fibrine,
 albumen, caseine, and gelatine of the body.
   CASTOR  OIL—Oleum  Ricini.—This  oil is comparatively a
 modern  discovery.   It is not prescribed in the old authors upon
 medicine.   It is pressed from the seeds of the palma christa, a
 plant which grows in the  West Indies and southern states.  The
 plant'or tree grows to the height of fifteen or twenty feet.  The
 seeds are of the size of small  beans.  They have brittle shells,
 which contain white kernels of a sweet, oily, nauseous taste. The
 skin has a burning taste, and one or  two of the seeds swallowed
 whole, operate as a purgative and emetic.
  The  kernels,  yield a fourth  part of their weight in oil.  One
 method of  obtaining the oil, is, to  shell the seeds and boil  them
 in water ; and as the oil rises,  to skim it off.   The other method
 is to put the kernels into bags, and  these  bags into a press, and
 apply a screw or weight in the same manner as is used to obtain
 the linseed oil.   The oil obtained in this way, is called the cold
 expressed oil, and is thought to keep much  better than that which
 is obtained  by the agency of  heat.  The  cold expressed  oil is
 white and clear ; castor oil, obtained by boiling the beans, is of
 a reddish color.
  The  castor oil is a safe, mild, thorough, sure  purgative.  Its
 taste is'somewhat nauseous, but it excites a motion of the  bowels,
 the nearest  to the natural,  peristalic motion, of  any purgative
 which has ever been discovered.  It often insinuates itself through
 the obstructed portions of the  bowels better  than more powerful
 purgatives.
  The proper dose for a grown person, is one  ounce, or two table-
spoonfuls.  The dose for an infant, a small tea-spoonful
  In  the disorders of the  bowels, such as dysentery, diarrhea,
and cholera morbus, the castor  oil is a charming remedy   In the 
CAT.
127
bowel complaints of children, mixed with a few drops of laudanum,
it has produced more cures, than all other remedies put together.
It appears to soothe the inflamed surface of the intestines, while
it inspires a motion.   In some instances, the castor oil cannot be
so well retained upon  the stomach as other  purgatives ; in such
cases, the medicine should not be urged.  To swallow it easily,
it  should be slightly warmed  by mixing it with a spoonful  of
warm water or  milk.   The thinner it is made, the  easier it can
be swallowed.  A tea-spoonful of molasses, or a spoonful of orange
juice, are as good as anything to take after it.   Two or three drops
of the essence of peppermint, will, sometimes make it set better
upon the stomach, and take the nauseous taste from  the mouth.
   In cases of rupture, where the bowels  protrude  through  the
walls of the belly, the castor oil is a very safe medicine to take.
It disentangles the involved portions without the danger of forcing
a passage, as it readily returns by the stomach, where the obstruc-
tion is complete.
   The castor oil is  never  employed in any other way, than as a
purgative, although its virtues may be applicable to other purposes.
A tea-spoonful  of castor oil, mixed  with  a  tea-spoonful of the
syrup of squills, is one  of the best medicines which we have ever
used in the coughs, colds, and sore throats of children.
   CATAPLASM—A Poultice.—White bread, rye meal, and flax-
 seed meal, make the  best  poultices  for inflammation.  These
 substances are often mixed with watery solutions of sugar of lead,
 white vitriol, and alum, to make  them more cooling and discu-
 tient.  In painful ulcers, such as cancers, a drachm of  the hem-
 lock leaves boiled  in a quart of  water, until it  is  reduced  to a
 pint, and mixed with  flax-seed meal, makes an excellent poultice
 for easing pain and destroying acrimony.
   CATARACT.—This is a disease of the crystalline  lens of the
 eye, or of  its capsule.   The lens, or its capsule, changes from a
 transparent to a perfectly white, or grey color ; and, in some rare
 instances, to a  black  color.  The opacity begins by  degrees, in
 small white spots, and  gradually involves the whole lens or cap-
 sule.   There is little or no pain, and seldom  any derangement of
 the health.  The lens sometimes become dissolved, or converted
 into a milky fluid.  The  blindness increases in proportion to the
 opacity.
   This affection, where the optic nerve remains sound, is often
 cured  by  extracting, depressing, or breaking up the lens.
   CATARRH.—Catarrh is, sometimes, a chronic disease, attend-
 ed  with a dropping or trickling of an acrid, watery matter, from
 the posterior nares into the throat.  This is  the  affection which
 most commonly goes  under the name of catarrh.   It  is attended
 with a continued hawking and raising, and,  in many people, ex-
 ists the whole  year round, but is particularly aggravated in  the 
12S
CAU.
fall and beginning of winter.   There is more or less of a cough,
which is generally troublesome in the fore part of the night.  In
some  cases, it will throw the person into a fever, and put on the
semblance of consumption, but is not apt to end fatally, unless
the person is advanced  in life.
  A person affected with chronic catarrh must be warmly clothed,
avoid all exposures to  sudden  and  intense  cold,  dampness, and
wet  feet.  When  the  affection becomes  aggravated, he should
take an emetic of  ipecac, follow an abstemious course of living,
and confine himself to a warm room.   In ordinary cases, a pill of
opium and  ipecac, one  grain of each, taken  at night, for a week
or fortnight, ensures  relief.  The fine powder of  bayberry root,
taken as a snuff, has helped many people.  Smoking tobacco is a
relief to some.   The removal to a warm  climate  is a pretty cer-
tain cure of the disease.  It is the consequence of the  epidemic
influenza and repeated colds.   In some cases, it is a family com-
plaint.  Dry feet, warm clothing, moderation  in eating and drink-
ing, and a particular caution in getting over-heated, and then go-
ing out into the cold air, will do much to ward off the complaint.
On looking into the throat, in this complaint, there is redness and
a thickening of the lining membrane, with the secretion of a pus-
like matter.   A gargle, of white vitriol dissolved in water, is well
adapted to this state of the throat.  See Influenza.
  CATECHU.—This  substance, is an extract obtained from the
inner  wood of a tree, which  grows in Japan.  It is one of  the
most powerful astringents, which the vegetable kingdom affords.
The color of it is a dark  brown, it is brittle,  hard, and  reducible
to a fine powder.   There are two kinds of the catechu, the one
is of a light yellowish brown  color, and the  other a dark brown
color.   It appears  to be a resinous substance, although obtained
by decoction.
  The  catechu is almost entirely soluble in hot water, and in
alcohol.  It is given to stop hemorrhages or bleedings, from the
bowels, bladder, stomach, and  womb ; to check  diarrheas, and
to strengthen the tone of the diseased organs.  In the canker, it
is used as a gargle, and drank in the form of  tea.  It is commonly
taken in powder, in a dose of  from fifteen to thirty grains.   To
a child, two years  old,  three grains may be given.
  In the monthly sickness of females, where  the menstrual secre-
tion is profuse, fifteen grains of the powder, taken three times a
day, dissolved in hot water, is an efficacious remedy.  In all cases
of a relaxation or weakened state of the flesh  and vascular system,
the catechu may be taken with advantage.
  CATHARTIC.—Any medicine which increases the motion of
the bowels and the number of alvine discharges, such as castor
oil, salts, aloes, rhubarb, magnesia, jalap, butternut, and sulphur.
  CAUSTIC.—A caustic  is a substance which eats,  or  corrodes 
CHA.
129
the flesh and solid parts of the body.  The aneients used a hot
iron, but the moderns employ corrosive substances.
  The most powerful caustics are crude potash, nitrate of silver,
aqua fortis, oil of vitriol, and the marine acid.  The mild caus-
tics, are red precipitate, alum,  calomel, and blue vitriol.   See

  CELANDINE,  THE  GREATER—Chelidonium Major.—
This plant grows in meadows and low wet places.  It is known
in some places, by the name of tetterwort.   It rises two or three
feet in height; has a multitude of tender, round, green, watery
stalks, with large joints; the leaves are large, with edges like the
teeth of a saw, and very tender; the flowers are yellow, succeeded
by  long pods which are very  brittle.  The leaves and the roots
are used for medicine.  They have a faint, unpleasant smell, and
a bitter, acrid, durable taste, which is  stronger in the roots than
in the leaves.  They are opening and diuretic, and useful in the
jaundice, when unaccompanied with inflammation.  Of the dried
root,  from half a drachm to a drachm, is a dose.  The root or
leaves,  green, steeped in water,  may be taken in the dose of half
an  ounce of the tea, or a table-spoonful.  Diluted with milk, the
fresh juice is used to destroy films in the eyes.  The clear juice
is said to kill warts.   A tea made of the fresh root, is often used in
the cure of dropsy, and affections of the skin,  such as tetter and
other running sores.
   CELLULAR MEMBRANE.—This membrane, is a thin, trans-
parent plate or sheet of  fibrous matter, which is involved in every
part of the body.   The cells  or little bags in this membrane, con-
tain  the fat or adipose substance.   It is  this  membrane  that
butchers blow up to improve the looks of their veal.  It is a tis-
sue of cells, variously connected together.  It makes a bed for the
muscles and bones, encloses them all, and unites them one to the
other.  In chronic  diseases,  where emaciation takes place, the
cells  of this membrane  are emptied of their fat, as the cells in a
honeycomb are  emptied by bees in winter.
   CENTUARY, AMERICAN.—The flowering  heads, are the
part  of this plant which is used in medicine.   The common
American centuary, has a bitter taste, and an aromatic smell.  It
is a tonic of no  inferior qualities.   It is often given in remittent
and intermittent fevers, instead of quinine  or the peruvian bark.
The  red centuary is said to be  a powerful medicine in promoting
the menstrual discharge  of females.   It is  used in the form of a
tea, taken in copious draughts,  several times a day.
    CHALK.—This substance  is composed  of lime and carbonic
acid  gas,  or choke  damp.  By the action of heat, the gas is
 driven off and  the lime remains.  Marble and chalk are  the
same substance, though they differ very much  in hardness and
outward appearance.  The white chalk is  the kind employed in
               17 
130
CHA.
 medicine.  In  its native  state,  it is mixed with sand and clay,
 from which it is freed by grinding in a mortar, and washing.   It
 is then called prepared chalk.  It is employed to neutralize acids
 or sourness in the stomach.  As an absorbent in looseness of the
 bowels it is deemed an excellent medicine.   For this purpose, it
 should be taken  in  powder in the dose of  a drachm.  A child,
 two years old, may take eight  grains.  Mixed with water, sweet-
 ened with loaf sugar, and seasoned with a few drops of the essence
 of cinnamon, it makes a palatable medicine to correct the sour-
 ness in the bowel complaint of children.
  CH ALYLEATE.—This name is applied to all those medicines
 of which iron composes a part.   The chief preparations of iron,
 to which it refers, are the rust of iron, the muriate of iron, cop-
 peras or sulphate  of iron, and the  mineral waters  which  contain
 iron in solution, such as the Ballston and Saratoga water.  Any
 mineral water which abounds with iron, is called a chalybeate.
  CHAMOMILE FLOWERS.—The  chamomile is a perennial
 plant,  indigenous to  the south  of England, but cultivated in gar-
 dens for the purposes of medicine.   It  is a mild bitter,  suitable
 for children and weak stomachs in general.   A strong tea, made
 of the chamomile, will excite vomiting, and is often used to assist
 the effect of other emetics.  In the  chronic  stages  of diarrhea,
 dysentery, and other  complaints of the bowels, the chamomile tea
 is a useful tonic.  It  is much used in nervous  diseases,  and the
 complaints of women.  The flowers may either be chewed or made
 into  a tea.   Half a tumbler of the tea should be drank three or
 four times a day,  where it is used to promote the appetite and the
 strength.
  CHANCRE—Syphilitic Ulcer—Venereal Ulcer.—A chancre, is
 a small sore produced upon the surface of the body, generally upon
 the genital  organs, by the  venereal infection, received by a pro-
 miscuous intercourse between the sexes.   It first appears in the
 form of a small red pimple, which afterwards ulcerates and spreads
 into an open sore.  After the pimple breaks  and becomes a sore,
there is commonly a  hard rim  formed around it, as if to prevent
 its spreading any  further.  A chancre, often resembles a pustule
 of the small pox or the cow pox ; it will  be  as  circular,  and the
edges of it as hard; and rise up  above the surrounding  surface
like a vaccine pock.   Commonly, several of these venereal pocks
will make their appearance at once, upon the part which have re-
 ceived  the infection.   The organs of generation in both sexes, are
 the principal  seat of chancres, as it is there, "that the infectious
 matter is applied.  Chancres will sometimes be irregular, ragged
 sores;  and, in this form, appear to spread with greater rapidity.
 The contaminated part will often swell, become red and extremely
 sore.   The surface of the pock or ulcer, will, in the first instance, 
CHI.                         131
be covered with a white coat or little white blister, but afterwards
discharges a yellowish matter.
  Chancres, commonly appear, about  five or six days after the
infection,  but, sometimes, not  until the lapse  of two or three
weeks.  Some have supposed the  infectious matter  which pro-
duces chancres to be different from that which produces the clap,
but most of the medical profession regard it as identically the same.
   The first  application which should  be made to a chancre or a
venereal ulcer upon  the genitals, is a wash  of white  vitriol.  A
rag, wet with this liquor, should be kept on, constantly, for the
first twenty-four  hours, after which, the pimples or ulcers should
be covered with the red precipitate or  calomel,  and washed off,
once a day, with the liquor of sugar of lead.  This course should
be pursued, until the ulcers are completely healed.  A solution of
the corrosive sublimate, in alcohol or new rum, applied as a wash,
will often heal the ulcers.  Eight grains of the corrosive subli-
mate to eight ounces of alcohol will make a wash as  strong as it
should be used.
  Where the foreskin cannot be drawn back from the glands, on
account of the swelling and inflammation, it will be necessary to
use soft warm water.  In some  obstinate cases, an incision must
be made in the prepuce, which will allow it to retract, so that the
ulcers on the glands can be washed, and dressed with the precip-
itate or calomel.
  At the same time that the chancres  are dressed with mercurial
preparations, it will be necessary to take mercury internally. Two
grains of calomel, in a powder or pill, should be taken, every day,
for a week, when it will be  advisable to stop three or four days,
and begin  again, and so continue it, until the ulcers  are healed.
What is called the blue pill, may be used in the  same  dose as the
calomel, if this form of mercury should be preferred.  In some
cases, a solution of the corrosive sublimate,  in spirits,  is taken in-
ternally.  Not more, however,  than an eighth of  a grain of the
sublimate should ever be  taken at a  time.    Four grains of the
corrosive  sublimate  may be dissolved in four ounces of spirits,
and of  this, a tea-spoonful may  be taken twice a day.   But, in
whatever form the mercury is used, it  should never be continued
long enough to salivate.   The effect is entirely unnecessary ;  on
the first perception of a coppery taste in  the mouth, the murcury
should be suspended until this taste has entirely gone.
  CHEST—Thorax.—The chest is divided from the belly or
abdomen  by the midriff.   This cavity, contains the lights or
lungs, heart, thymus gland, meat-pipe, thoracic  duct, part of the
aorta, eighth pair  of nerves, and a part  of several large veins.
It is divided into  two parts by a membranous partition, called the
mediastinum.  In breathing, this cavity expands and contracts.
  CHI.QKEN-POX—Variocella.—The eruption of the chicken 
132                        CHI.
pox, resembles that of the small pox, and is, sometimes, mistaken
for it.   But the pustules of the chicken pox, never contain matter,
like those of the small pox ; when punctured, they emit nothing
but a watery fluid.  The chicken pox, is contagious, like the small
pox, and like that disease, is never experienced but once in a
person's life. This distemper begins with a slight illness, seldom
amounting to a severe fever, and ends in five or six days.  There
is some sense of chilliness ; a slight increase of heat; thirst; head-
ache ; and pain in the back ; a quick pulse; and some degree of rest-
lessness.  On the second or third day of the illness, the pustules will
be filled with a watery fluid, and by the fifth, begin to dry away.
The pustules are commonly smaller than those of the small pox,
more pointed, and fewer in number. Although, when we have noth-
ing but the pustules to determine  by,  we may mistake a case of
chicken pox, for  one of the small pox, yet, if we have noticed the
early appearance of the pustules, in the chicken pox, the slightness
or total  absence  of fever,  the watery contents of the pustules,
and their drying away by the fifth day, we need not to be at a
loss to decide upon the nature of the  disease.  Medicines, in this
distemper, are, in general, quite unnecessary.  The most that will
be required, will  be a dose or two of the rochelle powders ; a lit-
tle ipecac in grain doses, or a solution of nitre to abate the fever.
The drink should be cold, and the  diet light.  There  is another
distemper, which somewhat resemble this, called the swine pox,
but which seldom requires the aid of medicine.   The swine pox
is not so common as the chicken pox, and the pustules are more
irregular.
  CHILD-BED  FEVER—Puerperal Fever.—It is  needless to
say,  that this fever is peculiar to women.   Generally, though not
universally, it attacks women after the birth of a child.   It is com-
monly, an infiamatory fever, though, sometimes, it is a malignant
or typhus fever.   Its course is generally short, and the commotion
of the system, during its continuance, great.
  The time of its appearance after delivery, corresponds, in gen-
eral, very nearly with the appearance of the milk; and some have
considered it a consequence of the commencement  of  that secre-
tion.   About the third or fourth day after child-birth,  is the usual
time of its  development.   From all the evidence derived from
observation, and dissections after death, the fever arises from an
inflammation of the womb, and the neighboring organs and parts •
the bowels ; the  peritoneum ; liver ; omentum j bladder, and kid-
neys, but especially, and primarily, the uterus  or womb.
   The common forerunner or harbinger of this disease  is a shiver-
ing fit, the degree and duration of which, show the danger of the
coming fever.  This is succeeded by a hot, dry skin; thirst: rest-
lessness; a quick  hard, and small pulse; disturbance of the stomach
and  bowels; and finally by a profuse sweat, which is  sometimes 
CHI.
133
critical, or carries off the fever.   In some cases, the patient never
recovers from the cold fit, but remains sunken ; oppressed in body
and mind ; and dies within twenty-four hours of the attack.   In
some cases, the puerperal fever commences without a shivering fit.
  In addition to a forcible, quick pulse, there is a tenderness, sore-
ness, and often pain in the region of the womb ; the belly is swel-
led ; the show or lochia  is generally stopped or much diminished ;
there is sickness of the stomach, and  a  vomiting of  a green or
yellow fluid; the milk dries away; the  patient cannot move
without  pain in the  abdomen ;  the tongue becomes furred;  the
bowels are affected with a constant instinct to go to stool without
a discharge; and the patient entertains the strongest apprehensions
of her own danger.
   The pain, and tenderness in the abdomen ; the suppression of
the secretions ; the cold fit; and the subsequent heat and sweating,
are the chief signs of the disease.
   The signs of inflammation in the abdomen, and the fever con-
tinue for a few days,  and are succeeded  by indications of putrid-
ity.  A black,  gummy coat, covers the inside of the lips ; purple
spots appear upon the cheeks and skin; the stomach refuses every
species of nourishment, and a twitching  of  the muscles, and hic-
cups, forbode a speedy termination of the disease, in death.   The
favorable signs, are a return of the lochia ; a warm, moist sweat ;
a reduction of the swelling of the belly by  the discharges from
the bowels ; the return of sleep ; and a subsidence  of the gene-
ral commotion of the system.
   An early delirium, is always  a  bad sign.  If an erysipelatous
tumor, of a dusky red color, about the size  of  a ninepence, ap-
pears upon  the knuckles, wrists, elbows, knees, or ancles, it is al-
most always a mortal sign.
   In many cases, a foundation for the puerperal fever appears to
be laid before  child-birth, or during labor.   The later its attack
after child-birth, the  more hope there is of a favorable termination.
   Domestic Remedies.   The first object is to determine whether
 the fever is of the typhoid,  malignant kind, or the inflammatory
 kind, of puerperal fever.  In the typhoid kind, the pulse is quick,
 but weak and small.   In the inflammatory kind, it is quick, full,
 hard, and strong ; the heat is greater; the pain in the belly more
 acute, and the prostration of the powers of the body and mind,
 much less than in the typhoid puerperal fever.
    Almost the only things which can be done, in this disease, with-
 out the  aid of a physician, are to administer an injection of warm
 molasses and  water ; to  foment the bowels  with warm water or
 brandy ; to give warm aromatic and carminitive drinks, such as
 peppermint and tansy tea, balm and pennyroyal, during the cold
 fit • together with a dose of castor oil,  or a rochelle powder, and
 to make warm applications to the feet and legs. 
134
CHI.
   Professional Remedies.—In the inflammatory puerperal fever,
blood-letting is the main remedy.   In the typhoid puerperal fever,
wine whey, quinine, cordials, gentle doses of castor oil, magnesia,
or salts • brandy, applied to the belly ; camphor, Hoffman's ano-
dyne liquor, acetate of armonia, the hot  drops or tincture of red
pepper, and chicken broth,  or barley gruel, are the proper means
to be used.
   The cold fit should be shortened, by applying warmth to the
surface of the body, and the administration of warm drink.  If
the pulse  is forcible, the heat above the natural standard, and the
pain in the abdomen, constant and severe, the patient should be
bled from the arm immediately on the  accession of the fever;
care being taken to distinguish it from the milk fever, and an in-
flammation of the breasts, which sometimes produce considerable
disturbance in the system.  If the first bleeding does  not subdue
the disease, a second, and a third,  may be necessary.   There is
no disease where this remedy is more  indispensable ;  but it must
always be employed in the earliest stage of the disease ;  if pos-
poned  until the disease  has reached  its  height, it will only do
mischief.   The  quantity of blood drawn must be graduated by
the strength of the disease and the violence of the  symptoms.
The tartrite of antimony in solution, in the dose of a quarter of a
grain, once an hour, should be given until a moisture is produced
upon the skin, and the bowels loosened.   If there is  nausea and
vomiting,  an emetic of ipecac will be  proper, in any stage of the
disease before the powers  of life are entirely prostrated.   The
bowels should be  drained, by a dose  of castor oil,  salts, mag-
nesia,  or  some  other  active purgative.   At night,  if  the  pain
and restlessness, prevent sleep, an opiate should be given.  Mor-
phine,  or the dover's powder, are, in general, more suitable than
laudanum or opium.
  In mild cases, the use of leeches will be preferable to  letting
blood from the arm.   And, even in severe cases, leeches may be
employed  to reduce the inflammation.                  %
  After the vehemence of  the fever has abated, a large blister to
the abdomen should be applied.  To assist and continue the secre-
tions by the skin and kidneys, the sal nitre, in six grain doses, should
be given, every three hours; or in its place, a tea-spoonful of the
sweet spirits of nitre.  Warm injections of molasses  and water,
or a solution of the gum ajabic, will assist in assuaging  the inflam-
mation of the abdominal viscera.
  The acetate of ammonia, in a state of effervesence,  is a charm-
ing remedy, whether it is made of the lemon juice  and  the  salts
of hartshorn, or of the distilled vinegar and that salt.
  Where there is not a looseness in the bowels,  they should be
daily drained by some purgative. 
C1IL.
135
  The stomach should be kept pretty well replenished with bar-
ley gruel, milk and water, bread water, or arrow-root gruel.
  The abdomen should be well fomented or steamed with heated
water or alcohol.   A flannel covered with the volatile liniment, is
sometimes found serviceable.
  The typhoid puerperal fever, like the typhoid pneumonia, de-
mands a mild, stimulating treatment.  The bowels must be moved
by gentle doses of physic, or injections ; the secretions of the skin
and kidneys, assisted by the use of the acetate of ammonia; and
the vital powers supported with wine whey,  quinine, columbo,
wine and cordials.  Blood-letting is improper, and  all reduction
of the system dangerous.
  This  fever, in some seasons, is  either epidemic or contagious.
It has once appeared in this city, to an alarming extent among
lying-in women, within the last seven years.   Dr. Francis, of New
York, relates an instance of its prevalence in the state of New
Jersey, when it was supposed that it was carried from one woman
to another by the accouchers  themselves.
  In conclusion, we must add,  that, in this formidable disease,
very much depends upon good nursing, and a comfortable situation.
A prompt, careful, sensible nurse, is almost the sine qua non of a
cure.
  CHILD-BIRTH.—For the managment necessary in the birth
of a child, see Midwifery.
  CHILBLAIN—Fernio.—The chilblains  are inflammations  of
the fingers, toes, and heels, in consequence  of being frost-bitten,
or exposed to a great degree of cold.   Snow water produces them.
The skin will be red, thickened, and painful.   An incessant itch-
ing, is,  however,  the most troublesome symptom.  Where the
degree of cold has been great, and  the  exposure to it long con-
tinued, the parts will mortify  and slough off.
  The parts that have once been frost-bitten, or injured by cold,
should afterwards be kept warm and dry.  Treading or standing
in snow water, renews the inflammation, and increases the itching.
  The parts should be washed in laudanum, to allay the itching,
and afterwards covered with plasters of diachylon.   If the inflam-
mation is deep, poultices should be employed.  In common cases,
lead water, and the solution of white  vitriol, will be found of the
most service.  New rum will  sometimes prove a good discutient.
Alum water,  well  applied, will cure them.   The calamine oint-
ment, is  also an  excellent  dressing.   But  the main point, is  to
avoid the cold and the  snow water, which produce  them.   If
ulcerations are formed,  they must be poulticed with  rye  meal,
mixed with the liquor of the wild indigo root, boiled.   The pow-
der of calomel,  where there is a slowness in healing, may be
strewed on the ulcers.
  CHLORIDE OF  LIME.—The bleaching gas or acid, called 
136
CHO.
chlorine, combined with lime, forms the chloride of lime.   Dis-
solved in water, it is one of the best correctors of putrefaction and
contagion.   A little of the solution is poured into  saucers, set in
different parts of the room, in cases of the small pox,  asiatic cholera,
typhus fevers and other contagious disorders, and allowed to evapo-
rate.   It will destroy the smell of putrid sores, and  of dead bodies.
Eight  or ten drops of the solution, in a wine-glass of water, makes
a useful gargle in the putrid sore throat.   The same dose, swal-
lowed, will correct a fetid breath.
  CHLORIDE  OF  SODA—This  substance  is composed  of
chlorine and  the alkali, called soda.   It is soluble  in water, and
principally used to correct contagions  and to destroy the smell in
putrid  diseases.   It is sold in bottles.  A few spoonsful of it pour-
ed into saucers and left to  evaporate  in a sick room, very soon
destroy all the bad  smells.  Its  properties  are very much like
those of chloride of lime, and may be used in its  place.  It cor-
rects the fetor of the breath, in a dose of eight  or  ten drops, in a
little water, and makes a good wash to destroy the smell of the
perspiration.  It is used as a gargle in the sore  throat.
  CHOLEIC ACID.—One  of the constituents of bile.  This
acid in combination with soda,  forms the principal part  of bile;
the combination is called choleate  of  soda.
  CHOLERA, ASIATIC.—This appalling disease originated in
Hindostan, and traveled progressively northward until it reached
the north of Russia ; then it took a course southward  and west-
ward, traveled through Poland, Prussia, Austria, the North of Ger-
many, and took up its abode for a while in Great Britain.   It finally
traveled across the Atlantic ocean, touched Canada severely and
New England lightly,  and visited in turn, all our  large cities  in
the middle,  southern,  and  western States.  In traveling from
Hindostan to the United States it took a period of fifteen years.
In traveling from Russia to this country it took a period of three
years.  It never went  further south  on this continent  than the
Havana in Cuba, and Campeachy on the Spanish Main.  It visit-
ed all  the  cities of Asia before it turned its course north.  It
commenced in IS 17, in the Delta of the Ganges, a  hundred miles
north of Calcutta.
  The Asiatic cholera commenced much in the same way as the
cholera morbus ;  with vomiting and purging, though, in general,
with more prostration of the strength.  The disease seemed  to
differ from the cholera morbus in the  same way that the typhoid
pneumonia differs from the common pneumonic inflammation__
in a malignant  condition of the  whole  system.   After a few
hours sickness, the eyes sunk into the head ; the  body became
cold ; the pulse  quick, but scarcely perceptible to  the feel ; vio-
lent cramps seized the muscles, especially of the legs and abdo-
men ; the skin  became purple and shrunk j  and the evacuations 
CHO.
137
from the stomach and bowels, instead of being of a bilious color,
resembled rice water, or the chyle itself.  There was not always
vomiting ; in some instances, a diarrhea constituted the only dis-
turbance of the alimentary canal.
  On dissection,  no very high degree of inflammation was ever
found ;  the  blood vessels were found engorged, and the mucous
membrane of  the intestines, red.   The same kind of  rice water
substance discharged before death, was  present in the small intes-
tines after death.
  No mode of treatment was ever found very successful, and it
still remains in doubt whether the disease was only an epidemic,
or propagated  by contagion.
  On the  first appearance of the  griping pains, however,  the pa-
tient should take a moderate dose of some kind of  physic ; and
perhaps the best would be rheubarb, or  rheubarb and senna
steeped with annis or some other kind  of aromatic seeds, sweet-
ened with loaf sugar ;  and a small quantity of brandy or some
kind of essence  added.   This should be repeated every  four
hours until it  produce a decided  operation on the  bowels, which
can be  known by the  change in the evacuations.   They will
contain more  fecal matter, and be more highly tinged with  bile.
After the  physic has had its effect, that is, produced from two to
four evacuations, should the disturbance continue, a full dose of
laudanum should be  immediately given, and a smaller dose re-
peated every four hours until the  bowels be quieted.  If they are
very much relaxed, the laudanum may be given in a little good
port wine or brandy, but in an ordinary case this  would be unne-
cessary, and should fever attend, improper.
  The  diet should consist  of flour,  rice, or arrow-root gruel,
crackers, and stale white bread.   A little good port wine  may be
taken if no fever exist, two  or three times a day, with loaf sugar
and water.   A tea made of common blackberry vine roots, pen-
nyroyal or catmint, may be used as a constant drink.   The feet
should  be kept warm  and dry.   The  bowels should be rubbed
with warm  brandy, spirits of turpentine, or some other powerful
stimulant, and be kept well covered with  flannel.   All kinds of
fruit and  green vegetables should be avoided, as they would cer-
tainly aggravate the complaint.
  CHOLERA INFANTUM.—This disorder is denoted by a
severe  vomiting  and  purging.   Tt is commonly a very short
disease, terminating either in health or dissolution in a few days,
and often in  a few hours.   In  the months of July and August,
we  have  seen children sicken and die of  this malady in five or
six  hours from  the  commencement of the vomiting.   It differs
in  nothing from  the cholera morbus, but in the age of those it
attacks, and in the inability of children to  support pain, sickness,
and evacuations for any length of time  without sinking.
            18 
138
CHO.
    An accumulation of heat  about the bowels and stomach, and
 in the hands and feet, is the most common forerunner of the dis-
 ease.  Soon succeed vomiting or purging, or both together; pain
 in the pit of the stomach ;  griping of the bowels ; shortness of
 breathing ; a sudden loss of heat; great prostration of the strength ;
 a quick, small, feeble  pulse ; thirst; followed by a cold perspira-
 tion.  In fatal cases, the  natural heat never returns, but the pa-
 tient becomes weaker and colder by every discharge, until disso-
 lution takes  place.
   The discharges  from the stomach  and bowels, consist of bile
 and the other juices from the digestive organs ;  and are either of
 a yellow  or green color.  The constant retching, and  the deep
 pain at the  pit of the stomach, are the most remarkable  symp-
 toms, and require our principal attention.
   Domestic  Remedies.—Strong  poppy tea should  be given the
 child every ten or fifteen minutes ; and if this does not allay the
 vomiting, a dose of laudanum or paragoric  should follow very
 soon.  The  dose of laudanum for a child, one  month old, may
 be one drop ; for a child three  months old, three drops ; for one
 of six months old, four drops ; for one a year old, five drops, and
 for one, two or three  years  old, from eight to ten drops.  This
 dose may be repeated  every two hours until the  stomach and
 bowels are tranquilized.  Twice the quantity of laudanum named
 for each dose may be given  by way of injection, if the stomach
 refuses it.  The vehicle  should consist of a  table-spoonful  of
 flaxseed tea or some other mucilage ;  a greater quantity will not
 be apt to stay.   If the discharges are principally downward, it
 will be best to give the  opiate  by the  mouth, but if they are
 chiefly upward, it will be advisable to give it by injection.
   Warm flannels should be  applied to the surface of the  body,
 and a warm  tea of  poppy-heads to the  pit of the  stomach.   If
 these cannot be had, ten or fifteen drops of laudanum or morphine
 may be applied.  As soon as the stomach is quieted, a dose of cal-
 cined magnesia, or which is  more likely to stay on the  stomach,
 calomel should be  given.  The  dose of calomel is from  half a
gram to five grains, for children between one month and  three
years old.  In  mild cases of the disease, a dose  of castor oil
should be  given.  A mustard poultice, or hot brandy may be ap-
plied to the stomach.   A few tea-spoonfuls of peppermint, cinna-
mon, ginger, or tansy tea will often assist  in settling the stomach.
If these remedies fail, an emetic of ipecac should  be given, unless
the vital powers are too low.  The chalk julep should be  tried.
mJn eJiSTB TtmJies for  some time, a blister may be drawn
bs° o  setrSerthChw- ^ lhQr, " ^ C°ldneSS °f  the SUrface and
 rstrenlthS  A  T' brand^or §in sh°uld be  given to restore
tne strength.   As relapses of the cholera infantum often  occur it
is safe to keep up the effect of the opiate for two or three  day 
CHO.
139
If an emetic can be given in the  hot stage before the vomiting
commences, it may prevent the disease.
  If the disease settles into a chronic bowel complaint, the reme-
dies  proper to be used will be found under the head of Bowel
Complaint of Children.
  CHOLERA MORBUS—Vomiting and Purging.—Like the cho-
lera infantum described in the preceding article, the cholera morbus,
begins with pain at the pit of the stomach ; vomiting and purging;
shortness of breathing ; thirst ; sudden loss of heat; great prostra-
tion of the strength ; a small, quick, feeble pulse, followed by a cold
sweat. It is principally a disease of the hot months, and is probably
owing to the effect of heat upon  the system, favored  by some
peculiar change in the temperature or constitution of the atmos-
phere.  The incidental  causes  are the use of indigestible food,
and of green fruit and vegetables.
  Domestic Remedies.—In the very commencement of the vomi-
ting and purging, it is  best  to give  several draughts  of warm
water, barley gruel, flaxseed tea, or  rice water, that all  the solid
contents of the stomach and bowels may be removed.   Flannels
soaked  in a hot tea of poppy-heads should be placed upon  the
stomach  and  renewed as often as they grow cool.   A steam
raised in this way assists  greatly in allaying the pain of  the
stomach and the griping of the bowels.
  A grain and a half of opium in pill, or forty drops of laudanum,
should be  given as soon as the  stomach appears to be unloaded,
and repeated  every two  hours,  if necessary.   But where  thq
vomiting and purging evidently arise from substances taken into
the  stomach,  a tea-spoonful  of the powdered  ipecac,  or some
other emetic must be given first, to remove the cause of the irri-
tation.
  If opium cannot be retained by the stomach, a tea-spoonful, of
laudanum may be given by injection in a wine-glass full of flax-
seed tea or some other mucilage,  and repeated every two hours
until the disease abates.   The surface of the body must be kept
warm by the application of dry heat.
  The  soda and  rochelle  powders,  and the acetate of ammonia,
often have the happiest effect in quieting the stomach.  Lemon-
ade, or  the sour  drops,  will  sometimes allay the commotion of
the  stomach and  bowels.  In  some  cases, a tea made  of  the
chamomile flowers, cascarilla  bark, or columbo, rendered sour by
a few drops of nitric acid, will succeed where other  means fail.
The  patient  must be kept very still, as all motion increases  the
vomiting and purging.
  Professional Remedies.—Where the disease  continues some
days and the heat of the body is  not much diminished, a dozen
leeches should be applied to the pit  of the stomach.  Five grains
of calomel should be given, three times a day, until it operates 
140
CIR.
  upon the bowels, followed by a dose of senna and manna, or
  castor oil.
     It will always be advisable to give an emetic where the other
  means fail,  and,  perhaps, to repeat it.   We have known  this
  remedy to have succeeded after almost everything  else had been
  administered.
    A large blister  upon the  chest assists greatly in  removing the
  irritation  of the main passage.
    Camphor,  musk,  ether, red lavender, tincture  of red  pepper,
  peppermint, and other  stimulants must be used in  case of great
  coldness of the extremities, loss of strength, and a passive sweat.
  The  chalk julep is no mean remedy in the cholera morbus.   A
  plaster of the anodyne balsam  upon the  stomach will assist in
  allaying the sickness.
    In some cases, two or three grains of opium, at a time, in pill
  will be required to allay the gastric irritation.
    But in  spite of  all remedies and the utmost skill, the  disease
  will sometimes be so rapid  in its progress and malignant in  its
  character,  that death  cannot be averted.  The retching and
  vomiting  continue ;  the heat of the  body departs; the  pulse
  sinks; the surface becomes  purple;  hiccup ensues; and  life
  goes out like the snuff of a candle.
   In hot weather, live temperately, and avoid the use of all crude
 and indigestible substances for food
   CHOLESTERINE.-One of  the chemical  principles of bile.
 liesS m       m Water and  incaPabIe of mixture with the alka-

   CHONDRINR—The substance of which the cartilages of the
 ribs is composed.                                    8
   CHORDEE.—A peculiar  symptom in the gonorrhea of men,
 arising from spasmodic  contraction.  The part should be kept
 7vervWnL,audanum  and a  dose  of  forty or  sixty  drops taken
 nlixture.g    mternall5r' in two table-spoonfuls of the camphor

 limCb^°a^thTSt-  VkUS'S  D/nce—Convulsive  motions of the
  CHRONTr  PnS°n weredancinS-  See  St.  Vitus's Dance.
  CHRONIC.—Diseases without much  fever, and of long con-
 tinuance, are called  chronic.   Diseases  in thJir ™      g
 are called acute.              leases,  m their commencement,

  CIRCULATION.-The circulation of the blood is one of the
 most  interesting subjects in the science  of  medicine   The mo

 zZtrtseT' ^^5^ Pulse> th* constant sTream of
 ffifo^S1? °Ver,the rh°le SyStem' the chan§e of the
men?wt"tS?tv J. u   i  °? ^ the HghtS' and lls endow-
e^te^SSn71  T^™!**!? £ ^^  CUri°Sit^ and t0
blood are of Vwo kind? th Tr I ^contain and circulate the
            wo Kinds, the arteries and the veins.  The arteries 
CIR.
141
are hard, stiff and elastic tubes, and the veins are soft and limber,
and when empty, collapse.  When an artery is opened, the blood
flows from  the orifice  in jerks.  When a vein is opened, the
blood flows in a  steady stream.   The reason of this, is,  that the
arterial  blood  is  moved  by the  motion of the heart,  and the
venous blood by  the force of the action of the  venous capillaries,
or by the secretory power of the veins, which is constant and
steady.
   The  small veins of the  body all  unite into two large veins,
called  the venae  cava?.   One of these large  veins receives the
blood from  the  head and  the  upper part of  the body, and the
other, from the lower part of the body.  They both empty the
venous  blood into  the right auricle  of the heart.   The auricle
contracts  and  sends  the blood  into  the right ventricle.   The
blood is prevented from returning back into the auricle by valves
situated between the auricle and ventricle.  The ventricle  con-
tracts and sends the blood into the pulmonary  artery—the vessel
which carries the blood into the lights or lungs.  In the  lights,
by the process of  breathing, the venous blood is  changed  into
arterial  or vital  blood,  and receives a  bright red  color.   Four
arteries  peculiar to the lights, return the blood  to the heart again,
where it enters the  left  auricle or chamber ; from that,  it is sent
into the left ventricle,  and, thence, into the great  artery, called
the  aorta, and distributed  over  the  whole body,  by means  of
lesser arteries which branch off from the aorta.
   The whole  blood  in  the system, about twenty-four pounds,
passes through the heart and  performs its circuit through the
body, in about a minute and a half.
   The contraction  and  dilatation which are called the beating of
the heart, are the cause of the  pulse.  Every time  the heart con-
tracts, it produces a beat in the artery of the wrist,  and, in every
other artery  which proceeds from the aorta.  Thus the  pulse in-
forms us of the force and activity of the heart, and, of the  quan-
tity of blood which it  throws out at each  stroke.  By marking
accurately the pulse of a healthy person and  comparing it with
that of a person in  a fever, we  are able to discover a striking dif-
ference, not only in frequency, but in force, and size.  In health,
the  pulse of a middle  aged person, is  about seventy-two in a
minute, moderately full, and soft.   In a person with a  common
continued or slow fever, the pulse  is not  less than ninety, and
often, a hundred and twenty in a minute.   It is also fuller and
harder than in health.  In some diseases, the pulse will  be small,
frequent,  and  soft, and in  others full,  frequent, and hard.   In
some diseases, again, the pulse  will be irregular, and intermitting,
which shows that the heart is irregular in its motion.  Since the
discovery of the  circulation of  the blood, the pulse has been con-
sidered  one  of the most certain criterions of disease. 
112                        CLA.
    The younger the person is, the quicker will be the pulse.
    At birth, the  pulse is from a hundred and thirty to a hundred
  and forty in a minute.
    At one year old, from a hundred and twenty to a hundred and
  thirty.
    At two years, from a hundred to a hundred and ten.
    At three years, from ninety to a hundred.
    At seven, from eighty-five to ninety.
    At fourteen, from eighty to eighty-five.
    At middle age, from seventy-two to seventy-five.
    At old age, from sixty to sixty-five.
    CICUTA—Hemlock.—See Hemlock.
    CLAP—Gonorrhea.—This disease is produced from an infec-
 tion communicated from one sex  to the other.  No certain time
 has been fixed upon,  before it makes  its appearance, after the in-
 fection has been received.   Its usual  time of appearance is about
 six days  after the infection has been conveyed.   In some cases,
 the infection  will lie dormant  a whole fortnight.   The disease
 begins with a sense of heat and itching in  the urinary passage,
 and a feeling of scalding in the discharge of the water.  There
 is a soreness throughout the whole urethra, and an appearance of
 a whitish matter, at the end of the passage.   In a few days, the
 matter will be discharged in considerable quantity,  at every dis-
 charge of the water.  The parts will look red, and the stream of
 water will  become much  smaller than usual, in consequence of
 the inflamed and thickened state of the lining of  the  urinary
 passage.  In every attempt  to  pass the urine, the  person  feels
 a great degree  of pain  and scalding heat.  Small  quantities of
 blood, are, sometimes, voided,  and a stricture produced in the
 passage, which   entirely  prevents the  discharge  of the water.
 There is a constant running of purulent matter from the urinary
 passage.  The inflammation, sometimes, ends in ulceration, and
 the formation of fistulous openings, in the  different  parts of the
 genital organs.   The neck of  the  bladder,  becomes irritable,
 producing a constant desire to void the urine.  The foreskin will
 become so swelled, in some instances, as to prevent its retraction
over the glands, and, in other instances, being retracted, it remains
tight around it.   In slight cases, there will be only a slight  heat
and scalding in the discharge of the water, and some little nar-
rowness of the passage.  If  proper care  and attention are paid to
the disease, it will get well in the course of two or three weeks,
 but where it is neglected, it will contiuue for many months, and
end in fistulous sores,  and death.

shoTwhP }-!? *f rf7 GXternal redness' celling, and soreness, it
should be treated like any other inflammation, with emolient poul-
tices and cooling lotions.   A  soft bread and milk,  or flaxseed
poultice, should be applied  to  the inflamed part, and every tTme 
CLA.
143
this is removed or changed, a wash of lead water, or a solution of
the white vitriol, should be used.  At the same time, the sal nitre
or salt-petre, in six grain doses, should be taken every four hours
during the day time.  One drachm of the salt-petre, may be dis-
solved in a gill of water, and a table-spoonful, taken four times
a day.   Of all the remedies which have been at various times,
and, by  various physicians, prescribed for the cure of this disease,
this we deem to be the best.  It exerts  the most power upon the
urinary organs, and is the most  cooling and friendly.   For the
first week, we seldom make use of any other remedy, than the sal
nitre, excepting the external local applications which  we have
named.  In many instances, a daily use of this salt, will effect a
cure, without the  help of anything else.  The  patient in  the
meantime, however, must live upon a vegetable diet, drink noth-
ing but cold water, or flax-seed tea, and preserve entire continence.
The last recommendation is absolutely  necessary, and should be
strictly fulfilled.   If the complaint is not sensibly ameliorated in
the  course  of a  week, and the external inflammation has been
reduced, an injection  of the water of sugar of lead,  into  the
urinary passage, made  of two grains of the  lead, to two ounces of
water, should be employed, three times a day.   The white vitriol
may be used, where the sugar of lead produces too much dryness
and heat.   If, however, the injection  into the urinary passage
occasions a weeping of the canal,  or  increases the discharge of
watery matter, it  should be suspended.   Fifteen drops of mor-
phine, or of laudanum,  taken every night,  will often lessen  the
discharge,  and incline the disease to abate.   The sweet spirits of
nitre, in  a dose of a tea-spoonful at a time, three or four times a
day, answers a similar intention  with  the sal nitre, though we
think its  effect upon  the  disease  is  much less salutary than the
neutral salt.
   The balsam of copaiva possesses a high reputation in the cure of
this disease, and is no  doubt, often successful.  It appears, how-
ever, to be more suitable to the chronic state  of the disease, or
to gleet,  as it  is called, than, in the beginning of the inflammation.
A dose of the copaiva, every other  day, has a good deal of efficacy
in reducing the inflammation.
   Such will sometimes be  the  height of the  inflammation and
swelling, as to require the application of  leeches, especially where
the seminal organs  are involved  in  the consequences of the in-
fection.
  The infection  produces  nearly the same  symptoms in both
sexes, but, as in the female sex, the  parts liable to the infection,
are less complex than in men, it is seldom that they are troubled
with strictures.   The same treatment is required  in both sexes*
In this disease, it  is much the safest way, to employ the aid of a
skilful  physician.   Mismanagement is always  attended  with the 
144
COA.
 most baleful effects, which may be regretted through life.   In
 strictures, the water must be  drawn  off by the catheter, and,
 often, the obstruction must be  overcome by the use of a bougie,
 an instrument made of gum elastic, wax, or catgut, of the size of
 the urinary passage.   The caustic bougie, has a thin roll of lunar
 caustic enclosed in  it, which eats off the obstruction as it passes
 along the urinary canal.   Catheters, bougies and syringes, suited
 to both sexes, may always be obtained at the apothecary's  store.
   There is a disease to  which women  are liable, very nearly
 resembling the foregoing, but which is not infectious.  This dis-
 ease is called flour albus or the whites, and may be distinguished
 from the other, by the mode of life which the person follows, and
 other  suspicious circumstances.
   The cubebs, a species of spice, imported from the East Indies,
 is peculiarly efficacious in the cure of this disease, in many cases.
 Emolient bathing of the parts,  is  of the  greatest  service in the
 treatment of the disease ; this should be done several times a day,
 and continued for half an hour at a time.   In females, the disease
 is, in  general, much lighter than  in males, but  it is always a
 dangerous disease, in both sexes.   Much injury  is done in this
 complaint, by unskilful hands, and the use of powerful astringent
 injections.  It should always be recollected, that  the parts con-
 cerned, are as sensitive as the eye itself, and  require a treatment
 as delicate.   Indeed, any common eye water, is as strong an in-
 jection as is generally necessary in the disease, and perhaps noth-
 ing better can be used.  They are composed of the most suitable
 materials  to reduce  the inflammation, and their general efficacy
 have been most amply tested.
   CLAVICLE.—Collar-bone.
   CLAVUS HYSTERICUS—A severe pulsating or throbbing
 pain in the forehead, occupying a space not larger than a nine-
 pence, which  feels as if a nail had been driven into  it.   The word
 clavus, in latin, means a  nail,  and  when this pain is associated
 with the hysterics, it is called clavus hystericus, the hysteric  nail.
   COACUM—Phytolacca  Decandria.—The medicinal  parts of
 the coacum are the roots, the leaves, and the berries.   It grows in
rich places by the road-side, everywhere  in New  England, and
in the  middle  and southern states.   It grows up in long stalks
like Indian corn, and about as high.   The leaves are large,  oval
and pointed, and grow  on  short stems.    The plant is of a deep
green  color.   At the joints of the  branches, long  branches  of
bluish  colored flowers shoot forth, succeeded by round, flattish
 berries, full  of juice,  and  of a  dark purple color.   The root is
large and bulbous.
  The properties of the extract or inspissated juice of this plant
are emetic and cathartic.   In rheumatism, cutaneous diseases and
venereal complaints, it is thought to be an efficacious medicine. 
COL.
145
One ounce of the powdered root,  infused in a pint of new rum,
and the whole allowed to stand for a week, makes a good tincture.
Two  table-spoonfuls  will  operate as an emetic.   Dose of the
powdered leaves, from twenty to thirty grains.
  COAGULUM.—A  clot of blood,  or the  curd of milk, is the
coagulum.  In a bowl of blood drawn from the arm, the coagulum
swims in the thin, watery part.
  COLCHICUM  AUTUMNALE — Meadow   Saffron.—This
plant  is a powerful narcotic, purgative, and diuretic.  The  root
is the part commonly  used in medicine, but the seeds possess the
same  properties.   Dose  of the  dried  root, pulverized, from four
to five grains, three times a day.  In rheumatism and dropsy, the
meadow  saffron  has  of late  been much used.   It has an acrid
taste,  and when taken into the stomach occasions a burning heat,
strangury, and tenesmus, in a small quantity only.
  The meadow saffron, has been  analyzed, and  found to contain
an  alkali, in which all the activity of the plant is  concentrated.
The alkali is called veratrine.   It is a white, inodorous, and easily
pulverized substance, with an acrid taste,  and very  soluble in
alcohol.   It produces  violent vomiting in very small doses.  See
 Veratrine.
  COLD.—Cold is the common name  for influenza.  It  is always
an inflammation, and  should be treated like any other inflamma-
tory disorder.  It  is caused as often by heat as  by cold.  A per-
son confined in a warm, crowded room, will often be seized with
a cold, without leaving it.  The bare heat excites the inflamma-
tion, without the least exposure to cold.   The  lining membrane
of the nose,  of the windpipe, and of the bronchia, is thickened,
red, sore, and often  painful.   It is, first, dry, and then pours
forth  an abundance of mucus.  Sneezing is  commonly the first
symptom of a cold, followed by a stoppage of the nostrils, chills,
and headache.  This disease, is precisely of the same nature with
an  inflammation  of the  eyes, the throat, or pleura.  It requires
abstinence, and a cooling treatment.   See Influenza.
   COLIC.—The bilious colic, is  a disease of much danger.  It
begins with a griping pain about  the navel;  with vomiting, and
a stoppage in some portion  of the intestines.  There  is thirst,
increased heat, and a discharge of bilious matter from the stomach.
In violent cases, the pulse is small, slow, or unusually frequent;
the face is pale; the features shrunk ; and the whole body cov-
ered with a cold sweat;  and the feet  and legs will often be cold,
while the head is hot.  In some instances, the  pulse will not  be
much quickened.  There is  great pain in the  lower part of the
belly.
  Remedies.—Blood-letting is a remedy of so much importance
in the true  colic, that .not much  can  be  safely done, until this
operation is  performed.   If the pulse  is active ;  if there is sore-
            19 
146
COL.
  ness at the pit of the  stomach and  about the naval, with a foul
  tongue, nausea,  and headache, blood should be drawn  in  pro-
  portion to the violence of the disease.  It should not be forgotten
  that the neglect of  blood-letting in this disease, is often attended
  with fatal consequences.   The disease will, sometimes, require
  two or three bleedings, before a remission of the symptoms will
  take place.   If the blood is drawn by leeches, they should be put
  on plentifully, not less than a dozen  and a half at a time, and re-
  peated every twenty-four hours, for  three or  four  days; if the
  disease does not  yield before.
   If there is much sickness at the stomach, the bowels must be
  operated upon,  by  injections.   For this purpose, a tea-spoonful
  of ipecac may be infused  in half a pint of warm water; or six
  grains  of tartrite of antimony,  may be dissolved  in  the same
 amount of warm water.  The ipecac and the antimony, when
 used by injection, have a similar relaxing effect as when taken by
 the stomach.   Two  great spoonfuls of spirits of turpentine, with
 as much castor oil, mixed with half a pint  of warm molasses and
 water,  have often been  found a very effectual injection.  The
 thoroughwort tea, also makes a very good injection in these cases.
 The sickness at the stomach and vomiting,  must be allayed by
 effervescing  draughts,  to  which, twenty-five  or thirty drops of
 laudanum are added.  As soon as the stomach is in any measure
 quieted, four or five  grains of calomel should  be given in the form
 of a pill, every two  hours, until it removes the stoppage.  Calo-
 mel, when  given in  small doses, is much better retained and
 much surer to operate, than in large doses.   The croton oil, is a
 purgative of great power, and often succeeds where other cathar-
 tics fail.  The  best way of giving it, is, in a dose of a drop, at a
 time, made into a pill with a crumb of bread, or a little manna,
 and  repeated every  hour until  it operates, or until five or six
 drops have  been  taken.   A  mixture of equal parts of spirits of
 turpentine and  castor oil, in a dose of a great spoonful at a time,
 repeated every  hour, until  it operates, or until five or six spoon-
 fuls have been taken, will, sometimes, answer as well as the croton
 oil.  Some give the  spirits of turpentine alone, to  the amount of
 half a  wine-glass full,  at  a time,  mixed with a little molasses
 and water.  Where  there is no vomiting,  Lee's  pills; the com-
 pound  infusion of senna; the elixir salutis, or  an infusion of
 senna will succeed in removing the stoppage.  The mild cathar-
 ics, should always be tried, first, since it is of no little importance
 to irritate the  bowels  as little as possible.  In one case of the
 ItnZZ-' a Sf" thG Cr°t0n 0il and the sPirits of turpentine had
wn n   ■ in theLway  We have recommended, and bleeding had
been carried to the  extent  which  we  thought  advisable  the
obstacle was removed by a tea, made of a scruple of the common
tobacco,  and given in two doses.  It is, however, a safer way to 
COL.
147
give the tobacco by  injection.   A plaster, made of snuff and
lard, and laid upon the bowels, or pit of the stomach, has a very
relaxing effect.
  The warm bath is sometimes found very effectual in producing
a relaxation of the bowels, especially, when  used immediately
after  bleeding.   In all  cases, the  stomach and  bowels should
be fomented with warm water or  boiled  herbs, particularly the
heads of the white poppy.  Some  physicians have advised cold
effusions, but these are very doubtful means of  cure,  liable to be
followed with more of mischief than of good.  The drinks should
be toast water, cream of tartar water, tepid water, and herb teas,
such as balm and sage.  Where the stomach is not much disturb-
ed, the  tartar emetic, in small  doses, given every hour, will often
move the bowels.   The same dose may be given here as  in fever.
Sleep should be  procured  every night, by an anodyne injection.
A tea-spoonful of laudanum,  in half a  gill of the  solution of
starch, or of flax-seed tea, will commonly  answer this  purpose.
In giving an anodyne injection, or one  which we wish to stay in
the bowels, we should always introduce  as small a  quantity as
will answer the  purpose, as the mere bulk of any liquid,  of itself,
will often excite an action of the rectum, and so defeat our object.
  In some  cases of the colic,  the motion of the bowels is so com-
pletely  inverted, that  the feces are  thrown up by the  mouth, and
whatever is given by injection is returned in the same way. This is
always a distressing sight.  In the bilious colic, there is nothing but
bile and the ordinary  contents of the stomach thrown up, but in
the ileus, or the iliac passion, the contents of the lower portion of
the bowels are discharged by vomiting.   This kind of colic is
often without fever.   The muscles of the abdomen, will be con-
tracted and drawn  inwards;  there will be  an  insufferable pain
about the lower part  of the  belly,  at stated intervals; a dying
sickishness at the stomach ; a sense of twisting and wringing of
the intestines at the naval; and a leaden hue to the countenance.
   In this species of the disease, on dissection of the body, after
death, one  portion of  the intestinal canal is  often found run into
the portion below it, so that  the part  which receives the upper
portion is effectually  blocked up,   It is named intro susception.
The same treatment is to be pursued, as in the bilious colic.  The
colic differs from cholera morbus and dysentery, in this, that the colic
is only the inflammation of a small section of the bowels, and the
cholera morbus and dysentery, are diseases of a large portion, or
of the  whole bowels.   The  cholera  morbus and dysentery are
confined to the mucus membrane,  whereas the colic appears to
be an inflammation of all the  coats, or of the whole substance of
the bowels.   In colic, all the coats are found constricted and often
ulcerated.
   A colic, resembling the  iliac  passion,  is  often produced by  a 
148                        COL.
 rupture of the bowels.  The bowel becomes choaked or strangu-
 lated by being  crowded into the rupture.  In these cases,  the
 bowel must be put back or reduced, and if  this cannot be done,
 an operation must be performed, and the bowel  put  back by the
 hand of the surgeon.  In all  cases of the colic,  it will be prudent
 to inquire whether the patient is afflicted with a rupture, as peo-
 ple who have ruptures, are often affected with colic or a stoppage.
 In the iliac passion, as in  the bilious colic ; bleeding; fomenta-
 tion ; blisters and poultices upon the abdomen ; injections; and
 after the stomach is quieted,  cathartics; anodynes, to procure
 sleep, and to ease the pain when it becomes intolerable, are  the
 means to be prosecuted.   Latterly,  it has been the  practice to
 introduce a long gum elastic tube into the  rectum, and to force
 warm water through this, into the colon, and, even beyond it by
 means of a force pump, or a syringe, made upon the principle of
 a force pump.  Sometimes, the syringe is  used alone.   Several
 quarts of warm water, can in  this way be thrown up  the  bowels
 and even forced beyond  the  valve  of the colon.  This  remedy
 should never be omited, as  it  can do  no harm, and may possibly
 force  up the portion of strangulated bowel.   The giving of crude
 quicksilver, with the view  of forcing a passage  mechanically, we
 believe to be generally condemned.  A colic will sometimes go
 on for seven or eight days,  in spite of all remedies, and,  then, all
 at once, give way, and the  bowels be set loose.
  The painter's colic, differs  with  respect to its cause, from the
 bilious colic and the iliac  passion, but  requires the same treat-
 ment.   The paint,  lead, or  putty, produces  an  inflammatory
 constriction of the bowels, which  is the same in its nature with
 the other kinds of colic, and indicates a cure by similar means.
 Alum, has been  given  with  success in the painter's colic.  A
 table-spoonful of the powdered alum,  is swallowed at a time,
 mixed with molasses or jelly.   This substance has been supposed
 to neutralize the lead by a chemical combination.
  When the colic  is occasioned by wind, it is not a very dan-
 gerous disease, although it  may be  very painful and distressing
 There will be a temporary stoppage of the bowels; sharp pain
and swelling about the pit of  the  stomach and  the navel   The
noise  of wind passing from  one portion of the bowels to another
can be distinctly heard;  and there will  be more or less sickness
at  the stomach.   The  slightest  discharge  of  wind from  the
stomach or bowels, is attended  with some relief.  The pent  up
 wind, produces great distention of the stomach, and the distention

tnrnin, nTtl  KP^°dUC/S ^ ***™*-   Theie Wil1 be a instant
x:id back.ody'first upon  the  stomach and then "P°* **
  w^re the colic follows upon eating a hearty meal of some
indigestible food, an emetic  should be  the  first thing g^to 
COL.
149
unload the stomach.  The wind colic is often produced by eating
unripe fruit and vegetables, and sometimes, in eating too large a
quantity of those which are ripe.   There are certain kinds of
fruit and vegetables, which  in particular individuals, always pro-
duce  the  wind  colic, such  as  cherries, currants, cucumbers and
cabbages.  When the colic has been produced by any of these
articles,  or  of  anything else  which  has been  taken into  the
stomach, vomiting should be excited and the offending substances
removed.   If an emetic does not entirely relieve  the difficulty, a
dose of oil, salts, aloes or some other cathartic, should be forth-
with administered.   In some cases, where there is no sickness at
the  stomach,  ten or fifteen drops of the essence  of peppermint,
in a little hot water, or a great spoonful of brandy will be suf-
ficient to expel the wind.   Hot pennyroyal  tea, or  even  hot
water, drank  plentifully, or hot ginger and water will remove
the colic.  Paragoric, seldom  fails  to  procure relief.  Children
can take from ten drops  to a tea-spoonful.  Half a tea-spoonful,
is a medium dose for a child, a  year old.  Dry, hot flannel cloths
should be put to the stomach, and a bottle of hot water, or a
hot brick to  the feet.   In children, where the distress is great,
an injection  made  of common  salt, dissolved in warm water,
will often procure the most instant relief.   Nursing children are
very  subject to  this kind of colic, which is often so severe as to
produce a cold sweat.  Half  a  tea-spoonful of castor oil,  and
half a tea-spoonful  of paragoric, mixed, will generally be found
to remove it.
   COLLYRRIA—Eye-waters.—One of the best eye-waters, is
composed of one or two grains  of white vitirol,  dissolved in an
ounce of rose-water, or rain water.
   COLOCYNTH—Bitter Apple—Cucumis Colocynthis.—This
medicine is imported from Turkey.  It is commonly called the
bitter cucumber, or  the bitter gourd.  The medicinal part of the
plant is the fruit, which  somewhat resembles the cucumber.  Its
taste is nauseous, acrid, and intensely  bitter.  It is  a powerful
purgative, and in a  dose of ten or twelve grains  frequently  pro-
duces gripes, bloody stools, and  pain.  Where milder  cathartics
have proved unsuccessful, the colocynth is sometimes used ; but
is commonly  mixed with other medicines.  It forms a part of the
pill cochiae.   The  proper dose for an adult is  from three to six
grains.  The dose for a child,  two years old, is half  a grain.  It
is the pulp or pith of the fruit selected for use.
   In obstinate stoppages of the bowels, in insanity, and in lethar-
gies, it is often  more successful than other purgatives.
   COLON.—This is the name of the greater portion of the large
intestine.  It commences in the right  side of the lower part of
the abdomen, ascends to the liver, crosses the back bone, to the 
150
CON.
  left side, passes under the stomach, and pursues a course like the
  letter S down into the pelvis, where it ends in the rectum.
    COLTSFOOT—Tussilago Farfara.—The medicinal parts of
  this plant are the leaves and flowers.  It is found in moist places,
  and flowers in  March and  April.   It is used in coughs  and
  affections of the mucous membrane of  the windpipe and lungs.
  In the form of candy, it is a very useful  remedy for a slight, tick-
  ling cough.   It is glutinous and somewhat acrid.
   COLUMBA ROOT.—The columba root is brought from the
  Island of Ceylon.   It comes to us in small round pieces, com-
  posed of the bark, and wood.  The wood is of a bright yellow
  color.  The root has an aromatic smell, and a pungent, bitter
  taste.   Steeped in water, it affords an agreeable bitter.  Alcohol
  dissolves it more perfectly, but this preparation is more heating
  than the watery infusion.  The dose of the powdered root is half
  a drachm.  A table-spoonful of the tea made of an ounce of the
  root steeped in  water,  is  an  excellent tonic  in dyspepsia,
 weakness  of  the bowels, and in  low fevers.   It  produces  no
 heat, while  it gives   tone to  the  stomach and strength  to the
 system.
   COMA—Lethargy.—A strong  propensity to sleep,  resulting
 from disease.
   COMFREY—Symphytum  Officinalis.—This is a common,
 New England  plant, which grows in moist places, and rises to
 about  two feet in height.  The leaves are large, and similar to
 those of the water  dock.  The root  is much esteemed among
 many people, for coughs and  catarrhs.  It contains a mucilage,
 and promotes expectoration.   It can be made  into a syrup and
 taken several times in the course of a day.
   CONSUMPTION-Phthisis Pulmonalis.-Consumption is an
 affection of the  lungs, attended  with a cough, the raising of
 purulent matter,  and   a  habitual  or  hectic fever.    The  ha-
 bitual  or hectic fever is, sometimes very slight, and,  at other
 times very severe.  The  more rapid the ulceration of the lungs,
 the  more aggravated,  in  general, will be  the  fever.   In the
 quick consumption, as it is called, the  hectic fever consumes the
 powers of life, exceedingly fast. By consumption, we do not mean
 that the substance of the lungs is  always consumed, but that a
 P^p'ir^ g°eSOn' of/orminS PU^ which is accomplished
 either by the destruction of the substance of the lungs or by an
 mflammatl011 f the        membranej in consequence of which,

 tinrcUhZT  '""L6^ °f mUCUS'  II is' s°™times, difficult to dis-
and onCTcnnTeen?e.mUCUS °r pWeSm which 1S raised in  * severe
^n la?eua^nU^     ^ °r,catarrh' or cold>as il is called in com-
KS,    Pll?i°r Pumlent matter raised in a consumption.
cut mere mucus or phlegm is commonly clearer transparent like 
CON.                        151
glass, but pus or purulent matter is white and opaque, that is, the
light  does not pass through it.   Phlegm or mucus is also tough
and  coheres  together very  strong, but  pus  is more  brittle and
easily separates  into particles.   Pus is a thicker and more solid
substance than phlegm.  Pus when thrown into water commonly
sinks, but phlegm or mucus swims upon the top.  Pus has a
more greenish  color than  mucus ;  though  mere mucus  will
sometimes have  something of this color.
  The  most certain mark of an  ulceration of the lungs is the
existence of the  habitual or hectic fever which  always attends it.
This fever is not constant  through the whole day and night, but
comes on twice a day, and has two abatements.  The person
begins every day about noon to feel some little  chilliness, but not
amounting to an ague fit.   This soon passes off, and the person
becomes hot, thirsty, restless, and the perspiration ceases.  About
five o'clock in the afternoon, the fever abates and ends in a pers-
piration.   The  same thing  occurs about midnight and is com-
monly more severe.  The fever is terminated by what are called
night sweats, but these  sweats are the result of  the previous fit
of fever.   The tongue, in this fever, is not apt to be much furred,
and  the  appetite will often  be tolerably good, especially during
the remissions.  In the  latter stages of the  disease, the tongue
and entrance of the throat will become inflamed.
  Upon each cheek of a consumptive  person, there will be, during
the existence of the fever,  a bright red  spot,  nearly circular.
The whites of the eyes will be bloodless, and almost shine like a
piece of  polished marble.   In the  progress of  the hectic, a diar-
rhea comes on, and the nails become rounded  and hooked, like
the claws of  a bird.  But the most remarkable feature of a con-
sumption, is  the wasting away  of the flesh, which  sometimes,
diminishes to such a degree as to leave nothing but the  skin
upon the bones,  and  even the bones themselves appear  to have
shared in the general waste.   Towards the last, the feet and legs
will be affected with dropsical swellings.
  Another remarkable  feature of  consumption is the  general
soundness of the mind  through the whole course of the disease.
Both the senses and the  judgment commonly remain clear to the
end ;  and the spirits  are often remarkably good, and even more
elevated than in health.
  The existence of  ulceration in  the lungs is now ascertained
with an increased degree of accuracy by an  instrument called a   •
stethoscope, formed  so  as  to convey the sound, produced in
breathing, more  audibly to the ear.   By first ascertaining by the
use of this instrument, the peculiar sound which is made by the
breathing of a healthy person, all the deviations from this sound
produced by disease can be determined.
  When a tubercle exists  in the lungs, and has discharged its 
152
CON.
 contents, the air in passing in and out of the cavity which re-
 mains, produce a peculiar sound, which the  French call rale, a
 deep cavernous kind of rattle, which can be detected by placing
 the ear  upon the chest, but very distinctly by the  stethoscope.
 This  instrument assists the ear in detecting the diseased sounds
 produced by breathing, in the same way, that the  ear trumpet
 assists the hearing of a deaf person.   Tubercles and ulceration
 can sometimes be detected in the lungs by merely tapping  the
 fingers upon the chest.  In a healthy  state of the lungs,  the
 sound will be comparatively clear and elastic, but when tubercles
 and ulceration exist, it is dull and heavy.  Whenever the rale
 or  deep  hollow rattle  has  been heard either by the ear or  the
 stethoscope, it has been found after death, that an ulceration had
 existed, and  that the sound was produced by the passage of  the
 breath in and out of the cavern which was  left after the matter
 of the ulcer or tubercle had been expectorated.
  In many cases of cough and expectoration, it is difficult to  de-
 termine  by the quality of the matter raised, whether ulceration
 actually  exists or not, but by the use of percussion and ausculta-
 tion, or  the  stethoscope, the case  may be decided with a great
 degree of certainty.   Many people who, for a long  time,  have
 labored under serious  apprehensions  of some fatal  pneumonic
 affection, or of consumption, have been relieved of all fear, by the
 intelligence conveyed by the  stethoscope.  Where much anxiety
 exists  as  to the nature of the disease or its actual  progress, the
 person should submit himself to an examination by this new  in-
 strument.
  After a tubercle, of the lungs has ulcerated,  and been emptied
 of its contents by coughing, a reverberation of the voice is heard
 in the empty tubercle,  and has been called pectoriloquism, from
 the resemblance which the sound has to ventriloquism.
  Consumption is the result of several  different affections of the
 lungs.  The  most common affection of the lungs, which ends in
 consumption, is the formation of tubercles.   The tubercle is a
 small,  globular body, which, in its origin, is not larger than a
millet seed, but will increase to the size of a nutmeg ; and when
it proceeds to suppuration is  often  as large as  a crow's egg and
sometimes becomes as large as a hen's egg.  Its substance resem-
bles cheese, or tallow;  it is white, and contains no bloodvessels.
 1 he lungs will, sometimes, be nearly covered with them   They
are  supposed to be the same  thing with scrofulous tumors which
affect the external glands of the body.   The  matter of both, in

 lea1^0^gHmv1, T6^ t0 bG T7 much alike J  they both commence
small and hard, and proceed to suppuration very much in the same
way.  1 he upper part of the lungs, under the clavicle or collar bone,
 is much oftener the seat of  them than the lower part.   They do
 not always suppurate, but will sometimes lie dormant  during the 
CON.
153
person's whole life.   Tubercles appear to be excited to inflamma-
tion  by influenzas or colds ;  by asthma ; by hemoptysis ;  by pe-
ripneumonies, and pleurisies ;  by the breathing of foul air, and
noxious gases ; by excess of living ; by paucity  of living ; by
over exertion in labor or exercise ;  by intemperance  in drinking ;
or in the gratification of the animal passion ; and by all the causes
which disease the lungs in general.
  Ulceration of the lungs or consumption is sometimes the con-
sequence of bleeding at the  lungs.   Bleeding at the lungs does
not,  however,  always produce ulceration.   Many people will
bleed at the lungs, a number of times in succession, and will en-
tirely recover  from  it, while others will go on from one  step to
another until  a confirmed consumption developes  itself.  It is
probable that  bleeding may take place at the lungs  as it does in
other parts of the body, and the vessels from which the blood
proceeds, heal as readily.   But as consumption often succeeds
hemorrhage from  the lungs,  nothing  should be neglected  in such
cases to restore the ruptured vessels to a sound state.  It is im-
possible to foretel the  instances in which, hemorrhage from the
lungs  will recover, although in sound  constitutions, we may
rationally look for more recoveries  than in those which  are un-
healthy, especially in people of a known scrofulous habit.   When
bleeding from  the lungs is  produced by accidents, such as falls,
blows  upon the chest, and concussions of the whole body, a heal-
ing of the lungs generally takes place.  Pistol balls and rifle balls
have ben shot through the lungs, and still those organs have heal-
ed, and remained as sound through life as though no such accident
had  befallen them.
  Consumption is not unfrequently the consequence of penpneu-
mony  and  pleurisy.   An  inflammation  of  the lungs and of the
pleura takes place from cold or other causes, and if not subdued
in time, a suppuration will often ensue.  In these cases, however,
if the constitution be good, and the blood in a pure state, the sup-
puration will not be followed  by a hectic fever, but will gradu-
ally  heal and  the lungs become sound  again.  It is not every
abscess of  the lungs,  therefore,  that  produces  consumption.
Abscesses  will sometimes form in  the pleura,  the  membrane
which invests the  lungs, and be  absorbed.  It is probable that
an abscess which arises  from hemorrhage, from peripneumony,
and  from the irritation of an  asthma, may sometimes heal  and
leave the patient in perfect health ; but it is not so probable that
an abscess which  proceeds from a tubercle, will ever  heal.   There
is something, in  those constitutions which  produce tubercles,
which also produce a kind of suppuration exceedingly unhealthy.
In all  other kinds of suppuration  there will  often  appear some
tendency to healing, but  in this, the matter forms  and  is  dis-
charged, and just so much of the lungs as the tubercle occupies,
           20 
154
CON.
  is destroyed ;  another and still another tubercle goes on to sup-
  puration in the same way, until so much of the lungs has been
  successively destroyed as to leave not enough for the purposes of
  supporting life.
    Influenza, cold or catarrh, for they all mean the same thing, is
  probably the  cause of consumption in many instances.   A bad
  cold, long continued, and attended with cough and the expecto-
  ration of phlegm, will finally excite some portion of the lungs to
'  inflammation and suppuration, will produce the hectic fever.  It
  is rather to be wondered at, however, when  we consider how
  many colds and coughs people undergo, that so few of  them end
  in phthisis pulmonalis.  Consumption is, sometimes, occasioned
  by the measles, whooping cough, the asthma, the syphilitic dis-
  order, and the small pox ; these diseases should, therefore, always
  be cautiously treated  on account of  the tendency which they
  leave to a more fatal disorder.
    Phthisis  pulmonalis most commonly appears in the young, be-
  tween the  age of sixteen  and  twenty-five.  It will sometimes
 appear at an earlier period, but the cases are seldom.   Whether it
 happens from hemoptysis, pneumonic  affections, or tubercles, its
 victims  fall about the same  age.  When the consumption arises
 from tubercles, it usually commences with a slight, short, tickling
  cough, which seldom  gives the patient much uneasiness.  The
 cough soon becomes habitual and the person loses his flesh. The
 breathing becomes hurried by any bodily motion, and the patient
 becomes  languid and disinclined to all exercise or motion.  He
 takes cold  more  easily than common, and coughs and  raises
 more.  This  condition of  the person may continue a  year, or
 even two years, before decided symptoms of the hectic  fever set
 in.   When  the cough arises from tubercles, it will remain dry for
 a long time, but at length will be accompanied with an expecto-
 ration of a  tough mucus or phlegm.   From phlegm or mucus,
 the matter  which is raised  by coughing, imperceptibly becomes
 purulent. While the cough and the expectoration are increasing.
 the breathing  becomes shorter and more  frequent, the pulse
 quicker,  and, at length, the most unequivocal symptoms of the
 hectic make their  appearance.  In  the female sex, sometimes,
 very  early  in  the disease,  the menses cease to flow   and it
 should not  be forgotten by  the friends of the sick, nor by prac-
 titioners of  medicine, that this is the effect  and not  the cause of
 the disease.   By attempting to cure it, we only attempt to cure a
 nlvir hm   .  Tu th,G difeaSG-  The  StrenSth of the Patient should
 never be wasted by fruitless attempts to re-establish this function,
 which can only be done by removing the consumption itself.
   Subsequent to the cough and the appearance of fever, more or
 less pain begins to be  felt in some part of  the chest, geTrallv
 under the sternum or breast-bone, but often m one of the s deS 
CON.
155
 The  pain  becomes more evident by drawing in a full breath, or
 in lying upon one or the other of the sides.  Most people in this
 disease can only lie on one side or on the back.  Whether the
 disease has been preceded  by hemoptysis or not, it  is very rare
 that it progresses to the end without more or less appearance of
 blood, either in a pure  or mixed state.  When the disease  pro-
 ceeds from tubercles, the spitting of blood is very rare.
   If  a consumption arises from a peripneumony or influenza, we
 may  have  some hope of its being cured ; or if it proceeds from a
 hemorrhage of the lungs, we should never despair of a cure ; but
 where  it  comes on with a  dry, hasty cough, emaciation of the
 body, indisposition  to  motion, and the other  symptoms which
 show a tuberculous state of the  lungs, our  hopes of a recovery
 will  almost always be disappointed,  although instances  have
 occurred of a complete  restoration to health in this form of the
 disease.
   The belief that people never recover from a consumption, we
 conceive to be  superstitious  and absurd.  There is no more diffi-
 culty in the healing of a tubercle in the lungs than of the healing
 of a  scrofulous  tubercle in any other  part of the body, provided
 the lungs, and  the general health are in the right condition.  Nor
 do we despair of the discovery of remedies which shall yet reach
 and subdue this hitherto fatal  disease  and render it as curable as
 the fever  and ague or the syphilis.   We believe the remedy for
 this disease will come  in the form of  a gas or vapor, or of some
 impalpable powder which shall be breathed into the lungs and
 operate locally  upon the ulceration.   The  inspiration of some of
 the  gases,  many years ago, received a partial trial under Dr.
 Beddoes,  but  this single trial of the  gases then known, and of
 their combination, was very far from settling the question, whether
 any substance inhaled  into the lungs, can  cure  ulceration  there.
 There are ten thousand substances which may be introduced into
 the lungs.   The lungs will  bear an immense quantity of impal-
 pable powder without  even exciting a cough, as we know from
 breathing  the dust of roads and streets when it has been ground
 to an impalpable powder, raised in clouds, and  diffused  through
 the atmosphere.  In the form of vapor, hundreds of medicines
 hitherto untried can be made  to reach the seat of the disorder.
 New  gases will probably be discovered, and  essential  improve-
 ments made in the administration of those which  are already
 known.  We have conceived that the inhalation of the impalpa-
 ble powders of lead and of other substances used by painters, pre-
 vents that class of people from  having the consumption as readily
 as other people, but have not as yet been able  to settle the ques-
 tion by a competent number of facts   In a hemorrhage from the
lungs, breathing the impalpable powder  of  the oxides of  lead,
would doubtless be as good an application as could be made to a 
156
CON.
bleeding surface.  If it should be ascertained  that painters  and
others who are constantly subject to the inhalation of the impal-
pable powders of lead and other substances, are exempt from he-
moptysis and consumption, or comparatively exempt  from them,
it will furnish a foundation for the trial of these substances in the
cure of  those diseases in others.  Calomel applied externally to
an ulcer in the form of powder, possesses great power  in restoring
a healthy action.   It is  highly probable  that this or  some other
substance rightly applied to the ulcers which form in the lungs,
may yet  be found to arrest their  progress and excite in them a
healing process.
  Consumption, by  many, is thought to be, in some situations
and circumstances, a contagious disease,  but  whether this is ever
the case or not, prudence will dictate the propriety of not sleep-
ing with a  patient in its last stages, and of not allowing children
to remain in the  same room with  aged people who  are affected
with it.
  Domestic Remedies.—It is of  essential consequence,  in  the
consumption, or in the commencement of those symptoms which
threaten  it, to  adopt such a  kind  and quality of dress, as will
most effectually  secure the person  against the changes  of  the
atmosphere, and  of  the seasons.   Atmospheric changes, have a
great agency in inducing the  disease,  and in hastening  its pro-
gress  when it has once commenced.    A shirt, made of wash
leather, and constantly worn next to the skin, and stockings made
of the same, have, probably, saved many a person, in our climate,
from the grave.   The invention of india rubber shoes, deserves to
be commemorated through all time.   They should always be
worn  in  cold and wet weather,  by people who are subject to a
cough and to cold feet.  No change of fashion should induce
consumptive  invalids to  lay them aside.   To some people, they
may be a little uncomfortable, on account of their tendency to
excite a  perspiration in  the  feet,  but this is no real objection to
their use.  As soon as the weather becomes  warm and the earth
dry, they may be left off with impunity ; but should  be resumed
as soon  as the weather becomes cold and wet, in the autumn.
The expenditure of the animal heat, is an expenditure not only
of the vital powers, but of the healing  powers of the  system.
To husband the animal heat, properly, requires no small degree
of attention.   Besides the leather  shirt and the leather stockings,
which can be purchased at any of  the apothecary stores, in  our
large cities, flannel drawers and a great coat or cloak, are none
too many clothes to be worn in the cold season, which commonly
lasts from the first of October to the first of June.
  The diet of a person who has any tendency to phthisis pulmo-
nalis, should be  confined chiefly to vegetable food.   Everybody
knows that vegetable food is less feverish than animal food, in other 
CON.                        157
words, that it is much less liable to create  heat, thirst and unea-
siness.  It softens the pulse and opens the body.   We once at-
tended a young man, of about  twenty-four years of age, whose
family had all died of consumption, and  who had several times
bled at the lungs ; he was left with a cough, and otherwise mani-
fested the peculiar symptoms of an incipient consumption, who
lived a whole year upon codfish, and potatoes, and hulled corn,
with a little sugar and  milk upon it, by which he arrested the
disease, and is now, twelve years since, a  well man.  A diet of
wholesome, nutritious vegetables,  will  cure  the  scurvy,  and
correct a putrid  state of  the  fluids and solids; it must there-
fore, in general, give a healthy tone to the whole system.  If
vegetables cause scorbutic sores  to heal, we may rationally expect
them to  promote the healing of tuberculous  ulcers.  We  have
known several, who have been threatened  with consumption, to
live for months, upon hominy and molasses, and  by this means
avoided the disease.  Dr. Cullen and others, formerly placed their
whole reliance, in the cure of comsumption, upon a vegetable and
milk  diet, but  we think  that  patients, in general, will stand a
better chance of recovery, without  the use of milk.  Milk  may
benefit some  constitutions, but  where there exists any degree of
fever,  it will  be very likely to increase it.   The vegetables most
suitable for the aliment of consumptive people, are potatoes,  cab-
bages, turnips, beets, hominy, hulled corn,  rye and  indian bread,
rice, parsnips, asparagus, coarse wheat  bread, buckwheat  cakes,
indian cakes, apples, peaches, pears, grapes, and  in fact, all the
nutritious and  easily digested vegetables which grow in our cli-
mate.   Where people are obliged to labor, in order to live, it  will,
perhaps, be necessary for them  to adopt somewhat  of an animal
diet, but where this is  the  case, meat  should  not be used more
than once a day.   Salted  codfish, is,  in general, as innocent as
vegetables, and may be eaten as freely.   Cheese is more innocent
than milk, and  may, where it agrees with the digestion, be eaten
with impunity.   Eggs are less feverish  than meat, and  more
nutritious than  vegetables,  they should be eaten where vegetables
alone do not sufficiently nourish the system.  Honey, is a nutrit-
ious and wholesome article, which ought  to be used instead of
butter.  It is less of an animal substance than either milk or eggs,
and  yet it cannot be considered entirely vegetable.   Molasses, is
also  nutritious and healthy, and may be made  a  substitute for
either cheese or butter. New butter, is much more healthy  than
old,  and may be  allowed  where the taste  absolutely requires it.
But  to render a vegetable aliment efficacious, it  must be perse-
vered in for a considerable length of time.  The solids and fluids
must be renewed by it.  We do not recommend a spare diet, but
on the contrary, would advise  rather  a full diet, but to be com-
posed chiefly of vegetable substances.   Even this disease may be 
158
CON.
  induced, by two spare a diet, or by the use of food which has been
  damaged or decomposed.   Deficiency of aliment, disposes the hu-
  man body  to unhealthy sores and many serious disorders.  The
  appetite corrected by personal  observation and experience, will,
  in general, be a safe guide as to the amount of aliment to be taken.
  Oysters, lobsters, turtles, clarns, and shell fish, in general, may
  be  eaten, where  the  strength  of  the  system  appears to require
  them, but should  always  be taken in  moderation.  All kinds of
  fish which are not of an oily nature, are more suitable than meat.
  Shad, herring, tautog,  scup, eels, and trout,  are probably less
  heating  and feverish, than even  milk or eggs.   Mackerel and
  the grey fish,  in general, being of an  oily nature, constitute an
  unsuitable aliment, in cases of local inflammation and ulceration,
  whether in the lungs or any other  part of the system.
   Next to clothing and aliment, exercise is of the most  conse-
  quence in  the treatment  of consumption.  In our  country, in
  nineteen cases out of twenty, any  inducement  to  exercise  is
  unnecessary.  By far the greatest part of  our  people, are either
  farmers, mechanics, or men in some active business, who need
 no  other spur to  exercise, than necessity or  ambition.   There
 are  however,  a  considerable  class  in our  cities,  particularly
 of the female  sex,  who suffer  for want of that constancy and
 degree of bodily  exercise, which  is essential to health,  and
 to the full development  of  all  the  animal organs.   The steady,
 constant labor, to which all our farmers and  mechanics  are sub-
 ject, is exceedingly favorable to health and to the development of
 the  full capacity of every  organ;  and there can be no question,
 but  that  consumption, is much less  frequent among them, than
 among the professional and wealthy classes.    No estimate  has
 hitherto been made between the people  of country towns, and
 the cities, as to their liability to consumption,  but when such
 an estimate  comes  to be  made, it will be found that country
 people, who follow an active life, are  much less liable to it, than
 the inactive inhabitants  of cities.   There  is, probably, no life in
 the world more favorable to health, in general, than  that of an
 American farmer.  He is, in general, temperate; his food is  of
 the  best  kind; the  air  he  breaths is  pure and salubrious ;  his
 sleep is sound; his anxiety as little  as it well can be in this life •
 his liability to excitement, either political or religious, much less
 than in the  cities and manufacturing towns,  and  his situation
 and occupation are  every way calculated  to  compose, to cheer
 and to strengthen his  mind.  We  would advise,  therefore, all
 those who can be  at all contented in a country town, on the first
 approaches of consumption, to take  up their abode  there.  The
 ablT£P°iiSrne'n lWeU u the °PP°rtunity for agreeable and suit-
Thev wm b'PT  if™ th/ m°f ?VOmble effect UP°n the disease.
 J.hey will be in  the midst of the  vegetable world, with all its 
CON.
159
beauties and  all its medicinal powers.   The sleep of the farmer,
is one of the most salutary and enviable enjoyments, which life
in any situation can afford.  This is a function of  the brain, and
the regulation  of it,  is of scarcely less importance to the enjoy-
ment of health, than that of digestion or of respiration.   No
healing process  can go on well, without sound, refreshing sleep.
It matters but little,  whether a person take exercise  on horse-
back, in a carriage, in walking, or in some kind of work, provid-
ed it be uniform and constant, and carried to such a degree, as to
feel  a slight fatigue, every night, when he  goes to bed.   In the
last  stages of consumption, exercise is of little or no service.  Oc-
cupation and labor have furnished more instances of  cure, in
consumption, than riding, walking, or any  of those  kinds  of
exercise, which  are pursued for amusement and recreation.  See
Exercise.
  In some instances of chronic phlegmesia of the lungs, exercise
is painful, and  probably  tends to aggravate the disease.   The
lungs, in such cases, are too extensively inflamed, to allow of any
acceleration of the motion of the blood ; and rest conjoined with
social amusement, is required  as a matter of necessity.
  Change of situation,  of air, and of climate,  has an  important
effect upon the disease of the lungs.  Where the consumption is
induced by the depressing passions, as it often is, a mere change
of situation,  from one town to another, and from old  associates
and  associations to new ones, will often work an agreeable alter-
ation in the spirits and  the disease.   The winter season of our
climate,  is supposed  to be very  unfriendly to the cure  of con-
sumption ; and it is thought, if consumptive patients, could only
live  in a perpetual summer, they would generally recover.  But
it has been pretty well ascertained, that people die of this disease
in all parts of the.earth, in the hottest, as well as in the coldest
climates,  and in the  most temperate, as well as in the most in-
clement parts of the  globe.   The temperate  and the equatorial
parts of  the  earth, however,  are much more exempt from the
consumption, than the cold and frozen regions.   All the northern
countries of Europe and America, are  remarkably productive of
this  disease, and no country more so, than the islands of Great
Britain.   In the early stage of consumption, if a person can re-
move to some one of  the  West India Islands, and remain there
until the lungs have become sound, or if he can winter there, as
long as the disease continues,  it will always be advisable to try
the change ;  but it answers little or no purpose, to pass  a single
season there, unless the health  becomes  entirely re-established.
A long voyage to sea, has, in  some instances, been the means of
recovery, and none is  more likely to be  productive of this effect,
than a whaling voyage  to the  Pacific, if made in the incipient
stage of the disease.  Some have supposed a salt air unfavorable 
160
CON.
 to the healing of the lungs, as it naturally tends to excite a eough.
 The sea air may have something of this  tendency, but hardly
 enough  to  counterbalance the good effects  of a warm, uniform
 temperature,  and  the  greater  degree  of purity  which  the  sea
 atmosphere, in other respects, possesses.   In some cases, the salt
 in the atmosphere,  may  have  a  salutary effect, especially, if it
 does not aggravate  the cough.  A small quantity of salt, applied,
 in solution, to an inflamed surface, would be as likely to promote
 a healthy action, as to excite inflammation.   It is probable, how-
 ever, that where the air is highly charged with salt vapor, it has
 a tendency like  the diffusion of any other foreign matter, in the
 atmosphere, to aggravate a cough.  But, still,  it  must  be recol-
 lected, that the sea air  does not excite a cough in well people,
 or in those whose lungs  are sound.  The salt air, therefore,  can
 have no great  tendency to irritate the lungs.
   It is the opinion of many, that those districts of country, which
 are most infested with fever and ague or  the bilious fever, are
 most exempt  also  from  phthisis pulmonalis, and therefore, that
 these places are  the most suitable residences for consumptive peo-
 ple.  From all the information which  we  can  collect upon this
 subject, we are inclined to think that the valley of the Mississippi,
 and the states beyond the Allegany mountains, are less produc-
 tive  of the consumption,  than the Atlantic states, or any of  the
 states on this  side of the Alleganies.  The northeast winds, are
 cut off by these mountains, and the southerly and southwesterly
 winds are known to prevail, more beyond them, than on this side.
 Spring is estimated to be two or three weeks earlier, on the same
 latitude in the state of Ohio,  than it  is in New  England, and  the
 cold season  is much drier and warmer.  The states of Alabama
 and  Mississippi, are, probably,  the best places  in the United
 States, for a winter residence, in  cases of a consumptive nature.
 There, the invalid is equally removed from chilly northeast winds
 and from the ocean air.
   The sulphur springs,  in Virginia, are well worth a  trial, by
those who are  apprehensive of a hectical tendency.  The  Saratoga
waters have not, in general, been  found  productive of much
benefit.   Change of scene, to be sure,  does something,  but  the
scene can be as well changed by going to some  other place, as to
 Saratoga.    Traveling, unless  people  can  be  entertained and
amused by it,  and unless  they can sleep better at night than they
can at home, is of no service, and had better be abandoned.
   The great mass of people,  who have the consumption, can
neither go a voyage to  sea, nor make  visits to foreign climates,
nor change  their residences  to other parts of  the country, and
can rarely take any other exercise, than what is performed upon
root, or in their ordinary  occupations; nor can they experience
 any other change of scene, than what chance, or friendship, or 
CON.                        161
 sympathetic kindness throws in their way, and, perhaps, after all,
 they are not so much the losers by their situation as they are
 apt to imagine.  Almost  every change is an experiment,  which
 may hasten, as well as ameliorate  the disease.   Some  consump-
 tive patients,  who have  sought health in foreign climates, have
 come to their death by accidents, or by some  other disease  than
 the one they  sought to  cure.   There  is, besides, a solace in
 home, be it ever so humble, when one is sick, which can never
 be  found abroad.
   During the cold season, where cold is found  to aggravate the
 cough, a very  good climate can be made within doors.   Such
 have been the  improvements in stoves, and the means of warm-
 ing houses and the rooms of the sick, that an artificial tempera-
 ture can be produced, quite equal in evenness, to the temperature
 of the West Indies or the south of Europe.  So far, therefore, as
 a dry, warm, even temperature is concerned, it can as well be
 obtained at home, as abroad.   We would not,  however, throw
 any discouragement in the way of those  who have the desire and
 the  means to go abroad.
   The most effectual remedies in the cure of cough, are opium and
 emetics. In all cases, where there is a tickling, dry, hacking cough,
 the  person should take twenty or twenty-five drops of laudanum,
 or the same quantity  of the solution of sulphate of morphia, every
 night.  The morphine is preferable,  where there is an  active
 state of the bowels, but in other cases, the laudanum, will have
 the  best effect.  If this does not remove the cough and regulate
 the  breathing, an  emetic  of ipecac,  should be taken, every day,
 until the desired result is obtained.   If ipecac cannot be obtained,
 an infusion of lobelia, or a great spoonful of powdered alum, may
 be used in its stead.  A daily emetic has been  productive of
 more good, in the early stages  of consumption,  than any other
 medicine or means, which have ever been used.  It may be used
 at any stage of the disease, when it  is not attended  with  active
 hemorrhage, or too great a degree of debility.   In ^the last stage
 of tubercular consumption,  neither this nor any other remedy, as yet
 known, will probably have any permanent effect.   Mucilaginous
 drinks, such as flax-seed tea, slippery elm tea, and a solution of
 gum arabic, will be found  serviceable, in  ameliorating the cough,
 and  promoting  the expectoration, but  will exert but very little
 influence in arresting the progress of the disease.  The lac am-
moniac, made by  grinding two drachms  of the gum ammoniac,
in a  mortar, and gradually pouring on half a pint of hot water, is
an old, but very excellent cough medicine.  This milky emul-
sion, is taken in table-spoonful  doses, three or four times a day.
   Where there  is pain  and soreness in  the chest, large blisters
should be drawn,  and repeated, as long as there is any chance of
being serviceable.   Large pitch plasters,  placed  between the
             21 
162                        CON.
 shoulders, serve to keep the chest warm and exert some influence
 upon the lungs.   The syrup of squills, liquorice, the balsam of
 tolu, and the hive syrup,  promote the secretion and the  raising
 of the  phlegm, and are often of essential service in relieving the
 distress in breathing.  A syrup made of the root of the burdock,
 will often afford much relief.   A tea made of the leaves of the
 white horehound, and sweetened with honey,  is one of the best
 cough medicines in use.
   Should the disease be attended with a diarrhea, a tea made of
 the ground log wood, should be given, two or three times a day;
 and where this cannot be  obtained,  a strong decoction  of the
 hardhack should be tried.
   Professional Remedies.—Broussais,  terms  consumption, a
 chronic phlegmasia or inflammation,  and prescribes the  same
 treatment, as in other chronic  inflammations.   He enjoins leech-
 ing and  setons.   There  can  be no doubt of the propriety of
 leeching in the early stage  of the  disease, where  there is pain,
 soreness,  and a pulse which will warrant it.  Leeching should
 always  receive a fair trial;  but setons, are more doubtful reme-
 dies.  We have never seen  any benefit from  them, or known of
 any from the practice of others.  In the  exhibition  of emetics,
 especially of ipecac, we have more confidence,  than  in all other
 remedies  put together.   Thirty grains of the  ipecac, should be
 given in a powder, mixed  with molasses or syrup, every day, for
 twenty  or thirty days in succession, if  the disease does not yield
 before that time has expired.  The sulphates of copper and of zinc,
 have, sometimes, been used  as vomits in  this disease, but  in  our
 estimation, they are inferior  to the ipecac.  We gave the ipacac,
 in one instance, to a patient, who  manifested every symptom of
 consumption, and continued  it  every day, for four weeks, at  the
 end of which time, to  the great surprise and gratification of his
 friends,  his lungs were restored to  soundness.  In  another  in-
 stance, we saw it administered  by another physician, in the same
 way, where it suspended the disease, for two years.
   The  tartar  emetic, applied  in the  form of  powder, or of a
 cerate, to the surface of a  blister upon the  chest, has sometimes
 been attended with the happiest effect in a long established cough.
 The tartar emetic, produces  small boils or tuburcles, wherever it
 is  applied  to the  denuded  skin, and,  in this way, imitates  the
 process  going on in the lungs ; and if  any diversion  of the dis-
 ease can be effected, this seems the  most likely way of accom-
plishing it.  It is a kind of a " similia similibus," which imitates
nature as closely as she can probably be imitated.
   The iodine, has received many testimonials in'its favor, in the
tubercular  consumption, and is entitled to a  fair trial. Where
 h! rfmT °rganS are  imPaired> and the fever will admit of it,
the Griffith mixture, is one of the best medicines which has ever 
CON.
163
been  used.   The quinine, will  often exert a benign  influence
upon  the whole system, and should always be given where there
is the slightest prospect of success.
  To moderate the diurnal fever, the safest and best means are
the sweet spirits  of nitre, Hoffman's anodyne liquor, and the
acetate  of ammonia.  Hoffman's anodyne will often supply the
place of opium.  The hemlock or cicuta, in the dose of a grain
and a half, of the extract, will often agree where opium fails.
The cicuta, used in the early stage  of the  disease, has been sup-
posed by many to produce a healthy suppuration of the ulcerated
.lungs, and to incline tubercles to heal.  We think the  cicuta has
some effect, in  promoting the absorption of tubercles, and it may
give a healthier tone to those which have already suppurated.
   The  blood root, which is nearly allied in its properties to  the
foxglove or digitalis, well deserves a trial, in the treatment of
phthisis pulmonalis.   Eight  grains  of the powdered  root,  will
operate as a gentle emetic.   In small doses, it  moderates and
softens the pulse; relaxes the skin,  and promotes the expectora-
tion.   The  foxglove  is  in more  common use,  than the blood
root,  and, perhaps, justly so ; both  should, however, be adminis-
tered, where there is a prospect of relief.   The wood naptha has
lately been  much commended for its  medicinal powers, in the
cure  of consumption, and deserves the notice of  the  profession.
 If  it  does not cure, it may alleviate the disease and prolong life.
 The  most that medicine can do in any disease is to prolong  life ;
 it cannot ultimately  save it.  The following receipe is one of the
 best  we have ever used for the relief of  the consumptive cough.
 Syrup  of squill, tincture  of lobelia, wine  of ipecac, and parago-
 ric, equal parts ;  to  be taken in the dose of a tea-spoonful, three
 or four times a day.  Another receipe, which will be found of
 great service in abating  the cough, is composed of one drachm of
 muriate of ammonia, ten grains of ipecac, and three drachms of
 the extract of  liquorice, dissolved in half a pint of boiling water.
  A table-spoonful may be taken, three or four times a day.
    The iodide  of potash,  in doses of five to eight grains, dissolved
  in a little water, has of late, been highly recommended, and also,
  the inhalation  of the vapor of iodine.  They both deserve a trial.
    CONTAGION.—The matter of any disease which  excites ,the
  same  disease  in another person, whether applied by  contact, by /
  the  breath,  or in any other way.
    CONVULSIONS OF CHILDREN.—The convulsion fits of
  children, and, of youth under the  age of puberty, seem to differ
  somewhat both from the hysterics and from the epilepsy of grown
  people.  The alternate  fits of laughter and crying, and the sensa-
  tion of suffocation by the rising of a ball in the throat, which are
  peculiar to hysteric  fits, are not experienced by  children in con-
  vulsions.   Nor do  they often  have that  foaming at the mouth 
164                        CON.
 and snoring sound in breathing which  are common in epilepsy.
 Convulsions are not very liable to affect children after the age of
 four or five years, though  they may happen, at any age, under
 puberty.  From birth to two years of age, is the period in which
 they are most liable to have them.
   A child without  any warning whatever, will often be seized
 with  convulsions ;  that is, it will fall  back as  in fainting, turn
 deadly pale, and its lips will become purple ;  it will commonly
 straighten itself out and become stiff all over,  its eyes will  turn
 up in its head, its hands will  be clenched, and its muscles will
 begin to twitch.  The eyelids and muscles of the face will either
 become stiff or keep in constant motion.  The teeth will be set,
 and the body start all over with  a sudden jerk, as if it had
 received an electrical  shock.    But these symptoms are more
frightful than dangerous.   In  the  majority of cases, the child
 comes out of the fit, in a few minutes, or at least begins to show
signs of consciousness, and in half an hour or an hour, after some
little drowsiness, it will  entirely revive.  As soon as the fit is
over, the child most commonly falls asleep and restores  the lost
powers  in  this way.    Its sleep  should  never be  disturbed.
In the  convulsions, the breathing partakes of the same kind of
spasms with the muscles.   In  some  instances, there will not be
much convulsion, the child will only turn pale, become uncon-
scious, and stiff, with its teeth set, and its eyes  partly closed and
turned up.   In other cases, especially where the fit proceeds from
previous disease, as it often does, the child will remain in the fit
for some hours ; its face will become purple, and then if it comes
out of it, another fit will soon follow until death relieves the suf-
ferer.   Many children die in convulsions occasioned  by diseases
of the brain, stomach, bowels and lungs.
   The most common causes of convulsions are teething, phlegm
in the stomach which has been swallowed in influenzas and lung
affections, indigestible  substances taken into the stomach, such
as orange  peel, the rind of  different kinds of fruit,  cheese, and
many other  things which children are greedy to ©at, but which
they should not have until after they get their teeth.   Any kind
of pain and distress  will produce convulsions in children.
   There is one symptom which almost always precedes convul-
 sions in children, and which if obviated in time, will prevent the
 fit.  If  the  stomach and  bowels of  the child become very hot,
 the breathing  short and quick, and the pulse  frequent, especially
after it has had one fit, we have good reason to anticipate another;
and if a gentle emetic of ipecac is given, and after it a little castor
oil, the  convulsion  may be  counteracted.  An injection of salt
and water will often answer instead  of both emetic and cathartic.
The heat and distress, in these  cases, appear to arise from indi-
gestion, and as soon as the digestive  organs are  unloaded, all dif- 
CON.
165
 ficulty is obviated.   The mother's milk will sometimes disagree
 with the  infant  and  occasion  convulsions; in such  cases the
 remedy is very plain.
   Domestic  Remedies.—After loosening the child's clothes, cold
 water should be dashed upon its face, stomach, and bowels, and
 continued for some minutes.   If this does not revive it, and it is
 unable to swallow, an injection  of salt and water, or of any other
 cathartic medicine  should be administered.  Indeed, in the majo-
 rity of cases, an injection is almost the  only thing which can be
 given.  If the affusion of cold  water and the injection  do not
 make any impression upon the fit, the  child should be immersed
 in a warm bath, and afterwards rubbed with the spirits of cam-
 phor or  new rum.   Cloths weted  with hot water, or  spirits
 should be constantly applied to  the stomach,  and mustard poulti-
 ces to the feet.   As soon as the  child can swallow, an emetic  of
 ipecac, alum, or lobelia should  be  given  it, and this should be
 followed by  a dose of oil, salts,  magnesia or some other suitable
 physic.  The child all the while should be rubbed with the hand
 or a soft flannel  cloth.   If  all  these means fail, a few drops  of
 laudanum and ether should be given.   Five drops  of laudanum
 and ten of ether can be given to a child of a year old, and less  or
 more as the  child happens to be younger or older.   Where the
 convulsions are  severe, and the teeth  set, eight or ten  drops  of
 laudanum can be introduced by  an injection made of starch.   A
 little peppermint, spirits of camphor, or  tincture of assafetida,
 where the patient is able to swallow, has a tendency to allay the
 convulsions.   The  child  should be  allowed to breathe the cool
 fresh air, and should not be over-dosed with medicine.
   Professional Remedies.—The leech we believe  to be  one  of
 the  greatest  blessings to man,  but especially to children who
 cannot bear the loss of blood so  well as  grown people.   Two  or
 three leeches placed upon  a child's head  or stomach, is often
 attended  with the  most decided relief.   In convulsions, if the
 child is taken in full strength, leeches, if  they can  be  obtained
 should always be applied ; but if previous sickness has reduced
 its strength, they will not be needed. Where leeches cannot be
 procured, a moderate bleeding from a vein, will be proper.  Much
 caution should be used, however, in drawing blood from children
 as mere emptiness, of itself,  will sometimes produce convulsions
 in them.   Where the convulsions  are occasioned by some local
 disease or irritation  which has long existed, the bowels should be
simply moved, and the strength supported by cordials.   Wine
brandy or rum, may be used indifferently.  The tincture of cas-
tor, in doses of fifteen or twenty drops to a child of one  or two
years of age, is one  of the best  medicines in use.  Blisters are
rarely found  to be of much  service  in this disorder.  Cold and
hot bathing,  the evacuation of the stomach and  bowels the 
166
COR.
giving of anodynes and carminatives, are about  all that  can be
usefully done for children in convulsions.   There is almost as
much  harm in doing too much as there is in not doing enough.
When the fits become frequent, the system should be strengthen-
ed with the mineral acids, quinine, and the tincture  of the muriate
of iron.  Griffith's mixture is an excellent medicine for children
who have been weakened by convulsions.   It may be taken in
tea-spoonful doses, twice every day.
  CORPULENCY—Polysarcia.—Fatness often becomes a dis-
ease.   The adipose substance under the skin, in certain instances,
becomes as thick as that of a hog.   The mesentary or substance
to which the bowels are attached, and the omentum or apron, as
it is called in the lower  animals, become  so loaded with fat as to
swell the abdomen and press upon the diaphragm.   This pres-
sure narrows the cavity  of the chest and produces a difficulty of
breathing.   The heart and the large blood  vessels also become
compressed, and consequently the pulse becomes weak and slow.
The motion of the  bowels is impeded, and muscular motion is
performed with difficulty.  Fatness produces insensibility and a
disposition  to sleep, and where  it becomes excessive, apoplexy
and death.   Neither the heart  nor the lungs having room to ex-
pand, the circulation of  the blood languishes, and the motions of
the vital organs are oppressed.  We once witnessed a case where
the cavity of the chest  became so filled up as to  induce an in-
flammation and a partial hepatization of  the lungs which ended
in death.
  Fatness is commonly  induced  by high living and a free use of
fermented liquors.   The laborer, and the active in  any pursuit of
life, rarely become fat.  People  in  easy circumstances who can
enjoy all the comforts of life without sharing in any of its cares
and toils, are extremely liable to become corpulent.   Care and
exercise are sure to make people lean, while quietude and  indo-
lence are  as sure  to make  them fat.  The means of cure, are,
therefore, in every one's power.   There is a wide  difference be-
tween a  fleshy  person  and  a fat  person.   Too much flesh or
muscle can injure no one, but too much fat,  which is an increase
of the  celular substance, necessarily produces disease.  To reduce
the fatness, people only have to reduce the quantity and the
richness of their food, and to take such a degree  of exercise or to
adopt such a system of labor as thinner people pursue.  Where a
person is enabled  to indulge  in rich food,  to lead an easy life,
without trouble or care,  and to sleep overmuch, he very soon be-
gins to grow corpulent.  He must, therefore,  if he wishes to
become thinner; eat less, sleep less, and exercise  more ; in a
word,  he must  become  temperate and active.  Some  people are
naturally inclined to corpulence,  but  austere living and hard
labor will effectually baffle this tendency. 
COS.
167
  The use of acids, such as vinegar, and lemon juice, by young
people, probably only increases the appetite, where it  does not
effectually destroy  it, and  make  the  matter  worse.  A too free
use of acids disorders the digestive powers, and a moderate quan-
tity only sharpens the appetite.   A grain or two of ipecac, or
some other nauseating medicine, just before dinner  or supper,
will have a much better effect.   But the best and safest method
of cure, is to adopt  a vegetable diet, to take active exercise every
day, rise early in the morning, and to keep awake as late at night
as the most industrious people are accustomed to  do.
   CORROSIVE SUBLIMATE—Muriate of Quicksilver—Mu-
rias Hydrargyri.—This salt is composed of the marine or muria-
tic acid and quicksilver.   It consists of  transparent  crystals,
which are soluble in hot water and in  alcohol.  It has a metalic,
styptic  taste, and is considerably corrosive, as its name imports.
Earths and alkalies decompose it, and neutralize  its effects upon
the stomach.   It is a poison.
   It  cannot be safely taken into the stomach in more than an
eighth of a grain, for a dose ; and it  should not  be given more
than three times a  day.  It is chiefly used, internally, in the cure
of the venereal disease.  It may, however, be used for other dis-
eases, especially the scrofula and  glandular diseases.   It produces
salivation like calomel.  In powder, it may be applied to vene-
real ulcers, cancers, and fungous sores.  Dissolved in alcohol or
hot water in the proportion of half a grain of the  salt to an ounce
 of the  solvent, it  makes a healing wash for sores, pimples, and
 eruptions upon the skin.   It is an effectual remedy for the itch.
    CORYZA—The Snuffles—Slight  Cold.—It is an inflamma-
 tion of the lining membrane of the nose.  It is cured by exciting
 a gentle sweat, or  a dose of salts.
    COSMETIC.—Medicines  used  to cure pimples, blotches, and
 freckles upon the skin.  The most celebrated is cologne water.
    COSTIVENESS.—This complaint is one of the  most com-
 mon to which mankind are liable.   A slowness of the bowels
 does not alone constitute the disease.  There is a great difference
 in individuals  with respect to the frequency of the motion of the
 bowels in perfect health.  Some  people are subject to  a daily
 movement of the  bowels ; others oftener than  this;  and some
 again will go two or  three days without the performance of this
 office, while each will enjoy entirely good health.   Sedentary,
 nervous, and  hypochondriacal people are almost always subject
 to a costive state of  the bowels ; on the  contrary, people who
 labor or  exercise  much and are free from nervous complaints,
 almost  as uniformly  enjoy  a quick and  healthy state  of the
 digestive organs.   The lower  portion of the intestines,  or the
 large intestines as they are called,  the colon and  the rectum. 
168                        COS.
are the chief seat of this complaint, although the whole length
of the alimentary canal probably partakes of  the same affection.
The action of  the  stomach is no doubt  slower in costive  habits
than in an open state of the bowels.
   When  the  motion of  the bowels becomes  slower than  it
habitually is, and, at the same time, the  contents of the bowels
become hard and dry, and the evacuation of them is performed
with  difficulty and without much desire, there  is  a disease of
some portion of the intestines, and this is the  disease implied by
the term costiveness.
   Sometimes the diameter of the intestines will not be lessened,
and, at others,  it will become much smaller  than usual.   The
alvine  discharges will often present  nothing but small, dry, hard
round balls, and the diameter of the rectum will be diminished to
the size of a goose quill.   There will be but very little desire, at
any time, to go to  stool,  and a constant weight and heaviness
will be felt  about the lower part of  the  belly.  There will be a
constant  sense  of confinement over the whole system, and the
head, in particular, will never feel right.   In this state, no bodily
or mental labor can be performed with comfort and ease.  After
eating, the sense of fulness remains for a long time, and hardly
subsides before another meal comes round.
   Domestic Remedies.—The best  and  surest remedy for this
complaint  is found in exercise and in  the aliment.  Exercise
gives  a quick  motion to the blood, and  a  quick motion of the
blood  gives a  quick  motion  to  the bowels.  Coarse vegetable
food quickens  the  motion of the bowels both by its properties
and its quantity.   The living of a New England  farmer is in
general well adapted to produce an  active,  healthy condition of
the bowels.  Rye and indian bread, potatoes, cabbages, turnips,
carrots, pumpkins, squashes,  salted pork  and  beef, fresh butter,
cheese, milk, buckwheat, beans, apples, peaches or  pears, are all
articles as well suited to health as  they are adapted to the  cli-
mate.  To these may be added a list of still  more opening arti-
cles, such as currants, whortleberries, raspberries,  strawberries,
cherries, grapes, walnuts, chesnuts, and butternuts.
  Fine flour bread,  on the contrary, especially hot biscuit, crack-
ers, gingerbread, doughnuts, and all the variety of rich  cakes
which are consumed in the  large towns and cities, are exceed-
ingly productive  of costiveness.  Fresh  meat, rich gravies and
sauces, where a large  proportion of  the  aliment is composed of
them, seldom fail, in the end, of inducing this complaint.
  Too small a  quantity of food, or unwholesome food, will pro-
duce costiveness.  The best medicines  for costiveness are, the
lenitive electuary,  butternut pills,  thoroughwort  pills, aloetic
pills, the elixer pro, the elixir salutis, rheubarb pills,  and, in ge-
neral, all the mild kinds of  physic, taken  in  just sufficient  quan- 
COW.
169
tity to move without weakening  the bowels; lastly, aperient
injections.
  COUGH.—The catarrh and influenza are attended with the
secretion and raising of phlegm ;  and the consumption with pain,
and soreness of  the lungs, and signs of a  general disorder, to-
gether with a cough ; but there is often a kind  of  dry  cough
which will last, for weeks and months, without any other trouble
than the cough  itself.  In some instances,  there will be  a little
raising of phlegm in this kind of cough, but for the most part it
is dry.  Mix an ounce of laudanum and an  ounce  of the wine of
antimony, and take thirty drops, twice a day.
  COUP DE SOLEIL—Stroke of the Sun.—This affection is
not distinguishable from apoplexy.  There is probably an  effu-
sion of blood or water upon the brain as in apoplexy, and the
same remedies are applicable.  See Apoplexy.
  COWITCH.—This  plant  grows  in the  West  Indies.  The
pods are about the length of the pea pod, and nearly of the same
size.  The  outside of the  pods is covered with  sharp, prickly
hairs, which rubbed upon the skin produce an intolerable itching.
The substance upon the pod is something  like the prickly head
of the burdock, or like the  chesnut bur.   Mixed with molasses
or syrup, it is given to children for worms.  The syrup  or mo-
lasses is made quite thick with the cowitch, and given  in the
dose of a tea-spoonful or table-spoonful, in the morning, fasting.
It acts mechanically, or by pricking the bodies of the worms.
  A tea made of the roots of the cowitch, is said  to be an effec-
tual remedy in the dropsy.
  COW POX—Vaccine Disease.—The cow is sometimes affect-
ed with a pustular eruption  upon  her  teats, which strongly re-
sembles the pustules of the small pox.  This eruption or collection
of pustules, is called cow pox.   It had been  noticed, for a long
time, by  farmers, that pustules upon the  teats of cows, would
produce similar pustules, upon  the hands  of those who  milked
them; and also that  those who  had  experienced this  eruption,
upon their hands, would never take the small pox.  This, how-
ever, was a mere tradition among country  people and farmers,
and whether there was anything in the belief, or  not,  its  protec-
tive power could only extend to those milkers, who might chance
to meet with the distemper in cows.   About fifty  years ago, Dr.
Jenner, an English physician, got hold of this tradition, and hav-
ing met with a milker, who  happened to have the pock upon his
hands, he conceived the idea,  and it was one of the happiest
which ever entered into the mind of man, of innoculating another
person from the  matter of these pustules, and  so, of extending it,
if it continued to produce  the  affection, to  the  community  at
large.  Accordingly, on  the fourteenth of  May,  seventeen hun-
dred ninety-six, he inserted the matter, taken with a lancet,  from
            22 
170
COW.
 the hand of a milker, into the arm of child, of eight years of age.
 The experiment succeeded.  In seventeen hundred ninety-eight,
 he published a history of his experiments, which effectually in-
 troduced the practice of vaccination to the notice of the public.
 Vaccination was  introduced into this country, in the year seven-
 teen hundred ninety-nine.
  The resemblance of the pustule of the  cow pox, to that of the
 small pox, is so great, that, among dairy people, it was no doubt
 always considered a species of the small pox, since  it was easily
 transfered from the teats  of  cows, to  the hands of those who
 milked them, and  naturally led them to infer that it might be an
 antidote  to  the small pox.   Observation, although necessarily
 very limited, confirmed  the  conjecture.  It is supposed that the
 original matter comes from the heels of the horse, and  is trans-
 ferred thence to the teats of the cow,  by those who handle the
 horses' feet.   The disease in  the horse, called  the grease, has
 been supposed to   be  the original foundation of the vaccine mat-
 ter ;  but  of late, this idea has been rejected.
  The disease produced by the matter of  the cow pox, is incom-
 parably milder,  than the disease  produced by  the matter of the
 small pox, even when the latter disease is  produced  by innocula-
 tion.  The vaccine disease, is not contagious  or communicable
 by the atmosphere, like the small pox, and never defaces the skin.
 Were personal beauty only concerned,  the discovery of the effica-
 cy of the cow pox, in protecting mankind from the physical rav-
 ages of the small pox, would entitle it to our eternal gratitude.
 The reputation of the  vaccine disease, in  protecting  people
 against the small  pox, has scarcely  suffered any loss,  since its
 first promulgation.  It is true, that the varioloid, a species of the
 small pox, which has been varied in  its appearances, by the per-
 son's having had either the vaccine disease or the true small pox,
 has been more prevalent  in the  last  ten or twelve years, than it
 was in the time of Jenner and the first propagation of vaccina-
 tion.  But this increase is probably owing to carelessness in vac-
 cination, to inattention in the selection of  the right kind of mat-
ter, both as respects the age and the  kind of it, and to its deterio-
ration, by having been so long transmitted  from one  person to
another, without going back to the  cow,  the original source, for
a fresh  supply.  When  we look about us, in  all our towns and
cities, and observe how rare it is to meet a person pited  with the
 small pox, and when  we  reflect, that  people,  now-a-days, have
 no other protection against the contagion  of the small pox, than
 vaccination,  and that  everybody we meet  would be more or less
 pited  without  this protection, we can hardly need more evi-
 dence, that the vaccine  disease,  is the most valuable discovery
 which has ever been made by man.
  The cow pox pustule, is a small, red, circular spot, about the 
cow.
171
size of a mallows'  cheese ;  instead of being pointed upon the
top, like most eruptive pimples and blotches, it is flat, or rather,
it is depressed in the centre.   About the sixth day, if it is pricked,
it will give out a little watery matter, and this matter, if put into
another  person's arm,  will, in about  three  or four days,  excite
another pock, just like the one from which the matter was taken.
There is a spurious kind of cow pox,  against which  we must be
on  our guard.   The pustules are  more or less pointed, and are
not so completely  circular.   The spurious  cow  pock is  white.
The vaccine matter, to ensure protection, must  either be taken
between the  sixth and the eighth day from the  time  it was  in-
serted in the arm, or we must wait until a dry  scab  has been
formed.
  After you insert a little of the cow pox matter under the skin,
the first appearance of its having  taken effect,  will  generally
occur on the  third day.  A small red spot, rather hard, will arise
from the place where the puncture was made.  There will, some-
times be  a  slight headache,  and other  symptoms of a trifling
fever,  but nothing  which calls for the use  of medicines.  The
pock in some instances, will  not appear until the fourth, fifth or
sixth day after the vaccination.  In young children, the infection
is harder to take, and in  them, especially while teething, it will
often be seven or eight days  before the pustule appears.   About
the ninth day, the pock, in general, begins to  grow hard, and to
form a scab, which gradually grows darker, until it becomes of a
mahogany color.  The mahogany color of the scab,  is a very
good  sign of the genuineness of the  pustule.   The  scab will
commonly come oft', about the  end of  the third week.  In most
cases,  there  will be a considerable redness, soreness,  and some
swelling around  the  pustule, about the eigth  or  ninth day and
continue  until  the  eleventh.   The  glands under the arm will
also become  somewhat swelled  and sore.   In some  cases, there
will be no surrounding inflammation or areola, as  it is called, and
the efficacy of the infection be nevertheless  equally reliable.  If
the pustule is circular, flat, and a little hollowing in  the centre ;
yields a  limpid fluid on the sixth or seventh  day; forms a ma-
hogany colored scab, and leaves a scar sunk in the skin, which
presents little indentions  like the top  of a  thimble, we may be
sure that the subject has had the cow pox, thoroughly.
  The most  common, and perhaps, the best method  of vaccina-
ting, is to take the matter upon a piece of a quill,  sharpened to a
point, diped into a cow pox pit, which is ripe, and after raising
the  skin with a needle or a lancet, to push the point  of the quill
containing the matter,  gently into the puncture which  has been
made by the  needle or lancet, keeping the quill in the puncture
until the blood,  if there has  been  any raised, has become dry. 
172                        C°w
It takes some little time for the matter to be absorbed; probably,
twenty minutes or half an hour.
   Another method is to put  a little piece of the scab into a
puncture, made in the same way.   The  scarf skin should be a
little raised, without drawing blood, if possible, and a small par-
ticle of the scab gently pushed under it,  and there  allowed to
remain.  But where you vaccinate from a scab, it is a better way
to soften a piece of the scab with a drop  of warm  water, and
reduce it to a paste; then to touch the point of a quill with this
paste, and insert the matter in  the arm, as you have been directed
to do in its liquid state.
   The matter in the shape of a scab, by inclosing it in a piece of
beeswax, can be kept good, for several months. Heat decomposes
it.  It must, therefore, be kept in a cool place.
   The cow pox matter which has been in use until very lately,
has been passing through the human subject, ever since the time
of Dr. Jenner, a period of nearly fifty years.  In the year eight-
teen hundred  thirty-seven,  the small  pox hospital of London,
obtained some of the  matter  directly  from  the cow,  and com-
menced vaccination from  the  original stock, which discovers a
much greater degree of activity than the matter which has been
so long in use.   The local inflammation is more severe, and the
constitutional  symptoms more perceptible.  Every person much
acquainted with the practice of vaccinating, must have observed
how very hard it often is to make the vaccine  matter  take, and
how apt it is to fail in young children.   The new matter, which
is now introduced, will probably remedy this defect.  Dr. Dung-
lison  of  Philadelphia,  has introduced  the fresh virus into this
country,  which will soon, everywhere, take the place of the old
matter.
   In all cases, where there is any doubt about the  taking of the
disease, vaccination should be  repeated.  It is a  good  plan to
vaccinate as  often as  once in four  or five years.  The disease
is trifling and vaccination  is  easily performed; and  where the
means of safety, are so  much  within our power, it would seem
the dictate of common sense to improve them.   Certain individ-
uals will  not  take  the  cow pox; but,  such individuals should
never neglect a good opportunity of vaccinating ; they may take
the disease at one time when they could not take it at another.
If, after  repeated trials, the virus cannot be made to  take, per-
haps, it would  be advisable, for such people, to be  innoculated
with the matter of the small pox.   The small pox, by  innocula-
tion,  is  a much  severer disease  than the  cow pox,  but per-
sonal safety would probably dictate the experiment,  rather than
to run the risk of taking the small  pox in the natural way.   A
child  or  any other person, should never be vaccinated when
there is any kind of humor about them, for, the vaccine  virus is 
CRA.
173
almost sure to aggravate every species of eruption upon the skin.
The existence of a humor is also liable to neutralize the effect of
the vaccine virus.  Neither is it advisable to vaccinate during the
time of teething, or of any other general disease.   It is now the
practice, in all  the large cities and towns, to vaccinate children
within six or eight  weeks after they are  born, and the practice
has not only been dictated by expediency, but is a very salutary
one.   In public vaccinations, where  large  numbers of children
undergo vaccination at the same time, many errors must neces-
sarily occur.   Some cases of the spurious  disease, will be mista-
ken for the genuine, and others will go away with  the idea that
they have had the disease, when they have only  had  a little red
swelling at the point where the matter was inserted.   Too much
care and attention  cannot be  well  bestowed upon  an  opera-
tion, which, though slight in its nature, is so nearly and vitally
interwoven  with our  welfare.   It must  not be  forgotten, that
the most proper time to take the matter from a vaccine pustule,
is between the sixth and eighth day,  and the earlier you take it,
after the sixth day, the more efficacious it will be.  The matter
should always be taken from a person who is free from all kind
of humors, and who has never been vaccinated before,  otherwise,
there  will be danger of having an abortive disease.   If some de-
gree of inflammation should be at any time  excited,  the  arm or
part which has been vaccinated should be  poulticed or fomented
with  warm  water, and washed with  cooling lotions, like  any
other  inflammed part.   The most proper place to vaccinate, is on
the outside of the arm, about  half way between the  elbow and
the shoulder.
  CRAMP.—We do not here mean to speak of spasms, in gene-
ral, of which  there are several  kinds, as tetanus or  the locked
jaw, hysterics, &c, but of that painful affection  of the muscles,
particularly the muscles of the legs, with which  people are often
troubled, and which always goes  by  the name of cramp.   Many
people are great sufferers by this disease.  It is not  dangerous,
but often more painful than some  diseases  which  are.  It attacks
young people while growing up, and those who perform heavy
work upon their feet.   It  will seize people in  climbing a tree or
a mast, and  sometimes force  them  to lose their hold. For the
most part, it proceeds from overstraining the muscles, and where
this is the case, nothing but a moderation of the labor  or exercise
which produces it, can effect  a  cure.  When fits of the cramp
become severe, the subject should take thirty drops of laudanum,
and rub a tea-spoonful or  two of it  upon  the muscles which are
affected.  A  tea-spoonful of the spirits  of camphor,  taken in a
little water,  will also serve to quiet the cramp.  The  same  may
be rubed on the seat of the  affection.    Fomentation with  a
warm decoction of poppy leaves,  may be used when the lauda- 
174
ORE.
 num and camphor are not at hand.  But, in most cases, simply
 rubbin^ the muscles with the hand or a piece  of dry warm flan-
 nel will carry off the disease.   Where it comes on after getting
 warm  in bed, it will be carried off by getting out into the cold,
 and where it is produced by  standing  or working too long  in
 the  cold, it  will be  relieved  by getting thoroughly  warmed.
 Pregnant women are peculiarly liable to the cramp, from a pres-
 sure of the gravid uterus  upon the nerves of the legs.   In them,
 the  affection  can only be palliated until  after delivery, when it
 entirely leaves them.
   CRANBERRY,  WILD—Arbutus Uva  ursi.—This vine  is
 sometimes  called bearberry.  It grows in all parts of New Eng-
 land, upon high land, and is an evergreen.  The leaves have an
 astringent taste, bordering upon bitter.  A tea made of the leaves
 is much used in affections of the  urinary passages,  particularly,
 in the  diabetes or excessive flow of the urine, and gravel.   The
 leaves  are of a pale, green color, smooth on the under side, small,
 and oval.  A dose of the powdered leaves is a  tea-spoonful.
   CRANE'S  BILL—Geranium Maculatum.—This plant  is a
 very active astringent,  well calculated to restore to  health those
 serous  and mucous membranes  which have lost  their elasticity
 and cohesiveness, or tone.   It is found everywhere in the United
 States, in a moist soil.   The stem is about two feet high, and the
 leaves  are  large, hairy, and  notched,  or toothed,  and become
 spotted as  they grow old, which has given  it  the name of the
 spotted geranium.
   The root is the part most  used in medicine.   From twenty to
 thirty grains, of the powdered root, is the common dose.   In the
 cholera infantum, boiled in milk, it is often given to  restrain the
 discharges.   In the last  stages of  dysentery and diarrhea, its as-
 tringency will  often be  found sufficient to control the complaint.
   CRANIUM—The Skull.—It comprises eight bones, the fron-
 tal, two  parietal, the occipital,  two  temporal, the ethmoid, and
 the spheroid.   It encloses the  brain, and is covered by the peri-
 cranium or scalp.
   CRASSAMENTUM.—The  coagulum  of the blood, or the
 clot which  forms in the  spontaneous decomposition of the  blood.
   CREAM OF TARTAR.—The crystals  of  tartar, of which
 the cream of  tartar  is made, by purifying and grinding, are ob-
tained from the sediment of  wines.   In the crude crystals, it has
a subacrid taste, and is partially soluble in water.   The  cream of
tartar is a mild, cooling, laxative, diuretic salt.  Half an  ounce
or an ounce of  it, mixed with molasses or water, will operate as
a purgative.
   In the dropsy, it  is esteemed one of the most certain and safe
 remedies.   In the form of drink, it  operates as a diuretic.   In
ounce  doses,  taken  daily, in molasses, it drains off the water by 
CRO.
175
the bowels, and proves more successful than in the form of drink.
A tea-spoonful, infused in a tumbler of water or flaxseed tea, and
sweetened with loaf sugar, makes a useful and cooling drink  in
ardent fevers and colds.   Combined with jalap, it is  still  more
effectual in draining off the water in dropsical swellings.
   It is often given, internally, to cure the cutaneous eruptions of
children.
   CREOSOTE.—This is a colorless oil, obtained by distillation
from tar, or the pyroligneous  acid.  It is a powerful astringent,
and styptic,  and  applied to the raw flesh, is caustic.   It is con-
sidered an escharotic.   Applied to small bleeding vessels, it will
stop  hemorrhages.   A drop of it upon a dossil of lint is often
used to  cure the  toothache.   Taken upon the tongue, it  has a
hot/burning, styptic taste.  It has the smell and flavor of smoke,
of which it constitutes the essence.  In smoked meats and fish,
creosote is the oil which  penetrates and preserves them.  It is a
greater preserver of animal substances than salt.
   Internally, it is administered in a number of diseases.   The
ordinary dose is from one to  four  drops, diluted with water  or
mixed with mucilage.   We have seen it successful in  stopping a
bleeding from the  lungs; and its  influence is very considerable
in arresting bleedings from other organs, especially the sanguine-
ous discharge in the monthly sickness of females.  It has acquired
some reputation in the cure of hysterics and other nervous affec-
tions.  In  the canker, some prefer it to  any other  gargle.
   CROTON  OIL.—This oil  is imported from  the  East Indies.
It is derived  from the seeds of a tree, called the croton tiglium.
The seeds are of a dark grey color, and, in shape, resemble the
seeds of the  castor oil plant.   The oil is the most powerful pur-
gative in use. One drop will operate upon the bowels forcibly.
The time it takes up in the operation is not commonly more than
forty minutes.  It has a hot, burning taste, more penetrating than
the juice of red pepper.   It may either be made into a pill with
a crumb of bread, or mixed with syrup or mucilage.   The tenth
part of a drop taken upon  the tongue will often move the bowels.
   This oil is mostly used in  the colic, strangulated  hernia  or
rupture, and  in obstinate obstructions of the bowels.  The arti-
cle is an invaluable addition to medicine.
   CROUP—Cynanche  Trachealis.—The croup is an  inflamma-
tion of the windpipe which is mostly confined to children  under
twelve years of age.  It is very rare that the croup affects grown
people.   Nursing children are mostly exempt  from this disease.
It, for the most part, attacks children within the period included
between two and eight years of age.  An inflammation of the
uppermost  part of the windpipe, which is called  the larynx, has
been considered a distinct disease from the croup, and denomina-
ted, the cynanche  laryngea, but the distinction is altogether too 
176                        CRO.
faint and unimportant to be treated as a separate  disease.   The
practice, in an inflammation of the windpipe, be it in what part
of the pipe it may, is the same, in the same degree of inflamma-
tion.                                                 .
  The  croup may be known  by the  peculiar sound which the
child  makes in breathing.   This sound resembles that  which is
made by the breathing  of a horse in the hives,  and when the
child coughs, the sound resembles the barking  of  a  dog, and
some  have likened  it to the crowing of a cock.   The sound
made in breathing is so peculiarly hoarse and croaking, as scarcely
to be forgotten after a person has once  heard it.  The  mere sound
indicates, that the pipe, through which the  air passes, must be
quite  choaked up.   In  coughing, there is little or no soreness
felt, as in an inflammatory sore  throat.  It differs from a hoarse
cold, inasmuch, as the breathing is performed with great difficulty,
whereas in. a hoarse cold, the  breathing  is not  essentially
impeded.  Besides the barking kind of noise made in coughing
and speaking in  croup, the  inflammation is accompanied  with a
quick, hard pulse, dryness of the mouth and tongue, thirst, heat,
and all the symptoms which usually attend local  inflammations.
The breathing resembles the asthma  of grown people, but the
mere asthma has not the peculiar sound, in coughing, which be-
longs  to the  croup.   The  asthma has very sensible  remissions,
and, sometimes, complete intermissions, but the croup abates but
very little until it is removed.
  In the beginning of croup, the  child will appear to have  only
a hoarse cold, but, if attention is paid  to the  coughing, which is
not very frequent, it will be  perceived to have an unusually
shrill sound.  The little patient will be inactive and  fretful, and
at night, the shrill kind  of coughing will be more apparent  than
in the day time.   It will, sometimes, appear to be " stuffed up,"
as it is called, for two or three nights before the difficult, wheez-
ing kind of breathing becomes  fixed.   In young children, it will
occasionally come on, of a sudden; the breathing will  hasten
from bad to worse ; the windpipe will become entirely closed up ;
and the child will  die in an hour or  two from the commence-
ment of the attack.   We once witnessed the death of a child, a
little under a year old, which  happened in one hour  from the
first notice which its parents had of the disease.   Usually, how-
ever, it  is about two days before the real symptoms of croup be-
come  fully developed, after the commencement of the indisposi-
tion.  As the disease progresses, the  fits of coughing become
more  distressing, the  child makes a great effort to inspire a full
breath of air, the face  becomes flushed, and the  eyes  protrude.
The tonsils  and  palate  will sometimes, though not always, be-
come red and swelled, and there will be some redness all around
the entrance of the throat.  The head is usually thrown back to 
CRO.                        177
escape suffocation, and the child will often rise up suddenly to
catch his  breath, and, in agony, dash its face upon the pillow.
It is not often that much of  anything is coughed up, but when
there is, the matter will consist of fibres, or pieces of thin mem-
brane, like isinglass.  This matter has been considered by some,
hardened and dried mucus, and, by others, an organized substance
thrown off by the process of inflammation.  There will some-
times be pretty long remissions in  the difficulty of breathing, so
as to give hopes of recovery, but the distress for breath will sud-
denly return and carry off the patient.
   The croup will sometimes  terminate  fatally,  in twenty-four
hours, but  children generally live  until the fourth or fifth day.
Even where considerable quantities of the membranous film are
coughed up, it only alleviates, for a while, the distress in breath-
ing, without affording any permanent ground for recovery.  The
inflammation, in croup, often extends to the bronchia  and the
lungs, and  involves  the whole  breathing  apparatus, in a similar
condition with the trachea.   The matter found in the  lungs after
death resembles that in the windpipe.
   Domestic Remedies.—The best  remedy which the family can
give to a child  attacked with  the  croup is an emetic.   A wine-
glass full of lamp oil or goose oil will often answer this purpose
where no better medicine can be obtained.   A tea-cupful of the
thoroughwort tea often proves a good vomit, but it is not always
sure.
   The best emetic which  can be given to a child in  the croup,
is, in our opinion, the powdered alum.  A heaping tea-spoonful
of the powdered alum, mixed with molasses or honey, should be
given every ten minutes until  it pukes  thoroughly.   The  alum
more than  any  other substance  operates upon the salivary glands
and makes them  pour out the saliva in great profusion. It  in-
stantly promotes the  secretion  of  the throat and fills the mouth
with a watery mucus.  It was  this property in the alum which
first pointed it  out to us as an appropriate remedy in  the croup,
and we have used it for  seventeen years with the  fullest confi-
dence in  its superiority as an  emetic in this disease.   It will
sometimes operate upon the bowels, but it is much less  likely to
prove cathartic  than  antimony or ipecac.  In one case, it acted
like a charm where the child was given up for  lost.   An  older
child had just died of the croup in the same family, and this was
attacked in the same way, and betrayed  the same  symptoms,
but, two or three  emetics of  the alum subdued the disease and
saved the child's life.  The lobelia, in tea-spoonful  doses, of the
infusion, is said to be a very effectual emetic.  Ipecac is always
a safe remedy, but, m this disease, it is not quite powerful enough,
The hive syrup, of Dr. Cox, of Philadelphia, has been used with
            23 
178
CRO.
 a good  deal of success ;  but for young  children it is  not so safe
 as the alum.
   A plaster of snuff and hog's lard, laid upon the chest, is one of
 the best means in use for relaxing the system and subduing  the
 inflammatory action.   A  tea-spoonful of common yellow snuff
 mixed with a little lard and spread  upon a rag,  composes  the
 plaster.    It will  sometimes make the  child  very sick  at  the
 stomach and vomit smartly, but where this effect continues long,
 it  will  be advisable to remove it, until  the  sickness subsides.
 The  drink should be flax-seed tea, or some other mucilaginous
 drink, and gruel.  If the emetic does  not operate as physic, a
 dose of  castor oil or salts should be given.  But this  disease, in
 general, runs  its course with such rapidity that no time should
 be lost in obtaining all the medical aid which is necessary.
  Professional Remedies.—In  the early  stage of the disease a
 sufficient quantity of blood  should be drawn to make an impres-
 sion upon the pulse.   If the disease is not subdued by the quan-
 tity drawn from the arm, it will be the safest, and, probably, the
 most  effectual way, to  draw more  by the use of leeches, placed
 upon  the neck.   Some are in the practice of using leeches only,
 and where they can be obtained in sufficient number, they may
 be found as effectual as drawing blood from the arm.  Blisters
 are doubtful remedies, especially when placed around the  neck.
 If the inflammation were upon the surface of the body, we should
 poultice it.  It has always appeared to  us, therefore, that warm,
simple,  emolient poultices were the  most solvent and effectual
local applications which could be made, and we have used  them
for many years with increasing confidence in their propriety.
 Dr. John D.  Fisher, of  Boston, has recommended the  use of
warm fermentations  to  the throat.  These  answer a purpose
 similar  to a poultice, and may be used with equal  propriety.
But where these applications are not attended with satisfactory
relief, the volatile liniment, which is composed of sweet oil, and
the water of ammonia, in the proportion of one drachm of the am-
monia to one ounce of the oil, should be substituted.  The lini-
ment  should be spread upon a pretty  wide piece of flannel, and
the flannel wrapt around the neck.   This application when'used
freely, will often of itself, raise a profuse  sweat over  the whole
surface of the body.  It increases the perspiration about the neck
very much, and, in this way, relieves the windpipe.
  Equal parts of  squills and of castor  oil, given in a dose of a
tea-spoonful every  hour, until it operates upon the bowels, is one
ot  the best combinations which has ever been  administered  It
serves to quicken the secretion of the windpipe, at the same  time,
mat  it produces a general relaxation of the system by evacuatine
 the bowels.  A tea made of the seneka root, boiled in water is
 a good solvent  of the  tough, filmy matter which  clogs up {he 
CUB.
179
 trachea.   Small doses of ipecac or of antimony, answer a similar
 purpose.  Great care should, however, be taken not to administer
 medicine too fast.  While the child is being vomited nothing else
 should be given, unless it be a little drink ;  and it is always best
 to raise a sweat before evacuating the bowels, as the two opera-
 tions cannot be well carried on at the same time.  The evacua-
 tion of the bowels lessens the perspiration.   After  the patient is
 bled, he  should first  be vomited, then  sweated, and afterwards
 purged.   After  making a thorough trial of medicine and anti-in-
 flammatory means, it will often be advisable to rest a while, and
 give  the patient a short respite, and ourselves a chance to see
 what particular  effects arise  from the medicines,  and, what  from
 the disease.
   Calomel  in a dose  of a grain or two, every hour, has  been
 highly extolled, and is probably,  sometimes, a  solvent of the in-
 flammatory action.  Calomel has,  no doubt, a tendency to in-
 crease all the secretions, and is  a  good remedy in good hands.
 An adroit practitioner will  produce  effects,  with this and every
 other medicine, which  never can be imitated  by the unskilful.
 The sharper and the more delicate the instrument, the more dex-
 terity it requires to wield it.
   Some  physicians are  under  the  persuasion,  that the croup is
 never cured ; but  this persuasion is without foundation.  There
 are two  degrees in this disease as there  are in  the  inflammatory
 sore throat.  The croup is, sometimes, mild, and, at others, severe,
 like almost all  inflammatory diseases.   The mild cases recover,
 and the  severe  ones often end fatally.  It  is probable  that one
 half of the cases of croup are of the mild kind,  and consequently
 recover.
   In cases, where all other means  have been used without success,
 tracheotomy or opening the windpipe, has of late years been tried.
 In this country, and in England, the operation has been rarely per-
 formed, but, in France, it is more common.  In one hundred and
 forty cases where  it was performed  in  France, twenty-eight  of
 the cases are reported to have been  successful.  " In one  case,
 performed by Dr.  Rhea  Barton, of  Philadelphia, at the earnest
 solicitation of the  physician and friends, when the child was
 apparently in the  article of death, the first  access  of air to the
 lungs produced effects as wonderful as those  of  galvanism.   The
 child looked round, embraced his parents, and, I believe, talked.
 It soon, however, sank again, and disappointed the hopes which
 had been raised."
  CUBEBS—Cubeba.—An  East India  spice,  resembling black
pepper, but  inferior in aromatic pungency and  warmth.  In the
gonorrhea, in the dose of a drachm of the powdered corns, it will
often effect  a cure.  It  may be  given  in any disease  where a
warming spice is required. 
180                       CYN.
  CUTANEOUS DISEASES.—The  description and treatment
of cutaneous diseases will be found under the heads of, Blotched
Face, Salt Rheum, Tetter, Red  Gum,  Yellow  Gum,  Yaws,
Elephantiasis, St. Anthony's Fire, Heat  Eruption,  Leprosy,
Itch, Small  Pox, Cow  Pox, Chicken  Pox, Measles, Scarlet
Fever,  and Scald Head.
  CUTICLE—The Scarf-skin.—It is  this skin which is raised
up in a drawn blister    It is  thin and transparent.  A mucous
membrane  called the rete mucosum lies between this and the
true skin.   It is the rete mucosum which gives the color to the
skin.
  CUTIS.—The true  skin, or rather,  the undermost membrane
which composes the skin.
  CYNANCHE  LARYNGEA.—Inflammation of the larynx or
uppermost part of the windpipe.   The symptoms of this disease
are scarcely distinguishable from croup.
  In an inflammation  of the larynx  or uppermost part of the
windpipe, however, there is always some redness and swelling of
the throat  in sight, and a pain  and difficulty in swallowing—
two  appearances which are absent in the  true croup.   In the
croup, the inflammation is lower down  the windpipe, or rather it
does not extend so much above the larynx as to be in sight.   On
dissection of those who die of this disease, the lining membrane
of the larynx is found inflamed and water effused under it.
  The chief remedies are leeches to the throat, or bleeding  from
the arm, purgatives, sudorifics, a blister to the back of the neck,
inhaling steam, and emetics.   The disease, in general, requires a
prompt depletion, and the same remedies are proper that are  used
in croup.   See Croup.
  CYNANCHE   MALIGNA — Putrid Sore Throat — Canker
Rash—Scarlatina  Anginosa,  Scarlet   Fever.—The  putrid sore
throat  takes all these  names.  In this disease, there is a wide-
spread ulceration of the throat instead of a healthy suppuration,
as in the inflammatory sore throat or quinsy.   The  ulcers are
commonly covered with a white crust, but, in some instances,
the coat will be black, as if the lining membrane were mortified.
The  inflammation is seated principally  in the mucous membrane
or lining of the mouth and throat, and  the accompanying fever is
of the typhoid type.  In some instances, the affection is attended
with a rash, and, in others, it exists without any eruption  upon
the skin.   See Scarlet  Fever.
  CYNANCHE  PAROTIDEA—Mumps.—See Mumps.
  CYNANCHE  PHARYNGEA—Inflammation of the Pharynx
or throat.—It is a disease of the same nature, and requires the
same remedies as  the  cynanche tonsillaris.   They are  both
known under the common name of  the inflammatory sore throat
or sore throat. See Sore Throat. 
DEA.
181
  CYNANCHE TONSILLARIS—Inflammatory  Sore  Throat,
Quinsy.—See Sore Throat.
  CYNANCHE TRACHEALIS—Croup.—See Croup.
  CYSTITIS—Inflammation of the Bladder.—See Inflamma-
tion of the  Bladder.
                             D.

   DANDELION.—This plant is commonly used for salad or
 greens, in early spring.   It opens the bowels and  increases the
 secretion by the kidneys.  It  is nutritious,  and cooling  to the
 blood.  In diseases of the skin, dropsy, jaundice, and  consump-
 tion, it is no  doubt efficacious.   The juice of the roots, is the
 most  medicinal.  A strong tea made of the roots,  and drank to
 the amount of two or three ounces or a wine-glass  full, three or
 four times a day, is the  usual  mode of dispensing  it.  The ex-
 pressed juice of the dandelion is bitter, particularly, of the root,
 and is doubtless strengthening as well  as  aperient  and diuretic.
 To have  its proper effect, the plant must be used with as much
 freedom as other common herbs.  An extract is made from the
 roots, the dose of which is from ten grains to a drachm.
   DEADLY NIGHT-SHADE—Atropa Belladonna.—This plant
 grows to two or three feet in height.  It is perennial, and branch-
 ing.   The leaves are oval, and the flowers come out in mid-sum-
 mer.  It is found  in  unfrequented roads  and  by places.   The
 berry is round, green, changing to red, and when ripe,  of a shin-
 ing black, resembling the black cherry in size and color.  The
 inside of the flower is of a dull purple color.
   The berry contains a juice of a nauseous sweet taste, and of a
 beautiful, durable purple  color.
   The belladonna  is a powerful narcotic and anti-spasmodic.  It
 also promotes  the  secretion by the skin, by the kidneys, and by
 the salivary glands.
  It is a deadly poison in  an over-dose, and requires  great caution
 in the use of it.  It has  the remarkable  power  of dilating the
 pupil  of the eye, when the diluted  extract  is rubbed  upon the
 eye-lids.   In extracting,  depressing, or breaking up the lens of
 the eye, it is used by the operator to expand the pupil and to test
 its sensibility.
   One grain of the powdered leaves, or  root, is a dose  for an
adult.  It is  frequently used in the cure  of palsy,  epilepsy, and
melancholy;  in amaurosis, dropsy,  rheumatism, gout, scirrhus,
cancer, and the locked-jaw.  It is now chiefly used in the form 
182
DEA.
of extract, beginning with a quarter of a grain at a time.   In all
painful affections, it is a medicine of undoubted potency.
  DEAFNESS—Paracusis.—Deafness, sometimes, arises from
an affection of  the nerve of the ear, and at other times from an
inflammation and  thickening of the  drum,  the  lining  mem-
brane of the ear, and of the eustachian tube.  Where it arises
from  a paralysis  of  the  auditory  nerve, it is very difficult to
cure.   It more  commonly happens  from an inflammation of  the
ear, which is manifested  by intense pain,  noise in the  ear, and,
finally,  by a discharge of  matter.  The  ears of  children will
often  inflame, suppurate, and discharge matter without  the loss,
or diminution of hearing, but  sometimes, there  will be  such a
disorganization  of the apparatus of hearing as to destroy that
sense entirely,  or at least  diminish  very much  its acuteness.
There is  a glandular structure in the ear which  secretes  the
wax, and when these little  glands are disordered, and there is a
sense of dryness and of heat in  the ear, the  organ should be daily
syringed with warm rain  water or a little castile soap and water.
A weak solution of sugar of lead or of white vitriol  in rain water,
washed into the ear with a rag, or thrown in with a syringe, will
abate the heat and reduce the inflammation. Dr. Thomas recom-
mends that a solution of common table salt should be dropped into
the ear ;  or a mixture of ox gall and the balsam of Peru, in  the
proportion of three tea-spoonfuls of the ox  gall to one tea-spoon-
ful of the balsam.  If it is suspected that the  nerve of the ear is
affected or  paralyzed,  the organ should be subjected to shocks of
electricity or galvanism.   The  organ  should also be stimulated
by dropping into it a mixture of the oil of almonds and the spirits
of turpentine, in the proportion  of four tea-spoonsful of the oil of
almonds to forty drops of the  turpentine.   A mixture  of sweet
oil  and the water  of ammonia, in the proportion of four tea-
spoonfuls  of oil to  half a tea-spoonful of  the ammonia, may be
used in the same way.  These  substances are  best applied to  the
ear upon a dossil of wool or lint.  Ether will  dissolve  the wax,
and lessens the  dryness of the ear.  Laudanum and the spirits of
camphor are of great service in quickening the hearing.   Where
the ear is sensitive to the cold,  a dossil of  wool worn in the ear,
will secure it from  the effects of the  cold. When the internal
passage from the mouth to the  ear, called  the eustachian tube,
becomes filled  up,  it has been recommended to  puncture  the
drum of the ear.   Tobacco smoke has been  forced through  it,
by  holding the mouth and nose, and making an  effort as if to
force the smoke through the nose.   When  the smoke enters  the
ear, a cracking  noise is heard.  Injections  have  been made into
the cavity of the ear through the eustachian tube, and we should
judge this to be an excellent remedy, if properly done.
  Deafness is sometimes produced in children  by  the swelling of 
DEG.
183
the tonsils or almonds of the ear, and will often remain for a long
time, but finally go off on the subsidence of the swelling.  This
is a frequent cause of deafness in children, but the disease  is not
permanent.   The scarlet fever and the venereal disease are also
frequent causes of deafness.   The ulceration of the throat from
whatever  cause, will  often be  the occasion  of  it.   Where
the eustachian tube is closed, it may be known  by the blowing
of the nose:  if the tube is not closed, the drum of the ear will
be forced out and the pressure of the air upon it can be distinctly
felt.  Bathing the ear with cold water, in deafness of long  stand-
ing, has perhaps been attended with as much success as any means
which have ever been used.  A course of mineral waters should
be tried where it can be conveniently done.   The waters should
be drank, and the defective organ thoroughly bathed with  them,
both in a warm and in a cold state.
  DECOCTION.—Any medicine  made by boiling  in water or
watery fluid is a decoction.  Some medicines require to be boil-
ed, in order to extract their virtues, while others only require to
have cold,  warm, or hot water poured upon them.  When cold,
warm, or boiling water is poured upon substances and allowed to
stand for a certain time, the mess is called an infusion.   The
medicinal properties of a great many substances are dissipated
and lost by decoction or boiling, which are extracted and saved
by infusion.   Steeping, is what is commonly meant by infusion.
and boiling, is the operation meant by decoction.
  DECOMPOSITION.—The separation of bodies into  the  ele-
mentary principles  of which  they are composed by  heat.  A
stick of wood, placed upon the fire, is decomposed by the heat. It
is first separated into carbon, hydrogen, and oxygen;  and finally.
the carbon or charcoal is  converted into carbonic  acid gas, leav-
ing a portion  of ashes.  When vinegar or  cider  is poured upon
pearlash, the acid unites with the1 potash, and the carbonic acid
gas flies off.  The pearlash is separated into potash, and carbonic
acid, the elementary principles of which it is composed.   Tn al-
most every decomposition of bodies, a new combination of theii
elementary principles takes place.
  DEGLUTITION.—Deglutition, signifies  the  act of  swallow-
ing the food,  after mastication, or after being chewed and mixed
with the saliva and moisture of the mouth.  The tongue presses
the food back upon the upper part of the  gullet or meatpipe,
which receives the masticated  ball, and, by a series of  muscular
motions, carries it down  into the stomach.   Every  time the act
of swallowing is performed, the upper part  of the wind-pipe is
drawn up and down.  This motion is distinctly  perceptible, not
only in  men,  but in the lower  animals.  Over the top of the
windpipe,  there is a valve or little fleshy lid,  called the epiglotis,
which is let down upon the orifice of that pipe, every time any- 
I84
DEL.
thing is swallowed, to prevent it from entering.  The muscles of
the upper part  of the  gullet contract and press the ball of food,
or swallow of  liquid,  upon the muscles below, which, in their
turn, contract,  and send the mass  further along,  until it reaches
the stomach.   In the descent of the  food and drink into  the
stomach, there is an abundance of mucus poured out to labricate
the passage and protect it from harm, as well as to facilitate deg-
lutition.  It should be recollected  that the upper part of the gul-
let, in medical language, is called pharynx, and the lower part
of it esophagus.
  DELIQUESCENCE.—The change of certain salts or saline
bodies to a liquid state, when left exposed to the  air, by absorb-
ing water from it.
  DELIRIUM TREMENS.—It is but recently that the deli-
rium tremens  has been noticed  as a distinct disease.  It is an
affection of the nervous system caused by hard drinking,  the
constant use of opium, and other narcotics.
  The excessive use of tobacco has been often known to pro-
duce a semblance of the disease, such as wakefulness, uneasiness,
and giddiness.
  In the delirium tremens, there  is a commotion in the system,
which somewhat resembles the cold fit of an ague.  There is an
aberration or wandering of the mental  faculties, and an uncon-
trolable trembling of the tendons and muscles, insomuch that the
person cannot  raise a tumbler or a bowl to his mouth,  without
dropping it, or spilling the contents, from the quivering  of. the
hands.  The  person is constantly seeing  objects  and hearing
sounds which  do not exist, and evinces a loss of judgment  and
reason.  He thinks he sees insects on the wall and bedclothes,
or hears people talking in the adjoining rooms.  He is sometimes
hurried to acts of violence upon himself or others, and commits
suicide or homicide to escape some impending imaginary evil.
There is a total departure of sleep and a constant muttering, as if
there were great distress in the head.   The pulse is quick and
variable in force, sometimes strong and at others weak and small.
The breathing is short  and quick ; the surface cold; and often
covered with a clammy sweat.   There is not, in ordinary, much
internal fever.   The eye is glassy and wild, and the countenance
haggard and pale.   There is sometimes sickness and vomiting.
   There can be no doubt, we think, that this disease is an inflam-
matory affection of the nervous system—the brain and its branches.
Both the trembling of the muscles and the inability to sleep are
a proof  of this.  It is permanent insanity, produced  by  the
agency of substances which cause a degree of insanity every time
they are taken.  Alcohol and opium both occasion delirium to a
certain extent when only taken in a moderate quantity.  The
frequent repetition of intoxication, which is an artificial delirium, 
DEL.
185
 finally ends in a disease or affection more permanent.   Intoxica-
 tion is no doubt a very near approach to an inflammation of the
 brain.  It  produces an enlargement of its vessels and  a strong
 determination of the blood to the head.   This state of the brain
 being produced daily, for weeks and months in succession,  can
 but end in a tender, sore,  painful and inflamed condition of the
 nervous system.   The sore state of the brain prevents sleep, and
 destroys the energy of the voluntary power.
   Domestic Remedies.—The person affected with delirium  tre-
 mens, should be  secluded from company ; confined to the house
 and closely watched ; and, if need be, secured either by sufficient
 help, or by straps.  Everything should  be done to  compose the
 mind and to produce sleep.  The room should be darkened, and
 no conversation  held  to  awaken the  attention of the patient.
 The head should be bathed with cold water, or vinegar and wa-
 ter, and the feet  bathed  in warm water.   The room should  be
 comfortably warm and the person fed on gruel, broth and  milk
 porridge, rice, rye puddings and  hominy.  The surface of the body
 should  often be sponged over with tepid water.   If there is vom-
 iting, an emetic  of ipecac  should be given, followed by chamo-
 mile tea.  Full draughts of poppy or hop tea should be drank as
 often as every two hours.   As much nourishment of a liquid
 nature, should be introduced, as  the stomach will bear.  If the
 person can take  nothing  by the stomach, broth or warm milk
 should be insinuated by injection.   We are jieither in  favor of
 giving ardent spirits, as is  the practice of some, nor much opium.
 It is a disease which is generally long in being contracted, and re-
 quires time to recover from it.  Rum or opium, whichever has pro-
 duced the disease, first destroys the appetite and occasions an emp-
 tiness of the stomach and  of the blood-vessels.  The  body, in
 ordinary, has suffered for  want of nourishment.  But little new
 blood is made in the system, and the brain and all the other organs
 are, in a famished state.   The system needs not stimulus,  but
 the empty blood-vessels need to be replenished with their accus-
 tomed food, the blood.
   Lemonade and soda water are very good  and grateful drinks,
 but molasses  and water with a little ginger in it, or warm milk
 and water will answer very well,  and afford some little  nourish-
 ment.   Most cases recover in the course of a week or fortnight,
 and need no violent remedies.  The symptoms  will sometimes
 be alarming, but in the great majority of cases, the person recov-
ers without  much  medicine.   The person goes without sleep,
until  a  kind of  syncope  or fainting takes place, and  then  the
nervous system is prepared to be refreshed by sleep.
  The calcined magnesia, by  its operation upon the kidneys as
well as the  bowels, is  the most preferable physic to give.  The
bowels  should be kept free, but nothing more.  Perhaps it is 
186
DIA.
better to allow the patient the liberty  of the room, than to con-
fine him too closely to  the bed.   The symptoms in this disease
must be  obviated by  medicine, pretty much as the occasion re-
quires.   Some cases  will require  much  more to be  done than
others.   The evil of overdoing, in this  disorder, and in all others,
is almost as common as that of not  doing enough.  In  some
cases it will be best to make  use of half  a  tea-spoonful, or a tea
spoonful of the solution of the sulphate of  morphine; or to give
camphor, cicuta, and hyosciamus; but in general, the best medi-
cines to quiet  the commotion  of the brain, and  to  restore sleep,
are the sweet spirits of  nitre, Hoffman's anodyne liquor, and  the
acetate of ammonia in the state of effervescence.
  Professional Remedies.—Where  the  brain appears by  the
redness of the face and the  force of the pulse to be overloaded
with  blood, either leeches should  be applied  to  the  head or
blood  should  be  drawn  from the arm.   But  this  is not  of-
ten required.  In  some cases, more quietude is obtained by  the
use of cathartics, than by any other mode of depletion.  But,  we
believe,  that  sustenance  is  oftener required in this disorder,
than depletion.   Dr.  Ware,  of Boston,  with great good  sense
and judgment, discourages the use  of ardent spirits and opium in
this disorder, and from his own practice, which is very extensive,
has recommended  a  reliance upon moderate  evacuations and
cooling medicines.  We do not say but people may be cured by
stimulants and narcotics, but  they  do  not appear to us to be the
most suitable remedies.  At night,  while  the patient is in bed,
the room should be  kept rather cool, as  coldness to a certain
extent,  favors sleep.  In  some cases,  the  quinine, and the pre-
parations of iron should  be  given; but whatever  is given, the
stomach should be supplied with sufficient  nourishment.
  DEMULCENT.—Mucileginous  and  oily  medicines, which
sheath the tender  and  raw surfaces of diseased parts,  and,  by
mixing with acrid and corrosive  matters  in the  several passages
of the  body, neutralize  their effects.  The most common demul-
cents, are flax-seed tea, oil  of almonds, solution  of gum arabic,
arrow-root tea, mullein tea, and a solution of the slippery elm bark.
  DENARCOTIZED  OPIUM.—This preparation of opium re-
lieves pain and induces  sleep  without  the  disagreeable effects of
constipation, and with less interruption to  the secretions by the
kidneys and skin, than  attends  the pure opium.  Laudanum is
made  of it, the same as of opium, and the dose is the  same
quantity, from twenty  to thirty drops.   In lung  affections, it
seems to be much preferable  to pure  opium; but  in dysentery
and other bowel complaints, inferior to it.  In nervous complaints,
the denarcotized opium is a more  suitable medicine than  the
opium itself.
   DIABETES.—This  is a rare disease in our country; but very 
DIA.
187
few cases of it ever occur in the practice of any one physician.
The diabetes manifests itself by the secretion and discharge of a
great quantity of urine.   It seems to  hold the same relation to
the  kidneys,  which the diarrhea holds to the bowels.   In  a
diarrhea,  everything taken  into  the  stomach, runs  off by  the
bowels, and, in diabetes, everything taken into the stomach, runs
off by the kidneys  and bladder.   In a  diabetes, there is much
more urine  discharged than in a state of health.  By what pro-
cess, both the food and the drink  should be"converted into urine
to such an extent, it is not easy to conclude.  The diabetes seems
also to bear some relation to the night sweats in a hectic fever,
or rather the action of the kidneys seems to resemble that of the
skin in this disease.   It is very evident that the secretory power
of the kidneys in this disease is very  much exalted.  The kid-
neys, in  the diabetes,  are  probably in the same  state that the
liver is in when there is an unusual flow  of the bile, or that the
lungs are  in, when there is an unusual secretion and  expectoration
of mucus or phlegm.
  There is, in general, but very little,  if any pain or soreness felt
in the urinary organs in this disease,  or  any heat or  swelling in
these parts, but  still we can hardly avoid the conclusion, that
there must  be  a certain  degree of inflammatory  action,  or an
action which results from an irritation of the kidneys.  To come
nearer the point,  we believe there  must  be an  extraordinary ful-
ness of the blood  vessels of the kidneys—a blood-shot state ;
redness ; and same degree of tenderness.  When there is a great
running of mucus and water from  the  eyes, although there may
be no actual soreness, swelling or heat, there is always a blood-
shot state, and a greater degree  of redness and tenderness than
usual.  We think this must be the state of the kidneys in the
diabetes.  This  state of things may  not appear on dissection,
after death; but, that, it really exists, we think there  can be but
little doubt.  A considerable degree  of inflammation of the eyes
may exist before  death, which cannot be detected after it.  The
arteries which carry  the red blood, the cause  of the redness of
the part in inflammation, are after  death, empty ; and, of course,
the part will appear very much like the sound parts, unless there
is suppuration, ulceration or a permanent thickening of the part,
or some unusual distention of the  veins, in which case, the part
inflamed will appear of a purple color, or rather, of a venous red.
  The diabetes usually comes  on gradually,  and  without any
general  disorder  of  the  system.  Besides  the immoderate dis-
charge of the urine,  there begins to be thirst, and, sometimes, an
inordinate appetite ;  the flesh begins to fall away and  the system
to become weak ; the  pulse  grows more frequent; and there is
more or less fever resembling the hectic.
  The bowels in this disease are costive, and the urine, of a clear 
18S                         DIA.
color, and of a sweetish taste.  The drinks appear to pass imme-
diately through  the diseased organs.  Nervous people are apt to
make a great deal of water, but this does not constitute the dis-
ease in question.  The diabetes constantly wastes  the flesh and
debilitates the system, but no such effect follows the redundancy
of water made by nervous people.
   Dr. Cullen supposed  the disease  to  be owing to some fault
in the organs and Vessels which convert the food  and drinks
into blood ;  or  in other words,  that the chyle was not per-
fectly  elaborated  before  it entered the blood vessels.   But if
this was the case,  it would not be  the kidneys  only that
would be affected, but  every other organ in  the body.  The
lungs and the liver  must feel the imperfection of  the half elab-
orated blood as  well as the kidneys.  The skin, too, would be
as likely  to let loose a  flood of  perspiration, as the kidneys to
secrete an inordinate quantity of urine.
  The kidneys,  on dissection, are found  enlarged and their blood
vessels in a  relaxed state.
  The disease is  often,  in consequence of intemperance, some-
times, of intermittent fevers, and  of a broken constitution, and
occasionally, of  substances taken into the  stomach, which oper-
ate particularly upon the  kidneys,  such  as mineral waters and
cantharides.   It  is sometimes  produced  by  protracted cases  of
gonorrhea, where the  urinary organs have been injured  by the
use of too strong injections or by continuing them too long.
  Domestic Remedies.—The diet, in this disease, must  be re-
stricted to animal food, such as beef, mutton, poultry,  and fresh
fish.  Eggs may be eaten, but  milk is to be avoided, unless it is
used as the vehicle  of some medicine,  as alum, or some other
astringent or  tonic  medicine.   The chief  remedies are such
as will restrain the action of the kidneys.  Alum, sugar of lead
and the white vitriol, are  the  most powerful.  Three grains of
powdered alum, which, in bulk, is about  as large as  a pea,  should
be swallowed in molasses  or  syrup, four or five  times  a day.
Small doses  of sugar of lead or of the white vitriol taken about
as often, may also  be tried.  A tea made of powdered logwood,
or of oak bark, will restrain the discharge of the urine.  A pill of
clear opium, about half  the  common size, taken morning and
evening, will check the  discharge  the most effectually of any
medicine in  use.   The poppy tea will have a similar effect.
  To operate upon the bowels and to remove  the costiveness,
salts will be  found the most serviceable.  The  system must be
strengthened by the use of quinine and bitters ; the exercise must
be exceedingly gentle.
  Spring waters which contain iron, are very suitable in this dis-
ease.  One scruple of Peruvian bark, one  scruple of the wild cran-
berry leaves, powdered, and half a grain of opium, mixed together, 
DIA.
189
and taken three times a day, have been found a cure for the dis-
ease.   The doses are to be taken in lime water.  The lime wa-
ter should  be used for drink, in this disease.
   In the commencement of the disease, leeches should be applied
to the small of the back, and an endeavor made to  remove the
irritation.  Cold  bathing,  especially  to  the small of the back,
should be  practiced, beginning at  first  with  tepid  water, and
gradually  using  it colder.  The catechu and  kino,  either in
the form of tincture, or in powder are the most powerful veg-
etable astringents, and will be among the most  proper to  use in
this disease.   The cicuta and hyoscyamus should be tried. Lau-
danum and pure opium are more proper in the diabetes than the
morphine.
   The nitric acid, aqua fortis,  has  been  found  extremely useful
in some cases.  But in every case the strength must be supported
by tonics and the excessive discharge of  urine restrained by the
use of sedatives and astringents.  A gruel made of  wheat flour
will be found  a suitable drink,  together with lime water, oyster
shell water, and pure rain water.
   DIACHYLON.—This famous plaster  is made of the semi-
vitrified oxide of  lead and olive oil, in the proportion of one part
of the lead to two of the oil, boiled together.   In bruises, exco-
riations of  the  skin, indolent  tumors, and slight inflammations
upon the surface, it is an excellent substance for a plaster.  It is
sometimes  applied to broken breasts.
   DIAGNOSIS.—Symptoms, by  which, one disease is distin-
guished from another.   All such symptoms are called diagnostic.
   DIAPHORESIS.—This is a medical word  which signifies
perspiration or the act of sweating.
   DIAPHORETICS.—Any medicine, or any substance,  which,
when taken into the stomach,  produces  a sweat, is called a dia-
phoretic.   Catnip, pennyroyal, and the bayberry root are diapho-
retics.   The most certain diaphoretic, is tartar emetic, in the dose
of a fifth or quarter of a grain.   Next, in certainty, to this, is the
antimonial  powder.  Many medicines operate  as  emetics, dia-
phoretics, cathartics, expectorants,  and  diuretics, such  as  the
squil, ipecac, and thoroughwort. Diaphoretic and sudorific mean
the same thing.
   DIAPHRAGM.—This is a medical name for  the  midriff.  It
is the muscular sheet  of flesh  which  separates the cavity of the
chest, or the thorax from the belly.
  The  contraction and  dilatation of the diaphragm or midriff,
are the chief  agent in breathing.  The midriff  being convex on
the side towards the lights, becomes a plane when  it contracts,
and makes  room  for the drawing in of the breath; and when it
relaxes, it becomes convex again, and forces the air out  of the
lights.   The bowels and other organs contained in the cavity of 
190
DIA.
  the belly, press upon the  midriff and  contract the cavity of the
  chest, by which means, the air is breathed out.  The abdominal
  viscera are moved upward and downward by the contraction and
  relaxation of the abdominal  muscles.
    DIAPHRAGMATIS—Inflammation of the diaphragm—This
  disease is attended with pain in the region of the  diaphragm or
  midriff, difficulty of breathing, and  delirium.  It  is rarely ever
  distinguishable from an inflammation  of the lights; it is of the
  same nature, and demands the use of the same remedies.
    DIARRHEA—Looseness of the Bowels.—This disorder con-
  sists in an increased motion  of the  bowels, with more or less pain
  preceding and  accompanying every evacuation.  There is com-
  monly little or no fever,  and  even the appetite is but slightly
  affected.  The surface of the body and the extremities are apt to
  be cold, and the perspiration diminished or suppressed.   There is
  often soreness,  or at least, tenderness, on  pressing the belly, and
  other indications of a slight inflammation of the mucous  mem-
  brane of the bowels.  But, in  general, the disease  does not ap-
 pear to be of  an  inflammatory nature, or if inflammatory, the
 self-depleting nature of it never allows the inflammation  to be-
 come very violent.  It is said,  by some authors, to  be an  irrita-
 tion  of the bowels,, but the distinction  between irritation and
 inflammation is more nice  than real, and of no service in the cure
 of the complaint.
   The discharges in this complaint are always thin and watery,
 and will frequently occur as often  as a dozen or twenty times a
 day.   There is much less pain, griping, and fever in diarrhea
 than in dysentery; and there  is also an absence of blood, and,
 for the most  part, of mucus in the stools.  In the dysentery,
 especially, in the  commencement of it, the stools are hard and
 compact, and mixed with mucus and blood.
   The  diarrhea  is sometimes attended with vomiting, but this is
 not apt to be very violent  or to last long.   In the cholera mor-
 bus  the vomiting and distress at the pit of the stomach  are the
 leading symptoms, but in the  diarrhea, the disturbance of the
 stomach is only  a secondary affection.   The diarrhea never dis-
 covers that sudden prostration of the strength and quickness in
 breathing which mark the cholera morbus.
   The  predisposing cause of diarrhea  appears  to be the  same
 with that which produces the cholera morbus—the action of the
 summer heat upon the system.  It is a disease of the  hot months
 like cholera morbus, and is  a similar disease of a part  of the  same
 viscus.  The diarrhea is a disease of a part,  and the cholera
 morbus, of the whole of the digestive organs.
   Ihe causes of this disease are, either,  the quantity  and quality
of substances taken into the stomach,  the action of the bde and
other secretions  flowing  into the bowels, or a slight species 0f 
DIA.                         191
inflammation induced  by the  heat of the season, or  the  atmos-
pheric changes.
  This disease prevails most, in the season when green fruit and
vegetables of all  kinds are most abundant.  And, perhaps, there
is no one thing which produces it oftener than green corn  or corn
and beans.   Cucumbers and other garden vegetables are a prolific
cause of it.   Shell-fish often produce it.   Too great a mixture as
well  as quantity  of food, will disorder  the  bowels and  leave a
diarrhea.  Almost any indigestible substance will be followed by
the complaint, if taken in sufficient quantity.  Small solid bodies,
one  or  two at a time, will often, however,  pass  through  the
stomach and  bowels  with impunity,  such as stones,  smooth
pieces of glass and silver, balls of lead, and the kernels of fruit.
   The  quality and quantity of  the bile, of the pancreatic juice,
and  of the  natural mucus of the  intestines themselves, appear
often to generate the  disease.   In many cases, the  discharges
will  appear  to consist almost entirely of bile ; and, in other in-
stances, of  watery matter, as if it came from the bowels them-
selves.
   In  other  instances,  the  pain, tenderness  and soreness of the
bowels, the frequency of the  discharges, and  some  degree of
fever, will  denote a certain degree of inflammation in the  inner
coat of  the  intestines.   In children, teething almost always pro-
duces more or less of a diarrhea.   The inflammatory action in
the gums is extended to the digestive organs.
   A sudden check to the perspiration  is a frequent cause of the
diarrhea.  It is not in general a dangerous disease.
   Remedies.—Where the disease has been immediately preceded
by a hearty meal,  or by eating food  difficult to digest,  the
stomach should be relieved by an  emetic.   After the stomach is
unloaded, the bowels  should be freed by a dose of castor  oil,
rheubarb, or butternut physic.
   The food  should consist of a gruel made of flour or crackers,
of boiled milk and water, or stale white bread soaked.  No solid
food should be taken until the complaint is cured. In most cases,
a milk  porridge made with flour meal will be found sufficiently
nourishing and well suited to the diseased state of the  bowels.
   Cold water may be drank,  but  too  great a quantity of it will
increase the disease.  Mullein and flax-seed tea, gum arabic water,
and rice water constitute the most  proper drinks.
   If the disease continues severe, forty drops of laudanum should
be given, once, in eight hours, until the discharges are stopped.
In general,  there is no danger in stopping the complaint, as  the
bowels can, at any time, be readily moved by a dose of oil,  rheu-
barb,  or some other purgative.  A  grain and a half or two grains
of opium, will often  answer better than the  laudanum.   A table-
spoonful of paragoric  may be given in the place of either, and 
192
DIF.
repeated, at the  same intervals.   The best way is to check  the
complaint entirely by opiates,  and to procure a motion  of  the
bowels, every other day, by a dose of oil.
   In some cases, astringent medicines will have more effect than
opiates.  One of the best astringents, is the logwood tea.   A tea-
cupful of this must be drank, every three hours, through the day.
If this  proves disagreeable to the stomach, twenty grains of  the
powdered catechu, infused in warm water, may be taken, and
repeated, at the same intervals.
   It is of the utmost importance, in the treatment of this disease,
to adhere to a  light, vegetable,  liquid  diet;  this alone will in
many instances effect a cure.
   If the disease has  become chronic, it will, sometimes, be neces-
sary to administer a little brandy, several  times in the course of
the day.  Spices and quinine  will  also be  proper.  We have
known the disease in its chronic stage, in many instances, to be
cured by ipecac in two or three grain  doses, given twice or three
times a day.   In this stage,  chicken  and meat broths, and plain
soups will often  be required  to support the strength.
   If there is much heat, soreness, and pain in the abdomen and
bowels, it  will  be  advisable to  apply a  dozen  leeches.   It is
seldom  necessary to  draw blood  from the arm.   In more mode-
rate  cases, blisters  should  be  drawn  upon  the abdomen.   A
moderate  use of calomel,  or  a  grain, every  night, combined
with a grain of opium,  may be  tried in  chronic  cases  where
other means  fail, and continued for a week.   The  Dover's
powder, in ten grain doses, given once in four hours, will cure
the disease.
   The  mineral  astringents,  such  as sugar of lead, white vitriol,
alum, and borax, are often found serviceable in protracted cases.
Large plasters of pitch upon the back and belly, by retaining  the
heat, will  assist  very much  in  restoring  the proper function  of
the bowels.
   In  some instances, mild  astringents, such  as  an  infusion of
peach-meats, hardhack, or  the  root  of the crane's-bill, will be
found more effectual than powerful ones.
   In all cases, the heat of the body should be properly regulated,
the feet should be kept  dry, and the  patient should remain at
rest.  All motion increases and  aggravates the disease.
   DIATHESIS.—Any particular state of the body.   In a putrid
fever, there is a putrid diathesis, and in the continued fever, there
is  a febrile  diathesis, or a state of the body which predisposes it
to fever.
   DIFFICULT  MENSTRUATION — Dysmenorrhea.—The
monthly sickness of  females, in some instances, is attended with
pain in the region of the womb, and in the back, loins, and lower
part of  the  abdomen.   Menstruation is not entirely suppressed, 
DIG.
193
but is troublesome and  difficult.  The  best remedy at the time
is to take ten grains of the Dovers' powder, and to employ a local
steam bath, of hot herbs, such as tansy, spearmint, and penny-
royal, on the approach of every return of the difficulty.  Thirty
drops of morphine is a suitable medicine.  In obstinate  cases,
the warm bath should be used, every other day, and a table-spoon-
ful of Griffith's iron mixture taken twice a day. The body should
be kept comfortably warm and the feet dry.  During the inter-
vals, much and constant exercise should be taken in the open air,
the  food  should be light and nourishing, and the  bowels kept
open, by the use of the aloetic pill, or the extract of butternut,
if they are liable to be confined.
   DIGESTION.—The process of digestion is not finished until
the food and drink pass from the stomach into the small intes-
tines, and combine with the bile, the  pancreatic juice, and the
mucous secretion  of the  bowels.   It is now ascertained with a
good deal of clearness, that the conversion of the food into chyme
is mainly effected  by the agency of  the gastric juice.   In  what
way, this powerful menstrum or solvent operates upon the aliment,
is not definitely known, but it evidently appears to be a chemical
action.  It has been  proved by  experiment, that aliment contain-
ed in  hollow metalic balls, pierced with holes,  is  digested the
same as if it were free in the stomach.   Hollow  silver balls en-
closing meat and other substances have been swallowed, and dis-
gorged, in  every state of digestion, and their contents found to
have undergone the  same change as  food  swallowed in the ordi-
nary way.  The gastric juice enters the perforations in the balls
and converts the food into chyme.   The gastric  juice is a ropy,
sourish, transparent  fluid, and  when analyzed, contains a large
quantity of water, with mucus, salts, and lactic acid.  The base
of the salts is soda and ammonia.
   The chyme  or the fluid substance, into which the food is con-
verted by the action of the gastric juice, is a uniform, soft, pulta-
ceous, greyish mass, of a sweetish insipid taste, and  slightly sour,
retaining something  of the flavor of the food.
   The food is chewed and broken to pieces by the teeth;  mixed
with the saliva and the mucus juices of  the mouth, throat, and
gullet; received into the stomach; acted upon  by the  gastric
juice ; propelled from the stomach  into the duodenum, where it
combines with  the bile, pancreatic juice, and the mucus of the
intestines, and finally converted  into a milky fluid, called the chyle.
From  the duodenum or first  portion of the intestines, the mass of
aliment passes  into the  second and third portions  of the small in-
tines, where the chyle is separated  from the fecal matter  by the
action of the  lacteal vessels, and carried by the thoracic duct
into the left subclavian vein or the great vein of the left arm.
            25 
194                        DIM.
  While the food undergoes a conversion into chyme, both orifices
  of the stomach are closed.
    The  ordinary period of digestion is about three hours, though
  the time varies from three  to  seven  hours.   The refuse of the
  food is  not  expelled  oftener  than once in twenty-four hours.
  Probably digestion is  not  entirely completed  short  of twenty
  four  hours.  Children who  live on milk, digest  their  food much
  quicker  than adults.  The  more  perfectly  substances are ani-
  malized,  the  quicker  they  are  digested;  meats  are  digested
  sooner than milk, and milk sooner than vegetables.
    The gastric juice is known to curdle milk and albumen.
    The gastric  juice appears to be  capable of dilution  or being
  weakened by water the  same  as other menstruums.  If a great
  deal of water or watery fluid is drank, the gastric  juice loses its
  strength  and becomes less  solvent.  No more  fluid  should be
 drank than is necessary to quench the  thirst, otherwise the power
 of digestion is enfeebled.
    The power of digestion seems to be the greatest in  the morn-
 ing, after a night's sound sleep.  The passions and emotions of
 the mind greatly  influence  the  function of digestion.   Some
 diminish  the power of digestion exceedingly, while others invig-
 orate  it.                                                   °
   DILUENT.—It is very evident that by drinking a large quan-
 tity of water, the proportion of water in the blood will be in-
 creased.   The blood is thus  made  thinner or diluted.   Water is
 the only proper diluent, although other  substances are often ad-
 ded to it  to  give it flavor and  smoothness.   No point is better
 settled in medicine than the propriety of giving diluents in acute
 inflammations.  There is certainly nothing in water which can
 increase an inflammation,  and it  appears to act with as  much cer-
 tainty in subduing a fever as in  extinguishing a fire.  Too much
 water may be detrimental after the subsidence of a fever or an
 inflammation.  The object of giving diluents in acute  inflamma-
 tions is to  lessen the stimulant quality of the blood.   Flax-seed
 tea  baum  tea, gum  arable water, lemonade, soda water, slippery

 ^^^SW™1 " ii"? n8 thecm°St co^on'diluentsy
   DlMlN^bb  Ut SIGHT, called Gutta Serena, and, sometimes
 Amaurosis is  supposed to be a  paralytic  affection  of  the optic
 aZLn   L?h    aPPearanf * the eye is not altered in L
 affection ;  but the cornea,  pupil and the ball of the eye will look
 as well as ever, at the same time, that the sight will be very dTm
 ,nol  wlY ?eStr°yed-  ThG PUP11 is' however> generally rendered
 ncapable of contraction.   In this affection there will ofUn aPnear
 o be motes or flies continually floating before the lyes   Akhoush
 there is no appearance of inflammation  in the eye yet it s oftfn
preceded by a violent headache  and a genera? affec ion o ? he
nervous system.   In one case which came under oufcare, h 
DIS.
195
dimness  of sight  had been  preceded  by headache  for several
years.   The pupil became fixed and insensible to the light, and
there was,  in  the  end, a total  loss of sight.  Blows upon  the
head have  been known to produce it, and also a constant  expo-
sure to the rays of the summer sun.   The growth of tumors in
the brain which press upon the optic  nerve has been  ascertained
to occasion it.
   The remedies which have been found to be the most effectual
in this disease, are  electricity, galvanism, and pungent  snuffs.
The dried  bayberry root reduced to an impalpable powder, is  one
of the  most powerful snuffs which can be used.   The turpeth
mineral is sometimes used, mixed with  other snuffs.  A tea made
of the red  pepper in the proportion of one grain of the pepper to
one  ounce  of  water, has sometimes  been dropped into the  eye
with the view of stimulating the nerve.  It  produces an intense
pain, for a short time, but the effect is very promising.  In this
affection, in passing  from a dark room  into the light, there is no
contraction of  the pupil as in the healthy eye.   Blisters and  setons
are  highly recommended in the  disease.   We advise the person
to try a course of the mineral waters, to pursue a vegetable diet,
and  to take a great deal of exercise.
  DISEASES  OF  THE  SKIN—Cutaneous  Diseases.—See
Cutaneous Diseases.
  DISLOCATIONS  OF  THE  ANKLE.—When  the  ankle
joint is dislocated or put  out of place, the foot is either  turned
outwards, or inwards; or it is pushed forwards, or backwards.
   The  foot is most  commonly  thrown outwards, and its inner
edge rests upon the ground.
   In reducing or setting the ankle, the person should be placed
upon a bed on, his injured side, and the  leg  should be bent in
order to relax  the stretched muscles.   An assistant should then
grasp the foot  and gradually pull it in a line  with the leg.  The
thigh must be held fast, and the tibia or shin bone pressed down-
wards to force it into its place.   The foot must always be drawn
slowly and steadily to give the muscles and cords time to relax.
Sometimes, there is such a tension of the muscles and cords,  and
swelling of the joint as to require  blood-letting and other  relax-
ing measures.
  After the ankle is set, a snug  bandage should be placed around
it, and kept wet with vinegar or new rum.
  When the dislocation is outwards, the foot is turned inwards
and its outer edge rests upon the ground.   In this case, the ex-
tension  is  made in the same way as in the  first.   One person
takes hold  of  the ham and holds  the  thigh  fast, while another
stretches the foot, and the operator presses the head of the shin-
bone inwards  towards its proper place.  The limb  should  rest
on its outer side, after being set. 
196
DIS.
   If the  dislocation is forwards, the  foot  is shortened and the
 heel is lengthened.  In this case, the extension is made as before,
 and the bone-setter pushes  the bone of the leg back  into the
 socket.   If the  dislocation is backward, the foot is lengthened
 and the heel shortened;  the  tibia in this case, must be pushed
 forwards while the proper extension is made.
   In dislocations of the ankle, the person may begin to use the
 foot gently in about five  weeks.  The  joint must be supported
 by splints, pads, and bandages, and kept perfectly still.
   DISLOCATIONS  OF  THE  ELBOW.—The  elbow  joint
 may be dislocated in several different  directions, but the disloca-
 tion of both bones of the fore-arm, backwards, is the most serious.
   To set the joint, in this case, the patient  must be seated in a
 chair, and  the  knee of  the bone-setter put on the inner side of
 the  elbow-joint; the fore-arm must  then  be bent, and, at the
 same time, both bones of the fore-arm pressed by the knee, so as
 to separate them from the  humerus, and to raise the  hooked end
 of the ulna or large bone of the  fore-arm from the hollow in the
 humerus where it is lodged.  Whilst the pressure is kept up by
 the knee,  the arm is to be forcibly, and gradually, bent, and the
 bones will slide into their  places.
   The  elbow and fore-arm must  be carried  in a sling, after a
 proper bandage is placed around them, and  kept wet with warm
 vinegar,  or a solution of muriate of  ammonia,  sal ammonia.
 All the other kinds of  dislocation of this joint, are set,  in nearly
 the  same  way.   The  principal  thing  to  be attended to, is, to
 make extension  enough for the heads of the bones to clear each
 other and to slide into their places.
  DISLOCATIONS OF  THE  JAW.—The lower jaw may be
 put out  of  joint by blows, falls,  and  sometimes, even by yawn-
 ing. ^ The jaw is easily set.  The operator has only to put his
 two rthumbs as far into the mouth of the patient as he can, and
 to press them  hard  down,  while the chin  is  gently  raised.
 The bones easily slide  into  their  places.   The jaw is known
 to be out when the upper and under teeth do not correspond
  DISLOCATIONS  OF THE KNEE  JOINT.—The knee
joint may be displaced in four  different directions, inwajds  out-
wards, forwards, and backwards, but  the bones are  replaced in
the same way, in all.
  A firm, constant, and  gradual  extension of  the leg, is all  that
is needed  to enable the heads of  the bones to ride over each
other and  to slide into their places.   The  thigh  must be held
inWi.0nft assjstant' wbilf another Pulls upon the  leg.  Great
foCIS if  «°ne t0 the  hSaments in a dislocation of the knee,
meanTof rJ^   ^T^  In this Case  lceches' salts' ™* other
means of reducing inflammation must be used. 
DIS.                        197
  DISLOCATIONS OF THE KNEE PAN.—The knee pan
may be displaced in three ways, outwards, inwards, and upwards.
  In setting this  bone, the patient is placed upon a bed or the
floor, and the leg raised by lifting it at the heel, in order to relax
the muscles.  The operator is then to press on the edge of the
pan which is the most distant from the joint; by this means, the
inner edge of the  bone is raised over the elevated portion of the
thigh bone, called the condyle, and the muscles  draw the knee
pan into its place.  The same applications are to be made to this
as to the other dislocations.
   DISLOCATIONS  OF THE  NECK.—When  the neck is
dislocated, the patient is deprived of all sense  and motion, and
his chin lies upon his breast.
   The bones of the neck are set,  simply, by extension.  If the
head is gently and firmly pulled  in a line with the body, while
the patient lies upon his back, the bones will easily slide into
their places.  As  soon as the bones are set the patient  begins to
r)rpfi.tnp
   DISLOCATIONS OF THE RIBS.—The ends of the ribs
which join the back bone are said  sometimes, to be displaced by
falls and strains.   To set a disjointed rib, the patient must be
laid upon  his belly on the floor or table, while the operator en-
deavors  to  crowd  the head of the bone into its place.   Some
little displacement of the ribs may happen, but we believe a dis-
location is very rare.
   DISLOCATIONS OF  THE  SHOULDER—The shoulder
may be  dislocated in  three several  ways.  It may be thrown
down into the arm-pit, drove  forwards upon the collar-bone, or
backwards upon the shoulder-blade.   It is most commonly drove
down into the arm-pit.
   In the last case, the patient cannot raise his hand to his  head;
and if the elbow  is carried outwards  at right angles with the
trunk, the head of the bone can be distinctly felt in the arm-pit.
The arm is rather longer than the  other, and the elbow is pushed
off from the side.  It commonly occurs from falling  upon the
shoulder.
   To set the shoulder joint, the patient  must be placed in a
chair, and the shoulder-blade confined  by a long, strong  strip of
new cotton cloth passed under the arm and over the well shoulder;
or the arm may be put through a hole in the cotton  bandage, and
the bandage drawn over the shoulder-blade ; one or more persons
must hold fast the shoulder-blade while another makes an  exten-
sion of  the arm.  A handkerchief  or towel is sometimes tied
around the arm just above the elbow to pull upon.   The operator
must  put his knee into the arm-pit, and when the proper  exten-
sion is made, lift the head of the  bone with his knee, while he
guides the bone into the socket, with his hands.   Sometimes, 
198
DIS.
the body of the patient is simply held by an assistant while the
operator extends the limb, and with his knee in the arm-pit for a
fulcrum lifts the  shoulder bone into its  place.   In  setting the
shoulder, the arm must be raised at right angles with the body.
The operator may tie a  towel about  his neck, after passing  it
under the arm, and lift the head of the  bone into its place, by
raising his neck.
  In extending the arm, the force should be applied  for three or
four minutes, in order to give the muscles and cords time to relax.
When the head of the bone is thrown forwards upon the collar-
bone, or backwards upon the shoulder-blade it is set in the  same
way.   The  body is to be confined in the  same manner, and the
extension  made in the same way.  When the bone,  however, is
thrown down  beneath the collar-bone, the extension should be,
at first obliquely downwards and backwards, until the bone has
cleared all impediments.   The arm should be carried in a sling
to support the shoulder.
  DISLOCATIONS OF  THE THIGH  OR HIP JOINT.—
The thigh bone  may be  dislocated in four  different directions;
upwards, or upon  the back of the haunch-bone ;  downwards, or
into the oval opening, called the foramen  ovale; backwards and
upwards, or into  the ischiatic  notch ; and  upwards, upon the
share-bone.
  In most cases, the head of the thigh-bone is pushed from the
socket  upon the  back  of the  haunch-bone.  The  leg will be
about two inches  shorter  than  the other, and the knee and foot
will be turned inwards.
  In setting the thigh-bone, the lower part of the trunk must be
firmly fixed by girts, or it may be held by assistants.  The pa-
tient must lie upon the back, and a strong girt or bandage placed
around the leg just above the knee, to pull upon.  Pullies are
used to make the  extension, by professed  surgeons.  But two or
three strong persons are commonly able to draw the bone into its
place.  The extension must be made for  four or five minutes
before the muscles will give way.   The operator must guide the
head of the bone and  lift it over the edge of the socket.  The
patient can lie with a bed-post placed between the thighs, in the
crotch, and the limb reduced in this way.
  When  the head of the thigh-bone  is thrown  down into the
foramen ovale, the leg is about two inches longer than the other,
and the head of the  bone  in thin people can be felt.   The empty
socket can also be felt.
  The extension is made in a similar way as in the  first case,
and the bone is lifted into its place by the operator in very much
the same way. The main thing with the operator, is, to ascertain
where  the head of  the bone is, and where  the socket is;  if he 
DIS.                         199
perceives these two points clearly, there will be no  difficulty in
setting the bone.
  Dislocations  in the two  other  directions are set  in a similar
way with those described.
  DISLOCATIONS OF THE WRIST.—In dislocations of the
wrist joint,  the head of one or both bones of the arm can  com-
monly be felt.   The  bones of the arm are either  pushed  over
the bones of the wrist, or the bones of the wrist over the heads
of the radius and ulna.
   To set the wrist joint, the operator must grasp  the patient's
hand with  his right  hand,  and the arm with his left; and an
assistant must  hold fast the arm above the elbow.   Both the
operator and assistant must then pull gradually until the bones
slip into their places.  A roller  should be applied round the arm,
and a flat piece of board applied to the back and fore part of the
arm.   The  joint should be  kept  wet  with vinegar,  or a solution
of sal ammonia.
   The joints of the thumbs  and fingers are set by simply making
the necessary degree of extension.
   DISTURBED SLEEP.—Nightmare, sleep  walking,  sleep
talking,  painful dreams and frightful images,  all appear to be
phenomena  of  the same  nature, and probably arise from the same
cause.  A greater  or less degree  of  nervous  derangement  will
generally, if not always, be  found to accompany disturbed sleep.
The phenomena of  the brain, by  which we mean the  thoughts,
the feeling,  the emotions and the  passions, are  deranged or  dis-
turbed in the same way that the digestion, or any other function
is disordered.   The symptoms  of the disorder are of a different
nature, but  the state of the organ is doubtless the same.  A dis-
order of the  stomach,  is manifested by acidity,  flatulence or
wind, eructations of the contents of that viscus, and sometimes
pain at the pit of the stomach.   A disorder of the brain is mani-
fested by painful thoughts and feelings, both while awake and in
sleep.   The degree in which the  brain and nerves are liable to
be  affected, is  as various as that to which the other parts  and
organs of the system are  liable.  A person in sleep is affected by
the same thoughts and feelings, passions and emotions to which
he is subject while awake.   When a frightful image presents it-
self in  sleep, it raises the same passion of fear  as when awake ;
and a semblance of the same efforts are made to avoid it.   The
person endeavors to scream,  and to run from it; but the usual
command of the limbs and muscles is paralized by sleep, and he
is incapable of making nothing  but convulsive  movements,  bro-
ken sounds, and ineffectual  screams.  A nightmare   is produced
by the fear  of some object which is seen in sleep, or some con-
dition which the person believes  himself to be in; and that
object or condition is as real as if the person were  awake.   He 
200                        DOC.
 therefore acts or tries to act as if he were awake and in real dan-
 ger.  The fright, which we experience in a nightmare, will often
 last us for some time after we have awoke, which evinces that the
 passion of fear has been very much excited.   Children will often
 laugh and cry and utter screams in their sleep, which only shows
 that  their minds have been agitated with the painful passions,
 grief, sorrow, or fear.  In general, we believe that those people,
 who are subject to considerable or unusual fear, grief, anger, and
 anxiety in their waking hours, are subject to the same thoughts
 and feelings while arjleep,  and are consequently more liable to
 nightmare, sleep walking, sleep talking and frightful dreams, than
 those who are more cheerful and blithsome.  Gloom is not en-
 tirely removed by sleep, although it  may be alleviated.  Sleep
 walking and sleep talking are produced by some agitation of the
 mind or of the feelings, which prompts the person to make those
 attempts to do and to say some things which excite in him great
 anxiety, desire, or aversion.  No ordinary thoughts and feelings
 could produce these efforts in sleep ; the  person must be oppres-
 sed  with some  extraordinary care,  either  real, or  imaginary.
 Walking in  the sleep is no more mysterious than  turning over in
 bed;  it is only making habitual  movements ;  the person  is only
 more awake and agitated with feeling, in the former case than
 in the latter.  Frightful dreams, and strange,  absurd,  incoherent
 images, the  ideal presence  of ghosts and hobgoblins,  and  the
 horrible accidents which we encounter by sea and land in sleep,
 are a slight  disorder  of the brain or of the nervous system, a
 small degree  of inflammation or sensitiveness, such as sometimes
 happens to the eye, by which, the vision becomes slightly pain-
 ful and inexact.
   The cure for disturbed sleep is the same as for nervous diseases
 in general;  a good  deal of exercise; a wholesome, modereate
 diet;  temperance ; the avoidance of hard study ;  and as much as
 possible, the  perplexities  and vexations  of life.   Sometimes, in
 cases  of costiveness, a pill  of aloes  or a dose of picra may be
 serviceable ;  and in  aggravated  cases, a few drops of assafetida,
 laudanum or some other anodyne may be advisable.  Over-eating
 which is a prolific cause of disturbed  sleep,  should never be in-
 dulged,  especially at bed-time.
   DIURETIC—All  medicines which augment the flow of the
urine  are called diuretics.   The  most certain and effectual diu-
 retic  is salt-petre or  sal  nitre.   Squill, sweet  spirits  of nitre,
acetate of ammonia, balsam copaiva, parsley,  wild cranberry, tar-
tar emetic, pumpkin seeds, water melons, and, in general, all wa-
tery fluids are diuretic.
   DOCK—There are two kinds of this plant; one is called the
yellow rooted water dock,  and  the other curled dock   Both
kinds are laxative and astringent.   The  medicinal properties re- 
DRA.
201
side  in  the root  and leaves.   The  yellow rooted water  dock,
grows in shallow rivers,  pools, and wet ditches.  The curled or
narrow dock, grows about barn yards, and in pastures.  The root
of both is of a yellow color.   A decoction of the root of either
species, makes an efficacious wash for foul ulcers and sores.   An
ointment made of the narrow  dock,  will cure  the itch.   A tea
made of half an  ounce of the fresh roots will operate as a  mild
purgative.   In the blotched face, tetter, and salt rheum, it should
be used both as a laxative and an ointment to the skin.
   DOSES OF MEDICINE.—The following scale has been es-
tablished for the regulation of the doses of medicine in general.
   If the dose for a person of middle age be one dradhm, the dose
for one  from fourteen to  twenty-one  years of age,  will be two
scruples or two-thirds as  much.
   From seven to fourteen, half a drachm, or one-half.
   From four to seven, one scruple, or one-third.
   The dose for a  child of four years, will be fifteen grains, or one-
quarter.
  For a child, three years old, ten grains or half a scruple.
   For one, two years old, eight grains.
   For one, a year old, five grains or one-twelth as much as for a
person of  middle  age.
   Women, in general, require smaller doses than men, owing to
a difference in size and constitution.
   DOVER'S  POWDER.—This powder  is made by grinding
together in a mortar, one part  of ipecac, one part of opium and
eight parts of vitriolated  tartar or sulphate of potash.   The seve-
ral ingredients must be triturated to a very fine powder.
   This powder is thought to be the most certain sudorific which
we possess.  It was the  invention of Dr. Dover, and probably
one of the happiest combinations which  was  ever  made.   In
rheumatism,  it has always maintained a high  reputation as an
effectual remedy.    The usual dose for an adult, is ten grains ; for
a child, two years old, two grains.  In this medicine, the heating,
feverish, and astringent effects of the opium are  counteracted by
the ipecac and the neutral salt.   It may be used in many casas of
inflammation where opium itself would be obviously mischiev-
ous.   In dysentery, and  the bowel complaint of children, it is
often an indispensable remedy.   It induces sleep, eases pain, and
promotes sweat.
  DRAGON ROOT—Indian  Turnip.—This plant is found in
swamps and  wet  places.   The  leaves are covered with  black
spots and often with white streaks.  It appears early in the spring.
The flower is succeeded  by a round,  red berry, which is exceed-
ingly hot and biting.  The root, which resembles a small turnip,
possesses the same acrid properties.   On becoming dry, the root
almost entirely loses  its  strength.   In  chronic  rheumatism,
             26 
202
DRO.
 asthma,  catarrh, and ulcerous sore throat,  the  powdered, fresh
 root, in a dose of ten to twenty grains, taken in syrup, every two
 or three  hours, has been often effectual.
   DROPSY.—This disease discovers itself, at first, by a uniform
 swelling or thickning of the skin, when it commences in the sur-
 face of the body; and  in a distention of the abdomen, chest or
 uterus, when it commences in these organs.  The general dropsy
 commonly begins in the feet and legs, and gradually extends  up-
 wards to the thighs,  belly, and  chest.   A dropsical swelling
 reaches uniformly round the ancle or leg,  and  is much  more
 perceptible  at night, after  standing or walking  all day, than in
 the morning.'  The  swelling, in  the  commencement of it, will
 generally subside  during the night, and reappear  during the next
 day.   Dropsical feet and legs will feel to another person, colder
 than  natural, and, if the  fingers are pressed upon the swelled
 parts, distinct prints of them will remain for  some  time in the
 skin ;  when hard pressed  with the thumb, a deep pit  will be
 sunk in the flesh.  As the  disease progresses upwards, the legs
 become so distended as to have a shining appearance, and finally  '
 crack open and let the water out.   While the disease is confined
 to the feet and legs, there will  not commonly be  much fever and
 general disorder of the system; but after it has reached the abdo-
 men, there will be more or less thirst; dryness of the skin ; want
 of appetite ; restlessness;  loss of  sleep;  shortness  of  breath;
 scantiness of urine, and  costiveness.   The face itself will, in this
 state, indicate the  nature of the disease.  The lips are commonly
 deadly pale, as well as the  cheeks and whites of  the eyes.
  In a general dropsy of the surface of the body, which is called
 anasarca,  although there is much swelling, there is no soreness;
 there is merely a feeling of stiffness and heaviness.
  Dropsy of the  chest  and of the heart discover themselves  by
 an intermission of the pulse; a shortness of breath,  particularly
 in ascending a pair of stairs or  a hill;  anxiety  about the region
 of the heart; and a  paleness of  the face and skin.   A sense of
 suffocation  will often seize the subject of it on first going to
 sleep at night, so as  to oblige him to rise up  immediately in bed.
 When the disease has  become  confirmed  there is a constant
panting for breath.   A fluctuation of the  water in the chest can
 often be  heard,  by placing  the ear upon the  breast, when the
 patient turns from one  side to  the other.  By the Stethoscope,
 the presence of water in the chest or heart case, can be easily de-
 tected ; the fluctuating sound becomes distinctly audible from the
 pulsation of the  heart, and  the motion of the lungs in breathing.
 A numbness of one or both arms is a very common  symptom in
 the dropsy  of the chest.  A dropsy of the chest, will, in some
 instances, exist  alone, and, in others, in  company  with  other
 parts of the body; or it will constitute a part of a general disease. 
DRO.
203
   The dropsy of the abdomen, ascites, discovers itself by a sense
 of distention, and  of weight in that cavity;  the weight being
 felt most on that side on which the patient lies.  Where the ac-
 cumulation  of water has become  considerable in the cavity of
 the belly, the breathing becomes short and difficult, and the swel-
 ling  becomes uniform over the whole abdomen.
    The fluctuation of the water can be felt, and, in some instances,
 distinctly heard when the patient moves.   The fluctuation of the
 water will  readily distinguish it from  pregnancy and tympanies.
 The water in this kind of dropsy, is  usually contained  between
 the bowels and the  walls of the abdomen ; but, in some instan-
 ces,  it is contained  between the lining of the cavity and the in-
 ternal muscles of the abdomen.
    The dropsy is for the  most part  the effect of other diseases.
 It is the sequel of profuse  bleeding from the lungs, nose, uterus
 and  bowels.   It succeeds to rheumatism, gout, diseases  of the
 liver, fever and  ague, inflammation of the brain, dysentery, and
 all diseases which  greatly debilitate the system.  It  arises, from
 pressure upon the blood vessels, as in pregnancy, aneurisms  and
 tumors.   It is especially produced by intemperance  in drinking.
 Drunkenness produces the dropsy oftener  than any other cause.
 Ossification of the valves of the  heart will produce a dropsy of
 that organ, and eventually of the whole chest.   The bowel com-
 plaint of children will produce a dropsy of the brain.   The scarlet
 fever will produce a dropsy in any part of the body.  There is a
 peculiar kind of dropsy which consists of little bladders of water
 resembling  turtle's  eggs, called hydatids.   The  seat  of this
 disease is commonly in the uterus, but, sometimes, in other parts
 of the body.   The dropsy is supposed to be produced by living
 in low, damp situations, and by poor, damaged  food.   It is very
 probable that  most  dropsies  arise from some derangement of  the
 digestive organs, and of the chylopoietic system, or of that system
 of vessels which form the blood.
   Domestic  Remedies.—Temperance  and  exercise are of  the
 greatest  importance  in the prevention and  cure of this  disease.
 Labor is  exceedingly beneficial to  dropsy in  its early  stages.
 Nothing contributes so much  to a free  and  lively circulation of
 the blood as exercise.  It assists the vital powers both in moving
 the blood and in hastening  the secretions  and the  excretions.
 The  perspiration, especially, is always increased by it;  and  the
increase of the perspiration diminishes the accumulation  of water
in the dropsical part.  Friction or rubbing  the dropsical part, or
the whole body, quickens the circulation of the blood  and the
absorption of the water.
   The effect of temperance or the due  regulation of the quantity
and quality of the food and drink, will assist as much in the cure
of dropsy as exercise.  The  food should be light and nourishing, 
*04
DRO.
and the drink nothing but water and common tea, or such medi-
cated drinks as are  known to be  favorable to the disease.  The
cream  of  tartar water, lemonade,  the rochelle powders, the soda
powders and the spirits of mindererus or acetate of ammonia, are
all favorable to the disease, and have a  tendency to cure it.
  The medicines most effectual in the  cure of dropsy are purga-
tives, and diuretics or those substances which increase the flow
of the urine.   The  cream of tartar in a dose of a table-spoon-
ful mixed with water should be taken  every  day.   Small doses
of the cream of tartar have but  little effect.   If, on a proper trial
of the cream of tartar, the dropsical swelling does not diminish
or diminishes but slowly, two table-spoonfuls  of epsom salts
should be taken every day, or enough to operate upon the bowels
three or four times, very thoroughly.  We have always observed
that  the salts  carried off  more watery matter from the bowels
than any other purgative.   Purgatives more drastic than salts are
often used, such  as scammony, gamboge and colocynth.  Lee's
pills  comprise one or more of  these articles  and will be found
sufficiently powerful.  The  efficacy of purgatives will  depend
upon the constancy with which they are used.  If used in small
doses, and at long intervals, they  will have but little effect.
  We once saw a general dropsy where the whole body appeared
to be filled with water, completely reduced in the course of three
or four days by the coming on of a diarrhea.  It was  summer
time, when  the  bowel complaints were  common, and  noticing
the effect which it had upon the disease, we let it run on until it
had  carried  off all the water.  The person,  a woman,  from an
unusually large size, was  suddenly reduced to her  natural size,
which  was rather small.   Her acquaintances looked upon her
with wonder, and were puzzled  to tell the cause of the alteration.
The  diarrhea was not very severe, although it amounted to eight
or ten  discharges in twenty-four hours.  We  learned from this
fact,  that unless the bowels were operated upon in a similar way
or to a similar degree, by art or  medicine, that  the dropsy will
not be  much benefited.
  This woman lived for  more than a year  afterwards, and for
the first part of  the  time, she was  comparatively free from the
disease ; but she afterwards  filled up with water, and  died ; but
her life was evidently procrastinated for more  than a year, as she
could not have lived in the state she was in previous to the diar-
rhea, but a few weeks.  The diarrhea  had no necessary connec-
tion with  the disease, but was  an accident which  happened to
her in common with many others  at that season of the year.  At
any other season of the year, she  would have escaped the acci-
dent, but would  have died very soon of the dropsy.   This case
fully convinced us that dropsy in its worst stages can be reduced
by purgatives, if they are  pushed  to a proper  extent.  We must 
DRO.
205
produce  an artificial diarrhea, or they will  prove of but little
service.
   The dropsy of the brain which is for the most part confined to
children under twelve years of age, should be treated in the main
like ;the  dropsy of any other part.   In this disease, however,
which is commonly marked by a squinting of one or both eyes,
paleness of the face, stupor, great sensibility to light, nausea and
vomiting, costiveness, intense pain in the head, and fever, blis-
tering the head is of the highest  importance.   The head should
be shaved, and large blisters  should be drawn upon it and kept
running,  by the savine ointment. .The bowels should be opera-
ted upon by calomel and jalap ;  and where the head is hot, and
the fever high, leeches should be applied to  the forehead and
temples.  If the disease arises from the ravages of other diseases,
as the scarlet fever and the  bowel complaint, neither leeching
nor severe purging will be proper, but the disease must be treat-
ed with  medicines which  will strengthen the system and pro-
mote absorption.
   Dropsical  people will do well, if it is in their power, to visit
the  Saratoga  Springs and  try the effect of the Congress water.
Both the water which contains  salts and that which contains
iron will often prove beneficial.   Perhaps there is no way in
which a  dropsical  person is  more  likely  to be  benefited  than
by a residence at these springs. The Sulphur Springs of Virginia
should also be tried.  Large quantities of water drank frequently,
operates very  much- Upon the kidneys, increases the flow of the
urine, and gives new activity  to these important glands.
  Professional Remedies.—-It is not often that blood-letting is neces-
sary in the dropsy, whether it be  general or local.   In some cases
where there are evident signs of an  inflammatory action, the abstrac-
tion of blood, either by leeching or opening a vein, will be demand-
ed.  Large and frequent doses of salts, cream of tartar and other pur-
gatives which drain the bowels of water, are the primary remedies.
The calcined magnesia operates both upon the kidneys by its alka-
line qualities and  upon the bowels, and should always receive a
trial where other things fail ; it is one of the very best medicines in
the dropsy.   The iodide of  potash in doses of five or six  grains,
once in three  or four hours, has lately been highly recommended
as a great promoter of absorption.  The sweet spirits of nitre and
the tincture of foxglove are often found serviceable in increasing
the  secretion by the kidneys.  The  sal nitre is, however, the
surest, and, probably, the best  diuretic which is,  at present,
known.
  The water  must be drawn  off by scarifying or  tapping where
other means fail.   A few punctures made with the lancet upon
the calves of the legs or other parts of the surface of the body, 
106
DRO.
will often let off the water in a few hours or a few days.  Tap-
ping is practised where the abdomen or chest is filled with water.
The water will, sometimes, run off by drawing a blister upon
the dropsical part, but the effect of a blister is apt to leave a sore
which is difficult to heal.
  DRY  BELLY-ACHE—Colica Pictonum.—See Colic.
  DRY  ROT.—See Mortification.
  DROWNED PERSONS, OR SUSPENDED ANIMATION.—
In  drowning, as soon as the breath is stopped  by the water or
rather by the exclusion of  the air, the skin  becomes of a purple
color, especially in the neck, face, and lips.  Some persons are
much longer in drowning  than others.  Whether this is owing
to the possession of more vitality by some than others, or to acci-
dental circumstances, is not easy to determine ; the same is true
of those who die by strangulation, or the breathing of carbonic
acid and other deadly gases.
  The first thing  to be done on taking persons out of the water
is to carry them, carefully, to some place where the wet  clothes
can be taken off, and a suitable degree of warmth supplied.  In
carrying  them, the  head and face should lie downward, and a
little lower than the rest of the body, that the water may  run out
of the mouth and throat.
  As  soon as it can be  done, some assistant should get  behind
the drowned person, raise him  up, and supporting  him by the
shoulder, should press the belly gently, but firmly  with both
hands, which will expel the air  and water from the lungs ; by
removing the hands, the midriff will fall, and air be  drawn in.
The hands should be pressed and relaxed in this way, for some
time,  by which,  an artificial  breathing  is  produced ; as it is
chiefly by the contraction and expansion of the muscles of the
belly that respiration is carried on.   Any person can demonstrate
this fact upon himself, by pressing, and relaxing the hands upon
the abdomen.
  At  the same time, a degree of warmth equal to blood heat,
should be applied to  the whole  body by means of dry, heated
blankets; the body, first, being wiped perfectly dry.   Warmth is
the prime agent in restoring the vital principle.   Warm bricks
should be placed to the feet, and flannels as warm as they can be
borne, to the pit of the stomach.   An injection of warm milk
with a little rum or brandy in it,  should be given as soon as  pos-
sible.   While these  things are doing, some one must try to inflate
the lights by blowing air into one of the nostrils,  either with the
mouth or a pair of bellows.  To do this, the other nostril  and
the mouth must be perfectly closed ; and  great care must be
taken not to use much force.  An inflating  bellows has been in-
vented, and  is getting  into use, so constructed as to throw air
into the lungs  by one motion, and by another, to exhaust them, 
DUM.
107
in imitation of the vital process:  where this instrument can be
obtained, it will be found a valuable  auxiliary in restoring ani-
mation.  The room should be warm, but fresh air must be freely
admitted.   Gentle rubbing with the warm hands or soft flannel
will be of some service, but all forcible friction will be injurious.
On the failure of  these means, the warm  bath should be  tried.
Galvanism is highly recommended.
  It is the common opinion that the lights, in the case of drown-
ing, are full of water, but this is an error.   It is seldom that much
water ever enters the  lungs, unless the person is entirely dead.
The contact of the water closes the epiglottis and prevents both
the air and water from entering the windpipe.  This  considera-
tion will be sufficient to deter people from  using improper efforts
to expel the water from the lungs, such as rolling drowned per-
sons upon a barrel, or hanging them up by the heels.
  Efforts  to recover  drowned persons, and people  strangulated
by  hanging, or suffocated by gases, should not  be  relinquished
until  the lapse of several hours, for, life, sometimes, returns after
animation  has been suspended a long while.  After  breathing
takes  place, it will be some  time  before  the senses  entirely re-
turn.
  In  cases of suicide by hanging, or suffocation by the carbonic
acid and other deadly gases, the same means are to be used.  In
strangulation  and suffocation, however, blood-letting is  some-
times  practised in a moderate degree, whereas, in drowning, it is
deemed improper.
  Dissections  of those who die  by  drowning,  show that the
lungs are in a state of collapse and that there  is an accumulation
of blood in the heart and the large vein which leads to it.
  DUCT.—All the arteries and veins are  but so  many ducts to
circulate the blood.  The word duct, however,  commonly signi-
fies, in anatomy, a vessel, which empties or transfers some  of the
secretions or the excretions,  such as the bile,  the chyle, the pan-
creatic juice, and the  tears.  The vessel which empties the bile
into the intestines is called the bile duct; and the vessel which
transfers the chyle into the left sub-clavian  vein,  is called the
thoracic duct.
   DUCTUS  COMMUNIS  CHOLEDOCHUS—The common
biliary duct, which conveys both the bile  of the gall bladder and
of  the liver into the duodenum or first portion of the bowels.
  DUMBNESS.—The deaf dumbness, is, in general, incapable
of cure,  although there are a few instances recorded of a com-
plete  restoration, both  to the hearing and the power  of speech.
Dr. Good relates the case of a man by the name of  Frazer, who
was born  dumb and continued dumb,  until he  was seventeen
years of age, but, in consequence of a brain fever, was fortunately
restored to hearing  and the power of speech.   The deaf-dumb 
208                      -  DYS.
 person, has no other resource but to learn the art of communica-
 tion by signs.
   People sometimes become mute from  disease or weakness of.
 the vocal muscles.   The scarlet fever has been known  to  pro-
 duce dumbness.  The organs of the voice will sometimes become
 paralized ; by which, the power of articulation will be lost.   The
 power of speech has been lost from  sudden and overwhelming
 affections of the mind, such as terror, anger, and grief.  Convul-
 sion fits,  and  heavy  blows upon  the stomach  will destroy the
 power of speech.   The tongue, is sometimes, so confined by the
 growth of the frenum  or  bridle, that the  person will  become
 almost mute.   This last affection, is, however, very easily reme-
 died  by the  severance of the  string or little membrane which
 confines the organ.
   Where the loss of the voice proceeds from an  affection of the
 nerves, or from a debility of the vocal organs, the usual remedies
 are blisters, emetics, and electricity.  Sudden fits of passion have
 not only destroyed the power of speech, and rendered the person
 mute, but restored the voice where it has been lost.   The same
 agent which produces disease will very often cure it.
   DUODENUM.—This is the  first portion of the intestines or
 bowels, and is only about a foot in  length.  The bile and the
 pancreatic juice are both emptied into this portion of the bowels,
 by means of two ducts.  From the stomach, the food and drink
 pass  into the duodenum  and mix with the bile and pancreatic
juice.  It must be recollected that the bowels are one continuous
tube, and that the names, duodenum, jejunum, ileum, colon  and
 rectum are only given to successive portions of it, from  certain
 differences in its structure.
   DYSENTERY.—The dysentery is a disorder of the function,
 and of the inner structure of the bowels.   It begins with a grip-
 ing pain in the belly and an incessant desire to void the alimen-
 tary contents.   In general,  little is voided at a time, and there is
a constant feeling  of a constriction or a bound state of the bowels,
which is commonly called tenesmus.   The matter, which is  dis-
charged, is chiefly composed of mucus mixed with blood. The
natural feces are small  in  quantity, and formed into round com-
pact balls or irregular hardened lumps.  The griping pain  will
continue to increase for  several  days, even  where the disease is
mild and recoverable, and  the alimentary discharges will  consist
mostly of blood in some, and in others, mainly, of mucus.   Where
the disease lasts for any length of time, the contents of the  bowels
will discover a mixture of green bile, mucus, blood, and the nat-
ural feculent matter.  In some  instances,  the smell is intensely
bad, and in others,  there will be hardly  any at all, especially
where the discharges consist mainly of blood.
   There is usually a considerable soreness in the lower  part of 
DYS.
209
the abdomen  and some uneasiness in the lower part of the
back.  Sickness,  and  vomiting are also  very common  atten-
dants of the  disorder; it will often begin with sickness at the
stomach and  shivering.   There  is a loss  of appetite ;  thirst; a
furred tongue ; an unusual heat; and a hard, quick pulse.  The
pulse, however, does not commonly  show  that degree of size
and force as in some other inflammatory disorders.  The fever is
much more inflammatory in some cases  than in others.  The
disease  will sometimes be so mild, and so short in its duration, as
scarcely to force the person to lie by for a day.  In other instances
it will  be  protracted for two or  three weeks ; and even  for
months.  It, like many other diseases, becomes chronic and pecu-
liarly ungovernable   The dysentery will sometimes change into
a diarrhea, or a state of the digestive organs wherein the food is
passed  through them, unchanged. It ceases spontaneously in
many cases,  and the natural function of  the  bowels is entirely
re-established in the course of a few days.
   The dysentery is an inflammation of the inner coat or mucous
membrane of the bowels, and, in most cases,  of the lower portion
of the bowels or  the large intestines.  The muscular or fibrous
coat,  and  the peritoneal coat, which  together,  constitute  the
outer side  of the  alimentary canal, are never involved in the in-
flammation.  The inflammation of the inner coat  of the  intes-
tines resembles very much the inflammation  of the mucous mem-
brane of the nose and windpipe, in an influenza or bad cold.   In
both  cases, the inflammation appears to be confined to the mucous
membrane itself, and never extends any deeper.  In  case of the
inflammation of all the coats  of the intestines,  it will produce a
complete stoppage and destroy the peristaltic action of  the part;
but in a dysentery, the  inflammation being  more superficial,  it
only produces a bound state,  or partial stoppages of  the different
portions of inflamed intestines.  The pain, in a dysentery, ap-
pears to be mainly produced by  the  peristaltic motion of the
bowels, for, when this motion is stopped  by opiates, there is no
pain  felt.  The  intermission  of the pain and its occuring just
before each evacuation, also show  it to result  from the action of
the bowels.  Were there no more  motion, therefore,  in a dysen-
tery, than in the  mucous membrane of the  nose, windpipe, and
bronchia, in an influenza, there would probably be no more pain.
The friction  and weight of the contents of the  intestines, moving
through the inflamed tube, also have some agency in the produc-
tion of the pain.   When the hardened balls of natural  feces are
removed from the inflamed canal,  there is always a  remission of
the griping, the pain, and the sense of  constriction.
   In the dysentery, purulent  matter will sometimes be voided,
but this is not so  alarming a symptom as it  might, at first, seem
to be.  The  phenomenon will  often happen in recoverable cases.
            27 
210                         DYS.
We have several times seen it  occur, where the disease has run
for some time, in people  who have recovered entirely  from the
disease.   The  formation of this  purulent matter in the  intes-
tines does not always  portend  an ulceration ; the mucous mem-
branes will all secrete pus under certain circumstances.
   The intestinal discharges will  often present the appearance of
water, in which raw flesh has been washed.  The appearance of
particles of flesh, floating in the watery discharges, is only con-
gealed,  clotted  blood,  broken into small fragments.  Ulceration
of the intestines is a rare occurrence, although, in chronic cases,
it  is sometimes seen.
   When the fever, in this  disease,  is highly inflammatory, the
patient will often be carried off in a very few days; and, in some
instances, where the fever is comparatively mild, the disease will
run on for some weeks, or even months.   Relapses are very com-
mon.   No pains should be  spared to prevent this occurrence.
   The dysentery is the most common in summer and fall, and
the hotter these seasons are, the more productive they are, of the
disease.  The most usual causes of the dysentery are the changes
from heat to cold, which suddenly check perspiration and repel
the blood from  the surface.  In hot climates, the disease is more
prevalent than in cool ones; and very  dry hot weather is more
productive of the disease, than moist hot weather.   The disease
is  sometimes epidemic ; and is more prevalent in  some districts,
in the same latitude,  than in others.   Limestone districts have
been pointed out as being  more productive of the disease than
other  kinds of soil.   On this account, it has been called endemic,
or more pecular to  certain spots  than  to  others.   All green,
unripe vegetables, and fruit, will produce the disease when eaten
in sufficient quantity.  Lobsters, and many kinds of fish also oc-
casion it.   All  substances  difficult of digestion have a tendency
to induce it.  The dysentery was  formerly thought to be conta-
gious, but modern physicians have become satisfied that it is not
so. Dr. Dewees, of Philadelphia,  has never seen a case where
the disease  has arisen from  contagion,  and other physicians of
eminence have  testified to  the same  fact.  It is barely possible
that the disease, in camps and hospitals, may become  contagious,
but, in general, like the cholera morbus and diarrhea, it is produced
by the changes of the weather, by the season of the year, and by
the food and manner of living.   It is probable that the season of the
year and the nature of the soil induce a state of the system which
easily runs into this disease, on the presentation  of any of the oc-
casional causes  which produce the other  diseases of the bowels.
   Domestic Remedies.—In mild cases of the dysentery, where
there is not much fever, thirst, nor pain, a table-spoonful of castor
oil, and two tea-spoonfuls of paragoric, mixed, taken once a day,
will be all the medicine actually required.  No solid food  ought 
DYS.
211
to be eaten in a dysentery, and the drink should be flax-seed tea,
or some  other mucilaginous  liquid, and cold water.  Brandy is
sometimes taken in this disease,  but it is not a good thing to use
in the commencement of the disease.   Where castor oil is not at
hand, five or six butternut pills,  or as  many pills made of the ex-
tract  of  thoroughwort,  may be  taken  to move the bowels.   If
the pain  is not allayed by the paragoric, two  tea-spoonfuls more
should be taken again, at the end of  four hours.   A dose of the
rochelle  salts, or  of senna, manna, salts, and anise seed, will,
sometimes, be found to  answer better  than the oil;  and thirty or
forty drops of laudanum to be more effectual than the paragoric.
Where the paragoric and laudanum do  not procure relief from
pain, a tea-spoonful of  laudanum may be given by injection in a
wine-glass full of flax-seed  tea,  or the  same amount of starch.
The quantity of flax-seed tea, or starch,  should always be small,
lest the bowels should be disturbed by the mere bulk and weight
of it.  At  the same time these  medicines  are  used,   the  feet
should be soaked in hot water,  and  plentiful  draughts of quite
warm flax-seed tea, or catmint, or balm tea, should be  taken to
produce  a perspiration.  Two grains of ipecac, once  in  three
hours, will be proper, where  the hot  teas fail to excite a sweat.
Thirty drops of the wine of antimony, once in three hours, will
have  an effect similar  to the ipecac, in raising a moisture upon
the skin.
   The dysentery of children, will generally yield to a mixture
of oil and laudanum, or paragoric.  To a child a year old, a table-
spoonful of castor oil, mixed with eight drops of laudanum, should
be given every day until the complaint is cured.   This dose of
oil may seem large for a child  of that age, but experience has
confirmed the safety and the  utility of it.  We have often admin-
istered two  table-spoonfuls  of castor oil in a day, to  a child of
that age,  with the happiest effect.  The object is to allay the
pain entirely by the opiate, and to clear the bowels thoroughly
with the oil.  If the first dose of laudanum will not produce the
effect, we administer another similar dose, in the course of eight
hours.  We  greatly prefer the oil to all other  purgatives, but
other cathartics, also, may be used in  place of it, where the oil
will not  agree with the  stomach.   Sickness at the stomach is so
often an  attendant of the dysentery of children,  that calomel  in
some cases, is almost the only purgative, which will be  found to
stay upon that irritable organ.   A dose of five or six grains of
calomel,  mixed with eight drops of laudanum, will both allay the
pain and evacuate the bowels.  It  must  be remembered  that
physic of all kinds,  is much longer in operating, when given with
laudanum or other opiates, than  when taken alone. A  dose  of
oil or other physic will  often be  two or three times as long in
operating, when the system is under the influence  of opium as it 
212                        DYS.
 will when no such medicine has been  given in conjunction with
 it.   It  will sometimes be  found, in the dysentery of children,
 that neither oil, nor any other pure cathartic, will answer the pur-
 pose in subduing the  disease.   In such  cases a grain or two of
 ipecac, given  once in three  or four hours, will often both  relieve
 the  pain and evacuate the bowels.  We have often seen ipecac
 given in this way, without the use of any opiate, cure the dysen-
 tery of children; when all other means  have failed.  Three grains
 of the Dover's powder given morning and evening,  to a child a
 year old, with five grains  of calomel, will, occasionally, be found
 more suitable  than laudanum or  paragoric.  Where the children
 are younger or older than one year, the dose must be diminished
 or increased in proportion  to their age.   To  a child six months
 old, five drops of  laudanum will be a full dose; and to one, two
 or three years old, ten drops are a proper dose.  To children who
 are older than three years, two drops for every year,  may be ad-
 ded.   The same doses of cathartic medicine, will,  in general,
 answer for all children between one year and eight years of age.
 We have often given  a child, six  months old, a table-spoonful of
 castor  oil at a dose, but when  they are younger than  this, a de-
 sert-spoonful,  or a tea-spoonful will be enough.   Sometimes an
 emetic of ipecac, will have  a wonderful tendency, if given early,
 in the disease, to resolve the inflammatory action  of the bowels;
 but, in general, this medicine does better in small doses.  A blis-
 ter upon the bowels where there is not much fever, is often very
 serviceable.  Fomentation, by  the use of cloths dipped  in  hot
 water, spirits,  or infusions of pennyroyal and other stimulating
 herbs,  is almost always beneficial, as it tends to solicit the blood
 to the  surface and to excite  perspiration.
   The best food for children, sick of the dysentery,  as well  as
 grown people, is a porridge, made of superfine flour.   The flour
 should be boiled much longer than porridge made of indian meal,
 and  should not be made very thick.   Children  at  the  breast
 should  be  allowed to nurse, but  should not be allowed to suck
 more than half the  usual quantity.   Boiled milk and water, in
 equal parts, may be allowed where the fever is not very high.
  Children as well as grown people, may always be  allowed to
 drink cold  water in this disease.   We believe  it  to be the most
 friendly substance  which can be introduced into the stomach and
 bowels.  The soda powders and  the rochelle  powders, are also,
 well adapted to the nature of the complaint.   A gruel made of
arrow root  or of boiled crackers may be given, both for food and
 drink.
  Professional Remedies.—The pulse, in the dysentery, is  not
always a sufficient index of the  degree of inflammation,  and
of the extent of mischief in  the bowels.   The pulse will, some-
times, be full and forcible, when there is  not a very high degree 
DYS.
213
of inflammation, and  there  will often be a very high degree of
inflammation, when the pulse is rather small, contracted  and not
very forcible.   We believe,  in  this disease,  the  pulse, in almost
all cases, is hard, although it may be small and contracted.  The
discharges from the bowels  and the degree  of pain and sense of
constriction, will often show, also,  a  great degree of disorder of
the bowels, when  the pulse is neither very  full nor  forcible.
Therefore, to judge properly of the degree and extent of the in-
flammation, we must take into the account, the height of the fever,
the severity of the pain, and the appearance  of the discharges as
well  as  the condition of the pulse.  If the fever be high, and
the pain, and the constriction great, and the appearance of the
discharges, angry, slimy and bloody, blood-letting will be neces-
sary.   This, however, should always be performed pretty  early
in the disease.   If the first bleeding does not subdue the severity
of the symptoms, a second  should  be  resorted to either by leech-
ing or by  opening a vein.   Where leeches can be obtained in
sufficient quantity, they are  to be preferred to opening a vein.  A
dozen and a half of leeches will produce about the same effect as
a pint of blood drawn from the arm.   The  application of half  a
dozen leeches or so at a time, is a  mere ceremony, productive  of
little  or no effect.  Dr. Dewees, in this disease, places the great-
est reliance  upon blood letting.  In  children, leeching is much
the best  form of abstracting blood, and is worthy of more atten-
tion than it has hitherto received.
   The combination of opiates  with purgatives, is the best  mode
of operating upon the diseased bowels.  The opium prevents the
diseased action and removes the pain, while the purgative relieves
the oppressed surface of the intestines.  An ounce of castor oil and
a grain and a half of opium  or forty drops of laudanum mixed, in
a severe  case of dysentery, is none too large a dose.  This  dose
should be given twice or three  times in the course of twenty-four
hours, if the bowels are not  sufficiently emptied and  the  pain
allayed,  by the first or second dose.   A grain and a half of  solid
opium in pill, or forty drops  of laudanum, may be given  to  a
grown person with perfect safety, once in eight hours.
   The pure opium or laudanum is much better than the denar-
cotized  opium, or morphine, as the two latter are deprived of a
portion of  the very property which is beneficial in this disease.
A quarter of a grain of tartar emetic dissolved in water and given
every hour will often empty the bowels more easily and safely
than  any other cathartic.  Thirty  drops of the wine of antimony
will have the same effect.   Two grains of the powder of ipecac,
every two  hours, will often succeed in procuring relief where
other means fail.  Both the  antimony and the ipecac, in  small
doses, are in our opinion among the best remedies in the dysen-
tery.   But castor oil and laudanum or pure opium, is our stand- 
214                        DYS.
ing  remedy.   Bleeding, blisters and  fomentations  are  often
required, but purgatives  and opiates can seldom, if  ever be dis-
pensed with.  Fomentations can always be used with safety and
are generally beneficial.  Opiates will not always agree with the
constitution of  the person or the degree of inflammation present,
and,  in such cases, gentle purgatives, emetics, sudorifics and  de-
mulcent drinks  must be used.   Next to castor oil, the purgatives
most  proper in  the disease, are  calomel, calcined  magnesia, salts
and  manna, rochelle powders, elixir salutis, butternut pills, tho-
rough wort pills, jalap and cream of tartar.  Rheubarb is a doubt-
ful remedy ; it is apt to increase  the griping  and sense of con-
striction.
   The  Dover's powder, in some cases, may be preferable  to
laudanum or opium, especially where the latter does not produce
a perspiration.  Injections are often useful, but are not, in  gene-
ral, productive of anything more than temporary relief.
   The diet should consist of flour gruel, rice water,  barley gruel
or boiled  milk and water.  A flannel shirt should be worn next
to the skin, and the greatest care should be taken to guard against
a relapse,  which is very common in this disease.  An indulgence
in eating  too soon, or too early an exposure to the weather and
to the excitement of the mind, has often proved fatal.
   The room where a patient is sick with the dysentery, it will
often be necessary to ventilate, and to correct the contaminated
air by the chlorides of soda and of lime or some other agent.  In
malignant cases of this  disease, where the  strength and vital
powers are prostrated, stimulants and tonics must be freely used.
Brandy, wine, camphor, and quinine must be  given as in other
diseases of debility.   If the dysentery is complicated with  the
intermittent fever, the fever must be  treated with the quinine,
and the local disease  combatted with  moderate doses of opium,
demulcents, and gentle purgatives.  In this complication, emetics
will  often be found compatible both with the fever and the dys-
entery.
   A great loss of strength, a  fetid  smell, tense  abdomen, cold
extremities, hiccup, and purple spots  upon  the skin, with an
irregular,  intermitting  pulse, foretel  an unfavorable  termination.
But a gradual subsidence of the pain and the desire to go to stool,
a gentle perspiration, a moistening of the tongue, and the return
of sleep, are favorable symptoms and foretel a speedy recovery.
   DYSMENORRHEA—Difficult Menstruation.—See Difficult
Menstruation and  Green Sickness.
   DYSPNCEA—Difficult Breathing.—It is not a disease of itself,
but a symptom of other affections, such as asthma, dropsy of the
chest, consumption, peripneumony, corpulence,  influenza, and
angina  pectoris.  The remedies  employed in these  diseases are
adapted to the relief of the difficult breathing. 
DYS.
215
   DYSPEPSIA  OR  INDIGESTION.—The  appearance  of
the inside of the stomachs  of those who have died of  dyspep-
sia, show that  the  disease is situated for  the  most part, in the
lower part of  the  organ.   The  valve  of the stomach, or the
aperture  which opens  into the intestines, is commonly found
either very much contracted,  ulcerated, or in  a scirrhous state,
having a hard insensible  tumor surrounding it. In most cases, there
is no doubt but the dyspepsia  is a slow, sub-acute  inflammation,
such as exists in the windpipe and  throat in a chronic  catarrh ;
not severe  enough to create  a general disturbance of  the system,
but sufficient to derange the natural office of the stomach.   This
species of inflammation is distinctly seen in what are called weak
eyes, when there is some redness, produced by the fulness of the
blood vessels; a tenderness hardly amounting to soreness ; a little
thickening of the eyelids ; and either a state of dryness or a secre-
tion of mucus which often glues the eye-lids  together..  In a
word, the eye is diseased, but not enough to  destroy its office.
Any over-action is  sure to increase the affection.  So with the
stomach  in dyspepsia; there is a certain degree of inflammation,
circumscribed in its nature, involving not the  whole of the
stomach  alike, but  inhabiting a portion only.  We are  inclined
to think  that the great majority of diseases, if not all, may be re-
solvable  into different degrees of inflammation.   Who can doubt
for instance, that the croup is only a higher degree of inflamma-
tion than the influenza, or that  the dysentery is only a lower
degree of inflammation than  enteritis, or that the diarrhea is a
still lower grade of inflammation  than the  dysentery  ?   Here
croup,  influenza, dysentery and diarrhea are only different names
for different  degrees of inflammation, and the same is  probably
the case with the great  majority of  diseases.   But  the work is
no less difficult and arduous to graduate remedies to the  different
degrees  of inflammation, than if each degree were a  distinct
entity.
   Writers upon dyspepsia have almost uniformly confounded a
disease of the nervous system with dyspepsia.  The two diseases
are just as distinct,  as the function and structure of the brain and
nerves are distinct from the function and structure of the stomach.
A disease of the nervous system disorders the function  of every
other organ, and the stomach in common with the rest; but the
dyspepsia is not sure to  disorder the nervous system, at least, to
that degree that the nervous system is disordered  by the excess
of its own action, or by the causes which act particularly  upon
that system.   The  nervous system is  always  long disordered
before the stomach  is involved, and the stomach is long  disorder-
ed with the dyspepsia before the nervous system is permanently
affected.   By ascertaining which disease commenced first and
the causes which were engaged in producing it, we may  come to 
216
DYS.
a pretty accurate  conclusion with  respect to the real seat of the
disease.
  We  believe the feelings and sensations of patients are always
a pretty good  index to the seat of disorders in general, and  may
be relied upon in relation to the seat of dyspepsia, and disease
of the nervous system.   If the patient constantly and uniformly
points to the stomach as the seat of his disease and the source of
his distress, we have good reason to conclude that it is that organ
which is diseased.   If, on the contrary, he uniformly points to
the  feelings of his head  and the affections of the nerves  as the
cause of his distress and misery, we  have as good reason to  con-
clude that it is the brain and  nerves which are the source of the
disease.  It is, indeed, no  very difficult matter to determine
whether the seat of thought and feeling,  or the seat of digestion,
is the diseased part.   Painful thoughts  and feelings may easily
be distinguished from a pain in the stomach.
  The disorder of the nervous system is, we believe, universally
attended with a state  of fearfulness  and  timidity, a wakefulness
either constant or periodical, and a multitude of  inconsistent and
absurd fancies, false  ideas, and groundless apprehensions which
are never witnessed in a case of dyspepsia or chronic derangement
of the stomach.
  Dyspepsia commences with a distressing feeling of a load upon
the stomach after eating ; pain which is relieved by belching up
wind ; heart-burn and sour eructations ;  a bound belly and  sud-
den distentions of the bowels.  This state of  thines will often
continue for weeks and months before there is much loss of ap-
petite or loss of the  flesh.  But  sooner  or later the appetite be-
comes variable or lost; the eyes look  hollow ; the skin  pale,
dingy or sallow ; the person  becomes thin; the voice becomes
hollow  and feeble ; and  the spirits  dejected.  At  intervals, the
appetite  often becomes voracious, and the spirits good, but this
does not last long.  A single fit of indigestion brings on another
series of the same symptoms.  The person now begins to grow
particular about what he  eats and the amount of food which he
takes at a time.  If he eats the usual amount of  food to which
he has been accustomed,  he is sure  to experience several hours
distress from it, or to throw it up.   He  feels a constant squeam-
ishness at the stomach, and,  sometimes,  he experiences sickness
and vomiting.  The feet and  hands are commonly cold, and the
body grows more sensible to the changes of the weather.  Some-
times, the person is thrown into a cold  sweat and experiences a
degree of faintness, swimming of the head, and a loss of sight,
especially if he stoops over, with his head down.   The tongue
in the morning is covered with a sticky, slimy coat; the  breath
emits a filthy odor; and the  bowels are  dry and costive.   The
bowels will often feel as if  bound with a cord, and the stools 
DYS.
217
instead of  being once a day as  they should  be, are not oftener
than every two or three days, and then they are dry, hard, and
small in volume.  Frequently  they will be mere  dry chips  of
fecal  matter, apparently devoid of mucus and deficient in bile.
Jn this  state, the person never  feels easy and  cheerful.'  Every
meal is attended with  more or less distress in  the  stomach and
bowels.   The  predominant feeling is a sense of weight at the pit
of  the  stomach  and a pressure of  wind in the bowels.  The
person sometimes flies to the use of tobacco or  ardent spirits, but
from this he  only experiences a temporary truce from his distress,
and an aggravation of his disorder.   If he has been a great eater
from habit, and still  retains an appetite, he finds abstinence from
food, intolerable, and  driven  by  habit,  he  foolishly prefers  to
gratify his appetite at the  expense of health.  For he might  as
well think of traveling  upon a broken  leg  as of digesting  his
usual amount of  food when the  digestive organ is deranged.   It
is no less the  dictate  of  common  sense and of  reason than  of
science,  to allow the organ to rest as much as  possible, which is
sore and inflamed.
   The  liver  is  apt to be  very much affected in  the dyspepsia.
Sometimes, a larger quantity of bile is secreted than ordinary, and
the bowels being costive, the bile  flows up into the  stomach.
The bile duct, which carries the bile (into the intestines, is not
more than five  or six inches below  the  lower orifice of the
stomach, which  accounts  for the easiness of the ascent of the
bile into the stomach  when the intestines below are bound.
Any considerable quantity of bile in  the stomach is sure to create
nausea, sickness, and pain.   The  natural juice of the stomach
seems to have  the effect of coagulating  the bile into lumps or a
kind of  green  curd which in this state is often thrown up.   It
sometimes turns the bile black and granulous  like  the appearance
of coffee grounds, and at others,  green.
   The  bile  is  exceedingly healthful to the bowels when it is
secreted in due  quantity, although it is hurtful to the  stomach.
Without the bile, the bowels are  torpid,  dry, and  contracted.
Their  motion  is invariably retarded whenever there is a defi-
ciency of this fluid.  It  is easy to see, therefore, how an affection
of  the liver  reacts upon the  stomach and the  intestines, which
compose a part  of the  digestive  powers.   The  disease of the
stomach is probably continued  to the liver, although  in many
instances of dyspepsia, the liver is scarcely affected.
  The affection of the  nervous system which often accompanies
the dyspepsia, probably, arises from the affection of the nerves of
the stomach, which are continued in a greater or less degree to the
brain, and  from the deficiency of nutriment which the brain ex-
periences in consequence of the  interruption of the usual amount
of nourishment, from the disease of the stomach.
           28 
218                        DYS.
   The  pulse is not apt to be much affected  in  the  dyspepsia
until the disease has  become permanent and severe.  The heat
of the body is  much  less than in health.  The skin is, in some
instances, dry and contracted, and, in others, moist and clammy.
Dyspeptic  people, we  believe, are  not apt to  be much more
troubled with a palpitation of the  heart than  well people.   In
this respect, dyspepsia differs again from a disease of the nerves.
The two diseases may, however, exist  together and no  doubt
often do ; in which case, a palpitation  of  the  heart may attend
dyspepsia.
   The muscular strength is very much impaired in dyspepsia as
well as  the energy of the mind.  Labor, amusement, and  study
are very apt to  be  irksome, and the sleep exceedingly unrefresh-
ing.   The wind and the distention of the stomach and  bowels,
keep the sufferer constantly tossing  from one  side to the  other,
nearly the whole night long, and afford but little time for rest.
   The  dyspepsia  in some instances ends  in an  affection of the
lungs, cough, and  all  the symptoms of hectic  fever.  This  ter-
mination of the disease always  makes it of the highest  impor-
tance to cure it in its incipient  stage,  or  when it first begins.
If taken in season, and properly treated, the dyspepsia is as cura-
ble a disease as any there is ; but if suffered to go on with little
or no attention, and without any alteration of the manner of
living, or avoidance of the causes which produce it, there is no
disease more intractable.
   The stomach may be considered as the root of the tree.   It is
to this organ  that  the nourishment is first applied, and here  it is
converted into a  fluid  state, preparatory to  its conversion  into
blood.   But the process of digestion is not finished in the stomach.
After the food is dissolved  by the gastric juice, it passes into the
first portion of the  bowels called the duodenum, which is about a
foot  in  length, and where it meets  the bile  and the pancreatic
juice.   Here  it receives a whitish color and is called chyle,  and
is ready to be secreted by the lacteal vessels which are situated
all along the  small intestines until their termination in the  colon.
Any disorder of this apparatus is precisely like a disorder of the
root  of  a tree.   The tree  can never flourish and grow  while
there is any interruption of  its nourishment from a disease of its
root.  From  the great variety and consistence of the food  which
people eat, the  hasty manner in which it is often swallowed, and
the surprising quantity sometimes thrown  into that small  organ,
we might expect  disease of the stomach much oftener than we
witness it.   The stomach is certainly a very tough, strong  organ,
or it would inevitably be diseased much oftener than it is, by the
multiplicity of  acid, alkaline, metalic, saline, fibrous, corrosive,
stimulating, sweet, bitter, rancid, putrefactive,  oily, solid, gristly
and bony substances which are daily poured into it.  But although 
DYS.
219
 it will resist abuse  and oppression to a great extent, without in-
 jury, it must  ultimately be overcome  in  the contest, and when
 once overcome, its lameness is apt to  last for some time and to
 produce more  or less disorder of the whole system.
    People  between  thirty and  forty years of  age are the most
 liable  to dyspepsia, although it will sometimes appear earlier or
 later in life.
    The most common cause of the dyspepsia is excess  in eating
 and drinking  and the want of  exercise.   Other causes, assist  in
 the production of it, such as great anxiety  and perplexity of mind,
 and the loss or frequent interruption of the  regular sleep.  Nothing
 sooner disturbs digestion than the loss of sleep.  The habitual
 use of ardent spirits, opium, tobacco, tea, coffee ; excessive study,
 exhaustion from  heat, cold, and venery ; diseases of the liver,
 spleen  and  nerves,  all  conspire, with  the over-acticn  of the
 stomach, to produce the disease.  The  stomach is often affected
 with a scirrhus at its lower  orifice ;  this gives  rise to the worst
 form of dyspepsia, but whether the scirrhus is always avoidable
 by any course  of living and  conduct which we can  adopt, is ex-
 ceedingly  doubtful.  A  disposition to  it is, in  many instances,
 hereditary.   Temperance, exercise, and regular  habits  of sleep
 are beyond a doubt, the  best means of obviating  such a disposi-
 tion.
   People in cities, whose minds are distracted with a multitude
 of business, and who are forced to great irregularity in sleep and
 eating, are peculiarly liable to dyspepsia.  Farmers and  their
 wives and children who live in the country, who labor daily, never
 hurry, sleep sound at night, and eat wholesome articles of food
 and much fewer in number than those who live in cities, who drink
 cold water, or  the weakest  dishes of tea and coffee, are seldom
 affected with it.  In the country, milk is the drink of children
 instead of  tea and coffee, which no doubt  contributes greatly to
 strengthen and fortify the stomach against  disease.  The dyspep-
 sia sometimes  makes its appearance  among  country people, but
 the  disease is rare in comparison with the instances of its occur-
 rence among the  inhabitants of cities.  Sea-faring men are also
 peculiarly  exempt  from dyspepsia.   There  again we see  the
 effects  of great simplicity of living, united with  exercise, good
 air, and a comparative freedom  from the embarrassing  cares of a
 city life.  All  active trades are more  favorable to  the  soundness
 of the stomach than sedentary employments.   The  fewer  the
 articles  of food which we eat,  and the greater  the uniformity
which we observe in eating  them, the greater will be our chance
of escaping this harrassing disease.
   Domestic Remedies.—In the  beginning of the disease, espe-
cially, if the symptoms are mild, there is no necessity of taking a
great deal of medicine.   We have only to alter the quantity, the 
220                        DYS.
variety and the quality of our food ; to secure a sufficiency of
sleep ; to avoid all dissipation; to take a good deal of exercise;
to regulate the bowels with some mild purgatives ; and to correct
the acidity and wind in the stomach with a few alkalies and car-
minitives.   Where sourness of the stomach is annoying, a little
crude soda, such as is used to soften the water in washing, dis-
solved in water, is one of the best things which can  be used.  A
piece of the size of a kidney bean should be  dissolved in half a
tumbler of water, and drank, at intervals,  until the sourness is cor-
rected.   The calcined magnesia, or a few spoonfuls of lime water,
where the other things cannot be obtained,  or a little chalk will
destroy the sourness.   The lye of wood ashes is also a good cor-
rector  of sourness, if the  ashes  are  pure.   To expel the wind,
spearmint or peppermint, tea, drank warm, are good medicines.
   If the distress amounts to a wind colic, a tea-spoonful of para-
goric, or a few drops of laudanum or of the sulphate of morphine
should be taken.   If the distress arises from the quantity or the
quality of the food,  a dose of salts or an emetic should be given
to free the stomach of the offending matter. ' The person, however,
must not go without food,  although the quantity must be smaller
than usual, and of a kind  that will digest easily.   Course wheat
bread is the most suitable, of all bread stuffs, for a dyspeptic stom-
ach, unless it be rye bread.  The  rye bread or  the rye flour
bread is more  opening than the  wheat bread, but less palatable
and rather more liable to ferment. But where the rye bread does
not ferment, it is preferable to the wheat.  Bread, made of wheat
flour, retards  the  motion of the  bowels  and  clogs the  stomach.
Stale bread or bread a day or two old is better for  the stomach
than new bread.  The indian meal bread, baked before  the fire,
or rye and indian meal bread, baked in an oven, if it  does not
turn sour upon the stomach, is much  better than wheat flour
bread.   The soda  bread, lately invented, will, in  many instances
be found to answer better  than  either of the other kinds.   Sea
bread and hard crackers  suit many stomachs better than softer
bread.   But after a fit of indigestion,  where the stomach has ex-
perienced a contest of wind, pain, heart-burn, and hot, sour eruc-
tations, and perhaps  sickness and vomiting, the patient for the
first twenty-four  or forty-eight  hours,  should take nothing but
rye pudding, boiled rice, or soaked wheat, or rye bread.
  A great quantity of drink of any kind  is pernicious.   The less
the gastric juice is diluted,  like any other solvent, the greater will
be its power of digestion.   If a  great quantity of tea,  water, or
other liquid is  taken into the stomach, the gastric juice which was
before strong,  becomes  weakened, and operates upon the  solid
food but slowly and imperfectly.  One gill of the gastric juice,
is, perhaps, dissolved in, or at least mixed with a quart of water,
by  which  its  solvent power is  lost.   No more drink should be 
DYS.
221
taken, than is necessary to quench the thirst.  For this purpose,
a porrige  made of indian or coarse wheat  meal, milk, and wa-
ter, commonly called milk porrige, will, in general, be found very
suitable.
  A dyspeptic person should not eat more than one kind of meat at
a time,  and of this only a moderate quantity, once a day.   Some
stomachs will not digest vegetable food so easily as animal food
or meat.  One kind of vegetable, eaten with the meat, will be as
much as the  stomach will bear, or ought to bear, and this maybe
potato,  bread, rice, or any other article of easy digestion.  We
have known  instances where  nothing but meat could be taken,
and other instances where nothing but bread could be digested.
Of the  meat  kind, mutton, beaf-stake, and poultry, are the most
digestible.  Eggs and milk, made into custards, are suitable arti-
cles of diet for dyspeptic people.  Ice creams, eaten slow, and with-
out any other substance at the same time, we believe to be whole-
some.   Salt-fish, eaten  either with bread, or mixed with potato,
is very  innocent; and so is salt pork or beef, eaten one at a time,
with  one kind  of vegetable.  Almost all white fish, which, in
general, contain  no oil, are light and very easy of digestion.
  Many kinds of ripe  fruit are  agreeable  to the stomach in dys-
pepsia, such as strawberries, whortleberries, blackberries, peaches,
but not apples  and  pears, unless they are cooked.   Indeed, all
kinds of fruit and vegetables  which create wind,  and ferment in
the stomach and bowels, must be avoided.
  There is always more or less wind in the  stomach and bowels
in a sound state  of health.  The digestive organs are not, how-
ever, sensible to the  presence of it, unless  they become inflamed
or a little sore.   When  any  part becomes sore and inflamed, an
ordinary degree   of  touch, pressure, or stimulation excites pain.
There may not be in the stomach  and bowels  of a  dyspeptic, a
larger quantity than  ordinary, of wind, or air,  but these parts be-
ing sore and inflamed, acute pain and  severe distress may be pro-
duced by it.  The stomach and bowels, having lost their ordinary
degree of cohesiveness and  strength,  are probably more dilated
and distended by the same quantity  of air, than they are in a
state of health.    When the eye becomes sore  and inflamed,  the
same  degree of  light  which only produced agreeable vision, is
now painful,  or intolerable.
  To endeavor,  therefore, to  expel the wind in every fit of indi-
gestion, and to produce relief in this way, will be attended with
fruitless effects.   But whenever there is fermentation in the stom-
ach and bowels,  which is indicated by sourness and acrid  fumes
arising,  it will be proper to make use of warming and soothing
teas and essences, such  as pennyroyal, peppermint, tansy, spear-
mint,  hop, poppy, red pepper, and ginger.   The poppy tea is 
222                        DYS.
 probably, the most certain to give  permanent relief.   The hop,
 ginger  or red pepper teas, stand next in point of strength.
   In many instances,  a gentle  emetic, either of ipecac,  or lo-
 belia  will  be  necessary.  If the  stomach  is loaded, there  is
 no other way to  produce  immediate relief, than  by  remov-
 ing  the  load.   This  should  be  followed  with  a dose  of
 salts, castor oil, rochelle  powders, aloes,  butternut  physic,  or
 thoroughwort  tea.   If there is a  constant feeling  of soreness,
 and  pain at the pit of the stomach, a large blister should be drawn.
 Small blisters are of no service.  A half a dozen  leeches should
 also  be applied to the pit of the stomach, every two or  three days,
 until relief is obtained.  If there is a constant costiveness of the
 bowels,  the  best medicine which  we have ever used, is  aloes,
 taken every  day, at night.   One, two, or three aloetic  pills, as
 the case  may require, must be  taken on  going to bed, and con-
 tinued for four weeks  at  a time, if the digestive  organs are not
 reinstated before.   We have cured many people  with no  other
 remedy.  In bad cases of dyspepsia, we have  often used  equal parts
 of the oxide of bismuth and aloes made into pills, with a  solution of
 gum arabic, or with molasses.  Four of the pills are taken every
 night until an improvement of the digestion takes place.  Such is
 the efficacy of bismuth which is a cooling white powder, and aloes,
 in this disease, that pills of these two articles are  often sold as  a
 patent medicine,  and sovereign remedy for the cure of dyspepsia.
   The oxide  of  bismuth can be used alone, in powder, of five
 grains at a dose.  In  cases where a daily use of  physic is not
 needed, it will be advisable to  use it in this way.   The powder
 may be mixed with honey, molasses, or any kind  of preserve or
 syrup.
   Daily exercise  continued until the person is a little tired, is of
 indispensable use in the cure of the disease.   This may be  done
by some light employment, by which the mind and feelings are not
much excited ; by walking ; riding,  either on horseback or in  a
carriage ; a trip to sea;  or  by fishing, hunting or searching  after
plants and minerals.  Labor or exercise always creates an appe-
tite or demand for  food  in  a state  of health, and  where the
strength will admit of it, it will undoubtedly have a similar effect
 in a diseased state of the stomach.   A journey from the seaboard
 into the country,  or from  the country to the seaboard, is almost
always productive of improvement.  The change of air as well
as of scene is peculiarly invigorating.
   There  is no disease upon which the sea air has an effect so re-
 markable as upon this.   The dyspeptic hardly  reaches one of the
 beaches upon our northern atlantic coast,  before he  begins to
 crave more  food and to digest  it better.   His sleep is sounder
 and more refreshing, and his strength is perceptibly improved.
 There is less  wind in his stomach and bowels, or it troubles 
DYS.                        223
him less, and his bowels begin to move without the use of medi-
cine.  If he bathes,  daily, in  the sea water, he improves still
faster.  Sea air and sea bathing  we should place among  the
cardinal remedies in the cure of dyspepsia.  Both the air and the
bathing  are, however, unsuitable where  there is a cough or any
sign of hectic fever.
   By increasing the tone and action of the skin, which is a large
surface crowded with capillary vessels, the circulation of the
blood is hastened, the heart acts with more force, and the vessels
which separate the  sweat from the blood, perform their office with
more effect.   The application  of cold sea water to  the skin,
where it can be borne, besides removing the scurf deposited  by
the evaporation of the sweat, which blocks up the mouths of the
capillaries,  acts as  an astringent  and gives a greater degree of
cohesiveness to the substance of the skin.  In sea bathing, it is
always best to  begin with a temperature just below the tempera-
ture of the  body, and to keep lowering it until it is used entirely
cold.   If we  bathe in  water  of the  temperature  of ninety
degrees, we bathe  in cold  water, or  water which  is colder
than the body, although it  may be warmer than the air.  Water
carries off heat from the body, much faster than the air, so that a
person might be seriously injured  by bathing in water, when he
could withstand the atmosphere  of the  same temperature with
perfect impunity.
   Rubbing  the skin is of great use.  This process arouses the
action of the blood-vessels of the  skin; awakens its sensibility;
and finally draws to the surface a greater amount of fresh blood.
This may be done either with a crash towel,  flesh brush, or  by
the hands.  But if the person is able to take a good deal of gene-
ral exercise, friction becomes less necessary.
   The white  mustard is  an excelled remedy in many cases of
the dyspepsia, especially where flatulence and costiveness prevail.
A table-spoonful operates upon  the bowels, warms the stomach,
and produces an expulsion  of wind.   It should  be taken every
day for three or four weeks.  The common mustard,  used as a
condiment,  will answer nearly the same purpose.  Either of them
may be taken in seed, or ground.   The ground mustard has the
most effect,  but is less palatable.  It may be taken  in molasses
or any kind of syrup.  This article, alone, has cured and helped
very many people.
   Thoroughwort, taken every day, in sufficient quantity to move
the bowels,  without violently purging them, has often been found
extremely helpful.
  The Saratoga water, and a residence at the springs, have effect-
ed many cures.  Where taking medicine is a fashion, and where
a fountain of it is found ready made by nature, it can be swallow-
ed every day, not only without  disgust,  but even with a degree 
224
DYS.
 of pleasure.  Almost everybody is a believer in natural remedies,
 and perseveres much longer in the use of them, than those which
 are artificially prepared.  In chronic  diseases,  this  kind of faith
 may, sometimes, be turned to good account, and especially in the
 dyspepsia.  The mineral waters which contain iron are extremely
 suitable to this disease.   The  Hopkinton springs,  in Massachu-
 setts, and the Stafford springs, in Connecticut, are both chalybeate
 and have often been found  serviceable.  The Com.stock springs,
 in our own state, are scarcely inferior to either.
   Were we to point  out  the place, which, of all others in our
 country, is the most suitable for the residence of a person laboring
 under the dyspepsia, we should designate the island of Rhode Is-
 land.  Its vicinity to the open sea ;  its high, dry, and delightful
 situation; the  nature  of its soil and productions;  its abundance
 of good water, and  of good fish ;  the facility for sea bathing,
 and agreeable  excursions;  the verdant and  picturesque face of
 the whole island and the adjacent country; the  extensive  views
 of the water, and the cooling breezes which are daily wafted from
 it;  the surpassing beauty and coolness of the  beach in summer;
 the freedom  of the  place from bustle and noise ; and its ancient
 reminiscences, all conspire to render it not only a place for health,
 but for recreation.  The  fact agrees with the  opinion  which we
 have given  of  the place.  Multitudes,  not only in our own, but
 in other states can testify to the benefit which  they have derived
 from a residence or a visit there.
  Professional Remedies.—The proper regulation of the diet in
 this disease, is no  easy  matter.  Habit  has made some things
 quite easy of digestion to certain people,  which are difficult of
 digestion in others.  To country people, salt meats are quite easy
 of digestion, while to  people in the city who are in the habit  of
 eating fresh meats, they are quite  indigestible.   People who are
 brought up on milk, find it  much easier  of digestion than those
 who have been brought up  without it.
  In general, things which  are preserved, are very difficult of di-
 gestion, and therefore, very unsuitable in this disease.   Indeed,
 to preserve a vegetable or animal  substance is about  the  same
 thing as to  invent  a process  for rendering  it indigestible.  A
preserve is intended to withstand the  action of the elements, that
is, the action of heat, air and moisture, or in other words, it un-
dergoes a chemical process by which  it will keep for a long time.
 It is therefore no less  calculated to  withstand the  action of the
gastric juice, than that of the air, heat and moisture.  Being pre-
served against putrefaction,  it seems also preserved against diges-
tion.   Digestion could not go on  in  the  stomach  without heat,
air  and moisture,  and although digestion and putrefaction are
different processes, neither can  take  place without the action of
 heat, moisture and air.   To render a  substance difficult of putre- 
                            DYS.                        225

faction, is to render it in the same degree, difficult of digestion.
Even salted meats and fish, which from habit are rendered diges-
tible, are much less so when eaten in the same quantity, than the
same substances are when fresh.  The stomach, among civilized
people, is much more  accustomed to salt than to the other arti-
cles  used in preserving substances from putrefaction, and, there-
fore, articles preserved by it, agree better than those which are
preserved by  acids, syrups, smoke,  dry heat, spirits, and other
antisceptics.   Sausages or the meat of sausages is preserved with
pepper, salt, sage and summer savory, which appear to render it
much more indigestible  than salt alone.   Pickles are much more
indigestible than the same articles before the action of the agents
which preserve them.
   In general, it may be laid down as a rule, that meat and vege-
tables are easier of digestion in a  fresh state, than in a state of
preservation, and that everything which preserves them from pu-
trefaction, preserves them against the action of the gastric juice.
   In general,  vegetable food is much  the most suitable in dys-
pepsia.  The quantity and the quality of this kind of food must
be regulated by observation and experience.   As much of this
kind of food  may always be taken as  the stomach will digest
without distress, pain,  or  uneasiness.  The columbo  root, quas-
sia wood, gentian and the cascarilla bark, will be found each in
its turn, suitable  to many  stages  of the disease.   A tea made of
these substances, by an infusion, in boiling water, is preferable to
a  solution of them in alcohol, ardent spirits, or wine.   In general,
it requires about an hour to extract the virtues of these substances
in boiling watert   They should not be boiled, but boiling water
should be poured upon them and allowed to stand an hour, before
the  bitter tea  is drank.
   Calomel, in  small doses, taken just long  enough to produce a
coppery taste  in the mouth, but not long enough to salivate, is
sometimes productive  of  the happiest effects.  Some physicians
make  great use of the blue pill,  in this disease, to obviate the
costiveness;  and where it can  be' so managed as not to salivate
the  patient, it is a very good medicine.
   The calcined magnesia is a  very suitable  medicine  in cases
of dyspepsia,  where  there is  sourness of  the  stomach, and
flatulence.  Pills  made of aloes and  myrrh, called the pill rufi,
form one of the best stomachics in use.  The myrrh is slightly
Stimulating and very strengthening.   The powder of myrrh may
be taken alone, in  a dose of twenty grains, three times a day.  It
warms the stomach and expels the wind, at  the same time, that
it improves the  strength of the digestive organs.  The sulphate
of iron  mixed  with myrrh in the form of a pill, or  Griffith's
mixture, which is about the same thing, has helped very many
people.  Ipecac, in grain  doses,  will often open the bowels and
              29 
226
DYS.
improve the digestion.   A quarter of a grain of tartar emetic, dis-
solved in hot water and taken every two hours through the day,
will have a similar effect.
  If the dyspepsia has become a chronic disease, or a  disease of
several months standing, bleeding will, in general, be  improper,
unless it be by leeches applied to the pit of the stomach.  Blistering
will be very proper ; or  a counter-irritation, excited by an oint-
ment made of  simple cerate  and tartar emetic.   The tartar
emetic may be sprinkled upon  the  denuded skin, after a blister
is drawn, and  irritation kept up  for  one  or two weeks.  The
agency of the tartar emetic, has, in this way, often been  produc-
tive of signally good effects.
  In  the beginning of  the disease, strengthening medicines are
inadmissible; but  after the  disease  has  impaired  the  general
strength and relaxed the solids, it will  be necessary to  use them.
The best tonic, as we have said before, is  the oxide of bismuth,
and it may be used much earlier in  the  disease than any other.
The  tincture of the  muriate of iron, and the rust of iron are
often found more  compatible with  the state of the stomach, than
the vegetable bitters.
   Quinine in small doses, is, no  doubt, the  most strengthening of
any of the vegetable tonics.   One  grain, taken early in the morn-
ing is enough to  begin with.  If  costiveness is a distressing
symptom, a tea-spoonful of the elixir pro., taken a few minutes
before each meal, will be found effectual.   We have cured many
chronic cases of dyspepsia,  by giving three or four aloetic pills,
every night for several weeks in succession.  The aloes  operates
almost entirely upon the large intestines,  which,  in  general, ap-
pear  to  be the seat of the costiveness.  The  little disturbance
and  irritation which it occasions in the stomach and small in-
 testines,  make it peculiarly suitable in this  disease.
   If vegetable food is found to disagree with the stomach, on ac-
 count  of its   tendency to  fermentation, and  the formation  of
 acid  and wind, the patient must  live chiefly upon animal food;
 but he should never eat more than  a small slice at a time, and
let this be fully digested before he resorts to more.  Tea, coffee,
 and ardent spirits should be avoided entirely,  in severe cases of
 the disease.   In mild cases, weak  dishes  of tea or coffee  may be
 drank with more impunity.   To many people  both tea  and cof-
 fee are a poison ;  that is, they irritate arid inflame the stomach,
 and produce all the distress which  other  poisonous  substances
 create in the stomach and bowels.
    In a state of health, an evacuation of the bowels occurs about
 once  in twenty-four hours.   In  a  state of health, also, this event
 is  attended with a very strong desire and pressure, and followed
 with as strong  a feeling of relief.  But when the bowels become
 sluggish and costive,  the person seldom feels much pressed to go 
DYS.
227
 to stool, or experiences much relief when the opperation is over.
 The bowels seem to have lost their sensibility to the load which
 oppresses them,  and when it is thrown off, they are as little sen-
 sible of the weight which is removed.  A daily habit of attend-
 ing to the natural calls of the bowels, however feeble the desire,
 should never be neglected.   A long retention of the feces  is at-
 tended  with the same  weakening effects as a retention of the
 urine in the bladder by inobedience to its dictates.
   The  use of injections,  although attended with some trouble
 and inconvenience, is in severe cases of dyspepsia,  a much better
 way of moving the bowels,  than by swallowing daily potions of
 physic.  The stomach and  small  intestines are left untouched.
 Molasses and warm water, or manna dissolved  in water, will, in
 general, be all the ingredients necessary to produce the effect.
   Such will often be the pain and distress, and the want of sleep in
 this disease, that relief can only be obtained by the use of opiates.
 Nor should these be withheld when  the necessity of  the  case
 demands them.  The morphine,  in  this disease, is in every re-
 spect superior to any other form  of opium.   Being, in a great
 degree, deprived of the astringent or binding property of opium,
 it is precisely the medicine  which  can  be used with the least
 injury  to  the organs affected.   Twenty-five or thirty  drops
 of morphine can be  used  once or  twice  a  day, should  the
 case require it.  Where a scirrhous  state  of  the lower orifice of
 the  stomach has been detected, the  cicuta has been  found  one of
 the  best medicines  to ameliorate the condition of the organ.
   We think that exercise before breakfast, in this disease, is per-
 nicious.  Food will never digest so well after the least fatigue.
 Experience, however,  is the best school-master.  If, on trial, the
 person should find his appetite improved, and his digestion better
 for early exercise, he should be allowed  to pursue it.  But we
 believe, in general, it will be found much better to delay exercise
 until after the stomach has been replenished with a sufficiency of
 food.  With dyspeptics there is commonly a degree of faintness
 in the morning,  arising from an emptiness of the stomach.
   DYSURY—A difficulty  in passing the urine.—In some cases
 of this affection, there is a painful, continual, and urgent  pressure
 to pass  the urine, while it only appears in drops ; in  others there
 is a hot, scalding  sensation, and a  contraction of the  passage.
 There are  but  few more  distressing complaints than this.   In
 general,  it arises from an  inflammation of the urinary passages,
induced either by the gravel, by hard drinking, or by the venereal
disease.  It arises, however,  in some instances, from a paralysis
of the bladder, particularly  in  old  people, and from the  pressure
of tumors,  and  of the womb in pregnancy.   Accidental causes
such as  the use of Spanish flies, taken internally, or applied in the
form of blisters,  will produce it 
228
EAR.
   In all urgent cases, the surest remedy is to draw off the water
by the catheter;  this is often indispensable to save the bladder
from mortification.   Where there are evident signs of  inflamma-
tion such as pain, heat, and soreness in the parts ;  a quick, full,
and hard pulse, and fever, the use of leeches,  or  bleeding from
the arm ;  medicines to produce a sweat;  to increase the flow of
urine ; and to drain the bowels will be needed.
   Thirty or forty drops of laudanum or morphine,  or  ten grains
of the Dover's powder,  should be given to ease the pain and dis-
tress, but must not be relied upon for a cure;  nothing short of a
free passage of the urine should warrant us in the discontinuance
of means for relief.  The warm bath,  both general and tropical,
is often of  essential service.   The best medicines to re-establish
the flow of urine, are the sal nitre, in six grain doses, and the spirits
of nitre.   If the difficulty proceeds from  the  gravel,  the reme-
dies recommended in that complaint must be employed.
                             E.

  EAR—The organ of hearing.—The anatomy and physiology
of the ear are exceedingly interesting, but the mechanism is very
intricate  and difficult to describe in a manner to be understood,
without a model.  Its situation and shape are admirably adapted
to its office, and  all its numerous parts, however minute, undoubt-
edly have their  respective functions, though some of them are
but imperfectly  understood  by the best  physiologists.   For the
sake of clearness, the organ is, in being described, divided into the
external  and internal ear.   The upper and larger portion of the
external ear is of a cartilaginous nature, and from a resemblance
which  it bears to a certain kind of shell fish, is'called pinna, and
the lower, soft, and pendulous portion, the lobe.  The deep de-
pression where the  canal called the meatus  auditorius externus
commences, is the  concha.   The circumference of  the  pinna
which  is  so  convoluted as to form a scroll, is called  the  helix,
and the curved and vertical eminence in the middle of the pinna,
the antihelix.  The upper part of  the antihelix divides into two
small ridges, p.nd  the depression  between  them is  called the
scapha.  Between the helix and the posterior half of  the antihe-
lix, is  an oblong depression, which  for the want of  a name is
called fossa innominata.  That elevation of the  pinna in front of
the concha  and which  inclines over  it, is  the tragus, and the
elevation opposite at the lower part of the concha, the antitragus
cartilage.   The canal called the meatus auditorius  externus,
leading to the internal ear, is in the adult about an inch in length 
EAR.
229
and three  lines in diameter, and  terminates at the tympanum or
drum.
  There are many small oval  bodies in this  tube which secrete
the ear wax, and a number of small  muscles are attached to the
external ear, the  action of which is to move  the different parts
and the whole ear upon the head, but as this action in the human
ear is very limited and apparently of little importance, a descrip-
tion of them would be superfluous.  The tympanum is a mem-
branous partition between the canal of the external ear and the
labyrinth  or internal ear.   Within  this partition is a small quan-
tity of  air, which is supplied  by the  eustachian tube, a duct of
about two inches in length, which communicates with the pha-
rynx just  behind the opening of the nostrils into the throat; and
four small bones, called the  malleus or hammer, incus or anvil,
orbiculare or round bone, and  stapes  or stirrup,  which  are so
articulated as to form a chain, one end of which is fastened to
the membrane of the tympanum, and  the other rests upon  a small
oval opening called the foramen ovale.  The labyrinth is situated
within  the tympanum, in the petrous portion  of the  temporal
bone, and consists of three parts, the  vestibule, the  semi-circular
canals,  and the cochlea.  The vestibule  is a cavity into which
the foramen ovale opens, and with the cochlea, causes a protube-
rance on the  tympanum  called the promontory.  The  semi-cir-
cular canals are three in number, they run inwards and backwards,
and joining together  form a common trunk, which ends at the
posterior and internal  part of the vestibulum.   The  cochlea is a
bony structure which  resembles a snail shell and forms the  fore
part of  the labyrinth.   There are are two small canals which go
through the petrous  bone from the labyrinth called the  acque-
duct of Cotunnius.   The internal ear communicates with the
brain by a long irregular canal which  is completely incased in
hard and thick  bone.   It is through this canal that the nerves of
the ear pass out from the brain.  The nerves are called auditory,
portio dura, and, trigeminus, or fifth pair.
  Sound is not a distinct agent, but consists of vibrations in the
air and other substances, variously produced, by sonorous bodies ;
these vibrations are transmitted in rays or waves, and falling upon
the external ear are conveyed as  by a tunnel or ear trumpet, and
strike  upon the tympanum  with concentrated force.  The air
contained in the tympanum  and the cavities connected with it,
and the chain of small bones which rests upon it, are important
vehicles for the transmission and augmentation of the  sonorous
vibrations, and  of transmitting them  to the gelatinous fluid con-
tained in the internal ear, in the midst of which the pulpy fila-
ments of the auditory nerve are  situated.   The essential  part of
the  organ of hearing, however, that without which  there could
be no  sensation of sound, is the auditory nerve, through  which 
230                        EAR.
 the sensation is communicated to the brain or organ of perception,
 and a consciousness of sound is thus realised.
   EARACHE—Otitis.—The  earache is an inflammation of the
 organ of hearing.   The internal part of the ear inflames, swells,
 becomes red, and painful, and,  in most cases, suppurates.  It,
 therefore, must  be treated, in  severe cases, like every other in-
 flammation.   The earache is  chiefly a disease  of children ;  it
 rarely affects grown  people.  In common  cases, it will only be
 necessary to give  the child a few drops of laudanum, and to fill
 the ear with a little wool moistened with sweet oil.   To a child,
 a year old, six drops of laudanum may  be  given, and to one two
 years  old,  seven  or eight drops ; and if the first dose does not
 ease the pain, as much more may be given in the course  of two
 hours.  If the pain becomes severe, so  as to make the child cry
 out  for a long  time,  a soft warm poultice  made of white bread
 and warm  water  should be  applied to  the  ear, and renewed  as
 often as it  becomes dry.  But,  in most cases, we believe an ano-
 dyne timely administered, with a dossil of lint wet with  oil  or
 laudanum,  will be all  the medical  treatment required.   An in-
 flammation of the  ear runs its course in a remarkably short time.
 It frequently commences in the evening after  going to bed and
 suppurates  before morning.   It will, however, in some instances,
 run  three or four  days, and  be  attended with a high fever, de-
 lirium, drowsiness, and convulsions.  In these cases it will be
 necessary to resort to the lancet or leeches,  cathartics, and sudo-
 rifics.   To raise a sweat should be the first thing  done, after we
 have found that the complaint  will not  yield to an anodyne and
 a poultice.   For this purpose, hot herb teas may be drank, the
 bed warmed, and the  feet  put  into hot water.  If these  means
 fail, a grain of ipecac or ten drops of the wine of antimony may
 be given every hour until  a  perspiration is established.  A few
 grains  of the Dover's  powder will answer  the same or a better
 purpose.  Ether put into the ear will often succeed in  reducing
 the inflammation.  The cause of this painful  disease  is  expo-
 sure to cold and dampness.   Wet feet and  cold chilly winds are
 to be particularly avoided by  children.   Fistulous  ulcers and the
 loss of hearing are no uncommon consequences of the earache.
  EARTH.—Clay, crystal stones, and  rocks are the best exam-
ples of what, in scientific language, are called earths.
  Clay is white, tasteless, inodorous, and infusible  by the heat of
a furnace.  Pure  clay is sometimes called  argil, and at others,
alumine.  Porcelain ware and various kinds of pottery are made
of a paste composed of pure  clay and water.  It combines with
oil of vitriol and forms the neutral salt, called alum.
  Crystal  stones and  rocks,  the substance of which is  called
silex, are tasteless,  inodorous, transparent, and fusible by the heat
of a furnace.  Glass is made  of this earth, and mixed with clay 
ELu.
231
or argil, it makes the china ware.  All transparent sand, stones,
rocks, or mountains, are chiefly composed of silex or crystal earth.
Gems and precious stones are composed of this earth.
  Magnesia and lime are also  accounted earths, although they
have a degree of the alkaline quality.  Many stones and rocks
are composed of one or both of  these earths.   They unite with
aqua fortis, oil  of vitriol  and the marine  acid, and:form neutral
salts.   The lump magnesia is a neutral salt composed of the car-
bonic acid and  the calcined magnesia or the pure earth of mag-
nesia. Both lime and magnesia are valuable articles in medicine.
   There are six other  earths, less known, but which enter into
the composition of the sands, stones, rocks, mountains, and strata,
of soil, of which the globe is formed.  The names of these earths
are barytes, strontites, zircon, glucine,  ittria, and  thorina.  Barytes
and strontites have active properties like lime and calcined mag-
nesia.   A  curious property of  the  strontites is, that of its  salts
causing inflammable bodies to bum with a blood red flame.
   EFFLUVIA.—This  is the plural  number of the latin word
effluvium.   It means the same as the  words contagion, fomes,
miasm,  miasmata, infection, noxious vapor, malaria and virus.  It
is the name of the poisonous gas, air,  or matter which arises from
dead animal and vegetable substances, and the bodies of diseased
persons.   The antidotes of poisonous  effluvia are the chlorides.
   ELASTICITY.—This is that property in bodies which re-
stores them to their original state after they have been  bent or
stretched.  The india rubber affords a remarkable example of
elasticity.  The muscular and  tendonous parts of the human
body are endowed in a greater or less degree with this property.
A perfectly elastic body or substance will restore  itself completely
to the shape and figure which it had before it was bent, stretch-
ed, or pressed.   This property  is supposed  to arise from the
attraction of cohesion.
   ELATERIUM.—This plant is sometimes called the wild or
squirting cucumber.  The dried, inspissated juice of this plant is
the elaterium in use.  It is tasteless, and  inodorous, and is thought
to  be the  most powerful purgative which has  been discovered.
From the eighth to the half of a grain is the usual dose, repeated
at suitable intervals/until it operates.  In the dropsy, it is thought
to be an efficacious remedy, but requires great caution in its use.
The active principle of the elaterium  is called elatin.
   ELDER.—The inner bark, flowers, and berries of the  elder,
all possess more or less of the purgative property.   The  berries
have  a sweetish taste, and contain malic acid.
   The inner bark is the most active part; an ounce of it, infused
in wine, will purge moderately.  A  syrup made from the juice
of  the  berries, is a good  medicine  for  young children, in erup-
tions  of the  skin.   It opens the bowels and cools the body.  A 
232                        ELE.
very cooling  ointment is made of the inner bark, by boiling it,
and mixing- the liquor with cream.   All good nurses in the coun-
try know the virtues of  elder.
   ELECAMPANE.—The root of  this plant  made into a syrup
is  a good medicine  for a cough.   It  loosens  the phlegm, and
quiets the tickling.   If rightly used, it will often cure.
   ELECTRICITY.—We believe there is scarcely an agent in
the materia medica, of  more potency in  the cure of certain  dis-
eases, than electricity.  This fluid is too well  known to need a
particular  description.   The body may either  be  charged with
an extra quantity of this fluid ; it may be drawn from the body ;
or shocks of  the  fluid may be passed through the body.   The
nature of the fluid  appears to  be stimulating.   If applied in a
steady stream to the  body, for some length of time, it  will excite
a profuse sweat and hasten the circulation.  This  is the manner
in which it is the most successful, in the cure of disease.  Shocks,    «
in rapid  succession,  will  produce  the  same  effect, but do not
operate with  so much certainty as a constant stream directed to
some one part.                                                 %
   In the discussion of indolent tumors, the electrical fluid applied  #•
daily, in a stream, is the most  certain remedy which we possess. ^
In stiff joints, chronic rheumatism,  palsy,  the green sickness, and
a suppression of the  menses, it is often attended with the  hap-
piest effects.   In deafness, incipient  blindness, and in all cases
where there is a dulness or numbness of the nerves, the electrical
fluid should be  tried.  In  scirrhous tumors of the female breasts,
and of other parts of the body, electricity can be employed with-
out danger, and effects a cure oftener than any  other remedy.
   There is an art, in the use of this agent as in the use of every
other remedy, which can only be  acquired by science, observa-
tion, and experience.
   The point to  which the operation of the fluid should  be carried,
is  the production of a gentle sweat.  In a torpid state of the liver
and other organs, electricity will be found of signal service.  In
acute inflammatory diseases, electricity is improper.   In the use
of this remedy,  it is important to obtain the most  improved elec-
trical machines, the  old-fashioned machines are. too  inefficient
and uncertain to be relied upon.
   ELEPHANTIASIS.—This is an unsightly disease of the skin,
particularly the skin  of the legs.   The affection when seated, re-
sembles the skin of  an  elephant, whence its name.  The disor-
der often comes on gradually without much previous illness, but
is generally attended with more or less fever, pains in the head,
back and loins, some degree of sickness at the  stomach, coldness,
and  shivering.    Soon, one of the glands in the  groin becomes
sore, painful, hard, swelled and inflamed,  but does  not suppurate.
The inflammation extends in a red streak down the thigh to the 
ELI.                        233
leg; and, in three or four days, the fever begins to subside.  The
leg is left rough and uneven, with thick  scales upon it, and the
skin becomes as hard, brown, and thick as that of the elephant.
The  scales do not separate  and fall  off, but keep on thickening
until  the leg becomes of an  enormous size.  After the fever has
subsided, the disease may last for many years without disturbing
the general health.   The incumbrance of the bulky leg is felt as
a great inconvenience, but  otherwise the system remains unaf-
fected.
   The cause of the disease is not well  ascertained.   It is proba-
bly owing, however, to  a filthiness of the skin, poor  living,  and
some sudden check of the perspiration.
   In  the beginning of the disease, the inflammation sometimes
runs so high as to require bleeding, purging, and sudorifics.  The
leg should be bathed well with warm water, and the groin poul-
ticed.  White poppy heads boiled in water and  applied as a wash,
will allay the irritation and pain.   This disease  is scarcely known
in New England, but prevails extensively  in  the  West Indies,
among^nepeople of color ;  it is not, however,  confined to them.
After Tie fever  has  subsided, the quinine, preparations of iron
and the mineral  acids are given.   The sulphur bath should be
used,  andopTates whenever  they are required.  A gentle sweat
should be supported for a considerable time.
   ELECTUARY.—The electuary is a medical composition of
the consistence of honey.  It is made by adding to any  kind of
powder a proportion of syrup or mucilage, sufficient to make it of
the requsite thickness.   The lenitive electuary is one of the best
in use.   The ordinary dose of an electuary is the bulk of a nut-
meg.
   ELIXIR PROPRIETATIS.—This is an old, but very excel-
lent medicine.  It is made  by dissolving in two pints of new
rum or diluted alcohol, two ounces of myrrh, two ounces of aloes,
and two  ounces of sliced saffron.  The whole  must stand for
four days, and then the liquor must be poured off  from the sedi-
ment.  The liquor or tincture, must be kept in a  bottle closely
corked.  Two tea-spoonfuls, taken once  or  twice a  day, are the
ordinary  dose for an adult.    It is  strengthening, stimulating, and
laxative.   In cold, pale,  watery constitutions, it is a medicine of
singular efficacy.  It is much used in dyspepsia, where a purga-
tive  is required which  does not  operate upon the stomach, but
upon  the lower portion of the alimentary canal.   It corrects flatu-
lency ar. I indigestion.   In obstructions of the  menses, it  oper-
ates very much like the Anderson  pills.  There  is no better med-
icine to strengthen a  weak stomach.  The dose, for a child two
vears old, is fifteen drops, in  a table-spoonful of water.
  ELIXIR  SALUTIS.—The elixir of health,  as this composi-
           30 
234                        ELM.
tion is called, is made by dissolving or digesting in new rum, or
diluted alcohol, the several following  ingredients :
   Leaves of senna, three ounces ; root of jalap, bruised, one ounce ;
coriander seeds, caraway seeds, each bruised, two drachms; dilu-
ted alcohol, or new rum, three pounds and a half.  This compo-
sition must stand for seven days and then be strained through a
cloth.  To the strained liquor or tincture, add four ounces of
loaf sugar.   Dose from one to two ounces.  A child, two years
old, may  take a tea-spoonful.    For costiveness, wind in the
stomach  and bowels, dyspepsia, and nervous complaints, the elixir
of health,  is a  very suitable cathartic ;  it warms the digestive
organs at the same time that it awakens a peristalic motion.  In
the colic of children it is one of the best of medicines.
   ELIXIR VITRIOL.—This is the sour  drop.   It was formerly
made by adding cinnamon and ginger to the diluted oil of vitriol
or sulphuric acid,  but latterly, these articles are omitted.   The
elixir vitriol is commonly made by adding six ounces of the oil
of vitriol to a quart of alcohol.  The acid must be added slowly,
or the heat which is generated, will crack  the  gkjfSjfvesseL  It
should he recollected  that it can be made only in a glass "fessel.
The dose is from ten to thirty drops, in half a tumbler of >water.
   The elixir  vitriol is often made by  mixing one ounce of the
oil of vitriol with eight ounces of  water, in a glass bottle.   The
dose of the sour drop made in  this way, is fifteen drops in  half a
tumbler  of water.
   The elixir  vitriol,  is tonic and astringent.  It is used in putrid,
febrile, diseases, hermorrhages or bleedings, menorrhagia, diabetes,
hectic fever, and dyspepsia.  It  is often used as a gargle for the
sore mouth and  the putrid sore throat.  The quinine,  dissolved
in a weak  solution of the  elixir vitriol,  forms  one of the best
tonic medicines in use.   It  is peculiarly well adapted to a weak
state of  the  digestive organs.   It is the  least heating of all the
tonic  medicines.  Mixed with  the mucilage of gum  arabic or
flax-seed tea, and sweetened with  sugar, it makes an agreeable
drink in  influenza, pulmonary affections, and protracted fevers.
   ELM  BARK.—The species of elm bark made use of in med-
icine is the red elm.   This  tree is native to our country, and
furnishes a new article of medicine.   The inner bark  is the med-
icinal part.   It contains an abundance of mucilage, easily extract-
ed by hot and  boiling water.  In dysenteries, diarrheas and the
complaints  of the bowels, generally, it  makes  an excellent diet
drink.   It forms a substitute for the deficient mucus of the bow-
els; it sheathes the  eroded intestines from the acrimony of their
contents  ; and allays the irritation of the inflamed portions.   The
ground bark forms an excellent poultice  for burns,  old ulcers,
and inflamed  surfaces.   The slippery elm  tea is made  by pouring
boiling water upon a handful of the bark.  It  may be drank as 
                            EME.                        235

 freely as water.   In coughs, colds, and diseases of the lungs, it
 is equal to any mucilaginous drink which has ever been discov-
 ered.
   EMACIATION.—People are often  surprised at the rapid loss
 of flesh, which  takes  place in a sickness,  of only  a few days.
 But this is not so much a loss of the flesh, as of the fluids of the
 body.  The weight of the fluids of the body, is eight or nine
 times greater than that  of the solid parts, and as the fluids easily
 and constantly pass off  from the system by means of  the various
 secretions, the real bulk of  the body may be lessened in a very
 short time, unless continually replenished.  In most diseases, the
 appetite is lost, and the digestive powers either greatly impaired,
 or entirely suspended, and of course, the diminution of the blood
 and of all the fluids which proceed from it, must  lessen the bulk
 of the body  in proportion  to the rapidity of the secretions.  A
 very sudden  loss  in  the bulk of the body takes place in a severe
 diarrhea or profuse perspiration.   In some diseases, the blood is
 often reduced to a very small quantity, probably to  one eighth
 part of  its usual amount.  The  heart,  arteries, veins, and absor-
 bents, all contract in a similar proportion, which of itself, dimin-
 ishes greatly the ordinary bulk of the body.  Be the  quantity of
 the blood what it may, the blood-vessels always accommodate
 themselves, in size, to the bulk of fluid which they contain.
  The work of emaciation is performed by the secretery vessels,
 the  lacteals,  and  the  lymphatics.   When the  blood and other
 fluids are devoured, the solid parts, the fat,  the  flesh, and even
 the  bones are taken up and carried into the circulation to furnish
 matter for the secretions, the perspiration, urine, mucus, bile and
 pancreatic liquor.   The diminution  of the size of the bones in
 chronic diseases is as remarkable as, of the muscles and other soft
 parts.   The diminution which takes place in the weight and bulk
 of the body,  in hot weather, is owing  to the excessive waste of
 the fluids of the body,  which are easily  replenished  as soon as
 the waste, by perspiration, is stopped by cool weather.
  The loss of strength is, probably, very nearly in proportion to
 the loss of the fluids of the body.   The fat and the flesh may be
 diminished without any material loss of strength,  but any al-
 teration in the quantity of the blood  and other fluids is sure to
 be followed by a  corresponding alteration in the strength.
  EMBROCATION.—Washes and liniments which  are applied
to any part of the body.  Those in common use are alum water,
lead water,  acetate  of* ammonia  in solution, volatile liniment,
lime water, spirits of camphor, and infusions of hemlock.
  EMETIC.—Substances capable of exciting vomiting.  They
may be  either vegetable or mineral.  The best  and safest vege-
table emetics are ipecac, squills, lobelia, and bay berry root.   The
mineral  emetics most in use  are the tartrite of antimony, sulphate 
236
END.
of zinc, sulphate of copper and alum.   Many substances operate
both as emetics and cathartics, such as thoroughwort,  tobacco,
and antimony.  Where poisons have been taken, or the  stomach
overloaded with food, or  oppressed  with indigestible subtances,
emetics are indispensable.  In  the commencement of fevers, in
lung affections, diseases  of the throat and windpipe, in bilious
disorders, and in dropsy, the utility of emetics has been demon-
strated by the experience and observation of ages.  Emetics are
hurtful in cases of inflammation of the abdominal  viscera, in rup-
tures, in a conflux of blood to the head, in the last stages of preg-
nancy  and of inflammatory and typhus fever.
  EMMENAGOGUE.— Medicines which promote  the  monthly
secretion of females, such as  aloes, antimony, tansy, American
centuary,  savine,  tincture of  flies,  assafetida, camphor,  sweet
spirits  of nitre, calomel, and a local steam bath.
  EMPYEMA.—Matter or pus formed in the chest after a pleu-
risy or peripneumony. The signs of it are a difficulty of breath-
ing, an inability of  lying  upon the side  opposite to that which
has been inflamed, and an oedematous swelling, externally.  The
matter is, sometimes, let out by an incision into the chest.
  EMPHYSEMA.—Swelling from the confinement of air under
the skin, in  the cellular membrane.   In  some instances, the air
will be confined to a particular place, and, in others, it will spread
over the whole body.  It  arises from wounds  in  the chest, from
poisons, and certain diseases, as the hysterics and hypochondrism.
It is known by a crepitus or a crackling noise upon pressure, and
difficulty in breathing. Great anxiety and oppression of the strength
sometimes attend  it.  It  is always dangerous when it  proceeds
from  wounds of the chest, and violent poisons.  It  has been
known to follow delivery, and to prove a troublesome complaint.
The air is often let out by puncturing, and pressing upon the part.
In cases  where it results  from wounds, the assistance of surgery
is necessary.
  ENCYSTED TUMOR—This kind of tumor consists of a sac
or bag, containing, sometimes, a fluid, and at others, a solid sub-
stance.  The matter contained in the sac, in  some instances, re-
sembles honey, in others, fat, and in a third kind, it will be soft
and pulpy.  Some grow to an enormous size,  while others will
be quite small.  They have been known to contain a  gallon of
matter.  It is almost in  vain to  attempt  to disperse them; the
only radical cure is to have them cut out.   In removing them, it
Li important to dissect out the whole sac without wounding it. If
any part is left, it may grow again.  Salt is sometimes used to
disperse  them, but it almost always fails.
   ENDEMIC.—Diseases which are confined to  certain persons
or to certain places.   The sea-scurvy is endemic,  and so  is the
fever and ague. 
EPI.                        237
  ENDOSMOSE AND EXOSMOSE.—The passage  of air or
water, or any other gas or fluid through membranes and mem-
branous substances.   A bladder, half filled  with atmospheric air,
being placed under a jar containing carbonic  acid, becomes more
distended;  and if the bladder which is placed in  the carbonic
acid,  contained hydrogen,  it becomes distended  to  bursting.
If, on the contrary, the jar  contains the hydrogen and the blad-
der the carbonic acid, the bladder becomes collapsed.   Gases, sepa-
rated by moist animal textures, will pass through and combine
with each other.  The oxygen of the air, in  this way, probably,
unites with the blood in the lights without  the  escape of the
globules.
   ENEMA.—An injection  or a clyster.  It is used both  to con-
vey medicine and nourishment into the body.
   ENTERITIS—Inflammation of the intestines  or bowels.—
See Inflammation of the Intestines or Bowels.
   EPIDEMIC.—Diseases which attack a large number of people
at the same time and place.   The influenza is often an epidemic.
The Asiatic cholera was an epidemic. The scarlet fever, dys-
entery,  and peripneumony are  often epidemic.   The prevailing
disease or epidemic may be contagious, or  it may proceed from
the constitution of the atmosphere.
   EPIGLOTTIS.—This is  a  lid composed of cartilage, which
covers the upper orifice of the windpipe.  In breathing,  this valve
opens and shuts;  and, in swallowing,  it closes down upon  the
top of the windpipe  to prevent the food from  going that way.   It
is fixed by a ligament to the root of the tongue, the os hyoides,
and the thyroid cartilage.
   EPILEPSY.—It is very difficult, in some instances, to distin-
guish a fit of epilepsy from  a fit of apoplexy.  In both cases,  the
person if standing or sitting, commonly falls down, but in apo-
plexy, there is little or no  convulsion, whereas in  epilepsy,  the
limbs, the muscles,  and  the  organs are violently  agitated  and
convulsed, insomuch that it often  requires the strength of two or
three people to prevent the patient  from doing violence  to him-
self.  The  tongue will be thrust out of the  mouth ;  the eyes will
be rolled about by the agitation of the muscles which move  the
eye-balls; a volume of froth will pour out of the mouth ; and often
the tongue will be bit to a greater or less extent by the gnashing
of the teeth.   The contortions of the countenance will some-
times become  frightful; but the subject of the fit, all the while,
will be as insensible as if nothing had happened.  In epilepsy,
there will often be a cessation of the convulsions, and the patient
for a time, will lie still and  insensible,  but they soon return with
as much violence as ever, and will  continue to come and go  for
a number of times in succession, when they will cease altogether.
The person will change from the fit into a profound sleep, and 
238
EPI.
awake quite rational and well.   The senses, however, commonly
return by degrees ; and when the person comes to himself, he is
entirely unconscious of what has happened, with the exception,
perhaps of feeling a little weakness, languor, nausea, or headache.
The breathing and the pulse, during the  fit, undergo something
of the same agitation which takes place in the limbs and muscles.
In this disease, one side  is very apt to be more convulsed than
the other; and, sometimes, the convulsion will be almost entirely
confined to one side, and this  side will become more or less  pa-
ralytic.
  The epilepsy is very evidently an affection of the nerves,  but
from what  particular state of  the brain and  nerves it arises, is
not easy to  perceive.   There  is always  some  derangement or
want of firmness in the nervous system, be the occasional causes
of it what they may.  The  people most liable to the  epilepsy
are those  whose  minds and feelings are easily agitated; who
pass easily from  hope  to  fear and the  reverse ; whose temper
is  changeable ; prone  to  gaiety and easily provoked  to anger;
and whose whole system is sensitive.  The skin  of  such per-
sons will  be ticklish ;  the  stomach easily oppressed;  the eyes
easily overpowered by light and the ears by sound ; the mind in-
capable of long-continued and intense study ;  and the bodily
powers very susceptible of fatigue   Women, children, and men
of an effeminate temperament,  are more subject to this distemper
than those who are strong and robust.
  The disease is often  attended or preceded by  a peculiar sensa-
tion or feeling, as if a cold vapor or fluid were moving along from
the arms and legs towards the head or heart.  The feeling  has
sometimes  been likened to an insect  creeping along  the body.
This sensation has been called Aura Epileptica, epileptic air, and
assigned as  one  of the causes of the disease, but we think it
merely a symptom.  We  once heard a lady,  who was  subject to
the disease, say, that she always saw a round black spot coming
towards her eyes, just as the fit was coming on, and  when  the
dark  spot  had reached her  eyes, she  became insensible.  The
aura epileptica we conceive to be a sensation  of the same nature,
and, in no way, the cause of the fit.   Dr. Cullen advises the re-
moval of the part where the aura  epileptica  commences, either
by the knife or the cautery, and where this  cannot be done, to
blister it or to establish an issue upon it; but all this we conceive
to be fighting a mere shadow ;  this peculiar  sensation is a mere
hallucination of the sense of feeling, and is a part of the disease.
Some have advised the application of  a ligature around the arm
or leg, just above where the  feeling  commenced, for the purpose
of preventing  the fit;  but we have no idea that a ligature was
ever of any service in the disease.   It is however a harmless  ex-
periment, and may amuse, if it does not cure. 
EPI.
239
   Every kind  of distress, whether of the mind or body, will
cause a fit of the epilepsy.   The sight of a hideous or disagreea-
ble object, or the reception of painful news, will be sufficient to
throw many people  into epileptic  convulsions.   Odors which
produce a sickish, disagreeable  feeling at  the  stomach, will also
occasion epilepsy.  But the most frequent cause is distention or
irritation of the stomach and bowels.   Too heavy a meal, or the
irritation of indigestible  substances, by oppressing the stomach,
have a strong tendency to bring on the disease. Many poisonous
substances induce epileptic fits.  The pains of childbed and the
loss of blood are frequently  the  cause of convulsions.   The
effects of heat, of over-fatigue, and of emptiness, have the same
tendency.   The  excitement  of public festivals,  the  sight of
crowds of new  and strange people, the beating of drums, and the
confusion of voices are a prolific source of epilepsy.
   Domestic Remedies.—These  fits are rarely ever anticipated ;
they come  on in the midst of health  and enjoyment, so that no
preventive means in the first instance can be adopted.  But after
a person is ascertained to be in a fit of the epilepsy, for  the  per-
son has no sense  himself, he should be exposed to the air where
it is neither  very hot  or  cold, and cold water should be dashed
with considerable force  upon  his  face, neck and chest.  His
clothes should  be loosened, and if the tongue has been gnashed
between the teeth, the jaws should  be opened and the tongue
put back.   Tf  the  person  can swallow, or as soon  as  he  can
swallow, an emetic of  ipecac  should be  given, followed  by
plentiful draughts of  warm water.  But in most cases, nothing
can be done, during the fit, except bleeding or the exhibition of
injections.   Bleeding  is not  always proper, and seldom needed,
but an injection can always be exhibited without  injury.  Com-
mon salt dissolved in warm water and mixed with molasses, is as
safe a material  as  any which can  be used.  A tea-spoonful of
ipecac mixed with warm water, will operate quicker, and on this
account, is  to be  preferred  where  it can  be  readily obtained.
After water  has been  dashed upon the face and neck, if the fit
does  not subside, the  head and face should  be  kept wet with
vinegar and water.   The  body, and particularly the stomach,
should be gently rubbed with the  hand, and if the  fit continues
long, mustard poultices should be applied to the feet.  Vomiting,
or  an  operation by the  bowels, or a  flow of the urine almost
always dissolves the  fit and silences the convulsions.   A tea-
spoonful of the spirits of camphor mixed with  a little cold water,
or a swallow of wine will  often help very much to  revive the
patient  after he has  come  out  of the fit, and, sometimes, will
excite the vital  action before the paroxysms have relaxed.
  If the fit has arisen  from anything which has been eaten, the
stomach should always be emptied as soon as  the person is able 
240                         EPI.
 to swallow.  After this is accomplished, thirty drops of laudanum
 or of  morphine should be given  to allay the  irritability of the
 nerves and to prevent the return of  another fit.  The bowels
 should then be moved, if it has not already been done  by an
 injection,  by taking a dose  of salts, senna, or jalap.  On the
 recovery of the patient from the  fit, the food  for several days,
 should be light  and spare.   A spare diet and  exercise are the
 surest means of a restoration to health ; and where the fits  have
 become frequent  and periodical, the person would do well to
 prosecute some kind of labor in the open air.   All study should
 be relinquished, and the  mind  should be amused and  recreated
 by objects which address themselves to the external senses.   The
 occupation of the external senses diverts the mind from thinking
 and reflection, and is always  congenial to the  nervous system.
 Labor in the open air and an abstemious diet, or a diet composed
 principally of vegetables,  must  always constitute the basis of a
 cure.  Every kind of business or study, which occasions anxiety
 or disquietude of mind, must be abandoned, at least, until a cure
 has been effected.   A journey to the Saratoga or White Sulphur
 Springs, and a course of the waters should always be tried where
 it can be conveniently done, but the patient should, at the  same
 time, avoid the excitement and confusion of company, and every
 scene which  strongly engages the  feelings.
   Professional  Remedies.—If  a  person,  in  full health  and
 strength, is attacked with a fit of  epilepsy, and there is no evi-
 dence  that it has been  brought on by the  quantity or quality of
 what has been eaten and drank, it will always be proper to bleed,
 either  by  opening a vein or by leeching.  The pulse will not be
 often a criterion in such cases, as it is very much disturbed, but
 the propriety of bleeding  must be  learned  from the general ap-
 pearance of the person, the hardness of the flesh, the color of the
 skin, and the habits  of living.  An emetic  of ipecac, sulphate  of
 zinc, or antimony will  in general  be  proper, unless a  previous
evacuation of the  stomach has been procured.  Some depression
 of the digestive powers, or a stoppage, always accompanies this
 disorder.   We have  often  noticed, that as soon as there was some
little rumbling in the bowels,  or evidence of motion, the person
came out of the fit.   It may, however, be, that  the  stomach is
always the first  organ to recover its  vitality ;  and  that  this
motion is only an evidence of the return of the sensibility in
general.
   The dispensation of an injection, composed of any of the sub-
 stances which will operate as  purgatives, will always be useful,
and, sometimes, effectual  in  dissolving the  fit.   A mixture  of
equal parts of the spirits of red lavender and the water of am-
 monia, in  a dose of thirty drops, in a little cold water, is an ex- 
EPS.
241
cellent stimulant to awaken the sensibility.   Ether is extremely
vivifying, and may be given every ten or fifteen minutes.
  After the fit has passed away, the system must be fortified
against a second  attack.   In  addition to an abstemious diet and
severe exercise of the body, the patient must resort to strength-
ening medicines.  Among these medicines, perhaps none is better
than  Griffith's mixture, which is  composed  chiefly of iron and
myrrh.   The tincture of muriate of iron in a dose of fifteen drops,
three times a day in any suitable drink, is another well established
tonic.  The  red oxide of iron  either in  pills  or  mixtures, is a
tonic medicine  in very  common use.  Tonic mineral waters
should always receive a trial.   Castor, in doses of ten  or twenty
grains of the powder or one or two tea-spoonfuls of the tincture, is
probably possessed of as much power as any other substance in
allaying  the  spasms.   After the stomach and bowels have been
evacuated, it will often be necessary to give an anodyne  either
of laudanum  or morphine.  With some people, opiates have a ten-
dency to prevent the  return of  the fits and even to destroy the
disposition to them.  The cicuta combined with the  red oxide
of iron, has, sometimes been given with success; as also the ex-
tract of gentian,  and the quinine.
  In those cases where epileptic fits are accompanied  with cos-
tiveness and  indigestion, or wind in the stomach, the elixir pro-
prietatis  and the  balsam of life will be found of peculiar service.
The tincture of aloes  and canella  bark, called picra, taken every
day in a dose of  two  table-spoonfuls, for  two or three weeks in
succession, has been  found in some  instances to prevent the re-
turn of the fits.  Assafetida, musk, and camphor should be tried
where other  things fail, but they do not enjoy the reputation
which they formerly did in the cure  of the disease.
  Cold bathing should be practised in all cases where the consti-
tution is  vigorous enough to bear it.   There will be many cases,
however, in which warm  bathing  will be found more  in agree-
ment with the peculiar state of the constitution and the condition
of  the nervous  system.   Young people,  especially those under
the age of puberty, often  recover  entirely from this disease, but
it is very apt to continue in those who are older.
   EPISPASTIC.—Substances  which  raise a blister,  such as
flies, red pepper,  mustard, and garlics.
  EPISTAX1S—Bleeding from the nose.—See bleeding from
the nose.
  EPSOM SALTS—Sulphate of Magnesia.—This salt takes its
name from the Epsom mineral spring, from the water of which
it was first made.  It is now obtained from sea water.  After the
muriate of soda, common salt, has crystalized,  the water, which
remains,  in  the  manufacture  of salt, contains  the  sulphate of
magnesia.  It is  extremely bitter, and consists of needle-like
           31 
242                        ETH.
 crystals.   It will  dissolve in an equal weight of water.   It is a
 safe, easy, and thorough purgative, and probably more used than
 any other medicine of the kind.   In all inflammatory affections,
 it has obtained a very high, and a just repute.  An ounce ope-
 rates as a brisk cathartic.  Dose, for a child two years old, a tea-
 spoon even full.
   ERGOT—Spurred Rye—Secale Cornutum.—A certain disease
 incident to rye, produces a kind of fungous  grain.  The seeds
 are enlarged, and when dry, are of a black, or violet color, and  of
 a brittle texture.  This substance taken, in a dose of ten or fif-
 teen grains, during parturition, has the singular power of increas-
 ing the frequency and the strength of the pains, and, of hastening
 the birth  of the child.   In lingering labors, it is now much used
 to assist  the natural efforts of the uterus.   Its operation  is re-
 markably quick.   In ten or fifteen minutes, from  the  time it  is
 swallowed, it will often produce expulsive pains.  The powdered
 seeds  are  infused in  boiling water, and after  standing for a few
 moments, the liquor  is fit to be  taken.   It is also given to pro-
 duce the expulsion of the after-birth, in cases of hemorrhage, and
 delay.  It will not operate  effectually upon every individual in
 labor, but  there is no question about its expulsive properties, in
 general.   Farmers have  long known the  fact, that rye will have
 a similar effect upon domestic animals, and have avoided feeding
 them with this species of grain while with young.  The diseased
 grain has  a much more powerful effect than that which is sound.
 Wheat and other grains are liable to a similar disease.  Ten or fifteen
 grains of  the powder of ergot can be taken in some convenient
 vehicle, or an infusion of it in boiling water, and repeated at in-
 tervals of half an hour or an  hour.
   ERRHINE—Snuffs.—Those medicinal snuffs, which are most
 in use, are the impalpable powders of  the bayberry root, blood-
 root,  hellebore, calomel, and asarabacca.   In catarrh, polypus,
 and some  other affections of the lining of the nose, and in several
 disorders  of the  eyes and  head,  errhines are found extremely
 serviceable.
   ERUPTION.—Pimples, blotches, spots, pustules, and running
 or dry sores upon the skin.   The itch, tetter,  small pox, chicken
 pox, measles, and the blotched face are examples of the meaning
 of eruption.
   ERYSIPELAS—St. Anthony's fire.  See  St. Anthony's fire.
   ERYTHEMA.—A morbid redness of the skin, such" as is ob-
 served in the cheeks of  hectic patients, in the surface  of boils,
an^Sner  species of inflammation.  It is the inflammatory blush.
  ESCHAROTIC.—Caustic and corrosive substances, or such
aS™£°J1?or decompose  the flesh and solid parts of the  body.
  iul HER.—There are several kinds of ether, but the descrip-
tion most m use and the most valuable, is the sulphuric or vitriolic 
EXE.
243
ether, or that which is distilled from equal parts of alcohol and oil of
vitriol.   It is the lightest, the most  evaporable, and the most in-
flammable of them all.   Left  exposed to the air, it is  dissipated
in a very few minutes ; and if dropped upon the skin, it excites
a sensation  of cold by the sudden abstraction of heat.  It has a
pungent taste, and a penetrating odor.  It is a cordial, an anodyne,
a  stimulant, and  antispasmodic.  In  faintness,  sickness at the
stomach, giddiness, epilepsy, hysterics, asthma, angina pectoris,
and in almost all diseases where the powers of life are prostrated,
ether is an invaluable and efficacious remedy.  In its action it is
quick and diffusive.   Even the breathing of it has a tendency to
recall life.  In  fainting fits, it is often applied to the  nose.  In
the asthma, the inhalation of it will relieve the distress for breath.
Applied to the  seat of strangulated  hernias, its power of produ-
cing cold and  constringing the flesh  by evaporation, will  often
assist essentially in reducing them.   Few medicines possess more
remarkable  powers than the sulphuric  ether.  The common dose
for  an  adult is from  half a tea-spoonful  to a  tea-spoonful.  In
adroit hands it is a great remedy.
   Ethers are made from all the mineral acids and several of the
vegetable acids.   They are mixed with alcohol, in  various pro-
portions, and distilled in retorts.
   The  chloric ether made  from chlorine and  alcohol, possesses
much the same nature with the sulphuric, but is  less powerful in
its taste, smell, and effects.   It is well suited, however, to weak
stomachs, and delicate people.
   Nitrous ether, dulcified spirit of  nitre, will be  found described
under the head of Sweet Spirits of Nitre.
   EXCRETION.—The act of separating from the  blood fluids
and solids which are useless to the body, such as the urine, pers-
piration, alvine  contents, menses, and  milk.  The power or pro-
cess of excretion and secretion appears to be the same.
   EXERCISE.—The  benefit  of muscular  exercise is well
known, but the manner  in which  the system  is benefited can
only be known by an illustration of the physiological phenomena.
The whole illustration depends  upon one  simple, obvious fact.
In bleeding at the arm, for instance, if the fingers and fore-arm
are put in motion, the quantity of blood emitted  from the orifice
is instantly and sensibly increased.   The amount of blood which
flows through the veins  by the  addition of this motion of the
muscles, is  doubled or trebled in the same time.  Every body
knows the necessity of keeping a person still who is bleeding  at
the nose, the lungs, or in any other part of the body.  We shall be
sufficiently  understood without going into a description of the
circulation  of the blood.  When the whole body is in motion,
the  same proportional  increase  in  the quantity of blood takes
place in all  the veins.  Twice or three times the ordinary amount 
244                        EXE.
of blood is sent into  the heart in the  same time.  The heart,
compelled  to receive  the blood, propels it  immediately into all
the organs of the body, the lungs, the brain,  the stomach, the
liver  the bowels, &c.   The organs being  thus doubly fed by
the agency of the  muscles upon the blood vessels, are actually
increased in size, in the same  manner as plants and trees are in-
creased in size, by increasing the amount of nourishment which
they imbibe.
  The great increase in the  size of the muscles, especially in the
size of the  muscles of the fore-arm and legs, in people who exer-
cise  constantly and  laboriously, is known to every  body.  A
corresponding increase in size  takes place in ail the other organs
of the body.
  In  opening the body of  a man brought  up to labor, we may
observe that it is not simply his muscles which are enlarged; his
brain, his lungs, his heart, his stomach, his  liver, bowels, bones,
and every other part, are all  of a size corresponding to the greater
size of his  muscles.   Yes,  the brain of the laboring  man is as
much larger and stronger than the brain of the inactive man, as
his  muscles are larger and stronger.  The organs of his  body
have been more  constantly  and abundantly supplied with blood
than the  organs of the  inactive man—premising that,  he has re-
ceived an ample supply of food.  The broad and ample chest of
the active  man  only expresses the magnitude of  the lungs and
the heart which it contains ; the broad back and well  developed
abdomen only show the ample size of the organs which  they
environ.
  Exercise, by itself, has no tendency to increase the size of the
body in general, or of the organs in particular.  We should say its
tendency was to diminish its size.   Neither is it by mere jacita-
tion or motion in itself considered, that  the body is benefited.
The main use of exercise consists  in its agency in supplying the
organs with a greater amount of blood.  Blood is to the organs
what  food is to  the  stomach.   It is their nourishment and
strength.   The constant cry of  all the organs is for blood, more
blood !  Faintness  and languor ensue  in  some one or in  all of
the organs  when this demand is not satisfied.
  Exercise is often recommended  for a want of action or torpor
in the various organs of the  body, and very justly.   For instance,
it is recommended for a torpor of the bowels ; but  mere motion
can  have no effect  in awakening the peristaltic  action of the
bowels ;  it  is only by the  agency of exercise  in  forcing fresh
supplies of blood into the coats of the intestines, thereby giving
them new  life and vigor, that  the peristaltic motion is increased.
People can never be  made to take a proper degree of exercise
until the necessity and the  benefit of it are clearly demonstrated.
This will constitute a sufficient and permanent motive.  Labori- 
EXT.
245
ous exercise will then even be valued and practised by the weak
and fragile.   Health, strength, and happiness very much depend
upon the agency of muscular  exercise in the propulsion and dis-
tribution of the blood.  It is well known that the right arm and
hand, as well as the right  leg and foot,  are  both larger and
stronger than the left.   This  effect is the result of the  greater
exercise which the right arm and leg are subject to; that is, the
muscles of that side meet with a more full and constant supply
of blood, aud are consequently enlarged and strengthened.  The
circulation of the blood will  always require the agency of mus-
cular exercise, for the health of the body and  the  full develop-
ment of its  organs.  Neither the  brain, the  stomach, nor the
lungs can attain their full strength  and size without it.   Weak-
ness and imbecility will lurk somewhere.   It not only aids the
circulation, but equally assists all the secretions and excretions.
  It matters  but  little what the nature of the exercise is, provi-
ded it be  constant, and sufficient  to aid the  circulation of the
blood.  Some  active employment, however, which engages the
mind at the same time that it aids the  moving powers of the
body, is to be preferred.  Farming, gardening, and all rural pur-
suits  seem to comport best  with the health of the body and of
the mind.   Any active mechanical employment will answer a
similar end.  Exercise in some form or other is as important for
children as food.   The  organism of the  body can  never be per-
fected without it.   People of leisure must seek exercise in active
amusements, such as walking, fishing, hunting, and riding.
   EXFOLIATION.—The separation of dead pieces of bone from
the living.  When bones  are badly splintered  and  shattered, the
fragments separate and  make their  way through the flesh to the
surface.
   EXPECTORANT.—Medicines  which  promote the secretion
and discharge  of phlegm from the windpipe and lights.  The
most  notable of this class  are  squill, gum  ammoniac, antimony,
ipecac,  opium, balsam copavia, elecampane, seneka or rattle snake
root, and lobelia.
  EXTRACT.!—Medicines which are obtained from plants and
roots by boiling and evaporation.  After  boiling the bark, roots,
stems, or leaves of plants long enough to get their strength, the
water must be evaporated or boiled down,  over a slow fire, or
which is altogether better, a salt water bath or another vessel of
water kept at a boiling  heat, in which, the vessel containing the
plants to be  operated upon,  must  be partially immersed.  The
liquor of the boiled barks, roots, or other parts of the plant, should
in general, be simmered down  to the thickness of honey, when'
if left to cool, will become hard enough to make into pills and
boluses.   The juices of plants are, sometimes, expressed and dried
or inspissated in the sun, and receive the  name of  extracts.  An 
246                        EXT.
extract of the cicuta or hemlock, is sometimes made in this way,
and  at others, by boiling and evaporation over a fire.
  EXTRACT OF BUTTERNUT.—This medicine is prepar-
ed by cutting up the unripe fruit or the inner bark of the butter-
nut in small pieces, and adding to it eight times its  quantity of
water.  When  one half of the water  is boiled away,  the rest
must be strained,  put into a suitable vessel, and simmered down
to the consistence of honey, in another vessel  of boiling water,
saturated  with salt.  The  salt, dissolved in water, enables it
to retain much more heat, or in other words, salt water heated to
boiling is  much hotter than fresh water, and  for this reason, af-
fords a higher and more even heat.
  The extract of butternut is  an  excellent domestic purgative.
Dose, for an adult from  ten to thirty grains.  In the same way,
may be made  extracts of  lobelia, thoroughwort, white poppy,
and cicuta, or of any other plant whose virtues  do not reside in
oil too volatile to be dissipated by  boiling.
  EXTRAVASATION OF BLOOD.—After the arm or leg, or
any part of the flesh  has received a heavy blow, the hurt place
will become black and blue, or purple.   This appearance is owing
to the rupture of some  of the  blood vessels, by which,  blood is
let out, and spreads under the  skin, giving the wound the purple
color.  This is called extravasation.   This  accident  will, some-
times take place spontaneously in the white of the eye, whereby
there will be a large red blotch,  occupying  a quarter or half of
that  part of the eye; the blood-shot part will neither be sore or
painful, which distinguishes it  from  an inflammation of the eye.
An extravasation of blood anywhere upon the surface of the body,
is not dangerous,  but, usually, is absorbed in a few days, leaving
the part, at first, a little yellow, but which soon  becomes white
as before.  In  bleeding at the arm, from a small puncture, the
blood will often spread under the skin and produce what is called
a thrombus or bag  of blood;  the  skin  will turn purple from the
color of the blood which appeals through it,  and look, for a day
or two, very bad, but the accident is accompanied with little or
no danger, and soon disappears.
  In the case  of  an extravasation of blood in  the white of the
eye, a little eye water will commonly, be all the medicine which
is required ; and,  in other parts of  the surface, the application of
a little pressure upon the part by means of a tight bandage and a
roll of cloth under it.  Blood boils which are an extravasation of
blood, should be allowed to go away of themselves.
  An extravation of blood into the ventricles of the brain ;  the
cavities of the chest, abdomen and  bladder, are attended with
danger,  and  often  produce sudden  death.   The other fluids of
the body are, sometimes, extravasated or let out of  their proper
vessels into other parts.   The urine and the serous fluid are both 
EYE.                        247
liable to extravasation.  In some  situations, the blood or  other
extravasated fluids can be let out  by puncturing the part, and
much mischief thereby prevented.   The application of lead wa-
ter, or a solution of the muriate of ammonia may be applied  to
hasten the absorption of the extravasated fluids.
   EYE—The organ of Sight.—In  the formation of the socket or
orbit of the eye, there are seven bones more or less largely con-
cerned.  It is of a conical figure, the apex projecting backwards
into the cavity of the skull and the base, which is a little narrow-
ed by a rim of bone  being in front.   The  ball of the eye is of a
spherical form and lies imbeded in  fatty and cellular substances,
which occupy a considerable portion of the socket.   The  strength
and figure of the ball depend  principally  upon a strong,  firm,
membranous covering called the sclerotic  coat.   This  coat has
but few vessels that  circulate red blood, and constitutes that part
of the eye,  which, in a healthy condition appears white.  It is
perforated on the back side, for the entrance of the optic nerve,
which  proceeds  from the brain,  and terminates in front at the
circumference of the cornea.  The  cornea  is a dense, perfectly
transparent, and colorless membrane, and takes its name  from its
resemblance to  horn.  It forms a segment of a smaller sphere
than that of the other portion of the  globe, and consequently is
slightly prominent.   The manner in which it joins the  sclerotic
coat, its transparency, its prominency give  it a  strong resem-
blance  to the crystal  of  a watch  set  in a case.  The  apparent
color of the cornea is caused by its perfect  transparency,  allowing
the  iris to be distinctly seen  through it.  In a sound state, there
is no red blood circulated in the  vessels of the cornea, but when
the  vessels  are  enlarged  by inflammations, they may sometimes
be distinctly seen carrying it into its substance, and thereby pro-
ducing a degree of opacity.  The ball of the eye is divided trans-
versely into two unequal portions  by a flat membrane called the
iris.  The  circumference  of the  iris corresponds  with the cir-
cumference of the cornea, and is'circumscribed by  what is called
the  ciliary ligament.   The internal and  posterior surface of the
iris  is  covered  with a black pigment, and has been called  uvea.
The anterior surface of the iris is the part  of  the eye that is col-
 ored, and  as  is  well known,  the  color is different in  different
individuals,  corresponding in  some  measure,  with the  com-
plexion of each particular  individual.  Through  the  centre of
the  iris, is a circular  hole, which  is the  pupil.   In all healthy
eyes, the pupil is black,  because the rays of light, instead of being
reflected, as they are from the iris, pass directly through it into
the  back part of the globe and are absorbed by the  black pigment
with which the internal surfaces of the coats of the eye are lined.
The size of the pupil depends upon the degree of  light  and sen-
sibility of the retina.  When the light is strong the circular fibres 
248
EYrE.
of the iris contract, thereby diminishing  the  pupil  and shutting
out some portion of it; but when there is but little light or the
retina loses its sensibility, the fibres of the iris relax, and the pu-
pil dilates so as to admit a greater number of rays to pass through
it.  Within the sclerotic  coat, and in contact with it, in almost
its whole extent,  is a very  delicate and  exceedingly vascular
membrane  called the  choroid coat.   Like the  iris, its  internal
surface is covered with a kind of black paste or pigment, pigmen-
tum nigrum.  Immediately around the margin of the cornea, the
choroid and sclerotic coats are firmly connected together, by the
intervention of cellular substance, which is dense and compact,
and forms a ring called the ciliary ligament.   The circumference
of the iris, is attached to this  ligament.   Immediately behind the
iris, and within the circumference  of the ciliary  ligament, the in-
ternal face of the choroid coat, forms  a  considerable number of
radiated  folds or  little  ridges which converge from behind, for-
wards and inwards.   These  folds coalesce one with another and
form the ciliary processes, the  central extremities of  which are
loose and float in  the aqueous humor.  The retina which is con-
sidered as one of the coats of the eye,  consists of a delicate, vas-
cular, membranous web, upon which is spread a  medullary, pulpy
substance ; this substance terminates at the commencement  of
the ciliary processes ;  but a  membrane of  a different texture is
continued from it to the cystalline lens.  The optic nerve is dif-
fused through, or constitutes  a part of the retina, and it  is this
expansion of the  nerve,  which is the seat of vision.  There are
three humors in the ball of the  eye,  the aqueous, the vitreous,
and the crystalline.  Between the cornea and the iris, is a small
cavity called the  anterior chamber,  and back of it is a smaller
one, called the posterior chamber ;  these cavities  communicate
with each other  through the pupil, and are filled with a clear,
transparent fluid, called the aqueous or watery  humor.   A very
delicate membranous  capsule invests this humor, and lines the
internal surface of the cornea. «In the centre of  the eye, immedi-
ately behind the pupil, is a dense,  perfectly  transparent,  double
convex  body, imbeded in a depression of  the vitreous humor,
which is called crystalline lens.  It is softer at  the surface than
at the centre, and like the other humor, is  invested with a tunic
or capsule, which also, in a  healthy state,  is  transparent.  An
opacity  of the lens, resulting from inflammation or other causes,
constitutes the disease called  cataract.  It is not absolutely essen-
tial to vision, and when required by disease, may be removed,
and a glass  of a  similar  shape  worn in front  of  the eye, sub-
stituted for it.  The use of the lens is to refract and concentrate the
rays of light, in such a manner that a distinct image of the object
may be  formed at the bottom of the eye, upon the the retina.
A large  proportion of the cavity  of the eye ball  is occupied by 
                            EYE.                        249

the vitreous humor.   As its name implies,  this humor resembles
melted glass.  The peculiar consistence of this humor, however,
is owing  to  a thin, transparent  membrane, called  the  hyaloid
coat, which not only incloses it  like a sac or bag, but so passes
through it as to form a great number of partitions, and a corres-
ponding number of small irregular cells, each of  which contains
a minute drop of a clear colorless fluid.   The vitreous humor is
supposed  to be necessary, to give the ball  of the eye a  suitable
size for the performance of its optical functions ;  to keep the re-
tina properly distended ; and to retain the lens at the  proper focal
distance from the retina.  An opacity of the hyaloid membrane
is one cause of blindness which is incurable.
   There is one coat of the eye  that is  common  to  the lids and
the ball, the tunia conjunctiva.   It commences at the edges of
the lids and appears to be a continuation of the skin, though dif-
fering  from it essentially  in its structure.   It  lines  the  internal
surfaces of the lids, and is reflected forwards on to the ball, the
anterior, third of which it completely covers, not excepting the
cornea.   In a healthy state,  this membrane is white  and  perfect-
ly transparent, but when inflamed, the vessels enlarge, and become
distended  with blood, giving it, in some instances, an intensely
red appearance.   With the  exception  of  that portion which is
over the cornea, the conjunctiva is so loose that it can easily be
taken up with a pair of foreceps,  and portions of it cut off with
scissors ; an operation is sometimes necessary, in order to destroy
the blood  vessels running on to the cornea in cases of inflamma-
tion, by which the transparency of this important coat is liable to
be destroyed.
   The eyelids or palpebrae  are  formed by a slit or orifice in the
skin ; under the  skin is a thin layer of muscular fibres, called the
orbicularis muscle, and under this, there  is  a plate of cartilage ;
and next  to the ball the lining membrane heretofore described.
The upper cartilage is broad in the middle and narrow  at each
extremity, corresponding  in shape and size with  the eyelid.   In
the under lid, there is only a narrow, flat rim of cartilage,  extend-
ing but a  little distance from the  margin.   On the inside of each
eyelid, between the conjunctiva and the cartilage, are  a number of
small yellowish, white lines, or glandular  bodies,  which secrete
an unctuous matter, which serves to prevent the tears from  run-
ning over the lids, and to  prevent them from sticking together.
These are the glands of Meibomius. The orifices of the ducts
leading from these glands open on  the edges of  the  lids.   The
tears, the  office of which is to keep the eye-ball and lid moist
clean and  flexible, and secreted by the lacrymal gland, are situated
in a depression in the upper surface of the  orbit near its external
margin.  There are six or seven  excretory ducts to  this gland
and they terminate near the upper  edge  of the cartilage, at the 
250                         FAI.
external angle of the eye.   " The tears are carried from the eye
by two small canals  which commence one  on each  eye-lid,  at
the internal extremities of the cartilages, opposite to each other."
The orifices of these canals are near the inner cantrrus or angle
of the eye; they are in a natural state, always open and can be
distinctly seen.  Through these punta lacrymalia, as they are cal-
led, the tears  run down into the lacrymal sac, a membanous bag,
situated upon the side of the  nose, just below the corner of the
eye, and  from this sac they are conducted into the nose through
the lacrymal duct.  Near the junction of the eye-lids, at the in-
ner angle, there  is a small triangular space, which is occupied by
a minute, reddish body, having a few short hairs growing from it,
and which is supposed to be glandular, denominated the caruncu-
la lacrymalis.  It probably aids  in directing the  tears into the
punta lacrymalia.
  The eye-ball is moved in its  orbit,  in various directions, by
six muscles, each one of which can act  by  itself, or in conjunc-
tion with another.   Four of these are straight; they all arise from
the back part of the socket, and are  inserted into the sclerotic
coat, in the form of flat tendons on the front  part of the globe,
near the  cornea.   Being opposite each other, they move the ball
in four opposite  directions.  The other two are  called oblique.
These arise near the origin of the straight muscles, and are insert-
ed between  the  insertion of the superior and internal straight,
and the internal  and inferior straight muscles.  By the individual
and combined action of these mucles, the eye-ball may be turned
in almost every  direction.  The cutting of these  muscles on the
front part of the eye-ball, constitutes the operation for strabismus
or squinting.
   EYE-WATER.—This wash is made, in general, either by a
solution  of white vitriol, sugar of lead, or some other cooling salt,
in water, or by an infusion of opium, hemlock, oak-bark, or some
other anodyne, or astringent substance, in  boiling water.   Rose
water is the  common menstruum used  in  making  eye-water.
One or two grains of white vitriol  dissolved in an ounce of rose
water is the  common form.
                             F.

  FAINTING—Syncope.—Fainting is commonly preceeded by
a feeling of distress about the heart ;  swimming of the head ; a
slight degree of sickness at  the stomach ; dimness  of  sight or a
sense of things growing  dark ; and coldness  in  the hands and
feet.  In some cases, there  is a palpitation of the heart, and a 
FAL.
251
sense of fulness ascending from the stomach to the head.  In all
cases, the breathing and motion of the heart are either suspended,
or become much  weaker  than- usual; the face and lips become
pale ; the eyes turn up in the  head ; the pulse becomes extinct
or scarcely  perceptible ;  motion in every part of the body lan-
guishes  or  ceases; the senses are bedimmed or gone;  and the
person is more or less unconscious of what takes place.   People
in fainting are sometimes convulsed, though not often.
   The  most frequent cause of fainting is  the loss of blood or
some other sudden depletion.  Fevers and inflammatory diseases
are ushered  in by fainting.  In many cases, fainting is owing to
an affection  of the nervous system ; in others,  to some  organic,
or functional disease of the heart.  After patients become weak-
ened, by disease, fainting takes place very easily.  We have long
believed  that the action of the spleen, by a sudden  transference
of a large quantity of the blood from the arterial to the venous sys-
tem, was the cause of this affection in people who faint from the
effect of  the passions and  emotions of the mind, and the sensa-
tions of the  body, or who are in the habit of fainting from  slight
causes.   The spleen and its blood vessels are often greatly enlarg-
ed, and  must exercise  no inconsiderable agency in the animal
economy.
   Cold water, dashed upon the  face, has, in general, the most
sudden effect in restoring the powers of life.   Air should always
be freely admitted, and gentle  rubbing employed.  Ether, spirits
of camphor, hartshorn, or vinegar, should be  held to the nose,
and a little wine, or  some other stimulant taken as  soon as the
ability to swallow  returns.   If  the stomach  is oppressed with
food, or  any nauseating substance, an  emetic should.be given.
Where fainting depends upon other disorders and affections, the
remedies must be adapted to the cure  of the primary diseases.
   FALLING OF THE RECTUM OR  LOWEST  PORTION
OF THE BOWELS—Prolapsus Ani.—In children and old people,
the lower extremity of the bowels, will sometimes protrude, in con-
sequence of a long continued diarrhea, or of a weakness of the part.
After the end of the bowels is turned out beyond the sphincter, it is
apt to swell and become sore and inflamed.
   The first  object is to replace it as soon as possible  by  pushing
it back with the fingers.   If it is so much swelled  as not to go
back easily, it should be very gently bathed  with cold water, or
which is better, iced  water.  The cold of the  water or ice will
contract  the distended blood vessels and reduce the bulk of the
protruded part.  In the bowel complaint of children, a protrusion
of the lower gut is no uncommon occurrence; and as they are
apt to be a good deal upon their  feet, it is often difficult to keep
the bowel in its place.
  A tea made of oak bark is  an excellent wash where  the part 
252
FAL.
is swelled  and hard to return.   A  solution of the white vitriol,
or of the sugar of lead, in the proportion of three grains of the vit-
riol or lead, to one ounce of water, may be applied with a  piece
of sponge, or soft  linen.   Alum or borax, dissolved  in warm
water are often applied with  success.  Injections of decoction of
oak bark and alum, or other astringents, are also very beneficial.
In some cases, there will be so much swelling and inflammation
as to require the use of warm fomentations with milk and water;
or which is better, a soft white bread poultice, covered  over with
a piece of muslin, and kept on with a bandage running over the
shoulder,  or fastened around  the  waist.    In  the worst cases,
leeches must be applied very  near  the  part, or immediately  to
it.   Where it proceeds from costiveness and hardness of the feces,
the gentlest aperients and mild injections must be used.  The but-
ternut pills answer  very well in such cases; but where it can  be
obtained,  the lenitive  electuary, taken every  day,  is decidedly
the best medicine which we have  ever  used.   A piece of the
size of a nutmeg is the ordinary dose for  an  adult, although  it
will, sometimes, require more, and in other instances, less will be
needed.  Where it  arises from long continued purging, it will be
advisable  to give opiates to keep  the  bowels  still.   The  part
should always be kept as free  as  possible from being chafed  or
rubbed by  the  clothes,  or from going long unreduced.  It  is
sometimes necessary to remove the  part by the knife.
   FALLING SICKNESS—Epileptic Fits.—See Epilepsy.
   FALLING  OF  THE  WOMB—Prolapsus  Uteri.—In  this
disease, the womb  is  displaced, and descends  into  the vagina.
In  some cases, it  will  only descend a  little way ; in others, it
will descend   half  way down  the passage  which   leads  to
the womb ; and in  the  worst  cases, a part or the whole of its
length will protrude from the vagina.  The disease happens  to
females of all ages, but  much the oftenest to those who  have
borne children.
   It commences with bearing  down pains, and an uneasy sensa-
tion in standing and walking.   The womb at length falls so low
as to hinder the discharge of the water, without laying down  or
pressing  back  the  displaced  organ.   It  often  produces  lan-
guor and inability to perform any very active duty-
  It is, sometimes,  produced by general  weakness of the system,
induced by other diseases, but more commonly it is the conse-
quence of frequent  miscarriages; profuse hemorrhages;  the use
of too much force  in difficult labor; and  too  early and violent
exertions after  delivery.   In unmarried women, it is occasioned
by jumping, dancing, and too great exertions of the strength.  It
is always a troublesome, painful, teasing disorder, and although
it does not often destroy  life, it makes it very  miserable.   In
those who are afflicted with it, it disappears after the fourth month 
FAS.
253
 of pregnancy, as the womb is then too large to remain longer in
 the vagina, and ascends into the abdomen.  Pregnancy often cures
 the disorder entirely, from the support which the womb receives
 from the bones of the pelvis, and the  changes which it undergoes
 in the process of gestation.  In the case of the protrusion of the
 uterus, it  will often  become  irritated,  inflamed, and ulcerated.
 The organ itself has sometimes been  extirpated  before a cure
 could be effected.                                         %
   In the falling of  the womb, the first thing to be done is to re-
 place the organ in its natural situation.  This must be done by
 a recumbent position, and  crowding the organ back as far as it
 will go.  While  the person  is  in this position, the womb may be
 maintained in its place by a ball of  sponge wetted with a solu-
 tion of white vitriol.   This should be  renewed as often as two
 or three times a day.
   To strengthen the ligaments of the uterus, and  to restore the
 tone of  the relaxed muscles, injections of lead water or of white
 vitriol  into the vagina  should be employed two or three times a
 day, for several weeks.   The  material of these injections should
 not  be stronger, in the commencement, than three grains of sugar
 of lead or of  white vitriol  to  an ounce  of water, and gradually
 increased in strength.
   If the person is able or disposed to walk and stand, the womb
 must be supported by an instrument called a pessary, which will
 be found for sale at almost every apothecary's store. The instru-
 ment is made  either of ivory,  wood or india rubber, and always
 renders the person very comfortable while wearing  it.  There  is
 a new instrument, called the utero abdominal supporter, which  is
 thought by many to be an  improvement upon the pessary.  As
 in this disease there is commonly a weakness of the  whole sys-
 tem, a resort must be had to strengthening medicines, gentle ex-
 ercise, and the open, fresh air.   The  preparations of iron are
 found to be the most available.  Griffith's mixture, the tincture
 of muriate  of iron, and mixtures  or pills of the red  oxide are the
 best and most  common forms.  The quinine and the tonic bitters
 should be tried.   A journey to  the Saratoga Springs, and a course
 of the waters will often be found of great service.   Cold bathing
 has  a powerful effect in increasing the cohesive  power  of the
 muscles, and in restoring their  tone. Every species  of dissipation
 must be avoided,  or a cure will be hopeless.
  FALLOPIAN  TUBES.—Two  small ducts which open into
 the  ovaria from  the womb.   The ovaria are two little apart-
 ments or chambers which  are supposed to be immediately con-
nected with conception.
  FASCIA.—The  thin, transparent  membrane which  covers
every muscle.   It also  encloses each  fibre of  every muscle as in 
254
FEL.
a sheath  lubricates it with fat, and enables it to slide among its
fellows with admirable ease.
  FAT__Adipose  Substance.—This substance is secreted by the
cellular membrane, which is interwoven with all the soft parts of
the body.  The amount  of fat which accumulates in the body,
sometimes doubles its weight, and has been  known to  treble it.
A certain amount  of fat is necessary to the performance of the
animal functions, but this amount is probably very small.  The
analysis of  fat discovers two distinct principles ;  one is liquid at
the temperature of 60°, and is called  elain ; the  other is solid,
and consists of small silky needles.   Elain  is fusible at about
45°, and the other principle, which is called stearine, is fusible at
100°.
  Elain is now manufactured  in the West from  hog's lard, and
sold as lard oil.  It is as  liquid and inflammable as whale oil.
' * Fat contains, in round numbers, seventy-nine  parts of carbon,
eleven parts of hydrogen, and  ten parts of oxygen.  The theory
has lately been advanced that, in the formation of fat there is an
evolution of  heat; that  the  oxygen set free  in this process is
given out in combination with carbon  and hydrogen.  It is also
contended that the fat, in the absence of food, supplies the carbon
and hydrogen which are consumed in breathing or respiration,
and thereby keeps up the natural heat.  It is true that  life will
continue much longer, without food, in fat animals than in lean
ones.
  FAUCES—The Throat—The throat commences behind or
back of the tongue and almonds of the ear, and ends at the com-
mencement of the  windpipe and meatpipe.
  FELON—Whitlow—Run-round—Paronychia.—This is a pain-
ful, inflammatory swelling around the end of the  finger, or root of
the nail   It is painful  and  troublesome  in  proportion  as it is
more  or less deep-seated.  Where  only the skin  is inflamed, it is
soon well; but where it  sinks  deep  into the flesh and  reaches
the bone, it is exceedingly painful, and  longer  in suppurating.
When the  inflammation is near the surface, the skin is red, but
if deep-seated, there is no appearance of redness, although the
swelling  be considerable.
  The best remedies in superficial felons are  the applications of
rum,  vinegar, lead water, or  solutions of zinc  and  alum ; but
when deep-seated, leeches should be applied, salts or other cool-
ing medicines  should  be taken, and the  diet  should be  light.
Poultices are  not in general of  much service.   If the pain is
severe, a dose  of laudanum or  morphine should be taken, once or
twice a day to procure rest at night. The only sure relief is to open
the felon and evacuate the matter.  In slight cases this may be
done  with a common needle, but when the inflammation is near 
FEV.
255
the bone, it requires  the  hand of the surgeon.   After the felon
has been opened, a soft, warm poultice will be beneficial.
  FEMUR.—The thigh bone which extends  from the  hip  to
the knee.
  FERN—Polypodium Felix Mas.—The medicinal part of this
plant is the  root.  It is mucilaginous, astringent, and bitter.   If
chewed, it has a sweetish taste.  A dose of the  powdered root is
from one to two drachms.    It is celebrated for its power in ex-
pelling the tape worm.   For this purpose it is necessary to drink
a pint of the strong fern tea,  daily,  until the worm is expelled.
   FEVER.—An increase of heat, a quick pulse, furred tongue,
a  depression of the  strength, and  a peculiar  affection  of  the
stomach constitute the most  uniform and general symptoms of
fever.   There are various kinds of fever, which will be found
treated of under the names  of fever and ague, intermmittent
fever, bilious or remittent fever, child-bed fever, continued fever
or  fever,  continued, hectic  fever, inflammatory fever, miliary
fever, lung fever, milk fever, scarlet fever, typhus fever and yellow
fever.
  FEVER AND AGUE—Intermittent Fever.—The fever and
ague is one  of the most  singular diseases  which  afflicts  the
human body.  The  first warning which, in general, the  patient
has of its attack, is being seized with severe chills ; he  begins to
shake all over with a feeling of intense cold ; the  teeth chatter ;
the face, hands, and skin become pale ; the size of every external
part of the body is diminished, and the skin over the whole sur-
face of the body becomes rough  and wrinkled.  How such  an
intense feeling of cold can be experienced in the warmest day of
midsummer or in a warm comfortable room where no change of
temperature actually takes place, is  a phenomenon which  has
hitherto  remained  inexplicable, but is probably owing to some
affection of that power or of those powers, which generate  the
heat of the body.  Previous to the accession of the chills, and the
shaking, and the chattering of the teeth, the patient will often
feel ill for some length  of time.  He will feel weak, sluggish, and
languid, with an uncontrolable disposition to gape and stretch ;
but these symptoms being  common  in  the  commencement of
other  diseases, cannot, with certainty, foretell an  attack of the
fever and ague.
  The patient's sense  of cold bears  no proportion to the actual
degree of heat in the body when measured by the thermometer.
His sense of cold  would indicate  that the  body was in a
freezing state, while  it is well known that the actual heat  of
body is not lessened  but a very little.
  The senseof cold, the shaking, and the chattering of the teeth
do not continue long, commonly, not more than half an  hour
before a sense of warmth begins to return.  The trembling and 
256                        FEV.
 quivering  subside,  and  gradually, the whole system  becomes
 flushed with heat.  The face becomes red, and the whole surface
 of the body glows with heat and color.  The patient begins to
 grow thirsty;  the head begins to ache ; the tongue becomes dry
 and parched;  and a feeling  of restlessness possesses the  whole
 body.  This  state  of heat, dryness of the skin, and uneasiness
 commonly continue about as long as  the  state of chilliness and
 shaking, and are then succeeded by a profuse sweat.   The  person
 sweats as profusely, as if hard at  work  in  the greatest heat of
 summer, although he  may be actually exposed to the greatest de-
 gree of cold.   The moisture is, first perceptable upon the forehead,
 and gradually extends downwards over the whole skin.   These
 cold,  hot,  and sweating stages  distinguish the fever  and ague
 from all other  kinds of fever.
  In the cold stage of fever and ague, the pulse is smaller,  weak-
 er, and more irregular than in a state of health.   The pulse ranges
 from a hundred to a hundred and thirty or forty.  The breathing,
 especially in the cold  stage, is short, quick and difficult,  but in
 the hot  stage,  is less difficult, although  still quick and  anxious.
 There is  no appetite for food until  the sweat has continued to
 flow for some length of time.  As  the cold stage comes on, sick-
 ness and vomiting often accompany it, and appear to  put an end
 to the chills and shaking.  The  matter vomited is commonly
 bilious.    Until the sweating comes  on, the mouth  is  dry and
 clammy, and the  saliva ceases to flow.   The urine  in the cold
 stage  is  without  color and sediment.  It is not a little remark-
able that  ulcers will  sometimes be  dried  up,  during the chills
 of an  ague, and recommence  the discharge of matter as soon as
 the perspiration begins to  flow.   In  fever  and ague, the mind
 becomes confused,  the  recollection  difficult,  and,  sometimes,
delirium will happen.
  Most commonly,  the train of symptoms which we have describ-
ed,  occurs every other day, with an interval of comparative health,
 and sometimes, of  entire health for  forty-eight hours, until the
disease has run its course, or been arrested by the use of  medi-
cines.  Sometimes, the same symptoms  will come on every day,
 and at other times every fourth day.  The intervals of compara-
 tive health, which take place in this  disease, have given it the
name  of intermittent fever.   The ordinary length of an intermit-
tent fever,  where no  remedies are used,  is about thirty days.
 Some agues do not  run so  long, and  others will continue six
months or a year.
  The cause of this remarkable disease is not  very well known.
It appears, however, to be confined to particular localities or dis-
tricts.  It is common to all new countries, to the shores of lakes,
and the  banks  of large, low rivers.  This circumstance has origi-
nated  the idea  that the disease is caused by an emination of some 
FEV.
257
 virulent matter from the vegetable, animal, watery,  and earthy
 substances peculiar to such places.  But what this peculiar effluvia,
 gas, air, or vapor is, has never been ascertained.  It occasionally oc-
 curs  in high lands and  airy situations.   In the southern and
 western states,  and  in  the vicinity of  all our large lakes and
 rivers, the fever and ague is a common disease.   Stagnant waters
 and extensive marshes, however, are, generally  looked upon as
 the breeding spots for this fever.
   After ascertaining the particular kind of disease with which we
 or our  friends are afflicted,  our most  important concern is to
 know the means  which  have  been discovered of curing, or of
 relieving it.
   Remedies  for the  fever  and ague.   The  best  thing to be
 done in an ague  fit,  is to place the patient  in a  warm  bed;
 put the feet in a  tub of  hot water, and  administer hot drinks,
 such  as pennyroyal tea,  lemonade, or hot molasses and water.
 Place a hot brick or a piece  of board, wrapped in flannel to the
 pit of  the  stomach,  and give thirty drops of laudanum; if the
 first dose  of laudanum  dose not produce warmth and quietude
 in  half an  hour, the  same   dose  should   be  given  again.
 After the first fit of fever and ague has gone off,  and another fit
 is anticipated, the  laudanum may be given just before  the time
 of the expected attack.   This  treatment alone will sometimes
 cure an ague.
   After the hot stage  has commenced,  all heating things should
 be laid  aside ; cool air admitted, and cool drinks given.   If the
 headache should be very great, the pulse full and hard, and the
 heat of the body excessive, a little blood should be  drawn from
 the arm,  or from the temples by the  application  of  leeches.
 This  often prevents local  inflammations, and ague cakes, which
 form  in  the liver and  spleen,  indurations  which sometimes
 eventuate in dropsy, or fatal visceral obstructions.  But in ordi-
 nary  cases, an emetic is the  most proper remedy at the  com-
 mencement of the  hot stage.   The powder of ipecac is of all  the
 substances hitherto discovered, the safest and the most uniformly
 effectual emetic.  A  common  sized  tea-spoonful, mixed  with
 molasses or water, is a common dose for  an adult.   Where this
 cannot  be obtained,  thoroughwort may  be  used.   Some may
 prefer lobelia, which  is  used  in a dose  of from ten to twenty
 grains of the dried, powdered leaves.  The preparation, however,
 of lobelia, which is most in use,  by the profession in this country, is
 a tincture made by putting two ounces of the dried leaves into a pint
 of new  rum, or diluted alcohol.   A table-spoonful of this  prepara-
tion, is given every quarter of an hour, until puking is produced.
Not more  than three  table-spoonfuls  should  be  given  without
waiting an hour or two before more is administered.   One spoon-
ful will often produce the effect.
            33 
258                        FEV.
  In case of pain in the  side  or  head, or any other part of the
body  a blister of a good size should  be applied, or fomentations
used.'  After the operation  of  the emetic is over,  two or three
pills of aloes should be given, or a dose of oil, salts, or of some
other  cathartic in domestic use,  to  free the bowels of bile and
other  offending matter.   Ten grains  of the Dover's powder may
also be  given to hasten the  perspiration,  or a tea-spoonful  of
the sweet spirits of nitre may  be given instead of the Dover's
powder.   Barberry  water is a very suitable  drink.   But the best
drink  which can be given to a patient in the hot stage of fever,
is the spirit of minderrerus, which is  made of the super carbonate
of potash and lemon juice, or distilled vinegar.
  The second  and  most important  thing to be attended to in a
fever and ague, is to prevent the return of the paroxisms.   If an
emetic is given an hour or two previous to the coming on of the
chills, it  will often prevent  their occurrence, and the patient will
pass on to the next  regular  period of the chills, and if another
emetic is administered, as  before, the chills will be again pre-
vented.   Thirty or  forty drops of laudanum, given several  times
in succession, an hour or two  before the accession of the chills,
will often break up  the whole  disease, and restore the system to
health.
  But the remedy the most to be relied upon, is the sulphate of
quinine,  a chemical salt procured  from the Peruvian bark.  The
bark itself was formerly given in  this disease, but  is now almost
entirely superceded by quinine.   The quinine is  given in  doses
of one grain of the  powder, once  an  hour for five or six  hours
previous to the chills.  A grain of it can  be mixed with a little
jelly of any kind, and swallowed  in this form, or made into a pill.
The best way, however, of taking it is to dissolve sixteen grains
of it in two ounces  of water acidulated with four drops of sul-
phuric acid.  The  water will not dissolve it without the acid.
A tea-spoonful is to be taken once an hour  during the intervals
of the disease.   Where the chills oecur  every day, the quinine
should be given every hour, but  where they occur every other
day, once in two hours will be quite often enough.  Care should
be  taken not to give the  quinine  until the sweating stage has
entirely  passed away, and the  pulse become soft and  quiet.
There are  several  kinds of bark which have  some efficacy in
curing  the fever and ague, besides  the Peruvian and the salt
extracted from it.  The most celebrated are the  cascarrilla, the
gentian, the quassia and the columbo.   Even chamomile flowers,
wormwood, and bitter herbs  in  general, have some tendency to
arrest this disease.
   Neither the bark, nor  the quinine should be  given, if any of
the organs evince a state of inflammation, otherwise, this disease
may be  converted into a worse one. 
FEV.
259
   A new remedy has within a few years been introduced, called
the piperine,  a chemical principle, discovered in the analysis of
black pepper.  A  grain  of  the  piperine is  made into a pill and
swallowed once an hour, for five or  six hours previous  to the
accession of the chills.  People, who can  be cured in no other
way, will often recover by removing from the district where  the
disease originated.   In  protracted cases, mineral  salts must be
used, such as blue vitriol, sulphate of zinc,  and murcurial prepar-
ations.   When ague cakes form  in the liver and spleen, and  the
abdomen becomes turgid, calomel in small doses, or the blue pill,
will be the only remedies upon which any reliance can be placed.
   The  diet, in a fever and ague, should be light and nourishing ;
food  should never be taken into the stomach  in a paroxism
of the  fever,  but when  the paroxisms have  subsided, broths,
soups, boiled chicken, and vegetables may be freely taken.   Mut-
ton and all meats of easy digestion may  be  eaten  with modera-
tion.    All  intoxicating  drinks  should  be studiously avoided.
They will invariably  retard  the  cure  where  they do not con-
vert the disease into incurable chronic inflammations of the vital
organs of the body.
   The  fever and ague is  not, in general, a dangerous disease, if
an ordinary  degree of prudence is used in the management of it.
A person who is disposed  to this disease,  or who already has it
upon him,  should  always adopt a dress which is calculated to
protect  him against all great and sudden changes of the weather.
He should constantly  wear  flannel next to the skin, avoid expo-
sures to wet feet and  damp  air,  and as  much as possible avail
himself of a dry air,  and a dry  situation to live in.   Much mis-
chief is done to patients afflicted  with  this  disease, by the pre-
scriptions and  recommendations of ignorant  persons.  A strict
course  of temperance, both in  eating and drinking  should be
pursued, through the  whole course of the disease; this of itself,
lays a good foundation for recovery.  After a fair trial of quinine,
or of the bark in powder, has been made, the other  medicines
enumerated  should be tried.   Where the piperine cannot be  ob-
tained,  eight or ten of the black  pepper  corns can be taken three
or four  times a day, instead of it.
   Should dropsical swellings begin to  manifest  themselves in
different parts of  the body,  medicines  should be taken which
have a  tendency to operate upon the kidneys and bowels.  The
calcined magnesia, cream of tartar, and epsom salts  should be
frequently taken to evacuate the bowels  and increase the flow of
the urine.   The mineral acids,  particularly elixir vitriol,  should
be taken as a mild, efficacious tonic.  The food should be nour-
ishing, and,  whenever distress and want of sleep require the  use
of opiates, they should not be withheld.  But where a person  has
been subject, for a long time, to  an annual return of this disease, 
260
FEV.
 and the constitution has become greatly enfeebled, he should, as
 a last hope   quit the district where  the  disease originated,  and
 locate himself in a soil and climate more congenial to his health.
   One of the greatest improvements which has taken  place in
 the  treatment of all fevers,  is in the free use which is made by
 the moderns, of cold water, both as a drink and as a bath.   The
 ancients were  afraid of its  use ;  indeed,  they not only looked
 upon nearly  all  diseases with some degree  of superstitious fear,
 but upon everything which they administered to the sick.  Cold
 water may be freely used, both as a drink and as a bath, in  the
 hot stage of the intermittent, and of all other fevers.   In all cases
 of high fever, and of a dry and  hot skin, the greatest relief is
 experienced  by  sponging the body over with cold water.  The
 body may also be showered or wrapped for a while in a cold, wet
 sheet.
  FEVER,  CONTINUED—Slow Fever.—This fever is partic-
 ularly  a disease of temperate climates, but occasionally of all
 climates.  Wherever man  is known,  this  fever is known ; and
 its symptoms are nearly the  same, the whole earth  over.  It is
 sometimes called slow fever, and at other times, nervous fever.
  A person in an attack of  this fever, commonly feels a loss of
 strength, a loss  of appetite,  and a loss of  mental activity.   He
 realizes a heavy, indescribable, sinking feeling  at the pit of  the
 stomach.  The  head  swims, and eyes  look  dull  and heavy.
 Cold chills, sometimes, though  not always, run  over the whole
 body, commencing in the back.  There is pain in the  forehead,
 and sometimes in the back and loins.   But the most uniform and
 remarkable symptom in this disease, is the  feeling of  a sickish
 oppression  in the stomach.  The  features of  the face and the
 dimensions of the  whole body  are   evidently shrunk.   The
 skin assumes'a dusky hue, and is more or less shrivelled.  There
 will  be frequent  rigors ;  the urine will be scanty and pale  ; the
 tongue and mouth dry ; and the breathing short  and  quick ; and
 the person complains of a universal weariness or tired feeling.
  The rigors and the sensations of cold usually continue for a
 few  hours, and  are  succeeded by  flushes  of heat  and an  in-
crease  of the headache, sickish  feeling  in the stomach, and
 dryness of the skin and tongue.  The eyes become red  ; the face
flushed ; and the pulse strong,  full, and frequent.   It will  often
beat from ninety to one hundred and twenty strokes in a minute.
The thirst will be great; the bowels costive ; the blood will rush
to the head, and there will be a disposition to vomit.   Delirium
is no uncommon symptom.
  When the fever runs high and  all the symptoms  are severe,
and continue  for a long time,  the greatest danger is  to  be appre-
hended.  The symptoms, which foretell  death,  are a sinking of
the pulse ; an involuntary discharge of the  urine and stools ;  an 
FEV.
261
 increasing coldness of the feet and hands; hiccups; starting of
 the tendons ; and the settling of the blood under the nails.
   The favorable symptoms are, the  return  of more quiet sleep;
 the appearance of a gentle sweat; an abatement of the thirst and
 heat; the secretion of the saliva; and the disappearance of the fur
 upon the tongue ; and, especially, an increased flow  of the urine,
 which, in cooling and settling, throws down a reddish colored sed-
 iment.  But, perhaps,  what is more favorable than all,  is the
 appearance of an appetite.
   The common continued, or slow fever, when it is not cured or
 shortened by medicines, usually runs from fourteen to thirty days.
 It will sometimes come to a crisis on the fifth, seventh, or ninth day.
 The usual length of this fever, in  our climate, is about two weeks,
 or seventeen days, unless it is very severe.
   Domestic Remedies.—While the  sense of cold lasts, in a con-
 tinued fever, the drinks should be warm, and warm applications
 should be made to  the skin.   Warm pennyroyal, or balm tea,
 should be given  plentifully to drink; the patient  placed in a
 warm bed, and  the feet  well bathed in hot water.  A gentle
 emetic of ipecac, a tea-spoon even full, should be given as soon
 as the coldness goes off, followed by frequent, draughts of warm
 water.   After the effects of the emetic are well  over, a dose of
 some gentle physic  should be  administered.   For this  purpose,
 an ounce of steeped physic, composed of senna, manna and salts
 may  be given,  or a dose  of  the rochelle powders in a state of
 effervescence.  Two or three pills of aloes, or five or six pills of
 the extract of butternut will answer, in case the other cathartics
 cannot be obtained.  Where ipecac  cannot be obtained, a tea-
 spoonful of powdered alum, mixed with molasses or syrup,  may
 be given in its stead,  as an emetic.  The alum operates very
 quick  and gently.  Many people  are partial to the use of the lo-
 belia as an emetic.   Where this article is  used,  an ounce of the
 dried leaves should be steeped in  half a pint of water, and only a
 table-spoonful given at a time, and repeated at intervals of fifteen
 minutes, until a gentle vomiting  has been produced.  Not more
 than four table-spoonfuls should, at  the most, be given,  without
 waiting an hour or two for its operation.   The caution of giving
 it, at  intervals of fifteen  or twenty minutes, should always  be
 kept in mind.  In fever, we prescribe its use simply as an emetic,
 in a  dose which has been sanctioned by the usage of regular
 physicians in our country.  A  table-spoonful  of the above infu-
 sion is a dose for  an adult.  A tea-spoonful will be a sufficient
 dose for a child two or  three years of age.
   The most suitable drinks, in a regular continued fever, are
cold water, lemonade, apple water, tamarind water, barbary water,
soda  water, and the acetate of  ammonia, which last is, perhaps'
in addition to its property of quenching the thirst, one of the best 
262
FEV.
 febrifuges in the materia medica.  Cold water, as innocent as it is,
 and as grateful as it may be, can be given to too great an extent.
 A  well  person  can drink  immoderately of cold water; much
 more then should we set bounds to its use by the sick.
   Sleep is a most desirable and necessary  refreshment in fever.
 And from nothing, does a  person affected with  this fever suffer
 more than from  a loss of it.   Opiates, in this fever, are for
 the most  part injurious and powerless.    We  must,  therefore,
 resort to means which lessen the heat and increase the secretions.
 Cold bathing should be  daily and thoroughly  made use of just
 before the usual  time  of sleep.  A tea-spoonful of  the  sweet
 spirits of nitre  should be  given every hour,  for at least  three
 hours before bed time, or which  perhaps may be  preferable, a sim-
 ilar dose of Hoffman's anodyne.  The room should be cool and
 the bed-clothes light.
   Blisters in the commencement of a fever, are rarely ever pro-
 ductive of much benefit, unless it is very light.   The first  stage
 of  a fever must have passed over before a blister will be a proper
 remedy to use.
   Professional Remedies.—Bleeding in a regular continued  fever
 is in the present day seldom resorted to,  unless the heat, thirst,
 and the force of the circulation  should be  very great.   Antimo-
 nial and saline medicines have  been found to be more  sure and
 efficacious.   The medicine of the most power in this disease is
 antimony, either in the form of tartar  emetic,  or of  the pulvis
 antimonialis, or antimonial powder.  Antimony moderates the
 force of the circulation, at the same time that it opens the  pores
 of the  skin, increases the secretion of the urine  and loosens the
 bowels.   This medicine has not only stood the test of time, but
 has increased in  reputation in proportion to the extensiveness of
 its  use.   It should never be given  in doses  which shall continue
 nausea to any length of time.   Three grains of the tartar emetic
 dissolved in three table-spoonfuls of hot  water, and given in a
 tea-spoonful dose, once in two  hours, is perhaps as good a way
 as any in which the medicine can be administered.   The antimo-
 nial powder, in eight grain doses, is often preferred, and is nearly
 as efficacious.  The powder may be given either in water, syrup,
 or molasses.
   Ipecac, in  grain, or grain and half dosps, has a reputation nearly
 as high as antimony, as a febrifuge.  Used in this way, it  often
 puts an end to fever.  It moderates the pulse, produces a perspira-
 tion, quiets the nerves and uneasy sensations, and induces sleep, all
 which effects appear to  be antagonistical  to fever.  All heating
 things in the early stage of the fever should be studiously avoided,
 especially stimulating  and  intoxicating drinks.   Wine is hardly
 ever admissible until  the  fever has subsided or  considerably
abated.   Bitters and strengthening medicines are also incompati- 
FEV.                        263
ble with this fever in ifs early stage.   But when the fever has
continued for sometime, and its  symptoms are not very severe,
the physician need  not wait until a  complete  crisis has been
formed, before he makes an attempt to strengthen the  system.
For this purpose, the quinine is pre-eminently entitled to the first
trial.   If it  does not increase  the  heat and oppression at  the
stomach, but on the  contrary, relieves  the  restlessness  and pro-
duces a greater degree of composure and sleep, it may be con-
tinued until symptoms of amendment and strength appear.  The
mineral acids, such as the elixir vitriol and the  muriatic acid are
often found more suitable tonics where any degree of fever re-
mains,  than the  quinine and the bitter medicines in general.
Preparations of iron are seldom  used  in the debilities of fever,
though where other tonics  cannot be  procured,  or do not agree
with the stomach, a  trial may be  made of them.   On a return of
the appetite, chicken broth, soup,  milk  porridge, custards, broiled
salt pork, salt  fish,  and toasts  of coarse wheat and indian
bread, will afford the  most appropriate diet.  But after all that can
sometimes be done  in  a continued fever, the patient will often
have to pass  many  wearisome  days and nights before recovery ;
and he can  only  reconcile himself to the endurance of so much
restlessness  and  misery  by the reflection that it  is  the  common
lot of humanity.
   Good nursing and proper attention to the  wants of the sick, of
this disease, will often work miracles in restoring the patient to
health ; while on the contrary, neglect, and the want of the com-
mon comforts of life, often hasten the sufferer to  the grave.
   In the latter stages of this fever, instead of giving cathartic
medicines as often as they may seem to  be required, it is much
safer and much more saving of the strength to administer injec-
tions.  For this purpose, a table-spoonful  of common  salt  dis-
solved in a pint of warm water or molasses  and water, is as good
a  way as  any to induce an operation of the bowels.   Where
nourishment cannot be retained by the  stomach,  broth,  milk and
water  gruel, and other  nutritive liquids are often given by in-
jection, mixed with tea or fifteen drops of laudanum to secure
their stay in the bowels.   Patients have, sometimes, been support-
ed in this way, for many days and weeks.
   The continued or  slow fever is not contagious.   It is  a disease
which originates  from a variety of causes ; from great exhaustion
of the strength  of  the  body or of the mind; from  excessive
watching and sudden depressions of the mind ;  from changes of
great heat  to cold and the  reverse ; from exhausting sweats and
want of food; and probably from  poisonous exhalations from the
earth,  In New   England,  the  country towns are much more
subject to this kind of fever  than the  cities;  the inland towns
and those situated upon the  seaboard,  and  low, flat places, than 
264                        FEV.
 the  hilly districts.  In some seasons, it is  far more prevalent
 than in others •  and in some towns and counties in New Eng-
 land it almost always prevails in the latter  part of summer and
 the  beginning of autumn.  Farmers after having gone  through
 with the fatigues  of haying, are  apt to be the  subjects of it.
 Their constant  exposure to  the heat of the mid-summer sun ;
 exhausting  sweats; and their  excessive labor  all combined,
 prove too debilitating for the human system.   They prostrate all
 the powers of life,  and disease is the inevitable consequence.
   In addition to what has been said upon continued fever, it may
 be observed that this fever is subject to  some variations and ir-
 regularities which  lead many people to confound it  with typhus
 and  remittent or bilious  fever.  It is  true that there will be at
 times and particular seasons, so much torpor of the mental faculties
 and  so much delirium, as to lead inexperienced persons to such a
 conclusion, but the event commonly proves the  conclusion to be
 fallacious.  The stomach, also, in this  disease,  will, in some
 years, be loaded with bile, and  there will be more or less of a
 bilious vomiting.  Emetics of ipecac, in such  cases, will be found
 singularly efficacious.  Where symptoms of  debility do  not for-
 bid it, an emetic may be given every day, until the  stomach has
 been entirely relieved.   In  other  instances of this  fever, there
 will be almost constantly a bilious diarrhea, which in spite of all
 remedies to allay it, will continue until the fever  has come to a
 crisis.  And where the diarrhea is not very  severe, it is not a
 symptom which calls for very powerful remedies.  It is commonly
 better combatted by a few anodyne injections than by potent as-
 tringents administered by the mouth.  A tea  made of the ground
 logwood,  is probably the most innocent and surest astringent
 which can be used.  Grain  doses  of the sulphate of zinc, or of
 the  sugar of lead,  either in pill, or in solution  in water, will
 sometimes, prove more effectual.
   The lungs, in this disease, are,  sometimes, so  much affected
 with a cough, and irritation, as to give this fever  the name of
 lung fever, but very improperly,  as the lungs are not the seat of
 the disease, and always recover when the fever disappears.  When,
however, the lungs are  more  affected than the other organs of
the body, local remedies, not  incompatible with the general fever
should be employed.  Large blisters should be applied to the
 chest; and, where the strength of  the  patient will allow of it, a
little blood should be drawn  by  leeches or cupping.   The lungs
will  occasionally be so sensitive in this fever as to require the use
 of warm drinks  and demulcent  medicines, such as solution of
 the slippery elm  bark, gum arabic,  and the gum ammoniac.
   Twenty or thirty years ago, the slow, continued, or autumnal
fever of New England, for this fever goes under all these names,
was treated almost  entirely with  calomel.  The medicine in this 
FIB.
265
 fever, is now almost entirely gone out of use.   We have no
 doubt but calomel,  properly administered, will sometimes, cure
 the continued fever, and oftener relieve it; but like every other
 good  article  in  medicine, and every other  good thing in this
 world, it is so much the more liable  to abuse.  Were it not an
 effectual remedy in  some diseases, we  very much doubt whether
 its use would ever have been  pushed  to  such an unwarrantable
 extent.   The mouth in  a  burning fever is  dry.   Calomel will
 almost invariably increase the  secretion of the saliva, and in this
 way  moisten the mouth.  The conclusion is certainly a very
 philosophical one, that calomel is good for the fever.  All the
 secretions in a regular continued fever are  checked or dryed up.
 If calomel will increase or promote one secretion, it may promote
 them  all and so carry off the fever.  It is probable that calomel
 does  promote the secretions,  in  general, although  its  opera-
 tion is more visible  in  the mouth and upon the salivary glands.
 It appears to us to be  a  general excitent of the  secretery sys-
 tem ;  if the mucous  membrane of the bowels is inactive and tor-
 pid, we think calomel will excite it to action in the  same way
 that it does the salivary glands ; if the liver is inactive and torpid,
 we think calomel will excite a flow of the bile ;  if the kidneys,
 lungs, or the skin  are  inactive  and torpid, calomel will  ex-
 cite them to action.  In this respect,  calomel differs  in  noth-
 ing from antimony,  ipecac,  and  many other articles  which
 promote  the secretions in  general.   Calomel, however,  when
 rightly used, does not, like  them,  diminish the strength.  It is
 slower, but more permanent in its effects.  In a word, calomel is
 a good servant but a hard master.
   FEVER ROOT—Triosteum Perfoliatum—This  plant is to
 be  found in  all parts of the  Union, but nowhere in great abun-
 dance.  It grows from one to  four feet high.  It is  sometimes
 called  wild ipecac.  Its flowers are of a dull, brownish purple;
 and its fruit, an oval berry,  of a deep orange color,  hairy, and
 somewhat three sided.  The flower cup contains three cells and
 three hard, bony, furrowed seeds.
   The properties of  the fever root are emetic and cathartic.  In
 places where medicines  are not easily obtained,  the  fever root
 may be found a good substitute for ipecac and jalap.   The dose
 of the  dry, powdered root, is  from twenty to twenty-five grains.
 Dr.  Bigelow thinks it easily  impaired by age.  The  fever root
 has a nauseous taste and  smell, like ipecac.  It is a newly dis-
 covered plant, and needs more trials.
  FIBRINE.—The  substance of which the flesh is chiefly com-
posed.   It is a proximate  principle of animal matter, that is, in
passing from  the blood which contains an abundance of it, into
the  form of flesh, it,  necessarily, undergoes no change.   All that
the  coagulum of the  blood differs from the  flesh,  consists in a 
266                         FIS.
certain form which the same  matter  assumes in different  situa-
tions.  If closely examined, the  coagulum  of the blood will  be
found to present the same fibrous appearance, displayed by the
flesh or muscles.  If blood, as it issues from  a  vein be beaten
with a stick, the fibrine will adhere to the stick  in  the form of
long, reddish strings, which,  when washed, become transparent.
It is easy to comprehend, therefore, that this matter in the blood
is a principle next in the series of changes to flesh itself, and that
the flesh may be said to be almost ready formed in the  blood.
  Fibrine is contained in the  matter  of vegetables, as well as of
animals.   All  the  properties of vegetable  fibrine,  and animal
fibrine are the same.  One of the constituents of  animal matter,
therefore, is formed in the process of  vegetation, and furnished to
the stomachs  of those animals  which  live on flesh,  in a state
ready to be carried into the blood.  In the process of digestion, it
probably undergoes no other change  than a disengagement from
extraneous matters.  Thus we see that vegetables produce in their
growth, one of the constituents of the blood of animals.   Indeed,
vegetables produce all the constituents of blood and flesh, since
vegetable albumen, caseine, and  fibrine, are identically  the  same
with animal albumen, caseine, aud fibrine.
  Fibrine is convertible into albumen, and albumen into fibrine;
their chemical elements are the same in number, kind,  and quality.
Fibrine contains,  in round numbers,  fifty-three  parts  of carbon
or charcoal, six parts of hydrogen,  fifteen parts of nitrogen, and
twenty-three parts of oxygen,  with a small quantity of sulphur and
phosphorus.  Albumen, and caseine contain the same  elements
or ultimate principles.
  A new  principle has  lately  been  discovered  called pro-
teine, which is the base of fibrine, albumen,  and caseine, both
vegetable and animal.   From  this newly  discovered element
all animal matter is supposed to  be formed, with the  aid of the
oxygen of the air and water.   Proteine is found in the fibrine of
wheat flour.
   Animal fibrine, albumen, and  caseine are compounds of pro-
teine.   All these principles-contain  nitrogen, and are  called the
nitrogenised constituents of animal matter.
   FIBULA.—The outer bone  of the  leg,  extending  from the
knee to the ankle.  Its mate  is the tibia, or shin bone.
   FISTULA IN  ANO.—This  disease is an abscess or a  matur-
ating cavity, formed about the verge  of the anus.  An  inflamma-
tory tumor forms in or near the rectum, or  lower portion of the
bowels, suppurates, and leaves an opening which constantly dis-
charges an unhealthy,  watery matter.   This opening will some-
times be made through  the  bowel,  so  as to let  the  watery con-
tents of the bowels through it.  In other instances, the tumor
will burst outwards, and not  extend  to the bowel;  but the sup- 
FIS.
267
puration will extend so far as to render the coats of the  bowel
thinner, and forbid the healing of the abscess, without laying the
fistula and the rectum into one  opening, with  the  history.  In
the third place,  the fistulous tumor will burst  into the rectum.
In this case, there is a kind of a sack formed, which will be fil-
led and distended outwards, every time the person goes to stool.
   The  fistula generally commences with a hard, circumscribed,
red, painful bunch, or tumor, very near the fundament.   It will
often create a high fever, quick, forcible pulse, and extreme pain,
especially when the contents of  the bowels  are  discharged.  In
this case, it will be  necessary to let blood,  either by opening a
vein, or by leeches, the  latter  always being  preferable, where
they can be conveniently obtained.   The swelling or swellings,
for, sometimes, there are two or three at a time, must be poulticed
and fomented, to bring them to suppuration.
   When the tumors first appear,  however,  we must always try
to disperse them by  the use of  lead water, or  a solution of the
white vitriol.   The bowels must be drained by mild cathartics,
such as the cream of tartar, the flowers of sulphur, or which is
better than  either, the lenitive  electuary.   The butternut pills
are scarcely inferior to either of the others.   A  perspiration must
be raised by the use of small doses of  ipecac, or antimony, as-
sisted by warm herb teas.  Eight grains of  the sal nitre, every
two hours, will assist greatly in the reduction of the fever.
   As soon as the matter is fully formed in the tumor, which of-
ten resembles a black boil, it must  be  let out  with the  lancet.
The opening  must  be large, to prevent the formation of more
matter.   In some instances, the abscess will be fiat  and not well
defined; these are the worst cases,  and the  least  likely to heal.
   There are  a great many boils  and tumors,  however,  which
form about the extremity of the rectum, which inflame, suppurate,
and discharge their matter, and heal as well  as  the  same  kind  of
abscesses in other places.   Probably not one  in a hundred  of
these tumors ends in a genuine fistula.
   In all kinds of suppurative tumors in the rectum, we have always
placed great reliance upon the daily use of the lenitive electuary,
taken internally, and the Turner's cerate for an external application.
These two articles are so efficacious, that they have often been
vended, for the cure of the piles, and other  tumors, as specifics.
The fistula often results from piles, a consideration which makes
it of the highest importance to accomplish a cure of that annoy-
ing complaint, in its commencement.  After the fistula  is once
formed, there is no other way than to lay it freely  open; and if
there are several, they must all be opened into  one.  If properly
treated, the fistula is not the desperate disease which it  is  com-
monly supposed to be.
  FISTULA LACHRYMALIS.—There is  a small  duct leading 
263                        FLO.
from the inner corner of each eye, through which the tears and
mucus are  conveyed into  the  nose.   This duct, sometimes,
inflames, and ulcerates.   The passage becomes  closed, or nearly
closed, and  an  opening is made by ulceration from the  sac,  or
belly of the duct, through the  cheek,  from which the tears and
mucus now flow.   This opening  is called  a  fistula.  In the
beginning of this affection, the tears are constantly running over
the cheeks.
  If only one of the puncta is  closed, it may be opened with a
pin, but if a fistulous opening has been formed, the  difficulty can
only be remedied by establishing a  new passage, by means of a
silver tube, inserted into the obstructed duct, for the conveyance
of the tears.  There is always  more or less redness, soreness, and
swelling of the inner corner of the eye, and the  formation  of
matter.
  FLATULENCY—Wind in the stomach and bowels.—Flatu-
lency is one of the symptoms of dyspepsia.  The quantity  of
wind or gas, which is often let loose in the stomach and  bowels,
is enormous.  The pain  and distention  which  the  wind in the
digestive tube produces,  seem to show that it  is different from
common air.  It is probably much more elastic and diffusive.
Some of it appears to be the sulphuretted hydrogen gas.  The
remedies adapted to the relief and cure of flatulency, will be found
under the head  of dyspepsia.
   FLESH—The Muscles.—A person  may  be fleshy without
being fat, and fat, without being fleshy.   If the muscles are large
and full the body  will be round and handsome.  Health, good
air, and good  living increase the size of the  muscles, or the
amount of flesh as well as the amount of fat.  Exercise increases
the amount of flesh or the size of the muscles, where a plenty  of
food is supplied, but diminishes the fat.  Exercise,  without a
sufficiency of food, diminishes the size of the muscles, as well  as
the fat.  To be fleshy is always desirable, as it increases the strength
and improves personal beauty; to be  fat is inconvenient, if not
uncomely.  To be fleshy, therefore, without being fat, a person
has only to  exercise enough, and  to eat enough.  This is  an
important distinction, which should be carried in the  mind of
every one who wishes to be  strong, healthy, and handsome.
   It is also, an important consideration in the  raising of domestic
animals.  To increase the size and strength of animals, the mus-
cles and bones must be  enlarged.  To accomplish this purpose,
the animals must not  only be well fed, but moderately work-
 ed, or left to run at  large in  pastures, that the blood may be pro-
 pelled into all parts of their bodies.
   FLOWERS OF BENZOIN—Benzoic Acid.—This substance
 consists of white, brilliant scales, or  flakes, like small flakes of
 ■now.   It is obtained by sublimation  from  the balsam, called 
FCE.
269
benzoin.  It has a  pleasant taste and a fragrant smell.  It dis-
solves in alcohol and hot water.  It  is one of  the ingredients of
paragoric.   The crystals or flakes, taken in a dose of ten or fif-
teen grains, have been esteemed an  excellent pectoral or cough
medicine.   We  think it deserves more attention as a remedy in
lung affections, than has commonly been given to it.
   FLUOR  ALBUS.—A disease peculiar to  females.   It  is a
chronic affection of the uterus and vagina, denoted by a secre-
tion of  whitish, or milk-like mucus.   See  Whites.
   FCETUS.—The beginning of the child in the womb is in-
volved  in great obscurity.   Existence is  supposed to commence
in the ovaria, two  small organs, each about the size of a Lima
bean, connected with the  fundus  of the uterus by two small
ducts or tubes, called the Fallopian tubes.  At  the  end of three
weeks after impregnation, a small gelatinous body becomes  per-
ceptible in the womb, but it is without organism or form.  About
the fourth week, a red spot is seen in this  mass, which gradually
expands, and forms the heart and blood-vessels of the foetus.  In an-
other week, the head, eyes, mouth, face, and ears, become develop-
ed. But it is not until the middle of the fourth month that the em-
bryo becomes completely formed, and  ten  weeks later before the
new being  has acquired  maturity enough to  live.   At seven
months, children will often live,  although the birth is premature.
   The  circulation of the blood in the foetus, or in the foetal state,
is different from what it is after birth.  The blood, in this state,
comes from the mother, by means of the placenta—a new medi-
um of communication  established* for the purpose of nourishing
the child.   The funis or navel  string of the child, which arises
from the placenta,  encloses a vein and two arteries.   The vein
carries the blood from the mother to the child, and the two arte-
ries from the child back to the mother.  Thus the blood, which
nourishes the child in the  womb, enters at the navel.   The vein
which conducts it, passes through the liver, leaving a branch to
nourish that organ, and enters the vena cava, or great vein, which
goes to  the heart.  But when the blood has reached the heart of the
foetus, instead of being propelled from the right auricle to the right
ventricle, and  through the lungs or lights to the left auricle and
ventricle, as is the case after birth, the greater part of it passes im-
mediately from the right to the left auricle through an orifice
called foramen ovale, which after birth closes  up.  The rest of
the foetal blood, after passing through  the right ventricle, goes in
part  to nourish the lungs,  and in  part through the pulmonary
artery which at this stage  of existence terminates immediately in
the aorta under the name of the ductus arteriosus.   In the fcEtus
the arteries which  return the blood  through the cord and navel
arise from the internal iliacs.
   The child in the womb is covered by  two membranes, or a 
270
FOO.
double membrane, which, after birth, is called the veil.   This
double membrane contains, besides the child, a large quantity of
water in which the foetus is immersed. The rupture of this mem-
brane or bag is sure to produce the loss of the child or a miscar-
riage.
   Thus we see that the foetus  is nourished by blood  alone.
Neither hunger nor thirst is felt till after birth ; breathing is not
necessary; and the  external senses, with the exception of that
of feeling, are  incapable of action.
   FOMENTATION.—The  bathing of a part of the body  by
means of  flannels dipped in hot medicated or simple liquids. Va-
rious kinds of  herbs, such as  pennyroyal,  spearmint, tanzy, and
hemlock, as well as simple hot or  warm water, are used  for fo-
mentations.  It is equivalent to steaming the part.
   FOOD.—The food of mankind consists of animal and vegeta-
ble substances.  Every species of vegetable  or  animal  matter,
which can be digested and converted into chyle, will support  the
body.  The digestibility of substances must be  determined  en-
tirely by experience and observation.  Animal substances,  being
composed of the identical  matter of the  human  body,  contain
more nutriment, in the same compass, than vegetable food.  Veg-
etable substances may be  considered the  raw materials out of
which the blood is made, and animal matter, the manufactured
article.  While animal matter only undergoes, in the digestive or-
gans, a kind of solution,  or a separation into the  proximate prin-
ciples of living human bodies, vegetable substances are  obliged
to undergo decomposition or chemical analysis to  a greater or less
extent.
   The most common articles of food among the  people of New
 England, are the mealy or farinaceous substances, such as  Indian
corn,  rye, wheat, barley, buckwheat,  potatoes,   rice, peas, and
 beans, with some others.  All these articles are healthy and  nu-
 tritious ; they  contain, in great abundance,  proximate principles
 of animal matter, viz : fibrine, gelatine, and albumen.  It should
 be particularly recollected that fibrine, the substance of which all
 the fibrous parts of the body are  composed, albumen, which is
 contained in the  watery part of  the blood, and  gelatine, which
 composes the  membranes of  the body, and exists in  great  abun-
 dance, in the bones,  tendons, and  other parts  of  the system, are
 all found ready formed in vegetable substances, and probably do
 not undergo an  entire chemical  change in their  conversion into
 living animal matter.  Caseine, a fourth  proximate  principle of
 animal matter, and which is contained in milk, is also  found in
 vegetables, such as peas, beans, and other milky  seeds.
   It is a remarkable fact, that vegetable fibrine, albumen,  and
 caseine are all composed of the same chemical elements with an-
 imal fibrine, albumen, and caseine, viz: carbon, hydrogen, nitro- 
FOO.
271
gen, and oxygen, with a trace of sulphur;  and that in a hundred
parts of each of these proximate principles, there are fifty-four
parts  of carbon,  seven of hydrogen,  fifteen of nitrogen, and
twenty-two of oxygen,  with a few fractions added to each part.
  Caseine composes our food  while we subsist on milk.   Gela-
tine,  another  proximate principle of matter,  is composed of the
same  chemical elements as fibrine, albumen, and caseine, but not
of the same proportions.   In a hundred parts of gelatine, there
are fifty parts of carbon or charcoal, six parts of hydrogen, eigh-
teen parts of nitrogen, and twenty-three parts of oxygen.   It is
extremely doubtful whether  we could subsist entirely upon gela-
tine, but it is demonstrated that we can live either upon fibrine,
albumen, or caseine.  The brain, nerves,  and the eggs of fowls
are chiefly composed of albumen.  This substance,  as we have
said, in the definition of albumen, is exemplified in the white of
an egg.
  The animal substances used by the people of New England,
are beef, pork, poultry, fish, mutton, veal, milk, wild birds, and
a small proportion  of wild game, such as rabbits, squirrils, rac-
coons, woodchucks,  bears,  and deer.  These substances are
rich in animal fibrine, albumen, gelatine, and  caseine.
  It may here be noticed that  the blood contains the same ulti-
mate  or chemical principles as the flesh.   Each is composed of
fifty-one parts of carbon or charcoal, seven parts of hydrogen, fif-
teen of nitrogen, twenty-two of oxygen, and four of ashes.  In
living on  flesh,  it  is probable that  our  food,  in  the process
of digestion, undergoes  merely a solution, and not a chemi-
cal change, nor a change into its ultimate principles and a recom-
bination of the same.
   Whether animal or vegetable food is best adapted to the  health
and longevity of man, is a question which remains to be settled
by  observation and  experiment, or a more perfect history  of the
dietary habits of mankind.  The health and the longevity of the
people of  New England,  particularly in the country towns, are
not probably surpassed by the  inhabitants  of any other part of the
world.  Their food consists of a mixture of animal and vegetable
substances, in which, we should  say, the  vegetable  part consid-
erably predominated,  especially  among the female and  juvenile
portion of the people.  The children  of New England  may be
said in the main to  be brought up upon bread and milk.   In all
the country towns,  brown bread or rye and  Indian  meal bread
and milk, hasty-pudding and milk, milk porridge, bread and but-
ter, bread and cheese, with pumpkin, apple, and minced pies,  are the
common and the standing food of children.  Fruit, apples, pears,
peaches,  strawberries, whortleberries,  currants,  and grapes, to-
gether with potatoes, turnips, cabbages, beets, carrots, and squashes
make up the rest.  The farmers and  mechanics, the working 
272
FOO.
class of people, live principally upon  the same kind of  vegeta-
bles, with the addition of salted beef, pork, and  fish, with  occa-
sional dishes of fresh meat and poultry.
  Whether any essential change can be made in this system of
living for the better, must be decided by further observation and
experience.   We  think, however, that  the use of meat may safe-
ly be restricted to one moderate meal a  day.   Even the laborious,
it appears to us, will do better  to use this moderation, and seden-
tary and inactive people had better use a still  greater moderation,
or, they may live  entirely upon vegetable substances.
  We wish  here to recommend one remark to the  particular at-
tention of our readers.   The  human stomach is very much like
the roots of  a tree.  If it has been long accustomed to a partic-
ular course of living, or to speak  figuratively, been naturalized
to certain substances, which must be considered  its soil, there is
some danger in a, sudden change  to another course,  in the same
manner as it endangers a tree to transplant it  into a new and un-
tried soil.
  It would  seem to  us that  blood wrought immediately out
of vegetable substances, or the raw materials as we have  before
expressed it, was better calculated to withstand decomposition, or
the agents of decomposition, than blood wrought from the  flesh of
animals ; but, every thing of this nature must be determined by
observation and experience.   Analogy  is fit to be followed only
where better evidence cannot be obtained.
  It is an established principle in medicine, and  perhaps there is
not one more fully and irrefutably established, than that a vegeta-
ble diet prevents the inflammatory diathesis, or state of the body
which  disposes it to inflammation.  In all  acute inflammatory
diseases, a vegetable diet is one of the preliminary means of check-
ing and reducing  the inflammation.  Is not,  therefore, a vegeta-
ble diet, or the use of vegetable food, a preventive,  in a measure,
of inflammatory affections ?   Many people live where no vegeta-
bles can  grow, which proves that they can subsist  upon  animal
food, but we know but little or nothing of their diseases, or the
length of their lives.
  We wish  here to record, or rather  to  repeat an observation
which  should be  borne in mind in every condition of life.  The
food of a domestic animal which labors,  must always be in pro-
portion to the quantity of work  performed,  or  the  animal will
become thin, weak, and emaciated.   So with man—the quantity
of his food must always be greater in  proportion to the  amount
of exercise which he takes, or labor which he performs.    Many
people  become thin and weak  merely from a  deficiency of nour-
ishment.
  No care can be too  great in selecting wholesome  articles of
diet.  Damaged grain or meat ought never to be  eaten, much less 
FRA.
273
sold to those who are ignorant of its qualities.  Those who have
the charge and supervision of public institutions,  such as poor-
houses, asylums,  and hospitals,  should always be those whom
the community, and even the unfortunate themselves, can trust in
providing wholesome and unadulterated articles of food.
   FORAMEN.—A little hole or opening in bones, muscles, and
membranes, through which a nerve or some other matter passes.
   FOXGLOVE.—Digitalis Purpurea.—The leaves of the fox-
glove  are  one of  the  most powerful  articles in the  materia
medica.  It is not native to  our soil, but has  been transplanted
from Europe  into  many of  our gardens.   The leaves have  a
nauseous, bitter taste, with considerable acrimony.   It  grows to
the height of about two feet, and  bears a  beautiful purple blos-
som.   It is cultivated as an ornamental plant.  The whole plant
is powerfully narcotic,  but the leaves possess the most  strength.
It also possesses the property  of reducing the force of the circu-
lation, and of increasing the secretions, especially  that of the
kidneys.  Administered in a  proper quantity, it has been known
to reduce the pulse from seventy beats to forty  or thirty-five in  a
minute.  An over dose, produces vertigo, dimness of sight, nau-
sea,  faintness, and  sometimes death.  A medium dose is half a
grain of  the powder, taken twice a day. But  the ordinary way
of using it  is in  tincture, which is made  by adding  one
ounce of the dried leaves to eight ounces of new rum or diluted
alcohol, and allowing it to  stand for a week, and then straining
it.   The dose of  the  tincture is ten  drops.  It should never be
given at first more than twice a  day, and it is much the  safest
way to administer it only once.  If too frequently given, its ac-
tion is liable  to accumulate in the system, and to produce some
sudden, unexpected effect.   In the dropsy, it  is a powerful and
effectual medicine.  In hemorrhages from the lungs, nose,  and
womb, it has been thought equally efficient.  It is often given in
inflammatory diseases to reduce the pulse and  to answer the in-
tention of blood-letting.  Asthma  has been relieved by it.  Its
first effect is supposed to be stimulating.  It should be  used only
by an experienced physician.
   FRiENUM.—The little fleshy  string  or  membrane which
ties the  tongue to the floor of the  mouth.   It is sometimes so
short and wide as to prevent the  child both  from  nursing and
speaking. The child is then said to be tongue tied. In this case it
must be cut with a pair of scissors,  or a sharp pointed bistoury.
Where it only produces a lisping in the speech it is best to divide
or cut it.
   FRACTURES  OR BROKEN  BONES—It is,  in simple
fractures only, where the bones are broken without wounding the
flesh or bursting the blood-vessels,  that people  in general can do
much towards setting them.
           35 
274
FRA.
   In the fractures of bones, the first thing to be done is  to stop
the bleeding, if there is any, and to place the patient in a com-
fortable situation.  If there is faintness, a little wine, rum, cam-
phor, or ether may be given; but as soon as the faintness passes
off thirty or forty drops of laudanum or morphine should be given
in a little water;  and if the limb is jamed or broken into  several
pieces, two or three tea-spoonfuls of laudanum  should be poured
upon  the bruised flesh.   In all  cases where  the flesh  is torn,
jamed, or ground  to pieces, laudanum, or opium dissolved in warm
water, should  be poured into the wound ; this  prevents the lock-
jaw, and eases the pain.  The patient should be kept under the
influence of laudanum or morphine  until symptoms of adhesive
inflammation commence.
   Broken bones are set very much in the same way that disloca-
tions are reduced; by extension ; and by putting  the bones into
their right position.
   When a bone is broken, the breach can commonly be detected
by an examination with the hands;  the broken ends can be felt;
and in rolling or twisting the limb, while one part is held still, a
grating noise will be heard.  Most commonly  too, the fractured
limb will either be longer or shorter than  the sound one, and
thrown into an unnatural position.  In some cases, the limb will
bend  at the broken place,  simply by lifting up  one  extremity
of it.
   In setting bones, a bone of the arm or leg, for instance, one or
more persons take hold of  the limb above the  fracture, and one
or two others below the fracture ; they  then pull or extend the
limb in the direction  which is natural to it, while the operator
places his hands upon the broken ends of the bones, and matches
them together, as soon as the  muscles are sufficiently stretched
to allow the ends to meet.  The extension should be slow, steady,
and  firm ; no sudden pulls will ever succeed.   The extension
should be made in the direction of the lower fragment.    In thin
people, bones are  much more easily  set than in fleshy ones.
  In fractures where the vessels and  flesh are wounded, and the
bones  splintered, the  bones must  be set before the wound is
dressed.
   After the bone is set, the patient must be  placed upon a bed or
mattress with the limb resting in a favorable position to recover ;
a bandage must be  placed around it, and  two or more  splints,
made either of wood, leather, or  pasteboard.   The many-tailed
bandage  is the most convenient, and splints of leather or paste-
board wetted when first put on, the most comfortable.   Leather
and pasteboard splints, after they become dry,  assume the shape
of the limb and offer but little impediment  to the circulation of
the blood.
   The limb  should  be kept entirely  still; and  no purgative 
FRA.
275
 should be  given,  if it can  be helped, until the bones  have
 united, on account of the motion  which the patient is obliged to
 make.   The diet must be vegetable for the first week, and con-
 sist principally  of fluids, such as  good rice porridge, and bread-
 water.  In  case there  is considerable inflammation, the ordinary
 means adapted  to moderate it, must be employed.
   The local applications suitable for broken bones, are new rum,
 vinegar and water, lead water, a solution of sal ammoniac, spirits
 of camphor, poultices,  and warm fomentations.
    In simple fractures,  of small bones, where  there is not much
 swelling and heat, a plaster of diachylon may be applied to the
 part.
   The  time which it takes for bones  to unite, is  from three or
 four weeks to as many months, according to the size of the bone
 and the nacure of the fracture.
   The art of setting bones depends upon  the presence of  mind
 of the operator, his habit of  observation, and the  number of ca-
 ses which happen to fall in his way.   The  art is perfected by
 a knowledge of anatomy, physiology, and surgery in general.
   The great object in  bone-setting is to  bring the ends of the
 bones in contact, and to restore the limb or member to its natural
 shape.
   In setting the bones  of the nose, you have only to introduce a
 silver  probe, or a stiff instrument crooked  like  it,  into  the
 nostrils, and to  lift the bridge of  the  nose into its proper place.
 If the arch requires support, you must introduce lint.
   In setting the collar-bone or clavicle, you have only to stretch
 the arms and shoulders  backwards as far as is necessary, and the
 ends of the bone will slip into their  place.   The part  should be
 covered with adhesive plaster, and  a bandage  should  be  drawn
 over one shoulder, and  brought down  under the opposite  arm,
 and round on to the back, to meet the other end of the bandage.
   In a fracture of the breast-bone  or sternum, not much is to be
 done, unless a part of the bone  is  depressed, when the trephine
 must be used, in order to afford a purchase for raising the portion
 of bone which has been driven in.
   There is as little getting hold of the ribs to set them, as of the
 breast-bone, when they are  broken.   The fracture of one rib is
 productive of little or no mischief.   It is usual to  cover the part
 with an adhesive plaster.   A fracture of the ribs  is,  generally,
 pretty easily detected by the  grating sound made by the broken
 edges of the bones in the act of breathing.
   If the shoulder-blade is broken,  all that  can be done, is to
keep the arm at  rest, or, at most, to place a thick cushion in the
arm-pit and raise the arm with a sling.
   Blood-letting  is sometimes required before the bones can be
set, especially in dislocations and fractures of the large  joints and 
276
GAL.
bones  such as the shoulder and the thigh.   Bleeding relaxes the
muscles and lessens the pain of the operation, as well as secures
the system against a violent inflammation of the part.  After the
bones are set, and the wounds,  if there  are any, are dressed,  the
patient must pursue a dietetic  course,  for four or  five  days, to
prevent the danger of  inflammation.  In the  process of healing
or uniting of the bones, the diet may be more nourishing, but not
rich.  Broths, soups, bread  and milk, and plain boiled dishes are
the best and the safest kinds of food.  No wine should be drank,
unless the constitution is  weak, feeble, or diseased.  The more
perfect  the rest of the limb or member, after  being  set,  the
quicker will be the process of re-uniting, and the less the danger
of having a crooked bone or a  stiff joint.
   The art of bone-setting  is  far behind the other branches of
surgery, and requires an additional degree of attention by medi-
cal pupils.
   FRAMBOSIA—Yaws.—A disease which resembles^ the rasp-
berry.   See Yaws.
   FROG—Ranula.—A swelling, or tumor under  the  tongue,
which  causes the person in  speaking to  make a croaking, thick,
noise, like a frog.  The contents of  the tumor are various, re-
sembling,  in different cases,  the saliva, the synovial juice, or a
fatty kind of matter.   Those which we have seen resemble little
transparent bags of water, or serous fluid.   They may either be
opened when they become  troublesome,  or allowed to burst of
themselves.
   FUNGUS HEMATODES—Rose Cancer.—See Cancer.
                             G.

   GALBANUM.—A gum, which, like the gum of a peach tree,
oozes from cracks and incisions in the stems of a peculiar, peren-
nial plant growing in Africa.
   This gum, easily melts by heat, and is soluble in alcohol.  It
has a bitterish,  acrid taste, and a peculiar strong smell.   It is
ranked among the fetid gums.  In nervous,  and spasmodic dis-
eases, it is a good  medicine.  The dose is from ten grains to a
drachm.   It is more efficacious  in  the form of a plaster.   For
rheumatic and white swellings, plasters of it  have been found of
signal benefit.   It is  sometimes applied externally, in the form of
tincture.
 ^ GALL  STONES—Biliary Concretions.—See Alvine  Concre-
tions.
  GALVANISM—The galvanic fluid is similar to that of elec- 
GAM.
277
 tricity.  It is excited, however, in a different way.   To produce
 galvanism, you have only to  lay  a half or a quarter of a dollar
 upon  the table,  and a  piece of wet,  woolen  cloth upon  it,
 and then upon the cloth a piece  of zinc plate, about the size
 of the silver piece; then to lay on another silver  piece,  and
 upon this another piece of wet cloth, and upon the cloth  another
 piece of  zinc, and so on till you  have  piled up  about  twenty
 pieces of each.   The pieces of cloth should be smaller than the
 metalic pieces, and squeezed a little to prevent the moisture  from
 getting between  the pieces  of metal.  If the pile  requires sup-
 port, it must be done by three glass rods confined perpendicularly
 around it.  If one hand is now applied to the top and the other
 to the bottom of the pile, a shock will be produced, resembling a
 shock of electricity.   The  galvanic fluid can be excited in many
 other ways, but  this is the simplest and most practicable.  The
 method now followed, is  the action of the galvanic trough, com-
 posed of plates of zinc and copper, with cells interposed, contain-
 ing either an acid liquor,  or a solution of common  salt,  muriate
 of ammonia,  or sal nitre.
   The electric and the galvanic fluids are supposed by many, to
 be one and the same power.   Galvanism produces a shock; emits
 light; excites the most intense heat;  ignites combustible bodies;
 melts crystals; and decomposes  the  alkalies  and metalic  bodies.
 Its most extraordinary influence, however, is upon the muscular
 and nervous  systems of animals.  It moves the muscles, and ex-
 cites the nerves of dead people and animals,  very much like the
 principle  of life itself.  If the eighth pair of nerves (the  branch
 which goes to the stomach,) be divided in animals, the process of
 digestion ceases ; but if the galvanic  fluid be applied to the end
 of the divided nerve, next to the stomach, the process of diges-
 tion is re-established, and goes on by the influence of the gal-
 vanic fluid, the same as if the stomach were connected with the
 brain.   When a dead body is galvanised, the legs  and arms are
 thrown about; the face and eyes move ; the  breathing is excited
 and the whole system is affected with convulsions, very much as
 in a fit of epilepsy.   The countenance expresses horror, and des-
 pair,  and exhibits the  most frightful contortions.  Are the mus-
 cular and the secretery motions performed by this influence ?
   In nervous  affections, such as apoplexy,  palsy, epilepsy, and
 debility, galvanism has been  found of signal benefit.  It is an
 agent which is destined to become of great utility in the cure of
 diseases.
   GAMBOGE.—The gamboge is a gum-resin, of a deep yellow
 color, and purges the stomach and bowels powerfully.  It is the
juice of a tree, which grows in the east, and hardens into a solid
mass.  Combined with jalap, calomel, cream  of tartar, and other
cathartics, it has  been found very effectual  in dropsies.   When 
278
GLA.
 taken alone, the dose is  from ten to fifteen grains.   It is one of
 the most drastic purgatives in use,  but a very good medicine in
 skilful hands.  It has  succeeded in the expulsion of the tape
 worm.
   GANGLION.—A knot-like enlargement  in  the  course  of a
 nerve.   The most notable ganglions are the solar and semilunar,
 situated near the centre of the abdomen.
   GANGRENE—Mortification.—See Mortification.
   GARGLE.—Washes for the throat and mouth.
   GAS.—Gas is  an elemental air.   The  common air  which
 we breathe, as light,  transparent, and  invisible  as it is, is com-
 posed of no less  than three different gases, oxygen, nitrogen, and
 carbonic acid.   Water is composed of two gases, oxygen, and
 hydrogen.   The hydrogen gas is the lightest substance known;
 it is fourteen times lighter than the atmospheric air.  Its light-
 ness enables it to rise with great force above the common air; it
 is the gas with which balloons are  filled.   It burns like  oil, and
 is hence called the inflammable air.  Gas was first discovered by
 Dr. Black, of Edinburg.  He obtained the carbonic acid gas from
 marble, by pouring upon it oil of vitriol in  a glass retort.  The
 gas flew off, and, by means of a leaden tube, was collected into
 a glass bottle,  or jar filled with water and inverted over a tub of
 water.  As  the gas passed into the jar, the  water  was pressed
 out.  This is one of the  greatest philosophical discoveries which
 has ever been made.
   Almost the  only medical use which  is made of the gases, is to
 inhale them in diseases of the lungs.  The carbonic  acid gas is,
 however, drank in the form of soda water, and applied to morti-
 fied parts in  the form  of yeast.   We anticipate great improve-
 ments in the administration of gases in diseases of the lights.
   GASTRITIS—Inflammation of the Stomach.—See Inflam-
mation of the Stomach.
   GELATINE—Jelly.—A good example of this animal substance
 is  the calves' foot jelly.   When  cooled it is elastic,  tremulous,
and quite solid, but if heated again,  it melts, and becomes fluid.
In this it differs from albumen, which becomes consistent by heat.
Gelatine is one of the proximate principles of animal bodies. The
skins of animals  are almost entirely composed of it. The principle
of tanning converts it into leather.  The  membranes are, also,
chiefly composed of it.  It is not a compound of proteine, like
fibrine, caseine,  and albumen, although derived from it.  It is
found  in vegetable as well as  animal substances.   Gelatine is
composed of fifty parts  of carbon, seven  parts of  hydrogen,
eighteen parts of nitrogen, and twenty-three parts  of  oxygen.
A  thorough knowledge, of the  proximate  principles of animal
bodies will  throw great light upon  the healing art.
  GLAND.—Those organs of the body which secrete a peculiar 
GLE.
279
kind of fluid, such as the liver, the  pancreas, and the female
breasts.  Some of the glands secrete mucus, others saliva, others,
lymph or  water, and others, wax, as those of the ear.   A gland
is  composed,  or formed of blood vessels, nerves,  parenchyma,
and an excretory duct, by which the  substance secreted is evac-
uated.
   GLAUBER'S  SALT—Sulphate  of Soda.   It is  obtained
from the  bittern which remains after the crystallization of com-
mon salt.  In a dose of half an ounce, dissolved in water, it is a
mild, safe, and thorough cathartic,  but latterly, is not so much
used as the epsom salt.
   GLEET.—This affection consists  of a discharge of a thin,
whitish, whey-like matter, from the urethra of the male and the
vagina of the female.  It may be a symptom of several different
affections  of the genital organs, but is most  frequently a conse-
quence of gonorrhea or clap.  It, in  fact, is  a remnant of that
disease.  It is unattended with pain or scalding, and is but slight-
ly, if at all, infectious,  except when aggravated by  intemperance
in eating, and drinking, or  other excesses.  As it is in some cases,
a matter of considerable importance to know whether this affec-
tion  is infectious, or not, it may be taken as a  general rule, that
whatever  the original cause of the disease may have been, if the
matter discharged, be thick and of a yellowish  color,  and espe-
cially if there be tenderness, or irritation in the urethral passage,
there will be a great probability that it may be communicated to
another person ; but, if the matter be  nearly colorless, and thin,
and there be no symptoms of inflammation, or irritation, it will
be equally probable that the case is  not infectious.  The dis-
charge is furnished by the mucous membrane  lining the passage,
which has been weakened and deranged in its functions by long
continued disease.   Gleet often coexists with, and may be caus-
ed by, strictures and ulcerations  in the urethra.  The  cure of a
confirmed gleet  is often tedious and  difficult, and the effects of
remedies,  in order to be successful, requires  to be aided by tem-
perance, abstemiousness in diet, and regular habits; cold bathing
and  the greatest attention to cleanliness.
   Cubebs and alum, in doses of twenty grains of the former, and
ten of the latter, taken three times a day, are sometimes beneficial.
Balsam of copavia, and oil of cubebs, in doses  of fifteen drops of
the balsam and five of the  oil, two or three times a day, are also,
sometimes successful.  Another remedy of considerable efficacy
is  a mixture of two parts of good spirits of nitre, with one part of
spirits of turpentine, taken in doses of thirty or forty drops, three
times a day, in sugar and water.
   Perhaps, however, there is no ^general remedy upon which  so
much reliance can be placed, as a mixture of equal parts  of the
tincture of muriate of iron, and tincture of Spanish flies.   Twenty 
280
GOU.
 drops may  be  taken, three times  a day, in half a tumbler full of
 upland cranberry  tea, or sweetened water,  until  it produces a
 slight strangury, or  irritation in the bladder, when it should be
 discontinued for a while, and resumed after the strangury has
 subsided, if the complaint be not cured.
   As the gleet is a local weakness, dependant  upon chronic in-
 flammation of the mucous membrane,  local remedies, or those
 applied directly to the part, will not  only be found serviceable,
 but  absolutely  essential to the  cure.  Indeed, injections are the
 principal remedies used  by many physicians.  Among the sub-
 stances employed for this purpose, some  of  the best  and  most
 common are the white and blue  vitriol, sugar, of lead, alum, lunar
 caustic, and corosive sublimate.   An infusion of nutgalls, white
 oak  bark, and  other vegetable astringents,  are sometimes used.
 Perhaps,  one  of the best injections,  and one  which  has  been
 universally  approved,  is made  by dissolving twenty  grains of
 white  vitriol, in half a pint of rain  water.  The addition of a
 little finely pulverized armenian bole,  is believed by some to in-
 crease its virtues.  The  proportion of lunar caustic is from eight
 to sixteen grains, to  a half pint of soft  water; of blue vitriol the
 same ;  and of corrosive sublimate, from one to two grains, to the
 same quantity of water.  Injections require  to  be repeated  fre-
 quently, that is, from four to six times, daily,  in order to pro-
 duce any permanent, good effect.  If much smarting, or irritation
 be produced, the strength of the  solution  must be  diminished;
 and  if no sensible effect be felt,  it must be gradually increased.
 When  gleet is complicated with strictures, or ulcerations in the
 urethra, the use of bougies and  caustics applied directly to the
 seat  of the difficulty, must be resorted  to, in  which case, and in
 fact, in  all difficult cases of this nature, the patient should put
 himself under the care of a skilful physician.
  GLOTTIS.—The upper part of the windpipe.
  GOITRE—Bronchocele.—An enlargement of the forepart of
 the neck.  See  Bronchocele.
  GONORRHEA—Clap.—See  that article.
  GOUT.—Podagra.—The gout is an  inflammation of some one,
 or of several of  the joints  of the  body.   Its  seat is most com-
monly  in the foot, especially in  the first joint of the  great toe.
It will sometimes occupy every  joint in the foot, and,  at others,
only the ancle or the toe joints.  The  whole foot  often appears
swelled,  and red.  In some instances,  it attacks both  feet  at a
time, but most commonly only one.  The swelling and redness
do not commonly  begin  to appear, until twenty-four hours after
the pain commences  in the part.
  The  person  will  feel unwell  for  several days before  the
commencement  of the  inflammation in the  foot.   The head
will feel heavy, and the body languid ; there  will be a loss of ap- 
GOU.
281
petite ; wind in the stomach ; and a general sense of uneasiness;
the feet and legs will be colder than common,  and sometimes
warm,  with a sense of prickling through  their whole length.
For some days before any pain is felt, the feet and legs will cease
to perspire, and be affected  with a degree of  chilliness.
   An attack of the gout usually takes place in the spring or the
beginning of winter, when the changes in the weather, and the sud-
den transitions from warm to cold, and from cold to warm, are the
most frequent, and when the atmosphere contains the most mois-
ture, and the  earth  is the  wettest.   Probably cold and wet feet
are the most common  cause of the disease.  The causes which
prepare the system for the disease, or which induce it, are in-
temperance ; excess in eating ; a daily use of wine at the table ;
night watching, or a want  of the  natural  sleep;  venery ; the
abandonment of the accustomed  labor  or exercise; and a diet
composed chiefly of animal food.  A diet of animal food has  a
direct tendency to produce the gout, especially if it is accom-
panied  with an  indolent  life.   If people  work  hard, sweat,
and  toil every  day, they can eat a large proportion of animal food
with impunity;  but  if  the  blood is allowed to  stagnate  daily,
like  some putrid pool sunk among the hills, the gout will be sure
to follow in those who are at all predisposed to it.
   An attack of the  gout usually commences in the  night,  or
rather about the hour of two or three o'clock in the morning.  A
pain seizes the ball of the foot, or the first joint of  the great toe,
and, sometimes, the middle bones of the foot.  A cold, shivering
fit is felt at the  same time, which gradually goes off as the pain
in the joints becomes severe, until it entirely ceases, and instead
of cold, the patient becomes hot, thirsty, and restless.   The pain
in the foot commonly  increases for about twenty-four hours,
when the  system becomes  exhausted, and the patient falls to
sleep, and begins to perspire.  The part now begins to swell and
to become red.  The disease is fully developed.  After the swell-
ing of the part, the pain is, in some measure, alleviated, but does
not  disappear.  It returns with more or  less severity, every even-
ing, until the disease or the system has become exhausted, and a
resolution of the inflammation effected by a process of nature, or art,
and  the patient restored to health.   The duration of the gout va-
ries  from a few days to several weeks, or a whole season.  Some
people are affected with it, for eight or nine months in the year.
It is only a little while in summer that they  are exempt from it.
To them the winter is synonymous  with the gout.  During the
interval between the attacks of the gout, the person usually en-
joys an extraordinary degree  of health.   Between  the first and
second attack  of the  gout, there  is often an interval of two or
three years; but afterwards they become more frequent, and oc-
cur every winter,  and,  sometimes,  twice or three times a year.
            36 
282                        GOU.
The gout is not apt to attack young people.  It seldom makes its
appearance until after thirty-five years of age.   It is much often-
er a disease of men than of women.  Dr. Cullen says that, " this
disease attacks especially men of robust and large bodies, men of
large heads and  corpulent habits,  and men whose skins are cov-
ered with a thicker  reticular membrane,  which gives a thicker
surface."  He also says that  the gout  seldom  attacks  men  em-
ployed in constant bodily labor, or persons  who live much upon
vegetable aliment.  This is almost equivalent to saying that the
disease is produced by living upon a meat diet;  and when we re-
flect how  much less  liable women  are  to the disease than men,
and that they, in general, are much less meat-eaters than men;
and that all writers agree that the most speedy and effectual way
of curing the disease, is by living upon a vegetable aliment, the
evidence becomes very strong that the constant stimulation of a
meat diet, prepares the system for the disease.   We do  not think,
however, that this is apt to be the case where a meat  aliment  is
united with hard labor, or severe exercise.  But if a meat diet is
combined with an inactive, sedentary, indolent life, we are fully
of the opinion that the gout,  or s6me other inflammatory disorder
will be produced by  it.   Dr.  Cullen says again, and we believe
he expresses  the opinion of medical men of the present day, as
well as of his own time, that " it is animal food which especially
disposes to the plethoric and  inflammatory state, and that food  is
to be especially avoided ; but on the other hand, it is vegetable
aliment of the lowest quality that is in danger of weakening the
system too much by  not affording a sufficient nourishment; and
more particularly  of weakening the stomach by its ascescency.
It is,  therefore,  a diet of a middle nature that  is to  be chosen ;
and milk is precisely of this  kind, as containing both animal and
vegetable matter."  The vegetable substances which contain the
greatest portion of  nourishment,  are  wheat flour  or  meal, rye
meal, Indian meal,  rice, buck-wheat, and barley meal.  Bread
made of any  of these substances, contain sufficient nourishment
to  keep the body in good  condition  where  people  have been
brought up upon it; and full enough for sedentary and inactive
people to live upon who have been reared upon a meat diet, or a
mixture of meat and vegetables.
   The idea that the gout travels about the system, stopping a lit-
tle while here and a little while there ; and, that it can be driven
from one place  to another by the force of medicine, or recalled to
 the foot again from  where it started, by the use of means, is al-
 most too fanciful to  need a refutation.  We should as  soon think
 of driving an inflammation of the brain, of the lungs, or of the
 liver, to the feet, as  of driving  the gout to the head or stomach.
 The gout is an inflammation, the part which it affects, is painful,
 sore  to the touch, red, hotter than natural, and swelled.  It fur- 
GOU.                        283
thermore raises an inflammatory fever in the system at large.  As
soon should we  think of driving an inflammation of the eyes or
ophthalmia, to  the brain or stomach by the application of eye
waters, as  of  repelling the gout by any  local application which
we can make  to the part inflamed.
   The other  parts of the  system, the stomach, bowels, head,
lungs, heart, liver, and kidneys, are beyond a doubt more or less
secondarily affected in the gout, but that they ever are attacked
with the same specific disease  which existed in the foot, is  be-
yond belief.   We think the idea is mischievous, and calculated
to lead the mind of the physician  into a labyrinth  of uncertain-
ties.
   An inflammation,  such  as exists in the foot in a case of  the
gout, if transferred to the stomach, would produce  gastritis, or if
transferred to  the brain would produce frenzy or phrenitis, and if
to the lungs, peripneumony, and those diseases could not be dis-
tinguished from the ordinary cases of gastritis, phrenitis and  pe-
ripneumony.  Attacks  of the gout often  leave the constitutions
of people in a broken state like  other severe diseases, and affec-
tions of the head, stomach and bowels, are the natural conse-
quence without  being parts of the same disease.   We shall there-
fore pass over all that authors have said about atonic, retrocedent
and misplaced gout as entirely conjectural and visionary.   It is
extremely  doubtful in our view, whether the gout  is a constitu-
tional disease, any more than  the influenza, peripneumony, or
gastritis.   All inflammatory affections are liable to extend from
one organ  to another, and from one part to  another.  A chronic
inflammation  of the stomach will sometimes extend to the lungs,
liver, heart, bowels, and spleen.  An inflammation will sometimes
commence in  the stomach, and after it has extended to the lungs,
the stomach will be relieved.   In fact, there  is no disease in  the
whole catalogue of disorders, about which there prevails so much
vulgar error and conjecture, as  about the gout.  Nothing can be
plainer to  us than that the gout is  an inflammation of the  parts
which it attacks, and that it requires a treatment similar to other
inflammatory  affections.  It is not  to be  supposed  or  expected,
that blood-letting in a  part so distant from the heart  and large
blood-vessels and vital organs, as the ball of the foot or the great
toe joint,  should be equally efficacious in  producing a resolution
of an inflammation,  as in those organs  and  parts where  large
blood-vessels abound, and which experience the most distention
from the  action  of  the heart.   The  tendons and bones con-
tain but few blood vessels, and these are extremely small.  The
abstraction of a gallon of blood from  the arm  would  have  but
little tendency to unload vessels so few in number, and so minute
in size.  General blood-letting, therefore,  unless for the purpose
of lessening the action of the heart, and of preventing the effects 
284
GOU.
of the inflammation upon other organs and  parts,  can have but
very little salutary effect in the gout.
  Domestic  Remedies.—A person  who  has not had  the  gout,
can never know the disease which is about to settle upon him by
the premonitory symptoms which we have enumerated ;  it is not
until after the pain has commenced in the foot or some other part
that he can  have  much suspicion  that  he is attacked with the
gout.   After the pain has commenced and become fixed, he may
be able to know what to do for himself, or what may be done for
others.   If there  is sickness at the stomach, a gentle emetic  of
ipecac or lobelia  will be  required.  After  the operation of the
emetic, a dose of  rheubarb, calcined magnesia, butternut physic,
a rochelle powder,  or two or three aloetic  pills should be given
to operate upon the bowels.  The patient should drink freely  of
hot catnip tea or of warm water.   The feet should be immersed
in water about the temperature of eighty-five or ninety, and
soaked  for  an hour  at a time.   After which they  should  be
wrapped in soft flannel or  combed wool.  The  wool is  thought
to be the best.  Eight grains of the powder of sal nitre should be
given every three hours; and if  the pain and distress prevent
sleep, thirty drops of the solution of morphine should be  given.
The  inflamed part may be bathed three or four times a day in
new rum, or alcohol slightly warmed, and where the pain becomes
intolerable, a tea-spoonful of laudanum may be mixed with the
rum or alcohol.  The spirits of camphor and laudanum are often
used with good effect, kept constantly applied to the part.  After
the part becomes swelled, red and sore, and the pain and general
commotion  of the  system have in a measure subsided, the do-
ver's powder, in doses of  ten grains, three times  a day, may be
given.   The diet must be light,  and consist of  fluids, such as
gruel, made either of barley, wheat, or indian meal;  rice  water,
bread water, or weak milk and water.   All heating things, such
as hot drops,  spirits, and composition  powders,  must be studi-
ously avoided.  Such medicines are only suitable where there is
no general  fever, or,  in  the  chronic  stage of the  disease.   A
warm,  soft, bread, or flaxseed poultice, if  changed often, is said
by Lord Bacon to be the  best application which can be made to
a gouty swelling.
   It  is  of  the greatest importance, that the  patient should be
kept warm and dry.  Warmth is friendly to the disease,  and cold
aggravates it.  In the inflammatory stage the part should always
be kept  still.                   fc
   Professional Remedies.—The  application of  leeches,  or  the
 extraction of blood by  cupping in the gout, we regard as an in-
 dispensable remedy,  if we wish to effect a cure of the disease.
 A dozen good Spanish, or German leeches, applied every  day
 for three or four days in succession, will be none  too many. 
GRA.
285
  The skin should be kept moist by the use of sudorifics, and
the kidneys free by  the  use  of the sal nitre,  or  the  acetate
of ammonia.  The sweet spirits of nitre, and Hoffman's anodyne
liquor should be used  as much as possible, instead of opiates.
  The colchicum, in the form of the saturated solution of the
seeds in wine, has lately been given with good success.  The
dose is from twenty to forty drops.   The gout  has  often been
treated successfully with purgatives.   In this case, a full dose of
salts,  senna, castor  oil, aloes, or pills, in which  colocynth is an
ingredient, such as Lee's pills,  is given every day, for one or two
weeks in  succession.    This  mode  of treatment  has, perhaps,
been  attended with as much success as any which has ever been
adopted.    The tartar emetic,  in solution,  and  given  to the
amount of a quarter of  a grain  once in  two hours, through the
day, will generally  operate sufficiently upon the bowels,  at the
same  time,  that  it moderates the pulse, moistens the skin, and
relaxes the kidneys.  The tartar emetic,  in  small doses, is con-
ceived to be the most anti-inflammatory medicine which we posses.
Calomel has often been used in the cure of the gout, but we be-
lieve it has never been attended  with any signal success.
  The warm bath  is sometimes found  serviceable.  The cold
bath applied to the inflamed part, both by effusion and immersion,
has, sometimes,  resolved  the inflammation.  The  volatile lini-
ment, with laudanum, is a good  local application.
  The strychnine, a new salt, procured from the  nux vomica,
should be tried.
  In the chronic stage of the disease, it will often  be necessary
to strengthen the system by the use of quinine, columbo, gentian
and preparations of iron.   The red rust  of iron, taken in a dose
of a scruple at a time, powdered fine, and mixed  with syrup, has
been  found remarkably serviceable.  The chalyheate spring wa-
ters are an excellent way in which  to take the  iron.  The sul-
phur  spring waters,  in  Virginia, are highly recommended  in
chronic gout.   The veratrine, a new  medicine,  has lately been
much extolled.   The mineral acids are, in many cases, found to
be better  tonics than  either iron, or  the vegetable  bitters.   The
The guaiacum is an old and justly celebrated remedy in chronic
gout.
   GRANULATION—The  formation of new flesh.—In the re-
newal of  dead parts, the process of creating the flesh anew con-
sists in the growth of little grain-like particles, which gradually
unite into larger ones, until^they fill  up the old part.  They are,
when healthy, of a deep red color, and never rise above the sur-
rounding  surface.   Proud  flesh is  an  unhealthy granulation,
which requires the  use of remedies.
  GRAVEL, AND STONE.—The size of the stones  which
are formed in  the  urinary organs, varies from that of the mere 
286
GRA.
atoms which compose sand, to  that of a stone, large enough to
fill the whole bladder.  In  the gravel, that is, where the stones
are small, consisting of mere grit, or sand, the disorder lies prin-
cipally in the kidneys.   In this case,  there  is pain in  the loins,
which shoots down towards the thighs, and which is sensibly in-
creased in attempting to walk or stoop.   The water, when passed,
deposits a gritty, or sandy sediment.   The settlings of the urine
discover little sandy particles.  There will,  sometimes be  more
or less mucus, or blood passed with  the  urine.  The pain and
distress will often come on very suddenly,  and be very violent,
occasioning  sickness at the stomach, and  vomiting.   When a
gravel stone drops from the  kidney, of a size which is sufficient
to fill the calibre of the ureter, the  duct  which leads from the
kidney to the bladder,  the urine is blocked up, and  distends the
ureter, which produces the most  excruciating pain, and often
fainting.   After the  gravel reaches the bladder, the  pain ceases,
until many particles, by collecting together, form  a stone.   Dur-
ing the  passage of the sandy particles, or  gravel  stones from
the kidney  to  the  bladder,  and  until they have been  void-
ed,  the urine is  of a high red, or of a dark brown color, and
shows that the small blood vessels have been torn open by the
sharp points  of  the  gravel.   If the urine  is long obstructed by
the gravel, there will be great uneasiness, heat, thirst, a quicken-
ed pulse, dryness of the skin, costiveness, loss of sleep, and finally,
if not relieved, an intermitting pulse, convulsions, mortification
and death.
  The cause of this disease is very obscure.  The disease appears
to be owing to the formation of an imperfect urine  by the kid-
neys.  The urine always contains a sediment, or settling of a red-
ish color, which, when it comes to be dried and examined, chem-
ically, is found to consist of the same ingredients which compose
the stones in the bladder.  The urine contains a number of acids,
alkalies, and  earths, which, when they exist in wrong propor-
tions,  readily concrete into sand, gravel,  and stones, and produce
the disease in question.  There are no less  than  seventeen dif-
ferent chemical principles, in the composition of the urine.  It is
the most complicated secretion in the whole  system and liable to
the most imperfections in its elaboration.
   Children, from infancy to puberty, the intemperate, and elderly
people are the most  liable to it.  Fermented liquors,  such  as ale,
beer, cider and wine are supposed to produce it.
  This disease  comes  on by fits, in those  who are afflicted with
it.   In some, it returns after short intervals, and, in others, it
will not appear  for years.
   Domestic Remedies.—If the disease comes on  with great pain
in the back, nausea, vomiting, fainting,  and a suppression of the
water, or great pain in passing it, it will  be advisable to give a 
GRA.                        287
dose of laudanum, or of morphine.  From three to ten drops to a
child ;  and from thirty drops to a tea-spoonful to a grown person.
After the opiate has  relieved  the pain and  distress, the person
should be put into a  warm  bath, and made to  drink freely of
warm rain or  spring water.   A tea-spoonful of the sweet spirits
of nitre should be given every hour, in a tumbler full of cuckold
weed or parsley tea.
   A tea made of the uva ursi, bear's berry, or upland cranberry, is
an excellent medicine in this disease.  A tea-spoonful  of the
cream of tartar, dissolved in a tumbler full  of the uva ursi tea,
and drank every hour, relaxes the kidneys, and causes a great
flow of the urine.
   The  garden  leek, sometimes, affords great relief.  Take  a
handful of the root or fibrous parts, with a  few sprigs of fennel,
and boil them in two quarts of water, over a gentle fire, until
the half is evaporated ; then pour off the remainder, strain it, and
drink about a pint a day.  A steam raised  about the lower part
of the back and belly, by the use of cloths, dipped in hot water,
or boiled herbs, tends to relax the urinary ducts,  and to hasten
the  passage of the gravel.  The drink should be pure spring or
rain water, gruel, rice water, gum arabic water, and flax-seed tea,
in addition to the teas we have already mentioned.   The  bowels
should be drained by the use of a dose of oil, salts, or calcined
magnesia.  Copious  injections of warm  water,  will favor  the
passage of the gravel.  Lemon juice, mixed with  the  salts of
hartshorn and drank in a state of foaming, is a cardinal remedy in
a fit of  the  gravel.    A tea-spoonful  of the  powdered  salts of
hartshorn, may be  stirred  into a great spoonful of lemon juice
and two great  spoonfuls of water.   This  forms the acetate of
ammonia, or spirits of mindererus.
   A weak lye, made from wood ashes, and drank  two or three
times a day, though a homely remedy, is a very good one.  Ten
 or fifteen drops of the water of ammonia, mixed with a tumbler
 of water,  and drank, every two or  three  hours,  during the day,
 and continued for two or three weeks, has been found to destroy
 the tendency in the urine to concrete into gravel.   It is supposed
 that the predominancy of an acid in the  urine, called the uric
 acid, is chiefly  the cause of the formation  of  stones and gravel;
 and that alkalies have  a  tendency to  neutralize  this result.
 Where alkalies fail, it will be advisable to employ acids,  such as
 lemon juice, vinegar, cream of tartar, sulphuric, muriatic and
 nitric acid, upon the ground, that,  the earths and  alkalies may
 predominate in the urine, and  so produce the calculi  or stones
 and gravel.
   The chalybeate mineral waters, or those which contain iron in
 solution, are sometimes completely effectual in checking the for-
 mation of gravel in  the kidneys and bladder, in this disease.  We 
288
GRA.
should place them in the foremost rank of remedies.   We would
therefore advise all those who are afflicted with  this disease, to
repair to some of the springs with which our country abounds,
and to abide there as long as the water  is found to make them
better, or until  health is restored.   The cathartic mineral wa-
ters are, in many cases, as serviceable as the chalybeate waters.
The congress water has been designated  as peculiarly beneficial,
in the gravel.
  An abstemious diet is of the highest  importance in this dis-
ease.   Where there is an appetite and but little fever, the aliment
should consist of milk, custards, eggs, and broths made of chick-
en, veal, beef and mutton.  A moderate quantity of  fresh meat
of any kind may be eaten once a day, but not oftener.   If there
is any considerable degree of fever, the diet should be  entirely
restricted  to  vegetable substances, bread, rice, fruits, potatoes,
beans, onions, beets, carrots, turnips, &c.   We take the  follow-
ing paragraph from Good's Studies of Medicine :
  " Of  the  mischievous effects of a  luxurious diet, and the ad-
vantage of abstinence, M. Magendie has given  a very  striking
example in the case of a merchant of one of the Hanseatic towns
who was habitually afflicted with the  complaint  before us.   ' In
the year 1814, this gentleman,'  he tells us,  ' was possessed of a
considerable fortune, lived in an appropriate style, and kept a very
good table, of which he himself made no very sparing use.   He
was at this time troubled with the gravel.   Some political mea-
sure unexpectedly took place which caused him the loss of all his
property,  and obliged him to take refuge in England, where he
passed nearly a  year in a state bordering upon extreme distress,
which obliged him to  submit  to numerous privations;  but his
gravel disappeared.  By degrees he succeeded in re-establishing
his affairs, he resumed his old habits of luxurious living,  and the
gravel very shortly began to return.  A second reverse, occasion-
ed him the loss  of all he had acquired.  He went to France al-
most without the means of subsistence,  when his diet being in
proportion to his exhausted resources, the gravel again the second
time vanished.   Again his industry restored him to comfortable
circumstances ; again he indulged in the pleasures of the table,
and had to pay the tax of his old complaint.' "
  An  abstemious diet,  pursued only for a few days,  or a
few  weeks, is  seldom  productive  of  much  good  effect,  un-
less  it  be  in very acute inflammation.  In chronic  inflamma-
tions  and diseases, the abstemious diet must be chronic also, by
which we mean, it must be pursued until, the disease  is conquer-
ed, be it for a longer or a shorter time.  The length of no disease
can be  measured by hours and days, neither should  the means
adapted to its cure be restricted to time.
   While the kidneys and the ureters are the seat of the disease, 
GRA.
289
or while only sand and small gravel  are formed in the urine, a
vegetable diet and some active  occupation  will,  in most cases,
cure the disease.  Sedentary people are much more disposed to
the disease, than those who are engaged in the active pursuits of
life.  Activity,  therefore,  must be ranked among the essential
means of cure.
   Rain  or spring water  is  much preferable  in this  disease,
to the use of well water.   Well water,  always  contains more or
less earthy and mineral substances, which make it hard.  There
may be some  danger that these earthy and mineral particles may
lodge in the kidneys, and  assist  in the formation of the gravel.
We believe it would be much better  for the health of mankind,
if they never were obliged to drink any other than rain or spring
water.
   Sailors are said to be remarkably exempt from the gravel.
   Professional  Remedies.—The assistance of  the physician is
often required in this disease, to draw off the water.  After the
gravel stones become so large as to block up the common urinary
passage, the bladder often becomes distended with urine, which
must be drawn away by the  catheter, or mortification and  death
would often ensue.  The irritation and inflammation which the
stones produce in the bladder, come  on by fits.   In these cases,
absolute rest  is required,  and, sometimes, blood-letting.   The
first concern is to  keep the  bladder free from distention, which
can be judged of by the quantity  of water passed, by the swelling
of the bladder externally, and the sensations of the patient.   The
catheter is a glorious invention, and has saved many a life.   The
bougie  is often of indispensable utility  in enlarging  the urinary
passage, and in facilitating the transmission of the gravel stones,
which,  when, they are of  a moderate diameter, can often be
made to pass the urethra, by a little assistance.   Lithotomy is a
formidable operation,  but the  necessity  of the case will,  some-
times, demand it.   We like the operation  of drilling and break-
ing up the stones  in  the bladder much better.   But, to the re-
proach of our country,  there is nobody to perform it.  We live
in hope that some discovery  will yet be made,  of a liquid or a
fluid substance, which, injected into the bladder, will completely
dissolve  the stones, as fast as they are formed.   Such  a discovery
looks to us exceedingly probable.  The urine itself is not a Bland
substance, for  when  taken into  the  stomach, or applied to the
skin, it excites irritation, although to the coats  of the bladder it
is  completely innocuous.   There is,  therefore,  a pretty wide
field for hope, that some solvent of the stones  may yet be dis-
covered, which may be introduced into  the bladder, without irri-
tating, or inflaming it; and  that the stones may be  passed in a
state of solution.
   The liquor  potassse, in doses of fifteen or twenty drops, three
            37 
290                        GRE.
times a day, in a tumbler of sweetened water, is one of the most
valuable  remedies, especially in those cases in which the urine
deposites a red sediment, indicating an excess of uric acid.
  GREEN SICKNESS, OR SUPPRESSION AND RETEN-
TION OF THE  MENSES.—The green sickness is exclusively
a disease of females.  It arises from the want of the sanguineous
secretion which distinguishes womanhood from childhood.  This
secretion called the menstrual discharge or the menses usually
commences in our climate about the age of fourteen.  In south-
ern climates it commences earlier,  by two or three years.  Under
the equator it commences  as early as the ninth year, and what
we consider as a child, is there capable  of  becoming a mother.
In our climate, girls frequently go until  they are fifteen and six-
teen  years of age, and, sometimes, seventeen  before this secretion
takes place;  but  fourteen years is the average age  of its com-
mencement.  With some among us, it begins as early as the age
of eleven or twelve.   The want or absence of this secretion does
not constitute a disease until it affects other parts or the whole
of the system.
  When a  girl has passed  the age of fourteen, without the ap-
pearance of this secretion, and begins to  complain of lassitude,
heaviness, weakness, palpitation of the  heart, pain in the small
of the  back and loins,  costiveness, indigestion, wind in  the
stomach and bowels, amounting sometimes to colic, and the coun-
tenance and whole skin become pale, or of a greenish yellow, we
may be sure that she has the green sickness.  In this disease they
usually become black under the eyes, and the lips become deadly
pale  ; they are timid and shy.   As the disease continues, the feet
and  legs begin to swell and dropsical symptoms  appear in other
parts of  the  body;  the pulse  will be quick and small, and the
person put  out of breath on  the slightest  exertion.  Hysteric
feelings, and spasms  in  the stomach are very  common; and,
in some cases, there will be a cough and night sweats.   Indiges-
tion  or  dyspeptic symptoms are very common attendants.  The
stomach and bowels are often so  much affected as to lead to the
suspicion that they are the seat of the disease.
   The cause of the retention, or  the suppression of the secretion
after it has once made its  appearance  is not known.  It may be
such a state of the womb as takes place in the other glands in a
fever when there is a retention of the saliva or a suppression of
it, or in  the skin  when there is a  suppression of the perspiration.
The mere want of this secretion must not be considered as a dis-
ease unless the general health is deranged by it.  If the general
health has suffered from the suppression of this secretion, it com-
monly improves as soon as the secretion  has become established
and  regular.  Sometimes  the  secretion will commence and ap-
pear a  few times, and then disappear for  a long time, but if it 
GRE.
291
does not injure the general health, it needs no particular attention.
In point of practice, it makes but little difference whether the
menses have never appeared or whether the secretion has  once
commenced and afterwards been checked.
  The most natural cure for this affection is marriage.  Any con*
siderable change in the mode of life, especially where that change
affords an agreeable excitement to the mind, and adds vigor to
the circulation of the blood, will operate very favorably upon the
complaint.  A removal to a warmer climate, or from the town to
the country will often  give new impetus to the circulation of the
blood  and awaken the  proper action in the uterine vessels.
  Nothing has more effect in regulating the natural, monthly se-
cretion of the uterus, than daily, systematic exercise.   Some
kind of work  in which the whole system is  exercised, is always
more efficacious, than mere  walks for pleasure, or even riding,
which are never pursued constantly enough or carried to a sufficient
extent, to  be productive  of a cure.   Girls who  are  always
upon their feet,  in the  open air,  and who  are very  active at
play or work, are seldom much troubled with this complaint.—
Nothing gives impetus to the blood and distributes it to every
part of the system like exercise.   Breathing the open, fresh air
also contributes very much to enliven the blood.   The breathing
of oxygen gas has been found effectual in the cure of the green
sickness ; what  an inducement then for such  invalids  to live
much  in the open air where they must necessarily breath a larger
portion of this vital gas than can be obtained within doors.  Even
the rays of the sun, and the light  have very considerable influ-
ence upon the general health.  It  is almost of as  much conse-
quence for people to take the sun as to take  the air.   Through
the medium of the eye the light affords an agreeable stimulus to
the brain and  to the whole system.   The rays of the sun also ex-
ercise an important influence  upon the skin and capillary vessels.
Riding on horseback  is a healthy and agreeable exercise where
it can be  pursued daily for  a considerable length of time.   A
nutritious diet composed chiefly of vegetables, though, not exclu-
sively, constitutes a very considerable part  of the  cure.   Milk,
eggs, and poultry together with vegetables, form a  very suitable
diet.   Wine and warming bitters will often be found of great
service.
   The medicines which are the best calculated to restore this se-
cretion and to establish it, are chalybeates or medicines in which
iron makes a  part; and purgatives.  Among the chalybeates, the
Griffith's mixture is probably the  most efficacious of  any; and
among the purgatives, aloes is by far the most preferable.  Where
the green sickness has become established, two or three,or four pills
of aloes, should be taken every day or two for at least two months,
if the  desired  effect is  not produced before.  At the same time,  a 
292
GITA.
table-spoonful of the Griffith's mixture should be taken twice a day.
The precipitated  carbonate  of iron in doses of a level tea-spoon-
ful, mixed in molasses or syrup twice  or  thrice a day, is one  of
the most potent and agreeable remedies.   Pills of iron rust may
be used instead of Griffith's mixture.
   Two pills of iron rust of the common size, may be taken at a
time.  The iron must be finely powdered and mixed up with a
crumb of bread or a little flour and molasses.
  The red centuary has a very considerable effect in restoring the
healthy tone of the uterus.  This medicine should always receive
a trial; it is given in the form of a tea or infusion, and should be
persevered  in for a  length  of  time.   The thoroughwort taken
every day for a month or two has often effected a cure.  Tansy
tea is not only an old remedy, but a very excellent one.  Warm
bathing, by which the blood is determined to the surface, is  of
great use, especially bathing the feet and legs.  Bathing the sur-
face over the uterus with hot cloths dipped in decoctions of pen-
nyroyal and tanzy are also extremely serviceable.
  This secretion should be particularly solicited by hot bathing,
and the other remedies above-named, at the expected time of its
return, whenever it can be ascertained by the pains  in the back,
sense of bearing  down,  and  other  symptoms common to the
monthly sickness.
  A visit to Saratoga or  some  other iron  spring  should always
be tried where the cure is procrastinated.  We believe the waters,
at Saratoga, are peculiarly well adapted to the cure of this com-
plaint.
  The steam of warming herbs applied topically should always
be used about the time of the  monthly period.  The elixir pro-
prietatis and the tinct. of guaiacum are very appropriateTemedies,in
the disease.   The pil ruef is often serviceable.  Emetics are some-
times effectual when other remedies have failed.
  GUAIACUM.—The  gum guaiacum is a resinous substance
obtained from the lignum vitas tree  which grows in  the West
Indies.   The wood  of this tree is  highly medicinal.  A strong
tea made of lignum vitse chips will open the pores, increase the
flow of the urine, and operate  gently upon  the  bowels.  It is a
warming aromatic.   Guaiacum is hard, brittle, of a greenish yel-
low color, and of a bitterish, hot taste.  The powder  in a dose  of
half a  drachm promotes  the urine, and raises a sweat.   In  a
larger dose,  it operates upon the bowels.   It possesses nearly all
the hotness and purgency of red pepper, besides its disposition  to
open the pores and relax the kidneys and bowels.  In the chronic
rheumatism, it is excelled by no other remedy.  In all complaints,
where there is no fever and  the body is cold, the guaiacum  is a
valuable medicine.   It has been given with success in palsy and
the dropsy.  In diseases of the skin,  it  exerts considerable effi- 
HAI.
293
cacy.  The tincture in the dose of a tea-spoonful is the common
way of giving it.
   GUINEA WORM—Dracunculus.—This worm is one or two
feet in length, and about the size of linen thread.   The egg, or
germ of  it  is in  some  way deposited  under the skin, where it
produces a swelling and inflammation, and, finally, an ulcer.
   The worm, coiled up in its nest of flesh, continues to grow,
until its  head protrudes through the skin.  It is peculiar to Afri-
ca, and the eastern  nations, but sailors  who  visit there, and the
natives who come from there,  are  liable to be  infested with it.
The only remedy for it  is  to pull the worm out.   This cannot,
however, be done until after it has got its growth, and the tumor
or boil in which it is imbedded, has suppurated and broke.  The
tumor is never very painful.  It is sometimes poulticed, like
other tumors.
   GUM   ARABIC—Mimosa  Nilotica.—This  gum  consists  of
round, transparent tears, without taste or smell.   It comes from
Africa, Arabia, and Egypt.   It is very tenacious, and well calcu-
lated for a medium  to form pills and other ingredients. Dissolved
in milk to the amount of three ounces  a day, it  is said to have
cured bleeding at the lungs.  In affections of  the bowels, such
as dysentery, diarrhea, and cholera morbus, dissolved in water, it
is an excellent demulcent.   It is no less useful in coughs and af-
fections of the throat and lungs.   It readily  dissolves in water,
and forms a mucilage.
   It is nutritious, so much so,  that the Moors, are said, in the fall
of  the year, to live upon  it.   In a stoppage of the water, and
affections of the urinary passage, the mucilage is one of the best
medicines we possess.
   GUTTA SERENA.—An affection of the  optic nerve.  See
Dimness of Sight.
                             H.

   HARDHACK.—The stem of this plant grows to the height
of about two feet, with yellowish flowers, and large, thin leaves,
of the shape of a heart.  The tops are the parts used in medicine.
It is a mild astringent.  Its taste is warm and pungent, and its
smell is aromatic.   In bowel complaints, where a mild warming
astringent is required,  the hardback is a useful medicine.  The
tops are made into a strong tea, and taken, three or four times, in
the course of a day.   It is sometimes applied as a healing wash
to ulcers, sores, and bruises.
  HAIR-LIP.—A slit in one  or both lips.  It is a deformity 
294
HEA.
with  which children are often born,  and which can  only be
remedied by a surgical operation.   The edges of the opening are
deprived of their skin, and brought closely in contact, by stitches
and plasters, when they grow together.
  HEADACHE.—In all febrile diseases, headache, is generally,
one  of  the first symptoms ; and  in the inflammations of other
organs,  a  pain in the head is very common, but the complaint
which we mean to treat of here, is  not a symptom of other  dis-
eases, but a  real affection of the brain,  and of the membranes,
and  bones which  enclose  it.   The bones  and  membranes are
often affected with rheumatic inflammation,  and the brain itself,
is liable to the same diseases as  other organs,  to irritation, weak-
ness, inflammation, tumors, abscesses, and dropsy.
  The seat of the headache  is  variable.  Sometimes it will be
confined to the forehead, at other  times,  to  the temples, and at
others again, to one side of the head.  In some instances, it  will
be deep seated, and, it will appear to arise from the bones of the
head or  the membranes.  The sensation of pain is the only guide
we have, with respect to its seat.   In  some  individuals, it  will
be attended with nausea, or sickness at the stomach ; in this case,
it is called the sick headache.  The  pain in some cases is dull and
heavy, and affects the whole head, and, in other cases, is sharp, dart-
ing,  or throbbing.  The headache varies in its duration, from  two
or three hours, to one or two days.   In many people, it is periodi-
cal, recurring every day or every other day, at a particular hour or
every two or three weeks.   The headache is commonly without
heat, thirst, dryness of the tongue, or any other symptom of fever.
It is relieved by vomiting and sleep, and increased by noise, light,
and motion.   The scalp and bones of the head, will often  feel
very sore  to the touch ; the countenance and eyes will be flushed
and the pulse quick.  The soreness always evinces a degree of
inflammation.
   The sick headache usually comes on  in the morning,  and is
generally  attended with a vomiting of bile or phlegm.   The  pain
darts from one part of the head to  another, until every part has
been affected in succession.   Sedentary people  are  the  most
severely afflicted with it.   With many people, the headache  will
always  occur in a particular  spot,  and that  spot will not be
larger in circumference, than a  ninepence or a quarter of a dollar.
The appetite is destroyed for the time; and the mind is incapaci-
tated for any employment.  Nervous people are extremely liable
to this form of headache.
   The  hemicrania, where the  pain  affects one side of the head,
usually occurs in the  evening, or soon after the digestion  of the
dinner.   This form of the headache is also, sometimes, attend-
ed with sickness at the stomach.   It affects people, in whom the
digestive  organs are diseased, and  who are subject to hypochon- 
HEA.
295
drism.   It will, however, in some instances, affect those who are
no otherwise diseased.
  The chief causes of  the  headache,  are some violence done  to
the head ; tumors ; abscesses; an effusion of water in the brain ; a
check  of the perspiration,  or too long an exposure to cold and
damp ;  dyspepsia; and a disease of the nerves.   It will often  be
brought on by hard study ;  anxiety and perplexity in business ;
by  extremely hot, or  extremely cold weather; by too great a
degree of the light of the sun, after a long spell of  cloudy weather.
Whatever disturbs the  nerves, in general, will, in many people,
bring on a fit of the headache.   Excess, in eating and drinking,
is a prolific  cause of the headache.   Old writers, oftentimes,  at-
tribute it to the suppression of accustomed secretions, and the
running of old ulcers;  and the  transition  of humors, but these
causes are extremely doubtful;  they have been  repeated by one
writer after another, from the earliest  ages, without having been
thoroughly examined by any.
   Domestic Remedies.—Where there  is no  fulness of blood in
the head, which is known by the pulse and the swelled, and red
state of the blood-vessels of the face and eyes, an emetic of ipecac,
lobelia, or antimony, will be trie most certain way of removing
the pain.  Immersing the feet in warm water, and drinking plen-
tifully of hot herb teas to produce a  sweat, will often be suffi-
cient.   Catnip, pennyroyal, motherwort,  thoroughwort, sage,
spearmint or peppermint, are either, or all well calculated, when
infused in hot water, to raise a  perspiration.  The application of
cold water, if continued for half an hour, or an hour, will often
remove a headache.  Vinegar,  will  accomplish  the same  thing,
if the head is thoroughly soaked with  it.  The spirits of camphor,
or any kind  of ardent  spirits will cure a fit of the headache, if
used as a bath.  Cologne water, applied freely to the head, is an
old and very effectual remedy.
   The most obstinate headaches have, sometimes, been cured by
drinking a tumbler of cold water soon as the person arises from
bed, in the morning, and by soaking  the  head or showering it
with the same.                                             +-
   Equal parts of James' powder, and  aloes,  made into four pills,
of the common size, and swallowed, at night, are often found to
prevent, and to cure the headache.   These pills will open  the
pores at the same time  that they unload  the  bowels.  Twenty
drops of morphine, or of laudanum, where there is no fever, will
succeed in many cases.
   Professional Remedies.—Nothing will relieve some headaches,
but the abstraction of blood, and where the blood-vessels of the
head are crowded as they often are, it is  the most natural reme-
dy.   Leeches  will,  however,  answer the purpose much better
than opening  a vein, in a majority of cases.   Sometimes,  it will 
296
HEA.
be necessary to strengthen the whole system by the use of bitters,
iron,  and mineral waters.   Where the headache arises from a
bilious stomach, or disorder of the digestive powers, attention
must  be paid to the restoration of these organs, before a cure can
be  expected.   Blisters upon  the  neck  or arms are   often of
great  service.  Valerian,  ether, castor,  cicuta,  or musk, are all
beneficial in certain cases and constitutions.  Spirits of Hartshorn
and other alkalies, will help some cases, especially where there is
much sourness of the stomach.  The calcined magnesia, admin-
istered as a cathartic, every day, for a length of time, will regu-
late the stomach and bowels.
  Where the pain appears to be in the bones of the head, it may
be inferred to be  rheumatic,  and to require the same treatment
with  rheumatism in general. The tincture or powder of guaiacum,
and the quinine will be proper.   The Dover's powder may be
given every night, and the. sal nitre, in powder, during the day.
There is no more powerful nor surer remedy, in chronic  rheuma-
tism,  than  the  sal nitre.   It should  be given in  six grain
doses, every  three hours.   Mustard poultices,  to the feet, are
often  productive of relief, in severe headaches.   In  these  cases,
the diet should always be light, and the drink bland and simple.
Cold water and common tea and acid drinks are the best.
  HEART—The human  heart is shaped very nearly  like the
heart  of  quadruped animals, particularly that of the hog.   If a
person has seen the shape  and the situation of the  heart in the
hog, he can form a pretty good idea of the same  organ  in man.
The heart is enclosed in a case called the pericardium, and lies a
little  on the left side of the chest, so that the beating of the heart
can be much better felt and heard on that side than on the right.
The  apex or point of the  heart  is  placed on the sixth rib
of the left side, and its under surface rests upon the diaphragm or
the partition between the chest and the belly.   The  heart  has
four separate chambers, two of which are called auricles and the
other  two ventricles.   The auricles are smaller than the ventricles.
The blood passes from the veins into the auricles or front cham-
bers, and from the auricles into the ventricles.  It enters the right
auricle, passes through this into the right ventricle, and out of
the right ventricle into the lungs; there it receives its vital prop-
erties, and  then passes back again into the left  auricle of the
heart, and  from this into the  left ventricle, and  thence  into the
aorta.   Between the auricles, there are valves to prevent the blood
from being forced back when the heart contracts, and to support
the column of blood beyond them.   The heart  is a muscular
substance, and by the manner in which its fibres are interwoven,
is endowed with remarkable strength.
  In  the  foetus,  the  blood passes  immediately  from  the right
auricle to the left, through  a hole called foramen ovale which 
HEA.
297
 closes up the moment the child is born.   In the foetus the blood
 does not pass through the lungs of the child, but receives its vi-
 tality from the lungs of its mother.
   HEART-BURN—Cardialgia—Pain at the pit of the stomach.
 It is one of the symptoms of dyspepsia.  The pain is accompanied
 with acrid, hot, and sour eructations.  Sometimes there is faint-
 ness, and oppression of the  stomach, with wind, and a discharge
 by the mouth, of a watery, ropy fluid.  A  little lye made from
 wood ashes, calcined magnesia, a few drops of  the water of am-
 monia, or  which is better than either, a little piece of crude soda
 dissolved  in water will correct the sourness and quiet the pain.
 The bowels should be kept open, and  the diet should consist of
 substances not  liable to  ferment.   See Dyspepsia and Water-
 brash.
   HEARTCASE—PERICARDIUM.—A transparent, membra-
 nous  bag  that  surrounds the heart  and secretes a watery liquor
 which lubricates its  surface.   A dropsy  of the heart takes place
 when the heartcase becomes filled with water.  This disease is
 known by a distress in breathing, an intermitting pulse, a pale or
 purple countenance and lips, and a fluctuating sound of the water
 in the beating of the heart.   See Dropsy.
   HEAT.—Heat is essential to life, and many have supposed it
 to be synonymous with life itself.  The young  of many animals
 appear to be called into life by the agency of heat alone.  But
 the  germ or egg is as essential as the stimulus which awakens it
 into life.   Chickens and many other animals are hatched  by  ar-
 tificial heat.  People apparently dead by drowning and strangu-
 lation, are resuscitated by heat.  It is probably the most powerful
 stimulant  in nature,  of the  vital actions.  Hence its  powers in
 exciting inflammations and inducing disease, as well as its prop-
 erties  of awaking  animal life.  Its diffusibihty exceeds other
 agents as much as its solvent power.   The proper application and
 regulation  of heat is one of the greatest means in curing diseases.
 A fever may be induced, moderated, aggravated, or cured by a
 mere change of  the temperature.  An inflammation may be ex-
 cessively aggravated,, or it may be subdued by a greater or less
 degree of heat.   A proper degree of heat increases the circulation,
 raises the spirits, promotes the secretions, and invigorates the whole
 system.  It stimulates the powers of the mind as well as of the
 body.   The verdure of spring  and the ripening influence of sum-
 mer  will give us some idea of  the wonderful agency of heat and
 its power in generating and curing disease.   It  is  essentially a
 stimulant.
  HEAT  ERUPTION OR  PRICKLY HEAT. —We take
notice  of this eruption more for the purpose of throwing  some
light upon  the  nature  of  other skin-diseases, than  because the
heat  eruption deserves any particular attention in a medical trea-
            38 
298
HEA.
tise.   It is allowed on all hands that this eruption is produced by
heat alone, either  by the heat  of the direct rays  of  the sun or
some violent exercise of the body.   No suspicion has ever fallen
on the digestive organs as the  seat of it.  In  this disease, heat
either acts as a poison, or a stimulant, and produces an eruption
which resembles several  other kinds of eruptions, incident to the
surface of the body.  The only inconvenience which this eruption
produces,  is a slight smarting and  tingling,  which are  easily al-
layed by  a little new rum, cologne water, or  laudanum.  The
eruption  consists of  a multitude of little red pimples about the
size  of a head of a pin, which, in about a week or fortnight die
away and leave a little white scurf or scale.  The pimples con-
tain  a watery matter.  The heat spots are perhaps vesicles rather
than pimples, being often of the nature of little blisters.
  We here wish to make a few remarks with respect to eruptions
of the skin in general.   We think they  are too often ascribed to
disorders  of  the stomach  and  bowels, or to acrid humors in the
blood or in the other fluids of the system.   If  such an agent as
heat can produce an eruption  of the skin in a perfectly healthy
person, there may be a hundred other agents capable of producing
the same thing without any particular affection of the  digestive
organs or  of the fluids of the body.   Dirt and filthiness  are be-
yond a question often the causes of diseases of the skin, and they
probably act  upon  it something in the same way with heat.  We
are also inclined to believe that many diseases of the skin are owing
to some  peculiar constitution of the atmosphere ; having often
noticed that some  particular kind of eruption of the skin, as the
eating tetter  for instance, has prevailed very much like an  epi-
demic among children.
  The salt rheum will prevail  much more in some seasons than
others.  One constitution of the atmosphere will produce an epi-
demic influenza ; another  an epidemic  sore throat; a  third will
produce an epidemic  peripneumony; and a fourth, an epidemic
dysentery, rheumatism, or  fever.   Why  a particular state of the
atmosphere should affect the  throat in  preference to  the lungs,
or the bowels in preference to the throat, we are unable to deter-
mine, but  such are  the facts, and we believe  the skin is often
affected with different eruptions from the same  cause.    The skin
is often affected with sores in  consequence of  eating fruit,  par-
ticular*/ sour apples and those fruits  in which there  is a great
excess of acid.   In this  case, either  the acid or  some other
quality of the apples affects the skin particularly, since all other
parts of the body remain sound.
  Mercury affects  the salvary glands especially.  Nitre affects the
kidneys ;  salts, the  bowels;  squills, the lungs; and  acid fruits,
the  skin.    There is no doubt but that the whole vegetable and
animal kingdoms,  more or less, partake of the constitution of the 
HEM.
299
air of the season and influence the human body in whatever we
eat. The sting of a wasp produces a peculiar pustule ; the sting
of nettles produces a different pimple; and dogwood, a very exten-
sive and painful eruption atttended  often  with much swelling
and inflammation.   It is very probable that most eruptions of the
skin will, if their causes are ever known, be traced to some pe-
culiar state of the  air, or to some  noxious agent applied either to
the skin or to the stomach.
  HECTIC  FEVER.—The hectic fever  does not oceur as a
disease  of itself, but  is symptomatic of other diseases.  It is a
pretty uniform attendant of  consumption, and often results from
chronic diseases of the stomach, bowels, liver, kidneys, and brain.
Any deep seated and  extensive injury of the bones, or essential
organs may be followed by  this fever.   It  is often  witnessed in
scrofula, chlorosis or green sickness,  nervous affections, insanity,
and  dyspepsia.  The hectic fever has two exacerbations or fits
of severity, in a day; one commonly occurs about noon, and the
other, in the  evening.  They go  off with profuse sweats, some-
times, called  night sweats, and are  succeeded by remissions or
abatements.   There  is usually a small, quick  pulse, moderate
thirst, restlessness, and a lateritious sediment to the urine.   This
fever can only be cured by curing the  disease upon which it de-
pends.   The quinine, columbo, cascarilla, opium, sal nitre, sweet
spirits of nitre, wine,  elixir vitriol and the other mineral acids, are
all given with more or  less  freedom in the latter stages of the
disease.
  HELLEBORE—Helleborus Niger.—This plant grows wild in
the mountains of Austria and Italy, and  is perennial.   It is a vi-
olent purgative and was formerly much used in melancholy and
insanity.  The proper dose for a purgative is from ten to twenty
grains.   The root  which is the medicinal part, consists of  small
fibres attached to  one head.   It  yields a resinous extract, upon
which  its  virtues appear to depend.    Its  taste is very acrid.
In the  dropsy and chlorosis, it has  been highly recommended.
The American or white hellebore or bear's foot grows in our own
meadows, and has been used to destroy worms, but is considered
too violent for common use.
  HEMATEMESIS— A vomiting of  blood.   See  Bleeding
from the Stomach.
  HEMATOCELE.—A tumor caused by blood being let loose
in the scrotum or  spermatic cord.
  HEMATURIA.—The voiding of blood from the urinary organs.
See Bleeding from the Bladder and Kidneys.
  HEMICRANIA.—A pain which affects only one side  of the
head.   It is  commonly periodical, occuring at longer or shorter
intervals in different  individuals.   Bilious, nervous, and hysteri-
cal,  or hypochondriacal people, are the most subject to it.  The 
300
HEN.
extract of cicuta or hemlock, has been known to relieve it.  It
requires rest, opening medicines, and temperate living.   A leech
or two, or a blister, applied to the painful spot, will often remove
the pain.   See Headache.
   HEMIPLEGIA.—A  palsy  of one  side  of the  body.   See
Palsy.
   HEMLOCK—Conium  Maculatum—Common Cicuta.—This
plant is indiginous to our soil. It grows in great abundance, in rich,
shady places, and by the side of hedges and fences.  The stalk is
hollow and marked with red and brown spots.  It grows to the
height of five or six feet, with leaves of a dark green color, which
have a faint disagreeable smell.  It is a powerful narcotic, or, in
other words, it resembles opium,  in  its effects upon the system.
Unlike opium, however, it does not produce  costiveness.  The
leaves powdered, may be used, or an extract can be procured from
the leaves and stems.
   A dose of the  powdered leaves is two or three  grains, and a
dose of the extract, one  grain,  gradually increased.  When taken
in an over dose, it causes dizziness, sickness at the  stomach,
tremors, stupor, and convulsions.  The cicuta,  mixed with  the
red rust of iron, is much used  in the cure of insanity.  In can-
cers and scrofula, it has  been long celebrated.   In consumption,
its powers have been no less esteemed, than in the alleviation of
painful cancers, and the  king's evil.
   In scirrhous affections of the stomach, and liver, and in painful
menstruation, few remedies have been attended with more bene-
fit.  It has been known to relieve  that painful affection of  one
half of the head, called  hemicrania.  The way to use it with ef-
fect, is to increase the dose by one or two grains, every day, un-
til a slight degree  of dizziness is felt  in  the  head.  The plant
should be collected anew,  every year, and the  extract made by
evaporating the liquor of  the  boiled leaves, by means of a  salt
water bath, kept at the boiling point.
   The hemlock, well prepared, and,  in  a  fresh  state,  is one of
the best narcotics in use.   There are few painful affections, but
what may be relieved by it.
   HEMOPTYSIS—Bleeding from the lights or lungs.   See
Bleeding from the Lungs, or Lights.
   HEMORRHAGE—Bleeding,  or voiding of blood.
   HEMORRHOIDS—Piles—See Piles.
   HENBANE—Hyoscyamus  Niger—Black Henbane.—This is
a biennial plant, which abounds  in  villages and by the side of
roads.  It is covered with long hair, from which exudes a sticky,
fetid juice.  The leaves are large and very soft.  The flower
cup is of a pale, yellowish color, beautifully veined with purple.
The Henbane is a  narcotic, and more than any  other, resembles
opium, in its action.  It is given in the form of an extract.  The 
HOR.
301
dose is from one to two  grains.   In epilepsy, hysterics, palpita-
tion, and many painful  and spasmodic  diseases, it is used with
much success.
  HEPATITIS—Inflammation  of the  Liver.—See Inflamma-
tion of the Liver.
  HERNIA.—A rupture of the bowels.  See Rupture.
  HERPES.—A disease of the  skin, called tetter.  See Tetter.
  HIVE  SYRUP.—This  syrup  is  made  by boiling  together,
over a slow fire,  half a pound of seneca  root, bruised, and half a
pound of  squills,  bruised, in four quarts of water.  It must be
boiled until half of the water is consumed ;  strain the liquor, and
add to it four pounds of honey.
  Boil the honey and the strained liquor to  six pounds, and add
to every pound of the syrup sixteen grains of tartar emetic.
  This is a famous croup syrup, recommended by Dr. Coxe, of
Philadelphia.  It operates by puking, purging, and sweating.  It
is given  to children in this disease, every  quarter, half hour, or
hour until it operates well.  The dose varies from ten drops, to
one or two tea-spoonfuls, according to the age of  the  child.  A
child six months  old  may take  half a tea-spoonful,  and one a
year old, a tea-spoonful.  It is an excellent  medicine in common
colds, and coughs ; in peripneumony, and  whooping  cough, or
in any of the diseases of the lungs, or throat, where an expecto-
rant is required.
  HOT  DROPS.—This is a tincture of red pepper and myrrh.
It is a good medicine in chronic rheumatism,  and all diseases
without fever, and where there is a coldness of the constitution.
It increases the heat, quickens the circulation, and raises a sweat.
It is also a good external application.  Applied to swelled joints,
and to the surface of the body in inflammatory complaints, it an-
swers, in  a measure, the purpose of a blister.
  It is not a medicine which can be used long at a time without
impairing  the tone of the stomach.   Any substance  which
raises a blister upon the  skin, will, if taken too  freely, have a
similar effect upon the stomach.
  HOREHOUND—Marrubium Vulgare.—The horehound grows
among rubbish,  and by  the side of roads.  The leaves  have a
very  strong smell, and  a rough, bitterish  taste.  It is a good
cough medicine.   It loosens the phlegm, and promotes the rais-
ing of it.   In asthma and affections of the lungs,  it is an excel-
lent domestic medicine.  An infusion, or tea can be made of the
leaves,  and taken  every two or  three  hours through the day,
sweetened with honey.   When taken plentifully  it loosens  the
bowels.   Made into candy,  it makes a very pleasant  medicine
for  common coughs and colds.
  HORSE RADISH—Cochlearia  Armoracia—This  plant is
often cultivated in  gardens and sold in market for a seasoner of 
302
HYD.
food.  It has a penetrating, hot, smart taste, and a pungent smell.
The root quickens the circulation of the blood, warms the stom-
ach  and  bowels,  and promotes  all the secretions.   In  dropsy,
chronic rheumatism, green sickness, and palsy, it exerts no incon-
siderable power as a remedy.  Applied externally, it is a  forcible
stimulant.   If not taken too often  it  improves digestion and in-
creases the flow of the bile.
   HUMERUS.—The large bone of the arm, which extends from
the shoulder blade to the elbow.
.   HYDATIDS.—A very singular  parasitic animal  growing in
different parts of the body, and especially in  the kidneys and liver.
Hydatids consist of small simi-opaque bags  or cysts, containing a
clear watery fluid.  They are formed like a bladder, and  vary in
magnitude, from the size  of a  small shot,  to that of an  orange.
Though usually white, they are occasionally met  with, of an
amber color.  They are  found in all the  cavities  of the body,
not excepting the ventricles of  the  brain, and are generally  at-
tached to the large glands.   Sometimes they  are scattered  and
distinct, but oftener grouped  together in clusters.   It is not un-
usual for many  small ones to  be attached to the insides of the
larger ones.
   The origin and real nature of hydatids are not fully understood,
though it is generally admitted, that they possess  a  distinct ani-
mal  life ;  neither is it often  that their existence  can be known,
with any degree of certainty, until after the death of the patient.
This however, is not of as much importance,  as  it might at
first  seem, as their location is generally such, that  they could not
be removed, if their  existence were  positively ascertained.
   The existence of  hydatids may be strongly suspected, (when
they are so large or  numerous,  or so situated as to produce a tu-
mor  that can be felt externally,) by the roundness of the  tumor;
by the obscure sound on percussion; by the fluctuation, such as
is observed in dropsies ; and by a peculiar feel and sound commu-
nicated to the hand and ear  of  one who is experienced in this
department of the profession; aided by exploration  with an ex-
ploring needle,  where this can be practised with  safety.   Their
existence may, occasionally, be  certainly known by the escape of
some of them, through the natural outlets of the body, or through
accidental wounds or sores, a circumstance that sometimes occurs.
   Remedies.—In regard to  the  treatment of hydatids, but little
can be said.  The muriate of mercury has by some been thought
to have a special action upon them, causing their death and ab-
sorption, but this opinion has not been confirmed  by experience,
and  it is extremely doubtful whether any  known medicine can
have any specific effect upon them,  except in those rare cases, in
which they are  so  situated, that  the remedy can be  applied
directly to them, without going through the stomach and blood. 
HYD.
303
   Inflammation, sometimes, attacks  the cysts of hydatids, occa-
sioning more or less pain and soreness in the parts to which they
are attached, and  general disturbance to the system; when this
occurs, it should be promptly met, with the means usually employ-
ed  to  subdue inflammation in  other cases.   Should they be sit-
uated within the reach of the surgeon, they  should be punctured
or extirpated, as may be most expedient.
   HYDRAGOGUE—Medicines which drain the body of water
in dropsy, such as cream of tartar, sal nitre,  digitalis, salts,  and
squills.
   HYDROPHOBIA—Canine Madness.—See Canine Madness.
   HYDROCELE.—A collection of water  between the testis,
and one  of the coats  or membranes, which invests it, called the
tunica vaginalis testis.  This is a local dropsy,  producing a  col-
orless pyriform tumor in one side  of the scrotum.  When accom-
panied with  disease of  the testis, it is unattended with pain,
soreness, or danger.  The swelling commences at the lower  part
of  the  testis, and gradually  proceeds  upwards.   The  tumor
sometimes attains an enormous size, and it is not uncommon for
it to remain for months or years, without any material alteration.
The swelling  is elastic, equal, and  partially transparent,  which
with  its pyramedal form, and the absence  of pain, will distin-
guish it from hernia, and scirrhus of the testis.   The cause of
this complaint is often involved in obscurity, appearing in many
cases to come on spontaneously, without any apparent cause.  It
has, however, been attributed to bruises and  injuries sustained in
riding on horseback and otherwise, colds, rheumatism, and an irri-
table state of the urethra.
  Remedies.—Medical treatment is unavailing in this complaint;
but it is curable by a surgical operation.   It  may be palliated, and
the inconvenience arising from the bulk of the tumor, obviated by
drawing  off the contents with a trocar.  The radical cure is ef-
fected by injecting the sack with  some stimulating liquor, such
as solution  of sulphate of zinc, or diluted tincture  of iodine, by
means of a suitable apparatus.
   HYDROCEPHALUS—Dropsy of the  Brain.—It appears to
be the consequence of inflammation, falls, rickets, or, of the weak-
ness and effects of other diseases.   It  is mostly confined to chil-
dren under twelve years of age.   It is often  the consequence of
the bowel complaints of children.  Where it is a chronic com-
plaint, the head sometimes becomes very  much enlarged,  and
the bones of the skull are even separated.
  The acute disease is known, by pain in the  fore part of the
head, stupor, dilitation of the  pupils, vomiting, slowness of the
pulse, and convulsions.   In the commencement of it, when there
is an inflammatory action of the  brain,  the  skin is hot and dry, 
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 the tongue furred, the face flushed, all the secretions of the body
 affected, the pulse quickened, and the senses more or less disturb-
 ed.  In this stage of the disease, the remedies employed in the
 treatment  of brain fever, will be proper, but after the disease has
 become chronic, the means used for the cure of dropsy, in gene-
 ral, must be  employed.  There is one remarkable  symptom in
 this disease.   It is the squinting of one or both eyes.  It  is not
 an invariable symptom,  but a very common one.  See Dropsy.
   HYDROCYANIC ACID—Prussic  Acid.—A powerful narco-
 tic  and sedative.   It  is obtained from the Prussian blue.  See
 Prussic Acid.
   HYDROGEN.—An elementary air.  It is highly inflammable,
 and fourteen times lighter than the common air.
   HYDROTHORAX—Dropsy in the Thorax or Chest.—This
 term is derived from two Greek words, meaning water and thorax.
 Dropsy in  the chest, very rarely, if ever exists, as a primary, idio-
 pathic or original disease, but is generally a symptom or  conse-
 quence of some other affection.  The diseases  with  which it
 most frequently  coexists,  or by which it is caused, are, affections
 of the heart and large blood vessels, and of the  lungs  and pleura.
 It may be a  consequence of a general debility, or broken  condi-
 tion of the whole system, or an extension of a general dropsy,
 dependant  upon disease of some part  more or less remote from
 the chest.   It may  be  confined to one side, or extend to both.
 The general  symptoms of dropsy in the chest are the same as
 those of dropsy  in general.   Those which are peculiar to hydro-
 thorax, are a dry and annoying  cough, difficulty of breathing,
 which is very much increased by a horizontal position, and by exer-
 cise ; the feet and legs swell, and become cedematous as the disease
 progresses; there is palpitation of the heart, and the patient is
 at times in  dread of suffocation ; the surface of the body shows
 signs of obstructed circulation, and the  lips become  purple or
 deadly pale; the pulse is quick, small and irregular, and at length
 the patient dies from exhaustion and suffocation.   When one side
 only is affected,  the side containing the water will be more round-
 ed,  and the  spaces between the ribs  will  be widened ; and the
 difficulty of breathing  will not be  as great  when lying on  one
 side as the  other.  The  sound elicited  by percussion  over the
 seat of the water, will  be dull, and on applying the  ear, or aus-
 cultating, there will be an absence  of the respiratory murmur, or
 it will  be very obscure, except over the spine on the back, where
 it will  be  more  distinctly  heard.  The  prognosis  is  generally
unfavorable, but depends  much upon the nature and seat of the
 original affection, of  which the dropsy is a symptom.  The dis-
ease may be slow and insidious, or rapidly fatal, but this, like the
prognosis, will depend upon the primary affection.
  Remedies.—The  treatment  of dropsy in the  chest,  must be 
HYP.
305
conducted upon the same general principles, that are observed in
other forms  of dropsy.   When practicable, the original disease
should be ascertained,  and  suitable  measures adopted for  its
removal, as  without this, no permanent benefit can be expected
to result from any mode of  treatment that, may be  pursued for
the removal of the  dropsy.   There is  no domestic  remedy,
that can be  depended upon, for the cure of this disease ;  but the
more potent medicines may be aided, by the use of the infusion
of dogs bane, or  indian  hemp, cleavers, upland cranberry, and
other diuretics.
   Among the various professional remedies, may be enumerated,
counter  irritation, by blisters and tartar  emetic ointment; jalap
and cream of tartar, or magnesia, in large doses ; foxglove, squills,
calomel, elaterium, acetate of potash, balsam of copaiva, spirits of
turpentine, cantharides, and other hydragogue cathartics and diu-
retics.
   HYPOCHONDRISM—This disease is known under the names
of low spirits, hypo, vapors,  or spleen.   It is a state of constant
fear, anxiety, and gloom.  In this  disease, all business and the
common pursuits of life become tasteless and  irksome.  In this
state of the  mind and feelings, the person is usually haunted with
the idea or  impression that something dreadful, either disease, or
death, or some  worldly calamity is about to  happen  to him.
Night and  day, he is oppressed  with a heaviness of the spirits
and a  load upon the heart.   He neither wishes to see anybody,
go anywhere, or  to do anything.  He  experiences the  greatest
distress  of feelings and gloominess of mind in the  morning.   Af-
ter  taking  breakfast and moving aoout a little, he begins to feel
more cheerful and disposed to attend to ordinary pursuits.   Peo-
ple affected with this distemper, commonly have a scowl upon the
 face:  the  countenance is  leaden  colored,  and inclinable  to
turn pale on the  slightest occasion ; they are hasty in their move-
 ments ;  fretful; fickle;  jealous; and exceedingly liable  to  be
 mistaken in  their judgment of the intentions of other people.
 They often misconstrue a jest into an affront, and feel the keen-
 est anguish at any omission of  attention  or apparant neglect on
 the part of those with whom they  associate.  Hypochondriacal
 people are  extremely apt to imagine  that  they are affected with
 some  dangerous  or troublesome disease.  Sometimes it will be
 one disease and  sometimes another, when nothing ails them but
 the nervous affection under which they constantly labour.  The
 heart, the stomach, the bladder, the liver, the bowels, the skin or
 senses are all fancied to be the seat of  some disease  in its turn:
 for no sooner do they get over the idea that one organ  or part is
 diseased than they fix upon  another.
   The pulse is variable, and quickened on the slightest emotion,
 a circumstance to which their attention is often turned as an evi-
             39 
306
HYP.
 dence that they are attacked with some new disease.   But when
 attacked with some  real disease, they  commonly  manifest  as
 much fortitude as other people.   The seat of Hypochrondrism is
 undoubtedly the brain and nerves.   It appears to be an irritation
 or a slight degree of inflammation subject to exacerbations.  It is
 aggrevated by all unfavorable occurrences and circumstances, and
 lessened by good fortune and success, although it will  sometimes
 be so severe as to render people indifferent to all the changes of life.
   When we reflect  in how many different ways  the  brain and
 nerves are operated upon, and the amount of wear and tear which
 this system sustains, we shall not be at a loss to comprehend how
 easy it is for the thoughts, feelings and sensations, and the func-
 tions of  other organs to which branches of this system  extend, to
 become  diseased.   Anxiety, care, fear,  expectation, disappoint-
 ment, the constant exertions of attention, memory and reflection,
 the uniform action of the five senses, together with the action of
 the will  or voluntary powers in muscular motion or hard exercise,
 require a vast amount of nervous  labor.   Hypochondrism  or
 low spirits we conceive, cannot  be  ascribable to a disease of the
 stomach or dyspepsia, as has been supposed by some.  The stom-
 ach  to be sure, is affected in the same degree that  the other or-
 gans are.  If particular attention is paid to each and every organ
 in this disease, they will all  be  found to deviate to  a  greater or
 less extent from a sound state of health.  The pulse evidently
 shows that the heart and arteries are involved in the disease and
 to as great an extent as the stomach.   The kidneys and liver are
 also affected in a similar degree.   The bowels  are  costive, and
 the  skin either  dry and  sensitive, or  liable  to  profuse  sweats.
 The spirits are  not  only sluggish, but all the functions of the
 body are affected in the same way.   The nerves which go to the
 stomach, partake of the disease  which is common to  the  brain
 and  to every nerve which issues from it.  The animal spirits' orig-
 inate from  the brain, and when  they are lower or  higher than
 common, the change  is ascribable to some change in the organ.
 We  do  not mean that these remarks shall interfere with the
 proper regulation of the stomach and bowels in this  disorder, for
 on the function of digestion depends the sustenance of  the whole
 system, but to impress upon the mind of the reader the impor-
 tance of  refering the disease to its true seat.
   This disease generally comes on in middle  life, but appears to
 have no  tendency to shorten the number of a man's days.
  Besides a costive state of the bowels, the tongue will often be
 covered with a brownish fur ; the sleep will often be unquiet;
 the head affected with various pains;  the muscles will  be stiff,
and a soreness felt in all the flesh, especially on motion ;  but the
most remarkable features of the  disease  are the sadness of the
heart and countenance, the thick, deep clouds which  rest upon 
HYP.
307
the mind, the fear of death or of some other evil, and where the
distemper is severe, a wearisomeness of life. With many there is
a strong inclination to lie in  bed and to muse in solitude ;  or to
shut themselves up at home and to avoid company.   In extreme
cases, people will  actually become afraid to go over  a bridge or
near a  river, precipice or steep hill, lest they should  be tempted
to destroy themselves  by leaping  off.   The fear of suicide be-
comes more tormenting than the fear of death in any other way.
A cloudy day, a dark night, or an easterly wind is sure to make
everything look much  more  horrible than in clear, still weather.
Windy weather, especially, aggravates  the  disease and produces
a more  intolerable state of the feelings.
   People who are unacquainted with the nature of the distemper,
and the impossibility of shaking it off, will hardly allow  it the
title of a disease.   Like other diseases it has its remissions and
its  intermissions.   Some people  will  be nearly free from  it for
months ; enjoy good spirits and be cheerful; and then relapse into
the old  state of depression again.   The countenance  will express
a deep concern of the  mind, the eye will  become dull, and the
face pale, sad, and sullen.  Many pass the greater part of their
lives in these relapses and intermissions ;  in sadness, tears, groans
and lamentations ; or in joyous hours and gay moments.
  The causes of Hypochondrism or low spirits, are over-action of
the mind and a want of activity in the body.  When the mind
labors hard in thought and feeling, and the  body remains inactive
or still,  this disease is very apt to follow.   The laborious and ac-
tive rarely suffer from it; and when it comes upon them, it is in
a very mild form.  Everything which teases, agitates, and har-
asses the mind, and annoys  the feelings, for any  great length of
time, will disease the nervous  system, and bring on the list of
symptoms which we have described.  Excessive study, and care or
concern of any kind long continued, end  in fatigue and exhaus-
tion of the seat of thought and feeling, and  eventually in an acute
sensibility of the whole system.   This disease is sometimes the
effect of other diseases which  have  been attended with a great
deal of  pain and watchfulness, such as fevers, affections  of the
digestive  organs, child bearing, and  nursing.  It is sometimes
owing to  a want of food, and excessive labor of the  body.  Se-
dentary people and those who are without occupation are  of all
classes the most subject to nervous diseases.  Hypochondrism is
a disease much easier prevented than cured.   When our parents
and  our teachers  shall take  as much pains to produce content-
ment with our worldly lot as they now take to foster our pride
and ambition ;  and when labor comes to be considered a blessing
instead of a curse, Hypochondrism, if not struck from the  list of
diseases, will become extremely mild in its nature.  In our coun-
try where labor is more reputable and lucrative than in any other; 
308
HYP.
and where independence is secured by moderate exertions, nerv-
ous diseases are much less common than in Europe.   Among us,
however, there is enough of these diseases  to arouse public at-
tention to methods of prevention.
  In  hypochondrism,  the  senses  manifest the  same  symp-
toms  of  functional  derangement, which are betrayed  in  the
thoughts, feelings, passions, instincts, and emotions.   Floating
atoms are often seen before the eyes and  are the cause of much
alarm, although they are indicative of nothing  more than some
little turgescence  of the blood vessels or slight  variation in the
strength  of the organ.  These atoms will  sometimes appear like
bright sparks ; and  it is not impossible that they may be slight
shocks of electricity or galvanism passing from, or to the eye ; or
some change in the condition of one or the other of those fluids.
There will often  be a roaring in the ears like the noise of a dis-
tant  carriage or a heavy waterfall.  At other times, one or both
ears will  be affected with a ringing sound like that of a bell, and
many other  kinds of noise as different from each other as there
are different individuals.  These  sounds are slight affections of
the organ of hearing in common with  the whole nervous system,
and are indicative of nothing but a want of soundness in that or-
gan.   With people who are ignorant of the cause of these noises,
they  are  supposed  to  foretell sickness,  death, or some great
calamity  in the family.   The sense of feeling is no  less perverted
or deranged.   Sometimes the person will feel as large as a hogs-
head,  and at others, very small and  light.  One leg will  even
feel as large as the whole body, and the head will feel as light as
a feather, or as heavy as lead.  In some instances, everything will
suddenly become  dark, which will last but for a  moment, and
pass away.
  The skin  is subject to little twitches  in  different parts; and
also to a  feeling of numbness ;  and, sometimes, to a peculiar sen-
sation as if spiders or other insects were crawling upon it.   This
only shows that the skin and sense of feeling are partakers of a
general disease.   Both  the smell and the taste in hypochondrism
are somewhat diseased.   The same substances will often become
changed, both in smell and taste; and the  hypochondriac will
perceive  odors and flavors where none are present.   These affec-
tions of the senses are no more extraordinary than that the mind
should perceive  danger  and disaster, mortification and  defeat,
poverty and ruin where in former days all was safety, success, and
hope.   The hysteric ball, the aura epileptica, and the black spots
which are seen  before the eyes in  epilepsy, appear to be only
aggravated affections of the same  nature with the above.
  Hypochondriacal  people are  subject to a kind of nervous faint-
ing.   There  will appear to be a stoppage of the bowels and of
the motions of life ; the breathing will appear to stop or to be 
HYP.
309
carried on only by the force of the will; the body will become
cold;  and  the skin and  face deadly pale, with an indescribable
anxiety and distress about the region of the heart; the action of the
heart will appear to stop, and the person will feel as if dying ; the
senses all the while will remain quite clear, although, in general the
person  is speechless.  At length the heart palpitates  violently,
and all  is commotion.  The person fears the stroke of death, but
it does not come.   The fit passes off with some little  motion in
the bowels, and the passage of wind.  These  nervous spells are
very alarming, but pass off without danger.  After one of  these
distressing turns is over, the person  usually  enjoys more than or-
dinary calmness and serenity, for several days, and, sometimes, for
weeks and months.   In time they become more supportable, but
never cease to alarm.
  Remedies.—If  we  are to name a remedy which  of all others
is of  the greatest  service,  and the  oftenness  productive of a
cure,  and in  fact,  without which  to a certain extent, almost
everybody  would become hypochondriacal, it is exercise or active
occupation.   The human body was made for motion, and without
it soon becomes diseased.  The blood cannot  be sufficiently dis-
tributed and  propelled into the several organs  without motion.
This fact may be learned by reading the article upon exercise.
It  is  necessary that the senses should converse much with the
material world. The eye should constantly be exercised in seeing
the objects of nature, the ear in hearing, and the sense of touch in
feeling.  The external senses are in this way strengthened and
prevented from diseased action.  Man is naturally a creature of
sensation, and if too much occupied with thoughts and feelings
and depp reflection, the brain and the nerves which issue from it,
are fatigued,  irritated, and rendered acutely sensitive.    The mind
must  be fed by the senses and not left to waste its digestive power
upon  its own operations.   In childhood, the  love  of motion is
one of its strongest propensities; to the child, motion is a luxury;
a pleasure  like the taste of agreeable food or the perception of
agreeable sounds.   The child moves, because motion gives it
pleasure, by  a forcible distribution of the blood.  All the organs
have an appetite—a taste for blood,  and this appetite is gratified
by the greater amount  of  blood which motion sends to  them.
Every  nervous man  should fly to some  active occupation  either
in  the workshop  or in the  open field, if he wishes an  exemption
from  suffering.
   The open, fresh air is another essential mean of restoring the
nervous system to its original soundness and energy. The air
in  the  best ventilated and largest  rooms is never so  pure, nor
contains so much oxygen,  which is  the vital portion of it, as the
open, moving  atmosphere.   The light  also, and the heat of the
sun contribute very much to enliven the operations of the mind, 
310
HYS.
to quicken the circulation of the blood, and to facilitate the evacu-
tions.  Temperance is indispensable to a recovery from this dis-
tressing affection.   There can  be no  doubt but this disease pro-
duces much intemperance.  Hypochondriacal people fly to intoxi-
cating drinks for relief.   This they  obtain, but, for a short time;
for as soon as the effect of the stimulus is gone, they are in a
worse condition than ever; but they fly to it again and again
until  drunkenness becomes a habit.   Cold water, exercise or la-
bor, and a wholesome diet, with patience and fortitude  will gen-
erally get the better of the disease, or  render it tolerable.
  In cases where the bowels are costive  or the stomach affect-
ed with  sourness,  wind,  and  indigestion,  medicine will be
required.  To correct  the sourness,  a little of the crude soda
should be dissolved in water and taken  as often as the sourness
becomes  troublesome.   A  little pearlash water  will  answer a
similar purpose though not quite as well as the soda,  Where the
bowels are at the same time, sluggish  or  costive,  a tea-spoonful
of the calcined magnesia should be  taken every day for three or
four weeks in succession.   The thoroughwort taken daily for a
length of time, has  often been  found  of  great service where the
digestive organs have become involved in the disease.  The elixir
pro. and the aloetic pill  are extremely good  in such  cases.  A
bowl of warm motherwort tea with  a tea-spoonful of the spirits
of camphor in it, may be taken when the  palpitation of the heart
and the sensation of dying  comes on.   A tea-spoonful of ether,
or a table-spoonful of paragoric will quiet the commotion of the
nerves.  In  the intervals of the nervous  fits, some agreeable oc-
cupation or amusement  must be followed.   Journeying is pecu-
liarly favorable to nervous complaints.  Chalybeate mineral wa-
ters are well adapted to strengthen the nervous system.  Warm
bathing is also very friendly; but cold bathing is inapplicable.
A voyage to  sea has cured  many people, and so has a  change
from a sedentary to an active life.   A tea made of valerian  is a
very suitable anodyne.  Camphor,  the  tincture  of castor, and
the extract of cicuta in pills, are all serviceable  in some cases.
But it is much better, where the same purpose can be answered,
to employ poppy tea, hop tea, and motherwort.   If laudanum or
opium are at any time  employed, lemon  juice or some kind of
sour  drink should be taken at the same time.   The  Griffith's
mixture, the tincture of the muriate of iron and the rust  of iron
give  tone to  the nervous system.  Emetics are commonly hurtful.
Blisters, where the head is very much  affected,  are sometimes
employed with advantage.   This disease  is sometimes  so severe
as to make retirement and seclusion from company not only de-
sirable, but necessary.   People should, however, be on their guard
against becoming wedded to their chambers and retirement.  The
fear of mankind is a foolish fear and attended with innumerable 
HYS.
311
evils.  A resolution to take the  rough and tumble of the world,
is always well recompensed  in the confidence which it produces
in ourselves, and  the squeamishness  and foolish fears which it
overcomes.
  Nothing is more necessary than that nervous people should be-
come acquainted with the  nature of their disease.  A proper
knowledge of it will often relieve them from much anxiety and
distress.   Nervous people require a good  deal of food.  They
are always better after a full  breakfast, which shows that empti-
ness aggravates the disease.   The food  should  be light and nu-
tritious,  and  eaten early in  the day, for  as digestion is always
slow in this disease, time  should be allowed it to digest before
the hour of sleep.  Everything should be  done to secure sound
and refreshing sleep, for  if sleep is not the staff of life, it  is as
essential to health, as food  itself.  The  whims and caprices of
nervous  people should always be treated with  tenderness, kind-
ness, and sympathy, precisely as we would treat  symptoms of any
other disease.   It  will often  be  necessary to be firm with such
people, but their complaints  and sufferings should never be  ridi-
culed nor trifled with.
  Physicians  are  often  called,  in these  complaints, and  find
it necessary   to  relieve  the distress of  this,  as  of  other
diseases.   If the bowels have been costive, a dose of calomel
will be  as good a  cathartic as can be given.   To quiet the
nerves and to remove the  apprehensions  of the patient, a tea-
spoonful of Hoffman's anodyne  liquor, or a tea-spoonful of the
tincture  of castor,  with the same quantity of the sweet spirits of
nitre, will be advisable.  If  there is palpitation of the  heart, a
gentle opiate will be required.  The Dover's powder, or the an-
odyne balsam will answer this intention.  The nature of their
disease should be explained to them,  and hopes of recovery in-
spired.    All violent remedies must be avoided.
  HYSSOP.—This  herb has an aromatic smell, and a warm,
pungent  taste.  In asthma, coughs, and other  affections of the
lungs, the powdered leaves, or a tea of the leaves are given as an
expectorant.   The leaves are often applied to bruises, in the form
of a poultice to alleviate  the pain and restore the circulation of
the part.
  HYSTERICS—Hysteria.—The hysterics is a much lighter
disease   than  the  epilepsy,   although  in some respects  it re-
sembles it.  In the hysterics, the  person does not fall down,  turn
purple, and froth at the mouth, as in epilepsy, but is agitated and
convulsed, very much as in  that disease.   An  affection resemb-
ling  hysterics, sometimes affects men as well as women.
  The hysterics commonly  begins with some  uneasiness about
the left side of the abdomen.   From this spot, the sensation  of a
ball is often felt,  moving upwards towards the  chest and throat. 
312
HYS.
The ball seems to take several turns about the bowels, and then
to ascend to the stomach, and finally, to the upper part of the gul-
let, where it  produces a sense of suffocation.   It has always ap-
peared to us that the hysteric ball, or globus hystericus, was of the
same nature with the aura epileptica, and the approach of black
spots in epilepsy, a halucination  of  feeling, or such a perversion
of the feeling  as takes  place in insanity.   It, in all instances,
precedes the fit, and although a disagreeable and painful sensation,
and  productive of  a sense of suffocation,  is attended with no
danger.  The sensation is  as fleeting as it is strange.
   After  the  ascent  of the ball, the  person  loses  her  senses,
becomes wild, grates her  teeth, and  finally  grows  stupid and
insensible.   The muscles  are violently agitated and convulsed;
the clenched fist beats upon the breast;  and the body is twisted
into every possible position.  After a little while, the person will
partly come to her senses, and then fall again into the same state
of stupor and  convulsions.   The disease  will  continue in this
way, from the space of an  hour to two or three days.   When it
continues long, there will  often be lucid and quiet intervals for
an hour  or  two at. a  time.   In  the intervals,  she will be
affected with sobbing, crying,  and involuntary laughter.  On  a
return to the senses, there  is no recollection of the circumstances
which attended  the fit.   In some  females,  the fits are  much
lighter than in others.  Some will scream and hollow, and be
quite deranged, while others will appear still  and silent.   Some
require the assistance of  several persons  to hold them,  while
others will have but little convulsion.  The agony in some cases
will be  very great,  while,  in  others, the  suffering will appear
to be very slight.
   The fit will often come  on with sickness  at the stomach, pal-
pitation at the heart, interruption of breath, and a sudden flow of
the urine.  After the fit has gone off,  the person will enjoy a great
degree of composure, and serenity of mind, until symptoms of an-
other fit make their appearance.   Some females will have these fits
every month, or on the return of the menstrual discharge.  The
disease seldom makes appearance before  the age of puberty, and
rarely ever continues longer than the menstrual  sickness,  and
commonly ceases by the  age of thirty-five.   It originates with
womanhood, and ceases on the cessation of the secretions peculiar
to the female sex.   To those who are afflicted with the disease,
there is some consolation in the reflection that it will finally cease;
and that the latter part of life may be quiet and healthy.
   It chiefly  attacks those  of a  delicate,  nervous tempera-
ment;  whose  thoughts,   feelings,  and   affection   are  easily
moved.  It is produced by  everything  which  excites the mind
and feelings.   The sight of disagreeable objects, and all painful
sensations, readily induce  a fit of hysterics.  Any  disturbance  of 
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313
the stomach, whether by disease or food, will bring on the hys-
terics.   But we believe the proximate cause, is some derangement
of the uterus and ovaria.
   Of late years, this disease has been  called spasms, from the
agitation and distress which are manifested about  the  chest and
stomach, and the convulsions of the limbs.
   Domestic Remedies.—As soon as the disease is ascertained to
be a fit of the hysterics, an emetic should be given, either of an-
timony, ipecac, lobelia, or some other article* which is  sure to ex-
cite vomiting.  A great spoonful of the wine of antimony, or a
tea-spoonful of the powder of ipecac,  will commonly answer the
purpose ; but if the first dose does not vomit, a similar dose should
be given again in  the course of fifteen or  twenty minutes.  A
smart vomit will often bring the person out of the fit, and  prevent
a  return  of it.   If the  emetic  does  not  dissolve  the fit,  a
tea-spoonful  of laudanum,  or morphine,  and a  tea-spoonful of
ether mixed together, should be  given in a little cold water.
The laudanum and ether  are probably the  surest remedy in use,
for the dissolution of the  paroxysm.  The dose may be repeated,
if necessary, in two or three hours.   Flannel  cloths, dipped in
boiling herbs, such  as pennyroyal, tansy, and spearmint should
be applied to the stomach and bowels, and  the head kept cool by
the application of cold vinegar and water.
   The fit may,  sometimes, be  dispelled by dashing  cold water
upon the face, neck, and stomach, as often  as the  spasms appear.
When the person is unable  to swallow, the dispensation of an in-
jection composed of common  salt,  dissolved in warm water, will
be necessary,  if the fit is  severe.   A dose of  oil,  magnesia, salts,
or some other gentle physic should  be given,  as soon as the
emetic has operated.   All  spirituous liquors should  be  avoided,
The drink should be balm tea,  cold water, and lemonade.   Moth-
erwort and catnip teas,  drank freely, are both peculiarly  suitable
in this disorder.   When it is connected with a suppression of, or
difficulty in the menstrual secretion, a dose of aloetic pills will be
very proper; and steaming the  lower part of the body with boil-
 ed herbs.   At the same  time, a bowl of motherwort tea, with a
 tea-spoonful of the spirits of camphor, should be drank, every two
 hours, until a profuse sweat is excited.
   Professional Remedies.—When the person is taken with a fit
 of hysterics or spasms, it. will often be advisable to  take twelve
 or fourteen ounces of blood.  Leeching is scarcely practicable in
 this disease, on account of the  convulsions and  forcible motions
 of the body and limbs.   It may,  however, be practiced  over the
 diseased organ, during  the  intervals of the  spasms with much ad-
 vantage.   To the course which has been advised above, may be
 added  the  administration  of asafetida,  castor,  musk, Hoflman's
 anodyne liquor, poppy tea, and  all  those sedatives which are
            40 
314
IMP.
commonly  given in nervous diseases.   During the intervals of
exemption from the disease, the greatest attention should be paid
to diet and  exercise.   Exercise  is  of the highest importance,
and  temperance  in eating,  as well  as in  drinking  should be
tenaciously  pursued.   The bearing  and birth of a child  very
often produce an entire exemption from  the disease.  But while
lawful Wedlock proves a cure to the disease, promiscuous intercourse
only increases it.   A course of the Saratoga spring water, should
be tried, in all cases where the disease becomes periodical.  Where
the complaint arises from debility, a tonic course must be adopted.
If a plethoric state exists, the  system must be drained by purga-
tives, and an abstemious diet.
  HYSSOP.—This herb has an aromatic  smell, and a warm,
pungent taste.  In asthma, coughs, and other affections  of the
lungs, the powdered leaves, or a tea of the leaves are given as an
expectorant.  The leaves are often applied to bruises in the form
of a  poultice, to alleviate the pain and restore the circulation of
the part.
                             I.

  ICTERUS—Jaundice.—See Jaundice.
  ICTERUS INFANTUM—Jaundice of Infants—Yellow Gum
—See Yellow  Gum.
  IDIOPATHIC.—A  primary disease.   Many diseases  appear
to be  only symptoms of other diseases, and are called symptomatic,
but an idiopathic disease is one which is independent of all other
diseases.
  IDIOSYNCRASY.—Some peculiarity of constitution.   One
person will be poisoned by handling dogwood,  while others will
not be affected by it at all.  Some people will  faint at  the sight
of blood; and others never take  the small pox, although freely
exposed to  it.   These  peculiarities,  and  many  others, are owing
to an  idiosyncrasy.
  ILEUM.—The lowest portion of the small  intestines, or the
section of the bowels between the jejunum and the colon.   It is
about fifteen hands breadth in length.
  IMPERFORATE ANUS.—Infants are sometimes born with
this defect.  The lower extremity of the bowels has no  opening;
of course, the child can live only a  few  day, without an opera-
tion,  by which an  artificial opening  is  made.  This has been
done,  and the child has lived.
  IMPERFORATE  VAGINA—A complete closure  of  the 
INF.
315
vagina is a defect with which female infants are sometimes born.
It can only be remedied by a surgical operation.
   INCUBUS—Nightmare.—See Disturbed Sleep.
   INDIAN HEMP—Cannabis Indica—The virtues of the indian
hemp reside in a resin,  which, in certain  seasons, exudes and
collects on  the leaves, stems, and  flowers.   This resin is  called
cannabin.   It is of a blackish  grey color, and hard at 90o of
fahrenheit.   Its  odor is fragrant  and narcotic; taste  slightly
warm, bitterish, and  acrid.   It  is  narcotic, and anti-spasmodic.
Its effects  upon the human constitution are alleviation  of pain,
augmentation  of  the appetite, and  great cheerfulness,  or a slight
degree of intoxication.  Whether  the American hemp possesses
similar properties, is not fully settled.
   INDIAN PHYSIC—Spiraea Trifoliata.—This is  an emetic
plant, which grows in all parts of the union.   The stem rises to
the height of two or three feet;  of a redish color, branched, and
round.   Its medicinal power resides in the root.  It is a  safe and
efficacious emetic.   The dose for an adult is about thirty  grains
of the powdered  root.  It  has  been used with success  in the
intermittent fever.   It possesses  tonic power, and has been used
instead of the peruvian bark.  The virtues of this native plant
should be  submitted  to further trials.   It must be  used with
judgment, or mischief may arise from it.
   INDIGO WEED—Wild  Indigo—Sophora  Tinctoria.—This
plant is sometimes called broom.  The stalk rises to two  or three
feet in height, and sends off numerous branches.  It grows in
great abundance in all  parts of the union.   It bears a golden
colored blossom,  and its leaves are small and inversely heart
shaped.  The  root is  woody,  rough, and tortuous.  Its taste
resembles that of ipecac. It is nauseous, subacrid, and unpleas-
ant.   As far as its medicinal properties  have been ascertained, it
is both emetic and  cathartic.   A  weak tea of it operates as a
laxative.
   It is the  most celebrated  for its  efficacy in preventing and
obviating mortification,  applied  as an  external  wash or poul-
tice.  In counteracting gangrene and mortification,  in  healing
foul sores, and in staying the progress of ulcers in the throat, the
wild indigo root is a powerful medicine.   To render it effectual,
a small quantity of the decoction should  be taken internally, at
the same time that it is used as a wash or a  poultice.  An infu-
sion of the root is a good remedy for canker in the mouth, sore
nipples, sore eyes, and ulcers in any part of the body. To make a
poultice of it, a strong tea or decoction of the root must be mixed
with rye meal, white bread, or flax-seed meal.  The wild indigo
is  one of the most useful native plants which we possess, and its
virtues cannot be too highly prized.
   INFLAMMATION OF THE  BLADDER—Cystitis—The 
316
INF.
first symptom in an inflammation of the bladder is a difficulty in
making water.   There will be a sense of fullness and distention,
and a pain  in the lower front part of the abdomen.   Sometimes
there  will be a complete stoppage of the water, or there will only
be a few drops passed at a time.  There is an incessant desire to
urinate  without the power.   This  disease runs its course very
quick.  If relief is not  obtained speedily, the disease  runs into
mortification of the bladder, and destroys the patient in a few
days.   Pain, heat, soreness to the touch, sickness at the stomach,
thirst, and restlessness  go to  make up the compliment of symp-
toms which characterise the disease.
   If the bladder is full and distended, the water must  be drawn
off by the catheter.  It  is of the greatest  importance that this
circumstance should be attended to, lest a mere distention of the
bladder should  bring on mortification.  The patient should not
be allowed to drink more liquids than are absolutely necessary to
quench the thirst, and no  medicine should be given to increase
the amount of urine, lest the bladder should suffer by distention.
Water moderately cool will be as proper a drink as any.  An in-
flammation of the bladder  will sometimes end in suppuration,
and the matter will  be discharged  with the urine, giving it a
cloudy appearance.  If the matter is discharged into the abdomen
it will occasion death.
   Blood letting  in this disease is indispensable.  Leeches should
be used freely.  The bowels should be drained by mild purga-
tives, a perspiration should be supported, and warm emollient injec-
tions  into the rectum should be repeated very often.  The warm
bath  either general or  topical will be found of essential ser-
vice.   The inflammation is often produced by taking the tincture
of flies and the use of blisters,  by  intemperance, and  sometimes
by taking  cold, but in  general, it is produced by gravel stones in
the  bladder, and is often  relieved when  these  stones are dis-
charged in the water.  Where blisters are the occasion of the
disease, it will be relieved  by simply taking sweet spirits of nitre
and sprinkling the blistered part with powdered camphor.
   In this  disorder, there is  intolerable restlessness  and  anxiety
with  cold  extremeties, vomiting, and, often, delirium. Too much
attention cannot be paid to drawing off the water and facilitating
the passage of the gravel stones where any  are present.
   INFLAMMATION OF THE BOWELS OR  INTESTINES
—Enteritis.—An inflammation of the intestines and the colic are
not  the same  disease.  There is a settled, obstinate fever in an
inflammation of the intestines, and a great deal of  soreness upon
pressure ;  in this disease the pain is fixed;  in colic it is shifting.
In this disease the pulse is quick and hard, in the colic it is quick,
but not hard.
   An inflammation of  the intestines begins with nausea and sick- 
INF.
317
ness at the stomach ; loss of strength; costiveness; great anxiety;
thirst; heat; and an intolerable pain in the belly which extends
all over it, being the most severe  about the navel.   In a short
time, the  whole belly becomes extremely tender  and sore to the
touch, and the pulse is quick, hard, and small.
  If the  large intestines  or the  lower portion  of the bowels,
are  the seat of the inflammation, the stomach is not apt to be
so much affected.   The seat of the inflammation being at a con-
siderable distance from that  organ, it will often remain compara-
tively quiet.   There will merely be a slight nausea and vomiting
at long intervals.   In fact, the degree  in which  the stomach is
affected is a pretty good criterion of the nearness or the remote-
ness of the inflammation from that organ.   If  the sickness is se-
vere and the vomiting constant, we  may be pretty sure that the
small intestines are the inflamed portion and that the more danger
is to be apprehended.  We have sometimes  thought that we
could tell the spot in the  intestines  which was inflamed, by the
length of time in which the  drinks, food, and medicines remained
upon the  stomach before they were thrown back.   This may not
be an invariable guide, but we conceive it to be a very good one.
  Where  the symptoms are present which we have described, we
should  always inquire whether the person so affected has a her-
nia or rupture.   A small rupture will sometimes become strangu-
lated and a portion  of the intestines inflamed without the knowl-
edge of the  person who is the subject of it.  It is said that some
females have had small ruptures even without their own knowl-
edge, and died of a disease which might have  been remedied.
   If the inflammation is not reduced either by the efforts of art
or nature, it  must speedily end in mortification, or  suppuration
and ulceration.  The evidences of mortification are a ghastliness
of the countenance, a  cessation of the pain, a swelling of the
bowels, a disappearance of the pulse in the wrist, and a cold clam-
my sweat.  The evidences of a suppuration  are cold chills, an
abatement of the fever, and the mixture of pus with the discharges
from the  bowels.
   An inflammation of the  intestines is very apt to be produced
by cold wet feet and by excesses in  eating.  Shell fish, cucum-
bers, and unripe  fruit are fruitful causes of  the disease.  It is
brought on  by extreme costiveness, strangulated hernias, and the
running  of  one  portion  of the  bowels into  another.   Corro-
sive substances taken into the stomach, or any indigestible body
lodged in the  bowels may  give rise to the inflammation.   It is
almost always the inner, or  mucous coat of the bowels which is
the seat of the inflammation, but, in  some cases, the outer or per-
itoneal coat will be the surface first inflamed.  But where either
one or the other coat is first  inflamed, the whole thickness of the
intestine  is finally involved in the inflammation, and where ul- 
318
INF
 ceration takes place there are almost always found holes through
 the intestine.
   Domestic Remedies.—Neither emetics nor purgatives are proper
 medicines to give in the commencement, of this  disease.   The
 only thing which can be done  to much advantage by the famify
 and friends, is to make  warm applications to the bowels and to
 give warm demulcent drinks.  The feet may be bathed in  warm
 water and the  lower portion of the bowels emptied by a  warm
 emollient injection.   Flax-seed tea, mullien tea, and gum arabic
 water are the most suitable drinks.
   Professional   Remedies.—Perhaps  there  is  no disease  in
 which  a free  abstraction  of  blood is  so  essential as in this.
 The smallness  of the   pulse  is no objection  to  bleeding, if
 there are other  evident  signs of  inflammation,  such as  pain,
 soreness, and fever.   In  inflammations of the lungs and of the
 liver, the pulse is full and large, but when the intestines are in-
 flamed the pulse  is small, though  quick.  There never can be
 any hazard in bleeding  where  there is great pain, soreness, and
 fever.   Many lives have no  doubt been lost from a fear of letting
 blood in this disease. It may often be necessary to bleed copiously
 as many as three or four times  in the course of the first  twenty-
 four hours; and besides this, to apply leeches freely to the abdomen.
   "In an inflammation of the intestines," says Dr. Thomas, "as
 well as  all visceral inflammations,  there cannot be proposed a
 more  useful  rule than that  of drawing blood  every four or six
 hours, in  such a  quantity each  time as  the action of the  heart
 will bear, and continuing the practice as long as the characteris-
 tic symptoms of inflammatory disease remain.   In inflammations
 of the brain, of the pleara, of the lungs, of the heart,  of the  liver,
 and of the bladder, the same practice will be advisable."  This
 advice  should be  well heeded.
   The belly should be well  steamed with cloths dipped in hot
 water and with warm emollient poultices. After the  force of the
 circulation has been reduced and the fever abated, blisters should
 be drawn upon the abdomen.  After the reduction of the pulse,
 the most  appropriate cathartic  which can be used is calomel, in
 three or four grain doses, every  hour.  If the stomach will retain
them, effervescing draughts  should be given, especially the  ro-
chelle powders.  Where medicines are constantly returned by the
stomach, the administration  of  injections will become necessary.
After the  bowels have once been  perforated with  medicine, a
constant action  should be kept up by the use of mild purgatives,
such as the rochelle powders, jalap, and the cream of tartar or the
butternut physic.
  The mercurial  ointment rubbed into the abdomen, where the
stomach  retains nothing, should be tried.  The iodide  of  mer-
cury in grain doses has lately been recommended. 
INF.                        319
  The affusion of cold water upon the abdomen has been some-
times of service in reducing the  inflammation.  This should al-
ways be done  in  a very early stage of the disease.   Opiates
should never be given until the system has been reduced by bleed-
ing and the lapse of time.  If given in the commencement, they
only aggravate  the disease, although they may obtain a truce
from the pain and distress.  But  after suitable evacuations have
been made, the Dover's powder or the acetate of morphine may
be given, combined with calomel  or some  other cathartic.  In
cases where suppuration has taken place, and symptoms of hectic
appear, the strength must be supported with quinine, the mineral
acids, and wine whey.  Chicken  broth and  beef tea should be
taken for food,  and every effort made to produce comfort where
we may despair of a cure.
   INFLAMMATION  OF THE BRAIN.—See Brain  Fever.
   INFLAMMATION OF THE BREASTS.—This disease sel-
dom or never happens unless it has been preceded by childbirth.
It most commonly happens about the time of the appearance of
the milk, but may happen at any time while the woman is nurs-
ing.  Tne inflammation commences with chills and heats; head-
ache ;  a full, quick and hard pulse ;  thirst;  and when vehement,
with sickness  at the stomach; a hot and dry skin, with  scanti-
ness of urine and a confined state of the bowels ; in fact,  in this
as in other inflammations, all the secretions are more or less dried
up by the fever.
   In a short  time, cakes or lumps will  be felt  in  one or both
breasts.  In some instances the cakes will occupy one half of the
breast  and in other instances the whole of it.  Not unfrequently
the whole  breast  will be uniformly swelled and  hard.    Some
time will commonly elapse before the  breasts become red and
very sore, but if the inflammation is not subdued, they ultimately
become red, and often, though not  always, painful; suppurate;
and discharge  a great quantity of pus, sometimes  thick  and at
others thin and watery.  If the inflammation is not subdued be-
fore the sixth or seventh day, it  commonly ends in suppuration.
The fever and disturbance of the system often commence  before
any hardness and swelling are detected in the breasts, so that the
breasts should always be well looked to in case any symptoms of
fever arise, especially after the puerperal discharge  or lochia has
ceased.  This disease is generally the consequence of taking cold,
or of neglecting to draw the breasts.  It is sometimes produced
by the constant irritation of  sore nipples.
   It should be the first object to produce a profuse sweat which
will often, of itself, carry off the cakes and dispel the inflamma-
tion.   The breasts should be constantly  steamed with cloths
dipped in hot water or which is better, in the first instance, alco-
hol or  new rum.   If the inflammation is very vehement and the 
320
INF.
force of the pulse much augmented, blood must  be drawn by
leeches or opening a vein, but this is not often needed.
   The breasts should be  kept empty,  either by  nursing or the
breast-pipe, and no food should be taken which will increase the
quantity of the milk.   A common decanter, filled with hot water,
wrapped with a woollen  cloth, and then suddenly emptied  and
applied to  the breast,  will  answer  for  a  pretty  good breast
pipe.  But the best of all ways,  where  anybody can be found to
do it, and it is an act of great kindness, is  to  draw  the  milk by
the mouth.   It is much less painful and irritating, and abundant-
ly more effectual.  The bowels should  be  drained  by the use of
salts, magnesia, rochelle powders, castor oil,  and  jalap ;  and the
kidneys kept free, by the use of the sal nitre, in six grain doses.
After the breasts have been steamed for about twenty-four hours,
a warm, soft white bread, rye meal,  or  flax-seed poultice should
be applied, and renewed, as often as  it loses its moisture.  The
solvent power of a poultice in inflammations of any  considerable
depth, is, in our opinion, superior to all other local means.   Warm
applications should always be tried  before cold ones.  After the
fever has somewhat abated, if the redness, hardness, and swelling
continue obstinate, the sugar of lead,  or the white vitriol, dissolv-
ed in tepid water, may be tried.   The water may  gradually be
made colder until it is used entirely cold.
   The perspiration is best kept  up by  the  use of  the  antimo-
nial  powder,  the spirits of camphor, the  sweet spirits of nitre,
the  acetate   of  ammonia,  and  small  doses  of  ipecac, or
lobelia.   A  solution of  the  tartrite of  antimony,  frequently
repeated, in small doses, will operate  both upon the skin and the
bowels.
   The volatile linament and the spirits of camphor applied in the
commencement of the cakes,  will, sometimes, soften and dispel
them.   But unless they are applied in  such  profusion as to pro-
duce a perspiration, they have never  appeared to  us  to be  very
solvent.   A common application in the  country  is to fry a
woolen,  or  linen  cloth  in  hog's fat,  and spread  it  upon  the
breasts, hot, or rather, very warm.  This probably operates upon
the principle of raising a perspiration in the parts, and  sometimes
upon the whole skin.  Our reliance has  always been upon steam-
ing and poultices.
  In some instances, where there is no fever, and the cakes remain
nearly stationary,  a  plaster of  white diachylon  will  scatter
them.   But, sometimes, in spite of all remedial opposition,  they
will  come  to  a  head.  In  this case, after the matter  is fully
formed, it is better to open them  with the lancet, than to allow
them to break.   By opening  the tumors,  they are less liable to
form a ragged, open sore.   The  lowest  side of the tumor should
always be selected to make the incision. 
INF.
321
  The drink should be tepid, and composed of sweetened water,
balm tea, gruel, and  bread  water.  Sour drinks are inadmissible
while the patient nurses, on account of  the  child.   The room
should be kept comfortably warm, and no more ; too much heat  »
increases the inflammation.   To  procure  sleep and respite from
the pain, the Dover's powder, or the sulphate of morphine,  must
be  given  as often as  the  case demands.   Opiates are attended
with much less danger in an inflammation of the breasts, than in
that of the  more vital organs.  They are,  however, improper in
the commencement of the  disease, and, always, when the fever
is high.
   INFLAMMATION  OF  THE BRONCHIA — Bronchitis—
See Bronchitis.
   INFLAMMATION OF THE EYES—Ophthalmia.—Inflamed
eyes begin  with an itching  sensation, a feeling of dryness and
stiffness of the eyelids, soreness, pain, and  swelling.  The eyes
are hotter than  common, and  the  eyelids are glued so fast to-
gether in the morning that it is sometimes difficult to get them open.
The eyelids become  red, and if the inflammation is severe, it will
extend to the eyeball;  the whites of the eyes  will become as red
as the eyelids  and as much engorged  with blood.   There will
be a deep-seated pain  in the  eye-ball, and,  sometimes, in the
head.   This inflammation  is not accompanied with much fever,
unless it occupies the  whole eye.   After  the inflammation has
extended to the ball of the  eye, the retina or the  optic nerve be-
comes sensitive, and  light  is extremely painful.   In the worst
cases, the eye becomes completely closed, and when the  eyelids
are opened and the  light let in, it sets the eye to running, and
produces a pain which scarcely can be borne.   If the inflamma-
tion is  not speedily reduced, matter is soon  secreted, which is
often so corrosive as  to excoriate and scald the cheeks as it runs
down.  The cornea being  destitute of visible vessels, commonly
remains clear for some  time, but if the disease continues long and
severe, it becomes cloudy, and at length, red.   Very often, little
white  ulcers will be  seen upon  it.  If  the inflammation  is
violent and extends to  all the membranes and  different structures
of the eye, a general  fever will be created.  The patient will be
dry and hot; the pulse, quick and forcible;  all the secretions
more  or less diminished ; and there will be neither rest nor sleep.
   Sore or  inflamed  eyes  are  produced  by several  different
causes.   Some  people will  have week eyes from  birth, seldom
free from redness.   This is owing to a scrophulous habit. An
inflammation of the  eyes, like  other  inflammatory diseases, is
sometimes an epidemic.  It has been known to prevail in certain
states of the atmosphere almost as extensively as the epidemic
influenza.  Cold, dry,  windy weather, is more apt to produce an
inflammation of the eyes, than calm, cold  weather.   The disease
           41 
322
INF.
  will, however, prevail in hot as well as in cold weather.   It  is
  often produced by chilly, misty weather.   Intense light will pro-
  duce it.  Too long  and constant, use of the eyes in  reading or
»  study is a very common cause of inflamed eyes.  The eyes of
  farmers, in the hottest  weather, will almost always look blood-
  shot and slightly inflamed.  In Egypt, the disease prevails con-
  stantly from the  heat and  light of the sun  and from the sand
  which is constantly blowing into the eyes.   The  effects of both
  the heat and the light are increased by the reflection from the
  glittering sand banks and the sandy desert.  Nearly all strangers
  are attacked with it, and some are made blind.
    Smoke and the fumes of chlorine  used in bleacheries, and the
  evolution of other gases often inflame the eyes, but probably the
  majority of cases of this disease are  produced in the same way
  that other inflammations are, by sudden changes  of the atmos-
  phere and the suppression of the perspiration.   The cases which
  are produced by particles  of dust,  sand, iron &c, are compara-
  tively small.
    In children, it is apt to arise from inflammatory affections of
  the skin which  often appear  to  extend to the eyes.   Running
  sores behind the ears and about the head, particularly the  scald
  head is apt to extend to the eyes, and to produce protracted and
  serious mischief.  Where the skin is pale and the blood thin and
  watery, and the child reduced by teething and the bowel com-
  plaint, if there are  any open sores about  the head and face, the
  eyes often partake of the  same  affection.  Some of  the  worst
  cases which we  have ever seen, have  originated from  this  habit
  of body.
     When the disease becomes protracted, it is  called chronic
  ophthalmia.  In this state it will often continue for many weeks
  and even months.   In what are  called week eyes which almost
  always look red, and run more or less, the  sebaceous glands, situ-
  ated in the edges of the eyelids, are inflamed.   The  inflamma-
  tion, in this case, is aggravated on the slightest occasions of expos-
  ure to the hot sun, or the light of rooms in  the evening.  The
  least indulgence in wine, ardent spirits, or heating food is sure to
  render it worse,   The greatest personal beauty is often disfigured
  by this unsightly disease.  No pains should  be  spared, and no
  habits of austerity in  living, avoided, which will  effect a cure.
  We believe it to be in  all  cases curable, if the right  means are
  adopted  and steadfastly persevered in. This disease is thought
  to be contagious; insomuch, that looking long at  a person whose
  eyes are affected, is supposed by many, sufficient to communicate
  it.   This we think very doubtful.  No class  of  people see more
  of  sore eyes than  physicians, and we have never known the
  disease to be taken  in  this way.   Where the matter  taken
  from one person's eyes has been rubbed into  the eyes of another, 
INF.
323
the disease  may have  been produced, but we do not  believe it
was ever communicated  by looking at the  eyes oftener  than in
looking at any other object.   Intensely looking at  any object
may disorder the eyes.
   Ophthalmia is an affection which attacks the eyes of all ages,
and both sexes.  In most cases, it is a mild disease, and of short
duration, but, in some cases, it is violent, and calls  for the most
prompt and active treatment.
   Domestic Remedies.—It is very difficult to do anything for in-
flamed eyes, unless the person can be kept from the light and the
use of the sight.  The constant action of the eyes and exposure
to the light  increase  the inflammation in a greater degree than it
can be allayed  by any treatment which can be pursued.  Unless,
therefore, the affection is very slight, the person should  be  con-
fined  to the house  and  excluded as much as  possible from the
light.  All  reading  and  fine work must be abandoned, and the
eyes kept as still  as possible.  The eyes, in an inflamed state,
require rest  as much as a broken limb.   The inflammation should
be dispelled as soon  as possible, or it may run into  a chronic dis-
ease, or an ulceration and suppuration of the several structures of
the eye.  Whenever the  whites  of the eyes become deeply in-
flamed, and redness begins to appear in the cornea, we may be
sure that the disease is attended with  danger.
   The best application which can be made to the eyes in the
beginning of an inflammation, is water  slightly  warmed.   It
should be about a degree or two cooler than the heat of the body.
If the water is warmer than the body, it may increase the inflam-
mation, or if it is very much colder than the temperature of the
body, it may have the same affect.
   We must avoid any great contrast between the temperature of
the water and  that of the eye, or  we may do more  mischief than
good.  The efficacy of cold applications, in our opinion, depends
upon the degree of cold  which we employ.   Water  of the tem-
perature of ninety-two, or three degrees, we call a cold applica-
tion, as it is colder than the body.  The heat of inflamed eyes is
 probably never less than a hundred degrees ; so that water of the
 temperature of ninety-five degrees may be considered a cold ap-
 plication.   The  eyes should be kept continually soaked with
 water, and  if rain water  can be procured, so much the better, as
it  is  much more solvent than  well  water,  which  is  already
saturated with several  ingredients.    The  person  should lie
back in a chair, and the  eyes should be covered with folds of soft
linen  soaked in water of the temperature we have named.  Every
hour, the water should be made about a degree colder until it is
used entirely cold.  If the temperature of the water is gradually
 lowered, it  may finally be used of the temperature of ice, or cakes
 of ice may  be  used instead of water.   But on no account, should 
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INF.
ice or water as cold as ice be used in the first  instance.   One of
the  worst  inflammations of the  eyes which  we  ever  have
seen was cured  by the process  which we have described, after
one bleeding at the arm, and the application of a dozen leeches.
The effect  of cold, in reducing inflammation, is very great if
properly used; but it must  be  used with great constancy, and
graduated nicely.  It is as improper to use very cold water to the
eyes in  the  beginning of an inflammation as it is to use very
strong solutions of lead and zinc.
   In slight cases where only  the eyelids are inflamed, abstinence
from animal  food, soaking the eyes in water, and a dose of salts
or some other purgative will be all the means required.  If, after
the lapse of two or three days, the inflammation is not dispersed,
eight grains of white vitriol or  a piece of  the  size of a  kidney
bean, may  be dissolved in  four  ounces of  rain  or  spring
water, or which is better still, rose water, and applied to the eye
continually until the soreness  is gone.   Everything depends upon
the constancy of the  application.   If much time  is suffered to
elapse between the applications, the affection progresses faster than
it  is subdued.  If the white vitriol does not succeed, a solution of
the sugar of lead of the same strength may be used. The strength
of these washes should be increased a  little every two days; an
increase of one grain to an ounce of water will be enough. When
the inflammation is deeper seated, and the ball of the eye  is in-
volved, and the sight obscured, bleeding by leeches or cupping, or
by opening a vein must be practised  Indeed, the inflammation
must be reduced by the same means which are employed in simi-
lar affections of other  parts.  The diet must be low, and the drink
nothing but  water, lemonade, or soda powders.   Every species
of stimulating drink  and high seasoned  food  must  be avoided.
After the violence of  the  disease has abated, blisters should be
applied to the back of the neck or to the arms; small doses of the
wine of antimony  given to raise  a sweat; and sal nitre and
the acetate of ammonia to free the kidneys.   The epsom  salts,
cream of tartar, magnessia, or the  Rochelle powders should be
given every day to operate upon the bowels.  Poultices are some-
times very good, if often changed.
   Professional Remedies.—In an acute inflammation of the eyes,
the physician  should  never hesitate in drawing blood until the
countenance of the patient becomes pale ; and the operation must
be repeated a second or a third time, if the case should require it.
There can be no better local applications for recent inflammation
than those we have recommended.  In chronic inflammation, an
eye-water composed of one part  of the wine of opium and two
parts of a solution  of two grains of white vitriol to an ounce of
water, may be used.   If there should be an ulceration of the cor-
nea, the ulcer may be touched with a  little calomel  or with the 
INF.
325
lunar caustic.   Alum water made weak at first, will, sometimes,
succeed better than preparations of lead or zinc.  Where a scale
is formed over  the cornea, a  little loaf sugar powdered fine, or
calomel may be blown into the eye.  A seton in the neck is often
serviceable, and if the system is reduced, quinine or the Grif-
fith's mixture should be taken.  A course of the Saratoga spring
water should be tried where other means fail.
   INFLAMMATION OF THE  HEART—Carditis—In an in-
flammation of the heart, the most striking symptom, is a disposi-
tion to faint, every few moments.  The countenance is ghastly
pale, inclining  to  yellow  ; the pulse quick, small, and intermit-
ting'; there is great restlessness and anxiety ; a panting for breath;
and coldness of the extremities   We have seen two well marked
cases of this disease unaccompanied with any symptoms of peri-
pneumony or affections of other organs.  Recovery took place in
one case, and death in the other,  in the fatal  case, there was a
slight, dry cough, but  no symptoms of peripneumony.   There
was  no expectoration either of bloody or mucous matter, or any
other sign  which indicated  an inflammation of the lungs.   In
both cases, the patients were constantly turning and tumbling.
We witnessed no particular palpitation which has been described
as a symptom of this disease.
   It is said by those who are familiar with the use of the stetho-
 scope, that a peculiar sound resembling the  sound of a bellows
 can be heard when the lining of the cavities of the  heart are in-
 flamed.   The French call this sound the bruit de soufflet.   We
 suspect that the heart is  much oftener the seat of inflammation
 than medical men are accustomed to imagine.
   The main remedy in an inflammation of the heart, and of the
 heart-case, which can not be well distinguished from each other,
 is blood-letting.   The fainting  and other signs of  prostration
 should not deter us from the free abstraction of blood whenever
 we become positive that  the heart is inflamed.  It will often be
 necessary  to repeat it two or three times.  If opening a  vein is
 objectionable, leeches or  cupping should be  employed.  Blisters
 should be used freely and all  those medicines which reduce the
 force of the circulation, such  as  digitalis, antimony, ipecac, and
 lobelia, in small doses.   The  bowels should be drained by salts,
 calomel, and other cathartics, and a perspiration raised by the use
 of the  antimonial  powder, the acetate of ammonia and the sweet
 spirits  of nitre.  Opium in any form is inadmissible.   Hoffman's
 anodyne liquor can be used in its place.
   An examination of the heart after death shows the  same signs
 of inflammation  which take place in other organs.   The lining
 of the heart-case  is  of a very deep, dark, red  color;  and, some-
 times  ulceration is discoverable.   The heart often  discovers a
 softening of its texture ; this will take place to  such a degree that 
326
INF.
the whole  of  the  lining membrane can be scraped off with a
knife.   An inflammation of the heart terminates in suppuration,
ulceration,  and dropsy.   The heart is supposed to be very often
the seat of rheumatic inflammation; but this appears to us to be
rather conjectural, than  founded on observation and fact.
  A chronic inflammation of the heart is manifested in the same
way with an acute inflammation, only,  that, in  the former, the
symptoms are  milder and more tolerable.
  INFLAMMATION OF THE KIDNEYS—Nephritis—Like
most other inflammatory diseases, an inflammation of the kidneys
generally commences with cold  chills and rigors particularly in
the back and loins, followed by  fever and pain of  greater or less
intensity.   The pain though  sometimes obtuse,  is commonly
severe and lancinating, and  frequently  extends  to the bladder,
loins, and even to the thighs.  It is increased by pressure, motion,
straining, and by taking a full breath.  There is  a sense of in-
creased weight felt about the lumbar regions, and  a sensation of
heat and gnawing constriction in the loins.   The urine, if not en-
tirely suppressed, is very scanty, high colored and voided drop by
drop, and occasionally bloody.   In some cases there are faintness,
nausea,  bilious vomiting, oppression at the stomach, hiccup,
tympanitic distention, and rumbling of  the bowels.  There may
be constipation of the bowels or a diarrhea with tenesmus.   A
very constant  symptom in this affection is  a numbness and re-
traction or drawing up of the testis on the  affected side.   The
pulse is frequent and hard ; there is  headache and  restlessness ;
the skin is hot and dry, and the tongue furred    Sometimes in-
stead of being dry the skin is covered with perspiration, having a
urinous smell.  The persons most subject to inflammation of the
kidneys are those  who are frequently troubled with gravel, gout,
rheumatism, lumbago, and eruptions of  the skin.   Intemperance,
the frequent use of cantharides and other diuretics, sudden chan-
ges in the  weather, the  recession of eruptions of the skin, exter-
nal  injuries, inflammation  of the urethra and bladder, and  the
irritation caused by the presence of a calculus in the kidneys or
ureter,  are some  of the most fruitful, exciting  causes of the
disease.
   Notwithstanding the intensity of the  pain and fever that some-
times attends this disease, it is rarely fatal in its acute stage.  It
sometimes terminates in suppuration, but the abscesses are not
usually very extensive.  When the quantity of  matter is small,
it may escape into the cavity of the kidney, and thence into the
bladder and be discharged through the  natural outlet.   In those
cases in which  the quantity of matter is very great, a complete
 destruction of the kidney, and dangerous symptoms may be the
consequences ; though it is rare for the abscesses to break into the
 abdomen,  or to point externally.  Suppuration is indicated by a 
INF.
327
subsidence of the more violent symptoms, a throbbing sensation,
and  a  sense of weight, with alternate chills,  flushes of heat
and  profuse sweating.   Should the disease become chronic, in
consequence of not being completely subdued during the acute
stage, induration and disorganization of the  kidney may be the
result,  nor is it unusual for the kidneys in these  cases to be con-
verted into a mass of hydatids, giving rise to general or local
dropsies, by diminishing or entirely preventing  the  secretion of
urine.   We have  witnessed some deplorable cases of  this kind
which terminated  in dropsy of the brain and other parts,  and in
which scarcely a  vestige  of the kidneys remained, being con-
verted into a mass  of hydatids and corruption.
   Domestic Remedies.—The  principal, and decidedly, the most
potent domestic remedy, for inflammation of the kidneys, is warm
bathing and fomentations.   The feet should be thoroughly bathed
in hot  water, rendered more  stimulating with mustard, or salt;
after which, the  patient should  be put into bed, and the back
and  sides over the region of the kidneys be fomented with large
woolen  cloths, wrung out  of water,  as hot as can possibly be
borne.   In applying hot stoupes in cases of this kind, it is neces-
sary that they be frequently changed,  keeping  up the heat and
moisture constantly, in order  to  derive from  them  the greatest
benefit.   A hot mustard poultice, applied  over  the  seat  of  the
disease,  and changed every hour  will  have  an  effect similar to
the  fomentations,  and may be  used  if preferred.  Putting the
patient into a warm bath, is also  a valuable remedy, but is  not
to be preferred to  fomenting the  diseased part.   Whichever may
be  tried,  it should be  persevered  in until the pain is relieved,
 after which, warm, dry flannel should be substituted, to prevent
 the  patient from taking cold.  The bowels should be opened with
 epsom salts, or jalap, and cream  of  tartar, and copious injections
 of warm water, or decoctions of emollient herbs.  Injections are
 peculiarly appropriate in this disease, affording great relief as a
 local  bath, besides aiding in procuring  evacuations from  the
 bowels, and they  should never be omitted.   The drinks should
 be warm flax-seed, slippery elm, and balm tea,  and  gum water,
 to which may be added a little cream of tartar.
   Professional Remedies.—Perhaps there is no  disease in which
 prompt and energetic treatment is more necessary than in this, and
 as it is highly inflammatory, our chief reliance must be upon de-
 pletion.   Early  and  copious bleeding, both general and  local, is
 the only agent upon which we can confidently rely.   One or two
 bleedings from the arm should be practised, and if the pain and
 other urgent  symptoms are not  relieved, blood should be drawn
 from the back and loins, by  cupping, if practicable ; if not, by
 leeching, to an amount sufficient to subdue, or very much allevi-
 ate the  pain.   Opium, in some of its  forms, hyoscyamus, cicuta, 
32S
INF.
or some other anodyne, is sometimes indispensable, and should
be given in combination with antimony, or ipecac, to an extent
sufficient to put the system under its influence and mitigate  the
sufferings of the  patient.   Nitrate of potash  and the spirits of
nitre, in small doses, combined with antimony are valuable aux-
iliaries,  but  irritating diuretics are inadmissable.   When the di-
sease is caused by gravel and the inflammation has been in some
measure subdued, twenty drops  of  the  liquor potassas, largely
diluted  with flax-seed and  upland cranberry tea,  will be  found
one  of  the most  valuable remedies. Should the disease become
chronic, it must be treated according to the character it may as-
sume.   Counter irritation, with tart, emetic ointment, or a gal-
banum plaster ; the balsam copaiva, or white turpentine, in small
doses; an abstemious diet,  temperance,  and a regular habit  of
body, may contribute to a cure.
  INFLAMMATION OF THE LIVER—Hepatitis—The symp-
toms of an inflammation of the  liver are  an  acute pain in  the
right side below  the  chest, frequently  extending to  the  chest
and  the right shoulder.  This pain is  more distinctly  felt  by
breathing, coughing, and in  lying on the left  side.  If the right
side is pressed with the hand, a soreness is felt,  and the pain  be-
comes  sharp.  The pain in  the  right shoulder is an equivocal
symptom, and not to  be relied upon, unless combined with the
other signs of inflammation.   The pulse is full, hard, and strong ;
the bowels are costive,  and  the stools are ash, or clay colored,
owing to the absence  of the  bile, which  has ceased to flow.   It
is the bile which  gives the yellow color  to  the contents  of the
bowels, and  when the liver is inflamed,  the bile is not secreted,
or but partially secreted, and the stools are deprived of their col-
oring matter.  The bile is also physical or cathartic in its nature,
and its absence leaves the bowels costive.  In this disease, the
urine and the skin are of a deep yellow color, and the whites of
the eyes are also deeply tinged with the same color.  This dis-
ease  is, however, different from jaundice, inasmuch as no symptoms
of fever exist in  that  disease,  but in this, there is a permanent
state of fever.   The  perspiration will  often  be so yellow as to
stain the linen.    The tongue is coated  with a yellow  fur; the
mouth is dry; the skin is hot; and there  is  constant thirst.
  In some instances, the stomach and bowels will  partake of the
inflammation, and when this happens, there will be sickness and
vomiting, and prostration of the strength.  There  is, commonly,
more or less of a dry  cough  in inflammations of  the  liver.   In
some cases, there  will be a swelling over the liver.   If percussion
is used, the liver gives a dull, heavy sound, but when the inflam-
mation has subsided, the sound will become elastic and lively.
   There is a chronic inflammation of the liver in which the same
symptoms are all  present, but less violent, and longer in duration. 
INF.
329
The same treatment is also necessary, but less active.  Less blood
should be taken, and less medicine used.  The fever will be less
in chronic  inflammation, and  there will be less call for powerful
remedies.
   If the inflammation is upon the surface of the liver, or in the
coat which covers it, the pain  will be sharper and more percepti-
ble on pressure than when it is deep seated.   In all deep  seated
inflammations the  pain  is more  dull  than  when the superficial
parts are inflamed.  Like other inflammations, an  inflammation
of the liver  may terminate  in mortification, in which case  it is
fatal;  in suppuration, in which case  it may break outward and
recovery possibly take  place ;  or break inwardly, and death  take
place.   The inflammation may be resolved  or reduced, in which
case, a perfect recovery takes place.   This disease is chiefly pre-
valent in hot climates.   With us, cases of it are extremely  rare.
It is occasioned  by excessive heat, and  sudden changes from hot
to cold weather.   Any of the causes which operate to produce in-
flammation in other parts of the system, may  produce an inflam-
mation of the liver.  Probably the passions of the mind often pro-
duce the disease;  and   intemperance is a  fruitful cause of it.
Temperance and evenness of temper are, therefore, golden habits
which are worth great pains to cultivate.
   Domestic Remedies.—In  inflammatory diseases, but very  little
can  be done to advantage  in a domestic way, until the system
has been reduced by blood-letting, and the circulation of the blood
moderated by the use of medicines which are known to accom-
plish this purpose.   In cases where bleeding cannot be performed
either by leeching, cupping or opening  a vein, small doses of an-
timony, ipecac or lobelia should be  given  which  shall  cause a
little  nausea but  not   vomiting,  which   is  always  injurious
to  the disease.   A quarter of a grain of tart, antimony dissolved
in hot water should be given  every hour until the  pulse is mod-
erated and a sweat produced.   Thirty drops of the  wine of  anti-
mony or of the wine of ipecac, or  a tea-spoonful of the tincture
of lobelia may be given  instead of the solution of  antimony.  A
dose of epsom salts should be given  every  other day;  and, after
the pulse is reduced, in force and frequency, a large blister should
be drawn over the place of  the liver.  This should be  succeeded
by a second or  a third, if the pain and fever are not removed.
After  the blisters come  off,  a large, soft, warm white bread or rye
meal  poultice should be placed over the drawn blister  and re-
newed as often as it gets  at  all dry and hard.   Eight grains of
the  antimonial powder, should be given as soon as the nauseating
doses  are omitted,  in order  to keep up a lively perspiration.  The
nitrate of potash, saltpetre,  in doses of six  grains, once  in three
hours, will assist greatly in  the reduction of the inflammation, by
operating upon the  kidneys.   Indeed, all inflammations are very
            42 
330
INF.
much lessened  by the  flow of a great quantity of urine.   The
skin, kidneys, and bowels should always be kept  well open.
Sometimes a profuse perspiration will dispel an inflammation, and
in other cases, a great flow of the urine or a full  draining of the
bowels will accomplish the same thing.   All heating  herbs and
medicines  which produce sweating by their heating  properties,
are unsafe.   Emetics are improper.   No  herbs should be given
but those which reduce the force of the pulse and assist  either
the perspiration, the water, or the motion of the bowels. It would
be more  proper to give the foxglove in small doses than to give
the hot drops in an inflammatory disease.
   Professional Remedies.—Nothing is of more importance in in-
flammatory diseases than to properly time and graduate the opera-
tion of bleeding.  In the hands  of the  unskilful, blood-letting
may be an unsafe remedy, but in the hands of the skilful  it has
saved thousands of lives.  Judgment and experience in this ope-
ration will prove a safe guide as in every thing else. If the  force
of the circulation is great and the violence  of the disease threat-
ening, even two or three bleedings may be necessary,  but  in or-
dinary cases one  or  two bleedings with leeching, will prove as
much as  will be safe.
   In an active inflammation, the use of calomel is seldom neces-
sary, but in a chronic inflammation this medicine in small doses,
continued until a coppery taste is produced in the mouth, is often
productive of the best effects.  Salivation should never, and need
never, in this disease, be  produced.   The  moment the taste of
the medicine is perceived in the mouth, the medicine should be
omitted until the taste is gone and then renewed  again, if neces-
sary.  The  employment of the mercurial  ointment over the re-
gion of the liver, has often been advantageous.   The blue pill and
cicuta in  doses of two grains each, made into a pill and taken twice
a day, is  a common and excellent  medicine.  Frictions with the
nitro-muriatic acid, over the liver  and stomach ;  and a foot bath
of the same, have of late, been highly commended, and we  have
used both with marked advantage.   The acid should be so weak-
ened with water  as to produce only a slight irritation, and em-
ployed, twice a day,  for ten or fifteen  days in succession.
  Drink acidulated with nitro-muriatic acid diluted with water, has
been highly recommended.  Equal parts of nitric and muriatic acid
diluted with water, and then used like the elixer vitriol to sour
the drink with, is the way in which the medicine  should be used.
   INFLAMMATION  OF THE  LUNGS  OR LIGHTS—Peri-
pneumony.—See Peripneumony.
   INFLAMMATION OF THE  PERITONEUM—Peritonitis.
—This is a disease of the extensive membrane which lines the in-
side of the belly, to which the bowels are attached, and a process
of which also forms the omentum or apron.   In an  inflammation of 
INF.
331
this membrane, although it is situated in the cavity of the belly, and
although it covers the external surface of the bowels,  the proper
action of the bowels is not very much disturbed.   In this respect
the disease differs very  much  from an inflammation of the bow-
els  or enteritis, and fiom the colic.   Neither is the  stomach apt
to be much  affected in the  first stage, but in the second, a vomit-
ing or belching of a blackish, or coffee ground matter, is a com-
mon symptom and indicates imminent danger.   The pain and
soreness in this disease are  felt  more upon the surface of the belly
than in  any inflammation of the bowels.  The pain  is often very
sharp and distressing, and  the soreness over the whole abdomen
extremely great.   The  surface of  the belly is  tense  and  some-
times swelled.   There is not apt  to be much swelling, however,
unless the apron is inflamed, in which case, the swelling is in the
upper part of the belly,  just under the pit of the stomach.   If the
inflammation is in that part of the peritoneum to which the bow-
els are attached, the pain and soreness will be deeper seated, and
the surface of the belly  less sensible to the touch.  The skin is
hot and dry and the pulse  small and quick; the countenance in-
dicates  constant pain; and the  legs are drawn up to  relieve the
tension  of the abdominal muscles.   Every long breath produces
pain in  the abdomen, so that the  breath is constantly cut short.
   The  bowels will sometimes be  costive and at other times loose,
but in many instances, they will  not  be essentially disturbed, or
not more disturbed than they are in a fever or in other inflamma-
tions.   The  pain  and soreness are  much greater  than ever  take
place in a diarrhea, and the obstruction much  less  than  takes
place in an inflammation of the  bowels.   It is  a disease much
longer in its duration than enteritis.  It will not therefore be very
difficult to distinguish it both from an inflammation of the bowels
and from diarrhea.
   Domestic  Remedies.—Small doses  of ipecac, antimony or of
lobelia,  to relax the pulse and to raise a moisture upon the skin,
will be perfectly  proper.  A large poultice of white  bread, rye
meal, or flax-seed meal  should  be applied to the belly, and often
renewed.    Lemonade,  soda  water, and  sweetened water are
appropriate  drinks, and  indian gruel, toast water and barley gruel,
a suitable diet.   A dose  of  butternut physic,  salts, magnesia,
castor oil or cream of tartar should be given every day unless
there should be a looseness of the  bowels.  It is of the greatest
importance  to keep up a moisture upon the skin, without the use
of medicines or drinks, which increase the heat and  the force of
the circulation.   The kidneys should be  kept free  by the use of
cream of tartar for drink, or the sal nitre.   In all deep-seated in-
flammations, bathing the feet  in hot water, twice or  three times
in twenty-four hours, and applying to them stimulating poultices,
will be found beneficial, and should always be early  employed. 
332
INF.
   Professional Remedies.—The application of a dozen and a half
of leeches every day for three days in succession, is the most ef-
ficacious remedy which can  be  employed.   If these cannot be
obtained, the patient  must be bled freely by the arm until the
pain and soreness abate.  Where the skin is hot and dry, and the
surface  of the belly painful, sore, tense and swelled, there  can be
no harm in trying a solution of the sugar of lead as a  topical
bath,  or the application of cold water.  Blisters should  not be
used until the violence of the fever has abated.   Calomel or the
iodide of mercury in  small doses, given long enough to produce
a metallic taste in the mouth, but not to salivate, should be tried, if
the inflammation does not yield to other remedies.   The antimo-
nial powder, the sweet spirits of nitre, and more especially the
acetate  of ammonia will  be found  necessary to subdue the fever
and to aid the  reduction of the inflamed parts.  After bleeding
freely and evacuating the bowels, if there be  much pain, opium
or the Dover's powder combined with small  doses of  calomel,
and alternated  with a nauseating dose of  antimony, every four
hours, will  afford great relief, and  assist in subduing the inflam-
mation.  This disease is produced by the same causes which pro-
duce other inflammations.
   INFLAMMATION  OF  THE  PLEURA — Pleurisy.  — See
Pleurisy.
   INFLAMMATION  OF  THE  SPLEEN—Splenitis.—The
spleen is situated on the left side of the abdomen opposite to the
liver.   An inflammation of this  organ is known by a pain just
under the short ribs of the left side, swelling, soreness to the touch,
and more or less fever.  The pain  in the side will often  shoot up
to  the diaphragm and  to  the left shoulder, and be  accompanied
with a short, dry cough ; a sense of tightness about  the heart;
sickness or vomiting ;  and a discharge from the bowels  of black
blood.  This disease like an inflammation of the  liver, is chiefly
prevalent in hot climates, and requires in general, the same treat-
ment, where the symptoms are equally violent.   The spleen ap-
pears  to be subject to  a chronic oftener than to an acute inflam-
mation, in which case, the disease must be combatted with leech-
es, the blue  pill, warm bath, a course of the mineral spring water
and  mercurial  plasters.    A mixture  of  muriatic  and nitric
acid  used as a sour  drink,  is a capital medicine  in a chronic
inflammation of the spleen.  A tea made of the barberry bark, and
drunk several times a  day, is  a medicine of considerable efficacy.
The spleen sometimes becomes enlarged to an enormous size, in
which case, it  has  been cut  out and  the person has lived.  It
would not seem therefore to be an organ essential to life, although
the disease of it, may destroy life,  or greatly derange the health.
Like  the organs of generation,  it  gives strength  and  greater
life to the system, although not indispensable to existence. 
INF.
333
   Where clear indications of an acute inflammation in this organ
 exist, the lancet should  be used  freely ; the sal nitre  should be
 given, and  a constant perspiration should be kept up by the use
 of the antimonial powder, or small doses of ipecac, or of lobelia.
 The bowels should be drained by salts, thoroughwort or butter-
 nut physic ; and the part steamed with moist, hot cloths.
   INFLAMMATION  OF  THE STOMACH—Gastritis—An
 inflammation of the stomach is a rare disease.   It commonly hap-
 pens from irritating and  corrosive substances which are taken into
 the stomach.  Arsenic,  corrosive  sublimate, aqua fortis and the
 other mineral acids, and alkalies are the usual causes of it.  It
 sometimes arises from the use of spirituous liquors ;  from  blows ;
 and a sudden suppression of the perspiration.
   This disease commences with  great  pain in the region of the
 stomach ;  an unquenchable thirst; intolerable restlessness and
 anxiety;  constant  vomiting ;  great prostration  of strength;  a
 quick, hard and small pulse; and  continual watching.  Often,•de-
 lirium and purging attend the disease. The countenance is sunken
 and the extremities  cold.  Where the  disease  is about to termi-
 nate fatally, there is a constant fainting and panting for breath  ;
 a cold clammy sweat and hiccup.  The inflammation terminates
 either in resolution,  ulceration, suppuration,  or gangrene.   If it
 terminates in gangrene it is fatal, and if in ulceration or suppura-
 tion, it may be protracted  for a length of time, but eventually
 ends in hectic fever and death.   In case of suppuration and the
 formation of an  abscess, the event is known by cold shiverings
 and an increase of fever at night, and  the accession of night
 sweats.
   The favorable symptoms are  a soft, full pulse, a  warm pers-
 piration, sleep,  looseness of the  bowels, and a greater state  of
 composure.   We  once  saw a fatal case of inflammation of the
 stomach, which was produced by eating quohogs and cucumbers.
 It sometimes happens from the eating of lobsters and other indi-
 gestible or poisonous fish.
   Domestic Remedies.—Where any acid, burning substance has
 been swollowed and produced the inflammation, sweet oil, melted
 lard or milk and water  must be given, to neutralize the  effect.
 If the substance is an alkali, such  as pearlash, potash or ammo-
 nia, lamp oil may be used, if the sweet oil is not at hand.  If the
 substance should be corrosive sublimate, or arsenic, pearlash dis-
 solved  in water, may be  drank.   Emetics should  be given and a
great plenty of  warm water or flax-seed tea, or sugar and water.
If the substance taken into the  stomach, should be aqua fortis or
any of the mineral acids, the water of ammonia, largely diluted,
should be administered.   The crude soda or a lye made of wood
ashes mixed with a large quantity of water, will neutralize  these
acids and render  them innocent, if taken immediately.  In gen- 
334
INF.
 eral, we must make use of the same remedies which are recom-
 mended in cases of poisoning.
   Professional Remedies.—After the  offending substance  has
 been removed, the inflammation must be allayed by infusing lau-
 danum into  flaxseed  tea, and  giving it by way of the rectum.
 As soon as the vomiting is allayed, gum arabic water and chicken
 broth  may be given.   Opiates should always be given if they
 can be made to stay upon the  stomach.  The cooling treatment
 must be strictly followed.  Soda water, the rochelle powders, and
 the acetate of ammonia  in a  state effervescence, will always be
 proper when they can be made to stay upon the stomach.  Cold
 water,  bread  water, rice  water, and arrow root gruel should com-
 pose the drinks.   An  inflammation of this organ will sometimes
 end in a scirrhus of the  pylorus, and where this  is the  case,  the
 disease can  only be palliated.   Opium,  cicuta, and hyoscyamus
 will be productive  of most relief.
   INFLAMMATION OF THE TESTES.—This inflammation
 begins with swelling, pain, and  soreness of the glands, and very of-
 ten sickness at the stomach. The seminal organs become very sore,
 and extremely tender to  the touch. The inflammation will some-
 times run so  high as to produce a general fever.   The  parts be-
 come red and extremely hard, and there is pain in the lower part
 of the  bowels.
   The most common  cause of  the inflammation  is the irritation
 of  the venereal  virus.  It  is  sometimes produced by  external
 wounds, and, occasionally, by atmospheric changes.   A reduction
 of the  inflammation may always be attempted by sweating freely,
 and the application of lead water to the inflamed parts.   If this
 plan does not succeed in  the course of twenty-four hours, a dozen
 of Spanish leeches should be applied, followed with a warm, soft
 rye  meal or white bread poultice,  or, perhaps,  what is better, the
 persevering application of woollen  cloths wrung out of hot water
 and removed  every twenty minutes.   If the first application  of
 leeches does  not resolve the inflammation, they must be used a
 second or a third time.  Where leeches cannot  be obtained, blood
 must be drawn from the arm.    The  bowels should, at the same
 time, be drained by salts, calomel, magnesia or  some other gen-
 tle  purgatives, and the inflamed organs supported by a suspen-
sory bandage.  The diet should be entirely vegetable, and spare,
and the drink nothing  but water.   If poultices do  not  assist in
dispelling the  inflammation, nauseating or even emetic  doses of
the tartrite of antimony will be found an efficient remedy. From
a quarter of a grain  to a grain, dissolved in a large quantity of
warm water  should be given, every three hours.
  INFLAMMATION OF THE THROAT—Sore  throat—See
Sore throat.
  INFLAMMATION  OF THE WOMB—Hysteritis—This dis- 
INF.
335
ease is the consequence of childbirth.   We know not that it ever
happens to unmarried women, unless the womb happens to be in-
jured by wounds or bruises.  Cancer of the uterus is a species of
inflammation, but it is easily  distinguishable from the disease we
are about to describe, by the slow, gradual manner in which it
commences, and the absence  of the ordinary arterial excitement
of inflammation in general.
   An inflammation of the  womb begins with pain  in the lower
part of the abdomen ; heat  and chills ;  headache ; restlessness ; a
frequent desire to make water,  accompanied with  pain;  some-
times a retention of the urine ;  and often delirium.   The pain in
the womb may be distinguished from the after-pains by its being
constant, while the after-pains are intermitting.   In this disease,
the uterus is  tumid, and sore  to the touch.
   The pulse is full, hard, and forcible, but not, commonly, very
frequent.  The mouth is  clammy and the tongue has a white
coat;  there  is thirst and a confined state of the bowels.   The
sanguineous  secretion  consequent on delivery, is lessened  or en-
tirely suppressed, and  the  milk though not often suppressed, is
diminished in quantity.  As the inflammation advances, the pain
becomes more severe, and extends to  the back and  down the
thighs.  The pain is, sometimes, dull  and heavy, and, at other
timesj acute and darting.
   The renewal of the puerperal secretion or the lochia is always
a good sign, as it imports an abatement of the inflammation.  If
there is also an increase of  water, a diminution of  the swelling,
an appearance of the perspiration, and a disposition to sleep, we
may expect   a favourable termination  of  the  disease.   An in-
flammation of this organ may end either in suppuration or gan-
grene, or, what is more common, may  extend to the peritoneum
and  produce  fatal inflammation of that membrane.  In  either
event, it is fatal.
   The disease is caused by too hard a labor; by some violence
done the uterus in delivery by the  use  of instruments, or,  in ex-
tracting the after-birth ; by taking cold ; and improper nursing.
   The treatment of  this disease is much more  perplexing than
that of ordinary inflammations.   It takes place after the loss of a
good deal of blood and a still greater loss of strength.  It appears
about the usual time of the milk fever, and the pain  and soreness
of the  part are not always, at  first, distinguishable from the after-
pains.   The  loss of strength may also be confounded with, or
mistaken for  the  exhaustion  of delivery.  The  organ  probably
loses in the process of child-birth, much of  its sensibility, which
renders the pain and inflammation somewhat obscure.
  Domestic Remedies.—The bowels in this  disease should be
constantly drained.   For this purpose, epsom salts, calcined mag-
nesia, castor oil, cream of tartar, calomel and jalap, or the rochelle 
336
INF.
 powders will answer, and where either of these is not obtainable,
 either the butternut physic or thoroughwort may be used.   The
 cream of tartar taken in the dose  of  a  great-spoonful every two
 hours until it operates, is a very fit medicine.  It operates not only
 upon the bowels but upon the kidneys,  by increasing the flow of
 the  urine.  The calcined magnesia  has the same or a greater
 tendency.   Dr. Dewees,  of Philadelphia, directs three drachms
 of calcined magnesia,  and three  of epsom salts  to be  mixed
 together and  taken in  sweetened  water or lemonade, in three
 doses, at the  interval of an hour between them, and  continu-
 ed until an operation is produced.   The operation of the bowels,
 he advises to be kept up by the use  of small doses of calomel,
 rochelle powders, or epsom salts, to  the extent  of  eight or ten
 times in the first twenty-four hours.  Afterwards, he  drains the
 bowels once every day by a potion of the same kind.  We cor-
 dially recommend the same course.
   The antimonial powder in doses of eight grains should be given,
 every three hours, to raise a moisture upon the skin, assisted by the
 use of the acetate of ammonia in a state of effervescence. The kid-
 neys should be operated upon by the  use of the sal nitre in doses
 of six  grains every three hours.   Balm tea,  mullien  tea and
 warm  lemonade  should be  given for drink; and barley gruel
 for nourishment.   Steaming with cloths wetted  with hot water
 are considered doubtful  applications;  dry heat is  more  suitable.
 A warm white bread, rye meal or flaxseed poultice kept con-
 stantly applied  over the  inflamed organ,  is probably the  most
 proper application which can be made. Vomits are improper, and
 opiates are unfit until the violence of  the disease  is abated.   In
 vehement,  deep-seated  inflammations, opium always does mis-
 chief.
   Professional Remedies.—Bleeding in  this disease is indispens-
 able, although the patient may have recently lost  much blood in
 consequence  of  delivery.   Perhaps  there  is no inflammation
 which demands it more than this.   It will  often be necessary to
 repeat  the operation two or three times.   Two or three dozen of
 Spanish  leeches with one bleeding, will, in many instances, be
 preferable to bleeding by the arm, the second time.
   A  free perspiration should be supported,  the kidneys  must be
 kept free, the bowels must be often drained, and a plenty of dil-
 uent drinks given.  After the force  of the disease has been broken
by bleeding and other  evacuations, the Dover's powder or the
morphine maybe given, to  ease the  pain, which is often quite
 insupportable.
   INFLAMMATORY FEVER—Synocha—This fever seems
 to be only a high degree of the simple  continued fever, or in oth-
er words, it  is  more inflammatory.   The  pulse in this fever is
always hard, full, and strong;  the heat  of the body is much in- 
INF.
337
creased ;  the urine is red; the skin dry and  parched; the eyes
inflamed  ; the face flushed ;  the tongue furred with white in the
centre, and is of a scarlet color at the sides ;  the bowels costive ;
and the stomach oppressed  with sickness.   The pulse ranges
from ninety to a hundred and thirty beats in a minute.
  The fever comes on with chills, lassitude, and pains in the
head, back and in all  parts of the body, with more or less affec-
tion of the stomach.  In the progress of the fever, the thirst be-
comes extreme, the breathing difficult, and the patient  uncom-
monly restless.   There  is the greatest commotion in body and
mind, and a high degree of gastric affection.  If blood is drawn,
it exhibits a sizy crust of uncommon thickness.  Delirum is com-
mon in the advanced stage of the disease.
  The inflammatory fever is produced by atmospheric changes
from heat to cold, from wet to  dry, and from certain unknown
states of the air itself.  It is  most common  in the spring ; and
attacks  people  in the vigor of  life oftener  than  the old or the
young.  The hale and full-blooded are particularly the subjects of
it.
  Domestic Remedies.—The patient  should not be  placed in a
hot room ;  the temperature of the place should never be above
sixty, and a lower degree of heat is preferable.  The head, face,
and surface of the  body should  be bathed with cold water by
means of a sponge or wet cloths  ; and if  there is any sickness at
the stomach, a gentle emetic should be  given.  Rochelle pow-
ders or salts should  be taken in  sufficient quantity to move the
bowels;  and the kidneys should be  freed by the use of sweet
spirits of nitre, and cold acid drinks.   Sweating, in this disease,
is not to be forced.   To procure  sleep and rest, Hoffman's ano-
dyne liquor in  tea-spoonful doses, is preferable to opiates.  But
when an opiate becomes indispensable, it will be advisable  to
give eight grains of  the Dover's powder, or twenty-five drops
of morphine.   The drink should be cold water, lemonade, soda
water, and barberry water ; and  the nourishment, indian gruel,
barley water, and bread and rice water.
  Professional Remedies.—Blood-letting  is  the main remedy
in  inflammatory fever.   Early  in  the  attack of the disease,
twelve or fourteen ounces should be drawn from the arm at once.
If the pulse continues full,  strong, and hard, and the appearance
of the  blood, sizy, the operation  should be repeated in the course
of  the  next twenty-four hours.  If the brain is more affected
than the other parts, leeches should be applied  to the  temples.
Cold water or ether should be constantly applied to the head, and
mustard  poultices to the feet; these last, however, should never
be  used  in the  height of the fever.  A free use of blisters must
also be made to the head.
  If the  breathing be oppressed, and delirium arises : if the pulse
            43 
338
INF.
sinks and the feet become cold, wine, ether, hartshorn, and cam-
phor must  be given to support the  powers of life.   If there is
much stupor,  intolerance of  light, and  excessive action of the
heart and arteries, the event will be doubtful.  Picking at the bed
clothes, starting of the tendons, and involuntary discharges by
stool and urine are fatal symptoms.
  In ordinary cases of the fever, the treatment  should be the
same as in  continued fever, with the exception of a more free use
of the lancet, blisters, and other antiphlogistic means.  Antimony,
ipecac, acetate of ammonia, sal nitre, and saline purgatives, with
the employment  of injections as the occasion  may require, will
be found severally useful and necessary.
  INFLUENZA—Catarrh.—The influenza is a  hoarse  cold.
When the  disease  is  fully developed, it is known by symptoms
of fever, and an increased quantity of phlegm in the nose, throat,
and windpipe.   The first approach  of it  is  perceptible  in the
mucous  membrane of the nose, by a tingling  feeling, and a de-
gree of dryness and fulness of the passage.   Soon succeed more
or less pain in  the forehead and difficulty of breathing through
the nose.  The dryness of the air passage to the lungs, is follow-
ed by a  discharge of a thin, serous fluid.  Water runs both from
the nose and eyes and there is pain felt in  all the bones.   This
condition  does not last  long before there is  hoarseness  in  the
throat, and a sense  of rawness and soreness in the windpipe.   A
cough arises, with more or  less  difficulty of breathing.  The
strength, and appetite are weakened or  lost, and there are  thirst,
restlessness, and other symptoms of fever.
   A remarkable chilliness or sensitiveness to cold is  one  of  the
most prominent symptoms of influenza.   The cold  air never fails
to strike a chill through  the whole system, and if  the patient is
much  exposed to it, a relapse is often induced.  Too much cau-
tion, therefore, cannot be taken to prevent all such  exposures.
   The cough, which is at  first dry, soon becomes loose, and
brings  up  a load  of phlegm;  and with  the looseness  of  the
phlegm  and cough, there follows an abatement of the violence of
the disease.   In common cases and in good constitutions, the in-
fluenza is  of short  duration.   In three  or four days, the hoarse-
ness and  soreness  of the throat, cease, the fever abates, and the
cough subsides.
   An inflammation of the tonsils or almonds of the ear often ar-
rises along with  the influenza, and  renders the  complaint more
severe and longer in duration.   This is evinced by pain in these
parts and difficulty of swallowing, as well as by a higher degree of
 fever.
   The exciting cause of influenza is generally deemed to be ex-
 posure to cold ; but the  disease is an inflammation of the mucous
 membrane of the nose, throat, and windpipe,  and may doubtless 
INF.
339
be produced  by any of the causes which produce inflammation
in general.  To confine its production to the application of cold
alone, is neither warranted by fact nor analogy. Heat is probably
oftener  the cause of inflammatory diseases than cold.  Heat is a
direct stimulant; cold is a sedative.  Heat excites the action of
the sanguiferous system ; cold allays it.  The action  of cold or
excessive  abstraction of heat from the body probably precedes
the stimulus  of heat in the production of inflammations.  The
sudden  transition from one extreme to the  other constitutes the
cause of diseased action.
   Influenzas are most prevalent in  the fall and spring, when the
earth and the  atmosphere are charged with a great quantity of
moisture,  and when freezing and thawing are daily occurrences.
   In general, it is a mild complaint, mostly free from danger, but
in people disposed  to lung affections, such as  asthma, coughs,
hemoptysis, it  often  lays  the foundation for consumption.   It
readily  induces tubercles and  bleeding from the lights.  It is a fire
whieh enkindles  the  train which, perhaps,  had  long  been laid,
but which would have remained unharmed but for this accident.
   The  variety of the changes which  the atmosphere  undergoes
in its constituent principles and its weight,  has never been made
a subject of very close inquiry.  It is probable that an inflam-
mation  may  be excited in the human body by  a change in  the
weight  of the air as well as by a change in  its temperature.  No
inconsiderable violence is done  to  the solids and fluids of the
system, every time  the barometer  rises or falls.  The  electrical
changes of the air are probably no less effective  in disturbing the
actions  of the animal economy.  Its changes from moist to dry,
without any  variation in temperature, may be a source of many
maladies.
   The  influenza is often an epidemic  disease,  pervading  the
whole country, and, sometimes, the whole globe nearly  at  the
same time.   At such  periods it often rages with great severity,
and assumes a malign character.   Within the  last twenty-five
years, it has prevailed three times  in this country and carried off
many of the  aged and not a few of the young.
   The  epidemic influenza has been known to prevail in all sea-
sons of the year, so that its cause cannot be the  effect  of changes
from warm to cold.   Many have  supposed it to be occasioned by
some peculiar constitution  of the air independent of  its sensible
changes.   But whatever the nature of its cause may be,  it  ope-
rates suddenly, and diffuses itself widely in a short space of time.
   Remedies.—In most cases of influenza, it is necessary only to
remain  in the house, for a few days, to adopt a vegetable diet, to
take warm demulcent drinks, such as flax-seed,  mullien, and slip-
pery elm bark tea,  in order to excite a gentle sweat.
   In severe  cases, an  emetic, of ipecac,  antimony,  or  lobelia 
340
INO.
should be given.   It will often be necessary to repeat the emetic,
several times.   A simple emetic is productive of great relief, but
will not always be found adequate to a complete cure.   As with
blood-letting so with emetics, the  disease can only be subdued
by a proper adjustment of the means to the end.  Vomiting has
great power over the mucous membrane of the lungs and wind-
pipe ; it  seldom fails to loosen the phlegm and  moderate the
cough.
   Blood-letting must sometimes be  resorted to  as well as medi-
cines which moderate the circulation  of the blood.   Blisters to
the chest  are often required, and generally productive  of much
benefit.
   After the violence of  the disease  is over, and the phlegm loos-
ened, a Dover's powder may be given,  or twenty-five drops of
morphine or laudanum.  The hive syrup, in tea-spoonful doses, is
a good medicine in this complaint.   The lac ammoniac is often
beneficial.  Equal parts of castor oil and the syrup of squills, in
the  dose  of a tea-spoonful, every three or four hours, will  be
found of great benefit.   In general, the  bowels should be kept
open, the kidneys free, and  the  body warm.   It should always
be borne in mind that the influenza is an  inflammatory disease,
and requires depletion instead of stimulants, unless where it as-
sumes a  malignant  form ; in  that  case, stimulants will  be de-
manded.
   INFUSION.—An infusion of any medicine is made by pouring
cold or hot  water, or any  other liquor upon it to extract its vir-
tues.  It  differs from a decoction in that the water is not raised
to the boiling point.  The material  is only soaked or steeped.
   INORDINATE APPETITE.—Nothing is more remarkable
in the animal economy than the difference between different peo-
ple of the  same age, size, and habits,  in the quantity of food which
they eat.   This difference is owing  to many causes.  The secre-
tion of the gastric juice appears to be the cause of the appetite in
general.   If this secretion is checked or suppressed, as in a fever,
the  appetite is  lessened or destroyed.   And the longer a person
goes, after the digestion of one meal before he eats another, the
more inordinate will the appetite become from the accumulation
of the gastrie juice in the  stomach.   The greatest eaters are not
always large, fleshy, or fat.   Often, people will have an inordinate
appetite who are thin, and emaciated.   It is  not  uncommon to
meet with individuals in apparent good health, who will eat three
or four times the quantity of food which is demanded by people
in general.  Where  the food makes  flesh in  proportion to the
quantity eaten, or where it is demanded by excessive exercise or
hard labor, or to replenish the empty vessels after the long ex-
haustion of  a  fever,  we cannot esteem the inordinate appetite a
disease; but when it  arises from a feeling of faintness and empti- 
INO.
341
ness, or from a  habitual indulgence in large and frequent meals,
it becomes a disease, and requires correction.
  In some cases of inordinate appetite, the food will be thrown
back from the stomach, and, in other instances, it will be digest-
ed.   The case  of Tarare, quoted by Dr. Good, as related to the
French Institute, by M. Percy, a surgeon in chief to the French
army, is a striking  illustration of an inordinate appetite attended
with a corresponding force of digestion.   " Tarare was a soldier ;
and before  his enlistment, was in the  habit of devouring enor-
mous quantities of  the coarsest flesh, fruits, and  roots; and sub-
sequently, he  was  found, after swallowing  his  own rations, to
feed on the refuse of  his comrades' messes  or  offensive meat
thrown on the dunghill; and  to  devour cats,  dogs and serpents.
He was strongly suspected of eating human flesh ; and was often
restrained with difficulty from the ward appropriated to the dead.
He at length fled  from the army before a rumor that he had de-
voured a child of sixteen months  old, which had suddenly disap-
peared.   The alvine evacuations  of this man were not immoder-
ate : but after gorging  his  stomaeh, he slept and sweated in tor-
rents of perspiration, a symptom common to the disease.   He fell
at length  into hectic and died of emaciation."
  Excessive perspiration always produces an inordinate  desire
for food, where there is no fever present in the system ; and it is
more or less so with all excessive evacuations,  whether of blood,
urine, or of the intestinal contents.   A dose of physic, taken every
day, in a  state of health, promotes the appetite enormously.
  Where  an inordinate  appetite is accompanied with emaciation
of  the  body or excessive evacuations, the method of  cure is to
restrain the evacuations, and to treat the system with tonic medi-
cines, such as quinine, chalybeate waters, mineral acids, and wine.
Opium is  found to allay the appetite very much.   Small nauseat-
ing doses  of ipecac, antimony, or of lobelia, by keeping up a slight
sickness at the stomach, will moderate the appetite.  In cases of
emaciation, the warm bath, moderate exercise, and a sea air will
have a tendency to correct the disorder.   Idiots and people who
have lost  their mental faculties are apt to be great eaters: a fact
which shows the  influence which the action of the mind exerts
upon the  stomach.  Man reduced to a brute, acquires the diges-
tive powers of a brute.
  INORDINATE  LUST—It is not more singular that the sex-
ual appetite should become morbid  than that any other function
of  the  body should become deranged.   The  sexual organs  are
capable of  irritation, and when from some cause or other this
happens to be the case, it is scarcely less to be deplored than the
most distressing diseases of other  parts.
  Young  men often confess and lament their own weakness in this
respect at the same time that they declare their utter inability 
342
INO
to remedy the evil.   Whether the disorder is owing to some fault
in the original temperament of the nerves ; to vicious habits or
to certain false ideas which have crept into their minds, it  is not
easy to determine.  Certain it  is that both sexes are liable to a
disorder of this nature.   Such was the severity of  this disorder
in a young man  belonging to one of the States, that he actually
besought his  physician to take from him the  physical power of
sexual gratification, and after a mature consideration of the whole
case, the request was  actually complied with, and the organs
were removed.  The case had become deplorable.   The young
man was reduced to a skeleton, his mental faculties had become
impaired, his resolution gone, and his life had  become a burthen;
so much was he tormented day and night, with inflamed desires.
The surgeon has been blamed, but the operation  was  attended
with entire relief, and the sufferer has never regretted it.
   An irritation of the sexual organs, or  inordinate lust is indicated
by sadness  of the  countenance,  a pale complexion,  lascivious
looks and  gestures, and  a want of spirit in the motions of  the
body.   In some instances there is a visible  local irritation, and,
in others,  inflammation.   The tincture of cantharides, it is said,
will produce an  irritation of the sexual organs. Lying-in women
are, sometimes, affected with a purely  local inflammation of  this
nature, but in these instances,  we believe,  it  is  always accom-
panied with some alienation of the  mind.
   The cure for this disorder  is a vegetable  aliment, cold water,
a cold bath and  constant exercise or labor.   Laborious people are
seldom  troubled with inordinate lust.   In them, the fluids of
the body are equally distributed ; their senses, at night, are  fast
locked  in  sleep; their thoughts,  during the  day, are occupied
with the material world,  and no space  is left for the imagination
by its bewitching imagery, to inflame  the desires.
   A life at sea for a few  years, has, sometimes, proved a cure for
this disorder.  But all medical authors agree that the most  effect-
ual remedy is a  suitable  marriage.   Where  it  is the consequence
of a debauched life, it is pretty sure to entail upon the individual
a  miserable old  age; lowness of spirits; melancholy, and often
an entire loss of the mental powers.
   The  cicuta taken in the form of a pill  three  or four times a
day,  gives  an obtuseness to the  irritation,  and composes the
nerves.   Camphor, in doses of five or  six grains, will have a  sim-
ilar effect.   But opium comes  the nearest  to an antidote of any
article,  at present, in use.  Two grains of opium taken three
times a day, and continued for several weeks  in succession,  will
often reduce the affection within due bounds.   The  application
of lead water or a  solution of the sulphate  of zinc to the parts
will assist  in the cure.   Instead of romances,  novels, and poetry,
a severe kind of reading  should be  pursued, such as history,  law, 
INO.                         343
newspapers, and political essays.  The study of mathematics and
natural philosophy will have a still better effect.
  INORDINATE THIRST.—People differ scarcely less in the
amount of food  which  they eat than in the quantity of water
which they drink.  Some people never drink excepting  at  their
meals, while  others will swallow several  quarts  in the course
of twenty-four hours.   We had a relative in  the  enjoyment of
the most perfect health, who never drank anything in the whole
day, but two or three cups of tea.   It is a fact, we  believe,  that.
people who are not troubled  with thirst, seldom perspire much,
or have the temperature of their bodies much raised.  The power
of salt in producing thirst is a singular phenomenon.   It  is  prob-
able that  inordinate  thirst where it is not a symptom of fever or
of some excessive secretion and evacuation, depends upon a state
of the stomach very much like that produced  by salt—a slight
irritation never amounting to pain, soreness, redness, and swelling,
but enough to demand the  presence of cool liquids.   An increase
of heat in the  system is almost invariably followed  by an increase
of the thirst.
   The habit of drinking large quantities of water or other liquids,
we believe, to be very pernicious ; it dilutes the gastric juice and
lessens its solvent power; and, eventually, destroys the appetite ;
it generates wind and weakens the coats  of the  stomach and
bowels;  it thins the blood and  destroys the cohesive power of
the muscular fibres.   In cases of inflammation, the  drinking of
large quantities of diluent liquids is precisely the course we take
to lessen the stimulant properties of the blood and to  restore it to
a healthy state.   In  a state of health the blood is impoverished
by large quantities of drink in  the same way that it is  in cases
of  inflammation and fever.  We believe, however, that where
people over-eat,  cold water is in a measure a corrector of its per-
nicious  effects.
   We once saw a case of  inordinate thirst  where  the individual
drank to the amount of a quart of water, every hour, or  twenty-
four quarts in  the course of the day and night.   It continued for
about a year, and gradually subsided.  There was in  this case no
excessive evacuation excepting by the kidneys ;  but  the  kidneys
did  not appear  to be diseased, nor was there  any other disease
apparent in the system.
   In cases of immoderate thirst, the best medicines are soda pow-
ders, lemonade,  cream  of  tartar, sweet  spirits of nitre, the sal
nitre, liquorice, gruel, balm tea, and  acetate of ammonia, or lemon
juice and the salts of hartshorn.  The cold bath should be often
used, and the  food should be eaten  in as fresh a state as  the pal-
ate will bear.   The  chewing of  liquorice stick  has  a wonderful
effect in abating the thirst.   Rain or spring water where it can
be obtained, is much preferable to well water, which always con- 
344
INS.
tains more or less of earthy, fossil or mineral matter.   A person,
afflicted  with inordinate thirst, should avoid exposure  to  great
heat of the sun, lest by  instinctively drinking too much cold
water at a time,  they should fall victims to their disorder.
  INSANITY.—This disease is a  derangement of the nervous
system.  But whether it is an inflammation, a paralysis, or a sim-
ple state  of debility, we have as yet found no means of deter-
mining.  An alienation of the mind may arise from either of
these three states of the brain and nerves.
  Mental derangement or insanity has been divided into several
different kinds, but  as all these divisions have been founded upon
the  mental manifestations, and not upon the  state of the pulse,
the  secretions, and variations  in the  operations of the functions of
the  body, generally, such  as  fonn the distinctive characters of
other species of disease, they do not seem to us of much moment;
much less are they calculated to throw light upon the nature of the
disease, or to be  a useful guide in its treatment.  Some  of  these
distinctions appear to us to have no  foundation  in fact.  There is
for instance, a certain state of the mental manifestations, called
monomania.   Now, we believe, that the nervous system of those
who are called monomaniacs, is often as deeply and as generally
diseased  as  the  nervous system of those who are deranged upon
every subject, although  it  is said that  the  monomaniac is sane
upon every subject, but one.   Some people will  appear, in con-
versation and perhaps in their general conduct, to be sane upon
every subject but one.   Others will appear to be sane upon all
subjects,  but two, and others again upon all subjects but three or
four, and  so on ; but the  man or  woman who is deranged on
three or four subjects, is seldom more  diseased than  the person
who is deranged  only upon one.   If  the  manifestations of the
nervous system  in general, are examined  by one well skilled in
this disease, he will very soon  perceive that the monomaniac is
as unsound as he who is deranged upon subjects in general.  A
man is often said to be insane only in his religious, or political
notions, or respecting his wife, children,  or  some philosophical
subject, but this  subject, as it  is called, often includes a large class
of subjects or of ideas and feelings,  and embraces as much in re-
ality as if the person manifested a more extensive range of aliena-
tion.
  Dr. Cullen has divided  insanity into two kinds, melancholy
and mania; and  most medical writers have adopted this division  ;
but it is well known that both these states of the mind often ex-
ist in the same  individual, at different times, and can, therefore,
only denote  certain mental symptoms.   Nothing is more common
than to see the melancholy man become maniacal or furious, and
the maniacal man  become melancholy, silent, wo-begone, shy,
timid, and solitary.  Insanity often  vibrates between a state of 
                            INS.                        345

melancholy, and mania, or of furious madness.  Melancholy and
mania only seem  to denote the two extremes  of insanity.   Or
rather it is expressive of the  spirits of two individuals who are
affected with  the  same disease; because if you  give a  certain
quantity of stimulus to the melancholic patient, he will immedi-
ately be thrown into a rage, or a state of mania.  If we examine
clearly into the real state of the nervous system, the seat of the
derangement,  we  shall find it in the same  state  in both cases.
   A proxysm  of  insanity is  like a fit of  intoxication, or  more
nearly like the state produced by the  exhilarating gas.   Indeed
the exhilarating gas produces for a time a complete state of men-
tal derangement.   Some it makes melancholy,  and others, lively
and  furious.   If people could  live in such  an atmosphere, the
whole  world  would  become  maniacs.    In  intoxication, the
thoughts and feelings are  all exalted  or depressed in  the same
way as in mental  derangement, but there is not commonly the
same false ideas, and  apprehension of  things, although in  some
people, it  produces halucination or false impressions.
   Some have contended that  insanity was not a disease of the
body, but entirely a disorder of the mind.   This idea, we think,
must inevitably lead to a wrong treatment of the  disease.   We
may as well say that  the  delirium of  a fever is not a disease of
the body.  In a fever, when  the nervous system and the  body in
general are  restored  to soundness, the mind is restored also to
soundness.  In most cases of insanity, a certain degree of fever
forms a part of the disease.   A  quick pulse, uneasiness, wakeful-
ness, costiveness, a dry skin, and a diminished  secretion  by the
kidneys, are very common symptoms attending the early  stage of
insanity.  Insanity is  neither more nor less than  an  unsound-
ness of the brain, and the nerves which  proceed from  it.  We
believe it to  be  a disease,  in every  instance, of the  nervous
system.
   The loss of sleep, if continued for several nights in succession,
produces a state of mind very closely bordering upon insanity.—
Indeed, the loss of sleep, often produces the disease ; and as soon
as sound,  refreshing sleep is restored, the insanity will begin to
abate,  and, in a short time, will  disappear.  This  again shows
that insanity is a disease of the  function of the brain, since wake-
fulness long  continued, ends in the disease, and since sleep is  a
function of the brain.  Sound sleep puts an end  to the delirium
of a fever, which is insanity, as long as it continues.
   Insanity in its commencement is merely an  excitement of the
mind.   The  person becomes uncommonly engaged in religion,
politics, business; in literary, scientific, and professional pursuits;
or mechanical employments ; he, every day, becomes more ardent
in these  pursuits,  until  he  cannot  sleep; and,  finally,  he  be-
gins to show clear marks  of extravagance in his language, plans, 
346
INS.
ideas, passions, and conduct.  Sometimes, the fit of insanity comes
on with a kind of  fainting fit in which  the limbs  become  stiff,
the eyes fixed, and the countenance considerably distorted. Some-
times the person becomes silent and mute ; and at other times,
commits some act  of violence  upon those  around him or upon
himself.   Often, the person  will dart out  of the house, and run
away as if to save  his life or to escape danger.   Under some
deep, overwhelming commotion in the mind, he will plunge into
the sea or leap from some fatal  precipice.   After this  paroxysm
is over, if he escape with  his life, perhaps,  he will become quite
calm, and appear to have some sense of his own condition.  But
this  state will  not continue long before he becomes excessively
lively; talks fast and loud ;  sings ;  laughs  merrily; moves with
rapidity ; and appears surprised at nothing.
  Insanity in another class of  people, comes on more  gradually.
The person will be observed to be under some  deep concern of
the  mind either about religion, his country, his  property, his
health, or his family, which will keep increasing until  both sleep
and the appetite are destroyed.   He feels as if he was either go-
ing to be reduced to poverty, to infamy, or to suffer in some shape
or other some unaccountable evil.  He will be seized with a fit
of the horrors, and  the derangement of his mind  will become
manifest.   This class of people will commonly manifest their
disorder, by great fearfulness,  suspicion, love of solitude, fickle-
ness of temper, watchfulness, shyness, torpitude of the senses,
and an indisposition either to ask or to answer questions.  They
are averse to motion, and commonly have a fixed scowl  of suspi-
cion upon  the  countenance, which is undoubtedly expressive of
the state of their feelings.   They will often lie in bed all day, or
stand fixed in a certain spot  in the room.   Fear and  suspicion,
resentment and despair are the prevailing states of the  feelings of
this class of people.  They are said, by writers, to be melancholic,
in opposition to another class who are maniacal or affected with
furious madness.   We prefer to describe the disease as it appears
in different  individuals.
  Deranged  people appear to have no absolutely new thoughts,
feelings, or states of the mind, but merely an aggravation of all of
them.   They manifest the  same  thoughts,  passions, emotions,
instincts, and sentiments which they ever did, but present a dif-
ferent combination, degree, or state  of them.  There appears to
be either an aggravation or a diminution of the mental operations.
The sphere of thought and feeling is either very much  widened
or very much circumscribed.
  Along with the deranged  state of the brain or mind, there is
almost always a deranged state of the stomach, bowels, pulse,
and temperature of the body.  Indigestion, flatulence, costive-
ness, coldness of the extremeties, or an unnatural degree of heat 
INS.
347
in the head ; a rapid or slow circulation of the blood ; a full or
empty state of the blood-vessels; a diminished or increased appe-
tite ; and a great sensitiveness or torpid state of the skin are com-
mon symptoms of the disease.
   In  violent,  furious  cases of insanity,  there  is a fullness
of the  blood-vessels of the head, and  often  intense pain,  a
high  fever, redness of the face, glistening of the eyes, violent ex-
ertions of the strength, loud screaming, and an unaccountable
hurry of the spirits.  There is a swiftness  of thought,  feeling
and utterance, which denote an intense commotion of  the brain
within.   People sometimes die of insanity within  a  week or
fortnight after the attack, but  more commonly the disorder con-
tinues for three, six, nine or twelve months, and they recover; or
lapse  into a confirmed state  of derangement.
   Some deranged people  have a propensity to destroy,  tear,  and
strip  to pieces everything which comes in their way; while oth-
ers are uncommonly harmless, gentle, and childlike  in all their
conduct and manners.   The finest specimens of amiability might
be copied  from  them.    Some are entirely negligent of dress,
while others are  constantly decorating themselves with feathers,
plumes, flowers,  girdles, sashes, ribbons, rags, shavings, and red
list.   The  brightest and gayest colors are always selected, from
which  they construct the oddest and most fantastical  combina-
tions.   The greater part of insane people profess to be  discover-
ers, either in the arts or sciences.   Some work in figures, others
in literature, improving the language, or its pronunciation.  Some
labor in the field of science and discover new laws and proper-
ties of  matter, and others, in mechanics, inventing new wheel
work or the perpetual  motion.  The  insane  man discovers as
great facility in believing the most incredible things, as he does
in executing the  most difficult plans.  He runs into the idea that
he  is a king, emperor, lord, duke  or  general, and  that those
around him are his  subjects or his soldiers as one does in a  dream,
and  acts accordingly.  To himself, he  is perfectly well, and if
anybody calls him  sick, or offers him medicine, he thinks it is a
trick, or that there  is a design to poison him, or to insult him.—
Some will  refuse to eat  or drink, from an  idea that  they can
live  without it, or  that it  is wrong  or  hazardous for  them to
do so.
   A propensity to wander is very common.   Some will  have a
propensity  to steal  who  are perfectly moral when well, either
from an idea that everything is theirs or that  some necessity of
state justifies  them in the theft.  Hurry, impatience, insensibili-
ty, and wit are common characteristics of the disease.
  A deranged person cannot bear to have a well person look him
steadily in  the eye, for any length of time.  It either conveys
some  suspicion, or discovers to him some weakness  which is 
34S
INS.
painful, and the countenance falls or  the eyes turn away.   It is
extremely painful for deranged people to confine their attention
to any new subject, or a  subject which does not interest them,
which shows that the brain and nerves are in an inflamed or sore
state.  That the brain and nerves of a deranged person are more
or less sore in the common acceptation of the word, we have  no
doubt.  Painful thoughts and  feelings, such as mark a  state of
derangement can only arise from such a state of the nervous sys-
tem.   The  paroxysms to which crazy people are subject, most
probably  arise  from an increase of  the  soreness of the nervous
system.   The comparatively lucid intervals which they often en-
joy, is no doubt owing  to a partial  subsidence of the  inflam-
mation of the  brain.   Phrenitis and the  delirium of fever are
evidences of this position.  The mental manifestations are nearly
the same  as in insanity, and  we know  that those manifestations
are the result of inflammation or irritation.
   Some  people are troubled with  sore or inflamed eyes for the
greater part or the whole of their lives.   The eyelids will always
look more or less red  ; feel a little sore, and secrete more than an
ordinary quantity of mucus.  The function of the eyelids are de-
ranged.   Yet, after death, the eyelids  will be as bloodless  as
other parts  of  the  body.  There is  often  an inflammation  of
the skin,  called St. Anthony's fire, or erysipelas, and  the func-
tion of the skin will be deranged.   But, yet after death, the skin
of such a person will  look blanched and bloodless.  No traces of
inflammation are discoverable.   A bloodshot eye is not apt to re-
main  so,  after death.  So, with  the  brain and nerves, they may
be inflamed or sore to a greater or less extent, through the whole
course of a person's life, and yet no trace of the inflammation be
visible after death.    The arteries which circulate the red blood,
the cause for the most part, of the red color of an inflammation,
are, after death, empty, and the parts  which were before slightly
red and inflamed, become pale like the other parts of the body.
  We have said thus  much to show that insanity is a disease  of
the body and especially of the nervous system.   Instead of men-
tal  derangement, it would be far more proper to call  the disease
nervous derangement.  It is essentially a disease  of the nervous
system, as much as  dyspepsia is a disease of  the stomach ;  oph-
thalmia a  disease  of the eye; or rheumatism, of the  joints and
muscles.
  The causes  of insanity are  chiefly  those  which  affect the
thoughts,  passions,  emotions, instincts, propensities,  prejudices,
and superstitions.   Any painful subject  of thought or feeling,
long revolved in the mind, will  produce insanity.  Injured feel-
ing which cannot be resented ; mortified pride ; perplexity  in
business,  in scientific studies,  in the arts, and  in  navigation,
will cause a derangement of the  nervous system.   Disappointed 
INS.
349
 affection ;  disappointed ambition ; and disappointed hopes or an-
 ticipations of any kind  will cause insanity.  Political, religious
 or social excitement will produce the disease.  In general, every-
 thing which worries and distresses the mind for a long time and
 creates a deep concern,  will produce the disorder.  Great terror,
 grief, anxiety; fear, despair, and hope deferred, produce the disease.
 These causes seem to operate by first occasioning a loss of sleep,
 and of the appetite, which cause an emaciation of the body and an
 empty state of the blood vessels.  The changes which take place
 in childbirth often occasion  insanity, either by  directly affecting
 the  nervous system or operating upon the instincts and feelings of
 the  mother.
   The causes which produce insanity generally operate  upon
 the  mind.   In the treatment of the disease, therefore, no sudden
 cure is to be expected.  A disease which has been long in con-
 tracting, will, in  general, be  long in recovering.
   Any affection  of  the  passions, instincts, propensities or preju-
 dices, which makes the person often absent-minded, and constant-
 ly awakens the same set of feelings,  is very apt to end  in insani-
 ty.   Pain and disease in other parts of the body will often disor-
 der  the mind.
   A prolific cause of insanity  is masturbation  which constantly
 exhausts the nervous system  and drains the blood of its  vital
 principles.   Intemperance, a debauched life, and loss of sleep are
 frequent causes of the disease.   Starvation almost invariably pro-
 duces it.
   Insanity is a disease which people  are never looking  out for as
 they are for other diseases, and  of  course  no  means  are ever
 thought of, or used for its prevention.   And, yet, perhaps,  there
 is no disease where  the  causes in general are  better known or
 easier avoided.   It is a calamity which no one wishes to think of,
 much less to make any provision for.  But it is one of the diseases
 of the human body and as certain to  occur as any other disease.
 Like other diseases, it is produced by the general wear and tear
 of the human body.  In some people,  the lungs are the first organ
 to give out, and in others, the stomach.   In some the heart will
 first  fail in its function, and, in others, the liver.   In some, again,
 the brain will  fail in  its  office, and  in others, one  or several of
 the senses.  The phenomena of insanity differ somewhat  from
 the phenomena of other diseases, but they are equally the result
 of a morbid condition of the  organ from which they proceed.  A
 dropsy of the brain disturbs or destroys all the operations of the
 mind, memory, reason, judgment, imagination,  association,  and
perception, and, in many cases, sensation, even  before life is ex-
tinct.  In a word, the  mind is deranged, in a way very similar
to its  derangement in  insanity.   In an  inflammation of the
brain, produced by the changes of the  atmosphere, the heat of the 
350
INS.
 sun or any other cause, the symptoms of the disease so far as the
 affection of the mental operations are concerned, are almost pre-
 cisely the  same as in a case of violent madness or insanity; and
 where the inflammatory affection becomes chronic, the disease is
 precisely the same.
   In the treatment of insanity we believe too much stress is laid
 upon endeavoring  to  regulate the  operations of the mind, or to
 bring the thoughts and feelings into the right channels.  In our
 view, it answers but very little purpose to reason with, persuade,
 or threaten a deranged person.   It is very much like  reasoning
 with, persuading, or  threatening a pain in the stomach, a sup-
 pressed perspiration, or a sore throat.  It is  true  that  the mind
 and the disease can  be  very much  irritated or soothed by harsh
 or kind treatment, but this is accomplished by affording pleasure
 or pain to  the diseased  organ.   The  disease is cured like other
 diseases, by a rest of the mental operations; by sleep; by a replen-
 ishment  of the blood-vessels ; by an increase of the flesh and of
 the  substance of the  body in general; by an enlargement of the
 organs; and a re-establishment of the strength. When the nervous
 system acquires its original strength and soundness, the mental
 operations  become right and sound.
  Emaciation of the flesh, and of the substance of the organs, is
 a very common characteristic of insanity.   In insanity,  it is
 very probable, almost certain, that the substance of the brain is as
 much wasted as the substance of the muscles.  It is essential, there-
 fore, that all the fluids of the body should be replenished, in or-
 der to cure the disease.
  When a  person becomes insane, he should  be confined to the
 house like  other sick people, and  for the first two or three weeks,
 at least, should not see company or  be disturbed  with any kind
 of business.  There is an acute stage to  this as  to  other diseases
 which requires complete rest.  If the patient is violent, wild, or
 disposed  to injure himself or others, he must either be watched
 by two strong, fearless men, or women, (if the patient is a woman,)
 or must be confined with  manacles or a strait jacket.   People
 should never be allowed  to  run at large or to be  by themselves
 after they have been discovered to be deranged.   The worst ac-
 cidents have happened from this negligence on the part of friends
and acquaintances.  Most of the homicides that are committed,
are  owing to the negligence of friends, and of the  public in pro-
tecting themselves against these accidents.   As soon as prepara-
 tions can be made, the person should be sent to an insane hospi-
tal where alone he  can receive that treatment which is suited to
his  disease  ; but whether to a private or a public hospital must be
left to the choice of the friends.  The public hospitals, in New
 England, are probably better managed  than the  private ones.
 They have a greater number of attendants  and more extensive 
INS.
351
accommodations. It is best to send the person to a hospital which
has but a moderate number of patients.   The most enlightened
treatment which the world now affords for the insane is at a public
hospital or asylum.  There they are treated like sick people, and
find those accommodations  and appliances which  are adapted to
the disease.   Suicides and homicides are prevented, and many a
person who would either have  destroyed himself or somebody
else, has  been prevented from it by proper care, and restored to
soundness and health.
   The public is deeply concerned in  providing suitable institu-
tions for the insane.  The public safety, as well as the common-
wealth of the people, require safe retreats for those who are shat-
tered and helpless.
   The treatment  at  an  insane hospital consists in the means
which are used for the safety, comfort, recreation,  and rest of the
patient; and those which are used to save the life and to restore
the  health.   Safe rooms, galleries, workshops, lodges,  bathing
rooms and yards or gardens for exercise or walking, safe, quiet,
retired, well aired, and clean bed-rooms, and  comfortable beds;
good dining rooms, and plain, wholesome, and nutritious food,
constitute the most essential provision of an insane hospital.   The
fare is regulated by the state of the patient.  If the patient is fe-
verish,  or betrays  any inflammatory  affection of the  brain  or
nerves, the  diet consists of  gruel,  milk  porridge,  broth or  some
liquid food.   If the disease is in a chronic state, the fare is very
much such as will be found at any well regulated boarding-house
in New England.   Chocolate, and tea and  coffee  of a moderate
strength,  are allowed twice, and meat, once a  day.
   To  make the patients comfortable and happy is one of the
principal  uses  of an insane  asylum; and did it secure no  other
object, it  must still be considered as answering one of the most
essential and best  of purposes.  An insane person is a sick and
diseased person, and although he may not be conscious of it him-
self, any more than a person in the delirium of a fever; or others
may not discover the diseased part, he labours under a disease of
which people  often die, and  from  which they suffer the keenest
anguish.
   In the insane hospitals  of New  England ample provisions are
made for exercise as well in-doors, as out.   Long,  well-aired gal-
leries for walking, workshops, nine-pin alleys,  and billiard tables,
furnish the patients with amusements and exercise at the same
time.  Recreation is an essential instrument in the cure of affec-
tions of the nervous system.   It  gives rest  to the weary mind
and  the sore and  torn feelings.   Sleep,  recreation, exercise, and
a plentiful supply of good, wholesome food, which is not stimu-
lating  but nourishing, lie at the foundation of all the means of
curing insanity. 
352
INS.
   The amusements of our  insane asylums  are cards, backgam-
 mon, chequers, chess, billiards, ninepins, dances, walking parties,
 riding parties, gardening, and an indulgence  in  all  the  arts of
 painting, music, drawing and  architecture for  which the several
 patients both men and women may have a taste.  The great ob-
 ject at the present day, is to allow the patients all  the liberty and
 enjoyment which are compatible with their safety  and welfare.
 Care and watchfulness on the  part of the  attendants are substi-
 tuted for the bars, bolts, fetters,  strait-jackets,  and  dungeons
 which formerly secured  the  insane.  It  has been found that
 these  wild  members of the human race, can, by sagacity, and
 kind, humane, but firm and consistent  treatment, be disarmed of
 their fury, and  the troubled nerves of mental emotion hushed.
 Provocation is  strictly prohibited, as it ever should be ; and  all
 mental excitement is guarded  against.   As much  as can  be, the
 patients are treated according to their attainments and stations in
 life.  The patients, in general, are  so  thoroughly watched by a
 competent number of attendants, and guarded by suitable appli-
 ances to prevent personal injury, that suicides are  extremely rare.
 Not more than one occurs in a well ordered asylum,  where twen-
 ty  would occur among the same number of people, treated at
 home.   No punishment is ever  inflicted, but if the patient be-
 comes excited and ungovernable, he is confined either in his own
 chamber, or in one of the lodges which are  so constructed as to
 shut out the light;  and are somewhat remote from the unexcited
 patients.   The  patients are classed  somewhat according to the
 degree in which they retain their  senses, and are  found to  be
 companionable.   This contributes very much to  their  pleasure
 and amusement, as well as to their improvement in health.
  Exercise is the great instrument in controlling  the circulation
 of the  blood, and in distributing it in  due quantity to every or-
 gan and part of the body ; and nowhere is this  powerful agent
better  understood  or  appreciated than in our insane asylums.
More or less labor or  exercise  by walking, or some  gentle  play,
is prescribed every day.  This induces sleep, composure, and, in
most cases, combined with suitable aliment,  eventually regulates
all  the functions of the body.   Those who enter  the hospital
constipated  or costive, commonly, in a few  weeks, as we  have
been assured by Dr.  Bell, of the Charlestown asylum, become
regular in their  bowels, and seldom need the assistance of ca-
thartics.   An abatement of the mental excitement appears to
be  concurrent with the healthy action of the  bowels, and  no
doubt contributes  in a great degree towards it.   Mental  excite-
ment of any kind even in  a state of health, will produce costive-
ness, as every body must have noticed who has only  been excited
enough to lose a single night's sleep.  As soon as  the excitement
is over, the bowels are restored to their usual activity. 
INT.
353
   The medical treatment in insane hospitals is generally pretty
uniform and simple.  It  consists in warm and cold bathing ;  in
suitable cathartics and tonics united with cicuta ;  in blood-letting
very rarely, which is  a great improvement in the  treatment of
the disease ; in administering food such as broth, gruel, and milk,
by the use of  the stomach pump or forcing  syringe, another in-
valuable improvement in the treatment of the insane, which has
saved many a life, and will  save thousands to come ; and in  the
administration of remedies suitable to  the increase or diminution
of the cerebral excitement,  sometimes cooling and anti-inflam-
matory, and sometimes stimulating.  The sal nitre,  sweet spirits
of nitre, small doses of antimony or ipecac, salts, castor oil, cal-
cined magnesia, quinine, carbonate of iron, opium,  cicuta, mor-
phine, Dover's powder, blisters, leeches,' and  bland, stimulating
poultices, are  the medicines in the most common use.  Every-
thing indigestible is  carefully avoided.  Strawberries, cherries,
apples,  peaches,  grapes, plums and  currents, are  allowed  in
abundance.   The drink is cold  or sweetened water.  The  pa-
tient  is forced to cleanliness by  washing every morning, and
bathing once a week.  They retire early to  bed, and rise early
in the morning.  Cheerfulness  and lively conversation are  en-
couraged ; and the  employment of the external  senses induced
instead of reflection and revery.   There  can  be  no doubt that
people come sooner  to their senses, and oftener recover from  the
disease in these institutions, than by any treatment which can  be
pursued  at their  own homes.   Either  the  state or town,  we
think, is bound to give every insane person a fair trial of recov-
ery at a public hospital, if too poor to  incur the expense himself.
It is an  obligation  which the town or state owes  to every in-
dividual.
   In private practice,  the remedies and means of  cure in insani-
ty should be as nearly copied from the public institutions as pos-
sible.   Insane people  behave much better abroad among  stran-
gers than they do at home.   This is natural, and  the fact should
be improved for the benefit  of the insane  person.   He is  often
removed from the  original  scene  of  his excitement; and  the
whole course of his thoughts, associations, and feelings is changed.
The objects  which enkindled the flame, he is  snatched *away
from, and the  fire is, in a measure, bereft of its fuel.  There are
some  cases, however,  where  the mind is so  much  destroyed as
to be  insensible to persons or places, and who are not affected  by
any change which can be made in their place of residence.
  INTERMITTENT FEVER—Fever  and Ague.—See Fever
and Ague.
  INTESTINES—Bowels.—See Bowels.
  INTUS-SUSCEPTION—The running of one portion of  the
           45 
354
IOD.
bowels into another.—It produces a stoppage of the bowels and
all the symptoms of colic.   See Colic.
  IODINE.—This material is obtained from  seaweed, or rather
from  the  ashes  of seaweed.  The ashes  of the  seaweed are
leached, and  to the lye is added oil of  vitriol.  The  mixture is
distilled in a retort, when  the iodine  passes over  into a receiver
and is condensed.   It consists of crystalized scales, of a bluish
gray color.  It has a metallic brightness, and a smell resembling
that of chlorine.   When iodine is volatalized  by heat, the vapor
into which it is converted, has a  brilliant violet  color.  Com-
bined with oxygen it forms the  iodic acid, and with hydrogen
gas, the hydriodic  acid.   The  iodine  has of late years been
much used as a medicine in the cure of the king's  evil or scrofu-
la, and  diseases  of the glands.   In the disease or excrescence
called the  goitre, it is said to have excelled  all other means of
cure.   In scrofulous affections, it is probably one of  the best
medicines known.   In  its properties, it resembles  the marine or
muriatic acid.  It is combustible, and emits a blue flame.  The
ordinary dose of iodine is from  a sixteenth to a quarter of a
grain, increased as the  case  requires.   It may be  given in the
form of tincture, in the dose of from ten to  fifteen drops, or in
solution in water, to which the essence of cinnamon and  simple
syrup have been added.   To  have its proper effect, it  must al-
ways be given  for a long time, and in a small dose.  It  bids fair
to become a valuable remedy for diseases in general.  Water dis-
solves it in a very slight, degree, but alcohol more readily.
  IODIDE OF  MERCURY.—This medicine is  made  by rub-
bing together in a mortar, an ounce of mercury and ten drachms
of  iodine, adding  alcohol gradually until  the globules are no
longer visible.   A red powder is  produced from the mixture, af-
ter  being dried by a gentle fire.   It is  of a beautiful vermilion
color, soluble in alcohol and ether.   It resembles, in external ap-
pearance, the red  precipitate.  It must be  kept  in a closely
stopped vessel  or its virtues will  be dissipated.   A dose of it for
an adult is from an eighth to a quarter of a  grain.  It is effica-
cious in the cure of the  venereal  disease,  and affections of ihe
skin.   Dissolved  in alcohol  and applied as a wash to eruptions
on the skin, its  efficacy is said to surpass  the effect of  all other
mercurial preparations.   The iodide of mercury is especially ap-
plicable to the venereal disease in scrofulous constitutions.   It is
often used in thp form of an ointment.
  IODIDE OF  POTASH—Potassii Cyanuretum—The cyanu-
ret  of potash is made  by exposing to  long continued  heat, the
ferruginous prussiate of  potassa.  It is white and transparent,
soluble  in water.   Its taste is sharp and alkaline.  The dose is
a quarter of a grain.   It  is usually dissolved in water, when it
forms the hydriodate of potash.   In glandular affections, such as 
IPE.
355
diseases of the liver, spleen, and  kidneys, it  exercises no incon-
siderable  effect.  In  all  scrofulous affections, its  operation  is
about the same with that of the iodine itself.   It is often used in
the form of an ointment to the surface.
   IPECAC—Ipecacuanha.—Ipecac as usually met with  in the
shops  is  a  finely ground root, the  product  of South America.
The botanical characters of the plant producing the genuine ipe-
cac, were long unknown  after the  introduction of the  root into
Europe as a medicinal  substance, and though it  has been used
nearly two centuries,  it is only within the  last half century that
it has  been  accurately described, by Doct. Gomez  of Lisbon,
who had seen and  obtained  specimens of it  in  Brazil.  It is  a
small shrubby plant, with a root from four to six inches long and
about  as  thick as a goose-quill, marked with annular wrinkles,
descending obliquely into  the ground, and sending off here and
there slender fibrils.  The stem  is  two or  three feet long, but
being  partly under  ground and often procumbent, it seldom rises
to more than a foot  in  height.  The lower portion is leafless,
smooth, and ash colored.   The leaves which are  near  the sum-
mit seldom  exceed six in number, are opposite, oblong, ovate,
acute  and entire, and  three  or four inches  long.   The  flowers
are  small and white, and the fruit an ovate, obtuse  berry.   It
flourishes in  Brazil,  between the 8th and 20th degrees of south
latitude, in moist,  thick and  shady woods.  The flowers appear
 in Jan. and Feb. during which time the root is collected, and is
 an important article of trade with the  Brazilian merchants.  The
 smell  of the  powder  is peculiarly nauseous,  exciting in some  in-
 dividuals violent sneezing, and  in others difficulty of  breathing
 resembling an attack of asthma.  The taste is  bitter, acrid  and
 nauseous.  Its virtues  are extracted  by water and alcohol, but
 are impaired by boiling.
   Pelletier discovered in the year  1817, a peculiar alkaline prin-
 ciple in ipecac, which is called Emetin, or Emetia, and in which
 its activity resides.   Emetia is a white powder.  It is inodorous,
 slightly bitter, and very soluble  in alcohol.  This substance  has
 been  tried on  the continent of Europe  as a substitute for  the
 powdered root, but has proved to be  too violent in its action  for
 ordinary use.  The  dose is from  half a grain  to a grain and a
 half, or  about  the  twentieth part of that of the root.  Among
 the almost countless number of medicinal substances  that have
 been employed  to a greater or  less extent, to alleviate suffering
 and cure disease, perhaps there  is no one more valuable, or more
 generally applicable  in the  treatment of the divers diseases to
 which man is subject, than ipecac.  It is a perfectly safe, prompt,
 and efficient emetic, a  good sudorific, febrifuge, and laxative.   In
 cases  of poisoning, fits,  croup, coughs, colds, consumptions, fe-
 vers of all  kinds,  jaundice,  headachs, measles,  hooping  cough, 
356                         1PE.

overloaded stomach, indigestible substances in the stomach, and
depraved  appetite, it is not only a suitable, but we will venture
to say the best vomit known for popular use.   For  the  whole
host of croup syrups,  expectorants, cough  syrups, and infallible
cures for  jaundice and consumption, it is a good substitute, and
probably is really a  better medicine than most of them, whatev-
er their pretensions.  It is  a simple  drug, and  those who may
have  occasion to use a medicine of the  kind, can at least have
the satisfaction of knowing that they are not taking a  deleteri-
ous  mixture, most  of  the  ingredients of which, for aught they
know, may  be inappropriate in their  respective cases.  The
dose of ipecac  as' an emetic, is  twenty grains, ,or about  a  tea-
spoonful by measure, but may be given in  much larger doses, or
repeated any number of times  if necessary to  excite vomiting.
For a child a year old, from three to five, and for  one ten years
old, from ten to fifteen  grains are the doses usually  required.  As
there is no danger of its producing poisonous effects if retained
in the stomach, or if a larger dose be given than  is requisite, it
may be dosed by  measurement with perfect  safety; taking a
heaped tea-spoonful as  an average dose for  an adult.  Given in
doses of half a grain, a grain, or two grains, as the stomach may bear,
every  three or four hours, it is one of the best medicines in
many kinds of fever, and especially those attended with cough,
also  in asthma, hooping cough, measles, and in bleeding from
the lungs  and other parts.  In very minute  doses it is beneficial
in dispepsia, and  various other deranged conditions of the stom-
ach and liver, exciting those organs to a healthy action, and pro-
ducing a  laxative effect  upon the bowels.   In  the treatment of
dysentery, perhaps  there is  no one  medicine  of more  value.
When combined with opium, the action of  which it modifies, its
controlling influence in this disease exceeds all  other remedies.
Ipecac is often  combined with nitrate  of  potash, and other medi-
cines in  making fever powders, and it  enters  largely into the
composition of Dover's powder, one of the most valuable com-
pounds ever known to the profession.  The dose of the wine of
ipecac, which is made  by macerating  an  ounce of  the root four-
teen days  in a pint of Lisbon  wine,  is a fluid; ounce, or two
table-spoonsfuls, for an adult, and a tea-spoonful for a child one
or two years old, when given as an emetic.   As an expectorant
or sudorific, from twenty to fifty drops  for an  adult, and from
five to twenty for a child.  This preparation and the syrup of
ipecac, which is about  the same strength, are applicable to most
cases in which ipecac  is indicated.  By combining the wine or
syrup  with  laudanum  or paragoric, it makes a medicine very
similar to  the Dover's powder, and may be  given as a substitute
for that preparation.  The safety and  efficacy of ipecac, and the
great number of accidents  and diseases  requiring  a medicine of 
ITC.
357
this description, entitle it to the first rank in a family medicine
chest.
  IRON RUST—Oxide of iron.—This is the form in which
iron is principally used.  In this state, it may be scraped from
any old iron, and is found in a variety  of mineral  waters.   The
most natural way in which it can be used is in the form of cha-
lybeate waters.   The dose of iron rust is from five grains to a
scruple.  It may be taken  in the form of powder, pills, or mix-
ture.   It is peculiarly friendly to the  stomach and to the diges-
tive powers; seldom failing to beget an appetite, and strengthen
the tone of the gastric powers.   In female diseases, its efficacy as
a tonic is unsurpassed.  It  is suited to  almost all diseases  of  de-
bility, and is given in those attended with a considerable degree of
fever.
   The vegetable tonics often produce and aggravate a fever, but
iron has but little or nothing of this tendency.   Insanity, dyspep-
sia, and nervous diseases are often essentially relieved, and, some-
times, cured by the use of  iron alone.
   ITCH—Psora.—The itch  shows itself  in  small  pimples  be-
tween the fingers, on the inside of the arms and wrists, and about
the waist and hams.   The pimples will often appear in clusters
in the bend of the arm and under the knee joint.   The  face is
the only part where  the eruption never appears.   In a few days
from the appearance of the eruption, the pimples  become quite
large pustules, which  often spread into rotten kind of sores. The
pustules contain a watery kind of matter which by the constant
scratching  and  rubbing kept up to allay the irritation, is  spread
wherever the  fingers touch, and excites a new cluster of pimples,
which in their turn pour forth new matter, and thus extend  the
disease over the whole surface,  if not  arrested by the employ-
ment of remedies.  The disease is chiefly known by its incessant
itching, whence its name,  of the itch.   It is  difficult to  distin-
guish  it in many instances from other cutaneous diseases, except-
ing by its uniform symptom of itching.
   Ic is contagious, and has its habitation chiefly in schools, poor-
houses, and among people in cold  mountainous  situations.   It
is taken by shaking hands or by any contact with those who are
infected with it.  It is taken by lying in  the  same bed, or by
wearing the  same clothes which those infected  with it, have
used.   It  is supposed to be produced  sometimes by bad air,  un-
wholesome food, and a want of cleanliness.
   The brimstone ointment in common use for this disease, is an
abominable remedy.   It may be easily cured by washes and oint-
ments which  leave no smell.   Take eight grains of the corrosive
sublimate and dissolve it  in half a pint of new rum,  or  in  the
same quantity of boiling water, and wash over all the places upon
the skin which are affected, for three or four nights in succession, 
358
JAU.
and the disease will be effectually cured.  The citrine ointment
will also cure the disease, if applied two or three times.  The
blue ointment is also a remedy for it, and a very efficacious one.
An ointment made  of calomel and hog's lard, in the proportion
of a drachm of the calomel to two ounces of the lard is a good rem-
edy for the itch.   The cream  of tartar  or the Rochelle powders
are as good medicines to  take internally in connection with the
external applications we have named, as  the famous dose of brim-
stone and molasses.
   Clean clothes, clean beds, and  a clean skin, are indispensable
conditions in freeing a family from the  itch.   Children who are
washed, every day, and wear clean clothes, although they asso-
ciate with children infected with  the contagion, seldom take it.
Dirt seems to furnish a nest for the generation of the disease.  It
has been supposed that the disease originates from the generation
of little insects in the skin ; but it is more probable that the ani-
malculae which have been discovered in the pustules are the effect
and not the cause of the affection.   All  rotten sores abound with
animalculas.
                            J.


  JALAP—Convolvulus Jalapa.—The  dried  root  of jalap is
brought from South America.   It is the oftenest seen in the form
of a powder. Its taste is bitter and subacrid, and its smell, faint and
nauseous.  It is an easy, safe and active cathartic.  The medicinal
properties of jalap reside in a resin which may be extracted from it.
The dose of the simple powder is from one to two scruples.  It is
often mixed with calomel,and given in a potion often grains of each.
No medicine is more common or better adapted for popular use.
Digested in new rum, it makes  a valuable cathartic tincture.  It
forms an active ingredient in the elixir salutis and several  other
compound medicines.
  JAMES' POWDER—Pulvis Antimonialis—See  Antimonial
Powder.
  JAUNDICE—Icterus.—The  jaundice is  one of the most com-
mon diseases in New England.   In every large collection of peo-
ple with which we meet, we may generally designate no incon-
siderable number whose complexions denote more or less of this
disease.
  The jaundice is denoted by yellowness of the skin, and, espec-
ially, of the whites of the eyes; by sleepiness;  loss of appetite ;
loathing of food ; disinclination to move or stir about; sourness, 
JAU.
359
and, sometimes, sickness of the stomach, and vomiting.  There
is commonly the feeling of a load at the pit of the stomach ; the
urine is as yellow as the skin, and will stain the linen of a yel-
low color, there is a bitter taste in the mouth, and the stools,  in-
stead of the yellow, bilious color  which they  naturally possess,
are of a clay color ; the bowels are costive ; and the strength and
energy of the body and mind are greatly lessened.   A dull pain
is felt in the right side which is increased on  the application of
pressure by the hand.  The pulse  is not often  much changed
either  in frequency or strength, unless there should be some evi-
dent signs of an inflammation of the liver.
   The  most  remarkable  appearances in the  jaundice  are  the
saffron color of the eyes and skin, the white color of the feces, and
the deep  yellow tinge  of  the urine.   This disease is apt to be
confounded with  the dyspepsia, since, there are always  more or
less dyspeptic symptoms produced by it, such as nausea, sourness,
wind, and  a slowness of digestion.  It  is however an  entirely
distinct disease from dyspepsia, and requires a different treatment.
   With us, the disease is commonly of a mild kind, and if prop-
erly treated in season, is  easily cured, but if neglected  or mal-
treated, will sometimes prove fatal.
   On dissection of those who have died  with it, the whole body
is found charged with bile.   The fatty substance of the body as
well as the  bones, muscles, and membranes are found of a deep
yellow color.   In this disease, the bile is diverted from the bow-
els, its natural tract, and absorbed by the  lymphatic vessels or the
secretory terminations of the veins, and  diffused over the whole
body.
   The  bile issues from the  liver through a small duct about the
size of a  goose quill, which leads  into the bowels, a short space
below the stomach, probably  about four or five inches.  This
duct or little vessel which is constructed like a vein and conveys
the bile as a  vein  conveys the blood,  receives  the bile from a
smaller vessel called the hepatic duct which penetrates the liver;
and, also, from  another duct which leads  to  the gall  bladder,
called the cystic duct.  If either of these three ducts become ob-
structed or blocked up by the thickened, hardened, or viscid bile;
by gall stones which are apt to form in the liver; or by anything
which irritates these ducts and causes them to  contract, the jaun-
dice to a greater or less extent is produced.  The hepatic duct
and the common duct which  lead into the  intestines, become
filled with bile which having no  outlet, greatly distends them,
and causes  pain  and soreness, sometimes extreme.  The pain
which is felt in the jaundice is probably, for the most part, owing
to  a distention of the gall bladder and the three bile ducts which
we have described.   When the urine is obstructed, the  stoppage
of  the water produces the greatest  uneasiness and pain, and the 
360
JAU.
same is the effect to a certain extent, of a stoppage of the bile by
a closure of the bile ducts.
  A temporary jaundice is sometimes produced by nervous affec-
tions, such as the hysterics, hypochondrism, and violent mental ex-
citement.   This is called the spasmodic jaundice from an appre-
hension that the bile ducts are closed by an  extension of the nerv-
ous affection. We believe that whatever renders the bowels costive,
produces a similar state in the bile ducts; the ducts undoubtedly
become contracted and the bile moves along them more sluggish-
ly.   Perhaps it would not be  very improper to say that the bile
ducts  are costive.   The bile  in this state  of things naturally
thickens and hardens  into cakes or balls, which, finally, entirely
blocks up its passage into the intestines.
  The jaundice appears to be produced by excessive heat; a se-
dentary life or occupation;  nervous affections and mental excite-
ment ;  by the  formation of gall stones ;  and by marsh miasm.
  Domestic Remedies.—In the  commencement of jaundice, the
most efficacious remedy which can be given is an emetic.   This
should be repeated every other day for a week or a fortnight. A
simple vomit  rarely ever relaxes  the system  sufficiently to pro-
duce a permanent flow of  the bile.   The first vomit should con-
sist of  half a drachm of ipecac  or fifteen grains of the powdered
leaves  of  lobelia, after which  the vomit had better consist of a
solution of four grains of the tartrite of antimony.   The antimo-
ny acts more  powerfully upon the  biliary ducts than the  ipecac
or lobelia.  The thoroughwort  is an excellent remedy in the
jaundice.  Its  operation, when given in a proper quantity, resem-
bles very much that of the  antimony.  Not  less than two tea-
cups full of  the strong tea should be drank  at a  time, and this
should be repeated every day for a week or fortnight.  While the
thoroughwort  is being taken, if it operates well upon the bowels,
no other medicine need be taken.   The inner bark of the  bar-
berry steeped  in cider is no  mean remedy in the jaundice.  The
food should consist of  vegetables, and as  much as possible of
green vegetables,  such as dandelions,  asparagus, spinage, lemons,
oranges, and  wild berries.   Horseradish and pepper-grass  are re-
markably  good in the jaundice.   The yolks of eggs have been
highly extolled in this disease, mixed  up with sugar and taken as
the daily food.
  Perhaps there  is no better remedy for the jaundice than sweet
oil, but it  must be taken in large doses.  Not  less than half a pint
of it should be taken every day until the feces become of a healthy
color.  Two gills of it, may  be drank every morning and evening.
Children,  of course, will need to drink less  of it in proportion to
their age.   Castor oil, no doubt, acts a similar part in the cure of
the disease, and may suit  some cases better, but not more than
an ounce of it  need be taken at a time.  A drink made by adding 
JAU.
361
 five drops of the muriatic acid to three drops of the aqua fortis or
 nitric acid, and mixing both with a tumbler of water, has been
 known to assist  wonderfully in  the cure of the disease.   This
 makes or should make an agreeable sour drink, and taken as of-
 ten as the thirst demands.  The warm bath, if used daily, has a
 powerful effect in  relaxing  the  bile ducts, and turning the bile
 into its right channel.
   While the vomits  are being used, a dose of Lee's pills, or  of
 calomel and jalap should be taken the same day.  Where the  disease
 becomes protracted or chronic, it will  be necessary to make use
 of quinine and the vegetable bitters in general; the  mineral acids
 and preparations of iron.   A regular system of moderate exercise
 is an essential condition in the cure ; and a total abstinence from
 intoxicating liquors should be persisted in.
   The passage of gall stones, which is one cause of the jaundice,
 is attended with infinite pain and  distress.   The common  bile
 duct, as we have said before, is not larger than a common goose
 quill, but  gall  stones as  large as a butternut have often been
 known to pass  through it, so great is its capacity of dilating.—
 These  gall stones  consist  of  hardened bile formed into  layers,
 some of which are of a black, and others of a yellow color; some
 are very hard, and  others  so soft that they may be  jammed be-
 tween the fingers.  They are commonly of an oval or round fig-
 ure, the largest  ones  are generally of the shape of  a butternut.
 When these stones  are formed in the gall bladder, they will often
 lie inoffensive through life.   In the gall bladder they have ample
 room to  lie, without incommoding the passage of  the bile  into
 the bowels, but when they are  formed in the secretory vessels of
 the liver and pass into the bile ducts, or are formed in the ducts
 themselves, more or less disease must follow.
   During the passage of  a gall stone, the pain and  distress are
 often so great as to  cause  the person to roll upon the floor  and to
 utter the most piteous cries. There is a most vehement pain about
 the  pit  of the  stomach, attended with nausea, and, sometimes,
 vomiting ; but  the pulse amid all this commotion and distress is
 never much accelerated.  Relief, in  the passage of  these  stones,
 must be  obtained  by large and frequent doses of opium,  lauda-
 num, or which  is more proper, a solution of morphine.   A tea-
 spoonful of the solution of sulphate  of morphine, must often be
 given and repeated  two  or three  times in the  course  of  as
many hours.   The  warm bath must be  used, and large and fre-
quent draughts of warm camomile tea  drank.  If the sweet oil
cannot be drank and  retained, strong carthartic injections must
be dispensed.   For this purpose there is nothing  better  than a
solution of tartar emetic in warm water.
  Professional Remedies.—Calomel we believe to  increase all
the secretions.   Mercury in some form has always been found an
           46 
362
JAU
efficacious  remedy in the jaundice.  Some give it merely as a
cathartic, while  others  prefer the  administration of it in  small
doses.   Ten grains of calomel with ten grains of jalap, form one
of the best  cathartics which has ever been used in the disease.—
Many physicians rely upon this remedy and  meet with  success
in the cure of the disease.   Another form of mercury used in this
complaint is  the blue pill.  Two pills of the common size, of
this substance, given every night, followed with a dose of castor
oil or senna, in the morning, is said to have  been attended with
more success in jaundice than any other remedy.  The mercurial
plaster is preferred by some, and is no doubt often attended with
as much Success as mercury, used internally.  It penetrates the
liver and quickens the activity of the bile ducts.  Plummer's pill
composed of  the sulphuret of antimony and  of calomel, or  the
blue pill, has been much celebrated as a remedy in this disease.
   The acid bath has proved in many instances a powerful mean
in the cure of jaundice.   It is composed of diluted muriatic and
nitric acid.  Three parts  by measure of muriatic acid is mixed with
two parts of nitric acid.    A pint of the combined acids is mixed
with a pint of water.  This mixture constitutes the diluted aqua
regia.   The acid bath is to consist of three ounces of this diluted
acid to a gallon  of water.   The strength  of  the bath should be
tried by the taste; when the diluted acid is of the right strength,
it will taste about as sour as weak vinegar, and slightly prick the
skin.   A convenient way of using  the  acid bath is to pour half
a gallon of water into an earthen  hand basin and then  add an
ounce and a half of the diluted aqua regia.   With this, the feet,
legs, and body can be bathed with a sponge  or a piece  of linen
or wollen cloth.   If the liquid produces a slight tingling sensa-
tion in the  skin, it is of the right strength.   A visit to the Sara-
toga springs and a course  of the waters  will  always furnish a
fair prospect of a cure in this disease.
  When the  sweet  oil is used in this complaint,  small  soapy
lumps are fonned in the intestines which will often be discharged
in large quantities.  These should not be mistaken for gall stones
or hardened bile, because they are produced by a combination of
the sweet oil with the bile in the intestines, and have no  connex-
ion with the  disease.    As soon as the oil  is suspended and some
other cathartic substituted, the yellowish green balls disappear.
  If stroug  purges  are given in  this or in  any disease,  and
continued daily for a considerable time, a large quantity of mucus
will be  discharged.   We have seen this mucus mistaken by igno-
rant people for a disease of  the liver or the bowels, and  the ne-
cessity of more  and stronger purges, urged  in order to bring it
away.    But this  mucus is the  natural  mucus of the bowels,
and  is  only  drained oft" by the  violence of the purges.  The
more  physic there is given,  the more of the  mucus comes away, 
KID.
363
and the bowels are in danger of being seriously injured.  It is a
gross mistake of the effects of medicine for disease.
  JEJUNUM.—This term means empty, lank.   It is the syste-
matic name of a portion of the bowels, and is called jejunum be-
cause it is usually found empty, or only containing air.   It is the
portion between the duodenum and the ileum and lies coiled di-
rectly under the navel.  It is studded with lacteal vessels, which
may be seen distended after a full meal.
   JUNIPER—Juniperus  Communis.—The medicinal  parts of
juniper are the  leaves and the  berries.  The virtues of the tree
reside  in an essential oil.   No grass will grow under the juniper
tree.   Its wood is hard and red, and the flavor of the berries, pe-
culiar.  It is essentially a diuretic, and one of the best in the veg-
etable  kingdom.  The  oil  of juniper has some effects upon the
uterine efforts.    It is warming, stimulating, diaphoretic, and su-
dorific.  An infusion  of juniper berries is  often given to promote
the menstrual secretion, and with the most promising success.—
They  require  two years before they ripen, when they change
from a green to  a bluish black  color.   It is the essential  oil of
juniper which communicates the peculiar flavor  to gin.  This
tree furnishes a gum called pounce or sandarach.  It is an ever-
green, and grows upon barren hills and dry places.  In stoppages
of the water, and in dropsy, the berries  are an excellent medi-
cine.
                             K.

   KERMES  MINERAL—Precipitated sulphuret of Antimony.
This is a light, orange colored powder.   It is a good diaphoretic
and diuretic.   The  dose is a grain or a grain and a half.  It is
prepared by means of sulphuret of antimony, a solution of potash,
water, and oil of vitriol.  It is sometimes  employed in diseases of
the skin and as a substitute for the other preparations of anti-
mony.
   KIDNEYS.—These are  two glands which secrete the  urine
and  are situated in the abdomen opposite to the small of the back,
one  on each side of the back bone, under  the peritoneum.  They
are of the shape of a kidney bean, and weigh,  in an  ordinary
sized person, about a half pound.   In the centre  of the kidney,
there is a large bag,  called the pelvis which tapers like a funnel,
and forms the ureter or vessel which conveys the urine  into  the
bladder.  Each kidney has an artery, a vein, and a duct to carry
the urine into the bladder.  It also has a set of absorbent vessels
which terminate in the thoracic  duct.  The kidney of a hog will 
364
KIN.
give us a very perfect idea of that of a man.   In the belly of the
kidney may be seen a system  of small tubes which terminate  in
the thoracic duct.  The outer  part of it  is very vascular, the in-
side is full of papillae, and the middle, full of tubes.   It is  of a
mahogany color,  much harder than the  flesh, and of a different
t Pirf n rG
  KING'S  EVIL—Scrofula.—The king's evil is  for  the most
part a disease of  cold climates.  Between the  tropics and under
the equator, it is  very rarely seen.
  This disease, in the commencement,  consists of small  hard,
moveable  kernels under  the skin about  the neck, and under the
jaws.  About the neck there are many little glands which secrete
a watery fluid, called lymphatic glands.   These glands become
hard, swelled, and enlarged before there is any soreness or red-
ness discernable.   They can often be felt as large as butternuts,
and sometimes, as large as  hen's  eggs, for six months or a  year
before they gather and break.   They sometimes form about the
abdomen and groins,  and in every  other  part  of the body.
The swellings will sometimes  be very broad  and flat; and when
they come to a head  will discharge a watery kind of matter from
several little round holes which look like artificial  issues.   The
scrofulous tumors are always exceedingly slow in  coming to a
head, and almost  as slow in healing.  They sometimes discharge
a pretty pure kind of pus, but,  in general, it is mixed with a great
proportion of  serum.   The tumors when they are fully grown,
are commonly as  large as hen's eggs, and of an oval shape, a dark
red color, and more or less soft.   The matter when discharged
will often resemble a mixture  of whey and curd.   Some of the
tumors will discharge an incredible quantity of matter, and others
will maturate by  degrees.
  In healing, the skin is apt  to  be puckered and the abscess
leaves an ugly scar. The tumors are never very sore to the touch
or very painful.  Nor is  the  inflammation ever sufficiently ve-
hement to produce a  general fever, until the disease has affected
a large number of the glands.  Where the scrofulous humour
attacks the eyelids, it causes them to thicken, become red, and to
discharge a great  quantity of mucus and  water.  The under lids
will sometimes turn out, and present a hideous sight.   The ball
of the eye will at length become inflamed and  the use of the eye
rendered painful  and difficult.  The  disease  called the white
swelling is supposed to be an affection of the same nature.
  The king's evil seldom attacks children before they are three
years of age, or after  they arrive to the age of maturity.  It seems
to be the most frequent between the age of  seven and of fifteen
or twenty years.
  To what condition of the system, this disease is really owing,
it seems difficult to discern.  It is said to attack people of white 
KIN.
365
 skins, thick lips, light hair, and of delicate constitutions, but this
 is not invariably the case.   When people are affected with this
 malady, they are said to have a scrofulous  constitution or tem-
 perament.  But  this seems to us very much like saying, when
 people are affected with boils that they have a carbuncular tem-
 perament, or when affected  with  erisypelas that they have an
 erisypelatous  temperament.   If the  scrofulous affection  must
 have a peculiar diathesis or condition of the  system to produce it,
 carbuncles and the erisypelas ought also to have each its peculiar
 diathesis.   In fact, every inflammatory humor or eruption should
 originate in the same way.   It appears to  us that there is more
 learning than wisdom in  this theory invented to account for the
 peculiar inflammation which affects the lymphatic glands.
   We shall give as nearly as we can the history and symptoms of
 the disease, and  leave  all conjectures  about its essential nature
 and origin to systematic writers.   We wish, however, to place
 our readers upon their guard wherever speculation is substituted
 for facts.   Light hair, light  eyes, and a light skin  cannot  cer-
 tainly have any very close connection  with the disease since it
 is quite as common among people of color as among the whites.
 The  doctrine of temperaments appears to us to be  exceedingly
 lame.   Black people are subject to all the diseases which affect
 the whites, and  to  apply the characteristics  of the different tem-
 peraments of the whites to  them  would be impossible.  The
 science of medicine in this respect must ere long undergo an en-
 tire change.
   The external  causes which appear to  produce the king's evil
 are the want of  sufficient food; the want of cleanliness;  living
 in cold, damp, impure air ; and the want of exercise.   People en-
 gaged in agriculture,  who labor; perspire much; live upon whole-
 some food and in the  open air, are much less subject to the king's
 evil than those who reside in cities and manufacturing villages.
 Children who play and run in the open fields where they breathe
 the pure air, and are  exposed to the sun, follow  the best method
 which can be invented for the preservation of health and the pre-
 vention of disease.    The exercise, which they take, forces open
 the pores and prevents the accumulation and condensation of the
 lymph in the glands of the body, and cleans the system of a mass
 of matter which only tends to disease it.  Exercise gives consis-
 tence  to the flesh, hardness  to  the  bones, and  strength to  all
 the fibres.   Inactivity produces despondency in the mind as well
 as feebleness in the body.
   Domestic Remedies.—The attention is generally drawn in  the
first place to the scrofulous tumors or sores.   While these swell-
 ings  in the neck and  other  parts are only hard kernels, they
should be rubbed with opodeldoc or new rum.   If this does not
dispell them, they should be covered with a plaster of brown or 
366
KIN.
 white  diachylon, which should be allowed to remain as long as
 it checks the growth of the tumor.  After they become sore and
 inflamed, and turn to a dark red color, the swellings  must be
 poulticed with flax-seed meal, rye meal, or white bread.  When
 the  top  of the swellings become soft, and the skin changes to
 white, it shows that the tumor contains matter and must be opened
 with a lancet.   After the matter is discharged, the ulcers should
 be dressed with a little salve made of bees-wax and sweet oil;
 and when another tumor  forms, it must be treated  in the same
 way.  If the abscess  is slow in healing, it should be washed with
 a solution of white vitriol or nitra of silver.
   The  tumors  before they become  sore  and inflamed, may  be
 washed,  several times a  day, with a solution of muriate of lime
 or of soda.  These washes are  somewhat new remedies and ap-
 pear to possess a good deal of power in scattering indolent inactive
 swellings.   Electricity and  galvanism, when they are applied
 long enough to produce  a  general  sweat, are capital means of
 scattering the condensed matter.  The current  of the electrical
 fluid should be applied, for half  an hour or an hour at a time.
   The  diet  should  consist of fresh meats, and poultry;  milk;
 and the most nutritious vegetables and bread stuffs.  The skin
 should be kept clean  by washing or bathing in soap and water, or
 salt and water,  and should be much  rubbed with a flannel cloth
 or with the hands.   It  is one of the most important considera-
 tions in this disease to keep the pores open, and the exhalents active.
 A bath composed of cold water, impregnated with the chloride of
 lime or of soda in a sufficient quantity to produce a slight tingling
 of the skin, should  be used as often as once  a week or oftener.
 The child instead  of being  shut up in the house, or factory, or
school, should  be  sent abroad into the open fields  or beside the
 sea shore.  The sea air is beyond all doubt very powerful in re-
storing the system to a state  of  health.   All sores heal better in
a sea air  than in any other.
   The colt's foot is in good esteem in the cure of the king's evil.
 It is used in the form of a tea, drank several times a day.  But a
tea made of the sarsaparilla, and drank, four or five times a day,
to the amount of a gill or half a pint at a time, is said to have
been more effectual in the cure of the disease than any other veg-
etable remedy.   Prunes, dates, almonds, pine apples, tamarinds,
oranges, peaches, and raspberries are all well suited to the condi-
tion of the system.
  Professional Remedies.—The iodine stands  the highest on the
list for the  cure of king's evil  of any  medicine  at  present
in use.     The iodine may  be  used in the following  way,
take one  scruple of the iodine and two scruples of the iodide of
potash and dissolve them in seven  tea-spoonfuls of  water, of this 
LAC.
367
solution give ten drops, three times a day.   The dose should be
gradually increased.
  The muriate of barytes, has, in many hands, been productive of
much apparent benefit.  Probably the oxide of  zinc is as  good
a medicine as can  be used to improve the condition of the diges-
tive  organs.   When the disease runs into  the hectic  fever, the
remedies prescribed for that fever, will  be proper in this disease.
  Lemonade, soda water, and the rochelle powders in solution.
are not only suitable but will operate favourably upon the diseased
glands.  A course  of chalybeate and saline spring  water should
not be neglected whenever it can be prosecuted.
  KINO.—This substance  comes from Africa. It has the ap-
pearance of a dried extract.  It is resinous, of a brown color, and
has an astringent, bitterish taste.  It  is  exhibited  internally, in
doses of from ten to  thirty grains, either in substance, or dissolved
in alcohol.  Its nature  is very much like that of the catechu.  It
is employed in dysentery, diarrhea, fluor albus, hemorrhage from
the womb, and other diseases arising from a  relaxed state of the
solids.
                              L.

   LACTEALS.—The vessels which secrete the chyle  from the
intestines.   They are very delicate and transparent, intersected
with a great many valves, and when filled with chyle,  present a
knotty appearance.   They arise from the inner surface of the
villous coat of the bowels,  perforate  the other coats, and form a
kind of network,—the greater part  of them uniting with  one
another between the muscular and external coats.   From the in-
testines, they penetrate through the folds of the mesentery, to the
conglobate glands, and by a variety of coils,  they mainly contri-
bute to the  formation of the gland through which they pass.—
The conglobate glands are  a knot of small vessels  which lie in
the  tract of the lacteals and lymphatic vessels, as they ascend to
form the thoracic duct.  The lacteals convey the chyle, a milky
fluid, from the organs of digestion into the thoracic  duct, and the
lymphatics are an extensive system of minute transparent vessels
which convey the lymph,  a  watery fluid, into the  same duct.
This duct is first apparent where the diaphragm  or midriff crosses
the chest, and increases  in  size until it reaches the junction of
the left subclavian and jugular veins where it empties.  The size
of its largest part is about that of a crow's quill.  The absorbents,
composed of the lymphatic and lacteal vessels, and  running from
almost every part of the body, empty their contents into this duct. 
368.
LEN.
The lacteals form what is called the chylopoietic  system, or the
system which elaborates and takes up the chyle.   The food and
drink  formed into chyme in the stomach, passes into the small
intestines, where it meets with the pancreatic juice and the bile,
and is converted into the  milky fluid called chyle.  The  lacteal
vessels are chiefly confined to the small intestines.  By the help
of a magnifying glass, an infinite number of them may be seen
issuing from the rough, shaggy coat of the bowels.
  LACTUCARIUM.—This is the dried juice of the lettuce. It
is obtained by making little cuts with  a knife into the stalks of
the lettuce plant, whence the juice exudes, is collected, and dried.
It has a bitter taste, a brown color, and becomes soft by moisture.
It was in high  esteem among  the ancients as a narcotic.  The
juice  of the lettuce  resembles  milk, having the  consistency of
cream.   Some  physicians have preferred it to opium.   Its effects
upon  the system are nearly the same with that narcotic. It is said,
however, to be  more peculiarly a sedative, without the stupifying
effects of opium.  It can  be  given where much nervous excite-
ment  exists, and where  a pure sedative is needed.   It is well
suited to allay a cough, and to quiet a fit of hysterics.
  The dose of lactucarium is from one third of a grain to three
grains.   It may be dissolved  in or mixed with water, or given in
the form of a pill.
  It is a medicine which ought, to come  into general  use.   Its
properties are  highly medicinal,  and   its   exhibition  compara-
tively safe.   A large dose of it, however, is to be avoided, as it
produces the same symptoms as an overdose of other  narcotics.
To diseases of children, the lactucarium appears to be a medicine
remarkably well adapted.
  LARYNX.—The larynx is the top part of the windpipe. The
upper rim of it  is formed by the glottis and the cartilaginous lid
which is called the epiglottis.  It is formed of four or  five car-
tilaginous rings, which make it very stiff and  hard.   It is the
principal organ  of the voice.   Only a slight inflammation of the
larynx destroys the voice entirely.
  LAVENDER—Lavendula Spica.—There are two varieties of
the lavender plant.  The  flowers of both have a fragrant, bitter-
ish  taste.   It is a native  of England, but  is often cultivated in
New England for the sake of its perfume.  It is a small, shrubby,
perennial  plant, and the  best sort has  a broad leaf.  This  sort
yields as much  again essential oil  and is much hotter and heavi-
er than the other.  The lavender is a warm aromatic.   The es-
sence is much used in the form of what  is called the red lavender.
It is an excellent carminative and stimulant in cases of wind colic,
pain in  the stomach, and faintness.
  LENITIVE  ELECTUARY—As a  laxitive medicine this is
one of the best  in use.  In the case of the piles it is worth all the 
LEP.
369
 other remedies which we have  ever  tried.  It is  composed of
 eight ounces of senna, four ounces of coriander seeds, three oun-
 ces of liquorice, figs and pulp of  prunes, each  one pound, tama-
 rinds half a  pound, double refined sugar two pounds and a half.
 Powder the senna with  the coriander seeds,  and  sift out ten
 ounces of the mixed powder.  Boil  the remainder  with the figs
 and liquorice in four pounds of water, to one half, then press out
 and strain the liquor. Evaporate this strained liquor to the weight
 of about a  pound and a  half; then add the sugar  and make  a
 syrup ; add this syrup by degrees to  the pulps, and lastly, mix in
 the  powder.
   A mass of it, of the size  of  a  nutmeg, is the common  dose.
 The taste is not disagreeable, and it seldom disturbs  the stomach.
 In cases of costiveness, it excites  an easy motion of  the bowels.
   LEPRA.—A systematic name of the disease  called leprosy.
 See Leprosy.
   LEPROSY—Lepra.—The leprosy is not a common disease in
 New England.   In the hot climate  of the  West Indies it is said
 to be much more common and much more severe. This disgust-
 ing  humor first  makes its appearance about the elbow and the
 back of the arm between the elbow and the wrist, but especially
 about the knee.   It comes in little red shining bunches in the
 skin, which gradually enlarge until they reach the size of a silver
 dollar.   The bunches have an oval shape and are covered with a
 dry  scab or  rather scale, and  surrounded by a red rim.   The red
 bunches in the skin contain no  fluid, and appear to  be a circum-
 scribed inflammation.  The distemper will  continue in this state
 for a long time.   In its progress, it diseases the skin of the face,
 forehead, and ears,  the eyebrows and the nose.   The skin thick-
 ens, and grows rough and scaly.  The wings of the  nose become
 thick, swelled, and scabby; the eyebrows and beard fall off; the
 nostrils ulcerate ; and the voice becohies hoarse. The lobes of
 the ears become greatly thickened and affected with hard bunches
 and  scabs; the breath is highly offensive ;  and putrid sores arise
 in various parts of the body.   It sometimes proves fatal, but in
 our climate it is for the most part  a harmless though disagreeable
 distemper.   It  commonly removes the hair from the surface of
 the body wherever it strikes,  and  leaves large white scars in the
 skin.   It is the most scabby disorder with  which we ever meet.
 When the humor arises at the point of ulceration, it is supposed to
 be highly contagious.  It is attended  with  a considerable degree
 of irritation and itching, and, when the skin is broken, discharges
a watery fluid.
  It appears to be caused  by a filthiness of the  skin ; poor living;
 improper food ;  cold ; dampness;  and depression of spirits.  In
 Egypt, the Barbary states, and in Asia Minor, it prevails continu-
ally.  In the cure of the leprosy, the first thing to be done is to
           47 
370
LIG.
cleanse the skin and to keep it in a state of softness.   Warm wa-
ter dilutes the acrid discharge and lessens the inflammation.   It
should be kept in  mind in the  treatment of all cutaneons erup-
tions  that they are inflammations, which,  though, for the most
part, chronic, must  be influenced more or less by all  those reme-
dial agents which are employed in inflammatory affections in gen-
eral.  A rigid  adherence  to a vegetable diet is another cardinal
condition in the cure  of  the  leprosy.  All sorts of animal food,
fish, butter and salt meats must be avoided, and bread, potatoes,
custards and fruits, substituted.  Lime water has  been highly
recommended as a wash.  Ointments made of the narrow dock
and the inner bark of  the elder,  are cooling  appliances for the in-
flamed surface.   Solutions of alum and borax may be applied to
the ulceated parts.  The spermaceti  ointment  spread  over the
skin will assist  in the  healing of the humor.   A table-spoonful of
the buckthorn syrup taken every day for a week at a time will
be found a cooling remedy for the system.   The sarsaparilla tea
is a highly approved medicine in the cure of the disease.
  An eighth of a grain of corrosive sublimate  dissolved in hot
water, given, every day, has sometimes been useful.  The cream
of tartar in a dose  of a table-spoonful, daily given, for a week at
a time, often drains the system  of an excess of watery fluid.   In
long  continued cases, the quinine, iron, and the mineral waters
should be employed.  The hot  sulphur springs of Virginia should
be tried.  A good  dry air should be  sought, and sufficient exer-
cise should be taken every day  to raise a gentle perspiration.  A
weak solution of the  oil of vitriol applied as a wash to the skin,
is said  to  have cured the leprosy.   But the medicine we have
found the most generally  useful is the Fowler's solution of arse-
nic.   This is an old established remedy.
  LETHARGY.—A mild species of apoplexy.   It is a symptom
of several diseases.  It is a deep, heavy sleep from which it is dif-
ficult to awaken the person, and when once awake, he falls im-
mediately to sleep with no recollection of what has past  or been
said.  It appears to be a certain degree of palsy of the brain, but
more recoverable much  than apoplexy.  It is most apt to affect
old people.   The  remedies are the same as for apoplexy.  See
Apoplexy.
  LEUCORRHEA.—A disease peculiar to females.  See Whites.
  LIGAMENT.—The strong elastic membranes which connect
the ends of  heads of bones.  Those which enclose the heads of
bones and contain the synovial juice are called capsular ligaments.
The others are  called  connecting ligaments.  Some of the last,
are round, white cords, inserted into the end of each bone.  The
ligaments hold the bony  system together, and  are subject to a
vast amount of labor.   It  is no  wonder, therefore, that the joints
should often be subject to inflammation or  rheumatic diseases. 
L1G.
371
   LIGHT.—The influence of heat and  cold, of moisture  and
 dryness,  of  air and  food  upon  the body, has received  a very
 thorough examination, but the  influence of  light has hitherto
 been scarcely noticed.   Light, aside  from its agency in the for-
 mation of images of  material  objects upon the retina of the eye,
 has no small effect upon the body.   It is a great stimulus.  Too
 great a quantity will  irritate the eye  immediately, and  cause a
 flow of tears or the secretion of an undue quantity of mucus.  A
 constant exposure to the light of the sun will turn the skin brown;
 and the entire absence of light will turn the skin to a sickly pale-
 ness.   The  spirits of people  are much more lively in the light
 than in the absence of it.  Night  is the time for melancholy,
 vapors, gloom, fear, and despondency.  There are  few poople who
 have not more courage in the daytime than in the night.  This
 effect cannot be owing  entirely to the influence of ideal associa-
 tions, although such  associations may have some influence.  A
 cloudy day will produce something of the same  kind of mental
 depression as a dark  night.  Here  there is but very little room
 for ideal associations  to have any influence, since in mere clouds
 there is nothing to occasion either fear or despondency ; there is
 an absence of light but not enough to interfere with our safety or
 pleasures.  People whose nerves are extremely sensitive will of-
 ten feel a degree of depression in the sudden passage of a cloud
 over the sun's disk.   The nervous excitement  is suddenly dimin-
 ished by an  abstraction  of light.  We  have never seen a person
 who had lost his sight, who was capable of that degree of gayety
 Which is common to  other people.  To be much in the light  we
 conceive to  be extremely  conducive  to  the  health.  A brown
 skin is, no doubt, more healthy than a pale skin, all other circum-
 stances being equal.
   Vegetables which grow in the shade where  they experience an
 equal degree of heat and air with those grown in  the light, are of
 a different color, texture, and quality; they seldom  reach maturity,
 and some never bear  fruit;  they are feeble and sickly.  Light is
 a different substance from heat; for a body may be heated in  the
 dark;  and a degree  of warmth is  created in  the human body
 greater than  that of the highest summer heat without the genera-
 tion of light.
   We think  there can  be no doubt but the  circulation  of  the
 blood is considerably influenced  by the action of light upon  the
 retina  of the eye and upon the skin.  As we have before said,
 light is a stimulus, and  this stimulus is necessary to the  proper
 action of the vascular system.  People, therefore, should court
 the light and learn to consider it one of the great constituents of
 the strength  and health  of the  body.
  LIGHTS—The  lungs.—The organs by which breathing or
respiration is  performed. 
372
L1V.
   LINIMENT—An ointment, or  balsam.—The  most common
 liniment is that called the volatile liniment.   It is made by shak-
 ing together in a phial two ounces of olive oil and two drachms
 of water of ammonia.
   Another often used, is  the  liniment of lime water, made  by
 mixing together eight ounces of olive oil, eight ounces of lime
 water, and one ounce of alcohol.  The volatile liniment is used
 chiefly in inflammatory affections ;  the liniment of lime water for
 burns and scalds.
   LIQUORICE.—This plant is a native of the South of Europe.
 It comes to  us in bundles of little  sticks about the size of the
 stems of a currant  bush.  It has a sweet, agreeable taste, and con-
 tains saccharine and  mucilaginous  matter.   An extract is easily
 made from the stick, and when refined is preferable as a medicine to
 the stick.   Liquorice is much used in coughs and colds, and is
 both a pleasant demulcent and a safe expectorant.  It appears to
 have considerable effect upon the mucous membrane of the lungs.
 Steeped with flax-seed or slippery elm bark, it makes a good do-
 mestic medicine for hoarseness and influenza.
  LITHONTRIPTIC— Medicines  which dissolve the  stone
 in the bladder, such as solutions of soda and potash, lime water,
 ammonia, and magnesia.
   LITHOTOMY.—The operation of cutting into the bladder for
 the extraction  of  a stone.—It is  one of the  most formidable
 operations in the practice  of surgery.  The method commonly
 employed, is thai; of making an opening through the perinaeum
 and neck of the bladder.  By this  method the  prostate gland is
 cut laterally, and  an opening  made  large  enough to extract a
 stone  of  any ascertained size.   The  opening is sometimes made
just above the pubes.  In this part, the bladder is not covered  by
 the peritoneum.
  LITHOTRITY.—The operation of breaking up stones in the
 bladder, by means  of a drill, introduced through the urethra, and
 enclosed in a delicate pair of forceps, which open after they  are
 passed into  the bladder, and grasp and hold the stone until it is
 drilled through.  The drill is turned  by means of a bow.  After
 all the stones are  broken into  fine pieces by the drill, they are
 easily passed in the water.  In France, this method of extracting
 stones from the bladder is practiced more than lithotomy.  Our
 countrymen have been extremely backward in adopting the im-
 provement.
  LIVER—Hepar.—The liver is  the largest glandular  body in
 the human system.  It is situated  principally in  the right  side,
 in the upper  part of the abdomen, immediately below the dia-
 phragm, and occupies  the Avhole right  hypochondriac region, a
 part of the left, and the upper half of the right epigastric regions.
 Its length is about ten inches,  and its width  six or seven ; and it 
LIV.
373
weighs from four to five  pounds.  The whole upper surface of
the liver is in contact with the diaphragm ;  the principal part of
the large or right lobe is covered by the lower ribs of the right
side, and  the  small or left lobe is over the stomach on the  left
side of the median line, being bounded on this side by the spleen.
The upper part of the liver is thick, and the lower, thin, tapering
down to an edge.  It is convex, and comparatively regular, ex-
ternally and  anteriorly, and flat and irregular on its posterior or
internal  surface.  It is  divided  by several  fissures into four por-
tions,  called lobes,  the two  principal of which are the right
and left, and the two smaller are called the lobe of spigelius and
lobulus quartus or fourth lobe.   Being  completely  enveloped by
the peritoneum, its surface is perfectly smooth and glossy, and its
color is a reddish brown, frequently  more  or  less spotted with
blue or dark  colored  patches on its under  surface and about the
edges, which  are not, however, an indication  of disease.   The
liver is retained in its  situation by a number  of ligaments, the
most important of which are the falsiform, or suspensory, begin-
ning at the umbilicus, extending along the linea alba and middle
line of the diaphragm,  and  being attached  to its upper surface ;
the right lateral and the left lateral coming off from the back part
of the  diaphragm, and being attached  to the posterior surfaces of
the right and left lobes  respectively.  The round ligament is the
remains of the umbilical vein,  through which  the  blood  passes
from the umbilicus to the liver in the foetal  state, and is contain-
ed  in the anterior margin of the suspensory ligament.  The liga-
ments are formed by the peritoneum, a thin, firm, serous  mem-
brane, which  completely invests the  liver.   By being reflected
from it to the walls of  the abdomen, and back part of the  dia-
phragm, in folds,  it forms strong  attachments to these'parts,
admitting however of some degree of motion.   The substance of
the liver is exceedingly fragile, and  easily lacerated, and has a
granular appearance.  It is very vascular, being bountifully sup-
plied with blood from two very different sources.   The nourish-
ment of  the  organ is supplied  by the hepatic artery, a branch of
the coeliac which comes off from the  abdominal aorta, near the
last dorsal vertebra.   The hepatic artery divides into three prin-
cipal branches, going to the principal lobes of the liver, and these
are subdivided into innumerable smaller branches, which are dis-
tributed  to every part of its substance.  The blood from which
the bile is secreted is venous, and is derived from the  stomach,
intestines, pancreas and spleen.   The veins from all these organs
run together into one large vessel called the vena potarum, which
enters  the liver by two  branches, one of which goes to the right
or largest lobe, and the  other to the other three lobes.  The blood
is returned from the  liver into the general circulation by three
large vessels called hepatic veins, which, after uniting into one, 
374
LIV.
empty into the ascending vena cava, just below the diaphragm,
and near the liver.  The gall  bladder, which is an appendage to
the liver, is attached to the under  side of the great  lobe, and
serves as a reservoir for the  bile, secreted at times when it is not
necessary that it  should be conveyed directly  to the bowels.
The gall bladder will contain about a gill, and, like  the intes-
tines, consists  of three coats, the outer one of which is  composed
of peritoneum ; the other two are the cellular and mucous coats.
From the gall bladder, there is a duct opening into the duode-
num, about four  inches below the  stomach.   The bile  in  the
liver flows into a great number of small vessels, called  biliary
ducts,  which  uniting, form a  principal  one, the hepatic duct.
The hepatic duct joins the duct coming from  the gall bladder,
called  the cystic, forming a common  duct, called ductus com-
munis choledochus.  By this admirable  arrangement of the gall
ducts, it  will be seen that the bile  may flow directly on into the
duodenum, or, if  uncalled for at the time, may regurgitate  into
the gall bladder, to be reserved until  it is needed.  The greenish
yellow with which the  bowels and other parts in contact with
the gall bladder are tinged, is occasioned by the  transudation of
the bile after death.
  The liver is a gland, or rather, perhaps, a congeries of an in-
finite number of small glands,  the function of which is  to secrete
or produce the bile from  the blood, and to discharge it through
its ducts  into the  duodenum or second stomach,  where it serves
some important and highly essential  purposes, by  being com1-
mixed with the  nutriment after it  has gone  through the  first
stage of digestion.  The part which  the  bile performs  in the
animal economy,  has until recently been  very imperfectly under-
stood ; and even   now, after the most elaborate researches  into
animal chemistry, the  precise office which it performs, in being
mixed with the nutriment; the full  extent to which it is essen-
tial to aniinalization ;  the production of heat by the combination
of its carbon with oxygen ; the necessity of its being  separated
from the  blood ; and its effects in exciting the bowels to a healthy
action, are far  from being satisfactorily explained.  Physiologists
formerly  considered  it  merely an  excretion, or something  that
was necessary to  be thrown off from the system,  to depurate the
blood and other  fluids, and  to stimulate the  bowels ; bin the
small quantities detected in the ingesta of a healthy animal, com-
pared with the quantity secreted by the liver, is strong presump-
tive  evidence  that this opinion is  too  limited, and that  it has
other and probably more  important uses.  It  appears probable,
from the  statement of the most modern physiologists and chem-
ists, that  in a healthy condition of the system, a large proportion
of the bile, after being mixed with  the  chyle, is taken up with
it by the  lacteals, and  returned into the blood, and goes again 
LIV.
375
the rounds of  the general circulation, yielding its different con-
stituents in the formation of new animal compounds, and its car-
bon, uniting  with  the  oxygen  of the  blood, which has  been
received in respiration, contributes to the production of animal
heat, and its carbonic acid and water are  given out through the
skin and lungs.
   The  quantity of  bile secreted  by a man is estimated  at  from
seventeen  to  twenty-four ounces daily ;  by a large dog thirty-
six ounces ; and by a horse thirty-seven pounds, far exceeding in
weight  the faeces discharged in the  same time, and from forty-
five to fifty-six times as much as can be  found in the  fasces by
chemical analysis.
   When  the  stomach is full, and its motion  quickened by the
process  of  digestion, an action is communicated to the  gall blad-
der, by  whieh the  bile is pressed out, and  poured  into the first
portion  of  the intestines ; but when the  stomach is deprived  of
food, it  contracts, resembling a portion  of intestine, and the bile
is retained in  the gall bladder ; and hence it is found  distended
in animals that have died of starvation.  The theory of the func-
tions of the bile  here briefly referred to,  should it be confirmed
by further experience  must expose the  absurdity  of the  pop-
ular practice, of  frequently  taking powerful emetics and ca-
thartics, with the  view of  " purging  off the bile."   By ma-
ny,  the bile   is considered  one of the greatest  enemies  to
health,  a  kind of vulture eternally gnawing  upon the  vitals of
man, and  under which mistaken  notion,  their  whole  broad-
side of  pills is directed  against it, in the  hope of exterminating
the  dreaded  foe ; but  happily for them,  the secretion still goes
on, and the  system is soon replenished.  We have long pro-
tested against this  practice, having been  convinced by observa-
tion and experience, that the lives of multitudes have been ren-
dered uncomfortable, and have  been  much  shortened, by the
frequent use  of Hygeien, Brandreth's, Anti-bilious, and  many
other pills  with which  people have been  deceived, like children,
by designing  men,  who would not  scruple  to ruin the health of
a nation, to make their own fortunes.   It  is to be hoped, that
the eyes of the community will be opened  to  these deceptions,
and their  understanding  sufficiently enlightened  to detect the
absurdity of  the  false  philosophy by which these quack  medi-
cines are cheated down their throats. It  is  almost superfluous to
add, that animals seldom, if ever, require, nor have we reason  to
believe, that they resort instinctively to medicinal plants for this
purpose; and  notwithstanding they secrete quite as much bile as
man, they generally enjoy uninterrupted  health.   Active cathar-
tics, however  necessary they may occasionally be as a means  of
curing disease, cannot be resorted to with  even as much propriety
as blood-letting, as they derange the digestive function, and, by 
376
LOB.
quickening the action of the bowels, carryoffthe nutriment thereby
preventing nutrition ;  and by promoting too much the secretions
and excretions, impoverish the blood and lessen  its quantity.
  LOBELIA—Emetic Weed—Indian Tobacco.—This plant is,
when grown, one or two feet high, with oblong leaves, slightly
serrated or indented like a saw.   It is annual, and native to our
soil.   It was in as high esteem among the Indians as it ever has
been with us.  The blossoms are of a pale color and solitary. Its
capsules are inflated with  numerous small seeds.  It flowers in
July or August, and is found in dry fields, and among barley and
rye stubble.
  The leaves are the part chiefly used as medicine.   Their taste
is at first  insipid, but  soon  produce a pungent  sensation, and  a
copious discharge of saliva.   A few swallows of the juice  pro-
duce extreme  nausea and vomiting, with giddiness, pain in the
head, and a tremor of the whole body.  Its taste and its action
somewhat resemble that of tartar emetic.
  In a dose of from ten to fifteen grains of the  powdered leaves,
it is found to operate as a speedy emetic.  It ought always  to be
given by weight.  Thirty grains  of the leaves may be steeped
in a gill of water and  a table-spoonful  given every fifteen min-
utes until  it operates, or rather until one-half of the  tea has been
taken ; after waiting an hour, the other half may be given in the
same way.
  The lobelia can  be made into a tincture by adding two ounces
of the dried leaves to one pint of new rum.   The tincture is the
most suitable for children.  A child, one or two  years old, may
take from  twenty to sixty drops, increased  as the occasion may
require.   An adult may take a tea-spoonful at a time, repeated, if
the proper effect is not produced.   The lobelia is an excitant of
all the secretions,—perspiration,—urine,—phlegm,—bile, and sal-
iva.   For  popular use it is not perhaps a more  unsafe  medicine
than antimony ; and, if the  same caution is used that people em-
ploy in the administration of other  active  remedies, it may be
made an  exceedingly serviceable  emetic.   Domestic herbs and
plants are  all used with too little discrimination, and lobelia has
sometimes been used without weight  or measure.  This evil
should be corrected.
   It yields an extract in considerable abundance, which may be
given in the dose of a grain,  repeated as the occasion may require.
   The  efficacy  of lobelia in asthma, influenza, and pulmonary
diseases, is beyond dispute equal to that of the best vegetable pro-
ductions.   Where  it  does not  cure, it  produces the most signal
relief.    Upon the pulse in inflammatory diseases, given in small
doses, it has the most striking effect.   In lung  affections of chil-
dren, it moderates the circulation,  opens the pores, and lets loose
the emunctories of the whole system.  It operates as an emetic, 
LOC.
377
 cathartic, diuretic, expectorant, and an emmenagogue.   In small
 doses, it abates the violence of a fever ;  and controls the  action
 of the heart in cases of dropsy.  With proper care, and, in suita-
 ble doses, it is a powerful  agent in equalizing the circulation of
 the blood.  It exerts no  inconsiderable  influence upon a cough,
 and may be taken with signal advantage in consumption.
   LOCKED  JAW—Tetanus.—This affection, which  takes its
 name from  the circumstance  of the  jaws being commonly ren-
 dered stiff and immoveable, arises for  the most part from wounds,
 such as punctures, cuts, and lacerations ;  it is said,  however, to
 arise sometimes from irritating substances in the stomach, and
 exposures  to  cold while the pores are open and the  body is in a
 profuse perspiration.  The locked jaw is much more frequent in
 warm climates than in cold ones.
   The symptoms  of  the disease  commonly show themselves in
 about eight days after the occurrence  of  the injury, which is the
 cause of it.   It commences with a gradual stiffening  of the mus-
 cles,  particularly those in the back part of the neck ; the motion
 of the head becomes difficult and painful;  there is a  difficulty of
 swallowing ; a great tightness about the chest ; the jaws are fast
 locked together; the teeth set; and a pain felt darting from  the
 breast-bone to the back-bone.   In many cases the contraction of
 the muscles is confined to the jaws, neck, and chest, but in others
 a universal spasm seizes the system, and the body is twisted into
 a variety of positions. Sometimes, the body is thrown backward,
 and at others, forward.  In the worst  cases, the whole  system is
 shaken with spasms ; the tongue is darted out of the  mouth, and
 injured between the teeth; the arms  are  immoveably  stiff; the
 abdominal  muscles are convulsed ; the  bowels are  obstinately
 costive ; the legs extended and stiff; the eyes set in their sockets;
 the pulse irregular; the countenance hideously  distorted;  and
 the strength exhausted with the violence of the spasms.
   The  spasms are subject to remissions, which last for ten or
 fifteen minutes, and are  renewed, until the strength  is worn out,
 and death puts an end to the scene.  During the remissions, if
 the patient  attempts  to speak, drink, or alter  his position, the
 spasms are renewed.
   It is not a little remarkable that all  this while the  person is in
 the full possession of his senses and no fever is discoverable. The
 locked jaw, when it arises from wounds, is almost always fatal.
 Gunshot wounds  and lacerations are the most likely to produce
it. It sometimes follows surgical operations. A very  quick pulse
in the early stage of the disease is a bad symptom.
  On  dissection of those who have died of this disease, no inflam-
mation of the injured nerve has ever been discovered, and conse-
quently cannot be assigned as a cause  of the affection.
  Remedies.—As the locked jaw arises  almost entirely from in-
           48 
37S
LOC.
juries done to the muscles, cords, and nerves, it is of the first im-
portance to excite a healing process in the part which is wounded,
and to allay the anguish and pain which ensue.
   In the case of a puncture, laceration, cut, or wound of  any
kind, particularly agunshot wound, the patient should  take forty
or sixty drops of laudanum, or an equal amount of some other
opiate,  as a  preventive of the future  spasms and  cramps,  and
should  be  kept under  the influence of opiates until the wound
has begun to heal.  After an opiate has been given, the splinter,
nail, ball, needle, shot, or whatever  substance  remains in  the
wound  must  be drawn out or removed.  A tea-spoonful or  two
of laudanum  must then be poured upon the injured part, which
should  be covered  with a soft,  warm bread or  flax-seed poul-
tice.  This dressing should be renewed, twice a day, for eight or
ten days.  Even, in slight  punctures from needles, pins, nails, and
other sharp instruments, an opiate should be given,  especially in
the case of children, and  the  wound bathed with  laudanum or
a solution of  morphine.  Much more can be done to prevent the
locked jaw than to cure it after it has happened.
   If the disease comes on  suddenly, and the jaws are fast locked
together, two tea-spoonfuls of laudanum should be given by way
of injection,  in a little starch or gruel.  The room should be
kept comfortably warm, and the drinks should be of a stimulat-
ing nature, such as wine and water, brandy and water, and pep-
permint  tea.   The  disease has been cured by wine  alone.   The
smoke  of a lock of "burnt  wool  or a piece of flannel, applied to
the injured part, is no mean remedy.
   In some  instances the cramp comes on after the surface of the
wound  has healed.  In this case, the wound has been opened,
and the spirits of turpentine dropped into it, in order to excite an
inflammatory action.   The practice should be followed where the
ordinary means fail.   The warm  bath should always be tried,
and the water should be impregnated with a little common pearl-
ashes, or nitro-muriatic acid.   It is  sometimes necessary to ex-
tract two or more of the teeth where the jaws become immovea-
ble, in  order  to introduce  medicine and nourishment.   In addi-
tion  to  opium, camphor,  musk, castor, cicuta belladonna, ether,
and assafetida are often given to allay the spasms.
  The carbonate of potash, alternated with opium has been em-
ployed internally with success.  Electricity and galvanism should
be tried.  The bowels should be moved every day by some mild
cathartic, such as castor oil, salts, or magnesia, and a perspiration
excited  and kept up by the use of small doses of  ipecac, lobelia,
James'  powder  or ihe  Dover's  powder.   The secretion  by the
kidneys should be promoted  by the use of nitre, and  warm, di-
luent drinks.   The food should  be gruel, bread  water, or weak
milk porridge. 
LUM.
379
  Where tetanus or locked jaw arises from severe wounds of the
limbs,  it is recommended by  some to amputate  immediately.
Mercury is said to have been employed with success where it has
been given in sufficient quantity to produce salivation.
  The  means  used to excite a healthy inflammation in the in-
jured part, are the lunar caustic, spirits of turpentine and alcohol.
Quinine should be given after the spasms have subsided.
  LUMBAGO.—This disease is a rheumatic affection of the small
of  the  back.   It consists in a greater or less degree of soreness
and pain of that part of  the body.  It prevents the person from
bending the body or stooping  forward Without producing pain.
It is sometimes called, when it exists in a slight  degree, a  crick
in the back.  It is produced by cold ;  and by straining the back
in labor or lifting.  It is often  brought on by carrying a pail of
water or hod of coal up stairs.  It is a disease which affects shoe-
makers, and all people who exercise the  back more  than other
parts of the body.  The disease, by neglect and an obstinate per-
sistence in the species of work which  causes it, sometimes ends
in a stiffness and crookedness of the back which make the person
bend forward.  It is more especially a disease of laboring people.
   The pain and soreness, in  the commencement,  may generally
 be removed by sufficient rest and by producing a free perspiration.
 Two or three Dover's powders, of ten grains each, taken at inter-
 vals of three hours, together with hot pennyroyal  tea, and  lying,
 a day or two, in a warm bed will usually restore the health.
   A large mustard poultice applied  to  the back or a large pitch
 plaster will often restore the back -without any other remedy.—
 The poultices  or plasters must be large or they will be of no per-
 manent service.   A plaster of shoemaker's wax will cure the
 complaint.  If the pain and soreness are severe, the volatile lini-
 ment mixed with a tea-spoonful of laudanum should be applied
 to the  back, and a few drops  of morphine taken to ease the pain.
 A flannel  shirt should be worn, and the body kept warm.
    LUMBAR ABSCESS.—The seat of this abscess is  in the
 muscles which lie  upon the inside  of the loins.   These muscles,
 called  the psoas  muscles, are what, in some  of the lower animals
 are called  the tender lines.  They are large, thick, and fleshy ;
 and when inflammation arises in them spontaneously or from me-
 chanical injuries, it ends in  a large abscess or cavity filled with
 matter.   As the matter cannot escape  through the back-bone
 without destroying it, it most commonly makes its appearance in
 the lower part of the belly,  just above the groin.   Lumbar ab-
 scesses will often increase to  the size of  a  two quart bowl and
 larger.   They are commonly a long time in forming, and  seldom
 show any external signs of  inflammation, such  as  redness and
 soreness until just before they break.  The swelling or tumor is
 commonly the first intimation of the disease.  The matter in the 
380                        LUN.
 tender lines seems to form  by stealth, and  seeks  its way to the
 surface by a blind circuitous route.   There is seldom much pain
 or soreness in the back ; the most, that is felt, is a sense of weight,
 uneasiness, and frequent chills.   There is sometimes a disease of
 the bones of the back which occasions the  lumbar abscess, and,
 at other times, the abcess will occasion a disease of the vertebrae.
   The most that can be done in the treatment of this disease in
 our present state of knowledge, is to strengthen the system by a
 free use of quinine, the rust of iron, the mineral acids, and nour-
 ishing food.  Wine and ale may also be used during the  forma-
 tion of the pus.   A gftain of quinine should be taken three times
 a day.   Fifteen drops of elixir vitriol should be taken as often, in
 half a tumbler of water.
   Lumbar abscesses are sometimes opened with a lancet or trocar,
 and the  matter discharged, but of late years, it has been thought
 better to allow them to break of their own accord.
   LUNAR CAUSTIC—Nitrate of  Silver.—This article is made
 by the combination of aqua fortis with silver. Eight ounces of the
 acid is diluted with four ounces of distilled  water, to which, four
 ounces of pure silver plates, cut into pieces, are added.   The sil-
 ver is dissolved in a phial with a gentle  heat, and evaporated to
 dryness. We commonly see it in shops, in the form of little sticks,
 about the size and length of a common  lead pencil.  It is solid,
 of a greyish black color, and when dissolved in water, makes an
 indelible stain upon the skin.  It is a strong caustic to the flesh,
 and is in the most  common use  for  consuming proud flesh, cal-
 lous  edges, scirrhosities, warts, corns, fungous  excrescences, and
 strictures in the urethra.   Of late, it has been used for touching
 indolent inflammations,  ulcerations,  and  canker spots in  the
 throat.   It  will effectually  destroy the venereal poison of chan-
 cres.
  Some have  employed it internally in dropsy, epilepsy, and an-
 gina  pectoris.    The  dose  is  from a  twelfth  to  a quarter of a
 grain, dissolved in distilled water, and made into a pill.  A solu-
 tion of  it, has been used for an  injection, in cases of gonorrhea.
 Employed  internally, it operates as  a cathartic, destroys worms,
 and brings  away a large quantity of water.   Well and spring wa-
 ter  decompose it; hence  it must be dissolved  in distilled  water.
  LUNGS—Pulmones—The organs of Respiration.—The lungs
 occupy the greater part of the thorax or chest, which is the cavity
included between the sternum or breast-bone  in- front, and  the
back-bone  behind, the ribs and intercostal muscles on the sides,
the clavicles or collar-bones  above,  and  the diaphragm  below.
 The heart is the only other  organ occupying much space  in the
cavity of the chest.   The size of  the lungs, therefore, must bear
an exact proportion to that of this cavity.   Unlike the liver, the
largest part of the lungs is below, and each lung forms an irregu- 
LUN.
381
lar cone, with its apex just  behind the collar-bone, and its base
resting  upon the  diaphragm.   The surface of the lungs corres-
ponding with the  insides of the ribs, is rounded or convex ;  but
that surface that looks towards the opposite  lung is concave, in
consequence of the  space  taken up by the heart.   As the dia-
phragm is convex on its upper  side, and  concave on its under
side, the  lungs in resting upon it are somewhat concave on the
bottom.  There are  two principal lobes to the  lungs, the right
and  left, which are separated from  each other by a membranous
partition  formed  by the plurae, called the mediastinum.  This
partition is formed by two portions of the plurae, which come off
from the spine  ; and the heart, enveloped  by the pericardium, is
placed  precisely in the centre  between them, with  its apex in-
clining to the  left.  The right lobe of the lungs  is divided  by
two deep fissures into three smaller lobes, and the left lobe  by
one  fissure into two lobes.
   The external surfaces of the lungs are in contact with the
walls of the thorax, but do not adhere to  them, except in those
cases in which  morbid adhesions have taken place from inflam-
mations.  The connexion by which they are maintained in their
situation, is entirely on their internal or concave face, where the
pulmonary vessels and bronchia enter them.
   "  Each lobe  of  the lungs is divided into  a great many distinct
lobules, which  are held together by intermediate cellular tissue.
The marks of these divisions are apparent on the surface, by lines
running in different directions ; but they are made still more dis-
tinct by tearing them asunder."   These lobules are again subdi-
ved  into very fine air cells, which may be  considered the fermi-
nations of the  ultimate branches of the bronchia.   Besides the
ramifications of the bronchia, the substance of the lungs is com-
posed of numerous blood-vessels and lymphatics, and  is  well
supplied with nerves.  The blood-vessels  are of two kinds, the
pulmonary and  the bronchial.   The  bronchial commonly come
off from  the aorta, but sometimes  from the superior intercostal.
There  is one  and occasionally two to each  lung.   They enter
with, and follow the course of  the bronchia, and are designed to
supply  nourishment to the lungs. Bleeding from the lungs prob-
ably often proceeds from these vessels.   For some further account
of the circulation in the lungs see Circulation.
   The lungs have no motion of themselves, but  are kept in con-
stant'motion, chiefly,  by  the action  of the diaphragm, and partly
by the numerous muscles situated upon the chest and abdomen,
called the respiratory muscles.   Though  these  muscles are  in
some degree subject to the influence of the  will,  respiration is or-
dinarily an  involuntary action, the author  of nature not having
thought proper  to commit the performance of so important a func-
tion  to the option of the individual. 
382
LUN.
  In  a healthy condition, the lungs  are of a light  pink color,
spotted with dark colored specks or patches, which become larger
and more numerous as the person advances in age.   After  res-
piration has been established, the texture of the lungs is exceed-
ingly light and  spongy, and floats upon water like the lightest
substances ; but in the foetal state, or  before they have  been in-
flated  by respiration,  they  are  comparatively solid  and heavy,
and do not float  upon water any better than other solid flesh.
  In cases of suspected infanticide, or in cases in  which it is de-
sirable to know whether  a child has ever breathed or not, the
specific gravity of the lungs, compared with that of water, is con-
sidered the strongest evidence.
  LUNG FEVER.—This term  has  been used  somewhat  dif-
ferently by physicians, as  well, as by people  generally, to mean
almost any affection of the lungs, attended with fever.  To be
informed that a person has the lung fever conveys  to the mind
no definite idea of the nature of the case.  It may be peripneu-
mony, bronchitis, or influenza,'all of  which affect the lungs and
are  often attended with more or less  fever.  In order, however,
to give our readers as clear and  consequently as useful views of
the diseases of the organs  contained in the cavity of the thorax,
as the nature of the subject will admit, the term will be here
limited to  mean an  inflammation of the mucous or lining mem-
brane of the bronchial tubes, and their innumerable  branches in
the lungs, attended with fever.   By referring to the articles pleu-
risy and peripneumony  it will be seen that the former is an in-
flammation of the pleura or membrane that envelopes the lungs,
and lines the  cavity of the chest; the  latter  an inflammation of
the substance or parenchyrma  of the lungs, the  lung fever is
the same affection located upon the  third  and principal other
structure of which these organs are constituted.
  Perhaps  this name is not  the most  appropriate that could be
selected, but  as it is the one by which the disease is  generally
designated, it is therefore the most suitable in a book of this kind.
The  general term, inflammation of the lungs, may mean  lung
fever as here  defined, or an inflammation of any other part of the
lungs.  Bronchitis and  influenza are  affections of the mucous
membrane of the bronchial tubes, and in this particular resemble
lung fever; but  these diseases are located and limited, in some
measure, to the larger branches of the bronchia, and frequently
exist with but a slight degree of fever, whereas the inflammation
in lung fever may affect this membrane in its whole extent, and
the fever is an essential characteristic. Lung fever as here intended
to be defined, is confined, principally to infants and children under
twelve years  of age.   When we  consider that the calibre of the
bronchial vessels in  infancy  is  very  small compared with the
same parts in the adult, it  will readily be perceived how much 
LUN.
383
   more liable they are  to be  obstructed, by a thickening  of the
   membrane, and by accumulated phlegm :  and when we take into
   account the rapidity of the circulation, the irritability of the ner-
   vous system and the consequent predisposition to febrile diseases
   in infancy, it will be perceived that the same causes which would
   produce great disturbance in the system of a child, would  have
   but  little effect upon that of an adult, in whom these circumstan-
   ces are reversed.   What would be an influenza or bronchitis in an
   adult might be lung fever in an infant.   That these different af-
   fections of the lungs,  may, and frequently do run into  each  other
   is well known, and  that there is often much difficulty in distin-
   guishing  them,  must be  admitted, but these are  not sufficient
   reasons why we should not endeavor to obtain distinct notions
   of each in its uncomplicated form.
      The most common,  if not the only causes of lung fever, are
   colds or influenza in whatever way induced.  Like other inflam-
   mations and fevers, this, probably, always begins with a greater
   or less degree of chilliness and shivering, debility, headache, pain
   in the back, &c, though  the patient is  generally too young to
   make any complaint except by fretfulness and crying.  The first
   symptoms which attract particular attention are, that the  nostrils are
   obstructed, and that there are sneering and a hacking cough. As the
   inflammation progresses downward into the windpipe  the cough
   frequently resembles that  of  croup, and as  there is difficulty of
   breathing, it is not unusual for parents to be very much alarmed,
   mistaking the case for  that alarming  disease.   These peculiar
   symptoms  soon  change, and especially if an emetic  be  given,
   which is a common remedy in croup. The seat of the  disease ap-
v   pears to be lower down in the chest than croup. The cough is short
   and frequent, and sounds as if some phlegm was raised at each time
   into  the throat, and this generally speaking is the fact, but as in-
   fants never spit out what they raise, it is immediately  swallowed
   into  the stomach, and passes off through  the bowels.  Parents
   are  frequently alarmed because the child does not  throw the
   phlegm off by  the  mouth, and at  the quantity which  passes
   the bowels, having the appearance of slime, but this alarm is un-
   called  for, as no  harm comes from  it.   The  lungs are  cleared
   just  as effectually as though it were spit  out.  The  skin is hot
   and  dry; the cheeks are flushed or there are circumscribed spots
   upon one or both of them ; the pulse is quick ; the tongue coated,
   and if the fever run high and the lungs are much oppressed  with
   phlegm, the child is often heavy and drowsy.   Sometimes, how-
   ever, it is sleepless and fretful.  Should the inflammation extend
   to the substance  of the lungs, a case that frequently occurs, there
   will  be pain in some part of the chest, the breath will be short,
   and the cough suppressed.   In those cases in which the child is
   too young to describe its feelings, the existence  of pain may be 
384
LUN.
known by its making a moaning noise when it draws in its breath.
This symptom  may  be  observed  especially during sleep, as the
breathing in this state is not shortened by an act  of  the will, as
it is when awake.
  Lung fever when uncomplicated with inflammation of the paren-
chyma  is not ordinarily a  very  dangerous disease,  though in
young infants in whom  the vessels are very small, the thickened
membrane and  accumulated phlegm may so completely prevent
the admission of air into the lungs, that a kind of suffocation will
take place and death  be the consequence.   If the substance of the
lungs be implicated,  death  may occur in the same manner  as in
perrpneumony, or the disease may become chronic and terminate
in consumption.
  Lung  fever generally runs about a week, at the end of which
time a crisis is formed as in other inflammatory affections.   The
sleep  becomes quiet  and natural; the respiration free  and  full;
the skin moist and cool; the pulse slow and soft; the cough di-
minished in frequency, though there may still be  occasional par-
oxisms  of hard coughing ; the expectoration  easy and copious;
and the appetite  returns.   Like  other  similar affections, this is
more frequent in some seasons than others, sometimes prevailing
epidemically.  As  it  is mostly produced by cold, wet and change-
able\weather, wet  feet, &c,  the spring and fall are consequently
the seasons in which it is most prevalent.
  Domestic Remedies.—In treating  lung fever  it should be borne
in mind thatrit  is  of an inflammatory nature  and consequently
that the remedies  employed must be antiphlogestic, or  such as
have a tendency to subdue inflammation.
  All solid and  stimulating food and drinks should be prohibited.
The drinks should consist of gum water, slippery  elm, flax-seed,
balm  or mullein  tea, indian meal  or  rice gruel, molasses and
water, or lemonade.   Warm drinks are preferable to  cold, but
cold water need not be entirely withheld.   If  the child nurse, it
should  be only in  small  quantities at a time, as digestion must
necessarily be imperfect, and the stomach will  be  oppressed, and
the complaint of the  lungs aggravated.  Bathing the extremities
twice a day, in  hot water, and mustard  poultices  to the  feet, are
among the most valuable domestic remedies.   They equalize the
circulation, promote perspiration, and thereby lessen the quantity
of blood at the seat of the disease, and therefore produce an effect
equivalent to extracting  blood from the system. Should the dif-
ficulty of breathing be great, hot stoups should be applied to the
chest.   In applying  stoups,  the water,  or whatever is used for
the bath, should be kept constantly hot, and two  pieces of  flan-
nel of suitable size,  and  of  four or  five thicknesses, should be
used, so  that when one is removed, the other may be in readi-
ness to apply immediately, in order  to prevent the cold air  from 
LUN.
385
coming in contact with the warm, moist surface.  The bathing
ought to be  continued until relief is obtained, which may require
from two to ten or twelve hours, and the cloths changed as often
as they begin to grow cold.   If well covered with warm,  dry
flannel, the stoups will retain sufficient heat, thirty minutes;  but
if this precaution be  not taken, they will require to be  changed
every ten or fifteen minutes.  We have described this process
the more minutely, in consequence of having seldom seen it con-
ducted in a manner to  be of the least possible benefit, and be-
cause, when not properly done, its effects are decidedly injurious.
A gentle emetic of ipecac or hive syrup, should be given twice
or thrice in  twenty-four hours, according to the urgency of the
case, and the bowels moved with castor oil, if the emetics do not
produce  this effect.   During the  intervals  between the emetics,
small, nauseating doses of the hive syrup,  ipecac, or antimonial
wine, should be administered every two or three  hours, to pro-
mote raising.   The nitrate of potash, sal  nitre, combined with
the  ipecac,  or  given by  itself in solution, alternately with the
nauseating  medicines, is the best medicine with  which we are
acquainted,  for mitigating the fever  in  the first stage.  In the
second stage of the complaint,  the sweet spirits of nitre  is prefer-
able to the  sal nitre, and  may  be mixed with the hive  syrup,  or
the wine of ipecac or antimony.   The syrup of squills and oil
of almonds, with the addition of a little tincture of tolu, is an
appropriate  remedy,  and  if the patient  be very young or much
debilitated,  will  be preferable to the hive syrup or any  medicine
containing antimony.  Lard and other oils, warmed with  molasses,
are  common domestic  remedies  in lung  affections of children,
and are  unobjectionable; and  perhaps in some cases will  prove
valuable auxiliaries.  While the skin continues hot and dry, the
pulse quick and hard, the cheeks  flushed, and the breathing labo-
rious, these means may be persevered in with perfect safety; but
if there should be a cold sweat, pale cheeks, slow and weak pulse,
and other symptoms of prostration,  they  must be discontinued
for a while  at least, and a little camphor or Hoffman's anodyne
be given.
   Professional Remedies—The most potent remedy in the treat-
ment of lung fever, is bleeding;  and in violent attacks, and par-
ticularly if  the  pain  be severe, and  there  be  reason to suppose
that the substance of the lungs is involved, it should be resorted
to, whatever  the age  of the  patient.  The  earlier  bleeding  is
practiced, and the more decided the impression  made  upon the
system  at the first  operation, the more beneficial will  be the
effects produced.'  If the patient be young, leeching  the chest is
the best mode of drawing blood.   After the leeches drop off, the
bleeding may be promoted by warm  wet cloths, until an impres- 
386
LYM.
 sion  is made upon the system.  In  older  children,  a prompt
 bleeding from the arm is the most effectual mode of arresting the
 progress of the disease.  Blistering the chest of young infants,
 though often practiced, is of doubtful utility.   The  irritation it
 produces, probably more  than counterbalances  its good effects.
 Blisters are by no means as safe, and but  little more efficient,
 than  mustard  poultices, and  should be used  with great caution.
 Calomel is often  given, and is a  medicine well worthy of a trial
 in dangerous cases, if other remedies do not  control the disease,
 but an indiscriminate use of it, in all cases, should be deprecated.
 It is  rare that the disease cannot be cured without it, equally as
 well as with it.  It sometimes  happens that the cough continues
 after  the fever  has subsided,  and when the patient is very much
 prostrated;  in  these cases camphor and  other cordials may  be
 given.  A solution of sal ammoniac, liquorice, and ipecac, given,
 as recommended in measles, and the lac ammoniac, are appropri-
 ate remedies, and an occasional dose of paragoric or Dover's pow-
 der, is indispensable in some cases, after the fever has in a measure
 subsided.   As  the doses of the medicines recommended in this
 disease are all given under their respective  heads, it is thought
 unnecessary to particularize  them.  In  giving liquid  medicine,
 however, to young children,  we would observe that they should
 always  be dropped from a phial,  in order that the doses may  be
 nicely graduated by the  ability  of the stomach  to bear them.
 During convalescence, which is usually rapid, the diet should  be
 light and nutritious, and all undue exposure to the weather avoid-
 ed, or the cough may be protracted, and the  disease terminate in
 a consumption.
  LYMPHATIC  VESSELS.—These  vessels are  distributed
 over the whole body.   They form a distinct system of vessels,
 and everywhere convey a fluid of the  nature of water, or serum.
 They are transparent, very thin, and cylindrical.  Their office ap-
 pears  to be to lake up and convey into the venous system, all the
 solids and fluids of the body.   It is by the agency of  these ves-
 sels that the body is continually changed.   The  lacteals intro-
duce new matter into the system ; the lymphatics carry away the
old.   If  water  or pus  is secreted in any of the cavities of the
body, the lymphatic vessels absorb it, and convey it into the cir-
culation.  Every part of the  old matter which will  answer  to
make new blood  is appropriated  by these vessels to the renewal
 of the system.  A network of them is seen traversing every part
of the body, except  the brain.  They are supposed  to exist in
the brain, but  hitherto  they  have escaped detection.   As they
proceed from the extremeties, they form into little  knots, called
glands, and finally end in the thoracic duct.   Some run near the
surface, and others are  deep-seated.  They  contain valves like 
MAN.                        387
veins, and are formed of an outer cellular membrane and an inter-
nal coat.  Large tumors are often taken up and carried away by
them.   In many cases  of dropsy the water is absorbed by the
lymphatics, and the disease is cured.
                             M.

  MACERATION.—This operation is the infusion of substances
into either cold or hot water, in order to  extract their virtues.
The ingredients are thrown into water, where  they are allowed
to stand and  soften until their essence is dissolved.   To  extract
the virtues of  plants  and other substances,  requires time,  and
much longer  by cold than by hot water.
  MAGNESIA.—Pure magnesia is one of the sub-alkalies.   It
is a white powder, of  an alkaline taste, and  possesses  purgative
and diuretic  properties.  The lump magnesia  is a carbonate of
the calcined  or pure magnesia.  The carbonic acid is expelled
from  the carbonate of  magnesia by heat.   The lump  magnesia
is put into a crucible and burnt like  limestone in a kiln, by which
process, the pure or calcined magnesia is obtained.  The calcined
magnesia  must be  kept in  closely stopped glass vessels, on  ac-
count of its disposition to absorb carbonic acid  from the air, and
to return  to its state of carbonate again.   Both the carbonate of
magnesia  and the calcined, are  laxative, and good correctors of
acidity  or sourness of the  stomach.  No substance neutralizes
the acidities  of the stomach so perfectly and safely, as mag-
nesia.   The  calcined  is preferable, because it  extricates  no air
or  gas.   The  lump magnesia  is chiefly used  as an  absorbent.
The dose of  calcined magnesia is from a tea-spoonful  to a table-
spoonful, mixed with milk or water.  It is one  of the safest, best
and surest cathartics which we  possess.   In nervous  affections,
such  as hysterics,  hypochondrism, insanity, and epilepsy,  the
calcined magnesia will be found  especially serviceable, as it ope-
rates both upon the kidneys and  bowels.  It is a peculiarly suita-
ble medicine for children  which are, continually, more or  less
troubled with acidities.  In dropsies, if used properly, it is a med-
icine of uncommon efficacy.
  MALIGNANT SORE THROAT—Scarlet Fever.—See Scar-
let  Fever.
  MANIA—Insanity,  Craziness.—See Insanity.
  MANNA—Fraxinus Ornus.—The tree, which affords manna,
grows in Calabria and  Sicily.  In the warm season of  the year, a
clear juice exudes from the stem and branches of this tree, which,
when concreted or thickened by the sun, is the real manna  that 
388
MEA.
we see in  shops, in the form of oblong, yellowish, friable flakes.
It has a sweet taste, resembling maple sugar, a greasy feel, and
easily dissolves in warm water.
  Manna is a mild laxative, peculiarly suitable to young children.
The dose for children is from one to three drachms, according to
their age;  the dose for  an adult, an  ounce, or an ounce and  a
half.  Mixed with liquorice stick and senna, and steeped in water,
it makes a  good medicine  for a cough.  Where it is often given,
the dose must be very much increased.
  MARIGOLD—Calendula Officinalis.—The flowers, leaves, and
branches of  the young plant have been  highly extolled in the
case of  cancers of the breast.  After  washing the cancer with a
tea of the plant, the expressed juice made  into an ointment with
fresh butter is to  be  applied, once  or twice a day, by means of
lint.  One  cr two ounces of the  tea  is at the same time to be
drank.  The  taste is bitter and somewhat pungent.  A dose of
the extract is from four to sixteen grains.   In  this form, it has
been given with success in cases of scirrhus  of the stomach.
  MARSH ROSEMARY.—This plant grows in salt marshes.
The flowers are blue, and grow on long spikes on the tops of the
branches.   The  stem is naked, branched,  and about a foot high.
The roots of this plant are highly astringent.  In the sore mouth
or canker, a tea made of  the roots, and used as a gargle, every
few minutes, in the course of the day,  with now and then a swal-
low of it taken into the stomach, has  often proved a cure.  It is
sometimes  used to cure the dysentery and diarrhea.  The  cele-
brated Dr.  Hews of this place was in the  habit of giving it as  a
substitute for the peruvian bark.
  MASTICATION.—The division of the food by the teeth, and
its mixture with the saliva and mucus of the mouth.  The sol-
vent power of the saliva is very great.  Most  of the alimentary
substances taken into the  mouth are wholly or partially dissolved
by this fluid before they reach the stomach.  If the mucus and
saliva of the mouth are absent, there is no appetite, and the di-
gestion of the food is very difficult.   Mastication is the first step
towards the  animalization of lifeless matter, or the food.   It  is
broken  down, comminuted, and  more  or less dissolved in the
mouth,  and prepared  to undergo  another  animal  process in the
stomach.   The action of  the jaws, cheeks, lips and tongue, are
all necessary in the dissolution of the  food  in the mouth.  The
tongue itself is one of the chief agents, not only in swallowing,
but in moving the food about the mouth, and mixing it with the
saliva.  Even the sight and smell of food excites the secretions
of the mouth.  There are six salivary glands ;  three situated on
each side of  the mouth, each of which  pours forth the saliva by
means of a small duct, or canal.
   MEASLES—Rubeola.—Measles is a catarrhal, eruptive fever, 
MEA.
389
of a peculiar character, and limited  duration, which affects the
same individual but once.   The principal locations of this disease
are the lungs and the skin ;  hence it is always attended  with a
cough and an  eruption.  The most common cause of  measles is
contagion, but it  sometimes attacks those who have not been ex-
posed to it, and  consequently must be produced by some atmos-
pheric  influences, or terrestrial emanations, the  nature of which
is not  known.   The matter of  contagion, or miasm, remains
latent, though probably not inactive, in the system from  nine to
fourteen days after  exposure, before  the disease  is sufficiently
developed  to  manifest  itself.   Measles  makes  its attacks very
much in the same manner  as a common cold.  There  is a harsh,
dry cough, often  somewhat like  that of  croup ;  hoarseness, and
difficult respiration ; the eyes are inflamed and the lids tumefied ;
there is a constant flow of  acrid tears, and the secretion from the
lining  membranes of the nostrils is so irritating that almost per-
petual  sneezing is sometimes produced ; the head aches, or  is
drowsy,  and  the  stomach  often rejects its contents ; the tongue
is coated ;  the pulse quickened, and other symptoms  of  general
fever are present.  The rash usually appears on the fourth day,
in irregularly grouped, crimson dots, which are slightly elevated.
By examining the mouth, red spots may be seen  upon the roof,
before  they appear upon the skin.  They next  appear  on the
head and  face, and in the  course of two days  extend over the
whole  body and  limbs, entirely to the hands and feet.   In the
course  of the next  twenty-four  hours they run together, begins
ning at  the  head, and  the disease comes to a crisis.   At this
period, by a close examination, a  fine scurfy appearance  of the
skin may be  observed, occasioned by minute portions of cuticle
or scarfskin, which are cast off from the vesicles that form in the
course of the eruption.  While the rash is coming out, and until
the crisis is formed, the cough  and all the other symptoms are
aggravated, and it is not unusual  for the patient to pass  two or
three uncomfortable and restless  days and nights; when, how-
ever, the disease  is unattended  by any unusual complication, or
violent inflammation of the lungs, almost immediate relief is ex-
perienced at the  crisis, and the recovery is frequently very rapid.
Measles may be distinguished from scarlet fever, by the eruptions
not  appearing until  the fourth, instead of the  second day ;  by
the  presence of  cough and  other catarrhal  symptoms;  by the
dots appearing first on the head, being grouped, and of a crimson
rather than a scarlet  color.   The pulse generally speaking is not
as frequent as in scarlet fever, nor is the intensity of the fever as
great.   When properly managed, measles cannot be considered
as a dangerous disease.  In those cases which do prove fatal, the
inflammation, which  is ordinarily confined to the  mucous  or
lining membrane, extends to the substance of the lungs, and dis- 
390
MEA.
solution takes  place in the  same manner as in peripneumony, or
the  disease degenerates into a  quick consumption, which  may
prove fatal after weeks or months.   Spring and fall are the sea-
sons in which  measles is the most frequently prevalent, though
it may occur in any season, or in any kind of weather.  Changea-
ble,  cold, and damp weather, however, undoubtedly aggravate its
character, and predispose to dangerous inflammations.
  Those, who from exposure to the contagion, are liable to have this
disease,should be warmly clad,and should avoid all undue exposure
to cold and wet weather.   The  feet, in particular, should be kept
warm  and  dry.   During the first stage of  the  complaint the
symptoms  may be mitigated by bathing the feet once or twice a
day  in  hot water, and by a free  use of warm demulcent and
sweating drinks.  Molasses and water, balm, mullein, flax-seed
and  slippery elm, are some of the most appropriate.  Should the
rash not appear in due season, a  strong mustard bath, followed by
mustard, or some other stimulating  poultices, to  the feet, and
warm  vinegar whey, saffron, summer  savory, or pennyroyal tea,
in copious draughts, should  be tried.   If there be much difficulty
of breathing, with a sense of oppression at the stomach, the ap-
plication of a strong mustard poultice to the chest, will sometimes
be followed with the happiest effects.
   These means, with  the addition of a dose of castor oil, or some
other gentle physic soon after the crisis, are all that are necessary
in ordinary cases ; we  however occasionally meet with  cases in
which the eruption seems to be  detained by excessive fever.   In
"hese the  greatest benefit will  often  be derived from moderate
bleeding, an emetic or cathartic, and nauseating  doses  of  anti-
mony, ipecac, or hive  syrup.  It is a popular opinion that cathar-
tics  are  injurious and unsafe before the crisis ; for this  opinion
however, there is  no well-founded reason.   It is true indeed, that
these medicines are not often necessary, but should circumstances
require them, they may be given with perfect safety.  If in any
stage of the disease, there should be fixed pain in any part of the
chest, aggravated  by coughing or taking a full breath, there will
be reason  to apprehend inflammation of the lungs, and  the case
must be treated accordingly, by bleeding either with the lancet
or leeches, hot poultices or stoups to the chest, nauseating doses
of ipecac,  antimony, hive syrup, or lobelia, and  nitrate of potass,
repeated every three  or four  hours ;  demulcent drinks, such as
flaxseed tea, gum water, or mucilage of slippery elm ; and if  re-
lief be  not obtained,  by blistering  over  the seat  of the  pain.
 Should the cough and expectoration, attended with  soreness and
 dull pain in the chest, continue  after the active  stage of the dis-
 ease has  passed,  the  sal ammoniac, muriate ammon, combined
 with extract of liquorice and ipecac, will be found one of the best
 medicines, and  often  produces  the most  salutary effects.  One 
MED.
391
drachm of sal ammoniac, three of liquorice, and ten grains of ipecac
should be  dissolved in half a pint of boiling water, of which a
tea-spoonful is a dose for a child two years old, and a table-spoon-
ful for an adult, to be repeated every four hours.   Under these
circumstances, quieting doses of paragoric or some other prepara-
tion of  opium, may also  be given with  advantage, especially at
night.  As the eyes are always more or less inflamed in measles,
the room should be darkened, and the eyes frequently bathed in
cold  rain water, milk and water or  green tea.  ]f, however, the
inflammation be severe and these means are not sufficient to sub-
due it, the case  must be treated in the same  manner  as when
occuring under other circumstances, and the reader is referred to
the article upon that subject.
   Before concluding this article it maybe proper to observe, that
cases of measles are occasionally met with assuming a very diffe-
rent character from that above described.  The cases referred to,
generally occur in debilitated or broken down constitutions, or
under circumstances  calculated to  enfeeble the vital functions,
and consequently interrupt the natural course of the  disease.
The  rash, instead of appearing on the fourth day, is  delayed
until the seventh, and is  intermixed  with spots of a dark or livid
hue, resembling those of spotted or petechial fever, which often
rema'ii ten or twelve  days.  There is but little fever ; the pulse
is small and frequent, indicating great debility, and the patient is
extremely languid.  This form of  the disease  partakes of the
typhoid  rather than  the inflammatory character,  and  must be
treated accordingly.  All reducing means and medicines are con-
tra-indicated.   The system must be supported with  nourishing
drinks, and its energies  aroused by tonics and stimulants.  One
of the  best tonics is the quinine dissolved in water acidulated
with  sulphuric acid;  and as stimulants, wine whey, camphor and
ammonia,  are  the most appropriate.  Expectoration should be
promoted with a decoction of  seneka root, lac ammoniac, and
squills.  N. B. By referring to the article lung fever, some obser-
vations will be found which apply equally well to measles.
   MEATP1PE.—This  pipe or canal, which conveys the food
and drink into the stomach, is composed of the  pharynx  and
oesophagus, or in other words, what, in  anatomical language, are
called pharynx and cesophagus form the meatpipe.   This chan-
nel is everywhere studded with little mucous glands, which, dur-
ing the  mastication of the food, pour  fourth an  abundance of
a ropy juice which moistens and lubricates the passage.
   MECONIUM.—The green, bile-like  looking matter which is
found in the bowels of children before birth and which is dis-
charged soon after.
  MEDIASTINUM.—The membranous partition  which sepa-
rates the cavity of the chest into two chambers.   It is formed by 
392
MER.
a duplicature of the membrane which lines the internal surface of
the chest, and which is called the pleura.  By an examination of
the chest of domestic animals, a good idea may be formed of this
partition in man.
   MEDULLARY  SUBSTANCE.—The spinal marrow,  and
the white substance of the brain.
   MELANCHOLY.—A species of insanity characterized by de-
pondency, gloomy ideas, excessive timidity, costiveness of the
bowels, inactivity, silence, and suspicion.  See Insanity.
   MEMIJRANE.—The  membranes are broad,  thin sheets of
elastic fibres, woven strongly together, which exhale either a mu-
cous or a watery matter.  The skin is the largest and most ex-
extensive membrane in the system.  Another covers all the mus-
cles, and is called the  cellular membrane, being  formed with in-
numerable  little cells, in which the fat is contained.  Another
membrane  covers  all  the bones, and is  called  the  periosteum.
This, when  raised from the  bones is thin, transparent,  and
looks like a  sheet  of isinglass.   The  mouth, throat, windpipe,
and lungs are all covered with a mucous membrane.   The inner
surface of the bowels is also lined with a  mucous  membrane.
The cavities  of the belly and chest  are lined with serous mem-
branes, or membranes  which secrete and exhale a watery fluid.
The brain is covered, and all its cavities Iinedy with a serous mem-
brane.  A proper  knowledge of  the membranes and the part
which they act in the system, should be an important study with
every well-bred physician.
   MENORRHAGIA.—Bleeding from the womb.
   MENSES.—Monthly sickness of females.   See Monthly Sick-
ness.
   MERCURY.—Quicksilver, and its several preparations, such
as calomel, corrosive sublimate, red precipitate, blue  pill, iodide,
and Ethops mineral.  It  is found in the earth in the state of an
oxide or rust, like  iron  ore.  It is sometimes found united with
silver, and, at others, with sulphur.  It is the  only metal which
exists in a fluid state.  It will however become solid in a tem-
perature 40 degrees below zero.  It is thirteen times heavier than
water.  It  combines with most of the acids, with sulphur,  and
with many of the metals.  Both in the arts and in medicine, it is
an invaluable mineral.
   MERCURIAL OINTMENT —Blue  ointment.—This oint-
ment is made of one part of  quicksilver, one of  hog's lard,  and
one  of  mutton suet.  The mercury must be carefully rubbed in
a mortar with a little hog's lard, until the globules entirely disap-
pear: then add the rest of the lard and suet gradually, rubbing them,
all the while, well together.   This ointment is used in a great va-
riety of diseases.  Mercury in this  form can be easily introduced
into the system, and has all the effect as if taken by  the mouth. 
MID.
393
Rubbed anywhere upon the skin, it is taken up by the absorbents
and diffused over the whole system.  The inside of the thighs
and legs absorb it the most readily and innocently.  The mercu-
rial ointment is often used to discuss or scatter indolent swellings
and hardened parts.  Where a bubo  arises in the groin, it is cus-
tomary to rub into the thigh just below it, a small mass of the
ointment, every day.   The  quantity used at a time, should be in
bulk about the size of  a filbert.   It  is often used in diseases of
the skin, such as the  itch and the venereal eruption.   Old sores
and ulcers may be cured with it.   Some physicians use  the mer-
curial ointment in fevers, where a sore mouth is to be apprehended
from an internal administration of it.
   MESENTERY.—This is the thick sheet of membrane to which
the bowels adhere.  It is spread out from the vertebrae of the back
something in the shape of a fan, to the edge of which the bowels
are attached.  It is formed  by several  folds of the peritoneum,
interwoven  together.   It is  traversed by a great number of lym-
phatics and lacteals, and allows motion to the bowels while it
retains them in their proper position.   It is a serous membrane,
or rather a layer of serous membranes.
   MIASM.—The  poisonous effluvia,  gas,  air,  or  vapor which
arises from  putrid  marshes, lakes, ponds, and stagnant waters of
any description, at\d from putrid and malignant diseases.
   MIDWIFERY.—The design of this  article is not to enter mi-
nutely into the details  of the obstetric art, or to teach an inexpe-
rienced person to conduct a difficult case of midwifery through
its different stages, without further instruction, but to impart  such
information as will enable a woman  of  good understanding, and
some  observation, to manage  an ordinary case of labor without
the aid of a physician.   To teach the art  of midwifery in all its
branches, is not in  accordance with the design of this work, nor
would it be possible to condense it within the limits of the space
that can be allotted to this subject.  It frequently happens, how-
ever, particularly in the country, that the services of a physician,
or a professed midwife, cannot  be  obtained in  season  to render
the assistance necessary on these trying and emergent occasions ;
under these circumstances it is  believed that the directions here
given, in addition to what is said upon the subjects of miscarriage,
after-birth, and pregnancy,  will prove a sufficient  guide.  It for-
tunately happens, that in those cases which terminate quickly,
but  little assistance is necessary; whereas those that  are  more
difficult are more lingering, and there is ample time to  procure a
physician.  Considering the great  number of accidents and un-
toward circumstances that are liable  to occur during the  course of,
or immediately after, a labor, we sincerely believe we should be
doing  our readers an injury to induce them to dispense with the
services of a physician who has a scientific knowledge of his pro-
            50 
394
MID.
fession when they can be obtained.  To know that a competent
and careful accoucheur is at hand, ready to meet all the exigen-
cies of the case, gives a woman confidence, relieves her from much
anxiety, and thereby enhances her chance of  going through  her
confinement safely.
  When  a woman  is expecting to be confined, the choice and
arrangement of her room, are important considerations.   This
should be large, and as airy and retired as circumstances will ad-
mit, and through eight or nine of the colder months of  the year,
should have conveniences for keeping a fire.  Even  when the
weather is not very cold it is often necessary  to have a little fire
in the morning and evening,  and chilly damp days, which are
liable to  occur  at  almost every season of the year.   A bed of
straw, husks, or what  is  preferable to  all others, a hair mattress
is decidedly more comfortable  and healthful  than a feather bed.
Feathers retain the  heat  and perspirable matter, which, besides
rendering the patient  uncomfortable, debilitate the system and
predispose to disease, and they are, therefore, particularly objec-
tionable during the warm  seasons. The bed, if possible, should be
so situated as to avoid a direct  draught  of air upon it from a door
or window, and the air  should  be so admitted that  the room
may be  ventilated without  blowing directly  upon the patient.
The bed clothes and garments intended for the use of the woman
should be well dried, and if the weather be cold, warmed, and so
made and in such readiness that there will be no delay when
they may be needed, or difficulty in changing them.   The bed
should be well protected,  and so arranged that  everything that is
wet or soiled can be removed,  to avoid  the disagreeable and un-
wholsome effluvia that would otherwise arise during the woman's
confinement in a warm and perhaps close apartment.
  Labor  usually takes place about  the end of the ninth calender
month or the thirty-ninth week  of pregnancy, which ordinarily
varies but little from four and a half months after quickening, or
the first perceptible motion of the foetus.  It is not unusual for
woman to be troubled with irregular pains more or less  severe for
a number of days or even  several weeks previous to her  labor,
which, from their not  producing  any effect towards expelling the
foetus are called false pains. These pains are usually most trouble-
some during  the  night, and may be  entirely absent during  the
day.  They are often  sharp and  tedious to bear, but they come
on at irregular intervals and do not bear down like  efficient and
expulsive contractions  of the womb, nor are  they attended with
a discharge from  the vagina as is usually the case  in real labor.
When the pains are suspected to  be false, ai» attempt ought to be
made to  relieve them  by warm sudorific and anodyne  drinks,
such as hop, poppy, sage, or summer-savory tea, camphor and hot
Water ; or, if these do not succeed, two tea-spoonfuls of paragoric 
MID.
395
 or thirty drops of laudanum may be given and repeated every
 three or four hours if necessary.   No danger need be apprehended
 from giving an anodyne, for if the labor be actually beginning it
 will  often have a happy effect in regulating the pains and facili-
 tating the labor.
   When the  pains come on  at  regular  intervals, gradually in-
 crease in severity, and are attended with a bearing down sensa-
 tion, a looseness of  the bowels, frequent inclination to make
 water, and a slight discharge, or a moisture of the organs of gen-
 eration, it will be presumable that true labor has began, however
 slow or feeble  they may  be at the  commencement.   The
 discharge which is called a " show," is often  colored and some-
 times there is an appearance of fresh  blood.  Should the case
 prove tedious, the pains inefficient, and irregular, bathing the feet
 in hot water, and the administration of warm summer-savory or
 tanzy tea will often  be followed by beneficial  effects, the pains
 becoming more  regular and efficient, and at  the same time per-
 haps not more distressing.  A dose of castor oil, or an injection
 of salt and water, by evacuating the lower portion of the bowels,
 contributes  materially to the ease and advancement of the  pro-
 cess, and ought never to be  neglected when the bowels are  not
 free.   When it  is desirable to increase  the force of the pains,
 drinking freely  of cold  water  often produces a good effect, and
 may be taken  with perfect safety.  The ergot  or  spurred rye is
 sometimes administered  for this purpose, but is an unsafe medi-
 cine except  in cases of a peculiar kind, and should not be given
 without the advice of a physician, as it will endanger the life of
 the child, if not  that of the woman.
   The location  of the pains is very different in different cases,
 though the common situation, in the first stage of the labor, is in
 the  lower part of the abdomen,  and extending round into the
 back and hips, and in the last stage, they are usually confined to
 the lower part of the back, which may be considered as the most
 favorable.   When the pains continue hard in the lower part of
 the  abdomen, in the  region of the pubic-bones for a long time,
 there will be reason to fear that the case  may prove to be what
 is called a face presentation, or that some part of the child rests
 upon these bones in such a manner that it cannot readily descend
 into the pelvis.
   It is not uncommon for the women in attendance to urge  the
 sick woman, to bear to  the  pains, to use the language employed
 on these occasions, and this is  undoubtedly proper to  a certain
 extent.   When the efforts of nature are inefficient and the woman
discouraged or inexperienced, by encouraging her in this manner
some additional force  may be given to the pains, and the labor »o
on the more rapidly, but when the  labor is progressing naturally
and especially  in the last stage, this practice is  uncalled for,  and 
396
MID.
 is liable to cause injuries that  might  not otherwise have  been
 sustained.   The more slowly and carefully the last stage of the
 process is accomplished, the  less danger will there be of the wo-
 man being injured, and of accidents, such as difficulties with the
 placenta or after-birth and flooding after the birth of the child. It is
 frequently necessary to retard in  some measure, the exit of the
 child, and prevent it from suddenly passing through the external
 parts, by the pressure of the  palm of the  left hand upon the peri-
 neum, after it  begins to be distended by the head, directing the
 pressure in  such a manner  as to give it  an inclination  forward
 under  the bone.   Neither should  the shoulders be too  much
 hastened through, but allowed  to remain until  the pains return,
 when the head and shoulders,  as they come through, should  be
 supported, inclined a  little forward, in reference to the  mother,
 and not  prevented from taking the natural turn, which will, when
 the hips are expelled, bring the child upon its  back or side.  Should,
 however, the child be large,  or expulsive  pains  not  come on, in
 a few minutes, its life will be endangered, and  an attempt must
 be  made to  bring one shoulder down in the direction it is found
 to move most easily, by the fore finger passed  into the arm-pit.
 While the labor is progressing  and  when there is no reason to
 suppose  that it is upon the  point of being finished, the woman
 should be permitted to sit up  in a chair, to walk about, and to put
 herself into any position she  may prefer.   To confine her to any
 particular position, or to the bed,  is quite unnecessary and  is
 very tiresome. When lying in bed,  upon the back, with the head
 and shoulders raised, it is  a natural and comfortable position, but
 upon the left  side  is generally preferred by physicians,  being
 natural and easy, and the most convenient when it is necessary
 to examine the patient, or to render any assistance.  When the
 right kind of pains come on, it is natural to draw the head forward
 and to pull downward with the arms, but if the woman be not in-
 clined  to do this, there is no  propriety in urging it.
  After the child is expelled, if it should not cry immediately, or
 breathe freely, it should be chafed upon the  stomach with a flan-
 nel cloth, a little cold water,  vinegar, or spirits be sprinkled upon
it, and occasionally a  sudden  gust of air  blown  upon it  with the
 mouth or a fan.  These means, if the child  be alive, will gener-
ally revive it, and the breathing will  be established, but should
 it  remain apparently  lifeless for some minutes, it ought  to  be
placed  in a warm bath and rubbed, and the lungs be inflated by
 putting a quill or pipe stem into one nostril,  and then closing the
 nose and mouth so as to prevent the  escape of  the  air  through
 them,  and blowing gently until the lungs are filled.  When the
 lungs are filled the mouth and nose should  be unclosed  and the
air forced out  by gentle  pressure upon the  chest and abdomen.
This process may be repeated  several times and the motion  of 
MID.
397
breathing be imitated by the pressure of the hand upon the abdo-
men, giving it a rising and falling motion.  By these means, chil-
dren that are apparently dead will sometimes be resuscitated.   A
beating of the  navel string is a sure sign that the child is alive,
and the absence of the beating, before the child  has breathed, is
strong evidence that it is dead ;  no means however should be left
untried to resuscitate it, for if it be very feeble an inexperienced
person may be deceived in regard to the pulsation  of  the chord,
and no harm can arise from trying to the full extent such means
as would be likely to rekindle the latent  spark into life.  Too
much haste in tying the navel  string should be avoided.   The
child should have time to  establish fairly the new  mode  of life
before that, by which it previously existed, is cut off.   It may,
and ought, in  many cases, to  remain ten or fifteen minutes, or
until the chord ceases to beat, before  its connexion  with  the
mother is severed.  If separated too soon its chance of  life is di-
minished.  In tying the navel string, a firm, strong string, about
as large as a knitting needle, made of thread, and twisted, should
be  used.   Tape is not very suitable, and a string that is too  fine
is liable when tied  firmly  to cut the vessels and endanger bleed-
ing.  It is necessary, particularly if the navel string be large, to
tie  it very firmly as the child may otherwise loose its life by the
loss of blood, a circumstance that has frequently occurred within
our knowledge.   An examination of the child should always be
made, if it  be laid  by for a time  before it is dressed, as is often
done, to ascertain whether it bleed or not at the divided end of
the chord, and another string be tied around it if it be  found in-
secure.   It is  not  a matter of  much importance as to  the place
where the navel string  is tied or divided, but about three  fingers
breadth from the belly of  the child is the place  usually chosen.
This leaves it long enough to tie again, should  it be required, is
convenient to dress,  and not so long as  to be in the way, or gen-
erate much smell while sloughing.   The child being taken away,
the after-birth should next  be attended to.   In a large proportion
of cases this will  come away spontaneously in the  course of ten
or twenty minutes after the birth of the child.  It will be proper
however to take hold of the chord and  carefully ascertain if  the
placenta can, be felt in the passage, and whether the  woman is
loosing more blood than is natural at such a  time.   If the  pla-
centa can be felt in the passage, no great danger need be appre-
hended, as a few pains, a little gentle motion, and very  moderate
extension of the chord will deliver it safely.  When it remains
high up in the abdomen, however, and especially if there be an
unusual loss of blood, the action of the  womb must be promoted
by pressure upon, and kneading the lower part of the bowels, and
grasping and squeezing the  womb gently in  the hand, at  the same
time pulling very moderately and moving the  chord,  so as to 
398
MID.
make the  extension in different directions.  Great care is neces-
sary in these cases not to pull so hard as to break, or to separate
the chord  from the placenta, nor to bring down the womb, the
latter of which accidents would be fatal, and  the  former, to say
the least of it, very troublesome.  In cases of excessive flooding,
whether the after-birth has come away or not. the woman should
be placed  upon her back with her head  and shoulders low, be
kept  perfectly still, and cold  vinegar, spirits, or  water  applied
freely to the lower part of the bowels and pudenda, by means of
cottou or linen cloths, which should  be changed every few min-
utes, until the flooding is arrested.   If under these circumstances
the after-birth be retained in the womb, the most skilful assistance
ought immediately to be obtained, as the  woman will  be in im-
minent danger until this is  delivered.   The drinks should be
cold water, toast water or tea, the room cool, and the air be freely
admitted.   Should there be  extreme faintness, a little camphor,
or a few drops of spirits of hartshorn may be administered in cold
water.  If the pains are severe after the placenta has come away,
thirty or forty drops  of laudanum  or two  tea-spoonfuls of para-
goric, or some other anodyne may  be given.  No  attempt should
be  made  to  move  the patient or  change her  clothes until the
flooding has abated, and she has revived from the  faintness.  In
changing  the woman's clothes and putting her into bed whether
there have been flooding or not, the greatest  caution should  be
observed that she do not exert  herself, so  as to  cause too great a
loss of blood.   She ought by no means to be permitted to walk,
or even stand  upon her feet without being supported.   During
the first two or three  days after delivery,  the  patient should be
kept perfectly quiet, should see but little company, and  be re-
stricted to a plain unstimulating diet.  The  most appropriate ar-
ticles of  diet  are gruel, rice, soda crackers, dry toast, and weak
tea;  no   flesh, fowl  or  fish is necessary, nor  should be al-
lowed during  the  first week, and  even after  this  time the
quantity should be very small and  consist  of those kinds that are
the easiest of digestion.  If the lochia or discharge that  follows
delivery be scanty, mustard draughts must be applied to the feet,
and an infusion of hops, tanzy, or mugwort be given in copious
quantities, and the bowels be moved with castor oil or some other
gentle cathartic. To give oil, the third day, is a good general rule,
but if the bowels move spontaneously and the woman be com-
fortable it will be unnecessary.  The free use of  laxative drinks
and food,  such as infusion of elder flowers and mullein, tamarind
water, rye pudding, and a moderate use  of  figs will  often su-
percede the necessity of giving cathartics, and perhaps is quite as
proper, and more agreeable to some stomachs.  Should the bowels
be very sore or painful, spirits of camphor, alcohol, or a liniment
prepared by adding of  gum camphor, and oil of origanum, each 
MID.
399
 one ounce, to seven ounces of alcohol, should be applied to them
 upon a flannel cloth.   An ounce of gum camphor dissolved in
 half a pint of sweet oil also makes a very good liniment for these
 cases  as well  as  for the  breasts when  they are  distended and
 painful. For the after-pains, poppy,  hop, and lettuce tea, camphor,
 and the extract of lettuce are suitable remedies, but when there
 is  no  special  objection to it, opium in some of its forms will be
 found to afford more relief than other medicine.   Anodyne bal-
 sam, the active ingredients of which, are opium and camphor, is
 one of the best preparations.   A pill of three grains of this may
 be given every four hours until the pains are mitigated.   Thirty
 or forty drops of laudanum, two tea-spoonfuls of paragoric, or an
 equivalent dose of  morphine may be  given in the  same  manner,
 if preferred or more convenient.
   The milk generally conies, on the third or fourth day, but it
 may  come the second, or be delayed till the fifth.   At this time
 it is usual  to  have some degree  of  fever.  There  may be chills,
 headache, hot skin, thirst, and flushed countenance.  The lochia
 is often suspended for twelve or twenty-four hours, when the
 milk comes, but returns when  this secretion  is established.  The
 breasts, should they become hard, must be softened  by the per-
 severing application of  lard, or some  oily liniment, by means of
 gently rubbing them  with the hands, and by the application of
 flannel cloths  squeezed  out of  lard as  hot as it can  be borne. We
 have seldom seen  any serious  trouble with  the  breasts when
 this  practice  has  been followed, and they have  been  properly
 drawn with the mouth or a suitable instrument.   It is rare that
 all the milk can be drawn out by the child during  the first week
 or ten days.
   An  error productive of much suffering is frequently committed,
 in  attempting to force  out the milk, when  the  breasts  are hard
 and caked, sore and painful, before they are softened by rubbing
 them with warm oils, as heretofore described, or with fomentations
 with hot water or poultices.   They ought not in  the first place
 to be allowed  to get very  full and hard, but when  they are so, it
 is worse than vain to attempt to force  out the milk with the
 breast pump or pipe, until they are  softened.  The pump is a
 valuable instrument  for  drawing  the  milk,  when  judiciously
 used, but  it is too powerful in the  hands of those who  are not
 properly instructed in the  manner of using it.
   When a woman has had a labor of only ordinary severity, and
is doing well,  she should be taken out of bed every day  after the
second, and after a few days be  allowed to sit a while in a chair
twice a day, particularly in warm weather, that her bedding may
be changed and her bed aired and adjusted.    This practice adds
much to her comfort, and  contributes to her regaining  strength.
It may not be proper for her to stand or walk much, the first 
400
MID.
 week or ten  days, but the too common  practice of confining a
 woman to her bed, two or three weeks, is unnatural and unneces-
 sary.  It debilitates her system, and retards her recovery.  Those
 who perfectly recover,  in  the shortest  time,  are  those who,
 whether from necessity  or  choice,  soonest  leave  their  beds.
 There are, it is true, exceptions to all general rules :  there are
 some who  cannot do without injury what  others are benefitted
 by doing.  We believe, however,  that there is less difference in
 their natural  physical  ability, in this particular, at least, than in
 their acquired habits, or in other words the constitutions which
 they themselves form, and the  circumstances with which they
 are surrounded.
   Those women who  take much  exercise and accustom them-
 selves to the air, and whose habits of eating and  sleeping are
 regulated by  the requirements of nature, are better fitted for be-
 coming mothers and rearing a healthy offspring, than the indolent
 and inactive,  and those whose habits are irregular and unnatural.
 During the first month, the diet of the patient should be well regu-
 lated ; it should be very plain and  unstimulating, but may  be
 nutritious, after the secretion of milk is established, in order to
 furnish a sufficiency of wholesome  nutriment for the infant. Her
 clothing  should be  warm, her feet well protected from the cold
 and dampness, her  exercise light, and her mind undistured by
 care or company.
   In regard to the utility of swathing the bowels immediately
 after delivery, there is some diversity of opinion, and the practice
 is far from being uniform.  By some it is thought to improve the
 form, by others to strengthen  the bowels, while others practice  it
 without a reason,  except  that it is  the custom of their friends or
 their countrywomen.   If the  woman have  been very large, the
 bowels very much distended, if there have been an unusual loss
 of blood, attended with faintness, and a sensation of sinking and
relaxation, a  moderately tight  and well adjusted  swathe is very
 proper, and undoubtedly beneficial, and under these circumstan-
ces, ought to  be applied and worn a few days.  Our own observa-
 tions have led us to doubt that a swathe improves the form enough
to compensate for the trouble and inconvenience of wearing it.  A
bandage  around the bowels sufficiently tight  to make any impres-
sion upon the form of the  body, must interfere more or less with
respiration, by preventing a free and easy  descent of the dia-
phragm, and by limiting the action of  the respiratory muscles; and
by compressing the  stomach and bowels, interrupt, in some mea-
sure, digestion  and  the healthy motion of the intestines.  The
tendency of a tight swathe as commonly  applied, must be to
press the womb down rather than  to prevent a falling  of that
organ, as it is by some supposed to do.  Upon the whole we are
inclined to the opinion  that it is generally unnecessary, and may 
MID.
401
as well be omitted, but  that it may occasionally be useful in the
particular cases heretofore described.
   It may seem almost superfluous to allude to the use of ardent
spirits in childbed, but as the custom is not yet entirely obsolete,
a few remarks  upon  the  subject are deemed  requisite.   Ardent
spirits are not  unfrequently given by  the women in attendance,
during  labor, with the mistaken view of hastening the process.
Under these  circumstances, alcohol, in wh&tever  form it may be
given, acts very much like opium.  There is a small proportion
of cases in which it may  regulate  the pains  and facilitate the
dilatation of the mouth of the Avomb, and thereby  hasten the
labor, but in  the great majority of cases it is not only unnecessary
but injurious.  If given in those cases not requiring an anodyne
medicine, or  given in such quantities as to put the system under
its full  influence, it  diminishes  the force of the  contractions of
the womb, and  very much retards the labor.  It. has  also the
effect of preventing a return of  the pains  after the birth  of the
child, which are necessary for  the expulsion of the afterbirth.
We have been called to cases where the  afterbirth had been re-
tained many hours, from this cause.  There are women whom
it  makes nervous and  hysterical, and  thus deranges the natural
operations ;  it produces a feverish excitement  and a tendency to
inflammation, which are always to be dreaded in ehildbed.   As
a remedy for afterpains, it is sometimes admissible, when opium
is  known to disagree with  the patient, and the simpler remedies
are insufficient; but it should always be given with caution, lest
by giving too much or repeating  it too often, more  serious troubles
be induced than those it was  intended to relieve.   Considering
the subject in all its bearings, we are more inclined to recommend
the use of opium without the advice of a physician,  than that of
ardent spirits.  Wine and strong beer, in  this climate at least, are
still more  objectionable than rum or gin ; they cause a deter-
mination of  blood to the head,  inflammation  and  fever,  and
sometimes, delirium.  In extremely debilitated persons, a little
wine given at regular intervals may be necessary as a tonic, but
ought only to be given under the supervision of a competent ad-
viser.
   The  pains and sufferings inseparably connected with  parturi-
tion, are often great and protracted, and  the mother and  friends
look  forward to the  birth of a child  with mingled hopes and
fears ; but when the  trial  comes, the  fortitude and  resignation
with  which these sufferings and dangers are braved by the most
delicate females, have ever called forth the wonder and  admira-
tion of the harder sex.   That women generally endure  pain and
sickness with more  fortitude  and patience than men, is a well
established fact, corroborated by their willingness to endure the
pains of parturition for the sake  of offspring, and  their husbands
           51 
402
MIL.
Few men  we believe, could be induced, for any consideration,
to suffer in a similar manner ; but nature has fitted everything to
its condition.  The anxiously expecting female, however, is not
without her consolations.   She is fulfilling the imperative re-
quirements of  nature ;  and the approving regards of  a fond  hus-
band, and the  pleasing hope of being the mother of a tender off-
spring, upon whom she can lavish  her affections, buoy up her
spirits, and sustain her in the hour of suffering.   Besides, women
are aware of the fact,  that whatever the  sufferings may be, the
comparative number of deaths in childbed is infinitely small, and
they generally reason correctly, that their chance of going through
safely amounts almost to a certainty.   In the present  improved
State of the obstetric art too, almost every variety of accident and
disease is susceptible of being remedied  by the skill of the physi-
cian.   The parturient  condition itself, when uncomplicated, is a
natural  one, from which the system soon rallies and regains its
wonted energies, and differs materially from a state of disease,
the tendency of which is to produce  decay and destroy life.
  The  diseases to which women are liable in childbed, that are
the most alarming, and which require the most prompt and ener-
getic treatment, after  the  danger of  flooding has passed, are in-
flammations of the womb, bowels, and bladder, milk delirium or
mania lactea, childbed  or puerperal fever, and  those  disorders of
the stomach and bowels produced by eating improper food.  Milk
fever, and inflammations of the breasts, are unattended with  dan-
ger, but require suitable remedies.  Childbed swelled leg, phleg-
masia dolens, is a severe and rare disease, but under proper man-
agement, seldom,  if ever, proves fatal.  For a description of these
diseases we refer the reader to the different articles respectively.
  MILIARY  FEVER.—The  distinguishing  characteristic  of
this  fever,  is an eruption on the  surface of the body, of a florid
color, and resembling in size the seeds of millet.  The eruption
commonly  appears first upon the upper part of  the body, about
the neck, back, and breast, gradually extending downward.
  The disease commences with a shivering  fit, and all the usual
symptoms of fever of the typhoid kind, such as low, quick pulse,
depression of the strength, anxiety, restlessness, and  disturbance
of the stomach, denoting a great amount of gastric irritation.  It
may be distinguished  from other eruptive  fevers by a peculiar
kind of sweat, which  gives forth a sour and  fetid odor,  by a
greater dejection of the spirits, anxiety, and sighing.  The mouth
is dry, the tongue coated  with a white  fur,  and the  bowels cos-
tive.  The  disease in  its worst form is attended with delirium
and a comatqse state of the brain.
  The appearance of the eruption  is  preceded by an  itching sen-
sation in the  skin, bordering  upon  pain.   This, however,  does
not last long, before multitudes of little,  hard, red pimples or pus- 
MIL.
403
tules everywhere discover themselves  upon the surface of the
neck, breast, and back, extending to the lower parts.  The com-
pletion of the eruption commonly gives  relief to the fever.   After
about two days, the eruption becomes vesicular, and discharges a
watery matter which dries  into a scale.  A second crop  of the
pustules, or a relapse of the disease, will occasionally occur.
  A sudden disappearance of the  eruption, with great anxiety,
dejection of the mind, violent vomiting, and a weak, rapid, inter-
mitting  pulse,  are bad  symptoms,  and portend an unfavorable
termination of the disease.
   This  disease is mostly confined  to females, and to  childbed.
Males sometimes have it, but the occurrence is rare.
   The  miliary  fever is not  regarded as a distinct disease, but as
the result of  other diseases or peculiar conditions of the system.
The time of its  appearance is for the most part, in the spring and
autumn.  The  chief cause of it appears to be the exposure to
too  great a degree of heat.   An overheated room in childbed is
particularly liable to produce it.
   The patient,  in this disease, should be covered lightly, and the
room freely ventilated by the admission of fresh air.
   Blood-letting is pernicious and inadmissible.
   The  system  must be supported by wine whey, quinine, elixir
vitriol, and other  tonics, and stimulants.  To  allay the  distur-
bance of the stomach, the patient  may take  the essences  of cin-
namon and peppermint, the  camphor mixture, camomile tea,  and
moderate doses  of the hot drops.   The bowels should be moved
with magnesia or castor oil, as often as every day, and the stom-
ach  refreshed with water or  barley gruel, rice water, and other
vegetable liquids, suitable to a febrile state of the system.
   In case the eruption recedes, the spirits of camphor, the water
of ammonia, and  saffron tea should be given to raise a perspira-
tion.  Dry heat may be applied to the surface, or the feet  im-
mersed in hot water.
   If the brain is much affected, blisters should be placed upon
the  back of the neck, and mustard  poultices upon the feet.
   MILK FEVER.—This fever arises  from the condition of the
breasts after childbirth.   In most cases, it amounts only to a few
chills, a slight pain in the head and back, a little  sickness at the
stomach, and a short turn of restlessness, with thirst.    But in
some instances, there is an obstruction in the flow of  the milk,
and the breasts will become hard, tumid,.and  painful, denoting
more or less inflammation.
   A dose of oil given immediately on the appearance of these
symptoms, followed  by small doses of spirits of  nitre, to raise a
sweat, will be the proper course to pursue.  The child must be put
to the breast, or it must be drawn by another person.  In  case the 
404
MIN.
 breasts cannot  be drawn  either by the child, or by another per-
 son, the breastpipe or the  breast pump must be used.
   Much  may be done to prevent the  fever by putting the child
 early to the breasts,  and by inviting a flow of the milk.   Where
 there is a great  and forcible flow of the milk, the mother should
 adopt a spare diet and abstain as much as possible from drinking.
 If there is considerable heat,  thirst,  and  restlessness,  rochelle
 powders, sweet spirits of  nitre, and the sal nitre may be given.
 On the appearance of any symptoms of fever in childbed, the
 breasts should always be carefully watched, and early and closely
 examined.  If cakes or any hardness  appear, they may be easily
 dispelled in the  commencement, by frictions with warm lard or
 fomentations.
   MINERAL WATERS.—Mineral waters hold in solution vari-
 ous ingredients,  such as iron, salts, sulphur, gases, and earths.
 They furnish many  medicines, in the most  agreeable way, and
 in the  most suitable  form, in which  they can be taken.  The
 most remarkable are those which contain the carbonic acid  gas.
 The water  when taken from the  spring and poured into a glass,
 evolves  innumerable  sparkles.   It has a lively, pungent, brisk
 taste, and produces a  grateful sensation in the stomach.   All such
 waters are peculiarly  friendly to the digestive  organs.
   The  chalybeate waters  or those which contain iron are the
 most common and the most used.  It is their peculiar nature  to
 strengthen  the  stomach,  and,  eventually,  the whole system.
 These spring waters are often perfectly transparent ar.d  beautiful,
 while they hold  in invisible solution, a large  quantity of iron,
 which maybe detected by a styptic  taste.   On standing, how-
 ever, the iron rust is  soon  disengaged and precipitated  ; and the
 stones and earth about the spring  become covered with a reddish
 deposite.  The iron first forms,  upon the surface of the water, a
 delicate pellicle or skin, which, by increasing in weight, sinks  to
 the bottom, and may  be scraped up.
   There is a spring in Virginia which contains a great abundance
 of sulphureted hydrogen gas.  This  spring possesses a tempera-
 ture much higher than  the air, and, in  both winter and summer,
 pours forth  a stream of hot water.  It is celebrated for the cure
 of skin diseases and the rheumatism.
   The  Ballston  spring, in  JSew York, contains both  salts  and
 iron.  Its water is cathartic, diuretic, and tonic, that is, it purges
 the bowels, promotes  the  urine, and  strengthens  the  stomach.
 The Congress water,  at Saratoga, is of the same nature.  These
 waters are resorted to in almost all chronic complaints, especially
 dropsy,  scrofula,  dyspepsia,  hypochon'lrism>, hysteria, palsy,
 chlorosis or  green sickness,  whites, gout, chronic rheumatism,
and  eruptions upon the skin ; and the estimation in which  the
efficacy  of the water is held, is not probably overrated. 
MIS.
405
   MISCARRIAGE.—One of the  greatest accidents to which
 pregnant women  are  liable, is the loss of the child or rather of
 the  foetus, before  the time of delivery.   This often happens very
 soon after conception, even before the child is completely formed
 in the uterus.   It is often not very easy to distinguish, in newly
 married women, between a difficult  menstruation, an extraordi-
 nary discharge of clotted blood, and a miscarriage.  The pain in
 the  back and about the loins, the faintness, uneasiness,  and loss
 of blood from the uterus, are, in the commencement of pregnancy,
 nearly the  same in each  case.  It is also difficult to distinguish
 between the hard masses of clotted blood  and the newly formed
 foetus.   The distinction can, however, be  made by throwing the
 discharges into a vessel of cold water and  mixing them  with the
 water;  blood will entirely dissolve in the water, while a fleshy
 substance will remain entire.
   There are certain kinds of false  conception, to which women
 are  subject.  These false  foetuses,  or moles, as they are commonly
 called, are small, formless lumps of  flesh, which cause  as much
 trouble and  loss of blood, in their separation from the uterus, as
 the  most perfect conceptions.  These moles never appear to arrive
 at, any great size, or to  continue  their growth in the uterus for
 any great length of time.  From three to six weeks, is  probably
 the  longest period to which they ever arrive, before their expul-
 sion  from the uterus.   They are  organized  masses of flesh, but
 without the form  and  shape of a human  being.
   Miscarriages or abortions, which we use as synonymous terms,
 are in general, owing  either to accident, or to some weakness or
 defect in the constitution.  A fall, a blow, overstraining, or  exer-
 tion in  some way or other, are the most usual causes of miscarria-
 ges in women of sound constitutions.  Tight lacing may also be
 added to the list  of incidental causes.  Miscarriages  are some-
 times produced by violent bursts  of passion, the sight of hideous
 and  disagreeable objects, or by the smell and taste of certain nau-
 seous druss and poisons.   And when once a disposition to mis-
 carriage has been commenced, it often continues and increases
 for years, insomuch that some women will go on miscarrying for
 six or seven or even a dozen times in succession.
   There is a certain irritability or feebleness of  the uterus  or of
 the  whole  constitution,  which is  probably the  most  frequent
 cause of miscarriages.  In  this class of women, the uterus appears
 to be, at least, for sometime, incapable  of bearing the  burthen
 imposed upon it,  or of distending only to a certain size,  before it
 is  irritated to such a degree as to admit of no remedy short of the
 expulsion of the  foetus.    An instance  is  recorded of a woman
 who miscarried twenty-three times in succession.
   Miscarriages  are not often dangerous,  although, sometimes,
accompanied with very  profuse  hemorrhage  and considerable 
406
MIS.
faintness.   The fainting, in general, checks the flowing of the
blood and prevents the over-action of the uterus.
  The  ordinary symptoms which  threaten  a miscarriage, are
frequent pains in the back and about the loins, and a sudden loss
of blood from the uterus.   The flowing in a miscarriage is dis-
tinguishable from the flowing  in an ordinary monthly period, by
its coming away in gushes and forming into clots  in the former
case, whereas, in the monthly sickness, it is even  and constant,
and does not coagulate.
  Remedies.—The first  thing to be done  in a miscarriage, or a
threatened miscarriage, is  to resort immediately to the bed or sofa,
or some place where the patient can lie  down and be quiet.  The
room should be cool, air freely admitted, and the utmost quietude
preserved.  If fainting occurs, a little cold water should be thrown
upon the face, and a draught or two should be given the patient
to drink.  A  tea-spoonful of the spirits  of camphor  may be added
to the water.   As miscarriages  are  sometimes prevented, after
they have commenced, by proper care,  attention, and  medicines,
the first object will be to  secure this result.  In very strong, full-
blooded women, blood-letting  will in certain cases, be necessary,
although very rarely.   After the miscarriage has once happened,
and a disposition to this accident is suspected, blood-letting may
be resorted to  as  a  prevention in  a second  pregnancy ;  but it
should be done about the  time  the first miscarriage happened,
and before it  has actually commenced.
  After the  patient has become quiet in bed, a tea of white pop-
py heads,  or of dried lettuce leaves, should be given, two or three
times, or until composure  has  been secured.   In  case these ar-
ticles cannot  be obtained or do not have  the effect, thirty drops
of laudanum or a table-spoonful of paragoric should  be given every
four hours until the pains are allayed and the flowing checked.
The tendency  to  abortion will  often  continue for three or four
days, before all- the symptoms entirely  disappear.  Where  the
flow of blood is profuse,  vinegar and water should be applied to
the body below the abdomen, by means of linen or cotton cloths,
and  if the loss of blood  is excessive, a piece of sponge or a soft
linen cloth should be pressed into the vagina.
  When the  event has become unavoidable, the expulsion of the
contents of the womb should be promoted, by drinking cold wa-
ter and the administration of the spurred  rye.  A table-spoonful
of a strong infusion of this medicine may be given every twenty
minutes until  the  desired effect is produced, or  as long as the
stomach will bear it.
  The  diet should consist of  broth, water gruel, milk porridge,
and of light vegetable food.  The drink should  be barberry wa-
ter, lemonade, apple water, and cream  of tatar water.
   In all cases of a constitutional tendency to miscarriage, great 
MON.
407
care should be  taken to preserve a quiet  state of the mind and
feelings, and to  avoid all violent exertions of the body.  Free
exercise in the open  air and about the  house, should be  taken
during the  time of gestation, but  all violent motions avoided.
Riding in an easy carriage or sailing in a boat, is a kind  of exer-
cise very friendly to those who  are constitutionally disposed to
abortions.  All drastic purgatives should be avoided, and expos-
ures to great heat and cold.
  When a miscarriage has really taken  place, and the foetus ex-
pelled, the same precautions should in general be observed as in
actual childbed.
  MONTHLY  SICKNESS—Menses, Menstruation.—Every
healthy woman  from the age of about fourteen to forty-five is sub-
ject to an effusion of blood from the womb, once, every month.  It
is a secretion like the bile or the milk, and appears to be essential to
the re-production  of  the  human species.  This  effusion never
amounts, in health, upon  an average, to  more than five  or six
ounces, nor  continues more than about three or four days.  The
time of its appearance in females varies with the heat of the cli-
mate.   In the West India Islands and  in  Mexico, girls  begin to
menstruate at eight, nine,  and ten years of age, and in Labrador,
not until they are nineteen or twenty, and then, at long  intervals
and in small quantities.  In some instances, they only menstruate
in the summer time.
  Some girls begin to menstruate  without any-previous ailment,
but most commonly the effusion  is  preceeded by pains in the back
and legs, a dragging sensation in the situation of the womb, disor-
der of the  stomach,  frequent changes  of the blood to and from
the face and head, and various  nervous and hysterical affections.
These symptoms in a greater or less degree commonly attend the
lunar appearance as long  as it continues.
  In our latitude, the monthly evacuation  or puberty begins about
the fourteenth year or a little earlier. We think, in New England,
it begins  rather earlier in life than in England,  and full  a year
earlier than it  does  in Scotland.    In our country towns, girls
are full a year later in  this  manifestation of  woman-hood than
in  the  city.  The  inactivity,  easy way of living, subjection
to  hot rooms  and soft beds, the stimulation of  a fresh meat
diet highly  seasoned, and the constant excitement both of  the
mind and body, all tend to foster a premature developement of the
functions of the body in  cities, while  in  the country towns, the
active employments of children, their less stimulating food, their
cooler habitations and constant exposure to the open air and sun,
serve to harden  the constitution, and to render all  the functions
of the system slower in their development.
  The way of life  in the  country towns of New England, is wor-
thy to become a pattern for a healthful regimen.  We mean where 
408                        MON.
the girls take a part with their mothers in all the household af-
fairs, churning  butter;  making cheese; milking cows; feeding
pigs and  hens, geese and turkeys ; washing; ironing;  cooking;
and looking after the welfare of the family.  A constitution formed
in this  way possesses more strength and  energy than  a dozen
which have grown up in  the city, unless in some fortunate in-
stances  where parents have preferred the health of their children
to delicate looks and  early refinement.   Girls should always be
allowed, while growing, to run, romp, and play as much as boys.
If they are restrained, their constitutions are sure to feel the ef-
fects of it.  Many more children are raised in the country towns
in proportion to the number born, than in cities, and the disorder
of the menstrual function is beyond  all comparison less in country
towns than in the cities.
   In some instances, the menstrual office is not performed at the
proper time, or is obstructed in its  course after it has been once
established.  In either case, the girl should be taken from school
or from any  employment which  requires  a sedentary life, or
which,  in the least, fatigues her mind, and sent abroad into the
open air, and obliged  to take exercise enough, at lenst, twice a
day, to  produce a moderate perspiration.  The perspiration is a
sign that the exercise  has increased the circulation sufficiently to
affect all the functions of the body.   If some kind of active em-
ployment can be substituted for riding, walking and  playing, so
much the better.  Books should be laid aside until  the natural
order of things is well established.  The menstrual effort is com-
monly preceded  in  its  first appearance, by a general uneasiness,
pains in the back and hips, nausea, sickness at  the stomach, and
headache.   At  this period,  hot. fomentations of tanzy tea,  or
poppy tea should be  applied  to  the  back, hips, and below the
stomach, and the patient made to sit over  a  vessel  of steaming
water until a  profuse  perspiration  has been produced.  Unless
this  effect is produced, we believe, but  little advantage will be
obtained from the use of these means.   Half-way measures often
defeat the effect  of the best directed means.  If a  perspiration
is  not easily effected, it may  be assisted by a gentle emetic of
ipecac or lobelia.
   The best and  most powerful medicines for  the  regulation of
retained or obstructed  menses  may be found upon almost any
farm in  New England.  The first article which we shall name is
the savin.   The  tops and leaves of this  free  ground into a pow-
der, or made into a tea, and taken'or drank in a sufficient quantity
to raise  a perspiration, for several days in succession, have been
ascertained to produce the menstrual effusion in four cases out of
five.  The dose in powder, which is the best way of giving it,
is a scruple at a time.   It should be given, at least, three times a
day. 
MON.
4091
   The next medicine whose virtues are established in the regula-
tion of the menstrual effusion is the red centuary.  A strong tea
should be made of it, and copious draughts of it taken hot,  every
hour or every two  hours, at such  times as nature appears to be
making an effort, until a moisture is produced upon the  skin.
   The tanzy is another article of tried virtues in establishing the
uterine secretion.   The tanzy tea drank warm is the  best way of
using it, although the essence is often used.  We apprehend that
little advantage will  be derived from it, however, unless a mois-
ture is produced upon the skin.   We regard a  sweat as a criterian
by which to ascertain the effect of these medicines  upon the
uterine secretion.
   Rue is a powerful herb in promoting the circulation in the  womb      /
as well as  the system generally, and well adapted to the  treat-
ment  of a retention  of the menses, as it is more powerful than
most herbs in common use, it should be used with more caution.
Of an infusion  made by steeping an ounce in a pint of boiling
water,  from a  wine-glassfull to a  gill is the usual dose.   It
may be taken several times a day, and particularly if there are
symptoms indicating  a monthly period.
   In  those cases in  which it appears, from  the full development
of the system indicating  the age of puberty, and from the pe-
riodical  indispositions, headache, pain in the  back, loins and
limbs, weariness, debility, pale countenance with occasional  flush-
es upon the cheeks, irritability, and capricious appetite, that this
evacuation has  become  necessary to health,  and when from a
want  of development of  the uterine system corresponding with
other parts, or from an inability in the general system to furnish
the secretion,  it does not make its appearance, a course of tonic
and emenagogue medicines will be indicated.   Fifteen or twenty
grains of precipitated carbonate,  or the same  quantity of the
phosphate of iron should  be given twice or thrice a day, mixed
with molasses, and the bowels should be briskly moved three times
a week with Hooper's pills, or  some aloetic  purgative.  Picra,
and pills composed of aloes and gum guaiacum are suitable purga-
tives  in these cases.   Equal  parts of elixir pro, and  tincture  of
guaiacum,  in two tea-spoonfuls doses, three   times a day,  on  an
empty stomach, we have often given with  advantage, combined
with  a course of the  carbonate or phosphate  of iron.   Perhaps,
however, there is no  better medicine to regulate the menstrual
function than the mixture of myrrh and  iron, called  Griffith's
myrrh mixture.  We have frequently  combined it with appar-
ent advantage with the elixir pro, in the proportion  of  one part
of the latter to three  of the former, using one quarter less  water
in preparing the mixture.  Of this preparation,  a table-spoonful
should be taken three  or four times a day. It is a safe and efficient
medicine and peculiarly appropriate in the deranged condition of
           52 
410
MOR.
the digestive organs which frequently attends these cases, and in
those cases  which require a long continued course of medicine.
When it is presumed  from the symptoms that nature  is  making
an effort to produce the discharge, the feet  should  be thoroughly
bathed in hot mustard water, the patient should sit over the steam
of hot  water or  a  decoction  of bitter herbs, a strong poultice
should be applied to the feet, and perspirative herb tea be freely
drunk.   A leech or two applied to  the  inside of  the knee  will
sometimes,  under these circumstances, very much relieve  the
symptoms, and has, in some  instances, brought on the monthly
discharge.
  Until the system is  fully developed and  the signs of puberty
are well marked, or until  there are  symptoms manifestly requir-
ing the establishment of this evacuation, a resort to medicine or
any interference with the  natural operations is  of  doubtful  pro-
priety.
  MORPHINE—Morphia.—This article is obtained by a chemi-
cal process from opium, and is the narcotic  principle of that  sub-
stance.   It consists  of white, transparent crystals, without smell.
It does not dissolve  well  either in cold or hot water, but  better,
in alcohol, and ether.   The  crystals are rectangular, four-sided
prisms.   The solutions of it have a nauseous, bitter taste.  Com-
bined with the acids, it forms salts which appear to have the same
medicinal properties as the morphine itself.  The  salts of mor-
phine in common use  are the sulphate, made  by diluted oil  of
vitriol, dissolving the morphine  in it, and evaporating to dryness;
and the acetate and the muriate are made in a similar way with
the acetic and muriatic acids.   Either of these salts dissolved in
distilled or spring water may be taken in drops like laudanum.
  The pure morphine  or morphia may be given in the form  of a
pill, or a powder, in the dose of a sixteenth, an eighth, or a quar-
ter of a grain, once or twice a day.  In all  cases where it would
be proper to give opium as a sedative, the morphine may be used.
Many persons, with whom opium  disagrees, can take morphine
and its salts with impunity.   In febrile and  inflammatory dis-
eases, the morphine in some form or other is deemed to be more
suitable than opium.    Where  astringent effects are needed,  as
in dysentery, diarrhea, cholera morbus, and  hemorrhages  the
opium is preferable.
  The dose of acetate of morphine is from one-eighth to half a
grain, one-sixth of a grain is equivalent to a grain of opium.   It
may be given in pill, powder, or solution.
  A dose of the sulphate, and muriate is the  same.   The sulphate
of morphine is  in the  most common use.   It consists of snow-
white feathery  crystals, which  are completely soluble in  water.
Solutions of it should always be made of the same  strength with
laudanum. 
MOR.
411
  MORTIFICATION.—The  proper meaning of mortification,
is the death of the part.  Mortification appears to take place from
almost every species of disease, but is most usually the effect of
active  inflammation, which has suddenly and  entirely exhausted
the vitality of the part.
  The usual signs of mortification, are a loss of feeling, heat, ac-
tion, and cessation of circulation in the part affected, which, ulti-
mately, extend to the whole  body.  Most commonly the mortifi-
cation begins in  a particular part, but there are some putrid dis-
eases and fevers where the whole  system mortifies at once. Mor-
tification often takes place in the surface of the body, and in the
extremities, and, sometimes, in the internal parts not very essen-
tial to life, without producing the  death of the whole body. We
often see the fingers and toes mortify and drop off without mate-
rially affecting the other parts of the system.   The skin, muscles,
and bones will often be so much injured in certain portions as to
mortify and slough off, while the uninjured parts will  granulate
and restore the lost portions.
  The ordinary appearances of a  mortified part  are, a purple or
brownish tinge of the skin ; a blister containing a bloody serum ;
and a crepitus,  or sound of air.
  Where mortifications terminates fatally, the event is foretold by
a livid, purple color of the part; sometimes, an  extrication of air or
gas under the skin, which occasions a slight rattling, like air in a
bladder; a deathly smell; loss of heat, feeling  and motion;  a
small, quick, soft, vibrating pulse ; a cadaverous countenance;
hiccup ; and a cold, clammy sweat.
  Inflammations which are circumscribed and tend to supperation,
are less  likely to  mortify  than those which spread and  involve
many  parts or tissues at a time.    Or to write more profession-
ally,  phlegmonous inflammations  are less apt to run into gan-
grene  than erysipelatous.   Where an inflammation or a  wound
has been very painful, and suddenly becomes easy, and loses its
feeling, we have reason to apprehend mortification, unless healthy
suppuration or resolution  take place.   We have, however, seen
people very much frightened and alarmed at the sudden cessation
of painful affections which had very suddenly terminated favour-
ably.  If the body is warm, the pulse good,  and the feeling re-
mains entire, there is never any need of alarm.
  Mortification will often take place from a compression of the
blood-vessels and a stoppage of the circulation.  Nothing is more
important in wounds, bruises, and injuries of parts, than to leave
them as free as possible, by removing all ligatures, bandages, and
tight dressings.  We never shall forget an instance of mortification
which appeared to happen entirely  from winding a tight rag spread
with  common  varnish  around a jammed  finger, and left in this
situation, for two or three days, by which, the circulation was 
412
MOPs
 stopped and the finger lost.   The whole arm was so much affect-
 ed as to be, for some  time, in great danger; but seasonable am-
 putation of the finger, saved the arm, and, probably, the life of
 the patient.
   The constitutional remedies  suitable in cases of mortification,
 are quinine, myrrh, wine,  charcoal, camphor,  alcohoL brandy,
 hartshorn, and the mineral acids.   To these may be added iodine,
 the chlorides of lime and soda,  salt, saltpetre, vinegar, creosote,
 and the wild  indigo.    In wounds, inflammations, and sores,
 where  mortification is liable to  take place, there is no dressing,
 in  our opinion, so suitable, as a soft, warm, thick  white bread
 poultice ; it leaves the part entirely free, while the warmth which
 it communicates, if frequently changed, has a tendency to restore
 the life of the part.  This  was the favorite dressing of the cele-
 brated John Hunter, even in green wounds where grangrene was
 apprehended, and we believe, experience abundantly confirms its
 superiority over all others.
   The local means suitable to be used in cases of incipient or threat-
 ened mortification, are charcoal, laudanum, alcohol, the spirits of
 camphor, the tincture  of myrrh, a watery solution of quinine, a
 decoction of the peruvian baric, and of the wild indigo root; yeast;
 pyroligneous acid, creosote, the chlorides of soda and lime, a so-
 lution  of common salt, warmth, and carbonic acid  gas, liberated
 from lime stone by the agency  of sulphuric acid.
   Where  mortification of the  bowels is suspected, soda water,
 which contains an abundance of the carbonic acid gas, should be
 freely  drank.   Wine,  brandy, rum, and cordials of every  kind
 are not only allowable in some of these cases, but are absolutely
 indispensable.   The warmth of the body should be restored and
 supported  by dry, hot  blankets, and  flannels  applied to the sur-
 face, and by the use of hot drinks.
   Cold not only causes, but generally hastens mortification.   Fre-
 quent doses of the hot drops, composed of red-pepper and myrrh,
 are, no doubt, a valuable  medicine  in an incipient  stage of any
 internal or  external mortification.  The stimulus is evanescent,
and must be taken often, but it promises as much  as any medi-
cine which can be used in such cases.
  A peculiar kind of mortification, called the dry mortification or
rot, sometimes attacks people,especially those advanced in life while
they are apparently in perfect health.   It most commonly attacks
the extremeties;  the hand,  foot,  toe, or finger.   It commences
in a small  spot  and gradually extends up the leg or arm.   The
mortified part is dry, shrivelled, hard, and dusky.   In some in-
stances the color is not changed,  but it is generally black.   The
dry gangrene often affects palsied  limbs.  The part does not pu-
trify but dries up and looks  like a piece of smoked  meat.    The
whole  arm is said to have rotted  in this  way, and to have drop- 
MUM.                        413
 ped off at the shoulder joint without the least bleeding, and with-
 out the loss of life.
   Laudanum, camphorated oils and warm balsams are the chief
 remedies.  In most cases the dry gangrene is fatal.
   MUCUS.—Mucus resembles jelly in its external appearance,
 but is wholly distinct from it in its chemical composition.  It is
 a secretion of the mucous membranes, and nothing, in the animal
 economy, is more  remarkable than the prodigious amount which
 is often poured forth by these membranes in a short space of time.
 The  nostrils,  throat, and bronchia, and  lungs are often loaded
 with a literal flood of this substance.
   Mucus resembles pus, insomuch, that it is often difficult to dis-
 tinguish one from the other.   Mucus is, however, the lightest,
 and will swim upon water, whereas pus will sink.  It has a salt-
 ish savor, and  is  transparent, and glutinous.  It appears to be
 composed of shreads.   Its use is to lubricate and defend the vari-
 ous passages and surfaces which secrete it.  The taste, smell, and
 appetite are all, more or less,  dependant upon this  secretion.  A
 part of the  mucus is  re-absorbed by the  membranes  which se-
 crete it, and the remainder is excreted or thrown off.  It contains
 water in abundance, muriate of potash and soda, lactates of lime
 and soda, and phosphate of lime.
   MUGWORT—Artemesia Vulgaris.—The mugwort  is an ar-
 omatic and a bitter.   The taste of the  dried root is  sweetish,
 sharp, and  nauseous.   The tops, leaves,  and roots  are said to be
 effectual in the cure of epilepsy or falling fits, and is excellent for
 after-pains.   The  plant must  be carefully dried and  kept  in a
 close vessel.
   MUMPS—Cynanche Parotidaea.—The mumps  is an  inflam-
 matory disease of  the maxillary and  parotid glands.  The disor-
 der is epidemic and infectious.   It  is  a  disease  of infancy  and
 early life.  It. comes on with chills ; a feeling of soreness in the
 bones ; and a swelling and soreness in the neck and in front of the
 ears.  The tumors, sometimes, appear on both sides, and at others,
 only on one.  The  swellings are moveable, hard, sore, painful, and
 ocasionally. of a large size.  They, sometimes, produce a difficul-
 ty  of swallowing  and  of breathing.   Other glands of  the body
 are affected  at the same  time, and in  the same  way.   In man
 the testicles  partake of the same kind of inflammation,  and in
 women,  the breasts.   These  several glands will  sometimes
 suppurate and cause considerable mischief.   When the  glands of
 the neck have broke inwards, they have been known to produce
 suffocation and death.   In ordinary cases, however, the disease
 is mild,  and requires  only a little  good nursing,  and  care that
 the body be kept warm and dry.   The child should stay in the
house, and if the swellings are  painful, should take  a  dose  of
paragoric or Godfrey's  cordial, and be got into a  sweat  by the 
114
MUS.
use of hot herb  teas, such  as pennyroyal, peppermint, or catnip.
A large, thick piece of flannel, or which is better, a clean wool-
en stocking should be worn around the neck, and the food should
consist of rye pudding, or brown bread, with sweetened water.
   If the  swellings  and inflammation become severe, bleeding,
cathartics, and sudorifics will be required.  The glands must be
steamed, poulticed, or bathed with cooling applications.  Leeches
must be applied ; and every effort made to reduce the inflamma-
tion of the glands, and subdue the fever.
   MURIATES.—These are the salts formed by the union of the
muriatic acid with metals, alkalies, and  earths, such as common
salt, calomel, corrosive sublimate, muriate of iron, lime, &c.
   MUSCLES.—People, in general, have formed but very little
idea of what is meant by a muscle.  The flesh which covers the
bones appears to an  unpractised eye, to be one entire mass. The
red flesh is a bundle of muscles  separated from  each other by a
thin transparent membrane.  The flesh of the legs, for instance,
is separated by dissection into fifty or sixty muscles, one-half of
which are destined to bend  and move the legs, and the other half
to straighten them.   Some of the muscles are round, and others
flat.   The large muscles of the leg are about an inch, or an inch
and a half in diameter, and of a cylindrical form.  The middle of
the muscles is much larger than the ends, and, for this reason, is
called the belly.   The  middle portion  is also  of a red color,
being  filled with blood-vessels and blood, and the ends are of a
white color, being destitute of  red blood and are called  tendons
or cords.   The cords are called the tendinous  portions of  the
muscle.   When  the flesh or fleshy part of the muscle is soaked,
it  becomes  white.  It is only the blood that gives the  flesh or
muscles their red color.  When deprived of its blood, the muscle
appears to be one entire tendon.
   Each muscle is separable into an innumerable number of fibres or
threads, and each fibre, like  the whole muscle, is enclosed in a
thin, transparent sheath of cellular membrane.  The same mem-
brane covers all  the bones, and is  called the periosteum.  The
fibres which compose the muscles may be seen, and separated from
each other in a piece of boiled beef or mutton.   The lean meat
is only a mass of muscles which in  life are employed in effecting
the motions of the animal.  Each muscle slides backward and
forwards in an oily sheath, as it is called into action  by volition,
or stimulus.  The flesh of the animal is, therefore, employed in
producing its  various motions.  This is its object and  its use.
The  amount of muscle which  an animal has, depends upon  the
quantity of food and exercise which it takes.
   MUSTARD  SEED—Sinapis Alba and Nigra.—With us,  the
black  mustard plant is very common.  The  seed communicates
both warmth and vigor to the  stomach and blood.  In a dose of 
.NER.
415
a table-spoonful, either the black or the white  mustard seed ope-
rates as a laxative.   It is the most active in the form of a powder.
It promotes an appetite  and gives a glow to the whole system.
It is an excellent remedy in dyspepsia, given every day as a laxa-
tive.   In palsy and chronic rheumatism it is given to quicken the
circulation and  promote  the  vital actions.   The  ground seed
makes  an  excellent poultice to relieve rheumatic pains, and to
produce a revulsion in the circulation of the blood.   Boiled with
milk it makes a medicinal whey, useful in low, nervous fevers.
In  its effect upon the system, it  resembles the red  pepper.  In
a large dose, it will excite vomiting.
   MYRRH.—This  substance is a gum-resin.  It is brought from
the East Indies.  Myrrh is semi-transparent, of a reddish yellow
color, and of a slightly pungent, bitter taste.  Its smell is aromatic ;
to the  palate it  is nauseous ;  to the system it  is warming and
strengthening.  It has, when  taken as a medicine, a strong  ten-
dency to resist and stop putrefaction, and is much used in putrid,
malignant, and pestilential fevers.
   The proper dose of myrrh is from twenty to thirty grains, in
powder.  It  is  an excellent  medicine in palsy, dyspepsia, and
chlorosis.
   A tincture  of myrrh is made  by putting three ounces of  the
gum into a quart of new rum.  A dose of the tincture is a te,a-
spoonful.
                             N.

  NAPTHA.—This is a bituminous fluid, which is found spring-
ing spontaneously from the earth.   It is of the color and consis-
tence of molasses, has a greasy feel, and a smell like  the smoke
of bituminous coal.   Applied to stiff joints, rheumatic swellings,
and palsied limbs,  it has often been found extremely serviceable.
It is of the same nature with bitumen, distilled from certain kinds
of coal.   Naptha burns  like oil, and  for  many purposes is used in
its  stead.  It is found in the  West  Indies and in the  south of
Europe.  It, sometimes,  appears upon the surface of certain lakes,
and is skimmed off.  It is but little used in medicine.  See Wood
Naptha.
  NARCOTICS.—Medicines which  produce  sleep,  such  as
opium, lactucarium, cicuta, belladonna,  and camphor.
  NECROSIS—The mortification and death of bones.—When
bones are diseased, the dead parts separate from the living in the
same manner as dead flesh.  The dead pieces are pushed off, and
make their way to the surface.   Necrosis, for  the most part, arises 
416
NER.
from fractures and injuries, or from the extension of sores on the
flesh to the bones beneath it.  See Mortification.
   NEPHRITIS—Inflammation of the Kidneys.—See Inflam-
mation of the Kidneys.
   NERVES.—The  nerves  are  round, white, long cords, which
proceed from the brain through various  holes or foramena in the
skull bones, and from the spinal marrow.   Those  nerves which
go to  the senses proceed immediately from  the brain.   Those
which  go to the trunk and extremities mostly proceed from the
spinal marrow.  Each nerve is enclosed in a sheath  of thin, trans-
parent  membrane, which keeps its action distinct from  that of
every other nerve.  The nerves proceed from the brain and spinal
marrow in pairs, one  nerve going to either side of the body.   As
they issue from the brain they cross each other, so that the nerves
of the right side of the body come from the left half of the brain,
and the reverse.  It is from this cause  that a blow upon the right
side of the head will palsy the left side of the body.
   It was long thought that the same  nerves produced both sen-
sation  and motion ;  but it has  been recently demonstrated  that
they form two distinct systems, so that sensation may be destroy-
ed and motion remain, and the reverse.
   It is the office of the nerves, spinal marrow, and brain to gene-
rate sensation, thought, feeling, and motion.  Wherever we find
a nerve, there we find sensation or a capacity for pain and plea-
sure  or action.  The opportunity which people in general have
of seeing the nerves  is not very frequent.  They are often con-
founded with the  sinews or tendonous cords.   The substance of
which  a nerve is composed, may  be  learned  by inspecting  the
brain of a calf.  It is often  that nerves may be seen in dishes of
boiled  beef  and mutton.  There are  but very few parts of  the
animal system that may not be learned  by an attentive observer
in the  flesh which is daily brought upon our tables;  the  nerves,
arteries, veins, ganglions, muscles, the different organs, and bones,
may all be discriminated from each other.
   If a nerve is separated, or entirely cut off, all motion and sen-
sation of the part  to which it goes, are  instantly lost.  Divided
nerves, however, like divided muscles, often grow together again,
and the feeling and motion are restored.
   The nerves form a kind of net-work  over the whole internal
and external surface  of  the body.  The skin is, however, much
the most  bountifully supplied with them.   Where there  are the
most nerves there is the most sensation.   The eyes, ears, and all
the organs of sense are better supplied  with them, than the other
parts.  The bones and  the tendons have  but a small supply of
nerves, and, hence, have but little feeling, unless they are inflamed.
The use of the little nodules, called  ganglions, into which the
nerves  are convoluted, is not known.   The nerves  have blood 
NER.
417
vessels, and are susceptible of inflammation and disease, like the
other parts of the body.
  NERVOUS DISEASE.—The seat of this disease  is in the
brain and nerves.  The  condition of the nervous system which
constitutes  the disease is not discernible after death; we think,
however, it must be owing to a sore and tender state of this sys-
tem, or, in other words, to a slight degree of inflammation.  The
word  soreness appears to us to express  the precise  condition of
the brain and nerves in what  is commonly called nervous disease.
A slight degree of soreness  constitutes the nervous  disease ; a
greater degree of soreness constitutes hypochondrism ; a still
higher degree constitutes insanity; and the  highest degree,
phrenitis  or  acute inflammation of  the brain.   These different
degrees of soreness are often discernible in the eyes, in the throat,
in the muscles, and  in the skin ; and the different grades  are as
discernible by the eye as by the  consciousness of the person who
is the subject of them.   When,  therefore, the  nervous system is
in this state, it must be treated like  every other organ which is in
the same  condition.
   Some writers confound this disease with dyspepsia, which is a
disorder of the stomach ;  others confound it with hypochondrism ;
and a third class, with melancholy.   The disease which we  mean
here to describe, arises from  over-action of the  brain, or of the
thoughts, feelings,  passions,   instincts,  and  propensities.   The
dyspepsia arises  for  the  most part  from an over-action of the
stomach ; and nervous disease from the same  excess on the part
of the  brain.  By over-action, we  mean the  amount  of action
which each of these organs, in various ways, sustains ; or, per-
haps, we  should be better understood by saying that the nervous
disease and the dyspepsia are produced  by the amount of suffer-
ance  which each organ  endures.   The nervous disease is pro-
duced by the sufferance of its own  function.   The dyspepsia is
also produced by the sufferance of its own function, but which is
entirely different from that of the brain.
   Nervous disease sometimes commences in childhood and youth,
before the subject is old enough to be aware of the nature of the
disease ; but commonly does not  appear before the age of puberty,
and occurs the oftenest between the age of thirty and forty-five.
   Sleep is a peculiar function of the nervous system, and seems
as essential  to life and health as the digestion of food.   Nervous
diseases may be better known by an indisposition to sleep,  or by
wakefulness, than by any other  symptom.  There  are periods
when the difficulty of sleeping is so great  that a whole week or
more  will pass without  once closing the eyes, or if the eyes
should be closed, there is no sleep.  The  general health all the
while will be as good as that  of other people, with the exception,
perhaps, of a little costiveness of the bowels.   It is said that the
            53 
418
NER.
 nervous disease is sometimes  attended with too much sleep, but
 we have never seen a case of it.  In the beginning of the disease
 there will not be much disturbance in the sleep, but in process of
 time there  will be more or less, almost  every night.  Painful
 dreams, nightmare, and all manner of distressing appearances and
 frightful images will occupy the  mind the whole night long, or,
 at least, the forepart  of it.   The  most quiet  sleep of nervous
 people is towards morning, or late in the morning.
   A swimming of the head is  a pretty constant symptom of ner-
 vous disease, especially on suddenly rising up.  A lightness  of
 the head is  a still more  common  feeling.  Sometimes the  whole
 body will feel  buoyed up and as light as a feather, and at  other
 times peculiarly heavy.  Sometimes, it will feel very small, and
 at other times, exceedingly large.  To  what  this difference  in
 the  consciousness of the weight and size of the body, is owing,
 we are unable to say, but such  is the  feeling.  Some nervous
 people  are constantly plagued with a sick headache ;  and  others
 with a violent pain in a part of the head, confined to a spot not
 larger  than a ten cent  piece, and as inveterate as if a nail were
 driven into  the head.   A singing  sound in the ears, or a ringing,
 which is sometimes superstitiously mistaken for the real ringing
 of a bell, which has been mysteriously heard,  is sometimes very
 annoying.   In  the healthiest people this affection of the drum  of
 the ear is no  very uncommon  thing, but when the  nerves are
 diseased, it becomes much more frequent and obvious.  A sudden
 departure  of the sight, or darkening of the room, especially by
 some untoward movement of  the head, and a little consequent
 bewilderment  or confusion in the thoughts, are very common
 symptoms of nervous disease.  A numbness of the head and  of
 other parts of the body is very common, and oftentimes temporary
 pains and soreness in the flesh,  and in every organ, which causes
 the person to imagine  himself  affected with various diseases,  at
 various times.   Wind in the stomach and bowels is a very trouble-
 some symptom ; and as the tract of the alimentary canal  is not
 very well  known to people in general, this wind in traveling up
 and down, will  produce sharp  pains in the whole trunk of the
 body, which will sometimes be mistaken for pleurisy, disease  of
 the liver,  heart, and every other organ in the vicinity of the
 bowels.
  Sudden departure of the thoughts, or loss of all  the ideas,  is
 often complained of by nervous people.   Cold hands, and feet,
cold shiverings, flushes of heat, paleness of the skin, sunken eyes,
little twitchings and quiverings of the  flesh,  wandering,  flying
thoughts, a painful want of energy, disposition  to  faint on any
sudden emotion, violent palpitations of the  heart, and a feeling of
 dissolution or apprehension of being in the article of death, are
 among the prominent symptoms of nervous derangement.   The 
NER.
419
 fear of dying some disgraceful death, or of committing  suicide,
 are among the torments of the nervous.   The fear of suicide is a
 foolish fear,  as death in this way, were it ever likely to  happen,
 being the result of disease, is as  natural as dissolution in any
 other way.  It has happened  from the foundation of the world,
 and will continue to happen as long as the brain and nerves con-
 tinue to be  diseased.   But  suicide is  never  the  consequence  of
 the grade of disease which we are  here  describing, but merely
 the fear of it, like the fear of almost everything else.
   Fear is a  prominent  symptom of  nervous disease.  A  nervous
 person will turn pale, tremble,  and become deprived of strength,
 at the sight,  hearing, or feeling of anything which is unexpected
 or novel.  An unusual  sound in the night, or a sudden tap at the
 door, will cause him to start and tremble as if it were a sure sign
 that a robber was about to  enter the house.   This state of the
 mind, or of  the brain and nerves, causes the subjects of it,  to be
 constantly mistaking   the  meaning, actions,  and  purposes  of
 others.
   As the nerves  extend to all the other organs of the body, and
 make a part  of them, each and every part  is liable to some devia-
 tion from health.  Nervous people are apt to make a large quan-
 tity of urine ;  to sweat profusely  and  more  easily than well
 people ;  to be more  sensible to heat and cold, and more  affected
 by the changes of the weather, and especially  of the wind.
   We think  nervous  people are more affected by changes in the
 weight of the atmosphere  than by its temperature.  We  have
 always observed them to be very uneasy in windy weather when
 changes in the weight of the air are known the oftenest to take
 place.  There are but few people who are not  more or less affect-
 ed by strong windy weather.
   The various affections of the stomach and bowels which  some
 writers have  attributed  to an affection of the nerves, appear to us
 to belong to the dyspepsia.  In a disease of the nerves, we believe
 the stomach  and appetite are  commonly pretty good.   Nervous
 people often  eat as  much as well  ones, and digest it nearly  as
 well.  This  circumstance, together with the interval of cheerful-
 ness and good spirits which they often enjoy, leads others  often
 to suppose them well, and that they make unnecessary complaints.
 A common complaint  of a nervous person is, that, at night, he
 thinks of everything and cannot get to sleep.   This disposition
 to think of everything, is owing to  an  excitement of the brain,
 which  must  have time to subside  before sleep can take place.
 People who are wakeful should always think of this, and never
 worry about  the difficulty  of  sleeping, for it  will be certain to
 come when the brain is free of all unnatural excitement.
  Fretfulness is  almost an  invariable sign of nervous disease.
Nothing can  be more variable  than the temper of a nervous per- 
420
NER.
son.  At one moment, he will be highly pleased, and the next,
as much displeased, without the shadow of a reason that other
people can  see, or that  he himself can  see, a short time after.
Indeed to name all the deviations and alienations of the thoughts,
temper, feelings, and propensities, from a state of soundness and
health, would require many pages.
   Domestic Remedies.—It appears to us of the utmost importance
that nervous people should know  as  much as possible  of the
nature of their disease, or that they should know  that there is a
cause for the  condition they are in.  They will be  much more
likely to treat themselves and to be treated by others, with that
care and circumspection which the nature of the  disease requires.
They should learn to know that they have a brain ; and that
this organ can be abused and disordered like the other organs of
the body.   It is an observation made by some author, that meta-
physics, or the science of the operations of the mind,  are in gene-
ral more remote from the notice and attention of mankind, than
any other  study, although  they the most nearly  concern us.
This is strikingly true of the diseases of  the brain, or the  distur-
bance of the operations of the mind.  To make the deviations of
our  thoughts, feelings and temper, and  the  office of the  brain,
the  subjects of contemplation and  reflection, requires no small
degree of patience and self-possession.
   In general, all excitement of the mind must be avoided, in the
cure of this disease.  Everything, which tends to  inflame the
feelings, and strongly to engage  the attention, is sure to hurt the
sore condition of the nerves.  All violent  strifes  in politics,
religion, or any party affair are exceedingly mischievous. Crowds
of people, tumult, confusion of  sounds  and voices, and a multi-
plicity of new and striking objects, overpower the attention and
weaken the nerves.  Retirement, rest to the thoughts and feel-
ings, and constant exercise in the open air, are indispensable con-
ditions in the cure of  the disease.
   There  are certain  times  or aggravated states of  the disease,
when it is best to be confined to the house and to keep as quiet
as possible.  Exercise at such  times will  only  aggravate the
complaint.   Even the full light of the sun will make the  person
feel worse  and indispose him to sleep.   The  nerves are  in too
tender and  sore a state to be  moved, and  like  other  inflamed
organs must be allowed to rest.
   Excessively hot and excessively cold weather is apt to aggra-
vate the disease, and the invalid should be as little exposed to it
as possible.  Hard work in the heat of summer should be avoid-
ed.  A moderate  degree of labor in some agricultural, mechani-
cal, or nautical pursuit, is not only an excellent  preventive of
nervous disease, but a successful remedy.
   In this disease people  appear to require more food than in firm 
NER.
421
health.  This is probably owing to the activity of the thoughts
and feelings.   The disease is apt to be worse in the morning, and
this  is probably  owing  to  the  emptiness of the stomach and
blood-vessels.   The  interval which  has elapsed since the last
meal, has been much longer than the other intervals between the
times of eating in the day time.  After breakfast  the  person
always feels better.  No exercise should be  taken before break-
fast, or none which produces fatigue.
   The food  should  consist of dried and ripe vegetables, and  of
salted meats  and fish.   There can be no better diet prescribed
for a person in this disease than  such as is found upon the tables
of the farmers of New England.  The drink  should  be cold
water, and very weak tea and coffee.   Milk  is a good article of
diet where it agrees with  the stomach.  The amount  of food
taken, should  always be in proportion to the amount of  exercise
or labor which the person undergoes.  It is dangerous to  exercise
or labor  much without an  increase of the food.  The half fed
horse or ox which is compelled  to labor, shows the exact con-
dition of the man or woman who attempts to do his or her ordi-
nary work upon  the same  amount of  food which they would
require, if idle.  The strength and energy of the mind as well as
of the body depends very much  upon a due amount of food.  It
makes but  very little difference whether the  food is of an animal
or a vegetable nature, provided there is enough of it and it is of a
wholesome kind.  We believe,  however, that vegetable  food is
the most friendly both to the body and the mind.
   To quiet the  confusion  and  disturbance  of  the nerves, or to
settle the head, as the vernacular phrase is, there is nothing bet-
better than a few draughts of poppy tea.  Half a tumbler of it
should be drank every half  hour until some  degree of composure
is produced.   A  dose of the butternut physic, or a few pills of
aloes, where  the stomach  and  bowels are  loaded, will greatly
assist in producing the  effect.   Motherwort  tea, to which a tea-
spoonful of the spirits of camphor has been added, taken  hot, and
in sufficient quantity to raise a little  perspiration, will often re-
store composure and sleep.  Hoffman's anodyne, the acetate of
ammonia, sweet  spirits of  nitre, the  antimonial powder, or any
other article  which will produce a moisture  upon the skin with-
out increasing the circulation, will compose the nerves.
   In severe cases of nervous disease, a few drops of laudanum or
morphine is the most certain to  moderate the painful feelings of
the mind.  All kinds of spirits are bad, and should never be used,
unless to obviate some  sinking  of the system which can be re-
lieved in no  other  way.   To  produce sleep, the laudanum or
morphine should be taken in the day time, at least four hours
before the usual bed-time.   Probably the best  and most appro-
priate anodyne  for this disease, is the valerian, when  obtained 
422
NEU.
fresh, and of a good quality.   A tea-spoon even full of the pow-
der  is about the ordinary dose.  It should be taken  once in two
hours  through the day.   An ounce of it may be steeped in half
a pint of water, and two table-spoonfuls  taken, every two hours.
   The  cicuta is scarcely less beneficial  than the valerian.  One
grain of the extract is the ordinary dose, given three times a day.
The nerves, sometimes, require to be strengthened by the use of
quinine, the rust of iron, or the mineral acids.  The rust of iron
or Griffith's mixture is the most appropriate tonic.
   NETTLE RASH—Urticaria.—This disease is an eruption of
wheals  or blotches upon  the skin, sometimes attended with fever.
It shows itself in elevated red spots or ridges, often whitish on the
top, which itch and sting, as if pricked with a nettle.  The eruption
will  appear in any part of the body, but does  not stay long in any
one place.   In some instances, it will last only four or five days,
and, in others, for several weeks or months.   It will often entire-
ly disappear in the day-time and re-appear in  the evening attend-
ed with febrile symptoms.  Some  women are troubled  with it
almost  every  summer.   Certain kinds of fish,  when  eaten, will
produce a disease which  very much resembles it, such as the sea-
crab, lobster, and  herrings, which have led to  the supposition that
the  nettle  rash may be caused by an irritation of the stomach,
and there is  some ground for this supposition.  It is probably
owing  to an unhealthy condition of the fluids of the  body, acted
upon by heat or some other irritating cause.
   If the skin becomes very much  irritated, and  fiery, it should be
washed in a little new rum or diluted alcohol, or cologne water;
and if there are feverish symptoms, the sweet spirits of nitre, or
a gentle emetic should be taken.  A dose or two of the cream of
tartar or epsom salts will commonly be all the medicine necessary.
Lemonade or the  soda powders drank, every day, with a light,
cooling diet, will  abate the heat and counteract the  itching.
   NEURALGIA—Nerve Ache.—In this disease,  there is no
swelling of the  part, nor sign of inflammation, but a darting,
throbbing pain, and acute soreness or sensibility.   The  ache is
subject  to intermissions and remissions ; and the disease is almost
always chronic or of long duration.  It has been known to attack
the face, the  foot, the  leg, and the  breast; and, probably, every
other part to which  nerves are distributed, may be subject to it.
It  is doubtless of the same nature with  the  nervous headache,
particularly hemicrania.  In the face, it is called tic  douleureux,
and the pain shoots  from the region of the mouth to the eye, and
often to the ear, and  over  the cheek, palate, teeth, and jaws.
The  adjoining muscles  are subject to  convulsive  twitchings.
The  pain always follows the course of particular nerves.   It may
be distinguished from rheumatism, hemicrania, and toothache, by
the brevity of the paroxysm, the stinging agony of the pain, the 
NIG.
423
absence of all swelling and inflammation, the superficial seat  of
the pain, and its being confined to the course of some particu-
lar nerve.
  We once saw a case of neuralgia or nerve ache in the leg, be-
tween  the  ancle and knee.   The  agony was intense, and lasted
for about five  weeks.  The disease is no doubt oftener  experi-
enced than recognized.
   The  palliating remedies are narcotics and carminitives.  The
radical  remedy, in obstinate  cases, is the division of the nerve.
Opium,  hemlock,  balledonna, camphor,  castor, valarian, strong
poppy tea,  and morphine should  be used both externally in the
form of washes and poultices, and,  internally, in the form of pills,
powders, and  tinctures.  Blisters  and setons have both been  ef-
fectual.  Stimulants and tonics must be used as the occasion and
nature of the case require.  Cathartics have a tendency to abate
the pain.  The hot bath and hot drops are worthy of trial.
   NIGHT  BLINDNESS—Nyctalopia.—In this peculiar affec-
tion the person can see perfectly well  and distinctly in the day-
time but gradually grows blind as night comes on, until the sight is
totally  lost, but the  sight re-appears  again in the morning, as
soon as the sun is up.  This disease prevails chiefly  in the hot,
sunny climates, but  instances of it sometimes occur among  us.
We have known one family, the  most of whose members were
subject to it, although not to that extent to which, it affects peo-
ple in the Torrid Zone.
   It appears to be a disease of the optic nerve or the retina,  by
which  its  ordinary sensibility to light is diminished, or in other
words,  more light is required to produce the same effect in these
people  than in others.  It appears to be to the  eye, what a  de-
fect in  hearing is to the  ear, or the nerve of the ear.  In Italy, it
is said  to be frequent, and, in Egypt very common.  The  peas-
ants of Italy will often become so  blind on the approach of night
as to loose their way home.   There is commonly some degree of
tenderness in the eye, and a fullness of its blood-vessels.   In
some, the affection seems to be coeval  with  birth, and  in others,
it is produced  by the agency of light, heat and other  causes.
   Where the eyes are weak, tearful, and engorged with blood,  the
same means must be used which have been recommended  in an
inflammation of the  eyes.
   NIGHTMARE—Incubus.—A peculiar affection which attacks
people  in  sleep.   It is  the most  common  with those who  lie
upon their backs.   The person feels conscious of being in some
painful, or frightful  situation, and makes strong  efforts to move
and speak, but without  effect.  When he  awakes, he is fright-
ened, anxious, and feeble ;  his heart  palpitates, and the whole
system is in a tremble.
   It is probably owing, in  most cases, to  the impression  made 
424
NIT.
upon the mind by the dreaming state ;  and is, in those instances,
a harmless affection.  People who are  sedentary, secluded from
the fresh air, and the sun's rays, and have no steady purpose in
life, are the  most liable to it.
  It often results from overloading the stomach at supper, and
may be avoided by an opposite course.
  The affection does not appear to differ from the terror, which
we often experience in our  waking  hours, only as the state of
sleep, prevents  the power of motion, while it creates a full belief
of actual danger.  If it results from dyspepsia, or nervous disease,
it can only be cured by curing the primary affection.
  Exercise, the open air, and the cultivation of  a cheerful tem-
per, are the  surest preventive and curative means in our power.
  NITRE—Nitrate  of Potash, Saltpetre.—This article  can  be
made  by mixing aqua fortis and potash, but is commonly obtained
in a natural state.  The earth under stables always contains  more
or less of it.  Most of it comes from the south of Europe, where
it  is manufactured by leeching  the earth with water.   It has a
sharp, bitterish, pungent taste, and consists of transparent crystals.
It is very soluble in water, and  explodes when  thrown into the
fire.
   We regard saltpetre as  the very best diuretic which we possess.
In fevers, it allays the thirst, and abates the  heat.  We have
seen it do more good in the scarlet fever, than any other remedy
which has ever been used.  It is a powerful refrigerent.
   The  dose of nitre or nitrate  of potash is  from three to eight
grains, dissolved in water, or given in  powder with molasses. An
over-dose acts as a violent poison.  It has sometimes  been mis-
taken for  Glauber's or Epsom salts, and produce the most violent
effects.   In this case, a dose of  ipecac should be given, immedi-
ately followed  by sweet  oil.
   In rheumatism, saltpetre has a remarkable effect in  shortening
and moderating the disease.   It  should be given in doses  of six
grains, at intervals of two or three hours.  In the scarlet fever it
makes an excellent gargle for the throat, at the same time, that
it assuages the violence  of the  fever.   By exciting a  flow of the
urine, it operates powerfully in relieving the distress and restoring
an equilibrium to the circulation.  In all fevers, it is an impor-
tant object  to keep the kidneys free.  In typhus, malignant, and
putrid fevers,  where the powers of life are diminished and the
circulation feeble, the sal nitre is inadmissible.   Even  in the scar-
let fever,  it should not be used in the last stage.
   NITRIC ACID—Aqua Fortis.—It is obtained from  sal nitre
or saltpetre.  If oil of vitriol is poured upon  saltpetre, a suffocat-
ing gas or  fume arises,  which  is the real aqua fortis  or nitric
acid.  If this fume  or gas is conveyed into a receiver containing
water, the water will absorb the fume or gas,  when it  becomes 
NOL.
425
 the liquid, called aqua fortis.   The application of heat is necessa-
 ry in the process.
   The oil of vitriol unites with the potash, and the nitric acid is
 set free, in the form of a gas or fume.
   The nitric acid or aqua fortis is a very cooling medicine in fe-
 vers.  It makes a sour drink like elixir vitriol, but has not quite
 so pleasant  a  taste.   The  dose is  five  drops in a  gill of
 cold  water.   It cannot be taken clear, being a  violent caustic.
 In mixing it with water,  it is best to be guided by the taste.  If
 five drops make the  water too strong of the acid, more water
 must be added, or if it is not sour enough, more of the acid must
 be added.
   In the venereal sore throat, the  nitric acid, taken internally, is
 one of the best medicines in use.  As a gargle, it heals the ulcers,
 at the same  time that it  communicates a healthful tone to  the
 whole system,  and  counteracts the peculiar virus of the  disease.
 In putrid, and malignant fevers, it is always a safe and excellent
 medicine.  It is often used with effect in jaundice and liver com-
 plaints.   It is both  a tonic and a  febrifuge.   The  method of
 using it is to take it as a drink once in  two or three hours.
   NITROGEN GAS—Azote.—An elementary air. It constitutes
 four-fifths, in volume, of the atmosphere.  When separated from the
 oxygen, the  other principal  constituent of the air, it will neither
 support life nor combustion.  To obtain it from the air, you have
 only to burn phosphorus in  a glass jar of common air, and allow
 the phosphoric fume or acid to be absorbed by water, previously
 introduced  into  the  jar.   This  elementary air composes  about
 nineteen parts in a hundred of the flesh and blood.
   NODES, VENEREAL.—Hard, round tumors, arising from the
 surface of bones, in consequence of the venereal infection.   They
 are immoveable, and appear to take their rise from the thin mem-
 brane which covers  the  bones.  After  the venereal disease  has
 penetrated the whole system, these swellings appear on the fore-
 head, shin-bone, and bones of the arm.   They are painful,  and
 if they continue long,  end in a destruction of the bone.   They
 can  only be cured,  by freeing the constitution of the  venereal
 diease.
   NOLI  ME TANGERE—Wolf,  Lupus.—This is an eating
 sore or ulcer which comes  chiefly upon the face,  nose and eye-
 lids, and is called a wolf, not from  any external resemblance to
 one, but because  it seems to devour the flesh like that voracious
 animal.   We once had a case of this disease which spread over
 the whole nose and destroyed both the skin and flesh.   We suc-
ceeded in curing it by applying a solution of lunar caustic, once
a day.   The ulcer commences  in the form of a tubercle or wart
and grows to the  size of a filbert, when it begins to assume  the
           54 
426
NUR.
 appearance of a sore.  It is painful, has a callous edge, discharges
 a corrosive matter, and spreads rapidly over the skin.
   In the early stage, it may be removed  by the  knife.   If it. is
 entirely removed, it is not apt to grow again.  It resembles the
 cancer, but is a very different  disease.
  w NURSING.—The term nurse, in its  general  sense, imports
 something of the same kind of office towards the sick, which the
 mother discharges towards her infant child.  A nurse should al-
 ways be a person of good sense, of sufficient health and strength
 to fulfil properly the duties of the employment, and faithful to
 the trust reposed  in her  or him.   Kindness, gentleness of man-
 ner, an indulgent disposition,  and  studious attention to  the  calls
 of the sick, together with habits of neatness, may be said to com-
 plete the character of a good nurse.  Some women, as well as
 men, have much more discernment, either natural or acquired, in
 adapting the  means to the end  in the  cure of diseases, than others.
 Some improve vastly by  observation, while others remain nearly
 stationary.
   The nurse may be said to work the machine, while the physi-
 cian only superintends it.  The nurse, therefore, has  the  oppor-
 tunity of knowing things, which must, to a greater or less extent,
 escape the attention of the physician, and if this opportunity is
 rightly improved, it must always multiply greatly the chance of
 cure.
  If there is  anything holy and sacred in life, it is the offices of
 the well towards  the  sick.   To be  unmindful of the agonies of
 the diseased,  to be heedless of their wants, and to be regardless
 of their cries  for assistance, is  like  looking upon a drowning  man
 without an effort to save  him.
   Sickness, whether in the hovel or  the palace, is the same, and
requires that  what we do, should be done quickly, as the oppor-
tunity of affording relief is  commonly of short duration.  Tn the
journey through  life, which  is short at best, fellow-travellers
should never  allow themselves to reach the end of  it, without
embracing many opportunities of  making  each other comforta-
ble in times  of sickness, for this is the lot of man, like infancy
and old age.
  There is one important principle in the practice of medicine,
as well settled by observation and experiment, as anything in the
philosophy of Newton, which should be as well understood, at
the present day, by nurses and  people in general, as by physicians.
It is the  effect of heat and cold and other stimulants, and anti-
stimulants upon inflammatory  diseases.   Heat quickens the cir-
 culation of the blood, and cold retards it.   In inflammatory dis-
 eases, the blood already  circulates too fast, and its force, is one
 if not the sole cause, of the continuance of the  disease.   In sore
 throat, in croup, in pleurisy, in peripneumony,  in inflamed eyes, 
NUR.
427
in brain fever, in small pox, in colds, and in every other inflam-
mation, whether  local  or  general, the  application  of heat only
adds  more intensity to the flame which is consuming the body.
This observation not only refers to the application of simple heat,
but to all those articles of medicine, food, and drink, which gene-
rate heat or produce warmth, such as hot drops, spirits, camphor,
heating teas,  peppermint, tanzy, ginger, pepper, mustard, animal
food, and rubefacients.
   The application of cold to the body, by breathing cold air and
immersion in  cold  water, or exposing  the  surface in  any way,
moderates the circulation of the blood, and produces an anti-in-
flammatory effect.  An inflammation may be subdued by the ab-
straction of heat alone, or  which is the same thing, the applica-
tion of cold.
   Antimony, ipecac, sal nitre, salts, and lobelia in small doses,
and cathartics in general, blood-letting, and all  medicines  which
nauseate without vomiting, retard  and lessen the rapidity of the
pulse and circulation, and subdue inflammation.  Hot rooms and
a hot atmosphere or climate increase inflammation.  In inflamma-
tions of the throat, and lungs, however,  such as sore throats,
lung fever, croup, pleurisy, peripenumony, consumption, asthma,
&c, a moderately warm, dry air is the most favorable to a cure,
as the contact of very  cold air tp the raw surface of the mucous
membrane of  the throat and  lungs, is found to increase the in-
flammation.
   Hot rooms are unfavorable to the recovery of women in child-
bed.   The air of the room in  such cases should not be higher
than  sixty-six or sixty-seven by the thermometer.   A higher de-
gree of heat operates in  general,  to quicken the pulse, and increase
the circulation, or produce the inflammatory  state.   To some
diseases, a summer  heat, or a heat  of seventy-five by the ther-
mometer is congenial,  but to acute  inflammatory diseases it is
unfavorable.
   If the art of nursing is well understood, much may be done in
fevers and inflammatory diseases by a discriminating adjustment
of the heat of  the sick room, and by the application of warm or
cold water as the case may require.
   Too much  dosing is exceedingly pernicious ; the nurse must
always look out for this error.   In  most diseases, the appetite is
suspended, and the system  is incapable of nourishment; the vital
strength, therefore,  is quickly spent from this cause alone, so that
much less medicine can be borne with impunity.   This observa-
tion is especially applicable to the diseases of children.
  Cleanliness  is a  cardinal principle in nursing.   Clean clothes
clean beds, clean vessels and utensils, and a clean well-aired room
devoid of offensive smells, contribute not only to the comfort of
the sick but to the prevention and cure  of diseases. 
428
NUX.
  The sick are, in general, feeble  in  mind, incapable of much
conversation  themselves, and seriously fatigued and injured  by
the conversation of those  around them.  A talkative nurse can
hardly be said to be a good  one.  Even physicians, sometimes,
err in this respect.  We have, many a time, seen a patient fairly
exhausted by the imprudent volubility of the medical attendant.
  A dry air as well as dry clothing must always be obtained, in
cases of  sickness, if possible;  but  a close,  confined air is to be
avoided.
  Cool air is favorable  to sleep ;  and hot air produces wakeful-
ness.
  It is generally thought to be a very important affair that the
patient should be pleased with the nurse and with the physician.
This is well enough ;  but we apprehend that it has but very  lit-
tle to do  with the right  operation of remedies, or the restoration •
of the sick.   We should scarcely  think of  selecting a mechanic
or an artist upon any such principle.  It  is  skill that the patient
should value, and not the  looks and manners of the person who
possesses it. For, what can the manners or appearance of a nurse
or physician have to do with the operation  of a dose of salts, the
abstraction of blood, or  the  agents employed to raise a sweat, or
strengthen the tone of the stomach.   Can the suavity of a nurse
or a physician have any agency .in  curing an inflammation of the
eyes, or a swelling of the  great toe joint ?   In a disease of the
nerves, where the mind is to be wrought upon, it may be an ob-
ject to please the fancy in  the selection of a nurse or medical at-
tendant who has the art of  pleasing, but otherwise it does not
appear to us to be an object of much importance.  If a person
wishes to be cured, he must rely upon the right selection and ap-
plication  of remedies.
  A nurse should have a thorough acquaintance  with  the nature
and operation of herbs and common plants.  Many diseases may
be  ameliorated and cured by the use  of  simple  means.  Often,
where potent remedies have  failed, milder means have succeeded.
  Lastly, the  nurse should,  in  general, follow the directions of
the physician, unless there is some special reason for the contrary.
The  physician is always the  best judge of his own way and
means of curing a disease.  If, however, the physician is very
young and inexperienced, and the nurse old and  experienced,
more liberty may be used.
  NUX  VOMICA—Strychnos Nux Vomica.—This medicine is
the seed or nut of a tree which grows in the East Indies.  It is
a deadly  poison;  but, in small doses,  is  an  efficacious narcotic.
The nut or seed is flat, round, about  an inch  broad,  and near a
quarter of an  inch thick, with  a prominence  in the middle on
both sides, of a gray color, covered with a kind of woolly matter;
and, internally, hard and tough like horn.  The taste is intensely 
OIL.
429
bitter, and without much smell.  It consists of a gummy matter,
easily dissolved  in spirits.  Its virtue resides in a chemical prin-
ciple, called strychnine.
  The proper dose of the nux vomica, is four grains, given, three
or four times a day, or two grains of the extract may be given as
a dose.   It  has  been used to cure the palsy,  and other nervous
affections.   In the cure of rheumatism and  gout, it has of late
become  much celebrated.  It has been employed in the cure of
insanity, hypochondrism, hysterics, and dysentery.   The strych-
nine has now almost entirely  superseded the use of the nux vom-
ica in substance.
   NYCTALOPIA—Night blindness.
   NYMPHOMANIA  See Inordinate Lust.
                             O.

  ODONTALGIA—Toothache.  See  Toothache.
  CEDEMATOUS SWELLINGS.—Accumulations of water be-
tween the skin and flesh, and in the cellular membrane generally.
They make their  appearance,  first, in the feet  and legs, and
gradually extend upwards.   They are commonly called dropsical
swellings.  The remedies  are  pointed out under  the  head of
dropsy.
  CESOPHAGUS—The meat-pipe.
  OIL OF CLOVES.—This oil is obtained by distillation from
the dried, unexpanded flowers of the clove tree,  which grows in
the Molucca islands.   It has a burning, pungent taste, and  an
aromatic smell.  It is  highly stimulant,  and one of the best appli-
cations in use to quiet the  toothache.   A  drop or two is applied
to a dossil of lint, and placed in the cavity of the tooth.
  OIL OF VITRIOL—Sulphuric Acid.—It is made by burning
sulphur or brimstone in the air or in a close leaden chamber with
saltpetre.   When brimstone is  burned  in  the air, as everybody
knows, a strong, suffocating white smoke arises which is the real
essence of oil of vitriol or sulphuric acid.  This  white  smoke or
fume, when absorbed  by water, becomes oil of vitriol. Water rap-
idly absorbs this white fume and holds  it in solution.  This is the
acid of  which the elixir of vitriol is made, so often  used as a re-
fri^erent and tonic in hemorrhages, protracted fevers, dyspepsia,
and a variety of other diseases of weakness.
  It makes an agreeable  sour drink and an excellent tonic.
  The oil of vitriol is a violent  caustic : taken into the stomach
in its undiluted state, it  is a deadly poison.  It  unites with the 
430
OME.
alkalies and metals, and forms a variety of neutral salts, such as
Glauber's salts, vitriolated tartar, Epsom  salts, blue  vitriol, and
green vitriol.
   Add  bv degrees, eight  ounces of water to one ounce of oil of
vitriol in a glass  bottle.  The water must  be added  slowly, or
the heat which is generated will burst the  bottle.   Of the acid
thus diluted, ten  drops in half a tumbler of  water  is a common
dose.
   This is a most  excellent medicine to induce  an appetite and
strengthen the stomach.
   OINTMENT—Unguentnm.—The chief  ingredient in  oint-
ments and cerates is oil or lard.  One of the most delicate  and
simple ointments is made by melting together white or yellow
wax with sweet oil, in the proportion of five ounces of the oil to
two of the wax.
   Another excellent ointment is made by melting together two
parts of spermaceti, one part of olive or sweet oil, and one part of
white wax.
   The  citrine  ointment, an excellent article for diseases of the
skin, is made of one part of quicksilver, two  parts of nitrous acid,
three  parts of lard, and nine parts of sweet oil.   The quicksilver
is  first dissolved in  the nitrous acid, by digestion in a sand bath,
and the lard  and  oil, after being melted together, added, while
the solution  is hot.  Stir them  briskly together in a glass or
wedgewood mortar, so  as to form the whole  into an ointment.
   Ointments and  salves can be made hard or  soft by adding more
or less wax, spermaceti, or resin.
   OLIVE OIL—Sweet Oil.—This oil is obtained from the fruit
of the olive  tree, which  grows in the south of Europe.   The
olives are a valuable and rich article of food.  The oil is laxative,
expectorant, and demulcent.   In the jaundice and biliary affec-
tions, the sweet oil is a capital medicine.  The dose is from half
a gill  to half a pint.
   In  case of corrosive substances and poisons  taken into the
stomach, there is no remedy more effectual  in neutralizing  them,
than the  sweet oil.  It is always safe, innocent, and soothing.
It  enters  into the  composition of a great variety of liniments,
ointments, salves, and  plasters.   It has also  been employed with
great advantage as an unction to the skin, in times of the plague
and other contagious diseases.   As an article of food it is thought
to  be preferable to animal fat; people of weak stomachs, how-
ever, should avoid the use of it.
   OMENTUM—The Apron, or Caul.—The caul is formed by a
duplicature of the membrane called the peritoneum.   It is a loose,
fatty looking membrane which  lies upon the surface  of the bow-
els, and is attached  to  the  stomach.  It often descends into the 
OPI.
431
 pelvis.   Its use appears to be to lubricate and defend the bowels.
 In fat people, the omentum or caul is literally loaded with fat.
   ONANISM—Masturbation.—This vice is almost sure to  end
 in a greater  or  less derangement of the  nervous system.   The
 most effectual correctors of it, are hard, constant labor, and early
 marriage.  A vegetable diet, and cold bathing, sometimes, assist
 in the cure.  See Inordinate  Lust.
    OPIUM.—Opium is the inspissated juice of the white  poppy.
 The  juice is a white, milky fluid which oozes  from  the  leaves,
 capsules, and stalks, when they are slightly cut.
    The white poppy has often been made to grow in this country,
 but hitherto  the opium which has been produced from it, is of an
 inferior quality.
   The juice of  the poppy, exposed for a few days to the sun and
 air, thickens into a stiff, tough mass, which is opium.  The best
 kind  of  opium  comes from  Turkey.   It has a peculiar,  heavy,
 disagreeable  smell ; and  a bitter, nauseous, acrid, and warming
 taste.   It is of a dark brown color, and when reduced to powder,
 yellow.   It is compact, solid, tenacious, and when broken, has a
 shining fracture.  The best part of it comes in flat pieces, cover-
 ed with  large leaves, and  reddish capsules of a species of rumex,
 probably used in  packing it.  The round  masses without the
 capsules adhering to. them, are of an inferior quality.
   The East India opium is soft, ductile, and about the consis-
 tency of tar.   It has something of a smoky  smell, a darker color,
 and a more nauseous and  bitter taste.  It is supposed to be about
 half the  strength of the Turkey opium.
   Opium is a powerful narcotic or inducer of sleep, and an astrin-
 gent.   No medicine has ever  been discovered, at  all comparable
 to it,  in moderating and relieving pain, or in promoting sleep.  It
 is soluble in  alcohol, wine, vinegar, and water, though  the  two
 last afford but weak solutions of it.   Its sedative virtue resides in
 a principle, called morphia or morphine.
   A grain or two of opium taken into the stomach, produces a
 remarkable composure of the mind, succeeded by a certain degree
 of languor and drowsiness ; the pulse becomes slower, fuller, and
 softer ; all the  secretions  are,  in  the first instance, diminished ;
 the motion of the bowels is retarded;  the  thirst increased, and
 the mouth, dried.  The heat of the body appears to be increased,
 and the  senses  rendered  dull.  In the course  of  three  or four
 hours a perspiration is produced.   The  narcotic effect of  a  dose
 of  opium lasts about eight hours; and in general,  a full  dose of
it cannot be given with safety oftener than three times in twenty-
four hours.   In cases of  great pain and distress, however, it can
be given much oftener and in  larger doses than in others.
  In too  large a dose it produces an apoplectic state and death.
  The medium dose of opium is  one grain,  given in the form of 
432
OXY.
 a pill.  It is often, however, given in doses of from one to three
 grains.  It operates differently upon different individuals.   Upon
 some  half a grain will  have as much effect as a grain or a grain
 and a half upon  others."  In  almost all  diseases,  attended with
 pain, distress, and loss of sleep, opium is more or less  used.  In
 the  commencement of inflammatory diseases,  it is deemed  inad-
 missible, unless its use becomes unavoidable from the  urgency of
 the  pain and  the  entire want of sleep.   In dysentery, diarrhea,
 cholera morbus,  colic,  epilepsy,  hysterics, locked jaw, spasms,
 small pox, dyspepsia, hypochondrism, gravel, the  passage of gall
 stones, menorrhagia, asthma,  consumption, burns, wounds, frac-
 tures,  dislocations, toothache, tic  douleureux,  and  threatened
 abortion, opium in one form  or another, is found of the  most
 essential service.   In dropsy of the brain and  brain fever, opium
 is commonly injurious.  The  two principal  forms in which it is
 used, are  laudanum  and  paragoric.   See tincture of Opium or
 Laudanum.
   OPHTHALMIA—Inflammation of the Eyes.  See Inflamma-
 tion of the Eyes.
   ORGAN.—In the animal system, this  term  means a structure
 which produces some peculiar  fluid, or performs a peculiar  func-
 tion, as the liver, stomach, lungs, heart, brain, and the senses of
 seeing, hearing, etc.
   OS—A bone, a mouth.
   OTITIS—Earache.   See Earache.
   OVARIA.—The ovaria are two  flat, oval bodies,  about an
 inch in length, and half an inch in breadth and thickness.  They
 are appended to the uterus by means of two canals or ducts called
 the  Fallopian tubes.   The insides of the ovaria  are filled with
 little, soft eggs or bladders of lymph, which are supposed to  have
 an important agency in conception.   When animals are deprived
 of the  ovaria, they become incapable of producing young. They
 extend about  an  inch  from behind the  fundus  of the uterus.
 The foetus, by some, is supposed to commence  in the ovaria, and
 to descend into the  uterus.   Others suppose  them to secrete a
 peculiar kind of fluid, which contributes  to the formation of the
 new being.
  OXIDE OF IRON—Iron  Rust—Carbonate  of Iron—The
red rust which  collects on iron by exposure to air and moisture,
if scraped off and ground to a powder, forms  the carbonate of
iron.   The carbonic acid is absorbed from the atmosphere, and
combines with  the iron.  Its  dose is from ten to  twenty grains.
It is an agreeable  tonic.   It strengthens the stomach and system
 generally without stimulation.
  OXYGEN GAS—An elementary air.—It is, like the atmos-
phere,  an elastic, invisible fluid.   It composes twenty-one  parts
in a hundred, by measure,  of the air.   Without it, no animal can 
PAL,
433
live, and no  combustible body can  burn.  When a lamp burns,
oxygen is separated  from the air  and combined with the carbon
and  hydrogen.  It is  oxygen which causes  metals to rust, and
sweet  liquids to become sour.   It  is obtained from  saltpetre,
manganese, and several other substances, by the application of a
strong heat.  This gas has relieved the asthma. It is disengaged
by wetting a piece of paper with a solution of saltpetre, and burn-
ing it in the room with the patient.
   OZ^ENA.—This  disease is an ulcer in  the nose, which dis-
charges a fetid, purulent matter, and results, in most cases, from
the venereal  disease, and  the scrofula.  It  begins with swelling
of the nostrils, insomuch  that the passages  are nearly or entirely
closed up.  A caries of the bone is often the consequence.  There
is, at first,  a  discharge  of mucus, followed by the  formation of
pus,  attended with sneezing, and a traee of blood.   The  ulcera-
tion  in some  cases will extend to the outside of the nose and the
cheek.
   A decoction of wild  indigo root  snuffed up the nose, several
times  a  day, is a good remedy, in this disease.  Solutions of
myrrh, alum, and a strong tea of the white poppy, used in the
same way,  are beneficial.   Calomel, in. small quantity, may be
taken as a snuff.  A tea made of the white  oak bark is  an excel-
lent  wash.  Where  the disease depends upon a scrofulous,  or
venereal  taint, these affections  must  be  cured before  anything
can be done for the oz-aena.
                              P.

   PALATE—Uvula.—This is a small, round,  fleshy process,
 which hangs in front of the throat, from the roof of the mouth.
 It is composed of a small, round, wormlike  muscle, and the com-
 mon membrane of  the mouth.   The palate becomes lengthened
 by inflammation  and relaxation,  insomuch  that both the speech
 and swallowing are impeded; in  which  case, it is sometimes
 amputated.
   PALM OIL.—The palm tree, whose fruit yields the palm oil,
 grows in the West Indies.   The  oil is of  an  orange color, and
 about as thick as lard.   It  has a strong, agreeable odor, but very
 little taste.   It is an excellent application to stiff joints, and old
 rheumatic swellings.  A small mass, of the bulk of a nutmeg, may
 be rubbed in every night.  It mitigates pain, and reduces tumors.
 It is often used to cure chilblains, cramps, and other similar affec-
 tions.  With camphor, and sal ammoniac, it forms valuable lini-
ments for indolent tumors, and swelled joints.
           55 
434
PAL.
  PALPITATION.—This  disorder is an  extraordinary beating
of the heart.   In some instances, the heart will appear almost to
jump out of the mouth from the violence of its action.   In run-
ning very fast, and for some distance, the heart will beat inordi-
nately, and the same effect produced, which we mean by palpita-
tion but this  is  not, in ordinary, accounted a disease.   Horses
will have a vehement palpitation of the heart at the  end of a race,
which will shake the whole body, for a long time.  All people
in a state of fear or terror will  have a violent  palpitation of the
heart, but as the  cause is a common one, and the  effect, in  a
measure, habitual, and as no apparent evil arises from it,  it is not
regarded as a disease.  Imaginary fear will produce this affection
of the heart, as well as if the passion were well-founded.  And,
we  imagine, that most cases of the palpitation of the heart arises
from imaginary  fear,  such as  the fear of instant death  or some
other great  evil.  People will often become frightened in their
dreams, and awake with a violent palpitation of the  heart.  They
forget the cause, and thinking only of the effect, become  alarmed
unnecessarily.
  There are various  organic  affections of the heart which pro-
duce this affection, such as dropsy, aneurism, and  ossification of
the  valves, but the most common  cause is  a delicate,  weak  state
of the nerves.   When the nerves become weak and delicate, the
emotions, passions, instincts, and  propensities of the mind, are
easily excited, as well as the functions of the body, and no func-
tion more so than that of the heart.  Indeed, the heart is almost
a complete index of the state of the nervous system.  The palpi-
tation seems to  be  produced  by a  sudden rush  of  the venous
blood into the heart, by which it becomes distended, and excited
to action in order to  relieve itself of the load.   The heart is over-
loaded with blood.   It is probable that, in the  palpitation of the
heart which arises from nervous affections, the spleen suddenly
transfers a large  quantity of blood from the arteries to the veins,
and thus overloads the heart.   This effect, the spleen is able to
produce, by the  size of its blood-vessels, and its liability in com-
mon with the  other organs of the body, to be controlled by the
affections of the mind.   Perhaps this is what the ancients meant
by  the disease, called the spleen.
  The method of curing the palpitation is no more nor less than
curing the diseased state of  the nerves and the local affections of
the heart which produce it.   Whatever tends to strengthen the
nervous  system and  to confirm the general health, or to remove
the local affections of the heart, will cure the  palpitation.  The
disease  is painful, distressing,  and often alarming,  but is not,  in
itself, a dangerous affection.  It is an important  point  to know
the cause of it,  and  knowing this, to moderate or remove it.   If
the cause is fear, arising from  some sudden apprehension of death 
PAL.
435
or other evils, we maybe assured that the palpitation will subside
in the same way as when the affection arises from fear in general,
or from over-exercise of the body.
   The best medicine is a few drops of laudanum, a tea-spoonful
or two of paragoric, or Hoffman's anodyne.   Thirty drops of the
water of ammonia, or a tea-spoonful of the spirits of camphor or
ether will moderate the affection.   A large  draught of poppy tea
will have the same effect.  If it proceeds from an overloaded and
distressed stomach, one of the most common causes, an emetic
must be given, followed  by a dose of castor oil or salts.   The
quinine, rust  of iron, and the chalybeate spring waters should be
used to confirrruthe strength of the nervous system.
   PALSY—Paralysis.—The  palsy,  in ordinary,  results  from
apoplexy.  We have seen it caused  by epilepsy, and we  think
it may be produced by insanity.  Some writers conceive that it
is always preceded by apoplexy, but we are certain that it some-
times  follows epilepsy, that it often affects  insane  people, and
sometimes, happens without  any apoplectic symptoms  whatever.
Even allowing the cause of palsy to be a pressure upon the  brain
in  every instance, it by no means  follows  that it must be  prece-
ded by apoplexy.  We  think it  to  be a  distinct disease from
apoplexy, although  both are diseases of  the  nervous system.
The apoplexy often appears and disappears, in the same person,
for two or three times in succession,  without betraying any more
symptoms of palsy than  a fit of epilepsy,  hysterics, or insanity.
Some consider apoplexy to be the  acute stage of palsy.  Dissec-
tions, of late years, have placed it almost beyond a doubt that
both apoplexy and palsy are caused  by hemorrhage or bleeding
from the blood-vessels of the brain.  In nearly four hundred fatal
cases of palsy, Mr. Andral, a French physician of eminence, found
clots of blood in  the  brain, varying in size from that of a pea to
the size of a hen's egg.   In different individuals, the coagulated
blood was  found  in different parts  of the brain.   It  is a well
established fact that any kind of pressure upon the brain will
produce a loss of sense and motion.  An effusion of water in the
brain is no doubt a cause of  apoplexy and  palsy.  The growth
of tumors and  the formation of abscesses are also productive  of
the  same effects.   Blows and wounds  are often the  causes  of
palsy.
   When a person sits for some time with  one leg  crossed over
the  other, both the feeling  and the voluntary power, are  for a
time lost in one or the other of the legs.   We say, the limb  is
numb.  It is in fact the numb palsy as long  as it lasts.   The pres-
sure upon the nerves of the thigh or ham has destroyed the feeling
of the limb below, and, perhaps, the motion.  Every one must have
often lost the sensation and the motion  of  one leg for a conside-
rable time from a pressure of the nerves  in this way.   By hitting 
436
PAL.
the elbow against some hard body the same numbness is produced
in the forearm.  If a nerve is taken up and tied with a ligature,
it destroys all feeling and power of motion in the parts to which
it extends, below the ligature.  These facts may serve to give us
some little insight into the nature of the palsy.
  The palsy affects the body  in  various ways.  Sometimes, it
destroys  the power of moving the  muscles of one  side of the
body, and in other instances, the  whole of the lower part of the
body.  When the muscles of one side of the body, up and down,
are palsied, it is called hemiplegia; and when  the lower half of
the body, that is, both legs and a part of  the Irunk, is palsied, it
is called  paraplegia.  The hemiplegia is a much more recoverable
disease than the  paraplegia.   In some instances, only one  arm,
or leg, or part of the face will be palsied.   Such cases are much
more recoverable  than either hemiplegia or paraplegia.  Indeed,
the chance of  recovery is somewhat in proportion to the extent
of the palsy ; if only a few of the muscles are  palsied, the chance
of recovery is great ; and if a large number of them are palsied,
the chance is small.  Young people  recover much oftener  from
the disease than  old  people.  Complete recoveries rarely take
place ; partial recoveries almost always.
  When a palsy comes on, the person is rarely ever conscious of
it.  The first  notice the patient  has  of it, is the  loss of motion
and of sensation in the part affected.   There are no pain, soreness,
sense of  heat, swelling, distress, or redness, as in  other diseases,
to mark the onset  of the  disorder.   The palsy is the opposite of
disease, in the literal sense of the word ;  it is  the rest or the par-
tial death  of the  affected muscles.   The  nerve or nerves are
nevertheless  far from being dead.   No decomposition of the
nerves or muscles  ever takes place  in the  case of  palsy.   The
circulation of the blood goes on in the palsied parts, and there is
none of the common evidences of dissolution.   Putrefaction  is no
more likely to take place in a palsied limb than in a well one.
The true nature of the disease is  wrapped in mystery.  There is
a partial  or  entire loss of motion, and a partial or entire loss of
feeling in the palsied  part, and this is pretty  much  all that we
know about it.  In  most cases the loss of feeling is but partial,
and, in some instances, the sensibility of the  palsied part is not
diminished at all.   After a complete palsy, the affected' parts ap-
pear to possess the same kind of life which exists in the hair and
nails.
  It was not known to the older writers, even  to Cullen, Buchan,
and Fordyce, that the nerves of sensation and the nerves of motion
are distinct systems, although often enclosed in the same sheath.
This discovery was made by Mr.  Charles Bell, and fully explains
the reason why the motion of the muscles may be lost, and still, 
PAL.
437
the feeling of the part be retained, and also why the feeling may
be destroyed, and the power of motion retained.
  Another phenomenon in  the  history of palsy, which puzzled
Cullen and the old school of physicians to account for, was the
paralytic  affection of the side of the body being opposite to the
side of the brain where the pressure was found, on dissection, to
exist.  It has, of late, been pretty clearly demonstrated that the
nerves cross each  other in  issuing from the brain, so that the
nerves of the right side of the body really come from the left side
of  the brain, and the nerves of the left side of  the body come
from the right half of the brain.  This fact  will account  for the
palsy of  the side of the body opposite to the half of the  brain
which happens to be injured or pressed, as the nerves of the pal-
sied side really come  from that part of the brain upon which the
pressure  is made.
   In the palsy of one side, the power of speech is sometimes lost,
and in most cases it is more or less  impaired.   It is not a little
singular  that one  half of  the  tongue will be palsied while the
other half  will remain sound.   In putting  out the tongue the
palsied  side will lop down, which gives it a tremulous motion.
One corner of the mouth is often drawn down, and the command
of  the eyelids of the same  side, lost.   The  features of the face
will be altered, and in consequence of the affection of the mouth,
a palsied  person is  apt to slaver or drivel, and finds it difficult to
swallow liquids.
   The mental faculties are always more or less affected, particu-
larly the  memory.   In some instances, the  powers of the  mind
are wholly destroyed.   In paraplegia, or when the lower  half of
the  body is palsied, the person  can neither  retain the urine nor
the  feces, but  both are discharged involuntarily.  The  use of
both legs is lost, and the person is left without the power of walk-
ing, or support.
   Painters are said to be peculiarly liable to  palsy, particularly of
the  hands and arms.   A too  great fullness of the  blood-vessels
from over-feeding, is supposed to be a frequent cause of the dis-
ease.  All great efforts of the mind and of the body produce this
disease.   Excitement of all kinds, by driving the  blood to the
head, endangers the blood-vessels of  that  organ, and prepares
them for a rupture.   No doubt, but a bare fulness of the blood-
vessels of the  head may cause the disease.    It appears  to  us,
however, that, in most cases of palsy, the brain is in an exhausted
state, from over-action of some kind or other ; and, that, its blood-
vessels being weakened or rendered thin and  emaciated, are easily
ruptured on any considerable agitation of the mind or body, and
hence  an effusion  of blood.   It is more difficult to account  for
partial palsies, where  there is no visible evidence of an affection
of the brain.   But, perhaps, these may be owing to some  little 
13S
PAL.
lesions of the minute blood-vessels, which penetrate the nerves',
and to an escape of blood.
  We have often seen palsies of the face, and other partial palsies
recover but the recoveries have commonly been slow.
  Domestic Remedies.—In a fit or stroke of the palsy, the person
should be placed in a room of  moderate temperature, or a tempe-
rature of about sixty-eight degrees by the thermometer.  If there
is a loss of sense and motion, or if the body should be very much
convulsed, cold water should be dashed upon the face and head,
and every part of the clothing loosened or removed which  may
impede the circulation of the blood.   As the patient in this state,
is commonly unable to  swallow,  an injection composed  of salt
and water, made very strong,  should  be immediately dispensed,
and repeated every hour until  the patient is able to swallow.  In
case the  stroke  or fit happens just after a full meal, or eating
anything  indigestible, a gentle emetic of ipecac or of  lobelia
should be given, followed by a dose of castor oil, aloetic pills, or
some other active physic.   As soon as the bowels  and stomach
are unloaded,  warm gruel or pennyroyal  tea  should be given
for drink, to which should be added a tea-spoonful  of tincture
of cayenne.  The whole surface should be washed  over with
castile soap and  tepid water, and  blisters applied about the arms
or upon the nape of the neck.  The  food, if any can  be taken,
should consist of water porridge, warm milk and water, chicken
broth made with rice, rye pudding, boiled rice, and soaked bread.
No meat  should  be allowed,  nor  anyT great  quantity  of broth.
Vegetable food  lessens the force  of the circulation and all  the
vital actions, and these are  great  objects to accomplish in all
cases where lesions of the blood-vessels occur  and hemorrhage
is  apprehended.    When a person lies upon his back with dis-
ease, vegetable food is always sufficiently nutritious to  support,
and replenish  the system.  We  conceive  no point to be more
important in the cure of palsy, than to live upon a vegetable diet.
A vegetable diet softens the pulse, relaxes the rigid tone of the
blood-vessels and of the heart, and promotes all the  secretions.
It lessens the heat of the body, and increases the activity of the
bowels.   It favors sleep and a composure of the nervous system.
Animal food on  the other hand, hardens the pulse, increases the
tone of the animal fibres, retards the secretions, increases the heat
of the body, and disturbs the function of  the  nervous system.
When the force of the pulse  is increased and the circulation of
the blood hastened, the oxygenation of the blood is increased,
and the brain thereby becomes over-excited, as oxygen is a pow-
erful stimulus.   High living,  which causes a forcible  circulation
and an excitement of the blood, is a frequent cause of the palsy,
and to cure the disease  and prevent a relapse, an opposite course
must be  pursued.   We do not mean  that the system must be 
PAL.
439
reduced very much, but, that, it must be brought to the standard
of sound health.   Both emaciation of the muscular and nervous
fibres, and the plenitude of muscular and nervous strength, in
different ways, induce the palsy.
   The drink in this disease  should be cold water, or  sweetened
water, lemonade, soda powders, and chocolate.
   Tn some instances of  palsy, where it commences with apoplec-
tic symptoms, there will be  more or less  fever, these symptoms
must be obviated like those of fever in general.   In such cases, a
dose of physic should be administered every day.  By thus drain-
ing the bowels, the pressure upon the brain is  lessened,  and the
nerves prepared to resume their proper function.
   All stimulating things should be avoided, especially all alcoholic
liquors. In this form of  the complaint, mustard,  red pepper, guaia-
cum, stimulating essences and oils, and medicines  to excite the
nervous action, commonly fail in their object and only produce mis-
chief. In this complaint, gentle friction with the hand or with a flesh
brush, and riding in a carriage,  where it can be borne, are very ser-
viceable.  Both cold and warm bathing are found in general, preju-
dicial.  The  skin should simply be kept clean by soap and tepid
water.  Being in the open air  as much as possible, and frequent
efforts to  use the palsied limb or  muscles  are of great advantage
to the disease.
   Profesional Remedies.—Depletion in some way or other, is
often needed in this disease.   Cathartics are always safe ; diuret-
ics and the antimonial sudorifics  are commonly useful and harm-
less.  Blood-letting is  the  most  potent mean  of depletion, and
requires the most  judgment in its application.   With respect to
the  propriety of bleeding, Dr. Dewees observes, that, " The pulse
will generally conduct us safely in such cases, if it be properly con-
sulted, together with the other phenomena, that the system pre-
sents at the same time.  If the pulse be full and slow, or unusu-
ally hard and frequent; if there be heat, or a  pricking sensation
in the skin, head-ache, or drowsiness, flushed cheeks, high colored
and scanty urine, and white tongue, the loss of a few ounces of
blood is  distinctly indicated either by the lancet, or by cups or
leeches—if the  pulse  be hard and frequent,  by the lancet; if
sluggish,  by cups or leeches to the back of the neck."   We can
give no better advice than this in  the choice of cases where bleed-
ing  is indicated.   The  bowels should be  drained every day by a
dose of salts  or aloetic pills, until  amendment becomes per-
ceptible,  or the case becomes so obstinate as to despair of a cure.
If the bowels become very torpid, more powerful cathartics should
be used,  such a,sxalomel and  jalap, the croton oil, spirits of tur-
pentine,  or  Lee's  pills.   Some  palsies have been cured by elec-
tricity and galvanism applied daily, for many days in succession.
But where these agents perceptibly increase the force of the heart, 
440
PAR.
and  excite feverish  sensations, they should  be omitted.   The
nitrous  oxyde gas has been used in some cases with advantage.
We think, however, that it should not be used in any recent case.
Blisters have generally been found to help the disorder.
  The strychnia  has been highly recommended by some, while
others as strongly disapprove of its use.  In most cases of palsy,
it has taken time  to  effect a cure.   A vegetable diet ; as much
exercise in  the  sun and  open air as can be comfortably borne ;
freedom from all  excitement of the mind ; and an avoidance of
cold and heat, and the  changes of the  weather, are the cardinal
conditions of a cure.   A residence at the springs and a course of
the waters, have, in many instances, hastened  recovery.   Both
the chalybeate and the cathartic waters have been found extreme-
ly serviceable.  The sulphur springs should be  tried.   Quinine,
iodine and the mineral acids will in many cases  assist in the pro-
cess of cure.
  There is a shaking  palsy well known  to  people  in  general,
which is hardly ever regarded as a disease, but  which is a great
misfortune  and exceedingly annoying.  It is mostly confined to
people advanced in life.  Like the impairment of sight in conse-
quence  of  age, it  is passed  over as  incurable.   It is, however,
much worse sometimes than at others,  and at such times should
receive  the  same  treatment which we have advised for the dis-
ease in general.
  PANCREAS.—This organ, which, in its shape and external
appearance, resembles a dog's tongue, is situated in the epigastric
region under the stomach, and secretes a fluid which resembles
the saliva.   The  innumerable small glands, which compose its
inner surface, excrete the pancreatic juice by as many little ducts,
which unite and form one large duct, called  the pancreatic duct,
which enters that portion of thebowels, denominated the duode-
num.  The pancreatic juice is supposed to act an important part
in the conversion of the  chyme into  chyle.   The  quantity of
fluid, which it secretes and pours  into the bowels, is  considera-
ble.   What its special chemical action  is, has never been  ascer-
tained.  It is an organ found  in almost all animals, and, though
small, is unquestionably essential to the life of man.
  PAPILLiE.—This term is used in general, to signify the fine
terminations of the nerves upon the skin and tongue.   The skin,
viewed through a microscope, is composed of innumerable  little
indentations and conical eminences.   These little nodules or em-
inences are  called papillae, because they resemble the nipple in
shape, though infinitely smaller in size.
  PARACENTESIS.—The operation  of tapping,the abdomen in
the  dropsy.  It  is performed by an instrument jballed a trocar,
consisting of a small tube to which a sharp instrument is adapted.
The trocar is pushed into the cavity containing water, and the 
PEN.
441
cutting instrument withdrawn, that the water may run off through
the tube.   We have seen sixteen quarts of water drawn from the
abdomen, at one time, by this operation.
  PARIETAL BONES.—Two arched and nearly square bones,
which compose the upper and lateral part of the scull.  One bone
is situated on each side of the cranium.
  PARACUSIS.—Deafness.
  PARAGORIC.—'To make the elixir paragoric, take one drachm
of opium, one drachm of benzoic acid, two scruples of camphor,
one drachm of the volatile oil of aniseed, and two pounds of di-
luted alcohol, or new rum.  Let the whole stand for ten days
and strain the  liquor through paper or a piece of fine linen.  The
dose for children is from one to twenty drops.  The dose for adults
is from  a tea-spoonful to a  table-spoonful.    A table-spoonful
contains about a grain of opium.  It is an excellent medicine for the
asthma  and coughs.  It  can be given in almost  any disease re-
quiring  an anodyne.  Paragoric is an opiate extremely well suited
to the condition of young children.
  PARALYSIS—Palsy.   See Palsy.
  PARENCHYMA.—This is the fundamental substance of the
organs,  in which the vessels and  nerves' are imbedded, and, by
which, they are connected  together.  The  structure is  spongy
and cellular.
  PAROXYSM.—A great increase  or aggravation of the symp-
toms  of a disease. The pains of the  gout and the hot stage of fe-
vers,  are called paroxysms.   Epileptic fits are composed of inter-
vals and paroxysms.  A violent pain in the teeth is called a par-
oxysm of the toothache.
  PARSLEY.—-The root and seeds of the parsley are extremely
serviceable in stoppages of the water, and in dropsy.  To increase
the flow of the water, an infusion is made of the roots, or seeds,
and drank freely through the day.   Says Dr. Chapman of Phila-
delphia, " no diuretic is more  valuable than  this in some cases."
  PATELLA—The knee pan.
  PELVIS.—The cavity below the belly, formed by four bones,
the two ossa innominata,  the os sacrum, and the os coccygis.   It
contains the bladder, the rectum, and, in females, the Uterus.   It
is, sometimes,  called the basin, from  its  having a brim, and oth-
wise resembling that vessel.  In females this cavity is much larger
than  in males ; in them it is shallow and  wide; in males it is
narrow, and composed of stouter bones.  In nothing, is the female
form  more distinguishable from  that of the male  than in the
breadth and capacity of the pelvis.  This is a matter of necessity
from its containing an extra organ.
  PENNYROYAL—Mentha Pulegium— This is one of the best
and most common domestic remedies.  A strong infusion or tea
of it drank hot, opens the pores, raises a sweat, and  loosens the
           56 
442
PER.
bowels.  Like the peppermint, it is a stimulant and carminitive ;
it quickens the circulation and  increases the heat.   In cases of
obstruction of the menses, the pennyroyal enjoys a high reputa-
tion.   In the commencement of a cold, while the shivering fit is
on  two or three cups of pennyroyal  tea, will often throw it off,
by a seasonable opening of the pores.
  PEPPERMINT—Mentha Piperita.—The  peppermint is a val-
uable herb.   The leaves have  a strong, aromatic  smell,  and a
warming, pungent taste, furnishing an essential oil, which, when
dissolved in  alcohol; forms  the  essence  of  peppermint,  a well
known stimulant,  and carminative in cases of wind  cholic, pains
in the stomach, faintness, hysteric fits, and a languid circulation
of the blood.   It  may be used in the foim of a tea made of the
leaves, or in that  of the distilled water, and essence.  Fifteen or
twenty drops in half a gill of water, is a dose of the essence. The
tea  can be drank  in large quantities.   It  communicates warmth
to the system, and invigorates the mind.  In all cold disorders
the  peppermint tea is an appropriate medicine.
  PERICARDITIS.—An  inflammation of  the  pericardium or
heart-case.   See inflammation of the heart.
  PERISTALTIC MOTION.—The vermicular motion  of  the
bowels by which  they urge along their contents.   It is astonish-
ing  how much this motion may be hastened or retarded by different
substances arid by different diseases.
  PERIPNEUMONY—Pneumonitis.—Peripneumony is an in-
flammation of the parenchyma or substance  of the  lungs.  It is
characterized  by  a heavy obtuse pain  in the  side or some part of
the chest, which  is increased  by coughing, a full inspiration,  and
generally by lying on" the affected side ; difficult and painful  res-
piration, particularly  when  in a recumbent position, or when ly-
ing on the side affected ; the respiration is voluntarily shortened to
prevent the suffering occasioned by a  full expansion of the lungs.
There  is always a cough, which is frequent,  short and moist,  and
like the respiration, is as much as possible, suppressed by an action
of the will.   The lungs are oppressed by swelling and with phlegm;
the face is swollen and often of a livid color; there  is an expectora-
tion of thick mucus  streaked or  mixed  with blood, and  which
frequently has the appearance of being mixed with fine  brick-
dust.  These symptoms are ushered in by cold chills, and more
or less general indisposition, which are followed by all the symp-
toms of inflammatory fever; the tongue is coated;  the skin hot
and usually dry ;  there is anxiety, thirst, and loss of appetite; the
pulse is frequent and full, but not hard.  In the advanced stages
the pulse is sometimes very weak, soft and irregular.
  Though the above is the train of symptoms usually observed
in peripneumony, it should be remarked that these symptoms are 
PER.
443
not all constant, or to be met with in every case, and that the
disease may exist, manifesting very different phenomena.
   It has been  known to exist without  any increase in  the fre-
quency or fullness of the pulse ; the skin is not always preternatur-
ally warm,  nor is it uniformly dry; and the pain  is scmctimes,
even  in severe attacks, very trifling.
   The position which the patient chooses, varies in different cases.
It is stated by  some authors that, on the back with the head and
shoulders raised, is the most common, and this we thiuk*corres-
ponds with our own observations.
   The most, certain means of ascertaining the existence of the
disease, is  by auscultarion, but much  observation and study are
necessary to qualify a person  to  practice this  newly discovered
and useful art with advantage.  On applying the ear to the  chest
over the seat of the disease, in the first stage, the sound which  is
heard  may be compared  to that  produced by sprinkling fine salt
on the fire.  This is called the crepitous rale.
   When any part of the lung is solidified by  the inflammation,
neither this sound nor the natural respiratory murmur is heard,
but in the  parts that, are  healthy  the  latter will be heard louder
than natural.   This increased  sound is called by Laennec, puerile
respiration.   In the second stage, when the inflammation of pus-
like matter begins to take place in the pulmonary tissue, the mu-
cous rale is perceived, to a greater or less degree, which Laennec
supposes is produced by the introduction of fluid into the bronchial
tubes;  where  a large portion becomes  softened, he calls  it an
abscess, and says that a very strong mucous or  cavernous rale  is
perceived over  its site with  pectoriloquisin.   " When resolution
takes place before the disease  has run into solidification, the crep-
itous  rale becomes daily  less perceptible,  while  the  natural sound
of respiration increases and becomes gradually more distinct, and
at length is heard without the least crepitous sound; but if solidi-
fication has  taken place, the  cure  is  invariably accompanied by
the return of the  crepitous rale, and  then, as that declines, the
respiratory murmur becomes  more and  more  distinct."   The
sound elicited by percussion in the first stage does not differ ma-
terially from that of health, but in the second it is dull over the
affected part.
   The lungs of those who have  died of the disease in the first
stage,  are found, on  examination,  surcharged  with blood, very
red, and increased in weight.   In the second  stage the diseased
lung  is softened,  and much  more easily broken between the
thumb and finger than in the healthy state, and has nothing of
the natural crepitous feel.  By putting the lung into water, its
weight will be  found to be very  much increased by its sinking
immediately to the bottom of the vessel, instead of floating as  it
would do in a  healthy condition.  When a person dies in the 
444
PER.
 third sta<re of the complaint, the diseased lung will be found to
 contain a great quantity of redish or  greyish fluid, which, when
 the lung is cut into, oozes from numerous points.
   The most  general cause  of  this disease is the application of
 cold to the body, giving a check to perspiration and determining
 a greater than usual  flow of blood to the lungs.  Other  causes,
 such as violent exertions in  singing, speaking, and playing upon
 windMnstruments, by causing a determination to this organ, have
 been  known  to produce it.   It most frequently attacks those of
 robust constitutions and full  habits of body ; and those who have
 had a former attack, have a greater predisposition to it than others.
 As would naturally be supposed when we consider what its most
 frequent cause is, peripneumony is a disease of cold  and varia-
 ble climates and seasons, though it may occur in any climate, or
 in any season of the year.  It is said that it sometimes  prevails
 epidemically, and  endemically, that is  generally,  and in  certain
 locations.
   When peripneumony proves fatal in its first stage, it is gener-
 ally by an effusion of blood taking place in the cellular texture of
 the lungs, producing suffocation ; the vessels of the neck become
 turgid and swollen, the face is bloated and of a purple color;  the
 breathing laborious; there is  great and sudden prostration;  the
 pulse is weak and irregular,  and death  ensues between the third
 and seventh days.   It  may also terminate suddenly in gangrene ;
 or if the attack be not  very violent, or the means that have been
 employed have partially subdued the disease, it may  terminate in
 suppuration.
  Gangrene of the lungs will be indicated by great and sudden
 prostration, a livid countenance, small  pulse, and  foetid expecto-
 ration and breath.
  When suppuration takes place, an abscess sometimes forms in
 the lungs called a vomica, which, sooner or later, generally in the
 course of the third or fourth week, bursts, and the matter is sud-
 denly discharged by the mouth.   If the abscess be large or unfa-
 vorably situated, the patient  may die almost immediately when
 this event happens ; but if it be small and  favorably situated, and
 the strength and constitution be good, a partial or even  perfect
recovery may take place.  Should  the  patient  survive the crisis
of one of these abscesses, he  can by no means be considered  out
of danger as long as the cough continues,  as it is not unusual for
 the secretion of pus to  go on  and keep  up a constant cough, and
re-accumulations repeatedly take place until he  is at  length worn
out with a kind of consumption.
  The formation of an abscess may be known by frequent, slight
shiverings, an abatement of the pain, a sense  of fulness  in  the
part, laborious breathing, great  debility,  and  the  patient  being
able to lie on the affected side; the pulse  at the same time con- 
PER.
445
 tinuing quick, the cheeks  at times flushed, and other symptoms
 of irregular fever being present.
   It also sometimes happens, when the violence of the  inflam-
 mation is not overcome in  the early stage of the complaint, that
 it degenerates  into what is called a quick consumption.  There
 is in these cases a copious  secretion  and  expectoration of puru-
 lent matter, indicating disorganization of the lungs.  Hectic fever
 ensues, and the patient falls a victim to an incurable malady.
   Hepatization or hardening of the lung so  that it resembles the
 liver is another consequence  of  this disease, which  may prove
 fatal, or from which the patient may slowly recover if the extent
 of the disease be small, by a gradual absorption of the hardened
 matter which had been deposited in the cellular substance of the
 lung by the inflammation.
   Inasmuch as the treatment  of peripneumony in its first stage
 is very similar to that of  pleurisy, to distinguish them, is not a
 matter of very great importance, practically considered.
   It may be observed,  however, that in pleurisy the pain is ex-
 tremely  acute, there is but  little if any expectoration, the  pulse is
 hard, and  though the cough is painful, the lungs do not seem
 oppressed  with phlegm, the  cough being  caused  by irritation
 rather than by the necessity of expectorating accumulated mat-
 ter, the  reverse of which  conditions it will  be seen usually ob-
 tains in peripneumony.
   Rheumatism which  is frequently seated in the muscles, cover-
 ing the chest, and sometimes in the diaphragm and the heart, oc-
 casioning great difficulty in breathing, may be distinguished from
 both of those complaints by the absence of cough and expectora-
 tion, and by being attended with a greater degree of lameness in
 moving, by changing its location, and in some  instances by its
 having previously affected  some of the large joints, or some other
 parts of the system.
  The duration of this  disease is about the same as  that of most
 other  acute  inflammations.  When it is properly treated, and is
 uncomplicated, and when  no  untoward  circumstance attend, it
 will seldom be protracted beyond the seventh or eighth day, be-
 fore symptoms of a crisis will  be manifest, but should it exceed
 this time and become chronic, it may be prolonged indefinitely.
  Remedies.—That peripneumony is a disease that runs its course
 rapidly, incurable disorganization sometimes  taking place in a few
 days, and that a cure cannot rationally be expected without prompt
 and efficient treatment, are  facts which should never be lost sight
of: no time should, therefore,  be lost in the adoption of the most
energetic measures to arrest its progress.   It is  a disease of too
violent and unyielding a nature to be subdued by domestic rem-
dies, and though some  benefit may be derived from bathing the
feet in hot  water, hot mustard poultices to the side,  warm muci- 
446
PER.
 laginous drinks, frequently repeated small doses of ipecac, antimo-
 ny or lobelia, the  attendance of a skillful  physician will  be ne-
 cessarv in order to conduct the disease  through its course with
 any chance of success.
   The  natural  crisis  of the disease is  by expectoration, none,
 however, hut the mildest cases, are likely to be cured spontane-
 ously. With such rapidity does it run its  course,  that irremediable
 disorganizati n is produced before a critical raising is established,
 unless aided by art.
   In order to unload the engorged vessels of the lungs, and there-
 by restore healthy action, it is necessary to bleed  freely  in  the
 early stage of the di-ease.   The quantity of blood to be  drawn
 must of course, vary according to  the age and constitution of the
 patient, the violence of the attack, the climate, and the season of
 the year.   A man of  ordinary strength  in a violent attack,  will
 require at least twenty ounces  to be drawn  at the first operation,
 and if the violence of the disease be not  mitigated, the operation
 should be repeated in six or  eight hours.   The  first bleeding
 should be sufficient to produce an impression  upon  the system
 whatever the quantity, but  the subsequent ones will not require
 to be so copious.
   Dr. Good advises eighteen or twenty ounces at least to be drawn
 at the first  bleeding, and the  operation  to be repeated  in twelve
 hours.  Mackintosh, who is decidedly one of the best authorities,
 recommends thirty or thirty-five ounces to  be drawn at the first
 operation.   He says, " nevertheless I am persuaded from experi-
 ence in treating the disease, and from examinations after death,
 that much  more mischief is done by bleeding too  little than by
 bleeding  too much ; but  I am not an advocate for the heroic prac-
 tice of taking seventy or eighty ounces of blood at one operation.
 The largest bleeding which 1 believe I ever took in my life was
 fifty-six  ounces.  In  general,  if the  operation  be properly per-
 formed, thirty or thirty-five ounces will  suffice, but  the patient
 should be seen again in the course of two or three hours."   The
 French physicians bleed less from the arm, at least, but they use
many leeches, and give the tartar emetic  in large doses, as recom-
mended by the Italians.  Laennec advises only from eight to six-
teen ounces,  and even claims to have cured  the disease without
bleeding, but much allowance must be made for the climate and
the national constition.
  In  bleeding, however, as in giving  medicine, it is idle to talk
of quantities  except in general  terms, it  is the effect which must
govern the practice in both cases.  While drawing blood, the ef-
fect it produces  upon the pulse, the countenance, and upon  the
other symptoms of the disease should  be  carefully  observed.
After two or three bleedings, and  particularly if  the  disease has
run four or five days, much caution will be necessary in repeat- 
PER.
447
ing the operation, or the powers of life may be too much depressed
and  serious injury be done, by preventing a  reaction of the sys-
tem, which is always  necessary after depletion.  In this case as
well as in all others where repeated abstractions of blood are prac-
ticed, we must be careful to distinguish between the real symp-
toms of the disease, and those of reaction.   Violent commotion of
the system, a throbbing of the  heart  and arteries, and even in-
tense pain follow profuse  discharges  of blood from  accidental
causes, and are equally liable to succeed the intentional  abstrac-
tion of it.   While the pain and difficulty of  breathing continue,
the  pulse  being quick, the skin  hot and  dry,  and  the strength
good, bleeding, to a greater or less extent, will be proper.   In the
second stage of the disease, or after the recuperative efforts of the
system begin to manifest themselves,  the loss  of blood will sel-
dom be required or justifiable.  When the system is  somewhat
reduced  by depletion,  leeching over  the seat of the pain  will be
preferable to bleeding from the arm.
   The blood in peripneumony as in  pleurisy is  buffed,  and when
drawn in a full stream  into a bowl, is cupped.  This appearance
of the  blood has been considered a criterion as to  the necessity of
repeating the operation, and  the  quantity to be drawn, but as it
may exist when the system  is sufficiently reduced, a  safe judg-
ment cannot be formed by  it.
   The most powerful auxiliary to bleeding is  the tartar emetic.
This medicine evacuates the stomach and bowels, promotes  pers-
piration and expectoration, equalizes the  circulation and favors
absorption, and thus unloads the engorged  vessels of the lungs.
Sixteen  grains of tartar emetic  may  be dissolved  in  a pint of
boiling water, and a table-spoonful be  given for the first dose.  It
should be  repeated  every  hour, adding a table-spoonful  to  each
successive  dose until it produces sickness at the stomach.  After
the effect of the medicine  has  been  once produced, and  particu-
larly if there have been vomiting and  purging, it will not be proper
to repeat it oftener  than every two  hours, and  the dose  may be
diminished for a few hours,  when it will  require to be again in-
creased.   After the stomach becomes accustomed to the action of
it, very large  quantities will be borne without nausea.   Six or
eight times the quantity it would require to produce vomiting at
first, will have no apparent effect  after using  it a day or  two.
This medicine should  be continued  through  the  whole course of
the disease, except there be great prostration or a tendency in the
disease to  assume the typhoid type.  Ten  grains  of  nitrate of
potash either in solution or combined with a grain of ipecac in a
powder, and administered alternately with the tartar emetic, is a
valuable remedy, and perfectly compatible with  the use of the an-
timony.  It is often given in solution with the  tartar emetic, and
the only objection to this mode of administering it, is  the neces- 
448
PER.
sity of varying so frequently the dose in order to obtain the de-
sired effects of this medicine.
   Durino- the first stage of  the disease, mustard poultices or hot
stoups should be constantly applied over the affected part, but
when the system has  been sufficiently depleted by bleeding, a
large blister should  be applied, and a discharge from it  be pro-
moted by a poultice or some suitable ointment.
   Should the bowels not be moved by the tartar emetic, a brisk
cathartic should be given, and its operations promoted  by injec-
tions if necessary.  In the second stage of  the  disease, after the
inflammation has been in a measure subdued, the syrup of squills
combined with the wine of antimony or ipecac will be an appro-
priate medicine.  During the continuance of the active  stage of
the fever, opium can seldom  be given with advantage; but if the
pain should  continue severe after  sufficient depletion, and the
head be  free from oppression, ten or twelve grains of Dover's
powders, or a quarter of a grain of morphine combined  with a
grain  of tartar emetic, will  often produce a pleasant effect.  A
dose of some anodyne  may sometimes, in the last  stage of the
complaint, be given three or  four  times  in the course of  twenty
hours ; usually, however, one or two doses are sufficient.
   Delirium, when not attended with drowsiness or stupor, is no
objection to the moderate use of anodynes when combined with
sufficient doses  of antimony.   We have witnessed cases in which
it has had a very composing  effect in a raving delirium attendant
upon this disease.  With the view of promoting expectoration in
the second and third or last stage of the complaint, lac ammoniac,
seneka root, or  the muriate of ammonia may be given instead of,
or in addition to the remedies  above prescribed, as the  circum-
stances of the case may seem to require.  Should the cough con-
tinue to be troublesome after  the fever has subsided, whatever
the condition of the lungs  may be, it should be quieted with oc-
casional small doses of opium in some of its forms, hyoscyamus,
cicuta, or lactucarium.   The lactucarium we think will often be
found a good substitute for opium, and  is not incompatible with
the use of any other medicines that might  be  necessary in the
treatment of the disease.
   Should symptoms indicating that the case is  likely to termi-
nate in gangrene, or  great prostration supervene, stimulants and
tonics must  be resorted to.   Camphor, ammonia, cayenne, wine
whey, and Hoffman's anodyne are some of the best and most
common  medicines in these cases.   These may be given  in con-
junction with the senaka root,  squills, or lac ammoniac.
   Food will not be required  while  the fever continues,  but the
system should  be supported by thin gruel, rice water and other
nourishing liquids.  The drinks should generally be warm, and 
PER.
449
those that are mucilaginous, such  as flax-seed and slippery-elm
tea, and a solution of gum arabic are the most suitable.
   Peripneumony sometimes occurs under a malignant  form, at-
tended  with typhoid symptoms, more or less marked.   In this
form  of the disease, which is called typhoid pneumonia,  the
heat  is less intense;  the pulse is small,  soft,  and  quick ;  the
tongue  is covered with  a dark brown fur,  or is naked and in-
tensely red; the matter expectorated  is often dark colored, and,
as in  gangrene of the lungs, is sometimes  fetid; and there is
great general debility.   We are inclined to the opinion  that ty-
phoid penumonia is, in the majority of cases at least, an affection,
occurring in the course of typhus fever, and  that it is caused by
the location of the fever upon the lungs, and that peripneumony,
when a primary disease, is seldom  of the typhoid character.
   In the treatment of typhoid  pneumonia  bleeding is rarely ad-
missible, and if it be practised at all, it must be with extreme
caution, small quantities of blood only being drawn at a time, and
leeching perhaps will be preferrable to opening a vein in the arm.
The  spirits  of nitre, camphor, spirits  of Mindererus, and other
remedies usually prescribed in typhus fever, should be combined
with squills, seneka root, gum ammoniacum, muriate of ammo-
nia, ipecac,  and  other expectorants, the operation of which will
not tend to  reduce the system.   Antimony is contra-indicated in
the treatment of this form of the disease, but blistering the chest
is peculiarly appropriate.   The strength requires to be supported
by nourishing liquids, and in extreme cases, wine whey and other
tonics and stimulants.
   When peripneumony degenerates into a chronic disease of the
lungs, it must be treated upon  the general principles of treating
such affections.   A combination of anodynes with expectorants ;
counter irritation  by blistering, croton oil, or tartar emetic oint-
ment ; a well regulated diet; warm clothing ; and the avoidance
of exposure to unfavorable weather, are the  means upon which
we must mainly depend.   In  those  cases  in which the cough
continues obstinate, and the pulse  quick, attended with some de-
gree of pain and soreness, the following mixture will often have
a happy effect.   Take of extract of cicuta and hoysciamus each
one scruple, pulverized gum arabic half an ounce, dissolve in five
cunces  of boiling water, and add of syrup of squills two ounces,
and wine of ipecac one ounce.   A table-spoonful of this prepara-
tion may be taken four or five times in twenty-four  hours, and
thirty drops of laudanum may be  added to a dose, taken at bed-
time, if necessary, to procure rest.  Digitalis,  bloodroot, wood
naphtha, tar-water, and the balsam of capaiva are also among the
remedies that are worthy of a trial under these circumstances.
  In regard  to the prognosis in peripneumony, it may be observed
in general terms, that the pulse  becoming slow, soft and full • the
            57 
450
PER.
respiration free and  easy;  the patient being able  to  take a full
breath without pain; the skin cool  and covered with a natural
perspiration ; the tongue becoming gradually clean and of a nat-
ural color; the thirst diminishing ;  the appetite and strength re-
turning ; the expectoration  being easy and copious, and the mat-
ter expectorated, light colored; and a return of refreshing sleep,
indicate  a favorable  termination.  On the contrary, should the
pulse become very quick and irregular ;  the respiration extremely
laborious ; the  skin  dry or covered with a profuse perspiration ;
the tongue covered with a dark  fur,  or suddenly cleaning and of
a fiery red color ; the expectoration difficult, and  the  sputa dark
colored or fetid; if there be sudden and great prostration, deliri-
um, a purple and bloated  appearance of the face, neck, and ex-
tremities, coldness of the feet, and hands, insensibility, and a start-
ing of the tendons, death may be apprehended.
   PERINEUM.—The space included between the organs of gen-
eration and the anus.
   PERIOSTEUM.—A thin, fibrous membrane which covers all
the bones except the crowns of the teeth.   When this membrane
is dry, and lifted from the bones, it  is nearly transparent.  The
use of the periosteum appears to be to furnish a medium for the
distribution of the vessels to the surface of the bones.  The in-
jury of this membrane is productive  of the most  serious conse-
quences  to the bones.
   PERITONEUM.—This is a smooth, moist membrane which
lines the cavity of the abdomen, and forms a case  for  all  the ab-
dominal  viscera or organs.  It proceeds from the diaphragm, from
the fleshy fibres of the  ribs and external lumbar fibres.  The
bowels, liver, and spleen are all  attached to it, or processes of it.
The  peritoneum is  a serous membrane, constantly  exhaling a
moist  vapor which  essentially  aids in the various motions  and
functions of the viscera of the belly and the pelvis.
   PERITONITIS—Inflammation of the peritoneum.—See In-
flammation of the peritoneum.
   PERSPIRATION.—The sweat is a secretion  by the minute
vessels of  the  skin.   It contains an acid, and several salts dis-
solved in, or combined with a large quantity of water.  Both the
acid and the salts are perceptible to the senses.  The lungs or
lights are subject to a continual transpiration of a watery vapor
like the  skin.  The  amount  of  the  insensible transpiration of a
watery vapor from both the skin and the lights, in the course of
twenty-four  hours, has  been ascertained with some accuracy to
be six pounds.   About one third of this transpiration comes from
the lungs, and the rest from the skin.  The perspiration is for
the  most part  insensible ;  when it stands  in drops, it is called
sensible  perspiration.  One of its principal uses appears to be to
cool the body or to regulate its temperature. 
PHI.
451
  PERTUSSIS—Whooping Cough—See Whooping Cough.
  PERUVIAN BARK—Cinchona  Officinalis.—The tree from
which this bark is taken, grows in  Peru.  The bark is stripped
from the trunk, branches, and roots of the tree, and dried.  There
are three kinds of it; the most common is of a light brown color;
a second species is of a yellow color; and a third of a red color.
All the three kinds have an aromatic flavor, and a bitter, astrin-
gent taste.  The yellow bark is the most bitter, but the red pro-
duces its effects in the smallest doses.  The peruvian bark shows
its power to the most advantage in the cure of the fever and ague
or intermittent fever.  It was  called cinchona after the name of
a Spanish viceroy, who  had been cured of a  fever and ague, by
it.  It certainly has more power in curing this disease than any
other remedy.  The dose of the fine powder is from ten grains to
two drachms.   The medium dose is half a drachm.  In the fever
and ague, it may be given in the dose of half a drachm, every
hour, during the intermission  of the disease, mixed with syrup,
molasses, wine, or water.  The same amount may be given either
in the form  of a tea, tincture, or extract.
   The essential nature of the peruvian bark appears to be that of
a tonic or a  medicine  which strengthens the  whole system.   It
is given in the latter stages of all fevers and in all diseases of de-
bility.  Wherever mortification is suspected or anticipated, there
is no remedy which will have more effect in arresting or prevent-
ing it than the bark.  In putrid diseases, such  as  the confluent
small pox, typhus  fever, yellow fever, dysentery, scarlet fever,
and scurvy,  the bark, or the quinine, which is the essence  of it, is
the most reliable remedy which we possess.  It is seldom given
in acute  inflammations, but in chronic  inflammations, it is often
found not  only compatible, but efficacious.  The bark  may be
given with three different intentions  at a time, as an astringent,
tonic, or as  an anti-septic.  These several effects are all produced
at the same  time.
  It exerts great power  in the cure of many periodical pains, in-
flammations, hemorrhages, spasms^and coughs.  Wherever a dis-
ease has  intermissions,  the  bark has been given, and almost al-
ways with good effect.   It is now almost  entirely superseded by
the quinine, a salt which has been extracted from it, by a chemi-
cal process.   See Quinine.
   PHARYNX—The mouth of the meat-pipe.—It is shaped like
a funnel; receives the  masticated food, and  conveys it into the
oesophagus.
   PHIMOSIS.—A constriction of the end of the foreskin, which
confines  it over the glands.   It is the consequence of inflamma-
tion and thickening of the part.   The remedies arc warm fo-
mentations,  poultices,  cooling lotions, leeches, salves, mercurial
washes and  ointments,  and  in the  worst cases, division  of the 
452
PIL.
 foreskin by the knife, or scissors.   It commonly proceeds from
 chancres  which, in their progress, produce swelling and thicken-
 ing  of the  prepuce.  In most cases, the ulcers beneath may be
 healed by warm water, and solutions of sugar of lead, white  vit-
 riol  blue vitriol, corrosive sublimate,  or alum, thrown between
 the glands and the prepuce, with a syringe.
   Paraphimois is a retraction of the prepuce over the glands, which
 binds it like a cord, and, sometimes, produces mortification. The
 remedies are the same as for phimosis.   The great object in both
 cases, is to  subdue  the inflammation, reduce the swelling,  and
 soften the skin.
   PHLEGM—Mucus.—In case of inflammation or irritation,  the
 mucous membranes, especially the mucous  membrane of  the
 lungs and throat, secrete a thick and tenacious  mucus, which is
 commonly called phlegm.
   PHLEGMASIA LACTEA—White-leg, Milk-leg.—A peculiar
 kind of swelling, which takes place in  one or both legs of women
 after their confinement.   See Swelled Leg.
   PHLEGMASIJE—Inflammations.—The principal characteris-
 tics  of inflammations  or  phlegmasia?,  are heat, topical  pain,
 redness, swelling, and soreness to the touch.  In most inflamma-
 tions, the blood, after being drawn, exhibits a buffy,  sizy coat.
   PHLEGMON.—A boil, or any bright  red pointed  tumor, with
 a throbbing pain, and tendency to suppuration.
   PHOSPHATE OF IRON—Phosphas Ferri—This prepara-
 tion of iron may be  obtained by mixing the separate  solutions of
 green vitriol or sulphate of iron, and the  phosphate of soda. The
 phosphate of iron will fall  down in the  form of a blue powder,
 which, when well washed and filtered, is the medicine in question.
 Exposed to  successive showers  of water,  the  blue  powder is
 changed to a yellow color, and becomes a milder medicine.
   The dose  of the  blue phosphate of iron is  from  eight to ten
 grains ;  of the yellow, from thirty to forty.
   This form of iron is though^Jp be peculiarly efficacious in sup-
 pressed and difficult menstruation, attended with disorder of  the
 stomach and digestive powers.  In scrofula, dysentery, obstinate
 diseases of the skin, and chronic  rheumatism, it has  been given
 with success-  It is  a valuable chalybeate.   It may be taken in
the form of a pill or powder.
   PHRENITIS—Inflammation of the Brain.  See Brain Fever.
   PHTHISIS  PULMONALIS—Consumption—See  Consump-
 tion.
   PILES—Hemorrhois, or Hemorrhoids.—In the whole  cata-
logue of diseases there  is  scarcely one which occasions  more
trouble and misery than the piles, although,  in general, it is not
a dangerous complaint.
   The piles are small tumors which arise in and about the lower 
PIL.                         453
end of the bowels.  Tn some instances, they are within the verge
of the anus, and, in others, without it.  The first are called the
inward piles ;  and the second,  the outward piles.
  Some of these little tumors bleed, at every motion of the bow-
els ;  and others are  attended with  no discharge,  hence, the dis-
tinction, into bleeding piles and blind piles.
  These tumors  are, in  some instances, separate, round,  and
prominent; and, in others, consist  of one large circular bunch.
  In most cases of the piles, there  is extreme pain, and often se-
vere anguish, in every motion  of the bowels.  The first notice,
which the patient will have of their existence, will generally be
a sense of weight in the back and lower region of the belly, sick-
ness at the stomach, headache  and vertigo,  wind in the bowels,
and, perhaps, a discharge  of blood  with the feces.  If the tumors
break  and discharge  their contents, relief soon  follows,  until a
new crop arises ;  but where they continue tumid and  unbroken
for some time, there will  be great  torment at every discharge of
the bowels.
  The piles are the consequence of costiveness,  intemperance in
eating and drinking, the pressure of  the uterus upon the rectum
in child-bearing, strong purgatives, fullness  of blood, and an in-
active, sedentary life.   They are sometimes  attended with severe
inflammation, pain, suppuration, and discharge of matter.  When
this is the case, there is danger of  the formation  of fistulous ul-
cers.   What is said by authors about  their being, in some cases,
a vicarious discharge, or salutary evacuation, is  a  questionable
opinion.   The same  may be said  with  equal propriety of a boil,
or a carbuncle, or any other tumor attended  with a discharge.
  The bleeding piles produce a paleness of the skin, and a weak-
ness of the whole system.  If a falling of the gut happens at the
same time, the exhaustion of  the  strength and the weakness of
the part, often require the utmost skill of the medical attendant.
  Domestic Remedies.—The  first thing  to be  secured, in  the
treatment, is a proper manner of living.   As the  seat of the dis-
ease is either in or near the bowels, and  as costiveness  always
aggravates the complaint, if it  does not invariably produce it, the
food should be of a laxative nature, such as  indian bread, brown
bread, rye pudding, coarse wheat bread, potatoes, ripe fruit, buck-
wheat cakes, pudding and milk, milk  porridge, broths, and in
general, a nutritious vegetable diet.   Those who have not self-
command enough to regulate their bowels by a proper diet, will
be compelled to take medicine.
  The best  medicine which we have ever used for the cure of
the piles, is the lenitive electuary, taken, every day, in sufficient
quantity to move the bowels, once or twice.   The bulk of a nut-
meg will, in general, accomplish this purpose.   If the piles are 
454
PIN.
 outward, they are  to  be anointed, at the same time, with Tur-
 ner's cerate, calamine ointment.
   Another good laxative is the cream of tartar, in the dose of a
 heaping tea-spoonful, mixed with water, molasses, or syrup.
   The butternut pills are  a mild physic and very proper in this
 complaint.  All strong, drastic purgatives are to be avoided. Cas-
 tor oil in small doses is admissible.   Pills made of the  extract of
 thoroughwort will cure the inward piles.   In cases of severe pain
 and inflammation, warm,  emollient  washes  and poultices, and
 injections will be necessary.
   If fever attends the inflammation,  it will  be useful  to  raise a
 sweat, by small doses of ipecac, lobelia, or antimony, or any other
 sweating  medicine.   In case of prolapsus, washes made of a de-
 coction of galls, or oak bark, may be used.
   Professional Remedies.—It is seldom, if ever, that  blood-let-
 ting is required by the lancet, but leeches are often of the most
 essential service.  Weak solutions of white vitriol or sugar of lead
 may also  be  used.   The  displaced  part must  be  carefully  re-
 turned, every time it comes down, and a recumbent position  ob-
 served while  the accident lasts.
   In obstinate cases  of the piles, it has been found  advisable to
 extirpate  them, either, by  ligature, or the knife; and in many
 cases, the practice has been successful.
   In cases of severe  hemorrhage, astringent  injections must be
 used ; and the constitution braced by the  use of iron, quinine,
 and the elixir vitriol.   In general, the diet should be cooling and
 nutritious, and everything avoided which tends to heat  the blood,
v and aggravate the humors.
   PILLS.—As most medicines have a nauseous and disagreeable
 taste, the  best way to conceal it, is to make them into pills.  In
 order to make powdered substances into pills, it is only necessary
 to mix them with molasses, quince, or some other syrup, or with
 the mucilage of gum arabic.  Aloes, myrrh, and other resinous
 substances may be reduced to a fine powder, and mixed with the
 mucilage of gum arabic.   Extracts are often of the right  consis-
 tence for pills without any  addition.
   Dry, fine powders require  some adhesive, sticky fluid to form
 them into a soft mass that  will bear being rolled into pills.
   Gums  and  inspissated juices that require softening, may  be
 moistened with new  rum or alcohol.  In general,  the mucilage
 or solution of  gum  arabic in hot water, is the best substance to
 mix pills  with.  Medicines operate more powerfully in the form
 of pill  than in any other way.  In some cases, this is  desirable ;
 and in others, to be avoided.   Ipecac, given in powder, will ope-
 rate as an emetic : given in pill, it will operate, as a cathartic,  and
 so with many  other  substances.   A pill should be made hard
 enough to retain its globular form after it is rolled up.
t 
PLA.
455
  PINK ROOT—Spigelia Marilandica—This plant grows  in
the southern states.  It is used  principally in the expulsion of
worms.  The roots  are the most medicinal, although the whole
plant  possesses the same properties.   A dose of the powdered
pink root is from ten to fifteen grains.  It is the most commonly
given in the form of a tea or infusion, mixed with an equal quan-
tity of senna.   Half an ounce of the pink may be mixed with an
equal quantity of senna, stepped in half a pint of water, and taken,
at three different times, in the course of the day.   For  children,
half the quantity of each will be sufficient to take, in one day.
   PIPERIN.—This substance is obtained from black pepper by
digestion in alcohol, and evaporating the tincture.   The first pro-
duct  is a fatty, resinous matter, which, after being washed thor-
oughly in boiling water, is dissolved again in alcohol by the  aid
of heat.  This solution,  after  standing for  some days,  throws
down a multitude of crystals.   This crystalline matter is piperin.
It possesses the same peppery taste with the substance from which
it is obtained.  In its pure state, it is of a white color, and trans-
parent, but is often combined with a resin, which gives it a yel-
lowish color.  It is without smell, readily melts  by heat, and is
slightly soluble in hot water.
   A dose of the piperin is two  grains in powder or pill.   It may
be mixed  with jelly, syrup, or molasses.   The  only disease in
which it has been  much used  is the fever and ague or intermit-
tent fever.  Two  grains  are given, every hour or two, between
the  fits of the fever.  Its  action seems to consist in exciting
warmth, and a perspiration.  It will doubtless be found of service
in chronic rheumatism, catarrh, and chlorosis.
   PLACENTA—Afterbirth.—See Afterbirth.
   PLAGUE.—The  plague is  a disease which, in its symptoms,
bears about the same relation to typhus  fever, which the Asiatic
cholera bears to the common cholera morbus of our climate. The
plague is an entire stranger to our country, and we believe to the
western continent.   It has  once or twice prevailed in  London
and the cities on the continent of Europe, but not in latter years.
In 1665, it carried off 60,000 people.
   The symptoms which the  disease  betrayed in 1665, in Lon-
don,  are the same  which  now accompanies the disorder in the
 Barbery States, Egypt, and the cities of the Turkish Empire.   In
 Egypt and the adjacent countries, the plague is an annual  epi-
demy.  The ancient Grecian historians take notice of  this dis-
ease  and define its character and symptoms very much  as they
are defined by the latest writers upon  the subject.  They relate
that  the air of the city of Athens became so putrid and pestilent
that  the dogs sickened and died in the  street.  Its destructiveness,
when it travels  north, appears to  be  much greater than when
confined to the countries in which it annually originates. 
456
PLA.
   The following is a description of its symptoms, as it appeared
in Morocco, some years ago, given by Dr. Jackson, an English
physician, who had the charge of the medical department of the
army stationed there.   " The symptoms of this plague," says he,
" varied in different patients : the variety of age, and constitution,
gave it a like  variety of appearances  and character.  In some
it  manifested  itself by a sudden and  violent shivering, and  in
others by a sudden  delirium, succeeded by great and unquencha-
ble thirst.   Cold water was  eagerly resorted to by the unwary,
and  proved fatal to those who  indulged in its momentary relief.
Some had one, two or more buboes which formed and  became,
in the course of a day, as large as a walnut; others had a similar
number of carbuncles or black boils; others had both buboes and
black boils, which generally appeared in the groin, under the arm,
or near the breast.   Those who were affected with shivering, but
who had no red swellings in the groins, black boils or red purple
pimples on the skin, were invariably cut off in less than twenty-
four hours;  and the body of  the deceased became quickly putri-
fied, so  that it was indispensably  necessary to bury it  in a few
hours after death."   The  European merchants  shut themselves
up in their respective houses as is the practice in the Levant.
" I did not," says  Dr. Jackson, " take this precaution,  but  rode
out occasionally to  take exercise,  on  horseback.  My  daily ob-
servation convinced me the epidemy was not caught by approach,
unless that  approach  was  accompanied by an  inhaling of the
breath or by touching the infected person."
  The symptoms of the plague may be summed up as follows:
a slight indisposition for a few days, such as weakness, headache,
and loss of appetite.  The patient is then seized with alternate
sensations of cold and heat; despondency; trembling of the limbs;
fainting; dizziness  and delirium; the pulse weak and  irregular.
As the disease advances, the breath becomes fetid, and discharges
of black bile take place from the stomach.  Black boils arise in the
groins, in the  neck, under  the arms, and about the breasts ; and
red or purple  pimples or spots  over the whole  body.   Passive
bleeding takes place from the nose and  mouth, and passive  diar-
rhea from the bowels.   The whole body assumes a putrid appear-
ance.
  The appearance  of the carbuncles or black boils and buboes
is commonly hailed as a favorable symptom, though where the
black boils do not suppurate but assume a putrid, livid hue, the
case  proves fatal.  In some  instances, people have been known
to drop down dead,  of this disease without a moment's warning ;
but more commonly it lasts five or six days, and in some cases
will run to thirteen  and seventeen days.
  The following graphic picture will give the  reader a more
complete idea  of the appearances of this pestilential disease.  "As 
PLA.
457
 I approached the beach, says the writer, to examine the sick and
 suspected Major transport in Egypt, the first object that presented
 itself was a young woman, named Francisca Kennis, supported
 in a chair, moaning under  the oppressive disease.  She stared
 wildly 'about, quite insensible to  every object  around her, and
 there was a muddy glistening in her eyes, which I had seen de-
 scribed, but had never seen.  Her  husband stood over her in the
 deepest distress and held a lovely infant to her breast, who  tran-
 quilly sucked  the poison that soon after destroyed it.   I feared
 at first that  force  would have been necessary  to separate the
 father from his wife and  child,  but  he  at  length  yielded  to
 entreaty, and was removed  from the infection, though too late to
 save his  life.   She  was soon after  conveyed to the pest hospital,
 where she soon expired, and the child was confided to an Arab,
 who fed and watched over it with the greatest care.   On the  28th
 of March, the fifteenth day after the separation took place, the
 infant was attacked  with the plague, and languished until the 4th
 of April, when death terminated its sufferings."
   As this disease has never made its appearance  in our country,
 we can only give a history of the treatment which  has been fol-
 lowed in those places where it has prevailed. In its earliest stages,
 blood-letting  appears to be  the most favorite  remedy, but more
 lately, blood-letting  is recommended by leeching  and cupping
 rather than  from the arm.  In the commencement of the disease
 while it is yet only an indisposition, an emetic of ipecac is given
 to evacuate the stomach and  to excite a general sweat.  Where
 retching continues after the operation of the emetic, effervescing
 draughts should be given with ten  or fifteen drops of laudanum.
 The  evacuation of the stomach should be followed by that of the
 bowels, after the stomach has been refreshed with  a little gruel,
 arrow root,  or water.  A dose of castor oil,  salts, magnesia or any
 other  gentle  cathartic  may be  used.   Strong  purgatives  are
 deemed injurious.   In the advanced stage of the plague, the bow-
 els should he moved by injections solely.
   There is a pretty general  agreement among writers upon, the
 plague, that the excitement  of a gentle sweat is one of the most
 desirable ends to be obtained, by  the use  of  remedies.   Small
 doses of antimony and ipecac, at intervals of one or two hours, or
 a few grains of the Dover's powder are the sudorifics most in  use,
 and the most  to be depended upon.  Camphor, ammonia,  and
 effervescing draughts are also given to support the strength,  and
 to favor the relaxation of the skin.  Blisters  are applied to re-
 lieve  the head and  stomach, or any other  organ  which may be
 particularly  affected.  Acid drinks are given to quench the thirst
and to neutralize the contagion.  Fomentations and  poultices are
applied to the stomach, bowels, or the feet, as the  case may re-
quire, and wine administered to sustain the strength, where it
            58 
458
PLA.
does not increase the fever.   Whenever a remission of the fever
takes place, the quinine is administered  freely, together with the
elixir vitriol and the vegetable acids.  Opiates are given  in any
sta°-e of the fever where they do not enrage the pestilence. Spong-
ing the body with cold water is a remedy much in use.
   The olive or any  other oil rubbed into the skin, is said to be
a protection against the contagion.  All communication which is
not absolutely necessary, should be prohibited between the sick
of this disease and the well.   It is very contagious, although the
contagion is not carried in the air to any great distance.  Contact
is pretty sure to produce  it.   Whether it originates in the first
instance from the earth, or whether  it is generated in the human
body, is a problem which has never been solved.
   PLAITED HAIR—Plica Pilonica.—This disease seems to
prevail  chiefly in  the north  of  Europe.   It is  an  affection
of the hair itself.  The hairs  become  greatly enlarged in their
diameters,  and are covered with  a kind  of slime  which mats
and  entangles them fast together.   The hair lays in folds and
plaits, and grows to much greater length than  common.   The
affection comes on with more or less symptoms of fever, there is
usually lassitude and heaviness; pain in the head and bones, and
an increase of heat, but these symptoms are  all said to subside as
soon as the affection of the hair commences.   The head contracts
.a fetid smell, and the hair becomes almost  inseparable from the
quantity of gummy matter which oozes from it.  The  nails of
the fingers undergo a similar affection, communicated  to them by
scratching the diseased hair.   They thicken, change  their color,
and  become corrugated.  Baron  Larrey found that  the disease
was produced by nastiness, cold, and negligence ; and that it was
not contagious.
   The disease is said to  be cured by antimony.   When feverish
symptoms exist, the medicines  used in fever, will be proper in
this disease.  The hair should be cut close  to the head, and the
scalp well washed with  warm  water and soap.   If there is heat
and soreness in the scalp, weak solutions  of corrosive sublimate,
of sugar  of lead,  or of  the  white vitriol, will  be proper.  The
Turner's cerate  and the citrine ointment are appropriate reme-
dies.  It is not a dangerous disease, although when not cured in
the early stage, it frequently lasts for life.   If the gummy matter
happens to lodge upon the surface of the body, it is said to pro-
 duce obstinate sores.
   PLASTERS.—In making plasters, the oily and resinous sub-
 stances are to be melted  with  a gentle heat, and then constantly
 stirred, adding at  the same time, the dry ingredients, if there be
 any, until the mixture,  on  cooling, becomes stiff.   Plasters are
 made hard by white lead and other metalic oxides.  See Diachy-
 lon Plaster, and Adhesive Plaster. 
PLE.
459
  PLASTER OF  SPANISH  FLIES—Take of mutton suet,
yellow wax, resin of pine, Spanish flies, finely powdered and sifted,
each equal parts.   Melt the suet, wax, and resin together over a
slow fire, and then add the powdered flies.  The flies should not
be added while the mixture is  very hot.   This is the common
blistering plaster.  It requires about twelve hours to draw a full
blister ; the blister is  then cut, and the tender surface dressed
with mutton suet or simple cerate.
  PLEURA.—The membrane which lines the inside of the chest
and covers its viscera..   A moist vapor is constantly exhaled from
this membrane which lubricates the surface of the lungs and inside
of the chest. A duplicature of the pleura forms the mediastinum or
partition which runs through the middle of the chest.   The two
folds, which form this partition, enclose the heart.   It is the seat
of the disease, called the pleurisy.
  PLEURISY—Pleuritis—Inflammation of the Pleura.—Pleurisy
is an inflammation of the membrane called the pleura, which lines
the chest  and invests the lungs, and in  its  active form  is one
of  the most violent diseases to which  man is liable.  It  is char-
acterized  by cold chills, followed by acute, lancinating  pain  in
one side of the chest, which is increased  by coughing,  and by
inspiration, by lying on the affected side, and sometimes by pres-
sure.  The cough, which is a constant symptom, is  short, dry,
and distressing.   If anything is expectorated, it is only a frothy
mucus, occasionally intermixed with a little blood; the  inspira-
tions are frequent, and are voluntarily shortened to prevent the
pain occasioned  by expanding the chest; the tongue is  coated;
the pulse quick and hard ; the skin is hot, and the cheeks flushed;
there is thirst, restlessness, and anxiety; the urine is scanty and
high colored.  There is  a dullness of sound on percussion, and
on auscultation the inspirations sound feeble, distinct, or are in-
audible.   The blood,  on being drawn, is cupped and buffy.
   Remedies.—In the treatment of pleurisy, the first and decidedly
most  important thing to be done, is to bleed copiously from the
 arm ; for without bleeding whatever else may be done, we cannot
 rationally expect success to attend our efforts.   The blood should
 be drawn, as early as possible after the nature of the disease is as-
 certained, from a large orifice, in sufficient quantity to relieve the
 pain and difficulty of breathing ; and should the pain return, the
 operation should  be  repeated until the inflammation is subdued.
 It  is  well known that  some  irregular  practitioners condemn
 bleeding,  and pretend  to  cure this  and all other diseases by
 other means, but we  have the experience and testimony of the
 most celebrated physicians of all ages and countries to oppose to
 their ultra and generally unphilosophical systems.  Undoubtedly
 many affections of the chest, some of which simulate,  pleurisy,
 may,  and have  been  cured  without it,  but  we  consider if 
460
PLE.
 a duty incumbent  on us to warn  those  who  may be  attacked
 with this  disease in its true form, against the danger of rashly
 trusting, exclusively, to any other remedies whatever.
   Frequently bathing the extremities in  hot stimulating baths,
 and hot poultices, or fomentations to the side, contribute much to
 the comfort of the patient,  and by calling the blood into the ex-
 treme vessels, and  thereby  diminishing the  quantity at the seat
 of the disease, are powerful  auxiliaries in bringing the inflamma-
 tion to a favorable termination.  The most efficient  medicine
 employed in the treatment of pleurisy, and indeed almost the only
 one that is necessary in  many cases, is the tartar  emetic.  The
 best form is that of solution in hot water.   It should be given in
 doses large enough to produce nausea, and be repeated every two
 or three  hours, according to its effects  upon the stomach.   Anti-
 mony is a medicine of which the stomach  will  bear more and
 more, the longer it has been taken, and it is necessary, therefore,
 that the dose be increased in proportion as the stomach  becomes
 accustomed to its action.   If this medicine cannot be obtained,
 or if there be any reasonable objection to  its use, lobelia and ip-
 ecac are the best substitutes.  If  these medicines should not op-
 erate upon the bowels, an active cathartic should be administered.
 After the system has been thoroughly depleted, should the disease
 prove obstinate, a large  blister  applied over the seat of  the pain
 should be tried;  a full dose  of Dover's powder every six or eight
 hours, will sometimes produce the best effects.   As in other dis-
 eases, in which the lungs are in any way implicated, the drinks,
 should be warm and dem'ulcent.
   When successfully treated, the violence of the symptoms will
 be almost immediately mitigated, and the disease, perhaps, arrest-
 ed at once, though  it more frequently happens that the improve-
 ment is more or less rapid from day to day until about  the sev-
 enth or eighth, when a perfect crisis is formed, as in other inflam-
 mations.
   But, if no efficient means be  used  to arrest its progress, it may
 terminate fatally in from two to seven days, according to the vio-
 lence of the attack.  Dissections have  shown that inflammation
 of the pleura, to a greater or less extent, is not an uncommon oc-
 currence in children, though often unsuspected by the physician
 or friends; and that adhesions are  frequently formed  between
 that portion of the membrane  which  envelopes the lungs and
 that which lines the  walls  of the chest.  These  adhesions are
 not dangerous, and no doubt exist in  many who have no suspi-
 cion of the nature of. their disease.   By preventing the  free and
 easy expansion and contraction of the lungs, they may be the
 cause of some degree of shortness of breath and pain, when tak-
 ing violent exercise.   When pleurisy  becomes chronic, that is,
continues on after the active stage of the inflammation has passed, 
POL
461
 it commonly terminates in an effusion of serum, or of purulent
 matter into  the cavity of the thorax, and the  disease is called
 empyema; or, if the parenchyma or substance of the lungs  be
 implicated, it may degenerate into consumption.  Cold chills occur-
 ing a number of days after the attack, vague pains in the side, diffi-
 cult breathing, dry  cough, irregular febrile symptoms, and the
 pulse continuing quick, small and wiery, are strong indications of
 an effusion.  (See Empyema.)   A subsidence of the pain, the
 breathing becoming  free and easy, the pulse slow,  the skin cool
 and moist, and a return of the appetite, are almost sure signs of a
 perfect  recovery, but the reverse of these symptoms forebodes
 danger.
  PLICA PILONICA—Plaited  Hair.  See Plaited Hair.
  PODOGRA—The Gout.   See Gout.
  POISONS.—Those substances, which, when introduced into
 the system whether through the  mouth or skin, produce deleteri-
 ous, dangerous, or fatal  effects.
  Poisonous  substances  exist in each of the three  kingdoms of
 nature,  the animal, vegetable, and mineral.
  Those belonging to the animal kingdom are called venoms, as the
 venom of various reptiles and spiders ;  and virus, or the poisonous
 matter produced by disease, as the virus of small pox.  Whether
 the  poison  introduced  into  the system  in  dissection wounds,
 sometimes producing the  most serious effects, is  the production
 of disease, or is generated  by the  decomposition  of animal matter,
 has not been satisfactorily determined, but probably the latter, as
 no symptoms of the  disease of which the  subject died, are pro-
 duced.  The  effects  produced by the  bite of rabid animals are
 caused by a virus generated by a peeuliar disease.
  The vegetable poisons  are very numerous, so much so indeed
 that only a small proportion of  them can be treated of in this
 article :  this, however, is a matter of  little regret, as the effects
 of most, if not all of them, are,  and must, in the present state of
 our knowledge, be treated according to the same general princi-
 ples.
  The number of poisonous  substances in the mineral kingdom
 is also very great, and the time will undoubtedly arrive when,
 through the aid of chemical science, antidotes will be found for
all of them, but at present there are  many for  which no antidotes
 are  known.
  Poisons have been differently arranged or classified, by dif-
ferent authors, according to their  mode of action,  some pro-
ducing irritating or corrosive  effects, some narcotic, some putres-
cent, and  others, various combinations of these effects.  These
classifications  are all liable to objections,  as they bring together
substances, the physiological action of which on the  system is
very different, and which  must therefore  require very considera- 
462
POL
 ble modifications of treatment.  Without regard to classification,
 we shall briefly lay down a few rules or principles applicable to
 the treatment of poisons in general, and then particularize a few
 of those that are most frequently taken or administered to destroy
 life, or are liable to be taken accidentally.
   In the treatment for poisons that have been swallowed, there
 are three indications to be fulfilled : the  first, is to remove the
 poisonous substance, or as much of it as is practicable, from the
 stomach ; the  second, to  neutralize, and  prevent  the  injurious
 effects of what remains in the stomach ; and the third, to obviate
 the effects which may have been produced  upon any particular
 organ, or the system  generally.
  The first of these indications is to be fulfilled by the use of prompt
 and powerful emetics, or the stomach pump.  The sooner active
 vomiting can be induced after the poison has been swallowed, the
 greater will be  the chance of preventing its baneful effects.  As a
 general rule those emetics which  operate the quickest are to be pre-
 ferred, avoiding of course  those that would  themselves  produce
 poisonous effects if not ejected.  The best emetics are ipecac, tartar
 emetic, white vitriol, alum, blue vitriol, lobelia,  and  thorough-
 wort.   Ipecac should always be preferred, and its action may be
 hastened  by combining it with  white vitriol, when not contra-
 indicated.  The lobelia and thoroughwort being  slower and less
 certain  in their operation, should be used  only when  there is no
 other at hand.  When an  emetic cannot  be obtained, vomiting
 may be produced  by passing  the  finger or some  irritating sub-
 stance  down the  throat.   Half a  pint of a moderately strong
 solution of  saleratus  or  pearlashes, followed  immediately by as
 much vinegar,  has been known  to produce violent vomiting, and
 in a case of poisoning by opium  or any other narcotic, should be
 tried.   When  emetics are not at hand, or do not  operate, or if
 the patient  be  incapable of swallowing, or obstinately refuse  to
 do so, the stomach pump is the only resource.  With this instru-
 ment the  stomach may be emptied, and any medicine  introduced
 that the case may require, and pumped out again if necessary.
  The second  indication is to be fulfilled by the  employment of
 those substances or antidotes which are known to neutralize  the
 particular poison,  and thereby render it inert; and if no antidote
be known, by such substances as will  combine with it  and shield
 the stomach from its action.
  All acids are neutralized by  the alkalies, such as magnesia,
saleratus,  pearlashes, ley, the super carbonate of soda, lime, chalk,
 and ammonia;  and the alkalies  by the acids, such as vinegar or
 lemon  juice ; and acrid or corrosive poisons,  as arsenic, corrosive
 sublimate, and  blue vitriol, are rendered less active, and their in-
jurious  effects  in some degree  prevented, by albuminous, oily,
and sweet mucilaginous drinks.   The whites of  eggs, milk,  the 
POI.
463
mucilages  of slippery elm, flaxseed, Irish moss, and sugar and
water, are  the most appropriate.
   The fulfilment  of the  third indication will depend  entirely
upon the nature of the  poison taken.  If inflammation and fever
have been induced, leeching, blistering, cold applications, cooling
cathartics and  antimony may be indicated ;  if narcotism, stupor
or insensibility, cold  applications  to  the  head, stimulants to the
extremities,  blisters,  frictions,  internal excitants, strong coffee,
vinegar and water ; if debility or  great prostration, wine, ammo-
nia, quinine, and nutritious liquids.
   Having  premised these general observations, which will be
found applicable to the great proportion of instances,  in order
to avoid repetition, in particularizing some of the most  common
poisons, only some of the peculiarities, with the antidotes, when
known, will  be noticed, leaving  the  application of the general
principles to  the judgment of the  reader.
   Arsenic.—Perhaps there is no poison that has been  taken or
administered with the intention of producing death, as frequently
as arsenic.   This is a corrosive poison of the most deadly char-
acter, for which no antidote has been known until very recently.
Why it has so often been selected for this purpose can hardly be
conceived, except  on account  of its certainty  to produce the
effect, as there is probably no one in the whole catalogue, that
causes a more distressing and awful death.  Violent burning pain
in the stomach and bowels, dryness and  tightness in the throat,
unquenchable  thirst, retching,  vomiting  of bilious and bloody
matter, tenesmus, scalding pain in voiding  and  sometimes sup-
pression of the urine, hoarseness,  and difficulty of speech, con-
vulsions, cramps, lividity of the  extremities,  hiccup, death-like
countenance, clammy sweats, red, sparkling eyes, and  delirium,
are the symptoms usually produced by it,  and death soon follows
in the train.   It has, very recently only, been ascertained that the
hydrated peroxide of iron is an antidote to arsenic.  The precipita-
ted carbonate and prepared red rust of iron are also recommended
•for the same purpose, but the first is to be preferred if it can be pro-
cured. It is given in doses of half a drachm to a drachm, every ten
minutes, diffused in water, until relief is obtained.  If Fowler's solu
tion of arsenic  have been taken instead of the white arsenic, lime
water, in copious draughts, may lessen its potency.   For the fly
powder and some other preparations, and even the white arsenic,
if vomiting  have not commenced, emetics  of white vitriol are
advised to  be given immediately.   The pains and cramps  may
be relieved by counter irritation with mustard  poultices, blisters,
opium, and  mucilaginous drinks.   Symptoms of inflammation
must be treated upon general  principles.   Large doses of mag-
nesia, lime water, chalk  and water, and  charcoal, are the reme-
dies that have generally been used, and by some are supposed to 
464
POI.
 be antidotes ; when the preparations of iron cannot be procured,
 these should be tried, but cannot be depended upon.  Hahneman
 recommended a pound of soap to be dissolved in four pints of
 warm water, and a cupful to be given every three or four minutes.
 This remedy has  the  advantage of being always at hand, and
 should be resorted to when nothing else can be done.
   The tests by which the existence of arsenic can be ascertained
 in the contents of the stomach, are the ammoniacal sulphate  of
 copper, the  ammoniacal nitrate of silver, and the sulphuretted
 hydrogen gas.   The first  will produce a green, the second a pale
 yellow, and the last a bright yellow precipitate,  if arsenic be
 present.  A  portion of one of these precipitates well dried, is then
 to be mixed with  charcoal and exsiccated carbonate of  soda put
 into a small glass tube, closed  at  one end, and  heated to a red
 heat in the flame of  a lamp.   "  The arsenic will be reduced and
 sublime  in the upper part of the tube, forming a dark metallic
 crust.  By heating this crust in a small flame, crystals of white
 arsenic will  form, having a high adamantine lustre."
   Corrosive Sublimate.—This preparation, the Red Precipitate,
 and several  other  preparations of  mercury, when  taken in over
 doses, are most  violent, irritating, and corrosive  poisons.  The
 symptoms are, a harsh,  astringent, metallic taste in the mouth, a
 tightness and burning sensation in the throat, burning pain in the
 stomach  and bowels, vomiting, purging of bloody matter, drowsi-
 ness, stupor, convulsions and  death.  The best remedies known
 are the whites of eggs, beaten up with milk or water, milk, and
 wheat flour  and water.  What is done must be done promptly or
 the remedies will  be unavailing.  Potash  produces with  corrc ^
 sive sublimate, a yellowish precipitate, ammonia, a white, lime
 water, an orange, and sulphuretted hydrogen, a black precipitate,
 There are various methods of testing this substance, but it is per*
 haps unnecessary to  describe  them here, as they would occupy
 room that might be more usefully appropriated to other matter.
  Antimony.—Some of the preparations of antimony are poison-.
 ous, in large doses.  They cause vomiting, pain in the stomach,
 colicy pains, and  violent  cramps.  The  remedies  are,  copious.
 draughts of sugar and water,  irritating  the  fauces to induce
 prompt and  free vomiting, followed by a decoction of nut-galls,
 oak bark, Peruvian bark,  or  the bark in substance diffused in
 water, as antidotes.
  The antidote to  Nitrate of Silver, lunar caustic, is common salt
in solution ;  by this it is rendered inert.
  The effects of Blue  Vitriol are best counteracted by albumen.
Vinegar is inadmissible.
  Nitrate of Bismuth is treated by milk and sweet mucilages.
  Copperas  and Muriate  of Iron.—-For these the carbonate  of
soda is the most promising remedy. 
POI.
465
   White Vitriol, sulphate of zinc and the oxide of zinc, are de-
 composed by the carbonate of soda in solution.   The vomiting
 will be relieved by large draughts of warm water.
   Tin, the same as other irritating poisons.  Milk in large quan-
 tities.
   Phosphorus.—When  this  has been   swallowed,  an emetic
 should be  immediately given, and followed by magnesia, sus-
 pended in water, and mucilaginous drinks.
   Lead, introduced into the system either by the mouth or skin,
 may produce nervous symptoms, spasms, palsy,  obstinate  con-
 stipation of the  bowels, colicy pains, rigidity of the abdominal
 muscles, sometimes salivation, giddiness, debility, torpor, coma,
 convulsions and death.   The  phosphate of soda and epsom  salts
 are antidotes to the sugar of lead.  For white lead, the red oxide
 and litharge, sulphuric acid largely diluted with water, is recom-
 mended.
   Oil of Vitriol,  Aquafortis, Muriatic Acid, and the Oxalic Acid,
 are  all violent corrosive  or escharotic poisons, when swallowed
 in their concentrated forms.  They act as powerful caustics upon
 the  parts with which they come in contact.   The  symptoms to
 which they give rise, are sour, acrid taste, burning and soreness
 in  the mouth and throat,  eructations,  intolerable pains in the
 stomach, a shrivelled  and excoriated appearance about the mouth
 and  other parts  touched by them,  glazed countenance, cold,
 clammy sweats, convulsions, death.   The nitric acid turns the
 skin yellow, and the sulphuric, black.
   For aquafortis and oxalic  acid, the  carbonates of magnesia,
 common lump magnesia, and of lime, chalk, are the only alkaline
 substances that can be employed with safety as antidotes, but for
 the oil of vitriol and  muriatic acid, the calcined magnesia, lump
 magnesia, chalk, and the carbonates of soda and potash, pearlashes,
 may be given indiscriminately.  When the oil of vitriol has been
 taken, water must  not  be drank, on  account of the  great  heat
 which is produced  by mixing  them.   Ammonia is an antidote to
 the acids.  It requires to be  largely diluted with water.  " Liquid
 chlorine has also  been found efficacious."  The matters vomited
 and the contents of the stomach  effervesce with chalk and mag-
 nesia.
   Potash,  Pearlashes, and the preparations of Ammonia, produce
 symptoms  similar to other irritating poisons, and  their action is
 counteracted by vinegar, lemon juice, the citric and tartaric acids.
   Carbonate of Barytes, and Lime, are neutralized by sulphate of
 soda, glauber's salts, and epsom  salts.   Lime is neutralized by
 the acids.
  Alcohol.   It would  be superfluous to  describe  the effects  of
 this  poison, as they are  by far  too generally known.  A smart
emetic, stimulating  injections, cold applications to the head, and
            59 
466
POI.
   if the head be very much oppressed, bleeding from the jugulai
   vein, are the best remedies.
      Prussic Acid, Hydrocyanic Acid.—This  is the most deadly
   poison known.  One drop of the pure acid would probably cause
   instantaneous death.  It is so rapidly fatal  that  its effects  have
   very seldom been  treated.  When not  instantly fatal, a sudden
   loss of sense, locked jaw, difficult and rattling  respiration, cold-
   ness of the extremities, small pulse, dilatation of the pupils and
   convulsions, are the symptoms usually observed.  There  is a
   smell of bitter  almonds proceeding from the mouth and in the
   contents of the stomach,  which  may aid in forming an opinion
   of the nature of the case.  Diluted water of ammonia  is consid-
   ered the best counter poison which can be used against this acid.
   Otherwise, its effects are to be combated according to the general
   principles  heretofore laid  down.
      Opium, though  incontestibly one of the most valuable reme-
   dial agents ever used, when judiciously employed, is nevertheless
   a powerful narcotic poison, producing certain death when taken
   in large quantities.   The manner in which it acts is peculiar, and
   not well understood, as it leaves no traces upon the system suffi-
   cient to reveal its mode of operation.  The symptoms of an over-
   dose of opium resemble those of an apoplectic fit.  The  breathing
   is slow, frequently interrupted  and  stertorious, a dark  suffusion
   often comes over the countenance, passes off, and returns again and
   again, the pulse is full, strong, and.  slow, there  is an  irresistible
   disposition to sleep, the intellect is confused, or there is complete
   insensibility ; the  sleep continues profound, the skin  at length
    becomes cool and  clammy, the extremities cold, the pulse feeble
   and thread-like, the countenance deathly, the interruptions in the
   breathing  more frequent  and longer, there is torpor and insensi-
   bility from which  the patient cannot be aroused.   The  length of
   time before death ensues, varies in  different cases, from one to
    ten or twelve hours : from four to six is the most common.   In
    cases of poisoning  by this drug,'the most powerful emetics must be
    resorted to.  The  white vitriol, ipecac, tartar emetic, blue vitriol,
    alum, saleratus and vinegar, and tickling the fauces, are among
    the  remedies to be essayed.   The  stomach pump is  peculiarly
    useful, and should be used as early as possible, before  the opium
i    has  produced its  full  effects upon  the system.  Bleeding and
    leeches are sometimes necessary.  Dashing the head and shoulders
    with cold water,  friction, keeping  the patient  in motion, and
    stimulants to the  extremities, and injections should be tried.   If
    these fail, and the patient appear to be near dying, the  breathing
    having nearly ceased, artificial respiration  should receive a trial,
    by alternately inflating and exhausting the lungs, until  the medi-
     cine has expended its force and the powers of life rally.  A case
     is recorded of a child apparently in a dying state, that was saved 
POI.
467
by this means.   We are not aware that galvanism has  ever been
proposed for the purpose of keeping up the  respiration and other
vital functions, in these cases, but it appears to us to be the most
rational and probable means, and  as  it would be  harmless, we
should strongly recommend a trial of  it.  The certain and pow-
erful effects which it has upon the  nervous and muscular system,
are witnessed daily, and it is well known to have been employed
with some success in cases of  a failure of the nervous influence
from  other causes.   It should  be  applied to the spine between
the shoulders,  and  over the abdomen and chest, to stimulate the
respiratory muscles.   When the system is somewhat  relieved
from  the  narcotic  effects, the  strength must  be supported, and
stimulants may be required.   Some of the best stimulants are
ammonia, strong coffee, and vinegar.   We  should never despair
of success as  long as the heart beats, for recoveries sometimes
take place under what appear to be the most  desperate circum-
stances.   We  witnessed a case of this kind not long  since  in a
child, that had, through the carelessness of  the mother, taken an
over-dose of Godfrey's  cordial ; and this was by no means a soli-
tary one that has occurred under our personal  observation.
   The treatment recommended for opium applies equally well to
Morphine, and all other preparations of that drug.
   The  Belladonna,  Deadly Nightshade, Cicuta, Hemlock,  Hy-
oscyamus, Henbane, and Stramonium, Apple  Peru, will serve as
examples of  the narcotic poisons generally,  the symptoms  and
treatment as far as  known at present, being  the same.  When
received into the system in too large doses,  these substances pro-
duce the following train of effects; heaviness in the head, intoxi-
cation, numbness,  sickness,  and sometimes vomiting, stupidity,
dryness  in the  throat, muttering  delirium, sometimes lively, at
others raving, convulsions  or  palsy.  The  pulse is variable, but
commonly full  and  strong, the pupils very  much dilated, the
breathing hurried, insensibility, death.  We  have witnessed a
number ef cases, occurring in children, that had eaten  green poi-.
sonous weeds,  in which the pupils  were contracted, the eyes red,
the pulse small, muttering delirium, vomiting and anxiety.   Re-
coveries took  place.  These cases are to  be  managed much in
the same manner as poisoning with opium.  No vegetable acids
should on any account  be allowed, until the stomach is thoroughly
evacuated, after which, vinegar, and strong coffee, in  a measure,
counteract the  effects  upon the system.   If the head be much
oppressed, bleeding, frictions, blisters, and stimulating injections,
will be the proper remedies.
   In  poisoning with  Colchicum, meadow  saffron,  the  most
troublesome symptom is vomiting.   This  may be allayed  with
soda powders, strong coffee, mustard poultices to the stomach, or
if the case prove obstinate, a pill of opium.  The effects of this 
468
POI.
medicine remain  two or three days in some instances.   We are
induced to notice  this article in particular, having  seen  several
troublesome cases, where the wine of colchicum had been mista-
ken for clear wine.
  Poisoning of the  skin with  Dogwood, or swamp sumach,
Common Parsnip, etc., very much resembles  erysipelas, and
requires nearly the same  treatment.  A favorite  remedy of the
late and  justly celebrated Dr. S. Drown, was the  witch-hazel,
applied as a wash in form of decoction.   A solution of sugar of
lead, and cooling  cathartics, are the remedies usually prescribed.
  Poisonous Mushrooms.—There are five varieties  of agaric, or
mushrooms, that  are poisonous, the fly, pepper, deadly, bulbous,
and the champinon.  They produce pain in the stomach,  nausea,
vomiting, purging, heat, thirst,  convulsions, faintings, small, fre-
quent pulse, dilated  pupils, delirium, stupor, cold sweats, death.
When the stomach is cleared with emetics, salts and  glysters, and
brandy and water should be administered, except inflammation
supervene, when  it must be treated as in other cases.
  Cantharides, (the  Spanish and potato fly) are exceedingly poi-
sonous when taken into the stomach.   They cause an offensive
breath, acrid taste, great heat in the throat, stomach,  and abdo-
men, pain in the  stomach, vomiting, bloody stools, painful  pria-
pism, burning pain in the bladder, strangury, retention of urine,
frightful  convulsions, delirium, and  death.   Large  draughts of
sweet oil, sugar  and water, flaxseed tea, and milk, are advised.
Inflammation of  the stomach and  bladder is to  be  subdued by
leeching, and a liniment of camphor and sweet  oil.   Camphor
internally is the best anodyne to relieve the strangury.
  The sting of  Venomous Insects, as the  tarantula, scorpion,
hornet and bee, is relieved by hartshorn and oil, salt and water,
the juice of raw onion, with hartshorn or camphor  internally.
The sting, when left, may be extracted  with a needle, sharp
pointed knife, or by pressing over it a watch key.
  Serpents.—The bite of venomous serpents is followed by pain
in the wounded  part, which extends  over  the  limb or body.
There is a hard swelling, which is  pale at  first, but soon becomes
red, livid, and gangreneous.  Fainting, vomiting, small irregular
pulse, convulsions, difficult breathing, a failure of the sight and
intellect, and cold sweats succeed.   Inflammation, extensive sup-
puration and gangrene in the wound, often precede death. When
a person is bitten by a venomous serpent,  perhaps the  surest way
to prevent its effects upon the  system is to cut  out a portion  of
the skin and  flesh around the bite, and then  to  promote the
bleeding by washing it in brook, or warm  water, if at hand.
Another  way of  treating  the wound is to wash it and  apply a
cupping glass over it to promote bleeding, and extract the poison.
Any glass, or other small vessel, from which  the air is exhausted 
POL.
469
 by a burning taper, will answer in the room of the cupping glass.
 Powerful caustics are sometimes used upon  the wound,  to pro-
 duce the death and sloughing of  the poisoned portion around it.
 A rod  of iron, heated to a white heat, and applied to the wound,
 would be the  readiest and surest  method of producing a slough.
 If nothing better can be done under the circumstances, a ligature
 may be applied around  the limb  to  stop the  circulation, the
 wound be enlarged and washed for a long time in pure water.
   Sucking  the wound is recommended by some, and  has  been
 practiced with success.   If  there be no abrasion or raw  surface
 in  the wound, and due  caution be used, this undoubtedly is a
 safe and  efficient practice.   Within a few years  past the spirit
 of hartshorn has been somewhat  extensively  tried as an antidote
 to the  poison of the rattle-snake.  It is applied to the wound and
 taken  internally.  Cases  have  been reported in which  it was
 given with  success, when the  system was under the full influ-
 ence of the venom.  Many  who are acquainted with the  virtues
 of  this medicine, and  are exposed to  these  reptiles, are  in the
 habit of always carrying it with them.  It is probably better
 entitled to confidence than any other  remedy at present known.
 Arsenic has been strongly  recommended as an antidote, and a
 number of indigenous plants have enjoyed a high reputation, but
 we are unable  to judge of their merits.  Inflammation, fever,
 debility, etc.,  arising from these bites,  must be treated  upon the
 general principles of treating these affections.   The wound from
 the bite of  a rabid animal should be treated in the same manner
 as that of a serpent.  It should  be cut out, the bleeding  promo-
 ted, and caustic applied.   For treatment of hydrophobia see Ca-
 nine Madness.
   Fish.—Stale fish often produce pain and sickness at the stom-
 ach, heat and pain  in  the  head and  eyes,  dizziness, and not
 unfrequently an eruption on the skin.   An emetic and purgative
 will be required,  after which the stomach  must be quieted, with
 super  carbonate  of  soda, soda  powder, calcined magnesia, and
 laudanum.  The  irritation of the eruption may  be  allayed  by
 bathing with  tepid water, alcohol and water, salt, or camphor,
 and vinegar.
   See  dissection wounds, on the subject of poisoning from that
 cause.
   POLYPUS.—A polypus  is a fleshy  tumor, which commonly
 grows  in the shape of a pear. Some of them are rapid in growth,
 and others, slow.  Some of them are of a scirrhous and cancerous
 nature, and others, are simply large growths of flesh.  The oftenest
 of anywhere, they make their appearance in the nose ;  sometimes,
 in the uterus and vagina.  They have  been  known  to grow so
large as to fill  the whole  nose ;  to push aside the partition be-
tween  the nostrils;  and to  prevent entirely  the passage  of the 
470
POU.
air •  the nasal bones are forced from their natural position, and a
frightful deformity is the consequence.
  Polypuses  are  commonly removed by  means  of a ligature,
which being drawn tight around the neck of the tumor, in a few
days  destroys the circulation, and  the  polypus drops off.   In
some instances where they lie within reach, they may be removed
by the knife.  It is said  that polypuses in the nose  have been
destroyed by the use of a snuff, made of equal parts of the blood-
root  finely powdered, and calomel.  Polypuses of the uterus have
been  known  to be expelled spontaneously.  The double canula
is the instrument  with which the ligature is put on.
  Practitioners  must have a care  that  they do not  mistake a
polypus for an inversion of the uterus, since these tumors  some-
times grow so large as to descend through  the vagina.
  POLYSARCIA—Fatness, Corpulency.   See Corpulency.
  POPPY—Papaver Somniferum.—The  white  poppy, which
may be  cultivated in every garden, is  an invaluable domestic
plant.  A decoction of  the poppy may be  made to answer many
of the purposes of opium itself.  In the diseases of young child-
ren,  it is far  preferable.   The leaves, stalks, and heads are  all
possessed of  the narcotic  principle.  Poultices  made  with a de-
coction of this plant, are excellent  applications  to assuage  pain,
and allay anguish in cases of  cancer, ulcers, and chronic inflam-
mations.  The  poppy  tea  may be  taken in hysterics, painful
menstruation, dysentery, diarrhea, cholera morbus, nervous head-
ache, toothache, earache, coughs,  consumption, and, in  general,
any painful disease where there is  not a high degree  of inflam-
mation and fever.
  POTASH—Potass.—This alkali is obtained from wood  ashes.
The ashes are first leached, by which the potash is dissolved in
water, or formed  into a lye.  The  lye is then  poured into iron
pots, and boiled down  or  evaporated by heat.  The potash is
left in the pots, which,  after cooling, becomes a solid mass.
  The caustic potash used to destroy proud flesh, tumors,  and ex-
crescences,  is made by taking a quantity of potash dissolved in
water, and evaporating  it in a covered clean iron vessel, until the
water is boiled away.   The potash is now about the consistence
of oil, and must  be poured  out upon a smooth, iron plate.  It
must be divided into small pieces  before  it hardens, and put up
in well stopped phials.
  POULTICE.—The  best poultice for an inflammation, or  for
any  green,  raw, angry,  or  ulcerated surface, is made of  white
bread or rye-meal, and  hot water.  It is the best, for this reason,
that, it is the  simplest and  most solvent.   Water is perfectly
evaporable, and mixes  the most readily with the humors  of the
body.  It should be made very smooth and soft, and never  cover-
ed with oil or grease, as that  forms an impervious layer  between 
✓
                           PRE.                        471

the poultice and the sore part.  A thin piece of muslin or gauze
may be laid over it, to prevent its sticking to the surface.
   The flax-seed meal poultice is preferred by many, but as that
contains an oil which chokes up the pores of the skin, like other
oils, it has never appeared to us equal to the simple bread poul-
tice.
   POWDERS.—Almost all the dried barks, roots, and leaves of
plants, are  capable of pulverization, and  may be  taken  in the
form of a powder.   Many substances lose their virtue by being
powdered, and kept for any length of time, such as fixed, alkaline
salts, aromatic plants, and volatile alkalies, such as the salts of
hartshorn, etc.   Jalap, ipecac,  lobelia, peruvian bark, cream of
tartar, calomel, aloes,  myrrh, opium, sal nitre, and a host of other
substances operate  the best in form of powder.  Tough, tenacious
substances, like  opium and camphor, require  some other coarse
and granular substance to be ground with, to divide and tear them
to pieces.   Opium may be powdered with  the prepared carbonate
of lime, and the gum camphor with loaf sugar.
   PREGNANCY.—There is no  one  sign by which it can cer-
tainly be known that a woman is pregnant, until the motion of
the foetus can be felt, which usually occurs at the end of about
four and a half  calender months after conception ; nor is there
any combination of  symptoms by which this condition is posi-
tively indicated, if this  sign be wanting.  By taking  into con-
sideration, however, a number of  symptoms, an opinion may be
formed that will generally prove correct.  The first, and  most
certain  sign of pregnancy, is  a suspension  of the  menses or
monthly evacuation.  If a woman  has previously been regular,
is in tolerably good health, and knows of no other very evident
cause of the cessation, this sign will seldom be deceptive.  Some
women continue to be regular  during pregnancy, and a suspen-
sion of the menses sometimes occurs without any obvious cause,
but these are rare  cases, and are  only exceptions to the general
law.  A fulness, tenderness, and sudden growth of the breasts is
a sign of considerable value, when taken  in connexion with the
former, but  it  is not to be  depended  upon when considered  by
itself.  It is not unusual for the breasts to be painful even in the
first months : this, however, happens so frequently, and especially
about  the time  of the monthly discharge, that it can hardly be
reckoned among the signs of pregnancy.  A secretion of a little
watery milk is  thought  by some to be  a sure indication; we
know, however, from personal  observation, that it is not  infalli-
ble, as women sometimes, though rarely perhaps, have this secre-^
tion in the unimpregnated state, and in fact those who have*never'
given birth to a child.  The color of the  areola or circle  around
the  nipple  is perhaps one  of  the surest  signs, except the  first,
when  particularly observed and  compared with the color in the 
472
PRE.
same individual, when pregnancy does not exist.   This circle is
much darker in some  persons than others, and consequently it is
only by comparing the color at  different times, in the  same indi-
vidual that any judgment can be formed from it.   Very early in
preCTnancy, the  areola grows darker colored, and  enlarges in
circumference, which we are not aware is produced by any other
cause.
   Occasional faintness, a shortness of the breath, a sense of ful-
ness in the lower part of the  abdomen, a bearing down, and a
difficulty in voiding urine, frequently occur in the early months ;
but a symptom of much more importance, is a periodical sickness
at the stomach, and vomiting.   This generally comes on in the
morning, on first rising out of bed, though it may come on at any
time in the day, and is sometimes almost constant.  A capricious
appetite, longings and antipathies, and an unnatural irritability of
temper are not unfrequent symptoms, and though  of little impor-
tance separately considered, may strengthen  an opinion formed
from  other signs.   Disturbed  sleep,  frightful dreams, nervous
pains in different parts of  the  body and  limbs, toothache, and a
perturbation of the mind, are occasional symptoms.
   When a woman becomes pregnant while  nursing, the secretion
of milk is diminished, and its quality deteriorated, and the child
becomes  indisposed, and emaciates.   To briefly  recapitulate, if
the menses are suspended, the  breasts enlarge, the areola grow
darker colored, and there be periodical  sickness and retching,
there will be but little doubt of the existence of pregnancy, but
it will require the motion of the foetus to render it positive.
   The natural  duration of pregnancy has,  by accurate observa-
tions, been ascertained to be nine calender months, or thirty-nine
weeks and one day.  A variety of circumstances may vary this
term a little, but all considerable deviations must be considered
as accidental and  unnatural.   The  first perceptible  motion of
the foetus, or quickening, is usually observed about  four  and a
half months from conception,  and the same length of time  previ-
ous to the woman's confinement.  It probably  frequently falls
short  of this time, a  few days, and  sometimes perhaps several
weeks.  Quickening unusually early, as well as the  coming  on
of labor a  few days  before the expiration of the ordinary term of
nine months, may possibly be owing to an unusual precocity of
the foetus.
  The most common and troublesome diseases of pregnancy, are
heartburn, sickness at the stomach and vomiting, dyspepsia, diar-
rhea, constipation, bearing down of the womb, difficulty of void-
ing urine,  jaundice, shortness  of breath,  faintness,   toothache,
salivation, pain  in  the breast, and in the right side,  rigidity or
tightness  of the abdomen, false  pains,  and  turbulency  of the
foetus. None of these diseases are of a dangerous tendency, and 
PRE.
473
 most of them may be treated upon general principles, except that
 those  medicines which have  a  specific action upon the womb,
 and are liable to occasion a miscarriage, must be avoided.  Heart-
 burn,  sickness, vomiting,  and dyspepsia, are most successfully
 treated by a well regulated diet, due attention to the state of the
 bowels, and the occasional use of those medicines that arrest
 vomiting, called anti-emetics.   The laxatives most appropriate in
 these cases are, calcined magnesia, fluid  magnesia, lenitive elec-
 tuary, rochelle  powders, epsom  salts,  castor oil, and extract of
 butternut.   Whichever of these medicines is taken, it should be
 in small doses at a time, and a laxative effect only should be pro-
 duced.   Figs,  prunes, and laxative  food and herb teas will often
 be sufficient, and supersede the necessity of resorting to medicine.
 To  allay the sickness  and vomiting, a quarter  of an  ounce of
 calcined magnesia and as much  super  carbonate of soda may be
 dissolved in half a pint of cold water, a little essence of  cinna-
 mon and loaf sugar added, and a table-spoonful  or two taken
 several times a day, and  particularly when  the  sickness is most
 distressing.  The following is an old, established remedy for the
 same purpose:  mix one drachm of calcined magnesia, one fluid
 drachm of  the water of ammonia, (aqua  ammonia) and  three
 ounces of  cinnamon water with five  and a half  ounces of pure
 water.  The dose of this mixture is one or two table-spoonfuls.
 It may be  taken at any time when the severity of the complaint
 may require.   The soda powders and other effervescing mixtures
 taken in small draughts are also appropriate and excellent reme-
 dies.  Should there be diarrhea, the chalk mixture may be tried,
 the  syrup  or tincture of rheubarb, in small doses, several times
 a day,  with the addition  of a  few drops of laudanum, may be
 useful.   The red raspberry leaves, crane's bill, rhatany and marsh
 rosemary, are also appropriate.  The difficulty of  voiding urine
 will be relieved by a free  use of a solution of gum arabic, and in-
 fusion of upland cranberry, except there be a bearing down of the
 womb,  in which case some manual assistance may be necessary.
 It is seldom of the least benefit to extract a tooth for the tooth-
 ache in pregnancy ;  this, however, may depend upon the condi-
 tion of the tooth, and should be left to the decision of a physician
 or dentist.  The pain of the tooth may be mitigated by the applica-
 tion of laudanum, anodyne balsam, or the smoke of grated nutmegs,
 drawn  through a pipe.   For rigidity  of the  abdomen  there is
 nothing better  than  frictions with sweet oil or lard.  The pain
 in the side which is commonly most troublesome from the fifth
 to the eighth month, will  be benefitted by light exercise, an easy
 state of the bowels, and frictions  with  a liniment of camphor
and sweet oil or other warming embrocations.  Bleeding, though
frequently  resorted  to, is seldom  beneficial, in this affection.
Swelling of the feet and legs, and of the flesh generally, is very
            60 
474
PRU.
common in the last  months of pregnancy.  This is a complaint
which though free from  danger, is often troublesome and is very
hard to cure.  It subsides soon after delivery.  Frictions  and
mild laxatives may be beneficial.  The daily use of sweet oil or
slippery elm gruel  in quantities sufficient to keep the  bowels
regular, relieves many of the  disagreeable  symptoms of the last
months, and may in some degree contribute to an easy labor.
  PREPUCE.—The  foreskin or membrane which covers the
glans penis and clitoris.
  PRIMiE YIM.—This expression signifies the first passages of
the body,  which are the stomach and bowels.  The second  pas-
sages are  the  lacteal  vessels ; and the third, the blood-vessels.
The food goes through all  these passages, before it is prepared to
nourish the body.
  PROLAPSUS ANI—Falling of the Rectum. See Falling of
the Rectum.
  PROLAPSUS UTERI—Falling of the Womb.  See Falling
of the Womb.
  PROSTATE GLAND—A glandular body situated between
the neck of the bladder  and the urethra.   It  is in the shape of a
heart, firm, and large.   It often becomes inflamed and ulcerated.
  PROTEINE.—A product of the decomposition  of  albumen,
fibrine,  and caseine.  Says Liebig,  in his  Animal Chemistry,
" When animal albumen, fibrine, and caseine are dissolved in a
moderately strong solution of caustic  potash, and the solution is
exposed for some time  to a high temperature, these substances
are decomposed.  The  addition of acetic acid to  the solution,
causes, in  all three, the  separation of a gelatinous, translucent
precipitate, which has exactly the same characters and composi-
tion, from whichever of the three substances above-mentioned it
has been  obtained."  This principle is regarded by Mulder, its
discoverer, as the base of the  blood and of all the animal tissues.
Both animal  and vegetable  albumen, fibrine, and caseine are
compounds of it.
  PRUSSIC ACID—Acidum Hydrocyanicum.—This acid may
be obtained by a chemical process from the prussiate of iron.   It
is a colorless fluid, of a  strong smell, resembling peach flowers,
and a pungent, sweetish taste.  It may be obtained from many
vegetable  substances.
  Dose for an adult  one  or two drops, twice or three  times  in
twenty-four hours, in distilled  water.  It is  used in asthma,
hooping cough, croup, consumption,  and  several spasmodic dis-
eases, such as locked jaw,  hysterics, and convulsions.
   The prussic or hydrocianic  acid must be used with the greatest
caution, as it is one of the most fatal and sudden poisons.   It is
a direct sedative, or anodyne.   It must be given in distilled water
as any other liquid will decompose it. 
PUL.
475
  PSORA—The Itch.  See Itch.  '
  PSORIASIS—Salt Rheum.   See Salt Rheum.
  PUERPERAL FEVER—Child-bed Fever.  See  Child-bed
Fever.
  PULSE.—The pulse is caused by the beating of the heart and
arteries.   It may be felt in any of the arteries of the body, but
most conveniently in the wrist.   Sometimes it is more percepti-
ble in the temporal artery—the radial artery being  small.  The
radial artery will sometimes divide,  and the larger branch run
uoon  the outside of the radius.   In  this case, the  pulse in the
usual  place will  be faint when the circulation is actually strong
and vigorous.   The physician must guard  against  this mistake,
as the patient may be thought  to be very weak, when  there is
nothing  the matter  with him.   We have seen several instances
of this nature.
   The  pulse is the  truest  index we have, of  the force and the
rapidity of the circulation.  In  nearly all inflammatory diseases,
the pulse is  large, full, quick, hard, and forcible.  In fevers, it is
full, hard, and  quick or frequent, though not so full and  forcible
as in  inflammations.  In the continued fever,  the pulse will beat
from  ninety to a hundred and twenty strokes in a minute.   In
general, the quicker the pulse, the more severe and dangerous the
disease.
   When there is not much strength in the system, from whatever
cause  it  arise, the pulse will be  small, quick, and  soft.   The
quantity of blood in the system may be pretty well told by the
size and  feel of the pulse.
   The pulse of a grown person in health, is estimated,\in  general,
to be seventy-three  beats in a minute. If it rises above eighty, it
is supposed to indicate  some degree of fever, or some disorder of
the system.  Some people have a remarkably slow pulse in health.
We have seen one person whose pulse was never more than forty
 in a minute.
   An intermitting pulse is  supposed  either to indicate some dis-
order of the  heart, a great state of weakness, the approach of
death, or some nervous affection.  By intermitting, is meant that
 the pulse beats a few times, and then stops  a beat or two, and
 begins again.  A mere nausea or sickness at the stomach, either
 from  disease or medicine, will  cause an intermitting pulse.   An
 intermitting pulse attends  dropsy of the heart, of  the chest, and
 of the brain.  Some people, however, will have an intermitting
 pulse nearly their whole  life time without  any apparent disease,
 unless it be some slight nervous affection.  For the pulse of dif-
 ferent ages, see  Circulation.
   PULMONARY.—Anything  which  relates  to  the  lights  or
 lungs.   The  consumption is a pulmonary disease ;  so are  the
 asthma, and the peripneumony. 
476
PYR.
   PURGATIVE.—A medicine which operates upon the bowels
so as to produce a number of discharges in a day, or increase the
natural motion.
   PUS.—This  is a whitish, cream-like matter, which forms in
ulcers and inflamed parts; or in other words, it is formed when
inflamed parts maturate.   It is commonly called matter.  When
pus or matter is  healthy, it separates  readily from the surface of
the  sore ; the granulations  underneath are small, pointed, and
red ;  the  matter is of a white color, has a mawkish taste, and
when cold is without smell, but when warm has a peculiar smell.
It sinks  in water.  Examined with  a microscope it consists of
grains or globules,  and a transparent  fluid.  It is less tenacious
than phlegm or mucus, and more opaque.
   Unhealthy matter is watery and  flaky, as may be  seen  in
scrofulous ulcers.  In some ulcers,  it  is of a blackish or greenish
color, and a fetid smell.  A good  constitution, in general, pro-
duces good pus.  Ulcers in  the extremities, which are at a dis-
tance from the centre of the  circulation, produce a poorer kind of
pus than when situated nearer the trunk of the body.   Matura-
tion commences in wounds in about four days after they happen,
never sooner than two days.
   PUSTULE.—A  pustule  is a little round, red,  sore  pimple
which contains  matter or pus.  It has several different shapes.
Some pustules, as in the small pox and cow-pox,  are round, and
flat upon the top ; others are  pointed, as in the  blotched face.
Some are oval, and others are globular.   Some pustules contain a
watery matter, and others, pure pus.  Some are painful, and others
merely sore to  the touch.   They are mostly confined  to the
surface of  the body.   Each  pustule is a separate inflammation
although they sometimes run together.  Some pustules terminate
in a scab, others, in a scurf, and some again are resolved without
any organic change  in the texture of the part or spot. A pustule
is seldom larger, in circumference  or  diameter, than a five cent
piece.
  PYLORUS—The lower orifice  of the stomach.—That por-
tion of the bowels called the duodenum, commences at  the py-
lorus.
  PYREXIA.—The literal  meaning  of this term is a habitual
heat, but is commonly used to denote  fever in general.  It implies
an increase of heat,  a diminution of strength, a frequency of the
pulse, thirst, a gastric  affection,  and a general disorder  of the
functions of the mind and of the body.
  PYROSIS—Water  Brash.—The discharge  of  a watery, ropy
fluid  from the  stomach, attended with heartburn.  See Heart-
burn and Water Brash. 
QUI.
477
                             q.

  QUARTAN AGUE.—This  is a form of the fever and ague
or intermittent fever, in which the fever fits or paroxysms happen
every fourth day.
  QUASSIA—A bitter wood which comes from South America
and the West Indies.—The  bark and the root of the quassia are
as bitter as the wood.   It is a white wood, and when cut into
chips, looks  like the ash wood.   It has  an intensely bitter taste
without  astringency, or any peculiar smell.  Boiling water  ex-
tracts from a sixth to a ninth part of  the weight of the wood.  It
is a pure bitter, and one of the best which  we possess.  Like the
peruvian bark, it has the power of curing the fever and ague.
Its  medicinal virtues are those of  a  tonic, stomachic, anticeptic,
and febrifuge.   In this  country, it is administered very much in
the rdebility which  follows  our slow  or  continued fevers,  the
small pox, and typhus fever.  In cases of a weak stomach it  is a
valuable remedy.   It is very suitable in nervous diseases, and in
the Weakness which often attends menstruation, or a loss of blood.
It may be given in almost any disease where there is not a high
fever and acute inflammation.
  The way in which it is  commonly taken is in the form of a
tea or infusion.  Twelve ounces or a pint of  boiling water may
be  poured  upon three or four  drachms of the quassia chips or
powder,  and of this tea, one, or two table-spoonfuls may be taken
at a dose, several times  in a day.
  QUICKSILVER—Mercury.—This is a liquid metal.   In its
pure state it has a shining lustre like polished silver.   If exposed
to the air for a length of time, a rust or oxide collects upon it, of
a dark grey color.   In a great degree of cold, forty degrees below
zero,  it becomes solid like melted lead when cooled.   It expands
by heat, which makes it a suitable index in the tube of the ther-
mometer, of the temperature of the  atmosphere.  Quicksilver is
sometimes found  pure  in the  earth.  There are mines of it in
Peru, Spain, Hungary, and  France.   It is most  commonly com-
bined with  sulphur, from which it is separated by heat or smelt-
ing.  In 1497, this metal was introduced into medicine as a
sovereign remedy for the venereal  disease, and has ever since
maintained  its  reputation.   The  pure  metal is never used ;  it
must be converted into  an oxide or salt  before it is suitable to be
introduced  into the system.  When a handful  of  it is  thrown
upon the floor, it separates into round globules about the size  of
shot.
   QUININE—Sulphate of Quinia.—This medicine is obtained
by a  chemical process  from the peruvian  or cinchona bark.   In
this salt all the virtues of the bark are concentrated.  It consists 
478
RAN.
of fine silky, flexible crystals.   It looks like small flakes of snow.
Its taste is intensely bitter, and retains the flavor of the bark.  It
is a compound of sulphuric acid or oil of vitriol, and a chemical
principle of the bark, called quinia.  In appearance the quinia,
and the sulphate of quinia, are very much the same ; both are in
the  form of a white powder.   The pure  quinia is  now seldom
used,  although it possesses equal efficacy, and is the pure essence
of the bark.
  The nitric, muriatic, and the  citric acids, all form salts with
the  quinia, which possess about the same properties with the sul-
phate.
  In all cases where the peruvian bark was  formerly employed,
the  quinine is now used as a substitute.   It  is one of the most
valuable improvements in the art of medicine.   It is an invalua-
ble  tonic.
  The common dose is one grain, given  one, two, three or more
times in a day, as the  case may require.  A child, a year old,
may take half a grain, once or twice a day.  In some cases, it is
given to adults in two, three, and four grain doses.  It may be
mixed with molasses, syrup, jelly, or water.   As good a way as
any, is to  make a tincture of  it, by dissolving it in  new rum or
diluted alcohol.   A drachm  of it may be dissolved  in  eight
ounces of  new rum, and taken in the dose of a tea-spoonful at a
time.
  No medicine possesses the power of strengthening the diges-
tive organs and the system at large, in  so great a degree as  the
quinine.  In the cure of the fever  and ague, no remedy can be
compared  to  it,  and in  almost  every other  disease requiring a
tonic, its virtues are equally effectual.
  QUINZY, OR QUINCY—Inflammation of the Tonsils—Sore
Throat.  See Sore Throat.
  QUOTIDIAN AGUE.—A daily ague, or  a form of the  inter-
mittent fever where the chills and  fever occur once in twenty-
four hours.
                             R.

  RABIES—Madness—Hydrophobia.
  RACHITIS.—The systematic name for rickets.
  RADIUS—The inner bone of the fore-arm.—It extends from
the elbow to the wrist, and has a rotating motion.
  RANULA.—A tumor or white bladder  under the  tongue.
See Frog. 
RED.                        479
  RATTLE-SNAKE ROOT—Polygala Seneka.—This plant
is commonly called seneka.   It grows in all parts of the Union,
but in most abundance  in Virginia  and  Pennsylvania.  It  is a
perennial, crooked, jointed root, resembling very much the  tail
of a rattle-snake, after which it is named.
  The  seneka  root is an active  stimulant, expectorant, and diu-
retic ; and, sometimes, will operate  as an emetic and  cathartic.
It is said to cure the bite of the rattle-snake.  In the croup and
other inflammatory affections of the  throat and lungs, it is ranked
among the best remedies.
  The maimer of using it is, to take half an ounce of the bruised
root, steep it in half  a pint of water, in a covered vessel, until it
is reduced to a gill;  of this a table-spoonful is to be  given every
hour or half hour, as the case may require.
  This root has been  found useful in the decline of pleurisy,
peripneumony,  in  coughs, and the asthma.  Dr. Chapman,  of
Philadelphia/has found it of signal  service in  obstructions of the
menses, administered to the extent  of four ounces of the decoc-
tion, in the course of the day, increased as the  menstrual effort
is expected.
  It acts  powerfully upon the salivary glands,  and  the mucous
membrane of the throat.   The mere chewing of it causes a sud-
den flow of the saliva.  There can be no doubt  of its efficacy in
inflammatory diseases of the throat.
  RECTUM.—When the large portion of the intestines or bow-
els, has reached the pelvis, it runs in a strait line, until it termi-
nates in  the anus.   The part which runs through the pelvis,
bein°- the lowest portion of the bowels, is called the rectum.  It
is to this  portion of the bowels  that injections are  applied.  Its
motion is much slower than that of the other parts  of the intes-
tines.
   RED GUM.—The red gum is a rash  or humor which comes
out on 'infants soon after they are born ; most commonly, within
a month after  birth.  How it came to be called the  red gum, we
are unable to say.  It makes its appearance before the gums be-
come red and inflamed, from  teething, and we have  never known
it to be attended with any affection of the gums whatever.
   The  red  gum  consists of a multitude of little pimples which
come out upon the  face, neck, and, sometimes, upon  the  body
and limbs of the child.  The pimples will sometimes have watery
heads, or be filled with yellowish matter.   The eruption, like alt
eruptions upon the skins of children, has been supposed to be an
effort of  nature to throw off  something  hurtful from the body;
and, therefore, should not  be repelled  by any external applica-
tion's.   But be this idea  true or false, it fortunately happens that
the humor seldom or never  requires any local  treatment.   We 
480
RHE.
 never could see why there  may not be a primary disease of the
 skin as well as of the stomach or bowels.
   Domestic Remedies.—Half a tea-spoonful of the calcined mag-
 nesia in a little milk, or a tea-spoonful of castor oil, is in general,
 all the medicine which is required.   If the skin be hot and dry,
 it should be bathed with warm water, and the child should take
 a little warm catnip tea to make it perspire.  The eruption usually
 dies away in the  course of two or three days.  If the stomach of
 the child is sour,  a julep of prepared chalk should be given it.  If
 there should be any  sickness at the  stomach, ten or fifteen drops
 of the wine of ipecac should be given, after which, as many drops
 of Godfrey's cordial  may be taken.
   REFRIGERANT.—Medicines which  lessen the  heat of the
 body, such as salts, nitre, rochelle powders, ice,  soda water, and
 the vegetable and mineral acids.
   REMITTENT FEVER.—In this country, the remittent fever
 is called the bilious  fever.   See Bilious  Fever.  It is called re-
 mittent because the fever  sensibly abates, every day or two, and
 returns again with equal violence.
   RENAL  CAPSULES—Supra-renal glands.—These  are two
 small glandular bodies of a triangular figure,  situated upon each
 kidney.  They have no excretory duct, and therefore can secrete
 nothing but blood and lymph, like the spleen.   They are much
 smaller  than the kidneys, and  their cavities are filled with a
 liquid of a reddish color.
  RESOLUTION.—The dispersion of an inflammation, either
 by the use  of medicines, or by some natural  operation.  The
 redness, swelling, pain, and  heat, all subside without maturation
 or gangrene.
  RESPIRATION—Breathing.  See Breathing.
  RETE MUCOSUM.—The  mucous coloring  matter  of the
 skin; it occupies  a space  between  the cuticle or scarfskin, and
 the cutis or true  skin.  In people of a dark  or black  color, this
 mucous membrane is dark or  black, and  in  people of a lighter
 complexion, it is light. Whatever be the  cast of the complexion,
it originates from this substance.   It is  known as  the  middle
layer between the dermis and the epidermis.
  RHEUMATISM.—There is no disease with which the human
constitution holds stronger contests  than  with the inflammatory
rheumatism, and  yet it is not a dangerous disease.  There are
two grades  of  this disease, one of which  is acute, and attended
with fever,  and the other chronic or  lingering, and without fever.
Rheumatism of both grades,  springs very  naturally from the
climate of New England, and may almost be  said to be endemial.
It is more or less a disease of all cold and wet climates, but with
us it is a standing disease.   In  the  country and in the town, in
the highlands and in the  low, in the workshop and in the open 
RHE.
481
field, stiff limbs, painful and swelled joints, lame backs and crip-
pled feet are at all times visible.
  The acute rheumatism is known by sharp pains in the joints,
muscles, and back bone ; the pain most commonly begins in the
joints of the knees, ancles, hips,  shoulders,  elbows  and wrists.
Sometimes  only one joint, and, at others, several of the joints
will be affected.  In  ordinary, one joint will  be affected after
another until all the large  joints  have experienced the disease.
The affected part usually becomes red,  swelled, dry, and hot.
The pain is extremely hard, and  much increased at night, and
by the action of heat.   The inflammation, for the acute rheuma-
tism is neither more nor less than an inflammation of the tendons,
the  sheaths or white cases of  the  muscles, and the coverings  of
the heads of bones, manifests itself by a general affection of the
whole  system,  by loss  of  strength, shiverings,  heat, thirst, rest-
lessness, inability to  sleep,  white fur upon the tongue, and a full,
hard, quick pulse.   The  skin, instead of being dry, as in fever
and  in  other inflammatory affections, is generally covered with
partial sweats,  and the sweat is always  clammy.  The painful
joints,  and the surface for some distance around, are always dry.
We  believe an inflamed part never perspires.  There is commonly
little or no headache in this malady, and the stomach is not much
diseased.   The bowels are costive.  The blood which is drawn
in the inflammatory  rheumatism is always sizy.
  Although the inflammation of the joints and muscles will often
run  very high and manifest much redness, swelling and pain, it
rarely ever suppurates.  Cases of  suppuration and the discharge
of matter, sometimes happen, but the inflammation  commonly
subsists  for three or four  weeks, and  then begins to decline,
leaving the parts weak, but not disorganized.  There is often an
effusion of watery or mucous matter in the inflamed joint, which
renders it swelled and stiff for a long time, but the motion of the
joint on the cessation of the disease, soon causes this matter  to
be  absorbed.   The  nature of  the parts  affected in  rheumatism
causes a considerable difference between the progress and termi-
nation of the inflammation, and the inflammation of other parts
and organs.  The tendons are not very essential to life and  do
not contain red blood.   In them,  an inflammation runs very slow
in comparison with its  course in  organs which are full of blood,
whose vessels  are large, and  through which the blood  moves
rapidly.   The  bloodless cords, like the nails  and the hair, being
removed from the  force of  the circulation, are very long in being
irritated ; and when once  irritated, the  irritation is as long  in
subsiding.   Some writers  have seemed to doubt whether rheu-
matism were an inflammatory disorder, but if pain, redness, swel-
ling, dryness, and an increased heat of the parts affected, consti-
tute' inflammation, then rheumatism  must be  an inflammatory
             61 
482
RHE.
disease and require an anti-inflammatory treatment.  It is a dis-
ease produced by cold, wetness, and the  wintry vicissitudes of
the atmosphere, like other acute  inflammations.  It attacks the
full-blooded and robust, in whom  other  inflammatory disorders
are most  apt to occur.  The  acute  rheumatism is peculiarly a
disease  of middle  life; it  rarely  affects  children, and does not
often attack the aged.  External  redness and swelling may not
in every instance accompany the disease, and we are not certain
that these two  appearances are always visible in other inflamma-
tions.
   The rheumatism is said in some instances to seize the internal
parts, the  brain, the  heart, liver and stomach, and to end fatally,
and we think we have seen the disease extend to these organs.  In
fatal cases of the rheumatism, the inflammation spreads like the
St. Anthony's fire, assumes a dark red color, and small  blisters
form upon the surface.   The pulse sinks, and the surface becomes
livid and cold.
   The  inflammatory  rheumatism commonly  runs, when  not
arrested in the commencement, from four to six weeks. In many
instances  where one joint  after another is attacked with inflam-
mation, the disease will take two or  three months in performing
its circuit.  It  is always a favorable  symptom to see the disease
moderated, and the  pain assuaged by medicines, if there is not
an entire  cure.
   Domestic  Remedies.—Sweating in  this  disease is not only
difficult to produce and to keep up, but when we have succeeded
in opening the  pores, the  disease does not appear to be much
bettered by it.   The part affected never sweats, and the skin
does not appear to be the channel  by which the inflammation in
this case, is to  be subdued.  The  bowels and the kidneys  seem
to be the outlets through which the proper evacuations  must
be made.  A person attacked with the  inflammatory or acute
rheumatism, should  be confined to a  room  heated to sixty-
five  or sixty-eight   degrees, upon  a soft  bed and  not  very
warmly covered.  A dose of salts,  senna, castor oil,  thorough-
wort or  aloes  should be given, and  repeated every  day for
several days  in succession.  The sal nitre, in eight grain doses,
 should be administered every two  hours,  dissolved" in a little
 water, with a plentiful supply of tepid drink.  Any kind of herb
 tea which will  operate upon the  kidneys and  produce a flow of
 the urine, will be suitable.  The  affected joints should  be kept
 bathed with equal parts of vinegar and new rum, or with vinegar
 and water ; but the  chill of the  liquor must be taken off.   Any
 entirely cold application, or one  that is  hot, appears  to  increase
 the pain  and inflammation.  A mixture of vinegar and new rum,
 if kept constantly applied with flannels, and gently rubbed in by
 the hand, abates  the heat, lessens  the  pain and soreness, and 
RHE.
483
reduces the inflammation.   Soft, tepid poultices made of flax-seed
meal, rye meal, or white bread, are extremely sui'able applications
to the inflamed and  painful parts and joints.   In other kinds  of
inflammation it is usual to apply lotions of lead water and solu-
tions of sulphate of zinc, and  we regard these  washes  as very
proper, perhaps the most proper of any which can be used.  Solu-
tions of lead and zinc should not be used very cold.  They should
always be raised to  the temperature of summer heat.  It is  an
old notion that there is danger in driving the inflammation away,
but, perhaps, it is quite as harmless to drive  the  inflammation
away in  the rheumatism  as in an affection of the eyes or the
throat.
   Mustard poultices and  the volatile liniment, are much in use
in  the rheumatism,  as local applications, but they seldom  do
much good.  Steaming the joints and the use of  the hot  bath are
sometimes recommended, and  may be suitable remedies.  The
plan of cure, in our opinion, should be strictly anti-inflammatory.
Other  means will, sometimes, succeed, but the reduction of the
inflammation by the use of the  same means which we employ in
other cases of inflammation, is the only rational method  of cure,
and, we believe it is the method which is sanctioned by the most
enlightened experience.
   The acetate of ammonia, or the carbonate of ammonia, dissolved
in distilled vinegar  or  lemon juice, is a capital medicine, in the
inflammatory rheumatism.   A draught of it should be taken every
two hours.
   The diet should consist of water porridge, barley porridge, rice
boiled soft, soaked white bread, and bread water.  The drink
should be tepid water, lemonade, molasses and water, and soda
water.
   For the  first two or three days no opium should  be given;
and if after  that, it  is  found necessary to resort  to it to produce
sleep, either the Dover's powder should be given, or the solution
of morphine.  The Dover's powder is probably  the least inflam-
matory.   Where the pain becomes intolerable, it is a better way
to bathe  the inflamed joints  in laudanum, than to charge the
system with it, by taking it into  the stomach.   Hoffman's ano-
dyne  liquor will be found  a very good substitute for opium, if
used in connection with the acetate of ammonia.  The inflam-
mation of rheumatism is  so long in running its  course,  that  the
system commonly depletes  itself almost enough before the crisis
of the disease, without the use  of any violent means in the begin-
ning.  Small doses of ipecac  or  antimony will often be found
useful, more with  the view of moderating the circulation and
 reducing the pulse,  than of exciting a sweat, which  seems to be
 for the most part valueless.   The tartar emetic,  used in rheuma- 
484
RHE.
tism precisely as it is used in a common continued fever, has, no
doubt, a happy effect in shortening the disease.
  The disposition of the disease to attack one joint after another
until several or all of the large joints have gone through with the
inflammation, has discouraged many from the use of topical reme-
dies.   But this is no reasonable argument against their use.  We
believe that where an evaporation of alcohol, vinegar, ether, lead
water, or  a solution of white vitriol  are  kept up,  they make  a
sensible impression upon the inflamed parts ;  and so do soft tepid
poultices.   Both  the heat  and the sore anguish are very much
lessened, the vessels are relaxed, and effusions much less likely to
take place.  The application  of evaporable substances to the in-
flamed joints and muscles, we regard as an essential  part of the
cure.   Hop, poppy, catnip, and motherwort tea, are all very good
in this disease.   The thoroughwort tea if used plentifully enough
to kjtep up a drain  by the bowels, will answer as well as any
physic which can be used.   The poppy tea is a very good liquor
to evaporate upon the inflamed parts.
  Professional Remedies.—As rheumatic inflammation does not
often settle upon the vital  parts, there is not  that indispensable
necessity for blood-letting which  exists in some other disorders.
There is more  certainty also,  that  the  system will reduce itself
before suppuration or ulceration takes place in this disease, than
in many others.  Or if the inflammation  should run to suppura-
tion, there is  not that danger which would follow from a suppu-
ration  of  an  internal  organ.   Every  physician, however, will
follow the path  of  experience and observation, who  abstracts
blood in this  disease whenever the inflammation is violent and
extensive, and the condition of the system will warrant  it.  To
let  a  full-blooded, able-bodied, and robust subject  struggle on
with a violent rheumatic inflammation of several joints, without
lessening  the  quantity of the blood, appears  to us be an absurd
practice.  To be sure, the same  thing will be accomplished in
the course of a week or two by the force of the disease and the
abstinence from food, but the  system may be greatly endangered
before that time.   If the subject has been attacked in full health,
and the pulse is full, hard, and quick, a pint of blood should be
taken from the arm as  early in the disease as it can be done ; and
if the vehemence of  the  disease  should continue, the subject
should be bled a second time on the day but one following.  We
would not, in general, carry the depletion  by blood-letting any
farther than this, unless it is by the use of cups or leeches.  Blis-
ters in the beginning of the disease are  commonly of but little
service, but  after the  fever  is somewhat abated, they  may be
employed with great advantage.   Calomel, in small  doses, con-
tinued for three or four days at a time, and then omitted for as
many more, is often extremely serviceable  in  the  latter  part of 
RHE.
485
the disease.  The mouth in no case should be made sore by it.
The strychnia, a salt procured from  the nux vomica, is said to
have been  effectual in the cure of the disease, but we have never
used  it.   The veratrine, an alkali  procured from the meadow
saffron or colchicum  autumnale, should be  tried.  Wine of col-
chicum itself we consider one of the most effectual remedies that
has ever been used in the cure of inflammatory rheumatism.  It
should be given  in doses of from  thirty to sixty  drops, every six
hours, until some effect is produced upon the stomach and bowels.
Some have recommended the use of opium in large doses, and often
repeated, as the best means of curing the disease, but it has never
appeared to us compatible with the essential nature of the disease,
and the inflammatory condition of the system.  Opium will ease
the pain, and, perhaps, may not essentially  lengthen the disease,
but we have  ever looked upon the plan with suspicion.   In the
chronic rheumatism,  or in the latter stage of the acute  rhJfcna-
tism,  the practice may be more harmless.   The use of hofrrrops
and all stimulating  medicines  are for the same reason inadmissi-
ble.   By following the  depleting, anti-inflammatory plan, if we
do not succeed in curing the disease any sooner,  we shall at least
use no means which will ultimately injure the system.
  The use of quinine is less objectionable, as it is not a direct
stimulus, and may operate as a moderator of the  fever.   The
testimony in  favor of  the use of the  peruvian bark or the quinine,
is indisputable, but still  the plan Ave have  recommended is sup-
ported by the highest and most general authority.   Where the
anti-inflammatory plan fails, it will be perfectly proper to use the
quinine, and, perhaps, not very improper to try the efficacy of
anodynes.  Camphor in  combination with the sal nitre has often
been found a useful medicine.
  In the use of purgatives we have the highest confidence.  Four
or five aloetic pills given every night for a week or fornight, in
succession, we have  often used with the happiest effect.   Under
the influence  of this purgative,  we have seen the swelling subside,
the redness disappear, the heat depart, and the inflammation re-
duced.  We believe the plan Is more successful when the disease
has passed  the acutest period of the  inflammation. We have seen
the sal  nitre, by operating upon the kidneys, produce a similar
result.
  The chronic  rheumatism being  an inflammation of  a lower
grade, and generally without fever, requires some variation in the
treatment.  In the cure of the chronic rheumatism we can heartily
recommend the  use of the hot drops, both  internally and exter-
nally.  Red  pepper,  mustard, myrrh  and bayberry root, are all
suitable remedies in  this grade of  dissase, and have been used
from time immemorial.   But  these remedies should not be used
if any considerable fever be present.  The  chronic rheumatism 
486
RHE.
is sometimes  said to be without fever, but this is not the case in
all instances.   Particular attention should be paid by those who
are  affected with chronic rheumatism to the dress.  The body
should always be kept warm and dry, and  more  especially, the
feet.  The india rubber shoe is an excellent invention to keep
the  feet warm  and  dry.   These  shoes should  be  worn by
rheumatic people through the whole cold  season.   Flannel or
wash-leather  shirts and  drawers  should be  worn constantly in
the cold weather.  Heat seems to be almost a sovereign remedy
for the chronic rheumatism.   The disease generally  vanishes as
the sun begins to grow hot.   Cold and moisture are  the invaria-
ble  cause of this disease in all its grades.   Sleeping in damp
beds, living within damp walls, sitting in wet clothes or working
in cold, damp places, and exposure to the changes of the weather
when the body  is heated, seem to have  the  principal agency in
proi^ing the disease, whether inflammatory or chronic ;  and
thesexauses are to be shunned as much as possible.  The laborious
and active are more subject to rheumatic diseases than the seden-
tary.   The occasion of this, probably, is,  that the disease attacks
the very instruments  of  motion, the cords or tendons and  mus-
cles, which are  prepared for disease  by the amount  of action
which they sustain.   Strains, bruises, and injuries of the cords
are constantly happening to the laborious and active, and lay the
foundation for future  disease.  Excessive labor must always be
repaid by disease and  weakness of the instruments of motion.
  The  food, in  chronic  rheumatism, should be of the vegetable
kind ;  and no more  exertion or labor should be allowed than is
necessary for the health of the sore parts.  If there is no exercise
at all, there will be some danger of effusion of mucus and lymph,
and the adhesion of the  different parts, and,  consequently, a stiff-
ness of the joints and muscles.  Effusion of any kind appears to
cause the cords and heads of the bones to grow together.
  The back, and the hip joints  are often  the seats of  chronic
rheumatism.   Deformity is  often the consequence of it.  In the
chronic rheumatism there is often a great degree of numbness in
the parts affected.  The extremities, and even the trunk of the
body will often be much colder than in a state of health.
  Large warming plasters and poultices are  wanted in this  grade
of the disease.   The  back should be nearly  covered  by a plaster
of pitch, when the disease is situated there.   A plaster composed
of  mutton tallow and resin, made stiff with armenian bole and
dragon's blood,  is an excellent  salve for  diseased joints.   It is
nothing more nor less than shoe-maker's  wax made stiff with the
articles we have named.  About two ounces  of the armenian bole
should be added to a  pound of the shoe-maker's wax. The drag-
on's blood is not essential.  The tincture of red pepper and myrrh,
called the hot drops,  is a good application for the sore cords and 
RHU.
487
joints.   But the best external  application which we have ever
used, is the common volatile  liniment to which the laudanum is
added, in the proportion of two tea-spoonfuls of the laudanum to
two ounces of the liniment.   This mixture, rubbed freely upon
the painful cords,  every twice or three times a day, seldom fails
to give relief.
   The internal remedies suitable in this grade of the rheumatism,
are purgatives and diuretics.   The aloetic pills taken, every night,
to the number of four or a five, for a week or fortnight in succession,
have, in our hands, produced  the greatest benefit.  Lees pills  are,
perhaps, better in some instances. The sal nitre, in eight grain doses,
every  three hours, is the most powerful agent  which we possess,
in freeing the kidneys.   We first learned the efficacy of this medi-
cine, under the tuition of Dr.  Levi Wheaton, one of the most emi-
nent and learned physicians who has ever practiced the art of medi-
cine in Rhode Island.  He, at that time, was in the habit of using it
in  combination with camphor, but we  have  commonly used it
alone.  The tincture of guaiacum, either alone or in combination
with the water of ammonia,  has long been famous in the cure of
chronic rheumatism. The dose is a tea-spoonful, three times a day.
The meadow saffron or colchicum antumnale,  or the veratrine, is
a powerful remedy and exerts no small influence in reducing the
swelling of the joints.
   Opium is more  appropriate in this grade of the disease, than in
the acute kind.   But the Dover's powder should, in general, be
selected as much  the  best form of using  it.   This powder is a
very happy combination, and peculiarly suited to the  condition
of the system in  the chronic rheumatism.  Sulphur  is a medi-
cine which has often been successful in removing the complaint.
 The quinine, if used with discretion, in cold,  feeble, and relaxed
constitutions, will sometimes  cure, when all  other means have
 failed.
   Where  the disease proves inveterate,  the  chalybeate  spring
 waters should be tried.  Warm bathing, especially in the sulphur
 bath,  and steaming the joints will, sometimes, be found extremely
 efficacious.   Hot  rum and vinegar, will  be found an efficacious
 wash  in the chronic  form  of rheumatism.   When the disease
 tends  to dropsical swellings, the treatment recommended in the
 dropsy will be proper in this disease.
    RHUBARB—Rheum  Palmatum.—The  rhubarb root comes
 from  Turkey, Russia  and China.  The  Turkey rhubarb is ac-
 counted the best.  It is yellow on the outside, and streaked  with
 tints  of a reddish color  within.  It comes in roundish  pieces,
 perforated in the  centre.
    The Chinese rhubarb  is  brought in longer pieces, which are
 harder and more solid than that imported  from Turkey.   The
 Chinese has less of an  aromatic flavor, but more astringency. 
488
RIC.
 Good rhubarb has a clear, yellow color, a solid, compact texture,
 brittleness, and a bitterish, astringent taste.   It readily colors the
 saliva, and is easily pulverized.
   One-half of the weight of rhubarb is abstracted by boiling.  It
 is a mild cathartic, and astringent.  In the diseases of women,
 children, and  all persons of a delicate make, it is an excellent
 purgative.   Its operation is never very drastic, although it often
 produces griping, owing probably to its astringency.   In a loose-
 ness of the Dowels, and a laxity of the muscular  fibres, it is one
 of the  most appropriate and effectual remedies.  But, in the acute
 stage of dysentery and an inflammation of the bowels, it  is not
 altogether a safe medicine to use.   In small doses, chewed in the
 mouth, it acts both as a tonic  and a laxative.   It strengthens the
 tone of the stomach, braces the  muscles, and  restrains the effu-
 sion of blood in diseased menstruation.   In  combination with
 magnesia, jalap, cream of tartar, or calomel, its purgative effect is
 increased and rendered more  effectual.  The best form of using
 it, by adults, is  that of a powder.  The dose is from a scruple
 to a drachm.  A tea-spoonful is a common dose.   A child, from
 one to three years old, may take  eight grains, at a time, in mo-
 lasses,  jelly, or syrup.  It may, however, be used in the form of
 an infusion, syrup or tincture.
  In cases of indigestion or costiveness, taken daily to the amount
 of five or ten  grains, it is scarcely excelled by  any other laxative
 medicine.  To some people it  is much more friendly than others;
 but where  it agrees with the  digestive organs, it often produces
 the happiest effects.
  RICKETS—Rachitis.—This malady seldom makes its appear-
 ance before the child  is a year old, and as seldom begins after the
 age of two years.  It is emphatically a disease  of children,  al-
 though sad and  deplorable marks of it are often carried through
 life.
  The rickets is a disease, insidious, and  without  pain.   In the
 commencement of the disorder, no fever is discernible, but it is
 not usually a long time before the  pulse  becomes quick, and
 more or less fever is manifested.  The child will  take its usual
 amount of  food, although  it will  begin  to grow  thinner.   The
 first thing which is usually discernible in the commencement of
 this disease, is an enlargement of the joints, and of the head, par-
 ticularly the forehead.  In  some instances, the breast bone will
 be found  to project and  to become quite  sharp, and  the whole
 shape of the  chest to  become peaked.  In other  instances, the
joints of the back will become enlarged,  and  the back  bone
 crooked.  The child bends under its own weight, and the back
 bone is not able to support the weight above.   The openings
 between the bones of the head, or the fontanelles and sutures, as
 they are called, are much wider than  are common  in well chil- 
RIC.
489
 dren of the same age; and the bulk of the head appears large in
 proportion to the  size of the neck, which is more slender than
 common.  In  the worst  cases of the disease, the  bones every-
 where become crooked, and there is a wonderful softness of  the
 flesh.  The  process of teething  goes on  very slow, and when
 they are formed, they turn yellow, decay, and drop out.  The
 bowels are commonly loose, and the belly more or less swelled.
 Rickety children will often learn to speak sooner, and their men-
 tal faculties  will be earlier developed, than well  ones ; but in-
 stances occur where the mind is not developed, and ideocy  fol-
 lows.  There are very many instances where the integrity of the
 nervous system will remain entire, when the body in general will
 be very much  disordered.   The  brain, the centre and origin of
 the nervous  system, is very much insulated from the other vital
 organs of the body, and is not involved in that variety of textures
 which encompass the other parts.   To a certain extent, it stands
 alone ; and the nature of its office and its substance,  makes it still
 less  like  other parts of the system.
   The rickets will  continue  to progress for  several years,  but
 commonly stops after a certain term of time, and leaves the bones
 sound, but distorted.  It is not a dangerous  disease,  although
 productive of  an ill-shaped  and distorted form.   The disease,
 however, sometimes terminates in death, after successively affect-
 ing every function of the body.
  In some instances, the  softening of the bones, ends in ulcera-
 tion  and an open sore.  We once  saw a case where a section of
 the back bone of a child appeared to be completely  melted down
 into  a mess of soft, spongy flesh, and pus.
   It has been ascertained by experiment, that the bones of rick-
 ety children, or rather a rickety bone, does not contain so much
 earthy matter by one-half, as  the bones of healthy children.   It
 is the hard, solid, earthy matter mixed with the cartilaginous mat-
ter, which produces the  solidity,  hardness, and stiffness  of  the
 bones, and when  an insufficient  quantity of the  hard,  earthy
matter is secreted, and deposited in the  mass, a softness and
 flexibility of  the bone,  necessarily ensue.  If  there is too great
 a quantity of the  earthy  matter deposited, in proportion to  the
cartilaginous or gelatinous, the bone becomes very brittle, and is
liable to be broken on the slighest occasions.  We saw one in-
stance of this nature, in the case of a young lady who had broken
 almost every bone in her limbs, and some of  them several times,
by the slightest accidents, such as stepping too hastily  from one
stair to another, or walking upon a side-hill.
  To what this fault, in the elaboration and deposition of earthy
matter is owing, has never  been ascertained.  Some have sup-
posed it to be owing to a derangement of the digestive organs,
but this is not confirmed by observation and experience.
           62 
 490                         RIC.

   The external causes of the disease, so  far as they have been
 ascertained appear to be  the want of cleanliness ;  the want of a
 sufficient quantity of milky or nourishing food ; the want of good
 air and the influence of the sun, and  the want of motion or exer-
 cise.  Children that are bathed every day in tepid or cold water ;
 feed at a good breast of milk, or have a  sufficient quantity  of
 good cow's milk ; take the fresh  air and the sun often ; and are
 sufficiently dandled, we believe will hardly ever have the rickets.
 Dandling children, after they get to be six weeks, or two months
 old, is as essential to their health, as  muscular exercise is to a
 grown person.   Breathing the  open, fresh air, is also as vivifying
 to their blood, as to that  of adult people.   Nor are the rays  of
 the sun less congenial to their bodies, than to the bodies of older
 children.   The skins of children are  much more affected by dirt
 and filth, than  the skins of adults,  and should always be kept
 clean, both by frequent washings, and clean clothes.
   The  rickets is commonly attributed to a  scrofulous condition
 of the body; but as many other  diseases about  the nature  of
 which there is but little known, are attributed to the same source,
 no great reliance should be placed upon such a  theory of the dis-
 ease.  It  is very common with writers, when they are at a loss
 about the character of a  disease, to  attribute  it to a scrofulous
 state of the system, as if this were the best disposition that could
 be  made of it.   We think the repetition of  such generalities, is
 often a stumbling block in the  way of all further inquiry.
  Domestic Remedies.—The necessity of  cleanliness, of air and
 light, of a due quantity of milk or nutritious food; and of mo-
 tion or exercise, has been  alluded to.   It is not  every case of en-
 larged joints, and apparent increase of the size  of the head, that
 can be called the rickets.   Not one case in ten  of those children
 to whom  our  attention has been called on  a suspicion of  their
 having the rickets, has in reality turned out to  be such.  There
 are many inequalities in the  size of the heads of bones, and er-
 rors in their shape, which children will entirely out-grow, and
 which cannot  be called rickety.  We have seen great promi-
 nences in  the breast bone  of children,  which in  a few years have
 entirely disappeared ; and so in the wrists and ankles.
  A child  that is ascertained to be rickety, should frequently be
 carried into the open air in dry weather, and often bathed in cold
 water.  The limbs, back, and rickety parts,  should be gently
 rubbed  every day, for half an hour  at a  time, with the hand.
 There is  nothing so good as  rubbing to harden the flesh and
 bones and to  give  them  their proper cohesiveness.  Alcohol,
 brandy and  rum, are  all good embrocations  for rickety constitu-
 tions.  Opodeldoc,  frequently rubbed  into the diseased parts,  is
 an excellent application.  The aliment should  be plentiful, and
suited to the age of  the  child.  If the mother's or the nurse's 
RIC.
491
milk has been the cause of the disease, the child will grow better
when it  comes to live upon the milk of cows.  We believe that
children  who  are  brought up upon  the milk of cows after they
are weaned, are much less likely to have the rickets  than those
who live upon other kinds of food.   The food of children should
always be soft, if it is not liquid.
   The most proper food  for children affected with this disease,
next to milk,  would be a soup made  by digesting the bones of
animals,  especially beef bones, by the action of heat  and water,
until they become a jelly.   Such a  mass would contain the pre-
cise elements  for making new bones, or supplying the deficient
properties of diseased ones.  Being  reduced to the condition of
aliment, and taken as food, the earthy part of bones would  be
supplied in much greater quantity than could be introduced into
the system in any other way.  By first powdering the bones by
grinding or pounding them in a mortar, and boiling the mess in
a  closely covered  vessel, the requisite degree of decomposition
could always  be obtained.  Pepin's digester, where it could  be
obtained, would be the proper utensil to reduce bones  to that de-
gree of softness which would be required for food.  All the heat-
ing articles which are commonly used in soups, might in a great
measure be dispensed with.
   A plaster of pitch reaching the whole length of the child's
back, should be worn where  that bone is affected.  The rickety
parts  should be washed with a decoction of oak  bark in which
alum is dissolved.   Where it is possible to obtain it, spring water
which contains iron, should be drank.  The bowels of the child
should be brought to the condition of health by the use of astrin-
gents or cathartics, whichever may be indicated by the frequency
or the slowness of their motion.  After a fever has commenced,
the sweet  spirits  of nitre and  the  antimonial powder will  be
proper, in doses suited to the age of the child.  The chalybeate,
called Griffith's mixture,  will be found one of the  best of tonics.
The rust of iron in  powder,  in  doses of four or five  grains to a
child  between one  and two  years of age, may be given  where
chalybeate spring water cannot be obtained.   If these  things fail,
the quinine, in the dose of one grain, should be tried.
   Professional Remedies.—In the cure of the rickets, the iodine
holds the  highest reputation of any medicine now in use.  This
medicine was  entirely unknown to Cullen, Buchan and the old
writers, and bids fair to become a valuable remedy in the cure of
many diseases.  This medicine should receive a fair trial.  Lime
water appears  to be a suitable remedy, from its containing in so-
lution the very element which is deficient in the softened bones.
The muriate of lime has  been esteemed a valuable medicine in
the cure of the disorder, and is well entitled to the attention of
the physician.   A little wine  or brandy, given two  or three times 
492                        ROC.

a day, will often be found serviceable.  The use of bandages and
supporters to the diseased limbs, are of little or no service ;  some-
times they are even injurious, by impeding the circulation of the
blood.   The child should sleep upon a hair mattress, and always
be kept comfortably warm.   It should be carried  to the sea-side
in the  summer time, and be bathed in the salt water.   The sea
air is peculiarly  strengthening to the  system in this disease;  it
vivifies the blood ; increases the appetite and the power of diges-
tion, and braces  the muscles and chords.
   RING WORM—Herpes  Serpigo.—This disease consists of red
rings, formed by a set of small pimples or blotches, which contain
a watery, corrosive  fluid.   From the size of a ninepence, these
red rings will sometimes spread to the  size  of a dollar.   They
are the  most frequently seen upon the lower part of the face ; but
often infest the scalp, breast, and other parts of the body.  They
present an unsightly, fiery,  rough looking eruption, resembling a
red worm coiled in a ring, whence  the name.  It is attended
with itching, and when scratched, with a discharge of a  fluid,
which, by touching other places, spreads the eruption to a greater
distance.  In some cases it proves a severe disease, and taints the
whole  system, corroding the skin, and producing  an intolerable
itching.
   It is thought  to be contagious : often conveyed by using the
same comb, napkin, or razor.  It has been named, in New Eng-
land, the barber's itch.
   Remedies.—One of the best applications is a solution of white
vitriol  in cold water, in  the proportion of five grains of the vitriol
to two ounces of water.   The skin should be kept clean, and the
wash often used in the course of the day.  If the head is attack-
ed, the hair must be shaved off.  The Turner's cerate is a good
application.  In bad cases, the citrine  ointment, made of nitric
acid, quicksilver, lard, and sweet  oil, should be applied  to the
eruption.   Small doses of salts, cream of tartar, or rochelle pow-
ders, will be all  the medicine necessary  to take internally.
   The lead water, or a solution of muriate of ammonia, or lunar
caustic, may be used as a  wash, if the white vitriol and cerate
fail.
   RISUS SARDONICUS—A deathly looking smile or laugh,
produced by convulsion, spasm, or delirium.   In most cases, it.is
considered a forerunner  of death.
   ROCHELLE POWDERS—These powders  are of modern
discovery or invention.   They unite the effervescence and grate-
ful flavor of the soda powders with the cathartic  effect of the
rochelle salt or tartrate of potash and soda. They are composed of
the powdered  rochelle salt and super carbonate of soda, which are
usually contained in one paper, and, of the tartaric acid, which is
contained in  another, in the proportion  of one  drachm of the 
RUP.
493
rochelle salt, thirty grains of the super carbonate of soda,and twenty
grains of the tartaric acid.   The rochelle powders are an invalu-
able cathartic, refrigerant, and antisceptic.  In all kinds of fever,
they are  appropriate and  useful.  They abate the heat, refresh
the stomach, promote sleep, move the bowels, free the kidneys,
and relieve  the  head.   Where there is sickness at the  stomach,
a draught made  of the rochelle  powders will often allay it ;  for
this reason they are often given  in the  cholera  morbus, and
hemorrhage from the stomach.   In cases of bleeding at the lungs,
nose, or  of any other  hemorrhage, they are  equally serviceable.
In  dyspepsia, costiveness, green sickness, pleurisy, peripneumony,
and in nervous complaints, these powders will be found signally
useful.
   The common dose for an adult is one of each  of the powders,
 dissolved in a gill, or  half  a gill of water, in separate  tumblers,
 and poured together.   They are often given in divided doses, as
 the stomach will bear  the medicine.  A corresponding quantity
 of each of  the  powders  can be dissolved in a  little water at a
 time ; or the whole may be dissolved, and a  table-spoonful of the
 solution taken  as the case may require.  Where it can be done,
 it is preferable to take them in a state of effervescence.
   ROSEMARY—Rosemarinus  Officinalis.—This  plant  grows
 wild in the south of Europe.  The principal use which is made of
 it is in the composition of red lavender and Hungary water.  For
 these purposes, the flowering  tops are distilled, and an essential
 oil obtained.   The rosemary plant and oil have a fragrant odor,
 and a warm, bitterish taste.  Medicines composed of it, are highly
 esteemed in  the relief of  nervous  affections, such  as hysterics,
 hypochondrism, palsy,  hemicrania, sick headache, and vertigos.
    RUBEFACIENT.—Medicinal  substances used  to  produce a
 redness of the skin or  part, without raising a blister, such as
 diluted  ammonia, flies in  small  quantity,  mustard, ginger, and
 garlics, applied just long enough to excite pain and inflammation,
 but not to produce a discharge of fluid.
    RUBEOLA—The Measles.   See Measles.
    RUPTURE—Hernia.—In a rupture, the walls of the belly
 are  bursted, and let out a portion  of the bowels, or of the caul,
 or both together.  In some  rare  cases,  the stomach, liver, or
 bladder, is pushed out into a sac.  Ruptures  most  commonly
 occur at the bottom of the belly, or at the  navel.  They appear
 in the  groin, in the  scrotum, in the labia  pudendi, and on the
 inside of the  thieh.   Some ruptures are very  large, and others
 small.   The small ruptures  are, in general, the most  dangerous.
 So liable are  mankind to  this accident, that it is supposed  that
 there is one  person in every ten, who has a rupture of one kind
 or another.
    In some cases they exist from birth, and are  called congenital, 
494
SAC,
 but in most  instances they are produced  by strains, blows, or
 violence in one way or another.
   The ordinary symptoms of a rupture are, a tumor or swelling
 somewhere about the belly, an increase of its size after a meal, a
 decrease of its size, or disappearance, when the patient lies down,
 its re-appearance on rising up and standing upon the feet, a gurg-
 ling sound when  the  contents of  the rupture return  into  the
 belly, a diminution of  the tumor when pressed  by the hand, and
 a sudden enlargement  when the pressure is  removed.  To these
 phenomena, may be added a disposition to vomiting, colic  or
 stoppage of the bowels, constipation, and flatulence.
   The  danger to be apprehended in ruptures, is strangulation of
 the bowels, or part included in the tumor.   This is known by a
 stoppage of the bowels, vomiting, pain in the bursted place when
 handled, a tense feeling  in the  tumor, and  all  the symptoms  of
 the colic.
   A rupture at the  navel is called an  umbilical hernia; one in
 the inside of  the  thigh, a femoral  hernia ;  one in the  groin, an
 inguinal hernia ; and one in the scrotum, a scrotal hernia.
   In case of a strangulation, the patient should lie upon the back,
 and endeavor to  reduce  the rupture  by a  constant, but  gentle
 pressure  with  the hand and fingers.   If this  does not succeed, he
 should take a full  dose of castor oil, salts, or magnesia.   If the
 symptoms of  colic become violent,  blood  must  be drawn from
 the arm, or by leeches  to the  part, and more powerful cathartics
 taken, such as the  spirits of turpentine in the dose of  an ounce
 or two table-spoonsful  at a time, or  the croton oil in drop  doses,
 or calomel and  other  active  purgatives.   The main  object, in
these  cases is to relax  the  system and to prevent  inflammation.
Frequent injections of ipecac,  antimony, or tobacco, will  often
greatly assist  in the reduction of the hernia, but in spite of all
internal  means,  an operation is  sometimes indispensable ; the
tumor must be laid open, and the bowel, or  other part, put back
into its  place.  The  operation  is  somewhat  dangerous,  but  is
often completely successful.
  In ordinary cases, after the bowel is returned, it must be kept
in its place  by a well  adjusted truss, and  only removed when
lying in bed.
                             S.

  SACRUM.—This bone  forms the back part of the pelvis ;  it
joins the hip bones on each side, the last lumbar vertebrae above,
and the os coccygis below.   In children it consists of five or six
separate  bones, which, in the adult, grow together, and make 
STA.
495
one bone.   It is concave on the inside, and convex on the out-
side.
  SAFFRON—Crocus  Sativus—The  best  saffron grows  in
England.   The tops are the medicinal part.   It is of  a deep
orange color, and, of a pleasant, aromatic, bitter taste.  The saf-
fron is a stimulant and narcotic.   It  exhilarates  the  spirits and
strengthens the stomach.  In hysterical and spasmodic affections,
it has been used with advantage.  But almost the only use which
is made of it at present is in the measles, and some other eruptive
complaints.   We  should think it might  be useful in hypochon-
drism and other nervous complaints.   It is  used in the form of a
tea, taken as the occasion may require.
  SAGE.—Sage  is a good medicine  for the head and stomach.
It  is  soothing, stimulating, and  strengthening.   A tea made of
the leaves, and drank in cupfuls, warms the body, excites an ap-
petite, and quiets  the  nerves.   It is a mild aromatic, a bitter, and
an astringent.  In fevers of debility, it makes an excellent drink,
especially if lemon juice is mixed with it.  It also makes a good
gargle for canker  and ulceration in the mouth and throat.
  ST.  ANTHONY'S  FIRE—Erysipelas.—Almost  everybody
must  have observed as many as four different kinds of inflamma-
tion.   The first and most common kind is where the part swells,
grows red and painful, and  maturates, or  comes to  a head and
discharges matter.   The second is red, but never swells  much,
and  ends in ulceration or an eating  sore.  The third  kind of
inflammation  consists of  pustules, pimples, and red  spots, as in
the small  pox, tetter,  and measles.  The fourth kind is spreading,
and runs to a blister or  vesication.
  The St.  Anthony's fire probably received its name from the
burning sensation which often attends it, and the disposition of
the disease  to spread  like the flames of fire.  In no disease does
a redness  of the  skin appear to kindle up and to spread so fast
and wide  as  in this.  In the course of a few hours, the legs
and arms  will often be covered with little blushes, varying in size
from  that of a ninepence to that of a silver  dollar ;  and, in the
worst kind of the disease, these blushes will cover a space as
large  as the two hands.
  The St.  Anthony's fire is a diffuse  inflammation  of the skin
and flesh, which  appears  for the most part upon the head, face,
neck, and chest, but sometimes extends by degrees over the whole
surface of the body.  It commences with a fever, and about the
third  day, the cutaneous inflammation appears.   There is always
more  or less tumefaction of the skin and flesh, and the disease is
attended  with sleepiness,  and often  delirium.   Sometimes the
inflammation is confined to a particular part, as to the face, or to
one le^, and, at bther times, it will travel over the whole surface,
dying *away in one part, and  then kindling up in another. 
496
STA.
   The inflammation differs  amazingly as to the depth to which
 it extends, and the extent of surface which it will occupy.  When
 the face, for instance, is the seat of the disease, it will  sometimes
 occupy one side of  it, and at  others, both.  In some instances,
 it will appear  to be merely the  skin which is affected, and, in
 others, the whole flesh of the  face will  become thickened and
 caked.  The eyelids will  be enormously thickened and swelled,
 and the whole  face .and head  tumefied to  twice their ordinary
 size.
   The  erysipelas or St. Anthony's fire comes on with chills and
 fever, pains in  the head, back,  and limbs, and  more or less heat
 and  dryness of the  skin.  About the third day or the second
 night,  the tumefaction of the part commences.   The swelled
 skin and flesh soon become of  a dark red  color, smooth and soft,
 and  attended with  a sensation of burning  and  tingling.  The
 eyelids will sometimes look like bladders  of water, so large and
 heavy as to close the eyes.  The inflamed  integuments are not
 extremely sore  to the touch, but will  bear to be pressed without
 much pain, and when so pressed the redness disappears, but the
 color returns when the pressure is  removed.
   On the fourth or fifth day minute  blisters arise in different places,
 but especially about the centre of the inflammation or spot which
 is of the deepest red.  The fever all the while keeps on increas-
 ing.   The blisters or vesications  are  filled  with a transparent,
 watery fluid which  accumulates   until it breaks the  skin, and
 then runs  out.  By the  eighth or ninth day, the disease comes
 to its height, and the blistered  parts  begin to dry and scale off.
 The fever now subsides, and recovery commences.   There will
 often, however, be a relapse of two or three day's duration, when
 a complete recovery takes place.   It sometimes ends fatally, but
 we believe it is very rarely, except where  it prevails as a malig-
 nant epidemic, and when it follows large wounds  and surgical
 operations.
   The St. Anthony's fire or erysipelas sometimes prevails  as  an
 epidemic, of which we have seen several instances.   At  these
 times, the disease has been much more severe than at others.   In
 scattering  cases, the  disease is usually light, and commonly of the
erratic, or  running kind, confined for  the  most  part to the skin.
In this kind of the  disease, the blisters  are smaller and more
numerous,  commencing commonly in the face and  extending
successively to  the contiguous parts.  In some cases, the private
parts will be very much swelled.   In the worst cases, the disease
runs into gangrene or mortification.
  The erysipelas is for the most part  confined to women, child-
ren,  and intemperate men.   It rarely attacks  robust  and  full-
blooded men.
   The disease  is induced by particular conditions of the atmos- 
STA.
497
phere, by intemperance, want of good, wholesome food, exposure
to cold, and a sudden check of the perspiration.
   Domestic Remedies.—The best medicines  in this disease are
the cream of tartar and the sal nitre ;  and in malignant cases, the
quinine.  The best external application is alcohol.  In the com-
mencement of the disease, a table-spoonful of  the cream of tartar
should be given, to operate upon the bowels, and if one spoonful
does not produce the effect, another  should be given.   After the
bowels have been unloaded, eight grains of the sal nitre should be
given, and repeated, every three hours, if the fever is severe. Where
the fever is severe and the inflammation deep,  the quinine in the
dose of a grain, should be given once  in four hours.  The acetate
of ammonia or lemon juice, and the salts of hartshorn, is one of the
most  cooling drinks which can be given.  The common drink
should be cold water or barberry water.   The food the same as in
any other fever; water porridge, bread water, or bread soaked in
molasses and water.   If balm tea is preferred, or China tea, either
may be drank, instead of water.   Tea is an antidote to drowsiness,
and in this disease seems to be very  appropriate.  Green tea has
the most effect in preventing lethargy or sleepiness.
   A tea made of  the buckwheat  meal, is a good wash  for the
inflamed  skin and flesh; and when  the blisters have burst, the
dry meal itself may  be  strewed upon  them.   But we  believe
that alcohol in some form other, will be found  the most effica-
cious external wash.  Dr.  Fordyce says, that  alcohol applied to
the inflamed surface will cure the disease.  New rum is the most
common  form  in  which  alcohol is  used.  The inflamed parts
should be kept wet with  it continually.   When the face is much
inflamed and  tumefied, it will  sometimes be  advisable  to make
use of soft bread  poultices  applied cold, and  of the  solution of
lead or white vitriol.  " Tepid water, or weak  alcohol  and water,
may be  constantly applied to  cool  the  inflammation, to wash
away the matter discharged from the minute  vesicles which are
constantly bursting, and prevent the disease from  spreading.
Flour  and other farinaceous substances are beneficial,  by absorb-
ing the watery matter and protecting the diseased  surface from
the air, and by some are  preferred to liquid applications."   We
have less fears than many people of driving the inflammation in,
as it is called.  We have no  idea that inflammatory diseases are
driven about the system,  first in, and then out, as was the belief
of our theoretical  fathers.   We believe, as a  general rule, it is
best to attack diseases where we find  them, without any reference
to the changes which they have been conjectured sometimes to
have made.
   Professional  Remedies.—In  the  light kind  of this disease,
where it  is only  confined  to  red spots on the skin, a gentle **...
            63 
498
STV.
emetic of'ipecac, a dose  of salts, and a drink of lemonade will
be all the medicine necessary.
  In the severe kind, where the fever is inflammatory or typhoid,
as has often been the case of late years in this vicinity, it will be
necessary to employ more  active means.   In almost all severe
cases, the inflammation  attacks the face  and  head, and if the
swelling is considerable, the color of a dark red, and  the fever
high, one bleeding  may be employed either from the arm, or by
the use  of a dozen leeches.  One grain of  tartar emetic may be
given in solution, to operate upon the stomach  and bowels, and
repeated as the occasion may require.  After it six or eight grains
of the antimonial powder may be given, every two hours.  The
acetate  of ammonia may be applied as a wash, and acid drinks
given to allay  the  thirst.  Sudorifics are thought by Sir Astley
Cooper  to be among the best  remedies.   Painting over  the  in-
flamed surface with tincture of iodine is much practised by some,
and is a remedy deserving some credit.  Nitrate of silver and blis-
ters are  also used to prevent the spreading of the inflammation.
  The worst kind of the disease is the malignant or gangrenous,
where the inflammation assumes a livid hue ; and if vesication
has commenced, a  crepitus or rattling  of the  air is  perceived
under the  cuticle.  The  only way to combat  such  cases is to
give wine, quinine, elixir vitriol, ammonia, and other stimulants
and tonics.
  ST.  VITUS'  DANCE—Chorea.—This  disease appears to af-
fect chiefly the motion of the muscles and limbs.  It approaches
in a  measure to the nature of hysterics and falling fits, but is
much less severe than either.   Such  is the disposition to motion,
that  it is difficult to keep the affected limbs still, even when the
body is  at rest.  The arms and legs  make a kind of dancing mo-
tion when an  effort is  made to walk or  handle anything.   The
motion  appears about half  way between a convulsive and a vo-
luntary  motion.  It most resembles the shaking palsy in old peo-
ple, of any affection we know of.   In some instances, it affects
only one side  of the body, and in  others, all the muscles  and
limbs.   In this disease, the will is either not directed to the right
muscles to be moved, or the muscles are partially paralyzed.   In
raising a cup or tumbler to  the mouth, a person affected with the
St. Vitus' Dance, will  put it in all manner of directions before it
can be brought to the lips.   In attempting to walk, the same va-
riety of movements is made by the legs, before a proper step can
be taken.  It  will  appear, every  moment, as if the person were
going to fall, such is the reeling and  dancing of the body.  The
hands and arms experience  the same awkward movements, before
anything can  be laid hold of.   The  movements of the limbs are
executed with much more  difficulty  in the presence of strangers
and curious observers, than at other  times. 
STV.
499
  To what this disobedience of the muscles to the will is owing,
seems  difficult to discern.  It is  probable, however, that the
nerves of motion are  partially  paralyzed.   The  motions  of the
limbs can be executed much better to the sound of music, than
in any other way.   This effect is probably owing to the tempo-
rary excitement which is  created by the influence of the dis-
ease.   These people will often appear as if executing some kind
of strange, fantastic dance.  Various  grimaces and gesture's will
be made, as if done to excite  merriment, but the whole is una-
voidable.
  A degree of idiocy is sometimes the effect of the  disease, but,
in most instances, the mind remains unaffected.   The speech is
often impaired, and the pronunciation  difficult.
  The causes of the disease are supposed to be the effects of cold
from being  badly clothed; the want  of proper nursing, and  of
nourishing food; too  great confinement to the house or work-
shop;  bad air; and the want of cleanliness.  The disease is prin-
cipally confined  to children, and youth between the age of eight
and fourteen years of  age.   Some cases happen after puberty or
manhood, but these are rare.  Both sexes  are alike  subject to it.
  The best method of cure is to place the child or  youth in the
country,  if he does not live  there, and to allow him the freedom
of the fields and the woods.   If some light employment can be
found  for him, so  much the better.   The  sea shore is the most
favorable place, if such a country town can be found.   In addi-
tion to a favorable situation and sufficient exercise in  the  open
air, the diet is of the most essential  importance.   This  should
consist mainly of milk, salted meats and  fish, and wholesome,
dry vegetables.  Rye bread is a good article of food ; it opens
the bowels, and sets well upon the stomach.
  Purgatives have more effect in this disease, than any other me-
dicines.   The bowels, in severe cases, should be drained, every
day, for  a fortnight or three weeks in succession.   For this pur-
pose, pills made of equal parts of aloes and the oxide of bismuth
will be found well calculated  to succeed.   One, two, or three of
them may be  given, every night, as the case may require.  The
quinine in the dose of a grain, every morning, may be given at
the same time.  Any kind of purgative,  or any kind of  tonic
will answer, but we have named the two most useful.
  Valerian  is an  excellent  anodyne.   The poppy tea, if drank
plentifully and strong, will have no inconsiderable  effect in bra-
cing the nerves.   In some cases where the motions  are very con-
vulsive, attended with an irritability of the nervous system, lauda-
num or  morphine will be found serviceable.  Ten drops may be
given to a child of eight years old, and one drop added for every
year after it, until the fifteenth year.   Cicuta and the belladonna
have, in  some instances,  been found effectual.  The elixir pro is 
500
SAL.
a good medicine in this disease, given in the dose of a tea-spoon-
ful  every morning,  especially  where the child is  affected with
pin worms.   Castor, camphor,  assafetida and musk, are  all wor-
thy of trial.  Electricity or  galvanism, if properly and persever-
ingly used, has cured very many.  It should always be applied
until a moisture is produced upon the skin.  Warm bathing, in-
terspersed with now and then a cold bath, will have a very salu-
tary effect.  A course of the mineral spring water, both  saline
and chalybeate, should be tried where more domestic means fail.
But the greatest benefit is derivable from sea air, the freedom of a
country life, wholesome food, constant exercise, and a clean, well
rubbed skin.
  SALIVA—Spittle.—There  are three pairs of  glands  destined
to secrete the saliva.  They pour  the saliva into the mouth by
means of six ducts.  The amount of saliva which  they are sup-
posed to secrete in twelve hours, is twelve  pounds.   This fluid
is solvent and antisceptic.   It  penetrates and  softens the  food,
and  fits  it to be  digested in the  stomach.  It  requires a greater
degree of cold to  freeze saliva than water.  The body is undoubt-
edly emaciated whenever any great amount of the saliva is wasted
by spitting.
  SALIVATION.—An increased  secretion of the saliva in the
mouth.  Many substances have  this effect, but mercury is the
one in most  frequent use.   Mercury produces  not only a profuse
salivation, but a  permanent one.
   SALTPETRE—Nitrate of Potash—Sal Nitre.—This salt,
when analysed, is found to consist of aqua fortis and potash.  It
is found ready formed on the surface of the soil in  many  places.
In  the south of  Europe the formation of the salt is favored  by
artificial  means.   The carbonate  of lime is mixed with  animal
and vegetable substances in a state of decomposition, exposed to
the air, but sheltered.   In this way, the salt is developed,  after a
chemical process for separating and cleansing it.  It can be made
by merely mixing aqua fortis and potash, and crystalizing  it.
   Saltpetre or nitre has a sharp, bitterish, pungent taste,  followed
by a sensation of cold.  It explodes when thrown into the fire,
by which it  may be distinguished from other  salts.  It  is one of
 the best, if not the very best  diuretic which we possess.  It les-
 sens the heat of  the body, abates thirst, and promotes insensible
 perspiration.
   The sal nitre is used in a great variety of diseases, particularly
 in  fevers  and stoppages of the water.   Its power of  lessening
 the heat and promoting the  secretion  by the kidneys,  makes it
 an appropriate medicine in all  cases where there is violent  inflam-
 mation.  In the scarlet fever,  it has been in our hands  of inesti-
 mable value.  It is often used in diseases of the skin in the form
  of a lotion, particularly in the  salt rheum. 
SAL.
501
  The ordinary dose for an adult is six grains of  the  powder,
although it may be given in a smaller or larger quantity, as the
disease and particular symptoms  may  require.  Dose for a child
from one to  three years old, two grains.  It may be taken in
powder,  or dissolved in water.
  People should have a care that it is not  mistaken  for other
salts,  as, in large quantity,  it is  a fatal poison.   In malignant
diseases,  where the pulse is low, it is an improper medicine.
  SALT RHEUM—Psoriasis.—The  salt  rheum  is one of the
most common skin affections in New England.  It usually makes
its appearance in the beginning of cold weather, and often con-
tinues through the winter.   It often comes and goes many times
in the course of  a person's life, after being once subjected to it.
It consists of red, rough  patches, which appear in every part of
the skin, but more especially about the forehead, neck, shoulders,
on the inside of the arm below the elbow, on the  back of the
hand, and between the fingers.  The skin of the affected spots is
thickened, hard, and red ; is apt to crack or be chapped, and be-
comes very  sore.  This humor is more or less covered with  a
thin,  branny, dry scale.   If the  eruption  is pricked or eroded,
there oozes a thin, transparent fluid, which soon dries into a thin
scab.   There are  several different kinds of  the salt rheum, but
they all  show a rough, scaly state of the  skin, and are for the
most  part, attended with a  thickening of the cuticle, an angry,
iuflamed appearance under the scale, with cracks or chaps.   One
kind of the salt rheum runs  from one part of the skin to another,
and looks something like  an earth worm.  It makes a kind  of
furrow in the skin, and, in its serpentine course, will travel nearly
over the whole surface.
  Another kind is seated on the  lips,  particularly the  lower lip.
The lips are thickened,  hard, red, and cracked.  The cracks  in
the lips from this kind of salt rheum are exceedingly troublesome.
In young people, it  will sometimes last for two or three years,
unless cured in the early stage.   The  salt rheum differs from the
tetter in the  small quantity  of matter which it  discharges, and in
the thickening of the skin, and in its never betraying a raw, sup-
purating surface.  If any matter is discharged from the salt rheum
eruption, it immediately dries into a scale, whereas  the  tetter
often remains in a running1  state for a long time.
   The salt rheum eruption  is attended with a sensation of heat;
smarting and itching like the tetter, but has more the character of a
dry sore and less of an ulcer, than the  tetter.  This disease proba-
bly derived  its name from the circumstance of the watery matter
of  the  eruption drying into a thin scale  like a solution of salt.
And, hence,  the conclusion, that the disease was owing to a salt
humor in the blood or the system.
   There is  one kind of this humor which spreads  into large 
502
SAU.
patches.   This kind appears on the temples, cheeks, chin, neck,
and about the ears ; it affects the arms  below the elbow, and,
sometimes, nearly encircles the fingers.   Even the  nails, some-
times crack, and peal off.  The spot first affected with it com-
monly gets well before the humor proceeds to a new place.  The
duration of the salt rheum is from one to four months, but, some-
times, it will become permanent.
   Domestic Remedies.—In  the first  stage of the eruption, the
best thing to apply to it, is a weak  solution of white vitriol, or
Thomson's eye-water.   Two  grains of the white vitriol to an
ounce of rain water, makes awash quite strong enough.   A solu-
tion of the sugar of lead  of the same strength will in some cases
suit the eruption better than the white vitriol.   This humor has,
in many instances,  been  cured by giving  the  buckthorn syrup,
three days in succession,  and then omitting its use for as many
days until the disease disappears.   The  calamine ointment, Tur-
ner's cerate, must be constantly applied to  the  eruption at the
same time.   The sarsaparilla tea is said to have  effected many
cures, in conjunction with some cooling ointment.   It is of the
utmost importance  in  this disease  to  soak the skin well with
warm water, and  to  soften it as much as  possible by soft, bland
poultices.   The diet should be light, nourishing, and fresh, and
the drink cold water.   Heat and soap aggravate the eruption ex-
ceedingly.
   SARCOMA—A fleshy tumor, such  as  a wen.—In some rare
instances,  they are  absorbed, but, in general,  they must be cut
out  to effect a cure.  Some are rapid in growth, and others ex-
ceedingly  slow.  They have  neither  soreness,  heat, nor  pain,
unless inflamed or irritated.
   SARSAPARILLA.—This root grows in Ohio and other  parts
of the Union, and in the Spanish West Indies.   It came into use
as a specific for the  venereal disease.   It  consists of bunches of
small roots, as long, and about the size of  whip cords ; the bark
is of a blackish color, and the woody part  of a white color.
   The virtues of  the root are said to reside in its bark.  It has a
bitterish, glutinous taste, and readily yields its virtues to cold or
hot water.   Infused in cold water, and allowed to stand for a day
or two, it  affords  a mucilaginous drink, which is valuable in dis-
eases of the urinary passages, and in  the  confirmed stage of
syphilis.   It is thought by many to alter and improve the blood,
and is given in many diseases to change  the state of the fluids.
It is probable that  it possesses a property of this  nature, when
used freely, and for a length of time.   An ounce  or two of the
root may be infused in half a pint of hot water, and drank in four
separate draughts in the course of the day.
   SAUNDERS,  RED—This  is a wood of a dull red color,
brought from the East Indies.  It is grounj, and  used in medi- 
SCA.
503
cine chiefly as a coloring matter.   It  communicates a deep red
color to alcohol and proof spirits.   It gives the color to red lav-
ender.
  SAVIN E—Juniperus Sabina—There is no one domestic medi-
cine of more value than the savine.  It has  the singular property
when  rightly administered, of hastening and  restoring the men-
strual  secretion.   Although a stimulant  in general, the  savine
more than  most other medicines, appears  to operate upon the
womb.  It is a common shrub, produces a blue berry, and evolves
a terebinthinate smell.  The leaves are the part used in medicine.
They are dried, powdered, and given in the dose of  twelve or
fifteen grains,  three  times  a day,  in molasses or syrup.   From
the leaves is distilled an essential oil, which has the same proper-
ties with the leaves themselves.  They have a bitter, acrid taste,
and a disagreeable smell.
   The savine increases  all the secretions and  the heat of the
body.  Upon the urine it has the  same effect as upon the men-
 strual discharge.   The  fine powder, mixed with  simple cerate,
 makes a valuable  ointment, with which to  dress issues and blis-
 ters,  where we wish  to  produce a discharge.   The value of the
 savine has never been properly appreciated.  In chronic rheuma-
 tism, it has been used with  success, and in several other diseases
 where there was a want of a brisk circulation of the blood and a
 proper degree of warmth.
    SCALD HEAD—Tinea Capitis.—The scald  head is a humor
 in the scalp which consists of large, yellowish colored  pimples,
 or rather, pustules.   These pimples continue to increase in size,
 for a few days, when they break  and discharge a watery, sticky,
 acrid, eating, hot matter, which mats the hair together and ex-
 tends the humor to other parts, and, in many instances, all over
 the scalp.  As fast as one  crop of the sores heal,  another is pro-
 duced by a diffusion of the hot, acrid matter, until the surface of
 the head becomes a complete, scab.   The  eruption is attended
 with  a considerable  degree of itching, and the matter of the hu-
 mor settles into dry  scales or yellow scabs.  The  humor uproots
 the hair, and for a considerable time, the child is left quite  bald,
 but  the hair  grows again, and, we  believe,  the  disease  rarely
 leaves the  scalp permanently bald.
    The pimples which appear in the eruption, are circular in form,
 and not pointed, but rather flatish, with an irregular edge.   The
 disease will  last from  three or four  months to as  many years.
 Grown people are seldom or never the subjects of it.
    Domestic Remedies.—The head,  in this  disease,  should be
 carefully soaked  every day with warm rain  or spring water, and
 the whole surface of the skin should often be  bathed, and kept
 clean.  When the  eruption first  makes its appearance, a weak
 solution of the sugar of lead will often arrest its progress, and, 
504
SCA.
especially, allays  the itching.  When  the irritation and  itching
become extreme, a dose of laudanum or paragoric must be given.
If the eruption runs badly, as is almost always the case, a little
of the lump magnesia, finely powdered, may be  strewed on, or a
little hair powder.   The ointment  called Turner's  cerate, spread
upon a piece of linen and laid upon the humor, is one of the most
cooling and the most healing applications  which can be made to
the scald  head.  Many people wash  the head with  soap and
water, but this will not answer in  every case.   Cooling applica-
tions should be tried first, and, afterwards, those which are stimu-
lating.  The inner bark of the elder  mixed with cream, is an
excellent ointment for small children.   An ointment made of the
narrow dock is also no mean remedy.   After the violence of the
humor has  somewhat  spent itself, the citrine  ointment will be
found  the  most healing of  any of the stimulating applications.
The tar ointment, made of  equal parts of tar  and  mutton  suet,
and spread  upon the scalp, has often cured the  disease.
   The diet in this disease should be light, but  nourishing ;  and
the scalp can never be bathed too much.   If  people would take
pains enough, we believe, the disease might be cured by bathing
alone.   The child should take quinine or  the Griffith's mixture.
A dose of  the cream of tartar should be given  every other day,
which may vary according  to the  age of  the  child,  from a tea-
spoonful to a table-spoonful, mixed with syrup or molasses.
   Professional Remedies.—It. will often be  necessary in  this
eruption, to give Ethiop's mineral or some other form of mercury.
To a child  between one and four years of age, two grains of the
mineral can be given, every day ;  and to those who are  older,
four grains.  It will often  be advisable to give small doses of
calomel.  Powdered charcoal has been known to cure the erup-
tion when applied locally to it.   The iodine should be tried.  A
course of mineral waters should be tried in obstinate  cases, and
medicated baths.
   SCALDS AND BURNS.  See  Burns.
   SCAMMOMY —Convolvulus Scammonia—This  medicine
comes from  Aleppo, in light, spongy, friable masses, of a shining
blackish ash color.  Indeed, the powder  looks very much  like
ashes.   It consists, in nearly equal  proportions, of resin and gum.
Scammony  is a thorough, strong, drastic purgative.  It is used in
cases of constipation, and torpidity  of the bowels, as in palsy and
chlorosis.   It is commonly mixed with milder  cathartics.  The
dose is from  three to twelve  grains, triturated with sugar, almonds,
or gum arabic.
   SCAPULA—The Shoulder-blade.
   SCARLET  FEVER—Scarlatina Anginosa, Rosalia.—This
disease has  taken its name from the peculiarly florid color of the
skin which  usually attends  it.  As this, however,  is  not a con- 
                            SCA.                         505

stant  symptom, it cannot be considered as characteristic of the
disease, nor can we form any opinion of the severity of the at-
tack,  or prognosticate what may  be the  termination,  by the
quantity of the eruption, or the degree of redness,  except when
considered  in  connexion  with other symptoms.   Like other
febrile diseases, scarlet fever usually commences with some de-
gree of chilliness and shivering, debility, and lassitude, or disin-
clination to take exercise, pain  in the head,  back and limbs; the
whites of the eyes become reddish, and the expression of the eye
is  peculiar, indicating great suffering.  There is sickness at the
stomach and vomiting, which are generally severe  in proportion
to  the violence of the attack.  The surface of the  body is often
intensely hot and dry, though the extremities are sometimes cold
in  the early stage, in consequence of  the unequal  circulation of
the blood.   When the eruption is present, which happens in the
great  proportion of cases, it makes its appearance in  the course of
the second  day, in innumerable fine scarlet dots, which are  at
first distinct, the intermediate spaces  appearing from contrast, pre-
ternaturally white; but as the disease advances, the dots become
more  numerous, spread, and run together, giving the skin a con-
tinuous scarlet color, resembling the  shell  of a boiled  lobster.
There forms on the top of each of these dots, small  vesicles filled
with a  pellucid fluid, which at, the  crisis dries away, leaving a
scurfy or scaly appearance of the skin, which lasts a number of
days,  until  in some instances the whole  scarf  skin is  cast off.
These vesicles have the appearance of small pimples or goose-
flesh,  but are not always apparent to the naked eye, and can sel-
dom be  seen without a close examination.  There  is frequently
a  peculiar swelling or puffiness of the flesh, particularly of the
hands, spreading and distending the fingers in a manner unlike
any other  disease.   The tongue in the  first  stage of the dis-
ease,  is  more  or  less coated with  a greyish  or brownish fur,
especially in the middle, through which may be seen many small,
reddish,  nipple-shaped eminences or papillae, the edges being of a
deep flush color; but as the disease advances, it often becomes
suddenly clean, leaving the surface of a  fiery and frequently
glossy red.  About the time of the crisis, it  is not uncommon for
the tongue and whole lining surface of the mouth, to be raw and
exquisitely tender, rendering it extremely painful to take into the
mouth any but the  mildest liquids.   The pulse is invariably very
rapid, frequently numbering  one hundred and forty or fifty in a
minute in children, and in  adults  one hundred and twenty or
thirty.   The artery feels small, and the beat  is rather soft and
often  obscure, though sometimes hard and wiery.  The symptom
which is the most constant in this affection,  the one without
which, in fact, the disease never exists, is a peculiar  inflammation
of the throat, which  almost immediately runs into  a state of ul-
            64 
506                        SCA.
ceration.  Upon pressing down the tongue with the handle of a
spoon, and looking into the mouth, the  palate and throat, as  far
as it can be  seen, appear swollen and of a deep florid color,  and
upon one or both tonsils may be seen whitish or  greyish ulcers.
These ulcers are sometimes  small, and  are usually confined to
the tonsils,  though they occasionally extend to  the  uvula  and
other contiguous parts.   The  inflammation and consequent swell-
ing and ulceration of the throat, are the cause of one of the most
troublesome symptoms attendant upon the disease; a great  and
painful  difficulty in  swallowing.   The  difficulty, indeed, is so
great in some instances, as to  render it impossible to get anything
into the stomach; liquids being frequently rejected through the
nostrils.   In some cases, however, swallowing is performed with-
out pain or difficulty.
  A circumstance that renders this condition of the throat pecu-
liarly distressing, is that the secretions of the parts are very much
increased  and acrid, creating almost an incessant inclination to
swallow, in order to clear the mouth and throat of the acrid mu-
cus with which they are constantly being filled.
  This preternatural accumulation of mucus in  the  throat  and
back part of the nostrils, to which the inflammation extends, also
gives rise to another symptom that is often observed, especially
in children, which is a disagreeable rattling noise  in breathing.
This is caused  by the passage of the air through the accumulated
phlegm, which is constantly being  forced forward and discharged
from the  nose.  This  symptom continues a number of days,
and frequently  gives  the friends much unnecessary alarm.
  The passage  from the throat  to  the ear, called  the Eustachian
tube, participates in the disease, the inflammation extending up
to the ear and  causing  pain and swelling in that region.  The
glands under the jaw and ear inflame and produce one or more
swellings externally, which sometimes  increase  to a large size.
Cases are occasionally  met with, in which these  swellings grow
very rapidly in the early stage of  the complaint, extend round
the fore part of the throat, and  pressing upon the windpipe,  pro-
duce suffocation  and death.  It more frequently  happens, how-
ever, that  they progress slowly, and many days or even weeks
after the fever has subsided, either gradually disappear, or go on
to suppuration, and ultimately break and discharge their contents
externally.
  When abscesses form and discharge through the ear, some de-
gree of deafness, which is generally incurable, is not an unfre-
quent consequence.
   Scarlet fever is what may be  termed a self-limited  disease,
and probably  there is no one, excepting  the  small pox,  and
two or three of  the contagious eruptive diseases,  that runs its
course with more regularity as to the time it  takes up in its differ- 
SCA.
507
ent stages.   The  eruption appears on the second  day, and con-
tinues with but little visible alteration  until about the seventh,
when it begins to  fade, and desquamation takes place, and when
the violence of the disease has not been so great as to destroy the
organism of the whole system or some  important, part, a general
amelioration in the symptoms may be expected.   It is a general
observation, that if no very fatal symptoms be present on the
ninth day, the patient may be considered out of danger.   Judging
from  our  own observation, this  remark  applies almost  equally
well  to the seventh  day, for in  those  cases where death takes
place  from the violence of the fever, and not from the sequelas of
the disease, which may be fatal  even after a mild run of fever,
there  are almost always unequivocal signs of dissolution, as early
as the sixth or seventh day.
   In those cases which prove fatal,  death may occur on the third
or fourth day, though it more frequently happens from the sixth
to the eighth or ninth.  We would not be understood to mean
that there  is no variation in the length of time this disease runs,
as there are many  circumstances which  may vary it more or less ;
when very mild, it may be shortened a  day or two, or if unusu-
ally violent, be protracted a few days.   We occasionally meet
with cases in which the prognosis is very difficult, as late as the
tenth or eleventh  day.  If we plant  the  seed of  any particular
vegetable, we may expect that  vegetable to arrive  at maturity in
a certain number of weeks or months, but it is well known  that
its growth may be hastened or retarded  by the nature of the  soil,
the character of the season and cultivation; so with self-limited
diseases, the constitution, the weather, the peculiar character of
the prevailing epidemic and the treatment, may produce slight
variations.
   Scarlatina may  be distinguised from  measles, the only disease
whiqh it much resembles, by the  absence of cough and other
catarrhal symptoms, by the appearance  of the eruption, it being
more  of a scarlet color and the dots smaller, and by its appearing
on the second instead of the fourth day, by the ulcerations in the
throat, and the prevailing epidemic.
   If measles be prevalent and the patient  have been exposed to
the contagion, we  should expect the disease to be measles, but if
there  have been no such exposure, or if the patient have previ-
ously had that disease, there will be  no difficulty in forming an
opinion of the nature  of the case.
   The quinzy being  seated in the throat, may be mistaken for
scarlatina, but as in quinzy there are no  superficial ulcerations
upon  the tonsils, there  being only a smooth glossy swelling, the
tendency of which is to the formation of  an abscess, and as it is
unaccompanied by an eruption, there can  be but little difficulty
in distinguishing them. 
508
SCA.
   Almost all  authors mention a variety  of scarlatina, which is
called  simple  rash,  scarlatina  simplex ;  but  it  is  our  opinion
that if the throat be not affected, it cannot be considered as a va-
riety of this disease,  but is a distinct affection.
   Whether  scarlatina is contagious,  is a question of the great-
est importance, and  one  which is  the  most difficult  to decide.
It is the common belief  when a  number of cases occur in the
same family or  neighborhood,  that one individual has  taken it
from another; but inasmuch as there is no good reason why the
same cause which produced it in the first instance may not have
produced it in the second  and so  on, it will readily be seen that
any conclusions  arrived at in this  manner, are liable to be falla-
cious.  Judging from our own observations, however, which have
been by no means limited, and the  best authorities on the subject,
we are inclined to the opinion, that it is in a greater or  less de-
gree contagious, and would recommend that all reasonable means
be used to prevent it from spreading in that way.  No harm can
come from keeping the  sick  and well as  much separated as cir-
cumstances will conveniently permit.
   The length of time the contagious matter, remains latent in the
system, probably varies from  a few days to several weeks, but it
has been satisfactorily ascertained, that the ordinary period is five
or six days.   The uniformity with which the disease has made
its appearances about the fifth  day after exposure to the conta-
gion, has been to our minds one of the  strongest  proofs of its
contagious character.  A number of cases  have recently occurred
under our observation, in which there could be  but little doubt
that  the disease originated in this manner.   It should be observed
here, that all persons are not equally susceptible to the contagion,
and though one may take it, another who  is equally exposed may
not.   It is a disease of infancy and youth, though the suscepti-
bilty to it is not  entirely extinct at forty-five, as cases sometimes
occur at this age.  A particular friend of ours, a man well known
in this community, when on a visit in  the north part of Massa-
chusetts, sickened, and died of scarlet fever, in a few days, at the
age of forty-one years ; and we  have had a violent case in our own
family, in a person aged forty-two.  It rarely however attacks
persons over forty, and when it does, it is not often dangerous.
The susceptibility to the disease  is  very much  lessened,  for a
time at least, by having  once had it, but it is not destroyed.
Whatever the  opinion of others may be upon this subject, we are
convinced from observation, that the same individual may have
the disease  twice or more, but are inclined to the opinion that
the  subsequent  attacks are  not likely  to be as severe as  the
first.
   Upon the subject  of the cause or causes of the scarlet fever,
but little is at present known.  All attempts to investigate them 
SCA.
509
 have proved futile.  It appears in all seasons of the year, and in
 all kinds of weather,  though it  more frequently prevails in  its
 severer types in the cold  and wet seasons than in the warm and
 dry.
   It often prevails epidemically, being undoubtedly produced by
 some kind of exhalations from the earth, miasms floating in the
 air, or other atmospheric  influences, the precise nature of which
 eludes detection.
   Remedies.—Perhaps there  is no disease  about the  treatment
 of which a greater diversity of opinion prevails than that of scar-
 let fever.  By some physicians of eminence the antiphlogistic or
 reducing  plan, by bleeding, cathartics, and  antimonials, is vigo-
 rously adopted : by others of equal celebrity the extreme opposite
 treatment, by wine, bark, quinine, and cayenne, is considered the
 most successful.   Some  have great confidence in medicine, and
 accordingly  prescribe it in unbounded quantities, whilst others
 again, believing it to be self limited and but little under the con-
 trol of remedial agents, and that the recuperative powers of the
 system are more  likely to bring the disease to a favorable crisis,
 when allowed to  operate undisturbed, give little if any active
 medicine, leaving it principally to nature.
   All  these, and the numerous other modes of treatment  that
 have been proposed, are  probably wrong when  indiscriminately
 adopted, though they may all  be occasionally right when applied
 to particular cases or epidemics.   Much attention to the character
 of the prevailing epidemic is indispensable, in order to be able to
 manage it with the greatest prospect of success.
   Should there be  a  general and unequivocal  tendency to  the
 inflammatory character, antiphlogistics may be  cautiously used.
 We  say cautiously,  for it should  be observed that  this class of
 remedies is  never  borne as well in this as in many other fevers
 when of the same  apparent degree of violence ;  but should  the
 symptoms of the case  under  treatment, or the general  character
 of the epidemic, be of the typhoid or putrid kind, stimulants,
 and tonics will undoubtedly be serviceable.
   It may be remarked in regard to the treatment of this violent
 and unmanageable  disease, that it is much  easier to say what is
 not right, than to point out what is.  We will, however, as con-
 cisely and explicitly as possible,  describe what appears to us to
 be the most  rational practice at present known; a course of prac-
 tice that will always be safe, and  if we mistake not, as successful
 as in the present state of our knowledge, can be expected.
  When a person is  attacked with the symptoms  of scarlet fever,
one of the first and most important things to be done, is to bathe
the feet and  hands in hot water, which may be rendered more
efficacious by the  addition of mustard, cayenne, salt  or  some
stimulating  herbs.   A deep vessel should be used, and the bath 
510
SCA.
 continued twenty or thirty minutes, and for the first two or three
 days should be repeated twice or thrice a day.
   After the fever is established,  the cold stage having passed  off,
 simple warm water will be  preferable  to a stimulating bath, and
 if the patient be very weak, once a day  will be sufficient.  Should
 the patient not have  strength to sit  in a chair,  he may recline
 upon  a bed, and  let his feet  hang off into a pail placed upon a
 stool of convenient height,  or woolen  cloths may be wrung out
 of the bath and wrapped around the feet and legs.  In applying
 baths in this manner, great care is necessary not to  have  them
 get cold before they are changed.  After the bath, if the head be
 affected, as  is usually  the case, mustard or some  other stimula-
 ting poultices should be applied to the  feet of sufficient strength
 to produce some  degree of  smarting.   As the disease advances,
 however, if the heat be great, stimulating applications  become
 uncomfortable and unnecessary, and should be omitted.  During
 the continuance of the cold  stage, warm sudorifics or perspirative
 drinks, such as saffron, pennyroyal, or catnip tea or vinegar  whey
 should be freely given, if the stomach will retain them, but should
 the stomach be irritable  and the vomiting frequent, very  small
 quantities only of liquid should be allowed, and these must  be of
 a nature calculated to allay the sickness.  For this purpose  toast-
 water, spearmint or small  draughts of  soda water are among the
 most suitable.  A strong mustard poultice applied over the  pit of
 the stomach is often  a valuable  remedy  for  the  sickness and
 vomiting.   Should  there be sickness or oppression of the  stom-
 ach, without  much vomiting, attended by headache, and the
 bowels be costive, a gentle  emetic of  ipecac or warm thorough-
 wort tea may be attended with beneficial  effects, and should it
 not operate upon the bowels, may be followed by a small dose of
 castor oil, epsom salts, calcined magnesia, or rochelle powders, or
 some other gentle physic.   Powerful  emetics and cathartics are
 not only unnecessary but  decidedly injurious, in  every stage of
 the disease,                                                ,
  The second or eruptive stage of the  fever may be reckoned
from the  second or third  day to the seventh  or eighth, during
which time the patient should be kept  perfectly quiet ;  if.  possi-
ble in an  airy room, from which the  light should be excluded.
The bed clothes, as well as  the body linen, should be light, and
frequently changed, and in  every  particular  the  greatest atten-
tion should be paid to cleanliness and the general comfort of the
patient.
  No  solid food of any kind will be required or allowable.   Pa-
tients  with this fever suffer much from  thirst, a strong indication
that liquids are necessary and proper, and as after recovering from
the first shock of the disease, the  stomach will generally retain
them in any reasonable quantities, cold  water, lemonade, barberry 
SCA.
511
or tamarind water, thin gruel, rice water, balm or flax-seed tea, or
some similar unstimulating beverage should be liberally allowed.
both as a means  of contributing to the present comfort of the
patient and of mitigating the fever.  Should the bowels be con-
fined, an infusion of elder flowers and mullein is an excellent
domestic medicine.   A tea-spoonful of cream of tartar dissolved
in a pint of flax-seed tea and sweetened to the taste and drank at
intervals, may also do well under  these circumstances.   If the
costiveness prove obstinate, a small  dose of castor oil, epsom salts,
calcined magnesia, and  rheubarb, or rochelle powder must again
be  resorted to.   With the view of promoting the  action  of the
skin and  kidneys, the spirits of nitre in doses of from ten  drops
to a tea-spoonful, according to the age of  the  patient, may be
given every two  or three  hours,  in cold water, or some  other
simple vehicle.   The nitrate  of  potash, saltpetre, being one of
the best refrigerants with which we are acquainted, and also an
excellent  local application to an inflamed and ulcerated surface,
appears to be  admirably adapted to the cure of this disease.  By
coming in contact with the ulcers in the  throat in being  swal-
lowed, it answers the purpose of  a gargle, and  in the stomach
it exerts a favorable influence upon the fever.  It may be  given
every three or four hours in doses of from one to ten grains, dis-
solved in  sufficient  water  to make a tea-spoonful dose  for an
infant, or a table-spoonful for an  adult.   Ipecac is a very safe
medicine, and as it promotes the healthy secretions of the  stom-
ach and bowels and also operates upon the skin, is well adapted to
the treatment of scarlet fever.  The dose should not  be so large
as to nauseate much ; from a quarter to half a grain  for a child,
or a grain for an adult, may be given every three or four hours,
mixed with molasses or syrup, or combined with  either  of the
medicines before mentioned.  Bleeding,  though  highly recom-
mended by some, is seldom necessary, and  should be resorted to
with great caution.   Cases may occur, however, when the fever
.settles  upon the brain or some other important organ, in which
bleeding  from the arm, or what is  preferable, by leeches, applied
to the part most  affected, will be followed by relief, and perhaps
contribute to the restoration of the patient.   Some physicians of
eminence  are partial to the use of calomel in this  disease,  and  it
is highly recommended by some of our most popular authors, but
never having  seen any  beneficial effects produced  by it, we have
long since ceased to give it, and mention it here  rather to enter
our protest against its indiscriminate employment  than to  recom-
mend it.
   The muriatic  acid is much used by some  physicians of emi-
nence in all severe cases of the disease, and as it combines tonic
with febrifuge properties, would  seem to  be well adapted to the
nature of  the complaint.   We have prescribed somewhat exten- 
512                         SCA.
sively, however, without  any very  striking advantage  from it,
and of late only recommend it in those cases in which  there is
great  debility and an obvious  tendency to putridity.  The most
convenient form  of giving it, is to  drop into a half pint glass
tumbler  forty-five drops of the acid, fill the tumbler with water,
and sweeten  with loaf sugar or honey.  A dose of a tea-spoonful
for a child, or a table-spoonful for an adult,  may be given  every
two or three  hours.  In extreme  cases these quantities  may be
considerably  increased  without danger.
   One of the most powerful and at the same time most pleasant
means of carrying off the  inordinate  heat, and  subduing  the
raging fever, is a persevering  application  of moderately  cold, or
tepid  water, vinegar  and water, or weak spirit and water.  When
the heat is very great it may be applied over the  whole  surface
of the body with  a sponge or soft cloth, but  if the  heat be mode-
rate and confined to the head, it should  be  applied to the head
principally.   If the sensation produced by the application of cold
be agreeable, we may expect a beneficial  effect from it, but if it
be  disagreeable it will be doubtful,  and tepid  or warm water
should be preferred.  Extremely cold water or ice gives a shock
to the system that will be followed by reaction more or less vio-
lent, and an  increase of heat, whereas  that  which is moderately
cold or tepid, though  it evaporates quite as rapidly and  conse-
quently dissipates fully as much  heat, is not liable to this objec-
tion.  Whenever  the heat of the  body is greater than natural, it
will be perfectly safe to keep up a constant  evaporation from its
surface.  This should always be the criterion, for if the tempera-
ture be below the natural standard, the application of cold, by
too much exhausting the vital  heat may prove injurious.
  None except  those who have experienced  them, can conceive
of the agreeable  and  soothing effects of bathing with cold or
tepid  water, when suffering from the  scorching heat of this fever.
   The introduction  of this practice is among the greatest im-
provements that have ever been made in the medical art, and has
conferred upon mankind one of the most inestimable blessings.
It is worth all other remedies, and has justly immortalized  the
name  of  Dr.  Currie,  by whom" the practice of cold effusion was
first introduced.
   When there is a tendency to typhoid or putrid symptoms, indi-
cated  by  great prostration, a  recession of the eruption, or  the
eruption  changing to a purple  or mahogany color, delirium, very
frequent, small pulse, deep red tongue, or the fur upon the tongue
being  of a dark brown color, and the ulcers in the throat becoming
gangrenous, the disease has been  called malignant or putrid sore
throat, scarlatina maligna, and  treated of by  authors as a distinct
variety.  As, however,  the scarlatina maligna is produced by  the
same  influences, appears simultaneously with, and under the same 
SCA.
513
circumstances, as scarlatina maligna, it appears more rational to
treat of this  form of  the  complaint as only aggravated cases of
the disease under consideration.
  In violent attacks, the system, which may be in an unfavorable
state to bear  the shock, soon sinks under its deadly influence, and
the powers of life being insufficient to sustain the vital functions of
the different organs, putridity supervenes, as a natural consequence.
   In this form of the  disease, the remedies must be of an entirely
different class.  Whether  the putrid symptoms  come on in the
course of the fever or begin with it, is immaterial as respects the
treatment; the  symptoms above mentioned are  sure indications
that the system is yielding under the poisonous influence of the
morbific cause, and unless it can derive some support from timely
and judicious means,  will probably sink into an irremediable con-
dition.   With the view of sustaining the system  and stimulating
it to the performance of the vital functions, tonics and stimulants
must be administered according to the circumstances of the case.
 In well marked  cases of  putridity, the quinine is perhaps one of
 the most  appropriate tonics ; a dose proportioned to the age of
 the patient  should  be  given every  four hours,  at  the  same
 time, Lisbon, Sicily, or old Madeira wine, in the  form of wine
 whey or mixed with toast water, should be frequently adminis-
 tered in small quantities.   Cayenne  is a remedy of much value
 in these cases.   It  may be given in the  form of tincture, hot
 drops,  infusion, or mixed with hot sweetened water.   As diffusi-
 ble stimulants, the aqua ammonia, spirits of hartshorn, carbonate
 of ammonia, salts of  hartshorn, and camphor, are among  the most
 advisable ; when the head is affected the camphor may be given
 in liberal doses in the form of a powder, mixed with syrup, or  in
 emulsion combined with the ammonia.
    Much importance has ever been attached to the use of gargles
 in all stages of the disease, and for this purpose innumerable pre-
 parations have been proposed.   When chosen with reference  to
 the stage and nature of the case, they are unquestionably among
 the most reliable means which can be employed, either to render
 the condition of the patient more comfortable, or to promote a
 healthy action in the ulcers.  During the  first four or five days,
 while active inflammation continues, stimulating  and acrid gar-
 gles are seldom beneficial, and often aggravate the local  affection,
 but the most soothing  effects are experienced from the frequent
  use of those that are mild and  unirritating.  Warm  water, flax-
  seed or slippery elm tea, and gum arabic water are perhaps the
  best.   The constant employment of these has the  effect of a
  soothing poultice to an inflamed sore, and besides assuaging the
  pain,  very much lessens the difficulty  of swallowing.   As very
  small children cannot  gargle,  a tea-spoonful  of one  of these
  should frequently be put into the mouth and allowed to be swal-
              65 
514                        SCA.
 lowed.  Toward the termination of the second stage, those that
 are somewhat stimulating will be proper.   Sage tea sweetened
 with honey, and a solution  of borax  are often used with happy
 effects, but perhaps one of the best domestic gargles is made by
 dissolving common salt in equal quantities of vinegar and water,
 sweetening with honey or loaf sugar.  No  bad effects need be
 apprehended from its being  swallowed in small quantities.
   In those cases in which there is an evident tendency to gan-
 grene and sloughing, cayenne pepper, myrrh, peruvian bark, and
 chloride of soda  must be resorted to.   Physicians often  use the
 white vitriol and lunar caustic.   The  former may be dissolved
 in water in  the proportion of twenty or thirty grains to half a
 pint.   If the lunar  caustic be used, it should be dissolved in the
 proportion of from four to eight grains to the ounce  of water, and
 applied with a small swab, or the ulcers may be touched with it
 in substtance.  The inhalation of the steam of water or herb tea,
 or if a stimulant be indicated, of myrrh and vinegar is sometimes
 preferable to, gargle, and  should always be used in aggravated
 cases.
   In regard to the advantages of blisters and other external appli-
 cations to the throat, some diversity of opinion prevails.  Blisters
 are much used by some, but when applied directly upon the seat of
 the principal irritation, it  certainly may be  questioned whether
 they do  not  add at least  as much as they take  from the  local
 disease, to say nothing of the general  disturbance  which they
 occasion. At the onset of the disease, if the throat be painful, a
 mustard poultice, a bag of hops or some kind of herbs steeped in
 vinegar, or a flannel  moistened with  volatile  liniment  may  be
 applied ; but during the hot stage these are uncomfortable, in-
 convenient and uncertain remedies.  If anything is  necessary at
 this time, evaporating  lotions of spirits of camphor,  alcohol and
water, ether,  or a warm, soft bread poultice should be preferred.
   Scarlet fever, even when  mild, is sometimes followed by an
 affection of  the windpipe, the  symptoms of which very much
resemble those of croup, and though  differing in  its nature from
 that  disease, has  commonly been called by  the  same name.
 Should symptoms of this affection come on, an emetic of ipecac
 or ipecac and white vitriol  may  be administered, hot fomenta-
 tions be applied to the neck, and the steam of water, or an infusion
 of emollient  herbs be frequently inhaled,  as  the most  rational
means of cure.   If the general system be in a favorable condition
 to rally, tracheotomy may be worth  a trial  as a dernier resort.
 This affection, to say the least of it, is alarming, and is fortu-
 nately very rare.
   A  much more frequent sequel to the scarlet fever is a dropsical
effusion  into the flesh or some of the cavities of the body.  In 
SCA.
515
 these  cases, active physic  and diuretics combined with mild
 tonics, are the remedies upon which we must depend.
   Calomel, though not to be depended  upon during the continu-
 ance of the fever, is  here an invaluable medicine.   It may be
 given in doses of from five vto fifteen grains, combined with jalap,
 rhubarb or castor  oil, and be repeated until it operates upon  the
 bowels.
   Cream of tartar and  jalap, calcined magnesia, epsom salts and
 senna are valuable  medicines for this  purpose, and if  preferred
 may be used instead of the calomel.   As diuretics, or those medi-
 cines that tend to increase  the secretion of urine, the  spirits of
 nitre, liquor potassae, acetate of potass, and digitalis, foxglove, are
 some of the most potent.   Dogsbane, apocynum canabinum,  is a
 powerful cathartic and diuretic, and is well adapted to the treat-
 ment of dropsies ; as, however, it is very active, caution is neces-
 sary in  administering it to children.   One ounce of this root may
 be steeped in  a pint of water, of which a table-spoonful is a dose
 for a child of two  years, to  be repeated  every two hours until
 some effect is produced upon the bowels.   As a domestic remedy
 in this and  other kinds of dropsies, perhaps there is no one equal
 to the cleavers, goose grass.   An  infusion of this weed may be
 given with  great freedom, and with  almost certain benefit.  Its
 activity will be increased, and its taste improved by being acidu-
 lated with cream of tartar.
   It has been observed that swellings upon the neck often con-
 tinue after  the subsidence of the fever, and this is among  the
 most common consequences of the disease.   Should this occur,
 a plaster of white  diachylon, or Noel's plaster may be applied
 over  them  for a few days, until it can be  ascertained whether
 they are disposed to disperse, or to come forward and suppurate.
 If the tendency be to  suppuration, the  process may be hastened
 by warm flax-seed or bread and milk  poultices, and if they do
 not  break spontaneously they  may  be opened with a lancet,
 when a cure will soon be effected.
   Pains in the limbs are  not uncommon during  convalescence.
 As the strength is regained, these  will  subside.  The pain may
 be mitigated by frictions with spirits of camphor, alcohol or stimu-
 lating  liniments, a  due attention to the  bowels, the  diet, and
 moderate exercise.   Tonics and mild anodynes, may be required
 if the pain be  great and attended with extreme debility.
   The  belladonna has been proposed and  extensively tried as  a
 prophylactic or preventive of the disease.   The testimony which
 has been  adduced is very conflicting, but upon the whole shows
a balance in its favor, and as an  experiment will be  harmless,
whenever the disease, is prevalent, or when persons are liable to
take it by contagion, a trial of it should never be neglected.
  Should it upon further  trial prove  to be a certain preventive, 
516
SEC.
or lessen the number of cases one-half, the discovery will deserve
to be ranked  among the  greatest improvements  that have ever
been made in the medical art.
   Three grains of the extract are dissolved in one ounce of boil-
ing water, and  of this solution  eighteen  or twenty drops are a
dose for adults, and as many drops  as a child is years old, for
children, to be taken three times a day.
   The  prognosis of  scarlet fever  is exceedingly  difficult and
uncertain.  It is a common remark of the best authors and most
experienced physicians, and a remark which we have  too often
seen verified, that the patient will sometimes be cut  off suddenly,
when, judging by all the appreciable signs, we have no reason to
apprehend such a result,  and on the  other  hand we  not  unfre-
quently witness cases where the patient  lies  for days in what
appears to be the most  alarming condition, and yet, ultimately
recovers.
   If, in the course of the  disease, the eruption instead of continu-
ing florid, becomes purple or mahogany color, and the extremities
assume a bluish appearance, attended with  delirium  or insensi-
bility,  great  prostration,  and a twitching or starting of the ten-
dons, death  is much  to be apprehended.   Great and sudden
swelling of the throat, the  non-appearance or  sudden  disappear-
ance of the eruption, dependant upon great prostration or a  failure
in the  powers of life to throw it out, and gangrene  in the  throat,
are  alarming  symptoms.  Croup supervening upon  the  scarlet
fever is perhaps always fatal.   Dropsy, coming on after the sub-
sidence of the fever, may generally be cured except it be located
upon the brain or in the chest,  in which  cases, the former espe-
cially, death may be expected.  On the contrary, should there
be a general  and universal  perspiration, the eruption continue of
a bright florid  color until the fever  subsides, and then gradually
fade, the swelling of the neck  be inconsiderable, if there  be no
appearance of  gangrene in the  throat, the mind  continue clear,
the sleep tranquil and the strength good, the  patient will proba-
bly recover.
   Cases frequently occur in which, after the  fever has declined
at the end of a week,  it  is again kindled up and  continues on to
the  end of another week, when it may prove  fatal  or  a recovery
slowly take place.  The vitiated state of the blood, the skin not
resuming  its healthy  functions, the irritation  of the inflamed
glands  and other consequences of  the disease, are the probable
causes of this relapse,  or rather protraction of the fever.
   SEBACEOUS GLANDS—Those organs  or vessels  which
secrete a fatty matter or  wax.
   SECERNENT—A lymphatic or other secretory vessel.
   SECRETION.—This is the evolution or formation of diffe-
rent kinds of matter from the blood,  as the urine, the sweat, the 
SCU.
517
bile, the milk, the mucus,'the menses, the tears, and the ear wax.
The organs and structures, destined for this purpose, all  have a
different organization, although they operate upon the blood.
   SCIATICA—A  rheumatic disease  of  the hip  joint.—The
remedies are such as are used for rheumatic affections in general.
See Rheumatism.
   SCIRRHUS.—The  scirrhus is, in most instances, an enlarge-
ment of a part or the whole of some glandular structure of the body.
In the beginning it is merely a hard, insensible lump under the
skin.  As it increases in size,  it  becomes  uneven on its  surface,
its veins are enlarged, the skin which covers it becomes shriv-
elled and puckered, and the lump assumes a livid or purple hue,
with a greater or less degree of pain.
   In some instances there is no tumor or enlargement of the part,
but merely a contracted, hardened, shrivelled spot in  the flesh.
 This is often the case with  scirrhous affections of the breasts,
 and the axillary glands.  After one gland has become affected,
 all the glands upon the surface of the body are apt to be succes-
 sively diseased in the same  way.
    The main thing to be done in case of  scirrhus is to adopt  an
 unirritating, vegetable  diet, to keep the  part free from  friction
 and wounds, and to avoid all  intemperance.   In some cases  they
 are absorbed, and, in others, if not irritated by corrosive applica-
 tions, will remain stationary for life.
    The best application which we  have ever known for a scirrhus
 is Lord  Noel's  leaden  plaster, commonly called the lead plaster.
 It should  be worn constantly, and  when it has been  on a week
 or two, it  should be  changed.   The diachylon plaster  is  often
 applied.
    Where  they threaten to become cancerous the practice  is to
 remove them by the knife.
    SCROFULA—King's Evil.   See King's  Evil.
    SCURVY—Scorbutus.—The  scurvy, once so  formidable and
 fatal to navigators and seamen, is now a manageable disease, and
 by proper care, is almost always avoidable.   The disease appears
 to be the consequence of remaining too long at  sea, and subsist-
 ing too long upon salt provisions  and putrid water.   In  damp
 dwellings, deprived of light and air, where cold, and the want of
 food and cleanliness, impoverish the blood, and weaken the pow-
 ers of life, the same disease will sometimes occur, but this is rare,
 compared with the instances which happen at sea.
    The  earliest signs of the scurvy are languor, loss of strength,
 and depression of the mind.  The sailor has no heart to  work,
 to play, or to move.   The  face and skin are pale and bloated, and
 the breath gives forth a putrid smell.  The gums are red, soft,
 spongy, swelled, and  so tender to the touch, as  to bleed on the
 slightest  injury, and,  sometimes, spontaneously.   The teeth be- 
518
SCU.
 come loose and fall out.   The skin is, in some cases, rough, and
 in others, smooth  and glossy, and covered with bluish or purple
 spots.  These  blotches spread and unite together, forming large
 patches of discolored skin.   They appear to be produced by dis-
 solved blood which has escaped from the ruptured capillaries  or
 extremities of  the arteries and veins.   These small vessels too
 attenuated and rotten to retain the blood, give way, and the pur-
 ple fluid spreads and settles under the skin.  Ulcers break out in
 various parts of the body, from which  a fetid smell arises, and a
 putrid sanies is discharged.  These  ulcers assume a spongy ap-
 pearance, and are  covered with a thick  crust,  which forms anew
 as soon as it is removed.   Sharp pains  are felt in the bones and
 various parts of the body.   The pulse is weak and soft, but sel-
 dom quick.   There is seldom or never any fever.  The thirst is
 not inordinate, and the appetite good.   All the  secretions have
 an offensive smell.  The urine and the discharges from the bow-
 els border on putridity.  The flesh falls away, and becomes soft,
 and even the bones are affected with a kind  of  rottenness, and
 break on the slightest, pressure.
  In the worst cases,  blood is discharged from the bladder, bow-
 els, nose and mouth ;  and  the slightest  exertion  brings on faint-
 ness, and, often,  immediate death.  The  sense  of weakness  is
 never equal to  the actual loss of strength,  and seamen often die
 in the attempt to reach the shore by their own exertions.
  There is  every possible  grade in  the severity of the  disease
 and the degree in  which the blood and flesh are  tainted.   Some
 will  be wholly disabled from exertion and covered Avith purple
 blotches, while others will be able to keep upon their feet, and
 assist in the management of the ship.
  The  disease is  so evidently owing to being  too long at sea
 and the use of decomposed food and drink, that the only sure
 remedy for it, is to return to the  land, and refresh the  system
 upon wholesome meat and  vegetables.
  It matters but little how long the voyage is, if the crew fre-
quently return to the  land  and procure fresh water and new pro-
visions.  Fresh water is as essential as  fresh food.  All intem-
perance hastens and  exasperates  the  disease.   It  is now the
custom of our whale ships, which uniformly make long voyages,
to seek the land often, and  take in a  fresh supply of water  and
provisions.  The  oftener this is done, the  safer and more hardy
will be  the seamen.   The  civilization of the islands in the Pa-
cific has wonderfully favored this  fbranch  of navigation, by the
friendliness of their inhabitants,  and  the greater  amount of pro-
visions which  they furnish, as well as  the safer depots which
 they afford to the stores which are landed upon them.
  Domestic Remedies.—As far as possible, cleanliness and dry
clothes should be aimed at  by all seamen.  Even where they are 
SCU.
519
obliged to live upon tainted provisions and bad water, the disease
will make  much less progress, if the skin is  kept clean, dry and
comfortably warm.  Spruce beer is easily made at sea, if the es-
sence is put up, and is a very good antidote to the scurvy.  Rice
and molasses, or any kind  of bread  pudding and  molasses, are
also good antidotes to the scurvy.  The meat should be fresh-
ened as much as possible, and  a drink  should be made of the
salts of lemon, sugar or molasses and water.  Cream of tartar
can always be carried to sea, and it makes a very good drink, by
adding  a tea-spoonful to a  pint  of  water.  Any kind  of  beer
which can be brewed at sea, will very much retard, and, some-
times, cure the disease.   The medicines proper to  be used in the
scurvy are, peruvian bark, worm-wood, the acetate of  ammonia,
quinine, and  all the  bitter vegetable  substances.   The quinine,
in two  grain doses,  twice a day, morning and evening, will, in
general, he found the most effectual.   Sour drinks made from the
juices of vegetables, are the most perfect antidotes  to the disease.
Lemons, oranges, plumbs, all kinds of berries, blackberries, straw-
berries, whortleberries,  grapes,  and all kinds of esculent plants,
which can be eaten raw or  boiled, are found effectual in restor-
ing the blood to its purity.  Scurvy grass, water cress and wood
sorrel,  are  all  valuable  remedies in this disease.  Where  the
bowels  are costive, cream  of tartar  should  be used, and if too
loose,  recourse  must be had to morphine, laudanum, or a tea
made of logwood.  Alum water should be applied to the gums,
and if hemorrhage takes place from  the bowels or bladder, four
or five grains of it, must be taken in powder, once in two or three
hours.  The soda powders are a good thing to carry to sea ;  but
the most important thing in the prevention of the disease, is a
plentiful supply of vegetable food.
   It is of  the utmost importance  in this disease, that  seamen
should not be overtasked, and when down sick with it, that  they
should  be  moved with  the  greatest care, lest the spark of life
should be suddenly extinguished.
   Every ship should be well supplied with  dried fruit, such as
raisins,  prunes, currents, whortleberries and filberts.  Peas,  rice,
beans, flour, and flour buiscuit, together with  sugar and molasses,
the essence of spruce, and of lemon; and dried herbs,  such as
balm, sage, and  pennyroyal, should never be wanting in a voyage
to sea.   Vinegar can be  made at sea from molasses  and water,
exposed to the sun; and this acid tends greatly  to prevent the
scurvy.  The sal nitre,  dissolved in vinegar, has been found of
singular use  in the disease,  both as a medicine and as a wash to
the skin.   Two ounces of the nitre dissolved in a quart of  vine-
gar, and given in a dose  of  two  table-spoonfuls twice a day, and
gradually increased, has  been attended with  the happiest effects.
3 SCURVY  GRASS—CochleariaOfficinalis.—The scurvy grass 
520
SEN.
is often cultivated in gardens, but may be found wild upon the
sea shore, and in mountainous places.  It is a stimulant and diu-
retic.   The fresh plant may be eaten in any quantity, or its vir-
tues may be extracted by pressure, infusion  in wine  and water,
or by  distillation.   By distillation, it affords a strong, pungent,
essential oil, which has the same effect as the plant  itself; the
fresh plant  is,  however, preferable in medicine.  The  juice is
often mixed with the juice of oranges.
  SEDATIVE.—Medicines which procure sleep and ease pain,
such as opium, hyoscyamus, hemlock, quinine, with many others.
  SEMEN.—The spermatic secretion.   This secretion often be-
comes  excessive by improper indulgence, by voluptuous conver-
sation, books and pictures, but above all, by a perverted imagi-
nation.  The nervous exhaustion consequent upon this excess, is
manifested  by listlessness, paleness  of  the  skin, incapacity of
fixing  the attention  long upon any particular subject, nocturnal
emissions,  horrors,  dyspepsia, and  nervous derangement.   Like
the secretion  of the bile, milk,  urine  and  perspiration, it  can
never exist in excess, without a corresponding diminution of the
strength and energy of the body and mind.  Indeed, excess in
the spermatic secretion, has  a more enervating effect upon the
brain,  than in that of any other in the body.
  The true remedy is early marriage, which should be encour-
aged not less by the tendency of  the laws and usages of nations,
than by individual  efforts.  Next to this, must be placed the ef-
fects of active and industrious pursuits.
  SENEKA.—Rattlesnake root.
  SENNA—Cassia  Senna.—There are  several  varieties of Cas-
sia, the plant  which furnishes the leaves and pods called senna.
The best kind grows wild in Upper Egypt, Nubia, Sennaar, and
other  parts of Africa.  That  imported  from   Egypt, is  called
Alexandria senna.   It is an important article of commerce in that
country. The plant, in some parts, yield two crops a  year.  They
are cut and dried by the natives,  the leaves and  pods  are stripped
off, packed  in bales, and sent to Alexandria for exportation.  The
different varieties are often mixed, and the better kinds are fre-
quently doubly adulterated, by being mixed with the leaves of
other  plants, as well as with the poorer kinds of senna.  It was
first used as a  medicine by the Arabians, in whose works it was
noticed as early as  the ninth century.  Senna has a faint, sickly
odor, and  a bitter, sweetish,  nauseous taste.  Its virtues are ex-
tracted by water and by alcohol.   One pint of water  extracts the
strength of an ounce.   It is usually prepared  by infusing  it in
hot water, with aromatic seeds  and manna.   The  dose  of the
powdered leaves is from half a drachm to a drachm, which may
be mixed  in molasses or other syrup.  Of the  infusion prepared
 by steeping an ounce in a  pint of water, the  dose for a child 
SHI.
521
four or five  years old, is a wine-glassful, and for an adult, half a
pint, and half the quantity may be repeated every six hours, until
it  operates.   The  addition of aromatic seeds, manna and salts,
renders it more active, and agreeable in its operation.  It should
be steeped about twenty minutes in a covered  vessel.   Its vir-
tues are dissipated by boiling.  Senna is an active cathartic, and
is  very generally used both  by physicians and as a family medi-
cine, in constipations, colds, coughs,  colics, fevers, and  all cases
requiring a medicine of this kind.   We are by no means disposed
to deny that senna is, in some cases, a suitable and valuable me-
dicine, but it is one to which we are  far from being partial, and
we seldom prescribe from preference.   In dysentery, bowel com-
plaints, in cases of women in child-bed, and young infants, we
consider  it decidedly inadmissible.   The great objection to it as
a family  medicine is, that it often produces intolerable and long
continued griping ;  it purges off too much of the natural mucus or
slime of the bowels ; sometimes occasions bloody stools, and other
symptoms simulating dysentery;  and in affections of the bowels,
aggravates or predisposes to inflammations.   The least objection-
able form of using it, is that of the lenitive electuary.   It enters
largely into the composition called cathartic infusion, an agreea-
ble preparation when the use of senna is indicated.  The griping
and other disagreeable effects produced by senna,  are best relieved
by injections of laudanum  and  starch, the warm bath, and re-
peated small doses of opium, or some of its preparations.
   SERUM.—The watery part of the blood.   All the watery se-
cretions of the body are called serous.   The water drawn off by
paracentesis  in dropsy, is serum.   The vapor exhaled  into  the
cavities of the belly and chest, is also serum.  Serum coagulates
by moderate heat,  resembling the boiled white of an egg; in-
deed, in a thousand parts of the serum  there are eighty parts of
albumen—the precise substance of the white of eggs ; nine hun-
dred and five parts  are water; six, muriate of potash and soda;
four, lactate  of soda with animal matter;  and four of soda and
phosphate of soda, with animal matter.
   SHINGLES—Herpes  Zoster.—A species of herpes, and by
some considered as a variety of erysipelas.  This  is an inflam-
mation of the skin, consisting of small  orbicular elevations, con-
taining lymph, and  terminating in a  scurf  or scab.   These ele-
vations are in clusters or  groups, and frequently  spread or  creep
around the body in the form of a belt,  dying away in one place
and  coming  out in  another.  They are attended with  more or
less itching and smarting, and when extensive may be preceded
by cold chills and fever.   It is a popular opinion that if the body
be entirely encircled by the eruption, that death  may be the con-
sequence, but for this opinion there is not the shadow of a foun-
           66 
SLE.
dation, nor is'there the least necessity for the application of the
disgusting  remedies that are  in  use among  the uninformed,
among which maybe mentioned a  blackcafs skin applied imme-
diately after  its removal  from the body of the animal.  The
disease is seated in the superficial vessels of  the  skin, and has
but little if any connexion with the general health of the system,
being strictly local.
   Remedies.—A light vegetable diet, cooling cathartics of cream
of tartar  or salts, keeping the body cool, and the frequent appli-
cation of alcohol and water,  or a bread and water poultice, are
all the means necessary for  a cure.  The disease is never dan-
gerous, and usually passes off in the course of a fortnight.
   SIMPLE CONTINUED  FEVER—See Fever, Continued.
   SINAPISM.—A mustard pultice.   It is made either  by mix-
ing ground  mustard with vinegar, or by  adding  a quantity of
mustard to a rye meal poultice.
   SINGULTUS.—Hiccough.
   SKUNK CABBAGE—Ietodos Fetidus—This plant, common
in the bog meadows of New  England, has leaves nearly as large
as those of a cabbage.   Its smell is strong and disagreeable, re-
sembling that of a skunk.   The root is highly anti-spasmodic. In
the asthma, hysterics, convulsions, epilepsy,  whooping  cough,
and even dropsy, it has produced very signal  relief.   The dose
of the powdered root is half a drachm, three times in a day.  It
may be given in the form  of  a strong tea, in the dose of a wine-
glassful, or in that of a syrup,  in the dose of table-spoonful. Some
have extolled the skunk cabbage in consumptive coughs.  It is
undoubtedly a medicine of some power, and deserving of atten-
tion.  The right use of our domestic plants  is often attended
with the  happiest results.
   SLEEP.—Sleep is a function of the brain, without which we
can no more  exist than without food or drink.  It is promoted
by a cool air, labor, silence, and sufficient food.  Sound, sweet,
perfect sleep  seems  to  be the lot of the poor, laboring  man.
This is his peculiar boon.  Much care and concern destroy sleep
or render it unrefreshing.  Excitement of any kind is unfavora-
ble to it.  Darkness, as well  as cold, favors sleep.   Much pain
or distress of any kind is incompatible with it.   Warm  rooms
are unfriendly to sound, healthy sleep.
  People should have a care that they do not lose their sleep by
violent passions,  emotions, and resentments, since once destroyed,
it ends in insanity.  This function  of the brain is intimately con-
nected with diseases of the mind.   Regular hours of sleep, like
regular hours of eating, contribute greatly to  a sound  state of
both body and mind.
  Some people require more sleep than others in the same em-
ployment.  People troubled with the nervous disease need more 
SMA.
523
sleep or more hours of sleep, than those in sound health.   From
six to eight hours is long enough for a well person to sleep.
  Where wakefulness prevails, the attendants of the sick should
never manifest much concern about  the  return of sleep, as  it
will  return like  the  function of  digestion, in its own due time,
after  the subsidence  of the excitement  or  irritation  which
produces it, has passed away.   The  medical attendant,  by an
imprudent manifestation of concern about the sleep of his patient,
often  puts off the period of its return.
   It is a great misfortune where people are troubled about their
dreams.  Dreams often come to pass, but not half so often as our
waking thoughts.   The fulfilment of a dream is no stranger than
that of a waking thought.  In general, we take no notice of our
waking thoughts, and, therefore, feel no surprise when there is a
coincidence between our reveries and subsequent events.  The
mind rambles on  in sleep,  by the  same  laws of association, as
when awake, taking in everything and everybody in a moment,
and if a single thought in sleep turns out  to be true, superstition
magnifies  it into  a much greater wonder,  than if ten waking
thoughts should prove true.  A person often  thinks of  all the
people he ever knew, ten times in the course of the day.   Is it,
therefore, any strange matter that one of these persons should come
to see him before night ? or that one of them should die in a few
days ? He also dreams of everybody he ever knew, in a sleep of
twenty minutes.  Is it  any stranger that one of them should
meet him the next day, or should die in  a short time, or  be
married, than if he thought of everybody in a revery ? Some
 people never dream; such, it is quite sure, can never  foretel any
 future events.  The most marvelous dreams occur in people of
 weak nerves.   It is  very singular  that people of unsound minds
 should have more knowledge of what is to come to pass, than
 those whose minds are  well ordered.  The ignorant often  see
 more and deeper  things in a dream, than ever occurred to  the
 mind of a Newton  or a  Franklin in the  whole course  of their
 lives.
   It is quite  certain that doleful,  hagard,  frightful dreams  are
 symptoms of disease, and should be  regarded  in no other light.
 The state of the stomach has an intimate connection with  the
 function of the brain; and indigestion can hardly exist  without
 more or less disturbance of the thoughts, feelings, and emotions,
 whether asleep or awake.  It is worthy of recollection, that light
 suppers are friendly to perfect sleep.
    SMALL POX—Variola.—The  small  pox is the most highly
 contagious disease  of which  we  have  any knowledge.  It is
 taken both by contact with the subject affected with it, and by
 breathing the air about the diseased  person.  It is even  commu-
 nicated by the mother to the unborn child ; and when the mother 
524
SMA.
 has previously had the small pox, and afterwards been with child,
 and exposed to the disease, the matter has been conveyed through
 the veins of the mother, and produced the small pox in the child,
 while she herself has remained in entire health.
   The small  pox  comes on very much  like other inflammatory
 diseases; with  pains in the  head, back, loins, and bones, faint-
 ness, loss of strength, weariness, redness of the eyes,  ague  fits,
 thirst, quick pulse, and  sicknessat the stomach.  There is one
 symptom which,  differs from the  commencement of  fevers in
 general, and  most of the  inflammatory diseases, and  that .is a
 soreness of  the throat, but this symptom is not very severe.
   The pustules begin to show themselves on the third or fourth
 day.  They first appear in little red spots upon the face, neck,
 and breast.   When pressed with the fingers, they feel  like little
 kernels or shot  under the skin.   These pimples continue to in-
 crease in  size and  number for three or four days, when they are
 found to extend over  the whole  body.   The spaces between the
 pustules  are red.  Sometimes  the disease is very light and the
 fever  hardly noticeable.   There may not be more than a dozen
 or twenty pocks, or the skin may be covered with them.  Hardly
 any two people  ever have the small pox alike.
   There  are two  distinct grades of the small pox;  one  is com-
 paratively mild, consisting  of separate pustules with spaces more
 or less wide between  them ; and the other of pustules which run
 together and form  one wide spread eruption.
   If the pustules are  distinct, with well marked spaces between
 them, they reach their full size about the fifth or sixth day, when
 they begin to suppurate.   Before this period, they contain only
 lymph  or a watery matter.  The lymph is the proper matter to
 inoculate  with it.  The  maturation of the pustules is completed
 on the  eighth or ninth day from their first  appearance.  If the
 pustules run together or coalesce, the maturation takes up a longer
 time, by two or three days.
   One of the most remarkable  appearances in the  disease is the
 swelling of  the  face,  head, and  eyes.  If the  pustules are very
 thick, it is  not  uncommon for the eyes to be completely closed
 up, and the  eyelids to be puffed out like little bags.   The whole
 face is  red,  and the   original features hardly discernible.  The
 voice is hoarse, the  swallowing difficult, and  the  throat filled
 with a tough saliva.
   The disease begins  to retrograde about the eleventh day.  The
 pustules now filled with a thick yellow matter, begin to discharge
 it; they then become dry, form into a scab, and fall off.  The
swelling of  the  face,  eyes and  head, goes down as soon  as  the
pustules have  come to maturity.  The scabs are of a mahogany
color, and when the pustules are numerous and  long in matura- 
SMA.
525
ting, they leave behind them deep pits or scars, which are at first,
red, but, in time, become whiter than the natural skin.
   When the pustules spread and run  together, forming, what is
called the confluent small  pox, there is always a vehement fever.
The heat, faintness, thirst, and sickness at the stomach are much
greater  than in the distinct kind ; and the pulse, instead of being
full  and strong, is  small  and more  frequent.  In  the confluent
small pox  there is often great stupor and delirium.  In the dis-
tinct kind of the eruption, the fever usually subsides on the ap-
pearance of the  pustules, but in the  confluent, the fever may
undergo a little  abatementwhen  the pustules appear, but does
not go  off.   The swelling  of the face, eyes, and  head, greatly
exceeds that in  the  distinct kind,  and the skin, loaded with
spreading pustules, resembles more the rough bark of  some dead
tree  than the natural  covering  of the  body.  In grown  people,
the throat is loaded with a tough, thick phlegm,  but in children,
there is a diarrhea.   The  disease, in children, is^commonly ush-
ered in  by convulsion fits.
   The  face, in the confluent grade of the disease, after the erup-
tion begins to scab over, looks as  if it were covered with a brown
mask, and  as  the large scabs or  scales begin to loosen, its de-
formity is most pitiable.  The  disease gives forth  an  intolerable
smell, and  the itching  is so great  that it is often necessary to
muffle th»fhands, especially in children, to prevent  the tearing of
the flesh.  In one case out of three or four, the fluids of the body
run into putrefaction ; the dissolved blood issues from the nostrils,
bladder, or bowels, and  death closes  the frightful scene.
   The  most critical  period in  the  confluent small pox  is the
commencement of the maturation of the pustules when the fever
returns  with  renewed strength.  This is  called the  secondary
fever, and is always attended with danger.
   The  commencement of the  small pox being  very much like
the attack of  measles or chicken pox, it is often difficult  to dis-
tinguish between them.  In the measles, the difference is discern-
ible as s\>on as the eruption  makes its appearance.  The pustules,
in the chicken pox, are smaller, fewer  in number,  and disappear
before  suppuration, or about the  sixth or  seventh  day.   If the
measles and small pox are taken,  at the same time, by the  same
person,  the measles run their course first, after which the  small
pox  pursues its usual  course.   If the small pox  has broken out,
and  the measles break out the  next day, the small pox stays
where it is, until the measles have disappeared.
   The  distinct  small pox is not  dangerous, unless the  eruptive
fever is  very high, but the fever has  as many different degrees as
there is difference in the number of  pocks.  The greater the
number of pustules, the greater the danger.
  After  a person has imbibed the  contagion of small pox, the 
5*0
SMA.
disease  usually makes its appearance  about the fourteenth  day.
In some instances, the disease will appear as early as the sixth
day after the exposure to the contagion, and, in other  instances,
it will not make its appearance before the  twenty-first day.
  Formerly it was held  that a person could not have  the small
pox a second time, but of late years, it has been fully established
by the amplest observation, that  this opinion was an error.
  Since the disease called the varioloid has been noticed, much
enquiry has been excited  upon the subject, and it has been clearly
ascertained  that this  disease is the real small pox appearing in
people the second  time.   It also appears in those who have had
the cow pox.  The varioloid is comparatively a mild disease, and
rendered so by having previously had either the small pox, or
the cow pox.   See Varioloid.
  Domestic Remedies.—If a person has been exposed to the con-
tagion of the small pox, he  should be immediately vaccinated.
This will in many instances prevent  the  disease, and, in all in-
stances be likely to render it milder, if the contagion has entered
the system too deeply to be subdued.   The person at the same
time should live upon a light vegetable diet, take no stimulating
drinks or heating things, and keep the blood as cool  as possible
by exposure to cold air, and the  use of some  cooling cathartics,
such as  salts or the cream of  tartar, taken  every day, in a suffic-
ient  quantity to move the bowels.  The  person shouts abstain
from all heavy work, and avoid the heat of the sun.   The cooler
the person can keep himself without being absolutely chilly, the
better.  Sour  drinks,  such as barberry water, lemonade, vinegar
and water, and the cream of tartar water have no small effect in
preventing the violence of the coming fever.   The same system
more  rigidly enforced, must be pursued after the contagion has
taken effect, and the fever has commenced.
  Where there is much heat, dryness of the skin, and sickness
at the stomach, a tea-spoon even full of ipecac, or the  powdered
leaves of lobelia, should be given, and a gentle evacuation of the
stomach procured.   An emetic will favor the full and early erup-
tion  of  the  pustules.   The  patient should be placed in a cool
room, and, in  the warm weather, the  windows should be open.
The  body should be sponged or washed with cold water, at least,
every evening, and none  but cool drinks should be given.
  A mattress is much cooler than a feather bed and less likely to
exasperate the fever.  The illness is so slight in some cases as to
require no medical treatment at all, especially  if the system has
been properly prepared to meet the disease.   A meat  diet after
one has been exposed to  the small pox, is a suicidal step, and  is
above all things to be shunned.
  If the fever is high, the pustules numerous, and the sleep pre-
vented,  the sweet spirits of nitre or Hoffman's anodyne must be 
SMA.
527
given in the  dose  of a tea-spoonful,  every  two  hours.   The
acetate of ammonia or lemon  juice and the salts of hartshorn
should be given two or three times a day.  The head should be
kept cool by the application of wet cloths.
  In the confluent small pox, the fever is apt  to be of alow type,
the pulse small and quick, and there is more or less oppression of
the brain.   In this  case, the system must not be too  much re-
duced.   The bowels should only be moved with a  great spoonful
of the cream of tartar, or a couple of tea-spoonfuls of salts ; the
body bathed with tepid water ;  and the strength supported with
wine whey, grain doses  of quinine, twice a day, and  Hoffman's
anodyne liquor.   Frequent potions of strong poppy tea should be
given to allay the excessive agitation of the system, when the
eruption appears.  A wash of the  same may be  applied  to the
face, neck,  and chest.   A tea-spoonful of the sweet  spirits of
nitre should be given every three hours.  The soda powders will
form an appropriate  drink,  together with a thin flour gruel, and
gum arabic  water.   In some cases, where the pusle and strength
will admit of it, leeehes may be applied to the head.  Cold water
may be drank freely.
  When the swelling of the head and face is  great, and the erup-
tion thiek or confluent, linen muslin dipped in a very weak solu-
tion of  sugar of lead, or of white vitriol, should be laid upon
them.  <l# the agitation and distress are severe, and the system is
likely to become exhausted under  the violence of the disease,
forty drops  of laudanum or of morphine should be given.   Five
drops will answer for a child of one year old, and eight drops for
one of  two years of age.  Children being  liable  to convulsion
fits, must take poppy tea or paragoric, once in six or eight hours.
  Professional  Remedies.—The small pox  is an inflammatory
disease  and requires a corresponding treatment.    If the fever is
severe, the  pulse full, hard  and  strong, blood should be  drawn
from the arm in proportion to the force of the circulation,  always
recollecting that the fever  has some  days to run, and that the
strength must not be permanently reduced. In  the  confluent
kind, bleeding  is inadmissible,  excepting  by leeches, and  then
very sparingly.
  The use  of antimony in the distinct small pox will be found
very serviceable before the eruption.  Calomel used as a cathartic
will often be found  equally beneficial.   In general, the fever of
the distinct small  pox is to  be treated like  a regular  continued
fever.   Blisters  are  seldom found of much service, as the whole
skin itself is but little less than blistered by the eruption.   Anti-
mony, after the eruption appears, is, for  a  similar reason, less
efficacious than in common fevers.  The sal nitre in eight grain
doses, once  in three hours, is one of the best medicines  which
can be  used after  the pustules  appear.   Is  is highly necessary 
528
SOR.
 that all  filth  should  be removed from the room, and that the
 chloride  of soda or of lime in solution, should be kept constantly
 evaporating to purify  the  air.   The chlorides are a modern dis-
 covery which have been found to be powerful agents in neutral-
 izing contagions.
   Where the throat is sore and  inflamed, and much tenacious
 phlegm  adheres, gargles of borax dissolved in warm water, or
 alum,  sugar of lead, or white vitriol must be used.
   It will sometimes be necessary to cover the face and neck with
 some mild salve or ointment when it is in a state of  maturation.
 A salve of bees wax and sweet oil is as good as anything. Proper
 nourishment,  such  as flour porridge,  bread water,  rice or  rice
 water  and indian  gruel  should not be forgotten in any stage of
 the disease.
   SORE EYES.—See Inflammation  of the Eyes.
   SORE LEGS.—Ulcers or sores upon the legs are very com-
 mon to old people,  especially if they  have lived luxuriously or
 intemperately.   They are usually accompanied with  a  swelling
 of the  feet and ancles, and, sometimes, of the legs.  A little spot
 on the leg becomes red, painful and sore to the touch, and in a
 short time, ulcerates and becomes an open sore, very difficult to
 heal.  These  sores usually form about  the ancle or a little above
 it.   They vary in size from the bigness of a ninepence to that of
 the palm of the hand.   They discharge a great deal o£> watery
 matter which  is very  corrosive and acrid.  In some instances,
 they will be very dry  and parched,  and much more troublesome
 than when  they discharge freely.   A hard,  tough  grisly  rim
 or edge  forms around  them,  which   appears to be  a defence
 which the life of the  part sets up against the further  progress of
 disease.  The skin, for  some distance  around, will be hard  and
 callous.  The ancle joint and  muscles of the leg and cords of
 the foot  become stiff, and, sometimes, almost  immovable.  As
 fast  as one  of these  ulcers heals, another breaks out.   In  hot
 weather  they  are apt  to become  very foul, and, sometimes, fly-
 blown.   The irritation and anguish at such times are intolerable.
 The general health all the while will be remarkably good.
  Some  have been of the opinion, that these sores are natural
issues,  which are necessary to the general health, and should not
therefore be healed.  But the same may be said of every other
ulcer or sore which breaks out upon  the body, the evidence being
as strong in one case  as in  the other.  We believe no possible
harm ever arose from healing them.
  To effect a cure in these cases,  it is absolutely necessary that
the manner of living should be strictly temperate  both in eating
and in  drinking.  The food should be for the most  part of the
vegetable kind, and the drink  nothing but cold water, or milk
and water. 
SOR.
529
  The  ulcers should be  kept entirely clean  by bathing  them
long and often in warm  rain or spring water.  They then should
be poulticed with rye meal or white bread, and, whenever  the
poultices are changed,  the sores  should be washed with a solu-
tion  of  sugar of  lead.  The lead water is by far the best local
remedy which we have ever employed.  If the ulcers have  be-
come very foul, and  give  forth an odious smell, a weak solution
of the chloride of lime  or of soda should be poured upon them.
They may also be washed with a tea made of the wild indigo
root; or a poultice, mixed with this tea, may be  applied to  the
sores.
  In some  instances where the flesh has lost its  vitality or life,
the sores should  be  sprinkled over  with calomel  or the red pre-
cipitate, or touched with the lunar caustic daily until they begin
to heal.  The powder of borax or alum strewed upon the ulcers
will  sometimes dispose them to heal.
  The swelling, which is of a dropsical nature, maybe reduced by
taking a daily potion of jalap or cream of tartar, and keeping the
leg and foot in a horizontal position.   This method we have often
tried, and proved it to be  effectual.   Very much is accomplished
by soaking  the ulcers and inflamed skin with warm water.  It
dilutes  the  acrimony of  the  discharge, softens  the  flesh,  and
lessens  the heat and dryness.   Charcoal finely powdered, sifted
through afine sieve and strewed upon the ulcers, will cleanse them
and  deprive them of the offensive smell.   The covering should
be light, and composed  of linen cloth or lint.
   SORE  THROAT—Cynanche  Tonsillaris.—What  is com-
monly called the sore throat,  is an inflammation of the almonds
of the ear or tonsils.   These two little fleshy balls, called tonsils,
are  situated on  each side of the throat at the entrance of the
swallow.  These glands  secrete  a quantity of mucus which is
discharged into the throat by twelve different ducts.   The mucus
mixes with the food, softens it, and prepares it for digestion.   An
inflammation of the  tonsils or  almonds of the ear, may be detect-
ed upon the outside  of the throat, by a hard, round swelling, just
under the ear, at  the angle of the  jaw.   The inflammation in this
disease is not always confined to the tonsils, but spreads more or
less  all over the inside of the throat.  On looking into the throat
when it begins to feel  sore, it will be  seen to be of  a deep red
color ;  one  or both of the tonsils will be swollen  to three or four
times its common size, and the  inner surface of the  throat will
be covered with a dry  crust,  which is the natural  mucus dryed
up by the heat of the fever.
   In the inflammatory sore throat, there is  in the  beginning of it,
a sense of  dryness,  and pain  in  attempting to swallow; hoarse-
ness of the voice  ; a difficulty in swallowing, and a furred tongue.
It is commonly ushered in  by cold chills; pain in  the head and
            67 
530
SOR.
bones;  listlessness; red face and eyes.   The inflammation where
it is not checked, will commonly increase for three or four days,
and the difficulty of speech, of swallowing, and,  sometimes, of
breathing, will be very much aggravated.   In the worst cases,
the dryness of the throat will almost stop the breath.  The pulse
is commonly hard, full  and quick, beating  from a hundred to a
hundred and forty strokes in a minute.   The skin is hot, and all
the secretions checked or retarded.  In some  cases, white spots
will be  seen upon the tonsils and the inner surface of the throat.
These spots are slight ulcerations, which denote that the inflam-
mation  is of a very angry nature.   In children, this malady some-
times runs into the croup, and, then it commonly proves  fatal.
In  aggravated cases of the inflammatory sore throat, the patient
will sometimes become delirious.   In general, it is not a danger-
ous disease.   The inflammation in a few days either subsides or
runs into suppuration.   As soon as the inflamed tonsils burst and
the matter is  let out, there is the most instantaneous relief.  The
swallowing,  breathing,  and the dryness of the throat begin to
amend,  and the danger is commonly over.
  This  disease is exceedingly apt to seize children in the spring
of the year and the  beginning of winter, when they are much
exposed to  cold and wet, and to the changes of the atmosphere.
We  seldom ever visit a child at  any season of the year, where
the disease  is not very apparent, without looking closely into the
state of  the throat.  We have many times found the throat  to be
the seat of the complaint, when we have  been called  to  see a
child for a very different disease, or for a disease which could not
be ascertained.  The swelling upon the outside  will often be
sufficient to settle the nature of the disease, without even looking
into the throat.
  There is another kind of sore throat with which this may be
confounded, and which  is very dangerous.   It is called the  ma-
lignant  sore throat, which  almost immediately runs  into ulcera-
tion or  gangrene,  instead of suppuration.  Its  tendency to run
into ulcers, has given it the name of  ulcerated sore throat.  In
the beginning of this kind of sore throat, the color of the inflam-
mation  is  of a much brighter  red, and  the inflammation  itself
spreads  much more upon the lining or surface of the throat. The
redness  will often extend over the roof  of  the mouth and  com-
pletely encircle the throat.   The florid  color of the imflamma-
tion has given it the name of the scarlet sore throat.  The ton-
sils in this kind  of sore throat will be  hard and swelled, but
being covered with ulcerations which deeply corrode them, they
are  in a very different  state from what  they are in the purely
inflammatory sore throat.   In the malignant sore throat, there is
commonly an  eruption  upon the skin, and the pulse is weak and
soft; there  is  great drowsiness, often stupor and delirium, and a 
SOR.
531
deeper affection of the brain.  The fever, instead of being of an
inflammatory, is of a typhoid nature.  For a better distinction of
the two diseases, the reader is referred to the article on scarlet
fever.
  The  causes of the inflammatory sore throat are very obvious.
They are cold ; wetness ; a chilly, moist state of the atmosphere ;
exposure to currents of cold air ; the transition from hot rooms
to the night air ; and, in general, every change which checks the
perspiration and suddenly cools  the blood.  From the  necessity
of breathing the cold, damp air, the  throat is always  more ex-
posed  to inflammations than any other part of the body.  The
wet, chilly air, is constantly drawn through the throat as through
a tunnel, and  with a force and velocity incident to no other part,
so, that, in addition to the effect which cold and wetness have in
suddenly chilling the body generally,  the throat is particularly
affected by their agency.
   Domestic Remedies.—-In slight affections of the throat, where
the soreness, swelling and difficulty of swallowing are  not great,
and  the inflammatory fever is not high, it is  only necessary to
confine the person to a warm,  dry room; to produce  a gentle
sweat by hot  herb  teas; to drink flax-seed, mullein or slippery
elm  bark tea; and to gargle or wash the throat with a solution of
white  vitriol of the strength of eye water.  This  gargle alone
we have known to cure the sore  throat.   It should be used every
half hour, and be allowed to remain  in  the throat as  long as it
can be  held, otherwise but little or no impression will be made
by it.   In severe cases, where there is difficulty  of swallowing,
and  the tonsils are  hard and much  swelled, an emetic  of ipecac,
alum, or lobelia should  be given, and repeated even two or three
times,  if the disease remains obstinate.   A tea-spoon even full of
ipecac,  or of the  powdered leaves of lobelia, will  be found a suf-
ficient  dose for an  adult.   If the  first dose does not operate  in
half an hour,  as much more, of  either, may be given.   The  pa-
tient should be made to drink plentifully of warm water, in order
to support  a free perspiration.   After the emetic has  operated,
and  the stomach is sufficiently  settled, eight grains of the anti-
monial powder should be given, every two hours.  The bowels
should  be unloaded with a dose  of castor oil, rochelle powders or
any  domestic  physic, and the external surface of the throat rub-
bed  over with the volatile liniment, or which we conceive to be
much  better,  a soft,  warm white bread or rye meal poultice ap-
plied around it so as to cover the whole throat.  In the  sore
throat of children, the poultice is the only local application which
some are in the habit of making.  The reason for its application
appears to  us to be the same as if the inflammation were upon
the  surface of the  body.   Gargling with  warm water greatly
promotes the  suppuration, or reduces the inflammation when its 
532
SOR.
tendency is to resolution.  The diet should be very soft, or liquid
vegetable food, such as rice, soaked cracker or  bread, and water
porridge.
  We  think the efficacy of the volatile liniment depends upon
its  tendency to excite a sweat.   If it is applied  extensively
and profusely  enough  to excite a sweat, it will do  good, other-
wise,  it will be of little benefit.   We  have observed the same
thing  when it has  been applied  in rheumatism.   Blisters to
the arms or  to the nape of the neck, are sometimes very service-
able, although they  may  almost  always  be  dispensed with.
Bathing  the feet in warm water,  by equalizing the  circulation,
contributes very much to the cure.   All heating teas, hot drops,
and stimulating medicines, are  improper ;  the treatment must be
anti-inflammatory.
  Professional Remedies.—If  the person  is full blooded, or the
subject of the sore throat be a  child taken in sound health, one
good bleeding will be the best and safest  means to subdue the
inflammation and  allay the vehemence of the fever.   In case,
however, the  inflammation of  the  tonsils  is very near suppura-
tion, which  may be  told by inspection, bleeding will be of no
use.  Or if  there  is  much ulceration, bleeding will be equally
improper.   The  symptoms, in  children, will,  sometimes, so
nearly resemble  those of  croup,  that  bleeding will  often be
found  necessary.   After one bleeding from the arm, it is better
to subdue the inflammation by leeches,  and the use of those
agents which  reduce the force of the  circulation, such as anti-
mony, ipecac, or  lobelia.  The medicine  called the hive  syrup,
is very suitable for children  sick  of the sore throat.  A  tea-
spoonful of  this, given every two hours, to a child  between one
and two or  three  years old, will  produce  a sweat, operate upon
the bowels, and reduce the action  of the  heart.  Two grains of
the antimonial powder are a suitable dose  for a  child of the same
age.
   People sometimes apply mustard poultices to the feet of chil-
dren, with the view  of drawing away the inflammation from the
throat.   But this, we  conceive, to  be a doubtful practice, espe-
cially where the fever is high, since it  only tends to hasten the
circulation of  the blood and  to  disturb  the  nervous  system.
Opium, in any form, is generally inadmissible in this  inflamma-
tion.   If the continued want of sleep, and anguish in the throat,
should compel us to make use of it, it had better be used in the form
of the Dover's powder or the morphine.   When we  speak of the
use of the morphine, we mean the solution of the sulphate of
morphine in water, of the strength of laudanum.  In all inflam-
matory affections attended  with fever, the evacuation by the
kidneys is an important consideration.   In the  sore throat, a free
and copious discharge of urine often relieves  the disease more 
SPI.
533
than any other evacuation.   The fever is always  very sensibly
abated by the discharge of a large quantity of urine.  For this
purpose,  there is  nothing so  effectual as the sal nitre, in eight
grain doses, once in two hours, during the day.  As little medi-
cine should be given in the  night as possible, as it always more
or less interferes with the sleep.   In the malignant sore throat or
scarlet fever, we have often relied entirely upon  the discharge
from the kidneys, for the cure of the disease.  To children over
a  year old, we give the  sal  nitre or salt petre in doses of about
three grains each, every two hours, until a free discharge of urine
is effected.  The sal nitre is also as good a gargle as  can be used
in the  sore throat of young children.  The state of the skin in
the scarlet fever  forbids  the idea of raising a sweat, the determi-
nation of the  fluids, therefore, should be towards the kidneys.
   SPASM.—A contraction of the fibres of muscles.   The more
common name is cramp or convulsion.   All twitchings  of the
skin and flesh are a species of spasm.  Hysteric fits are spasms.
   SPEARMINT—Mentha Viridis.—The effects of spearmint tea
in the stomach  are warming  and carminative.  It raises the
spirits, quickens  the circulation, and' allays pain and sickness of
the stomach.   It may^be found in watery situations, in the vicin-
ity of almost every house in New England.   It is a good medi-
cine to raise a sweat;  and useful in the colicy pains of children.
   SPHACELUS—Gangrene, mortification.—See Mortification.
   SPINA BIFIDA.—A tumor in the lower part of the backbone
 of new-born  children.  It is at first of  a purple color, but as  it
 enlarges, the  color  disappears, and it assumes nearly the hue of
 the skin.  The  disease  is of a scrofulous nature, and the  tumor
 contains a watery matter, which should be  allowed to^find  its
 own way out.  Opening one of these tumors  is dangerous.  The
 spina  bifida  prevents the use of  the lower limbs, and commonly,
 an upright position.   There is an extreme weakness of the back,
 and debility of the whole system, although  children will live in
 this situation for several years.   The remedies are iron,  quinine,
 elixir vitriol,  and  tonic medicines in general;  cold  bathing,
 braces to the back, and  a nutritious diet.
    SPIRIT  OF  MINDERERUS—Acetate of ammonia.—Take
 of carbonate of  ammonia, smelling salts, any quantity, and pour
 upon  it  as much distilled vinegar, gradually, as will  neutralize  it.
 It can be made  in a tumbler  or a bottle.  The vinegar unites
 with the carbonate, and sets free  the carbonic  acid, which flies
 off in a foam.   It is best to take it in a state of effervescence,
 although it has about  the same effect, if kept in a bottle, and taken
 in spoonful doses.   Lemon juice or common vinegar, may be used
 instead  of distilled vinegar, which is not always readily obtained.
 Ten or fifteen grains of the carbonate may  be mixed in  a turn- 
534
SPR.
bier with a table-spoonful of lemon juice or vinegar, and drank
with the addition of a little water, or without it.
  It is an excellent medicine to raise a sweat and to promote the
flow of the urine.   It moderates the circulation of the blood and
lessens  the heat of the body.  In  febrile diseases, it is  a choice
remedy.  It is  equally beneficial  in the diseases of children, as,
of grown people.   The common doses of the acetate of ammonia,
are  a  table-spoonful for an adult, and a tea-spoonful for a child.
Children are unable to take it in a state of effervescence.  There
is scarcely a remedy which we  have used oftener  than this, or
with more satisfactory results.
  SPIRIT OF  SALT—Muriatic  acid—Marine acid.—It is ob-
tained from sea salt, by pouring upon it oil of vitriol, sulphuric
acid.   The acid and salt are distilled in a retort, and the spirit of
salt is  liberated, and  absorbed by water,  when it  becomes the
muriatic acid,  sold  in  shops.  This acid,  when  diluted  with
water, is a cooling tonic.  In putrid diseases it is preferred to the
elixir vitriol, or the nitric  acid.   The method of taking it  is to
add just enough of it to a  tumbler of water  to render it agreea-
bly sour.   Sugar is often added  to make the  drink more palata-
ble.   It is often.used as a gargle in the putrid sore throat, scarlet
fever.   It is  a valuable tonic, antisceptic and refrigerent.   The
pure acid may also be used as a caustic.  Fordyce recommends
it as the best remedy we possess in jail and camp  fevers, in ma-
lignant sore throat, small pox, and plague.
  SPIRIT OF WINE—Alcohol.—This  liquid is  called either
spirit or spirits of wine.   It is obtained from wine and other
fermented  liquors  by distillatiqn.   All  intoxicating drinks  con-
tain more  or less  alcohol ; it is this principle in  liquors which
produces intoxication.   Pure alcohol is colorless, transparent,
pungent to the  taste, and  fragrant.  In medicine it is the  great
menstruum  or  solvent  of  vegetable, animal,  and  some mineral
substances.   It is a powerful and highly diffusible stimulant.  In
its effects, it is  the  same thing as rum, which is alcohol diluted
with water.  The  purest  new rum will answer nearly as  well
for a solvent  or menstruum as alcohol.  As a topical application
in cases of inflammation, cramps,  pains, and  fevers, alcohol is a
most valuable remedy.   It is not taken internally in  its  pure
state.   In rheumatic  inflammations, both  acute and chronic, hot
spirits of wine, applied  to  the part, is an  excellent remedy.  In
inflammation of the uterus, breasts, and bowels, hot applications
of alcohol are among the best means of cure.
  SPLENITIS—Inflammation of the Spleen.  See Inflamma-
tion of the Spleen.
  SPRAINS.—A  sprain is a subluxation of a joint, by which,
the tendons  and  ligaments receive a sudden stretch, and, are 
SQU.
535
sometimes, torn.  It is commonly produced  by falling, slipping,
running, jumping, or wrestling.
  A sprain is sometimes longer in getting well, and more painful
than a dislocation, owing to the greater mischief which is done
to the cords and ligaments.   In some people, it is probable  that
the tendons and ligaments are more yielding and elastic than in
others, in consequence of which, one person will have a complete
dislocation where another will have only a sprain, but the sprain
may be the worst injury.                    ,           ,
  A sprain  is attended with pain and  swelling  of the injured
part, and, sometimes, discoloration.   If  any  of the blood vessels
have been ruptured, the wounded part immediately becomes  of a
purple color.  If only the lymphatics are lacerated, the swelling
will be white.
  The first thing to be done in a sprain, which commonly takes
place in the wrists, ancles or knees, is to administer a dose of laud-
anum or morphine, in proportion to the degree of pain.   The wrist,
ancle, knee  or  other joint, should be  wet  with the same, and
then covered with  a soft,  warm rye-meal, flax-seed, or white
bread poultice, and renewed as often as  it grows hard.  If lauda-
num or morphine is not handy, new rum or vinegar may be  used
for a wash.  Cold  applications, in the  first  instance,  before any
inflammation has come on, and the vitality of the part returns,
 appear to us improper, and injurious.  If  the joint becomes hot,
 dry, and sore, leeches should be applied until the inflammation is
 reduced.  Lead water and a solution of white vitriol  should be
 applied after the leeches are removed.   The limb should be kept
 at  rest • a dose of salts or some qther physic, taken ; and the diet
 should be light. In old sprains, the opodeldoc mixed with lau-
 danum is an excellent medicine.  The volatile  liniment mixed
 with laudanum, is  another external  application of equal efficacy.
 Vinegar and new rum mixed, and applied warm, or hot, has been
 found extrsmely good. In cold weather, the sprained joint should
 be covered with flannel and kept comfortably warm.   The  great
 object is to prevent inflammation and  to re-establish the circula-
 tion of the part.
    SPURRED RYE—Ergot.  See Ergot.
    SQUILL—Scilla Maritima—Sea-onions.—The squill  is the
 root of a  plant which  grows upon the shores of the Spanish
 peninsula.  It is  bitter, nauseous,  and acrid.   The  squill is a
 powerful stimulant, diuretic, emetic, expectorant, and sudorific.
 The dose of squill is one or two grains.  The way in which it is
  commonly used, is in the form  of  a  syrup, which  is made by
  addin" three parts of the vinegar of squill to two parts of simple
  svrup°  The  dose of the  syrup of squill is from one to two tea-
  spoonfuls.  A child, from one to  three years old, may take a
  tea-spoonful. 
536
STA.
  In cases of. coughs, lung fever, influenza, peripneumony, and
consumption, the  squill  is a most effectual remedy.   It  is safe
and innocent.  Its efficacy in the cure of dropsy is  hardly sur-
passed by that of any other medicine.   It promotes the secretion .
of the urine, at the same time that it opens the pores of the skin,
and relaxes the mucous membrane of the lungs.   It may be used
in combination with  sweet spirits  of nitre,  lobelia,  antimony,
calomel, copaiva, and several other medicines.
  SQUINTING—Strabismus.—When a person is cross-eyed the
defect is sometimes in the muscles of one eye, and sometimes in
both.   It  has been supposed  that  squinting or cross-eyes were
owing to some defect in the sight or vision.   But it is no doubt,
in many instances, caused by the involuntary contraction or short-
ening of the muscles which move the eye-ball.  When the mus-
cles on one side of the eye-ball become shorter than those of the
other, the ball must turn in the direction of the shorter muscles.
In some rare cases, the ball will turn out, but in most cases, the
obliquity is towards the nose, or one  eye is turned towards  the
other.  If a child is born with an obliquity of one or both eyes,
there is no way to correct it but by an operation ; and even where
it appears to be acquired, we imagine it very rare that anything
can be done to obviate the habit.
  Very fortunately for this class of  people, a remedy has of late
been discovered.   The  operation is trifling, but it is one of  the
greatest  improvements  of the age, and does honor to the dis-
coverer.   It  consists  in taking hold of the shortened  muscle
which  causes the obliquity, with  a small sharp hook, called a
tanaculum, and cutting  it off  with  a pair of sharp pointed  scis-
sors.  As soon as the  muscle is entirely severed or dissected off,
the ball of the  eye or rather its axis becomes  strait.   Nothing
more is necessary than to  cover the eye  with a handkerchief or
bandage  until the incision heals up.   If the shortened  muscle
has been entirely cut off, the axis of  the eye will  ever after remain
strait.  It is sometimes  necessary to perform the operation upon
both eyes, as both are oblique.
  STAMMERING.—This affection of the voice proceeds from
some weakness in the muscles engaged in the faculty of speech.
Bashfulness and  timidity increase  the difficulty very much,  for
when the stammerer  is speaking to his familiar friends and ac-
quaintances, he talks  with a much  better grace.  The difficulty
appears to be owing to a partial paralysis of the vocal muscles,
which can only be surmounted by care and attention in the pro-
nunciation of single words and short sentences.   By constantly
reading aloud and speaking  pieces of his own composition, the
stammerer may always  overcome the impediment.   Women are
much less liable to stammer than men, because  they feel the mor-
tification of the disagreeable habit much keener, and make greater 
STR.
537
efforts  to  conquer it.   Singing and reading poetry are a great
help in the conquest of the habit.  There are always some words
upon which the stammerer is more likely to blunder than others.
These words should be remembered, and pronounced over slowly,
until they can be spoken without impediment.  The words yes
and no, for instance, should  be spoken until a habit is acquired,
of pronouncing them without hesitation. The habit of repeating
dialogues  will  very soon cure the awkwardness of pronunciation.
But, if this lameness of the  vocal organs is suffered to go uncor-
rected until manhood, it will be found very difficult to remedy it.
Since it is well known that the impediment may be surmounted,
no one should  allow so embarrassing and awkward a habit to get
the better of him.
   STERNUM—The breast-bone,
   STIMULANT.—Medicines which excite the activity of the
body and  mind.    Alcohol, wine,  camphor, heat, light, mustard,
peppermint, cinnamon^ and  ginger, are  examples of stimulating
agents.    Everything which exalts  the heat of   the body or
the part to which it is applied, and quickens  the  circulation of
the blood, is a stimulant.
   STOMACH.—The stomach is situated  in the cavity of the
belly, in  its upper part, and in the left side, opposite the liver.
It is a portion of  the alimentary canal  between the meat-pipe
and the duodenum.  In its shape, it somewhat resembles a bag-
pipe, oblong and  round.    As  the  stomach  terminates in the
pylorus or its lower orifice, it becomes  smaller.  It is composed
of three   coats, an outermost or peritoneal coat, a muscular or
middle coat, and a villous or shaggy coat.  The stomach secretes
a  mucus,  and a  peculiar  liquid  or juice,  which is called the
gastric juice.  This juice  is secreted  in large quantities, and dis-
solves  the food as it passes  into the stomach.  Digestion seems
to consist  in the action of  the gastric juice upon the food.   It is
a truly astonishing menstruum or solvent, although out of the
stomach it is comparatively inert.   It acts  upon solid substances
in the stomach  by a kind  of corrosion, until they are entirely
consumed, or  converted into a pultaceous mass.  The stomach
is bountifully supplied with  nerves and mucous glands.
   STRABISMUS—Squinting.  See Squinting.
   STRANGULATED HERNIA.—See Rupture.
   STRANGLING OR  CHOKING.—People  often choke  to
death for  want of very little assistance, or knowledge.  When a
piece of meat, bread, or any  other substance, gets into the throat
without the ability to swallow it, the first  thing to be done,  is to
run the fingers into the mouth and  pull it out.   In most cases,
especially in young children, the irritation of the finger excites
an act  of vomiting which throws the  substance from the throat.
   Small,  smooth  substances, sometimes, enter  the  windpipe  or
            68 
538
STR.
go down the wrong way.  In this case an act of coughing should
be excited,  or an expulsion of the air  from the lungs effected.
Striking with  the flat hand upon the back, between the shoul-
ders, has this  effect  in  some  measure—but, if adroitly done, a
sudden pressure  made upon the abdomen or belly in an upward
direction, has  this effect in a much greater degree.  Hartshorn
held to the nose, or a little bayberry snuff will, sometimes, excite
coughing.   A little sulphur, or a match burned, will be pretty
sure  to  excite coughing, if any air can  enter the  windpipe.
Sneezing will  have  nearly the same effect as coughing.   The
chloride cf soda or lime, or burned feathers  will excite coughing.
Vomiting has  some  effect  even  to expel  substances from the
windpipe ; and for this purpose, the finger should be run into
the throat, or  the fauces, or the  palate tickled with a  feather.
This  operation can  almost  always be effected by means of the
finger.
  The crust of bread, chewed and  swallowed, will sometimes
carry down  substances lodged in the meatpipe.
  Adults should always have presence of mind and recollection
enough, if they retain their senses, to attempt to cough, of them-
selves, without trying to draw in the breath.
  Where small bones or other small  substances  lodge  in  the
meatpipe, an emetic of ipecac, or  some other kind, can be swal-
lowed, and the offending matter thrown up.
  Substances  can, sometimes, be  taken out of the throat with a
pair of sugar tongs, a spoon, or a pair of blunt scissors, where a
pair of forceps cannot be obtained.
  If the substance fills the  meatpipe so that swallowing is pre-
vented, it must be pushed  down  with a gum catheter, or a pro-
bang ; but great caution must be used in this operation, lest the
pipe  be torn, and  more mischief done than good.
  In  cases where  the windpipe is nearly or completely stopped,
and the face turns purple from suffocation, after other means have
been  tried, tracheotomy should be performed, and the substance
extracted, or the  air let in through an artificial opening.  But it
must  not be forgotten, that in all cases where vomiting can  be
excited, it ought to be done, as it  relaxes the passage, and is the
most effectual  means of  removing  the cause of the  strangulation.
Bleeding will in some instances, relax the  pipes and relieve the
breathing.
  STRANGURY—A suppression of urine.   See Dysury.
  STRYCHNINE—Strychnia.—This is an  alkaline  substance
obtained by a chemical  process from nux vomica.   It is a white
powder, but  consists of small crystals.  It has an extremely bitter
taste, but no smell.  It is unalterable by the action of the atmos-
phere, and but slightly soluble in water. With the acids it forms
salts, which  still retain the bitterness of the strychnine.   In the 
SUI.
539
volatile oils, such as cinnamon and peppermint, it dissolves very
readily, but,  in alcohol only in a partial  degree.  Next to the
prussic acid, the strychnine is probably the  quickest and strongest
poison.   An eighth of a grain is sufficient to kill a dog.
  The  dose is from one sixteenth to an eighth of a grain in the
cure of diseases.  It  may be given in pill, or dissolved in water
to which a little acetic  acid has been added.  The acid converts
it into a salt.  The strychnine is used in palsy, tic douleureux,
suppression  of  the  menses, St. Vitus' dance, and  some  other
diseases.
  It has been used with  success, applied to the raw surface of a
blister, by which it is  absorbed into  the  system.  The quarter
of a grain may be  sprinkled upon the denuded surface, twice a
day.
   STUPOR—Insensibility.   See Lethargy.
   SUGAR  OF  LEAD—Acetate of  Lead—Acetis  Plumbi—
This is a crystalline,  metallic salt.   It  is the combination of
distilled vinegar with white  lead, in the proportion of ten parts
of the vinegar to one of the lead.
   It dissolves readily either in hot or cold water.  It is a power-
ful styptic and discutient.  It is given internally to stop hemorrha-
ges from the stomach, bowels, womb, and lungs.  The dose is from
one to three grains, repeated every hour.   Its principal use, how-
ever,, is as an external application or wash to inflammations upon
the surface, to the eyes, and wherever there is local irritation,
heat, redness, swelling, and  pain.   There is nothing which will
lessen heat in a greater degree, and with more certainty than the
sugar of lead in solution, properly applied.
   As a wash it is used in solution.  A drachm, or the eighth part
of  an ounce, dissolved in half a pint of water, forms a wash of
moderate  strength, although more  or less  may be  used as the
case requires.   It  is a healing wash for old ulcers as well as for
sore eyes.  In the  gonorrhea, it is often used by way of injection
into the urethra.                                            .
   Sugar of lead  is  a powerful astringent, and is employed in
obstinate cases of dysentery and diarrhea.
   SUICIDE.—This  unnatural  act is, in almost all  cases, the
result of disease.   The love of life is one of the deepest instincts
of man, and nothing,  but disease,  or an escape from a worse or
more ignominious  death  than  suicide, can extinguish it.  Disease
 subverts every propensity, passion, and action  of the body and
mind  ;  destroys  the  taste for the most  savory food ;  turns to
 disgust  the loveliest  objects, and weans us from  the dearest con-
 nections in life.   All  those  ties which bind us to  life  and the
 inestimable value which we  place  upon  the world  and its plea-
 sures, may all  be  dissolved, and lost, by a burning  fever, or a
 painful  sore of only a few weeks continuance. 
540
SUI.
  The affections and diseases of the brain and nerves are more
intolerable  than those of the other organs.   When the seat of
thought and  feeling becomes the seat of pain and disease, we
may well imagine a greater intolerance of distress.   As the eye
becomes intolerant of light, so does the mind, in some  instances
become intolerant of its own operations.
  We  believe, however, that people do not so  often take  their
lives to relieve  themselves  of distress of which they are sensible
and  cannot bear,  as  from false  apprehensions  of more horrid
death,  of disgrace, or some  evil which is magnified by a diseased
condition of the seat of thought and feeling.  We once attended
a deranged person who had become persuaded that  she should
live on earth forever.  This idea agreeable enough to most peo-
ple, was  to her the source of the greatest misery and torment.
The most agreeable ideas to a person in health, may become the
most painful and  disagreeable  in a disorder of the  brain  and
nerves.  A person  may be deranged in  consequence of disap-
pointed love, and  the object of  the passion, instantly turned to
disgust by  the disorder which is  the consequence of it.   Another
person whom we knew, plunged out of a window where he stood
a thousand chances of being killed, to escape from the hands of
two or three  doctors whom he imagined to have come to dissect
him, but who  had only  come  to consult upon  his case.   The
history of  those people who  have attempted to commit suicide,
but have been prevented by some accident, or by some precaution
on the part of others, shows pretty conclusively that suicide is,
in most instances, the result of false impressions.  Few commit
the act in a sound state of  the mind.  The best  of people  are as
liable  to commit it as others, and  the records of mortality will
show that  the  deed has been  as often  done by the good and
virtuous as by the bad.
  In former  times, the deed was followed by  the most direful
ignominy ; the property of the suicide was confiscated, and his
body buried in the  fork of the road.  This relict of superstition
is fast  fading away, and the subject"has come to be viewed in a
more rational light.   Men  have died in this way from the foun-
dation of the world, and  always will to the end of time.  As
long as the mind is susceptible of disease  and of false impressions,
the unnatural act will be committed.  It appears to be one of the
manifold ways  in which human  life is terminated, and  where it
is the  result of disease it is like  death in any other way, deplo-
rable, but  inevitable.   No  dishonor can  rationally appertain to
such a death any more than to a death occasioned by a fit of the
palsy or of apoplexy, or by any other disease.
  There is one fact connected with this subject well worthy of
remembrance and attention.  That is, that, the propensity to
commit suicide is, for the  most  part transitory, and if the false 
SUR.
541
impression or suicidal paroxysm can be counteracted or suspend-
ed for a while, the act may not only be prevented, but the pro-
pensity cured.  Thousands  have  made the attempt at one time,
who have shuddered at the  thought, a few days or a few weeks
after. ~ Suicide appears to result from the condition of  the mind
in the  same way that all other insane  acts arise.  Some insane
people will inflict wounds upon themselves ; others will mutilate
themselves ; some will eat nothing ; others will drink nothing ;
some are full of  fear and apprehension ; others, full of courage
and confidence ;  and some will destroy themselves by starvation
who would tremble at the idea of being hung or shot.
   Probably many sane people would destroy themselves if they
believed for a certainty, that they were to be put to death by an
enemy.   Insane people under the full belief, induced by disease,
that they are to suffer immeasurably in some way or other,  act
in the same way.  In the former case the impression is true, in
the latter, it is false.  But to the  mind they are equally true, and
the impulse which springs  from  both, is the same.  Brutus  fell
upon his sword to avoid an ignominious death.   Insanity places
many thousands  in the same condition with Brutus.
   SULPHATE  OF COPPER—Blue Vitriol.   See Blue Vitriol.
   SULPHATE  OF  IRON—Green Vitriol.—It  is  formed by
 dissolving iron filings in oil  of vitriol in a warm sand bath, evap-
 orating the solution to a certain  degree, and allowing it to crys-
 talize.   It consists of green crystals, semi-transparent, and solu-
 ble in  water.  It is styptic,  astringent, and  tonic.  It may be
 taken in the form of a pill,  or in solution.   The medium dose is
 from three to five grains.  In chlorosis or green sickness, it is
 accounted one of the best remedies.  It is ofen  used in the form
 of Griffith's mixture.   The sulphate of iron is  a  valuable medi-
 cine in debility  of the stomach  and bowels.   It  is, next to the
 carbonate or rust of iron, one of its best preparations.
   SULPHURIC ACID—Oil of Vitriol.   See Oil of Vitriol.
   SUPER TARTRITE OF  POTASH—Cream of Tartar.  See
  Cream of Tartar.
   SUPPRESSION  OF  THE  MENSES—Chlorosis—Green
 Sickness.  See  Green Sickness  and Monthly Sickness.
   SUPPURATION.—The formation of matter or pus in inflam-
 matory swellings.  After suppuration commences, the pain com-
 monly lessens until it finally ceases, which announces the com-
 pletion of the maturation.
    SURGERY.—That department of the medical art that relates
 to the  performances  of  operations for the removal  of  diseased
 parts.   Local diseases often proceed from general  causes, and the
 general system is frequently diseased by local causes;  it is there-
 fore essential that the surgeon  should have a thorough  knowl-
 edge of the science of medicine, as well as of anatomy, to enable 
542
SWE.
him to practice the art successfully.   Wounds received by acci-
dent, tumors, abscesses, ulcers, mortifications, fractures, and dis-
locations of the bones, cancers,  diseases of the eye  and ear,
ruptures, and stone in the bladder, are some of the cases which
most strictly belong to the surgical department.  Surgical diseases
are produced by, or are very much  influenced by inflammation,
irritation,  suppuration,  ulceration, grangrene  and  granulation,
each of which subjects require to  be well understood by the
practical surgeon.
  SUTURE.—Uniting the  lips of a wound by sewing.   This
is sometimes done  by pins, where the wound is deep and  large.
A pin is run through the edges of the wound, when the lips are
brought in contact, and a waxed thread is twisted around the pin
in  the form of the  figure 8.  The pin  acts the part of a skewer.
A  second and  a third  pin are passed through the lips of the
wound at convenient distances, in the same way, and a ligature
twisted  around the ends of them, which project on each side  of
the cut.   In this way  the incision or wound is perfectly secured.
The distance between the pins should not be  more than a half
or  three quarters of an inch,  and the number of them determined
by the length of the wound.
  SWELLED LEG—Phlegmasia  Lactea.—This  disease  is
sometimes called the milk leg or  the puerperal swelled leg.   It
appears  to be  occasioned  by the pressure upon the veins and
arteries made by the increased size and weight of the womb dur-
ing pregnancy.   The blood-vessels of the legs, in the last months
of child-bearing, being heavily pressed upon above, and the  blood
in them prevented from returning with its accustomed  freedom,
are  continually distended  and  strained to an unnatural degree.
After child-birth, the condition of the  whole system is  changed.
The loss of blood and  of strength changes the tone of the whole
system,  and  the powers of life  are doubtless very much lowered,
in consequence of which, the injured vessels inflame and swell.
  This affection of the leg usually comes on very suddenly in the
course of the second week of confinement.  The secretion of milk
is almost always suspended, which has been thought by some  to
be the cause of the disease, and hence  the name of milk leg.   In
one or two days from the commencement, a slight pain and sore-
ness are felt in the groin, and the leg will often be found swelled  to
twice its usual size.   The limb will be hot, exquisitely tender,
very heavy,  and cumbersome.   From the glands  in the groins,
the swelling and soreness  extend  to the private parts and  down
the whole length of the limb.   Instead of being red like  other
inflammations, the  leg is white, glossy, hard, smooth, and even
upon the surface.   The lymphatic glands situate in the groin and
fleshy part  of  the limb, feel  swelled, hard, and knotty.  The
pain soon becomes severe, and, in some instances, is intolerable, 
SWE.
543
 without the use of opiates.   When the limb has become swelled
 to its full  extent, the  pain,  in a measure, ceases.   The skin of
 the leg is whiter than  natural, exceedingly tense, and the heat is
 that of a fever.  If the swelled limb is pressed by the finger, no
 indentation is  left as in a dropsical swelling, but the impression
 instantly disappears.  Nor does the swelling lessen any by a hor-
 izontal  position, as in a case  of dropsy.  Only one leg is affected
 at a time,  but  the other leg sometimes, goes through with  the
 same disease after the  first has recovered.
   The  disease varies very much  in its duration.   In  some
 instances,  it will  terminate  in two  days,  and in  others, it will
 continue a fortnight or three weeks.  There  is, in this disease,
 always  more or less fever ; in the commencement of it, especially,
 there is often much general  heat,  thirst, restlessness, and want
 of sleep.
   Domestic Remedies.—The best local application which can be
 made to the limb in the commencement, is alcohol or  new rum, a
 little warmed.   The whole  leg should be kept moist with it for
 the space of twenty-four hours.   A dose of epsom salts should be
 swallowed, and a perspiration raised by the  use of the antimonial
 powder in  eight grain  doses,  once in four hours.  If there is sick-
 ness at the stomach, an emetic  of ipecac  or of lobelia should be
 given,  followed with  a plentiful supply of warm water.  Two
 tea-spoonfuls of epsom salts should be  given, every day, until the
 swelling begins to subside.    The drink should be water with the
 chill taken off, lemonade, and barberry water.  The diet, should
 be  liquid vegetable substances,  such as  water porridge, bread
 water and  flour gruel.  To procure  sleep, ten grains  of the Do-
 ver's powder should be taken, once or  twice, just before evening.
   Usually, in about a week  or  fortnight, the  swelling and pain
 begin to abate  and the symptoms of the fever to diminish.   It is
 a painful though not a  dangerous disease.  Death from this affec-
 tion, seldom, or never  takes place.
  Professional Remedies.—If  the  swelled limb is very painful
 and sore to the touch, and the pulse is full, hard and strong, blood
 should  either be drawn from the arm or from the limb itself, by
 the use  of  leeches.  The  use  of leeches  is  always  preferable
 where  they  can be obtained in  sufficient numbers.   Not less
 than a dozen should be employed, and at as many as two or three
 different times.  The  sal nitre in eight grain  doses  should be
 employed to cool the system as much as  possible by a free dis-
 charge  of urine ;  and  to prevent the  increase of the swelling.
 Much relief is obtained in all inflammatory and febrile complaints,
 by a plentiful  flow of the urine.  If the  urine  is scanty, thick,
and high colored, it causes great restlessness  and heat.  What-
 ever relaxes the kidneys and opens  the passage of the water, is
 sure to be followed by a mitigation of the disease. 
544
SWE.
   After the vehemence of the disease is somewhat mitigated, the
leg should be  bathed with a solution of the sugar of lead, eight
or ten times a day.   If the pain is severe and the soreness great,
a tea-spoonful of laudanum may be added to the wash, every time
it is used.  Equal parts of new rum and vinegar, used warm, is a
powerful agent in subduing inflammation.
  Where  opium  cannot be used without  increasing the heat,
thirst, restless and  pain,  Hoffman's anodyne and the acetate of
ammonia should be  employed.  Blisters have, in some instances,
been  found beneficial where the heat  of the body is not great.
But above all the local remedies which can be employed, if they
can be applied often and extensively enough, are soft, warm poul-
tices,  made  either of  rye  meal and water, flax-seed  meal, or of
white bread.   A poultice should never  be allowed to become dry
or hard, or be covered with any oily substance.   If covered with
lard or oil, we might as well  use the  lard or oil alone, and dis-
pense with the  poultice.   To prevent its sticking  or breaking,
the poultice  may be covered  with  a piece of  old muslin  or
gauze.
  SWEET FLAG—Alcorus Calamus.—This  plant is  too well
known to need any particular  description.   The root is the part
used in medicine.   It is spongy, knotty, and marked with rings.
The  taste  is  warm, bitterish,  and pungent ;  the   smell, aro-
matic.  The  spicy flavor of  the sweet flag root,  has  recom-
mended it in the colicy pains of children.  It warms  the  stomach
and expels the wind.  In  cases of weak stomach and  indiges-
tion, it is often used'with advantage by adults.   It is a tolerably
good  stomachic.
  SWEET SPIRIT OF NITRE—Dulcified Spirit of Nitre—
Spiritus Etheris Nitrosi.—This liquid is composed of nitrous acid
and spirit of wine or alcohol.   The  composition is  effected by
distillation  in a glass receiver or distillery.   The process is some-
what  difficult, and requires caution, lest the materials explode.
  There is hardly  a  medicine in more common use  than  the
sweet spirit or spirits of nitre,  nor one  which is more deservedly
popular.
  It abates the heat of fever,  quenches the  thirst, increases  the
flow of  the urine and insensible perspiration,  and  relaxes  the
whole vascular system.  It  has a sourish, pungent  taste, and a
fragrant ordor.  It evaporates, unless confined in a  close phial.
The dose is from  one to  two drachms.   A tea-spoonful may
be given,  every two hours, in a  severe fever,  in water or any
other  simple liquid.   The sweet nitre  relieves spasms and nerv-
ous strangury.  Forty drops of laudanum or morphine, and four
tea-spoonfuls of sweet nitre, given every hour or two, have been
known to relieve the most violent cases of strangury or stoppage
of the water.  Six  or eight drops in  a little water is the best 
TAB.
545
medicine we have ever used in the case of infants where there
is a delay in making water.
  The sweet  nitre,  rightly used,  will cure a fever without the
aid of any other medicine.  It is  an efficient remedy in dropsy,
or inflammatory diseases.
  SYMPATHY.—This principle appears to us to be entirely
theoretical.  That the whole system participates more or less in
the disease of any of its parts, is a matter of fact, established by
daily observation and experience  ; but,  that one part or  organ
has such  a  connexion with another as  to disease that part or
organ while  all the other parts of the system remain unaffected,
is  a  matter  of conjecture  merely.   The  particular  connexion
which  is supposed to exist between  the uterus and  breasts, and
the throat and the sexual organs, is  a matter of  coincidence and
not of sympathy.   The simultaneous development of those parts
and their functions take place in no otherwise than the maturity
of other organs and parts.
  SYMPTOMATIC—Diseases which are merely symptoms of
some other disease, such as a headache which arises from a foul
stomach, and dropsy of  the brain  which arises from the bowel
complaint of children.
  SYNCOPE—Fainting.  See Fainting.
  SYNOCHUS—Simple Continued Fever,  See  Fever,  Con-
tinued.
  SYNOVIAL FLUID.—The greasy  juice contained in the
joints.   Its use appears  to be to produce an easy motion of the
joints.
  SYPHILIS—Pox—Venereal.   See Venereal.
  SYRUP OF BALSAM—Balsam  of  Tolu.   See Balsam of
Tolu.
  SYRUP OF LEMON.—Take of Lemon juice, after the feces
have subsided  and it has been strained,  three pounds, double
refined sugar five pounds.  Dissolve  the sugar in the juice so as
to make a syrup.   This is an excellent  medium  in  which to
take  powders and  mixtures.  It makes  an agreeable drink, and
when mixed with flax-seed tea, or  a mucilage of slippery elm and
gum arabic,  it greatly improves their  taste.
  SYRUP OF SQUILLS.—See Squill.
                             T.

  TABES.—A  gradual wasting or consumption of the whole
body, but without cough, raising,  or any particular affection of
the lungs.  The most remarkable symptoms are a wasting of the
flesh, and debility, with hectic fever.  This is for the most part
           69 
546
TAR.
a disease of youth before puberty.  It is owing to some natural
defect in the constitution, aggravated  by an unwholesome atmos-
phere, want of exercise and proper food, and excessive labor  in
manufactories where they have no time for recreation and change
of scene.  It is apt to end in dropsy.
  In this disease the patient  should  be supplied with the best
and most nutritious food, and  take as much exercise in the open
air as he can bear without fatigue.  A warm bath, quinine, elixir
vitriol, rust of iron, and chalybeate waters, are all serviceable  in
their turn, and should  be employed as the symptoms of the dis-
ease may require.   The bowels must be  regulated by mild pur-
gatives, and the blood renovated  by  the  use of  ripe, acid fruit.
A residence by the sea-board and a fish diet  are  always worthy
of trial.   If meat increase the heat, quickens the circulation, and
disturbs  the sleep, it should be laid  aside entirely.   Tabes is a
difficult disease to cure.
  TJENIA—The  tape-worm.—It is  a long, flat, jointed worm,
resembling a piece of tape.   The spirits of turpentine  in the dose
of a table-spoonful, once a day, for several days in  succession,
will destroy and expel  it.   See Worms.
  TANSY.—The leaves and  seeds  of this plant are a warm
bitter, and promote the menstrual function.   It may be used  in
the form of a tea or essence.   It is often employed to expedite
lingering  labors, and to hasten the expulsion of  the  after-birth.
A strong tea is good for the vapors, flatulence, and hysterics.
  TAR.—This  substance,  dissolved  in water, is often used  in
chronic  rheumatism, dyspepsia,  hypochondrism, and  complaints
attended with want of heat, and excess of phlegm.  It is a good
medicine in chronic catarrh and obstinate coughs.   It warms the
blood, promotes the urine, animates the feelings,  and  invigorates
the digestive powers.
  The tar ointment has often been found  to cure foul ulcers, old
sores, and the  scald head.  It  is made by melting  together five
parts of tar and two of yellow wax.
  TARTAR  EMETIC—Tartrite of Antimony.—This article
is a composition of tartaric acid and the oxide or rust of the  metal
called antimony.   It is a neutral substance.  The antimony itself
is found in the shape of an ore in the earth.   When melted, to free
it from  impurities, and hardened by cooling, it is of a white sil-
very color, very brittle, and  quickly oxidized by  the air.  In  its
native state, it somewhat resembles anthracite coal.   The pure
metal is hard and easily melted.
  The tartar emetic is  one of the most valuable medicines in our
possession.  It is a  white  powder, rather lighter in  color  than
calomel.   It is both an emetic  and a cathartic.  Three grains
are a sufficient dose for an emetic, and this should be given,  in
solution, at three different times, about a quarter of an  hour apart. 
TEE.                        547
It  dissolves readily in hot water and alcohol or new rum.  If
the use of the medicine is continued, it operates upon the bowels.
  The quarter of a grain is a sufficient dose for a child from one
to two years old, as an emetic.  In general, it is an unsafe emetic
for  young children.
  In small doses,  tartar  emetic or tartarized antimony increases
all the secretions of the  body, and  lessens the heat.  The skin,
the lungs, the kidneys,  and the bowels, are all affected by it.
In a most signal  manner, it relaxes the  vascular system, mode-
rates the action of the heart, and lessens the force of the circula-
tion.   Even where it does not excite nausea, it produces all these
effects.
   The best dose in which to give it, in order to produce sweating
and to lessen fever, is that of a quarter or fifth of a grain.   We
prefer the quarter of a grain dose, whether we use it in a fever,
or  in an inflammatory disease.   In  peripneumony, pleurisy,  and
other  inflammatory diseases, if given in this dose  often,  it will
accomplish all the effects which have been ascribed  to it when
used  in larger doses.  The operation of tartar emetic comes the
nearest to blood-letting, in its effects upon the system,  of  any
medicine in use.  It lessens the size as well as the  velocity of
the pulse, and makes an  impression upon the system which is
felt in all its parts.                            '
   In  fevers, it  was  the favorite remedy of Fordyce, and  has
maintained its reputation to the present day.  A single dose  will
often  still the greatest  commotion  in the system, and produce
composure.  Its  most signal effects are upon the skin;  when
the hottest and the driest,  a few small doses of tartar emetic,  will
 often  abate the heat and bring  a moisture.
   TARTARIC  ACID.—This acid is obtained from the settlings
 of wine, or a deposit of super-tartrite of potash.  The acid con-
 sists  of solid, square, transparent crystals.  They readily dissolve
 in water, and make an extremely sour liquid.   It is used princi-
 pally  in the formation of neutral salts.
    TARTRITE OF ANTIMONY—Tartar Emetic.  See Tartar
 Emetic.
    TEETHING.—The whole number of a child's first teeth are
 twenty, although sixteen  are all that commonly appear the first
 two years.  There are four cutting teeth  in each jaw or four upper
 and four under cutting teeth. They are called the cutting teeth  or
 incisors, because they have a sharp edge to cut the food.   These
 teeth have but one fang.  There are four canine teeth, two upper
 and two under ;  these have only one prong or root. The two upper
 ones are called eye-teeth.   The child cuts two grinders or double
 teeth.  Some children  cut four double teeth.  They are called
 double teeth because they have two sharp edges  with a groove
 between  them,  and  resemble two cutting teeth put together. 
548
TEE.
They are also called grinders, because they grind the food after
it  is cut  by the  fore-teeth, or torn to pieces by the eye teeth.
The double teeth of the under jaw  have  two  prongs, and the
double teeth of the upper jaw have  three  prongs, except those
next the  eye teeth, which have but two.
   In children, two of the lower cutting teeth are commonly the
first to make their appearance.   Next to these, two upper teeth,
which correspond to the lower ones, make their way through the
gums.  The four double  teeth appear next.  The canine and the
eye teeth are the last in the set to make their appearance.
   The process of teething, to some children, is productive of no
evil consequences, but to others it brings sore distress  and pro-
longed disease.  The time of teething continues, in general, from
the fifth  or six month, to the sixteenth month.   Some  children
will begin  to cut teeth as early as three months, and others not
until they are eight or twelve  months old.   If the first teeth are
cut easily, it is a pretty sure sign that there will not be much trou-
ble with the others.  But if the child begins to cut its teeth in the
hot weather, about the time that bowel complaints make their ap-
pearance, it often has a long  sickness, if  the  disease does not
prove fatal.  It is very fortunate if the process of teething com-
mences  in the winter,  or early in the fall,  and closes before
summer.      *
   When teething commences, the child begins to drivel ; the
skin becomes hot; the gums look red and swelled, and are tender
to the touch.  The child often makes attempts to rub them, as if
there were a violent itching, and will be  quiet when they are
gently rubbed by its mother or nurse.  Its sleep is interrupted
and imperfect, and there is more or less disorder of the stomach
and bowels.  Most  children are loose,  although some will be
costive.  A slight degree of looseness is not, perhaps, productive
of much evil, but in hot  weather it is very apt to run  into a
severe disease of the bowels.   We have some doubts  about the
truth of  the old  doctrine, that a looseness is an effort of nature to
carry off the disease.  It appears  to us to be  an indication that
the irritation of teething  is severe enough to disorder the bowels,
and,  that,  the symptom, instead of being  favorable, should be
closely watched and properly restrained.  Gripings, green stools,
undigested food, mucus  and watery  matter must be considered
as indicative  of a disease of the bowels,  and  call for medical
aid.
   Teething very  often produces convulsive fits, sourness of the
stomach, and a remarkable hotness of the belly.  There will ap-
pear to be  a stoppage, which  produces a hotness of the belly, of
the soles of the  feet, and of the  palms of the hands,  followed
very soon by a convulsion fit.   The  fit may often be prevented,
if the bowels can be emptied in  season by a dose of  oil or an 
TEE.
549
injection.  If the bowels are full, hard, and hot, no time should
be lost in procuring a free evacuation.
  Domestic Remedies.—In ordinary cases  of teething, where
there is  no great  disorder of the  stomach or bowels, no other
remedy will be required but an occasional dose of the  calcined
magnesia to correct the  sourness of the stomach, or a little poppy
tea or paragoric to make the child sleep and to deaden the itching
and pain of the gums.   A few tea-spoonfuls of lime water or of
burnt oyster-shell water, will correct the sourness of the stomach.
Prepared chalk is often used, but it is too apt to clog the stomach.
   If there  is much griping of the bowels,  peppermint, spearmint,
or pennyroyal tea should be given, every little while,  in sufficient
quantity, and  of a sufficient strength, to  bring a  moisture  upon
the skin.  Ginger tea, strained, may be given.
   If the bowels become seriously disordered, with  a  constant
fever and loss of appetite or indisposition  to nurse, the best med-
cine which we have ever used, is a mixture of castor oil and par-
agoric or laudanum, given  every day.  A  table-spoonful of castor
oil may be given  to any child after  the age of teething  com-
mences, or after it  is nine months old.  To this from three to five
drops of laudanum should be added, or forty drops of paragoric
which  contain an  equal amount  of opium.  To a  child  eight
months or  a year old, six drops of laudanum may be given with a
table-spoonful of oil.   When there is sourness of the stomach, or,
of the discharges from  the bowels, a tea-spoonful of the calcined
magnesia  should be  used  instead of the  castor oil.   If there is
sickness at the  stomach, five grains of calomel should be  given
in  preference  to any other  physic, as it is  the best of anything to
stay upon  the stomach.  It is always a good sign, if the anodyne
produces a sweat.
   In some cases, it will be advisable  to cut the gums, especially
if they are much swelled and inflamed.   This may be done with
a sharp  penknife or a gum lancet.   If the skin is hot and dry, it
should be  bathed two or three times a day  with tepid water.  If
the brain  is affected, the head hot, and the eyes  engorged with
blood, five or six leeches must bPapplied to the forehead.
   If children do not nurse, their food should be boiled milk and
water, about half and half.   A thin gruel made of flour well
boiled with water  and  a little salt, is the  best food to restrain the
looseness  of the bowels.
    In the hot season, it is of the greatest importance that children
 should be kept cool.  Many more  children die from the effects
 of teething in the cities than in the country towns, where they
 are exposed to  a less degree of heat.  Fewer die upon the sea-
 shore  than either in  the cities or inland  towns.  The coolest
 places are, in all respects, the safest and best for teething children.
 We  advise all  parents who  travel with  children  of  this age, to 
550
TET.
take them to the sea-board.   The clothing of children, in teeth-
ing, should be light, and their food  restricted to milk and bread,
boiled rice, molasses and water, with bread soaked in it, custards,
and indian and flour puddings.  Children do not thrive well upon
solid food for some months after all  their teeth are cut.
  TEMPERAMENT.—Four different temperaments have been
ascribed to  mankind—the phlegmatic, the sanguine, the  bilious,
and the nervous.  But as the characteristics or signs of the diffe-
rent  temperaments as they have been laid down in books, refer
only to  white people, and as people  of other  complexions are
known to possess the same constitution of body, to be subject to
the same affections of  both  mind and body, and to  discover the
same diversity of character, the whole doctrine must be discarded
as erroneous.  Every one must perceive  the impossibility of de-
termining the temperament of an African, an Indian, or an Asiatic
by the characteristics which are defined in medical books.
  TENDON—The white, transparent part of a muscle.  The
ends of muscles are  always  tendinous.  In common language,
it is the gristle.
  TENESMUS.—A constant desire to discharge the contents of
the bowels  without the ability, attended with a  sense of constric-
tion or bound state of the belly.
  TERTIAN AGUE—An  intermittent  fever which  returns
every third day.  See Fever and Ague.
  TETANUS—Locked Jaw.  See Locked Jaw.
  TETTER—Herpes.—The skin is subject to an indescribable
variety  of  eruptions, pustular tumors, ulcers, and humors.  To
treat them  successfully the  physician ought to  know the nature
of the disease for which he  prescribes ; but, perhaps  to know
this, it is not always  necessary to know  also the precise  species
to which each disease of the skin, belongs.
  Four kinds of the tetter are  quite common  diseases in New
England, and pretty well known  to  people in general.  The
tetter consists of an assemblage of little creeping  ulcers which
come in the form of small  pimples or pustules, clustering  thick
together, and which itch excessively, and  finally  terminate in
dry scales or scabs.   They  seldom  eat below  the  skin so as to
form a permanent scar, though,  sometimes, the skin will be so
deeply corroded  as to destroy its texture  as far  as the ulcer runs.
We  have seen  cases of the  tetter which looked  as if  a large
blister had  been drawn in  several  places, and left the naked
surface in a state of  suppuration.  In the tetter, the blotches are
very apt to run together and to form one ragged, broad, suppura-
ting ulcer.   The dry tetter is the most harmless of  either of the
kinds of this disease.   It will make its appearance in any part of
the body, but commonly comes out  upon  the face, neck, arms
and wrists.  The itching which attends it, makes it exceedingly 
TET.
551
troublesome, but, otherwise, it is  entirely harmless.   At first,
there appears a cluster of pimples or broad red spots which do
not  continue long before  they die  away, and leave the  places
covered with a transparent, thin scale ;  to this  succeeds another
crop of the same nature, until the  face, neck, and other parts
have been completely overrun with them.
   The second kind of this eruption  is called the pustular tetter.
This is the  kind which so often appears  behind, and about the
ears of  children while they are teething and  quite young.   It
appears in separate pustules which run together and form  a com-
mon sore or ulceration of the skin.   This eruption afte.r continu-
ing about the ear awhile, will extend  to the eyes and cause  in
them a troublesome  inflammation and ulceration.   The pustules
in  this kind of tetter, will appear to  contain only  a  watery
fluid,  but  after  they run  together and form  a common sore,
there will  be a  watery suppuration, or a mixture of water and
pus.  The ulceration will be covered with a kind of tough slime.
This slime is hot, biting,  and inflames the surface wherever it
runs.   The  matter  often  runs among the hair and mats  it hard
together.   This kind of tetter  will sometimes excoriate the skin.
It will often hang about the child for six  months or a year.  It
rarely deranges the health  or ends in any serious disease.  Much
is said about repelling the  eruption or driving it in, but we  have
never seen an instance of this, and have but little faith in the
idea of driving  in diseases upon the brain, stomach, or bowels.
With many physicians, every disease of the stomach,  bowels or
lungs, is a humor which has been  repelled from the skin, and
must be driven back  again.   They hardly dare touch a  cutane-
ous eruption for fear of driving it in, and thus children, and some-
times, grown people are left  to worry out a tedious irritating
disease of  the  skin which might easily have been cured in the
beginning.   The tetter or running  sores  about the ears or heads
 of children, have been supposed to be really beneficial to children
 while teething, or while they are affected with a bowel  complaint,
but this idea to  say the least of it is mere conjecture. The disease
is evidently owing to a watery, impoverished state of the blood,
and affects children whether they are teething, or not; or whether
 they have the bowel complaint or not.
   A third  kind  of this humor is the miliary tetter.   This kind
 of tetter most, commonly breaks out about the loins, breast, pri-
 vate parts, and  in the groins.  The disease is sometimes very
 troublesome to  old people, in whom it appears about the seat and
 perineum.  It is attended with itching, smarting, and heat.  The
 humor in this form, consists of small red pimples  about  the size
 of millet seeds, or mustard seeds.  From these little pimples there
 oozes a pure watery matter, but which is very biting  and corro-
 sive.   Wherever it spreads it excites a  new  crop of pimples. 
552
TET.
This matter becomes very tough and sticky, so that whatever is
applied to the part is removed with much difficulty.
  A fourth kind of this humor is called the eating tetter.  This
kind appears in small, smarting  ulcers,  or  little  blisters which
soon begin to ulcerate.  The skin of the part becomes red, an
irregular, shapeless  blotch forms, the skin is excoriated  as by a
blister, and a large, spreading ulcer is formed.  We have seen
the neck, head, and breast of children half ulcerated  over by this
kind of tetter.  It runs excessively, and the itching, smarting,
and  burning  are extreme.  The ulceration  in this kind of tetter
is much deeper than in either of the other kinds.   It resembles a
large burn, or scald, and the thin, sharp, watery matter discharged
from the ulcerated skin, penetrates, in some cases, even down to
the muscles.   The  ulceration will finally dry away into a large
crust, which, at length, peals off.   This species of the disease
is sometimes  so severe and distressing as to destroy the appetite,
and to raise a considerable degree of fever.
  The tetter  in all its forms appears to be owing to a thin watery
state of the blood, induced by want of nourishment, or by feed-
ing upon food which does not agree with it ; by want of cleanli-
ness ; by foul air, and, probably, by particular states of the atmos-
phere which  directly debilitates the system or operates upon the
skin.
  Domestic Remedies.—The skin should be thoroughly soaked
with warm water  every day, and  made  entirely clean.   When
the disease runs upon the head, the hair should be shaved close
and the whole head covered with sweet oil to prevent the matter
which oozes  from the ulcers, from  excoriating the skin any fur-
ther.  The oil should  be washed off every day by a little castile
soap and water, and put on anew.   In the dry, pustular, and mil-
iary tetter, a weak solution of the sugar of lead should be first ap-
plied.  A solution of white vitriol in the proportion of four grains to
two ounces of water, is a good application.  Rose water is a pecu-
liarly suitable wash.  After the humor  begins  to  run and to
maturate, there is no better  application than the ointment called
Turner's cerate.  The whole diseased surface should be covered
with  it, by spreading  the ointment upon a piece of soft linen.
The covering should always be light as  possible, lest  the part
should become  too hot. Before  the eruption begins to run, it
may be washed in rum or diluted alcohol, but after  the  pimples
have  broken out into  open  sores, the  spirits will be too heating
and stimulating.  The matter of the humor may be prevented
from  running, by strewing  upon it the  carbonate of  magnesia,
finely powdered, prepared chalk, or hair  powder.   Pomatum is a
good application for  small  children.   Mutton tallow and  the
simple cerate are also good  local remedies.   An ointment  made
of cream and the inner bark of the elder, is a cooling and suitable 
TET.
553
medicine.  The Ethiop's mineral in a dose of two grains, once a
day, should be given  internally.  A dose of the cream of tartar
should also be given every other day.
  The eating tetter often requires  a treatment peculiar to itself.
Besides the local remedies, the system will require to be strength-
ened by the use of iron, quinine, and the mineral acids.  In every
species of the tetter, the itching and local irritation will often  be
so great as to require the use,of laudanum, morphine, paragoric
or the Dover's  powder, but  especially in this.   In some cases of
the eating  tetter, we have been obliged to steep a few grains  of
opium in water  and apply it to the surface of the running ulcer
to allay the  intense  itching and  burning.   A tea made of the
white  poppy heads will  answer the purpose very well.  The
child should, at the same  time, be made to drink of the poppy
tea.   After washing and soaking the raw surface, every day, for
half an  hour at a time, with warm water, a strong  decoction of
the poppy tea should be poured on, or laid on  with soft linen.
  To neutralize the sharpness of the running matter, a layer of
charcoal finely powdered should be strewed on.   The charcoal   i
absorbs the matter, cleanses the ulcer, and destroys the bad smell;
for these ulcers will, sometimes, be really phagedenic.  Weak
solutions of  the chloride of lime  or soda may be  employed to
correct  the fetor of the sores.  A strong tea made of the wild
indigo root and applied as a wash will have  a tendency to heal
the ulcers.
  The  ointments proper to be used in this species of the tetter
are the calamine, the citrine, and the simple  ointment or simple
cerate.
  Weak solutions of the sugar of  lead and of white vitriol are
the  most cooling washes which  can  be used.  The  Griffith's
mixture, given in a dose  of a tea-spoonful,  three times a day, is
one of the  best tonics.  All kinds of acid fruit and watery vege-
tables  should be avoided in either  species of  this disease.  The
food should be milk, eggs and fresh meat, white  bread, and rice
and flour puddings.  Butter, cheese, fried cakes, and  all fat meats
are improper, and unwholesome.  Vegetable acids of every kind,
are pernicious.   The physic, should be cream of tartar, sulphur,
Rochelle powders, and calomel.   The syrup of buckthorn has,
sometimes, been found to cure the disease when used in connec-
tion with the  calamine ointment or Turner's cerate, applied to
the diseased  surface.
  In those cases which prove  obstinate, the spring or mineral
waters should be tried.
   Professional  Remedies.—It is  the duty of the  physician, if
possible, to ascertain the cause of the disease ; the error of diet,
or the poisonous article of  food which produces it, for almost
every article of food, is poison, in some respect, to particular peo-
            70 
551
THO.
 pie ;  whether the child is sufficiently fed, or fed upon unwhole-
 some  food.  It may have  been produced by the effect of some
 other  disease upon  the system, or some fault in the digestive
 organs.  Calomel if rightly used, is  an extraordinary medicine.
 It possesses the most  healing  properties of  any article  in  the
 materia  medica.  It should, however, be used with the greatest
 caution, and never continued above five or six days in succession
 without an intermission of two or three days.   The child  should
 never be  salivated; it is enough to  moisten  the mouth. The
 sarsaparilla is often effectual in removing cutaneous diseases.
 The iodine should be tried.  Decoctions of the cicuta should be
 applied  as a local remedy where other washes fail.   A solution
 of the corrosive sublimate is often  applied to the dry, pustular,
 and miliary tetter, but,  really, it seems to us improper in the eat-
 ing tetter.
   THORACIC  DUCT.—The trunk  of all the  vessels  which
 secrete the chyle and the lymph.  It is about the size of a crow-
 quill, and resembles an artery.   The  lacteal and lymphatic ves-
 sels all terminate in this duct near  the posterior  opening  of  the
 midriff.  The thoracic  duct extends from thence in a serpentine
 course along the spinal  bones to the union of the left subclavian
 and jugular veins, where it empties  the chyle and  lymph.   This
 is the  fundamental vessel of  the system, as it receives and con-
 veys into the blood vessels all the nutriment of the body.
  THORAX—Chest.   See Chest.
  THORN APPLE—Apple  Peru—Datura Stramonium. See
 Apple  Peru.
  THOROUGHWORT—Boneset—Eupatorium  Perfoliatum—
 This  plant may be found in almost every meadow and marshy
 place  in the Union.   The stem is erect, and rises to four  or five
 feet in height, perforating  the  leaves at  each joint.  It is  hairy,
 woolly, and near the top, spreads into  numerous branches.   The
 leaves  are rough and indented.   The  flowers are  white, and ap-
 pear in mid-summer.  The  medicinal  parts are the leaves and
flowers.  The thoroughwort is an emetic, cathartic, and sudorific.
In correspondence with  its name, it  acts thoroughly  upon the
stomach  and bowels.  In small doses, it is a tonic.
  Where it is given to evacuate the stomach and bowels, a  strong
tea is used.   The dose  is a tea-cupful, every half hour, until it
operates  as a cathartic.  In  bilious  colic, and in all cases  where
the stomach is oppressed with bile, the  thoroughwort is  one of
the best  remedies.  It  is a safe domestic medicine to use  in the
commencement of febrile diseases, jaundice, and  colds. It may
be used in the form of powder, tea, tincture, or  extract.
  The extract in external appearance, resembles aloes.  It is an
active  and easy cathartic.   The dose is four or five pills  of the
common  size. 
THR.                        555
  The dose of the  powdered  leaves for a sudorific and tonic, is
from twenty to thirty grains, every two hours.
  In a costive, indolent state of the bowels, the thoroughwort is
a peculiarly appropriate remedy.  Where it operates as an emetic,
it produces at  the same time a profuse sweat.  It forces open the
pores and produces  something of the same  kind of  relaxation of
the vascular system, which follows the use of tartar emetic.  It
may be employed  in many diseases, but it operates to most ad-
vantage in remittent fever, jaundice, and accumulations of bile in
the stomach and bowels.   The hot tea is an efficacious medicine
in suppressions of the  menstrual function.   Besides the profuse
sweat which it excites, it relaxes the vessels of the uterus, and
operates upon  that organ as it  does upon the skin.
  THROAT   AFFECTION  OR   FAILURE   OF  THE
SPEECH.—This disease has either been recently discovered,
or its  prevalence  has been  much  greater of late years  than
formerly.    We are inclined  to think that the disease never
attracted  the  particular  notice  of  former  ages,  and  that it is
only of late years, that it has  been properly defined, and distin-
guished from other  diseases.
  The affection  seems to have  been the most common among
clergymen,  although instances  of  it occur among  singers and
other classes of people.
   The cause of it, as nearly as we can ascertain, is  the excessive
exertion of the voice, together with an effeminacy of constitution
or derangement of the  general health.
   The  seat of the affection is  the  top  of  the  wind-pipe or
the  larynx.   There is  in most cases, no  cough,  or  soreness
of the part which  can be discerned.  In a female  singer which
we once  attended  for this  affection,  there was  a perceptible
redness at the entrance  of  the throat which  involved nearly
its whole circumference, but no swelling or difficulty in  swallow-
ing.  The complaint was  cured in a few weeks by a suspension
of singing, and using a  solution of white vitriol  for a gargle.
We are inclined to  think  that there is a sub-acute  inflammation
of the vocal muscles, although no external signs may be visible.
We  can  scarcely conceive that mere  relaxation can produce  a
permanent disease.   Fatigue, faintness, and exhaustion, the ordi-
nary causes of relaxation  of the muscles, are in general very soon
recovered.  A permanent  atony may be produced  by paralysis,
but the throat affection is not  of this nature.   In another case
which came under our observation, there was a total loss of the
voice for two years, but  the faculty  of speech finally returned
again as  well  as ever.
   The  affection commonly  comes  on very  gradually.   The
person feels only  a slight degree of  hoarseness of the voice,
and  this  only at  particular  times, but at length, it  becomes 
556
TIC.
difficult to speak in the  usual tone, and he is obliged to lower
his voice.   Some degree of dryness is  felt  in  the  throat,  and
a kind of an aching  which  does  not  fairly amount to a pain.
The vocal  muscles are  evidently fatigued in  speaking, which  is
manifested by a hollowness of the voice.  Dyspeptic and nervous
people often experience a similar  kind of  inability in speaking,
but in them, the same  inability is felt in all  the  muscles of the
body.
   Some suppose the disease to be produced  by the use of tobacco,
but it often occurs in those who do not make use of  that sub-
stance, particularly in females who indulge  much in music.  Dr.
Mauran of this city, who has made this affection a particular sub-
ject of inquiry, has ascertained that there is as many, if not more
cases, occurring  among those who never indulge in the  use  of
tobacco, as among chewers and smokers.   The  excessive use  of
tobacco may in particular people aggravate the disease or assist
in its production, but the real cause of the  disorder, we think
will be found in the  excessive exertion  of the vocal organs by
people of effeminate constitutions and habits.  We are even  dis-
posed to adopt the opinion of Dr. Mauran, that the use of tobacco
may in some instances  contribute to cure  the complaint.  This
opinion is  fairly  inferable from the  cases of  recovery which he
has recited.
   The cure  of the complaint  must consist  in a suspension  of
public speaking or singing, and in the use  of  such medicines  as
will restore the strength of the vocal muscles.  The confirmation
of  the muscular  strength in  general, by  exercise or labor  in the
open  air, or by the recreation of traveling,  will contribute to the
restoration of the strength of the vocal  muscles.  The quinine,
mineral acids, especially the  elixir vitriol, and chalybeate medi-
cines are the most proper to  be used.  Cold  bathing, especially
the cold shower bath will greatly assist in the cure.
   THROAT ROOT—Water Avens—Geum Rivale—This plant
may be found in bog meadows.   The root is a powerful  astrin-
gent.  Tn  cases  of canker and ulcerated sore throat, it is used
with  success as a gargle, and drank as a tea.  It is said that the
powdered root will cure the fever and ague.
   THRUSH—An ulcerous state  of  the mouth and throat.  See
Canker.
   TIBIA.—The  shin bone.
   TIC DOULEUREUX—Neuralgia.—This  disease consists in
a painful state of the nerves of the face.   There are no signs of
inflammation, no redness, swelling, increase of heat,  or fever.
Indeed, there are  no external  signs of  the  disease.   The  pain
always follows the course of the nerves, and when the affected
nerve is divided  by  the knife above the  place  of the pain,  in
some cases, it immediately ceases.   This cannot, however,  be 
TIC.
557
considered as a certain sign that the pain is in  the nerve, since
pain in any other structure would cease just as soon on a division
of the nerve which penetrated it.
   It is said that the  slightest touch will  bring on a paroxysm of
pain.   The nerves of the cheek-bone are the  most frequently
affected,  but  all the  nerves of the face and jaws are subject to
the disease.  The pain while it lasts, is  said  to be the most ex-
quisite torture, and  but  for the intermissions  which occur,  it
would be absolutely  insupportable for any length of time.  Even
the nerves of the ear are sometimes the seat of the disease.  Tic
douleureux resembles  the nervous headache or hemicrania in its
nature, and like that disease, is generally periodical, the  parox-
ysms coming on regularly every day at a particular  hour.  The
intervals, however, sometimes last a number of days or a week or
two.
   During a paroxysm  of tic douleureux,  tears start from the eye
over the affected nerve  ; the pain darts in different directions along
the branches of the nerve; and convulsive twitchings tell the
spot where the anguish emanates.  Compared with the toothache,
the pain of neuralgia is superficial, and more acute.
   Remedies.—The pain may be palliated by opium and other nar-
cotics.   A tea-spoonful of laudanum or liquid morphine may be
given, every  two hours, until the pain is allayed; or two grains
of opium may be given  in its place.  The  extract of  hemlock
or cicuta in  two  or three grain doses,  every three hours, will
sometimes succeed.  The extract of belladonna in the dose of  a
grain,  and taken  as often, has  even  succeeded better than the
cicuta.
   A strong laudanum  poultice  applied to the painful spot, will
procure  relief.   Blisters drawn  over the diseased  nerve, leeches
applied to the face,  and the hot drops employed both internally
and  externally, should be tried.  The mercurial  ointment, and
calomel are said io have effected cures.
   'The face should be steamed, and the  body relaxed by physic,
emetics,  and  nauseating doses of ipecac, or  lobelia.  The most
successful  practice however  that we  have ever tried, is to give
the extract of stramonium in one grain doses, every  two or three
hours  during the  paroxysm, until  some degree of  narcotism is
produced and the pain is  relieved, and the Fowler's solution of
arsenic in doses of  six or eight drops, three times a day during
the intervals.   The  stramonium should  be discontinued as soon
as its effects  are manifest, and resumed a little in anticipation of
the next expected return of the pain.   The arsenic should not be
taken  when  the stomach is  entirely empty,  but  about an hour
after eating moderately of plain food or gruel.  Should it occa-
sion nausea, the dose  must be lessened,  or it may be increased a
drop or two if the stomach bear it without sensible effect.   The 
558
TIN.
 precipitated carbonate of iron in twenty grain doses, three times a
 day, is one of the most appropriate  remedies, and  may be used
 instead of the arsenic if prefered.  Dividing the nerve above  the
 seat of the pain has sometimes beeiir practiced with success,  but
 it is an operation seldom resorted  to, and is by no means a certain
 cure.
   TINCTURE.—Medicines dissolved  in alcohol or proof spirits.
 Alcohol  or rum  dissolves  a great variety of  substances, such as
 resin, camphor, essential  oils, extracts, barks,  roots, and  gums,
 and when so dissolved,  they will keep  for  a long time.  The
 spirituous solvent is sometimes  impregnated with ammonia or
 ether to increase  its power.
   In general it is only necessary to  put substances into diluted
 alcohol or proof spirit, to let them stand a week, and to strain off
 the liquor.  The alcohol or proof spirit dissolves only a certain
 amount of the substances before it becomes saturated, or can dis-
 solve no more.   If more of the substance is added, the tincture
 is no stronger.   If a tincture is to be a saturated solution, there
 is no need of weighing or  measuring the substance to be  dis-
 solved.
   It will be necessary, therefore,  to enumerate only a few of  the
 tinctures.
   TINCTURE  OF  ALOES.—See Elixir Proprietatis.
   TINCTURE  OF BLOOD ROOT.—Put two ounces of pow-
 dered blood root into  one pound of proof spirit,  let it stand a
 week, and strain the liquor.  The dose is from  thirty to sixty
 drops, twice a day.
   TINCTURE  OF  CAMPHOR.—Dissolve one or two ounces
 of gum camphor in a pint  of proof spirit.  Dose from half a tea-
 spoonful  to a tea-spoonful.   This  tincture is  also used as a wash
 to the surface in rheumatism, palsy, tumors, and inflammations.
   TINCTURE OF  CASTOR—Put  an ounce and a half  of
 Russian  castor in powder,  into  one pound  of  alcohol, let the
 solution  stand for a week, and strain the liquor.  The  dose is
 from one to two tea-spoonfuls.
   TINCTURE  OF CATECHU.—Put  three ounces of the  ex-
 tract of catechu, and two ounces of the  bark of cinnamon bruised,
 into two pounds and a half of diluted alcohol, digest for a week,
 and  strain  the  liquor.   The dose is two or three  tea-spoonfuls,
 frequently, in water or red wine.
   TINCTURE OF  COLUMBO—Put two ounces and a half of
powdered columbo root into two pounds and a half of proof spirit,
let it stand a week, and strain the liquor.  It is a most excellent
bitter.   The  dose is two  or three tea-spoonfuls.   A  child from
 one to three years old, may take half a tea-spoonful.
   TINCTURE OF  FOXGLOVE—Put one ounce of the dried
leaves of common foxglove  into eight  ounces of proof spirit, let 
TIN.
559
 the solution stand a week, and strain the liquor.  The dose is
 ten drops, gradually increased.
   TINCTURE  OF  GUAIACUM.—Put  one pound of  gum
 guaiacum into two pounds and a half of proof spirit, let it stand
 for a week, and strain the liquor.  The dose is from a tea-spoonful
 to a table-spoonful.  A child between one and three years old,
 may take  twenty to  thirty drops in water.  It is an efficacious
 remedy in chronic rheumatism, and dyspepsia.
   TINCTURE OF  LAVENDER,  COMPOUND—Red Laven-
 der.—Take of spirit of lavender, three pounds,  spirit of rosemary,
 one pound, bark of cinnamon bruised, one ounce, flower  buds of
 the  clove tree bruised, two drachms, nutmeg bruised,  half  an
 ounce,  wood of red  saunders  rasped,  three drachms.   Let the
 whole stand  for a week, and  strain the liquor.
   The dose  is from ten to a hundred drops, in sugar and water,
 or dropped upon sugar.
   TINCTURE OF  LOBELIA—Put two ounces of the dried
 plant into a pint of new rum,  or proof spirit, digest for  a week,
 and strain the liquor through linen.  Dose, a tea-spoonful, repeat-
 ed at intervals of half an hour.   A child, between one and three
 years old, may take  from twenty to forty drops, increased until
 vomiting is produced.
   TINCTURE OF MURIATE OF IRON—Tincture of  Iron-
 Take of carbonate or  red rust of iron, half a pound, muriatic acid,
 three pounds, alcohol, three  pounds and four ounces.   Pour the
 acid  on the carbonate of iron in a glass vessel; shake the mix-
 ture now  and then, during  three days.  Set it  by, until the feces
 have subsided, and then pour  off  the liquor;  evaporate  this  to
 sixteen ounces, and when  cold, add to it  the  alcohol.   This is
 one  of the most eligible forms of iron.   The dose is from ten  to
 twenty drops in water.
   TINCTURE OF OPIUM—Laudanum.—Put  two  ounces  of
 opium broken into pieces, into  two pounds of  new rum or proof
 spirit, let it stand  for a week, and  strain the liquor.  The  pro-
 portion of opium to the spirit, is five grains to a drachm  or tea-
 spoonful or every sixty drops.   The usual dose  is twenty-five
 drops, though more or less may be  given as the case requires.  A
 tea-spoonful is a large dose, and can be given only in extreme
 pain and distress.   The dose, for a child between  one and three
 years old, is  from five to  eight drops.   A child six months old
 may take  four drops.  One  drop may be given to a child, a week
 old.
   TINCTURE OF QUININE.—Put  one drachm of  quinine
into  half a pint of new rum.   It dissolves immediately, and  is
ready for use.   The dose is a tea-spoonful.   This tincture  almost
entirely supersedes the use of the tincture of bark.
   TINCTURE OF RHUBARB—Sweet tincture of Rhubarb.— 
5G0
TOO.
  Take of rhubarb in coarse powder, two ounces, root of liquorice
  bruised, one ounce, anise seeds bruised*, one ounce, double refined
  sugar in  powder,  two ounces,  proof spirit,  two  pounds and  a
  half.  Let  them stand for a week and  strain the  liquor through
  linen.
    This is an excellent medicine in the bowel complaints of chil-
  dren as well as  of grown people.   The  dose for an adult is  a
  table-spoonful;  for a child, a tea-spoonful.
    TINCTURE OF  SQUILL.—Put four  ounces of  the squill
  dried and bruised,  into two pounds of proof spirit; let it stand
  for a week, and pour off the liquor.  The dose is from twenty to
  sixty drops. Vinegar is commonly used instead of proof spirit.
  The syrup  of squill is made from the vinegar.
    TINEA  CAPITIS—The Scald Head.   See Scald Head.
    TONIC.—Medicines which give strength  to the system, such
  as  quinine, bark, elixir vitriol, rust of iron, wine, and  bitters in
  general.
    TOOTHACHE—Odontalgia.—One of the  most ornamental
  features of  personal beauty is a good set of teeth;  and no pains
  should  be spared to  preserve them.  When a pain is felt  in a
  tooth, great care should be taken to ascertain whether  the tooth
  is defective or  rotten.  The  teeth will sometimes ache when
  they are sound, either  from an  inflammation of the nerve, or of
  the  membranous covering of  the jaw and  socket.  In this case,
  it is best to cure the pain without extracting  the tooth.  Such
  is the value of the teeth in the mastication of the food, and in ar-
  ticulation, that much pain should be  suffered and no reasonable
  expense spared to repair them.   The toothache is often stopped
  by filling the tooth with tin-foil or gold leaf.
    The  art.  of dentristry has  now become  so common, and the
•  price of repairing  the  teeth so moderate,  that it is within the
  means of rftost people, either  to have their teeth filled as soon as
  they manifest any  defect, or replaced with artificial ones where
  they are entirely decayed.  The filling with tin-foil answers the
  purpose in-  most cases, and the work may be  done very cheap.
  But some teeth are so decayed  that they cannot be filled or re-
  paired.   They must either be cured by other means or be drawn.
  Many teeth are drawn unnecessarily, or long before they need to
  be removed.
    The toothache proceeds from an inflammation of the teeth, or
  the  parts with which they are  connected.   This  inflammation
  can be often resolved or dispersed without  the extraction of the
  teeth.  The means are precisely those of reducing any other in-
  flammation. The  toothache  can sometimes be driven away by
  a dose of salts or aloes.  In other instances, it can be relieved by
  a profuse  sweat produced by hot herb teas,  such as pennyroyal,
  catnip,  or thoroughwort.   A sweat produced by eight  grains of 
TOO.
561
Dover's  powder, given every  four  hours,  will often cure  the
toothache.
   With  the exception of  extraction, the surest remedy for  the
toothache is a dose of laudanum or opium.  Half a tea-spoonful of
laudanum, or of morphine  of the same strength, will in  general
stop the  pain in any case.   A child  must take  less in proportion
to  its age.   Ten  drops will be enough for a child of seven or
eight years  of age ; and fifteen drops for one  from eight to twelve.
Twenty  drops  may be taken by a youth from twelve to sixteen
years old, in a  severe toothache.  In a severe toothache we have
been in  the habit, for many years, of giving opium in a pill of
two or three grains.   In extreme  cases we  have given a pill of
three grains, and in more moderate cases, one or two grains.  All
local remedies compared with this, are ineffectual and uncertain.
This remedy will sometimes  fail,  but we  believe  it to be  the
most certain which we possess.  In some cases the pill must be
repeated in  the course of three  or four hours.
   Various medicines are applied to the rotted cavity of the tooth,
the best  of  which are-laudanum, strong spirits of  camphor,  the
cajaput  oil, the powder of alum, the spirits  of  turpentine, ether,
red  pepper," a drop or two of the elixir vitriol,  the  oil of cloves,
and the smoke of grated nutmeg drawn through a pipe.
   The  creosote is a  late  remedy, and appears to  possess more
efficacy  than either of the others,  unless  it  be opium,  and is
probably more  effectual than even this applied, locally.
   Mustard and ginger poultices, the tincture of red pepper, and
blisters applied externally, are often found serviceable, and some-
times, effectual.  Leeches  are more efficacious than either.
   The toothache is often produced  by colds, and, in many cases,
appears  to be an epidemic arising from the state  of the atmos-
phere, but  it seems  to us  to  be oftener  produced by  sucking,
picking,  and irritating  the defective teeth.   If a decayed tooth is
let entirely  alone, neither used  in chewing the  food, nor sucked,
picked, nor irritated  in any other way, it  will seldom become
inflamed and sore.   This we  have observed, a thousand  times.
A slight pain produces some little  nervousness, which  disposes
everybody to feel of,  or to work  upon the tooth, which soon
brings on a high degree of soreness and inflammation.  A little
resolution and self-command in this respect,  will often save many
hours of severe torment.
   When other  means fail,  and  the pain, soreness, and inflamma-
tion continue or increase,  the  diseased tooth or teeth must  be
drawn.   For this purpose, the straight forceps are the best, as the
direction, in which the  tooth is drawn saves the socket from being
injured.  No one should undertake to extract a tooth, who can-
not work deliberately and carefully.  Timidity, hurry, and con-
fusion, almost invariably produce mischief.   The operator should
            71 
562
TRE.
take the same time to draw a tooth, that he would to do any other
mechanical piece of work, which requires the same accuracy or
nicety.
  To stop the hemorrhage or bleeding which sometimes follows
the extraction of a tooth, there is nothing better than eight or ten
drops of the tincture of catechu applied upon a dossil of lint.  If
the bleeding  is profuse, a  hard ball of lint must be pressed upon
the spot from which the blood  issues, and  the pressure kept up
as long as there is any disposition to bleed.
  To preserve the teeth from decay, there is nothing better than
the  Peruvian bark  used  as a  powder.  The teeth and  gums
should be rubbed with this substance every morning.  It hardens
both the gums and the teeth, and keeps them from all impurity.
All  gritty substances should  be avoided, lest the  enamel of the
teeth  be worn off.   The powdered charcoal makes  a very good
dentrifice.
  TRACHEA—The windpipe.—Its upper part is called  the
larynx; its lower part, which divides into two branches, is called
the bronchia.
  TREMBLING—Tremor.—This affection of the nerves and
muscles is somewhat different from the shaking palsy.   It affects
young people, and is only produced by particular causes, and at
particular times.  It is a peculiar weakness of the nervous sys-
tem induced  by severe sickness or disease; by intemperance in
eating, drinking and venery; by the use of opium ;  and, some-
times, an immoderate use of tea.
  This trembling of the muscles shows itself the most manifestly
under the passions of fear and anger; in the presence  of stran-
gers ;  and in situations where presence of mind is required.   We
knew one  individual who was  invariably seized with a fit of
trembling whenever a stranger entered his house.  The trembling
resembled that of an ague fit  in the commencement of an inter-
mittent fever, and would last him for fifteen minutes or half an
hour.   The health of this person was  otherwise  good, and his
mind  uncommonly sound.  He lived a retired life, and was ad-
vanced in age when he  died.  He was a laboring man and was
not reputed intemperate.
  In  this disease, recreation  is peculiarly necessary.   Diversion
of any kind which is not attended with dissipation, is beneficial.
Excessive labor, and indulgence in any of the animal pleasures,
must  be avoided.  A course of  the quinine, and of iron in some
form or other, would be likely to strengthen the nerves.  Some
acquaintance  with the world, and an occasional mixture with the
crowd would be attended with  no evil.  The chalybeate spring
waters, and the round of diversions which watering places afford,
promise as  fair a prospect of  recovery as any which we can re-
commend. 
TYP.
563
  TUBERCLE.—A  small, round swelling or tumor.  Scrofu-
lous swellings are an example of tubercles.
  TUMOR.—A preter-natural  eminence developed in any part
of the body.   Some  consist of flesh ;  others, of fat;  some of a
fluid, like honey contained m a bag or sac ; others, of a cheese-like
substance.   Fatty tumors or wens have been removed from the
body, weighing forty pounds.   An  instance of encysted  tumors
is recorded, and well authenticated,  which reached  from  the
socket of  the eye down to  the thigh.  It was  filled with a fluid
matter, and hung down in front of the body like a satchel or bag.
The neck of it was slender, but the  tumor  gradually enlarged as
it descended.
  TYMPANITES—Tympany.  See  Air Swellings.
  TYPHUS  FEVER—Typhus Gravior—The typhus fever in
our country is a very rare disease. The common slow fever of our
climate, often called the mild typhus,  in seasons when it is very
prevalent and mortal, is frequently mistaken for it.  Perhaps the
continued or  slow fever may sometimes resemble it and require
a similar treatment,  but we are satisfied that the true typhus
gravior fever is a very rare occurrence in NewEngland.   It has
probably not prevailed in New England, more than two or three
times in thirty years.   It has usually appeared in the coldest sea-
son of the year; in the dead of winter or late in the fall, though
not always.   It is generally known in this region under the name
of  the spotted fever.   This name has been given to it, on account
 of  the dark,  purple  spots  which, in malignant cases, cover the
 whole surface of the body, and particularly  the dark red or purple
 spots upon the cheeks.  It has oftener visited  the  country towns
 than the  cities.  In our jails and  hospitals, the ordinary seats of
 it in Europe, it has rarely, if ever occurred.
   The apprehension  of people, therefore, need  hardly ever be
 excited from  the danger of being affected with the typhus fever.
 When the typhus fever does occur, its  symptoms are generally
 distinct enough from  the symptoms  of other fevers, to determine
 its real nature.  At  the first onset,  of typhus fever, there is an
 amazing loss of strength, and  dejection of the spirits ; a great
 sense of weariness ;  heavy, deep pains in the head and back:
 dry, parched tongue ; beating  of the temporal  arteries; and  a
 universal  feeling of  cold.  The eyes are dull and  heavy;  the
 urine pale and the pulse  small, hard,  and  quick, sometimes une-
 qual, beating from i00 to 130 times in a  minute.  A deep load
 and a dull pain often affect the pit of the stomach.
    In the  progress of this  disease, the tongue, mouth, teeth, and
 even the lips, will be covered with  a  black, thick coat.  Mutter-
 in°-  moaning, and delirium will arise as the disease advances, and
 the'thirst and heat of the  skin increase, until  symptoms of putre-
 faction appear.  At this period the breath becomes offensive, and 
664
TYP.
bleeding will often take place spontaneously from the nose, mouth
and  gums;  the urine and stools will pass off involuntarily, and
dark, purple spots appear on the skin.  Finally the pulse sinks,
hiccups come on, and the patient soon dies.
  The typhus fever in this  climate generally runs from fourteen
to thirty days.   It is deemed  to be  contagious, and to originate
from the decomposition of vegetable and animal matter, or a pecu-
liar miasm or effluvia emanating from the earth.   The immediate
removal of people to a pure air, who are seized with this disease,
is of the utmost importance.   Ships, jails, hospitals, and barracks,
are  often the theatres of this disease.  The congregation of so
many different breaths, and the accumulation of so many different
secretions and excretions, can hardly fail  to generate contagions,
unless the greatest precaution  and care are  taken to have  a free
circulation of air, and to remove all  offensive matter.  This dis-
ease has  often been noticed  to  arise among  the poor  in low,
crowded, ill-ventilated houses- or huts, where a want of air, food
and cleanliness  conjoin  to  produce  the disease.   In  such cases,
the  first  thing  which their neighbors in  better circumstances
should do, is either to remove them  to an airy situation, to sup-
ply  the well ones with food and the sick with clean, comfortable
bedding.   Good fires which dry the air without overheating the
rooms, have been observed  to moderate and check the spread of
the  disease.  The  muriate  of  soda or lime, dissolved in a little
water and placed under the bed of the sick, has great power in
preventing  the spread of the disease and  neutralizing the conta-
gion.   Burned sugar or vinegar has  something of the same ten-
dency.  Where bodies have been dissected, inflammations of the
 brain, stomach,  and bowels almost always appear.
   From the oppression of the  brain and the  disorder of the senses
 in this disease,  many have  supposed it to be an affection of the
 nervous  system and have  styled  it a nervous  fever.  This may
 or may not be ;  we have chiefly to  do with its history and treat-
 ment.
   Domestic Remedies.—If the attack comes on with a hot, dry
 skin ; quick pulse and pain in the  head, after being placed  in a
 comfortable bed and airy room, the patient should be washed all
 over with  cold water either  by the use of a napkin or sponge,
 and the head kept constantly bathed.  If sickness at the stomach
 be  present, a  gentle emetic  of ipecac should  be given, and a
 plenty of  warm water administered  during  its  operation.   If
 there should be no great  disturbance of the  stomach, a dose of
 physic  should  be  given first.  This  may be  either two table-
 spoonfuls of  castor oil, two  tea-spoonfuls of calcined magnesia,
 five or six butternut pills,  two or three tea-cupfuls of thorough-
 wort tea given at an interval of fifteen  minutes each, or ten
 grains of calomel and as much jalap. The effusion of cold water 
ULC.
565
should be repeated every day, and where the heat and thirst are
great, twice or  three times a day.   After  the  fever has  been
established for several  days, the skin may be bathed in  tepid
water, as cold cannot be so well borne.
  The effervescing draughts are peculiarly applicable in this dis-
ease.   The half or a quarter of a soda powder in a wine-glass of
water, may be given every half hour if the thirst should demand
it.  The acetate of ammonia, made  by mixing a tea-spoonful of
lemon juice with  half  a  tea-spoonful of  carbonate of ammonia
may be taken  in  the same way.  Sweating medicines are not
commonly much used in this disease.
  The  drinks  should be  cold water, balm tea, lemonade, tama-
rind water, or a  sour  drink  made  of elixir vitriol and water,
fifteen drops to a tumbler  of water, and swallowed at intervals.
  Mustard poultices may be applied to the stomach or head when
either of these  organs  is  unduly affected.   The  nourishment
should consist of gruel, rice water, chicken broth, milk and water
and arrow-root.
  Professional Remedies.—Blood-letting is  deemed a doubtful
measure in the genuine typhus ; and antimonial medicines are in
no  greater repute.   Gentle cathartics  every other day, cold  ablu-
tion, the mineral acids, particularly the muriatic acid, effervescing
draughts, a moderate quantity of wine, camphor, especially, the
camphor julep, and  the quinine  are  the  principal means relied
upon.   Blisters are accounted doubtful remedies.  Where  there
is  great sleeplessness, an  opiate of  twenty-drops of laudanum
or of ten grains of the Dover's powder should be given at night.
  When an abatement of the feverish symptoms has taken place,
the quinine in one grain doses should be commenced and  given
every three or four hours.   If the quinine should not agree with
the stomach, the columbo may be given in  its  stead.
  There is no more favorable symptom in this disease than the
return of sleep.  An abatement of the heat and a gentle moisture
upon the skin are also favorable indications.   The flow of the
saliva, the cleaning of the tongue and mouth, and the moderation
of  the  pulse  generally precede the turn of  the  fever and entire
recovery from the disease.
                             U.

  ULCERS.—Ulcers  are  of  various kinds, and proceed  from
various causes.   Some ulcers secrete pure pus, and  others, a
watery or  sanguineous matter.   An  ulcer is  commonly under-
stood to be an open sore, not very well disposed to heal.  Some, 
566
ULC.
indeed, never  heal, such as the cancer and some  fistulous sores.
An ulcer situate in the bones, is very slow in healing.  Venereal
and scorbutic  ulcers are often inveterate.   Every wound  which
does not  heal by the first intention, or by simply  putting the lips
of the wound together, and without its maturating, is an ulcer.
   When  ulcers  on the surface of the  body are slow in healing,
they must be stimulated  by some substance  which will eat away
the callous or fungous flesh.  For this  purpose, calomel, red pre-
cipitate, burnt alum, borax, blue  vitriol, caustic  potash, and the
nitrate of silver are  used.  Some vegetable substances, such as
the powdered  leaves of savin, the bay berry and  the  blood-root,
have something of the same nature.  The powdered blood-root,
mixed with calomel, in equal parts, and used as a snuff,  is said
to have cured the  polypus in the nose.  Some  ulcers are healed
by the application  of astringents, such as  sugar of lead, white
vitriol, white oak bark, creosote and catechu.   In all ulcers, the
sides of the cavity should be brought as near together by sticking
plaster, as possible.
   There  is nothing better for ulcers in general, than to soak them
well with warm water.   This  dilutes the acrid matter and renders
it  bland.  It relaxes the tense  and hardened blood-vessels, and
resolves  that feverish  and inflamed state, which prevents their
proper action.   The matter which ulcers discharge is an unnatu-
ral secretion.  The injured or  disordered vessels perform  a new
office.
   A strong tea made of  the narrow dock  root both taken inter-
nally and used as a wash, is an excellent remedy for  old ulcers.
But a remedy on which great reliance may be placed, is the daily
use of the lunar caustic.  The hardened, horn-like  edges, and
the proud flesh  should be touched over every morning, and the
next morning washed off with a tea of narrow dock.   Many pre-
fer the caustic potash,  and where this is the case it should be
used daily like the lunar caustic.   It is very certain  that many
ulcers would never heal without the use of these  means.
   It is important  at the same time to renew the blood by the
use of nutritious  and unirritating food,  and sometimes wine,
quinine,  and  acids.  In  general, a vegetable diet is to be prefer-
ed, unless the person is obliged to labor, or  has been reduced in
consequence of a poor, meagre, and unwholesome diet.   There
is no better  diet,  perhaps, than pudding  and milk, or  rice and
milk.
   The secretion of a confirmed ulcer is poisonous to the contigu-
ous skin, flesh, and  tissues.   This poisonous ichor must, some-
times,  be neutralized by sprinkling on finely  powdered  chalk,
charcoal, and  magnesia, and  by daily soaking the part in warm
water.  If this is not done, the corrosive matter  or ichor will be
sure to spread the  ulcer to a greater extent. 
UTE.
567
  A drachm of the sugar of lead dissolved in half a pint of water,
gradually increased, has in  our hands,  proved the best of all
washes to  heal old, foul ulcers.  Solutions of blue  and white
vitriol are suitable in some cases.   To  correct the bad smell,
there is  nothing so  good as charcoal, although the chloride of
soda or lime will answer the  same intention.   See Sore Legs.
  ULNA—One of the bones of the fore-arm.   It extends from
the wrist to the elbow, where it locks into the humerus or upper
bone of the arm, and forms a kind of hinge or pulley.   Its mate
is the radius.
  UREA—A crystalline salt, obtained  from urine.   It  consists
of four sided  prisms, which  have a slight pearly lustre.   Of all
animal substances, urea  possesses the most nitrogen in its com-
position, and  the inference has been drawn that the secretion of
urine is designed to abstract the excess of nitrogen from the blood,
as the respiration separates  the excess of carbon.  Nearly one
half of  this salt is nitrogen.   Liebig thinks that  urea is formed
from the metamorphosed tissues of the body.
   URETERS—The  two ducts  or vessels which convey the
urine from the kidneys to the bladder.   They are about the size
of a goose-quill, and enter, one on each side of the bladder.  The
urine flows, drop by drop,  from the kidneys into the ureters.
   URETHRA—This is the passage which conducts the urine
from the bladder out of the body.
   URINE.—The urine is secreted by the  kidneys.   It is the
most plentiful  secretion in the body, and contains the greatest
variety of salts, the principal of which are urea, muriate of  soda,
common salt, phosphate of  ammonia, and muriate of ammonia.
It is pretty evident that  the substance of the bones passes off by
way of  the  urine.  Healthy urine  is perfectly transparent and
clear when passed, but on standing in a  vessel, deposits a reddish
colored  sediment.
   In the crisis of a fever this sediment is always in greater abun-
dance than in health, but is  of the same nature.
   The urine  is expelled by the contraction of the bladder.
   In summer when the  perspiration is abundant, the secretion  of
urine is smaller, but in winter when the transpiration by the skin
and lungs is  less, the amount of urine is greater.  In proportion
to their size  the kidneys secrete  more  than any other glands  in
 the body.  More blood goes to them than to any other organs of
 equal size, and more secreted fluid comes from them.
   UTICARIA—The Nettle Rash.   See Nettle Rash.
   UTERUS—The Womb.—This organ is situated in the pelvis,
 between the bladder and  rectum.  It is in the shape and  about
 the size of a common pear, a little  flattened. Its length is  about
 three inches, its breadth in the middle about two, and at the
 mouth about one  inch.   The largest part is called  the fundus, 
568
VAC.
the middle, the belly,  and the smallest,  the  cervix  or  neck.
The fundus is  the upper part.  The cavity  of the uterus is small
at the  entrance, and gradually enlarges  to  the  fundus, where it
expands into a triangular chamber, out of which proceed the Fal-
lopian tubes, two ducts  about three inches in length, which com-
municate with the ovaria.  The internal surface of  the womb is
corrugated at the entrance, but smooth in the fundus.  The womb
is abundantly  supplied  with blood vessels and nerves, and  its
walls always preserve the same  thickness both in pregnancy and
in the virgin state.
  The Fallopian  tubes terminate  in  a kind of fibrous  fringe,
called  the  fimbriae.   The womb is suspended by  strong  liga-
ments from the brim of the pelvis, but these often become relax-
ed in consequence of general debility and local irritation, when a
falling of the uterus takes place.
  UVA URSI—Cranberry, Wild.   See Cranberry,  Wild.
  UVULA—The palate.
                             V.

  VACCINATION.—This is a very simple operation.  If the
vaccine matter is taken immediately from a pustule, in a liquid
state, it may be inserted in the flesh with  a needle or a pin.  A
little place  may be scratched in the thick  part of the outside of
the arm between the shoulder and the elbow, and the fresh matter
rubbed in with the point of a pin or needle.   Another method is
to lift the skin with the point of a lancet,  dip the point into the
matter of the ripe pustule  and then insert it under the skin.  A
third method is to divide a scab into small  grains, and to insert
one of these under the skin with a needle or lancet.
  The most common method, at present, is to receive the matter
upon the points of pieces of quills, which have been  split  and
sharpened for  the purpose.   In  this way the matter may be in-
serted  either in a fresh or  a dry  state.   After  the  matter has
become dried  upon the quills, it requires  a  longer time for it to
be absorbed, and the point of the quill upon which the matter is
carried, must remain in the  puncture fifteen minutes or half an
hour.
  The matter  may always  be taken as soon  as the pustule is
formed, which is about the  sixth .day.  The matter is the best
between  the sixth and the eighth  day after vaccination.  After
the eighth  day, the matter begins  to lose its virtues until a scab
is formed, which appears to contain all the virtues of the freshest
matter.   The  scab commonly comes off  in about eighteen to 
VAR.
569
twenty days. The scab can be moistened with a little warm water
and made into a paste, received on quills or the point of a needle
or lancet, and inserted in the same way with the fluid matter.
The paste should be soft and finely mixed.   No covering or. dres-
sing is necessary in vaccinating.  A scab can be kept for a long
time by cutting  a hole in a piece of bees-wax, inserting the scab,
and  covering it  with  the piece which has been cut out.  In this
way the  scab is hermetically sealed.   If the matter is received
on quills, the quills should be inclosed in closely stopped phials.
The matter should be kept  in a temperature of about fifty-two.
Extreme heat or cold decomposes it.
  VAGINA—The passage to the uterus.
  VALERIAN—Valeriana  Officinalis.—This  plant grows wild
in England, and in the State of Ohio.  The root, the part used
in medicine, consists of numerous small fibres matted together,
and attached to one head.   It has a strong, not unpleasant odor, a
warm, bitter taste, and a brown color.  It is given in the form
of tea, tincture, and powder.
   It is an anodyne and antispasmodic.  The valerian tea in ner-
vous diseases, such as hypochondrism, wakefulness, falling fits,
hysterics, St. Vitus' dance,  delirium  tremens, palpitation  of the
heart, and hemicrania, is an efficacious and safe remedy.   The
common dose of the powdered roots is from a scruple to a drachm.
The same amount may be  taken  in the form of  tea or tincture.
An ounce of the root  may be steeped in three gills of water, and a
table-spoonful taken  every three hours through the day;  in bad
cases the dose may be doubled.
   VALVE.—A small membrane contained within the veins, lym-  „.
phatics, and other  vessels, to prevent the fluids from flowing back.
After  the blood or other fluid passes  the  valve,  if it returns,
the valve closes, as in a suction pump, and  keeps the fluid  from
returning.
   VARIOCELLA—The Chicken Pox.  See  Chicken Pox.
   VARICOSE  VEINS.—The superficial veins, especially those
of the legs are apt to be distended with blood, and to become, in
places, swelled  into  purple bunches.  The  veins will  present
here and there  little  bags of blood.   The valves lose their tone,
the  sides of the veins give way in certain  parts, and  the  blood
accumulating, dilates them to such  an extent that it sometimes
ruptures their coats.
  This disorder is occasioned by exhausting  labor performed upon
the  feet, by strains, and by pressure, which stop the  blood  from
ascending to the heart.  The affection happens to  people of weak,
soft, and relaxed muscles and blood vessels.  It is frequently seen
in women in child-bearing.   At such  times, the veins will present
a series  of knots  extending  from the  ankle  to the  groin, and
where the veins run very near the  surface, the knots will be of
            72 
570
VAR.
a purple color, looking very much  like what  are  called blood-
boils.  Indeed they are of the same nature, but much slower in
forming, and for this reason, they are not sore or painful.   They
produce a distress in the limb,  but no acute pain.
  In  pregnancy, the dilated veins are best unloaded by blood-
letting.  A pint of blood taken  from the arm will commonly
reduce thern to their  ordinary size.   The bleeding  should be
followed by two or three doses of salts or some other physic, and
the legs should be swathed with a wide  bandage, which will
prevent the sides of the veins from being  distended.  In  most
cases, the mere support of a bandage will obviate the whole dif-
ficulty.  Showering with cold water will  strengthen the veins
and prevent their swelling.   But, in whatever veins the distension
happens, moderate, steady, and continued pressure is the  safest
and  surest remedy.   Cooling astringent lotions,  such  as lead
water, alum water, and a solution of white vitriol will assist in
restoring the lost tone of the veins.   Where varicose veins occa-
sion much distress in the limbs, new rum,  brandy, laudanum, or
poppy tea may be applied.   Plantain and burdock  leaves are
extremely serviceable, if bound upon the skin and changed before
they become dry.
  VARIOLA—The Small Pox.   See Small Pox.
  VARIOLA VACCINA—The Cow Pox.  See Cow Pox.
  VARIOLOID.—The varioloid is the having the small pox, the
second  time  or  after having had the  cow pox  by vaccination.
Among the great  multitudes who are protected from the small
pox  by having had that disease, or by having had the cow pox
by vaccination, there are some who will take the disease a second
time, or after having had the vaccine disease.   But the disease is
varied in its nature and symptoms, and is hence called the  vario-
loid.   There is nothing very strange in this, although, in general,
the vaccine disease as well as the small pox is a protection  to the
system.
  Compared with  the  small pox taken in  the natural way, the
varioloid is a mild  disease.   The varioloid is shorter in its course,
the fever which accompanies it is much milder in its nature, the
pustules are fewer  in number, smaller, more pointed, and sooner
come to maturity and die away.   The pustules often come to
maturity in five or six  days, and the scabs  fall off in four or five
days more.
  In the most severe cases, the disease does not differ materially
from the true small pox of  the distinct kind, though we believe
that the varioloid rarely if ever assumes the character of the con-
fluent or malignant kind.  The fatality of the varioloid is one in
a hundred ; that of the true  small pox, one  in eight.
  The treatment of the varioloid consists  in the use of cooling,
depleting means.   The diet  should be light ; a moderate dose of 
YEN.
571
 salts, or a  rochelle powder should  be taken daily ; the room
 should be  cool, the drinks cool, and if the fever is high, blood
 must be drawn from the arm.   The  sweet spirits of nitre in tea-
 spoonful doses  should be given every two hours, or the sal nitre
 in six grain doses.  Barberry water,  lemonade, the cream of
 tartar water, or cold water, should  compose the drinks.  In case
 of much sickness and vomiting a gentle emetic may be employed.
    VEINS.—The veins are the vessels which circulate the purple
 blood.   They are more numerous than the arteries and run more
 upon the surface of the body.   The  veins return the blood from
 every part of the body, except the  lights.  The blood is sent out
 from the heart by the arteries, and  brought back by the veins.
 The two  great veins which enter  the right auricle of the heart,
 and return  the blood from the  upper  and lower part  of the body,
 are called the venas cavae.  Those which return the red blood
 from the lungs  are called the pulmonary veins.   The pulmonary
 veins  are  the only veins in the system, which  circulate red or
 vital blood.  In the veins, the blood runs much slower than in
 the arteries.  The  arteries have no valves ;  the veins are full of
 valves, which  assist in the upward course  of the blood.   The
 veins, when empty, collapse; the  arteries  remain  open.   The
 coats of the arteries are hard, stiff, and cartilaginous ; the coats
 of the  veins  are  limber, soft, and membranous.  The  arteries
 pulsate or beat; the veins are passive.
   The veins  secrete the  purple blood  from the arteries with  a
 force sufficient to propel it to  the  heart.  As the vessels of the
 breasts secrete  the  milk  and  propel  it from the nipples, so  the
 veins secrete the venous  blood and  urge it along to  the  heart.
 The veins stand in the same relation  to the arteries that  the
 ureters  do to the kidneys.   After death the veins are found  full
 of blood : the arteries are found empty.   The bleeding from veins
 is much more ^gsily stopped than from the arteries.
   VENEREAL  DISEASE—Syphilis.—This  disease  is  pro-
 duced by an animal poison.  It is  the general or secondary dis-
 ease which we mean to  treat of in  this place.   The chancre,
 bubo, and  clap have been described,  and the treatment suitable
 to each, advised, under their several  names. The venereal disease,
 lues, or pox, as it is variously called,  commonly  originates from
 one or  the  other of those  local diseases.  The venereal matter
 after the lapse of six or eight weeks,  if  the local disease be allowed
 to go on without cure, is  taken into  the system,  and produces a
 general disease.
   Vfhen the venereal matter has impregnated the whole consti-
tution, the  throat, mouth,  and skin  are the first parts to show the
signs of the affection.   The throat becomes red, and  inflamed,
but not much swelled; and deep, round ulcers are immediately
formed.  The voice becomes hoarse,  and the speech somewhat 
O I Ad
VEN.
difficult.   The ulceration gradually spreads to the palate, tonsils.
roof of the mouth, tongue, and the inside of the cheeks.   There
is an offensive fetid smell to the  breath, and a great flow of the
saliva.   The swallowing is difficult and painful.   In the progress
of the  ulceration, the palate  is often eat off, the  bones and car-
tilages of the nose consumed, and the bridge of the nose falls in,
and  is on a level with the face.   The inflammation and ulcera-
tion extend to the eyes, destroy the eyelashes and eyebrows, and
cause a painful and disgusting running of corrosive matter.  The
person  talks through  the nose; and  from the destruction of the
palate and the mischief done  the throat, articulation is very indis-
tinct.
  The skin is  covered with copper  colored spots about  the size
of a ten  cent piece.   These  blotches or spots become  covered
with a scurf which is continually pealing off and  a  new scurf
forming,  until,  finally, a thick  scab  appears.  When the scab is
thrown off, there is  left a fetid, running sore.   The ulcers  or
sores break out  over  the  whole  surface of  the body;  as fast  as
one heals another makes  its  appearance.  From  the suface,  the
disease sinks deeper,  and  affects  the bones,  cartilages, cords and
the periosteum  or  membranous covering of the bones.   Deep-
seated pains arise, especially  in the night time.  Hard swellings
spring up upon the  bones; the bones soften, ulcerate, and waste
away.  The scull  bones, in particular, are  apt  to  ulcerate and
exfoliate  in large pieces.  The shin bones and the  bones of the
arms are  covered with nodes or hard, painful swellings.   The
flesh wastes away ; the hair falls off;  the strength  and  appetite
fail; the sleep is disturbed and unrefreshing ;  and in the end, all
the symptoms of hectic fever appear.  In the worst  cases of the
disease, a universal  rottenness pervades the flesh, skin, and bones.
Next to the confluent small pox, it is the most filthy,  loathsome
disease in the whole  catalogue of human maladies.   One might
think this disease alone were enough to make the human family
virtuous.
  The venereal is  a disease incident to civilization ; it is not
known to heathen nations.  When, or where it originated, is not
known.   It was  first noticed about  the time of  the discovery of
America, or the year 1498.  It may have always  existed,  or it
may have been produced by  accidental circumstances.   The hu-
man body in different states of civilization,  evidently appears to
produce different kinds of contagion.
  Domestic Remedies.—Cleanliness, or frequent and thorough
washings with  rain or spring water  and soap, are  indispensable
conditions of a cure.  If the  skin is first affected, a general wash-
ing or bath should be resorted  to  every day.  After bathing,
about one-third of the body should be  rubbed over with  the cit-
rine ointment or a solution of the corrosive sublimate.   The day 
VEN.
573
 following another third should be served in the same way, and
 the rest of the surface on the third day.   The solution of corro-
 sive sublimate should contain one grain  to an  ounce of brandy
 or hot water.   The blue ointment is sometimes used for this pur-
 pose, but it is stronger, and but little of it can be used at a time.
 The diet should consist  entirely  of vegetables and milk, and the
 drink  should  consist of  nothing  but cold  water.   Spirituous
 liquors are  a violent  poison in the disease.  All venereal plea-
 sures must be entirely foregone; and the purest air should  be
 sought.
   If the throat is ulcerated, a solution of borax must be used as
 a gargle, and  a  portion of the  solution  swallowed  every  time
 the mouth  and throat are rinsed.  A  scruple, or about a tea-
 spoon  even full of the powdered borax,  should be dissolved in
 half a pint of  water, and a table-spoonful of  the  solution  swal-
 lowed four  times  a day.   We have seen this medicine cure the
 worst case of venereal sore throat.  The strength  of the solution
 should be gradually increased.   At the same time that the borax
 is used to rinse the throat, fifteen drops of the diluted aqua fortis
 should be mixed with half a tumbler of water, and drank, morning
 and evening.   The aqua fortis should be first made of the same
 strength with  the elixir vitriol or sour drop.   One ounce of the
 aqua fortis should be  mixed with eight ounces of water, and of
 this fifteen drops may be used.
   In addition to this, one grain of calomel should be taken every
 day until a coppery taste is perceived in the mouth,  and then it
 should  be omitted, four or five  days, when it should be taken
 again,  and continued in  this  way four  or  five  weeks.  Two
 grains  of the  blue pill may be taken instead of the calomel
 where  it is prefered.   An eighth  of a grain of the corrosive sub-
 limate dissolved in hot water or brandy, may be used where the
 others  fail.   A grain  of the corrosive sublimate  should be dis-
 solved  in four ounces of hot water, and half an ounce  of the solu-
 tion taken once a day.
  In some cases, it agrees much  better with the  constitution, to
 rub the mercury into  the surface  of the body.   For this purpose,
 a piece of the blue ointment of the size of a nutmeg, is rubbed
 into one or both of the groins every night, until  the same  cop-
 pery taste is perceived in the mouth.  After this peculiar taste is
 observed,  the ointment must be omitted for four or five days,
 and then resumed again ; and so continued for the space of four
 or five weks.
  There are  some cases of the disease which will not bear mer-
 cury at all.   It only  aggravates  the affection and weakens the
constitution.   In such cases, sarsaparilla or yellow dock tea, the
antimonial  powder, and  cooling  medicines must be used.  The
sarsaparilla tea may be used for a drink.  The antimonial powder 
574
VER.
may be  taken in four grain doses,  three  times a day.   The
acetate of ammonia in a state of effervescence, is  of much service
in such cases.  Lemonade, oranges, pine apples and all ripe fruit,
are beneficial.  All salt provisions are pernicious.
   There is no disease which  requires  the early and  careful at-
tention of the physician  more  than  this.  In addition  to mer-
curials, the nitric acid, sarsaparilla and antimonials,  it will be
found  necessary  often  to employ  the  iodine  and the iodide of
mercury; the nitro-muriatic "acid bath ;  to apply  lunar  caustic
and other escharotics to the ulcers of the throat and other parts;
fumigations of mercury ; cooling, astringent washes of the sugar
of lead and of the white vitriol; and soft bread  and water poul-
tices to the surface.
   VERATRINE—Veratria.—This substance  is an alkali, ob-
tained by  a chemical process from  the  colchicum autumnale,
meadow saffron.'  It  has  the same properties with  the meadow
saffron in a concentrated, and more active form.  It is a grayish,
white  substance, without smell, but  bitter, and  acrid, leaving a
stinging  and  finally numb  sensation in the tongue.  It is not
very soluble in water, but in  ether and alcohol, it dissolves readi-
ly.  It combines with several of the acids and forms salts, which
still retain the properties of the alcohol.
   It is a powerful poison.
   In small  doses, it is used in medicine.  The proper dose is
from a sixteenth to a twelfth of a grain, several times  a day.  It
may be given either  in pills,  or tincture.
   The veratrine  is  a  diuretic,  highly  extolled  in  the  cure of
dropsy.  In this country, however, it has been  mostly used in
the cure of rheumatism, acute and chronic.   In  cases  where the
meadow saffron would be  useful, the veratrine may be used, per-
haps, with equal or  greater  advantage.   Its use requires, much
caution.
"WERDIGRIS—Sub-Acetite of Copper.—Verdigris is produced
by the action of vinegar upon copper.  It is a greenish rust, cor-
rosive, and poisonous.  It is seldom employed internally,  but
often as an escharotic upon the surface.   Reduced to a fine pow-
der and mixed into a paste with the spirits of  turpentine, it will
destroy scirrhous tumors and cancers.  Applied to indolent ulcers,
it has a more stimulating effect than most other plasters.
   YERTEBRiE.—The bones which compose the spine or back-
bone.  They are twenty-four in  number.   Seven of the upper-
most are called cervical or neck bones ;  the twelve which follow,
are called  dorsal; and the  lowest, five  in  number,  are  called
lumbar vertebra,.  There is another set, which in the  adult sub-
ject  compose  one- bone, called false verlebrce.   This  set, com-
bined,  forms the os sacrum and coccyx, and makes a part of the
pelvis.   Through each of the vertebrae, there is a round hole of 
vo:,i.
575
the size of the fore-finger, designed to receive the spinal marrow
or great nerve which comes from the brain.  The hole in each
corresponds to the others, so that they all together make a strong
tube through which the great nerve passes from the brain to the
termination of the spinal column.  Each bone of the true verte-
bras is separated from  the other by a layer of cartilaginous  sub-
stance which  forms a soft bed on which the bone turns or plays,
and through which proceed a pair of nerves, one  on either side
to the abdominal viscera and the muscles.  Each pair is double,
consisting of  a nerve of sensation and a nerve of motion, in sep-
arate sheaths.
   VERTIGO—Swimming of the  head,  giddiness.  It is com-
monly a symptom of fever, fainting, epilepsy, hysterics, sickness
at the stomach, and other  affections. # In some  instances, how-
ever, it is owing to a  fulness of blood, or a rush of the blood to
the head.   In such cases bleeding is proper.   If it is owing to bile
in the stomach, an  emetic of ipecac or antimony will remove it.
Vertigo will  often  follow, an overloaded stomach; m this case
 vomiting  must be excited as soon as possible.  Abstinence from
 animal food,  and a  gentle dose  of physic, will assist in effecting
 a cure.   Some people are  troubled with it very often, in which
 case it appears to result from a nervous disease.   Sour drinks,
 such as  lemonade  and  elixir vitriol, together with rest, will  re-
 lieve it.   Hard study will produce it.
    VESICLE—A  little bladder or  blister filled with a watery

    ViOLINE—An alkaline  and bitter principle  obtained from
 the violet, supposed to be the  same with emetine, which  is ob-
 tained from  ipecac.  Emetine is  the active principle of ipecac
 without  its disagreeable smell and nauseous taste.   It is  an alka-
 line substance, consisting of reddish-brown, or white scales, and
 uniting with the acids  forms neutral salts.  It is  used instead of

    VISCERA —Those organs and parts of the body which  dis-
 charge  an appropriate office, like  the kidneys, bladder, bowels,
 liver, and uterus.                                          .
    VITRIOLATED TARTAR—Sulphate of Potash.—This is a
  salt which  results from  the combination of oil of vitriol  and
  potash.   It consists of hard, ragged, transparent crystals   It has
  a bitter  taste, and dissolves slowly in water.   In the dose of a
  scruple or half a drachm it operates as a laxative  ; in the dose of
  half an ounce, as #mild purgative.   It forms one  of the constitu-
  ents of Dover's powder.   It is no doubt an active diuretic.
    VOMITING.—The acl of  vomiting  is merely a symptom of
  some affection of  the  stomach.   It shows that  either the  nerves
  or coats of  the stomach are diseased or that there is some irrita-
  ting substance within the cavity of that organ. It is not improba- 
576
VOM.
ble that the gastric juice or some acid or other  secretion  may
irritate the organ and excite vomiting.  The most ordinary cause
of vomiting is bile, which has forced its way into the stomach
from some stoppage below, or from an excess of bile in the intes-
tines.  There are  many kinds of  food  taken into the stomach
which excite vomiting, even where  no excessive quantity has
been  taken.  Almost  any article which is entirely new, or to
which we are not accustomed, will produce more or less uneasi-
ness.   Headache  and many other affections  of the body, even
where there is no fever, will excite vomiting.   Sailing in a boat,
and riding in a carriage will produce  sickness  and  vomiting.
The affections of the  mind or of the brain  and nerves will occa-
sion vomiting.  Anything which  produces faintness, will cause
the stomach to throw.
   The stomach itself is often the seat of irritation  and inflamma-
tion, which is manifested by vomiting and retching.
   If bile  or  the headache is the  cause  of  vomiting, the  proper
remedy is an emetic.  A tea-spoon even  full, of ipecac, or of the
powdered leaves of  lobelia, is always a suitable dose for a grown
person.  If the stomach has  been overloaded with food, or op-
pressed with  any article which does  not agree with it, no  time
should be lost in giving an emetic.   In  some  cases the stomach
will be sufficiently evacuated by drinking large draughts of warm
water, or  camomile tea.  If the stomach is  neither  oppressed
nor- overloaded, the  vomiting may be  allayed  by a little calcined
magnesia, super carbonate of soda, or a  wine-glass full of spear-
mint, peppermint, ginger, or spice  tea.   Wormwood tea will, in
some  cases, succeed.   If the vomiting  is very obstinate, thirty
drops of morphine or of laudanum with  a dose of castor oil  may
be given.   If the vomiting is owing  to sourness of the stomach,
a piece of crude soda of the size of  a kidney bean dissolved in
water and swallowed, will stop it.
   A tea-spoonful or two of paragoric is almost sure  to stop  an
ordinary case of vomiting. The same effect will follow a draught
or two of poppy tea.
   If after the stomach has been thoroughly emptied, and sooth-
ing things taken, the vomiting  still continues,  we may suspect
some  disease of the stomach itself, which  will require the  use
of leeches, and a depleting treatment.   Such  a treatment  may
be found described in the articles on Cholera Morbus and Inflam-
mation of the Stomach.
   In almost all cases where the stomach is rftt overloaded with
food or distressed with some poisonous article, the  poppy tea will
be found a potent remedy.
   In  sea  sickness, the vomiting can be allayed  by pretty  full
doses of morphine and laudanum.   Forty drops may be given at
a time, in a little water, and repeated in  half an hour, if the first 
WAR.
577
dose does not succeed.   Vomiting in children may often be allay-
ed by wetting a piece of cloth with laudanum, and laying it upon
the pit of the stomach.  Lemonade, a soda powder, or  a little
hartshorn in water  will often  allay  sickness at  the stomach.
The creosote has of late been used with success in sea sickness.
  VOLATILE LINIMENT.—Take of sweet oil, two  ounces,
water of ammonia,  smelling drops, two  drachms ;  or in other
words, a wine-glass  full of sweet oil, and two tea-spoonfuls of
water of ammonia, and mix them  together in a phial.   Shake
the  phial and the  contents will combine  and form the liniment.
This is an excellent  application to the skin in cases of  rheuma-
tism, sore throat, and  other inflammatory complaints.  If thor-
oughly applied, it will  cause a  sweat ; and, perhaps, in  this, its
efficacy may consist; at least, it should be regarded as an evidence
that the application is properly made.  The liniment may be made
stronger or weaker as the  case may require.   Mixed with lauda-
num, in the proportion of  a tea-spoonful to  two  ounces of the
liniment, it seldom fails to relieve chronic pains in the joints and
muscles.
   VORACIOUS  APPETITE.—See  Inordinate Appetite.
                            W.

  WARTS  AND CORNS.—Warts are small unsightly excres-
cences of the scarf-skin, most frequently met with upon the hands.
Children, young persons and laboring men are more subject to warts
than old and infirm people, and those who do not labor.   They
are strictly local and indicate an active circulation in the skin.
They have a regular growth  and then die away of themselves.
Sometimes they are difficult to remove, though they often disap-
pear without any  sufficient known  cause.  Perfect  cleanliness
and rubbing them every night with  common hard soap and wash-
ing it off in_the morning with warm water, will  sometimes  re-
move them.  Touching them with blue vitriol, or lunar caustic,
every day or two, and  burning them by passing a heated needle
through  them,  are often practised with success, but perhaps the
best remedy is aqua fortis, nitric acid.  This requires to be applied
with caution, as by using it too freely or carelessly, unneccessary
sloughing and  inflammation may be the consequence.  As they
do not penetrate the true skin no scar is left  except it be from
the too powerful action of the caustic.
   Corns partake somewhat of the nature of warts, and it is the
common practice to treat them by the means which  have been
recommended  above.   But the best and safest  way of  curing
            73 
578
WAT.
them, is  to make a hole of the size of the corn in one or more
pieces of wash-leather spread  with diachylon plaster, which shall
admit the  corn, and to cover the top with  another  piece of a
larger size. . This keeps the corn free from all friction or rubbing,
and  allows it to heal.  Corns are cured by frequently bathing
and  soaking  them in warm water. It is however,  very difficult
to cure them without wearing a loose cloth or india rubber shoe,
or going barefooted.  The moisture which  collects in an india
rubber shoe  softens them, while  the  shoe itself allows them a
free playr. Those who  go  barefooted never or seldom have corns,
which shows that  they are produced by tight  shoes and boots.
If they become sore and inflamed, a dossil of lint wet with lauda-
num should be used.  This eases  the pain and  relieves the sore-
ness.   Merely covering  them with a lead or diachylon plaster
affords relief  and sometimes effects a cure.
   WATER.—Water is  composed of two distinct elementary airs
or gases.  Hydrogen, which is extremely light and inflammable ;
and  oxygen,  which is the  supporter of life  and combustion.
Eighty-five parts in a hundred, are oxygen;  and fifteen, hydro-
gen.  Water dashed upon a hard coal fire or a red  hot  iron will
separate into  these two elements.   The hydrogen gives an offen-
sive smell.   When the hydrogen is burned in the air, water is
reproduced.
   The principal kinds of fresh water are well water, spring water,
ice, snow, and rain  water, river water, and stagnant water.
   Well water is commonly impregnated with earthy and saline
substances.   The  cause of hard water is owing  to  the  chalk,
clay, or mineral with which  it is saturated.   It is supposed that
well water, in  general,  contains five  grains of  earthy salts to a
pint.   This  renders well  water less friendly to the system than
rain water.
   Spring water is rather more pure, in general, than well water,
but  it always  contains more or  less of the  same substances in
solution as well water.
   Ice, snow, and rain  water are   almost  entirely free  from any
kind of gas  or earthy  substance.  It is  soft, light, and readily
passes through the  body.  If it were possible, it would be exceed-
ingly desirable to drink nothing  but rain water.   Indeed, in all
acrid humors, cancerous  affections, and malignant ulcers, the
patient should drink only rain or  distilled water.
   River water, as it runs near the surface,  contains much less
earthy matter than well or spring water, and is much better when
pure, for drink.
   Stagnant water is always unhealthy ; besides earthy matter, it
holds in solution noxious  gases and decomposed vegetable matter.
Even the vapor of  a lake or a marsh is supposed to generate the 
WAT.
579
bilious and intermittent fevers.  Its use if possible should always
be avoided.
  The purest of all water is distilled rain water.  In this there is
neither gas, nor earthy matter.  It is,  however, seldom used ex-
cept for medical purposes.
  WATER  BRASH—Pyrosis.—This  disease is  synonymous
with  heart-burn.  The water brash  consists of a ropy, transpa-
rent, watery matter discharged from the stomach.  Usually there
is a burning sensation in the stomach which precedes and attends
the discharge, and appears to  give rise to  it.  There is not always
a sourness  in  the  stomach, although it  is  a frequent attendant.
The glairy discharge, which will sometimes pour from the mouth
in a stream, has, often, a sweetish taste.  A fit of the heart-burn
or cardialgia in many  people will always  end in the eructation of
this ropy fluid.  The  discharge  appears to be the natural mucus
of the stomach increased by a specific irritation, or sub-acute in-
flammation of the secreting membrane.
  The water-brash is  attended with  cold hands and feet, and is
supposed to be produced by exposing the  feet to cold, and by
violent emotions of the mind.  The  disease affects young per-
sons,  and is the source of much distress, although not dangerous.
People affected with this disease can seldom eat rye#nd indian meal
bread, indian puddings, baked beans, dried herrings, chipped beef,
or sausages, without causing a fit of the water-brash.   The disease
may be  owing, simply to a weakness of the stomach.   If the
watery discharge from the stomach consists of the gastric juice,
we  might  suppose from  the  quantity of it, that  the digestive
power and the appetite would be very great, which, in general,
is not the case.
  Domestic Remedies.—As bread is with most people a principal
article of food, it will  be necessary to  live  upon  such a kind as
will not ferment or turn sour  upon the stomach.  In general, the
unbolted wheat meal  bread is the least liable to ferment, and the
most  friendly to  the  action of  the bowels.  Flour bread  eaten
cold is much less  liable to ferment or to turn sour than  indian
meal  bread.   Hard bread, soda crackers,  and  sea  biscuit,  are
found to sit easy upon the   stomach in this complaint.   The
drink should be confined to cold water or milk and water.  Fresh
meats are preferable to salted food.
  To relieve  a fit of the  water-brash, a  tea-spoonful of the cal-
cined magnesia should be taken  in a little water.  More effectual
relief is always obtained by taking enough to move the bowels.
Ten or fifteen drops of the water of ammonia, in half a tumbler
of water, will quiet the distress and check the discharge.  A lye
made from clean wood ashes,  or a  little  pearlash  or saleratus
water, will have the same effect.  If the heart-burn and distress
are severe, thirty drops of laudanum or  of  morphine should.be 
580
WEN.
taken.   A draught of  strong poppy tea will answer the same
purpose.
  Five*grains of the oxide of bismuth  taken in  powder, every
morning, for several weeks in succession, will often cure the dis-
order effectually.  If costiveness attends the disorder, a couple of
aloetic pills should be taken with the oxide of bismuth.  Chalybe-
ate  spring water is often  found extremely serviceable.  Large
blisters drawn upon the  chest will sometimes afford essential
relief.
  WAX.—This substance is made by melting the honeycomb
of bees in hot water.  It is of  a yellow color, hard,  and tough.
It may be whitened  by melting it, running it into thin plates,
and  exposing  it to the sun,  frequently wetting it with water.
In a word, it is bleached precisely as farmers used to bleach cloth.
The white looks the most delicate, but for medical  purposes, it
is no better than the yellow.  Wax is chiefly used for salves,
plasters, and  ointments.
  WEN__Tumor.—A wen is a swelling  formed upon  the surface
of the  body.   It is neither sore  nor painful,  and is of a very slow
o-rowth.  Wens  are  contained  in a bag or sac, and consist  of a
fatty or a fluid substance  like honey.  Others consist of a sub-
stance which  resembles  the  curd of cheese.  Wens  most com-
monly appear "upon the  head,  neck,  shoulders  and back, but
are sometimes seen  upon the fleshy part of the  legs, and other
parts of the body.  They are usually of a round, oval shape, but
sometimes have a neck  and are shaped like a pear.   When they
grow upon the head, they are not covered with hair,  but present
a white, shining appearance.
  Wens,  sometimes,  grow to  an enormous size.   Sir Astley
Cooper says,  he once  saw a wen upon a man's thigh which
weighed,  after it was  removed, between  fourteen  and fifteen
pounds.   Mr. Copeland removed a wen which weighed  twenty
pounds.   The usual size of  a  wen is about that of a hen's egg.
The substance of  which wens  are composed is various.   Some
are full of blood vessels and others appear to contain none.  The
matter of some, resembles the substance of  the brain  ; of others,
the  substance of a cow's udder;  the matter of   some again
will resemble the pancreas, and of others, the fatty substance of
pork.
   The applications which have gained most repute for discussing
encysted tumors are such as contain sea salt, muriate of ammonia,
etc.   The only certain remedy however,, for these  tumors is to
have them extirpated by the knife.  In  cutting them out it is of
the utmost  importance, to dissect out all the sac in  which they
are contained, otherwise the wen will be apt to grow again.  They
are caused by some disease of the blood-vessels of the part where
they are situated.  We only  know it to be  some wrong action of 
WHI.                        531
the vessels of the part, but what the particular nature  of the
action is, we are unable to discern.
   WEEPING  SINEW.—This  is a tumor filled with a watery
matter, and situated in the white or tendinous part of the  mus-
cles.  They may be cured by pressure, washes of lead and white
vitriol, lunar caustic, and frictions with alcohol  and opodeldoc.
They are  seldom sore  or  painful.   They first  appear in hard
knots or bunches, and, sometimes, will appear in great numbers
upon the inside of the arm.
   WHITES—Fluor Albus, Leucorrhea.—This disease consists in
the discharge, from the womb or vagina, of a whitish fluid, which is
sometimes thin, and, at others, thick.   It varies between the con-
sistency of cream and milk.  The precise condition of the  inter-
nal surface  of the womb, which produces this unnatural discharge,
is  not well  known ; but there can scarcely be a doubt of its  being
the result of a  chronic, subacute inflammation ;  the internal sur-
face of the  organ  is in a sore, red state.  We  know  very well
what the situation  of the mucous membrane of the throat is in
chronic catarrh, and of the eyelids, in chronic opthalmia, and
have every reason to suppose that the  mucous membrane which
lines the womb is  in the  same state  in the disease before  us.
The  alteration in the natural  secretion  is nearly  the same in
each case.   There is an increase in quantity and a change in
quality.
   The older writers attribute the disease to a laxity of the secre-
tory vessels of  the  organ.  But the term laxity  has no intelligi-
ble meaning.   There is no such alteration of any of the functions
of the body from mere laxity that we  know of.   A mere laxity
implies a want  instead of an increase of action.
   The whites  is evidently a local disease, although when long
continued,  it deranges the tone of the whole system like  other
local, chronic disorders.
   It commonly makes its appearance just before or soon after  the
monthly sickness, and is chiefly incident to those who are subject
to an immoderate flow of the menses.   It varies  both in quantity
and quality; and the disease is subject to every  degree of sever-
ity.   In many  females, the discharge is constant, and  in others,
periodical.   It  never lasts long without producing a weakness of
the whole  system, and a disorder of the nervous  and digestive
systems.  Dyspeptic symptoms are  almost sure to follow to a
greater or less  extent when the disease is severe.   A paleness of
the  skin, a want of muscular  energy,  and  a general delicacy of
health are the sure  concomitants.  Like all great drains upon the
body and blood, this unnatural flow of vitiated mucus is sure to
undermine the general health.   The precise nature of the fluid
has never been analysed, but, is evidently in some instances very
acrid, and may be mistaken for  the gonorrhea.   The latter, how- 
582
WHI.
ever, is a more inflammatory disease, attended with more  heat,
scalding, and soreness.
  In the  commencement, the discharge in the whites, is  mild,
but becomes more acrid as the disease continues.  Dr. Cullen
supposes the discharge to proceed from the same  vessels which
secrete  the  menses;  this may or may not  be true,  but  from
whichever set of vessels',  the issue takes place, we think the con-
dition of these vessels must show a slight degree of inflammation.
  Remedies.,—In this disease, as  in the chronic catarrh, emetics
have been found  to  be  of as much  service  as any medicines
which  have  been  tried.   They are peculiarly friendly to the
diseased mucous membranes.   A gentle emetic of ipecac may be
employed every three days, until three or four have been taken.
After this treatment has  had its full effect, one grain  of opium
and one of ipecac in pill, may be taken twice a day for three or
four weeks in succession.   The diet should consist of vegetables,
but should be plentiful and nutritious.  Regular  hours of  sleep
should be observed, and as much  exercise taken about the house
and in  the open air, as will refresh the  system without exhaust-
ing the strength.   Warm bathing may be resorted to, but cold
bathing  is,- we  think,  a doubtful remedy.  The  feet should
always be kept dry and warm, and the  dress sufficient to prevent
chills and colds.   Some  constant but gentle employment of the
mental and muscular powers, will contribute to the cure.  Women
in the  country towns who  lead a more  active life, are less lia"ble
to the  complaint than those  in cities.   In women of  a delicate
make and inactive  life, the disease is more easily induced than in
those of a firmer texture.
4The precipitated carbonate  of iron and extract of cicuta in the
proportion of twenty grains of the iron to one of the cicuta, taken
twice a day, for a length  of time, will both strengthen the tone of
the system and allay  the irritability of  the uterus.  The poppy
tea drank two or  three  times a day, is a  good medicine.   Six
grains  of the Dover's powders, taken twice a day, is one of the
best of means to quiet and restore the proper action of the uterine
vessels.
  A strong tea of nut galls or of oak bark, used as an injection to
the internal surface of the organ, has often produced lasting good
effects.  Solutions of alum, sugar of lead,  and white vitriol, are
often  employed with  the same intention.   But the use of warm
spring  or  rain water in this way, is often preferable to either of
the foregoing, if employed often.
  Forty drops of the balsam  of copaiva, three times a day, will
often be advantageous.   Twenty  or thirty  drops of the spirits of
turpentine on sugar, will  have much the same effect.  The bal-
sam of life in tea-spoonful doses, is an excellent medicine in this
complaint. 
WHI.
583
  The bowels should be kept open by the use of  lenitive elec-
tuary, rochelle powders, extract of butternut, or aloes; and plas-
ters of pitch or galbanum worn upon  the small  of  the back.
The Griffith's mixture  is  an old and  an  excellent  medicine.
Rhubarb  is thought  by many to be a useful medicine.   The
consolidated  balsam  of copaiva  should  be  tried.  The sweet
spirits of nitre and Hoffman's anodyne liquor are often useful, in
the dose of a tea-spoonful.
  Where  there is much general weakness, the strength  must be
restored by the use of quinine, wine, the mineral acids, and cha-
lybeate medicines."  The  Congress spring water  has benefitted
many, and<jhould be resorted to wherever practicable.
  WHITE 13 WELLING—The  seat of  this disase  is for the
most  part in the knee joint, although it,  sometimes,  affects the
ankle, wrist, and elbow joints.   It is a hard, shining, glossy en-
largement of  the joints;  in  most instances, extremely painful,
but in some, there is scarcely any pain.   Such is the hardness of
the swelling, that no print is left when  pressed by the fingers.
However vehement the pain and  large  the swelling, the skin
remains white.  The joint in time becomes more or less stiff and
inflexible.  The flesh of  the limb above and below the  joint
wastes away, and this makes the enlargement of the joint appear
much greater  than it otherwise would.   In its  progress, the dis-
ease is exceedingly slow.   Suppuration at length ensues ; matter
is formed in the joint, and discharged by several openings.   One
ulcer continues  to form after another, until the strength, flesh,
appetite, and sleep of the patient  are exhausted.
  In some cases, several years will elapse before any ulceration
takes  place.  In other  cases, the disease will  subside in a few
months without either ulceration or stiffness of the joint.   But
where the disease continues for a long time, it is apt  to end in a
hectic fever, and carry off the sufferer.
   The disease appears to be sometimes the effect of rheumatism,
and, other times, of sprains and bruises.   It is supposed, in many
instances, to be  the result of a scrofulous temperament; but this
is the opinion of others, not our own.
   The pain in this disease can only be relieved by opium.   The
joint  should be bathed, several  times a day, with warm poppy
tea.  If the pulse is  good, leeches should be applied to the extent
of four or five dozen in the course of eight or ten days.   The
effect of steam should be tried upon it.   Soft rye  meal, flax-seed,
or white bread poultices, wet with laudanum, should be employed
between the times of bleeding.   The volatile liniment, to which
laudanum has been added, in the proportion of one ounce of the
laudanum to eight  of the liniment, has been found  a potent
application.  Equal  parts of new rum and vinegar used hot, is
remarkably good as an  external application.   Blisters applied 
584
WHO.
above and below the diseased joint, have a tendency to remove
the swelling  and to ease the pain.  Solutions of sugar of lead
and of white vitriol, salt and brandy, and sal ammoniac, are among
the most valuable external applications.
   Where the disease does not yield to local applications, general
medicines should be employed.   The warm sulphur bath, steam-
ing the whole body, and frequent bathing in warm water, will
be likely to  be of service.  In cold, enfeebled constitutions, the
hot drops, tincture of myrrh and red pepper, may be taken inter-
nally, and rubbed upon the diseased joint.  Sarsaparilla tea, in
combination with  an  eighth of a grain  of corrosive  sublimate
taken daily, is said to  have cured the disease.   Sw aim's panacea
has had a high,  and apparently well-deserved repute in the cure
of the disease.   We have great faith in soft,  warm  white bread
poultices.  In case these remedies fail, the antimonial  powder,
sal nitre, and cathartics must be  employed to operate upon the
system generally.  A dose of salts or of aloes taken frequently for
three  or four weeks in succession, may reduce  the swelling better
than  any other remedy.  The cold shower bath should be tried
upon  the limb.   If  the strength fails, quinine, Griffith's mixture,
and the mineral acids must be employed.
   WHITLOW.—See Felon.
   WHITE  VITRIOL—Sulphate of Zinc—This substance is a
composition of oil of vitriol and  the metal, called zinc.   It is a
mild,  but efficient, mineral asrtingent.   It consists of small white
crystals, very soluble  in water.   In the  dose of ten or twenty
grains, it is one of the  speediest emetics  which we  possess, and
in all  cases of emergency it may be administered.   Dissolved in
water it is a good remedy in croup.  In small doses it is a good
tonic  as well as  astringent,  and is given in hemorrhages from the
womb and the bowels.
   Its  principal use is as a cooling lotion to the skin and inflamed
surfaces.  Two  grains dissolved  in an ounce of water, makes a
good  eye-water, and a solution of the same strength  may be
used  in the cure of gonorrhea by way of injection.   The white
vitriol is one of the best articles in the materia medica.  It makes
a  good wash  for old ulcers, and a great variety of  cutaneous
affections.
   WHOOPING  COUGH—Pertussis.—In the commencement,
it  is very difficult to  distinguish the whooping cough  from an
influenza or common  cold.  It comes on very much in the same
way,  and the cough is not distinguishable from a common cough,
for several  days.   Sometimes it will be a fortnight before the
real whooping sound will be  heard.  After the whooping com-
mences, symptoms  of strangulation attend  almost every fit of
coughing.   The breath will often be lost for  so long a time, that
the face, lips, and  neck will  turn purple, and the  eyes will be 
WHO.
585
 swelled  almost out of the head.  The child is obliged to take
 hold of something in order to support  the  convulsion of cough-
 ing.  The fit of coughing is very often cut short by vomiting.  The
 rapidity of the coughing, hooping, and the vomiting, distinguish it
 from other coughs.  There is usually brought up by every fit of
 coughing a load of tough, glairy phlegm, Which, in young child-
 ren, is swallowed  into the stomach, and by those who are older,
 is expectorated.   The act of vomiting not only throws off the
 phlegm which  has been swallowed, but greatly relaxes the wind-
 pipe and lungs and promotes  the secretion of the mucus.  There
 is often  considerable  fever,  especially in  the night, when the
 disease is  coming  on.   The child will appear heavy, the face
 red, and the eyes filled  with tears, with sneezing, and running
 from the nose.
   In  ordinary  cases,  the disease will  run  about six weeks ;  it
 will be three weeks in getting to its height, and about as long in
 subsiding.   When the skin is moist and warm, the appetite good,
 and the  expectoration and vomiting free, the disease will  com-
 monly end favorably.  In some cases the disease will  be protract-
 ed to three or four months.   In infants, convulsions, suffocation,
 apoplexy, inflammations of the brain, and ruptures are to be feared,
 and in adults, consumption.   The coughing will be so rapid and
 violent as to force blood from  the nose, mouth and ears.  The
 looser  and the greater the quantity of phlegm, the milder the
 disease will be.
   The whooping cough is evidently an  inflammation of the wind-
 pipe.   This is proved by the quantity of phlegm which is secre-
 ted, an effect which could not be produced by spasm.   Mere
 spasm  would not  materially affect  the  function of  the  part,
 although it might  account for the convulsive efforts of coughing.
 Moreover, it is  not the nature of spasm to produce febrile symp-
 toms and to remain permanent for so long a time.
   The treatment  of the disease consists chiefly in  the use  of
 emetics, and expectorants or medicines  which loosen the phlegm.
 In some cases  where the pulse is full and  hard, the fever con-
 siderable, and the  cough violent and suffocating, leeches should
 be applied to the neck  and chest.  Blisters are often extremely
 useful  in moderating the inflammation  of the air passages.   The
 syrup of squills and castor oil in equal parts, given every day as
long as the  cough continues violent, is an excellent  remedy.
 The diet should  always be light,  and the child  be strictly
 guarded  against the extremes of heat and  cold, and all violent
 play or work.   Indeed the disease should be treated very much
as we would treat a severe case of influenza or violent  cold.  It
is  too  much the  custom to  let children run at large with this
complaint.   In some  cases  to be sure it may answer, but  as  a
o-eneral rule, some degree of confinement and dieting are necessary.
           74 
586
WIN.
The tincture of lobelia either as an emetic, or in smaller doses
as an expectorant, is probably as good a medicine as there is in
use in  this disease.   To  procure  sleep  and respite  from the
violence of coughing, we must sometimes make use of the Dover's
powder, paragoric, or morphine.  It is always best however, to
combine them with  some  expectorant, as antimony, squills, or
lac ammoniac.   The whooping cough is contagious, and usually
comes on in about two weeks after being exposed to it.
   WINDPIPE—The trachea.
   WINE.—Wine  taken in a suitable manner is a good remedy.
It is one of the best diffusible  stimulants which we possess.  It
quickens the vital energy when  sunk by disease, animates the
spark of life when  extinguished  by faintness, produces warmth,
raises the pulse,  and  cheers the spirits.  It gives strength in less
time than it can be produced by any other substance.  For this
reason it is often given in low fevers and diseases  of debility.  It
quickens the appetite and  improves the condition of the whole
system.   If it increases the fever it should be discontinued.  It
should be used only as a medicine.
   Drank to excess, it  inflames the liver,  disorders the nervous
system,  produces dropsy, apoplexy, delirium tremens, and a host
of other diseases.
   The intoxicating quality of liquors depends  upon the quantity
of alcohol,  or highly rectified spirit which  they contain.  Brandy
possesses fifty-four per cent, or a little more than one-half by  mea-
sure, of alcohol.  Rum, gin and whiskey, possess nearly the  same
proportion of the intoxicating principle.   The strongest Madeira
wine contains twenty-four parts in a hundred, or about one-fourth
part alcohol.  Port wine contains a little more than one-fourth of
alcohol; and sherry, nineteen  parts in a  hundred.  Claret and
champaign contain twelve  parts  in a hundred, or one-eighth of
alcohol.  The wines, on an average, contain about one-fifth part
alcohol, while the distilled liquors  contain more  than one-half.
In a glass of distilled spirits, there is commonly three, and  often
seven times the quantity of alcohol contained in a glass of wine.
Ale and cider contain from five to ten parts of alcohol.
   Distilled liquors were not known until about  the thirteenth
century;  the  ancients knew  no  stronger  liquor  than  wine.
But hear what Seneca says of  wine or a wine-bibber.  "It is an
ill thing, says this philosopher, for a man not to know the meas-
ure of his stomach ; nor to consider that men do many things in
their  drink, that they are ashamed of when sober ;  drunkenness
being nothing  else  than  a voluntary madness.   It  emboldens
men to  commit all sorts of mischiefs.  It  both irritates wicked-
ness and discovers it.   It not only makes men vicious but shows
them  to be so.   It makes him that is insolent, prouder; him that
is cruel, fiercer ; it takes away all  shame.  How many warlike 
WOR.
587
and strong cities that have stood invincible to attacks and sieges,
has drunkenness overcome !   Is it not a great honor to drink the
company, dead ?   A magnificent virtue to swallow  more wine
than  the  rest and yet  be outdone by a hogshead ?  What shall
we say of those men who invert  the offices of day and night, as
if our eyes were only given us to make use of in the dark ?   Is
it day ?   It is the drunkard's time to go to bed.  Is it night ?  It
is his time to rise.  Is it morning, he goes to supper—when other
people lie  down, he rises ;  and he  lies  until  the next night to
digest the debauch of the day before."
  The human pulse  in all ages of the world, has been consulted
as an index of  health or disease.  It is a kind of dial within us,
which gives  us both  the true measure of time and of  health.
The pulse of a person in health beats about seventy strokes in a
minute, and  the ordinary term of human  life is about  seventy
years.   In this seventy years, the pulse of a temperate person
beats 2,575,440,000 times.  If no actual disorganization should
happen, a drunken person might live  until his pulse beat this
number of times, but by the constant stimulus of ardent spirits,
the pulse becomes greatly  accelerated, and the 2,575,440,000
pulsations are performed in little more than half the ordinary term
of human life.   Life goes out in  forty or forty-five years instead
of seventy.  This application  of numbers to express the vital
forces, is given to show  that the acceleration of  those forces,
diminish the  term of human life.
  WOLF—Noli me tangere.  See Noli me tangere.
  WOLFSBANE—Aconite.  See Aconite.
  WOMB—The Uterus.  See  Uterus.
  WOOD  NAPTHA.—This substance is a colorless and some-
what fragrant  liquid.  It has a pungent disagreeable taste, and
the smell of  tar water.  It  has lately been introduced  for  the
cure of coughs and incipient  consumption.  The use of this article
has been attended with some success, and promises to be a useful
remedy.   From our own observation  we  think it worthy of a
more extensive  trial.  The dose is from ten  to twenty drops,
given three or four times a day in a little water.
  WORMS.—A thousand remedies are given for  worms when
there are none present in the intestines.  Not one case in  twenty
where worms are supposed to exist  by parents and friends, turns
out to be  true in fact.   Worms are, however, the source of dis-
ease, and, sometimes, the cause of  death.  Those which infest
the intestinal canal are of three kinds, the tape worm, the round
worm, and the pin or thread worm.  Besides these there is  a
long hair worm and a broad  tape worm which sometimes, though
very rarely, inhabit the bowels.
  The round worm  will  grow to a foot  in length.   The  tape
worm will grow to twenty  or  thirty feet  in length, is flat, half 
588
WOR.
an inch or an  inch wide, and  is full of joints.  It  infests  the
upper part of the bowels and  feeds on the  chyle.  It produces
great  emaciation of the flesh and an enormous appetite.  The
voracious  appetite is probably occasioned by the immediate con-
sumption of the chyle by the worm.  It has been supposed that
each joint of  the  tape worm will  live independently, but this
idea is erroneous.
  The pin worm is never  more than an inch in length, starts
quick, and infests the  lower end of the bowels, and, sometimes,
appears  upon the outside.   These worms  produce an intolerable
itching, and, in  children, are the occasion  of convulsions and
fever.  The pin or thread worm is very white, and never appears
to ascend  higher in the  bowels than the rectum and  colon.  It
feeds  on  the mucus of the bowels ;  and,  by destroying  this,
probably,  produces costiveness.   Indeed, all worms are fond of
still water, if we may use the expression, and appear to require
it in  order to breed.   Costiveness, stoppages, and indigestion
appear to be necessary to the formation of nests for the worms to
breed in.  A brisk, regular motion of the bowels, would no doubt
always prevent their generation and abode in the  bowels.
  The round worm traverses the whole length of the alimentary
tube, although  its  natural  abode appears to be in the  colon.  It
often ascends to the stomach, and sometimes,  will crawl up the
gullet, and come out of  the nose and mouth.  In the  worst case
of*worms which we ever had, not more than twenty came away
in the stools.
  The symptoms  of  worms are very obscure.   In  children,
troubled with worms, the appetite is changeable,  but  most com-
monly voracious.   They  crave  sour,  indigestible  substances,
such as unripe apples, currants, and cherries.  The belly is  hard
and swelled, and the bowels costive.  There is more or  less heat
and dryness of the skin.   The sleep is disturbed, and there is a
dryness and itching of the nose which causes children to rub and
pick it.   In their  sleep, they are apt to  start, and awake with
pain in the bowels.  They have a pale countenance, and the
eyes are sunken, and sometimes purple underneath.  The flesh be-
comes wasted and they are liable to convulsions. There is always
a great'irritation of the nervous  system.  There  will often be a
grinding of the teeth, foulness of the breath, and  sickness of the
stomach.   Worms will sometimes bring on  an oppression of the
brain, and occasion symptoms resembling those  of a dropsy of
the brain.
  The round worm and the pin worm mostly infest children be-
tween the time of weaning and that of puberty.   The tape worm
is more common to adults.  The symptoms which manifest the
existence  of the tape worm, are very nearly those which attend
the presence of the round worm.  We once had a case of tape 
WOU.                        589
worm of a foot and a half in length, which caused an indomitable
vomiting for the space of three weeks.   The woman  felt  the
motion of the worm in her stomach, but  it was not discharged
until she took several doses of the columbo root tea, which  de-
stroyed  the worm, when it was thrown up in the act of vomiting.
  Domestic Remedies.—All bitter substances  are poisonous to
worms.   Worm-seed  is a  good  medicine  for small  children.
Mixed with molasses, it may be given in the dose of a tea-spoon-
ful, twice a day.  The dose for an adult is a tea-spoonful and a
half of  the seed.  Wormwood tea, as the name imports is a de-
stroyer  of worms.   Thoroughwort tea or any strong physic will
dislodge worms.
  The medicine which we have often used for round worms, and
which we consider one of the best, is five grains of calomel and
five of rheubarb mixed with molasses and given at a dose. This
is a suitable dose for a child from one to four years of age.  To
older children  the  dose may be doubled.  Pink and senna is a
very sure remedy.   An ounce of each should be steeped  in water,
and a quarter of the liquor given at a time, once a day for  four
dayain succession.
   For the  tape worm, and also the  round worm, the  most pow-
erful medicine is the spirits of turpentine.   A half table-spoonful
mixed with milk may be given to  a child between two and seven
years of age, for a number of days  in succession.  Adults may
take two table-spoonfuls at a  time.  Mixed with  an equal  por-
tion of castor oil, the turpentine  is  thought by many to operate
more effectually.  The cowitch, both for the tape and the round
worm,  is often employed.
   The  pin worm  may be destroyed  by a dose  or two of the
elixir pro, or a pill or two of aloes.  An injection of aloes dis-
solved in warm water will dislodge  them.  Aloes is a sovereign
remedy for this kind of worm.
   WORMWOOD.—This is an excellent domestic bitter.  In a
dose of half a drachm  or a drachm of the powdered tops, it will
destroy worms.  Children may take for the same purpose, from
ten grains  to half a drachm.
   In dyspepsia, hypochondrism,  and  stomach complaints, a tea
made of wormwood, and drank  just  before each meal, will  do
more good than almost any other  remedy.  It strengthens the
tone of the stomach, improves the appetite, and frees the kidneys.
   WOUNDS.__Wounds  are divided into several different kinds,
 which  take their names from the manner in which they are pro-
 duced,  and the particular part injured.  Those which derive  their
 names  from the manner in which they are produced, are incised
 or cut, lacerated  or  torn, contused or bruised,  punctured, gun
 shot, and  poisoned wounds, and  some of the  principal of those
 named from the parts injured, are wounds of the  arteries, of the 
590
wou.
head, throat, thorax,  abdomen,  joints, and  tendons.    Each of
these kinds of wounds requires some peculiarity of treatment,
which it is our intention to briefly point out in the following arti-
cles, taking the standard authorities  for our guide in those cases
with which we are not familiar.
  The simplest and most common wounds are  those made with
cutting or  edged  tools, such as the knife or chissel, and scythe.
In these wounds, the  principal  injury done  to the  parts is the
mere division of the fibres of the flesh, without any contusion or
laceration.   They are not liable to inflame,  suppurate, ulcerate
or slough, under favorable circumstances, and if properly treated,
generally unite very readily.   The first thing to t>e attended to
in this, as  well as most other  kinds of wounds, is the bleeding.
Should there be considerable  bleeding, it must be stopped before
any permanent dressings are  applied.  Bleeding  from  veins and
small arteries may generally be arrested, by a little pressure upon
the wound with  sponge  or soft  cloth ; but if a large  artery be
divided, it  will require firm  pressure upon  the wound  or on the
main trunk of the artery above it.   When  an artery runs over a
bone, there will be but little  difficulty in  stopping  the bleeding
by compression, but if the parts  underneath it are soft,  it will be
done with  more difficulty.  Large arteries will require to be tied,
or dangerous bleeding may be the ponsequence.  Small pointed
forceps, or  a tenaculum is commonly used  in taking up the end
of an artery to tie it, but a  needle  annealed in  the blaze of a
lamp and the point bent into a hook, will be found a good sub-
stitute for  the  tenaculum.  By  wiping a wound  and  observing
the source  of the  blood, the end  of the artery can often be seen,
and seized, when  it may  be drawn out and tied with a small lig-
ature of silk.  The blood from an  artery is very florid  and  flows
in jets; from a vein, it flows more slowly and steadily, and is of
a darker or  purple color.   When  a ligature  is applied to  an artery,
one end  of it should be cut off near the knot, and the  other left
long enough to hang out of the wound at the most convenient
place, between the plasters, in order that it may be withdrawn after
the artery  has closed and sloughed.   The veins never require
tying,  as bleeding  from  them can be arrested by compression
upon the wound.   Wounds frequently, perhaps generally, occur
under  circumstances, and in situations, where it is impossible to
obtain assistance  and the conveniences for dressing them.   For
instance, it is not unusual for a man who is  chopping in the
woods or mowing in a meadow at a distance from  any habitation,
to cut  himself with an axe or scythe, and  perhaps sever a large
artery.  The blood flows rapidly, he soon faints, and  is unable
to regain his home or get to any place where assistance can be
rendered him, or should he be barely able to drag himself along,
the bleeding will be increased  by the exertion, and  when  he 
wou.
591
arrives,  his system is exhausted, and he  lies many weeks  or
months  before the wound heals and his blood-vessels are replen-
ished.   Under these circumstances, the wound should be seized
with one or both hands, the sides be brought  together, and firm
pressure made upon it, which will in a measure check the bleed-
ing.   A compress made of a folded handkerchief or a portion of
some garment, should be applied and bound on by tying a hand-
kerchief, a  strip of cloth or a cord  tight around  it.  If this should
not succeed, a part  of a handkerchief, a piece  of cotton or linen
cloth, or  other  soft  substance, such as  tow or lint, may  be
crowded into the wound, a compress applied over it and bound
on as before.  The puff ball, a kind of agaric, is often used for
this  purpose with  much  success,  by people in the  country.
The constant application of snow, ice or cold water, very much
aids other  means in stopping bleeding.  The  loss of blood may
sometimes  be prevented  by thrusting the finger or thumb into
the wound  and pressing  it upon the part from which the blood
seems to flow, and  by pinching between the  thumb and finger
the mouths of the vessels.   The blood from an artery will always
come from the side  of the wound which is  towards the heart, as
it flows  from this organ in the arteries and towards it in the veins.
When the  wound is on the arm or leg, the  surest and sometimes
the only means of stopping the bleeding from an artery,  is by a
ligature around the limb above the wound, which must be drawn
tight enough to stop entirely the circulation, so that no pulsation
can be felt in the arteries  below.  A moderately tight  ligature
around a limb will increase'the  bleeding from the veins, and will
not lessen it from the arteries, as is daily witnessed in the opera-
tion of bleeding.  A silk handkerchief, a strip  of strong cloth, or
a cord may be used for this  purpose, and it should be so applied
that a stick can be passed under it, by which  a twist may  be
taken powerful enough to stop the circulation of the blood in the
limb.   The best  place to apply a ligature on  the arm or leg, is
near the body, and  a compress of folded cloth over the principal
artery, which is on the inside of the limb, will insure the success
of the operation.   As by entirely stopping the flow of the blood
in a part  for any considerable length of time, would produce
swelling and serious consequences, other measures should be im-
mediately taken to  secure the arteries permanently.  It  should
be observed that the  introduction  of any foreign body into  a
wound to stop bleeding, is only to be resorted to in extreme cases,
in which nothing better can be done, as by preventing the wound
from being accurately closed, the healing process will be retarded.
When such means are necessarily used, it  should only be  for a
short time, until more suitable remedies can be employed.   The
bleeding being staunched and proper assistance  and suitable dress-
ings obtained,  all foreign  substances should  be removed, the 
592
WOU.
wound cleansed and closed, and there will still be a chance for
union by the first intention  to  take place.  The object to be
attained in dressing a wound, is to favor its healing immediately,
and without  the formation of matter.  When a wound  heals in
this manner, it is said to heal by the first intention.   As it is evi-
dent that a wound cannot heal by the first intention unless its
sides are  in contact, the  propriety of accurately closing it, and
retaining the parts as nearly as possible in their natural situation,
by plasters and stitches, must be manifest  to every one.   When
the edges of a cut wound are retained in close contact with each
other, it 'is not unusual  for it  to  unite in a few  days; but if
allowed to remain unclosed  and filled with lint, and salves,  or
spirits, as many weeks will be  required for it to fill up and close
by the tedious process of granulation.  The best way to hold the
sides of wounds together,  is by strips of sticking plaster.   Before
the plasters are applied, the wound and skin around it should be
wiped dry, in order that  the plasters may adhere firmly.  The
plasters  should be  cut into long, narrow  strips, which should be
warmed  as they are applied.   In applying the strips,  one end
should be attached at a little distance from the wound on one
side, the wound being held together, the plaster should be carried
over it in such a manner as to hold the edges in accurate and close
contact.   If the wound  be long, several strips  should  be used,
and a very narrow space left between them, for the  escape of the
blood that may ooze from the wound, or the matter, should any
form before they  are removed.   A  pledget of lint or soft cloth
should be applied  over the plaster,  and  the whole  secured by a
bandage, which ought not to be so tight as to impede the circu-
lation, except it may be  necessary to keep  up some degree of
compression for a short time  to guard  against a return of the
bleeding.   If the wound  does  not bleed  much, nor inflame and
swell, the dressing will not require to be removed before the sixth
or seventh day.   Care should  always be taken that the wound
be not closed over a large clot of blood, as  this will prevent it
from healing inside, and if it unite  externally, it will require to
be reopened and the cure will  be rendered tedious.   Where the
dressings are removed, great care must be  taken that the wound
be not drawn asunder, should  the adhesion be imperfect, for an
accident of this kind would at least make the healing  process
doubly tedious, if it did not excite inflammation. To avoid this the
plasters  should be peeled off in a direction lengthwise to the
wound.   One strip only at a time should be removed, and if the
union be not perfect, the wound may be wiped clean and a fresh
one applied before  another is disturbed.  When a  wound heals
kindly by the first intention one or  two dressings are all  that are
necessary,  but if  it suppurate,  it will rquire to be dressed daily
and to be cleansed each time with castile soap suds  or spirits and 
wou.
593
water.  If it be disposed to gape and is not much inflamed, the
adhesive plasters may be continued, by which it may be gradual-
ly drawn together,  and the discharge of matter will thereby be
lessened and the scar diminished.   Should there be much  inflam-
mation and swelling, the plasters must be taken off and the wound
poulticed until the inflamation is subdued, after which it may be
dressed with the simple  cerate or other mild  salve  upon lint or
old muslin,  until the cure is completed.
   Some incised wounds are so large, or the sides are drawn so far
apart by the contraction of the flesh, that they cannot be brought
together and retained in proximity without the use pf stitches,
called by  surgeons sutures.  When it is necessary to  close a
wound by sutures,  the thread or ligature should be small and no
more stitches taken than  are absolutely  necessary  to fulfil the
indication, and  they should be removed in six or seven days, or
as soon as it can be done without endangering a reopening of the
wound.   When suppuration takes place,  the stitches  should be
removed, as they can no  longer answer any useful purpose, and
will add to the irritation and increase the difficulty of curing the
wound.   If a wound be angular, a stitch  should be taken in the
angle and the plasters so applied  as to aid it in holding the parts
in a  natural situation;  or, if the  suture appear to be sufficient
without the  plasters, they may be omitted,  and the sore dressed
with simple cerate and light dressings.  In most wounds, how-
ever the sticking  plasters will  be the most suitable  dressings,
even when the sutures are  employed. We have the best authority
for the opinion  that sutures, if not too large or too numerous, do
not prevent a wound from healing readily and kindly.
   Wounds  on the  face should be  dressed with  great  care, in
order to prevent an unseemly scar.
   The sooner a wound is  dressed, the greater will be the chance
of its healing by the first  intention, or without suppurating.
   " Parts which are nearly separated, readily unite, as the  finger
or nose where it has been cut or torn, and a suture is required to
aid its union.  Parts entirely separated  will  sometimes  unite.
When adhesion of  an incised wound can  be completely  affected,
the danger ceases.   An incised wound into the abdomen, expos-
ing its different vicera, is not followed by danger if the wound  is
made to unite.  Wounds of the chest, even  complicated with
iniury to the lungs, cease to be  dangerous under the adhesive
process.  Wounds  of  the  brain will  unite by adhesion,  and the
patient recover."
   The above facts, quoted from the highest  English authority,
 show the  propriety and enforce  the necessity, of always endea-
voring to  effect, if possible, the  union of all incised wounds by
 the first intention.                                 .
   Lacerated or torn Wounds differ from cut wounds in the greater
            75 
594
WOU.
amount of injury done to the parts by the  violence which  has
produced them.   The flesh is generally more or less contused or
bruised, and its vitality,  and consequently its aptness to heal
diminished.   These  wounds are  often produced  by machinery
and such implements and substances  as tear the  fibres asunder,
and  great force is therefore required  to produce them.  Torn
wounds of  whatever  magnitude, seldom  bleed  much.   Even
large arteries may be torn asunder without occasioning any dan-
gerous loss  of  blood.  We  have, in several instances,  seen an
arm torn in pieces, and one completely  torn off above the elbow,
with less bleeding than sometimes attends a cut finger.  In dress-
ing these wounds, however, should there be bleeding, the  first
thing to be  done will be  to arrest it, by compression, a ligature
above  the wound if it be upon  a limb, by tying the artery or
other means, as pointed out under incised wounds.   It frequently
happens that extraneous bodies,  such  as pieces of stone, wood,
glass  or iron, are imbeded in a wound of this  kind.  These
should  be  carefully  removed, if practicable, and the  wound
cleansed and bathed with laudanum or spirits, before the dress-
ings are applied.  Lacerated wounds seldom entirely heal without
maturating,  or  by the first intention, and are much more liable
to inflame than those produced by cutting instruments ;  but this
should not  deter us from  attempting to produce  a union of as
large a portion of them as is possible,  by approximating and re-
taining the  torn edges by plasters  and bandages.  Sutures are
seldom necessary, except perhaps  upon  the face.   We  have often
used them upon the face, and particularly over the eye, when a
flap of the wound was hanging  down arid  difficult to keep in
place, with great advantage, the  wound healing kindly and leav-
ing only a small scar.  It is not necessary or practicable, in apply-
ing  sticking plasters to lacerated wounds, to retain the edges in
such  accurate  and  close  contact as in cut  wounds,  and wider
spaces should be left between the strips, though  the more  per-
fectly this can be done at the first dressing, without violence or
impeding the  circulation, the sooner will union take place, and
the less will be the  deformity.   If one-half or one-third of the
wound adhere by the first intention,  it will shorten the time
required to heal it, and lessen the amount of purulent discharge,
a consideration of some importance in large wounds.   The dress-
ings should be light and  the bandages easy.  Tight bandages
impede the  circulation, prevent the restoration of  healthy action,
and thereby increase the danger  of sloughing.  If the wound be
painful, the dressings  may be kept saturated with laudanum, a
solution of opium, spirits of camphor or rum ; and if it swell and
the  dressings become uncomfortable,  they  must be  removed,
being careful not to  tear apart the wound and break up the adhe-
sions that may have  formed.  This kind of wounds often requires 
WOU.
595
after a few days, to be poulticed, in order to favor the suppurative
process and subdue the  inflammation.   Even  in the beginning
when it is not deemed necessary or proper to attempt a union by
the first intention, such wounds will do well under the use of soft
bread and milk poultices.  The poultices should  be changed often,
and if the sore discharge matter, it should be frequently cleansed
with warm suds and spirits.   After the inflammation has subsided,
some kind of salve may be applied, or adhesive plasters be used,
and  the wound  gradually  closed  by drawing the edges  near
together.   During the healing process, in those wounds in which
it is desirable to avoid deformity, the sticking plasters are partic-
ularly useful.  They should be so applied,  as to constanly draw
the  flesh  together into its  natural situation.   Torn wounds are
often  painful, and when large a severe shock is given to the
nervous system, and locked-jaw may be a consequence.  With
 the view  of allaying irritation, easing the pain, and preventing any
 serious effects upon the nervous system, a full  dose of laudanum
 or other  anodyne should be taken immediately on the receipt of
 the injury, and  repeated as often as circumstances may require.
 Should there be appearances of gangrene, and a disposition to
 slough, the case must be treated with wild indigo, yeast or char-
 coal  poultices, a wash of chloride of soda, tonics, and a nutritious
 diet, as recommended in the article on mortification.
    Contused.or  Bruised Wounds are produced  by blows and falls,
 which may not break  the skin, but which severely injure  the
 parts underneath.  Contused and lacerated wounds are often com-
 plicated, but when the injury  done to  the  flesh is considerable
 and  to the skin but little, no regard need be paid to the latter, and
 the case  should be treated  as a simple contused wound.   Bruised
 wounds  rarely  bleed externally, but the blood often escapes from
 the  injured vessels  into the cellular substance and among the
 muscles, causing swelling  and  showing  through  the skin, which
 is the cause of  the dark or " black and blue" color observed in
 these injuries.   In very serious contusions the  nerves are so dead-
  ened, that the sensibility of the part is destroyed and the pain is
  less than it is in those that are less severe.  When the bruise is
  not  very severe, the blood which is effused into the flesh will be
  gradually absorbed, the  color change to a brownish or yellowish,
  and finally disappear, the  swelling subside, and a perfect restora-
  tion take place in the course of a week or two; but if  the parts
  have been injured  beyond a  certain degree, the vitality being
  much lessened  or destroyed, suppuration and  sloughing  will
  follow, and  the breach of continuity be afterwards  repaired by
  granulation and cicatrization.
   ' The best applications to recent bruises are cold water, spirits
  and  water, laudanum, ether, solution of sal  ammoniac, salt and
  vinegar or brandy, and  other cold and stimulating washes. These 
596
WOU.
stimulate the action of the vessels, hasten reaction  and promote
absorption of the effused blood.  When reaction comes on, if the
wound is large and there is a tendency to inflammation, leeching
and cathartic medicines will  be the most suitable remedies.  In
those cases in which there is more or  less laceration or breach of
continuity, and where  suppuration and  sloughing are to be ex-
pected, fomentations and poultices must be used to expedite these
processes.  After  the  suppurating or  sloughing  process is  com-
pleted, the fomentations and poultices must be discontinued, and
the sore treated as a simpla ulcer.  The general treatment will
consist in giving opium to allay irritation, cathartics to keep the
bowels  free, and tonics to  support the strength and  favor the
digestive and sloughing processes.  During the  healing process,
the sides of the sore should be approximated by adhesive plasters,
as in lacerated wounds.
   Punctured Wounds  are those that are  made by narrow, sharp
pointed bodies, such as the sword, bayonet, scissors, hooks, points
of broken bones, stubs, pitchforks, awls  and various other  sub-
stances and  implements.   They penetrate deep in proportion to
the extent of the external opening, and  are infinitely more dan-
gerous than incised wounds.   The fibres of the flesh are forced
asunder, instead of being divided as by edged tools.   Inflamma-
tion of the absorbent vessels, extending to parts remote from the
puncture, as from the hand to the arm-pit, or from the foot to the
groin, is not an unfrequent  consequence.   Abscesses sometimes
form in the track of the absorbents, and even in  the  glands in
which these vessels terminate.  The pain produced by punctures
is sometimes intolerable, and serious nervous affections, and even
locked-jaw may supervene.
   In  the treatment of these wounds,  the most important thing
to be done is to relieve the pain and quiet the  nerves, by the use
of  anodynes,  both externally and internally employed.   The
wound should be bathed with laudanum  or  a  solution  of opium,
and enough given internally to assuage the pain and compose the
nervous system.  If laudanum cannot be obtained, rum or  some
other spirits may be used as a  substitute.  In the mean time, if
any foreign  body have been left in  the  wound, such  as a  stub
or a  portion of  the  instrument with  which the wound  was
made, for instance, it should be removed immediately, if it can
be done without a greater risk than would  result from allowing
it to remain.
   It is  recommended  by  some to convert  a  punctured into an
incised  wound, by enlarging the orifice  with a lancet or  other
sharp instrument; and others  advise the  application of powerful
caustics in addition to dilating the orifice.  The nitrate of silver,
nitric acid, and caustic potash, are used for this purpose.  Stimu-
lating and anodyne lotions to facilitate reaction, leeches and cold 
WOU.
597
lotions  to  prevent or subdue inflammation,  fomentations  and
poultices to promote maturation and granulation, are the remedies
usually advised, according to the stage of the case.   We are of
the  opinion,  however, that  a  large  proportion  of  punctured
wounds may be successfully treated, by the internal use of ano-
dynes and  the immediate  and constant application of warm poul-
tices, saturated with laudanum or solution of opium.   Fomenta-
tions with  poppy  heads, hops, apple peru, hemlock or henbane,
may have  an effect equally as good as  the poultices and opium.
Should abscesses form, they should be opened as soon as the ex-
istence  of matter can be ascertained.
   Gunshot Wounds  partake of the character both of lacerated
and contused wounds.  The vitality of the parts in  the vicinity
of the  injury is destroyed, and more  or less sloughing is  the
usual  consequence.    They seldom  bleed much, except very
large vessels are divided.   The hole made by the ball is rather
less than the size of  the ball, and its  edges are generally of a
livid color.   A numbness  or torpor of the limb, or of the whole
system, is a  common  effect, but the symptoms  differ materially
in different persons.   The difference in the velocity of the ball
produces a difference  in the symptoms.  The edges of the wound
where the ball enters, are turned inwards, but if it passes through,
the edges of the hole where it escapes are ragged and everted.
   In the treatment of gunshot wounds, there are three indications
to be fulfilled : first, to remove  all foreign or extraneous bodies ;
second, to  prevent excessive inflammation; and third, to  promote
suppuration.
   As the management of these  wounds is very similar to that of
lacerated and contused wounds, and is  conducted upon the same
general principles, it is deemed unnecessary to enter  into partic-
ulars.
   Poisoned  Wounds.—Upon the subject  of poisoned  wounds we
refer the reader to the articles on hydrophobia and poisons,  and
shall here  only  briefly explain what  is meant by dissection
wounds.   It  not  unfrequently happens that in dissecting that a
person  wounds  himself with  a  scalpel  or other instrument,  and
the wound is poisoned by  the matter generated by the disease of
which  the patient died, or more probably  by the putrefactive pro-
cess.    Pain  and irritation, extending up  the  limb in the course
of  the  absorbents, swelling and suppuration of  the lymphatic
glands  of the arm or axilla, fever, and constitutional irritation are
.often produced.   The best practice in these  cases is to cleanse
the wound immediately with warm water, and suck it powerfully
to  free it from the poison.  Cauterization with caustic potash or
liquid  muriate of ammonia is advised  by the French surgeons,
but the practice of the English is, after extracting the poison, to
apply warm poultices, to  keep  the arm in a sling, attend to the 
59S
WOU.
diet and bowels, and to use tonics if necessary.  Inflammation
arising from this cause  often continues a long time, and has fre-
quently proved fatal.
   Wounds of the  Abdomen may be  superficial, wounding the
flesh only, without penetrating the cavity.  These wounds are
not dangerous,  and are to be treated like wounds in other parts
by closing  them with  adhesive  plasters5 or  sutures, and a com-
press and bandages.  They may penetrate  the cavity without
wounding any of the internal organs.  Extensive wounds  of this
kind are often  recovered from,  but  are not  free from danger.
The symptoms peculiar to wounds which  open this  cavity, are
vomiting, faintness,  and an immediate and  universal  coldness
and paleness.   It  is recommended  to close these  wounds  by
sutures, passing the needle deep among  the  muscles, but not
through the peritoneum.  " Between the stitches, strips of stick-
ing plaster or lint dipped in blood thould be applied.  The patient
should be  bled from the arm and leeches applied, if there are
symptoms  of  inflammation.   Physic must not be  given, nor
should any solid food be taken for a number of days."  A third
kind of these wounds  is where, besides penetrating the cavity,
the intestines or  some other internal organ  is injured.  The
escape of the contents of the stomach, bowels, or gall bladder, is
a sure  sign that these organs are wounded.
   Wounds of this description are almost always fatal, but an
attempt should be  made to save the  life of the patient  by keep-
ing him  perfectly quiet and upon the  lowest  fluid diet,  by the
use of warm fomentations and emollient poultices, and the most
vigorous employment of antiphlogistic remedies.
   Wounds of the  Chest, like those of the abdomen, are of three
kinds;  superficial, penetrating the  cavity,  and wounding the
lungs or other viscera.   Those which are superficial do  not differ
from  common wounds, and are  managed in the same manner,
except when one of the arteries is divided between the ribs, when
it will be necessary to press the  fingers upon the mouth of the
vessel  until the disposition to bleed ceases,  after which the wound
must be closed with a suture  passing through the muscles, but
not the pleura or lining membrane.  When  the cavity  is  opened
the breathing will  be difficult, and air will be alternately drawn
in and forced out through the wound with a hissing noise ; there
will  be irritation  in  the  larynx, cough, suffocation, extreme
anxiety, and if the lungs be wounded, blood will be coughed up,
which will be  florid and  frothy. In these  cases air  is effused
into the cellular substance, at first in the vicinity of  the  wound,
and often spreading to a considerable extent.  The flesh has a
crackling feel like parchment.  This symptom is called emphy-
sema.   When the  lungs  are wounded the patient may die from
the loss of blood, inflammation, or emphysema. 
WOU.                        599
  While the bleeding continues the wound should not be closed,
as the blood in the cavity of the chest  may occasion irritation
and  inflammation.  If the loss of blood from the wound or the
mouth is not very great it will be proper to bleed  largely from
the arm, both as a means of arresting the hemorrhage and of pre-
venting inflammation.  Sir Astley  Cooper says: •' There is but
little  danger of bleeding too much  in one of these cases, as it is
an object not only to  diminish the flow of the circulation, but the
quantity of blood in the pulmonary vessels."   Should inflamma-
tion terminate in an effusion of pus or bloody serum  into the
cavity of the thorax it may be drawn off by the operation called
paracentesis.   Emphysema is less dangerous  than inflammation.
The  treatment consists in applying a bandage  around the chest
tight enough to prevent any crackling during a deep inspiration.
Very small punctures may be made in the cellular tissue, and  the
patient should lie on  the wounded side.  The most perfect quiet
is essential to recovery in all cases of wounds of the chest  or
lungs.
   Wounds of the Throat are often made in attempts to commit
 suicide, and may sometimes occur  accidentally.  When in these
 wounds the carotid arteries are divided, death almost immediately
 ensues, but as the incision is generally made high up where these
 arteries are very deep, these vessels in a great proportion of in-
 stances, escape, and the pharynx, larynx, trachea and oesophagus
 are the principal parts wounded.   Wounds in  the throat should
 be closed by several  sutures, after securing the blood vessels  and
 stopping the bleeding.  The sutures should be put  through  the
 integuments, and sticking  plasters applied to assist in retaining
 the sides  of  the wound  together.   The head must be brought
 forward upon the  chest ; but little of anything  should  be swal-
 lowed ; the mouth should be frequently moistened with lemon
 dipped in water, and the patient  be  supported with glysters  of
 gruel or broth to which opium or laudanum is added  to prevent
 them from returning.  Where food can be given by the mouth,
 jellies will be the most suitable, and a little solid food will excite
 less  irritation than liquids.  At the end of a week the stitches
 should be removed, but the plasters ought to be continued until
 the wound is perfectly healed.   Wounds that  divide the trachea
 low down on the neck, and those in which the oesophagus is in-
 jured, are more  dangerous  than those which  are higher up and
 those in which the oesophagus escapes.   Sutures should be used
 in these  cases,  but  plasters are objected to, as they prevent  the
 discharge of the blood and air in coughing, and thereby produce
 additional difficulty of breathing and occasion emphysema.
    In extensive  wounds of the pharynx, in which the ability to
 swallow is entirely destroyed, the  stomach pump may sometimes
 be used with great advantage in supplying the patient with nour- 
600
WOU.
ishment.  A  case of this kind was successfully treated not long
since in this city, by the use of this  instrument.  The objection
to the stomach  pump in  ordinary cases,  is that it is necessary
to throw the head  back in order to introduce the tube, which is
liable to prevent or break up adhesions of the wound.
   Wounds of the Tendons.—The  frequency with which the
tendons have of  late  been divided by the operation of tenotomy,
for the correction of deformities, and the infreqency of any serious
effects following the simple  division  of them  accidentally, have
led to the conclusion that  these wounds are not as formidable as
was formerly supposed.  Punctured and lacerated wounds  of the
tendons sometimes produce serious nervous affections and, rarely,
locked jaw, but the  mere division of  them is unattended with
danger, and the only consequence, in  addition to the effects of
wounds in general, is the loss of  motion for a short time in the
part to which  the  tendon is attached.  It has  been found that
when a tendon is divided the  ends are separated to a greater or
less extent by the contraction of the muscles, that the space is
filled  up with a new substance, and the  motion of the part restored
in the course of two  or three weeks.  Sir A. Cooper recommends,
when the  tendons are  divided, that the  ends be approximated
by the posture of  the limb, which  must, in order to effect this,
be retained in a more or less restrained position until the wound
heals.   When the heel cord,  tendo  Achilles,  is divided for  in-
stance,  a high heeled  shoe,  straps  and  rollers  are  advised to
keep  the  heel up, the wound in  the skin is then to be closed,
all pressure avoided, and cooling lotions  applied : a contraction
of the muscles takes place  during the healing process, and the
heel continues to be drawn up after  the wound has  united.  To
remedy this deformity, the heel of the shoe is gradually lowered
until finally the muscles and tendon  are sufficiently stretched to
allow the heel to come down to a  level with  the  foot.   This
may all be necessary, but we apprehend that raising the heel
much  above a level, and keeping the foot in this uncomfortable
position is productive of no essential benefit, and that all  that is
required is to prevent the heel  from falling too low, by which the
tendon would be elongated,  the heel  lowered and the toes  raised.
When the tendons  are divided  by a cutting  instrument, the
wound over them should be accurately closed, and union by the
first  intention in  every way  promoted.  The  limb, while the
wound is healing,  should be kept in  the easiest and most natural
position, so  that  no  deformity or inconvenient  position will be
left when the cure is completed.
   The  heel  cord, and several other  tendons and muscles  are
sometimes lacerated by violent  efforts and strains.   In  these
cases as there is no external wound,  all the treatment necessary
is to keep the limb in a proper position to prevent deformity, and 
WOU.
601
to guard against inflammation by the ordinary means. Lacerated,
bruised, and punctured wounds, in which the tendons are injured,
must be managed  according to the general principles of treating
these kinds of wounds.  We would recommend that in all wounds
of the tendons and other  deep seated parts, in which there is an
opening in the  skin and  flesh covering them, that the  external
wound be closed, as soon  and as accurately as the circumstances
of the case will permit, with the view of  preventing the  action
of the air upon parts that  are not accustomed to it, as this is un-
doubtedly one of the principal causes of inflammation. It is now
a well established fact that tendons and muscles heal in  a very
short time, and without any considerable degree of inflammation,
when divided under the skin, through a small valvular opening.
   Wounds of the  Joints,  penetrating the capsular  ligaments are
trivial or dangerous, very  much in proportion to the  skill  that is
exercised  in treating them.   "If the patient  has a poultice ap-
plied, or if the utmost attention is not paid to the immediate
closure of the  wound, inflammation of the  synovial membrane
arises,  and suppuration ensues.  The most violent  constitutional
irritation succeeds, shivering, heat, flushing, and profuse  perspira-
tion, generally great swelling and excessive pain  in the  joints.
Abscesses form in different parts of the  joint,  one succeeding
another, until the strength becomes exhausted."  In young and
healthy persons these wounds are much less dangerous than  in
those who are weak or advanced in life.  Wounds of the  joints,
when improperly managed, are tedious in healing, and a stiffness
of the joints or anchylosis is the usual  consequence, but says the
author above quoted,  " All ill effects from wounds  of joints may
be prevented by care and skillful treatment."  The  wound  should
be closed with a needle  and  thread, passing through the skin
only, and bringing the edges  perfectly together.  A pledget  of
lint dipped in blood is then to be applied over the surface  of the
wound, and over this the adhesive plasters.  The joint must then
be covered with soft linen moistened with  lead water or spirits
and water, a splint applied to the limb to prevent its  motion, and
a roller bandage to confine the other  dressings.   The  bandage
must  not be  so tight as to impede  the circulation or press too
much upon the wound.
  " Purging  medicines should be as much as possible  avoided,
and a rigid abstinence enforced.  In eight days, the thread may
be cut  and  drawn away, but the   adhesive  plaster and  lotion
should be continued.   Three weeks should elapse before the
patient be allowed to quit the  bed."   Inflammation and  suppura-
tion, should  they ensue, must be  treated  as in  other  cases.
Should a stiffness in  the joint remain, frictions with oily lini-
ments, exercise and motion of the limb, persevered in for a long
time, will be the best means of restoring it. 
602
WOU.
  Hard, cartilaginous substances are sometimes met with, loose
in the knee  joint, giving rise, at times, to lameness and  inflam-
mation.  These can only be removed by an operation.   We re-
moved one nearly an inch in length, some  years ago, and a per-
fect cure was affected in a few days.
  An escape of the synovial  fluid, either in  an operation or an
accident, is of trifling importance, provided the wound be imme-
diately closed, as it  soon re-accumulates.
   Wounds of the Arteries  and  Veins.—As this part of  the sub-
ject  has been  anticipated  under the  head of incised  wounds,
where all has  been  said that would interest the common reader,
we shall conclude the subject  of wounds with a few observations
upon injuries of the head.
   Wounds of the Head may be simple and limited to the scalp;
the skull may be fractured; or the brain be injured, without any
wound of the external  parts.   Wounds in the scalp will require
no  peculiarity of treatment except an artery be cut, in which
case it is often difficult to stop the  bleeding.   It is rarely neces-
sary to take up  ah  artery in  this situation, and very difficult to
find it should  it be  attempted ;  the bleeding  must therefore be
arrested by compression ; by completely severing the artery with
a lancet  when it is not entirely divided  by the wound, which
will allow it to retreat within the  flesh ;  or  by a suture.   The
last is the  mode which we  have generally  adopted, and have
found , nothing necessary  but  to  apply   a  compress  and the
ordinary dressings,  except  in wounds of the  temporal arteries,
which can  commonly be  tied  without difficulty.  The  stitch
should be taken deep in the scalp, and the wound firmly closed,
which will  usually stop the  bleeding.  After  the bleeding has
ceased, the ordinary dressings may  be applied.
   When the skull is fractured, it may  or may not be followed by
symptoms of compression of the brain  ; in the latter case all that
will be required will be to  guard against inflammation by bleed-
ing, cathartics, and antimonials, but if there  be compression of
the brain, indicated by a  slow pulse, dilated  pupils, squinting,
stertorous breathing, stupor or complete insensibility, the opera-
tion called  trepanning, by  which the depressed portion of bone
is raised, will be advisable.
   We frequently see cases occurring  from falls and blows upon
the head, in which the patient is stunned,  and more  or less com-
pletely deprived of sense  and the power of motion.  In these
accidents, vomiting is  a common symptom, the patient is insensi-
ble or is aroused with  much  difficulty, there is loss of memory
and aberration of the mind.  Immediately after the receipt of the
injury, the  countenance is pale and  deathlike, the pulse slow,
soft and small, all the powers of life are depressed, and a violent 
YAW.
603
struggle of nature is required to bring on reaction and restore the
vital functions.
  Under these  circumstances, the common practice has been to
bleed, and if the patient do not recover, it is attributed, by the
lookers on, to his not being bled enough, and the physician  who
would pursue the most rational practice, can hardly act in accord-
ance with his own  judgment  without danger of losing his repu-
tation.   The use of the lancet too early is unquestionably a great
error in  practice,  and  productive of serious  consequences.  A
celebrated author after strenuously recommending bleeding as a
means of preventing and curing  inflammation, says, " but do not
go on to bleeding  largely, for you would by this means reduce
the strength of your patient too much, and  prevent the repara-
tive process of  nature.  You  are to use  bleeding as a means  of
preventing inflammation, not as a matter of course, the moment
you are called to a patient  under concussion.   You will always
find the pulse very weak and scarcely perceptible at the moment
of the injury ; wait till the pulse rises and reaction is indicated,
and then extract blood."  And further, he says, "do not extract
blood indiscriminately, use the lancet with caution, lest you reduce
the animal powers too much, and evade a favorable termination of
your case."   We have been induced to make these observations
and quotations, which apply equally well to all serious concussions
of the body, as well as of the brain, in consequence of having fre-
quently been urged to bleed, and having seen bleeding practiced
under circumstances in which  cordials and  stimulants were  in
our opinion  the more appropriate remedies,  and with the view of
correcting in some  measure a very prevalent, popular error.  In
concussions of the brain and other important internal organs, per-
haps the  most  rational mode of practice is  to use cordials and
stimulants,  both externally and internally,  if the  patient can
swallow, until  reaction comes on  and the pulse rises, then  to
employ bleeding,  cathartics  and antimonials, derivatives  and
counter-irritants, as the circumstances of the  particular case  may
indicate.
                              Y.

  YAWS__Frambcesia.—This disease consists of an eruption of
pustules upon the skin, preceded by a slight degree  of fever.   It
is supposed  to have been imported from Africa, and never affects
the same person but once.   It is not one of the diseases of New
England.
  The yaws comes on with pains in the joints, languor and loss 
604
YEL.
of  strength, and.for some days, resembles an attack of rheuma-
tism.  The pustule is at first of the size of a pin head  and in-
creases to that of a ten cent piece or ninepence.  The pustules
are, in the first  place, filled with  a watery  fluid,  which  be-
comes thick  and tough, and settles  into  a  thick  scab.   They
sometimes degenerate  into a fungus resembling in  appearance a
mulberry.  The  pustules appear in  successive crops, beginning
in the face and neck, and extending down to the legs ; and every
new crop excites a new degree of fever.   When the  disease has
reached its height,  one  pustule will commonly become  much
larger than the rest, equaling the  size of a half dollar, and turn
to a foul, running ulcer ; it eats deep into the flesh, and,  some-
times, affects the  bone.
  The affected person should  be separated  from the well, and
fed on a light vegetable diet.  In the commencement of the dis-
order a gentle  emetic  may be given, followed by eight  grain
doses of pulvis antimonial is, once in three hours.  The sal nitre,
sweet spirits  of nitre,  and the acetate of ammonia are  each of
them, suitable  to  give during the febrile stage.   The bowels
should be kept open with gentle doses of salts, magnesia or rhu-
barb, and the  skin  well bathed with warm water.   If the  irrita-
tion of the eruption becomes severe, the Dover's powder  must be
given.  The  chief reliance in  the early stage  of the  distemper
should be upon sweating medicines.   The spurge laurel or meze-
reon is a good medicine in this  disease.
  YEAST.—This  article is often  employed  as an  antiseptic in
putrid fevers and  inflammatory diseases.   It contains a quantity
of the carbonic acid gas which is probably the active principle.
Two table-spoonfuls of it may be given every two or three hours.
It is easily made,  by mixing with boiled, mashed potatoes,  when
they are half cold, a cupful of yeast, and allowing it to stand two
or three hours.   Where a putrid state of the throat or bowels is
apprehended this simple remedy may be of great service.
  YELLOW  FEVER—Black Vomit—This fever, for the most
part, prevails  in the sultry islands and territories which lie be-
tween the tropics.   It,  however, prevails more or less  every year
in New Orleans,  Pensacola, Mobile,  Natchez and  all  the  more
southern states of the Union, and occasionally travels as far  north
as Virginia ; but seldom visits the  cities farther north.   Two or
three times in the course of  fifty years,  it has  prevailed in the
cities of Philadelphia, New York,  Providence, and  Boston.  In
the states of Vermont,  New Hampshire, and  Maine, and in the
British Provinces, we believe, it has never prevailed.   To people
unacquainted with  the disease, it is  much more  terrible  than
where it is an annual epidemic.
  Many physicians believe  the yellow fever to be only an aggra-
vated form of the remittent or bilious  fever, rendered  malignant 
YEL.
605
by some peculiarity of the season and vitiated state of the atmos-
phere, while  others regard it as a distinct disease produced by a
specific, morbid exhalation  from the earth and  the substances
which  cover it.  Where it is an epidemic or prevails to a great
extent, it is very evidently contagious ; though in scattering cases
of it, it does not appear to communicate itself to others.   In low
marshy  places,  and in cities  built on alluvial soils or soils which
have been washed up from the bed of rivers or from the sea; and
on new made  lands, this fever commonly originates.   In  hot,
sultry seasons, with  a stagnant atmosphere, and after the fruits
of the climate  have ripened  and begun to decay, it is more apt
to arise  than  in cooler and  drier seasons.  Cold and frost ap-
pear to  have the  power of checking its progress at once  and of
putting  an end to it.  Its origin is very generally attributed to
marsh miasm or a noxious exhalation from the  earth.  And when
the disease has once been produced from this cause, a matter is
generated in the human body which  will propagate it indepen-
dently of the miasm itself, though both causes almost  always
combine where the fever becomes an epidemic.
  The  indisposition which  ushers  in an attack of the yellow
fever does  not  differ materially  from the  symptoms  which
attend  the  commencement  of  all fevers.   A sudden  loss of
strength and a constant restlessness will generally be felt a day
or two before a complete fever is formed, though this warning is
not always given of  its impetuous onset.  Faintness, swimming
of the head, chilliness, and shuddering are  the ordinary  forebod-
ings of  an attack of the yellow fever.  There  soon follows great
heat, dryness of  the  skin,  throbbing of the arteries,  want of
breath, flushings of  the face, white tongue, tinged with  yellow,
unquenchable thirst, retchings of the  stomach, pains in the head
and  back, and  a quick, and  generally a full  and  strong pulse, a
sickish, sinking sensation at the bottom  of the  stomach, vomiting
of bile, a deep  colored urine, sometimes plentiful and at others
scanty.
  This  state of things will continue one, two, or three days, be-
fore  an abatement of the symptoms takes place ;  and this abate-
ment will commonly only be of some  of the  symptoms, while
new appearances will  arise.  The heat in a degree subsides, and
often a deceitful tranquility ensues.   The eyes and  skin  become
yellow, and great  discharges  of bile take place from the  stomach
and  sometimes from the bowels ; the bile will be sometimes of
a natural, but oftener of a greenish or  black color; the tongue
in some cases will  be dry and black or yellow, and at others moist.
Delirium is often  though not a constant symptom of the black
vomit •  costiveness is nearly  a constant  attendant.  The vomit-
ing of'a black  matter of the  appearance  of coffee grounds is the
most distinguishing symptom of this disease.  The yellow color 
606
YEL.
of the skin is also a peculiar symptom, but not quite so constant.
These two symptoms render the disease  sufficiently remarkable
not to be confounded with other fevers.  Sometimes a copious
perspiration puts an end to the disease, and at others, quiet sleep,
bleeding from the nose, or a looseness of the  bowels.
  The unfavorable  appearances are, a sinking of the pulse, cold
clammy sweats, a constant retching without  being able to vomit,
torpor of the brain, hollow sunken eyes, oozing of blood from
the mouth and nostrils, and twitching of the  muscles.   It will
sometimes  destroy the patient in twenty-four hours.  In hot cli-
mates, it runs its course in four or five days.
  Domestic Remedies.—The most powerful remedy which  can
be made use of in the commencement of the disease, where no
chilliness is present, is the affusion of cold water over the body,
either by means of a shower  bath or a wet sheet.  When  the
fever is  high  this cannot be done too  constantly or perseveringly.
Cold water may be given for drink, and a dose of  the Rochelle
powders to operate upon the bowels.   Ten grains of calomel and
ten of jalap is a cathartic which has the highest repute in the cure of
this disease of any medicine which has ever been used. This dose
is  commonly given every day until  some improvement of the
symptoms appears.  Acid drinks and the soda powders are given
to quiet  the stomach ; blisters  and  mustard poultices are applied
for the same purpose ; and sometimes stoupes or cloths wet with
warm water with thirty or forty drops of laudanum.  Where the
vomiting is severe and the first rage of  the  fever is over, injec-
tions of water gruel with fifty or sixty drops  of laudanum should
be administered every six or eight  hours.  To relieve the head-
ache, a  large  blister should be drawn between the shoulders,  and
the feet  thoroughly bathed in warm water.   Cold applications of
vinegar  and water, or of ice water  should be constantly "made to
the whole  head.
  The  nourishment where any can  be  given, should be barley
water, gruel, arrowroot and toast water.  Where great  debility
and prostration of  the strength exist, wine will be necessary and
proper.
   Professional Remedies.—From all  the  evidence which we
can collect upon this subject, it. appears that bleeding is not, in
general, necessary or salutary. Where the symptoms are decidedly
inflammatory, bleeding as in any other  fever, will  be required ;
but the strength and degree of all the symptoms must be the
only guide.  The  physician  should not bleed merely because
it is the yellow fever or the black vomit.   If the pulse is hard,
full and strong, and the febrile symptoms  all run high, blood
taken from the arm, and the operation repeated  two  or  even
three times, if benefit results from the first  bleeding, should be
tried.   There should be a gentle evacuation  of the bowels daily. 
YEL.
607
Emetics are for the  most part condemned as productive of mis-
chief.  Effervescing draughts, camphor, ether and ammonia ad-
ministered frequently and in small doses;  cold bathing; blisters
to the head  and mustard  poultices to the feet, with anodyne
injections to quiet  the stomach ; and a gentle ptyalism by the
use of small doses of mercury, are the chief remedies which have
been found effectual in the black vomit.
   The greatest  cleanliness should  be preserved, and the air of
the sick  room frequently changed.   The chloride of soda or of
lime should be evaporated in the room, and the attendants should
take frequent airings.  In the earliest distinct remission of  the
disease the quinine  should be given, unless  its use increases  the
fever.  But the chief object should  be to tranquilize the stomach
and to  turn the flow of the bile  downwards by every means,
which may be compatible with the  strength of the fever.
   YELLOW GUM—Icterus Infantum.—The yellow gum  is  a
yellowness  of the  skin, attended with sleepiness, languor, and,
sometimes, a disinclination to  nurse, and is a disease of infants
soon after they are born.  It rarely ever  occurs  after they are  a
month old.   Like the red gum,  it only continues  for a few days
and then disappears.  It is sometimes  fatal, but, in general, re-
quires but little medicine.   It is probably owing  to a superabun-
dance of  the bilious secretion, which is probably excited in con-
sequence of some disagreement of the mother's milk, or the cow's
milk, with the stomach of the child.
   A little rhubarb,  magnesia, or castor oil should  be  given to
the child every day, as long as it is disinclined to nurse.  A weak
solution of the super-carbonate of potash or soda should be given
where the yellowness and drowsiness continue obstinate.  A  few
tea-spoonfuls of mild thoroughwort tea administered every  day
for three  or four days in succession, will remove  the disease.  In
dangerous cases, it will be  advisable to give half a grain  or a
 grain of calomel to excite the biliary ducts to carrry off the bile.
 In this affection, the water of the child will often be tinged with
 yellow, as well as the  skin and the whites  of  the  eyes.   The
 whole system appears to be impregnated with the  bile.   Medi-
 cines which purge or drain  the bowels are the only ones which
 appear to be of much service.  If a diarrhea attends the  affection,
 Godfrey's cordial or paragoric must be used.
   YELLOW  ROOT—Zanthoriza—This shrub  grows  in the
 southern and western states.. The stem is of the size of a goose
 ouill and two  or three  feet high :  it is ligneous and of a bright
 vello'w color   The  root is  horizontal, and from a foot to three
 inches in length.    In  its  properties it  resembles the quassia,
 columbo, and other simple bitters,  and is used for the same  pur-
 poses.   The dose is from one to two scruples.
    There is a shrub found growing in this vicinity known by the 
608                         ZIN.
name of yellow root.  This has a woody stem varying in size
from  that of a goose  quill to an inch or two in thickness, and
rising  to  twenty or thirty feet  in  height, with a very gradual
taper, being nearly of an equal thickness for many feet.  It winds
itself  spirally around trees or other objects so  closely that it is
difficult to remove it.   The bark of the root is of a bright yellow
color, and is much  used, prepared in an ointment with lard, for
the dispersion  of  inflammatory  swellings, particularly of  the
breasts.  This shrub or vine somewhat resembles the ivy, and is
sometimes mistaken for it.  We have seen a  number of cases of
poisoning, in one instance of a whole family,  occurring from this
mistake.
                             Z.

   ZINC.—This  metal in  its pure state  is  of  a whitish  color,
nearly resembling lead.  In its metallic state it is not used, but
in that of  oxide and combined with acids, it is employed exten-
sively. The zinc ore is found in England, Hungary, and in other
countries.  The sulphate or white vitriol is the preparation of
zinc principally used in medicine.  One of the most wonderful
things, in the art of medicine, is, that an inert metal can be con-
verted into an active and efficacious remedy ; that, by dissolving
zinc, copper, or iron, for instance, in oil of vitriol, a potent emetic
can be elaborated.   Many of these things perfectly familiar to us,
were  hid in darkness but a few ages ago. 
 
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